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Govind Rao

A report that diagnoses health care's ills; David Naylor's examination of Canada's barr... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150723|225447148

from heather medicare accord federal government

shared by Govind Rao on 23 Jul 15 - No Cached
  • The Globe and Mail Thu Jul 23 2015
  • Just more than a year ago, Health Minister Rona Ambrose announced, with some fanfare, the creation of the Advisory Panel on Healthcare Innovation. The blue-ribbon group, led by Dr. David Naylor, former president of the University of Toronto, was asked to recommend the five most promising ways the federal government could support innovation in a manner that would both improve accessibility and reduce costs. The move was widely seen as a token gesture by Ottawa to show it was interested in health care when, in fact, it has disengaged to the point of doing little other than cutting cheques for everdiminishing transfers of health dollars to the provinces.
  • Critics assumed the right-leaning panel would behave Dragons' Den-like, embracing a handful of showy private sector innovations and deliver a kick in the pants to the proponents of socialist medicare. What it delivered was something else entirely - a nuanced examination of the barriers to innovation and a sharp rebuke of governments for their lack of commitment to keeping medicare current and relevant. This is not what the Harper government wanted to hear, so it released the report on a late Friday afternoon in summer, hoping it would be ignored. But the Naylor report is a must-read for anyone who cares about the future of Canada's health-care system. It is loaded with stinging truths, beginning with "medicare is aging badly" and a "major renovation is overdue," and stressing that despite our being blinded by pride, the publicly funded health-care system provides coverage that is inadequate, slow and costly; performance is middling at best.
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  • The report also features a decent "to-do" list of where to begin the renovations, with its mandated five point list: Embrace patient engagement and empowerment; Integrate fragmented health systems and modernize the work force; Invest in technological transformation, namely digital health and personalized medicine; Get better value for money by improving procurement, reimbursement and regulation; Partner with industry as a catalyst for innovation. There's nothing new here, and that's not a knock on the panel. What needs to be done to modernize medicare is no secret; how to do it is the challenge. This is where the insight of Dr. Naylor and his cohorts is most evident and useful. The panel says, essentially, that you will never get meaningful innovation without real commitment, and lambastes governments - and Ottawa in particular - for its lack of engagement. Dr. Naylor and his team stress that Canada's health-care system is rife with innovation and creativity but initiatives worthy of emulation are not being embraced and scaled up by make-no-waves policy-makers.
  • By clinging to the status quo - the path of least political resistance - governments have created an outdated system that is ill-prepared to deal with fundamental shifts such as patients demanding more engagement and the impending arrival of personalized medicine. In the end, the panel states the problem - and the solution - in the stark language of business: There is no system-level innovation in health care because there is a lack of working capital, an absence of expert management and little incentive for or investment in improvement. In short, there is no business plan, no goals. The panel bemoans, quite rightly, the lack of federal-provincial co-operation, saying it is "chagrinized and puzzled by the inability of Canadian governments to join forces" in the best interests of patients. But it saves its most stinging indictment for the federal government.
  • In the quick reporting after the report's release late Friday, most attention was focused on the call to merge three existing federal funded groups to create a federal Healthcare Innovation Agency of Canada, with a budget of at least $1-billion annually. But what the Naylor report is proposing is not the old fallback position of simply spending more to do the same. In fact, it deliberately avoids saying anything about federal spending or health transfers. Rather, it calls for a new philosophy, one that involves Ottawa having ideas and taking action beyond cutting cheques; to quote: "... a different model for federal engagement in health care - one that depends on an ethos of partnership, and on a shared commitment to scale existing innovations and make fundamental changes in incentives, culture, accountabilities, and information systems." Stated more colloquially, if the next prime minister - whether his name is Harper, Mulcair or Trudeau - wants medicare to actually meet the needs and expectations of Canadians, he needs to put on his big-boy pants and lead, not lie down, and innovate, not just pontificate.
Govind Rao

HealthCareCAN | Interview with Dr. David Naylor - 0 views

www.healthcarecan.ca/...recan-talks-to-dr-david-naylor

from heather federal government innovation

shared by Govind Rao on 24 Aug 15 - No Cached
  • In June 2014, Canada’s Minister of Health, the Honourable Rona Ambrose, announced the creation of the Advisory Panel on Healthcare Innovation. The mandate of the panel was twofold: Identify the five most promising areas of innovation in Canada and internationally that have the potential to sustainably reduce growth in health spending while leading to improvements in the quality and accessibility of care. Recommend the five ways the federal government could support innovation in the areas identified above. On July 17, 2015, after “thousands of hours of engagement, consultation, research, and deliberation”, the panel delivered its report titled, “Unleashing Innovation: Excellent Healthcare for Canada”.  HealthCareCAN applauded the major recommendations and encouraged all levels of government, all parties and all healthcare stakeholders to embrace the need to spur innovation and act on these recommendations. On August 13, 2015, HealthCareCAN sat down with Dr. David Naylor, Chair of the Advisory Panel on Healthcare Innovation, to discuss the development of the report, its recommendations and highlights. Dr. Naylor provided valuable and thought-provoking insights as you can see and hear in the videos below. Enjoy!
Govind Rao

Medicare needs a culture change - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150728|225795170

