Healthcare Horizons Revisited

Several waves of crisis are affecting health systems in Canada and across the globe, putting a strain on accessibility and quality of care. Some of the key drivers impacting this trend include:

1. An aging population: According to Statistics Canada’s latest Annual Demographic Estimates, in 2024, 18.9 per cent of the population was 65 or older while only 15.2 per cent was under 14 years old.¹ According to Statistics Canada’s projections, by 2030, seniors will represent 21.3 to 22.9 per cent of the Canadian population.²
2. Workforce shortages: According to Health Canada, as of February 2024, roughly 22% of the Canadian adult population did not have a family doctor, and a State of the Health Workforce in Canada report projects a shortage of 78,000 doctors and 117,600 nurses by 2030 and 2031, respectively.³
3. Ballooning health spending: According to CIHI, healthcare spending is estimated to have reached $372B in 2024 ($9,054 per Canadian).⁴ This represents an increase of 5.7 per cent over 2023 and outpaced our projected GDP growth of 3.7%.
4. Widening health inequalities: The Health Inequalities Reporting (HIR) Initiative has found that significant health inequalities were observed for those with lower socioeconomic status, Indigenous peoples, sexual and racial/ethnic minorities, immigrants, and people living with functional limitations (such as physical or mental impairments) in Canada.⁵
5. Climate change: Climate change poses a risk not only to individual health, but our healthcare infrastructure. The Canadian Medical Association has flagged that 1 in 4 Canadian Healthcare facilities are built on 20- to 100- year flood plains and that the 2021 heat dome in BC resulted in a 180% increase in workplace injury claims.⁶

To deal with these issues, we believe that a fundamental change of course in how healthcare systems operate is essential. Senior healthcare leaders need transformational and innovative approaches to sector problems as traditional interventions are no longer effective given the magnitude of the sector’s unprecedented challenges.

In this year’s report we explore a home-grown example of successful transformation in healthcare. Nova Scotia Health has been on a five-year transformation plan called “Action for Health” focused on people, processes and technology, which to date, has removed 282,000 annual hours of administration from the system and delivered net increases in family physicians, nurse practitioners and registered nurses of 106 per cent, 187 per cent and 165 per cent, respectively, since 2020-2021.