Next move to break impasse on health care deal is up to premiers: Duclos

Health Minister Jean-Yves Duclos said Wednesday that it's now up to the premiers to break the impasse over a new health care funding agreement since he and his provincial counterparts already have agreed in private on what must be done to fix the health care system.

Duclos says he and provincial counterparts were in 'total agreement' but premiers insisting on 'futile fight'

Federal Health Minister Jean-Yves Duclos says that in talks on improving Canada's health care system, the premiers have to agree on the ends before they can agree on the means. (Darryl Dyck/The Canadian Press)

Health Minister Jean-Yves Duclos said Wednesday that it's now up to the premiers to break the impasse over a new health care funding agreement since he and his provincial counterparts already have agreed in private on what must be done to fix the health care system.

Speaking in Ottawa, Duclos said that despite the failure to sign a new deal at a November meeting in Vancouver, he and the provincial ministers agree on what ought to be done.

"The ball is in the premiers' court," he said. "We were in total agreement in Vancouver in private. The problem is the premiers don't want [federal and provincial health ministers] to speak about those outcomes and those results."

Duclos suggested the debate has gotten hijacked by the premiers' insistence on the federal government covering 35 per cent of health costs.

"They want to maintain the futile fight on dollars," he said. "And that's a futile fight because they ask for 35 per cent. If you do the calculations correctly, we are already at 35 per cent."

Manitoba Premier Heather Stefanson, chair of the Council of Federation, called Duclos' comments "inaccurate."

"The Canada Health Transfer wasn't even on the agenda when health ministers met last month. He gave media soundbites outside the meeting, but came with no actual proposals of any kind. Those are the facts," she said in a media statement.

"Canadians are tired of federal games, where the prime minister has avoided talking about health care for over two years while his ministers deflect."

Stefanson said the prime minister must meet with the premiers for "serious discussions" on health care because it's a fundamental priority for Canadians.

Canada's premiers say the federal government is only paying 22 per cent of the cost of providing health care. They want that amount boosted to 35 per cent — an increase of $28 billion to the $45.2 billion Canada Health Transfer (CHT) starting this year.

The premiers also say that once federal health spending has increased, they want it to continue rising by six per cent annually going forward.

At the heart of the disagreement is how the federal contribution to the provinces is calculated. 

In 1977, direct federal funding for hospital and physician services was reduced. The federal government cut some taxes it collects and gave those tax points to the provinces, allowing income and corporate taxes collected at the provincial level to fund health services directly.

WATCH: Duclos: 'My job is to be an ally of health ministers':

Duclos: 'My job is to be an ally of health ministers'

3 months ago
Duration 2:21
Federal Health Minister Jean-Yves Duclos is asked how the federal government can help address strained health services across the country.

The federal government said that when the CHT and those tax points are combined with the money Ottawa spends on bilateral deals for long-term care, home care, mental health and some other services, the portion of health care spending covered by the federal government in 2021-22 came closer to 38.5 per cent.

The premiers have not included the tax points in their calculation, saying the CHT — the largest federal transfer to the provinces — covers only about 22 per cent of the cost.

Premiers silenced health ministers, Duclos claims

Duclos said that there have been 12 meetings between the provincial and federal health ministers to discuss health care funding and system reform over the past year.

Duclos said that, thanks in part to the leadership of B.C. Health Minister Adrian Dix, the provinces and the federal government reached common ground on two key issues over the past year. 

The first issue was recruitment and retention of health care workers. They also agreed, Duclos said, on data sharing initiatives to streamline care.

Duclos said that when the premiers went to Vancouver last month, he was optimistic that the agreement on those issues would be released publicly.

"Unfortunately, just a few days earlier, my health ministers received an order from their premiers not to speak about those results publicly," Duclos said.

"That's an unfortunate thing, because before we come to the means that we need to achieve some ends, we need to agree on the ends and to speak publicly about them."

Divide and conquer 

"This is not the correct discussion to be having," Duclos said. "The right discussion is what are the results that we want to reach together."

The minister said that, in private, provincial health ministers agree that the health-care system has to be transformed through increasing access to family doctors, recruiting and retaining staff, training more workers, recognizing the qualifications of foreign-trained health care workers, reducing the surgical backlog and implementing a modern data-sharing system.

Asked if the united stand on funding among the premiers could lead his government to divide and conquer by striking deals with individual provinces, as the Liberal government did back in 2017, Duclos said that it's possible.

"We did this in 2017 and during COVID-19 and sometimes we need to recognize the diversity of conditions and ambitions that we naturally have in a federation," he said.

"This is my role as well. It is to make sure our agreements with the provinces and territories take into account the different circumstances. And I am sure that that's what we'll do in the following months."


Peter Zimonjic

Senior writer

Peter Zimonjic is a senior writer for CBC News. He has worked as a reporter and columnist in London, England, for the Daily Mail, Sunday Times and Daily Telegraph and in Canada for Sun Media and the Ottawa Citizen. He is the author of Into The Darkness: An Account of 7/7, published by Random House.


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