Since no one disputes that early diagnosis is the key to optimal health care management, the contents of the Fraser Institute report should raise alarm bells for Canadians, generally, and more specifically,
for policy makers in our health care system. Although Canada ranks fifth (as a percentage of GDP) on health spending among Organization for Economic Cooperation and Development (OECD)
countries, we have a dismal record when it comes to availability of diagnostic and medical instrumentation.
A glaring example is Canada's rank of 21st among 28 OECD countries in availability of computerized tomography (CT) scanners, one of the most powerful tools for the detection and treatment of cancer,
head injuries and strokes. When it comes to lithotriptors (a non-invasive method for removing stones lodged in the kidney or ureter) and magnetic resonance imaging, Canada ranks 19th among 22 and 27 OECD countries respectively. Ottawa, with a regional population well over a million, acquired its first lithotriptor only a few weeks ago!
Bill McArthur, author of the report and a practicing physician, is highly critical of the short-sightedness of government bureaucrats who fail to recognize the long-term benefits of new medical technologies. In his words, 'the failure of the medical technology infrastructure means that surgery and diagnostic procedures are delayed and this results in declining patient health.'
Paradoxically, Canada has been at the forefront of research and innovation in the area of medical technologies. A case in point is the National Research Council's Institute for Biodiagnostics (IBD)
in Winnipeg. Under the leadership of Ian Smith, IBD's team of internationally recognized experts in magnetic resonance, infrared spectroscopy and informatics has achieved spectacular breakthroughs in non-invasive diagnostic technologies.
One of these breakthroughs is the world's first intraoperative MRI system, which permits surgeons to follow the course of a surgical procedure in real time. Instead of relying on images taken prior to surgery that become dated as surgery proceeds, real-time images provide orders of magnitude of more reliable information during the removal of tumors or when locating and evaluating the significance of lesions resulting from a stroke. Think of the impact this will have on saving lives and the potential for recovery.
Our health system must improve its record of making available state of the art health technologies if Canadians are to benefit from these advances. Health providers and users of the health system should have much greater flexibility in deciding on the best diagnostic procedures and treatments. In the long term we would be more likely to have a high quality and more cost effective system than the present one, which is overburdened with bureaucracy and regulations imposed by individuals with short term budgetary objectives.
It will be sad indeed if the trend continues of Canadians seeking better medication and treatment in US clinics. It will be even sadder if Canadians eventually are forced to travel to the US and elsewhere to access medical technologies developed in this country.
Peter Morand is a distinguished academic and organic chemist who served as dean of the faculty of science and engineering, and later as vice rector at the U of Ottawa before being appointed president of the Natural Sciences and Engineering Research Council of Canada. He is currently chair of Adherex Technologies and CEO of a fund that invests in early stage high tech businesses. He may
be reached at pmorand@netcom.ca
