The government spends too much on health care relative to its GDP, and the volume of health care services is declining. This is stated in black and white in the report by the commissioner health and well-being (CSBE), released on Thursday.
During the period analyzed, from 2015 to 2023, “the average growth in public spending on health and social services was higher than that of the government’s consolidated revenues and GDP.” The report notes that during this period, “the volume of services per capita in the main health service sectors has declined, and, in general, access to services has not improved.”
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The report notes that human resources are insufficient and physical resources are aging. It states that, to ensure the sustainability of the health and social services system, profound organizational transformations are needed “while the budget allocated to it is constrained by the rate of GDP growth.”
The document emphasizes that the challenges facing the healthcare system stem primarily from organizational issues and budgetary constraints, while healthcare professionals work tirelessly in a context of resource shortages to provide care to the population.
“Have we hit the dreaded wall?” writes Joanne Castonguay, CSBE, in the report. “While the creation of Santé Québec and the reorganization of the Ministry of Health and Social Services (MSSS) demonstrate a commitment to efficiency, our analyses suggest that the system’s long-term viability remains fragile. Budgetary constraints, without changes to the organization of services, limit the network’s ability to continue meeting needs.”
Castonguay adds that the system is still “too hospital-centered, ill-equipped for prevention, and insufficiently aligned with other stakeholders—community, municipal, and social—who influence health and well-being on a daily basis.”
The commissioner does not question that stakeholders share the same goal, namely not only to focus on treating diseases but to improve the health and well-being of the entire population. She notes that this vision is increasingly reflected in public policy directions.
The Commissioner advises the government to undertake three key initiatives. First, to intensify the shift toward population health. To do so, she suggests rebalancing resource allocation in favor of health promotion and prevention, as well as community-based care. She also calls for efforts to improve support for marginalized populations and reduce health inequities.
Second, the value generated by the healthcare system must be increased to meet the population’s needs. Castonguay recommends that the government, among other things, strengthen services that maintain independence and prioritize investments that directly improve the population’s experience in navigating care and services.
Third, the system’s decisions must be more transparent. In this regard, the CSBE recommends that the MSSS document the criteria used to guide decision-making. She also recommends “simplifying and clarifying existing policies, clarifying the existing portfolio of public policies, and ensuring that any new policy takes into account what is already underway.”
“The public wants ‘accessible, user-friendly, continuous, and compassionate care,’” the report states. However, citizens are largely dissatisfied “with the accessibility and user-friendliness of organizational processes, as well as the continuity of care and services, despite a positive perception of the compassionate nature of care.” The Commissioner warns that “this disconnect” risks undermining people’s trust in the healthcare system.
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The Canadian Press’s health coverage is supported by a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content.
–This report by La Presse Canadienne was translated by CityNews
