PRINCE EDWARD ISLAND Health Challenges and Opportunities Delivered by The Honourable Doug Currie Minister of Health and Wellness April 2012
Since the day this government was elected, health care has been one of our top priorities. Today I would like to highlight the progress that has been made since we set out three years ago to change the course of health care in this province...... and to illustrate for Islanders the continuing challenge and the significant opportunities that we have before us in Health. The challenge, simply put, is to slow the growth of health spending... and to shift more resources to areas where we get better health outcomes and more value for taxpayer dollars. Health spending in Prince Edward Island, and indeed across Canada is now outpacing our ability to pay. We have never spent more on health care. Compared to five years ago, we now spend: 25 per cent more on hospitals 39 per cent more on physician services 23 per cent more on long-term care 22 per cent more on drugs 55 per cent more on home care Per capita health expenditures in PEI are now higher than the Canadian average. We now spend $3,865 per year on health care for every man, woman and child on the Island... Health now takes over 40 cents from every taxpayer dollar and it will soon take much more if we continue to spend the way we did in the past. Per capita health expenditures in PEI are now higher than the Canadian average. We now spend $3,865 per year on health care for every man, woman and child on the Island, more than the Canadian average of $3,575. Health Challenges and Opportunities 2012 1
Spending on health increased by an average of 6.4 per cent a year since 2007, from $421 million to $555 million, much higher than provincial revenue or economic growth. And it will exceed $700 million in three years time, even if growth is held to 3 per cent or 3.5 per cent per year. Across the country, many people are now asking the question How much is enough to spend on health? And others are asking How do we use existing resources better without adding more? And some are taking action. New Brunswick just capped health care spending at 1.6 per cent, and Ontario at 2.1 per cent and Nova Scotia at 2.5 per cent. Today we are facing historic lows in federal health care funding. Finance Minister Jim Flaherty unilaterally announced in December that health care transfers will grow at 6 per cent a year until 2016-17. After that, increases will be based on individual provinces economic growth. That simply does not provide PEI with the same resources as the rest of the country. Added to this is our demographic challenge. When Medicare was founded in 1958 the Canadian population was relatively young, at 27. Our average age is now 47 and it s going up. By the year 2020, one in five Islanders will be over 65. And over the next 25 years, the number of seniors in this province will double. 2 Health Challenges and Opportunities 2012
An older population will place even more pressure on the health care system. It is estimated that health spending on Canadians between the ages of 65 and 75 are nearly triple what we spend on people under 65. And the average cost for those over 75, are double that again. With such major challenges ahead, we must be sure that we have the best health service delivery models. Unfortunately, our current health care model has remained relatively unchanged since the introduction of Medicare. It is still very much about doctors and hospitals... and about treating people after they are sick. Globe and Mail reporter Andre Picard referred to this issue at a public policy forum at Dalhousie University last month by saying: We re trying to deliver 21st Century care with a 1950s system, and we re trying to insure a population of chronically ill citizens with an acute care insurance scheme that s why we re spending too much on health care delivery. Even though we are spending more money on health than ever before... even though we have more health professionals than ever before... and even with our modern facilities, equipment and lifesaving drugs we are not getting any healthier. Islanders still have some of the highest rates of chronic disease in the country. It is time to increase our focus on promoting health and preventing illness.... time to start talking about solutions. And time to end the adversarial talk surrounding health care this discussion has to transcend politics. Health Challenges and Opportunities 2012 3
Our vision has to be long. The decisions we make today will determine the viability of our health services in the future. Since becoming minister of Health and Wellness, I have listened to what Islanders have told me. I have listened to what our health care professionals are telling me. I have paid close attention to other jurisdictions successes. I ve learned from my experience that good public policy needs good public debate. Soon I will be calling for a discussion with Islanders, with health professionals, educators and community health organizations. In the coming months I will be traveling the Island, tip-to-tip, to talk to Islanders about their health care system It is important to me, as Minister, that I hear from Islanders about their vision of health care today and in the future. I will be announcing more details of this endeavor in the coming months. Prince Edward Island began the transformation of health care in 2009 following a comprehensive review by Corpus Sanchez. The review showed that immediate investments were needed in home and primary care and in the way we staff health facilities. We listened to the experts and we made bold decisions that have reshaped our health care system. We separated the operational arm that delivers health services. Now the Department of Health and Wellness decides what happens in health care and Health PEI follows through on how. Many improvements in services have resulted from the new structure. 4 Health Challenges and Opportunities 2012
