March 2011 - Our Voice in Action

Child Health: moving the Pascal Report forward

by Sue Makin, Chair, OPHA Child and Youth Health Workgroup

It is hard to believe that it was almost two years ago, in June 2009, that Dr. Charles Pascal released his report “With Our Best Future in Mind: Implementing Early Learning in Ontario”. The report presented a bold vision for early learning and care that was based on a solid understanding of childhood brain development, best practice, and extensive community consultation.

Dr. Pascal’s recommendations extended well beyond implementation of full-day early learning for 4 and 5 year olds. He proposed a comprehensive approach to seamless child care, a common early learning curriculum, streamlined and improved access to a broad range of services for prenatal women, young children and families, and the establishment of public policies that support families. Such recommendations would be truly transformative in nature.

It was immediately apparent that the report had the potential to significantly change the way public health units deliver programs under the Reproductive Health and Child Health Standards: it had implications for public health service, accountability, and funding.

OPHA expressed its support for the Report and its recommendations and called on the Premier to approve and implement the full vision. At the same time, OPHA called for the establishment of inter-ministry collaboration and coordination, the development of a better understanding of the role of public health and the inclusion of public health in the planning process.

To date, implementation has, not surprisingly, focused on the establishment of an Early Years Division within the Ministry of Education, the phased-in implementation of full day kindergarten, and the transition of the child care system to the Ministry of Education. However, recommendations that relate to the “re-engineering” of the broader issues of early identification/intervention and family support recommendations, including the establishment of Best Start Child and Family Centres, have moved at a slower pace. At the present time, Dr. Pascal is currently advising the Ministry of Children and Youth Services on the development of a provincial framework for these Centres.

While the public health sector has participated in a number of consultation sessions over the past 18 months, it is now more critical than ever that public health be involved in the development of this framework.

The Report specified that the Best Start Child and Family Centres would provide a wide range of comprehensive child and family support services, including prenatal and postnatal information and support, nutrition counseling, early identification and intervention resources, and parenting and family programming. However, other than the delivery of the Healthy Babies Healthy Children program through the Centres, the Report does not clearly identify a role for public health.

Dr. Pascal has established an External Reference Panel to inform development of the framework and there is a public health representative at this table. In addition, on February 9, 2011, a consultation session specifically related to public health was held. This meeting included Medical Officers of Health and Senior Family Health representatives from health units across the province, along with Assistant Deputy Ministers and senior staff from the Ministries of Health and Long Term Care, Health Promotion and Sport, Children and Youth Services, and Education. It provided an opportunity for the field to come together to engage in a dialogue about the vision for public health within the Best Start Child and Family Centres framework and went a long way towards enhancing a shared understanding and appreciation for a role for public health that includes:

  • Leading and supporting program planning;
  • Networking and working in partnership;
  • Understanding and meeting local community needs;
  • Applying best practice;
  • Measuring and analyzing health surveillance data;
  • Delivering direct services to prenatal women, young children, and families.

There are still many unknowns and we still don’t fully understand the full implications of the proposed “re-engineering” of the early years system. So, public health will continue to actively participate in the ongoing development of the provincial framework. Later this month, OPHA will participate in an “association” consultation session and we will continue to advocate for public health. We will be ready to respond to the proposed framework and remain open to the opportunities that this exciting “transformation” offers.