Yukon panel recommends 'major, system-level changes' to health-care system

A panel of experts appointed by the Yukon government is recommending the creation of a new arms-length super-agency to take over the provision of most health and social services including hospitals, and long-term care facilities.

That would include phasing out privately-owned doctor's clinics. They would be replaced by publicly-owned polyclinics where teams of professionals would provide care to every Yukon citizen.

Those are some of the 76 recommendations from an independent panel created in 2018. It is headed by Bruce McLennan, a former deputy minister of the Health and Social Services Department.

Members of the five-person panel presented their recommendations at a briefing on Wednesday afternoon.

In its "Putting People First" report, the panel says "major, system-level changes" need to be made to improve health care in Yukon, and keep costs manageable.

It says the Yukon government spends about $8,000 per person per year on health care, "much higher than the national average." 

"While we found that some parts of the system are working well in Yukon, other parts are not. More importantly, there is a lack of co-ordination across the system," the report says.

"This makes it hard to deliver services in a person-centred, holistic, preventative, safe and respectful way."

Panel member Diane Strand, a former chief of the Champagne and Aishihik First Nations, says the holistic approach is key to resolving First Nation concerns about the system.

"The model that we're recommending is going to help, not just the First Nations governments and citizens, but all of the Yukon," Strand said on Wednesday.

McLennan said he's not worried the transition from private doctor clinics to publicly-owned clinics will be strongly opposed by doctors

"It's a direction that new doctors coming out of school — they don't want to work late, they don't want to be running a payroll, they just want to be doctors," he said.

"So it's partly a mindset as well among physicians to move in that direction."

More virtual care, higher travel subsidies

Among the recommendations:

• The creation of "Wellness Yukon," an arms-length government agency that delivers health and social services in the territory and contracts non-government organizations and others to deliver specialty services.
• Work with the Yukon Medical Association to "transition away from primarily fee-for-service payment for medical services."
• Increased use of virtual care for Yukoners to access services from their homes and communities.
• Double the current medical travel subsidy from $75 per day to $150 per day, beginning on
  the first day of travel.
• Create residences in Whitehorse and Vancouver so medical travellers won't need a hotel.
• Expand the territory's vaccine program.
• Work toward fully-funded, universal early childhood education for all Yukon children over the age of one.
• Expand palliative and end-of-life care programs with direct funding to individuals and families.
• An Office of First Nations Health within the Department of Health and Social Services.

Other recommendations focus on making a more holistic system, by focusing on social determinants of health, preventative health and community involvement.   

"Beyond fixing some of the immediate and obvious problems, these changes could make Yukon a leader in health and social service reform in Canada and perhaps the world," the report says.

The report comes amid the ongoing COVID-19 pandemic, and the panel says that delayed its release by a month. But the panel also says the pandemic has not changed the substance of the report, or the recommendations.

"We believe that our recommendations continue to be valid in this changing context," the report says.

"A stronger, more integrated health and social system that puts people first would be resilient and responsive to changing circumstances and needs, including the challenges that we are currently facing."

McLennan said the group of public servants who worked with the panel will become a secretariat whose job is to, "decide which recommendations can move quickly, which will need more time, which will need more cabinet direction or support."

He said he's optimistic that arrangement will result in things actually moving forward.

In a statement on Wednesday, Health Minister Pauline Frost said her department will now review the plan "to determine the feasibility of the suggested changes."

"While there is still extensive analysis that must be done, I believe this is the right direction for our territory and I am very pleased to see such a progressive, modern approach to revitalizing health services in Yukon," Frost's statement reads.