Sunday, January 22, 2012

Canada’s Minister of Health calls for Innovation

Canada’s Minister of Health calls for Innovation

Late last week the Canadian Minister of Health Leona Aglukkaq wrote an open letter to her provincial counterparts proposing that it is time for greater collaboration to improve innovation and accountability in our collective health care system, including a better pan-Canadian approach for monitoring performance as a way to improve care and curb costs.
This is a concept that I would like to strongly get behind.  It is consistent with my personal philosophy of Quality Management.  It is consistent with my belief and commitment in national organizations such as the Canadian Standards Association, the Standards Council of Canada, and the Canadian General Standards Board.  It is consistent with my annual hosting of medical laboratory Quality seminars. 

It is also a total waste of time.

The problems of Canadian health are unsolvable for another 50 years, at least.  It is not the way it should be, but it is the way it is.  It is the product of bad luck, bad decision making and bad design.

We are not the only country that decentralized health at the time of carving up jurisdiction and responsibility.  The United States and Australia took a similar approach.  But when it came to global issues, in particular Quality, Canada stands alone at refusing to develop a structure for comprehensive national approach to Health and Quality.  One the federal side, the government sits and waits to be “allowed” to become engaged, knowing with the full confidence that the provinces will never engage in constitutional reform. On the provincial side, our provinces hold on to their jurisdictions more like fiefdoms.  Health is a mechanism that results in transfer of federal money to the provinces, and anything that could put that in jeopardy would be dead in the water.

Private and public organizations understand that our provinces do not cooperate with the federal government and they refuse to get along with or trade with each other or with any common external agency.

And so we sit.

I think there is a solution that might start the process of moving forward.  It replaces the idea of giving up with the idea of taking small baby steps.  Rather than shoot for the moon for a pan-Canadian approach, perhaps pan-Regionalism might be less threatening.  More like a series of mini-unions of comparables, such as a pan-Atlantic Quality Assurance Program and a pan-Prairie Quality Assurance Program to go along with a Quebec Program and an Ontario Program and a BC Program, with the Territories participating along with the provinces. 

There could be several advantages.  Canada has too many provinces with low population that cannot afford to set up and operate functional Quality Assurance.  For the programs that are currently working it would increase their access to personnel for improved audit timetables and decrease their costs.  In time a national board of the 5 parties could meet, and perhaps develop a common philosophy and code of standards.  Sometime down the road the party of 5 could unite. 

Personally I think that this is a poor approach, but on the other hand Leona Aglukkaq’s hoping for a provincial initiative on pan-Canadiana is a waste of time.  At least a five-Region strategy could be step forward.  A tiny, but constructive step forward. 

Either that or just forget all that amending formula stuff (nobody really cares anyways) override the constitution and change the law..

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