36th Parliament, 2nd Session
EDITED HANSARD • NUMBER 100
CONTENTS
Thursday, May 18, 2000
| ROUTINE PROCEEDINGS
|
1000
| GOVERNMENT RESPONSE TO PETITIONS
|
| Mr. Derek Lee |
| EXPORT DEVELOPMENT
|
| Hon. Pierre S. Pettigrew |
| THE UNKNOWN SOLDIER
|
| Hon. George S. Baker |
1005
| Mr. Peter Goldring |
1010
| Mr. Paul Mercier |
| Mr. Gordon Earle |
1015
| Mrs. Elsie Wayne |
1020
| QUESTIONS ON THE ORDER PAPER
|
| Mr. Derek Lee |
| Mr. Derek Lee |
| QUESTIONS PASSED AS ORDERS FOR RETURNS
|
| Mr. Derek Lee |
| GOVERNMENT ORDERS
|
| SUPPLY
|
| Designated day—Canada Health Act
|
| Ms. Alexa McDonough |
| Motion
|
1025
| Mr. Ted White |
1030
| Hon. Lorne Nystrom |
| Ms. Judy Wasylycia-Leis |
1035
1040
| Amendment
|
| Mr. Grant Hill |
1045
| Mr. Werner Schmidt |
1050
| Hon. Allan Rock |
1055
| Ms. Alexa McDonough |
1100
| Mr. Grant Hill |
1105
| Mr. Ovid L. Jackson |
1110
1115
| Mr. Gordon Earle |
| Mr. Grant Hill |
1120
1125
1130
1135
| Mr. Brent St. Denis |
1140
| Mr. Dick Proctor |
1145
| Mr. Janko Peric |
| Mr. Réal Ménard |
1150
1155
1200
1205
| Hon. Ethel Blondin-Andrew |
1210
| Mr. Greg Thompson |
1215
1220
1225
1230
| Mr. Peter Stoffer |
1235
1240
| Mr. Dick Proctor |
1245
1250
| Ms. Bev Desjarlais |
1255
| Mr. Nelson Riis |
| Mrs. Michelle Dockrill |
1300
1305
| Mr. Nelson Riis |
1310
| Mr. Alex Shepherd |
1315
1320
| Mrs. Michelle Dockrill |
| Mr. John Reynolds |
1325
| Mr. Yvon Godin |
| Mr. Grant Hill |
| Ms. Judy Sgro |
1330
1335
| Mr. John Reynolds |
| Ms. Bev Desjarlais |
| Mr. Wayne Easter |
1340
| Mr. John Reynolds |
1345
1350
| Mr. Alex Shepherd |
| Ms. Bev Desjarlais |
1355
| MESSAGE FROM THE SENATE
|
| The Deputy Speaker |
| STATEMENTS BY MEMBERS
|
| INTERNATIONAL MUSEUM DAY
|
| Ms. Sarmite Bulte |
| TAXATION
|
| Mr. John Duncan |
| MEDICALERT MONTH
|
| Mr. Bernard Patry |
1400
| ST. MARY'S CHILDREN'S CHOIR
|
| Mr. John Richardson |
| GABE KRALJEVIC AND DOUG MCPHERSON
|
| Mr. John Harvard |
| HYACK FESTIVAL
|
| Mr. Paul Forseth |
| SANDRINE'S GIFT OF LIFE
|
| Ms. Aileen Carroll |
| ESTHER BRYAN
|
| Mr. Bob Kilger |
1405
| VIMY RIDGE
|
| Mr. Peter Goldring |
| PRIME MINISTER
|
| Mr. Mark Assad |
| CO-OPERATIVE HOUSING FEDERATION OF CANADA
|
| Ms. Libby Davies |
| INTERNATIONAL MUSEUMS' DAY
|
| Mr. Pierre de Savoye |
| TOM LONG
|
| Mr. John O'Reilly |
1410
| HUMAN RESOURCES DEVELOPMENT
|
| Mrs. Maud Debien |
| CONSECUTIVE SENTENCING
|
| Mr. Peter MacKay |
| BOOK DRIVE FOR IQALUIT SCHOOL
|
| Mr. Mauril Bélanger |
| EXPORT DEVELOPMENT CORPORATION
|
| Mr. Deepak Obhrai |
| ORAL QUESTION PERIOD
|
1415
| HUMAN RESOURCES DEVELOPMENT
|
| Miss Deborah Grey |
| Hon. Jane Stewart |
| Miss Deborah Grey |
| Hon. Jane Stewart |
| Miss Deborah Grey |
| Hon. Jane Stewart |
| Mrs. Diane Ablonczy |
| Hon. Jane Stewart |
| Mrs. Diane Ablonczy |
1420
| Hon. Jane Stewart |
| Mr. Gilles Duceppe |
| Hon. Jane Stewart |
| Mr. Gilles Duceppe |
| Hon. Jane Stewart |
| Mr. Paul Crête |
| Hon. Jane Stewart |
1425
| Mr. Paul Crête |
| Hon. Jane Stewart |
| THE ECONOMY
|
| Ms. Alexa McDonough |
| Hon. Jim Peterson |
| HEALTH CARE
|
| Ms. Alexa McDonough |
| Hon. Allan Rock |
| NATIONAL DEFENCE
|
| Mrs. Elsie Wayne |
| Hon. Arthur C. Eggleton |
| Mrs. Elsie Wayne |
| Hon. Arthur C. Eggleton |
1430
| HUMAN RESOURCES DEVELOPMENT
|
| Mr. Monte Solberg |
| Hon. Jane Stewart |
| Mr. Monte Solberg |
| Hon. Anne McLellan |
| Mr. Michel Gauthier |
| Hon. Martin Cauchon |
1435
| Mr. Michel Gauthier |
| Hon. Martin Cauchon |
| Ms. Val Meredith |
| Hon. Jane Stewart |
| Ms. Val Meredith |
| Hon. Jane Stewart |
1440
| Mr. Michel Bellehumeur |
| Hon. Jane Stewart |
| Mr. Michel Bellehumeur |
| Hon. Jane Stewart |
| Mr. Rahim Jaffer |
| Hon. Jane Stewart |
| Mr. Rahim Jaffer |
| Hon. Jane Stewart |
| Mrs. Pierrette Venne |
1445
| Hon. Lawrence MacAulay |
| LABOUR
|
| Ms. Susan Whelan |
| Hon. Claudette Bradshaw |
| PRIVACY
|
| Mr. John Reynolds |
| Hon. Anne McLellan |
| Mr. John Reynolds |
| Hon. Jane Stewart |
| THE ENVIRONMENT
|
| Mr. Bill Blaikie |
| Hon. David Anderson |
1450
| MINING INDUSTRY
|
| Mrs. Michelle Dockrill |
| Hon. Ralph E. Goodale |
| NATIONAL DEFENCE
|
| Mr. David Price |
| Hon. Arthur C. Eggleton |
| Mr. David Price |
| Hon. Arthur C. Eggleton |
| MISHTAPEW AWARDS OF EXCELLENCE GALA
|
| Mr. Guy St-Julien |
| Hon. Martin Cauchon |
1455
| HUMAN RESOURCES DEVELOPMENT
|
| Mr. Leon E. Benoit |
| Hon. Jane Stewart |
| SMART COMMUNITIES PROGRAM
|
| Mrs. Suzanne Tremblay |
| Hon. John Manley |
| EMPLOYMENT INSURANCE
|
| Mr. Yvon Godin |
| Hon. Jane Stewart |
| HUMAN RESOURCES DEVELOPMENT
|
| Mr. Bill Casey |
| Hon. Jane Stewart |
| CRTC
|
| Mr. Roger Gallaway |
1500
| Mr. Mauril Bélanger |
| PRESENCE IN GALLERY
|
| The Speaker |
| PRIVILEGE
|
| Correctional Service Canada
|
| Hon. Lawrence MacAulay |
1505
| The Speaker |
| BUSINESS OF THE HOUSE
|
| Mr. Chuck Strahl |
1510
| Hon. Alfonso Gagliano |
| POINTS OF ORDER
|
| Division No. 1319
|
| Ms. Wendy Lill |
| GOVERNMENT ORDERS
|
| SUPPLY
|
| Allotted Day—Canada Health Act
|
| Motion
|
| Mr. Gary Lunn |
1515
1520
| BUSINESS OF THE HOUSE
|
| Mr. John O'Reilly |
| Motion
|
| SUPPLY
|
| Allotted Day—Canada Health Act
|
| Motion
|
| Ms. Judy Wasylycia-Leis |
1525
| Mr. Ted McWhinney |
1530
1535
1540
| Mr. Grant Hill |
| Ms. Judy Wasylycia-Leis |
1545
| Mr. Peter Stoffer |
1550
| Mr. Peter Stoffer |
1555
1600
| Mr. Grant Hill |
1605
| Hon. Lorne Nystrom |
1610
1615
| Mr. Peter MacKay |
| Mr. Grant Hill |
1620
| Mr. Bryon Wilfert |
1625
| Ms. Judy Wasylycia-Leis |
1630
| Ms. Angela Vautour |
1635
| Mr. Steve Mahoney |
1640
1645
| Hon. Lorne Nystrom |
| Mr. Bill Casey |
1650
1655
1700
| Mr. Gordon Earle |
1705
| Mr. John Bryden |
1710
1715
| Mr. Steve Mahoney |
1720
| Mr. Bill Blaikie |
1725
1730
| Division on amendment deferred
|
| PRIVATE MEMBERS' BUSINESS
|
| PROPORTIONAL REPRESENTATION
|
| Hon. Lorne Nystrom |
| Motion
|
1735
1740
1745
1750
1755
| Mr. Peter MacKay |
1800
1805
| Mr. Derek Lee |
1810
| Mr. Ted White |
1815
1820
1825
| Mrs. Madeleine Dalphond-Guiral |
1830
| Amendment
|
1835
| ADJOURNMENT PROCEEDINGS
|
| Communication
|
| Ms. Wendy Lill |
| Ms. Bonnie Brown |
1840
| Human Resources Development
|
| Ms. Angela Vautour |
1845
| Ms. Bonnie Brown |
(Official Version)
EDITED HANSARD • NUMBER 100
HOUSE OF COMMONS
Thursday, May 18, 2000
The House met at 10 a.m.
Prayers
ROUTINE PROCEEDINGS
1000
[Translation]
GOVERNMENT RESPONSE TO PETITIONS
Mr. Derek Lee (Parliamentary Secretary to Leader of the
Government in the House of Commons, Lib.): Mr. Speaker, pursuant
to Standing Order 36(8), I have the honour to table, in both
official languages, the government's response to 12 petitions.
* * *
EXPORT DEVELOPMENT
Hon. Pierre S. Pettigrew (Minister for International Trade,
Lib.): Mr. Speaker, pursuant to Standing Order 109, I have the
honour to table, in both official languages, the government's
response to the report of the Standing Committee on Foreign
Affairs and International Trade entitled “Exporting in the
Canadian Interest: Reviewing the Export Development Act”.
* * *
[English]
THE UNKNOWN SOLDIER
Hon. George S. Baker (Minister of Veterans Affairs and
Secretary of State (Atlantic Canada Opportunities Agency),
Lib.): Mr. Speaker, I rise today to bring to the attention of
the House important events that will be taking place in France
and Canada next week, events that will mark a singular tribute to
Canada's veterans of the past, to our serving men and women of
today and to those who may, in the future, be called upon to
defend our country and to stand on guard for peace and freedom.
1005
Next Tuesday, it will be my privilege, in the company of
representative veterans and other Canadian witnesses, to fly to
Vimy, France, to receive the remains of an unidentified Canadian
soldier from World War I.
Canadian veterans, military from Canada and France, diplomats,
along with French government and community leaders will all
witness the event. Honorary pallbearers from our wartime allies
will bear the casket which our delegation from Canada will
officially receive from the Commonwealth War Graves Commission.
The casket will contain the remains of a young soldier who made
the supreme sacrifice in the area of Vimy. We do not know his
name, we do not know his age, we do not know his unit but we do
know that he was one of our brave Canadian soldiers.
After the ceremony at Vimy Ridge, the remains of the unknown
soldier will be flown to Ottawa on the afternoon of May 25. In
Ottawa there will be a procession to Parliament Hill where the
unknown soldier will lie in state for three days in the Hall of
Honour. The casket will be under constant vigil of serving
members of the Canadian Forces and the Royal Canadian Mounted
Police. Members of the public will be invited to pay their
respects.
On May 28 the casket will be taken on a gun carriage to the
National War Memorial accompanied by a military escort, Her
Excellency the Governor General of Canada, the Prime Minister,
members of the diplomatic corps, veterans and the RCMP. There
the casket will be placed on a specially designed memorial tomb,
after which a committal service will be conducted with military
honours.
Soil from each province and the territories will be mixed with
the soil taken from his resting place in France and placed in the
tomb. After completion of the service the tomb will be sealed
forever.
This will be a unique occasion of commemoration as we honour the
unknown soldier. I want to express, on behalf of all members of
the House, our deep appreciation for the great efforts of the
Royal Canadian Legion and others who have worked so hard to bring
the unknown soldier home.
Mr. Peter Goldring (Edmonton East, Canadian Alliance): Mr.
Speaker, I am pleased to rise to respond to the statement of the
Minister of Veterans Affairs.
The events to occur next week are truly historic and long
overdue. The ceremonies in Ottawa will bring together all
provinces, since earth gathered from each province and the soil
of France where a soldier fell so long ago, will be interred with
his remains.
Next week a soldier will be carried home from the shadow of Vimy
Ridge to rest forever on Canadian soil, not to the town he left
so long ago, for we know not where he lived, not to his family's
home, for we know not who his family is, but home he will come to
rest in an honourable place and to receive the deserving respect
of all as we, the public, remember the war, think of his soul and
ponder the supreme “price of peace” that his death reflects.
These actions show to us that the unknown soldier represents all
Canadians. In falling at Vimy, the unknown soldier fell in a
crucial battle, a Canadian victory that all the world would see.
Many would say that Canada took birth that day. Born into the
world of nations with respect, born by the blood of our young,
born through the determination and skill. Their spirit lives on
to this day.
Over 60,000 Canadian soldiers died in “the war to end all
wars”. This last century, over 100,000 Canadians never returned
home. More than 27,000 of our war dead, nearly 25% of all
Canadians who lost their lives in fighting for our freedoms, have
no marked grave having been buried at sea or on land.
It is this soldier's life and his death that is of singular
importance at this time. The unknown soldier is whom we speak of
today. His name is known only unto God. Soon he will rest in
peace on Canadian soil. Soon he will be with his family; all
Canadians who will honour his past. Soon he will be home at long
last.
1010
[Translation]
Mr. Paul Mercier (Terrebonne—Blainville, BQ): Mr. Speaker, I am
somewhat familiar with the Vimy area, in France, where, next
week, we will go to gather up the remains of an unknown Canadian
soldier.
A few years ago, I visited this World War I battlefield. I
remember walking over the plain, which now looks so peaceful
with its wheat fields and small wooded areas, in a contemplative
mood but also feeling the anguish that grips us when we find
ourselves in a place where thousands of men died while fighting
for freedom.
“Morts pour la liberté”. These people made the ultimate
sacrifice for freedom.
It is with reluctance that I use this expression, because I am
well aware that after having been used in so many speeches and
read, unfortunately, on so many tombstones, it may have lost
some of its meaning and may no longer fully reflect the noble
yet terrible reality that it should evoke. Still, let us try to
visualize what happened.
We are close to the village of Vimy. Can we see that young man,
whose remains we will bring back home? Like thousands of others
he is there, alive, with his helmet, his rifle and his khaki
uniform in a trench, where he is taking cover, alongside his
brothers in arms.
Stunned by the din of battle, which prevents him from thinking,
he shoots again and again. His rifle is hot.
But in the lulls between firing, he lights a cigarette and,
leaning on the muddy wall of the trench, he dreams. For the
hundredth time, we can be sure, he imagines the wonderful moment
when the war is ended, he has travelled back across the ocean,
and the train carrying him and his buddies home finally reaches
its destination.
He can picture himself already, a young soldier flush with
victory, searching through the cheering crowd on the platform
for the anxious faces of his mother, his father, his girlfriend
or his wife, and perhaps his children, older now. “Will he be
there”, they must be asking themselves. There, he has seen
them. “Yes, yes, I am here”, he shouts to them, leaning out the
open train window.
A whistling sound, an explosion, a blast—it must have been a
shell that killed him because his remains, likely mixed in with
those of other soldiers, could not be identified.
A shell which shattered his dream and robbed him of his
identity. But today, it is this anonymity which has earned him
a place in history by conferring on him the honour of forever
representing in his native land, to which he has returned after
more than 80 years, all those who, like him, gave their lives
for us.
Next week, the coffin of this soldier will be on view in
parliament's Hall of Honour so that his fellow Canadians may pay
tribute to him. I hope that many men and women will do so for,
were he not back among us, they might perhaps have eventually
forgotten to whom they owe their freedom. They need not be
great readers of literature to help make the following two lines
of verse ring as true today as when they were first written:
Those who for their country gave their lives
Should hear the prayers of many at their grave
[English]
Mr. Gordon Earle (Halifax West, NDP): Mr. Speaker, I am
pleased to rise on behalf of the New Democratic Party of Canada
in response to the minister's announcement of the significant
events that will take place in France and Canada next week.
Indeed, the repatriation and interment of the remains of an
unidentified Canadian solider from World War I is important to
all Canadians. This unknown young man will receive posthumously
the honour, respect and recognition that was so devoutly earned
as he, like so many others, gave his life in service to his
country and fellow man.
The ceremonies that will take place will express the
appreciation of all Canadians and their allies for the ultimate
sacrifice that was made by this young man and so many other men
and women who fought for the peace and good order that we enjoy
today.
1015
At the same time, these ceremonies will be a stark reminder of
the horrors of war, of man's inhumanity to man and the real and
tragic cost involved when nations rise against nations, when
greed, hatred and lust for power and domination take precedence
over love, respect, sharing, kindness and a sense of fair play,
equality and social justice.
As we pay our respects to this young Canadian while he lies in
state in the Hall of Honour, may each of us search our hearts for
what we can do individually and collectively to advance the cause
for which this young man died: peace on earth and goodwill to
all.
Yes, at long last we are bringing him home, but perhaps he never
really left. While his body may have left home and died, I
believe his spirit, like the spirits of many others who have gone
on before, remains with us seeking peace and justice for all.
Mrs. Elsie Wayne (Saint John, PC): Mr. Speaker, I rise
today to honour one who is without a name, one who carries the
names of many. Next week I will be accompanying the minister to
Vimy. Next week for Canada, an unknown soldier becomes the
Unknown Soldier. He will be removed from his many, many comrades
at Vimy to lie in a new place of equal but solitary honour in
Canada.
This man's family should escort him to his new grave for he is
our father, he is our son. On behalf of his country, I am proud
to be part of the mourners who will bring him to his Canadian
resting place of honour.
Our men and women who died in war are all equally honoured by
this act. We remember those who died in the fields of foreign
nations. So too we remember those who died in the air and on the
seas. Their mortal bodies were committed to earthless graves
that cannot be visited.
All across this country there are monuments, memorials sacred to
the remembrance of those who died in the wars fought in our name.
On many of the cenotaphs is written these appropriate words from
Ecclesiasticus, “their name liveth for evermore”. Today, let us
also remember the words preceding this citation:
And some there be, which have no memorial...and are become as if
they had never been born...But these were merciful men, whose
righteousness hath not been forgotten...Their seed shall remain
forever, and their glory shall not be blotted out. Their bodies
are buried in peace; but their names liveth for evermore.
On this solemn occasion, we again express our sorrow and
sympathy for the families of those who have died in the service
of Canada. They survive with a lifelong loss and unending pain.
Some will feel extra grief because their family member was killed
in a manner that did not permit identification or burial. May
they know serenity through this expression of the perpetual
gratefulness of all Canadians for all time.
We express our gratitude to those who took up the torch, who saw
injustice and tyranny and were prepared to suffer and die for
their fellow Canadians. We remember those who returned from war
and who still suffer the pains of physical and mental wounds. We
pray that in paying homage to one unknown soldier we and future
generations will remember and honour those who died for Canada.
* * *
1020
QUESTIONS ON THE ORDER PAPER
Mr. Derek Lee (Parliamentary Secretary to Leader of the
Government in the House of Commons, Lib.): Mr. Speaker, the
following question will be answered today: No. Q-29.
.[Text]
Question No. 29—Mr. John Cummins:
With regard to the purchase of mefloquine from the manufacturer
and the oversight of mefloquine by the Health Protection Branch
as mandated by the Food and Drug Act: (a) did the Canadian
Forces indicate to the manufacturer on the order form when
ordering mefloquine for Somalia that it was for use under the
Food and Drug Act's Lariam Safety Monitoring Study; when was the
order submitted; and when was the shipment received; (b) was
the Health Protection Branch informed by the manufacturer that
the Canadian Forces had indicated on the order form that the
mefloquine was being ordered under the authority of the Lariam
Safety Monitoring Study and that this mefloquine was apparently
purchased for the Somalia deployment; and when was the Health
Protection Branch so informed;
(c) did the Health Protection
Branch receive from the manufacturer a request to fast track
licensing approval for mefloquine (Lariam), and was licensing
approval granted prior to the end of the Canadian Forces
deployment in Somalia; (d) what was the date the Health
Protection Branch received the final results of the Lariam Safety
Monitoring Study from the manufacturer, and the date of the
receipt by the Health Protection Branch of the last submission of
the Safety Monitoring Study's results prior to licensing
approval; (e) did the Department of National Defence prepare an
advisory note acknowledging that evidence provided to the Somalia
Inquiry had mislead the Inquiry as to the status of mefloquine
approvals for the mefloquine used in the Somalia deployment; was
the advisory note forwarded to the Minister of National Defence;
and what action was taken when the Minister was so informed?
Mr. Derek Lee (Parliamentary Secretary to Leader of the
Government in the House of Commons, Lib.): I am informed by the
departments of Health and National Defence as follows:
(a) The Canadian Forces did not indicate on the order forms for
the mefloquine to be used on the Somalia deployment that it was
for use under the Food and Drugs Act Lariam Safety Monitoring
Study or on the Somalia deployment. This type of statement is
also not on the initial order form that was addressed to the
Ottawa Civic Hospital for the procurement of mefloquine earlier
in the safety monitoring study. The order dates were September 9,
11, 14, 15 and 28, 1992 and the drugs were delivered within three
working days of the order being placed.
(b) At the time of the transaction, the manufacturer was not
required, nor did they inform Health Canada that the mefloquine
was being ordered under the authority of the Lariam Safety
Monitoring Study, and that this mefloquine was apparently
purchased for the Somalia deployment.
Health Canada was informed only after the allegations arose in
the media in October 1994, and after investigation and
consultation with the manufacturer subsequently.
(c) Health Canada
Health Canada records reveal that the manufacturer did
indeed request fast tracking of the new drug submission for
Lariam.
Health Canada issued a notice of compliance for Lariam on
January 22, 1993. Health Canada is not privy to significant dates
related to Canadian Forces activity in Somalia and is therefore
unable to comment on the date of approval of Lariam—January 22,
1993, in relation to the end of the Canadian Forces deployment in
Somalia.
National Defence
Health Canada's response indicates January 22, 1993, as the
date of approval for Lariam. Licensing approval for Lariam was
therefore granted prior to the end of the Canadian Forces
deployment in Somalia.
(d) The last submission of the safety monitoring study results
received by Health Canada prior to marketing approval was on July
17, 1992. The final results of the Lariam Safety Monitoring Study
were received from the manufacturer on July 30, 1993 and in
August/September 1993, subsequent to marketing approval.
(e) An advisory note was prepared for and passed to the Minister
of National Defence in October 1997 which states, with regard to
the approval of mefloquine, “there was no intention to mislead
the Commission”. However, this document goes on to explain,
“Until very recently, it was believed that the Surgeon General
Branch had informed Health Canada that mefloquine was being
dispensed without the consent of individuals—even the
directorate which authorized the use of mefloquine in Somalia
was under this misconception”. Consequently, any information
the department may have passed to the Somalia commission of
inquiry related to the approval of mefloquine would have been
based on the assumption that Health Canada and the drug
manufacturer had been informed that the Department of National
Defence was administering mefloquine outside the boundaries of
the manufacturer's study.
Since the advisory note was prepared some four months after the
publication of the Somalia commission of inquiry report in June
1997, no action was taken to advise the commission. However, as a
result of the misunderstanding experienced with the
administration of mefloquine in Somalia, the department
implemented several corrective actions to improve monitoring and
recording procedures relating to the use of unlicensed products.
A regulatory affairs position has been established to serve as a
single contact point with Health Canada regarding unlicensed
products; procedures for acquisition, distribution, use and recording of
unlicensed medical products have been promulgated; detailed drug
and vaccine information sheets for health care providers and
Canadian Forces members are being prepared; and an adverse
effects monitoring and reporting database is being developed.
* * *
[English]
QUESTIONS PASSED AS ORDERS FOR RETURNS
Mr. Derek Lee (Parliamentary Secretary to Leader of the
Government in the House of Commons, Lib.): Mr. Speaker, if
Question No. Q-28 could be made an Order for Return, the return
would be tabled immediately.
The Deputy Speaker: Is that agreed?
Some hon. Members: Agreed.
.[Text]
Question No. 28—Mr. John Cummins:
With regard to the recording and reporting of adverse events
related to the use of the antimalarial drug mefloquine by the
manufacturer, the Health Protection Branch and the Canadian
Forces: (a) did the Deputy Chief of Defence Staff in May 1995
make a finding that mefloquine was a contributing factor in the
suicide death of a Canadian soldier in Rwanda in December 1994,
and did a United Nations inquiry come to a similar conclusion;
(b) what problems with the use of mefloquine did the January
21, 1993, Canadian Forces medical services unit's post-op report
of the relief phase of the Somalia mission record, and what
actions were taken as a result of these findings; (c) what
problems with the use of mefloquine did the April 1993 Canadian
Forces medical services unit's post- deployment report on the
Somalia mission record, and what actions were taken as a result
of these findings;
(d) what problems with the use of mefloquine did the October
1993 Canadian Forces medical services unit report “Medical
Operations in Somalia, Surgical Section” record, and what
actions were taken as a result of these findings; (e) what
reporting procedures did the doctors of the Canadian Forces
medical services unit in Somalia employ to ensure that soldiers
exhibiting what the product monograph refers to as signs of
unexplained anxiety, depression, restlessness or confusion
discontinued use of the drug, as such signs were to be considered
prodromal to a more serious event; (f) what special reporting
procedures did the doctors of the Canadian Forces medical
services unit in Somalia employ on the day that mefloquine was
administered, normally referred to by soldiers as psycho-Tuesday
or Wednesday, etc., to establish whether soldiers were exhibiting
what the product monograph refers to as signs of unexplained
anxiety, depression, restlessness or confusion;
(g) did the doctors of the Canadian Forces medical services
unit report to the manufacturer on a regular basis adverse events
suffered by soldiers under their care who had been administered
mefloquine between December 1, 1992, and December 1, 1995, and
were these adverse event reports made available to the Health
Protection Branch by either doctors of the Canadian Forces
medical services unit or the manufacturer; (h) did the Health
Protection Branch regularly receive from the manufacturer
mefloquine (Lariam) adverse event reports; how soon after the
adverse event occurred did the manufacturer normally report the
event; and how many such events were reported by the manufacturer
to the Health Protection Branch since 1990; (i) how many
mefloquine related adverse events were reported to the Health
Protection Branch by either doctors or their patients since 1990;
(j) did the doctors of the Canadian Forces medical services
unit have a responsibility to report to either the manufacturer
or the Health Protection Branch suicide or suicide attempts by
soldiers under their care who had been administered mefloquine
(Lariam); (k) what were the findings of the August 24, 1992,
“Review of the Safety Report Update for the Lariam Safety
Monitoring Study” by the Infection and Immunology Division of
the Health Protection Branch as regards investigators failing to
return their completed case record forms to the manufacturer, and
did this indicate that the safety data from the Safety Monitoring
Study was incomplete; (l) following the August 24, 1992,
“Review of the Safety Report Update for the Lariam Safety
Monitoring Study” by the Infection and Immunology Division of
the Health Protection Branch, what remedial steps were requested
of the manufacturer so as to ensure the manufacturer required the
investigators to comply with the reporting requirements of the
Safety Monitoring Study; and
(m) following the shipment of mefloquine by the manufacturer
to CFB Petawawa ordered for the Somalia deployment, was the
Canadian Forces medical services unit informed or reminded in any
manner on any occasion by the manufacturer of the Canadian
Forces' responsibility to comply with the requirements of the
Lariam Safety Monitoring Study as to administering the drug,
recording adverse events and reporting them to the manufacturer
or the Health Protection Branch and if so when?
Return tabled.
[English]
Mr. Derek Lee: I ask, Mr. Speaker, that the remaining
questions be allowed to stand.
The Deputy Speaker: Is that agreed?
Some hon. members: Agreed.
[Translation]
The Deputy Speaker: I wish to inform the House that because of
the ministerial statement Government Orders will be extended by
15 minutes.
GOVERNMENT ORDERS
[Translation]
SUPPLY
DESIGNATED DAY—CANADA HEALTH ACT
Ms. Alexa McDonough (Halifax, NDP) moved:
That this House call upon the government to act on the words of
the Health Minister when he said, “we have grave reservations
about investing public funds in private for-profit facilities”,
by immediately amending the Canada Health Act to provide that
provinces be financially penalized if they allow public funds to
be used for the provision of insured services by private,
for-profit hospitals.
She said: Mr. Speaker, I am going to share my time with my dear
colleague for Winnipeg North Centre.
[English]
The motion we put forward today comes as a result of what
transpired here last week. After months of hand wringing, after
months of promises to carefully study, after months of posturing,
the health minister stood in this place and gave the green light
to Ralph Klein's efforts to privatize health care in this
country.
The Minister of Health said that he has a problem with Alberta's
bill 11. Our motion today offers a solution. With today's motion
we are offering the government a way to act on the concerns of
the health minister, the concerns he himself has been forced to
acknowledge again and again.
It is a way to stop Alberta's bill 11 from triggering a huge
expansion of for profit health care for Canadians. It is a way
to uphold the intent and promise of the Canada Health Act that
all Canadians shall have equal access to health care when they
need it. It is a way to do what Canadians expect of this
government which is to stand up for our most cherished social
program.
Let us back up a bit. Let us go over the highlights of the
tragic comedy known as the federal reaction to bill 11. Since
last fall the minister has voiced concerns about bill 11. The
Klein government has dismissed those concerns, barely able to
conceal its contempt for Canada's Minister of Health.
The minister's strategy is to buy time. First he waited to see
the actual legislation. The draft the Alberta government sent
him was not good enough. Then he waited to see the amendments,
then the legislation in its final form, then it was the
regulations. Now he wants to see specific violations of the
Canada Health Act before he is prepared to do anything.
[Translation]
It is time for the minister to take action, and right now. All
his protestations to the contrary, let us be clear about it, the
minister does have an option. If he continues to claim that he
cannot apply the Canada Health Act, he can change it in order to
ensure that no Canadian has to make a choice between paying
extra or taking the risk of getting second class treatment.
[English]
Accessibility is a fundamental principle of the Canada Health
Act. The act requires that provincial governments as a condition
of receiving federal transfers ensure that insured health
services are provided on uniform terms and conditions. The
minister knows that bill 11 compromises the principle of
accessibility. He said so in a letter to his Alberta
counterpart. He stated:
To permit for profit facilities to sell enhanced services, in
combination with insured services, would create a circumstance
that represents a serious concern in relation to the principle of
accessibility.
1025
The concern which we share is that bill 11 permits, in fact
encourages and facilitates, queue jumping and two tier health
care. All the pious statements by Mr. Klein aside, that is the
main goal of bill 11. Patients in private for profit hospitals
will be offered uninsured, or enhanced services so-called, for
which they will be required to pay extra and if they refuse they
will undoubtedly face second class treatment.
Let us forget about the technical and legal arguments. Let us
think about Canadians who are put in that position, Canadians who
are vulnerable, scared and sometimes desperate, often suffering
severe pain, Canadians who have always trusted their doctors but
in that position are not so sure. With bill 11 American health
corporations put doctors in the position of having one hand on
the scalpel and one hand on the cash register. Canadians who
cannot pay will be forced to settle for inferior service.
The minister hoped to make bill 11 magically disappear by
beefing up monitoring. However, this move described quite
rightly by the auditor general many months ago, does not solve
the root problem because these staff cannot be in an operating
room or in the doctor's office when a patient is asked whether
she wants to pay a little extra or settle for the minimum level
of service. They cannot see inside the doctor's head when she
schedules a procedure or books an appointment for us with a
specialist.
The minister himself said in his letter that the threat to
accessibility is the circumstance created by bill 11, namely
allowing for profit hospitals to sell uninsured services while
also providing publicly funded insured services. That is why it
is a shameful evasion to now say that the Minister of Health must
wait for specific documented violations before moving to enforce
the Canada Health Act. He is hiding behind a legal ambiguity in
the act to avoid doing anything whatsoever.
Our motion removes that ambiguity. It clarifies how the
principle of accessibility must be upheld in a world in which
commercial health corporations aided by their political cronies
are trying to dismantle our public health system. It ensures
that all Canadians are treated equally in hospitals receiving
public health care dollars.
Mr. Ted White (North Vancouver, Canadian Alliance): Mr.
Speaker, my question for the leader of the NDP has to do with the
province of British Columbia.
The Government of B.C., which is an NDP government I might add,
recently allowed a hospital in my riding, Lions Gate Hospital, to
experiment with the contracting out of services to the private
sector. The two areas of treatment covered by the experiment are
eye surgery and simple surgical procedures. As a result of the
contracting out of these services to the private sector, the
waiting list for eye surgery has dropped by 60% and the waiting
list for simple surgical procedures has dropped by 20%.
Will the leader of the NDP recognize the success of this private
sector involvement in the health care sector or will she continue
to oppose these new approaches which have alleviated the
suffering of dozens of my constituents? Would she rather condemn
her followers to long waiting lists and inadequate procedures?
Ms. Alexa McDonough: Mr. Speaker, let me say first, as I
have said on many occasions and said again this morning, we are
absolutely in favour of innovation to improve the public health
care system.
However we stand against what bill 11 is all about. Bill 11
clearly intends to create a two tier health care system where
those who can pay extra money can jump the queue and get
preferred services and those who do not have that private wealth
and deep pockets are not in a position to do so. That is why
bill 11 is so lethal. It threatens the very heart of
universality and the concept that people shall be eligible for
equal treatment regardless of where they live or what their
financial circumstances are.
1030
That is a fundamental difference between those provinces. Let
me say that the NDP provinces have backfilled, infilled dollar
for dollar, the huge sum of money taken out of the public health
care system by the federal government. Also the NDP provinces
are standing up and fighting against this very serious threat to
the total health and universality of access to services in the
public not for profit health care system.
Mr. Ted White: Mr. Speaker, with all due respect, the
leader of the NDP did not answer my question. Does she approve
of the type of private sector contracting out which is being
experimented with by the NDP government in British Columbia, or
would she rather condemn her followers to lengthy waiting lists
and inadequate procedures?
Ms. Alexa McDonough: Mr. Speaker, it is a sad thing,
which is exactly why Canadians are so alarmed, that members of
the official opposition talk not at all about the need for
innovation in health care. They talk not at all about the threat
of bill 11 not just to universal not for profit health care in
Alberta but to universal not for profit public health care across
the country.
When they finally get up out of their seats and start to raise
issues about health care, it is after Canadians have noted that
they have completely abandoned their responsibility as the
official opposition to stand up for a public not for profit
universal health care system. They have it in their heads that
there is some either/or here.
We absolutely want to see innovation. We need innovation in the
health care system. At the very least we need the government to
deliver on its commitment to home care and to a pharmacare
program, but it cannot be at the expense of the universal
provision of health care to those who need it. That is what the
official opposition party does not seem willing either to accept
or take any leadership on.
Hon. Lorne Nystrom (Regina—Qu'Appelle, NDP): Mr.
Speaker, I know the Canadian Alliance finished with 4% in
Newfoundland slightly ahead of the extreme wrestling party. That
tells how much credibility it has on health care.
I noticed yesterday the Minister of Finance announced that the
surplus for 1999-2000 was $11 billion higher than projected in
February. Would the leader agree with me that this money should
be spent on health care, on the CBC and on other social programs
that are a necessity for the future development of our country?
Ms. Alexa McDonough: Mr. Speaker, I think my colleague
from Regina has said it all. If Canadians depended upon
leadership from the Reform Party, in whatever its newest
incarnation, then we would now have already Americanized our
health care system in exactly the way that actually some of the
candidates for the leadership of its renamed party have been
advocating.
I do not think there is any problem with the agreement with my
colleagues in my caucus on the issue. Neither is there any
problem with Canadians understanding the transparency and the
hypocrisy of the official opposition position.
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): Mr.
Speaker, I am very pleased on behalf of my colleagues in the New
Democratic Party to be able to address a situation that is
obviously at a very critical juncture in the history of the
country.
We come to this debate with a serious, constructive motion to
demand that the government stand and take action. We come to
this debate with the understanding of so many Canadians that we
are at a defining moment in our history when it comes to the
number one priority facing Canadians: health care, access to
quality health care across the country, and the preservation of a
system that has held the country in good stead.
I am very pleased to be able to follow my leader, the leader of
the New Democratic Party, who has been leading the fight in
speaking out on behalf of Canadians and their number one concern.
She is the only leader in the House, the only leader of a
national political party who has decided to hold the government
to account and to reflect the concerns of the Canadian public.
1035
All my colleagues in the New Democratic Party have been fighting
this issue day in and day out, week after week, month after
month. It is an important issue. It is imperative for us to
hold the government to account and to move it from its words and
rhetoric to the point where it is prepared to have political
courage and to take action.
We have a very constructive proposition for the government
today. We hope the Minister of Health is listening carefully, as
I see he is, and will convince his colleagues to support us in
this request.
As my leader has done in her opening remarks, let me just
briefly put the motion in some historical context. It will come
as no surprise to the Minister of Health when I say again today
that we have been pressuring the minister month after month to do
something about bill 11.
I do not need to mention the fact that for seven months the
Minister of Health has said he will act later. He said he will
act when he gets the mail. He will act when the bill is
unveiled. He will act when the bill is introduced. He will act
after amendments, after regulations, and now he is saying after
implementation.
What has been the action so far? Nothing, nil. I do not like
to get carried away with the rhetoric in the House, but I have a
difficult time not pointing out that this is a very shameful
performance on the part of the Minister of Health, and I think he
knows it.
Let us look at the response of the Minister of Health and his
colleagues over the last number of months. We tried in the House
to do something as simple as getting the government to
acknowledge the existence of a number of legal opinions about how
bill 11 violates the Canada Health Act and how it opens up NAFTA.
We could not even get the government to allow us to present
those legal opinions. It did not even want to have a look at
them. It did not even want to acknowledge their existence
because it would put the government in the terrible position of
having to recognize the facts forcing it to act now and act
today.
We asked about the NAFTA implications, something that has been
acknowledged as a very serious concern by credible organizations
from one end of the country to the other. What did the Liberals
do? They reversed themselves without a single legal opinion to
back them up. All the while we have the reform alliance and the
Tories cheering Ralph Klein on, supporting, aiding and abetting
an agenda which opens up our health care system to a two tier
American style approach.
By the inaction of the Minister of Health the government is
letting the right wing forces send a message, make a difference,
influence the public agenda. The passivity and inaction of the
minister are destructive and dangerous in more ways than one when
it comes to the future of the country and the future of national
health care that held Canada in good stead.
What the Canadian Alliance and the Tories are suggesting is
something that Canadians abhor, something that has been rejected
time and time again. It is absolutely critical for the
government to stand today to put an end to that kind of agenda,
to counter it immediately and to do so by way of concerted and
decisive action.
