Health board calls cuts by province ‘dangerous’
Warns decision to slash $200M will make Ontario vulnerable to disease outbreaks
In a special meeting on Monday that raised the spectre of the SARS crisis and Walkerton tragedy, Toronto’s board of health voted unanimously to ask the province to reverse its decision to reduce public health spending by $200 million and slash the number of public health departments in the province.
Dr. David Mowat, the former chief medical officer of health for Ontario, said the cuts will undoubtedly affect efforts aimed at preventing disease and injury of all kinds.
“I think it’s reasonable to characterize them as dangerous,” Dr. Mowat said. “I’ve been doing this for 40 years.
“We’ve had this experience several times, the most notable being SARS. After we had that terrible outbreak, we had reports and inquiries that said that one of the fundamental problems was that we were underfunding public health.
“It’s not as though we don’t know what is going to happen.”
Public health departments are in charge of vaccination programs, the safety of prepared foods, including food in restaurants, and for spotting and handling disease outbreaks in their communities. Public health departments also focus on disease prevention and health promotion.
Councillor Joe Cressy (Ward 10 Spadina-Fort York), who also chairs the board of health, called the special meeting on Friday, a day after the provincial budget was tabled, cutting the number of public health units in the province to 10 from 35.
“This is a dangerous cycle that we’ve seen in the past, where we have governments cut funding for public health, resulting in an emergence of infectious diseases and outbreaks, resulting in public outcry and then the eventual restoration of funding,” Cressy said.
Funding for public health units is shared between the province and municipalities, with the province funding 75 per cent and cities funding 25 per cent.
Currently, Toronto Public Health receives approximately $147 million annually from the province, according to Toronto’s medical officer of health, Dr. Eileen de Villa.
Former city councillor and board of health chair Joe Mihevc, who spoke at the meeting, estimated that a $200-million provincial reduction in spending would cost Toronto Public Health $40 million a year, a figure that de Villa would not confirm. She said she needs more details from the province before she knows exactly what the impact will be.
“Presumably, if cuts are to be made across the province, Toronto Public Health would, by definition, be affected. To what extent, I think has yet to be determined,” Dr. de Villa said.
“The question is, is it even across the province or might it be differentially applied?”
Dr. Robert Kyle, president of the Association of Local Public Health Agencies, said that reducing the number of public health units from 35 to 10 “will cause major disruptions in every facet of the system.”
“The reality is that this $200 million savings is a 26 per cent reduction in the alreadylean annual provincial investment in local public health. This will greatly reduce our ability to deliver the front-line public health services that keep people out of hospitals and doctors’ offices,” Kyle told the board.
The 2003 SARS crisis claimed 44 lives in Canada. In Walkerton in 2000, six people died and thousands were sickened after drinking water contaminated with E. coli. “When public health works, it’s not always obvious,” de Villa told the board. “The effect of prevention is that nothing happened.”
During question period at Queen’s Park, Christine Elliott, minister of health and longterm care, said the province made the cuts to modernize and improve health to ensure that people have access to “better, more connected services.”
“That’s what we’re doing with public health, allowing it to be more responsive by having a smaller number of units being able to mobilize in case there’s a public health emergency. That’s the goal here and we have had lots of support for that,” Elliott said.