How the deal to spice up federal funding for well being care got here undone

Confusion reigned in Vancouver on Tuesday as media gathered exterior the room the place a information convention by federal and provincial well being officers was meant to happen.

Employees from federal and provincial well being ministers had simply completed explaining that there could be no joint announcement about federal funding for provincial well being care; as a substitute, two separate press conferences have been now anticipated.

Quickly after, the finger-pointing started over which aspect was answerable for a breakdown in discussions that have been purported to result in a brand new deal involving the Canada Well being Switch — the cash Ottawa sends to the provinces for well being care. The thought a deal was coming stemmed from a proposal federal Well being Minister Jean-Yves Duclos floated in the beginning of the week, which marked the primary in-person well being ministers assembly since 2018.

Ottawa mentioned it was keen to spice up health-care funding if the provinces and territories dedicated to constructing a nationwide information assortment system and increasing the usage of frequent well being indicators — each measures of how a health-care system is performing. However by Tuesday afternoon, the premiers had launched a letter stating zero progress on their demand that Ottawa enhance its share of health-care funding to 35 per cent from 22 per cent.

Days later, as health-care techniques throughout the nation wrestle with lengthy wait instances, exhausted staff and overburdened emergency departments, the way forward for the well being switch and why the talks failed remains to be mired in uncertainty.

Provinces say they have been caught off guard by the switch being raised within the first place and the shortage of any significant particulars from the federal authorities on how a lot it might enhance funding and when.

“There was no proposal that was put ahead on the well being ministers assembly,” mentioned Manitoba Premier Heather Stefanson, chair of the Council of the Federation. “Minister Duclos went out and began to speak about just a few concepts. These discussions by no means got here ahead in the way in which of any form of a proposal in any respect.”

Whereas a health-care, data-collection system and the usage of well being indicators have been meant to be agenda gadgets on the second day of talks, making these points situations to obtain a better share of federal funding had by no means been mentioned, British Columbia Well being Minister Adrian Dix mentioned.

Dix, who co-chaired this week’s assembly, initially thought Duclos’s supply was “excellent news” and awaited extra data.

“There weren’t any extra particulars, both on cash or on their view of what we must always do to obtain that cash,” he informed the Star.

“We requested a number of questions on it and there was no additional data. There nonetheless is not any additional data from the federal authorities as to what their proposal may be. So it’s a little bit of a thriller, really, their conduct.”

However a federal supply near the file informed the Star that the communication breakdown started earlier than the conferences obtained underway.

The supply mentioned two “pan-Canadian methods,” one to deal with workforce challenges and one other on digital well being — which would come with an information assortment system with improved indicators — have been supposed to return up through the assembly. Each side had been discussing these methods for months, the supply mentioned.

“That’s the place we have been (at) up till per week earlier than the assembly, the place officers on the provincial ranges began calling officers and Well being Canada saying, ‘Can we take away these two gadgets from the agenda?’”

Nevertheless, an settlement was reached and people topics have been put again on the desk, however Ottawa felt compelled to increase an “olive department,” mentioned the supply, “to additional enhance our probabilities to have any significant engagement.”

That culminated in Duclos’s announcement to media that federal health-care funding would enhance — with strings hooked up.

These strings matter, mentioned Steven Lewis, an adjunct professor of well being coverage at Simon Fraser College.

Lewis informed the Star that frequent key well being indicators embrace issues like wait instances and the standard of prescriptions. An actual-time information system would permit Well being Canada, provinces and well being organizations to evaluate efficiency by analytics, he mentioned.

At the moment, he mentioned, information comes on the pleasure of the provinces or is previous by the point it’s being analyzed.

A second federal supply informed the Star that such a system would be sure that Ottawa, the provinces and territories can see how health-care funding is contributing to enhancements in care. They acknowledged there are jurisdictions already making some data out there to the general public, however {that a} system primarily based on related indicators is required to share and evaluate outcomes.

Lewis mentioned it’s affordable for the federal authorities to ask for some kind of system to be in place the place the successes or failures of health-care techniques throughout the nation will be measured by a set of agreed upon requirements.

That’s as a result of federal well being care switch funds are given to the provinces and territories to spend nonetheless they want, he mentioned.

Lewis mentioned the provinces want to appreciate that “if all of us agreed on just a few issues that all of us must get higher at, possibly we’d have a greater likelihood at succeeding, however that’s not their stance.

“Their stance is far more insular,” he mentioned. “The one factor they appear to have the ability to unify on is preserving Ottawa the hell out of it.”

For now, the stalemate continues, with Ottawa insisting that each one sides should first agree on a possible resolution earlier than slapping a price ticket on any kind of settlement.

And provinces say they need to know the main points of any proposals earlier than being requested to return to the desk.

“I feel each the federal authorities and the provincial governments look dangerous right here. I feel Canadians anticipate and deserve higher,” one federal supply mentioned.

“I feel {that a} publicly funded common health-care system is one thing that all of us cherish, we’re all pleased with as Canadians. And it’s by no means been in such a state of disaster.”

Raisa Patel is an Ottawa-based reporter overlaying federal politics for the Star. Observe her on Twitter: @R_SPatel

Jeremy Nuttall is a Vancouver-based investigative reporter for the Star.

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