A Fine Balance: introduction
A Fine Balance: A Public Health Perspective on Health System Reform
CPHA's mission is to constitute a special national resource in Canada that advocates for the improvement and maintenance of personal and community health according to the public health principles of disease prevention, health promotion and protection and healthy public policy.
On behalf of the Canadian Public Health Association (CPHA) I would like to thank you for this opportunity to speak with the Commission on the Future of Health Care in Canada about the future of Canada's health system.
The CPHA is a national, independent, not-for-profit, voluntary association representing public health in Canada. The public health community is multidisciplinary and multisectoral in nature, including many different professions, among them administrators, policy makers, academics, community health nurses, medical officers, health educators, health promoters, environmental health workers, public health inspectors and nutritionists. Through these diverse professionals, CPHA addresses a broad range of health and social issues, and has links to almost every community in Canada and to the international public health community.
CPHA members believe in universal and equitable access to the basic conditions that are necessary to achieve health for all Canadians. We are keenly interested in helping the Commission fulfil its mandate to recommend policies and measures to ensure the long term sustainability of a "universally accessible, publicly funded health system, that offers quality services to Canadians and strikes an appropriate balance between investments in prevention and health maintenance and those directed to care and treatment."1
I would like to underscore the fact that the mandate statement speaks of the health system, not the health care system. Unfortunately, the scope of the mandate seems to fade somewhat in the glare of media and political attention to the problems of the treatment sector.
The UK's Acheson Report defines public health as "the science and art of preventing disease, prolonging life and promoting public health through organised efforts of society."2 By that definition, public health is more than a set of functions within the health system (monitoring the population's health situation and the determinants of health; prevention and control of disease, injury and disability; health promotion; and protection of the environment): it encompasses the entire social endeavour of assessing population health status and threats to it, developing policies and strategies across the full spectrum of intervention (from health promotion and disease prevention to treatment and care), and assuring that health needs are met and that services meet agreed-upon standards.