In February, a long-awaited meeting between the prime minister and the provincial and territorial premiers will take place in Ottawa.
The discussions will focus on how to fund and manage health care across Canada, as stories about personnel shortages and surgery delays dominate the airwaves.
We have seen health care rising as an issue at the federal level, particularly among Canadians aged 55 and over who continue to voice concerns about the viability of the system. The meeting will also provide an opportunity for Prime Minister Justin Trudeau to reconnect with the electorate after a complicated end of 2022, even if the supply and confidence agreement that the Liberal Party reached with the New Democratic Party (NDP) ensures that no federal election will take place until 2025.
Every six months, Research Co. and Glacier Media ask Canadians about national unity and their heads of government. At the start of this year, more than half of Canadians (52 per cent) think their province would be better off with a different prime minister in Ottawa, up one point since our previous survey in June 2022.
As has been traditionally the case, animosity towards Trudeau is particularly high in Alberta (66 per cent, up two points) and Manitoba and Saskatchewan (65 per cent, up five points). The proportions of dissatisfied Canadians are lower in Atlantic Canada (44 per cent, down eight points) and Quebec (42 per cent, down three points).
There are bigger problems for Trudeau in two other provinces.
In Ontario, which has proven crucial for the Liberal minority wins in 2019 and 2021, 52 per cent of residents (up four points) think they would be better off if someone else takes over at the federal level. In British Columbia, where Trudeau did remarkably well in 2015, 57 per cent (also up four points) appear to be ready for a new prime minister.
In Ontario and British Columbia, the Liberals need to maintain support in cities. There is an evident challenge from the Conservative Party, as outlined by the way in which federal opposition leader Pierre Poilievre has discussed housing – an issue that is particularly prominent among young urban voters.
Trudeau has not gained much traction as an economic manager, with just over two in five Canadians (42 per cent) telling us that they trust him to make the right decisions on this file. The First Ministers’ conference provides a chance to reconnect with voters, as well as establish some rapport with the new faces Trudeau will see around the table.
When we assess the perceptions of Canadians on their premiers, there are some shifts in the four most populous provinces.
More than two in five Quebecers (45 per cent) believe their province would be better off under a different premier, down three points since June, before François Legault fought an election that resulted in a new majority mandate. The needle did not move much in British Columbia, going from 41 per cent with John Horgan in June 2022 to 40 per cent under David Eby this month.
Majorities of Ontarians (57 per cent) and Albertans (55 per cent) think their province would be better off under a different premier. In Ontario, the proportion is up by 14 points, after a provincial election where a disjointed opposition was unable to get traction against Doug Ford. Alberta’s case is different. Danielle Smith’s showing is a 10-point improvement from the numbers that Jason Kenney posted in mid-2022.
The premier rankings also help tell the story of national unity. In Quebec, separatist sentiment fell from 32 per cent to 26 per cent. In Alberta, 26 per cent of residents also think their province would be better off as its own country, but this represents a seven-point drop since June.
We have asked Albertans this question six times. In December 2019, when Kenney’s tenure was starting, 40 per cent of the province’s residents were ready to flirt with independence. This month, the proportion is at an all-time low of 26 per cent—hardly “winning conditions” if we were to borrow Lucien Bouchard’s phrase from the late 1990s.
It is certainly peculiar that, now that Alberta has a premier who has made sovereignty a cornerstone of her policies, the proportion of residents who feel that separation is the best course of action has dropped. What may have been regarded as a unique opportunity to herald the benefits of a different relationship with Ottawa appears to only have succeeded in turning voters off.
Mario Canseco is president of Research Co.
Results are based on an online study conducted from January 20 to January 22, 2023, among 1,000 adults in Canada. The data has been statistically weighted according to Canadian census figures for age, gender and region. The margin of error – which measures sample variability – is +/- 3.1 percentage points, 19 times out of 20.
We are seeing more of the nature of our new premier.
He is one-part eager beaver, one-part lone wolf.
