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Annual Conference of Federal-Provincial-Territorial Ministers of Health
Toronto, Ontario - October 22-23, 2005

TORONTO – At their annual meeting this weekend Canada's Federal, Provincial and Territorial Ministers of Health reaffirmed their commitment to the implementation of the 10-Year Plan to Strengthen Health Care, signed last year by all First Ministers.

REDUCING WAIT TIMES

Federal/ Provincial/Territorial Ministers of Health agreed that substantial and definable progress is being made to make health care more accessible across Canada at a time when society is ageing and demand for health care services is increasing.

Building on their successes, provinces and territories are taking constructive steps to improve access to care across Canada. Ministers remain committed to providing health care that is patient-centred, integrated, and accessible. Innovative approaches to primary care are providing better access to physicians, nurses, and other health providers. New technologies are being harnessed to provide care to people in rural and remote communities. Enhancements to community care are allowing hospitals to focus on what they do best. Canadians have more opportunities than ever to make healthy choices that promote wellness and help to prevent illnesses.

Accountability and transparency have also been strengthened in every province and territory. In just one year, Canadians now have more information than ever before about wait times in their communities and investments have been made to increase the number of medical procedures.

As agreed by First Ministers in the 10-Year Planto Strengthen Health Care, all jurisdictions will establish, by December 31, 2005, a first set of evidence-based benchmarks for medically acceptable wait times in all of the five priority areas: cancer, heart, diagnostic imaging, joint replacements and sight restoration.

As evidenced-based benchmarks are defined, corresponding access targets will be developed. Access targets may also be set in areas where clinical evidence does not yet exist. The access targets will be adjusted as progress is made. Targets are goals informed by a range of considerations, including the capacity of provincial and territorial health systems.

To help achieve these benchmarks and access targets, all jurisdictions are improving the way that wait times are monitored, measured, and managed through strategies, which may include:

• Building the capacity of their health systems;
• Monitoring and measuring wait times using information technology to create patient-based registries and other tools;
• Managing access using consistent and fair ways to assess the needs of patients and how urgently they require care, including single wait lists for procedures, more efficient approaches to scheduling surgeries, and wait list co-ordination to help patients navigate the health system;
• Clarifying how hospitals, health service organizations and health providers are responsible for making health care more accessible and accountable to Canadians;
• Evaluating patients’ access to health care and health outcomes to help governments determine where resources should be directed for the most effective results; and
• Communicating information so that Canadians can track wait times, and measure the progress that all jurisdictions are making.

Governments acknowledge that they cannot reduce wait times on their own. Physicians in every province and territory have already provided valuable advice about improving access to care.

Now, physicians must play an even greater role in developing integrated wait lists and wait list management processes so that Canadians get the medical treatments when and where they need them.

Federal, Provincial and Territorial Ministers agreed to undertake a joint research program to develop a body of clinical evidence that demonstrates how wait times affect patients’ health. This program would build on the work that has already been undertaken by the Canadian Institutes of Health Research. With the benefit of this research, federal, provincial and territorial governments can develop better approaches to review and assess clinical evidence in support of wait time benchmarks.

In addition, all jurisdictions will establish, by December 31, 2005, comparable indicators of access to health care professionals, along with diagnostic and treatment procedures. The Canadian Institute for Health Information is providing advice to establish comparable indicators that will allow for wait times to be measured consistently across the country by the end of the year.

NATIONAL PHARMACEUTICALS STRATEGY

Health Ministers, noting that drugs are the fastest rising cost in the system, reaffirmed their commitment to the National Pharmaceuticals Strategy.

The National Pharmaceuticals Strategy, announced in 2004 must, among other priorities, protect all Canadians from catastrophic drug costs if it is to be viewed as a success. Ministers discussed options for catastrophic drug coverage and asked officials to accelerate this important work.

The ministers reviewed the issue of expensive drugs for rare diseases, including Fabrys disease and MPS1—Hurlers Schie. Ministers also asked officials to take the necessary steps to proceed with time-limited-research programs, including clinical studies for patients meeting treatment guidelines for these two rare diseases. Ministers committed to this research on a risk-shared basis with manufacturers as quickly possible.

As part of the National Pharmaceuticals Strategy, all jurisdictions are committed to better align their regulatory and reimbursement regimes to ensure the best possible outcomes for Canadians.

As a start, Ministers are pleased to:

• Expand the Common Drug Review, which makes recommendations on which drugs are eligible for reimbursement, to all drugs, and to work towards a common national formulary, which will lead to more consistent access to drugs across the country.
• Give the Patented Medicine Prices Review Board responsibility to monitor and report on non-patented drug prices. To allow the Board to regulate the price of non-patented drugs, provinces will consider formally delegating their responsibility in this area to the federal government.
• Work together to collect, integrate and disseminate information on the real-world risks and benefits of drugs.

Ministers reaffirmed their commitment to report on the development and implementation of all elements of the National Pharmaceuticals Strategy to First Ministers in June 2006 and will ensure that progress is attained in all areas. Key to this report will be further consultations with stakeholders.

PANDEMIC INFLUENZA AND EMERGENCY PREPAREDNESS

Federal, provincial and territorial governments have been planning for a pandemic influenza outbreak, but additional work is required so that Canada is better prepared. This work will build on the internationally recognized Canadian Pandemic Influenza Plan, released last year, after a collaborative process among federal, provincial, territorial, local and regional governments. Efforts are underway to develop policies regarding anti-viral supplies. Ministers also discussed the international conference on global pandemic preparedness that Minister Dosanjh will host, and some provinces will participate in, on October 24-25, 2005.

BLUE PRINT ON ABORIGINAL HEALTH

Health Ministers reaffirmed their commitment to continue to work with Aboriginal Leaders to close the gap in health status between Aboriginal peoples and other Canadians. Ministers discussed the Blueprint on Aboriginal Health, which will be presented at the November 2005 First Ministers’ Meeting on Aboriginal Issues.

MENTAL HEALTH

Ministers heard from Senator Michael Kirby and Senator Wilbert Joseph Keon who presented highlights of the Standing Senate Committee on Social Affairs, Science and Technology findings on mental health and the proposal for the establishment of a Canadian Mental Health Commission.

HEALTH GOALS

Ministers further demonstrated their commitment and leadership in advancing public health through agreement on a set of goals for improving the health of Canadians. The Health Goals for Canada were developed collaboratively with Canadian governments, public health and other experts, stakeholders and citizens. Ministers agreed that the goals would inform each provincial and territorial government in development of their own initiatives. To help strengthen public health, Healthy Living Targets seek to obtain a 20% increase in the proportion of Canadians who are physically active, eat healthy food and are at healthy body weights.

ACTION ON METHAMPHETAMINE ( CRYSTAL METH)

Health Ministers acknowledged that a collaborative approach involving federal, provincial, and territorial governments and key health, education and justice stakeholders is necessary in order to effectively address methamphetamine use. The federal government has agreed to explore how to control chemicals that are used to make methamphetamine.

Ministers also discussed other initiatives, including a Framework for Collaborative Pan-Canadian Health Human Resources Planning, and The 2005 Tobacco Progress Report on Tobacco Control.

Quebec’s approach, as regards the efforts to reduce wait times, the Pan-Canadian strategies on pharmaceuticals, healthy living and health goals are described in the document entitled “Asymmetrical Federalism that Respects Quebec’s Jurisdiction”, which accompanies the 10-Year Plan to Strengthen Health Care.

Health Ministers concluded the meeting with a commitment to continue working together on strengthening Canada's public health care system.

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Backgrounder: Pandemic influenza planning

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