The federal Conservative government will stop funding the council created to ensure common standards for health-care across provinces and territories – a move that critics say will fragment the national system of medicare.
The Health Council of Canada was established in 2004 at the recommendation of former Saskatchewan premier Roy Romanow in his sweeping report on the sustainability of the Canadian health-care system. One of its jobs was to monitor the nine-year-old accord governing health transfers from Ottawa to the provinces and territories. Because that accord expires next year, the Harper government has told the council its work will no be longer required.
“Largely its mandate was related to reporting around the existing health accord,” said Steve Outhouse, a spokesman for federal Health Minister Leona Aglukkaq. “It is a time of fiscal restraint, so, with the current health accord coming up for expiry, it’s a natural time to wind down the organization, or wind down federal funding for it.”
The government will invest more money into the Canadian Institute for Health Information, which reports on the health-care system, Mr. Outhouse said. But it has been clear that health care is the jurisdiction of the provinces, he said.
By cutting off the council’s funding, the government will save about $6-million annually. The council’s chief executive officer, John Abbott, said there is enough money to keep operating until the end of March next year.
Mr. Romanow said he is sad but not surprised to learn about the council’s dismantlement, which he labelled a “retrograde” measure. The council is an agent of interprovincial and intergovernmental collaboration and discussion, he said, “and it is absolutely necessary if we are to move forward as a nation with roughly the same kinds of expectations and reformed outcomes of health care that we so desperately needed then and really need now. So that is a really big blow to me.”
Mr. Romanow said the decision speaks to the Harper government’s move away from co-operative federalism to a system in which the role of the federal government is distinct from that of the provinces and territories. But “health care is something that falls squarely within both [levels of government], both through funding and through standards and the like,” he said.
Michael McBane, the national co-ordinator of the Canadian Health Coalition, an advocacy group for public health care, said the closure of the health council was “shocking” because it implies the government does not intend to negotiate a new health-care accord to replace the one that expires next year.
The role of the accord is to maintain national standards and a national co-ordinated approach to health care, Mr. McBane said.
“Without that you will fragment into 14 pieces,” he said. “There is no province in Canada that can, or can ever be expected to, play the role of the federal government. So it leads to the serious fragmentation of the system and it will basically be the end of national medicare.”
Raisa Deber, who teaches Canadian health policy at the University of Toronto, said she believes the health council has been “quite effective” and has helped provinces and territories save money by trading ideas about best practices.
“There is sometimes an advantage in having each province not having to reinvent the wheel,” Dr. Deber said. The council “was never set up to run a system. It was set up to encourage information sharing. So you would think it would be an advantage, if one province has figured out an effective way to manage things, to have the ability to share that information with the other provinces.”
Even without a new health accord, the Harper government has said it will continue to increase the money it transfers to the provinces and territories for health care by 6 per cent annually until 2016-17. After that, it will tie the increases to the expansion of the economy, with a promise that they will never fall below 3 per cent.