Federal Transfers in Support of the 2000/2003/2004 First Ministers’ Accords

• Since 2000, the federal government has provided increased transfer support to provinces and territories primarily for health care and child care through three federal-provincial-territorial accords on health and early childhood development.

• The September 2000 Agreements on Health Renewal and Early Childhood Development provided $23.4 billion in additional funding, including:

• $21.1 billion in additional Canada Health and Social Transfers (CHST) funding over five years, including $2.2 billion for early childhood development earmarked in the CHST;
• $1 billion over two years to provinces and territories in support of necessary diagnostic and treatment equipment;
• $800 million to provinces and territories support innovation and reforms in primary care;
• $500 million to Canada Health Infoway to help accelerate the adoption of modern information technologies to provide better health care.

• Building on the 2000 Agreements, in February 2003, the First Ministers’ Accord on Health Care Renewal provided $36.8 billion over five years to improve the accessibility, quality and sustainability of the public health care system and enhance transparency and accountability in health care spending.

• The majority of this funding, $31.5 billion, was provided to provinces and territories through cash transfers, including:

• $16 billion over five years through a new Health Reform Transfer targeted to primary health care, home care and catastrophic drug coverage;
• $14 billion in increased CHST cash transfers to provinces and territories over five years; and
• $1.5 billion over three years to provinces and territories in a Diagnostic/Medical Equipment Fund in support of acquisition of equipment (and related specialized training) to improve access to publicly funded diagnostic services.

• The remaining $5.3 billion supported federal direct initiatives under the 2003 Accord, such as increased funding for federal health programs for First Nations and Inuit, the creation of the compassionate care benefit under Employment Insurance, support for research hospitals, improved health care technology and pharmaceuticals management.

• As part of the 2003 Accord, First Ministers agreed to restructure the CHST effective April 1, 2004 to create two new transfers to improve the transparency and accountability of federal support to provinces and territories:

• The Canada Health Transfer (CHT) in support of health; and
• The Canada Social Transfer (CST) in support of post-secondary education, social assistance and social services, including early childhood development and early learning and child care.

• The September 2004 10-Year Plan to Strengthen Health Care built on commitments in the 2000 and 2003 health accords. The Government of Canada increased cash transfers to provinces and territories for health care by $41.3 billion over 10 years, including:

• $35.3 billion to establish a new CHT base of $19 billion in 2005-06 (closing the Romanow Gap), and apply a six per cent annual escalator effective 2006-07;
• $5.5 billion over 10 years through the Wait Times Reduction Transfer to assist provinces and territories in their respective strategies to reduce wait times; and
• $500 million in 2004-05 for additional investments in medical and diagnostic equipment.

• In addition, the legislation to implement the funding commitments of the 10-Year Plan provides for a Parliamentary review in 2008 and 2011 on progress achieved in implementing the 10-Year Plan.

Reporting and Accountability

• 2000 Health Accord: First Ministers committed their governments to report regularly to Canadians on health status, health outcomes, and the performance of publicly funded health services, and the actions taken to improve these services.

• 2003 Health Accord: First Ministers established an enhanced accountability framework under which all governments committed to providing comprehensive and regular reports to Canadians based on comparable indicators relating to health status, health outcomes, and quality of service. Governments also agreed to the establishment of the Health Council to monitor and make annual public reports on the implementation of the Accord.

• 2004 10-Year Plan: First Ministers agreed to collect and provide meaningful information to Canadians on progress made in reducing wait times, including the establishment of comparable indicators of access to health care services and evidence-based benchmarks for medically acceptable wait times.

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