Anthony Dale is president and chief executive officer of the Ontario Hospital Association.
Over the past three decades, Ontario hospitals have become highly efficient, improving the quality of, and access to, patient care, while increasing transparency and mobilizing like never before in response to the COVID pandemic. Now, Ontario continues to spend the least per capita in the country on hospitals while producing some of the best results when it comes to quality and access.
As we look to the future, though, it’s clear that we have reached a critical turning point. Ontario’s health system is grappling with high inflation, rapid population growth, increasingly complex health needs and huge pressures on its existing capacity.
If we insist on sticking with the status quo, our public health care system will not be able to cope. Addressing this crisis requires a clear understanding of the future burden of disease in Ontario and its impact on the system.
Last year, the Health Foundation, a British health-policy think tank, released a study called “Health in 2040: Projected patterns of illness in England.” It reported that the number of people living with major illnesses in England is projected to increase by 39 per cent – more than a third – by 2040. This is more than 3.5 times the rate at which the working population is expected to grow.
The hospital sector is working to identify this same projected burden of disease in Ontario. Once this is completed and health-system partners better understand our future capacity needs, we must be prepared to find creative and innovative ways to address them.
Effective health care systems aren’t only driven by today’s efficiency and output. They also embrace change with an eye on the future, and by investing in new ways to improve their effectiveness. This is a balancing act based on stable funding and planning for capacity. But it’s also critical to have dedicated funding for innovation. That’s how we drive system change.
Innovation can help create a future with less disease, better treatment and universal access to care. Hospitals are already working toward this goal. It’s within reach.
Biomedical and technological innovation has led to significant clinical improvements. It’s also delivered cost savings, and at times improved the way we deliver health care. Laparoscopic surgery, mRNA vaccines and advanced medical imaging have transformed health care as we know it today. More recently, artificial intelligence, gene therapy and personalized medicine are demonstrating astonishing potential.
We must also change the way we plan, fund and co-ordinate health services. We shouldn’t be afraid to embrace value-based care and funding that promote the best outcomes and collaboration. We have a significant opportunity to establish new revenue sources for our hospitals through the commercialization of new approaches to care.
The population of Ontario is expected to increase by three million people over the next 10 years, and we already know that Ontarians will be living longer with more chronic health conditions. We need to do more in implementing evidence-based public-health and social programming efforts aimed at disease prevention. We already know that we can better manage chronic disease and reduce the costs associated with preventable illness – all leading to greater quality of life for Ontarians.
Addressing the core reasons why people get sick and need health care in the first place is essential. We need a stronger system of primary care where everyone has access to team-based care. Decision making needs to be decentralized and health providers need some freedom to take risks, experiment and integrate health and social services at the local level.
Ontario’s hospitals are already embracing change – they are Canada’s engine room for health research and innovation. Building on this tremendous capability, we must continue to adapt and create new tools, resources and approaches to help our dedicated health care workers meet the needs of patients and clients.
Hospitals and other health care organizations also need far more financial and operational certainty than they have today, so they can continue to provide bedrock services to their communities. Health care in Canada is already a hybrid of public and some private services, and more thoughtful integration of private services that complement but don’t compromise universal public health care should be part of the solution.
Accountability and transparency are cornerstone values of Ontario’s hospitals. Over the past few decades, hospitals have consistently supported the introduction of new accountability measures to enhance quality of care and patient safety. The private sector must also be subject to the same standards of transparency and accountability if it is to play a larger role in our health system.
Health care is vital. But that doesn’t mean we should shelter it from change. As we face the challenge and responsibility of providing health services for a growing and changing province, now is the time to be ambitious, embrace innovation and unlock our incredible potential.
The future of universal health care in Ontario depends on it.