37th PARLIAMENT,
3rd SESSION
EDITED HANSARD • NUMBER 052
CONTENTS
Tuesday, May 11, 2004
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Routine Proceedings
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Committees of the House |
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Environment and Sustainable Development |
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Hon. Charles Caccia (Davenport, Lib.) |
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Petitions |
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Taxation |
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Mr. Jay Hill (Prince George—Peace River, CPC) |
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Marriage |
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Mr. Darrel Stinson (Okanagan—Shuswap, CPC) |
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Hon. Andrew Telegdi (Kitchener—Waterloo, Lib.) |
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Health |
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Mr. Garry Breitkreuz (Yorkton—Melville, CPC) |
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Marriage |
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Mr. Garry Breitkreuz (Yorkton—Melville, CPC) |
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Radio Canada International |
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Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP) |
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Immigration |
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Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP) |
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Trans Fats |
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Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP) |
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Labelling of Alcoholic Beverages |
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Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP) |
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Questions on the Order Paper |
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Hon. Roger Gallaway (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.) |
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Government Orders
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Supply |
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Allotted Day--Health Care |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Hon. Bill Blaikie (Winnipeg—Transcona, NDP) |
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The Deputy Speaker |
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Hon. Bill Blaikie |
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Mr. Jay Hill (Prince George—Peace River, CPC) |
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Hon. Bill Blaikie |
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Mr. Stockwell Day (Okanagan—Coquihalla, CPC) |
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Hon. Bill Blaikie |
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Mrs. Carol Skelton (Saskatoon—Rosetown—Biggar, CPC) |
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Hon. Bill Blaikie |
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Mr. Maurice Vellacott (Saskatoon—Wanuskewin, CPC) |
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Hon. Bill Blaikie |
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Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.) |
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The Deputy Speaker |
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Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ) |
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Hon. Pierre Pettigrew |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Hon. Pierre Pettigrew |
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Hon. Carolyn Bennett (Minister of State (Public Health), Lib.) |
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Mr. Jay Hill (Prince George—Peace River, CPC) |
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Hon. Carolyn Bennett |
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Ms. Wendy Lill (Dartmouth, NDP) |
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Hon. Carolyn Bennett |
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Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ) |
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Mr. Paul Szabo (Mississauga South, Lib.) |
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Mr. Réal Ménard |
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The Deputy Speaker |
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Mr. Yves Rocheleau (Trois-Rivières, BQ) |
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Mr. Réal Ménard |
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The Deputy Speaker |
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Mr. Pierre Paquette (Joliette, BQ) |
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Mr. Réal Ménard |
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Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.) |
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Mr. Réal Ménard |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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The Deputy Speaker |
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Mrs. Bev Desjarlais |
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Mr. Paul Szabo (Mississauga South, Lib.) |
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Mrs. Bev Desjarlais |
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Ms. Wendy Lill (Dartmouth, NDP) |
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Mrs. Bev Desjarlais |
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Mr. Julian Reed (Halton, Lib.) |
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Ms. Wendy Lill (Dartmouth, NDP) |
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Mr. Julian Reed |
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Mr. Murray Calder (Dufferin—Peel—Wellington—Grey, Lib.) |
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Mr. Pat Martin (Winnipeg Centre, NDP) |
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Mr. Murray Calder |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Mr. Murray Calder |
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Mr. Rob Merrifield (Yellowhead, CPC) |
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Mr. Paul Szabo (Mississauga South, Lib.) |
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Mr. Rob Merrifield |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Mr. Rob Merrifield |
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Mrs. Bev Desjarlais |
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Mr. Rob Merrifield |
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Mr. Paul Szabo (Mississauga South, Lib.) |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Mr. Paul Szabo |
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Mr. Paul Forseth (New Westminster—Coquitlam—Burnaby, CPC) |
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Mr. Paul Szabo |
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Mrs. Elsie Wayne (Saint John, CPC) |
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Mr. Paul Szabo |
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Ms. Libby Davies (Vancouver East, NDP) |
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Mr. Paul Szabo |
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Ms. Wendy Lill (Dartmouth, NDP) |
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The Acting Speaker (Mr. Bélair) |
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STATEMENTS BY MEMBERS
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Princess Patricia's Canadian Light Infantry |
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Ms. Anita Neville (Winnipeg South Centre, Lib.) |
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Equalization Payments |
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Mr. Brian Fitzpatrick (Prince Albert, CPC) |
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Notre-Dame-de-Grâce Community Council |
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Mrs. Marlene Jennings (Notre-Dame-de-Grâce—Lachine, Lib.) |
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Police Officers |
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Mrs. Elsie Wayne (Saint John, CPC) |
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McMaster Children's Hospital |
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Ms. Beth Phinney (Hamilton Mountain, Lib.) |
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Member for Vancouver Kingsway |
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Mr. Charles Hubbard (Miramichi, Lib.) |
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National Nursing Week |
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Mr. Rahim Jaffer (Edmonton—Strathcona, CPC) |
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Employment Insurance |
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Mr. Gérard Binet (Frontenac—Mégantic, Lib.) |
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The Prime Minister |
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Ms. Monique Guay (Laurentides, BQ) |
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Employment Insurance |
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Mr. Andy Savoy (Tobique—Mactaquac, Lib.) |
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Justice |
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Mrs. Carol Skelton (Saskatoon—Rosetown—Biggar, CPC) |
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Seasonal Workers |
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Mr. Christian Jobin (Lévis-et-Chutes-de-la-Chaudière, Lib.) |
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National Nursing Week |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Sponsorship Program |
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Mr. Pierre Paquette (Joliette, BQ) |
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Le Baluchon |
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Ms. Yolande Thibeault (Saint-Lambert, Lib.) |
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The Speaker |
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Prime Minister of Canada |
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Mr. David Chatters (Athabasca, CPC) |
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Lindsay Kinsmen Band |
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Mr. John O'Reilly (Haliburton—Victoria—Brock, Lib.) |
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Inuit History Travelling Exhibit |
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Ms. Nancy Karetak-Lindell (Nunavut, Lib.) |
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ORAL QUESTION PERIOD
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Government Contracts |
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Hon. Stephen Harper (Leader of the Opposition, CPC) |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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Hon. Stephen Harper (Leader of the Opposition, CPC) |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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The Speaker |
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Sponsorship Program |
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Hon. Stephen Harper (Leader of the Opposition, CPC) |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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Mr. Peter MacKay (Pictou—Antigonish—Guysborough, CPC) |
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The Speaker |
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Mr. Peter MacKay |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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Mr. Peter MacKay (Pictou—Antigonish—Guysborough, CPC) |
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The Speaker |
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Hon. Reg Alcock (President of the Treasury Board and Minister responsible for the Canadian Wheat Board, Lib.) |
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Mr. Gilles Duceppe (Laurier—Sainte-Marie, BQ) |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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The Speaker |
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Mr. Gilles Duceppe (Laurier—Sainte-Marie, BQ) |
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Hon. Jacques Saada (Leader of the Government in the House of Commons and Minister responsible for Democratic Reform, Lib.) |
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Mr. Michel Gauthier (Roberval, BQ) |
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Hon. Jacques Saada (Leader of the Government in the House of Commons and Minister responsible for Democratic Reform, Lib.) |
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Mr. Michel Gauthier (Roberval, BQ) |
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The Speaker |
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Hon. Jacques Saada (Leader of the Government in the House of Commons and Minister responsible for Democratic Reform, Lib.) |
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Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP) |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP) |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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Mrs. Diane Ablonczy (Calgary—Nose Hill, CPC) |
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Hon. Stephen Owen (Minister of Public Works and Government Services, Lib.) |
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Mrs. Diane Ablonczy (Calgary—Nose Hill, CPC) |
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Hon. Stephen Owen (Minister of Public Works and Government Services, Lib.) |
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Mr. Jason Kenney (Calgary Southeast, CPC) |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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The Speaker |
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Mr. Jason Kenney (Calgary Southeast, CPC) |
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The Speaker |
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Mr. Jason Kenney |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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Employment Insurance |
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Mr. Paul Crête (Kamouraska—Rivière-du-Loup—Témiscouata—Les Basques, BQ) |
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Hon. Joseph Volpe (Minister of Human Resources and Skills Development, Lib.) |
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Mr. Paul Crête (Kamouraska—Rivière-du-Loup—Témiscouata—Les Basques, BQ) |
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Hon. Joseph Volpe (Minister of Human Resources and Skills Development, Lib.) |
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Mr. Michel Guimond (Beauport—Montmorency—Côte-de-Beaupré—Île-d'Orléans, BQ) |
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Hon. Joseph Volpe (Minister of Human Resources and Skills Development, Lib.) |
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Mr. Michel Guimond (Beauport—Montmorency—Côte-de-Beaupré—Île-d'Orléans, BQ) |
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Hon. Joseph Volpe (Minister of Human Resources and Skills Development, Lib.) |
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Gasoline Prices |
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Mr. David Chatters (Athabasca, CPC) |
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Hon. R. John Efford (Minister of Natural Resources, Lib.) |
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Mr. David Chatters (Athabasca, CPC) |
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Hon. R. John Efford (Minister of Natural Resources, Lib.) |
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The Environment |
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Mr. James Moore (Port Moody—Coquitlam—Port Coquitlam, CPC) |
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Hon. Ralph Goodale (Minister of Finance, Lib.) |
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Airline Industry |
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Mr. James Moore (Port Moody—Coquitlam—Port Coquitlam, CPC) |
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Hon. Tony Valeri (Minister of Transport, Lib.) |
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Health |
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Mr. Andy Savoy (Tobique—Mactaquac, Lib.) |
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Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.) |
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The Speaker |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.) |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.) |
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Government Contracts |
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Mr. Garry Breitkreuz (Yorkton—Melville, CPC) |
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Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.) |
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Mr. Garry Breitkreuz (Yorkton—Melville, CPC) |
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Hon. Stephen Owen (Minister of Public Works and Government Services, Lib.) |
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Veterans Affairs |
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Mr. Rick Casson (Lethbridge, CPC) |
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Hon. John McCallum (Minister of Veterans Affairs, Lib.) |
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Mr. Rick Casson (Lethbridge, CPC) |
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The Speaker |
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Hon. John McCallum (Minister of Veterans Affairs, Lib.) |
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Iraq |
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Ms. Francine Lalonde (Mercier, BQ) |
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Hon. Bill Graham (Minister of Foreign Affairs, Lib.) |
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Ms. Francine Lalonde (Mercier, BQ) |
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Hon. Bill Graham (Minister of Foreign Affairs, Lib.) |
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The Speaker |
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Fisheries |
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Mr. Loyola Hearn (St. John's West, CPC) |
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Hon. Geoff Regan (Minister of Fisheries and Oceans, Lib.) |
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Mr. Loyola Hearn (St. John's West, CPC) |
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Hon. Geoff Regan (Minister of Fisheries and Oceans, Lib.) |
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Foreign Affairs |
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Mr. Sarkis Assadourian (Brampton Centre, Lib.) |
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Hon. Bill Graham (Minister of Foreign Affairs, Lib.) |
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Government Orders
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Supply |
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Allotted Day--Health Care |
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Ms. Wendy Lill (Dartmouth, NDP) |
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The Speaker |
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Ms. Wendy Lill |
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Mr. Peter Stoffer (Sackville—Musquodoboit Valley—Eastern Shore, NDP) |
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Ms. Wendy Lill |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Ms. Wendy Lill |
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Mr. Peter Stoffer (Sackville—Musquodoboit Valley—Eastern Shore, NDP) |
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Ms. Marlene Catterall (Ottawa West—Nepean, Lib.) |
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Mr. Peter Stoffer |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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Mr. Peter Stoffer |
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Hon. Lorne Nystrom (Regina—Qu'Appelle, NDP) |
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Mr. Peter Stoffer |
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Hon. Hedy Fry (Parliamentary Secretary to the Minister of Citizenship and Immigration, Lib.) |
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The Acting Speaker (Mr. Bélair) |
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Hon. Hedy Fry |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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The Acting Speaker (Mr. Bélair) |
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Hon. Hedy Fry |
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Ms. Libby Davies (Vancouver East, NDP) |
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Hon. Hedy Fry |
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Mr. Peter Stoffer (Sackville—Musquodoboit Valley—Eastern Shore, NDP) |
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Hon. Hedy Fry |
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Hon. Lorne Nystrom (Regina—Qu'Appelle, NDP) |
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Hon. Hedy Fry |
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Ms. Christiane Gagnon (Québec, BQ) |
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The Acting Speaker (Mr. Bélair) |
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Ms. Christiane Gagnon |
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The Acting Speaker (Mr. Bélair) |
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Ms. Libby Davies (Vancouver East, NDP) |
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Ms. Christiane Gagnon |
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Ms. Libby Davies |
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Ms. Christiane Gagnon |
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The Acting Speaker (Mr. Bélair) |
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Mr. Jean-Yves Roy (Matapédia—Matane, BQ) |
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The Acting Speaker (Mr. Bélair) |
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Business of the House |
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[------] |
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Ms. Diane St-Jacques (Shefford, Lib.) |
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The Acting Speaker (Mr. Bélair) |
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(Motion agreed to)
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Supply |
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Allotted Day--Health Care |
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Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.) |
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Mr. Jean-Yves Roy |
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Mr. Jeannot Castonguay |
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Mr. Jean-Yves Roy |
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Hon. Jim Karygiannis (Parliamentary Secretary to the Minister of Transport, Lib.) |
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Hon. Jim Karygiannis |
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Mr. Richard Harris (Prince George—Bulkley Valley, CPC) |
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The Acting Speaker (Mr. Bélair) |
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Hon. Jim Karygiannis |
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Ms. Libby Davies (Vancouver East, NDP) |
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The Acting Speaker (Mr. Bélair) |
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Hon. Jim Karygiannis |
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Mr. Art Hanger (Calgary Northeast, CPC) |
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Hon. Jim Karygiannis |
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Mr. James Moore (Port Moody—Coquitlam—Port Coquitlam, CPC) |
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The Acting Speaker (Mr. Bélair) |
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Hon. Jim Karygiannis |
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The Acting Speaker (Mr. Bélair) |
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Hon. Jim Karygiannis |
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Hon. Lorne Nystrom (Regina—Qu'Appelle, NDP) |
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The Deputy Speaker |
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Mr. James Moore (Port Moody—Coquitlam—Port Coquitlam, CPC) |
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Hon. Lorne Nystrom |
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Mr. James Moore |
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The Deputy Speaker |
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Hon. Lorne Nystrom |
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Mr. Dick Proctor (Palliser, NDP) |
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Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.) |
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Mr. Dick Proctor |
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Mrs. Lynne Yelich (Blackstrap, CPC) |
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Mr. Dick Proctor |
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The Deputy Speaker |
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Private Members' Business
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Criminal Code |
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Mrs. Lynne Yelich (Blackstrap, CPC) |
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Mr. James Moore (Port Moody—Coquitlam—Port Coquitlam, CPC) |
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The Deputy Speaker |
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Mr. James Moore |
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Hon. Sue Barnes |
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The Deputy Speaker |
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Mr. James Moore |
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Mrs. Bev Desjarlais (Churchill, NDP) |
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The Deputy Speaker |
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Mr. Leon Benoit (Lakeland, CPC) |
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The Deputy Speaker |
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ADJOURNMENT PROCEEDINGS
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Health |
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Right Hon. Joe Clark (Calgary Centre, PC) |
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Hon. Reg Alcock (President of the Treasury Board and Minister responsible for the Canadian Wheat Board, Lib.) |
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Right Hon. Joe Clark |
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Hon. Reg Alcock |
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The Deputy Speaker |
CANADA
OFFICIAL REPORT (HANSARD)
Tuesday, May 11, 2004
Speaker: The Honourable Peter Milliken
The House met at 10 a.m.
Prayers
Routine Proceedings
[Routine Proceedings]
* * *
(1000)
[Translation]
Committees of the House
Environment and Sustainable Development
Hon. Charles Caccia (Davenport, Lib.):
Mr. Speaker, pursuant to the order of reference of Friday, May 7, 2004, your committee has considered Bill C-34, an act to amend the Migratory Birds Convention Act, 1994 and the Canadian Environmental Protection Act, 1999, and agreed, on Monday, May 10, 2004, to report it without amendment.
I want to thank the hon. members who supported this bill and helped facilitate the completion of the work.
* * *
(1005)
[English]
Petitions
Taxation
Mr. Jay Hill (Prince George—Peace River, CPC):
Mr. Speaker, it is indeed a pleasure for me to rise this morning to present to the House a petition signed by individuals from Braeside, Arnprior, Renfrew and Perth in Ontario, and from Lampman, Weyburn, Tribune, St. Walburg and Carnduff in Saskatchewan. The petitioners draw the attention of the House to the fact that adoptive parents make a significant social contribution to our society and often face significant adoption related costs, but out of pocket adoption expenses are not tax deductible.
Therefore, they are calling upon Parliament to pass legislation to provide an income tax deduction for expenses related to the adoption of a child, as contained in the private member's bill, Bill C-246.
* * *
Marriage
Mr. Darrel Stinson (Okanagan—Shuswap, CPC):
Mr. Speaker, on behalf of my constituents of Okanagan—Shuswap, I am pleased to present a petition calling upon Parliament to pass legislation to recognize the institution of marriage in federal law as being the lifelong union of one man and one woman to the exclusion of all others.
Hon. Andrew Telegdi (Kitchener—Waterloo, Lib.):
Mr. Speaker, I am going to be tabling a number of petitions. They call on Parliament to invoke the notwithstanding clause and pass a law so that only two persons of the opposite sex can be married. Approximately 100 people have signed the petitions.
* * *
(1010)
Health
Mr. Garry Breitkreuz (Yorkton—Melville, CPC):
Mr. Speaker, the first petition that I would like to present concerns my woman's right to know act. I am presenting petitions signed by 3,263 concerned Canadians from across Canada who support my woman's right to know act. These petitioners support my bill because it would guarantee that all expectant mothers considering an abortion would be given complete information by their physician about all the risks of the procedure before being referred for an abortion and would provide penalties for doctors who perform an abortion without the fully informed consent of the mother and penalties for doctors who perform a medically unnecessary abortion.
On Thursday of this week, thousands of people will gather on Parliament Hill for the annual March for Life. They march every year to mourn the death of more than 100,000 unborn children in Canada through medically unnecessary abortions. As you can see, Mr. Speaker, there is quite a number of petitioners.
* * *
Marriage
Mr. Garry Breitkreuz (Yorkton—Melville, CPC):
Mr. Speaker, the second petition I would like to present is with regard to preserving the traditional definition of marriage. These petitioners point out that in 1999 Parliament voted to preserve the traditional definition of marriage, and a recent court decision has redefined marriage contrary to the wishes of Parliament. Now the government wants Parliament to vote on new legislation, but only after it has been approved by the Supreme Court. This is a dangerous new precedent for democracy in Canada. Elected members of Parliament should decide the marriage issue, not appointed judges. The petitioners are calling on Parliament to hold a renewed debate on the definition of marriage and to reaffirm, as it did in 1999, the traditional definition.
* * *
Radio Canada International
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP):
Mr. Speaker, I have the privilege of presenting four petitions.
The first petition pertains to Radio Canada International. The petitioners are concerned about the reduction in the number of hours of international broadcasting to Ukraine. They believe that RCI plays an important role in strengthening Ukraine's emerging civil society.
They call upon Parliament to indicate its support for the reinstatement of full Radio Canada International broadcasting to Ukraine.
* * *
Immigration
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP):
Mr. Speaker, the second petition pertains to immigration and the concern about a narrow and restricted definition for family class sponsorship. The petitioners are anxious to see this provision under the Immigration and Refugee Protection Act changed.
They call upon Parliament to give full consideration to the addition of other relatives to this class so that family reunification can once again be a cornerstone of our immigration policy.
* * *
Trans Fats
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP):
Mr. Speaker, the third petition pertains to the issue of trans fats. The petitioners are concerned that trans fats raise levels of bad cholesterol in the body and prevent good cholesterol from clearing the circulatory system.
They call upon Parliament to eliminate trans fats from Canada's food supply.
* * *
Labelling of Alcoholic Beverages
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP):
Mr. Speaker, the final petition, which is a matter very close to my own heart, pertains to fetal alcohol syndrome and the need to have warning labels on all alcohol beverage containers.
The petitioners call upon Parliament to remind the government of the motion that was passed in the House and to enact provisions to ensure that a warning is placed on all alcohol beverage containers stating that drinking alcohol during pregnancy can cause birth defects.
* * *
Questions on the Order Paper
Hon. Roger Gallaway (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.):
Mr. Speaker, I ask that all questions be allowed to stand.
The Deputy Speaker: Is that agreed?
Some hon. members: Agreed.
Government Orders
[Supply]
* * *
[English]
Supply
Allotted Day--Health Care
Mrs. Bev Desjarlais (Churchill, NDP)
moved:
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That this House condemn the private for-profit delivery of health care that this government has allowed to grow since 1993. |
Hon. Bill Blaikie (Winnipeg—Transcona, NDP):
Mr. Speaker, the NDP is pleased today to provide the House with an opportunity to debate a motion having to do with the delivery of health care in the country. We think it is particularly appropriate given the confusion that seems to abound on the government side with respect to the Liberal position.
We hope that during the course of the debate today, assuming that Liberals wish to speak to the motion, that we might get some clarity with respect to the Liberal position, particularly when it comes to private for profit delivery of health care.
Therefore it is no coincidence that our motion reads:
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That this House condemn the private for-profit delivery of health care that this government has allowed to grow since 1993. |
In effect, what the motion addresses is the Liberal record, as much as any abstract or ideological debate about the merits of for profit delivery versus non-profit public delivery, although we stand firmly on the side of non-profit and-or public delivery of health care, as did Roy Romanow in his conclusions vis-à-vis the royal commission that was conducted by Mr. Romanow on health care.
However our concern today is what has happened under the Liberals over the last 10 years. Privatization of our health care has increased markedly in that last 10 years,as a result of changes that the Liberals made to the Canada Health Act, as a result of cuts that were made by the Liberals, particularly under the current Prime Minister when he was the minister of finance, and also just the way in which the Liberals have sort of turned a blind eye to the creeping privatization of our health care system. We see that blind eye continuing to operate in the kinds of things that have been said recently by the Minister of Health.
At the same time as he acknowledged that there was room for the private delivery of insured services within the Canada Health Act, he did not express any concern about the tendency of that sector within our health care system to grow. We would have liked to have heard him say that the government was concerned about the growth of that kind of privatization and was determined to do something about it.
Instead, it was obvious that this was regarded as a neutral fact about the current health care system by the Minister of Health. It was only after alarm bells rang that the minister felt obliged to stand and say that the government was not encouraging the private delivery of publicly insured services. However it would have been much more authentic and convincing if this had been said right off the bat, which it was not.
It is also important that we get some clarity on this matter of health care because we are facing an election. In the election it is obvious that the Liberals want to create what we think is a false distinction between themselves and the official opposition when it comes to health care. It is no secret that part of the Liberal strategy is to demonize the official opposition when, in our view, there is very little daylight between the position of the Liberal government and the official opposition when it comes to health care, particularly when it comes to the role of private for profit delivery of health care in the country.
If the House will permit me a little bit of historical reflection, I think I am one of the few members of Parliament left in the Chamber who was here when the Canada Health Act was brought into being in the spring of 1984, 20 years ago. In fact, I was the NDP health critic at that time and sat on the Standing Committee on Health and Welfare that considered the Canada Health Act, amended it and heard the witnesses. Certainly it was one of my formative political experiences to be part of that process by which the Canada Health Act came into being. Therefore I know a little bit about it.
(1015)
I find it curious that the Minister of Health, instead of answering the questions we ask him in the House of Commons, all he says is that the Liberal government will stand by the Canada Health Act, as if this tells us what we want to know. It is not enough to say that the government will stand by the Canada Health Act because the act, frankly, was not designed to deal with the problems that our health care system has today.
The Canada Health Act, which was the successor to the Medical Care Act which brought medicare into being in the first place, came as a result of advocating that the then Liberal government, under Pierre Trudeau and health minister Monique Bégin, do something about the proliferation of extra billing by physicians and user fees in the health care system.That is what the Canada Health Act, to the extent that it was different than the legislation that proceeded it, was designed to do.
The principles that are embedded in the Canada Health Act were also in the previous legislation. What is substantially new about the Canada Health Act is that it has given the federal government the ability to withhold from provinces, which allow the extra billing and user fees for medically necessary services, the equivalent amounts, so there would be no incentive, in fact there would be a punishment for allowing extra billing and user fees. This is what the Canada Health Act was about.
The Canada Health Act was not designed to punish, discourage or deal with the whole question of privatization. It is quite disingenuous, not to say intellectually dishonest, for the Minister of Health and the ministers of health before him, to get up, whenever they are asked a question about oranges, say privatization, and say that they are all for apples. As I said before, that is not what the Canada Health Act was designed to deal with.
It was very interesting that at that time, in 1983-84, after the second Hall commission report and the recommendations by Justice Emmett Hall, the government would do something like the Canada Health Act. The Conservatives of the day were led by Brian Mulroney after his entry into the House in August 1983 in a byelection in Central Nova. I remember going down to Central Nova to challenge him to a debate on health care, which, incidentally, he did not take up.
In any event, the Conservatives at that time moved to the left to adopt the emerging Liberal position. It was not easy to get the Liberals to move on and create the Canada Health Act. It took three or four years of persistent questioning in the House and agitation by the Canadian Health Coalition, the Canadian Nurses Association and all kinds of people who were concerned about what extra billing and user fees were doing at that time.
The principles are the same with respect to extra billing, user fees and privatization. What unites those issues is the concern that Canadians have to pay out of their own pockets, whether it is in the form of extra billing, user fees or privately run clinics, particularly those who are now making available diagnostic services so that people can actually pay for those services, and then even more unacceptable, jump the queue because they have their diagnosis before someone else who has to wait in the public system.
I want to get back to the politics of this. In 1983-84 Brian Mulroney decided that he would not stick to the usual historical Conservative position on health care, which was to be critical of medicare or at least not defend it. In fact, in all those years leading up to the Canada Health Act I do not think there was a single question asked in the House of Commons by the Conservative opposition at the time with respect to extra billing and user fees, just as, 20 years later, there has not been a single question asked by the Alliance and now Conservative Party in the House leading up to this current debate on health care with respect to privatization, with the exception of the official opposition raising the question of health now as a way of trying to get around the Liberals' strategy.
The difference now is that I think there was for a while, until Mulroney changed it, a genuine difference between the Liberals and the Conservatives at that time. I am not so sure that the Liberal government is anywhere near as progressive when it comes to health care as Monique Bégin and Pierre Trudeau were in the early 1980s and which culminated in the Canada Health Act.
(1020)
Instead of the Conservative position moving over to adopt the Liberal position, we have a kind of meeting of the minds, and I use that word loosely, meeting somewhere in the middle of the aisle, with there being very little distinction between the Liberals and the Conservatives, when it comes to private delivery of health care.
The leader of the official opposition said--
The Deputy Speaker:
I hesitate to interrupt the hon. member for Winnipeg—Transcona. The Chair needs some guidance in terms of whether it is his intention to use the full 20 minutes allocated or will he be splitting his time with a colleague.
