Following a presentation to council last week by the region’s medical officer of health, Dr. Kieran Moore, Lennox and Addington County is advocating for a renewed focus on preventative health care.
Moore was at the County Courthouse in Napanee to speak as part of a Kingston-Frontenac-Lennox and Addington (KFL&A) Public Health presentation councillors requested to learn about the services the health unit offers. Specifically, he was discussing the new Ontario Public Health Standards, which came into effect Jan. 1.
“What we do is pretty well dictated by the ministry. They’ve come out with a publication of public health standards. Right now, those standards tell us what to do and how to do it,” he said. “As well, right now we’ve been asked to work closely with our health system partners and that’s something completely new for us.”
Moore said through its Patients First initiative, the provincial government is working to create a more integrated care model to allow all members of the public to have access to high-quality care and, in that scope, public health units have an important role to play in areas like education, preventative health, environmental safety, and infection control.
Some of that collaboration is already taking place — one such example being discussions across the health-care spectrum on the best response for Ontario’s developing opioids crisis.
Moore indicated there’s some uncertainty for public health units, however, as under the same Patients First schematic, it has been suggested there could be fewer public health units and both governance and funding models could change.
While answering a question from Warden Bill Lowry about the increasing threat of diabetes in North American society, the physician didn’t hide his feelings about one area where he thinks Ontario must alter its health-spending priorities.
According to Moore, when asked about a condition like diabetes, physicians will often talk about treatment instead of prevention because that’s how they’re trained. In his new position as a medical officer of health, he sees it differently.
“It drives me a bit crazy that 90 per cent of Type 2 diabetes is absolutely preventable and yet our Ministry of Health spends all of our time discussing best practices from a clinical vantage point,” he said.
While there’s a need for discussing medications or specialized services, Moore said promoting a healthy lifestyle with something as simple as a half-hour walk a day could be transformative and save costs in the system. Referencing the provincial budget released hours before Wednesday’s council meeting that pumped more money into acute care, he advocated for another approach.
“Yes, we can spend all our money downstream on treatment or we can start emphasizing prevention as a community,” he said. “I’m very frustrated that we’re not hearing that strong voice from a federal level or from a provincial level and in today’s budget, a 4.5-per-cent increase to the $50-billion budget we’re already spending on the treatment piece upsets me to no end — and zero dollars to public health and the prevention side.”
He reasoned money spent on prevention has reduced the instance of tobacco smoking and it could likely have a similar impact on diabetes. The health unit could also play a similar role with marijuana.
KFL&A Public Health treasurer Alida Moffatt added that public health funding has been frozen at the same level since 2015 and municipal partners have had to shoulder the cost of maintaining services. This year, Lennox and Addington is spending $1,266,401 for its share of public health costs and that is up 1.5 per cent from last year. For councillors tasked with paying for an ambulance service and reducing wait times that were also asked for a substantial contribution to acute care hospitals this year, the cascading costs of limited investment in preventative health was apparent.
Stone Mills councillor John Wise called the provincial funding freeze “incredibly shortsighted” and argued for change.
“We often hear in the public sector about investment. We use that term a lot. You don’t say you’re smelling, you say you’re investing. Sometimes it’s very loosely used,” he said, noting investing in roads and bridges helps with economic development, but it’s hard to quantify a pay back. “Public health is a genuine investment because it will reduce costs in the health-care system. It absolutely astonishes me with the diabetes crisis and with so many things occurring due to sedentary behaviour, the province cannot see or the federal government cannot see that spending money now will reduce budgets later. It’s a direct cause-and-effect.”
Wise also asked Moore how Ontario compares to other jurisdictions.
Moore indicated there’s not a clear-cut comparison. He said in Ontario, about 1.5 per cent of the overarching health-care budget goes to public health units dedicated to prevention and protection. In the United Kingdom, he said it represents about 6.5 per cent. He noted KFL&A Public Health board chair Denis Doyle recently visited England and noticed more prevalent messaging on social media, on television, and in public areas.
“They’re actually putting their money where their mouth is,” he said.
Moore vowed the health unit would carrying on in its efforts to emphasize prevention, but wouldn’t be able to be “as robust as we need to be.”
Hearing the comments made by Wise and Moore, Greater Napanee councillor Gord Schermerhorn wanted to take action.
“I think we should write a letter to the premier and share with her that concern Mr. Wise was talking about that the budget is not there for public health and for preventative medicine. I think we should also write our MP Mike Bossio and say we are disappointed in the leadership in the federal department and suggest some funding should be given to the province for public health or given to the municipalities or health units.”
The motion passed.