October 23, 2026

Reality Check: Is Canada Keeping Pace?

Opening:

Good morning and thank you for the invitation to join you today.

For those who may not know HealthCareCAN, we are the association that represents hospitals, health authorities and other healthcare organizations across Canada.

The question in today’s program is seemingly simple: Is Canada moving quickly enough to translate innovation into better patient outcomes?

When it comes to translating scientific discovery and health innovation into better patient outcomes, stronger healthcare capacity and lasting economic value, the evidence suggests that, no we are not keeping pace as well as we could.

But the true answer is more nuanced than a simple “no”.

Canada has many of the ingredients needed to be a global leader. We have excellent researchers, world-class universities and teaching hospitals, highly skilled health professionals, and companies developing promising new medicines, technologies and approaches to care.

But too often, discoveries made here do not become the care patients receive here. And when that happens, the investment, intellectual property, companies and skilled jobs that could grow around those discoveries may grow somewhere else.

Our challenge is not simply to generate more innovation. It is to close the gap between the innovation we create and the value we realize from it.

And that gap has consequences for patients, for our healthcare system, for Canadian businesses and for our country’s long-term prosperity.

A healthcare system under pressure

Let’s start with the healthcare system we have today.

Canada spends approximately 11.3 per cent of GDP on healthcare, compared with an OECD average of 9.3 per cent.

Yet we have approximately 2.5 hospital beds per thousand people, compared with an OECD average of 4.2, and 2.7 practicing physicians per thousand people, compared with 3.9.

At the same time, our population is aging. By 2030, more than one in five Canadians will be over the age of 65, and millions of seniors are already living with multiple chronic conditions.

These pressures will only intensify.

We need to care for more people with increasingly complex needs, while supporting the healthcare professionals who deliver that care.

Innovation can help. New treatments, artificial intelligence, digital technologies and different approaches to delivering care offer opportunities to improve outcomes and make better use of scarce resources.

But there is a fundamental tension here.

The healthcare systems that most need innovation can also be the systems that find it hardest to adopt it.

When a health system is operating under intense pressure, clinical staff have little time to test new approaches, research teams lack the infrastructure to conduct studies, governments are challenged to reimburse for new therapies and organizations struggle to absorb change.

Even proven innovations can find it difficult to move from demonstrated effectiveness into routine care in Canada.

And nowhere is that tension more apparent than in clinical research.

Clinical trials: A Canadian strength losing ground

Canada has historically been a global leader in clinical trials.

In 2023, we ranked third globally for new clinical trials and had the highest number of ongoing trials per capita in the G7.

Clinical trials represent approximately $3 billion in annual direct expenditures in Canada. They support highly skilled jobs, strengthen our research institutions and offer patients opportunities to participate in research and potentially access to new promising treatments.

But despite these strengths, Canada’s share of global clinical-trial activity has reportedly declined from six per cent in 2021 to four per cent.

The federal Pharmaceutical and Life Sciences Sector Task Force estimated that this decline represented approximately $2.5 billion in foregone clinical-trial spending and around 20,000 jobs.

Think about what those numbers represent for Canada.

When a clinical trial moves elsewhere, we lose more than the immediate investment.

We lose opportunities for patients. We lose research expertise, skilled employment and relationships between hospitals, researchers and industry. And we risk losing the future investment that grows from that activity.

Meanwhile, other countries are moving aggressively to attract clinical research.

Australia has steadily expanded its clinical-trials sector, and China has become an increasingly important destination for research investment.

Companies are making decisions about where to conduct research based on clinical expertise, infrastructure, recruitment capacity, regulatory pathways and the predictability of the environment.

Healthcare is also an industry

There is another dimension of this challenge that I believe deserves much more attention.

Healthcare is not simply a public service or a cost to government. It is also a major industry, employer, purchaser and potential launch market for innovation.

We tend to discuss healthcare spending almost exclusively as an expenditure.

But those dollars also shape an enormous economic ecosystem. They influence which technologies are tested, which solutions are purchased, which companies find their first customers and where future investment takes place.

We have a significant life-sciences industry in Canada. RBC has identified more than 2,000 life-sciences firms in Canada, employing as many as 220,000 people.