from heather medicare accord innovation

shared by Govind Rao on 28 Jul 15 - No Cached
  • The Globe and Mail Tue Jul 28 2015
  • apicard@globeandmail.com 'Canada is a country of perpetual pilot projects," Monique Begin famously wrote in the Canadian Medical Association Journal. The former minister of health and welfare pithily described a long-standing, frustrating problem in our medicare system: We have solved every single problem in our health-care system 10 times over, but we seem incapable of scaling up the solutions. This inability to learn, to share and embrace innovation across jurisdictions, is explored thoughtfully in the new report of the Advisory Panel on Healthcare Innovation. The panel, led by David Naylor, a physician and former president of the University of Toronto, stressed that "Canada has no shortage of innovative healthcare thinkers, world-class health researchers, capable executives, or dynamic entrepreneurs who see opportunity in the health sphere."
  • But innovation is stifled by the structure and administration of the health system, and a dearth of leadership. Medicare - the name we give our publicly funded health insurance scheme - is, in fact, not a system at all; it's a collection of 14 federal, provincial and territorial programs that are neither integrated nor co-ordinated. Worse yet, within those programs, there is a near total absence of vision and goals. The role of our health bureaucrats is to hold the line on spending as best they can and, above all, ensure that the names of their political masters don't appear in damaging headlines. Improving patient care is rarely the No. 1 priority.
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  • The way our system is funded - predominantly with block transfers to hospitals and fee-for-service payments to physicians - encourages volume of procedures and the status quo. It does not reward quality of care, or responsible stewardship. In fact, when an individual or a program goes out on a limb and makes changes to improve efficiency or costeffectiveness, the benefits often accrue to others; perverse disincentives are commonplace and counterproductive. These problems and frustrations are not new. The Naylor report cites an example from 1974, when Canadian researchers published a landmark paper showing that nurse practitioners could do 70 per cent of doctors' work with no difference in outcomes or patient satisfaction.
  • Using NPs also saved money, but hiring more nurse practitioners was hampered by the fact that, generally speaking, doctors are paid on a fee-for-service basis and nurses are salaried. Four decades later, that same bureaucratic hurdle remains. Most other Western countries acted on the research: NPs are an integral part of healthcare delivery and most physicians are salaried. But in Canada, NPs are still grossly underused - except in pilot projects, of course.
  • We still negotiate physician and nurse contracts separately and our management of health-care human resources is a mess. Until you get workers with the right skills in the right place at the right time, you will never deliver seamless, patient-centered care and you will never control costs, because labour accounts for twothirds of all spending. As the NP story and countless not-actedupon research findings since illustrate, innovation is hampered by policy gridlock. The managers of the system, who are largely powerless and beholden to the whims of politicians, are with few exceptions profoundly mistrusting of entrepreneurship and pathologically risk-averse. For decades, we have produced reports about the need to transform health-care delivery and funding while, simultaneously, clinging to the same old way of doing things. It's a fundamental disconnect between evidence and action. If you don't take risks, you will never innovate. So how do we break the logjam?
  • According to the Naylor report, it has to begin with leadership, and it should come from Ottawa. One of the panel's central recommendations is the creation of an independent health innovation agency to not just fund pilot projects, but promote scaling-up, using searchable repositories of successful programs, financial incentives, regulatory change, all with the aim of spurring innovation. More resources alone will not ensure the scaling-up of good ideas. There needs to be partnership, commitment and monitoring to ensure implementation. In short, it's not more money the system needs, it's culture change - a shift from perpetual pilot projects to embracing best practices.
Irene Jansen

Senate Social Affairs Committee review of the health accord, Evidence, September 29, 2011 - 0 views

