CAMPBELL COMMISSION PART TWO Jane Speakman City of Toronto Legal Division alPHa All Members’ Meeting April 21-22, 2005 Toronto, Ontario

The Past: Cracks Exposed SARS Outbreak: February 23, 2003 to April 18, 2003; May 22, 2003 to June 11, 2003 Walker Panel On Infectious Diseases Naylor Committee on SARS and Public Health Campbell Commission of Inquiry into SARS (first interim report)

The Present: Progress Operation Public Health Bill 124: Strengthens the role and the independence of the Chief MOH Capacity Review Committee Increased funding for local public health units Provincial Infectious Disease Advisory Ctte iPHIS/Revised Reports Regulation

The Future: Hope and Optimism Campbell’s Recommendations Medical Independence and Leadership –public health lab transfer to CMOH – reporting duties re state of public health –concurrent powers with the CMOH –public health emergency planning –protection from personal liability

Local Governance –2007: decisions re funding and control of public health –Strengthen s. 67 of HPPA –Mandatory health programs and standards –Composition of the Board of Health

HPPA Tune-UP –Reduce categories of disease –Health hazards: definition and application –Section 22 Orders: Standard of Proof and Jurisdiction

Stronger Health Protection Powers –Role and Authority in relation to hospitals –Define a trigger for reporting unexplained illness of cluster of illnesses –Reporting threats to the public –Public Health Directives –Temporary detention –Section 35: Entry into a private dwelling

Reporting Infectious Diseases –Physicians’ duty to report –Expand definition of ‘practitioner’ –CMOH power to collect, analyze and retain lab specimens –Providing additional information to the MOH/Clarify ambiguities in the regulation –Reports to hospitals and amendment to s.39(2) HPPA re information in Orders

Privacy and Disclosure –Mandatory reporting to the MOH in PHIPA –Good faith disclosures to MOH protected –Amendments to HPPA s. 39 permitting disclosures –Timely access to phi for urgent research

Whistleblower protection –Enact new provisions in the HPPA that conform with seven enunciated principles

Quarantine –Compensation packages be ready for use –Availability of timely information –HPPA amendment for LOA without pay –Class Orders for isolation: consult with group –Service of Class orders is effective when notice given –Introduce the word ‘Quarantine’ to the HPPA

Legal Access and Preparedness –Simplify appeal processes in the Act –Codify enforcement procedures in Superior Crt. –Include authority for special procedures in HPPA (ex parte, video hearings) –S. 35 orders may be directed to any police service –Legal preparedness an integral part of public health emergency planning

Emergency Legislation –Clarify that HPPA powers continue to apply –Specify who does what and who is in charge –CMOH has primary authority for public health aspects of every emergency –Subject emergency powers to legal, practical and policy analysis (eg: mass immunization) –Include protocols for speedy access to courts.

Conclusions Recommendations: –continue to advocate a critical shift in thinking in relation to public health reform –identify many deficiencies requiring immediate amendments to the HPPA Evidence of tangible government commitment to change is essential or momentum for reform will dissipate Reform, will make a difference. Advocate!!