Ministry of Health - Prince Edward Island · Ministry of Health Annual Report for the year ending...

Ministry of Health

Annual Reportfor the year ending March 31, 2006

For more information on this report, contact:PO Box 2000, Charlottetown, PE, Canada, C1A 7N8

Tel: 902 368 5272 Fax: 902 368 4969or visit our Web site at www.gov.pe.ca/health

Message from the Minister

To the Honourable Barbara A. HagermanLieutenant Governor of Prince Edward Island

May It Please Your Honour:

It is my privilege to present the Annual Report of the Ministry of Health for the fiscal year endedMarch 31, 2006.

Respectfully submitted,

J. Chester GillanMinister of Health

Table of Contents

Deputy Minister’s Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Overview of New Department of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Organizational Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Roles of Divisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Community Hospital Authorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Community Hospital Authority Interim Board Members . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Year in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Highlights of the Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Wellness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Healthy Child Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Access to Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Human Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Health Information Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Partnerships to Address the Determinants of Health . . . . . . . . . . . . . . . . . . . . . . 29

Results Achieved . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Goal 1: Improve the health status of Islanders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Goal 2: Increase our acceptance of responsibility for our own health . . . . . . . . . . . . . . 39Goal 3: Improve the sustainability of the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Goal 4: Increase public confidence in the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49Goal 5: Improve workplace wellness and staff morale . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Legislative Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55Legislative Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63Appendix A - Summary of Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63Appendix B - Budget Estimate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Deputy Minister’s Overview

The Honourable Chester GillanMinister of HealthProvince of Prince Edward Island

Honourable Minister:

It is my pleasure to submit the 2005-2006 Annual Report for the health system.

This past year the health and social services system restructuring process was completed resultingin the new Department of Health. The 2005-2006 Annual Report for the Department of Healthreflects the progress we have made toward the goals outlined in the 2001-2005 strategic plan forthe health and social services system. An extensive strategic planning and consultative processhas started that will establish the health system priorities for the coming years and we lookforward to unveiling that in 2007.

I am proud of our many accomplishments in 2005-2006 and would like to highlight somemajor achievements:

• The QEH Redevelopment Project began with the completion of the MasterProgram/Master Plan. This project will ensure that health care services at the QEH willcontinue to be efficiently and effectively delivered well into the future.

• Island EMS was chosen to provide an enhanced, province-wide ambulance system to thecitizens of PEI.

• The (interoperable) Electronic Health Record / Clinical Information System Project led byCerner Canada was initiated in January 2006 and will involve the development andimplementation of a clinical information system within the seven acute care hospitals andfour health centres.

• The addition of the pneumococcal conjugate vaccine to the routine schedule for childrenbrought the PEI schedule up to the full recommendation of the National AdvisoryCommittee on Immunization.

• The number of physicians practicing on PEI was at an all time high. As well, nursepractitioners were introduced to PEI and regulations on their role were developed.

• Nutrition policies were implemented for elementary and consolidated schools in both theEastern School District and the Western School Board in partnership with the PEI HealthyEating Alliance, School Districts, PEI Home & School Federation, Department ofEducation and UPEI.

I am pleased with the progress we have made in the last year and I look forward to meetingfuture challenges as we work together towards improving the health status of all citizens on PEI.

Respectfully submitted,

David B. RileyDeputy Minister

Overview of New Department of Health

In April 2005, the Government of PEI restructured the provincial health and social servicesdelivery system. Prior to 2005, health and social services on Prince Edward Island wereadministered and delivered by four regional health authorities and the Provincial Health ServicesAuthority (PHSA), each with their own budget and administrative structure. The Department ofHealth and Social Services provided the regional health authorities with advice and assistance onmatters of policy and strategic direction, and provided regulatory and public health servicesdirectly to the public. As a result of the restructuring process, the pre-existing Department ofHealth and Social Services was replaced by two new departments, the Department of Health andthe Department of Social Services and Seniors.

In addition to the creation of two new departments, the restructuring also resulted in a numberof administrative changes. Some of the most significant include:

• The role of the Department of Health changed from responsibility for providing adviceand assistance on policy and strategic direction to responsibility for overseeing directservice delivery;

• Administration and support for line services moved from a regional to a departmentalmodel;

• Under the previous organizational structure, each of the four regional health authoritieshad governing boards (PHSA had an Advisory Council). Under the new organizationalmodel, each of the five community hospitals has a governing board. The QueenElizabeth Hospital, Prince County Hospital and Hillsborough Hospital are administeredthrough the Department of Health and do not have a board due to the provincial natureof their role.

The role of the new Department of Health is to:

• Provide leadership in maintaining and improving the health and well-being of citizens;

• Provide leadership in innovation and continuous improvement and to provide specifichigh quality administration and regulatory services to the health system and Islanders;

• Provide high quality, client-centered health services consistent with community needs.

The Department of Health fulfills this role by providing public health services, primary care,acute care, community hospital and continuing care services to Islanders to help ensure theiroptimal health.

Organizational Structure

The Prince Edward Island Health System is comprised of the Department of Health and fiveCommunity Hospital Authorities: Souris, Montague, Tyne Valley, O’Leary and Alberton. As adepartment of government, the Department of Health is overseen by a Minister of the Crown,who is ultimately accountable for departmental performance and results to the rest ofgovernment and the citizens of the Province.

The Department of Health is managed by a departmental management committee comprised ofthe Deputy Minister and eight senior directors. This group is responsible for providing overallmanagement direction to the department and for overseeing long term strategic planning.

Executive DirectorQEH/HH

Rob Philpott

DirectorFinance

Terry Keefe

MinisterHon Chester Gillan

Deputy MinisterDave Riley

DirectorCorporate Services

Pam Trainor

DirectorPrimary CareLeanne Sayle

DirectorMedical Services

Dr. Richard Wedge

Community Hospital Authority

Boards

Executive DirectorPCH

Arlene Gallant-Bernard

DirectorCommunity Hospitals and Continuing Care

Cecil Villard

DirectorPopulation Heath

Teresa Hennebery

Support Services

Line Services

Roles of Divisions

Direct Service Delivery (Line) Divisions

Queen Elizabeth Hospital and Hillsborough HospitalThis Division is responsible for the delivery of medical, nursing , hospital and support services atthe Queen Elizabeth Hospital (QEH) and Hillsborough Hospital. Administratively, theExecutive Director of QEH/Hillsborough Hospital is responsible for this division and is amember of the Departmental Senior Management Team.

Prince County HospitalThis Division is responsible for the delivery of medical, nursing , hospital and support services atthe Prince County Hospital. Administratively, the Executive Director of Prince County Hospitalis responsible for this division and is a member of the Departmental Senior Management Team.

Community Hospitals and Continuing CareThis Division provides acute care services to rural communities and supportive services to adultsand seniors in need of continuing care. Programs and facilities include five communityhospitals, long term care, home care, palliative care, the Provincial Geriatrician Program, the PEIDialysis Program, convalescent care, and under 60 population care. Administratively, theDirector of Community Hospitals and Continuing Care is responsible for this division and is amember of the Departmental Senior Management Team.

Primary Care This Division provides primary health care services. Programs and facilities include CommunityMental Health and Addictions (including the Provincial Addictions Treatment Facility), sevenhealth centres, Public Health (including Public Health Nursing, Speech Language / Audiology,and Community Nutrition), Diabetes Education, and Healthy Living. Administratively, theDirector of Primary Care is responsible for this division and is a member of the DepartmentalSenior Management Team.

Population HealthThis Division provides public health, health protection and regulatory services throughout theprovince. Programs and services include Environmental Health, Vital Statistics, Private NursingHome / Community Care Inspection (including dietetic inspection), Adult Protection, PublicGuardian, Communicable Disease Control and Immunization, and Health EmergencyPreparedness. In addition, the Division contains the Office of the Chief Health Officer and theEpidemiology Unit. The Divisional Director is also the Director of Emergency Health Servicespursuant to the Emergency Measures Act. Administratively, the Director of Population Health isresponsible for this division and is a member of the Departmental Senior Management Team.

Corporate Support Services

FinanceThis Division is responsible for the financial planning, financial accounting and reporting, andmaterials management for the Department of Health. The financial planning section isresponsible for the preparation and coordination of the Department of Health’s budget ensuringthe public funds are properly budgeted and monitored. This section provides support andadvice in matters relating to financial management. The financial accounting and reportingsection is responsible for the timely and accurate processing, administration, and reporting ofaccounts payable, account receivable, and payroll transactions. The material managementsection is responsible for the economical procurement of goods and services as well as inventorymanagement. Administratively, the Director of Finance is responsible for this division and is amember of the Departmental Senior Management Team.

Medical ProgramsThis Division is responsible for the delivery of medical programs and services which include theProvincial Medicare Program, physician services, physician referrals, physician recruitment andmedical education, physician billing assessment and payment, Out-of-Province Liaison Program,air and ground ambulance, in-province and out-of-province medicare claims, medicaltechnology assessment, Interprovincial Blood Services, and organ and tissue donation. Administratively, the Director of Medical Programs is responsible for this division and is amember of the Departmental Senior Management Team.

Corporate ServicesThis Division provides leadership and support to the Department of Health in the areas ofhuman resources / labour relations, communications, policy and evaluation, resultsmeasurement, utilization of health services, quality and risk management, Freedom ofInformation and Protection of Privacy (FOIPP), records information management, legislation /processes, French language services, federal-provincial relations, accreditation, and occupationalhealth and safety. Administratively, the Director of Corporate Services is responsible for thisdivision and is a member of the Departmental Senior Management Team.

Community Hospital Authorities

Together with the Department, the health system includes five community hospital authoritieswhich were created through the Community Hospitals Authorities Act, effective January 1, 2006. The five community hospital authorities are each governed by a Community Hospital AuthorityBoard. The community hospital authorities are as follows: the Souris Community HospitalAuthority has responsibility for Souris Hospital; the Montague Community Hospital Authorityhas responsibility for Kings County Memorial Hospital; the Tyne Valley Community HospitalAuthority has responsibility for Stewart Memorial Hospital; the O’Leary Community HospitalAuthority has responsibility for Community Hospital; and the Alberton Community HospitalAuthority has responsibility for Western Hospital.

Community Hospital Authority Board’s ResponsibilitiesEach Community Hospital Authority Board is accountable to the Minister and has a mandate todeliver the programs and services offered through the community hospitals. Boards will becomposed of elected members, with the exception of the current interim board members whowere appointed by the Minister.

The Community Hospital Authority Board is responsible for:• The operation and management of the community hospital; • Meeting the regulations of the Community Hospital Authorities Act and Hospital Act; • Identifying and prioritizing the health services needs of the community; • Preparing an annual business plan;• Holding a public meeting; • Reporting on the facilities performance and results to the Minister and local communities.

Minister’s ResponsibilitiesThe Minister is ultimately responsible for the administration of the Community HospitalAuthorities Act. As such, the Minister has the authority to establish parameters and givedirections to a community hospital authority in relation to planning, organization, managementand delivery of health care services by the community hospital authority.

The Minister may:• Establish annual performance targets with respect to:

2 Its development as an organization;2 Its financial management;2 Ensuring access to approved health services provided by the community hospital

authority;2 Achieving satisfactory patient outcomes;2 The level of patient satisfaction with the approved health services; and 2 Any other matters prescribed by the regulations.

• Approve by-laws or policies of the community hospital authority.• Appoint the Administrator after consultation with the Community Hospital Authority

Board.

