Manitoba Members’ Final Report in English

Manitoba Priorities Panelon PrimaryCare:

Newperspectivesand possibilitiesforthefutureof primarycareinCanada

AReportbyMembers ofthePublic

NotefromtheCo-Chairs

JasminKay

OurCareMBPanelCo-Chair

Director,MASSLBP

Dr.MandyBuss

OurCareMBPanelCo-Chair

IndigenousHealthLeadforDepartmentofFamily MedicineandUndergraduateMedicalEducation CourseDirector,IndigenousHealth,MaxRady CollegeofMedicine,UniversityofManitoba

TheManitobaPrioritiesPanelwasthe lastoffiveOurCarepanels,andit broughtthirtyvolunteerstogetherto learnaboutprimarycareinManitoba anddeliberateaboutitsfuture.This reportistheproductofthecollective learningandthethoughtfuldialogue thatensued.

DeliberativeprocessesliketheManitoba PrioritiesPanelbringpeoplewithdiverse experiencesandperspectivesintoa room,andaskthemtofindcommon groundandasharedsenseofpurpose andresponsibility.Theiraimistocome toconsensusaroundasetofvalues, priorities,andrecommendationsthat reflecttheneedsandtheinterestsofthe broaderpublictheyrepresent.

ThemembersoftheManitobapanel broadlyreflectedthesociodemographicsofManitobaitselfandwe workedhardtoensurethatthe proportionofIndigenouspanelmembers wouldbeclosertotherealworld numbersthanthosefoundinthecensus (whichiswidelyunderstoodtobean undercount).Werecognizethat IndigenousPeoplehave

ourcare.ca

historicallybeenunderrepresentedat tablesandindiscussionsaboutdecisions thataffecttheirhealth. FirstNation,Métis, andInuitPeoplesinCanadahave experiencedoveracenturyofpoorer outcomesinallhealthindicators comparedtonon-Indigenous Canadians.Thisisthedirectresultof colonizationandentrenched anti-Indigenousracism.Thepanelalso includedindividualsfromsmaller, northerncommunitiesaswellasthe rapidlygrowingnewcomerpopulationin Manitoba.

Thisreportputsforward37 recommendations,nineofwhichwere developedbyitsIndigenousmembers aboutimprovingaccesstoprimarycare forIndigenousPeopleacrossthe province.Theother28recommendations arecallstoactionforclearer communication,moreaccountability, andforprimarycaredeliverythatbetter meetstheneedsofManitobansinurban, rural,andremotepartsoftheprovince.

Wewouldliketothankthepanel’smany guestspeakerswhosharedtheir perspectivesonwhatisneededto elevatetheprimarycaresystemin Manitobasothathighqualitycareand equityarethenorm.

Finally,wealsowishtothankand commendthemembersoftheManitoba PrioritiesPanelthemselveswhobrought conviction,perseverance,openness,and goodwillintotheroom.Theirreportisa rallyingcryforpolicy-makersto implementsomelongoverduechange, anditcouldn’tcomeatabettertime.

JasminKay

OurCareManitobaPrioritiesPanelCo-Chair

Dr.MandyBuss

OurCareManitobaPrioritiesPanelCo-Chairs

WhatPolicyMakers ShouldKnow

Dr.AmandaCondon, OurCareManitobaCo-Lead

FamilyPhysician,NotreDamede Lourdes,MBAssociateProfessor, DepartmentofFamilyMedicine, MaxRadyCollegeofMedicine, UniversityofManitoba

Dr.TaraKiran, OurCarePrincipalInvestigator

Dr.AlanKatz, OurCareManitobaCo-Lead

FamilyPhysicianandHealth ServicesResearcher,Winnipeg,MB Professor,DepartmentsofFamily MedicineandCommunityHealth Sciences,MaxRadyFacultyof HealthSciences,Universityof Manitoba

FamilyPhysician,St.Michael’sHospitalAcademicFamily HealthTeamScientist,MAPCentreforUrbanHealth Solutions,St.Michael’sHospital,UnityHealthTorontoFidani ChairinImprovementandInnovation,UniversityofToronto

Manitobansarepassionateabout healthcareandareconcernedabout thestateofourhealthcaresystem. Thereisabundantevidencethata high-functioninghealthcaresystem mustrestonasolidfoundationof accessible,high-qualityprimarycare.

Manitobahasthelowestpercapita numberoffamilyphysiciansinCanada, andthehealthofourgeographically dispersedpopulationissufferingdueto astrugglingprimarycare“system.”The systemneedsreformandaswemove forward,itiscriticalthatweinvolve Manitobansthemselves—thosewhom thesystemissupposedtoserve—to helpshapeitsredesign.

BetweenSeptemberandOctober2023, OurCaregathered30Manitobansfrom

differentwalksoflifetolearnaboutthe primarycaresystemandarriveat recommendationsforhowtoimproveit. TheManitobapanelistscollectivelyspent 30hourslearninganddeliberating. Togethertheywrotethisreportwhich includesthevaluesthatshouldunderlie thesystem,identifieskeyissuesthatneed tobeaddressed,and,finally,laysouta numberofboldrecommendationsfor improvingprimarycareinManitoba.

TheOurCarepanelistshighlightedthat primarycaredeliveryinManitobadoes notcurrentlymeettheneedsofall Manitobans.Thepanelhighlighted accesstoprimarycareinrural,remote andFirstNationscommunitiesasa specificchallenge.Accesstoprimary careforallManitobanswasaprincipal valueidentifiedbythegroupandwas evidentinalloftheirrecommendations.

Thepanelistsidentified recommendationsforamorestructured, accessible,andeasilyunderstandable primarycaresystem.Thepanelistswant aprimarycaresystemthatis coordinatedthroughacomprehensive datasystemandwantaccessto servicestobeavailableatallhours. Electronicmedicalrecordsthatareeasy toaccessbybothpatientsandclinicians wasalsoakeyrecommendation. Thepanelrecognizesthatwehavea humanresourcescrisisintheprovince andproposedaseriesofactionsto addressboththeshortageand maldistributionofhealthcareproviders. Community-basedprimarycareteams, withteammembersworkingtogetherto addresspatients’needsinamore comprehensive,whole-person-focused way,wasanotherkeyrecommendation.

TheManitobaOurCareAdvisory Committeeinsistedthatweincludea robustIndigenousvoiceinourPriority Panel.Almostone-thirdofourpanel membersself-identifiedasFirstNations, MétisorInuit.Thepanelistsmadeseveral recommendationstoaddressthe specificgapsinaccesstoprimarycare forFirstNations,MétisandInuitpeople.

Boldly,theycalledforaseparate Indigenoushealthdepartmentand recommendedIndigenizingthemedical educationcurriculum.They recommendedtrainingandmentoring Indigenouspeoplestotakeonmore rolesinthehealthcareworkforceand wantedclinicianstohaveacommunity orientationtoensurecarewas trauma-informedand community-centred. Panelistsalsohad severalrecommendationsrelatedto promotingequityandaddressingthe socialdeterminantsofhealthmore broadly,includingmandatorycultural humilitytrainingforhealthcare professionals.

Accountabilityandtransparencyofthe systemwereidentifiedasessential elementsbythepanelistswhonoted thatthecurrentsystemhasseveral significantbarriersthatmakeit challengingformanypeopletoaccess. Thepanelistshighlightedtheimportance ofthepublicininformingaprimarycare systemthatmeetstheneedsofits citizens,andtheywanttobeableto easilyunderstandhowthesystemis performing,usingrealworld measurementsthatmattertothem.

TheManitobaOurCarepanelistshave providedrecommendationsthatgive clearguidanceonthevalueofprimary careanddemandacommitmentto buildingastrongerprimaryhealthcare systemforallManitobans.Astheywrite inthereport,“Thecurrentsystem honoursthesystemmorethanithonours andcaresforthepeopleitshouldserve… Thispanelhasmodeledtherespect, compassion,activelisteningand relationship-buildingthatneedstobe reflectedintheprimarycaresystem.”

Dr.AmandaCondon,OurCareManitobaCo-Lead

Dr.AlanKatz, OurCareManitobaCo-Lead

Dr.TaraKiran,OurCarePrincipalInvestigator

ManitobaPriorities PanelonPrimaryCare

TheOurCareManitobaPrioritiesPanelbroughttogether30peoplelivinginManitoba,randomly selectedtoroughlymatchtheprovince’sdemographics.Theyspentapproximately30hourslearning fromexpertsanddeliberatingtogetherbeforemakingrecommendationsonwhatabetterprimary caresystemshouldlooklike.OurCarehasalsoconductedPrioritiesPanelsinOntario,Quebec,British ColumbiaandNovaScotiain2023.Formoreinformation,visitOurCare.ca/PrioritiesPanels.

ManitobaPriorities Panel At-a-Glance

30members

15speakers

31programhours

37recommendations

RecommendationHighlights:

Increasethenumberofhealthprofessionals

● Expeditetheprocesstorecognizethequalificationsof internationallytrainedmedicalgraduatesanddeveloppeer mentorship-basedtrainingtohelpthemintegrateintothe Canadiansystem.

● UniversityofManitobaandUniversityCollegeoftheNorth shouldestablishandofferarangeofeducationandtraining programs,inthenorth,forprimarycareproviders.

Members’Values Available

● ActivelypromoteManitobaasanappealingplacetoliveand practicemedicine.

Ensureholistic,person-centredcare

● Continuetheshiftfromindividualfee-for-service practitionerstoteam-basedmodels(e.g.ACCESScentres) thatofferholisticcarefromavarietyofin-house professionals.

● Offerafterhourscare,24/7accesstoprimarycaretoensure continuousaccessandmovebeyondthetraditional9-5 practicehours.

EquityandSocialDeterminantsofHealth

● Mandateculturalhumilitytrainingasarequirementto keepingone’slicenseingoodstanding.

● Establishmobilehealthclinicsthatbringprimarycaretorural andremoteresidents.

● Mandateasocialworkerorcommunityresourceworkerasa full-timememberofallhealthteams.

RecommendationHighlights(cont’d):

TheProblemswe WantSolved

Thepublicfeels disrespected•Careisnot coordinatedorconnected• Careisdifficulttoaccess• Thereisacrisisinhuman resources•Thesystem lacksaccountability•The systemisnotdesignedto serveeveryone•Funding andpoliticalwillarelacking

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CareforIndigenousPeoples

● CreateandpromoteanIndigenousHealthDepartmentwithin theprovincialgovernment.

● Indigenizetheentiremedicalcurriculumtocreatea trauma-informedcurriculumthatstandsfirmlyagainst anti-Indigenousracism.

● Implementamandatorycommunityorientationprocessfor newprofessionalsenteringacommunitytowelcomeand guidecliniciansthroughrolesandresponsibilitiestothe community.

FosterConnectivityandTransparency

● Ensurepatienthealthinformationissafelyandsecurelystored inacentralizedelectronicdatabasethatpatientsandhealth careproviderscaneasilyaccessatnocost.

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● Requirehealthcareproviderstofollowaclearlydefinedseries ofcommunicationstepsthatalignswiththepatientcareplan sothatpatientsareinformedandunderstandtheirtreatment plan.

● EstablishapubliclyfundedhealthcareOmbudspersonto ensurethepublic(i.e.patientsandcaregivers)haveastrong, accessible,andmandateddefenderoftheirrights.

InformandEngagethePublic

● Developanddeliverasustainedmulti-facetedpublic educationcampaignde-mystifyingtheprimarycaresystem, toempowerindividualstomakeinformedchoicesabout theircare.

● Provideasinglepointforongoingaccesstodataabout performanceoftheprimaryhealthcaresystem.

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● ExtendthemandateoftheManitobaPrioritiesPanelasan ongoingcitizens’panelonprimarycarepriorities.

Understanding thePanelProcess

APrioritiesPanelisalong-form deliberativeprocessthattypically involves30to48randomlyselected residents.Theseresidentsarechosen usingaprocesscalledaciviclottery, arandomselectionmethodthat prioritizesfairnessandwide representation.Theindividuals selectedforaprioritiespanelcome togethertolearnabout,andthen advisepublicauthoritieson,divisive andcomplexissuesthattypically involvetrade-offsorcompromises. Thepanelmembers’objectiveisto reachaconsensusonaseriesof recommendationsthatcanbe directedtogovernment,professional associations,andsocietyatlarge.

WhatisaCivicLottery?

Aciviclotteryisabalancedwayof selectingthemembersofapriorities panel.Itisbasedonaformof sortitionthatusesarandomized selectionprocesstorecruitpanelists fromapoolofvolunteerswhohave indicatedtheirinterestinservingon thepanel.Thestratifiedciviclottery processensuresthatmembersofthe panelarefairlyselectedandbroadly representativeofthedemographic makeupofManitoba.

OurCaredeliberatelysoughtto overrepresentresidentsknowntobe underservedbytheprimaryhealth caresystem,namely:racialized,lower income,newcomer,andgender non-conformingresidents;thosewho liveinrural,remote,ornorthern regionsoftheprovince;and membersofFirstNation,Métis,and Inuitcommunities.Inshort,thepanel wascomposedinsuchawayasto deliverdemographicdiversityandto ensureweheardfromresidentswho aremostdisadvantagedbythe currentsystem.

