The experts' subject-by-subject comments

See shortened versions of these report cards

Michael McBane, national coordinator, Canadian Health Coalition

Wait times
Grade: D
"They have made some partial action based on the Federal Advisor on Wait Times, Dr Brian Postl, but a lot of people are worried that this is a case of fixing short-term problems by throwing money at them but not looking at a long-term, national health human resources strategy."

Management and leadership
Grade: F
"They're missing in action. The fear is that they are getting ready to cut and run from health altogether. You can't get national standards by devolving everything to provinces -- that is why we have a federal government. If Harper doesn't understand that, he is in the wrong job."

Physician recruitment
Grade: F
"They haven't really been moving towards a national coordinated approach, because basically Harper believes health is a provincial responsibility. Without federal leadership you have province competing against province for resources. They've failed to provide national leadership."

Medical research
Grade: D
"I think the whole approach of the federal government in research and development is fundamentally flawed. It's replacing public interest research with the commercialization of research. To be fair, this is not something started by Tony Clement -- it was started under the Liberals -- but he's obviously not changed directions."

Public health
Grade: F
"Overall, in terms of consumer protection, we are heading in the wrong direction by deregulating, leaving product safety in hands of manufacturers, speeding up drug approval instead of trying to strengthen safety assessment of drugs, and pursuing new legislation for that. They're trying to wrap themselves in the mantle of consumer protection but they're weakening legislation. They get an A in spin."

First Nations and Inuit health
Grade: F
"Basically they walked away from a multimillion dollar agreement, the Kelowna Accord, and replaced it with photo ops."

Nadeem Esmail, director of Health System Performance Studies, Fraser Institute
Wait times reductions
Grade: C+
"They are at least talking about, recognizing it is out there. A significant problem with the current approach is we are focusing on a goal that accepts Canadians will always be waiting -- not just waiting, but waiting incredibly long. They're just throwing money and making statements about a problem that is a symptom of a greater problem."

Management and leadership
Grade: C
"It's more of the same from Ottawa except now they're talking care guarantees instead of just more money and vague promises."

Recruiting and retention of physicians
Grade: C
"The Organisation for Economic Co-operation and Development found that countries not involved in regulating the number of physicians have enjoyed higher ratios of physicians per population and growth rates in ratios than countries that have, like Canada. The solution here is not to focus on international medical graduates; the solution is to let Canadians treat Canadians by pulling the shackles off [med school admissions limits]."

Research and development
Grade: no response

Public health
Grade: no response

First Nations and Inuit health
Grade: C
"It's basically being run the way it always has been. Now there are targets, and maybe a bit more talk now than before. The opportunity here is to show the provinces how to run an efficient healthcare system, and they haven't done that."

Dr Tom Noseworthy,director of the Centre for Health and Policy Studies, University of Calgary; member of the board of directors, Canadian Doctors for Medicare

Wait times reductions
Grade: D
"A lot of talk, no action. They're sending large quantities of money to the provinces but not extracting any guarantees. They failed miserably and they whitewashed it. But at least they are trying to do something."

Management and leadership
Grade: C
"The context is that this federal government has gone to sleep on healthcare, hoping it will go to sleep and not cause a fuss. Most of the innovation from the federal government has dissipated. I had high hopes for Tony Clement, with his experience, but he's probably been the worst Health Minister since David Dingwall [1996-97] -- and that's saying a lot. The only reason I didn't give them an F is because they haven't done anything yet."

Recruiting and retention of physicians
Grade: B
"At least this is one area where they are trying to have a positive impact in terms of participation in the debate."

Research and development
Grade: D
"They don't understand how critical healthcare research is. They really didn't boost the funding on CIHR or, I think, the CFI competition. The Canada Research Chairs have all kind of gone into abeyance. At least they didn't take the money away."

Public health
Grade: C
"They haven't pulled the plug on the Public Health Agency of Canada -- most people thought they might -- though they also haven't done anything to help it. The only thing that got into the news of late was that nuclear safety thing which was a mess, but the Health Minister did wade in."

First Nations and Inuit health
Grade: B
"I think [former Minister of Indian Affairs and Northern Development Jim] Prentice did a pretty decent job in that portfolio, and I am not hearing a lot of fussing from aboriginal folk as of late."

Dr Edwin Coffey, former president of the Quebec Medical Association; associate researcher at the Montreal Economic Institute

Wait times reductions
Grade: A
"The Conservative federal government has high marks on at least their attempt to put money in, but I think looking at wait times as the major problem that needs reform to correct the system is misleading because the delays in access and care are the result of the rationing of health resources. Wait times reduction is a symptomatic exercise and in medicine you don't just treat symptoms -- if you have pneumonia you don't only take cough syrup."

Management and leadership
Grade: C
"They are not trying to tell the provinces to obey the Supreme Court ruling [in Chaoulli v Quebec, 2005], that is where they should be putting their political and financial support, through the Canada Health Act. They should motivate the provinces by providing funds to provinces who would reform their healthcare system according to the Chaoulli judgement."

Recruiting and retention of physicians
Grade: C
"Instead of cutting down on the enrolment of students in medicine in the late 80s and early 90s, now we have rationing of hospital facilities and diagnostic equipment. Without those resources it is very difficult to attract physicians who want to use the modern tools of medicine, and who find it's illegal for them to get together and form a private clinic and form private diagnostic clinics. It's a circle -- unless you fix the weak link, it [recruiting and retention] is always a problem."

Research and development
Grade: A-
"I think they have done a reasonably good job in that area. They've provided funds for lots of research, some of that on better ways of financing healthcare."

Public health
Grade: B+
"I would think on public health they are okay. They send out quite a few fliers. And on food management, processing, labelling -- they seem to be doing a pretty good job on that."

First Nations and Inuit health
Grade: A
"From what I know and see happening around, we are sending a lot of physicians up north from McGill to service the Inuit. This is the feds' real jurisdiction, one of their primary obligations, and they are doing a good job there."