The Republic must be careful not to exacerbate existing difficulties in its health system when it embarks on health service reforms, a prominent Canadian health administrator has warned.
Dr David McCutcheon, assistant deputy minister for health in Ontario and a former chief executive of Tallaght Hospital, said the focus of healthcare needed to shift from acute care to primary care.
He told the Adelaide Hospital Society conference on Equity and Access in Healthcare in Dublin at the weekend that changes in the Canadian health system had focused on access, including an ability to move easily from one service to another.
"Patients must be able to understand and navigate the system, have genuine choice and be able to access services close to where they live and work."
Spending on health was "significantly different" in the two countries; in Canada the percentage of GNP spent on health is 9.1 compared with 6.7 per cent in the Republic."There is a national culture of entitlement to universal and accessible healthcare in Canada," Mr McCutcheon said.
He told the conference of a recent election campaign in Ontario, which had brought the Liberal Party into power. "It was ideologically opposed to the privatisation of health delivery and, in fact, campaigned aggressively against two-tier medicine."