NLIS 3
October 24, 2005
(Health and Community Services)
Annual conference of
Federal-Provincial-Territorial Ministers of Health
Toronto, Ontario - October 22-23, 2005
At their annual meeting this weekend,
Canada's Federal, Provincial and Territorial Ministers of Health
reaffirmed their commitment to the implementation of the 10-Year
Plan to Strengthen Health Care signed last year by all First
Ministers.
REDUCING WAIT TIMES
Federal/ Provincial/Territorial Ministers of Health agreed that
substantial and definable progress is being made to make health care
more accessible across Canada at a time when society is aging and
demand for health care services is increasing.
Building on their successes, provinces and territories are taking
constructive steps to improve access to care across Canada.
Ministers remain committed to providing health care that is patient-centred,
integrated and accessible. Innovative approaches to primary care are
providing better access to physicians, nurses and other health
providers. New technologies are being harnessed to provide care to
people in rural and remote communities. Enhancements to community
care are allowing hospitals to focus on what they do best. Canadians
have more opportunities than ever to make healthy choices that
promote wellness and help to prevent illnesses.
Accountability and transparency have also been strengthened in every
province and territory. In just one year, Canadians now have more
information than ever before about wait times in their communities
and investments have been made to increase the number of medical
procedures.
As agreed by First Ministers in the 10-Year Plan to Strengthen
Health Care, all jurisdictions will establish, by December 31, 2005,
a first set of evidence-based benchmarks for medically acceptable
wait times in all of the five priority areas: cancer, heart,
diagnostic imaging, joint replacements and sight restoration.
As evidenced-based benchmarks are defined, corresponding access
targets will be developed. Access targets may also be set in areas
where clinical evidence does not yet exist. The access targets will
be adjusted as progress is made. Targets are goals informed by a
range of considerations, including the capacity of provincial and
territorial health systems.
To help achieve these benchmarks and access targets, all
jurisdictions are improving the way that wait times are monitored,
measured and managed through strategies which may include:
- Building the capacity of their
health systems;
- Monitoring and measuring wait
times using information technology to create patient-based
registries and other tools;
- Managing access using consistent
and fair ways to assess the needs of patients and how urgently
they require care, including single wait lists for procedures,
more efficient approaches to scheduling surgeries and wait list
co-ordination to help patients navigate the health system;
- Clarifying how hospitals, health
service organizations and health providers are responsible for
making health care more accessible and accountable to Canadians;
- Evaluating patients� access to
health care and health outcomes to help governments determine
where resources should be directed for the most effective
results; and
- Communicating information so
that Canadians can track wait times, and measure the progress
that all jurisdictions are making.
Governments acknowledge that they
cannot reduce wait times on their own. Physicians in every province
and territory have already provided valuable advice about improving
access to care.
Now, physicians must play an even greater role in developing
integrated wait lists and wait list management processes so that
Canadians get the medical treatments when and where they need them.
Federal, Provincial and Territorial Ministers agreed to undertake a
joint research program to develop a body of clinical evidence that
demonstrates how wait times affect patients� health. This program
would build on the work that has already been undertaken by the
Canadian Institutes of Health Research. With the benefit of this
research, federal, provincial and territorial governments can
develop better approaches to review and assess clinical evidence in
support of wait time benchmarks.
In addition, all jurisdictions will establish, by December 31, 2005,
comparable indicators of access to health care professionals, along
with diagnostic and treatment procedures. The Canadian Institute for
Health Information is providing advice to establish comparable
indicators that will allow for wait times to be measured
consistently across the country by the end of the year.
NATIONAL PHARMACEUTICALS STRATEGY
Health Ministers, noting that drugs are the fastest rising cost in
the system, reaffirmed their commitment to the National
Pharmaceuticals Strategy.
The National Pharmaceuticals Strategy, announced in 2004 must, among
other priorities, protect all Canadians from catastrophic drug costs
if it is to be viewed as a success. Ministers discussed options for
catastrophic drug coverage and asked officials to accelerate this
important work.
The ministers reviewed the issue of expensive drugs for rare
diseases, including Fabrys disease and MPS1-Hurlers Schie. Ministers
also asked officials to take the necessary steps to proceed with
time-limited-research programs, including clinical studies for
patients meeting treatment guidelines for these two rare diseases.
