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Local Guides
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HOW MCGUINTY CAN FIX OHIP
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by
Sarah Veale
November 1 - 7,2007 |
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How Premier McGuinty handles the province’s health care system
— or doesn’t — will likely be the one area which defines his
legacy.
With wait times piling up and a doctor shortage that
threatens to leave millions of Ontarians without steady health
care, it’s going to take more than two aspirin to make this
headache go away.
So far, the McGuinty government has been a mixed bag
when it comes to addressing Ontario’s health care woes. On the
upside, the government’s increased med school enrollment (a
crucial solution that, admittedly, will take years before its effect is
felt on the front lines), expanded hospitals and moved physicians
into team–oriented community health centres.
On the downside, Ontario lags behind the other provinces
when it comes to health care delivery and, according to the
Ontario Medical Association, ranks 7th in per capita doctors and
casts–off an estimated one million residents to walk–in clinics, or
worse, no care at all.
“We know that we’re 8,000 nurses short. We’re 2000 doctors
short,” says Dr. Janice Willett, president of the Ontario Medical
Association. “We think that’s a pretty precarious place to for us to
be in.”
The OMA feels the province isn’t just treading water when it
comes to access, but that the whole system is about to capsize
under a whole new load of problems.
On the doctor side is an aging population which sees
approximately 2500 physicians and specialists retiring over the
next decade. In addition to retirees, the province also looses a
remarkable amount of younger students to other jurisdictions: an
estimated 30% of all new med students scram to areas with better
pay, better access to resources, and lighter workloads within two
years of their training. (The OMA reports that 85 per cent of
physicians are working at or above their maximum capacity).
Willett says the province needs to do more, not just to retain
what GPs remain, but to entice others to stay. “Right now we’re
behind the eight–ball and we have to start moving forward,” she
says, noting that more human resources will be necessary to deal
not just with the shortage, but with a population increasingly
afflicted by chronic disease, not to mention a younger,
increasingly obese, clientele. These two new population profiles,
she says, will undoubtedly place an unusual strain on the system.
The OMA is recommending Queen’s Park reduce
administrative tasks, which detract from doctor–patient “face
time,” institute electronic recordkeeping that can be easily
transmitted between doctors, improve working conditions for
doctors, and create student incentives, such as loan interest
deferment programs for newly minted docs staying in the
province. “There’s no waiting for this. There’s no ten–year plan on
this. We need to start moving pretty quickly on this,” Willett says.
Despite the bleak prognosis, the numbers suggest health
care has improved on McGuinty’s watch. Wait times for some
procedures are down and, while the number of Ontarians without
a family doctor remains astronomically high, it’s actually smaller
than it was in 1995, or 2002 for that matter.
However, some feel McGuinty has a long way to go before
completely addressing the province’s needs and, in some cases, is
going about it all wrong.
“The health system has really been battered by a couple of
decades of policies that have favoured a short–term view,”
observes Natalie Mehra, director of the Ontario Health Coalition, a
public interest group which works to preserve the public health
care system. The “roller coaster” of funding cuts and funding
increases, she says, has “created all kinds of instability in the
system and has really gotten in the way of good planning.”
The OHC feels the province needs to do more for young
doctors and improve access for patients by enticing doctors to
locate throughout the province, instead of just in centres with
dense populations. However, they point to one way the McGuinty
government may be hurting healthcare in the guise of helping it.
“There is all kinds of privatization going on under the radar
aided and led by this government,” Mehra says, noting that the
migration of doctors to private clinics, such as sports medical
centres, is partially to blame for the doctor shortage. “Those
doctors should be working in the system providing actual care to
people under OHIP,” she says. “Their university educations are
hugely subsidized by the public. They ought to be working in the
public interest.”
Whether or not McGuinty can save OHIP during the next four
years depends on how closely he listens to recommendations
made by both doctors and the public. For many, it’s imperative
the government focuses on restoration of the province’s health
care system so Ontario can once again be a leader in health care.
“The truth is, a lot of that is just regaining ground,” says
Mehra of the myriad suggestions put forward. “I think in terms of
priorities, let’s undo the worst of the damage and then we can
start to build a more holistic, more effective and accessible health
system.” V [SARAH VEALE]
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