The federal Minister of Health wants to lay the foundations for an agreement on health transfers as early as next week. Jean-Yves Duclos insists, in an interview at To have to, to say that he will join his counterparts for a meeting in Vancouver in a “positive” spirit, of “collaboration”. However, the Minister also hopes that his interlocutors will agree with the five major priorities set by Ottawa and, above all, that they will agree to bet on common solutions.
The provincial premiers have been calling for more than a year to sit down with Justin Trudeau to renegotiate the agreement on federal health transfers, which expired last March. The federal prime minister repeated, however, that these talks had to wait until the pandemic was over. Ottawa is now ready to talk. But the Trudeau government wants the discussions to take place first at the level of health ministers, so that they first agree on the targets for the new federal funds.
In interview with The duty, in his office overlooking the Ottawa River, Minister Duclos says he is hopeful that his provincial counterparts will agree with him, at a federal-provincial meeting next Monday and Tuesday, on the “diagnosis” to be made of the “chronic disease” that afflicts the health systems in Canada. And that they will then be able to begin discussions on the “solutions” to be favored to remedy this.
The minister, more pedagogue than battler, recalls that he wants to dialogue with the provinces. The measures favored by one or the other may differ, he assures us, but the “findings will be the same”, he decides.
Ottawa has already announced the five priorities that the provinces should address: the shortage of health care workers, primary health care and family medicine, long-term care and home care, mental health and addictions , as well as virtual healthcare.
“I sincerely believe that the vast majority of Canadians and Quebecers included want collaboration between governments. Quarrel is bad. Especially in the current context of crisis in our health system”, supports the former university professor who became minister in 2015 and responsible for Health a little over a year ago.
But four days before the meeting, the office of the Quebec Minister of Health, Christian Dubé, again rejected the federal objective and reiterated its request for “unconditional” transfers. “If Ottawa really wants to support us, it will be by increasing federal health transfers that it will be able to do so, and not by playing in our skills,” said Mr. Dubé’s press secretary, Antoine de la Durantaye. .
A “futile” war of numbers
The federal government now certifies that there will indeed be new health funds for the provinces. However, Minister Duclos did not advance on the sum envisaged. First of all, it is necessary to establish the findings and the remedies. “Once we’ve done that, we can move on to the next steps, which will be to assess what common support would be to achieve a better situation for our patients,” argued the minister during a long interview. .
The provinces want a recurring and unconditional increase in these transfers, so that Ottawa covers 35% of the bill rather than the current 22%. Reaching this threshold would represent an initial additional investment of $28 billion.
“This debate on dollars and percentage points is a debate that can lead us to a futile speech,” retorted Minister Duclos. And the most useful work is to recognize that our health care system has chronic challenges that require additional investments in certain files that we know are important. »
The offices of the ministers of health of Quebec and Alberta, however, reiterated the traditional request of the provinces.
The Trudeau government reduced the annual increase in health transfers from 6% to 3% or the equivalent of inflation five years ago. The provinces will therefore see their transfers increase by 10% in March (i.e. $49 billion for the year 2023-2024), but we can already predict that the increase is likely to return to the floor of 3% the following year given the slowdown economic expected.
Minister Duclos does not rule out changing the annual transfer increase formula.
The negotiations could also be accompanied by investments in some of the areas deemed priorities by Ottawa.
A barrier to confrontation
Mr. Duclos is trying to calm things down, a few days before the federal-provincial meeting, after an article in the Toronto Star indicated that Ottawa would be prepared to exclude recalcitrant provinces from its agreement and even to cut off transfers from those that reduced their own health budgets.
“This is not at all how we envisage the future in the Canadian government,” replied the minister, disavowing the article in question.
However, the Trudeau government had concluded piecemeal agreements with the provinces in 2016-2017. Quebec, Ontario and Alberta ended up accepting Ottawa’s offer, after the majority of their colleagues had done the same.
Jean-Yves Duclos recognizes that “there are provinces that are already a little ahead of others” in certain areas and that “may need less time to indicate what they want” as support . But he maintains that it is too early to predict that his government will again try to convince the provinces one by one.
Ditto for this idea that Ottawa could cut off its transfers to the provinces that would restrict their health budgets. Mr. Duclos would find it “inconceivable” and “inexplicable” that these budgets would be reduced, given the current crisis. “But again, we’re talking about resources, dollars, and that’s for later,” he repeated.
The federal minister is counting first on his good understanding with his counterparts so that the meetings next week will enable him to begin these negotiations, with a view to then entrusting them to the premiers once the framework has been established. “We know that at the level of prime ministers, things can easily get complicated,” admits Mr. Duclos. But we, the Ministers of Health, are really focused on what is important for patients and workers. “.
A few hours later, his boss already seemed to be sharper. “We are there with more money, yes. But we are also here to ensure that we have real results for all Canadians, ”said Justin Trudeau in the Commons in the afternoon.