A gathering of Canada’s premiers centred on health care funding has concluded with no resolution, only traded jabs between provinces and Ottawa over hypothetical, conditional investments.
At Tuesday’s Council of the Federation meeting, the provincial and territorial leaders accused the federal government of not paying its fair share of health care costs, creating a national crisis in the sector that has been characterized by growing wait times, crowded hospitals and shuttered emergency departments.
Meanwhile, Ottawa has countered that it would only increase its share of funding if jurisdictions maintained and increased their own, and that Canadians would need accountability in how that money is spent.
B.C. Premier and COF Chair John Horgan said that the federal government is “creating a problem that doesn’t exist,” and that provinces and territories are accountable every day through their legislatures.
“I think it’s a cop-out and it’s a mechanism to divert attention,” Mr. Horgan said. “It all goes into a pot and it all comes out for the services Canadians need. That’s our jurisdiction.”
But several provinces have previously faced the scrutiny of their auditor-generals on the issue of financial accountability. Last month, Alberta Auditor-General Doug Wylie issued a scathing report saying that, owing to poor reporting practices, it was unclear what billions of dollars meant for COVID-19 strategies and programs actually achieved. This included $1.3-billion in federal funding through the Safe Restart Agreement “to help protect public health and safety, prepare for potential future waves of the virus, and further support the safe reopening of economies across Canada.”
“We could not trace funds through to the recipient ministry results analysis sections to see who spent the money and what was achieved,” Mr. Wylie’s report says.
In Ontario, Auditor-General Bonnie Lysyk determined the provincial government distributed $210-million in COVID-19 relief to 14,500 ineligible small businesses and made no attempt to get it back. In a 2021 report, Ms. Lysyk said the grant program lacked a number of basic controls including a system to track how much money each business received. Some businesses that needed help were missed, and others gained more from the program than they lost in revenue.
Only small businesses with fewer than 100 employees forced to shut down due as a COVID-19 measure in December, 2020 and suffered a revenue decline of more than 20 per cent were supposed to be eligible for the program that offered two payments between $10,000 and $20,000.
At the time of the report, Premier Doug Ford said the goal was to get money out the door as quickly as possible to support struggling businesses.
Similarly, Quebec’s Auditor-General, Guylaine Leclerc, found the provincial government delivered $68-million worth of emergency loans to businesses that didn’t meet the criteria.
Asked by The Globe and Mail about these examples, Mr. Horgan said the federal government has no authority such issues.
“The federal government is not a superior order of government, it’s not a better order of government, it’s an equal order of government. We’ll take no lessons from the federal government in fiscal probity,” he said. “I think there was an issue or two over time that auditor-generals in Ottawa have highlighted, or the parliamentary budget officer has suggested, were grotesque or egregious expenditures.”
Alberta Premier Jason Kenney said every dime his province spent on “extraordinary investments” during the pandemic was for public health.
“Our focus was just responding in real time to the emergency, and not clearing through mountains of paperwork,” he said. “There’s no doubt about it, we cut the normal corners on procurement.”
The premiers say that health care funding began as a 50-50 split between the federal government and provinces and territories, with Ottawa’s share dwindling to 22 per cent. Provinces now find themselves in a human-resources crisis in health care, exacerbated by the pandemic, that has led to crowded hospitals, growing wait times in some emergency departments and the temporary closure of others, significant challenges in accessing family doctors, and soaring rates of self-reported burnout and worsening mental health among workers.
The federal government disputes the characterization of the cost split, saying that when the transfer of tax points is 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.
As governments continue their negotiations, health systems across Canada continue to buckle. Recent data from the Ontario Hospital Association highlights 900 patients were in hospital waiting for home care as of June, a record high for the past five years. A total of 5,587 patients in hospital at the end of May were in line for an alternate level of care.
Association president and CEO Anthony Dale said ambulance offload times in May were at a 12-year high. The average stay in an emergency room for those waiting to be admitted was 20.1 hours, the highest in 14 years, aside from January of this year during the peak of the Omicron wave. Only 24 per cent of patients were admitted to hospital within the target timeframe of eight hours.
“While Ontario hospitals are currently reporting significantly higher than usual wait times in emergency departments across the province … hospitals will always be here to care for the communities they serve no matter the circumstance,” Mr. Dale said in a Monday statement.
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