Remarks from the Minister of Health on Backlogs Top-Up & Five Areas of Priority for the Future of Federal Provincial Relations on Health Care, March 25, 2022
March 25, 2022 | Ottawa, ON | Health Canada
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And thank you all for being here today.
I just had a wonderful exchange with young students here, at the University of Ottawa Nursing School.
These young Canadians are focused, dedicated and determined to provide the best possible care to their fellow citizens and so is our government.
Today, I’m joined by my colleagues Minister Bennett and Minister Khera.
We have some very important news for Canadians and their family.
Our announcement is two fold.
First, I have news to share with regards to surgical backlogs, and second, I will briefly lay out our vision for the future of federal and provincial collaboration on health care in Canada.
As we all know, the past two years have been challenging for our health care system, our health care workers and patients, especially our seniors and their families across the country.
In many cases, the pandemic has brought to light problems that have already existed for many years and made things even more difficult.
This is particularly true in the case of delays for diagnostics, treatments, and surgeries of all kinds.
This problem is not new, but the pandemic has contributed to exacerbating it even more acutely.
These delays are a burden that can be very hard to bear for the affected patients, their families and loved ones, as well as for the health care workers caring for them.
Imagine for a moment that you were diagnosed with cancer, recommended surgery and that, when the time comes, you’re informed that your surgery must be postponed.
The reality is that for lack of time, lack of space and lack of staff available to operate, too many of our fellow citizens have suffered and are still suffering this ordeal.
These delays not only impact people's health in the short and long term, they also have an impact on the stress that patients and their families are under, and on the stress felt by our health care workers who have been on the front lines for over two years.
In 2022, this should simply not be happening in Canada.
Today, on behalf of the federal government, I am pleased to announce an investment of $2 billion dollars to help our provincial and territorial partners significantly reduce the backlog of surgeries delayed because of COVID-19.
This major investment could help provinces and territories clearing hundreds of thousands of backlogged surgeries.
For the folks at home, this means that the surgery you’ve been waiting for months or even for years, will finally be scheduled.
This means that the hip replacement your mom or your dad has been waiting for will stop being postponed.
For a lot of Canadians, today’s announcement will be a huge relief.
These amounts will be transferred to our provincial and territorial partners through a one-time top-up of the Canada Health Transfer.
This is a significant first step on the road to addressing the major health care challenges ahead of us.
In addition to the $4 billion for backlogs announced in March 2021, today’s announcement will help repair the damage caused to our health care system by the pandemic.
It is also setting us on the long-term path towards ensuring that our healthcare system can meet the structural and demographic challenges of the 21st century.
In order to do this, we will want to work collaboratively with our provincial and territorial partner and focus on the needs of patients and the achievements of concrete outcomes.
Although it is not over yet, we already can and must learn from the pandemic.
As of right now, we can and must protect our public and universal health care system, a health care system that respects certain fundamental principles as set out in the Canada Health Act, a system based on:
- public administration
- portability; and
Historical Role of the Federal Government in Healthcare
We sometimes forget it or take it for granted, but several decades ago, in Canada, we made the choice to have a public and universal health care system.
Collectively, as a country, we’ve made the choice to leave no one behind and to deny no one necessary care, regardless of status or ability to pay.
Allow me to take a little historical detour to tell you very briefly how we collectively came to make this choice.
At the national level, not without a good deal of inspiration from the health insurance the late Tommy Douglas put in place in Saskatchewan, we first made this choice under the leadership of the government of Louis Saint-Laurent, with the passage of the Federal Hospital Insurance and Diagnostic Services Act, in 1957.
For the first time in our history, the idea of publicly funded health care became law.
For the first time in our history, Canadians could go to the hospital without fear of bankruptcy or worse: not being cared for because they couldn’t afford it.
A few years later, in 1966, the federal Medical Care Act was introduced before finally being signed into law in 1968.
With this law, for the first time, the principle of universality was codified in a Canadian law, applicable from coast to coast.
In exchange for a guarantee that the provinces and territories would respect this principle, the federal government committed to reimbursing the provinces and territories for a portion of their health care expenditures.
In 1977, the Federal-Provincial Fiscal Arrangements and Established Programs Financing Act, known as the EPF, was passed.
Instead of being reimbursed for their expenses as they occurred, the provinces and territories would receive annual block funding from the Canadian government and the federal government would agree to reduce its tax rates to allow the provinces to raise theirs to fund health care.
This long road culminates in 1984, with the unanimous adoption of the Canada Health Act, to which I referred a little earlier.
Now, why this long detour?
Because today, almost 40 years after the adoption of the Canada Health Act and two years after the beginning of the worst pandemic the world has known in over a century, we need to acknowledge that if we do not act quickly and decisively, the long term survival of the universal and public health system Canadians cherish is at risk.
A Collaborative Approach With Provincial and Territorial Partners
Fortunately, over the course of the last two years, the pandemic has shown what we can achieve when all levels of governments work together.
Thanks to the investments announced today, many people across the country will have faster access to the surgical treatments they need.
This is great news, but we also want to be clear-headed.
While today’s announcement is great news, we know that much more needs to be done.
The challenges we face require concerted and collaborative action by our government and our provincial and territorial governments.
As the years go by, the demographic, social-health and environmental context will place increasing pressure on our health care systems.
