Health ministers’ meeting signals new federal-provincial relations

[Health Minister Jane Philpott rises during question period in the House of Commons on Parliament Hill in Ottawa on Dec. 8, 2015. THE CANADIAN PRESS/Sean Kilpatrick]

For the first time in a long while, the federal health minister will join her territorial and provincial counterparts when they gather for their annual meeting this week in Vancouver.

At first blush, that may not seem like big news.

But after nearly a decade of the hands-off approach to health care of the former Conservative government, just the appearance of Health Minister Jane Philpott at the meeting is ushering in a new era.

“That fact that this meeting is even happening with the federal health minister is promising,” says Dr. Monika Dutt, chairwoman of the board of directors of Canadian Doctors for Medicare.

Provincial and territorial health ministers will gather Wednesday in Vancouver. Philpott, herself a physician, will join them Thursday on the second day of the gathering.

Already, the Liberal government has signalled a new prescription for federal-provincial relations on health care.

Philpott’s Conservative predecessor skipped the annual meetings.

The former government allowed a national Health Accord, signed in 2004 to lay out long-term funding commitments, to expire in 2014.

In a mandate letter to Philpott as she took the helm of the health portfolio, Prime Minister Justin Trudeau made it a priority for her to renegotiate that agreement.

“Healthcare across Canada is changing at a rapid pace to keep up with the changing needs of an aging population and advances in health technology,” Trudeau wrote.

“The federal government must be an essential partner in improving outcomes and quality of care for Canadians. I expect you to work with provincial and territorial governments to support them in their efforts to make home care more available, prescription drugs more affordable, and mental health care more accessible.”

“There were a lot of good directions in the mandate letter that went to the health minister… but it’s always what comes next that’s really important,” Dr. Dutt tells Yahoo Canada News.

Her organization would like to see a clear commitment to a national pharmacare program, in addition to the initial discussions of a multi-year accord.

The group would also like some clarity from Ottawa on enforcement of the Canada Health Act, which the previous government left in the hands of the provinces.

Individual provincial health ministers have suggested demographic-based funding, home care and prescription drug costs are on their agendas for the two-day meeting.

Steve Morgan, a professor at the University of British Columbia’s School of Population and Public Health, says the health ministers are unlikely to emerge from the gathering with any concrete agreements.

But they will emerge with a new tone and direction for what will likely be months of negotiations ahead.

“They haven’t been at the table with the provinces in a long time but they have a really unique constellation of the people around that table right now, so at the political level there’s a window of opportunity,” Morgan says — one that hasn’t existed for decades.

There is a “remarkable alignment” of the political interests of the provincial and federal governments, he says.

“And you have in Alberta a once-in-a-lifetime opportunity of an NDP government who might be willing to do things that other Albertan governments wouldn’t do in terms of investment in the public health care system,” Morgan tells Yahoo Canada News.

There are economic constraints, he says, but those, too, may be an opportunity.

“I think the majority of experts in health care policy in this country would argue that more money is not, in and of itself, the solution to the woes of the Canadian health care system,” Morgan says.

“The government needs to be looking at things that transform the system without requiring new money, or if they need new money for the public system, does it free up money in the private sector that can be viewed by taxpayers as significant savings?”

Universal drug coverage, a national strategy on aging, home and long-term care and funding — there is an opportunity for transformative change, he says.

“There are elements of hope, if the governments have the courage to say yes we’re going to do this,” Morgan says.

“Not this week. I don’t think this week is going to be much other than setting the tone and direction of the negotiations.”