Mr. Chair and committee members, thank you for inviting me to make submissions about Bill C-43 concerning changes to the Public Health Agency of Canada Act.
By way of background, I'm an assistant professor of law and director of the global strategy lab at the University of Ottawa. My research focuses on global health governance and institutional design.
Based on my research, it's clear that our chief public health officer needs an independent voice and the ability to speak scientific truth to members of the public and to those in power. This bill, in splitting the chief public health officer's role in two—one part technical, one part administrative—removes the little independence this position once offered. This bill achieves this effect by demoting the chief public health officer from his current deputy minister rank, by removing his direct line to the minister, by making him subservient to a bureaucratic agency president, and by eliminating reimbursement for his public activities.
Any loss of independence matters because it erodes the trust that we can all place in our chief public health officer of Canada. In reviewing this bill, it seems to me that we've forgotten the harsh lessons of SARS. It was just 11 years ago, in 2003, when the World Health Organization slapped Toronto with a travel advisory, costing that city $2 billion and 28,000 jobs. That's a lot of money and a lot of jobs. This loss was not because of the number of SARS cases. Singapore had a similar number. The loss was because the federal government did not have a trusted public health leader who could effectively coordinate with the provinces and communicate the outbreak status with other countries.
SARS shone a light on the hurdles that Canada's version of federalism places before effective pandemic responses. Significant changes followed, including the creation of the Public Health Agency of Canada and its chief public health officer. The big idea behind all of this was that we needed to build trust. Provinces and their public health departments needed a guarantee that the federal government's public health pronouncements were based on scientific principles, rather than political talking points. Unfortunately, this guarantee was never realized. The chief public health officer was made an officer of government instead of an officer of Parliament, thereby preventing him from exercising full independence, as our Auditor General or Privacy Commissioner would have. Let there be no doubt about this: in my mind that was a mistake.
But this bill takes us even further away from where we need to be. At least the original legislation gave the chief public health officer some independent powers to speak and be reimbursed for those public activities. This encouraged the provinces to buy into a nationally directed system. The removal of these limited independent powers is not helpful. On this basis, demotion and politicization of the chief public health officer is undoubtedly a wrong-headed move. With an Ebola outbreak raging in West Africa, it seems that this isn't the right time to be weakening our national public health infrastructure. This change would make us less prepared for Ebola and other diseases like it.
I understand that last week this committee heard contradicting testimony from the new chief public health officer. I understand he said that shrugging off managerial oversight of the agency would free him to focus on providing scientific advice. He might win back some of his time, but I think we all need to ask this question. After his demotion, will anybody be listening to him? Will his bureaucratic boss even allow him to speak?
Ultimately, if this change really must go forward, I would suggest two very small revisions that would lessen its harm.
The first is to add a provision granting scientific independence to the chief public health officer and legislatively allowing him to speak without political interference.
The second is to just drop section 258 that would remove the reimbursement for the chief public health officer in performing his public duties.
These two small changes would ensure that the chief public health officer could serve that interprovincial coordination function that was shown to be so important in SARS, and ultimately be trusted by all Canadians.
I would have suggested a third small revision, to maintain the chief public health officer's deputy minister rank, which is important for him to access federal decision-making tables, but I think I'm already pushing my luck by suggesting any changes at all.
Just to conclude, in coming here today my only hope is that we won't need another SARS or Ebola in Canada to make us realize the harm that the proposed changes would cause. I implore you to do whatever you can to minimize the bill's damage. We would all be less safe with these proposed changes, and we're all going to suffer the consequences if the committee allows them to pass.
Thank you.