The aging of the population is both increasing the need and reducing the availability of our health care workers.
All the experts agree that we are facing and will face an increase in chronic diseases and rare diseases, a rise in the cost of technology and the cost of drugs, not to mention the escalating impacts of climate change on people's health.
When addressing these significant challenges, Canadians are not interested in a jurisdictional debate or a fiscal and financial fight.
Patients waiting for surgery and families hoping to gain access to family health services want results: they want care.
As promised during the election campaign and as often repeated since, our government wants to work in collaboration with the provinces and territories to deliver results for Canadians, their families and for our health workers.
Today, we want, publicly, to offer our cooperation to all provinces and territories.
Canadians aren’t interested in a sterile fiscal debate.
I’ll say it again, Canadians are interested in results: they want care.
In the wise words of the Honorable Monique Bégin, former federal Minister of Health and mother of the Canada Health Act:
"Nothing is more unproductive in Canada than a numbers war between two levels of government."
I’m an economist and - even I - don’t care much for a numbers war.
These fiscal and financial debates are sterile.
Of course, this collaboration needs to respect the jurisdictions and competencies of each level of government and focus on shared responsibility and results.
I call it the rule of the three Rs: respect, responsibility, and results.
- Respect for jurisdictions;
- Shared Responsibility; and
- Focus on Results.
As I described in the little historical detour we took earlier, the federal government played a key role in the creation of our public and universal health care system - we all have a role to play in maintaining that universality and accessibility.
I reiterate, the long-term survival of our public and universal health care system depends on it.
Five Areas of Priorities
In our conversation with Canadians and in our conversations with provincial and territorial partners, we have heard that in order to ensure the long-term strength of the health system, our collaborative work should focus on five fundamental areas of priorities.
- Backlogs and Health Workers
The first of these five priorities is the one that relates to delays in treatments, diagnosis, and surgeries and which is inextricably linked to the critical issue of health care workers.
The investments we’ve just announced will allow significant progress, but if we want to uphold the principles of universality and accessibility that are dear to all Canadians, we must better support health care workers.
We must find ways to attract and retain more of them, like the brave students we just met today at the University of Ottawa.
- Access to Family Health Services
The second area of priorities relates to access to family health services, also known as primary care.
More than 4.5 million Canadians are still looking for better access to family health services.
These services are essential for both preventive health care and for access to appropriate, effective and equitable health care.
- Long Term Care and Home Care
The third priority concerns long-term care and home care.
With our rapidly aging population, we know that the long-term care and home care needs of a growing part of our population will only increase.
The pandemic has also been a stark reminder that our long-term care and home care services need to be supported.
They need to be supported to ensure that our seniors and people with disabilities can live safely and with dignity.
Indeed, while it is now established that we should all have the right to die with dignity, our elders must also have the right to live and age with dignity.
My colleague, Minister Khera, is already hard at work on these issues and I know she will have more to say in a few minutes.
- Mental Health and Substance Use
The fourth area of priority relates to mental health and substance use.
In recent years, some of the most enduring taboos about mental health have fallen away, and mental health has taken on a more prominent place in the public sphere.
The pandemic has also had a significant impact on the mental health of many Canadians.
Our health care systems need to recognize these changes and impacts and be equipped with the resources necessary to meet the challenges they bring.
In addition, when it comes to addiction and substance use, we need to pay more attention to the opioid crisis that continues to rage in the background.
My colleague Minister Bennett has always shown tremendous leadership on these issues and continues to do so.
- Health Data and Virtual Care
Finally, digital health and virtual care must also be at the heart of our collaboration with provincial and territorial partners.
In 2022, it is not normal that from one hospital to another, from one city to another and from one province to another, Canadians are unable to access and consult their own medical records in one and the same place.
These five priorities are obviously not exhaustive, but in terms of delivering concrete outcomes for Canadians, they represent the fundamental basis upon which we want to continue working with our provincial and territorial partners, in addition to dental care and the rising cost of medicines.
If there is one thing that the last two years of the pandemic have demonstrated, it is that with good will and hard work, the federative nature of our country can yield considerable benefits.
We have demonstrated our ability to do this on a number of occasions over the course of our history and even more so over the last two years, in the context of the pandemic.
We’ve demonstrated it on housing, with 13 bilateral agreements.
We are demonstrating it on childcare.
We have demonstrated it with the delivery of billions of items of personal protective equipment and millions of vaccines.
We have demonstrated it with the support of the Canadian Armed Forces in our long-term care facilities.
We continue to demonstrate this with the supply and administration of antivirals.
And we continue to demonstrate this with the procurement and distribution of hundreds of millions of rapid tests.
Since the beginning of the pandemic, our government has invested more than $72 billion in the health of Canadians.
- In addition to this:
- $3 billion for bilateral agreements on long-term care
- $3 billion for bilateral agreements on mental health; and
- $3 billion for bilateral home care agreements.
We are looking forward to negotiating these agreements with all our provincial and territorial partners.
Finally, we must not forget the $45 billion represented by the Canada Health Transfer.
Clearly, we are prepared to do our part.
Together with our provincial and territorial partners, we will continue to roll up our sleeves, seize this historic opportunity and deliver results together in the best interests of everyone.
Together, with our partners from provinces and territories, we can deliver results in the best interest of all.
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