Response from Liberals to National Health Accord

April 24, 2014

The following is the response received from the Liberal Party of Canada to concerns raised by SOHC about the loss of our National Health Accord, received April 24th.

From Hedy Fry, Liberal Health Critic:

Thank you for your email concerning the need for federal leadership in health care and for a renegotiated Health Accord in 2014. Canada’s Medicare system is facing many challenges and it takes real leadership to make the necessary changes to ensure its sustainability and improve the health outcomes of Canadians. When Canada’s Medicare system was established under Prime Minister Lester B. Pearson, it was to cover hospital and physician-based care only. We now know that hospitals are not necessarily the best places to deliver care and physicians are not the only ones who can deliver that care.

The previous Liberal governments, led by Prime Ministers Jean Chretien and Paul Martin, recognized that transformative changes were needed to ensure our system was sustainable and that Canadians received the care they need, when they need it. That is why Prime Minister Chretien met with the Premiers in 2003 to negotiate a Health Accord. That work was continued by Paul Martin in 2004, when the Health Accord was signed.

The Health Accord was a $41.2 billion agreement with the provinces with clear objectives and oversight to make those transformative changes. They agreed on a new collaborative approach to health care, with jurisdictional flexibility that allowed for the federal government to partner with provinces and territories on specific projects that needed to be changed and that was usually held to be provincial jurisdiction. Those objectives were: wait times; Health Human Resource Strategy; National Pharmacare Strategy and; shift from an acute care model to new models of community care, home care and chronic care. These would include appropriate, multidisciplinary teams.

Three organizations were charged with monitoring the progress of the Accord: The Wait Time Alliance (WTA), Canadian Institute of Health Information (CIHI), and the Health Council of Canada (HCA). In their reports they have stated that despite some progress made in the area of wait times, there has been very little progress made in the other areas identified in the 2004 Health Accord. In each case, they have stated the reason for such little progress is the lack of federal leadership.

In 2006, the Conservative government walked away from the 2004 Health Accord. They had to continue transferring the $41.2 billion with a 6% escalator per year because it was legislated in the 2005 federal budget. Not only has the Conservative government walked away from the Health Accord, the Prime Minister has refused to meet with the Premiers to discuss Health Care, despite the Premiers’ many calls for a First Ministers Meeting.

Had the Conservative government remained committed to the goals and provided the necessary leadership, we could be nearly ten years into developing a National Pharmaceutical Strategy and a Health Human Resources Strategy to address health care provider shortages. It would also put us on track to develop more multidisciplinary, community care teams that would have worked to keep our population healthier and manage chronic diseases at home.

The premiers and health care professionals were working towards what they thought would be a new Health Accord in 2014. Instead, then Finance Minister Jim Flaherty unilaterally decided to cut increases in health care transfers by 50% starting in 2017. Furthermore, the Conservative government moved to a per capita funding, instead of basing transfers on equalization and on regional demographics. This means that smaller provinces, and provinces with large seniors populations or at risk demographics, will not be able to provide the same level of care as other provinces. Never before in Canada had a federal government unilaterally imposed a funding arrangement without first negotiating with the provinces

Many Canadians struggle to pay for medications with one in ten not even filling much needed prescriptions. This can lead to a further deterioration of their condition, so that they may end up in hospital or emergency rooms – the most costly place to deliver care. In fact, a recent report showed that as many as one in three prescriptions go unfilled. Liberals support the development of a national pharmaceutical strategy, in collaboration with the provinces. That is why we made it a priority in the 2004 Health Accord. We are the only industrialized nation with a national health care system that does not have a national pharmacare strategy.

We further recognize the need for a national Health Human Resources Strategy. The federal government must bring the provinces together and provide the necessary leadership. Training a family physician in Canada takes nearly ten-years. We need a strategy that looks 10, 20, or 30 years into the future to assess current and future needs. In Prime Minister Paul Martin’s government, I was assigned the responsibility for speeding up recognition of foreign credentials, particularly as it relates to health care professionals. This was a key aspect of the 2004 Health Accord, but the Conservative government has refused to act. In fact, they walked away from the federal-provincial working group on HHR in 2006.

As I noted earlier, the Canada Health Act covers only hospital and physician based care, but the needs of
Canadians are constantly changing. We know that health promotion and disease prevention are key factors in making our health care system sustainable. For example: evidence shows that proper dental hygiene can prevent many chronic conditions in the future including heart disease.

I appreciate you informing me of your concerns and I can assure you that the Liberal Party has as its priority an effective, timely, and quality health care system for all Canadians and a pan-Canadian, collaborative model of health care where there is federal leadership, consultation and cooperation with provinces. To that end, if we form government, our first priority would be a meeting between Prime Minister Trudeau and all Premiers to discuss a plan of action to achieve a sustainable health care system.

Sincerely,

Hon. Hedy Fry, P.C., M.P.

Vancouver Centre

Liberal Health Critic

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