Download Federal Election 2015 Wake-Up Call

Federal Election 2015
Wake-Up Call:
National Priorities for Patients,
Families, and a Healthier Future
The Canadian Cancer Society
Powered by 140,000 volunteers and a network of nationwide
staff, and supported by millions of Canadians, the Canadian
Cancer Society is Canada’s largest national health charity.
Over the years, we have invested more than $1.3 billion in Canadian
science, which has resulted in fewer people developing cancer
and more people surviving it and living longer, healthier lives.
Throughout our 77-year history, the Society has been a champion
of healthcare improvements and innovation. We are dedicated to
finding new and better ways to protect the health of Canadians,
shrink cancer rates and reduce cancer’s toll on our country.
We are building on our legacy, and we are ready to work in
partnership with the Government of Canada – on behalf of all
Canadians – to make the recommendations in this document
a reality.
Stock photos: © Getty Images
Licensed material is for illustrative purposes only; persons depicted are models.
Executive summary
Two of every 5 Canadians will develop cancer during their lifetimes.
About 25% of us will die from the disease, making it our leading
cause of death.
Cancer cases are projected to climb 40% over the next 15 years
as our population grows and ages, according to the recently
published 2015 Canadian Cancer Statistics. This will create a
potentially devastating burden on families, healthcare providers
and our country’s economy. Cancer already costs Canadians more
than $17 billion per year.
Without a strong national response, there is a risk that the rising
number of cancer cases will overwhelm our healthcare system,
compromising the quality of care available to patients today and
crowding out the investments required to better prevent and treat
the disease tomorrow.
While most new cases will occur among people 50 years of age or
older, the decisions we make now will directly affect all Canadians.
If we are unable to make the necessary long-term investments in
research, training and public education – because we have allowed
the cost of meeting acute care needs to spiral out of control – then
the future health and well-being of all Canadians, including our
children and grandchildren, will suffer.
The federal government has made some important commitments
in the last few years – restricting sales of some flavoured tobacco
products, expanding support for family caregivers, funding the
Canadian Partnership Against Cancer – but their effectiveness
has been weakened by contradictions and missed opportunities.
This is a symptom of the declining priority given to health issues
generally in Ottawa over the past decade.
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Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future
In the upcoming federal election campaign, all party leaders have
the opportunity and obligation to show leadership and move the
national health debate forward. Cancer is too large and complex a
problem to solve in isolation from a larger health agenda. Success
requires a new era of federal health leadership and accountability.
We won’t get there in a single day, week or year, but the journey
must begin now.
The recommendations that follow – for a stronger tobacco control
strategy, guaranteed access to palliative care and smart long-term
federal research investments – are steps all federal party leaders
must support. Together these actions will help stop more cancers
before they start, provide badly needed support to patients and
their families and establish a practical foundation for making
longer-term progress. longer-term progress.
Summary of recommendations
1. Tobacco control: reduce tobacco use by adopting plain packaging
rules and replacing the Federal Tobacco Control Strategy with a
comprehensive and properly funded plan.
2. Palliative care: guarantee in federal legislation the right of all
Canadians to affordable, high-quality palliative care.
3. Research: commit to long-term investments in health research
that keep up with rising costs and population growth and are
delivered through simple, streamlined funding programs that
maximize the impact of every dollar.
© Canadian Cancer Society 2015
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Federal Election 2015
Canadian Cancer
Society Platform
Our cancer challenge
Every single hour about 22 Canadians hear the words “I’m sorry,
you have cancer,” joining the more than 810,000 people across
the country already living with the disease. One of every 4 of us
can expect to die from cancer, making it Canada’s leading cause
of death.
The number of cancer cases is projected to increase by 40%
over the next 15 years as our population continues to grow and
age, according to the recently published 2015 Canadian Cancer
Statistics. Without a strong national response, this growing
challenge will result in a potentially devastating burden on our
healthcare system.
