The Honourable Carolyn Bennett M.D., M.P. McMaster Medical School February 20, 2013

1.Respond to individual patient health needs and issues as part of patient care; 2.Respond to the health needs of the communities that they serve; 3.Identify the determinants of health of the populations that they serve; 4.Promote the health of individual patients, communities and populations.

 Patient as Partner  Doctor Multidisciplinary  Hospital Community  Social Determinants of Health 3

“The worst thing for a physician is to help someone get well and then send them straight back into the situation that made them sick in the first place” 4

“Good public policy is developed when the policy-makers can keep in their mind’s eye the people affected.” Jane Jacobs

When physicians speak, people listen  Dr. Albert Schweitzer - Humanitarian  Dr. Gro Harlem Bruntland - Norway  Dr. Helen Caldicott – anti-nuclear activist  Dr. Michelle Bachelet -Chile  Dr. Howard Dean –Governor  Prime Minister Charles Tupper- Canada

from cynicism to effective citizenship “A politician’s guide to listening A citizen’s guide to being heard work in progress !!!

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Patient as Partner Ask people what’s wrong and listen, together develop a plan Patient knew their body best, Doctor knows the system best

 Sharing risk  getting people the health care they need when they need it  Keeping people well not just patching them up once they get sick 11

“Politics in Canada has always been the art of making the necessary possible. Peter C. Newman

Deciding ‘what’s necessary’….. is political

14  Fair  Transparent  Takes people seriously

 INITIATED BY  Government  Parliament PUBLIC CONSULTATION  INITATED BY  Citizen  Stakeholder group ADVOCACY

“People don’t want to govern they want to be heard.” “Civic efficacy” “Two-way accountability”

Government vs Parliament

INFORMATION COMMUNICATION SEND AND RECEIVE

 NGO’s  Professional Organizations  Media  Electoral Politics

 Who  What  When  Where  Why  And HOW

 What  Why  Who  Where  When  And HOW

 WHAT  Short Term  Long Term

 WHY  Evidence  International, other jurisdictional examples  Win, win

 WHO  Minister, staff  MP’s on Committee  Other possible MP champions  Opinion leaders  Getting ‘unusual suspects’ onside  Gotta get a posse

 WHEN  Have a look at the Parliamentary Schedule !  Earlier the better !!!

 IDEAS floated  Think tanks  party platform  Speech from the Throne  White Papers, Green Papers, Draft Leglislation  Bill tabled

 HOW  Tell the truth !! what will the opponents be saying ?  Bills:  Prepare possible amendments  Suggest other witnesses  Questions for QP  Petitions  Media

2005 CAUSE S of the CAUSES 33

As a nation, we aspire to a Canada in which every person is as healthy as they can be – physically, mentally, emotionally and spiritually. 34

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HYGEIA: Goddess of Health 36

I swear by Hygieia, the goddess of health making her my witness that I will fulfill according to my ability and judgment this oath and covenant: I affirm that the ultimate goal of all health providers is to promote health, prevent disease and injury whenever possible. 37

 Patchwork quilt of non- systems  Focus on sickness… and the repair shops 38

 “For every complex human problem, there is a neat simple solution. It’s just that it is wrong.”  HLMencken  Complex problems require complex solutions  We need simpler messages……

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A) strong fence at the top of the cliff B) state of the art fleet of ambulances & paramedics waiting at the bottom ? 42

A) Clean air B) Enough puffers and respirators for all 43

A) a falls program to reduce preventable hip fractures B) private orthopaedic hospitals and more surgeons 44

A) how much they spent on the sickness care system B) the health of their citizens, leaving no-one behind 45

 Most appropriate care  In the most appropriate place  By the most appropriate person – paid and unpaid 46

PREVENTION  Public Health Network – 13 jurisdictions  Regulation  Transfats, Sodium, Generic Oxycontin  Social Determinants of Health  Poverty –EI, housing, pensions  Violence – gun control  Environment – air, water, land  Equity  Education – FN’s, post secondary 47

QUALITY  Health Council Canada  was overseeing 2004 Accord  6 provinces have Quality Councils  ? Insist on 13  Hold Federal Government accountable for results  Aboriginal, Corrections, Military, Veterans, (RCMP) 48

 Use the system wisely  Keeping our families well  Clinical guidelines  Self Care Manuals  Fight for more HEALTH so we`ll need less health care  Democracy between elections 50

Putting the ‘poli’ into policy  Research  Policy  Practice

research practicepolicy

research practicepolicy KT

research practicepolicy KT Political Will

research practicepolicy KT Political Will Applied research

research practicepolicy KT Political Will Applied research CITIZEN ENGAGEMENT

Physical and mental energy come from feeling in control of your life, having real choices, and being involved with other to find ways of organizing change for the better. Barbara Rogers

“We are not tinkers, who patch and mend what is broken. We must be watchmen, guardians of the life and health of our generation, so that stronger and more able generations may come after.” Dr. Elizabeth Blackwell first woman physician North America 58