(1025)
Hon. Bill Blaikie:
If I intended to split my time, Mr. Speaker, I would have indicated that to you at the beginning of my speech. However, I thank you for your concern.
The leader of the official opposition is reported to have said that he does not really care who delivers health care. Whether it is public or private, it is not a big deal for him. I commend the leader of the official opposition for at least being honest about his position. If he had said otherwise, I would not have believed him. I know where he is really at. I did not just walk into this chamber yesterday. Anybody who has listened, particularly to former Alliance members over the years, really knows where the Conservatives also are on this, and is not surprised by that position. I commend him for at least being straight up about his indifference. I would say he probably has a preference in some cases for private delivery, but at least he is willing to say that it does not make any difference to him.
Whereas the Liberals are being quite disingenuous and dishonest with the public about their true feelings on private for profit health care. Either they are indifferent or in their heart of hearts they think this is part of what they mean when they talk about the need for innovation or part of what they mean when they talk about the accord they want to reach with the health ministers on new federal money, plus innovation and reform in the health care system.
When I asked the Minister of Health the other day in the House if he saw a place for a privately owned chain of MRI clinics in the Liberal vision of health care in this country, he would not answer the question.
If we were going to have an honest debate about health care, then instead of answering a question I did not ask or repeating the mantra about the Canada Health Act, which is what he did, would it not be useful for Canadians to know before the election what the Liberal position on this is? We know what the Conservative position is. We know what the NDP position is. Why can we not know what the Liberal position is? Why can we not even know what their preference is? Liberals might say that this is what they prefer and then go into negotiations with the provinces, but they will not even go there. We hope they might go there today and shed a little light on their position.
While I am talking about user fees, extra billing and the origins of the Canada Health Act, I was very distressed to see that the National Post, in its editorial about the Canada Health Act, actually had the nerve to recommend user fees in an article by Nadeem Esmail, senior health policy analyst at the Fraser Institute. I suppose it does not take much nerve at the Fraser Institute to come up with a recommendation like that. If the Fraser Institute has its way, I cannot believe we will have another debate about user fees. I thought that debate had been put to rest 20 years ago.
We have had study after study. We have the Romanow Commission. We even have studies that do not necessarily agree with everything that the NDP says. None of them have advocated a return to user fees. Unless we have significant enough user fees, the cost of administering them cancels what we gain from the user fees. If we have significant enough user fees, then we begin to punish people who do not have the money straight up to go to the doctor or whatever the case may be, and we begin to penalize people. This has been proven over and over again.
Every once in a while we might get an intelligent notion from the Fraser Institute or from the National Post about these kinds of issues, but to suggest that somehow a return to user fees is the answer is really retrograde and harmful to what could be a useful debate about the future of health care.
While I have not had a chance to check, at the end of the debate on the Canada Health Act 20 years ago, on various occasions during that era I had occasion to say that no amount of principles enshrined in the Canada Health Act and enforced by the federal government would save medicare if it were progressively underfunded to the point where the system became untenable and people therefore felt they needed some kind of alternative to the publicly funded health care system.
(1030)
We have not exactly reached that point yet, but there is no question that over the last 20 years successive federal governments have unilaterally changed the terms of reference by which medicare was created in the first place. The original deal that brought provinces into medicare, the fiscal midwifery that brought provinces into medicare, was the fact that for every 50¢ provinces spent on health care, they would receive 50¢ from the federal government. What is that 50¢ down to now? The most popular and accepted percentage that I have heard is 16% of spending on health care. Clearly, we have a case of governments progressively, in an unprogressive spirit, reducing the role of the federal government in health care.
This goes all the way back to a Liberal finance minister under Allan McEachern. Under the Mulroney Tories in 1984, the first budget had unilateral cuts in federal spending on health care. This occurred in budget after budget. The mother of all cuts was in the budget of 1995, when the Prime Minister was the then minister of finance. All those other nicks and cuts were bad, but they paled in significance to the cuts that came under this current Prime Minister. Billions of dollars were taken out of the federal transfer to provinces for health care.
It is that cut, the deepest cut of all, that created the circumstances in which we now have this debate. There would not be any need, perceived, real or otherwise, for MRI clinics and for other private for profit delivery of health care services if the public system was adequately funded. If we are to save medicare, the public system does have to be adequately funded or Canadians will rightfully want an option to a system in which they have no trust.
I think at this point Canadians still have trust in their health care system, although they know that it is not perfect. They know that with respect to certain kinds of services, diagnostic tests and others, there are unacceptably long waiting lists, et cetera, but they do not think it is beyond repair, and it is not, if we can gather the political will across this country to create a federal government that is willing to contribute its fair share.
What are we talking about here? Romanow was only talking about 25%. A minute ago, I was talking about 50%. That was the original deal. For the longest time, the NDP and others who were concerned about medicare advocated a return to fifty-fifty cost sharing. We still do in our heart of hearts, in our dream world. However, for now, we would be happy with a Liberal government that is willing to spend 25%, half of the original contribution by the federal government to medicare. That is not what we have over there.
It is clear to us that we need to have a much more honest debate about health care. The Minister of Health has come into the House. I hope he is not here to tell us that he stands by the Canada Health Act over and over again. As I said before, and I will say it for the benefit of the Minister of Health, that is not enough. The Canada Health Act was not designed to deal with that which now threatens the health care system; and that is, the proliferation of private for profit delivery of even insured services. However, we have the private for profit delivery of diagnostic services, which people are able to pay for and then they jump the queue.
(1035)
Since 1993, there has been a complete lack of will on the part of the Liberals to deal with this. Why have they been unwilling to deal with it? They do not exactly have the moral high ground with the provinces. On the one hand they are drastically reducing their contribution to health care and on the other hand they are laying down the law to the provinces. The provinces are rightly irritated that the Liberals are reneging on the fiscal side, but they want to get tough on the regulatory side, and they have a case with regard to this. Some provinces have tried to deal with it differently than others.
We think it is time for the Liberals to fess up to where they are really at on private for profit delivery of health care. They should share our concern. Even if the for profit sector in our health care system is providing insured services now, at some point a second tier will be created. A private health care system would be created that initially would deliver insured services, but five or ten years from now say that it could make a lot more money if it were not under medicare. It could break free of medicare and create a second private tier all by itself. That is the danger.
Our system has always been an ideological hybrid, but public delivery and non-profit delivery of health care has been the dominant mode. If this Liberal government allows the private for profit delivery of health care to become the dominant mode, to expand even more so than it already has in their last 10 years of government, medicare will suffer a defeat on its watch, despite the fact that the Prime Minister's father had something to do with it in the 1950s.
Mr. Jay Hill (Prince George—Peace River, CPC):
Mr. Speaker, I certainly agree with the hon. member. It is way past the time that we in Canada had an honest, open and fair debate about the future of health care. I appreciate the fact he has recognized that the leader of the Conservative Party has been forthright in expressing his opinions on where Canada should go in the health care field. However, I have a few questions for him in the interest of adding to the openness of the debate.
I watched a discussion of a panel on television last night. His colleague from Vancouver East was asked whether the NDP proposed that existing private clinics, such as MRI clinics and other clinics that provide health care services for Canadians, be shut down. Is that the NDP's position? His colleague from Vancouver East did not answer the question.
My colleague mentioned jumping the queue and also stated that if we were not careful, there would be a second tier. I would suggest to the member that there already is multi-tiered health care in Canada. If we are going to be honest about it, then let us talk about it.
When Canadians are faced with terribly long waiting lists, partially because of inadequate funding from the federal government, they seek other means. If people are told by their doctors that they might have tumours, but they might have to wait six months to have an MRI in Canada, or they could go to the United States, pay a few thousand dollars and get one next week, what would people do? They would try to access other health care services. If that is not another tier, then what is, even if it does not exist within our borders? It is a situation where those who can beg, borrow or plead with their banker to get the money, if they do not have it in their bank account, would consider to find out what their true health is.
He mentioned adequate funding in his speech. Could he attach a number to that? What is the amount of adequate funding that would solve all the woes of Canada's health care system?
(1040)
Hon. Bill Blaikie:
Mr. Speaker, obviously the solution to the clinics that now exist is twofold at least. One solution is to create a publicly funded health care system where there is no demand for such clinics, particularly those clinics that enable people to pay for diagnostic services by themselves and then queue jump because they got their diagnosis and people who are waiting for the public system do not.
There were private clinics in Manitoba. I can think of one in particular. The Manitoba NDP government did not want to have this private for profit clinic in Manitoba, so it negotiated with that clinic and brought it into the public sector. This is certainly one of the things that was done by the Manitoba NDP government. It has been a huge success as far as I know.
There are different ways to do this. The member wants to force us into some kind of radical unacceptable position, that somehow if the NDP government was elected, all these places would be shut down tomorrow. We want to initiate a process by which, by a certain time, there would not be these kind of private for profit clinics. If that means changing the Canada Health Act, then that is exactly what we would do.
In terms of the so-called second tier that exists by virtue of the fact that some Canadians can go to the United States, we can never change the fact that some Canadians may choose to go to the United States for health care. What we can do is reduce the number of Canadians who feel that they have to go to the United States in order to access particular services. We can do that by properly funding the publicly funded health care system.
I am glad to see that the Conservatives are now saying this kind of thing. However, it is getting awfully close to the election. I can remember when the hon. member's colleagues often rose in the House and talked about the fact that there needed to be cuts in federal transfer payments to the health care system. The record will show this.
The member makes a point that, yes, we will always have this other tier called the United States, for people who either have the money or who can get the money together. We should create a publicly funded health care system in this country where no one feels that they have to do that.
With respect to adequate funding, I have already said that we accept the recommendations of the Romanow commission.
Mr. Stockwell Day (Okanagan—Coquihalla, CPC):
Mr. Speaker, I would appreciate some more clarification. The hon. member said that he could not see any daylight between the positions of the Conservatives and the Liberals on health care.
The member said that the NDP endorses what the Manitoba government did with a clinic. He used the words “brought it into the public sector”. There is a clinic, one or more, delivering services and he says that is all right. It sounds like something I have heard from the Liberal side and something along the lines of what we talk about in terms of delivery of services, but still full access to everyone.
Would the member shed a little more light on the narrowing daylight between the NDP position and the Liberal position? They sound identical. He is talking about allowing a clinic to deliver services within the public system. That is what it sounded like to me.
Also, would the member reflect on the federal government when it talks about a transfer of payments? This is referring to health care also, and it includes going back to the 1970s where a certain amount of tax points would be transferred when the government talked about fiscal responsibility. What does he see as the present percentage of that tax point transfer and would he like to see that continued or expanded, especially as it relates to requests from Quebec?
Hon. Bill Blaikie:
Mr. Speaker, I have debated the member before and he is always very careful with his words. He talked about clinics. He did not say private clinics, for profit clinics, or non-profit clinics. All of a sudden he is trying to misrepresent the NDP position.
I said that we do not want for profit clinics. What happened in Manitoba was that a for profit clinic was turned into a non-profit clinic and brought under the public health care system. That is what I said was done in Manitoba. That is the sort of thing that we would like to see done right across the country.
That is our position. The member does not have to like it or agree with it. It is clearly quite different than the federal Minister of Health who stood up and talked about for profit private delivery of services in clinics or otherwise that he did not seem to feel was a problem.
The next day of course he said that he did not want to encourage that sort of thing, or he did not want to promote it. These were afterthoughts after the alarm bells went off that showed that the Liberals were actually sort of neutral when it comes to providing our public health care services by for profit private delivery.
(1045)
Mrs. Carol Skelton (Saskatoon—Rosetown—Biggar, CPC):
Mr. Speaker, I would like to ask my hon. colleague what he thinks about the NDP government in Saskatchewan sending compensation patients out of province for MRIs and diagnosis that they need? How does he feel about that?
Hon. Bill Blaikie:
Mr. Speaker, I am sure that if the federal Liberal government, over the last 10 years, had been providing the kind of money to the provinces that it should have been providing, provinces like Saskatchewan or, for that matter, other non-NDP provinces would not feel that they have to do some of the things that they have to do today.
Mr. Maurice Vellacott (Saskatoon—Wanuskewin, CPC):
Mr. Speaker, I want to ask my colleague from Winnipeg a question. He did answer the question from the hon. member for Okanagan—Coquihalla in the matter of the tax point transfer. Could the hon. member for Winnipeg--Transcona give us a response to that as it relates to Quebec?
The hon. member for Winnipeg--Transcona did not remark on whether or not it was a private clinic. The member talked about profit and not for profit, but I would like to ask whether or not it was a private clinic? It is obviously not making money now. I do not know if what he meant by that. Was it going into a hole? Was it a private clinic or not? What was the status there? I would like a response to the tax point transfer as well.
Hon. Bill Blaikie:
Mr. Speaker, how often do I have to explain the nature of the clinic in Manitoba to the hon. member and his colleagues? However, we will get him some more information on that so that he can be as well informed on that as he likes.
Clearly, it is not a for profit clinic. It was a for profit clinic and the Manitoba NDP government did something about that because it found it philosophically unacceptable and changed the clinic. I can get the hon. member more details on that.
With respect to tax points, this is an ongoing debate between the provinces and the federal government as to what the federal government is contributing vis-à-vis tax points. It goes back to the seventies. The provinces and the federal government, depending on which stage we enter the argument, are guilty of various kinds of sophistry with respect to tax points.
I wonder, is the hon. member suggesting that the Conservative position is that the federal government is already giving enough money through tax points and that there is no need for more federal funding for health care? Is that what the hon. member is suggesting because that is what is implied in the question.
With respect to Quebec, I believe that Quebec has made even more suggestions with respect to the transfer of tax points. This is something that would have to be worked out between the federal government and the provinces and/or Quebec, but this is not relevant to the debate today about privatization. It is only relevant to the extent that anything that impinges on the federal government's ability to regulate with respect to for profit health care in this country because it is not contributing its fair share to the overall cost of health care and therefore it has no moral high ground from which to preach to the provinces.
Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.):
Mr. Speaker, I would like to advise you that I will be splitting my time with my colleague, the Minister of State for Public Health.
I welcome the opportunity that this motion offers to speak to the government's commitment to ensuring the long term sustainability of Canada's public health system.
I want to assure Canadians that this alarmist motion is both misguided and unnecessary as it in no way reflects the government's vision for health and our 10 year plan, which I believe to be consistent with and founded upon Canadian values.
[Translation]
The Government of Canada, like all Canadians it serves, cares a great deal about the fundamental values behind our health care system, namely equality and justice. These values, which are at the heart of our social program most appreciated by Canadians throughout the country, define us and unite us as a people and a nation. They sum up perfectly what it means to be Canadian.
The members of my party reject the idea of having a system whereby jumping the queue—in other words, using one's ability to pay in order to avoid waiting in line—determines one's access to health care or how quickly it is delivered. We expect all our partners to honour to the spirit of the Canada Health Act.
I can assure all Canadians, regardless of where they live or how much money they earn, be they men or women, young or old, that they can have complete faith in their public health care system, which is universal, accessible and single-tiered. The system is there for them and their family if and when they need it because that is the medicare promise.
This national program provides all Canadians with access to medically required health services according to their needs, not their means. Clearly, user fees for insured and medically required services are contrary to the Canada Health Act.
Over and above any debate, this government has a commitment with respect to the health system of our country. The 2004 throne speech and budget have sent a clear message: we plan to bolster the social foundations of Canada, including our universal health care system.
The announcement in the budget of an additional $2 billion on top of the $34.8 billion in new funding over five years announced a year ago in the 2003 agreement, are all proof of our commitment to provide the provinces and territories with lasting, predictable funding that will increase over the long term so that the system may continue to meet the needs of all Canadians.
The federal government's transfer payments in support of social and health programs will be increased by an average of 8% a year for five years. Thanks in large part to these investments, the health system in Canada compares favourably with that of other OECD countries as far as accessibility and health outcomes go.
(1050)
[English]
However, I am certainly not pretending that we have achieved perfection. The health system, like society itself, is not static. It is constantly undergoing change and, indeed, must continually improve to keep pace with Canadians' evolving needs and expectations.
There are all kinds of pressures confronting the system, from the introduction of new diseases that sweep the globe in a matter of days, to our aging population, which puts more demands on the system, and to the impacts of new technologies that offer treatments and therapies unimaginable at the time Canada adopted medicare four decades ago.
Of course, a lot of misinformation and exaggerated anecdotes have led to urban legends about Canada's health system, which motions like the one we are debating today only inflame. But we have to acknowledge some legitimate concerns that arise out of real encounters with the health care system.
For example, we know we need to deal with long waiting lists by addressing mismatches in the demand, supply and distribution of health human resources and service delivery capacity. We also require greater progress in delivering care in the most appropriate setting, whether in a primary care clinic rather than an emergency room, or at home with the right support to recover from surgery.
Given the explosion of health problems related to obesity and unhealthy lifestyles, we clearly need to develop national health promotion and protection strategies to relieve pressure on the health care delivery system. My colleague, the Minister of State for Public Health, will have the opportunity to speak about that contribution of our government. I want to thank her and congratulate her for the excellent job she has been doing on the public health file. Canadians also want greater transparency and accountability to be sure that their tax dollars are put to good use.
Undeniably, these are very real problems that need fixing. That is precisely what we propose to do in partnership with the provinces and territories, health care providers and interested individuals, because Canadians have told us they see their health care system as a collaborative partnership. This is not only what Canadians want and expect; it is what first ministers have agreed to do.
Since the first ministers meeting in September 2000, all governments have been working together, implementing important health reforms to ensure timely access to quality health care services. Despite these improvements, we know more needs to be done. To that end, the Prime Minister will convene a first ministers meeting this summer to discuss the sustainability of the health care system. Our efforts will be aimed at building and strengthening the public health system in Canada. The Prime Minister has promised that first ministers will meet “for as long as it takes...to agree on a long term plan for a health system that is properly funded, clearly sustainable and significantly reformed”.
What has become abundantly clear to users of the system as well as to those who have studied it and those who work within it is that the sustainability of the health care system is about far more than funding. It is equally about fundamental structural reforms to ensure that Canadians receive the services they need and that these services are delivered in an efficient manner.
What is equally obvious is that reforming the system really comes down to strengthening the relationship with our provincial and territorial partners, because we share responsibility for this critically important social program. Clearly, it was by design that the Prime Minister assigned me to the dual role of serving as Minister of Health and Minister of Intergovernmental Affairs, recognizing that these responsibilities are directly related.
I can assure the House that I am committed to working in partnership with the provinces and territories to restore Canadians' confidence in their health care system and to make the reforms necessary to revitalize the system and place it on a more secure financial footing for the future.
I will work closely with our colleagues in other governments to do just that, ensuring that the principles of the Canada Health Act are upheld so Canadians can have access to a single-payer, publicly administered and publicly delivered health system when they need it. There is every reason to be optimistic that we will succeed.
(1055)
The Canada Health Act has been and remains for Canadians a symbol of national solidarity and shared values. Its five principles are as relevant today as they were two decades ago when the legislation was unanimously supported by all political parties. I have every confidence that together with our provincial-territorial partners and all members of the House we can strengthen and expand the public health care system, recognizing that it provides our citizens with the best system possible.
[Translation]
I am in no way suggesting we remain with the status quo. Canadians do not want to have better access to a 1960s-era health system. They want to have access to a dynamic system on the leading edge of technology, one that is patient-focussed and quick to integrate new medical technology and the best, and most recent, treatment possibilities. This is what I am seeking to do, in conjunction with the provinces and territories.
I am sure that, with a good plan and the proper resources, the health insurance plan will remain appropriate for all Canadians. Working with our partners, and with all Canadians, we will be able to improve access and put solutions in place that will last for a generation. This is the direction we need to take.
I cannot support this motion by an opposition member, but instead strongly encourage her to work along with this government in continuing to build a health system that reflects our country's reputation as a compassionate and humanitarian society.
[English]
The Deputy Speaker:
Since we are at the early stages of this debate, I want to remind the House that when members choose to split their time, it also means that the time for questions and comments is equally divided. As the minister took only 10 minutes, there are only 5 minutes for questions and comments. If members ask questions that are brief and succinct, more people can participate.
(1100)
[Translation]
Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ):
Mr. Speaker, I was extremely surprised by the minister's speech because he left some things out. I would have felt better if the minister had made a clear commitment and agreed to what all the provinces are demanding—which also happens to be a recommendation in the Romanow report—that the federal government provide 25% of health care funding.
Hon. members all know the story. I will not go over it again because there is not a lot of time. Nonetheless, the one thing Canadians and Quebeckers want to know is how the federal government could be so negligent and refuse to fulfil its responsibilities with respect to funding. What is the Minister of Health waiting for to make a firm commitment whereby his government will contribute 25% of the cost of health care, as recommended by the Romanow commission?
Hon. Pierre Pettigrew:
Mr. Speaker, I hope that my colleague from Hochelaga—Maisonneuve will take the opportunity that I expect will be given to him to make his own speech in the House and tell us exactly what the position of his party is, 25% of what? I would like him to be more precise, when he asks us to invest 25%.
What I would like to say is that we, the government, are very much committed to caring for the health care system. These arguments over the numbers, figuring out what share—
Some hon. members: Oh, oh.
Hon. Pierre Pettigrew: The members of the Bloc do not want to hear the answer, because the answer bothers them. The only thing that interests them is money, Ottawa's money, federal money. They are always trying to eliminate responsibility. That is normal, because they belong to a political party that wants, essentially, to completely remove responsibility from the political process. They never seek to govern; they certainly do not want that. They want to stay in opposition.
What I am saying is that while we are governing, we are determined to invest $34.8 billion in health, plus an additional $2 billion, over and above our current investments, over the next five years.
What Canadians and Quebeckers want to know is that our government is determined to invest additional money when we sit down at the next meeting of first ministers, where we will sit down with representatives of the provinces and determine the best way to make these investments so as to ensure the long term viability of our health care system. We shall try to do so without bickering over numbers.
[English]
Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, in response to the minister's comments that he cannot support the motion, I have to wonder what part he cannot support after his flip-flop at the health committee a few weeks back.
He indicated that he supported Romanow's position that public delivery was the best way to provide health care services to Canadians. There are numerous reports that have proven it is more cost effective, so one has to wonder why we would not be looking toward public delivery. I think the key factor in this is not for profit delivery. That is the key factor: that it is not for profit. If we have private and not for profit delivery, there will not be an objection. We have the Victorian Order of Nurses, which is a not for profit organization.
I wonder whether the minister has done another flip-flop on his position that he supports Romanow's comment and also on the fact that the government has allowed this to grow since 1993. All we have to do is look at the figures. It has grown immensely since 1993, so what part does he not support?
Hon. Pierre Pettigrew:
Mr. Speaker, I find it quite interesting to hear the policies of the NDP evolving this very morning. Now its members are telling us that they support private delivery in the health care system. That is quite interesting.
I will say one thing. This government is absolutely committed to every one of the five principles of the Canada Health Act. We are determined to work with the provinces to continue to build on it. We have looked at the Romanow report, which came to the same conclusions as the Kirby report, the Mazankowski report and the Clair report done in the province of Quebec. We believe that the road to reform involves investments in home care and our interest in pharmacare, and we have begun to do work on catastrophic drug care. These things are new elements.
The NDP loves to live in the 1970s. The NDP thinks the 1970s were so much nicer. Those members want to turn back the clock. Canadians do not want access to the public health system of the 1960s or 1970s. They want to make sure that our health care system integrates the best technologies available and integrates what exists now with the new way of delivering services on the health front with home care and with primary care that can be done differently.
The system has evolved. It is not only hospitals and doctors. It has other elements. That is what the government is trying to integrate and give Canadians: the best possible public health care system in Canada.
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Hon. Carolyn Bennett (Minister of State (Public Health), Lib.):
Mr. Speaker, as my colleague the Minister of Health has clearly articulated, we are committed to the values that make the Canadian health care system one of the best in the world. In his speech the Minister of Health spoke about a comprehensive and collaborative system. I want to expand on this idea by speaking to the House about the balance of upstream and downstream in health.
Just as we are committed to a publicly funded and administered health care system, the government also believes that we must be proactive about the health of Canadians today and in the future. That is why we approach health from a holistic perspective. We understand that poverty, violence, the environment, shelter, education, equity are all about trying to keep as many Canadians healthy for as long as possible. This is absolutely pivotal in our vision for a long term sustainable system.
Shortly after I was appointed the Minister of State for Public Health, I was asked if public health was the opposite of private health. I have to admit I was little surprised at the question. Today I want to state publicly that absolutely a strong public health system for Canadians stands in stark contrast to the for profit health care that waits for people to get sick and then lets the market determine their costs and their access, leaving countless people out. This is indeed about the public good. It is about Canadian values. It is about those public health goals of health protection, prevention and promotion.
Canadians should be proud of the health care system they have created, a system founded on accessibility, universality and quality. Some have described it unfortunately as a sickness system that has too much focused on the repair shop or the tyranny of the acute.
Our recent experiences with SARS, West Nile and the avian flu have exposed areas of our system that need to be improved. Developing trends such as obesity and inactivity and health disparities tell us that more can be done and more should be done.
The clear consensus of the Naylor and Kirby committees last year, as well as that of other public health experts, is that the Government of Canada must act to demonstrate leadership in this field. We are acting.
The Speech from the Throne clearly articulated our commitment to public health and the federal budget has given us the means to move forward. We have committed in the budget over $665 million targeted at issues like the first ever national immunization strategy, building surveillance capacity through the Canada Health Infoway and supporting front line provincial and territorial capacity.
The immunization strategy is a perfect example of our commitment to proactive and preventive public health and investing in the system. It is also a splendid example of real federal-provincial cooperation.
In the 2004 federal budget the Government of Canada has committed to providing the provinces and territories with $400 million over the next three years to enhance their immunization programs and help relieve the stresses on local public health systems. Three hundred million dollars will be earmarked to support the national immunization strategy. It will support the introduction of new and recommended childhood and adolescent virus vaccines such that no longer will family physicians have to recommend a vaccine and then ask if the family can pay for it.
In the 2003 federal budget $45 million over five years was allocated to pursue this national immunization strategy. With these investments we have begun strengthening key federal infrastructure programs for addressing immunization issues such as vaccine safety, surveillance of vaccine preventable diseases and immunization coverage, procurement processes and professional and public education.
The strategy will result in an enhanced national collaboration on immunization issues; improved monitoring and control of vaccine preventable diseases; better vaccine safety monitoring and response to safety concerns; more affordable vaccines; improved security of the vaccine supply; increased public and professional confidence in vaccines and immunization programs; and better information on which to base policy decisions related to immunization.
Additionally the funds will support a forum for discussion and exchange of information on immunization with provincial and territorial jurisdictions and other stakeholders in order to improve the safety, effectiveness and efficiency of immunization programs in Canada.
The national immunization strategy will address a number of challenges currently being faced by all jurisdictions. It will allow federal, provincial and territorial governments to work in partnership to improve effectiveness and efficiency and toward equitable access to immunization programs in Canada. It is a proactive investment in the future and wellness of our children.
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We are confident that this and our other investments will strengthen public health care capacity across Canada, ultimately contributing to a stronger and more responsive public health system for the future.
