57 Health Accord recommendations include basic income, integration of services for N.L.

The Newfoundland and Labrador Health Accord has released its long-awaited final report, which makes 57 recommendations to both improve health outcomes and save money over the next decade.

Recommendations include implementing a universal basic income, integrating ambulance services, reducing the number of emergency care centres and focusing more on the social determinants of health.

"We all know the health care system needs to change, as we continue to spend the most per capita yet have the worst outcomes," said Premier Andrew Furey in a statement. "I look forward to reviewing this re-imagining of our health care system to take place over the next 10 years."

The Newfoundland and Labrador government created the Health Accord in November 2020, and tasked co-chairs Sister Elizabeth Davis and Dr. Patrick Parfrey to evaluate problems in the province's health-care systems and develop solutions.

The report notes that people in Newfoundland and Labrador have markedly worse health outcomes than the rest of the Canadian population by most indicators. Newfoundland and Labrador's life expectancy is 2.4 years lower in men and 2.3 years lower in women than the Canadian average — a statistic that's steadily worsened since 1980.

According to the report, the rate of children with complex health needs in Newfoundland and Labrador is 53 per cent higher than the national average, and the rate of chronic disease is worse too.

Though the report includes 57 calls to action and many more smaller recommendations, it does not delve into the cost of those measures. The authors say another report, called The Blueprint, will be released within two months and will show how the Health Accord can be implemented.

Despite the province's fiscal situation, the report is light on cuts to health care — though it does recommend finding efficiencies.

"We are not recommending taking any services out of any areas," said Parfrey in an interview with CBC News. "We need to plan for the realities that we're faced with."

The province's air ambulance service and 60 ambulance operators would be brought under one system with public oversight. There would be one central dispatch system for the province, and virtual care for rural areas. The plan also includes a separate transportation system for non-emergencies, which would free up ambulances.

"We have to have a system that works together," said Davis. She said the Health Accord taskforce has not determined if that new system will mean cutting ties with any of the province's private ambulance services.

Additionally, emergency services at 23 health centres serving less that 5,000 people would instead be provided by one of 13 hospitals less than 90 minutes away. The 23 health centres would still provide 12-hour urgent care, and would develop "collaborative care models" that use virtual care to link to hospital emergency departments.

Parfrey said implementation would involve discussions with communities that will be impacted.

The report focuses on the social determinants of health, or the social, economic and environmental factors that impact how people live. The authors argue that by improving those factors, the government can improve health outcomes too, and ultimately spend less on health care overall.