Tuesday, July 24, 2012

An Open Letter to Canada's Auditor General Regarding Health Canada


Yoni Freedhoff
Medical Director, Bariatric Medical Institute
Assistant Professor, University of Ottawa
575 West Hunt Club, Suite 100
Ottawa ON K2G5W5

July 24th, 2012

Michael Ferguson
Auditor General
Office of the Auditor General of Canada
240 Sparks Street
Ottawa, Ontario
K1A 0G6 Canada

Dear Mr. Ferguson,

My name is Yoni Freedhoff and I'm a physician and public health advocate. I am writing to you today in regard to the actions of Health Canada, and to be very clear, I'm not writing to you to consider their public health decision making, but rather to inform you of willfully mismanaging public funds in their creation of task forces and working groups whose recommendations are summarily rejected nearly the moment they're reported.

The first such example involved our Trans-Fat Task Force. Struck in 2005, the Task Force consisted of 24 members and involved the commissioning of a literature review, 3 full day face to face meetings, 5 teleconferences, 2 public consultations and the writing of a 116 page final report. The Task Force called for a regulatory approach to reducing trans-fats in Canada's food supply. Then Minister of Health Tony Clement elected instead to launch a 2 year trial program of voluntary reductions followed by regulation if voluntary efforts failed.   Unfortunately voluntary reductions did fail, yet rather than implement the regulations promised by Minister Clement, Minister Aglukkaq elected instead to extend the taxpayer funded trans-fat surveillance program.  In April 2010, she herself reported that the program's,
"results indicate that further reductions are needed to fully meet the public health objectives and reduce the risk of coronary heart disease."
However just last week she reported that the surveillance program was,
"a time-limited initiative that ran its course",
and summarily ended it. As a taxpayer I'm quite concerned by all of this. From initially ignoring their own undoubtedly expensive task force's advice, to establishing an undoubtedly expensive surveillance program, to extending that surveillance program rather than follow through with the promise of regulation if it failed, to finally eliminating the program and not enacting a regulatory approach ultimately it means a great deal of public money was wasted.

The next example involves Health Canada's Sodium Working Group. Struck in 2007, the group was tasked with developing a population-health strategy to reduce sodium in the diets of Canadians. Their report was released on July 29th, 2010 and it made two dozen recommendations meant to bring down Canadian salt consumption. 8 months later and Health Canada announced that rather than follow the expert recommendations they themselves commissioned (at a reported cost of $1,000,000), that they would instead seek further guidance from the Food Expert Advisory Committee - a committee with strong ties to the food industry - and that the Working Group was to be disbanded. This led one member of the original working group to state,
"What's the government doing? They got the group of experts and industry people together and spent three years putting together a strategy. Now they're trying to find some other people to give them a different strategy? It just doesn't make any sense."
No it doesn't. And it also costs us a great deal of money.

While I realize it's beyond the purvey of your office to determine the scientific soundness of Health Canada and Minister Aglukkaq's decisions, as a taxpayer I need to ask, why are many millions of taxpayer dollars being spent to fund expensive expert advisory panels and surveillance programs if their recommendations are simply to be wholly and completely ignored?

Respectfully yours,


Yoni Freedhoff, MD
Medical Director, Bariatric Medical Institute
Assistant Professor, University of Ottawa
575 West Hunt Club, Suite 100
Ottawa ON K2G5W5

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8 comments:

  1. May indeed be a waste of money.

    The Canadians I know are smart enough to decide and monitor their own consumption levels of trans fats and sodium, without benefit of government nannies.

    -Steve

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    Replies
    1. That's wonderful Steve. I'm sure the Canadians you know are representative of our entire population. Also, could you please ask them which trans fat detector they use in restaurants and coffee shops? I'd love to buy one as for me at least (and perhaps I'm just an outlying Canadian), I can't see, taste or smell trans-fat.

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    2. Darius Szpilewski7:32 am

      Steve, quick glance at the state of food industry, and the fact voluntary efforts to reduce trans-fats failed, clearly indicates that "nannies" is exactly what is needed.
      I am sure people are smart enough to monitor their food intake and they really want to, after-all, who doesn't want to feel, perform, and look great. But in an environment where people's brains are being hijacked and wisdom of our body and mind is overridden with aggressive marketing and over-stimulating foods, people do need "nannies" - or as I like to call it - proper guidance.

      I'll go one step further here...it is really disturbing when an MD makes a preposterous statement such as "The Canadians I know are smart enough to decide and monitor their own consumption levels of trans fats and sodium, without benefit of government nannies." Shameful to say the least.

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    3. Anonymous11:36 am

      Steve, we must work with different Canadians.
      The ones I see are more worried about how to make ends meet and at the end of the day, they will purchase the food that fits their budget -not their doctor's recommendations.

      Sadly, I see many people who rely on food banks, soup kitchens and other charities for their groceries. There is little to no healthy options and rarely is anything fresh or unprocessed.

      These are the Canadians who rely on the government to make sure their only food options are safe. Those who are marginalized members of society, children with less than stellar parents and seniors for whom reading a food label is a gargantuan task simply can't make the healthiest choices.
      Jane

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  2. Anonymous8:44 am

    That's twice that I have seen someone come on to your blog to suggest that government are not "nannies." This is faux logic (the straw man fallacy) in that:

    a) You never requested that they "nanny" Canadians, and you are not complaining about their "nannying" skills.

    b) It ignores the issue raised by you, which is that Government is displaying profound incompetence or duplicity in consulting expert panels at great expense and then running to industry people instead for what is obviously not good advice at all, it being from the industry that the government should be regulating in the first place.

    It all seems a little like these people on your blog are shills for a government that likes to manipulate the public in secrecy while ensuring their own continuance as the governing party.

    It certainly does not seem like the government cares about the health of its nation. More like the government cares about the health of itself.

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  3. Your letter raises good questions. It is easy to say that the government shouldn't be nannies to us all, but the main purpose of government is to protect the citizenry and especially their children.

    We have regulation of products that may do harm (and may cost provincial medical systems).

    For example:
    - car seat belts, air bags and child seats to make cars safer
    - age restrictions on tobacco, alcohol, gambling
    - recreational drugs have been made illegal.

    There is evidence that trans fats, sodium (and excessive amounts of sugary drinks) can hurt health. We should be protecting ourselves from hugely increasing medical costs and protecting those who cannot make informed choices.

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  4. Anonymous10:33 pm

    I follow you regularly and I love almost everything you post...

    I am wondering how we as citizens can follow in your foot steps and press our Government to actually "DO" something based on our best interests in Health and Money? Although I like your comments on facebook and comment on posts, to me that isn't enough action on my part and I am tired of sitting here, so what would be a good first step?

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    Replies
    1. I wish I had a great answer for you. I'm not sure how much the average citizen can do. Certainly you can write your MP and/or MPP, or even call them on the phone. You can get involved with school boards and write letter to editors and call in to radio shows.

      I suppose my best advice is simply not to remain silent but at the same time, I wouldn't want you to hold your breath for change.

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