Ont. primary care initiative ‘worthy, workmanlike and not enough’

Dr. Jane Philpott’s Primary Care Action Team has launched its first call for proposals as part of plan to connect every person in the province to primary care by 2029.Worthy, workmanlike and not enough would be my take. It may be a practical first step but it leaves a bunch of basic questions unanswered and has little innovation. The request for proposal will solve about one-seventh of the problem that has been identified by the OurCare report. There is explicitly no model innovation: “Applications are focused on creating or expanding one of the existing team-based models: family health teams, community health centres, nurse practitioner-led clinics, and Indigenous primary healthcare organizations.”The Health Care Connect list of unattached patients is acknowledged to only be a small portion (one third?) of the total unattached/under-attached population. How will the people not on the list be served? In the Atlantic provinces a virtual service has been implemented to immediately improve access and to improve list quality. Read: Rosalie Wyonch and Will Falk: The school solutionThere’s been huge interest recently in international models: Danish, Dutch and other models have been promoted at length as providing near 100% primary care. Yet there is no mention of municipalities or purchaser/provider splits; no model change at all. The proposed solution appears to continue to rely upon the Ontario Medical Association negotiation process. Which (politely) is flawed and reduces innovation and access.There is no mention of modernization, AI, or even virtual care. The solution is geographic to a fault and must inevitably lead to either forced geographic placement of clinicians or poor access in rural remote and underserved communities. It is fundamentally inequitable in this regard.Will Falk is a senior fellow at the CD Howe Institute and an executive fellow at the Rotman School of Management. This item originally appeared on LinkedIN.

Ont. primary care initiative ‘worthy, workmanlike and not enough’

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