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Sean Speer: The federal public health agency needs to get back to its core functions

Commentary

Over the coming days, The Hub will publish mandate letters for the incoming cabinet ministers that set out a series of bold policy prescriptions that would cumulatively tilt Canadian politics towards a different and better future.

The best antidote to anger and frustration is aspiration and purpose. The campaign has demonstrated how urgently Canada’s body politic needs such a remedy. There’s no time to waste. It’s time to get to work.

Dear Minister of Health,

I am honoured that you have agreed to serve Canadians as the Minister of Health.

As you know, our government must have a both a short- and long-term orientation. The immediate priority is to help the country through the COVID-19 pandemic and to catalyse a post-pandemic recovery. Getting Canadian businesses and families to the other end of this crisis is the key to restoring stability and optimism in our economy and society.

Beyond that, though, over the long term, we face many opportunities and challenges including geopolitical instability, aging demographics, climate change, reconciliation with Indigenous peoples, long-term fiscal challenges, low productivity, and slow growth.

Each of these issues could easily consume a government’s attention, focus, and resources. But we do not have the luxury of prioritizing one or some of them. They require similar levels of energy and ambition if we are to lay the foundation for a different and better future for Canadians.

An emphasis on the future is a much-needed antidote to the growing anxiety and pessimism in our country. Even before the pandemic, too many Canadians worried that their children will not have the same opportunities and living standards as them. The pandemic has exacerbated these concerns and cast a pall of uncertainty over our economy and society.

In this context, Canadians have grown skeptical of the ability of government to put aside partisan differences or short-term political advantage and make the hard yet necessary choices to mitigate our long-term challenges and accentuate our opportunities. It is incumbent on us to prove to Canadians that their skepticism and doubt is unwarranted. We must rebuild their trust through our actions and choices.

This principle extends to all aspects of governance. Our government must live up to the highest ethical standards, including openness, honesty, and accountability. I expect you to reflect these values in your work. It is critical that we honour Canadians’ trust in us and the history and dignity of the institutions and roles that we occupy.

Our immediate policy priorities flow from the best ideas and rooted in evidence. As the Minister of Health, I would ask that you work with your colleagues to deliver on the following key priorities:

  • Conduct a comprehensive review of the Public Health Agency of Canada with the goal of eliminating as much of its programs and operations that are duplicative of provincial public health organizations as possible and instead rationalizing its core activities on the crucial federal function of global pandemic monitoring and control, emergency preparedness planning including pandemic-related research and stockpiling medically-necessary goods and equipment.
  • Amend the Canada Health Act to enable provinces and territories to adjust the single-payer model to reduce coverage, on a means-tested basis, for hospital and physician services in exchange for increasing public coverage, in a fiscally-neutral way, for presently non-insured services on behalf of low-income Canadians.
  • Clarify that the Canada Health Act permits publicly-funded yet privately-delivered services with parameters in place to ensure fair access and prevent human resource shortages in the public health-care system.
  • Work with the minister of finance to reform the Medical Expense Tax Credit to make it refundable, larger and more generous so as to help Canadians without employer-provided health insurance or who are not eligible for current public drug programs to be able to purchase individual private insurance.
  • Reform the Canadian Institutes of Health Research’s funding processes to enable more breakthrough-type projects by experimenting with replacing the peer review process with lotteries and prizes in order to eliminate the tendency towards “gatekeeping” and incremental research.
  • Work to harmonize various of the department of health’s regulatory processes – from drug approvals to agriculture and agri-food regulatory approvals – so as to accept scientific inputs submitted in other jurisdictional processes and even possibly adopt harmonized decision-making with peer jurisdictions such as the United States.
  • Conduct a comprehensive review of the federal department of health to ensure that its activities are not duplicative of provincial and territorial health ministries and instead are focused solely on areas of federal jurisdiction.

I know I can count on you to fulfill these responsibilities and help to deliver a different and better future rooted in prosperity and opportunity for all Canadians.

Sean Speer is The Hub's Editor-at-Large. He is also a university lecturer at the University of Toronto and Carleton University, as well as a think-tank scholar and columnist. He previously served as a senior economic adviser to Prime Minister Stephen Harper....

Geoff Sigalet: No housing plan is effective without the provinces

Commentary

Over the coming days, The Hub will publish mandate letters for the incoming cabinet ministers that set out a series of bold policy prescriptions that would cumulatively tilt Canadian politics towards a different and better future.

The best antidote to anger and frustration is aspiration and purpose. The campaign has demonstrated how urgently Canada’s body politic needs such a remedy. There’s no time to waste. It’s time to get to work.

Dear Minister of Intergovernmental Affairs,

I am honoured that you have agreed to serve Canadians as the Minister of Intergovernmental Affairs.

As you know, Her Majesty’s government faces many challenges that will require co-ordination, trust, and respect between federal and provincial authorities. We cannot manage the COVID-19 health crisis, encourage economic recovery, nor tackle issues such as unaffordable housing, threats to the environment, divisions in national unity, and reconciliation with indigenous Canadians, unless we co-ordinate federal and provincial policies. To that end, we must build trust with the provinces and territories and respect the Constitution’s division of powers.