Manitobahasthehighestproportion ofIndigenousresidentsofany provinceandupontheadviceofthe ManitobaAdvisoryGroup,wesetout toensurethePrioritiesPanelwould haveastrongFirstNations,Métis,and Inuitpresence.Withthehelpand supportoflocalpartnerslikethe ManitobaMétisFederation,the UniversityofManitoba,and Ongomiizwin,wesentoutthe invitationtovolunteerforthepanelto Indigenousresidents.Intheend, almost30percentofthepanel membersself-identifiedasFirst Nation,MétisorInuit,which,bysome estimates,islikelyclosertothereal worldproportionofIndigenous peoplelivinginManitoba.

PanelSnapshot

30members

Gender:*

16-women

13-men

1-non-binary

Age:

2- 18-29yearsold

7- 30-44yearsold

14- 45-64yearsold

7-65+yearsold

Memberswhoidentifyas Indigenous:9

Memberswhohavebeenin Canadalessthan10years:5

Geography:

18-Winnipeg

4-North

4-South

2-Interlake

2-PrairieMt.

Memberswhoidentifyas partofaracializedgroup:5

*-“Women”referstocisgenderandtransgenderwomen.“Men”referstocisgenderandtransgendermen.

TheMembers’ Reportofthe Manitoba PrioritiesPanel onPrimaryCare

WhoWeAreandWhyWe Volunteered

The30membersofManitoba’s OurCarePrioritiesPanelare individualsconnectedbyacommon passiontoimprovetheprimarycare systeminthisprovince.

Weareactivists,advocates,and problem-solvers.Wetrytomakelives easierforthepeoplewecareabout, andthepeopleweworkwithandfor.

Wecomefromallareasofthe province:ruralcommunities,remote andisolatedcommunities,urban settings,andIndigenous communities.Wereflectthe demographicsoftheprovinceby age,gender,andsocio-economic background.Someofushavelived hereforgenerations,someofusare newcomerswithlittletono experiencewithManitoba’shealth caresystem.Weareworkers,weare patients,wearecaregivers.Allofus arepotentialfuturepatients.

Weholddiversefundamental perspectivesandconvictions,butwe cameheredeterminedtowork togetherforthebettermentofall. We’velearnedaboutworkingasa teamandwe’velearnedabouthow teamworkcanrevolutionizeour primarycaresystem.

Therichdiversityofourgroup allowedustoidentifyandanalyzethe problemsrelatedtoprimarycare fromvariousperspectives,consider manydifferentpointsofview,and debateawiderangeofpossible solutions.Wewereencouragedto haveanopenmind,beempatheticto oneanother,andsharechallenges wemaybeexperiencingwithhealth care.

Weallhavelivedexperiencewith primarycareindifferentwaysandto differentextentsandwithunequal outcomes.

Overthecourseofthepastthree days,wehaveheardourcolleagues sharehowtheyhavebeenabused, marginalized,andignoredbythe system.

Wehavealsoheardfromhealthcare professionalsandlearnedfromtheir passionanddedicationabouthow thesystemcouldbemadebetter.

Togetherwefeelthatthecurrent primaryhealthcaresystemhonours thesystemmorethanithonoursand caresforthepeopleitshouldserve.

Wetrulyhopethisreportisthe vehiclethroughwhichourvoicesand

ideasforimprovementareheard, andthatitwillbemeaningfullyacted uponbydecision-makers.

Thispanelhasmodelledtherespect, compassion,activelistening,and relationship-buildingthatneedsto bereflectedintheprimarycare system.

Someofushavebeenvulnerable andsharedourstories,trusting othersintheroomwebarelyknow,in ordertoinformtheissueswe’re addressingandmakethempersonal insteadofabstract.

Afterourintensetimetogetherinthe room,andintwopreviousonline sessions,wedon’twantthistobethe lastopportunitywehaveforour voicestobeheard.

Thiscannotbeareportthatendsup onashelf.Weexpecttohaveour collectivevoiceacknowledged,truly heard,andactedupon.

WhatWeLearned

Duringourfirstonlinemeetings,the ManitobaPrioritiesPanelmembers wereaskedtothinkofprimarycare asthe“firstcontact”withhealthcare andasanentitythatprovides comprehensive,coordinated,and continuouscarethatisconvenient andprovidedwithculturalhumility.

Duringtheonlineandin-person sessions,thepanelwasprovidedwith moreinformationaboutlocalhealth carefromprofessionalsworkingin ManitobaandotherpartsofCanada.

Throughthesepresentationsand paneldiscussionswithkey stakeholdersandactorswithinthe healthcaresystem,itwasclearthat thegoalsofbothpatientsand providersistoimprovethedeliveryof primarycare.Formanyofour members,therelationshipbetween patientandproviderhasfelt adversarialduetoentrenchedissues withinthehealthcaresystemandits administration.

Sharingourstoriesofgrief,hardship, andalsosuccess,wefelt empowered.Weallhaddeeply personalandimportantstoriesto share,andthiscommonality providedabasisforunity.

Ourgroupacknowledged unanimouslythedisproportional negativeimpactthatourcurrent healthsystemanditsadministration hashadonIndigenousPeoplesdue tothehistoricandongoing enactmentofcolonization.We ensuredthatIndigenoushealthwas anundisputedpriorityinthe developmentofthisreport.

Attimes,weexperienced hopelessnessforthefutureof primarycare.Wewereskepticalof whetherourwork,andthe recommendationsinthisreport, wouldbeusedandifourvoices wouldbetakenseriously.

Whatbroughtushopeinthese momentsweretheconnectionswe madewithotherinvestedmembers, sharedexperiences,expressionsof optimismfromourguestpresenters, andachangeinourprovincial governmenttoonethatisfocusedon improvingthehealthcaresystem. Ultimately,healthcareproviders, patients,andpatients’caregiversare allinvestedintheimprovementof primarycare.

TheChallenges WeWantSolved

Weidentifiedsevenchallengesto solve.

Thepublicfeelsdisrespected

Thegeneralpublicislargelyunaware ofinitiativesthatareunderwayto maketheprimarycareexperience betterforallpeople.Notknowinghow primarycareissupposedto“work” causesunduestrainandneedless confusiontoanyvisittoaprimary carecentre.

ThisOurCarepanelhasidentified deficienciesaroundpubliceducation, communicationtoseniorsandother highneedsgroups,evaluation,and accesstoinformationthatcontribute tothisfeelingofdisrespectand isolation.

Careisnotcoordinatedor connected

Duetoalackofaconnectedand integratedcaresystem,peopledo nothaveaccesstotheirmedical recordsinacoordinatedmanner.For thesamereason,careprovidersalso donothavevisibilityintothewhole pictureofone’shealth.Thislackof connectedsystemsofcare,accessto personalhealthinformation,and uniformproceduresmeansthat accesstohealthcareisoften

disjointed,andcoordinationand information-sharingrelatedtocareis difficultandinefficient.

Careisdifficulttoaccess

Accessingprimarycareisalmost certaintoputunduestrainand disruptmanypeople'sdailylivesand thisproblemdisproportionately affectsManitoba’smostvulnerable populations.

Thereisalackofaccessiblecarethat isclosetohomeandopenat reasonabletimes.Longwaittimesfor primarycareappointmentsmake medicalproblemsworse,andthe needformanytotraveltoreceive careputsstrainonfinancial resourcesaswellasworkandhome responsibilities.

Primarycareisnotconvenient,nor aretheresourcestoaccessthesein atimelymanner.Whencareis difficulttoaccess,supportfrom family,newcomerandsocialgroups offeringhelptoIndigenousPeoples, newcomers,andotherswhoare inequitablyrepresented,isoften missingorinsufficient.

Thereisacrisisinhuman resources

Thereisaninadequatenumberof primarycareprofessionalsespecially outsideofurbanareas.Manyhealth careprofessionalswhochooseto workinruralandremotegeographies stayinthoselocationsforonlyshort periodsoftime,contributingto significantstaffturnover.Staffing issuesareexacerbatedinthe northernareasoftheprovince.

Standardizedmeansof reimbursementandproper compensationforhealthcare providersareimportantissues. Barrierstogettingmoreand appropriateprimarycareclinical staffinclude:

● Toofewseatsin post-secondaryeducation, especiallyforthosewishingto workinCanada,inManitoba, andinManitoba’sruraland remoteregions

● Barrierstoseamlesslymerging internationallytrainedand/or accreditedprofessionalsinto meaningfulhealthcare positionsinManitoba

● Alackofdiversityintrained professionalswhochooseto workinManitoba

● Financialbarrierstotraining

post-secondaryeducationmay revealsignificantbarriersbothwithin theadmissionsprocessandinthe underlyingstructureofadmission procedures.

Thesystemlacksaccountability

Thesystemlacksaccountabilityand thereistoomuchbureaucracy arounddecisionsabouthealthcare —decisionsthatarenotalways communicatedacrossthesystem nortothepublic.

Itisnoteasytoknowwhenthe systemoraproviderdoesnotfollow existingpoliciesorwhatenforcement mechanismsexistasarecourse. Careisinconsistentbetweendifferent centersandproviders,andfocusof carevariesbasedonlocation.Itfeels likethesystemisantiquatedandhas notevolvedtomeettheneedsofthe populationinthisprovince.

Thesystemisnotdesignedto serveeveryone

Thesystemisdesignedtosupporta businessmodel,ratherthanto providecareforpatientsandtheir caregivers.Thisleavesroomfor providerbiasagainstminoritygroups likeIndigenousPeoples,2sLGBTQIA+, neurodiversepopulations,and

supportsexistingsystemicracism.It encouragesbiastowards violence-relatedinjuriesand addiction.

Thesystemisdesignedtoserve thosewhoarebetterequippedto vigorouslyseekoutinformationand advocatefortheirhealth,whilethose withoutadvancedresearchand advocacyskills(likenewcomers, thosewithlanguagebarriers,and Manitobanswhohavebeen consistentlyandcriticallyoverlooked andmarginalized)arelefttosuffer withsubstandardcare.

Fundingandpoliticalwillare lacking

Thesystematlargeisunderfunded andresourcesaremisdirected.Many hospitalsinManitobahave significantfundraisingteamsto makeupforunderfundingandmany peopledonatebecausetheybelieve thatiswherefundingismostneeded. Often,donorsandthepublicare unawareoftheextenttowhich primarycarehasbecome underfundedandthereisacommon misconceptionamongthose contributingtohealth-related charitiesthattheseorganizationsare theareaswherefundsaremost needed.

reactionaryratherthanproactive. Thefundingmodelcanbedescribed as“attention-based”(theshinyapple getsthefunding)ratherthan “needs-based.”

Theallocationofresourcestohealth careneedstobede-politicized,and spentontherealneedsofthe Manitobanpublic,withapriority placedoninnovationandinclusion. Theexistingmodeldoesn’tallowfor innovationandappliesa bureaucraticlensthatoftenmisses thejurisdictionalgapsthatmake primaryhealthcareinManitoba inequitable.Moreattentionmustbe placedonthelong-termhealthof thoseinrural,remoteandnorthern geographiesaswellasmarginalized peoples.Moreattentionneedstobe spentinresolvinglong-standing gapsincareprovidedtoIndigenous Peoplesthroughahodge-podgeof federalandprovincialfunding.

OurValues

Weidentifiedeightvaluesthatwe wanttoguideprimarycarerenewal inManitoba.Theyare:available, accessible,holistic,understandable, connected,accountable, considerate,andsustainable.

Available

Availableprimarycaremeansthatall Manitobanshavetherighttocare.

Accessible

Primarycareisaccessiblehealth careinatimelyfashiontoallpeople whenandwheretheyneedit. Accessiblecareisimportantbecause accesstoprimarycarepromotes wellnessandpreventsorreducesthe severityofhealthissues.

Accessiblemeansbroaderandmore comprehensivehealthcarethanis currentlyavailableatnoadditional personalcost.Accessibleprimary careshouldendeavourtoremove financial,social,physicaland geographicbarriersandother negativedeterminantsofhealth.

Holistic

Holisticcareaddressesaperson's well-beingasitrelatestotheir physical,medical,emotional, spiritual,social,andfinancial situations(tonameafew).Holistic

carerecognizesthenecessityof continuous,ongoingcare,which leveragesavailableresourcesacross thespectrumofneed.

AllManitobanshavetherightto accesscontinuousholisticcare. Holisticcareisimportantbecausewe needtorecognizethatpeopleare morethanjustbiology, andtotreatthepersonasawhole.

Understandable

Inanunderstandableprimarycare system,individualsknowhowand wheretheycanaccesscareandhow andwhytheyarebeingprovidedwith specificcare,prescriptions,tests,etc. Anunderstandablesystemincludes:

● Publiceducationaboutbasic preventativehealthcareand basicprimaryhealth proceduresandmeans throughavarietyofmethods andmedia;

● Onceinaprofessional’scare, interactivecommunication amonghealthcare professionals,caregiversand individuals;

● Knowledgetranslationsothat thepatient(andtheir caregivers)understandwhat careisgivenorrefusedand why.

Anunderstandableprimarycare systemempowersindividualstolearn aboutandparticipateintheirown care.Itincreasesaccessto appropriatecare,reducesstrainon emergencyservices,andbuilds confidenceinprimarycare.

