Sudbury Roundtable Report
April 13, 2004
In Sudbury, 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 must be comprehensive, extending beyond infectious diseases
to include chronic diseases and health promotion, and addressing the
full range of health determinants. There was concern with the notion
of a "phased in" approach, ie, one that focuses on infectious diseases
first, other issues second, because of the risk that the other phases
will never come.
- Clearly define public health and articulate how the Agency's
mandate will fit within this definition. Define the core functions
of public health, and establish national consensus. Consider those
identified in the CIHR report: population health assessment, health
surveillance, health promotion, disease and injury prevention, and
health protection.
- Ensure that the full range of government policies and programs support
public health objectives by applying a public health "lens" to policy
decision making across all departments.
Accountability and Citizen / Stakeholder Engagement
- The Agency must be accountable to Canadians, and decision making
must be transparent. This can be accomplished by:
- Developing a balanced scorecard / "report card" for public
health;
- Encouraging citizens to participate in the Agency's
governance through membership on its board, with outside expertise
provided through advisory committees of health professionals
and other experts; and,
- Ensuring that responsibilities to the Canadian public, other
levels of government and in international fora are well articulated.
- The Agency should also engage Canadians by:
- Encompassing principles of social inclusion;
- Going beyond elected representatives;
- Involving citizens in its design; and,
- Learning from experts who currently engage citizens, such as grass
roots coalition groups.
Regional Considerations
- Ensure the Agency addresses regional inequities in health status.
Areas of greatest need are those with decreased access to resources
and capacity, for example, the north.
2. Regarding Operational Strategies for a Public Health Agency of Canada:
Communication
- Communication is paramount; it must be:
- Clear and consistent to be credible (SARS was cited as an example
where messaging was confusing and sometimes contradictory);
- Delivered through multiple channels (do not rely only on technology)
in order to facilitate widest possible dissemination; and,
- Timely, this includes French language translation of communications
(written and oral) for Official Language Minority Communities.
- Make better use of the media to communicate. Ensure messages get
to sometimes difficult to reach groups (ie, seniors).
Collaboration and Integration
- Intergovernmental cooperation is key, extend the concept beyond
federal - provincial - territorial to include municipal governments.
- Involvement of local public health units is paramount, especially
in program and service delivery.
- Pharmacists are the most accessible health professional - more Canadians
enter pharmacies than any other health care institution in the country
- and they need to be engaged. Pharmacists can play three important
roles:
- Advisors, informing policy makers of community needs, the
effectiveness of initiatives, etc;
- Conduits, delivering PH services and education; and,
- Sentinels, signalling emerging community symptoms.
- Establish partnerships with municipal social planning councils.
- Ensure activities impacting public health are vertically and horizontally
integrated among all sectors, including:
- All other levels of government;
- Non-governmental organizations (NGOs);
- Other government departments (beyond health); and,
- Stakeholders.
Agency Activities
- Set national public health standards and guidelines to ensure equity,
reduce duplication and make better use of limited resources.
- Once the core functions of public health have been identified (see
section on "Broad Scope" above), identify the specific competencies
needed by the Agency and public health professionals to guide public
health education, research and practice.
- The Agency should assess the strengths and weaknesses of the current
system. Build upon existing innovation, expertise and success. Local
examples include the Northern Ontario Medical School, the Public Health
Research Education & Development (PHRED) Program and the Northern
Ontario Child Consortium.
- Implement Canada's Drug Strategy.
3. Investments:
Funding Mechanisms
- Ensure that adequate resources are provided to fund public health
at all three levels of government.
- While municipalities are willing to stay engaged in supporting /
promoting the public health of its citizens, they would like to revise
the current 50-50 cost sharing funding formula so that the full municipal
public health budget is absorbed by the province.
- Target investments to traditionally overlooked areas such as addiction
services, harm reduction, mental health, etc.
4. Public Health Issues:
- "Northern factors" that impact the health of the population include
small communities spread over large distances, weather, and disparities
in resources, compared to larger southern centres. These factors exacerbate
the inequity and access issues facing northern Ontarians. Lack of services
in language of choice also impedes access.
- The most effective way to improve the health of the population is
to integrate the population health approach with individual health
care. This is the principle underlying the World Health Organization's Unity
for Health declaration.
- Focus on the determinants of health to improve population health,
they are more influential than health promotion efforts targeting lifestyle.