Canada ranks poorly for child poverty
Unicef places nation 19th among 26 developed countries
By MARGARET PHILP, Globe and Mail

Tuesday, March 1, 2005

Among the world's wealthiest nations, Canada falls near the bottom of the
pack when ranked by its level of child poverty.

In a Unicef report to be released today, rare for turning a lens on the
rich rather than the developing world, Canada is 19th among the 26
countries ranked according to their record of child poverty, a dubious
distinction that places the country behind the Czech Republic, Hungary and
Poland, though ahead of the United States and Britain.

It is the second report by the Florence-based Unicef Innocenti Research
Centre on child poverty in countries of the Organization for Economic
Co-operation and Development. It shows that the number of poor children,
14.9 per cent in Canada in 2000, barely budged in the nearly five years
since the first study placed this country 17th out of 23.

"We're doing extremely poorly," said Barabara Strang, a spokeswoman for
Unicef Canada. "I think Canadians will be quite shamed to see we're in the
bottom third of OECD nations in terms of child poverty."

The report regards poverty as a relative measure, calculating the
percentage of poor children as those whose families' incomes fall below a
line drawn at 50 per cent of the median for the country.

In the eyes of the Unicef researchers, poverty in rich countries is the
point below which children cannot afford the trappings that are considered
normal and necessary to others around them.

Unicef draws special attention to Canada's definitional dithering over a
poverty yardstick. It says countries must set targets for eliminating child
poverty, next to impossible while they remain stalled by endless debate
over its measurement.

"Clearly, 18 other nations in the OECD have figured out a better system for
protecting their children from poverty," Ms. Strang said.

For Maria Rodrigues and her four-year-old daughter Rowan, child poverty in
a rich country such as Canada is not a case of starvation and ragged
clothing, but rather food banks, long waiting lists for subsidized housing
and scrounging for free children's recreational programs. Ms. Rodrigues is
a regular at her local library.

Trained as a bookkeeper, she suffers from bipolar disorder and has endured
long stints of unemployment most of her life. She collects a $579 welfare
cheque every month, but even second-hand clothes are a luxury she can
scarcely afford.

Still a preschooler, Rowan is oblivious to her poverty.

"I think it probably starts when they go to school and start comparing
themselves to other kids," said Ms. Rodrigues, a single mother who pays
$235 a month for her subsidized apartment in Toronto.

"You know how you go to the store and they say, 'I want this and I want
that'? I just say, 'I don't have the money right now. I'll get it for you
later.' And she says, 'Okay, later.' I'm trying to instill a sense of
limitation and not take whatever she has for granted."

The Unicef report shows that the lowest rates of child poverty are in
Scandinavian countries where more than 10 per cent of gross domestic
product is devoted to social programs that have worked to reduce so-called
market poverty, the percentage of people who would be poor were there no
tax breaks and other government intervention, by at least 80 per cent.

The countries with the lowest rates of child poverty are Denmark, at 2.4
per cent, followed by Finland, Norway and Sweden.

"We can do better as a country," said John Anderson, vice-president with
the Canadian Council on Social Development. "We have the resources right
now to do better and I don't think this is acceptable to be 19th out of 26
when there are so many countries who are not as rich as we are and able to
do better."

Bringing up the rear on the list are Mexico, with a child poverty rate of
27.7 per cent, the United States, at 21.9 per cent, and Italy, at 16.6 per
cent. All six of the non-European countries on the OECD list ranked near
the bottom.

Of the 24 countries with statistics dating back to the early 1990s, the
report found that child-poverty rates climbed in all but seven. Part of the
story was a drop in social spending in countries such as Canada, where the
report showed that children received 12.2 per cent less in social spending.
Across the globe, developed nations are spending more on health care and
pensions at the expense of children.

© Copyright 2005 Bell Globemedia Publishing Inc. All Rights Reserved.

-- NEWS FROM OUR PARTNERS --

For immediate release Feb. 11, 2005

Advocates to Dryden: Keep pushing for quality child care

VANCOUVER --Advocates monitoring federal/provincial talks here encouraged the federal government to hold strong and insist on conditions for its child care funding. At the same time, they want the provinces to quit stonewalling and come to the table with plans to turn their substandard services into quality child care.

The provinces are holding out for the federal budget before making any commitments. At the same time, Ottawa is not prepared to release its $5-billion child care fund until the provinces agree to accountability measures.

"The federal government has a responsibility to Canadians to ensure public funding produces good quality care. The provinces should not get money with no strings attached," said Debra Mayer, Chair of the Child Care Advocacy Association of Canada.

"If waiting means good quality child care then the wait is worthwhile. However there are thousands of families lined up for child care across Canada. They are not prepared to wait forever," said Mayer. "Minister Dryden needs to jump start the national program with those provinces that are prepared to move."

She said the call for accountability, quality and non-profit services had an impact. "The concerns of parents were heard." The Association said it will continue to call on the federal and provincial governments to put the needs of children and families first, and reach an agreement containing adequate public funding, legislation, concrete accountability measures and non-profit expansion of services.

In the interim there are provinces and territories willing to provide the necessary assurances, Mayer said. "The federal government can immediately enter into bilateral agreements with those provinces to kick start the plan."

-30-

For information:

Bozica Costigliola (613)866-1440

Kerry McCuaig (647) 295-2808

Satisfaction gauge may be used to shape government policy

Jordan Heath-Rawlings
Toronto Star, May 8 (page A8)

A new Canadian index will gauge how people are faring overall, not just how much they're spending.

