The Capital Health District in Nova Scotia proclaims that about 20% of people have access to family doctors working with an interdisciplinary team and with access to community health teams.  In Toronto, the Local Health Integration Networks looks after a minority of Toronto residents (about 1.1 million of the 2.5 million people living in Toronto).

The largest majority of people in Toronto and Halifax, do not have this preferred access.  This two-tiered system of government funded care is not what the late NDP leader, Tommy Douglas had in mind.

What this difference in access means, is that even though Canadian pays the same amount, at the time of care (nothing), many of you do not have access to the same level of services as your neighbors.

A recent article posted by the Manitoba Health reporting on the benefits of multidisciplinary teams suggests that patients, providers, and the community in general benefit when they are cared for by multidisciplinary teams. The authors say “In particular, patients treated by interdisciplinary health care teams enjoy better health outcomes, shorter wait times, and a greater degree of patient empowerment, all of which lead to an increase in patient satisfaction rates and cost savings to the health care system. Health care professionals, in turn, benefit from interprofessional collaboration by gaining diverse knowledge of other practitioners on the health care team. Furthermore, health care professionals benefit from the more equal distribution of workload among team members,
Which contributes to an increase in the practitioner satisfaction rates.”

The Toronto Local Health Integration Network suggests that members “Are getting easier and faster access to key services such as community based seniors programs, emergency roomservices, home care and supportive housing.”

It is difficult to understand why Provincial governments insist on maintaining different standards of care for different groups of people.  Not all clinicians are given the option of working in these preferred practices, and their patients must contend with a different level of care, and a different level of access to health care services. 

In the area of communication electronic communication (e-health) we also have a 2 tier system. Some practitioners have electronic health records, largely paid for by government, other doctors and their patients do not.  Patients in practices where government supports multidisciplinary teams and advanced information and communication technology are often able to telephone their doctors (or possibly have an e-mail conversation) and get personal advice.   The rest of you do not have such privileged access and might even find yourself in the unfortunate circumstance of having to call 811 to get advice from the impersonal voice, of a person who doesn’t know you, and who is located in a remote location.

Nova Scotia and Ontario have about 30 health workers per 1,000 population, slightly less than the Canadian average.  We don’t know whether the number is too high, too low, or just right because your government doesn’t have information about the benefits health workers produce.  We know however, that many of you wait too long for care, have to travel to inconvenient locations for services, and sometimes might be forced to go to emergency because many people in Nova Scotia and Ontario  do not have a doctor.

Despite this unsatisfactory state of affairs, the N.S. Government is slashing health care funding.  As part of the Nova Scotia “Better Care Sooner” (but not now) campaign, Capital Health has been asked to cut $30 million from its budget.  Following the Drummond report it is likely that Ontario will begin to slash as well. Numerous jobs will be lost, at a time of major unemployment. At the same time governments search for ways to spend money to stimulate the economy. 

Many of you, especially those in the disadvantaged majority, will find it even more difficult to get proper health care.  Sadly, despite the inability of governments in Nova Scotia and Ontario to provide excellent  and timely care to all, they remain determined to bar the unfortunate majority from paying health workers to provide the services that government freely provides to the privileged few.

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