Regina Roundtable Report
In Regina, the Minister of State met approximately 16 Saskatchewan 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
- Mandate for an Agency is not just about infectious disease:
- Must also be about chronic disease; and,
- Suicide and motor vehicle accidents are also big killers.
The Agency will have to work on those kinds of issues, even if
the political opportunity to create the Agency arises because
of infectious disease crises.
- Agency has to create opportunities for Canadians to have healthy
choices at their disposal. For example, alcohol is same price across
Saskatchewan, but milk is 5 times as expensive in northern parts of
the province as in the south;
- Agency must be closely and quickly linked to the research community:
- This includes links to US research; and,
- Agency needs an ability to contract applied research quickly
to respond to emerging threats.
- Mandate should be promotion and protection; and,
- Agency has a key role to transfer knowledge between public health
regions across the country:
- Local authorities do not have the resources to share information
and coordinate approaches nationally; and,
- Real measure of the Agency's success will be the ability to
engage communities.
2. Regarding Operational Strategies for a Public Health Agency
An Agency should consider the following:
- Undertaking ongoing citizen engagement:
- The Romanow Commission on the Future of Health Care taught
Canada that citizen engagement works;
- Current expert consultation is not citizen engagement; and,
- Citizens understand the determinants of health and they want
to have that consultation.
- The unique priorities of First Nations communities:
- How will the Agency combine evidence-based public health practice
with traditional health practice when dealing with such matters
as diabetes, smoking, addiction, etc?
- Offering "guidelines" rather than "standards" would allow
a new Agency to engage the unique needs and abilities of First
Nations communities;
- On-line public health education is a "huge problem" in many
First Nations communities because of access to technology; and,
- First Nations need true collaboration with Health.
- Agency needs to look at the social determinants of health - like
housing - especially with regard to helping the following groups be
able to pursue healthier lifestyles:
- Aboriginal communities;
- Women living in poverty; and,
- Women living in rural and remote areas.
- Agency can only keep its focus if it has set, and is working towards,
a national public health strategy:
- This should be an early product - to be delivered through
the federal-provincial-territorial network; and,
- The network should start with setting health priorities.
- Linking closely with community-based organizations:
- They deliver programs most effectively; and,
- The Agency should link these community-based organizations
with the research community to evaluate what community practices
work and what don't.
- Looking at health delivery in Fransaskois communities as a model
for delivering information to front-line workers:
- We are building a network of services for our community -
it could be a model for the Agency; and,
- Distance learning - we have a system in Saskatchewan that
connects all our community centres - and we are open to partnering.
- Advancing on mandatory food labeling and increasing the number of
mandatory food inspections;
- An Agency would have to plan "inter-jurisdictional" with provincial,
territorial and local governments:
- No room for federal unilateral action that creates tension
in the federation; and,
- Can't be simply a debate about money. It must also be about
the fundamental principles of good health care for all Canadians.
- Setting and applying public-health standards across the country:
- Currently, different governments decide on which standards
to apply; and,
- Public Health Agency of Canada should focus on quality assurance
of public health standards throughout the country.
- Working closely with veterinarians and animal-health research:
- Large number of new and emerging diseases in people have their
origins in animals.
3. Investments
Participants urged an Agency to focus on the following priority
investments:
- Developing a network for public health training:
- The federal Agency can't rob the best public health talent
from across the country. It has to build capacity, develop ways
to train people and make access to training easier;
- This should include public health units training public health
professionals in the same way that teaching hospitals train doctors
and nurses;
- Training should be both applied and academic - so that academics
can experience real work public health issues, and public health
practitioners develop useful research questions; and,
- Front line staff have problems with computer-based distance
learning in public health:
- Few in remote areas have access to a computer; and,
- Even if they do, there is no one to cover their work while they
are studying.
- Local H.R. capacity in public health is more important than a national
vaccine stockpile:
- Public health staff at the local level allows us to respond
to daily issues, and not just crises.
- Develop a health status and infectious disease surveillance system:
- There has been a problem getting investment because governments
believe the need for surveillance isn't as great as the need
for an advanced diagnostic machine (e.g. MRI).
- Governments cannot choose between addressing waiting lists and addressing
public health. They have to manage both:
- Need to better integrate public health into the rest of the
health system; and,
- Must protect funding so that funding for public health units
doesn't get siphoned off by needs of the acute care system.
4. Public Health Issues
Participants also raised concerns about specific public health
issues:
- Mental health services have never really been addressed in the discussion
about the public health agency of Canada .
5. Chief Public Health Officer
- The Chief Public Health Officer has to be a key public health leader
- not a manager, but a public leader;
- The Chief Public Health Officer should relate to the World Health
Organization the way that Canada's chief veterinarian currently relates
to the multilateral organization monitoring international animal epidemics
in Paris; and,
- The Chief Public Health Officer's advisory board should not be a
governance body. It should be strictly advisory:
- It should not include MPs;
- Should have no more than 20 people; and,
- No more than four members should be provincial, and no more
than four should be federal.
Other members should be from public health groups - including at least
one veterinarian and a livestock expert.