As hospitals strain under the burden of record-high numbers of COVID-19 patients, two former health ministers warn that there is no silver bullet that can reform the health-care system and safeguard it for the long run.
“People always want to have a quick single solution to a complex problem,” former federal health minister Jane Philpott said in a panel interview on CBC’s The House, which aired Saturday. “There is not a single thing that will fix the whole picture.”
“Spending more money to do a lot of things the same way that we’ve always done them” will not fix structural issues with resource allocation and the workforce, added Fred Horne, a former Alberta health minister.
The stresses of COVID-19 hospitalizations, driven by the current wave of infections, are being felt acutely across the country, including in Quebec.
19:29How can this country fix a health care system under pressure?
A Montreal ER nurse shares some of the stress on the hospital frontlines, and former health ministers Jane Philpott and Fred Horne talk about how to reform Canada’s health care system. 19:29
In Montreal, ER nurse Marie-Pier says she worries that cratering morale could lead to a collapse in the hospital system. CBC News is using only her first name because she fears disciplinary action for speaking out.
“My biggest concern is that I am mostly scared that we’re just going to crumble and literally have nurses stop working, people stop working period, or completely change profession because it’s too much,” she told host Chris Hall.
She said health-care workers are exhausted, and while many try to keep working and push through, sometimes they simply burn out because of stress and fatigue after several waves of the pandemic.
“Out of nowhere, we just fall.”
Marie-Pier said steps such as increasing pay, reducing forced overtime and creating better overall conditions would help to bring workers back into the health-care system.
“It’s a beautiful job. I love to care for people just to help people to feel better and to be able to see them rise and leave the hospital after,” she said.
Hospitals under stress across country
Similar workforce and resource strains are being felt across the country, prompting questions once more on how the health-care system, which experts say can be overwhelmed during a normal flu season, can be reinforced and reformed for the long term.
“Most Canadians would agree that even before COVID-19, our capacity was often stretched too thin,” federal Health Minister Jean-Yves Duclos said earlier this month.
A key question in the debate over a potential solution is the role of the federal government. Over the past two years, provinces have consistently asked for Ottawa to boost its health-care transfer to provinces — up to 35 per cent of costs versus the current 22 per cent.
Prime Minister Justin Trudeau, right, and Health Minister Jean-Yves Duclos. Trudeau has said he is open to discussing federal health transfers once the pandemic ends. (Justin Tang/The Canadian Press)
Prime Minister Justin Trudeau has said he is open to renegotiating the transfer system once the pandemic is over.
“I think that it’s a good time for the federal government to exert itself more strongly in the health space, and we do need more investments,” said Philpott, who served as federal health minister from 2015 to 2017.
But she cautioned that there is a need for other reform as well, because “you can’t keep throwing more money at doing things the same way we’ve always done.
“People know how much care is needed in hospitals, but we also need to spend in places like home care and mental health and primary care,” she added.
Former federal health minister Jane Philpott says greater federal involvement in health care is just one part of the long-term solution. (Adrian Wyld/The Canadian Press)
Changes to support the workforce, such as allowing easier movement of workers from province to province and more efficient assignments of physicians versus nurses or general practitioners, would also help, Philpott said.
“There are very few provinces that have a really good workforce plan, and there is no existence of a national health workforce plan. So that would be an area that I would put a lot of attention to if I were a federal minister.”
Horne, who served as provincial health minister in Alberta from 2011 to 2014, said transformational change of the type that’s needed “takes a lot longer than one political cycle or one budget cycle.”
Privatization debate a ‘red herring,’ Philpott says
Both former ministers expressed skepticism that the debate over private health care was a fruitful one.
“I think the whole issue of public-private [care] is highly misunderstood and can often be used as a red herring,” Philpott said. There is a great deal of private delivery already built into the system, she said, and the concern should be making sure privately paid systems don’t disrupt access to care for all.
Former Alberta health minister Fred Horne says it’s difficult for ministers to accomplish systemic reform in one electoral cycle. (CBC)
Horne said that during his time in office, private delivery of publicly insured services had not been a “huge issue” in his conversations.
“In fact, [people] were expecting us to make best use of the public funds — and that includes, you know, partnerships with the private sector and industry as appropriate,” he said.
Philpott said that “we’re actually starting to see some good things happening behind the scenes,” such as a national data health plan, but to push forward requires strong collaboration between levels of government.
Horne said his advice to health ministers now is to focus on accomplishing things that will survive their tenure as head of the system.
VANCOUVER – Contract negotiations resume today in Vancouver in a labour dispute that has paralyzed container cargo shipping at British Columbia’s ports since Monday.