1040
What does the minister continue to do? He continues to dodge
and weave, wait and see, hide and seek. He is now saying after
all the time he has had to study bill 11 that it complies with
the Canada Health Act. He has given us no legal opinion. He has
given no evidence for the sudden decision to claim there is no
violation of the Canada Health Act.
I know I should not comment on how many Liberal members are in
the House, but I hope the Minister of Health will get to all of
them over the course of the day. I would like them to think
about what they are doing and what is happening. The health
minister has said private for profit hospitals do not violate the
Canada Health Act. The legacy of the government will not be
brave decisive action but explicit consent to a two tier American
style health care system.
We used the words of the minister in the motion because we
thought they were a significant indication of the wishes of
Canadians. He says that he has grave reservations about investing
public funds in private for profit facilities. Grave concerns do
not stop health care from becoming a commodity to be bought and
sold on the open market. Grave concerns do nothing to stop bill
11 from being proclaimed.
We know the minister has had a heck of a time trying to get his
head around it and do something decisive over the past seven
months, but we are here today saying that he now has a window of
opportunity to act before bill 11 is actually proclaimed.
I have lots more to say and I think the best way to actually say
what the motion is all about is to read a letter to the editor of
the Globe and Mail of today by Don Schmidt. He wrote:
The Deputy Speaker: Order, please.
Ms. Judy Wasylycia-Leis: I am quoting, Mr. Speaker.
The Deputy Speaker: The member may quote but I know she
will want to comply with the rules by referring to the Minister
of Health by title and not by name.
Ms. Judy Wasylycia-Leis: I apologize, Mr. Speaker. The
letter continued:
Most Canadians expect (the Minister of Health) to
legislate—that's right: pass laws—so that a two tier health
system is unable to develop further. Do your job, (Mr.
Minister).
There is much more to be said. I hope the Minister of Health
has the message and sees it as a constructive suggestion. Before
concluding, I move:
The Deputy Speaker: The question is on the amendment.
Mr. Grant Hill (Macleod, Canadian Alliance): Mr.
Speaker, my colleague asked a question of the leader of the NDP a
few moments ago. He tried to do it twice and did not get an
answer, so I would like to try again.
The NDP government in B.C. wants to protect medicare, as I
believe every individual in the House wants to do. It has
recently experimented with private practice procedures relating
to cataract surgery and minor surgical procedures.
They have reduced the waiting lines for those two procedures in a
relatively short time. This is an innovation and it involves
doing exactly what bill 11 attempts to do, reduce waiting lines
in Alberta. The NDP government is making innovations in exactly
the same way.
1045
Would the member comment about B.C.'s attempt to reduce waiting
lines by doing exactly what bill 11 is trying to do?
Ms. Judy Wasylycia-Leis: Mr. Speaker, the alliance
members want to have it both ways in this debate. On the one
hand they say that they are in support of medicare, while on the
other hand they do not acknowledge that these principles are
being violated today. The principle of accessibility is being
violated under bill 11. Members cannot stand in the House and
say they support medicare and then say we should go further than
bill 11.
The member also seems to feel that the only way we can deal with
waiting lists and the need for more efficiencies in our system is
through privatization. Since when did privatization become the
only solution for innovation? Alliance members joined with New
Democrats in the House many months ago and said that the solution
to the problem was in convincing the government to restore the
cash transfer payments so that there would be adequate cash on
the table to meet the needs of Canadians so we could shape our
system to deal with growing and emerging needs in the health care
system today.
Why have these members suddenly decided to support the likes of
Ralph Klein, Stockwell Day and Mike Harris to pursue an American
agenda, and not a Canadian approach to something as vital as
universal access to health care?
Mr. Werner Schmidt (Kelowna, Canadian Alliance): Mr.
Speaker, I want to thank the hon. member for becoming so dramatic
and so excited in her answer to my colleague from Macleod.
There is a very simple question being asked. Does the member
support or not support the NDP government's approach to an
innovation that is being tried in Vancouver? Why is it that the
member cannot say yes or no?
The hon. member has suggested that there are many different ways
of innovating, and I quite agree with her. This is a sister
organization, an NDP government in British Columbia, which is
using a particular innovation. All we want to know is whether
those members would support that innovation.
Ms. Judy Wasylycia-Leis: Mr. Speaker, we have a motion
before the House today to try to get some support to stop bill
11. That party is confused about its own position and is afraid
to clearly indicate to Canadian people that it is in favour of a
parallel, private two tier health care system. That party comes
to the House with specific issues pertaining to provincial
governments.
I would be happy to look into examples of health care delivery
that are innovative. I would also inquire into each of the
examples to see if there is any breach of the Canada Health Act.
What is fundamental to us today—and I would hope alliance
members would eventually come to this point—is the preservation
of medicare; it is giving Canadians the wherewithal to preserve
medicare and build for the future.
My goodness, I would hope that in this kind of questioning from
alliance members they are not skirting their responsibilities. We
are engaging in a debate about the future of medicare and whether
the Canada Health Act is able to uphold the principles of
medicare. Are those members prepared to say clearly through this
debate, and on how they vote on this motion, that they believe in
medicare and will do anything to uphold the principles of
accessibility, comprehensiveness, universality, portability and
non-profit administration? Are they or are they not prepared to
join us in this most critical and fundamental question?
1050
Hon. Allan Rock (Minister of Health, Lib.): Mr. Speaker,
I will be dividing my time this morning with the hon. member for
Bruce—Grey.
I welcome the opportunity to address the House, as Minister of
Health, on an issue of such current and continuing priority. I
acknowledge the importance of the motion which the hon. member
for Halifax has put before the House of Commons today. The issue
is of fundamental significance because the way a nation chooses
to provide for health care services to those who are sick speaks
directly to the values of that nation.
In our case, the values of Canadians are reflected and codified
in the Canada Health Act. Although the Canada Health Act was
written and adopted many years ago, its principles are as
relevant now, as important now and as necessary now as they were
when the statute was first written.
Public medicare in Canada has allowed us to provide health care
services to our citizens in a way that is socially fair, while at
the same time putting in place a health care system that is
economically efficient and is a competitive advantage in the
business world to our businesses when they compete with those of
other nations.
Let me say at the outset that we, on this side of the House,
share the concerns that have given rise to the motion which is
presented today on behalf of the New Democratic Party. While we
share those concerns, our strategy in dealing with them differs
from that proposed by the leader of the NDP. Simply stated,
there is no need to amend the Canada Health Act to deal with the
concerns that have been raised. The Canada Health Act already
contains both the rules and the penalties to enable the
Government of Canada to ensure compliance with its principles.
They are already in the Canada Health Act.
[Translation]
I would like to point out that, as Minister of Health for
Canada, it is my responsibility to monitor the health systems of
the provinces and territories in order to ensure that they meet
the criteria and conditions of the Canada Health Act. If there
is an infraction, I am required by the act to consult the
provinces or territories in question.
Over the years, a number of potential problems of non-compliance
have been resolved by negotiation, without having to invoke the
penalties provided by the Canada Health Act. If negotiations
failed, however, the Government of Canada has the power to
withhold funds from the provinces.
[English]
I want to emphasize that this power is not simply theoretical.
It is not just a rule written on paper. This authority has been
exercised a number of times in recent years. For example,
between 1984 and 1987 the Government of Canada withheld about
$245 million from seven provinces that permitted user fees and/or
extra billing.
In 1992 to 1993 the Government of Canada withheld funds from
British Columbia in respect of extra billing arising out of the
dispute between the provincial government and the B.C. medical
association.
In 1995 our government deducted payments from four provinces
that charged facility fees for medically necessary services at
private clinics.
In each case the principles of the Canada Health Act, without
being amended, had been contravened and in each case the
Government of Canada acted.
In the context of bill 11 I have both spoken publicly and
written directly to the Government of Alberta to express my
concerns with that legislation. Indeed, I asked the Government
of Alberta to amend bill 11, and I expressed the view that while
on its face bill 11 does not contravene the Canada Health Act, by
allowing private for profit facilities to both provide insured
services and to charge fees for enhanced services bill 11 creates
circumstances which could be used to contravene the principle of
accessibility in the Canada Health Act. That is the real
concern.
1055
When we combine that with the fact that the policy of the
Alberta government contemplates overnight stays in private for
profit facilities, which takes private for profit further than it
has so far gone in the country, we asked the Government of
Alberta to amend its legislation. It did not. As a result, one
week ago today, in a ministerial statement, speaking on behalf of
the Prime Minister and this government, I said in the House that
because Alberta has gone ahead with this legislation, which we
thought was ill-advised, we would do the following things.
First, we will deem these private for profit facilities, as they
are called in bill 11, hospitals within the meaning of that term
in the Canada Health Act. The practical consequence of that is
that charging anyone for any part of an insured service will be
considered a violation of the Canada Health Act and will attract
the penalties provided for in that statute.
Second, in response to the concern expressed by the auditor
general last year that Health Canada does not have the resources
to monitor and enforce the act, we are increasing considerably
the capacity of Health Canada to do just that, and, as we have
watched in the past, we will watch carefully to see if these
private for profit hospitals imperil the principle of
accessibility, contravening the Canada Health Act. If they do,
as we have done in the past, we will act. We will exercise the
power of the Government of Canada under the Canada Health Act and
do what is necessary to protect medicare.
[Translation]
Clearly, we have the will and the means to ensure that the
Canada Health Act is respected. We are going to ensure that
the principles set out in the act are respected in Alberta and
elsewhere in the country.
Let me be perfectly clear: this government would not like to
merely to play the role of referee. We would much prefer to
work in partnership with our provincial colleagues.
[English]
Let me say a few words in closing about medicare renewal. Like
almost every other developed country in the world, Canada is
going through the process of improving and adapting its health
care system to meet the pressures of our current time: an aging
population, the increased cost of drugs and technology, and
changes in the way in which medical services are delivered on the
ground.
We have an enormous advantage in this country because we have
the best health care system in the world. Our challenge, indeed
our duty, is to renew medicare in a way that is consistent with
our principles and to overcome the problems of the shortages, the
waiting lists, while staying true to our basic principles.
While the federal role of enforcer which we are discussing today
is crucial, simply enforcing the rules is not by itself
sufficient to achieve the medicare renewal that must be
undertaken. It will require much more. It will require more
federal money for health care transferred to the provinces. It
will require hard work with the provinces to develop common goals
and priorities to know that additional money is going to support
a plan that will produce better health care for Canadians. It
will require our listening to the health care workers, the
doctors, the nurses and others, so that they are involved and a
part of the process, and not excluded. It will involve hearing
the public, its concerns and its priorities.
I have started a process with my provincial partners toward
medicare renewal. I have invited them to come to the table with
me and talk about a plan for this purpose. It is to that process
and that purpose that I am unconditionally committed.
We will succeed. We must succeed. Canadians expect and deserve
no less.
Ms. Alexa McDonough (Halifax, NDP): Mr. Speaker, let me
say first that I could not agree more with the Minister of Health
when he says that Canadians want this government and this
minister to be more than just an arbiter of disputes and more
than just an enforcer when provincial governments violate the
principles of the Canada Health Act.
1100
He then goes on in his usual way to talk about the importance of
partnership. There is no government in the history of this
country, since the introduction of the first steps of universal,
not for profit health care, that has done more damage to the
health care partnership than this government.
What clearer indication could there be than provincial
governments of all political stripes from coast to coast to coast
having said that if this government is sincere about wanting to
restore the partnership, then it has to recognize that it cannot
even claim the mantle of partnership when the federal government
has reduced its contribution to health care funding from 50% to
below 14%, and in some provinces, as low as 11%?
Canadians have already spoken. The minister, in his pious list
of things that this government must do, said that we must listen
to Canadians. Canadians have said that they want universal, not
for profit, single tier health care protected and they want it
protected it now. They want the federal government to recommit
to the partnership, to rescind, to get rid of the duplicitous 12
point deal that it entered into secretly with Alberta, which
opened the way for bill 11, and to enforce the Canada Health Act.
This means that when a government brings in a bill, such as bill
11, which so clearly and deliberately threatens the universality
and the most important access principles of the Canada Health
Act, then this government must take action.
The former minister of health, Monique Bégin, when there was an
explosion of extra billing of user fees, did not hesitate to
bring in legislative measures, and we did not hesitate to support
her in that.
How can the minister think that an American solution is what
Canadians want, if has he listened to them, when it is a Canadian
health crisis created by the actions of this federal Liberal
government?
Hon. Allan Rock: Mr. Speaker, whatever sympathy the
member might inspire by going generally in the right direction on
values, she forfeits through her overstatement and
misunderstanding.
I take the member to suggest that enforcement means amending the
act. I take the member to insist that taking action means
introducing a bill to change the Canada Health Act. She is
wrong. Taking action, protecting medicare and standing up for
the principles means doing exactly what we have undertaken to do,
which is to watch what is happening on the ground.
If those private for profit hospitals use the power to charge
for enhanced services at the same time as insured services in
order to restrict access only to those with the cash or give
preferred access to those willing to pay more, that will be a
contravention of the act and we will act. We have the power, the
political will and the mandate.
The leader of the New Democratic Party has just suggested that
the only kind of action she thinks is appropriate is to amend the
Canada Health Act. There is no need to amend the Canada Health
Act. The principles, the purpose and the powers are already
there.
This House, this member and Canadians have the solemn
undertaking of this minister, the Prime Minister and this
government that, if necessary, we will use that power to protect
those principles not only in Alberta but throughout this land.
Mr. Grant Hill (Macleod, Canadian Alliance): Mr.
Speaker, I will try the same question that I asked of the NDP.
In B.C. contracting out for private facilities is being
attempted to reduce the waiting lines on some minor surgery and
cataract surgery. Does this minister have a problem with the NDP
government in B.C. doing that, yes or no?
Hon. Allan Rock: Mr. Speaker, I am familiar with that
example. The member for Macleod will discover, if he looks a
little more closely, that under those circumstances they are not
permitted to charge for enhanced services at the same time that
they are charging for insured services. They do not talk about
overnight stays. The policy is not to create private for profit
hospitals.
There is room for innovation in Canadian medicare but there is a
line that should not be crossed. Imperilling the principles of
the Canada Health Act is something that ought not to be
encouraged.
1105
What is described in B.C. is not what bill 11 has provided for.
Bill 11 expressly says that the private for profit facilities can
charge for the enhanced services as well as the insured services.
That is the crucial distinction between Alberta and the example
that the Canadian Alliance is referring to in British Columbia.
Mr. Ovid L. Jackson (Bruce—Grey, Lib.): Mr. Speaker, it
is my pleasure to speak to the opposition motion regarding
Alberta's bill 11. This is a very important topic and of concern
to all Canadians.
At the outset, I must say that on May 5 the Alberta legislature
passed bill 11. The bill will create the regulatory framework
for contracting services to private for profit facilities. The
federal health minister has relayed his concerns about this bill.
Prior to the passage of the bill, and contrary to the remarks
made by the opposition, time and time again the minister has
voiced his concerns about the bill. He has said that the federal
government was really concerned about some of the views
expressed.
The government is committed to ensuring that our health care
system will not be put in jeopardy. We wish to make sure that
the opportunity exists to detail these concerns and commitments.
There are some disturbing trends happening with medicare. I
share the views of my fellow Canadians about what is happening in
Alberta. These trends do not speak to the values of Canadians.
Indeed, we need to know how people are looking at medicare. On
one hand, Alberta will have the medically necessary services. On
the other hand, it will also provide enhanced medical services. I
believe that is a contradiction. Time and time again when we
have compared services provided by the private sector, double
billings have occurred and it has not worked.
Our medicare system is one of the best in the world. Like many
medicare systems, things are changing. MRIs and various other
things are causing this change. Adopting new technology does not
mean that Canada should end up with a two tier medical system.
In a policy statement in November 1999, the Alberta government
announced its intention to have private delivery of some surgical
services. At the same time, the federal health minister raised
some important issues related to the sustainability and integrity
of the public health care system, including the consistency of
the proposed measures with the spirit and intent of the Canada
Health Act. He conveyed these views publicly not just in one
province but across the country.
In November we asked how private for profit delivery of health
services would reduce waiting lines for services in a way that
would contain costs and maintain quality, but these questions
were not answered. On the contrary, based on the opinions of
experts, and actual experience in Alberta, the waiting period for
services had increased. In areas where private for profit
clinics were used, these lists exceeded those of the public
sector.
On the subject of costs, our minister asked if we could expect
private for profit hospitals to save money. Would they be more
cost effective? Again, the Alberta Consumers Association of
Canada found that a shift in cataract surgery from the public
sector to the private sector resulted in increased costs for
consumers not only in the actual cost of the operation, but in
administrative costs as well as transaction costs.
1110
The health minister asked how pressure from private investors to
de-insure more services, so services can be charged for privately
and their profits will balloon, would be addressed. He also asked
how pressure from private investors to purchase medical goods or
services patients do not require would be addressed. He asked
how the tendering process for contracting would be open and
transparent.
The bill was passed. It contains a commitment to preserve the
principles of the Canada Health Act as the foundation of the
health system in Alberta. However, the sincerity of this
commitment is suspect given that the question is still
outstanding.
Earlier this year the Prime Minister and the Alberta premier
asked all Canadian health ministers to compare the bill to
similar provincial legislation. There are important differences
in the way Alberta intends to proceed. In particular, the sale
of enhanced or extra services in combination with medical goods
and services insured in the public system, unlike in other
provinces, represents a serious concern in relation to the
principles of accessibility in the Canada Health Act.
How serious is this? The day the bill was passed, the
Saskatchewan premier, Mr. Roy Romanow, answered. He said “When
we released our legislation our press release was entitled a bill
to prevent two tiered health care”. He continued “We are at
odds with bill 11 in Alberta”.
Back in Alberta the legislation bans queue-jumping, where
supposedly people who could afford to pay for these enhanced
services get quicker access to insured services but concerns
remain about how this ban will be monitored and reported on.
The health minister respectfully suggested that the bill be
amended to prevent this, as does the legislation in Ontario and
Saskatchewan, but it was not.
Another key concern, specifically and clearly expressed by our
government, relates to private for profit facilities
accommodating overnight stays for patients. This too represents
another important difference between the approach of the Alberta
government, going far beyond what is in place in other provinces.
The health minister suggested that the bill be changed to
prohibit services involving overnight stays until the full
implications for Canada's health care system are understood.
On April 7 the health minister put the Alberta government on
notice that these types of facilities that would be regulated
under this legislation would be considered hospitals under the
Canada Health Act. This means that all hospital services
provided by these facilities must be fully insured and, like
hospitals, these facilities are prohibited from selling any
insured service to an insured person on a private basis. As the
federal health minister said “This is in keeping with the
fundamental principle of our single tiered health care system,
care based on need not on the ability to pay”, or the size of
their pocket book or credit card.
On the day after bill 11 was passed, the federal health minister
reiterated these concerns noting how the Alberta government did
not respond to any of his recommendations. He said “Bill 11 is
not the direction in which we should be heading to strengthen our
publicly funded health care system. We have grave reservations
about investing public funds in private-for-profit facilities”.
He also announced that the federal government would be
strengthening its capacity to detect violations under the act,
should they occur.
1115
We will act. The strengthening means that the minister has now
committed some $5.5 million to improve administration of the
Canada Health Act. With additional staff distributed across the
country our health care monitoring capabilities will be enhanced
and will ensure compliance with the act.
I want to say categorically that the health care system reflects
one of the basic values of Canadians. I am not animated too
often in the House, but I will be right behind the minister to
make sure that there is not a two tier system. Let us imagine
for a minute that somebody thinks he or she could make money from
somebody who is ill. I rest my case.
We will be monitoring the legislation. The government is
committed to make sure that Canadians get the care they desire,
that it is not two tiered, and that it is not based on someone's
pocketbook.
Mr. Gordon Earle (Halifax West, NDP): Mr. Speaker, I
will ask the hon. member a question which I had hoped to ask the
health minister. I am sure he can answer it. Does the
government have in its possession a legal opinion concerning
Alberta's bill 11 and the Canada Health Act? If so, will it
table that document for the benefit of the House?
Mr. Ovid L. Jackson: Mr. Speaker, I am not aware that the
government has any such document. If the minister has that
opinion, I am sure that based on the usual conditions of whatever
privacy laws are involved he will share it with the House.
Mr. Grant Hill (Macleod, Canadian Alliance): Mr. Speaker,
I appreciate the opportunity to speak to health care in broad
terms and Alberta's bill 11 in more specific terms.
It is interesting that the NDP has actually called for
amendments to the Canada Health Act. It does that with a view to
strengthening the Canada Health Act, in its opinion. My idea of
going down that road would be to make the Canada Health Act more
rigid, and I would not do so. I would like to make the Canada
Health Act more innovative and allow some changes.
Let me talk briefly about the Canada Health Act and how it is
doing, a subject that is not often addressed in the House. I
should like to talk first about portability, one of the big
principles of the Canada Health Act. How are we doing with
portability?
[Translation]
As far as the people of Quebec are concerned, each Quebec
patient who goes to another province has difficulty with
services, because the Province of Quebec does not pay full
compensation for services provided in the other provinces.
[English]
Portability in this instance is being broken every day. The
health minister sits here saying that he is the enforcer of the
Canada Health Act. My comment is that it is complete nonsense
because portability is being broken. He knows it, and he does
nothing about portability.
How are we doing with accessibility in the Canada Health Act? It
is pretty straightforward. We just have to look at the waiting
lines in Canada. They are now being monitored by the government.
A year ago it set up a monitoring system to see how we were doing
with the waiting lists.
I wait with great interest to see what that monitoring shows.
There are monitors that have been doing this for almost 10 years
now. I monitored it as a physician in my own practice. When I
set up my practice in 1970 and I closed it in 1993 I know my
patients were waiting longer for services. On accessibility we
are doing very poorly.
Comprehensiveness is another big principle of the Canada Health
Act. How are we doing with comprehensiveness?
I listened to members opposite say that delisting is going on.
That is absolutely true. More and more procedures are being
taken off the provincial lists of what is covered and what is not
covered by health care. Comprehensiveness is also at risk.
1120
One part of the Canada Health Act is doing wonderfully well, and
that is public administration. There is a monopoly in health
care in Canada which many of us believe is serving the Canadian
public poorly.
Medicare is in stress. This is not unique to Canada, but there
are specific things going on in Canada which put our medicare
system even more at stress. I have mentioned the waiting lines.
I have not mentioned the brain drain of some of our most
experienced nurses, lab technicians and physicians who are
leaving the country.
One of the big reasons for it is that we are falling behind in
technology. A well trained nurse who works in a critical care
unit and does not have the most modern facilities says “I am
doing a bad job. I learned in school how to do a better job.
Just across the line in Boston they have better equipment. I
will go there and serve my patients better”. I hear people say
that it is only about income. It is not. There is an income
difference. There is a tax difference. There is also a
technology difference.
I am reminded of a young woman who told me the other day that
she was having trouble getting pregnant. She went to her
physician in Ottawa who said that at one time there was no
problem because there were a couple of world experts in
obstetrics in Ottawa. He wanted to send her to them but they had
both left. One of them is in Boston and the other is in Florida.
He said she would have to wait a little while until we get
another world renowned expert in obstetrics for those who are
having trouble getting pregnant. That was in Ottawa, and that is
taking place in every city in the country.
I mentioned technology. There are ways to measure it. We have
dropped from the top three in technology in 1993 in the OECD
countries to being number twenty-three. Something happened in
1993. Most people who watch politics will know that there was a
new government elected at that point in time.
I will speak specifically to bill 11, what it means and what I
think it offers to Canadians. I am not certain that bill 11 is
the answer for waiting lists, but the Klein government has
plainly said that it wants to try a specific mechanism to reduce
the waiting lines in that province. Waiting lines are
measurable. It is not that tough. It also said if there were
complications in terms of minor procedures that it would allow
people to stay overnight in private facilities which exist in
Alberta and in every other province.
For those who stand back and say that we should not talk about
private for profit facilities, every abortion clinic in the
country, every Morgentaler clinic, is a private for profit
clinic. I know that my colleagues in other parties recognize
this but will not talk about it. They will not talk about the
cosmetic surgery clinics that are totally private and are doing
things that are outside medicare because they are not covered by
the system. They will not talk about private facilities that are
doing minor procedures like vasectomies outside hospitals.
Is there some advantage to those facilities? There are some
potential problems recognized but there are some advantages. The
cost per day to the taxpayers for a major hospital with an
emergency, critical care and administration is about $1,500. A
private freestanding facility with very little administrative
cost, with all the cost being borne by the people who are
investors in that clinic, some of whom might well be nurses or
lab techs, has relatively low costs which average somewhere
around $150 per day in terms of overall cost.
Could we take a minor procedure like a tonsillectomy from a
major hospital costing $1,500 a day and do it in a facility
costing $150 a day? Could we free up some spaces in that $1,500
a day facility for the bigger procedures that are required to
happen there, the major surgery, the major problems?
There is some advantage to moving such procedures out of the big
facility and into a smaller one.
1125
Bill 11, according to the health minister's own words, does not
tread on the Canada Health Act. However he says that it might.
Here we are talking about motivation. He said that there was a
threat of selling uninsured services while offering insured
services. He said to me today that was not done in any other
facility or province. I want to say that is categorically and
demonstrably false.
I hope the minister will listen to this example. In every
emergency department in the country that provides insured
services an individual with a broken arm can obtain a cast. The
cast is covered by health care. However, if the individual wants
to upgrade the cast to a fibreglass one he or she will pay. It
is the individual's decision. It is a little lighter. It is
waterproof. It allows significant mobility in some cases.
That upgraded service, that enhanced service that is not covered
by medicare, is being provided in a facility which provides
insured services. The minister says that it is not the same. I
beg to differ. Is it not for profit? Out of the pocket comes
the $10 for the fibreglass cast. That is an uninsured service
being provided by an insured facility. The minister can say
anything he wants. It is just flat out provided.
Let me go to bill 11. I have a copy of it. I believe in going
to the source. As I said, this is Alberta's mechanism to try to
reduce waiting lines for surgery. Will it be successful? I am
not sure but I am willing to give them a chance to prove that it
will be.
On the issue of enhanced services bill 11 says that enhanced
medical goods and services are upgrades that are not medically
necessary, like foldable lenses for cataract surgery. A person
might choose those upgrades. A sensible patient could say that a
foldable lens has some advantages. It is not covered under
medicare, so he or she will have to pay for it. The information
must be explained to the person in writing. It cannot be nudge,
nudge, wink, wink, we cannot provide the lens wanted but only the
enhanced lens. The information must be provided in writing with
an outline of the costs and advantages. Patients then have an
opportunity to review it and change their minds as long as they
have not received the service.
There is are big fines of $10,000 for the offence of not
providing the information and $20,000 for every offence
thereafter. This is legalistic stuff. I think the health
minister would like it. It is important to note that if the
upgraded product or service is all that is available, in other
words if the foldable lens is all that is available, it cannot be
charged outside medicare.
This gets away from the legitimate concern that the facility
might say that it has no lenses other than foldable lenses. If
foldable lenses are all that is available, it cannot charge for
them. Those are responses to legitimate concerns. I admit the
concerns are legitimate because it would break the principles of
the public health care system if those services were offered in
an inappropriate way.
I strayed from my NDP colleagues and the health minister on bill
11. Will it work? This is Alberta's opportunity to prove
whether or not it will work. Would I hire more health police to
look after it? There are health police in Alberta. There are
patients in every hospital in Alberta in waiting lines. They will
decide whether to step out of a waiting line and go to an
overnight facility to receive services. If it were my mom, I
might take her in my car and try to get her out of the waiting
line.
1130
Should we let Albertans decide this? If it does not work, what
will happen? Bye-bye bill 11, maybe bye-bye Klein. I think
Albertans will turf Klein out if it is an inappropriate bill. We
do not need health police.
An hon. member: That would never go down. Elect the
Liberals.
Mr. Grant Hill: My colleague across the way said to elect
Liberals. Maybe that would happen if bill 11 is inappropriate.
But do we need an all-seeing omnipotent health minister from
Ottawa to come along and say he does not think the motive behind
the bill is good? Not in my books we do not.
I do not have forever, but I will talk about a couple of other
innovations which I think are worth considering. These are for
public consumption, to reject, think about, or not. This is not
alliance policy. These are my thoughts on the issue.
What about thinking of a completely different way of delivering
the money to individuals in Canada for health care services?
What about a medisave account? I would equate this to an
insurance policy on a car. We do not insure our cars for oil
changes. We insure them for major catastrophes like an awful
crash that would break us if it happened. We insure for the
repair bills on a major issue.
What if we insured for catastrophic things in Canada? Instead
of giving money to the governments to look after everything, what
if we gave $100 to each patient in a medisave account? This
would be for the regular run of the mill preventive things,
regular checkups, a visit to the emergency room for suturing and
whatnot. It would be the patient's responsibility. That first
$100, which is a very arbitrary figure, would be the patient's
responsibility. The person would not spend it if he or she did
not need it. The government would allow the person to put those
funds into retirement, but the person would be able to keep those
funds in a medisave account for the future.
What would that do? That would make people think about what
medical procedures cost in this country. Many do not know. Many
do not know what an ultrasound for a newborn baby is worth today
because they never ever get a bill for it. It is free, paid for
by the taxpayer.
That would put a person in a position where, if they had had a
cardiogram a year ago and had paid for it out of their medisave
account, and they were told during their annual physical they
needed a cardiogram again, they might ask whether they really did
need it because it would eat up their medisave money. There
would be a discussion as to whether or not that would be useful.
I believe there is some degree of personal responsibility when it
comes to the funding for our health care system.
That was the medisave account idea. It was a very brief
overview and I admit not very thorough, but it is an idea.
I have a second idea. The threat of suit in Canada for nurses
and doctors is a major cost driver. Somebody who comes into the
office with a headache is often given procedures that are not
really the best for looking after a headache. They are procedures
that are designed to prevent a suit, prevent medical legal action
if the individual ends up having more than a simple headache, for
example a tumour. The medical legal system in this country is
driving costs up. It is becoming more and more like the U.S. in
terms of litigation.
In my first speech in the House many years ago I asked the
health minister to address the issue of medical jurisprudence. I
thought as a lawyer he would grab on to that. Of course, it would
mean fewer lawyers, so maybe I understand now.
What principles do I think should guide the federal government
on health care? First, I value our public system. I have
practised in it and I know that it is a valuable system. But I
think we have gone astray when we talk about American style two
tier, because on this issue it is literally the wrong debate.
Medicare is being used in most countries in the world. It is not
being used in the U.S. Taxpayer funded medicare is not there.
1135
When we compare ourselves, let us compare ourselves to similar
medicare systems such as those in Europe, Asia or Scandinavia.
Countries there have chosen some safety valves in addition to
taxpayer funded medicare. Medicare is not falling apart. It is
not going down the tubes. Ours would not either if we looked at
some of those innovations.
The big principle is that we should remember the patient. Let
us put the patient first. Let us stop putting the system first.
If we did that in our deliberations here in Ottawa and across
Canada, we would be much farther ahead.
The federal government has a role as a paymaster. It is so
straightforward that the funding should be predictable. It should
be obvious that it is going to medicare and it should be growing
with our population growth. Our aging population is another
issue. As a paymaster the federal government has a very specific
role to play.
The health minister said he would play the role if the provinces
played by his rules. I disagree with that. The current approach
of threatening the provinces if they do not follow the health
minister's rules to bring in health police to enhance the number
of people wandering around the country trying to find breaks to
the Canada Health Act, deeming private clinics as hospitals, have
we ever heard a more legalistic view? Deeming. He is going to
deem a private clinic as a hospital.
I say again that if we forget about imperilling the system and
instead look at the perils to the patient, we will be better off.
Mr. Brent St. Denis (Algoma—Manitoulin, Lib.): Mr.
Speaker, I listened to the hon. member's speech. While he covered
a lot of territory, he confused me a bit. The member is a
physician and has worked in the system. He is probably aware
more than most of us in the House of the daily difficulties faced
not only by practitioners such as himself but by those who depend
on the system for their health needs.
The member skated around some of the more important fundamental
issues. In using that reference, I would like to comment that he
is a pretty good hockey player. We on this side appreciated the
chance to play against that side last night. He has shown marked
improvement from the first time we had the experience a few years
ago. I commend him in that regard. But skating around important
issues such as health care is another matter.
Like others in the House, I read a fairly thorough report in one
of the national papers which reported on the Australian
experience with what in no other way could be described as a two
tier health system.
The member and his fellow reform-alliance members are in the
midst of a leadership race. I cannot claim to know exactly what
position on two tier health care each of the candidates has. The
member for Esquimalt—Juan de Fuca has made it clear that he
supports a two tier system. I would suspect that another
candidate, the treasurer of Alberta who is on leave from that
position, obviously supports bill 11.
I am not an expert on the health system except for having to
visit the doctor from time to time. I wonder if the member could
tell us where he stands with regard to a two tier system where
those with the resources can have speedier access to certain
procedures compared to those who depend on a publicly funded
system.
1140
Mr. Grant Hill: Mr. Speaker, in reference to skating, I
think he checked me into the boards and it was not very nice at
all. I meant that as a joke, it is not true at all.
On the issue of a two tier system, personally I reject two tier
medicine. My colleague from Esquimalt—Juan de Fuca who is also
a physician has chosen that as his solution. That is a personal
solution. That is not the alliance position.
I have already suggested the sort of thing I think would be
useful to innovate in health care. We need to have more
responsibility for knowing what the costs are and have a reason
to husband the resources. Let me take this opportunity to put
forward another suggestion.
Every patient for every service in Canada should get a bill that
shows the date for the service, what the service was and what the
cost was and they should have to sign it. They would not pay a
nickel for that bill, but they would simply sign it to say that
they received it. That would do two things. It would let them
know what the procedure cost and it would also prevent extra
billing or padded billing by physicians. Some physicians put in
bills that are not really appropriate. My colleagues do not like
me to say that, but it is accurate and true. This would be a
mechanism for bringing some of the responsibility back to the
individual patient. There is none today.
My colleague across the way said that I skated around. I hope
that is as direct and forceful a way of saying what I believe
should be some of the changes.
I am willing to listen to others. Would the Minister of Health
say the same thing? I wish he would.
Mr. Dick Proctor (Palliser, NDP): Mr. Speaker, I
appreciate the opportunity to ask a question. I know there is
probably not much time given the hockey references across the
way.
The hon. member for Macleod is a physician. He is basically
saying he is not sure about Bill 11, but let us try it and give
it a chance. His arguments are that in one of these new surgical
facilities it might be $500 a day versus the $1,500 that it would
cost to run the health care system in a major hospital. Let me
ask the doctor a hypothetical question. What happens at one of
these facilities when there is a complication in the surgery?
The member for Macleod mentioned tonsillectomies. We have all
heard horror stories about tonsillectomies. It is normally a
minor procedure, but there can be serious problems from time to
time. What happens at that point? Presumably the difference of
$1,000 a day between the surgical facility and the major hospital
is that the surgical facility does not have all the bells and
whistles that the major hospital has. That sick person now needs
intensive care and has to be rushed to the major hospital. What
happens at that point? Do we have queue jumping? Is the person
in the other system who has been slated for that bed available at
the Edmonton hospital all of a sudden bypassed because somebody
coming out of the private facility is in intensive care and needs
help in a hurry?
That is the problem a lot of people have with this notion. I
would appreciate the hon. member's response to that.
Mr. Grant Hill: Mr. Speaker, what a refreshing change to
actually have a non-attack. That is a very legitimate question
and one which I appreciate.
Since I did tonsillectomies on my own in a public facility, I
know that the complication rate is somewhere around 1%. Of 100
tonsillectomies, one of them will bleed and require the trip to
the major facility the member talks about.
Would I then do the 100 in the $1,000 or $1,500 a day facility?
Not a chance. I would do the 100 in the $150 a day facility and
for the complication would go to the big major public facility.
Surely the math is not tough to figure out. They are both being
covered by public funds. They are not being covered by private
funds because a tonsillectomy is an insured service under
medicare.
It would be a very legitimate concern if there were 99 coming
from the one facility and plugging up the major facility. Surely
the 99 that would be done outside the major hospital would open
up beds that are not currently opened up.
I thank the hon. member for what I consider to be a
constructive, eyeball to eyeball comment. It is refreshing and a
treat to get.
1145
Mr. Janko Peric (Cambridge, Lib.): Mr. Speaker, I have
high respect for the hon. member for Macleod as a professional.
I am glad to hear that the hon. member, as a professional, is not
in favour of a two tier system.
Early in his speech he mentioned brain drain, but I am not sure
if the hon. member is aware of brain gain.
In the Waterloo region there are probably close to 40 medical,
highly qualified and experienced doctors from all over the world.
As he knows, there is a quota in Ontario. I believe that there
are quotas all over the country. Would the hon. member encourage
the provincial ministers to leave those quotas and to give those
opportunities to newcomers to practise medicine in the country, as
well as nurses?
Mr. Grant Hill: Mr. Speaker, I thank the hon. member for
that sensible question. The issue of brain drain could not be
made more clear than to recognize that one-third of the current
medical graduates from our 16 medical schools in Canada do not
set up practice in Canada. They leave this country and never set
up practice. That is a tragedy. We, as taxpayers, have a lot to
say in terms of their training.
On the issue of foreign graduates and other individuals, some of
them are driving taxis while their medical credentials are left
unused. That is another tragedy.
We have a closed shop mentality in our country. We have an idea
that the only training that is good is North American training,
and that is not accurate. Those individuals should be able to
pass an examination. I would open my arms and my heart to their
experience, their thoughts, their ideas and their talents. Many
of them go to far-flung spots to practise in areas that have
difficulty getting practitioners. They will go anywhere to
practise their skills.
The sad thing is that governments bought the idea that
physicians were driving health care costs and if we restricted
the number of physicians we would drive down costs. It would be
wrong for me to talk so much about physicians. There is a
shortage of nurses now due to the same issue.
It is a very sensible suggestion and I appreciate the hon.
member's input.
[Translation]
Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): Mr. Speaker, I
generally pretty much agree with NDP proposals. This morning,
however, I must say that, unfortunately, we will be unable to
support the motion proposed by the NDP on this opposition day.
I would like to recall the terms of it in order to explain our
concerns. Our colleague, the leader of the NDP, moved the
following:
That this House call upon the government to act on the words of
the Health Minister when he said, “we have grave reservations
about investing public funds in private for-profit facilities”,
by immediately amending the Canada Health Act to provide that
provinces be financially penalized if they allow public funds to
be used for the provision of insured services by private,
for-profit hospitals.
I submit to the members of the House that there is a trap in
this motion. First, and I say this right off, our party
believes that health care must be the most important of all
public responsibilities. We believe in a system of universal,
accessible and public health care for our fellow citizens.
Happily—and I will have the opportunity to return to this—the
Government of Quebec is miles away from considering
privatization, which of course does not prevent some of our
fellow citizens from having private health insurance plans.
The trap in the motion by the NDP lies in its inviting the
government to intervene in the way the provinces organize health
care.
1150
Favourable as we on this side of the House may be—the Bloc
Quebecois is, as a party, highly favourable to this idea and
believes without any shadow of a doubt in the appropriateness of
using public funds to put in place a health system that must
also be public—we nevertheless believe that the way the provinces
organize their use of the health system does not concern the
federal government.
We believe that the Canada Health Act in fact constitutes an
overstepping of boundaries, because according to the
Constitution of 1867 and its revision of 1982, there are just
two areas of the health sector in which the federal government
is concerned.
These are the health of aboriginal people and of military
personnel. Perhaps there might be a third, the whole matter of
epidemics and quarantine. The rest of the health system does
not concern the federal government. Nevertheless, over the
years, the federal government has come to adopt a Canada Health
Act, which proposes five principles.
