Recommendations

RECOMMENDATION 1
That the committed annual increase in funding transferred from the federal government to the provinces and territories, through the Canada Health Transfer, be used by governments in great part to establish incentives for change that focus on transforming health-care systems in a manner that reflects the recommendations outlined in this report, and the overarching objectives of the 2004 10-Year Plan to Strengthen Health Care, including the need for measurable goals, timetables and annual public reporting through existing mechanisms.

RECOMMENDATION 2
That provinces and territories continue to develop strategies to address wait times in all areas of specialty care, as well as access to emergency services and long-term care, and report to their citizens on progress.

RECOMMENDATION 3
That the federal government work with provinces, territories and relevant health-care and research organizations to develop evidence-based pan-Canadian wait-time benchmarks for all areas of specialty care that start when the patient first seeks medical help.

RECOMMENDATION 4
That the federal government provide the Canadian Health Services Research Foundation291or the Canadian Institutes of Health Research with funding to:

RECOMMENDATION 5
That the Health Council of Canada examine best practices in reducing wait times across jurisdictions, through improvements in efficiency, focusing in particular on management practices such as pooling waitlists, the adoption of queuing theory and the development of referral guidelines and clinical support tools.

RECOMMENDATION 6
That the federal government work with provincial and territorial governments to develop a pan-Canadian vision statement that would foster a culture of patient-centred care in Canada through the establishment of guiding principles that would promote the inclusion of patient needs and perspectives in an integrated health-care-delivery process.

RECOMMENDATION 7
That the federal, provincial and territorial governments ensure accountability measures be built into the Canada Health Transfer agreement, to address the needs of disabled persons.

RECOMMENDATION 8
That the federal government take the lead in working with the provinces and territories to:
a) evaluate the impact of health-human-resource observatories in other jurisdictions;
b) conduct a feasibility study, and determine the benefit of establishing a pan-Canadian health-human-resource observatory and report on the findings.

RECOMMENDATION 9
That the Canadian Institutes of Health Information include linguistic variables in their collection of data related to health human resources and populations served by health-care systems across Canada.

RECOMMENDATION 10
That the federal government work with the provinces and territories and relevant health- care organizations to reduce inequities in health human resources, such as rural and remote health care, vulnerable populations, and Aboriginal communities.

RECOMMENDATION 11
That the federal government, through its Foreign Credential Recognition Program, take the lead in working with provincial and territorial jurisdictions and relevant stakeholders to accelerate their efforts to improve the assessment and recognition of the foreign qualifications of internationally educated health professionals and their full integration into Canadian health-care systems, in line with the principles, obligations and targets agreed upon in the Federal/Provincial/Territorial Pan-Canadian Framework for the Assessment and Recognition of Foreign Qualifications.

RECOMMENDATION 12
That the federal, provincial and territorial governments work with universities and colleges to increase inter-professional training of health-care practitioners to continue the development of multi-disciplinary health-care teams in Canada.

RECOMMENDATION 13
That the federal government work with provincial, territorial governments and other relevant stakeholders to develop indicators to measure the quality and consistency of home care, end-of-life care, and other continuing-care services across the country.

RECOMMENDATION 14
That where necessary, jurisdictions expand their public pharmaceutical coverage to drugs and supplies utilized by home-care recipients.

RECOMMENDATION 15
That the Mental Health Commission of Canada work with the home-care sector to identify ways to promote the integration of mental health and home-care services.

RECOMMENDATION 16
That Health Canada, taking the lead, work with provinces and territories to create and implement an awareness campaign for Canadians about the importance of planning end-of-life care.

RECOMMENDATION 17
That the federal government work with provincial and territorial governments to develop a pan-Canadian Homecare Strategy, which would include a focus on reducing the burdens faced by informal caregivers.

RECOMMENDATION 18
That the federal government work with the provinces and territories to increase access to palliative care as part of end-of-life health services in a broad range of settings, including residential hospices.

RECOMMENDATION 19
That the federal, provincial, and territorial governments develop and implement a strategy for continuing care in Canada, which would integrate home-, facility-based long-term, respite and palliative-care services fully within health-care systems. The strategy would establish clear targets 87
and indicators in relation to access, quality and integration of these services and would require governments to report regularly to Canadians on results.

RECOMMENDATION 20
That the federal, provincial and territorial governments share best practices in order to examine solutions to common challenges associated with primary-care reform, such as: the remuneration of health professionals; the establishment of management structures to guide primary-care reform; and the use of funding agreements linked to public health goals.

RECOMMENDATION 21
That the federal government work with the provinces and territories to re-establish the goal of ensuring that 50 per cent of Canadians have 24/7 access to multi-discliplinary health-care teams by 2014.

RECOMMENDATION 22
That the Government of Canada continue to invest in Canada Health Infoway Inc. to ensure the realization of a national system of interoperable electronic health records.

RECOMMENDATION 23
That Canada Health Infoway Inc. target its investments to:
a) projects aimed at upgrading existing components to meet national interoperability standards set by the organization; and
b) promoting the adoption of electronic medical records by health professionals in Canada, including working with stakeholders to identify effective incentives in this area.

