Dear Premier:

I thought it would be useful to you and your colleagues who will be attending the Annual Premiers’ Conference next week in Winnipeg to have my perspective on some of the key priorities facing Canadians. I support the strong focus you will bring to the strengthening of our health care system. I know you will be focussing as well on how we can work together on other issues to meet the needs of Canadians, to help prepare them for the new knowledge-based economy of the 21^st century, and to strengthen and renew policies and programmes so that they are relevant, effective and sustainable.

You are meeting at a time of tremendous opportunity, resulting from the progress we have made in recent years in turning around our fiscal situations and securing the basis for sustained economic and social progress. Federal, provincial and territorial governments have had to make tough decisions to achieve fiscal health. Those decisions were not without pain or sacrifice for Canadians. Important investments had to be deferred until we could afford them.

As we both reduce taxes and make substantial new investments for Canadians, we must not undo or put at risk our fiscal achievements or the structural reforms that have been made. We have learned that we must choose our priorities wisely and that simply more spending on everything is not the answer. To this end, all governments have agreed on the importance of advancing on the shared priorities of health, children and infrastructure, and I believe we can make meaningful progress in each of these areas by continuing to work together and by focussing our efforts.

Canada’s health system is the key agenda item at this year’s Annual Premiers’ Conference and with good reason. Our health care system has served us very well and has been a competitive advantage for Canada. In the face of social, economic and technological change, we must work together to strengthen and renew Canada’s health system to serve the needs of Canadians now and for future generations. We all have a huge collective stake in ensuring a health care system that respects the five principles of Medicare, provides all Canadians with timely access to health services of high quality, and is sustainable.

Our Health Ministers have been working extremely hard and well together in preparing a plan for health renewal in Canada. Two weeks ago, Health Ministers met in Ottawa. I was pleased to receive a report of that meeting, indicating that significant reforms are already being implemented in a number of jurisdictions, and that Health Ministers are committed to working together to broaden and accelerate this renewal.

Ministers found much common ground on primary health care reform, the supply and distribution of nurses, doctors and other health practitioners, pharmaceutical issues, medical equipment and infrastructure, information and communications technologies, health promotion and wellness, and performance indicators.

Health Ministers agreed to prepare a draft text containing the elements of an agreement on health as quickly as possible that could be ratified by First Ministers when we meet next month - subject to an agreement on financing.

My colleague, the Honourable Allan Rock, Minister of Health, has now circulated a draft which attempts to capture the consensus of health ministers, outlining a vision, principles, priorities, an action plan, funding and accountability mechanisms that would support renewal of the health system. I believe that if First Ministers agree to work together on such a plan for health renewal, Canadians will be very well served.

We are all agreed that our health system requires significant additional investment. But such investment will meet the needs of Canadians now and for the future only if guided by a shared vision and plan and our collective commitment to account to Canadians for the results of our expenditures. Agreement on such a plan by First Ministers will permit a substantially increased federal investment in health, largely through an enriched Canada Health and Social Transfer (CHST).

Health care is clearly important to all Canadians. But it is not the only priority. As First Ministers, we know that no one area can be allowed to absorb all of our new investments. The CHST is designed to deal with post-secondary education and social services as well as health. If there is to be a significant increase in CHST funding, we as First Ministers also have an obligation to do better in each of these areas. Indeed it is important in the new knowledge-based economy that Canadians not only have access to high quality public health care, but that they also have access to high quality post-secondary education without excessive debt loads, and that every child can get the best possible start in life. This is all part of the Canadian competitive advantage.

For its part, the Government of Canada has increased by billions of dollars its investments in our research infrastructure, post-secondary student support, as well as helping families through the National Child Benefit.

In addition to health care renewal, governments have also agreed to work together to improve the well-being of Canadian children, by putting in place the investments and plans to help all families ensure that their children grow to be healthy, ready to learn and able to seize opportunities later in life. That is why we jointly created the National Child Benefit as the first step towards the National Children’s Agenda. Ensuring the optimal development of our young children requires an integrated early child development system that provides all families throughout Canada with the information, support and services they need to ensure the best possible outcomes for their children. To this end, when we meet in September, I hope we can endorse a shared framework for early childhood development including appropriate indicators of progress which will guide our joint investments.

In recent years, all jurisdictions had to defer investments in infrastructure that are essential to the health, well-being and economic prosperity of Canadians. A modern physical infrastructure is an integral component of the economy of the 21^st century. Discussions on a new shared cost federal/provincial/territorial/ municipal infrastructure programme are well advanced at the officials level. I expect that we will be in a position to sign new agreements in September.

I am sending a copy of this letter to all Premiers and Government Leaders for their information.

You have my very best wishes for a successful Annual Premiers’ Conference.

Sincerely yours,

(ORIGINAL SIGNED BY THE

RIGHT HONOURABLE JEAN CHRÉTIEN)