Canada Healthcare November 2022-

Flu (influenza): Get your flu shot
Canada Health Act
Patented Medicine Prices Review Board
CIHR Dementia Research Strategy
Canada Healthcare August 2020-August 2022
Canadian Institute for Health Information

Canada needs doctors.
Explore the Medical Council of Canada’s top three suggestions to help internationally-trained doctors licensed and onto health care’s frontlines in Canada. (June 2022)
High drug prices in Canada are just one side of a bad equation (July 2023)

9 September
Ottawa pressed to create accountability officer to navigate health care deals
(Globe & Mail) The organization that represents Canadian doctors is calling for the appointment of a chief health accountability officer to gauge whether tens of billions of dollars in new federal spending is leading to tangible improvements in the health care system.
The Canadian Medical Association plans to propose the new role on Monday as it releases a report from the consulting firm Deloitte analyzing a laundry list of bilateral health deals signed by Ottawa and the provinces and territories since 2017.
The CMA concluded that the deals are so complicated, and their accountability mechanisms so opaque that an independent office should be created to publicly report on the shortcomings and successes of the agreements as they’re implemented

10 July
Ottawa must amend Canada Health Act to allow meaningful health-care reform
(Fraser Institute) Canada’s health-care system is broken, with patients enduring record delays in one of the least accessible—and most expensive—universal health-care systems in the developed world. In response, the federal government has doubled down on the same old approach of big dollar announcements alongside promises that things will improve.
But in fact, big spending increases and a bigger role for Ottawa are the opposite of what’s required. The federal government should learn from its own past policy successes and allow the provinces to innovate and finally fix health care for Canadians.
Consider the state of health care after more than two decades of the same old approach (including 2004’s 10-year Plan to Strengthen Health Care, the 2017 Common Statement of Principles and the Trudeau government’s latest $46 billion commitment). In 2023, wait times in Canada reached an all-time high of 27.7 weeks from GP referral to treatment, roughly 50 per cent longer than the 17.7-week wait in 2004. Canada also ranks at the bottom in international comparisons of wait times for specialist consultations and non-emergency surgery. And Canadians still have some of the worst access to medical technologies, physicians and hospital beds in the developed world, just like in 2004.
And yet, Canadians foot the bill for one of the developed world’s most expensive universal access health-care systems (as a share of the economy, accounting for Canada’s relatively youthful population), a distinction Canada has held since the early 2000s.

27 May
From fire to flood, experts urge governments to disaster-proof hospitals against climate change
2016 Fort McMurray wildfire prompted largest medical evacuation in Canadian history
(CBC) The 90,000 people who fled the region had to wait until the hospital and other essential services were back up and running before they could return home.
The ventilation system was scrubbed clean and every one of the 8,200 ceiling tiles in the facility had to be replaced.
Disasters that bring people to the emergency room — like fires, floods, heat waves and other extreme weather — often also strike the hospitals themselves, Ness said.
And with the number of climate-related emergencies expected to worsen in coming years, some parts of the country will need to move quickly to disaster-proof life-saving infrastructure.
Last month, the Canadian Medical Association warned that Canada’s health-care facilities are among the oldest public infrastructure in use. Half were built more than 50 years ago, making them especially vulnerable to extreme climate events.
… The Spaulding Rehabilitation Hospital in Boston famously tried to learn from that harrowing and costly experience [2012 Superstorm Sandy] by designing the building with disasters in mind. Emergency services are provided above the predicted 2085 100-year flood plain, accounting for expected sea-level rise in future years.
That kind of future-proofing was highlighted as a priority in a massive report issued by Health Canada in 2022, called Health of Canadians in a Changing Climate.
“Adaptation measures that get ahead of the curve of increasing climate impacts on ecosystems, infrastructure, communities and health systems will need to move beyond incremental approaches to adopt transformative changes,” the authors of the report said.
The authors of that study pointed to a 2019 survey, which found only eight per cent of Canadian health-care facilities acknowledged climate change in their strategic plan or had identified climate risks in specific policies.

22 May
The Social Determinants of Dementia: Canada Needs Collective Action to Prevent a Public Health Crisis
By Stéfanie Tremblay
(Policy) Canada has developed a national strategy for dementia in response to the WHO Global Action Plan on the Public Health Response to Dementia. This strategy articulates principles and main objectives that should guide the actions of governmental, non-governmental, and community organizations working on dementia. Prioritizing a population-level approach (area of focus 2.4 of the national dementia strategy) to prevention is essential to ensure that the human rights and diversity principles set out in the national strategy are respected.
Risk factors for dementia
The dementia public health crisis is often seen as the inevitable product of an aging population. While age is a major risk factor for dementia, it is also a non-modifiable one, as are sex at birth (females are more at risk) and genetics. However, there are several risk factors that can be acted upon. Modifiable risk factors include many lifestyle habits such as physical activity, diet, tobacco and alcohol consumption, exposure to air pollution, and social and cognitive activities. Treating health conditions that predispose to dementia (e.g., hypertension, diabetes, depression, and hearing loss) is another way to reduce risk. New research also suggests oral health may be an important determinant of brain health with conditions like periodontitis increasing the risk of dementia.
Although these risk factors are deemed modifiable, … [they] “are only truly modifiable if the proper supports are provided by our communities, public health agencies and other governmental organizations,” per The Many Faces of Dementia in Canada, the 2024 Alzheimer Society of Canada’s Landmark Study/Volume II.

