MONTREAL - Quebec has the country's third-worst health care system, an index ranking the quality of health care in Canada's 10 provinces has found.

The Manitoba-based Frontier Centre for Public Policy and the Brussels-based Health Consumer Powerhouse published what it calls Canada's Health Consumer Index Tuesday.

The report measured patient rights and information, primary care, waiting times, outcomes after treatment and the range of available services.

Ontario came out on top, followed by British Columbia, Nova Scotia, New Brunswick, Alberta, Prince Edward Island, Manitoba, Quebec, Saskatchewan and Newfoundland.

The report found Quebecers have the worst access to family physicians in the country, which has led to many of the other problems. The province also has the highest rates of hospital-borne infections "by a large margin," the report's author said.

The index found only 73.5 per cent of Quebecers have access to a family doctor, compared with the national average of 84.8 per cent. Quebec's access to family doctors was far below any other province. The next-worst was Alberta, with 81.6 per cent.

"It's clear it's important to overall health to have regular contact with one doctor who's responsible for your file, and Quebec is the lowest by far," said Rebecca Walberg, director of health policy at the Frontier Centre.

Quebec Health Minister Yves Bolduc didn't get a chance to review the report yesterday, but he is well aware of the shortage of family doctors, said his spokesperson, Marie-Ève Bédard.

"That's the next challenge that the minister will address," Bédard said.

Each year at medical schools, positions for specialists' residencies fill up, she noted, "while there are vacancies in family medicine. We'll have to work to make conditions better to attract family doctors."

Walberg said the province should also improve access to home care and long-term care, so patients don't stay longer than necessary in hospitals.

That would decrease hospital infections and help reduce the mass of people in emergency rooms.

On a brighter note, the province scored high for its efforts to reduce waiting times, particularly for access to specialists and radiation therapy for cancer patients.

Walberg said while patients in Quebec have the shortest wait time, it's still too long.

"Compared with what people can expect in almost any other country in the western world that has a social safety net, it's not very good," she said.

The province was also commended for the range of services it offers, compared with other provinces, particularly its drug insurance plan.

The report had a scathing assessment of Canada's overall health care system, saying "even the best-performing provinces do not provide the standard of care that is commonplace in western Europe."

Peter Holle, the president of Frontier, said the problem is the system is too bureaucratic.

He said Canada should follow Europe's lead and allow private companies to manage health services funded by public money. That would introduce competition into the health marketplace and ensure money would be better spent, Holle argued.

Patients' rights activist Paul Brunet, of the Conseil pour la protection des malades, said he doesn't mind some private enterprises managing the public system, but he stressed those enterprises must be paid by the government, to ensure the health system remains free and accessible to everyone.

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