The Importance of Prevention; 17 years later…still waiting for action

j0407140.jpgI was reading this article about the need for Canada to focus on prevention in Health Care. How many years have we been hearing this same refrain? We can see the logic of it but are unwilling to hold government accountable for actually implementing it. After all prevention is not crisis. Crisis is the here and now and requires all of our resources and attention. It reminds me of the ongoing call for more focus on prevention in child protection services. Obviously, it is far better to prevent a situation that will require a child to be apprehended.

I am beginning to believe that these calls for focus on prevention will never come to fruition. Prevention requires linking and integration of services which just cannot happen when each Ministry is worried about keeping their slice of the pie and holding on to what they’ve got. This is as much of a problem at the highest Ministry levels as it is at the community level.

I began paying attention to this issue for about 17 years ago. Since that time I have witnessed many efforts to improve collaboration across provincial Ministries (e.g. health, ministry of children and family development, education), but all of these consultation processes have not resulted in real positive change. Now in my second decade of watching these ongoing sideshows, I am beginning to believe they are clever diversions to ensure that the public “thinks” action is taking place.

Our systems our designed to focus on crisis and do not allow for a focus on prevention. Ministries responsible for these services at both the federal and provincial level operate in silos, and there is little collaboration across Ministries. Government may implement intergovernmental committees at the highest levels to work on cross Ministry planning, but these planning processes are a joke if funding dollars are not specifically allocated for prevention services. It’s all just smoke and mirrors to fool the public. The truth is government knows a great deal about prevention but rarely enact well-researched prevention services because of the cost. If you actually identify that there is a problem you then become obligated to try to fix it…so it’s better to stick your head in the sand and ponder the issues in consulations that will go nowhere.

One shot programs that address problems as they become fashionable (e.g childhood obesity) are the norm in this country and this approach to prevention has been a complete failure. This approach is all about about making politicians look good and provides excellent material for news releases and photo ops.

If community prevention services (e.g child care, early learning, dental care for the poor, housing, health screening followed by effective intervention, home care services for the elderly, etc) are in a constant battle for resources and funding and always stretched to the limit, then it is only the crisis situations that will ever be addressed. There is no funding or time for prevention. There is no doubt that prevention is the key to better, more cost effective health, child and family and education services, but paying lip service to the problem is never going to change anything.

Later that evening……………

Update March 6, 9 pm: Take a look at Public Eye online today…..we have a plan for MCFD in BC. Well don’t that beat all…..I complain in my blog and I find a new a plan on the same day. It will be interesting to see how this shakes out. It appears some big changes are in store for some MCFD folk. Let’s see what happens. I am crossing my fingers!!

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