Who doesn't deserve excellent care?

Discussion on implementation of the Excellent Care for all Act, 2010 (ECFA Act), Bill 46, has focused on the hospital sector in Ontario, but it also has relevance outside the hospital setting. As primary healthcare, long-term care and home care all receive public funding, these sectors should be expected to be compliant with Bill 46. But does the act also govern government-funded (i.e., by other than the Ministry of Health and Long-Term Care) community-based programs such as adult day programs, meals-on-wheels, nutrition programs for children, and more? We propose that we cannot exclude any of these essential programs. We also consider the non-hospital sector and health organizations that do not receive public funding. The healthcare system will be well served if we consider whether the EFCA Act's key elements should be implemented across the system both vertically and horizontally. Vertical implementation in the hospital sector could be followed by primary care, home and community care, long-term care, and the rest of the vertical silos within the healthcare system. But by taking the horizontal approach, all sectors within and outside of what we traditionally think of health would be integrated using an evidence-informed and outcome-based approach and methodology.