Alberta politics “catch up” and Ottawa “drops out”. . .

Wendy Armstrong, Co-chair Health Committee, Consumers' Association of Alberta

I am one of many Canadians with family members and close friends living in other provinces. I am also one of many Canadians who travel to other provinces for both work and pleasure and to meet family obligations. This makes the personal security and comfort of being able to count on a reasonably common set of healthcare services, standards and portability in our national public healthcare system important. So too is the cooperation of all the provinces and the federal stewardship that enables this to occur.

The value of this security was recently brought home to me when my otherwise healthy 91 year old mom-in-law arrived from Ontario this Christmas and her swollen leg led to eight days of outpatient IV therapy at a local Edmonton hospital - without any hassle or charges. It was also a far cry from our less pleasant experience last year when she broke her shoulder line-dancing in Ontario and was sent home from an ER in severe pain with her arm strapped to her body and told that “home care” would call her in a few days. We had little choice but to turn to one of this country's official private home care providers – Westjet.

Therefore the announcement that Alberta has now reversed its historic position and decided to participate in the Health Council of Canada is music to my ears. It’s good for Albertans and good for all Canadians.

The decision also reflects some remarkable events and changes in the political landscape of Alberta over the past year, including the unexpected victory of Premier Alison Redford in a nine-month contest for leadership of the of the Conservative Party following the resignation of Premier Ed Stelmach. Taking a position against greater reliance on private surgery clinics and proposing new family care clinics as well as promising to hire more teachers, Redford (considered a long-shot during most of the campaign) won on a second ballot.  When asked by reporters what she attributed this unexpected win to, she responded, “I actually think the province changed some time ago, and politics is catching up with it.”

Discouragingly, however, just when politics in Alberta have begun to catch up, it seems the politicians in Ottawa are dropping out. Recent federal government announcements that it plans on dropping out of equalization funding and federal stewardship of Medicare threaten common standards and portability as well as long overdue recovery of benefits lost as services have been decanted out of hospitals.  There is an important role for the Health Council in monitoring this situation.   

Key Words: Alberta, Health Council of Canada, Health Accord

Alberta Becomes a Member of the Health Council of Canada: Some Patients and Consumers Have Mixed Views on this Partnership

Katharina Kovacs Burns, MSc, MSHA, PhD

Albertan and Patient Advocate & Associate Director, Health Sciences Council & Director, Interdisciplinary Health Research Academy, University of Alberta

Recently I was told about Alberta’s intention to join the Health Council of Canada by the start of 2012, and was asked about my thoughts on how patients/consumers in Alberta might feel regarding the significance and hopes for this new partnership. I know how I feel about this, and although I often think I know how other patients and consumers might feel about our provincial government’s partnership arrangements, I was not certain in this case.

I informally canvassed a number of individuals who consider themselves patients and consumers of health care in Alberta. My initial thoughts were that most of these respondents would think as I do and would be unanimously supportive of this partnership, and believe that the benefits would be seen over the long term, such as strengthened ties between Alberta and other provinces in cross-country health care decisions including for primary care, catastrophic and other drug coverage, and a new Canada Health Accord. However, views of this small sample of 48 non-randomly selected patients/consumers and patient advocates varied. The 43% of respondents that knew of the Health Council of Canada (HCC) and its many health reports and ongoing discussions/debates, felt this move was necessary and positive for Alberta; while many more others who did not know of the HCC (52%), did not know or could not say how this move would benefit, or perhaps cost Alberta. There were very few (5%) who thought or said that this was a waste of time, energy or money on the part of Alberta.

The test for support is based on how well Albertans have been made aware of this partnership. From my perspective, there is no doubt that the benefits could go both ways. Albertans can provide the needed good or bad feedback on health and healthcare issues which our Minister of Health needs to hear and take forward to the HCC; and in turn, this is an opportunity for our Minister to engage Alberta’s patients and consumers for their perspectives on provincial and national health issues and priorities, especially as the time is approaching for discussions regarding a new Health Accord. 

Key Words: Alberta, Health Council of Canada, Health Accord

Alberta builds on leadership role in health care in Canada

John Sproule is the Senior Policy Director of the Institute of Health Economics in Edmonton, Alberta.

The Alberta government, Premier Alison Redford and Health Minister Fred Horne should be commended for their recent decision to join the Health Council of Canada.  Since the Council was formed in 2004, the Province has been represented indirectly through the participation of distinguished individual Albertans; the Government's decision to formally join the Council sends a positive signal.

Partnerships such as the Health Council are invaluable because the complex issues facing the health system can only be solved through cooperation, collaboration and learning across Canada and internationally.  Our policy forums routinely draw on expertise from around the world, and we believe Alberta has much to contribute to, and learn from, exchanges with healthcare leaders in other provinces and countries.  (The presentations from our most recent series of forums commissioned by Alberta Health Services can be accessed by clicking here)

IHE believes an important role for independent bodies is to assess and report to the public on progress in achieving the goals laid out by governments and health-care systems for improving health systems. This role is essential at the local and provincial levels, as well as on a national scale - bearing in mind that "national" does not mean "federal" in health policy in Canada, with our shared jurisdiction in health care.  

Alberta's participation in the Health Council builds on the Province's longstanding leadership role in health care;  it will enrich the health policy landscape both nationally and in Alberta.  There are great benefits from the natural experiments that can occur in our decentralized healthcare system in Canada – but the benefits will only be realized if innovations are assessed from a pan-Canadian perspective, and if learnings from new approaches are shared.  The Health Council provides a supportive vehicle for such efforts.

