Canada is falling behind other rich countries in health care, new report warns

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A new report says Canada is lagging behind its peers on primary health-care spending and access to family doctors.

It concludes that Canada should emulate other countries with higher rates of patient-doctor placement to improve its health-care system.

“Health systems with strong primary care have better outcomes, lower costs and better equity,” the report states.

The study, published in the Canadian Medical Association Journal on Monday, compared Canada with nine other countries with similar health systems and where most people have reported having a regular health-care clinician or place to seek care, including the United Kingdom, Norway and Germany.

It found that countries with high rates of primary care attachment have stronger contracts and better accountability for doctors, and doctors are paid by capitation (where doctors are paid per unit of time per patient) or are salaried.

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It also found that fewer doctors in those countries work in walk-in clinics or specialized areas.

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Canada, however, spends less on health care than other rich countries, has fewer people training as family doctors and more graduating doctors are not practising in generalist, office-based care.

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Just over 90 per cent of Canadians have family doctors or use a regular clinic – but the nine countries used to evaluate Canada have 95 per cent placement or higher.

“In Finland, residents are automatically registered with the health centre that is closest to where they live,” the study reads, also noting that general practitioners are salaried and receive paid vacation and a pension.

General practitioners “also provide care in inpatient wards, long-term care, maternity and pediatric primary care clinics and schools,” in addition to working in their own clinics.

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A national program in Norway “ensures that all residents are automatically assigned,” while public officials notify British parents who haven’t registered their newborn with a nearby health centre six weeks after being born.

Around 4.6 million Canadians are without a family doctor, according to a 2019 report by Statistics Canada. In Ontario, 15 per cent of the population is without a family doctor, 2022 research released by Inspire Primary Health Care showed.

A 2022 Canadian Medical Association (CMA) report found that family physicians reported a higher rate of burnout than other medical or surgical specialists. And 62 per cent of family doctors said increased workload and lack of work-life balance negatively affected their mental health.

— with a file from Global’s Katie Dangerfield.

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