Winter 2005 ONP Newsletter

First Ministers Meeting Sept. 2004: A Ten-Year Plan to Strengthen Health Care

Canada 's federal, provincial and territorial First Ministers met in Ottawa September 13 - 16 to formulate an historic ten-year plan to strengthen health care. Foremost on their agenda was the need to make timely access to quality care a reality for all Canadians. First Ministers were committed to the dual objectives of better management of wait times and the measurable reduction of wait times where they are longer than medically acceptable.

First Ministers also recognized that improving access to care and reducing wait times require many elements, including:

• cooperation among governments;
• the participation of health care providers and patients;
• strategic investments in areas such as: increasing the supply of health professionals (e.g. doctors, nurses and pharmacists);
• effective community based services, including home care;
• a pharmaceuticals strategy;
• effective health promotion and disease prevention; and
• adequate financial resources.

Building on the renewal agenda set out by the First Ministers' meeting in February 2003 and related investments, significant progress has been made and numerous efforts are underway throughout Canada across jurisdictions to make health care more responsive and sustainable. First Ministers are committed to achieving results, recognizing that making health care able to adapt to the ever-changing needs of Canadians will take time, sustained commitment and adequate resources. First Ministers agreed on an action plan based on the following principles:

• universality, accessibility, portability;
• comprehensiveness, and public administration;
• access to medically necessary health services based on need, not ability to pay;
• reforms focused on the needs of patients to ensure that all Canadians have access to the health care services they need, when they need them;
• collaboration between all governments, working together in common purpose to meet the evolving health care needs of Canadians;
• advancement through the sharing of best practices;
• continued accountability and provision of information to make progress transparent to citizens; and
• jurisdictional flexibility.

Recognizing that asymmetrical federalism allows for the existence of specific agreements for any province, First Ministers concurred that a separate communiqué be released to reflect the arrangements between the Government of Canada and the Government of Québec regarding the interpretation and the implementation of the plan.

In addition, all governments agreed to work together on the important matter of Aboriginal health.

The resulting First Ministers agreement contains the following commitments:

Reducing Wait Times and Improving Access

All jurisdictions have taken concrete steps to address wait times. Building on this, First Ministers committed to achieve meaningful reductions in wait times in priority areas such as cancer, heart, diagnostic imaging, joint replacements, and sight restoration by March 31, 2007 , recognizing the different starting points, priorities, and strategies across jurisdictions.

Strategic Health Human Resource (HHR) Action Plans

As part of efforts to reduce wait times, First Ministers agreed to continue and accelerate their work on Health Human Resources action plans and/or initiatives to ensure an adequate supply and appropriate mix of health care professionals. Governments agreed to increase the supply of health professionals, based on their assessment of the gaps and to make their action plans public, including targets for the training, recruitment and retention of professionals, by December 31, 2005 .

Home Care

All governments have recognized the value of home care as a cost-effective means of delivering services and are developing home care services to prevent or follow hospitalization. First Ministers agreed to provide first dollar coverage by 2006 for certain home care services, based on assessed need.

Primary Care Reform

Timely access to family and community care through primary health care reform is a high priority for all jurisdictions. Significant progress is underway to meet the objective of 50 percent of Canadians having 24/7 access to multidisciplinary teams by 2011. Building on this progress, First Ministers agreed to establish a best practices network to share information and find solutions to barriers to progress in primary health care reform such as scope of practice. First Ministers also agreed to regularly report on progress.

Access to Care in the North

Access to family and community-based health care services is a particular challenge in Northern communities, where the system's capacity to provide timely, health care services to a remote population can be limited. The federal government agreed to help to address the unique challenges facing the development and delivery of health care services in the North on a priority basis.

National Pharmaceuticals Strategy

First Ministers agreed that no Canadian should suffer undue financial hardship in accessing needed drug therapies. Affordable access to drugs is fundamental to equitable health outcomes for all our citizens. First Ministers directed Health Ministers to establish a Ministerial Task Force to develop and implement the national pharmaceuticals strategy and report on progress by June 30, 2006 . It was understood that Quebec will maintain its own pharmacare program.

Prevention, Promotion and Public Health

First Ministers recognized the progress that has been made by all jurisdictions to strengthen Canada 's public health system, including the creation of the new Public Health Agency of Canada. Governments committed to further collaboration and cooperation in developing coordinated responses to infectious disease outbreaks and other public health emergencies through the new Public Health Network. The federal government also committed to building on recent investments in immunization through ongoing investments for needed vaccines through the National Immunization Strategy. In addition, governments committed to accelerate work on a pan-Canadian Public Health Strategy.

Health Innovation

A strong, modern health care system is a cornerstone of a healthy economy. Investments in health system innovation through science, technology and research help to strengthen health care as well as our competitiveness and productivity. Investments in science, technology and research are necessary to develop new, more cost-effective approaches and to facilitate and accelerate the adoption and evaluation of new models of health protection and chronic disease management. Recognizing the progress that has been made, the federal government committed to continued investments to sustain activities in support of health innovation.

Accountability and Reporting to Citizens

All governments agreed to report to their residents on health system performance including the elements set out in the agreement and to seek advice from experts and health providers on the most appropriate indicators to measures of health system performance. All funding arrangements require that jurisdictions comply with the reporting provisions of the agreement. First Ministers of jurisdictions participating in the Health Council agreed that the Council prepare an annual report to all Canadians, on the health status of Canadians and health outcomes. The Council will report on progress of elements set out in the agreement.

Dispute Avoidance and Resolution

Governments formalized the agreement reached on dispute avoidance and resolution with regard to the Canada Health Act struck in April 2002.

For more details concerning the First Ministers' plan to strengthen health care, visit Health Canada's website.