Political leaders across Canada are teaming up with doctors and nurses for the first time to develop national standards for delivering primary health-care services, including treating chronic diseases.

The goal is to protect the countrys cherished universal system at a time when chronic disease is on the rise and provinces are under pressure to rein in health-care costs. But the initiative runs the risk of stalling unless the Ontario government ends its bitter standoff with the provinces doctors over fees.

We are not going to transform health care for the benefit of Canadians unless there is a co-operative approach, Canadian Medical Association president John Haggie said on Friday at a meeting of provincial and territorial health ministers in Toronto. You cant coerce goodwill from people, and you cant make a system change by fiat.

The health-care practitioners with the knowhow and the politicians with the power to make change all need to be in the same room, Dr. Haggie said at a news conference.

In an effort to create momentum, the meeting was led by Saskatchewan Premier Brad Wall and Prince Edward Island Premier Robert Ghiz, co-chairs of a working group on health-care innovation. Mr. Wall pledged during the news conference to move quickly and deliver a report to his provincial colleagues in July at the premiers annual meeting.

It cant just be a report that gathers dust, he said.

This is not the first time premiers have tried to develop a pan-Canadian approach to health care. At their annual meeting in 2010, they unveiled plans to set up a national agency that would be responsible for purchasing prescription drugs. But Mr. Wall and Mr. Ghiz both expressed frustration that little progress has been made in using the provinces combined purchasing power to lower drug costs.

The premiers are now turning their attention to improving primary health care and clinical practices as most regions confront an aging population, coupled with a growing numbers of Canadians suffering from diabetes and other chronic diseases.

Judith Shamian, president of the Canadian Nurses Association, told reporters this country is very good at delivering acute care in hospitals. But it lags other developed countries in primary care, including services to keep seniors in their homes longer.

Dr. Shamian acknowledged that the collaborative initiative could have started sooner. But better later than never, she said.

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Initiative seeks pan-Canadian approach to health care