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Why Canada’s new health minister needs to speak up

Rona Ambrose is the Health Minister.

DAVE CHAN/The Globe and Mail

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There is a new federal health minister. In case you missed it, Rona Ambrose was appointed to this once-important cabinet position in the July 15 cabinet shuffle.

Since then she has, well, issued a press release on World Hepatitis Day.

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There have been no funding announcements, no speeches, never mind using the position as a bully pulpit for promoting what is presumably Canada's most beloved social program, medicare.

But, hey, Ms. Ambrose is simply doing her job.

In a government that believes health care is strictly a provincial responsibility, health has become a de facto junior cabinet post.

The federal health minister is expected to keep a low profile, and the lower the better. So far, Ms. Ambrose has verily mastered the art of invisibility.

But, no matter how hard she tries, it may be difficult to continue doing so.

After all, the 2004 Health Accord, a 10-year deal that established annual transfers from Ottawa to the provinces, expires soon. Ottawa has so far refused to negotiate terms of renewal, preferring instead to table a take-it-or-leave it offer, albeit a generous one. The current transfer, $30.3-billion this year, will increase by 6 per cent a year until 2017, then rise by a minimum of 3 per cent per annum afterwards.

The Minister of Health doesn't have much real say in these financial matters, but she will be a target for the ire of her provincial counterparts as the accord expiry date expires.

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Despite the rhetoric about health-care delivery being strictly a provincial matter, the reality is that Ottawa has a constitutional responsibility to provide health services to First Nations, Inuit and Métis peoples, along with the Canadian Armed Forces and the Royal Canadian Mounted Police. As such, it operates the country's fifth largest health system.

Ottawa is responsible as well for a health promotion and safety of consumer products, including drugs. Not to mention that the position of Chief Public Health Officer of Canada has been vacant for months now, and one of the minister's top priorities should be to appoint Canada's top doc.

The federal government also has a legislative mandate to ensure that there is a modicum of a national health system. And while the government of Stephen Harper likes to pretend the Canada Health Act does not exist, it is still on the books. Like it or not, Ottawa's role in health care extends well beyond grudgingly writing cheques to the provinces.

All this to say, Ms. Ambrose has a lot of work on her plate and it is unfortunate that, by all appearances, she is in no hurry to get to it. (Or more precisely, her political masters in the Prime Minister's Office are in no hurry to unshackle her.)

Moreover, Ms. Ambrose brings some baggage with her. She did not exactly distinguish herself in her prior cabinet roles, which included stints in environment, intergovernmental affairs, labour, western economic diversification and status of women. But, again, the role of ministers in the current government is to toe the party line and keep your head down.

Ms. Ambrose made waves only once when, as the minister responsible for the status of women, she voted for a motion that called for study of the legal rights of the fetus. Widely seen as a back-door attempt to restrict access to abortion, this motion raised the ire of many health professionals.

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On the flip side, Ms. Ambrose championed some interesting health initiatives before becoming Health Minister, notably the Women's Brain Health Initiative and the Medical Isotope and Cyclotron Facility at the University of Alberta.

But funding announcements are the easy part of the job. The difficult (yet essential) role of a federal health minister is to bring life to the philosophy of medicare – which, for those in Ottawa who have forgotten, is to ensure access to essential health care for all regardless of ability to pay. Her role should be to talk passionately and eloquently about the importance of keeping Canadians healthy, and champion measures that can and should be taken by government(s) to attain that goal.

You can't do so when you're silent and invisible.

André Picard is The Globe and Mail's health columnist.

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