The Canadian Index of Wellbeing will be far more accurate than its economic cousin, the gross domestic
product, says Roy Romanow, who was in Toronto last week to present it at the United Way of Canada conference.
"(The GDP) tells us how much total income we are producing, but tells us nothing about how that income is
distributed," said Romanow, the former Saskatchewan premier who chaired the 2002 commission into medicare.
The index has been five years in the making, and some of its first quarterly figures are due to be published in the
fall.

"When the single most influential national lens that we use to measure our progress and wellbeing as a country is
confined to a narrow set of economic indicators, it sends inaccurate and even dangerous signals to policy makers."
The gross domestic product is driven skyward when bad things happen and money is spent to fix the problems,
Romanow said. Problems like the Quebec ice storm, traffic accidents, street crime, deforestation.
But the Canadian Index of Wellbeing is driven down by negative things like crime, poor health and unaffordable
tuition.

The index takes its cue from countries like the Himalayan kingdom of Bhutan, where the government measures
the level of satisfaction among its populace and attempts to shape public policy to better those levels. In Canada,
a national working group of about 20 organizations was convened with funding from the Atkinson Charitable
Foundation. "We, along with others, had been doing this work in a very scattered way," said Ron Colman,
executive director of Genuine Progress Index Atlantic, a non-profit organization that had been developing a
wellbeing index for Nova Scotia. "What the Atkinson foundation did is bring everybody together."
Measuring the level of life satisfaction among the people of a country is certainly not confined to Bhutan, although
it was there that the king declared in 1972 that "the Gross National Happiness is more important than Gross
National Product."

New Zealand also produces national reports on the wellbeing of its citizens, which are often taken into account by
the government in making decisions.

Colman says the Canadian group is learning from the models of New Zealand and Bhutan how to best ensure the
government, which has no real connection to the wellbeing index, acts on what the data indicate Canadians are
experiencing.

"We're learning how to push this further along on the public policy agenda," he said. "But they are also learning
from us that there is strength in having data come from an independent source."

Researchers across the globe have been attempting for decades to find a formula that objectively measures how
satisfied people are with their lives, without much concrete success.

Dutch professor Ruut Veenhoven, a highly regarded researcher in positive psychology - the study of what makes
us happy and why - has for 20 years been working on the World Database of Happiness. He has found that,
although the most prosperous nations tend to score higher than the poorest ones, there are exceptions. El
Salvador for instance ranks 7 2 out of 10 the same as Great Britain

Salvador, for instance, ranks 7.2 out of 10, the same as Great Britain.

Veenhoven's research was largely based on people's own judgments of how satisfied they are with their lives. The
Canadian Index of Wellbeing will be calculated based on data gathered by about 20 researchers, from Statistics
Canada, Environment Canada and researchers from several universities.

While it's unavoidable some self-reported data will be used, researchers are planning to take into account harder
numbers, such as the costs of education and of everyday essentials.

"This is not a feel-good type of self-survey," said Charles Pascal, executive director of the Atkinson foundation.
"This is using data to measure, in a very tangible way, the things that matter to Canadians."

The working group will measure areas such as living standards, health and welfare and levels of political
engagement.

Said Dr. Robert McMurtry, a London physician who also serves on the Health Council of Canada: "I can remember
the days when you didn't have so many people who couldn't afford higher education, when you felt a lot safer
walking the streets at night and when pollution wasn't such a problem. I'd like to see us have a standard by which
we can measure whether these things - which are so important to us - are going upwards or downwards."

Ten Years of Federal Budgets: Double Whammy for Women (Feb 3, 2005)

This latest report of the Canadian Feminist Alliance for International Action was authored by Armine Yalnizyan, a recipient of the Atkinson Foundation's Economic Justice Award. 

---

10 YEARS OF FEDERAL BUDGETS: DOUBLE WHAMMY FOR WOMEN

OTTAWA - February 3, 2005 - Federal fiscal choices have done little to improve most women's economic security over the last 10 years, says the first ever analysis of federal budgets on Canadian women.

The ground-breaking report, released today in Ottawa by the Canadian Feminist Alliance for International Action (FAFIA), tracks a decade of federal budgets. Written by award-winning economist Armine Yalnizyan, it measures the federal government's performance against the explicit commitments it made to gender equality in Beijing in 1995.  It shows that massive spending cuts unduly hurt women in the deficit era and women's interests have been largely ignored since Ottawa began posting surpluses.

"On the 10th anniversary of the adoption of the Beijing Platform for Action, we found that the promises didn't match up with the federal government's fiscal choices," Yalnizyan said.

"Since 1998 Canada has posted annual surpluses, but the federal government has been more interested in tax cuts and debt reduction than in reinvesting in social supports that help women," added Yalnizyan.

By comparing federal budget promises with federal public accounts, Yalnizyan was able to trace where the money was cut during the nation's deficit era, and where it was spent during the surplus era. The results make it clear that promises made to women were not kept.

*       Cuts and changes made to vital programs -  such as Employment Insurance, the Child Tax Benefit, housing, and the Canada Health and Social Transfer - during the deficit era were never fully reversed during surplus years;

*       Almost $12 billion a year was cut from these social supports between 1994 and 1997;

*       Once the federal government began registering surpluses in 1998, it allocated  $152 billion to tax cuts and $42 billion to new program spending on initiatives such as defence and innovation, while programs that benefit women lost out;

*       Only a fraction of new spending went to affordable housing or quality child care - programs that make a central difference in women's lives.