Long-term Care In Long-term Care, we invested $63 Million to replace five public manors so our seniors the people who built our Island communities can live comfortably and with dignity. We added 76 long-term care beds. Our wait time for long-term care continues to be the best in the Maritimes. Acute Care Hospitals are the most costly part of our health system. Often, people are staying in hospital longer than necessary because there are no alternate beds, or because they don t have the supports at home to be discharged safely. We re looking at ways to reduce the use of costly acute bed-based care, things like: reducing the length of stay by making beds available in other facilities for convalescent, respite and palliative care; increasing access to home care, ambulatory care and same day treatment programs; and investing in primary care programs where patients can be diagnosed and supported earlier, eliminating the need for hospital beds in the first place. We ve strengthened cancer services through the $4.1 million expansion of the PEI Cancer Treatment Centre, where we added newer and better equipment and hired more staff. We re leading Atlantic Canada in reducing radiation wait times. Health Challenges and Opportunities 2012 5
The wait for Breast Cancer Screening has been reduced to days rather than months. We ve added 10 new cancer drugs. Since we launched the Colorectal Cancer Screening Program last year, more than 3,300 Island men were screened for this deadly disease. And we began immunizing Grade 6 girls against HPV the leading cause of cervical cancer. One area we know we can improve is the way we are using our acute hospitals. For example, we know our lengths of stay at some rural hospitals are much higher than in other jurisdictions. This is not an efficient use of our resources and an example of something we need to work toward fixing. Over the last few years Kings County Memorial Hospital has been providing emergency department services on reduced hours. This has taken significant pressure off our health care workers without negatively impacting patient safety. The hours of operation of the emergency department at Kings County Memorial Hospital will be permanently reduced to 14 hours. Also, with the opening of Tyne Valley Health Centre, there has been significant duplication in having both the Health Centre and the outpatient department at the Stewart Memorial Hospital. I have approved the closure of the out-patient department at Stewart Memorial Hospital and have directed Health PEI to implement this decision in an appropriate period of time that will allow for proper planning with physicians, staff and the community. Dialysis There has been a 75 per cent increase in hemodialysis patients in Prince Edward Island in the past three years. 6 Health Challenges and Opportunities 2012
In response, we are building a new hemodialysis unit at the Prince County Hospital which will serve up to 54 people, more than double the existing capacity. A new provincial renal clinic and dialysis unit will also be established as part of the new QEH Ambulatory Care Centre this spring. To meet the rising demand for hemodialysis beginning October first, we will be consolidating hemodialysis clinics at Western, QEH, PCH and Souris into two clinics at the QEH and PCH. Five new dialysis seats are being added in a quarter of a million dollar investment. This will improve the use of our human resources. Ambulance Services We have also taken action to improve ambulance services. Ambulance coverage has been expanded in Kings County, Summerside and West Prince. With new technology and the increased expertise of Advanced Care Paramedics, we established trip destination policies that ensure the patient is transported to the facility with the most appropriate level of care. Demand for ground ambulance services is steadily increasing as the number of seniors on Prince Edward Islander grows. Ground ambulance costs have increased 50% in the last five years. As of October first, those over 65 will now pay a $75 co-pay, a small fraction of the full cost of a ground ambulance transport. This fee is half of what seniors were paying prior to April 2009 and considerably less than other Atlantic provinces. Health Challenges and Opportunities 2012 7
Home Care We increased funding for Home Care by 59 per cent. As a result, more people are able to be cared for at home... while freeing up hospital beds for those who need them most. We invested $1.3 million in pain medication for palliative patients at home. As a result, we increased the time patients with end stage illness were able to stay in the comfort of their own homes by 22 per cent. And it meant that we saved $6.5 million in acute hospital care. Physicians and Health Professionals Today, we have more doctors than ever before. Today, 233 physicians are practicing in the province. We have 96 family physicians compared to 81 in 2006. We stack up well against other parts of the country in this area. Today, 94 per cent of Islanders have a family doctor well above the 85 per cent average recommended by the Canadian College of Physicians and Surgeons. In parts of Quebec and Ontario only 50 per cent of residents have a family doctor. We also have more nurses and fewer vacancies than ever before. Through the new Model of Care, we are working to ensure all health care providers can work to their full potential. We have added 125 Registered Nurses to our rosters in the past four years. And we have teams of health care providers working collaboratively, and using all the skills in which they have been trained. 8 Health Challenges and Opportunities 2012
Since the Collaborative Model of Care was implemented, inpatient satisfaction has remained high at 96 per cent, we ve seen fewer bed closures, and we ve added 78,400 hours of patient care in less than two years the equivalent of 40 full-time staff. Drug Programs We are also making positive changes to the way we provide Islanders with the drugs they need.... we ve added 78,400 hours of patient care in less than two years the equivalent of 40 fulltime staff. Over the past four years, we have invested 25 percent more in our drug programs. We added or expanded 149 new drugs to our formulary. Drugs are another rapidly growing budget item in health. The escalating cost of effective new drugs has forced other provinces to take a serious look at their drug programs. As a result, they have been able to find significant cost savings, and PEI now pays more for generic drugs than any other province. We added or expanded 149 new drugs to our formulary. We are now proposing fair generic drug pricing measures that hold potential for significant savings for Islanders and our public drug programs. These savings will help to fund high-cost drugs and other important health services. Children s Dental Coverage The province is moving to a public model of dental care for children and will become the payer of last resort - available to families without private insurance who make less than $35,000 a year. Health Challenges and Opportunities 2012 9
