While provincial and territorial health ministers meet behind closed doors in Vancouver today, advocates for public health care, including doctors and nurses, staged a demonstration to call for reform of a "neglected" system.

Justin Trudeau's Liberals have promised a new health accord with the provinces, and these meetings — which federal health minister Jane Philpott will join later today — are seen as the first step.

Outside, representatives from nearly 20 groups, including the Canadian Labour Congress, Canadian Doctors for Medicare and Canadian Federation of Nurses Unions, called for action while acknowledging that might not come with much money.

"We'd like to encourage the health ministers to use this tremendous opportunity," said Dr. Vanessa Brcic, a family physician in Vancouver. "We've had a lot of neglect in health care reform."

Brcic and others want a new health accord to focus on spending smarter, not just spending more — including a national prescription drug or pharmacare program.

"There are certain costs that have been growing in the last 10 to 20 years, drug costs is one of them," said Brcic.

Drug costs 'number one issue'

The ballooning cost of drugs is one of several issues, including home care, medical marijuana and doctor-assisted dying, expected to be discussed at the meetings.

A universal drug plan has long been championed by some in the health care system. A University of B.C. study last year claimed it could save the system billions of dollars.

Linda Silas, president of the Canadian Federation of Nurses Unions, said the groups want to see a concrete plan between the ministers and Ottawa in the next 18 months.

"[Philpott] can't wait at all," said Silas. "There are systems out there like long-term care, home care, hospitals, that are starving."

Silas echoed calls for a national prescription drug program. "That's a number one issue and has to be done," she said.

Hearts demonstration health ministers

The demonstrators strung up hearts along a street in downtown Vancouver, with their wishes for the health ministers' and a promised new accord with the federal government. (CBC)

With files from Catherine Cullen