National Drug Plan Stalled
At a gathering at the Fairmont Château Laurier Hotel in Ottawa last week, a bunch of doctors and pharmacists threw up their collective hands. There, through the windows of the conference hall and beyond the Rideau Canal, stood Parliament Hill, seat of government. It may as well have been located across the Panama for all the answers they were getting. Gathered to discuss something called the National Pharmaceuticals Strategy, the group was discussing instead how little there was to talk about. Almost two years after its launch, a federal-provincial task force charged with drawing up a strategy for a national drug plan had yet to talk to the very people who know most about drugs: the doctors who prescribe them, pharmacists who distribute them, the people who take them.
The NPS was former prime minister Paul MARTIN's brainchild, part of his $41-billion initiative to fix health care "for a generation." In a first ministers' meeting in September 2004, the premiers had demanded that the feds help defray their rising pharmacare costs. Over the last decade, they'd watched as drug costs rose 62 per cent, according to the Canadian Institute for Health Information. Martin's response to the crisis: the NPS, which would examine such possibilities as a catastrophic drug plan and a bulk-buying program, before reporting back in June 2006.
Since then, Health Canada and its provincial counterparts, excluding Quebec, which is not involved in the process, have met behind closed doors, providing few hints of what they're planning for this summer's deadline. "In the absence of any kind of relevant discussion, what we're seeing is a whole bunch of speculation and lots of rumour and innuendo," says Marc Kealey, CEO of the Ontario Pharmacists' Association. Innuendo? Try paranoia. Nurses, for example, are convinced the process is being directed by industry. "You can bet that pharmaceutical companies have been actively voicing their views," Linda Silas, president of the Canadian Federation of Nurses Unions, said in one release. Those pharmaceutical companies, meanwhile, complain bitterly they've not been consulted. Others worry that the NPS is a cost-containment exercise run by provincial bean-counters who lack front-line health care expertise. "You run the danger of having a purely fiscal discussion," says one man at the symposium.
While a Health Canada spokesman said consultations with stakeholders would happen later in the process - after the deadline - the promise leaves some skeptical. "The worry is that decisions are being made now in the absence of clinical practice experience and patient involvement," said Brian Battison of the Better Pharmacare Coalition. "That the cart is too far out of the barn for us to change things." Battison, who says he has enough trouble getting the attention of his own provincial capital, Victoria, wonders why the federal government is involved at all. "Can you imagine if Ottawa is responsible for the medications you need to prolong your life - to save your life. If they have control over that, it's a long walk to Ottawa." He adds: "These are the same people who brought us the gun registry."
At worst, some at the symposium say, the NPS is a creature of the Martin Liberals, with little support from Stephen HARPER. What will happen on June 30, the task force deadline? "I will bet you nothing will happen," says Kealey. Meanwhile, by the NPS's own figures, six million Canadians will continue living with inadequate drug coverage.
Maclean's April 3, 2006