Question Period Note: Family Health Teams

While far too many Canadians are still struggling to secure timely access to family health service, whether from a doctor, nurse, or team of providers, this issue disproportionality impacts those living in rural communities.

The Government of Canada recognizes that far too many Canadians lack timely access to a regular family health services provider, and that those Canadians living in rural and remote communities, have a harder time accessing needed health care services, including virtual care.
Transforming the delivery of those services, including through virtual care, will help Canadians to get care when and where they need it, from a team, doctor or nurse practitioner.
Our Government is investing nearly $200 billion over 10 years for health care, including $46.2 billion in new funding to improve health care services for Canadians across the country.
This includes $25 billion over ten years to support provinces and territories through bilateral agreements.
Improving access to family health services is at the core of these bilateral agreements and is one of the four shared priorities that were identified with PTs for these investments. We want to incentivize team-based, family health services as much as possible.
Canadians deserve high quality health care and our Government is building on our strong partnership with provinces and territories to transform health care.
IF PRESSED ON VIRTUAL CARE
In response to the pandemic, the Government worked with provinces and territories to accelerate uptake and use of virtual care, supported by $200M in funding in 2020.
Since then, virtual care has become an important way for Canadians, including those in rural and remote communities, to get the care they need, when they need it.
We recognize that for many rural and remote communities, challenges in infrastructure contribute to difficulties in accessing virtual care.
The historic investments announced in Budget 2023 enable provinces and territories to transform the way family health services are delivered, including through virtual care, in ways that make sense in their respective contexts.
IF PRESSED ON TEAM-BASED CARE AS A WAY OF INCREASING ACCESS TO FAMILY HEALTH SERVICES IN RURAL COMMUNITIES…
Transforming how family health services are delivered will be key to increasing access to those services, particularly for Canadians living in rural and remote communities.
Like virtual care, team-based care can play a key role in expanding access to family health services in that it is centred on the patient, who can get the services they need from a range of health providers depending on their needs.
The historic investments announced in Budget 2023 enable provinces and territories to transform the way family health services are delivered in ways that make sense in rural contexts.
IF PRESSED ON THE NUMBER OF CANADIANS WITHOUT A FAMILY HEALTH SERVICES PROVIDER…
Our government recognizes that Canadians continue to face challenges in accessing a regular health care provider, be that a doctor, nurse practitioner, or team of health care professionals.
According to Statistics Canada, in 2022, 14% of Canadians did not have access to a regular health care provider.
As part of the Working Together plan, there is a federal, provincial and territorial commitment to collect, use and share health information and to inform Canadians of progress with key common indicators.
The Canadian Institute for Health Information (CIHI) is leading a process to review and refine eight initial common indicators, including one related to measuring access to family health services.
CIHI released an initial snapshot in August 2023 drawing from available data. CIHI relied on the 2021 Statistics Canada data for the family health services indicator, but due to differences in calculations, the CIHI report indicates that approximately 12% of Canadians do not have a regular health care provider.
CIHI and Statistics Canada are currently working together to refine these indicators.
IF PRESSED ON LACK OF FOCUS ON FAMILY HEALTH SERVICES WITHIN BRITISH COLUMBIA’S ACTION PLAN…
The Government of Canada recognizes that provinces and territories have their own unique circumstances. As such, bilateral agreements on Working Together to Improve Health Care for Canadians are intended to be flexible, and provinces and territories may tailor these agreements to address the unique needs of their populations and geography.
Like other provinces and territories, British Columbia is already investing and making significant efforts to advance work on all four shared health priorities.
British Columbia will use federal investment to support health workers and reduce backlogs, modernize the health care system and increase mental health and substance use supports.
By introducing additional recruitment and retention initiatives, patients across British Columbia will have improved access to team-based family health care, including to family doctors, nurses and nurse practitioners.
Efforts to integrate primary care and mental health and substance use is an excellent example of the interconnectedness of the shared health priorities.
We are encouraged by the shared urgency for driving progress through these bilateral agreements.
IF PRESSED ON HEALTH HUMAN RESOURCE CHALLENGES IN RURAL AND REMOTE COMMUNITIES…
Our government recognizes that Canadians living in rural and remote communities face specific challenges in getting access to the family health services they need, when and where they need it.
We are working with all interested partners to find solutions. The Coalition for Action for Health Workers provides practical input and ideas on concrete actions that all levels of government can implement for the health workforce.
Budget 2023 confirmed funding of $45.9 million over four years, starting in 2024- 2025, with nearly $12 million ongoing to expand the reach of the Canada Student Loan Forgiveness program to more rural communities, to encourage more doctors and nurses to practice in rural and remote communities. Communities with populations of 30,000 or less will now be eligible for the program.

