Nova Scotia Roundtable Report

In Halifax, the Minister of State met approximately 28 Nova Scotia 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

• Federal government needs to clarify and clearly define 'public health', and clearly define the federal role within it;
• Federal government has a major role in addressing:
  • New infrastructure development;
  • Health human resource shortages;
  • Surge capacity (in case of emergencies); and,
  • Education and training of public health professionals, including field epidemiologists.
• Agency should address health disparities between segments of the Canadian population and between regions in Canada;
• Agency should focus on public-health policy development; and,
• Governance:
  • Agency must be transparent, clearly accountable, and work at arms length from government;
  • Agency must work towards a long term vision; and,
  • Health Canada should evaluate what kinds of federal structures have worked in public health and what have not - and advise on the structure of the Agency.

2. Regarding Operational Strategies for a Public Health Agency

An Agency should consider:

• Building a national approach to public health around national public health goals and standards;
• Defining the roles that hospitals and infection control systems play, in order to integrate the health care system with public health infrastructures, so that the two are not separated artificially;
• Taking a multi-sectoral and multi-jurisdictional approach to its work;
• Committing to working in collaboration with provinces, territories and local governments, using a population health approach;
• Enhancing knowledge transfer between academics, decision-makers and community practitioners;
• Working to integrate the whole health and health care system, including using the Health Council to increase overall accountability of the health and health care system for the continuum of health;
• Making education and communication of public health and population health must a priority;
• Addressing current barriers to data collection. It needs to address privacy and ethical concerns, citizen autonomy and professional autonomy in the use and management of public health data;
• Focussing all programming on people and communities, and making it flexible; and,
• Ensuring the Agency's mandate to advance public-health research balances the collection of health-status data with research on outcomes of health strategies to determine effectiveness.

3. Investments

Participants urged an Agency to focus on the following priority investments:

• Canada does not need a lot of "bricks and mortar" around a National Agency. Rather, Canada should invest in developing new models and virtual networks, including significant investment in information and communication technologies;
• Funding must ensure a comprehensive public health infrastructure across the country;
• Funding required to address the lack of surge capacity and lack of flexibility in dealing with public health emergencies;
• Investments necessary to address inadequate local laboratory capacity - need a network of public health laboratories; and,
• Infrastructure issues are paramount - need funding to flow down to the local levels. Suggest targeted funding to bypass primary and acute care. Funding must be long term.

4. Public Health Issues

Participants also raised concerns about specific public health issues:

• Agency needs to recognize mental health as a public health issue; and,
• Oral health, largely ignored in policy, also needs attention as a public health issue.