The Canadian Indian Health Transfer Policy provides a framework for the assumption of control of health services by Indigenous peoples in Canada and set forth a developmental approach to transfer centred on the concept of self-determination in health. Through this process, the decision to enter into transfer discussions with Health Canada rests with each community. Once involved in transfer, communities are able to take control of health program responsibilities at a pace determined by their individual circumstances and health management capabilities.
64-465: To put health transfer in context, it is useful to understand from a historical perspective how First Nations , Inuit , Métis and the Canadian federal government through Indian and Northern Affairs have worked together to respond to Indigenous peoples expressed desire to manage and control their own health programs. The White Paper was a federal government policy paper which proposed to remove
128-495: A royal warrant issued by the King or Governor-in-Council. All Cabinet meetings are held behind closed doors and the minutes are kept confidential for 30 years, Cabinet members being forbidden from discussing what transpires. Decisions made must be unanimous; though, this often occurs at the prime minister's direction and, once a decision has been reached, all Cabinet members must publicly support it. If any of these rules are violated,
192-537: A bill passed by the federal Parliament. One of the main duties of the Crown is to appoint as prime minister the individual most likely to maintain the confidence of the House of Commons; this is usually the leader of the political party with a plurality of seats in that house. But, when no party or coalition holds a majority (referred to as a hung parliament ), or similar scenario, the governor general's judgment about
256-462: A federal contribution as large as suggested in the Romanow Report . Jean Chrétien left satisfied from the meeting, talking of a deal on a fundamental reform whereas the provincial premiers showed disappointment. The Premier of Quebec, Bernard Landry even mentioned that the deal was an example of predatory federalism . These difficult negotiations were held in a context of controversy over
320-593: A lower salary as defined by the Salaries Act, despite the Ministries and Ministers of State Act giving them full authority for any government function delegated to them. However, after details of the aforementioned orders-in-council were published, the new Cabinet stated its intent for there to "be no levels of Cabinet members" and it would table in Parliament amendments to the salary statutes, but also that
384-583: A major promotion taking on the Housing file, and Pascale St-Onge took over at the Department of Canadian Heritage . This is the first major cabinet shuffle of Trudeau's tenure as Prime Minister and resembled a cabinet after a new government is sworn in with how many significant changes were made. Notably, Southwestern Ontario was left without representation in a critical economic region. There have been no Ministers from Southwest Ontario since Bardish Chagger
448-564: A poorer province. Currently Alberta and Ontario, the two provinces with the highest revenue raising ability, receive lower per capita CHT cash payments than the other provinces. However, beginning in 2014-15, the Canada Health Transfer allocation to provinces will be determined solely on an equal per capita cash basis and no longer include tax point transfers. According to economist Livio Di Matteo, this will result in 'a particularly large windfall to Alberta.' The CHT, which
512-562: A position in parliament although they are almost always selected from the House of Commons. As with other Westminster-derived governments , but unlike the United States Cabinet , the size and structure of the Canadian Cabinet is relatively malleable, the slate of Cabinet positions tending to be substantially restructured periodically, the last major period of realignment occurring between 1993 and 1996. Throughout
576-585: A process which: In 1989, the Treasury Board approved the financial authorities and resources to support pre-transfer planning and to fund community health management structures. The process is designed to occur within the present funding base of federal health programs for First Nations , Inuit and Métis peoples. Communities are required to provide certain mandatory programs such as communicable disease control, environmental and occupational health and safety programs, and treatment services. Initially,
640-621: A report of the Advisory Committee on Indian and Inuit Health Consultation was issued, known as the "Berger Report". It recommended methods of consultation that would ensure substantive participation by First Nations and Inuit in the design, management and control of health care services in their communities. In 1983, the Report of the Special Committee on Indian Self-Government, known as the "Penner Report", recommended that
