Agency releases snapshot of national health care system – with notable gaps

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Canada’s health information agency has released its first snapshot of the national data available to begin assessing a federal health care plan unveiled earlier this year – but Quebec’s figures are conspicuously absent from the effort.

The province’s refusal to participate in the new Canadian Institute for Health Information report, published Wednesday, underscores the fact that the jurisdiction is the only one that hasn’t signed a bilateral health care deal with Ottawa.

While negotiations continue between the federal and Quebec governments, CIHI had to settle for gathering existing data from the other provinces and territories to serve as a rough starting point for the national health system performance data it plans to produce on four priority topics, including primary care and mental-health care.

“At CIHI, we’ve had excellent working relationships with Quebec and are able to include Quebec in many reports that we do,” said Kathleen Morris, the agency’s vice-president for research and analysis. “In this particular instance, because Quebec has yet to sign the agreement, they’ve asked to be excluded from this report, but it’s entirely possible that they could be part of future reporting.”

The new CIHI report stems from a health care funding offer that Prime Minister Justin Trudeau extended to the premiers in February. The federal government proposed sending a total of $196-billion to the provinces and territories earmarked for health over the next decade, a figure which included $25-billion for bespoke agreements tailored to the needs of each province and a $2-billion unconditional top-up to the Canada Health Transfer this year.

In return, Ottawa asked the provinces and territories to commit to giving patients better access to their own digital medical records and to significantly improving health-system data collection.

Ottawa is “confident” a deal in principle can be achieved with Quebec as has been the case with every other province and territory, according to Guillaume Bertrand, a spokesperson for federal Health Minister Mark Holland, who took over the portfolio in last week’s cabinet shuffle.

Meanwhile, Antoine de la Durantaye, a spokesperson for Quebec Health Minister Christian Dubé, emphasized in a statement that health falls under provincial jurisdiction and that Quebec already has an online dashboard that makes data about its health system available.

The CIHI report provided a snapshot of data in four priority areas: expanding access to primary care; increasing the supply of health workers and decreasing backlogs in care; improving access to mental-health and substance-use services; and modernizing health information systems.

As an example, the report included Statistics Canada data, based on surveys conducted between 2019 and 2021, that show 88 per cent of Canadians report having regular access to a primary care provider, usually a family doctor or nurse practitioner.

It also showed that half of Canadians who required community mental-health counselling received a first appointment in less than a month, but data for that metric wasn’t available for Prince Edward Island, Quebec, Ontario and Nunavut – meaning well over half the national population was excluded.

As Ms. Morris of CIHI emphasized, Wednesday’s report is only a starting point. In the months ahead, CIHI, along with other health-system partners, will determine what additional data should be collected.

Separately, the Council of Canadian Academies, a non-profit organization that convenes expert panels on thorny scientific questions of public interest, is working on a report about health data sharing that is expected to be published later this year.

Chaim Bell, chair of the CCA’s expert panel on data sharing and the physician-in-chief at Sinai Health in Toronto, said CIHI already produces great national information in some areas, particularly hospital use. However, he said the health system often falls short in capturing what happens to patients as they transition to rehabilitation facilities, long-term care homes and other care in the community.

“Where do people fall through those proverbial cracks and how can we patch up those cracks?” Dr. Bell said. “By not having this totality of data, we really miss that opportunity.”

Editor’s note: The headline in an earlier version of this article incorrectly referred to the Canadian Institute for Health Information as a federal agency. In fact, CIHI is an independent not-for-profit organization. This version has been corrected.

With reports from Tu Thanh Ha and The Canadian Press