Community Hospital Authority Interim Board Members

Souris Community HospitalAuthorityDavid MacAulay, ChairThelma MacDonaldDenis ThibodeauWalter TownshendBill Rooney

Montague Community HospitalAuthorityMichael Gallant, ChairSherry KacsmarikMarion TrowbridgeNiall MacKayHugh Robbins

Tyne Valley Community HospitalAuthorityLorraine Robinson, ChairSusan WilliamsDenis MarantzChief Darlene BernardAllan Lewis

O’Leary Community HospitalAuthorityAllison Ellis, ChairThelma Sweet, Vice ChairEileen McCarthyJustin RogersEllen Larter

Alberton Community HospitalAuthorityColleen Handrahan, ChairPhyllis PorterClaude DorganDonna CrockerDavid Cahill

Year in Review

Departmental Planning

The new Department of Health is currently undergoing a departmental planning process todevelop its priorities for the coming years so that the evolving health needs of Islanders areeffectively met now and into the future, and challenges and opportunities facing the system areeffectively addressed. This new plan does not fall within the time line for this annual report;therefore, this report will be based on the former strategic plan of the health and social servicessystem (2001-2005).

The five-year strategic plan for the health and social services system on Prince Edward Island wasestablished to provide a framework to improve the health of Islanders and the performance ofthe system over the five-year period from 2001 to 2005.

Based on consultation with service providers and the public, the 2001-05 strategic planidentified six critical issues that face the system: public expectations and demand, recruitmentand retention of health professionals, appropriate access to primary health care, personal healthpractices, the aging population and disease prevention.

In the 2001-05 strategic plan, six strategies outlined the direction the system was taking toimprove its desired results. These strategies included Wellness, Healthy Child Development,Access to Services, Human Resources, Health Information Technology and Partnerships toAddress the Determinants of Health. The following section highlights the progress achieved bythe system in 2005-2006, in relation to each strategy and the aforementioned critical issues.

Highlights of the Year

Wellness

Wellness initiatives, which encourage people to reach and maintain their full health potential, havebeen implemented to focus on disease prevention and improve the health status of Islanders.

Strategy for Healthy LivingThe Prince Edward Island Strategy for Healthy Living was launched in June 2003. The strategycontinues to enable government, community alliances and non-government organizations(NGOs) to work together to encourage Islanders to address the three common risk factors forchronic disease: healthy eating, active living, and reduction of tobacco use. The development,implementation and evaluation of the strategy is coordinated through a steering committeecomprised of provincial government departments of Health, Social Services and Seniors,Education, Community and Cultural Affairs, and Attorney General, federal and municipalgovernments, non-government organizations and the PEI Healthy Eating Alliance, the PEI ActiveLiving and the PEI Tobacco Reduction Alliance.

Over this past year, several initiatives that contributed to the overall strategy were undertaken:

Healthy Living CoordinatorsRegional Healthy Living Coordinators connected and worked with various partner organizationsand members of the community to enhance existing programs, create new initiatives anddevelop supportive environments for healthy living.

Healthy EatingThe Department of Health continued to be actively involved in the implementation of theHealthy Eating Strategy which was developed and released by the PEI Healthy Eating Alliance in2002 to improve current eating behaviours of Island children and youth through nutritioneducation, promotion and by creating supportive environments.

Several initiatives were undertaken this past year to increase awareness and knowledge of goodnutrition among parents and children:

• September 2005 marked the implementation of nutrition policies for elementary andconsolidated schools in both the Eastern School District (ESD) and the Western SchoolBoard (WSB).

• Work on the promotion of healthier school nutrition environments in intermediate schoolshas continued.

• Monthly healthy eating tips were developed and distributed to elementary and consolidatedschools. The tips consist of practical information to assist parents and children in makinghealthy life choices.

• The Nutrition Education and Promotion (NEP) working group organized a new initiative in2005 - the School Terry Fox Run Contest.

• The NEP group partnered with the Active Living Alliance in securing funding from thePartnerships for Children Fund to produce “Eat Right! Stay Fit! A Healthy Living Song” andaccompanying DVD.

• The Access to Safe and Healthy Food Working Group continues to administer the Breakfastand Snack Programs in Island Schools. In 2005, there were 43 such programs in operation,up from 18 in 2003.

Tobacco Reduction The Department of Health continued to be an active member in the PEI Tobacco ReductionAlliance (PETRA). The Department of Health worked collaboratively with others to help non-smokers stay smoke-free, to encourage and help smokers to stop using tobacco, and to promotehealthy environments by eliminating exposure to second-hand smoke.

The Students Working In Tobacco Can Help (SWITCH) tobacco prevention clubs in Island highschools organized numerous awareness raising activities in their schools and communities.

PEI continues to be a leader in providing comprehensive, bilingual support for quitting smokingthrough the toll free PEI Quitline (1-888-818-6300) and the Quit Care Program at AddictionServices across the province.

Stepping Out ProgramThe PEI Stepping Out program is a pedometer-based program designed to increase the physicalactivity levels of Islanders. Since 2002, the Department of Health provided funding to the PEIActive Living Alliance to offer the Stepping Out program to communities and workplaces acrossthe Island.

During 2005-06, there were 12 community based programs with 475 participants. The SteppingOut Schools had 9 schools participating with a total of 12 programs for a total of 763participating students. The Stepping Out to the Olympics challenge was an exciting and friendlycompetition that was offered to workplaces across the Island. Workplace programs totalled 11,with 312 participants. The partnership with Provincial Libraries continues to be beneficial formany Islanders. The number of pedometers borrowed from Provincial Libraries totalled 564.

Active Healthy School Communities Initiative The education sector contributed to the Strategy for Healthy Living through the Active HealthySchool Communities Initiative. This initiative is intended to build active healthy schoolcommunities where students, teachers, parents and communities work together to encourageyouth to adopt healthy lifestyles that last a lifetime.

Pap Screening Program The PEI Pap Screening program was established in January 2001 to reduce the incidence andmortality from cervical cancer through regular Pap screening. Cervical cancer is largelypreventable. About half of the women who develop cancer of the cervix have never had a Papsmear or have not had regular Pap smears. PEI’s overall two-year screening rate for women aged20 to 69 remains at 58 per cent.

Highlights of the PEI Pap Screening program’s fifth year include the following:

• Public Education and AwarenessThe program held its 6th Pap Awareness Campaign, “Take Action - Regular Pap Tests PreventCervical Cancer,” in October 2005. This year was the second year that a television commercialproduced in collaboration with Nova Scotia and Newfoundland was used and it aired inJanuary 2006.

• Pap Screening Clinic and Out-reach Pap ClinicsIn response to an increasing demand for Pap clinic services, the PEI Pap Clinic continued tohold out-reach Pap clinics across the Island. These clinics have been successful at providingalternative access to under-screened women - 65% of women attending had not had a Pap testwithin the previous two years.

• Pap Screening GuidelinesDraft provincial Pap screening guidelines have been developed and are currently under review.

In 2006, the Pap Screening Program Advisory Committee and Mammography SteeringCommittee were dissolved and replaced with a Cancer Screening Committee.

Cancer Control Strategy In October 2004, “Partners Taking Action: A Cancer Control Strategy for Prince Edward Island2004-2015,” was released. The strategy has three main goals: to reduce cancer incidence,mortality and morbidity in P.E.I.; to enhance the quality of life of cancer patients and families;and to improve the sustainability of the healthcare system. The Strategy includesrecommendations regarding cancer prevention, screening and diagnosis, treatment andsupportive care, palliative and end-of-life care, and survivorship.

The report was developed by an advisory committee comprised of representatives of theCanadian Cancer Society, the Department of Health and Social Services, the Hospice PalliativeCare Association, the Cancer Registry, the Cancer Treatment Centre, the Health ResearchInstitute, the Medical Society of P.E.I., the Provincial Health Services Authority and cancersurvivors.

In 2005/06, the Department of Health has continued to work with its partners to address cancercare in PEI.

Over the last year, the province has undertaken several initiatives to improve support given tocancer patients and their families in PEI through enhancing the Cancer Treatment Centre,including new staff positions and the addition of cancer drugs to the formulary.

West Nile Virus Strategy and Mosquito Surveillance ProgramA dead bird surveillance was again conducted during 2005. Birds of concern included crows,ravens and blue jays. All calls received by the Department of Health regarding dead birds of thesespecies were acted on by staff members from the Department of Environment, Energy andForestry. All recovered birds were submitted to the Atlantic Veterinary College and tested forWest Nile Virus. None from PEI were found positive in 2005.

A mosquito technician was again hired by the Department of Health in 2005 and mosquito trapswere set up in West Prince, the Charlottetown area and the north shore of Queens County. Lowcounts prevailed throughout 2005 with Culex species found mainly in West Prince, with lowernumbers in the Charlottetown area. No control measures for mosquitoes, such as spraying, werenecessary in 2005.

Environmental Health OfficersPrince Edward Island Environmental Health Officers inspect restaurants, child care facilities,nursing homes, community care facilities, schools, swimming pools, slaughterhouses and tattooparlours. Environmental Health staff are responsible to enforce the Tobacco Sales and Access Actand Smoke-free Places Act. Additionally, boil water advisories are issued when a private watersupply serving a public or semi-public building experiences water quality problems.

Healthy Child Development

Positive experiences in early childhood have a lasting impact on education and the ability to formrelationships and participate in community life.

During the restructuring process in 2005/06, the components of the Healthy Child DevelopmentStrategy were realigned between the newly formed Department of Health and the Department ofSocial Services and Seniors.

Immunization ProgramIn June 2005, the addition of the pneumococcal conjugate vaccine occurred to the routineschedule for children. This vaccine protects against infections caused by a bacteria calledStreptococcus pneumoniae including meningitis, pneumonia, blood infection and earinfections. The vaccine is administered at ages 2, 4, 6 and 18 months during immunizationclinics conducted by Public Health Nursing.

The addition of this vaccine to the routine schedule for children brought the PEI schedule up tothe full recommendation of the National Advisory Committee on Immunization. The rate ofimmunization coverage for this vaccine of children on PEI exceeds 90%.

Pertussis VaccinePertussis (Whooping Cough) cases during childhood were dramatically reduced as a result of theuniversal infant and childhood immunization programs. However, the increasing incidence ofpertussis in adolescents and adults has likely been caused by the decreasing immunity to thepertussis vaccine received in childhood. Until recently, the recommended time period to waitbefore administering a booster dose for continued protection against pertussis was 10 years afterthe initial vaccine, which is normally given at 4 years of age.

A recent study of children and adolescents attending PEI schools was carried out to obtain clearresults for a recommendation to reduce the time period for administering the pertussis vaccinebooster dose to less than 5 years. This study was led by Dr. Scott Halperin (Clinical TrialsResearch Centre, Dalhousie University) and Dr. Lamont Sweet (Chief Health Officer, PEIDepartment of Health) and was completed in October 2005. This study demonstrated that atime period of less than 10 years, after the initial 4 year old injection, was in fact possiblewithout concern for a significant increase in adverse reactions. The results of this study werepresented in the Final Adacel (Tetanus - Diphtheria - Acellular Pertussis) Vaccine Report(Pediatric Infectious Disease Journal, 25(3): 195-200, March 2006).

The pertussis vaccine is now given, as part of the Adacel Vaccine, to adolescents on PEI. Adultsand very young infants (who have not completed their initial series yet) have a greater chance ofprotection against Whooping Cough as a result of this program.

Nutrition PoliciesThe PEI Health Research Fund contributed finances to support research to improveunderstanding of the enabling factors/barriers to implementing nutrition policies in schools onPEI.

The Department of Health worked closely with the PEI Healthy Eating Alliance, School Districts,PEI Home & School Federation, Department of Education and UPEI, to develop and implementnutrition policies for elementary and consolidated schools in both the Eastern School District(ESD) and the Western School Board (WSB). These polices were implemented in September2005. Work continued on the promotion of healthier school nutrition environments inintermediate schools throughout 2005/06.

Stepping Out ProgramThe Department of Health provides funding to the PEI Activity Living Alliance to offer theStepping Out Program to junior and senior high schools and communities across PEI. Thisprogram is pedometer-based and is designed to increase the physical activity levels of childrenand youth. During 2005/06, 763 students participated in a total of 12 programs at 9 schools.

The Stepping Out Program was piloted in targeted elementary schools across the Island in2005/06. The program was adapted to be age appropriate for younger children.

