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Wanted: one ideal Canadian federal health minister (who walks on water)
  1. R Labonte1,
  2. A Williams2,
  3. L Biggs3
  1. 1R Labonte , Saskatchewan Population Health and Evaluation Research Unit and Community Health and Epidemiology, University of Saskatchewan, Canada
  2. 2Research Faculty, Saskatchewan Population Health and Evaluation Research Unit and Geography, University of Saskatchewan
  3. 3Women’s and Gender Studies, University of Saskatchewan
  1. Correspondence:
 Professor R Labonte, SPHERU, Health Sciences Building, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK, Canada S7N 5E5;
 ronald.labonte{at}usask.ca

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You are excited by the challenge of Canada’s interesting constitutional division of powers, in which the federal government is expected to contribute to health systems largely under the control of provincial governments, most of which will constitutionally disagree with anything you propose except the promise of more money.

You are resistant to media attacks that continually point to the declining federal contribution to health systems, and are able to convince your finance and international trade colleagues in the cabinet of the wisdom of progressive taxation to increase public funding for effective health services. Your conviction in evidence based policy making (rather than policy based evidence making) allows you to confront head on the economic interests behind the push for widespread privatisation of health (and education, and social services, and anything else “inefficiently public”), with convincing references attached.

You are inspirational in your communication to the nation’s diverse publics that not only is progressive taxation a fair way to finance public goods; it is also good for our publics’ health. Your sophisticated knowledge of population health research allows you to acknowledge that income inequality remains a contested health determinant. It also allows you to point out convincingly that public investments allowing universal access to education, shelter, good nutrition, and environmentally safe and playfully stimulating homes, neighbourhoods and communities are good for our health, our economy, and our planetary survival.

You both think and act globally, knowing that a resistant disease in Africa can hop to Canada in less than a day, and that escalating disease coupled with widening inequalities and weakened public services are the greatest drivers to regional conflict, hence global insecurity. You are a tireless advocate in public and in camera for trade agreements that promote health and protect the environment, and for Official Development Assistance levels that do not make a mockery of the 0.7% of GNP commitment.

You fully grasp the tenets of health promotion, whereby health systems, even as they provide downstream cure and care, also participate in upstream prevention and protection. You support efforts to cull good practices (never letting the tyranny of the “best” get in the way of the simply “good”) in health education, community development, and the health system’s “watchdog” role as advocate for social and physical environments—in the home, the community, the workplace—that enhance health and form a foundation of our social capital.

You are a weaver of “joined up” governance, knowing that the publics’ health requires collaborative policy making from many more ministries than your own; involves many other government levels; and needs input from a messy range of stakeholder groups in civil society, where business interests and public interests are not always the same. You know how to put problems, rather than your own ministry, in the centre of intersectoral collaboration, and understand that converting others to your discourse is neither necessary for, nor even useful in, effective collaboration.

You are an experienced activist in the politics of the excluded, and not simply the politics of the party. You have spent time with our Inuit, First Nations, and aboriginal communities. You recognise the diversity of women’s health needs. You have a deep empathy for minority ethnic groups, regional variations, and linguistic differences. You have heard the Maritime lament of fishless oceans. You are fluent in both official languages. You respect the populous weight of our industrial centre, understand its urgent drive towards the knowledge economy, and recognise the need to ensure thedignity of those caught in the transition’s wake. You respect rural life, its deeply valued traditions and commitment to community. You share the fears of drought, climate change, and corporatisation with our Prairie farmers. You wrest over the dilemmas of resource based economies devastating our environment (its health, our health), or reeling from past devastations of depletion and exhaustion, and ponder the challenges of the new global economies.

Finally, your years in community work are complemented by your years in tertiary learning, providing you with a healthy respect for the spectrum of health research required for better political and public decision making, and to help build our nation’s human capital.

(Ability to leap tall buildings in a single bound desirable but not required.)

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