In addition to this, we are following through on our announcement in the Speech from the Throne to create a public health agency of Canada. Using Health Canada's population and public health branch as a foundation, the agency will be a focal point for federal efforts in the areas of public health emergencies, chronic and infectious disease prevention and control, and will also promote population health and wellness.
The agency will be key in building on the existing relationships with our counterparts in the provinces and territories as we work toward the ultimate goal of making Canadians among the world's healthiest people. It will also be key in representing Canada and working with international health organizations, such as the World Health Organization and the Centers for Disease Control in the United States.
We are also moving forward with the appointment of the chief public health officer of Canada. The chief public health officer will manage and lead the agency, providing clear federal leadership on public health. He or she will be the national spokesperson in public health emergencies. He or she will be seen as the country's doctor, someone whom Canadians can count on for accurate and timely public health information.
Finally, we are developing a pan-Canadian public health network that will ensure coherence and collaboration across all jurisdictions and structures, a truly integrated public health system for Canada. We are in the process of establishing an action plan for this network. We are confident that it will lead to a more robust public health partnership.
The network will be founded initially in five centres of collaboration, one in each region of the country. Each centre will be a champion for a component of public health and will build on the already existing expertise in each particular area. These centres will be national resources for the benefit of all Canadians. We are confident the network will strengthen federal, provincial and territorial collaboration and increase public health capacity in all jurisdictions.
I should mention that we recognize the role of our partners in this integrated public health strategy. The public health system must be built on a strong common purpose and respect the local wisdom and local knowledge to get the job done.
Provinces, territories, local authorities, various other stakeholders and the citizens themselves are the real experts on the challenges and opportunities in their own communities. They have a key role to play in relation to emergency response, disease control and prevention, and health promotion. It is absolutely essential that all stakeholders and citizens have a chance to contribute to the development of our public health strategies.
Over the last few months I have met with numerous public health stakeholders across the country on a broad range of public health issues. Their input has been invaluable to our vision on a way forward for public health in this country. I have also met internationally with the World Health Organization, the U.S. Centers for Disease Control and public health experts from the United Kingdom and the European Union.
As we talk about the health care system in Canada, we remain committed to continuing to foster this interaction.
I am personally committed to ensuring that citizens and stakeholders will be embedded into the very DNA of this new agency. They will play a role in all future public health strategies.
Together with my colleague the Minister of Health, I have provided tangible examples of the government's commitment and vision for a comprehensive strategy on health in this country, one that values the preventive, proactive and educational pieces as much as it values a responsive health care system that will be there when Canadians need it.
Building on the voice of Canadians, we are confident that we are taking the right steps to ensure that citizens get the public health care they deserve and more important, that as many Canadians stay healthy for as long as possible.
Mr. Jay Hill (Prince George—Peace River, CPC):
Mr. Speaker, I appreciated the comments of the junior minister for public health.
I note that in her speech she remarked about the Canada public health agency and the chief public health officer for Canada, which were key recommendations contained in the Naylor report.
I should point out to the viewing public who might be watching the proceedings that the Naylor report to which the hon. minister referred was tabled last October. The commitment to go through a process to appoint a chief public health officer for our country was contained in the budget in March, a couple of months ago. To our knowledge there is not even an application form out there yet.
The minister made the statement that the government is following through on its commitment or its promises in this regard. Especially in light of the fact that SARS has reared its ugly head again and is only a plane trip away, and that the West Nile virus will certainly be flaring up again this summer, I think it is incumbent on the government to further enlighten us about where it is in bringing about the actual existence of this agency and the appointment of the chief public health officer for Canada.
What is the government waiting for, would be the question, and will these steps actually be taken before an election is called?
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Hon. Carolyn Bennett:
Mr. Speaker, in my view, from the tabling of the Naylor report, to what was in the Speech from the Throne, to the dollars we actually got in the budget so that a chief public health officer could actually do his or her job, to what I have seen in my 32 consultations around the country, we are trying to make sure that in the job description for the chief public officer for Canada we have reflected the voice, relevance and responsiveness of what the people of Canada have said that they would expect of that person.
I am pleased to tell the member that we now have the job description and it includes a very significant piece of citizen engagement. We will be able to announce the committee within a few days to commence that really important search for Canada's doctor.
Ms. Wendy Lill (Dartmouth, NDP):
Mr. Speaker, I thank the member for her comments and commitment to public health which I believe is very real.
I am trying to understand as I listen to the thousands of comments that are now flying around about health care. All Canadians have the same concerns. They have concerns about the lack of diagnostic services, about waiting lists, about the lack of cancer treatment, about the fact that we have a sicker population, about the fact that we have an unequal level of services across the country.
All of those problems are deeply embedded in our very troubled health care system which has been underfunded for many, many years. I do not believe that money is the only thing that is required at this point in time but it clearly is one of the things that is needed to bolster our system.
In light of the huge structural problems that now exist, how is it that the government can actually stand up and say that it is going to do this and this without putting forward a significant dollar figure? That figure at this point is way above what is going to be available from what I am hearing from the member.
Hon. Carolyn Bennett:
Mr. Speaker, I share the member's concern. Really this is about confidence. Canadians need to know that over the next generation the health care system they cherish so much will be there for them when they need it.
As much as money is an issue, I think the member will recognize that a lot of the concern has been about our not having a real system. It has been a patchwork quilt of non-systems, with perhaps not as much emphasis on quality, appropriateness of care and a real integration of the way the system works.
I was pleased on my trip to and from Whitehorse this weekend to have read the book by Michael M. Rachlis, Prescription for Excellence. He makes a very good case that there may well be some need for additional funds but really we have to work hard on sharing best practices across the country and looking at results, the areas that are really getting good results.
Therefore I say to the member, I am thrilled that since the Romanow report we have been able to establish the Health Council of Canada. Michael Decter and his colleagues at the council have been able to tackle the really important issue around wait times.
As we look to the first ministers meeting with the Prime Minister, what they call that long, boring technical meeting, we will look at important things like the confidence around getting diagnostics and treatment and outcomes. We can share across the country where it is working better, where areas have certain needs and how we can get the best value for the money that we are spending.
I cannot resist explaining to the House that after seeing a National Post headline criticizing the Canadian system, I want everybody to look at the Fraser Institute survey and look seriously at why it would leave out the United States when it is trying to slam us. It is purely partisan and poor methodology. We cannot tolerate that kind of bad examination of our really fabulous health care system.
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[Translation]
Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ):
Mr. Speaker, I am pleased to speak on the motion moved by our colleagues in the New Democratic Party, and I will have an opportunity to answer the question the Minister of Health put to me earlier.
I must say that I was taken aback by his remarks, which struck me as somewhat petty and vicious, since there is no question of taking responsibility away from anyone, or playing partisan politics with the health care system. I think it was beneath him, as a minister, to say what he said. Since he became one the 24 lieutenants in Quebec for the Liberals—it is hard to tell who is in charge—the higher his hierarchical standing, the more demagogic he becomes.
That said, what is important to recall is that, by the end of the 1970s, the provinces were spending $11 billion on their respective health systems. Since 2000, they have been spending $56 billion, and it is estimated that, in 2010, which is really not too far in the future, they will be spending $85 billion.
It must be remembered that, when hospital insurance was first introduced back in 1957, the federal government had made the commitment to cover 50% of health care costs.
There is no doubt that the system has evolved in such a way that, currently, many services are no longer provided in a hospital setting. The fact remains that the so-called medically necessary and medically insured services account for a major portion of the services provided by the health care system.
If there is a single example of the federal government's ability to cause fiscal instability in the provinces—justifying ultimately the need for the people of Quebec to achieve sovereignty—the health care system is the best example.
When Jean Chrétien's government was sworn in in October 1993 et assumed responsibility for the nation's business, the CHST was $18.7 billion. Today, as we know, this transfer has been divided; since April 2004, there is a dedicated health transfer and a dedicated social transfer.
In the early budgets presented by the current Prime Minister, the ceiling dropped to a rather disturbing $12.5 billion. Thus, in 1996, 1997, 1998, 1999, 2000, 2001, 2002 and 2003, the provinces obviously had to continue providing health services in a profoundly altered environment. We know that people are living longer, and living with debilitating diseases, and they want to remain in their own communities longer. Still, throughout all these years the federal government was decreasing funding, there was never any consultation.
Just now, the Minister of Health showed he has a lot of nerve. He has the nerve of a herd of wild bulls to rise in this House, his hand to his heart, with his soft little philosopher's voice, and tell us that in the summer of 2004, there will be a first ministers health conference, as if the government itself were not responsible for the mess in the health care system.
I have seen and I have read—I will mention it later as well—the speech that the Minister of Health gave in Toronto, talking about a new partnership and new conditions.
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The Minister of Health talked about four requirements for the health care system. But they are responsible for the mess in the health system. And here I can make the connection to the New Democratic Party motion. In fact, if our fellow citizens have turned increasingly to the health care system, it is not because they believe in it philosophically; it is because of the federal government's cuts to health. Health transfers have declined from $18.7 billion to $12.5 billion, which means that the ability of the provinces to provide adequate health care has been seriously cut.
I would like to answer the health minister's question. He can act innocent, and resort to philosophy and rhetoric, but he will fool no one. The provinces are asking for one thing. The provinces have made common cause, something that is very rare in federal-provincial diplomacy. In 1999, 2000 and 2001, all the premiers—whether New Democrats, Conservatives, Liberals or, of course, the premier of the excellent Parti Quebecois government, when they were at the helm in Quebec—were part of this consensus. They mobilized their civil servants. They submitted a report to the health minister and the Prime Minister of the day about the evolution of the health care system.
The premiers documented this report with econometric models with which the member for Joliette is familiar. In the years to come, even before offering any new services, all provinces will have to invest an additional 5% in health if they want to continue to offer just the same services, without adding even one more.
In the meantime, the federal government has disengaged, disinvested in health services. People wondered how it could be that the systems were working so badly, why there were waiting lists, and why people did not have immediate access to the health system they wanted. What were the consequences of this? The irresponsible actions by the federal government have increased the private sector's part in the system in all provinces. It was not that certain health services were no longer insured, but rather that people who could afford it wanted to have faster access to a system that was slowing down because the federal government had not met its responsibilities.
Before speaking about Quebec's Arpin report on the private health system, I would just like to remind hon. members of three figures. Even with the February 2003 agreement signed by the premiers, the federal government's contribution to health system funding—and I hope the hon. member for Shefford realizes this—will, after hitting its ceiling in 2005-06 with cash transfers of $24 billion, be no more than about 15%.
It is unbelievable, when we know that the government's commitment, when the first joint federal-provincial programs were signed in the 1950s, was to contribute 50%.
Secondly, for 2004-05, that is for next year, there is a cumulative shortfall. Looking at the 2004-05 level for the Canada health and social transfers in comparison with their initial level in 1994-95, and taking inflation into account, we will see that $14.7 billion is needed to bring these transfers up to where they ought to have been based on the initial 1994-95 levels. This is dramatic. Once again, it must be kept in mind that the provinces continue to be under pressure to deliver services to their populations.
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In 2004-05, Quebec will be receiving a mere $200 million more in CHST payments than it did in 1994-95. That is absolutely ridiculous, especially considering the fact that Quebec has had to increase its spending on health, education and social programs by $9 billion. Meanwhile, the federal contribution is a meagre $200 million, or 2% of the additional costs.
This is the background of the situation we are facing: underinvestment by the federal government; a minister who puts on a philosopher's air and suggests, in a charming tone, that the government has taken its responsibilities, when in fact it has acted totally irresponsibly; provinces whose ability to provide our fellow citizens with services has been strangled.
Again, I refer to the motion by the NDP, our neo-Bolshevik friends, as we like them to be. In Quebec, a commission was struck which produced the Arpin report. It makes for interesting reading. I would like to quote two excerpts.
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From 1982-83 to 1998-99, cuts in federal health transfers totalled $16 billion, or nearly two-thirds of the cuts in federal transfers in Quebec. |
I spoke earlier of the 1995 to 1999 period.
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For the period between 1995-96 and 1998-99 alone, the shortfall in health funding for Quebec totalled $8.2 billion. |
The federal government reduced transfer payments from 1995 to 1999, while major changes were taking place in the health care system. It is not the Bloc Quebecois, the Parti Quebecois or the NDP, but the scientists behind the Arpin report who reported an $8.2 billion shortfall. That is one comment.
I have a second, very interesting one to make, which, in my opinion, captures the quintessence of the Arpin report. I want to stress that point. It reads as follows:
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It was observed that, between 1989 and 1998, the increase in the relative share of private health care spending does not originate in the categories of services funded mainly through public programs, but essentially in categories of expenditures that are mostly the responsibility of individuals, including seeking treatment from institutions other than hospitals, buying medicine and consulting practitioners other than medical doctors. |
What does that mean? That means that in the mid-1990s, after Alberta, 30% of health spending in Quebec occurred in the private sector. I am not talking about private insurance, which was not a factor because the services were not insurable. That is not what we are talking about. It is not because there were fewer services in the hospitals. Of course the services had slowed down and the waiting lists were longer, that is for sure, since the government had made cavalier cuts to health transfers.
The reason private services increased in Quebec is twofold. First, more people consulted health professionals not practising in hospitals. Second—and my colleagues will not be surprised to hear me say this—the biggest reason is the whole drug issue.
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I would like to quote the Arpin report again:
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Private spending on drugs has increased from 32.3% in 1989 to 34.2% in 1998. This increase can be attributed in part to the significant increase in the price of drugs and in part to the increase in rates for pharmaceutical services— |
Now, we really must talk. Hon. members know that of all the budget items for health, the one that has grown the fastest is for drugs, prescription drugs in particular.
What does that mean? That means that the federal government acted irresponsibly, in a cavalier manner and with obvious contempt for the basic principles of federalism.
When I was studying political science and the topic was federalism, we were told that a certain number of conditions were required in order for there to be federalism. There are two levels of government that are sovereign in their respective spheres. Obviously, there cannot be federalism if a government, namely the federal government, can destabilize provincial public funding without any consultation or any warning.
The fact is that there needs to be extremely serious reflection on the issue of drugs. At the Standing Committee on Health I tabled an order of reference with four very specific proposals. The first is on the entire issue of drug advertising.
We know that direct consumer advertising is not allowed under the Food and Drugs Act. There can be no connection made between a drug and a particular condition, no claims made in TV advertising that a product will cure this or that disease or disability.
The Department of Health has not been able to gain compliance with the Food and Drugs Act. Television ads contain more and more direct links between products and conditions.
I do not know, Mr. Speaker, whether you have ever paid any attention to the Viagra ads. Who does not get the message, when someone is depicted as leaping with joy first thing in the morning, that he has had a great night. Imagine if there were a court challenge on this, it would not have been easily settled.
The federal government has not been able to enforce its own legislation. More and more, we are finding direct consumer advertising on television and in print. We know that advertising of this type is allowed in the United States, and it has certainly increased the tendency to take medication.
The second thing the Standing Committee on Health will have to consider is the issue of renewing patents. We in the Bloc Quebecois believe in intellectual property. We know that if a company, on the West Island of Montreal, or anywhere in Quebec—in Laval, for example, because there is a very strong biotechnology development there—spends $800 million to bring a drug to market, we agree that the company should earn a return on its investment. The problem, however, is that some pharmaceutical companies, when a patent expires, renew the patent without any real therapeutic innovation in the medication. Without questioning our international obligations under the TRIPS agreement, we must look at the way we deal with this reality.
Thirdly, the generic companies must be subject to regulation by the Patented Medicine Prices Review Board. There cannot be a double standard. We cannot say that we will examine the expenses of the innovative companies while allowing the generic companies onto the field without having to be accountable.
Those are the proposals my representative took to the Standing Committee on Health.
I could also talk about the whole phenomenon of Internet pharmacies. That is a very worrisome thing.
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My conclusion, since time is flying, will be this. The best way to keep our fellow citizens safe from privatized health care is for public investment to be sufficient. On that matter, we have no praise for the federal government, which has withdrawn from this sector in a cavalier manner. What we are going to ask during the election campaign is for the government to assume its responsibilities, for it to contribute 25% of the funds in the health transfers to provinces, in order to provide and keep viable the public health system, which we in the Bloc Quebecois believe in.
[English]
Mr. Paul Szabo (Mississauga South, Lib.):
Mr. Speaker, the motion is very important but I note the reference to delivery of health care, which, in itself, is not defined, although I think there was an intent to define it.
The member, who just gave his speech, spoke substantively to the issues of pharmacare and drugs, which is not covered by the Canada Health Act or in terms of federal responsibility. The fact is that we have had this speech which includes or suggests somehow that the whole debate should be inclusive of all the things that we can imagine are in health care, as someone said, for example, dental care, vision care and mental health care, none of which is paid for under the public health system.
We define health care holistically and we are using that in this discussion. I am pretty sure, based on the member's identification of priorities, that he would be opposed to the motion simply because health care, as he defines it, is not as it is intended by the mover of the motion. This may be part of the problem of what we are trying to address here.
What does the Canada Health Act cover and what is the federal responsibility? More specifically, how do we define medically necessary? I think Canadians have quite a different view as to what constitutes medically necessary. That is a very important element. Maybe the member would like to comment on the element of medically necessary.
[Translation]
Mr. Réal Ménard:
Mr. Speaker, I think that the intent of the motion before us today is to say that, when hospital insurance was introduced in the mid-1950s, we had a service delivery model which was essentially based on in-hospital care. I recognize that many services are no longer provided in a hospital setting.
The NDP motion is intended to recall that the federal government has acted unilaterally, without consulting the provinces, and in a cavalier manner, and transfers have been reduced from $18.7 billion to $12.5 billion. Accordingly the waiting lists for medically insured services, provided in a hospital setting, have grown longer and longer. Some services have become less accessible because the provinces were financially strangled, and the federal government did nothing about it. In certain provinces, this has created room for the private sector where none was planned.
It is hard not to correlate the federal government's irresponsible attitude with the appeal of private health care. I was in agreement with the minister when he said that no one should be able to jump to the front of the line because they have money. But at the same time, for this to be true, the federal government must take its responsibilities. What we are calling for is 25% in cash transfers of the cost of operating the health care system.
That is very clear. That is what the Romanow report says. I am sure that my hon. colleague from Joliette will have a question for me.
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The Deputy Speaker:
I can understand that a number of members may want to ask questions, but it is always up to the Chair to make this difficult choice. I will give the floor to the hon. member for Trois-Rivières.
Mr. Yves Rocheleau (Trois-Rivières, BQ):
Mr. Speaker, I will begin by congratulating my colleague for Hochelaga—Maisonneuve for again demonstrating his expert knowledge of this matter.
I would, however, like to ask him whether perhaps there are not two ways of looking at things. My colleague for Hochelaga—Maisonneuve is right to criticize the federal government for its attitude over the years and its cavalier, authoritarian and irresponsible attitude. As hon. members are aware, there have been attempts ever since 1867 to gain more and more control, particularly over health, which is such a crucial aspect of our collective lives.
Are there not, however, grounds for seeing the situation as even more threatening? The federal government can be faulted for its cavalier and disdainful attitude, except when it has a post-referendum game plan to ensure that things will be done here in Ottawa, where all national standards and objectives will be determined for the provinces to adhere to or be penalized. This can be seen from a negative angle, as my colleague has done, but it can also be seen from a positive angle, which is even more dangerous.
I would like to have my colleague's impressions on this. Where are we headed, Quebec in particular? It is no doubt a good thing for Canada that all decisions are made here, once and for all. But what happens to the Quebec difference then? What happens to the Quebec genius in health, as in other sectors, when the huge federal steamroller comes along? What is happening in health is also happening in education, culture, and with the municipalities. Where will it end? What would become of Quebec if it were to remain within Canada?
Mr. Réal Ménard:
Far be it from me, Mr. Speaker, to deny you prerogatives. You do the deciding when you are in chair. There is no doubt about that.
I think that the Minister of Health and member for Papineau—Saint-Denis will recognize that health will be to his government what the Rowell-Sirois report was to the last century, in the sense that it will provide an opportunity, the framework for nation building. The federal government will use the Romanow report in its effort to define health policies.
I have published an article in Le Devoir, which I hope the hon. member for Papineau—Saint-Denis has read. The four conditions for the partnership he proposed would be the way to nation building in the area of health, and that is something we cannot accept.
The Deputy Speaker:
I give the floor to the hon. member for Joliette, because he is always very patient.
Mr. Pierre Paquette (Joliette, BQ):
Mr. Speaker, one should never hesitate to be patient and I am pleased to see that you agree and have given me the floor.
I, too, would like to congratulate the hon. member for Hochelaga—Maisonneuve, who has given a brilliant demonstration of the problems in the health systems in the provinces and Quebec, and the relationship between these problems and the federal government's withdrawal from funding.
I would like to return to the question the Minister of Health asked during his speech. We know that there has been a withdrawal, and everyone agrees on that, including the finance ministers and premiers of the provinces. The Romanow report also made reference to it and all parties in the National Assembly are agreed. At present, the federal government's share of transfers to the provinces for health care costs stands at 14 or 15%.
We have found one other measurement that I think the hon. members would be interested in. In a report prepared by the former president of the Quebec treasury board, Mr. Léonard, it can be seen that in 1994-95 for every dollar the federal government collected in revenue, in all kinds of taxes, it invested 4.5¢ in the CHST. If we look at the breakdown in the CHST, 60% for health and 40% for other social programs, it means 2.8¢ for each dollar in revenue the federal government collected. That was at the time the Liberals took power, with the current Prime Minister as Minister of Finance.
In 2002-03, the federal government's share in health and social programs was only 2.7¢, or 1.7¢ on health for every dollar of revenue. And they want to make us believe there has been no federal withdrawal.
Once again, for the benefit of the our audience, I would like the hon. member for Hochelaga—Maisonneuve to explain the Liberal government's mathematical sleight of hand.
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Mr. Réal Ménard:
Mr. Speaker, I thank the hon. member for Joliette who, as you know, is my former professor of economics—a most fascinating course.
Basically, when the Liberal government came to power under Prime Minister Jean Chrétien, the Canada Health and Social Transfer was $18.7 billion. It has dropped as low as $12.5 billion. Today, as we know, the federal government's contribution is not even 16% for health spending.
This is utterly unacceptable, and I am counting on the Minister of Health to correct this situation.
Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.):
Mr. Speaker, I would like some clarification from the member for Hochelaga—Maisonneuve, who says that we should take Mr. Romanow's 25% funding model. Mr. Romanow was very specific, however. He said that the Canadian government should invest some 25% of funding in health, but that money alone would not be enough.
The supplementary sums of money to be invested in the health care system must allow us to make some changes that would ensure the long-term sustainability of our health care system.
I would like the hon. member to explain just how far he is going with Mr. Romanow. Did he just happen to focus on the 25% but not think it necessary or important to look at the recommendations in the Romanow report, which states that this money must be invested, in a sense, to ensure the long term sustainability of our health care system?
Mr. Réal Ménard:
Mr. Speaker, I thank the minister for his question. I follow the Romanow report right from its beginnings until it hands on the torch to the Clair report.
The latter identified the reforms clearly. First of all, the Minister of Health must be aware that seven out of ten provinces held commissions to reform their system from the inside, and they have carried out that reform. The Romanow report says reforms must be carried out. This is true. The provinces need to have the torch passed on to them so that they may accomplish this.
The difference between the minister and us is that he suggests our fellow citizens need to be accountable to the federal government, whose share of funding is less than 16% but who would like to become the guardian of the health care system.
This is where we deviate from the Romanow report and the minister's position. We say that it is not true that the government, which makes a contribution of under 16%, will become the guarantor, the definer, the guardian of the system. There must, however, be reporting mechanisms, and the National Assembly will provide them.
[English]
Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, I want to acknowledge your indication to try to correct a technicality in our presentation of the motion. As a result of it, I need to seek the unanimous consent of the House to proceed with my speech.
The Deputy Speaker:
Is that agreed?
Some hon. members: Agreed.
Mrs. Bev Desjarlais:
Mr. Speaker, I want to reintroduce the motion so people throughout the country will know specifically what we are dealing with here. The motion reads:
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That this House condemn the private for-profit delivery of health care that this government has allowed to grow since 1993. |
I want to emphasize that by saying that we are talking about the private for profit delivery of health care and that there is no question that privatization and for profit services have been increasing in Canada since 1993 by great amounts. If there is documentation out there contradictory to that, I am certainly willing to take it in, but, quite frankly, I would be surprised if anyone found it because we have numerous documents that say otherwise.
Canadians still raise health care as their number one priority: access to new technology for testing, receiving care in a timely manner, cost of prescription drugs, cost of home care services, availability of services throughout the country and the numbers of health care providers, as well as the increasing costs for services that are not presently covered.
Canada is regarded as having the best, most affordable health system in the world. When critics of our system, mostly private for profit interests, highlight the faults in our system they tend to compare us with the U.S. and they tend to focus on two areas: one, Canadians have to wait too long for tests or treatments; and two, if those who can afford to pay want to go elsewhere or pay a private service they should be able to do so and this would free up spaces in the public system.
A few months back, Belinda Stronach, one of the Conservative leadership candidates, stated that she favoured a two tier system. That was no surprise. Two tier health care favours the rich, but even the wealthy have difficulty with the expenses of a serious illness. Thus, we have the push for private insurers.
Private insurers must market and make profit and, to sell their goods, make the need for private providers who can deliver to their clients quicker since they are paying. It goes without saying that those private providers want to make a profit so these costs are higher. To keep the costs down for their clients without giving up their profit, the private insurer and a service provider will argue that the public system should pay the portion it would have paid in the public system and the client should just pay the extra.
There have been a number of high profile reviews of Canada's health system. All those reviews came to the same conclusion: public funding of health care is more equitable and more efficient. The for profit supporters would have us believe their system is more efficient and more economical to the public purse. The facts do not support their statements.
First, Romanow's report on health care, which was extensive and included hundreds of presentations and meetings throughout the country, concluded that our health outcomes, with a few exceptions, are among the best in the world, and that a strong majority of Canadians who use our system are highly satisfied with the quality and standard of care they receive.
Medicare has consistently delivered affordable, timely, accessible and high quality care to the overwhelming majority of Canadians on the basis of need, not income. It has contributed to our international competitiveness, to the extraordinary standard of living we enjoy and to the quality and productivity of our workforce.
Opponents of our system fail to mention that in Canada administration costs amount to 16.7% of health care spending. In the U.S. the cost is 32%. Canada spends 10% of its GDP on health care, the same as in 1992. The U.S. spends 14.9%. In Canada everyone is covered. In the U.S. 44 million people have no health coverage. The same arguments that were used to oppose medicare in its beginnings are the ones being used today.
Canadian health economist, Bob Evans, described private pay advocacy for health care as a zombie: “intellectually dead but destined to keep rising”. Gordon Guyatt, in a Winnipeg Free Press article a few months back, noted that for the wealthy the security of universal publicly funded health care could not begin to make up for the necessity of waiting their turn.
One of my favourite quotes, and I apologize that I do not know who said it, is “The critics say in Canada we ration our health care”. That is true. We ration according to need, whereas in the U.S. it is rationed according to the bank balance.
