Open Letter to the Canadian Medical Association: Improving health and healthcare for Canadians

The Canadian Alliance of Community Health Centre Associations (CACHCA) has issued the following open letter to the Canadian Medical Association. CACHCA welcomes input and feedback from Canadians as we all strive to improve health and health care for Canadians.

Attn: Dr. Jeff Turnbull

President, Canadian Medical Association

1867 Alta Vista Drive

Ottawa, Ontario   K1G 5W8

Dr. Turnbull:

We are writing to express our appreciation for the efforts being made by the Canadian Medical Association (CMA) to engage Canadians around steps to enhance our cherished health care system. We embrace and support this renewed dialogue and will do our utmost to continue participating in the process, while encouraging individual Community Health Centres and community members across Canada to do the same. The Canadian Alliance of Community Health Centre Associations (CACHCA) also wishes to take this opportunity to provide some preliminary input into this pan-Canadian conversation.

CACHCA represents a vibrant and diverse network of Community Health Centres across Canada.  There are over 300 publicly-funded health care organizations across Canada delivering comprehensive primary health care through the Community Health Centre model, consisting of:

  • collaborative, interprofessional health teams that include family physicians, nurse practitioners, nurses, chiropodists, dietitians, counsellors, pharmacists, health promoters and other health and health care staff;
  • integration of team-based primary care with health promotion, illness prevention and community-oriented social and economic development programs; and
  • routine engagement of local community members in planning health services and programs tailored to local needs, in many instances including governance from volunteer Boards of Directors composed of members directly from the community.

As of 2011, we conservatively calculate that over two million Canadians benefit from comprehensive primary health care delivered through the Community Health Centre model. Although these health centres themselves vary from province to province, and community to community, they share a commitment to ensuring health for all Canadians, with particular emphasis on services and supports for vulnerable individuals and groups.

Our shared experience provides valuable insight into many of the barriers and solutions to health and health care for a wide range of Canadians. It is from this perspective that we submit our preliminary input into the pan-Canadian conversation initiated by the CMA. We wish to underscore our belief that in engaging in discussions around the future of health system planning, financing, service delivery and partnerships across Canada, we must carefully consider the needs and impact of potential reforms on all Canadians.

CACHCA strongly supports the CMA’s cross Canada health care conversation, and we believe that it can be an important step in improving health for individuals, families and communities. We also believe it can lead to more equitable and appropriate access for all Canadians to an improved health care system.

At the same time, we believe that there are many voices, experiences and needs that will likely be under-represented in the CMA’s process due to physical, environmental and social barriers to participation. We issue this concern not as a criticism, but as a statement of our shared responsibility in ensuring that input into this important discussion reflects the broad and diverse experience of Canadians.

Over the course of the coming months, CACHCA will continue to encourage individual Canadians, CHCs and partner agencies across the country to provide input into the pan-Canadian dialogue. We also commit ourselves to providing further input, informed by the experiences of Community Health Centres across Canada – input geared not only to improving the functioning of our health system, but to keeping Canadians healthy in the first place.

In the meantime, we submit to you and to Canadians a set of four principles that we believe must shape the pan-Canadian discourse that we are embarking upon. Along with these principles, we cite several supplementary resources that provide important insight into solutions for health and health care in Canada. These core principles are:

  1. Commitment to preserving and enhancing Medicare as a single-tier, public health system in order to ensure access to appropriate health care for all Canadians. In further support of this principle, we recommend as background:
    1. The Sustainability of Medicare – Hugh Mackenzie, Dr. Michael Rachlis and the Canadian Federation of Nurses Unions (2010) 
    2. Research Shows Medicare Sustainable Without Increased Private Funding – Canadian Doctors for Medicare (2010) 
    3. The Economic Case for Universal Pharmacare: Costs and benefits of publicly funded drug coverage for all Canadians – Marc-André Gagnon and Guillaume Hébert (2010)
  2. Commitment to balancing our focus on health care and illness treatment with an integrated strategy to keep people well in the first place, thereby building a stronger Canada and reducing avoidable burdens on health care services. In further support of this principle, we recommend as background:
    1. Stepping It Up: Moving the Focus from Health Care in Canada to a Healthier Canada – Canada Health Council Report (2010)
    2. Achieving the Second Stage of Medicare – Resources from the Association of Ontario Health Centre
    3. The Second Stage of Medicare – Resources from the Wellesley Institute
  3. A stronger, more active role for the Federal Government of Canada in establishing policies and funding mechanisms that improve health and guide critical health system reforms across the country. In further support of this principle, we recommend as background:
    1. In From the Margins: A Call to Action on Poverty, Housing and Homelessness. Report of the Canadian Senate Standing Committee of Social Affairs, Science and Technology – Subcommittee on Cities (2009) 
    2. Community Health Centres: An Integrated Approach to Strengthening Communities, and Improving the Health and Wellbeing of Vulnerable Canadians and Their Families – The Canadian Alliance of Community Health Centre Associations (2009)
    3. Ipsos Reid (January 25, 2011): Canadians Agree Healthcare Should Be the Priority for Both the Provincial (84%) and Federal Governments (73%)
  4. Commitment to expanding and better coordinating community health and population health efforts in order to build a stronger, healthier Canada and reduce avoidable health system costs. In further support of this principle, we recommend as background:
    1. A Healthy, Productive Canada: A Determinant of Health Approach. Final Report of the Canadian Senate Standing Committee of Social Affairs, Science and Technology – Subcommittee on Population Health (2009).
    2. Prescription for Excellence: How Innovation is Saving Canada’s Health Care System – Dr. Michael Rachlis (2004)

As these core principles and supporting resources demonstrate, there is already a wealth of research and current innovation in Canada to help guide future action on health and health care in Canada.

The Canadian Alliance of Community Health Centre Associations looks forward to further discussion with the Canadian Medical Association, other partner organizations and Canadians in communities across the country with regards to improving our collective health and the health care system. We welcome a response to our preliminary input into this pan-Canadian dialogue from the CMA and from Canadians from coast to coast to coast.  This may be done by:

  1. Providing a comment (below) on this online posting of the CACHCA Open Letter to the CMA.  
  2. Writing to us at:
    1. Canadian Alliance of Community Health Centre Associations
    2. c/o Somerset West Community Health Centre
    3. 55 Eccles Street
    4. Ottawa, Ontario  K1R 6S3
  3. Connecting to CACHCA via our Facebook and Twitter pages.

We also take this opportunity to strongly encourage Canadians to continue providing input directly into the CMA’s online discussion of the future of health care. We continue to direct Canadians to: http://www.healthcaretransformation.ca.