www.parl.gc.ca/...49055-e.htm

accord waits senate

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Christine Power, Chair, Board of Directors, Association of Canadian Academic Healthcare Organizations
  • eight policy challenges that can be grouped across the headers of community-based and primary health care, health system capacity building and research and applied health system innovation
  • Given that we are seven plus years into the 2004 health accord, we believe it is time to open a dialogue on what a 2014 health accord might look like. Noting the recent comments by the Prime Minister and Minister of Health, how can we improve accountability in overall system performance in terms of value for money?
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  • While the access agenda has been the central focal point of the 2004 health accord, it is time to have the 2014 health accord focus on quality, of which access is one important dimension, with the others being effectiveness, safety, efficiency, appropriateness, provider competence and acceptability.
  • we also propose three specific funds that are strategically focused in areas that can contribute to improved access and wait time
  • Can the 2014 health accord act as a catalyst to ensure appropriate post-hospital supportive and preventive care strategies, facilitate integration of primary health care with the rest of the health care system and enable innovative approaches to health care delivery? Is there an opportunity to move forward with new models of primary health care that focus on personal accountability for health, encouraging citizens to work in partnership with their primary care providers and thereby alleviating some of the stress on emergency departments?
  • one in five hospital beds are being occupied by those who do not require hospital care — these are known as alternative level of care patients, or ALC patients
  • the creation of an issue-specific strategically targeted fund designed to move beyond pilot projects and accelerate the creation of primary health care teams — for example, team-based primary health care funds could be established — and the creation of an infrastructure fund, which we call a community-based health infrastructure fund to assist in the development of post-hospital care capacity, coupled with tax policies designed to defray expenses associated with home care
  • consider establishing a national health innovation fund, of which one of its stated objectives would be to promote the sharing of applied health system innovations across the country with the goal of improving the delivery of quality health services. This concept would be closely aligned with the work of the Canadian Institutes of Health Research in developing a strategy on patient oriented research.
  • focus the discussion on what is needed to ensure that Canada is a high performing system with an unshakable focus on quality
  • of the Wait Time Alliance
  • Dr. Simpson
  • the commitment of governments to improve timely access to care is far from being fulfilled. Canadians are still waiting too long to access necessary medical care.
  • Table 1 of our 2011 report card shows how provinces have performed in addressing wait times in the 10-year plan's five priority areas. Of note is the fact that we found no overall change in letter grades this year over last.
  • We believe that addressing the gap in long-term care is the single more important action that could be taken to improve timely access to specialty care for Canadians.
  • The WTA has developed benchmarks and targets for an additional seven specialties and uses them to grade progress.
  • the lack of attention given to timely access to care beyond the initial five priority areas
  • all indications are that wait times for most specialty areas beyond the five priority areas are well beyond the WTA benchmarks
  • we are somewhat encouraged by the progress towards standardized measuring and public reporting on wait times
  • how the wait times agenda could be supported by a new health accord
  • governments must improve timely access to care beyond the initial five priority areas, as a start, by adopting benchmarks for all areas of specialty care
  • look at the total wait time experience
  • The measurements we use now do not include the time it takes to see a family physician
  • a patient charter with access commitments
  • Efficiency strategies, such as the use of referral guidelines and computerized clinical support systems, can contribute significantly to improving access
  • In Ontario, for example, ALC patients occupy one in six hospital beds
  • Our biggest fear is government complacency in the mistaken belief that wait times in Canada largely have been addressed. It is time for our country to catch up to the other OECD countries with universal, publicly funded health care systems that have much timelier access to medical care than we do.
  • The progress that has been made varies by province and by region within provinces.
  • Dr. Michael Schull, Senior Scientist, Institute for Clinical Evaluative Sciences
  • Many provinces in Canada, and Ontario in particular, have made progress since the 2004 health accord following large investments in health system performance that targeted the following: linking more people with family doctors; organizational changes in primary care, such as the creation of inter-professional teams and important changes to remuneration models for physicians, for example, having a roster of patients; access to select key procedures like total hip replacement and better access to diagnostic tests like computer tomography. As well, we have seen progress in reducing waiting times in emergency departments in some jurisdictions in Canada and improving access to community-based alternatives like home care for seniors in place of long-term care. These have been achieved through new investments such as pay for performance incentives and policy change. They have had some important successes, but the work is incomplete.
  • Examples of the ongoing challenges that we face include substantial proportions of the population who do not have easy access to a family doctor when needed, even if they have a family doctor; little progress on improving rates of eligible patients receiving important preventive care measures such as pap smears and mammograms; continued high utilization of emergency departments and walk-in clinics compared to other countries; long waits, which remain a problem for many types of care. For example, in emergency departments, long waits have been shown to result in poor patient experience and increased risk of adverse outcomes, including deaths.
  • Another example is unclear accountability and antiquated mechanisms to ensure smooth transitions in care between providers and provider organizations. An example of a care transition problem is the frequent lack of adequate follow-up with a family doctor or a specialist after an emergency department visit because of exacerbation of a chronic disease.
  • A similar problem exists following discharge from hospital.
  • Poorly integrated and coordinated care leads to readmission to hospital
  • This happens despite having tools to predict which patients are at higher risk and could benefit from more intensive follow-up.
  • Perverse incentives and disincentives exist, such as no adjustment in primary care remuneration to care for the sickest patients, thereby disincenting doctors to roster patients with chronic illnesses.
  • Critical reforms needed to achieve health system integration include governance, information enablers and incentives.
  • we need an engaged federal government investing in the development and implementation of a national health system integration agenda
  • complete absence of any mention of Canada as a place where innovative health system reform was happening
  • Dr. Brian Postl, Dean of Medicine, University of Manitoba, as an individual
  • the five key areas of interest were hips and knees, radiology, cancer care, cataracts and cardiac
  • no one is quite sure where those five areas came from
  • There was no scientific base or evidence to support any of the benchmarks that were put in place.
  • I think there is much less than meets the eye when we talk about what appropriate benchmarks are.
  • The one issue that was added was hip fractures in the process, not just hip and knee replacement.
  • in some areas, when wait-lists were centralized and grasped systematically, the list was reduced by 30 per cent by the act of going through it with any rigour
  • When we started, wait-lists were used by most physicians as evidence that they were best of breed
  • That continues, not in all areas, but in many areas, to be a key issue.
  • The capacity of physicians to give up waiting lists into more of a pool was difficult because they saw it very much, understandably, as their future income.
  • There were almost no efforts in the country at the time to use basic queuing theory
  • We made a series of recommendations, including much more work on the research about benchmarks. Can we actually define a legitimate benchmark where, if missed, the evidence would be that morbidity or mortality is increasing? There remains very little work done in that area, and that becomes a major problem in moving forward into other benchmarks.
  • the whole process needed to be much more multidisciplinary in its focus and nature, much more team-based
  • the issue of appropriateness
  • Some research suggests the number of cataracts being performed in some jurisdictions is way beyond what would be expected to be needed
  • the accord did a very good job with what we do, but a much poorer job around how we do it
  • Most importantly, the use of single lists is needed. This is still not in place in most jurisdictions.
  • the accord has bought a large amount of volume and a little bit of change. I think any future accords need to lever any purchase of volume or anything else with some capacity to purchase change.
  • We have seen volumes increase substantially across all provinces, without major detriment to other surgical or health care areas. I think it is a mediocre performance. Volume has increased, but we have not changed how we do business very much. I think that has to be the focus of any future change.
  • with the last accord. Monies have gone into provinces and there has not really been accountability. Has it made a difference? We have not always been able to tell that.
  • There is no doubt that the 2004-14 health accord has had a positive influence on health care delivery across the country. It has not been an unqualified success, but nonetheless a positive force.
  • It is at these transition points, between the emergency room and being admitted to hospital or back to the family physician, where the efficiencies are lost and where the expectations are not met. That is where medical errors are generated. The target for improvement is at these transitions of care.
  • I am not saying to turn off the tap.
  • the government has announced, for example, a 6 per cent increase over the next two or three years. Is that a sufficient financial framework to deal with?
  • Canada currently spends about the same amount as OECD countries
  • All of those countries are increasing their spending annually above inflation, and Canada will have to continue to do that.
  • Many of our physicians are saying these five are not the most important anymore.
  • they are not our top five priority areas anymore and frankly never were
  • this group of surgeons became wealthy in a short period of time because of the $5.5 billion being spent, and the envy that caused in every other surgical group escalated the costs of paying physicians because they all went back to the market saying, "You have left us out," and that became the focus of negotiation and the next fee settlements across the country. It was an unintended consequence but a very real one.
  • if the focus were to shift more towards system integration and accountability, I believe we are not going to lose the focus on wait times. We have seen in some jurisdictions, like Ontario, that the attention to wait times has gone beyond those top five.
  • people in hospital beds who do not need to be there, because a hospital bed is so expensive compared to the alternatives
  • There has been a huge infusion of funds and nursing home beds in Ontario, Nova Scotia and many places.
  • Ontario is leading the way here with their home first program
  • There is a need for some nursing home beds, but I think our attention needs to switch to the community resources
  • they wind up coming to the emergency room for lack of anywhere else to go. We then admit them to hospital to get the test faster. The weekend goes by, and they are in bed. No one is getting them up because the physiotherapists are not working on the weekend. Before you know it, this person who is just functioning on the edge is now institutionalized. We have done this to them. Then they get C. difficile and, before you know, it is a one-way trip and they become ALC.
  • I was on the Kirby committee when we studied the health care system, and Canadians were not nearly as open to changes at that time as I think they are in 2011.
  • there is no accountability in terms of the long-term care home to take those patients in with any sort of performance metric
  • We are not all working on the same team
  • One thing I heard on the Aging Committee was that we should really have in place something like the Veterans Independence Program
  • some people just need someone to make a meal or, as someone mentioned earlier, shovel the driveway or mow the lawn, housekeeping types of things
  • I think the risks of trying to tie every change into innovation, if we know the change needs to happen — and there is lots of evidence to support it — it stops being an innovation at that point and it really is a change. The more we pretend everything is an innovation, the more we start pilot projects we test in one or two places and they stay as pilot projects.
  • the PATH program. It is meant to be palliative and therapeutic harmonization
  • has been wildly successful and has cut down incredibly on lengths of stay and inappropriate care
  • Where you see patient safety issues come to bear is often in transition points
  • When you are not patient focused, you are moving patients as entities, not as patients, between units, between activities or between functions. If we focus on the patient in that movement, in that journey they have through the health system, patient safety starts improving very dramatically.
  • If you require a lot of home care that is where the gap is
  • in terms of emergency room wait times, Quebec is certainly among the worst
  • Ontario has been quite successful over the past few years in terms of emergency wait times. Ontario’s target is that, on average, 90 per cent of patients with serious problems spend a maximum of eight hours in the emergency room.
  • One of the real opportunities, building up to the accord, are for governments to define the six or ten or twelve questions they want answered, and then ensure that research is done so that when we head into an accord, there is evidence to support potential change, that we actually have some ideas of what will work in moving forward future changes.
  • We are all trained in silos and then expected to work together after we are done training. We are now starting to train them together too.
  • The physician does not work for you. The physician does not work for the health system. The physician is a private practitioner who bills directly to the health care system. He does not work for the CEO of the hospital or for the local health region. Therefore, your control and the levers you have with that individual are limited.
  • the customer is always right, the person who is getting the health care
  • It is refreshing to hear something other than the usual "we need more money, we absolutely need more money for that". Without denying the fact that, since the population and the demographics are going to require it, we have to continue making significant investments in health, I think we have to be realistic and come up with new ways of doing things.
  • The cuts in the 1990s certainly had something to do with the decision to cut support staff because they were not a priority and cuts had to be made. I think we now know it was a mistake and we are starting to reinvest in those basic services.
  • How do you help patients navigate a system that is so complex? How do you coordinate appointments, ensure the appointments are necessary and make sure that the consultants are communicating with each other so one is not taking care of the renal problem and the other the cardiac problem, but they are not communicating about the patient? That is frankly a frequent issue in the health system.
  • There may be a patient who requires Test Y, X, and Z, and most patients require that package. It is possible to create a one-stop shop kind of model for patient convenience and to shorten overall wait times for a lot of patients that we do not see. There are some who are very complicated and who have to be navigated through the system. This is where patient navigators can perhaps assist.
  • There have been some good studies that have looked at CT and MRI utilization in Ontario and have found there are substantial portions where at least the decision to initiate the test was questionable, if not inappropriate, by virtue of the fact that the results are normal, it was a repeat of prior tests that have already been done or the clinical indication was not there.
  • Designing a system to implement gates, so to speak, so that you only perform tests when appropriate, is a challenge. We know that in some instances those sorts of systems, where you are dealing with limited access to, say, CT, and so someone has to review the requisition and decide on its appropriateness, actually acts as a further obstacle and can delay what are important tests.
  • The simple answer is that we do not have a good approach to determining the appropriateness of the tests that are done. This is a critical issue with respect to not just diagnostic tests but even operative procedures.
  • the federal government has very little information about how the provinces spend money, other than what the provinces report
  • should the money be conditional? I would say absolutely yes.
Irene Jansen

