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Some Prime Ministerial advice for a health minister (borrowed from Canada)

Canada’s new Prime Minister, Justin Trudeau, has written a “mandate letter” to the country’s new Minister of Health, Dr Jane Philpott, who is a family doctor. It is reproduced below.

The bolding of sections has been added by Croakey. (Note that there is no explicit mention of tackling health inequities or the social determinants of health, and that climate change is mentioned only briefly.)

***

Dear Dr. Philpott:

I am honoured that you have agreed to serve Canadians as Minister of Health.

We have promised Canadians a government that will bring real change – in both what we do and how we do it. Canadians sent a clear message in this election, and our platform offered a new, ambitious plan for a strong and growing middle class. Canadians expect us to fulfill our commitments, and it is my expectation that you will do your part in delivering on those promises to Canadians.

We made a commitment to invest in growing our economy, strengthening the middle class, and helping those working hard to join it.  We committed to provide more direct help to those who need it by giving less to those who do not. We committed to public investment as the best way to spur economic growth, job creation, and broad-based prosperity.  We committed to a responsible, transparent fiscal plan for challenging economic times.

I expect Canadians to hold us accountable for delivering these commitments, and I expect all ministers to do their part – individually and collectively – to improve economic opportunity and security for Canadians.

It is my expectation that we will deliver real results and professional government to Canadians. To ensure that we have a strong focus on results, I will expect Cabinet committees and individual ministers to: track and report on the progress of our commitments; assess the effectiveness of our work; and align our resources with priorities, in order to get the results we want and Canadians deserve.

If we are to tackle the real challenges we face as a country – from a struggling middle class to the threat of climate change – Canadians need to have faith in their government’s honesty and willingness to listen. I expect that our work will be informed by performance measurement, evidence, and feedback from Canadians. We will direct our resources to those initiatives that are having the greatest, positive impact on the lives of Canadians, and that will allow us to meet our commitments to them. I expect you to report regularly on your progress toward fulfilling our commitments and to help develop effective measures that assess the impact of the organizations for which you are answerable.

I made a personal commitment to bring new leadership and a new tone to Ottawa.  We made a commitment to Canadians to pursue our goals with a renewed sense of collaboration.  Improved partnerships with provincial, territorial, and municipal governments are essential to deliver the real, positive change that we promised Canadians. No relationship is more important to me and to Canada than the one with Indigenous Peoples.  It is time for a renewed, nation-to-nation relationship with Indigenous Peoples, based on recognition of rights, respect, co-operation, and partnership.  

We have also committed to set a higher bar for openness and transparency in government. It is time to shine more light on government to ensure it remains focused on the people it serves. Government and its information should be open by default. If we want Canadians to trust their government, we need a government that trusts Canadians. It is important that we acknowledge mistakes when we make them. Canadians do not expect us to be perfect – they expect us to be honest, open, and sincere in our efforts to serve the public interest.

Our platform guides our government. Over the course of our four-year mandate, I expect us to deliver on all of our commitments. It is our collective responsibility to ensure that we fulfill our promises, while living within our fiscal plan. Other issues will arise or will be brought to our attention by Canadians, stakeholders, and the public service. It is my expectation that you will engage constructively and thoughtfully and add priorities to your agenda when appropriate.

As Minister, you will be held accountable for our commitment to bring a different style of leadership to government. This will include: close collaboration with your colleagues; meaningful engagement with Opposition Members of Parliament, Parliamentary Committees and the public service; constructive dialogue with Canadians, civil society, and stakeholders, including business, organized labour, the broader public sector, and the not-for-profit and charitable sectors; and identifying ways to find solutions and avoid escalating conflicts unnecessarily. As well, members of the Parliamentary Press Gallery, indeed all journalists in Canada and abroad, are professionals who, by asking necessary questions, contribute in an important way to the democratic process. Your professionalism and engagement with them is essential.

Canadians expect us, in our work, to reflect the values we all embrace: inclusion, honesty, hard work, fiscal prudence, and generosity of spirit. We will be a government that governs for all Canadians, and I expect you, in your work, to bring Canadians together.

You are expected to do your part to fulfill our government’s commitment to transparent, merit-based appointments, to help ensure gender parity and that Indigenous Canadians and minority groups are better reflected in positions of leadership.

As Minister of Health, your overarching goal will be to strengthen our publicly-funded universal health care system and ensure that it adapts to new challenges. Healthcare across Canada is changing at a rapid pace to keep up with the changing needs of an aging population and advances in health technology. The federal government must be an essential partner in improving outcomes and quality of care for Canadians. I expect you to work with provincial and territorial governments to support them in their efforts to make home care more available, prescription drugs more affordable, and mental health care more accessible. When Canadians are in good physical and mental health, they are able to work better, be more productive, and contribute more fully to our economy while living healthier, happier lives. Our health care system provides Canadians with peace of mind, but we need to make the investments necessary to ensure it can continue to evolve and innovate.