RECOMMENDATION 24
That Canada Health Infoway Inc. work with provinces and territories and relevant stakeholders to:
a) establish a target that would outline when all existing components of the EHRs would be upgraded to meet national interoperability standards;
b) establish a target that would outline when at least 90 per cent of all physicians in Canada will have adopted electronic medical records;
c) ensure that electronic health-record systems are currently being designed and implemented in a way that would allow for secondary uses, such as health-system research and evaluation; and
d) develop a systematic reporting system in relation to access to tele-health services in Canada.

RECOMMENDATION 25
That the federal government work with provinces and territories to examine approaches to addressing differences in privacy laws across jurisdictions in relation to the collection, storage and use of health information.

RECOMMENDATION 26
Recognizing the ongoing unique challenges associated with health and health-care delivery in the North, that the federal government extend its funding of the Territorial Health System Sustainability Initiative beyond 2014 in a manner that is both sustainable and predictable.

RECOMMENDATION 27
That the Federal/Territorial (F/T) Assistant Deputy Ministers’ Working Group work with relevant stakeholders and communities to:
a) improve accountability measures to evaluate the performance of health-care systems in the North; and
b) address jurisdictional barriers as they relate to health-care delivery and addressing the broader social determinants of health, including potable water and decent housing.

RECOMMENDATION 28
That the federal government work with the provinces and territories to develop a national pharmacare program based on the principles of universal and equitable access for all Canadians; improved safety and appropriate use; cost controls to ensure value for money and sustainability; including a national catastrophic drug-coverage program and a national formulary.

RECOMMENDATION 29
That governments, acting together, work with private health-insurance companies to encourage their adoption of best practices in cost-containment strategies.

RECOMMENDATION 30
That Health Canada report on progress towards the development of a regulatory framework for expensive drugs for rare diseases as part of its annual performance report to Parliament.

RECOMMENDATION 31
That the Public Health Agency of Canada continue its efforts to renew the National Immunization Strategy, including the establishment of goals, objectives and targets.

RECOMMENDATION 32
That the federal government work with provincial and territorial, and municipal governments to develop a Pan-Canadian Public Health Strategy that prioritizes healthy living, obesity, injury prevention, mental health, and the reduction of health inequities among Canadians, with a particular focus on children, through the adoption of a population-health approach that centres on addressing the underlying social determinants of health.

RECOMMENDATION 33
That Health Canada, upon receipt of the Mental Health Commission report, use data developed on pan-Canadian child and youth mental-health issues to inform policy and program decisions relating to child and youth mental health.

RECOMMENDATION 34
That the federal government, taking the lead, work with provincial and territorial governments to establish a Canadian Health Innovation Fund to identify and implement innovative and best-practice models in health-care delivery, and the dissemination of these examples across the health system.

RECOMMENDATION 35
That the Canadian Institutes of Health Research provide an interim report in five years, evaluating the implementation and impact of its Strategy for Patient-Oriented Research, including its findings related to new primary-care models.

RECOMMENDATION 36
That Health Canada create a network between federally funded pan-Canadian health-research organisations and other interested stakeholders that would focus on identifying leading practices in health-care delivery, and work together to promote their dissemination in health-care systems across Canada.

RECOMMENDATION 37
That the federal government ensure ongoing funding dedicated towards health services and systems research, either through the Canadian Institutes of Health Research or the Canadian Health Services Research Foundation.90
RECOMMENDATION 38
That the federal government through Health Canada work with organizations such as the Canadian Patient Safety Institute to promote the development of health-quality council concepts.

RECOMMENDATION 39
That the Canadian Institute for Health Information work with provincial and territorial governments and relevant stakeholders to develop a pan-Canadian patient-centred comparable-health-indicator framework to measure the quality and performance of health- care systems in Canada.

RECOMMENDATION 40
That all governments put measures in place to ensure compliance with the Canada Health Act and more accountability to Canadians with respect to implementation of the Act.

RECOMMENDATION 41
That Health Canada work with provincial and territorial partners to ensure equitable access to programs and initiatives related to improving Aboriginal health.

RECOMMENDATION 42
That Health Canada work with provinces and territories to ensure that the design and delivery of its programs and initiatives meet the unique needs and culture of Inuit people.

RECOMMENDATION 43
That Health Canada work closely with provincial and territorial governments to ensure improvements in Aboriginal health through the federal, provincial and territorial multi-year funding agreements.

RECOMMENDATION 44
That the federal government work with Aboriginal communities to improve the delivery of health-care services in Canada, and deal specifically with removing jurisdictional barriers.

RECOMMENDATION 45
That Health Canada establish a working group with provincial and territorial partners and all national Aboriginal organizations to identify ways in which the role of Aboriginal organizations could be strengthened in the policy-making and development process.

RECOMMENDATION 46
That the federal government work with the provinces and territories to address the social determinants of health, with a priority focus on potable water, decent housing and educational needs.