(1155)
I will gladly give whatever information people need on where I got my figures. I want that to set the tone for the discussion on whether or not for profit health care is what Canadians want. I suggest it is not.
Canadians want to have access to their health care services and to the new technology, and they should have that right. They would have had it made available in most instances without the long lineups had there been proper funding of our health care system.
When we have the health minister work around and fiddle with the fact of what is medically necessary, I am sorry I do not have the opportunity to question him or his colleague, the public health minister, because I am sure she would be indicating that if he has to work around what is medically necessary and possibly suggest that diagnostic tests are not medically necessary, I would question whether he should be the health minister.
No doctor worth his or her grain of salt would suggest that blood tests, when checking for different types of cancers, or an MRI, a mammogram or a PSA test for prostate cancer are not medically necessary when looking to make a diagnosis. To suggest that our health care system should not be funding those tests, I think, is unconscionable. Quite frankly, I think Romanow was very clear when he said that we need to enhance what is covered under our public system.
I will now go into the arguments on for profit health care. I have a pile of paper around me because there and so many reports that put to rest that ridiculous argument, which has been called a zombie, that private health care delivers quicker, is better and is more efficient. The facts just are not there.
Furthermore, it is not the best economically sound position for our government to be taking. The public system delivers a more cost efficient system.
In the United States the Americans have those figures. They have for profit and public hospitals. The figures show that the non-profits provide equal services, they are less costly per hospital patient to the tune of something like $1,000 U.S. It would be much less in Canada.
I will read into the record the following comment, “Independent health service providers, the private for profits, need to pay advertisers, investors, insurance companies, marketing and a whole host of other hidden costs which would in the end get passed on to the public deliverer”.
The government wants to use the argument that as long as health care is publicly delivered it is all right to waste taxpayer dollars paying a for profit company, when it can be provided, and the figures are there, for at least 15% less if it is in a publicly delivered system.
It is shameful that members of the Conservative Party, who at one time were reform and then alliance, who try to present themselves as the grassroots people and the protectors of the public purse, are in here saying that taxpayer dollars should be used to set up for profit clinics to provide health services. I make no bones about the fact that ideologically I do not believe anyone should be profiting from someone's ill health.
I firmly stand behind the principle of a balanced budget. Without question, we cannot do everything all at once. However, without question, the most cost effective way to provide existing services or new services is through the most cost effective measure, which is not for profit. The moment we bring in the for profit aspect, somewhere along the way there will be increased costs to the public deliverer or to the patient. I think that argument needs to be put to rest.
I would wager that most members have not read the Romanow report. I know most Canadians have not because, although the government supported the Romanow commission, the cost for a full copy of the report in hard cover is $50, unless people have access to the Internet. I know it may come as surprise to many members but not everyone in Canada has access to Internet services.
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The report states that this is what private, for profit companies do:
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--these facilities “cream off” those services that can be easily and more inexpensively provided on a volume basis, such as cataract surgery or hernia repair. This leaves the public system to provide the more complicated and expensive services from which it is more difficult to control cost per case. |
I will say that this is like going to Shoppers Drug Mart for a loss leader sale. We buy something at a special rate, but we spend extra money. We should not be putting that kind of system in reverse into the health care system, where we have private companies that are going to deliver the services they will make a whole lot of profit on, but the public system has to pick up the real costs.
Here is what a colleague of mine once told me. The province of Manitoba had a program with Manitoba Hydro. To encourage sound energy resource use, it provided people with assistance such as loans if they wanted to put on new doors or new windows to conserve energy. These were loans, and people paid the money back. It came off their hydro bills. Someone asked me why it would do that when its whole intention should be to make a profit. I said, for crying out loud, if we had that kind of attitude on health care we would not do the preventive work to treat people with heart problems or diabetes. We would be waiting until people get really sick so we could make a buck. That is what a lot of private providers do. They want to make the big bucks. Quite frankly, that is what has happened in our health care system.
We have not provided the community clinics and the preventive measures. Health Canada or the Minister of Health did not come up with a piece of legislation to ban trans fatty foods. Those are the things that prevent excessive use of health care dollars. That did not happen.
There is something I want people to know. Frankly, I was quite surprised, because many times over the years I have heard about medicare and Tommy Douglas and the great things that were done, but I have to admit that I had not read the whole plan from way back then. Members should know that community clinics and preventive medicine were supposed to be there at the same time that medicare was brought in, but the Conservatives, Liberals and governments time and time again never did any of that stuff. As a result, we have greater costs within our health care system.
I do not believe in throwing the baby out with the bathwater, so I say we get in there right now, implement the changes that need to be done and put in place the community clinics. We absolutely need to do those things.
My colleague, the Minister of State for Public Health, mentioned Dr. Michael Rachlis. Dr. Rachlis mentions a number of different alternatives that we can do. They have been talked about time and time again, but the provinces have not been able to implement a lot of those projects or changes to the way things are done because they do not have the dollars. They have been fighting to survive and provide whatever services they could. Why? Because this Liberal government in the last decade has cut more from health care than any of the others all together. As a result, we are playing catch-up.
The time has come. There needs to be the commitment. There needs to be the sound commitment to our health system. My colleagues have asked how much has to go in and I will say that right now what is being recommended is to just get it up to the 25%. I think a good number of provinces have indicated that we should start with 25%. It was meant to be a fifty-fifty deal. We have heard that. The federal government provides 50% and the provinces provide 50%. I have yet to hear anyone argue that this is still not fair, but what we are hearing now is, “Let us just get it up to the 25%”.
What would that mean in actual dollars? We have to break down the health and social transfer payments, which covered a number of things. I think Canadians want to see transparency, not just within health care funding but within all the other government funding. We are seeing that there is not a lot of transparency. As a result, we are seeing a lot of misuse of taxpayers' dollars. Let us have some transparency. Let us look generally at the figures. It is not always easy to get the total figures, but the figure I have heard is roughly $24 billion. Right now that goes specifically to the health care funding that would apply under the Canada Health Act.
That is $24 billion. If we are looking at increasing funding to 25%, some have said it would be roughly $8 billion. I use those figures because those are the different figures that have come out. There is no specific breakdown because of the health and social transfers. We would be looking at $8 billion to bring it up to 25%.
My colleague from Winnipeg—Transcona mentioned Monique Bégin. At times I have been in attendance when she has spoken about public health care and its needs. She used a figure of 25% at one point too, but also said that it needs to be moved further. We should be back to the relationship where there was the agreement.
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Again, I would not for one second suggest that we just throw a bunch of money at it and not have a guarantee that services will be provided. Or, quite frankly, what if we do not have the money? But if we have the dollars we should be putting them into the system and we should be ensuring that Canadians nationwide get the same services. It is not always easy to do. Sometimes we have to pay a little more in an area of the country.
I specifically want to mention first nation communities here. I want to tell the House about something that happens in first nation communities. Over the last number of years, through the First Nations and Inuit Health Branch, communities have been trying to get additional funding to have full time nurses in their areas. They could not get the additional funding through Health Canada. However, Health Canada was quite willing to pay out to a private agency to provide a nurse to the tune of $900 a day.
That was $900 a day to a private agency for the nurse, but Health Canada would not give first nations the dollars to provide full time services in the community. There has been a huge increase in agency nurses throughout the whole system. Hospitals may say they do not have to pay the benefits and stuff, and yet $900 a day was paid to a private agency to provide a nurse. That is way beyond the cost of benefits.
This being nursing week, I think it would be indicative to mention the stress on health care professionals overall but certainly on nurses as the government has cut time and time again. They were there because nurses tend to be the kind of people who cannot just say, “To heck with it. I'm not going to work here anymore”. They keep struggling along because people do not go into that profession unless they genuinely care about what they are doing. Anybody who has worked in a hospital will tell us that. People do not become doctors or nurses unless they care about their patients, and they have a hard time not continuing services and not giving their 200%. They have suffered a great deal under the cuts.
I mentioned the increase in agency nurses and Health Canada's position of not funding the first nation. The government says it does not want to encourage private health care but it seems to me that paying $900 a day is encouraging private health care costs.
There was another situation, and I can bring in the news articles about it to prove that this is accurate. Again it involved the first nations health branch. There was a mammogram clinic located in one of the remote communities. In order to make it cost effective, the clinic wanted to fly in patients from a short distance, from one community in the riding to another, to have the mammograms done. Let me tell members, though, that Health Canada would not cover the cost. The reason I was given by the health branch--and this is not just out of the blue--was that it did not cover the preventive side of health care. These patients could not just have a routine mammogram; that was their reason for not doing it. That is the type of health care service first nations are getting from this government, that is the position the government is taking, and that is not acceptable.
I know I only have a minute more. There is obviously a fair bit to comment on with regard to the private, for profit health care system. That is the key factor here and I make no bones about that fact. I am adamantly opposed, as most Canadians are, to someone profiting from someone's ill health. It is unacceptable. I do not think those private providers have any moral ground to stand on. There have been numerous situations involving drug companies in the States where court cases have been brought against them because of their illegal positions in a good many cases. I do not think they have any moral ground to stand on when they say they are going to give the same service. The proof is out there that private, for profit companies do not provide the best service.
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Mr. Paul Szabo (Mississauga South, Lib.):
Mr. Speaker, I would like to make a couple of comments and then finish with a question for the member. The member started by talking about health care, the term that is in the motion. Then she went on to mention drugs and home care and spoke in much of her speech about prevention and so on.
As members know, home care and pharmacare are not within the purview and jurisdiction of the federal government. These are not items that the federal government can withdraw or somehow police.
The definition of health care that we are talking about in regard to the motion is unclear. We should be talking about those elements of health care which are under the purview of the Canada Health Act and which are medically necessary. I think the motion is flawed in that regard.
Second, I notice that the member was shifting her definition of private, for profit care in terms of what she was referring to. In one instance she was referring to private, for profit care being the situation wherein a Canadian or a resident would go to some health care provider and pay that doctor for the services rendered. It is two tier. She talked about two tier, where, instead of getting it through the hospital and having it covered under the health card, someone actually paid. That is private, for profit care as most Canadians would understand it.
Then the member started to talk about private, for profit care--and confuse everybody--in the sense that it would provide the service and bill the public health system an amount which would include its return on investment. So the private, for profit scenario is one where the patient would pay and the other is where the public health system would pay. Those are two different aspects on which she was not clear.
My question for the member is with regard to the motion. If she agrees that the motion has to deal with items for which the federal government under the Canada Health Act has responsibility, and the motion says that these are items which the government “has allowed to grow since 1993”, could she give the House some examples of the specific matters, specific services or health care elements, which, under the Canada Health Act, under federal jurisdiction, we have allowed to grow?
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Mrs. Bev Desjarlais:
Mr. Speaker, health care might be unclear to the member, but I could pretty much wager that health care and what people see it as is not unclear to Canadians.
His colleague, the health minister, suggested that somehow the NDP was not in tune with what was happening today because there were more things that should be considered under health care now, such as technological changes and the difference in delivery. There is no question there have been changes to what people consider necessary.
I tried to make it clear, that there should be no question in some areas about what is medically necessary. We have private MRI clinics and we have doctors who order them because they are medically necessary. Should anyone pay extra money to get that or should dollars be provided through the system? Should this not be the position of the government, to make enough dollars available?
We have a situation with home care. Manitoba, under the Conservatives, tried to privatize home care. I urge members to get the results. We are talking about private for profit. Whether the member thinks it is federal or not, if he goes to the Romanow report, he will see that Canadians think this needs to be covered. I know it was a big report, but each member received one. They did not have to pay the $50.
Conservatives brought in private home care in Manitoba. It was so bad even they had to cancel it. The cost was that much greater. The service was much worse. It was horrible. They did not have to wait until the NDP got there. It was so bad they got rid of it because it did not work. There is not full funding for every type of home care service provided because the provinces are struggling to make a go of things. There is no question about the issue of what is being provided.
I mentioned a number of different things in my speech, and I am sorry it was confusing in the way it came across. However, it will be in Hansard tomorrow. I urge my colleague to read it. It was not my intention to mix apples and oranges. I want to be very clear that we do not support for profit delivery. I know later on one of my colleagues will mention a number of plans within our platform for our health care system.
We have not seen any plans from the Liberals, and I do not want to get into the election issues. We are quite comfortable where we stand on health care. We do have a plan in place. It is not all over the board. We are not just saying throw money into it. We have a plan on how we would proceed to improve the health care system, to improve access for Canadians, to improve the number of services covered and to decrease the cost of prescription medications, which is a huge part of it. I would challenge anyone to suggest that some of the prescriptions are not medically necessary. They certainly are.
(1220)
Ms. Wendy Lill (Dartmouth, NDP):
Mr. Speaker, I want to thank my colleague for her comments about private for profit delivery. One of the ways provinces struggle with the cuts to health care funding is very clearly to put their money into such things as P3 facilities. We have seen this happen across the board in terms of schools. We now have public-private partnership schools and public-private partnership health care clinics. That allows the provincial governments to put off the payments until a later date and to get them off the books.
Everyone is struggling with the financing of both education and health care. The point is it is just putting the costs off. They pay now or they pay later. With these public-private health care clinics, we see an increase in long term care for people, an increase in user fees and an increase in hospital support services that the private companies need to put in place simply to get their profits. Could the member comment on the phenomena of P3 health care services?
Mrs. Bev Desjarlais:
Mr. Speaker, there is no question that governments are trying to promote the whole P3, the public-private partnership, approach as an answer. There is also no question, in my mind, that the reason they are doing this is so those dollars will not show on the books. The reality is that the Canadian taxpayers will ultimately pay more out of their pockets. That is the one thing they fail to mention when they talk about this. Over the long term, it will cost the taxpayer more and, quite frankly, it will be a lot more.
The same scenario will show in toll roads. It will show in the partnerships. In the building of hospitals, schools, any of those things, it becomes a much greater cost. The government can get away with saying it does not owe this much money because it is not on the books.
I just want to mention a couple of things that happen with the private for profit providers. Investors expect 15% profits annually. This is a U.S. survey. We do not have all the comparisons within Canada because no one has bothered to go ahead and do that. I mentioned already the significant time and money that has to be put into strategies for defence, marketing, insurance administration and bill collection, which drive up the costs.
There is also a necessity to compete. Imagine one hospital or one clinic competing with another so it gets all the business and, as a result, it increases the cost because there is a duplication of services.
Here is the clincher, and I do not think many people out there will doubt this any more, the prevalence of fraud among for profit providers in the U.S. has become a major cost factor. The cost of monitoring, suppressing and prosecuting such behaviour has become part of the administrative overhead associated with for profit providers.
Mr. Julian Reed (Halton, Lib.):
Mr. Speaker, I will be dividing my time with the hon. member for Dufferin--Peel--Wellington--Grey.
I appreciate the opportunity to make a few comments on the motion from the member for Churchill.
April 17 marked the 20th anniversary of the passage of the Canada Health Act, Canada's federal health insurance legislation and the cornerstone of the Canadian health care system. The five principles enshrined in the act reflect the values that inspired Canada's single payer, publicly financed health care system over 40 years ago. The Canada Health Act aims to ensure that all residents of Canada have access to necessary physician and hospital services without direct charges.
As Roy Romanow said in the Romanow Commission report, the principles have stood the test of time and continue to reflect the values of Canadians. No single issue touches Canadians more deeply than health care. Our health care system is a practical expression of the values of fairness, equity and solidarity that define us as a country. Medicare is part of our heritage.
Before the second world war, Canadians paid for health services in the same way they paid for any consumer service. Many Canadians had debts for health care and many suffered because they just could not afford the health care they needed. After the war, both commercial and non-profit insurance began to spread, but many Canadians could not afford that either.
I would like to inject, if I may, a very personal story. In 1941 our family was just beginning to recover from the effects of the depression. At that time, my late mother was admitted to hospital for a routine surgery, a tonsillectomy, that was botched. She ended up with blood in her lungs which caused a series of infections. She spent 13 weeks in hospital and nearly succumbed. In those days there was not even penicillin, so any drugs to combat infection were known as sulpha drugs in those days. At any rate she recovered and came home from the hospital, but the process bankrupted my father. He spent the rest of his life, until he passed away in 1957, paying off that debt. Therefore, the whole subject of medicare is particularly personal, as far as I am concerned.
By 1957, the year my late father passed away, 40% of the population of Canada still had no coverage at all. Medicare predates the Canada Health Act, but the passage of the act was a defining milestone. The Canadian health insurance system in fact evolved into its present form over several decades, and it will continue to evolve and continue to be improved as the years go by.
Saskatchewan was the first province to establish universal public hospital insurance in 1947. Ten years later the Government of Canada passed the Hospital Insurance and Diagnostic Services Act to share in the cost of these services.
By 1961, all provinces and territories had public insurance plans and provided universal access to hospital services. Saskatchewan again pioneered in providing insurance for physician services beginning in 1962. The federal government adopted the Medical Care Act in 1966 to cost share the provision of insured physician services with the provinces.
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By 1972, all provincial and territorial plans had been extended to include physician services. Through cooperation between the provinces and the federal government, Canada developed a national health insurance program which became the hallmark of Canadian federalism.
The federal government agreed to contribute financial support and the provinces would administer the programs. The conditions were that each province had to guarantee that its program would be universal, comprehensive, portable and publicly administered. With these guidelines established, the interlocking provincial plans formed our national health insurance program. It was tailored especially for Canada. Coast to coast medicare was created.
However, in the late 1970s, extra billing by some physicians and user charges levied by some hospitals were increasingly becoming a cause for concern. Universal access was at risk. In 1979, at the request of the federal government, Justice Emmett Hall undertook a review of the state of health services in Canada. In his report he reiterated that health care services in Canada ranked among the best in the world, but warned that extra billing by doctors and user fees levied by hospitals were creating a two tiered system that threatened the accessibility of care. This report led to the adoption of the Canada Health Act in 1984.
The Canada Health Act was introduced to ensure that Canadians had access to the medical care they needed without out-of-pocket charges. The road to passing the legislation was not always smooth. It involved four years of intensive debate and negotiations before the Canada Health Act was passed with the unanimous support of all political parties by Parliament on April 9, 1984 and received royal assent on April 17, 1984.
The act consolidated previous legislation on hospital and medical care insurance, and set out standards and criteria that had to be met for the provinces to qualify for federal funding. Canadians were assured universal and timely access to the health care they needed on a pre-paid basis.
Universally accessible health care is not just a program. It is much more than a system. It is central to our way of life, a source of pride and identity. The Government of Canada is committed to protecting the health care system that Canadians consider part of their identity. The Prime Minister recently stated that our health care system is more than a program; it is a statement of our values as a nation.
Canadians continue to strongly support the principles of the Canada Health Act. They want a system based on need, not wealth. They consider equitable and timely access to medically necessary health care services to be part of our national character, not a privilege of status or income.
Times have changed considerably since the act was passed. What has not changed is the support among Canadians for the principles underlying the health care system. There are challenges and pressures to continue to provide quality services in the face of rising costs, emerging and costly technology, and increases in the ability of physicians to treat hitherto untreatable diseases.
The Canada Health Act has been instrumental in protecting reasonable access to medically necessary care by all, regardless of age, income or place of residence. Canadians have expressed their support for universal health care time and time again, and all levels of government remain committed to upholding what Canadians consider a top priority which is their publicly funded health care system.
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Ms. Wendy Lill (Dartmouth, NDP):
Mr. Speaker, I thank my colleague for his comments and for telling us of his mother's situation and the importance of, in his own life, the passing of the Canada Health Act and what that meant, and of the kind of duress his family was under financially. I do not think anyone could have said it better.
I think the problem is that many Canadians now feel that they are heading back to those bad old days and that they are actually experiencing them themselves. People feel that they can be just a step away from being wiped out financially because of the high cost of drugs. They do not have any drug insurance and they are in fact incurring huge costs that are taking years to repay.
In many parts of the country, and mine being one of them, there is no health care coverage for seniors in nursing homes. They are paying their own health care costs in nursing homes so that at the end of their lives they are finding themselves having to eat up absolutely every penny of their savings to pay for health care coverage that is available in hospitals for other Canadians across the country.
There are so many examples of people who do not feel they are protected in the way that some feel they once were protected. I would like the member to address the strong concern that Canadians have across the country with the state of our present health care plan.
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Mr. Julian Reed:
Mr. Speaker, I thank my hon. friend for those comments. There is no question in my mind that our health care system is constantly evolving, and constantly needs to be improved and upgraded as we go along.
We also know that the standards that are applied in different provinces sometimes differ. For instance, there are some provinces that charge for ambulance service and other ones that do not, and so on. It takes constant vigilance, if we like, to impress on the provinces that there is a standard to be maintained and that there are improvements to be made.
I do sympathize with the cost of the new drugs that come on the market. Some of them are very effective for curing or controlling illnesses that could not be controlled 20 or 30 years ago. They are, admittedly, very costly. It is the constant tossing the balls in the air as to how much of that can be borne by the taxpayer.
We still have excellent basic medical care in the country and I would not take that away for a minute. I talked to one physician who took the Canadian health care idea to other countries in the world. I met him at the Ottawa airport about a year ago. He said there was a lot that had to be continually improved and fixed in the Canadian health care system and when we do that we should never forget that compared to every other country in the world this is still the very best health care system.
Mr. Murray Calder (Dufferin—Peel—Wellington—Grey, Lib.):
Mr. Speaker, I am grateful for the opportunity to speak to the motion by the hon. member for Churchill respecting health care delivery.
Canadians enjoy one of the world's most successful health care systems. Canadians are among the healthiest people in the world. Our universal, publicly administered health care system has worked well for our country. The principles, as enshrined in the Canada Health Act have conferred significant benefits, both in terms of health status and our economy.
Nothing optimizes this philosophy better than Canada's universal, single payer health system that provides everyone, regardless of income, age, gender or place of residence, with equal access to quality medical health care. In the view of many, our health system is central to our national identity. It defines us and unites us as a nation.
On standard measures of both life expectancy and infant mortality, Canada outperforms the United States. In 1990 the life expectancy for Canadian men was two years longer than American men. By 1995 it was 2.8 years longer. In the same timeframe, Canadian women's life expectancy increased from 1.6 to 1.9 years beyond that of American women. Medicare has contributed to the improved health outcomes for our children. In fact, our infant mortality rates are among the lowest in the world. This is largely because Canadians have access to necessary medical care.
A report just released by the Commonwealth Fund on the quality of health care in industrialized countries comparing Canada, the U.S., the U.K., Australia and New Zealand found no single country to be superior overall. However, it did note that the U.S. spends 13.9% of GDP on health care versus just 9.7% of GDP in Canada, with no appreciable difference in health results. The results of that study clearly demonstrate that Canada has a quality health system and that Canada spends 57% less per capita than is spent by the U.S.
Similarly, according to a 1991 KPMG study, the administrative costs of maintaining health care accounted for 31% of health expenditures in the United States and just 16.7% in Canada. In Canada, more of our health care dollars go to providing the health care services our residents need, not paying to administer the program.
In the United States, where health care is privatized, there are over 43 million people who do not have any health insurance because they cannot afford it. American media reports have indicated that just over one-half of bankruptcies in that country are the direct result of an inability to pay medical bills. This alone is a strong argument for single tier medicine in Canada. We do not want to see Canadians suffering serious financial loss because of health related difficulties.
Health care in the United States is based on income and an individual's ability to pay rather than the need for care. Health costs continue to be a major burden for employers. The difference between our public system and the American private system is that a two tiered system simply costs more to deliver and administer.
Our health care system is critical to our country's productivity and ability to compete in an aggressive global marketplace. In Canada, we recognize that our success as a nation comes from our ability to commit to our core values: sharing risks and benefits; looking out for the most vulnerable; and equality of all citizens, all of which contribute to a strong economy.
The Canadian single payer health care system has made Canadian businesses more competitive in the world markets by helping to keep their costs of doing business down. This is because the cost of health care is shared between individuals, businesses and government. Medicare is an economic asset, not a liability.
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Medicare is one of the factors that has allowed Canada to have one of the lowest payroll taxes among the G-8 countries.
The very nature of our health care system puts Canada in an excellent position to control the aggregate expenses of the health sector in our economy, since each provincial and territorial government is a predominant buyer of health care in this jurisdiction. This provides enormous leverage to negotiate fee structures and service costs, and to manage spending to achieve cost effective health outcomes.
Resources can be directed to factors that improve health status, not only those related to health care but also other determinants of health. Obviously, a lower cost system leaves workers with more disposable income to stimulate the economy, but that is only part of the story.
We also know that when there are fewer work days lost to illness, productivity increases. There are greater opportunities to obtain better paying jobs and a higher standard of living for all.
Finally, healthier people, as we know, make fewer demands on the health care system, live longer and contribute significantly to the overall wealth of a nation. What is good for society is good for our economy and vice versa.
The government is committed to doing its part in sustaining medicare. In addition to the commitment of $34.8 billion under 2003 accord, the government also created a new health transfer. This transfer enhances transparency and accountability and provides Canadians with a more accurate picture of federal contributions to health care and other key social sectors.
Provinces and territories retain their flexibility to decide where and how they will invest federal resources in each sector, but Canadians know what the federal government's significant contribution to health is all about.
We acknowledge that our health care system is in need of revitalization. We must find news ways of responding to Canadians' health care needs in a timely manner. We must not be afraid to accept the challenge of adopting new approaches consistent with the principles of the Canada Health Act.
Let me remind the members what those principles are. Public administration: In order to satisfy the criteria of public administration, the health care insurance plan of a province must be administered and operated on a non-profit basis by a public authority appointed or designated by the government of the province. The public authority must be responsible to the provincial government for that administration and operation.
Universality: Under the universality criteria all residents of a province must be insured persons under the provincial health plan.
Portability: Portability means that the insured persons are covered for medically necessary services when they move from one province to another within Canada.
Comprehensiveness: Under this criteria, the health care insurance plan of a province must insure all medically necessary health services provided by hospitals, medical practitioners or dentists in a hospital setting.
Accessibility: Accessibility ensures that insured persons have a reasonable access to medically necessary hospital and-or physician services without any financial or other barriers.
However, as we move toward finding solutions and implementing lasting changes to renew the health system, we must not lose what we value most; the social equity and the economic advantages of a publicly funded, single tier health care system.
Renewing medicare will take perseverance, commitment, hard work and time. As a government, we are prepared to face the challenge and we are dedicated to working with the provinces and the territories and Canadians as partners.
The true test of commitment is where we stand in times of challenge and of change. We, as a nation, had the sense to invent medicare, now we need to find the will and the way to strengthen it for the long term.
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Mr. Pat Martin (Winnipeg Centre, NDP):
Mr. Speaker, I thank the member for Dufferin—Peel—Wellington—Grey for his thoughtful remarks regarding the need and the value of our publicly funded health care system.
What struck me about my hon. colleague's speech is that, like the Minister of Health, he never once used the term publicly delivered health care system. He focused on the importance of a publicly funded health care system.
If he had read the motion properly, the one we put forward today, he would have seen that we were calling into question the growth of the delivery of health care services by private for profit initiatives. That is where my colleague's comments fall short of the mark.
