Jillian Horton is a physician and the author of We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing.
Last week, the British Medical Journal published a series co-authored by a number of distinguished Canadian experts examining our national response to the COVID-19 pandemic and calling for a national inquiry – something many of us assumed would be well under way by now. And yet, there have been no other recent high-profile calls for a national inquiry that I can recall – no provincial medical associations, no national health care organizations, no political parties. There is a weariness when it comes to rehashing events of the past three years; a sense that we’ve already heard this song, and an inquiry is just wasting more time talking about what we already know. Time for action, the refrain goes.
Well, it is time for action. But weary or not, the best path we have when it comes to getting that action right is a federal inquiry.
National commissions of inquiry are investigations called by the federal government, and their terms are laid out in the Inquiries Act. Under that act, cabinet has the power to call for an inquiry whenever it likes. The cabinet can set the scope of the inquiry, and the act is broad enough to allow for very specific tailoring to the circumstance.
There is no single recipe for the format of an inquiry. It can be courtlike (with witnesses and cross-examination), or something else altogether. Ultimately, the inquiry issues recommendations. An example of the real-world impact of a previous inquiry was the creation of Canadian Blood Services in the wake of one of Canada’s worst public-health disasters – the “tainted blood” scandal that resulted in thousands of cases of Hepatitis C and HIV in transfusion recipients.
In 2022, survey data suggested that two out of three Canadians wanted to see a Federal inquiry into Canada’s handling of COVID-19, and support among the general public remains high. But other voices have been notably silent on this issue. Some who have been vocal critics of government response to COVID-19 are expressing cynicism, suggesting an inquiry is pointless because some other inquiries have not led to action, or the process will inevitably be a “fiasco.”
I share the underlying frustrations. But let’s not pretend we know everything we need to know about what has happened in this country over the past three years. We do not have a complete picture of the scope of political interference in many public-health decisions, particularly at the provincial level. We do not know why the country has been so slow to educate citizens on the airborne nature of COVID, or what other interests have influenced this dialogue. And we don’t really know whether the country has even a semblance of a strategy going forward to deal with the profound national security threat of organized disinformation campaigns.
As with our gross neglect of the welfare of older adults and marginalized communities, all of these massive problems can – and must – be part of the scope of a national inquiry.
Some trusted voices have suggested that an inquiry, while necessary, may not be the right vehicle. But we have no other formal vehicle at present. An implementation commission has nothing to implement without an inquiry to inform it. And if there needs to be a better vehicle – and indeed, maybe there does – that recommendation can come from an inquiry. An inquiry can also examine the historical reasons we have failed to heed the lessons of other inquiries. Maddening? Yes. But we need to use existing processes as portals to create new frameworks, and build that better way.
We also have to hold onto something else that might feel impossible right now: hope. If you feel disillusioned with our systems – I do too. But the idea that an inquiry won’t lead to change because some other inquiries have not is nihilism, and it won’t help us right now. In the medical community, it may even be a sign of collective burnout, or a post-traumatic response. Bertrand Russell once said that a symptom of an approaching breakdown was the belief that one’s work was terribly important. But the same thing is true when we lose faith that big things still matter. Cynicism isn’t a slippery slope – it’s a cliff. Lean in and fall over, and you might never make your way back up.
Is an inquiry a daunting task? You bet. We’re a country of 40 million people spread out over 10 provinces and three massive territories. But we need this to be a watershed moment in public policy and health care. It can be. And I’ll take it over jumping over that cliff into the water, or sitting around and shedding more tears.