Nurses will play lead role in a dynamic, publicly funded health-care system

Canada's nurses will play a lead role in ensuring a dynamic, publicly funded health-care system for all Canadians, according to the National Expert Commission's (NEC) Report released to the public today at the Canadian Nurses Association (CNA) biennial convention in Vancouver. Titled A Nursing Call to Action, the evidence-based report represents a full year of work by a national group of high profile nursing and public experts in the fields of nursing, law, medicine, business and public service. The NEC was co-chaired by international nursing expert Dr. Marlene Smadu of Regina and well-known health and equality lawyer and author, Maureen McTeer.

"Our consultations and research told us repeatedly that nurses are innovating and nurses are finding sustainable solutions, but we still require a fundamental shift in how our system is funded, managed and delivered," says Commission Co-Chair Marlene Smadu. "Canada has to deal with the reality of an aging and more diverse population, along with rising rates of chronic disease, so how and where we care for Canadians has to change." The Commission's Call to Action recommends a much stronger emphasis on primary health care services delivered at the community level and other options that optimize nursing leadership and nursing contributions to the transformation of Canada's health-care system.

"We've called this A Nursing Call to Action because we want to invigorate individual nurses and the nursing community, along with all of the players in our national health-care system, so together they can focus on the goals of better health, better care and better value for Canadians," says Commission Co-Chair Maureen McTeer. "We've also set some ambitious targets for change because we believe that they are possible, especially if we collaborate effectively and leverage nurse-led practice and innovations."

"Registered nurses are a powerful force for change, and they can lead health-care transformation," adds McTeer. "They are over a quarter of a million strong and they work at every level of health care — from the bedside to research labs to governments. They are with us at every stage of our health-care journey and they know what needs to be done."

The Commission report recommends a fundamental shift in the way Canada's health-care system is funded, managed and delivered in Canada. Within a 9-Point Plan of Action, the report argues for a patient- and family-centred system of primary health care with a strong focus on health promotion and prevention that is based close to Canadians in their homes and communities. The Commission's consultations and research highlight that the system's current focus on the provision of acute care services in hospitals is no longer adequate for a population challenged by more chronic disease, greater cultural diversity and the complex needs of an aging population. The Commission contends that community-based care involving teams of health professionals, including nurses and doctors working to the full scope of their practice, must be the model that Canadians and their governments support to create a sustainable national system for the future.

Research analysis developed for the Commission also compelled it to concentrate on the impact of social, economic, environmental and indigenous determinants that affect health. "We need to address many of the non-health system factors like poverty, food insecurity, lack of access to clean water and housing that persist and diminish the health of our nation," says Dr. Smadu. "We can't expect better outcomes if these issues linger and are not integrated into our thinking about what makes a healthy country. Health care, no matter how good, just can't do it alone."

In addition, A Nursing Call to Action addresses the significant opportunities and challenges faced by the nursing community itself. The report documents the strengths of many nurse-led innovations and approaches, while noting that nurses will need to work to their full scope, educate or re-educate themselves and rapidly adopt new technologies to optimize their impact on health outcomes.

The report also makes an innovative proposal regarding Canada's sliding health standard and reputation compared to other developed countries in the world. Commissioners believe that a national, collaborative initiative should begin immediately to move Canada back into the top five international ranking within the next five years.

"The best gift Canada could give itself for its 150th birthday celebration in 2017 is a revamped and sustainable health-care system," says Ms. McTeer. "There is consensus on many of the key elements that would deliver that gift, so we just need to get on with it." Commissioners also stressed that this commitment to health is a measure of Canada's wealth, success, competitiveness and status in the world.

A Nursing Call to Action also provides recommendations regarding national home care, pharmacare, palliative care and performance measurement.

The Commission delivered its report to the CNA's Board of Directors in Vancouver. The CNA will determine how to prioritize and implement the Commission's various recommendations.