Brad Wall Urges 'Lean' Health-Care Reforms

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Brad Wall says premiers are acting on their own to share best practices with each other.
Brad Wall says premiers are acting on their own to share best practices with each other.


Saskatchewan Premier Brad Wall is urging health-care providers across the country to use "lean management techniques" in their service delivery, and thinks the federal government could play a bigger role in enforcing the Canada Health Act.

Wall shared his views on health care on Power & Politics on Wednesday, after speaking at a conference in Montebello, Que., that brought together health and policy leaders and was focused on how to use innovative practices to improve services for patients.

The conference was organized by Canada Health Infoway, the non-profit organization that is funded by the federal government and works with the provinces to implement electronic health records.

Wall said discussions about innovation often involve a debate about private and public health care and he talked about how Saskatchewan is using private clinics to provide surgeries.

"No one's jumping the queue, no one's slapping down a credit card to get ahead of the line, but to add capacity we have private clinics operating in the province. But it's demonstrating results," Wall told host Evan Solomon.

The province has promised residents a guarantee of surgeries within three months and wants to reach that target within four years. The rate of people now waiting longer than three months has dropped by 92 per cent, Wall said.

When it comes to what is permitted under the Canada Health Act – the federal legislation that is meant to ensure Canadians have access to insured health services – Wall said different provinces have different interpretations.

Feds could be more "active" on Canada Health Act

"Here's where the federal government perhaps needs to take a more active position," Wall said. The federal government is responsible for ensuring the provinces and territories meet the criteria in the Canada Health Act in order to receive their funding from Ottawa. Penalties can be applied if provinces don't comply with the legislation.

Wall noted that the federal government wasn't interested in the idea of a health innovation fund with the provinces so premiers are acting on their own to share best practices with each other.

The federal government often refers to health care falling under provincial jurisdiction. It caught the provinces off-guard in December when Finance Minister Jim Flaherty abruptly announced a new funding formula for health transfers to the provinces after the current accord expires in 2014.

"On the issue of the Canada Health Act, that is the federal area in health care, there's no question about it, no dispute there and in the meantime, each province is interpreting it in a different way," said Wall.

He said the Canada Health Act is still "very much valid" despite varying interpretations of it, and that fundamentally, Canadians still value a health system that is not based on how much money people have in their wallets, but is a public one.

Using innovative practices in health care is about more than the mixed-use of private and public providers, Wall said.

His province is implementing a model developed by the car manufacturer Toyota, called lean management techniques. Wall said the efficiencies that have been found have reduced wait times and improved experiences for patients, but importantly, have saved money.

Changing the way the blood supply is managed, for example, has saved the province $10 million.

"It can have big results or incremental results, but that's part of innovation too," he said.

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