The BC Maritime Employers Association and International Longshore and Warehouse Union Local 514 are scheduled to meet for the next three days in mediated talks to try to break a deadlock in negotiations.
The union, which represents more than 700 longshore supervisors at ports, including Vancouver, Prince Rupert and Nanaimo, has been without a contract since March last year.
The latest talks come after employers locked out workers in response to what it said was “strike activity” by union members.
The start of the lockout was then followed by several days of no engagement between the two parties, prompting federal Labour Minister Steven MacKinnon to speak with leaders on both sides, asking them to restart talks.
MacKinnon had said that the talks were “progressing at an insufficient pace, indicating a concerning absence of urgency from the parties involved” — a sentiment echoed by several business groups across Canada.
In a joint letter, more than 100 organizations, including the Canadian Chamber of Commerce, Business Council of Canada and associations representing industries from automotive and fertilizer to retail and mining, urged the government to do whatever it takes to end the work stoppage.
“While we acknowledge efforts to continue with mediation, parties have not been able to come to a negotiated agreement,” the letter says. “So, the federal government must take decisive action, using every tool at its disposal to resolve this dispute and limit the damage caused by this disruption.
“We simply cannot afford to once again put Canadian businesses at risk, which in turn puts Canadian livelihoods at risk.”
In the meantime, the union says it has filed a complaint to the Canada Industrial Relations Board against the employers, alleging the association threatened to pull existing conditions out of the last contract in direct contact with its members.
“The BCMEA is trying to undermine the union by attempting to turn members against its democratically elected leadership and bargaining committee — despite the fact that the BCMEA knows full well we received a 96 per cent mandate to take job action if needed,” union president Frank Morena said in a statement.
The employers have responded by calling the complaint “another meritless claim,” adding the final offer to the union that includes a 19.2 per cent wage increase over a four-year term remains on the table.
“The final offer has been on the table for over a week and represents a fair and balanced proposal for employees, and if accepted would end this dispute,” the employers’ statement says. “The offer does not require any concessions from the union.”
The union says the offer does not address the key issue of staffing requirement at the terminals as the port introduces more automation to cargo loading and unloading, which could potentially require fewer workers to operate than older systems.
The Port of Vancouver is the largest in Canada and has seen a number of labour disruptions, including two instances involving the rail and grain storage sectors earlier this year.
A 13-day strike by another group of workers at the port last year resulted in the disruption of a significant amount of shipping and trade.
This report by The Canadian Press was first published Nov. 9, 2024.
The Royal Canadian Legion says a new partnership with e-commerce giant Amazon is helping boost its veterans’ fund, and will hopefully expand its donor base in the digital world.
Since the Oct. 25 launch of its Amazon.ca storefront, the legion says it has received nearly 10,000 orders for poppies.
Online shoppers can order lapel poppies on Amazon in exchange for donations or buy items such as “We Remember” lawn signs, Remembrance Day pins and other accessories, with all proceeds going to the legion’s Poppy Trust Fund for Canadian veterans and their families.
Nujma Bond, the legion’s national spokesperson, said the organization sees this move as keeping up with modern purchasing habits.
“As the world around us evolves we have been looking at different ways to distribute poppies and to make it easier for people to access them,” she said in an interview.
“This is definitely a way to reach a wider number of Canadians of all ages. And certainly younger Canadians are much more active on the web, on social media in general, so we’re also engaging in that way.”
Al Plume, a member of a legion branch in Trenton, Ont., said the online store can also help with outreach to veterans who are far from home.
“For veterans that are overseas and are away, (or) can’t get to a store they can order them online, it’s Amazon.” Plume said.
Plume spent 35 years in the military with the Royal Engineers, and retired eight years ago. He said making sure veterans are looked after is his passion.
“I’ve seen the struggles that our veterans have had with Veterans Affairs … and that’s why I got involved, with making sure that the people get to them and help the veterans with their paperwork.”
But the message about the Amazon storefront didn’t appear to reach all of the legion’s locations, with volunteers at Branch 179 on Vancouver’s Commercial Drive saying they hadn’t heard about the online push.
Holly Paddon, the branch’s poppy campaign co-ordinator and bartender, said the Amazon partnership never came up in meetings with other legion volunteers and officials.
“I work at the legion, I work with the Vancouver poppy office and I go to the meetings for the Vancouver poppy campaign — which includes all the legions in Vancouver — and not once has this been mentioned,” she said.
Paddon said the initiative is a great idea, but she would like to have known more about it.
The legion also sells a larger collection of items at poppystore.ca.
This report by The Canadian Press was first published Nov. 9, 2024.