We must also remember that the 2021 election once again revealed the stark challenges facing Canada’s national unity and reconciliation with indigenous Canadians. The Western provinces have once again voted overwhelmingly for the Conservative Party as an expression of their frustrations with the way the federal government has treated Western interests. Quebecers have elected numerous separatists to Parliament in a renewed demonstration of concerns about their unfair treatment in our confederation. And new discoveries about the past injustices on Canada’s Indian Residential Schools have underlined the need for redoubling our efforts to achieve reconciliation with indigenous Canadians.

  • Co-ordinate healthcare policy with the provincial governments to ensure the health and safety of Canadians, and to do so with special concern for fighting back against the COVID-19 pandemic. You must accomplish this with upmost respect for the provinces’ exclusive rights to legislate on the management of hospitals and municipal institutions.
  • You will also need to proactively respond to provincial needs. For example, Alberta’s Minister of Municipal Affairs has written to the federal Minister of Public Safety to request assistance in increasing aero-evacuation capacity and augmenting Alberta Health Services staff. COVID-19 has hit Alberta hard, and as Minister of Intergovernmental affairs I ask that you work with the Minister of Public Safety, the Minister of Health, and provincial counterparts to establish a COVID-19 emergency response committee for assisting provinces that find themselves in Alberta’s situation. The committee will help foster clear lines of communication between the federal government, provinces in crisis, and those with more manageable hospitalization numbers, and will also develop measures for what kinds of resources will likely be required in different scenarios. We must learn from the COVID-19 crisis as it develops and enters new phases.
  • COVID-19 has exacerbated the economic challenges facing Canadians, especially the middle class. A swift recovery requires that our economic policies must be enacted in partnership with provincial governments. You must work with the Minister of Finance and the provinces to find ways of incentivizing and supporting Canadian workers across the country. This work will involve encouraging free trade between the provinces by inviting the first ministers to renegotiate the Canadian Free Trade Agreement and encouraging the removal of more barriers to inter-provincial trade in exchange for significant reforms to transfer payments and tax swaps (e.g. the elimination of the GST).
  • In the 2021 election it became clear that Canadians of almost every political party supported reforms addressing the increasing unaffordability of housing. No housing policy plan will be effective at making houses more affordable without the involvement of provincial governments. One of your key tasks as Minister will be to meet with the premiers to negotiate standardizing provincial taxes on foreign buyers of residential property in tandem with new exemptions for out-of-province Canadian home buyers. The new tax regimes should be agreed to alongside federal commitments to encourage the construction of residential housing.
  • It is also important to work with the provinces in designing policies that will help Canada protect its environment, which requires meeting its commitments at the Paris Agreement. That means reducing greenhouse gas emissions. In the References Re. Greenhouse Gas Pollution Act, the Supreme Court upheld the constitutionality of federal legislation imposing a pricing backstop on greenhouse gas emissions in the provinces. But the decision also highlighted just how narrow the federal government’s jurisdiction is under the “Peace, Order, and Good Government” clause of the Constitution Act, 1867. As minister, you must work with the provinces to ensure that the regulatory backstop is not applied arbitrarily in ways that devolve into the kind of punitive taxation that the Supreme Court suggested would be unconstitutional.
  • But there is much more to protecting the environment than climate change. Other threats to the environment will require you to work with the provinces for constitutionally respectful solutions. For example, Pacific salmon and steelhead stocks have declined in many areas. Provincial and federal policy must be co-ordinated to ensure that salmon and steelhead stocks are protected. This will require you to better co-ordinate policy with the Department of Fisheries and Oceans and British Columbia’s Ministry of Forests, Lands, and Resource Management. Funding for the federal Pacific Salmon Initiative and efforts should be increased in tandem with increased provincial involvement and the project’s mandate should be extended to protecting wild steelhead stocks. Wild Pacific salmon and steelhead populations must not be allowed to collapse the way that Atlantic cod populations did in 1993.
  • To resolve Western alienation, you must organize a constitutional convention to negotiate with the provinces to amend section 36 of the Constitution Act, 1982 to make Canada’s equalization payments scheme more equitable, and to clarify how the division of powers relates to environmental matters. As part of these negotiations, you must also seek to have the other provinces agree to constitutionally recognize Quebec’s status as a nation and the primacy of the French language in that province. Together, these bold constitutional amendments promise to unite our country. And a meeting of the first ministers offers an exciting chance for the representatives of indigenous Canadians to make their own constitutional concerns heard.
  • Finally, as a gesture of good faith to the provinces, and in the interest of ensuring that federal policymaking respects the constitutional division of powers, you must work with the Minister of Justice to develop a “Federalism Statements” program akin to the current “Charter Statements” measure. The Department of Justice Act currently requires that every government bill is accompanied by a “Charter Statement” from the Minister of Justice explaining the effects of the proposed bill on the Charter of Rights and Freedoms. The Act should be amended to require a joint “Federalism Statement” from your Ministry and the Ministry of Justice attesting to the effects of government bills on the division of powers.

I know I can count on you to fulfill these responsibilities and help to deliver a different and better future rooted in prosperity and opportunity for all Canadians.

Geoff Sigalet

Geoff Sigalet is an assistant professor of political science at UBC Okanagan.

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