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Provinces should stop cutting taxes if they want more money for health care, Prime Minister Jean Chrétien said yesterday in dismissing urgent calls for federal action on the crisis in health-care funding.

"Most of the premiers find money to cut taxes. But they should put some of that money into their health care," a combative Mr. Chrétien said when asked whether he would respond to demands from provincial health ministers to increase federal health-care funding. This year's federal budget offered much more money for tax cuts than new spending.

Mr. Chrétien, in Cape Breton to make an announcement about a new call centre, spoke to reporters after federal and provincial ministers ended an acrimonious two-day meeting near Toronto with no resolution on funding.

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The provinces say health care is eating about 40 per cent of their budgets and they may have to force their citizens to pay for some medical procedures if they don't get some federal help.

Mr. Chrétien's tone was far less conciliatory than that of his Health Minister, Allan Rock, who says there will be more money for health care once Ottawa and the provinces can agree on a long-term plan to fix the system. After the meeting of federal and provincial ministers, Mr. Rock told reporters it was "useful" for the federal government to hear directly from the provinces why they need more money. But some of the provinces didn't seem to find the meeting all that useful. Led by Ontario, they called for an immediate meeting of premiers and the Prime Minister, saying that further talks with Mr. Rock would be of little use since he has no mandate to negotiate more funding.

"Since Mr. Rock has no mandate, it's important that the first ministers meet again with the Prime Minister," said Ontario Health Minister Elizabeth Witmer, whose government has been publicly attacking Ottawa over cuts to health-care funding. "I know the Prime Minister had a time line of the fall. I think we recognized today that that's not good enough.

"The time line needs to be now. The restoration [of funding levels]needs to be now. The reaffirmation to the Canada Health Act needs to be now," Ms. Witmer said.

Provincial health ministers also accused Ottawa of using them as pawns in the lead-up to the next federal election by stalling on any announcement of more funding until it's politically expedient.

"Politics always enters into these things. But it would be a mistake to hold off until a fall federal election or a spring federal election," B.C. Health Minister Mike Farnworth said. "The urgency of the situation means the provinces need help now."

Mr. Chrétien, however, said he didn't want to meet with the premiers until the provinces come up with a long-term plan.

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This is the second time in less than two weeks that the Prime Minister has adopted a much different tone than his health minister. Last week in Alberta, Mr. Chrétien was far more conciliatory about Alberta Premier Ralph Klein's controversial proposal for private hospitals than Mr. Rock had been.

Yesterday, he insisted the Liberals have restored health-care funding to 1993-1994 levels and have added $2-billion to boot.

More money would not solve the problems in the health-care system, he said.

"We have problems in health care. . . . We have to find new ways, and we have to talk, to work together. Just to ask for money is not the solution, it is a difficult problem. And I want to sit down and find new ways."

In 1995, the federal government made steep cuts to provincial transfer payments for health and education. Ottawa has since restored some of the funding and given the provinces one-time cash infusions.

But the provinces argue that health care is increasingly expensive, especially with an aging population and new drugs, and they want the government to increase transfer payments by $4.2-billion.

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Mr. Rock says Ottawa won't put up any new money unless it is tied to a plan to reform the health-care system and to an agreement on priorities.

"Why can't we combine additional money with a plan of shared objectives, a framework of common action for changes that are needed to makes ours a sustainable health-care system of the future, so we don't simply have to go back next year and the year after and talk about how many billions of more dollars are needed, without addressing the underlying issues?" he asked.

He said he and the provinces had agreed on a list of eight to 10 issues that were of common concern and which Ottawa and the provinces may be able to work on together. The list includes health human resources, technology, health information, primary care reform, home and continuing care and pharmaceuticals.

Mr. Rock has said repeatedly he is open to suggestions from the provinces and does not want to "micromanage" the way provinces deliver health-care services.

Saskatchewan and British Columbia indicated a willingness to discuss Mr. Rock's plans. But the talks between Mr. Rock and the provinces did not progress far enough to assign government officials to begin working on the list and actually put together a framework agreement.

The federal minister said he wants to meet with his provincial counterparts again in May and as many times as it takes to forge a national strategy to present to the Prime Minister some time in June.

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But the provinces were non-committal yesterday, saying they would have to check with their premiers to see whether it was worth talking to Mr. Rock again.

Meanwhile, they expect Mr. Rock to push hard at the federal cabinet level for more funding immediately.

"We expect Mr. Rock to fight like hell for our interests at the cabinet table," said Mr. Farnworth, the B.C. Health Minister.

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