We are not opposed to those five principles, but we do believe
that their implementation must be provincial. What are these
principles?
Section 8 of the act is, of course, where it is stated that the
health insurance system must be administered and operated on a
non-profit basis by a public authority.
There is also the principle of comprehensiveness, which
provides, under the terms of section 9, that the plan must cover
all the services provided by hospitals, medical practitioners or
dentists and, where permitted, services provided by other health
care practitioners.
The third principle is universality. Section 10 provides that
100% of the insured persons of a province are entitled to the
insured health services provided for by the plan.
There is also the principle of portability, and section 11
provides that a person leaving their province must also be
eligible for coverage under the health care system of the
province they move to.
Finally, section 12 provides for accessibility. This refers to
the ability of our fellow citizens to receive treatment.
An important distinction has to be made: we are not addressing
the right question when we say that provinces tempted to
privatize should be penalized.
I repeat once again that we do not believe in privatizing the
health care system. Those of you who have doubts as to the
merits of a public health care system need only look to the
United States.
There, last year—so this is recent—53% of Americans' spending on
health care was private. With this high percentage of use of
the private system, we must remember that 16% of Americans are
excluded from health care systems and have no form of protection.
This means 44 million people who, as we are speaking, are
excluded, because they do not have the protection that is often
associated with the workplace and must therefore pay when they
go to a hospital, or when they require health services.
The real debate that we must have in this House is the one that
we were reminded of by the premiers. The federal government has
money. Let us not forget that the budget surpluses for the
coming years have been estimated at around $95 billion. Yet, the
federal government backed out of its responsibilities toward the
provinces.
When the Canada Assistance Plan and medicare were created, the
federal government pledged, as with the other major joint
programs that existed at the time, to pay 50% of the costs of
health care services, just like it had pledged to pay 50% of the
costs of post-secondary education.
1155
But, as we speak, what is the federal government's contribution
to health care services? How much money does it give to the
provinces? In Quebec, for example, for each dollar spent on
health by the provincial government, the federal government
invests 12 cents.
Let us be clear: it takes a lot of nerve on the part of the
Minister of Health to rise in the House and, with his smooth
voice, tell us that the federal government cares about health
services in this country. If the federal government cares about
health services, there is a solution. Its only option is to
restore transfer payments to their 1994-95 level.
There is nothing partisan about asking that transfer payments be
restored to their 1994-95 level, when it is what all the premiers
did. The most vocal was Newfoundland's premier, Brian Tobin, a
former cabinet minister.
It is what the Progressive Conservative premier of New Brunswick
did; it is what the premier of Nova Scotia did; and it is what
the premier of Ontario did. All the premiers called on the
federal government to restore transfer payments to their 1994-95
level.
We submit to the NDP that the real issue here is transfer
payments. Why is this important? We know very well that there
is not one health care system in Canada but several, and that
health care is first and foremost a provincial jurisdiction.
All the provinces must cope with new realities affecting how
they must deliver health care.
The first reality that should be pointed out to the House is
that people are living increasingly longer. We no longer talk
about the elderly but about the very elderly.
If the parliamentarians here pay a bit of attention to their
health, to the determinants of health, if they eat well, do not
smoke or drink too much, and take part in a moderate amount of
physical activity, they stand a chance of living to be 79, in
the case of men, and 81, in the case of women. This means that
people are living longer and longer. But that means pressure on
the various components of the health care system.
One of the things that is happening in Quebec, in particular, is
that the population is aging. It will take less time for a
significant proportion of our fellow Quebecers to reach age 65
than will be the case in other provinces.
In 35 years, 25% of the population of Quebec will be over 65. I
say this to the pages, who will take our place, especially those
who come from Quebec. In 35 years, in Quebec, there will be
more people aged 65 and over than there will be aged 15 and
under.
This has all sorts of ramifications in social terms. It will
significantly affect our ability as taxpayers to provide public
services. It is mostly the people in the labour force who pay
for public services. There will be pressure on the system as
well in the provision of services.
1200
Not only will people live longer, but they will be wanting very
specific services. They will also want to remain in their
natural surroundings longer, which will mean home care. There
are pressures in demographic terms, but also in terms of
specialities. I will give a few examples.
When people live increasingly longer, when the population is
aging, it means people are more likely to end up in hospital
emergency rooms. I have a few statistics on this point.
As far as Quebec's emergency departments are concerned, in
1998-99, in other words one year ago, there were 50,000 more
patients in emergency department beds than the figure for
1994-95. Of that number, 56% were over the age of 75. More and
more people are going to emergency departments and half of them
are aged 75 or more. This means that system administrators need
to plan for additional care.
Taking the sector of radiation oncology, which has to do with
the treatment of cancers, the demand is increasing, particularly
for people aged 50 and over. The baby boomers, born between the
second world war and 1966 or 1967, have reached the age to
require such services. There is a 3% increase in cancer cases
every year.
As for cardiology, demand for services is increasing,
particularly in the 50-plus age group. Once again, health
determinants are important.
The better a person eats, the more physically active he is, the
less he smokes or drinks, the better his chances of not having
heart problems. There is an undeniable statistical correlation
between lifestyle and the probability of using public health
services.
The community has only recently become aware of this connection.
A whole generation of us grew up with a positive picture of
smoking. It was connected with sex appeal. We can all remember
the images televised until very recently of attractive young
girls with their cigarettes.
Let me digress for a moment to say that, five years ago, 29% of
Canadians aged 15 and over smoked daily and were addicted to
tobacco. Today, that percentage is 25%.
We hope that in five years it will be down to 20%. However, the
heaviest smokers are found among young people and in Quebec in
particular, with 38% of young Quebecers being smokers, compared
to 23% of young British Columbians. As a society, we must make
sure that all the information is available to young people so
that they never start to smoke.
1205
It is not a coincidence that, for years, tobacco companies
targeted that clientele. Just remember that picture of a race
car driver. Mr. Speaker, you know what I am talking about,
because you were a young man once, some years ago. I do not dare
say many years ago, because I know that you are a very dynamic
person, you are really very alert physically. I had the
opportunity to go up some stairs with you and you were not even
out of breath. You have a good cardiovascular system. You could
work a little on your muscle mass, but I know that your days are
very full.
All this to say that it was just recently that our society
realized the importance of having winning conditions, from a
health point of view, to be in good shape. Until very recently,
tobacco companies were looking for young consumers.
I can explain why. If we conducted a survey among
parliamentarians, we would see that 95% of smokers do not change
brands of cigarettes. The only opportunity for tobacco
manufacturers to increase their share of the market is to reach
young people. These new entrants on the market will, of course,
adopt new brands of cigarettes.
This is why I support any measure suggested by either
government—Quebec has done a lot in that area—to tell people that
tobacco is the primary cause of avoidable deaths in Canada.
Every year, 45,000 people die as a result of smoking and this
could be avoided if we made it socially unacceptable to start in
the first place, and helped people stop.
I will close by saying that there are two ways to end the health
debate in the House. The first is to restore transfer payments
to their 1994-95 level. Quebec alone is out $6.5 billion, or $1.2
billion annually, of which $500 million would go to health and
another $500 million to income security and post-secondary
education.
If Quebec had 500 million additional health dollars, it would
not be tempted to consider privatization. It is not tempted to
consider privatization but let us not be hypocritical.
The government cannot be surprised that some provinces are
considering privatization when it is the reason they are
cash-strapped.
As long as I am the Bloc Quebecois health critic, I will never
stop calling on the government to restore transfer payments.
The government has literally robbed the provinces; it has
slashed their budgets and misappropriated funds. We cannot sit
still for this.
Do I have the time to point out to the House what the Quebec
government could do with the 500 additional millions that are
its due? That is almost one-quarter of the budget of all
Montreal's hospitals.
I will close by saying that I hope government members will be
extremely vigilant and bring pressure to bear on the government
so that it will restore transfer payments.
[English]
Hon. Ethel Blondin-Andrew (Secretary of State (Children and
Youth), Lib.): Mr. Speaker, I would like to thank my hon.
colleague for his comments. I note that I too have a very great
concern, as the Secretary of State for Children and Youth, and
being an aboriginal woman, about the rate of consumption of
tobacco products by different sectors of society.
In particular, it should be noted that Quebec has a 30% higher
intake of tobacco products than the rest of the country. It is
an extremely huge problem. Inuit women also have a very high
rate of lung cancer and very high intake.
There is a pervasive influence on young people across the
country.
In recent months it has been stated that Quebec has $500 million
in a bank account in Ontario. Would it not be wise or at least
appropriate for it to make use of that money for such purposes?
Would that not make sense? I am sure that all Canadians watching
us today would want to know how we could tolerate this situation,
with that surplus or money not being used for these means.
1210
I would like to hear the explanation the member would give, not
to me but to Canadians on this issue.
[Translation]
Mr. Réal Ménard: Mr. Speaker, I would expect our hon. colleague,
with the responsibilities that she has, to be a little better
informed and a little less of a grandstander.
Quebec's finance minister, Bernard Landry, an excellent finance
minister, who has no equal in this House, may I point out, has
clearly indicated that Quebec put the money the hon. member
refers to in trust in order to protect itself from Treasury
Board accounting practices that would not, had he included it in
Quebec's operating revenues, have guaranteed the National
Assembly that this money would be used for health.
The finance minister, with the agreement of the health minister,
wanted to significantly increase the funding allocated to health
care in Quebec. I want to reassure all my fellow Quebecers
that, if there is a government in recent years that has fully
assumed its health care responsibilities, it is the government
of Lucien Bouchard.
I ask the hon. member if we can count on her as a committed
voice in her caucus to make it known to the Minister of Finance
and the Minister of Health that we want transfer payments to be
returned to their 1994-95 level.
How can she remain silent? We are waiting for the government
caucus to provide something other than the sorry spectacle of
silent lambs with the government's cuts simply being confirmed
uncritically.
I ask her to join with the members for Rosemont,
Hochelaga—Maisonneuve and our colleagues in the New Democratic
Party to say that the real crisis in the provinces' public
health care system can be laid at the federal government's
doorstep. Unilaterally, as of 1994, the federal government made
cuts in transfer payments.
Since 1994, these cuts have totalled $33 billion, $6.5 billion
for Quebec alone.
If transfers were to be restored tomorrow morning, Quebec's
share would be $1.2 billion. It would use half of this amount,
or almost $500 million, for health, and the other half for
income security and postsecondary education.
I therefore call on the Liberal members to rise out of their
stupor, to take matters into their own hands and to stand up and
be counted with opposition members when we call on the
government to restore transfer payments to the 1994-95 level.
[English]
Mr. Greg Thompson (New Brunswick Southwest, PC): Mr.
Speaker, this is certainly an interesting debate and I am very
pleased to take part.
Health care is the number one issue in the country. There is no
question about it. The reason, of course, is that we fear for
the future of health care if the present government continues the
way it has since its election in 1993. It has been in power for
seven years. In that seven years we have seen the erosion of
health care. What is even more frightening is that it has no
plan.
Most of us would take a little comfort in action being taken by
the government, in any action it might take. What we have
basically said all along is that without a plan nobody knows.
Without a plan we cannot predict the future of health care.
The difficulty in Canada, in the eyes of most Canadians, when
they compare our health care system with others, is that we see
what is happening in the United States. People in the country
south of us do not have a health care system which is universal
and managed by the federal government.
Basically they have a health care system which is managed by, run
by and controlled by litigation lawyers and insurance companies.
We have all heard the horrendous stories in the United States of
families going bankrupt because of the burden of health care
forced upon them because they are sick. In other words, there is
no one there to help them. We do not want to see that happen in
this country.
1215
In this country about 9.5% of our gross national product is
spent on health care. In the United States that percentage is
around 14.5%, the difference being that in Canada everyone is
included. In the United States about 40% of the population is
excluded from any health care coverage at all.
What this boils down to is that the health care system we have
in Canada, in terms of the percentage of our GNP, is actually a
good deal for Canadians. We want to see it preserved, but there
is no evidence on the part of the government that it intends to
pay attention to it to ensure that we will have a system down the
road.
I have with me a couple of documents which I thought most
Canadians would enjoy. I have the two red books. I will be
quoting from both of them, red book one and red book two.
Incidentally, one of the books was written in preparation for the
1993 election, the infamous red book one, which has a section on
health care.
In the 1993 election members of the now federal government, then
the opposition Liberals under the leadership of the present Prime
Minister, promised some things in terms of health care. I want
to show how the Liberals have deviated from what they said they
would do to what they have actually done.
If we are unfortunate enough to have these people in office in
the year 2004, by that date they will have effectively taken $30
billion out of health care. That $30 billion represents the
crisis we are experiencing today. They have simply taken too
much money out of the system.
None of us would stand in our place to argue that money alone
would solve the problem, because it is about more than money. We
are talking about a plan. We are talking about everyone getting
together in the same room and talking about a strategy, a game
plan, which will take us through the next 15 to 20 years.
I will read from red book one, which was the Liberal policy
platform going into the election, which incidentally brought a
lot of Liberal members into the House in 1993. We are going to
hear some grumbling on the other side because I am getting into
something that is very painful for them. I am reciting, line and
verse, what they ran on in 1993. Here is the promise which is
found at page 77, under the title “Canada's Health Care
System”:
A Liberal government will face these challenges squarely,
thoughtfully, and with confidence. Our approach will be based on
our values. Our solutions will be predicated on our commitment
to the five fundamental principles of our medicare system...
A Liberal government will not withdraw from or abandon the
health care field.
Those are the very principles which we are debating today.
Quoting again from the same book:
Liberals cannot and will not accept a health care system that
offers a higher quality of care for the rich than for the poor.
1220
In other words, according to the Liberals in 1993 we would not
have a two tier system. We know what happened.
I am going to table this document. We will at least send it
upstairs for Hansard to use in getting the correct quotes,
the page references and that sort of thing, because we want it
squarely on the record.
What did the Liberals do between 1993 and the election of 1997?
They extracted over $17 billion from health care. Why were they
able to do that so easily, so effectively and without a lot of
criticism?
At that time just about every province in the country was
Liberal. The Liberal premiers of Nova Scotia, New Brunswick,
Newfoundland and Prince Edward Island nodded in agreement. All
of the Liberal members of parliament nodded in silent agreement
as money was hacked and cut out of health care.
On this side of the House the Bloc Quebecois was the official
opposition. It was focused on one thing: leaving Canada. Those
members had one thing on their minds: a new country. They were
not focused on health care. They did not care.
The other major party in the House at that time was the Reform
Party, now known as the united alternative. No matter what the
government did to health care, the reformers would not stand to
protect it. Nothing could be too draconian for the Reform Party.
If the government had simply massacred the system completely,
taken it down to ground zero, the Reform Party would have been
pleased with that. Basically there was no intelligent debate in
this House on health care between 1993 and 1997.
To make matters worse, the Liberals went into the 1997 election
looking for a deathbed reprieve. They had put some money back
into health care, but not enough. They knew they were in
trouble. They had taken out $17 billion and they had replaced $1
billion or so, thinking that would do the trick leading into the
election.
They did not do it, of course. They did not fix health care.
The sad thing about this whole story is that in the 1997 election
they went on to promise more. Let us read what they said in the
1997 red book.
The 1997 red book was their policy book for that election. We
just heard in red book one what they promised. They completely
reneged on that. I guess most parties would have abandoned their
position, knowing that they had misrepresented the Canadian
people in the election. No, they did not. They had the gall to
stand and say the same thing all over again. On page 72 of red
book two it states:
Medicare is a cherished legacy that we will never abandon. The
Liberal government remains firmly committed to the five
fundamental principles of health care in Canada: it must be
universal, accessible, comprehensive, portable, and publicly
administered.
However, they simply abandoned us again. They went on the
same—
An hon. member: Tired old track.
Mr. Greg Thompson: Mr. Speaker, I was going to say burn
and destroy mission; a scorched earth policy in terms of health
care.
Thinking that might not be enough, given their record between
1993 and 1997, they went on to promise even more. They went on
to promise a home care program in red book two, on which they
were elected. They promised home care and more money for health
care. Not to end it there, they promised a pharmacare program,
which they knew they could not afford, but they promised it
anyway. Apparently the Liberal philosophy is: the bigger the
promise, the more votes.
I suppose we could say: the bigger the promise, the bigger the
votes.
1225
Again they were successful. Since 1997 they have gone on with no
plan and things are getting worse. Approximately $90 billion will
be spent in Canada on health care this year. That $90 billion
will be made up of the federal government share, the provincial
share and the private sector. I want to remind Canadians that
there is a private sector. Our system is not totally funded by
the federal government.
My party's concern is that more of our health care system is
becoming private. We have to be very careful of the direction we
go in. That is what the NDP motion today is about. The NDP is
suggesting that the federal government take strong action against
the province of Alberta because of the introduction of bill 11.
I would like to give an example of how difficult it is for the
provinces to manage given the set of circumstances that the
federal government created. In my home province of New Brunswick
spending in support of health care is the single largest
expenditure. It even overshadows debt charges, believe it or
not.
In 1998-99 the Department of Health and Community Services in
New Brunswick expected to spend $1.3 billion, approximately 30%
of its total provincial budget, on health care. About half of
that total was spent on hospitals; 17% on medicare, which is
predominately payment to physicians; 8% on nursing homes; nearly
5% on the prescription drug program; 12% on social services; and
nearly 8% on other things, including mental health services and
public health. Mental health services and public health received
1.7% of the total budget.
The situation in Newfoundland is worse. What is so hypocritical
is that the present premier of Newfoundland, Mr. Tobin, sat in
the House of Commons and supported the federal Liberal government
at the time. He sat in the front row as the minister of
fisheries. Mr. Tobin voted for all of the cuts that affected
every province, including his home province of Newfoundland, of
which he is now premier.
In the province of Newfoundland 42% of all spending is on health
care. Per capita health care costs are now $2,037, compared to
approximately $1,700 four years ago. Ironically, Newfoundland's
population is decreasing, but health care costs are going up.
That is the worst of all worlds. A lot of this was created by
the federal government, of which Mr. Tobin was a member. He is
starting to pay the price back home in terms of his government's
ability to manage the system. The system cannot be managed
without money.
The province of Saskatchewan is going through the same set of
difficulties. Saskatchewan's population is declining as well.
Mr. Dick Proctor: It is not.
Mr. Greg Thompson: Let me speak. If members are opposed
to what I am saying they can get on their feet and debate. But
while I am on my feet I expect them to listen, as good children
normally do.
1230
In the next few weeks Roy Romanow will take a look at
Saskatchewan's health care system. He will have a public review
of what we would consider to be the holy of holies if we were
members of the NDP, health care, and will define what services
are essential.
This is almost parallel to what Mr. Klein is doing in Alberta,
the province next door. The difference is that Alberta has taken
measures on its own to deal with the shortfall coming from Ottawa
in terms of funding. It is looking at privatization.
Saskatchewan will take a slightly different view. It will
determine what services are essential. I hope hon. members are
listening to this because it is quite important. It is important
for members of the NDP because medicare is the holy of holies
when it comes to their party. That is great, because we have to
have more people in the House defending health care.
Instead of going down the Ralph Klein road in terms of
privatization, with the aid of the stroke of a pen the premier of
Saskatchewan will actually take procedures off the list of those
that today are considered to be essential. Why? To cope with
the shortfall in funding which hurts the poor provinces. Mr.
Romanow knows that Saskatchewan cannot keep on paying to the
degree it has. It has gone beyond its capacity to pay. The
point I am attempting to make is simply that the federal
government has created the problem.
I am sure Canadians get confused when they hear us debating this
issue in the House ad nauseam. They want this sorted out because
once we get into the numbers it gets so confusing.
Under the Canada Health Act primary care delivery is the
responsibility of the provinces. This is where the equation has
gone wrong. Primary care is the responsibility of the provinces
and the 50:50 cost share which we originally entered into back in
the 1970s has been abandoned. The provinces started out in a
situation where the federal government would share the costs. The
equation was that the federal government would pay half of all
the costs. Now it is down to about 15%, 15 cents on the dollar
being taken care of by the federal government.
It is imperative that we get all the players into one room. The
federal government poisoned the atmosphere a few years ago when
it unilaterally took $17 billion out of the system. We have to
get all the players, the premiers, the health ministers, the
federal health minister and the Prime Minister along with the
health care leaders in the country, in the same room to debate
where we are going and to come up with a plan. If there is
anything missing in Canada today, it is a national health care
plan to let the Canadian people know where we are going.
We do not want to see the Americanization of a system that is
capable of being saved. We have a good system. Let us work to
preserve it. It is up to the federal government to come up with
a plan that will work.
Mr. Peter Stoffer (Sackville—Musquodoboit Valley—Eastern
Shore, NDP): Mr. Speaker, I commend the hon. member from the
Conservative Party for his fight when it came to the hepatitis C
battles and his efforts in his province to fight for medicare as
well. But there is a contradiction when the Tories talk about
health care.
Recently at a byelection in St. John's West, which the NDP came
very close to winning, the Conservative member said that one of
the greatest things he will do is fight for health care. He will
fight for the universal, not for profit health care system in
this country. Yet his leader, Joe Clark, said that he supports
bill 11 in Alberta. The problem is, does the member not agree
there may be a contradiction in that? The member for St. John's
West said he would fight for health care, yet the leader of the
Conservative Party said he supports some sort of tinkering with
the private system.
1235
I believe that is some form of contradiction. I would like the
member to comment on that.
Mr. Greg Thompson: Mr. Speaker, I am glad the hon. member
asked that question. That is an issue on which I have spoken a
number of times, as has our leader Joe Clark.
I want to set the record straight. This is why I talked about
Roy Romanow, the NDP premier of Saskatchewan and the radical
measures he will have to take as an NDP premier to deal with the
shortfall in funding in health care. Let us start with Mr. Klein
who said that this is something he would prefer not to have to
do. He is on the record as having said that. He did not want to
do it, in other words, bring in bill 11. If we talk with Roy
Romanow, Saskatchewan is reconstructing the list of essential
services. In other words, some of the services deemed to be
essential will be taken off as a cost saving measure in the
province of Saskatchewan.
The two premiers are next door to each other. One is a
Conservative premier and one is a socialist premier, and I am not
saying that in a derogatory way, but our position on the issue
has been much the same as Mr. Klein's. This is something we
would not want any government to have to do nor would we want
Premier Romanow to have to strike off essential services, those
that are deemed essential today, eliminate the list and make the
list shorter. Unfortunately he is being forced to do it. That
is exactly what Ralph Klein was forced to do. Our position and
Mr. Clark's is simply that we support his right to introduce that
bill in the legislature. We understand why he did it. It is a
question of survival.
It comes down to what province will be next. We already know
which one it is. It is Roy Romanow in the province of
Saskatchewan. It will be a raging debate in his province, as it
will be in my province and every other province until we come up
with a plan that is sustainable and which will work. That is why
our leader, Mr. Clark, has suggested in addition to the five
principles which I mentioned in the House, there has to be one
more principle and that is sustainable, predictable funding.
That is not to say funding in itself will do it because it will
not. Throwing huge gobs of money at the problem will not solve
it. That is one of the points John Crosbie, the former fisheries
minister who is from Newfoundland made this week at our policy
conference. We agree with that. We have to have honest debate
and dialogue on where we are going.
For the NDP to point at us or any other party in terms of where
we are going and what we want to do, that is not what Canadians
want to see. We want to see honest dialogue with honest
solutions.
The federal government has not engaged in honest dialogue. On
bill 11 it has not. It has sent out mixed signals to the premier
of Alberta and every other premier in the country because it
wants the best of two worlds. It wants to be able to balance its
books on the backs of every province. The finance minister wants
to be able to stand in this place on his hind legs and brag about
how he balanced the books. He repeats that day in and day out in
the House. He has been successful, but let us examine why he has
been so successful.
He has done it at the expense of every single living Canadian.
The government has taken it out of health care. That is not a
lot to be proud of. The truth will be in the next election. That
is why I am very supportive of our leader Mr. Clark. There is no
national leader who is more respected than Mr. Clark when it
comes to dealing with the provinces and premiers from one end of
the country to the other.
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We need honest dialogue in an attempt to come up with solutions.
We do not have all the solutions. We want to engage Canadians in
the debate so that at the end of the day they will say, “ We can
see where this is going. We do not want Americanization of our
health care system. We know it will cost us some money but this
is where it is going. This is a plan we can live with. It is an
honest plan, a sustainable plan and one that will do the trick”.
That is what Canadians want. Pointing fingers back and forth is
not going to work. The Liberals have done that for the last
seven years.
In fact, when I concluded my speech, I mentioned that the
Liberals poisoned the atmosphere. When we talk about bringing
the premiers and health care ministers together, they holler
across that they will not do it. They will not do it because
they have poisoned the atmosphere. Only by having an honest
dialogue and having a broker come in to solve it will the problem
get solved.
The present government cannot do it. It has been scrambling for
the last seven years. We can measure its approach to every
single problem that has besieged Canadians in the last number of
years. Those problems exist today because of the lack of
leadership. In other words, it has not honestly addressed them.
The Liberals have been coasting for a number of years.
If any other members would like to ask a question, I would be
more than happy to answer them. Maybe some Liberal members have
a question or two for me.
Mr. Dick Proctor (Palliser, NDP): Mr. Speaker, I am
sharing my time with the member for Bras d'Or—Cape Breton.
I want to say how pleased I am to take part in this debate as a
member for parliament from Saskatchewan, the birthplace of our
cherished medicare system. I also want to acknowledge all of the
hard work that has been done by our leader, the member for
Halifax, and our health critic, the member for Winnipeg Centre,
to keep this issue first and foremost in parliament over the last
several months.
I would like to begin by picking up to some extent where the
previous speaker ended in terms of setting the history of what
has happened over the last 40 years. As many Canadians know,
this is our most cherished and most important social program. It
started in Saskatchewan where it was finally brought in by former
Premier Tommy Douglas and his successor Woodrow Lloyd in 1962. It
was a program that took 18 years to deliver because the
Government of Saskatchewan at that time was adamant that it was
not going to bring in the program until it could fund it for the
long haul. It took from 1944 until 1962 for the program to come
in.
Five years later it was extended to the rest of Canada by the
then Prime Minister Lester Pearson on the basis of 50:50 funding.
I remember well that premiers like John Robarts of Ontario and
Ernest Charles Manning of Alberta wanted nothing to do with
socialized medicine, but they could not resist the 50 cent
dollars that were on the table so everybody joined in. In 1967
we got a national medicare program.
As I said, it has been a cherished program. Until the last few
years, medicare has been something Canadians have been
justifiably proud of. They have talked about it as they have
travelled throughout the world and visited other countries.
The question before us today is what has happened in recent
years to the program, which we were so proud of in 1990, 1991 and
1992, that we are anxiety ridden as to whether we will have a
national medicare program in the next short while? There are a
number of reasons.
There have been cutbacks. I would submit that the principal
problem we have today happened in 1995 with the Canada health and
social transfer and the end of the Canada assistance plan and
established programs financing.
At that point the government, on its mantra for balancing the
books and eliminating the deficit as quickly as possible, took
more than $24 billion out of our health care system.
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When we talk about the problems the provinces are having,
whether it is Alberta, Saskatchewan or another province, they are
problems driven by the lack of cash in recent years from the
federal government. Provinces have had to resort to backfilling.
Notwithstanding the comments of previous hon. member, the
province of Saskatchewan has backfilled 100% on the cutbacks to
federal funding for medicare. I worked in the department of
health of that province for a brief period of time before I was
elected.
I would also submit that many other provinces have done the
same. The modern day John Robarts, Ernest Mannings, Mike
Harrises and Ralph Kleins have basically no commitment to
medicare, especially when there are only 11 cents, 13 cents or 15
cents of funding instead of the 50:50 funding they once enjoyed.
At some point in time, sooner rather than later I would submit,
one of those provinces will tell the government to forget its 11
cents or 13 cents and have its own health care system. That will
be the end of the national medicare program, which concerns us a
great deal.
The government has taken billions out of health care. We have
an aging population, as the Minister of Health said earlier in
the debate. We have a number of new technologies. Health care
is not getting less expensive. We have more demand and less
money. There is simply not enough money in the system but the
culprit is across the aisle.
I urge members of parliament to concentrate on that issue and
not get too bogged down in the backbiting of which province is
doing what. Although, having said that, I want to come back at
some point before I close to what is specifically happening in
the province of Alberta.
I have tried to suggest that there is an end to the partnership
and that 1995 was a watershed in that regard. We now have a
government of a province with very little commitment to health
care, to medicare. I do not think that is reflected accurately
by the people of the province of Alberta, but bill 11 would set
up a legislative framework for surgical facilities offering
overnight stays as far as we are concerned. It would also offer
diagnostic and treatment services, services for both medically
necessary surgeries as required under the CHA and elective
surgeries.
I have been involved in various organizations that have been
fighting privatization for decades. The pattern is always the
same. Privatization occurs where there is a fast return on
profits and the more expensive long term care is left to the
public. When we talk about tonsillectomies, cataract surgery
and hip and knee replacements, we are talking generally about
relatively minor short stays in hospital, quick release in 24
hours or less. People are back home and recovering and not a
burden on the health care system. That is what people interested
in privatizing our health care system want to do. They will
leave long term care for the public system and we will quickly
end up with two tiers. That is the heart of what the bill and
bill 11 are all about.
By way of conclusion, the initial announcement back in 1995 was
that cash transfers would be cut by 40% and for most provinces
the cash portion of the transfer would ultimately phase out. In
future under the CHST it would be up to the provinces to decide
how to allocate their much reduced cash transfer.
1250
I should like to make mention of one point that has not been
talked about in the debate. It caught my eye last week that five
of the largest pharmaceutical industries in the world have now
decided in their benevolence to do something about the horrific
problems with the outbreak of AIDS in Africa. They have agreed
under an umbrella agreement that they would provide AIDS related
drugs to Africa at a much reduced cost. I guess we would say
that is a very noble endeavour on the part of the pharmaceutical
industry.
We can think about what is driving the cost of medicare and
pharmacare in Canada, the high cost of drugs, and the fact that
we had to comply with Bill C-92, the 20 year patent protection
and the inability to use generic drugs. How is it that the
pharmaceutical industry can arbitrarily say that it will provide
these drugs as a noble endeavour to the continent of Africa? We
in Canada are prohibited from saying that we would like reduced
pharmaceutical costs to benefit our population from coast to
coast to coast and keep the costs of our health system down.
As I indicated I am sharing my time with the member for Bras
D'Or—Cape Breton, but I am pleased to have had the opportunity
to participate in this important debate today. I look forward to
hearing from members of all parties on the issue.
Ms. Bev Desjarlais (Churchill, NDP): Mr. Speaker, I
thank my colleague for his excellent remarks. He certainly gave
the real reasons for being in the situation we are today in terms
of the health care service in Canada.
A good number of members and I are from a generation in Canada
that has never had to fight for the benefits in our health care
system. We have never had to truly experience the horrendous
situation that went on prior to medicare.
I will mention an incident that I heard about from the Canadian
Alliance member for Selkirk—Interlake. I happened to meet a
constituent in his riding last week. He recognized that his own
member of parliament was not on the right side of the issue, so
he mentioned to me that he recalls the years when his brother on
the farm had an appendicitis attack. They called a doctor who
came out to the farm. Before seeing his ailing brother in the
house, the doctor went out to barn to check out the cow he was to
receive by way of payment. That was the state of health care in
Canada. That was our health care system prior to medicare.
I find it absolutely unconscionable that the government would
not put enough funding into our health care system nationwide to
ensure that we have those services for all Canadians. Has my
colleague heard of any of such instances?
Mr. Dick Proctor: Mr. Speaker, the member for Churchill
is saying that there was a time and there may be a time again
soon when the medical profession will be checking our purse first
and our pulse second.
It might help to elaborate on the answer by recalling why Tommy
Douglas, the founder of medicare, became so passionate and
committed to it. It went back to a time when he was growing up
and had a problem with his leg. He was living with his family in
the United States. He was an ironmonger's son, as I recall. He
was in a hospital and they were getting ready to amputate his leg
when a surgeon came along, looked at him, and said that he could
fix it without the amputation and did so. Tommy Douglas thought
from that day until his death why it was that we would have a two
tier system. If his parents had the money the possibility of the
amputation would never have been an issue.
It was only the generosity and kind services of the surgeon in
the Chicago area that actually saved his leg.
1255
This kind of thing has been at the forefront of medicare
throughout the years since it was introduced in 1962 in
Saskatchewan and in 1967 nationally. It is what we want not just
to look back on fondly but to look forward to for coming
generations.
Mr. Nelson Riis (Kamloops, Thompson and Highland Valleys,
NDP): Mr. Speaker, I listened to my hon. colleague who spoke
eloquently about the need to support the motion. I have a
question for him. Was he delighted this morning when he found
out that the federal government surplus was now in excess of $14
billion?
It is clear that money ought not to be an issue. The money is
there if the government has the will to provide the financial
support. Could he tell us whether he too was delighted to get
this news?
Mr. Dick Proctor: Mr. Speaker, I was delighted to hear
the news. If I heard it correctly it was $14 billion more than
the projected surplus which is considerable.
What the member is suggesting in his question and what I will
suggest by way of response is that there is money. Despite the
dripping sincerity of the Minister of Health, one more time as he
did this morning, we have the money in the system. What we do
not have so far is the will to dispense it in this very necessary
program.
Mrs. Michelle Dockrill (Bras d'Or—Cape Breton, NDP): Mr.
Speaker, I am pleased to participate in the debate but somewhat
disappointed given that my first speech in the House in 1997 was
with respect to the deplorable health care system from which the
constituents of Bras d'Or—Cape Breton were suffering. Here we
find ourselves three years later and the only change has been
that the health care system has become progressively worse and we
are very close to a two tier private health care system.
The Canada Health Act is under attack and the government
continues to do nothing. A recent poll showed that nine out of
10 Canadians clearly stated that they believed there should be
equal access to medical treatment for everyone regardless of
income. What else does private for profit health care do but
prevent equal access? This is the essence of the motion we are
debating today.
One reason the government has had to backtrack and sidestep
Alberta's bill 11 is that the Canada Health Act is not clear. The
Canada Health Act needs its own clarity bill and the motion
begins the process of ensuring that the government is accountable
for what it says.
We hear members of the government talk about health care. They
continue to talk about the cost of maintaining a public health
care system. I do not think there is anyone, certainly not in
the New Democratic Party, who would dispute that public health
care is costly. However, as we have heard from my hon. colleague
from Kamloops, we just found out this morning that the government
has $11 billion more than it had projected. It is not about not
having money. The reality is that Canadians have paid for the
services and the government is denying them the money to allow
for those services.
We are here because the government is still not providing the
leadership Canadians want. For months the government waited and
waited and continued to tell those of us in the House and
Canadians that it would intervene if the health act were
violated.
When I talk about health care I cannot help but worry and
concern myself about the importance of health care to women. It
is not that men do not use the health care system, but it is
certainly true that women tend to be greater users of health care
services because we live longer and are unfortunately more often
in poorer economic circumstances than men. The effect a
privatized for profit health care system would have on women also
concerns me.
Profit means that people will have to pay for services rendered.
The percentage of women who live in poverty in Canada is 18.2%.
How will they be able to pay for private services? Will they be
able to access the same quality of health care that their richer
neighbours have access to? I think not.
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We have a poverty rate of 25% in my regional municipality. The
child poverty rate, I am ashamed to say, is quite a bit higher
than 25%.
Eighty-eight percent of Canadians recently polled think it is
very important that everybody be able to access the same level of
health care no matter what their income. Canadians do not want a
two tier system. Why does the government continue to stand by
the tiresome excuse that bill 11 does not violate the Canada
Health Act?
We are all aware of the link between poverty and access to
quality health care. This is only one of the concerns Canadian
women have about these possible changes to our health care
system. Women will bear the brunt of a privatized for profit,
two tier health care system.
Women already fill in where the government has failed to provide
the assistance to its citizens that they expect. More and more
women are adding the burden of caring for elderly relatives as
the system becomes overburdened because of all the cuts to
funding. This will not change if bill 11 becomes law and sets
the precedent for private for profit health care in Canada. In
fact, the burden will probably increase even more. Women already
perform two-thirds of the unpaid work in Canada. How much more
are Canadian women expected to do?
The government changed the Canada Health Act in 1996. Why not
change it again now? Why not make sure that there are more
incentives to provide accessible, quality health care than
incentives to make a profit? Why has the government not
increased transfer payments and earmarked them specifically for
health care services to make sure that there is no market or room
for foreign companies to come in and begin competing with the
health care system that the overwhelming majority of Canadians
want us to maintain?
The reason is because the government continues to be influenced
by a powerful lobby group that would love to see for profit
health care that they could benefit from.
In 1995 the Prime Minister sent a clear message to the provinces
that they were basically on their own in their provision of
health care because of the steady cutbacks to cash transfers over
the years.
When health transfers were folded into the CHST, this government
had to make changes to the act. First it had to get rid of the
then health minister who wanted to stop the cuts in funding and
ensure that the federal government played a leadership role in
the enforcement of the Canada Health Act. The government made
sure it appointed a successor by the name of David Dingwall who
made nine major changes to the Canada Health Act which paved the
way for the existence of bill 11.
The NDP is not standing here today saying that there is no work
to be done in our health care system. I, as a health care
worker, know that changes need to be made within the system. What
we are here to tell the Minister of Health and the government is
that we are all sick and tired of hearing the government say that
we should just sit and wait.
Canadians do not want the government to wait. The government's
excuses are wearing pretty thin these days as we see its
inability or unwillingness to jump in and show the leadership
necessary to protect the Canada Health Act.
Canadians want the Liberals to act now. They do not want the
government to pass off the responsibility to the provinces.
Canadians are sick of this juvenile game of tug of war.
Nobody should ever make the mistake of thinking that the Canada
Health Act is or should be a finished document. It should be
open to debate and open to change. Canadians are telling us that
there are some basic principles that, in their opinion, are not
open to change. Highest on their list is accessibility
regardless of income.
The government should act now. It should change the Canada
Health Act and do what Canadians want it to do. The government
should make sure that bill 11 is stopped and that no other
province tries to introduce legislation that so clearly violates
the principles, the morals and the ethics behind what Canadians
believe their health care system should be.
I urge all my colleagues in the House to support this motion
which sends the clear message that private for profit health care
is not the kind of health care Canadians want and it is not the
kind of health care that we are going to give them.
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Mr. Nelson Riis (Kamloops, Thompson and Highland Valleys,
NDP): Mr. Speaker, once again I listened with much interest
to my hon. colleague from Cape Breton who spoke so eloquently
about the crisis in which health care finds itself, particularly
as a result of the lack of adequate federal financing.
The question I have for the member has to do with the situation
south of the border in the United States where it does have a for
profit health care system. A report came out last week
indicating that the reason for the lion's share of personal
bankruptcies filed in the United States was as a result of the
horrendous health care costs that families were required to
provide and that once those health care costs were provided it
bankrupted the family operation and they had to declare personal
bankruptcy as a result.
Based on the United States experience, would the member share
the concern that this may threaten us here in Canada?
Mrs. Michelle Dockrill: Mr. Speaker, fortunately, I have
relatives who have been living in the United States for
approximately 45 years. I have talked about standing here today
and being disappointed at having to fight for health care. One
of the interesting discussions that I continue to have with my
relatives is that they do not understand what this government is
doing. They have been south of the border for 45 years looking
at Canada and saying “My God, we wish we had what you have”. I
have an uncle who fortunately was not seriously ill but who had
to be hospitalized for three days. I think the bill totalled
something like $8,000. It does concern me and it should concern
all Canadians.
Unfortunately, we recently had a medical crisis in my family. My
mother-in-law had three heart attacks in three days. The doctors
put her on a nitroglycerine intravenous so they could hold her
over for the Easter weekend before they did a triple bypass
because of the shortage of staff, the shortage of surgeons and
the cost to do the surgery. We sat around for four days and
prayed that she would not take that one massive heart attack and
not make it to the surgery table. That is a reality every day in
this country.