Moving to this model will ensure the children s basic dental care program is available in the future for those who need it to the most. Our dental hygienists and assistants will continue to provide preventative care in schools and other sites. Primary Care Major steps have been taken to strengthen and expand primary care, helping Islanders to actively take charge of their own health. Major steps have been taken to strengthen and expand primary care, helping Islanders to actively take charge of their own health. We are developing five primary health care networks in East and West Prince, East and West Queens and Kings to improve access to all Islanders. Each network uses teams of providers who deliver services ranging from acute to chronic illness diagnosis and treatment; health promotion; illness prevention; and chronic disease management. We envision a robust primary care system where every Islander is within a 30-kilometre radius of a primary health care centre. We envision a robust primary care system where every Islander is within a 30-kilometre radius of a primary health care centre. Pilot projects have been launched to help Islanders prevent and manage COPD, diabetes and high blood pressure. And a highly successful model is now in place to help people quit smoking after being admitted to hospital. Mental Health and Addictions We are also addressing the needs of young people at risk. To help youth who are struggling with addictions, we created the Strength program, an eight-week provincial day treatment with supervised housing for youth ages 15 to the mid-20s. To date, almost 200 young people have benefitted from the program, along with their family members who take part in support sessions. 10 Health Challenges and Opportunities 2012
I am a firm believer in the idea that there is no health without mental health. While we are making headway to meet the growing demand for mental health services, there is much more to be done. We will be undertaking an independent expert review of Mental Health and Addictions services across all government departments to ensure that these services are meeting the high standards that Islanders expect. Population Health To protect our population from preventable disease, we have added new vaccines, introduced tanning bed guidelines and amended the Smoke Free Places Act. We will be undertaking an independent expert review of Mental Health and Addictions services across all government departments to ensure that these services are meeting the high standards that Islanders expect. We are all concerned by the fact that childhood obesity has tripled in the last 25 years... and that the current generation of children is the first one ever that is predicted to die younger than their parents. Being overweight due to poor nutrition and lack of physical activity is one of the greatest risk factors for chronic disease in the 21 st Century. We must appeal to parents to help their children understand that the choices they make today will affect them tomorrow. And we need our educators, ministers, doctors and coaches to spread this message as well. We are taking steps to get Island children moving. After-school programs are being introduced across the province to foster a lifelong love of exercise. We ve developed a Provincial Wellness Strategy which will be implemented in the coming months. The goal of this strategy is to encourage and support Islanders to improve their quality of life by reducing risk factors for chronic disease. We ve developed a Provincial Wellness Strategy which will be implemented in the coming months. The goal of this strategy is to encourage and support Islanders to improve their quality of life by reducing risk factors for chronic disease. Health Challenges and Opportunities 2012 11
Our Living a Healthy Life program teaches people with chronic disease to overcome daily challenges and it has reached over 400 Islanders. Countless Islanders are learning to love exercise through go!pei, which helps them take charge of their health and enjoy life. We have made substantial investments in facilities, in equipment, in services and in staff to provide the people of this province with access to high quality health care. We are encouraged by what we have accomplished, and we are firmly committed to doing more. The success of our health system does not rest solely with government... It rests with me, with you with the Opposition with all of us. It is about managing services wisely. And it s about all of us making hundreds of small choices everyday for our good health and wellbeing. This government is going to keep on the right track to transform our system into the most efficient, safest, smartest one in the country. The most recent report from the Canadian Institute for Health Information shows we re getting there, we ve got the lowest Hospital Mortality Rates in Canada. And we ve reduced Emergency Department visits demonstrating the value of our investments in primary care and chronic disease management. We re also seeing significant reductions in the acute length of stay in our larger hospitals and our Lean program, which empowers staff to maximize their effectiveness and reduce waste, is well underway. 12 Health Challenges and Opportunities 2012
The three-year health plan will see contained growth in health spending to 4.1 per cent this year and 3.5% the following two years. Despite having the lowest fiscal capacity in the country, we are fourth in health spending to only Quebec, Alberta and Saskatchewan. Over the next three years we will invest $1.7 Billion in to strengthening Prince Edward Island s healthcare system. Our Premier and Saskatchewan Premier Brad Wall have been tasked to co-chair a national working group on health care innovation. We have much to learn through their process... and opportunities to pioneer innovative solutions to health care challenges. Because of our small size and single health authority, solutions can be rolled out with standards and processes in Prince Edward Island. We are in a strong position to deliver integrated, safer care for Islanders.... and a system that is as sustainable as we make it. I would like to call on all Islanders to take charge of our health, and to be part of the solutions that will ensure our excellent health care system is a reality for future generations. Thank you. 13 Health Challenges and Opportunities 2012