November 26, 2004

Giving Doctors More Support Crucial to Health Reform, Council Head Says

HALIFAX (CP) - Giving family doctors more support by spreading out the burden of primary care is crucial to reforming Canada's health-care system, says the head of a council evaluating nationwide efforts to improve medicare.

Michael Decter, chairman of the Health Council of Canada, said progress is being made to improve Canada's health-care system.

However, the pace of change will have to quicken if provincial governments want to ease public frustration with the system, he said.

"The public is rightly somewhat impatient," Decter told reporters in Halifax on Friday.

"They've heard a lot of debate about the grand ideas. There's been three (health) accords - one in 2000, one in 2003 and one in 2004.

"They want to see the results."

The recent health-care accords have seen the federal government shore up health-care funding with billions of dollars, in response to demands by the provinces.

In the meantime, the 26-member council of health professionals, government officials and economists has travelled the country for past year, talking with health-care providers about steps they're taking to improve medicare.

Halifax was the council's final stop before the release of its first report, expected in late January.

It plans to offer a list of "best practices" or options from which provinces and territories can select what they think will work best for them.

Decter says one of the most difficult aspects of reforming health care is expanding the traditional concept of primary care.

While stressing the excellent work done by family physicians, Decter said the doctors are overloaded and need more of a support network.

"Not that many new entrants in medical school want to be family doctors. It's become a very tough life," he said.

"They don't want to be on perpetual call, they don't want to be working the long hours that the older generation worked."

Decter said some tasks typically handled by doctors could be spread around in order to ease the pressure. He said community health centres are one way to accomplish that.

"We need to surround them with a team - nurses, nurse practitioners, nutritionists," he said.

"We're trying to move from a system that was really about the family doctor to a system that is about a broader team of providers. And that's a tough corner to turn."

In Nova Scotia, for example, some family physicians are working 80-hour weeks, according to Doctors Nova Scotia.

Dr. Cal Gutkin, executive director of the College of Family Physicians of Canada, said a movement towards more collaborative care is beginning to unfold across the country.

"It doesn't totally resolve the manpower or human resource shortage, but it can spread some of the work out," he said.

Decter said the council is hoping an increasing level of information technology can help close the gap between rural and urban health care.

He said the council heard this week that by 2009, half of Canadians will have electronic health records which can be easily accessed by doctors.

It's possible the entire population could be covered by similar databases within 14 years, he added.

The databases would give doctors an instant and complete medical history for their patients.

"We're going to look at how we can accelerate that," Decter said.

The creation of the health council was recommended in the Romanow and Kirby reports on health care.