Healthcare PolicyPub Date : 2025-02-01DOI: 10.12927/hcpol.2025.27562
Stephen Duckett
{"title":"Commentary: Fixing Fraying? A Response to Milinkovic and Hurley.","authors":"Stephen Duckett","doi":"10.12927/hcpol.2025.27562","DOIUrl":"10.12927/hcpol.2025.27562","url":null,"abstract":"<p><p>Privatization - either of funding or provision - is not a solution to Canada's health system woes. However, access issues abound, and part - but only part - of the solution should be to look to improve efficiency of service delivery so that better access can be achieved with the same money.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 2","pages":"41-43"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare PolicyPub Date : 2025-02-01DOI: 10.12927/hcpol.2025.27560
Fiona Clement, Jason M Sutherland
{"title":"From Talking to Action: Changing Healthcare in Provinces and Territories.","authors":"Fiona Clement, Jason M Sutherland","doi":"10.12927/hcpol.2025.27560","DOIUrl":"10.12927/hcpol.2025.27560","url":null,"abstract":"<p><p>There is no doubt that healthcare systems in Canada's provinces and territories are under duress - staffing problems, costly technology adoptions and barriers to accessing care are endemic. Among those who are already ill, the systems' problems create frustration, anxiety and even unchecked disease progression for some people. The worst instances are seen in the media almost daily; the result is an erosion of trust among the Canadian public who had been assured that high-quality medically necessary services would be accessible when needed.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 2","pages":"6-16"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare PolicyPub Date : 2025-02-01DOI: 10.12927/hcpol.2025.27561
Cameron Cattell, Cheryl Mack
{"title":"Commentary: Ethics and Advance Requests for MAiD: Thresholds and Applicability.","authors":"Cameron Cattell, Cheryl Mack","doi":"10.12927/hcpol.2025.27561","DOIUrl":"10.12927/hcpol.2025.27561","url":null,"abstract":"<p><p>We seek to highlight key ethical considerations that arise as Canada considers an expansion of medical assistance in dying (MAiD) to include advance requests. To do so, we will first highlight the ethical and practical concerns that arise with advance care planning and advance directives in general and then draw attention to the unique considerations that arise with advance requests for MAiD. Finally, we will take a closer look at the concerns that will arise with an expansion to include the population with dementia. We will argue that the stakeholder concerns for a vulnerable population such as dementia patients are significant. Legislative frameworks will need to address these concerns to ensure the safety of individual patients and support the role of surrogates and healthcare providers in this process.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 2","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare PolicyPub Date : 2025-02-01DOI: 10.12927/hcpol.2025.27502
Amity E Quinn, Rachelle Drummond, Tom Noseworthy, Fiona Clement, Stephana Moss, Emily Fitzgerald, Melanie Columbus, Brenlea Farkas, Henry T Stelfox
{"title":"The Role and Influence of Federally Established Health Policy Advisory Bodies in Canada.","authors":"Amity E Quinn, Rachelle Drummond, Tom Noseworthy, Fiona Clement, Stephana Moss, Emily Fitzgerald, Melanie Columbus, Brenlea Farkas, Henry T Stelfox","doi":"10.12927/hcpol.2025.27502","DOIUrl":"10.12927/hcpol.2025.27502","url":null,"abstract":"<p><p>Since the passage of the <i>Canada Health Act</i> (1985), there have been many advisory bodies established by successive federal governments, each tasked with providing advice and making recommendations about where and how to improve the health system. Our analysis of interviews with advisory board members and implementers (e.g., ministry of health leaders, staff and consultants) addresses why participants perceived their advice and recommendations were generally not implemented and informal strategy groups used to facilitate implementation. We recommend that future health system advisory bodies focus on coalition building during policy development, integrate implementation plans into policy recommendations and evaluate the impact of policy recommendations.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 2","pages":"52-65"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare PolicyPub Date : 2025-02-01DOI: 10.12927/hcpol.2025.27538
Deborah Milinkovic, Jeremiah Hurley
