- Major Federal Transfers -

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, is being provided to provinces and territories through increased transfer payments, including:

• 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.
• In order 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.

2003 Accord Increased Support for Health

	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 Accord Increased Support for Health (2003-04 to 2007-08)
Provincial/Territorial Allocation - By Category and By Year

	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
1Figures 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.

Health Reform Transfer
Equal per Capita Provincial/Territorial Allocation

	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 CHST Supplement
Equal per Capita Provincial/Territorial Allocation

	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 CHST Supplement for Health
Equal per Capita Provincial/Territorial Allocation

	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 Diagnostic/Medical Equipment Fund
Equal per Capita Provincial/Territorial Allocation

	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.

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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]

- Major Federal Transfers -