704-432: A third option for communities to further increase their control of health services. Self-governance gives bands more flexibility to establish program priorities in response to tribal needs rather than following federal program objectives. Bands are able to expand, consolidate and create new programs to improve services to their communities and to make certain laws governing their community with respect to health. Furthermore,
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#1732765225702768-700: Is a body of ministers of the Crown that, along with the Canadian monarch , and within the tenets of the Westminster system , forms the government of Canada . Chaired by the prime minister , the Cabinet is a committee of the King's Privy Council for Canada and the senior echelon of the Ministry , the membership of the Cabinet and Ministry often being co-terminal; as of November 2015 there were no members of
832-606: Is chaired by a senior minister whose own portfolio may intersect with the mandate of the committee. Each minister of the Crown is responsible for the general administration of at least one government portfolio and heads a corresponding ministry or ministries , known in Canada as departments or agencies . The most important minister, following the first minister , is the minister of finance , while other high-profile ministries include foreign affairs , industry , justice , and health . The official order of precedence does not follow
896-604: Is defined by the constitution as the King acting on the advice of his Privy Council ; what is technically known as the Governor-in-Council , referring to the governor general as the King's delegate. However, the Privy Council—composed mostly of former members of parliament, current and former chief justices of Canada , and other elder statesmen—rarely meets in full; as the stipulations of responsible government require that those who directly advise
960-507: Is expected to grow to $ 28.6 billion in 2012-2013, a growth rate of approximately six per cent. Annual cash levels are set in legislation up to the 2013-14 fiscal year as a result of the September 2004 Health Accord between the federal government and the provinces/territories. While the CHT is allocated on an equal per capita basis, the CHT cash component is not because it takes into account
1024-417: Is set to top $ 36 billion in 2016-17, is now divided among the provinces on a purely per-capita basis. The Canada Health Transfer was created by the 2003 First Ministers Health Accord signed by the provincial premiers and Jean Chrétien , prime minister of Canada at the time. The accord, signed on 3 February 2003, is a compromise between the two levels of governments, as the provincial premiers did not obtain
1088-747: Is the Canadian government 's transfer payment program in support of the health systems of the provinces and territories of Canada . The program was originally combined with the Canada Social Transfer in a program known as the Canada Health and Social Transfer . It was made independent from the Canada Health and Social Transfer program on April 1, 2004 to allow for greater accountability and transparency for federal health funding led by then prime minister Paul Martin . Unlike Equalization payments , which are unconditional,
1152-684: The 29th Canadian Ministry , was sworn in on November 4, with Justin Trudeau appointed as prime minister. The swearing-in of the new Cabinet also marked the first gender-balanced Cabinet in Canada's history, wherein an equal number of female and male ministers (15 of each, including the Prime Minister) were appointed. Trudeau has continued to maintain a gender-balanced Cabinet throughout several Cabinet shuffles during his time in office. Initially, five members of Cabinet were appointed by orders-in-council as ministers of state , but styled without
1216-446: The inner Cabinet , was the body that set the strategic directions for the government under Stephen Harper, approving key appointments and ratifying committee memberships. This committee ceased to exist under Justin Trudeau. Other Cabinet committees common across committee structures include operations, social affairs, a committee focused on economic growth, foreign affairs and security, the environment, and energy security. Each committee
1280-424: The 20th century, cabinets had been expanding in size until the Cabinet chaired by Brian Mulroney , with a population of 40 ministers. Mulroney's successor, Kim Campbell , reduced this number and Jean Chrétien eliminated approximately 10 members of the ministry from the Cabinet, so that, by 1994, there were a total of 23 persons in Cabinet. Under the chairmanship of Paul Martin , the number increased again to 39, in
1344-519: The CHT is a block transfer; the funds must be used by provinces and territories for the purposes of "maintaining the national criteria" for publicly provided health care in Canada (as set out in the Canada Health Act ). The CHT is made up of a cash transfer. In 2008-09, CHT cash transfer payments from the federal government to the provinces and territories were $ 22.6 billion and tax point transfers were worth $ 13.9 billion. The cash transfer
