The provinces want an increase from 22 per cent to 35 per cent of health-care costs. The feds are not likely to match the demand, but will certainly come close. But the most important element of the agreement is the fine print on the five priorities that the federal government has established.
By Sheila Copps
First published in The Hill Times on January 30, 2023.
OTTAWA—The first ministers’ upcoming health-care meeting will be trumpeted as the solution for Canada’s broken health-care system.
While it is certainly a start, the patient benefits may not be felt for years.
The first part of the agreement involves money. The provinces will get more, but it won’t be as much as they asked for.
All premiers are making positive noises.
Even Saskatchewan’s Scott Moe, who can usually be called on to trash the prime minister on command, has been publicly promoting the potential agreement.
New monies will start flowing immediately. But the heavy lifting on this agreement is likely going to take years to accomplish.
Health Minister Jean-Yves Duclos has made it very clear that the increase in transfers will come with conditions.
The provinces want an increase from 22 per cent to 35 per cent of health-care costs, for a whopping transfer hike of $28-billion.
The feds are not likely to match the demand, but will certainly come close. A 10 per cent hike had already been planned in the previous transfer agreement with the provinces.
The parties will probably split the difference.
But the most important element of the agreement is the fine print on the five priorities that the federal government has established.
Those priorities include reduction of surgery waiting times, enhancement of access to primary care, national data-sharing and virtual care, long-term care improvements and more mental health services.
The list is not lengthy, but it certainly is meaty.
Millions of Canadians do not even currently have a family doctor, so when mention is made of enhancing access, that includes tackling the issue of getting foreign-educated immigrant health-care workers’ credentials officially recognized.
Ontario Premier Doug Ford has been running a campaign to poach health-care workers from other provinces with bonuses and quick accreditation.
But simply shifting health-care professionals from one province to another does not remedy the problem.
That is why we need a national approach. One of the critical pieces is recruiting nurses, doctors and other health care professionals from other countries as quickly as possible.
That means the country needs to get serious about fixing foreign accreditation issues.
When I was a provincial member of parliament in Ontario, I was promoting the issue of officially recognizing the credentials of foreign-educated immigrants back in 1982. That was more than 40 years ago and the problem still has not been adequately addressed.
At the time, the head of the Ontario Medical Association told me in a private meeting that his organization could not support foreign credential improvements because that would allow “too many brown doctors” into the country.
No one would dare say that today, but the organizations that can stand in the way of credentialling are numerous and only a national push could finally break the logjam.
As for strengthening mental health resources, that also requires recognizing psychologists as key to universal health, by including them in public health-care funding mechanisms.
Reduction of wait-times is also a key issue and it, too, is dependent on better information sharing.
The circuitous referral service where family doctors triage patients also needs an overhaul. At the moment, a patient with potential for skin cancer who has already had pre-cancerous lesions removed, often has to go back to the family doctor for referral when new lesions appear.
How redundant is that?
A properly integrated data-sharing system should allow patients to bypass the interminable delays that cost time and money to the system.
The federal government plans to sign individual bilateral agreements with provinces focusing on their priorities. But it is also laser-focused on a national agreement to strengthen the five priority areas.
That agreement will not likely kick in until the latter years of the proposed 10-year agreement. Is that too little too late?
The work on long-term care improvements has already begun. That is one area where provinces and the federal government are in agreement.
The fact that the prime minister has scheduled a first ministers’ meeting means that the parties are very close to an agreement on shared national priorities.
That agreement could turn out to be the saving grace of Canada’s universal health-care system.
The last time the federal government rolled out a real national plan was the introduction of the Canada Health Act by Monique Begin when Justin Trudeau’s father was the prime minister.
This agreement could become one of the great legacies of Justin Trudeau’s time in office.
But the results will likely take a decade to determine.
Sheila Copps is a former Jean Chrétien-era cabinet minister and a former deputy prime minister. Follow her on Twitter at @Sheila_Copps.