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Operation Health Protection
An Action Plan to Prevent Threats
to our Health and to Promote a Healthy Ontario

Speaking Notes Presented by George Smitherman
Minister of Health and Long-Term Care

June 22, 2004
Check against delivery

Thank you Jim [Brownell] for your kind introduction.

I'd also like to thank Dr. Jamieson [Medical Microbiologist, Central Public Health Laboratories] for hosting us here at the Central Public Health Laboratories.

The Central Lab is a main artery in our public health system.

This is the place where a lot of the critical 'behind the scenes' work goes on. This is where investigators often identify and track infectious diseases for the first time.

I want to thank the staff here today and say how much I respect the phenomenal work that you do to keep the people in this province safe.

And I want to tell you that our provincial lab professionals will play a key part in our plan for public health renewal.

Our goal is to make Ontarians the healthiest Canadians.

And we know that we won't have a healthy population if we don't rebuild public health in this province.

Public health is the very bedrock of health care.

This conviction drives the changes our government is making in health care.

The fact is, we don't really have a well-developed health care system in Ontario. We have more of a "sick care" system. That is, our system does a pretty darn good job at diagnosing and treating people once they have a health problem. But the system is not set up to keep people from getting sick in the first place.

We're changing that.

We need to expand our concept of health care beyond just the treatment of illness and truly embrace the concept of being healthy. The health care system we're creating in Ontario puts prevention and health promotion back at the centre.

Let me put this in concrete terms.

Our government is launching an all out battle against smoking, with a comprehensive tobacco strategy. We are taking aim at obesity by promoting physical activity and helping people to eat healthier. For starters, we're taking junk food out of schools. In days, a free childhood vaccination strategy to protect Ontario kids will thrust Ontario forward as a leader in the nation.

But, there's much more to do.

Because prevention and health protection have taken on a new importance in Ontario.

Walkerton, West Nile virus and SARS finally woke us up. A decade or more of deterioration and neglect in our public health system have taken a major toll on the health of Ontarians.

Thanks to advances in public health and medical science, we are better able to protect ourselves than in the past. Our life expectancy and health status prove this.

But, in other ways we are living in a more dangerous and unpredictable time. Diseases move more quickly, over vaster distances than in the past. Disasters and health crises can strike with little warning and on a massive scale.

As the final report of the Expert Panel on Infectious Diseases chaired by David Walker points out, Ontario is not alone in its neglect of public health. Other provinces and countries across the world are facing declining public health systems too.

But they lack what Ontario has : An Opportunity.

In Ontario, we are fortunate to have three groundbreaking reports on the SARS crisis to show us the way forward. The National Advisory Committee on SARS chaired by Dr. David Naylor demonstrated how the federal government and provinces must come together to create a common national system of public health. Then Justice Archie Campbell's impassioned interim report uncovered what went wrong and the dire consequences of multiple system failures. The Final report of the Expert Panel on Infectious Disease chaired by Dr. David Walker maps out in fine detail the steps to rebuild a declining public health infrastructure.

Our government's plan to reform public health responds directly to these reports.

Exactly two months ago when the interim Campbell and Final Walker reports were released, I made a commitment to Ontarians that our government would come back in two months with a comprehensive action plan to rebuild public health in this province.

I knew I could fulfil such an ambitious pledge because Ontario made a key decision months ago. In the months since, Dr. Sheela Basrur has herself been a tremendous source of leadership and her determination is contributing to the renewal of public health in Ontario.

We call our plan - Operation Health Protection. Just like military operations or surgical operations, the job of rebuilding public health will take steady leadership and the teamwork of many different players mobilized for one common mission. A mission with a clear sense of vision.

Operation Health Protection marks the first comprehensive change to public health since the 1980s.

I am pleased to announce that our government is immediately investing $41.7 million in new funding this year to kick start Operation Health Protection.

This investment is in addition to core funding for public health of $273 million in 2004/2005, growing to $469 million a year beginning in 2007-2008 that we announced in our Budget.

Shortly, Dr. Basrur will take you through the details of our Plan today.

But first, I'm going to touch on the six key areas of reform and how they will be implemented over the next three years.

First, we are bringing newer, stronger leadership to public health. We will strengthen the role of the Chief Medical Officer of Health by introducing legislation this year to give the person holding this position the necessary independence to protect the health of Ontarians.

In the words of Justice Campbell "The Chief Medical Officer of Health, while accountable to the Minister of Health, requires the independent duty and authority to communicate directly with the public and the Legislative Assembly whenever he or she deems necessary."

This is exactly what we are going to do.

