“O would some power the giftie gie us to see ourselves as others see us…” No other country has stayed with the same system as the UK.

If only we could see the health service from abroad. Gary Mason in the Vancouver Globe and Mail reports 2nd September 2016: Changing Canada’s health-care system is a life-long fight . It seems even in Canada’s British Columbia there is unhappiness with their system. Although New Zealand and Scandinavia began with similar systems, they have both changed to allow for financial probity and fortitude. Doctors who have left, and more and more are doing so, see the UK health services through different eyes. “…. if you talk to politicians privately, as I have, they nearly all admit that the kind of hybrid, public-private health-care system common in Europe is likely best for this country as well. France has the top one. The facts speak for themselves….”

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All of us, in some ways, are shaped by our upbringing and early-life experiences. In Brian Day’s case, three elements of his back-story explain a great deal about the person we know today.

One was his upbringing in Toxteth, a depressed working-class neighbourhood of Liverpool. For a young boy growing up there, it was as you might expect: a near daily fight for survival. And when he grew to only 5 feet 4 inches tall, the brass and toughness it took to endure his bullies would form an essential component of his adult persona.

Dr. Day was a young surgeon in Vancouver when he got a call from his sister with some horrific news. Their dad, a pharmacist, had been followed home from work in Toxteth by two drug addicts. They burst into the house and bludgeoned their victim to death – getting a measly 18 months in prison for their crime. It was an injustice that made Brian Day always be on the lookout for injustice.

His mother, also, would die too soon. Ms. Day was just in her 50s when she was admitted to hospital in England with symptoms doctors diagnosed incorrectly as a heart attack. She died of a bleeding ulcer. Dr. Day later confessed that his anger at the British health-care system over what occurred incited the activism for which he would eventually become best known in his adopted country of Canada.

Next week, Dr. Day takes centre stage in a drama that has become central to his existence. After years of delays, a court case that could profoundly reshape our national health-care system begins in B.C. Supreme Court. At the heart of the case lies the elemental question of whether Canadians have the right to get medical treatment from a private health-care provider if they can’t get care in a timely and effective manner in the public system.

The court challenge of the B.C. law that restricts residents from buying health-care services privately if they are covered by the public system is a fight for which Dr. Day has prepared nearly his entire life. The war he has waged in the name of those who have waited, often in agony, to be cared for by an overburdened public system has not been easy. He has been vilified and demonized by those intent on defending the status quo.

Dr. Day’s detractors will be represented in court by the B.C. government, which will attempt to defend a single-payer system built on the principle that everyone in this country should be treated equally and no one should be able to buy better health care.

The trial is expected to last four months. It could have nearly 200 witnesses, including six of the original eight plaintiffs. (The other two have died since the case was launched eight years ago.) While he is not named as a plaintiff himself, Dr. Day, as head of the private Cambie Surgery Centre, is leading the challenge against the B.C. Medicare Protection Act, which prohibits doctors from directly billing patients for care they have provided.

A variation of this issue was tested 11 years ago, when the Supreme Court of Canada ruled that a Quebec ban on private health care was unconstitutional. It is almost a certainty that this case will also end up in the hands of the country’s highest court.

The irony about all this is that if you talk to politicians privately, as I have, they nearly all admit that the kind of hybrid, public-private health-care system common in Europe is likely best for this country as well. France has the top one. The facts speak for themselves: The heaps of money that is spent on health care in Canada have little correlation with the quality of the care offered.

We spend the sixth most per capita globally, while our system is ranked 30th for effectiveness. And yet governments in Canada feel they need to protect the idea of universal health care, even if it is not in people’s best interests. And even if we already have two-tier health care on so many different levels.

This is a struggle that is still years away from being resolved. But Brian Day is in for the long haul. And as he sits in court over the next few months, his mind will no doubt wander and he will think of his parents and the role they have played in the crusade that, in many ways, he launched in their memory.

This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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