By Klara Pachner
Centretown’s two community health centres provide medical care but neither is anything like an ordinary medical office.
The foyer at the Somerset West Community Health Centre is spacious, bright and colourful. Big windows let the light flow in while colourful flags hang from the walls behind the receptionist’s desk representing the many ethnic groups in the community.
The atmosphere is light and cheerful for the constant stream of people — many of them mothers with small children — who come in and out of the centre.
Cooper Street’s Centretown Community Health Centre is no less welcoming with its old fashioned road-like hallways, brightly lit by streetlights. The facility is all on one floor to make it easier for those with disabilities to get to the many services provided.
Together, the two centres provide the diverse Centretown community with services that cover a spectrum of issues important to preserving the area’s physical and emotional health.
In addition to regular doctor’s offices, the centre focuses on illness prevention, health promotion, health education, and community development.
The provincial government has been so impressed by the example set by Ontario’s network of 55 community health centres they are now at the centre of a provincial debate on restructuring front-line health care.
A recent report on primary health care put out by the Ontario Health Services Restructuring Commission (HSRC) — a group of health professionals appointed by the Progressive Conservative Ontario government to redesign the provincial health system — says there is a need for access to primary health care providers.
The commission is recommending the Ministry of Health set up a network of facilities called primary health care groups, similar to the community health centre models.
Greater access is meant to relieve pressure on crowded hospitals, prevent so-called doctor shopping (where patients see multiple doctors for no good reason) and to keep provincial medical costs from spiralling out of control.
“It’s an idea that’s been around for quite a few years and has taken different forms,” says MacLellan. “The HSRC is now saying it’s time for the government to move ahead and implement it across Ontario.”
Current programs at the Centretown Community Health Centre, which provides services to over 9,000 individuals per year, include a homeless initiative, community-based diabetes education, infant development, and special counseling aimed at seniors.
Programs at the Somerset West Community Health Centre, which is in the heart of Ottawa’s Chinatown, include street health outreach and a youth internship program. The centre provides many services in Southeast Asian languages in addition to English, French and Italian.
Jack McCarthy, executive director of the of the Somerset West centre says health centres like his take special care to help populations poorly served by the current health care system.
McCarthy’s centre supplies services to 13,000 registered clients, gives special attention to people who have a low-income, are recent immigrants, single parents, disabled, don’t have a family or have other special needs.
Both Centretown centres are staffed by multidisciplinary teams, which include physicians, nurse practitioners, nurses, social workers, health promoters, community health workers and often chiropodists, nutritionists or dieticians.
Funding comes from provincial and regional government, grants and fund-raising.
The Ontario Ministry of Health is the biggest source of their funding, accounting for 82 per cent of the Somerset West Community Health Centre’s 1998-99 budget and 76 per cent the Centretown Community Health Centre’s budget.
A main government push of primary health care groups is to get groups of doctors working together at one clinic, taking turns providing around-the- clock service.
This is meant to keep people from using (walk-in) clinics or emergency rooms where doctors are unfamiliar with them.
The other idea is that there would be different health-care professionals working together who would be able to provide specialized service at one location, again keeping patients from having to go to clinics where the doctors don’t know them.
“It makes sense to have different career people working together,” says McCarthy. “It’s a way of keeping people out of (more) expensive (forms of) health care.”
But MacLellan stresses the proposals are not about cutting costs.
“It’s about improving the sharing and co-ordination of services and providing better care,” he says.
Marguarite Keeley, executive director at the Centretown Community Health Centre, is happy about the restructuring commission’s recommendations.
“It’s a wonderful model,” she says.
Keeley says she hopes the proposals may mean funding for community health centres, which are financially strapped like other health care providers.
Both she and McCarthy say their centres are operating at close to capacity.
“People come in droves to our centre,” McCarthy says. “But we’re not quite at the ceiling,” he adds.
Keeley says her centre has waiting lists of up to a month for services like individual counseling.
“Money is very tight. We always feel we need more than we have.”
McCarthy says his staff hasn’t received raises in seven years.
But both Keeley and McCarthy say they are optimistic about the future of their centres.
“We have a presence and a history that makes us a vital part of the health care system (in Centretown),” Keeley says.
And after years of struggle, they say they’re thrilled to see their model of primary health care receive so much attention.