David Eby was the premier-in-waiting for many years. Had John Horgan not outmanoeuvred Christy Clark for the opportunity to co-op Andrew Weaver’s Green Party in 2017, Eby was pretty much mentally measuring the drapes for the Opposition leader’s office.
Instead, he had to wait and wait and wait some more. And when the chance came last year when Horgan’s health prompted his resignation, he had so clearly built the establishment NDP support as to make his caucus competition tuck tail and hail him as the successor.
Of course, as we all know, there was a pretty significant speed bump to deal with in Anjali Appadurai’s left-field candidacy that voraciously sold memberships and threatened to take the race. With the Eby campaign’s assistance, the party’s internal review found Appadurai’s membership recruitment techniques outside the sandbox and disqualified an opponent who could well have catapulted into the premier’s office. She was probably measuring the drapes, too.
Eby’s learning in that debacle was that his campaign style was flat when it needed to be fizzy, so even though he was an eventually acclaimed candidate, he began acting like he was running for his life. Policy after policy after policy began oozing from pores, as if he had been biting his tongue for ages and could wait no longer – not for the party to proclaim him leader, not for an election campaign, but just because the premier’s job was in his sightline.
His spring to life sent out signals on housing, on crime and safety, on mental health approaches, on the Downtown Eastside. He was suddenly a premier who was also the Minister of Everything.
When it came time to put his cabinet together, he chose to elevate by several steps Katrine Conroy as his most important appointment in finance. Either she had been a sleeping giant or, more likely, he is the alert six-foot-seven one.
Of late, Eby has decided it isn’t enough to have cabinet ministers and a bureaucracy to inform him, but that he needs dedicated advisers directly in his office: The prominent former deputy health minister and pandemic vaccine guide Dr. Penny Ballam on health, the former Victoria mayor Lisa Helps on housing and Coast Salish lawyer Doug White on Indigenous issues.
These moves are exactly the sort of confidence-deflating exercises that make ministers and their teams feel like fifth wheels. They smack of micro-management approaching nano-management. They distort the chain of command. They offer little additional value except to have people within earshot of the big guy when he calls across the office for an answer.
But they also signal a lone wolf premier who wants to do it alone and not depend on the team. This is the modern design of first ministers. Our prime ministers have centralized power in their offices for decades, with many ministers saying they rarely saw the boss one-on-one. It is less of a construct of the premiers, although earlier BC Liberal leaders did centralize considerably the environment for pronouncements and Ontario’s Doug Ford is a larger-than-life presence.
What is also clear is that, with a $6 billion surplus owing to a serendipitous revenue bulge, Eby is into a spending spree to effect a visible impact of his priorities before a 2024 election. He had options to pocket the money to pay down the $98 billion debt, but the eager beaver in him wants to be seen, heard and understood as action-oriented more than deliberative.
This might be wise politics but it is bad economics. The current window for spending seemingly aligns with a slowing economy and an opportunity for a provincial boost. But given the glacial pace of announcements translating into spending, the money won’t get into play until inflation has subsided somewhat and the economy is again reviving, so the timing isn’t likely to be ideal.
It is clear that more federal funds are coming for health, as they will be for reconciliation, as they have been for housing. They don’t appear to require a new layer of idea-driven spending, yet that appears to be the path the province is pursuing.
All because the new premier wants everyone to know he has priorities – loads and loads – and his fingers – all 10 – into them. He’s been waiting a long time, hoarding ideas as he kept his counsel under Horgan, and a spring spree is soon upon us.
Kirk LaPointe is publisher and executive editor of Business in Vancouver and vice-president, editorial, of Glacier Media.
The BC Greens are moving to shore up their credentials on the health care file, by naming a high-profile surgeon to be deputy leader of the party.
It’s not a bad idea, and it might help the Greens increase their relevance ahead of the next election – or, just as easily, it could devolve into a mess that pushes them further to the fringe.
Both potential outcomes were on display Monday when Furstenau announced she’d hired Dr. Sanjiv Gandhi, the former chief of paediatric cardiovascular and thoracic surgery at BC Children’s Hospital, to serve as the party’s second deputy leader.