{"title":"The Fraying at the Edges of the Public Healthcare System in Canada.","authors":"Deborah Milinkovic, Jeremiah Hurley","doi":"10.12927/hcpol.2025.27538","DOIUrl":"https://doi.org/10.12927/hcpol.2025.27538","url":null,"abstract":"<p><p>Since the passage of the <i>Canada Health Act</i> (CHA) in the mid 1980s, advocates for private finance in Canada have challenged the CHA and its underlying access and equity principles. Such challenges have grown in recent years to encompass, among other things, facility fees, membership fees, private virtual care, private interprovincial surgery clinics and private practice nurse practitioners. The continued technological and organizational evolution of healthcare will expand and complicate this further over time. A multipronged approach is needed that includes expanded data to support research on the impacts of such activity, new regulatory frameworks and coordinated action across levels of government.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 2","pages":"31-40"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare PolicyPub Date : 2025-02-01DOI: 10.12927/hcpol.2025.27564
Veena Sriram, Meena Rakasi, Kartik Sharma, Michael R Law, Sorcha A Brophy
{"title":"Health Worker Protests in Canada: A Descriptive Analysis of Protest Events From 2021-2022.","authors":"Veena Sriram, Meena Rakasi, Kartik Sharma, Michael R Law, Sorcha A Brophy","doi":"10.12927/hcpol.2025.27564","DOIUrl":"10.12927/hcpol.2025.27564","url":null,"abstract":"<p><strong>Objectives: </strong>We analyzed protest events undertaken by health workers in Canada in 2021 and 2022. Our analysis focused on the quantity and distribution of protests within Canada, policy demands expressed by organizers and the temporal sequence of protest events.</p><p><strong>Methods: </strong>Our data came from the Armed Conflict Location and Event Data (ACLED) project, which includes a dataset with all health worker-involved protest events in specific jurisdictions, including Canada. Using an existing taxonomy of policy demands for protest events, we analyzed specific types of protests, protest demands and temporal trends.</p><p><strong>Results: </strong>Over our study period, ACLED identified 157 health worker protests. Events took place in all provinces, with Ontario recording the highest proportion (~40%). The majority of protests focused on working conditions and remuneration (57%), followed by public policy (26%) and health services delivery (21%). The most frequent subcategories were compensation (<i>n</i> = 48), anti-vaccination mandates (<i>n</i> = 38) and understaffing/patient overload (<i>n</i> = 19).</p><p><strong>Conclusion: </strong>Canadian health workers expressed concerns on policy issues ranging from opposition to COVID-19 mitigation to underinvestment in health systems. Identifying and recognizing these drivers and developing targeted policy to address them through inclusive and sustained engagement with health workers will contribute to long-term solutions.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 2","pages":"66-82"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare PolicyPub Date : 2024-09-01DOI: 10.12927/hcpol.2024.27411
Lanre Tunji-Ajayi
{"title":"\"You Can't Let Go\" - A Black Community Leader's Perspective on Engagement and Advocacy.","authors":"Lanre Tunji-Ajayi","doi":"10.12927/hcpol.2024.27411","DOIUrl":"10.12927/hcpol.2024.27411","url":null,"abstract":"<p><p>Lanre Tunji-Ajayi is president and CEO of the Sickle Cell Awareness Group of Ontario (SCAGO). This charitable organization focuses on ameliorating the lives of those living with sickle cell disease by providing evidence-based support to patients and supporting clinical and psychosocial research, health promotion and the development of best practice guidelines. Lanre's passion for this work is personal. Following the death of her brother Sunday Afolabi from preventable and treatable complications of sickle cell disease, Lanre immersed herself in advocacy for community health and quality patient care. In this oral history narrative, Lanre reflects on her decades-long journey advocating for those living with sickle cell disease - a disease which disproportionately affects Black people. Her reflections focus acutely on the challenges she has faced in raising awareness and visibility, including through formal public engagement policy processes. Lanre also speaks to the personal costs she has encountered engaging in this advocacy work and the subtle and institutionalized forms of anti-Black racism that have punctuated this already difficult effort to bring about change.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"79-82"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare PolicyPub Date : 2024-09-01DOI: 10.12927/hcpol.2024.27415
Joanna Massie, Katherine Boothe
