Survey: Healthcare Providers and the Public Rate the Issues
Most Important Healthcare Issue Facing Canada
For the third straight year, lack of funding and government cutbacks continue to stand as the most important top-of-mind healthcare issue facing Canada. Nearly two-in-ten Canadians (19%) specifically point to this issue, followed by other resource scarcity related issues such as lack of staff and work overload (10%) and long waiting periods (7%). The issue of staff overload has shown considerable growth over the past two years (up from 4% in 1999 and just 2% in 1998).
Other healthcare issues which have captured the public's attention include the aging population (5%), the so-called "brain drain" of physicians moving to the United States (5%), accessibility issues (4%), bed closures and shortages (4%), the cost of healthcare (3%), the quality of service and proper care (3%) and hospital issues (3%).
Both doctors and pharmacists are also most likely to point to lack of funding and government cutbacks as the most important issue facing Canada (38% of doctors, 27% of pharmacists). Among nurses, this issue takes a back seat to issues surrounding lack of staff and work overload (31%).
Issues Facing Healthcare ProfessionalsWhen asked to comment on the most important healthcare issue facing their own profession, physicians most commonly cite lack of staff and work overload (13%), lack of funding and government cutbacks (12%) and a shortage of doctors and specialists (12%). Nurses specifically mention a shortage of nursing staff (22%), followed by mentions of work overload (18%) and lack of funding due to government cutbacks (10%). Pharmacists themselves most frequently say the number one issue is a lack of pharmacists (22%), while another 7% mention a lack of reimbursement from the government or third party sources.
Human resource issues dominate nurses' responses when asked their opinion on the biggest challenge facing their profession. The most frequently mentioned issue is recruitment (15%), while another 10% cite work overload, 9% mention a nursing shortage and 5% specifically point to an aging workforce with retiring nurses (4%). Other issues include the ability to provide safe, quality healthcare (12%), lack of respect and support (8%), changing roles and a lack of role clarity (5%), lack of funding (3%) and a need to be more involved in decision making.
Currently, the majority of nurses believe they influence physicians' treatment choices, although just 13% believe they have a great deal of influence while 46% say they have just some influence. Nearly four-in-ten say they have either not much influence (28%) or no influence at all (11%). In contrast, more than nine-in-ten nurses believe they should have at least some influence, including 37% who believe they should have a great deal of influence and 59% who believe they should have some influence.
Public View of the Canadian Healthcare SystemThe majority of Canadians continue to demonstrate declining confidence in the Canadian healthcare system (51% state they have falling confidence, down from 55% in 1999 and 59% in 1998), although a rising number say their confidence is the same as it ever was (41%, up from 38% in 1999 and 35% in 1998). Only a small minority claim rising confidence in the system (6%, up from 5% in 1999 and 1998).
This year, there is also a significant jump in the number who worry that Canadians are not receiving quality healthcare right now (41%, up from 28% in 1999 and 31% in 1998).
Declining confidence is compounded by the view that the overall quality of healthcare services is decreasing (58%). Just one-in-ten (11%) believe the quality of care is increasing while 29% believe it to be the same.
As discussed in last quarter's column, confidence in the ability of the healthcare system to deliver quality care has reached what is likely its nadir, and there is a growing appetite for the kinds of changes need to ameliorate the situation. The public is ready to enter into a rebuilding stage, and healthcare professionals are leading them there.
About the Author(s)
Don Guy is Senior Vice President with POLLARA Inc.
AcknowledgmentHealth Care in Canada 2000 is a national telephone survey of 1,200 adult Canadians (conducted between September 6 and September 14, 2000), 200 physicians, 200 nurses and 200 pharmacists (conducted between September 15 and October 6, 2000) regarding healthcare in Canada. Overall results for the public are considered accurate to within plus or minus 2.9%, nineteen times out of twenty, while the margin of error for the healthcare providers' results is +/- 7.1%, nineteen times out of twenty.
This information is provided with the kind permission of the Ontario Hospital Association (OHA). This survey is sponsored by Merck Frosst Canada and Co. in partnership with the Coalition of National Voluntary Organizations, the Canadian Medical Association, the Canadian Nurses Association, the Canadian Association for Community Care,
the Canadian Homecare Association and POLLARA.
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