Prime Minister Paul Martin says he wants a "real, not a symbolic fix" to the health care file.

And if that takes more than the one meeting scheduled with the premiers for next week, so be it, he told reporters in Kelowna, B.C. on Wednesday.

Martin and his cabinet finished two days of meetings in the Okanagan Valley city to prepare for both the three-day health care summit -- which starts Monday -- and the opening of Parliament, which is scheduled for Oct. 4.

"There is one thing that's crystal clear; we want a 10-year plan" on health care, he said in French.

"We've seen two accords, and maybe within a matter of months, maybe a year, all of a sudden those accords have been re-opened and people have come back to the table," he said.

"What we believe is required is an agreement that will in fact set out a plan for 10 years."

However, the accord won't deal with such things as training medical professionals, he added.

"There are going to be transitions that are going to be required as we proceed to home care, as we to proceed to a better information network ... you can't do that with a quick fix."

The provinces want predictable funding, and that means long-term, he said.

In addition, Martin said he was prepared to be flexible in that the accord could include deals with individual provinces.

"We all have the same objectives. How you arrive at those objectives may well depend upon the circumstances of an individual province ..."

Equalization payments could be a part of the deal, Martin said -- although he wouldn't confirm or deny a report he would increase such payments by $1.3 billion annually as part of the deal.

Martin has made fixing the health care system, particularly reducing waiting times, a central focus of his government.

But the government had an overall heavy legislative agenda, with initiatives coming in early childhood development and cities.

Some rumours in recent days had the Liberals engineering a confrontation with the premiers -- one that would lead to an election call (Canadians last went to the polls on June 28 and elected a Liberal minority government).

"We're not here electioneering. We're here to govern," Martin said.

Senate rumblings

One reason Martin held a full 37-member cabinet meeting in Kelowna was to help reduce Western alienation.

An issue that has angered some Westerners is the Senate. An early focus of the old Reform Party was an equal, elected and effective Senate. Alberta even has two elected senators in waiting.

"We will (fill the 15 current vacancies) do so in due course. It will be through the method that exists," Martin said.

The prime minister appoints senators.

CTV's Craig Oliver asked Martin about the realistic chance of reaching a deal after two or three days of televised talks.

"I think that remains to be seen," Martin said. "I do think that before this process is over that we will have a long-term agreement."

When the premiers first met in late July, they wanted Ottawa to pay for a comprehensive national pharmacare program. Cost estimates for it range between $7.5 and $12 billion annually.

Various senior ministers have essentially said that won't happen.

Asked if he would tell B.C. Premier Gordon Campbell that pharmacare won't fly, Martin said no.

"What we said during the election campaign is that we want to see established a national strategy to deal with pharmacare and catastrophic drug costs," he said.

"We have said we would like to do it together with the provinces ... we think there are a lot of things we can do working together."

What it means

Rosemary Thompson, deputy Ottawa bureau chief for CTV, told CTV Newsnet her sources are saying that cabinet discussions are turning on how much to spend on health care.

"Health care is a very important issue, but it's not the only issue on Canadians' agenda," she said.

The premiers sense Martin is in a politically vulnerable position, so they want to press him for every dollar they can, she said.

"It's going to be a tough slog ... because the prime minister is holding the purse strings pretty tightly."

Martin's election commitment was for $9 billion over five years, "but the premiers said last week that isn't enough," she said.

Thompson said expectations were raised very high for next week's health summit.

"What the prime minister is trying to do today is lower expectations and say, 'well, if we don't get a deal it's still not a failure," she said.

"He ran on health care. It was his number one issue. He wants to get some kind of movement on this issue before the next election, but he wants to give himself a little bit of breathing room if he doesn't succeed next week."