HAMILTON — Prime Minister Justin Trudeau is downplaying the prospects of signing a final health-care funding deal with the provinces at a high-stakes first ministers’ meeting he is convening in Ottawa on Feb. 7.
On Wednesday, Trudeau cast the long-awaited health summit with provincial and territorial leaders as a working meeting, not one that will simply be called to “celebrate” a predetermined outcome after more than a year of talks, during which the premiers have demanded an extra $28 billion in health-care funding from Ottawa.
“We’re not going to be signing deals on that particular moment,” Trudeau said. “It’ll be about starting the very direct hard work of the bilateral arrangements that will happen with every province, while at the same time we move forward with a frame around data and health information and results that I think every Canadian wants to see. ”
Governments often manage expectations by under-promising results. However, there have been months of intense negotiations behind the scenes, and several provincial and federal sources have suggested a deal is very close. Trudeau has refused to sit down with the premiers until now, leaving them to publicly complain that he refuses to meet.
As a three-day federal cabinet retreat wound down, Trudeau declined to specify the amount of money he would offer, saying only that his government will propose “an appropriate amount” when he meets the premiers.
“It’s not just about money, although of course, money is part of it,” said Trudeau, with his cabinet standing behind him on risers for a morning news conference at a university machine research lab working on electric vehicle research.
Trudeau said, as the Star reported last week, that the federal government is looking to focus on results and offer a “combination” or hybrid solution to the health-care funding gaps.
It will offer predictable increases over the long-term for federal health transfer payments, and additional billions via separate bilateral agreements with provinces that agree to spend the money on “shared” priorities like recruiting and hiring more doctors and nurses or improving mental health and long -term-care services. Health Minister Jean-Yves Duclos suggested there would be a third funding component tied to national data collection and sharing.
But neither Trudeau nor Duclos would specify whether Ottawa would offer 10-year funding deals — as in the past — or look at a shorter period of guaranteed federal funding. Intergovernmental Affairs Minister Dominic LeBlanc said he and the prime minister recognize the premier would like agreements that stretch beyond five years to allow for predictable budget planning.
The provinces have demanded billions more.
Premiers want Ottawa to increase its share of health-care funding from what they say is now 22 per cent to 35 per cent — meaning an extra $28 billion a year from Ottawa via the Canada Health Transfer. The federal government has currently budgeted this year’s health transfer at $45 billion. It’s an amount that rises along with economic growth, but sets a minimum annual increase of three per cent.
Duclos said that transfer rose five per cent last year, and this March is set to rise another 10 per cent to $49 billion before any further deals are struck.
The federal government argues its share of health-care spending is actually about a third, because it has transferred taxation powers to the provinces to increase their ability to collect and direct money to health care. Trudeau has repeatedly said the federal government contributed $72 billion to provinces to boost health services during the pandemic.
Still, with inflation running well over three per cent, an aging population and rising health-care costs in a system strained by the pandemic, pressure has grown on all levels of government to spend more money.
Until recently, provincial leaders have publicly bristled at the notion of Ottawa attaching conditions to increases in health-care funding, maintaining a common front that only provinces should decide how the money should be spent in their jurisdictions.
However, some premiers have recently noted that the provinces share many of the federal government’s priorities when it comes to reducing surgical and emergency room backlogs, as well as improving mental health services and long-term care for seniors. Two weeks ago, Premier Doug Ford said he could “live with” some conditions on funding, saying it all comes from one taxpayer, while Quebec Premier François Legault acknowledged Ottawa’s demand for national data collection and said he was willing to share what Quebec already gathers . Saskatchewan’s Scott Moe has also downplayed the idea of Ottawa setting conditions, saying “’strings attached’ is not the term I would use.”
On Wednesday, Ford tweeted in response to Trudeau’s announcement. “We have a lot to discuss, including making sure the federal government properly funds the health care people rely on,” he wrote. “When Team Canada works together, there’s nothing we can’t do.”
Trudeau said improvements in health-care delivery are needed right across the country, “including timely access to family doctors no matter where you live, a strong and sustainable health workforce, access in a timely fashion to better mental health care and access to digital health information that follows them to any health professional they see.”
He said his meeting with the premiers would focus on immediate concerns, but also how to “build a system that Canadians are going to be able to rely on to deliver outcomes and results for them for years to come.”
Trudeau said there needs to be “harmonization” on how health data is collected and shared. “We don’t think applying a one-size-fits-all across the country is the best way to do it,” he added, “but there will be elements of what we’re working on that will be an agreement with the entire country.”
NDP Leader Jagmeet Singh, whose party’s support is propping up the Liberal minority in Parliament, welcomed news of a first ministers’ meeting, saying both levels of government have a responsibility to improve health care.
“If a funding agreement with the provinces does not permanently add thousands and thousands more nurses, doctors and other health-care workers, it will fail Canadians,” he said. “The only thing that will solve the health-care crisis is more health-care workers.”
Singh criticized what he said was a failure of the Trudeau government to condemn the Ford government’s decision to outsource some surgeries to private clinics.
He said he was “incredibly disappointed and worried that the prime minister’s cabinet retreat ended with the Liberals standing in support of Conservative premiers’ American-style, for-profit health-care schemes.”
Conservative Leader Pierre Poilievre, speaking to reporters on Parliament Hill, refused to say whether he would support more of a role for the private sector in health care, or whether he’d meet the provinces’ demand to increase federal health transfers by $28 billion. He said only his three priorities are to reduce wait times, to hire more doctors and nurses by recognizing the credentials of immigrant health-care workers, and to accelerate approvals of medicines already approved in the US and Europe.
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