These companies, together with our universities, hospitals and research institutes, generate valuable intellectual property, from breakthrough medicines to medical devices and digital technologies.

Yet too often, intellectual property developed through Canadian research is acquired by organizations outside Canada and commercialized elsewhere.

We generate the science, but we don’t always retain the companies, investment, skilled jobs and commercial activity that can grow around it.

This is the economic dimension of our innovation gap.

We should be asking ourselves: How much scientific, commercial and economic value are we generating from our substantial investment in healthcare, and how much of that value is ultimately benefiting Canadians?

For HealthCareCAN‘s members, these questions are practical, not theoretical.

Hospitals, health authorities and research institutes are where innovation meets real patients and real operating conditions.

They conduct clinical trials, generate evidence, train talent and determine whether new approaches can be integrated into clinical practice.

They are not simply the places where innovations are used after all the important work has been done.

They are essential participants in developing, testing, validating and scaling innovation.

Consider what it takes for a hospital to participate in a clinical trial.

It requires research nurses with time to recruit patients, appropriate clinical space, reliable data systems and teams able to integrate research safely into everyday care.

The same is true when a Canadian company needs its first customer.

A healthcare organization that can test and evaluate a promising solution provides more than a sale. It provides the real-world validation that can help a company improve its product, attract investment and expand into other markets.

When that pathway is difficult to navigate, companies may find stronger reasons to test, launch and scale their innovations elsewhere.

This is why healthcare institutions must be understood as part of Canada’s innovation and industrial base.

Their capacity matters not only for the care they deliver today, but also for the innovation and economic opportunity they can help generate tomorrow.

The ultimate test: Does innovation reach patients?

Of course, the ultimate measure of health innovation is whether patients actually benefit from it.

And here, too, Canada faces a significant challenge.

According to published figures, Canada ranks last in the G7 for timely access to innovative medicines.

Only 18 per cent of globally available medicines reach Canadians through public drug plans, compared with an OECD average of 28 per cent.

Other comparisons indicate that Canadians can wait more than two years, on average, between regulatory approval and public reimbursement.

For patients, the distinction between regulatory approval, reimbursement and actual access is not technical.

It can determine whether a promising treatment is a real option.

And for pharmaceutical companies, the predictability of market access can influence where products are launched, where clinical trials are conducted and where future investment takes place.

The innovation challenge does not end when a discovery is made, or even when a medicine receives regulatory approval.

It extends through the entire journey from research and development to commercialization, adoption and patient access.

An innovation that never reaches the patient is a potential left unrealized.  We must work harder to ensure innovations can deliver their full potential value.

The international challenge

And we need to recognize that Canada is not competing in isolation.

Other countries are investing in research infrastructure, attracting talent, strengthening clinical-trial capacity and building the conditions that allow innovation to flourish.

South Korea, a recognized leader in innovation, provides a striking comparison.

According to published figures, South Korea increased its research and development investment from just over two per cent of GDP in 2000 to nearly five per cent by 2020.

Over that same period, Canada’s investment declined from approximately 1.9 per cent to 1.6 per cent.

The point is not that Canada should replicate another country’s model.

It is that innovation capacity is built over time.

Conclusion: From discovery to delivery

So, what does all of this tell us?

Canada is not lacking in scientific talent, research capability or entrepreneurial ambition.

We have the researchers, the institutions, the companies and the ingenuity to compete with the best in the world.

But the signals are difficult to ignore.

Our share of global clinical trials has declined.

Promising discoveries do not always become successful Canadian businesses.

Innovative medicines do not always reach Canadian patients in a timely way.

And our healthcare system faces mounting pressures that make both innovation and the capacity to adopt it more important than ever.

These are not separate problems. They are interconnected.

But the scale of the challenge should also remind us of the scale of the opportunity.

Canada has the science. We have the talent. We have the healthcare institutions, the companies and the patients who can benefit from innovation.

What we must not take for granted is our ability to connect those strengths.

The question before us is not whether Canada can innovate.

We know that we can.

The question is whether we can translate that innovation into better care, a stronger Canadian economy and lasting economic value.

That is the reality check. And it is also the opportunity.

Our goal must be not just to discover the future of healthcare, but also to deliver it — to patients in Canada, and to the world.

Thank you.