As premiers mull their response to the Liberal government’s multibillion-dollar health funding proposal, health-care workers are urging government leaders to work quickly to finalize a deal.
Dr. Alika Lafontaine, president of the Canadian Medical Association, says every day that goes by without an agreement on tangible improvements to the health system is a day in which Canadian patients are waiting without the care they need, and health-care workers are left to labour within an underfunded system.
“Time is not on our side,” Lafontaine told Global News.
“Every moment that we wait is another moment that patients come to harm and suffer, and it’s another moment that providers experience burnout and then consider whether or not what they’re doing is really making a difference.”
The significant pressures within Canada’s health system should have been addressed more urgently months ago, he added, which is why he hopes high-level talks between governments keep at the forefront the needs of patients and health workers most affected by a “crisis” in health care.
“The deterioration of health systems has spread in such a way that it’s touching the lives of every Canadian, and for that reason, we have to move quickly.”
On Tuesday, Prime Minister Justin Trudeau met with all 13 of Canada’s premiers in Ottawa to present a plan worth $196.1 billion over 10 years, including $46.2 billion in new money for health care.
The proposed financial package includes a number of elements, including a $17-billion increase to the annual Canada Health Transfer over five years and $25 billion in new money for 10-year bilateral deals that would be negotiated individually with each province and territory.
These bilateral agreements would be tailored to each region’s specific needs, but focused on four key areas, including: improved access to family health services; addressing health worker shortages through recruitment, retention, training and improved mobility and recognition of credentials; better access to mental health and substance use treatment; and modernizing the health system through improved collection and sharing of health data.
To access these new funding streams, provinces will have to agree to target the money for measures that support these priority areas with action plans to improve transparency in how the funds are spent.
Lafontaine said he was pleased to see these conditions attached to Ottawa’s funding offer, noting that many of the key priorities identified by the federal government are ones for which the CMA has been advocating for improvements for some time.
“In our opinion, those shared priorities are the right things … elements like a national data strategy and also encouraging provinces and territories to move towards recognition of credentials as a path towards free mobility of physicians and other health providers across the country – I think it’s the right move,” he said.
The real question is whether provinces will accept the terms of the bilateral agreements and, if they do, whether the money spent will manifest in improvements on the front lines, Lafontaine added.
In a press conference Tuesday afternoon, some premiers indicated they would need time to digest the details and what they would mean for individual provinces and territories.
Tim Guest, CEO of the Canadian Nurses Association, also expressed optimism about the funding package presented to the premiers, especially in its focus on specific priorities that could improve access to care, reduce wait times for patients and deal with staffing shortages.
Nurses have been sounding the alarm about the strains in the health system for some time, and as their calls for help have gone unheeded, many have left the workforce – an exodus that has only made things worse, he said.
Nurses in Canada would like to see more urgency from government leaders in addressing the problems in the system, which means coming to an agreement on these health funding negotiations soon, Guest said.
“We are already seeing the public’s reaction to the deterioration of the system with lack of access, increased wait times, and I think the public (is) already saying what their expectations are,” he said.
“So, I’m really hopeful that all levels of government will come together and put politics aside and work collaboratively for the betterment of the health system, for the betterment of the health workforce and for the betterment of those living in Canada that need the system.”
Doris Grinspun, CEO of the Nurses Association of Ontario, says she, too, was pleased to see the priority areas identified by the federal government and that improvements in these areas will be tied to funding increases.
With a nationwide shortage of nurses contributing to a “crisis” in the health system, the hope is that more targeted investments will start to ease pressures and improve working conditions for health-care staff and access to care for patients, she said.
“I am hopeful about the money and I’m hopeful that the government will see fit to launch improvements for the nursing profession, to launch nurse practitioner clinics and other improvements to primary care,” Grinspun said.
“I think that it’s very easy to only criticize and find shortfalls in what happened yesterday. Nurses are choosing to say, ‘Yes, we need more, but let’s get moving with what is in there.’”
Federal officials are demonstrating they do not want to waste time, with Health Minister Jean-Yves Duclos saying Tuesday he will begin writing to provinces and territories immediately to ask whether they will accept the funding deal.
And, even as some premiers expressed initial disappointment on Tuesday, some have since signalled a willingness to accept the offer.
Ontario Premier Doug Ford and his provincial health minister, Sylvia Jones, will meet with Duclos and Intergovernmental Affairs Minister Dominic LeBlanc on Thursday to start negotiations.
Ford said Wednesday that Ontario will agree to the deal but is concerned about the length of the funding being offered by Ottawa.
“I’m confident we’ll get the Ts crossed, the Is dotted,” Ford said.
“We’re grateful for the offer. We’re grateful for sitting down with the prime minister, but we want sustainability. We need certainty moving forward, not just for a few years, five or 10 years, but decades to come.”
Quebec Premier Francois Legault expressed disappointment that Ottawa’s offer did not meet the demands of the premiers to increase federal funding of health care costs to 35 per cent from the current 22 per cent.
He pledged to continue to fight for more, but noted that Trudeau did not indicate a willingness to budge on the amounts offered.
“We got one-sixth of what we were asking for, so it’s better than nothing but it’s not enough, for sure,” Legault told reporters Wednesday.
NDP Leader Jagmeet Singh called the health funding plan a “failure” Wednesday, saying it does not offer “a clear path” to hire more health-care workers or address the shortage of family doctors.
He rejected the notion that conditions have been placed on the provinces as part of Ottawa’s funding offer, pointing to a lack of explicit measures to address health worker shortages or wait times for patients.
“There’s no guarantee in terms of staffing levels or a path to increasing health care workers. That, to me, I’ve always said, would be the major test,” Singh told reporters in Ottawa Wednesday.
“So far, the government has failed on that point. There is no clear path here. There’s no clear plan to hire more health care workers.”
Singh also took strong issue over the fact the deal does not require provinces and territories to agree not to use the billions in new funds to pay for private health services.
“The prime minister had a chance to stand up for public health care, increasing staffing levels, instead he stood down. The prime minister used to believe in public health care – why the flip-flop?” Singh asked Trudeau during question period in the House of Commons Wednesday.
Trudeau took issue with this portrayal of events, saying he began his meetings with the premiers Tuesday telling them respect for the public, universal system and the principles of the Canada Health Act are “foundational to this government and will be foundational to any money that we flow to the provinces and to health-care systems across this country in the coming years.”
Conservative Leader Pierre Poilievre, meanwhile, said he would honour the health-care increases Ottawa promised the provinces if his Conservatives form the next government.
But he echoed criticisms from some premiers that the overall increase falls far short of what provincial and territorial leaders were hoping for, after years of complaints that Ottawa isn’t paying its fair share of health-care costs.
– with files from Global News’ Katherine Ward and The Canadian Press