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Thursday, 20 November 2014

Public health officers under duress. How well do we stand up for Canadians?


This week saw public health officers nationally licking their wounds following a scathing commentary Globe and  mail - November 17th by a Maclean’s editor.   Colleagues within Canadian Doctors for Medicare among others responded G&M November 19 with a bolstering defense.  Those wishing entertainment need only scroll down to the commentaries submitted to either of the pieces to see the divisiveness of the debate.

As one commentary suggests - what is worse six health officers saying don’t limit our activity? or a magazine editor thinking they understand disease better than doctors?  

Colleagues, time for some solid reflection.  Clearly the debate on Canada's CPHO role has fueled burning embers and ignited a few fires.   There are those on either side of the fence that are using the opportunity to express opinions.  In the absence of a solid documented evidence base we have excellent individuals expressing opinions.  

The medical profession led by the Canadian Medical Association have increasingly migrated in the past few years to encouraging governments to address foundational issues that affect health and support those in staying healthy.  On National Children’s Day the Royal College issued a policy statement calling on greatly increased spending on early childhood development Royal college statement on early childhood development .  Such migration is also being seen in other health disciplines as well. 

However, the Globe and Mail editorial is a sobering reminder that Canada is a nation of diverse opinions,  and we are stronger for the diversity.  It is a reminder that as a public health professional we need to continuously justify our roles and carry our responsibilities with dignity.  It is a call to action to meet with those groups that perceive investment in social supports as a drain on their wallets rather than as a contributor to economic vitality nationally.  

To address the concerns on a moral basis will have limited benefit.  To speak in economic terms using well established value for money arguments will help influence the Peter Taylor’s of the world who are not prepared to accept moral arguments on the betterment of society. 
Can we use this latest in a series of onslaughts to rise to something better?  Or do we wallow in self-pity and fuel the skepticism of our critics?

It is notable that on numerous public attempts to eliminate or constrain the voice of public health, the public has risen in support.   It has been the behind doors suppression of the public health voice that has been most hurtful, and even more hurtful when such suppression is supported by other health colleagues. 

1 comment:

  1. A few emailed comments added below anonymously. Of note are the questions related to the final paragraph. Readers are encouraged to check out the February 25 2013 blog on this site on Muzzling civil servants, in particular the list of ways that backrooms and behind doors approaches are used to keep public health and other voices silenced

    "My impression is rather that our colleague seems to be saying
    - Non-public health health actors (CMA, RCPSC) are getting into the health game, so what makes public health special anymore
    - We need to engage people on monetary, not moral grounds, especially the libertarians

    The last paragraph is particularly confusing to me. It seems to suggest that if we as public health maintain that "dignified outlook", we will come out smelling like roses, even if the government (backdoor suppression) and the other non-public health health actors (CMA, RCPSC) are in cahoots.

    Interesting view, regardless.


    I think there are a few points...public health is shifting its focus, but are we doing as well as we like to think we are? Are we making enough of a case for the work of public health? Are we undermining our work ourselves? (I'm not sure if that's in reference to federal Ebola-related work).

    I re-read the piece a few times and I'm still not quite sure what they're trying to say....