Background: 

On April 7, the Honourable Chrystia Freeland, Deputy Prime Minister and Minister of Finance, presented the Budget 2022: A Plan to Grow Our Economy and Make Life More Affordable.

The budget proposes $9.5 billion in new spending for 2022-23. The budget includes $452.3 billion in spending, with annual deficits expected to rise to $52.8 billion. There was also approximately $60 billion in total new spending announced.

In terms, of the health and well-being of Canadians, in 2022-23, it was shared that the Canada Health Transfer will provide provinces and territories with $45.2 billion in support, which is an increase of 4.8 per cent over the baseline for 2021-22. The Canada Health Transfer is projected to provide provinces and territories with $12 billion more in funding over the next five years

The budget announced yesterday was organized into the following areas: (1) Economy Context; (2) Housing Affordability, (3) Clean Air and the Economy, (4) Jobs for the Middle Class, (5) Canada’s Leadership in the world (6) Public Health Care (7) Reconciliation (8) Inclusive Communities (9) Tax System and Effective Government.

CPA Advocacy Ask for the Expansion of the Canada Student Loan Forgiveness Represented:

The budget included a focused chapter on “Strong Public Health Care”, which included our 2022 Pre-Budget recommendation to the Government of Canada to expand the eligibility of the existing Canada Student Loan Forgiveness measure to additional health professionals beyond family doctors and nurses who work in designated rural and remote communities[1].

Today, our strong organizational and coalition advocacy efforts were represented by the government’s affirmation that they will “expand the current list of eligible professionals under the program, with details to be announced in the coming year.”[2]

This announcement is welcome news, and we will continue our advocacy efforts to ensure that the Canada Student Loan Forgiveness program is extended to physiotherapists. We will also advocate for its timely implementation as this will allow for increased access to health services for Canadians living in underserved rural and remote areas.

Key Areas of Interest for Physiotherapy Professionals:

Here are some important investments and details relevant to health and well-being for Canadians, which include:

Health Care Strain:

  • The government recognizes that the publicly funded health care system has been under strain, which has worsened issues such as health care worker shortages and the lack of access to primary care across Canada.
  • The government is proposing measures to reduce pandemic-related backlogs by increasing the number of doctors and nurses in communities experiencing a high need.

Health Care System:

  • The budget details now more than ever; the government must strengthen the health care system and ensure quality care to Canadians.
  • The government will continue to build on the expansion of virtual care.
  • The government is committed to ensuring reliable data to support health system improvements and Canadians’ access to their own personal health records.
  • Budget 2022 proposes to amend the GST/HST eligibility rules for the expanded hospital rebate to recognize the increasing role of nurse practitioners in delivering health care services, including in non-remote areas. 

Canada Health Transfer:

  • In 2022-23, the Canada Health Transfer will provide provinces and territories with $45.2 billion in support—an increase of 4.8 per cent over the baseline for 2021-22.
  • $6.5 billion in top-ups to the Canada Health Transfer (CHT) for provinces and territories to support their pandemic responses, including $2 billion proposed in March 2022 to continue to address immediate pressures, including backlogs in surgeries and procedures.
  • With respect to the Canada Health Transfer and the calls from provinces for greater federal funding, Budget 2022 reiterates the federal government’s position: that any conversation between the federal government and the provinces and territories must focus on delivering better health care outcomes for Canadians.

Long-Term Impacts of COVID-19:

  • $20 million over five years, starting in 2022-23, for the Canadian Institutes of Health Research to support additional research on the long-term effects of COVID-19 infections on Canadians and the wider impacts of COVID-19 on health and health care systems.
  • Budget 2022 proposes to invest an additional $190.5 million in 2022-23 to Indigenous Services Canada for the Indigenous Community Support Fund to help Indigenous communities and organizations mitigate the ongoing impacts of COVID-19.

Universal national pharmacare program:

  • The government will work towards a universal national pharmacare program, which will include tabling a “Canada Pharmacare bill” and aim to have it passed by the end of 2023.
  • Should the bill pass, the Canadian Drug Agency will develop a national formulary of essential medicines and bulk purchasing program.

