Aglukkaq’s letter to provincial health ministers: slip-slidin’ away

by Paul Wells

PostMedia’s Jason Fekete is a good reporter who writes about serious things, so I’m a little nervous to note I read Leona Aglukkaq’s new letter to provincial health ministers pretty much the opposite of the way he reads it. Maybe I’ve got it wrong. Wouldn’t be the first time. Let’s go through it.

Fekete says Aglukkaq is “calling for more teamwork” and “urging the provinces” to adopt a national approach to measuring health outcomes and “proposing greater collaboration.” An activist, what. Before I explain why I read it differently, I’ll point out that at least Fekete and PostMedia think a statement from the federal health minister on health transfers is worth covering. I sure do think they’re right on that, and at this hour they don’t have a lot of company.

Anyway. Aglukkaq’s letter is short enough to run in full. Here you go:

I am writing to follow up on my letter of December 20, 2011 and this week’s Council of the Federation meeting.

I have appreciated the opportunity to meet with several of you in recent weeks to discuss how we can best work together to deliver on our collective commitment to a health system that provides all Canadians with timely access to the best health care possible.

I welcome the Council of the Federation’s initiative to form the Health Care Innovation Working Group and I agree that “more can be done together”. In that spirit, I reiterate my commitment to work with you to address our shared priorities in the renewal of our heath care system.

 As you know, the federal government invests over $1 billion in innovation through the Canadian Institutes for Health Research, Canada Health Infoway, and other programs supporting research and health human resources. This is in addition to our recently announced long-term, stable funding arrangement that will see transfers reach $40 billion by the end of the decade. Federal health care contributions will continue to increase to record levels, and we have certainty around future levels of the Canada Health Transfer and other major federal transfers. This stability and a shared commitment to innovation and accountability provide a solid foundation for our efforts to optimize the results of our health care investments.

 I would be pleased to continue to engage in intergovernmental discussions and actions with respect to innovation, improved accountability and other areas that will enable better, more sustainable health care. We could also pursue a coordinated approach to measuring and reporting performance across jurisdictions in order to improve health care for Canadians.

 As health ministers, we are all focused on improving the health of Canadians and our health care system, and Canadians are best served when we work together. I look forward to further discussions with you on these matters as we work together to improve quality of life of families from coast to coast to coast.

 Sincerely,

Leona Aglukkaq, P.C., M.P.

Second paragraph: “The opportunity to meet with several of you” is a subtle way of saying she hasn’t met with all of them as a group. (UPDATE: Well, she did meet them in Halifax on Nov. 24-25, before the feds tabled their transfer plan. My bad.) Which is why Christy Clark and the other premiers sounded like kids at the dance who can’t find anyone to dance with when they met earlier this week. Harper federalism is built on private meetings in different cities, which ensures the provinces can’t gang up on the fed, and that it won’t be clear who’s telling the truth if accounts of all those conversations diverge.

Third graf: “More can be done together,” she says — quoting the provinces — and then she “reiterates” her “commitment” to work with them. But then she reveals what she thinks working with the provinces is. The feds already spend $1 billion on innovation, she asserts, citing two programs introduced by Jean Chrétien more than a decade ago, and then she spends the rest of a long paragraph justifying Jim Flaherty’s “announced” — i.e., not proposed and not negotiable — “long-term, stable funding arrangement.” Now, as I’ve already written, the provinces should be pretty happy with what Flaherty proposed announced. But if they’re hoping for more, or for some kind of innovation sidecar newer than anything Chrétien did, so far they’re not getting much from Aglukkaq.

Onward. “I would be pleased to continue to engage in intergovernmental discussions,” apparently much like the ones she’s already had in a series of capitals that have left her admiring the Chrétien legacy and Flaherty’s December announcement. “We could also pursue a coordinated approach to measuring and reporting performance across jurisdictions.” I dunno; what do you wanna do? I dunno; what do you wanna do? Well, we could pursue a coordinated approach to measuring and reporting. I’ve seen more urgent phrasing in my day.

And here we are at the bottom of the letter. “I look forward to further discussions with you on these matters.” How much does she look forward to those discussions? Here’s a hint: she proposes no date, no venue and no agenda. For a test of her eagerness, watch for her response when a provincial minister proposes a date, a venue and an agenda.

I don’t think this is a complete stonewall. I suspect there will be something in the next budget that the feds can point to as a contribution to (pick one) innovation, collaboration or accountability. But I see nothing in this letter to suggest it will substantially modify or supplement Flaherty’s announced transfer schedule.




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Aglukkaq’s letter to provincial health ministers: slip-slidin’ away

  1. It’s what’s commonly known as a ‘KFO’ letter….for ‘kindly fuck off’.

  2. I think you’re right on the money.  This is a typical say-nothing-with-a-lot-of-words type of letter.  I also like your point that it’s wise for the feds to meet with just a few at a time.

    The “innovation fund” is a total load of manure. You don’t innovate by creating a slush fund.

  3. When you assert that  throwing large amounts of money at a problem isn’t the answer, it seems odd. when criticized, to defend yourself by claiming you are spending large amounts of money supposedly on it.

    • There’s the problem, and there are the symptoms.  One symptom is escalating health costs funded by governments.  Another is long waiting lists. The problem is that the health system, the bureaucratic monopoly that it is, is causing costs to escalate too much and waiting lists to grow, in an unsustainable manner.

      For the time being, you can address the symptoms with more money, while at the same time denying that more money will solve the problem.

  4. The fact that the letter can be read both ways is convincing evidence that it means nothing, as Paul has concluded.

  5. is  this not the same health minister out in the same.boat as witch doctors from africa when she stated intervenious clean needles do not help.stop hiv transmission where do these people get.the nerve  it is.clear.feom listening to health care.professionals that more.preventative gelath care is the route.by.gerting doctors.spend longer time with each patieint and paid a.large.lump salary comparae to a.full out see.sixty.patients a day.clinic and people.will end up healthier and more.confortable not.wanting to end up in the emergency.room but ona.tread.mill.we.rank near.last for the dollars.spent in our country when will.ahealth minister.actually have.courage.to help.rather then pontificate or spend or.cut funds.sincerly canadian health care.lover.a.mac isaac

    • Tony Clement, when he was health minister,  claimed that this government does not believe in harm reduction.  He did this at a WHO meeting.  I haven’t heard anything that would indicate a change in policy.  This is totally out of step with the rest of the civilized world.

  6. king harper speaketh

  7. If the federal government does not want to get involved in health care or enforce the national program in place now, then why do we need a federal health minister?

    Could the federal government not just reduce the federal taxes by the amount collected for health care and leave the taxation room for the provinces to collect?

    • “If the federal government does not want to get involved in health care or enforce the national program in place now, then why do we need a federal health minister?”

      Well, someone has to pen and sign pointless letters to premiers like this one.It might as well be the relevant minister for a change. Although it might have been more to the point if Bev had simply supplied Leona with one of her snappy memos – the ones with the NOT penciled in.

      • Yes, but we are supposed  to respect them for putting women in these important and critical cabinet posiions. Sigh.

        • The really sad thing is i’m pretty sure both of those women are bright, intelligent, competent individuals

          …Oda does seem to be doing her best to make me a liar though.

          • I feel especially sad for the health minister because I know she could contribute so much to our understanding of the north. Oda –  I give up.  The one I cannot figure out is Kelly Leitch.  To give up a medical career  in order to stand up in the HOC and read mindless talking points – what on earth is she thinking?

          • I’m with you on this one. Left a job as a pediatrician and got the ConBorg flipper implants.

  8. Gee, and here I thought that the phrase “I look foward to further discussions” meant that she looked forward to further discussions.

    How sinister, that.

    Line after line, word after word, Mr. Wells scours the text for the most negative, sinister, dare I even say evil, interpretation.  Thank you so much Mr. Wells for explaining those subtleties, or putting it another way, telling us what we should take her words to mean. 

    It’s important for regular Canadians to view the world through the same far left Harper hating prism that the approving leftist commenters on this site do.

    Who knows, by next election perhaps Canadians will come around to the fact that whether dad has a job at the end of the day, or the kids have any prospects of a bright economic future, will pale in comparison to the true headline grabbing “news” (plastered on nearly every front page in the heart of an election occuring during a worldwide economic downturn) that two liberals were kicked out of a Conservative campaign rally – more evidence of the dark heart of Conservatives.

    Maybe Canadians will learn how to appreciate the subtleties and will no longer require translations into the “real meaning”  behind the seemingly innocuous (though truly sinister) doings of Conservatives.

    Maybe.  Though I suspect Mr. Wells and the rest of the media have much work ahead of them.

    • So Calvin has been replaced.  I must say you have a much better command of the language,

      • No, Calvin is still here—but he`s getting bored by most of the Libs here—you especially. You are a very negative person, but I do agree with your compliment to Chesterson`s writing style. I look forward to improvement from Jan.

    • well said. 

  9. You know I might respect a federal government reducing its share of healthcare expenditures via transfers and telling provinces to get their houses in order if we ever had a federal government that practiced what it preaches when it comes to the healthcare delivery it is constitutionally responsible to provide to First Nations.

    The feds talk a great line about coordination and achieving targets and standards by the provinces but preside over the worst care delivery system in Canada and seem incapable of creating, let alone alone achieving outcome-based targets.

    • Good catch. I’ve fixed it to reflect that. Thanks.

  10. It appears obvious that none of the provincial governments have any stomach to propose innovations to health care providing.  They expect the federal government, which has little, if any, direct hand in health care provision to do the heavy lifting.  The federal health care minister is only stating that the federal government is willing to meet with interested provincial governments.  If a time, a place, and an agenda are brought forth, agenda meaning something more than an obtuse bureaucratic document, I will cheerfully decry the federal health minister’s declinations to attend as Mr. Wells expects.  Until then, the provinces are dropping the ball, not the feds.
    The “heavy lifting” is on the table.  It is in the provinces’ courts at this time.
    A pissing contest of course. 
    But the provinces need to show what they have.
    The feds have declared. 

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