TORONTO - Although Ottawa and the provinces have made good on some promises to improve the health-care system, governments have failed in one key commitment -- to keep Canadians up to date on their progress, says the Health Council of Canada.
In a report released Thursday, the council said the public has no sense of how health-care services have been improved since the 2003 First Ministers' Accord that pledged to renew the system and boosted funding by billions of dollars.
"In some cases, we know governments are measuring up; in other areas we know they're missing the mark," said Jeanne Besner, interim chair of the Health Council of Canada, which was created under the 2003 accord to monitor and report on the progress of health care renewal.
"But all too often, we just don't know or we just don't know enough," Besner said in a statement. "We don't have sufficient evidence to evaluate the strength and sustainability of health care renewal on a system-wide basis."
"We need to strengthen transparency and accountability in health care."
The report tracks progress the federal, provincial and territorial governments have made in meeting commitments to reform primary health care, reducing wait times, modernizing information systems and improving drug coverage for Canadians.
While some headway has been made, the report says there is inconsistent and incomplete reporting of patient data, making it impossible to accurately compare what strides forward each jurisdiction has achieved compared with another.
Federal, provincial and territorial first ministers were to report on comparable health indicators this year, but the committee that oversees that work was disbanded, the report says, noting that information about how jurisdictions spend targeted federal funds is not easily accessible, or in some cases, not available at all.
Without better data, the provinces and territories will fall short of their commitment to provide more transparent public reporting and greater accountability, says the council's report, which points out both advances and shortcomings. Findings include:
- Primary health care reform includes expansion and training of interprofessional teams, but measuring and comparing progress has been difficult because jurisdictions are not collecting and reporting data using agreed-upon measures.
- Wait times are being reduced in most of the five targeted areas -- cancer treatment, cardiac procedures, joint replacement and cataract surgery -- but benchmarks for diagnostic imaging are still needed, except in Ontario. It is unclear whether these efforts are inadvertently increasing wait times for other services. (A Canadian Medical Association survey this week showed doctors believe emphasis on the five priority areas is causing patient wait times for other services to balloon.)
- Medical and nursing school enrolments are up and most jurisdictions have developed health human resources plans, but only a few have set targets based on the needs of their populations.
- A progress report on implementing a national pharmaceutical strategy was released with options for coverage of catastrophic drug costs. But so far, no such strategy exists and there's no indication whether Ottawa would help cover costs. Meanwhile, 3.5 million Canadians, including 600,000 in Atlantic Canada, have little or no drug coverage.
- Many governments - federal, provincial and territorial - have programs to address health inequalities experienced by aboriginal peoples, but it is unclear whether Stephen Harper's Conservatives will revive any part of the Blueprint on Aboriginal Health and the Kelowna Accord put forward in 2005 under the previous Liberal government. Harper scrapped the $5.1-billion plan after taking office.
"While there are many instances of progress and innovation, the picture we have of health care renewal in Canada remains clouded," said council vice-chair Ian Bowmer. "In too many cases, the information is incomplete, inconsistent or simply unavailable."
"With billions of dollars being spent on this historic undertaking, Canadians expect more."