As my colleague indicated, what will happen to a single mother
if she has to pay for health care? I had a case in my riding
where a single mother went to a pharmacy with her two young
children who were sick but, fortunately, not seriously sick. As
any mother knows, when our kids are sick we are worried and
concerned. The pharmacist called me because he was so disturbed.
The single mother asked him if he could tell her which one of her
children was the sickest because she only had enough money for
the medicine for one. The pharmacist told me that he gave her
enough medication for two and that he did not care if he lost his
licence because he was able to sleep well with himself. Imagine
a mother having to decide which one of her kids would get the
medication.
We are at the tip of the iceberg if this government does not
stand up and act now to give Canadians what Canadians are clearly
telling this government and this House that they want. They are
saying clearly that they do not want two tier for profit health
care.
Mr. Nelson Riis: Mr. Speaker, I have a supplementary
question for the member. After having given a presentation that
will help people to understand the crisis nature of our health
care issue, could the member confirm two things? Does the
average American family in the United States that is actually
able to pay the premiums to get some kind of health coverage, all
of which is deductible I might add, pay an average payment per
family of between $5,000 U.S. and $7,000 U.S. annually, which is
a tremendous cost for every household?
As a matter of fact, as my hon. friend from northern Manitoba has
told me, that is one of the major reasons that people enter the
American Armed Forces. It is an easy way to get good personal
and family health coverage.
1310
Would the member confirm that the annual family cost ranges
between $5,000 U.S. and $7,000 U.S.? Would she also confirm
from the information that she has that in terms of a cost
effective system the actual cost of health care in the United
States, albeit there are millions of people without any coverage,
actually costs more than it does in Canada on a GDP per capita
basis?
Mrs. Michelle Dockrill: Mr. Speaker, I do agree with my
hon. colleague in terms of what the cost is of guaranteeing
medical coverage for our neighbours to the south. As I said, I
have had firsthand experience with those costs. Even the cost of
small needle for a fly bite is absolutely astronomical.
With regard to the second part of my colleague's question, the
figure I saw, and I would not want to be quoted, but the overall
cost of the American system is something like 40% more than a
publicly funded system. Our friends south of the border want
what we have and our system is going to where they are at.
Mr. Alex Shepherd (Durham, Lib.): Mr. Speaker, it is
interesting that the member for Kamloops, Thompson and Highland
Valleys has a problem with his memory today. Indeed, he has
probably forgotten the fact that it was the Liberal Party that
brought forward medicare in the first place.
Mr. Speaker, I will be sharing my time today with the member for
York West.
I am very honoured to take part in the debate about health care.
As I observed and listened to the New Democratic Party bring
forward this issue once again in the House, I think forward to
what its campaign will be like in the next election. I know it
will be able to save a lot of money on stationery presenting
public policy documents because, quite simply, its whole public
policy is based on two words, and that is, more money.
In the last couple of days we have heard the NDP members talk
about the problems at CBC. It simply needs more money. When
they speak about unemployment insurance, it simply needs more
money. Today, on health care, it is more of the same, more money
for health care.
Canada spends close to 10% of its gross domestic product on
health care. Canada is one of the highest spenders in the
western world on health care.
It is only reasonable that policymakers would sit down and ask
themselves how much money they would need to spend on health care
and what is applicable to our population. Does that mean that we
are discriminating and getting a poorer quality of health care?
Of course not. The problem with our health care system is clear
to me: We are not getting value for our money. It is not about
spending on health care.
We have had this constant debate that the federal government is
not carrying its share of the health care issue. We contribute 33
cents on every dollar to health care. It is not as high as it
was when it was originally brought in but we cannot ignore the
whole issue of tax points, even though everyone wants to forget
they exist.
Tax points occurred when the premiers and the federal government
sat down and decided that rather than the federal government
taxing people, collecting the money and then turning around and
giving it to the provinces in transfer payments, that it would
allow the provinces more tax room to tax directly and collect
that money and spend it on health care. Today, provinces, like
the province of Ontario, choose to ignore that part of our
history.
I am not making these things up. Anyone can go down to the
archives and get various documents and agreements that were
signed at the time when provinces agreed to this kind of formula.
Today they want to ignore that. Mr. Harris in my province has
caused the spending of something like $6 million to carry on an
ongoing battle with the federal government for no particular
purpose at all, as far as I can see.
1315
The fact is that we continue to spend significant amounts of
money on health care. I did my own analysis to show that the
province of Ontario was not even spending the money we gave it
for health care.
We hear from members of the New Democratic Party that it is
simply more money that is needed. They do not have any ideas
about how they want to change the health care system. The health
care system is important to Canadians.
Since we are giving anecdotal information, my commitment to a
publicly funded health care system is also based on a bit of a
life experience. I remember being on a dock down in Key West. The
next door neighbour of a friend of ours who was a retired doctor
from Illinois had been out fishing with a friend. His friend
collapsed with cardiac arrest on the dock. His friend said to
the doctor, “Do not take me to a doctor. I cannot afford it”.
I thought that was such a great statement, because he was saying
it to his friend who was a doctor.
Most of us in this Chamber would agree that we do not want that
situation in Canada. It is important to maintain a publicly
funded system.
Having said that, there are things we have to fix. The problem
with this whole file is that the federal government is seen by
many of the provinces as a dispenser of cheques. That is not the
answer to the problem. That is not the answer to this file. We
should look at the way the country is changing, its demographics.
Our population is aging.
Many, many governments before us of all stripes had problems
with health care. I would like to reiterate that the New
Democratic Party was in control of the government in the province
of Ontario during a significant period of time and our health
care system eroded during its watch as well. If we are honest to
the public, we should say that yes, we think there are some
problems with the health care system but we have to have a
comprehensive plan to make it better. It is not just those two
words the New Democratic Party constantly uses, more money. It is
not about more money.
There are problems in our primary care service. There are people
who are not receiving adequate medical care from their GPs
because the provinces have developed systems of remunerating
doctors which quite frankly such as in my own province
discriminate against the doctors for working certain long hours.
It is hard for people to get 24 hour health care in the province
of Ontario. It is because of the way governments have structured
the payment system for doctors.
We have heard in the House that we have to have a publicly
funded health care system. Let us be honest with ourselves. The
reality is that what most people think of health care will
probably have a broader definition than that of a good number of
politicians. They probably think of chiropractic medicine. They
may think of pharmaceuticals. They may even think of
naturopathic medicine. If we actually looked at the total
expenditures on what people think is health care in this country,
50% of it is probably privately funded already.
I think we are talking about the elements and the aspects of a
health care system which includes health care workers, nurses and
doctors and institutions we still feel should be controlled by
the public because of some of the very reasons that are enshrined
in the Canada Health Act, accessibility. That is the basic
principle which I want to address today.
We need to change the way we do health care, primary and
permanent care. We have not developed as a nation a full
appreciation of how to deal with permanent care. Indeed, Mr.
Harris in my province said, “Gee, we have all of these beds and
we have too many people using them. Really what we need is a
home care system so we will close the hospitals”. He forgot the
other side of the argument. The other side of the argument is
that we have to enforce a home care system. We have to have
places where people can go, whether they are geriatric cases or
otherwise, nursing homes or other facilities.
Constant studies have been done. An empirical study was done by
going to people who were either in nursing homes or in acute care
in their own homes. They were asked the very fundamental
question would they rather be there or would they rather be in an
institution like a hospital. The majority of the people said,
“We would rather be in a home care facility where we have loved
ones around us assisting us. And when it comes to dying, heaven
forbid that we can die with dignity and respect”.
Lo and behold when we take those figures and start extrapolating,
it is $2,500 more costly to get this service in an institution.
It costs the hospital.
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Those are the kinds of changes that are needed and the federal
government is not in the position to do that. The only position
we have is to tell the provinces, with our money in our
back pocket, that we have to move in the area of home care. I do
not hear members of the NDP talking about this. I hear them
saying to just give them more money and that will solve the
problem. It is not going to happen that way.
We have not put the investment in technology. We should be able
to track patients across the country. We cannot even do
something simple, use the technology that is available to us
today, to simply track patient records. We cannot even do that.
We talk about investments in MRI equipment and all kinds of other
new technology. We have not done that. We have not put our
money in those areas.
We need to restructure the health care system. I would be the
first to agree with that but we cannot simply talk about more
money. We have to talk about the real things that matter to
people.
That is why I am having a health care forum. The provincial
members of parliament in Ontario do not care about this area.
That is why I am having a health care forum in my riding and
bringing in a former assistant deputy minister of health. It is
to talk with the people and ask them how they want the health
care system to change. It is not about giving us more money. It
is about making the thing work so it protects our health.
Mrs. Michelle Dockrill (Bras d'Or—Cape Breton, NDP): Mr.
Speaker, I have to say it is sometimes very frustrating on this
side of the House when we hear some of the comments from the
government that clearly indicate it is clearly not in touch with
Canadians. Canadians have clearly said that they want the
guarantee of a publicly funded health care system.
My question is very simple. Canadians have said the problem
with the health care system is the lack of money. We know the
government has the money. Why does the government not want to use
money from Canadians to guarantee them the services for which
they pay?
Mr. Alex Shepherd: Mr. Speaker, that is very simple. The
people of Canada are not asking for more money. It is the
members of New Democratic Party because they cannot think
themselves beyond dollars and cents.
The people in my riding are asking us for better quality health
care. That is the issue, better quality health care, not more
money. Let us talk about money.
I heard these comments today, that now we have $14 billion more
in surplus. But we forget about the $890 billion in debt that
the country still has and the $44 billion we spend every year in
servicing that debt. The members over there would walk away from
it; to heck with money, money is not important.
Mr. John Reynolds (West Vancouver—Sunshine Coast, Canadian
Alliance): Mr. Speaker, it is seldom that I agree with my
colleague but on that question I agree with her totally.
The government has cut $25 billion out of health care in the
country. The member opposite said, “We need to restructure the
health care system”. He said the MPPs in Ontario do not care.
That is nonsense. They do care. What they care about is that
the federal government has taken out $25 billion from the
provincial system.
Why does the member think he has to solve the health care
problem? Health care is a provincial jurisdiction. Many members
in the House have been in provincial governments. They know how
difficult it has been to operate a proper health system with the
federal government taking out $25 billion.
When will the money be put back in? Give them the money and let
the provinces run the system. They can do it very well if they
get their share of the funding.
Mr. Alex Shepherd: Mr. Speaker, the issue of a collapsing
health care system occurred while there was that $25 billion. By
the way, the statistics are quite clear. With the transfer
payments we have restored all the money that we were funding in
health care back in 1993-94. Does the member want to ignore
reality and forget about tax points?
That is just not reality. The money is back in the system
today. My province has something like $300 million from the
federal government in one time start up funding that was not even
spent on health care. So do not tell me that the provinces know
how to spend money on health care. The fact is that health care
across the country is in collapse and the provinces are
responsible.
1325
[Translation]
Mr. Yvon Godin (Acadie—Bathurst, NDP): Mr. Speaker, I have just
a brief comment and a question.
The member across the way said that the Liberals had the money
in their back pocket. Could they take it out and put it on the
table? That would be really good for Canadians.
[English]
I want to be sure so I will repeat it in English. My colleague
across the way said that the Liberals had the money in their back
pockets. Canadians wish they would take it out of their back
pockets and put it on the table where it needs to be to serve
Canadians. That is what we need for health care. It is not
right that people cannot get into hospitals because of a six
month wait for heart surgery and every other sickness. They just
cannot get the service. That is the fault of the federal
government and all the cuts it has made to health care.
Even the Liberal from Newfoundland, Brian Tobin, said the same
thing. Maybe they should talk to their cousins down there, too.
Mr. Alex Shepherd: Mr. Speaker, I talk to our health care
workers, people such as nurses who actually work in the system.
They have told me that more money is not the answer. If we pump
more money into the system, it is going to be just as inefficient
as it is today.
The only way the federal government can show leadership on this
file is to say that these are the ways the health care system
should change across the country from sea to sea to sea. Yes, we
will put some more money on the table, but we want to see
commitment from the provinces that they are going to spend it on
improving health care for people.
Mr. Grant Hill (Macleod, Canadian Alliance): Mr.
Speaker, the member for Durham said that some of the provinces
that were given money by the federal government kept that money.
With his accounting background, he would recognize that the money
transferred to the provinces was for three years.
If he were in the province and received $100 million for health
care, would he have spent that $100 million in the first week, or
would he have spread it out over three years, which is what the
provinces are doing?
Mr. Alex Shepherd: Mr. Speaker, by all means, no I would
not. But I would not be like the province of Ontario which is
saying that it does not have any money when in fact it has $300
million sitting in an account. It turned around and took $160
million out and did not spend it on health care. It spent it on
tax cuts. That is not my idea of leadership on the health care
file.
Ms. Judy Sgro (York West, Lib.): Mr. Speaker, I am glad
to have the opportunity to speak to the opposition motion by the
NDP.
As the minister has said, the government does have grave
concerns about public funds going to private for profit
facilities. In Canada our health care system is predominantly
publicly financed and privately delivered. It is publicly
financed in that our universal single payer health care system
accounts for about 70% of total health care expenditures in
Canada. It is privately delivered in that most health care
providers and facilities operate in a private not for profit
manner.
The system has always had private components. For example, most
of our doctors are private practitioners or entrepreneurs, if you
like. Most Canadian hospitals are operated as private non-profit
entities.
In addition to the publicly insured physician and hospital
services we all receive, provinces and territories also provide
public coverage for other health services that remain outside the
national health insurance framework for certain groups of the
population, such as seniors, children and welfare recipients.
These supplementary health benefits include prescription drugs,
dental care and vision care. While provinces and territories do
provide coverage for some of these additional benefits, for the
most part they are privately financed. These health care
benefits account for about 30% of Canadians' total health
expenditures and are financed privately through supplementary
insurance, employer sponsored benefits or directly out of pocket.
As Canadians know and appreciate, the values that underpin our
medical care system are synonymous with being Canadian. The fact
that people in this country have access to hospital and physician
services based on their need and not their financial means is
truly a unifying feature of Canadian life. Our publicly financed
health system is a social contract between governments and
citizens to take care of one another regardless of financial
means or economic position.
One has only to talk to Canadians born before medicare and
listen to the stories of families who lost their life savings, of
individuals who could only have surgery when the community got
together and raised funds, or of loved ones who suffered because
they could not afford health services, to know how important
medicare is to being Canadian.
This alone is a strong argument for a one tier, single payer
health care system and, more important, for all of us to be
working to keep it together.
1330
The real threat to medicare is the increasing involvement of the
private sector in the delivery of necessary health care services
on a for profit basis. This raises concerns about the integrity
of our public system and whether a two tiered system is not far
in the future.
This is worrisome, especially since our system is envied by many
other countries. Globally, Canada's health system is seen as not
only a core social value, but also a program that enhances our
competitive position in the world economy.
Let us look at overall health spending. Canada spends about
9.2% of its gross domestic product, the GDP, on health. The
United States spends 14% of its GDP on health, and still 43
million Americans do not have health insurance coverage. Another
100 million are under-insured.
How can we spend 9% of the GDP and still cover everyone? The
big difference is the cost of administration. The American
multi-payer system simply costs more.
Look at payroll costs in Canada and the United States. In the
U.S. they are six times higher. Medicare is one of the reasons
Canada has the lowest payroll taxes of any country in the G-7.
Canada's business leaders recognize that medicare is a key
economic asset, not a burden. Our single payer, publicly
financed health system makes Canadian businesses more
competitive by keeping their costs down.
As John McCallum, chief economist at the Royal Bank of Canada,
said recently with regard to health care in Canada “The goals of
efficiency and financial egalitarianism go hand in hand”.
While Canada is the country best equipped to deal with the
pressures of an aging population and increased health costs,
there are still challenges and problems.
The Minister of Health and the Prime Minister have both said and
emphasize that the status quo is not on. However, the way to
solve these problems is not to replace the status quo with a
private, parallel, for profit system. Innovation and change do
not necessitate private for profit health care delivery, but
sometimes provide an excuse for that very fact. Yet ironically
we hear time and time again that the answer is to turn to private
for profit systems for health care delivery when in fact from an
economic standpoint there is little evidence to support this
conclusion.
Numerous studies from countries where there is private for
profit health care demonstrate that when compared to publicly
provided health care it costs more, provides lower quality and
fewer services, reduces equity and accessibility and drives up
the cost of public service.
A parallel for profit system would draw the best and brightest
doctors and other health providers also from the public system,
leaving the rest of us in the public system with diminished
services. However, if procedures in the private system get
complicated and more elaborate service is required, we know where
those cases will be, right back in the public system.
The public system ends up subsidizing the private one by having
to provide services that will not turn a profit in the private
system. In short, Canadians would be worse off than if the
services were delivered publicly. From my perspective Canadians
will be better served when changes, innovations and capacity
issues are addressed within a publicly financed and publicly
provided health care system.
An important decision about changes to medicare should be guided
by sound, solid evidence, by governments working together to
address Canadians' needs. Instead of privatization we need to be
working together to better organize and manage the current public
health system.
It is quite clear that the Government of Canada has a long term
sustainable plan to modernize, strengthen and preserve public
health care in Canada. Canadians expect their governments to
work together to ensure the renewal of this most cherished social
program. The government stands ready to engage in this most
important challenge. It is not beyond us to solve the problems
that confront medicare, but we must get on with the job.
The Canada Health Act is flexible enough as it stands now to
protect public health care. The Minister of Health has stated
that, as we have in the past, we will enforce the Canada Health
Act in the future if violations occur. This government will
enforce the authority in the Canada Health Act if practices
threaten the five principles on which our health care system is
based.
1335
Mr. John Reynolds (West Vancouver—Sunshine Coast, Canadian
Alliance): Mr. Speaker, it is interesting that the Liberal
member seems concerned about the fear of privatization. She
talked a lot about a two tier system. Does she not think that we
not only have a two tier but probably a three tier system in
Canada already? We have our system that is not working well. We
have a system of a number of procedures growing in just about
every province that is not covered by medicare any more, so that
only people who can afford certain procedures have them. Then we
have about $5 billion a year going out of the country to the
United States and to other parts of the world because Canadians
leave to have operations they cannot get quickly enough in
Canada. Do we really not have a three tier system already?
Ms. Judy Sgro: Mr. Speaker, I think that is a gross
misrepresentation of the facts that I stated and of comments that
were made earlier in the House.
The government is firmly committed to enforcing the Canada
Health Act and providing Canadians with access to great medical
care in the country. We have no intention of standing back and
allowing anything to deteriorate the system.
Ms. Bev Desjarlais (Churchill, NDP): Mr. Speaker, I want
to thank my colleague. I recognize that she was speaking as if
there were a real commitment on behalf of the government to
support a public health care system and that there was no way it
would allow for profit medicare or health care within our system.
However, the reality is that there has been a decrease in
funding.
The government is not funding health care to the degree it was a
number of years ago. There is not the 50:50 sharing with the
provinces. It is not happening. That is not accurate. The
government is not doing it. As a result, the provinces make the
choice as to whether they want to go ahead and start charging for
this or not covering that, instead of having a system where over
time we improve it and where we continually benefit Canadians
with increased services that are covered.
I want to comment on the point of what Canadians want to see.
Canadians have made it perfectly clear a number of times when
governments of the past have gone to them and asked what they
wanted to see in health care. They have already told the
governments. Where have the governments been? Why have they not
been listening?
Canadians have said that they want a universal health care
system. They want a national pharmacare program. They want
national home care standards. If people have never heard that
they should get their ears to an ENT and get them cleaned out.
That is what Canadians have said loud and clear. They have said
that they want a national system. They want national standards.
They want to be able to move from one province to the other and
get those services. That is not possible.
How can my hon. colleague stand behind her statement of what the
government believes in if it is not willing to put an equal share
of dollars on the table for the provinces?
Ms. Judy Sgro: Mr. Speaker, I agree with everything the
member has said in the sense that we are all here as Canadians.
This is an issue of major importance to each and every one of us
in the House. It does not matter what party we are with, we all
want to make sure that we have the best health care system.
The commitment from the Prime Minister and the Minister of
Finance is that there will be additional dollars on the table.
This is not a pot that we can keep putting dollars into. We have
an aging population and a lot seniors in need. We need to make
some changes in the system. We can raise all the concerns about
home care we want, but we need to work with the provinces. We
cannot just keep writing the cheques. Funding, as I understand,
is back up to the 1993-94 levels. More money has been committed
in the health area, but there have to be changes.
The province of Ontario is sitting with money in the bank while
people are desperately in need of care. That is a real problem.
Giving the province of Ontario more money is not the answer. The
question is, what are the changes and how are we going to make
sure that we have a sustainable health care system for all?
There is no issue that will unite Canadians, politicians and all
governments to make sure that happens more than this one.
Mr. Wayne Easter (Malpeque, Lib.): Mr. Speaker, I
enjoyed listening to the hon. member's remarks compared to some
of the comments I heard this morning about throwing more cash at
the problem.
The hon. member mentioned in her speech that changes are needed
concerning innovative and capacity issues. Could she expand on
that?
1340
Ms. Judy Sgro: Mr. Speaker, we only provide the money.
We have to be able to co-operate and work with the provinces to
ensure that they make the changes necessary to preserve our
health care system so that we will have an effective pharmacare
program and a home care program that will look after the people,
which we are all very committed to seeing happen.
Mr. John Reynolds (West Vancouver—Sunshine Coast, Canadian
Alliance): Mr. Speaker, I will be sharing my time with the
hon. member for Saanich—Gulf Islands.
It is a pleasure to participate in the debate on this motion on
health care. At the outset, let me say that the motion is
characteristic of NDP policy on many things. Regrettably for
them, times are changing and we must move with the times. This
is no more so than in health care. The situation is code blue.
It is critical.
In reality, the NDP is no closer to supporting provincial
innovations in health care than are the Liberals. They do not
like what Mr. Klein is doing, but they will not comment on what
they are doing in British Columbia, which is very similar to what
they are doing in Ontario. They are not willing to demonstrate
flexibility in reforming the health care system. Until someone
is, the situation will continue to deteriorate and the lives of
Canadians will remain pawns in this game of lethargy by both the
Liberals and the NDP.
For the NDP it is easier to point fingers and lay blame. They,
like the Liberals, are applying the Canada Health Act as a hammer
to penalize the provinces, which are in dire straits because of
lack of funds and increasing pressures on the system.
I listened to the hon. member for Malpeque say that we just
cannot throw money at a system. Why does he not stop to think?
This money belongs to Canadians. This is not the Liberal
government's money. The provinces deserve that money. Medicare
is supposed to be a 50:50 proposition. It is not any more. It
is funded 11% to 14% by the federal government. Money would make
a difference.
Why do we not let the provinces do what our constitution says
they should be doing, which is running the health care system?
The Liberals use this big “We are going to do this for the
health care system”. Stay out of the health care system and let
the provinces run it.
When I was in the provincial government in British Columbia we
had an emergency room system which operated very well. We had a
$10 user fee. It was not mandatory. At the bottom of the form
which people signed it stated that if they did not have the money
or if they did not want to pay, they did not have to. It was a
voluntary $10 fee. We were forced by the Liberal government to
stop taking that $10. The costs in the emergency rooms went up
by 145% the next year. There was no need for it. That was big
brother managing a province that was doing quite fine operating
its own system with a user fee that did not bother anybody in the
emergency rooms, but the government said it would take away our
highway grant of $90 million for that year if we did not stop
collecting that $45 million worth of user fees in the emergency
rooms. That was big brother operating. It has not improved the
health care system in British Columbia. Perhaps it makes some
people feel better.
The interesting part is that in all the years I was in the B.C.
government we collected 98.5% of those $10 fees. Nobody refused
to pay. Nobody minded paying. The usage rate in the emergency
rooms went up the next year by a tremendous amount. Now people
use it as a drop-in centre when they cannot get in to see their
doctor.
The system was operating fine in the province until the
interference of this government.
Let us be realistic and look at the government's track record on
health care spending. The government has cut $25 billion out of
the Canada health and social transfer over the past seven years.
It will be cutting another $10 billion over the next four years.
What does the government expect the provinces to do? They cannot
provide the required services now and the government wants them
to cut more. How can we expect that services are going to get
better? They are going to get worse.
Let us take a look at the impact of the decrease in federal
health care spending. Can hon. members imagine being told they
have a cancerous tumour and have to wait three months for
treatment? That is happening in this country. People are
being told that it takes three months. Is it not bad enough that
the doctor says that word, which shakes everyone from head to
toe, without having to wait for x-rays?
As Canadians we can brag about our health care system, and so we
should, but why are we spending $5 billion to cross the border
into the U.S. to have MRIs and hip replacements? Because we
cannot get it done here.
We have to solve this problem. The Liberal government is doing
nothing to help solve that problem. The costs of people going
across the border for treatment are increasing every year because
of the lack of facilities in Canada. We have forgotten about
technology in Canada. We have developed some of the best
technology for medicine in the world, which the Americans are
using, and we are paying to use it in the U.S. because the
Liberal government has cut funding from the provinces.
There is one major failing in our health care system, and it is
catching up on us. Canada has not kept up with technological
innovations. Among the OECD countries, Canada is rated 23 out of
29 with respect to health care.
In other words we are in the bottom one-third of the
industrialized countries. We can sit here and brag all we want
about our system but we are in the bottom third of the OECD.
1345
Technology is the key to propelling our health care system and
we have it in the country. I had a call the other day from one
of my constituents. His grandmother has a hip which is not
working. She can no longer walk and get to her car. She has
been told there is an 18 month wait. She has to suffer for 18
months. What is the family doing? They are all chipping in a
few dollars so she can go across the border to the Mayo Clinic
and get her hip replaced. Are they not lucky that they all have
a bit of money to help get their grandmother across the border?
Why should she have to wait? She spent 84 years paying her
taxes, being a great Canadian, and now we have to ship her off to
an American hospital for a hip replacement. How many people in
the House have mothers and grandmothers with failing eyes who are
waiting months and months and months to get into a hospital? It
is awfully nice of my friends from Malpeque and elsewhere on the
other side to say that money is not the problem, that it is the
way the provinces are managing the system. That is not the
problem. The provinces do not have the money to manage the
system properly.
Why do we not sit down and negotiate that? Instead of giving
great speeches about how we are here to protect the five
principles of the health care act, why does the Minister of
Health not talk in realistic terms? It should be a public
hearing. We should let the public come to listen to the
provincial health ministers and the federal minister debate the
issue. Then they could get it out in front instead of the
nonsense that is taking place.
The country is being divided over the health care issue.
Provinces are trying to do their best, whether it is British
Columbia, Alberta, Ontario, or any other one, but they are
getting very little co-operation from the federal minister.
We have an aging population. There will be greater demands, not
less, on our system of health care delivery. That will happen
year after year after year. Currently one in ten Canadians is
over 65. By the year 2025 it will be one in five, in just
another quarter of a century. Mr. Speaker, you and I will be in
that age bracket 25 years from now. We will be one in five
instead of one in ten. It will be tougher and harder to get our
hips replaced and to get our eyes fixed if the program does not
improve.
Another very scary statistic is that the average age of a
specialist in Canada right now is 59. With program and training
cutbacks and so forth, foreign countries are seducing students
with lower tuitions, better tax environments and better training
tools. We will be losing more doctors and thus more specialists.
While this is happening the Prime Minister is saying that there
is no brain drain.
The average age of specialists is 59. They are not staying
here. I know in my riding, which includes Whistler, the number
one ski resort in the world, the odd person falls down. In fact
the minister of fisheries is still using a cane these days
because of a little accident on a ski hill. We used to have four
of the best bone doctors at the Lions Gate Hospital. There are
two left and one is leaving. In Vancouver right now it takes
months and months to see one of those specialists after that kind
of an accident. It is a serious problem and the government is
not looking at it.
In 1974, with a population of 22 million, some 2,640 new doctors
entered the system. In 1997, with a population of 30 million,
only 1,882 new doctors entered the system. We cannot afford to
lose any of these doctors to other countries, let alone the
specialists.
In some cases Canadians are currently waiting for up to nine
months to see a specialist. We are in a critical situation and
the government says that it cannot throw money at it, that it has
to look at the system, that we have a better system than the
Americans and that we cannot have two tiers.
As I mentioned earlier, we have a three tier system right now.
Every member of the House knows that. We have a system where we
have to make an appointment to visit a doctor. If we need to see
a specialist we have to wait one, three, six or nine months.
Also every province has increased the number of services not
covered under medicare. Every time I have been to my doctor's
office there is a new list on the wall of items no longer covered
under medicare. Who pays for those procedures? We pay for them
out of our pockets. They are not being covered by medicare. That
is a two tier system.
What about the constituent who is going down to the states for a
hip replacement? That is the third tier: $5 billion going out
of the country every year. It should be staying here. That is
what Ralph Klein is trying to do and it is going to work very
well. These people will rue the day they tried to call this a
two tier system.
They already have a three tier system because they have let the
medicare system go to pot. They try to defend it by saying it is
anti-American, which is typical Liberal-NDP action. Anytime
there is a problem they say it is anti-American. That covers it
up for all Canadians who think they are doing a good job.
1350
Millions of Canadians of all political persuasion know that the
system is broken. It is not Ralph Klein's fault. It is not the
fault of the premier of British Columbia or of the premier of
Ontario. It is the fault of the federal government which has
knocked $25 billion out of medicare.
Mr. Alex Shepherd (Durham, Lib.): Mr. Speaker, I
listened very intently to the member's speech. He mentioned a
lot of things that have merit. While he described some of the
chronic problems of the health care system, he has taken all the
examples, turned them around and shifted them solely on to the
shoulders of the federal government.
I criticized some of my other colleagues who want to get this
done on the basis of money because I do not think it is about
money, but the hon. member seems to think that the sole purpose
of the federal government is to dole out money. I should like to
have the member's opinion.
In approximately 20 minutes some of his colleagues in the front
row will jump up to cross-examine the government. They will say
taxes have to be reduced, that expenses have to be cut and so
forth. Yet the member says that we should be spending
significantly more money on health care. I think some more
funding is in the cards.
Having said that and looking at the reality in terms of spending
on health care, 10% of our gross domestic product is spent on
health care. In all seriousness, if they criticize the federal
government for not spending enough money, what is the percentage
of our gross domestic product that Canada should spend on health
care? We are already one of the highest spenders in the world.
I want the member to be honest and tell me if the issue is about
spending or the administration of the spending.
Mr. John Reynolds: Mr. Speaker, I am hoping that my
constituent who wants a hip replacement is listening to the
debate. I hope there are thousands of others across the country
who are listening. They do not give a damn about the gross
national product or what percentage it is because they do not
understand it. All they know is that our health system is
broken. If it takes 11%, 12% or 13% to make it work, let us make
it work.
We say we have the best health care system in the world. Let us
make sure it is the best. With all due respect I say to the
member that there is an administration problem. There are more
bureaucrats in our health ministry than we need. The provinces
should be running health care. We do not need a big federal
bureaucracy spending millions of dollars. We need to get Mrs.
Smith's hip fixed. We need to get Mr. Smith's eyes fixed. We
need to make sure there are no long six to nine month waits to
cure our health problems. That is what the issue is all about.
It is not about percentage. It is not about spending more here
or less there.
The member is right. In a few minutes we will be up during
question period asking lots of questions about the waste of $1
billion in HRDC. That money should be put into health care. We
will be asking about files. How much did it cost to keep 39
million HRDC files on every Canadian? Why do we need them? Each
of those files must have cost a few hundred bucks. There are
tens of millions of dollars there that could be put into health
care instead of having a secret file on how many times Canadians
went to hospital.
I do not want a file in any government department indicating how
many times I had to go to a hospital in a year. Do I smoke
cigarettes or do I not? Did I not wear my seatbelt and get a
ticket for it? The RCMP could show the file to an insurance
company that will increase my insurance. I want my health care
fixed.
The Canadian Alliance Party, the NDP and the Bloc will give
Liberal members a list of the wasted money in the federal system
that could be going toward better projects than what it is going
to right now. The Tories will not participate because they are
part of the problem.
Ms. Bev Desjarlais (Churchill, NDP): Mr. Speaker, I
thought it rather strange but it sounded good that the NDP would
be able to give the answers to the health care problems. We
certainly can give the answers.
We never have suggested that money is the only issue. We never
have suggested that there is an unending pocket of money to be
used for health care. We have said that Canadians want dollars
put into health care. If there is a surplus of $11.9 billion or
$14 billion within the federal government, it is not because the
Liberals did some good money management as compared to everything
else they did.
It means that they cut $25 billion out of health care, took away
services, continued to take Canadian taxpayer money and never
provided the services. I want to get the member's comments on
that.
1355
Mr. John Reynolds: Mr. Speaker, unfortunately I did not
hear the end of the question. All I can say is that when I left
the Government of British Columbia in 1991, because we were
replaced by the NDP, our deficit was slightly under $1 billion
and our health care system was working very well. The
deterioration started when the federal government took money away
from us for emergency rooms. It took $45 million out of the
system.
I agree with my NDP friend. They have not just asked for money.
They have asked for a curing of the system. We all agree with
but it takes money to do it. There is a lot of waste in other
government departments that we could use and should be priorized.
There are a lot of government departments. We do not need the
minister of fisheries. Fisheries is a provincial jurisdiction.
We should get rid of him and his department and put that money
into health care.
There is a lot federal issues on which we could reduce money so
that average Canadians could get the health care they deserve.
* * *
[Translation]
MESSAGE FROM THE SENATE
The Deputy Speaker: I have the honour to inform the House
that a message has been received from the Senate informing the
House that the Senate has passed a bill to which the concurrence
of this House is desired.
STATEMENTS BY MEMBERS
[English]
INTERNATIONAL MUSEUM DAY
Ms. Sarmite Bulte (Parkdale—High Park, Lib.): Mr.
Speaker, today is International Museum Day. The theme for this
year's celebration is “Museums for peace and harmony in
society”.
Canada's heritage is one of our most important assets. It tells
us who we are, where we came from and what influences shaped our
development as a nation. It ties together generation upon
generation. This rich and multifaceted heritages is preserved in
our museums and galleries across the country.
International Museum Day highlights the important role that this
institution plays in our society. It is not only a source of
entertainment. It is also a vital means of cultural exchange,
enrichment of cultures and development of mutual understanding,
co-operation and peace among people.
Today museums across Canada will be opening their doors. I
encourage all members and all Canadians to see an exhibit, take a
guided tour and experience the wonders that our museums have to
offer.
* * *
TAXATION
Mr. John Duncan (Vancouver Island North, Canadian
Alliance): Mr. Speaker, Canadian students must claim
scholarships as income. A Canadian student lucky enough to
receive a large scholarship is actually unlucky because he must
pay tax to Revenue Canada on the value of the scholarship as if
it were income.
Scholarships to American universities are often large because
the tuition rates are high. Canadian students are being forced
to pay income tax on money they never see because much of it is
earmarked for tuition. This situation turns to farce when the
student spends his whole summer working just to pay taxes. On
the other hand, American students receive the tuition portion of
their scholarship tax free.
This draconian tax policy is unfair to Canadian students,
encourages the brain drain and penalizes bright students who are
awarded the larger scholarships. This needs to be fixed.
* * *
[Translation]
MEDICALERT MONTH
Mr. Bernard Patry (Pierrefonds—Dollard, Lib.): Mr. Speaker, I
have the pleasure of informing the House and all of the Canadian
public that the month of May has been designated MedicAlert
Month by the MedicAlert Foundation.
More than 900,000 Canadians are protected by this service,
recognized world-wide, which provides identification and medical
information in an emergency.
It is estimated that one Canadian in five has a medical problem
or allergy about which medical personnel should be informed in
an emergency.
MedicAlert allows individuals at risk to be identified quickly
in a medical emergency, and gives medical service providers
immediate access to reliable personal and medical information.
During MedicAlert month, the Canadian MedicAlert Foundation will
be launching a special campaign to increase public awareness of
its services.
Let us all express to the Canadian MedicAlert Foundation our
best wishes for the unqualified success of its campaign.
* * *
1400
[English]
ST. MARY'S CHILDREN'S CHOIR
Mr. John Richardson (Perth—Middlesex, Lib.): Mr.
Speaker, it is once again my pleasure to rise in the House to
sing praise to the Presto Group of the St. Mary's Children's
Choir who recently captured first place at the 13th annual CBC
national competition for amateur choirs.
Carried live over the radio on CBC Radio 2, and under the
tutelage of the choir director Eileen Baldwin, the St. Mary's
Presto Choir group performed three brand new, unaccompanied
pieces to beat Edmonton's Scholata Cantorum Chamber Choir to
claim the national title.
In winning the title, the St. Mary's choir received $3,000 in
prize money which will be used to fund their upcoming tour to
Vancouver where they will be participating in the World of
Children's Choirs featuring 40 of the best children's choirs from
around the world.
This latest achievement is just another feather in the cap of
the St. Mary's Choir, having won numerous awards at provincial
and national level competitions over the years.
Let me finish by saying, bravo.
* * *
GABE KRALJEVIC AND DOUG MCPHERSON
Mr. John Harvard (Charleswood St. James—Assiniboia,
Lib.): Mr. Speaker, I want to recognize two constituents
whose dedication and commitment have earned them the respect of
their colleagues and students and now of the Prime Minister and
the country.
I am referring to Gabe Kraljevic and Doug McPherson who received
Prime Minister's awards for teaching excellence.
Mr. Kraljevic teaches computer technology at West Kildonan
Collegiate. His approach of balancing technology training by
integrating language, communication, creativity and teamwork
skills has ensured that his students develop the skills necessary
for success in the information age.
Mr. McPherson teaches electronic technology at John W. Gunn
School. His philosophy of start small, integrate subjects and
provide differentiated learning opportunities has led at least
one parent to say “My daughter's academic progress in your
program has been exceptional—because you have designed a middle
years program that is unparalleled”.
On behalf of the House of Commons, I extend congratulations to
these two teachers.
* * *
HYACK FESTIVAL
Mr. Paul Forseth (New Westminster—Coquitlam—Burnaby,
Canadian Alliance): Mr. Speaker, the royal city of New
Westminster, British Columbia, is again proud to sponsor its
annual Hyack Festival in the month of May.
This year marks the 130th May Day, making it the longest running
celebration of its particular kind in the British Commonwealth.
In the past, dignitaries like Queen Elizabeth have joined the
festivities, witnessing firsthand the traditional cannon blast
salutes in memory of Queen Victoria.
With children dancing around the historic maypoles, a parade
with fancy floats and many marching bands, it is no wonder that
people from all over North America come to take part in such a
wonderful historic festival.
While Victoria may be British Columbia's capital, New
Westminster remains the original royal city, given its name by
the Queen. The word hyack comes from an Indian word for hurry
up.
I urge my parliamentary colleagues to come to New Westminster
next week and learn more about hurrying up because this is
exactly what Canadians want. Congratulations to the Hyack
Festival organization of New Westminster.
* * *
SANDRINE'S GIFT OF LIFE
Ms. Aileen Carroll (Barrie—Simcoe—Bradford, Lib.): Mr.
Speaker, I rise today to congratulate you in your role as
honorary co-chair for the national Sandrine's Gift of Life organ
donation awareness campaign. Among the groups represented at the
meeting you held today, were police services, funeral services,
media, health services and fire chiefs.
Sandrine's Gift of Life is an awareness campaign launched by a
family who donated a young girl's organs a year ago after a
tragic school bus accident.
Canada has one of the lowest donor rates in the industrialized
world. More than 3,500 Canadians are waiting for transplants and
150 people will die on that waiting list. These facts tell why
co-operation in these organizations is so critical.
The campaign message “Talk to your family about organ donation.
