TO THE POINT: Can Prince Edward Island afford eight hospitals?

The aging of the population is about to create an unprecedented crisis to P.E.I.'s healthcare system.

Already, the demands on the healthcare system are nearing a breaking point. The budget for health care in the province for the next fiscal year is approaching 40 per cent of the total provincial budget — and that could increase by 50 per cent by 2030 when the number 65-year-olds or older increases by more than 50 per cent compared to 2015?

The good news for the Island is that with a growing economy and more jobs, there will be an additional capacity to afford these increases, but the population is already older than the rest of the country and is getting rapidly older.

The model of healthcare delivery will have to change if the system is to become sustainable long-term. The promise that every citizen will have their own doctor isn't practical. The new generation of private family practice doctors aren't willing to work the long hours of their predecessors, seek more work/life balance and prefer to work in group practices rather than independently. That's one of the reasons it's becoming more and more difficult to attract family doctors to rural areas.

What governments should promise is that every citizen will have access to a doctor — but not necessarily the same one each time. This encourages a group practice model and more daytime and after hour walk-in clinics. The use of strategically located walk-ins would provide some relief from over-crowded emergency rooms.

Establishing a network of walk-in clinics means tough decisions will be needed in terms of how many of P.E.I.'s eight hospitals continue to operate. The hospitals in Summerside and Charlottetown serve nearly 90 per cent of the population living within 30 minutes or so of those two centres. Tough choices are required.

The government of Nova Scotia recently announced the closure of two aging and irreparable hospitals in Cape Breton. In announcing the closure of these two hospitals, the government indicated those facilities would be replaced by collaborative healthcare centres (think walk-in clinics) to provide non-urgent care. The emergency centres at the two remaining hospitals would be significantly improved to replace the ERs at the two closing hospitals (which had been experiencing emergency room closures due to unavailability of physicians). Further, the number of long-term beds would be increased in the community. This is perhaps the way forward for the rest of the region.

As people age, their use of the healthcare system increases. Baby boomers will define provincial healthcare, just as they have defined every other stage of their lives, simply due to the sheer size of this cohort. With baby boomers now quickly crossing over into the 65-year-old group, there will be many consequences. Think about joint replacements, incidents of dementia, the need for more long-term care beds. How will Nova Scotia’s healthcare system cope with the inevitable increase in demand?

This age pyramid illustrates the challenges P.E.I. will face in delivering healthcare to an aging demographic. - Don Mills

The number of long-term care beds will have to increase significantly by 2030, perhaps by as much as 50 per cent. Currently, there are 1,141 long-term beds in 18 public and private sector facilities across the province. This doesn't count all those taking up space in hospitals or their own homes waiting for a long-term bed. Perhaps some hospitals could be converted into long-term care facilities in the province?

The government recently announced the addition of 100 long-terms beds, but does the province have an estimate of the need for long-term beds over the next 20 years and a strategy to address that need? The Conference Board of Canada estimates capital costs of each new long-term care bed is over $300,000, while annual operating costs are $75,000. There are currently 255,000 long-term beds in Canada, with an additional 200,000 expected to be needed by 2035.

At a minimum, the population must become open to a new model of healthcare delivery that will include:

fewer, but more enhanced regional hospitals within a reasonable commute;
improved access to a family doctor, although not necessarily the same doctor each time;
more use of walk-in clinics for urgent but not life-threatening care;
the use of more nurse practitioners in the provision of front line health care;
and the adoption of preventive health strategies to encourage healthy lifestyles.

The good news? With the passing of the baby boom generation, the pressures on the healthcare system will abate, just as it did with the demand for public education and universities when the numbers of students declined following the baby boomers. But that's still a couple of decades into the future.

Don Mills is the former owner of Corporate Research Associates and a recognized expert in data trends in Atlantic Canada. After selling his business recently, he remains passionate about data — and learning the guitar. He can be contacted at [email protected] or on Twitter at @donmillshfx.

RELATED: