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At Canadian Medical Association: "Working Together for Real Outcomes" - the Honourable Rona Ambrose Minister of Health

August 19, 2013
Telus Convention Centre
Calgary, Alberta

Check Against Delivery

Thank you, Dr. Anna Reid, for that warm introduction.

Good morning ladies and gentlemen and thank you all for joining me this morning.

I have been looking forward to this, my first speech as the Minister of Health.  I am thrilled to have the privilege to serve in a portfolio of such significance.  Together, through policy leadership and collaboration, we can make a difference in the lives of Canadians.

I'm pleased to have this opportunity to attend such an important gathering of health care providers so early in my tenure as Minister - to hear from you, to listen to you and to forge a true partnership with you.

Canadians expect us to work together towards solutions in challenging areas - I am certain that we will do just that.

CMA Acknowledgements

The CMA's history - of engagement, advocacy and innovation - has set a benchmark for professional organizations for 146 years.

And that tradition continues today, through your leadership on issues as diverse as health care transformation, clinical practice guidelines and, of course, on social determinants of health.

I want to acknowledge the work of Dr. Reid as she completes her term as President. Congratulations to you.

I also want to congratulate Dr. Francescutti on his appointment.  He and I are both from Edmonton. I expect we will be cheering for the same hockey team... so we're off to a good start.

While I may not have all the answers, I'm a good listener and a quick study - and I pledge to you and your membership- both an open mind and an open door.

I look forward to working with you to discuss issues facing the health care community and to work on our health care system to the benefit of all Canadians across our great country.

And my ask to you is that you support me in some of the areas that I hope to lead in the coming months and years.

I'd like to take a few minutes to talk about my focus, priorities and a number of topics that are familiar to you.

Family Violence

I have been active in the area of ending family violence and specifically ending violence against women for most of my life.

Before entering politics I was involved in the Status of Women's Action Group, the Victoria Sexual Assault and Sexual Abuse Crisis Centre, and the Edmonton Women's Shelter.

Family Violence is a health issue.

In my previous portfolio as Minister of Status of Women, I brought a new, more holistic focus to the issue of family violence. 

For the first time, we engaged men and boys in the public policy dialogue about preventing violence against women and girls, ensuring that men and women, girls and boys are playing a part in the solution.

I also directed federal funding to projects across Canada to engage Young People to come up with solutions to Prevent Violence against Women on university and college campuses, where 25 % of young women will experience sexual assault.

Family violence includes elder abuse, child abuse and neglect, child sexual abuse, and domestic violence.

The consequences on our society are far reaching.

Last year a report from Justice Canada  found spousal violence alone cost society at least $7.4 billion annually. Of that total, an estimated $6 billion accounts for health care costs for medical treatment and psychological services.

The report stated:

"Victims of spousal violence are susceptible to sustaining costly and long-lasting physical, emotional and financial consequences. ... Every member of society eventually feels the impact of spousal violence through the additional financial strain imposed on publicly funded systems and services."

In 2012 in Calgary alone, the Calgary Police Service Child Abuse Unit investigated 329 cases of child abuse involving incidents of severe sexual abuse and severe physical abuse of children under the age of 17.  Approximately 25% involved male victims.

We also know that aboriginal women have experienced violence more often than any other group in Canada.

Aboriginal women are three and half times more likely than non-Aboriginal women to be victims of violence, and face the same, profound financial and social impacts of family violence as non-Aboriginal women.

Family violence threatens not only our physical and mental health; it also puts a huge strain on day-to-day personal and business activities, on the communities in which we live, and on our health care system.

The Public Health Agency of Canada has a clear mandate in the area of family violence and is responsible for coordinating the Federal Family Violence Initiative.

Importantly, the Canadian Institutes of Health Research has made the question of violence and health one of its six research priority areas. We have already committed $8.5 million over 5 years to support research under CIHR's Violence, Gender and Health Initiative.

We all have a role to play in ending family violence.

As medical professionals, you have a vital role to play in helping to address violence by recognizing the signs, reporting violence and ensuring your patients get the physical and mental support they need.

You are often the first to interact with patients who are dealing with family violence; and research shows that you are the ones victims are most likely to disclose abuse to.

I have asked the Public Health Agency of Canada to identify opportunities and partnerships that will help end family violence in Canada within the health portfolio.

As Health Minister, I will work hard to encourage change and work on improving the mental health and wellbeing of Canadians, particularly those who are most vulnerable to violence and abuse.

I am committed to working with all orders of government and organizations to lead change and gain momentum on the issue of Family Violence.

We have a track record of success working together on initiatives such as the Canadian Partnership Against Cancer, and with organizations such as the Mental Health Commission of Canada. 

These joint undertakings have produced results quickly as we work shoulder to shoulder with health care providers, community organizations and other orders of government.

Working With Stakeholders/Overall Objectives

On that note, many people I work with in both Ottawa and Alberta, know that I am a bit of a policy wonk.

I like to dive into difficult issues, most recently, policy areas such as reforming military procurement, to advancing the role of women in leadership and decision-making in the corporate community, to settling tough labour disputes collaboratively as labour minister.

What you will hear from those that have worked with me is that I believe in surrounding myself with passionate and smart people; I'm not afraid to go out on a limb to tackle tough issues; I collaborate and consult with others; and I will champion those who need my support.

Throughout my political career I have made a point of engaging stakeholders on a broad range of issues, because I believe that most often the best answers lie outside of government - in organizations like yours.

I will continue this type of dialogue with health stakeholders, as well as the provinces and territories.  In fact I have already reached out to my provincial and territorial colleagues.

I believe we are at a critical point where we must improve the productivity of the health system and improve the health of Canadians together.

Federal Funding & Leadership

I think we can all agree that nothing is more important than good health. When we have it, we are at our best. And when we lose it, we're willing to do just about anything to get it back.

We must work together to strengthen our system so Canadians have access to services when and where they need them most.

And we also need to focus on preventing Canadians from getting sick in the first place.

Smoking, poor eating habits, obesity, inactivity and injuries all mean more Canadians in doctors' offices and hospitals.

We need to work together to promote healthy living, prevent injuries and keep our populations healthy.

As Minister, I will strive to practice what I preach. I just came off my annual hike into the rockies where I hiked 70 kms in the backcountry, packing everything I needed on my back.

I'm a big believer in preventative health and the benefit of focusing more on what we can do in our own lives to keep ourselves healthy.  Not only so we can live longer and happier lives, but because of the opportunity to reduce the cost burden on the healthcare system.

Dr. Francescutti, I am especially pleased to hear how passionate you are about injury prevention.  

I believe there is a lot we can achieve together to promote safety, encourage healthy living, prevent injuries and keep Canadians healthy.

We must strive, together, to be the healthiest population in the world.

I also want to be clear from the outset that our Government remains committed to a strong, publicly funded system guided by the Canada Health Act.

I am, and have always been, a strong supporter of Canada's publicly funded healthcare system.

No system is perfect, of course, but I believe that we have the fundamentals right - and we can work to improve it together.

That is our policy challenge and one which I plan to lead in my tenure as health minister - improving our system in a way that will maintain the integrity of our publicly funded system, but capture productivity gains so our system is sustainable.

I believe we can achieve those gains through a concerted effort in research and innovation.

As a nation we spend vast sums of money on health care. Every year, our collective spending amounts to over 11% of our GDP. 

Federal health funding, alone, will reach a record high of $30.3 billion this year and continue to grow to more than $40 billion by the end of the decade.

That is a substantial increase.  An increase that will provide provinces and territories with the financial predictability and flexibility to meet the health care needs of Canadians now, and in the future. 

But we need to also ask: what are we doing to make the system more efficient?

The reality is that increased spending doesn't necessarily mean we're getting better results. It doesn't necessarily mean we are transforming the system in a way that will guarantee long term sustainability. 

If we want better results, if we want to transform the system - we have to acknowledge what's working well, take a close look at what isn't, be open to change and take appropriate action.

At this juncture, I would like to give you a few examples of how we are improving things for the better at the federal level.

Aboriginal Health

One example is our government's leadership and commitment to delivering better, more integrated health care to First Nations.

