"People often refer to the “Canadian health care system,” when in reality, it has distinct health systems for each of the provinces and territories. The Canada Health Act outlines the basic tenets for health care to be universal and accessible for essential physician and hospital health services across the country. However, the details of how each system operates, including what is covered and how, is determined provincially. In addition, the federal government has responsibility for Aboriginal and veteran health care.
Add it together, and Canada has a whopping 15 unique health care systems. On the plus side, this means provinces can tailor health services to the particular needs of their residents; the downside is that co-ordinating health reforms across the country remains a significant challenge."
So as you can see, it depends largely on which province you live in as to which service is covered and which is not. Many of the so called "covered things" have been contracted out to private agencies. Home care for instance, is handled very differently from one location to another. What I have learned is it is very different even within Ontario. They say it is tailored to the needs of it's citizens, however I have seen it to be covering the convenience of the agency first, worker next, then the client. In this article from the Globe and Mail there is a scathing review of home care in Ontario.
"But critics of Ontario’s nursing clinic model warn that other patients who might be better cared for in their homes – for example, those who are too ill to travel or do not have relatives to chauffeur them to the clinic – are being pressured to use the clinics by the CCACs, primarily as a way for the publicly funded centres to meet their budgetary targets."
I have my own personal story to collaborate their findings. Last spring I was very ill from a kidney infection. I was seen at at clinic first, and treated with an antibiotic which did not work. The second time I was seen was by my own doctor, at which point I was listless, clammy dark circles under my eyes, weak and very ill. My doctor even wondered if I was at the beginning stage of sepsis. He wanted to hospitalize me, but felt with my weakened immune system I may be better served as out patient with a series of I.V antibiotics. I agreed. Who wouldn't? I could get the medication I needed, at home, by a registered nurse and be cared for by family, with home cooked meals. Sounded like the best of two worlds.
What happened in fact was very different.
I went to the hospital to be set up with the I.V. It was a long process as I was so sick at this point the I.V was very difficult to get in. I was black and blue up my arms from them trying when I finally said "No more, find someone who is an expect in this."
Finally along comes a nurse who they all knew was very efficient at doing I.V's, it was in, first try. I was given my first treatment there. I was to get home care for the fourteen other treatments. I was exhausted but glad I could just go home, rest and wait for them to come to me.
I was wrong! Very wrong. I got a call from CCAC and was given appointment times to go to VON office to receive my I.V treatments. I was at a loss, shocked even. What a very different scenario than I had pictured. I had thought I would be in my own bed, in my quiet house with a qualified nurse arriving to administer what I needed.
No, I was told. You can walk so you have to come in! Period. They knew my previous history of a spinal cord injury, and how very sick I was. They knew my doctor wanted them to come to me and had discussed concern over infections. I was told in no uncertain terms that my doctor had no say, and neither did I.
I want to pause in the telling of the story, to remind people who may be caring for a loved one. When they are that sick and told to do something they will do it. Whether it is their best interest or not. There was no fight left in me at that point. I did what I was told to do.
I hauled myself out of bed, got washed and dressed got into a car and was driven to the VON, all because I was told to. Too weak to protest what I was told was my responsibility. We got out of the car and into the building which also housed a pizza joint, and a Chinese restaurant. Immediately the smells made me want to vomit. The car ride had made me dizzy, it took a few minutes; we got on an elevator, then down a very long hallway, finally we reached their office. Barry sat me down, and checked in. We were told to sit and wait, and wait we did. That first day I fell asleep, maybe to try to escape the nauseous feelings I was experiencing.
Finally we were called in for the appointment, and assessed once more. Yes, I could walk so I must come into their office. My only other choice was to be admitted to the hospital and risk infection of another more serious form.
I ask anyone, is this a humane thing to do to someone who is that sick? Trust me it is not. I cried every day. I was defeated. Many times the I.V had to come out and be reinserted. There were times I was sent back to emerge to have it reinserted. It was a nightmare of which I am giving you the few details I care to remember.
Cancer patients must do the same. It doesn't matter, if you can walk, you must go to them. Money, and lots of it is saved. It doesn't matter about the needs of the patient. It was a humiliating experience, one I am glad is over. Canadians are experiencing the same thing day after day as our healthcare erodes. We are brainwashed into thinking we have the best system in the world, but believe me, just scratch the surface and you will see and smell something rotting. It's our beloved health care system.
At the risk of being long winded, I want to give another side. I have a fantastic Family doctor who has never failed me. I have a complicated medical file and he is on top of it all. He converses with specialists about me when needed, and listens to my point of view. He shows value for what I want for myself as a patient. We have a relationship built on mutual respect.
At Toronto Western recently my care was exemplary! The surgeons were fantastic in every way. I was informed, consulted, and felt cared for by them. The nursing staff was busy, but professional and attentive. The food was "hospital food" but editable.
Fast forward to the rehab hospital, and it all fell apart. The food was inedible, the nursing staff was too few. I met 20 different nurses in as many days, therefore they did not know my case. There were many casual nurses who didn't follow any routine. Medications given at different times etc. There was not a commitment to care and consistency for the patient, far from it. The doctors, physiotherapist, occupational therapist were professional and consistent. The nursing staff rarely followed their orders.
In the two experiences I have outlined, the further you get from the traditional hospital setting and direct care of doctors, and committed nurses, the further you get from what we define as the Canadian health care system. I am not one who believes that doctors are the be all, and end all; but every time we say a doctor has no say about how his patient is being cared for in the community, our health care system has failed us.
We believe in our hearts that if we get sick in Canada, we will be taken care of. That is not always the case. The acute care will from my experience, be handled effectively and in a timely way. Once life and limbs have been saved, and we just need to be cared for, there is another story to be told.
In a country where we have some of the best medical researchers in the world; our hospitals are well equipped, our doctors and nurses have gone through rigorous training, what is wrong? Have we stooped to low, have we taken on too much too quickly? Once s patient leaves the hospital things do not always go as planned, and families are left to deal with it.
I hope you won't have to scratch the surface, but if you do, I'm here to tell you to bring nose plugs, and be ready to advocate on those deaf ears!