Health Minister Jean-Yves Duclos says the “principal vital goal” of a gathering subsequent week along with his provincial counterparts is to “proceed constructing a powerful relationship” between the folks answerable for this nation’s health care system.
So no matter else can be stated about the slow-moving and progressively agitated dialog about the way forward for Canadian health care, not less than Duclos’ mild tone is holding up.
When Duclos tried to body federal-provincial negotiations with a speech in March, he talked about “collaboration” and dealing “collaboratively” and taking “collaborative” motion. He completed with a flourish that repeated the phrase “collectively” 3 times. He pitched a three-Rs strategy that begins with “respect” for jurisdiction (adopted by shared “duty” and “outcomes”).
“If there is one factor that the final two years of the pandemic have demonstrated,” he stated, “it is that with good will and laborious work, the federative nature of our nation can yield appreciable advantages.”
Seven months later, the provincial governments are operating radio adverts accusing the federal authorities of failing to present adequate funding for Canada’s struggling health care system. Last week, federal sources informed the Toronto Star that the federal authorities was ready to transfer ahead with provinces which are prepared to lower a deal — and freeze out the recalcitrant ones.
Manitoba Premier Heather Stefanson stated that gave the impression of a menace. But in an interview with CBC News this week, Duclos stated that suggestion made by the sources – that Ottawa is keen to go away some provinces out in the chilly – is not correct and that it would be “unfair to Canadians who anticipate our collaboration between health ministers to be constructive, to be fruitful, to be targeted on outcomes.”
“The federal position is a job of acknowledging … the issues, convening folks, bringing folks collectively, not dividing them … supporting one another in order that we do issues otherwise this time from what maybe in the previous these efforts have led to,” he stated.
Maybe that is wishful pondering from a former professor and economist. Maybe Duclos is making an attempt to clear up after federal officers who obtained forward of themselves with their off-the-record feedback. Maybe he’s the good cop on this negotiation.
Whatever the case, there is an apparent want to get on with the enterprise of turning statements of concern into an precise deal.
Results first, cash later
The suggestion that the federal authorities may begin making bilateral offers with particular person provinces is not less than value contemplating — as a result of there is precedent.
In 2016, the federal aspect — Jane Philpott as health minister, Bill Morneau as finance minister — got here to the desk with a suggestion to enhance funding by $11.5 billion over ten years, with funds earmarked for residence care and psychological health. The premiers, who needed a big enhance to normal funding, balked.
But over the ensuing months, the federal authorities began making offers with particular provinces — first New Brunswick, then Nova Scotia and Newfoundland, then the territories and finally Ontario, Quebec and Alberta. Philpott stated it wasn’t a matter of “divide and conquer.”
However one describes the strategy, it labored — not less than from the federal perspective.
Duclos is not threatening to pursue the same technique now. At one level on this week’s interview, he described himself as an “ally” to provincial health ministers. “I’m there to assist them,” he stated.
The federal authorities’s want for outcomes focuses on 5 broad areas of concern: the health care workforce, entry to household health providers, long-term care and residential care, psychological health and habit, and health knowledge and digital care. Duclos and the Liberals would really like to focus on the desired outcomes earlier than they begin speaking about how way more cash the federal authorities may put up.
“We need these outcomes to be concrete and tangible,” Duclos stated, “And earlier than we come to the signifies that will be crucial to obtain them, we first want to converse to the substance round these outcomes.”
As a federal supply put it this week, “Before we put extra money in, let’s discuss what we wish to do with it.”
Another federal supply urged focused outcomes might be tied to devoted funds, whereas a lift to the Canada Health Transfer might be tied to an settlement on higher sharing and standardization of health knowledge throughout provinces. (Both sources spoke confidentially as a result of they weren’t approved to converse publicly.)
Dix says provinces ready for a ‘critical’ response
Focusing on outcomes and outcomes might have each sensible and political benefits for a federal authorities that would really like to say one thing was achieved with the cash it spent.
Objective observers may ask whether or not the focused outcomes are bold sufficient. And provincial governments may argue they’re the ones who finally will be held accountable if outcomes aren’t achieved.
It’s laborious to think about this coming collectively with out some robust conversations — even when these are left to the finance ministers.
But the Liberals have one thing at stake right here, too. If they need to stand towards privatization experiments like Saskatchewan’s pay-for-access MRI scheme, they want to present a stage of funding that will make such strikes appear pointless. If they do not, their protests will ring hole.
How a lot subsequent week’s conferences in Vancouver may advance this dialog is unclear. In an interview with the CBC’s Power & Politics this week, British Columbia Health Minister Adrian Dix stated he had the “highest regard” for Duclos but argued that the provinces have but to hear a “critical response” from the federal authorities.
“Frankly, leaks from political staffers to reporters should not engagement and that is what we have seen in the final week. We want a critical strategy and we take a critical strategy to this problem,” Dix stated.
“They’ve obtained to get with it, come to the desk and work on an actual reply on the Canada Health Transfer.”
Dix urged that type of dialog wants to occur between the prime minister and the premiers.
Duclos might have been right when he stated in March that Canadians weren’t fascinated by a “sterile fiscal debate” or a “numbers struggle” between provinces.
“Canadians should not significantly fascinated by proportion factors or tax factors or billions of {dollars} if they do not really feel that this is going to be helpful for growing the high quality of care,” he stated this week.
But nevertheless the dialog takes place, Canadians may finally change into impatient to see it concluded.