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Canadian Public Health Association

The Canada Health and Social transfer and health equity in Canada


In his budget address February 27, 1995, Finance Minister Paul Martin announced new federal/provincial cost-sharing arrangements for health, social assistance, social services, and post-secondary education. The transfer arrangements, now called the Canada Health and Social Transfer (CHST), establish new ground rules for federal/provincial collaboration on social and health programming that will have an important impact upon conditions that affect health equity in Canada.

Health Equity and the CHST

CHST health and social policy directions and implications that are directly related to health equity include:

  • A massive, immediate cut in cash to the provinces
  • Federal cash continues to decrease until it runs out
  • Targeted support for extended health care services will disappear
  • Loss of the economic-stabilizing function of federal welfare transfers
  • Elimination of previous federal standards for social services
  • A shift in funds from social determinants of health to acute health care services
  • Lack of health policy direction
  • Exclusion of the public from national, health policy discussions

In developing and implementing the CHST the federal government has allowed fiscal imperatives to distort and overrule health and social policy considerations. The Canadian Public Health Association (CPHA) does not deny the need for the federal government to get its fiscal house in order. But fiscal change must not take place within a health and social policy vacuum. Other social policy reform initiatives currently underway or being considered in sectors such as pensions, income security and child care will have a significant impact upon conditions for health equity and it is essential that the government develop a social policy approach that will encompass these initiatives within a comprehensive health investment framework.