"What we found is that women bore the brunt of the federal government's deep fiscal cuts," said FAFIA spokesperson Lise Martin.

The report shows that since the deficit was eliminated way ahead of schedule, and since the surpluses have been much larger than projected,
the depth of the cuts made between 1995 and 1998 may not have been necessary and many women may have suffered needlessly.

"Even now, social programs that directly benefit women remain low on the government's list of fiscal priorities. Whether times are bad, or times are good, women are made to wait," emphasized Lise Martin.

"A commitment to equality means a commitment to allocating resources to the programs that make a difference," said Shelagh Day of FAFIA. "After 10 years of waiting for progress, it's time for the Government of Canada to stop ignoring women. Women have a claim to make on this surplus."

For more information:

Nancy Peckford: (613) 232-9505, x222 or (613) 292-7941 (cell)

Lise Martin: (613) 563-0681

Shelagh Day: (604) 872-0750
Report available from: http://www.fafia-afai.org/gvt/CanadaCommitmentToEquality.pdf

Media Release:
YORKTOWN CHILD AND FAMILY CENTRE EARNS $50,000 AWARD FOR INNOVATIVE PROGRAMS SERVING DIVERSE TORONTO COMMUNITY

TORONTO- October 20, 2004 – Awarding its work assisting “children at risk”, the Atkinson Charitable Foundation will be presenting a $50,000 cheque today to Yorktown Child and Family Centre, a mental health agency operating in one of Toronto’s most ethnically diverse communities.

Betsy Atkinson Murray, President of the Atkinson Charitable Foundation noted that "this year, again, we had a wonderful response to the RAH Award Call for Nominations.  The Foundation selected Yorktown from among those, for its comprehensive and culturally sensitive programs that serve over 1000 children every year in the former City of York.

“This is ground-breaking work in a community that requires a very nimble and open approach,” said Nancy Hindmarsh, Chair of the award selection committee. “We were impressed by the constantly updated programs and partnerships that reach out to the heart of the many communities this agency serves.  Yorktown does everything possible, so that families in crisis, especially families new to Canada, feel comfortable seeking assistance.”
 
Sixty-five per cent of Yorktown’s clients have recently arrived from other countries.  One innovative program for immigrant families, called Reconnecting offers support and counseling for adolescents trying to reintegrate with their family members after a period of living apart in their home country.  Another initiative, the Somali Outreach & Education Program, offers parenting and family support to Somali parents and is tailored to respect their cultural values and customs.  Both Reconnecting and the Somali Outreach & Education Program are unique in Toronto, and the latter is being replicated in Scarborough.

“Yorktown responds swiftly, but we also respond thoughtfully”, said Yorktown Executive Director Karen Engel. “We believe that service which is responsive, culturally relevant and close to home is important for children and families.  We make every effort to work with local schools and community organizations to ensure easy access for all of our participants. We are extremely honoured to have been recognized by the Atkinson/Hindmarsh families.”

Community leader and children’s advocate June Callwood originally nominated Yorktown for the award. “Yorktown Child and Family Centre is a paragon among social agencies and I cannot think of a more worthy recipient for this illustrious and significant reward,” she said.

The Ruth Atkinson Hindmarsh Award, is presented annually in memory of Ruth Atkinson Hindmarsh who served as president of the foundation, from 1966 until her death in 1994 at the age of 101.  Established in 1998 to improve the lives of disadvantaged children, the award is the largest of its kind in Canada.

For more information visit:
www.yorktownfamilyservices.com or www.atkinsonfoundation.ca
Contact:  Yorktown Family Services Executive Director Karen Engel, 416-394-2424 or Atkinson Foundation Charles E. Pascal, Executive Director:  416-869-4022

Prominent Canadians urge Dryden to stand firm on child care deal

      Two prominent Canadians are offering Social Development Minister Ken Dryden their advice as he prepares to meet his provincial counterparts later today.  Dryden is seeking a child care agreement as a precursor to the feds flowing $5-billion to the provinces over the next five years.

       The money isn't enough to meet the needs of every child, says Margaret McCain, co-author of the Ontario Early Years Study, but "it is an important start and how it is spent will determine the look of the new national program to come".

      McCain joins Toronto banking executive and children's champion Charles Coffey in urging the ministers to put their usual wrangling aside.  In the context of last week's scathing indictment by the Organization of Economic Co-operation and Development, the Ministers are charged with the need to convert Canada's "dismal junkyard of poorly supported programs from a user-pay to a public service," he says.

      The pair applauds Dryden's vision for an early learning and child care system as the next great social initiative.  Creating a new national program will require federal leadership they advise, warning Ottawa not to allow the provinces to 'do their own thing'.  Past early childhood agreements had consensus but soon exacerbated the fragementation the OECD decried.  "If getting everyone's okay means a race to the bottom, move forward with those provinces willing to participate," the letter says.

      Other counsel offered by the Order of Canada recipients, include:

Encourage provinces to rationalize their disconnected early education, child care and parent support services to provide a stable platform for expansion.

Raise government standards for early learning and care programs to promote quality and win public trust.

Develop service plans with goals and timetables for expansion and quality enhancements to hold governments accountable.

