In the field of medicine, doctors always begin by assessing a patient’s overall well-being before treating their illness. They gather information about symptoms, conduct tests and blood work, and gather any available details. This process, known as establishing a baseline, helps determine the effectiveness of the treatment. Similarly, when it comes to addressing the issues within Canada’s healthcare systems, policymakers have often failed to establish this baseline, making it difficult to gauge the success of their strategies. Haizhen Mou, a professor at the University of Saskatchewan Johnson-Shoyama Graduate School of Public Policy, embarked on a research project to assess whether past health accords between federal and provincial governments have truly made a difference in the quality and accessibility of healthcare in Canada. However, she encountered immediate obstacles in finding comparable data for a meaningful evaluation of the impact of these accords.
Successive federal governments have attempted to measure the impact of their financial contributions to provincial and territorial health systems over the years by requesting reports on specific indicators. Each new agreement has led to gradual improvements in health data collection. Currently, the government aims to revolutionize the way Canada collects and shares health data in order to develop a comprehensive understanding of the system. Prime Minister Justin Trudeau has offered $46 billion in new spending over the next decade in response to the health crisis triggered by the COVID-19 pandemic. In exchange, provinces are required to establish measurable goals for the funds and agree to a pact that harmonizes health data nationwide, making it more accessible. All provinces, except Quebec, have endorsed the deal in principle, and in March, deputy ministers of health from all provinces and territories (excluding Quebec) approved a new plan to implement this vision. The effort actually began under former Prime Minister Paul Martin with the 2004 health accords, a $41 billion deal that was initially hailed as a “fix for a generation” set to revolutionize the healthcare system. Although the expected transformation did not materialize, there was a significant emphasis on measuring success, which is now starting to yield results.
The 2004 accords established the now-defunct Health Council of Canada, which was tasked with monitoring and reporting on the progress made by provinces in fulfilling the commitments outlined in the deal. Former Prime Minister Stephen Harper introduced the $612 million wait-time guarantee in 2007, which led to some improvements in wait times for specific procedures in the short term. Trudeau’s government also attempted to measure the impact of the 2017 one-on-one funding agreements with provinces, focused on enhancing home care and mental health services. Provinces agreed to provide information on their progress in various areas, such as wait times for community mental health counseling. However, Mou found that no one had taken a baseline snapshot to measure progress. As a result, the data obtained were incomplete or nonexistent.
Although there is some available information, such as data collected by Statistics Canada, Health Canada, and the Canadian Institute for Health Information, comparing this data across the 13 independent health systems can be challenging. The federal government now aims to make all health data from provinces more accessible, rather than focusing on specific indicators. Canada Health Infoway, an organization funded by the federal government, has developed a plan to enhance the accessibility of individual health records and information for patients and clinicians. This comprehensive approach enables the measurement of population and overall system health. The implementation of this plan is still in its early stages, with some provinces being further along in upgrading their technology than others. The cost of the project has yet to be determined. This long-term investment and change beyond electoral cycles is commendable, as it allows for continuous adaptation as technology evolves.
If successful, this initiative will provide politicians with a clearer understanding of the effectiveness of their agreements. Moreover, patients will also gain valuable insights into their own health baselines.
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