Connected

Connectedprimarycarehasa comprehensive,centralized databasethatisaccessibletoall healthcarepractitionersand patients,whereallpartsofthe systemcommunicatewitheach other.

Connectedcareremovesbarriersfor patientstoaccesstheirownhealth informationandtreatsthat informationsecurely,confidentially, andwithrespect.

Connectivityisimportanttoasystem becauseitencouragesa collaborativeapproachtotreatment andrespects individuals’rightsto accessandmanagetheirown information.

Accountable

Thehealthsystemmustbe accountablefordependable, respectful,andcomprehensive primarycareforALLpeoplebecause careisamoralandconstitutional

right.Whenmanagedsuccessfully, thiswillbenefitManitobansandthe provinceasawhole.

Accountabilitymeansthatallpeople inthehealthsystem—frompatients tohealthproviders—knowand understandthathealthcareisaright andthatthehealthcaresystemis responsibleforprotectingand deliveringthoserights.

Considerate

Consideratecarecreatesan environmentwherethereisdignity, compassion,andrespect.Itis characterizedbyrecognizinga person'sinherentrightsand emotions.

Sustainable Sustainableprimarycaremaximizes efficiencyandresourceutilizationto advanceholisticcommunityhealth whileempoweringindividualstotake ownershipoftheirhealthand well-being.Byupholdinga sustainableprimarycaresystem,we ensureequitableaccesstohealth careforgenerationstocome.

OurRecommendations

A.IncreasetheNumberofHealthCareProfessionals

Education,TrainingandDevelopment

1. TheCollegeofPhysiciansandSurgeonsandtheCollegeofNursesshould expeditetheprocesstorecognizethequalificationsofinternationally trainedmedicalgraduates.Asystemofpeer-to-peer,mentorship-based trainingshouldbedevelopedtosupportinternationallytrained professionalstoworkinateam-basedenvironmentandtohelpthem integrateintotheCanadianmedicalsystem.Byassessingtransferable skillsandforeigneducation,andofferingpeer-guidedtraining,wecan ensuretherearemorehealthcareprovidersdeliveringprimarycareto patients.

2. TheUniversityofManitobashouldpartnerwiththeUniversityCollegeofthe Northtoestablishandoffertrainingforallprimarycarepositions(LPN,RN, NP,PAandmedicaldoctors)inthenorthernpartsoftheprovince.

3. Entryrequirementstomedicaltrainingshouldberevisedtomoveaway fromrelyingheavilyonstandardizedtestscores.Entrancerequirements shouldbemorecomprehensiveandevaluation-focused,andscorefor academicCV,personalessays,andcommitmenttocommunityservice, similartotheassessmentcriteriausedbytheUniversityofToronto’s medicalentranceframework.Thiswouldnotonlyimprovethequalityof studentsintheseprofessionalprogramsbutalsoreducethenumberof domesticstudentsleavingCanadatogettrainingabroad.

RecruitingandRetainingStaff

4. SharedHealthandtheRegionalHealthAuthoritiesshouldcommitto enhancingtheirrecruitmentstrategyforhealthcareprofessionalsinorder toencourageprimarycareproviderstowork,liveandplayinManitoba. Governmentshoulddevelopastrongervaluepropositiontoencourage

professionalstochooseManitobaasanappealingplacetosetdownroots andtopracticeprimarycare.Theyshouldalsoenhancetheiradvertising campaignswithfinancialandculturalincentivestoattractalargerpoolof qualifiedindividualstoManitoba.Potentialstrategiesinclude:

● Talentattractionthroughpersonalizedstorytelling,brand ambassadorsandcompellingvideotestimonialsthathelppeople feelapersonalconnectiontoManitoba;

● Highlightingfiveecosystems,celebratingfourdistinctseasonsand oneofthesunniestprovincesinthecountry,andshowcasing Manitobaasanaffordablefamily-orientedprovinceespeciallywhen comparedtootherpartsofCanada.

5. Immigration,Refugees,andCitizenshipCanada(IRCC)andtheProvincial NomineeProgram(PNP)shouldprovideregularreportstoregionalhealth authoritiesandSharedHealth,detailingthenumberandanticipated arrivaldatesofnewCanadiansarrivingfromabroadwhomayhave primarycareskills.Whenanewcomergivespermissionforthesharingof thisinformation,itcouldbechanneledintotheworkforceplanningprocess forvettingandreview.Thiswouldmakeiteasierfornewcomerstofind employmentinManitobaasaprimarycareprovider.

6. Workforceplanningbodiesshouldreviewtheuseofshiftworktoallowfor morework-lifebalance.

7. Workforceplanningreviewsshouldalsotakeintoaccountsuccession planningtofillretirementgapsandensurethenumberofnetnewroles andbackfillsneededforeachpracticeareaareknownsothatpracticums fromtheUniversityCollegeofNorth,andothertraininginstitutions,can placestudentstomeettheseneeds.

Compensation,Benefits,andIncentives

Itisdifficulttorecruitandretainqualifiedandcompassionatecareproviders withoutconsiderationofhowtheyarebeingcompensated.Financial compensation,benefitsandotherincentivesmustbecompetitiveboth

nationallyandinternationally.Assuch,wemakethefollowing recommendations:

8. Thecurrent(primarilyfee-for-servicebased)compensationmodelneeds tobereviewedandupdatedtoencourageproviderstocareforpatients asawhole,andnotjustasacollectionofparts.

● Providersshouldbeincentivizedtoworkinaninterdisciplinaryteam settingandtocarryafullrosterofpatientsseekingcare;

● Additionalincentivesshouldbeofferedtocareprovidersasitrelates tohousing,food,travel,andrelocation,particularlyforproviders locatedinrural,remote,andunderservedcommunities;

● Bonusesforlongercontracttermsandtoretainstaffwhenitistime foracontractrenewalshouldbeoffered.

B.Ensureholistic,person-centredcare

9. Werecommendacontinuedshiftfromindividualfee-for-service practitionerstoteam-basedmodels(suchas,ACCESScentres)thatoffer holisticcarefromavarietyofin-houseprofessionals.Theseteamsshould includeaccesstomedical,alliedhealthcare,spiritual,social,andother preventativeservices.

Primarycarecliniciansshouldalsobeabletoeasilyconnectwith out-of-houseprofessionalsneededforapatient’scarewhenneeded.With consentfromthepatient,aprimarycareclinicianshouldbeableto connectwithotherclinician(s)treatingthepatient.

10. Issueanimproved,durable,personalplastichealthcard,withaphoto,that registerseachindividualforhealthcoverage(i.e.nomorefamily registration)andrepresentstheimportanceofhealthcareinManitoba. Asthehealthcardwillbemoredurabletherewilllikelybeareductionin demandforreplacementcardsfromdamageorgeneralwearandtear. Thehealthcardshouldbeacceptedasaformofgovernmentphoto identificationandcouldincludeaQRcodethatdirectssecureaccessto one’spersonalhealthinformationinawaythatprotectspatientprivacy.

11. TheManitobaHealthRegionalAuthoritieswillofferafter-hours,24/7 accesstoprimarycareservicestoensurecontinuousaccesstohealth care,movingbeyondthetraditional9-5practicehours.Thiscouldbe accomplishedthroughshiftwork.

12. Recognizingthathealthisbynatureholistic,assurethatitisstandardfora patienttohaveaccess,whendesired,totheirfaithorspiritualcommunity, includingelders,knowledgekeepers,andspiritualleaders.

13. Addmorepractitionersthatspecializeinpreventiveandholisticstreamsof careinhealthteamswiththeaimtoreducetheworstoutcomesthatarise asaresultof,forinstance,chronicdisease.

C.EquityandSocialDeterminantsofHealth

Addressingracism,discrimination,andothersociologicalfactorsaffecting health.

Thefollowingrecommendationsaredesignedtopromoteequitabletreatment amongstthepersonsandgroupsprotectedbyanddescribedinsections9(2) and9(3)oftheManitobaHumanRightsCode.Forthepurposeofthisreportwe highlightthefactthatthefollowinggroups'experienceofprimarycareis influencedbymultipleintersectingidentities:IndigenousPeoples, neurodivergentpersons,transgenderpeople,personswithdisabilitiesand chronicmedicalconditions,andnewresidentsofManitoba.

14. Mandateculturalhumilitytrainingforallhealthcareprovidersand professionals intheformofapre-approvedcourseorprogram.This trainingwouldberequiredtokeepone’smedicallicenseingoodstanding andberequiredtobecompletedwithinthreeyearsofthis recommendationbeingissued.

15. Consideradditionaltrainingcoursesasarequirementforannual,orother relevanttimeframe,licenseoraccreditationrenewalprocesses.The numberofhoursandproofofcoursecompletionsshouldbesubmitted withlicenserenewaldocuments.ProvincialHealthAuthoritieswouldbe requiredtomaintain

alistofpre-approvedtopics,coursesandapplicableeventsthat professionalscouldtaketomeetthisrequirement.

Exampletopicsinclude:2SLGBTQIA+andneurodiversitytraining,asocial sciencescoursethatexposesstudentstothesocialdeterminantsofhealth (suchashousing,income,foodinsecurity),andintersectionality.

Traininginhowtoprovidetrauma-informedcareshouldbeconsidered essential.

Exampleofdifferentcoursesinclude:ManitobaIndigenousCulturalSafety TrainingfromRegionalHealthAuthorities;BringingintheBystander trainingfromtheSexualViolencePreventionProgramattheUniversityof Manitoba;theIndigenousCanadacourseofferedthroughtheMassive OpenOnlineCourseandtheUniversityofAlberta.

Examplesofapplicableeventsinclude:Attendingvariouslocal IndigenousceremoniesincludingsweatlodgeandvolunteeringforTruth andReconciliationDayevents.

Inordertoincreasethediversityandrepresentationofhealthcareprofessionals acrossManitoba,andtoprovidethemwithmoreexperiencedeliveringcarein sociallycomplexareas,werecommend:

16. Anewrecruitmentstrategyandprocesstoattractamorediversestudent base tomedicalprofessionsandundergraduatestreams.

17. Includeruralpracticumplacementstoremotecommunities(population <5000)includingIndigenousreserves(e.g.St.TheresaPoint,GardenHill, PowerviewPineFalls,Altona,Morris,Verden)forallhealthcarefieldsto exposestudentstomorediverserural,remote,andnortherncommunities thatexperiencehigherhealthserviceneeds,andhavehighratesof recurringissues.

Thefollowingrecommendationsarebuiltontheassumptionandpreferencefor ateamhealthmodelthatcanblurjurisdictionallinestotreatmultiplegroups andcommunities.

Guidelinesandrecommendationsforrural,remote,andnorthernHealthHubs

18. Increasethenumberofinternethubsandimprovedigital/ telecommunicationsinfrastructureinrural,remoteandnorthernareasin ordertoincreaseaccesstovirtualcare.Everyoneshouldbewithinone hourofcommontravelofaninternethubwheretheycanaccessprimary careandprovidefeedbackonthecaretheyreceive.

19. Establishregular(monthlytoquarterly)mobilehealthclinicsthatbring primarycaretoruralremoteandnorthernresidentsoverenoughdays andwithsufficientnoticesothatallthosewhorequirecarehaveagood opportunitytoreceiveit.Thiscouldreplacethecurrentdefaultofbringing patientstocare.Thesevisitswouldfocusonpreventativeandprimary carewithafocusontheroleofdiet,physicalactivityinhealthaswellas trackingongoinghealthconcerns.

Recommendationsforhealthteamsatlarge

20. Designanddeployabetterandmorefrequenthealthcensuswithpublicly availabledata.Thecensusshoulddetailthesocialconditionsandthe healthoutcomesofanareaandthisdatashouldbeusedtosuggest wheremorecareandspecializedcentersareneeded(suchasCancer CareinChurchill).

21. Mandatetheinclusionofafull-timesocialworkerorcommunityresource workerinallhealthteamswhowouldbetaskedwithrecommendingand enrollingindividualsinsocialserviceprogramsasneeded,suchaspublic housingprograms,incomeassistance,foodbanks,etc.

D.CareforIndigenousPeoples

NOTE:Theserecommendationsappearinorderofpriority.

22. CreateandpromoteanIndigenousHealthDepartmentwithinthe provincialgovernmentsothatIndigenoushealthisafundedand strategizedprioritywithinthemedicalfield.

23. Indigenizetheentiremedicalcurriculumutilizingtherecommendationsof Elders,KnowledgeKeepers,Indigenousandalliedresearchers,Indigenous organizationsandIndigenouscommunitiestocreateatrauma-informed curriculumthatstandsfirmlyagainstanti-Indigenousracism.

24. Implementamandatorycommunityorientationprocessformedical professionalsenteringnewcommunitiestoguideandwelcomethemto theirrolesandresponsibilitiestothecommunity.Theaimistoensure bettercare,staffretention,andcontextualized,trauma-informed, anti-racistcare.

25. Recruit,promote,train,apprenticeandmentorIndigenousPeopleswitha focusonyouth.Thiswillhelpfillhealthcarepositionsfromlocal communitiesandstrengthenstaffretentioninrural,remote,andreserve communities.

