Primary Health Care Transition Fund
(All funding allocations have been completed and no further funding is available.)
Background
Funding Envelopes
Synthesis and Dissemination
Program Evaluation
On September 11, 2000, First Ministers agreed that "improvements to primary health care are crucial to the renewal of health services" and highlighted the importance of multi-disciplinary teams. In response to this agreement, the Government of Canada established the $800M Primary Health Care Transition Fund (PHCTF).
Over a six-year period (2000-2006), the PHCTF is supporting provinces and territories in their efforts to reform the primary health care system. Specifically, it provides support for the transitional costs associated with introducing new approaches to primary health care delivery. In addition to direct support to individual provinces and territories, the PHCTF is also supporting various pan-Canadian initiatives to address common barriers, and offers the opportunity for participation by health care system stakeholders. Although the PHCTF itself is time-limited, the changes which it is supporting are intended to have a lasting and sustainable impact on the health care system.
Collaboration among federal, provincial, and territorial governments is a key element of the PHCTF. An intergovernmental advisory group, with representation from all jurisdictions, provided advice on fund design and project selection from the outset and continues to play an active role. All governments agreed to the five common objectives of the PHCTF. All initiatives must support at least one of these objectives.
The PHCTF consists of five funding envelopes. All funding allocations have been completed and no further funding is available.
Provincial/Territorial
Multi-jurisdictional
National
Aboriginal
Official Languages Minority Communities
The provincial/territorial envelope accounts for the bulk of PHCTF funding ($576 million) and is directly supporting provinces and territories in their primary health care reform activities. Funds were allocated on a per capita basis, and smaller jurisdictions (Prince Edward Island and the three northern territories) received an additional $4M each to ensure sufficient funding for initiatives on a significant and sustainable scale.
Initiatives were negotiated on a bilateral basis between each province or territory and the federal government, based on the unique circumstances of each jurisdiction and the common objectives of the PHCTF. All other PHCTF-funded activities are intended to complement provincial and territorial activities.
For further information, please consult the funding
guidelines and summaries of initiatives
for the provincial/territorial envelope.
The multi-jurisdictional envelope accounts for $30.4 million and was available to provincial and territorial governments. It offers the opportunity for collaboration among two or more jurisdictions in order to:
- realize economies of scale;
- encourage the sharing of strengths and experiences across jurisdictions;
- increase efficiency by avoiding duplication of effort; and
- overcome common barriers to primary health care reform.
In addition, all initiatives must address one or more of the common objectives of the PHCTF, and complement provincial/territorial direction in primary health care reform. Multi-jurisdictional initiatives were selected by Health Canada in consultation with provincial and territorial governments.
For further information, please consult the funding
guidelines and summaries of initiatives
for the multi-jurisdictional envelope.
The national envelope accounts for $63.4 million and was open to federal, provincial, and territorial governments, and not-for-profit non-governmental organizations. It supports initiatives of national significance in order to:
- create the necessary conditions on a national level to advance primary health care reform beyond what any single jurisdiction can achieve on its own; and
- address common barriers or gaps to primary health care reform.
In addition, all initiatives must address one or more of the common objectives of the PHCTF, and complement provincial/territorial direction in primary health care reform. Initiatives were selected by Health Canada in consultation with provincial and territorial governments.
The national envelope, in turn, consists of three elements:
National initiatives are national in scope or relevance but occur primarily in local or regional settings. Many focus on developing the skills and capacity of primary health care providers, and creating supports to facilitate greater collaboration.
National strategies maximize synergies and cost-effectiveness by developing collaborative approaches to key areas of renewal. Three areas were identified by governments: evaluation, awareness, and collaborative care. Each strategy consists of several initiatives which are collectively addressing the common issue or barrier.
Tools for Transition focusses on change management for front-line providers and administrators. Initiatives are relatively small-scale and focus on activities such as developing tools and facilitating opportunities for information-sharing. There are two streams within Tools for Transition:
- the Federal/Provincial/Territorial-directed Component, which supports initiatives identified as priorities by governments; and
- the Responsive Component, which supports workshops and similar activities on a cost-shared basis and was open to both governments and not-for-profit non-governmental organizations.
Numerous workshops and other events are planned over the coming months.
For further information, please consult the funding
guidelines and summaries of initiatives
for the national envelope.
The Aboriginal envelope accounts for $35.2 million and was open to federal, provincial, and territorial governments; First Nations and Inuit communities and health organizations; and not-for-profit non-governmental organizations. It responds to the needs of Aboriginal communities by:
- promoting more productive and cost-effective primary health care service delivery through the integration of existing services and resources;
- enhancing coordination of service delivery between Health Canada, provincial and territorial governments, and First Nations/Inuit communities and health organizations;
- enhancing the ability of federal, provincial, and territorial systems to be accountable to each other and to their publics through collaborative information development;
- improving the quality of services delivered to Aboriginal peoples, including cultural appropriateness; and
- improving linkages between primary health care services and social services.
In addition, all initiatives must address one or more of the common objectives of the PHCTF, and complement provincial/territorial direction in primary health care reform. Initiatives were selected by Health Canada in consultation with provincial and territorial governments.
The Aboriginal envelope consists, in turn, of two components:
- health system renewal initiatives which are large-scale and intended to renew entire health systems; and
- health system enhancement initiatives which are focussed on niche areas (such as telehealth) which improve the delivery of primary health care in a way which benefits Aboriginal peoples.
For further information, please consult the funding
guidelines and summaries of initiatives
for the Aboriginal envelope.
The official languages minority communities envelope accounts for $30 million and responds to the needs of French- and English-speaking minority communities within Canada by:
- improving information-sharing and networking among primary health care providers, governments, and official languages minority communities;
- developing training activities and tools for primary health care providers to improve the effectiveness of services delivered to official languages minority communities; and
- increasing providers' capacity to offer primary health care services to official languages minority communities in Canada.
In addition, all initiatives must address one or more of the common objectives of the PHCTF, and complement provincial/territorial direction in primary health care reform.
Two consultative committees (representing Anglophones within Quebec and Francophones outside of Quebec respectively) advise the federal Minister of Health on the needs of official languages minority communities. These committees were responsible for identifying the not-for-profit non-governmental organizations which were eligible for funding under this envelope.
For further information, please consult the funding guidelines and summaries of initiatives for the official languages minority communities envelope.
Although PHCTF initiatives are time-limited, they are not pilot projects. Rather, they are intended to support the transitional costs of fundamental changes to primary health care delivery. Primary health care reform is a long and complex process which will continue beyond the PHCTF, and the results of these initiatives will inform ongoing developments in the sector.
Therefore, analysis and dissemination of the results of PHCTF-funded initiatives is a key element of the program. Each individual initiative is required to include evaluation and dissemination activities, and is receiving targeted funding to this end. In addition to these individual efforts, the PHCTF plans to develop and implement a national dissemination strategy to maximize the usefulness and availability of results to provinces, territories, and health care system stakeholders.
The PHCTF has developed a statement of principles to inform this work, and further information will be posted as it becomes available.
Health Canada's Departmental Program Evaluation Division is conducting
a program evaluation of the PHCTF to determine how effectively it
is meeting its objectives. A formative evaluation was conducted
in 2004-05 and the report will be available later in 2005. A summative
evaluation will be undertaken following program completion. More
information will be posted as it becomes available.
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