Roy Romanow says it wouldn't be feasible to implement a Senate committee recommendation that patients be given a guarantee of timely medical care.

Canadian Press

OTTAWA — Roy Romanow says it wouldn't be feasible to implement a Senate committee recommendation that patients be given a guarantee of timely medical care.

Romanow, whose report on the future of health care is due in two weeks, says it would be impossible to enforce an across-the-board guarantee for care within set time limits. "We considered this very carefully," Romanow said in an interview Thursday.

"If you make a vast array of health care and medicare procedures subject to some sort of guarantee you're not likely to match those guarantees."

A Senate committee headed by Liberal Senator Michael Kirby recommended last month that a maximum waiting time be established for each medical procedure.

If it was exceeded the patient would be sent to another province or the United States for care at government expense, under Kirby's proposal.

Romanow praised Kirby's report overall but politely dismissed the health care guarantee - one of its key recommendations.

He said Denmark is the only country with such a guarantee, and it applies only to four or five categories of extremely serious illnesses.

"Try to draw the line on what's guaranteed and what isn't," he said. "In a country that's tried, it's very narrow. In other countries, where it isn't narrow, the guarantee is there but it isn't fulfilled.

"What would be the consequences of missing the guaranteed timelines? What would be the impact of these kinds of incentives on reforming the system? I think it's a questionable impact."

Long waiting lists for medical care are probably the biggest single problem in Canada's health care system, and are regularly cited as an argument for allowing private, for-profit care.

A poll released last week found a sharp jump in support for private health care in Quebec, where the problem of access to care has been especially acute.

"We ought not to be surprised if you see some jump-ups in (support for) private, for-profit delivery of health care," said Romanow.

"This is a reflection of several years of a dysfunctional federal-provincial environment where there's been a lot of hollering and name-calling."

That has caused a loss of confidence in the ability of governments to solve health care problems, he said.

Romanow said the problems in the system also reflect steep cuts in federal health spending during the 1990s.

"Unless and until we can stop this erosion of public confidence we're going to see people looking for other alternatives, even though the facts won't back up the alternative.

"We've got to put the funding on a stable, adequate and predictable basis."

But money alone is not the answer, Romanow emphasized.

"We need leadership at this stage in the game, desperately. We need leadership to end the confusion and the loss of confidence and to deal with the problems."

Romanow denied that he is implicitly accusing the current ranks of health ministers of failing to show leadership.

"I'm not pointing any fingers at anybody here. I sat around that table and did my fair share of finger-pointing behind closed doors."

He again emphasized his belief in a single-tier medical system that treats everyone equally.

"Health care affects us all, whether you live in Chicoutimi or Surrey, B.C. Illness and injury is one thing which will afflict, unfortunately, all of us, as will death.

"It knows no boundaries, doesn't respect the rich or the poor, coloured, male or female, it affects all of us. We should organize the system along those lines too."

Romanow said he didn't have detailed information about a private hospital being built in Brampton, Ont., but had been assured it complied with the Canada Health Act.