Calgary Roundtable Report

In Calgary, the Minister of State met approximately 22 Alberta public health stakeholders.

They advised the Minister to consider the following factors in building a Public Health Agency of Canada.

1. Regarding a Mandate for a Public Health Agency

• An Agency needs to take the lead in restoring federal-provincial cooperation in public health:
  • A lot can be done with federal leadership if that relationship is better - especially in national disease surveillance;
  • Federal Agency should help set national best practices and health goals; and,
  • If a federal Agency sets national goals and objectives, they can increase public health accountability at all levels.
• The Agency should spearhead public health research:
  • To tell us which population-based interventions are working; and,
  • Must be done at a federal level because large populations are needed for research.
• Not just focusing on individual accountability for health, but especially on social determinants of health;
• Should pay particular attention to vulnerable groups; and,
• Should have, as part of its mission, the need to work with a wide range of health disciplines.

2. Regarding Operational Strategies for a Public Health Agency

An Agency should consider:

• Ways for all levels of government to avoid the "tyranny of the acute":
  • Acute health care issues tend to grab the most attention and funds, depriving public heath of scarce resources; and,
  • Better training in medical schools for public health may be one way to shift the culture.
• Engaging First Nations people directly in their communities, not just through the Assembly of First Nations:
  • First Nations and Inuit Health Branch of Health Canada can't address all the health problems that aboriginal communities face.
• Working directly with municipal governments:
  • They are a ready-made conduit to lots of Canadians for citizen engagement; and,
• Federal Agency should also have a voice in local planning for specific populations, such as seniors.
• The positive effect of health regionalization - in creating closer relations between public health and clinical health sectors:
  • For example, infection control in Lethbridge reports to a public health officer.
• Animal Health should be recognized as part of the public health system:
  • Many, if not most of the infectious diseases mentioned in Naylor report have an animal host.

3. Investments

Participants urged an Agency to focus on the following priority investments:

• Restoring a strong disease surveillance system;
• Ensure that health money doesn't just go into acute care and primary care, especially in provinces that have regionalized health and health care;
• Investing in enough staff for surge capacity in case of an emergency:
  • Federal-provincial-regional coordination helps ensure there is no duplication of efforts.
• The Agency should consider funding provinces to pursue targeted programs, not general public health, for greater accountability; and,
• Federal government should also include funding to regional health authorities directly, not just to the provinces.

4. Public Health Issues

Participants also raised concerns about specific public health issues:

• Among Alberta First Nations:
  • Housing quality and crowding are two critical public health issues in need of immediate attention;
  • Parents on reserve need better education about nutrition;
  • Mental health is the biggest issue for many communities; and,
  • Fetal Alcohol Spectrum Disorders is also a critical issue - especially since on- and off-reserve schools do not provide facilities for affected children.

5. Chief Public Health Officer

• Needs freedom to speak out on unpopular issues; and,
• Needs to keep a profile for public health when there is no public health emergency.