Monday, 2 April 2012
Canada`s 2012 Budget - Public health implications
If Jim Flaherty’s Canadian 2012-13 budget was sending a message on public health, it is two fold – one that health is a provincial responsibility and the federal government is getting out, and secondly that the Conservative philosophy is that supporting big business will result in a healthier Canada. On the latter the only comment is what did we expect when we elected a Conservative majority? On the former, another cop out and downloading onto the provinces that are also reeling under financial pressures and squeezed by federal government offloading.
The NDP will take up the national health care banner in defence. We should be glad that somebody will, but it politicizes national health when a solid pan-Canadian pact that holds to the vision of the Canada Health Act is needed. Flaherty has already indicated that he is willing to impose the new social pact on health with the provinces without negotiation. It clearly is reminiscent of the school yard bully.
Drilling deeper, and remembering that often the devil is in the details that are not released. What does the budget signal?
Increased support for health professionals, particularly pharmacists, in their health business efforts. Changes to sales tax expectations will benefit other primary health care providers and expand the number of front line health professionals providing ‘service’.
Solutions are being sought for the medical isotope production challenge – a good move for the federal government to be taking leadership in.
Expectations of increased presence and service by Health Canada and PHAC in the Territories – also good news.
CIHR will see funding go down $30M and then half this reinvested in research – read into this what you will. It is a clear message on streamlining government administrations.
Gone is the Assisted Human Reproduction initiative – apparently the victim of a court decision that this is a provincial responsibility. No doubt that there is no funding being transferred to the provinces to assume the costs.
More subtly in the reduced discretionary funding for advertising, apparently the truth in food advertising work will fall to the wayside . This from a government that really did not savour loosing salt in its food when the recommendations of the pan-Canadian group came forward in 2010. Score another one for the “Big Food Industry”.
More obvious is the announcement on streamlining of environmental assessments. On the surface a clear message that prolonged debate over mega-projects will not be tolerated. Where the details need to be flushed out is do environmental and health agencies have clear assessment protocols in place now? They should and a sleeker assessment process would be appropriate and welcomed by all. The slimmer approach should not mean rubber stamped approvals – just coordinated assessment.
Ok, who are we kidding? Environment Canada is loosing over 8% of its staff, how are they to undertake a streamlined assessment process with fewer staff? It has taken decades to finally get public health impacts integrated into some of the mega-projects and consistency is already lacking.
Not surprising the Liberal legacy of the Public Health Agency of Canada has had the first shovels of its grave dug when supposed streamlined ‘increased efficiencies in mergering the backroom activities of similar agencies such as Health Canada and PHAC’. So expect the health assessment components of the mega-project assessments to take a big kick as well.
As the provincial budgets have been released, little positive in support of public health or investing in reducing inequities has been sounded. Conversely, the hacking sound of slashing has yet to be heard prominently despite the tough times being felt on the front lines.
In the midst of tough economic times which this blog has discussed (eg DrPHealth equity and taxation), the federal budget is receiving minimal criticism for what it has accomplished and what it threatened to do but didn’t. Not surprising a more detailed health analysis of the budget is needed, and strong comment made about:
1. Lack of federal leadership on health
2. Offloading of health costs onto the provinces
3. Early warning signs to reducing the role of PHAC
Readers who are aware of other public health messages in the 2012-13 budget are invited to send their comments and add to our collective understanding. Post a comment, or send an email to firstname.lastname@example.org