Call for Innovative Practice Stories - CPhA - 0 views

www.pharmacists.ca/...or-innovative-practice-stories

innovation pharmacists utilization

shared by Irene Jansen on 23 Jan 12 - No Cached
  • Pharmacy Practice Innovative Showcase – CPhA is looking to showcase creative professional services that contribute to the development and advancement of pharmacy practice and positive patient outcomes
  • Irene Jansen on 23 Jan 12
     
    innovative practice story: 1. Patient-care need addressed. 2. Innovative pharmacy service/initiative and how it was implemented. 3. How did the service/initiative affect patient outcomes and your pharmacy practice? 4. Was the service/intervention successful? Has it been reproduced in or expanded to other settings? 5. Barriers to implementation and lessons learned.
Govind Rao

Panel implores Ottawa to take charge of innovation - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150718|225111252

from heather innovation federal government

shared by Govind Rao on 21 Jul 15 - No Cached
  • The Globe and Mail Sat Jul 18 2015
  • "The federal government should play a stronger role in spurring innovation in Canadian health care, according to an expert panel that is recommending Ottawa set up a new arm'slength agency and a $1-billion fund to transform successful pilot projects into systemwide improvements. "The report from the Advisory Panel on Healthcare Innovation comes just three months before a federal election in which the opposition parties are hoping to make health care a more prominent issue than it has been in recent contests. ""I think there is a moral responsibility and an onus on the federal government to come back to the table," David Naylor, the former University of Toronto president who chaired the panel, said. "I also think there's a big onus on the provinces and territories to work together with the federal government and with stakeholders and try to improve this system."
  • "When the panel, which was introduced by Health Minister Rona Ambrose at a splashy news conference in Toronto in June, 2014, first embarked on its cross-country research, members had to decide whether to take a narrow approach or look at the systemic problems impeding the modernization of Canada's health-care system. ""I think the flurry of submissions we received from people who had a great piece of software or who wanted to pitch some device to us suggested there was a bit of a sense that we would be headed in a Dragons' Den direction," Dr. Naylor said.
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  • "Instead, the panelists decided to take a wider approach and suggest changes that would not immediately get bogged down in jurisdictional bickering. "The group's chief recommendations are that three existing agencies - the Canadian Foundation for Healthcare Improvement, the Canadian Patient Safety Institute and Canada Health Infoway - be collapsed into a single, politically neutral agency that would help guide health-care innovation.
  • he panel proposes a healthcare innovation fund be established to support the new agency with a budget target of $1-billion a year by 2020. "The idea, Dr. Naylor said, is that the agency would act as an "Innovation Switzerland," helping to bring together coalitions of two or three provinces or stakeholders at a time to scale up innovative ideas that are already working well on a smaller level. ""The degree of politicization, we believe, would be reduced," Dr. Naylor said.
  • The panel avoided recommending changes to federal health transfers to the provinces, which the Conservative government, beginning in 201718, plans to reduce to 3-per-cent annual growth or the growth rate of gross domestic product, whichever is larger. "Despite the fanfare with which the panel was first introduced, its $700,000, 164-page report was released quietly by Health Canada on a Friday in July when Parliament is not in session.
  • "When you release a report on a Friday afternoon in the middle of the summer, one can draw certain inferences from that," Murray Rankin, health critic for the NDP, said. "Maybe this panel is taking positions that the government of Canada doesn't share." "Ms. Ambrose declined an interview request. "We will review that panel's report," her office said by e-mail. "To date, our government has increased health-care transfers to the provinces to record levels." "A spokesman for Health Canada, meanwhile, said the department received the report just this week and required time to prepare for its release. ""Stakeholders were eager to see the report and therefore the Department worked quickly to release it at the earliest opportunity."
Govind Rao