As Chief Medical Officer, Dr. Basrur will have the duty to report to the public on public health issues and will make an annual report on the health of Ontarians to the Legislature. Legislation will ensure that the Chief Medical Officer has the protection to speak independently and candidly about public health issues. The Chief Medical Officer of Health will have the legal authority to take all necessary actions to protect the people of Ontario from health risks.

Second, we will renew our public health capacity province-wide and at the local level.

Recent public health crises have shown that we need independent scientific leadership on matters that are critical to the health of Ontarians.

I'm pleased to announce that we will create an arms-length Health Promotion and Protection Agency to provide crucial scientific leadership. The Agency will support the Chief Medical Officer of Health and be a vital resource to health providers, researchers, and non-governmental organizations in the areas of health protection, prevention and health promotion. We aim to have the Agency fully operational, including new a new public health laboratory by 2006/2007.

If there is one resounding message from SARS it's this : we need to create a true system of public health. The reality is, the system is only as strong as its weakest link …. and we can't afford to have any weak links.

Renewal must happen from the top down, from the bottom up and across the health system. And an effective public health system rests on the foundation of strong local public health units.

That's why we announced a few weeks ago that our government is increasing its share of public health funding to 75 per cent over three years, reversing the former government's damaging download. We will provide a solid funding base for local public health programs. And with this increased funding commitment, our government will accept greater accountability for public health.

I want to be clear that public health funding must be spent on public health. We expect that municipalities will continue to meet their funding commitment to public health.

We will begin a review of the capacity of local Public Health Units this year to ensure that they have the resources and operational support to respond to local public health needs. This summer we will be creating a Task Force to lead the capacity review.

We will begin review of the capacity.

The third initiative is bolstering our capacity to respond to health emergencies. The Emergency Management Unit at the Ministry will continue to play a pivotal role in coordinating our province's response to health emergencies. And it will have even more tools at its disposal.

Last month we released Ontario Health Pandemic Influenza Plan so that we are ready to respond when a pandemic strikes. The Emergency Management Unit has also developed a system to stockpile and rapidly distribute supplies to hospitals and other facilities if a disaster strikes.

Our fourth initiative is an investment in our capacity to control infectious diseases. Starting this year, we will invest in better infection control at the front lines where outbreaks must be contained. Over the next three years, we will fund new full-time infection control positions in hospitals and long-term care facilities. The hiring will begin immediately.

We will also increase training in infection control.

We are creating a permanent central Provincial Infectious Disease Advisory Committee (PIDAC). And I am pleased to announce that Dr. Dick Zoutman, Chair of Ontario SARS Scientific Advisory Committee, and Dr. Dave Williams the Medical Officer of Health for Thunder Bay will be the co-chairs of PIDAC.

Dr. Basrur will talk more specifically about how we will shore up our infection control resources in a few minutes.

People often talk about public health in terms of technology and test tubes. But public health is a very human endeavour.

That's why our fifth initiative will ensure we have the right professionals, with the right skills, in the right place, and that we are providing them with the best possible work environments and opportunities.

We will work with the Ministry of Training, Colleges and Universities and professional bodies to initiate a major drive to attract and keep public health professionals. That means giving professionals in public health disciplines the opportunity of full-time work and reducing the casual employment that impairs our ability to respond to an emergency.

We've already started by investing in 2,400 new full-time nursing positions in hospitals and long-term care facilities since February of this year.

The SARS crisis was a story of multiple communication breakdowns. That's why our sixth initiative is an investment of $24.9 million this year in state-of-the art information and communications technology for public health.

This year we will create an Integrated Public Health Information or IPHIS system specifically for infectious disease tracing and reporting and managing quarantines during outbreaks.

We are also developing a system to enable the rapid exchange of information on-line. This will include a public health portal that all health providers can access, a registry of all providers and stakeholders and secure email networks so that public health units can speak with hospitals and long-term care facilities in real time. This system will be completed in 2005/2006.

In closing, I want to be clear that the decline in public health did not happen overnight. It took more than a decade.

It will take a long-term commitment to reverse this damage and bring public health system up to the standards Ontarian's expect and rightly deserve.

The McGuinty government will take immediate action so that the people of Ontario see real improvements in their public health system starting this year.

Ontarians can be confident that with each passing year of our plan the public health system will be stronger.

Operation Health Protection marks a new beginning for public health in Ontario. Its success depends on all of us working together.

I call on all municipalities, public health units, health providers and men and women on the front-lines and in behind the scenes to work with the province to rebuild public health in Ontario.

12 million Ontarians are counting on us!

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