He made lots of lofty comments, with which I wholeheartedly agree, about the importance, the value and even the economic advantages of our publicly funded health care system in this country. It is a national treasure. However we are drawing attention to the fact that our national treasure is being eroded by the growth of the privately delivered health care system.
I would ask the member if he is aware of the following facts. Most of our evidence regarding for profit health care comes from the United States where there is a mix of publicly funded, private for profit and private not for profit. The evidence or the examination of figures that we have comes from the American model. Is he aware that the for profit hospitals in the United States bill about $8,500 for every discharged patient, while the non-profit hospitals bill about $7,300 for each discharged patient?
Mr. Murray Calder:
Mr. Speaker, I thought maybe the preamble would let me off answering the question but I will answer it.
I just want to give the member a bit of my background. I sat as a hospital board member for 12 years at the Louise Marshall Hospital in Mount Forest. I was the corporation treasurer for four years for that hospital. I see the exercise that is in front of us right now, that we have to enter into negotiations with the provinces and the territories, as the federal government, on a proactive basis to take health care into the next century, which is where we are at.
I am 54 and a baby boomer. People are turning 50 at the rate of over 52,000 a year. A lot of pressure will be put on the health care system so it has to be up and ready to run.
One of the things that irritated me more than anything else when I was a corporation treasurer is that if the administrator of the hospital and myself found a savings in our budget, for instance, $40,000, we were not allowed to put that money in a capital trust account to take a look at expenditures that the hospital would be faced with, such as needing a new MRI, an x-ray machine or anything else. In fact, it was even worse because the $40,000 that I had found, if I did not spend it at the end of the year, in the next budget year my budget would be reduced by $40,000.
That is something that actually exists within the province of Ontario which encourages wasteful spending. What I am saying is that we as a federal government have to get past the fact that we walk into the room with a blank cheque. We have to be part of the administrative process with health care to take it into the next millennium. That is what I am behind and what I want to see done.
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Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, I do not think there is any question that there may be cost savings within the health care system and that there needs to be some reform. I think Canadians have said loud and clear that they want the federal government to take a lead role in ensuring that the services are provided nationwide. The government will have to work out that partnership arrangement with the provinces.
In trying to clear the air on exactly where the government and members of the government stand, do they think it is all right to provide for profit delivery of health care services?
Mr. Murray Calder:
Mr. Speaker, to clear the air, very simply we as a government have always said that we take a look at the five principles of the Canadian Health Act and we stand behind them.
To go further than that, this becomes a negotiating situation with the provinces and territories. Where do we want to take the health care system, knowing that the issues that are facing it right now and the increased usage that is coming in the future as the aging baby boomers hit it? Those are the questions that will have to be negotiated this summer with the provinces and the territories.
Mr. Rob Merrifield (Yellowhead, CPC):
Mr. Speaker, as the health critic for the new Conservative Party of Canada, it is a pleasure to take part in a debate that is very important to most Canadians. Health care is the number one issue for Canadians from one side of the country to the other.
Before we actually get into a debate on health care, we must understand the principles of health care and the values Canadians hold near and dear.
Our medicare system was founded on the principle that no one should go without health care because of an inability to pay for it. No one should lose their life savings because of a serious illness. That is a very compassionate and principled value. It is different from what our neighbours to the south have.
The Americans have a different value system. I am not here to judge them but that it is not a system we would want to applaud. It is a system that has a different value system. They say that they will not let anyone die on the streets and that they will look after people's medical needs but they have no problem draining people's bank accounts in the process. They have their value system and we have ours.
I do not hear any province or any party advocating an American system. I hear everyone applauding the Canadian value system with regard to that aspect.
How we sustain our system becomes the issue. We have to understand that is the value that we want to hold near and dear.
First, there is a lot of misinformation or uncertainty around the whole idea of where our present government is at with regard to our health care system. Of late, we have heard all sorts of conflicting messages coming from our federal government. It is really interesting to have a debate on it today where we can perhaps clear up some of this confusion.
I cannot determine how another party lays out its platform or communicates that platform, but I can communicate our platform. I will try to do that in the most aggressive and clearest way I possibly can and hope I can achieve that in the next few minutes.
As we move into the 21st century, we have to realize who is paying for our health care system and why it is so important to put the patient first. For far too long our emphasis has been strictly around this sacred cow, the health care system. We have to realize that the system is there and is paid for by the patient. The patient, therefore, has to be our primary focus and the primary focus of decisions made with regard to health care.
Let us take a look at what our health care system looks like today after a decade of Liberal government. Wait times have extended to a period beyond what we ever thought imaginable. Since 1993 the wait times have doubled. General practitioners are having serious problems managing their offices and coping with the stress of their jobs.
Among the OECD nation, Canada's medical wait lists are among the longest in the world. We actually are only second with regard to per capita spending.
It is not just a matter of throwing more money at a system and solving the problems in health care. We have to look far beyond that. We have to understand that it would consume all the money we could possibly throw at it and we have to be very discerning as to how we do that.
We have medical workplace shortages, shortages of doctors and nurses. The ideology in the 1990s, when this federal government came into power, was that the doctors drove health care costs, so if we get rid of the doctors we get rid of costs. That ideology was faulty at that time and it is faulty today.
The Canadian Medical Association said that in a decade from now we would have serious problems, and that is what we have. We have a workforce that is overworked, overstressed and burnt-out.
The SARS crisis of last year demonstrated just how vulnerable we are in the health care system. We saw how the threat of a SARS epidemic hit the Toronto area and how stressed the workforce was during that period of time. We even had nurses saying that they would not go into work because they were too stressed or burnt-out.
We have a serious situation when it comes to that side of health care because of the massive cuts and the direction in which the government went in the mid-1990s. Since 1995, $25 billion has been taken out of the purchasing power of the provincial governments to deliver on their health care, which is their mandate.
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It is very important to understand that we are where we are because of a lack of leadership on health care. The Prime Minister when he was finance minister decided to unilaterally cut the legs out of health care. Unfortunately that did two things. Not only did the government cut the money out and leave the provinces high and dry with regard to the funding of health care, but it ruined a trust relationship which was an agreement on health care as to how both jurisdictions would jointly deal with health care. That relationship was broken and it is no wonder the provinces are a little shy when it comes to dealing with future plans, like a 10 year agreement on health care. I will talk about that later on.
Not only did we lose the money and health care was left to drift but also we lost the relationship with the provincial governments. Therefore, it should be no surprise to anyone what the state of health care is at the present time.
What are we looking at? What are some of the stresses and strains that are going to come on to the system as we look further into the 21st century? It is very important that we understand these stresses because if we do not, we will not get a clear picture of what we are headed into.
My hon. colleagues have been mentioning the demographic curve, which is important. The baby boomer generation is about to hit the health care system and that will have great significance. The last figures I saw are two years old, but it costs around $4,300 to $4,400 to look after an individual between the ages of 44 years and 65 years. For an individual between the ages of 65 and 75 years, the cost almost doubles. It doubles again for an individual between the ages of 75 and 85 years. The figure is over $14,000 by the time a person is 75 to 85 years of age. That is the average annual cost to look after those individuals.
When we look at the demographic curve, we see that the fastest growth in our population is those 65 years and over. When that hits our system and increases, it will be 2041 before we start to see any relief. The pressure on our health care system will continue to increase until that period of time.
We have to couple that with the obesity problems in our youth. I spoke to people from the Heart and Stroke Foundation and other associations. They were in my office a while back. They say the problem is that our young people today are going to be looking at heart and stroke problems at the ages of 45 to 55 instead of 65 to 75. They will hit the health care system at the same time.
We have to understand the dynamics of what we are looking at. Diabetes, cancer, heart and stroke and lung problems are all going to hit our system much more aggressively than we have seen in the past.
Until we understand what is coming at us, we cannot logically sit around the table and have a good discussion on how we are going to sustain our health care system into the future. It is very important that we do so. Right now 32% of the provincial and territorial budgets go into health care and by 2020 it is expected to be 44%. Almost half the money the provincial governments spend will go into health care. That is very significant.
Many of the challenges to health care are actually rooted in some of the good news stories. Our health care professionals are trained very well. Medical equipment is becoming much more sophisticated and new technologies are doing amazing things. Pharmaceutical products are more advanced and more specialized than ever before. Because of that, time spent in hospitals and acute care centres is being reduced.
I had to lay out that part of the scenario before getting to some of the solutions. As we move forward, I see three ways in which we could actually make a significant difference in health care.
The first one is to understand exactly what happened with the health accord on February 15 last year. For the first time in a decade both orders of governments, provincial and federal, sat down and decided on a plan on how to sustain the health care system for the next five years. It was a significant time because it was an attempt at mending a relationship, but it was also an attempt to look at health care funding more significantly and respecting both jurisdictions, the federal and provincial governments. This accord was very significant.
Our party agreed with the accord. We said the accord was a valuable road map ahead and that we should make sure that we comply with it. The second thing we wanted was to look at improving delivery and regulations of prescription drugs because of their significant role. The third thing was to renew our commitment to health promotion and disease prevention.
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The Conservative Party of Canada agrees with the funding in the health accord. We do not agree with the numbers the health minister and the Prime Minister are using. They are saying there is $37 billion in new money, but people have to understand that $20 billion of that was from the 2000 accord and it is reannounced money. Nonetheless I do not want to confuse people with the numbers. Let us just say there is going to be some new money put into the accord.
The accord recognized the flexibility of provincial jurisdiction in delivering health care. It also looked at reforms to primary care, providing greater home care delivery systems and catastrophic drug coverage. It is very important that the flexibility be maintained in the hands of the provincial governments.
The accord created a dedicated health transfer so that we could stop the noise about who is paying for what. When the Auditor General takes a look at the books in Canada and how much money the federal government is putting in compared to the provinces, she says that she does not know because of the way it is struck. We are saying let us clear up this silly game of the numbers of dollars going into health care. It is all the same payers for the system. It is all taxpayer money, so let us just get that cleared up right off the bat.
The accord provided significant funds for diagnostic equipment as well as health information systems and research for hospitals. It promoted and established a national council which hopefully will give us some better performance measures for our health care system. Some of the provinces said that what the council's mandate was coming out of the accord was different from what was agreed to with the provinces, and that is why Alberta and Quebec decided to bail on the accord. The Health Council of Canada was supposed to be struck on May 6 and it did not get up and running until after December last year.
The timelines and many of the things that were supposed to be done in the accord have not been complied with by the federal government. One of those is the implementation of home care. The minimum basket of services was supposed to be decided by September last year. The common health system performance indicators were also supposed to be done by September. This was not complied with.
We also wanted to see progress, and there should have been progress already, on the catastrophic drug coverage. We realize that the health minister said in December last year that work on that has not even been thought about and has not even started yet. We are really nervous about that.
The aboriginal health reporting framework was also supposed to be initiated and worked on. Nothing is being done on that either.
We have had a year to comply with the health accord, with specific timelines of what should be done, when and why. The first time the Prime Minister met with the premiers, one would think they would have discussed what was not done and why that was not complied with, but none of that took place.
The Friday before the Monday of the throne speech, when the Prime Minister met with the premiers, all that was talked about was $2 billion more going into health care. It had nothing to do with how both orders of government had failed to come up with the actual agreement on the accord. We are really quite nervous in our party when we see a lack of commitment from the federal government with regard to the health accord.
Michael Decter, the chair of the national council, recently said that all of what we need to do with regard to laying out this five year plan in the accord is that we should get on with it, that we do not need another 10 year health accord. That is what is being proposed by the government, that we sit around and talk with the premiers again to come up with a 10 year plan on health care. We have a five year plan that is not being complied with. Why would we think that the government would agree with a 10 year plan that is somebody's dream at this stage of the game?
We are very nervous going into an election at the lack of commitment to what was already on the table, and the talk of something in the future that likely will not happen. It is just a political game. We cannot afford to play politics with health care anymore. We have seen that happen many times before. We cannot let that happen to us at this stage of the game. Health care should be a non-partisan issue. It should be something that is not fought on a political basis. It should be fought on the best interests of the patients and the best interests of the Canadian population.
Our party is saying that we want adequate, predictable and growing levels of funding for health care. We agree with more dollars going into health care but we must balance that off with greater accountability so that those dollars are spent in ways that are accountable and are actually going to achieve some of the goals that are asked for in the accord. We cannot make annual multibillion dollar infusions into health care without that kind of accountability happening.
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Performance measures must be in place. Citizens and taxpayers must be able to see where those moneys are going to improve the health care system in Canada. If that is not the case, then we will be continually going in circles and spinning our wheels and not achieving what really needs to be done with regard to the sustainability of health care. We do not have the time to make these mistakes again.
I would also like to talk about prescription medication, because it is such an important area of our health care system. Our spending on prescription and non-prescription drugs is the fastest growing category of health expenditures in the country and is only second to hospitals. Very close to the same amount of money goes into hospitals and pharmaceuticals. Prescription medication is the fastest growing at 14.5% last year.
Prescription drugs play an important role in enhancing the health of Canadians. We all understand that. We know about some of the treatments and some of the technologies. They are doing amazing things. They are allowing Canadians to live healthier, more comfortable and longer lives. Over the past few decades pharmaceuticals have had an enormous impact on the health care system. New drug therapies have replaced many of the surgeries and have enabled patients to leave their hospital rooms much sooner.
Our aging population will ensure that drug consumption and spending will only increase when it comes to pharmaceuticals. Because of that, we have to go back to what I started with, which is the Canadian value on health care. No one should lose his or her life savings because of a serious illness. Many prescription medications and what is done with therapies and treatments are much different today from 20 years ago and the costs of those are going up much higher.
The health accord includes the pledge to provide Canadians with reasonable access to catastrophic drug coverage, with which we agree, to make sure that value is preserved. Canadians no longer would have to risk losing their life savings because of a serious illness.
Yesterday our leader announced that a Conservative government would propose that the federal government assume direct responsibility for this program. The drug costs are one of the fastest growing expenditures. We have to be sure that Canadians are comfortable in knowing that we will comply with the health accord with regard to catastrophic drug coverage.
It is important to understand that it is within federal jurisdiction to allow new drugs to come into this country and not only that but also the regulation of those drugs. That is all federal jurisdiction.
The health committee travelled this country from one end to the other dealing with the whole area of addiction to prescription medication and the misuse of medication. The reports are about to come in on some of the studies, but we know there is a minimum of 10,000 deaths per year because of misuse of prescription medications in Canada. From a federal perspective we could control that side of it. We have to do a much better job than what has been done in the past. We also must make sure that new drugs and better drugs are available for our citizens so that we can have the best health care system in the world.
It is very important that we put the patients first. One way to put the patients first is by helping them not to be patients in the first place.
The Conservative Party will do that by recognizing that wellness promotion and disease prevention are keys to improving the health of Canadians and ensuring the sustainability of our health care system. That is why we support the renewal of the Canadian strategy on HIV-AIDS. That is why we as a party support the tobacco prevention program, particularly aimed at our youth. That is why we will support the patient safety institute. That is why we will devote 1% of health care spending to the promotion of physical fitness and amateur sport.
We support also the new chief medical officer of health and the creation of the public health agency. It is unfortunate the government has dilly-dallied on this. We have been sitting vulnerable for a year now, waiting for the government to put in place a chief medical officer and an agency. Instead we have seen very little leadership in this area. Mark my words, we will likely see something within the next week with regard to a statement on a chief medical officer or the agency and where it will be placed. It is strictly about politics. It is unfortunate that we have to play politics with health care again. That is what I mean by putting the patients first, by making the kinds of decisions that are in the best interests of Canadians and not politics.
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It is really interesting to see the position of Liberal Party on health care. I am not exactly sure what Liberals are thinking because we see so many conflicting areas and statements coming from them. A few weeks ago the Minister of Health talked about the Canada Health Act and what it allowed and did not allow. Then we hear that the Prime Minister goes to a private clinic for his services.
The Conservative Party is clear on its position on health care. We support Canada's system of universal public insurance. No one should be denied medical services because of inability to pay and no one who receives such services should find themselves and their families faced with health bills they cannot afford.
We need leadership on health care like never before.
Mr. Paul Szabo (Mississauga South, Lib.):
Mr. Speaker, the member has touched on a number of aspects of health care. I am not sure if he heard my earlier question for the member from Churchill, but I would pose a similar one to him on how he defines health care. As he knows, under the Canada Health Act we talk about medically necessary, and that is hospitals and doctors.
An example, a doctor provides cosmetic surgery for anyone who wants to pay for it, but also provides services to the health care system where someone, for instance, has been injured in an automobile accident, has facial damage which requires that same surgery. One is as the result of an accident and the other is not. We are talking about a physician who is private for profit totally or a physician who has certain other aspects in his or her activity, depending on why the service is being provided and who is paying for it.
Would he clarify that in the context of this motion? I have some concern that the motion would basically state that doctor should not be in business because he or she would be characterized as being business for profit.
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Mr. Rob Merrifield:
Mr. Speaker, there is a very simple answer to that. When we look at the Canada Health Act, it is for medically necessary services. Medically necessary services are determined by the provinces. We have to respect their jurisdiction on that and we have to understand that is the way it works. If we want to change the Canada Health Act, that debate would have to happen nationally. That is what the NDP is suggesting. I disagree with that. Provinces need to have the flexibility on delivery.
The problem is not about who delivers the service. The problem is that we have no accessibility to the service. Canadians are really concerned about that. They want to have the services, which they pay for through their taxes, when they are in need of them. Right now a million people are on wait lists, many dying and many dying in emergency rooms because of inability to access the services for which they pay.
We put $121 billion a year into health care. All Canadians ask for is when they are sick and when they need it, it be there for them. That is being jeopardized right now. We have not seen anything yet.
The pressure on our health care system has not started. Just give it 10 or 20 years. What will our health care system look like in 2040? We have to change the paradigm. We have to make the patient first and we have to make decisions based on their best interests. We do that by allowing and respecting the jurisdictions of the provinces to deliver on health care. They will be rewarded or they will be victimized on how well they do in this.
Under a publicly funded system, we need competition within that system and there are many ways of doing that such as funding hospitals differently, funding doctors differently, how it is structured, who they contract out and so on. That all has to be part of a system that is strong and healthy. As we move forward, that flexibility has to be there. The health accord allowed for that and that was one reason we had no problem with the accord. We have a bigger problem with a government that has not committed to the health accord.
Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, I will to allude to the fact that obviously my colleague from Mississauga South has a hard time understanding some the processes within the motion.
Without getting into that, I agree that patients want to be able to access the health service. Does the Conservative member believe that we should have a for profit system of health care delivery? My colleague from Mississauga suggests that when a doctor provides his services, that it is for profit. He is being paid to provide the service.
The for profit comes into play when a clinic operates so that there is a profit overhead apart from the cost of the physician's services or a nurse's services, or whatever. There is profit built into the equation, and the facts show that profit is usually around 15%.
Does my colleague believe that Canadian taxpayers should be paying for a for profit health care delivery?
Mr. Rob Merrifield:
Mr. Speaker, all sorts of studies have been done on this issue over the last decade. In fact $243 million has been spent by this Liberal government on studying health care. Mr. Romanow said that 31% of our health care system was private right now, but he did not recommend getting rid of that element of our health care system.
Under the Canada Health Act, those delivery options are available. I hope my colleague is not suggesting that we shut down every medical clinic or doctor's office, because 90% or more of them are privately funded.
If we were to privatize the whole system would that be right or wrong? Certainly nobody is advocating privatizing the whole system. If we were to eliminate those flexibility options, will that save our system? It will not.
We have to stop the rhetoric about the nonsense of who delivers it and instead look at accessibility. Canadians are really concerned about whether the health care system will be there for them in their time of need. That is what we have to concern ourselves with as we move forward into the 21st century. It will take every Canadian, working together, to ensure that there is enough accountability in the system and that their dollars are spent in a way that will achieve those goals. It will tax everyone in the House to drop the politics and start to work in the best interests of Canadians.
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Mrs. Bev Desjarlais:
Mr. Speaker, I challenge my colleague's figure of 90% of clinics operating on a for profit basis in Canada. I would love to see those figures because I find them hard to believe.
Can proof be presented that the delivery of health services through private clinics already in place will deliver 14% to 15% less cost to the taxpayer? Let us say the provinces make a decision to provide this through public delivery because it will be cheaper. Will my colleague acknowledge that this is what we should do with taxpayer dollars? Will he agree that we should use that other 14% or 15% to enhance services elsewhere, whether it be to provide more home care, or respite care or other types of health care services? Is that not a better utilization of taxpayer dollars than giving that 14% to 15% to for profit providers?
Mr. Rob Merrifield:
Mr. Speaker, the argument there is that it is the provinces that deliver on health care. They will either be rewarded or they will be disciplined by the electorate as to how successful they are in that delivery.
My colleague has asked why 14% or 15% of the profit should come out of taxpayer dollars, but she has not recognized the fact that private operators deliver a lot more efficiency in some ways. Under a single tier system, there has to be enough efficiency and competition so we know we are getting the best bang for the dollar.
That is where this is at. It is provincial jurisdiction. Medically necessary services are provided for Canadians from one end of the country to the other, regardless of their ability to pay. That is what we believe in. How those services are delivered is something with which the provinces will have to wrestle. It is their mandate. We should encourage them to be as aggressive as possible in the best interests of Canadians so services will be there for them.
This is not about delivery options. Can we stretch taxpayer dollars to the point where health services are available to Canadians when they have a serious illness and when they need the service?
Right now we have some serious problems with waiting times for services. Over one million people are on waiting lists. Many of them are beyond the medically acceptable level of wait time. We have a serious problem today, and the stress on the system has not even started yet.
This is not a productive debate with regard to whether we need public or private health services. What we really need to look at is accessibility. How can we ensure that Canadians will have a health care system in place in their time of need?
Mr. Paul Szabo (Mississauga South, Lib.):
Mr. Speaker, today we are debating health care. I will talk about the motion in a moment, but I want to start by expressing my own view about the measure of success of a country.
Some would argue that it has something to do with economics. I would say the measure of success of a country is the measure of the health and well-being of its people. That is the true measure of success of a country.
The particular motion before us refers to private for profit delivery of health care. As I indicated earlier in my questions, I thought it lacked the clarity that was necessary for the House to really address it. However, the motion has brought us the opportunity to discuss some of the elements of our health care system, some of which is under the purview of the federal government, some of which is under the purview of the provincial government and some of which is the choice of Canadians who may choose to seek uninsured services from a health care provider.
The Canada Health Act has just celebrated its 20th anniversary for medically necessary insured services, and it passed unanimously in the House of Commons. I believe the existence of our publicly funded universal health care system is one of the most unifying elements that Canada has. It is that which we cherish so much, and most will agree that it is the most important asset we have in Canada, in terms of what is identified outside of Canada, is as one of our strongest points.
The health care system is very broad: obviously hospitals, doctors and nurses. However, these days health care for the public at large has been talked about in a much broader context than was ever envisaged or included in the Canada Health Act responsibilities. We now talk about pharmacare, the drug system. We now talk about home care, providing assistance to those who have had medical services and require care in the home for at least a point of time.
We also have dental care. That is a part of health care. Vision care is a part of health care. Psychiatric care is a part of health care. Not all these are included under the umbrella covered in the Canada Health Act. The Canada Health Act is for medically necessary insurance services.
The federal government has no responsibility to provide pharmacare. It has no responsibility to provide dental care. It has no responsibility to provide vision care, except if the need for that service is as a result of another occurrence, for instance, when someone needed dental care because the individual was in an accident. That would be covered. Normal, preventative and routine maintenance of dental care is not covered.
All of a sudden, in listening to the debate today, it is very clear to me that we are talking about health care in a much broader context than simply the responsibilities of the federal government. Having said that, there is no question in my mind that the public at large does not care to hear anything more about which jurisdiction is responsible.
Quite frankly, year after year, regardless of the issue, whether there are dual responsibilities or maybe even spread right down to a third level of government, Canadians do not care who is responsible. All they care about is that it is one taxpayer dollar. With regard to our health care system, all we really care about is that when medically necessary services are needed, they will be there on a reasonable basis and in accordance with the five principles of the Canada Health Act.
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Those principles are: universality, which means it is available to all in Canada; accessibility, which means I can get it where I am, taking into account the geographic circumstances and the alternatives that would be necessary to qualify as providing accessible services; comprehensiveness, which means covering the full range of medically necessary services, not just providing a certain part of it in some areas but saying that it has to be comprehensive; portability, which means that regardless of where we live in Canada we would be able to get that service anywhere else in Canada; and finally, public administration, which is what most of this debate has been about in the context of private, for profit health care.
Private, for profit care has been talked about during this debate in two contexts. One has to do with a situation whereby an individual would go to a health care provider and pay for those services. Most Canadians would understand that to be private, for profit health care. It means that I go to a doctor and I want this and I want it now, and I am prepared to pay for it, so I can jump the queue. It might be, for instance, an MRI, magnetic resonance imaging.
There is another context in which private, for profit care has been discussed and I think it is the subtlety of this difference that is the important element of this discussion. This is private, for profit care in the context that the publicly funded system would acquire the services from a private, for profit institution, like a stand-alone clinic. Let us say, for instance, that someone went to the hospital after an auto accident and needed services. Let us say that the person had facial damage and had to have cosmetic surgery. That particular hospital may not have that particular service, so the public system would engage a private cosmetic surgeon. Cosmetic surgery is not an insured service unless it is as a result of, for instance, an accident. That means the health care system pays for it, not the individual.
There are two contexts here. I think it is important to understand that we are really trying to focus on the aspect of where the publicly funded or public administered system of our health care system would rely on services to be provided by those who are outside, who are not full time employees. They are in fact satellites out there that can provide those services for a fee, and there is a profit component. This is what this discussion and this debate have been swirling around. We have to make sure we are clear about the elements of which part we are talking about in terms of private, for profit health care.
Having said that, let me say that I spent almost 10 years on the board of the hospital in my own community. I learned a fair bit about the health care system. I have the ultimate respect for the primary care givers: the doctors and the nurses. These professions are extraordinary, and there are extraordinary credentials and extraordinary criteria, codes of ethics and guidelines for them.
In my own hospital in the 10 years I was on the board, the average length of stay of a patient in the hospital went down from about 7.2 days to about 4.7 days. That is a dramatic drop in the average length of stay. The reason it happened was that the health system is in its evolution, with the new technology, the new medicines, and the shift to an ambulatory system. One does not go to the hospital and prepare for a couple of days for surgery, have that surgery and recuperate for a couple of days. Now one can walk in and get same-day surgery and go home and recuperate there. It has totally changed the model of how health care is delivered.
I have a fundamental problem, though, with an ambulatory system. It is less invasive because of the technology, but what it does mean for people who are in the hospital and stay there for two or three or four days is that during that period of time when they have drugs required as a consequence of their surgery or their treatment, the cost of those drugs is covered by the publicly administered health care system. However, if one goes for ambulatory care treatment and it is day surgery, the cost of drugs required as a consequence of that surgery would be one's own cost. They would not be covered by the publicly administered health care system.