20 May
Increasing the capital-gains taxes will hurt health care in Canada
By Cheryl V. Reicin, internationally recognized adviser to life-science companies that develop novel therapeutic, medical device and health technologies, and to investors.
(Globe & Mail) … Canada’s expertise in scientific and medical research is second to none; its universities conduct world-leading research and innovation; and its hospitals are among the best in the world. Canada is just starting to have real economic success in commercializing its life-science innovations and has the opportunity to be a top hub for medical innovation. However, rather than creating a friendly environment to expand the life-science sector, the new capital-gains tax will limit and perhaps reverse growth.
Canadian life-science companies are struggling to recruit experienced management personnel, many of whom are located in the U.S. and Europe. These seasoned executives worry that if a company is sold or fails, there simply aren’t enough opportunities in the Canadian ecosystem to secure a comparable position in the same city, forcing their often-young families to relocate again. Unless we create critical mass, the Canadian life-science hubs are likely to flounder.
The proposed capital-gains tax increases will render Canadian cities even less competitive than locales south of the border or abroad. For private startups and public companies alike, stock options are used to attract and retain top-tier talent, many of whom will agree to forgo substantially larger salaries for a possible upside years down the road.
In the life-science sector especially, compensation practices rely heavily on equity compensation programs as young, innovative companies tend to be cash-poor. As a direct result of the planned increase in capital-gains taxes, companies will have no choice but to offset the lost value by offering more stock options and other non-cash incentives to remain competitive. This in turn will dilute the holdings of investors who will be increasingly deterred from investing in Canada.

7 May
Feds put $15M into pathogen tracking, health-care supply chain research to prep for next pandemic
Funding will pay for 4 years of the study and equipment
(CBC) A new $15-million cross-border research project is underway to monitor the movement of pathogens in Canada and the U.S. in the event of future pandemics.
The federal government put up the money that will cover four years of equipment and research.
The Integrated Network for the Surveillance of Pathogens: Increasing Resilience and Capacity in Canada’s Pandemic Response (INSPIRE) brings together 43 researchers from seven universities and public and private agencies. The team consists of biochemists, microbiologists, engineers, computer scientists, and supply chain public policy experts.
INSPIRE will partner with academics in Michigan, Ohio and New York — where many supply chains supporting Canadian industry originate.

4 April
Canadians waiting longer for surgeries and other procedures compared to 2019: report
Patients in all provinces are waiting longer for hip and knee replacements, cancer surgeries and other priority procedures than before the COVID−19 pandemic, national data shows.
A report [Canadians waiting longer for priority surgeries and diagnostic imaging compared with pre-pandemic period] released Thursday by the Canadian Institute for Health Information says that’s the case even though more people underwent those procedures between April and September 2023 compared to the same months in 2019.
The institute’s latest data looks at wait times for hip and knee replacements, hip fracture repair, certain cancer surgeries, as well as radiation therapy.
The data shows that 66 per cent of hip replacement patients had surgery within the recommended time frame of 26 weeks compared to 75 per cent in 2019, even though the number of procedures rose by 18 per cent.
As for knee replacement surgery, 59 per cent of people had the operation within that time frame, compared to 70 per cent before the pandemic.

15 March
Pricey pills
A new report from Canada’s drug pricing regulator has found that this country has now become the second most expensive country for patented medicines.
Now that Canada has the second highest drug prices in the world, pharmacare proponents say the Liberals have one last chance to show whether they will keep their promises to lower medication costs for Canadians
Canada has now become the second most expensive country for patented medicines, according to a new report from Canada’s drug pricing regulator – a milestone that comes after years of Liberal promises to lower drug prices for Canadians.
Experts say some of those promises died years ago when Ottawa failed to appeal a court decision against some of the federal government’s proposed reforms of Canada’s drug pricing regime.
However, the final test of the Liberals’ resolve on lowering drug costs for Canadians now rests with the new pharmacare bill.
While the proposed pharmacare program, which will cover only diabetes and contraceptive medications, is far more limited than what many expected when Justin Trudeau promised in 2019 to begin implementing “national universal pharmacare,” the question now is: how aggressively will the Liberals try to get this bill passed before the next election?

10 March
Montreal doctors develop a virtual reality tool that could save children’s lives
Nearly a million children die each year from injuries sustained in accidents:WHO
For anyone who is rushed to emergency, every second counts. The virtual reality tool developed by Montreal doctors will help medical teams hone their skills in pediatric trauma — preparing them for scenarios before they happen.
Dr. Fabio Botelho, a pediatric and trauma surgeon from Brazil and a research fellow at the Montreal Children’s Hospital, and Dr. Dan Poenaru, the medical director of the trauma program at the Children’s, developed PeTIT VR in conjunction with UK-based i3 simulations.
Using real-life situations, they created an immersive environment for surgical teams that may not see pediatric trauma very often — like in small or remote hospitals — to hone their skills and work together to improve.
Doctors in remote regions in Canada and around the world can use PeTIT VR to build their skill sets, both as individuals and as a team. With no expensive medical mannequins or travel required, training can be done anywhere, anytime.
That, according to Poenaru, is what energizes him the most. “The idea of being able to train all these people, literally in their homes with a $300 headset on their head, that’s so exciting,” he said.
In a validation study done by a consortium with the University of Ottawa and the McGill University Health Centre, 87 per cent of clinicians found PeTIT VR to be a useful tool for honing trauma care skill and 93 per cent were interested in trying it if given the opportunity.
Right now PeTIT VR is still in its testing phase but that could change by the summer.
There is international interest from the WHO and Botelho plans to share his findings at a conference of the American Pediatric Surgical Association this spring.