Require plans to demonstrate they are meeting quality and accessibility standards as a condition of funding.

Institute common data collection, research and assessment mechanisms to provide a Canada-wide picture of progress.

Restrict the new funding to non-profit/public delivery to prevent foreign operators from grabbing up public funds to establish 'big box' child care.

The complete letter is available on www.atkinisonfoundation.ca

For more information contact: Charles Coffey 416 254 5939.

 

Toronto Star (Saturday, July 30, A15)

 

U of T prof is awarded early child development honour

 

Leadership role in early years research

Appointment caps long career’s work

 

Peter Edwards

Staff reporter

 

Carl Corter, a University of Toronto Psychology professor with more than three decades of experience in childcare issues, has been awarded the Atkinson Charitable Foundation Chair in Early Child Development and Education.

 

“This is the culmination of all the things that I’ve been interested in, and the hope that it can be applied to young children and families,” Corter said in an interview yesterday.

 

He said it’s “a terrifc honour” to be following in the tradition of John J. Kelso, a Toronto reporter in the late 19^th century whose fight for vacations and excursions for impoverished children led to the creation of the Star’s Fresh Air Fund.

 

Keslo, a friend of then Star publisher Joseph Atkinson, was also a founder of the Toronto Humane Society and the Children’s Aid Society. 

 

Corter, 59, received his PhD from the University of North Carolina at Chapel Hill, and joined U of T’s psychology department in 1971.

 

“Dr. Corter’s demonstrated excellence in scholarship, coupled with his community leadership and strong advocacy for early childhood development and education make him a perfect fit for the role of the Atkinson Chair,” Charles Pascal, executive director of the Atkinson Charitable Foundation, said in a statement.

 

The appointment is for five years at U of T.  Corter replaces Daniel Keating – professor of human development and applied psychology at the U of T’s Ontario Institute for Studies in Education – who held the chair for three years.

 

As Chair, Corter will play a leadership role in the Atkinson Centre for Society and Child Development, a network of researchers, practitioners, and policy-makers engaged in research, training and pilot projects aimed at enhancing understanding and support for the early years, a statement from the Atkinson Foundation said.

 

Corter will continue as director of research and evaluation for the Toronto First Duty Project, a partnership between the Atkinson Charitable Foundation, City of Toronto and the Toronto District School Board that focuses on linking child care, kindergarten and family support programs.

 

The Atkinson Charitable Foundation established the Chair in Early Child Development and Education and the U of T in 2001 with a $1 million endowment fund.

 

Copyright Toronto Star Newspapers Limited

Economic indicators only tell part of the story. Enter the CIW: Canadian Index of Well-being

By ANDRÉ PICARD

Globe and Mail

Thursday, May 12, 2005 Page A19

What is the best measure of the health of a nation? In our money-obsessed, business-driven society, we tend to depend on a narrow set of economic indicators like gross domestic product, fluctuations of the dollar, and the closing numbers of the TSX.

At times, we will look to life expectancy, the unemployment rate, and the number of people living below the poverty line.

But to get a true measure of the overall health of a country -- and more important, whether its status is improving or declining -- we need to track a broad spectrum of health indicators, environmental factors and social measures like community participation.

That's why a group of leading academics and policy-makers has set out to create a Canadian Index of Well-being, or CIW.

The idea got an important boost last week when Roy Romanow, head of the Commission on the Future of Health Care in Canada, enthusiastically endorsed the idea. "Our mission for the CIW is to provide Canadians with a clear, valid, and regular accounting of the things that matter to them and the genuine progress of Canada," Mr. Romanow told the annual conference of the United Ways of Canada. "The task before us is to create a new tool that will help foster a common vision for the future of Canada. We want to account honestly and accurately for changes in the human, social, economic and natural wealth. We want to use that as a basis for improving our performance in areas that matter to Canadians."

Mr. Romanow said promoting the index is a natural extension of his work on the commission, whose overriding goal was "to make Canadians the healthiest people in the world." He hopes to use his high profile to get the issue in the public eye and on the political agenda.

Mr. Romanow, postcommission, is a professor at the University of Saskatchewan and a fellow at the Atkinson Charitable Foundation. He has also become the public conscience of medicare, a role elected officials have abandoned.

Yet, he never tires of saying that no matter how good is the health system (or as he has taken to calling it, the "illness-care system"), it cannot on its own produce a healthy population.

For this to happen, attention must be paid to the social and economic determinants of health, such as income, housing, employment and the environment. The well-being index would try to measure progress in those key areas in a concrete manner, and be used to make governments more accountable on social and health matters.

The team working on creating a CIW includes representatives from Statistics Canada, Environment Canada, eight universities and six non-government research organizations, and they have $1.5-million in initial funding from the Atkinson Charitable Foundation.

They are developing a set of indicators in seven areas: living standards; health outcomes; education and literacy; environmental quality; community vitality; citizen engagement; time use and work-life balance.

Many of these data are much more difficult to compile than traditional economic indicators. But, as Mr. Romanow pointed out in his speech, those traditional measures are flawed and send "inaccurate and dangerous signals to policy-makers."

The GDP, for example, does not distinguish between activities that bring benefits and those that cause harm. "As long as money is spent, the GDP goes up. Crime, accidents, sickness, smoking, war, pollution, natural disasters -- ice storms, floods, tornadoes -- all increase the GDP simply because money is being spent on prisons, lawyers, doctors, drugs, hospitals, cigarettes, guns, pollution cleanup and damage repair."

