New health deal needs transparent monitoring and evaluation process to make sure healthcare outcomes improve

The Canadian healthcare system is letting us down. Cancer care is just one of the many disease areas harmed by the pandemic resulting in a lack of access to doctors, hospital beds and operating rooms. We need to do better. Patients are waiting longer than ever to receive medically necessary treatments. Specialist physicians surveyed report a median waiting time of 27.4 weeks between referral from a general practitioner and receipt of treatment. This is the longest wait time recorded in this survey’s history—and it is a whopping 195% longer than wait times reported in 1993, when it was just 9.3 weeks. Lengthy wait times result in more cancer patients dying. For all patients, wait times have serious consequences, such as increased pain, suffering and mental anguish. In many instances, wait times can result in poorer medical outcomes, transforming potentially reversible illnesses or injuries into chronic, irreversible conditions or even permanent disabilities. Canada also has a doctor shortage. Many Canadian families might not even be able to access primary care. A recent Canadian Medical Association Journal survey found that more than one in five Canadians—an estimated 6.5 million people—do not have access to a family physician or nurse practitioner. The devastating human costs behind the statistics should concern all of us. Some organizations have put hard numbers around this. A report from All.Can Canada predicts that disruptions to cancer diagnosis and care alone could lead to 21,247 more cancer deaths in Canada over the next decade, representing 355,173 years of lost life. For breast cancer screening, a six-month interruption could lead to about 670 additional advanced breast cancers and 250 more breast cancer deaths. For colorectal cancer, a six-month delay in screening could increase colorectal cancer cases by about 2,200 with 960 more colorectal cancer deaths. The good news is that the federal government has taken steps to try to ameliorate the problem. In February, the Prime Minister announced an investment of over $198 billion to help improve the healthcare system, noting that the public will judge whether this deal is a success. The four key areas of investment include family health services, health workers and reducing backlogs, mental health and substance use services, and modernizing the healthcare system. As the leaders of a new grassroots collective of patients and patient group leaders, Patients for Accountable Healthcare, we will hold the federal, provincial and territorial First Ministers accountable for this deal. Of concern, the agreements do not have a transparent monitoring and evaluation process built in, so the federal government should take immediate steps to track and determine the success of these investments. Eventually, the data plan that the Canadian Institute for Health Information (CIHI) is leading will provide some answers, but that is years away. Canadians deserve accountability now. We need to know how this money is being spent and we need to see direct improvements in healthcare quality and access as a result. Our healthcare system must provide timely, equal, and equitable access to resilient, safe healthcare, respecting the Canada Health Act, while being accountable to the public. If the government doesn’t monitor progress of the new deal, you can be sure Canadians will. At Patients for Accountable Healthcare, the underlying values guiding our work are respect, meaningful and ethical engagement, accountability, transparency, timely access, excellence, capacity building and mentorship, social justice and safety. We should expect no less from our health system. We are enlisting the help of patients in urban and rural and remote parts of the country, and from all ethnicities and backgrounds, to join us in monitoring and sharing findings from each jurisdiction. We will not shy away from undertaking relevant education to patients, caregivers, and the public. We will monitor and evaluate the progress of this new deal using measurable, transparent, patient-oriented outcomes, to assess changes that adapt to the needs of the individual. It would be most effective if the government invited us to the table. After all, healthcare is for the people. Gail Attara is the Chief Executive Officer of the Gastrointestinal Society. Louise Binder is a Health Policy Consultant with the Save Your Skin Foundation. Together they lead Patients for Accountable Healthcare.

New health deal needs transparent monitoring and evaluation process to make sure healthcare outcomes improve

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