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#17327652257021408-438: The Cabinet persons chosen by the prime minister— John A. Macdonald once half-jokingly listed his occupation as cabinet maker . While there are no legal qualifications of the potential ministers, there are a number of conventions that are expected to be followed. For instance, there is typically a minister from each province , ministers from visible minority , with disability and Indigenous groups, female ministers, and, while
1472-475: The Cabinet, calling it a "bad habit" that "endorses while concealing the swollen pretension of the executive branch." Each party in His Majesty's Loyal Opposition creates a shadow cabinet , with each member thereof observing and critiquing one or more corresponding, actual Cabinet portfolios and offering alternative policies. The Official Opposition's shadow cabinet comprises members of the party holding
1536-518: The First Nations and Inuit Health Branch to proceed with a health transfer to First Nations as part of administrative reform, the policy framework, authorities and resources had to be developed and secured. A subcommittee on the Transfer of Health Programs to Indian Control was established with representation from First Nations people with experience in health care. The subcommittee incorporated
1600-591: The House of Commons. Further, under the constitution, all legislation involving the raising or spending of public revenue must originate from the Cabinet. Members of various executive agencies, heads of Crown corporations , and other officials are appointed by the Crown-in-Council; though, some of these may be made only by the Governor General-in-Council, specifically. Royal commissions and public inquiries are also called through
1664-584: The Indian Health Transfer Policy began to be seen increasingly by First Nations people as a stepping stone towards the inherent right of self-government. Transfer became the cornerstone of Health Canada 's relationship with First Nations and Inuit communities. Health services transfer agreements between Health Canada and First Nation and Inuit provided the opportunity for communities or First Nations and Inuit organizations to manage their own health programs and services. At first, transfer
1728-490: The Liberal Party as saying Cabinet had become "a kind of focus group for the prime minister," while Simpson called cabinet a "mini-sounding board". Coyne wrote in 2015: "Cabinet does not matter [...] It does not govern: that is the job of the prime minister and of the group of political staff he has around him, and of the bureaucracy beyond them." John Robson criticised the use of the prime minister's name to identify
1792-794: The Native Alcohol and Drug Abuse Program and the Community Health Representative Program. The stated goal of the Indian Health Policy adopted by the federal government on September 19, 1979, was "to achieve an increasing level of health in Indian communities, generated and maintained by the Indian communities themselves". In this regard, the policy emphasized the historic responsibilities of both federal and provincial governments to provide health services to Indigenous peoples in Canada. It removed
1856-550: The abolition of the 6% escalation factor in favour of a 3%-minimum escalation would withdraw 36 billion dollars of financing to the provinces. On 2 December 2020, a Bloc motion asking the federal government to increase health transfers by the end of 2020 was adopted by 176 votes against 148 with the support of both the Conservative Party and the NDP . Starting in 2024-2025, the population by province statistic used for
1920-436: The collaborative effort of the federal government and Indigenous peoples to begin serious planning for the future. This resulted in the 1975 paper, The Canadian Government/The Canadian Indian Relationships, which defined a policy framework for strengthening the control of programs and services by Indigenous peoples. In the health sector, under contribution agreements 75 percent of the bands became responsible for such programs as
1984-610: The computation of the CHT is based on the July 1 estimate and no longer the June 1 estimate. On 7 February 2023 the government announced that the CHT would grow at a minimum rate of 5% per annum for fiscal years 2023-2024 to 2027-2028 through annual top‑up payments . Only provinces who have reached an arrangement with the federal government pursuant to the Working together to improve health care for Canadians federal framework will qualify for
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2048-506: The effective appearance of ministers without portfolio, or be delegated problems or initiatives that cut across departmental boundaries, a situation usually described as having the [situation] file . Members of the Cabinet receive assistance from both parliamentary secretaries —who will usually answer, on behalf of a minister, questions in the House of Commons—and deputy ministers —senior civil servants assigned to each ministry in order to tender non-partisan advice. Composed of advisors to
