Renewal in Canada’s primary health-care system needs a North Star |
(Version française disponible ici.)
Something remarkable is happening in Canadian health policy.
After decades of incremental change, provinces and territories are making serious, sustained investments in primary care via bilateral agreements which represent a genuine federal-provincial commitment. Billions of dollars are being directed toward the kind of team-based, patient-centred care that Canadians have been seeking.
The people designing this care deeply. The intent is right. But when the accountability reviews come, how will we know if it worked?
Canada keeps reinventing primary care reform province by province
An unfortunate pattern has emerged. When a province sets out to transform primary care, it consults international models, such as Alaska’s Nuka system of care, England’s primary care networks and Australia’s primary health networks. It convenes researchers, hires consultants, then builds something thoughtful and locally responsive based on these examples.
However, there is no Canadian forum where this provincial work is gathered, compared and shared. So the learning stays in the province where it happened.
Then, the province next door does the same thing. Starting fresh. Learning the same lessons from international models but not from other approaches within Canada. Building something from which no one in Canada can easily learn because Canada lacks the necessary co-ordination hub.
This is not a failure of effort or intention. It is what happens when provincial systems operate without a shared reference point. Canada’s bilateral agreements are designed to honour provincial autonomy. That is appropriate. Provinces should choose their own........