This enactment amends the Canada Health Act to add to the requirements that a province must meet in order to qualify for a full cash contribution the criterion of accountability in relation to the timely delivery of health services. It also provides for the referral of certain defaults to arbitration for determination.

Her Majesty, by and with the advice and consent of the Senate and House of Commons of Canada, enacts as follows:

Additional criterion — accountability

7.‍1 In addition to meeting the other requirements of this Act, in order that a province may qualify for a full cash contribution referred to in section 5 for a fiscal year, the law of the province must, throughout the fiscal year, satis­fy the criterion described in section 12.‍1 respecting accountability.

Accountability

12.‍1 In order to satisfy the criterion respecting accountability, the law of a province

• (a) must provide for measures to ensure that insured health services are delivered in a timely manner that meets reasonable standards of care;

• (b) must provide that legal proceedings may be brought against the government of the province in respect of insured health services that are not delivered in a timely manner; and

• (c) must permit an insured person to receive hospital services, physician services or surgical-dental services that are provided outside the health care insurance plan of the province if there is no reasonable access to care under the plan.

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Referral to arbitration

14 (1) Subject to subsection (3), the Minister shall refer a matter to Insertion start arbitration if Insertion end the Minister, after consultation in accordance with subsection (2) with the minister responsible for health care in a province, is of the opinion that Insertion start a default described in any of paragraphs (a) to (c) is occurring in the province Insertion end and the province has not given an undertaking satisfactory to the Minister to remedy the default within a period that the Minister considers reasonable:

• (a) the health care insurance plan of the province does not or has ceased to satisfy any one of the criteria described in sections 8 to 12;

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  (b) the law of a province does not or has ceased to satis­fy the criterion described in section 12.‍1; or

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• Insertion start (c) Insertion end  the province has failed to comply with any condition set out in section 13.

Consultation process

(2) Before referring a matter to Insertion start arbitration Insertion end under subsection (1) in respect of a province, the Minister shall

When no consultation can be achieved

(3) The Minister may act without consultation under subsection (1) if the Minister is of the opinion that a sufficient time has expired after reasonable efforts to achieve consultation and that consultation will not be achieved. Insertion start However, the Minister shall first notify in writing the minister responsible for health care in the province that the matter is to be referred to arbitration Insertion end .

Request

(4) On referring a matter to arbitration, the Minister shall make a written request to the chief justice of the superior court of the province in which the matter arises to appoint a judge of that court to act as arbitrator.

Appointment of arbitrator

(5) Within a reasonable period after receipt of a request referred to in subsection (4), the chief justice shall, after any inquiry that he or she considers necessary, appoint a judge as arbitrator.

Joint statement

(6) On the appointment of an arbitrator, the parties shall prepare a joint statement of the issues in dispute and shall submit that statement to the arbitrator.

Hearing

(7) Within 21 days after being appointed, the arbitrator shall hold a hearing.

Determination

(8) Within 60 days after being appointed, the arbitrator shall determine whether a default described in any of paragraphs (1)‍(a) to (c) is occurring in the province and advise the Minister of his or her determination.

Judges Act

(9) Subsection 57(3) of the Judges Act does not apply in respect of a judge acting as an arbitrator under this Act.

Order reducing or withholding contribution

15 (1)  Insertion start If Insertion end , on the referral of a matter under section 14, Insertion start the arbitrator’s determination is Insertion end that the health care insurance plan of a province does not or has ceased to satisfy any one of the criteria described in sections 8 to 12, Insertion start that the law of a province does not or has ceased to satisfy the criterion described in section 12.‍1 Insertion end or that a province has failed to comply with any condition set out in section 13, Insertion start the Minister shall so inform Insertion end the Governor in Council Insertion start who Insertion end may, by order,

Reimposition of reductions or withholdings

16 In the case of a continuing failure to satisfy any of the criteria described in sections 8 to Insertion start 12.‍1 Insertion end or to comply with any condition set out in section 13, any reduction or withholding under section 15 of a cash contribution to a province for a fiscal year shall be reimposed for each succeeding fiscal year as long as the Minister is satisfied, after consultation with the minister responsible for health care in the province, that the default is continuing.