Dr. Katharine Smart
Pediatrician, past CMA President
Emily Gruenwoldt
CEO of Children’s Healthcare Canada
Canada must shift from illness-based care to early childhood investment to improve population health, reduce system strain, and ensure long-term sustainability.
Across Canada, emergency departments are overcrowded, wait times and costs are rising and workforce shortages persist. Governments respond with investments, but despite increased spending, Canadians are no healthier.
Canada will never spend its way out of a model that is illness-based. If Canada is serious about stabilizing healthcare systems, the only sustainable path forward is to improve population health, starting with children.
Children’s health is the basis of a sustainable healthcare system. When children receive timely, coordinated care, the benefits extend far beyond families.
Over the past two years, Children’s Healthcare Canada has engaged with child health leaders nationwide through a 20-episode series of our podcast, SPARK: Conversations focused on exploring what it means to right-size children’s healthcare systems. One consistent message emerged: the long-term health of Canadians — and the affordability of healthcare — depends on whether we invest intentionally and strategically in children and youth. Not later. Not incidentally. Now.
Early health is developmental and time-sensitive, and interventions cannot be recovered once missed. Delays in care are not merely inconvenient; they can permanently alter health trajectories and the costs of compounds across decades.
Right-sizing children’s healthcare begins with acknowledging several realities.
First, from 8 million kids in Canada today, projections show an additional 1.2 million children by 2040.
Second, children’s needs are increasingly complex, with rising rates of neurodevelopmental conditions, mental health challenges, and chronic illness.
Third, children are not small adults, and they need specific healthcare systems tailored to their unique needs.
If Canada is serious about stabilizing healthcare systems, the only sustainable path forward is to improve population health, starting with children.
Right-sizing does not mean building larger hospitals or adding unlimited downstream capacity. A right-sized system delivers the right care, in the right place, at the right time — before illness occurs.
Community-based developmental, rehabilitation, and mental health services; strong primary care; home care; and regional outreach programs allow children to receive support earlier, while enabling tertiary and quaternary hospitals to focus on the most complex cases.
We know that when children experience illness or developmental delay, families’ mental health, economic stability, and ability to remain in the workforce are threatened. Evidence consistently shows that when families are supported, children’s outcomes improve while system utilization decreases.
A National Children’s Strategy
Currently, responsibility for children’s wellbeing is fragmented. What Canadian children need is a National Children’s Strategy. It would provide the structure needed to move beyond crisis management toward long-term sustainability. It would not replace provincial delivery of care. Rather, it would establish shared goals, common data, aligned investment priorities, and measurable outcomes.
Children’s health is the basis of a sustainable healthcare system. When children receive timely, coordinated care, the benefits extend far beyond families.
Only by making people healthier will we be able to afford and sustain the system we value — and that begins in childhood.
The decisions we make today will shape not only the sustainability of our healthcare system, but the health, resilience, and prosperity of the next generations.
Listen to CHC’s podcast series to learn more about right-sizing children’s health systems.
