EDITOR’S NOTE: This article originally appeared in Parliament Today, a Village Media newsletter devoted to covering federal politics on Parliament Hill.
Federal Liberal leadership candidates called for more provincial accountability and transparency in how health transfers from Ottawa are used during Tuesday’s debate, while also pledging to remove barriers to allow professionals in the field to work anywhere in Canada.
The English-language debate saw the four remaining candidates vying to replace Prime Minister Justin Trudeau on March 9 debate Canada’s relationship with the United States, the economy and climate change, among other topics.
The participants included former Bank of Canada governor Mark Carney, former government House leader Karina Gould, former finance minister Chrystia Freeland and former MP Frank Baylis.
Halfway through the debate, moderator Hannah Thibedeau asked a question about health care, a sector that is primarily within provincial and territorial responsibility, noting that Canadians are worried they can’t access a doctor or a nurse.
“What would you do as prime minister, working with the provinces of course because it is provincial jurisdiction … to help solve the issue?” she asked.
While the federal government transfers funding to provinces and territories, it is up to premiers to deliver those services.
Common responses did not include pharmacare or dental care, but featured a call for greater transparency in how federal transfers are used while ensuring health-care professionals can travel across the country to provide services.
They also vowed to help expedite credentials for foreign-trained doctors.
“In many cases, access to a health-care professional, it's not possible. Health care is a right in Canada. We are not living up to our commitments,” Carney said.
The federal government has offered $200 billion in health transfers to provinces over 10 years, a $46 billion increase fuelled by requests from premiers as they recover from the COVID-19 pandemic. Ontario, for example, signed a bilateral agreement in 2023 that was finalized in February 2024, with $3.1 billion over three years earmarked for creating new primary health-care teams, opening up spots in medical education programs and upgrading health data reporting.
In total, Ontario is set to get about $8.4 billion over a decade, with another $776 million as part of an emergency top up. Doug Ford, who was premier at the time and is in the home stretch of a provincial campaign that wraps up on Thursday, called the money a “down payment on future discussions.”
But Gould asked where that money was being used.
“When it comes to health transfers, we need greater accountability from provinces, not to the federal government but to their own citizens on the outcomes that they expect to deliver for their citizens,” Gould said.
“It can go into the general revenues of provinces and territories, and we have no way of knowing how that money is spent.”
Freeland, meanwhile, praised the work done to increase health transfers, saying the federal government “stepped up” when they saw the system under “unbearable strain after COVID.”
She also said there is an opportunity to use technology to reduce red tape, but ultimately agreed that “transparency is the winning ticket.”
“Having real transparency on health-care outcomes across the country would help all Canadians, and it would help Canadians to see what's working and what isn't,” she said.
“But I do want to say to the premiers of the provinces and territories, I respect your work running the health-care systems.”
Baylis went even further, arguing a systematic “change in paradigm” is needed, saying that pharmacists need to expand their scope of practice, more nurses need to be trained and more investments need to be made in home care.
Health care has been a fixture of the Ontario Liberal Party election platform over the last month, with Leader Bonnie Crombie — who recently endorsed Carney for prime minister — pledging to get everyone a family doctor by 2029.
She also said in her platform that the Liberals would audit how Ontario is using the federal health transfers it receives each year.
It should be noted that Ford, who is running for re-election, made legislative changes that address some of Baylis’ concerns, such as removing some barriers to out-of-province health-care workers and allowing pharmacists to diagnose more ailments.
Canada’s relationship with the U.S.
The first half of the debate was primarily about the threat of U.S. President Donald Trump, with each leader trying to prove they are the right one to counter a possible trade war between the neighbouring countries.
Trump has indicated that the 25 per cent tariffs on Canadian goods would be imposed on March 4 following the 30-day pause negotiated by Trudeau. The new Liberal leader and therefore prime minister will be chosen on March 9, meaning that one of their first acts will be to deal with any fallout if those tariffs are implemented.
Carney and Gould both said the first thing they would do once prime minister would be to call Canada’s premiers to share the federal government’s plan and ensure everyone was on the same page.
Dollar-for-dollar tariffs were suggested as retaliation, with Carney saying Canada should put the U.S. on notice in terms of the commercial relationship the two countries hold.
“Then I would call President Trump,” Carney said. “It’s going to be a long day.”
Freeland said Canada’s retaliatory tariffs should “be a lot smarter than their dumb tariffs” and target products like Tesla, Wisconsin dairy and Florida orange juice. She also said she would work closely with Canada’s democratic and military allies, starting with Nordic partners and European NATO allies.
All party leaders committed to reaching the NATO goal of spending two per cent of GDP on defence spending, with Gould and Freeland saying they would do so by 2027.
Carney said he could commit to 2030, as planned by the current Liberal government, with the possibility of expediting the timeline, while Baylis pushed back saying that it was more important to spend the money wisely than to spend it just to meet a target.
“There is a lot of uncertainty. But it’s important to distinguish what you can and cannot control,” Carney noted in his opening statement. “We can’t change Donald Trump, but we can control our economic destiny.”
No more consumer carbon tax
Carney said he supports “canning” the consumer carbon tax because the issue has become “too divisive for Canadians.” He also noted that it makes up less than 10 per cent of Canada’s emissions reductions.
Freeland, who has been in Trudeau’s cabinet since 2015 before resigning last fall, agreed with the sentiment, saying that "democracy is about listening to people.”
“Canadians were very clear with us, in conversations with me, that they didn't think that policy worked for them,” she added.
Gould said she would keep the consumer carbon tax but will freeze the scheduled April increase.
“Politics is also about leadership, and it's also about conviction. And I'm not going to abandon the fight against climate change because (CPC Leader) Pierre Poilievre is telling us to do that,” she said.