November / December 2000 Table of Contents
In this Article
Be informed. Know how the system works…
How to find out the views of your party candidates on the 8 priorities:
8 Priorities as Identified in the First Ministers Action Plan for Health System Renewal
Increasing Access to Occupational Therapy Services: CAOT's Actions
s
by Claudia von Zweck & Mary Clark Green
A Federal election offers an ideal opportunity for debate on national issues and priorities. Health care will certainly be a key issue of debate for Canadians in the coming election. According to an Angus Reid poll conducted in July 2000…
- eight out of ten Canadians ranked access to affordable and high quality
health care as one of the top three priorities for ensuring a high quality
of life for them in the future.
- 83% of Canadians felt that the amount of funding available for public health care should be increased, either by reallocating funds from other government programs or by raising taxes.
During this election, occupational therapists must take the opportunity to ride the tide of popular public opinion in favour of increased health spending to make voters and policy makers aware that occupational therapy services are a vital,s yet under-recognized component of the Canadian health system.
Be informed. Know how the system
works…
Health services in Canada are financed primarily through medicare, a cost
shared program between provincial/territorial governments and the federal
government. Federal contributions for medicare are provided through the
Canada Health and Social Transfer (CHST). Medicare is legislated under
the 1984 Canada Health Act and provides public funding for hospital and
physician services across Canada. Services provided under medicare must
meet the five principles of the Canada Health Act including public administration,
comprehensiveness, universality, portability and accessibility.
Unfortunately many services such as occupational therapy are not specified in the Canada Health Act. Health programs administered outside of hospitals such as home care also are not included and therefore are not subject to the five principles of medicare. As a result, many vital health services and programs in Canada are characterized as a patchwork with varying types and levels of federal, provincial and municipal funding and with different eligibility criteria and levels of care.
The present situation …
On September 11, the Federal Government struck an agreement with the provinces
and territories to further increase the amount of the CHST. At the same
time, the First Ministers issued a Communiqué on Health which outlined
The Vision, Principles, Action Plan for Health System Renewal, and Clear
Accountability. There is also a section called Working Together which
articulated the importance of a national system whereby Canadians will
"have access to reasonably timely, high quality health services wherever
they live or move, and provide for regular reporting to them on the progress
of [health system] renewal. The Health Ministers have already met and
begun to implement the priorities outlined in the document.
With the announcement of an increase in CHST from the Federal Government next Spring and the commitment outlined in the communiqué, there is renewed hope for our publicly-funded, national health system. We now have a second chance at preserving a system, admired around the world, that we took for granted and almost lost. Occupational therapists now have a chance to influence the direction of renewal. Your first challenge, as an individual occupational therapist, is to participate in the discussions regarding the implementation and demonstrate that occupational therapy is a vital and under-utilized health service. Your individual efforts, as well as the work of your provincial/territorial associations will complement the work of CAOT. Just as the First Ministers have agreed to work together, to implement the eight priorities, so must the professional associations which represent you as an occupational therapist.
How to find out the views of
your party candidates on the 8 priorities:
The way you ask questions of your federal election candidates will influence
the value of the information you receive about the issues that are important
to you. The September
2000 Communiqué on Health outlines the vision, principles and
priorities for rebuilding Canada's health system. While federal election
candidates and political parties will agree with the vision and principles
of this important consensus document, the interpretation and implementation
plans for the eight priority action areas may differ significantly. These
differences may have important implications for your election vote.
Ask the difficult questions
As an example, when talking to your candidates, do not ask them if they
support home and community health care. Candidates are aware that health
and social programs are on the top of Canadians election concerns. Instead,
ask how they will ensure that Canadians in Nova Scotia will receive equitable
home and community health services to those provided in other provinces.
Ask candidates about what level of public and private spending are acceptable
to them for Canadians to access acute health care, community health services,
and long term care. Ask candidates about how primary care can be delivered
differently to reduce the need for emergency health services.
8 Priorities as Identified in
the First Ministers Action Plan for Health System Renewal
1. Access to Care
Improvement in the timely access to, and quality of health services.
Implications for Occupational Therapy
Opportunities:
Occupational therapy services are not presently specified in the Canada Health Act. We must promote and demonstrate that occupational therapy keeps Canadians out of hospital, reduces hospital stays and assists individuals to become contributing and productive members of our society. The present crisis in our hospital and emergency departments can be solved through increasing Canadians' access to occupational therapy services.Threats
Other health professional groups who are specified in the Canada Health Act will remain covered and could assume occupational therapy roles. The importance of occupation to the health and well being of Canadians will be lost.CAOT's position?
See statements on…
- Everyday occupations and health
- Primary Health, Evidence-Based Practice
- Home Care, Telehealth
2. Health Promotion and Wellness
Development of strategies and policies that recognize the determinants
of health, enhance disease prevention and improve public health. This
also supports the shared priority of early childhood development.
Implications for Occupational Therapy
Opportunities
Health is viewed in occupational therapy as more than the absence of disease, and is understood to be strongly influenced by what people do in everyday life. Meaningful occupations provide Canadians with housing, employment, community and enjoyment. Occupational therapy enables Canadians to perform the occupations that are important to them. Occupational therapy maintains Canadians health and well-being.Threats
Funding will be limited to prevention of disease neglecting health promotion focused on quality of life issues.CAOT's position?
