March 26, 2008

By Gloria Galloway, Globe and Mail

OTTAWA - A long-awaited report by the doctor who was hand-picked by the federal Health Minister to look into issues around children's health has found that Canada ranks "surprisingly poorly" when it comes to promoting the wellness of its young people.

Dr. Kellie Leitch, the head of pediatric surgery at the London Health Sciences Centre in London, Ont., makes five key recommendations in her 230-page report, including the creation of a national adviser to raise awareness of the issue.

Both the Canadian Medical Association and the Canadian Pediatric Association had argued for the establishment of a child commissioner like the one in place in Britain with the power to force government to act in the best interests of children.

But Dr. Leitch said in an interview yesterday that advocating for a commissioner was outside of the mandate handed to her by Health Minister Tony Clement.

"What I believed was really the essential component is that there needed to be an advocate for child health," she said.

"I think the mandate of that person is raising awareness, so doing an annual report card and making sure the minister is aware of what's going on with regards to child health, policy development, collaboration ... and championing research and surveillance."

And even though she is pushing for less than what the medical organizations might have liked, there was no indication that Mr. Clement was prepared to adopt any of the recommendations in her report, a document that was completed last fall but not released publicly until yesterday.

Mr. Clement said in a press release that he welcomed Dr. Leitch's recommendations and looked forward to reviewing them.

"While our review will concentrate on items under federal jurisdiction, I hope that others may find this report useful as well," he said.

Dr. Leitch began her analysis by pointing out that, among 29 countries that are part of the Organization for Economic Co-operation and Development, Canada ranks 22nd in preventing childhood injuries, 27th in childhood obesity and 21st in child well-being, including mental health.

Most Canadians are aware of the obesity problem, she said, but it is in injury prevention that Dr. Leitch said she believes the biggest impact can be made.

"I think there needs to be a national injury prevention strategy," she said. "We will never get to a year where there is not a single child that has an injury, but we need to strive toward getting those preventable injuries, whether that is motor vehicle crashes, chokings, drownings, falls, those things, down to zero."

Dr. Leitch also recommends that Canada establish a centre of excellence on childhood obesity, improve mental-health services for Canadian children and youth and undertake a broad study to help understand environmental factors affecting children's health.

"Everyone's shown an interest" in such a study, she said, "but no one's had the critical mass. So my recommendation is that there are certain big things that government needs to do and it needs to be the leader in bringing all the layers together."

Despite the report's comprehensive nature, Carolyn Bennett, the Liberal public health critic, said it falls short by placing the social determinants of health in an appendix.

And Mr. Clement "is lowering expectations that he will do anything with it," Dr. Bennett said. "We have serious work to do requiring serious leadership."