{"title":"Recruiting for Engagement in Health Policy.","authors":"Joanna Massie, Katherine Boothe","doi":"10.12927/hcpol.2024.27415","DOIUrl":"10.12927/hcpol.2024.27415","url":null,"abstract":"<p><strong>Background: </strong>Who participates in public and patient engagement processes, and in what capacity they participate, matters. The strategies employed to recruit participants shape the outcomes and legitimacy of engagement processes. We explore these issues through a case study of workshop recruitment.</p><p><strong>Methods: </strong>We conducted a mixed-methods study drawing on literature about existing theories of engagement, and integrated findings from the research team's own public engagement workshop in September 2022. We sought to align theoretical frameworks with practical approaches to recruiting for engagement.</p><p><strong>Results: </strong>There are inherent trade-offs in recruitment methods. While the theory of recruitment is valuable, practical implementation is complex and highly context-dependent. Engaging existing partners and fostering relationships beyond specific events is crucial. Hybrid workshops and low-barrier honoraria promote participation; however, decisions about location and time create barriers. Finally, balancing trusting relationships with critical perspectives can create tension.</p><p><strong>Discussion: </strong>Recruitment is foundational for the engagement process, and requires flexibility, responsiveness and a realistic understanding of barriers. Our study suggests that there is no universal formula for ideal participant makeup or event format. Meaningful engagement requires ongoing dialogue and constant adjustment based on practice. Policy makers can use these insights to align recruitment and engagement strategies with their goals in order to move beyond quick, technocratic fixes.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"36-47"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare PolicyPub Date : 2024-09-01DOI: 10.12927/hcpol.2024.27417
Julia Abelson, Katherine Boothe, Alpha Abebe, Roma Dhamanaskar
{"title":"Public Engagement in Canadian Health Policy: Looking Back, Taking Stock and Charting the Future.","authors":"Julia Abelson, Katherine Boothe, Alpha Abebe, Roma Dhamanaskar","doi":"10.12927/hcpol.2024.27417","DOIUrl":"10.12927/hcpol.2024.27417","url":null,"abstract":"<p><p>Canada has a rich history of public engagement in the health policy sector. However, current political, economic and social challenges call for critical reflection on this history, to assess whether current approaches to engaging Canadian <i>publics</i> are up to the task, and what adaptations or new approaches might be needed. If the persisting inequities in health systems across Canada are going to be addressed, it is imperative that those designing, developing and implementing policies find ways to reflect the needs and preferences of the communities and populations most adversely affected by these inequities in their decisions. The purpose of this special issue is to address this important topic through a series of research papers and commentaries. Our work is targeted to health policy makers across Canada who are seeking to engage with various publics on a wide array of health policy issues. We offer key insights into what more purposeful and equitable public engagement might look like, as well as common pitfalls in public engagement practices and how they can be avoided.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare PolicyPub Date : 2024-09-01DOI: 10.12927/hcpol.2024.27413
Rhonda C George, Alpha Abebe
{"title":"Black Community Health Advocates in Ontario: A Look at Health Policy Engagement From the Ground Up.","authors":"Rhonda C George, Alpha Abebe","doi":"10.12927/hcpol.2024.27413","DOIUrl":"10.12927/hcpol.2024.27413","url":null,"abstract":"<p><strong>Study objectives: </strong>Disproportionately negative pandemic outcomes, lack of race-based data collection and poor engagement of Black communities in policy decision making have been widely documented for Black Canadians. We examine this to understand how formal public engagement processes might be more inclusive of Black peoples to inform more responsive policies.</p><p><strong>Methodology: </strong>The study employed an asset-based lens to examine how Black communities have engaged in health policy and advocacy in Ontario. In-depth interviews were conducted with eight participants who self-identify as Black, recruited using purposive and intensity sampling to (1) identify <i>information-rich</i> cases, including people who have been at the forefront of high-impact work in this space and (2) participants whose mission and mandates represented diverse approaches and sub-populations.</p><p><strong>Results: </strong>Our findings suggest that while Black community advocates face systemic and contextual barriers, they also embody deep and multifaceted knowledge, training and experience, which inform the rich ways that they approach advocacy.</p><p><strong>Discussion: </strong>Despite its Ontario focus, this study adds breadth and depth to the existing literature on health policy and historically marginalized populations, offering broader lessons for policy makers across jurisdictions. Our findings encourage policy makers to better recognize, make space for and cultivate fertile advocacy foundations, cultural knowledge and community-driven systems already present in Black communities.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"62-73"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}