On the one hand, Gandhi’s credentials immediately allowed the Greens to jump into the debate over an ER-doctor shortage in Port Hardy, with Gandhi calling on the government to hire physician assistants to help alleviate the crisis.
“Absolutely, 100 per cent, categorically, no doubt that we should have PAs (physician assistants) in British Columbia, not just for Port Hardy but everywhere for Metro Vancouver,” he said.
“I worked with PAs for 17 years in the United States. They are active in other parts of Canada. They’re a phenomenal resource.… Why we don’t have them in British Columbia is beyond me.”
It was a solid response and a well informed critique of government health policy.
“I’ll fight for the people of B.C. with the same energy I gave to sick kids and their families,” added Gandhi, in one of the best lines of the day.
But then, just as suddenly, the Greens veered sideways – during one of several tangents by Gandhi – into why the NDP government had bungled the COVID-19 pandemic.
“Despite what many would like to think, we’re still in the midst of a global pandemic,” he said.
“Partly, that’s the virus’s fault, but primarily it’s ours. We have not embraced the changing science. Though we’ve acquired knowledge about SARS-CoV-2, we haven’t used that knowledge appropriately.”
The government has failed to properly educate people, mitigate the risk, give people the right information and focus on clean-air policies like HEPA-filters in all school classrooms, he said.
Oh, and everyone should be forced to return to wearing masks indoors for the indefinite future, he added.
“I think in closed indoor public spaces we should have mandatory masking,” said Gandhi.
“And people are to say, ‘Well, are you going to mask forever?’ I don’t know. But I certainly think that during the winter season it’s something that we ought to consider from here on in.”
B.C.’s current policy is that masks indoors are encouraged, but not mandatory. The vast majority of people seem happy with that.
It’s not clear if forcing people to wear masks again is something the BC Greens intend to present to voters as a campaign issue. Furstenau stood behind Gandhi and nodded while he said it at an event she billed as a campaign-readiness press conference. She announced him as someone who helped her understand COVID-19, and someone who will help craft health policies for her platform.
“The important thing is we will be prepared whenever that election is called, and this leadership team is core to that preparation,” she said.
The two health issues in the press conference highlight the political choice in front of the BC Greens when it comes to relevance in the eyes of mainstream voters.
Polls continue to show that the larger issue of post-pandemic health care (including a family doctor shortage) is considered a top issue of concern for British Columbians, with 52 per cent of people surveyed by Angus Reid last month calling it the most important issue facing the province.
On that, the Greens can clearly use Gandhi’s expertise to backstop a serious policy agenda, which would offer practical solutions for the health-care crisis and grab the broader public’s attention, raising the Green party’s profile.
On the other end of the spectrum is COVID-19. Few voters appear to care about it anymore. The issue consistently ranks near the bottom, with only seven per cent identifying it as important in the same Angus Reid poll.
And yet, the Greens can’t seem to let it go.
The party has long been preoccupied with COVID-19. Furstenau was the first politician to publicly break with Provincial Health Officer Dr. Bonnie Henry in 2022, saying she’d failed to do her job and was wrong in her decisions.
Since then, her Greens have flirted dangerously with a toxic social media crowd that delivers venomous personal attacks against Dr. Henry and peddles in conspiracy theories.
A quick search of Gandhi’s background suggests he, too, remains fixated on COVID.
His social media feeds show evidence of someone with an axe to grind against Dr. Henry, Health Minister Adrian Dix, the hospital he used to work at and several other key players in the health care sector for, according to Gandhi, unfairly silencing him and forcing him out of the profession. He spends a great deal of time on Twitter, writing long threads about the issue.
All of this presents both a problem and an opportunity for the Greens.
The problem is that the party has a leader, and now a deputy leader, fixated on an issue that voters don’t particularly care about anymore, which has only served to push the party into fringe territory and won’t do anything to make Green candidates relevant in the next election outside the two ridings the party already holds.