Awareness of Exposure to Tobacco SmokeOngoing efforts to increase awareness on the dangers of children and youth being exposed tosecond hand smoke occurred in partnership with the PEI Tobacco Reduction Alliancethroughout 2005/06. The Department of Health continued to distribute smoke-free decals, to beplaced on vehicles and homes, to promote awareness of the need to protect children fromexposure to tobacco smoke in homes and the community.

In addition, the Students Working In Tobacco Can Help (SWITCH) tobacco prevention clubs inIsland high schools organized numerous awareness raising activities in their schools andcommunities.

Breastfeeding The PEI Breastfeeding Coalition presented Beyond the Basics: Breastfeeding Conference inSeptember 2005 with guest speaker Barbara Wilson-Clay, a prominent clinician/researcher fromAustin, Texas. The conference was held in partnership with the PEI Reproductive Care Program,Atlantic Lactation Consultants Association and Association Women’s Health Obstetric andNeonatal Nurses (AWHONN) Canada.

Additionally, a pre-conference presentation Everything You’ve Always Wanted to Know aboutBreastfeeding (But Were Afraid to Ask) provided little known facts about breastfeeding and wasfollowing by a question and answer period. This presentation was held especially for mothersand families, as well as the general public.

PEI Reproductive Care ProgramThe aim of the PEI Reproductive Care Program (RCP) is to optimize fetal, maternal, newborn,and family health during the prenatal through postnatal periods. A number of practiceguidelines were reviewed and updated to reflect current best practice information in 2005/06.

In March 2006, the RCP, in partnership with the Aboriginal Women’s Association of PEI,coordinated a two day workshop Raising Awareness about Alcohol Use in Pregnancy and SupportingChange. The goals of the workshop were to increase awareness of the impact of personal beliefson our work, to increase awareness of the role of alcohol in our society, to increase skills inscreening for alcohol use in pregnancy, and to look at effective strategies to assist pregnantwomen in addressing alcohol use. In addition, the RCP developed an information resourceentitled Be Safe: Have an alcohol-free pregnancy.

Joint Consortium for School HealthIn 2005, the PEI Departments of Health and Education became part of the Joint Consortium forSchool Health. The Consortium was established by provincial and territorial ministries andfederal departments to strengthen the capacities of health, education, and other systems oragencies in school health promotion.

Provincial Diabetes ProgramThe Provincial Diabetes Program continued to develop its pediatric program to better meet theneeds of Island children and youth with diabetes in 2005/06. Regular pediatric diabetes clinicsare held in Summerside and Charlottetown. These clinics are delivered by a multi-disciplinaryteam, and at a minimum, include a pediatrician, nurse and dietitian.

Public Health Public Health NursingPublic Health Nursing provides a standard immunization schedule to protect against serious andlife- threatening childhood illnesses at 2, 4, 6, 12, 15, 18 months and 4 years of age. Theproportion of PEI children 2 years of age and under (Born from April 1, 2004 to March 31,2006) who were fully immunized for childhood diseases rose from 92% in 2004/05 to 94% in2005/06. This rate is one of the highest in Canada.

Public Health Nursing conducts a Best Start Program, which is an intensive screening, assessmentand in-home visiting program that targets children at risk and their parents in preventing childabuse and neglect. In addition, Public Health Nursing performs thorough nursing assessmentsof normal growth and development enabling early problems in children to be found andreferred on to other specialists or family doctors. Information on parenting and children’shealth issues (nutrition, preventing poisonings and accidents, toilet training, etc.) is alsoprovided to families.

Speech Language PathologySpeech Language Pathology provides assessment, diagnosis and intervention for individuals withcommunication difficulties. Research supports the efficiency of early intervention for speechlanguage difficulties; therefore, priority has been placed on younger children, with pre-schoolersreceiving focused therapy, and grades 1-3 receiving consultative services.

AudiologyThe Audiology Program provides services to children and youth who are deaf or hard of hearing,and who are at risk of hearing loss due to noise exposure, genetic causes, and exposure to certaindrugs or middle ear infections.

Community NutritionThe Community Nutrition Team provides nutrition assessment, counseling, education, advocacyand consultations to high risk, pregnant women, infants, children, and low income families sothey can achieve optimal nutrition to improve their health and reduce their risk of chronicdisease. The Community Nutrition Program also provides free milk tickets and prenatalvitamin/mineral supplements to pregnant women receiving nutrition counseling and consideredto be in financial need.

Access to Services

The success of improving access to services relies on our ability as a health system to embraceinnovation in service delivery to benefit the health and well being of citizens and to improve the qualityof those services.

Queen Elizabeth Hospital RedevelopmentThe Queen Elizabeth Hospital (QEH) is 24 years old. There have been many changes inprograms, services, and standards over these years . The QEH Redevelopment process aims toensure that health care services can continue to be efficiently and effectively delivered well intothe future.

The Master Program/Master Plan for the QEH Redevelopment project has been completed. Thisphase provided a high level description which outlined where expansion is needed, whichdepartments logistically need to be located adjacent to one another and a high level projectionof the cost of the redevelopment project. Functional Programming for this project will beconducted during the fall and winter of 2006/2007.

The QEH Redevelopment project will be implemented in two phases. Phase 1 of the projectincludes the initial architectural design and construction of a new Emergency Department andAmbulatory Care Centre and improvements to Day Surgery and associated services. (Phase 1will be designed and developed over the next several years.) Government has allocated a budgetof $47 million toward this first phase.

Hearing Access ProgramPatients with hearing loss and /or deafness have barriers in accessing services. A Hearing AccessProgram was developed at the Queen Elizabeth Hospital to educate, identify and provideappropriate equipment and signage to ensure these patients receive a safe and quality service. This program was implemented after completing staff education through the use of classroomsessions and written materials. This information has also been incorporated into the stafforientation sessions. The Hearing Access Program is currently being evaluated.

Prince County HospitalUpon opening in 2004, the new Prince County Hospital had 14 In-patient Mental Health(Psychiatry) beds. Of these, two were designated as observational beds. These two beds are nowbeing used as In-patient Mental Health beds, thereby increasing access for Mental Healthpatients.

Island EMS (Emergency Medical Services)In November 2005, the Department of Health issued a Request for Proposals for the delivery ofan enhanced, province-wide ambulance system to commence operations on April 1, 2006. Theenhancements sought by the Department included: a seamless ambulance service where existingoperator geographic boundaries are removed; a centralized dispatch service; standardizedvehicles and equipment; and enhanced life-saving skills training.

In late January 2006, Island EMS, a subsidiary of Medavie Blue Cross, was selected as the “Bidderof Choice” by Government. In February, Government entered into a Memorandum ofUnderstanding for the operation of the province-wide ambulance system commencing on April1, 2006.

Family Health Centres (FHCs)FHCs are community-based and bring together physicians, registered nurses and other healthproviders working collaboratively with shared responsibility for patient and client outcomesbased on assessed health care needs. These centres provide a defined set of services withemphasis placed on diagnosis and treatment, health promotion, illness prevention, and chronicdisease management. Family health centres are based on the interdisciplinary collaborativepractice model and continue to be an integral part of primary health care.

Collaborative practice family health centres on the Island include: Eastern Kings (Souris); FourNeighbourhoods (Charlottetown); Central Queens (Hunter River) and Gulf Shore (satellite sitein Rustico); Harbourside (Summerside); and Beechwood (O’Leary). Other family practicemodels include: Southern Kings (Montague)and Evangeline (Wellington).

Central Line Dialysis Pilot ProjectMany diseases contribute to kidney failure, but the most common causes are diabetes and highblood pressure. Dialysis is required when kidneys become permanently impaired and can nolonger function normally to maintain life. Dialysis cleans the blood of wastes and removesexcess fluid.

There are two ways to deliver hemodialysis - peripheral vascular access and tunneled catheteraccess. Peripheral vascular access is the preferred method, and approximately 50% ofhemodialysis patients on PEI undergo this type of treatment. For some people, though, thismethod is not a viable option, and tunneled catheter dialysis is required. For this reason, thisservice is valuable to those Islanders.

Prince Edward Island participated in a pilot project to offer tunneled catheter (central line)hemodialysis. The treatment was initially made available from the existing satellite dialysisclinic, located in East Prince. On the basis of positive results in the pilot, the service wasextended to Queen’s Dialysis Unit in Charlottetown.

French Language ServicesOpportunities to obtain health services in French have been identified as a high priority by theAcadian and Francophone community. Accordingly, the Department of Health, in collaborationwith the P.E.I. French Language Health Services Network, has worked towards theimplementation of the French Language Services Act. A French Language Services Analyst positionis shared between the Department of Health and the Department of Social Services and Seniors. This position is responsible for monitoring compliance with the French Language Services Act andfor providing advice and assistance to the Department of Health and the Department of SocialServices and Seniors to improve the delivery of French language services.

In order to increase access to French language services, the Department of Health obtainedproject funding from Société Santé en français. Three projects were started during the year indifferent areas of Prince Edward Island:

• The Primary Care Division implemented a project entitled Healthy Choices, HealthyCommunities. This project included the development of French educational workshopsand French health promotion materials on the topics of tobacco reduction, healthyeating, and physical activity. The project’s main objectives were to increase awarenessamong the Acadian and Francophone population of the risk factors leading to chronicillness, and to increase collaboration on health promotion between the Acadian andFrancophone community and the health system.

• The Prince County Hospital began work on a project to improve the Health ResourceCentre. This initiative was focused on: ensuring the addition of French language healthresources to the existing Health Resource Centre to assist the Acadian and Francophonepopulation in better managing its own health; improving linkages between and amongfacilities, health care providers and specialists, the Department of Health and PEI’sAcadian and Francophone community; and improving the capacity of the organization torespond to demands for delivery of health services in French in a manner that iscompliant with the French Language Services Act.

• The Eastern Kings Acadian and Francophone residents benefited from an initiative thatoffered French health and educational services through videoconferencing technology. Videoconferencing increases access to French language services in a manner that iscompliant with the French Language Services Act. It also provides employees with someeducational opportunities in French.

French Language Health Services NetworkThe PEI French Language Health Services Network (FLHSN) was established in November 2002by the Minister responsible for Acadian and Francophone Affairs and the Minister of Health andSocial Services, who agreed that the most appropriate means for the health system to prepare forthe full proclamation of the French Language Services Act was to create a jointgovernment-community network. The purpose of the FLHSN is to propose practical solutionsfor the delivery of French-language health and social services in PEI and share informationbetween the health system and the Acadian and Francophone community.

The FLHSN has 17 members and includes representatives from health, social services, and theAcadian and Francophone community. The network reorganized its structure during the pastyear, to be in line with the new government structure. The updated membership includesrepresentatives from the public, the Société Saint-Thomas-d’Aquin, the Société éducative, theAcadian Communities Advisory Committee, a number of Divisions within the Department ofHealth, the Department of Social Services and Seniors, and a representative from the Acadianand Francophone Affairs Division.

Setting the Stage ProjectA significant achievement during the year was the completion of the Setting the Stage project. Setting the Stage was coordinated by the FLHSN and fully funded by Société Santé en français. Through this project, a set of recommendations and an accompanying Action Plan for theDelivery of Primary Health Care Services in French were developed and submitted to theDepartment of Health.

Wait Times StrategyIn the 2004 Ten-Year Plan, First Ministers agreed to collect and provide meaningful informationto Canadians on the progress made in reducing wait times. PEI has participated in all nationaldiscussions regarding wait times. To date, the Provinces and Territories have approvedcomparable indicators for each of the five priority areas (including cancer, heart, diagnosticimaging, joint replacements, and sight restoration)and have agreed to benchmarks wheresufficient evidence is available.

PEI, in consultation with its physicians, surgeons and other health providers, has started thework required to develop a strategy to improve access to services in priority areas. Sub-groupshave been established in four areas: joint replacement, site restoration, radiation oncology anddiagnostic imaging (cardiac surgeries are not included as they are performed out-of-province). These sub-groups will identify multi-year strategies and targets to decrease wait times in line withnational benchmarks.

Human Resources

A number of human resource planning initiatives have been undertaken to ensure an adequate supplyand the correct mix of professionals to meet the health needs of Islanders.

