Bennett (Keynote Health & Health Care Northern Ontario 2010)

A Vision of Health & A Vision of Health & Health Care Health Care

in Northern Ontario in Northern Ontario

March 31, 2010March 31, 2010

Hon. Carolyn Bennett, M.D., M.P.Hon. Carolyn Bennett, M.D., M.P.

Geography is no excuse Geography is no excuse for inequality…for inequality…

Allan RockAllan Rock

Minister of HealthMinister of Health

19981998

Rural Health in Rural HandsRural Health in Rural HandsStrategic Directions for Rural, Remote, Northern and Aboriginal CommunitiesStrategic Directions for Rural, Remote, Northern and Aboriginal Communities

2002 2002

Building Healthy CommunitiesBuilding Healthy Communities Infrastructure for Community Capacity-Infrastructure for Community Capacity-

buildingbuilding Intersectoral CollaborationIntersectoral Collaboration Rural Health ResearchRural Health Research Health Information TechnologyHealth Information Technology Health Human ResourcesHealth Human Resources Aboriginal HealthAboriginal Health

Canadian legacy: Canadian legacy: HEALTH trumps health CAREHEALTH trumps health CARE

Tommy Douglas… Father of MedicareTommy Douglas… Father of Medicare Lalonde Report 1974Lalonde Report 1974 Ottawa Charter 1986Ottawa Charter 1986 SARS, Naylor Report 2003SARS, Naylor Report 2003 WHO Commission SDOH 2005 WHO Commission SDOH 2005 Health Goals for Canada 2005Health Goals for Canada 2005

Goal of Medicare… Goal of Medicare…

Sharing riskSharing risk getting people the health care they need when they getting people the health care they need when they

need itneed it

Keeping people well not just patching them Keeping people well not just patching them up once they get sickup once they get sick

The Tyranny of the AcuteThe Tyranny of the Acute

As long as citizens think of the As long as citizens think of the sicknesssickness care care system whenever they hear the word system whenever they hear the word ‘health’‘health’ we are not going to be able to reorient health we are not going to be able to reorient health systems.systems.

Canadian Institute for Advanced Research

25% health attributable to health care system 15% biology and genetics 10% physical environment 50% social and economic environments

Fleeing the Medical Model,Fleeing the Medical Model,Embracing the Medicine WheelEmbracing the Medicine Wheel

Humbling realityHumbling reality The health of our population cannot be the sole The health of our population cannot be the sole

responsibility of the Ministry of Health and the responsibility of the Ministry of Health and the health care sectorhealth care sector

For Canadians to be as healthy as they can be, For Canadians to be as healthy as they can be, and in order to close the unacceptable gap in and in order to close the unacceptable gap in health status for our most vulnerable Canadians health status for our most vulnerable Canadians we must work across we must work across all government all government departments, all jurisdictions and in all sectorsdepartments, all jurisdictions and in all sectors. .

Process ….Process ….

‘‘Health in all Policies” - FinlandHealth in all Policies” - Finland Article 54 in PQArticle 54 in PQ Health Impact AnalysisHealth Impact Analysis

All MC’s , budget, TB guidelinesAll MC’s , budget, TB guidelines Better data…. Disease registriesBetter data…. Disease registries

Real Strategies – Real Strategies – What, by when, and howWhat, by when, and how

Poverty reductionPoverty reduction HousingHousing TransportationTransportation Injury PreventionInjury Prevention Healthy Ageing – DementiaHealthy Ageing – Dementia Mental HealthMental Health others others ??????????????????????

Sustainability of Health Care System Sustainability of Health Care System

Our cherished health care system will only be Our cherished health care system will only be sustainable if we redouble our efforts to sustainable if we redouble our efforts to keep keep Canadians wellCanadians well

We must develop integrated systems for health We must develop integrated systems for health that are accountable for that are accountable for resultsresults

Health as % GDPHealth as % GDP

In 2007 In 2007 US 16.2 % US 16.2 % Canada 10.6 %Canada 10.6 %

$7,421 per American and $5,170 per Canadian $7,421 per American and $5,170 per Canadian . .