26. Expand,promote,andmovetheTraditionalWellnessClinicattheHealth SciencesCentretoamorevisible,accessiblespace.Expandthenumberof daysandgeographicalreachoftheTraditionalWellnessClinictoprovide traditionalhealingpracticestointerestedpatients.

27. DirectfundstoIndigenous-ledcommunityhealthprograms.Reducethe amountofpaperworkandtimerequiredtoprovidefeedbacktothe funders,allowingmoretimetoimplementthework.

28. EnhanceIndigenouscarebyprovidinginclusiveaccesstoceremonial traditionaleventsbyprovidingfunding,traditionalmedicinesandaccess opportunities.

29. CreateandpromoteanIndigenousrepresentativebodythatworkswith governmentstakeholders(Provincial,Federal,andTerritorial).Itmust providetimelyandequitableresolutionstohealthandjurisdictionalissues.

29. CreatepositionsinjurisdictionsacrossManitobaforIndigenousmedical supportssuchasnavigatorsandadvocates.Physicalspaceshouldbe providedineachmedicalcenterallowingfortheserolestobepresent. EnsurethattheseIndigenoussupportersworkproactivelytoengagewith Indigenouspeoplesinhospitalsbyfocusingonoutreachandpre-emptive check-inswithIndigenouspatients.

E.FosteringConnectivityandTransparency

30. Wewantourhealthinformationtobesafelyandsecurelystoredina centralizedelectronicdatabasethatweandourhealthcareprofessionals caneasilyaccessatnocost.Keyhealthinformationshouldinclude(but notbelimitedto)vaccinationrecords,diagnosticreports,prescriptions, andhospitaldischargesummaries.

AseChartiscurrentlyonlyavailableforproviders(withtheexceptionof immunizationrecords),apatientportaltoaccessourownhealthcare recordsisessential.Itisunacceptablethattheonlyelectronicpatient portalsavailablearecommercialandchargepatientsamonthlyfee.

TheprovincialgovernmentandtheDepartmentofHealthinManitoba shouldlegislatethatpatienthealthinformationisthepropertyofthe patientandbekeptinrecordsthatincludeprivacyanddatasharing controlsthatwould:

● Protecthealthcareprovidersinspecificsituationsthatmay compromisetheirsafety;

● Accountforlegaltransitionsinrelationshipstatus,likewhenachild reachesageofmajority(expected)oradivorce(unexpected).

(Considerationfortheprivacyofdependents/childrenasitrelatesto theirpersonalhealthinformationisanimportantareaforfuture conversationandpolicydevelopment.)

Electronichealthrecordsshouldalsoupdatewheneverapatientaccesses healthservicesinanunexpectedwaysothattheirprimarycareclinician wouldbenotified. Thecurrentsystemusesfaxmachinesandlettermail whichdonotrepresentamodernizedhealthsystem.

31. Wewanthealthcareprofessionalstoberequiredtofollowaclearly definedseriesofcommunicationstepsthatalignswiththepatientcare plan.Thesestepsshouldbedesignedwithpatientinput,andwouldensure thatpatientsareinformedandunderstandtheirtreatmentplan regardlessofthetime/resourcesrequiredbythecliniciantoensurethe patientunderstandstheplan.Thepatient’scommunicationspreferences (phone,email,mail,papercopyinhand,etc.)mustbeacknowledgedand respected.

Thegoalofthisrecommendationisforallpatientsandtheircaregiversto beinformedofandunderstandtheirtreatmentplan.Thiswillmakethem feellessstressed,haveownershipoftheirplan,andmakethemfeelsafer andmorecaredfor.

32. Wewantanonlineplatform,similartoasocialnetwork,forhealthcare professionalsthatwouldallowthemtocommunicateandreferpatientsto eachothernomatterthesizeoftheclinicians’practice.Thisplatform wouldbedrivenbyanopenandup-to-datedatabaseofinformation aboutclinicians,theirservices,andaveragewaittimesforaconsultation ortreatmentappointment(whereapplicable).Effectiveandefficient coordinationandcollaborationbetweenallhealthcareprofessionals,both inandoutofprovince,isessential.

Theaimistoempowerprimarycareprofessionalswithinformationand connectionsthatallowsthemtodevelop acomprehensivetreatment planfortheirpatientsthatdrawsoncliniciansnearandfar,evenoutof province,withinreasonorwhenrequired.

33. WewantaHealthCareOmbudsperson,apublicpatientadvocacy organization,publiclyfundedandmandatedto:

● Raisepublicawarenessabouthowtoresolvecomplaintsabout primarycare.Thiscouldincludere-developing andlaunchingan accessiblereportingandcomplaintssystemthatpatientscanuse toreportpotentialManitobaHumanRightsCodeviolations.This systemwouldberoutinelypromotedtoManitobans;

● Investigateindividualpatientorsystemicissues;

● Recommendactionand/orchanges;

● Reportitsfindingstothepublic.

Thisombudsperson/organizationcouldbemodelledaftertheLawEnforcement ReviewAgencythatwasestablishedin1985toinvestigatepubliccomplaints aboutpolice.Thegoalofthisrecommendationistoensurethepublic(both patientsandcaregivers)haveastrong,accessible,andmandateddefenderof theirrights.Thiswouldalsohelpensurepublicaccountabilityofhealthcare professionals,organizations,andthesystem.

Thisorganizationcouldhelppatientsnavigateavenuesforredressrelatedto complaintsandwrongdoing,aswellastorecommend,enforce,andoversee changesandactionstootherhealthorganizations,suchastheManitoba CollegeofPhysiciansandSurgeons.Thisneworganizationshouldbewell promoted,easilyfound,easytoworkwith,andaccessibleforall.

F.InformandEngagethePublic

34. Werecommendthatthegovernmentdevelopanddeliverasustained multi-facetedpubliceducationcampaignwhosegoalistodemystifythe primarycaresystem,inordertoempowerindividualstounderstandthe optionsavailabletothemandmakemoreinformedchoicesabouttheir care.

Thiscampaignwould:

● Beginimmediatelybycompilingandsharingalready-available informationaboutservicesinsimple,easilyaccessibleformats;

● Bedevelopedbyacollaborativeteamofstakeholdersincluding,but notlimitedto,membersofthepublic,healthcareproviders,youth, patientandcaregiveradvisors,communityadvocates,and membersofunder-representedcommunities;

● Acknowledgediverselearningstylesandabilities;

● Reachdiverseandunderrepresentedcommunitiesbyusingmultiple platforms,spaces,systemsandcreativeapproaches.Thismay includesocialmedia,print,andin-personcommunication,for example“pop-up”spacesconnectedtoorinestablishedand trustedcommunityorganizations;

Thecampaignwouldaimto:

● Alleviatethestrainonacutecareprovidersandtheacutecare systembyhelpingpeoplebetternavigatethesystem;

● Proactivelyinformindividualsabouttherightplacetogoforthecare theyneed;

● Buildconfidenceintheprimarycaresystem;

● Educateindividualsabouttheirrightstoprimarycare;

● Setreasonableexpectationsforbothpatientsandhealthcare providersaboutthecarethatisprovided;

● Providepubliceducationsurroundingself-care(forexample, physical,mental,spiritualandnutritionalhealth).

35. ProvideavenuesforcollectingfeedbackfromallresidentsofManitobaon theprimarycaresysteminordertoinformcontinuousimprovementsto thesystem.Thisincludessharinginformationaboutprogramsthat alreadyexist forpublicengagement.

36. Provideasinglepointforongoingaccesstodataabouttheperformance oftheprimarycaresystem.

37. TakinginspirationfromtheOurCareNovaScotiaPrioritiesPanel,we recommendextendingthemandateoftheManitobaPrioritiesPanelasan ongoingcitizens’panelonprimarycarepriorities.Thiswillbuildonthe momentum,foundationalknowledge,andestablishedrelationships developedthroughthisinitiative,andensureaccountabilitytothevision putforwardinthisreport.

OurCarePrioritiesPanel Program

TheManitobaPrioritiesPanel, consistingof30membersfromacross theprovince,metonlinetwice(ontwo SaturdaysinSeptember2023)and thenagainin-personoverthreedays inWinnipeg(October13-15,2023).

Duringmorethan30hourstogether, panelmemberslearnedabout primarycareinManitobaandother jurisdictionsastheyheardfromand engagedwith15subjectmatter expertsinpresentationsand moderateddiscussions.Themembers alsospentasignificantamountof timeinconversationwitheachother astheyparticipatedinaseriesof facilitateddiscussionsand deliberationsthatculminatedinthe consensusrecommendationsput forwardinthisreport.Videosofsession presentationsandrelatedmaterials areavailabletothepublicat ourcare.ca/prioritiespanels.

InordertoensurethatIndigenous protocolsandworldviewswere respected,theManitobapanelteam alsoincludedanIndigenous Co-Chair,Dr.MandyBuss,Métisfrom theRedRiverSettlement,whoisa familyphysicianandIndigenous HealthLeadforDepartmentofFamily MedicineandUndergraduateMedical EducationCourseDirector,Indigenous Health,MaxRadyCollegeofMedicine, UniversityofManitoba,aswellas AlbertMcLeod,aKnowledgeKeeper fromNisichawayasihkCreeNation andtheMétiscommunitiesofCross LakeandNorwayHouse.Knowledge KeeperAlbertledanopening ceremony,wherehegaveteachings tohelpguidethesessionsand finishedwithaclosingceremonyto givethanksfortheworkthatwas accomplished.Bothwere accompaniedbydrumsongs performedbyDr.LisaMonkmanand Dr.MandyBuss.

Session1:

Saturday,September9,2023

Virtual

TheopeningsessionoftheManitoba PrioritiesPanelbeganwithaformal welcomeandintroductionfromthe panel’sco-chairs,Dr.MandyBuss, andJasminKay,NationalProject DirectorandDirector,MASSLBP. Togethertheypresentedabroad descriptionoftheOurCareinitiative, itsmandate,objectives,processes, andthekeyquestionstoguide membersintheirparticipation.

Followingashortbreakoutgroupfor smallgroupintroductions,thepanel welcomeditsfirstguestspeaker,Ms. JeannetteEdwards,formerProvincial LeadofSystemIntegrationand QualityManagementforShared HealthinManitoba,andformer RegionalDirectorofPrimaryHealth CareandChronicDiseasewiththe WinnipegRegionalHealthAuthority. Ms.Edwardsgaveadetailed presentationonPrimaryCare101,with anemphasisonthekey characteristicsandhistoryofprimary careintheprovince,thekey challengesfacingthesystem,and putforwardthecaseforreform. Membersthentooktheopportunityto engageinarobustQ&Awiththe guestbeforebreakingintosmall,

facilitatedgroupsforadiscussionon thevaluestheybelieveshoulddefine theexperienceofprimarycarefor Manitobans.

Next,membersheardfromDr. AmandaCondon,afamilyphysician inNotreDamedesLourdes,Associate ProfessorwiththeDepartmentof FamilyMedicineattheMaxRady CollegeofMedicineattheUniversity ofManitoba,andtheOurCare ManitobaPrimaryCareCo-Lead.Dr. Condonpresentedthefindingsfrom theOurCareNationalSurvey,which, duringSeptemberandOctober2022, gatheredinsightsfrommorethan 9,000Canadiansabouttheir experienceswithprimarycareand theirpreferencesandprioritiesforthe future.Thefullresultsofthesurvey areavailabletothepublicat data.ourcare.ca.Dr.Condontook questionsfrommembersaboutthe surveydataandhowitmayguide theirworkasapanel.Thefirstsession thencametoaclosewithathank youfromtheOurCareteamanda previewofthesessionstocome.

Session2:

Saturday,September23,2023

Virtual

Afteratwo-weekbreak,themembers oftheOurCareManitoba

PrioritiesPanelreconvenedviaZoom fortheirsecondsession,whichbegan withawelcomefrompanelco-chair JasminKayandarecapofthe previoussession.Membersthen welcomedDr.TaraKiran,OurCare’s PrincipalInvestigator,whodelivereda presentationonmodelsandfeatures ofprimarycaresystemsinOECD comparatorcountries(including Finland,theUnitedKingdom,Norway, andtheNetherlands)andother Canadianprovinces.The presentationhighlightedhowthese modelsdifferfromthecurrent structureanddeliveryofprimarycare inManitobaandofferedpotential ideasformemberstoconsider.

Next,memberswelcomedMelanie MacKinnon,HeadofOngomiizwin,the IndigenousInstituteofHealthand Healing,partoftheFacultyofHealth SciencesandtheUniversityof Manitoba,andDr.IanWhetter,a familydoctorandMedicalDirectorat Ongomiizwin,inamoderated discussionwithpanelco-chairDr. MandyBussonaccesstocarefor historicallyexcludedcommunities.As partofthediscussionmemberswere abletoaskquestionsoftheguest speakerswithaneyetowards understandingequityconsiderations ofprimarycaredeliveryespeciallyfor

Indigenouscommunities,Blackand otherpersonsofcolour,2SLGBTQ+ communities,thosestrugglingwith drugaddiction,lowincome populations,andthoselivinginrural andremoteareas.

