Canada’s public health system is “stretched dangerously thin,” and without urgent attention, future patients will suffer, Canada’s chief public health officer said in her annual report.
“The COVID-19 pandemic has served as an important wake-up call,” Dr. Theresa Tam said at a press conference Monday.
“Simply put, we were not prepared to face a public health emergency of the magnitude of COVID-19. We can no longer dismiss the voices or delay necessary actions — there are increasingly urgent signs that we need to act now.”
The report contains several suggestions for improving Canada’s public health system, including improving data-sharing and pandemic surveillance tools, strengthening the role of public health in federal and provincial governments, ensuring stable funding for public health, and recruiting and retaining the public health workforce.
“We must renew and reinvigorate our public health workforce. The pandemic has seriously impacted public health workers across the country, with frequent reports of burnout,” Tam said.
This is an area that Canada definitely needs to work on, said Sara Allin, an associate professor at the Institute for Health Policy Management and Evaluation at the University of Toronto.
“There’s been huge issues with recruiting and retaining workforce,” she said. “If you look at the whole health system, health human resources is going to be a major challenge going forward, which is not unique to Canada, but it’s a major challenge that we will face for many years to come.”
Health stakeholders generally agree with the report’s conclusions about the state of Canada’s public health system.
“The foundations of the public health system within Canada have been neglected for too long. And it really shouldn’t have taken a pandemic for us to realize that investments in public health pay off down the road,” said Dr. Katharine Smart, president of the Canadian Medical Association.
Governments need to invest now, she said.
“It’s very clear that these issues cannot wait and Canadians cannot continue to wait for care,” she said.
“The health-care crisis is not going away. Even when the pandemic, hopefully at some point ends, we’re going to be left with hundreds of thousands of Canadians who still have health-care needs that need to be addressed.”
The Canadian Public Health Association applauded the release of the report, in particular the call for a stronger role for public health governance and stable funding.
“In order to be better prepared for the next infectious disease outbreak, we need federal legislation for public health – a Canada Public Health Act – with clear roles and responsibilities defined for all governments and stakeholders,” CPHA executive director Ian Culbert said in a press release. “Such legislation would require a national funding accord that incorporates performance measures for the delivery of public health services according to national standards.”
Funding for public health tends to dry up shortly after a crisis, Tam noted.
“As we have seen in the past, public health resources are often scaled back after public health emergencies as governments move to address other priorities,” she said.
Having stable funding tied to specific outcomes would help to maintain the public health system, Tam added.
Canada has been here before, Tam said – every chief public health officer has called for the renewal of Canada’s public health system since at least 2008.
“The eternal struggle of public health” is that it tries to prevent disease or injuries from happening, Tam said, and as a result, it’s hard to prove that it’s working – since by definition there is often nothing to point to.
It also takes a very long time to see results, she explained, with programs taking multiple years or spanning several election cycles.
“Investing in public health is about that longer duration and sustained effort,” she said. “Without further investments, we will not be able to tackle the health impacts of climate change, antimicrobial resistance, mental health issues, so our population will fall behind.”
— with files from Global News’ Jamie Mauracher
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