2112-424: The enthusiasm for this process was varied. For some, it was seen as an important link to self-government where the community plans and controls health programs in their communities according to its own priorities. It was seen as a way to develop programs relevant to a community's own cultural and social needs. Others took a more hesitant approach. As the uptake of control of health services by First Nations increased,
2176-623: The essential differences between the "Integrated Approach and Transfer". The "Integrated Approach" was an intermediate measure which provides more flexibility than Contribution Agreements, but less flexibility than the transfer agreement. In 1995, the federal government announced the Inherent Right to Self-Government policy. This policy recognizes First Nations and Inuit have the constitutional right to shape their own forms of government to suit their particular historical, cultural, political and economic circumstances. The policy thus introduced
2240-487: The existence of a fiscal imbalance between the federal government and the provinces. The 2003 Health Accord introduced several measures to improve the healthcare system in Canada, notably introducing the Canada Heath Transfer starting on 1 April 2004 to increase transparency and accountability on the use of federal transfers. Little over a year thereafter on 15 September 2004 another accord on healthcare
2304-566: The experiences from the Community Health Projects and recommended a developmental and consultative approach for health transfer. These recommendations were then used to finalize the health transfer policy framework. On March 16, 1988, the Canadian Cabinet approved the health transfer policy framework for transferring resources for Indigenous health programs south of the 60th parallel to Indigenous control through
2368-447: The federal government establish a new relationship with First Nations and Inuit and that an essential element of this relationship be recognition of Indigenous self-government. The report identified health as a key area for takeover. Between 1983 and 1986, the First Nations and Inuit Health Branch sponsored demonstration projects for Indigenous peoples. The experiment was initiated to provide both federal and First Nations authorities with
2432-581: The first Minister of Citizen's Services, and Soraya Martinez Ferrada as Minister responsible for the Economic Development Agency of Canada for the Regions of Quebec . Ministers Joyce Murray , Omar Alghabra , Carolyn Bennett all announced they would not be seeking re-election. Ministers Mona Fortier , Marco Mendicino , and David Lametti were removed from cabinet. A total of over 30 changes were made. Notably Sean Fraser received
2496-525: The following goals: In further support the search for alternative pathways to transfer, in late 1994, the Treasury Board approved the "Integrated Community-Based Health Services Approach" as a second transfer option for communities to move into a limited level of control over health services. 1995 saw the distribution and implementation of Pathways to First Nations Control Report of Project 07 Strategic Planning Exercise. This cornerstone document set
2560-419: The interrelated Canadian health system, with its federal, provincial, municipal, Indigenous and private sectors. A further important aspect of the new policy was the recognition that First Nation and Inuit communities could take over any or all aspects of the administration of their own community health programs, at their discretion and with the support of the Department of National Health and Welfare. In 1980,
2624-413: The issue of treaty rights from health policy considerations. The policy reasoned that improvements to the health status of Indigenous peoples should be built on three pillars: (1) community development, both socio-economic and cultural/spiritual, to remove the conditions which limit the attainment of well-being; (2) the traditional trust relationship between Indian people and the federal government; and (3)
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2688-512: The latter who were not also members of the former. For practical reasons, the Cabinet is informally referred to either in relation to the prime minister in charge of it or the number of ministries since Confederation . The current Cabinet is the Cabinet of Justin Trudeau , which is part of the 29th Ministry . The interchangeable use of the terms cabinet and ministry is a subtle inaccuracy that can cause confusion. The Government of Canada , formally referred to as His Majesty's Government ,
2752-441: The majority of those chosen to serve as ministers of the Crown are members of Parliament , a cabinet sometimes includes a senator , especially as a representative of a province or region where the governing party won few or no ridings . Efforts are further made to indulge interest groups that support the incumbent government and the party's internal politics must be appeased. It is not legally necessary for Cabinet members to have
