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Saskatchewan Premier Brad Wall poses for a portrait following an interview at the Inn at Laurel Point in Victoria, B.C., Jan. 17,2012.

Chad Hipolito/chad hipolito The Globe and Mail

Canada's premiers are joining forces to reform the delivery of health-care services, in a bid to rein in ballooning costs and better meet the needs of an aging population.

The initiative marks the first time the country's provincial and territorial leaders are collaborating on a pan-Canadian health-care strategy. It comes in the wake of the federal government's no-strings funding formula for health care, one that leaves it up to the provinces to shape social policy.

Saskatchewan Premier Brad Wall and Prince Edward Island Premier Robert Ghiz will lead a two-day meeting of provincial and territorial health ministers beginning Thursday evening in Toronto. As co-chairs of a working group on health-care innovation, Mr. Wall and Mr. Ghiz will look at everything from how many doctors and nurses should graduate each year to adopting the best clinical practices across Canada.

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It's an ambitious agenda for a country where the provinces have autonomy over health care and where premiers are not used to co-operating on developing social policies. But with health-care costs consuming a growing chunk of program spending in every region, the premiers are under pressure to tackle reforms as a group.

"These are changes we can make immediately to provide better care, and hopefully in the long term bend that cost curve a bit and make it more sustainable," Mr. Wall said in an interview.

The premiers set up the working group at a meeting last January, following Prime Minister Stephen Harper's signal that Ottawa will no longer play a key role in shaping national social policy. His government unveiled a 10-year federal plan for health-care funding last December, but did not stipulate how the provinces should spend the money.

The working group is following an earlier model used by the premiers to remove internal trade barriers between the provinces and promote labour mobility. The group is also relying on health-care professionals, including the Canadian Medical Association and the Canadian Nurses Association, to help shape its recommendations. The initiative takes the premiers into unchartered waters, but they are filling a void left by the federal government, said CMA president John Haggie.

"The CMA really do feel the feds have walked away here and abandoned health, and it's the premiers who have opted to try and step up and provide a national framework," Dr. Haggie said.

Mr. Ghiz of PEI acknowledged that the working group has a "tall order for a country with 13 distinct health-care systems." But the goal, he said, is to learn from other provinces and deliver similar care regardless of where a patient lives.

The working group is focusing on such areas as making greater use of nurse practitioners. Policy makers believe nurse practitioners can improve access to care and reduce costs by doing work that was once done solely by physicians. These practitioners are registered nurses with additional training that allows them to diagnose patients and prescribe some medications.

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The group is also looking at speeding up the development and adoption of the best clinical and surgical guidelines so that all Canadians benefit from up-to-date practices.

Mr. Wall and Mr. Ghiz plan to submit a report to their provincial colleagues at the premiers' annual meeting in July.

Ontario Health Minister Deb Matthews said she is looking forward to learning more about how other provinces deliver health-care services.

"If we can do it in a way that improves quality and at lower cost then we're all ears," she said in an interview.

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