Transcript Dr. David Mowat, Deputy Chief Public Health Officer

PUBLIC HEALTH AGENCY of CANADA
L’AGENCE DE SANTÉ PUBLIQUE du CANADA
ANDSOOHA Annual General Meeting
Dr. David Mowat, Deputy Chief Public Health Officer
October 5th, 2005
COSTS - SARS
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Tourism
$200-$350M
Lost jobs
5250
Airline industry
$220M
Tax revenue
$161M
Non-tourism retail sales $380M
Provincial health system >$1B
Deferred medical care
Exhausted health workers
The Naylor Report
Recent History
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Blood – Krever Enquiry
Walkerton, North Battleford
Capacity Report of ACPH
Chronic Diseases
The Current State
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Emerging and re-emerging diseases
Global travel and trade
Bioterrorism
Food & water-borne disease
Obesity, diabetes, syphilis
Persistent inequities
“The preventable goes unprevented”
New, Emerging & Re-Emerging Diseases
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HIV/AIDS
Legionnaire’s
VTEC + HUS
SARS
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Hepatitis C
H5NI Influenza
Rabies
TSEs
ARO
Reported Infectious Syphilis Rates in Canada by sex,
1993 – 2002*
3
Rate per 100,000
2.5
2
male
1.5
female
total
1
0.5
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Year
*Data for 2002 are preliminary and changes are anticipated
Source: Sexual Health and STI Section, Community Acquired Infections Division, Health Canada 2003
Public Health
• the organized efforts by society to protect,
promote and restore the health of the entire
population
A properly structured and functioning
public health system will contribute to:
• Improved levels of health status of the population
and decreased health disparities
• Decreased burden on the personal health services
system and thereby contribute to its sustainability
• Improved preparedness and response capacity for
health emergencies
Public Health in the Background
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semantic confusion
long-term perspective
probabilistic outcomes
negative outcomes
diffuse vs. concentrated interest
weak links to academia
F/P/T issues
complexity
funding
voice
PH in Canada - Overview
• Provincial/territorial mandate to protect the
public’s health and deliver public health services.
– public health activities in each jurisdiction governed by
public health act (or equivalent) and regulations, and by
other specific legislation.
• Planning, programming and delivery of services
devolved to regional/local structures.
– elected/appointed boards responsible for planning and
delivery of all health services.
Governance
• 3 patterns:
– Regional health authorities/districts
• responsible for all health services (the most common pattern).
– Regional/district boards
• responsible for public health and other community services.
– Quasi-municipal (Ontario)
• Responsible for public health and other community services serving single or multiple municipalities, with boards
appointed by both municipality and province.
– Provincial only (small jurisdictions)
Governance (2)
• Aboriginal populations
– Public health services provided by:
• FNIHB
• or
• a variety of contracted arrangements (transferred
communities)
Legal Basis
• Department of Health Act
• Acts for food, drugs, pesticides, radiation
• Quarantine Act, Importation of Human
Pathogens Act
• P/T privacy legislation, PIPEDA
Federal Roles
• “own jurisdiction” – e.g. Quarantine,
aboriginal
• national leadership
• highly specialized services
• efficiencies of scale
• “naturally” national issues, e.g. HHR
• surge capacity
• International
Federal Strategy
• 2004 and 2005 Budgets
• Agency & CPHO
• Pan-Canadian Public Health Network
Funding
Agency:
$404m existing
$80/85m additional 2004 & on
$60m p.a. additional 2005 & on
One-time: $300m immunization
$100m public health,
general
$100m Infoway
The Response (2)
the new Public Health Agency of Canada
Prime Minister Paul Martin launched the
new Agency on September 24th, 2004
– Dr. David Butler-Jones appointed Chief Public
Health Officer (CPHO)
– Headquartered in Winnipeg and Ottawa, with
offices across Canada
Federal Health Portfolio
Minister of Health
Minister of State,
Public Health
President, CIHR
Deputy Minister
of Health
CPHO
Canadian Institute
