CHARLOTTETOWN — Although it’s debatable whether Canadians view their health care system with a measure of moderate or grim realism, a new poll indicates the majority are deeply concerned that it is deteriorating and increasingly unsafe, to the point where as many as 54 per cent “know of someone who got an infection while staying in a hospital.”

Some 70 per cent “worry they’ll fall through the cracks” of the system within the next 5-10 years, while 52 per cent “know a friend or family member who cannot afford prescription medication and have had to skip or delay renewing prescriptions as a result;” according to the poll, conducted for HealthCareCAN by Ipsos Reid in the run-up to the national health organization’s conference, the “Great Canadian Healthcare Debate,” being held here through Tuesday.

Some 61 per cent of Canadians “lack confidence that hospitals and long-term care facilities can handle the needs of Canada’s elderly population,” while 66 per cent “worry about the risk of infection in hospitals and other health care facilities in their area.”

So concerned are Canadians about the future of the system that health care (41 per cent) was once again the “top issue of national concern,” as it has been since 2010. That tops unemployment and jobs (36 per cent), taxes (30 per cent) and political/financial corruption (26 per cent), and poverty & social inequality (24 per cent) in the IPSOS survey. Other issues, such as education (19 per cent), crime & violence (18 per cent), threats against the environment (15 per cent), immigration control (12 per cent), “moral decline” (10), terrorism (10), climate change (10), “rise in extremism” (10) and maintaining social programs (9) trailed the pack.

The poll also demonstrates that Canadians have a remarkable accurate and realistic read of the health system’s current capabilities and weaknesses, as well as the trade-offs that must be made in public spending priorities.

That’s particularly true of community-based care for seniors. A staggering 61 per cent “lack confidence that hospitals and long-term care facilities can handle the needs of Canada’s elderly population,” while 81 per cent of Canadians older than age 45 are concerned about the quality of care they’ll receive as they age. Some 78 per cent fret about having “access to high quality home and long-term care in their retirement years.” Just 48 per cent believe “there is enough health care support for seniors in their area to live at home as long as they are able to do so.”

Drug coverage, mental health care, palliative care and frailty screening for their elderly are also identified as major weaknesses in the system, with 65 per cent of Canadians saying they’d be willing to pay higher taxes so as to have prescription medicines covered as a part of Medicare, while 54 per cent would like some manner of national agency to be made responsible “for deciding which drugs are covered and negotiating the prices for them.”

Health infrastructure is also identified as a national priority, with 77 per cent of Canadians saying “that while governments mostly talk about the need to invest in roads and bridges, investing in ageing hospitals is a higher priority,” and just 66 per cent are of the view that “hospitals and other health care facilities in their area are modern and state of the art.”

Overall, Canadians believe there’s a need for systemic reform, with 91 per cent saying that the system could improve quality of care through greater efficiency, and 64 per cent saying they believe the Canadian system is falling behind its international counterparts.

But a remarkable 75 per cent of Canadians say they don’t know who to trust to guide improvements in the health care system, though they’re more inclined to believe that doctors (70 per cent), nurses (65 per cent) and researchers (61) should play a role in making that determination than hospital administrators (58), patients (57) and pharmacists (53) or policy makers (39), politicians (38) and businessmen (29).

Canadians appear to have similarly skeptical when it comes to electronic health records (EHRs). While 85 per cent believe such records would improve efficiencies in the system, 53 per cent say “there are too many privacy and security issues for them to support an EHR system.”