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Canada needs a national seniors strategy

The Daily Gleaner (Fredericton)
Published: May 13th, 2016

New Brunswickers must give the provincial government a little leeway to explore and takerisks as it goes through the process of re-thinking the provincial aging care system, says Dr. Chris Simpson, past-president of the Canadian Medical Association. 

While speaking to a room full of aging care experts and nursing home operators for his presentation at the Nursing Home Association of New Brunswick’s annual general meeting in Fredericton, the Kingston, Ont.-based cardiologist, who hails from Nackawic, said Canada needs a national seniors strategy.

He feels it should be embedded within the next federal health accord, a pact that sets the terms for how health-care dollars flow from the national level to the provinces and territories.

As New Brunswick finds itself among the oldest provinces in the country, Simpson believes there is a special opportunity for innovative thinking to address the coming needs of the aging baby boomers.

“We’ve spent the last couple of years kind of building the platform around seniors care. It seems to have particularly resonated in New Brunswick,” he said.

“It seems to be at the front here, at least more than in other places. We now have this unique opportunity where we have a federal government that clearly wants to re-engage on health care. They get the seniors message. We’ve had lots of discussions and they clearly know that something has to be done to address seniors care. So why doesn’t New Brunswick lead the way?”

Much like the creation of the Extra Mural program, which has been celebrated across the globe for improving home health care, there’s a chance for the province to find a new road for healthy aging supports.

“In New Brunswick, there’s always been an innovative, can-do approach, one that’s allowed us to do some great things without a whole lot of resources,” he said.

At the national level, the Canadian Medical Association has been lobbying government for a new health accord to replace a previous 10-year agreement that expired in 2014. Ideally, said Simpson, a national senior care strategy could be a significant part of that pact.

“A key part of that would be a demographic top-up, which would recognize that provinces who have older populations simply need a bit more money to be equitable,” he said.

For example, Simpson grew up in New Brunswick, where he benefited from the health-care and educational services he received in his youth. 

In his career as a physician, he moved to Ontario, where he is now paying taxes in that province. 

But when he retires, he believes he’ll move back to New Brunswick, where he’ll be accessing health-care services more frequently than he does now, as he moves towards the end of his life.

“I’m an economic contributor to the economy of Ontario. But one day I’ll come back here and become a recipient of economic benefits. There’s a national responsibility that only the federal government can fulfil,” he said.

“But it has to be different. We can’t just say, ‘Here’s the cash and there’s no accountability for it.’ We really want to build into the health accord a targeted purpose and accountability for this money. In seniors care, that could be easily developed and tracked.”

Simpson suggested the creation of an innovation fund, one that supports the creation of unique programs and services that will improve the level of care in the community.

“These types of things should be used to relieve the burden on the system [caused by an abundance of seniors living in hospitals while waiting for a nursing home placement],” he said.

When asked how governments can be convinced to be more daring and exploratory, particularly during difficult financial times, Simpson said they have to take risks to find the next big idea.

“It’s tough for governments. It has to be OK for governments to occasionally makemistakes. But what they also have to do is to recognize that when they’ve got it wrong, they have to fail fast and switch gears,” he said.

“Yes, governments have to be accountable to voters. Yes, we’ve had one-term governments here in New Brunswick recently, which has never happened before, and that makes them very risk-averse. But I think the electorate has to enable them to take some risks. It has to be OK to stumble a little bit along the way. In most change-management cultures, people will say, ‘If you don’t get it wrong every once in a while, then you’re not doing it right.’ You’ve got to be daring. By taking risks we will fail sometimes, but we’ll also stumble upon some spectacular successes too. My dream for New Brunswick is that it can show all of Canada the way.”

Simpson was one of many speakers at the two-day conference, which was designed to generate new discussions for the aging-care sector’s frontline professionals.

Jodi Hall, executive director of the Nursing Home Association of New Brunswick, said Social Development Minister Cathy Rogers attended the opening night’s festivities and spoke to the invited guests.

In recent months, there’s been a rocky relationship between Rogers and the association, which has criticized some proposed changes to staffing mixes and food-funding allotments for nursing homes.

But Hall said things have improved in recent weeks and there’s a much more respectful dialogue happening now.

“I feel like we’re at a place where we realize we need each other, we need to work together,” she said.

“Our issues are bigger than each other. It’s going to take all of us working together to get back to where we need to be … Sometimes when you have disagreements I feel like they can lead you down a more productive path.”

Hall said the this week’s conference is about raising some potential avenues to a transformational change in aging care.

“What we’re trying to do, by bringing in some speakers outside our normal circle, is to reframe some of the questions that we’re struggling with,” she said.

“We’re a traditional model. We’ve done a tremendous amount of work over the last few years to get to a new place, to figure out new ways to operate, to become more relevant for the times. We’re in the midst of an important demographic transition. So we have to figure out how to reinvent the nursing home sector so that we’re not only relevant for the residents we care for, but also in the greater picture, in the dynamic of all of these communities. And who has the greatest opportunity for scalability? I believe it’s nursing homes.”