Task force chairs say the culture of health care has to change

·5 min read

Sister Elizabeth Davis is a compassionate, level-headed voice when it comes to health care and social issues in Newfoundland and Labrador.

But even she bristles a little when asked about skeptics possibly shrugging off the value of a new 10-year Health Accord Task Force formed by Premier Andrew Furey.

“The cynical thing is to say they’re not going to do any good; they didn’t before so why would they now?” she says.

“But if you care enough to even make the comment, I think you should be one of the ones who challenges this task force to do what it’s promising to do.”

The premier announced the appointment of Davis and Dr. Patrick Parfrey as co-chairs of the task force on Thursday.

Davis has been involved with numerous health care bodies in the province, including a stint as CEO of Eastern Health in St. John’s. Parfrey is a well-known nephrologist and epidemiologist, and is currently clinical lead of Quality of Care NL and Choosing Wisely NL.

Both sat for a virtual interview on Friday.

The undertaking is not to simply tinker with the existing health-care system, Parfrey said. It’s to completely reimagine it.

That means focusing primarily on what are called social determinants.

“That really means the social issues that are present in the community and in individuals that predispose to adverse health,” Parfrey explains.

The hospital system will not change, he said. But the approach to community care and social inequalities must.

“The social aspects that relate to health are probably more important to the province than the medical system,” he said. “We’ve got a 50-year-old health care system providing care to a demographically changed population and we do need to reimagine that health care system.

“To get it in balance across the regions, urban and rural, requires a pretty detailed plan that’s holistic and integrated.”

Both Parfrey and Davis say there are misconceptions about how well health care is delivered in the province.

“There’s an irony in this province that when you ask Newfoundlanders and Labradorians to rate their health, we’re actually up quite high in our belief in our status being healthy people,” Davis said.

“And yet when you look at the facts, the evidence shows that our life expectancy is not as long as others, our death rates from certain diseases is higher than the rest of Canada. The reality is we’re not as healthy as a province as people are in the rest of Canada, and that should not be so, so what can we do to change that?”

Since she was in charge of Eastern Health 20 years ago, Davis says her own personal awareness has grown. Much of that came with her current role as co-chair of the board at The Gathering Place in St. John’s.

“I did not understand that there were thousands of people in St. John’s who were literally invisible, she said. “I know that today through The Gathering Place.”

She also says she’s come to understand more fully how seniors have become a huge segment of the population.

“But if you counted in Newfoundland today the number of geriatricians and the number of pediatricians, you would assume we have the same population format as the year I was born,” she said.

Parfrey says the accord is a 10-year project because its goal is to completely change the culture, not just the mechanics.

“The creation of the plan won’t take 10 years and the implementation of the plan won’t take 10 years, but the impact of the plan will take 10 years because you’ve got to change culture,” he said.

“All that is going to take time.”

Davis points to health inequities in indigenous communities as a glaring example of how the overall approach to health care has to change.

“If a little indigenous girl is born today in Happy Valley-Goose Bay and a white girl is born today in St. John’s, why should they have a different star in terms of health status?” she asked.

That can’t be changed from the top down, she added.

“The health status of indigenous peoples in this province is lower than other people in the province, but on the other side, indigenous people have very wise insights into health and healing and wholeness, so it so important that we engage with the indigenous communities, but they have to tell us how best to do that,” she said.

“Neither one of us is indigenous, so we don’t understand the complexities of the five distinct communities of indigenous peoples in this province, to start with, and we don’t always understand the structure within the communities.”

She said the plan is to make sure the indigenous population is represented among task force members.

“If we don’t listen, we’re not going to learn, and if we don’t learn, any talk of culture change is myth, fantasy, a dream,” she said.

In fact, engagement will be the watchword as task force members and structures are rolled out over the next few weeks.

“We only change culture together. Nobody can dictate, we’re going to have this different culture in this province. That is why the term ‘accord’ is so important,” Davis said.

Media, she said, is pivotal to facilitating the dialogue, she said, especially since the pandemic has hampered the ability for direct community consultations.

“We have to find ways to engage with people to talk about these issues, and then together imagine ways of addressing those issues,” she said. “That’s the only way to bring about change, the kind of change we want here.”

Peter Jackson, Local Journalism Initiative Reporter, The Telegram