We’re falling behind on care
Ontario’s medical system rests on delivering quality primary care, but fractures in that foundation are producing unacceptably slow and unequal service.
Most Ontarians are enrolled with a primary care provider, such as a family doctor or nurse practitioner. When sickness strikes, however, less than half are able to book an appointment on the same day or the next, according to a revealing new report from Health Quality Ontario. That anemic performance puts this province, and the whole country, in last place when compared to 10 other nations of similar social and economic status — a list that includes the United States.
That’s unacceptably slow service from professionals whose work is described as being “fundamental to their patients’ health.” Furthermore, about one-in-five Ontarians can’t even rely on having a phone call to their primary care provider returned on the same day.
If Canada’s health-care system was once the envy of the world, it surely is no longer.
Health Minister Eric Hoskins has promised to “significantly improve” same-day or next-day access, and it’s vital that the province succeed in doing so.
High-quality primary care represents a fundamental building block of the entire health system. Family doctors, general practitioners, nurse practitioners and others who do this work serve as a gateway to a host of medical specialists. They’re also the people most familiar with each individual patient’s needs. And they’re in the best position to monitor someone’s overall health and catch problems early, before they become more serious threats.
Patients who turn to a walk-in clinic don’t get much of this ongoing oversight. That’s hardly an ideal solution. But neither is relying on a primary care provider who is able to “provide” only two or more days after someone falls sick.
Making matters worse, access is slower for some people than for others, according to Health Quality Ontario, an agency set up to advise the province on ways to optimize care. It found that while only 44 per cent of Ontarians receive same-day or next-day service from their primary care provider, the number falls to only 28 per cent in northwestern Ontario.
People in rural areas get slower service, too, and patients whose primary language is other than English or French are much less likely to be called back on the same day.
Hoskins is currently embroiled in a bitter feud with Ontario physicians over what they should be paid. The province has imposed a unilateral fee cut and doctors have responded with a court challenge, arguing their Charter rights have been violated.
Primary care delivery involves more than just physicians, and the dispute over fees goes well beyond the demands of family doctors. But there may be some way, in the context of broader talks, to nudge physicians toward providing faster access in return for contract gains elsewhere.
Timely service and equal access to primary care are worthy goals of the system, but both objectives remain far from being met. Ontarians have every right to demand better from the government in charge of their health care and the primary providers who deliver it.