Why a health-care report was dead on arrival - Infomart - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150722|225356574

from heather federal accord innovation government

shared by Govind Rao on 22 Jul 15 - No Cached
  • The Globe and Mail Wed Jul 22 2015
  • When the Harper government has something to brag about, we hear about it, endlessly. When the government has something to hide, the information comes out without ministerial comment on a Friday afternoon. So it was last week that the Prime Minister's Office buried a long, detailed report about federal innovation in health care that the government itself had commissioned.
  • The Advisory Panel on Healthcare Innovation, chaired by former University of Toronto president and dean of medicine David Naylor, was to have been released at a news conference in Toronto on July 14. The day before the news conference, however, the PMO cancelled it and decided to release the report without notice on the Health Canada website on July 17. Just as the PMO hoped, the report received little attention. Health Minister Rona Ambrose, who was to have spoken about the report, was gagged. The posting on her department's website was timed so that it appeared only after the provincial premiers had finished their final news conference in St. John's, in case the report gave any or all of them ammunition to embarrass the federal government. Such is the way this government works.
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  • It's not hard to figure out why the Naylor report displeased the government. The panel was given a difficult, bordering on impossible, job: recommend innovations without Ottawa spending any more money. The panel's mandate read that recommendations "must not imply either an increase or a decrease in the overall level of federal funding for current initiatives supporting innovation in health care."
  • The Naylor panel ignored the mandate, explaining in its report that "although it was not an easy decision, we did not follow this guidance." Later, it warned that "absent federal action and investment, and absent political resolve on the part of provinces and territories, Canada's healthcare systems are headed for continued slow decline in performance relative to peers." To that end, the panel recommends creating a health innovation fund with a $1-billion yearly budget to invest in changes to the health-care system in conjunction with willing provinces and health-care institutions.
  • Such a fund would be just about the last thing the Harper government desires. This government is running on balancing the budget. Adding $1-billion a year in spending would not be what the government wants. Such an investment fund would have little political profile - nothing as sexy as, say, national pharmacare (which the panel cursorily debunked). It would also run the risk of provoking premiers who screamed in St. John's for more cash transferred from Ottawa to them, without strings attached.
  • For 2017-18, the federal government has announced it will reduce the increase in Ottawa's annual health-care transfer to the provinces from 6 per cent to something in the range of 3 per cent to 3.5 per cent, depending on economic growth. The provinces would likely not appreciate losing money from Ottawa with one hand, and then getting some, but only some, of it back through the innovation fund. The Harper government was hoping for change-on-the-cheap from the panel: innovation that would cost nothing but improve the system. It certainly has no interest in an expanded, direct federal role in health care, having made it abundantly clear that health care is for the provinces, except for Ottawa's responsibility for aboriginal and veterans' health, public health and drug approvals.
  • Moreover, provincial health budgets are rising on average now by only 2 per cent a year, compared with 7 per cent a decade ago, far below the 6-per-cent increases in transfers still coming from Ottawa. The premiers would love the transfer to return to 6 per cent, as would the federal New Democrats. That would be the single dumbest move any federal government could make, given the lamentable experience of the 2004-11 period, when money gushed out of Ottawa but bought little improvement in the healthcare system. The Naylor panel noted, as have many observers, that the money improved things for providers, but not for many patients.
  • The Naylor report covers all the ground about the manifold weaknesses and sturdy strengths of the Canadian system compared with other countries. It hails, quite rightly, some aspects of the U.S. system, especially the coordinated care of the best health organizations such as Kaiser Permanente.
  • Its broad recommendations, however, are dead on arrival in Mr. Harper's Ottawa, which is why the report slid into the public domain with such little notice.
Govind Rao

Panel head defends health-care report; David Naylor presents findings on innovation nee... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150724|225519539

from heather accord innovation federal government medicare

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  • The Globe and Mail Fri Jul 24 2015
  • David Naylor, head of an expert panel for the federal government that saw its months of work on health-care innovation quietly buried last week by way of a Friday afternoon release, is not ready to concede its death just yet. Absent any plans by Ottawa to talk up the $700,000 report's findings, Dr. Naylor did the job himself on Thursday, telling a Toronto audience action is needed to break the political "gridlock" around health-care reform and warning that without it, the system will continue to lose ground.
  • Canada needs "strengthened and shared political resolve," Dr. Naylor said at a quickly arranged event at Toronto's MaRS innovation centre, a medical-science hub steps from the University of Toronto, where he was president and dean of medicine. Dr. Naylor, joined by fellow panel member Neil Fraser, took on critics of the report's call for a $1-billion health-care innovation fund controlled by a new agency that is arm's length from government - an "innovation Switzerland" with a Swiss bank account, he called it.
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  • This "supposedly controversial innovation fund," he said, would represent a small fraction of the approximately $265-billion Ottawa will spend this year on programs and people. Rather than a big-ticket proposal, he called the measure a "marginal reallocation of existing funds" that would represent less than 0.5 per cent of spending - a "no brainer" considering the sustainable improvements it would spur.
  • The report from the Advisory Panel on Healthcare Innovation comes just three months before a federal election in which opposition parties want to emphasize health care. Asked how the report's findings might shape that debate, Dr. Naylor spoke generally, saying there is a question of what is the federal government's correct share of health-care funding.
  • "Canadians need to have that discussion with those [who] would lead this country," he said. "I also think it's important to discuss what are the terms for that sharing." Parties also need to be asked what they would do with new money, since history has shown that increased investments do not always improve things for patients, he said.
  • Dr. Naylor said news of the report's death is premature. "This zombie report has climbed out of the grave and acquired new life," he told the Toronto audience. "I think that the panelists are a very patient bunch," he said later in an interview. "Most of us have been around public policy and health care a very long time. We've seen a lot of governments come and go, we've seen governments change their minds about issues and we're quite prepared to see where our ideas land in the fullness of time."
  • Provincial reaction to the report has been slow. Contacted on Thursday, Ontario Health Minister Eric Hoskins called on Ottawa to return to "the health-care table." He praised the panel for going beyond its narrow mandate.
  • "Canadians can be glad that the Panel chose to not let their work be arbitrarily constrained by limitations placed upon them," he said in a statement. B.C. Health Minister Terry Lake praised the report's call for transfers to take into account the disproportionate number of seniors in provinces such as his own. Changes to health transfers "do not recognize population needs of provinces," he said in a message to The Globe.
Govind Rao

