Canadian Medical Association urges health-care strategy for seniors

Theglobeandmail.com
Aug. 24, 2015
By Andrew Picard

Reshaping the health system to deal with the onslaught of aging baby boomers is urgent and needs to be a political priority, the head of the Canadian Medical Association says.

“Addressing the growing and evolving health-care needs of Canada’s aging population is one of the most pressing policy imperatives of our time,” Dr. Chris Simpson told a news conference on Monday at the CMA’s annual meeting.

“The country must act now to create a health strategy to ensure that all seniors have access to effective, integrated, affordable care.”

He made the comments as the CMA, which represents the country’s 80,000 physicians, residents and medical students, unveiled what it called a “policy framework to guide a national seniors’ strategy for Canada.”

The 33-page document calls for significant changes across the health-care continuum to make care more seamless and senior-friendly in the following areas:

Wellness and prevention: Pay attention to the social determinants of health and ensure seniors have adequate income, housing, food security and social connections to keep them in the community.

Primary care: Ensure seniors have a primary-care provider and a co-ordinator of their chronic-care needs.

Home care and community support: Provide sufficient long-term home care and support for unpaid caregivers.

Acute and specialty care: Address the lingering issue of wait times for surgery and deal with the “alternate level of care” problem - seniors living in hospitals because they have nowhere else to go.

Long-term care: Invest in infrastructure so there is an adequate number of beds, and so they are affordable, particularly for seniors with specialized needs, such as those with dementia.

Palliative care: Promote advance-care planning and ensure everyone gets palliative care at the end of life.

In a wide-ranging discussion, delegates to the CMA meeting identified a number of specific issues that are hampering the provision of care to seniors with chronic health conditions, such as the lack of electronic health records, the way health-care delivery is siloed in Canada, the absence of pharmacare, physician payment schemes that reward volume rather than quality of care, the lack of training in geriatrics and a lacklustre commitment to patient-centred care.

The overarching theme was that if care is going to be improved for the burgeoning population of seniors, it must begin with better co-ordination.

Dr. David Naylor, who headed the federal Advisory Panel on Healthcare Innovation, also stressed this as an essential element of reform.

In a keynote address to the CMA meeting, he said that while Canadians love their medicare system - at least in theory - the reality is that “the scope is narrow and performance is middling.”

Dr. Naylor said the main reason Canadians don’t get good value for money when it comes to health spending is a lack of co-ordination of care. “The critical factor is integration of services,” he said.

Right now, far too many patients, especially seniors with chronic conditions, are being cared for in hospitals rather than in the community and their care is disjointed, the CMA’s report notes.

Fixing that will, among other things, require a reorganization of roles between various health professions, including physicians, nurses and pharmacists. “All health-care professionals are going to have to do their bit to deal with this grey tsunami,” he said, stressing that many innovative solutions have been put in place across the country, but they are too rarely scaled up.

Dr. Naylor said policy-makers, and federal politicians in particular, need to take a leadership role to ensure this happens.

Dr. Simpson of the CMA also called for federal political parties to commit to a seniors’ strategy during the current election campaign, and said he is confident they will.

“We know they’re thinking about it. We know their hearts are in the right place,” he said. “Now we want them to start talking about seniors’ health care in the context of the election campaign so people can cast their votes accordingly.”