With the clock ticking down on former prime minister Paul Martin's health-care accord, which guaranteed 10 years of stable funding to the provinces and territories to tackle much-needed improvements, Ottawa is facing increasing pressure to negotiate a new deal. But as campaigning provincial party leaders across the country push the issue, there is little to show for the seven years of funding the accord has provided so far.
Mr. Martin, whose Liberal government established the $41-billion health accord in 2004, says Ottawa is squandering its opportunity to reform the system. The accord was designed to give the provinces a decade with predictable health care money in which to make major fixes to the system, such as reducing waits for some procedures. While progress has been made, many of the goals – such as a national pharmaceuticals strategy – have not been reached.
The accord was a response to provinces' complaints that they lacked resources to change the system.
"What we did in 2004 is say, 'Okay, look, we're going to transfer the funding you need for the next 10 years and we're going to put inflation protection of 6 per cent in there. The reason we are doing this is that we believe we've got to take the next 10 years to make sure the health care system evolves and is reformed,'" Mr. Martin said in an interview.
"You don't have to be a biblical prophet to understand that an aging population is going to put more pressure on your health care system," he said. "So don't wake up in 2015 and say, 'Oh my god, we've got a crisis, we've got all of these older people.'"
Seven years on, Mr. Martin is disappointed with the progress. "There are still three years before 2014, and [the federal government]should be sitting down with the provinces now, while the cash pressure isn't on, to reform the system," he said. The Conservatives said during this year's election campaign that they intend to continue the 6 per cent annual increase in health transfers to the provinces and territories under the current accord until at least 2016, but Mr. Martin warned that simply extending the deal isn't the answer.
"My worry is that they've now come along and said they're going to extend the 6 per cent for two years, that they're just going to sit there and waste all this time," Mr. Martin said.
The Harper government is signalling that it will await the results of provincial elections to see who will be at the negotiating table. Conservative Health Minister Leona Aglukkaq recently told a meeting of the Canadian Medical Association that Ottawa intends to work with the provinces and territories to renew the accord, but it is still in the planning stages.
"When the time does come to sit down with provinces and territories, we will put patients first," Steve Outhouse, a spokesman for Ms. Aglukkaq, said in an e-mailed statement. "We'll focus on accountability, meaning that patients will see results for the money spent on health care."
The best outcome would be a new accord that sets detailed ambitious goals as part of a new health care strategy that incorporates prevention, and rewards provinces for improving the health of their citizens by, for instance, reducing smoking rates, said Janet Davidson, CEO of Trillium Health Centre.
"There's no doubt that reform is required. Since the last accord, Canada has spent a lot more money but our performance has not improved relative to other developed nations," she said.