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 drphealth@gmail.com
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