Donald Trump’s tariff threats took up much of Ontario residents’ attention during the federal election. But we shouldn’t lose sight of another problem where many challenges remain: health care.
The province faces severe understaffing that leads to longer wait times, while 2.5 million Ontarians are without a family physician and there is no clear direction in its fight against cancer.
Provinces release multi-year cancer plans to guide their work in prevention, treatment and care. A good plan is a roadmap. It talks about funding; describes what the province will emphasize and how it will measure changes; tells us who is responsible for keeping us on course; and describes how treatment and services can continue during a state of emergency.
However, the recently released and much-delayed Ontario cancer action plan 2024-28 is like reading a map without the big red YOU ARE HERE sticker.
The main problem is the lack of robust metrics, which means patients could be at risk and Ontarians don’t know if we are headed in the right direction in cancer care.
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The government should prioritize the development of a comprehensive and transparent cancer action plan that includes specific, measurable goals and timelines. This plan should also establish clear accountability mechanisms to ensure that progress is tracked and reported regularly in a transparent manner.
For those of us who live with cancer, are caregivers, help patients, or do research and innovate for this disease, this plan should have given us clarity and confidence on the direction of cancer care in Ontario.
Instead, we have a 27-page document that is heavy on the successes of the last plan and light on outlining the specific commitments and measures that will define the next four years.
Structured with aspirational, nebulous goals, it lacks clear actions and performance metrics. It also leaves important questions: Where is the funding that will support these objectives? How will the government be held to account?
Yes, some mention is made of a robust measurement plan. Performance indicators are operating somewhere in the background, but no specific details are shared and it’s not made clear if they ever will be in a timely and transparent manner.
Instead, the plan commits to publicly reporting provincial results through Ontario Health’s annual report, through cancer screening performance reports and through the cancer system quality index. But some of the reports have not been updated since 2023 and feature even older data. This makes it challenging to determine even an appropriate baseline.
The current two-year Quebec cancer plan, constructed with input from health-care providers and patient groups, has key actions connected to goals – all of which rely on modernizing the data. This effort includes updating the Quebec cancer registry, which is crucial to monitoring progress on the plan and adjusting policy as that government moves forward.
Or consider British Columbia’s 10-year cancer plan released in February 2023. Little more than a year later, BC Cancer posted 20 metrics such as hiring 92 more cancer-care physicians and distributing almost 30,000 HPV self-screening kits for a first-in-Canada at-home program. These are clear metrics that track progress such as the number of new screenings, consultations and treatments.
Meanwhile, back in Ontario, the province’s plan lays out valuable, patient-centred goals but too often supports them with fuzzy commitments to “continue to build” and “work to strengthen” as key actions.
While still vague, the plan’s strategic objective to implement a streamlined approach for timely adoption of innovation and technology has our attention. This could help patients with faster access to innovative medicines.
Take the example of the biomarker test. It could take anywhere from 10 days to several weeks for the results. Delayed test results can delay diagnosis, which can then delay treatment, leading to a worse outcome.
The plan talks about access to diagnostics in its goal to create seamless and effective integration of cancer services. But it doesn’t go much deeper. It just says Ontario has made significant efforts to improve access to diagnostics and expedited follow-up. Where’s the metric? Much less the commitment?
Ontario has long been a leader in cancer care. It has the highest cancer-survival rate in the country. For the past two decades, multi-year provincial cancer plans have ably guided change in our system. Thousands more lives were saved each year by improving how we prevent, diagnose and treat cancer.
Cancer plans should be more than aspirational. They are the strategic framework that focuses our efforts. In a disease characterized by insidious uncertainty, a realistic cancer plan can provide Ontarians with a version of certainty, a sense that things can be better. Ontario should act now to fix the flaws in its current approach.
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