Category: Social Policy meets the Frontline

Calls for urgent attention on new Omnibus bill and seeking explanations of the downward trend of health funding in Ontario

When budgets and Legislation meet. The Ontario Health Coalition alerts us to new relevant legislation and Defend Public Health Care critics of the provincial health budget. 

It would be useful to have actual discussion on the meaning and practical impacts of what is happening here.  For example, are provincial funds being strengthened into core parts of the Social Determinants of Health like housing and employment instead of going into the category of health care?  Thus potentially suggesting a re-framing of “Health” by the government? 

Omnibus Legislation

The Ontario government is moving forward with legislation that lifts the ban on private hospitals, rolls private hospitals in with private clinics and renames them, offensively, Community Health Facilities, and makes it easier for private hospitals and clinics to expand and more difficult for the Minister to stop them.

This legislation was brought in with no prior public consultation. It is a massive omnibus bill that repeals or enacts 7 entire Acts, and amends more than 30 Acts. We were given 5 minutes to present to the Standing Committee on this massive piece of legislation. Now we have only four days to try to get the worst part of it withdrawn. Without due consideration of the consequences, the government is making a grave mistake that could easily usher in very significant new privatization and threats to our local public hospitals.

Health care funding

provincial health care expenditures in Ontario and Canada
Across Canada real per person funding is in its fourth consecutive year of increase. Since 2009, real provincial funding across Canada is up $89 — 3.6%.
In fact the funding gap between Ontario and Canada as a whole has gown consistently for years (as set out below in current dollars).
See the full presentation by Doug Alan, Defend Public Health Care here:
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Policy Partnerships within government itself, ingredients for “buy-in”

The Centre for Urban Studies via http://stmichaelshospitalresearch.ca/research-programs/urban-health-solutions/our-projects/building-healthy-policy-and-practices/increasing-collaboration-within-governments-to-improve-population-health-and-equity/  supports linking of policy to practice. One example of their efforts focus’ specifically on policy development within government itself, providing this paper below.  

Using Win-Win Strategies to Implement Health in All Policies: A Cross-Case Analysishttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0147003

  • Agnes Molnar,
  • Emilie Renahy,
  • Patricia O’Campo,
  • Carles Muntaner,
  • Alix Freiler,
  • Ketan Shankardass

…Findings

Our results yielded no support for the use of awareness-raising or directive strategies as standalone approaches for engaging partners to implement HiAP. However, we found strong evidence that mechanisms related to “win-win” strategies facilitated implementation by increasing perceived acceptability (or buy-in) and feasibility of HiAP implementation across sectors. Win-win strategies were facilitated by mechanisms related to several activities, including: the development of a shared language to facilitate communication between actors from different sectors; integrating health into other policy agendas (eg., sustainability) and use of dual outcomes to appeal to the interests of diverse policy sectors; use of scientific evidence to demonstrate the effectiveness of HiAP; and using health impact assessment to make policy coordination for public health outcomes more feasible and to give credibility to policies being developed by diverse policy sectors. …

Thinking, living, struggling with how activists TALK social change

A useful and rare discussion, led by Steve Paikin https://tvo.org/programs/the-agenda-with-steve-paikin/ , and the guests who clearly are living it.  I would have re-titled it: Anger, Empathy and Activism for Change. I found midway the interview got a little lost in campus freedom of speech issue, but hang in as brought back to thinking, living, struggling with how we try to talk of social change.

See video here: https://tvo.org/video/programs/the-agenda-with-steve-paikin/activism-allyship-and-making-change

Links to the interviewee’s web pages.

http://animaleadership.com/

http://www.citizenempowerment.ca/

 

A structured approach to analyzing public policies – Online course

Florence Morestin, shared this resource for ” structured approach to analyzing public policies” from the National Collaborating Centre for Healthy Public Policy http://www.ncchpp.ca/

 

Dear colleagues,

I would like to let you know that the NCCHPP’s online training courseA framework for analyzing public policies” is now being offered for free and is offered in a format compatible with PC, Mac, tablets and phones.

This online course will enable participants to make use of a framework for analyzing public policies in order to inform policy makers in the context of healthy public policy development.

Upon registration, you will have 24/7 access to the course. It is made of four self-paced modules presented on a user-friendly platform, allowing you to progress at your own pace. It takes from 6 to 8 hours to complete the course. Once you will have completed the course, you will be eligible for a certificate of completion.

To learn more or to register, click here: http://www.ncchpp.ca/438/Online_Course.ccnpps

 

For more information about the course, please feel free to contact us at ncchpp_training@inspq.qc.ca.

Article – Going beyond ‘context matters’: A lens to bridge knowledge and policy

While this article from INTEGRATION AND IMPLEMENTATION INSIGHTS is more relevant to EDs, it does have value for front line workers as we attempt to have a grip and work to understand our organization’s and the broader government and social institutions efforts to bridge research to practice. 

… context-matters_echt

  1. the macro-contextual approach, which has dominated the existing (though limited) literature on context, focuses largely on factors that are usually beyond the sphere of control or influence of those trying to promote the use of knowledge in policy (such as the extent of political freedom, media freedom, etc). In contrast, our intention was to strategically identify potential areas of change for different types of interventions.
  2. we believe that governmental institutions constitute the most direct environment where practices to promote the use of knowledge in policy take place. They are the setting where most decisions about policies are discussed and, most importantly, where they are implemented.
  3. the role of institutions in enabling systemic change has also been widely recognized in development-related projects. Focusing at the institutional level has promising potential to contribute to change because of the significant role borne by institutions within any system  …

See the article here: Going beyond ‘context matters’: A lens to bridge knowledge and policy

Article explains and critiques current federal housing budget plans

Article from http://spacing.ca/national/2017/04/05/hulchanski-trudeaus-housing-spending-smoke-mirrors/ by leading housing/homeless policy leader

HULCHANSKI: Trudeau’s housing spending is smoke and mirrors

In a year when the high cost of housing dominates the headlines, this year’s federal budget is promoting a bright shiny object: the allocation of $11 billion for housing.