There is a very real risk that the dramatic increase in cancer cases
will overwhelm families, healthcare providers and our economy.
Beyond its terrible physical and emotional toll, cancer has a crushing
financial impact. Cancer costs Canadians $17.4 billion per year,
according to a 2004 Statistics Canada report. Tens of thousands
of cancer patients are struggling to pay for medication, find
affordable homecare and continue earning enough income while
they undergo chemotherapy or radiation treatment.
While the vast majority of new cancer diagnoses will affect people
50 years of age or older, the stakes are high for all Canadians. The
future health and well-being of younger Canadians will be directly
affected by the decisions we make now. Their odds of developing
cancer during their lifetimes, and their hope of recovering from it,
will depend on what we do to better treat and prevent the disease.
Today we are all beneficiaries of life-saving advances achieved
through decades of work by cancer researchers, clinicians, advocates
and policy-makers. We must build on their achievements so that
all Canadians, including our children and grandchildren, will also
benefit from continued progress. If we are unable to make the
necessary investments in research, training and public education –
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because we have allowed the acute care needs of our aging population
to spiral out of control – then we will have failed.
The need for national leadership
To succeed we will need strong national leadership. In recent
years the federal government has made some helpful commitments,
but too often when Ottawa has taken a step forward, it has also
stumbled a step back (table 1).
Table 1. Federal policy scorecard (2010–2015)
Progress
Failures and missed
opportunities
Raised federal tobacco taxes by
$700 million per year and, in 2011,
enhanced warnings on cigarette
packages.
Cut funding for tobacco control by 40%,
depriving Health Canada of the resources
necessary to stop tobacco sales to
minors, enforce other federal tobacco
laws and to maintain national tobacco
prevention and reduction programs.
Brought forward legislation restricting
the sale of flavoured tobacco.
Took 5 years to close just one of many
serious loopholes in its own flavoured
tobacco legislation.
Offloaded the national responsibility
for banning menthol cigarettes onto
13 different provincial and territorial
legislatures.
Stopped opposing international efforts Failed to adequately improve its
to officially designate asbestos as a
own domestic strategy for reducing
hazardous substance.
asbestos exposure, Canada’s leading
cause of workplace death.
Extended the Compassionate Care
benefit for family caregivers from 6
weeks to 6 months.
Made no broader commitment to
improve access to home and palliative
care for tens of thousands of Canadians
fighting cancer and other life-threatening
illnesses.
Failed to build political partnerships
Maintained $50 million annual
investment in the Canadian Partnership among different levels of government.
Against Cancer, which brings researchers,
charities and public servants together
to fight cancer.
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Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future
The federal government’s effectiveness has been undermined by
contradictions and missed opportunities. This is a symptom of a
deeper decline in the political priority given to health issues
inside Ottawa.
Over the past decade, health policy has been pushed to the margins
of the national agenda. Canadians’ real-world health concerns don’t
receive the same attention or priority they once did.
What’s left is checkbook federalism: Ottawa takes in and ships
out billions of tax dollars for healthcare but without setting clear
national objectives for its investments or effectively measuring
their impact.
While federal health spending has gone up, federal accountability
for health has gone down.
According to the Minister of Finance, annual federal health transfers
to provinces and territories will reach $40 billion by 2020. But what
concrete improvements will that money buy Canadians? What holes
in nationwide health coverage will it repair? How will it improve
disease prevention from Victoria to St. John’s? The federal government
offers few answers.
The country needs federal leaders to revive our national health
debate if we’re going to meet our growing cancer challenge.
Cancer touches too many lives, takes too great a toll and is too
intertwined with other health issues to be dealt with in isolation
from a bigger picture health agenda.
We won’t get there in a single day, month or year – this job is
much bigger than that. But during this election campaign, all
parties have the opportunity – and the obligation – to show
leadership and move the health debate forward.
