Provincial-Territorial Premiers’ Meeting

Premiers met in Vancouver to review the progress made since their August 2001 Annual Premiers' Conference on provincial and territorial initiatives aimed at protecting the sustainability of health care. This meeting is part of the ongoing process initiated by Premiers to ensure that quality care is available to patients when and where they need it.

Premiers discussed the critical challenges facing health care in their respective jurisdictions. All agreed that health care systems are at a turning point: they must be renewed to meet today's needs and must rest on a solid foundation to be available for future generations

Financial Pressures on Health Care

Despite significant reforms, Premiers confirmed their assertion that in order to sustain quality health care the current level of federal contributions to health care is not adequate. Premiers reiterated their consensus expressed at the Annual Premiers' Conference in August 2001 regarding federal funding of health care (see attachment).

Premiers Commit to Create Premiers' Council on Canadian Health Awareness

Premiers agreed to launch a jointly-funded Premiers' Council on Canadian Health Awareness aimed at improving Canadians' access to information and enhancing public awareness of the challenges of and solutions for the future of health care in each jurisdiction.

The Premiers' Council is expected to be operational before May 1, 2002. Provinces and territories have agreed to cooperate by pooling some health research and resources to fund the Council.

The Premiers' Council will have a mandate, budget and full-time staff to gather and disseminate information to Canadians on issues such as health care funding, health services innovation and best practices, human resource planning and management, drug effectiveness and assessment, and statistical comparisons provided by provinces and territories.

The Council will develop a multi-media website that will provide all Canadians, including health providers, researchers, educators, and students, with an unprecedented window to access provincial and territorial health data, global health research, and information on health care reforms within Canada.

Dispute Resolution Mechanism for the Canada Health Act

All Premiers support the principles of the Canada Health Act¹. At the same time, they acknowledged that disagreements over the interpretation of those principles could delay or inhibit innovation and lead to unnecessary federal/provincial conflict.

In the 1999 Social Union Framework Agreement² (SUFA), it was agreed that a dispute resolution mechanism would be developed for the interpretation of the Canada Health Act. Over the last three years, provinces have pressed for development of such a workable dispute resolution mechanism that would enable disputes relating to the Canada Health Act to be resolved in a transparent and open way. Premiers noted that a dispute resolution mechanism should provide for independent, third-party fact-finding and for independent third-party advice, mediation, and recommendations to assist governments in the event of a dispute. The Premiers recognize that such advice and recommendations would not be binding on either government.

Premiers asked Premier Klein to take the lead in working with the federal government to finalize, by April 30, 2002, a dispute resolution mechanism that provides for third-party mediation, recommendations and advice. Should discussions not be successful by April 30, Premiers agreed that the federal government will have essentially abandoned the Social Union Framework Agreement.

Aboriginal Health Care

Premiers strongly urged the federal government to fulfill its responsibility with regard to the provision of health services to all Aboriginal people, wherever they live in Canada. The federal government has yet to act on last year's Throne Speech commitments to improve health care services to Aboriginal people. Even though the recent budget identifies additional funding for Aboriginal health issues, such as Fetal Alcohol Syndrome, the allocated funds are restricted to Aboriginal children living on-reserve. This includes the effective implementation and expansion of federally funded home care services to Aboriginal Canadians.

Pharmaceuticals Management*

   
• Collaborating in Drug Assessments

Building on the experience of Atlantic provinces, Premiers agreed to start a common review process for new drugs. This significant new agreement will reduce duplication of effort and help to provide best quality of care. This review process will incorporate common assessment of cost effectiveness based on sound scientific and economic analyses. Premiers directed their Health Ministers to develop common recommendations for the approval of all new drugs to be covered under provincial and territorial drug plans by the end of August 2002. Premiers also directed their Health Ministers to approve all new drugs for coverage on a probationary basis subject to ongoing assessment of cost effectiveness.

   
• Streamlining Approval of Generic Drug Processes:

Premiers directed their Health Ministers to streamline the approval process for generic drugs by December 2002 so that effective but less expensive drugs are available more quickly.

Shared Utilization of Sites of Excellence for Low Volume Surgery*

Premiers recognize that some types of surgery and other medical procedures are performed infrequently, and that the necessary expertise cannot be developed and maintained in each province and territory. Building on the experience in Canada's three Territories, and Atlantic Canada, Premiers agreed to share human resources and equipment by developing Sites of Excellence in various fields, such as pediatric cardiac surgery and gamma knife neurosurgery. This will lead to better care for patients and more efficient use of health care dollars. Premiers directed their Health Ministers to develop an action plan for implementation of such sites before their August meeting in Halifax.

Human Resource Planning*

In the October, 2000 Nursing Strategy for Canada, provincial and territorial health ministers recommended an increase of 10% in nursing positions across the country.

Provinces and territories are making progress in a number of areas to address shortages of health care professionals and the provision of quality care including more use of primary care teams, nurse practitioners and alternative payment models.

Premiers committed to work with the Canadian Institute of Health Information to institute a Pan Canadian database on human resource needs, training requirements and scope of practice to assure a sustainable supply of health professionals to maintain patient care. Premiers recognize that this critical challenge must be addressed through common strategies that meet each province's and territory's unique needs, geographic challenges and fiscal capacities.

Home and Long Term Care

Premiers noted that they were all increasing investments in continuing care and noted increased quality benefits. In the absence of the federal government meeting its commitment to fund improvements, Premiers will be developing a coordinated long term care response for the Annual Premiers' Conference in August 2002.

* Québec will contribute to these efforts by sharing information and best practices.

                              

¹   Taking into account that Québec governments have never recognized the Canada Health Act even though, in practice, Québec's health care services respect those principles.
²   Québec is not a signatory of the Social Union Framework Agreement.

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