TORONTO -- Health Minister Jane Philpott drew a proverbial line in the sand Monday as she warned her restive provincial and territorial counterparts agitating for more federal money that all such funding must be earmarked for health care.
"I'm fixated on delivering better health for Canadians," Philpott said during a matter-of-fact news conference in Toronto, where the provinces and territories are also gathered in advance of meetings with her on Tuesday.
"I have a responsibility as the health minister for Canada to invest in health, to help improve health systems ... but when we are going to my finance minister to ask for more money, I need to be able to tell that finance minister it is going to be used for health."
Philpott's remarks set the stage for a confrontation Tuesday with provincial and territorial health ministers, who are united against her government's efforts to slash in half the amount by which federal health payments are set to increase next year.
Quebec Health Minister Gaetan Barrette, among the most outspoken provincial ministers on the issue of federal transfer payments, said cutting that annual increase to three per cent from six per cent will mean diminished services for patients.
The financial squabble is expected to dominate discussions with Philpott on Tuesday.
"I am very comfortable in my position," Barrette said outside Monday's meeting room at a downtown Toronto hotel.
"The reason I am very comfortable in my position is that it reflects everybody's position. Some might not want to have the same way of communicating but at the end of the day, what I am expressing is basically what is the position of everybody."
The conversation with Philpott on Tuesday will be very clear and direct, he added.
Ontario Health Minister Eric Hoskins, himself a Liberal and host of this week's meeting, struck a more diplomatic tone, but made it clear the province is not happy.
"We have a very strong, collaborative relationship with the federal government, myself and Jane Philpott ... but what is true is that provinces and territories now pay for approximately 80 per cent of health services delivered in this country," he said.
"The portion of the federal contribution is declining with their current position to decrease the escalator down to three per cent."
Later, at a news conference, Hoskins said that decision would mean a "huge blow" for the provinces: a $400-million shortfall in Ontario alone in 2017-18 and $1 billion across the country, Hoskins noted.
B.C. Health Minister Terry Lake has acknowledged there cannot be unbridled spending on health, but said he remains strongly opposed to what the federal Liberals have on offer, considering the persistently upward trajectory of health costs.
"This is a series of discussions," Lake said. "I think we set the table here ... we want to have a good relationship."
Finance ministers from B.C., Ontario and Quebec also attended Monday's discussions while others listened in over the phone.
In a joint statement Monday, provincial and territorial health and finance ministers suggested the federal government should consider postponing cutting the transfer increase until the premiers and Prime Minister Justin Trudeau can sit down and hash out an agreement.
The current annual rate of increase was established in 2004 under the last health accord.
For her part, Philpott has spent the last weeks playing down the transfer payment issue, insisting it is a matter for finance officials to hammer out.
Instead, she wants health ministers to review how to make the current health-care system more effective, while ensuring financial accountability.
Philpott has also made it clear the federal government plans to spend $3 billion on home care over four years, including palliative care.
Officials note federal health expenditures totalled $41.3-billion in 2015-2016 including $34 billion for the Canada Health Transfer.
"It is not all about money in health care," Philpott said.
There have been dramatic increases in the Canada Health Transfer over the last 12 years, she noted.
"I don't know where that money is going, we give the money to the Canada Health Transfer and it actually goes to the general revenue streams of the provinces ... we want to talk about making sure that money goes to health."
The health accord is supposed to be an agreement to outline goals between the levels of government.
In a statement on Monday, the Canadian Medical Association said it believes a new accord is urgently needed so Canada's publicly funded health-care system can meet needs and remain sustainable.