Health Canada will continue to work towards strengthening First Nations and Inuit health programming.

Going forward, we will continue to look for creative ways of integrating First Nations healthcare into the broader system.

In British Columbia, the Tripartite First Nations Health Plan provides a model of how First Nations can have a greater role in the design and delivery of health care while increasing integration with the provincial health care system.

My hope is that we can learn from this work in BC.

Consumers and Safety

Our government has also strengthened its focus on consumer and product safety.  We have brought forward programs such as the Plain Language Labelling Initiative - where drug labels and safety instructions must be written in easy to read and understandable language for the benefit of consumers.

We have also modernized the Consumer Product Safety Act to help protect Canadian families from potential harmful products. 

I will continue to lead programs and actions that assist and defend the health and safety of Canadian families. 

I look forward to sharing with you and Canadians over the next few months important steps our government is taking to continue to protect the health and safety of Canadians.

Innovation and Research

I want to end my address by returning to a topic I think we can all agree is key to transforming our health system and making it more efficient and sustainable: and that is innovation.

I have been spending a great deal of my time since being named health minister reading, thinking and discussing with others the issue of innovation in healthcare.

I know innovation is on everybody's mind, including prominent policy makers and industry professionals such as yourselves.

Innovation is very important when it comes to the long-term sustainability of our health care system.

The Conference Board of Canada stated that "The sustainability of Canada's public health-care system will depend in large part on innovations that can enhance the efficiency, safety, quality, and productivity of health and health-care services". 

In another report by former Bank of Canada Governor David Dodge on the topic of healthcare spending, he says "the expansion of the scope and quality of healthcare services, coupled with the apparent low rates of productivity growth in the healthcare sector, has meant that the share of national income devoted to healthcare has increased substantially in the last decades." 

He goes on to make the point that from a policy perspective the role of technology in driving productivity makes it a key area for health policy initiatives aimed at improving the efficiency of the delivery system and the incentives for more cost-effective healthcare interventions.

This is the policy challenge that I believe is worthy of federal leadership and an area I believe we can make gains together.

The consequences of not acting are staggering - healthcare is projected to continue to eat up the vast majority of government budgets in the coming decades.

If we want to ensure our public system is sustainable then we must explore the important role of innovation and technology as a means to improve the efficiency and productivity of the health system.

As many of you know the federal government remains the largest, single-investor in Canadian health innovation, primarily through grants made by the Canadian Institutes of Health Research (CIHR).

Each year, our Government invests approximately $1 billion in the Canadian Institutes of Health Research, to support Canada's health researchers.

We are also supporting Canada's Strategy on Patient Oriented Research, which is designed to ensure that patients received the right treatment, at the right time, by putting research in the hands of healthcare providers.

Federally, we will continue to invest and make innovation a priority because it's through innovation that we will help provinces and territories improve the quality, accessibility and sustainability of our health care system so it's there for our children and grandchildren.

In the coming months, you will hear more from me on the topic of innovation and research as a means to make our health system more efficient, more sustainable and more productive and I look forward to your feedback.

Before I close, I know some of you may have questions and want to discuss issues facing health care today.  Rather than taking two or three questions now from delegates, I will be staying for the entire day to engage with many of you that are here.

This is an important dialogue and I want to hear from you one-on-one.  I am meeting with doctors, nurses and the Executive Committee to hear the various perspectives from the front line.

As a new Minister, I think listening is better than telling you what I know about the portfolio.

I am committed to working with the provinces and territories, health care providers, the research community, and organizations like the CMA to learn about your priorities and how we can work together to improve the health system for all Canadians.

As the new Minister of Health, I come to the job with an open mind and with a spirit of collaboration.
In that regard, I value the input and advice of the CMA.

So, let us take as our common cause the objective you expressed so well in your own Mission Statement, "to provide for the people of Canada the highest standards of health and health care."

I look forward to working with you as we pursue that goal together for the benefit of all Canadians.

Thank you for inviting me today to share my experience, my priorities, my commitments and my desire to foster a strong partnership with industry professionals such as yourselves.

I look forward to meeting many of you over the course of the day.

Thank you.