Dental care:

  • Budget 2022 proposes to provide funding of $5.3 billion over five years, starting in 2022-23, and $1.7 billion ongoing, to Health Canada to provide dental care for Canadians.
  • This will start with under 12-year-olds in 2022 and then expand to under 18-year-olds, seniors, and persons living with a disability in 2023, with full implementation by 2025. The program would be restricted to families with an income of less than $90,000 annually, with no co-pays for those under $70,000 annually in income

Vaccination:

  • Canada is one of the most vaccinated countries globally, with over 85 percent of Canadians having received at least two doses.
  • $17.6 billion to support vaccine procurement, deployment, and administration
  • Over $10 billion for testing, contact tracing, data management, and to support provinces and territories in securing rapid tests for Canadians; 9 Over $12.8 billion for the procurement of personal protective equipment and medical equipment for our health and essential service sectors.
  • $2 billion through the 2021 Economic and Fiscal Update to support the procurement of COVID-19 therapeutics and the associated logistics and operational costs.

Public Health Investment:

  • $436.2 million over five years, starting in 2022-23, with $15.5 million in remaining amortization, to the Public Health Agency of Canada to strengthen key surveillance and risk assessment capacities within the Agency.
  • This will include supporting the real-time tracking of the evolution of viruses, monitoring the longer-term health impacts of COVID-19, and expanding risk assessment capacity and research networks for new strains of flu, emerging respiratory infections, and vaccine safety and effectiveness.

Surgery Backlogs:

  • The government will take immediate steps to reduce backlogs in surgeries and procedures.
  • On March 25, 2022, the federal government announced its intention to provide provinces and territories with an additional $2 billion through a top-up to the Canada Health Transfer to address these backlogs. This will build on the $4 billion in support provided in 2020-21 as provinces and territories work towards eliminating the backlogs in surgeries and procedures and on providing the health care that Canadians deserve.

Loan Forgiveness for Doctors and Nurses in Rural and Remote:

  • $26.2 million over four years, starting in 2023-24, and $7 million ongoing, to increase the maximum amount of forgivable Canada Student Loans by 50 per cent.
  • This will mean up to $30,000 in loan forgiveness for nurses and up to $60,000 in loan forgiveness for doctors working in underserved rural or remote communities.
  • Note: as shared above, the government will be expanding the current list of eligible professionals under the program in the coming year.

Foreign Credential Recognition in the Health Sector:

  • $115 million over five years, with $30 million ongoing, to expand the Foreign Credential Recognition Program and help up to 11,000 internationally trained health care professionals per year get their credentials recognized and find work in their field.
  • This will also support projects—including standardized national exams, easier access to information, faster timelines, and less red tape— that will reduce barriers to foreign credential recognition for health care professionals.

Seniors & Aging at Home:

  • Creation of an expert panel to study the idea of an Aging at Home Benefit.
  • The panel will report to the Minister of Seniors and the Minister of Health. More details will be provided in the months to come.
  • $20 million over two years, beginning in 2022-23, for an expanded New Horizons for Seniors Program to support more projects that improve the quality of life for seniors and help them continue to fully participate in their communities.

Dementia and Brain Health Research:

  • $20 million over five years, starting in 2022-23, for the Canadian Institutes of Health Research to learn more about dementia and brain health, to improve treatment and outcomes for persons living with dementia, and to evaluate and address mental health consequences for caregivers and different models of care

Aging and Brain Health Innovation:

  • $30 million over three years, starting in 2022-23, to the Public Health Agency of Canada for the Centre for Aging and Brain Health Innovation to help accelerate innovations in brain health and aging.

Labour Market:

  • Canada’s unemployment rate dropped to 5.5 percent, falling below its pre-pandemic level for the first time and near the 50-year low of 5.4 percent reached in May 2019.
  • Canada has seen the fastest jobs recovery in the G7 —recouping 112 per cent of the jobs lost at the outset of the pandemic, compared with 90 per cent in the U.S.

Mental Health and Well-Being:

  • The federal government will invest in identifying and expanding effective mental health interventions.
  • The government also intends to engage with provinces and territories to inform the development of a new Canada Mental Health Transfer that will support the expansion and delivery of high-quality and accessible mental health services across Canada.
  • $140 million over two years, starting in 2022-23, to Health Canada for the Wellness Together Canada portal so it can continue to provide Canadians with tools and services to support their mental health and well-being.

Distinctions-based Mental Health and Wellness:

  • $227.6 million over two years, starting in 2022-23, to maintain trauma-informed, culturally appropriate, Indigenous-led services to improve mental wellness, and to support efforts initiated through Budget 2021 to co-develop distinctions-based mental health and wellness strategies.

Safer Sport System:

  • $16 million over three years, starting in 2022-23, to the Department of Canadian Heritage to support actions to create a safer sport system. This will include funding for the Sport Dispute Resolution Centre of Canada for the implementation of the new Independent Safe Sport Mechanism, and funding to ensure national sport policies and practices reduce the risk of harassment, abuse, and discrimination and create a safer and more inclusive sport system.

