Thursday, 28 August 2014

Notes on Mayors' Discussion on Health Care

Below are some notes I took during a meeting of mayors to discuss the delivery of healthcare in municipalities.

Regina: August 18, 2014

Scope of Healthcare participation
·         The delivery of healthcare has elicited different responses from communities
·         Subsidies of varying degrees
·         Provision of clinic buildings
·         Construction of a new facility
·         Provision of housing and vehicles
·         Own and operate clinic
·         Provision of incentives

Issues
·         Recruitment
·         Uneven playing field for recruitment (wealthy vs less wealthy; urban vs rural; hospital vs clinic (scope of practice offerings))
·         Communities are competing on the provincial and national scale rather than collaborating
·         The current model, no recruitment and retention guidelines, does not ensure sustainability but encourages competition amongst municipalities
·         Physicians shop around for greater pay (their market is provincial, national, and international)
·         Make communities compete against one another (divide and conquer)
·         Irregular level of service provided
·         Across the province and within regions
·         Fragile, dependent upon physicians’ ‘happiness’
·         Communication
·         Lack of transparency and openness
·         Broken agreements
·         accountability
·         Human Resources
·         Shortage of EMTs
·         Volunteer fatigue
·         Shortage of physicians (docs may shop around)
·         Scope of practice in an area has been compromised
·         50% of physicians leave within 5 years
·         Health is to be non-profit (Health Authorities/Ministry) yet has a profit driven centre (Physician Centres)
·         Municipal funding of healthcare is not sustainable

Policy Challenges
·         Level of service:
·         Physician staffing
·         EMT staffing
·         Geographic question
·         Communication
·         Accountability
·         Broken agreements
·         Open/Transparent
·         Funding
·         A question of population based delivery across large distances
·         Recruitment & Retention
·         Intense competition between communities
·         50% of physicians leave within 5 years
·         Subsidies
·         No accountability
·         No transparency
·         No legislative protection or jurisdiction

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