The Patients’ Association of Canada

Over the last several years I have been part of The Patients’ Association of Canada (PAC). It began in June of 2007 out of the experience of a number of patients in their contacts with the health system. The founding group was made up of patients, many of whom also have some special knowledge of the system. Doctors, nurses, health care managers, medical sociologists, researchers, health care consultants, social workers, among others are represented in PAC.

In our organizing meetings held in 2007 and early 2008, the group began by sharing experiences. These included single elective interactions with the health care system, recurring encounters for chronic conditions, emergency episodes, and interventions to support the care of spouses, children, and parents. These varied experiences produced a shared interest in PAC, and gradually illuminated some of the many areas where members felt that the system worked well and not so well. There was a high degree of appreciation for those organizations and individual practitioners who offered personalized, humane, and caring support. There were also areas where systematic improvement could occur.

5 Futures of Community Care

The South West Community Care Access Centre in London, Ontario, held a large conference on the future of Community Care on February 24, 2009. This was the lead off session. The audience was 250 people from across the community and the health care system who were sitting at small tables of 6 to 8 people. The presentation precipitated discussion at the tables about five future scenarios for community care, including the effects of market dominance, scientific breakthroughs, environmental movements, global recessions, and the recognition of health complexity. Votes were taken about which of these futures people preferred and which they thought was most likely before and after their discussions.

Primary Care Reform in the UK / Purchaser-Provider Split in the UK

These presentations were delivered at the INSIGHT Conference on Local Health Integration Networks (The Old Mill, Toronto, Ontario), February 28, 2005.

Preparing for LHINS

This presentation was delivered to the Ontario Association of Community Care Access Centres (Toronto, Ontario), February 16, 2005.

Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like?

A discussion paper written for the Commission on the Future of Health Care in Canada (The Romanow Commission), 2002.

In this paper we argue that health care systems are complex, and that repairing them is a complex problem. Most attempts to intervene in Medicare (and in many other health care systems) treat them as if they were merely complicated. We demonstrate this failure of understanding by tracing the deterioration of Medicare through a series of complicated interventions to its present destabilized state. We identify the tensions that seem to represent intractable problems in the Canadian and other systems that elicit strong responses from warring ideologies and professions.