44th Annual Premiers’ Conference


CHARLOTTETOWN, July 11, 2003. - Constructive and cooperative federalism means that everybody is doing their part to strengthen the country.

The arrangement announced by the Prime Minister at the February 2003 First Ministers’ Meeting was a good step, but it did not adequately address Canadians’ need for a sustainable health care funding partnership, as identified by the federal government’s Royal Commission on the Future of Health Care in Canada. The arrangement raised the share of federal funding from 14% in 2002/03 to just under 16% in 2003/04, but failed to meet the objective of increasing the federal share of health care funding to 25% of provincial and territorial health and social expenditures.

The poll released today by the Premiers’ Council on Canadian Health Awareness confirms that Canadians are concerned about current levels of federal health care funding and the effect that this inadequacy has on services now and in the future.

9 in 10 Canadians support Premiers’ continued efforts to get the federal government to increase its share.

Provinces currently pay 84% of the costs of health care in this country, while Ottawa only pays 16%. This is clearly not enough. Canadians agree with Premiers that the federal cash share of funding must rise over time to total at least 25% of provincial expenditures.

Premiers agreed that the federal government should act immediately to make good on its previous commitment to provide a further $2 billion from its 2003/04 surplus.
Ottawa clearly has the capacity to honour its pledge and provide the additional funding now.

Premiers called on the federal government to address the ‘Romanow gap’ in its 2004 Budget. This means increasing federal funding by $3 billion in 2004/05 and 1% per year after that until the federal share of funding is 25% of provincial/territorial health and social expenditures. Premiers called on all federal party leaders and leadership contenders to directly address their respective positions on this critical need for all Canadians.

Health Council

Premiers reiterated the support they expressed in February 2003 for a Health Council and improved accountability to Canadians. Premiers envisage that an effective Council will be consistent with the Arrangement reached at the February First Ministers’ Meeting.
The Council will report on the implementation of the Health Arrangement and be an advisory body to Health Ministers with a limited budget. However, Premiers agreed that before full implementation, more work needs to be done to ensure that the Council is affordable, with an appropriate mandate and non bureaucratic in nature. Premiers expressed a willingness to address these issues with the next Prime Minister.

Responding to Public Health Emergencies

Public health emergencies such as SARS further strain the sustainability of our health care systems.

Serious public health emergencies present challenges that often extend beyond any one jurisdiction. Existing arrangements for federal disaster financial assistance are inadequate for addressing these situations. Canadians need to know timely, predictable federal funding will be in place when they are faced with the considerable personal and health care costs and burdens of responding to emergencies. This is a shared Canadian responsibility regardless of where it occurs.

SARS is an extraordinary situation which requires an extraordinary national response. The SARS emergency will cost Ontario close to $1 billion in unforeseen extraordinary health care costs.

Premiers unanimously agreed that Canadians expect the federal government to immediately provide Ontario with the financial assistance it needs at the 90% level provided in response to crises of similar magnitude.

Premiers call on the federal government to improve the way it works with provinces and territories confronting a public health emergency by establishing a financial assistance program that appropriately responds to large-scale public health emergencies.

Premiers are committed to working together and with the federal government and U.S. border states to improve their ability to execute a coordinated response to public health emergencies, from prevention and preparedness to recovery.

Collaborative work between provincial-territorial Health Ministers and Ministers responsible for emergency management will continue with the goal of enhancing coordination, communication and action in these areas.

Health Ministers will work on a priority basis to address the sharing of resources across provinces and territories, including licensing or other barriers that may hinder rapid deployment of necessary health personnel to other jurisdictions in response to an emergency.

Above all, Canadians need to know that, in the face of public health and other emergencies, all orders of government will be responsive in supporting them and promoting economic recovery.


Premiers expressed disappointment that so little progress has been made in the current round of equalization renewal. Premiers are in full agreement that the federal government must work in true partnership with provinces and territories to address the disparities that exist among provinces. Premiers agree that it is critical for their Finance Ministers to have meaningful discussions with the federal minister before the federal proposals are finalized in September. The opportunity exists now to provide a meaningful strengthening of the equalization program. Possible approaches include a ten-province standard that recognizes the volatility around resource revenues, and comprehensive revenue coverage. They expressed their concerns over the significance and seriousness of the issues facing the equalization renewal and support their Finance Ministers’ call for an immediate meeting with the Federal Finance Minister to ensure that the program is strengthened in a meaningful way. Premiers noted that the equalization ceiling has been removed, but this removal has had no immediate fiscal impact for provinces or the federal government. Premiers support the removal of the equivalent ceiling in the Territorial Financing Arrangements.

Premiers recognized that the revision of population figures this September to embody the 2001 Census could have significant impacts on transfer payments to provinces and territories. While the exact impacts are not yet known, it is evident that some provinces and territories could face very large negative adjustments. The timing of the release of data, combined with the unknown effects of the data itself, will require some provinces and territories to react to potentially large negative impacts well into their fiscal year. As a result, Premiers call on the federal government to provide census forgiveness and fair and meaningful relief to provinces and territories that face dramatic data shocks that negatively affect their fiscal arrangements with the Federal Government.

Cooperation to Improve Programs and Services for Our Citizens

Provinces and territories are making advances in the level of health care services to Canadians as a result of renewal efforts. Premiers are committed to making health care work. Provinces and territories are adding staff, reducing waiting times and finding greater efficiencies.

Provinces and territories are also collaborating on several initiatives to improve health care for their citizens, including the common drug review, health care sites of excellence, a nursing strategy, health human resources, and home care. Quebec participates in home care and will continue to participate in other initiatives by sharing information and best practices.

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Patrick Dorsey
Office of Premier Pat Binns
Tel: (902) 368-4402