Dr. Alika Lafontaine: Healthcare System is Under Strain as Canada Faces Growing Gaps in Care

By Chevi Rabbit, Local Journalism Initiative Reporter

(ANNews) – Dr. Alika Lafontaine says Canada’s healthcare system is entering a period where long-standing structures are no longer holding up, and governments must rethink what the system is actually designed to deliver.

He argues that healthcare responsibilities between federal and provincial governments are clearly divided, but increasingly interdependent.

“In the broader framework of healthcare, the federal government and provincial governments have different roles,” Lafontaine said. “The federal government has always been more about creating that national framework in the realm of funding, and then looking at big-picture items around things like medical assistance in dying and its criminality.”

He also referenced federal legislative discussions tied to forced sterilization, noting Ottawa’s role in shaping national legal standards, while provinces remain responsible for delivery.

“Provinces take that funding and then operationalize it,” he said.

But Lafontaine says the current moment is pushing Canada toward greater national consistency, particularly in how funding is used and how systems communicate with one another.

“There’s a greater expectation that the money gets spent in ways that are more consistent across the country,” he said, pointing to health data systems as an example. “Our different systems of collecting data should be able to talk to each other, and information should flow back and forth in a way that protects privacy, but also makes it easier for people to receive excellent care.”

He said while provinces will always retain authority over how healthcare is delivered, the era of fully isolated provincial systems is no longer sustainable. “We’ve moved out of the era where having your own tailored system that only works in the province that you’re in is probably a bad way of approaching healthcare,” he said.

Instead, Lafontaine argues healthcare is most effective when organized around teams, shared responsibilities, and patient flow rather than rigid structures.

“Healthcare systems function most effectively when centered around things like teams, people shifting and sharing tasks, making sure that we treat patients where they are, and treating infrastructure in the context of how people actually flow through that infrastructure,” he said.

He also pointed to the reality of rural and northern care, where patients routinely cross regional and provincial boundaries to access services. “In Grand Prairie, we see a lot of patients from Dawson Creek, which is two hours away. We get folks from the Northwest Territories who can’t get access to care,” he said, adding that even patients from Edmonton sometimes end up in regional systems due to how care corridors are structured. “People are moving around sometimes across provincial lines in order to receive care,” he said.

He also highlighted inequities in access, particularly for Indigenous communities. “Métis communities and First Nations within Alberta often have much longer travel times than other communities,” he said. “The reason that happened is because that’s how we built the system.”

That reality, he argues, makes standardization and coordination essential – not optional. “We have to make decisions to start to standardize what should be standardized and then get more consistent with what patients can expect.”

In his closing reflection, Lafontaine said the healthcare system is now at a point of instability that requires honest public discussion about its purpose and limits.

“We’re currently in this place where everything feels really unstable,” he said. “The ways that we used to do things have stopped working.”

He said repeated crises across Canada and Alberta are evidence that the current model is under strain.

As governments consider reforms, he argues the most important question is no longer structural – but philosophical.

“The place that we really have to focus our time and attention is: what do we expect from healthcare and what do we not expect from healthcare?”

Lafontaine said that question needs to be asked across all levels of the system – from governments to frontline providers to administrators.

“That’s a much more useful conversation to have between the government and the public, between providers and administrators – whoever you’re thinking about, that question should be asked.”

He added that answering it could reshape how care is delivered, particularly for rural, remote, and First Nations communities that continue to face long travel times and uneven access.

“Communities and First Nations within Alberta often have much longer travel times than other communities,” he said. “The reason that happened is because that’s how we built the system.”

He said the current structure raises difficult but necessary questions about whether today’s system still makes sense for today’s realities.

“Should we expect a system that is living in today to still have those same sorts of gaps when it comes to local infrastructure, distance to treatment, and how information moves across systems so patients can make good decisions about their health?”

“And I think that’s a conversation that has to happen.”