© Canadian Cancer Society 2015
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Our next federal government must be prepared to take strong
sustained action to stop more cancers before they start and repair
dangerous holes in our publicly funded health system. It must
build on the research, treatment and public policy breakthroughs
of the past several decades, which have dramatically improved
survival rates and saved hundreds of thousands of lives.
What follows are practical, affordable steps that all federal
candidates can support. Together these recommendations will
make a lasting improvement in the lives of people touched by
cancer and contribute to a healthier future for all Canadians.
Recommendations
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Prevention:
Stopping disease
before it starts
Recommendation 1
Reduce tobacco use by adopting plain packaging
rules and replacing the Federal Tobacco Control
Strategy with a comprehensive and properly
funded plan.
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No health issue cries out louder for leadership than disease
prevention, and nowhere are the opportunities for progress
greater, or the need for action more urgent, than in cancer.
There is no more effective way for the federal government to
protect and prolong Canadian lives than by improving cancer
prevention. By making prevention a priority, the federal government
would also reduce the incidences of other widespread chronic
ailments that share cancer’s key risk factors, including heart and
lung disease, strokes and diabetes.
We’ve learned that about half of cancers can be prevented
through a combination of healthy living and reduced exposure
to cancer-causing substances. By applying this knowledge, we can
stop more cancers before they start, which will lower long-term
cancer rates and reduce future health risks for all Canadians,
including our children and grandchildren.
Reducing cancer risks
Many Canadians encounter risk factors at home or in the workplace,
often without realizing those risks are even there. The federal
government must help Canadians by promoting sun safety and
protecting them from asbestos, radon and ultraviolet radiation. As a
country, we must also confront the problems of excessive body weight,
physical inactivity, alcohol consumption and unhealthy diets, which
together are increasing Canadians’ cancer risks.
Tobacco: Public health enemy #1
The tobacco epidemic is one of the biggest public health
threats the world has ever faced, killing nearly 6 million
people a year. – World Health Organization
Canada’s monumental effort to reduce tobacco use over the past
50 years is among the most important public health achievements
in our history. But there is still a great deal of work left to do.
Despite the dramatic decline in the percentage of Canadians who
smoke, the total number of smokers – 5.4 million across the country –
remains stubbornly high. Smoking remains our number 1 preventable
cause of death, leading to about 30% of all cancer fatalities. Making
matters worse, an unacceptably high number of young people begin
smoking each year.
By taking strong, innovative actions against tobacco use in the past,
the federal government saved lives at home and enhanced Canada’s
reputation on the world stage. Now Canada must again become
the world’s leader in tobacco control, as it once was. The federal
government has faltered on several fronts in the last few years.
For example, as other governments have taken action to ban menthol
cigarettes and adopt plain packaging rules, Ottawa has stood still.
Investing in tobacco control
One factor undermining the federal role in tobacco control has been
declining resources. When it was created almost 15 years ago,
Canada’s Federal Tobacco Control Strategy was intended to have
an annual budget of $110 million, but today’s investment is barely
one-third that amount.
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In the wake of major budget cuts announced in 2012, annual
investments in tobacco control by the federal government stand
at $38 million – equal to just one cent of every dollar collected by
the federal government through tobacco taxes.
Proper funding is a prerequisite for the comprehensive and sustained
tobacco strategy Canada needs. With the right resources, we can
target youth tobacco use, a top priority given that most smokers
begin as teenagers or pre-teens.
The federal government must also:
• Develop
a “game changing” tobacco control plan to push
tobacco use down to its lowest possible level by implementing
bold new measures that more aggressively reduce tobacco
demand and regulate its supply.
• Accelerate
research on youth smoking trends, e-cigarettes and
other topics.
• Expand
programs that prevent smoking and help smokers to
stop, including telephone quitlines.
Plain packaging
At the heart of our new national tobacco strategy should be a
plan to eliminate the most effective tool that tobacco companies
are still using to promote their products: the colourful,
market-tested designs on cigarette packages themselves.
