Michael Kirby calls on graduands to reform the health care system

During York’s Spring Convocation ceremonies for the Faculty of Health on Sunday, June 28, Michael Kirby challenged graduands to use what he called the most valuable part of their university education – thinking through problems in a logical and structured way – to reform the health care system.

Chair of the Mental Health Commission of Canada, Kirby told graduands that “it is this method of tackling problems that will remain with you long after you’ve forgotten all those picky little facts you had to memorize in order to get through an exam.”

As future leaders of the health care industry, Kirby urged them to take on the challenge of making the health care system more efficient and, as a result, better for patients, better for those who work in the industry and better for governments who fund it. “This will be a very difficult task,” said Kirby, who received an honorary doctorate of laws from York. “The necessary changes will be resisted by almost everybody in the business because as Mark Twain so truthfully said 50 years ago, ‘Everybody is in favour of progress, it’s just change they don’t like.’ But people of your age are far more accepting of change than people like me, and that’s why your leadership on this issue is so crucial.”

Left: Michael Kirby

Canada has taken an all-or-nothing approach, insisting that medicare must remain exactly as it was when it was created 40 years ago. “Every attempt at changing the system is met by a diatribe by people claiming to be a friend of medicare and who set as their goal to keep the system frozen exactly as it was in the late 1960s, and to never let it change,” said Kirby, who served as an adviser to former prime minister Pierre Elliott Trudeau, and as a senator chaired the Standing Senate Committee on Social Affairs, Science & Technology, which produced the first-ever national report on mental health, mental illness and addiction. “I ask you to think of any other service industry…that has not changed in 40 years.”

One of the things Kirby said most surprised him when he began working in health care a decade ago was “the extent to which health care providers…are closed-minded about changes to structure in the system.” This is where today’s Faculty of Health graduates come in. “I want you to take what you have learned about how to tackle complex problems and take that skill and apply it to the problem of how to change the health care system, because frankly the system has to change or it won’t survive.”

New technologies, new drugs, an increasingly older population which is living longer and a shrinking workforce make health care as it is presently structured not financially sustainable. “Canada can still have a universal health care system where everyone is covered…but to meet this goal, the health care system needs to be restructured so it can meet the organizational efficiencies that other service industries have gained over the last several decades.”

The key to achieving that goal is to create incentives that encourage health care providers to provide the most efficient service possible consistent with high quality standards. “It is time in this country that we stopped focusing on the senseless and frankly uniquely Canadian question of whether or not a health care institution is publicly or privately owned,” said Kirby. “Nearly every other industrial country in the world other than the United States has universal health care systems, everybody is covered, and yet those services are provided by a wide mix of publicly owned and privately owned institutions.”

Kirby said it will take leadership from the newest generation to ensure the long-term survival of Canada’s beloved health care system. As he turned to look at the graduands once again, he said: “A lot is resting on your shoulders; a lot of Canadians are going to depend on your success.”

To watch archived video of convocation ceremonies, click here. This speech is part of ceremony No. 10.