Public health-care advocates and unions from across Canada are calling on the provincial and territorial leaders to push Ottawa for a national health accord

Groups including Friends of Medicare, the Alberta Union of Provincial Employees and the Health Sciences Association of Alberta rallied Wednesday outside the Edmonton hotel where the annual Council of the Federation meeting was taking place.

The federal government has signed individual agreements with every province except Manitoba.

The groups say these bilateral agreements will take $33 billion out of the health-care system over the next decade, providing no mechanism for a national pharmacare program or seniors' long-term care.

The groups estimate Alberta will get $3.4 billion less than it needs under its agreement with Ottawa.

Linda Silas, president of the Canadian Federation of Nurses Unions, noted the premiers were talking about the challenges of meeting Ottawa's July 2018 deadline for legalizing cannabis.

"I have no problem with with legalizing marijuana," Silas told the crowd. "But I have a problem when the debate in that house is on legalizing marijuana when one in 10 Canadians can't afford medically-necessary medication."\

HSAA members

Members of the Health Sciences Association of Alberta joined other unions and public health care advocacy groups in a rally outside the premiers' meeting at the Hotel Macdonald in Edmonton Wednesday. (CBC)

Adrienne Silnicki, national coordinator for the Canadian Health Coalition, said these individual agreements make it difficult to enforce national standards.

Silnicki said the provinces were forced to sign the deals on short notice and she's calling on them to push back.

"They need to stand together. Manitoba hasn't signed on yet. They could stand together and say, 'Listen, we want a health accord,' " she said.

Health-care funding was not included in the issues covered in the premiers' joint statement released at the end of the conference Wednesday.

However, they said they will ask their ministers of health to initiate talks with Ottawa on pharmacare. 

Ontario Premier Kathleen Wynne said the premiers will also send a letter to the prime minister on the issue. 

"I think we can all agree that this is a gap in medicare," Wynne said at the final news conference of the annual summit. "It's something that needs to be dealt with."  

The last 10-year health accord expired in 2014. Talks between Ottawa and the provinces in December failed to produce a new agreement.