AfteralivelyQ&A,membersbroke intosmall,facilitatedgroupsto discusstheprosandconsofthe differentmodelsandfeaturesof primarycareaspresentedbythe guestspeakersandworkedtogether toidentifywhichtheybelieveshould beavailabletoallManitobans.The secondsessionwrappedupwitha plenaryreport-backofthemembers’ ideasandapreviewofthe forthcomingsessionstogetherin Winnipeg.

Session3:

Friday,October13,2023 Winnipeg

Havingworkedtogethervirtuallyfor severalweeks,themembersofthe OurCareManitobaPrioritiesPanel gatheredinpersonattheAltHotelin downtownWinnipeg,locatedon ancestrallands,Treaty1territory,the traditionalterritoryofthe Anishinaabeg,Cree,Oji-Cree,Dakota, andDenePeoples,andonthe NationalHomelandoftheRedRiver Métis.Anopeningceremonyand

traditionalteachingswereledby KnowledgeKeeperAlbertMcLeod,of theNisichawayasihkCreeNationand theMétiscommunityofNorway House.TheCeremonyincludeda drumsongperformedbyDr.Mandy BussandDr.LisaMonkman,an Anishinaabefamilyphysicianwith BrokenheadFirstNation.

Fortheremainderoftheafternoon, panelmembersworkedinsmall groupswithfacilitatorstodefinethe valuesthey’didentifiedinthefirst session,beforebreakingtoeatdinner together.

Followingthemeal,members welcomedtwomoreguests,Dr. AinslieMihalchuk,AssistantRegistrar overseeingQualityfortheCollegeof PhysiciansandSurgeonsof Manitoba,andRichardCloutier,a journalistwith680CJOBWinnipeg andSeniorReporteratGlobalNews. JasminKaymoderatedadiscussion aboutaccountabilityandservice deliverybeforeopeningupthefloor toquestionsfromthemembers.

Session4:

Saturday,October14,2023 Winnipeg

OnSaturdaymorning,members gatheredatthehistoricCentennial ConcertHallindowntownWinnipeg forafulldayofwork.Followingabrief recapofthepreviousday’sworkfrom JasminKay,Dr.Bussledamoderated discussiononAccesstoCarefor RuralandRemoteCommunitieswith threeguestspeakers:TaraClarke, ProgramLeadofthePhysician ExtenderProgramforOngomiizwin andaformerruralparamedic;Dr. RafiqAndani,AssociateChiefMedical OfficerforSharedHealth;andDr. AmandaCondon.AfteraspiritedQ&A withthespeakers,membersbroke intosmallgroupstoidentifythekey challengesandobstaclesaffecting accesstoprimarycareforresidents ofManitoba.

Followingabreak,Jasminmoderated aseconddiscussiononTradeoffs

BetweenTimelinessandContinuityof PrimaryCare,withthreemoreguests: Dr.DenisFortier,ChiefMedicalOfficer forSouthernHealth-SantéSud;Dr. TrinaMathison,familyphysicianat theDauphinMedicalClinicandChief MedicalOfficeroftheDauphin RegionalHealthCentre;andBarbara Wasilewski,AssistantDeputyMinister ofHealthPolicyandPlanningwith ManitobaHealth.

Afterbreakingforlunch,members spentthebulkoftheafternoonin

small,themedgroups,workingwith facilitatorstodevelop recommendationsfortheir forthcomingreport,periodically sharingbackwitheachotherin plenarydiscussionsandmoving amongtablestoengagewithone another.Havingearnedabreak followingaproductiveday,the membersrestedbeforereconvening intheVioletFuschiaRoomoftheAlt Hotelforadinnerfollowedbyan“Ask MeAnything”sessionwithDr.Alan Katz,theOurCareManitobaPrimary CareCo-LeadandProfessorinthe departmentsofFamilyMedicineand CommunityHealthSciencesinthe RadyFacultyofHealthSciencesat theUniversityofManitoba.Dr.Katz helpedthememberspreparefortheir finaldayofdeliberationbyanswering lingeringquestionsandconcerns acrossawiderangeoftopics.

Session5:

Sunday,October15,2023 Winnipeg

Onthemorningoftheirfinalday, onceagainatCentennialConcert Hall,followingaplenaryreflectionled bypanelco-chairJasminKayonthe workachievedtothispoint,members oftheOurCareManitobaPriorities Panelgatheredintonewworking

groupstocontinuetorefinetheir consensusrecommendationsand polishothersectionsoftheirreport withthesupportoftheOurCare facilitators.Membershelpedone anotherfindclarityintheir presentationofideasandarrivedat howtospeakwithonevoiceonthe keyfeaturesofprimarycarethatthey wanttoseeavailableforall Manitobans.

Followingalunchbreak,panel membersreconvenedandprepared topresenttheirdraftreporttoan audienceofkeyleadersandpolicy makersinprovincialhealthcare, joiningbothinpersonandvia webstream.

Panelco-chairDr.MandyBuss welcomedallguestsandspoke abouttheimportanceofhearingand sharingstories,asthepanel membershaddone,inordertobe abletothinkandactwithall Manitobansinmind.JasminKay presentedanoverviewofthe OurCareprojectbeforeturningthe podiumovertovariousmembersof theprioritiespanel,whopresented thechallenges,values,issues,and mostimportantlyrecommendations thatemergedfrommorethan30 hoursofworktogetheroverfive sessions.

Afterthepresentationofthedraft report,memberswelcomedLanette Siragusa,CEOofSharedHealth,who thankedthemforworkingtogether withafocusonequityanddiversity, andnotedwithgratitudethe potentialimpacttheirreportshould haveonhealthcareintheprovince. Next,membersandguestsheard fromDr.EricJacobsohn,anintensive carephysician,formerMedical DirectorofResearchatHealth SciencesCentreinWinnipeg,and memberofthetransitionteamofthe incomingNDPgovernmentof Manitoba.Dr.Jacobsohnlikewise thankedmembersforworkingand speakingonbehalfofthediverse needsandperspectivesofall Manitobans,andforfindingcommon ground.Finally,OurCareManitoba PrimaryCareCo-LeadsDr.AlanKatz andDr.AmandaCondon,aswellas OurCare’sPrincipalInvestigator,Dr. TaraKiran,offeredtheirgratitudefor the“imaginativecourage”shownby participants.

TheOurCareManitobaPrioritiesPanel onPrimaryCareformallydrewtoa closewith finalwordsfrom KnowledgeKeeperAlbertMcLeodand adrumsongledbyDr.MandyBuss andDr.LisaMonkman.Before departing,panelmemberscollected CertificatesofPublicServicein

recognitionofandgratitudefortheir workonbehalfofallManitobansto helptransformprimarycareinthe province.

MeettheMembers

MuhammadAldhshan

MuhammadAldhshanisapassionate advocateofHealthsustainabilityandequity andaboardmemberoftheManitobaPublic HealthAssociation. BornandraisedinEgypt, MuhammadmovedtoWinnipegin2019to pursueanMScDegreeinPhysiologyand Pathophysiology,wherehestudiedsomeof theneuronalcircuitscontrollingbehaviourat thebrainlevel.Followinggraduation, MuhammadworkedasthePolicyandHealth InformationManagerattheManitobaMetis Federation,whereheadvocatedforthe healthandwell-beingofRedRiverMetis Citizens.Presently,MuhammadistheSystem PerformanceSpecialistatCancerCare Manitoba,workingwithhisteamtodevelop performanceindicatorstomaximizethe efficiencyofcareforallManitobansafflicted bycancer. WhetherininitiativeslikeOurCare orinotherhealthforums,Muhammaddoes notmissachancetolearn,contribute, support,andadvocateforthehealthofALL Manitobans.

VibhutiArya

IwasbornandraisedinIndiaand immigratedtoWinnipeginDecember,2016.I pursuedaBSc.MolecularBiologydegree (May,2021)andrecentlygraduatedwithMSc. PhysiologyandPathophysiology(June,2023) fromtheUniversityofManitoba.Currently,I workasaResearchCoordinatorforthe Children’sHospitalResearchInstituteof Manitoba(CHRIM).Duringmymaster’s,I investigatedtheeffectofflaxseedin

protectingtheheartsofwomenwithbreast cancer.Now,Iaminvestigatingtheroleof dialecticalbehaviourtherapy(DBT)inthe preventionoftypeIIdiabetesinindigenous youth.Iampassionateaboutepidemiology andpublichealthresearchandwanttowork asaClinicianScientistinCanada.Outsideof academia,Iliketovolunteer,teach,hikeand longdistancerun.ThroughOurCare,Iam gratefultobeabletocontributeinthe creationofamoreequitableandaccessible healthcareforallCanadians.

DouglasBartlett

MynameisDouglasBartlett.Iamoriginally fromThePas,Manitoba.ImovedtoWinnipeg in1983toattenduniversityandlivedtherefor approximately35years. In2019Imoved hometotakethepositionofExecutive DirectorofThePasFriendshipCentre.Iam marriedtoGail.Weareraisinganamazing granddaughter,Kyre.Althoughmywork takesupmuchofmytime,Istillmaketimeto enjoyallthatnorthernManitobaoffers. Springandsummerwespendasmuchtime aswecanonorinthewater,thefirstbeing fishingandthesecondbeingswimmingat oneofthemanybeaches. Duringthewinter monthsweenjoyicefishingaswellasgoing outonsnowmobiles.

DianeBeckett

DianecurrentlylivesinChurchill.Shehas workedacrossCanadaandinadozen countriesinternationallyforgovernments, non-governmentalorganizations, universities,andtheUnitedNations ourcare.ca

addressingenvironment,climatechange andbiodiversityissues.Apassionforthe environmentrunsdeeplythroughher personallifeandshetriestolivelightlyonthe earth.Shealsogetsoutintonaturewherever sheis,andhastrekkedintheHimalayasand tropicalrainforests,canoedintheboreal forest,kayakedwithbelugas,andsnowshoed onthetundra.Shehashadavarietyof experiencesaccessinghealthcarein differentsettingsinCanada,aswellas internationally,andisthrilledtohavebeen selectedforthispaneltolookatamore equitableandsustainablesystemthat deliversbetterprimaryhealthcareforall.

StevenBlack

I’maretiredpastornowlivinginBrandon. BorninToronto,Igotmyeducationat McMasterUniversity(BA,MTh)andTyndale University(MDiv).I’velivedandworkedin SouthernOntario,Sherbrooke(QC), andMinitonas(MB).I’mmarriedwithone son,andmyhobbiesandinterestsinclude flightsimulation,curling,andanythingtodo with“up.”

NeelamBorrison

IhavelivedinAltona,Manitoba,sincelast year,beforethatIlivedinOntarioformore thantwentyyears.Iworkinthehealth industry.Ilovetherelaxedcultureandsettled lifeinManitoba.IenjoybeinginWinnipeg andenjoythefoodandculture.Ivolunteered forOurCareprojectbecauseIwantedto sharemyopinionandalsohearwhatother groupmembershavetosay.Iamsurethis projectwillbringaboutpositivechangesin theprovince.

HarveyBrandt

MynameisHarveyBrandt.Iwasbornin Manitoba,andcurrentlylivewithmyfamilyin aruralcommunitynearWinnipeg.Ihavealso livedinAlbertaandSaskatchewan.Health carechallengesandopportunitiesarethe sameineachprovince.Iliketofollowthe newsofManitoba,Canadaandtheworld extensively.Ienjoyoutdooractivities,reading andNetflix(especiallyforeignfilms).

Currentlytakingapauseinemployment,my employmentbackgroundincludesasa SafetyandHealthOfficer,andmanagement inrailroadandmanufacturing.Istartedmy careerasatradesapprenticeandalsoloved workingincustomerservice.Ihaveworked withindividuals,teamsandlargegroups.I amafanofcontinuousimprovement. ThroughourjointOurCareworkIhopewe canimprovehealth.

AdrianaBrydon

IwasbornandraisedinRegina, Saskatchewanbutpartofmyfamilycomes fromPeterBallantyneCreeNation,whichis locatedinNorthernSaskatchewan.Imoved toWinnipeg,Manitobaasateenagerin2005 andhavecalledthisplacehomeeversince.I amasinglemothertofivechildrenandhave createdmyownfamilythroughconnections andrelationshipswithpeopleIhavemet here.IamaSocialWorkerwhohas experienceworkinginchildwelfareand healthcare.AsanIndigenoussinglemother andworkingasasocialworker,Ihaveboth personalexperienceaswellashear/see others’experiences/challengeswith accessingandreceivingprimarycare

servicesinWinnipeg.Ivolunteeredforthis panelbecauseIbelievethatIcanbeavoice fortheexperiencesothershavesharedwith me,whomightnothavethechancetoshare. IhopetogivewhatinputIcanandgiveback tothiscommunityInowcallhomeand believethisisanamazingopportunity.Ekosi.

MandyBuhler

Hi.I’mMandyBuhlerfromSouthEastern Manitoba.Asanactiveparentadvocateand educator,andasamomoffivekids,Iwanted tobeapartofthispaneltocreatesome changeinthefutureofhealthcareformy kidsandthefamiliesIsupport.Asa chronicallyillperson,thispanelisagreat wayformetosharesomeofthepatient experiencesI’vehadandthingsI’venoticed. FunFact:Ireadover100booksayear!

