Monday, November 02, 2009

Conservative public health choices coming home to roost

At the height of the listeriosis outbreak, as the Conservatives were messaging and stifling any accountability on that health crisis, the journal of the Canadian Medical Association reminded us of what the Conservatives have done, since taking office, on the public health front:
The listeriosis epidemic is a timely reminder that the Harper government has reversed much of the progress that previous governments made on governing for public health. Following the 2003 SARS epidemic and subsequent recommendations of the National Advisory Committee on SARS and Public Health,7 the Public Health Agency of Canada (PHAC) was created and given its own minister in government — a direct line to the prime minister. But in 2006, among Prime Minister Stephen Harper's first acts was to eliminate the PHAC minister and public health's seat at the Cabinet table. His government also left the chief medical officer of health within the ranks of the civil service, working under the minister of health. In so doing, it left our country without a national independent voice to speak out on public health issues, including providing visible leadership during this crisis.

And listeriosis may be the least of it. The same November 2007 Cabinet decision that handed self-inspection to the owners of meat plants did the same for operators of animal feed mills and cut back the avian influenza preparedness program. Yet bad animal feed led to the epidemic of bovine spongiform encephalitis (mad cow disease), and in an influenza pandemic tens of thousands of Canadians may die.8 Listeriosis pales in comparison. Overall, it would seem that, as a country, Canada is far less prepared now for epidemics than in the past.
Combine that with questionable funding choices that have accompanied their pandemic "preparedness."
In the 2004 Budget we put in place a trust fund for the provinces of $100Million dollars to build the capacity for front line public health. In 2007 the Conservative government cancelled the fund. The 2006 Budget booked $400 Million for Pandemic RESPONSE. We now find out that this government put the reserve fund into 5 annual packages of $80M and each year without a pandemic the money disappeared. The Minister of Health has continued to state that she was working with the provinces and territories, but she has unilaterally decided that the Provinces and Territories would pay for 40% of the costs of the vaccine and ALL of costs of the administration of the vaccination programme. The provinces and territories have been asking for help. The government has refused to listen. (emphasis added)
The public health choices of this government are there for all to see and experience over these weeks. Hopefully Canadians will start tweaking to the impact of the voting choices they are making in the next election. There are reasons why this H1N1 vaccination rollout has become a confusing spectacle and there is plenty of Conservative responsibility to account for it.

(h/t anndouglas on twitter)