5 March
Federal Pharmacare Bill Proposes Universal Drug Coverage
(Fasken) According to the text of the Bill and the information provided in the government’s technical briefing, the government recognizes the role of the provinces, territories, and Indigenous peoples in the provision of healthcare. The government intends to respect their jurisdiction and cooperate with them to support efforts to improve the accessibility and affordability of prescription drugs and related products.
Based on the information provided in the technical briefing, the national pharmacare program is meant to enhance rather than replace existing provincial drug benefit programs. This raises questions about how the national pharmacare program will interact with coverage arrangements in various provinces, under both public and private plans.
27-29 February
Canada’s pharmacare bill [Bill C-64] has officially been introduced in Parliament
(Global) Health Minister Mark Holland has tabled the legislation to create the framework for a national single-payer pharmacare program Thursday afternoon.
This legislation is a key piece of the supply and confidence agreement that sees the NDP support the Liberals on confidence votes in exchange for advancing key priorities including pharmacare.
In addition to a framework, the legislation includes coverage for contraception and diabetes medication, plus devices like insulin pumps. In order for this to be implemented, Ottawa will need to first negotiate deals with the provinces and territories to include these provisions in their medical systems.
The original deadline to introduce legislation was the end of 2023, but it was pushed to the end of February. In exchange for the extension, the NDP pushed for coverage of contraception, like birth control and emergency contraception, and diabetes medication to be included in the future implementation of pharmacare.
Tasha Kheiriddin: Trudeau brings in substandard pharmacare to stay in power
Latest Liberal-NDP scheme will ensure cutting edge medicines don’t come to Canada
Is pharmacare doomed to fail? Last week, Quebec announced that it would opt out of the Liberal-NDP plan for a national pharmacare program. This week, it was Alberta’s turn. Health Minister Adriana LaGrange blasted the lack of provincial consultation and accused the federal government of overstepping its jurisdiction.
“We’re not going to allow Ottawa to pick and choose what coverage should be available to Albertans based on issues they find politically palatable.” Instead of taking orders from Ottawa, Alberta will take the cash. “Give us the dollars,” LaGrange said. “Allow us to enhance the programs we actually have now, rather than create more bureaucracy.”

2023

19 December

Number of Canadians living with dementia expected to triple by 2050, Alzheimer’s society says
A new study from the Alzheimer’s Society of Canada predicts that the number of people in Canada living with dementia will triple over the next 30 years.
The study used data from Statistics Canada to create representations of people living in Canada and looked at how many of those people would develop dementia over time in what is called a “microsimulation.”
In 2020, more than 597,000 Canadians were living with dementia; by 2050, that number is expected to reach 1.7 million.
Navigating the Path Forward for Dementia in Canada: The Landmark Study Report #1
Canada needs bold action to head off an impending dementia care crisis. This new report from the Alzheimer Society of Canada says actions to reduce risk have potential to change the future of dementia in Canada — if governments act now. (Sept 2022)

Oral health is health: Better access to dental care may have potential benefits beyond Canadians’ mouths
Noha Aziz-Ezzat Gomaa, Assistant Professor, Dental Public Health and Oral Medicine, Schulich School of Medicine & Dentistry, Western University
(The Conversation) Oral diseases, particularly dental decay and periodontal (gum) diseases, are largely preventable, yet are some of the most common non-communicable diseases around the world. Pain due to untreated dental decay impacts eating and sleep quality, among other essential functions. Indeed, the agonizing nature of dental pain earned it the title of “the hell of all diseases” more than 200 years ago.
But pain is only the most obvious of the many ways oral health is linked to overall health.
The federal government recently launched the long-anticipated Canada Dental Care Plan (CDCP) to improve access to dental care for the almost nine million Canadians who lack dental insurance.
The World Health Organization (WHO) defines oral health as “the state of the mouth, teeth and orofacial structures that enables individuals to perform essential functions such as eating, breathing and speaking, and encompassing psychosocial dimensions such as self-confidence, well-being, and the ability to socialize and work without pain, discomfort and embarrassment.”
A healthy, disease-free mouth is key to quality of life and well-being. Being fundamental to various essential functions, the lack of oral health connects it to a number of chronic diseases in several ways.
Canadian Dental Care Plan
The Canadian Dental Care Plan (CDCP) will help ease financial barriers to accessing oral health care for eligible Canadian residents with an annual adjusted family net income of less than $90,000 who do not have access to dental insurance.
Starting in mid-December 2023, letters will be mailed to seniors aged 87 and above who may qualify, followed by those aged 77 to 86 in January 2024, then those aged 72 to 76 in February 2024 and those aged 70 to 71 in March 2024. These letters will include a personalized application code and instructions on how to apply.

18 October
The impact of not having a family doctor: Patients are worse off, and so is the health system
Cathy Risdon, Professor and Chair, Family Medicine, McMaster University
(The Conversation) About 6.5 million Canadians — roughly one in six — do not have access to primary medical care.
It’s a problem that puts their health at greater risk and renders the entire public health-care system less efficient than it could be, both economically and in terms of the quality of care for everyone.
In other words, if we can fix the shortage of family physicians, we can save lives and money at the same time.
Research has shown that patients who have a regular general-practitioner relationship for more than 15 years need about 30 per cent less after-hours care or hospital admissions and experience approximately 25 per cent less mortality compared to those who had a regular general practitioner for just one year.
Having access to family medicine provides four ingredients essential to good care: continuity, access, comprehensiveness and co-ordination.

