Welcome to the New Climate

Douglas C. Thomson
CEO, Canadian Orthopaedic Association

What just happened here?

The recent conversion of Prime Minister Harper to a full fledged Environmentalist is an event that even the most seasoned observer of the Canadian political landscape could not have foreseen a mere six months ago. For the first time since the Exxon Valdez ran onto the Bligh Reef in 1989, the environment eclipses health care as the number one issue for Canadians according to a number of recent polls. The environment has surfaced as a primary issue for the electorate in previous polling cycles, but it often lost to other overriding issues. This time it looks to be different.

So what does this mean for organized medicine?

In COA Bulletin #67 (November/December 2004) we reported on the federal government's well publicized 10-year plan for health care renewal in Canada - the $40 billion of new money, with a significant portion of that money focussed on reducing wait times for the now infamous five priority areas. At the time, we said there was a risk that with this 2004 announcement, that the federal government would now officially declare that they had slain the dragon of wait times forever. The COA joined the Wait Time Alliance and had much success in bringing attention to appropriate wait time benchmarks that were eventually adopted (in some fashion) by the provinces. It was relatively easy to advocate for improvements in orthopaedic treatment then - the real challenge will be for the COA (and the rest of organized medicine) to continue the battle with health care seemingly so far down the list of governmental priorities.

What about provincial shifts in health care policy? There are five or perhaps six provinces likely going or have already gone to the polls this year (ON, QC, SK, MB, PE) and all have a shared interest in going to neutral. There appears to have been an unofficial truce declared whereby the federal government won't hold the provinces to task for missing wait time targets (i.e. there will be no wait time guarantees from the feds) if the provinces stop publicly asking for increased federal health care transfers. This may be the only area of agreement between the two levels of government. It appears that there is no current federal health policy right now in Ottawa, only health politics.

Federal/provincial relations are now more strained than they have been for years. The average tenure of a federal or provincial deputy minister of health is 1.9 years - how can any relationship be nurtured and trust built when the players change so frequently?

All a minority government needs to do is put something into the "showcase" so that they can check off the health care box as "done". Skeptics like me might suggest that Mr. Harper did just that with his paediatric wait time announcement from the lobby of Sick Kids Hospital in January, mere steps away from ON Premier McGuinty's office who seemingly knew nothing about the announcement until he read about it in the newspapers.

Have Canadians given up on health care? Not likely, but we must re-examine our approach to advocating for health care policy changes as they impact COA members.