Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
Since 2004, provincial governments have had very mixed results in effecting
the reforms necessary to meet the waiting time targets despite the influx of
extra federal funding.
In the 10-Year Plan, governments agreed to extend first-dollar coverage for
targeted home care services in three areas: (1) two weeks of acute home care
after release from hospital; (2) two weeks of acute mental health home care; and
(3) end-of-life home care. It appears that most provinces now provide coverage
for these limited services, although considerable provincial and territorial
variability for other home care services remains the rule (Canadian Healthcare
Association, 2009).
Progress on primary care was also identified as a policy priority under the
10-Year Plan. All governments agreed to provide at least 50% of their respective
populations with (24-hour, 7-day-a-week) access to multidisciplinary primary
care teams by 2011, a major commitment given the fact that the vast majority
of primary care was still being provided by physicians in 2004. While it has not
yet been calculated whether any jurisdiction has reached the 24/7 target, it does
appear that approximately three-quarters of family physicians are now working
in multi-professional practices (Hutchison et al., 2011).
With the exception of the Government of Quebec, which declared that it
would not abandon or change its provincial prescription drug plan, the 2004
accord also committed P/T governments to work with the federal government
on what became known as the National Pharmaceuticals Strategy. Under the
direction of F/P/T health ministers, this initiative was to create a pan-Canadian
system of prescription drug coverage and pricing policy. However, despite some
early progress, the National Pharmaceuticals Strategy eventually died due to
lack of interest among the participating governments, one of the more notable
failures of the 10-Year Plan (HCC, 2009; MacKinnon & Ip, 2009). While a
number of provincial governments have introduced catastrophic drug coverage
on their own, this has sometimes come at the price of rolling back categorical
coverage for older Canadians, and it is unclear whether these changes have
produced an overall improvement in financial protection (Daw & Morgan,
2012).