Build on Success: CIPHI Challenges for the Next Millennium

In 2013 the Canadian Institute of Public Health Inspectors (CIPHI) celebrated its 100th anniversary, a good time to reflect on where we have been and where we may be going. I became a Public Health Inspector 50 years ago and have been privileged to have been both witness and participant in the evolution and growth of both the profession and the Institute. During the century, the profession grew dramatically from its origins from primarily locally based by-law enforcement officials prepared through on-the-job training to well-educated professionals in all aspects. Professional preparation and qualifications have evolved to the point that today’s graduates are the best educated in history. Environmental Public Health professionals in Canada have become well recognized for their role in public health, occupational health and safety, environmental management, and their substantive contributions to the dramatic improvement in public health in Canada. The vision of the Institute’s founders in the Western Canada Sanitary Inspectors Association in 1913 and that of the Canadian Institute of Sanitary Inspectors in 1934 has been exceeded. So, should we be complacent and rest on our laurels? Like any organism we must continue to adapt and evolve. Knowledge is expanding exponentially, and the pace of technological change is nothing short of astounding. How we respond as individuals and organizations will determine how successful we’ll be. Environmental public health is science-based and entry to the field of practice requires constant evaluation of university curricula, professional accreditation, continuing education, and professional development. In 1980, Ryerson University in Toronto, Ontario, implemented the first degree program in Environmental Public Health in Canada, and it is now developing graduate programs. There is a growing trend for agencies to demand that specialists and management have graduate degrees now that an undergraduate degree is the norm for eligibility for certification. In the last decade, many universities have launched MSc and MPH initiatives and internet-based programs are readily available both domestically and abroad. Access is no longer an issue and the number of practicing health inspectors who are enhancing their professional education is encouraging. It is a far different scene from 1964 when I entered the field after a one-year course! Every jurisdiction in Canada has carried out reviews of its health care system over the past three decades and all shared the same conclusion*the public health system was under resourced. There were concerns about the infrastructure, public health workforce, and insufficient financial and political support. The 2003 Naylor Commission Report on the SARS outbreak forced federal and provincial governments to respond. The creation of the Public Health Agency of Canada (PHAC) in 2004 and its subsequent sponsorship of infrastructure development, skills enhancement, core competencies and the National Collaborating Centres for Public Health (especially the NCC Environmental Health) considerably strengthened public health in Canada. In its 2007 2012 Strategic Plan, PHAC made a committment to ‘‘place a priority on collaborating with other levels of government to fill gaps in public health human resources, both within the Agency and in other jurisdictions, and on working with partners to provide leadership in the areas of training and skills development, core competencies, accreditation and recruitment and retention policies’’ (p. 23). Provincial agencies such Public Health Ontario, the British Columbia Centre for Communicable Disease Control, and the INSPQ in Quebec have become centres of excellence to complement PHAC. They not only serve their own provinces but act as reference centres for other jurisdictions as well. There is a good foundation for environmental public health in Canada. So, what challenges need to be addressed? Let’s start by reviewing the continuum of education from entry level to graduate. There is a need for coherence and consistency so that a clear career path can be discerned. The certification process needs to be assessed. The Board of Certification has evolved since its origin in 1935, but is it the best model for the future? Dedicated volunteers have provided countless hours working off the corners of their desks, but it is time to consider a permanent accreditation office funded by fees. The practicum requirement must be changed in recognition of the fact that it is impossible to cover the full range of subjects in three months of highly variable field experience. Dr. Tim Sly, Professor Emeritus, Ryerson University, did a review for the Association of Supervising Public Health Inspectors in Ontario several years ago that recommended adopting a full-year paid post-graduation ‘‘apprenticeship’’ prior to sitting a certification exam. That suggestion is in line with what other professions require. It is a reasonable proposal that should be considered, and it would strengthen ongoing attempts to achieve provincial licencing and registration. Finally, it is time to address the issue of where environmental public health fits in the public health realm. Public health inspectors work in a variety of agencies, reporting lines are inconsistent, and many issues are often delegated to them on a 85

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