Recruitment and Retention Government is committed to maintaining an adequate supply of health professionals in PrinceEdward Island. A number of initiatives have been implemented to meet this challenge. Activerecruitment was carried out throughout the year for a variety of health professionals andadditional initiatives were implemented to deal with some of the more difficult to fill positions.

Physician Recruitment Strategy In February 2000, government implemented the four-year, $4.2 million dollar PhysicianRecruitment Strategy to address serious challenges in physician resources. The strategy includedfunding for family practice and specialist training, new medical school seats, medical traineesponsorships, student loan assistance, location grants, relocation cost assistance, locum support,continuing medical education, hiring a recruitment officer, enhancing recruitment resources andincentives to attract international medical graduates.

The physician complement and number of physicians practicing on PEI was at an all time highin 2005/06. In March 2006, the physician complement (total number of allowable positions forphysicians)on PEI was 203.1, up from 195.1 in March 2005.

Physician’s Master Agreement The enhancement of physician services continues to be a priority of government. The MasterAgreement, effective April 1, 2004 until March 31, 2007, ensures PEI remains competitive withother jurisdictions so that Islanders can continue to access a quality health care system.

Government and the physician community collaborated significantly to bring this process to asatisfactory conclusion. The issue of recruitment and retention remains an important focus forthe government. Many advancements have been made and this agreement will continue tosupport government’s priority in this area.

The current Master Agreement provided for economic increases of 2 per cent in the first year, 2.5per cent in the second year, and 3 per cent in the final year. Also, government will invest anadditional $2.1 million, to be implemented over three years, to address areas which will makethe health system more competitive so that it can maintain services and increase the success ofrecruitment and retention efforts for physicians. Negotiations will commence in the fall of 2006with representatives from government and the Medical Society of PEI to contract a new MasterAgreement effective April 1, 2007.

Medical Education ProgramThe Medical Education Program continued to provide training opportunities in 2005/06. Theprogram is administered under the Department of Health which works closely with DalhousieMedical School in Halifax. Residents in medical schools across Canada are also welcomed byavailable teaching physicians.

Residents are doctors enrolled in postgraduate training after receiving their medical degrees. Aresidency is otherwise known as an apprenticeship. This is a time during which doctors taketheir theoretical skills and apply them, practicing their clinical skills. Family practice residentsapprentice for two years while residents in other specialities spend from four to seven yearsacquiring their expertise.

Medical residents spend time with preceptors - qualified doctors who mentor them. WhenIsland physicians work with medical residents it is beneficial for both since such teachingopportunities are one of the most rewarding aspects of medical practice. Teaching helpsdemonstrate pride in one’s craft, helps sustain the discipline as a whole, and aids in recruitmentefforts.

Medical residencies are also opportunities to show what the Island has to offer. Encouragingresidents to complete clinical rotations on Prince Edward Island provides the Island with anopportunity to have an influence on the resident’s choice of where they would like to practicemedicine.

Atlantic Health Human Resources Planning StudyThe Atlantic Health Human Resources Planning Study was initiated in February 2002 to integrateinformation on regional demand for the health disciplines and health education trainingprograms to allow for informed health education planning and decision-making in AtlanticCanada.

In September 2005, Deputy Ministers agreed to accept the final report on the Atlantic HealthHuman Resources Planning Study and all task deliverables. Six reports were delivered andaccepted, meeting the requirements as specified in the agreement with the contractor, including:(1) Executive Summary; (2) Final Report; (3) Comparative analysis of previous provincialstudies; (4) Roll-up of data contained in the provincial studies; (5) Inventory of healtheducation/training programs – database user manual; and (6) Environmental scan of healtheducation/training issues.

Bachelor of Nursing Sponsorship ProgramRegistered nurses comprise the largest group of health care providers on PEI. The Bachelor ofNursing Sponsorship Program enhances recruitment and retention by providing financialassistance to third and fourth year nursing students who agree to work in the province upongraduation.

Nurse Practitioner Role Implemented The Department of Health supports the introduction of the title and scope of practice for nursepractitioners (NPs) in PEI and recognizes the need to assess the appropriate allocation of thisnew health care provider in various areas of health care delivery. The new Registered Nurses Actreceived assent in the House in December 2004. This new Act is a complete revision of theprevious Nurses Act and includes the provision for recognizing NPs and defining their scope ofpractice. The Association of Registered Nurses of Prince Edward Island (ARNPEI)and the PEIGovernment developed the four sets of regulations to accompany the Act. Governmentproclaimed the new Registered Nurses Act on February 25, 2006. A Nurse Practitioner PositionAssessment Committee has been established to receive and review proposals for nursepractitioner positions within the Department of Health according to specified criteria thatincludes value to the system, sustainability, collaborative practice arrangements, and evaluation.

Radiation Therapist SponsorshipA sponsorship program was put in place for Islanders to receive radiation therapy training. Anagreement was made with Capital Health in Nova Scotia to provide for an Island student toreceive radiation therapy training at the Michener Institute in Toronto, Ontario with clinicaltraining provided by the QEII Health Sciences Center in Halifax, Nova Scotia. One sponsorshipagreement was in place in the 2005/06 fiscal year and a three year return-in-service agreementhas been signed. The student will complete the program in November 2006.

Medical Laboratory Technologists Seats Medical laboratory technologists provide laboratory testing related to the diagnosis, treatmentand monitoring of disease. In 2003, the PEI and New Brunswick provincial governmentsentered a three-year agreement which provides qualified Islanders guaranteed access to threeseats each year in the Medical Laboratory Technology diploma program at the CommunityCollege in Saint John, New Brunswick. A two-year return-in-service agreement will ensurestudents have a job in the health profession on PEI when they complete the training.

Internationally Educated Health Professionals (IEHP)The PEI Department of Health has entered into partnership with the Nova Scotia Department ofHealth and Health Canada to undertake a number of initiatives to better integrateinternationally educated health professionals into the PEI health care system.

PEI Health Professional Registration Database ProjectThe PEI Health Professional Registration Database Project provides a number of healthprofessional associations with the capability to electronically capture and manage registrationdata and provide annual information to the Department of Health to assist in human resourcesplanning. There are 15 professional associations participating in this project.

Health Human Resource PlanA Health Human Resource Plan was developed as part of the First Minister’s 10-Year Plan toStrengthen Health Care. Meeting the Needs of Islanders: An Action Plan for Health Human Resourceson Prince Edward Island was released in December 2005. This plan sets out goals and strategiesfor moving forward to ensure the health system has the health professionals required into thefuture.

Musculo-Skeletal Injury Prevention Strategy for Health Care WorkersThe Musculo-Skeletal Injury Prevention (MSIP) Strategy for Health Care Workers is a HealthyWorkplace Initiative funded by Health Canada as part of the Pan-Canadian Health HumanResources Strategy. The project’s objectives are to (1) enable provincial health care services toprogress and expand their present MSIP programs, and to (2) develop provincial strategies,standards and resources in regards to MSIP. The goal of the project is to enhance and expandinjury prevention strategies for health care workers on PEI.

A Project Coordinator was hired in October 2005. A Provincial Advisory Committee, establishedin December 2005, has received Departmental approval on recommendations for the allocationof project resources.

Queen Elizabeth Hospital - SecurityA need was identified at the Queen Elizabeth Hospital to provide a safer environment forpatients and staff. A video surveillance system (cameras) was installed providing securitycoverage throughout the hospital. Progress on this initiative is ongoing. Additionally, a CodeWhite policy was developed to provide a safe work environment to protect patients, staff andvisitors from violence and abuse, which is a growing issue in health systems across Canada. Thispolicy is in the final stages of the approval process.

Health Information Technology

Services provided to Islanders are improved by providing quality information to health care providers. Accurate and reliable health information helps Islanders take more control over, and improve, theirhealth.

Electronic Health Record / Clinical Information System ProjectThe (interoperable) Electronic Health Record / Clinical Information System (iEHR/CIS) Projectinvolves the development and implementation of an electronic clinical information systemwithin the seven acute care hospitals and four community health centres. The CIS is comprisedof an integrated suite of Cerner Canada acute care systems, including Charting, Orders,Laboratory, Pharmacy, Emergency, Surgery, Registration, Records and Scheduling. Benefits ofthe iEHR/CIS project include: improved secure access by clinicians to patient information,improved patient safety, reduced duplication of tests, improved service efficiencies, supporthealth accreditation clinical requirements, and improved recruitment and retention of staff.

Capital funding for the project was secured through several partnerships, including the CanadaMedical Equipment Fund, Canada Health Infoway, the Hospital Foundations, and the Province. Preparation for the iEHR/CIS Project began in September 2005 with the development of aprovincial project structure comprised of representatives from each hospital. Led by CernerCanada, the project was initiated in January 2006 and will result in the development andimplementation of a single provincial clinical information system within the QEH and PCH in2007, with subsequent roll outs to the community hospitals and system enhancements to becompleted by spring 2008.

Drug Information SystemThe Prince Edward Island Department of Health, in collaboration with the Department of SocialServices and Seniors and Provincial Treasury Information Technology Shared Services (ITSS), isdeveloping a Drug Information System (DIS) that will capture information on all prescriptiondrugs dispensed to Island residents. The system will build on the Pharmaceutical InformationProgram (PhIP) to include the collection of All Drugs All People (ADAP). The Province’sjourney towards the DIS was first initiated in 1997 when community pharmacies begansubmitting claims to the Provincial Drug Programs electronically via PhIP.

The purpose of the DIS is to electronically link all health care sites, including communitypharmacies, physicians’ offices, addictions centres, hospital pharmacies and emergency roomswith a database that maintains patient medication records. The system is intended to providepharmacists and physicians with medication profiles of individual patients to assist in thepatient’s care, to provide electronic information for the administration of government drug-benefit plans, and to provide information for approved health planning, evaluation, andresearch respecting both beneficial and adverse effects of medications used by residents of PrinceEdward Island. The DIS is supported by the Pharmaceutical Information Act, which was passedby Government in December 2000.

The PEI Department of Health is collaborating with Canada Health Infoway on this project toensure that the DIS aligns with the pan-Canadian movement towards the Electronic HealthRecords model. The DIS will be built using standards that adhere to newly established pan-Canadian standards for the exchange of electronic health information across the country. PEI isamong the first jurisdictions to reach the stage of implementing these leading edge healthtechnologies.

Partnerships to Address the Determinants ofHealth

The development and strengthening of partnerships is key to ensuring that the health system achievespositive impacts on the health and well-being of Islanders.

The Department of Health is proud of the partnerships it is able to foster. The positive resultsnoted in this annual report could only be accomplished with the help of our many partners.

Healthy Living Strategy partners include: The Prince Edward Island Tobacco Reduction Alliance; PEI Active Living Alliance; PEIHealthy Eating Alliance; provincial Departments of Health, Social Services and Seniors,Education, Community and Cultural Affairs, and the Office of the Attorney General;Canadian Diabetes Association; Canadian Cancer Society, PEI Division; Heart and StrokeFoundation of PEI; Western School Board and Eastern School District; PEI Federation ofMunicipalities; PEI Recreation Facilities Association; and other community-based groups.

P. E. I. Tobacco Reduction Alliance partners include:The Canadian Cancer Society, PEI Division; PEI Lung Association; provincial Departmentsof Education, Health, and Social Services and Seniors; Early Childhood DevelopmentAssociation of PEI; Evangeline Community Health Centre; Federation of PEIMunicipalities; Health Canada; Heart and Stroke Foundation of PEI; Holland College;Medical Society of PEI; PEI Home and School Association; Eastern School District andWestern School Board.

P. E. I. Healthy Eating Alliance partners include:The provincial Departments of Health, Education, Agriculture and Community andCultural Affairs; community representatives including the University of Prince EdwardIsland; Cancer Society; school boards; Home and School Federation; Medical Society ofPEI; Association of Nurses of PEI; Queen Elizabeth Hospital; Heart and StrokeFoundation; PEI School Milk Foundation; Dietitians of PEI; PEI Active Living Alliance;CBC; Canadian Red Cross; School Breakfast Programs; PEI Home Economics Association;Chartwells International; and parents.