Ministers committed to this research on a risk-shared basis with
manufacturers as quickly as possible.
As part of the National Pharmaceuticals Strategy, all jurisdictions
are committed to better align their regulatory and reimbursement
regimes to ensure the best possible outcomes for Canadians.
As a start, Ministers are pleased to:
- Expand the Common Drug Review
which makes recommendations on which drugs are eligible for
reimbursement, to all drugs, and to work towards a common
national formulary which will lead to more consistent access to
drugs across the country;
- Give the Patented Medicine
Prices Review Board responsibility to monitor and report on
non-patented drug prices. To allow the board to regulate the
price of non-patented drugs, provinces will consider formally
delegating their responsibility in this area to the federal
government;
Work together to collect, integrate and disseminate information
on the real-world risks and benefits of drugs;
- Ministers reaffirmed their
commitment to report on the development and implementation of
all elements of the National Pharmaceuticals Strategy to First
Ministers in June 2006 and will ensure that progress is attained
in all areas. Key to this report will be further consultations
with stakeholders.
PANDEMIC INFLUENZA AND EMERGENCY
PREPAREDNESS
Federal, provincial and territorial governments have been planning
for a pandemic influenza outbreak, but additional work is required
so that Canada is better prepared. This work will build on the
internationally-recognized Canadian Pandemic Influenza Plan,
released last year, after a collaborative process among federal,
provincial, territorial, local and regional governments. Efforts are
underway to develop policies regarding anti-viral supplies.
Ministers also discussed the international conference on global
pandemic preparedness that Minister Dosanjh will host, and some
provinces will participate in, on October 24-25, 2005.
BLUE PRINT ON ABORIGINAL HEALTH
Health Ministers reaffirmed their commitment to continue to work
with Aboriginal Leaders to close the gap in health status between
Aboriginal peoples and other Canadians. Ministers discussed the
Blueprint on Aboriginal Health which will be presented at the
November 2005 First Ministers� Meeting on Aboriginal Issues.
MENTAL HEALTH
Ministers heard from Senator Michael Kirby and Senator Wilbert
Joseph Keon who presented highlights of the Standing Senate
Committee on Social Affairs, Science and Technology findings on
mental health and the proposal for the establishment of a Canadian
Mental Health Commission.
HEALTH GOALS
Ministers further demonstrated their commitment and leadership in
advancing public health through agreement on a set of goals for
improving the health of Canadians. The Health Goals for Canada were
developed collaboratively with Canadian governments, public health
and other experts, stakeholders and citizens. Ministers agreed that
the goals would inform each provincial and territorial government in
development of their own initiatives. To help strengthen public
health, Healthy Living Targets seeks to obtain a 20 per cent
increase in the proportion of Canadians who are physically active,
eat healthy food and are at healthy body weights.
ACTION ON METHAMPHETAMINE (CRYSTAL METH)
Health Ministers acknowledged that a collaborative approach
involving federal, provincial, and territorial governments and key
health, education and justice stakeholders is necessary in order to
effectively address methamphetamine use. The federal government has
agreed to explore how to control chemicals that are used to make
methamphetamine.
Ministers also discussed other initiatives, including a Framework
for Collaborative Pan-Canadian Health Human Resources Planning, and
The 2005 Tobacco Progress Report on Tobacco Control.
Quebec�s approach, as regards to the efforts of reducing wait times,
the Pan-Canadian strategies on pharmaceuticals, healthy living and
health goals are described in the document entitled �Asymmetrical
Federalism that Respects Quebec�s Jurisdiction� which accompanies
the 10-Year Plan to Strengthen Health Care.
Health Ministers concluded the meeting with a commitment to continue
working together on strengthening Canada's public health care
system.
Backgrounder: Pandemic influenza planning
Aussi disponible en fran�ais:
Media Inquiries:
Carole Saindon
Health Canada
(613) 957-1588
Adele Blanchard
Office of the Honourable Ujjal Dosanjh
(613) 957-0200
Dan Strasbourg
Ministry of Health and Long-Term Care
Ontario
(416-) 314-6197
David Spencer
Office of the Honourable George Smitherman
(416) 327-4320
BACKGROUNDER
Canada�s National and International Collaboration on Pandemic
Influenza Planning
The greatest known emerging health
threat that we face as a global community is pandemic influenza
which can emerge very rapidly and become widespread, affecting the
entire globe.