12 October
Pharmacare would cost governments billions more per year but save economy money: PBO
Single-payer universal drug plan would cost $11.2 billion in first year, report finds
(CBC) The parliamentary budget officer says a single-payer universal drug plan would cost federal and provincial governments $11.2 billion in the first year, and $13.4 billion in five years.
The PBO released a report on Thursday that provides an estimate of the cost of a pharmacare program between 2024-25 and 2027-28. It follows up on a previous costing the PBO published in 2017 for a pharmacare plan.
The new report calculates the incremental cost of the program, taking into account current spending by governments on public drug plans as well as revenue that would be generated from co-pays under a pharmacare plan.
… Currently, Canadians pay for their prescription drugs through a mix of public plans, private insurance and out-of-pocket spending. Excluding hospital drugs, the PBO says total prescription drug spending was $36.6 billion in 2021-22, a 28 per cent increase from 2015-16. Of that amount, 46 per cent was covered by governments, 40 per cent by private insurers and 14 per cent was paid-out-of-pocket.
Total spending on prescription drugs under a single-payer, universal pharmacare plan is expected to be $33.2 billion in 2024-25, rising to $38.9 billion in 2027-28.
However, the report also said such a plan would lead to economy-wide savings, despite its prediction that the use of prescription drugs would rise by 13.5 per cent.

1 October
Early indicators of dementia: 5 behaviour changes to look for after age 50
Daniella Vellone, Medical Science and Imaging PhD Candidate, University of Calgary
(The Conversation) Dementia is often thought of as a memory problem, like when an elderly person asks the same questions or misplaces things. In reality, individuals with dementia will not only experience issues in other areas of cognition like learning, thinking, comprehension and judgement, but they may also experience changes in behaviour. …
Cognitive and behavioural impairment
When cognitive and behavioural changes interfere with an individual’s functional independence, that person is considered to have dementia. However, when cognitive and behavioural changes don’t interfere with an individual’s independence, yet still negatively affect relationships and workplace performance, they are referred to as mild cognitive impairment (MCI) and mild behavioural impairment (MBI), respectively.

16 August
New health minister says pharmacare legislation is coming this fall
Liberal agreement with NDP stipulates that pharmacare legislation must be passed by end of 2023
Health Minister Mark Holland says conversations on pharmacare legislation continue but he plans to table a bill when the House of Commons returns.

25 July
Paul Wells: Pressure for a COVID inquiry mounts
The common theme of the suite of articles and opinion pieces on Canada’s in The BMJ (the leading British medical trade journal) is that Justin Trudeau’s government needs to convene an independent national inquiry into the way COVID was handled in Canada.
Today’s post lands on the eve of a major cabinet shuffle. Let’s state the stakes clearly, then: It will simply be unacceptable if organizing a COVID inquiry on a reasonably short timeline isn’t at the top of the next health minister’s list of mandate-letter responsibilities. … There’ll be a new cabinet tomorrow, and new public mandate letters to ministers sometime after that.
Fine: The prime minister must include in his next letter to the health minister a clear instruction to launch an independent experts’ inquiry into Canada’s handling of COVID. Theoretically this government has two more years in it. The expert panel on COVID should be told to report in half that time.
The world expected more of Canada
A BMJ series examines Canada’s covid-19 response and calls for an independent national inquiry
Accountability for Canada’s covid-19 response
Covid-19 led directly to 52750 deaths in Canada with more than 4.6 million reported cases as of mid-2023. This cumulative covid-19 death rate of 1372 per million exceeds the global average of 855 per million. Despite a universal healthcare system, communities experiencing social and economic marginalisation in Canada were hardest hit in each wave of the pandemic. Those living and working in long term care homes were particularly affected, which was a cause of national shame. Canada achieved high vaccination coverage domestically, but its hoarding of vaccination doses and failure to fully support multilateral efforts to share vaccination doses globally led to global vaccine inequity. Lessons from a previous outbreak of, SARS-CoV-1 — which in 2003 impacted more Canadians than anywhere else outside of Asia— went unheeded and left the country’s governments and health authorities ill prepared for covid-19. An independent, national inquiry is needed to review Canada’s covid-19 response, draw lessons, and ensure accountability for the past and future pandemic preparedness
Modelled after the UK Covid Inquiry Series, The BMJ’s Canada Covid Series comprises articles by Canadian experts that critically review topics such as: data sharing and access; research use and misuse; jurisdictional coordination; fitness of healthcare and public health systems; and surveillance; and the ways in which Canada’s enormous geographic, linguistic, social, ethnic and other diversities were supported by an ostensibly universal but fragmented system. This series offers a reflection and analysis of what worked and didn’t in Canada’s covid-19 response, what a national inquiry should address, and pathways for the future.

10 May
Thousands of foreign-trained nurses can now practise in Canada as provinces change licensing rules
Provinces across the country are rapidly licensing thousands of internationally trained nurses after introducing a flurry of regulatory changes designed to make it easier to work in their jurisdictions, as governments try to address pressing staffing shortages afflicting the health care system.
The College of Registered Nurses of Alberta (CRNA) says it’s been inundated with inquiries from foreign-trained nurses after it overhauled its application process last month, changes it says are already reducing processing times from over a year to a matter of weeks.
Nova Scotia and British Columbia recently introduced similar changes to their regulatory process, and have also seen a crush of applications from nurses educated outside Canada.
In Alberta, the response to the new streamlined registration process has been dramatic. The nursing regulator says it registered 1,413 internationally trained nurses since changes were introduced April 4 – more than 2½ times the number processed in the past four years combined. Once registered, these nurses can begin working immediately.

