Healthcare Governance for a Post-COVID Canada: Leveraging Hard-Earned Experience for a More Equitable and Supportive System

The COVID-19 pandemic has served as a deadly reminder of the critical importance of public health (including immunization). Despite the International Health Regulations 2005, the epidemiological warnings, and post-SARS recommendations, Canada was ill-equipped to anticipate the pandemic, ill-prepared to effectively meet its demands, and it relied on provincial interventions, which were driven in part by political objectives. The result was unnecessary deaths, service breakdowns, and healthcare worker (HCW) burnout. All of this clearly points to a pressing need for more robust governance standards, institutions, and practices organized by a more coherent and resilient governance framework instantiated in a comprehensive Canadian Public Health Act. Through its diverse and pan-Canadian team, the 'Healthcare Governance for a Post-COVID Canada' (HGPC) Project will examine the impacts of COVID-19 of public health. Evidence generated will inform a governance framework design through a process that draws on the experiences of groups profoundly impacted by the pandemic but habitually sidelined in the development of rules and standards. Specifically, it will draw on data from regulated and unregulated HCWs and support personnel, and from individuals from equity-seeking groups (including Indigenous and other racialized individuals and newcomers). Evidence generated will feed into a series of deliberative engagement exercises wherein a selection of policymakers and knowledge-users and ground-level actors will collaboratively consider a range of scenarios and collectively imagine the future that Canada's public health governance framework needs to deliver. We will then make recommendations for a public health governance framework, with legislative elements.