About 72% of Canadians are critical of their provincial government’s handling of the healthcare system, according to a new survey.

In contrast, about 25% said their province is managing healthcare well, which is at the lowest point in 8 years.

Across the country, at least two-thirds of Canadians in every province said their government is doing a poor job with the healthcare system.

Dave Korzinski

“As we enter a new phase, whether it is post–COVID-19 or ‘living with COVID-19,’ many Canadians are shifting their focus to issues left unattended or delayed throughout the pandemic,” Dave Korzinski, research director of the Angus Reid Institute, told Medscape Medical News.

“Myriad issues, such as a lack of primary care physicians and wait times for procedures, are afflicting the public, and it’s important to track public sentiment alongside these core healthcare data,” he said. “Understanding the level of concern or frustration gives us a key indicator for the temperature in the country and the number of people who are not only affected personally, but also vicariously through other friends and family who may not be picked up by official data.”

The institute published a full report about the survey results on June 22.

Increasing Disapproval

The Angus Reid Institute, founded in 2014, is a national, nonprofit, nonpartisan public opinion research foundation. The online survey was conducted from June 7 to 13 among a randomized, representative sample of 5032 Canadian adults who are members of the Angus Reid Forum.

About 52% of respondents identified healthcare as a top-three priority for their province. At least two out of five people in every province said healthcare was a top issue, following behind inflation and the cost of living. Healthcare ranked higher than other issues such as housing, climate change, jobs, education, the COVID-19 response, and the opioid crisis.

Older Canadians were more likely to express concerns about the healthcare system. For ages 55 and older, about 68% of women and 62% of men said healthcare was the top priority.

In terms of government response, nearly three-quarters of respondents said their provincial government is doing a “poor” or “very poor” job handling healthcare. The disapproval rate increased throughout 2021, reaching above the pre-pandemic average of about 60%.

At the beginning of the pandemic in 2020, about 53% said their provincial government was handling healthcare well. That number has now fallen to 25%.

In June 2022, three in 10 Canadians at most believed their provincial government was doing a “good job” with healthcare. Those in Saskatchewan and Nova Scotia gave the highest marks, though two-thirds in those provinces still said the province is doing a poor job.

‘Heightened Level of Frustration’

“The heightened level of frustration and priority that Canadians are putting on healthcare right now is somewhat expected but nonetheless staggering,” Korzinski said. “The tracking data is unique in just how quickly concern has shifted from COVID-19 management to the foundational aspects of healthcare.”

The Angus Reid Institute will continue to conduct surveys throughout 2022 about Canadians’ views of the healthcare system. In an upcoming report, researchers will look at access to care, including provincial trends.

“I think the one message that is clear is Canadians are being underserved in many parts of the country and expecting more,” Korzinski said.

Healthcare policy experts also want to know more about access and differing views among subgroups, particularly those who face inequities.

‘Social Fault Lines’

Dr Amélie Quesnel-Vallée

“As the pandemic exacerbated the cracks in our health system, it also shone a bright light on the social fault lines in our society,” Amélie Quesnel-Vallée, PhD, the Canada Research Chair in Policies and Health Inequalities at McGill University and director of the McGill Observatory on Health and Social Services Reforms in Montreal, Quebec, Canada, told Medscape.

“I am very concerned that these broad trends mask important underlying inequities. We know that COVID-19 hit many racialized groups the hardest, between their being on the front lines of essential services without sufficient [personal protective equipment] and ventilation and being less likely to be afforded the privilege of distancing,” she said. “They will need just as much, if not more, access to services (given long COVID, for instance).”

In addition, women tended to rate their healthcare system more poorly than men did across multiple provinces. At least three-quarters of women of all ages said their provincial government has done a poor job.

“I am particularly struck by the gender differences, which suggest that the situation might be even worse than the average lets on. Women access the system more frequently than men do, and they more often serve as caregivers; they are also overrepresented among health professionals,” said Quesnel-Vallée. “Therefore, I would assume that their bleaker view of the system would tend to better capture the lived experience of Canadians providing care, trying to access the system, or supporting loved ones in that process.”

The survey was self-commissioned and paid for by the Angus Reid Institute. Korzinski and Quesnel-Vallée reported no relevant disclosures.

ARI. Published online June 22, 2022. Full text.

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