23 February
Federal, Ontario and Atlantic Canadian governments reach agreement on health-care funding
Ontario and all Atlantic provinces have reached agreements-in-principle on the health-care funding offer made by Prime Minister Justin Trudeau’s government at the first ministers’ meeting in Ottawa earlier this month.
At a town hall at Dalhousie University in Halifax on Thursday afternoon, Trudeau confirmed that Prince Edward Island, Nova Scotia, Newfoundland and Labrador and New Brunswick have reached agreements-in-principle with Ottawa.
At the first ministers’ meeting, premiers agreed to accept the federal government’s offer of more than $46 billion in new health-care money for the provinces and territories over the next ten years. The funding boost will see the Canada Health Transfer (CHT) increase by five per cent annually and will target other specific areas of the health system.
The federal government said that $25 billion of that new money will be targeted at improving four priority areas: family health services, health workers and backlogs, mental health and substance use and a “modernized health system.”

13 February
Premiers to accept federal health-care funding offer, focus turns to bilateral deals
(CTV) Canada’s premiers have agreed to accept Prime Minister Justin Trudeau’s 10-year health-care funding offer and are now turning their focus towards inking their respective bilateral agreements with the federal government.
“We’ve agreed to accept the federal funding,” Chair of the Council of the Federation and Manitoba Premier Heather Stefanson said on CTV’s Power Play with Vassy Kapelos on Monday.
The $196.1-billion federal offer to assist ailing health systems presented at an in-person First Ministers’ meeting last week includes both increases to the amount budgeted to flow through the Canada Health Transfer (CHT) as well as $25 billion for bilateral deals tailored to each province and territory’s health-care system’s needs.

8 February
André Picard:  Lots of numbers, little imagination: The federal funding deal won’t fix health care
Going into the talks, Ottawa was talking tough about “buying change” and putting conditions on the increased funding. But the money is being offered up with no real strings attached, other than some polite requests to share data, adhere to the principles of the Canada Health Act and draft “action plans” for how they plan to spend the money. No talk of penalties or clawbacks, and no real accountability.
Ottawa’s offer also features very limited targeting, with some money for wage increases for personal support workers, mental health and substance use, home care, and long-term care.
What’s dispiriting about the whole process is how much it has focused almost exclusively on money.
Meanwhile, waiting times grow – in operating rooms, in emergency departments, in doctor’s offices and more – and so does the suffering of Canadians.
Where is the vision? Where is the real reform that is required to get medicare back on track?
What we need from our leaders is some true leadership, for example a firm commitment that every Canadian will have ready access to a primary care provider.
That would make a real difference to health care. It’s an initiative we could cost out, invest in and measure its progress in real time.
Konrad Yakabuski: Trudeau offers a Band-Aid for our bleeding health care system
Mr. Trudeau had just pulled a fast one on the provincial and territorial premiers who had gathered in the capital for what had been billed as a historic meeting aimed at fixing health care, but which may instead go down as the moment Canada’s national myth of universal health care expired with a whimper, not a bang.
For a federal government that rarely passes up the chance to spend more when it could spend less, the offer put on the table on Tuesday was an out-of-character nod to fiscal responsibility. Mr. Trudeau scheduled barely two hours to meet with the premiers, signalling from the outset that he was not interested in negotiating with them.

7 February
PM Trudeau presents premiers $196B health-care funding deal, with $46B in new funding over the next decade
The federal government is pledging to increase health funding to Canada’s provinces and territories by $196.1 billion over the next 10 years, in a long-awaited deal aimed at addressing Canada’s crumbling health-care systems with $46.2 billion in new funding.
This new cross-Canada offer includes both increases to the amount budgeted to flow through the Canada Health Transfer (CHT) as well as federal plans to sign bilateral deals with each province and territory that are mindful of each system’s unique circumstances.
This funding influx is coming with an expectation that in order to access new federal dollars, provincial and territorial governments have to maintain their current health spending levels and commit to new transparency and accountability requirements around how health information is collected, shared, used, and reported to Canadians.
While Trudeau is billing the Liberals’ commitment as “a major federal investment in health care,” early indications are, the offer hasn’t satisfied provinces’ demands.
Largely, the sense of optimism coming from premiers over the fact that the two sides finally were able to meet to discuss how to address Canada’s strained health-care systems seemed to dissipate somewhat after the meeting, with Ontario Premier Doug Ford calling it a “starting point,” and a “down payment.”
“There wasn’t a lot in a way of new funding that is a part of this package,” said Chair of the Council of the Federation and Manitoba Premier Heather Stefanson during a post-meeting press conference. “I think we were a little disappointed at that.”

13-30 January
Singh meeting with Trudeau about private health care ahead of PM’s sit-down with premiers
NDP leader Jagmeet Singh says for-profit facilities will poach doctors and nurses away from understaffed hospitals
Singh said now is the time for the Liberal government to make clear that funding private health-care facilities will not improve the shortage of health-care workers Canada is facing.
While health care falls under provincial jurisdiction, Singh believes the federal government could be using the Canada Health Act more aggressively to challenge for-profit care.
Doug Ford prescribes a needed dose of private health care in Ontario
(Globe & Mail Editorial Board) …whenever the word “private” floats into the perennial debate about how to improve widespread underperformance in medicare, there’s a recoil. Ontario Premier Doug Ford encountered that knee-jerk reaction this week as he announced relatively modest reforms that would give private surgical clinics a modestly larger role in the province’s health care system. For some, the use of the word “private” anywhere near the phrase “health care” implies the start of a descent into an American mess.
Reality differs from rhetoric. Large portions of Canadian medicare have always been delivered by private entities, from doctors to pharmacies – which administered many free COVID-19 vaccines. The public pocket pays private providers. That’s the key.
Doug Ford government will give for-profit clinics bigger role in surgeries
Cataract operations, knee and hip replacements are ‘backlogging’ Ontario’s health system, says Ford
Ontario Premier Doug Ford’s government is preparing to significantly ramp up the number of surgeries done in privately run for-profit clinics.
Ford and Health Minister Sylvia Jones are planning to make an announcement next week on expanding the number and range of surgeries performed in independent health facilities outside of hospitals, said a senior government official, who asked not to be named because they were laying out government plans.
For Ontario patients, the official says the move will lead to thousands more surgeries and diagnostic procedures performed each year, an immediate way to reduce wait times for such operations as cataract removals.

