Canada should look to Germany and the Netherlands for primary health-care solutions: report

The new report says Canada should follow the lead of two European countries, in alleviating stress on the primary healthcare system.

The Montreal Economic Institute’s report released Thursday cited data that 26 per cent of Canadians reported being able to get a same-day or next-day appointment with a primary care provider last year, compared to 51 per cent of respondents in Germany, and 54 per cent in the Netherlands.

“We looked at what they were doing right in those countries,” said Renaud Brossard, a vice-president of communications at the institute. “One of the things we noticed is that they don’t spend more money than we do; they spend roughly the same amount.”

Brossard said German and Dutch primary health-care providers “use their time much better than we do.”

The institute recommended health-care systems in Canada allow patients to access a medical specialist without the requirement of a general practitioner’s referral. There’s no such requirement for a specialist referral in Germany, and the Netherlands employs a relaxed policy with exceptions.

“Right now there’s this impression that gatekeeping helps to keep costs low, and it’s understandable why that impression exists. Specialists are much more expensive than family doctors,” said Brossard. “But the literature when it comes to showing whether or not it helps to keep costs low is unclear.

“It does significantly increase the number of visits to family practitioners.”

In a statement, Doctors Nova Scotia said it would “want to understand how the Nova Scotia health-care system might be impacted” with referrals being lifted, adding, “We believe family physicians and specialists should be consulted for their opinion and experience in the Nova Scotia context before making any move to allow patients to refer directly to specialists.”

Another recommendation from the institute was to give health-care professionals the ability to work in both the public and private sectors, at the same time.

“Germany and the Netherlands allow that, and one of the things we found is that it helps to keep more doctors in the public system,” said Brossard.

The New Brunswick Common Front for Social Justice said sharing staff between two health-care sectors undermined the public system. Provincial coordinator Audrey Gagnon said those with a lower income or living in poverty would ultimately be at a disadvantage.

“I hope people will keep that in mind when brainstorming for the future,” said Gagnon. “I think maybe the appetite for opting for such a model comes from a place of desperation.”

The institute’s report also recommended a ban be lifted on individuals having duplicate private insurance for services insured under the Canada Health Act.