Ottawa’s role in advancing PHC

January 2016   Comments

We invited Lisa Ashley to speak about what the federal government can and should do to advance primary health care in Canada. As part of her work as one of CNA’s senior nurse advisors, she advocates for healthy public policy.

There are challenges to moving a primary health care (PHC) approach forward in Canada. Health-care funding and accountability are imbalanced, with an overemphasis on illness-based, treatment-focused and biomedically driven care and little attention to broader, comprehensive approaches to health promotion and chronic disease prevention and management, including patient self-care.

The federal government has an essential role to play in realigning health and social policy and resources to promote health, prevent disease and support wellness to strengthen Canada’s publicly funded, not-for-profit health system. The new Liberal government has a unique opportunity to work with its provincial and territorial partners on addressing several challenges.

Health-care needs of Canadians are becoming increasingly complex. We need a strong nursing workforce to advance a PHC approach. While the central role of RNs and NPs in PHC interventions is becoming better understood, some health-care providers are reluctant to embrace promising advances in interprofessional practice.

Epidemiological data about population health program planning is sparse and insufficient to effectively inform PHC programming, reach and evaluation.

Demographics are changing in Canada. We are living longer with more chronic diseases, which further burden our health-care system. Seniors are the most vulnerable to poverty and have the highest demands for home, community and acute care services. There is a shortage of community-based care and lack of government support for informal caregivers.

However, these challenges can be overcome.

Sustainable health care requires universal access to quality health services that are adequately resourced (financial, human and material) and delivered along the full continuum of care in a timely and cost-effective manner. For First Nations and Inuit communities to achieve similar health levels as other people in Canada, the government must fulfil its responsibility to ensure health services are available and accessible.

By taking a Health in All Policies approach, our population’s health and well-being would improve. And better health promotes economic growth, productivity and prosperity; helps children do well in school; and allows citizens to be more engaged in their communities. A healthy population also requires fewer social supports and health-care interventions.

Ottawa needs to support collaborative strategies among the various sectors — strategies that emphasize social justice and health equity, and recognize the role of the social determinants of health in shaping health at the individual, community and population level.

The government must lead strategies that provide seniors with comprehensive health care by redirecting health funding to preventive health-care services and programs, including investing in our public health workforce.

Patients must be at the centre of health care, with seamless access to care based on their changing needs. The government can support health-care reform with a focus on home- and community-based services, emphasizing interprofessional collaborative models of care.

Ottawa needs to invest in PHC research, innovation and knowledge translation. Specifically, it needs to implement federal interventions and national standards to guide the planning, organization and evaluation of policy and health services. Such standards would guide provincial and territorial governments and relevant stakeholders in developing a pan-Canadian PHC framework, which would serve as the basis for measuring and reporting on the performance of Canada’s health-care systems.

To read CNA’s revised PHC position statement, go to Policy Support Tools under Advocacy at

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