By Kerry Gibson, Health Convenor

With the cabinet shuffle in the federal government came a new Minister of Health, Mark Holland. Other than a brief stint at the Heart and Stroke Foundation, Minister Holland is a career politician with no significant experience in health care. However, he is seen by recently consulted ministerial colleagues as ambitious, less risk-adverse than his predecessors, and a bit of a bulldog which could potentially be beneficial in setting Canada’s health care system back on track…at least until the next election cycle.

Babylon/Telus, Amwell, and Teledoc (Canada’s top three virtual care providers) continue to lay off employees and show significant losses in the past year as their limited technological offerings fail to live up to quality-of-care standards. The tech companies that do seem to be growing favourably are the ones that offer peripheral products/services to support telemedicine such as system management software, medical personnel agencies, and translation services. However, between venture capital investment flatlining and internal technological capabilities failing to meet compliancy and quality, these start-ups will not have the necessary market or funding to succeed without intervention or a shift in economic climates.

PEI just announced free tuition for licensed practical nursing, paramedicine, and resident care worker students with a two-year return-of-service agreement. BC does offer limited paid employer-sponsored health care assistant/support worker training with no prior experience in the field, but the program has not expanded to include advanced levels of medical training, which does not address the shortfall in medical professionals.

MAID (Medical Assistance in Dying) continues to be a topic in the press as health care and social work professionals are being called out for recommending the program to veterans and persons with disabilities as a “viable option” to resolving care and pain concerns. Registration into the program of persons with disabilities has been alarmingly high, as people have lost hope in any quality of life without the care they require. Young mother and quadriplegic/diabetic Rose Finlay registered for the program in protest to being informed that her care support application would take eight months to be assessed. Her struggles have received national attention, with no results other than qualifying to end her life in record time instead of receiving medical support for a set-back in her health. Prior to her current health crisis, Rose lived independently and without financial support, running her own company. With care, she would be able to return to the quality of life she previously enjoyed.

By Kerry Gibson, Health Convenor

Current inflation and market instability will have dire long-term consequences for health tech innovation and private sector plays that the Canadian health industry relies on since investors are pulling back. This will also affect NGOs in the health and social services fields as funders are favouring a more conservative approach. The pandemic created extraordinary interest in investment into health care. However, much of that investment was pushed into hype stock rather than strategic investments with longevity. Many tech companies that had large raises did not yet have a proven technology, but were operating as a lucrative pump and dump investment scheme. Now, with markedly reduced investment overall, and with women-led companies only receiving 1% of investment funding, health care and research for women is going to fall even further behind.

The conversation and controversy regarding privatization of health care continues as Ontario passes Bill 60, which theoretically uses private clinic capacity for publicly funded procedures. Certain allowances have already been made in BC and Quebec, and Alberta is considering how much private involvement to allow in the public sector. However, BC is already having second thoughts as the private entities are upselling creating an inequitable service rather than a universal one. The need for additional capacity is indisputable, but stringent policy, process, and procedural regulations must be piloted particularly to protect marginalized, remote, and lower-income populations.

BC is known for its innovation of creative solutions, but the bureaucracy disallows BC born companies to thrive locally and pushing the intellectual property, manufacturing, and distribution out of Canada to more welcoming economies. For instance, a Richmond-based company announced its new health care robot that is designed to do menial tasks in a hospital (sanitize, take out the garbage, deliver supplies, provide security, etc.), but with a $200,000 price tag, it is unlikely that Canadian health care staff will benefit from this technology. The provincial government might want to reconsider the terms and boundaries of public private partnerships (the current regulations are onerous and prohibitive) in order to welcome pilots for Made in BC innovation to be used as a proof of concept for local hospitals and clinics, benefitting both the company and its public partner.

By Kerry Gibson, Health Convenor

The Covid-19 Pandemic has shown us, once again, that crisis breeds innovation. The crisis is not only demonstrated by the virus, but in the systemic issues pre-existing in our health care infrastructure that were so greatly exposed under such stressors. However, the innovation that resulted may indeed be our pathway forward in building a more resilient system; innovation in thought, policy, process, and technology.

