Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 125<br />
across provincial health systems, including the establishment of voluntary<br />
(intergovernmental) <strong>for</strong>ms of per<strong>for</strong>mance benchmarking (Fenna, 2010; Fafard,<br />
2012).<br />
Following the Romanow Royal Commission’s recommendations of 2002,<br />
F/P/T first ministers met to decide which commission recommendations<br />
could be implemented. In the resulting First Ministers’ Accord on <strong>Health</strong><br />
Care Renewal, they focused on re-igniting primary care re<strong>for</strong>m, improving<br />
catastrophic drug coverage, facilitating greater substitution of home care<br />
services <strong>for</strong> hospital-based services and accelerating the adoption of EHRs<br />
(CICS, 2003).<br />
In 2004, F/P/T first ministers negotiated A 10-Year Plan to Strengthen<br />
<strong>Health</strong> Care, the most significant intergovernmental health accord reached<br />
in the last decade. In addition to increasing the level of the <strong>Canada</strong> <strong>Health</strong><br />
Transfer, the 10-Year Plan also guaranteed that the federal government would<br />
increase federal health transfers to the provinces and territories by 6% per year<br />
<strong>for</strong> the following decade. In return <strong>for</strong> this generous funding, the provincial<br />
and territorial governments agreed on the proposed plan’s key policy priorities,<br />
including waiting times, home care and pharmaceutical policy. While some<br />
governments have made progress in one or more of these areas, as reviewed<br />
below, the collaborative or pan-Canadian aspect of these ef<strong>for</strong>ts especially those<br />
aimed at trans<strong>for</strong>mative changes, were not realised (Senate of <strong>Canada</strong>, 2012).<br />
The 10-Year Plan was facilitated by a federal Wait Time Reduction Fund<br />
(C$5.5 billion over 10 years) to assist provinces in meeting their waiting<br />
time targets in five priority areas – cancer, cardiac, sight restoration, joint<br />
replacement and diagnostic imaging. Provincial and territorial governments<br />
worked with the CIHI to establish benchmarks <strong>for</strong> every priority area except<br />
diagnostic imaging. 1 All provinces provide CIHI with comparable waiting times<br />
data, and all provinces, 2 with the exceptions of Manitoba and Newfoundland<br />
and Labrador, have set targets based on individually established benchmarks<br />
(Fafard, 2012). In addition, all provinces in<strong>for</strong>m their residents about waiting<br />
times in these priority areas. Overall, they have made progress in managing<br />
and reducing surgical and diagnostic waiting times since 2004. While there<br />
remains considerable variation across provinces, most Canadians receive these<br />
priority procedures within the benchmarks set by the provinces (CIHI, 2012b).<br />
1 According to the majority of participants, there was insufficient evidence on the appropriate waiting times<br />
<strong>for</strong> diagnostic imaging.<br />
2 Since patients living in the territories are usually referred to hospitals in the provinces <strong>for</strong> elective surgeries,<br />
the three territories are excluded in the remainder of the discussion on waiting times.