The concept of plain packaging rules is simple. They ensure that
cigarette packages no longer function as mini-billboards by
eliminating the use of brand-specific colours, logos and graphics
on the package itself. Health warnings remain, but packages can
no longer convey positive lifestyle messages nor can they be sold
in “super slim” packs (targeting women) or in other special formats.
Canada must catch up with the global trend toward plain packaging.
First implemented by Australia in 2012, Great Britain and Ireland
have also now legislated their own plain packaging rules, which
will take full effect in May 2016. New regulations are also under
advanced consideration in France, Norway, Finland, Sweden and
New Zealand.
• Increase
enforcement of the ban on tobacco sales to minors
and other federal tobacco laws.
• Launch
a mass media, nationwide public awareness and
outreach campaign – Canada’s first in more than a decade.
The next federal government must be ready to act when the
current Federal Tobacco Control Strategy expires in 2017. All
political parties must support a more effective and properly
funded replacement. In the United States, per capita federal
investments in tobacco control are more than 2 times higher
than in Canada.
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Palliative care:
The care you need
when you need it most
Recommendation 2
Guarantee in federal legislation the right
of all Canadians to affordable, high-quality
palliative care.
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One of the federal government’s most important obligations
is to ensure that all Canadians have access to affordable,
high-quality healthcare. Of the areas where Ottawa has failed
to meet this responsibility, palliative care is one of the clearest
and most pressing.
Palliative care refers to an array of treatments and support
services required by people who are facing life-threatening
illnesses, including emotional and psychological counselling,
specialized pain and symptom management and advanced care
planning. Palliative care was initially developed for, and is still
largely delivered to, patients with advanced cancer, but there’s
a growing realization of the broader need for this form of
patient-centred care right across healthcare systems.
Most Canadians would be shocked to learn about the problems
plaguing palliative care across our country today. Given our common
belief in a universal, publicly funded health system, we assume that
the necessary services are available to all Canadians, especially the
sickest and most vulnerable among us. Tragically, this is not
the case.
Palliative care services vary dramatically across Canada, not only
from one province to the next, but among communities in the
same region. However, no one knows the exact size and severity
of the system’s gaps. The lack of reliable nationwide indicators and
data collection makes measuring the problem extremely difficult.
Often palliative care can be effectively delivered outside of a
hospital setting. Receiving care at home is the preference of many
patients and often less costly for a publicly funded healthcare
system. Unfortunately, for many Canadians this type of care is not
available. For some this will mean dying in an emergency room or
while lying in a corridor waiting to be assigned a bed, when they
could be in their home or elsewhere in their own community,
comfortable and at peace, surrounded by loved ones.
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Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future
The financial burden
Palliative care is just one example of a service that is not adequately
provided by Canada’s publicly funded health system. Despite the
widespread belief that Canada has universal health coverage, there
are a number of areas where essential treatments and services are not
covered. These gaps, combined with job and income insecurity, place a
suffocating financial burden on many cancer patients.
No Canadian should go broke paying for cancer medication, yet access
to affordable drugs is unequal and unfair. That must change. From job
protection and temporary income support, to specialist care at home
when you recover, there are critical gaps to fill.
While some excellent support programs and service delivery
models exist across the country, we know that many Canadians
are falling through the cracks in Canada’s patchwork of palliative
care services.
No single government or political party is to blame for our current
situation. Our understanding of the importance of palliative care
has steadily increased in recent years, and the roots of our current
problems run back decades, through the mandates of different
governments.
The next government, however, will have no excuse for failing to
act. As our population ages and cases of cancer and other chronic
diseases increase, the need for early access to high-quality palliative
care has never been clearer or more urgent.
The first step toward a solution is for the federal government to
recognize a fundamental principle: that all Canadians have a
right to palliative care. The government must enshrine this right
in federal legislation, and guarantee Canadians’ access to these
essential health services, by adopting a new national Palliative
Care Act.
