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BC Health Act
Renewal Project
May 2005Dr. Brian Emerson
BC Ministry of Health Services
Brian.emerson @ gems1.gov.bc.ca Ph 250-952-1701
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Outline of Presentation
Project overviewPublic Health Legislation FrameworkProposed Public Health Act ContentPolicy IssuesPublic Health Law Network
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Rationale for the Project
Public Health legislation is a cornerstone of effective public health action. Current legislation is outdated, fragmented, and has many gaps.New health challenges require new public health legislation that is modern, coherent and connected, comprehensive, and flexible to meet emerging needs.
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Rationale for the ProjectFailure to update the act may have the
following consequences:Public health practitioners lack tools available in other jurisdictions. Public health service delivery barriers. Reduced ability of government to protect and improve health, and respond adequately to public health issues and emergencies, with potential serious consequences for the government and the public.
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GoalPublic health legislation will be improved and streamlined through a greater focus on the outcomes, and the repeal of redundant and outdated clauses. Ultimately, a new public health act will contribute to increasing effectiveness and efficiency of the public health services, with greater prevention of premature death, disease, injury and disability.
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Project Outcomes
Framework for public health legislationNew public health actSupporting regulations, policies, and proceduresComplementary changes to other public health legislation
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Sources
BC legislationOther Canadian provincial legislationModel State Public Health Act Other Countries Literature reviews
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Structures
Steering Committee Working Committee Task Groups
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Processes
Policy analysis, discussion papersTargeted consultation – email, website, attend meetings, teleconferences, conference presentationsPublic Health law network
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Public Health Legislation Framework (proposed)
Public Health Act is a source document for prescribing powers, duties, functions, structures, personnel, organisations.Public Health Act includes issues that are central to public health, those which for Public Health officials are the lead, and those of limited scope.Separate statutes for matters in which others are the primary players, who whose actions impact the public’s health i.e. Food, Water, Tobacco.
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Public Health Legislation Framework (proposed)
Other ministry statutes may regulate public health matters i.e. waste disposal, fish sales.Public health provisions may be included in other statues where there is a public health component to that statute for specific reasons i.e. School Act.A rationale of what should be included in an act or regulation will be developed.
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Principles - General
Proactively improving and protecting the public’s healthA focus on the health of populationsCollaborative partnerships with communitiesAttention to inequalities in health status
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Principles – Specific to exercise of Authority
Least restrictive or intrusive alternatives should be used initiallyRestrictions of liberty for prevention of harm to the public’s healthDue process in decision making will be followed to ensure rights and fairness.
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Principles – Specific to exercise of Authority
Reciprocity – Reasonable consideration should be given to providing assistance, support and other alternatives in situations where individuals are adversely impacted by public health actions as part of a measure to protect the health of the population
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Content of proposed Public Health Act
Draft Purpose – “The purpose of the Act is to provide
the authority for the Minister and Health Officials to establish organizational arrangements and take action to protect and promote the health of the population of British Columbia.”
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Draft Definition “Public Health”Public Health is the organized effort of society to protect and improve the health and well-being of the population through
health monitoring, assessment, and surveillance;
health promotion; reducing inequality in health status;
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Draft Definition “Public Health”prevention of disease, injury,
disability and premature death; andprotection from environmental and
other health hazards.This will be done through an
appropriate balancing of the rights and responsibilities of individuals and organizations and the responsibility of government to protect and promote health.”
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Content of proposed Public Health ActDraft Objectives
Establish powers, duties, functions of minister, PH officials, agencies, etc.Establish a common terminology.Establish core public health functions in broad terms.Define requirements for population health planning.
(continued)
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Draft Objectives ContinuedProvide measures for central public health functions I.e. Communicable Disease Control, Health Hazards, Public Health EmergenciesProvide for regulations and other procedures to deal with specific issues.
Provide for penalties, immunities, and administrative processesProvide linkages between public health statutes.Ensure individual privacy protection and public interest information release.
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Policy IssuesDefinitions, purpose, objectives, values, principlesModernization of powers of minister and other health officials regarding communicable diseases, public health emergencies, testing, treatment, isolation, quarantine, contact tracing, vaccination, health hazard abatement, expropriationOrganism culture regulationBlood exposuresPersons in need of care(continued)
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Policy Issues continuedCore functions in the actCapacity and infrastructureTraining and qualificationsRegistriesSurveillance, mandatory reporting, screening Protection of advocacy role of Provincial Health Officer, Medical Health Officers, other Public Health staff (continued)
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Policy Issues continued
Provincial, regional, and local planning prescriptionsLegislative options for health promotion and chronic disease preventionAboriginal issuesLocal boards of health, joint boards of health, health districts,
(continued)
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Policy Issues continued
Powers in respect of persons in need of careVaccine adverse effect compensationIndoor and outdoor air qualityProtection of individual privacy and release of information of public protectionHow to evaluate public health legislation
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Potential Barriers
Discussion about exercise of public health powers can result in fears that these will be used excessively
These are necessary to have but are only used as last resort and only when health of public is threatened, after careful consideration of all alternatives.
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Potential BarriersProposals regarding “core public health functions” could result in reactions from Health Authorities that their autonomy and flexibility is being undermined
This is to provide for consistency of public health services across the province, while recognizing the need for local flexibility.There will be minimal requirements in legislation, but rather these will be required through performance agreements.
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Next Steps
Update website for consultation.http://www.healthservices.gov.bc.ca/phact/index.html
Posting of discussion papers.Targeted consultation on policy issues.Preparation of legislative proposals.
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Public Health Law Network
Informal group established to share information, ideas regarding public health lawAll provinces, territories, Health Canada, USCDC invitedPreparing for the possibility of a formal public health law group
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Public Health Law NetworkExample Topics discussed
Emergency Public Health LegislationCompensation for quarantinePrinciples of Public Health legislationModel Public Health LegislationLab cultures with bioterrorism potentialFederal Health Protection RenewalBlood ExposuresLinkages to other national processes