The projection for 2018 in the US is a The projection for 2018 in the US is a staggering 20.3% of GDP. staggering 20.3% of GDP.

Boom, Bust and EchoBoom, Bust and Echo

“ “Over the next 2 decades, as 9.8 million baby Over the next 2 decades, as 9.8 million baby boomers turn 50, we will witness a significant boomers turn 50, we will witness a significant exodus from big-city Canada to small-town exodus from big-city Canada to small-town Canada. Canada.

The participants in this exodus are going to The participants in this exodus are going to need the same need the same hospitals hospitals that provincial that provincial governments want to close in the mid-1990’s”governments want to close in the mid-1990’s”


““Governments should view Governments should view small-town small-town hospitalshospitals not as a burden on the health care not as a burden on the health care budget but as budget but as a powerful tool for the economic a powerful tool for the economic development of rural regionsdevelopment of rural regions. .

In the years to come, the reassuring presence In the years to come, the reassuring presence of a good local hospital will act as a magnet of a good local hospital will act as a magnet for relatively prosperous new retirees, whose for relatively prosperous new retirees, whose arrival will create new demand for good and arrival will create new demand for good and services.” services.”


“… “…. bring their new wealth with them. . bring their new wealth with them.

… …. already happening in the Okanagan and . already happening in the Okanagan and other parts of the B.C. interiorother parts of the B.C. interior

… …..one scenario where increased population ..one scenario where increased population does lead to increased prosperity….. does lead to increased prosperity….. A Region A Region that loses its local hospital may be losing its that loses its local hospital may be losing its best chance for economic rebirth.best chance for economic rebirth.” ”

`Hospital` vs Health Care Centre`Hospital` vs Health Care Centre

Form follows functionForm follows function Needs assessmentNeeds assessment Population servedPopulation served Evidence-basedEvidence-based Outcomes - QualityOutcomes - Quality

What services What services ??

Volume ?Volume ? Triage/TransferTriage/Transfer TelehealthTelehealth Back-upBack-up

What Health Human Resources ?What Health Human Resources ?

InterdisciplinaryInterdisciplinary RecruitmentRecruitment RetentionRetention CMECME Relief/locumsRelief/locums

The Grey Tsunami ?The Grey Tsunami ?

R.O.M.P.R.O.M.P.

CollingwoodCollingwood

April 24, 2008April 24, 2008

Dr. Carolyn Bennett M.P.Dr. Carolyn Bennett M.P.

The Grey The Grey Tsunami ?Tsunami ?

Age-Friendly Age-Friendly Rural And Remote Communities: Rural And Remote Communities:

A GuideA Guide Outdoor Spaces and BuildingsOutdoor Spaces and Buildings TransportationTransportation HousingHousing Respect and Social InclusionRespect and Social Inclusion Social ParticipationSocial Participation Communication and InformationCommunication and Information Civic Participation and Employment OpportunitiesCivic Participation and Employment Opportunities

Community Support & Health ServicesCommunity Support & Health Services

Age-Friendly Age-Friendly Rural And Remote Communities: Rural And Remote Communities:

A GuideA Guide

Community Support & Health ServicesCommunity Support & Health Services Caring and Responsible ProfessionalsCaring and Responsible Professionals Home Health and Support ServicesHome Health and Support Services Diversity of Health Services and FacilitiesDiversity of Health Services and Facilities Availability of Equipment and AidsAvailability of Equipment and Aids Caregiver Support (including respite)Caregiver Support (including respite) InformationInformation

Age-Friendly Age-Friendly RuralRuralAnd RemoteAnd RemoteCommunitiesCommunities

The Issue:The Issue: 21% of Canadians are rural21% of Canadians are rural 9.4% of Canadian physicians are rural9.4% of Canadian physicians are rural Rural Canadians have more illnessRural Canadians have more illness Rural Canadians have shorter life Rural Canadians have shorter life expectancyexpectancy

SOCIETY OF RURAL PHYSICIANS OF CANADANATIONAL RURAL HEALTH STRATEGY: SUMMARY

Rural Canadians do not have fair access to Rural Canadians do not have fair access to health care:health care:

