$9.5 million campaign plugs primary care

Health Minister Dosanjh's pet project gives detractors plenty to squawk about

By Michael Citrome

You return home from the clinic after seeing to a waiting room as overcrowded as the local emerg, frustrated that it's taking months to get a patient in for an MRI, let alone a hip or knee replacement. You turn on the TV hoping for a little mindless entertainment.

Instead, you're immediately confronted with a commercial featuring Pepto-Bismol pink-tinted images of happy Canadians jogging, kayaking and doing Tai Chi. A voiceover actor explains in a voice reminiscent of an airline safety video, "It's called primary healthcare, where a team of healthcare providers works together...." When the government agency logo flashes on the screen you wonder if the cost of those ads is coming out of the healthcare budget. It is.

WHAT IT'S ALL ABOUT
The National Primary Health Care Awareness Strategy (NPHCAS) is federal Health Minister Ujjal Dosanjh's latest pet project. Its aim is to "help Canadians understand what primary health care is, how it can improve their health, and how it can keep our healthcare systems healthy," according to John Nilson, Saskatchewan's health minister and Mr Dosanjh's campaign cohort.

Central to the strategy are the four pillars of primary care — building medical teams, improving access to care and information and encouraging healthy living. Pillars don't come cheap though — the campaign carries a $9.5 million price tag. Print and TV ads, running through the end of October, and a website are the main vehicles being used to get the message across.

"The objective of the strategy is to raise awareness and not force behaviour change, although that is the longterm goal," explains Paul Duschene, a Health Canada spokesperson. The campaign is part of a larger movement within Health Canada. "Primary healthcare can keep Canadians out of emergency rooms when all they need is information and advice," he adds.

IS IT WORTH THE MONEY?
"It's ironic that the Liberals are trying to explain primary care to Canadians when many of these viewers have difficulty even seeing a doctor or getting necessary treatments," says Steven Fletcher, Conservative health critic and a Manitoba MP. "Resources should be spent fixing the problem, not talking about primary care," he adds.

Dr Michael Golbey, a GP and the president of the British Columbia Medical Association, thinks educating patients is key. "In BC, a patient needs to be referred by a family doctor to any specialist. Therefore, it's important for patients to know where to start," he says.

But he's not convinced that the multi-million dollar campaign is worth it. "Even though in the healthcare scheme of things, $9.5 million is not a whole lot of money," he says, "it would take care of approximately 900 people currently on the waiting list for hip or knee replacements."

Like Mr Fletcher, Dr Golbey can think of a few ways the money could have been better spent. "It could be put towards longterm care funding which is creating a back up in the acute care hospital in-patient system, which in turn is contributing to overcrowding in emergency departments," he says. Information technology is another needy area of Canadian healthcare, adds Dr Golbey.

ONE PART OF THE SOLUTION
Still, not all physicians see campaigns like this one as a poor use of federal funds. "They increase knowledge of the importance of a problem, and create a social-media environment which supports and reinforces other intervention strategies," says Dr Gilles Paradis, a professor of epidemiology in the faculty of medicine at McGill University. He admits they're costly but insists that to be effective campaigns must be used over a prolonged period of time.

That's not to say he thinks they hold the answer to all of Canada's healthcare problems. "Used alone campaigns will have little, if any, impact," he says. "Ultimately, using only awareness campaigns can shift attention from underlying causes of poor behaviour such as poverty, social exclusion, et cetera, and focus on the smokers, physically inactive or poor dieters who 'don't get the message'."