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Health Minister Leonoa Aglukkaq speaks at a Toronto news conference on March 10, 2011.The Globe and Mail

Federal Health Minister Leona Aglukkaq has responded to calls by provincial and territorial leaders to find innovative ways to make health-care work by listing the investments the Conservative government has made in medicare.

In letter sent Thursday to the premiers, Ms. Aglukkaq praises their efforts to work together but holds out no hope Ottawa is willing to contribute more than it has already promised to ensure the sustainability of the public health system.

Saskatchewan Premier Brad Wall and Prince Edward Island Premier Robert Ghiz agreed while meeting with other premiers earlier this week to co-chair a working group to draft standards that will ensure innovations are shared between the country's 13 separate health-care systems. It is an effort that will focus heavily on reducing labour costs.

Ms. Aglukkaq said in her letter that she welcomes the effort to form the Health Care Innovation Working Group and she agrees that more can be done together. She also reiterated her commitment to work with the provinces and territories to address shared priorities.

But she went on to point out that her government invests more than $1-billion in innovation through the Canada Institutes for Health Research, Canada Health Infoway and other programs supporting research and health human resources.

"This is in addition to our recently announced long-term, stable funding arrangement that will see transfers reach $40-billion by the end of the decade," Ms. Aglukkaq wrote. "This stability and a shared commitment to innovation and accountability provide a solid foundation for our efforts to optimize the results of our health care investments."

Some of the premiers had hoped to unite behind a call for a health-care innovation fund on top of the transfer payments mentioned by Ms. Aglukkaq in her letter. But Prime Minister Stephen Harper swiftly rejected that appeal on Monday, delivering the message through a television interview that the premiers learned about while they were meeting.

Ms. Aglukkaq writes that she would be pleased to "engage in intergovernmental discussions" with regard to innovation and improved accountability as well as a co-ordinated approach to measuring performance across the country.

But it is clear from her letter that the funding formula unilaterally determined by the federal government has no wiggle room.

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