Half the number of doctors serving people who are sickerHalf the number of doctors serving people who are sicker Lack of specialists: 3% of Canadian specialists are ruralLack of specialists: 3% of Canadian specialists are rural Pregnant women have to move away from home to deliver, Pregnant women have to move away from home to deliver, increasing cost and causing poor medical outcomesincreasing cost and causing poor medical outcomes


Why the doctor shortage is twice as severe in rural Why the doctor shortage is twice as severe in rural

Canada:Canada: Medical Schools and residency training programsMedical Schools and residency training programs90% of medical students come from wealthy urban families90% of medical students come from wealthy urban families medical schools promote specialist care and researchmedical schools promote specialist care and research Medical schools require urban living for 7-8 yearsMedical schools require urban living for 7-8 years Medical schools teach skills for urban practiceMedical schools teach skills for urban practice

Working Conditions and remunerationWorking Conditions and remunerationMaintaining licensure requires attendance at urban coursesMaintaining licensure requires attendance at urban courses Urban hospitals do not support rural physiciansUrban hospitals do not support rural physicians Attrition rate is highAttrition rate is high


For every rural community we should aim forFor every rural community we should aim for Clean water and sanitary waste disposalClean water and sanitary waste disposal Appropriate public health and social servicesAppropriate public health and social services Modern and well-supported health care facilitiesModern and well-supported health care facilities

For every rural Canadian we should aim forFor every rural Canadian we should aim forAccess to a well-trained rural family physician with primary support Access to a well-trained rural family physician with primary support teamteam Access to emergency and other general hospital services within a Access to emergency and other general hospital services within a reasonable time and distancereasonable time and distance Access to specialized diagnosis and treatment within an integrated Access to specialized diagnosis and treatment within an integrated system with outcomes comparable to patients who live in citiessystem with outcomes comparable to patients who live in cities

SOCIETY OF RURAL PHYSICIANS OF CANADAGOALS FOR A PAN-CANADIAN RURAL HEALTH STRATEGY

For Canadian medical schools we should aim forFor Canadian medical schools we should aim for A representative proportion of rural/urban studentsA representative proportion of rural/urban students Rural learning experiences for all students and residents to increase Rural learning experiences for all students and residents to increase interest and understanding of rural practiceinterest and understanding of rural practice Rural streams for interested students and residentsRural streams for interested students and residents Procedural and other advanced training for rural physicians to enhance Procedural and other advanced training for rural physicians to enhance provision of local servicesprovision of local services

For Canadian health research we should aim forFor Canadian health research we should aim for Development and support of a rural health research networkDevelopment and support of a rural health research network Development and support of community-based rural health research Development and support of community-based rural health research involving rural physicians and other health care providersinvolving rural physicians and other health care providers

SOCIETY OF RURAL PHYSICIANS OF CANADAGOALS FOR A PAN-CANADIAN RURAL HEALTH STRATEGY

Ministerial Advisory Council on Rural HealthMinisterial Advisory Council on Rural Health Rural Access to ScholarshipsRural Access to Scholarships Rural Access Development ProgramRural Access Development Program Rural Medicine Skill Enhancement ProgramRural Medicine Skill Enhancement Program National Rural Medical Round TableNational Rural Medical Round Table Extension of Medical School to Rural CommunitiesExtension of Medical School to Rural Communities Enhanced Training of Residents in Rural Residency ProgramsEnhanced Training of Residents in Rural Residency Programs Strengthen Rural Health ResearchStrengthen Rural Health Research Facilitated Implementation of Broad Band TelehealthFacilitated Implementation of Broad Band Telehealth

SOCIETY OF RURAL PHYSICIANS OF CANADASOLUTIONS…

Strategies must be developed to improve:Strategies must be developed to improve: Return-of-service programsReturn-of-service programs Financial incentives for rural practiceFinancial incentives for rural practice Stable group practices with appropriate facilities and health Stable group practices with appropriate facilities and health care teamscare teamsCommunity involvement and supportCommunity involvement and supportFunctional referral networksFunctional referral networks

