Quebec Health Minister Gaétan Barrette quickly nixed any possibility of a ceasefire in the ongoing dispute over a new health accord, accusing the federal government of trying to "trap" the provinces into a cut-rate deal.
Dr. Barrette and his federal counterpart, Jane Philpott, shared the same stage at a medical conference in Ottawa on Thursday, but showed they are far from being on the same page.
Dr. Philpott launched into her speech by saying the government and the provinces need to find common ground to improve services in areas such as home care and mental health.
"If you think that I am here to squabble, you will be disappointed," Dr. Philpott said at the event, organized by think tank Canada 2020 and the Canadian Medical Association.Speaking immediately afterward, Dr. Barrette ratcheted up the rhetoric, launching into a long presentation to show how provinces like Quebec do not have any fiscal leverage to improve services in Ottawa's areas of concern.
"The ongoing discussions on a new health accord are off to a bad start, because they are based on issues [such as home care], while what we really need to talk about is funding," Dr. Barrette said. Canada's provincial governments are applying increasing pressure on the federal government to boost its annual cash transfers beyond next year's planned increase of 3 per cent.
Ontario's Liberal government – a traditional ally of the Liberals in Ottawa – said it "cannot support" the federal position heading into discussions on a new accord on Oct. 18. "For Canada's health-care system to remain sustainable, the federal government must play a larger role in covering the costs of health care," Ontario Health Minister Eric Hoskins said in a statement.
In a recent letter to Prime Minister Justin Trudeau, the provinces called for a meeting "dedicated solely to long-term health-care financing," ahead of another first ministers meeting on the environment later in the year. The underlying threat in the letter was that the provinces will balk at a deal on climate change if they do not come to terms on a new health accord.
The other option offered by the provinces was to keep existing transfers in place for another year. As it stands, annual increases in health transfers of 6 per cent a year, which have been in place since 2004, are due to fall next year to as low as 3 per cent.
One of the difficulties in the runup to negotiations is that Dr. Philpott said her mandate is to improve the delivery of home-care services in Canada, with no sway over funding matters.
"The finances I will leave to the Finance Minister and the first ministers," she told reporters after her speech. "My goal is to make sure Canadians are healthy and get better health care." Dr. Philpott rejected the notion that Ottawa is impinging on provincial jurisdictions by pushing for improved home care, stating "this is about us being a contributor, about us being a facilitator.
"The facts simply don't support the notion that the major issues facing our health system will be solved simply by tossing more money at the system.
"We have an obligation as the government of Canada to do more than simply open the federal wallet," she said.
Dr. Barrette responded that because of infrastructure and personnel costs, Quebec's health-care system grows by 3 per cent a year before any new or improved services are factored in. He said better home care is a clear priority for his government, but that Ottawa needs to put more money on the table before Quebec agrees to talk about anything else.
"Talking about conditions is their way not to talk about funding," he told reporters. "It's a trap."
In his speech, Dr. Barrette cautioned that "innovation" is a buzzword that often leads to increased health-care costs. He said Ottawa is offering $232-million a year in increased funding for home care – or about 5 per cent of Quebec's need.