CarolinBund

IcurrentlyliveincentralWinnipegwithmy red-earedslider(turtle)namedFredbutonly forthelast15years.Ihavetravelledalotto everyprovinceandterritory(except Nunavut)inCanadaplusover40statesin theUSA.Ilovemeetingnewpeopleand culturesalongthewayespeciallywhenIwas livingineitherDallas,Vancouver,Calgaryor Banff.Ilovetopaint,sculptwithcementor createwithwhatevermediumcomesmy way.Myfavouritewascreatingbackdrops, setsandcostumesforanon-profittheatre companyinToronto.Ichosetobeonthis panelbecauseIwasheavilyabusedbyour medicalsystemandIwanttobeavoicefor myselfandforthosethatfeeltheydon'thave

oneinrelationtothemedicalprofessionals. Alsobeingonthispanelhasbeenhealingfor mebutIstillviewthisprojectwithcautious optimism.

LaurieChristianson

Igrewupinasmalltowninnorthern Manitoba,withapopulationofunder600 people,butImovedtoWinnipegtoattend universityinthelate1980sandhavebeen hereeversince.Iworkedasarealestate paralegalforseveralyears,butforthepast 20yearsI'vebeenworkingwithcontracts relatedtotelevisionandfilmproduction.In mysparetime,Ienjoygardening,reading, videogames,andrestoringmyslightly bedraggled1928bungalow.Ijoinedthepanel becauserecentexperiencesI'vehadwiththe healthcaresystemmademevery concernedforthewaythesystemisbeing managed,andIhopethatthesepanelscan helptoturnthataroundandcreateamore functionalsystemforeveryone.

JasonCook

JasonCookstartedhisvolunteerposition withtheBurntwoodRegionalHealthAuthority, nowcalledNorthernHealthRegion,almost eightyearsago.Afterspendingmorethana decadeadvocatingforhiscommunityand workingtoimprovehealthcare,henowgives someofhistimetotheSharedHealthPatient andFamilyAdvisoryNetwork.Hishopeisthat sharinghisstoryandchallengesmayhavea positiveimpactonotherswithsimilar struggles.Jasonhopestodothisworkfor manyyearstocome.

ourcare.ca

SandyEpp

Iamasingle(full-time)motheroftwoteen children(16and18).Bothmychildrenhavehad numerousstruggleswiththeirphysicaland mentalhealth,andwehavehadasignificant numberofstrugglesfindingthem adequate/relevantcare.Iamalsoadaughter, andhealthcareproxy,totwoagingparents whoareneedingalotmoresupportfromthe medicalcommunity.Iamcurrentlyemployed withSharedHealth/SharedServicesasa projectanalyst/testleadfortheProject ManagementOfficeandhavebeeninvolvedin anumberofacutecareandpublichealth softwareinitiatives.

Itismydesiretohelpprovidefeedbackto provincialmedicaldecisionmakers,sothat, perhaps,othersmaynotneedtostruggleas muchaswehave,inourquestformedicalcare forourselvesandlovedones.

MartiFord

MartihasmixedheritagewithInuitand English/Irishsettlerroots.Sheisaneducator andhasworkedthroughouttheprovinceof Manitobaasaschoolsuperintendent,Deanof IndigenousEducation,arecruiterofteachers andiscurrentlyanassistantprofessorinthe FacultyofEducationatUniversityofManitoba. MartihasworkedwithIndigenouscommunities throughoutCanadaandinternationallyin Brazil,ChileandBotswana.Shevolunteerson theboardoftheRoyalAviationMuseumof WesternCanada,andisacommitteemember ontheUnitedWay’sCommitteeonIndigenous Relations,andamemberoftheCanadian ForcesLiaisonCommittee.Martihasoneadult daughterandtworescuedogs.

KarenGabriel

MynameisKarenGabriel,IliveinPortagela Prairie,Manitoba.Imovedhere26yearsago andhaveworkedatPortageDistrictGeneral Hospitalgoingon13years.IamanIndigenous Supportworker.IprovidesupporttoIndigenous andMetiswhentheypresentintheemergency departmentaswellaspatientswhoare admittedinhospital.Ialsositinfamily conferenceswithdoctorsandclients.Thereare timeswhenwearepagedtode-escalatea situationonthewardsoremergency department.Ialsoprovideinterpretationshould apersonpresentintheemergencydepartment whohasalanguagebarrier.Ialsowork alongsidethesocialworker,sheistheonewho sentmeanemailregardingOurCarepanel, andfeltIwouldbeagoodcandidateto participate.

IenjoywhatIdoasIfeelweneedmore programslikethisinthehealthcaresetting.I enjoymeetingnewpeopleandlearningnew things.InmyfreetimeIliketogocampingand huntingwithfamilyandfriends.

BethGlass

ImovedtoMorris,Manitoba,fromWinnipegin 2020withmyfamilyforaquieter,countrylife.I ammarriedtomyhusbandof8yearsandwe havea4yearoldsontogether.IamanEarly ChildhoodEducatorIIandworkatanEarly LearningCentrewithchildrenages0-4.Iam alsoapart-timestudentattheUniversityof ManitobawhereIampursuingaBachelorof HumanEcologymajoringinChildandYouth DevelopmentalHealthandSocialDevelopment. InmyfreetimeIlovetoread,cook,and watercolourpaint.IvolunteeredbecauseIwant torepresentmycommunityandworktowards positivechange.

AndyHumphreys

IwasbornandraisedinWinnipegandhave spentmylifegrowing,workingandenjoying livingintheprovinceofManitoba.Iammarried withtwogrownchildren. IholdaB.Sc.A.degree (1980)andaM.Sc.degreeinAnimalNutrition (1985)fromtheU.ofM.Ihaveworkedinthe fieldofanimalnutritionfor37years,workingfor severallargercorporatecompanies,aswellas becomingthefoundingpartnerofan independentnutritioncompanyin2009. ThroughoutmycareerIhavehadthe opportunitytotravelacrossthecountryto experiencethenatureandculturesofCanada. Ivolunteeredforthepanelasanopportunityto makeanimpactfulchangeinthehealthcare offellowCanadians.

JudiJanzen

Iamaretiredteacher,recentlymovedfroma ruralhomeof40years,nearBrandonMB,to apartmentlivinginWinnipeg.Ileftbehinda milkweedpatchwhereIrescuedandreleased monarchbutterflieseachsummer.Quiltingisa hobby,mymostrecentprojectbeingquilted mapsofourruralcommunity.Myvolunteer commitmentwaswiththeorganizationProject LinusWestmanChapter,giftingcommunity handmadeblanketstochildreninneed.Ihave firsthandexperiencewithchronichealthcare needsformyself,mydaughterandmyelderly mother.Friendsandfamilywillconfirmthat“ howtofixormodernizeourantiquatedhealth caresystem”isacommonconversationtopic inourhousehold.HowcouldInotvolunteerfor thiscitizens’panelopportunity.

MeenuKapoor

IamfromIndiaandimmigratedtoCanadain 2014thoughIhavebeenlivingpermanentlyin WinnipegsinceDecember2018.Ihavea ourcare.ca

doctorateinPoliticalScienceandwasan assistantprofessorinauniversityinIndia.Here inWinnipeg,Iamworkingasavolunteer settlement&supportworkeratA&OSupport ServicesforOlderAdultsandaRegistered CanadianImmigrationConsultant.Iliketoget involvedinthecommunityinwhateverway possible.IwasatraineroftraineesforWomen inUrbanGovernancebackhomeandhave volunteeredasafacilitatorforEnglish conversationclassesfornewimmigrantsin variousorganizationsinWinnipeg.Iwantto playmypartinthecommunityandhopethat thepaneldiscussionswillhaveapositive impactoncommunityservicesinfuture.

DonnaKostiuk

Frommyearlieryears,Igrewupinasmaller northerncommunity,movedtoWinnipegfor post-secondaryeducationand,asalater adult,movedtoabedroomcommunity outsideofWinnipeg. Ihavewitnessed first-handtheissuesandchallengesofboth familyandfriendsastheyhavenavigatedthe healthcaresysteminManitoba.My experiencesalsoincludeworkingwithan indigenoushealthdepartmentandacancer agencyinManitoba.Ihavealsovolunteeredas amemberoftheInterlake-EasternRegional HealthAuthority(IERHA)LocalInvolvement Group(LHIG)andasamemberoftheEthics CommitteeoftheIERHABoardofDirectors. Joiningthisconsultation,Iamhopingto provideaninsightintomywideandvaried background.

AlainLouer

IamafirstgenerationCanadianbornand raisedinWinnipegwhereIstilllivewithmywife andourtwocats.Myparentsimmigratedhere fromFranceinthe1950sinsearchofabetter liveandwheretheymet,marriedandstarteda family.Irecentlyretiredafterseveralyears

workingasacivilservantwiththeFederal Government.Inowworkforaschooldivision asacleaneronacasualbasis.Thispast summerIendedayearofworkingasan uncertifiedhealthcareaideinalongterm healthcareresidence.Myhobbiesinclude cycling,gardeningandotheroutdoor activities.Ivolunteeredforthispanel becauseIliketosharemyopinionsasaway tohelpimproveourcommunity.

LaurelMartin

Imovedfromafarminsouth-western SaskatchewantosouthWinnipegin1984to pursuepost-secondaryeducation.Iama ProfessionalHomeEconomistwitha non-typicalcareerasasocialscience researcher.AsIwinddownmycareer workinginfor-profit,not-for-profit, government,andacademicorganizations,I continuetolearnanddonewandpractical thingsandIvolunteerfororganizationsthat alignwithmygoalsandvalues.My bio-familyarescatteredwidelyacross Canadaandthroughthem,Ilearnalot aboutthestarkprovincialdifferencesin healthcare.Thisknowledge,andmy experienceswithmylargechosenfamilyin Winnipegwillinformmyparticipationonthis panel.Mycurrentvolunteerworkfocuseson helpingnewcomersfromwesternAfricaand mycurrenthobbiesincludelearningtodo basichomeimprovementsandkeepingan environmentallypositivehomeandyard.

PaulaOrecklin

MynameisPaulaOrecklinandI’mfrom Winnipeg.I’mveryactiveinpatient engagement,workingwithaboutadozen

organizationsonthelocal,provincial, national,andinternationallevels.This includesSharedHealthManitoba,the WinnipegRegionalHealthAuthority,the GeorgeandFayYeeCentreforHealthcare Innovation,theCentreforDigitalHealth Evaluation,theCanadianAgencyforDrugs andTechnologiesinHealthuptilllastyear whenmytermonthePatientand CommunityEngagementCommittee finished,PatientsforPatientSafetyCanada, HealthcareExcellenceCanada,Patient AdvisorsNetwork,ChoosingWiselyCanada, theBoardofDirectorsforTenTenHousing, Inc,andothers.ThisisbecauseI’vehad ComplexRegionalPainSyndromeforthe past22yearsandIcaredeeplyabout makingsomethingpositiveoutofwhatis otherwisepointlesssuffering.

I’veseenwhatthemedicalsystemislikeasa patient,andIseehowitcouldbeimproved. Justasimportantly,I’veseenhowpatients, providers,andthewidercommunitycome togethertoshareourlivedexperiencesand createrealchanges.

Beyondthat,I’manerd,amnevernot readingabook,andhaveanembarrassing fondnessforsomerealityTV.

Jean-LouisPehe

IamJean-LouisPéhé.Iammarriedandthe fatherofthree.

IamtrainedasajournalistbutIamcurrently teachingintheHighSchoolprogramat CentreScolaireLéoRémillard,Winnipeg,MB.

IcametoManitoba13yearsagowithmy family,fromFrance(ParisandAuxerre)

whereIwasmarriedandwheremychildren wereborn. Sincemyarrivalin2010,Ihave beeninvolvedinseveralfrancophone communityorganizations,throughl'Acccueil francophoneandl'Amicaledela francophoniemulti-culturelleduManitoba (workshopsandconferences).Ihavebeen vice-presidentofL'AmicaleandIam currentlysittingasaboardmember.

IhavebeenamemberoftheChambrede CommerceFrancophonedeSaint-Boniface; aswellasamemberoftheMuséede Saint-Boniface.Iamcurrentlythe Francophonerepresentativeatthe ComplaintsCommitteeoftheManitoba OrderofPhysiotherapists, appointed/mandatedbytheMinisterof HealthofManitoba.

AsaFrancophone,Iaminterestedinour communityissuesandthatiswhyIwouldbe honouredtoworkwithyouandtohavethe opportunitytohavemyvoiceheardonthis panel.

TomasPonzilius

IamfromWinnipeg,Manitoba,howeverIam currentlylivinginOttawa,Ontario.Imoved temporarilyawaybecauseIamgoingto CarletonUniversityasastudentfora BachelorofSocialWork.Ienjoyfishing, science,politicsandbeinginnature.Inthe 2010sIobtainedBachelorofArtsdegreein CriminalJustice,howeverIhadtostop furtherworkandacademicprocessbecause ofchronichealthchallengesandlearning disabilitiesinwhichIhavedoneadvocacyfor sinceIwas12yearsold.Ihavepriorworkwith theProvincialLiberalsofManitobainwhichI advocatedforvariouspolicychangesunder aNeurodiversityreportthatwillsoonbe published.Thishaslentme

experiencerelatedtoactionablepolicyand procedure.

