Hello, Mr. Chairman, and thank you.
I'll very briefly say thank you for the opportunity to present at this hearing. I'm going to speak as an individual, although I'm affiliated with the university and with other organizations that I won't take the time to describe at this moment. I'm going to speak mostly from my experience as a provincial chief public health officer in Manitoba, which I was for 12 years, and from my work in public health in general.
I'm going to approach the changes proposed to the Public Health Agency of Canada Act from the perspective of how I think they might have impacts on the effectiveness of the chief public health officer in particular, but more broadly on the ability of the Public Health Agency of Canada to fulfill its roles and mission. I think many important points have been raised by previous witnesses, and I look forward to the question and answer period, where we can go into more of those in some detail.
I believe there are pros and cons in these changes, so I'm going to go through what I think are the most important ones, and I'm going to frame it on what I'm going to call “six functions” of the chief public health officer. I will look at each one and how they may be affected by the way the act is written now, and with the changes that have been proposed.
The first function is that of adviser to the minister, and of course in this case it's the Minister of Health. The old act specified that the role was to assist the minister and to be “the lead health professional” within the Government of Canada. I believe that has not changed. Specifically, there is now a clause that says the role is to advise the minister and in addition the president—this is the new role—of the Public Health Agency and that it should be “on a scientific basis”. I think it could be a good thing to have made that more clear, because that is the role of the chief public health officer with respect to government, particularly through the minister to the government.
The second function is that of communicator to the public, a very important role that others have spoken about, because the act allows the chief public health officer to prepare and publish a report on any issue related to public health. That has not changed. I do not believe that the ability of the chief public health officer to communicate to the public freely and without direction by the minister—or now by the president of the agency, as proposed—should be changed. I certainly hope that it isn't changed. I'm also hopeful that the interpretation of “reports” is broad, and that includes all communications to the public and to anyone else that the chief public health officer feels he or she needs to communicate with.
With regard to the leadership of the agency itself, I think there are many models that exist across this country in the provinces and also around the world and, frankly, I'm not sure which is the best. However, I don't think this model that's being proposed necessarily diminishes the ability of the chief public health officer to continue to provide advice to government and also to influence the leadership and decisions in a collaborative way with the lead administrator, who has the deputy head status. As I think was pointed out, if the two of them can't figure it out together, they must have it resolved by the minister. That's actually the way it goes in public health departments of governments anyway, because in the act, as is the case in most provinces, it is the minister who is really responsible for government public health practice. That's I think mostly as it should be, because the political decisions that are most important in public health need to be made by elected officials and their governments.
As far as collaborating with other chief public health officers goes, I think that being a deputy minister potentially could be—and has been—a difficulty there, because other chief public health officers are not at that level. The ability to be equal collaborators and then bring advice through the conference of deputy ministers to the ministers in a collaborative way can be limited by having one of them designated as a deputy minister. Also, my observation and experience, without reference to individuals, is that being at the deputy minister level makes it even more difficult to speak freely and independently to the public.
Finally, I would like to just say this about the act itself. Where it needs most strengthening, or at least most use, is to recognize that regulations can be brought in to collect and analyze data across the country that so far has not been used. The agency itself has not had the power to coordinate and collect information, when needed, on a national basis to deal with a national issue.
I'll make one last point around the capacity of the chief public health officer within the agency. Whether this is written into the law or just understood as policy, I think it's very important for there to be a strong office for the chief public health officer, with a deputy chief officer and a staff including research assistants, communications people, and others who can ensure that those functions of the chief public health officer are preserved, no matter what.