Health Minister Jane Philpott is hinting that provinces won't get a promised $3-billion infusion of health care funding in the coming federal budget unless they commit to spend it on home care.
The federal minister said Tuesday she wants that money to be in the Trudeau government's second budget early next year.
But she tied the budget to her upcoming negotiations with her provincial counterparts on a new health accord.
"I'm saying I've got money on the table and there has been no firm decision in terms of how that's going to be divided up, how it's going to be spent, what Canadians are going to get for that money," Philpott said.
"So those are things that it would be really good to talk about, because I want that $3-billion for home care to be in the 2017 budget, but I have a responsibility to Canadians to hear what we're going to get for those further investments."
Asked if the money won't be in the budget if the provinces don't commit to spend it on the priorities identified by the federal government, Philpott did not answer directly.
"I am pretty determined to make sure that's in the budget, but again ... $3-billion is not an insignificant amount of money. What's the most fair way to divide that money? What can Canadians expect for that money?"
Philpott's veiled warning comes on the heels of Prime Minister Justin Trudeau's willingness to play hardball with the premiers on climate change.
Trudeau announced Monday that the federal government will unilaterally impose a floor price on carbon pollution – $10 a tonne starting in 2018 and rising to $50 a tonne by 2022 – in any province or territory that doesn't impose its own carbon price or set up a cap-and-trade system. The revenue would be returned to the province in which it was generated.
The announcement was blasted by Saskatchewan Premier Brad Wall and prompted environment ministers from three provinces to storm out of a meeting with federal counterpart Catherine McKenna, where they were supposed to be negotiating a pan-Canadian climate deal.
Trudeau is poised to rile even more provinces over health-care funding.
Premiers are seeking a first ministers' meeting with Trudeau to push their demand that federal health transfers to the provinces continue to rise by an automatic six per cent each year, as has been the case since Ottawa agreed to a 10-year health accord in 2004.
Trudeau has so far not said yes to a meeting and has indicated that his government intends to stick with the unilateral decision of the previous Harper government to limit annual increases in health transfers to a maximum of three per cent, starting next year.
Philpott, who is scheduled to meet her provincial counterparts on Oct. 18, said transfer payments are a matter for finance ministers. As far as she's concerned, negotiations on a new health accord will focus on the separate $3-billion over four years that Trudeau promised "as an immediate commitment" during last fall's election to bolster home care, including palliative care – money that did not materialize in the Liberal government's inaugural budget.
She has added mental-health services, affordable prescription drugs, innovation and indigenous health to the list of federal priorities on which to spend that money.
Some provinces, particularly Quebec, strenuously object to the notion of federal conditions on how they spend health-care funds. And none are likely to enthusiastically embrace Philpott's priorities as long as the federal government refuses to reconsider scrapping the six-per-cent annual increase in transfer payments.
Asked Tuesday if there's any wiggle room for increasing health transfers by more than three per cent, Finance Minister Bill Morneau said the Liberals promised "very clearly" that three per cent "is the place where we should be at."
"We also gave some specific initiatives that we know are important – home care, we talked about the issue around how we buy pharmaceuticals, mental health, palliative care," he added.
"So we'll be working together with the provinces to get to an answer that will make a real difference for Canadians over the long term."