Opioid Crisis:

  • $100 million over three years, starting in 2022-23, to Health Canada for the Substance Use and Addictions Program to support harm reduction, treatment, and prevention at the community level.

Cannabis Sector:

  • Launching a new cannabis strategy table that will support an ongoing dialogue with businesses and stakeholders in the cannabis sector.
  • Led by the Department of Innovation, Science and Economic Development, and will provide an opportunity for the government to hear from industry leaders and identify ways to work together to grow the legal cannabis sector in Canada.

Reconciliation and Improving Health Outcomes in Indigenous Communities:

  • An additional $11 billion over six years to continue to support Indigenous children and families and to help Indigenous communities.
  • Budget 2022 continues the work of addressing the legacy of harms to Indigenous children and families with additional investments of more than $4.7 billion to support communities as they cope with their past and build a future where Indigenous children can thrive.
  • Investment of $268 million in 2022-23 to continue to provide high-quality health care in remote and isolated First Nations communities on-reserve.
  • $398 million over two years, starting in 2022-23, to Indigenous Services Canada to support community infrastructure on reserve, of which at least $247 million will be directed toward water and wastewater infrastructure.

Jordan’s Principle:

  • $4 billion over six years, starting in 2021-22, to ensure First Nations children continue to receive the support they need through Jordan’s Principle. This funding will also support long-term reforms to improve the implementation of Jordan’s Principle.

Childcare:

  • $625 million over four years, beginning in 2023-24, to Employment and Social Development Canada for an Early Learning and Child Care Infrastructure Fund.

LGBTQ2 Action Plan:

  • $100 million over five years, starting in 2022-23, to support the implementation of the forthcoming Federal LGBTQ2 Action Plan.

Systemic Racism, Discrimination and Hate:

  • $85 million over four years, starting in 2022-23, to the Department of Canadian Heritage to support the work underway to launch a new Anti-Racism Strategy and National Action Plan on Combatting Hate.
  • $5.6 million over five years, with $1.2 million ongoing to support the Special Envoy on Preserving Holocaust Remembrance and Combatting Antisemitism.
  • $5.6 million over five years, with $1.2 million ongoing to support the new Special Representative on Combatting Islamophobia.
  • $50 million over two years, starting in 2022-23, to Employment and Social Development Canada for the Supporting Black Canadian Communities Initiative.

To view the 2022 Budget in detail, click here.

Next Steps for CPA:

The CPA applauds the government for their affirmation to expand the Canada Student Loan Forgiveness program to additional health professionals. We are pleased to see the government’s recognition of the need to increase health services in underserved rural and remote communities. However, we know the distinct value that physiotherapy can bring to the trajectory of Canadian’s health and well-being. Therefore, we will continue to advocate that physiotherapy must be included in this program expansion.

The 2022 Budget highlighted the immense pressures on the Canadian health workforce. To continue our ongoing advocacy on this matter and to support the sector, the CPA submitted a written submission to the Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities. Our submission details the impact of these labour shortages and working conditions as it pertains to the physiotherapy profession.

The CPA will review the 2022 Budget in greater detail and look at how the contribution of physiotherapy can maximize these proposed government investments. We will also monitor the budget as it will be going through four days of debate in the House of Commons.

Resources:

  • Canadian Physiotherapy Association. (2022). Federal Pre-Budget Submission. Retrieved online.
  • Canadian Physiotherapy Association. (March 2022). Responding to the Study of Canada’s Health Workforce – Submission to the House of Commons Standing Committee on Health. Retrieved online.
  • Conservative Party of Canada. (April 7, 2022). Statement from Conservative Leader Candice Bergen on the 2022 NDP-Liberal Budget. Retrieved online.
  • Government of Canada. (March 29, 2022). Media Advisory- Government of Canada Announces Date of Budget 2022. Retrieved online.
  • Government of Canada. (April 7, 2022). News Release – Government of Canada Releases Budget 2022. Retrieved online.
  • Government of Canada. (April 7, 2022). Speech – Budget 202 – Address by the Deputy Prime Minister and Minister of Finance. Retrieved online.
  • Green Party of Canada. (April 7, 2022). Green Party Responds to Budget 2022. Retrieved online.
  • NDP Canada. (April 7, 2022). New Democrats are using their power to secure results that will make a big difference in people’s lives. Retrieved online

[1] CPA. (2022). Written Submission for the Pre-Budget Consultations in Advance of the 2022 Federal Budget. Retrieved online.[2] Budget 2022. Retrieved online: https://budget.gc.ca/2022/pdf/budget-2022-en.pdf, p. 152.