30 January
Canadian doctors spend millions of hours on unnecessary paperwork each year: report
Monday’s CFIB report concludes that if governments across Canada set a target to reduce physician administrative burden by 10 per cent, they could reduce fatigue and burnout, improve the quality of patient care and open the equivalent of 5.5 million patient visits a year.
(CBC) In 2019, the provincial government partnered with Doctors Nova Scotia to research physician administrative burden and how to reduce it. A new report released Monday builds on this research and draws conclusions that apply to the whole country.
The Canadian Federation of Independent Business’s report, Patients Before Paperwork, shows Canadian doctors spend 18.5 million hours annually on unnecessary administrative work — the equivalent of 55.6 million patient visits.
“Health ministries across Canada are facing many complex challenges,” the report said. “A chronic shortage of health professionals, an aging population and capacity constraints all have put pressure on the health-care system and the physicians who support it.”
An Angus Reid poll from September 2022 found half of Canadians are either unable to see their family doctor within a week, or they can’t find a doctor at all.

13-25 January
Trudeau agrees to health-care meeting with premiers but ‘won’t be signing deals’
Trudeau said there are bigger issues at play, including staffing shortages, support for mental health and better data and it’s not only about money
Trudeau announced Wednesday morning he had invited premiers to Ottawa on Feb. 7 for a “working meeting.”.
‘A huge priority’: Feds aiming to ink long-term health funding deals ahead of 2023 budget
(CTV) Intergovernmental Affairs Minister Dominic LeBlanc says the federal government is aiming to have long-term funding agreements inked with the provinces and territories ahead of presenting the 2023 federal budget.
LeBlanc also confirmed that the federal government is looking at both increasing the ongoing stream of funding to the provinces, known as the Canada Health Transfer (CHT), as well as looking at signing what could be 10-year agreements that would see even more federal money put into specific areas of concern and common priority.
“I don’t think we’re going to have an agreement in the next two weeks, but I hope we have an agreement that will benefit Canadians by the time we have to bring down a federal budget… So you can figure that it’s in the next two or three months that we would need to have the details of an agreement,” LeBlanc said in an interview with CTV National News Ottawa Bureau Chief Joyce Napier at the Liberal cabinet retreat in Hamilton, Ont.
Health ministers making progress on funding talks, finding common ground: Duclos
The impasse over a new federal-provincial health-care deal has broken as both sides close in on how to get better results from new spending, federal Health Minister Jean-Yves Duclos said Friday.
That includes agreeing to invest in the technology to improve digital health records and data collection, he said at a news conference in Ottawa.
Duclos said the tone and direction of the talks with the provinces has changed and improved in the last few weeks. He said the conversation about getting results is “stronger now than it used to be.”
Negotiations are in full swing for the premiers and Prime Minister Justin Trudeau to sit down in person in Ottawa to push through the final details, but no date has been finalized for that to happen.
It’s a complete turnaround from the fall, when a health ministers’ meeting in Vancouver in early November fell apart.
The provinces demanded significant increases to federal health transfers with no strings attached. The federal government insisted new funds would only flow with clear accountability measures attached.
‘Very constructive conversations’: Is Trudeau closer to a health deal with provinces?
In recent days, some premiers have voiced optimism about reaching a deal soon with the federal government over increasing health-care funding, something Prime Minister Justin Trudeau says he still wants tied to improved outcomes before the money rolls out of Ottawa.
During his year-end interview with Chief Anchor and Senior Editor of CTV National News Omar Sachedina, Trudeau said that while the federal government was willing to send “billions more” he wouldn’t pull up a chair at the table until there’s a more concrete plan for provincial accountability.

Paul Wells comments:
In hindsight, we should have known the serious talks began as soon as everyone started saying they were over.
On Nov. 8, federal health minister Jean-Yves Duclos met his provincial counterparts in Vancouver for the first in-person meeting of federal and provincial health ministers since 2018. The meeting collapsed in acrimony. Provincial premiers blamed Duclos for refusing to talk about money. Duclos, in a cringey statement I am sure was written by a seven-staffer army of junior comms people, blamed the premiers for insisting on talking about money.
“The Premiers are preventing us from taking concrete and tangible steps that would make an immediate difference in the daily life of health workers and patients,” Duclos said. “Premiers keep insisting on money and a First Ministers’ Meeting. Once again, I will be very clear: before we start talking about the means, we need to talk about the ends. And that can only happen and continue to happen at the Health Ministers’ Table.”
Clear enough. No discussion of money before agreement on reform. And that “can only happen” among health ministers.

2022

27-31 December
Trudeau wants ‘outlines’ of a health deal before meeting with premiers
(CTV) While premiers continue to call for a meeting with the prime minister to talk about boosting federal health-care funding, Justin Trudeau says that’ll only happen “once there is the outlines of a deal.”
“Right now, they still want all this money with no accountability and no clear results. I have to say, that’s not what Canadians need. We’re going to be sending more money, but we need to see real change, real results,” Trudeau said in a year-end conversation with Chief News Anchor and Senior Editor of CTV National News Omar Sachedina, airing in full on Dec. 31.
“I look forward to sitting down with them once there is the outlines of a deal,” said the prime minister.
The premiers have been ramping up pressure for Trudeau to meet with them to discuss the federal government increasing the Canada Health Transfer—which funnels federal dollars into provincial health-care systems—to 35 per cent up from the current 22 per cent of coverage for health-care costs.
This longstanding but recently re-emphasized demand comes as hospitals and health-care facilities appear to be in crisis mode, between staffing shortages and a cold-weather surge of illnesses compounding in extended wait times and other struggles to access adequate care.

