When Dr. Pat Parfrey opened his edition of The Telegram Feb. 2, he probably couldn’t help but smile.
There, on page A7, was a full-page manifesto signed by a dozen health-care unions and associations, all asking for the same thing: a team-based approach to primary care in Newfoundland and Labrador.
“That is an amazing political statement, to think this objective, which is new and progressive, is supported by everybody in health care,” Parfrey said in a video interview last week.
“It’s a solution to the kind of chaos that’s been happening in community-based care and primary care in the province, particularly in rural areas. It’s a perfect storm of opportunity.”
Parfrey and task force co-chair Sister Elizabeth Davis are conducting a second round of town halls this week as part of the 10-year Health Accord initiative to re-envision how health care is delivered in the province. A draft report is due in September.
Although the input received so far is very preliminary, Parfrey and Davis say a major consensus is already starting to form.
“There’s been a very substantial overlap across all the ways of assessing what people thought,” Parfrey said.
About 350 participants signed up to take part in town halls last December, and another 70 people offered submissions by email. Thousands more responded to surveys conducted by regional health authorities.
“What was surprising was the unanimity across all the voices,” Davis said,
“The major conclusions were that there was a voice for the importance of the social factors in health, and that something should be done about it,” added Parfrey. “And there was undoubtedly a voice to get a better balance between the community system and the hospital system.
“One of the most striking statistics was that 83 per cent of the respondents felt there needed to be change in the way we delivered care.”
There’s good reason to want to change.
“We have terrible health inequity between our province and other provinces,” said Davis. That includes lower life expectancy, higher rates of death from cancer, cardiac disease and stroke, and more chronic illness.
And there are inequities within, as well.
“If you’re born into an aboriginal community in this province or into a poor family in this province, your chances of having worse health are higher. And that’s not fair,” she said.
Davis feels the three issues that need more focus are poverty, food insecurity and housing.
These are among the social determinants of health, a term the co-chairs hope to ingrain in the conversation as solutions are sought.
Their surveys showed most people don’t equate better health care with the bricks-and-mortar side of it. Two-thirds of respondents identified social factors.
“We can’t waste a good crisis. We’re in three crises right now: the COVID crisis, the financial crisis, and the health crisis in this province. Every single leader has to say, I’m in this. I’m willing to put my self-interest aside here and make this happen.” — Sister Elizabeth Davis
In any country, rich or poor, research has shown at least 60 per cent of the factors that affect health are social, economic and environmental factors. Davis said about 20 per cent are lifestyle and cultural influences, and around 20 per cent are health-care services.
“It’s not the hospital system that determines our health, mainly,” she said. “That only comes in to fix up the pieces that are broken.”
Davis said the alignment of crises facing the province makes now the perfect time to address the problem.
“We can’t waste a good crisis,” she said. “We’re in three crises right now: the COVID crisis, the financial crisis, and the health crisis in this province.
“Every single leader has to say, I’m in this. I’m willing to put my self-interest aside here and make this happen.”
Parfrey said transparency will be key in making sure everyone understands what will work and what won’t.
“It’s our job to try and change the myths that are out there about what contributes to good health outcomes and replace them with evidence-based ideas,” he said.
Peter Jackson is a Local Journalism Initiative reporter covering health issues in St. John’s.