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Tuesday, 2 October, 2007

Conservative government looks to further decentralize healthcare

Through an access-to-information request, Hill Times reporter Bea Vongdouangchanh has unearthed some of the current state of federal-provincial relations as they pertain to healthcare funding issues and the Conservative government's grand "open federalism" decentralization agenda.

This story is a little old by now, but it got such a minuscule amount of attention when it was published a month ago that it's worth bringing up now even if we're a bit late.

Here's an excerpt, but it is worth reading in full:

Feds' 'direct participation' in national health care being limited: documents

The Conservative government's approach to national health care is one of "collaborative federalism" with "little or no hierarchy" and the provinces and territories are trying "to limit the direct participation of the federal government" in the review of health policy and programs, according to a 2006 Health Canada briefing package released to The Hill Times. [...]

The briefing note is a year old, but is still significant to the health care debate, said University of Regina professor Gregory Marchildon. "The broader issue of the respective roles has always been important and there's always been real tension between provinces and territories, which want as much maneuver ability [sic] as possible, yet they want to optimize the amount of federal financing going into it; and the federal government wants to minimize the amount of federal financing yet maximize its policy influence[...]"

The Conservative government has stated that it does not want to interfere in provincial jurisdictions, however, putting forth the idea of "open federalism." The briefing note states that although intergovernmental experts such as Harvey Lazar, a fellow at Queen's University's institute of intergovernmental relations, believe that "disentangled federalism may be appealing ... intergovernmental relations in the health sector should preferably fall into the collaborative federalism category where the different orders of government are working together with little or no hierarchy but are subject to ongoing and difficult bargaining."

The federal government "recognizes and respects the division of powers, responsibilities, accountability and jurisdiction of [provinces and territories] ... under open federalism," the briefing note says. As a result, the government "continues to review many activities to ensure they fall clearly within our federal roles and responsibilities–disentangling the department from those activities where we do not belong–while ensuring that we maintain appropriate processes to facilitate collaborative federalism with the P/Ts."

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