Prime Minister Justin Trudeau has written back to Canada's provincial and territorial premiers, saying he will not commit to personally meet with them to discuss a new health accord before mid-December.

In a letter sent to Trudeau last month, the premiers asked for a face-to-face meeting with Trudeau on health funding — adding they wanted that commitment before a planned first ministers' meeting on climate takes place in November.

But in a reply sent last week, obtained by CBC News, Trudeau said that he will instead let Health Minister Jane Philpott meet with her provincial counterparts as planned and see what happens from there.

"The federal-provincial-territorial health ministers meeting on Oct. 18, 2016, presents an opportunity to further advance joint work on specific actions under each of the shared health priorities," Trudeau wrote in his response.

"I look forward to learning about progress being made and to working with you to determine next steps."

In his letter, Trudeau referred to a five-year accord, half the term of the 10-year deal former prime minister Paul Martin struck with the provinces in 2004.

The Conservatives kept that deal in place, extending the funding increase of six per cent annually up to the end of this fiscal year, after which the annual increase would drop to a minimum of three per cent.

Trudeau's dispatch was in response to a Sept. 15. letter sent to him by Darrell Pasloski, premier of Yukon and chair of the Council of the Federation that represents all provincial and territorial leaders.

That letter asked for a meeting between the premiers and Trudeau "solely dedicated to long-term health-care financing before mid-December," and asked that the commitment to hold that meeting come in advance of the meeting with Trudeau to discuss a national climate change policy.

If no meeting could be set between Trudeau and the first ministers by that time, Pasloski asked the prime minister to postpone the change to the Canada health transfer for "at least one year."

Federal, provincial tug of war

The premiers have been vocal in their displeasure with the reduced annual health transfer increase, which begins on April 1, 2017.

The provinces and territories have also expressed concern with Trudeau's plan to introduce an additional $3 billion in federal health money for a national home-care plan. The premiers say health care is their jurisdiction and any new health money should come without strings attached.

A planned photo op between Trudeau and the first ministers at the Council of the Federation meeting in Whitehorse in July to celebrate federal changes to the Canada Pension Plan was called off when it was made clear to Trudeau that if he showed up he would have to talk health funding.

Trudeau notes in his letter, dated Sept. 30, that "after a decade of federal disengagement by the previous government" Philpott is engaging with the provinces to work on a new deal.