Good morning.
My name is Jack Kitts, and I'm chair of the board of the Association of Canadian Academic Healthcare Organizations, known as ACAHO. I'm also president and CEO of the Ottawa Hospital.
I'm joined by Mr. Glenn Brimacombe, who is the president and CEO of the association.
The association appreciates the opportunity to appear before you to highlight our recommendations, which are designed to more effectively align our potential with our performance, which in turn contributes to the country's overall prosperity.
Let me briefly mention that ACAHO is the national voice of research and teaching hospitals, academic regional health authorities, and their research institutes. There are no other organizations in the health system that provide the unique combination of health services, teaching, and research that our members do. We consider our institutions as important hubs in the system, in addition to being a national resource.
Let me now turn to our three recommendations.
First, we recommend that the federal government invest in innovative health delivery infrastructure. Members of ACAHO have a tripartite mission: first, to provide Canadians with the most complex and specialized health care; second, to conduct research that impacts health and health services in Canada in support of better care and better systems in the future; and third, to train health providers who in turn will practise anywhere in Canada. However, this work is largely taking place in buildings that need to be retrofitted, repaired, and in many cases rebuilt in order to meet current standards of safe, quality care and increasingly to meet environmental standards.
Based on a recent survey of ACAHO members, over 300 shovel-ready infrastructure projects over the next 12 to 36 months have been identified as a priority, at a cost of over $20 billion. Of note, 30% of these projects are new buildings and 70% qualify as repairs, renovations, or expansions.
While Budget 2009 created several infrastructure funds—that is, the infrastructure stimulus fund, the knowledge infrastructure fund, and the green infrastructure fund—members of ACAHO were not included as eligible to receive any of this funding.
Recognizing that the role of ACAHO members extends well beyond local, regional, and provincial borders, the association calls on the federal government to create a one-time strategically targeted national health delivery infrastructure fund. It is proposed that this fund have a time limit of five years and be valued at $1 billion.
From the perspective of ACAHO, health infrastructure investments create short-term jobs that build legacy institutions that fully acknowledge the role and contribution of the federal government for residents at the community level and will allow facilities to meet new safety, efficiency, environmental, and patient care standards. It also instills a deep sense of community pride and promotes social cohesion, and it accelerates the transformation of the health system delivery infrastructure to meet both today's and tomorrow's needs.
The second recommendation is to invest in science and technology that drives new knowledge and innovations. Over the past decade, the federal government has made significant investments in Canada's health research enterprise through a number of instruments for which we are extremely grateful. Importantly, these investments recognize the four key components that underpin the research, innovation, and commercialization spectrum: first, people; second, programs; third, infrastructure; and fourth, indirect costs.
While it is crucial to ensure that there is a proper balance and strategic alignment between these four pillars, ACAHO believes that now is the time to increase support for the direct costs of undertaking world-class health research by increasing base funding to the Canadian Institutes of Health Research, the CIHR.
Again, I must say that ACAHO fully recognizes and applauds the federal government for the significant resources that have been invested in CIHR since 2000. However, the association remains concerned that CIHR must be funded at internationally competitive levels so that we can continue to support research excellence and a number of cutting-edge health research initiatives. In order to remain competitive internationally, we must respond to prevent a brain drain to countries that are ramping up their investments in health research and looking to attract the best and brightest minds.
Finally, we recommend that the federal government align the goods and services tax with the health system. In principle and practice, ACAHO is of the view that good tax policy should reinforce good health care policy by promoting the efficient allocation of resources in the system. As it stands, hospitals are entitled to an 83% rebate on the GST paid for all eligible inputs. Health research, publicly funded long-term care facilities, and home community care services receive a 50% GST rebate.
The range of rebates hinders the overall efficiency of the tax and its administration at the local level, and to simplify this process and to better align with the integrated nature of health governance structures, we support a more cohesive approach to how the GST should be administered in this area.
It's also important to note that the provinces of Alberta and New Brunswick, given the manner in which their health systems are configured, do not effectively pay any GST on their health inputs. Given the unfairness of how the GST impacts upon the rest of the health system across the country, the federal government has a unique opportunity to create a level playing field for all provinces.
This recommendation is fair, reasonable, and above all it avoids a situation whereby the federal government gives with one financial hand and takes with the other. It will also keep federal dollars where they were originally intended: in the country's organizations dedicated to providing Canadians with timely access to a range of quality health services.
Thank you.