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       Liberal Leader Justin Trudeau makes a campaign stop at Soccer World in Hamilton, Ont., on Sept. 10.

       Sean Kilpatrick/The Canadian Press

       Liberal Leader Justin Trudeau says he respects provincial jurisdiction on health care, but still intends to attach strings to the $25 billion in new health funding he has promised if he gets re-elected.

       The Liberal plan includes targeted funding over five years to hire 7,500 new family doctors, raise wages for personal support workers in long-term care and a new direct transfer for mental health that will rise to $2 billion annually by 2025-26.

       “I think Canadians know that we need better health-care systems across the country,” Trudeau said, speaking inside a soccer dome in Hamilton on Friday. “We saw that during this pandemic.”

       But last spring the premiers asked for an immediate $28-billion increase to the annual Canada Health Transfer followed by a six per cent increase a year. The premiers say the $43-billion Canada Health Transfer this year covers only about one-fifth of the cost of providing health care.

       They say a $28-billion injection would bring the federal share to more than one-third.

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       A 2004 agreement between Ottawa and the provinces under Liberal prime minister Paul Martin set the formula for health transfers to grow at six per cent annually for a decade. In 2011, the Conservative government of prime minister Stephen Harper said the six per cent increases would remain until 2016-17, after which it would grow at a minimum of three per cent, or a three-year average of economic growth, whichever is higher.

       Trudeau’s Liberals have maintained that formula and, since 2017-18, the increase has grown by an average of 3.64 per cent.

       Trudeau has previously said he is willing to renegotiate the federal transfer program after the pandemic, but immediate funding is needed to address specific issues in long-term care, mental health and a backlog of surgeries and testing, which grew as the health-care system was forced to pivot to respond to COVID-19.

       “Yes, we respect premiers delivery on health care, but we are going to make sure that the investments the federal government puts towards health care across the country delivers results for Canadians,” he said.

       Trudeau said Conservative Leader Erin O’Toole is promising “all the money to the provinces, no strings attached” without any interest in whether the efficiencies and proper services needed are achieved.

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       “I’m not saying that and that’s a very important and distinctive point,” he said. “I’m going to make sure the Canadian tax dollars go towards delivering the results that Canadians need.”

       O’Toole’s plan doesn’t include the $28-billion immediate boost to the health transfer either. He has promised to increase transfers back to the six per cent a year formula for a decade and says that will increase health spending by $60 billion over that time frame.

       But his party’s costing document is based on economic projections that suggest the transfer is already set to rise by close to that amount for the next several years because it is based on economic growth.

       Over the next five years, the Conservatives’ promise adds $3.6 billion to the transfer, their costing document indicates.

       O’Toole said his plan provides the provinces with stable funding for a decade.

       Trudeau is also promising to use the Canada Health Act to go after provinces that allow private clinics to charge patients for medically necessary services.

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       The Liberals already added new regulations to the Canada Health Act to specifically mention diagnostic testing as a medically necessary service to try and stop Saskatchewan from allowing private MRI clinics in Regina from charging some patients for tests as long as they provide the same number of tests for free to people on the public waiting list.

       They’re planning to add abortions to the Act now as well.

       The act spells out the conditions for the federal health transfer program and allows the government to claw back transfers to the province in the amount that was charged directly to patients.

       O’Toole has indicated he will allow provinces to decide how best to run their systems, and has been evasive on how far he would allow provinces to go in charging patients directly for services that are covered under the Canada Health Act.

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