Panel recommends health care innovation fund to be administered by new agency - 0 views

www.cmaj.ca/...E363

from heather innovation federal government cma doctors

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  • CMAJ September 8, 2015 vol. 187 no. 12 First published July 27, 2015, doi: 10.1503/cmaj.109-5117
  • Laura Eggertson
  • The federal government should invest in a new, arms-length health care innovation fund — with a budget that would grow to $1 billion a year by 2020 — that would finance high-impact initiatives, break down structural barriers and accelerate promising health care innovations, recommends the Advisory Panel on Healthcare Innovation in its new report, Unleashing Innovation: Excellent Healthcare for Canada.
Govind Rao

HealthCareCAN | Advisory Panel on Healthcare Innovation provides welcomed focus on pati... - 0 views

www.healthcarecan.ca/elcomed-focus-on-patient-needs

from heather federal innovation research

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  • July 21, 2015 (Ottawa, ON) – The four largest pan-Canadian health organizations welcome the overall direction set by the Advisory Panel on Healthcare Innovation’s final report released last Friday, which they believe appropriately emphasizes patient needs. The G4, made up of the Canadian Nurses Association (CNA), the Canadian Medical Association (CMA), the Canadian Pharmacists Association (CPhA) and HealthCareCAN, is unanimous in calling for focused action on innovation in healthcare in order to achieve better quality care as recommended in the panel’s report titled, “Unleashing Innovation: Excellent Healthcare for Canada.” The Advisory Panel recommends the creation of a Healthcare Innovation Fund with the objectives of supporting high-impact initiatives, breaking down barriers to change and accelerating the adoption of promising innovations.
Govind Rao

CFNU rejects Innovation Report's recommendation to eliminate the Canadian Patient Safet... - 0 views

nursesunions.ca/...adian-patient-safety-institute

from heather nursing union innovation federal government

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  • Publication date: Fri, 2015-07-24
  • Canada’s nurses, as represented by the Canadian Federation of Nurses Unions (CFNU), are questioning the recommendation that the Canadian Patient Safety Institute (CPSI) be merged into the proposed Healthcare Innovation Agency of Canada as recommended by the Advisory Panel on Healthcare Innovation in its report, Unleashing Innovation: Excellent Healthcare for Canada. “Since 2003, the CPSI has given patients and families a voice in our healthcare system. It has ensured that the issue of patient safety is a national priority, central to any discussion about the future of our health care system,” said Linda Silas, President of the Canadian Federation of Nurses Unions. “We are concerned that the original mission of the CPSI will be diluted in the proposed Innovation Agency. We must maintain an organization whose fundamental mission is the improvement of patient safety and the quality of patient care.” Last year, CFNU published a report by Dr. Maura MacPhee entitled Valuing Patient Safety: Responsible Workforce Design which vividly documents the effects of the UK’s failure to focus on patient safety in the Mid-Staffordshire NHS Foundation Trust. The report noted that the NHS has taken steps towards making patient safety a priority and improving transparency and public accountability. It recommended that we implement similar measures in Canada. Silas commended the Advisory Panel for its acknowledgement that “federal action and investment” are needed if we are to prevent the decline in Canada’s health care performance relative to our peers.  She added, “Both the CFNU and the Premiers have called on the federal government to cover at least 25% of total health care spending by the provinces and territories.”
Irene Jansen

Health Innovation Challenge Health Council of Canada Oct 2011 - 0 views

www.facebook.com/healthinnovation

innovation canada

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  • Irene Jansen on 23 Jan 12
     
    The Health Council of Canada is looking to showcase a new generation of leaders in health - college and university students - and stimulate discussion on timely health issues, innovative practices and policies in Canadian health care. Your challenge is to find an innovative practice (or) policy in health care that you think is working based on one of the two following questions, and let us know why and how it would benefit the whole country.
Irene Jansen

Recommendations Call for Culture Transformation Within Canada's Health Care System - Ne... - 0 views

www.ivey.uwo.ca/...111128.htm

privatization competition consumerism innovation think tank neoliberalism

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  • International Centre for Health Innovation at the Richard Ivey School of Business
  • “Strengthening Health Systems Through Innovation: Lessons Learned”
  • “We must transform the current, traditional, highly ‘prescriptive’ approach to health care into one that places consumers at the centre of service delivery models,” said Dr. Anne Snowdon, Chair of the Centre, and lead author of the study. “This means redesigning health service environments to create consumer choice, and engaging consumers directly in the choice of providers to select health services that meet their personal health and wellness goals.” 
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  • The white paper draws lessons from seven comparator countries (U.K., Australia, Germany, U.S., France, Switzerland and the Netherlands), which formed the foundation for the Centre’s key recommendations for Canada’s health care system. The Centre’s recommendations include the following: Create financial incentives using insurance programs or personal health budgets that empower consumer decision making to drive competition and innovation among health system stakeholders. Make the case for innovation adoption by empirically measuring and capturing the impact of innovation on health system sustainability and patient outcomes. Transform Canada’s health system from a dominant acute care focus to a community-based system focused on chronic illness management and prevention. Create accountability systems whereby health providers, and physicians in particular, assume 24/7 responsibility for managing health and wellness in communities.
  • arm citizens with the tools and resources to manage their own health and welfare in partnership with health providers
Doug Allan

