Frontier’s Euro Canada Health Consumer Index has repeatedly shown Canada scoring towards the bottom of a 32 country comparison with Europe. Our study showed that Canada could learn from the higher performing countries by 1) replacing global budgeting for hospitals with a funding model based on patient volume and service quality, and 2) adopting a purchaser provider split where private and public facilities competed for funding to deliver services.
B.C. and Ontario are beginning to experiment with European style smarter payment systems but overall progress continues to be slow with our political class remaining mostly paralyzed on the health reform front.
One of Britain’s top independent think tanks, Reform, recently had a commentary in the Times Newspaper, on the need to be open to new healthcare ideas. It offered several useful examples of cutting edge delivery which involve lower costs and measuring results to benchmark improving service. The item is hidden behind the newspaper’s pay wall so here is the clip from Reform’s website (http://www.reform.co.uk):
Nick Seddon, the Deputy Director of Reform, has written an article in The Times arguing that the NHS must be open to healthcare ideas around the world:
“England offers excellent healthcare in our best NHS university and specialist institutions, such as University Hospitals Birmingham and Great Ormond Street. The Department of Health and UKTI are to be commended for trying to get them to think big and sell their services in emerging global markets. Healthcare organisations around the world have a head start on doing this and we should certainly seek to catch up.
“However, a little extra cash is not going to make a fundamental difference to the NHS and the more urgent need is not to export but to import. Around the world a new generation of innovators and entrepreneurs is transforming healthcare for patients and defining global standards of what the best care looks like. On international comparisons of quality and efficiency the NHS does not fare very well. Only by being open to the best can the NHS hope to become to best.
“We can learn from best practice in management. At the world-leading Cleveland Clinic in Ohio, data is published in real time, in every major disease area, on how patients are faring. The numbers are used to rank the staff on performance and to show them where they could improve. This creates the peer pressure which makes better doctors — if they’re not up to the job, they leave.
“In the Spanish region of Valencia private companies run a quarter of the hospitals and primary care services. They cost 20 per cent less per patient than their state-run competitors, yet have maintained clinical quality. One IT system links the whole system, so even in their own homes patients can check the length of the queue for their GP.
“Across the globe, patients are being given the tools to take charge of their own healthcare. Mexico boasts a sort of turbo-charged NHS Direct: $5 (£3.20) a month added to the phone bill allows patients to access Medicall Home’s doctors 24/7. Calls are answered within three seconds and nearly two thirds of callers have their health queries resolved over the phone. This is the kind of game-changing idea that could reduce pressure on our GPs.
“The IMF says that rising government spending on healthcare is now the main risk to the budget balances of major countries. The next global industry is better, cheaper healthcare. In a world where trade barriers are tumbling and borders are opening up, we cannot afford to be protectionist.”
