Canada’s health care system is on the fast track to becoming 14 splintered systems as the Harper government is clearly signaling that it is vacating the field with its decision to axe the Health Council of Canada, health policy experts and political critics charge.
“Scandalous,” “short-sighted,” and “frightening” were among the responses to yesterday’s iPolitics disclosure that the council’s funding will be discontinued with next year’s expiry of the intergovernmental health accords.
“I don’t think it’s just a signal. I think it’s a bullhorn,” said Dr. Greg Marchildon, Canada Research Chair in public policy and economic history at the University of Regina and former deputy minister of intergovernmental affairs for the Saskatchewan government. “Both health reform and any kind of collaborative federalism are really off the agenda for the Harper government.”
“This is really a shame,” he added. “There are very few mechanisms that we have in this country that allow us to think about the large reform issues and the Health Council was one of them.”
Among the consequences will be a shortfall in “objective, high quality evidence” about the performance of the health care system, argued Dr. Noralou Roos, director of the non-partisan Evidence Network of Canadian Health Policy and professor of medicine at the University of Manitoba. “I don’t understand. The health care sector is so important to Canadians, and we need information on how well it’s functioning and that’s what they are providing.”
As significant will be the loss of one of the few national accountability mechanisms within the system, said Canadian Medical Association President Dr. Anna Reid. “Really, who else is monitoring this stuff?,” she asked. “I think it’s very unfortunate that the federal government is once again stepping away from its responsibility to show some sort of leadership in health care.”
The decision to axe funding for the council is also an indicator that the Harper government is vacating its responsibility to “set national standards in health care,” said Dr. Ryan Meili, vice-chair of Canadian Doctors for Medicare and a family physician in Saskatoon. “There are elements of the Canada Health Act that are in jeopardy here.”
But Steve Outhouse, director of communications for Health Minister Leona Aglukkaq, dismissed the criticisms, saying the minister has written all provincial health ministers offering to take a lead role in setting national standards. “That letter was sent about 18 months ago and we have not received one reply.”
“The critics really need to get new talking points,” Outhouse added in response to the proposition that the government is walking away from the national health field. Rather, he said, it is investing heavily in many areas of health research, particularly palliative care, Aboriginal health and new models of health care delivery.
“There is a lot of federal leadership in the health field. Unfortunately, we have, again, these political agendas where people feel that we should be interfering in provincial and territorial jurisdiction and they think that’s the only way things can be done,” Outhouse said.
But others argued there are still other agendas at play.
The council cut was another broad indicator of the Harper government’s anti-science attitude, Meili argued. “It’s part of vacating a much larger field, which is that of science, knowledge and research. They’re cutting information gathering and structures at so many levels, as well as the ability to communicate what information is gathered.”
Liberal party health critic Dr. Hedy Fry called it “a bold, bold, in-your-face move” that reflects the Conservative government’s fondness for the “muzzling of anyone who dares to give evidence and scientific data and research data to hold them accountable for anything.”
Fry also rejected the proposition that a need for fiscal restraint justified the council cut. “Fiscal responsibility comes with accountability,” she said, charging that the move was actually driven by Prime Minister Stephen Harper’s ideological desire to decentralize as much of the federal government as possible “now that he has a majority government.”
Meili and Marchildon concurred, while also rejecting the Harper government’s argument that there’ll no longer be a need to report on the system’s performance after next year’s expiry of the 2003 First Ministers’ Accord on Health Care Renewal and the 2004 10-Year Plan to Strengthen Health Care.
“If you cut your ability to understand whether you are providing quality, efficient care, you either cost yourself more money, or you’re costing yourself in terms of human outcomes,” said Meili.
Relative to the amount spent on health care in Canada (roughly $210 billion), “this is a drop in the bucket,” particularly in light of potential council findings that might help reduce systemic costs, said Marchildon. “This leaves quite a space, quite a vacuum.”
“This was very ideologically motivated,” he added. “It has to do with your definition of government, first and foremost, and secondly, the role of the federal government in terms of the federal-provincial division of powers.”
But Outhouse contended the cut “was a fiscal decision overall. We’re looking for ways to obviously save and bring the federal books back into balance.”
Still others surmised the council is being punished for its hard hitting reports. “We’ve seen from this government over and over again that when you have evidence and you show it, when you show the federal government in a negative light, you get cut,” said Adrienne Silnicki, health care campaigner for the advocacy group, the Council of Canadians.
Several observers also contended that there will ultimately be severe health consequences for Canadians, particularly in terms of access to care, as well as in variations in the quality of care that they receive from province to province.
“What they’re signaling is that we’re to take it from this announcement that there will be no renewed health accord beyond 2014,” said Mike McBane, national co-ordinator of the public advocacy group, the Canadian Health Coalition. “Which literally means a blank cheque to the provinces. It’ll mean the dismantling of the national health system. It means no accountability for how that money [health transfers to the provinces] is spent. There’ll be no national standards, no goals, no benchmarks, no co-ordination, no collaboration, no common measures, no common approaches to wait times and above all, no reporting to the people of Canada, who own the health care system.”
McBane also argued the Harper government is breaching its constitutional responsibility to ensure comparable levels of service for all Canadians. “I would characterize this as revolutionary. This is ripping up the last national social program left in Canada.”
