Nova Scotia Roundtable Report
In Halifax, the Minister of State met approximately 28 Nova Scotia 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
- Federal government needs to clarify and clearly define 'public health',
and clearly define the federal role within it;
- Federal government has a major role in addressing:
- New infrastructure development;
- Health human resource shortages;
- Surge capacity (in case of emergencies); and,
- Education and training of public health professionals, including
field epidemiologists.
- Agency should address health disparities between segments of the
Canadian population and between regions in Canada;
- Agency should focus on public-health policy development; and,
- Governance:
- Agency must be transparent, clearly accountable, and work
at arms length from government;
- Agency must work towards a long term vision; and,
- Health Canada should evaluate what kinds of federal structures
have worked in public health and what have not - and advise on
the structure of the Agency.
2. Regarding Operational Strategies for a Public Health Agency
An Agency should consider:
- Building a national approach to public health around national public
health goals and standards;
- Defining the roles that hospitals and infection control systems
play, in order to integrate the health care system with public health
infrastructures, so that the two are not separated artificially;
- Taking a multi-sectoral and multi-jurisdictional approach to its
work;
- Committing to working in collaboration with provinces, territories
and local governments, using a population health approach;
- Enhancing knowledge transfer between academics, decision-makers
and community practitioners;
- Working to integrate the whole health and health care system, including
using the Health Council to increase overall accountability of the
health and health care system for the continuum of health;
- Making education and communication of public health and population
health must a priority;
- Addressing current barriers to data collection. It needs to address
privacy and ethical concerns, citizen autonomy and professional autonomy
in the use and management of public health data;
- Focussing all programming on people and communities, and making
it flexible; and,
- Ensuring the Agency's mandate to advance public-health research
balances the collection of health-status data with research on outcomes
of health strategies to determine effectiveness.
3. Investments
Participants urged an Agency to focus on the following priority
investments:
- Canada does not need a lot of "bricks and mortar" around a National
Agency. Rather, Canada should invest in developing new models and virtual
networks, including significant investment in information and communication
technologies;
- Funding must ensure a comprehensive public health infrastructure
across the country;
- Funding required to address the lack of surge capacity and lack of
flexibility in dealing with public health emergencies;
- Investments necessary to address inadequate local laboratory capacity
- need a network of public health laboratories; and,
- Infrastructure issues are paramount - need funding to flow down to
the local levels. Suggest targeted funding to bypass primary and acute
care. Funding must be long term.
4. Public Health Issues
Participants also raised concerns about specific public health
issues:
- Agency needs to recognize mental health as a public health issue;
and,
- Oral health, largely ignored in policy, also needs attention as
a public health issue.