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Premiers want Ottawa along for 'generational opportunity' to modernize health care

VICTORIA — Canada's premiers want the federal government to stop "quibbling" about its share of health-care funding and partner with them on a "generational opportunity" to modernize a failing system, they said Tuesday after two days of meetings.
Premiers mingle during a photo op while at the summer meeting of the Canada's Premiers at the Fairmont Empress in Victoria, Monday, July 11, 2022. Canada's premiers are meeting again today in Victoria after a day of talks dominated by health care. THE CANADIAN PRESS/Chad Hipolito

VICTORIA — Canada's premiers want the federal government to stop "quibbling" about its share of health-care funding and partner with them on a "generational opportunity" to modernize a failing system, they said Tuesday after two days of meetings.

British Columbia Premier John Horgan, chair of the Council of the Federation, said unprecedented collaboration between Ottawa and all jurisdictions during the pandemic paved the way for innovation, and it needs to continue with ideas on how to train, retain and recruit more health-care workers.

"In a time of disruption, that's when innovation happens," Horgan told a news conference alongside his dozen counterparts. 

"You don't see that innovation by ignoring opportunity to engage. You take advantage of opportunity by engaging, and it's completely absent right now. And that's the tragedy. It's out of sadness, not anger, that we sit here today."

Horgan has said Prime Minister Justin Trudeau promised eight months ago to put together a team to address health-care funding but sent just a text on Monday saying he was aware of the funding situation as premiers began their meetings.  

Premiers want the federal government to pay 35 per cent of health-care costs, up from 22 per cent, and say Trudeau has to "come to the table" and work with them to provide sustainable, long-term funding for all Canadians.

However, the premiers ended their talks without a commitment from the federal government on any meetings to discuss health-care transfers.

Andrew Furey, premier of Newfoundland and Labrador, said expanding virtual medicine is part of the solution to the future of health care in Canada.

Furey, who is also an orthopedic surgeon, said he would have patients travel eight hours for a two-minute appointment but seeing patients virtually would allow more of them to be seen, making the best use of a limited number of physicians.

While that would unlock "the value of medical professionals," it would also require an investment in technology and changes in licensing doctors and nurses to allow them to work across jurisdictions, he said.

"Despite some of the conversations here today, there is a significant amount of hope and optimism for a modern system that is sustainable and one that addresses the permanent needs of Canadians long term," he said. "But this is a generational opportunity right now. We all recognize it and I hope the federal government does too."

Horgan said the premiers are ready to accept any accountability measures the federal government would have alongside more funding, but provinces and territories are accountable to their own citizens. 

As for what the money would be spent on, jurisdictions have different health-care priorities, like long-term care in British Columbia, for example, which is not the most pressing need for a younger population in Alberta, Horgan said.

Caroline Cochrane, premier of the Northwest Territories, said long-term care is not at the top of her list for health-care expenditures when so much else is lacking.

"We have communities in the Northwest Territories, because of the short staffing, we don't have a health centre. We've closed down the medical care facilities in communities," she said.

"Could you imagine living in a hometown, if you have an emergency, something happens to your child, to your parents, to yourself, that you can't even get a service? So, that is what we're talking about. We need the flexibility. I'm willing to tell you where I spend my money. But don't tell me I have to spend it all on long-term care when I don't even have a doctor and a nurse in our communities."

Earlier Tuesday, Health Minister Jean-Yves Duclos said the federal government has been working with the provinces and it recognizes that health systems are in crisis.

"Many workers have left the profession ... because of the physical and mental health toll that COVID-19 brought to them and their families," he said in an interview.

"Provinces and territories legitimately feel that crisis because they are most directly impacted by the health-care crisis that we're all seeing across the country."

Duclos said he's been working steadily with his provincial and territorial counterparts, while transferring billions of dollars to shore up the system.

"We have stepped up together in terms of policy but also in terms of funding," he said, adding Ottawa has already agreed to do more over the long term. 

Duclos did not offer a timeline for those negotiations. Previously, Trudeau said the talks would happen when the pandemic is over.

Currently, federal contributions to provincial health systems grow in line with a three-year moving average of nominal gross domestic product.

Based on that formula, the health transfer payment to provinces increased by 4.8 per cent in the most recent federation budget, amounting to an extra $12 billion projected over the next five years compared to pre-pandemic estimates. 

Ontario Premier Doug Ford said that along with the need for more health-care funding, his province is concerned about the highest labour shortages in a generation, which are hurting the economy.

Alberta Premier Jason Kenney also announced that his province is funding a study to examine the potential for provinces and territories to recognize each other's trade and labour regulations.

Canada has a patchwork of thousands of different provincial and territorial regulations that hinder economic growth and add costs for consumers, he said, adding efforts to harmonize those rules are moving far too slowly.

It would be a "revolutionary step forward" for the provinces and territories to develop a model to recognize each other's regulations, he said. 

Kenney acknowledged anxiety around provinces "poaching" each other's health-care workers, but said patients aren't better off under a series of labour "silos" across Canada.

"(The premiers) all want to take care of their citizens, but at the same time understand that we would all benefit from a more streamlined movement within the country.”

The study from the Macdonald-Laurier Institute is due to the Alberta government by September.

— With files from Laura Osman in Ottawa

This report by The Canadian Press was first published July 12, 2022.

Brenna Owen, The Canadian Press