Owen Sound Roundtable Report
April 17th 2004
In Owen Sound the Minister of State met approximately 20 local public
health stakeholders.
1. Regarding a Mandate for a Public Health Agency of Canada:
Broad Scope
- The mandate should respect the determinants of health and include
national health information and communication, emergency response,
chronic and infectious disease prevention, injury prevention, health
promotion, and mental health.
- Apply a "health lens" to the development of all new legislation in
Canada. The federal government should also consider a Canadian Public
Health Act that promises citizens access to services that will optimize
their health potential.
- The Agency may struggle between its mandate to focus on infectious
diseases, for instance SARS, and its mandate to provide health promotion,
typically the former takes priority. However, in this region lifestyle
problems and health determinants pose a greater risk to population
health than infectious diseases.
Accountability
- The Agency should be governed by public health experts, not politicians.
2. Regarding Operational Strategies of a Public Health Agency of Canada
:
Collaboration and Communications
- The Agency presents an opportunity for improved collaboration and
for setting shared federal - provincial public health objectives. The
proposed network should foster research, innovation and collaboration.
- Pharmacists are the most accessible health professional, they can
play enhanced roles in underserviced communities and should be considered
a key partner in public health. They are ideally positioned to provide
health information to the public, and to make referrals to appropriate
services.
- The Agency's activities must build upon strengths and support
local public health efforts. Community Action Program for Children
and the Canada Prenatal Nutrition Program represent good examples of
federal programs that support and work collaboratively with local public
health providers.
- The responsibility for communications should be removed from politics,
development of a trans-Canadian public health information and communication
system would provide a common resource for local providers, while not
crossing jurisdictional lines.
Agency Activities
- The Agency can provide information that public health units need
to plan and evaluate programs, connect community providers, etc. Develop
standards for public health education and a virtual school of public
health.
- The Agency should be a catalyst for action but not the direct service
provider. It should support initiatives that are relevant and meaningful
to people in their every day lives.
- Establish national public health goals based on the determinants
of health and national standards to promote consistent access and practice
nation-wide.
- Establish a national strategy for palliative care.
- Make better use of the good research available which shows the effectiveness
of health promotion, for example, Dr. Gina Browne's work showing
the effectiveness of recreation and child care for single mothers,
etc. Disseminate research.
- Apply a "rural lens" to all Agency activities to ensure initiatives
are sensitive to the unique needs of rural Canada. Or, support targeted
rural initiatives.
Role of Nursing
- Public health nurses are the "glue" of the system. Apply efforts
to address the nursing shortage and improve workplace conditions to
public health settings. Establish wage parity for public health nurses.
- Create a Chief Nursing Officer for the Agency to support public health
nursing practice and represent the workforce at senior decision making
tables.
3. Investments:
- Reallocate resources to meet public health objectives.
- Ensure public health investments reach front line communities by
targeting them to local levels, as well as to specific objectives,
for example, cardiovascular initiatives, transportation, research etc.
- Fund a national daycare program to promote healthy pre-school development
and improve readiness for school. Such investment would result in upstream
savings across sectors, such as health care, justice system, etc. This
requires long term investment and political courage.
- Fund a national mental health promotion initiative; include a special
focus on children and youth.
- Invest in an electronic health record.
- Provide funding to support the visually impaired, especially for
alternate format books.
- The current system of provincial - municipal cost sharing for public
health diminishes accountability and results in inconsistent service
levels across the province.
4. Public Health Issues:
- Public health needs of an ageing population, since the region has
a high seniors population.
- Depressive illnesses will soon be the leading disease burden in Canada.
- This region has high youth suicide rates.
- Transportation is a key determinant of health, 85% of our population
lacks access to affordable transit.
- Rural area fare most poorly with respect to the determinants of
health. Poor access to primary health care, recreational programs,
has significant impact on rural residents.
- Public health crises in recent years have served to increase public
awareness of the issues. At the same time, public expectations are
increasing.
- Small rural communities and the voluntary sector are experienced
with innovation and stretching dollars, tap into that expertise.
- First Nations communities face unique health challenges requiring
specific attention and financial resources.