Here are some of the issues facing Canada’s health system:
WHAT ARE THE MAIN CHALLENGES?
A shortage of healthcare workers fueled in part by burnout and attrition has plagued Canada’s hospitals, clinics and primary care resources. The health and social services sector vacancy rate was 5.7% in November, down from a multi-year high of 6.6% two months earlier.
According to the Canadian Institute for Health Information there were 93,998 physicians in Canada in 2021, or 2.46 per 1,000 people.
According to the World Bank using World Health Organization statistics, the United States had 2.6 physicians per 1,000 people in 2018 and the United Kingdom had 5.8 in 2019.
WHERE ARE THE PRESSURE POINTS?
The crisis is most evident in the country’s hospitals, which faced a surge in respiratory illnesses last fall that left some people waiting hours in emergency departments, sometimes being treated there because of a lack of staffed beds. There were high-profile deaths of people whose families said they could have lived had they received timely care.
WHAT IS THE PRIMARY CARE CONUNDRUM?
Primary care providers are considered the “front door” of healthcare – they are the clinicians who follow patients, deal with a range of concerns and determine who needs a specialist’s care. But millions of Canadians do not have one. A survey conducted last fall found 22% of respondents lacked a family doctor or nurse practitioner they could talk to about their health. Lacking a primary care provider can mean problems do not get caught early or people rely on walk-in clinics or emergency rooms.
WHAT ROLE DOES AN AGING POPULATION PLAY?
Canada has failed to address the growing healthcare needs of an aging population, said Alan Drummond, an emergency physician at the Great War Memorial Hospital in Perth, Ontario.
On any given day, a fifth of hospital beds in Ontario are taken up by people who do not need to be hospitalized, Drummond said. They are often awaiting transfer to a long-term care facility or to their home where they are assisted by a caregiver. But there are not enough home care or long-term care resources to provide for them, Drummond said.
WHAT DOES CANADA SPEND ON HEALTHCARE?
Total health spending in Canada was expected to reach C$331 billion in 2022, or C$8,563 per Canadian, according to the Canadian Institute for Health Information.
Total health expenditure in 2022 was expected to rise by 0.8%, following a high growth rate of 13.2% in 2020 and 7.6% in 2021. From 2015 to 2019 health spending growth averaged 4% per year.
In 2022 total health spending was 12.2% of GDP, down from 13.8% in 2020. According to the Organisation for Economic Co-operation and Development, Canada’s per-capita health spending was below that of the United States, Germany, Switzerland and other rich countries in 2021.
WHAT DO THE PROVINCES WANT?
The provinces have asked for billions more in funding from the federal government. Ottawa, for its part, has said such a funding boost must come with strings attached. This could include improvements in data collection and the provision of mental health care, among other things. The federal government and the provinces have cautioned not to expect finalized deals on Tuesday.