The National Health Council: Pillar of medicare, or not

Paul Wells takes sum of the Harper government cuts

The Harper government has notified the National Health Council that it won’t be renewing the organization’s funding once the 10-year health accord Paul Martin struck with the provinces in 2004 runs out. The critics are raving. Saskatchewan’s former deputy health minister is displeased; Michael McBane of the Canadian Health Coalition calls the decision to wind down the National Health Council “a decision to wind down national medicare.”

One suspects the feds will manage to move on after this broadside. McBane’s online bio puts quotation marks around the “Free” in “North American ‘Free’ Trade Agreement” and the Health Coalition’s board includes executives of CUPW, the Steelworkers and the CAW, along with the author of a book on Harper’s foreign policy that was blurbed by rogue Senate page Brigitte dePape. But there remains the substantive question of the Health Council’s necessity; let’s take a look.


Certainly, the Health Council was hotly disputed in its day. It was a central recommendation of former Saskatchewan Premier Roy Romanow’s report to the Chrétien government on health-care reform. When the report came out, the three parties in Quebec’s National Assembly voted to reject its recommendations. The Bloc Québécois introduced a supply motion calling for unconditional transfers to the provinces; the Canadian Alliance, led by Stephen Harper, supported it. At the first ministers’ meeting where Chrétien created the council, premiers were split. Ontario’s Ernie Eves was against, Quebec’s Bernard Landry threatened (with his usual lack of follow-through) to hold an election over the notion, and Alberta’s Ralph Klein left the meeting early, although there was some uncertainty about his motive in doing so. He made it clear before he left that he didn’t like the health council. Chrétien was a tough duck: he told the premiers they could have the money and the council, or no council and no money. He won the day.

But he was opposed by the premiers of three of the four largest provinces and by two of the opposition parties in the Commons. Later one of those opposition parties formed the federal government. The same parties that governed Quebec and Alberta then govern those provinces today. (I presume, with some confidence, that Harper will get precisely zero credit in Quebec for dismantling an “intrusion” that once gravely preoccupied the combined furrowed brows of every man and woman in the National Assembly.) (I also note, in a fascinating tidbit, that Alberta never belonged to the National Health Council until four months after Alison Redford became premier.)

Health transfers to the provinces have increased since 2005 in line with Martin’s 2004 health accord; when that accord runs out next year they will continue to increase less rapidly. In Figure 2 of this historical survey, we see that the cash component of EPF, the CHST’s predecessor transfer, was cut in every year from 1988 to 1995, as governments struggled with budget deficits. That’s some handy perspective: the decade from 1997 to 2017, barring drastic change in governing priorities, amounts to a bipartisan decade of substantial federal re-investment in transfers to the provinces for health care.

And a council announced in 2003 as a monitor of that reinvestment is being shut down. The wisdom of that is worth discussing, but I note that the Globe’s excellent André Picard, who covers this beat more closely than I do, shares the sense that the Health Council is no canary in a health-care coal mine.

Nor is it the only such move by the Harper government. The National Council of Welfare, the National Round Table on the Environment and the Economy, the First Nations Statistical Institute, and the National Council of Visible Minorities have been closed in the last two years. The Millennium Scholarship Foundation, the Council for Canadian Unity and the Canadian Council on Learning  closed earlier, or had funding cut earlier and closed eventually. Rights and Democracy closed after last year’s budget, although that one’s a long story. The end of the mandatory long-form census was not the only upheaval at a sharply smaller and less ambitious Statistics Canada. Unlike Michael McBane I won’t cry wolf about the significance of one change. But I’ll certainly argue that all the cuts, taken together, add up to a very substantially different vision of the federal role in Canada from that of the Liberals. I have colleagues who spend about half of their time writing that there is no ideology in today’s Canadian politics. I think they’re blind as bats.

A footnote: The NDP’s Libby Davies asked two questions about the National Health Council’s probable demise today in Question Period. She was standing next to Thomas Mulcair, who voted in 2002 with his Quebec National Assembly Colleagues against the notion of a health council. That’ll be fun for the NDP to explain, or it would if this story got bigger, as I frankly suspect it won’t.