News and analysis Nouvelles et analyses

Is Newfoundland’s increased health spending part of premier’s bid to become PM?

Newfoundland Premier Brian Tobin ing budgets because health is the top “efficiencies.” Still, the extra financing put more than just an accent on health priority. was welcomed as a promising start by care in his government’s latest budget, Tobin’s gestures on health care at groups such as the Newfoundland and which uses deficit financing and a roll home are often derided by the political Labrador Medical Association. of the dice to pump substantially more opposition, which says they are being The province is taking budgetary risks money into the province’s hospitals and motivated by his own career interests. to bolster health care. After running con- clinics. Tobin is widely known to be interested secutive budget surpluses, the province is Tobin — who in recent months has in succeeding Jean Chrétien as Liberal forecasting a deficit this year of $34.7 earned a national profile in his fight for party leader and as prime minister. A million. As well, the reinvestment will increased medicare spending, using tac- March Star poll of Liberals consume all of Newfoundland’s share of tics that critics say have more to do determined that Tobin ranks second a one-time Canada Health and Social with his own ambitions than with only to as a potential suc- Transfer payment, announced in Febru- health reform — has been under con- cessor to the prime minister. ary’s federal budget and amounting to siderable pressure to improve health Much of the extra money has been about $43 million. delivery on his home turf. earmarked for one-time capital expen- The disbursement could have been To that end, overall health-care ditures and hospital upgrading, includ- used over 4 years. Finance Minister spending in last week’s budget in- ing projects that were delayed in the Lloyd Matthews said he is “quite confi- creased $136 million to about $1.2 bil- belt-tightening 1990s. dent” that Ottawa will spend more on lion. The total provincial budget is The governors of the province’s re- health care in coming years. now $3.4 billion. “We have put our gional health care boards, which oper- In an interview with CMAJ, Health money where our mouth is,” Tobin ate hospitals and nursing homes, have Minister remarked, said on budget day, touting the plan as also been allotted extra money, but not “We’re confident that our gamble is a wise reaction to demonstrated needs. enough to cover existing deficits. More- not going to be a gamble. We think the He added that most other sectors of over, they have been asked to find at money will be there next year.” the government will hold tight to exist- least 1% of their budgets in cost-saving Part of the government’s confidence is rooted in the turnaround in New- foundland’s economy. For the last 2 Making her stamp on the globe years, real economic growth in the province has led the rest of the country, Canada’s medical missionaries, and in and is forecast to do so again, thanks particular Dr. Lucille Teasdale, have been largely to offshore oil production and a honoured with a new Canada Post stamp. diversified fishery. Teasdale, who ran a hospital in Uganda Grimes said the provincial govern- with her pediatrician husband for more ment has been under pressure to attend than 30 years, was one of Canada’s first to health, in part because of frequent female surgeons. She and her husband reports of inadequate access. He de- converted a 45-bed clinic in Gulu, scribed such reports as “partially politi- Uganda, into a 450-bed facility with sur- cally driven, partially based in reality.” gical and pediatric wards and schools for Tobin himself had built high expec- nurses, laboratory technicians, health ed- tations for a budget focused heavily on ucators and physicians. Teasdale, who better health care management. This was born in , earned the Order winter, he gave several high-profile of Canada, Order of Quebec and the speeches across the country on the state CMA’s F.N.G. Starr Award, as well as in- ternational acclaim. She died in Uganda of medicare. For instance, in Ottawa in in 1996 from complications relating to AIDS. The work of 5 Canadian January he described the “funding crisis physicians are celebrated in Canada Post’s Millennium Collection. in medicare” as a national “tragedy” and added his mission was to “issue a wake- up call.” — John Gushue, St. John’s

CMAJ • MAY 2, 2000; 162 (9) 1337

© 2000 Canadian Medical Association or its licensors