of Health Research
Health Canada
Public Health
Agency of Canada
PHAC Organization
Dr. David Butler-Jones
Chief Public Health Officer
Infectious Disease
and Emergency
Preparedness
Dr. Paul Gully
Deputy CPHO
Health Promotion
and Chronic
Disease
Prevention
Public Health
Practice and
Regional
Operations
Dr. Sylvie Stachenko
Deputy CPHO
Dr. David Mowat
Deputy CPHO
Corporate
Services
Jim Harlick
ADM
Infectious Disease and Emergency
Preparedness
Centre for Infectious
Disease Prevention and
Control
Dr. Frank Plummer/Bersabel Ephrem
Centre for Emergency
Preparedness and
Response
Dr. Ron St. John
National Microbiology
Laboratory
Dr. Frank Plummer
Laboratory for Foodborne
Zoonoses
Canadian Science Centre for Human
and Animal Health
Dr. Mohamed Karmali
Health Promotion and Chronic
Disease Prevention
Centre for Health
Promotion
Claude Rocan
Centre for Chronic
Disease Prevention
and Control
Dr. Greg Taylor (A)
WHO collaborating centre for
chronic disease policy
Dr. Clarence Clotty
Public Health Practice and Regional
Operations
Office of Public Health
Practice
Regional Offices
Dr. David Mowat (A)
Gary Ledoux
Infrastructure
(as in Naylor Report)
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Renewing laboratory infrastructure
Building Research Capacity
PHAC
Pan-Canadian Public Health Network
Clarifying Legislative & Regulatory
Context
• Information & Knowledge Systems
• Renewing Human Resources
Evidence-based decision-making
• expansion of research related to public
health
• synthesis
• identification of research gaps
• knowledge translation & exchange
• more research on KTE
• all require more people and more skills
National Collaborating Centre Program
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determinants
policy & risk management
tools & methodologies
infectious diseases
environment
aboriginal
Workforce Issues
• Naylor report Learning from SARS (chp. 7 on health
human resources)
• Unfilled positions in many PH occupations
• Existing PH staff need skills upgrading
• Insufficient number of new graduates
• Aging workforce, uneven distribution, etc.
• Prior emphasis on research only
• Increased demand
“No attempt to improve public health will
succeed that does not recognize the
fundamental importance of providing and
maintaining in every local health agency
across Canada an adequate staff of highly
skilled and motivated public health
professionals”
The Naylor Report 2003
Gaps
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non-thesis masters
practice-based education
faculty with experience in practice
access & flexibility
cross-disciplinary education
continuing professional development
exposure of students
New & Expanded Federal Programs
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Canadian Field Epidemiology Program
Skills Enhancement Program
Competencies & HHR planning
Community medicine residency funding
Scholarship Program
Competencies
A Foundation Piece
used for: planning
job specification
educational development
curriculum development
Pan-Canadian Public Health Network
• New way of working with provinces and territories on
public health
• Key mechanism for national collaboration
• Will bring together experts/officials from all
jurisdictions
• Facilitate national approaches to public health policy and
planning
Pan Canadian Public Health Network
Proposed Initial Structure
Issue Groups
Expert Groups
Issue Group
( 13 )
(permanent expertise)
Communicable Disease Control
Issue Group
(3)
Emergency Preparedness & Response
Issue Group
(1)
Canadian Public Health Laboratory
FPT
Conference
of Deputy
Ministers of
Health
Council
FPT members
(14)
Is accountable to
Surveillance and Information
Issue Group
(2)
Non-Communicable Disease & Injury Prevention
& Control
Issue Group
(5)
Health Promotion
Task Groups
(time limited)
Task Group
Existing
In development
To be developed/
or aligned
( #) indicates number of Issue Groups
Issue Group
(4)
Pan-Canadian Public Health Strategy
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Goals
Specific health targets
Benchmarks for progress
Collaborative mechanisms to maximize pace of
progress
• Collaborate with all departments, jurisdictions and
stakeholders
Conclusion
• Canada’s Public Health Agency…an
important step towards making
Canadians “the healthiest population in a
healthier world”.