Taking back health care
March 14, 2023
Health care is one of the most pressing topics in Canada today. With a proposal for significant new federal spending recently announced, there is a lot of debate about how best to improve a system in crisis.
Jane Philpott, Dean of Queen’s Health Sciences, is playing an important role in this ongoing discussion. She has been a national voice on the topic and received widespread media attention for the report she has co-authored with other leaders of health care, postsecondary education, and the private sector. Taking Back Health Care, which has been released as part of The Public Policy Forum’s Future of Health Care initiative, identifies many areas of the Canadian health system that need to be modernized, including access to care, data strategy, and performance standards. The report also makes the case that the renewal of the health care system needs to be driven by the expectations of Canadians above all.
The Queen’s Gazette spoke with Dr. Philpott about the new report and the role of universities in contributing to change.
Taking Back Health Care looks at many different facets of the health care system, and it’s calling for transformational change. Why are you making this case now?
People in Canada have always been proud of our health care systems, but the strains of the pandemic have highlighted the shortcomings, such as the shortage of primary care providers, outdated approaches to technology and patient data, and overly long wait times for procedures. All those problems have intensified during the past few years, leaving us with health care systems in crisis and struggling to meet our needs. Canadians are becoming increasingly aware that something needs to be done. If we want to save our care systems, we can’t wait any longer.
To make meaningful changes, we need to understand that the problem is not a lack of funding. Canada spends more on health care than most high-income countries while falling short on equity and excellence. The problem is that we don’t have clear expectations for how our health systems should work and what they should achieve. Taking Back Health Care starts a conversation about how Canadians need to ask for more from our health systems. Because they belong to all of us, not just governments and policymakers.
You have seen health care systems from a wide variety of perspectives, including chief of family medicine at a hospital, federal health minister, and dean. What are some of the key changes that you believe could dramatically improve our health care systems?
One of the major problems we’re seeing is that many people in Canada do not have access to primary care. We need to make it an expectation that every person has access to a primary care team within 30 minutes of their home or place of work. We can connect significantly more people to primary care by rethinking the model of delivery we use now, which is largely small businesses providing physician-led care. We need to invest in creating primary care teams that draw on the expertise of different health professionals beyond family doctors, such as nurses, physiotherapists, occupational therapists, and pharmacists. These teams will enable us to serve many more patients and help alleviate downstream issues, such as delayed diagnosis and hospital overcrowding.
Another significant change we need to make is giving people timely, accurate information about their own health. By expanding access to data, we can help create user-empowered health care systems, in which people can use their data to help them make informed decisions about their care. It will also help patients share their data with different care providers in different institutions and regions, something that can be unreasonably difficult in the current approach where data is kept in service silos accessible only to certain providers.
With so much that needs to be rethought about our systems, is there a role for the postsecondary education sector to lead the way in making these changes?
Postsecondary education is going to be crucial as we move forward, as it is uniquely positioned to foster transformative ideas and train the health care leaders of tomorrow. At Queen’s Health Sciences, we decided we wanted to find ways to lead Canadian health systems into the future when we launched a new strategic plan, Radical Collaboration for a Healthier World, which calls for a revolution in academic health sciences. One goal we lay out in the plan is to become more responsive to the needs of patients and communities. That’s the kind of thinking that health systems will need to embrace to provide people across Canada the care they deserve.
Our guiding principle for the plan is radical collaboration. A big part of that is moving towards interprofessional and cross-disciplinary education, where students in our Schools of Medicine, Nursing, and Rehabilitation Therapy will have more opportunities for team-based learning to promote a culture of mutual respect. This model of training means students will be well prepared to work in the primary health care teams that will likely become a staple of our systems in the future. By 2026, 20 per cent of curricula in our programs will bring students together across disciplines and professions to learn and solve problems as teams.
It’s been a little more than a year since the faculty launched the new strategic plan. Can you share some of the progress that’s been made so far?
One of our strategic priorities is ‘clinical impact in the community and beyond’ and we are currently working on a number of bold and unique initiatives to support this (you can learn more about our progress in our Year 1 Report). Recently, we announced our partnership with the Weeneebayko Area Health Authority (WAHA) and support of the Mastercard Foundation to create a new Health Education Program that will be delivered in the WAHA region. We are working together to create a decolonized, interprofessional curriculum to train Indigenous youth in medicine, nursing, physiotherapy, occupational therapy, midwifery, and paramedicine. It is exciting to think how this can help address the health care challenges facing Northern communities, including the need for culturally-safe care and increasing Indigenous representation within health professions.
In September, we plan to welcome the first students in a new program that will train much-needed family physicians at a regional campus based at Lakeridge Health in Durham Region. We are building a community-based curriculum solely focused on educating those who intend to work as a family doctor in their local community. This initiative helps address the critical shortage of primary care physicians that negatively impacts our overall health care systems in Canada. We also are using this as an opportunity to upend the status quo by being more productive and effective at training family doctors and developing new models of care.