Hope, Belonging, Meaning, Purpose
This article was first published in the Minden Times in September, 2024.
Dr. Jane Philpott, family practitioner and previous federal Minister of Health, in her book Health for All: A doctor’s prescription for a healthier Canada, starts from the premise that health is holistic, involving body, mind and spirit; primary care is the gateway to the complexities of human need and the systems that serve them; it must be universally available if we are to be a healthy country.
Her prescription is that Canada’s health system be structured like our education system: every community should have a ‘primary health home’ that is adequately resourced with a multi-disciplinary team appropriate to the characteristics of the community. Anyone who moves into the community is assigned to a health home – just like every kid is assigned to a school when a family moves in.
This is not a new model: it has long been in practice in other countries.
This is not an expensive model: timely provision of universal primary health care saves money downstream. Our current health system costs $8563 per year per Canadian, one of the highest among OECD countries, even though – perhaps because -- more than six million Canadian adults don’t have primary care. A new regime doesn’t have to be very good to be much better.
This is not a stand-alone model. The social determinants of health – the living conditions that determine personal and therefore community health such as housing, education, income – need attention as well. The same rationale applies, that money spent on conditions that undermine health will save money downstream. Philpott also notes that Research and Development are important but she doesn’t address them in this book.
So how can we mere mortals contribute to this overdue transformation? Philpott identifies hope, belonging, meaning and purpose as foundational to spiritual health, which she sees as critical to overall health. These elements are all exclusively within our personal domain. They’re not a commodity. They’re not for sale at the local pharmacy or health food store. They’re a made-from-scratch product.
So we could make a contribution by working on our spiritual health. Where to start? Hope, belonging, meaning, purpose: I think they’re a bundled deal, inextricably entwined, like most important accomplishments in life. Like loving or grieving or creating or parenting or being a friend.
Which means you can start anywhere and move around the circle however you choose, however circumstances offer. In my professional practice, I believed that hope was foundational: without hope, you can’t help or be helped. Job one was discovering hope. I explored relationships (belonging), what one cared about (meaning), aspirations (purpose). Philpott, who was a Presbyterian minister’s kid, thinks hope comes from the sense of a greater power, regardless of how it is named. She cites indigenous people who think it comes from a sense of connection to nature which is also a connection to the past. The Four L’s, one elder calls it: land, language, lineage, and loved ones. That sounds pretty universal. Philpott accepts gracefully that this part of health is not about science but about intuition. The immeasurable. The unproveable.
Philpott is quite clear that the change needed to establish a health system (she reminds us we have an insurance system, which is good as far as it goes but it isn’t a health system), we need political will. She knows a thing or two about politics, having joined the Liberal party at age 55 to run in the 2016 campaign that brought Trudeau to power, serving as Minister of Health for 22 months, Minister of Indigenous Affairs for five months, President of the Treasury Board for six weeks and then was punted from caucus for siding with Jody Wilson-Reybould in an ethics issue. She remained in parliament as an Independent and was not re-elected in 2019.
In spite of her experience – and to some extent because of it; she understands the power of policy and funding choices – Philpott is not ruling out re-entering politics when she completes a 5-year stint as Dean of the Faculty and Director of Queen’s University School of Medicine. She will continue to find ways to move the dial on other aspects of an improved health system – broader recruitment and retention of family physicians, streamlined entry of foreign-trained health professionals, improved Indigenous health services, enlightened opioid treatment strategies, doubtless many others.
Philpott is purpose driven. She understands that political leaders lead where their constituents tell them to go. We who care about the health of our community and our country should be equally purpose driven. We should flex our political muscles, the power we have as citizens, and tell them where to go.
