OTTAWA –
The impasse over a new federal-provincial health care deal has broken as both sides grapple with how to get better results from the new spending, federal Health Minister Jean-Yves Duclos said on Friday.
That includes agreeing to invest in technology to improve digital health records and data collection, he said at a news conference in Ottawa.
Duclos said the tone and direction of the talks with the provinces have changed and improved in recent weeks. He said the conversation about getting results is “louder now than it used to be.”
“I’m pretty optimistic that it continues to move in the right direction,” he said.
Provincial governments and federal Liberals are much more optimistic, in fact, utterly confident that a new long-term healthcare financing deal will be reached in time for the next federal budget in the spring.
Negotiations are in full swing for the prime ministers and Prime Minister Justin Trudeau to meet in person in Ottawa to work out final details, but no date has been set for that to happen.
It’s a complete reversal from the fall, when a meeting of health ministers in Vancouver in early November fell apart.
The provinces demanded significant increases to unconditional federal health transfers. The federal government insisted that the new funds would only flow with clear accountability measures attached.
That came as the health care system was once again stressed beyond its limit in the face of an unexpectedly early and intense flu season and labor shortages exacerbated by burnout from the COVID-19 pandemic. A nationwide shortage of children’s pain and fever medications didn’t help.
The provinces are responsible for providing healthcare, but Ottawa offers a direct transfer to cover some of the costs. In 2022-23, that transfer totaled $45 billion, an increase of more than 40 percent over the past eight years.
The current funding formula ensures that Canada’s annual health transfer increases by at least three per cent a year, and more if Canada’s economic growth exceeds that amount. It rose 4.8% between 2021-22 and 2022-23 and is currently projected to rise nine percent, to $49 billion, next year.
The provinces, which collectively spend more than 34 percent of their budgets on health, say Ottawa pays for about a fifth of the cost of providing public health care. They want it to increase to more than a third.
In a December interview with The Canadian Press, Prime Minister Justin Trudeau said this negotiation for a new funding deal is a time for governments to try to fix what is plaguing the public health system Canadians hold dear.
“It wouldn’t be right to throw more money at the product and sit back and see how it doesn’t fix the problem because we don’t use this moment to say ‘No, no, no, it’s time to improve.’ the system in very, very real ways.
About a week after that interview, Trudeau met with Quebec Prime Minister Francois Legault in Montreal, one of the most vocal opponents of accepting any terms with the new money.
Legault expressed optimism that a deal would be reached after that meeting. But the first real sign of progress came on January 11, when Ontario Premier Doug Ford said his government was open to providing the accountability that Ottawa was asking for, as long as it was understood that the provinces also they needed flexibility.
Then, on January 18, Legault said he was willing to move, too, and that he and Ford had agreed to provide the data enhancements the federal government wanted. He said it is now up to Ottawa to get the other provinces on board.
The Liberal government has struck individual deals with provinces in the past, including last time federal-provincial health financing negotiations broke down.
In 2016, with provinces collectively resisting federal targets for home care and mental health funding, New Brunswick broke ranks and signed a bilateral agreement. Other provinces then followed suit, signing their own individual agreements over the next few months.
Ford said that will not be repeated.
“It’s not going to be something unique to Ontario, another to someone else,” he said Friday. “We all agree, all the prime ministers, we all have to work together and stick together and that’s exactly what we’re going to do.”
The federal government has laid out five specific commitments they want to see, including reducing waiting lists and surgical backlogs, improving access to family medicine, mental health care, aging with dignity, and modernizing medical technology. healthcare and data sharing.
That last issue was one of the biggest sticking points. Duclos said Friday that it is mainly about sharing medical records between health providers.
He said that only about a third of health professionals can access the shared data. Nurses and doctors treating someone in the ER can’t get quick information about their patient, such as pre-existing conditions or what medications they’re taking, which can delay care and lead to worse outcomes.
Only about a third of patients also have access to their own medical records, Duclos said, which is also a barrier to allowing them to be an informed participant in their own health care.
This report by The Canadian Press was first published on January 20, 2023.
— With files from Allison Jones in Toronto.