In particular, I will expect you to work with your colleagues and through established legislative, regulatory, and Cabinet processes to deliver on your top priorities:

  • Engage provinces and territories in the development of a new multi-year Health Accord.  This accord should include a long term funding agreement. It should also:
    • support the delivery of more and better home care services. This includes more access to high quality in-home caregivers, financial supports for family care, and, when necessary, palliative care;
    • advance pan-Canadian collaboration on health innovation to encourage the adoption of new digital health technology to improve access, increase efficiency and improve outcomes for patients;
    • improve access to necessary prescription medications.  This will include joining with provincial and territorial governments to buy drugs in bulk, reducing the cost Canadian governments pay for these drugs, making them more affordable for Canadians, and exploring the need for a national formulary; and
    • make high quality mental health services more available to Canadians who need them.
  • Promote public health by:  increasing vaccination rates; introducing new restrictions on the commercial marketing of unhealthy food and beverages to children, similar to those now in place in Quebec; bringing in tougher regulations to eliminate trans fats and to reduce salt in processed foods, similar to those in the United States; and improving food labels to give more information on added sugars and artificial dyes in processed foods.
  • Work with the Minister of Sport and Persons with Disabilities in increasing funding to the Public Health Agency of Canada to support a national strategy to raise awareness for parents, coaches, and athletes on concussion treatment.
  • Introduce plain packaging requirements for tobacco products, similar to those in Australia and the United Kingdom.
  • Support the Ministers of Justice and Public Safety and Emergency Preparedness on efforts that will lead to the legalization and regulation of marijuana.
  • Work with the Minister of Indigenous and Northern Affairs to update and expand the Nutrition North program, in consultation with Northern communities.

These priorities draw heavily from our election platform commitments. The government’s agenda will be further articulated through Cabinet discussions and in the Speech from the Throne when Parliament opens.

I expect you to work closely with your Deputy Minister and his or her senior officials to ensure that the ongoing work of your department is undertaken in a professional manner and that decisions are made in the public interest.  Your Deputy Minister will brief you on issues your department may be facing that may require decisions to be made quickly.  It is my expectation that you will apply our values and principles to these decisions, so that issues facing your department are dealt with in a timely and responsible manner, and in a way that is consistent with the overall direction of our government.

Our ability, as a government, to successfully implement our platform depends on our ability to thoughtfully consider the professional, non-partisan advice of public servants.  Each and every time a government employee comes to work, they do so in service to Canada, with a goal of improving our country and the lives of all Canadians.  I expect you to establish a collaborative working relationship with your Deputy Minister, whose role, and the role of public servants under his or her direction, is to support you in the performance of your responsibilities.

In the coming weeks, the Privy Council Office (PCO) will be contacting you to set up a meeting with PCO officials, your Deputy Minister and the Prime Minister’s Office to further discuss your plans, commitments and priorities.

We have committed to an open, honest government that is accountable to Canadians, lives up to the highest ethical standards, and applies the utmost care and prudence in the handling of public funds.  I expect you to embody these values in your work and observe the highest ethical standards in everything you do.  When dealing with our Cabinet colleagues, Parliament, stakeholders, or the public, it is important that your behaviour and decisions meet Canadians’ well-founded expectations of our government. I want Canadians to look on their own government with pride and trust.

As Minister, you must ensure that you are aware of and fully compliant with the Conflict of Interest Act and Treasury Board policies and guidelines. You will be provided with a copy of Open and Accountable Government to assist you as you undertake your responsibilities. I ask that you carefully read it and ensure that your staff does so as well. I draw your attention in particular to the Ethical Guidelines set out in Annex A of that document, which apply to you and your staff. As noted in the Guidelines, you must uphold the highest standards of honesty and impartiality, and both the performance of your official duties and the arrangement of your private affairs should bear the closest public scrutiny. This is an obligation that is not fully discharged by simply acting within the law. Please also review the areas of Open and Accountable Government that we have expanded or strengthened, including the guidance on non-partisan use of departmental communications resources and the new code of conduct for exempt staff.

I know I can count on you to fulfill the important responsibilities entrusted in you.  In turn, please know that you can count on me to support you every day in your role as Minister.

I am deeply grateful to have this opportunity to serve with you as we build an even greater country.  Together, we will work tirelessly to honour the trust Canadians have given us.

Yours sincerely,

Prime Minister of Canada signature

Rt. Hon. Justin Trudeau, P.C., M.P.
Prime Minister of Canada

– See more at: http://pm.gc.ca/eng/minister-health-mandate-letter#sthash.IaTVxd3g.dpuf

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