13-14 December
Provinces must commit to health-care reform, Trudeau says as health systems strain
The federal and provincial governments appear deadlocked in their negotiations on the future of health care in Canada, and Prime Minister Justin Trudeau’s latest comments suggest he will not be the one to blink first.
In a year-end interview with The Canadian Press on Monday, Trudeau said he’s not willing to kick health-care reform down the road any further, even as provincial premiers clamour for more federal funds to bolster their ailing health systems.
“It wouldn’t be the right thing to do to just throw more money at the problem and sit back and watch the problem not get fixed because we didn’t use this moment to say, ‘No, no, no, it’s time to improve the system,’” Trudeau said.
The stalemate is happening while children’s hospitals across the country are inundated with kids suffering from respiratory diseases. In some cases, hospitals have been overwhelmed by the calamitous combination of record numbers of sick patients and critically low numbers of staff to treat them.
Trudeau says he’s not willing to kick health-care reform down the road any longer
The federal and provincial governments appear deadlocked in their negotiations on the future of health care in Canada, and Prime Minister Justin Trudeau’s latest comments suggest he will not be the one to blink first. …
In a year-end interview with The Canadian Press on Monday, Trudeau said he’s not willing to kick health-care reform down the road any further, even as provincial premiers clamour for more federal funds to bolster their ailing health systems.
The stalemate is happening while children’s hospitals across the country are inundated with kids suffering from respiratory diseases. In some cases, hospitals have been overwhelmed by the calamitous combination of record numbers of sick patients and critically low numbers of staff to treat them.
The problem goes back to more than a year ago, when provinces first demanded a sit-down with the prime minister to talk about long-term and sustainable funding increases after pandemic strain left them with large backlogs and a burnt-out work force.
They want to see Ottawa cover 35 per cent of health-care costs across the country, up from the current 22 per cent, by increasing the Canada Health Transfer.
Trudeau told them those discussions should wait until after the pandemic but dedicated $2 billion in one-time funding to tide them over during the Omicron wave.
Hoping to attract new doctors to Canada, recruiters abroad are hobbled by licensing rules at home
With too much bureaucracy and too few residency spots, Canada is getting a global reputation as a hard place for physicians to work
(Globe & Mail) Dublin- The global competition for physicians and other health workers is laid bare at medical job fairs like this one in Dublin, where recruiters from Prince Edward Island and Newfoundland and Labrador recently came to help fill gaps in their health care systems.
Nearly every exhibitor offered lucrative perks such as signing bonuses, relocation allowances and housing benefits along with help with immigration. … [Canadian] recruiters can only do so much. Canada’s system for assessing and integrating physicians who were trained outside of the country is plagued by barriers and chokepoints, and the country is increasingly losing physicians to other places as a result.
While fewer graduates of international medical programs are applying to train in Canada, nearly two-thirds of the foreign physicians who came here as immigrants aren’t practising medicine in part because of licensing hurdles.
Some 5,135 foreign doctors became permanent residents in Canada between 2015 and 2020, according to figures from Immigration, Refugees and Citizenship Canada. Only a portion of them, about 37 per cent, are working in their field. Those trying to find solutions to the crisis in Canadian health care say the country needs to do a better job of putting foreign physicians to work.
…the federal government just announced $90-million to expand the Foreign Credential Recognition Program with projects that streamline medical credential recognition, remove red tape or provide Canadian work experience to internationally trained health workers. …
For physicians who have already completed a residency and been licensed by another country, they can try to enter through Canada’s Practice Ready Assessment programs, which confirm their qualifications in a supervised setting and shave several years off the licensing process.
Seven provinces use a national standardized system, which requires a 12-week clinical field assessment, and assigns successful candidates to an underserved hospital or region where they work under supervision.
The problem with the Practice Ready Assessment system, however, is capacity. Nationally, the PRA programs only add about 120 foreign-trained physicians to the Canadian health work force every year, across all specialties. But some provinces are expanding their ability to add international doctors more quickly.

5 December
Government of Canada launches call for proposals to help internationally educated professionals work in Canadian healthcare
(CNW) – Canada’s healthcare sector is experiencing critical labour shortages, heightened by the pandemic, and we need qualified workers to fill these vacancies. To help address these shortages, the Government of Canada is investing in projects that will give internationally educated health professionals the support and experience needed to pursue opportunities in the areas where we need their skills most.
Today, Minister of Immigration, Refugees and Citizenship, Sean Fraser, on behalf of Minister of Employment, Workforce Development and Disability Inclusion, Carla Qualtrough, launched a call for proposals under the Foreign Credential Recognition Program. Up to $90 million will be invested in projects that will help remove barriers preventing qualified and skilled newcomers from gaining Canadian work experience in their own profession or field of study.
Eligible projects must focus on at least one of the following areas:
Reducing barriers to foreign credential recognition for internationally educated health professionals (IEHPs) by improving recognition processes, simplifying steps in credential recognition and offering increased access to practice in the field. …

1 December
Health care surpasses inflation as top national issue of concern: Nanos
With reports of hospital emergency rooms under strain and cases of flu, RSV and COVID-19 spiking across Canada, health care has surpassed inflation and jobs as the top national issue of concern, according to Nanos Research’s weekly tracking
The latest Nanos tracking shows a four-week change in the top unprompted national issue of concern – unprompted meaning the Canadians surveyed were not provided a list of issues to choose from.

