Harper cuts funding to Health Council of Canada – will the provinces step in?

The Health Council of Canada’s days may be numbered. A creation of the 2003 10-year health accord between the provinces and the federal government, the Harper government has indicated that the Council will go the way of the Accord itself – into history – unless someone else decides to fund it.

The question is: will the provinces see value in maintaining the Council after the Accord is complete?

If you are expecting to see your taxes cut or the federal deficit to be reduced by shuttering the Council’s offices, don’t hold your breath. The most recent Annual Report from the Council indicates expenditures of about $5.7 million. This is  relatively small change given Canada spends more than $200 billion on both public and private health care. Having an actual roadmap is not an entirely bad plan.

The Council is very much the creature of its participants – each provincial and territorial government appointing their own representative. The Ottawa Hospital CEO Jack Kitts is Ontario’s appointee and serves as the Council’s chair.

The Council therefore tilts towards what the provinces want it to tilt towards. In recent years it’s been all about “health care renewal.”

It’s not like the Health Council is the only organization taking a pan-Canadian approach. There are at least eight other organizations with a national view, some of them more specific in scope, such as the Mental Health Commission of Canada or the Canadian Partnership Against Cancer.

While the demise of the Council will likely not mean the end of the province’s conversation about system planning, it will likely mean we will not have the kind of access we have had into the thinking behind it.

The Council is prolific — it has produced six reports since last May. That includes a report on how physicians rate Canada’s health system, a progress report on health renewal, a report on self-management for Canadians with chronic conditions, a video primer on understanding clinical guidelines, a report on cultural safety for aboriginal people in urban health care settings, and most recently, a report dealing with perspectives on quality improvement.

Former Saskatchewan Premier Roy Romanow told the media that the Council facilitates interprovincial and intergovernmental collaboration and discussion.

“It is absolutely necessary if we are to move forward as a nation with roughly the same kinds of expectations and reformed outcomes of health care that we so desperately needed then and really need now,” he told the Globe and Mail, calling the cut a “really big blow.”

Others have pointed out that information sharing at the Council has led to cost-savings by the provinces. The University of Toronto’s Raisa Deber has indicated that by sharing best practices provinces don’t have to each reinvent the wheel.

The move also means there is no progress to renew the accord. Last year the Federal government simply told the provinces how much they planned to transfer to them for health care and walked away. Evidently they have not changed their mind since.

This likely means the provinces are also free to stray from the Canada Health Act given Federal disinterest in how the health care is administered — something the Harper government would likely welcome, especially if it involved further privatization.

Given Health Canada is withdrawing its funding for the Health Council, it will be interesting to see whether the provinces are content to see it dissolve, or whether each feels its worthwhile to rattle the tin cup among themselves to keep it going.