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explainer

The federal government is injecting tens of billions of dollars into Canada’s struggling health care systems, but before they can acquire all the money, provinces and territories have to agree to some conditions about how they’ll use it. Almost all provinces have signed their bilateral deals, with Quebec and the territories to follow. Check back here to see how much each deal is worth.

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Prime Minister Justin Trudeau sits between Premier Heather Stefanson of Manitoba and Premier François Legault of Quebec, in Ottawa, on Feb. 7.Sean Kilpatrick/The Canadian Press

What are the provinces agreeing to, exactly?

On Feb. 7, Prime Minister Justin Trudeau promised his provincial and territorial counterparts $46.2-billion in new health care funding over 10 years, including an immediate $2-billion top-up to the Canada Health Transfer (CHT). Combined with previous funding pledges, that adds up to $196-billion over 10 years, far short of the $300-billion that premiers wanted. But for hospital systems shaken by the pandemic, any sum is an improvement, so the premiers reluctantly said yes. “We’re going to look at investing those dollars in our health care and so we will accept this, and move on from here,” said Manitoba’s Heather Stefanson, chair of the Council of the Federation.

Some of the money comes with strings attached. Each government has to make a bilateral deal that meets a list of federal priorities:

  • Standard digital tools to make records easily shareable
  • A health care work force that can clear surgery and diagnostic backlogs
  • Access to mental health, substance use and addictions services
  • Family health teams

For all levels of government, the challenge is to keep up with health care spending habits that keep increasing as Canada’s population ages. Many Canadians lack family doctors, or have trouble seeing the ones they have, and hospitals are struggling with long surgical wait times and limited staff.

Health deals so far, by province and territory

Newfoundland and Labrador

  • Have they signed? Yes, an agreement in principle was announced on Feb. 23.
  • The numbers: Newfoundland and Labrador will receive a total of $2.18-billion in federal funding over 10 years, including $749-million for the new bilateral agreement and $27-million through the one-time CHT top-up to address urgent needs.

PEI

  • Have they signed? Yes, an agreement in principle was announced on Feb. 23.
  • The numbers: PEI will receive a total of $996-million in federal funding over 10 years, including $288-million for the new bilateral agreement and $9-million through the one-time CHT top-up to address urgent needs.

New Brunswick

  • Have they signed? Yes, an agreement in principle was announced on Feb. 23.
  • The numbers: New Brunswick will receive a total of $3.64-billion in federal funding over 10 years, including $900-million for the new bilateral agreement and $42-million through the one-time CHT top-up to address urgent needs.

Nova Scotia

  • Have they signed? Yes, an agreement in principle was announced on Feb. 23.
  • The numbers: Nova Scotia will receive a total of $4.81-billion in federal funding over 10 years, including $1.01-billion for the new bilateral agreement and $52-million through the one-time CHT top-up to address urgent needs.

Quebec

  • Have they signed? Not yet.
  • Details: Quebec has agreed to the proposal and has begun bilateral negotiations to finalize funding agreements before signing.

Ontario

  • Have they signed? Yes, an agreement in principle was announced on Feb. 23.
  • The numbers: Ontario will receive a total of $73.97-billion in federal funding over 10 years, including $8.413-billion for the new bilateral agreement and $776-million through the one-time CHT top-up to address urgent needs.

Manitoba

  • Have they signed? Yes, an agreement in principle was announced on Feb. 24.
  • The numbers: Manitoba will receive a total of $6.74-billion in federal funding over 10 years, including $1.22-billion for the new bilateral agreement and $72-million through the one-time CHT top-up to address urgent needs.

Saskatchewan

  • Have they signed? Yes, an agreement in principle was announced on March 1.
  • The numbers: Saskatchewan will receive a total of $5.94-billion in federal funding over 10 years, including $1.11-billion for the new bilateral agreement and $61-million through the one-time CHT top-up to address urgent needs.

Alberta

  • Have they signed? Yes, an agreement in principle was announced on Feb. 27.
  • The numbers: Alberta will receive a total of $24.18-billion in federal funding over 10 years, including $2.92-billion for the new bilateral agreement and $233-million through the one-time CHT top-up to address urgent needs.

B.C.

  • Have they signed? Yes, an agreement in principle was announced on March 1.
  • The numbers: B.C. will receive a total of $27.47-billion in federal funding over 10 years, including $3.32-billion for the new bilateral agreement and $273-million through the one-time CHT top-up to address urgent needs.

Territories

  • Have they signed? Not yet.
  • Details: Nunavut, Yukon and Northwest Territories have agreed to the proposal and have begun bilateral negotiations, but the territories say further negotiations are needed to address challenges in the North before signing. In a letter to Mr. Trudeau, the Northern premiers are calling on the federal government to instead reconsider a proposal for the Territorial Health Investment Fund they presented in November.

What about First Nations?

Indigenous leaders weren’t invited to the meetings in Ottawa that hashed out the health care deal, to the consternation of the Assembly of First Nations, whose National Chief formally asked Mr. Trudeau for a seat at the table. Mr. Trudeau said his government would give $2-billion more over the next 10 years to Indigenous health care. Some chiefs have demanded nation-to-nation talks about how Ottawa funds their health services, which fall under a mix of federal, provincial and territorial jurisdictions.


Compiled by Globe staff

With reports from Marieke Walsh, Bill Curry, Marsha McLeod, Justine Hunter and The Canadian Press

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