(Ottawa) Prime Minister Justin Trudeau will offer provinces a “substantial” increase in the Canada Health Transfer and additional funds if they agree to enter into individual agreements targeting specific problems in their system.
A senior government official familiar with the federal plan said Trudeau would present a 10-year offer on Tuesday when he meets with the 13 provincial and territorial premiers in Ottawa.
The Canadian Press agreed to grant the senior official anonymity because he was not authorized to speak publicly about the case.
According to this source, the federal offer will include an increase in the Canada Health Transfer, which Ottawa sends to the provinces each year with very few conditions. Ottawa has thus transferred 45 billion this year, which is equivalent to 22% of the provincial budget for health care.
The premiers of the provinces and territories are asking that this federal participation increase to 35%, which would have required $26 billion more in federal transfers this year.
Trudeau will offer more money to provinces that want to enter into bilateral agreements in specific areas, and with accountability measures such as setting improvement targets and sharing data.
Health Minister Jean-Yves Duclos has previously stated that priority areas for the federal government include improving access to a family doctor, better mental health care, reducing wait times for surgery and a massive improvement in data collection and sharing.
The federal offer will be made public, but not before being presented to the premiers on Tuesday. Manitoba Premier Heather Stefanson, who is this year’s chair of the Council of the Federation, said Monday it was frustrating that the premiers had yet to see details of the offer.
“If we had had it in advance, we could have had a more in-depth discussion tomorrow [mardi]there is no doubt,” she said.
She would not say whether the prime ministers would be flexible on their 35% demand, or what concessions or conditions they would be open to. “We want to see what the proposal will look like,” she said. We’ll go in with an open mind, and then we’ll go from there. »
“No conditions”, recalls Legault
Upon his arrival Monday afternoon in Ottawa, Prime Minister François Legault said he was happy to meet Mr. Trudeau “finally […] after two years” and to “have a proposal” from the federal government on the table.
“Now we will see the amount. We asked for it to be an unconditional proposal, so we’ll find out tomorrow. Then we, the prime ministers, we meet this evening, then we always have a beautiful common front, indicated Mr. Legault in a press scrum.
“I will wait to see tomorrow (Tuesday) before telling you if I am optimistic or pessimistic. Before Christmas he told me it looked good and then the amount would be substantial so I can’t wait to see that. »
The leader of the Bloc Québécois, Yves-François Blanchet, indicated Monday that he was putting himself “in the skin” of the “real world” in this file.
“What should be our fundamental motivation in this exercise is to quickly deliver services, services that are currently delivered by the provinces and Quebec,” he said in the foyer of the Chamber.
Mr. Blanchet implores the Prime Ministers not to make it “a ‘game’ of power or issues of jurisdiction” around the table. “I appeal to the humanity of the players in this case so that people who are currently on stretchers or awaiting surgery will sleep better tomorrow night than they did tonight.
“The federal government is withholding money to force the provinces to accept interference in a jurisdiction of Quebec and the provinces. It remains unacceptable. It does not serve the interest of people who are suffering, who are afraid and who are waiting,” said the Bloc leader.
New Democrat Leader Jagmeet Singh said Monday that “any deal that doesn’t include clear commitments to hire more frontline health care workers will be a failure.”
The Conservatives have been hesitant to comment before seeing Trudeau’s offer, but are worried about the costs.
By the spring budget?
Mr. Trudeau said his government did not expect to sign the same agreement with all the provinces. “We recognize that different provinces have different needs and different priorities, and that flexibility is an important part of our responsibility,” he said Monday.
After Tuesday’s talks, Mr. Duclos and provincial health ministers will meet to continue ironing out the details. There is no specific deadline, but it is hoped that a new agreement will be in place before the next federal budget, which is generally tabled in early spring.
The federal source said that one of Ottawa’s main demands is that the provinces agree on common indicators and the collection and sharing of data, both with other provinces and with Canadians, in order to be able to measure the progress made.
Results, otherwise…
Former health minister Jane Philpott, who was responsible for the file in 2017 during the last federal-provincial negotiations, said Monday that it was an essential part of any successful plan.
In 2017, Ottawa signed bilateral agreements with each province and territory to provide $11.5 billion over 10 years to improve mental health care and home care. These agreements included an agreement that the provinces would report annually on certain common indicators. Although this has happened, the data is often incomplete and it is difficult to assess progress.
“Looking back, I would say those deals weren’t as specific as they could have been, and I think that’s the lesson to be learned from this round,” Ms.me Philpott.
“When the federal government puts more money on the table, there has to be accountability for how that money is spent. I think this time I would advise being much more specific about those expectations – and maybe even using legislative tools to be able to ensure that the results will be what they need to be. »
Mme Philpott even thinks that the federal government could recover the sums transferred if the provinces did not respect their obligations.
The former minister believes that one of the objectives, admittedly difficult, would be to ensure that within five to seven years, every Canadian has access to a family doctor or at least to a first-line care team. But to do that, she says, would require knowing a lot more about the number of doctors in Canada, where they are and how many hours they work.