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Health Council now appears pointless
October 20, 2003

The Hill Times

By Svend Robinson, M.P. (NDP, Burnaby-Douglas)

Nearly one year has now passed since the Report of the Romanow Commission on the Future of Health Care in Canada was tabled, and little has changed. Many of the concerns outlined in the report remain unaddressed: Canadians are still forced to contend with waiting lists for surgeries, diagnostic services, specialists, treatments, and even to get a family doctor to see them; public hospitals are still closing while private clinics and hospitals replace them; and nurses and doctors are still over-worked and in desperately short supply.

In February of this year, the Minister of Health, Anne McLellan, appeared to have adopted one of the Romanow Report's key recommendations: the creation of an arm's-length, independent council to oversee the performance of the health care system, to provide strategic advice and analysis to health ministers on important and emerging policy issues, to seek ongoing input and advice from the public and stakeholders on strategic policy issues, and to act as a collaborative mechanism capable of driving reform and modernization of the health care system. At that time, Prime Minister Chrétien secured the agreement of the provincial and territorial Premiers to create the Canada Health Council (although its mandate, principles, and composition were left unaddressed) within three months (ie by May 5th).

May 5th came and went, and the Minister hadn't taken action to establish the Council, and she then suggested that it would take shape in the coming weeks.

May turned into June, the House of Commons rose for its summer recess, and still no word from McLellan on the Council. Late last month, the Minister finally announced that the provinces and territories had agreed on the composition of the Council: 27 members, of whom 13 would represent the provinces and territories, 13 would represent non-government organizations, and one chairperson. As Mike McBane of the Canadian Health Coalition pointed out, a 27-member board is so large as to be unworkable. "It's designed to fail," he stated.

The Romanow Commission had recommended a 14-member board, consisting of 7 representatives of government, 3 representatives of the public, and 4 representatives of the provider and expert community recognized for their competence in health policy and practice.

Apart from its unwieldy size, the Council as envisioned at this time would lack all legitimacy as a government watchdog, since no member would be appointed without the consensus of the federal and provincial governments. The Minister has already broken her promise to Canadians that the Canada Health Council would be in place by May, and now she's betrayed them again by breaking her promise that the body would be "independent" from government.

The First Ministers are scheduled to meet this month to discuss the mandate of the Council, and there is little hope among Canadians who care about our health care system that the body will be endowed with any meaningful responsibility or authority, as recommended by the Romanow Commission. The fact that the provinces and territories have been asked to submit names for the membership of the Council without knowing what the Council will be tasked with accomplishing suggests that the whole exercise is lacking in serious intent. Just as the commissioning of Romanow to lead a study and write a report recommending steps to improve health care seems to have been a means for the Liberals to procrastinate while the system crumbles, so too does the Health Council now appear to be a pointless effort, designed to deceive Canadians into believing that the Liberals are interested in protecting public medicare.

Sadly, not only is Liberal apathy eroding our national health care system, but so too is the federal government's continuing infatuation with corporate globalization. By promoting incessant liberalization of international trade, the Liberals are jeopardizing not only our citizen-based democracy, but even our personal health. Free trade agreements like NAFTA, GATS, and the proposed FTAA risk compelling us to open our publicly-funded and delivered health services to competition from private, foreign corporations, which would inevitably result in a two-tiered health care system. As more and more health services are contracted out to private companies, a door to foreign competition is being forced open which will not be easily shut.

Again, the Romanow Commission's report was clear that this threat is real and must urgently be opposed: "In almost every one of the Commission's public hearings, as well as the regional roundtables, concerns were expressed by experts and citizens alike that Canada's health care system should be protected from the impact of international trade agreements." The report recommended that the Liberals ensure that health care in Canada remains a "public service," and that Canada's position that the right to regulate health care policy should not be subject to claims for compensation from foreign-based companies, is reinforced and stubbornly maintained.

Next month, governments from across the Americas will send their representatives to Miami for the next ministerial meeting to negotiate further the terms of the proposed FTAA. The draft version of the agreement already contains rules that could open up the Canadian health care markets to foreign corporate service suppliers, while making it difficult to expand public medicare to include prescription drugs or homecare. Furthermore, the draft FTAA contains provisions which go further than the WTO's TRIPS agreement on pharmaceutical patent protections, making it even more difficult for governments to grant generic drug makers licenses to produce affordable medicines.

More than 50,000 Canadians from across the country have already signed petitions and postcards calling on the Liberals to acknowledge that "the FTAA is Hazardous to Your Health," to stop the negotiations of the FTAA and all trade agreements that put profits before public well-being, and to listen to Canadians who demand that universal publicly-funded and delivered health care services be preserved. These signatures will be joined in Miami with hundreds of thousands of others collected throughout the Americas, and presented to the Trade Ministers meeting there. We can only hope that the Liberals will finally choose to stand up for medicare and indeed for all Canadians, and say no to the FTAA.

Our cherished health care system has been sorely abused and neglected by the Liberals during the Chrétien era, and particularly the years when Paul Martin, as Finance Minister, was so intent on slashing much-needed federal funding for medicare. Now, as Martin assumes de facto authority as Prime Minister, there is little reason to expect any improvement. Already we have seen John Manley hinting broadly that $2 billion in promised federal health care funding to the provinces in early 2004 will not be forthcoming. It seems that so long as the Liberals remain in power, Canadians will be denied a fully funded, fully accountable, and fully public medicare system.