The Naylor Report on Innovation, from a panel formed by the Minister of Health, is a waste of taxpayers’ money and is an example of the cognitive inertia in our system.
The so-called Naylor report on Innovation was released last month.  It was disappointing, but not surprising, in its lack of substance and relevance.
The Minister of Health charged the panel with identifying the five most promising areas of innovation in Canada and internationally that have the potential to sustainably reduce growth in health spending while leading to improvements in the quality and accessibility of care, and recommending the five ways the federal government could support innovation in the areas identified above. It failed to do so.
Regrettably, the panel did not grasp the same definition and meaning of innovation that the rest of the world does; they confused process change and technology catch-up with innovation. They did recognize the country of Denmark and its role in medical innovation for such a small country, but even though it is the archetypal nanny state, Denmark provides tremendous incentives for industry as compared to the increased taxation of business that this panel suggested.
At tremendous waste of taxpayers’ money, this report should be archived along with all the other Health Canada commissioned studies. Even though it reported that Canadians do not believe that the healthcare system needs more money per se, they recommended more funding of bureaucratic positions with no eye to the actual realization of improved performance results. The government may merge federal-provincial-territorial agencies (FPTs) as recommended, but they should do so for cost- savings, rather than the enlarged mandate as envisaged by the panel. The panel was most critical of the PMPRB (Patented Medicine Prices Review Board) which follows its mandate very carefully, but made no critical mention of CADTH (Canadian Agency for Drugs and Technologies in Health) which has been problem-plagued for several decades.
This report, rather than illumining on innovation and providing a set of actionable recommendations, is an example of the cognitive inertia in our system.
The most glaring findings in the report were the juxtaposed poor access to family physicians with the rapid rise in their remuneration. In many of our studies we have identified labour as the number one driver of costs in healthcare. An all too simple solution would be the creation of family-medicine-only medical schools to increase the number of family doctors as well as the bridging of only doctors trained off-shore in family medicine, for the time-being. But this will not happen as this defies the very control- of-entry economics employed by the CMA and their provincial partners over the decades; so no recommendations from the panel here.
It was also very misleading for the panel to use 30 year old US data to make their point about integration of healthcare delivery. The reality is that almost all of the integrated delivery systems in the US have been dismantled after huge cost-over-runs with no increase in productivity or access. The reason Kaiser Permanente works in the US is that it is driven by managers not doctors; by insurance risk and not interest groups because they have the deep pockets to withstand their pressures. Kaiser works, not so much that it is integrated, but it is comprehensive with a single EHR that compares provider against provider with a significant portion of their income tied to performance.
The EHR graphic in the report is misrepresented. The 5 countries with the highest compliance with EHRs have ONE EHR; we have many stand-alone products none of which provide epidemiological or provider- comparison analytics.
There are several pages dedicated to the exciting future of personalized medicine (or as they prefer, precision medicine, which subtly places the focus back on the provider rather than the patient) but nothing new is presented.
It was also clear, sadly, that they did not understand some of what they reported. For example, they claimed that Canada has performed poorly by international standards in keeping the prices of drugs down but their data showed just the opposite. They failed to clearly differentiate our performance in keeping the prices of patented drugs contained versus the prices of generics, although recognition is given to the efforts on the latter to date. They do not understand the concept of differential pricing in consumer products nor the cost offset from increased utilization of medicines. Of course, the real problem is that governments do not have the political will to capture those cost offsets.
Missing the point of their mandate entirely, the panel dwelled upon the cost of drugs as a healthcare cost driver while admitting earlier in the report that labour was the real culprit (although they only mentioned doctors and did not examine the huge rise in nursing, administration and public service wages/salaries and benefits compared to healthcare in the rest of the world and the private sector here at home).
Just a thought, but maybe an innovation we could consider is to stop studying and to start doing.
Dr. D. Wayne Taylor
The Cameron Institute
D. Wayne Taylor, PhD, recently retired from McMaster University, serves as the Executive Director of The Cameron Institute, a not-for-profit think tank specializing in health, economic, and social issues.
 Unleashing Innovation: Excellent Healthcare for Canada, Final Report of the Advisory Panel on Healthcare Innovation, Health Canada, July 2015.