2816-568: The minister for international cooperation, head agencies under the umbrella of a department run by another minister. Further, the prime minister may recommend the governor general appoint to Cabinet some ministers without portfolio , which was last done in 2021, when Prime Minister Trudeau advised the appointment of Jim Carr as Special Representative to the Prairies. Unlike in many other Westminster model governments, ministers of state in Canada are considered full members of Cabinet, rather than of
2880-440: The ministerial advice tendered is typically binding; though, it is important to note that the royal prerogative belongs to the Crown, not to any of the ministers, and the royal and viceregal figures may unilaterally use these powers in exceptional constitutional crisis situations. There are also a few duties which must be specifically performed by, or bills that require assent by, the King . Royal assent has never been denied to
2944-465: The ministry outside it, which has the effect of making the Canadian Cabinet much larger than its foreign counterparts. These individuals are assigned specific, but temporary, responsibilities on a more ad hoc basis, fulfilling tasks created and dissolved to suit short-term government priorities from within a department under a full minister of the Crown. Ministers of state may also be named, but not specified any particular responsibilities, thus giving them
3008-597: The monarch and governor general on how to exercise the Royal Prerogative be accountable to the elected House of Commons , the day-to-day operation of government is guided only by a sub-group of the Privy Council made up of individuals who hold seats in Parliament. This body of ministers of the Crown is the Cabinet, which has come to be the council in the phrase King-in-Council . In the context of constitutional monarchy and responsible government ,
3072-427: The most suitable candidate for prime minister must be brought into play. The prime minister thereafter heads the Cabinet. The King is informed by his viceroy of the acceptance of the resignation of a prime minister and the swearing-in of a new ministry and he remains fully briefed through regular communications from his Canadian ministers and holds audience with them whenever possible. The governor general appoints to
3136-864: The new ministers would continue to work with the existing departments rather than forming new ones. On July 18, 2018, Trudeau reshuffled Cabinet. This included adding five new ministry positions, expanding the size of Cabinet 35. The Prime Minister shuffled Cabinet again on October 26, 2021, following the federal election that year, increasing Cabinet's membership to 39, thus upsetting the gender balance. On July 26, 2023. Trudeau re-shuffled cabinet, adding 7 new ministers: Gary Anandasangaree as Minister of Crown–Indigenous Relations , Rechie Valdez as Minister of Small Business Ya'ara Saks as Minister of Mental Health and Addictions and Associate Minister of Health , Jenna Sudds as Minister of Families, Children and Social Development , Arif Virani as Minister of Justice and Attorney General of Canada , Terry Beech as
3200-471: The offending minister is usually removed by the prime minister and, if the disagreement within the Cabinet is strong, a minister may resign, as did John Turner in 1975, over the subject of wage and price controls, and Michael Chong in 2006, over a parliamentary motion recognizing "the Québécois" as a nation within Canada. However, the Cabinet's collective influence has been seen to be eclipsed by that of
3264-528: The prime minister alone. Former Prime Minister Pierre Trudeau is credited with consolidating power in the Office of the Prime Minister (PMO) and, at the end of the 20th century and into the 21st, analysts, such as Jeffrey Simpson , Donald Savoie , and John Gomery , argued that both Parliament and the Cabinet had become overshadowed by prime ministerial power. Savoie quoted an anonymous minister from
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#17327652257023328-599: The range of resources for health programs which can be included in a self-government arrangement is greater than those included in a Health Service Transfer arrangement and may eventually include fixed assets and services under the Non-Insured Health Benefits Program. The flexibility in terms of how resources are allocated is also greater and reporting requirements are fewer. Canada Health Transfer The Canada Health Transfer ( CHT ) ( French : Transfert canadien en matière de santé )
3392-434: The same pattern, however, with ministers being listed in the order of their appointment to the Privy Council; if appointed on the same day, the individuals are placed in order of their election or appointment to Parliament. Unique positions in Cabinet are those such as leader of the government in the House of Commons and president of the King's Privy Council , who have no corresponding department and some ministers, such as
