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Federal Investments in Support of the 2003 Accord on Health Care Renewal1
The February 2003 First Ministers' Accord on Health Care Renewal is a commitment to improve the accessibility, quality and sustainability of the publicly-funded health care system as well as to enhance transparency and accountability in health care spending.
The 2003 Accord provided for federal support for health care to increase by $36.8 billion over the five-year period 2003-04 to 2007-08. The majority of this funding, $31.5 billion, was provided to provinces and territories through increased transfer payments, including:
- $16.0 billion over five years through the Health Reform Transfer;
- $14 billion (including the $2 billion in additional funding announced in Budget 2004) for increases to health and social transfers (through the Canada Health and Social Transfer (CHST)); and
- $1.5 billion for diagnostic and medical equipment.
The remaining $5.3 billion support has been allocated to meet other federal commitments made under the Health Accord, notably increased funding for federal health programs for First Nations and Inuit, the creation of a compassionate care benefit under Employment Insurance, support for research hospitals, and improved health care technology and pharmaceuticals management.
To improve the transparency and accountability of federal support for health, First Ministers agreed to restructure the CHST effective April 1, 2004, to create two new transfers: a Canada Health Transfer (CHT) in support of health; and a Canada Social Transfer (CST) in support of post-secondary education, social assistance and social services, including early childhood development and early learning and childcare.
A legislated five-year funding track for transfers in support of health and other social programs was put in place to 2007-08 as part of the 2003 Accord. As a result, total cash transfers were set to grow to $28.1 billion in 2007-08 from $19.1 billion in 2002-03, including the Health Reform Transfer.
The 2003 First Ministers' Accord also established an enhanced accountability framework under which all governments committed to provide comprehensive and regular reports to Canadians based on comparable indicators relating to health status, health outcomes, and quality of service. Governments also agreed to the establishment of the Health Council to monitor and make annual public reports on the implementation of the Accord, with an emphasis on its accountability and transparency provisions. This will allow Canadians to monitor progress toward reform, the level of access to health services and the overall efficiency of the health care system.
| Cumulative 5 Years (2003-04 to 2007-08) |
|
|---|---|
| ($ billions) | |
| Canada Health and Social Transfer (CHST)1 | 9.5 |
| 2003 CHST supplement | 2.5 |
| 2004 CHST supplement for Health | 2.0 |
| Health Reform Transfer | 16.0 |
| Diagnostic/Medical Equipment Fund | 1.5 |
| Information Technology | 0.6 |
| Research Hospitals | 0.5 |
| Direct Health Accord Initiatives | 1.6 |
| Other Reform Initiatives | 1.4 |
| First Nations and Inuit Health | 1.3 |
|
|
|
| 36.8 | |
| 1Transfers to provinces and territories are provided under the CHST up to 2003-04 and under the Canada Health Transfer (CHT) and the Canada Social Transfer (CST) for 2004-05 and beyond. All amounts are increases relative to 2002-03 levels. Totals may not add due to rounding. | |
| 2003 CHST Supplement |
2004 CHST Supplement for Health |
CHST Increases1 |
Health Reform Transfer1 |
Medical Equipment Fund |
Total | |
|---|---|---|---|---|---|---|
| ($ millions) | ||||||
| Newfoundland and Labrador | 42 | 32 | 150 | 252 | 25 | 501 |
| Prince Edward Island | 11 | 9 | 40 | 68 | 7 | 135 |
| Nova Scotia | 74 | 59 | 274 | 461 | 45 | 913 |
| New Brunswick | 59 | 47 | 220 | 370 | 36 | 731 |
| Quebec | 587 | 471 | 2,232 | 3,757 | 352 | 7,399 |
| Ontario | 967 | 778 | 3,695 | 6,224 | 580 | 12,243 |
| Manitoba | 91 | 73 | 344 | 580 | 54 | 1,142 |
| Saskatchewan | 80 | 62 | 289 | 486 | 48 | 965 |
| Alberta | 248 | 201 | 972 | 1,639 | 149 | 3,209 |
| British Columbia | 333 | 262 | 1,254 | 2,113 | 200 | 4,162 |
| Yukon | 2 | 2 | 9 | 15 | 1 | 30 |
| Northwest Territories | 3 | 3 | 12 | 21 | 2 | 41 |
| Nunavut | 2 | 2 | 9 | 15 | 1 | 29 |
|
|
||||||
| Total | 2,500 | 2,000 | 9,500 | 16,000 | 1,500 | 31,500 |