New Health Minister says public health care must innovate to be sustainable - The Globe... - 1 views

www.theglobeandmail.com/...article13840108

Accord CHT funding

shared by Doug Allan on 20 Aug 13 - No Cached
  • In a striking about-face from her predecessor’s hands-off approach to medicare, the new federal Health Minister, Rona Ambrose, is promising an era of leadership and co-operation to ensure that the publicly funded health system is sustainable and affordable.
  • Ms. Ambrose said the way to improve the system is to make it more efficient and cost-effective by investing in innovation and research.
  • “Innovation is very important when it comes to the long-term sustainability of our health-care system,” she said.
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  • The speech, her first as Health Minister, was warmly received to the point where CMA president Anna Reid
  • She also expressed concern that Ms. Ambrose remained mum on the 2014 health accord. Ottawa has offered to increase transfer payments to the provinces by 6 per cent annually until 2017 and then 3 per cent subsequently, but otherwise has refused to negotiate.
  • Ms. Ambrose, for her part, said federal funding has reached unprecedented levels – $30.3-billion this year and growing. “Now that the funding is there, we need to have a conversation on what can be done to make the system more sustainable,” she said.
  • She said promoting health innovation is “worthy of federal leadership
  • The minister said she has already reached out to many of her counterparts, but discussions will begin in earnest at the federal-provincial-territorial meeting of health ministers in October.
  • She will also “reach out” to the working group on innovation that was created by the Council of the Federation.
  • She said another priority will be work with her provincial and territorial counterparts to improve health care for seniors,
  • Doug Allan on 20 Aug 13
     
    In a striking about-face from her predecessor's hands-off approach to medicare, the new federal Health Minister, Rona Ambrose, is promising an era of leadership and co-operation to ensure that the publicly funded health system is sustainable and affordable.
Govind Rao

Health care innovation panel needs more time to make recommendations | CTV News - 0 views

www.ctvnews.ca/...make-recommendations-1.2400297

from heather federal government innovation accord

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  • June 1, 2015
  • OTTAWA -- The much anticipated report of a federal panel that is to recommend ways to improve health care across Canada will be released in the coming weeks.
  • The Advisory Panel on Health Care Innovation was struck last June by Health Minister Rona Ambrose to make recommendations on reducing health spending and improving the quality and accessibility of care. Its job was to seek out the five most promising areas of innovation in Canada and internationally, and recommend five ways for the federal government to support that innovation. The recent federal budget said the panel's recommendations and final report were due by the end of May, but a spokeswoman for the panel said Sunday its final report has been drafted and is currently being reviewed and edited.
Govind Rao

More cash is not the solution; If Ottawa wants provincial sustainability, it should bec... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150827|227961753

from heather accord funding privatization

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  • The Globe and Mail Thu Aug 27 2015
  • kyakabuski@globeandmail.com The federal government will transfer $34-billion to the provinces for health care this year, an amount equal to about 23 per cent of provincial health budgets. That's up from barely 15 per cent in the late 1990s, and represents a 70-per-cent increase in federal cash in the past decade. When equalization is taken into account, Ottawa's share of health spending might even exceed 25 per cent, since most have-not provinces likely use some of the $17.3-billion they get in equalization to pay for hospitals, doctors, prescription drugs and other health-related expenditures. Equalization, after all, is meant to allow poorer provinces to offer comparable public services at comparable rates of taxation, with health care being the great equalizer among Canadians.
  • Sadly, that is no longer saying very much. As last month's report by Ottawa's advisory panel on health-care innovation noted, the performance of Canada's healthcare system has been "middling" even though "spending is high relative to many [developed] countries." Ottawa already turns over cash for health care without any requirement on the part of the provinces to account for how they use it. (It only asks that the provinces conform to the principles of the 1984 Canada Health Act, which bans such practices as extra billing by doctors.) And no federal leader is about to pick a fight with the premiers by insisting it should be otherwise.
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  • Since federal transfers have been growing at more than twice the rate of health spending since 2010, some federal cash destined for health care is presumably being diverted elsewhere or replacing provincial cash. The Canadian Institute for Health Information says spending on health care in Canada grew by 2.1 per cent in 2014. But federal health transfers grew by 6 per cent. Starting in 2017, federal health transfers will grow at the same rate as the economy, with the floor for increases set at 3 per cent. The advisory panel on health innovation led by former University of Toronto president David Naylor rejected provincial calls to maintain the annual 6-per-cent escalator adopted in 2007. It also rejected a "return to earlier approaches that depended on unanimously agreed priorities and formulaic allocations of funds" between Ottawa and the provinces.
  • Yet, this is precisely what NDP Leader Thomas Mulcair and Liberal Leader Justin Trudeau are promising should one or the other become prime minister after Oct. 19. "If my party forms government, it will call a federalprovincial meeting to reach a long-term agreement on health care funding," Mr. Trudeau wrote last week in a letter to Quebec Premier Philippe Couillard. Mr. Mulcair promises an NDP government would "use any budget surplus" to restore the 6-per-cent escalator. "Money alone cannot solve the problems facing our health-care system. But without money, we won't solve a thing," he told the Canadian Medical Association in 2014.
  • The approach promised by Mr. Mulcair and Mr. Trudeau has a clear track record of failure. Despite its good intentions, the 2004 health accord negotiated by former prime minister Paul Martin reduced pressure on the provinces to overhaul the outdated architecture of their health systems. As the Naylor panel noted, most of the $41-billion transferred under the accord was used to increase doctors' fees rather than invest in innovation or more cost-effective ways to deliver health care. This is exactly what should have been expected. As William Robson and Alexandre Laurin of the C.D. Howe Institute concluded in a recent report on this history of fiscal federalism: "The more federal transfers appear to respond to provincial fiscal pressures, the weaker are the incentives for provincial governments to raise [provincial taxes] or manage expenditures efficiently."
  • Now, the premiers are warning that their provinces are about to be submerged by a grey tsunami. Though the proportion of healthcare spending devoted to seniors' care has not budged, remaining steady at 45 per cent since 2002, the CMA projects it will hit 62 per cent by 2036. But that's only if Canada keeps on doing what it has always done - pumping more money into a system designed in the 1960s and which has barely changed since.
  • It's hard to see how yet more federal cash would incentivize the provinces to innovate their way to health-care sustainability. The Naylor panel's recommendation for the creation of a $1-billion federal health-care innovation fund hits the mark. The most meaningful contribution Ottawa could make to saving Canadian health care right now is as a catalyst for change, not as an enabler of the status quo.
Govind Rao

