Healthy Skepticism Library item: 1492

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Publication type: news

Branswell H.
Group that advises doctors on preventive health care loses funding, must fold
Canadian Press 2003 Nov 24

Full text:

TORONTO (CP) – It’s hardly a household name but the Canadian Task Force on Preventive Health Care has exerted a guiding influence on the health care Canadians receive for nearly a quarter century.

That may soon end. The group routinely reviews mountains of clinical evidence to advise family doctors when they should and shouldn’t order expensive tests or conduct examinations to prevent disease or catch it early.

Now its future is in peril. Health Canada has pulled the plug on funding and, unless the decision is reversed, it will close next April, the Canadian Medical Association Journal reveals Tuesday in an editorial bemoaning the turn of events.

“Without some resolution of our current situation, we will cease to operate in the spring,” confirmed Dr. John Feightner, the family medicine professor at the University of Western Ontario who has chaired the task force for the past six years.

“There is no other group that makes recommendations in the Canadian context that focuses on prevention. It will be a tremendous gap.”

A spokesman for the College of Family Physicians of Canada goes further.

“It seems shocking to me personally, especially where our focus has been to move more to preventative health care in Canada for the last number of years,” said Dr. Peter MacKean, past president of the organization and a family doctor from Kensington, P.E.I..

“I couldn’t possibly understand what the rationale would be for that . . . It doesn’t fit with our focus in Canada right now.”

Health Canada says the move is regrettable and it hopes to be able to find money to save the task force but, to date, prospects don’t look good.

“Nobody questions the validity and the work that they’ve done at all,” said Dr. Gregory Taylor, director of the chronic disease prevention division.

“But given SARS and West Nile and the massive pressures on the branch . . . we’ve just been unable to find a secured funding – so far.”

The task force plays a critical role in an era when the volume of medical literature has exploded to the point where even the most conscientious doctor has no hope of keeping up with the latest in research.

Volunteer members regularly review literature on a variety of subjects. In 2001, for example, they tackled the controversial question of whether healthy women in their 40s should be screened for breast cancer using mammography.

The task force then makes recommendations for doctors based on the weight of accumulated evidence. “All those doctors need some authoritative group to distil that information down to a much more practical level and make it easily accessible to the physician and the patient during the clinical encounter,” journal editor Dr. John Hoey said in an interview.

The task force, which issued its first recommendations in 1979, has always operated with federal funding. About seven years ago, the provincial and territorial governments were brought into the equation as well.

One year into the second three-year contract, the provinces announced they were pulling out, reportedly as part of the ongoing feud with Ottawa over who pays for what in health care.

The task force’s budget had been set at $400,000 a year, with Health Canada picking up $80,000.

When the provinces pulled out, Health Canada upped its contribution to $100,000 for 2002-03 but then announced it could no longer come up with its portion of operating costs – an amount Hoey says is “trivial” considering the department’s overall budget. The task force received no funding this year.

The organization’s work saves health-care systems across the country considerably more than it costs, Feightner said. In addition to steering doctors away from tests and procedures that aren’t sound, it helps identify ways to keep people from developing disease.

“I think that it’s a double-barrelled benefit.”

If it goes, guidelines will likely end up being developed by conferences paid for by drug companies.

Research has shown participants in such conferences are prone to recommending the products of the people paying for the event, Hoey said.

“That’s not ideal,” he noted wryly.