The GDP tells us how much total income is being produced, but not how it is being distributed, and this has often lead to skewed public-policy priorities.

The CIW will not, of course, come up with a single tidy answer. But it will give us a better measure of the health of Canadians, and the society they live in, than can be measured in dollars alone.

Good health and a good life -- for individuals and for society as a whole -- is a complex equation but, by and large, people know what matters.

"If you look at what people have said about what makes a 'good life' going back to at least the 5th century B.C., they will say things like: 'Well, if you have health, if you have somebody who loves you, if you have financial security and you live in a friendly community and have decent housing, then you're having a fairly good life,' " said Alex Michalos, director of the Institute for Social Research and Evaluation at the University of Northern British Columbia.

"The Canadian Index of Well-being is about that kind of common sense."

Copyright of the Globe and Mail

http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050512/HPICARD12/TPHealth/?query=romanow

 

 

"Stand on guard for child care"

 

Op-ed by Margaret McCain and Roy Romanow argues that a new national child care program could be as significant to nation-building as Medicare and public education.

 

in the Globe and Mail - Friday, February 4, 2005 Page A15

 

Click here to view the op-ed

Thu, January 27, 2005

Big degrees, small employment

By BRODIE FENLON, TORONTO SUN

HEMANT PANCHPOR speaks 12 languages, has a master's degree in economics, another degree in energy planning, and years of experience as a mid-level manager at an IT firm in his native India. Yet the 40-year-old immigrant has spent the last year in Canada bouncing from one temporary job to another.

Since he immigrated in December 2003, he's done telemarketing at minimum wage, worked an assembly line, customer service for a bank and is now employed part-time in data entry for a local insurance company.

Panchpor is the human face behind the numbers in the new Statistics Canada labour study, which has found new employees are increasingly being offered temporary jobs.

Of all women newly hired in 2004, 23% held temporary jobs, more than double the rate of 11% in 1989, the study notes. Likewise, 20% of men hired in 2004 held temporary jobs, compared with only 12% in 1989.

"It's really saddening. These employers just want to make profits. They are just using immigrants and temporary workers and the people are getting crushed," Panchpor said.

Temp workers "are not speaking out, because if they speak out, they will lose their jobs. It's a vicious circle," he said.

Temp jobs offer low wages, no benefits and no job security, which is why companies are relying on them to cut costs and boost their bottom lines, said Juana Berinstein, policy co-ordinator with Toronto Organizing For Fair Employment, a workers rights and information centre.

Panchpor offers another solution. He said the industry needs to be regulated.

 

Speech for The Cooperators

Halifax

April 15, 2003

I am very pleased to be here with you. I am pleased to have the opportunity to talk about the future of our health care system. It's also nice to be with friends who understand the power of cooperation and the creative expression of its principles in community based cooperatives and entrepreneurial business versions as well. And frankly, given the chaotic world in which we live, I am pleased to be anywhere!

It's been just over 4 months since my final report was submitted, and just over 2 months since Canada's First Ministers came together to achieve the landmark 2003 Health Accord.

I must say that I take no small amount of pride in the fact that First Ministers agreed to act as quickly as they did to give effect to many of the key recommendations included in my Commission's Final Report.

Pride, not because the Accord's proposed directions are a vindication of what I recommended; after all, even a cursory review of the myriad of recent task force and special committee reports on the future of health care will reveal broad consensus already existed on most key issues. Rather, pride because First Ministers clearly listened to Canadians' urgent plea for fundamental changes to the health care system and for governments to work collaboratively to strengthen it.

Indeed, I referred to the Health Accord as a landmark for a number of reasons.

First, the first ministers have publicly confirmed their commitment to the five principles of the Canada Health Act.

Second, they recognized that reform and new public investments are required to meet Canadians' desire for a sustainable health care system that provides timely access to quality health services.

Third, they took a solid first step toward reform by not only reaching consensus on a number of targets and objectives for improving the health care system, they also agreed to report publicly on their individual and collective progress in meeting them.

Fourth, they accepted the imperative to improve transparency and accountability of Canada's health care system.

Fifth, they recognized the urgent need to better monitor population health and to address health disparities by directing Health Ministers to "continue to work on healthy living strategies and other initiatives to reduce disparities in health status."

Last, and perhaps most significantly, they agreed to work collaboratively with each other, with providers and with Canadians, in shaping systems future, by agreeing to the creation of a Health Council of Canada. I'll have more to say on this issue shortly.

These are not insignificant achievements, and First Ministers deserve credit for their efforts, for their flexibility and for their leadership.

Over the past number of weeks, I have made a number of presentations in which I commented on specific aspects of the Accord. Let me briefly summarize the gist of my comments. I will then outline for you what I believe to be the critical next steps on the journey toward reform.

In doing so, I will focus specifically on the need for a strong and effective health Council of Canada.

The 2003 Health Accord

In addition to the points I have already covered, there is much to commend the 2003 Health Accord.

For example, Canadians should be pleased that First Ministers agreed to embrace a reform agenda that goes beyond a simple focus on hospitals and physician services. The ambitious and explicit targets that have been established for ensuring 24/7 access by Canadians to frontline primary health care is an important and positive development.

Canadians should also welcome the collective commitment by First Ministers to set certain national objectives in regard to home care, especially for community mental health services.

