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What We Learned from SARS

The Canadian health-care system comes under scrutiny

Last May, Federal Health Minister Anne McLellan appointed an 11-member committee to examine how the Canadian public health and health-care systems handled the SARS crisis and to explore long-term options for the future. Dr. David Naylor (MD 1978), dean of medicine at U of T, chaired the National Advisory Committee on SARS and Public Health. Other U of T faculty members on the panel included Dr. Sheela Basrur (MD 1982, MHSc 1987), chief medical officer of health for Toronto Public Health, and Dr. Allison McGeer (BSc 1974 UC, MD 1982), director of infection control at Mount Sinai Hospital.

The committee’s final report, released on Oct. 7, includes more than 75 recommendations, many of which urge action on multiple fronts. Among the key proposals are that the federal government create a new Canadian Agency for Public Health. Naylor’s committee believes that the new agency, led by a chief public health officer of Canada, “would reduce the likelihood that the health of Canadians would inadvertently be held hostage in a jurisdictional disagreement among levels of government.” Like the U.S. Centers for Disease Control, the new Canadian agency would not only support provinces and municipalities fighting disease outbreaks, but would strategically fund other levels of government and non-governmental partners.

The commission also recommended that Ottawa initiate a national plan for targeted cost-sharing with the provinces to ensure that Canada is better able to respond to “the next SARS.” “Unlike Australia or the U.S., Canada does not have national health goals or a national health strategy tied to federal funding,” says Naylor. “We have a flimsy national patchwork for health protection and disease control.”

Other recommendations to be implemented as part of the strategy include: building more intergovernmental partnerships and creating a national immunization strategy with financial contributions from the provinces; rapid creation of a new federal, provincial and territorial network for communicable disease control; a review and improvement of laboratory systems for better detection and response; and implementation of a national strategy to renew human resources for public health and infectious disease control.

“Some very short-term spending on infectious diseases, human resources, laboratories and research is needed,” says Naylor. “The rest can follow more slowly. We’re talking about an eventual target of $700 million per annum in new spending by Ottawa to build a seamless disease control system. That’s what the federal and provincial governments spend on personal health services in three days.”

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