Someone's life depends on it” emphasizes the key role of
communication, as almost half of families refuse consent for
donation, often not aware of their loved one's wishes.
I also want to thank those MPs who have helped to spread
awareness of this campaign to their constituents.
* * *
ESTHER BRYAN
Mr. Bob Kilger (Stormont—Dundas—Charlottenburgh, Lib.):
Mr. Speaker, artist Esther Bryan, a resident of my riding of
Stormont—Dundas—Charlottenburgh, with the help of hundreds of
volunteers and participants from across Canada, is bringing to
life an immense textile artwork entitled, “Invitation”, a
reflection of Canada's cultural fabric and history.
All ethnocultural groups, Inuit and first nations communities
within Canada are each contributing a handmade textile block of
traditional materials and designs symbolizing their unique
contributions to our Canadian identity.
This quilt of belonging is a work in progress. Many completed
blocks will be on display at five o'clock this afternoon in the
Centre Block Hall of Honour.
1405
I invite all members of parliament to join the Canadian
Ethnocultural Council and the Board of the Invitation Quilt to
participate in the national launch of this project.
A special congratulations to artist Esther Bryan for her vision
and commitment to this very special millennium project.
* * *
VIMY RIDGE
Mr. Peter Goldring (Edmonton East, Canadian Alliance): Mr.
Speaker, today its majestic white spires are basking in the sun
and gentle breezes. The tranquillity of Vimy Ridge supremely
contrasts the terror of old when 100,000 Canadians moved forth in
a hell of inhumanity testing their mettle and mortality of soul.
They advanced on unconquerable Vimy. Canada's finest young men
won the contest that day. A victory for all the world to see.
Today the monument that honours Canada's great war soldiers
decays. Vimy shamefully succumbs to the ravages of neglect. This
superb memorial to our veterans and war dead must not crumble and
slip to the plains below. Vimy must not be allowed to fade to
dust. We must keep the will to preserve this majestic torch and
to keep it lit for all time as a reminder of Canada's true price
of peace this century past, 100,000 war dead.
* * *
PRIME MINISTER
Mr. Mark Assad (Gatineau, Lib.): Mr. Speaker, I want to
quote a letter from Senator De Bané on the article he co-authored
with the John Sigler, a professor from Carlton University, on the
Prime Minister's trip to the Middle East.
The Ambassador of Lebanon, the Dean of the Diplomatic Corps
writes:
Your article gave a considered and balanced view of this
successful trip which was contrary to how it was portrayed by the
Canadian media and some members of the Canadian Parliament.
In a recent de-briefing regarding the trip, the heads of
missions to those Arab countries visited by the Prime Minister
expressed their deep satisfaction at the success of the trip.
The warmth displayed by the various heads of state and
governments toward the Prime Minister, which I witnessed during
his visit to Lebanon, demonstrated their deep respect for the
Prime Minister, as well as the great admiration and sincere
friendship that the people of the region hold for Canada and
Canadians.
The Speaker: The hon. member for Vancouver East.
* * *
CO-OPERATIVE HOUSING FEDERATION OF CANADA
Ms. Libby Davies (Vancouver East, NDP): Mr. Speaker,
today 800 delegates from the Co-operative Housing Federation of
Canada are meeting in Ottawa. They are discussing urgent issues,
including the unthinkable but very real possibility of the
economic eviction of low income co-op owners, because of CMHC's
failure to provide fair and reasonable help to co-ops that are
facing complete building failure due to poor construction and
leaky co-op syndrome.
About 30 co-ops in B.C. alone are facing their demise because of
this serious situation. While the B.C. government's home
protection office has helped, so far the response from CMHC has
been appalling.
Is the minister responsible for CMHC aware that officials have
not even responded to urgent calls to meet with representatives
from CHF to discuss this disastrous situation?
I implore the minister to urge his officials to come to the
table immediately to help these co-op owners who are facing
economic eviction and building failure.
* * *
[Translation]
INTERNATIONAL MUSEUMS' DAY
Mr. Pierre de Savoye (Portneuf, BQ): Mr. Speaker, on this
International Museums' Day, I wish to draw attention to the
unique role our museums play in the cultural landscape of Quebec
and of Canada.
Museums put the public in contact with fine arts, with technical
and technological development, with folk tradition and with
history. The museums of Quebec and of Canada are without rival
as windows opening onto cultures and civilizations.
Museums play a key cultural role. They also play a social role,
one that has been aptly described by Roland Arpin of the Musée de
la civilisation du Québec. According to him, museums are
mediators between art, history and science, and their visitors,
and as such they contribute to the development of critical
abilities, thus making their own contribution to building a
democracy.
In each museum, countless people, some of them working behind
the scenes, are contributing their multiple talents to the spread
of knowledge, to sharing the experience—
The Speaker: The hon. member for Haliburton—Victoria—Brock.
* * *
[English]
TOM LONG
Mr. John O'Reilly (Haliburton—Victoria—Brock, Lib.): Mr.
Speaker, I wish to inform the House of a telephone call some
members are receiving.
It goes something like this, “Hello, you all. I am calling you
on behalf of my good buddy, Tom Long. Will you all help my good
old buddy Tom to get them Canadian taxes down?”
1410
I asked “Are you calling long distance?” He said “You all,
it's a Tom Long call. Tom is one of the good guys and he will
save you Canadians from your further misery. He is a really good
organizer and he wants to move from the back room to the front
room so he can see the porch. He wants you all to support him up
there and down here. Charlton will thank you”.
* * *
[Translation]
HUMAN RESOURCES DEVELOPMENT
Mrs. Maud Debien (Laval East, BQ): Mr. Speaker, yesterday
Quebecers learned to their astonishment that the federal
government had created, without their knowledge, files which
contain a unique, complete, permanent and virtually invisible
record on each individual.
If more than four million deceased persons' records are still on
file, it is very possible there are major errors in the
information held on an individual by this department, which has
demonstrated such total inefficiency in managing the grants it
gives out.
The Bloc Quebecois is therefore inviting everyone to check the
contents of his or her personal file, by filing a written
application under the Access to Information Act with to Human
Resources Development Canada, Attention Jean Dupont, Place du
Portage, Hull.
* * *
[English]
CONSECUTIVE SENTENCING
Mr. Peter MacKay (Pictou—Antigonish—Guysborough, PC):
Mr. Speaker, it has been almost one year since the House passed
the bill empowering judges to impose consecutive parole
ineligibility periods on multiple and serial killers. Bill C-247
was introduced by the member for Mississauga East and was
supported by members of all parties, including her own.
The PC Party unequivocally reaffirmed support for the principles
of consecutive sentencing and its opposition to section 745, the
faint hope clause, last weekend at our policy convention. Joining
us in Quebec City were Gary and Sharon Rosenfeldt, whose son
Daryn was Clifford Olson's third murder victim. This reminded us
of the importance of this bill; when remembering Daryn as the
third victim, the current system did not count him in the
sentencing calculation.
During last year's debate, Carolyn Solomon, whose son Kevin was
the second of three victims murdered by a federal parolee, also
told me she felt her son did not matter to the justice system.
The PC Party calls on the government to stop stalling the
progress of this bill, respect the will of the House and let it
proceed to the Senate justice committee to give victims further
say in the debate.
* * *
[Translation]
BOOK DRIVE FOR IQALUIT SCHOOL
Mr. Mauril Bélanger (Ottawa—Vanier, Lib.): Mr. Speaker, in
early February the principal of a school in Iqaluit, Nunavut,
sent a letter to the editor of an Ottawa daily newspaper
describing the urgent need of books for his school.
After speaking to him, and to my colleague from Nunavut, we
launched a book drive with hopes of collecting 100 or 200 boxes.
To our surprise, we ended up with more than 1,000 boxes, in
excess of 25,000 books.
I would like to thank everyone in the region who contributed,
particularly one young lady, Catherine French, who collected over
2,000 all by herself.
I would like to thank the people of Mattawa, the village where I
was born, the people at F.J. McGellight Secondary School, St.
Victor's and St. Anne's schools and the municipal library, for
contributing more than 200 boxes of books.
I also wish to thank Susan Scullion of my colleague from
Nunavut's office, and Suzanne Demers of my own, without whom this
project could not have been the success that it was.
* * *
[English]
EXPORT DEVELOPMENT CORPORATION
Mr. Deepak Obhrai (Calgary East, Canadian Alliance): Mr.
Speaker, today's response by the trade minister to the review of
the Export Development Act represents nothing less than a lost
opportunity for the government to tackle issues of transparency,
accountability, competition with the private sector and the
politicization of EDC's lending practices.
As a federal crown corporation, the EDC must be prepared for a
certain level of transparency and accountability to the Canadian
taxpayer. The EDC must not compete directly with the private
sector and must operate within the tested and recognized
international environmental framework of the World Bank.
Finally, the EDC must not be used as a political tool for this
government to provide jobs and financial rewards to its friends.
This response reveals who is really pulling the strings of this
minister and the department.
What the EDC wants the EDC gets.
This minister chose to take his marching orders from the EDC
rather than the elected representatives or the Canadian taxpayer.
ORAL QUESTION PERIOD
1415
[English]
HUMAN RESOURCES DEVELOPMENT
Miss Deborah Grey (Leader of the Opposition, Canadian
Alliance): Mr. Speaker, the privacy commissioner has warned
us that the HRD minister is collecting detailed private
information on each and every Canadian.
The minister's own security audit warns that “a formal national
information technology security awareness program has not been
established at HRD”.
It is bad enough that such a database exists in the first place,
but why is the minister not concerned that it might fall into the
wrong hands?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, as she was doing yesterday, the hon.
member is mixing apples and oranges. She speaks about an audit
in my department and that had to do with general information
technology systems in the Department of Human Resources
Development.
In the context of what the privacy commissioner is looking at,
it is a stand alone system that is highly controlled. There is
limited access and the information is secure.
Miss Deborah Grey (Leader of the Opposition, Canadian
Alliance): Mr. Speaker, I thought HRD grants were highly
secure too. Not even dead Canadians can be out of the clutches
of this minister's database. Mr. Speaker, once you are on that
list you cannot get off.
The privacy commissioner is worried about it and he still is,
even though that came out in September. He said, “So much
personal data on almost every person in Canada poses significant
risks to our privacy”. The fact that so much sensitive
information is in the hands of a minister who cannot even seem to
balance a chequebook is downright scary.
At which point did the government decide to ignore the rights of
Canadians' privacy?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, the hon. member is wrong again. In fact
as one of the things that we did in response to the request of
the privacy commissioner, we have curtailed the amount of time
for which the data is managed.
Miss Deborah Grey (Leader of the Opposition, Canadian
Alliance): Mr. Speaker, the privacy commissioner has been on
TV the last day or two with serious concerns about this. Here is
something out of the audit: “One administrator told the internal
audit branch that the main method of finding out about changes to
an employee's status or access rights is at the employee's going
away party”.
Canadians want to know why a minister who bungled a billion of
their dollars is now gathering the most private intimate details
about their lives. Will we have to wait until the minister's
going away party to find out?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, I want to be very clear that the hon.
member is mixing apples and oranges.
In the audit that she is making reference to it was actually
identified that our security measures are satisfactory, in fact
probably better than we would find in the private sector.
With regard to the issues that are the focus of the privacy
commissioner's review, it is a completely separate system. It is
stand alone. The access is very limited. All the information is
encrypted. It is secure.
Mrs. Diane Ablonczy (Calgary—Nose Hill, Canadian
Alliance): So, Mr. Speaker, the minister is telling us that
security is great in system A but terrible in system
B. I do not think so.
Canada's privacy commissioner is warning of HRDC's
“extraordinarily detailed database” on everyone in Canada. The
privacy commissioner states bluntly, “Canadians should be
concerned”. The minister has been shown to be spectacularly
unfit to safeguard our money. Why should Canadians want to trust
her with the personal details of their private lives?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, today in committee I addressed this very
issue that the hon. member raises. She time and again talks
about a billion dollars being missing out of my department for
grants and contributions. That is absolutely false.
The audit that we were talking about today at committee on
grants and contributions deals with the very important issue of
paperwork and administration. I wish the hon. member would
actually stand up and for once tell Canadians that she has been
wrong all along.
Mrs. Diane Ablonczy (Calgary—Nose Hill, Canadian
Alliance): Mr. Speaker, it would be easier to do that if the
evidence did not keep accumulating that I am right.
The privacy commissioner says his report shows “how far we have
to go in the ongoing—
The Speaker: Order. I wonder if I could appeal to the
hon. member from Hastings—Frontenac to please lower his voice.
Mrs. Diane Ablonczy: Mr. Speaker, the privacy
commissioner says his report shows “how far we have to go in the
ongoing battle to protect the right to a life free of
surveillance and intrusion”.
1420
He disclosed that the minister has been quietly accumulating a
dossier on everyone and then sharing this private information
with groups outside government, all without the permission of
citizens.
Why does the minister violate Canadians' privacy without their
consent?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, protection of the privacy and the
information of Canadians is fundamental and I will not tolerate
any breach of that in my department.
Let us look at where we are at. I quote the privacy
commissioner who wrote:
Certainly we are not aware, nor has it been brought to our
attention, that the database has ever been compromised or access
inappropriately obtained by virtue of deficiencies in security
safeguards. For that your department should be commended.
[Translation]
Mr. Gilles Duceppe (Laurier—Sainte-Marie, BQ): Mr. Speaker,
the minister admitted this morning to the Standing Committee on
Human Resources Development that her six point plan was intended
only to correct the administrative problems encountered in her
department.
Does the minister realize that she is in fact saying she had no
concern about the real problems that worried the public, namely
fraud, patronage, influence peddling and cronyism?
[English]
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, on the contrary, indeed the six point
plan is addressing the administration of grants and contributions
in my department. I think that was made clear this morning.
Separate from that, I have always said that if there is ever any
information that comes to light either from within the department
or from outside that suggests that moneys may be misused, we take
swift action. We refer it to the appropriate authorities as
necessary. Should they come back to us and suggest further
action, we take it.
[Translation]
Mr. Gilles Duceppe (Laurier—Sainte-Marie, BQ): Mr. Speaker,
I hope that she does not think we believe her. This report is
smoke and mirrors—
Some hon. members: Oh, oh.
The Speaker: I would remind hon. members that here we take the
word of someone who provides an answer or puts a question.
Believing or not believing is not an issue. It is simply a
matter of what is presented as facts.
Mr. Gilles Duceppe: The facts are totally wrong, Mr. Speaker.
No one can believe these facts, this version of the facts,
neither us, nor the public, nor the members of the opposition,
and I know of many on the other side who are uncomfortable with
what the minister has done.
How can she have us believe that this report is valid and
truthful, when the 13 files under investigation amounting to $6
million are not part of these audits? Can she say the opposite?
Is she going to tell me that these 13 files are part—
The Speaker: The Minister of Human Resources Development.
[English]
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, the hon. gentleman refuses to accept the
facts. He refuses to accept that the audit was a focus on the
administration of grants and contributions and that indeed we are
fixing that.
He also refuses to accept, even though there is very evident
proof, when we are informed of possible breaches, when there is a
possibility that moneys may have been misused, that we take swift
action, that we may indeed refer it to other authorities and then
those authorities do their job.
[Translation]
Mr. Paul Crête (Kamouraska—Rivière-du-Loup—Témiscouata—Les
Basques, BQ): Mr. Speaker, one of the OECD'S principles for the
protection of personal information, and one on which there is
international consensus, is that information files must be
regularly cleaned up, which means that they must contain quality
data. I would remind hon. members that Canada has subscribed to
these principles.
Can the minister explain to us how she can prove to us that such
a file clean-up has taken place, when we know there are 34
million records, yet only 30 million Canadians?
[English]
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, the hon. member may be referring to a
reference by the auditor general to social insurance numbers. As
I have told him and as I have made clear to the committee, we
have taken significant action. We have reduced the number of
social insurance files within the database. We have taken the
references and the actions suggested by the auditor general in
this case very seriously. The hon. member knows that.
1425
[Translation]
Mr. Paul Crête (Kamouraska—Rivière-du-Loup—Témiscouata—Les
Basques, BQ): Mr. Speaker, I have to give permission right on my
income tax return for my name to be put on the voters list, which
is perfectly in line with one of the OECD principles, namely that
the consent of those whose personal information they want to keep
on record must be obtained.
Out of the 34 million records on file at Human Resources
Development Canada, how many people's consent has the minister
obtained?
[English]
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, precisely the issue of how Canadians know
how the information they provide is used is important. That is
one of the issues that the privacy commissioner makes reference
to in his report and in the correspondence we have had with him.
That is why I would like my department to sit with him and his
department in a working group to determine how we can ensure that
Canadians do know how their information is being used.
* * *
THE ECONOMY
Ms. Alexa McDonough (Halifax, NDP): Mr. Speaker, again
the government has lowballed the surplus. It is $11.5 billion
more than Canadians were led to believe.
With health care hemorrhaging, with the CBC amputating limbs and
students staggering under education debt, what is it going to
take for the government to address the real priorities of
Canadians and if not now, then when?
Hon. Jim Peterson (Secretary of State (International
Financial Institutions), Lib.): Mr. Speaker, along with
putting our fiscal house in order, we have addressed, with
respect, the priorities of Canadians. In the past three budgets
we have brought in tax measures, a 25% reduction. At the same
time we have increased the investments in health care by a record
25%, another $2.5 billion in the last budget. In the previous
budget we brought in $7.5 billion for students and for education.
* * *
HEALTH CARE
Ms. Alexa McDonough (Halifax, NDP): Mr. Speaker,
Canadians' priorities are not just about money. They are also
about political leadership and some sense of political will.
In 1984 when the Canada Health Act and medicare were under
attack, Monique Bégin did not make excuses, she made laws. When
is the government going to muster the political guts to
strengthen the Canada Health Act and outlaw American style two
tier for profit health care?
Hon. Allan Rock (Minister of Health, Lib.): Mr. Speaker,
the member lauds the Canada Health Act. Now she ought to read
it. If she does, she will find that we have already in the
Canada Health Act the principles and the rules we need to
safeguard medicare. What this government has said consistently
and unconditionally is that we will use the powers in the Canada
Health Act to protect the principles in the Canada Health Act.
That is not true just in Alberta, that is true across the
country.
* * *
NATIONAL DEFENCE
Mrs. Elsie Wayne (Saint John, PC): Mr. Speaker, industry
sources are expressing grave concern at reports that the
government is preparing to announce a sole source contract for
the Sea King replacement.
Will the Prime Minister guarantee to the House that the Sea King
replacement will go through a fair and competitive public tender
process and not a private political one?
Hon. Arthur C. Eggleton (Minister of National Defence,
Lib.): Mr. Speaker, it certainly is not going to be a private
political process. It will be a very open process. We are going
through the final stages of the procurement strategy for the
replacement of the Sea King which, as I have said many times, is
our number one procurement priority.
Mrs. Elsie Wayne (Saint John, PC): Mr. Speaker, the
Minister of National Defence has had the statement of requirement
for the Sea Kings on his desk for almost a full year. Why has
the Prime Minister not called for industry bids? What reason
does he have for not doing it today? Why the delay?
Hon. Arthur C. Eggleton (Minister of National Defence,
Lib.): Mr. Speaker, there is more to a procurement strategy
than a statement of requirement. A statement of requirement is
part of it.
1430
This is a very complex purchase, not only in terms of the air
machine, but in terms of the equipment that goes inside. In
fact, the equipment that goes inside is at least as much of a
cost factor as is the helicopter.
There are a number of factors that need to be taken into
consideration. It is a very major government undertaking,
requiring government approval. We are moving on the file, as I
have indicated many times. We hope that an announcement will be
made soon.
* * *
HUMAN RESOURCES DEVELOPMENT
Mr. Monte Solberg (Medicine Hat, Canadian Alliance): Mr.
Speaker, here is the situation.
Private citizens grudgingly give personal information to
government departments on the understanding that it will be kept
confidential and never go beyond that particular department. Now
we find out that this confidential information is freely traded
between departments, collected on a master list and, according to
the privacy commissioner, even traded with the private sector.
When did the government decide that its desire to do government
research should trump one of the most basic rights of a free
people, the right to privacy?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, there is a Privacy Act in this country
and it applies to its citizens. We respect it. The privacy
commissioner himself has said that we are not breaking any laws.
The privacy commissioner has looked at the way we operate this
file. He has said that there has never been a breach of
information.
Indeed, we have to make sure that that secure system maintains
itself into the future, and that is why it is important for us to
continue to work with the privacy commissioner to ensure that is
the case.
Mr. Monte Solberg (Medicine Hat, Canadian Alliance): Mr.
Speaker, I remind the minister that yesterday the justice
minister said that the Privacy Act probably needs an overhaul.
There are big problems with that department and the minister
knows it. All we have heard just now is a rationalization for
big brother to collect personal dossiers on 30 million Canadians.
Big sister, the minister, says whatever she wants.
The public is alarmed at the idea that their most—
The Speaker: Order, please. I would ask the hon. member
for Medicine Hat to put his question.
Mr. Monte Solberg: Mr. Speaker, with whom has HRDC shared
this information since the database was created, and will she
table that information?
Hon. Anne McLellan (Minister of Justice and Attorney General
of Canada, Lib.): Mr. Speaker, I must respond to the
inaccurate representation of my comments yesterday in the House
by the hon. member for Medicine Hat.
I did not say that the Privacy Act needs an overhaul. What I
said was that the Privacy Act, in light of technological change
and advancements in areas like DNA, may in fact need to be
reviewed.
Let me reiterate for the House—
Some hon. members: Oh, oh.
The Speaker: Order, please. We will hear the answer.
Hon. Anne McLellan: Mr. Speaker, I want to reiterate for
everyone in the House that the information in question is secure.
The privacy of Canadians is protected under this law.
[Translation]
Mr. Michel Gauthier (Roberval, BQ): Mr. Speaker, all Canadians
are in shock. The federal government is collecting information
on each of us without our knowledge. The Minister of National
Revenue is merrily supplying information from our tax returns to
his colleague, the Minister of Human Resources Development,
without our permission.
How should I feel today, when the tax return I just sent in will
be forwarded to HRDC so that the government can help itself to
the information it apparently needs?
Hon. Martin Cauchon (Minister of National Revenue and Secretary
of State (Economic Development Agency of Canada for the Regions
of Quebec), Lib.): Mr. Speaker, I think that we must not start
crying wolf.
One of the fundamental principles of the Income Tax Act is the
confidentiality of information. This is a principle that we will
continue to defend as long as the Liberal Party forms the
government.
I said yesterday that information was exchanged with other
departments in connection with jointly administered programs.
1435
One example, to be a bit more specific than I was in my answer
yesterday, is paragraph 241.4(d)(x) of the Income Tax Act.
Mr. Michel Gauthier (Roberval, BQ): Mr. Speaker, the minister
can tell us not to cry wolf, but there is a whole pack of wolves
on the other side of the House.
There is nothing complicated about it: all the information that
this government has worries the privacy commissioner. And we are
the ones crying wolf?
Will the Minister of National Revenue assure us that the
information he is handing over to the Minister of Human Resources
Development is the same as what he hands over to the RCMP in the
case of a fraud investigation, for example?
Hon. Martin Cauchon (Minister of National Revenue and
Secretary of State (Economic Development Agency of Canada for the
Regions of Quebec), Lib.): Mr. Speaker, at the risk of repeating
myself, the element of confidentiality is a fundamental element
we will continue to protect.
I have said that there could be exchanges of information in the
case of jointly administered programs. I briefly alluded to
sections of the Income Tax Act authorized us to exchange this
information, which is done with a view to improving government
administration.
Once again, I think that the opposition should join with the
government so that we can explain to the public that when we
speak of confidentiality, privacy, it is something we do not take
lightly.
[English]
Ms. Val Meredith (South Surrey—White Rock—Langley, Canadian
Alliance): Mr. Speaker, the claims by the human resources
minister are not to be believed. Her own internal security audit
warns: “Most HRDC personnel do not have a good understanding or
clear knowledge of current information technology security
policies”. How can the minister claim that her department will
safeguard Canadians' private files when her own officials are not
even aware of the policy on security?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, again we see that party fabricating and
repeating misinformation.
Some hon. members: Oh, oh.
The Speaker: On one side we have “not to be believed”
and on the other side we have “fabricating”. I urge members to
stay away from words—
An hon. member: Oh, oh.
The Speaker: I ask the hon. secretary of state for
finance to please keep his voice down.
Hon. Jane Stewart: Mr. Speaker, again the opposition is
mixing apples and oranges. It is trying to confuse Canadians.
It is suggesting things that really are not there.
In the context of this audit we were looking at an information
technology system and network that has nothing to do—nothing to
do—with the program that the privacy commissioner focused upon.
In that case it is a stand alone system. It is highly secure.
There is very limited access to this information. The
information is encrypted and it is secure.
Ms. Val Meredith (South Surrey—White Rock—Langley,
Canadian Alliance): Mr. Speaker, I find it amazing that the
system does not belong and yet it is encrypted. It would seem to
me that the technology that is there now is what is being used to
gather this information on 33 million people.
HRDC security policies are not even uniform across the country.
The security audit states: “Variances among regional offices
led to inconsistent IT security measures, such as various IT
security risks not being appropriately addressed”.
Why is the minister pretending that she can protect Canadians'
privacy when she cannot even enforce a basic uniform policy?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, that same audit said that our processes
and practices were satisfactory and in fact exceeded those of the
private sector.
We all have to be careful when we talk about individual
information. On this side of the House we are careful. On this
side of the House we protect data.
I am wondering, when we find out that one of the leadership
candidates for that member's party has been inappropriately
collecting and using lists, if indeed she is talking to him about
how appropriate it is to manage personal information in an
effective way.
1440
[Translation]
Mr. Michel Bellehumeur (Berthier—Montcalm, BQ): Mr. Speaker,
yesterday, people asked at an office of Human Resources
Development Canada to have the information contained in their
personal files. Their request was denied, and they were referred
to Ottawa and told to make a request for access to personal
information.
Will the minister tell us why it is so complicated for an
ordinary citizen to obtain personal information on himself, when
her department can get it without the consent of the individual?
[English]
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, in this regard we have to ensure that the
citizen asking for information is indeed the person that he or
she purports to be. To use and benefit from the access to
information process is the right strategy in this regard.
If the hon. member knows people who want to obtain this
information, it is available, but it should be obtained through
the access to information system.
[Translation]
Mr. Michel Bellehumeur (Berthier—Montcalm, BQ): Mr. Speaker,
let us be clear. In order to obtain information that concerns
me, information in my file, I go personally with my identity
cards, me the person on file, to Human Resources Development
Canada where I have to make a request for access to personal
information in Ottawa with all the delays that entails.
Could the minister explain why I have to submit a request for
access, when the departments exchange personal information that
concerns me, on request, with a snap of the finger?
[English]
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, again I want to make it absolutely clear
that what we do is in the context of the laws of this land.
There is no breaking of the law in this undertaking.
Surely the hon. member agrees that to use the access to
information process, that which comes from an act of this
parliament, is the appropriate thing to do when dealing with
sensitive information.
Mr. Rahim Jaffer (Edmonton—Strathcona, Canadian
Alliance): Mr. Speaker, the minister can claim all she wants
that she has information security under control, but the fact is
that her own officials who run her computer systems do not even
get security training. Listen to this: “Since most
administrators received no formal information technology security
training or had little background in IT security, their concerns
and expertise for IT security varied and led to inconsistent
practices”.
Why should Canadians entrust their most private information to a
proven bungler whose staff is not trained to handle it?
The Speaker: I would ask members, please, to address each
other by their proper titles.
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, the hon. member does not have to believe
in me. Let us review again what the privacy commissioner said.
He said: “Certainly, we are not aware, nor has it been brought
to our attention, that the database has ever been compromised or
access inappropriately obtained by virtue of deficiencies in
security safeguards. For that your department should be
commended”.
Mr. Rahim Jaffer (Edmonton—Strathcona, Canadian
Alliance): Mr. Speaker, it is not just what HRDC does with
its computers now that is a problem, it is how it gets rid of
them as well. The security audit warns: “There is no assurance
that all hard drives are erased of potentially sensitive data
prior to disposal”.
I realize that keeping track of what leaves her office is not
exactly the minister's specialty, but this kind of neglect leaves
privacy vulnerable.
Why is the minister who bungled $1 billion now in possession of
Canadians' most private information?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, again, as I have said on a number of
occasions with reference to this particular audit, it has nothing
to do with the program that the privacy commissioner is
reviewing.
As I said in the House yesterday, this was an audit done by the
department, which is the right thing to do. We reviewed it, we
have taken action on it and we have made improvements.
[Translation]
Mrs. Pierrette Venne (Saint-Bruno—Saint-Hubert, BQ): Mr.
Speaker, there is a lot of concern following the discovery of a
unique file of citizen profiles at Human Resources Development
Canada.
Could the Solicitor General tell this House if CSIS or the RCMP
or one of their agents has not had access to this file at Human
Resources Development Canada?
1445
[English]
Hon. Lawrence MacAulay (Solicitor General of Canada,
Lib.): Mr. Speaker, all the files at CSIS are reviewed by
SIRC. SIRC has reported on a number of cases and there is
absolutely no problem.
* * *
LABOUR
Ms. Susan Whelan (Essex, Lib.): Mr. Speaker, for three
weeks now the people of Pelee Island have been cut off from the
mainland, isolated by a crippling labour dispute with the ferry
operators. Farmers are unable to plant their crops. Tourism has
stopped in its tracks and the entire economy of the island is in
severe jeopardy.
How has the Minister of Labour tried to resolve the situation
which involves an Ontario provincial government agency?
Hon. Claudette Bradshaw (Minister of Labour, Lib.): Mr.
Speaker, I am very concerned with the situation affecting the
residents of Pelee Island.
An officer of the federal mediation and conciliation service met
with the parties on May 8, 2000. They were unable to reach an
agreement. The federal mediation and conciliation service
officer remains in contact with the parties and is available to
provide them with mediation assistance once they resume
negotiations. I urge both parties to return to the table and put
an end to this dispute.
* * *
PRIVACY
Mr. John Reynolds (West Vancouver—Sunshine Coast, Canadian
Alliance): Mr. Speaker, the Minister of Justice jumps to the
feds and says the lists are secure. The Minister of Human
Resources Development says that there has been no breaking of the
law and that it has never been compromised. Let me quote the
privacy commissioner who says:
If that right can be violated, where is the security?
Hon. Anne McLellan (Minister of Justice and Attorney General
of Canada, Lib.): Mr. Speaker, I have no firsthand knowledge
of the example that the hon. member has just provided, but let me
reiterate that the information under discussion is secure.
The privacy rights of Canadians are being respected and the
privacy commissioner himself indicates that information in the
possession of HRDC is being managed properly.
Mr. John Reynolds (West Vancouver—Sunshine Coast, Canadian
Alliance): Mr. Speaker, the Minister of Justice can read the
report. I was quoting from the privacy commissioner. There was
a violation. In his report the commissioner expressed real
concern with the confidentiality and security of privatization.
This minister has been denying it for three days. Five months
ago we heard the same minister denying that HRDC grants were a
problem. She was telling us everything was just fine. Now we
have 20 police investigations into that department for those
grants. Has the minister a plan, even a six point plan, to tell
Canadians what she is doing to protect their privacy?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, very clearly the most important thing we
are doing is working with the privacy commissioner. Let me say
again that he has indicated we are abiding by the laws. He is
saying that the information is secure. He is saying that there
are things we can do to ensure Canadians know the information is
being collected and how it is being used.
I agree there are ways that we could improve it. I hope to work
with him in the future to ensure that security is sustained and
that we can ensure Canadians that the information being collected
is held appropriately.
* * *
THE ENVIRONMENT
Mr. Bill Blaikie (Winnipeg—Transcona, NDP): Mr. Speaker,
my question is for the Minister of the Environment. We now know
that the Minister of the Environment, along with Mexico, vetoed a
recommendation by the NAFTA environment commission to investigate
the enforcement of Canada's environmental laws.
Could the Minister rise in the House and tell us why he did
that? While he is on his feet, could he tell us what his
response is to the charge by Robert Kennedy, Jr., that Canada is
deliberately trying to undermine the NAFTA environmental
commission?
He dismissed the claims made by the NDP environment critic on
Monday to the same effect as rubbish. Is he prepared to say to
Robert Kennedy, Jr., that his claims are also rubbish?
Hon. David Anderson (Minister of the Environment, Lib.):
Mr. Speaker, I never thought I would rise in the House to tell
members of an opposition party that by their own admission they
believe an American political figure with little contact with
Canada knows more about what we do in the environment than they
do as a group. That is incredible. Members of the NDP admit
they know nothing and they are relying upon someone from outside
the country as an authority on what happens here.
With respect to the first part of the question, if I may, and
with respect to the Quebec livestock case, the Quebec government
and the auditor general of Quebec, there has been an
investigation. The process has been changed.
Any continuation of this investigation would be strictly
historical.
* * *
1450
MINING INDUSTRY
Mrs. Michelle Dockrill (Bras d'Or—Cape Breton, NDP): Mr.
Speaker, there is growing concern that the contract between the
government and the prospective buyer of Devco includes conditions
for no development, no expansion. No development means no more
mining industry in Cape Breton.
Could the minister today guarantee the House that coal
production will continue in Cape Breton? Will he make it a
condition of the sale? Or, will Cape Bretoners continue to watch
imported coal from Colombia being delivered on their shores by
Canada Steamship Lines while Cape Breton coal stays in the
ground?
Hon. Ralph E. Goodale (Minister of Natural Resources and
Minister responsible for the Canadian Wheat Board, Lib.): Mr.
Speaker, the whole objective of the sale process with respect to
the assets of Devco is to place the coal mining operations of
Cape Breton on a secure long term foundation for the future of
the private sector in the most viable terms possible.
Obviously we will be looking for a transaction that has within
it the best possible economic terms, most especially the
maintenance of the largest number of jobs for Cape Bretoners.
* * *
[Translation]
NATIONAL DEFENCE
Mr. David Price (Compton—Stanstead, PC): Mr. Speaker, we have
learned that, when the Prime Minister visits France, he will be
discussing a directed contract for replacement of the Sea Kings.
He will be meeting with representatives of the French government
and of Aérospatiale and Daimler Chrysler.
My question is for the Minister of National Defence. Is the
government planning a directed contract to purchase in France the
Eurocopter Cougar 2 as a replacement for the Sea Kings?
[English]
Hon. Arthur C. Eggleton (Minister of National Defence,
Lib.): Mr. Speaker, as I have said before, no decision has
been made with respect to the procurement strategy on the
replacement of the Sea Kings. It is our number one priority. We
have that matter in front of the government. It is a major
procurement matter. Of course, an elected, accountable
government must make a final decision about that.
What the hon. member is saying is not true. No decision has
been made by the government. We certainly want to get on just as
quickly as we possibly can. We are moving the file along and
finalizing the procurement strategy so that we can get on with
the replacement.
Mr. David Price (Compton—Stanstead, PC): Mr. Speaker,
that is very strange. Our information says it seems that the
Cougar II may come with a promise of a Daimler-Chrysler plant,
probably in Shawinigan. A more interesting angle is that this
deal may also come with a promise of neutrality from the French
government in the next Quebec referendum.
Will the Prime Minister or the Deputy Prime Minister assure the
House that a competition to replace the Sea Kings will be fair,
open, public and in accordance with the approved statement of
operational requirement?
Hon. Arthur C. Eggleton (Minister of National Defence,
Lib.): Mr. Speaker, all of that sounds like a lot of nonsense
to me. We are proceeding to replace the Sea Kings with a
helicopter that will meet our operational requirements. It is a
major government expenditure. We want to make sure that the
Canadian public gets best value for the taxpayer dollar and that
it meets the needs of the Canadian forces.
* * *
[Translation]
MISHTAPEW AWARDS OF EXCELLENCE GALA
Mr. Guy St-Julien (Abitibi—Baie-James—Nunavik, Lib.): Mr.
Speaker, my question is for the Minister of National Revenue.
Last night, the Liberal minister from Outremont attended the
gala for the Mishtapew awards of excellence held at the Capitole
in Quebec City. This was a perfect occasion for celebrating and
congratulating the determination of business leaders from a
number of Quebec's aboriginal and Inuit communities.
Can the minister let us know what his priorities are for
promoting the long term economic development of the aboriginal
and Inuit people of Quebec?
Hon. Martin Cauchon (Minister of National Revenue and Secretary
of State (Economic Development Agency of Canada for the Regions
of Quebec), Lib.): Mr. Speaker, of course I thank my colleague
for his excellent and important question.
Yesterday evening, at the Capitole in Quebec City, the third
gala of the Association d'affaires des premiers peuples was
celebrated. It celebrated the absolutely extraordinary dynamism
that characterizes the new wave of economic development.
The Canadian government was rather proud to renew its
partnership in the context of this gala. We therefore announced
that we will be providing an additional $1.5 million of support
to the association, in order to enable it to provide other
services to the first nations business community, such as
services to entrepreneurs or—
The Speaker: The hon. member for Lakeland.
* * *
1455
[English]
HUMAN RESOURCES DEVELOPMENT
Mr. Leon E. Benoit (Lakeland, Canadian Alliance): Mr.
Speaker, the minister of HRDC said in response to a question
earlier that she would not tolerate a breach of security in her
department.
Listen to this dandy from the HRDC security audit: “When asked
to define and describe their interpretation of an IT security
breach people did not know exactly what this term meant or how to
report it”.
How could the minister claim that she will not tolerate a
security breach when the people in her department do not even
know what an IT security breach is?
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, I can think of nothing better to say than
to remind the House what the privacy commissioner said in his
report.
He first of all identified that the way we were using this
information was useful in terms of improving the quality of our
programs. He said that HRDC people were being careful with what
they do with this information. He said “I am not suggesting
either that they have done anything unlawful here or that is not
legal”.
We have to remember that things are in working order here, but
we have to ensure in the future that remains true. That is why
to me it makes sense for us to continue to work—
The Speaker: The hon. member for Rimouski—Mitis.
* * *
[Translation]
SMART COMMUNITIES PROGRAM
Mrs. Suzanne Tremblay (Rimouski—Mitis, BQ): Mr. Speaker, the
Department of Industry launched a special competition for smart
communities.
Groups from Bromont, Laurier—Sainte-Marie, Rimouski, and
Shawinigian were among the finalists from Quebec. The winner was
Groupe Forces, whose general director, Mario Pépin, was suspended
following the CITEC scandal.
In order to remove any doubts about the merit of the winning
project, will the Minister of Industry promise to make public the
criteria used in judging entries, and the results obtained by
each of the finalists?
Hon. John Manley (Minister of Industry, Lib.): Mr. Speaker,
there was a completely independent process for determining which
communities could apply as smart communities.
There are some who did not qualify and who had no trouble
understanding that it was an independent committee.
[English]
The mayor of Deer Lake, Newfoundland, said “I have been around
government for many, many years and I have not seen a process as
fair and apolitical in my whole life as this one was. These
people won it on their own merit so our committee offers sincere
congratulations to them”.
* * *
[Translation]
EMPLOYMENT INSURANCE
Mr. Yvon Godin (Acadie—Bathurst, NDP): Mr. Speaker, on May 9,
members of this House unanimously approved a motion to review the
EI program.
Recently, the Minister of Human Resources Development announced
a recommendation to change the boundaries of EI economic regions.
Will the Minister of Human Resources Development tell us today
when all the changes to the EI program will take place, because
the regional committees are waiting to see what the response to
their recommendations will be?
[English]
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, if the hon. member is referring to the
process of consultation on the EI boundaries, it has begun. It
was gazetted on Saturday. There are 30 days now for all
Canadians to consider the proposals that have been presented.
They were built with the support of citizens across the country
but now more have the opportunity to comment.
I would expect that the hon. member himself may wish to make
comment in this regard over the course of the 30 day period.