See statements on…
- Everyday occupations and health
- Health promotion
- Primary Health
3. Primary Health Care (first level
of contact)
Timely access to the most appropriate care, by the most appropriate providers,
in the most appropriate settings.
Implications for Occupational Therapy
Opportunities:
We believe an interdisciplinary and intersectoral strategy that spans the educational, health, individual, family and community sectors is required for effective primary health care.Threats
The role of occupational therapy continues to be under-
recognized and under-utilized in many primary care settings.CAOT's position?
See statements on…
- Primary Health Care
- Home Care
- Everyday occupations and health
- Continuing Professional Education
4. Supply of Doctors, Nurses and other Health
Personnel
Improved education, training, recruitment and retention of our future
health work force. Improved work life conditions; for e.g. flexible working
arrangements and continuing education.
Implications for Occupational Therapy
Opportunities
Increased funding and opportunities for the education of occupational therapists.Career and mobility advancement with opportunities to maintain and enhance professional competencies.
Threats
Governments at all levels may not recognize the importance of supporting interdisciplinary, health human resources in order to make the shift from "sick care" to "wellness care".CAOT's position?
See statements on…
- Continuing Professional Education
- Agreement on Internal Trade
- Support Personnel
- Evidence-based Practice (joint statement with ACOTUP, ACOTRO & PAC).
5. Home Care and Community Care
Strengthen investment in home care and community care as critical components
of a more fully integrated health system.
Implications for Occupational Therapy
Opportunities
A fully integrated approach to home and community care will increase the opportunities for occupational therapy. CAOT believes that occupational therapy is an essential component to a comprehensive and home and community care strategy.Threats
Increased volume of demand for health care services will reduce accessibility to occupational therapy services.
Many Canadians would only be able to access our services through private funding.CAOT's position?
See statements on…
- Home Care
- Everyday occupations and health
- Health promotion
- Primary Health
- Continuing Professional Education
6. Pharmaceuticals Management
Canadians will have access to new, appropriate and cost-effective drugs.
Implications for Occupational Therapy
Opportunities
With better drugs, individuals are more able to engage in the occupations that are important to them. Their performance and satisfaction in their occupations can also increase leading to less dependency on the health system. New and appropriate drugs facilitate the occupational therapy process.Threats
Drugs will be seen as the only solution and occupational therapy remains under-funded.CAOT's position?
See statements on…
- none at this time
7. Health Information & Communications Technology
Strengthen a Canada-wide health infostructure by developing electronic
health records, and to enhance technologies like telehealth.
Implications for Occupational Therapy
Opportunities
Tele-health which includes tele-occupational therapy increases access to occupational therapy services.
Communications and information technology facilitates the dissemination of evidence-based knowledge to, and among, occupational therapists.Connectivity of services within the continuum of health services will promote communication and facilitate service delivery.
Threats
Client and public safety if guidelines for the use of information, supervision and remote consultation are not developed.CAOT's position?
See statements on…
- Telehealth and tele-occupational therapy
- Agreement on Internal Trade
- Evidence-based Practice (joint statement with ACOTUP, ACOTRO & PAC).
8. Health Equipment & Infrastructure
Invest in equipment, new technologies and facilities.
Implications for Occupational Therapy
Opportunities
Technological advances have increased Canadians lifespans and quality of life, allowing for greater access to their occupations of choice. New technologies facilitate the occupational therapy process. Occupational therapists and their clients will have the opportunity to engage in ethical and best use of technology discussions.CAOT's position?
See statements on…
- International Marketing
- Telehealth and tele-occupational therapy
- Evidence-based Practice (joint statement with ACOTUP, ACOTRO & PAC).
Increasing Access to Occupational Therapy Services: CAOT's Actions
The September 2000 Communiqué on Health states that all governments are accountable to their public. Although there is support for a national set of indicators upon which to judge the health system's performance, it is very clear that if the public demands a change, the present, governing body, either provincial or federal must listen. Because of this CAOT's national representational efforts are far reaching and include the following:
- National Public Awareness Campaign: Occupational Therapy - Skills
for the Job of Living is targetted at women 30 to 55 years of age who
are identified as frequent users of the health system as well as key
decision makers regarding their family's health needs.
- Private Insurance Lobby. Currently one in every six CAOT members
relies on private sources of payment for some of their services. A multi-level
campaign is necessary to influence the extended health care insurance
industry to increase funding of occupational therapy services.
- Participation in national task forces and coalitions, promoting occupational
therapy's vital role in the health and well-being of Canadians.
- Collaboration with other occupational therapy groups, as well as national health coalitions such as HEAL. Both the National Awareness Campaign and the Private Insurance Lobby are joint ventures with our provincial/territorial occupational therapy partners. HEAL (The Health Action Lobby) is a national coalition of 30 health professional and consumer organizations and is a well-recognized resource to government and the media regarding Canadian health care. Activities of HEAL are focused on ensuring appropriate federal financing of Canadian health services and include: annual presentations to the federal Finance Committee; regular meetings with the federal Ministers of Health and Finance and other political representatives and government bureaucrats; media communications; events and special projects. When you hear or read about HEAL in the media, remember that CAOT, therefore occupational therapy, is part of this powerful and influential voice.
November / December 2000 Table of Contents
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