Canada’s premiers met Monday in Victoria to present a united voice in demanding an increase in recurrent health care funding from Ottawa to address a staffing crisis that has forced the temporary closing of emergency departments, led to record levels of worker burnout and created obstacles for Canadians accessing health services.
Quebec Premier François Legault said provinces spend roughly $200-billion a year on health services, with the federal government footing about $40-billion (or 22 per cent) of that in Canada Health Transfer payments. The premiers have for years called on Ottawa to increase that to 35 per cent.
“It’s important that they share more than 22 per cent because health is the only expense growing at a rate of 5 to 6 per cent a year, because of aging and the impact of new technologies,” Mr. Legault told reporters Monday heading into the two-day meeting. “We cannot afford to continue like we’re doing right now.”
Canada’s 13 provincial and territorial premiers are members of the Council of the Federation (COF), established in 2003 to promote interprovincial-territorial co-operation. This week’s meeting is the first in-person gathering since 2019.
Health leaders have described provincial health care systems as being in crisis. Staffing shortages in British Columbia, Alberta and Ontario have led to hours-long wait times and pushed emergency departments to capacity, with some being forced to close because of a lack of staff. Six emergency departments in rural, southwestern parts of Ontario experienced temporary closings over the weekend with some extending into this week.
B.C. Premier and COF chair John Horgan said one-time injections of cash are insufficient to resolve these issues because they don’t allow for long-term planning.
“We need sustainable, predictable funding from Ottawa so we can build out our budgets, make commitments to health care professionals about how we’re going to meet their needs, and most importantly, offering service to patients that expect nothing less than our best,” he said.
Mr. Horgan said the premiers will also be discussing the barriers to getting more internationally trained health care workers credentialed to work in Canada, and the issue of interprovincial staffing challenges.
“The notion of poaching is part and parcel of what we’ll be discussing today,” he said. “We have a national challenge when it comes to recruiting and retaining skilled health care workers, whether it’s nurse practitioners, doctors, surgeons, general practitioners.”
A statement from the office of Health Minister Jean-Yves Duclos said that Ottawa has invested more than $72-billion into health since the beginning of the COVID-19 pandemic, in addition to $3-billion each for three other investments: bilateral agreements on long-term care, mental health and home care.
Some premiers have argued that health care funding began as a 50-50 cost split, with the federal government’s share shrinking over the years. However, a change in 1997, agreed upon by provinces, replaced the federal government’s share with a mix of cash and tax points transferred from the federal government to the provinces.
The federal government says that when the value of those tax points are taken into account, the share of provincial and territorial spending covered by the Canada Health Transfer averages 33 per cent today, which is similar to the historical average.
Katharine Smart, president of the Canadian Medical Association, said years of poor planning led to the crumbling of the health care system, and that governments now seem in a state of inertia.
“This is years of lack of political will to recognize we have a health system that was designed in the 1960s and has been failing for years, with no one wanting to take action,” she said.
“Let’s stop with the finger pointing and winning the political points. Even just a willingness to move away from the politics and more to the action-oriented, and solution-oriented, would go a long way.”
Canadian Association of Emergency Physicians president Michael Howlett said the issues facing health care systems across the country have been amplified by the pandemic and created a “perfect storm” leading to the crisis in emergency departments.
Crowding combined with a decreasing work force and lack of resources have led to record-high hospital occupancy and significant wait times, Dr. Howlett said in an interview with The Globe and Mail on Monday. An increasing number of people in hospital waiting for community care has led to a backlog in the system for both people needing beds and more nurses to care for them.
“We’re losing a lot of staff because of these inherent pressures related to crowding. So crowding coupled with decreased staff means a spiral where we have increasing needs because of the elderly population, we have fewer staff to take care of them and fewer hospital resources as well and no way of getting them out into the community,” Dr. Howlett said.
In Quebec, paramedics across 40 ambulance services have been on strike since Canada Day, calling for salary and retirement conditions comparable with other health care workers in the province after significant burnout during the COVID-19 pandemic. Emergency care will still be provided under the province’s essential services law and the strike will see paramedics limit some non-urgent services and stop doing some other tasks, such as completing billing forms.
Alberta’s health care system is also facing staffing shortages and some rural facilities have been hit with temporary emergency room closings amid a sharp increase in patients. In an effort to address pressures on paramedics, the province recently added nine ambulances in the major cities of Calgary and Edmonton to reduce demand on the existing fleet.
With a report from The Canadian Press.
Our Morning Update and Evening Update newsletters are written by Globe editors, giving you a concise summary of the day’s most important headlines. Sign up today.