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Tuesday, 2 July 2013

Canada's Chief Public Health Officer is resigning - what does a changing of the guard hold in store for public health?

Thank you David.

After 9 years as the first Chief Public Health Officer and key architect of the Public Health Agency of Canada, David has bowed to the impacts of less than ideal health. 

A dominating figure in any room, with a booming voice and ability to mesmerize through his speeches, Dr. Butler-Jones has lead public health in Canada in many different settings as well as his current role.   He will best be known as the voice and face of the H1N1 response. 

While the agency he led was a product of a Liberal government reeling from the SARS catastrophe, his tenure in the position was under an ideologically opposite government that cares little for disease prevention and can perceive public health as a left wing plot.    

His major success,  for which we should be grateful was to have survived and maintained an independent and politically neutral public health agency throughout these years.   His legacy is the very agency that we have come to know as PHAC (pronounced P-hack by some, Fack by others).  Like all government activities, PHAC has taken its share of downsizing, but to the credit of its leadership – it has only taken its share and not more.  That he could hold his own amongst the political power brokers in Ottawa at the Deputy Minister level is likely a story that cannot be told but is part of his legacy.  That PHAC remains an autonomous agency is itself a credit to his leadership. 

His critics will comment on the lack of public profile, that even the annual reports lacked any government recognition or commitment, that he did not turn PHAC into the pan-Canadian public health enterprise that might supersede certain pockets of provincial power, and that on an international basis, Canada’s public health profile has diminished.  Were it not for the comments of critics, there would be no targets for his successor to address as they place their stamp on the role.  

While the easy questions about who fills his large shoes will form speculation across the country, the bigger question should be in how the Harper government will react to this ‘opportunity’ in the form of change?  The change in leadership provides a weakness in the public health structure that might well be manipulated - in a similar fashion to other changes under the current government.  And, don’t be surprised to see Minister Aglukkaq wandering the corridors of a new government department with a new Minister of Health charged with marching orders to limit the effectiveness of Canada’s Public Health Agency.  (DrPHealth does not mind being wrong,  and on this one, we can only hope that such a prediction is wrong).   Minister Aglukkaq has now walked the halls of the Ministry for 56 months, the third longest tenure for any Minister of Health since WWII (only topped by Jay Monteith at 66 months and Paul Martin Sr. at 126 months)

David, may good health find you.   Thank you for your decades of contribution to Canadian public health, and for all your future contributions.  

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