The opportunity is to retool that energy and expertise into something more politically productive, in the form of bold, innovative ideas to tackle the broader issues of health-care wait times, nursing shortages, the family doctor crisis and more.
Furstenau opened the press conference Monday saying she wanted to challenge the notion that the BC Greens are only focused on climate and the environment.
“The BC Green Party is much broader,” she said. “But if we are fundamentally focused on one thing, it is health and well-being.”
The party’s health and well-being depends on it moving on from the pandemic and becoming more relevant on the issues voters are worried about. The longer the Greens wait to do that, the further the party falls behind.
Rob Shaw has spent more than 14 years covering B.C. politics, now reporting for CHEK News and writing for Glacier Media. He is the co-author of the national bestselling book A Matter of Confidence, and a regular guest on CBC Radio.
Premier David Eby has hired veteran health executive Penny Ballem as his new special adviser on health, adding yet another civilian expert into his office to tackle a complex issue on which he’s planning major reforms.
Ballem most recently oversaw the government's COVID-19 vaccine rollout. She’ll now serve as the “premier’s health systems specialist.”
“Every province is facing renewed challenges as a result of longstanding impacts of the pandemic on our health-care system,” Eby said in a statement.
“Penny Ballem will be part of B.C.’s team as the premier’s health advocate, putting her at the centre of government to help move priorities forward, and solve and address crises in our health-care system.”
Ballem is the second special adviser to the premier, after Eby in December hired lawyer and former First Nations Justice Council Doug White to serve as his “special counsel” on Indigenous issues.
In hiring Ballem, the new premier is getting a blunt, formidable and notoriously hard worker, whose experience in health and politics spans multiple political parties and levels. She is a medical doctor who, decades ago, worked in the Downtown Eastside. She’s been a staunch defender of harm-reduction and universal health care.
Ballem served as a deputy minister of health in the BC Liberal government from 2001 to 2006, before quitting in high-profile fashion after a dispute with then-premier Gordon Campbell.
Ballem publicly accused his government of making health “policy on the run” and spending much of her job trying to keep politically negative stories from influencing ministers and “decisions that get made two hours after question period when it’s been a bad hair day for the minister, or worse, the premier,” she said at the time in 2007.
“I learned that if you can see a little niggling story that's going to take off and realize the potential for it to create really ugly policy on the run, my job was to prevent that happening.”
From there, Ballem was hired on contract by the government of Ontario to help negotiate with doctors, before taking on an equally high-profile job as Vancouver’s city manager under Vision Vancouver Mayor Gregor Robertson. She served in that pressure-cooker of a position from 2008 to 2015.
The NDP government hired her in 2021 to to head its COVID-19 vaccination campaign – one of the largest, most complex health projects ever performed by the province.
Ballem pulled it off, largely without issue, managing to oversee the creation of a registration system, mass clinics, mobile outreach efforts, specialized Indigenous vaccination campaigns and multiple vaccine brands being delivered in sometimes unreliable amounts by the federal government.
Her help did not come cheap – she was paid more than $400,000 for 10 months of work (the full amount was never released by government).
Eby is expected to draw upon Ballem’s wealth of experience – and occasional bluntness – as he seeks to try and stabalize a health-care system collapsing under the weight of staffing shortages and a post-pandemic surge of flu cases.
The problems are many.
The NDP is struggling to find enough doctors to run its urgent and primary-care centres, which are overwhelmed each morning when they open by people unable to find a family doctor.
Many hospitals are overflowing with patients, including rural and remote facilities where the ER is frequently closed due to lack of staff (Port Hardy’s hospital ER has been closed almost a month).
The ambulance system remains overwhelmed and unreliable, despite a new tentative contract with paramedics.
The province has been forced to delay some non-urgent surgeries due to the struggling system, adding to wait times for things like certain cancer screenings that have risen to alarming levels.
And B.C. is fighting an unexpected battle against private virtual health-care providers, like Telus Health, whose paid services are creeping into the system to take advantage of the growing frustration.