SOCIETY OF RURAL PHYSICIANS OF CANADASOLUTIONS…

Health Care or a Real System for Health Care or a Real System for HealthHealth

Patchwork quilt of non- systemsPatchwork quilt of non- systems

Focus on sickness…and the repair Focus on sickness…and the repair shopsshops

Re-orienting Health Systemsfrom Health Care to Health

Rx: Rx: Civil society insisting on healthy Civil society insisting on healthy

public policypublic policy Health literacyHealth literacy

Civic efficacyCivic efficacy

Enlightened leadershipEnlightened leadership Change in attitude… Change in attitude… respect for respect for Bottom up Bottom up solutions “Democracy BETWEEN elections”

Citizens have to ‘get it’Citizens have to ‘get it’

More health …less health careMore health …less health care

Service contract ??????Service contract ?????? Or longer warranty ????Or longer warranty ????

““Health is Politics”Health is Politics”

“ “ If you want to move healthy public policies If you want to move healthy public policies forward, you have to have forward, you have to have political dynamite”

Dr. Halfan MahlerDr. Halfan Mahler

HOWEVER……HOWEVER……

Public policy usually follows public Public policy usually follows public opinion….opinion….

BECAUSE…….BECAUSE…….

Doing the right thing is very difficult is Doing the right thing is very difficult is the people aren’t onside…the people aren’t onside…

““Father knows best” not great politicsFather knows best” not great politics

CYNICISMCYNICISM

Political Will Political Will to do the right thingto do the right thing

Dramatically improves with an educated Dramatically improves with an educated public…… public…… health literacyhealth literacy

Citizens pulling healthy public policy…. Citizens pulling healthy public policy…. Civic Civic efficacyefficacy

Values... Versus public opinionValues... Versus public opinion

Public opinion ? Public opinion ? sometimes very shortsightedsometimes very shortsighted What’s in in for me ?What’s in in for me ? What we see in polling dataWhat we see in polling data

Need to drill down to Need to drill down to values…values… Deliberative dialogueDeliberative dialogue

EmpowermentEmpowerment taking the time to educate and listen taking the time to educate and listen speaking plain languagespeaking plain language 2 –way accountability2 –way accountability

Health Literacy QuizHealth Literacy Quizversion 1version 1

Is ‘surveillance’ ?Is ‘surveillance’ ? Pattern of diseasePattern of disease cameras in school corridorscameras in school corridors

Is ‘Accessibility’Is ‘Accessibility’ Getting the businessman to work from the suburbsGetting the businessman to work from the suburbs Ramps and closed captioningRamps and closed captioning

Chronic Disease managementChronic Disease management What or who is being managed What or who is being managed ?? Isn`t this about the health care providers too Isn`t this about the health care providers too ?? Why are we blaming the patients Why are we blaming the patients ?? How many specialty clinics should one human have to attend How many specialty clinics should one human have to attend ??

Primary Care … provider, settingPrimary Care … provider, setting Have you ever heard a real person say these words Have you ever heard a real person say these words ??

“What we have here is a failure to communicate”

Cool Hand Luke 1967

The solutions are complexThe solutions are complex

For every complex human problem, there is a neat For every complex human problem, there is a neat simple solution, it’s just that it’s wrong… simple solution, it’s just that it’s wrong…

HL MenckenHL Mencken

Tax cutsTax cuts More copsMore cops More prisonsMore prisons another MRI machine being used 9-5another MRI machine being used 9-5

Health Literacy QuizHealth Literacy Quizversion 2version 2

Empowerment Pulling Healthy Public Policy

Putting the Public back into Public Health

Public Health 101 Public Health 101

1.Do you think we should have a:1.Do you think we should have a:

A) strong fence at the top of the cliffA) strong fence at the top of the cliff

B) state of the art fleet of ambulances and B) state of the art fleet of ambulances and paramedics waiting at the bottom ? paramedics waiting at the bottom ?