Well before budget day, we were told to expect that $11 billion. On budget day, there it was, in all its glory.

But when you look closer, the money is not actually there. It’s not real. The $11 billion for housing is an alternative fact, distracting us from a gaping hole in the budget figures.

The bright shiny object has, unfortunately, led many NGOs and charities to praise the Liberal government. The praise is likely the product of hope mixed with fear. The promise comes from a political party with a well-earned reputation for not keeping its promises.

The fear is that the Liberal Party’s housing policy has not changed since the 1990s.

After promising a host of progressive housing initiatives during the 1993 election that returned them to power, the triumphant Liberals then declared that housing was no longer a federal responsibility, that no more social housing would be funded, and that existing federally owned public housing would be downloaded to the provinces.

Then-Finance Minister Paul Martin, in his Budget Plan of March 6, 1996, stated: “CMHC will phase out its remaining role in social housing, except for housing on Indian reserves. The first step has already been taken – there has been no funding for new social housing units since 1993. To further clarify jurisdiction in the social housing field, the federal government is now prepared to offer provincial and territorial governments the opportunity to take over the management of existing social housing resources.”

Twenty-one years later, the most troubling proviso in this budget is that the $11 billion will be spent over eleven years. Eleven years? Not three? Not five?

Out of a budget of more than $300 billion annually, is $1 billion a year the best that one of the wealthiest countries on Earth can do? Is our housing system so well developed, are Canadians so well housed, are there so few un-housed people, that the remaining social need for housing assistance now requires only a tiny fraction of our federal monies?

Worse, the amount pledged is not an average of $1 billion per year. It is not huge spending now, tailing off over the remaining years. Instead, there will be almost no new money for housing until after the next election.

That shiny $11 billion object cannot obscure what’s on Page 151 in the Budget, a page with few words and many numbers. Look closely at those columns full of zeros or very small numbers.

All those zeros sit next to the impressive list of housing initiatives included this year with a paltry $20 million allocation next year and the following year, with only $305 million.

Let’s face it: there is no new money for housing this year, and almost nothing for next year. Furthermore, only $3.1 billion of that bright shiny $11 billion is accounted for during the initial five years. The “$11 billion” is an alternative fact for partisan political use.

We now have it in writing that the Liberal government has no plan for any significant spending to address Canada’s housing needs until after the next election.

Yes, last year’s budget allocated $2.3 billion over two years and partly responds to some of the 2015 election promises. But that’s it, out of two budgets that allocate more than $600 billion dollars in total.

We should judge politicians and parties by what they do, not by what they say. The current budget offers no real change from the 1990s philosophy about the limited role of the federal government in Canada’s housing system – aside from the mortgage system.

But let’s look at a budget that actually described expenditure decisions rather than producing partisan talking points. Let’s go back to a previous Trudeau government.

In 1981, interest rates were high, house construction was in a slump, unemployment soared. Given these realities, the 1981 budget introduced a new Canada Rental Supply Plan and then, in 1982, doubled the allocation to 33,000 new private-sector rental units.

The 1982 budget provided funding for a Canadian Home Ownership Stimulation Plan. It doubled the existing Canada Home Renovation Plan, and increased the annual allocation for non-profit and co-operative housing from 25,000 units to 27,500 units for that year.

Those budget announcements were real and immediate, and actually resulted in the construction of affordable ownership, private rental, and social housing, not to mention the creation of thousands of construction jobs.

The cost was about $1 billion in new spending (inflation-adjusted to 2017), on top of existing housing expenditures – e.g., amounts set aside to build 20,000 to 25,000 new social housing units annually.

Now look at last year’s budget, which included funds for a new affordable rental housing innovation program. How much “innovative” rental housing? Just 4,000 units — over five years. In other words, 800 units per year for the entire country. Really?

Really.

We used to recognize and make some progress in addressing the pressing housing needs facing Canadians. As a nation, we have the wealth and ability to do so. But our government no longer chooses to address housing shortages.

In an era of alternative facts, it is easy to confuse voters so as to maintain our housing system as it is — a highly efficient mechanism for increasing inequality – rather than providing adequate and affordable housing for all Canadians. We reformed our health care system decades ago. It’s time to reform our housing system.

Who will be the Tommy Douglas of our housing system?

photo by Marcus Bowman


David Hulchanski is Professor, Housing and Community Development, Factor-Inwentash Faculty of Social Work, University of Toronto. Follow him at @Hulchanski.

Guardian article on the use of statistical data in politics and advocacy

Micheal Gurstein https://gurstein.wordpress.com suggested this article

Rather than diffusing controversy and polarisation, it seems as if statistics are actually stoking them. Antipathy to statistics has become one of the hallmarks of the populist right, with statisticians and economists chief among the various “experts” that were ostensibly rejected by voters in 2016. Not only are statistics viewed by many as untrustworthy, there appears to be something almost insulting or arrogant about them. Reducing social and economic issues to numerical aggregates and averages seems to violate some people’s sense of political decency.

https://www.theguardian.com/politics/2017/jan/19/crisis-of-statistics-big-data-democracy