Linda Silas is President of the Canadian Federation of Nurses Unions.
As a nurse who has practiced for many years and now has the honour to sit at many policy tables, I am confident that, when others read this excellent report from the Health Council of Canada (HCC), they also will ask themselves: “Haven't we learned anything in the last decade or two?” The HCC report, Better health, better care, better value for all, remains positive while it highlights a decade of disappointing results. Despite many unimplemented recommendations, in its latest report the Health Council still urges us to find an explicit vision of what we want to achieve.
It reminds us that the recent focus on quality, safety and a cost-effective health system go back to the Kirby and Romanow reports and the promises in the 2003 Health Accord. What the Health Council of Canada politely omits is that it is all about politics, or should I say, it is all about politicians. While the evidence and recommendations are abundant, well thought out and achievable, these publicly funded tomes are left to gather dust because they don't fit the political agenda of the day.
Canadians want a focus on health care. We know there are things we could be doing to make improvements, but as soon as the ballots are counted the promises are quickly broken. To go from the original 50-50 split in cost-sharing to the federal government paying 11 or 12 percent by 2016 sends a clear negative message. The Federal Government is effectively saying to provinces: “This is your problem to solve.” Unfortunately, Canadians are the ones suffering as the response of most provinces and territories proves less than inspired, choosing to revert back to what resembles the early 1990s.
Canadians have to speak out or we will lose universality in health care. We need to control waste, to stop unnecessary testing and to contain the cost of prescription drugs. We need to move beyond a boom-and-bust approach to planning, and to manage our human resources with a more comprehensive approach.
The Canadian Nurses Association's Expert Commission from June 2011 reminded us: “Above all do no harm. Safe, high-quality health care and services should be a national goal.”
The Commissioners also said that nurses are a key link in the chain of safety and must be leaders in developing and sustaining a comprehensive national commitment to safety and quality in health care and services.
My organization, the Canadian Federation of Nurses Unions, in a recent research paper by Dr. Lois Berry, has highlighted the link between quality care and safe staffing:
“Nurses are the largest health professional group in the health system. They are well-educated, highly skilled, and positively regarded by the patients and families they serve. And yet they continue to practice in systems that do not engage their expertise in making decisions about patient care, or how nurses should be assigned to provide that care. The system lacks the nimbleness to adjust available nursing hours to changes in patient acuity, and the political will to create systems that acknowledge that matching nurse staffing levels to patient needs saves lives.”
Nurses deliver more care than any other group in the health system. Politicians would do well to listen to experienced voices from the front line and stop ignoring evidence-based recommendations we all pay for. The loss of the Health Council of Canada will be felt for many years to come. Without the political will to implement positive recommendations, nothing will change.