P. E. I. Active Living Alliance partners include:The provincial Departments of Health, Education, and Community and Cultural Affairs;Active Living Alliance for Canadians with a Disability; Allied Youth; Arthritis Society;Association of Nurses of PEI; Canadian Association of Health, Physical Education,Recreation and Dance; Canadian Cancer Society, PEI Division; Canadian Diabetes;Canadian Mental Health; Canadian National Institute for the Blind (CNIB); CanadianParaplegia Association; Cerebral Palsy Association of PEI; Coaches Association of PEI;College of Piping and Celtic Performing Arts; Commission Scolaire de Langue Francaise;East Prince Youth Development Centre; Eastern School District; Evangeline CommunityHealth Centre; Federation of PEI Municipalities; Girl Guides of Canada, PEI Council;Heart and Stroke Foundation of PEI; Island Fitness Council; Island Trials; L’Associationdes Femmes Acadiennes and Francophones; Licensed Practical Nurses’ Association of PEI;Medical Society of PEI; Outside Expeditions Inc.; Paralympics PEI; Parkinson Society ofCanada, Maritime Region; Partners for Living - Hunter River; PEI 55(+) Plus GamesSociety; PEI Association for Community Living; PEI Council of the Disabled; PEI Homeand School Federation Inc.; PEI Lung Association; PEI Occupational Therapy Society; PEIRecreation and Facilities Association; PEI School Athletics Association; PEI SchoolPhysical Education Association; PEI Senior Citizens’ Federation Inc.; RCMP of PEI; ScoutsCanada, PEI Council; Shapers Life Fitness and Wellness Centre; Special Olympics PEI;Sport PEI; Western School Board; Women's Institute; Women’s Network PEI; YMCASummerside; Holland College Sport and Leisure Management Program; and Worker'sCompensation Board.

P.E.I. Cancer Control Strategy Advisory Committee partners include:The provincial Department of Health; PEI Health Research Institute; Canadian CancerSociety, PEI Division; cancer survivors; Hospice Palliative Care Association of PEI; PEICancer Registry; PEI Cancer Treatment Centre; and PEI Medical Society.

P.E.I. Cancer Screening Committee partners include:The provincial Department of Health; Canadian Cancer Society, PEI Division; PEI MedicalSociety; and Queen Elizabeth Hospital Cytology Laboratory and Diagnostic Imaging.

Results AchievedIn the 2001-05 strategic plan, the health and social services system set six goals to improvehealth system performance and results. They are as follows:

1. Improve the health status of Islanders2. Increase personal responsibility for health3. Improve sustainability of the system4. Improve public confidence in the system5. Improve workplace wellness and staff morale6. Maintain other results at current levels

In order to measure progress in relation to each goal, indicators were identified. This sectionreports on results in relation to those indicators. Where possible, PEI results are compared tosimilar Canadian data to illustrate how our province is doing within a national context.

This report uses the most recent available data. This data may not always be updated each yearas many data sources do not release new information annually. Data may vary from previousannual reports due to differences in reporting (i.e. using age standardized data) or updated databeing released from the respective source.

Goal #1: Improve the health status of IslandersHealth status indicators are used to provide a snap shot of our health as Islanders. Specificindicators include life expectancy, infant health, self-reported health, major health concerns, andchronic and preventable diseases.

Length and Quality of Life on the Island

Life Expectancy and Health Adjusted Life ExpectancyLife expectancy is a widely-used indicator of overall population health. Life expectancy isdefined as the number of years that a person could expect to live on average, based on themortality rates of the population in a given year. The following table outlines life expectancy bygender, for Islanders compared with all Canadians for 1993 and 2003.

Life expectancy in years, 1993 and 2003

1993 2003 Change in life expectancy(1993-2003)

men women men women men womenPEI 74.2 80.1 76.5 81.6 +2.3 +1.5Canada 74.8 80.9 77.4 82.4 +2.6 +1.5

Source: Statistics Canada,Vital Statistics, Birth and Death Databases

Life expectancy is an average and does not reflect individual health circumstances. Nevertheless,these findings reveal several trends:

• Life expectancy rates in Prince Edward Island have been similar to Canadian rates over thepast ten years.

• Women live on average 5.1 years longer than men in this province.

• The gender gap is shrinking. Male life expectancy improved by 2.3 years between 1993and 2003 in PEI. Female life expectancy improved by 1.5 years during that period.

Health Adjusted Life Expectancy (HALE): Whereas life expectancy is an indicator of thequantity of life, health adjusted life expectancy (HALE) reflects quality as well as quantity of life. HALE is the number of years in perfect health that an individual can expect to live given thecurrent morbidity and mortality conditions. Since level of income is a significant non-medicaldeterminant of health, the health adjusted life expectancy rate is reported by income.

Life expectancy and health adjusted life expectancy rates, by sex, 2001

lifeexpectancy

health adjusted life expectancy

all incomegroups

income (lowest)

income (middle)

income (highest)

PEI males 75.2 yrs 67.3 yrs 65.2 yrs 67.5 yrs 69.5 yrsfemales 82.6 yrs 71.7 yrs 71.8 yrs 70.5 yrs 72.5 yrs

Canada males 77.0 yrs 68.3 yrs 65.8 yrs 68.6 yrs 70.5 yrsfemales 82.1 yrs 70.8 yrs 69.1 yrs 70.8 yrs 72.3 yrs

Source: Statistics Canada, Vital Statistics, Birth and Death Databases; National Population Health Survey

• The health adjusted life expectancy rate for PEI women is about 10 years less than lifeexpectancy. For PEI men, the HALE is about eight years less.

• PEI women have a health adjusted life expectancy which is above the Canadian averageby about one year. For Island women, income had little effect on HALE.

• PEI men have a health adjusted life expectancy which is shorter than the Canadianaverage by one year. For men on PEI, health adjusted life expectancy for the third of thepopulation with the highest income was 4.3 years longer than the third of the populationwith the lowest income.

Infant Health

Infant MortalityThe rate of infant mortality (children under one year of age) is affected by a variety of factors,including quality of maternal and childcare services provided by the health system and healthcare providers, as well as social factors such as maternal education, smoking and nutritionaldeprivation. Rates of infant mortality for PEI and Canada, presented as five-year averages for theperiod from 1982 to 2001, are outlined in the table below.

Infant mortality: five year average rates per 100,000 live births for the past two decades, 1982 to 20011982-1986 1987-1991 1992-1996 1997-2001

PEI 7.02 6.56 5.30 5.94Canada 8.30 6.96 6.08 5.32

Source: Statistics Canada, Vital Statistics, Birth and Death Database

• Over the past two decades, infant mortality rates have decreased steadily for PEI andCanada, with the exception of a slight increase for PEI in 1997-2001.

Birth WeightBirth weight is a reliable predictor of a newborn’s chances of survival and future health. Bothlow birth weight and high birth weight are associated with a variety of health risks.

Low birth weight is associated with decreased chances of infant survival and increased risk ofdisease and disability, with examples including cerebral palsy, visual problems, learningdisabilities and respiratory problems. Appropriate medical care and a healthy lifestyle for themother can improve the chances that the baby will have a healthy birth weight.

The low birth weight rate is the proportion of babies born with a birth weight of less than 2,500grams (just over five pounds) in relation to the total number of live births in a given year, statedas a percentage.

High birth weight is associated with maternal obesity and gestational diabetes. High birth weightposes increased risk for complications during delivery for mother and baby.

The high birth weight rate is the proportion of babies born with weights greater than 4,000grams (just under nine pounds) in relation to the total number of live births in a given year,stated as a percentage.

Low and high birth weight rates, 2000 to 20042000* 2001* 2002** 2003** 2004**

Low Birth Weight RatePEI 4.3% 4% 5.3% 4.2% 5.6%Canada 5.6% 5.5% 5.8% 5.8% 5.9%High Birth Weight RatePEI 19.9% 22.0% 17.4% 17.8% 16.8%Canada 13.8% n/a 13.2% 12.8% 12.3%

* Source: Vital Statistics, Birth Database** Source: Statistics Canada, Canadian Vital Statistics, Birth Database

• The low birth weight rate on PEI is consistently among the lowest rate in Canada.

• The rate of high birth weight babies born in PEI during the years 2000-2004 was higherthan the Canadian average.

Self-reported HealthSelf-reported health is based on the response provided by individuals in the CanadianCommunity Health Survey when asked to rate their own health. Self-reported health reflectshow healthy individuals feel they are, and is a general indicator of the overall health status ofindividuals. This indicator includes features that other measures may miss, such as diseaseseverity, coping skills, psychological attitude and social well-being. Numerous studies havefound that self-reported health can predict death rates even when more objective measures aretaken into account. The table below presents the proportion of the population aged 12 andolder who reported that their health was “very good” or “excellent” in 2003 and 2005.

Self-reported health, the proportion of the population aged 12 years and over who reported “verygood” or “excellent” health, age standardized, 2003 and 2005

2003 2005PEI 66.0% 60.9%Canada 59.8% 61.5%

Source: Statistics Canada, Canadian Community Health Survey, 2003 and 2005

• The proportion of respondents who reported “very good” or “excellent” health wassimilar for both PEI and Canada in 2005.

• On PEI, the proportion of respondents who reported “very good” or “excellent” droppedslightly from 66.0% in 2003 to 60.9% in 2005.

Major Health Concerns

Several acute and chronic conditions including cancer, heart attack, stroke, diabetes, arthritis andasthma, pose major health problems for the general adult population of Prince Edward Island.

Cancer and Cardiovascular DiseaseThere are many types of cancer, but the most common forms are colorectal, lung, prostate andbreast. The following table outlines the estimated incidence rate of these leading cancers for2005. Incidence rates are based on the number of newly diagnosed primary cancer cases in agiven year per 100,000 population.

Estimated age-standardized cancer incidence rate (per 100,000 population) 2005***colorectal lung prostate* breast**

PEI

male 65 86 179 n/afemale 59 50 n/a 98

Canada male 62 71 121 n/afemale 41 49 n/a 106

Source: Statistics Canada, Canadian Cancer Registry, 2005* Male population only** Female population only, although a small number of men each year are diagnosed with breast cancer.*** 2005 age-standardized rates are estimates produced by Health Canada through extrapolation of cancer incidence data

from the National Cancer Incidence Reporting System (NCIRS, 1969-1991) and the Canadian Cancer Registry.

• For both men and women, incidence rates for three of the four cancers listed were higherfor PEI than Canada.

• Prostate cancer is the most frequently occurring cancer in men, with an estimatedincidence rate for 2005 of 179 per 100,000.

• Breast cancer is the most frequently occurring cancer in women. The incidence rate isexpected to remain steady through 2005.

The following tables present the mortality rates associated with the most common forms ofcancer, as well as heart attack and stroke. Cancer mortality rates are based on the number ofpeople who die each year as a result of a particular cause or condition per 100,000 population.

Estimated age-standardized mortality rates (per 100,000 population) for major cancer sites, 2005***

colorectal cancer lung cancer prostate cancer* breast cancer**PEI male 31 80 34 n/a

female 22 50 n/a 28Canada male 27 63 26 n/a

female 17 40 n/a 24Source: Statistics Canada, Vital Statistics, Death Database* Male population only** Female population only, although a small number of men each year are diagnosed with breast cancer.*** 2005 age-standardized rates are estimates produced by Health Canada through extrapolation of cancer incidence data

from the National Cancer Incidence Reporting System (NCIRS, 1969-1991) and the Canadian Cancer Registry.

• The mortality rate for prostate cancer in men is comparable to that of breast cancer inwomen, even though the incidence rate for prostate cancer is higher. Prostate cancer isrelatively slow-growing and many men diagnosed with it die of other causes first.

