Dear Mr. Martin,

On behalf of the Health Action Lobby, we submit seven recommendations for enhancing the federal government's financial commitment to the health system.  We ask that these recommendations be considered in the development of the government's up-coming financial statement.

HEAL is a coalition of national organizations dedicated to protecting and strengthening Canada's health system. Its 29 member organizations represent more than half a million providers and consumers of health care. HEAL is committed to working collaboratively with governments and with others to ensure  the health system meets the changing needs of Canadians.

We welcome the September 11, 2000 announcement of new federal investments to support the agreements by First Ministers on Health System Renewal and on Early Childhood Development. The investments re-confirm the government of Canada's presence in the health policy field.  The investments are significant and will lay the groundwork for re-building of the health system. HEAL believes additional funding is needed in the following areas to assist in that re-building effort.

  1. Many of our members believe that the increases to the CHST cash floor must become effective immediately, and not be delayed until April 2001. This recommendation reflects the fiscal realities faced by the current health infrastructure.
  2. We note that, in addition to increasing the CHST cash transfer, the federal government has established three targeted funds. HEAL supports the creation of these funds and recommends that the allocation to each of these funds be augmented to ensure that those health services not currently covered through publicly funded health insurance programs, are embraced. Specifically, HEAL believes that the development and adoption of information technology systems, must facilitate the connectivity within the acute care system, among the acute care system, community-based health services and long-term care services, as well as between that system and health care providers, such as dietitians, pharmacists, physiotherapists, and psychologists,  whose services may fall outside the publicly funded system. HEAL recognizes that the allocation made on September 11 for information technology will need to be augmented when the scope of the effort is broadened.
  3. HEAL believes that the creation of the medical equipment acquisition fund is a positive step.  It recommends that the fund be complemented by a targeted investment in training of personnel, professionals, para-professionals and others, to operate the equipment and interpret its findings.
  4. Our fourth recommendation relates to the conditions of accessibility and portability of health services, as envisaged in the Canada Health Act. HEAL believes that Canadians, no matter where they live in Canada, are entitled to comparable and quality health services. Moreover, HEAL believes that the varying fiscal capacities of provincial governments must not compromise that entitlement.  We support the commitment to review the equalization formula. HEAL recommends that one of the criteria in defining the appropriate formula, be ensuring access to comparable and quality health services for all Canadians across this country.
  5. We support, too, the inclusion in the equalization formula of an escalator linked to the GDP. In previous years, HEAL has recommended that the federal government index the cash allocations to health care.  We recommend today that the government commit to a review of the viability of the GDP as a growth rate to address changes in the costs of delivering health services.
  6. HEAL is encouraged by the fact that governments have agreed to a common framework for rebuilding the health system. Two of the key commitments in the framework were the agreement to ensure the appropriate supply of health care personnel, and the direction to improve worklife conditions for the health workforce.  Unfortunately, no funding was allocated on September 11 to these purposes. HEAL recommends that the federal government invest in initiatives that facilitate the recruitment and retention of the health workforce and in improving worklife conditions.  A national approach to human resource planning in the health sector is vital to ensure the integration and thus the efficiency and effectiveness of initiatives undertaken in individual provinces.  A national approach also recognizes the increased international mobility of the health workforce.
  7. Last year HEAL commended the government for its vision in creating the Canadian Institutes for Health Research. We continue to believe the CIHR will foster an integrated research agenda, promoting the collaboration among disciplines and ensuring investments in disease prevention.  HEAL recommends the federal government invest in the synthesis and dissemination of the results of research and of new knowledge, not only from the CIHR and from the Health Transition Fund, but from other programs and initiatives as well.


Adoption of these seven recommendations, coupled with the implementation of the initiatives announced on September 11, will position the health system to respond to the health needs of Canadians. HEAL would be pleased to meet with you and your officials to discuss these recommendations

Yours sincerely,

Mary Ellen Jeans, RN, PhD, Co-Chair 
Sharon Sholzberg-Gray, Co-Chair