© Canadian Cancer Society 2015
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Cancer research:
The road to hope and progress
Recommendation 3
Commit to long-term investments in health
research that keep up with rising costs
and population growth and are delivered
through simple, streamlined funding
programs that maximize the impact of
every dollar.
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Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future
Photo: Dr Bruno Salena and Dr Yingfu Li, McMaster ©
University
Canadian Cancer Society 2015
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Health science is key to the fight against cancer. Its discoveries
can lead to better treatments and prevention strategies and
ultimately to cures. What researchers learn in the lab, clinic and
out in the community can help stop more cancers before they
start and enable more Canadians to survive and thrive after a
cancer diagnosis.
Cancer research has fueled tremendous progress over the years.
Decades of work by dedicated researchers have led to better
cancer prevention, detection and treatment. The impact on
survival rates has been especially dramatic. Today over 60% of
Canadians diagnosed with cancer will survive at least 5 years.
In the 1940s, survival was about 25%.
With 40% more cancer cases expected by 2030, we must continue
investing in new research while vigorously applying the vast
knowledge of cancer biology that’s been accumulated over the
past century. Future research findings will be essential to diagnose
cancers earlier, treat patients with more precision and less toxicity and
help Canadians understand how to lower their risks of developing
cancer in the first place.
The federal government will play a critical role in future health
research. In addition to charitable funding for health research –
including the Canadian Cancer Society’s $40-million annual
research investment – Canadian researchers rely on public funding,
including major investments by Ottawa.
The next government must protect and expand health research
funding to keep up with rising costs and the changing needs of
a growing and aging population. Failure to do so will weaken the
Canadian research community, and compromise our ability to
understand and respond to our country’s future health challenges.
It would also diminish our standing globally, costing Canadians’
research and leadership opportunities that transcend international
borders.
Ottawa’s preference for short-term funding commitments leads to
inefficiencies. On-again, off-again funding cycles force researchers
to spend more time ramping up and shutting down projects and
less time running them. The repeated search for funding support,
qualified staff and appropriate facilities can all end up costing time,
money and progress.
Finally, the tendency to create a multitude of separately delivered
programs, each with its own set of eligibility criteria and application
procedures, can create an administrative burden for our scientists
that is a drag on productivity. Historically low success rates in federal
granting competitions is also discouraging researchers, especially
young ones, from submitting proposals at all.
Federal funding programs are so fundamental, in fact, that their
design and delivery can have a decisive influence on how much
health researchers achieve and how quickly they can achieve it.
Without clear national objectives and the commitment to provide
long-term, dedicated funding, there is a growing risk that the most
fundamental health research will be crowded out by a federal
innovation agenda skewed toward short-term commercial interests.
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Conclusion
As our population grows and ages in the years ahead, the number
of cancer cases will increase dramatically. The stakes are high for
all Canadians: without a strong national response, our healthcare
system will be overwhelmed and patients, families and our
economy will suffer.
The sooner we confront this challenge, the better we will do.
By taking swift and sustained action, we can properly care for
our aging population while building a healthier future for all
Canadians, including our children and grandchildren.
Success requires a renewed commitment to health by all political
parties, leading to a new era of federal leadership and accountability.
We will not get there in a single day, week or month, but the journey
must begin in this year’s federal election campaign.
Stronger tobacco control, guaranteed palliative care and smart
long-term research investments: these are steps all federal party
leaders must support now. Together these actions will help stop
more cancers before they start, provide badly needed support to
patients and their families and establish a practical foundation for
making longer-term progress.
As Canada’s largest national health charity, the Canadian Cancer
Society is ready to help make these recommendations a reality
and to continue working with all partners to build a future where
Canadians no longer need to fear cancer.
Contact:
Gabriel Miller
Director, National Public Issues
Canadian Cancer Society
[email protected]
613-565-2522 x 4982
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Federal Election 2015: Wake-Up Call: National Priorities for Patients, Families, and a Healthier Future