Age-standardized mortality rates (percentage of all-cause in hospital deaths) for heart attack and stroke30-day acute myocardial infarction(heart attack) in-hospital mortality rate2001-2002 to 2003-2004

30-day stroke in-hospital mortality rate 2001-2002 to 2003-2004

PEI 14.3% 17.4%Canada 11.1% 19.1%

Source: CIHI, Hospital Morbidity Database

Chronic Disease

Prevalence of arthritis, asthma, heart and stroke, and depressionThe following table reports the prevalence of arthritis, asthma, heart and stroke, and depressionas found in the 2003 and 2005 Canadian Community Health Survey. In this table, theprevalence rate for a disease is the percentage of the population aged 12 and over who reportedin the survey that they were diagnosed with a particular disease by a health professional.

Prevalence of self-reported cases of chronic disease, aged 12 and over, age standardized, 2003 and2005

arthritis* asthma** heart and stroke*** depression****PEI 2003 18.3% 9.32% 4.94% 6.3%

2005 17.5% 8.85% 6.29% 3.8%Canada 2003 15.2% 8.59% 5.18% 6.0%

2005 14.6% 8.49% 4.92% 5.3%Source: Statistics Canada, Canadian Community Health Survey, 2003 and 2005* Arthritis includes rheumatoid arthritis and osteoporosis, but excludes fibromyalgia.** Asthma includes asthma, but excludes bronchitis and emphysema*** Heart and stroke includes heart disease and stroke, but excludes high blood pressure**** Depression refers to the proportion of the population aged 12 and over who show symptoms of depression, based on

their responses to a set of questions that establishes the probability of suffering a “major depressive episode” as definedby DSM-III-R and ICD-10. Probable risk (0.90) of depression was indicated with at least one episode of 2 weeks ormore with depressed mood, loss of interest, and health problems.

• Self-reported prevalence rates for the chronic conditions listed above remained relativelyconstant from 2003 to 2005 for both PEI and Canada.

• Arthritis was the most prevalent chronic condition in both PEI and Canada in 2003 and2005.

Prevalence of DiabetesThe following table reports the prevalence of self-reported cases of diabetes for PEI and Canadaas found through the Canadian Community Health Survey in 2003 and 2005.

Prevalence of self-reported cases of diabetes, aged 12 and over, aged standardized, 2003 and 20052003 2005

PEI 4.70% 5.32%Canada 4.14% 4.33%


• Self-reported diabetes prevalence rates remained relatively constant from 2003 to 2005 forboth PEI and Canada.

Incidence of Notifiable DiseasesA number of diseases can be controlled by immunization programs. The table below reports theincidence rates for six vaccine preventable diseases. Incidence rates are the number of new casesin a given year per 100,000 population.

Notifiable diseases, incidence rate per 100,000*1998 1999 2000 2001 2002 2003 2004

invasive meningococcal PEI 0.74 0 0 0 0 0 0.73Canada 0.51 0.67 0.78 1.19 0.68 0.55 0.6

haemophilus influenzae b(invasive) (HIB)

PEI 0 0 0 0 0 0 0Canada 0.17 0.07 0.11 0.15 0.14 0.14 0.22

measles PEI 0 0 0 0 0 0 0Canada 0.05 0.11 0.65 0.11 0.02 0.05 0.03

tuberculosis PEI 1.5 1.5 1.4 2.2 0.7 no data no dataCanada 5.9 5.9 5.5 5.5 5.2 no data no data

pertussis PEI 15.5 7.3 8.1 6.6 0 29.9 11.6Canada 29.5 19.2 15.5 9.5 10.3 7.1 8.8

hepatitis C PEI 43.4 19.1 8.1 19.8 27.8 27.7 22.5Canada 67.6 61.8 58 54.3 50.9 45 44.7

Source: Health Canada, Notifiable Disease Reporting System* The numbers in this table were updated from previous Annual Reports based on updated Health Canada data.

• There have been no reported cases of invasive haemophilius influlenza B since 1995, orthe measles since 1992. Immunization is now available for invasive memingococcal,haemophilus influenzae b and measles.

Outbreaks of pertussis occur every 3-4 years in PEI and the increase in the number of cases seenin 2003-04 reflects that trend. Efforts to control outbreaks of pertussis included the following:

• The upgrade in 2003 of the Grade 9 booster to include acellular pertussis with thetetanus-diphtheria immunization routinely given.

• Immunization of over 7,000 school age students between Grades 3-12 (excluding Grade10) in the 2004 Adacel Clinical Trial.

• Offering a one time dose of Adacel as the tetanus containing immunization adult boosterin Public Health Nursing clinics since 2003.

It is hoped that the province will experience fewer cases of pertussis in the school age and adultpopulations in the future.

Goal #2: Increase our acceptance of responsibilityfor our own health

Many diseases are preventable, or have complications which can be lessened, through healthylifestyle choices, early prevention, and early detection. Increased prevalence and/or severity ofdisease imposes a burden on individuals and their families, and contributes to increased costsfor health care service delivery systems. The health system can help people accept responsibilityfor their own health by providing educational programs, disease prevention and managementprograms, increased access to primary health services, increased access to health information andpartnerships to address determinants of health.

Lifestyles, Risk Factors and Health

SmokingTobacco use is the leading cause of preventable illness and death in Canada. Health Canadaestimates that smoking is responsible for the deaths of more than 37,000 Canadians per year.

This table reports the percentage of the population over age 15 who reported they were currentsmokers in the Canadian Tobacco Use Monitoring Survey.

Reported smoking rates of current smokers (aged 15+), 2000 to 20052000 2001 2002 2003 2004 2005

PEI 26% 26% 23% 21% 21% 20%Canada 24% 22% 21% 21% 20% 19%

Source: Canadian Tobacco Use Monitoring Survey, Household Component, 2000-2005

• In 2005, 20 percent of Islanders reported being current smokers - a decrease from 26percent in 2000.

Teen Smoking Youth smoking is a concern since nicotine is an addictive substance and approximately eight outof every 10 people who try smoking become habitual smokers.

The following table reports the percentage of the population aged 15 - 19 (inclusive) whoreported in the Canadian Tobacco Use Monitoring Survey that they were current smokers.

Reported teenage smoking rates of current smokers (aged 15-19), 2004 and 20052004 2005

PEI 17% 13%Canada 18% 18%

Source: Canadian Tobacco Use Monitoring Survey, 2004 and 2005

• The PEI rates for current smokers were lower than the Canadian rates.

• In PEI and Canada, among teens aged 15-19, a higher proportion of females smoke thanmales.

Fitness and Nutrition

Reported Physical ActivityRegular physical activity provides many well documented physical and mental health benefits. On the other hand, physical inactivity is a risk factor for a variety of serious illnesses, includingheart disease and diabetes. The following table provides a summary of activity rates for peoplein PEI and Canada obtained through the 2003 and 2005 Canadian Community Health Surveys. Survey respondents were asked about the frequency, duration, and intensity of theirparticipation in leisure-time physical activity during the previous three months. The followingtable presents the percentage of the population aged 12 and over who rated their physicalactivity as either “active” or “inactive”.

Self-reported physical activity rates, aged 12 and over, aged standardized, 2003 and 2005 2003 2005

active inactive active inactivePEI 23.8% 54.3% 22.3% 54.6%Canada 27.5% 47.4% 27.6% 47.2%


• Physical activity rates in PEI were lower than Canadian rates in 2003 and 2005.

• In 2003 and 2005, over 50% of Islanders were inactive.

Reported Body Mass Index (BMI)Obesity is a risk factor for a number of serious illnesses, including high blood pressure, stroke,type 2 diabetes, heart disease, osteoarthritis and other musculoskeletal disorders and cancer.

Body Mass Index (BMI) is used as a measure to determine appropriateness of weight in relationto overall body size. This measure is calculated by dividing weight in kilograms by height inmeters squared. Obesity is defined as a Body Mass Index above the threshold of 25.

The following table presents self-reported rates of Islanders and Canadians who are anacceptable weight, overweight or obese according to an estimate of BMI obtained through theCanadian Community Health Survey.

Self-reported BMI rates, aged 12 and over, age standardized, 2003 and 2005acceptable weight overweight obese

PEI 2003 44.7% 35.9% 19.5%2005 43.8% 34.2% 21.0%

Canada 2003 54.6% 31.5% 13.9%2005 51.4% 31.5% 14.3%


• Compared to the Canadian average, a smaller proportion of Islanders are an acceptableweight and a larger proportion are overweight or obese.

Diet: Fruit and Vegetable ConsumptionDiet and health are closely connected. Poor dietary habits are linked to a number of seriousillnesses, including cancer and heart disease. Adequate fruit and vegetable consumption is abasic component of a healthy diet. The Canada Food Guide recommends a minimum of fiveservings of fruit and vegetables per day. Average daily fruit and vegetable consumption is used asan indicator of the dietary habits of the population.

The following table presents self-reported rates of fruit and vegetable consumption for thepopulation aged 12 and older as reported in the Canadian Community Health Survey.

Self-reported fruit and vegetable consumption rates, aged 12 and over, aged standardized, 2003 and2005

2003 20055 or more times per day 5 or more times per day

PEI 31.4% 32.7%Canada 41.5% 43.9%


• Fruit and vegetable consumption rates were lower in PEI when compared to Canada inboth 2003 and 2005.

• In 2005, only 32.7% of Islanders ate five or more servings of fruit and vegetable per day.

Early Prevention

Influenza Immunization: Adults Aged 65 and OlderInfluenza can pose a serious health risk for many people, including those aged 65 and over. Immunization is effective in preventing the flu. Immunization for those most at risk forcomplications associated with influenza, including adults aged 65 and older, is an importantprevention measure.

The following table presents the percentage of the population 65 years of age and over whoreported having a flu shot in the 12 months prior to the survey.

Self-reported influenza immunization rates, aged 65 and over, 2003 and 20052003 2005

PEI 72.1% 69.8%Canada 75.7% 71.3%


• Influenza immunization rates are similar for both PEI and Canada, with approximately70% of people aged 65 and over receiving a flu shot in 2005.

Children and Second-Hand SmokeExposure to environmental tobacco smoke (second-hand smoke) is harmful to children, and isassociated with respiratory illness, sudden infant death syndrome (SIDS) and ear infections. Children are especially vulnerable to the effects of second hand smoke because their bodies arestill developing, their breathing rates are higher than adults, and they have little control overtheir indoor air environments. The following table reports the percentage of children regularlyexposed at home to environmental tobacco smoke.

Exposure of children at home to environmental tobacco smoke2004 2005

% ChildrenAge 0-11

% ChildrenAge 12-17

% ChildrenAge 0-17

% ChildrenAge 0-11

% ChildrenAge 12-17

% ChildrenAge 0-17

PEI 13% 18% 15% 12% 17% 14%Canada 12% 19% 15% 9% 16% 12%

Source: Canadian Tobacco Use Monitoring Survey, 2004 and 2005

• PEI rates are similar to national averages.

• Exposure to second hand smoke has been decreasing in PEI and Canada since 1999.

Breast-FeedingBreast-feeding is a recommended source of nutrition for babies. More than just a food source,breast milk contains immunoglobulins and antibodies which provides the baby with protectionagainst disease. Breast-fed babies have fewer childhood illnesses, such as gastrointestinal andrespiratory infections, asthma, eczema, food allergies, and middle ear infections than otherbabies. There is evidence as well that breast-feeding may contribute to cognitive development.

The table below reports the percentage of women who were breast-feeding at hospital dischargeon PEI.

Breast-feeding rates (at hospital discharge) on PEI2004-05 2005-06

PEI 63.5% 64.5%

Source: Integrated Services Management (ISM), 2004-05 and 2005-06

Early Detection

Pap Screening RatesMore than 90 percent of cervical cancer can be prevented by regular screening with the Pap test. The PEI Pap Screening Program was established in 2001. Program objectives included: reductionof incidence and mortality from cervical cancer among Island women; increased accessibility tothe service; and increased number of women screened.

Pap screening rates are the percentage of women between 20 and 69 who participated in a Papscreening program within a defined period of time.

