Primary Healthcare In Newfoundland And Labrador Essay

Jordan Dean

Elizabeth Schwartz

POSC 2600: Intro to Public Policy & Admin

20 June, 2023

The Challenges Federalism Poses When Improving Access to Primary Healthcare in Newfoundland & Labrador

Introduction:

Accessible and high-quality healthcare is a core goal for any government. In Canada, healthcare delivery is primarily the responsibility of the provincial and territorial governments, as mandated by the Constitution Act, 1867. This distribution of authority and resources can pose challenges when attempting to address issues such as increasing access to primary healthcare services. Furthermore, the distribution of authority and resources often fails to promote cooperation and coordination between provinces and territories. This paper aims to

Under the Canadian healthcare system, the federal government provides funding to the provinces and territories through the Canada Health Transfer (CHT) program. Today the CHT allocation to provinces is based solely on an equal per capita cash basis (Government of Canada). However, this method of distributing funds may not always align with the specific needs and priorities of individual provinces, as variations in population health needs, regional socioeconomic factors, and the cost of delivering healthcare services are not accounted for. Newfoundland and Labrador is a province that is particularly affected, the province is the most sparsely populated, the oldest, and the most rapidly aging (Smellie). Since provinces with higher healthcare demands may face additional challenges in addressing access issues effectively. It is no surprise that Newfoundland and Labrador, which has unique geographical and demographic factors, has the highest per capita spending on healthcare (Roberts). With high spending and the same amount provided by the federal government as other provinces, one can only wonder what other government services are being neglected to foot the bill. And despite

While the federal government sets broad healthcare principles and guidelines through the Canada Health Act, the provinces have the flexibility to design and implement their own healthcare policies. This autonomy can be advantageous, as it allows provinces to tailor healthcare services to their specific needs. However, it can also impede the adoption of innovative approaches and hinder the implementation of national strategies to improve access. While, some provinces are making progress such as Nova Scotia, which now allows licensed doctors from the U.S. to practise in Nova Scotia without extra certification (Laroche). If this was managed nationally all Canadian provinces and territories would benefit from Nova Scotia's innovative policy solution. In Newfoundland and Labrador, the province has implemented initiatives to enhance primary healthcare, such as the establishment of telehealth services. However, the capacity to fully leverage innovative models of care may be limited by resource constraints and the province's small size. Furthermore a more flexible division of powers could allow for a national telehealth service that could take advantage of low demand periods in each province and put them to use elsewhere; this is also very reasonable as Canada spans six time zones. An overlap of some aspects of healthcare—especially primary healthcare—across jurisdictions could