Health Workforce Policies in OECD Countries: Right jobs, Right Skills, Right Places
OECD Health Policy Studies (2016), OECD Publishing, Paris
Health workers are the cornerstone of health systems, playing a central role in providing health services to the population and improving health outcomes. The demand and supply of health workers have increased over time in all OECD countries, with jobs in the health and social sector accounting for more than 10% of total employment now in several OECD countries. This publication reviews key trends and policy priorities on health workforce across OECD countries, with a particular focus on doctors and nurses given the preeminent role that they have traditionally played in health service delivery.
OECD (2016), Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places, OECD
Health Policy Studies, OECD Publishing, Paris.
An Undisciplined Economist Robert G. Evans On Health Economics, Health Care Policy and Population Health
Available June 2016!
Edited by Morris L Barer, Greg L. Stoddart, Kimberlyn M. McGrail and Chris B. McLeod
Incisive analysis of health policy issues in Canada by a pioneering health economist.
For four decades Robert Evans has been Canada’s foremost health policy analyst and commentator, playing a leadership role in the development of both health economics and population health at home and internationally. An Undisciplined Economist collects sixteen of Evans’ most important contributions, including two new articles.
The topics addressed range widely, from the peculiar structure of the health care industry to the social determinants of the health of entire populations to the misleading role that economists have sometimes played in health policy debates. Written with Evans’ characteristic clarity, candour, and wit, these essays unabashedly expose health policy myths and the special interests that lie behind them. He refutes claims that public health insurance is unsustainable, that the health care costs of an aging population will bankrupt Canada, that user charges will make the health care system more efficient, and that health care is the most important determinant of a population’s health.
An Undisciplined Economist is a valuable collection for those familiar with Evans’ work, a lucid introduction for those new to the fields of health economics, health policy, and population health, and a fitting tribute to an outstanding scholar.
Robert G. Evans is professor emeritus of economics and a founding member of the Centre for Health Services and Policy Research at the University of British Columbia.
Morris L. Barer is professor in the School of Population and Public Health at the University of British Columbia.
Greg L. Stoddart is professor emeritus of clinical epidemiology and biostatistics at McMaster University.
Kimberlyn M. McGrail is an associate professor in the School of Population and Public Health at the University of British Columbia.
Chris B. McLeod is assistant professor in the School of Population and Public Health at the University of British Columbia.
Principles-based Recommendations for a Canadian-Approach to Assisted Dying
In February 2015, the Supreme Court of Canada released its decision in Carter v. Canada that challenged the constitutional validity of Criminal Code provisions prohibiting physician-assisted dying in Canada. In a unanimous decision, the Supreme Court SCC ruled that the Criminal Code provisions on voluntary euthanasia (section 14) and assisted suicide (section 241(b)) are constitutionally invalid in that they violated the right to life, liberty and security of the person under the Canadian Charter.
The Supreme Court suspended its decision for 12 months to give governments time to consider the development of legislation and/or regulations; they additionally granted a four-month extension on Jan. 15, 2016. Following the 16-month suspension, assisted dying will be legal in Canada, and no longer a criminal act, even if legislation is not enacted in response to the Supreme Court’s ruling. The Supreme Court’s reversal of the prohibition on assisted dying raises a host of complex issues with implications for both practice and policy. In response to the Supreme Court’s ruling, the CMA has developed principles-based recommendations to guide the implementation of assisted dying in Canada. This has been the product of extensive consultation with CMA members, provincial and territorial medical associations, and medical and health stakeholders.
The goal of this process was two-fold: to foster discussion and develop recommendations on a suite of ethical-legal principles; and to provide input on specific issues that are particularly physician-sensitive and are worded ambiguously or not addressed in the Supreme Court’s decision.
This document is intended as a framework for the development of legislation and/or regulations on issues of particular importance for the physicians of Canada through the lens of the practising physician, who will be tasked with carrying out these activities. While other stakeholders have important and valued perspectives, only physicians will be involved in the actual actions required to carry out assisted dying. Their views, accordingly, must be given special weight and consideration. The Charter rights of both physicians and patients must be respected and reconciled as part of this process.
For purposes of clarity, the CMA recommends national and coordinated legislative and regulatory processes and systems. There should be no undue delay in the development of laws and regulations.
Eliminating Code Gridlock in Canada's Health Care System: 2015 Wait Time Alliance Report Card
For the past decade, the Wait Time Alliance (WTA) has been reporting on Canada’s progress to reduce health care wait times. There have been reductions for the initial five areas identified in the 2004 Health Accord even as health care systems have faced increased demand for care. But despite these encouraging signs, there are more areas in need of attention, such as primary care, mental health services, home care, long-term care and palliative care, if wait times across the system are to be reduced on a sustained basis.
Code gridlock is a term used by hospitals for a system-wide situation where patients can’t move. Without access to more appropriate community-based resources, patients who no longer require acute care continue to occupy in-patient hospital beds. This causes a cascading effect on wait times: these beds are no longer free for patients in the emergency room or recovering from surgery; ambulances are unable to offload and elective surgeries are cancelled. Code gridlock is an issue that involves many parts of the health care system and requires a system-wide solution.
The 2015 WTA report card highlights timely access on two broader system-related issues: seniors care and care provided to populations falling under federal jurisdiction (i.e., First Nations, refugees, veterans, Canadian Forces and inmates in federal prisons).
Changes to WTA grading
While previous report cards have graded provinces against both government and WTA wait-time benchmarks, the WTA believes that its own benchmarks are the most appropriate assessment of performance. As such, this year’s report grades wait times using only the WTA benchmarks.
- The WTA benchmark for coronary artery bypass graft (CABG) is six weeks for patients awaiting elective surgery whereas the government pan-Canadian benchmark is 26 weeks.
- The WTA benchmark to access radiation therapy is 10 days whereas the government pan-Canadian benchmark is four weeks.
- Through the efforts of the Canadian Association of Radiologists, the WTA has set a national benchmark of eight weeks (60 days) to access a MRI or CT scan.
National Health Expenditure Trends, 1975-2015
National Health Expenditure Trends, 1975 to 2015 provides an overview of how much is spent on health care annually, in what areas money is spent and on whom, and where the money comes from. It features comparative expenditure data at the provincial/territorial and international levels, as well as Canadian health spending trends from 1975 to the present.