* * *
HUMAN RESOURCES DEVELOPMENT
Mr. Bill Casey (Cumberland—Colchester, PC): Mr. Speaker,
my question is for the minister of HRD. The privacy commissioner
recently described the comprehensive files about Canadians. I
should like to ask the minister if she will provide me with my
file, complete with the names of all government agencies that
have accessed my file.
I would like her to do it without going through the delay
process of the access to information process. I would like her
to explain if she will provide my file and, if not, why not.
Hon. Jane Stewart (Minister of Human Resources Development,
Lib.): Mr. Speaker, as I have said time and again, I think in
this particular circumstance, should the hon. member want that
information and would like to detail the source of information he
would like in particular, he should best go through the access to
information process.
* * *
CRTC
Mr. Roger Gallaway (Sarnia—Lambton, Lib.): Mr. Speaker,
my question is for the Minister of Canadian Heritage. For two
days last month CRTC commissioners actively participated with
industry representatives at the Canadian Cable and Television
Association convention.
At a time when many Canadians question the neutrality of the
CRTC, would the minister care to comment on the propriety of the
commissioners' actions?
1500
[Translation]
Mr. Mauril Bélanger (Parliamentary Secretary to Minister of
Canadian Heritage, Lib.): Mr. Speaker, it is entirely proper
that CRTC commissioners make efforts to improve the public's
understanding of the CRTC as well as to improve their own
knowledge of the technological evolution in the
telecommunications industry.
This is why CRTC commissioners regularly attend a number of
business and consumer conferences.
Not so long ago, I personally attended a dinner organized by a
consumer association in which CRTC members participate. This is
therefore behaviour that we encourage.
* * *
PRESENCE IN GALLERY
The Speaker: I wish to draw the attention of members to
the presence in our gallery of His Excellency, Mr. Alami Tazi,
the Minister of Industry, Commerce and Handicrafts of Morocco.
Some hon. members: Hear, hear.
[English]
The Speaker: In this order I would like to hear the last part
of a point of privilege, then I will take the Thursday question
from the opposition House leader, and then I will hear a point of
order from the member for Dartmouth and then whatever comes after
that.
To put everything in perspective, a few days ago the hon. member
for Wild Rose rose on a point of privilege. Today we will hear
the other side of this argument.
* * *
PRIVILEGE
CORRECTIONAL SERVICE CANADA
Hon. Lawrence MacAulay (Solicitor General of Canada,
Lib.): Mr. Speaker, I wish to rise to respond to a question
of privilege raised on May 16 by the hon. member for Wild Rose.
The allegations made in the question of privilege are serious.
I agree with the hon. member that members of parliament must be
treated with respect by Correctional Service Canada and by all
parts of the government. That is why I have spoken at length
with both the commissioner of Correctional Service Canada and to
the corporate secretary to the service concerning this matter.
Mr. Speaker, I have been advised that there was no threat to
withhold information made by anyone in Correctional Service
Canada, nor was there any attempt to intimidate either the hon.
member or his staff.
First, it should be noted that the commissioner and the
corporate secretary have often dealt with the hon. member's
assistant in the past.
1505
In fact, the hon. member's assistant had placed a phone call to
the corporate secretary last Friday concerning this very report.
In this instance I have been informed that following question
period on Monday, May 15, the corporate secretary phoned the hon.
member's office seeking particulars regarding the report to which
he had referred in question period.
Although the hon. member's assistant offered to fax a copy of
the report to CSC, the corporate secretary declined that offer
and indicated that she would get the report from senior
Correctional Service Canada officials in the prairie region. When
she was unable to locate the report within the CSC in a timely
fashion, the corporate secretary phoned the hon. member's office
and the hon. member's assistant again offered to fax her a copy
of the report.
I am advised that when no fax was received, the corporate
secretary placed a further call to the hon. member's office. She
stated that she was on the speakerphone because she was in a
meeting with the commissioner and the headquarters management
team. The management team wished to discuss the report in an
effort to respond to the hon. member's question as quickly as
possible.
I have been informed that the hon. member's assistant indicated
that she would not be able to provide the document. The
commissioner inquired why the report would not be provided and
was advised that the hon. member had instructed his assistant not
to provide the report.
The corporate secretary concluded the conversation by stating
she would continue her efforts to obtain a copy through CSC
channels.
Fortunately for the commissioner and the corporate secretary,
this conversation took place with nine other CSC executives in
the room. These people have each confirmed that both the
commissioner and the corporate secretary acted in a businesslike
manner and that they did not at any time say that the CSC would
refuse to offer the hon. member help or information concerning
that report or any other Correctional Service Canada matter.
These nine individuals have also confirmed that the tone assumed
by both the commissioner and the corporate secretary through the
conversation was professional and was not intimidating or rude.
When the corporate secretary asked me the other evening what
would have happened if there had been nobody else in the room, I
did not have an answer for her.
Having reviewed this matter personally, I am satisfied that CSC
and its officials at all times acted in a proper and professional
manner. I therefore believe that there is no substance to the
allegations put forth by the hon. member.
The Speaker: What we have is a situation where the
hon. member himself was not there to hear the conversation nor
was the hon. minister. We are getting two reports secondhand on
both sides. It is possible, I would imagine, for two different
people to interpret facts in a different way. Both hon. members
are to be taken at their word here. I think that their staffs
passed down their interpretations and there may have been a
misunderstanding on both sides.
I would find that there is no point of privilege in this
particular case. However, I would like some kind of a
communication between the person who is working in the minister's
office and the secretary who is working in the office of the
member for Wild Rose to see if they can straighten this thing out
and get whatever information they need.
* * *
BUSINESS OF THE HOUSE
Mr. Chuck Strahl (Fraser Valley, Canadian Alliance): Mr.
Speaker, could the government House leader give us some idea of
the government agenda we will face for the rest of the week and
for the week after the break week coming up?
1510
Specifically, could he give us the status again of the grain
transportation act which I asked about last Thursday? We are
looking forward to getting our hands on that as quickly as
possible.
Also, is the Minister of Justice planning to bring forward any
type of a review or changes to the Privacy Act about which we
have been musing in the House of Commons?
Hon. Alfonso Gagliano (Minister of Public Works and
Government Services, Lib.): Mr. Speaker, the business
tomorrow will be report stage of Bill C-12, the labour code
amendments.
Next week is a constituency week. When the House resumes on May
29, the business will be Bill C-16, the citizenship bill; Bill
C-33, the species at risk legislation; and Bill C-31, the
immigration bill.
Tuesday, May 30 shall be an allotted day. I understand that
there will be agreement to sit later than usual to consider a
proposed change to the migratory birds convention.
On Wednesday, May 31 we hope to deal with third reading of Bill
C-12.
With regard to the two specific pieces of legislation to which
the opposition House leader referred, I will transmit the
question to our House leader. I am sure that when he is back in
the House tomorrow, he will answer that.
The Speaker: I am now going to hear a point of order from
the hon. member for Dartmouth.
* * *
POINTS OF ORDER
DIVISION NO. 1319
Ms. Wendy Lill (Dartmouth, NDP): Mr. Speaker, I would
like to ask the House that the record show that the MP for
Dartmouth was in fact not in the House for the first vote last
evening. She was in fact approaching it at a run but was not in
her seat and the hon. member realizes that was not good enough.
Ironically the hon. member was late for this vote because she
was in the West Block at the launch of a new book about M. J.
Coldwell, a parliamentarian with such honesty and integrity that
it has reached legendary proportions.
I apologize for my error in judgment and any difficulty it may
have caused. I will work harder to keep the standards high in
this important public place.
The Speaker: The hon. member's statement is noted.
GOVERNMENT ORDERS
[English]
SUPPLY
ALLOTTED DAY—CANADA HEALTH ACT
The House resumed consideration of the motion and of the amendment.
Mr. Gary Lunn (Saanich—Gulf Islands, Canadian Alliance):
Mr. Speaker, I am pleased to speak about the very important issue
of health care. We have seen the decline of health care for a
number of years. I can only go to the facts in my own riding with
which I am very familiar. I hear the stories from across the
country about waiting lists. I would like to take a few minutes
to talk about some of these problems and then what I see as the
solution to fix health care in the country.
For those who are not from British Columbia, Victoria is in my
riding of Saanich—Gulf Islands. Victoria has one of two level
two ICU pediatric intensive care units. The other is in
Vancouver. The Victoria level two ICU unit for children is in
the process of closing purely because of money. I spoke
privately with Mr. Closson, the CEO of the Victoria health board.
He told me that this discussion started purely because of
economics.
There are other concerns. Saanich Peninsula Hospital is in my
riding. Health services are being restructured there as well.
What are we seeing? We are seeing a decrease in the level of
service. It is believed that the hospital will be shutting down
the emergency department and will have only acute care beds.
Patients on the Saanich peninsula will now have to go to Victoria
General.
1515
The problem is that wherever we go in this country, from coast
to coast to coast, the level of service is decreasing and the
waiting lists are getting longer. The system is seriously
broken. I think members opposite recognize that we need to
revisit how we deliver health care. If we look at the
demographics, the population is aging. Nobody can deny that
greater demands will be placed on our health care.
I personally believe in one national public health care system.
We need to work harder to make sure that happens. Our health
care system is sacred to Canadians. The status quo is not going
to do it now. We saw the magnitude of something like $25 billion
knocked out of health care in the last seven or eight years,
which is a significant amount of money. When that much money is
taken out of the pot, it is impossible to deliver the same amount
of health care.
Beyond the financial aspect, we also have to be very innovative.
We have to look at new ideas and be open to them. We have to be
open to change on how we can best deliver the most amount of
health care to Canadians and that the money we put in reaches the
patient.
There are two side to this, the money side and the innovative
side when looking for new ideas for delivering health care.
I first want to talk about the economics of health care. We
often hear members from all parties in the House talking about
putting more money into it. It needs to be emphasized that there
is only one way we will be able to put the amount of money into
health care to sustain it for a long time and that is through the
private sector. I am not talking about the private sector
creating its own health care system.
However, it is important to understand that governments cannot
create wealth. The only people who can create wealth is the
private sector. I firmly believe, if we want to have a truly
sustainable health care system that Canadians can be proud of,
that we will have to cut taxes to make Canada number one in the
world and allow the private sector to flourish so that we attract
investors from around the world to come to Canada. Only then
will we begin to create wealth that the government can then use,
through taxation, to deliver health care.
That me brings to the second part of why I got into politics.
When I spoke to Mr. Closson in Victoria, he said “Mr. Lunn, yes,
we are having to restructure what services we deliver out of what
hospitals because there is only such money in the pot and we can
only deliver so much. He continued on to say that they had a
bigger problem that was not getting the emphasis it needed. He
said that in Victoria this summer they will have to close
hospital beds because they will not have the staff. He said that
they could not attract people for summer relief because they were
going south. He said that the brain drain in the health care
sector was a real crisis, that it would take a long time to fix
it and that they needed to start now.
We are not addressing those concerns and it comes back to taxes.
It is my personal belief that this all comes back to economic
prosperity. I firmly believe that if we are going to have the
money to deliver health care, if we want to attract people to
stay and if we want the graduates out of post-secondary school to
achieve their dreams, we will have to look at how we tax people.
I want to emphasize that because I do not believe it is said
often enough.
The other half of the equation is that we have to be innovative.
We often hear about bill 11. The New Democratic Party motion, in
particular where it says “we have grave reservations about
investing public funds in private for profit facilities”, are
words it likes to use to try to raise the hair on the back of
people's necks. It talks about profits and corporations making
money. I absolutely believe that we have to look at what is
being done in Alberta before we blatantly criticize it. At least
Alberta is trying to be innovative.
1520
I firmly believe in a truly national public health care system,
not the two tiers that we have now. The majority of the Canadian
population lives within 100 or 150 kilometres of the U.S. border.
The border very accessible to people across the country.
The status quo is not working. I know my colleague from Okotoks
is listening with interest to this and feels very passionate
about this subject. I am no expert in this, but maybe the private
sector could do a better job in some parts of our public system.
For example, with MRIs and CAT scans, maybe there are places
where clinics could be set up that could do a better job at
delivering these services. This would reduce the waiting lists
across the country. I do not know, but we have to be open to
looking at these ideas.
If we are going to be able to deliver health care to an aging
population, we need to ensure that we receive the very best value
for our health care dollars. I do not know the actual number,
but I think we spend something in the magnitude of $90 billion on
health care globally across the country. That is a number that
we cannot even wrap our heads around.
Are we getting $90 billion worth of health care? The people in
my constituency would argue that they are not. I am going to a
meeting on Saturday when I go home because people are really
upset about the emergency ward being shut down at the Saanich
Peninsula Hospital. They are shutting down one of two ICU level
two pediatric units in British Columbia. All of them will now
have to go over to the children's hospital in Vancouver. When we
start to withdraw our services in various areas that is wrong.
I personally will be voting against this motion because I think
we need to be innovative when we look at how we deliver health
care. We have to be open to new ideas. They may not work but we
need to know that and we need to let the rest of the provinces
learn from that. Let us try new things. Let us collectively
collect all of that information. If we need to open the Canada
Health Act, let us make it better and stronger.
Most important, we need to look at the economics of this. We
need to attract investors from all sectors. We need to reduce
taxes so people will want to stay in the country. It has been
proven in every single jurisdiction, whether it is Hong Kong,
Ireland, Ontario or Alberta, that when taxes are cut government
revenues go up.
Let us make Canada number one. We can be better than the United
States. We can be the best. We need that economic wealth if we
want to sustain the health care that Canadians take so much pride
in.
* * *
BUSINESS OF THE HOUSE
Mr. John O'Reilly (Haliburton—Victoria—Brock, Lib.): Mr.
Speaker, I rise on a point of order. I believe you will find
unanimous consent for the following motion. I move:
That this House endorse the initiative of the delegation of
members of parliament, under the leadership of the Minister of
Veterans Affairs and composed of a member of each party
officially recognized in the House, to travel to France and to
return to Canada with the remains of the unknown Canadian soldier
who gave his life in defence of liberty during World War I.
The Acting Speaker (Mr. McClelland): Does the hon. member
for Haliburton—Victoria—Brock have the unanimous consent of the
House to present the motion?
Some hon. members: Agreed.
The Acting Speaker (Mr. McClelland): Is it the pleasure
of the House to adopt the motion?
Some hon. members: Agreed.
(Motion agreed to)
* * *
SUPPLY
ALLOTTED DAY—CANADA HEALTH ACT
The House resumed consideration of the motion and of the amendment.
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): Mr.
Speaker, I have a couple of questions for the member of the
Canadian Alliance Party.
During his comments he implied that the words that we were using
in this motion, private for profit, were there simply to raise
the hairs on the backs of people. I want to tell the hon. member
that the words in this motion are an accurate depiction of
reality.
The reason this motion is here today is to make a deliberation
and a determination about where we want to go with our health
care system.
1525
I sat through question period today and heard over and over
again from members of the Reform Party about how offended they
were regarding breaches in privacy legislation and about their
demands to change the law to ensure that fundamental rights are
not violated.
When it comes to something as fundamental as the right of
Canadian citizens to quality health care, why does the member's
party not believe it is important enough to stand up for? Why is
that party prepared to support the Liberals in a most passive,
inactive response to a fundamental shift in our health care
system? Why would that party endorse any system that ensures
different treatment depending on ability to pay?
Mr. Gary Lunn: Mr. Speaker, first, I want to remind the
member, in case she has forgotten, that we are the Canadian
Alliance and we are very proud of that.
Second, why are we staying on the HRDC issue? I remind the
member that this government gave more money in this fiscal year
to grants and contributions under HRDC than it gave to health
care. That is why we are questioning it. We do not believe in
that program and we think we need to look at it again and
redirect money into core programs, such as health care.
Do I believe a private for profit health care system is
inflammatory? Yes. We have specialists in the public health
care system who get paid very well, as they should. If they can
also earn a living in a private setting and do just as good a
job, then we should be open to that. I believe in my heart that
the status quo is not going to work.
Let us listen to the people who want to try new ideas. This is
not about politics, this is about something that is very dear to
Canadians. We have to be open to new ideas. We have to look at
how we deliver health care. We have to make sure we can afford
it.
With all respect to the member, the only thing I hear is that we
should raise taxes, which I do not agree with. The NDP believes
Canadians should be taxed more. Since I have belonged to the
Canadian Alliance, formerly the Reform Party of Canada, nobody
has ever once suggested that health care should not be available
to every single Canadian. It should be available to every single
Canadian regardless of their ability to pay. We in this party
believe in that principle and we will fight for it. However, we
will not have that if we are not open to new ideas, not willing
to try new things and if we do not recognize that we have to have
the economic prosperity to deliver those programs. If we stay on
our present course, public health care will no longer be
available. That is a fact.
The issue of health care is something Canadians take seriously.
Let us look at it, cut out all the politics and work together to
find solutions instead of playing politics with this issue.
Mr. Ted McWhinney (Vancouver Quadra, Lib.): Mr. Speaker,
it is a pleasure to intervene in this debate which has given us
the opportunity across party lines to examine the Canada Health
Act and the fundamental principles of which our system of social
insurance and health is based.
My own constituents have made it very clear to me, and I have
communicated their views to the Prime Minister and the
government, that as we attain our budgetary surplus, as we have
done in the last three years, 50% of the surplus should be used
to reduce taxes and amortize the external public debt and 50%
should be used in priority areas, such as advanced education,
research and health and health insurance. Those principles have
been accepted by the present government and they are the hallmark
of the present budget and the present administration.
Many on this side of the House would take credit for the health
care system and the work of Paul Martin Sr., the distinguished
minister of health of some years ago, in the establishment of the
Canada Health Act and the establishment of the five fundamental
principles on which it is based: universality,
comprehensiveness, accessibility, portability and public
administration.
1530
The motion before us is very specific and it has been given an
even more specific association with the reproaches to the
Minister of Health that he has not been combative enough, that he
has not gone mounted on a charger against the enemy, sword in
hand, and put them to flight. This minister is known for his
quiet judgment and the use, as many skilled appellate lawyers
like himself have, of the velvet hand in the iron glove, or
reversing it if hon. members wish, the iron hand in the velvet
glove. In other words, economy in the use of power, but use
power when one has to. It is reproaching the minister for being
something that he is not.
Our preference is co-operative federalism. We are often
reproached for not being co-operative enough. It is interesting,
from one of the parties in opposition, to have the reproach that
we are not aggressive enough and we should be more so.
We have been trying to have a dialogue with provinces over a
period of years; not always a happy situation. Some provinces,
given money for education purposes, have used the moneys to build
highways into the never never land. We do not like that and in
those cases we are forced to take action of a corrective nature.
In relation to health care and health services, it has been
suggested to us that we are neglecting certain legal principles.
It has been said that we should get a reference to the supreme
court. That is a misunderstanding of the nature of the supreme
court reference. The supreme court reference is always on a
hypothetical question. It is always on an abstract question. It
is not and cannot be a substitute for a case controversy, even an
anticipatory case controversy, and I think the minister, as an
excellent lawyer, rightly rejected that approach and rightly
rejected the possibility of a situation where the supreme court
would rule against us, saying that it would not exercise
jurisdiction.
Equally, however, the suggestions for disallowance of a
provincial bill, bill 11, ignore the fact of the evolution of our
constitutional system. The power of disallowance has not been
used in half a century. In fact, I remember as a private citizen
giving advice to a prime minister 30 years ago that the power was
dead and that there were other remedies, and that it would be a
constitutional voie de fait, a constitutional tort, in effect, to
try to revive it at this stage. That is not our way.
We do, however, have ample powers under the Canada Health Act to
take corrective legislation if and when that should come to be
demonstrated as necessary. But the demonstration, the prior fact
that it is demonstrated as necessary, has to be properly proven
and properly established for us.
There are problems that I will take the opportunity of referring
to, legal problems, and I would hope that these would be
discussed by the Minister of Health with his provincial
counterparts. One of these is simply that if private health
facilities are allowed on a commercial basis, then under the
provisions of NAFTA it is potentially open on a legal ground for
foreign, financially based private institutions—I guess they are
always financially based—from abroad, from the signatories to
NAFTA, to enter Canada on a competitive basis. Some would say in
the spirit of the market economy, what is wrong with that?
I will communicate to hon. members, nevertheless, reservations
communicated to me by the board of one of our great hospitals in
Vancouver—and the boards include many people with skilled
knowledge of NAFTA—that we could see a situation of selective
competition by specialist foreign—that is, U.S.—institutions
with existing Canadian all-purpose hospitals.
In the city of Vancouver, one such hospital I have been
associated with, St. Paul's, right in the heart of the city,
performs the most advanced style of research and corrective
medicine in those areas at the frontiers of medical knowledge.
1535
That hospital is also downtown, so it deals, particularly every
Friday and Saturday night, with emergency cases: hit and run
accidents, incidents in bars, cases of drug overdose. It is
pointed out to me that in terms of quantifying and costing the
hospital administration, those are cases literally handled at a
severe loss in medical terms. They are balanced, however, by the
more specialized type of work this hospital does for which
higher, offsetting compensation is available.
That concern has been expressed to me and I think it is a
serious concern, one which warrants conversations between the
Minister of Health and his counterparts in the provinces, and
this would include the province of Alberta. I can see solutions
here, but it would be premature, I think, to get into these.
The act as it stands has opportunities for the federal
government, constructively and pragmatically, to talk with the
provinces in the spirit of co-operative federalism to see if
differences can be ironed out.
There are some principles that go beyond the five principles of
the Canada Health Act that I have already adverted to, and it is
perhaps worth referring to them.
We make full cash contributions to the provinces on the
principle of good faith, but on a basis of specified conditions,
and I will simply recite them for the record: no extra billing
by medical practitioners or dentists for insured health services,
no user charges, and reporting at the times and in the manner
prescribed in the regulations. These are very basic conditions.
If they are not complied with, the precedent exists, and it has
been used, to cut back, or to indicate that one is prepared to
cut back on the transferring of funds to the provinces.
It is enough in many cases to indicate that the power is there.
It is certainly premature and not good federalism to apply the
remedies before the actual case of conflict exists beyond the
point where it can be settled by negotiation.
The attitude indicated by the Minister of Health is simply this.
On his legal advice he was satisfied that he had no grounds
constitutionally for challenging the specific bill, the Alberta
bill 11, at this stage. This is not to say, though, that at a
future stage, on particular facts, it could not arise on
constitutional grounds.
More importantly, however, if breaches did occur, and one was
satisfied that they occurred through an exercise of ill faith or
a lack of appreciation and respect for the principles of
co-operative federalism, then the machinery could be set in
motion of corrective legislation by the federal parliament, or
the use of the full discretionary power that remains in the
federal government to withhold, to reduce or to block altogether
the transfer of funds to the provinces.
I say, in this context, that there are extremely positive
initiatives which flow from the emphasis that my constituents and
I gave, and no doubt other people in the government caucus, and I
am sure other members on the other side of the House, to the
emphasis on spending of surplus constructively in subsidizing
medical research and services. The present budget provides $2.5
billion additional to the Canada health and social transfer. It
is a 25% increase over the last two years alone. There is a
further cash component that will reach $15.5 billion in each of
the next four years, and it will continue to grow as the economy
increases.
I welcome, on the government side, the support given by all
parties in opposition for spending our money on medical research.
The amount of investment in medical research is simply
remarkable, and I would say to members on the other side of the
House that the concentration on the frontiers research in
medicine in western Canada is truly remarkable.
1540
I take great pride in the concentration in British Columbia, but
it does extend to other provinces. That is reflected in the
extra funding under other areas of the budget for research, for
fundamental research in medicine, for the creation of the
millennial professorships which will allow us to arrest the brain
drain of our leading medical researchers who have been going to
the United States. There are already very welcome signs for
people who could quadruple their salaries in the United States by
moving there that they are satisfied with the relatively modest
increases in their stipendiary under the millennial professorship
plan and they intend to remain here.
This joins the increase in cash transfer payments and the
commitment that we have made and the minister in particular.
This is a man who relies on friendly persuasion, but as an
experienced lawyer well recognizes that a certain element of
power can be used, if it should be, but it should not be
escalated or opted for in too quick a fashion.
That is our position. At the present stage we are monitoring
the situation in relation to the province of Alberta, which has
been specifically raised with us. We will seek to work with the
province of Alberta. If we find that actions taken are
incompatible with the Canada Health Act we will move at the
appropriate time. But we will continue to discuss. We will
bring, in particular to the attention of the province of Alberta
and its health minister, the fears that we have under NAFTA.
I would be very sorry to see an institution like St. Paul's have
its frontiers research experience and expertise drained away by
competition from a sort of single issue specialist institution
from another country. I think that any institutions coming in
would be expected to play their part in carrying on what might be
called the ordinary, tedious, but so vital a part of hospital
administration's work.
That is the message from the minister. He will not engage in an
unnecessary war with the provinces. He is determined to maintain
the five fundamental principles of the Canada Health Act. He is
determined to see that there will be full co-operation by the
provinces in the spirit of that, but he will look to ways of
working with them to effectuate that purpose.
Mr. Grant Hill (Macleod, Canadian Alliance): Mr.
Speaker, the member for Vancouver Quadra lives fairly close to a
private clinic called the Cambie Clinic. This clinic is unable
to look after individuals from British Columbia. It is illegal
for them to enter the door. But this clinic can look after
people from the U.S., from Asia, from Alberta, people who come
from outside B.C.'s boundaries. However, those who are Workers'
Compensation Board patients and those who have become sick
through the armed forces or the RCMP have access to that private
clinic.
Does this clinic cause any anxiety to the member opposite?
Mr. Ted McWhinney: Mr. Speaker, I thank the member for
that question. This is the sort of issue that I would expect, in
the spirit of co-operative federalism, will be part of the
ongoing discussion between the federal government and the
provinces.
In the specific province that has been discussed, the province
of Alberta, our big fear is that it will possibly lead to a two
tier system of medicine in which the financially privileged will
get extra and prior benefits to others. I think that the debate
would become simpler if it could be established that such a
danger did not exist, but we have to work on the assumption that
the principle of fundamental equality of access and of treatment
is the bedrock principle of the Canada Health Act. On specific
cases, just as I mentioned with the NAFTA situation, I would
myself look for further discussion. But we cannot change that
bedrock principle. It is fundamental to us and fundamental to
the Minister of Health.
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP):
Mr. Speaker, I am tempted to put a rather rhetorical question to
the member, having listened to his very thoughtful remarks, and
ask whether Liberal members of parliament were put through a
workshop before this debate where they were all trained to
express grave concern and then make excuses for the inaction of
their government.
1545
It is fine for us to call for co-operative, thoughtful
approaches at the federal-provincial level, but are we really
prepared to forsake medicare in the interest of keeping peace at
the federal-provincial table no matter what the consequences?
If in fact we could believe for one minute that the member's
government would be prepared to act immediately upon a violation
of the Canada Health Act given bill 11, how can we wait for one
second knowing the consequences under NAFTA? Is it not better to
be safe than sorry? Is it not better to take every precaution
now and amend the act so that there is no possibility of this
bill opening the door so that multinational American corporations
are able to enter our health care sector in Canada and provide
hospital services?
Mr. Ted McWhinney: Mr. Speaker, I advise the hon. member
that if one expects an immediate decision from NAFTA one may be
very disappointed. These are lengthy labyrinthine processes. The
issue was raised with me because the answers require extensive
research and my opinion was asked. I simply said that there will
be time, but it is a matter that we need to discuss with the
provinces and to point out to the premier of Alberta that this is
a matter of concern. If the issue would arise as a practical
matter, there are intermediate legal steps that we could take to
block any action, and we would take them.
I think it is important not to jump into a case-controversy
situation before it exists. That is why I stress the necessity
for study and caution before acting. As far as approaches in
this government are concerned, my constituency has a very large
number of medical practitioners, professors of medicine and
others. They have been educating me in their discipline, which I
admire and respect. It is part of my response to them that I
have campaigned for the last three or four years to establish the
centres for innovation, those special centres for medical
research that are parts of the last two, three, four federal
budgets.
Most of my colleagues are getting the message, just as I think
every member on the other side of the House is getting the
message that the principle of universality of access to medical
care is fundamental to Canadians. If it is threatened in any way
in the interstices of federal-provincial relations, we will come
down on the federal side. If there is no threat or if the
actions of the provinces can be reconciled with those principles,
we would be in my view ignoring our responsibilities as part of
the federal system if we put it in issue.
As things stand we have full powers. We have not at the present
time on the legal advice given to the Minister of Justice found a
case warranting action of a punitive nature against a province.
Mr. Peter Stoffer (Sackville—Musquodoboit Valley—Eastern
Shore, NDP): Mr. Speaker, I have great respect for the member
for Vancouver Quadra, but in a province like Nova Scotia, for
example, we have a critical shortage right now of nurses and
doctors. There is no light at the end of the tunnel that this
situation will improve.
I ask the member for Vancouver Quadra who is a representative of
the Government of Canada what his government will do to address
the very serious situation of the shortage of nurses and doctors
not only in Atlantic Canada but in more rural parts of the
country.
Mr. Ted McWhinney: Mr. Speaker, it is a very crucial
because one of the facts of life one discovers on talking to
medical deans and deans of nursing schools is that a very large
number of our graduates of nursing schools go on to the United
States.
If one experiences any of our hospitals one will know a good
proportion of the staff is immigrants from other countries.
Solutions there will require larger solutions to the brain drain
problem.
Part of that is bound up with the principle of reducing taxes
which is, as I have said, part of the policies my constituents
have communicated. We have 50% of the budget surplus going into
tax reduction and amortization of the external debt.
1550
We have looked at the issue of subsidizing medical and nursing
schools by means of scholarships and the like. We still face the
problem that the salary is too low. We have to get more money
into the hospitals. Then we are getting into provincial
jurisdiction. We may have to move on that.
Some of us have said what a pity the constitution was not
written in 1967. We would have given advanced research and
perhaps advanced education to the federal government. Then
somebody reminded me that in 1864 universities belonged to the
federal government. It was a vestige of royal power. It was
after a whiskey laden voyage around Cape Breton and the like that
federal representatives dropped higher education into the
provincial area of responsibility in 1867.
There, though, we are dealing with problems on which the
provinces must move, but I think proposals for ways in which the
federal government can help will be received. I take that as the
thrust of the hon. member's question.
Mr. Peter Stoffer (Sackville—Musquodoboit Valley—Eastern
Shore, NDP): Mr. Speaker, before I start on this very
important issue, I just want to say that I could not help but
notice what a great place the House of Commons is for our pages
who come from all parts of the country to work and use up their
first year of university education.
It is doubly exciting to know that one of those pages is with us
today in the capacity of our Hansard concerns. It is
wonderful to see them use the experience they gain as pages in
the House to secure gainful employment in the House of Commons in
other capacities. It is wonderful to see. It is a great
improvement for our young people.
Speaking about young people and what we hope to give them in the
future, we in the New Democratic Party hold health care as the
primary issue. It is the core of what we do in most cases. It is
the aspect of why people like Tommy Douglas, M. J. Coldwell and
many others brought the issue to the forefront time and time
again. I also wish to say that I will be splitting my time with
the member for Regina—Qu'Appelle.
I had mentioned to the member for Vancouver Quadra that in Nova
Scotia we have a critical shortage of doctors. We also have a
critical shortage of nurses. There is a lack of dollars in what
the federal government is transferring to the province. The
provincial Conservative Party said during its last campaign that
health care would not be reduced in any way, shape and form. Then
it took $51 million from health care in the recent provincial
budget.
That instils fear in the people in rural parts of my riding.
Indeed that is the case in all of Atlantic Canada and in Nova
Scotia especially. It instils fear in seniors, people of fixed
incomes and single mothers with children. They wonder what will
happen to them if they become seriously ill. Will the hospital
remain open? Will there be an ambulance for them? Will they be
able to afford the so-called extra user fees that are being
charged?
Right now pharmacare for seniors in Nova Scotia has gone up
another $160 per person. They simply cannot afford that. Any
government, municipal, provincial or federal, should not balance
its books on the backs of our most vulnerable people, our
seniors. In many cases they are veterans who fought overseas and
lost their brothers and sisters. Many of them raised their
families during the depression, during war and during the
post-war eras as well. It is absolutely unacceptable for
governments to treat them that way in their golden years.
Our seniors are our knowledge base. We talk about a knowledge
based economy. Our seniors have more history and more knowledge
than we could ever care to think about. For governments to treat
them as a cash cow on which to balance their books is simply
unacceptable. There are many other avenues on which to balance
the books without taking it out on our seniors, especially those
in the beautiful province of Nova Scotia.
In terms of the hospitals right now, the stress within hospitals
is phenomenal. In the news today the husband of a personal
friend of mine required bypass surgery.
He went to the hospital the other day and waited seven hours for
his surgery. He was told at the last minute that his surgery had
been cancelled and he would have to come back another day. This
is the type of health care we are giving people in Nova Scotia.
This man happens to be 63 years old.
1555
Can we imagine the confidence the youth of the country would
have in the health care system as they go through life after
reading stories like this one? It is sometimes amazing and
sometimes not very surprising at all why some people choose
greener pastures in other parts of the world when they leave
Canada. We in the House all say that Canada is the number one
country in the world. One of the reasons for saying that is our
health care system or our medicare system. It is absolutely
unacceptable that governments at all levels in all provinces have
been chipping away at that most basic and fundamental foundation
by which we define ourselves as Canadians.
Other hon. members have mentioned that it is time for the
Minister of Health, along with all premiers of other provinces,
territorial leaders and aboriginal leaders, to get together in a
health care summit to start defining the health care of the
future.
In poll after poll the people of Canada have demanded through
their tax dollars a publicly funded not for profit health care
system. This is what Canadians want. This is what they are
saying loud and clear. It is not very difficult. They are
asking for a publicly funded not for profit health care system to
be available for everybody from coast to coast to coast, no
matter what their income and where they live. In the unlikely
event that they require emergency health care, long term health
care, or any health care under any circumstance, they want the
service to be there for them. Right now many Canadians are
losing trust and faith in the system. It is absolutely
unacceptable that we as members of parliament, the leaders of the
country, are saying to them that we really do not know the future
of health care.
I always like to recite the story of when Tommy Douglas first
introduced health care. He was hung in effigy by doctors in
Saskatchewan. He was considered Satan. They asked how he could
take away the right to earn dollars from medicine and socialize
medicine, how he could possibly think like that.
Many New Democrat members of parliament were at the Canadian
Medical Association awards dinner the year before last when Tommy
Douglas was posthumously inducted to the Canadian Medical
Association Hall of Fame. This just showed how ahead of the
times he was. He personally fought battles so that the
experiences he had would not happen to any child in the country.
Our party and indeed all Canadians owe Mr. Douglas, Mr. Coldwell
and many others in the movement a sincere debt of gratitude.
Without them we probably would not be having this debate today
and we would probably be into the American style right now.
It is unacceptable that many groups would love to see a two tier
system. Insurance companies would love it. American
multinational corporations would love it. Health care spending
is anywhere from $40 billion to $90 billion. The figures bounce
around a lot. Many private businesses would love to get their
hands on that. The fact is that it would place a tremendous
burden on those Canadians who cannot afford it, those Canadians
who are on fixed incomes, and those Canadians who do not have the
wherewithal to compete like that.
I should remind the House that according to the latest
statistics from the United States 43 million Americans have no
access to health care services, a land that calls itself the land
of the great, the home of the brave, the land of great democracy.
I would hate to be in the House years from now saying that three
million Canadians have no access to health care.
That would be a disgraceful thing to have to say.
1600
It is why the New Democrats have brought forth this motion
today, so we can stress to the public and fellow members of
parliament from all parties the seriousness of this issue. We
cannot allow health care to be eroded any more than it has now.
We have to reinvest in health care and understand that it is the
core public concern today. Everyone talks about health care.
For all governments at all levels to sit back and say that they
will think about it and that they are gravely concerned about it
is absolutely unacceptable. We have to put those words into
action. Part of that action starts with this motion today.
I encourage all members of parliament to think deeply, to look
into their hearts and talk to their constituents. See what they
say about this motion and what they are saying about health care.
I am sure they would find that the majority of people in their
ridings agree with us.
Members themselves probably would agree as well, if they would
get away from the politics of it and understand what defines us
as Canadians. Members should forget about being Liberal, Canadian
Alliance, Bloc Quebecois, Tory or New Democrat and think in terms
of being fellow Canadians, and to know that no matter where they
go in the country if they become ill they will have the best
quality health care possible. People should not have to go into a
hospital wondering whether they have enough money for a
particular procedure. That would be unacceptable.
If I can do one thing in this House of Commons as a member of
parliament for my own two children, it is to stand and fight for
the number one concern of Canadians, which is health care. That
is why I am standing today on this very important subject. I want
my children to have the same access to health care that I had
when I broke my leg, when I had my appendix out, when I had my
tonsils out, when I fell out of a tree, landed on a fence and
stayed for a week at the Vancouver children's hospital back in
the 1960s.
I had access in all those instances. My parents had nine
children and ran a group home for over 400 children. All those
kids had access to health care as well. We have to be able to say
that 20 or 30 years from now the children of tomorrow will have
the same quality access I had when I was a young man.
I thank the House for the opportunity to speak to this very
important motion. I literally beg all members of parliament from
all parties to seriously consider this motion and to support the
New Democrats on this one.
Mr. Grant Hill (Macleod, Canadian Alliance): Mr.
Speaker, I had an opportunity to ask the member from Vancouver
what he thought of a private facility in Vancouver. Let me take
the opportunity to ask the member from Nova Scotia what he thinks
of the Wolfville hospital in Nova Scotia. That hospital was
threatened with closure and the Wolfville citizens said, “You
are not closing down our hospital”.
Here is what they did. They said they would disregard some of
the rules and regulations and charge people for some things such
as syringes when they go to emergency. That is against the
Canada Health Act according to the rules. That is a user fee.
However, the people of Wolfville said their hospital was more
important than some rules.
What does the member from Nova Scotia say to the citizens of
Wolfville who valued their hospital more than the rules?
Mr. Peter Stoffer: Mr. Speaker, I thank the hon. member,
who himself is a physician, for his question. Unfortunately I do
not know about the situation at Wolfville at all. It is the
first I have heard of it and I apologize for not knowing about
it.
I will relate an experience that I do know. Dr. Herb Dickieson,
who is the leader of the Prince Edward Island New Democrats, was
elected in 1995 because he stood on the principle that he did not
want his O'Leary hospital closed. At that time the government of
the day in Prince Edward Island was going to shut it down. He
fought along with the citizens of that area to keep that hospital
open. I am not aware of what he did in terms of funding in order
to keep the hospital open.
I can only say to the people of Wolfville that I would assume,
and I do not know this for sure, that they probably would not
have had to go to the user fee aspect if all governments had
respected and honoured the commitment of dollars to that hospital
and had not put those people in that situation in the first
place. Desperate times call for desperate measures. I am sure
they do not like charging user fees for other things as well.
In retrospect, I would have to say that without knowing the
incident, those people did what they felt they had to do and
there is not much I can say about it. I wish them well in their
endeavours but the fact is, if provincial and federal governments
did not download and shirk their responsibilities, the people
probably would not have faced that situation in the first place.
1605
Hon. Lorne Nystrom (Regina—Qu'Appelle, NDP): Mr.
Speaker, today's debate is a very important one in terms of the
future of health care in the country.
I come from Regina. Regina was the birthplace of public health
care in the country many years ago. It really started with the
CCF in the election of 1944. It was after the Great Depression
and there had not been an election since 1938 in the province.
The previous Liberal government had gone on for six years during
the war without an election campaign. When the campaign came,
Tommy Douglas and the CCF were swept to power. One of the
promises they made to the people of that province was for health
care and hospitalization.
In those days there was not any thought at all of the federal
government cost sharing health care. Under our constitution,
health care comes under the jurisdiction of the provinces and the
federal government gets involved through the use of the spending
power, but it was a long time before those discussions were held.
