ARCHIVED - Public Health Agency of Canada

Special Senate Committee on Aging

On April 21, 2009, the Special Senate Committee on Aging tabled its final report  Canada’s Aging Population: Seizing the Opportunity. The report outlines the challenges facing Canada’s aging population, including healthy and active aging.

The Standing Committee on Public Accounts

The Standing Committee on Public Accounts held a hearing on March 10, 2009, to seek an update from the Agency concerning progress made on the recommendations in  May 2008 OAG Report on the Surveillance of Infectious Diseases.

The focus of the Auditor General’s audit had been to determine whether the Agency had:

• Defined its roles and responsibilities and set objectives and priorities for surveillance based on the public health treats of infectious diseases;
• Obtained, analyzed, and reported information on selected existing and emerging infectious diseases;
• Met its new international obligations under the International Health Regulations; and
• Made progress on selected recommendations from their past reports.

The Auditor General’s Report outlined four key concerns regarding surveillance of infectious diseases by the Agency:

• Weaknesses related to strategic direction, data quality, results measurement, and information sharing were noted in previous OAG audits still remain;
• While the Agency relied heavily on the good will of provinces and territories for surveillance information, there are gaps in information-sharing agreements;
• In the event of a public health emergency, critical arrangements need to be sorted out; and
• The Agency and the Canadian Food Inspection Agency have not jointly determined which of the animal diseases that could affect the health of people are the highest priority for surveillance, and which of the two agencies will carry out surveillance of what diseases.

In their May 2009 report, the  Standing Committee on Public Accounts made five recommendations:

1. the Agency provide an interim status report to the Public Accounts Committee on its progress in implementing the Office of the Auditor General’s recommendations by 30 September 2009, and that additional status reports be submitted to the Committee annually until the recommendations are fully implemented.
2. Health Canada and the Agency provide the Public Accounts Committee by 30 September 2009 with a clear timeline for a legislative review which would determine whether additional statutory authorities are necessary.
3. the Agency provide the Public Accounts Committee by 30 September 2009 with a proposed timeline for negotiating information sharing agreements with the provinces and territories, and report progress in making these agreements in its annual status report to the Committee.
4. the Agency provide the Public Accounts Committee with its assessment of core surveillance and response capacity requirements by 30 September 2009, along with a timeline detailing how it intends to meet the World Health Organization Regulations by the mandatory deadline of 2012.
5. the Agency include in its Departmental Performance Reports an outline of the challenges and risks it faces as an organization; and that the Agency provide a balanced appraisal of the results it has achieved in improving its surveillance activities.

Agency Response:

The Agency is committed to providing a response to the Standing Committee’s recommendations before September 30, 2009.

The Agency’s response to the Auditor General Report is presented later in this table.

Senate Subcommittee on Population Health

On June 3, 2009, the Senate Subcommittee on Population Health tabled its final report,  A Healthy, Productive Canada: A Determinant of Health Approach,in the Senate. The Subcommittee was mandated to examine and report on the impact of the multiple factors and conditions that contribute to the health of Canada’s population, known collectively as the social determinants of health. The report contains 22 recommendations directed at all orders of government and several federal organizations, both within and outside the health portfolio. Recommendations are grouped under four categories:

1. Governance: a whole of government approach (9 recommendations);
2. Population health data infrastructure (4 recommendations);
3. Healthy communities (4 recommendations); and
4. Aboriginal population health (5 recommendations).

In 2008-09, the Agency continued efforts in relevant areas, as well as undertook new work that is in line with the recommendations. For example:

• Early child development:
• The Canada Prenatal Nutrition Program (CAPC) and the Community Action Program for Children (CPNP), programs funded by the Agency, promote health and address health inequalities affecting pregnant women, young children and their families. The Agency has supported CAPC and CPNP programs to mobilize community-based groups and coalitions to increase access to health and social supports for groups that may be at risk of poor health due to poverty, social and geographic isolation, recent arrival to Canada, or substance use.
   
• Focus on Aboriginal populations:
• The Agency Aboriginal Head Start program prepares Aboriginal children for success at school by providing an opportunity for preschoolers to learn traditional languages, culture and values – along with school readiness skills – while acquiring healthy living habits. Today more than 4,500 children and their families in urban and northern communities across Canada are benefiting from the Aboriginal Head Start program.
   
• Collaboration across and among governments:
• The Agency continued to support the Pan-Canadian Public Health Network (PHN), a network of federal, provincial and territorial public health leaders and select stakeholders, to share knowledge, expertise and best practices. The PHN also develops and implements efficient and collaborative approaches to public health issues and challenges. The Agency also worked with the World Health Organization to develop best practices for inter-sectoral and multi-jurisdictional mechanisms to inform future population health efforts.
   
• Population health data systems and intervention research:
• The Agency worked with Statistics Canada and the Canadian Institute for Health Information on a Population and Public Health Indicator framework. The Agency also produced an important background report on the development of health disparities indicators in Canada; taken together, these activities will provide more comprehensive indicators that better reflect health disparities.
   
  
• Health status of vulnerable populations:
• The Agency, along with other portfolio partners, has engaged on other fronts to enhance the health status of vulnerable populations, such as the homeless, through support for the Canadian Mental Health Commission’s demonstration projects on homelessness and mental health.

At the time of writing, a comprehensive government response has not been requested by the Subcommittee. However, the Agency will review the report in detail and prepare further analyses of the recommendations to assess the implications for their implementation.

 May 2008 OAG Report on the Surveillance of Infectious Diseases contained recommendations which are presented above in the section on the Standing Committee on Public Accounts. The Agency’s response is included in the OAG Report. Steps already taken to address the concerns in the report include:

• Developing a comprehensive Action Plan to implement its Surveillance Strategic Framework and surveillance strategy, which integrate the recommendations of the May 2008 Report;

• Establishing a Surveillance Integration Team to improve and better integrate surveillance activities across the Agency;

• Working to put into place official intergovernmental agreements that formalize the well-established working arrangements for information-sharing; and

Moving towards meeting International Health Regulation requirements through the creation of Memoranda of Understanding for information-sharing and mutual assistance during public health emergencies with all the provinces and territories.

No external audits were issued during 2008-09.