Report: A Public Health Agency for Canada

Working Group on a Public Health Agency for Canada April, 2004

II. A Chief Public Health Officer for Canada

One of the main recommendations of the Naylor Report was a proposal to create a Chief Public Health Officer (CPHO) for Canada. Naylor noted:

"The Chief Public Health Officer would be a leading national voice for public health, particularly in outbreaks and other health emergencies, and a highly visible symbol of a federal commitment to protecting and improving Canadians' health...."

Naylor further suggested that the duties of the CPHO be to:

• "protect and advance the health of Canadians by advocating for effective disease prevention and health promotion programs and activities".
• "articulate scientifically-based health policy analysis and advice to the federal Minister of Health and, as requested, provincial and territorial Ministers of Health, on the full range of critical public health and public health system issues".
• "provide leadership in promoting special health initiatives (e.g. relating to health inequalities, childhood injuries, Aboriginal health) with governmental and non-governmental entities, both domestically and internationally".
• "elevate the quality of public health practice in professional disciplines through the advancement of appropriate standards and research priorities."

The Working Group supports these duties as the "core mandate" for the CPHO. Building from this base, the specific responsibilities of the CPHO should be to:

• Act as the Chief Executive Officer of a new Public Health Agency.
• Coordinate the federal government's policies, programs and services in the area of public health.
• Provide advice to Ministers, and as appropriate work with provincial and territorial governments, the international community, the public health community and individual Canadians on public health issues.
• Assume the role of the federal government's lead health professional and officials' level spokesperson on public health issues, particularly emergencies.
• Play a leadership/advocacy role in national public health matters and citizen engagement in public health.

In effect, the CPHO should be a widely recognized symbol of our national commitment to the protection and improvement of the health of Canadians. In that capacity, the CPHO should oversee the direction and all operations of the public health agency described below, and would be accountable for ensuring it carries out its tasks in accordance with its mandate; in particular with regard to the scientific excellence of activities, the adequacy of the services it provides, and the transparency of governance and management processes.

The CPHO should also be expected to work collaboratively at a number of levels in order to develop and implement comprehensive strategies for disease prevention and control, while providing national leadership and coordination of policies and programs that promote health and encourage the avoidance of health risks. In doing so, the CPHO would manage a complex range of specialized subject areas and an equally varied mix of professional and technical experts.

With regard to public health emergencies, the CPHO should lead and coordinate national public health responses, in collaboration with other federal departments or agencies, provincial and territorial authorities, and local officials responsible for emergency preparedness and the protection of the public against public health threats. Finally, the CPHO should represent the Government of Canada within a variety of arenas, including international forums and organizations.

Meeting these needs will require a person of considerable skill and experience. It will also require someone who has capacity and confidence both within the realm of government, and more broadly, in the practice and delivery of public health services. In this context, the Working Group believes the CPHO should be a senior Governor in Council appointment, reporting to the Minister of Health, and that necessary qualifications for this position should include:

• Demonstrated experience and leadership at the professional level in the field of public health.
• A licensed health professional qualification in medicine, nursing or another profession associated with the field of public health, as well as a post- graduate university degree in public health or a closely related field.
• Experience in the administration and management of a scientific or professional organization.
• A demonstrated capacity to build and maintain relationships with the research community, and if possible, experience in academic research.

Finding a person who can ably meet these qualifications and fulfill the responsibilities of this position will not be an easy task. In this context, the Working Group believes there would be merit in launching a broadly-based search utilizing a dedicated recruitment committee that includes recognized members of the public health community. Such a search should be undertaken in a clear and transparent manner.

While such a search should appropriately include national and international advertising, the Working Group believes there is merit in ensuring that first consideration is given to qualified Canadians, residing either in Canada or abroad.

As noted previously, a key role for the CPHO will be to act as the Government of Canada's chief spokesperson at a professional level on public health issues - especially in times of emergency. To play this role effectively, it would be preferable for the successful candidate to be fluent in both of Canada's official languages. That said, the Working Group recognizes that there will likely be a limited pool of potential candidates for this position. To this end, it is the Working Group's view that:

• Fluency in both English and French should be a preferred consideration in assessing potential candidates for the position of CPHO.
• As a requirement, all other senior executives in the new Agency should be required to maintain a high level of fluency in both English and French, consistent with that normally required for bilingual positions in the senior federal public service.
• Beyond this general capacity, a fully bilingual senior health professional should be specifically designated within the Agency to assist the CPHO with public communications - and particularly emergency communications - in the event the CPHO is either unable or unavailable to perform his or her duties.

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