Good afternoon, ladies and gentlemen. I want to welcome you to the health committee today.
I have to especially welcome our guests this morning. I am very pleased that you could join us today and that we'll have an opportunity to listen to your very insightful comments.
We have, from the Department of Health, Dr. Karen Dodds. She is the assistant deputy minister of the health policy branch. We have Ian Potter, assistant deputy minister of the first nations and Inuit health branch. Welcome.
From the Public Health Agency of Canada, we have Jane Billings, senior assistant deputy minister of the planning and public health integration branch. We have Dr. Arlene King, director general of the centre for immunization and respiratory infectious diseases.
From the Department of Finance, we have Krista Campbell, who is the senior chief. She is from the director's office of the federal-provincial relations and social policy branch. That's a very large title. We have Yves Giroux, director of social policy with the federal-provincial relations and social policy branch as well. That's another long title, but a very important one. And we have Jonathan Roy, senior policy analyst, health, justice, and culture, social policy, with the federal-provincial relations and social policy branch.
Ladies and gentlemen, pursuant to Standing Order 108(2), the motion adopted by the committee on March 13, 2008, and section 25.9 of the Federal-Provincial Fiscal Arrangements Act, the committee today begins the first of four meetings on the statutory review of the progress in implementing the 10-year plan to strengthen health care.
We have with us the senior officials today, the Public Health Agency and the Department of Finance--those members I've just gone through.
Dr. Dodds, we will have your presentation now, for approximately 10 minutes, but seeing that you're speaking for everybody, we might push that forward a bit.
Good morning, Madam Chair and members of the committee. Thank you for the opportunity to provide an overview of the progress on a wide spectrum of health care reform initiatives as set out in the 2004 health accord.
In my opening address today I would like to take about the nature and purpose of the accord and the progress made by Health Canada and the Public Health Agency of Canada on fulfilling the commitments made in the accord.
The 2004 health accord was a historic agreement by all federal, provincial, and territorial governments to renew their health care systems and to enhance accountability to their residents.
In the accord, the first ministers established a five-year plan to ensure that Canadians have access to the health care they need when they need it.
To achieve that goal, all governments committed to move forward on a comprehensive set of health care renewal initiatives. The accord initiatives were broad in scope, including, but not limited to, such things as reducing wait times, reforming primary care, developing electronic health records, expanding healthy living and public health initiatives, supporting health innovation and research, and improving aboriginal health.
To allow Canadians to see how governments were doing on meeting their commitments, the accord tasked the Health Council of Canada to report on the performance of the health care system and the progress of accord implementation.
Today I would like to talk about what Health Canada and the Public Health Agency of Canada have done to advance initiatives to reform health care.
I'd like to describe the funding commitments that have enabled provincial-territorial governments to move forward on health care renewal.
As a result of that funding, the public health care system in Canada is on the road to sustainability. Its level of funding is foreseeable and is growing.
To support the accord, the Government of Canada is flowing an additional $41.3 billion over 10 years to provinces and territories. This funding includes $35.3 billion in increases to the Canada health transfer, $5.5 billion in wait times reduction funding, and $500 million for medical equipment.
Funding to provinces and territories through the Canada health transfer alone will amount to over $22.6 billion cash in 2008-09, and with the annual 6% escalator, it will reach over $30 billion by 2013-14.
In addition to fiscal transfers to provinces and territories, the Government of Canada has demonstrated leadership through investments in patient wait time guarantees, electronic health records, public health and disease prevention, and support for the Health Council of Canada and the Canadian Institute for Health Information to ensure accountability to Canadians on health care.
I would like to begin the overview of specific initiatives with one of the key accord commitments: reducing wait times.
Recognizing that provinces and territories have primary responsibility for the delivery of health care services, the Government of Canada is providing them with $5.5 billion through the wait time reduction fund. This fund has allowed provinces and territories to augment their investments and diverse initiatives to reduce wait times.
In addition, the government has invested in developing strategies to manage and reduce wait times, as part of the National Wait Times Initiative.
This program has supported work by health care professionals and provincial governments to improve the management of wait times for hip and knee surgery. It has supported work to ensure diagnostic imaging is used appropriately, so that patients can have timely access to the care they need.
In a variety of ways, the program has assisted knowledge sharing and the adoption of best practices in addressing wait times.
Coming after these achievements, the government introduced the idea of patient wait times guarantees when it came to power two years ago. The goal was to give Canadians better assurance that they would receive the health care they need when they need it.
Today, all provinces and territories have committed to establish guarantees by 2010 and to conduct pilot projects to help pave the way.
In Budget 2007, the Government of Canada invested more than $1 billion in patient wait time guarantees, including $612 million for a patient wait times guarantee trust, which provinces and territories can use as they see fit in working towards their guarantees. The trust includes base funding of $112 million, from which each province received $10 million and each territory received $4 million. The remaining $500 million was allocated on an equal, per capita basis.
The budget also invested $400 million in funding to Canada Health Infoway to support the implementation of guarantees through the development of health information systems and electronic health records.
And the budget included a $30 million patient wait times guarantee pilot project fund. This fund is assisting provinces and territories in testing innovative approaches, including offering patients options for alternative care or recourse when guaranteed timeframes are exceeded.
The Government of Canada is also directly supporting four pilot projects to test guarantees. Two will test timeframes for diabetes and prenatal care in selected first nations communities. A third, managed by St. Elizabeth Health Care, will evaluate a patient wait times guarantee model for diabetic foot ulcer care in selected Manitoba first nations communities. And the fourth addresses surgical wait times for children, in collaboration with Canada's 16 pediatric health sciences centres.
