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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
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CAMPBELL COMMISSIONPART 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 OptimismCampbell’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!!