Original Article
Source: ipolitics.ca
Author: Wayne Kondro
“Scandalous,” “short-sighted,” and “frightening” were among the responses to yesterday’s iPolitics disclosure that the council’s funding will be discontinued with next year’s expiry of the intergovernmental health accords.
“I don’t think it’s just a signal. I think it’s a bullhorn,” said Dr. Greg Marchildon, Canada Research Chair in public policy and economic history at the University of Regina and former deputy minister of intergovernmental affairs for the Saskatchewan government. “Both health reform and any kind of collaborative federalism are really off the agenda for the Harper government.”
“This is really a shame,” he added. “There are very few mechanisms that we have in this country that allow us to think about the large reform issues and the Health Council was one of them.”
Among the consequences will be a shortfall in “objective, high quality evidence” about the performance of the health care system, argued Dr. Noralou Roos, director of the non-partisan Evidence Network of Canadian Health Policy and professor of medicine at the University of Manitoba. “I don’t understand. The health care sector is so important to Canadians, and we need information on how well it’s functioning and that’s what they are providing.”
As significant will be the loss of one of the few national accountability mechanisms within the system, said Canadian Medical Association President Dr. Anna Reid. “Really, who else is monitoring this stuff?,” she asked. “I think it’s very unfortunate that the federal government is once again stepping away from its responsibility to show some sort of leadership in health care.”
The decision to axe funding for the council is also an indicator that the Harper government is vacating its responsibility to “set national standards in health care,” said Dr. Ryan Meili, vice-chair of Canadian Doctors for Medicare and a family physician in Saskatoon. “There are elements of the Canada Health Act that are in jeopardy here.”
But Steve Outhouse, director of communications for Health Minister Leona Aglukkaq, dismissed the criticisms, saying the minister has written all provincial health ministers offering to take a lead role in setting national standards. “That letter was sent about 18 months ago and we have not received one reply.”
“The critics really need to get new talking points,” Outhouse added in response to the proposition that the government is walking away from the national health field. Rather, he said, it is investing heavily in many areas of health research, particularly palliative care, Aboriginal health and new models of health care delivery.
“There is a lot of federal leadership in the health field. Unfortunately, we have, again, these political agendas where people feel that we should be interfering in provincial and territorial jurisdiction and they think that’s the only way things can be done,” Outhouse said.
But others argued there are still other agendas at play.
The council cut was another broad indicator of the Harper government’s anti-science attitude, Meili argued. “It’s part of vacating a much larger field, which is that of science, knowledge and research. They’re cutting information gathering and structures at so many levels, as well as the ability to communicate what information is gathered.”
Liberal party health critic Dr. Hedy Fry called it “a bold, bold, in-your-face move” that reflects the Conservative government’s fondness for the “muzzling of anyone who dares to give evidence and scientific data and research data to hold them accountable for anything.”
Fry also rejected the proposition that a need for fiscal restraint justified the council cut. “Fiscal responsibility comes with accountability,” she said, charging that the move was actually driven by Prime Minister Stephen Harper’s ideological desire to decentralize as much of the federal government as possible “now that he has a majority government.”
Meili and Marchildon concurred, while also rejecting the Harper government’s argument that there’ll no longer be a need to report on the system’s performance after next year’s expiry of the 2003 First Ministers’ Accord on Health Care Renewal and the 2004 10-Year Plan to Strengthen Health Care.
“If you cut your ability to understand whether you are providing quality, efficient care, you either cost yourself more money, or you’re costing yourself in terms of human outcomes,” said Meili.
Relative to the amount spent on health care in Canada (roughly $210 billion), “this is a drop in the bucket,” particularly in light of potential council findings that might help reduce systemic costs, said Marchildon. “This leaves quite a space, quite a vacuum.”
“This was very ideologically motivated,” he added. “It has to do with your definition of government, first and foremost, and secondly, the role of the federal government in terms of the federal-provincial division of powers.”
But Outhouse contended the cut “was a fiscal decision overall. We’re looking for ways to obviously save and bring the federal books back into balance.”
Still others surmised the council is being punished for its hard hitting reports. “We’ve seen from this government over and over again that when you have evidence and you show it, when you show the federal government in a negative light, you get cut,” said Adrienne Silnicki, health care campaigner for the advocacy group, the Council of Canadians.
Several observers also contended that there will ultimately be severe health consequences for Canadians, particularly in terms of access to care, as well as in variations in the quality of care that they receive from province to province.
“What they’re signaling is that we’re to take it from this announcement that there will be no renewed health accord beyond 2014,” said Mike McBane, national co-ordinator of the public advocacy group, the Canadian Health Coalition. “Which literally means a blank cheque to the provinces. It’ll mean the dismantling of the national health system. It means no accountability for how that money [health transfers to the provinces] is spent. There’ll be no national standards, no goals, no benchmarks, no co-ordination, no collaboration, no common measures, no common approaches to wait times and above all, no reporting to the people of Canada, who own the health care system.”
McBane also argued the Harper government is breaching its constitutional responsibility to ensure comparable levels of service for all Canadians. “I would characterize this as revolutionary. This is ripping up the last national social program left in Canada.”
Original Article
Source: ipolitics.ca
Author: Wayne Kondro
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