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March 8, 2022

From: Don Drummond and Duncan Sinclair

To: Canadians Concerned About Well-Being

Date: March 8, 2022

Re: Does Ottawa’s New Home for ‘Quality of Life’ Mean a New Direction?

Last June the federal government embarked on consultations about incorporating “quality of life measurements into government decision-making and budgeting, drawing on lessons from other jurisdictions such as New Zealand and Scotland.”

An excellent supporting framework paper by Finance Canada made a useful distinction between “top down policy shaping” and “bottom up policy setting.”

The intent seemed to be that Quality of Life would henceforth form a key federal policymaking and budgeting focus, emulating New Zealand's pioneering 2019 Well-Being Budget. It focused on achieving clear health and well-being objectives and establishing procedures to align policies and monitor and report on results.

Late last year, however, lead Quality of Life responsibility was moved from Finance to Treasury Board. It does retain the same minister, Mona Fortier, who moved from Associate Finance Minister to President of the Treasury Board in December’s cabinet shuffle. Accompanying that change, the relevant mandate letters may also signify a different direction.

Ms. Fortier’s new mandate letter directs initiation of “a comprehensive and continuous strategic policy review of government programs to examine . . . improving fairness and equality and promoting quality of life and growth for everyone.”

Her previous letter was a bit more specific: “Lead work within the Department of Finance . . . to better incorporate quality of life measurements into government decision-making and budgeting, drawing on lessons from other jurisdictions such as New Zealand and Scotland.”

This apparent shift from “top down” to “bottom up” is consistent with moving leadership to Treasury Board with its responsibility to manage spending programs. Applying a comprehensive and consistent Quality of Life lens to spending reviews would be a major improvement on traditional practice.

But no matter the department, there is work to do.

In the end, reports on how individual programs affect Canadians’ quality of life will not give them a perspective on how well or poorly we are meeting quality of life goals and objectives, the identification of deficiencies, and on the strategies of the whole of government, accompanied by budgets, to address those goals and objectives.

We earlier described several necessary steps to make those considerations effective. Those included further work on measures and data, involvement of provinces, territories and municipalities, a wholesale cultural shift away from a focus on spending toward outcome assessments across the population.

While Quality of Life measures and indices are being developed, work should continue on the individual domains of prosperity, health, environment, society, and good governance; the results could be reported individually, as is the case now in several of these domains.

Health is divided in the Finance framework document between ‘Healthy People’ and ‘Healthy Care Systems.’ The data for the former are now partial, diverse, scattered, and hard to find. There is tremendous value in pulling these data together, centralizing their publication, and making links available to such underlying health determinants as income, education, housing, and personal security.

As the data and linkages are largely in the Statistics Canada domain, that agency should take the lead, working in collaboration with others including the Canadian Institute for Health Information, the Public Health Agency of Canada, Health Canada, and provinces and territories. Then the work could be merged into a Quality of Life measure/index to serve as the focus of a policy target somewhat comparable to Gross Domestic Product (GDP) when sufficiently developed.

We understand a portal is being built for Quality of Life measures and that health outcomes data will be placed there as available.

If this good plan works, data could be put together on health-adjusted life expectancy, self-rated overall health and well-being, self-rated mental health, physical activity, and functional health status, and other measures.

Having this information in one place/portal along with links as they become established to various socio-economic databases would be tremendously useful to guide an agenda to foster healthier Canadians.

Other key information may become available soon, such as access to long-term care and its quality. Recently, we argued more resources should be devoted to home care support to enhance quality of life for seniors and contain cost increases. We are encouraged discussions are underway on gathering data on how home care needs are met, or not.

The new home for the Quality of Life initiative within the Treasury Board will likely enhance its applicability to spending reviews. We hope the prospect of Quality of Life being front-and-centre of policy strategy and budgeting will be strengthened not diminished.

Don Drummond is Stauffer-Dunning Fellow and Adjunct Professor, School of Policy Studies, Queen's University where Duncan Sinclair is Professor emeritus.

To send a comment or leave feedback, email us at blog@cdhowe.org.

The views expressed here are those of the authors. The C.D. Howe Institute does not take corporate positions on policy matters.