Currently, avian influenza H5N1 has the most potential to become a
pandemic. It has affected many species of birds and animals and the
World Health Organization (WHO) now considers it to be endemic in
Asian poultry. Since 2003, there have been 100 confirmed human cases
of avian flu and more than 60 deaths. Scientists agree the number of
humans affected by the virus is an indication of its potential to
mix with human influenza virus creating a new strain with the
ability to transmit directly from human to human. With no resistance
to this new strain, the virus could spread rapidly and result in
significant illness, death and social disruption.
Three influenza pandemics have occurred in the last century, and
scientists recognize that another is inevitable. While it is
impossible to predict when a pandemic will occur, advance planning
and preparation is critical in order to minimize the impact of this
new virus on individuals and communities across Canada.
Canada was one of the first countries in the world to develop a
national plan to manage the risk of a pandemic influenza. The
Canadian Pandemic Influenza Plan (//www.phac-aspc.gc.ca/cpip-pclcpi/index.html),
released in February 2004, was developed by federal, provincial and
territorial governments together with more than 200 health experts.
The plan outlines actions to be taken by the various levels of
government, so that a coordinated response that protects the health
of Canadians is implemented in the event of a pandemic, including
risk assessment and communication to Canadians. The continued
development of these plans will aid improvement in the general level
of preparedness in Canada to confront other emerging infectious
diseases. As well, provinces and territories have developed their
own response plans including disease surveillance, operational
planning and limited stockpiling of antivirals.
The Public Health Agency of Canada, and provincial and territorial
governments, continually monitor the threat of a pandemic influenza.
They will adapt and revise their plans as the situation evolves and
new knowledge becomes available.
Vaccines are the most effective public health tool to fight an
influenza pandemic. Vaccines provide immunity against the influenza
virus but cannot be produced until the pandemic strain of influenza
has emerged. In the meantime, it is important that Canada builds
vaccine production capacity in the event of a pandemic. That is why
the Government of Canada has put in place a ten-year contract with a
domestic manufacturer. The contract includes a pandemic readiness
component to strengthen production capacity and pandemic vaccine
production. In addition, the Government of Canada has committed $34
million over five years to assist in the development and testing of
a prototype (�mock�) pandemic influenza vaccine.
Until a vaccine is available, antivirals will be an important part
of our response to a pandemic.
Combined, federal, provincial and territorial governments currently
have approximately 40 million capsules of oseltamivir, enough to
treat four million people. Specifically, governments currently own
35 million capsules, with another five million on order.
Antivirals, however, are limited in their effectiveness and,
therefore, are only one part of our overall strategy. They alone
cannot be relied on to reduce the impact.
Providing leadership and collaborating on these types of issues at
an international level is a cornerstone of Canada�s preparedness.
Canada continues to work multilaterally to build mutually beneficial
partnerships in addressing the global threat of a pandemic
influenza. Canada is in active discussion with the World Health
Organization (WHO) and our partners in the G7 plus Mexico on the
appropriate measures to slow down or contain an initial outbreak of
a novel virus that could cause a pandemic.
Over the past few years, Canada has provided continuous support to
the World Health Organization and the countries affected by avian
influenza. For example, Canada continues to provide technical
assistance to Vietnam to help with H5N1 avian influenza diagnosis,
and has provided public health expertise in WHO consultations in
Thailand, Vietnam and China.
In September 2005, Canada announced a five-year, $15-million project
to strengthen the capacity of public health systems in Southeast
Asia and China to detect and respond effectively to emerging
infectious diseases. The Canada-Asia Regional Emerging Infectious
Diseases (CAREID) Project will focus on assisting the region in
improving surveillance and outbreak investigation and response,
strengthening lab systems, increasing preparedness and improving
effective communications and public education. The project is the
result of meetings and consultations with international partners, as
well as a mission to the region to assess their capacity needs to
combat emerging infectious diseases currently underway.
In October 2005, Canada will host an International Meeting of
Ministers of Health to facilitate international collaboration in
pandemic preparedness. The meeting will provide a forum for
identifying priority actions in the global response to a pandemic
influenza. Ministers will discuss four key themes:
- Intersectoral collaboration on
the animal-human health interface;
- Risk communication and
assessment;
- Development, supply and access
to vaccines and antivirals;
- Surveillance and capacity
building.
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