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Monday, 24 March 2014

Obituary for the Health Council of Canada: Where does public health care go now?

It is somewhat of a distorted honour to be allowed to write one’s one obituary, but the Health Council of Canada has done just that in its final report before funding is eliminated on March 31.  In the 2003 pan-Canadian health accord which is also set to expire, the council was formed.  Those accords have perhaps begun to turn the direction of the health care system with a re-emphasis on primary health care and the Health Council of Canada was charged with monitoring that progress.

In its final report to Canadians, it outlines what it sees as accomplishments in its short life. Perhaps it might be better viewed as a short history of Canadian Health Care for the past decade as it richly touches on the pressing issues of electronic health records, pharmaceuticals, primary health care, home and community care, telehealth, wait times and access, aboriginal health  and patient care and safety among others.  Read the report at Highlights of health care reform  

Two areas it perhaps failed in were in the mental health and addictions (perhaps because of the Mental Health Commission of Canada having taken a lead) and Public Health.

The passing of the council is perhaps the most tangible and obvious change associated with a more disconcerting situation.  It marks the extraction of the federal government from any formal involvement in health with some minor exceptions.  International issues, quarantine at the borders, federal public services and federal lands, and First Nations under treaty.   Noting that even for First Nations the federal government is slowly divesting itself of long term responsibility through redefined relationships with the First nations and provinces in what may be a constructive change.

To those who served on the Health Council of Canada, our heartfelt thanks.  Given the lack of attention, the relative dismissal of its work, and the strained relationship with the federal government, it persevered and leaves a legacy that others will have to live up to.

Most importantly though, it was the only body in place that attempted to hold the system accountable through cross jurisdictions comparisons.  That function falls to the wayside and the system once again becomes accountable only to itself. 

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