Advancing a Public-Centered Vision for Primary Care-Lessons from Ontario and Inspiration from the Netherlands

Area of Science:

• Health Services Research
• Public Health Policy
• Patient Engagement

Background:

• Reforms in primary healthcare often lack clear patient and public expectations.
• Canada faces challenges in providing universal access to primary care, with millions lacking a regular clinician.
• Existing primary care systems struggle with team implementation, resource equity, and physician capacity.

Purpose of the Study:

• To define public expectations for primary care delivery in Canada.
• To develop a standard for a publicly funded, relationship-based, timely, culturally safe, and accountable primary care system.
• To inform policy and practice for achieving universal primary care access.

Main Methods:

• The OurCare initiative involved nearly 10,000 Canadians in a structured, deliberative process.
• Analysis of public input to articulate core expectations for primary care.
• Examination of international experiences, such as the Netherlands, for insights into achieving universal access.

Main Results:

• The OurCare Standard outlines six key expectations for primary care.
• Ontario's Primary Care Act incorporates these priorities, aiming for universal access by 2029.
• International examples suggest demand management, team roles, and physician scope optimization are vital for access.

Conclusions:

• Achieving universal primary care requires more than team expansion; it necessitates redesigning organization, delivery, and accountability.
• Meeting community needs is central to effective primary care.
• Publicly defined standards are essential for guiding primary care reform and ensuring accountability.