Harper, the economic meddler. Who knew?; Record sums to provinces for health care, bail... - 0 views

www.fpinfomart.ca/doc/doc_display.php?key=pr|246199|ntgm|20150917|229446679

from heather medicare federal election

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  • The Globe and Mail Thu Sep 17 2015
  • kyakabuski@globeandmail.com Canadians should have known when they elected a Conservative government, especially one led by such a notorious small-government crusader as Stephen Harper, that it would mean an implacable withdrawal of the state from the economy. Nine years on, the results are in.
  • The Harper government wasted no time after its 2006 election disembowelling the federal state, forcing the provinces and private sector to sink or swim. This wholesale retreat showed up in the 2007 budget, with its record cash transfers to the provinces for health care and a boost to the equalization program, which was such an unexpected bonus for then-Quebec premier Jean Charest that he turned around and awarded Quebec voters a $700million income-tax cut. Mr. Harper, the fiscal taskmaster, stuck to his ideological guns during the Great Recession with a $63-billion stimulus program, supplemented by the $9.1-billion that Ottawa contributed to the bailouts of General Motors and Chrysler. The cuts just kept coming as his government nearly tripled non-stimulus-related infrastructure spending to $5-billion from $1.7-billion annually, with an additional $1-billion a year promised for public transit in the April budget.
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  • And what can be said of Mr. Harper's contempt for Canadian scientists? Under his rule, federal expenditures on university research have put Canada near the top of the global rankings for publicly funded research and development. The Conservative Leader clearly believes the state has no place in basic research. Why else would his government give the Canadian Institutes of Health Research $1-billion a year, or provide the Canadian Foundation for Innovation with $1.3-billion to support research infrastructure at postsecondary institutions and hospitals?
  • Mr. Harper's war on state-funded science includes the $243-million he has promised to fund Canada's participation in the Thirty Meter Telescope project; the extra $45-million awarded this year to the TRIUMF cyclotron particle accelerator; the $105-million committed to enable scientists to collaborate on research through the CANARIE cloud-computing network; and the $15-million promised to the Council of Canadian Academies to conduct "science-based assessments." The GM and Chrysler bailouts set the tone for the Harper government's hard line on corporate welfare. It has been a dry well ever since. Most recently, this unyielding insensitivity toward the pleas of manufacturers has manifested itself in a $300-million loan to Pratt & Whitney Canada to develop jet engines and a $60-million loan to Toyota to upgrade two auto plants in Ontario.
  • The Harper Tories have shown their disdain toward the Liberal fetish for picking winners by boosting (after renaming) a smorgasbord of industrial policy slush funds, including the $1-billion Strategic Aerospace and Defence Initiative and the Automotive Innovation Fund. The latter's $250-million annual kitty was increased to $500-million a year for two years in the 2014 budget. The Harper government's clean-tech fund, Sustainable Development Technology Canada, has doled out $740-million so far, with hundreds of millions more still to go out the door. No wonder the Liberals and New Democrats have been calling for the state to re-engage with business to boost Canadian innovation. After all, the Tories abdicated their responsibility in this area by conducting the most comprehensive review of federal support for private-sector research in decades and implementing the main recommendations of a 2011 expert panel's report on the matter. The Scientific Research and Experimental Development Tax Credit, which cost $3.5-billion annually and had been subject to much abuse, was scaled back by about $500million - with most of the savings plowed into direct grants to businesses, just as the experts ordered.
  • It's debatable whether any of this largesse has made Canada's economy more competitive or innovative. No amount of state support can compensate for a lack of vision or guts among businesses. It's not for a lack of trying by Ottawa that innovation policies that seem to work elsewhere aren't replicable here. The state can go only so far to substitute for the private sector's listlessness. To wit, firms in the oil patch are reacting to tough times by cutting R&D, which is exactly the opposite of what they should be doing right now. They should know only innovation can save them.
  • Now, Liberal Leader Justin Trudeau is vowing to "invest in Canada" by doubling infrastructure spending, while NDP Leader Thomas Mulcair promises to be a "champion" of manufacturing (subsidies). They have big shoes to fill. Both would be hard-pressed to outdo Mr. Harper, who, if you haven't gleaned by now, has turned out to be as much of a meddler as any Liberal who preceded him.
Irene Jansen

Tackling innovation solo, premiers hope to lure PM back to health table - The Globe and... - 0 views

www.theglobeandmail.com/...article2305279

accord innovation cof

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  • Tackling innovation solo, premiers hope to lure PM back to health table
  • As a start, Saskatchewan Premier Brad Wall and Prince Edward Island Premier Robert Ghiz will lead the work that aims to draft national standards to ensure innovations are shared between the country’s 13 separate health-care systems.
  • They’ll also look at ways to try to limit competition for health workers, and opened the door to a national fee structure for services.
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  • The heads of the Canadian Medical Association and Canadian Nurses Association, responding moments after the announcement, said they were pleased to have a role in the looming assessment in health care.
Irene Jansen

Innovation Procurement Conference Board of Canada July 2011 - 0 views

www.conferenceboard.ca/...abstract.aspx

privatization canada uk fromdelicious

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  • Irene Jansen on 23 Jan 12
     
    Innovation Procurement in Health Care: A Compelling Opportunity for Canada The Conference Board of Canada, 54 pages, July 2011 Report by Gabriela Prada This report examines the strategic use of procurement to drive innovation within the U.K.'s public he
Irene Jansen

Premiers craft own health agenda, hoping Ottawa joins later - Yahoo! News - 0 views

ca.news.yahoo.com/ck-health-talks-090012882.html

transfers innovation cof

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  • 95 per cent of all federal transfer funding arrangements expire in 2014, and that includes the health transfer.
  • Equalization funding and infrastructure and training funding agreements also expire in 2014
  • Wall, who came to Victoria extolling health innovation as a best practice and money-saver, said the newly-formed Health Care Innovation Working Group will focus on the provinces and territories finding and sharing new ways to meet health challenges, including the needs of seniors, patients with chronic diseases and northern populations.
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  • He joked that he and Ghiz won't employ a good-cop-bad-cop routine
  • The working group will focus on saving dollars while providing the best and most up-to-date health services to Canadians.
  • "We're going to do our work," said Wall. "The federal government is not needed for this work. They don't deliver health care. The expertise is in the provinces and the territories."
  • Wall told reporters in Saskatchewan following the meetings he was disappointed that Ottawa hasn't backed health innovation with federal dollars.He said federal Health Minister Leona Aglukkaq expressed support for an innovation fund, but that appears to have dried up.
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