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So now we have two situations. The hospital saves money and in fact closes beds, and indeed, in this particular hospital it went down from 650 to 400 beds, but it still could claim that it serviced more people with less beds because it was having a lot of day surgery. So suddenly not only were we downloading the cost of drugs to people, we were also downloading the recuperative care to families and to home care. That home care is not covered under medically necessary and insured services. That is provincial. The existence of home care and the extent to which it is provided is a provincial decision. It is not covered under medically necessary insured services under the Canada Health Act. Thus, over time, things have changed on what our view of health care is. It is much different today from what it was 20 years ago when the Canada Health Act came in.
In this morning's National Post there is what I think is a very good article written by Ms. Jane Brody on women and reproduction. It is an excellent piece. One of the things commented on is the fact that societally women are waiting a little longer before they have their families. It states, “Biologically speaking, the ideal age at which to have a baby is between 18 and 20”.
We know that is not happening very often now. In fact, people are waiting until their thirties before they have children. But the article also goes on to say that older women are more likely to suffer pregnancy complications: genetic abnormalities are more common in their fetuses and the miscarriage rate rises as the fertility rate falls.
Here is an example of how even societally how we live our lives is in fact changing the demands on our health care system. We have decided that we are going to wait longer to get married and longer to have children. As a consequence, however, it means that the costs to the health care system are also increasing, so there are other dynamics.
The point is that for the health care system as it was discussed and debated 20 years ago this past April 17--and in Parliament the Canada Health Act was passed unanimously--it was talking about hospitals and doctors and about what was medically necessary.
Today, “medically necessary” is not a defined term in the Canada Health Act, and it should be. We should define it. I would even refer it to the Standing Committee on Health. Let us talk and let us have some experts come and talk about what is medically necessary. As many of the people who have participated in this debate have already said, health care to them is what the people think health care is. Health care is not just the doctors, nurses and hospitals. Health care is community clinics. Health care is pharmacare and home care. It is the health and well-being of the person, the whole thing.
When we consider that we now get pharmacare, dental care and vision care, we suddenly are talking about a much different health care system and health care need that Canadians have focused on than what Parliament was talking about some 20 years ago.
When I was elected for the first time, in 1993, one of the first major tasks the government initiated was the National Forum on Health. It engaged some of the top medical professionals and administrators from right across the country. It spent two years studying our health care system. It provided interim reports and had consultations with Canadians. I can remember the booklets we had. I can remember the interim reports and the final report.
If members will hearken back to that period, the National Forum on Health concluded that there was enough money in the health care system. The problem was that we were not spending it wisely. That was the principal conclusion of the National Forum on Health, an independent public consultation with all of the expertise that was available. It concluded that there was enough money in the system.
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We have now had another round with the Romanow commission. It consulted again all across Canada. Suddenly Mr. Romanow did a favour for us, I think, by telling us that we have to start thinking about our health care system in much broader terms than we contemplated back 20 years ago. We have to start talking about the health and well-being of Canadians in terms of what they need so that their health and well-being can be rated “high”. Because the higher the rating of the health and well-being of people, it is the measure of success of a country.
We have not yet finished the debate. I think that members would agree that pharmacare is a very important element, but drug costs now, in terms of the cost of medical services or medical expenses, are equal to what we spend on doctors. This is the result of change in the cost of medications.
This is not to say that on a blanket basis the pharmaceutical industry is somehow taking advantage of the health care system. The technology has changed. The drugs have changed. People are living longer. We only have to look at the average life expectancy of people these days. There is a significant increase in the length of our lives.
Members should also know this, which is one of the first things I remember from when the officials from the health department came before us back in 1993, at the first committee meeting I ever went to. The officials said that we spend 75% of our health care dollars fixing problems and only 25% preventing them. They said that this model we had back in 1993 was unsustainable. They also said that a dollar spent on prevention was far more productive than a dollar spent on curative or remedial health care spending.
So things have changed, Mr. Speaker. Things have changed dramatically in the health care system. Parliamentarians, with a motivation that I hope is beyond the political, are now seized with an opportunity to talk about what the people need. I think there is agreement that our health care system should be there for us when we need it, not because we can afford to pay.
One of the facts we in the health committee also found out early in my career was that about 75% of the health care costs in a person's lifetime will be incurred in the last two years of a person's life. Let us imagine that: 75% of the health care costs in our lifetime are spent in the last two years of our lives.
Why would that be? The reason is that we are talking about more life-threatening types of situations as we age. This means that the types of interventions, the specialists, the more expensive drugs and the equipment are all some of the most sophisticated equipment possible. It means that the resource intensity that is being used for life threatening situations goes up. That is why the health care cost is so high at the end.
We can all imagine that we have a system where we are now faced not only with defining what health care is and what is medically necessary, but we are also looking at an aging society and what demands that will make. The urgency is now.
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I will conclude with what I believe is a fair assessment of my position on for profit health care delivery. To the extent that private for profit health care exists, the public health care system must be disadvantaged. The reason is not because of costs. It is because we are taking resources out of the public health care system and feeding the human resources into a private system. That means that the public system must be diminished. In my view, private for profit health care should not be an option in Canada.
Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, it would be great if the government as a whole would make that statement and put some effort into ensuring that private for profit does not become the battle cry of the next election between the two parties.
My colleague mentioned a number of things. I just want to clarify some of those things with him.
He mentioned that the Canada Health Act did not envision all the things we are dealing with today within the health care system. That is absolutely true. I do not think people envisioned the rate of increase in new technologies and the increased costs being incurred by patients and the health care system. That is why we in the New Democratic Party have no problem looking into the Canada Health Act again and ensuring that it now addresses what Canadians see as their wish for a health care system.
The Liberals have in the past acknowledge that and promised in their last red book to implement pharmacare but here it is, seven years later, and we still do not have pharmacare. The Conservatives say that they will stand behind providing a pharmacare program. I am sure the Liberals will come out saying that as well but the reality is that it is not here.
My colleague also mentioned that some services would not be covered unless one was in an accident. I think this is the same in all provinces, but certainly within the province of Manitoba if there is an accident, whether it is a car accident or a work related accident, which is workman's compensation, it is a third party billing process through the health care system. These should not be dollars coming out of the health care system but as a third party liability.
However those costs often do get incurred by the health care system when, by rights, they should be handled by different service providers. That is already in place. I firmly believe that if it is a workplace injury it should be covered under workman's compensation.
I also want to comment on the fact that there is a schedule of payment for services, certainly within the province of Manitoba, and I would think the same in other provinces, where there is a maximum amount that can be paid for a particular service that a doctor performs.
If it is necessary to change the Canada Health Act to reflect the changing needs within the health care system so there is no longer the need for long hospital stays, as he said, and to provide medications when a person leaves, should we not be addressing those changes and including them within the health care system?
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Mr. Paul Szabo:
Mr. Speaker, to amend the Canada Health Act in order to put in the wishes of Canadians, as the member pointed out, theoretically we would have to take all the health care delivery services provided by the provinces and put them under federal jurisdiction. I would think that will probably not happen.
When the member commented on private for profit delivery versus a publicly administered system, she indicated that the public health system was more cost efficient. I want to repeat why I believe we should not have private health care. It is not so much that there are cost efficiencies. The issue is that to the extent that there is private for profit health care delivery out there, almost two tiered or semi-tiered, that means that real resources, like doctors, nurses and the best specialists, will be taken out of the public system. Therefore, if the resources available, the doctors, nurses and other resources, stay the same that means that the public system is losing real resources and probably some of the best resources available to the public system. That is the reason I oppose private for profit health care delivery.
By the same token though, there is a debate going on that if our only alternative, for instance in terms of having a hospital, is to enter into a P3 arrangement, a public-private partnership, do we want a hospital or no hospital? If there is no money, would it not be better to lever or co-finance the hospital for the community than to have no hospital at all? The services still have to be delivered at the best available price. In some cases, I think there is probably a good case where hospitals, even in a P3 partnership, would probably be more cost efficient than a publicly administered system that has to go out and borrow the money.
Mr. Paul Forseth (New Westminster—Coquitlam—Burnaby, CPC):
Mr. Speaker, does the member have any comments on the current court case winding through various levels of the courts? The case has to do with a charter challenge on the basis of discrimination and equality that attacks the principle that denies me purchasing services from a clinic in Vancouver where Canadians are being serviced by ICBC, accident victims or workman's compensation, and says that I cannot do that, which means I would have to drive to Bellingham, an hour south, and buy that service.
(1350)
Mr. Paul Szabo:
Mr. Speaker, if there is a simple answer to that complex question, it is probably wrong.
This is part of the reason this debate is going on in terms of private for profit delivery. The ultimate question is, how do we provide the services that Canadians require when they need them? There are circumstances, clearly, when the timeliness of the need may require some other arrangements. I would see that as an extraordinary circumstance, not the norm.
Mrs. Elsie Wayne (Saint John, CPC):
Mr. Speaker, how does the hon. member feel about what is happening right now in Manitoba to those who want to study to be a doctor and be part of the health care system if they are not pro-choice? We know what happened to the young man who said that he was against abortion. He was told that he could no longer study to become a doctor in Canada. I was truly shocked when I read that. I could not believe that we were doing this in Canada.
How does the hon. member feel about that situation?
Mr. Paul Szabo:
Mr. Speaker, I am familiar with that particular case where I believe the student would not be able to take his exam unless he, as a future obstetrician, would perform abortions. I do not agree with that position in terms of criteria, but, fortunately, the institution relented and understood there was a problem. It withdrew and that particular person was able to proceed with his education.
Ms. Libby Davies (Vancouver East, NDP):
Mr. Speaker, when the member for Mississauga South began his remarks he said that he was speaking about his own position. I am not sure if that was on everything he said or if at some point he began to articulate where his party stands. I am somewhat confused because I think either one supports our public health care system and the public delivery of services that have been ensured through that system or one does not.
We all recognize that there has been a huge encroachment on our public health care system and an enormous growth in these private for profit services and the delivery of those services.
The question I have for the member is, where does his party stand? It has been incredibly confusing.
I congratulate the member for Churchill who, as a member of the health committee, drew out the Minister of Health and actually made him articulate some of his own vision of where he thought health care was in terms of privatization. Maybe the member could enlighten us in terms of where his own party stands in stopping this encroachment of for profit private delivery of health care services because that is what we are seeing in almost every province.
Mr. Paul Szabo:
Mr. Speaker, earlier in a question to the mover of the motion, the member for Churchill, I asked her to please give me an example of where there has been a matter under the federal jurisdiction, the Canada Health Act, of medically necessary insured services where there has been private for profit delivery of those services. The member was unable to give the House one example. I therefore understand why the member is confused.
I also want to indicate that when I said I was giving my view, it was the terminology that I was using, but the view of the Liberal Party of Canada is to vigorously defend the five principles of the Canada Health Act.
Ms. Wendy Lill (Dartmouth, NDP):
Mr. Speaker, I will be splitting my time with the member for Vancouver East.
It is a pleasure to take part in the debate today, especially on the day when the NDP leader, Jack Layton, is in Halifax delivering the health care platform for the New Democrats for the upcoming election. I would love to have been there but I am here instead taking part in this important debate that condemns the private for profit delivery of health care that the government has allowed to take root since 1993.
For the last 10 years, Canadians have been telling the Liberal government that they want innovative public health care that they can count on. I hear it all the time in Dartmouth. People do not want the long waiting lists. They fear the rising cost of drugs. They do not want to be put on a long waiting list for an MRI or for other kind of treatment. They want health care that they can count on and health care that will be there for them, their children, their grandchildren and their grandparents when they need it. That is a very simple and straightforward request.
There is no ambiguity in their statements and yet the Liberals have not listened to what people have asked over the last 10 years. They have been listening clearly to someone else. They have allowed for the private for profit delivery of health care to grow and, for practical solutions, to be ignored.
Today the NDP's platform has been released. We are saying that it is time to put new energy into health care and come up with practical solutions to fix the system and improve it, similar to the way Roy Romanow suggested changes and created solutions just over a year ago.
Included in the NDP's health platform are practical solutions for an innovative health care system that is improved through new ideas and investment, not privatization and not for profit delivery. The NDP is calling for restoring the federal government's capacity to act as a partner for innovation and practical delivery by increasing funding for health care to 25%, up from 16%, as recommended by the Romanow commission.
We are calling on government to prepare for the aging population and to relieve the burden on hospitals and families through a national home care program based on public and non-profit delivery. We are calling on implementing a pharmacare program to ensure Canadians have access to prescription drugs, starting with low income Canadians and people with catastrophic illnesses, and cutting health care costs through bulk buying of prescription drugs and clamping down on patent abuses by drug corporations.
(1355)
The Acting Speaker (Mr. Bélair):
The member will have seven minutes after oral questions this afternoon.
STATEMENTS BY MEMBERS
[S. O. 31]
* * *
[English]
Princess Patricia's Canadian Light Infantry
Ms. Anita Neville (Winnipeg South Centre, Lib.):
Mr. Speaker, during the weekend of June 18 to 20 of this year, the 2nd Battalion Princess Patricia's Canadian Light Infantry will conduct a variety of parades and activities in the city of Winnipeg.
One of these activities is to celebrate the 90th anniversary of the regiment's service to Canada. On August 10, 1914 the charter of the regiment was signed in Ottawa and in just over a week the regiment grew to 1,098 members.
Named after Her Royal Highness Princess Patricia of Connaught, the regiment is best known to the public as the Princess Pats or the Patricias.
The combat and peacekeeping record of the Princess Pats runs from World War I right through to last year's tours of duty in Bosnia and Afghanistan. Throughout this period, the regiment distinguished itself in a manner in which all Canadians take pride. The regiment deserves our thanks for duty well done.
It gives me great pleasure to offer my sincere congratulations to the Princess Pats on its 90th anniversary. While we will miss them in Winnipeg, we wish the 2nd Battalion well in its new regimental home in Shilo, Manitoba.
* * *
Equalization Payments
Mr. Brian Fitzpatrick (Prince Albert, CPC):
Mr. Speaker, Saskatchewan is being seriously mistreated. Academics say that the current equalization formula is grossly unfair toward the province of Saskatchewan. Who is responsible for this gross inequity? It appears that our new Minister of Finance is the culprit.
Academics say the problem could be resolved by removing the formula's reliance on non-renewable natural resources and moving to a 10 province formula.
The minister's response is that the formula is far too complicated to change in any significant way. In other words, he is saying to the people of Saskatchewan that they may as well get used to being treated in an unfair manner.
The Canada West Foundation says that of all the western provinces, Saskatchewan has the highest degree of western alienation. With the unfair treatment that Saskatchewan people are receiving from the Liberal government, is there any wonder that my province is alienated?
* * *
(1400)
[Translation]
Notre-Dame-de-Grâce Community Council
Mrs. Marlene Jennings (Notre-Dame-de-Grâce—Lachine, Lib.):
Mr. Speaker, I would like to recognize the Notre-Dame-de-Grâce Community Council's initiative in organizing the conference on the “Quality of Life” in NDG last Saturday.
[English]
The all day event attracted over 150 concerned citizens of NDG. They spent the day discussing how to improve the quality of life in our neighbourhood, in our city and indeed, throughout the world.
They touched on a variety of subjects important to life in NDG, mainly housing, youth, environment, public safety, community relations with law enforcement, recreational services and finally, local democracy.
I was truly honoured to take part in this event as it is true grassroots community initiatives such as this one, by the NDG Community Council, that make our communities liveable.
* * *
Police Officers
Mrs. Elsie Wayne (Saint John, CPC):
Mr. Speaker, yesterday Her Excellency the Governor General presided over the third investiture ceremony for the Order of Merit of the Police Forces.
The House will recall that this great honour was created in the year 2000 to recognize outstanding service by members of Canadian police forces.
I know that all members will share the sincere and heartfelt appreciation that I have for the selfless dedication of our men and women in uniform.
It is indeed a great privilege and pleasure to single out one recipient for specific mention. One of this year's recipients of this great honour is Chief Clarence “Butch” Cogswell of Saint John, New Brunswick.
I have known Butchy for many years and can personally attest to the fact that he is an outstanding police officer of the first order and truly deserving of every honour awarded to him.
The people of Saint John are fortunate to have such a fine officer in their service. I join with his friends and family in offering my hearty congratulations to him.
* * *
McMaster Children's Hospital
Ms. Beth Phinney (Hamilton Mountain, Lib.):
Mr. Speaker, on May 2 I had the pleasure of taking part in McMaster Children's Hospital Celebration 2004 in Hamilton.
McMaster Children's Hospital provides outstanding service and care for approximately 150,000 children every year. The 12th annual telethon raised $3.8 million that will be used toward establishing a neuromuscular and neurometabolic disease clinic. The funds raised will also provide the hospital with a neonatal echocardiography machine and ventilator.
This event would not have been realized without the support and involvement of those who generously donated their time and money. All participants should be proud of what they have accomplished.
I know that all the members will join me in applauding the efforts of the patients, staff, volunteers, corporations, and the Hamilton community for a successful telethon and celebration.
* * *
Member for Vancouver Kingsway
Mr. Charles Hubbard (Miramichi, Lib.):
Mr. Speaker, I had the pleasure of working closely with my colleague, the hon. member for Vancouver Kingsway, when we were both serving on the executive of the national Liberal caucus.
My colleague was first elected in 1997 as the member of Parliament for Vancouver Kingsway. She has brought to Parliament her vast experience in community service and the spirit of diversity. As a recipient of the Order of Canada, she also made history by becoming the first Asian female member of our Parliament.
As a true model in her nation she inspired young people from all over Canada. As the chair of the northern and western Liberal caucus she strongly voiced the important issues and concerns of western Canada. She courageously and persistently sought the attention and support of the Prime Minister, ministers, and other members of Parliament in our national caucus on behalf of western Canada.
I would like to pay special tribute for her seven years here as a member of Parliament on issues dealing with immigration, economics, finance, health, human rights, and education. I invite all my colleagues to join me in wishing her happiness and peace in her future endeavours.
* * *
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National Nursing Week
Mr. Rahim Jaffer (Edmonton—Strathcona, CPC):
Mr. Speaker, tomorrow is the beginning of National Nursing Week. Yesterday I had the pleasure of attending a reception at the University of Alberta launching the first bilingual nursing degree program in western Canada.
The University of Alberta Faculty of Nursing in cooperation with Faculté Saint-Jean offers this program to meet the educational needs of bilingual students helping to respond to the needs of French speaking communities in western and northern Canada.
[Translation]
This program is a major step in honouring Canada's commitment to provide health services in both official languages. As we know, language should not be a barrier to access to medical care.
[English]
On behalf of the official opposition, I wish to congratulate Dean Genevieve Gray, Faculty of Nursing and Dean Marc Arnal, Faculté Saint-Jean for pioneering this program. This proves once again that the University of Alberta is quickly becoming one of the finest universities in Canada.
* * *
[Translation]
Employment Insurance
Mr. Gérard Binet (Frontenac—Mégantic, Lib.):
Mr. Speaker, my colleague, the hon. Minister of Human Resources and Skills Development announced this morning new measures worth some $270 million over two years to better meet the needs of employment insurance claimants.
The changes announced today will ensure that the program promotes greater labour force participation by encouraging workers to accept any available work.
In addition, the provinces that participated in the Older Workers Pilot Projects Initiative will be offered additional funding in 2004-05. The projects are designed to help older workers aged between 55 and 64 to remain employed or reintegrate into the labour force.
Today's initiatives are but the beginning of a solution. It is still our government's intention to implement more sustainable solutions as soon as the Task Force on Seasonal Work has submitted its final report.
* * *
The Prime Minister
Ms. Monique Guay (Laurentides, BQ):
Mr. Speaker, since his coronation as head of the Liberal Party of Canada, the Prime Minister claims to be change incarnate. Yet, he was finance minister in the Liberal government for nine years. He signed the cheques in the sponsorship scandal. He signed the cheques in connection with the firearms registry. He cut funding for health and education. He pirated $45 billion from the EI fund. He personally saved $100 million in taxes by registering his shipping company in a tax haven and amending legislation in his favour. He made off with $3.2 billion from the poorest seniors. He took $1 billion from Quebec families who use the reasonably priced child care centres. He refused to recognize the nation of Quebec.
The Prime Minister is not change incarnate, he embodies the usual traits of the Liberal Party of Canada: patronage, waste of public funds, demagoguery and anti-Quebec policy.
* * *
Employment Insurance
Mr. Andy Savoy (Tobique—Mactaquac, Lib.):
Mr. Speaker, this morning's announcement about employment insurance by my colleague, the Minister of Human Resources and Skills Development, is remarkable in many ways.
The transitional employment insurance measures in the Madawaska-Charlotte regions of New Brunswick and in the Lower St. Lawrence and North Shore regions of Quebec will be extended. Thousands of claimants will have increased access to EI benefits and for a longer duration as well.
The minister's initiative could be extended to all regions that report an unemployment rate greater than 10%.
[English]
I want to congratulate my colleague the Minister of Human Resources and Skills Development. His announcement this morning is great news.
This government ensured that transitional employment insurance boundary measures in the Madawaska-Charlotte, Lower St. Lawrence and North Shore regions were extended. Approximately 15,000 EI claimants will benefit from increased access and longer benefit duration. Moreover, these new measures could apply to any economic region where unemployment exceeds 10%.
* * *
Justice
Mrs. Carol Skelton (Saskatoon—Rosetown—Biggar, CPC):
Mr. Speaker, the crime rate in certain areas of Saskatoon is on the rise. As the member of Parliament for Saskatoon--Rosetown--Biggar, this is of grave concern to myself and my constituents.
Limited resources, a failing justice system, and a federal government that turns a blind eye is making it worse. Break and enters and home invasion have people scared, and living in fear in their own homes. The whole community is suffering because of this.
About 82% of my constituents said child prostitution was a problem in their neighbourhood and 82% believed date rape drugs should be classified as a weapon. Some 18% knew a victim and 80% said mandatory minimum sentences would better protect the public. Close to 93% said current sentences were too lenient and 89% said the Liberals were soft on crime. Not a single person said they were doing a good job of running our prisons.
My constituents have spoken. Why will the government not listen?
* * *
[Translation]
Seasonal Workers
Mr. Christian Jobin (Lévis-et-Chutes-de-la-Chaudière, Lib.):
Mr. Speaker, seasonal workers in several regions of Quebec have every reason to be pleased today.
Indeed, my colleague, the Minister of Human Resources and Skills Development, announced a series of measures aimed at meeting the specific needs of seasonal workers.
From now on, seasonal workers will be allowed to take part in a pilot project that will give them the possibility of receiving up to five more weeks of EI benefits, while encouraging them to find more work.
Our government is using a balanced approach that will not only consist in providing income support to workers, but that will also give them an opportunity to acquire skills which will allow them to remain employed, or to reintegrate into the labour force.
Canadians can congratulate the government on this initiative and may be assured that we are still contemplating other changes after the Liberal task force tables its final report.
* * *
(1410)
[English]
National Nursing Week
Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, May 10 to 16 is National Nursing Week.
Nursing Week is celebrated each year throughout Canada and the world during the week of Florence Nightingale's birthday of May 12. This week is an opportunity for all Canadians to express their gratitude for the hard work and important role that nurses perform, and also for the courageous manner in which they expose themselves to the risk in the provision of essential nursing care such as during last year's SARS outbreak.
While this week offers all the opportunity to recognize the vital role nurses play in our health care system, we should respect the contribution of nurses and other health care workers year round by ensuring proper funding, and fair and equitable employment conditions.
It is an outrage that we as a country continue to face significant shortages of nurses due to a decade of funding cuts to our health care system, coupled with the continued lack of a coherent strategy for stable funding from the federal government.
I would like to take this opportunity to thank all Canadian nurses for their hard work, often above and beyond their assigned duties. It is through their dedication and sacrifice that our health care system continues to be one of the best in the world.
* * *
[Translation]
Sponsorship Program
Mr. Pierre Paquette (Joliette, BQ):
Mr. Speaker, already back in 2000, the Bloc Quebecois had put its finger on the disturbing behaviour of the communications agencies run by friends of the Liberal Party of Canada and on the huge contracts that they were getting from the federal government. In fact, it is increasingly clear that, under the cover of Canadian unity, the Liberal Party used these agencies for electoral purposes in 1997 and in 2000.
Since then, the Bloc Quebecois has asked over 450 questions in the House on what was to become the sponsorship scandal. However, we did not get a single answer from this government.
What happened to the $100 million and who pocketed that money? Who is responsible for this disgusting scandal to paraphrase the Prime Minister?
The Liberal Party of Canada is now discredited. Cabinet ministers have lost the public's confidence. Today, the question is no longer whether the Liberal Party is corrupted. Everyone knows that. The only question that remains is: How badly is it corrupted?
* * *
Le Baluchon
Ms. Yolande Thibeault (Saint-Lambert, Lib.):
Mr. Speaker, the government is ensuring that Canada is a country where people are treated with dignity.
On behalf of the Minister of Labour and Minister responsible for Homelessness, I announced yesterday in Saint-Hyacinthe a contribution of $350,000 for the Maison Le Baluchon under the National Homelessness Initiative.
This community organization provides shelter, support andassistance in response to needs expressed by young people between the ages of 12 and 17 who are facing difficult family or social situations. This contribution of $350,000 is for the purchase of two buildings to provide young people who are homeless with supervised shelter.
Since it was launched in 1999, the National Homelessness Initiative has produced tangible results. We are aware, however, that much remains to be done to provide the homeless with all the help they need, and which goes far beyond the basic—
The Speaker:
The hon. member for Athabasca.
* * *
[English]
Prime Minister of Canada
Mr. David Chatters (Athabasca, CPC):
Mr. Speaker, on May 5 the Prime Minister said that the Leader of the Opposition should prepare to be accountable for everything he has said over the course of the last eight years.
I am glad the Prime Minister has decided to take the idea of accountability seriously. The next election will be about accountability and he is a man unable or unwilling to take responsibility. We believe in ministerial accountability and the Prime Minister must be responsible for his record over the past 10 years.
Canadians will remember the former finance minister when they think of ad scam; CSL's tax haven; his use of the private health clinic; the GST flip-flop; the 5,000% cost overrun in the gun registry; the HRDC boondoggle; the Challenger jet purchase; Sea King replacements; tainted blood; the Bronfman billions; the Pearson airport debacle; and the list goes on.
The Prime Minister has much to be accountable for.
* * *
(1415)
Lindsay Kinsmen Band
Mr. John O'Reilly (Haliburton—Victoria—Brock, Lib.):
Mr. Speaker, this year marks the 50th anniversary of the Lindsay Kinsmen Band.
Formed in 1954 by a group of interested parents under the leadership of Lloyd McMullen and Earl and Muriel Kennedy, this boys and girls band has performed all over North America.
Teaching children to play a musical instrument, read music, march, and be part of a respected musical organization has been the focus of everyone involved in the Lindsay Kinsmen Band.
Congratulations to the instructors, the executive, the parents, the auxiliary and the Kinsmen Club of Lindsay for a job well done. We wish the band continued success.
* * *
Inuit History Travelling Exhibit
Ms. Nancy Karetak-Lindell (Nunavut, Lib.):
Mr. Speaker, I would like to draw your attention to the role the government is playing in recognizing and sharing Inuit culture and history.
The Inuit History Travelling Exhibit was launched on May 3. Its main purpose is to tell the stories of Inuit communities and share those stories with all Canadians, especially in the north.
