Toronto Public Health 2024-2028 Strategic Plan consultation -- input from a community conversation
Copy of completed and acknowledged submission for the public record.
Dear members of the Toronto Board of Health and Toronto Public Health (TPH) staff,
I would like to submit notes from a community conversation among five Toronto residents held via Zoom on the evening of Thursday, 14 March 2024. We reviewed the existing 2015-2019 Strategic Plan's mission, foundational principles, and priority directions, and then had an open-ended discussion for over one hour, attempting to respond to two of your proposed questions:
What in your opinion should be TPH’s top priority over the next four years?
Where do you believe TPH can make the most significant contribution to the population health of Toronto in the next four years?
Summary of our thoughts:
The existing Strategic Plan includes important guiding principles – accountability, transparency, inclusion, diversity, excellence – but these are not always consistently followed.
First and foremost, we believe that TPH needs to re-commit to fundamental principles of public health and medical ethics. Ethical public health practice should employ voluntary participation in interventions to truly engage the community. Values of autonomy and self-determination are essential for individual and population health and wellbeing.
We are very concerned that during the COVID pandemic, TPH participated in coercing residents into compliance with a number of non-pharmaceutical and medical interventions, the necessity, efficacy, safety, and ethics of which are increasingly coming into question. People should be allowed, indeed encouraged, to make their own individual choices, e.g. with regards to vaccination, without coercion or manipulation. Immunization cannot be presented as the only strategy for dealing with future infectious diseases.
In this context as well as on a broader scale, we call on TPH to commit in its new strategic plan to support alternative approaches to health, and welcome alternative schools of medicine, such as naturopathy, as an asset rather than restricting them. Similarly, we believe that TPH staff should be directed to seek out and analyse dissenting research and opposing evidence without prejudice. Public health decisions that look at evidence on multiple sides and allow for open argumentation will be more solid and more widely supported.
Additionally, we discussed that decisions with direct impact on the community should be made at the local level. In this sense, we encourage TPH to not blindly rely on recommendations developed at higher levels (provincial & federal governments, WHO) that may be out of touch with our local needs. An independent critical check should be done of any guidance received from higher jurisdictions. TPH is accountable to Torontonians first.
We also noted the involvement of "community stakeholders" in the healthy public policy direction of the current plan and suggest a dedicated effort to review who these "stakeholders" currently are, how they are selected, and whether they truly represent Toronto residents. Are, or should, stakeholders be allowed to self-identify?
We are concerned about possible "mission creep" in Toronto Public Health, e.g. when during the pandemic, TPH appeared to take responsibility for everyone's individual health and safety, and the Medical Officer of Health became “everyone’s doctor.” This totality of responsibility and reliance is neither realistic nor desirable. But this attitude, fostered by the media, created an environment in which significant restrictions such as playground closures or vaccine passports were implemented without democratic public debate. There should be more negotiation next time, with entities other than TPH given agency to advocate for the needs and values of the people they are responsible for in a shared decision-making framework.
We also call on TPH to commit to communicating medical information in an honest and modest manner. We understand that public health officials may be using slogans such as “safe and effective” in order to broadcast messages that are simple and easy-to-understand. However, this aim should not override the need to be truthful and disclose risks and uncertainties, without which informed consent is not possible. We also urge TPH to refrain from causing divisions. Explicit and implied messages about people who chose to not get vaccinated being a problem during the COVID pandemic led to a lot of division amongst our families and communities, in direct conflict with TPH’s commitment to diversity and inclusion.
Similarly, the next strategic plan should ban broad social distancing and isolation policies. In addition to relationships lost due to divisive public health messages, many of the pandemic policies (school and workplace closures, masking, social distancing, restricted group gatherings, long term care lockdowns, etc.) caused loneliness and broke social ties, which has devastating health effects.
Several members of our small group are supporting Torontonians with reported & accepted COVID vaccine injuries. The recognition of "post-vaccine syndrome" needs to be improved, appropriate diagnostic testing provided, and a dedicated support system established. Many vaccine injured have PTSD related to how they have been treated in hospitals here. TPH should take a leading role in research, diagnosis, and treatment of vaccine injured individuals. In this regard, the accountability principle in the strategic plan needs strengthening.
Of great concern to this group is parental/guardian consent for children to get a vaccine. Vaccinating 12 year olds without their parents’ knowledge is not acceptable. All medical care of children should be the responsibility of parents who know them best. Instead of facilitating pharmaceutical interventions, let's invest in truly healthy children. Kids need nourishing food, exercise, stress relief tools, etc.; interventions that could be part of the school system.
Lastly, we call on TPH to continue making all population-level data proactively available so that independent citizen analysts may review the impact of public health policies on Torontonians.
We appreciate the opportunity to contribute these thoughts to inform the 2024-2028 Strategic Plan.
With kind regards,
Claus Rinner, on behalf of all group members