Major renovation is long overdue Big, bold changes could be ahead for our national healthcare system.
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as the new government in Ottawa begins to lay out plans for changes in Canada’s healthcare arrange- ments. “The panel,” the report said, in reference to its
own deliberations, “has been left in no doubt that a major renovation of the system is overdue, and is chagrined and puzzled by the inability of Canadian governments – federal, provincial and territorial – to join forces and take concerted action on recom- mendations that have been made by many previous commissions, reviews, panels and experts.” In short, the panel found there’s been little change in the way Canada’s health systems and operations are structured and managed since the days of the 1960s and 1970s when public healthcare was first set up.
In two key recommendations it proposes estab- lishment of a fund with an operating budget reach- ing $1 billion a year, to pay the costs on the new process.
They could, after all, choose to be bold. And the six-member panel, headed by former University of Toronto president, Dr. David Naylor, has come up with some new and resourceful ways of dealing with healthcare's shortcomings head on. We are paying a lot for a relatively narrow bundle of publicly-insured services. Although there are many great ideas in cir- culation and extraordinary pockets of innovative ac- tivity across the country, Canada has not been suc- cessful in mobilizing large scale change at the system level. Put differently, though it starts many a pilot project, it has neglected to cultivate the good ones, and upscale them, possibly to reach people across the nation.
As its mandates required, the panel names a hand- ful of areas where innovation would make Canada’s healthcare more effective and sustainable, virtually putting the country on a catchup path with it's peers. Firstly, it calls for patient-centred health care.
“The patients want in,” says the panel. Patients in- creasingly see themselves as partners in their own care. They expect to interact with a responsible sys- tem that is designed around their needs. Second, the panel wants healthcare to respond to the needs produced by Canada’s changing demo- graphics. It points to the coming increase in seniors populations, and the need for medical teams that can deal with the chronic illnesses that fill out their lives. Aboriginal numbers are rising fast on the prai- ries, and healthcare needs will intensify. The digital revolution is bringing on a range of challenges, involving how and how widely we use and benefit from the data that is already waiting to be collected. And then, for individuals, a potential for smarter clinical decision-making, remote moni- toring, mHealth tools and more informed and en- gaged patients. Coming over the horizon, there will be profound medical changes to be wrought at the individual level through precision medicine. And then, if the government listens, there could
be huge changes at the centre of it all. First of all, healthcare moves into these new processes, not via a set of proposals, to be universally adopted by the provinces and paid for, in part, by federal largesse, but by opening up to the provinces the opportunity to participate through “coalitions of the willing”, involving a shared commitment by provinces and territories, along with stakeholders, medical institu-
tions and others to scale up innovations and make fundamental changes in incentives, culture, ac- countabilities and more. The initiative could make a meaningful difference to Canadian healthcare in the next 10 years.
As key to the upscaled innovation that is to come in Canadian healthcare, the panel is proposing a mighty agency, possibly at arm’s length from gov- ernment, which will play a leadership role in foster- ing the spread of new processes.
Now, as then, this panel lamented in its report,
“there is no logic to the existing payments and ac- countability silos. Healthcare remains disjointed, with poor coordination within and across the vari- ous professions, acute and chronic care institutions and community care.”
Stakeholders, said the panel, repeatedly cited frag- mented financing as a barrier to the spread of in- novative healthcare practices and an impediment to high quality, cost-effective care.
It is no wonder that it takes hard work to make improvements. For a modernized procedure to spread beyond the boundaries of its own unit, these are seemingly unsurmountable difficulties. Pioneer- ing health authorities deplored the situation for decades. It explains why Canada has fallen behind many of its peers in the western world in its health- care offerings.
For a nation currently cheered by the promise
that its new federal government will bring in “real change” the panel touches a chord. And the Naylor report, in a series of proposals that would, over a period of time bring Canadian healthcare practices up to modern-day standards, points the way.
Making distant villagersʼ dreams come true Local shops partnership offers craftsmen dignity and an honest living.
en and women around the world have a simple dream – to earn an honest living, to
provide for their children and to be gainfully em- ployed in a job that brings dignity and joy. Ten Thou- sand Villages can testify to this, having partnered with thousands of talented artisans in healthy business relationships.
The inspiration for our name came from a Ma- hatma Gandhi quote: “… India is not to be found in its few cities but in the 700,000 villages…we have hardly ever paused to in- quire if these folks receive sufficient to eat and clothe themselves with.” At Ten Thousand Villages, we believe that each village in the world rep- resents a unique and distinctive people, offering extraordinary products born of their rich cultures and traditions. Ten Thousand Villages began in 1946
friends and neighbours. The pieces be- came quite popular, and she soon added cross-stitch needlework from Palestinian refugees and hand-carved Haitian
Gwen Repeta Fair Trade
her inventory. In the early 1970s, the flourishing project moved out of Byler’s basement and became SELFHELP CRAFTS, an official MCC program. Thousands of loyal customers and vol- unteers have helped to build this program into the strong alternative trad- ing organization that, in 1996, became known as Ten Thousand Villages. Often referred to as
when Edna Ruth Byler, a Mennonite Central Committee worker, visited vol- unteers in Puerto Rico who were teach- ing sewing classes in an effort to help improve the lives of women living in poverty.
From this trip, Edna brought several pieces of embroidery home to sell to
“Fair Trade”,' our philosophy of help- ing to build a sustainable future is based on the principle that trade should have a conscience. Through Fair Trade, ar- tisans receive the respect, dignity and hope that come from working hard and earning fair value for their work. Stepping into a Ten Thousand Vil- lages store is a true sensory experience. You hear music from many lands, smell grasses and spices from far away places and taste coffee or tea from countries we dream about, all from small scale pro- ducers and farmers.
From handmade rugs crafted in Paki-
Gwen takes the time to visit with the rug artisans.
stan to blown glass pitchers and goblets from West Bank, hand-beaded jewellery or the many tasty varieties of chocolate, all products have their makers’ stories. Our volunteers share these stories with you, and the product becomes more than what you see, it becomes a way that an individual makes a difference in the world.
By choosing to purchase an item brought here through a Fair Trade busi- ness model you will have voted for an ethical business model and have affected change in people’s lives! Who knew you could change lives just from choosing how you spend your dollar?
In my column in the months ahead, I will tell you about some of these mak- ers. For example, the Bangladeshi wom- en who are making bed throws out of recycled saris. They were trained in this work to give them the means to support their children, instead of working in a red light district. Sales for the first train- ees went so well they called on women from a nearby village to help them fill their initial order In Winnipeg, Ten Thousand Villages outlets are located on Plaza Drive and Henderson Highway. Check out www. tenthousandvillages.ca
for a list of its 35 stores in Canada.
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