The Conservative Party of Canada is in the midst of a leadership race to replace former leader Stephen Harper. Since the 2015 federal election, the party has been led by interim leader Rona Ambrose. On May 27, party members will gather in Toronto to select a new leader.
As of Jan. 31, there were 14 leadership candidates (bios are available at conservative.ca). CNA invited them to provide their views on health care and the policies they would adopt if elected prime minister in 2019. Twelve candidates responded to this request. Neither MP Steven Blaney nor venture capitalist Rick Peterson responded after multiple attempts.
MP and former cabinet minister Chris Alexander says his policies and priorities include increasing resources to front-line health-care workers. He is also calling for additional support for mental health and home care.
He says he wants to strengthen our focus on excellence in research, discovery, innovative service delivery and patient-centred problem-solving. “Canadian biotech, health sciences and pharma start-ups should have enhanced access to public funding to drive innovation forward.”
Alexander argues that health-care workers licensed to work in one province or territory should be eligible to work in all others and that we “also need to improve our outcomes in terms of preventing illness, promoting healthy lifestyles and communities, countering obesity and addiction and promoting fitness.”
MP Maxime Bernier provided his plan to “put an end to squabbling between Ottawa and the provinces over health-care funding and encourage provincial governments to take the necessary tough decisions to deal with wait times and rising costs.”
Bernier’s plan has three components: “Replace the Canada Health Transfer by tax points of equivalent value given to the provinces; [e]nd the current confusion over who does what. Provinces should take their responsibility for health-care funding and management and be fully accountable for the results, while Ottawa should respect the Constitution and stop meddling; and [c]reate the conditions to encourage provinces to innovate and adopt reforms in line with what is normal in the mixed universal systems of all other developed countries apart from the U.S., such as allowing for private insurance and private service delivery.”
Bernier says he believes that having “the longest patient wait times of any developed country” is not the result of a lack of funding and that “[t]hrowing good money after bad clearly isn’t working.”
MP and former cabinet minister Michael Chong says “we are operating in the 21st century under a Canada Health Act whose last update was over 30 years ago.” He goes on to say that our “population is rapidly aging and our system must change to adapt to this reality. Our system also needs to take advantage of the major advances in technology and automation in the last thirty years.”
Chong says we should look across the Atlantic to public health-care systems in Europe “that achieve better outcomes for the money we spend. We have to consider these best practices, while protecting the principle that no Canadian should have to use a credit card to pay for care.”
He stressed that the “biggest long-term threat to public health care is the big deficits the federal government is accumulating.”
MP and former cabinet minister Kellie Leitch is also a pediatric surgeon. She says she has “a unique perspective that the rest of the candidates don’t.” Leitch says she has been in the operating room and has studied innovation in health care as an academic. She affirms there are real problems in the health-care system and “no simple answers. Anyone who tells you there are is not being honest.”
Leitch says her approach would focus “on the patient and not the bickering between the federal and provincial governments.” She acknowledges that the federal government “has a significant role to play to ensure equal access for all Canadians. But most importantly, you and your loved ones deserve to be taken care of and get the care you deserve.”
Former MP Pierre Lemieux shared his views on conscientious objection to medical assistance in dying. “It is alarming that people feel that there is no better choice in our health-care system than to end their lives,” he says, “[a]nd just as bad: medical professionals are facing pressure to act against their deeply held beliefs and terminate the lives of their patients…as Canadians, we need to encourage our doctors and nurses to deliver excellent health care, not force them against their conscience and their deeply held convictions.”
MP Deepak Obhrai addressed the need for regulations ensuring portability of licensure for health-care professionals. He would create a national standardized qualifications system to fill the gaps that are arising in health care. “Creating a national arm that works with credible researchers and institutions will help standardize certifications [and] code of conduct, and, in particular, look for innovative ways of implementing evidence-based medicine or research in the health-care system.”
Obhrai also says he supports nurses and informal caregivers. Canadians need to ensure the “nursing profession is always up to the highest standards as it is today by supporting training centres, as well as innovative teaching tools.”
On the issue of pharmacare, he says he would create a task force to address the affordability and accessibility gaps that are found within the system.
