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One of the many weaknesses that #COVID has revealed relates to how public health agencies function. And while it is still too early to do a full review, some ideas to reform and improve those agencies can be presented to begin those conversations on lessons learned.
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One of the many weaknesses that #COVID has revealed relates to how public health agencies function. And while it is still too early to do a full review, some ideas to reform and improve those agencies can be presented to begin those conversations on lessons learned.
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A large issue has been confusion regarding the Public Health Officers’ role. They are perceived as more than just key advisors to the Government, and government leaders are often quick to hide behind these officials to defend their own choices. This undermines confidence.
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To address this, the chief public health officer should be a position appointed for a fixed term “on good behaviour.” This would mean that, unlike most other government appointees, the officer can only be removed for cause. This gives the officer greater independence.
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In addition, there should be less overlap of what a public health officer can do and what the Government can do. Generally speaking, this would mean the types of measures that have a broader impact on society and the economy could only be done by the Government.
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This provides greater accountability. It would be harder for the Government to blame the officer for certain measures being taken or not taken, as only the Government could take those measures. It also limits inconsistencies in who is doing what.
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For example, in Toronto, City Council enacted a by-law to require masks. In Ottawa, the local public health agency made the requirement. Consideration should be given to only having one body capable of making such an order.
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As another example, in Ontario, businesses were closed and gatherings limited by regulations made by the Government. Alberta, however, primarily relied on orders from the chief medical officer. In my view, Ontario’s approach was better and should be the only option.
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Consideration could be given to requiring the Chief Medical Officer to make certain of their recommendations public. This does not have to happen in advance of decisions taken (not practicable in emergencies).
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I would also consider giving Public Health Officers some regulatory powers. In particular, this would include being able to inspect the adequacy of public health safeguards in hospitals, clinics, long-term care homes and schools.
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The federal Public Health Agency should develop reporting standards and formats that the provincial and local health officers would follow (for diseases and for vaccinations). The goal is to ensure everyone has timely, accurate and consistent data on outbreaks.
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Likewise, the federal agency should work with provincial ones on the procuring of PPE and other commonly-needed medical supplies during crises, as well as how to maintain stockpiles and to distribute them.
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Underlying many of these reforms is to ensure that the public can be confident that chief medical health officers are giving the same message to the public as to the governments they serve. Ensuring independence from political interference builds trust, which is needed.
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