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The federal and provincial governments’ ten year plan for medicare is seriously off the rails, Paul Moist told a parliamentary committee May 13.

The plan, established in Feb. 2003 at a meeting of first ministers, was supposed to strengthen health care over the next ten years. And there was extra money attached to it.

But if the best-laid plans often go astray, what happens to plans that are set up without any accountability, with no regard for medicare standards, and goals that run counter to Canadians’ needs?

The answer, CUPE argues in its brief to the House of Commons Standing Committee on Health, is not good.

  • No information or accountability: The Health Council of Canada was established to monitor how provinces were putting the plan into action, but the council gets no information on how provinces are spending federal health care money. Quebec and Alberta do not participate in the council at all.
  • For-profit delivery doubling: The number of for-profit clinics delivering medically-necessary services has likely doubled since the plan was signed. We have no firm data on this because the federal government refused to collect it.
  • Wait time strategy: The plan’s “wait time guarantees” fund has hastened the commericalization of medicare in some provinces. Worse, there is little reporting required on how the money is spent or what results were achieved.
  • Public-private partnerships: Despite substantial and growing evidence that public-private partnerships cost more and deliver lower-quality service, there are 38 P3 hospitals planned or underway in four provinces. P3 hospitals open the door to two-tier medicare a number of ways.
  • Hospital cleaning contracting out: Hospital cleaning services are being privatized - both through P3 schemes and stand-alone contracts even though privatized cleaning presents a major risk to patient safety.
  • Home care: The 10 year plan promised modest advances in home care but fell far short of what’s needed. As with primary care, there is no monitoring of how funding is spent, the plan excludes support services like housework and cooking, and the plan permits spending funding on for-profit providers.
  • Health care human resources: Recruiting internationally-trained health professionals should be done using an ethical recruitment policy. The federal government should suspend the it should suspend the Temporary Foreign Worker Program, which subjects workers to recruitment fees, withheld pay, and dismal living conditions.
  • Aboriginal health: According to the Health Council of Canada’s 2007 report, planned improvements of aboriginal health are now in limbo.
  • Pharmaceutical strategy: Promises to develop a national pharmaceuticals strategy are stalled. Meanwhile pharmaceutical companies violate the ban on direct-to-consumer advertising and the federal government wants changes to the Food and Drug Act to speed up drug approvals with little regard to safety.

CUPE recommends:

  • Enforce the Canada Health Act and turn back the privatization of our healthcare system.
  • Establish a national long term care program that includes targeted funding and national standards for home and residential long term care, including minimum staffing standards.
  • Implement a public-sector only wait time strategy that would:
    • combine and better manage lists;
    • fully use hospital operating rooms;
    • expand team work and case management;
    • expand primary care and continuing care; and
    • address retention and recruitment problems.
  • Establish a national pharmacare program that provides equal access to safe and effective drugs while keeping rising costs in check.
  • Create a national infrastructure fund to build and redevelop hospitals and long term care facilities.
  • Follow through on commitments made in the Kelowna Accord and the Blueprint on Aboriginal Health.
  • Establish a national strategy to combat healthcare acquired infections that includes:
    • mandatory public reporting of healthcare acquired infections;
    • stringent infection control, cleaning, sterilization, and disinfection standards;
    • improved healthcare housekeeping and nursing staffing levels;
    • maximum occupancy levels in hospitals; and
    • increased staffing levels and no contracting out of healthcare cleaning services.
  • A health human resources strategy that offers better working conditions, training and upgrading programs and wage parity to improve retention and recruitment in the health sector
  • Primary health care reform that makes progress on illness prevention, health promotion, social equity, and personal/community empowerment, as exemplified in the community health centre model.