The president of Canada’s nurses’ unions is urging Ottawa and the provinces to stop “squabbling” and to focus on finding practical solutions to the country’s health care crisis, including addressing a chronic shortage of nurses, when they meet early this week to discuss federal health transfers.
Linda Silas, president of the Canadian Federation of Nurses Unions, says provincial and federal ministers need to stop pointing fingers at one another over who is responsible for funding, and address pressing issues such as how to persuade scores of nurses who have left the profession during the COVID-19 pandemic to come back.
“It is very upsetting for nurses who are working short [staffed] every day to hear about all the squabbling. It is disappointing,” she said. “The key is to not let the politics of it all fail us – that’s the danger here.”
The crisis in health care is the backdrop for the federal-provincial meeting with hospitals overstretched across the country because of COVID-19, an alarming increase in pediatric admissions for respiratory syncytial virus (RSV), an early start to the flu season and chronic staff shortages. In an effort to make inroads on the staffing issue, the British Columbia government is increasing pay to family doctors as part of a package to recruit and retain general practitioners.
With the debate over federal funding of health care becoming increasingly acrimonious, Health Minister Jean-Yves Duclos is scheduled to meet his provincial counterparts on Monday and Tuesday in Vancouver, in the first in-person summit of federal, provincial and territorial ministers of health since 2018.
Some provincial governments have run radio ads accusing Ottawa of not pumping sufficient funds into Canada’s health care system.
Rose Zacharias, a family physician who is president of the Ontario Medical Association, said there are unprecedented numbers of doctors suffering from burnout and considering quitting the profession. She said there is currently a backlog of one million surgeries, including knee replacements and hernia operations, in Ontario.
“Part of the solution is the licensing of more internationally licensed physicians – physicians who have had their medical training,” she said, adding that the “roadblocked” system could be resolved with “practice-ready assessments” which could take weeks or months to complete.
In July, at a meeting in Victoria, provincial premiers renewed accusations that Ottawa is shortchanging them on health care.
They reiterated a demand that the federal government boost its cash contribution to 35 per cent of health care costs from 22 per cent, which would come with a $28-billion price tag.
British Columbia Health Minister Adrian Dix says the provincial and territorial ministers will be making a case to Mr. Duclos for further talks on more money.
“One would always be hopeful, but I am not optimistic,” Mr. Dix said in a weekend interview. “Will there be a breakthrough? That’s largely a decision the federal government will make.”
“This [meeting] is significant, first of all, because we’re getting together in the room, and spending time comparing notes, and I think there’s value in that,” he said.
Steve Buick, spokesperson for Alberta Health Minister Jason Copping, told The Globe and Mail on Friday that health transfers should be per capita with no strings attached.
“The federal government should focus on being a better, funding partner,” Mr. Buick said in a statement. “We do not need the federal government to tell us what our priorities are or how to address them.”
A spokesperson for Quebec Health Minister Christian Dubé said the meeting will be a chance to restate the province’s position, which has not changed in more than four years.
“If Ottawa really wants to support us, they will be able to do so by increasing federal health transfers, not by playing within our jurisdiction,” Antoine de la Durantaye said on Friday. “We want the federal government to increase transfers without conditions so that it can finance 35 per cent of health spending.”
The Canada Health Transfer (CHT) to the provinces is set to jump by 9 per cent next year – a $4.1-billion increase – driven by the fact that the current formula takes inflation into account.
The automatic boost will occur at a time when the Prime Minister is under mounting pressure from the premiers to to approve a major increase in funding.
Ottawa says it wants the funds to be used to address key issues in health care, and not handed over to provinces, some of which have financial surpluses, as a blank cheque to spend as they wish.
‘’Canadians expect that we continue our strong collaboration with provinces and territories in order to deliver solutions to challenges that our public health care system is facing right now,” said Emelyana Titarenko, a spokeswoman for Mr. Duclos.
She said the minister will use the Vancouver meeting to “further discuss how we can continue working together to address the health care worker crisis and improve access to family health services across Canada.”
Federal NDP health critic Don Davies urged Mr. Duclos and his counterparts to work to find practical solutions and to “get beyond the incessant loop where we are not making progress” on the Canada Health Transfer.
He said the Canadian health care system is in such acutely poor shape that they have an obligation to knuckle down to tackle issues such as the shortage of family doctors, and overstretched hospitals including emergency room shutdowns because of staff shortages.
Mr. Davies said Ottawa could make immediate progress toward easing the pressure on doctors and nurses by helping to set up a Canada-wide system to make it easier for foreign-qualified staff to practice in Canada, including by giving them more access to hospital residencies to complete their training.
The government of Newfoundland and Labrador plans to discuss with Mr. Duclos at the Vancouver meeting giving provinces and territories “the flexibility they need to recruit health care workers through immigration,” according to Tina Coffey a provincial government spokeswoman.
Aman Grewal, president of the B.C. Nurses’ Union, said there are many internationally trained nurses in the province unable to work there. She called for a cut in the number of bureaucratic “hoops” nurses who qualified outside Canada have to jump through.
Tracy Zambory, president of the Saskatchewan Union of Nurses, said the provinces and Mr. Duclos need to “clear the deck” at the meeting and create a “pan-Canada strategy” to address the “human-resources crisis” across the country, not just among nurses and doctors but auxiliary medical staff.
Janet Hazelton, Nova Scotia Nurses’ Union president, said there were around 22,000 nursing vacancies in the province.
Mr. Duclos has pushed back on the premiers’ call for a significant boost in funding, saying that they fail to take into account a 1977 deal in which Ottawa gave up some of its tax room so that provinces could increase taxes in order to raise more money for health care.
While the premiers say additional federal funding is desperately needed, Ottawa asserts that some provincial governments have surplus cash.
“The nub of the problem is there is a standoff between the two,” said Steven Staples of the Canadian Health Coalition. “We need to get through this standoff. There needs to be some compromise between the two positions.”