Dreaming of a bold and courageous health-care system for all

As we enter the holiday season, my wish for Canada’s health care system is that we strengthen the collaboration between physicians, health care organizations and the dedicated professionals working on the front lines. Every day, difficult decisions are made in hospitals, clinics and communities across the country. These decisions are not taken lightly. They are shaped by the expertise of doctors, the support of their organizations and the compassion of those who provide care directly to patients. My hope is that we continue to build a system where collaboration and trust guide us, ensuring that patients receive the best possible care and that health care workers feel supported in the vital work they do.

My fervent wish for our health-care system is one of courage: For our Chief Medical Officer of Health to declare that COVID-19 (and other respiratory infections) is airborne. Such a declaration is needed to compel safety changes for health-care facilities, workers and patients that would elevate our collective health a great deal. Such changes, which will not happen on their own, include effective regulations for better ventilation, and for effective use of personal protective equipment. We have all the science and tools we need. What we have been missing is the courage to act on what we already know.

In a nutshell, my vision for our health-care system is bold but achievable: to fully restore and fully fund our public system so every patient, resident and client receives the timely, high-quality care they deserve. This starts by making safe workplaces and safe staffing levels the foundation of care, not an afterthought. And it requires raising our voices – together – so the Ontario government hears that change cannot wait. Those who have seen the Ontario Nurses’ Association’s powerful “Code Black and Blue” campaign know the truth: violence has become a daily reality in health care. When we implement safe staffing, we protect nurses and patients, and we take a decisive step toward the system we all believe in – a public health-care system that supports our patients, residents and clients.

My one wish – which is not really for the health care system per se – is that society and governments recognize that the health-care system is really an illness and injury-care system, and that better health comes mainly from how we organize our society and communities socially, environmentally, culturally and economically. In the face of the mounting global polycrisis and declining state of planetary systems, we need to build our nation based on making peace with nature and becoming a Wellbeing Society committed to equitable health now and for future generations while remaining within planetary boundaries.

As to the health-care system, it needs to get behind the idea of a Wellbeing Society and push the issue hard, partly because done right a Wellbeing Society will have a lower burden of disease, mental health problems and injury, which takes a load off the health-care system, but mainly because better health is supposed to be what the health sector is all about. And as part of that, the health sector itself needs to commit to reducing its large ecological footprint and becoming a “One Planet” health system.

We need a better use of federal dollars, at least in Ontario. Premier Doug Ford has been underspending on health care for years. Meanwhile, he has diverted revenue streams to private entities (Shoppers Drug Mart, for example) and, according to the Auditor General, spent $112 million on advertisements. All while 2 million Ontarians are without family physicians and our province has had little success in improving family physician numbers.

In my hometown of Windsor, we have been waiting for a badly needed teaching hospital and trauma centre for at least 13 years (capital funding announced in 2012). It has been “in the works” for a decade prior. A completion date of 2030 is optimistic. Local access to diagnostic imaging and (emergency department) services is poor. Governance has failed us.

So, my wish is for a sweeping review of the health-care system at both the federal and provincial levels. We should be open to reviewing the Canada Health Act and asking “what does universality and accessibly mean in 2026? How can we entice provinces to embrace these tenets of the Canada Health Act?”

The current health care situation demands provinces and territories carry out systemic reviews of their infrastructure and delivery. Experts in medicine and health economics should identify strengths, weaknesses and opportunities for improvement in a transparent fashion. The goal must be to direct funding in a value for dollar setting. Perhaps an additional focus on health care will direct governments to improve funding where required. Health-care workers are an amazing and resilient lot – Ontario’s health-care pillar. We will erode their resilience if governments do not address infrastructure and staffing needs. A tsunami of seniors will soon be upon us – I fear we are grossly unprepared to meet their needs.

The best way to avoid the false promise of for-profit care is to build a system that cares for everyone. Fundamentally re-thinking primary care is a massive part of that. That will need not only new public money, but transformation of delivery. Team-based care should be the everyday, not the exception. And we need to take a population health approach, caring not just for individual patients, but neighbourhoods. We don’t need a Christmas miracle to make this happen, just a little imagination, some political support and a lot of hard work.

My health-care wish is that we see higher quality data to more definitely demonstrate the benefits of gender affirming care for young people with gender dysphoria. There is a massive political project that has sought to undermine the public’s confidence in this branch of medicine that has had a positive impact on the lives of young people, (a project) that has demonized care providers and the parents who love and support these children. These kids, like all kids, deserve the best chance to become happy and flourishing adults, and I still firmly believe that gender affirming care is going to provide the majority of them with the best chance of achieving that goal.

If I had one thing to wish for, I’d wish that people who were living rough had a place to stay that was supportive and had the resources they needed to access a better future. That would have a massive impact on their health because if you look at the life expectancy of people who struggle with homelessness, they die far earlier than people that have a home.

Similarly, on a system-wide level, I think timely access to care is also something that really needs to be improved in our health-care system.