2. Would you prefer:2. Would you prefer:

A) Clean airA) Clean air

B) Enough puffers and respirators B) Enough puffers and respirators

for all for all

3. Would you prefer that wait-times 3. Would you prefer that wait-times were reduced by:were reduced by:

A) a falls program to reduce preventable hip A) a falls program to reduce preventable hip fracturesfractures

B) private orthopaedic hospitals and more B) private orthopaedic hospitals and more surgeonssurgeons

4. Should we invest in:4. Should we invest in:

A) early learning, child care, literacy,the early A) early learning, child care, literacy,the early identification of learning disabilities and identification of learning disabilities and bullying programmesbullying programmes

B) increase the budget for young offenders’ B) increase the budget for young offenders’ incarcerationincarceration

5. Should we:5. Should we:

A) assume that the 'grey tsunami' will bankrupt A) assume that the 'grey tsunami' will bankrupt our health care system our health care system

B) include our aging population in the planning B) include our aging population in the planning of strategies to keep them wellof strategies to keep them well

6. Is the best approach to food 6. Is the best approach to food security:security:

A) food banks and vouchersA) food banks and vouchers

B) Income security,affordable housing, B) Income security,affordable housing, community gardens and community kitchens community gardens and community kitchens and a national food policyand a national food policy

7. Governments should boast about:7. Governments should boast about:

A)A) how much they spent on the sickness care how much they spent on the sickness care system system

B)B) the health of their citizens, leaving no-one the health of their citizens, leaving no-one behindbehind

teachable momentsteachable moments

20032003 Canada… 44 died of SARSCanada… 44 died of SARS France…14,000 died in the heat waveFrance…14,000 died in the heat wave

2005..2005..Katrina, KasheshewanKatrina, Kasheshewan

Beyond borders…. Beyond borders…. SARS as a teachable momentSARS as a teachable moment

Beyond silos Beyond silos DepartmentsDepartments DisciplinesDisciplines

Beyond jurisdictional squabblingBeyond jurisdictional squabbling

Germs don’t respect bordersGerms don’t respect borders

Neither do the social contagionsNeither do the social contagions Nor the humanitarian imperativesNor the humanitarian imperatives

Social Determinants of HealthSocial Determinants of Health

vs vs

Choose HealthChoose Health(modifiable risks)(modifiable risks)

The Causes of the CausesThe Causes of the Causes

VersusVersus

The CausesThe Causes

Evolution of the Healthy Canadians TreeEvolution of the Healthy Canadians Tree

ProgressProgress

First MoS Public Health 2003-2006First MoS Public Health 2003-2006 Public Health Agency of CanadaPublic Health Agency of Canada Chief Public Health OfficerChief Public Health Officer Public Health Network for CanadaPublic Health Network for Canada Health GoalsHealth Goals National Collaborating CentresNational Collaborating Centres Knowledge Networks for the SDOH Knowledge Networks for the SDOH

CommissionCommission

CommuniquéCommuniquéFMM September 2004FMM September 2004

““In addition, governments commit to accelerate work In addition, governments commit to accelerate work on a pan-Canadian on a pan-Canadian Public Health StrategyPublic Health Strategy. For the . For the first time, governments will set first time, governments will set goals and targetsgoals and targets for for improving the health status of Canadians through a improving the health status of Canadians through a collaborative process with experts. The Strategy will collaborative process with experts. The Strategy will include efforts to address common risk factors, such include efforts to address common risk factors, such as physical inactivity, and integrated disease as physical inactivity, and integrated disease strategies. First Ministers commit to working across strategies. First Ministers commit to working across sectors through initiatives such as Healthy Schools.”sectors through initiatives such as Healthy Schools.”

Health Goals for CanadaHealth Goals for Canada

As a nation, we aspire to a Canada in which every person is as healthy As a nation, we aspire to a Canada in which every person is as healthy

as they can be – as they can be – physically, physically, mentally, mentally, emotionally and emotionally and spiritually.spiritually.

Next stepNext step

Indicators…for each goal ?Indicators…for each goal ?