Family health services
Family health services are the backbone of high-performing health care systems. They serve a dual function in the health care system as the direct provision of first-contact services and a coordination function to ensure continuity across health care settings. However, Canadians continue to struggle to access family health services. In 2022, 14% of Canadians 12 years and over lacked a regular health care provider, with gaps felt particularly acutely by Indigenous populations. In 2021, while 18% of Canadians lived in rural communities, they were served by 8% of physicians practicing in Canada.
It is well recognized that multidisciplinary team-based care is critical to increasing timely access to care for patients. Team-based approaches, with optimized scope of practice, create efficiencies that can allow primary care providers to add new patients to their panel thereby increasing provider-patient attachment, and improving timely access to care. Team-based models of care can improve quality of life, well-being and satisfaction for providers resulting in improvements to retention and recruitment. Team-based models also offer the potential to enhance access to services that have traditionally not been well integrated with primary care, such as mental health and substance use and addiction services, as well as with the broader social services sector.
Virtual Care
Virtual care is increasingly recognized as an important component of high-quality care and can help support access to family health services, particularly in northern, rural and remote communities. The adoption of virtual care accelerated as a health system response to the COVID-19 pandemic. In 2020, in response to the pandemic, the Government collaborated with provinces and territories to accelerate uptake and use of virtual care, supported by $200M in funding in 2020. $150M of this funding was provided to provinces and territories through bilateral agreements to enhance virtual services and $50 million went to Canada Health Infoway to support provinces and territories to implement virtual care.
Federal Investments
Budget 2023 outlines the federal government’s plan to provide close to $200 billion over ten years in health transfers to provinces and territories, including $46.2 billion in new funding through new Canada Health Transfer measures, tailored bilateral agreements to meet the needs of each province and territory, funding for personal support workers, and an increase to the Territorial Health Investment Fund. In addition, Budget 2023 announced $2 billion over 10 years to address Indigenous health priorities and $505 million over five years, starting in 2023-24, to the Canadian Institute for Health Information (CIHI), Canada Health Infoway, and other federal data partners.
Canada Health Transfer Five Percent Guarantee: The federal government will provide top-up payments to achieve Canada Health Transfer increases of at least five percent per year for the next five years. The last top-up payment will be rolled into the Canada Health Transfer base at the end of the five-year period, resulting in a permanent funding increase. This represents an estimated $17.1 billion over ten years in additional funding through the Canada Health Transfer.
Tailored Bilateral Agreements: The federal government will provide $25 billion over ten years through a new set of bilateral agreements to address individual provincial and territorial health system needs, such as expanding access to family health services, supporting health workers and reducing backlogs, increasing mental health and substance use support, and modernizing health systems.
Bilateral agreements are intended to be flexible and provinces and territories have options to tailor their respective Action Plans in response to the unique needs of their populations and geography.
HHR and FPT Collaboration
On October 12, 2023, FPT Ministers of Health issued a public statement reaffirming their commitment to supporting Canada’s health workforce so our health workers are able to provide high-quality, accessible, and effective health services for people living in Canada. In particular, FPT governments committed to concrete actions focusing on:
• Retention, reducing rates of stress and burnout and improving workplace culture, flexibility, and wellness so health workers can stay in their jobs;
• Domestic education supply and demand, enhancing Canada’s capacity to produce a domestic supply of key health professionals, including more training opportunities for Indigenous Peoples that meets national demand for care and keeps pace with a growing and aging population;
• Foreign credential recognition and ethical recruitment, making Canada a country of choice for health care providers by reducing the time it takes for internationally educated health professionals (IEHPs) to join our workforce;
• Labour mobility, supporting an agile and flexible workforce to support access to care; and
• Health workforce data and planning, improving the availability, sharing and standardization of health workforce data to support health workforce planning.
On November 1, 2022, the Government of Canada established a Coalition for Action for Health Workers. The Coalition’s efforts are focused on identifying approaches to drive pan-Canadian action and progress on policy implementation, informed by real world perspectives. The Coalition is comprised of representatives from key groups, including nurses, doctors, personal support workers, colleges and universities, patients, and equity-seeking communities, and reports to the Deputy Minister of Health.

In 2022, 14% of Canadians 12 years and over lacked a regular health care provider.
In 2021, 18% of Canadians lived in rural communities, but they were served by 8% of physicians practicing in Canada.
There are significant data gaps regarding First Nations, Inuit and Métis health disparities in primary care.
Access to family health services is a shared health priority identified in the Government’s plan for Working Together to Improve Health Care for Canadians.