Provincial-federal turf battles over health, housing on agenda of premiers meeting in Halifax

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Healthcare, housing and the environment will be on the agenda as Canada’s premiers gather in Halifax for the annual summer meeting of the Council of the Federation.

The 13 leaders will also be pushing back on federal encroachment of provincial and territorial responsibility even as they demand help for their priorities.

In a letter sent to Prime Minister Justin Trudeau last week, the premiers urged the federal government "to refrain from unilateral actions in areas of provincial and territorial jurisdiction, particularly in healthcare, education, and housing."

"We hope this letter will serve as an invitation to engage with premiers on ways to renew our relationship so that we can collectively deliver for Canadians,” continued the letter signed by Premier of Nova Scotia, Tim Houston, who is the Chair of the federation for this year.

Housing flashpoint

In the past year, the federal government has increasingly bypassed the province to channel billions of dollars directly to municipalities to build apartments to deal with the massive housing shortages.

Provinces, in particular Quebec, have also placed the blame for housing shortages and increased pressure on the province’s social welfare costs on the federal government’s immigration policies. Premier Francois Legault has demanded that Ottawa reduce the number of temporary immigrants in the province and pay the costs linked to their housing and care. In June the federal government agreed to give Quebec $750 million to help pay for the surge in temporary migrants and distribute would-be refugees across the country.

Healthcare accountability

As the premiers meet, a new Environics poll released by the Canadian Health Coalition shows that 74 per cent of Canadians say that health care in their province is in crisis.

The Canadian Medical Association (CMA) and its provincial and territorial counterparts are urging the leaders to "stabilize the health system."

"We must plan for a better future, where patients can get the care they need in a timely fashion and physicians and other health professionals can work in a safe, well-resourced environment," said the letter signed by the presidents of the CMA and 11 other provincial and territorial medical associations.

According to the CMA, patients were waiting up to 22 hours in emergency rooms this past winter. The problem has been compounded by the fact that an estimated 6.5 million Canadians do not have a family physician. The letter notes that climate change will make the "overstretched health system more vulnerable to climate-related health risks and emergencies, including floods, wildfires, heat domes and other extreme weather events."

Reluctant provincial partner

Alberta has refused to be a provincial partner in two new federal health programs. Premier Danielle Smith wrote Justin Trudeau last month to inform the prime minister that Alberta would opt out of the dental care program in 2026. Alberta also plans to opt out of the national pharmacare program that would provide Canadians with free diabetes medication and birth control.

"Alberta intends to opt out of the program, and to instead receive our full per capita share of that funding for deployment into our provincial health-care system," Alberta Health Minister Adriana LaGrange has said.

The Liberal minority government, supported by the NDP, earmarked $1.5 billion dollars for pharmacare over the next five years in its 2024 budget.

Ontario Premier Doug Ford will take over chair of the Council of the Federation next year.

The premier's office says one of his focuses will be getting new publicly funded medicines to people as fast as possible. A spokesperson for Ford notes that patients in Canada wait almost two years to access life-saving breakthrough medicine, "a year longer than other developed countries, placing us last in the G7."

The premiers will begin their three-day gathering by meeting with national indigenous leaders first on Monday.