Most physicians in New Brunswick are not directly employed by government. Most doctors don’t have a boss, other than the thousands of patients they care for.
Public health physicians are a bit different. These are the doctors that work for the section of government that inspects restaurants and our water supply, examines the impact of real and potential hazards on our health, and more. These doctors do work for government directly, and they do report to senior bureaucrats, including our elected politicians. They can face restrictions (like other government employees) in terms of what they say. The challenge lies in the fact that these ‘employees’ are also physicians, who are duty-bound to speak out on behalf of their patients.
In other provinces, governments have recognised the challenge this presents for these physicians. In some others, governments have not – Canada has seen examples of public health doctors fired for speaking out on issues, usually against the political viewpoint of their elected leaders.
New Brunswick’s doctors want our provincial public health physicians to be able to speak to their patients – all New Brunswickers – just the same as a family doctor would be able to speak to their patient in their office. They need to have a measure of independence from government to enable them to do this.
We’ve asked all political parties to follow the lead of other provinces and change the law so that these doctors can share their recommendations and advice with us. We’ve made the following five recommendations:
#1: Medical Officers of Health need the clear ability to speak to the public, independent of the opinions of the government of the day.
#2: The Chief Medical Officer of Health should prepare an annual report for the legislature on subjects of their choosing, free from political interference in its preparation and publication.
#3: Medical Officers of Health must be able to investigate issues of public health concern, outside of emergencies, at their own discretion.
#4: Our definition of public health hazards must be updated to reflect 21st century health hazards. (This means Medical Officers of Health should be able to discuss non-imminent but relevant health impacts of various actions, not just public health emergencies.)
#5: The Chief Medical Officer of Health should remain as a senior leader within the Department of Health. (This means we believe that the Chief Medical Officer of Health should not become an officer of the Legislature like the Auditor General or Ombudsman – they need to remain under the Department of Health, but with clear lines around their ability to talk to New Brunswickers).
Our own recent past shows that we need this clarity here, too. We believe strongly in this, but it is no surprise that our view is that the first duty of any doctor is to their patient, not to their boss.
At their core, Medical Officers of Health are doctors, not bureaucrats, and their patients are all New Brunswickers. If there is a health risk – imminent or long-term – the patients need to hear it straight, right away, from the experts who know best. We call on all political parties to support our position.
Read the full paper here.