Senator Kirby on health care

Senator Michael J. L. Kirby presented a lecture entitled “Impediments to the Reform of the Health Care System” at the Faculty of Medicine on Mon., May 12. The Chair of the Standing Senate Committee on Social Affairs, Science and Technology said major changes to the health care system are needed in order for it to be sustainable in the future.


“The industry of health care must be judged like any other industry in Canada… on it’s delivery of services in the right quantity at the right time,” he said. “Although health care is a publicly-funded industry, it is not absolved of the responsibility to provide services as efficiently and effectively as possible. In fact, it should be more so because it is entrusted with the public’s money.”


Kirby stated that future health care needs are difficult to predict, and hence provision currently. He recommended that the scope of medical practitioners’ activities be evaluated nationwide and modified to deliver the right level of service to patients, and that standards be established to evaluate the productivity of health care providers and the industry as a whole.


“In every other industry, new knowledge and technology has greatly increased productivity of workers for the past 20 years,” he said. “Better knowledge and technology must have made physicians more productive, but the sad fact is that health care does not have an effective measure of productivity, and no means to evaluate the health care industry as a whole.”


Kirby also criticized provinces and the federal government for inefficient health care spending where provinces only receive funding increases when labour demands more resources and better pay, which he says keeps up to two-thirds of any new funding from reaching patients. He stated that the influence of health care providers, particularly doctors, in government decision processes also hampers reform.


“The committee concluded that continuing government micromanagement of health care would make reform of the health care system impossible,” he said. “Top-down control stifles rather than encourages fundamental change.”


One of the committee’s recommendations was to organize health care providers into multidisciplinary units that would both provide more integrated patient care and provide health care professionals with more challenging and rewarding work. Kirby stated that such a proposal also requires health care providers to get paid on a per patient rather than a per incident basis, something tried but not widely adopted in Ontario.

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