John Ibbitson

On H1N1, Canada is a jurisdictional mishmash

Four-year-old Rowan Watchmaker looks on as her mother is injected with the H1N1 flu vaccine at a clinic in Ottawa.

Four-year-old Rowan Watchmaker looks on as her mother is injected with the H1N1 flu vaccine at a clinic in Ottawa. Fred Chartrand/The Canadian Press

The structure of our federation means that, as with the national outbreak of swine flu, cracks form between the levels of government

John Ibbitson

John Ibbitson

At times such as these, authoritarian dictatorships have a certain appeal.

Whatever its strengths, Canada's federal system is singularly ill-equipped to manage a pandemic, with federal, provincial and municipal jurisdictions overlapping or leaving cracks for things to fall through.

In the case of this year's swine-flu outbreak, Ottawa was responsible for approving a vaccine, contracting for its manufacture and distributing the product to the provinces.

But a glitch arrived when GlaxoSmithKline unexpectedly failed to meet production targets as it switched to making a version of the vaccine for pregnant women.

In turn, the provincial governments, and various regional health authorities within provinces, developed protocols for distribution. Some have done better than others.

“There's plenty of finger-pointing to go around,” observes Roger Palmer. He is the former dean of University of Alberta's School of Public Health, and now teaches at the university's School of Business.

For the opposition Liberals in Ottawa, all fingers should point in the direction of Prime Minister Stephen Harper.

The Globe on H1N1

“Is the H1N1 pandemic the ‘Hurricane Katrina' of our own laissez-faire, fend for yourself, government?” Liberal Party president Alf Apps rhetorically asked in a letter to party members, referring to the hurricane that cost thousands of lives in New Orleans and elsewhere, mortally wounding the credibility of U.S. president George W. Bush's administration.

Canadians can only hope and pray, Mr. Apps wrote, that “the threat to general health and the risk of loss of life flowing from this government's incredible irresponsibility is contained to the absolute minimum.”

The Liberals accuse the Conservatives of failing to educate Canadians about the need to get vaccinated, and failing to help provincial governments administer the vaccine to the population.

These are strange criticisms. Surely, the Canadian public is more than aware that the disease is in our midst. Tragically, the deaths of two previously healthy teenagers late last month made getting their children vaccinated a priority for many parents. The problem is not ignorance or apathy; the problem, in part, is queue-jumping by those who need vaccine less than the most at-risk groups.

As for the rollout of the vaccination program, the provinces administer health care, and while the federal government might have done a better job of co-ordinating with provinces and municipalities, this largest vaccination in Canadian history is ultimately a job for governments on the ground.

Eight million doses of the vaccine will have been distributed to the provinces by the end of next week, according to the latest federal government data, more than any other developed nation on a per-capita basis, as Conservatives never hesitate to mention. GSK predicts that Canada will be one of the first countries to have vaccine available for the entire population.

It remains true, however, that the federal government is a chronic laggard at preparing for national emergencies, as the Auditor-General noted this week in her audit of Public Safety Canada.

The department “has not exercised the leadership necessary to co-ordinate emergency management activities,” Sheila Fraser concluded in her report.

The good news, as Prof. Palmer observes, is that “Thank the Lord, this is a relatively mild flu.” A similar response by the federal and provincial governments to a much more serious illness could lead to catastrophic loss of life and public fury.

What has been learned? Ottawa might try to contract for vaccine from offshore firms, although other countries are also struggling to meet demand for the H1N1 vaccine. And all levels of government could do a better job of copying each other's best practices to avoid the confusion and lineups that have marred the rollout of the vaccine in these early weeks.

If anything really is missing from the federal government's response to this pandemic, it may be empathy – that intangible ability of a prime minister to identify with the fears and concerns of citizens during a stressful time.

But Canadians long ago accepted that, whatever his other qualities, Mr. Harper does not excel as comforter-in-chief.

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