Ontario is worried necessary innovations in home care for seniors and other health-care reforms will suffer if the federal government doesn't help set national standards, Premier Dalton McGuinty said Monday.

The provinces have been scrambling to figure out how to move forward with health-care reforms after Finance Minister Jim Flaherty surprised them last month with a 10-year health funding package that had no policy strings attached.

Ontario urged Prime Minister Stephen Harper to put conditions on the federal money, McGuinty said after touring St. Lawrence College in Kingston.

"What I would have liked is for the prime minister to — what I encouraged him to do — is say here's more money for the provinces and territories, but here's a new condition: you must invest in more home care, you must invest in more seniors care," he said.

McGuinty said it's less expensive and more desirable for seniors to stay in their homes as long as they reasonably can.

Premier fears patchwork quilt of services

The cash-strapped provinces — Ontario is struggling under a $16-billion deficit — could end up taking different approaches to health-care reform as they try to rein in spending, leading to a patchwork quilt of services across the country without Ottawa's oversight, warned McGuinty.

"What is unfortunate is that we've given up the opportunity to partner with respect to progress in health care, and I think just as a Canadian, I would like to know we're going to have strong national standards and that we can find a way forward together," he said.

"In light of that, what I'm hoping we might do more as provinces is come together ourselves and share our best practices, learn from each other and find some ways forward where we can do more for all Canadians by way of co-operation."

Prime Minister Stephen Harper was asked last week during a radio interview whether Ottawa is, in effect, telling the provinces to take full responsibility for health care.

"That's partly what we're saying," Harper told The Rutherford Show.

"The provinces themselves are going to have to look seriously at what needs to be done to make the system more cost effective."

The premiers and territorial leaders will meet in Victoria Jan. 15 to 17 to discuss a health-care plan or strategy, and federal Health Minister Leona Aglukkaq is touring the country to meet with her provincial counterparts to talk about ways of holding the provinces to account for their federal health transfers.

2004 health accord made real progress, McGuinty says

McGuinty called Ottawa's decision to give the provinces a take-it-or-leave-it health-care funding proposal "less-than-ideal," and said the different levels of government made real progress in their 2004 health accord by linking the funding to improved patient outcomes and shorter surgical wait times.

"I had, together with my colleagues from across the country, looked forward to having a really important conversation with the prime minister about the future of health care and what it is we might do together in a partnership," he said.

"We struck that kind of a partnership back in 2004, made some specific commitments together in return for funding, and by and large, we were quite successful in achieving those stated objectives."

However, Ontario's Progressive Conservatives said the Liberals had mismanaged the province's finances so badly for the past eight years that they were not surprised Ottawa doesn't want to partner with the province.

"I don't know how the federal government can have any faith in the way the provincial government is handling our health-care dollars right now and that's why they've gone this route," said Opposition critic Todd Smith.