PEI Pap screening rates, by age group, 2001-2003screening period

age group one year (2003) two years (2002-2003) three years (2001-2003)20 to 34 44% 62% 69%35 to 49 39% 59% 67%50 to 69 37% 52% 57%total 20 to 69 40% 58% 65%

Source: PEI Pap Screening Program, 2003 Report

• Approximately 40 percent of Island women between the ages of 20 and 69 are screenedwith a Pap annually. Over a three year period, 65 percent of Island women underwent aPap screening.

• The overall two year Pap screening rate for women aged 20 to 69 on PEI remains at 58percent. The screening rate has stayed constant over the past nine years.

• Participation in Pap screening decreases with age, regardless of the screening interval, withthe highest participation rate for women in their reproductive years.

The Canadian Community Health Survey (CCHS) also provides information on Pap screeningrates. These participation rates are based on self-reported data and tend to be less accurate thanthe findings from the PEI Pap Screening Program. However, the CCHS data does allow forcomparison to the Canadian average. The following table presents the percentage of womenaged 20-69 who reported receiving a Pap screen within the past three years.

Self-reported Pap screening rates, aged 20-69, 2001-20052001-2003 2003-2005

PEI 78.2% 82.5%Canada 70.1% 75.7%


• In 2005, 82.5 percent of Island women reported that they had a Pap screen within thepast three years. This was up from 2003, and was above the Canadian average of 75.7percent.

Mammography RatesBreast cancer continues to be the most frequently diagnosed form of cancer for women inCanada. However, breast cancer mortality rates have been declining over time. Improved breastcancer screening programs and treatments have contributed to the decrease. On PEI, there were10,078 mammograms performed in 2005/06. This number includes women of all ages andboth diagnostic and screening mammograms performed at the QEH and PCH. The following table shows the percentage of women aged 50-69 who reported receiving amammogram for routine screening or other reasons within the past two years as reported in theCanadian Community Health Survey.

Self-reported mammography screening rates, aged 50-69, 2002-20052002-2003 2004-2005

PEI 70.7% 64.9%Canada 72.6% 72.1%


• In 2005, 64.9% of Island women aged 50-69 reported having a mammogram within theprevious two years. This was down from 2003, and was lower than the Canadian averageof 72.1%.

• Actual mammography screening rates tend to be lower than self-reported rates.

Goal #3: Improve Sustainability of theSystem

Several factors pose challenges to the long term sustainability of the health system. Factorsinclude: increased demand for new and existing services, rising costs, supply of healthprofessionals, requirements for capital investments in aging health facilities, and public pressureto make costly new technologies available close to home. The following sustainability indicators are being monitored: health system expenditures; healthsystem costs per capita; supply of health professionals; and patient satisfaction.

Health System ExpendituresPEI Health System program expenditures (in current dollars and reported in millions), 2001/02 to2005/06*

2001/02 2002/03 2003/04 2004/05** 2005/06health care expenditures $277.9 M $311.4 M $324.4 M $326.7 M $335.2 M

Source: PEI Department of Health, Finance and Administration, 2006* These numbers have been adjusted retroactively from previous annual reports to reflect the move of Provincial

Pharmacy from health to social services expenditures.** In 2004/05, 2.3 million for Information Technology was moved to the Provincial Treasury budget.

• In 2005/06, the provincial government spent $335.2 million on the delivery of healthcare.

• For the five year period between 2001/02 and 2005/06, health system spending increasedby $57.3 million or 20.6 percent.

Health System Costs Per CapitaPEI Health System costs per capita (in current dollars): 2001/02 to 2005/06*

2001/02 2002/03 2003/04 2004/05 2005/06health care costs per capita $2,033 $2,273 $2,355 $2,371 $2,490

Source: PEI Department of Health, Finance and Administration, 2006* These numbers have been adjusted retroactively from previous annual reports to reflect the move of Provincial

Pharmacy from health to social services expenditures.

• In 2005/06, average cost per capita for provincial government spending for health care onPEI was $2,490.

• For the five year period between 2001/02 and 2005/06, per capita costs for health careincreased by $457 per capita or 22.5 percent.

Health Professionals The number of health professionals per population of 100,000 is an indicator used provinciallyand nationally to monitor and compare trends.

Health professionals, number per 100,000 population: 2002-20042002 2003 2004

Canada PEI Canada PEI Canada PEIregistered nurses 734 921 760 994 769 1000licensed practical nurses 191 423 199 448 198 456general practitioners / familyphysicians

96 85 97 88 97 95

specialist physicians 93 51 91 54 92 57pharmacists 84 98 87 108 89 110dentists 57 44 58 44 57 47physiotherapists 48 38 49 38 49 37occupational therapists 31 27 33 25 34 25dental hygienists 51 31 53 49 55 36chiropractors 20 6 21 6 21 6optometrists 11 10 12 11 12 11dietitians 23 42 24 44 24 44

Source: CIHI Health Indicators 2004, 2005, 2006

• In 2002, 2003 and 2004, the number of registered nurses, licenced practical nurses,pharmacists and dietitians per 100,000 population on PEI was higher than comparablenational rates. In fact, the PEI rate for licensed practical nurses was more than twice thenational rate.

• PEI had a lower number of health professionals per 100,000 population when comparednationally for physicians, dentists, dental hygienists, physiotherapists and occupationaltherapists. It is important to note, however, that Islanders receive some services, such asmedical specialist consults, out-of-province. Thus, while the number per 100,000 ofsome health professionals may be lower on PEI than elsewhere, Islanders may still haveappropriate access to these services, but on an out-of-province basis. In addition, thesefigures are affected by provinces that have training schools/educational institutions;therefore, in some provinces figures are falsely high when compared to PEI.

Patient SatisfactionReported patient satisfaction with any health care service, community-based services, hospitalservices and physician services were measured in the Canadian Community Health Survey.

Community-based care includes any health care received outside of a hospital or doctor’s office. Examples include home nursing care, home-based counseling or therapy, personal care, andcommunity walk-in clinics. For the purpose of this survey, physicians included family doctorsand medical specialists, but excluded services received in a hospital.

The table reports the percent of survey respondents, aged 15 and over, who rated themselves aseither “very satisfied” or “somewhat satisfied” with the way services were provided in theprevious 12 months.

Proportion who reported they were “very satisfied” or “somewhat satisfied” with health services, aged15 and over, 2005

any health careservice

community careservices

hospital care physician care

PEI 88.7% 86.8% 86.9% 93.1%Canada 86.0% 82.1% 81.4% 91.6%

Source: Statistics Canada, Canadian Community Health Survey, 2005

• The majority of Islanders and Canadians were satisfied with the various health servicesthey received in 2005.

Goal #4: Increase public confidence in thesystem

Public confidence in the health system is essential to advance system goals and strategies. Publicconfidence can be measured by a public rating of the quality of services received. Perceptions ofservice quality were measured through the Canadian Community Health Survey.

The table below reports the percentage of the population rating any health care service,community-based services, hospital care and physician care as “excellent” or “good.”Community based care services include home nursing care, home based counseling or therapy,personal care and community walk-in clinics.

Proportion of the population who rated the quality of health care services received as “excellent” or“good”, aged 15 and over, 2005

any health careservice

community-basedservices

hospital care physician care

PEI 88.8% 82.0% 90.3% 93.1%Canada 86.0% 79.1% 82.5% 91.3%

Source: Statistics Canada, Canadian Community Health Survey, 2005

• Islanders and Canadians generally responded positively about the quality of care theyreceived, 88.8 percent rated the quality of any health care service on PEI as “excellent” or“good.”

• In all four areas of health service, the PEI rate was above the Canadian rate.

Goal #5: Improve workplace wellness and staffmorale

Long term quality and sustainability of the health care delivery system requires a sufficientsupply of skilled health human resources. A variety of efforts directed toward recruitment,retention and employee wellness have been undertaken at all levels of the system.

Full time equivalents (FTEs) in the Department of Health,* as of March 2006as of March 2006

Management 130.03Front Line Staff 2,888.17Total FTEs 3,018.2

Source: DH Human Resources 2006* In 2005 as a result of restructuring, the pre-existing Department of Health and Social Services was replaced by two

new departments - the Department of Health and the Department of Social Services and Seniors

This is the first year that the Department of Health is reporting as a new organization. Insubsequent annual reports, the 2005/06 data will be used as a baseline to trend future employeeinformation.

Employee Sick HoursSick leave usage is related to a variety of factors. For instance, collective agreements (articlesutilize sick leave balances for medical appointment and addictions treatment), organizationalculture and staffing issues can all contribute to increases or decreases in the usage of sick time. The following table presents sick leave utilization in the Department of Health for 2005/06.

Sick leave utilization in the Department of Health 2005/062005/06

Total Hours 7,521,178Total Sick Hours 280,324Sick hours as a percentage of total hours 3.7%Average number of sick days per year used per FTE* 12.4

Source: Department of Health, Human Resources* FTE is “full time equivalent” and refers to full-time hours which is 1950 hours per year.

Statistics indicate that health care has an increased incidence of employee absence compared toother industries. In 2004, full-time employees in health occupations lost an average of 12.8 daysof work due to illness or disability per year in Canada, compared with 7.4 days lost byemployees in all other occupations (CIHI, 2005). Many factors contribute to this including theaging employee population and the 24 hour shift environment.

As previously mentioned, this is the first year that the Department of Health is reporting as anew organization. Sick leave utilization will be monitored overtime and the 2005/06 data willprovide a baseline for the organization to trend data in future annual reports.

Workers Compensation Board ClaimsWorkers Compensation Board claims, 2002/03 to 2005/06*

2002/03 2003/04 2004/05 2005/06Claims Filed 452 401 379 345Time Loss Claims 162 142 115 97Days Lost 5,704.67 5,643.87 4,569.72 4,043.8

Source: Workers Compensation Board, PEI* Some numbers have been adjusted from previous annual reports because the number of individuals in the Department

of Health changed with the regrouping of the health and social services system during reorganization.

• The number of claims filed and the number of days lost have both decreased over the lastfour years to less than 100 time loss claims in 2005/06.

• The number of days lost between the periods 2002/03 and 2005/06 decreased by 29percent.

Recruitment and Retention

Attrition RatesFor the twelve month period ending December 4, 2004, the rate of attrition for the health andsocial services system was approximately 4.4 percent. In summary, 180 non-casual employeesexited the system during that one year period for the following reasons: resignation (43percent); retirement (28 percent); term positions ended (12 percent); and other reasons (16percent). These numbers are consistent with previous years. Attrition rates for 2005 arecurrently being assessed. The number of retirements for 2005 would be higher as a result of theWorkforce Renewal Program.

Physician Recruitment SuccessAll provinces are experiencing physician shortages in both family medicine and specialty areas. Vacancies in the physician complement, whether in family medicine or a specialty area, affectservices to the general public. The province is responding to the issue of physician shortages andvacancies in the physician complement through ongoing recruitment efforts.

The following table reports on the total physician complement and number of positions filledwithin that complement for 2003 to 2006. The physician complement is the total number ofallowable positions for physicians in PEI.

Physician complement and filled positions, PEI: 2003 - 2006 *as of March 2003 as of March 2004 as of March 2005 as of March 2006

Physician practicearea

complement

filled** complement

filled** complement

filled** complement

filled**

Family Practice 78.5 72.5 80.6 76.6 81.6 78.9 84.6 79.1Specialists 104.5 93.8 111 102.1 113.5 104.4 118.5 104.6TOTALS 183 166.3 191.6 178.7 195.1 183.3 203.1 183.7

Source: PEI Department of Health, Medical Programs* Revised** Filled positions reflect full-time equivalent permanent positions which could be filled by permanent physicians or

locums.

• The physician complement on PEI increased by more than 20 positions (10.9 percent)from March 2003 to March 2006 (183.0 to 203.1).

• Since 2003 the province has increased the number of physicians required for internalmedicine, emergency medicine, psychiatry, physical medicine and family medicine.

