The Harper Shift is a month-long look at how Canada has changed over a decade of Conservative government – and at what kind of country we want to become. Here Trevor Hancock considers Ottawa’s dubious approach to public health.

In the final analysis, the purpose of government is to maximize the level of health, well being and quality of life of every person. It is not — or should not be — simply to grow the economy, which has to be understood as but one of the means to achieve that greater end. Our success as a society, and the success of our government, should be measured in terms of the level of health and, more broadly, human development that we achieve.

By this measure, how has the Harper government fared?

On health care, Stephen Harper’s dubious record is well known — his view that health is strictly a provincial jurisdiction has led Ottawa to abdicate entirely its traditional leadership role. Harper has refused to meet with the premiers or provincial health ministers during his tenure and, while health transfers have risen, the federal share is slated to decline deeply, passing both costs and risks to the provinces.

Less well known is the damage Harper has done to Canada’s public health system, and thus our ability to keep people healthy, protect them from harm and prevent disease, injury and disability.

Some wise governments take what has become known as a “health in all policies” approach. They understand that policies in areas such as housing, food, education, transportation, energy supply, environmental quality and urban development have to be developed with an eye to their impact on human well-being. And they set up mechanisms to co-ordinate policy in these areas and undertake health impact assessments of policy proposals.

In fact the Senate’s Sub-Committee on Population Health proposed such a mechanism in a 2009 report that was completely ignored by the government. That’s a shame given Ottawa’s dismal record:

Successive federal governments have cut investments in housing, an important determinant of health, by almost half in the past 25 years. As a result, insufficient social housing is being built. In 1982, more than 20,000 new social housing units were being built each year, but by 2006 this was down to fewer than 4,400 units.

The Harper government’s policies have sped the rise in food insecurity in Canada. In a 2012 report, the UN Special Rapporteur on the Right to Food stated that, “These rates of food insecurity are unacceptable, and it is time for Canada to adopt a national right-to-food strategy.” Three years later, we’re still waiting.

The Harper government has failed to act decisively to reduce dietary salt levels, relying on a voluntary approach that is proving to be as unsuccessful as its critics warned it would be. Apparently, the Conservatives are more concerned with protecting the health of the food industry than the health of Canadians.

When it comes to programs specifically designed to promote public health, the picture is not much prettier.

The Conservatives inherited a strong new Public Health Agency and a Minister of State for Public Health. But far from building on this new asset to promote and protect the health of Canadians, they have systematically undermined it. The Minister of State position was swiftly dispensed with, while the agency suffered significant funding cuts.

One of the first acts of the Harper government was to scrap the Kelowna Accord agreed to by Paul Martin, which would have given much-needed support to Canada's Aboriginal Peoples in closing the gap in health, education, housing and economic and social circumstances. In doing so, they further jeopardized the health and well-being of Canada's most vulnerable and least healthy people.

Harper has largely ignored the provinces in changing established public health programs and introducing new ones without adequate consultation. For example, the funding established for a national immunization strategy was instead diverted — without consultation — to a one-time HPV vaccine fund, with downloading to the provinces of subsequent costs.

The Tories abrogated all the work done by the provinces to set up a chronic disease prevention program, instead sending all the funding to establish the Canadian Partnership Against Cancer, where less than 10 per cent of the funds went to prevention.

The Harper government has also been stubbornly opposed to the establishment of safe injection sites such as Vancouver’s Insite, in spite of good evidence that this approach works.

Finally, in cancelling the long-form census on entirely spurious grounds, they undermined public health’s ability to conduct good disease surveillance and study the effects upon health of changes in social and economic conditions.

Loading... Loading... Loading... Loading... Loading... Loading...

Public health is not accorded the respect it deserves in Harper’s Canada, a place where the political focus has too often been on individual choice rather than collective responsibility. In these and many other ways, this government has failed in one of its principal duties — to protect and promote the health of Canadians.

Dr. Trevor Hancock is a professor and senior scholar at the University of Victoria's school of public health and social policy. thancock@uvic.ca

Read more about: