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The Hill Times – April 24, 2000 BACK - NEXT

ROCK SAYS POLITICS DISRUPT TALKS

Federal health minister talks No. 1 issue in the land and tells it the way he sees it, 'that's politics'
 By Angelo Persichilli
                                         The Hill Times           (Versione Italiana)

It's the No. 1 issue in the land, but Federal Health Minister Allan Rock says politics is slowing down talks between the provinces and the federal government over reforming Canada's health-care system.

Mr. Rock (Etobicoke Centre, Ont.) told The Hill Times that this was made clear at the recent provincial meeting in Markham, Ont.

"Politics is the first impediment. I think the reason we didn't get anywhere in Markham is because health ministers were sent by their premiers on a mission. Not to talk about solutions, but only to talk about CHST [Canada Health and Social Transfer]. That's politics," Mr. Rock said.

Moreover, Mr. Rock said that the only thing that keeps all the provinces together "is money."

Mr. Rock, one of the next Liberal leadership candidates who will run if Prime Minister Jean Chrétien steps down, said it is time to change Canada's healthcare system.

"The principles that we adopted 50 years ago with the Canada Health Act are still very sound, but our practices have not changed in terms of taking into account real differences in the nature of the needs of health-care services," he said, in a wide-ranging interview with The Hill Times at his ministerial office in Ottawa recently.

Mr. Rock said 20 years ago hospitals accounted for almost half of the total health-care spending, now less than one-third. He said that people used to go for a surgery for 14 days, but today are in and out on the same day.

"The focus has shifted to hospitals in the community in so many ways. Whether it's recuperating from surgery or with an aging population needing care at home or in the community, the Canada Health Act only ensures services in the hospitals, provided by doctors."

According to Mr. Rock, the Canada Health Act has not been broadened to include other places where care is provided. "Furthermore, costs have gone up, the nature of the services have changed and we haven't kept pace. That means that we really have to modernize the way we organize in delivering the services," he said.

Obviously, the problem is also related to money "because it costs more," but the minister said that also some fundamental structural changes are needed.

"We went through a period when those changes were going on during the eighties and nineties, and in the nineties all governments reduced their spending because we all had deficits. And, those two things conspired to produce real problems."

On top of those problems, he said some provincial governments went about the changes at a different pace and in different ways.

"With some greater or different successes, you end up with diminished access and higher anxiety on the part of the public, producing the present situation."

Moreover, Mr. Rock dismissed the accusations from the provincial leaders who are asking the federal government for new ideas.

Declared Mr. Rock: "We are going to. In fact, we have already."

He said politics should be put aside for a moment, and recalled in his opinion what has happened to Canada's health-care system. He said in the 1997 federal budget, the federal government set aside $150-million and called it the Health Transitional Fund.

"We said, 'This money is available to you and you spend it, we don't.' You can have it for pilot projects in any one of the four areas. Changing the way primary care is delivered, developing home and community care, finding new ways to ensure pharmaceutical products and integrating services so they are not so fragmented. The monies have been spent. Provinces have had pilot projects and have learned from that experience. And that is an example where we have put ideas on the table and we put money with it and we said, 'Let's learn more about the direction we should be going in.' "

Mr. Rock said his department also put forward ideas during the federal-provincial summit in Markam.

"We gave them a document, which identified 10 areas where we were prepared to add money to make things better," he said.

The areas included, hiring more doctors and nurses to run a national health information system, renewing medical technology in hospitals, focusing on aboriginal health, home and community care and adding prevention and promotion efforts.

"Those were only some of good and sound ideas, coupled with an offer to provide more money," he said.

Unfortunately, Mr. Rock said, "They said we do not want to talk about that, we only want to talk about restoring the CHST. I believe we missed a good opportunity. We are going to meet again in May and, I hope, their agenda will change."

Mr. Rock said he agrees with the suggestion that the problem is not just about money, but also about a different role that the provinces see for the federal government in this country.

"Definitely. I do agree. Depending on the province you are dealing with, some don't believe in the role of the federal government at all, like Quebec."

But Mr. Rock said lately also, "Ontario begrudges any role for the government of Canada in important areas of Canadian life. And I feel just as strongly that I am not going to apologize for the role of the government of Canada."

Mr. Rock said he is convinced that "Canadians, generally, understand that while the responsibility to deliver the services might be provincial, the health-care system is Canadian. And, while the responsibility may be provincial, certainly the preoccupation is nationwide."

He also had some tough words for Alberta Premier Ralph Klein who is trying to get the contentious Bill 11 through the legislature. The bill would expand and regulate private health care in Alberta. Mr. Rock dismisses his statement that the reforms proposed in Alberta are already implemented in other provinces.

"I took him at his word and I compared his legislation to Saskatchewan and Ontario. We found that in Saskatchewan, although they had a statute that you can have private for profit clinics, it was done to limit them, not open the door like Klein wants to do. Second, there is no clinic opened in Saskatchewan since they adopted the law."

Mr. Rock said he also found out that "Saskatchewan forbids the clinics from charging for extra services. In Ontario, it is the same thing."

Mr. Rock said "in reality, Alberta is the first province in the country that says that they have the right to charge for what he calls enhanced services."

In a letter he sent to Mr. Klein, Mr. Rock asked him to amend Bill 11, adding that if he refuses to do so, "we have to respond accordingly."

Mr. Rock said it's time to solve the problem of Canadian health care.

"I believe that what we are talking about in terms of changes in the way primary care, probably five to seven years."

He, however, believes that there are things that can be done immediately, "like upgrading equipment and technology and diagnostic machines.

"There is no reason why Canada should have not access to the most recent surgical and diagnostic equipment in the world. We can afford it, we should have it and we should renew the medical technology across the country."

Between the different vision of this country, the politics and the money, Mr. Rock said he believes that "politics is the most difficult obstacle."

As for the money issue: "Paul Martin already said that there will be more money even this year, if we get it right. That can be solved because we have a surplus and that is a No. 1 priority."

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