Accelerate health system renewal, says Health Council
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* Barbara Sibbald

It's time to accelerate the renewal of Canada's „patchwork” approach to healthcare with an emphasis not only on access, but also on quality, says a new report from the Health Council of Canada.

„Access is important, but it's time to balance the discussion and devote equal attention to the quality of care we receive,” Chair Michael Decter said at the launch of the Council's second annual report, *Health Care Renewal in Canada: Clearing the Road to Quality* ([www.healthcouncilcanada.ca](http://www.healthcouncilcanada.ca)). „Having access to something that's of uneven quality isn't the answer.”

The 2003 First Ministers' Health Accord created the Council to monitor and report on progress in renewing the system. Thus far, that progress has been „tentative and uneven,” said Decter. „It needs to happen faster.”

Health Minister Tony Clement agreed that „having a health care focus on [quality] will be beneficial.” But he told reporters „We're about access, not just quality.” He did not commit Ottawa to implementing any of the report's recommendations.

The Council's emphasis on quality includes a push to reduce adverse events (AEs) and their resultant drain on resources. Among the 20 hospitals studied in the year 2000, AEs led to 1521 additional hospital days (*CMAJ* 2004;170:1678-86).

To improve patient safety the council wants:

• mandatory accreditation of all health care facilities as a condition of public funding, and a public release of accreditation reports;

• re-examination of no-fault compensation for victims of AEs;

• job protection for whistleblowers;

• quality councils in all provinces; and

• electronic health records for all Canadians by 2010 at a cost of roughly $10 billion — 10 times the current budget of Canada Health Infoway, the organization charged with leading that initiative.

Richard Alvarez, Infoway's president and CEO, says „You can't have primary health care reform without a shared record.” The UK recently invested $60 billion in electronic health records, but in Canada, „it's happening too slowly,” he added.

Alvarez says electronic health records could save up to $6.1 billion per year, mostly by reducing adverse drug events. They are the „foundation for improving safe quality care,” added Decter. The council and Infoway are meeting in June to discuss ways to accelerate progress.