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HAMILTON — The federal New Democrats plan to make pharmacare a central issue in the next election if the Liberals do not meet the bar the opposition party has set for legislation to reduce the cost of prescription drugs.

The confidence-and-supply deal that sees the NDP supporting the minority Liberals on key votes in the House of Commons says the government will introduce a bill to create a framework for national pharmacare this year.

NDP members drew a line in the sand by passing an emergency resolution at their policy convention in Hamilton this weekend that says the party should withdraw its support if the Liberals do not commit to "a universal, comprehensive and entirely public pharmacare program."

The New Democratic Party's national director, Anne McGrath, said getting a bill that has teeth will be her party's biggest priority as parliamentarians return to the House of Commons this week.

And that if the NDP ends up walking away from the deal over the issue, she said in an interview on Sunday, then: "Pharmacare will be a ballot-box issue. Absolutely, it will be."

Singh shared a message of hope in his keynote speech to about 1,200 delegates at the party's policy convention on Saturday, with the NDP testing new language around "rebuilding Canada" as it tries to position itself as a party that can bring change. 

"We will build a Canada where we take care of each other. A Canada where we all rise together," said Singh, who received an 81 per cent confidence vote from delegates, down from the 87 per cent he received in 2021. 

Singh and his NDP caucus also threw their support behind the non-binding resolution on universal pharmacare, a topic that dominated the convention floor and was widely celebrated. 

"Weak legislation is not going to be acceptable to New Democrats," McGrath said.

"It has to be strong. It has to have teeth. And I feel like that resolution gave Jagmeet and the caucus a lot of bargaining power. It gives them a lot of strength."  

However, even if a bill is introduced by December, it is unclear when a program could be operational — and when Canadians could begin to save money when filling out their prescriptions.

The NDP's health critic, Don Davies, said pulling out of the deal does not mean the party will push to trigger an election, but instead would consider whether to support Liberal legislation one vote at a time.

The next federal election must occur no later than Oct. 20, 2025. But since the Liberals do not have a majority of the seats in the House of Commons, they must convince at least a dozen opposition MPs to vote with them in order to pass legislation and, crucially, survive confidence votes.

The agreement the Liberals and NDP, which has 25 MPs, entered into in March 2022 would see the opposition party support the minority government, and avoid triggering an election, until Parliament rises for the summer break in June 2025. In exchange, the Liberals have promised to take action on a list of shared priorities — including pharmacare.

"Whatever the next few months or years brings us, we know that we have to be ready for an election," McGrath said.

New Democrats, who have long campaigned to make universal access to prescription drugs part of the public health-care system, believe that pharmacare is an issue that separates them from the Liberals.

The Liberals did campaign on a promise to implement a national pharmacare program in the 2019 election, but made no such pledge when they went back to the polls in 2021.

During the NDP's three-day policy convention, delegates had carved out a plan to recruit candidates and hosted workshops for them while focusing on policies that address housing needs and the rising cost of living.

The party expects health care to be top of mind for voters in the next election, and noted the successful campaign of NDP premier-designate Wab Kinew in Manitoba, which focused heavily on the topic.

"They rejected the message of division that our opponents were peddling and they chose to embrace our message for the future of this province, which is to bring people together," Kinew said in a pre-recorded message that was played at the convention.

Singh took that message to heart, using his appearances at the convention to portray Conservative Leader Pierre Poilievre as angry and divisive.

Jennifer Howard, a former Manitoba NDP cabinet minister who is now chief of staff to Singh, said the party can also learn from the "phenomenal ground game" of their provincial cousins in the Oct. 3 election there.

"They got people to the advance votes early. They made sure that people who were in ridings that felt more secure were helping out people where they were trying to grow. They nominated candidates early," Howard said.

"And the message they put forward is very focused on things that matter to people, like health care and affordability."

John Harris, 23, a student activist and the son of former NDP MP Jack Harris, said pharmacare often comes up on the doorstep when he's door-knocking in Newfoundland and Labrador.

"We have seniors cutting pills or choosing between taking their medication or paying for food or rent or heating," he said. 

"And it's a very serious thing for people who don't have insurance."

The party has said it's looking to take back the Newfoundland riding of St. John's East, which Jack Harris held from 2008 to 2015 and again from 2019 to 2021, as well as Halifax, previously held by the NDP. Both are now represented by Liberals.

McGrath said the NDP has just under 50 candidates already nominated, but have names for each of the 338 ridings in Canada.

Party members and supports "want us to do whatever we can to make their lives better," she said, "and they want us to get ready for an election, and we're doing it."

This report by The Canadian Press was first published Oct. 15, 2023. 

Mickey Djuric, The Canadian Press