Celebrity businessman Kevin O’Leary says he believes the existing health funding model is broken. “Simply, you cannot fund a system that is going to be called upon more as our population ages and when our economy only grows by one per cent annually. You cannot be socially responsible when you are fiscally broke. Our economy is failing. We have only to look at the current government who went from a balanced budget to, in less than a year, a
$34-billion deficit; $5 billion more than what Justin Trudeau ran on.”
“Canadians are forced to travel great distances for care they could once receive in their local towns,” O’Leary says. “Hospitals are underfunded. Home and community care is underfunded. But to fund the health system properly, our economy must grow at a rate of three per cent. We need leadership that can rein in spending and help create an attractive investment environment. We will create jobs, help the economy bounce back and help ensure that the provinces have the tools and funding they need to keep Canadians healthy.”
MP and former cabinet minister Erin O’Toole says his government would improve the quality and ensure sustainability of our health-care system. His plan includes a number of measures:
- balance the budget, including a debt-repayment plan, to safeguard the sustainability of transfer payments for health care
- encourage provinces to test alternative service providers and innovative solutions, as long as they provide timely access and positive outcomes
- encourage provinces to partner with the federal government on bulk-buying negotiations to get better prices on pharmaceuticals that would be consistent across Canada
- require provinces to report back on improvements made to health-care access for rural and northern communities
- encourage medical practitioners to open practices in northern and rural communities by reducing the Small Business Tax Rate from 10.5 per cent to 5 per cent
- work with provinces and First Nations on new approaches to health care for First Nations people to meet the requirement of the Truth and Reconciliation Commission’s recommendations.
MP and former cabinet minister Lisa Raitt says the investments her government would make would focus on mental health and autism.
Ottawa has considerable leverage over the provinces and territories when it comes to health funding, she says. While working in partnership with the provinces, “we need to set priorities in areas such as wait times, mental health issues, opioid abuse and extended senior care.”
Another priority for Raitt is drug costs. She notes that the Harper-led Conservatives “called for the provinces and territories to cooperate with the feds to help slash the cost of prescription drugs.”
She says that we “need to focus on the people falling through the cracks. We must always provide the social safety net for those struggling today. The reason I am running for leader is to help those who are struggling.”
Former MP Andrew Saxton listed his priorities as seniors care and lowering the cost of pharmaceuticals, accountability on provincial/territorial health transfers, preventive care for children, epidemics of illegal drugs, funding spaces to address shortages of health-care professionals, access to health care and emergent health-care issues.
On drug costs, Saxton says: “We need to figure out how to encourage innovation in pharmaceuticals while also encouraging companies to sell their drugs at more reasonable prices.”
On accountability, he notes: “Health care will continue to be a bigger and bigger piece of provincial budgets. The money Ottawa sends to the provinces for health care must be spent on health care.”
As for the fentanyl crisis, he says emergency action is needed. He would sit down with the provinces and work out a system “to quickly and definitively deal with health epidemics regardless of their source.”
MP and former Commons speaker Andrew Scheer says: “The Conservative party under my leadership would work hard to spend federal dollars wisely — including running balanced budgets — in order to ensure we maintain stable federal funding to the provinces. As well, I believe it is important to allow the provinces the autonomy to innovate without fear of federal intervention.”
MP Brad Trost says his health-care priorities as prime minister would focus on devoting “substantial resources to expand palliative care immediately as a replacement for euthanasia.” His government would introduce “federal conscience legislation” to “protect doctors, nurses and other medical personnel from being forced to violate their constitutional rights.”
“[O]ur centralized health-care system does not respect the provinces in regards to their constitutionally mandated jurisdiction as the primary providers of health care.” Trost says one size does not fit all and flexibility is the key to managing health care with provincial and territorial partners. “Patients in rural Newfoundland don’t have access to [the] same number of specialists as their fellow Canadians in Toronto, for example.”
In addition to accessibility, Trost’s government would concentrate on two other pillars of the Canada Health Act: universality and portability.
He says he would “not stand in the way of any provincial innovation (like more home care or increasing the number of nurse practitioners)” that does not violate the core principles he supports.
A similar article on the New Democratic Party leadership race is being planned for the September/October issue of Canadian Nurse. According to the party’s website, a new leader will be selected no later than Oct. 29.