Canadian Index of WellbeingCanadian Index of Wellbeing

Atkinson Foundation Atkinson Foundation ….very interesting….very interesting

Changing the way we do things..Changing the way we do things..Managing for results…..Managing for results…..

Whole of Government – results.Whole of Government – results. Health outcomes – NY State…. Hb A1C reportableHealth outcomes – NY State…. Hb A1C reportable Health system performance – readmission ratesHealth system performance – readmission rates The Causes (modifiable risks)The Causes (modifiable risks) The Causes of the Causes (SDOH)The Causes of the Causes (SDOH)

Transparent, comparable and understandableTransparent, comparable and understandable Newfoundland and Labrador Community AccountsNewfoundland and Labrador Community Accounts ““Measuring Quality of Life: The Use of Societal Outcomes for Measuring Quality of Life: The Use of Societal Outcomes for

Parliamentarians”Parliamentarians” 2001, Library of Parliament, Canada2001, Library of Parliament, Canada

GIS …invaluable….. GIS …invaluable….. http://www.statcan.ca/english/freepub/82-221-XIE/2007001/maps/maps.htm#dt http://www.statcan.ca/english/freepub/82-221-XIE/2007001/maps/maps.htm#dt

With the Public Health Map Generator, you can produce high quality, detailed maps of your own health data, in combination with extensive geography from our spatial data warehouse…

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The Public Health Map Generator is a secure, web-based mapping application, accessible only to clients registered with the GIS Infrastructure at the Public Health Agency of Canada.

All of the Infrastructure’s services, including the Public Health Map Generator, are available at no cost to all public health professionals in Canada.

““The mobilization of shame”The mobilization of shame”Irwin CotlerIrwin Cotler

Management 101

“If it’s measured it gets noticed, if it’s noticed it gets done”

Scotland – Honourable Andy Scotland – Honourable Andy KerrKerr

Health outcomes down to postal codeHealth outcomes down to postal code Letter from Family DoctorLetter from Family Doctor InterventionsInterventions Already paying offAlready paying off

Process ….Process ….

Article 54 in PQArticle 54 in PQ HIA…. All MC’s , budget, TB guidelinesHIA…. All MC’s , budget, TB guidelines Gender Based AnalysisGender Based Analysis Disability lensDisability lens Triple bottom line…. NWTTriple bottom line…. NWT UK…Children’s Commissioner.UK…Children’s Commissioner.

impact on children of all policiesimpact on children of all policies Bias-free framework :Mary Anne Burke, Margrit Bias-free framework :Mary Anne Burke, Margrit

Eisler; Global Forum for Health ResearchEisler; Global Forum for Health Research

Structure Structure Gridlock Gridlock

horizontal – departmentshorizontal – departments vertical - jurisdiction vertical - jurisdiction

StructureStructureSilo- busting - HorizontalitySilo- busting - Horizontality

Ministries or Ministers Ministries or Ministers ACTNOW B.C.ACTNOW B.C. Seniors, Children, WomenSeniors, Children, Women Multicultural/SettlementMulticultural/Settlement UK Minister of Joined-Up GovernmentUK Minister of Joined-Up Government

Cabinet committees Cabinet committees Paul Martin’s Aboriginal Affairs – KelownaPaul Martin’s Aboriginal Affairs – Kelowna Manitoba – Cabinet Committee on ChildrenManitoba – Cabinet Committee on Children

Parliament… Parliament… Status of WomenStatus of Women Persons with Disabilities…. Persons with Disabilities….

Population Health: Population Health: Keeping Canadians healthy….Keeping Canadians healthy….

‘‘Citizen centered’ federalism…Citizen centered’ federalism… bottom upbottom up

Strong common purpose…. Strong common purpose…. Local wisdom, local knowledge to get it doneLocal wisdom, local knowledge to get it done Aligning all levels of government and all Aligning all levels of government and all

government departments to what is determined government departments to what is determined in communities.in communities.

