Overhaul needed to keep pan-Canadian health organizations relevant: report

OTTAWA — The role the federal government and its arms-length organizations play in the Canadian medical system needs a dramatic overhaul, including phasing out three of the eight agencies, says a new report.

An external review released Tuesday found serious gaps and overlaps among the federally funded organizations tasked with co-ordinating federal health-care policy across the country.

The eight so-called pan-Canadian health organizations were created over the last three decades as self-governing, not-for-profit entities whose areas of focus include substance use and addiction, drugs and technology, health information, patient safety, cancer and mental health.

“If the (pan-Canadian health organization) suite is to become a more effective lever for a re-engaged federal government, more than mere tinkering or housekeeping changes are required,” the report said.

“What has helped advance Canadian health systems to where they are today is not what will take them where they must go in the future,” it adds, describing the current framework as having “serious gaps, redundancies and misalignments that cannot be remedied without retooling.”

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The eight organizations have a combined budget of $300 million and employ about 1,300 people.

The report suggested three of the eight — the Mental Health Commission of Canada, the Canadian Partnership Against Cancer and the Canadian Centre on Substance Use and Addiction — be phased out, with their expertise and resources moved elsewhere.

“It is not because we believe that these problems or issues have been dealt with and are finished that we make this recommendation,” said Dr. Danielle Martin, one of the report’s two co-authors.

“It is because they are such critical areas where action is needed that we think that we need to ensure that the organizations and structures that support these issues need to be of the appropriate scale and with the appropriate missions and mandates to be successful.”

The mental health agency was established by the Harper government in 2007 in response to a Senate committee recommendation.

The Tuesday report, commissioned by the federal government, presents four scenarios intended as a “menu,” from which the government can balance its priorities and vision for the future of health care by choosing either one or a mix of the proposed solutions.

Martin said changes will be necessary to accommodate the federal government’s plan to develop a national pharmacare program, as well as to take advantage of big data to improve health delivery and outcomes. A dedicated agency for each is recommended in all four proposed scenarios.

“If we want to get to 21st century health systems in the country, then we need 21st century pan-Canadian health organizations,” Martin said.

Health Minister Ginette Petitpas Taylor said she is looking forward to reviewing the report, adding that the review was not intended as a cost-cutting measure and that the government’s response could be revenue neutral or involve additional investments.

“All organizations, I have to say, have done tremendous work over the years. Some of them were created over 30 years now. Some of them have actually done what they were created to do,” Petitpas Taylor said, but “the status quo will not remain.”

The report’s other co-author, Pierre-Gerlier Forest, said one of the system’s shortcomings is how the organizations are funded.

“They compete for attention and they compete for money instead of working together in the same direction,” he said.

The report also recommends the government make better use of its health organizations to promote Indigenous health and wellness.

— Follow @gwomand on Twitter

Geordon Omand, The Canadian Press