Meanwhile, the cost of health care continues to grow, and it eats up almost 40 per cent of all provincial government spending.
How much of this Ballem will be tasked with fixing is unclear. Eby already has a formidable health minister in Adrian Dix, and a highly competent deputy health minister in Stephen Brown.
But clearly she is expected to play a leadership role of some kind, with direct access to the premier for her proposals.
Throughout her career, Ballem has made a practice out of telling politicians what they don’t want to hear, when they need to hear it.
“They want all the good news, they don’t want any of the bad news,” Ballem said in 2007.
Eby doesn’t seem too worried about that. Her appointment signals major changes ahead.
Rob Shaw has spent more than 14 years covering B.C. politics, now reporting for CHEK News and writing for Glacier Media. He is the co-author of the national bestselling book A Matter of Confidence, and a regular guest on CBC Radio.
Sometimes it’s a couple of pints of beer after work with friends, sometimes it’s a margarita to go with your tacos. Sometimes it’s an actor’s cocktail of choice that goes viral the world over.
However you encounter it, alcohol is so commonplace few realize how harmful it can be, and most don’t know where the line crosses from moderate to excess. The recommendation from Canada’s updated low-risk drinking guidelines coming out this week is no more than two drinks a week, and avoid binge drinking which is four or more drinks in one setting.
According to the World Health Organization, alcohol consumption is “a causal factor in more than 200 diseases, injuries and other health conditions”. It is associated with the risk of chronic diseases like heart disease, high blood pressure, stroke, and digestive issues, as well as several types of cancers including mouth and throat cancer, stomach cancer, and in women, breast cancer.
This information is cause for concern given recent increases in alcohol sales and consumption in B.C. Data from Statistics Canada showed 22% of British Columbians increased their drinking, an increase that came with pandemic restrictions and closures, as well as the loosening of some alcohol policies in the province, including pilot projects by some jurisdictions that allowed more off-sales and drinking in parks.
In 2020, it is estimated that alcohol was responsible for 173,531 hospitalizations and 2,672 deaths in BC. To put this into context, in the same year opioid overdoses were responsible for 1,767 deaths and COVID-19 led to 1,391 deaths. Researchers say these figures are expected to increase over the next few years, as we see the shift in drinking behaviour take effect.
Despite its links to chronic diseases and cancers, we don’t often see this information. Surveys show Canadians don’t know about the link with cancer.
So, what are some ways we can promote moderate drinking habits and support health? The first step is to give consumers useful information so they can make informed choices.
Alcohol warning labels should be like nutrition labels: providing details on the number of calories and how much ethanol is in each bottle or can, what a standard drink size is, and the risks associated with drinking over the recommended amount.
Consumers have a right to know what is in their drink and what the effects of alcohol are on their bodies, which is why the BC Alliance for Healthy Living (BCAHL) supports the use of alcohol warning labels.
The BCAHL also supports pricing based on ethanol content, rather than on the volume of liquid or the type of alcohol. This creates a disincentive for producers making high-strength “fortified” beers, hard ciders and coolers that are heavily marketed to young people and promote binge drinking.
Studies show that adjusting alcohol prices this way decreases excessive consumption among youth and heavy drinkers – and these are two populations for whom it is critical to reduce the harms associated with excessive alcohol use.
A third way we can decrease alcohol use is by reducing the density of liquor outlets so that there’s not a bar or liquor store everywhere we turn. One study found that an increase in the density of liquor stores was associated with increased alcohol-related deaths.
So rather than approving more outlets, private or otherwise, we urge the province to put a cap on how many there are per capita, to set prices according to ethanol content and to work with the federal government to put warning labels on containers so consumers know the risk in their drink.
Beyond disease prevention, reducing alcohol can improve your sleep, energy levels and mood. Instead of a happy hour or new year, these measures will go a long way in ensuring that we all have healthier and happier years ahead.
Rita Koutsodimos is the executive director of the BC Alliance for Healthy Living.
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