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Institutionalizing HIA in Québec: Section 54 of the Public Health Act
Dr. Alain Poirier, National Public Health Director and Assistant Deputy Minister Ministère de la Santé et des Services sociaux
Granada, April 14 -15, 2011
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Origin of HIA in Québec
International movement for the promotion of health (Ottawa Charter, 1986)
Recognition of the impact of decisions made in other sectors on the health of the population and on the social inequalities of health
Need to develop public policies that are conducive to health
Issue of consistency in government decisions
HIA: a tool of choice for taking health issues into account in the various spheres of government activity
Mutual Influences: Canadian Initiatives in HIA
1980: in Québec, the Regulation respecting environmental impact assessment and review came into effect, providing for the participation of the health sector in the consultation process
1993: first attempt to institutionalize HIA in British Columbia
Since 1989: willingness to include HIA in environmental impact assessment in all provincial and federal jurisdictions
2001: effective integration of HIA within the Government of Québec with Section 54 of the Public Health Act
HIA through environmental impact assessment
Institutionalizing HIA at the central level
Today, other provinces such as Alberta are considering the possibility of establishing a legal basis for HIA
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Mutual Influences: diversity of Canadian initiatives in HIA
Nova Scotia: the practice of community health impact assessment
Ontario (city of Toronto): a model based on the contribution of public health experts
Québec: a model based on intersectoral collaboration in the Montérégie region
Stronger networking among the provinces
The role of the National Collaborating Centre for Healthy Public Policy
Three examples of local HIA initiatives
Sharing experiences in Canada
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Origin of HIA in Québec
Review of the Public Health Act in 2001
Establishment of conditions conducive to carrying out the essential functions of public health
Implementation of a dynamic link between the various actors at the central, regional and local levels
Legal framework for acting upon public policy
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Origin of HIA in Québec
Public Health Act
Section 54. The Minister is by virtue of his or her office the advisor of the Government on any public health issue. The Minister shall give the other ministers any advice he or she considers advisable for health promotion and the adoption of policies capable of fostering the enhancement of the health and welfare of the population.
In the Minister's capacity as government advisor, the Minister shall be consulted in relation to the development of the measures provided for in an Act or regulation that could have significant impact on the health of the population.
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Strategy for Application of Section 54
1. Implementation of an intragovernmental health impact assessment mechanism
2. Development and transfer of knowledge on public policies that are conducive to health
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Strategy for Application of Section 54
Goals Enable ministries and public agencies to assess beforehand the
potential impacts on health of the various measures put forth in the form of bills and regulations
Promote mitigating measures and inform decision making
Access to relevant expertise
Tools to assist in decision making
The ministère de la Santé et des Services sociaux (MSSS) supports HIA through :
The decision-making process at the central level
Strategy for Application of Section 54
M/A
M/A
M/A
M/A
Secretary General Permanent ministerial committees Cabinet of
Québec
Briefs Analyses and recommendations Decisions
M/A
CT-MFPriorities
Committee
LegislativeCommittee
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Strategy for Application of Section 54
Achievements of the MSSS Establishment of a network of
ministerial representatives
Distribution of a briefing document on determinants of health
Distribution of a practical HIA guide
Distribution of a liaison bulletinhttp://www.msss.gouv.qc.ca/article54
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Strategy for Application of Section 54
Requests for Advice 2003-2011 : 434 requests for advice
directed to the MSSS
Most of the requests were from the ministère du Conseil exécutif (Cabinet)
but there had been prior involvement by the MSSS in many of them, through agreements and interministerial committees :
Government Action Plan to Combat Poverty and Social Exclusion
Government Sustainable Development Strategy
Government Action Plan to Promote Healthy Lifestyles and Prevent Weight-related Problems
Latest information published by the MSSS in 2008
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Strategy for Application of Section 54
Findings
Greater awareness-building and participation by partners and an increasing integration of the process within ministries and public agencies
Requests for projects other than bills and regulations
However, many requests are sent in at the end of the process
Some bills and draft regulations still do not include HIA
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2. Development and Transfer of Knowledge
Funded research Interdisciplinary research on public policies that are conducive to
health Transfer of knowledge to appropriate decision makers and
professionals
Agreement between the MSSS and the Institut national de santé publique du Québec Evidence-based reports on public policy and health produced to
support the Minister in his role of advisor to the other ministers Training and support for the development of HIA tools Public Policy and Health Portal and monitoring
Strategy for Application of Section 54 of the PHA
http://politiquespubliques.inspq.qc.ca/en/index.html
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The importance of developing and transferring knowledge on public policies that are conducive to health Multiple innovations showing government commitment
and investment by public health partners
However, it will be essential to: Ensure that the knowledge needs of intersectoral partners
are met Ensure that knowledge transfer is carried out at the right time Strike a balance between an expert-based approach and
assistance in decision making
Strategy for Application of Section 54 of the PHA
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Challenges and Perspectives
Support changes in practice for greater use of HIA Support partners in the economic and social spheres Ensure the quality of HIA in the government environment Develop effective means for knowledge transfer, especially to
the decision makers and professionals concerned
Develop strategic monitoring in order to act at the beginning of the decision-making process
More generally, strengthen intersectoral actions at all levels of government Create horizontal and vertical synergies so as to remove
certain obstacles and take advantage of all opportunities
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