Alberta has been, and continues to be, a strong contributor to many national and regional health collaboration efforts.  The Province was a leader in the formation of the Canadian Institute for Health Information and the Canadian Coordinating Office for Health Technology Assessment (CCOHTA), which has evolved into the Canadian Agency for Drugs and Technologies in Health (CADTH).  With the creation of Alberta Health Services, Alberta remains at the forefront of innovation in healthcare delivery.  The IHE firmly believes that Alberta belongs at the table in any discussion of health policy in Canada.

Key Words: Alberta, Health Council of Canada, Health Accord

Health Innovation Challenge wrap up

The Health Innovation Challenge has now closed and we’ve got lots of work to do reviewing the incredible entries we received.

If you haven’t been following, in September we challenged students to find innovative policies or practices in Canadian health care and tell us about them for a chance to win $1,000 and a potential internship with the Health Council of Canada.

Students prepared entries of up to 2,500 words, answering one of these two questions:

How are innovations in public policy having a positive impact on health care in Canada or abroad? Describe a ground-breaking public policy initiative that is changing practices, outcomes or perceptions of health care.

How are new practices having a positive impact on the delivery of health care in Canada or abroad? Describe leading edge research, technology or processes that are changing practices or outcomes of health care.

We are impressed not only with the calibre of the entries, but of the sheer volume of them, and so we want to share a few early results from the Challenge.

• Number of students who entered: 223
• Number of entries submitted (individual and team): 154
• Biggest turnout from one school: 84, from St. Francis Xavier University in Antigonish, Nova Scotia
• Received entries from: Nova Scotia, Alberta, New Brunswick, Ontario, Manitoba, B.C., Saskatchewan, Quebec and Newfoundland and Labrador.

                                                           

We received entries on a wide variety of health practices and policies. Some recurring themes were: safe-injection sites, HPV vaccines, Aboriginal health, poverty reduction, wait times, technology in health care, and obesity initiatives.  

We were especially impressed by students who added to their entries by crafting a blog post, or a video to support their message (hopefully we will get a chance to share some of these on this blog).

We will be announcing the shortlist on February 15, 2012, and after our panel of experts have reviewed the list we will announce the winners on March 26, 2012. Good luck to all the contestants, and thank you to each and every professor who either encouraged students to enter or who used the Challenge as a class assignment.  

Key Words: Health Innovation Challenge, Innovative Practices, Student Contest

Health, Not Health Care – Changing the Conversation

Ontario’s Chief Medical Officer of Health recently released her 2010 Annual Report, calling for a change in the way society thinks about health. Titled Health, Not Health Care – Changing the Conversation, the report calls for a clear understanding that our health is significantly affected by the economic, social and environmental conditions that shape our lives.

Dr. Arlene King wants to see a comprehensive plan to improve the health of Ontarians that features clear health goals, targets, and health indicators. She urges provincial, regional, and municipal governments to apply a health lens to every program and policy in the province, using a tool such as Health Impact Assessment (HIA) to assess the potential health effects of any policy, program or project. And she recommends breaking down the systemic barriers that get in the way of collaboration between different sectors, including health, education, social services, and the environment.

These are important messages from a provincial Medical Officer of Health. The majority of factors affecting our health are complex and intertwined, requiring the problem-solving skills of multiple government departments, multiple levels of government, and other sectors of society. The report is an excellent and accessible summary of the issues. As Dr. King points out in her report, a comprehensive overall plan is needed “to address the disconnect between what we know needs to be done, and our ability to do it.”

Elaine Kachala (policy lead) and Judy Irwin (writer) worked on the Health Council of Canada’s report on the determinants of health, Stepping It Up: Moving the Focus from Health Care in Canada to a Healthier Canada (Dec 2010).

Second edition of BC Atlas of Wellness shows connection between “healthy, wealthy and wise”

Researchers at the University of Victoria have released an expanded edition of the British Columbia Atlas of Wellness. The Atlas details indicators that they believe measure the foundation of a healthy community – like exercise, smoking, diet, and adequate housing – in an attempt to explain why certain communities are healthier and fitter than others.

Using more than 400 maps, the Atlas shows a connection between “healthy, wealthy and wise”:  the healthiest communities tend to be wealthier, better educated, have better diets, exercise more and smoke less.

In a recent report, we looked at how the determinants of health, for example, income, education, relationships, and housing, affect Canadians over the long term. We found that individuals with the lowest incomes are more likely to suffer from chronic conditions such as diabetes, arthritis and heart disease, live with a disability, be hospitalized, suffer from mental distress, and to die earlier. Low income Canadians are twice as likely to use health care services as those with the highest incomes – which means addressing the determinants of health can play a significant role in health system costs.

Governments need to recognize that in order to reduce the burden on the health care system, we must achieve a better balance between investing in an acute care system and investing in factors like these that affect our health. Moreover, governments need to think and work differently, since health is not just the responsibility of health ministries – rather, it is the responsibility of governments and society as a whole. Our report spoke to how governments can and are moving towards a whole-of-government approach – that is to say, involving multiple ministries and levels of government and other sectors of society to improve health.

The first edition of the BC Atlas of Wellness was published in 2007. Both the earlier and current editions can be viewed online at www.geog.uvic.ca/wellness.

Key Words: Health Promotion, BC Atlas of Wellness