This is a praiseworthy step forward, as is the recognition by First Ministers of the need for action to provide catastrophic prescription drug coverage for Canadians and the decision to allocate $1.3 billion for First Nations health.

Finally, the agreement to replace the Canada Health & Social Transfer with a dedicated Canada Health Transfer will improve transparency and accountability in regard to what each level of government is contributing to the health care system.

However, I also have some fairly strong views in relation to the adequacy of the dollars on the table and where and how they will be spent to improve and strengthen the health care system for all Canadians.

Make no mistake: there is a lot of taxpayer money on the table in the current Accord. Depending on the assumptions used - and I don't care to get drawn into sterile debates over what constitutes "new" and "old money" - there si somewhere between $30 and $34.8 billion at stake over the next several years.

But I have 4 major concerns with the dollars.

First, there is less money than what the Premiers were seeking, less money than what the Senate Committee report suggested was necessary, less money than what my own Commission recommended and, most importantly, less money than is needed for the federal government to contribute its historical federal share of the medicare bargain.

Second, while First Ministers accepted allocating some $16 billion over the next 5 years to a Health Reform Fund, there are still too few details available to know what the Health Reform Fund will actually achieve, what conditions, if any, will apply, or what criteria will be used to evaluate its effectiveness.

I have similar concerns about the immediate $2.5 billion top-up that has been agreed to, ostensibly for assisting provinces to address urgent priorities-like reducing waitlists and improving timely access to care, especially advanced diagnostic services. If the $2.5 billion is spent wisely and according to a coherent plan, it can make a positive difference.

However, unless the federal government is prepared to step up to the plate, the only real guarantee that the additional $2.5 billion monies will in fact be devoted to health care will be hard public scrutiny.

Third, much of the money available within the Health Reform Fund will be back-loaded, and this will delay urgently needed reforms in a number of areas.

For example, my report recommended an additional $3.5 billion in federal health funding in 2003/2004 and a further $5 billion in 2004/2005- all of it specifically targeted in 5 priority areas to kick-start the process of transforming the system.

Thats $8.5 billion over 2 years, all targeted toward change. Thereafter, federal funding would be fixed at 25% of provincial CHA-related spending. Under the Health Reform Fund, less than $1 billion will be available in Year 1 for transforming the system, and funding increases will only rise gradually thereafter. This doesnt mean change will not occur, only that it will occur more slowly than would, in my view, be desirable.

Last, the inability of First Ministers to agree on a method for financing health care that results in stable, predictable funding that supports long-term planning, is frankly disappointing.

The Path Ahead

I do not want my comments to be construed as damning the Accord with faint praise. As a former Premier, I can personally attest to how difficult and politically fraught the federal-provincial arena can be. The Health Accord is, I repeat, a landmark achievement that provides a strong foundation for revitalizing our health care system. It is a strong step forward, not a step back.

Now, as you know, there is no shortage of areas in our health care system where we can do better:

      We need to better coordinate and support the expansion and alignment of health professionals and of our health infrastructure, making sure plans in all jurisdictions can keep in step with patient needs and expectations.

      We need to much more to make timely access to quality care for all Canadians a reality.

      We need to focus more on preventing chronic diseases and invest more in population health and wellness initiatives that make the system more sustainable and that promote self-reliance.

      We need to upgrade our national capacity in health research, especially as it applies to population health, and in applied health informatics.

      We need more collaborative initiatives, like the Common Drug Review process that came on stream earlier this year, to help us to get a handle on containing rising drug costs. And we need to ensure we have a regulatory system that is more responsive to public policy imperatives for safety, affordability, security of supply, ethical standards and competitiveness.

However, I believe that only limited progress can be made in tackling these problems anywhere in this country in the absence of a coherent and coordinated national plan of action. This presupposes that the conditions exist for the federal and provincial governments to move forward together.

We are getting much closer, as the restraint exhibited by First Ministers throughout the meetings leading up to the Health Accord indicates, but we are not there yet.

To make headway on this problem, I believe we must continue to make progress in three key areas.

First, I believe we must change the way we finance our health care system, not just to provide the necessary stability, but to reduce the unproductive tensions between the Federal government and the provinces.

Second, I believe we need to modernize the Canada Health Act to reflect the reality of how health care is delivered in Canada today.

Last, we need to establish an effective Health Council of Canada to make the health system more accountable to taxpayers and to give patients and providers a stronger voice and a greater say in shaping its future directions. Permit me to summarize my views:

Permit me to summarize my views:

Funding the Health System & the CHA

In my final report, I recommended that by 2005/06, the federal government cover a minimum of 25% of provincial health spending for CHA expenditures and that this be provided in the form of a dedicated cash-only transfer. I also proposed an escalator clause within the transfer to allow the federal share of health spending to track inflation and adapt to changing patterns of provincial health care spending.

Taking account of tax points that were permanently transferred to the provinces in 1977, the 25% cash transfer would restore the federal governments share of CHA-covered health spending to historic levels.

What would this new funding mechanism achieve? For one thing, it would remove an ongoing irritant from the already volatile inter-governmental relations mix, while simultaneously improving transparency and accountability. The federal and provincial governments would be working from the same numbers, and they would not be continually negotiating the size or growth of the federal transfer.

In short, the result would be a more positive federal-provincial dynamic and adequate, stable and predictable funding for the system.

I also linked the 25% federal funding floor by 2005-2006 to targeted funding in a number of specific areas over the next two fiscal years.