IamvolunteeringtotheOurCarePriorities PanelbecauseIbelieveIcanusemy combinedprofessional,educationaland livedexperiencerelatedtopolicyand proceduretobestassistthepanelputforth recommendations.

GregSametz

GregSametzisaretirededucatorfromthe SevenOaksSchoolDivisioninNorthwest Winnipegwhereheservedasschool principalanddirectorofthedivision's languageprogrammingintheimmersion, bilingualandheritagestreams,Hehas recentlybeenabletoreignitehispassionfor languagelearningbyofferingEnglishclasses tonewManitobanshavingarrivedfrom war-tornUkraine.Greghasoffered professionaldevelopmentworkshopsto teachersandtheirstudentsfocusingon culturalenrichment.Studentscallhimthe ”spoonman.”AtypicalManitobavolunteer, Greghasenjoyedvolunteeringatmanyof theprovince'ssportingandculturalevents. Gregandhiswifehaveraisedtwinsonswho togetherwiththeirfamilieshaveprovided manydecadesofthe“double”pleasuresof life.Heisanardenttraveller,havingvisited destinationsinallprovincesandterritories andin6outof7continents.Greg'shopefor thefutureistoenjoyapositiveexperienceas heagesinaplacewherehecanfeel respected,valuedandheard.

AlexanderWatson Biographynotavailable.

ChadZolinski Biographynotavailable. ourcare.ca

GuestSpeakers

FifteenexpertsgenerouslygavetheirtimeandsharedtheirknowledgewiththeManitoba PrioritiesPanelonPrimaryCare.ThePanelextendsitssincerestthankstoeachofthem.

Dr.RafiqAndanicompletedhis northern/remotefamilymedicine residencyattheUniversityofManitobain 2015.Overthepastdecade,hehas garneredavarietyofclinicalexperiences indiverseenvironments,rangingfrom healthcentresintheArctictotertiary caresettingsinWinnipeg.Atrue generalist,Dr.Andanipossessesabroad rangeofskills,includingexpertisein addictionsmedicine,emergency medicine,criticalcare,oncology,and healtheconomics.Currently,heserves astheAssociateChiefMedicalOfficerfor SharedHealth,wherehisfocusison expandingequitableaccessto modernizedclinicalresourcesthat transcendregionalandjurisdictional boundaries.

TaraClarkeisaformerruralparamedic andagraduateoftheMPASprogramin Manitoba.Sheworkednineyearsin urbanandruralemergencymedicine andin2019pioneeredanovel applicationforthePAdisciplinein NorthernManitoba,establishingthe PhysicianExtenderProgramfor OngomiizwinHealthServices,whereshe servesasProgramLead.Shemaintainsa clinicalappointment,servingthe communitiesofLittleGrandRapidsand IslandLakeswhilementoringnewPAs andteachingmedicalandPAstudents.A busymomoffive,sheispassionate aboutintegratingholisticmedicineand improvingprimarycarehealthaccess forIndigenouscommunitiesinManitoba.

RichardCloutierisajournalistwith680 CJOBWinnipegandSeniorReporterat GlobalNews.Hehasakeeninterestin healthcare,theenvironmentandother issueskeytothefutureofWinnipeg, Manitobaandourcountry.Cloutieris co-hostoftheNewson680CJOBRadio andhasbeenwiththestationsince1992. Heistheproudfatherofthree,acyclist andanavidJetsfan.

Dr.AmandaCondonpractises comprehensiveruralfamilymedicinein NotreDamedeLourdes,Manitoba.She alsosupportsCharleswoodCareCentre, along-termcarefacilityinWinnipeg.In additiontoherclinicalwork,Dr.Condon servesasanassociateprofessorwiththe DepartmentofFamilyMedicine,Max RadyCollegeofMedicine,atUofM.With acommitmenttofamilymedicine educationandsupportingmedical learners,sheproudlychampionsjoyin workandinterprofessionalcollaboration asfoundationaltoexcellenceinprimary care.Since2019shehasservedas AssociateDean,PostgraduateStudent AffairsandWellnessandhasrecently becometheDirectorofImmunization withtheRadyFacultyofHealthSciences.

JeanetteEdwardsissemi-retired.Up untilFebruary2021,shewasthe ProvincialLead,SystemIntegrationand QualityManagementandInterim ProvincialLead,IndigenousHealthfor SharedHealthinManitoba.Previously, EdwardswastheRegionalDirectorof

PrimaryHealthCareandChronic DiseasewiththeWinnipeg RegionalHealthAuthority.Shealso workedwithManitobaHealthinthe capacityofSpecialAdvisortotheDeputy MinisteronPrimaryCare.Inthisrole, Edwardsledthedevelopmentand implementationofthePhysician IntegratedNetworkInitiativeinManitoba wherefee-for-servicefamilyphysicians wereactivelyengagedindeveloping complexprimarycarerenewal strategies.

Dr.DenisFortieris theChiefMedical OfficerforSouthernHealth-SantéSud. Dr.Fortierisalsoaretiredruralfamily physicianwhopracticedattheCentre deSantéNotreDamelocatedin Notre-Dame-de-Lourdes,wherehehas livedandworkedforover36years.Dr. Fortier’smedicinepracticeincluded primarycare,hospital,emergency, obstetrics,long-termcarewithsome minorsurgery,andhecontinuestobean ardentdefenderofruralhealthcare.He wasalsoactivelyinvolvedinteaching, includingavarietyofprogramsand committeestomaintainandimprove standardsatmanylevels,withinthe medicalcommunityandwithinhis community.

Dr.AlanKatzisafamilyphysicianand healthservicesresearcher.Heisa ProfessorinthedepartmentsofFamily MedicineandCommunityHealth SciencesintheRadyFacultyofHealth SciencesattheUniversityofManitoba. HerecentlyservedastheDirectorofthe ManitobaCentreforHealthPolicyandis thepastpresidentoftheCanadian AssociationforHealthServicesResearch (CAHSPR).

Dr.EricJacobsohn isatenured ProfessorintheDepartmentof Anesthesiology,PainandPerioperative Medicine,andintheDepartmentof InternalMedicine,MaxRadyCollegeof Medicine,RadyFacultyofHealth Sciences,UniversityofManitoba.Heis currentlytheAssociateDeanof Professionalismandwaspreviouslythe AssociateDeanofPostgraduateStudent Affairs.EricJacobsohn currentlyserves onthetransitioncommitteeofthenew PremierofManitoba,MrWabKinew.

Dr.TaraKiranistheFidaniChairin ImprovementandInnovationatthe UniversityofTorontoandVice-Chairof QualityandInnovationatthe DepartmentofFamilyandCommunity Medicine.Shepracticesfamilymedicine attheSt.Michael'sHospitalAcademic FamilyHealthTeam(SMHAFHT).Dr.Kiran completedherfamilymedicine residencyatMcMasterUniversityin2004 andspentherfirstcoupleofyearsin practiceasalocuminIndigenous communitiesinnorthernOntarioandin CommunityHealthCentresinurban Toronto.ShepracticedattheRegent ParkCommunityHealthCentrefrom 2006to2010beforejoiningSt.Michael's in2011.

MelanieMacKinnonistheHeadof Ongomiizwin–IndigenousInstituteof HealthandHealing,FacultyofHealth Sciences,UniversityofManitoba.Her expertiseliesinprovidingfacilitation, research,planning,operational,and advisoryandnegotiationservicesthat assistFirstNation,MétisandInuit organizationsandgovernmentand non-governmentagenciesinreaching theirmaximumpotentialinthehealth

servicearea.MacKinnon,whoisoriginally fromMisipawistikCreeNation,remains aninfluentialcommunityvoiceand advocatewithintheprovince.

Dr.TrinaMathisoncurrentlypracticesin DauphinattheDauphinMedicalClinic andDauphinRegionalHealthCentre.She hasdedicatedhercareertoserving patientsinWesternManitoba.Asarural physician,shehasabroadscopeof practiceincludingcancercare,inpatient care,emergencymedicineandsurgical assistance,aswellasofferingcarefor theelderlyandpalliativecare.Dr. MathisoniscurrentlythesiteChief MedicalOfficeroftheDauphinRegional HealthCentreandthemedicalleadfor theCancerCarecommunityprogramin Dauphin,withpalliativecareandcarefor theelderlybeingherareasofspecial interest.

Dr.AinslieMihalchukistheAssistant RegistraroverseeingQualityforthe CollegeofPhysiciansandSurgeonsof Manitoba.Sheisapassionateadvocate forpatientsafetyandsupporting continuousqualityimprovementwithin themedicalprofession.Dr.Mihalchukisa familyphysicianprovidingpatientcare incommunity,hospital,andlong-term caresettings.

LanetteSiragusawasnamedShared Health’sChiefExecutiveOfficeronMay1, 2023.SiragusafirstjoinedSharedHealth in2017astheorganization’sfirstChief NursingOfficerandProvincialLead, HealthSystemIntegrationandQuality.In thatrole,sheledthedevelopmentof clinicallyinformedandevidence-based

practicesthatformthefoundationof Manitoba’sClinicalandPreventive ServicesPlan,andalsoservedasthe province’sCOVID-19co-incident commander.

BarbWasilewskihasbeenintheroleof theAssistantDeputyMinister,Health PolicyandPlanning,sinceJanuary2020. Shehasledandoverseenthe developmentoftheStevenson ImplementationPlan(longtermcare), theimplementationoftheFamilyDocfor Allplan(primarycare)alongwiththe developmentoftheVirgoreport(mental healthandaddictions).Barbhasworked intheDepartmentsince2006invarious seniorleadershippositions,overseeing policiesandprovincialprojectsrelating toprimarycare,mentalhealth,maternal child(includingmidwifery),longterm careandhealthyliving.Shespentthe majorityofhertimeastheprovincial policyandclinicalleadinprimarycare, andwasresponsibleforintroducing variousreformsinprimarycare,manyof whicharestillinplacetoday.Barbisa RegisteredNurse,whoalsohasher MastersinBusinessAdministration(MBA) andrecentlyreceivedhercertificationin ProjectManagement(PMP)andChange Management(CCMP).

Dr.IanWhetterisafamilydoctor, medicaleducatorandfatherofthree. HeworksattheUniversityofManitoba withafocusonincreasingaccesstohigh quality,non-judgemental,and anti-racisthealthcareforunderserved communities.HeistheRadyFacultyof HealthSciences,Co-leadoftheOfficeof CommunityEngagement,amemberof theExecutiveofthePGMETruthand ReconciliationWorkingGroupandthe UGMELeadforSocialAccountability.Heis MedicalDirectorwithOngomiizwinHealth Servicesandapreceptorwiththe NorthernRemoteFamilyMedicine ResidencyStream.

Appendix

MinorityReports

DianeBeckett

HalfofCanadians(52percent)overtheage oftwentylivewithachronicdisease. ThistakesahugetollonCanadians,causing prematureillnessanddeath.Managing thesediseasesalsoputsahugeloadonthe healthcaresystem,asthesediseasesmake upthelargestshareofthecosttothe system.

Memberswereencouragedtoshareallpointsofviewthroughoutthepanelprocess.Discussion remainedlivelybutrespectfulthroughouttheproceedingsand,whilesomeminordifferencesin opinionremained,everymemberofthepanelendorsedtherecommendationsinthisfinal report.However,membersalsoweregiventheopportunitytowriteaminorityreportifthey wishedtohighlightanypointsofagreementordisagreement,ortoincludetheirown commentary. processedmeats,whichincludebacon, sausage,hotdogs,pepperoni,ham,corned beef,andcoldcutslikebolognaandsalami, eatenregularlycausecancer.Eatinga coupleofstripsofbaconadayincreases cancerratesby18percentover7years. Maybeyoudon’teatbaconeveryday,but howoftendoyouhavepepperonionpizza, hotdogsorsausages,processedmeat sandwiches,andbaconinaweek?

Thegoodnewsisthatchronicdiseases, includingcardiovasculardisease,diabetes, stroke,dementia,andcancercanbe reducedbyabout80percentbyeatinga healthydiet,beingphysicallyactive,andnot smoking.

Thehealthcaresystemhasdevelopeda myriadofapproachestohelppeopletostop smoking,andthereisalsoaconsiderable effortputintogettingCanadianstobe active.Ithasnotyetaddressednutritionin thesameway,althoughtheresearchclearly showsthatwecansignificantlyreduceour chronicdiseaseburdenbyreducingour consumptionoffat,sugarandprocessed foodsandincreasingourconsumptionof fruitsandvegetables.

Oneexample:Theresearchhassostrongly identifiedprocessedmeatsasacarcinogen thattheWorldHealthOrganizationhas classifiedthemasagroup1carcinogen,the highestlevelofcertaintythataproduct causescancer.Evensmallamountsof

Whenaproductsoclearlyiscounterto promotinghealth,whywerebothbaconand sausageservedattheOurCarebreakfasts? Shouldn’taforumthatlookstoexaminehow wecanimprovetheprimaryhealthcare system,whichincludesafocusondisease prevention,havemodelledhealthiereating?

