Health ministers move forward on improving health care in Canada

NLIS 7
September 26, 2001
(Health and Community Services)

Health Minister Allan Rock and Newfoundland and Labrador Minister of Health and Community Services Julie Bettney, on behalf of federal, provincial and territorial health ministers, today announced agreement and progress on a number of initiatives which will improve Canada's publicly funded health system and ensure the system continues to serve Canadians well in the future.

The meeting was an opportunity for ministers to take stock of the progress achieved since September 2000, when first ministers outlined their priorities and a vision for health � "Canadians will have publicly funded health services that provide quality health care and that promote the health and well-being of Canadians in a cost-effective and fair manner." First ministers committed to strengthen and renew Canada's publicly funded health care services through partnership and collaboration. The vision and priorities shall be interpreted in full respect of each government's jurisdiction.

Since the September meeting, intergovernmental collaboration has resulted in significant advances on the action plan first ministers developed to make the vision a reality, in particular:

�	development of a multi-faceted and collaborative approach to pharmaceuticals management
�	addressing the issue of the supply and retention of health care professionals
�	ongoing development of performance indicators that would provide Canadians with information
	about the performance of the health system and health outcomes
�	groundwork on better integration of home care and community care into the health system

Sustainability and the future of health care

Health ministers discussed elements of sustainability of Canada's health system.

Health sector emergency response

Early in the meeting, ministers discussed the health sector's response to the September 11 terrorist attacks in New York City and Washington, D.C. Ministers committed to maintaining vigilance and undertook to enhance and strengthen prevention, detection and response capability. Some of the items discussed included improving federal/provincial/territorial coordination in responding to emergencies; enhancing laboratory diagnostic capacity; updating stockpiles of necessary vaccines, antibiotics and antidotes; and ensuring Canada has trained staff ready to respond to any crisis across the country.

Improved pharmaceuticals management

The September 2000 action plan directed health ministers to develop strategies to ensure Canadians continue to have access to appropriate and cost-effective drugs.

Pharmaceuticals are an increasingly important aspect of health care, but also one of the key cost drivers in the health system. It is crucial that public drug benefit programs focus on the most therapeutically beneficial and cost-effective drugs. Today, health ministers announced agreement on a multi-faceted approach to better pharmaceuticals management that consists of:

�	The establishment of a single, common review process for coverage of new drugs in Canada.
	While decisions on benefit coverage and formulary listing would be retained by individual
	provinces, territories and the federal government, future cooperation in these areas is both
	possible and desirable. Ministers also agreed to increase collaboration and further enhance the
	assessment of cost effectiveness in the drug review process.

�	An initiative to support best practices in drug prescribing and utilization. Doctors, pharmacists
	and patients all have a role in ensuring that the patient is receiving optimal drug therapy, and that
	the health system is getting as much value as possible from prescription drugs that are paid for
	through public funds.

�	The establishment of a National Prescription Drug Utilization Information System which can
	provide critical analyses of price, utilization, and cost trends; so that Canada's health system has
	more comprehensive, accurate information on how prescription drugs are being used, and
	sources of cost increases. In addition, doctors and pharmacists would have better information
	from which to provide care to patients.

While participation in these processes will be optional, information sharing amongst jurisdictions is expected.

Minister Rock updated his provincial and territorial counterparts on the Government of Canada's pursuit of an enhanced post-market assessment system that would complement the other efforts through improved monitoring of safety and efficacy after a drug has been approved for sale.

Ministers also approved the release of several cost-driver reports prepared by the Patented Medicine Prices Review Board on behalf of the federal/provincial/territorial Pharmaceutical Issues Committee. The reports look at the reasons for increasing costs and are an important component of the collaborative work done by governments to ensure that drug prices are fair and reasonable.

Home care and community care

Ministers took an important first step towards strengthening an increasingly critical component of Canada's health system by receiving a report on a common vision and principles for home and community care, under which Canadians would have access to a range of publicly and privately funded health and support services that meet the assessed needs of individuals and enable them to live as independently as possible in the community.

Ministers agreed to forward the vision and principles to first ministers for further consideration - Quebec did not contribute to the elaboration of the federal/provincial/territorial document on home and community care.

Palliative Care

Following a presentation on this subject, ministers had discussions of current pressures and directions that are being pursued to ensure Canadians have access to high quality end-of-life care and support.