• More physicians are working in PEI than in 2003. The number of FTE physician positionsfilled has increased from 166.3 in 2003 to 183.7 in 2006 (10.5 percent). Some of thecurrently unfilled positions are new and recruitment is on-going.

• The alternate payment model for physicians has enhanced recruitment and made comingto PEI more attractive. This has helped PEI to stay competitive with the other provinces.

Nurse RecruitmentRegistered nurses comprise the largest group of health care providers on PEI. The Bachelor ofNursing Sponsorship Program enhances recruitment and retention by providing financialassistance to third and fourth year nursing students who agree to work in the province upongraduation. The following table reports the number of student sponsorships through theBachelor of Nursing Sponsorship Program from 2002/03 to 2005/06.

Bachelor of Nursing Sponsorship Program*2002/03 2003/04 2004/05 2005/06

Number of student sponsorships (for 3rd and 4th year) 78 127 77 32**Source: Department of Health and Social Services, PEI Nursing and Retention Strategy, 2005* During 2005/06, the Sponsorship was suspended for one year.** Government committed to sponsoring the 32 students in their 4th year of study (nursing students with sponsorship who

completed their 3rd year)

• Between 2002/03 and 2005/06, 314 sponsorship years were provided to nursing studentsthrough the Bachelor of Nursing Sponsorship Program.

Legislative ResponsibilitiesLegislation administered by the health system for which the Minister of Health is responsible:

Adult Protection ActChange of Name ActChiropractic ActCommunity Care Facilities and Nursing Homes ActCommunity Hospital Authorities ActConsent to Treatment and Health Care Directives ActDental Profession ActDenturists ActDietitians ActDispensing Opticians ActDonation of Food ActHealth Services ActHealth Services Payment ActHospital and Diagnostic Services Insurance ActHospitals ActHuman Tissue Donation ActLicensed Practical Nurses Act

Long-Term Care Subsidization ActMarriage ActMedical ActMental Health ActOccupational Therapists ActOptometry ActPharmacy ActPhysiotherapy ActProvincial Health Number ActPsychologists ActPublic Health ActRegistered Nurses ActSmoke-free Places ActTobacco Sales and Access ActVital Statistics ActWhite Cane Act

NOTE: There are two other statutes that are private member’s bills, not in the province’s officialconsolidation, but are considered to be within the responsibility of the Health Ministry:

Dental Technicians Association ActFuneral Directors and Embalmers Association Act

Legislative ChangesActs

• The Health and Community Services Reorganization Act received Royal Assent on June 7,2005. This legislation dissolves the health authorities, transfers assets and liabilities togovernment, and makes consequential amendments to many other statutes. This Actcame into force (became law) on January 1, 2006.

• The Community Hospital Authorities Act received Royal Assent on June 7, 2005. This Actdesignates specific hospitals as community hospitals, establishes community hospitalauthority boards, sets out roles and responsibilities, provides for appointment ofadministrators, and provides that the community hospital authorities contract withgovernment for the provision of staff. The Community Hospital Authorities Act came intoforce January 1, 2006.

• The Health Services Act received Royal Assent on June 7, 2005. This new Act replaces theformer Health and Community Services Act following the split of the Department of Healthand Social Services into two distinct departments (Department of Health and Departmentof Social Services and Seniors). It sets out the responsibilities of the Minister of Health,provides for protection from liability for the Minister and employees of the Department,and protects the work of quality assurance groups. The Health Services Act came into forceJanuary 1, 2006.

• The Long-Term Care Subsidization Act received Royal Assent on June 7, 2005. This Actreplaces what was formerly Part II of the Social Assistance Act, and it concerns subsidizedcare in nursing homes. This Act came into force November 8, 2005.

• The Act to Amend the Social Assistance Act received Royal Assent on June 7, 2005. Thislegislation severs the Act, Part II of the former Act moves to a new Act (Long-Term CareSubsidization Act, above), and the remainder becomes the responsibility of theDepartment of Social Services and Seniors. The Act to Amend the Social Assistance Act cameinto force November 8, 2005.

• The Act to Amend the Health and Community Services Act received Royal Assent on June 7,2005. This amendment deals with the split of the Department, and it allocatesresponsibility for health services to the Department of Health and responsibility for socialservices and services for seniors to the Department of Social Services and Seniors. Thisamendment came into force November 8, 2005.

• The Health and Social Services Reorganization Act received Royal Assent on June 7, 2005. This legislation effects various consequential amendments to various Acts in order toreference the appropriate Department once the split occurs. This Act came into forceNovember 8, 2005.

• The Health Authorities Employees Act received Royal Assent on June 7, 2005. This Acttransfers all employees of the health authorities to government, and provides for labourrelations dispute resolutions. This Act came into force on June 28, 2005.

• The Registered Nurses Act received Royal Assent on December 16, 2004. This new statute isto replace the former Nurses Act, and it governs the practice of registered nursing in theprovince. This Act came into force February 25, 2006.

• The Act to Amend the Tobacco Sales to Minors Act received Royal Assent on December 16,2004. This legislation changes the title of the Act to the Tobacco Sales and Access Act, andamendments primarily concern the retail sale of tobacco and designates places wheretobacco cannot be sold. This amendment came into force August 1, 2005.

• The Act to Repeal the Pre-Marital Health Examination Act repealed a dated piece oflegislation concerning examinations that had been done in an effort to control the spreadof syphilis. This repeal came into force December 15, 2005.

• The Act to Amend the Health Authorities Employees Act received Royal Assent on December15, 2005. This amendment clarifies pension issues with respect to some civil serviceemployees. This amendment came into force retroactive to June 28, 2005.

• The Hospitals Act received Royal Assent on December 15, 2005. This new Act replaces theprior Act by the same name and reflects the newly reorganized health system. This Actcame into force on January 1, 2006.

Regulations

• The Emergency Medical Services Regulations under Part II of the Public Health Act wereamended to reflect the change in levels of licensing from two levels (basic, beyond basic)to three levels (EMT Level I, II, and III). This change came into force April 1, 2005.

• The following amendments were made to regulations under the Pharmacy Act (all of thesechanges came into force May 1, 2005):

2 Changes were made to Authorization Regulations to generally update theseregulations, and specifically to account for trade mobility requirements.

2 New Drug Schedule Regulations were created to specify which drugs are restricted invarious categories according to the National Association of Pharmacy RegulatoryAuthorities (NAPRA). These regulations set out some prohibitions concerning the saleof drugs, and require pharmacies to follow certain rules, depending on the category ofthe drugs.

2 New Interchangeable Drug List Regulations were created. These regulations establish acommittee to recommend and maintain an interchangeable prescription drug list forthe province, and set out criteria for these drugs, rules for pharmacies, and rights ofpatients.

2 Changes were made to the Standards Regulations to update standards for thepharmacy profession, including rules for labeling and records.

• Amendments were made to the regulations under the Tobacco Sales and Access Act,including signs to be displayed in premises selling tobacco, and acceptable identificationto establish proof of age. The old regulations under the Tobacco Sales to Minors Act wererevoked. These changes became into force August 1, 2005.

• The regulations under the Marriage Act were amended to revoke an earlier provision andto revise some of the forms under the regulations, mostly to accord with the new federaldefinition of marriage. These amendments came into force August 18, 2005.

• The regulations under the Vital Statistics Act were changed to replace the phrase “bride andgroom” with the word “spouses”and to revise some forms. These changes came into forceAugust 18, 2005.

• An amendment was made to the Slaughter House Regulations under the Public Health Actconcerning an exception for processing a dead animal, subject to the specialcircumstances outlined. This amendment came into force December 3, 2005.

• Amendments were made to the Supported Adoption Regulations under the Adoption Actto remove references to the health authorities. These amendments came into forceJanuary 1, 2006.

• Amendments were made to the regulations under the Child Protection Act to removereferences to the health authorities. These amendments came into force January 1, 2006.

• The regulations under the Civil Service Act were changed to clarify which employees arenot represented by the Union. These changes came into force January 1, 2006.

• The Participating Employer Regulations under the Civil Service Superannuation Act wereamended to remove the health authorities from the list of participating employees. Thischange came into force January 1, 2006.

• New regulations were created under the new Community Hospital Authorities Actconcerning the boards of the community hospital authorities, including the interimappointed boards. These regulations came into force January 1, 2006.

• An amendment was made to the Special Project Funds Regulations under the FinancialAdministration Act to revoke a reference to a Program no longer in operation. Thisamendment came into force January 1, 2006.

• The regulations under the Health and Community Services Act were revoked the day beforethe Act was repealed. This change came into force December 31, 2005.

• Amendments to the regulations under the Health Services Payment Act were made toremove references to the health authorities. These amendments came into force January1, 2006.

• Amendments to the regulations under the Hospital and Diagnostic Services Insurance Actwere made to delete references to the health authorities and generally to update theregulations to reflect the reorganized health system. These amendments came into forceJanuary 1, 2006.

• Amendments to the Hospital Management Regulations under the Hospitals Act were madeto delete references to the health authorities and generally to update the regulations toreflect the reorganized health system. These amendments came into force January 1,2006.

• The Low Income Assisted Home Ownership Supplement Program Regulations, ProvincialContribution to Senior Home Repair Regulations, and Serviced Lot Subsidy Regulationsunder the Housing Corporation Act were changed, for the most part, to delete references tothe “Board” and correct them with references to the “Corporation”. These changes cameinto force January 1, 2006.

• The regulations under the Mental Health Act were amended to remove references to thehealth authorities. These amendments came into force January 1, 2006.

• The Notifiable and Communicable Diseases Regulations under the Public Health Act wereamended to clarify to whom the Chief Health Officer provides information. This changecame into force January 1, 2006.

• The Discipline Regulations Revocation, Registration and Licensing of Nurses RegulationsRevocation, and Schools of Nursing Regulations Revocation occurred under the oldNurses Act. These old regulations were revoked the day before the Act was repealed. These changes came into force February 24, 2006.

• New Nurse Practitioner Regulations, Professional Conduct Review Regulations,Registration and Licensing of Nurses Regulations, and Schools of Nursing Regulationswere written for the new Registered Nurses Act governing the practice of registered nursingin the province. These regulations came into force February 25, 2006.

Appendix ASummary of Expenditures

2005/06 2005/06 EXPENSES ESTIMATES

$ $

Corporate Services 5,002,646 4,943,000

Financial Services 8,717,828 8,713,300

Population Health 2,672,670 2,658,600

Medical Programs 90,628,176 86,413,800

Provincial Acute Care Queen Elizabeth Hospital 85,534,039 86,468,800 Prince County Hospital (Incl capital funded by PCH Foundation - 675,000) 32,756,860 31,567,800 Hillsborough Hospital 8,920,314 8,862,500

Community Hospitals Western Hospital 4,058,511 4,116,800 Community Hospital (Note 1) 4,046,628 4,025,300 Stewart Memorial Hospital 2,035,758 2,135,800 Kings County Memorial Hospital 5,613,705 5,775,000 Souris Hospital 3,906,304 4,117,800 Community Hospitals Total 19,660,906 20,170,700 Note 1: Removed 1.7 m to Provincial Homes and Manors

Provincial Homes and Manors 40,838,269 38,276,100 Note 1: Added 1.7 m from Community Hospital for Long Term CareIncludes 991,300 expenses for Sherwood Home budget in Social ServicesIncludes 806,995 expenses for Kensington Laundry expense budget in Acute Care

Home Care and Support, Dialysis 10,002,620 10,488,900

Private NursingHomes

8,992,252 9,113,600

Primary Care 24,423,720 24,957,000

Total HealthInformatics

(Revenue offsets) 5,092,472 10,832,700

TOTAL DEPARTMENT OF HEALTH 343,242,772 343,466,800

Note : Adjustment for hospital based revenue included in above and moved to government revenue schedule

Appendix BBudget Estimate

Budget Estimate

2006/2007

Department of HealthGross Expenditure $343,850,200.00Gross Revenue $12,917,900.00

Net Ministry Expenditure $330,932,300.00

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