Primary Health Care and Health System Renewal

High-quality, effective primary health care services have profound implications for the entire health care system. As the final report of the Romanow Commission stated, "there is almost universal agreement that primary health care offers tremendous potential benefits to Canadians and to the health care system ... no other initiative holds as much potential for improving health and sustaining our health care system."

This potential for system-wide improvement has several facets:

• A greater emphasis on health promotion will help Canadians remain healthy and avoid or delay preventable illness.
• When Canadians need health care services, improved quality will maximize effectiveness (for example, early management of chronic diseases can avoid the development of complications and the need for specialized care).
• When more specialized services are required, the coordinating role of primary health care will provide continuity of care and follow-up to hospitalization.

As such, primary health care offers a sustainable approach to the challenges of waiting lists for specialized services and pressures on hospitals. This potential has been tangibly demonstrated by models such as the Sault Ste Marie Group Health Centre, which has introduced quality improvement programs in areas such as diabetes management and congestive heart failure. For example, its congestive heart failure discharge transition program has reduced hospital readmission rates by 44% over two years.

For these reasons, governments have been working to accelerate primary health care reform.

• September 2000: First Ministers agreed that improvements to primary health care were crucial to the renewal of Canada's health care system, and the federal government announced the creation of the $800M Primary Health Care Transition Fund to support these efforts.
• February 2003: First Ministers agreed to a Health Care Accord which identified to a target of 50% of Canadians having 24/7 access to an appropriate primary health care provider by 2011.
• September 2004: The target was reiterated in the Ten-Year Plan to Strengthen Health Care, and First Ministers further agreed to establish a Best Practices Network for information-sharing and collaboration. These developments were accompanied by additional federal funding.