In recent days, some premiers have voiced optimism about reaching a deal soon with the federal government over increasing health-care funding, something Prime Minister Justin Trudeau says he still wants tied to improved outcomes before the money rolls out of Ottawa.
During his year-end interview with Chief Anchor and Senior Editor of CTV National News Omar Sachedina, Trudeau said that while the federal government was willing to send "billions more" he wouldn't pull up a chair at the table until there's a more concrete plan for provincial accountability.
The prime minister said at the time this was because he wasn’t willing to just put money into a "strained, if not broken" system without assurances it would result in better care.
With some premiers now signalling a willingness to agree to conditions in exchange for more money, are the federal and provincial governments getting closer to an agreement?
Here's what premiers and the prime minister have said this week.
PRIME MINISTER JUSTIN TRUDEAU
"I've had some very constructive conversations with premiers, including premier Ford and premier Legault. Our ministers and their counterparts are working very closely, and I'm hopeful that we're going to be able to come to an agreement soon," Trudeau told reporters during a press conference on Thursday. "We know that Canadians deserve better health-care services, and the federal government will be there to support."
The prime minister also offered examples of potential outcomes provinces would be accountable for, such as better access to family doctors, shorter wait times for accessing mental health services, or reducing the backlog for important surgeries.
Coming out of the meeting with Francois Legault Trudeau referenced late last year, the Quebec premier indicated he was "more optimistic" than he was previously about reaching a deal with the federal government after his conversation with Trudeau.
ONTARIO PREMIER DOUG FORD
On Thursday, Ford told reporters that he believes in "sticking with" other premiers, and that he's recently been in talks with Manitoba Premier Heather Stefanson—who is also the chair of the Council of the Federation—about getting "a fair deal" for all provinces and territories.
"We want a deal but we need to sit down with the federal government and the prime minister and really have a talk across the table… I'm still confident we're going to get a deal. I really am," said the Ontario premier.
"I'm very, very confident. So we're going to keep working at it," Ford continued. "And I'm sure all of us will be out making an announcement, hopefully sooner than later."
ALBERTA PREMIER DANIELLE SMITH
In an interview on CTV News Channel's Power Play with Vassy Kapelos on Monday, Smith said she has no issue with the federal government wanting strings attached to a funding increase.
"I'm working on accountability measures right now. I want more accountability from the health-care system," she said.
However, her preference would be to have a federal partner that trusts the premiers to know how to best manage their provinces' health pressure points.
For now, Smith also indicated that she won't be waiting for federal money to reform her province’s health-care system because in her view the federal government has been "pretty clear they are not coming to the table."
NOVA SCOTIA PREMIER TIM HOUSTON
Houston, who came into office after campaigning almost singularly on fixing the provinces health-care system, is currently facing considerable scrutiny over the recent deaths of two women following lengthy waits in Nova Scotia hospital emergency rooms.
In an interview on CTV News Channel's Power Play with Vassy Kapelos on Tuesday, Houston said he knows there is a lot of work to be done to improve his provinces' health-care system, and doing so will take "a lot of money."
While like Smith, Houston said he isn't waiting around for more federal dollars to be put on the table, he'd still like to see Trudeau come to the table to talk about what commitments he needs before a deal can be reached.
"It's not about us not wanting to be held accountable. I've looked the federal government in the eye and said, 'look, we're held accountable every single day,'" he said.
"There's no more being held accountable than then facing the tragedy that we're facing now. There's no more evidence of the work that needs to be done. So… let's have that meeting. Let's talk about how we can work together."
NEWFOUNDLAND AND LABRADOR PREMIER ANDREW FUREY
On Friday, in an interview on CTV News Channel's Power Play with Joyce Napier, Newfoundland and Labrador Premier Andrew Furey offered a more tepid response to the question of whether he'd be on side with accepting federal funding with strings attached.
"I think that that's simplistic in the approach, I think there is the ability to have shared priorities while preventing jurisdictional creep. I think some of the issues that other premiers and I frankly share because I don't think the federal government has the desire nor the agency to run a health-care system," Furey said.
Both federal and provincial governments should be accountable when it comes to how taxpayers' money is being spent, the premier said.
"I've always just wanted the discussion, the conversation, because I can tell you as a provider myself, having sat on the other side of the gurney and delivered bad news, never once in the thousands of patients I've dealt with, has anyone ever asked who's paying for this federal government or the provincial government," Furey said.
Though, Furey shared Ford's optimism that should both sides come together, a deal could be reached "very quickly,” while noting that rebuilding Canadian health-care systems will not be a quick fix.
"If there was a quick fix—even if it was just monetary—other jurisdictions would have done it already. We need to reimagine a health-care system that Canadians have trust in, have faith in, believe in, and are proud of. And, I think we can achieve that together so that we're not anchored in a system that was designed for the 1960s and being delivered in 2023."
HOW DID THE TWO SIDES GET HERE?
(B.C. Health Minister Adrian Dix, front right, is flanked by his provincial counterparts as he listens to a question during a news conference without federal Health Minister Jean-Yves Duclos after the second of two days of meetings, in Vancouver, on Tuesday, November 8, 2022. THE CANADIAN PRESS/Darryl Dyck)
A longstanding call, in recent months premiers have been ramping up pressure for Trudeau to meet with them to discuss the federal government increasing the Canada Health Transfer—which funnels federal dollars into provincial health-care systems—to 35 per cent up from the current 22 per cent of coverage for health-care costs.
This recently re-emphasized demand comes as hospitals and health-care facilities appear to be in crisis mode, between staffing shortages and a cold-weather surge of illnesses compounding extended wait times and other struggles to access adequate care. The latest push for a funding increase came even as some provinces are sitting on budget surpluses.
In November, a meeting between Duclos and provincial health ministers ended in acrimony after the two sides couldn’t come to an agreement to boost health funding. Duclos put the blame for the breakdown on the premiers, who he said did not want to accept conditions in exchange for more federal money.
WHAT FORMER PREMIERS THINK IS NEXT
During Thursday's "Front Bench" panel on CTV News Channel's Power Play with Vassy Kapelos, a trio of former premiers weighed in on where things stand and what they anticipate is about to unfold.
"They'll get to an agreement, I have no doubt about it," said former British Columbia premier Christy Clark. "They'll decide to spend a bunch more money, there will be no way to keep track of it as if there ever is. So, they can attach as many strings as they want. I mean, it's really kind of a hopeless, never ending circle of the blame game. More money, no accountability, more blame, and the circle keeps going around and around."
Former Ontario premier Kathleen Wynne said there have been strings attached on past money put into the health-care system, but with different levels of distrust of Trudeau among premiers she said she wouldn’t be surprised to see Ottawa try to initially negotiate bilateral agreements with some provinces.
"Maybe there'll be a unified front, but I would be very surprised if there weren't some initial agreements between the federal government and a province, or a couple of provinces, and then you'll see everybody come on side, that's what I would predict would happen," Wynne said.
Former Nova Scotia premier Darrell Dexter echoed Wynne in saying that he certainly felt accountable for health-care outcomes when he was in the premier's office. He said Trudeau's approach when it comes to the rate of increase of the Canada Health Transfer has not been dissimilar to that of the former Conservative government under Stephen Harper.
"And so it's been that way for now more than a decade and you know, the health-care funding could use a serious reset," Dexter said.
The former premiers agreed that the status quo is unsustainable and right now may be the time for both the provinces and the federal government to show leadership and get serious about wholesale changes to the system, while being mindful about Canadians' expectations that publicly-funded health care is upheld across the country.
