The Canadian way
The new HiT (Health Systems in Transition) health system review for Canada has just been released. In Canada there has been a major reinvestment in public health since the cuts of the early to mid-1990s. The last 2 decades have produced a dense network of intergovernmental agencies, and while collaboration has succeeded in some areas (e.g. ensuring universal accessibility to hospital and physician services), it has been less effective in other areas (e.g. more effective use of IT). The Canadian government has focused on improving the timeliness, quality and safety of health care, and this has resulted in more doctors and nurses as well as an increase in the proportion of both, relative to the general population. In addition, governments have invested heavily in capital infrastructure including medical equipment, and recently, there have been improvements in quality outcomes as well as reductions in waiting times, although primary care performance remains weak in Canada.