While total health care spending has increased over the last 20 years, Canadian capital investment in health infrastructure has fluctuated, with a noted decline in recent years.1 Healthcare institutions across the country must regularly dip into fundsBest estimates of deferred maintenance in the healthcare sector come from a study conducted in 2015 and was already at a staggering $15.4 to $28 billion at that time2 allocated to updating infrastructure to provide patient care.
This necessity effectively mortgages the future of Canadian healthcare infrastructure, leaving it woefully outdated, environmentally unsound, and at risk for climate change related damage. Most importantly, a lack of investment in healthcare infrastructure undermines patient care and poses potential risks to patient safetyThe 2021 cyberattack against the Newfoundland and Labrador healthcare system resulted in a complete shutdown of the patient booking and health information portals, resulting in thousands of appointments and procedures getting delayed, including chemotherapy treatments..
Federal-provincial-territorial jurisdictional issues are often cited as a major impediment to direct federal investment in healthcare infrastructure and healthcare more broadly. However, the public dismisses these concerns. Polling conducted by Abacus Data for HealthCareCAN in late 2020 shows that the majority of those polled do not care about political jurisdictions and want all levels of government to work together to improve healthcare.
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What actions can Canada take to support the health system in addressing its infrastructure challenges?
Why must Canada better support the health system in addressing its infrastructure challenges?
HealthCareCAN actions to support better aging and older adult care
The COVID-19 pandemic highlighted the serious challenges facing Canada’s health infrastructure.
In long-term care, multiple-bed rooms did not allow for proper implementation of infection prevention and control protocols, and older facilities fared far worseIn Ontario, the Office of the Auditor General’s blistering report identified that overcrowding and a lack of room for isolation made it nearly impossible to observe proper infection control protocols and concluded infrastructure was a major contributing factor to the high death toll.3 in terms of cases and deaths.
In acute care, hospitals often could not keep up with the volume of COVID-19 patients because they lacked the space and equipment needed to treat them.
In primary and specialty care, providers quickly shifted to providing virtual services, but often had to implement digital platforms and tools as they went. Canada’s digital health systems, fragmented across jurisdictions, made it difficult to collect comprehensive data on the association between infection rates and socio-economic factors, geographic location, and age and hindered the sharing of critical patient information across organizations.
Further, the combination of legacy technology, remote work without robust cyber security measures, and highly sensitive information has made healthcare a highly lucrative targetIn 2020 there was an increase of over 45% in cyberattacks, the largest increase by sector. for cyber criminals.
And finally, a lack of health-related manufacturing infrastructure and capabilities meant Canada could not produce much-needed personal protective equipment, drugs, and vaccines domestically.
Providing healthcare organizations with direct and equal access to existing infrastructure funding programs will:
Increasing investments in health system infrastructure will:
Supporting the expansion of virtual care and digital health will:
Improving information technology and digital infrastructure across the health system will:
Bolstering the healthcare sector’s cybersecurity capabilities through investments, programs and standards will:
Continuing to enhance broadband services in rural and remote areas will:
Working with provincial and territorial counterparts to ensure administrative and regulatory policies are in place to support virtual care will:
Annual capital expenditure on health as % of GDP (2015‑2019) by type of asset (click image to expand)
Source: OECD. 2021. Health at a Glance 2021: OECD Indicators.
% of Canadians that believe investing in health care technology should be a top government priority.
Source: Canada Health Infoway. 2020. Executive Summary: Consulting Canadians on the Future of Their Health System – A Healthy Dialogue.
Canadians’ preference for first point of contact when seeking medical advice from a doctor
Source: Canadian Medical Association. 2020. Virtual care is real care: National poll shows Canadians are overwhelmingly satisfied with virtual health care.
% of Canadians open to sharing their anonymized health data
Source: Canada Health Infoway. 2020. Executive Summary: Consulting Canadians on the Future of Their Health System – A Healthy Dialogue.
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