The Inuit have a unique culture that spans thousands of years and vast geographical distances, from northern Manitoba to Nunavut, the Northwest Territories and outside of Canada in Greenland. The Inuit Heritage Trust is dedicated to the preservation, enrichment and protection of Inuit cultural heritage. By circulating the Inuit History Travelling Exhibit, this rich heritage will be presented.
I am very happy to say the exhibit will be available in four languages: English, French, Inuktitut and Inuinnaqtun.
ORAL QUESTION PERIOD
[Oral Questions]
* * *
[English]
Government Contracts
Hon. Stephen Harper (Leader of the Opposition, CPC):
Mr. Speaker, yesterday's charges finally came two years after the Auditor General's report on Groupaction. There are other police investigations outstanding, on sponsorship, on DND, on HRDC, on the Liberal Party of Canada's Quebec wing. I could go on and on. There are in fact at least 36 separate police investigations we are aware of into the conduct of this government. It is unprecedented in our history.
Are these charges not just the tip of the iceberg into the culture of corruption that has been the hallmark of the government for over a decade?
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
Mr. Speaker, I reject the outrageous premise of the question just asked by the leader of the official opposition. In fact, the RCMP is conducting investigations. Charges have been laid. The RCMP will continue to pursue this matter as it sees appropriate, but I do want to underscore how singularly inappropriate I find the premise of the hon. member's question.
Hon. Stephen Harper (Leader of the Opposition, CPC):
Mr. Speaker, instead of rejecting the premise, the Deputy Prime Minister should accept it and accept accountability for it.
I want to point out the pattern of what is going on here. The police investigations have been going on in secret for years. The judicial inquiry is not scheduled to start for a month. Now the Liberals are shutting down the public accounts committee.
Is this not the Liberals' real only hope and their real only strategy to get it all out of sight and out of mind?
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
Mr. Speaker, I am not exactly sure what the Leader of the Opposition is saying in relation to police investigations. Let me reassure all Canadians that police investigations are conducted in an independent fashion. I would hope the Leader of the Opposition is not suggesting otherwise.
In relation to the public accounts committee, as I have said before in the House, this committee has been meeting now for months. It has heard, I believe, well over 40 witnesses. I do not think it is unreasonable at this time for this committee to--
The Speaker:
The hon. Leader of the Opposition.
* * *
Sponsorship Program
Hon. Stephen Harper (Leader of the Opposition, CPC):
Mr. Speaker, I will ask Jean Lapierre and François Beaudoin about independence.
[Translation]
The Liberal members want to interrupt the work of the committee. The witnesses will not appear before the public inquiry until the fall. The people who were arrested yesterday will not be able to testify.
Is this not simply a Liberal strategy to keep Canadians in the dark?
(1420)
[English]
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
Mr. Speaker, again I reject the premise of the leader of the official opposition's question.
I want to come back to a very important point here. He has again, I believe, called into question the independence and integrity of the Royal Canadian Mounted Police.
Everyone in this country should be under no illusions. That police force is independent. It conducts its investigations with integrity. To suggest otherwise is completely unacceptable.
Mr. Peter MacKay (Pictou—Antigonish—Guysborough, CPC):
Mr. Speaker, APEC, Shawinigate, there is all kinds of evidence that we can point to.
The arrest of Mr. Guité and Mr. Brault has no bearing--
Some hon. members: Oh, oh.
The Speaker:
Order. Hon. members will have to have some compassion for the Deputy Prime Minister. She has to be able to hear the question. We need to have some order so the hon. member for Pictou—Antigonish—Guysborough will want to proceed and put his question.
Mr. Peter MacKay:
Mr. Speaker, there are a lot of thin-skinned Liberals in the House these days.
The arrests of Mr. Guité and Mr. Brault have no bearing on the work currently underway at the public accounts committee. We still have no idea which Liberal ministers were involved in the cover-up and who gave the political direction the Prime Minister spoke of.
The Liberal motion to shut down the public accounts committee before any conclusions, with 90 witnesses outstanding, with undisclosed files, does not allow anyone to get to the bottom of this. What is the Prime Minister afraid of and what is he hiding?
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
Mr. Speaker, far from hiding anything, the Prime Minister has put in place actions to ensure that we get to the bottom of this matter, so that Canadians find out what happened here.
In fact, who is playing politics with the public accounts committee? We called that committee together so that they could meet quickly in early February. What are they doing now? As opposed to hearing witnesses, the opposition is filibustering the activities of the public accounts committee. That is hypocritical and shameful.
Mr. Peter MacKay (Pictou—Antigonish—Guysborough, CPC):
Mr. Speaker, how sad. While the Prime Minister is out doing his “I feel your pain, I will share your wealth” tour, some of his ministers are shaking in their boots because two of the key players in the sponsorship scandal are now facing the slammer and possibly they may sing.
Fraud and corruption charges seem to have a lot of clarity of thought. It will maybe cure that convenient memory syndrome that has been suffered by a lot of witnesses at the public accounts committee.
With the possibility of credible witnesses now being called before the committee, why is the Liberal government trying to shut down the only truth seeking exercise in the country into what went wrong with the sponsorship--
The Speaker:
The hon. President of the Treasury Board.
Hon. Reg Alcock (President of the Treasury Board and Minister responsible for the Canadian Wheat Board, Lib.):
Mr. Speaker, I thank the member for his question.
I would repeat for the member that the Prime Minister has launched one of the most open, transparent processes that the House has ever seen.
I would ask the member, why is he so afraid to share with Canadians who financed his leadership campaign?
[Translation]
Mr. Gilles Duceppe (Laurier—Sainte-Marie, BQ):
Mr. Speaker, on February 12, 2004, the Prime Minister was categorical. On the subject of the sponsorship scandal, he declared, and I quote, “There had to be political direction.”
Is the Prime Minister now able to tell the House where the political direction in the sponsorship scandal came from?
[English]
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
Mr. Speaker, the Prime Minister has been absolutely clear on this matter. What we want to do is get to the bottom of this situation. We want Canadians to know what happened here. We want to know why it happened and who was involved, so that we can ensure it does not happen again.
In fact, that is what we see with the judicial inquiry led by Mr. Justice Gomery. That is what we should be seeing with the public accounts committee. Instead, what we see in relation to the operation of that committee is the most hypocritical approach by members of the opposition. What do we see? Filibustering. What do we see? Wasting the Canadian--
(1425)
[Translation]
The Speaker:
The hon. member for Laurier—Sainte-Marie.
Mr. Gilles Duceppe (Laurier—Sainte-Marie, BQ):
Mr. Speaker, we have been told that the Prime Minister is very clear. He said he wanted to shed all possible light on the sponsorship scandal. He also said that there was political direction. He said that himself. No one forced the Prime Minister to say such a thing.
I wonder, if he is so transparent, if he is so clear, why he is refusing to testify before the Standing Committee on Public Accounts and tell us, before the election, who was the person behind that political direction? Was it his predecessor? Was it he? He knows things that we do not know and he does not want to reveal them. What do we call someone who refuses to tell the truth?
Hon. Jacques Saada (Leader of the Government in the House of Commons and Minister responsible for Democratic Reform, Lib.):
Mr. Speaker, it is always interesting to listen to that party's contradictions as it calls for transparency but refuses to let the Standing Committee on Public Accounts make an interim report to the Canadian people on what they have heard in the past three months of listening to witnesses that included politicians, public servants, and other interested individuals. How can they be transparent—or demand transparency—on the one hand, and on the other hand, prevent the people of Canada from finding out what has really happened in that committee?
Mr. Michel Gauthier (Roberval, BQ):
Mr. Speaker, because the government is unwilling to understand the Bloc Quebecois leader's questions, I will put it differently. In the sponsorship scandal, the little fish got caught in the net but the big fish are still swimming in murky waters. That is the reality.
What we want to know, since the Prime Minister was the number two man in the Chrétien government, vice-president of the Treasury Board, a member of the Quebec caucus, and, having spent nine years with that bunch, he must know a few things.
He says that there was political direction, so why does he refuse to appear before the committee, and why does he want to put an end to what it is doing before he can even tell us what he knows?
Hon. Jacques Saada (Leader of the Government in the House of Commons and Minister responsible for Democratic Reform, Lib.):
Mr. Speaker, this reference to fish reminds me of how much of a fishing expedition the Bloc has been on for some time now in this connection.
The committee met more quickly at the instigation of the Prime Minister. Mechanisms have been put in place to get at the truth. The parliamentary committee has been meeting for more than three months now. It is being asked to produce an interim report so that the Canadian public can know what it has heard so far. What are they hiding in not wanting an interim report?
Mr. Michel Gauthier (Roberval, BQ):
Mr. Speaker, continuing the fish references, I would remind hon. members that the Prime Minister's political lieutenant is the one who made reference in a speech in Quebec to the government's having left a rotten fish in the refrigerator, one that had to be got rid of because it was starting to smell bad. If he wants to talk fish, let him go and talk to Jean Lapierre.
The Prime Minister made the following comment on the sponsorship scandal: “The fact remains that very few Quebec ministers were aware”. I would like the Prime Minister to come and tell the committee which Quebec ministers were aware of the sponsorship scandal, because he himself has—
The Speaker:
The hon. government House leader.
Hon. Jacques Saada (Leader of the Government in the House of Commons and Minister responsible for Democratic Reform, Lib.):
Mr. Speaker, they can fish as much as they like, but the fact remains that this is not the way to get at the truth.
The way to get at the truth is to have a responsible parliamentary committee, one which does not beat around the bush but comes up with a report to inform the Canadian public of exactly what it has heard. In Quebec, the people are particularly keen on having such a report. The Canadian public must be able to form an opinion on what went on. They do not want such a report, but we do.
[English]
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP):
Mr. Speaker, my question is for the Deputy Prime Minister.
I could focus on Jean Lapierre's convenient Jo-Jo impression in predicting the future, but I would rather focus on the Prime Minister's comments of February 12, where he clearly laid the blame on political masters for the sponsorship file.
Given that the Liberals feel the parliamentary committee's work is done, they must be able to now name who the political masters were, unless of course it is convenient for Chuck Guité to be the fall guy.
I would like to ask the Deputy Prime Minister, can the government now tell us which Liberal called the shots?
(1430)
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
Mr. Speaker, no one is suggesting that the committee's work is done. As I understand it, there was in fact a motion from a member of the committee asking for an interim report. I do not believe it is unreasonable after hearing some 40 witnesses to take stock and inform Canadians as to what has been heard to date.
In fact I would remind everyone in this House that it was the chair of the committee himself, the hon. member for St. Albert, who in February suggested that a preliminary report would indeed be an appropriate approach.
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP):
Mr. Speaker, the Liberals simply have no shame. Canadians are not buying Chuck Guité as the lone gunman. They know there is a grassy knoll full of Liberals that the government is desperate to hide until after Canadians get to vote. However, $100 million has been squandered and all we have heard is how angry Liberals are that they were caught.
Will the Deputy Prime Minister, on behalf of her colleagues, apologize right now for being so careless with so many taxpayer dollars? Will the government apologize? Will it say it is sorry?
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
Mr. Speaker, the government has been absolutely clear. We want to get to the bottom of this situation. That is why we want public accounts to get on with its work. That is why the Prime Minister put in place an independent judicial inquiry. That is why we have special counsel at work determining how much of the dollars spent can be recovered. That is why we introduced whistleblower legislation. That is why we are reviewing the relationship between crown corporations and the government. We are committed to finding out what happened here.
Mrs. Diane Ablonczy (Calgary—Nose Hill, CPC):
Mr. Speaker, someone gave Chuck Guité that huge pot of money, a quarter of a billion dollars, so he could pose as captain Canada. Someone authorized all those millions to flow out of the public treasury.
Was that someone the former finance minister, now Prime Minister?
Hon. Stephen Owen (Minister of Public Works and Government Services, Lib.):
Mr. Speaker, the public accounts committee has been sitting for over three months now, hearing approximately 40 witnesses, including three former ministers of public works. It has been looking into this issue. Surely this is the time. In fact the chair of the public accounts committee on February 11 said that he felt money was stolen and people should go to jail. He was drawing conclusions in February, when the committee had just started.
Surely at this stage, the members would bring their thoughts and evidence together and lay it out in an interim report so we can get an idea of what they feel about it.
Mrs. Diane Ablonczy (Calgary—Nose Hill, CPC):
Mr. Speaker, the Liberals want to shut down the committee with over 90 witnesses still to be heard. We know someone gave the orders that allowed Guité to play fast and loose with a quarter of a billion dollars. Someone masterminded this scheme. Even the Prime Minister confessed there had to be political direction. Yet, the critical question of who gave this political direction remains very much unanswered.
Which politicians are the Liberals trying to protect by shutting down the committee early? Is it the Prime Minister?
Hon. Stephen Owen (Minister of Public Works and Government Services, Lib.):
No, Mr. Speaker. The Prime Minister has made it very clear to the House inside and to the general public that he wants to get to the bottom of this, and every action of this government is toward that end.
The public accounts committee has heard from Mr. Guité twice now over the last two years. It has heard from three former ministers of public works. Let us have the hon. member ask the public accounts committee to answer the question she has just posed herself, at least in an interim way, so we can get some measure of where the committee is going.
Mr. Jason Kenney (Calgary Southeast, CPC):
Mr. Speaker, if that minister wants to know what the committee has heard, perhaps he should read the newspapers.
Yesterday, the Deputy Prime Minister said, “On behalf of the government, I would encourage the public accounts committee to continue its work”. The problem is, today her members are about to force through a motion to shut down hearings for the week, and next week the Prime Minister apparently will dissolve Parliament and the committee along with it.
How exactly can the committee continue its work and hear more witnesses if it is being shut down by the Liberals?
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
Mr. Speaker, the government does not want to shut down the committee. I see nothing wrong with a member of the committee asking for an interim report. I go back to February when the chair of the public accounts committee, the member for St. Albert, said that he would like to have a preliminary report based on the committee's work.
Therefore, far from shutting down the committee, I think what the motion speaks to is that they are doing what the chair wants. They are going to inform Canadians--
(1435)
The Speaker:
The hon. member for Calgary Southeast.
Mr. Jason Kenney (Calgary Southeast, CPC):
Mr. Speaker, we all know about the testimony before committee. We know about all the Liberals who have come before the committee to lie. What we want is to hear from other witnesses. We want to hear from Jean--
The Speaker:
The hon. member for Calgary Southeast I think may have crossed the line in this case. He was suggesting that perhaps there were members who were there telling untruths. If that is the case, I know he would not want to do that. He will have to withdraw that remark and continue.
Mr. Jason Kenney:
Mr. Speaker, I was referring to former Liberal members of this place who have lied before the committee, like Mr. Gagliano.
We want to hear from people like Jean Chrétien. We want to hear from people like Warren Kinsella. We will be unable to that if the Liberals shut down the committee.
I have a question. I have a motion before the committee to continue its hearings Monday through Friday of next week. Will the Deputy Prime Minister encourage the Liberal members to vote in favour of hearings all next week?
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
Mr. Speaker, I have no doubt that all members of the public accounts committee will consider the hon. member's motion and they will vote on that motion in due course. However, that is up to the public accounts committee.
I go back to the fact that I find it somewhat strange that the official opposition does not think it is appropriate to provide an interim report to the Canadian public. The committee has heard well over 40 witnesses. I think it is not inappropriate at this point to take stock, prepare a preliminary report and decide how to move forward from there.
* * *
[Translation]
Employment Insurance
Mr. Paul Crête (Kamouraska—Rivière-du-Loup—Témiscouata—Les Basques, BQ):
Mr. Speaker, today I feel cheated. I feel cheated by the Liberals, just as the people of Quebec and our regions feel cheated by the Liberal government, which, after substantial election promises in 2000 and four years of waiting, has just announced very inadequate changes to employment insurance.
After having taken $45 billion from the employment insurance fund, how does the minister have the audacity to deliver another round of short-lived, transitional measures once the election is over? How unbelievably cynical.
Hon. Joseph Volpe (Minister of Human Resources and Skills Development, Lib.):
Mr. Speaker, perhaps the hon. member has not understood the entire context of the measures I am implementing today. I have been the minister for four months and during those four months I have acted quickly. It seems a little odd that the member opposite finds that $140 million is not enough to cope with the problems reported in the regions.
Mr. Paul Crête (Kamouraska—Rivière-du-Loup—Témiscouata—Les Basques, BQ):
Mr. Speaker, $150 million is three one-thousandths of the $45 billion surplus that was stolen from the unemployed.
After four difficult years of waiting, the Minister of Human Resources and Skills Development is announcing extremely inadequate transitional measures, on the eve of an election in an attempt to win votes, but the reality remains: the government is leaving thousands of unemployed people to fend for themselves. Not one more unemployed person will qualify for benefits.
How can the government, which took another $3 billion out of the pockets of the unemployed last year, have the nerve to announce a measly $270 million over two years in temporary measures that are far from meeting the needs in any permanent way?
Hon. Joseph Volpe (Minister of Human Resources and Skills Development, Lib.):
Mr. Speaker, the Liberal task force that examined the situation and proposed very positive measures has suggested some solutions. I have acted according to them. I am not cynical like the member opposite, who tries to feed on the misery of others. It seems a little ironic that a separatist is trying to get solutions from federalism that he is not capable of providing.
(1440)
Mr. Michel Guimond (Beauport—Montmorency—Côte-de-Beaupré—Île-d'Orléans, BQ):
Mr. Speaker, I remind the minister that even Claude Béchard, the Quebec Liberal minister responsible for employment, said that it was not enough. To my knowledge, Mr. Béchard is not a sovereignist, but a federalist.
It is all the workers and the unemployed who have been betrayed by these so-called reforms, which are once again delaying the real solutions. This has a distinct air of improvisation about it.
How can the minister be credible when all he is announcing are schemes cobbled together at the last minute, on the eve of an election, in an attempt to win votes, when what is needed is an in-depth reform?
Hon. Joseph Volpe (Minister of Human Resources and Skills Development, Lib.):
Mr. Speaker, I proposed some very concrete and positive measures, as suggested by the members of the Liberal the task force.
I am not interested in the hon. member's antics. He has nothing better to offer. I already said that I proposed four measures in the amount of $280 million, over a two-year period. These are very concrete measures aimed at solving the problems in the employment insurance program.
Would the hon. member prefer I did not take these measures?
Mr. Michel Guimond (Beauport—Montmorency—Côte-de-Beaupré—Île-d'Orléans, BQ):
Mr. Speaker, I invite the minister to come to the regions to explain his reform, if it is such a good one. What the minister is saying is “Wait until after the election. The Liberal task force will carry on its exercise until 2005 and then we will see about a true reform”.
How can we lend any credibility to this Prime Minister, to this government and to all these Liberals, when even the hon. member for Bonaventure—Gaspé—Îles-de-la-Madeleine—Pabok admits that the need for major changes to the employment insurance program is far from being unanimously recognized in this government? What can the unemployed expect from the Liberals? Zero.
Hon. Joseph Volpe (Minister of Human Resources and Skills Development, Lib.):
Mr. Speaker, Bloc Quebecois members, separatists, do not mention the other figures that precede the first zero. Be that as it may, I just announced the implementation of very concrete measures worth $280 million.
The Liberals did their homework. They submitted proposals to me and I implemented them. I just mentioned it. I have been in this position for four months. The task force did its job. It made a proposal and I acted on it immediately.
* * *
[English]
Gasoline Prices
Mr. David Chatters (Athabasca, CPC):
Mr. Speaker, the price of gasoline has been going through the roof across the country. This morning the price of gas in Victoria was 95.9¢ a litre.
The Minister of the Environment is on public record, indicating that he believes motorists are not being charged enough for their gasoline. Could the minister tell his constituents in Victoria how much more they should expect to pay?
Hon. R. John Efford (Minister of Natural Resources, Lib.):
Mr. Speaker, all members opposite and all members in the House know and understand quite well what is happening to the world price of oil. Internationally and globally, the price per barrel of oil has escalated to almost $40 a barrel. That is being reflected at the pumps. There is nothing that he or I can do to stop the world price of oil. Consumer demand is growing worldwide.
We are concerned about it. We are checking into it to see if everything is being done according to the Competition Act. If there is anything wrong done, it will be corrected.
Mr. David Chatters (Athabasca, CPC):
Mr. Speaker, I am not surprised the minister did not want to answer my question. A study that the Minister of the Environment commissioned speculated that the price of gasoline would have to double to change Canadian driving habits to meet the targets within Kyoto. This would produce increased revenue to the Canadian governments by over $33 billion a year.
Is it not a fact that his government's position is that we need higher gas prices to meet his Kyoto targets?
(1445)
Hon. R. John Efford (Minister of Natural Resources, Lib.):
Mr. Speaker, every member of the House and every minister in the government is quite concerned about the price of oil, reflected at the pumps by gasoline, home heating fuel, all of it. We are very concerned about it. It is an international problem. The Competition Bureau is checking into it and if there is anything reflected in that investigation, it will be dealt with by the Competition Bureau.
* * *
The Environment
Mr. James Moore (Port Moody—Coquitlam—Port Coquitlam, CPC):
Mr. Speaker, perhaps I can get the environment minister to answer a question here. Almost half the cost of a litre of gasoline is taxation. Half that taxation comes to Ottawa. Virtually none of it goes back to municipalities at all.
What I want to know from the Minister of the Environment, the minister for Victoria, is this. Does he not believe that perhaps giving some of those gas tax dollars back to the city of Victoria might help it clean up the over 80 million litres a day of raw sewage pumping into the environment minister's own riding?
Hon. Ralph Goodale (Minister of Finance, Lib.):
Mr. Speaker, indeed, sharing the fuel tax with municipalities will help them with a whole variety of local priorities and that is why this government invented that idea on the recommendation of the Federation of Canadian Municipalities.
* * *
Airline Industry
Mr. James Moore (Port Moody—Coquitlam—Port Coquitlam, CPC):
Mr. Speaker, as the cost of fuel goes up, it is not just consumers and drivers who are hit. It is also the air industry that is hit. Fourteen per cent of Air Canada's overall net costs is the cost of fuel and this government is doing nothing whatsoever about it. We have heard nothing from the Minister of Finance and nothing from the Minister of Transport at all.
Over 30,000 jobs are at stake with Air Canada and this government is completely silent. It is silent on excise fuel taxes and it is doing nothing about eliminating the air tax and nothing at all about landing fees.
Why does the government not have anything at all to say about helping the air industry by lowering fuel taxes so that more people will fly and the air industry will be safe and ready to go for the future?
Hon. Tony Valeri (Minister of Transport, Lib.):
Mr. Speaker, in fact the air industry is safe. I do not understand why that member continues to portray that kind of message.
In fact, what is happening is that we have more competition in the air sector today than at any time before. We have Jetsgo, we have CanJet, we have WestJet, and we have Air Canada, which is going through a restructuring period, always a difficult time. I would refer the hon. member to the comments made by Judge Farley just recently, which called on all individuals involved in the Air Canada restructuring deal to get around the table, strike the deal and ensure that Air Canada comes out a strong and united company.
* * *
Health
Mr. Andy Savoy (Tobique—Mactaquac, Lib.):
Mr. Speaker, my question is for the Minister of Health. In my riding of Tobique—Mactaquac, the provincial government is making significant changes to the way rural health care will be delivered. Can the minister assure my constituents that health care services in the rural communities will continue to meet the standards of availability and accessibility as guaranteed by Canada's Health Act and can he tell us whether this important issue of rural health care will be addressed at this summer's meetings with Canada's premiers?
Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.):
Mr. Speaker, the Government of Canada is committed to working with the provinces and territories to identify ways we can best serve rural areas. Provinces have the primary responsibility for the organization and delivery of health care services to their residents. The Government of Canada confirmed its commitment to improving access to quality health care for all Canadians by increasing its support by $34.8 billion over five years.
In October 2003, Health Canada and the CIHR--
The Speaker:
The hon. member for Churchill.
Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, my question is for the Minister of Health. Given that the Liberal strategy is to yet again try to pretend there is a big difference between its health care policy and the Conservatives' health care policy, I am sure the health minister can answer a very simple question. However, I predict he will not answer a very simple question, because the real difference is between what Liberals say and what they do, but let us see.
Does the health minister condemn the growth of private, for profit delivery of health care that we have seen since the Liberals took office in 1993, yes or no?
Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.):
Mr. Speaker, let me be very clear. If the opposition member has a difficulty seeing the difference between us and them, I will tell her that between the tax cutters, who pretend that while cutting taxes substantially they would be able to build a new health care system, and the mega-spenders, who live in the 1970s and want to have the health care of the 1970s, we Liberals have a way to build a plan which we will build with the provinces. It is a plan that Canadians will be able to trust because it will be between the tax cutters and the mega-spenders. It is a balanced approach.
(1450)
Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, if I were a Liberal MP being told by the Earnscliffe boys to pretend there is a big difference between the Liberal health policy and the Conservative health policy, I would be a bit nervous with a Liberal health minister who has no opinion on the growth of private, for profit delivery over the last 10 years.
Let us try another simple question. In the 1997 red book, the Liberals promised a pharmacare plan, but seven years later we are still waiting. Can the health minister explain why the Liberals chose to spend $100 billion on tax cuts instead of keeping their promise to help Canadians with prescription drug coverage?
Hon. Pierre Pettigrew (Minister of Health, Minister of Intergovernmental Affairs and Minister responsible for Official Languages, Lib.):
Mr. Speaker, we have been working on catastrophic drugs; it is in the health accord of 2003. This is a government that will continue to work with the provinces. We are working on the home care front. We want to do a better job on primary care with the provinces. We will be looking into doing more on the pharmacare side, as we already have done in the health accord of 2003.
Our health system is a work in progress. We believe it needs to be improved year after year to reflect the values and interests of Canadians and the evolution of our society.
* * *
Government Contracts
Mr. Garry Breitkreuz (Yorkton—Melville, CPC):
Mr. Speaker, the public safety minister's firearms office said it has no knowledge and no records of a mystery $150,000 firearms communications contract that is the subject of fraud charges against Chuck Guité and Jean Brault. The minister even said that this contract had nothing to do with the operation of the gun registry.
This does not pass the smell test. How is it possible that the minister who was responsible for the gun registry for so many years knows nothing about these mystery contracts?
Hon. Anne McLellan (Deputy Prime Minister and Minister of Public Safety and Emergency Preparedness, Lib.):
In fact, Mr. Speaker, I can be absolutely frank. I have no knowledge of the two contracts that were referred to yesterday in relation to charges laid by the Royal Canadian Mounted Police.
As I think the hon. member knows, charges have been laid. This matter is now before the courts. It would be inappropriate for me to comment further on the specific case other than to say I have no knowledge of the two contracts referred to in the charges.
Mr. Garry Breitkreuz (Yorkton—Melville, CPC):
Mr. Speaker, it gets even worse. We have documents from the minister's own department which show that Groupaction was getting government firearms contracts after the Auditor General blew the whistle on the first $330,000 bogus contract.
For years, the minister has repeatedly said she was fully accountable and responsible for the firearms program. Why does she not finally accept some responsibility instead of claiming ignorance every time a new scandal in the gun registry is exposed?