| 1 Figures are based on Statistics Canada population estimates for 2003-04 to 2006-07 and projections for 2007-08. Figures beyond 2003-04 are subject to revision upon periodic release of Statistics Canada official population estimates. Totals may not add due to rounding. | ||||||
| 2003-04 | 2004-05 | 2005-06 | 2006-07 | 2007-08 | Total | |
|---|---|---|---|---|---|---|
| ($ millions) | ||||||
| Newfoundland and Labrador | 16.4 | 24.3 | 55.7 | 70.4 | 85.2 | 252.0 |
| Prince Edward Island | 4.3 | 6.5 | 15.0 | 19.1 | 23.2 | 68.1 |
| Nova Scotia | 29.6 | 44.0 | 101.5 | 129.1 | 156.7 | 460.9 |
| New Brunswick | 23.7 | 35.3 | 81.5 | 103.5 | 125.6 | 369.6 |
| Quebec | 236.7 | 354.0 | 823.7 | 1,055.8 | 1,286.8 | 3,757.0 |
| Ontario | 387.0 | 582.0 | 1,360.5 | 1,749.0 | 2,144.2 | 6,223.6 |
| Manitoba | 36.7 | 54.9 | 127.4 | 162.5 | 198.0 | 579.5 |
| Saskatchewan | 31.4 | 46.7 | 107.5 | 136.0 | 164.5 | 486.1 |
| Alberta | 99.8 | 150.3 | 354.7 | 464.8 | 569.8 | 1,639.3 |
| British Columbia | 131.2 | 197.1 | 461.2 | 594.5 | 728.6 | 2,112.7 |
| Yukon | 1.0 | 1.5 | 3.4 | 4.3 | 5.2 | 15.3 |
| Northwest Territories | 1.3 | 2.0 | 4.6 | 5.8 | 7.1 | 20.8 |
| Nunavut | 0.9 | 1.4 | 3.2 | 4.2 | 5.2 | 15.0 |
|
|
||||||
| Total | 1,000.0 | 1,500.0 | 3,500.0 | 4,500.0 | 5,500.0 | 16,000.0 |
| Figures are based on Statistics Canada population estimates for 2003-04 to 2006-07 and projections for 2007-08. Figures beyond 2003-04 are subject to revision upon periodic release of Statistics Canada official population estimates. Totals may not add due to rounding. Under the 2004 10-Year Plan to Strengthen Health Care, the Health Reform Transfer was folded into the Canada Health Transfer effective April 1, 2005. | ||||||
| 2003-04 | 2004-05 | 2005-06 | Total | |
|---|---|---|---|---|
| ($ millions) | ||||
| Newfoundland and Labrador | 16.8 | 16.6 | 8.2 | 41.6 |
| Prince Edward Island | 4.4 | 4.4 | 2.2 | 11.0 |
| Nova Scotia | 29.9 | 29.7 | 14.8 | 74.4 |
| New Brunswick | 23.9 | 23.8 | 11.8 | 59.5 |
| Quebec | 236.1 | 234.7 | 116.6 | 587.4 |
| Ontario | 385.5 | 387.0 | 194.2 | 966.6 |
| Manitoba | 36.4 | 36.2 | 18.0 | 90.7 |
| Saskatchewan | 32.0 | 31.8 | 15.8 | 79.6 |
| Alberta | 99.2 | 99.3 | 49.7 | 248.1 |
| British Columbia | 132.6 | 133.4 | 67.1 | 333.1 |
| Yukon | 0.9 | 0.9 | 0.5 | 2.3 |
| Northwest Territories | 1.3 | 1.3 | 0.7 | 3.3 |
| Nunavut | 0.9 | 0.9 | 0.5 | 2.3 |
|
|
||||
| Total | 1,000.0 | 1,000.0 | 500.0 | 2,500.0 |
| Based on notional allocation schedule of trust fund. Provinces and territories have the flexibility to draw down funds as they require up to the end of 2005-06. Total may not add due to rounding. | ||||
| 2004-05 | 2005-06 | Total | |
|---|---|---|---|
| ($ millions) | |||
| Newfoundland and Labrador | 16.3 | 16.2 | 32.4 |
| Prince Edward Island | 4.3 | 4.3 | 8.7 |
| Nova Scotia | 29.4 | 29.2 | 58.6 |
| New Brunswick | 23.6 | 23.4 | 46.9 |
| Quebec | 236.1 | 235.4 | 471.4 |
| Ontario | 388.2 | 389.5 | 777.7 |
| Manitoba | 36.7 | 36.5 | 73.2 |
| Saskatchewan | 31.2 | 30.9 | 62.0 |
| Alberta | 100.1 | 100.5 | 200.6 |
| British Columbia | 131.0 | 130.8 | 261.8 |
| Yukon | 1.0 | 1.0 | 2.0 |
| Northwest Territories | 1.3 | 1.3 | 2.7 |
| Nunavut | 0.9 | 1.0 | 1.9 |
|
|
|||
| Total | 1,000.0 | 1,000.0 | 2,000.0 |
| Based on notional allocation schedule of trust fund. Provinces and territories have the flexibility to draw down funds as they require up to the end of 2005-06. Totals may not add due to rounding. | |||
| 2003-04 | 2004-05 | 2005-06 | Total | |
|---|---|---|---|---|
| ($ millions) | ||||
| Newfoundland and Labrador | 8.4 | 8.3 | 8.2 | 24.9 |
| Prince Edward Island | 2.2 | 2.2 | 2.2 | 6.6 |
| Nova Scotia | 15.0 | 14.9 | 14.8 | 44.6 |
| New Brunswick | 12.0 | 11.9 | 11.8 | 35.6 |
| Quebec | 118.0 | 117.3 | 116.6 | 352.0 |
| Ontario | 192.8 | 193.5 | 194.2 | 580.4 |
| Manitoba | 18.2 | 18.1 | 18.0 | 54.3 |
| Saskatchewan | 16.0 | 15.9 | 15.8 | 47.7 |
| Alberta | 49.6 | 49.6 | 49.7 | 148.9 |
| British Columbia | 66.3 | 66.7 | 67.1 | 200.1 |
| Yukon | 0.5 | 0.5 | 0.5 | 1.4 |
| Northwest Territories | 0.7 | 0.7 | 0.7 | 2.0 |
| Nunavut | 0.5 | 0.5 | 0.5 | 1.4 |
|
|
||||
| Total | 500.0 | 500.0 | 500.0 | 1,500.0 |
| Based on notional allocation schedule. Provinces and territories have the flexibility to draw down funds as they require up to the end of 2005-06. Totals may not add due to rounding. | ||||
1 Note: This document is accurate as of the date of signing the 2003 Accord on Health Care Renewal and does not reflect subsequent federal investments in support of health care, such as the September 2004 10-Year Plan to Strengthen Health Care. [return]
