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Ontario's Minister of Health and Long Term Care, Deb Matthews, has called them "a bit of a secret in health care". The Honorable Roy Romanow is a big supporter of them. They are Tommy Douglas' "Second Stage of Medicare" in action. Are Community Health Centres (CHCs) the best kept secret in health care and, if so, why?

Keeping people and communities well are what Community Health Centres are all about.

CHC clients receive inter-professional clinical care from doctors, nurse practitioners, nurses, dietitians, social workers and other kinds of clinical health providers. Health promoters, community workers and others respond to health problems triggered by social, environmental or economic problems with customized services, community programs, and advocacy. Community Health Centre staff work together to not only provide primary care when people get sick, but to help keep people well in the first place. In Ontario alone there are over 70 Community Health Centres and there are dozens more in communities across Canada.

Community Health Centres are especially effective in providing care to those populations that have, for whatever reason, traditionally faced difficulties in accessing health care. CHC services are specifically structured to eliminate system-wide barriers to access such as poverty, racism, heterosexism, and other harmful forms of social exclusion. Their approach helps to close the health equity gap, which I will look at further in a future blog post.

Every Community Health Centre is unique. Because their differences reflect the great diversity of the communities they serve, they have learned to customize their programs and services to meet the specific needs of their clients and communities. But, despite great diversity, every CHC applies a common model of care that holds much promise and potential for primary health care.

The newly released Ontario's Action Plan for Health Care talks openly about the need for better access to community-based primary health care, as well as the need to emphasize prevention, wellness, and health promotion. An early leak from the forthcoming Drummond Report mentions that a mere 1 per cent of the population of Ontario accounts for fully half of all hospital spending, or about one-third of total health expenditures. One has to look no further than the social determinants of health, such as poverty and housing, to understand the huge role they play in downstream health care costs, as I highlighted in my previous blog "Poverty and Health". The Community Health Centre model of care is an excellent example of one kind of community-based primary health care that is needed to address many of these larger systemic issues. Continued expansion of Community Health Centres across Ontario and the rest of Canada should be part of an upstream, long term investment to help address many of our complex health care and health equity issues. As a staff person at a Community Health Centre, I will continue to tell our stories and successes and I hope you will, too. No more secrets!

question

1, If you were not a member of a community that you felt could benefit from a Community Health Center and you had the power and resources to create one, how would you support that community?

2, If you were to establish a CHC in your community, what are the first steps you would take? Who would you involve and why?

3, Think about your community and the challenges, needs, and barriers faced by its members. What could a CHC operating in that community do to further health promotion efforts and offer more equitable access to health services?