Supply of doctors, nurses and other health care providers

Discussions also addressed the supply of health care personnel in Canada. Steady progress has taken place on the Nursing Strategy for Canada, announced at the October 2000 Health Ministers' meeting. This progress includes the establishment of the Canadian Nursing Advisory Committee, an arm's length expert advisory group that is developing recommendations on ways to improve the quality of work life for nurses � key to encouraging nurses to continue in the profession. Quebec reiterated that it chose not to participate in pan-Canadian strategies regarding health human resources.

Ministers also considered how intergovernmental cooperation in training and recruiting could be enhanced to alleviate the many challenges associated with the shortage of key health care personnel.

Ministers underlined the importance of continuing to work with health care providers to find shared, effective, and sustainable solutions to health human resource issues. It was noted that Quebec is pursuing its own strategy on health human resources.

Primary health care

The subject of primary health care reform is an important element in enhancing accessibility to health care. Ministers committed to continue pursuing innovative approaches to primary health care delivery, such as telephone triage systems, teams of health-care providers, and greater emphasis on prevention and health promotion. Provinces and territories are collaborating and accelerating reform in this sector. The Primary Health Care Transition Fund was one of the federal initiatives related to the September 2000 First Ministers' Meeting Communique on Health.

Health system performance and reporting

As a follow-up to the commitment to improve feedback to Canadians on the performance of the health system, ministers reviewed the status of efforts to provide Canadians with information about how their health dollars are spent.

Provinces, territories and the federal government have been investing in new sources of system information. An intergovernmental group chaired by Alberta is working on comparable indicators that will measure health status, (such as life expectancy) health outcomes (such as reduced burden of disease and illness), and quality of service (such as patient satisfaction and hospital re-admissions). These indicators will be used in performance reporting by each government to their respective citizens beginning in September 2002.

Prevention of illness

The promotion of health and the prevention of illness are keys to the long-term sustainability of our publicly funded health system. Strategies that address the causes and effects of addiction are one part of this effort. Ministers received and released two reports that represent ongoing intergovernmental work in this area:

�	The National Strategy: Moving Forward, The 2001 Federal Provincial Territorial Progress Report on
	Tobacco Control follows a joint tobacco control strategy endorsed at the September 1999
	Conference of Ministers of Health. The report outlines recent successes, concerns and areas where
	there is a need for more action.
�	Reducing the Harm Associated with Injection Drug Use contains recommendations on how
	prevention, outreach, treatment and rehabilitation, research, and national leadership can reduce
	the problems that injection drug use causes for individuals, their families and communities.

The health system and genetics technology

Genetic testing � which involves analysing a patient's DNA to determine whether he or she has a predisposition to develop a disease � is emerging as a new component of the health system. Ministers discussed the need to prepare for and respond to this development, focusing on the appropriate role for this new technology within the publicly funded health system, and recognizing the need to address patent and proprietary issues. They agreed that continued analysis of the clinical validity and value to health of genetic testing is required to determine what this role should be, and directed their deputies to collaborate on a work plan to manage implications for the health system over the short and longer term.

Canada Health Act - Dispute Avoidance and Resolution

Governments, except Quebec, are working on the development of a Canada Health Act (CHA) dispute avoidance and resolution process as soon as possible related to the interpretation of the CHA principles and recommitted themselves to this work.

Concluding remarks

"Although much work has been accomplished in the past year, ministers agree that they must continue to cooperate on health sector issues with a view to improving our provincial and territorial health systems and ensuring patients receive quality, publicly funded health care for years to come," said Minister Bettney.

"Today's meeting builds on the commitments we made last year to strengthen the renewal of Canada's health system," said Minister Rock. "These past two days we've had time to reflect on the progress to date, reaffirmed our resolve to continue collaboration and we worked on a number of areas for the next phase which will bring improvements over the coming year."

Backgrounders:

Advisory Committee on Population Health (ACPH) Report: Moving Forward, The 2001 Federal Provincial Territorial Progress Report on Tobacco Control

Federal/Provincial/Territorial Committee on Injection Drug Use Report: Reducing the Harm Associated with Injection Drug Use in Canada

Reports:
Moving Forward, The 2001 Federal Provincial Territorial Progress Report on Tobacco Control

Reducing the Harm Associated with Injection Drug Use in Canada

Drug Prices and Cost Drivers 1995/96 - 1998/99

Public inquiries: (613) 957-2991

Media contact:

          Tara Madigan
          Health Canada
          (613) 946-4250

          Catherine Lappe
          Office of Allan Rock
          (613) 954-1328

          Carmel Turpin
          Office of Julie Bettney
          (709) 685-4624

2001 09 26                                     3:10 p.m.

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