The CCF came to power in that small province of about one
million people. They had come through the Great Depression and a
tremendous dust bowl in terms of drought. There was bankruptcy
such that the province was almost foreclosed upon by the bankers.
Despite that, three or four years after it came to power, the
CCF set up the first hospitalization plan anywhere in North
America. That was about 1948.
As the years went on, it became more and more popular and the
idea caught on around the country that public health care was
extremely important. By the time the CCF government had improved
and strengthened the economy with balanced budgets and so on, it
made a commitment. In 1960 with Tommy Douglas as premier, it
promised it would bring in North America's first public medicare
program.
The people of Saskatchewan re-elected Tommy Douglas and the CCF
and they had a mandate to bring in public health care. Tommy
Douglas resigned about a year later to become the leader of the
federal New Democratic Party, but the minister of education, Mr.
Woodrow Lloyd, became premier. It was Mr. Lloyd who was premier
at the time medicare became a reality in the province of
Saskatchewan.
I was 14 or 15 years old at the time and just going into high
school. I remember the summer of 1961 or 1962 when health care
came in. There was a doctors' strike against what they called
the socialistic move to intervene in the marketplace in terms of
health care. The opposition of course was the Liberal Party but
it was a very conservative Liberal Party, quite similar to what
is called the Canadian Alliance today or the Reform Party. It
opposed this as a tremendous infringement on the freedom of
Saskatchewan people and predicted that it would spread across the
country.
The doctors' strike went on for about 28 days and created a
great deal of emotion. There were many demonstrations and a lot
of struggle and debate in the province, but the provincial
government prevailed. I remember very well seeing a picture of
the leader of the opposition, because the legislature was not in
session in the summer, going to the legislative chamber and
demanding that the speaker call a special session to deal with
the doctors' strike. Of course it did not happen, but I still
remember the picture of him kicking the door of the Saskatchewan
legislature. He had his foot up in the air and he was kicking
the door. That snapshot of him went right across the country.
The people prevailed and the CCF government of Woodrow Lloyd
prevailed. In 1961 and 1962 we had our first ever medicare
system anywhere in the country, financed entirely by the people
of the province of Saskatchewan as the federal government was not
involved in any way in a cost sharing program in those days.
A few years later the federal government established the Hall
commission with Justice Emmett Hall of the supreme court.
He looked at the idea of a national health care program and
federal funding for health care along with the provinces in a
co-funding operation.
1610
In 1967, centennial year, I think Lester Pearson was Prime
Minister at the time and the health minister was Paul Martin Sr.,
the federal government finally brought in a national health care
program modelled on the prototype in the province of
Saskatchewan. The agreement was that the federal government
would cost share with the provinces 50% of the costs for health
care. In other words for every dollar put up by the province of
Nova Scotia, Saskatchewan, or British Columbia the federal
government would put up a dollar as well.
In the original negotiations the federal government was not
going to be that benevolent or generous. But guess what, it was
an Ontario premier in those days as well, and the Government of
Ontario under Robarts was threatening not to participate in the
national health care program. When the federal government
decided to put up 50% of the costs, the carrot was so big that
even Ontario with its wealth in those days decided it could not
afford not to participate and became part of the national health
care program we know today.
Things went pretty smoothly for a number of years. Then in the
1970s if I recall—I was a member of parliament by that time
being elected in 1968—the federal government of Pierre Trudeau
brought in a bill that untied the federal contribution from going
directly to health care in terms of the transfers to the
provinces. I remember Tommy Douglas sat roughly where the
Conservative Party is sitting today at the far end of the
Chamber. He stood up and said that if we untied the federal
contribution to health care, that which goes directly to health
care, the day would come when the federal government involvement
would lessen gradually and gradually and we would have a crisis
in the funding of health care.
I remember him speaking in Winnipeg in about 1981 or 1982 and
giving the same warning in front of a huge crowd at a national
convention. I remember him saying that people assume that health
care is here to stay. We assume it is here. It is a good plan.
We assume it is here forever but some day someone is going to try
to take it away and that day is not too far down the road. How
true that was.
If I were to sit back in those days and predict who would try to
do it, I do not think I would have predicted it would be a
Liberal government that would get us into a health care crisis.
However it was the Liberal government, the Prime Minister and the
Minister of Finance and their famous budget in 1995 that had the
most radical cutbacks in social programs and health care this
country has ever seen at any level of jurisdiction in the history
of Canada.
I look across the way at the member from New Brunswick, the
minister in charge of homelessness, the Minister of Labour. I
know her background in activism. I sometimes wonder how she can
sit in that government and support it after these tremendous
conservative cutbacks that Brian Mulroney would not have even
contemplated in his most conservative days when he was Prime
Minister.
That is the legacy of the Liberal Party that sits across the
way. Now we are in a crisis. We are in a crisis where some
provinces, such as Alberta, are getting into the business of two
tier medicine and looking at privatizing part of the medical
system, allowing people to get back into health care for a
profit. If we go down that steep and slippery road, the time will
come when health care will be destroyed. We will have two
systems in this country, one for the rich who can afford to buy
the extras, jump the queues, get health care, and one for the
poor who have to line up at the doors of public care
institutions.
The reason public health care started in the first place was so
that each and every Canadian citizen, regardless of wealth,
regardless of income, regardless of region would have equal
access to a public health care system. That is the kind of
system we are going to have to keep in this country.
I will close by saying something that makes it even more sad in
my opinion. I picked up this morning's newspaper and the
headline was, “Federal surplus is higher by $11 billion”. The
federal surplus is $11 billion higher for the year 1999-2000 than
was predicted in the budget last February. In other words the
federal surplus will be $14.9 billion instead of the predicted
$3.9 billion, an extra $11 billion. A lot of that extra $11
billion could have been spent on health care in terms of helping
the crisis from one end of the country to the other.
1615
The money is there. It is not as if we were running a huge
deficit. It is not as if we cannot afford to do this. The money
is there. What we are lacking is the political will. That is
why we tabled this motion in the House today to try to instigate
a great national debate, to say “Health care is the most
important priority in the country. It is about time we reinvest
in social programs, starting with health care”. The money is
there. Let us use the people's money to invest in a good health
care system for the people of this country for our future.
Mr. Peter MacKay (Pictou—Antigonish—Guysborough, PC):
Mr. Speaker, I commend the hon. member for his participation in
this debate, for his words and the actions of his party in
bringing this debate forward. It is very timely and very useful
that we embark on this debate.
I also thank him for the feint praise that he heaped upon the
Progressive Conservative Party, although I believe it should be
real praise when one compares the record of that government to
the current government.
I listened very carefully because I, like all members of the
House of Commons and the Senate, am extremely concerned about
what is taking place. One only has to visit our local hospitals,
and I have, the Aberdeen Hospital in New Glasgow, St. Martha's in
Antigonish and other health clinics, to know the effect that is
being felt at this time as a result of the drastic cutbacks that
have been downloaded to the provinces as a result of this
government's actions. It is, as the previous speaker has
indicated, very stark when one considers that this surplus
continues to grow while the provinces are crying out for
reinvestment in this area.
It is fine to engage in this debate and to talk about what is
wrong with the system, but what seems to be missing is: What are
some positive initiatives that we can take?
The Progressive Conservative Party and the hon. member for New
Brunswick Southwest, who is our health critic, have put forward
some positive ideas. He talked first and foremost about the
resources that need to be put back in, putting them back to 1993
levels. He also talked about convening a first ministers'
conference with premiers.
What positive initiatives are the hon. member and his party
putting forward as to how we could fix the crisis in health care?
We could talk about it until the cows come home, but what is he
presenting as a positive initiative that would work to move the
yardstick forward in this area?
Hon. Lorne Nystrom: Mr. Speaker, we have a five point
plan, which starts with more cash from the federal government.
That is what I spoke about today. The federal government is
putting in about 12 cents or 13 cents on the dollar. It used to
be 50 cents on the dollar and we have to start moving back toward
that level of contribution.
Mr. Steve Mahoney: You know that is not true.
Hon. Lorne Nystrom: The member across the way is now
trying to interject. He is saying that it is untrue. It is 12
cents or 13 cents on the dollar, depending on the province.
Those are well documented facts. The only people who dispute
them are some Liberal members of the House of Commons. If we
look at Statistics Canada, that is the kind of information we
get.
The other things we are talking about are home care and
pharmacare, as well as amending the Canada Health Act to make
sure that bill 11 in Alberta does not pass without the Government
of Alberta being penalized. Those are three or four of the
points that we are talking about.
Mr. Grant Hill (Macleod, Canadian Alliance): Mr. Speaker,
I appreciate the member's nice, historical overview of health
care. He mentioned Justice Emmett Hall. It is interesting to
note that Justice Emmett Hall's son became an orthopaedic surgeon
and was so frustrated with the Canadian situation and the
technology that we have in Canada that he left. He has abandoned
the country of his dad and the country that trained him.
I try to go to the home community of each speaker on this issue
and ask a question about what is going on. I lived in
Regina—Qu'Appelle as a young man and I have a couple of
colleagues who still practise there.
What does the member think, when there is a shortage of capital
in his community, of a foundation that is set up to raise money
for those nasty for profit corporations? It raises money for
MRIs and for equipment that is not available in any other
connection. Those foundations are set up literally across the
country to raise capital. What does he think of those dollars
from those dirty, for profit corporations?
1620
Hon. Lorne Nystrom: Mr. Speaker, it is unfortunate that
people have to do this. The money is in the federal treasury.
There should be more money put into transfers from the federal
government. The surplus is now $11 billion more than it was
thought to be only a few months ago. The federal government
should be putting up its fair share of the money. If that were
to happen, then private fundraising would not be required.
I also say to the member that Saskatchewan is one of the few
provinces which backfilled the drop in federal contributions
dollar for dollar. That is actually quite a feat for a small
province which does not have a big treasury like Alberta or
Ontario.
[Translation]
The Acting Speaker (Mr. McClelland): It is my duty, pursuant to
Standing Order 38, to inform the House that the questions to be
raised tonight at the time of adjournment are as follows: the
hon. member for Dartmouth, Communication; the hon. member for
Beauséjour—Petitcodiac, Human Resources Development.
[English]
Mr. Bryon Wilfert (Oak Ridges, Lib.): Mr. Speaker, I will
be splitting my time with my colleague from Mississauga West.
I am pleased to participate in today's debate concerning the
Canada Health Act and to deal with the issue of enforcement.
The federal health minister is responsible for monitoring
provincial and territorial health systems to ensure that they
adhere to the criteria and conditions of the Canada Health Act.
Canada's publicly funded health care system is a partnership.
In terms of the federal government, Health Canada is responsible
for the administration of the Canada Health Act, while the
provinces and the territories are responsible for the
organization and the delivery of health care services in their
respective jurisdictions. This shared role requires us to work
in close co-operation with one another.
The Canada Health Act contains nine requirements that the
provinces must fulfil to receive their full share of federal
funds, which are provided to the provinces and territories in the
form of tax points and cash under the CHST. These include the
five program criteria of public administration,
comprehensiveness, universality, portability and accessibility,
which apply to insured health services.
In addition to the five criteria, there are two conditions of
the act, information and recognition, which apply to not only
insured health services, but also extended health care services.
As members may know, insured health services are medically
necessary hospital and physician services. Extended health care
services are nursing home intermediate care services, adult
residential care services, home care services and ambulatory care
services. Finally, there are the extra billing and user charge
provisions, which only apply to insured health services.
The Canada Health Act provides sufficient flexibility for the
provinces and territories to restructure their health care
systems so that they continue to respond to the individual needs
of their populations.
Changes to Canada's public health care system can occur without
violating the principles of the Canada Health Act. We all know
that the time has come for a national effort to renew and
strengthen medicare. All governments believe that the status quo
is no longer an option. The changes required can and should
occur within our public health care system. The principles of
the Canada Health Act are broad and flexible enough to allow for
innovation while building on the strengths of our single payer
system.
The federal government's commitment to maintaining the
principles of the act is to ensure that the integrity of one of
the best health care systems in the world is not jeopardized and
that Canadians continue to have access to a comprehensive range
of medically necessary services on the basis of their need, not
on their ability to pay.
Many potential issues of non-compliance with the Canada Health
Act criteria or conditions over the years have been resolved
without resorting to CHA penalties. In these instances,
discussion and negotiation at the official level were
instrumental in bringing these matters to a satisfactory
conclusion.
1625
In the event that discussions and negotiations between the
federal and provincial officials prove ineffective in reaching a
resolution, the Canada Health Act provides a process by which
suspected violations can be investigated and resolved, or indeed
penalized.
When the federal health minister receives information and is of
the opinion that there is a suspected violation of the act, the
minister must undertake consultations with provincial and
territorial counterparts. Only after these consultations does
the minister proceed to invoke the penalty provisions of the act,
if the facts of the matter under investigation confirm that a CHA
violation has occurred.
Under the Canada Health Act penalties for violations of the
criteria and conditions are financial. The government uses moral
suasion and financial penalties under the CHST to persuade the
provinces and territories to take corrective action.
While the government is prepared to act if there are violations,
let me reiterate that it is always our hope that we do not reach
that point, that issues of potential non-compliance can be
resolved through discussions and negotiations, without resorting
to penalties.
There are broad, fundamental challenges which are facing the
health care system in Canada. The federal government is
committed to working with the provinces and the territories to
meet these challenges. We would always prefer to build on the
co-operative relationship we have shared with provinces and
territories over the years, and to build on the creativity and
innovation which created our public health care system that is
the envy of the world.
In response to the auditor general's concerns about Health
Canada's capacity to enforce its responsibilities vis-à-vis the
Canada Health Act, the federal minister made a statement to the
House of Commons on Thursday, May 11, announcing a budget
increase of $4 million to the existing $1.5 million for the
Canada Health Act division. This will allow for an increased
enforcement capacity to monitor and assess compliance with the
act across Canada, as well as to investigate potential
non-compliance issues on a proactive basis.
As well, the announcement of the realignment of the
administration of activities at Health Canada on April 17 will
strengthen the department's regional presence and increase the
policy and analysis capability in the regions to strengthen
Health Canada's ability to monitor Canada Health Act compliance
on the ground.
Information is an essential tool for the federal government in
administering the Canada Health Act. To that end, Health Canada
is developing an improved information gathering framework that
will assist the federal government in improving its monitoring,
assessment and reporting of provincial and territorial compliance
with the criteria and conditions of the Canada Health Act.
Health Canada's response to the auditor general's report, and to
Alberta's bill 11, will result in the development of a process
which will ensure a comprehensive and fair approach to the
administration of the Canada Health Act. This new approach will
take time to implement and requires the support of our provincial
partners. This is why the government is working closely and
collaboratively with the provinces and territories on all the
issues related to the Canada Health Act.
Our goal is to ensure that the underlying principles of our
health care system are protected for the benefit of all
Canadians. By working with the provinces we are putting a much
needed emphasis on making the co-operation and administration of
our cherished, publicly financed health care system more
transparent and accountable to Canadians.
In closing, I want to reaffirm the government's commitment to
working with the provinces and territories to ensure compliance
with the principles and conditions of the Canada Health Act. The
changes that are needed to see us into the 21st century are
possible within the public health care system, and are fully
consistent with and supportive of the principles of the Canada
Health Act.
Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): Mr.
Speaker, we heard a great deal from the Liberal member about
plans by the government to enforce the Canada Health Act. This
is of course used as an excuse for its inaction on bill 11.
1630
My question for the member is quite simple. All the enforcement
officers in the world will not mean anything if there is nothing
left to enforce. A million medicare cops will not do anything if
the bill and the consequences under NAFTA are allowed to proceed.
Can the member not see the importance today of amending the
Canada Health Act to ensure that there is absolutely no
possibility of private for profit hospitals being allowed to be
included as part of our health care system?
Mr. Bryon Wilfert: Mr. Speaker, I outlined very clearly
the process by which the federal government would respond if
there were a violation of the Canada Health Act. Having the
appropriate information and the proper monitoring is critical.
I will point out to my hon. colleague one of the difficulties we
have. Earlier she talked about the fact the we as a federal
government gave about 11 cents to 13 cents to the provinces.
Again I want to correct that. It is about 33 cents to 34 cents
in cash and tax points. I heard some provincial members say that
they do not recognize tax points. If that is the case we should
simply take them back.
In answer to my colleague, one way to add to the accountability
of provinces that are responsible for the administration of
health care is to add two new principles: accountability and
transparency. If the provinces do not feel that the tax points
are of much use to them, maybe the federal government should take
them back and go back to silos. My hon. colleague from Regina
Qu'Appelle mentioned the fact that we had gone to the CHST. I
would suggest to him that maybe we should go back to silos and
say that this is for health; this is for post-secondary
education; and this is for social services. This would put the
onus back on the provinces where it belongs.
In terms of accountability, when we transfer money to the
provinces we have no idea what they do with it. Coming from the
province of Ontario I can point out very clearly that the
province is sitting on half a billion dollars. At this point it
has the ability to provide for tax cuts, but it does not seem to
be able to provide for the administration of hospitals, which is
in its jurisdiction. Those are two principles that my hon.
colleague might think about in this debate.
Ms. Angela Vautour (Beauséjour—Petitcodiac, PC): Mr.
Speaker, if I am correct, I should remind the member that the
change to the CHST was made under his government. We know that
is a problem.
Would the member admit that lack of funding is the cause of the
problem we are seeing in health care right now? Every province
is asking for health care funding to be restored to the 1993-94
level. Why is the member's government not restoring it so we can
stop the privatization of our health care? I did a survey in my
riding—
The Acting Speaker (Mr. McClelland): I am sorry to
interrupt but the member's time has expired.
Mr. Bryon Wilfert: Mr. Speaker, I point out to my
colleague that last year the government restored $11.5 billion in
health care transfer payments. It was the largest amount of
money that any government put into the health care system. Again
this year we put in $2.5 billion.
We have provinces crying for money at the same time as they are
giving tax cuts. The Ontario government will mail every taxpayer
in that province a $200 cheque. That is $1 billion. If it can
afford those kind of tax cuts while sitting on half a billion
dollars, it cannot cry wolf too often as it has.
Maybe my colleague might ask her kissing cousins in Ontario,
although I am not too sure how close they are in terms of kissing
any more, what is going on. How can it afford tax cuts but not
afford to restore health care which according to her is a
priority under its watch?
1635
Mr. Steve Mahoney (Mississauga West, Lib.): Mr. Speaker,
while my colleague was attempting in a very articulate manner to
answer the question we could hear cat calls coming across
indicating that it was not enough. That is the mantra of the
NDP. Perhaps that member should cross back into the NDP fold.
Hon. Lorne Nystrom: No, no.
Mr. Steve Mahoney: He does not want her. I can
understand. This is an interesting situation. I thank the NDP
for putting the motion forward today. We owe it to all of our
constituents to talk about the issue of health care, the issue of
bill 11, the issue of whether or not it is enough, the issue of
the tax points and the issue of cash transfers. It is very
confusing. All my constituents want us to do is to fix the darn
system. They do not care much about who is responsible.
Part of the difficulty, however, is that we have this convoluted
mechanism called Canada whereby we have entered into agreements.
Members opposite know full well that the federal government's
role is to collect revenue from around the country and
redistribute it to the provinces for various services.
We are not allowed to deal directly under the terms of the
constitution and the agreement. It is up to us to provide a
certain floor, ceiling or whatever. It is clearly up to the
provincial governments to deliver the health care services to the
people. All we need do to find out the difficulties is to have a
loved one who is involved in it.
Since I am here most of the time, my wife and I, and my wife
particularly, are going through the terrible experience of having
a family member with a serious illness who is in and out of
hospital. She is phoning 911 at three o'clock in the morning and
frantically going to the hospital where she is being kept for two
or three days and then discharged back into her home. Then it is
911 again and the ambulance costs. I am talking about this
occurrence happening five or six times a month every month for
the last several months.
We have tried to find out how we can put her into some kind of a
care facility to ensure that someone is available to take care of
her and can react to it. The waiting lists are incredible. We
are talking years, unless one is in a position to do what the
former Reform Party and current CA would have us do, that is
simply privatize it all. Then if one has the money the waiting
list disappears. We do not believe in that. I think this debate
is all about a vision for health care.
The New Democrats should always be congratulated for the
leadership that some of their former leaders, Tommy Douglas and
others, showed in bringing into Saskatchewan and then on to the
national stage the necessity for a health care system based on
the five principles.
The first one is universality, which means that it is available
to all regardless of financial status.
The second is accessibility, which means that we should be able
within any kind of reasonable timeframe to access whatever health
care is needed.
The third is comprehensiveness, an issue that I think the
provinces are flirting with, never mind bill 11. When they start
deregulating and decommissioning certain health care services
from OHIP, in the case of Ontario, and start saying they will not
pay for certain services, in essence they are flirting with
damaging the comprehensiveness of the system. That is an issue I
have not heard members talk about today. I think it is something
we need to watch very carefully.
1640
The fourth is portability, the ability for a Canadian from
British Columbia, Nova Scotia or Ontario to access a
comprehensive health care plan right across the country.
The fifth and final one is administration. What is the issue
there? The issue is that if we do what some would do, if we do
what Tom Long, the former leader of the former Reform Party and
the former treasurer of Alberta who is a member of the former
Reform Party, public administration goes out the window. I am
sure hon. members get my point in using the word former.
Why is that important? Canadians know that there must be a
sense of control in costs and in what kind of health care is
being provided. If it is turned over to the private sector in a
for profit scenario, I think we lose that control.
I want to talk about another issue. The New Democrats should be
particularly interested in this one. There is a health clinic in
my home of Sault Ste. Marie. It is a health clinic that operates
on a capitation system. In a city of 80,000 with two hospitals
there is also a health clinic. Capitation means it submits a
roster, a list of the members of the health clinic, to the
provincial government and the provincial government gives the
clinic a cheque. It does not operate on the OHIP principle. It
operates under capitation.
Who do we think built it? It was not the government. I can
tell hon. members that no provincial or federal money was put
into the health clinic in Sault Ste. Marie. It was built by the
private sector, except that the private sector in this case
happened to be the United Steelworkers of America. It was built
by the union. It was built with its funds, with its membership
money. It was done in the fifties and it was great. The reason I
know a bit about it is that my dad was the national director of
the union at the time it was built.
I often quote a man named Johnny Barker in Sault Ste. Marie who
was a great union leader. He had one of the greatest lines that
I like to tell NDP members they should remember. Johnny Barker
once said “Don't let your bleeding heart run away with your
bloody head”. It is a terrific quote and NDP members should
think about it more often.
Johnny Barker and my dad built the health clinic in the Soo.
Some say it was a fight between Sault Ste. Marie and Hamilton.
The reason it went to the Soo, they tell me, is that dad and
Johnny Barker used to get together and drink the odd glass of
pop. They got to be great buddies and they decided the clinic
should go to the Soo.
Who knows what the reason was? However, do members know why it
was so effective? It was because there was a large membership,
which tragically does not exist there any more, that worked at
the steel plant. There was a local community that could be
harnessed. There was a membership that could be developed and
brought in for health care services, and it worked.
I have tried to promote this idea in other communities. I went
to the Chinguacousy Health Board in the city of Brampton when I
was in the provincial house and suggested that it take a look at
the model in the Soo. It is a terrific concept. It involves the
community. It makes sure that health care is delivered. It was
built with private dollars. It is operated on a not for profit
basis and it truly works.
Instead of just putting their blinkers on and saying that under
no circumstances will they look at anything, perhaps members of
the NDP should take a look at what happened in Sault Ste. Marie.
That clinic, which was built with union money, could be a model
for many different communities around the country.
In the case of Chinguacousy I thought it made sense to get the
CAW and Chrysler involved. Again a certain membership or a group
of people could be identified to be involved. Perhaps the region
of Peel could have been involved. Unfortunately it did not happen
because people still had the grandiose idea that great new
hospitals would be built.
We have a wonderful hospital in my riding, the Credit Valley
Hospital. We call it the Credit Valley Hilton. Those days are
over.
We will not be building those kinds of facilities any more. We
have to find new ways of delivering both in terms of medical
services and in terms of the facilities in which they get
delivered. We have to find new ways of doing it.
1645
Instead of just fearmongering and pretending that none of this
should be talked about, and that we should just amend the Canada
Health Act and punish people, we need to look at news ways and
new alternatives. They exist. I invite the NDP members to check
the record, talk to the steelworkers and check out the operation
in the Sault. I think they will find it is good advice.
Hon. Lorne Nystrom (Regina—Qu'Appelle, NDP): Mr.
Speaker, knowing the member's background and his affinity to the
labour movement many years ago, is he not embarrassed about
sitting in a caucus that is led by a government that has
instigated the largest cutbacks in the history of our country in
terms of social programs and health care?
The 1995 budget of the Minister of Finance was the most
draconian budget in terms of cutbacks in the history of our
country. This government almost makes Brian Mulroney look like a
raving socialist in comparison, in terms of funding for social
programs.
I wonder if the hon. member can tell the House whether or not he
has lobbied the Minister of Finance and the Prime Minister to
reverse their ways, to mend their ways and to open up the public
purse and make sure there is more money going into health care.
I think he saw the statement yesterday as well that the surplus
is now $11 billion more than the government thought it was going
to be. It is $14.9 billion instead of $3.9 billion. The money
is there.
What has this member done to lobby the Minister of Finance and
the Prime Minister, or is he part of this great conservative
trend in the Liberal Party that makes Brian Mulroney look like a
compassionate socialist?
Mr. Steve Mahoney: Mr. Speaker, I am probably what one
would call a right wing Liberal. I make no apologies for that.
In fact, not only am I not embarrassed, I am proud of a
government that wiped out a $42 billion deficit and put this
country into a sound financial position so that we can in fact
deal with the problems in health care. Believe me, we will.
I am used to getting misrepresentation from some members
opposite in the official opposition, but it disturbs me when a
man of the quality of the member from Regina stands here and says
something that he knows is patently false. To say that this
government's transfer for health care is 13 cents is just not
true. The member knows that in 1977 the federal government
reduced its share of the tax base and gave the power to tax for
that reduction directly to the provinces. They are called tax
points.
The member knows that when we combine cash and tax points the
amount being transferred is 33 cents. He says that it used to 50
cents. It was when it started. It was reduced because the
provinces increased the number of items being covered down to 41
cents. The real truth here, and let us not play too much with
numbers, is that it has gone from 41% down to 33%.
Yes, that needs to be increased. There is no question about it.
We will work with the provinces. The one thing I can say is that
this government is not about to hand blank cheques to Mike Harris
and Ralph Klein so they can turn around and give 30% tax cuts to
their wealthy friends without putting that money into health
care. We are going to make sure it goes where it is needed.
Mr. Bill Casey (Cumberland—Colchester, PC): Mr. Speaker,
it is certainly a pleasure to rise and speak to this motion
today. I find the motion takes a strange direction. Rather than
have a negative approach, why do we not have a positive approach?
Why do we not say what we can do and not what we cannot do? Why
do we not say what we need is to replenish the health care system
back to where it was in 1994, or 1995 at least, rather than where
it is now, where there is such a crisis in health care and no one
knows whether they can get a doctor, whether the doctor who comes
to their community is going to stay, whether he is going to leave
and what is going to happen? It is the same with nurses and all
other health care workers. It is a crisis.
If anyone thinks health care it is not in a crisis they are
certainly operating under false pretences. It is clear to all of
us. It is certainly clear in my riding where a site was prepared
and the foundation laid for a new hospital years ago. They have
been gathering information and money for seven years and are
still in the planning stages for this hospital. We are still
having trouble putting it together because of the reduction in
transfers for health care funding from the federal government.
1650
The federal government unilaterally began cutting health care
funds when it was the number one issue. Health care is the one
thing that ties the whole country together. Every region, every
province and every culture depends on our health care system.
We have been proud of our health care system in Canada. It has
been the model that many countries have used as the example upon
which to build their health care systems. Then the Liberal
government, which has always prided itself on having a social
interest and a social conscience, just sucks the system dry. It
has reduced funding steadily year after year and then makes these
tiny, insignificant motions to try to pretend it has put money
back into health care. However, it has not fooled anyone.
The premiers have not been fooled. They are all calling for
health care to be the number one issue for the federal government
to address. Every community is asking the federal government to
re-invest in health care and to work with the health communities
to come up with a better system to resolve the issue.
What happens when the federal government withdraws its funding?
The provinces then have to explore other areas. They have to
experiment. They have to become innovative. If the funding was
back at former levels, the province of Alberta would have no need
to do what it has done, and other provinces would have no need to
explore the other innovative angles and efforts they are trying
to experiment with now.
I come from a rural area in Nova Scotia that has a lot of small
communities. We used to have several hospitals in my riding but
they have continually been reduced. They have been turned into
clinics, into senior citizens' homes or into something like that.
Meanwhile, these communities are losing their health care system.
When a community loses a hospital or a health care facility, or
when a facility deteriorates and does not maintain its standards
because it has no money, then the doctors leave. It is very
important for doctors to maintain their practice and to have the
ability update their technical knowledge and training.
Health care is a work in progress. A doctor never finishes
training in health care, especially with the recent developments
in technology, genetics, health care, medications and treatments.
Today doctors have to maintain their ability to compete by
continuing their education and everything else.
The doctors in my riding are faced with obsolete hospitals and
equipment. The money is not there for the new technology and new
equipment that is need to treat the patients and for the doctors
to continue their training.
The waiting lists are incredible. A short time ago I visited
one of the main hospitals in my riding. The hallways were filled
with patients in beds waiting to get a room or just to get into
the hospital. The waiting room was full of patients who could
not get a doctor. When they did get a doctor he or she was a
stranger.
For decades people had family doctors who they could become
familiar with, get to know, feel comfortable with and trust.
Health care is a very personal thing. Today people do not know
their doctors because the doctors change so fast. When the
doctors realize that the workload is too much and the
responsibility too great they pack up and go somewhere else. They
go wherever there is more money, less work, less hours, more
people to share the burden and a much higher quality of life for
doctors. We lose our health care workers. We lose our nurses.
What I primarily run into is the loss of doctors, the turn over
in doctors and the shortage of doctors.
In my job as a member of parliament, I deal a lot with Canada
pension clients, Canada pension disabled clients, worker's
compensation victims and people who need but cannot access the
health care system. They cannot get the help from the doctors
because the doctors do not have the time to deal with these
issues. If it is not an urgent issue, the doctors will not deal
with it. They deal with the patients who need help right away.
Meanwhile, these people who are disabled and are applying for
disability, or need help in worker's compensation or need
specialists to qualify for pensions to which they are entitled,
cannot get support from the health care industry because they are
just too busy.
Recently I talked to a person who had a bad accident. The
person is totally disabled with broken bones and organs that are
damaged.
He cannot get his doctor to write a report because the doctor is
just too busy dealing with people who need care right now. I have
asked the doctor on two occasions to write us a report. I do not
tell him what to say, but we need a report from the doctor and we
cannot get it. That goes on and on.
1655
Just when patients get to know their family doctor, the doctor
changes or moves. This creates a lot of stress for people,
especially seniors and disabled people who have effectively
educated their doctor about their problems, their ailments, their
lifestyle and their situation, and then they have start all over
again. When it happens again and again it becomes even more
stressful.
All we can say about this motion is that it should be a motion
to restore health care funding. That is the solution. Yes,
other changes are needed but they are not going happen without
the money to back up the innovative ideas that are necessary.
There is no question about that.
It all boils down to the fact that the government has reduced
the funding to the provinces and then tells the provinces that
they have to honour the Canada Health Act but does not give the
leadership nor the funding.
How many months, years and times has the issue of health care
been brought up in the House of Commons? The Minister of Health
continues to say that they are working on a plan and that they
need ideas and leadership. The ideas and the leadership are
supposed to come from the government. It blames everybody else
for the problem but itself.
The fact of the matter is that the problem starts right over
there with the Department of Health and the Minister of Health
because they will not make the commitment to health care, which
we have always had in this country, to maintain the health care
system of which we have been so proud for so many years. It is
not complicated. All the government has to do is to restore the
funding to 1993-94 levels and most of these problems will go
away.
I do not disagree that health care is changing really fast.
Technology, medications and treatments are changing at lightning
speed and they have to be baked into this whole process, but
without the money that will never happen. Until the government
makes a fundamental decision to re-fund health care, all these
ideas that the minister speculates about will never see the light
of day without the funding, the research, the development, the
technology and the tools to work with.
We are siding with the premiers of all the provinces. I do not
remember this ever happening before, but all the provinces have
now united in one stand and are demanding that the federal
government restore the money to health care that it has taken
away over the years. I have never seen this happen on any other
issue, not immigration, not transportation, not anything except
health care. The federal government should listen to the
premiers and respect what they are saying because it is actually
the provinces that deliver the health care.
The provinces and the provincial ministers of health understand
the problem and they know what the solutions are. They are
calling on the federal government to restore health care funding.
It is not complicated. They are on the front lines of this
whole debate. They know what the problem is and they know how to
solve it. They have spoken very clearly with one voice.
I just hope that the federal Liberal government will get the
message to stop stalling and to do something. Day after day,
week after week, month after month, year after year there are two
issues in the House that get stalled, one is the health care
issue and the other is the helicopter issue.
Time and time again the federal government says that it is
developing a plan and exploring the options. The Minister of
National Defence has now said that the file is moving. Is that
not what he has said?
An hon. member: A top priority.
Mr. Bill Casey: The minister said that the helicopter
situation is a top priority. I think he is now saying that the
file is moving. Well, it is moving awfully slowly.
It is the same with the health care file. The government talks
about solving the health care problem but it does absolutely zero
about it.
The problem is simple: Just listen to the premiers of all
parties in all the provinces because they are the frontline
people. They are the ones who have to deal with the actual
health care system. It is a simple as that. If it would just do
that, the problem would be solved. Mr. Speaker, I am depending
on you to tell them to do that.
1700
Mr. Gordon Earle (Halifax West, NDP): Mr. Speaker, I was
quite interested to listen to the member, a fellow Nova Scotian,
who spoke about some of the health care problems which we
experience in the province of Nova Scotia. He certainly outlined
many of them well.
He spoke about the waiting lists in hospitals and delays because
of the lack of funding in the health care system. Those
illustrations support the motion we put forward because we are
suggesting that public funds not be allowed to move out into the
private realm and the for profit hospitals. Public funds should
be maintained within the public system. We should strengthen,
maintain and keep this system of publicly funded health care.
I would be interested in hearing the hon. member's views on
another aspect of health care which is very important to this
entire picture of the health care system. That is the issue of
pharmacare, one thing which we feel is very important.
I have witnessed it in my province and many seniors have spoken
to me that quite often they need certain medications but cannot
afford them because of their fixed incomes. Sometimes they
either go without their medication or stretch it out in a way
that is unrealistic according to how it has been prescribed. If
they are supposed to take it three times a day, perhaps they will
end up taking it once a week. They figure they can make the
prescriptions last longer because they just cannot afford their
medication.
I am wondering if the hon. member has any comments on that
aspect of the health care system. There is a need for the
government to put funding into a national pharmacare system to
aid our seniors who have given so much of their lives to our
communities. It is time that we helped them.
In particular, in our province the provincial government has
moved to the extent that it costs the seniors more for their
pharmacare program. It has increased the amount that the seniors
have to contribute to the program.
Would the hon. member comment on that aspect of the health care
system?
Mr. Bill Casey: Mr. Speaker, the hon. member does make an
excellent point. Our party's main point is there has to be a
stable funding program on a long term basis, a program which will
allow the departments of health in the provinces to have a long
term plan. This is not an industry or a business that can have a
six month plan or even a five year plan. The planning has to go
much further than that. To do that the government has to provide
stable funding.
On the pharmacare issue, the member brought up a really good
point. Let me read from the Liberal red book two of 1997. “The
Liberal government endorses pharmacare as a long term national
objective”. I am sure the hon. member will be pleased to hear
that. It goes on to say, “Some provinces are already developing
a system of drug care. We will work with our provincial partners
to ensure that all Canadians have access to medically necessary
drugs within the public health care system”. The hon. member's
problem will be solved because surely the Liberals will honour
all their promises in the red book.
It goes on to say, “The federal government has a role to play
in bringing together its provincial and territorial partners”.
This is strange because it refused to meet with its provincial
and territorial partners on the health care issue, but if it says
so in the red book, it must be true.
Mr. Greg Thompson: Like the GST promise.
Mr. Bill Casey: What else does it say? It is full of
good promises.
“A new Liberal government will pursue a strategy, together with
representatives of provincial and territorial governments”—why
does it not do that—“health care service providers, private
payers”—private payers, is that not interesting—“and
consumers to address the fact that drugs have become an essential
component of health care. We will develop with these groups a
timetable and fiscal framework for the implementation of
universal public coverage for medically necessary prescription
drugs”.
I am pleased to put that on the record for the member. It
answers his question. It is right in the red book, so surely the
Liberals are going to develop a pharmacare program. The hon.
member from Nova Scotia can sleep well tonight.
1705
Mr. John Bryden (Wentworth—Burlington, Lib.): Mr.
Speaker, I am very delighted to rise in this debate because I
have wanted to have my say about the problems with health care
financing for some time. I think the debate has been skewed in
the wrong direction. It is not a matter of giving more money to
medicare, it is a matter of greater accountability.
I regret that my NDP colleagues are leaving the Chamber now as I
begin a speech. They really ought to listen to it because it is
not just a matter of throwing money at issues, it is a matter of
creating the climate of transparency in corporations that deliver
the health services to ensure that the money is adequately spent.
What I am alluding to is the fact that hospitals around the
country are some of the greatest users of taxpayers' money,
something in the order of $30 billion to $40 billion a year. They
are the prime deliverers of health care.
The difficulty is that hospitals are charities and charities are
not governed by any meaningful legislation which requires them to
meet the standards of corporate governance, standards of
transparency. The result is that across the country we will find
hospitals that vary in the quality of their financial
administration and their ability to efficiently deliver health
services. We are talking about billions of dollars of waste
because we cannot see whether the hospitals are spending the
money effectively.
What has happened with the cutbacks in health care, whether the
cutbacks were done by the federal government or the cutbacks were
done by the provincial governments during the mid-1990s, is a
cutting off of the services rather than cutting back the
administration. This was a phenomenon that occurred in the
United Kingdom.
The United Kingdom went through a similar period when it tried
to rein in the high costs of medicare. The British government
cut back investments in its hospitals and what happened was an
enormous cutback in nurses and nursing staff and of course the
administrators remained. The Tony Blair government learned its
lesson and in fact it is restoring many of the service personnel
and cutting back on the administrators.
Mr. Speaker, you might ask what is he really talking about? Does
he have any real examples? We do not have to go very far in my
community to discover a real example of waste in the delivery of
hospital services.
Next to my own riding is the Hamilton Health Sciences
Corporation which last year posted a $40 million deficit. This
coming year it is expected to post a $90 million deficit. Mr.
Speaker, it has something very much to do with the failure of the
board of governors or the failure of the hospital management to
adequately inform the board of governors on the needs of that
hospital and the proper functioning of that hospital.
Indeed, Mr. Speaker, there was a scandal not very many years ago
at the hospital. The chief director was brought in at a huge
salary.
Mr. Steve Mahoney: They are all getting huge salaries.
Mr. John Bryden: Oh, yes. Her salary was something like
$400,000.
The point is, after a couple of years it was decided that she
was not an efficient chief executive officer so the hospital let
her go. It gave her a $1.8 million golden handshake. It
absorbed in one fell swoop all the money that had been raised by
the various hospital association charitable foundations. They
are out there doing telethons raising money to try to buy x-ray
machines and that kind of thing and that money goes to a golden
handshake for an executive it is trying to unload. It is the same
situation around the province.
In fact, in a recent article from my local newspaper it is
suggesting that not only is the Hamilton Health Sciences
Corporation in difficulty, but other hospitals are in trouble.
