Danish Health Diplomacy in Canada
I hadn’t given much thought to how the Danish health system might differ from our own Canadian system before the evening of November 16, when Katrine Dalsgaard Skovly gave us her talk on health diplomacy. After all, we have universal health coverage in Canada too. How different could the Danish system be? Well, a lot more different than had occurred to me, I was soon to discover.
First of all, the Danish health care system is very closely linked to something Katrine called the life sciences industry, which receives a lot of funding from philanthropical foundations. The life sciences industry is a significant part of Denmark’s economy and is growing rapidly. It is a major player in Danish exports, and employs around 50,000 people, making it a direct contributor to the wealth of the country. Profits are reinvested in the industry, and medical research has become Denmark’s highest research priority.
The close co-operation between Denmark’s health care system and its life sciences industry is essential for optimal health treatment as well as for good working environments. Denmark has formulated a Life Sciences Strategy, which is currently being updated to improve conditions for research and development even further, and to make better use of health data. Internationalization and health diplomacy are part of this strategy too and this is where Katrine comes in! As Health Counsellor for the Embassy of the Kingdom of Denmark in Canada, her role is to promote Denmark’s approach to health and life sciences and increase knowledge of Danish products while at the same time bringing back knowledge from Canada.
Canada and Denmark face similar health challenges; in particular, aging populations that entail many chronic diseases but a lack of skilled professionals to treat them. The two countries take different approaches to these challenges and it is in both of their interests to learn from each other and determine the benefits of each approach and the best way to create a feasible, resilient and efficient health care system.
Denmark has digitalized its health care system and has focussed on patient involvement and empowerment. Danish officials have engaged with Health Canada with regard to the governance and structure necessary for collecting and sharing health data. Canada’s challenges in this regard include the individual provinces’ separate responsibilities for health care as well as the many different entities which provide health care, from hospitals to clinics to retirement residences. These various entities do not necessarily share health data, which can be problematic for patients and it is certainly inefficient to re-enter the same health data into numerous data systems multiple times.
Denmark is well ahead of Canada when it comes to centralizing individuals’ health data, in large part due to the high degree of trust that Danes have in their government. They are generally happy to share their data for the benefit of others and of their society. There is a greater tendency in Canada to want to protect personal data. Discussions on this issue are focussing on how to engage patients so that they will consent to the efficient use of their health data.
Denmark has also interacted with our provinces. Virtual meetings have been held between the Danish Minister of Health and the Quebec counterpart, resulting in the drafting of a memorandum of understanding. A similar process is underway with Nova Scotia.
Both countries are focussed on how to ensure healthy and dignified aging. Denmark has a well-established system that allows seniors to “age in place. ” A CBC Marketplace documentary called “Fixing Elder Care: Lessons from Denmark” (https://www.cbc.ca/player/play/2027838531842) makes a strong case for the humanity and economics of the Danish approach.
But Katrine noted that Canada’s system has its strengths too. She mentioned our emphasis on diversity and our health care in the Canadian Arctic in particular as being superior to the health care available in Greenland.
Katrine stressed early on that Denmark’s universal health care system is the cornerstone of its welfare system and is a top priority for its government. In the discussions that followed her talk, it emerged that Denmark’s higher tax rates mean that citizens expect the state to provide good health care right up until the end of life. Children of elderly parents are not expected to look after their parents’ health care needs, as they often are in Canada. Such care is provided by employees of the local counties and the emphasis is strongly on home care. Seniors age in their own homes to the extent possible and daily visits, even multiple daily visits, from health care workers make it possible.
All in all, it was an eye-opening evening and I certainly left more convinced than ever that Canada should, at the very least, completely rethink its approach to caring for its aging population.