The targeted funding was to focus on addressing key short-term priorities of Canadians, such as improving timely access to care and to advanced diagnostic services. It was also intended to "kick-start" the revitalization of Medicare by providing federal funding to support home care and prescription drug treatment as integral components of a modern health care system.

To entrench these changes, I also recommended that the Canada Health Act be amended to include priority home care services and, over time, prescription drug coverage. In my view, this would acknowledge that health care today is more than just about doctors and hospitals.

Keeping in mind that prescription drug coverage and homecare are the fastest growth areas of health care spending, this would also ensure the federal government was financially responsible for paying its share of the system's expansion.

I do want to clarify that my preference for a fixed federal funding floor does not mean carte blanche for provinces to spend health dollars as they see fit. I absolutely recognize that under our constitution, provinces have primary jurisdiction for health care.

But they do not have exclusive jurisdiction, and the federal government has a legitimate and constitutionally recognized national interest responsibility for ensuring the integrity and effectiveness of the system. The need to encourage and facilitate coordinated action to reduce health disparities among the poor and our First Nations is only one example.

Should the funding approach outlined in my report be accepted, it will make all the more important the need for an inclusive, objective and effective Health Council of Canada.

A Health Council of Canada

One of the real barriers to improved cooperation and coordination in our health care system is that the different levels of government, and sometimes different provincial governments, begin from very different starting points on simple issues of fact.

Hence, my report suggested the creation of a Health Council of Canada whose membership would be broadly reflective of the various interests at play in health care: patients, providers and officials.

Its main purposes would be to provide clear, accurate, and transparent information to the public and the providers regarding both expenditures and results and to promote collaboration among governments.

This would incorporate the following features:

      It would being together, under a single roof, a number of existing federal and provincial advisory structures and agencies and provide an objective and neutral forum whose expertise governments could draw upon as required for support.

      It would give patients and providers a more direct say in how the system operates and the means to monitor its performance.

      It would serve as a focal point for gathering health information, for setting common health data and informatics standards, and for interpreting and reporting to Canadians on health outcomes.

      And in time, as trust was gradually built, the Council would become a trusted source of advice for governments on how best to discharge their individual and collective responsibilities for the system and assist in fact-finding and in resolving disputes over interpretation of the Canada Health Act.

I note that the 2003 Health Accord commits governments to establish a Health Council of Canada by May 5, 2003. Obviously, the Councils eventual terms-of-reference and governance structure, and the autonomy and quality of those selected to serve on it, will determine its effectiveness.

I remain hopeful that the First Ministers will create an effective, inclusive and independent Health Council that will do more than just focus narrowly on the implementation of the Accord.

Many experts, and Canadians generally, will be watching carefully in hope that the eventual Council has the mandate, resources, independence and leadership it requires to make a positive difference and to influence the future direction of health care in Canada.

Conclusion

The 18 months I spent as Commissioner were among the most exciting, challenging and rewarding of my public life.

The process renewed my faith in Canadians, in their maturity, in their capacity to understand and make tough choices, and in the common values that unite us as a country.

I believe absolutely that we can make our health care system the best in the world if we are prepared to heed the advice of Canadians and to respect their wishes. And I believe that the Health Accord is a good starting point for getting there.

Before I conclude, I would like to note that, while our health care system will always be central to ensuring a healthy population, it is also important for us to remember that it is not the only factor.

Income, the quality of our air and water, early childhood education and development opportunities, the security and availability of affordable and nutritious food, adequate shelter, and recreation, are among the other critically important determinants of the health outcomes we seek as individuals and as a nation.

If we reform and stabilize our health care system but neglect these other factors, we will not achieve our health goals nor will we be cost effective.

Our vision of becoming the healthiest nation on Earth requires a coherent and integrated approach.

Permit me one final observation... this time not as a former Health Commissioner, but as an individual with a profound respect for democratic institutions and processes and a deep love of this wonderful country.

It will be for political scientists and historians to assess the significance of that remarkable six-month period last year when Canadians came out in massive numbers to participate in the debate over the future of their health care system. When they came out to try and make a difference.

I don't think anyone ever expected- I certainly didn't- that our processes would have so galvanizing an effect.

I'm acutely aware that over the past decade, public opinion polls have ranked health care the foremost issue for Canadians.

I know too that the extent of what I would characterize as "health literacy" among ordinary citizens was one of the most eye-opening aspects of our consultations.

And yet now, in the aftermath, when I reflect upon all that I heard, and all that I learned, I am left with a clear sense that it was not just health care people were talking about when they came to our meetings, or wrote, or e-mailed or called to share their views. It was also the health of our political institutions and of our democracy.

I think that a fair number Canadians saw in our consultations an opportunity to participate in a direct way in the democratic process. That their contributions could make a difference.

That for once, they were not powerless. That the demise of a program to which they were profoundly attached, and which appeared under threat, was not necessarily a foregone conclusion.

I am proud and relieved that through the Health Accord, Canada's First Ministers chose to respect the wishes of Canadians.

To be sure, there is still some distance to travel before we achieve the type of health care system Canadians expect and deserve.  But we are certainly a lot closer to our destination today than we have been for some time and I am more convinced than ever that it is within our reach.

The vision is clear, the pathway set. All we need to move ahead is uncommon cooperation and you folks know all about that.

Thank you.

