Now that we have a new Conservative Party leader, let's have a closer look at his health policy platform...
"[R]especting the fact that healthcare is a provincial responsibility" and the feds "should not be telling the provinces how to run their systems." Concern that this is code for allowing provinces to explore privatization and feds may not enforce the Canada Health Act.
"Augmenting international recruitment of healthcare workers." While Canada does need to work on recruitment, this doesn't even acknowledge the concerns with recruiting workers away from countries with fewer resources than Canada. See WHO Code of Practice: who.int/hrh/migration/…
"Diversifying our supply chains for critical supplies" like drugs and PPE. Depending how the gov goes about this, this could be a good thing. Drug shortages/shortages of raw ingredients have been a problem in Canada for years. For a brief discussion: theconversation.com/how-coronaviru….
"Speeding up the approval of new medications and health technologies, so that Canadians get access to life-saving innovation." This is an important issue but would have to be done properly or we risk sacrificing safety for quicker access. See eg: jamanetwork.com/journals/jamai…
"Convening a Royal Commission on the Pandemic within 100 days of taking office." Post-COVID review is obviously important, but this may duplicate efforts that will have already occurred by then. If a review is already complete, he should instead focus on implementing reforms.
Working with provs "to strengthen support for mental health across Canada." Whether this is a good thing depends on what the feds do. For example, we don't need Alberta's approach to addictions making its way to other provinces.
I will stay in my lane and won't comment on environmental, immigration, gun control, etc. policies. However, others have raised concerns in these and other areas, which affect health and the social determinants of health.
Protect "the conscience rights of all health care professionals whose beliefs...prevent them from carrying out or referring patients for services that violate their conscience." Removing the duty to refer is concerning and may significantly limit access to abortion and MAiD.
Reform the Not Criminally Responsible designation to protect public ensure "those who commit heinous acts do not escape justice or walk free after a short period of time." This may risk criminalizing mental illness and not taking rehabilitation goal of criminal law into account.
Toughen "penalties for elder abuse and broadening the definition to ensure that mistreating or failing to care for vulnerable seniors is a criminal offence." This is a very incomplete solution to the problems in long-term care.
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Manning report on covid has dropped. Notably, the panel's mandate wasn't to look broadly into the management of covid, but more narrowly to look at governance in a public health emergency. /1
I'm not going to disparage any specific person, but it is fair to say that the panel's composition seems designed to reach particular conclusions on the issues. /2
Report immediately mischaracterizes who makes decisions in a pub health emergency by putting Cabinet at the top of the list and saying cmoh is merely "highly relevant". Although that's what happened during covid, the law is quite different (for now...see bill 6). /3
Watching the presser on changes to the health system...
Smith highlights challenges with staffing and surgical wait times, but unclear how their proposed reforms will fix any of this. Says that current system lacks accountability and falls short on putting patients 1st /1
Delivery system will now focus on 4 areas, each with their own organization: primary care, acute care, continuing care, mental health & addiction. Calls current AHS structure "scattered" and "rigid". Will apply province-wide to avoid pre-AHS regional fragmentation. /2
Smith says this new model will be more responsive to issues, better able to mange performance, more accountable, more adaptable to innovation, and responsive to make space for local input. Unclear how the new model will facilitate these goals. /3
Gov announced forthcoming changes to the Public Health Act today that will give cabinet greater power over decisions during a public health emergency. Some thoughts... /1
First, clarity over the role of the CMOH was much needed. This should have been fixed much, much sooner when it became clear that what was happening during covid (i.e. cabinet making decisions) was out of step with the law (i.e. CMOH making decisions). /2
Two questions required attention. First, who ought to make decisions during a health emergency (CMOH, cabinet, combo)? And second, how much independence should the CMOH have (e.g. a bureaucrat reporting to the Minister of Health or able to disclose recommendations publicly)? /3
Much anticipated decision in Ingram v Alberta (CMOH) is out! This case addresses the legality of covid public health orders. A summary and some thoughts... /1
As discussed ad nauseam during covid, this decision clarifies that the authority to issue public health orders is that of the CMOH and not cabinet. Despite this, Hinshaw repeatedly said that she was merely an advisor, thereby improperly delegating her power to cabinet. /2
Specifically, the Act "requires that decisions with respect to public health orders must be made by the CMOH" or her delegate. Instead, decisions here "were made by cabinet" or its committees. This delegation was "not permitted" by the Act. /3
Catching up on the Smith/Copping presser...
Smith commends front line staff and scapegoats AHS. Appoints administrator to replace AHS board. 4 priorities: EMS response times, ER waits, surgery waits, develop long-term reforms through consultation with health professionals. /1
Copping also commends front line staff and talks about the need for more capacity (doesn't address preventing people from needing hospital services in the first place). Claims a temporary administrator is preferable to board because they can work on these issues full time. /2
Administrator will work with CEO and will report to Minister of Health/Premier.
EMS: fast track transfers, use other modes of transport for non-urgent cases, empower EMS to step down calls from 911, empower paramedic to triage and determine need for ER transfer by ambulance. /3
Hot off the press! The Court of KB releases its decision in the school masking case. Some thoughts to follow... /1
The applicants challenged the chief medical officer's order rescinding masking in schools and the Minister of Ed's direction that schools not impose their own masking requirements. /2
Notably, and as @UbakaOgbogu and I have said many times, the Court finds that the authority to make public health orders rests with the CMOH, not cabinet. Because the masking decision came from cabinet and not her, it was unreasonable. /3