| Last updated at 8:53 AM on 20/11/09 |
Flu fight should be federal territory 
PETER MCKENNA
Canwest News Service
The federal government, through its spending power, already plays a meaningful role in the health-care field. There is also something called the Canada Health Act, which enshrines certain core principles like comprehensiveness, public administration and portability.
Strictly speaking, though, the provinces exercise legislative competence in the area of public health. In a word, provincial governments are jurisdictionally charged with the delivery of health-care services and programs.
That, of course, applies to the rollout of the current H1N1 inoculation program in each province. While Ottawa does pay for the lion's share of the flu vaccine itself (some 60 per cent) and deals with vaccine approval and distribution, the actual implementation and protocols for the vaccinations themselves fall within the purview of the provinces.
One political commentator recently wrote that the problems now plaguing the inoculation process rest largely with the nature of federal-provincial relations. As he went on to explain: "Whatever its strengths, Canada's federal system is singularly ill-equipped to manage a pandemic, with federal, provincial and municipal jurisdictions overlapping or leaving cracks for things to fall through."
It's true that the provinces have quietly complained about a lack of federal consultations and updates, vaccine shortages and uncertainties, and mixed messages and a lacklustre communications strategy. Ottawa, on the other hand, has maintained that it has distributed more than enough vaccine doses to the provinces. It's up to them, say the feds, to handle the logistical side of things.
An argument could be made, though, that leadership on the flu pandemic should rest mostly with the federal government - while obviously utilizing provincial infrastructure. To be sure, there is a need for federal oversight, national standards and procedures, and overarching national accountability.
This, in turn, would serve to avoid what we essentially have today - namely, a patchwork of provincial, municipal and even regional inoculation regimes. There is precious little in the way of consistency or uniformity in terms of rolling out the vaccine from one coast to the other.
There is no doubting that the provinces would be apoplectic at the thought of Ottawa playing a leading role on this file. But this is an issue of national or country-wide significance. After all, when peoples' lives are at stake, this needs to be seen in the context of a national emergency or crisis.
Of course, if Ottawa were to move to exercise jurisdictional control over the pandemic response, provincial governments would likely fight this in the courts. They would argue, and with good reason, that health care is constitutionally demarcated as a provincial responsibility. Ottawa, however, would not be without its own legal firepower. It could base much of its case on the urgency of a national emergency and the Canadian Constitution itself.
As it has done in the past, the federal government could invoke the "peace, order and good government" (POGG) clause of the Constitution to bulletproof its argument. Let's remember that Ottawa has previously used the POGG clause to ensure its central role in the regulation of liquor, national control of aeronautics and atomic energy, and control of off-shore resources. Could anyone dismiss Ottawa's claim that it was acting for the general welfare of the country?
We are now seeing what happens to this country when a weakened federal government is confronted with a deadly flu pandemic. Put another way, stronger provinces do not necessarily ensure a focused, purposeful and comprehensive response in time of national crisis.
Over the last 25 years or so, there has been a slow, yet noticeable, shift in power away from Ottawa and toward the provinces. It's time for national political leadership to reassert itself and to swing the federal-provincial pendulum back toward the central government.
One means of achieving that goal would be for Ottawa to stake out its turf on public health during a national pandemic. This could also have the ancillary benefit of fortifying the unity of the country.
Clearly, a pandemic is one of those issues that should not be handcuffed by federalism and jurisdictional squabbling. For this reason, Ottawa should take charge of this file and demonstrate much-needed leadership in these extraordinary circumstances.
It goes without saying that there should not be different inoculation rollout programs right across the country. This is one of those rare occasions in a federation where the central government needs to step to the front of the health-care line and override provincial autonomy.
Peter McKenna is an associate professor in the department of political studies at the University of Prince Edward Island, where he teaches Canadian federalism.
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