Summer Meeting of Canada's Premiers - Final Communiqué

SAINT ANDREWS, NB, July 20, 2018 /CNW/ - Premiers discussed ways to improve health care for Canadians. Their discussions focused on pharmacare, addictions and mental health, healthy aging and collaborating on health care procurement. Premiers reiterated their concerns over the declining federal share of overall health funding. The health needs of Canadians are not well served when provincial and territorial governments do not receive fair and sustainable funding from the federal government. Premiers unanimously call for the federal government to restore health care funding to sustainable levels.

Pharmacare
Provinces and territories have made great progress in improving the affordability and accessibility of prescription drugs, including through cooperative initiatives such as the pan-Canadian Pharmaceutical Alliance (pCPA), which is resulting in over $1.98 billion in annual savings for public drug plans.  Premiers discussed the need for continued efforts to ensure Canadians have access to the medications that keep them healthy.

Premiers discussed national pharmacare and its potential benefits and challenges, emphasizing that a successful program requires adequate and sustained federal funding. Premiers stressed that participation by Provinces and Territories must be voluntary.

Discussions with the federal government on pharmacare will be governed by the following principles:

• Improving access through removing cost barriers for patients should be the focus;
• Development should be based on the best available evidence about potential benefits, risks, costs, and reliability of supply;
• Provinces and territories must retain responsibility for the design and delivery of public drug coverage; and
• Federal pharmacare funding must be long-term, adequate, secure, flexible and take into consideration present and future cost pressures.

Premiers reiterated their support for the principle of asymmetrical federalism and that any jurisdiction that wishes to maintain full control over drug insurance should have the right to opt out unconditionally, with full financial compensation, should the federal government participate financially in the establishment of a pharmacare plan. Québec has already indicated its intention to follow that path and all Provinces and Territories reserve the right to do the same.

Addictions and Mental Health
The opioid addictions epidemic in Canada and other crises of addiction associated with substances such as methamphetamine have led to tragic loss of life and have had devastating impacts on families and communities across the country. Premiers discussed the work that provinces and territories are undertaking in their own jurisdictions and stressed the value of intergovernmental cooperation in addressing this urgent and evolving issue. Premiers also discussed the value of provincial and territorial work with governments in the United States and around the world to address these crises with one another.

Provinces and Territories will continue to collaborate on preventing and responding to opioid overdoses and deaths and other aspects of problematic substance use in a number of critical areas, including: surveillance of overdose-related deaths and opioid-related overdose monitoring; prescriber and public education; dissemination of guidelines to improve prescribing of opioid pain medications; take-home naloxone; and prevention and treatment of opioid use disorders.

Premiers welcomed the funding to respond to problematic substance use and the opioid addictions emergency included in the federal government's Budget 2018. However, as these crises continue to unfold, Premiers call on the federal government to improve long-term funding and use its levers to sustain overdose response and harm reduction efforts and support provinces and territories in meeting the needs of people with mental health, alcohol abuse and substance use challenges. Premiers acknowledged the important linkages between inadequate or overcrowded housing and addictions and mental health issues.

Provinces and territories are strongly committed to continue taking action to address this crisis and prevent further tragic deaths.

Healthy Aging
Supporting and promoting healthy aging has many social and economic benefits. Benefits of healthy aging can include delaying illness for the aging population, relieving financial and capacity stress on our health care systems, and encouraging continued economical productivity.

Premiers discussed the challenges faced by individuals living with chronic diseases and conditions, and the need to better support this population. Healthy aging with dignity and vitality is an important component in the management of chronic diseases and conditions.

Premiers discussed best practices in improving health outcomes for seniors.

Procurement in Health Care
Building on the success of the pCPA, Premiers committed, in July 2017, to exploring further collaboration in medical equipment procurement.  Based on this work, provinces and territories will be advancing multi-jurisdictional procurement processes for computed tomography (CT), ultrasound, home-based hemodialysis, hip/knee implants, and magnetic resonance imaging (MRI).

Provinces and territories will also develop a robust process to support future common procurement efforts. Ongoing collaboration on health equipment procurement poses a unique opportunity for provinces and territories to work together to share innovative best practices, and explore strategic opportunities to realize efficiencies, achieve cost savings, and improve health care for all Canadians.

Public Health and Safety in Legalization of Cannabis
Premiers remain focused on protecting public health and safety and reducing the illicit market as the legalization of cannabis by the federal government proceeds in Canada.

Premiers are committed to supporting an effective transition towards cannabis legalization and will continue to collaborate and share information to achieve this goal. Provinces and Territories have made considerable progress in developing cannabis distribution, retail and oversight mechanisms under very tight federal timelines. Provinces and territories are responsible for significant aspects of this complex undertaking and are incurring substantial costs as a direct result of the federal government's decision.

As Provinces and Territories continue to work toward the October 17, 2018 legalization date, determined by the federal government, Premiers stressed the need for the federal government to address several outstanding concerns to support the orderly implementation of cannabis legalization:

• Commit to fully addressing ongoing provincial and territorial resource requirements for drug-impaired driving enforcement, and expedite the approval of oral fluid screening devices to allow adequate time for procurement and training ahead of legalization;
• Enhance collaboration with Provinces and Territories to ensure an effective seed-to-sale cannabis tracking system, with clarity on system governance;
• Increase federal funding for aligned public education and awareness efforts to reduce negative outcomes related to cannabis use, such as vehicle and equipment-related accidents and preventable health consequences, particularly among young Canadians and their parents. This should also include ongoing and appropriate resource coordination and support for Provinces and Territories, including the timely sharing of public education and awareness materials;
• Respect provincial-territorial jurisdiction with regard to regulatory decisions, including additional limitations on home cultivation; and
• Ensure full flexibility for provincial and territorial governments to design appropriate age-verification mechanisms for online promotions, sales, and retail models that fit specific provincial/territorial circumstances, including remoteness.

Non-port of Entry Border Crossers
Premiers discussed the increased number of individuals crossing the border outside of regular ports of entry, and how this has put pressure on shelters, housing, education, health care, language training and other support services in impacted jurisdictions.

Premiers call on the federal government to provide full compensation to affected provinces for the costs incurred. They also urged the federal government to make the necessary investments to ensure the timely adjudication of refugee claimant hearings and expedited processing of all immigration applications into Canada.

Suspension of Greyhound services 
Premiers discussed Greyhound Canada's decision to suspend services throughout western Canada and northwestern Ontario, noting the impacts it will have on Canadians living in remote, Northern, rural, and Indigenous communities. These and other communities will continue to be impacted as long as shipping and transportation costs remain significantly higher than in other parts of Canada. Premiers welcomed the commitment of the federal government to try to find a path forward, and urged the federal government to work with Greyhound to extend the notice period to ensure affected communities have adequate alternative services in place.

Justice and Community Safety
Provincial and Territorial governments are undertaking meaningful work to address crime rates. This includes problem solving, therapeutic courts, reintegration planning and restorative justice initiatives as models that contribute to community safety.

Premiers discussed their governments' commitments to work together to exchange information and best practices, and called on the federal government to continue collaboration with Provinces and Territories.

SOURCE Canada's Premiers