30 November
Breaking the damaging cycle of persistent sleeplessness
(Global) help2sleep.ca, a sleep guidance site, cites reports from the Public Health Agency of Canada that one out of three Canadian adults between 35-64 years old are not getting enough sleep — enough being seven to nine hours if you’re between 18-64 years and seven to eight hours if you’re over 65.
Trouble falling asleep or staying asleep could be stress-related if you have difficulties at work or in your relationships. It could also be a co-morbidity with another illness, such as depression or anxiety or insomnia.
… too little sleep can have significant health ramifications. A disruptive cycle of interrupted, nights can shift your brain into overdrive, resulting in intrusive thoughts and overthinking. …restless nights are followed by days where you can’t concentrate, you have memory trouble and you’re cranky.
The health consequences of a chronic lack of sleep can be severe. It can contribute to developing Type 2 diabetes, heart disease, stroke, dementia, Parkinson’s Disease, breast cancer, chronic pain and more.

23 November
Canadian health-care system struggling amid ‘multi-demic’ of flu, COVID-19 and RSV

18 November
How Canada can retain nurses amid a struggling health-care system: report
(CTV) A new report released Thursday by the Canadian Federation of Nurses Unions (CFNU), called Sustaining Nursing in Canada, laid out a list of solutions that could help to address the shortage of nurses during this dire situation for Canada’s health care system.
Among the issues facing nurses in Canada’s health-care system today are chronic shortages, ongoing burnout, consistent overtime, poor mental health and poor working conditions, according to the report.
In order to address the issue and keep more nurses in the field, the report laid out a “multi-layered” strategy with three steps: retain and support, return and integrate, and recruit and mentor.
Solutions from the report were among the suggestions presented during the discussions between federal, provincial and territorial health ministers at a two-day meeting in Vancouver last week.

17 November
Don’t be afraid of your colonoscopy, doctors say. It could save your life
Colorectal cancer is the fourth most common cancer in Canada, but if caught early, many people have a good chance of surviving. But screening for it is key. Dr. Jill Tinmouth, lead scientist at the colorectal cancer screening program at Ontario Health and gastroenterologist at Sunnybrook Health Sciences Centre, speaks with guest host Dr. Peter Lin about colorectal cancer screening.
With colon cancer being the second most common cause of cancer death in Canada, doctors say it’s an important procedure to have when necessary to catch cancer early. …research shows that when colorectal cancer is detected early, it is 90 per cent treatable, according to the Canadian Cancer Society.

8-14 November
John Ivison: Why Jean-Yves Duclos is not happy with provincial health ministers
But history suggests that the federal government will get its way, empowered by its purse
According to the health minister, he met with his provincial and territorial counterparts in good faith, hoping to conclude a deal that would see the provinces agree to pan-Canadian action on a health workforce strategy and health data sharing. On Monday, he issued a statement saying that a deal on health data would unlock an unspecified number of federal dollars to add to the Canada Health Transfer. Yet, before those discussions had concluded, the premiers issued their statement, saying that they were only interested in a First Ministers’ meeting with Justin Trudeau and an unconditional boost to the CHT that would cost Ottawa nearly $30 billion.
The fall surge of influenza, respiratory syncytial virus and COVID has created what experts are calling a “multi-demic” and some emergency rooms report seeing 80 per cent more patients than in previous years. At the same time, as anyone who has braved a hospital in recent months knows, there are acute staffing shortages, and the nurses who are there are exhausted and demoralized.
Duclos said Ottawa has two streams of funding in mind: … The second…would be related to the Canada Health Transfer, which would be increased by an unspecified amount if provinces sign on to share health data.
“In 2022, it’s not normal to still use faxes and paper forms to make pharmacists work with physicians and nurses with lab technicians. It’s not just data sharing between governments, it’s data sharing between health professionals, and about people accessing their own electronic medical records. Only one-third of Canadians have access to some part of those medical records. We want to speed up that transition and that’s why we made that a condition of receiving additional Canada health transfers.”

Provincial health ministers reject proposed federal health care funding over data collection system
Canada’s provinces and territories have rejected a proposed increase in federal health care funding, in part because Ottawa tied the offer to the creation of national human resources and data collection programs.
(Globe & Mail) The impasse emerged at a meeting of Canadian health ministers in Vancouver on Tuesday, impeding progress on co-operation between governments at a time when health care services across the country are in crisis because of understaffing, continuing waves of COVID-19 infections and other problems.
Federal Health Minister Jean-Yves Duclos had said on Monday that Ottawa was prepared to increase health care funding to provinces by an unspecified amount if they committed to a national health data system as an accountability measure. Tuesday’s agenda included two “decision items” that ministers were asked to approve: a pan-Canadian health-human-resources action plan, and a pan-Canadian health data strategy.
But at midday, with meetings still under way, Canada’s premiers issued a joint statement to say no progress had been made with the federal government. In response, Mr. Duclos backed out of a joint news conference and refused to sign a joint communiqué.
At the meeting’s conclusion, Mr. Duclos told reporters the federal, provincial and territorial governments had worked collaboratively on the two items for months, and that his counterparts had voiced no specific objections until just days earlier, when they received “marching orders by their premiers not to make further progress.”
… Several organizations, including the Canadian Medical Association, have been calling for the federal government to include pan-national licensure as part of the health-human-resources aspect of its proposal. Such a change would eliminate the need for physicians to seek new licenses when they move between provinces, allowing them to work where they want and are most needed.