Fostering Federal, Provincial and Territorial Relations in Health Policy Development
Disclaimer: The summaries and interpretations provided on this page are unofficial and have not been reviewed, endorsed, or approved by the Canada School of Public Service (CSPS).
Summary
- Jocelyne Voisin serves as Assistant Deputy Minister of the Health Policy Branch at Health Canada and co-chairs five different tables with provinces and territories on various health subjects
- The policy development process begins with understanding expert perspectives in relevant fields that influence health systems across provinces and territories
- Information from experts is used to facilitate conversations with provinces and territories to determine appropriate priorities and assess what actions they are taking in their jurisdictions
- These discussions help inform whether federal direction aligns with provincial needs and whether agreements can be reached based on shared priorities
- Policy work often lacks perfect timing for advancement or announcements, but the work continues and is never truly lost even if delayed for years
- Context consideration is crucial when determining timing for policy initiatives, including understanding what is happening globally, nationally, and at the provincial or territorial level
- When entering a new policy area, reading seminal works provides essential historical context and shows how policies have evolved over time in the country
- Seminal reports reveal patterns of what has been tried previously, what worked, and identify key experts in the field through references and citations
- Understanding diverse perspectives is especially important given how Canadian society has changed significantly over recent decades
- After identifying major issues, policy makers should organize them into manageable categories and consider available federal levers for influence
- Federal tools include spending power which is heavily used in health, tax policy through finance, legislation, regulation, and convening power
- The federal convening role brings together not just provinces and territories but all stakeholders to advance common goals
- Indicator development work with the Canadian Institute for Health Information focuses on creating common measurement tools across the country
- Success indicators must be developed collaboratively with provinces and territories rather than being imposed federally, requiring input from experts and those with actual health system data
- Federal-provincial-territorial health relations are particularly contentious due to significant financial stakes, with health funding representing at least 40% of provincial and territorial budgets
- Policy discussions often become intertwined with health funding discussions because of their interconnected nature
- Building consensus requires starting incrementally rather than presenting fully developed strategies demanding immediate agreement
- Effective consensus building involves gradually developing buy-in and understanding of issues before presenting formal policy proposals
- Success requires active listening and thorough research to understand each province’s specific context and issues
- Proposals should be sensitive to different provincial contexts and designed to be appealing based on their specific circumstances
- Personal relationships are critically important and help resolve issues that would be impossible to address without good rapport
- Strong relationships with provinces, territories, other departments, and stakeholders increase willingness to provide assistance and collaboration
- Curiosity and thorough research enhance the value of opinions and advice provided in policy discussions
- Maintaining enthusiasm and finding enjoyment in the work, including research and meeting diverse people, contributes to professional success
Actionable Advice
- Read seminal works and reports when entering a new policy area to understand historical context and evolution
- Identify experts in the field by following references and citations in key documents
- Organize major issues into manageable categories or buckets for systematic analysis
- Consider all available federal levers including spending power, tax policy, legislation, regulation, and convening power
- Start consensus building incrementally rather than presenting fully formed strategies
- Listen actively and conduct thorough research to understand each stakeholder's specific context and issues
- Build personal relationships with colleagues, provincial representatives, and other stakeholders
- Remain curious and continuously research your policy area to add value to discussions
- Collaborate with experts and data holders when developing indicators or measurement tools
- Consider timing and context when advancing policy initiatives
- Be sensitive to different provincial and territorial circumstances when making proposals
- Use the federal convening power to bring diverse stakeholders together for common goals
- Maintain enthusiasm and find enjoyment in research and relationship building aspects of policy work