InternationalInternationalWHO NGO Advisory Group WHO NGO Advisory Group

Health PromotionHealth Promotion Clear they need to be includedClear they need to be included Clear they know it’s politicsClear they know it’s politics strengthsstrengths

Respond to needs in communityRespond to needs in community Identify policy gapsIdentify policy gaps Advocacy and consensus buildingAdvocacy and consensus building Resource mobilizationResource mobilization

MahlerMahler

All I learned was from developing countries. All I learned was from developing countries. Learned the word Empowerment Learned the word Empowerment

Community Empowerment Community Empowerment

Family EmpowermentFamily Empowerment

Individual EmpowermentIndividual Empowerment

NB dynamic centre is the family NB dynamic centre is the family

Research….Learning CultureResearch….Learning Culture

Evidence-informed practiceEvidence-informed practice Practice-informed evidencePractice-informed evidence

Courage to fund what worksCourage to fund what works Courage to stop funding what doesn`tCourage to stop funding what doesn`t

Complex adaptive systems…Complex adaptive systems…

Research

Practice Policy

Research

Practice Policy

KT

Research

Practice Policy

KT

Political will

Research

Practice Policy

KT

Political will

Appliedresearch

Research

Practice Policy

ENGAGED CITIZENS

KT

Political will

Appliedresearch

Health in CubaHealth in Cuba2009

Infant mortalityInfant mortality

20 x 1000 new born

American Region

4,7 x1000 newborn

Cuba

DispensarizacionDispensarizacion

`the constant assessment of population and `the constant assessment of population and risk`risk`

``We don`t expect people to get sick and come ``We don`t expect people to get sick and come to us``to us``

Pride in their resultsPride in their results

Family doctors annual reportFamily doctors annual report Smokers,obese,sedentary,lipids,BPSmokers,obese,sedentary,lipids,BP

Statisicians, Epidemiologists, PsychologistsStatisicians, Epidemiologists, Psychologists

Accountability to Govt and LegislatureAccountability to Govt and Legislature Weekly meeting with Minister Weekly meeting with Minister

Integration of Health Professional Integration of Health Professional Education & CommunityEducation & Community

health professional must be a professor and health professional must be a professor and give tutorials to the students.give tutorials to the students.

`Polyclinics` - Teaching University`Polyclinics` - Teaching University `̀We don`t train basketball players on a soccer We don`t train basketball players on a soccer

pitch and vice versapitch and vice versa `̀

POLICLINICO UNIVERSITARIO PLAZA DE LA REVOLUCIÓN

Actividades con la comunidadActividades con la comunidad

Círculos de abuelos.Círculos de abuelos. Círculos de gestantes Círculos de gestantes

(clases de (clases de psicoprofilaxis).psicoprofilaxis).

Círculo de lactantes.Círculo de lactantes. Círculo de adolescentes.Círculo de adolescentes. Círculos de interés de Círculos de interés de

escolaresescolares

PolyclinicsPolyclinics ““The family is the centre of our attention”The family is the centre of our attention” Risk rated – Risk rated – potable Hpotable H22O, violenceO, violence

HealthyHealthy SickSick DisabledDisabled

The sick can be “admitted to their own homes”The sick can be “admitted to their own homes” Goal is to improve all health outcomesGoal is to improve all health outcomes ‘‘Psychoprophylaxis’Psychoprophylaxis’ Every child a ‘wanted child’Every child a ‘wanted child’

No time for pessimists

““We are not tinkers, who patch and mend what is We are not tinkers, who patch and mend what is broken. We must be watchmen, guardians of the broken. We must be watchmen, guardians of the life and health of our generation, so that life and health of our generation, so that stronger and more able generations may come stronger and more able generations may come after.”after.”

Dr. Elizabeth Blackwell Dr. Elizabeth Blackwell

Sir Michael MarmotSir Michael Marmot

““Evidence is not enough. There has to be the Evidence is not enough. There has to be the desire, the political will for change. Given that desire, the political will for change. Given that will - a big given but I am an optimist - the will - a big given but I am an optimist - the evidence of what works will be a great help.”evidence of what works will be a great help.”

Bennett (Keynote Health & Health Care Northern Ontario 2010)

Health & Medicine

Transcript of Bennett (Keynote Health & Health Care Northern Ontario 2010)