Just found what Canada is up to, and it makes me wonder what exactly are the purposes of all the changes to health and social services that are happening here. Have we lost the plot in Britain?
The key feature of primary health care reform is a shift to teams of providers who are accountable for providing comprehensive services to their clients.
There is a growing consensus that family physicians, nurses, and other professionals working as partners will result in better health, improved access to services, more efficient use of resources, and better satisfaction for both patients and providers.
Such teams are well positioned to focus on health promotion and improving the management of chronic disease. This team approach, along with telephone advice lines, facilitates access to primary health care services after-hours, reducing the need for costly emergency room visits.
Other technologies can support information-sharing among providers so that Canadians need not repeat their health histories or undergo the same tests for every health care professional they see.
In these ways, all aspects of personal care are brought together in a coordinated way.
Presently, relatively few Canadians access primary health care services in this way. All provinces and territories are implementing plans for primary health care reform, with funding support from the federal Primary Health Care Transition Fund. Each jurisdiction is undertaking its own approach but some common areas of focus have emerged:
- the creation of primary health care teams and organizations which are responsible for providing comprehensive services to their clients (including coordination with other levels of care);
- the creation or enhancement of telephone advice lines to provide 24-hour first-contact services;
- improvements in the management of chronic diseases (which account for a large portion (40-70% according to various estimates) of health care system costs);
- a greater emphasis on health promotion and illness/injury prevention;
- voluntary participation by providers and patients alike;
- capacity-building in evaluation, so that system performance may be monitored; and
- an explicit focus on change management activities to support all of the above.
Will our reforms enable a mum at 3:00 in the morning worried about her baby to talk with a professional health worker who knows her and take the appropriate action, receive a home visit the next morning, ensure all her families health needs have been thought about and comprehensively planned for, enabled the mum to feel confident about being in control?
These are the standards that are being achieved elsewhere with properly trained community health workers. It is win win – communities are taking responsibility for their health, it is far cheaper, it is preventive.
But I cannot see this is on the agenda here even to be discussed. Instead we have gone to strange 111 systems where you are not talking to a professional, which will result in more emergency calls and will be more expensive with poorer service.
All I see is further splitting up of services and more bureaucracy.