Roy J. Romanow's Pan-American Health Organization (PAHO) Speech

I am both humbled and honoured that the Pan-American Health Organization has seen fit to confer upon me this award, one that I quite frankly believe has been earned by the people of Canada.

This is no false humility on my part; if my Commission's final report has come to be recognized as a success, it is not the result of any grand scheme or deliberate strategy..

Rather, it is becuase the report is faithful to what Canadians themselves said they wanted expressed in the policies and programs that define their health care system.

It wasn't always easy; consensus on how and where to begin the process of transforming our health care system, to improve its effectiveness and to place it on a more sustainable footing for the future, often seemed elusive.

As the Ministers and officials gathered here today know better than most, for any given problem in public policy, there are an endless array of potential solutions, each with their own compelling logic and intellectual foundation..

But what was never, ever in doubt was the commitment of the overwhelming majority of Canadians to the core principles at the heart of our health care system.

Principles that express shared values and that transcend any particular ideological affinity.

Principles of fairness, of equity, of mutual repect and of collective responsibility for improving human health.

Indeed, the same principles that have defined, nurtured and that I know will continue to sustain, PAHO itself.

As you reflect on the lessons learned in regard to the evolution of primary health care in the Americas since the 1978 Alma-Alta Conference..

As you discuss how best to realize the vision that inspired its authors more than a quarter-century ago..

As you comtemplate how to move forward - both within your respective jurisdictions and together as partners in this geographic space we share - there are two lessons from my Commission's work that I believe to be germane to your delibertations.

The first lesson is that values matter. Initiatives and policies inconsistent with the values of those they ar intended to benefit, that do not resonate with citizens, will ultimately fail. And make no mistake: the choices we make in relation to health care or to primary care ar utlimately choices between competing values.

The second lesson is that respect matters.  Actively engaging citizens in shaping the policies and programs that will affect them is critical to their success.  Given an opportunity to contribute, and given access to the hard facts, to the trade-offs and choices, people can be trusted to make the right and responsible decision.  I have no doubt whatsover on this point and I hold this to be a universal truth, equally relevant to all nations and peoples, regardless of their level of development, wealth or demographic realities.

Let me close by saying that what made the Commision a particularly meaningful experience for me was my deep personal belief that Canada's program of Medicare is the single greatest symbol of our uniqueness as Canadians.

What makes Medicare the quintessential Canadian program is that it is the convergence point where so many of our values come together.  That's why we called the Commision's report Building on Values.

Medicare demonstrates that as community we can accomplish so much more thatn we could ever dream of doing as individuals.

It underscores our belief that citizenship confers upon us rights that are based on the strength of our need and not the size of our wallet.

And it highlights one of the new realities of a young century - that economic growth cannot advance at the expense of social cohesion, or social cohesion at the expense of economic growth - the two have to go hand-in-hand.

I was honoured to help prepare a road map for a collective journey by Canadians - a journey to reform and renew our health care system.  And I will continue to act as an advocate in this regard.

Thank you.

For Further Information

Michel Amar 1-613-290-7537

 

 

 

 

• Private, Canadian Foundation established in 1942 by Joseph E. Atkinson Story
  
• Granted 58 million since inception (Funded Projects / Awards)
• 2001 Annual Report
• Location:

  One Yonge Street, 15th Floor
  Toronto, Ontario M5E 1E5
  Office: (416) 368-5152
  Fax: (416) 865-3619

• Contact: Charles Pascal, Executive Director Charles E. Pascal Bio and Photo
  

On September 27, 2003 the Gatehouse was awarded the Ruth Atkinson Hindmarsh Award for its work helping sexually abused children by providing a safe and comforatable setting for criminal investigations to take place. 

The $50,000 award, the largest of its kind in Canda, was made by Atkinson Charitable Foundation Trustees Betsy Atkinson Murray and Peter Armstrong, following the Gatehouse's sixth annual 5k fundraising run.  The Atkinson Charitable Foundation gives the award every year in memory of Ruth Atkinson Hindmarsh, who served as president of the foundation until her death in 1994.  See the entire Press Release.

The Atkinson Fellowship In Public Policy, an award to Canadian journalists, established in 1988, is now entering its sixteenth year. The award is designed to further both the tradition of liberal jounalism in Canada and the commitment to social and economic justice of Joseph E. Atkinson, former publisher of the Toronto Star.

The Fellowship, worth up to $100,000, is sponsored by the Atkinson Charitable Foundation, The Toronto Star, and the family of Beland Honderich.

Full-time Canadian journalists in any of the print or broadcast media, either English or French, are eligible to apply for the fellowship. The successful candidate will pursue a year long research project on a topical policy issue and publish the results as a series of newspaper articles which the journalist is then free to develop into a book. As well as the $75,000 stipend, the Atkinson fellow may receive up to $25,000 for research expenses.

The members of the Selection Committee include Committee Chair, John Honderich, Publisher of the Toronto Star; Rosalie Silberman Abella, Justice, Ontario Court of Appeal; Peter A. Armstrong, Trustee of the Atkinson Charitable Foundation; Paul Fox, professor Emeritus, University of Toronto, Dona Harvey, Journalist; and Charles E. Pascal, Executive Director of the Atkinson Charitable Foundation.

Closing date for this year's entries was March 17, 2003.

Email info@atkinsonfoundation.ca with some information about yourself and receive an application form. ACF will email an application to you if you are eligible. See also What We Fund - Fellowship in Public Policy.