Hon. Stephen Owen (Minister of Public Works and Government Services, Lib.):
Mr. Speaker, in May 2002 the Auditor General and the Government of Canada referred Groupaction files to the RCMP for investigation. In June of that year, public works stopped all contracting with any agency that had files referred to the RCMP. In August 2002, if the members opposite are at all interested in listening to the answer, we stopped all contracting with any company whose files had been sent to the RCMP, including Groupaction.
* * *
Veterans Affairs
Mr. Rick Casson (Lethbridge, CPC):
Mr. Speaker, a trip by the Governor General and 59 of her closest friends, $53 million; the ad scam, a national disgrace the Prime Minister is about to bury, $250 million; HRDC mismanagement, $1 billion; and a misguided and useless gun registry, over $1 billion. Sending Canadian D-Day veterans to the 60th anniversary of D-Day should be priceless, but it is obviously not to the government.
Sixty veterans out of a possible 18,000: How can the minister possibly justify this lack of consideration for our veterans?
Hon. John McCallum (Minister of Veterans Affairs, Lib.):
Mr. Speaker, the respect of the government for our veterans is deep and profound. In fact, when I think of those Canadians almost 60 years ago jumping out of ships onto a flaming beach or out of airplanes into enemy territory, the scale of the sacrifice, the degree of the risk they were called upon to take on behalf of their country is almost incomprehensible for people of my generation.
That is why this government in a short five months has done more for veterans than any government in a generation, and that is why we are working on the D-Day expedition right now.
(1455)
Mr. Rick Casson (Lethbridge, CPC):
That is right, Mr. Speaker. They were all sent there to fight for their country, but they are not all getting the opportunity to go back there and be thankful for the fact that they did not die on those beaches.
It is all very well and good, but another day has gone by and now there are only 24 days left before the start of D-Day celebrations in Normandy. The minister, only after coming under severe pressure, has indicated that he is going to send more than the 60 he originally planned to send.
With the days quickly passing by and this government able to toss out billions of dollars in pre-election promises, why can the minister not simply tell us how many more veterans are going to D-Day celebrations? They were sent there to fight for this country 60 years ago. They have the right to go back and--
The Speaker:
The hon. Minister of Veterans Affairs.
Hon. John McCallum (Minister of Veterans Affairs, Lib.):
Mr. Speaker, a few facts might be in order. It was over a year ago that our D-Day advisory committee, which is comprised of veterans organizations and D-Day veterans, recommended to the government that the appropriate size of the official delegation of veterans be 60. That is in line with past Canadian history. It is in accordance with the traditions of other countries. The Americans, with a much bigger size, have a contingent of 100, and the British have 80.
Yet the government is listening. The government realizes the public wants more, and the government is going to act very soon.
* * *
[Translation]
Iraq
Ms. Francine Lalonde (Mercier, BQ):
Mr. Speaker, yesterday, to everyone's surprise, the Prime Minister made a statement in Montreal to the effect that Saddam Hussein does have weapons of mass destruction and that they are now within the reach of terrorists.
Given that neither Hans Blix, President Bush, Tony Blair or the UN were able to provide any evidence of the existence of such weapons of mass destruction in Iraq, has the Prime Minister, who seems to know, taken steps to share what he knows with other world leaders?
Hon. Bill Graham (Minister of Foreign Affairs, Lib.):
Mr. Speaker, only someone intent on misunderstanding this statement by the Prime Minister could have reached such a conclusion.
The Prime Minister clearly stated that the proliferation of weapons of mass destruction around the world is a problem, which is something everyone agrees on.
He also said that there are some dangerous weapons in Iraq, and that we must fight terrorism all over the world and take these two aspects into consideration. These are two separate aspects. the Prime Minister made a clear distinction between the two. Let us not try to confuse the matter.
Ms. Francine Lalonde (Mercier, BQ):
Mr. Speaker, the Prime Minister should have made the distinction. The Minister of Foreign Affairs ought to read the newspaper accounts today however.
Does the Prime Minister not realize that it is totally irresponsible to make such statements and say something as serious as what he said without something solid to back it up, and should he perhaps not just admit that he made a mistake and apologize?
Hon. Bill Graham (Minister of Foreign Affairs, Lib.):
Mr. Speaker, I do not think that the Prime Minister should apologize for having said something everyone knows. There is a problem with the proliferation of these weapons of mass destruction around the world. This represents a problem. There are individuals in Iraq who are dangerous. That is clear. There are people dying everyday over there.
Some hon. members: Oh, oh.
Hon. Bill Graham: We must be absolutely clear. There are a lot of weapons of mass destruction around the world. There are also means of delivering these weapons. Terrorism has to be brought under control. That is what the Prime Minister said. That is clear, and we all stand behind that statement.
Some hon. members: Oh, oh.
The Speaker:
I must say that it was impossible for the poor member for Mercier to hear the minister's answer to her question. That has been a problem, not only at this end of the House today. So, we could do with a bit more order, please.
The hon. member for St. John's West.
* * *
[English]
Fisheries
Mr. Loyola Hearn (St. John's West, CPC):
Mr. Speaker, the Minister of Fisheries and Oceans brags that the European Union is allowing one of the two Portuguese trawlers caught in violation of fishing regulations on the Grand Banks to return home: home, not to a Canadian port. This is the trawler that cut loose its nets. What choice does it have but to return home? How can it fish without a net?
What excuse can the minister drag up to explain why the second trawler is not being called home or, better still, towed to a Canadian port?
(1500)
Hon. Geoff Regan (Minister of Fisheries and Oceans, Lib.):
Mr. Speaker, it is not at all surprising to me that the hon. member would take a defeatist attitude toward this issue considering his leader's attitude toward Atlantic Canadians.
We are taking a serious, strong attitude toward this. The fact is that last week there were 14 ships out there fishing in the area of the moratoria species and now they are not fishing in that area. We forced them away. Today there are only four vessels left in the area at all, and they are all in the areas where they are allowed to fish.
Mr. Loyola Hearn (St. John's West, CPC):
Mr. Speaker, if the government had been listening to this member, we would not have a problem today.
In February 1990 in Charlottetown, the Prime Minister said he would impose sanctions against Portugal, Spain, France and the United States for overfishing around Canada when he came into power. That is a whale of a commitment, but who does he think he is codding? Because after 14 years, we still see what is going on. How can we trust a Prime Minister who ignores such an important issue until he finds himself up to his neck in sharks a week before an election?
Hon. Geoff Regan (Minister of Fisheries and Oceans, Lib.):
Mr. Speaker, my hon. colleague knows that this line is nonsense. He knows that this in fact has been a priority of the Prime Minister for a long time. When I was appointed Minister of Fisheries and Oceans, the Prime Minister made it very clear to me that this was an important priority. It has been a priority for me and for this government and it will continue to be.
* * *
Foreign Affairs
Mr. Sarkis Assadourian (Brampton Centre, Lib.):
Mr. Speaker, my question is for the Minister of Foreign Affairs.
Could the minister give the House his reaction to the abuse and torture of Iraqi prisoners by the U.S. forces in Iraq?
Hon. Bill Graham (Minister of Foreign Affairs, Lib.):
Mr. Speaker, the other day in the House the Prime Minister was asked a similar question. Canadians, the House and the government condemn, absolutely, the treatment of those prisoners in Iraq.
We welcome the fact that the United States government, the Senate, the House of Representatives and other American authorities are doing their best to rectify a terrible situation and one that has had an impact on the difficult situation in Iraq.
We in the House and we in the government urge all of us to look at the fact that what we need are clear international norms and international rules with enforceability so that all people can be protected at all times, which is why this government has the international policy that it has.
Government Orders
[Supply]
* * *
(1505)
[English]
Supply
Allotted Day--Health Care
The House resumed consideration of the motion.
Ms. Wendy Lill (Dartmouth, NDP):
Mr. Speaker, first, I would like to mention that I will no longer be sharing my time with the member for Vancouver East. Instead, I will be sharing my time with the member for Sackville—Musquodoboit Valley—Eastern Shore.
Some of the things to which we have been speaking very passionately and to which we will be speaking in the upcoming election are, first, the issue of restoring 25% of federal funding to health care; and second, the issue of a comprehensive home care program and pharmacare program for Canadians.
The NDP believes that we should be preventing future illness by restoring funding to participaction and banning trans fatty acids, a significant risk factor in heart disease.
Along with its health platform, the NDP will be working on its environmental platform, previously released, to provide cleaner air and reduce health care costs through renewable, pollution free energy and sustainable funding for public transit and rail.
Another one of our major issues is the idea of changing the law to stop public money paying for the private for profit delivery of health care and plugging loopholes in the law that allow more diagnostic services to be provided privately for profit.
Halifax is home to a new private for profit MRI clinic that opened in 2002. The clinic was not opened by the Leader of the Opposition. It was opened under the Liberals, just like private for profit MRI clinics in Quebec, private for profit home care in Ontario, private for profit hospitals in Alberta and rapidly expanding private for profit clinics in British Columbia.
It is a fact that the Liberals have allowed private for profit delivery to grow by neglect when they cut health care funding and ignored Roy Romanow's practical solutions. Liberals have allowed private for profit delivery to grow by design; by changing the Canada Health Act and refusing to enforce it, and by agreeing to some of Ralph Klein's radical privatization in Alberta.
Upon being appointed Prime Minister, the Prime Minister appointed a parliamentary secretary for P3 privatization and a former corporate lobbyist for private for profit health care providers to key positions in his government. He also, in both the throne speech and the budget, refused to mention public delivery of health care or the Romanow commission. We feel that those are very telling absences.
If Canadians want to see Paul Martin's 10 year plan for health care they should look at the last 10 years of growing privatization and ignored innovation. Nobody is going to be fooled by another vague promise from Paul Martin's Liberals because if Liberal promises--
The Speaker:
Order, please. The hon. member for Dartmouth knows she cannot refer to hon. members by name. She will want to refrain from such activity. It is an apparent breach of the rules.
Ms. Wendy Lill:
I apologize, Mr. Speaker.
If the Prime Minister's 10 year health care plan is something that we should be taking seriously, we should have a look at his last 10 years of growing privatization and ignored innovation. That seems to me to be the record that we have to be taking to the people in the next few weeks in terms of an election.
I will return to the issue of home care for a minute because that is an issue that is critical to people in Dartmouth and in all of Nova Scotia.
Canadians made it very clear in the Romanow submissions that home care services were too important to be excluded from the definition of insured health services under the Canada Health Act. Much of the care that was once provided in a hospital or in physician's office has moved to a patient's home. The care is still medically necessary but is provided in a different setting.
Why do the Liberals think that type of care should not be covered, or worse, why do they think it should be provided by for profit businesses?
Statistics show that for profit delivery of health care, regardless of the setting, results in reduced outputs for the patients.
I want to read from the Romanow report. It states:
|
|
--a comprehensive analysis of the various studies that compare not-for-profit and for- profit delivery of services concluded that for-profit hospitals had a significant increase in the risk of death and also tended to employ less highly skilled individuals than did non-profit facilities |
In his report, Roy Romanow called home care the next essential service. It is the fastest growing component of the health care system and provides comfort and independence to the people who use it. It costs less than equivalent care in a hospital or in a long term care facility while improving the care and quality of life of patients.
The NDP wants to implement a public non-profit system of home care based on the successful Manitoba model. Since care in a hospital can cost from $9,000 to $16,000 more per patient per year than community based home care, this plan makes economic sense.
In my role as NDP critic on the status of persons with disabilities, I have heard over and over how important our health care system is to persons with disabilities. Groups, such as the Council of Canadians with Disabilities, have asked for a national system of disability supports, including home care or support to help people with disabilities with their quality of life.
Right now, many people with disabilities cannot access adequate home support for their needs. In some provinces, home support is only available after an acute health emergency. People with disabilities literally have to be sick enough to go to a hospital before they can get any support in their homes, and then the home care only responds to the acute medical emergencies, not an ongoing disability.
In other provinces, there is a monetary limit to how much home care a person can use per month. People with a disability must pick and choose which services they will give up each month so that they do not go over their limit.
In other situations, access to home care is linked to eligibility for other programs. For example, someone who is injured at work can access a home care program as part of workman's compensation, while a young person with a disability who wants to live independently in his or her own home is not able to.
There are many startling examples of people with disabilities finding today's health care system insufficient to meet their needs. This is the true danger of a not for profit system of health care. People with disabilities are disproportionately poorer than other Canadians, so if for profit health care costs increase, it will affect them more than ever.
The NDP is very clear and passionate about its commitment to a not for profit, publicly delivered health care system which will include pharmacare and home care in its new evolution in the years going onward.
(1510)
Mr. Peter Stoffer (Sackville—Musquodoboit Valley—Eastern Shore, NDP):
Mr. Speaker, my hon. colleague from Dartmouth has been a tireless advocate of health care, not only for her own family and her community but for those people with disabilities as well.
I have one simple question that the Liberals and Conservatives find very difficult to answer. Do they believe in publicly delivered health care?
Why does the member think those two parties have such great difficulty answering the question on whether they think health care in this country should be publicly delivered?
(1515)
Ms. Wendy Lill:
Mr. Speaker, what we seem to have witnessed over the last two terms in the House of Commons is a connection of disturbing proportion between the government side and the official opposition. There seems to be a consensus that it is acceptable to allow for profit health care to take place. Roy Romanow and many studies around the world have shown that for profit health care does not provide effective, efficient or reasonably priced health care benefits for the population.
The idea is to allow for profit companies to get into our health care system and make that additional 15%. That is the money we all hear is the sacred trust that private companies have to make at the end of the day. That additional money comes out of the pockets of individual Canadians in user fees. Some people cannot even go to hospitals or to doctors because they cannot afford those additional costs.
As profits in for profit health care companies increase, we see a decrease in the health status of Canadians
Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, I know my colleague mentioned the lack of adequate services for disabled people within the health care system. In listening to what a number of Liberals have said, we would probably get an argument that the Canada Health Act does not specifically say that we have to provide those kinds of services. Maybe they are not medically necessary or they are not mentioned in the Canada Health Act.
There is certainly an understanding among most Canadians that when types of services are needed, we expect it to be delivered. How would she respond to some of the comments that came from the Liberal side about only reflecting what is absolutely in the Canada Health Act, somehow leading to a misunderstanding of what they see as medically necessary?
Ms. Wendy Lill:
Mr. Speaker, any Canadians I know, if asked where we should draw the line as to what is medically necessary, would say that this. People who require medical assistance on a regular basis throughout the course of the day because of an illness or other condition, such as a post-operation situation, is medically necessary and they require the health care. Canadians believe that is the system for which we want to pay. We want to that system for all vulnerable people in our society.
It is important to note that the Canada Health Act has to be an evolving act. We have to look at our health care system, our future health prospects and our challenges, environmentally and medically. Certainly the New Democrats are very eager to do that. Roy Romanow in his report was very eager to do that. We have to look at new ways, smarter ways and more effective ways of delivering health care within our communities, in shared clinic situations and in preventive medicine situations. There are ways and we believe we can do it together as a nation.
Mr. Peter Stoffer (Sackville—Musquodoboit Valley—Eastern Shore, NDP):
Mr. Speaker, this is an issue brought to the House of Commons by the federal New Democratic Party. Of course we all know Tommy Douglas from Saskatchewan brought health care to his province, through very difficult circumstances. That showed real leadership. When we look at the battles in those days, it is quite ironic that groups of doctors hung Tommy Douglas in effigy. Forty years later, who has been entered into the Canadian Medical Hall of Fame? Tommy Douglas.
Sometimes it is very difficult to do the right thing under tremendous pressure. Mr. Douglas went through some very personal experiences. He witnessed some very serious circumstances through the 1930s and the 1940s of what happened to people when they became seriously injured and did not have the finances to look after a loved one or themselves. They became destitute, and that should never happen in a caring country like Canada. No one should lose opportunity. No one should lose a future. No one should be set back because of a serious illness that either occurs individually or to a family member.
Federally and provincially, the New Democratic Party believes in this one very simple philosophy when it comes to health care: a publicly funded, publicly delivered, not for profit health care system. That is it in a nutshell. We know very clearly that the Liberals and Conservatives will be unable to say that when they are on the campaign trail. It goes against their philosophy.
I do not believe a Liberal or Conservative will go across the country and say to Canadians “I believe in a publicly funded, publicly delivered, national health care system in this country”. I do not think Liberals or Conservatives, on threat of resignation of their seat, will stand up and echo the views of Canadians and mirror the policy of the NDP. If they do that, it will be a glorious day. Then and only then will the NDP realize a fully--
Ms. Marlene Catterall: I am standing up.
Mr. Peter Stoffer: It is nice to see the member from Ottawa standing up right now. She should be talking to her health minister. He said very clearly that the private sector can play a role in health care. What that means is we eventually turn over the public system into the hands of private corporations. If they follow suit, like the Conservatives would like them to do, eventually those corporations become foreign corporations.
Then what happens? Someone can become very ill in this country and someone from another country makes money from that illness. That is unbelievably wrong. The New Democrats will fight against that and we will continue to fight against as long as we remain in the House of Commons and in legislatures across the country.
This will be one of the major issues in the campaign. Canadians want to know and they are clear. The vast majority of Canadians support a publicly funded, publicly delivered health care system.
All of us in the House of Commons talk about health care to the nth degree. We talk about people being ill and what to do about that. Very little debate takes place about the preventing illness. When it comes to this, the Liberals and Conservatives are at huge fault. They have made massive cutbacks to the provinces.
The provincial conservative government in Nova Scotia cut physical education from the school system. What happens when provinces cut physical education from the school system? We end up with kids that no longer have activity in their classrooms or in their schools. Many reports have said that we are breeding a group of children who are rapidly becoming more and more obese.
What happens when we have obesity? We then have diseases like diabetes. Diabetes is very expensive to treat, with the proper insulin and everything else. We try to save a dollar by cutting physical education from the classroom, but we are more than willing to spend hundreds of dollars years later to treat something that we could have prevented.
(1520)
It is very clear, if we really want to prevent people from accessing health care in the end, we should bring back physical education into the school system. We should bring back other aspects into our lives that make Canadians more physically fit. George Chuvalo once said, “a healthy mind and a healthy body makes a healthy choice”.
It brings me to my next point, which is an idea that the New Democrats put forward. We thank the government on the one hand. It took the idea and put it into effect, but only in small part. That is the aspect of palliative care and special rehabilitative care.
Sometime in our lives we are either going to become caregivers or have care provided for us. When it comes to palliative care or special rehabilitative care, the best thing for an individual going through that care is the ability to be in the surroundings of their choice, to be free of pain and to be surrounded by their loved ones. When we reach the time for us to exit this world and go on to the next one, we would like the opportunity to die in the comfort of our own homes. Hopefully all of us will be very old when it happens. Poll after poll shows that when Canadians have the choice, they prefer to die in the comfort of their own homes.
There are people who need to provide that care for those who remain in their own homes. That generally falls upon a relative, and that relative generally is a woman. Too often women have to make the choice to leave their workplace and to care for a loved one, their child, their partner, or another relative.
We thank the government for recognizing this after years of debate and for establishing a six week program, although very limited. People can stay at home for six weeks to care for someone under palliative care, be it a child, husband, wife. Six weeks is a start, but we in the NDP would like to see the exact same benefit for maternity leave given to people who are on what I call eternity leave.
All of us have relatives who go through certain stages in life, under palliative care or special rehabilitation. People of my generation are called the sandwich generation. We have children to look after and we have elderly parents to look after.
Here is a classic example of what happens. My wife and I have two children and she works outside the home. She can have a year of maternity leave or I can take a year off on paternity leave. I would receive an employment insurance cheque every two weeks for up to one year. If the doctor diagnosed one of my children with cancer and said that our child had six months to live, what would we to do? That is a heavy question to ask anyone. Would my wife or I be able to leave our place of employment and care for the child for the six month period? Would my company allow me the time off to do that? Would my company pay me for that time off? The answer to those questions mostly likely would be no.
Eighty per cent of caregivers are women. Most of them are elderly women. Most of them have other jobs to which they attend. That is a very difficult situation to put a person in.
We in the NDP believe people should not have to go through that decision on their own. We believe the government should be there to help them. We believe very clearly that if people make that choice and leave their place of employment to care for a relative under very special rehabilitative care or palliative care, they should be allowed to collect employment insurance for up to one year or at least six months at minimum. They also should have job protection until the time they returned.
This would save money. It is fiscally responsible and accountable. We have proven over and over again that for every dollar of employment insurance we would spend on this program, we would save over $4 on the health care system. We all know it is very expensive to institutionalize someone.
In a society such as ours, it is my belief, my hope, my dream and aspiration, and that of many people throughout the country, that we will be much more compassionate in this type of debate than we are being right now.
(1525)
It is not just dollars and cents, although what we propose does save money. If we just want to use the fiscal argument, it saves money. The provinces would win in terms of the fiscal side of it, because they would save a lot of money. That money could then go toward assisting other aspects of health care.
Another program was introduced by the NDP but I see my time is up. I am sure I will have more time to discuss this valuable topic in the near future.
(1530)
Ms. Marlene Catterall (Ottawa West—Nepean, Lib.):
Mr. Speaker, the member challenged somebody from the Liberal Party to stand up. I am sure he will see lots of us during the election campaign, including the party platform and the Prime Minister, so I hope he does not hold his breath.
I am sure as a responsible citizen the member takes good care of his health, has his annual checkups and so on. The last time he had his blood tested or perhaps an X-ray, could he tell me whether he had it in a public facility or a private lab?
Mr. Peter Stoffer:
Mr. Speaker, on two points, actually it was about six months ago and I had it at Cobequid hospital, a publicly run, publicly delivered facility.
For the information of the hon. member, for whom I have great respect, every 56 days or thereabouts I go to the Canadian Blood Services clinic to donate blood. My blood is severely tested right there for the presence of any diseases.
The hon. member talked about her platform and that of the Prime Minister. I challenge her to rise again in the House and tell us that in the Liberal Party platform in the upcoming election we will see the words “publicly delivered, publicly funded, not for profit health care”. Is she prepared to stand in the House and tell us that is the Liberal position in their platform for the next federal election?
Mrs. Bev Desjarlais (Churchill, NDP):
Mr. Speaker, a colleague was chattering behind me saying “sports, sports”. Therefore, I say to my colleague, it has been mentioned that the involvement of young people and certainly all people in physical activity does improve their health.
I am the seniors critic. I am someone who has met with a number of seniors and quite frankly, I am someone who is on that doorstep, but I am not quite there. I actually do agree that it is crucially important that seniors and others have the opportunity for recreational activity. There is a severe lack of facilities for seniors in our system. It is crucially important that more infrastructure dollars go toward that. I would like the hon. member's comments on the recreational opportunities for seniors.
Mr. Peter Stoffer:
It is not just for seniors, Mr. Speaker, but for families right across the country. The NDP introduced Bill C-210, which would offer people the opportunity, when they sign up for physical activity or sports, to claim the registration fees as a tax deduction similar to that of a charitable donation.
Seniors who are in the lawn bowling clubs and dance clubs and families who put their kids in hockey, soccer or whatever, the fees that they pay should be tax deductible. That would encourage more and more people to become physically active in our society.
If a person is physically active, the chances of the person using the health care system are greatly reduced. Physically active Canadians are healthier citizens. A healthy body and a healthy mind mean a person makes healthy choices.
For the investment on the tax deduction for people who participate in sports and physical activities, we would save tremendous amounts of money on the tail end of the health care services. If we provided proper recreational facilities for our youth, families and seniors, we would prevent the health care system from being overused and we also would prevent a lot of social injustice issues in the very near future.
Hon. Lorne Nystrom (Regina—Qu'Appelle, NDP):
Mr. Speaker, I want to ask my colleague from Nova Scotia about the Conservative Party. I notice here in the Toronto Star there is statement from the Conservative Party calling for more privatization of health care in response to Roy Romanow.
The Conservatives have a record with Brian Mulroney. Brian Mulroney was their leader for years. Members, like the member for Saskatoon—Wanuskewin, are big Brian Mulroney fans, being a former leader of that party. Grant Devine was one of the leaders in Saskatchewan.
I want to know why the Brian Mulroney-Grant Devine party is now calling for more privatization of health care according to the current leader. Members of that party get very sensitive when I talk about their former leader. In Moncton he endorsed with great enthusiasm the current leader.
I wonder if the member could talk about what he thinks about this privatization move being pushed by the Mulroney-Devine-Mike Harris Conservatives to my right.
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Mr. Peter Stoffer:
Mr. Speaker, the three scariest names in this country are Brian Mulroney, Mike Harris and Grant Devine. Each one of them promotes in some way the privatization of our health care system. That is the Conservative agenda. The Conservative agenda very clearly says government should get the hell out of the way and let the private sector take over. That is what we will be saying on the doorsteps.
Can any Conservative stand up in the House and say very clearly that the platform of the Conservative Party will be a not for profit, publicly delivered and publicly funded health care system? Will they be able to say that?
Hon. Hedy Fry (Parliamentary Secretary to the Minister of Citizenship and Immigration, Lib.):
Mr. Speaker, I rise to speak to the motion proposed by the hon. member for Churchill. I have always had a problem with politicizing an issue as complex as health care with simplistic statements as the motion on the floor proposes to do, because it tends to create disinformation, anxiety and confusion and fuels a false debate on an issue of critical importance to Canadians.
The hon. member knows that the government and the Prime Minister have reiterated over and over their commitment to medicare in word and in deed. Let me quote:
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Any discussion of this government's priorities must begin with health care for there is no other issue of such vital and visceral importance to Canadians. Nowhere does government interact with people in a more meaningful and consequential way. |
That was said by the right hon. Paul Martin.
The government is proud of its historic credentials on medicare. While the idea began with Tommy Douglas in Saskatchewan with public hospital insurance, and let us give him credit where it is due, this idea became a concrete national medicare plan under a Liberal prime minister, Lester Pearson. It took two years to get all the provinces onside. Our Prime Minister, Mr. Martin, remembers with pride the debates around the dinner table--
The Acting Speaker (Mr. Bélair):
I am sorry to interrupt, but the member has used the Prime Minister's name instead of his position twice already. Please refrain from doing so.
Hon. Hedy Fry:
Mr. Speaker, the Prime Minister remembers with pride the debates around the table with his father, a strong supporter of Prime Minister Pearson's initiative. Our Liberal roots on medicare run very deep. The tools for ensuring the five principles of medicare, which is the Canada Health Act, again under a Liberal minister of health, Monique Bégin, and under a Liberal prime minister, Pierre Elliott Trudeau, was passed exactly 20 years ago.
Pretty clear principles were set up in the Canada Health Act. They are accessibility, comprehensiveness, universality, public administration, and portability.
The hon. member's motion pertaining to not for profit private care is kind of cute by far. She knows that this is prohibited under the same Canada Health Act that we brought in and to which we continue to reiterate our commitment, as recently as the first ministers meeting on the health care accord in 2003. In fact the hon. health minister in 1995, a Liberal minister, actually enforced the Canada Health Act by withholding transfer of health payments to Alberta for the very infringement of private for profit clinics that were charging user fees and allowing preferential treatment to those who could afford to pay for medically necessary services. Let me explain so the political semantics can be laid to rest.
The key words here are “medically necessary”. In theory anyone has always been able to buy an ankle X-