3456-695: The same substantive information with respect to First Nations control of health services. The Sechelt Indian Band Self-Government Act was passed by Parliament in 1986. In April 1987, the British Columbia Legislative Assembly unanimously passed a bill to give the Sechelt community municipal status. Consequently, the Sechelt Indian Band signed the first self-government agreement in which a First Nations community assumed control of their health services. In order for
3520-483: The second-largest number of seats and is appointed by the leader of the Opposition ; it is generally regarded as a "government in waiting". Its members are often, but not always, appointed to a Cabinet post, should the leader of their party be called to form a government. The Liberal Party of Canada won the federal election of October 19, 2015 , with a majority of seats in the House of Commons. The Cabinet, within
3584-455: The sovereign, the Cabinet has significant power in the Canadian system and, as the governing party usually holds a majority of seats in the legislature, almost all bills proposed by the Cabinet are enacted. Combined with a comparatively small proportion of bills originating with individual members of Parliament , this leads to Cabinet having almost total control over the legislative agenda of
3648-624: The status of treaty individuals under the Indian Act and to discontinue special services so identified, advocating the increased assimilation of Indigenous people into the culture of Canada . The Red Paper was an Indigenous response to the White Paper emphasizing federal responsibility for health care for First Nations peoples and emphasizing plans to strengthen community control of their lives and of government-delivered community programs. The White and Red Papers served as an impetus for
3712-449: The top-up. Such agreements should contain provisions improving collection and sharing of health information The first agreement was signed with the province of British Columbia on 10 October 2023. All provinces eventually reached an agreement with the federal by the 1 December 2024 deadline, the last province to sign being Quebec on 27 March 2024. Canadian Cabinet The Cabinet of Canada ( French : Cabinet du Canada )
3776-471: The traditional of state in their titles. These were the Ministers of Science , Small Business and Tourism , Sport and Persons with Disabilities , Status of Women , and La Francophonie . (However, the new Minister of La Francophonie was, at the same time, appointed Minister of International Development .) Ministers of state had previously represented a second order within the Cabinet (determined by
3840-548: The transfer approach. The First Nations and Inuit Health Branch searched for ways to respond to communities desiring to increase their control of community resources, either through the transfer process, or through other initiatives. This movement was further supported by a decision of the Departmental Executive Committee of Health Canada on March 15, 1994, which directed the First Nations and Inuit Health Branch to commence planning all activities toward
3904-472: The value of provincial/territorial tax points. The value of a tax point represents the amount of revenue that is generated by one percentage point of a particular tax (in the case of the CHT and the CST, the personal income tax or the corporate income tax). Since provinces do not have identical economies and, therefore, have unequal capacity to raise tax revenues, a tax point is worth more in a wealthy province than in
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#17327652257023968-504: The vicinity of which it has remained. The Trudeau Cabinet comprised 37 ministers in 2021. Cabinet itself—or full Cabinet—is further divided into committees. The Treasury Board , overseeing the expenditure of the sovereign's state funds within every department, is one of the most important of these. The structure of Cabinet fluctuates between and within ministries. For example, the Priorities and Planning Committee , often referred to as
4032-629: Was signed during a First Ministers Conference . This 10-year plan outlined $ 18 billion in increased transfers to the provinces over 6 years, notably through increases in the CHT: Jim Flaherty , federal minister of Finance, announced in December 2011 a reform package for the CHT to take over from the 2004 Agreement after 2014. The reform plans for 2 successive phases: The latter phase was heavily criticized by some provincial ministers, notably Dwight Duncan (Ontario) who pointed out that
4096-590: Was the only option communities had for increasing their control over health programs and services beyond contribution agreements. Although many communities were interested in assuming increased control over health services and programs, not all communities were ready to move into this level of control so quickly. It became increasingly apparent that one design could not fit all the diversity of readiness. Some communities expressed interest in alternative strategies which would also give them increased control of resources. Each year brought pressures for change and restructure in
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