Dr. Ronald Wyatt, for instance, has been making headway highlighting the issue of and closing the gaps on institutional racism throughout the United States. His medical expertise, and that of his professional peers and researchers are bringing to the attention of the medical establishment the specific health needs and concerns of persons of colour, and the need to focus research spending in order to provide effective treatment. Also, his work has shown the impact racism plays on these demographics through discriminatory care. This type of work and research could be invaluable in a Canadian context whether borrowing the research for further development or expanding upon it particularly in the Indigenous context if the government is truly sincere about Truth and Reconciliation in more than virtue signaling but creating true change.

The United States has recently trended to the adoption of Food RX or Food as Medicine as a vital factor in preventative care propositions, financially supported by government, Medicare, and Medicaid initiatives. Canada has a vital agricultural industry, however food distribution is inequitable, resulting in remote communities unable to benefit from the same nutritional knowledge and access as urban centres. Therefore, greater investment in local and traditional food systems growth should be a key budget consideration for health care investment. This would also include a review of colonialist laws that prohibit Indigenous populations from benefitting from traditional fish and game harvests. The “catch a fish, eat a fish” legalities prohibit able harvesters from providing nutritional opportunities to the greater community through food banks, school and elders programs, and local hospitals that would benefit from a minimization of processed options. Regions such as Quebec have already made exceptions and are evaluating an evolution of legislation on hunting, processing, and distribution. The US SNAP program (food stamps) is even working with private partners such as InstaCart to not only enable persons with limited access to nutritious food the ability to pay through government credits or medical programs, and also these sites have registered nutritionists that create shopping lists for specific conditions where the patient can access the InstaCart app, click on either a “prescribed” shopping list from their physician or a list associated with their diagnosis (ie., Diabetes, heart disease, etc.) and the list will be auto-ordered, delivered quickly, and covered by the appropriate government program.

Although the Canadian Federal Government has pitched a CAD $46 Billion ten year health care investment proposal, the concern is distribution and allocation processes as well as the dire need to restructure Health Canada and other bureaucratic agencies that would allow more effective methods and means to be introduced from outside Canada or even private entities within Canada that would allow the alignment of Canada’s one-tier health care system with improved systems and tools that would ease the strain on traditional structures. For instance, the paramedicine program introduced on Vancouver Island in 2016 has shown great results with zero growth. With additional tools such as ZiphyKits and RPM technology and a province wide expansion, particularly given that paramedics across BC have been repositioning themselves for more lucrative opportunities, the government could re-engage that lost talent into full-time paramedicine, ease the burden on hospitals and clinics, reduce cost from readmission (or preventable admission), decrease overhead, increase cultural relevancy, and a multitude of other factors that would create a more equitable health care system at a reduced cost. Strategic investment would then allow time to build in other areas, such as medical student recruitment and retention, northern health care initiatives, and legislative advancements that would streamline relationships between private and public. Currently, most Made in BC tech firms are focussing their market growth in other geographies (Alberta, Ontario, US, Europe) as in BC there lacks a clear path and requires a significant investment to adoption of innovative technologies. Tech that has been adopted and implemented here in BC has been sourced from over-hyped sources with little due diligence (Babylon, whose Canadian rights were purchased by Telus Health, were not only pushed out of Alberta for lack of data compliancy and has appeared in many scathing articles in the UK regarding both the leaking of private medical records as well as the inaccuracy of its bots, but currently the majority of its executive and management staff have been jumping ship which shows considerable concerns that the public may not yet be aware of). With a non-biased approach, technology from all corners of the world could be tested, analyzed, and implemented without it being yet another BC Ferries government debacle. Then, a public procurement process could introduce these technologies to schools, institutions, hospitals, and any other agency that would benefit from the knowledge, experience, and implementation while remaining a one-tiered system. The current vetting process is an obscure one which is cumbersome for both government and innovator, which provides significant barriers to change and betterment.