Canada’s provinces and territories have rejected a proposed increase in federal health care funding, in part because Ottawa tied the offer to the creation of national human resources and data collection programs.
The impasse emerged at a meeting of Canadian health ministers in Vancouver on Tuesday, impeding progress on co-operation between governments at a time when health care services across the country are in crisis because of understaffing, continuing waves of COVID-19 infections and other problems.
Federal Health Minister Jean-Yves Duclos had said on Monday that Ottawa was prepared to increase health care funding to provinces by an unspecified amount if they committed to a national health data system as an accountability measure. Tuesday’s agenda included two “decision items” that ministers were asked to approve: a pan-Canadian health-human-resources action plan, and a pan-Canadian health data strategy.
But at midday, with meetings still under way, Canada’s premiers issued a joint statement to say no progress had been made with the federal government. In response, Mr. Duclos backed out of a joint news conference and refused to sign a joint communiqué.
At the meeting’s conclusion, Mr. Duclos told reporters the federal, provincial and territorial governments had worked collaboratively on the two items for months, and that his counterparts had voiced no specific objections until just days earlier, when they received “marching orders by their premiers not to make further progress.”
“Premiers are forcing my colleagues to speak only of one thing and one thing only: money,” Mr. Duclos said.
“All that premiers keep saying is that they want an unconditional increase in the Canada Health Transfer sent to their health ministers,” he added, referring to the program that accounts for the largest share of federal health funding for lower governments. “That is not a plan; that is the old way of doing things.”
“If there was anyone still doubting it, the current crisis is the undeniable proof that the old way doesn’t work. We need to do things differently.”
British Columbia Health Minister and meeting co-chair Adrian Dix told a news conference Mr. Duclos’ offer had moved the parties “a sound bite further ahead,” but that demands from provinces and territories for increased health care funding had not been met.
“We are making progress on important files. But this question of the Canada Health Transfer is foundational,” Mr. Dix said. He called for Prime Minister Justin Trudeau to meet with premiers on the matter.
At a news conference on Tuesday, Mr. Trudeau took issue with what he described as provincial governments engineering tax breaks while claiming to need more federal money for health care. He was speaking in New Brunswick, which has announced plans to cut tax rates for residents who earn more than $45,000 a year in taxable income.
The Prime Minister said Canadians need to ask questions when their provincial governments demand more federal health care money “while, at the same time, they turn around and give tax breaks to the wealthiest.”
“We are going to be there with more money, but we are going to make sure that money actually delivers the kinds of results that people here in New Brunswick and across the country actually deserve,” he said.
The premiers have argued repeatedly in the past that health care funding began as a 50-50 split between the federal government and the provinces and territories, but that Ottawa’s share has dwindled to 22 per cent. They are asking for an increase to 33 per cent, or an additional $28-billion in funding a year, without conditions.
The federal government has countered by arguing 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.
Several organizations, including the Canadian Medical Association, have been calling for the federal government to include pan-national licensure as part of the health-human-resources aspect of its proposal. Such a change would eliminate the need for physicians to seek new licenses when they move between provinces, allowing them to work where they want and are most needed.
“I live in northern Alberta, and I’m 2.5 hours away from Fort St. John,” said CMA president Alika Lafontaine. “I would love to go there for a couple days with a group of surgeons in order to provide care to B.C. patients, but I don’t, because it’s going to take me nine to 12 months to register for a B.C. licence, and this is despite me practising for more than 10 years.”
He added that several issues in Canadian health care are interrelated, and that action on one component would spur action on others.
“If we change one thing, we actually change everything,” he said. “If we figure out pan-national licensure, for example, we open up the opportunity for providers who are in short supply to provide virtual care across the country.”
With a report from Ian Bailey