The CMA prez's point of view

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No easy fix for health care
CMA’s next president says ailing system needs more than patchwork cures
By KELLY SHIERS Staff Reporter The Herald Mon. Apr 19 - 4:53 AM

Fixing the province’s health-care system is too big and too important a job to leave to politicians alone, says the incoming president of the Canadian Medical Association.

Dr. Jeff Turnbull says what’s needed is a national movement to address the challenges confronting every province.

In Nova Scotia, emergency rooms close periodically because there aren’t enough doctors to staff them. The government doesn’t pay for an expensive drug that could save the eyesight of people with age-related macular degeneration. Not everyone can find a family doctor. And patients face long waits for surgeries, like hip and knee replacements.

But while some issues may be particular to this province, governments across the country are all facing rising health care costs and the need to reign in spending.

"Every province is grappling with trying to improve the quality of the health-care services they’re providing in the face of significant fiscal restraint — that’s across the board," Turnbull said during an interview Friday.

"Fundamentally, the problem is we have a very fragmented system that doesn’t focus enough on quality and safety. We focus a lot on acute care and we don’t really talk about the continuum from health promotion and illness prevention (to) chronic care and end-of-life care."

Turnbull, who takes over the presidency of the association in August, was in Halifax to address the Academy of Medicine about challenges in the health-care system, including issues around access and sustainability.

The chief of staff at the Ottawa Hospital, he received the Order of Canada in 2007, in part for his work providing medical care to the homeless.

Canadians, no matter where they live, want health care to be there when they need it, he said.

"But, (for example, Nova Scotia is) spending 42.5 per cent of your provincial budget on health. It has an insatiable appetite, so when is it going to stop?"

Turnbull said the discussion doesn’t have to be about tossing out the old system, but improving the existing one.

Moving to electronic patient files is one way to make the system more efficient, he said. Detailed files outlining medical history, medications, specialist appointments and test results would be available to a patient’s family doctor, specialist, or doctor in a hospital, reducing the likelihood of missed appointments, duplicated tests and other misunderstandings.

"I think we can achieve a lot of that in efficiencies in how we do it . . . and focusing on the right things," he said.

"But in the end, we may need more money."

Turnbull said he hopes people come forward to talk about the issues.

"I think this is so fundamental for all of us, it can’t be left solely to the hands of politicians or to the (Canadian Medical Association) or to other groups that have a vested interest. . . . We all have to get around that table. We all have to have a meaningful dialogue and our patients have to be there, front and foremost," he said.

"If we could get that dialogue, and that sense of almost a civic movement, that people are now starting to talk about their health care, what they would like to see and how we’re going to support it, that would be very valuable."

( kshiers@herald.ca)