The accord also committed governments to reform primary care and continue the development of electronic health records.
Investments by the Government of Canada in the Primary Health Care Transition Fund supported the far-reaching reform of the health care system, which in fact changed the organizational culture and deliver of primary health care. From 2000 to 2006, the government invested $800 million in that fund to help the provinces and territories and other stakeholders improve the way primary health care services are delivered throughout Canada.
These investments have increased the emphasis on health promotion, disease and injury prevention, and chronic disease management. They have expanded 24/7 access to health care services, created the tools needed for team-based care, and facilitated better coordination and integration of health care services through improved use of information technology.
There has also been accelerated development of electronic health records as a result of new Government of Canada investments in Canada Health Infoway. These investments now total $1.6 billion, including $400 million provided in Budget 2007. All provinces and territories are working with Canada Health Infoway to implement electronic health records and telehealth, which allow health care to be provided to Canadians more effectively and efficiently.
In the 2004 accord, all governments acknowledged that public health efforts on health promotion and disease and injury prevention are critical to achieving better health outcomes for Canadians and ensuring the long-term sustainability of the health care system.
The Government of Canada is placing greater stress on public health and disease prevention. It will invest $1 billion over five years in federal preparedness to deal with bird flu and flu pandemics. It will support the FPT National Immunization Strategy.
This strategy works to strengthen immunization infrastructure--such as support for FPT and expert committees, and data collection--and align publicly funded childhood immunization programs across jurisdictions, including pneumococcal, meningococcal, chicken pox, and whooping cough vaccines. Through a Budget 2007 investment of $300 million over three years, the Government of Canada has further advanced the strategy by promoting the launch of human papilloma virus vaccine programs to prevent cervical cancer.
The government also launched Canada's first national cancer control strategy, providing $260 million over five years to support the Canadian strategy for cancer control, in collaboration with the Canadian Partnership Against Cancer. In addition, the government has contributed $4.2 million in 2007-08 and $5.2 million per year thereafter to support the development of the Canadian heart health strategy and action plan.
In November 2008, an advisory committee will report back to the minister with recommendations and options for a comprehensive national strategy. In order to improve the quality of life for Canadians and their families dealing with mental illness, the government established the Mental Health Commission of Canada. Budget 2007 provided $55 million over five years for the commission, while Budget 2008 allocated $110 million for the commission's innovative demonstration projects.
The accord also committed the Government of Canada to continuing to invest in science, technology and research relating to health-specific innovation.
Over the last four years, the government has provided $440 million in new funding for health-specific innovation and $1.6 million in new funding for innovation with a health component. The importance of the Government of Canada's support for health innovation was confirmed by the science and technology strategy announced by on May 17, 2007, which recognizes health and life sciences as a priority sector.
Aboriginal peoples continue to face health disparities compared to the rest of Canada. However, the Government of Canada is making progress on achieving better health outcomes for aboriginal people.
We are starting to see the results of the $700 million that the Government of Canada invested in Aboriginal health over five years as part of a commitment made at the special meeting of first ministers and Aboriginal leaders in 2004. This led to improvements in health promotion and disease prevention programs, Aboriginal health human resources and the adaptation and integration of federal and provincial health services for Aboriginal people.
In addition, the government continues to invest new resources in health services. Budget 2008 provides $147 million over two years to stabilize current health programs, make concrete improvements aimed at better health outcomes for first nations and Inuit, and support improvements in health care delivery through greater integration with provincial and territorial health systems.
The government is also building strong partnerships with first nations and provincial governments. The tripartite first nations health plan between the Government of Canada, the Province of British Columbia, and the British Columbia First Nations Leadership Council will help us improve service delivery and health service integration.
We will continue to work with our provincial and Aboriginal partners to improve the health of Aboriginal people and bridge the health outcomes gap.
In the accord, governments committed to keeping their residents informed of the progress made to improve their health care system.
The Government of Canada has always demonstrated leadership when it comes to public accountability in these issues.
As part of this commitment to enhanced accountability, the government issued reports based on comparable indicators and national data in 2002, 2004, and 2006. Another report is planned for later this year.
The government also fully funds the Health Council of Canada so it can report to Canadians on the progress of health care reforms. Since 2004, the Health Council has issued a number of public reports on the various elements of the accord.
Canadians are also benefiting from highly regarded data analysis from the Canadian Institute for Health Information, such as reporting on wait times and health expenditures. This further advances health care system transparency and accountability.
The government provided an additional $22 million per year in Budget 2007 for the Canadian Institute for Health Information. This brings Government of Canada funding to this organization to a total of $81 million annually.
Less than four years after signing the accord, much progress has been made on implementing accord initiatives.
The Government of Canada has provided the provinces and territories with sustainable funding to support their efforts to reform their health care systems.
The government has also demonstrated leadership in health care system renewal in other ways: by supporting provincial and territorial governments to introduce patient wait time guarantees, increasing investments in Canada Health Infoway to accelerate the development of electronic health records, and placing more emphasis on public health initiatives.
Strengthening health care requires leadership and partnership between patients, health care providers, and all levels of government. The government will continue to work diligently and closely with all its partners to maintain, improve, and protect the health of Canadians.
Health Canada and the Public Health Agency of Canada will be glad to provide support for the committee in reviewing the accord. We will give you all the assistance needed so that the review is a success.
This concludes my opening remarks. My colleagues and I from Health Canada, the Public Health Agency, and Finance Canada look forward to answering your questions.