The vast majority of Canadians (96 per cent) have either a family doctor or a place where they regularly go for primary health care, finds a new survey. But many of those people say they also have a hard time getting care when they need it.

The survey from the Health Council of Canada found that one-quarter of respondents who had minor health problems said they had trouble getting an appointment on short notice.

The report also cites data from an international study which found that 30 per cent of Canadians report waiting six or more days to get an appointment with their regular doctor, compared to just 20 per cent of patinets in the U.S., 12 per cent in the U.K., and 10 per cent in Australia.

As well, more than one-third who used an emergency department believed their family doctor could have treated their condition if he or she had been available.

"Clearly, all Canadians are not getting timely access to the right care providers when they need it," said Dr. Don Juzwishin, CEO of the Health Council of Canada.

The survey, conducted by Statistics Canada in early 2007, is the first of its kind to examine the public's experiences with the health care system during the previous year. Some 2,200 people participated.

While 73 per cent of participants rate their primary health care provider as excellent or very good, the picture is less rosy when they are asked more detailed questions. For example:

  • 32 per cent of participants say their doctors don't always explain test results
  • 21 per cent say their health care providers rarely or never explain possible side effects of medication.
  • 25 per cent report that their doctors rarely or never talk to them about lifestyle changes or activities that could prevent illness and improve their health.

The report, called "Fixing the Foundation: An Update on Primary Health Care and Home Care Renewal in Canada", offers a number of suggestions for improving health care, including ensuring that patients have 24/7 access to health care providers.

As well, the report suggests there need to be improvements to allow family doctors to be informed when patients seek care through other services. For example, the report found that although most jurisdictions offer 24/7 access through the use of telephone health lines, family doctors rarely learn that their patients have called those lines or that they have then visited after-hours clinics.

"Formal systems must be put in place to communicate this information," the report recommends.

Electronic health records and e-prescribing improve coordination of care could also reduce problems such as medication errors.

"Unfortunately, a majority of physicians across Canada still rely on hand-written records," the report notes, adding that only five per cent of Canadians have an electronic health record. The Health Council urges all jurisdictions to make this a priority.

The report also calls for improvements to home care, particularly for seniors. It notes that three to four per cent of seniors aged over 65 said they needed home care services they did not receive.

It notes that there is still a great need for home care in this country, since in 2006, one in four Canadians said they cared for a family member or close friend with a serious health problem in the last 12 months. Of those, 22 per cent said they had to miss one or more months of work to help their friend or relative and 41 per cent used personal savings to provide care.

"Our report highlights the many initiatives to improve access to care for patients who need it," said Dr. Jeanne Besner, Chair of the Health Council of Canada. "But when the Health Council asked provincial and territorial governments about their efforts to renew health care delivery, many said that barriers such as funding and human resource issues prevent them from fully realizing their visions.

"Canadians continue to tell us reform is needed. We must find ways around these barriers to ensure Canadians receive accessible, comprehensive and well-coordinated care, which we know is possible."