WhenIaskedanOurCarerepresentative aboutit,thereasonthatwasgivenfor servingthebaconandsausagewasthat “thereareexpectations.”Therewere expectationsthatpeoplecouldsmoke everywhereandanywhere.Thatchanged. Whenwilltheprimaryhealthcaresystem modelhealthyeating?

Thiswastheperfectopportunitytohavehad apresentationonthecontributionofpoor nutritiontothechronicdiseaseburdenand thenmodelhowthatcanchange,by providinguswithhealthy,delicious,nutritious meals.

CarolinBund

Myonlywishthatthegroupswewereinon October15(finalsession)couldhavegotten togethertwoweeksafterthatonZoom.So thatwecouldhavehadachanceto read/respondtothewrittenreport,collect andthenreportonnewspecificoutside information,debriefandgothroughthe reporttogetheronelasttime.Itwasreally hardtogetspecificinformationbeforehand becausehealthcareisjusttoobigofa concerntohaveextrainformationonthe wholesubject.

InthatOctober15sessionIwasinthe ombudspersongroup.SincethenIGoogled theManitobapolice,firedepartmentandall levelsofgovernmentsandtheyallhavean ombudsperson.Ihopewecanmodelthe medicalombudspersonsectionlikethelaw enforcementreviewagencyLERA.

https://www.gov.mb.ca/justice/lera/compla int/index.html

Thewebsitewaseasytofindandthepage isclear,easytoreadandnavigate.The questionsappearinthemiddleofthepage. Whenyoupressontheindividualquestions theanswerappearslikeadrop-boxmenu.

1)TowhomdoestheActapply?

2)WhatdoesLERAinvestigate?

3)Whomaycomplain?

4)Howisyourcomplaintfiled?

5)Aretheretimelimits?

6)Howisacomplaintinvestigated?

7)Preliminaryscreeningofcomplaint.

8)Doyouneedalawyer?

9)Howarecomplaintsresolved?

Onthelefthandsideofthewebsitepage therewasacolumnoflinksdirectly associatedwithLERAtoo.

Manser,L.(2020).CanadianMilitaryFamilyDemographics.CanadianForces MoraleandWelfareServices.UniversityofTorontoPressJournal. https://jmvfh.utpjournals.press/doi/pdf/10.3138/jmvfh-2019-0003

AboutOurCare

OurCareisapan-Canadianconversationwitheverydaypeopleaboutthefuture ofprimarycare.Itseekstounderstandwhatresidentswantinahighquality, equitableprimarycaresystemandtocapturetheirrecommendationsfor change.

TheprojectisledbyDr.TaraKiran,FamilyPhysician,St.Michael'sHospital AcademicFamilyHealthTeam;Scientist,MAPCentreforUrbanHealthSolutions, St.Michael'sHospital,UnityHealthToronto;FidaniChairofImprovementand Innovation,UniversityofToronto.

OurCarehasthreestages:

NationalResearchSurvey

ThesurveywasonlinefromSeptember20toOctober25,2022.Morethan9,200 Canadianscompletedthesurvey,sharingtheirperspectivesandexperiences. VoxPopLabsco-designedandexecutedthesurvey.

PrioritiesPanels

PrioritiesPanelsarebeingheldinfiveprovinces:NovaScotia,Quebec,Ontario,British ColumbiaandManitoba.MASSLBPisco-designingandexecutingthepanelswith OurCareadvisorsandlocaldeliverypartners.

CommunityRoundtables

Communityroundtablesarebeinghostedineachofthefiveprovinceslistedabove, focusingonequity-deservinggroupsthatwedidnothearenoughfromduringstages oneandtwo.MASSLBPisco-designingandexecutingthecommunityroundtableswith OurCareadvisorsandlocalcommunityorganizations.

OurCareProjectPartners

OurCareisfundedby:

HealthCanada

HealthCanadaistheFederaldepartmentresponsibleforhelpingCanadiansmaintain andimprovetheirhealth,whilerespectingindividualchoicesandcircumstances. Productionofthisdocumenthasbeenmadepossiblethroughafinancialcontribution fromHealthCanada.Theviewsexpressedhereindonotnecessarilyrepresenttheviews ofHealthCanada.

MaxBellFoundation

MaxBellFoundationbeganmakinggrantstoCanadiancharitiesin1972.Today,the Foundationsupportsinnovativeprojectsthataredesignedtoinformpublicpolicy changeinfourprogramareas:Education,Environment,Health&Wellness,andCivic Engagement&DemocraticInstitutions.TheFoundationalsodeliversthePublicPolicy TrainingInstitute,aprofessionaldevelopmentprogramdesignedtohelpparticipants moreeffectivelyengageinthepublicpolicyprocess,andPolicyForward,a future-orientedspeakerseriesthatbringsthoughtleaderstogethertodiscussthe intersectionsofpolicy,technology,andinnovation.

StaplesCanada—EventheOddsCampaign

StaplesandMAPhavecometogethertocreateEventheOdd,:aninitiativetoraise awarenessofinequityinCanadaandtohelpbuildvibrant,healthycommunities.The partnershipisbasedonthesharedbeliefthateveryoneshouldhavetheopportunityto thrive.EventheOddsfundsresearchandsolutionstohelpmakethefuturefairfor everyone.Learnmoreatstaples.ca/eventheodds.

OurCareisbasedat:

MAPCentreforUrbanHealthSolutions

MAPCentreforUrbanSolutionsisaresearchcentrededicatedtocreatingahealthier futureforall.Thecentrehasafocusonscientificexcellence,rapidscale-up,andlong termcommunitypartnershipstoimprovehealthandlivesinCanada.MAPisbasedat St.Michael’sHospitalinToronto.

St.Michael’sHospital,UnityHealthToronto

St.Michael’sHospitalisaCatholicresearchandteachinghospitalindowntownToronto. ThehospitalispartoftheUnityHealthTorontonetworkofhospitalsthatincludes ProvidenceHealthcareandSt.Joseph’sHealthCentre.

OurCareSupporters

OurCareisalsosupportedby:

DepartmentofFamily&CommunityMedicine,UniversityofToronto

TheUniversityofToronto’sDepartmentofFamily&CommunityMedicineisthelargest academicdepartmentintheworldandhometotheWorldHealthOrganization CollaboratingCentreonFamilyMedicineandPrimaryCare.

St.Michael’sFoundation

Establishedin1992,St.Michael'sFoundationmobilizespeople,businesses,and foundationstosupportSt.Michael’sHospital’sworld-leadinghealthteamsindesigning thebestcare–when,whereandhowpatientsneedit.Fundssupportstate-of-the-art facilities,equipmentneeds,andresearchandeducationinitiatives.BecauseSt. Michael'sFoundationstopsatnothingtodeliverthecareexperiencepatientsdeserve.

OurCareisworkingwith:

ManitobaAdvisoryGroup

KeirJohnson,DoctorsManitoba

AshleyPlypowich,IndigenousServicesCanada

MikeLoudon,Interlake-EasternHealthAuthority

ConnieNewman,ManitobaAssociationofSeniorCommunities

GanesanAbbu&LisaGoss,ManitobaCollegeofFamilyPhysicians(MCFP)

BarbaraWasilewski,JeanetteEdwards&PhilJarman,ManitobaHealth

ScottSinclair,ManitobaMinistryofHealth

Chukwuma(Chuck)Abara,NorthernHealthAuthority

IanWhetter,OngomiizwinHealthServices

MphoBegin,Pan-CanadianPatientCouncil

BrianSchoonbaert,PrairieMountainHealth

DenisFortier&VikasSethi,SharedHealth

AlanKatz,DepartmentsofCommunityHealthSciencesandFamilyMedicine, UniversityofManitoba

AmandaCondon,DepartmentofFamilyMedicine,UniversityofManitoba

IanAlexander,DepartmentofFamilyMedicine,UniversityofManitoba;SelkirkMedical Associates

JoseFrancois,DepartmentofFamilyMedicine,UniversityofManitoba

KarenAppel,DepartmentofFamilyMedicine,UniversityofManitoba

MandyBuss,DepartmentofFamilyMedicine,UniversityofManitoba

NathanColeman,DepartmentofFamilyMedicine,UniversityofManitoba

RebeccaMueller,DepartmentofFamilyMedicine,UniversityofManitoba

JoanneMaier,MaxRadyCollegeofMedicine,UniversityofManitoba

SaraGoulet,MaxRadyCollegeofMedicine,UniversityofManitoba

KarenCook,OfficeofcommunityEngagement,UniversityofManitoba

MelanieMacKinnon,OngomiizwinInstituteofHealthandHealing,Universityof Manitoba

ChristineDuprat,JossReimer&MikeNader,WinnipegRegionalHealthAuthority (WRHA)

NationalCollaboratingOrganizations

AkoAnyaduba,BlackPhysiciansofCanada

RickGlazier,CanadianInstituteforHealthResearch

JohnFeeley&MoiraTeed,CanadianMedicalAssociation

ChristieNewton,CollegeofFamilyPhysiciansofCanada

BenjaminDiepeveen,KajanRatneswaran,SusannahTaylor,ElizabethToller&Jocelyne Voisin,HealthCanada

BillCallery&JenniferMajor,HealthcareExcellenceCanada

MelanieOsmack,IndigenousPhysiciansAssociationofCanada

AdditionalCollaborators

AishaLofters,DepartmentofFamilyandCommunityMedicine,UniversityofToronto

AlanKatz,ManitobaCentreforHealthPolicy

AmandaCondon,UniversityofManitoba

AndrewMacLean,DalhousieUniversity

AndrewPinto,St.Michael’sHospital,UpstreamLab&DepartmentofFamilyand CommunityMedicine,UniversityofToronto

BrynHamilton,AssociationforFamilyHealthTeamsofOntario

DanaCooper,NursePractitioners’AssociationofOntario

DanielleBrown-Shreves,RestoreMedicalClinics

DerelieMangin,DepartmentofFamilyMedicine,McMasterUniversity

DominikNowak,JimWright&RoseZacharias,OntarioMedicalAssociation

EmilyGardMarshall,DalhousieUniversity

IsabelleLeblanc,McGillUniversity

JenniferRayner,AllianceforHealthierCommunities

KamilaPremji,DepartmentofFamilyMedicine,UniversityofOttawa

KimMcGrail,CentreforHealthServicesandPolicyResearch

LeslieGreenberg,MekalaiKumanan&KimberlyMoran,OntarioCollegeofFamily Physicians

MaggieKeresteci,CanadianAssociationforHealthServices&PolicyResearch

MikeGreen,DepartmentofFamilyMedicine,Queen'sUniversity

MonicaAggarwal,DallaLanaSchoolofPublicHealth,UniversityofToronto

MylaineBreton,UniversityofSherbrooke

NebKovacina,McGillUniversity

NicoleBlackman,IndigenousPrimaryHealthCareCouncil

NoahIvers,DepartmentofFamilyandCommunityMedicine,UniversityofToronto

RuthLavergne,DalhousieUniversity

SabrinaWong,UniversityofBritishColumbia

SarahCook,DalhousieUniversity

SarahNewbery,NorthernOntarioSchoolofMedicine

ScottGarrison,UniversityofAlberta

SophiaIkura,HealthCommonsSolutionsLab,SinaiHealthSystem

VanessaWright,Women’sCollegeHospital

VivianRRamsden,UniversityofSaskatchewan

PatientAdvisoryGroups

CanadianMedicalAssociation’sPatientVoiceAdvisoryGroup

MAPCentreforUrbanHealthSolutions’ImprovingPrimaryCarePublicAdvisorsCouncil

OurCareisengagingwithdistinctAdvisoryGroupsineachprovincewhereitisworking. VisitOurCare.caformoreinformationaboutoursupporters.

PanelDevelopmentandFacilitation

TheManitobaPrioritiesPanelonPrimaryCarewasdesignedandfacilitatedbyMASSLBP. Foundedin2007byPeterMacLeod,MASSisCanada'srecognizedleaderinthedesignof deliberativeprocessesthatbridgethedistancebetweencitizens,stakeholders,and government.Formorethanadecade,MASShasbeendesigningandexecuting innovativedeliberativeprocessesthathelpgovernmentsdevelopmoreeffective policiesbyworkingtogetherwiththeirpartnersandcommunities.

PrioritiesPanelTeam

Co-Chairs:

JasminKay,NationalProjectDirectorandManitobaPanelCo-Chair

DrMandyBuss,ManitobaPanelCo-Chair

SpecialGuests:

AlbertMcLeod,KnowledgeKeeperfromNisichawayasihkCreeNationandtheMétis communitiesofCrossLakeandNorwayHouse

Dr.LisaMonkman,FamilyPhysicianinBrokenheadFirstNation

SocialWorker:

DoritKosmin

Facilitators:

LellaBlumer

LibbyChunyk

ChrisEllis

DanielleHart

TobeLe

AmberO’Donnell

Interpreter:

AlexieAndré-Bélisle

CivicConcierges:

MackenzieAlexiuk

KayteMcKnight

Imagecredits:YuriMarkarov,UnityHealthToronto

TolearnmoreaboutMASSLBP’swork,pleasevisitmasslbp.com. Tofollowdevelopmentsonthisproject,pleasevisitourcare.ca.