Well, that was Canada.  My bags are packed and I’m ready to go…

What have I learned?

Everyone I’ve met has a relative in England or Scotland or Wales or Northern Ireland.

What else?  A packet of ‘OMG’s’ chocolate thingamabobs has a total calorie count of 702 per bag and Canada has lost the plot on portion control.

Apart from that, Canadians are the warmest most charming race on earth and I have just been in the town where Justin Bieber was a busker.


They are reorganising.  Not good news!  They have groups that we would recognise as PCTs; commissioning healthcare.  The most recent changes authorise them to provide community care.  As you will know, it was the EU rules on completion and collusion, that stopped us ‘providing’ and commissioning. 

I’m sure they’ll catch up!

The conference was something else.  By far and away one of the best I been to.

A speaker who was a Mum and recoverer, reminding us that cancer doesn’t strike an individual, it strikes a family.  An expert on equality and diversity; ‘don’t tolerate me, include me, respect me’.  And, a guy in a wheel-chair who gives away ramps to make access to shops easier.

As I say good-bye to my generous hosts I am drawn to the similarities in our systems.  They don’t have enough money, they have an ageing population and for economic development, they must rely on an influx of migrants.

The big call, in Canada, is integration.  Finding ways to get health and social care to work together.  Does that strike a bell?  The imperative to find new models of care.  And, guess what… to shift care from hospital into the GP’s surgery.

There have been times when I have wanted to shout ‘NO!’  As well as times I have wanted to shout ‘Wow’.

It’s hard to think of any healthcare system in the world that isn’t perplexed and worried about the irreconcilable equation of demand versus resource.

There probably isn’t a Holy Grail or a magic answer but there is the prospect that if we share the best we have and help people get to know what good looks like, we may have half a chance that we’ll find better ways to do what we do.

Sharing best practice has to be the most sensible, common-sense thing we can do.  I have come away from the conference, convinced that sharing the best of what we’ve got, is the only way to leverage quality and get a handle on costs.

I looks to me like we have to move beyond the hierarchies we share now into new-age values, understanding there is a speeding up of evolution.  We are internationalists and non-sectarian.  We share an environment and have a redefined responsibility for all of it, not just our bit.

Economic interdependence relies upon the economic success of us all.  The pressures required to deliver health care moves us beyond love and compassion into social justice and self determination.

It’s not right for patients, relatives, carers and friends to be powerless in a service, carved out of a world that is moving, ever-closer, to informed and powerful customers, or shall we call them patients?

Next week I will be in Portugal to see what healthcare philosophies they have, to look after their citizens.

All I can say is; the worLd gets smaller and the problems get more aligned.  The solutions are there, before us.  The trick has to be; don’t spend time reinventing the wheel.

Working together takes on a new imperative.

Have a good weekend.