Provincial leaders were frantic about the poor state of their health-care systems last year when Prime Minister Justin Trudeau sat them down and offered urgent treatment worth $46.2 billion.
It wasn’t enough, but most provinces reluctantly accepted the broad terms of the agreement and returned home to negotiate the finer points behind closed doors.
Since then, Ottawa and the provinces have continued to negotiate a collective long-term vision to improve health care. But doctors, nurses and other health advocates say the crisis is only getting worse.
Health workers want governments to act faster to deal with the crisis. But a real solution will take time, Health Minister Mark Holland acknowledged in an interview.
“We’re not looking for a placebo policy here,” Holland said.
That’s why the federal government has pushed for provinces to make specific promises about how they will spend the money, “which is why it takes time to negotiate these agreements,” he added.
The scenes that have unfolded over the past 12 months have been jarring: people turned away in emergency rooms, elderly people languishing for days in hospital hallways, family doctors abandoning their practices, exhausted nurses leaving the profession that they once loved.
The state of Canada’s health systems has already cost many people their lives, said Dr. Alan Drummond, an emergency physician in Perth, Ont., and spokesperson for the Canadian Association of Emergency Physicians.
“It’s only by the grace of whoever God is that they haven’t died anymore,” said Drummond, who has been practicing medicine for 45 years.
“Something is really wrong here and it really feels like a crisis.”
So far, Ottawa has signed four individual agreements with provinces for targeted funding, as long as the provinces set out how they plan to spend the money.
Alberta, British Columbia, Prince Edward Island and Nova Scotia have all made specific promises about how they will eventually transform their health systems.
Other deals are still in progress, although Quebec has strongly opposed Trudeau’s proposed deal because it would force the province to meet measurable targets and force it to share health data.
Many elements of the system are in crisis, Holland acknowledged. But the overall trajectory of the system is positive, he insisted.
“In different jurisdictions, there are different leaderships taking on different elements of the health system, different innovations are occurring and a spirit of learning and evaluation is being incorporated.”
Those discussions occur primarily at the bureaucratic level, said Linda Silas, president of the Canadian Federation of Nurses Unions.
“For the nurse who works at 2 in the morning, other than a lot of conversations, nothing has changed,” Silas said.
The nurse and her patient, who probably already had to wait hours in the emergency room, want governments to act faster, she added.
The federal government has given the provinces until March to reach an agreement if they want to get their share of the funding. Holland said all provinces and territories are in a position to finish them by the deadline, with the possible exception of Quebec.
The agreements so far invest primarily in community care, he said, and provinces have agreed to make health data, including patient records, more compatible across the country.
Health advocates appear divided on whether the plans will fix what’s broken.
“I think the current situation has placed Canadians in a crisis of confidence in their health care system,” Drummond said.
“Equally, I think there’s a crisis of trust from health care providers in our leaders, because we really don’t believe that they know what they’re doing or that they have a plan to get us out of the mess we’re in.” actually in.”
The Canadian Medical Association and the College of Family Physicians of Canada are also concerned about declining public trust.
“Canadians continue to suffer and are rapidly losing faith that positive changes are coming,” the Canadian Medical Association and the College of Family Physicians of Canada said in a joint statement.
“Health care providers can no longer be asked to sustain systems that are on the brink of collapse.”
But once the plans are in place and the money is flowing, Silas said, the nurse who works the night shift at the hospital at 4 a.m. will eventually bounce back.
It’s just a matter of when.
“I can understand where ministers are coming from,” he said. “But it’s not going fast enough.”
This report by The Canadian Press was first published Feb. 7, 2024.