OTTAWA-
Federal and provincial governments appear to be at an impasse in their negotiations over the future of health care in Canada, and Prime Minister Justin Trudeau’s latest comments suggest he won’t be the first to blink.
In a year-end interview with The Canadian Press on Monday, Trudeau said he was unwilling to speed up health-care reform, even as premiers push for more federal funds to bolster their health care systems. struggling health.
“It wouldn’t be the right thing to do to just throw more money at the problem and sit back and watch the problem go unsolved because we didn’t use that moment to say, ‘No, no, no, it’s time to improve the system, ”said Trudeau.
The standoff occurs as children’s hospitals across the country are inundated with children suffering from respiratory illnesses. In some cases, hospitals have been overwhelmed by the calamitous combination of record numbers of sick patients and extremely low numbers of staff to care for them.
The problem dates back more than a year ago, when provinces first requested a meeting with the Prime Minister to discuss long-term, sustainable funding increases after pandemic pressure left them with large backlogs and an exhausted workforce.
They want to see Ottawa cover 35 per cent of health care costs across the country, up from 22 per cent currently, by increasing the Canada Health Transfer.
Trudeau told them those talks would have to wait until after the pandemic, but dedicated $2 billion in one-time funding to ride them out during the Omicron wave.
Now the Prime Minister says the system needs to be reformed and that he will not give the money away unless the provinces commit to change.
“Canadians are right to look at all levels of government and say, ‘This is terrible. You really have to fix this,'” Trudeau said.
Reform is already underway in most provinces, but the federal government does not yet seem willing to join them at the table, British Columbia Health Minister Adrian Dix said in an interview on Tuesday.
His province has embarked on primary care reform, making room for more nurses and signing new collective agreements with health care workers, all while facing an extraordinary increase in demand for services, he said. declared. And Trudeau praised many of the recent changes that British Columbia has undertaken.
“I think the federal government would want to be a part of that and contribute its bit, and that’s what we’re asking for,” Dix said.
Health Minister Jean-Yves Duclos made an overture to the provinces last month, offering an increase in the federal health transfer in exchange for better data sharing across the country.
But the meeting ended with no progress. Dix said Duclos came to the table without any specifics and conversations about the health transfer remained elusive with the Liberals.
“It’s always a new moving excuse, a new line in the sand receding after the rising tide,” he said.
Imposing performance measures on provinces that affect their access to the Canada Health Transfer is more or less unheard of, said Haizhen Mou, a University of Saskatchewan professor who studies health policy.
It’s understandable that provincial leaders don’t want to change that precedent, she said in an interview Tuesday.
“I don’t think the federal government has the right to impose performance indicators like this on the broad type of health transfer,” she said, but added that she understands why the Liberals don’t want to. not continue to invest in a system that is not working.
A more politically acceptable situation might be to offer targeted funds for specific priorities and sign individual agreements with each province, she said, rather than treating them all the same.
It’s what Paul Martin’s government did in 2005 to reduce wait times, and what Trudeau did in 2016 to fund mental health and home care services in similar circumstances.
In 2016, the provinces were united as they pushed for an unconditional increase in the health transfer, “but in the end they went their separate ways, the alliance broke up,” Mou said.
That year, the government first signed a bilateral agreement with New Brunswick and other provinces, then followed suit individually. Mou said she thinks it’s only a matter of time before it happens again.
“I don’t know how long they can hold out, because the revenue, the power of fiscal capacity, is still in the hands of the federal government,” she said.
Health care advocates, including nurses and doctors associations, have echoed Trudeau’s call for a plan to transform Canada’s broken system, and to do it quickly.
“Patient care is suffering while working conditions for nurses and other health care workers deteriorate,” Canadian Federation of Nurses Union President Linda Silas said after the end of the talks between health ministers last month.
“It is absolutely essential that we put politics aside and enter into productive discussions around concrete solutions to the health workforce crisis.”
Dix said that couldn’t happen until the prime minister was ready to come to the table for an open discussion. He said Trudeau did not commit to it.
Trudeau tends to speak often to health care premiers individually, and his ministers also work bilaterally with their provincial and territorial counterparts.
When asked on Monday how he plans to get the negotiations started if he doesn’t sit down with the premiers as a group, Trudeau seemed to suggest that it’s up to provincial and territorial leaders to take the step. next.
“We are very willing to invest much more in health care, but there must be clear commitments and results that will make a difference for Canadians,” he said.
For now, each side seems to believe that the ball is in the other’s court.
This report from The Canadian Press was first published on December 13, 2022.
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