The following is an editorial repost from the Canadian Medical Association Journal. All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association. ©2015 8872147 Canada Inc. or its licensors CMAJ 1 CMAJ Editorial.
Matthew B. Stanbrook MD PhD, Ken Flegel MD, Diane Kelsall MD MEd, Kirsten Patrick MB BCh DA, Erin Russell MSc, John Fletcher MB BChir MPH
Dear Dr. Philpott,
We congratulate you on becoming Canada’s new Minister of Health. As the first physician to hold this post in 80 years, your appointment is a historic achievement. Your colleagues are proud to see a fellow physician in such an important role.
Prime Minister Trudeau’s choice of a physician for the health portfolio is particularly laudable following the lack of interest toward health policy displayed by the previous government. Your long clinical career affords you a considerable advantage over your predecessors, and Canadians have high expectations that you will be able to draw upon this as a political leader. Although you bring to Parliament ample experience as a leader and innovator, being a government minister brings new challenges. As long-time observers of and commentators on the federal government and the Ministry of Health, we offer the following suggestions for you to consider.
First, keep your promises. We are delighted by the government’s immediate announcements to redress several problems that CMAJ, among others, has raised in recent years: restoring the mandatory long-form census,1,2 unmuzzling Canada’s scientists2 and reinstating full health care coverage for refugees.3 We are further encouraged by many other commitments in the Liberal platform, including new investments to expand home care services and long-term care facilities, new strategies to address mental health and improve vaccination rates, and a promise to require plain packaging for tobacco. It is an ambitious agenda.
Second, let science and evidence be your constant guides. You will understand the importance of this better than most elected officials, as you have shown in your academic career. We are pleased that your colleagues in cabinet seem to understand this too, based on campaign pledges to consider science in government decisions, create advisory councils of scientific experts, and legislate, based on past scientific advice, to help Canadians make healthy food choices. We note in particular a promise to support initiatives that help health care providers collaborate to ensure the most appropriate and effective treatments. Canada already has, yet risks losing, one of the most authoritative and respected sources of evidence to guide such initiatives. We urge you immediately to restore, through the Canadian Institutes of Health Research or your direct authority, the $2 million annual base funding for Cochrane Canada.4
Third, give Canadians the medicines they need. We must remove the inequitable financial barriers that keep millions of Canadians from receiving necessary medications. We urge you, by the end of your mandate, to commit Canada to a specific timeline for implementing universal pharmacare, as supported by compelling evidence5 and an overwhelming majority of Canadians. We think that doing so would be the single greatest achievement of any Minister of Health in generations.
Fourth, defend the Canada Health Act. Its criteria — public administration, comprehensiveness, universality, portability and accessibility — constitute most of the attributes that have made our health care system a defining national value. Canadians in every province and territory equally deserve access to a health care system that observes these principles, yet these principles are being eroded across jurisdictions. Correcting such inequities should be a primary objective as you negotiate the government’s promised new health accord and may require you to leverage the threat of a reduction in health transfer payments for jurisdictions that do not comply.
Fifth, address the root causes of health inequities: the social determinants of health. We are encouraged by the government’s promised new support for children and seniors and investments in affordable housing. We hope that you will also enact specific initiatives to address the health disparities faced by Aboriginal Canadians6 and work productively with our colleague Dr. Carolyn Bennett, whom we congratulate on becoming Canada’s new Minister of Indigenous and Northern Affairs.
Last, never forget that you are a physician. You carry with you the values and responsibilities of our profession — most saliently the expectation to advocate for the health and wellbeing of Canadians — as do we. The mission of CMAJ is “To foster excellence in the science and art of medicine and promote the health and well-being of the Canadian public.” We are passionate in this mission, which has led us at times to write critically of our country’s government. We may do so again as we remain vigilant on behalf of Canadians. But if so, we will always endeavour to communicate with the respect becoming of a discussion among colleagues, believing that we are striving toward the same goals.
1. Cohen M, Hébert PC. Ideology trumps evidence with new voluntary survey. CMAJ 2010;182:E541.
2. Russell E. We deserve a government that respects scientific integrity. CMAJ 2015; 187:1107.
3. Stanbrook MB. Canada owes refugees adequate health coverage. CMAJ 2014;186:91.
4. Fletcher J. Central funding for Cochrane Canada must continue. CMAJ 2015;187:947.
5. Morgan SG, Law M, Daw JR, et al. Estimated cost of universal public coverage of prescription drugs in Canada. CMAJ 2015;187:491-7.
6. Richardson L, Stanbrook MB. Caring for Aboriginal patients requires trust and respect, not courtrooms. CMAJ 2015;187:162.
Competing interests: See www.cmaj.ca/site/misc/cmaj_staff.xhtml
Affiliations: See www.cmaj.ca/site/misc/cmaj_staff.xhtml
Correspondence to: CMAJ editor, firstname.lastname@example.org
CMAJ 2015. DOI:10.1503/cmaj.151398