Prime Minister Justin Trudeau has invited premiers to Ottawa for a “working meeting” on Feb. 7, to discuss reaching cross-Canada health-care funding deals.
The prime minister said Wednesday morning in announcing the upcoming meeting, that he views the gathering as a chance for federal, provincial and territorial governments to discuss an agreement—or series of agreements—that will see more funding put into health-care systems across the country, in exchange for improved care.
“It will be an opportunity to share with them our plans to support the health-care systems across the country, hear their priorities for investment, and start working together concretely to ensure that we’re transparent about how this money is being invested,” Trudeau said. “So Canadians can have the confidence that they’ll get the high-quality health care they deserve, for years to come.”
Momentum has been building towards a deal over the last few weeks, after premiers began indicating that they’d be willing to agree to funding with strings attached, seeing them held accountable for delivering improved care in exchange for more federal dollars.
Trudeau confirmed Wednesday that the federal government is looking at coming to a nationwide agreement, perhaps on data and health information sharing, as well as signing long-term bilateral deals on a province-by-province basis that includes specific metrics relevant to each system’s needs.
The shared priorities that both the federal government and premiers have been discussing include:
Timely access to family health teams;
Reducing backlogs in surgeries and diagnostics;
Retaining, recruiting, and recognizing the credentials of health-care workers;
Investing in mental health; and
Modernizing the health information system so medical records can be shared with various providers, electronically.
“We don’t think applying a one size fits all across the country is the best way to do it. But, there will be elements of what we’re working on that will be an agreement with the entire country,” Trudeau told reporters during a press conference as his cabinet enters its third and final day of a pre-Parliament retreat in Hamilton, Ont., where they are plotting out 2023 priorities.
While Trudeau is signalling that he is ready to offer up billions of dollars to improve Canada’s health-care systems, this is a signal that what’s coming is likely to look different than the provinces’ long-standing blanket demand that the federal government increase the Canada Health Transfer (CHT).
The provinces have recently ramped up pressure to see the CHT—which funnels federal dollars into provincial health-care systems on an ongoing basis—increase to 35 per cent up from the current 22 per cent, as hospitals and health-care facilities appear to be in crisis mode.
On Wednesday, Health Minister Jean-Yves Duclos noted that the transfer is already slated to increase by 10 per cent in March, and “it will increase further,” but the federal government still won’t specify how much money it’s willing to spend.
Trudeau said Wednesday that while he’s not planning on signing any agreements during the meeting coming up in two weeks, he sees the gathering as a starting point towards work with each province and territory on respective accords.
“We have been working closely with many, many, if not all of the premiers over the past weeks and months to ensure that we’re able to respond to the pressing needs Canadians are facing in health care right now,” Trudeau said. “But also building a system that has learned from the real challenges we’ve gone through since the pandemic.”
Ontario Premier Doug Ford was quick to confirm he will be at the Ottawa sit-down with Trudeau and his fellow premiers.
“We have a lot to discuss, including making sure the federal government properly funds the health care people rely on. When Team Canada works together, there’s nothing we can’t do,” Ford tweeted.
Anouncement of a date to sit down is an indication of how far these talks have come, after Trudeau told CTV News at the end of 2022 that he would only pull up a chair “once there is the outlines of a deal.”
The health funding issue has been a key discussion during this week’s cabinet retreat, as has been question of how the federal Liberals plan to pay for it, alongside their outstanding pledges, while being mindful of their vow to be fiscally prudent given the risk of a recession.
Deputy Prime Minister and Finance Minister Chrystia Freeland indicated that despite the economic uncertainty, the Liberals will find fiscal room to move ahead with their pledge to protect Canada’s health-care system, while noting Canadians also expect that provinces will use their “fiscal capacity” to also support the systems that everyone depends on.
Earlier this week, Intergovernmental Affairs Minister Dominic LeBlanc said that the federal government was aiming to have long-term funding agreements inked ahead of presenting the 2023 federal budget. On Wednesday, he told reporters that the Liberals still hope that agreements can be finalized between the February meeting and the budget release.
SYSTEM ‘NOT LIVING UP’ RIGHT NOW: PM
From staffing shortages and a cold-weather surge of illnesses compounding extended wait times in emergency rooms, to hundreds of thousands of surgeries and medical procedures backlogged due in part to COVID-19 cancellations, there are steady calls from those in the sector for urgent action as Canada’s population continues to grow and age.
Trudeau has previously acknowledged that Canada’s health-care system is “strained, if not broken,” but as the back-and-forth between Ottawa and the premiers over an increase in funding has stretched on for months some provinces have announced plans to forge ahead with initiatives to address their specific health-care systems’ needs, including plans to allow more private clinics to offer certain procedures.
This has revived the privatization debate and raised questions over whether what some provinces are doing contravenes the Canada Health Act, which ensures all eligible residents have reasonable access to publicly-funded health services. In order to maintain eligibility for their full Canada Health Transfer, provinces are required to uphold the Act’s criteria and ensure there is no extra-billing and user chargers for insured health services.
Largely, federal officials asked about privatization creep concerns have said they take their responsibility to uphold the Canada Health Act seriously, but that they are confident premiers intend to uphold the universal health-care system.
On Wednesday, Trudeau said that while Canada’s universal system has “long been a model to the world… What Canadians are experiencing right now, is simply not living up to that promise or pride.”
“Too many people don’t have access to a family doctor or a nurse practitioner. Wait times in emergency rooms across the country, particularly in rural areas, have become dangerously long. Health-care workers themselves are under incredible strain as they’ve stepped up over the past two years. So many of them are on the verge of burnout, so many of them continue to work incredibly long hours to keep everyone safe, but need extra support,” Trudeau said.
The prime minister added that while access to health services based on needs and not Canadians’ ability to pay is “fundamental” and needs to be maintained, “the most important thing for Canadians is that we build a system that improves right now, but that can hold and continue to serve Canadians in this public universal model for decades to come.”
“That’s what we’ve been working with the premiers on, and that’s what we’re going to sit down to really accelerate together in two weeks,” he said.
However, Trudeau’s remarks seemingly have not satisfied NDP Leader Jagmeet Singh, who issued a statement on Wednesday stating he was disappointed that his confidence-and-supply deal partner didn’t reverse course on permitting provincial privatization plans.
“It’s good that the premiers and prime minister will meet in February… It’s the right thing to do because both levels of government have a role to play,” Singh said. “But, I join millions of Canadians who are incredibly disappointed and worried that the prime minister’s cabinet retreat ended with the Liberals standing in support of Conservative premiers‘ American-style, for-profit health care schemes.”
Even though work remains, the health-care funding talks appear to have come a long way from November, when an in-person meeting between federal Health Minister Jean-Yves Duclos and provincial health ministers ended in acrimony, with Duclos blaming the breakdown on the premiers telling their ministers to stop negotiating. Last Friday, Duclos said the two sides have been working “very hard and quite well” to get to this point.
Should Trudeau secure long-term funding deals with each province and territory, one of the outstanding questions would be whether they would be future-proof or if a future government at either level could tear them up. Asked earlier this week whether he’d want to renegotiate or commit to upholding federal-provincial health funding agreements, Conservative Leader Pierre Poilievre wouldn’t say.
Asked on Wednesday what role he sees for the private sector in providing care in Canada, Poilievre said “what matters” is seeing shorter wait times, more doctors and nurses, and faster approval of new drugs and treatments.
“Those are the priorities that I will set,” Poilievre said during a brief media availability on Parliament Hill.