The London Health Sciences Centre in 1999 ran an $18 million
deficit. Mount Sinai and Mississauga Trillium hospitals were in
an $11 million deficit and the Cardiff Valley hospital was at a
$10 million deficit.
Members may say that the problem is simply that they have a
greater demand than they have the money to meet it. That is
possible, but other hospitals around the country do run within
their means.
1710
So long as we cannot be sure, so long as we do not have the
ability to thoroughly examine the decisions made by a
corporation, made by a hospital or any kind of social services
institute, so long as we do not have the opportunity to examine
how they are making those decisions, we cannot be sure that they
are running efficiently.
Indeed on a smaller scale, in Hamilton there was a classic
instance that was the joke of all the social services providers a
few years ago. If you recall, Mr. Speaker, the Harris government
came in and said it was going to cut 20% off the bottom line of
all the social services organizations that were receiving Ontario
provincial funds. An organization in my riding absorbed that 20%
cut by eliminating all the service staff and just retaining the
administrators and it continued to function without delivering
any services.
The reality is when we talk about cuts to health care we have to
remember that we cannot do cuts to health care until we create
the efficiencies. The reality is if an organization, whether it
is a corporation or a non-profit organization or a charity, is
running really inefficiently and we compare it against an
organization that is running very efficiently and we cut 20%, the
efficient organization is hurt and the inefficient organization
is not touched, no problem, because it can absorb the cutback in
its inefficiencies.
That is the situation. We have done nothing as the federal
government and we have done nothing as the provincial government
to correct problem. What we need to do is we need to have a
debate here not about whether we should restore funding to health
care, we should have a debate about how we can make health care
delivery more transparent, how we can make it more accountable,
how we can make sure that those executive officers are reporting
correctly to their boards of governors.
I have known, and other members in this House will have had the
experience as well, instances where politicians—oh, that word
politicians—have been on the boards of directors of hospitals in
their communities and they have not been able to get the salaries
of their chief officers. They cannot get the information. They
are told, “No, you cannot have that sort of information. That
is confidential”. The difficulty as the situation sits right
now is that every hospital and other charitable organizations
that deliver social services are only as responsible as their
letters patent that were originally formulated for them, and only
as responsible as their boards of directors show due diligence.
One of the sad things about social services and charities that
deliver social or medical services is that too often what happens
is people get on the board of directors in order to have a
credential or in order to have a place in society so that when
they are at cocktail parties they can show what grand
contributors they are to the community because they are on the
cancer society or a hospital board or whatever you will, Mr.
Speaker. But too often these people do not do the due diligence
and they leave it to their executive officers and those executive
officers are not of the very finest quality. We the public have
no guarantee that our taxpayers' money is going to be spent
efficiently.
There we have it, Mr. Speaker. It is so simple. Why can we not
just do something in this legislature? I have to say I have been
struggling with this issue about bringing transparency and
accountability to not for profit organizations for four years no,
maybe five years, and so far we have not come to grips with it.
So far, although I will admit I have had some, shall we say,
warmth of response from cabinet, still there has not been a
commitment.
What is saddest of all is the fact that the very conservative
government that we see in Ontario and elsewhere in the country
but let us take Ontario as the example, is always saying that we
must cut taxes, we must cut spending, we must be efficient. That
is not the government that is demanding transparency of the very
institutions that are absolutely swallowing up money right, left
and centre and not giving us a guarantee that money is being used
effectively.
1715
In my view, it is something that we as a House should certainly
address. We should try to look at the problem of bringing
charitable organizations to account, particularly hospitals.
We have had a tradition, through the 1970s and especially the
1980s and early 1990s, that when we have a problem in society or
a problem where people are not getting the care they deserve—and
it is a serious problem, I will not argue that—we seem to think
that it can be answered by simply throwing more money at it. I
think the government has seen only too well, particularly in the
case of the money that went to the Atlantic provinces to help the
situation when the cod moratorium took effect, a clear example of
where it was very difficult to simply fire money at a problem and
solve it. The analogy to the health care delivery systems is
apt.
If we really care about Canadians who are in need and who are
not getting the services from the health system that they need,
then we as a parliament should be moving as quickly as possible
to create legislation that brings charities and non-profit
organizations under the same level of transparency that now
exists for for profit corporations.
I am sure the members opposite do not realize this, but the
Canada Corporations Act, under which many hospitals and other
charitable organizations are incorporated, provides standards of
corporate governance only for for profit organizations. It
provides standards of transparency only for for profit
enterprises. It specifically excludes from those requirements
non-profit organizations. We have a situation in which a large
hospital, which may be spending billions of dollars, literally,
does not come under the same type of minimum regulations or
minimum requirements for transparency and governance that is
required of a for profit corporation.
I ask you, Mr. Speaker, at the very minimum, let us bring
non-profit organizations and charities under the Canada
Corporations Act when they incorporate so that they at least have
a minimum level of transparency, accountability and standards of
governance. At least let us do that. We would save billions.
The federal government would not have to add to the transfers for
health care, the provincial governments would save money and all
Canadians would benefit.
Mr. Steve Mahoney (Mississauga West, Lib.): Mr. Speaker,
I listened carefully to my colleague's remarks. I find it quite
interesting that CEOs of major urban hospitals, particularly in
the Greater Toronto Area, are paid amounts of money that are
really quite surprising. They are paid $400,000 to $600,000,
which is four to six times the amount of money that CEOs of
entire municipalities are paid. I think his point about
transparency and the need to look at it is well taken.
I am a little concerned, however, about the comment that could
be taken as castigating all volunteers. It is my view that many
of the people who sit on hospital and charitable boards, as well
as those who work in the community, do so out of dedication and
commitment to the community, not simply so they can talk about it
at cocktail parties. Would the member agree with that?
Mr. John Bryden: Mr. Speaker, the member is right. It is
always dangerous to make sweeping statements. There are a great
many volunteers in all types of social and medical service
delivery charities.
The problem is that hospitals have under their control enormous
amounts of money. I think the thing we have to be concerned
about is that people who volunteer for these boards must remember
that when they volunteer for them they are shouldering a very
high responsibility. I would suggest, with great respect to the
many people who do volunteer for such organizations, that they
should not volunteer unless they are prepared to make the
commitment and to put real energy into it.
1720
On the other side of the coin—and I think this is where there
is a fundamental problem—too often people get on these boards
with only the very best of intentions, but they do not bring to
the job the kind of cynical rigour that is sometimes needed by
the boards of directors of large corporations which are managing
huge amounts of money.
We need to change the Canada Corporations Act. We need to set
standards for the boards of directors to ensure that they will
understand very clearly what their responsibilities are and
realize that if they take on that appointment they do so with the
full knowledge that they have a responsibility that is exactly
equivalent to, say, running the Steel Company of Canada, or
Dofasco, or any other large corporation, and perhaps even more
so.
In the case of organizations that deliver our medical
services—and we all need and cherish the ability to have free
services for all Canadians—this is a heavy responsibility and
one which people who serve on these boards of directors can never
take lightly.
Mr. Bill Blaikie (Winnipeg—Transcona, NDP): Mr. Speaker,
no amount of speech-making about the faults of others, whether
they be hospital executives, hospital management or provincial
governments, such as we have heard from the Liberal member who
just spoke, can absolve this federal government of the fact that
it was responsible for the single most massive reduction in
federal transfer payments to the provinces for health care that
this country has ever seen.
That is the root of all evil. The lack of that money is the
root of all evil when it comes to our health care system. It is
what has put hospitals, emergency wards and other health care
facilities in this country in the situation they are in today.
It is what has set up premiers like Mike Harris and Ralph Klein,
who, for ideological purposes, would like to privatize our health
care system. They are using the federal reductions as a cover
for their philosophical agenda.
The massive reduction in 1995 came on top of a systematic
withdrawal of the federal government from funding for medicare
that began in 1982 under a Liberal government. It was under one
of the budgets of Allan MacEachen in which the first unilateral
withdrawal of funding took place, and the first shattering of the
federal/provincial fiscal partnership that medicare represented.
From then on, every single federal government has proceeded to
unilaterally withdraw more and more money from medicare,
particularly in 1995, the crowning glory of cutbacks that the
current Minister of Finance brought in, until we arrived at a
point where the federal government now feels that it does not
have the moral authority to act, even when a province like
Alberta has done something which is so clearly a threat to the
spirit and the future and the practice of medicare.
Why does it feel it does not have that moral authority? Because
of that systematic reduction, culminating in 1995, which puts the
Minister of Health in the pathetic position of only being able to
say to himself—and here we perhaps give him more credit than he
is due—that he might want to act but he feels he cannot because
the federal government has ruled itself out by being a government
that only contributes somewhere between 8 or 13 or 15 cents on
the dollar, depending on whose figures are believed.
There was a time, in 1984, in the context of a previous threat
to medicare that developed through the proliferation of extra
billing by doctors and the charging of user fees by provinces,
when a previous Liberal government and a previous Liberal health
minister, Monique Bégin, was able to act. Though it took a while
to make them act. It took a lot of pressuring by the NDP at that
time.
1725
It has been a bit of a rerun for those of us who were there at
that time. The NDP pushed the Liberal government to do something
about health care. The Tories at that time were silent, in the
same way that the Tories and the Canadian Alliance members are
silent today with respect to protecting our health care system.
At least the minister of health at that time eventually acted
and brought in amendments to the legislation that governed
medicare in the country. It was not always called the Canada
Health Act. It was the medicare act and there was another act.
Those two acts were brought together and made into the Canada
Health Act, which provided penalties for provinces that allowed
the things which the federal government saw to be a threat to
medicare.
The government has admitted that what is going on in Alberta is
a threat to medicare. The difference is that this time we have a
Liberal government that does not have the political courage, the
political will, or whatever we want to call it, to act in a way
that previous government did.
When the history of medicare is written, and when the eulogy for
medicare is given some day, we hope not, but if it is ever given,
they will point to this parliament, this Minister of Health and
this Liberal government as the one federal government that not
only should have done something about bill 11, but should never
have done what it did in 1995, which created the context for bill
11 and all the other attacks on medicare that we have seen since
that time.
Is this really a surprise? The Liberals like to take credit for
medicare, but maybe they will not be so high and mighty about
medicare from here on in because let us remember that they really
only act when they perceive that they have to act. Only in this
case they have even lacked the will to do that.
I am referring of course to the fact that the Liberals first
promised medicare in 1919 to the people of Canada. When did they
deliver? It was 1967. There is always a bit of lead time with
Liberal promises. If we calculate the time between 1919 and 1967
we could figure out when those promises about pharmacare and home
care will be lived up to. We just have to calculate the lead
time that always exists between Liberal promises and delivery.
Of course, some things are never delivered.
What we see here is part of a larger pattern that I do not have
time to go into, unfortunately. However, medicare is one of the
things that people value. It is on a list of things that have
been under attack by the government. I think of medicare, the
CBC, the CNR and Air Canada. I think of a lot of different
public sector institutions, things that we have done through the
agency of government, through the agency of public ownership.
These things have been systematically undermined and destroyed by
the government.
In recent days we have seen the reticence on the front benches
to act with respect to the CBC. We see a lack of will when it
comes to medicare. The government already sold out the CNR a
long time ago, in one of the greatest acts of quizzling economics
I have ever seen, and it finished the job on Air Canada that the
Tories started. It has allowed the whole country to be bought up
week after week by foreign corporations. It is not a record of
which I would be very proud.
Despite all the great cheering that goes on in question period
whenever a Liberal cabinet minister gets up to deliver one of
those—I am not sure what to call it. I am trying to think of
something polite. I certainly would not call it an answer.
I was astounded at the member who spoke before me, albeit he
pointed to some legitimate problems that exist with respect to
how hospitals are run and the way some provinces behave.
However, the way the federal government acted in 1995, the way it
has continued to act now that we have a surplus by not restoring
full federal funding to medicare, and the way the Minister of
Health has refused to act decisively with respect to bill 11 all
adds up to a strong condemnation of the Liberal government with
respect to health care.
1730
All we have asked in this motion is for the government to do
what is its responsibility to do with respect to medicare and
what is within its constitutional jurisdiction. It can put
conditions on the spending of its own money. It can say to the
province of Alberta that it will not transfer money to that
province if it allows for profit hospitals to provide insured
services. It is within the power of the federal government to do
that.
We say that it is against the spirit and the intent of medicare
and of the Canada Health Act. If the Minister of Health does not
agree with us about the current act, he should do what we have
asked him to do today and change it, change the Canada Health Act
as former ministers of health have done and create an entirely
different situation.
We know when we are getting to the Minister of Health because he
gets up and says that we do not have any ideas and that we are
not putting forth any suggestions. We have put forward
suggestions with respect to restoring federal funding so he has
the moral authority to act and also with respect to innovation.
For years we have been talking in this place about how medicare
was only the first step and that the next step was to develop a
more preventive, community oriented model. Now we have suggested
dealing with problems with respect to high drug prices and the
provision of pharmacare and home care. I am just getting started
on the way the Liberals sold out the low cost of drugs with
their—
The Deputy Speaker: I know the hon. member will not want
to get started on drugs because we have run out of time.
It being 5.30 p.m. it is my duty to interrupt the proceedings
and put forthwith every question necessary to dispose of the
business of supply.
The question is on the amendment. Is it the pleasure of the
House to adopt the amendment?
Some hon. members: Agreed.
Some hon. members: No.
The Deputy Speaker: All those in favour of the amendment
will please say yea.
Some hon. members: Yea.
The Deputy Speaker: All those opposed will please say
nay.
Some hon. members: Nay.
The Deputy Speaker: In my opinion the nays have it.
And more than five members having risen:
The Deputy Speaker: Call in the members.
And the bells having rung:
Mr. Bob Kilger: Mr. Speaker, I would ask that the vote be
deferred until Monday, May 29, at the expiry of Government
Orders.
The Deputy Speaker: At the request of the chief
government whip the vote on the amendment is deferred until
Monday, May 29, at the conclusion of the time provided for
Government Orders.
It being 5.30 p.m. the House will now proceed to the
consideration of Private Members' Business as listed on today's
order paper.
PRIVATE MEMBERS' BUSINESS
[English]
PROPORTIONAL REPRESENTATION
Hon. Lorne Nystrom (Regina—Qu'Appelle, NDP) moved:
That, in the opinion of this House, the government should work
towards incorporating a measure of proportional representation in
the federal electoral system, making use of a framework which
includes: (a) a report on proportional representation prepared by
an all-party committee after extensive public hearings; (b) a
referendum to be held on this issue where the question shall be
whether electors favour replacing the present system with a
system proposed by the committee as concurred in by the House;
and (c) the referendum may be held either before or at the same
time as the next general election.
He said: Mr. Speaker, I rise today to put a motion before the
House as a private member, asking that the House conduct a study
in a parliamentary committee of the idea of incorporating a
measure of proportional representation into our electoral system;
that a committee look at the various models which might be
appropriate for the country; and that, if the House adopts one of
these models, we put that model to the people of the country in a
referendum at or around the time of the next federal election
campaign.
1735
I do this realizing that this issue has hardly ever been
discussed in the Parliament of Canada. The last time there was a
private member's motion on the whole idea of changing our
electoral system and bringing in a measure of proportional
representation was back in 1979 when then Liberal member Jean-Luc
Pepin proposed a non-votable motion that was debated by the
House. The last time parliament actually voted on the idea of
proportional representation was back in 1923. That was a long
time ago so I think the time has come now for a debate on whether
or not we should look at changing our electoral system.
Parliament was strangely silent on the issue for most of the last
century.
I also believe that one of the great issues of the next few
years will be the issue of governance or democracy, how we govern
ourselves as a people, how we organize our society, how we
organize our institutions. We talk about governance. We talk
about democracy. We talk about an electoral system. We talk
about the empowerment of people to make sure that they have a say
over what kind of government, what kind of society and what kind
of institutions they want to evolve in Canada.
I believe we have to take a serious look at changing our system.
Most Canadians do not realize that we are one of only three
countries in the world with more than eight million people that
has a democratic system which does not have some measure of
proportional representation. The other countries are the United
States and India. The world has passed us by in terms of
evolving an electoral system that reflects more accurately what
the people want.
Even in the mother of parliaments, the British parliament,
current Prime Minister Tony Blair in his policy of devolution of
powers created a Scottish parliament where some people are
elected through a measure of PR. It is the same in the Welsh
parliament. As a matter of fact in the British Isles all members
of parliament who go to the European parliament from Great
Britain are elected strictly by proportional representation and
the Jenkins committee has recommended PR in England, which I
predict will happen in the election after next.
We are being left behind by modern democracies in the world
along with the United States and India by using the old first
past the post system designed for a two party system. We have
left that behind us about 50 or 60 years ago with a multiparty
system that creates tremendous distortions in terms of the
representation in the House of Commons.
I remember very well when I was first elected back in 1968.
There was excitement in the air. People were engaging in
politics. People were involved in campaigns and fully 80% of the
people in that election campaign cast a ballot. It was common in
those days that 80% or more of the people would participate in
federal campaigns and in provincial campaigns.
In the last campaign in June 1997 the turnout was 67% of the
polls. The turnout has been plummeting in every province in the
last 25 or 30 years. The reason for it is that people feel
alienated from the political process. They feel politicians do
not listen to them, that politicians do not reflect what they
want.
There is truth in that and that is one reason people do not
participate in the political system. I submit that we are
sleepwalking to a crisis in democracy. If we do not look at
changing the system to have it more reflective, we will have a
real crisis in a few years time.
I want to take a look now at how distorted the present electoral
system is. I will use the last election campaign. In 1997 the
Liberal Party received 38% of the vote. It got a solid majority
that could constitutionally run the country for five years in a
system that concentrates a lot of power in the hands of the Prime
Minister's Office and the Privy Council Office.
Let us look at the opposition side. We have two parties that
got around 19% of the vote, the Reform Party and the Conservative
Party. The Conservative Party got 19 seats and the Reform Party
got 60 seats, with the same number of Canadians voting for each
of those two political parties. Each of the NDP and the Bloc
Quebecois got 11% of the vote. The Bloc Quebecois got 44 seats
and the NDP got 21 seats, with the same number of Canadians
casting a ballot for each of the political parties.
1740
We have a House of Commons that does not reflect or mirror how
the people of the country voted three years ago. When people
turn on their television sets and see a debate in the House of
Commons, parliament does not reflect or mirror the composition of
the electorate that voted for us in the first place.
As I said, we are one of only three countries in the world with
a population of over eight million people which does not have a
measure of proportional representation in the electoral system.
That will have to change.
Let us look at the history of our country back in 1921. We have
had many majority governments elected over the years but only
four of them were elected by a majority of the people. Except
for John Diefenbaker in 1958, Mackenzie King in 1945 and Brian
Mulroney who had almost 50% of the noes in 1984, all other
majorities have been elected by a minority, which means that a
minority of the people are governing and ruling a majority of
people. That leads to all kinds of alienation.
As a result many issues in the country are now realities that
would not have been realities if we had proportional
representation. I will name but a couple. I remember the 1988
election campaign. We had two parties, the Liberal Party and the
New Democratic Party, campaigning against the free trade
agreement with the United States. Between the Liberals and the
NDP, the two parties together picked up around 56% or 57% of the
vote. That was reflective of the opinion polls which said that
the overwhelming majority of the people did not like the free
trade deal with the United States.
Brian Mulroney and the Conservatives got 42% of the vote. They
won a big majority. Free trade went through and it changed the
country forever. It was the same with the GST. There have been
many such distortions over the years despite the fact that the
majority of people voted against the party that was advocating a
particular policy.
We have another distortion. For example, at the provincial
level today two provinces have a majority one party government:
British Columbia and Quebec. The leading opposition party
received more votes than the governing party that by itself forms
a majority. We have those kinds of distortions in the electoral
system.
I think we need change. The motion today is saying that we
should strike a parliamentary committee to look at the ways of
incorporating a measure of proportional representation into our
system. The motion is very deliberate in saying that we should
set up a committee to study the ways of incorporating a measure
of PR into the system or, in other words, mix some PR into the
system. There are many examples of this in New Zealand, Germany
and other countries. We have the Welsh example and the Scottish
example. There are many other examples in the world where we
have a measure of PR.
There have been studies in this country which have talked about
a top-up of 20 members, 30 members, one-third of the members,
one-half of the members, or a quarter of the members being
elected according to the proportion of votes that a party
receives. If at the end of the process a party receives 30% of
the votes, say in the province of Quebec, that party should get
roughly 30% of the members in the House of Commons from the
province of Quebec.
We have great regional distortions today. I look across the way
and I see three of my friends from the Liberal Party in Ontario.
In Ontario in the last campaign 101 members of the 103 are
Liberals. We would say that everyone in Ontario is a Liberal,
but if we look at the results in Ontario the Liberals are members
of a minority party in Ontario, receiving slightly over 49% of
the vote. The majority of Ontarians voted for the NDP, the
Reform Party, the Conservative Party and for independents. Almost
51% of Ontario residents voted that way yet only 2 of the 103
members from Ontario represent members who are now sitting in
opposition in the House.
I do not think that fosters good nation building or a good
vision of what the country should be. It has created great
balkanization and great regionalism in the country. If we can
bulk up with heavy votes in certain regions we can do well, but
if the vote is scattered across the country we do not do anywhere
near as well. I think it has created all kinds of regional
tensions.
1745
Imagine that we had a system of PR, whatever the appropriate
model is for our country. I want to say to members across the
way, including my friend from Hamilton who is opposed to the idea
of PR, that my motion does not advocate any particular model.
That is why I want a parliamentary committee to look at what
models may be appropriate to our unique federation. Then take
that model back to the House of Commons. If it is approved by
the House of Commons, then go to the people in a referendum and
let the people decide whether they want the status quo or a new
model of proportional representation. What could be more
democratic than that in terms of a process?
I appeal to my Liberal friends across the way to give this
process a chance. Let us have a discussion for the first time in
the history of our country since 1923 as to whether or not we
should modernize our electoral system and whether or not we
should engage people and empower people in a system that is much
more relevant.
Back to regionalism. Imagine an election where we had a measure
of proportional representation. Proportional representation
would force all the parties in the country to have a national
vision about Canada. If they did not have a national vision they
would not receive votes.
It would force us in the NDP to look more seriously at Quebec
and its uniqueness and distinctiveness. In the same way,
Canadian Alliance would look at Quebec and its uniqueness and
distinctiveness. It would force the Liberal Party to take the
crisis of Saskatchewan and Manitoba farmers more seriously. As
a matter of fact, part of the frustration was when farmers from
our province came here to lobby, when they asked why the
government would not take them more seriously the answer was it
only has one seat in Saskatchewan anyway, so what does it matter?
If we had PR, a vote in Kamsack, Saskatchewan would be worth as
much as a vote in Trinity—Spadina. It would force all parties
to take all parts of the country equally seriously in terms of a
national vision as to where they want the country to go. A dream
people have, is that we have national parties that would knit the
country together to unite it. PR would probably be the greatest
step toward national unity we could possibly dream of in terms of
the future of our country. I recommend that people think about
that as we go on with the debate over the next few weeks.
Another thing is the empowerment of people. If we look at
federal and provincial campaigns, the majority of people vote for
losers. How many times have we heard, “Well, I vote for losers.
My person did not win. My woman did not win. My man did not
win. My candidate did not win. I wasted my vote. I voted for a
loser”.
In fact, the majority of people in the last campaign voted for
losers. The majority of people in my riding voted for losers. I
got 43% of the vote. Fifty-seven percent of the people voted for
other parties. Even in ridings where people had a majority, such
as yours, Mr. Speaker, I suspect 40% to 45% of the people in your
riding voted for losers. They feel they waste their vote so why
should they engage themselves in the process?
Under proportional representation no one votes for a loser.
Everyone is a winner. Every single vote counts. Every single
vote has weight in the Parliament of Canada. When we turn on our
televisions the day after the election, our vote will count no
matter where we are in the country, because our vote will be
going to a certain political party that will get a certain number
of members in the House of Commons in accordance with the vote
for that party. That is what almost every country in the world
does. It means we could vote Reform in Newfoundland, it means we
could vote NDP in Alberta, it means we could vote Liberal in
rural Saskatchewan and our vote would still count.
Our point of view would still count. Our point of view would
still be important not just on election day but for four years.
Our vote would count for four years each and every single day as
we empower a member of parliament to speak on our behalf because
our vote is reflected in the House of Commons for four years.
It would do something else that is extremely radical, so radical
for our system that maybe it is heresy. It would force
politicians to work together. We could not harangue each other
all the time. We would have to work together. We would have to
form coalitions and work together like they do in most countries
around the world.
Since the second world war Germany has never had a majority
government by one party. There has always been a working
coalition, Social Democrats, Christian Democrats, the Liberal
equivalent in that country, and so on.
It is the same in most Scandinavian countries, France and many
other countries around the world. It would force politicians to
form a consensus in terms of what we want to do and where we want
to go.
1750
PR in Canada would radically change voting patterns. How many
times have we heard people say, “I would vote for your party but
you cannot win”. I have a friend who has voted for a party that
he does not like for the last 20 years in every single federal
election campaign. He votes for that party because he is trying
to keep out another party he likes even less. For the last 20
years he has not voted for the party of which he is a card
carrying member. Under PR he could vote for the party of his
preference because his vote would count. We might see a radical
change in voting patterns because we would not have such a thing
as strategic voting. A vote would count no matter who an
individual voted for. That is another reason we should look at PR
in terms of empowering people.
Those are some of my arguments in favour of proportional
representation.
Some people may ask would proportional representation not create
all kinds of fringe groups and all kinds of instability and
uncertainty? I want to respond to a couple of those questions. I
think they are myths.
In almost every country in the world where there is proportional
representation there is a threshold above which parties must
achieve votes before they are represented in parliament. In some
countries that threshold is 3%, some countries 4% and some
countries 5%. That is something we could look at as well.
Other people may ask if it would not create a great deal of
instability. We have more instability now because we are a first
past the post system. With a minor change in the votes we create
great U-turns in terms of policy. Free trade is a good example of
that. I think with proportional representation where all parties
were represented in the governing process there would be more
gradualism in terms of policy changes and more stability in terms
of the direction of the country because a consensus representing
the people at all times would be needed.
There are a number of other criticisms of the PR system that
some people have, but my time is coming to a close. I say to my
colleagues that in private members' hour we have a chance to
debate and vote on something that might be done outside the
constraints of the party whips.
I appeal to all members of the Bloc Quebecois. René Lévesque
spoke very passionately about proportional representation. Many
people in the Parti Quebecois and the Bloc spoke about PR. I say
to them that my motion does not define a particular method of PR.
My motion deals with a process that will lead us to an
appropriate model of PR for Canada which could be good for the
Bloc Quebecois.
I say to the Reform Party, now the Canadian Alliance, that many
of its people were among the first to advocate proportional
representation in this country, including the member from
Vancouver who is about to speak. This system could also be
helpful to get their ideas in a permanent mix in the country. The
same thing is true of our party in terms of being social
democrats. It could be a system for the Conservative Party which
is really underrepresented now because of our first past the post
system.
I appeal in particular to the government. The first past the
post system works very well for the government in power just
because of the mathematics. I say to the government across the
way that the day will come when it will not be in power. I would
like the government members to think about that because when they
are sitting on the opposition benches, when they get a lot more
votes than seats in the House, then maybe the idea of doing what
almost every other country in the world has done, having a
measure of PR in our electoral system, will look a lot more
appealing to them.
I remember sitting on this side of the House and seeing the huge
Conservative majority of Brian Mulroney with 211 seats. Suddenly
in a few short years that majority disappeared. I was very
pleased to have heard many Conservatives talking about PR at
their convention recently. I am talking of individuals such as
Hugh Segal and others.
I appeal to the House to take my motion seriously and look at
changing our electoral system to make it more democratic. Let us
make sure it is a system where no vote is wasted, where people
are empowered and the Parliament of Canada will truly reflect the
way the people vote.
1755
Mr. Peter MacKay (Pictou—Antigonish—Guysborough, PC):
Mr. Speaker, I congratulate the hon. member for
Regina—Qu'Appelle for an excellent and informative speech and
for taking the initiative to bring this matter to the House of
Commons. I also extend my thanks to members present who
permitted me to speak in this order.
The motion as set out calls upon the government and all members
of parliament to embark on what would be a very historic and
important journey. That is to examine our federal electoral
system making use of a report on proportional representation that
would come about as a result of participation of an all party
committee.
I know, Mr. Speaker, that you personally and many others
followed with great interest the proceedings of the Progressive
Conservative Party's policy conference which took place last
weekend in Quebec city. I note the acknowledgement by the hon.
member for Regina—Qu'Appelle. He would know that over 1,200
delegates participated in that exercise. They debated and voted
on a number of policy issues, including this issue.
The issue of proportional representation, although judgment was
reserved as to how we would proceed in the future, was a topic of
great interest and participation by delegates. It signals the
fact that this is a very important issue on the public's mind. It
is something on which we should not close the options when it
comes to this discussion.
The wording of the current motion troubles me somewhat in the
sense that it calls upon the government to embark on a referendum
process. Do not get me wrong. The Progressive Conservative
Party has never shied away from national referendums and can lay
claim to having been one of the national governments that ever
openly participated in national referendums in a tangible way.
It is a party that has done this and it continues to look at this
type of participation in our democratic process.
The difficulty with the motion as framed is that it would be
virtually impossible to carry it out within the timeframe we have
to work in. The next general election is very likely less than
one year away. It would be virtually impossible and highly
dubious that the machinery which would be necessary to put it in
place could be implemented. I do not say that with any false
premise. I believe that this exercise is extremely fruitful and
one which again I congratulate the member for having the impetus
to bring forward.
In his speech the member mentioned the fact that it has led to
certain policies. He mentioned the GST and free trade. The
government when in opposition chastised and said the sky would
fall if the country were to embark on these. We know it has
embraced, expanded and called these same Conservative policies
its own. This type of duplicitous reaction and approach is what
has added greatly to much of the cynicism that exists not only
about our electoral system but about politics in general.
What we are looking for and what is underlying this type of
debate is the issue of relevancy in people's lives and the
legitimacy of government in the undertakings which Canadians
participate in on a daily basis. In a sense it is a very
interesting scenario in that I know the hon. member was also
present in the fall last year when we had a conference in which
you, Mr. Speaker, were very much a participant and a chair with
respect to citizen empowerment. And I openly thank you for that,
Mr. Speaker.
I believe that the exercise we are partaking in today is
something that furthers the debate. It brings about hope for the
achievement of some relevance and an achievement of a system that
would be far more representative of Canadians' interest, their
participation and their ability to hold government and elected
members accountable.
At that conference much was discussed in a very positive light
about a system of proportional representation. As you will
recall, Mr. Speaker, we discussed other countries that have
embarked on such systems. There is much to be learned from
examining those other countries.
One has to have a very healthy degree of caution as well when we
go into this debate. There is no panacea. There is no one
system or one magic bullet when it comes to changing a system
which will ensure that it actually will improve what we have in
the country today. The hon. member quite fairly indicated in his
remarks that there is no one answer. However, the exercise of
looking for that answer is what we should all be doing today.
1800
With that reservation I say that we must proceed with caution.
When we are talking about fundamental changes to our democratic
process this must be ever present in our minds.
With that reservation it is fair to say that there are a broad
number of academics and members of parliament present, who I
expect we will hear from, who are very interested in this idea of
empowerment and, by extension, citizens being empowered in a
system of second round run-off elections.
It is interesting to see the electoral process being mirrored in
some leadership races. That is something as well that can stand
as a benchmark and stand as a precedent as we proceed in this
exercise.
This run-off type of system would result in every member of the
House being mandated to achieve at least a 50% threshold in the
electoral district for which they were running.
The motion before the House calls for a statement of the opinion
of the House as to actions that the government should take. We
all know that the government could and likely will ignore this
resolution. However, governments generally, in fairness, are
very reluctant to embark or change a system that propels them
into office and gives them a docile backbench. That is very much
implicit in this debate as well, because it is not only members
of the opposition but very much members of the government who are
forced to clam up and bow down to a very centralized and very
powerful executive branch of government.
It is even more unlikely, I suggest, that the current Prime
Minister, in the dying days of his administration, would launch
into such a vigorous reform of the electoral system. This Prime
Minister is too comfortable and complacent with a system that has
propelled him to office, and he knows that he has never been an
innovator or very willing to embark upon new ideas. That is
demonstrated, as I indicated earlier, by the policy approach
which this government has taken.
The Prime Minister is at the head of a very powerful executive
dictatorship. I do not use that word lightly, but that is the
acknowledgement and that is very much the undertone of many
academics who have been looking at this exact issue. There are
no effective checks or balances in the current system. As
Professor Donald Savoie described in his very important book
Governing from the Centre, the Prime Minister is no longer
first among equals, he is an all powerful individual. Even
ministers in this government who wield a great deal of power are
toiling in the shadow of the Prime Minister's senior staff. There
is ample evidence of this outlined in Professor Savoie's work.
The real power brokers are Eddie and Jean, not Paul and Allan.
Regionalism, which was touched upon by the hon. member, has also
been exacerbated by our current system. I would suggest that
this is very much a motivating and propelling force for us to
look at the system we are currently saddled with.
This is not to belittle anyone personally; it is to set out a
problem that exists and that very much weakens parliament in its
ability to be effective and accountable. Accountability is
something that we have to be conscious of.
One of the remedies that is put forward by many as leading to a
stronger parliament, and one that I must acknowledge, is that if
we abandon the parliamentary form of governance we must be
prepared very quickly to move into a new and effective
replacement. The proponents of proportional representation argue
that members of parliament with the support of 50% plus one have
the ability to enhance the mandate from their community and this
would very much further embolden and empower the member who was
elected. I agree with that sentiment.
Would that human condition be that simple. We know that is not
the case, for party machinery will always play a role in our
electoral process. Party leaders will always wield tools. We
have seen instances in the very recent past where the government,
without having a nomination process, simply appointed candidates.
The current government has embarked on that process.
Any examination of this subject needs to pay particular
attention and detail to the proponents of a new electoral law.
There is an important example of small changes to the system
having important effects on the balance of power. When public
financing became very much a part of the electoral system, a
provision was inserted to require the leader of a party to sign
the electoral papers of every candidate. The supposed purpose
was to ensure, dare I say the word, clarity in who was to be the
official party candidate, since public money would flow to that
person's and that party's electoral machinery. This was
seemingly an insignificant detail at the time, but the devil is
in the detail and that is why I say we have to go forward with
caution.
1805
That procedure has led to a process which allows the government,
or any party for that matter, to simply appoint candidates as
opposed to having an electoral run-off system through a
nomination.
This sort of backroom bludgeoning, I suggest, will continue to
occur with proportional representation unless we have some
defining guidelines. Change is fine. However, it should not be
taken lightly and not embarked upon simply for the sake of
change.
I am encouraged by the hon. member's initiative. I support him
in what he is trying to do. We have reached a threshold of
dissatisfaction and we must go forward from here.
Mr. Derek Lee (Parliamentary Secretary to Leader of the
Government in the House of Commons, Lib.): Mr. Speaker,
Canadians are very proud of the fact that they have one of the
most stable and democratic political systems in the world. It
has made Canada a model for many other countries.
This is not something that just happened by accident. We are
the beneficiaries today of what our ancestors have provided and
what political leaders over the last century and a half have
handed down to us. However, even the best system in the world
will have its critics.
It is natural that from time to time members of parliament and
others interested in the political process will come forward with
suggestions for improving our system, which in this case is our
system of election.
Today's private member's motion is an example of this, with its
call for the introduction of a new electoral system,
incorporating a measure of proportional representation. If I
may, I would like to take a few minutes to discuss some of the
aspects of the motion, how it might impact Canadians and why in
the view of some it may represent a risky gamble for Canadians,
which I maintain might not be warranted under present
circumstances.
To begin with, it is important to note that proportional
representation is not a new idea. It has been tried in a number
of forms in a number of countries all around the world, with
varying degrees of success. Currently it is used in one form or
another in many countries, notably Germany, Israel, Ireland and
New Zealand. I understand that it was used in France, but it has
now been substantially abandoned.
The member for Regina—Qu'Appelle indicated that we are one of
only three countries in the world which does not use proportional
representation. I did not quite understand that. If we include
the U.S.A.—and I do not recall what the other country was—
An hon. member: India.
Mr. Derek Lee: India. Within the last couple of months I was
over at Westminster in the United Kingdom. The last time I
looked, they do not use proportional representation. Some
British members of parliament and I discussed the issue when I
was over there. Notwithstanding that the party in power had held
out the possibility of increased proportional representation, I
did detect a drawing back from that in the British House of
Commons. They were looking at it carefully, and it is not
everything that its advocates make it out to be. There are some
pluses, to be sure, and there are minuses.
While all of these systems are called proportional
representation, they often vary enormously and use different
approaches, such as the following.
Some have preferential ballots where voters rank candidates in
order of preference, with votes for low-polling candidates being
transferred to the remaining candidates, according to voter
preference.
There are pure proportional representation systems where the
entire country is treated as one constituency, with members being
selected from party lists based on the percentage of the popular
vote received by the parties.
There are mixed systems where some members are chosen on the
basis of first past the post, while others are chosen from party
lists.
While proponents of the system claim it leads to better
representation, particularly of minorities, minority interests
and regions, with a higher voter turnout, the experience of those
countries currently using proportional representation suggests
that there may be some potential negative impacts as well.
For example, it could lead to a splintering of political
interests in parties and therefore lead to more minority
governments. It could make governing more difficult. It could
increase political instability. It could force parties to engage
in lengthy political deal-making in order to cobble together
coalitions involving very different interests.
1810
Some will say that process is actually quite democratic and
representative but there are two sides to the coin and there is
more than one view of this. As well, small one issue parties can
sometimes find themselves in the position of being kingmaker
which may allow them to force their own narrow agendas onto the
nation as a whole.
Proportional representation sometimes can give a voice to
extremist groups who would have been shut out in a first past the
post system. Examples of such situations can easily come to
mind.
Some countries have also found that proportional representation
can exacerbate regional differences and cleavages within a
society and can make it more difficult to reach a national
consensus on some important issues. That is an important issue
for a country as vast and as regionally segmented as Canada is.
Other countries have found that the use of party lists in
selecting members of legislatures can strengthen the power of
those party insiders responsible for deciding who will be on the
list and in what order of precedence. I also as a member of
parliament representing a constituency am curious as to what the
balance would be, for example if I would continue to represent a
constituency but those selected from a party list would not have
that responsibility at all. They would not have the constituency
responsibility, something to which all members of the House pay
considerable attention and devote considerable resources.
These are just a few of the issues, some say problems, that we
would encounter in moving toward a system of proportional
representation. There are some other problems that might be
specific to Canada. We have benefited in the past from an
electoral system that allows for the diversity of our peoples to
be drawn together in a parliament where there is a reasonable
likelihood of a majority government. Minority governments might
not so easily maintain our focus and our unity.
In addition it could under certain models involve a change.
These changes could involve changes to our constitution, and this
is a particular policy envelope that I am not convinced Canadians
would want to open at this particular time. A referendum on the
issue could also prove divisive judging from recent past
experience.
Finally, one of the strengths of our electoral system is that
Canadians are represented at the constituency level by members of
parliament. All of us here do represent constituencies and that
is a real strength for the House, something that might be—I am
not saying would be lost—but could be lost if we are selecting
MPs simply from party lists without reference to particular
constituencies.
For these reasons, I am not inclined to support the motion in
its whole. However, if there is a broad interest among members
to pursue the issue of proportional representation, and I know
there are members on both sides of the House who do have a real
interest in this, the House could ask a committee of the House to
look at this. I suggest the Standing Committee for Procedure and
House Affairs as one possibility.
Members of that committee discussed the issue in the course of
their 1998 review of electoral issues. There may be merit in
further study. Such a review would provide us with information
on the strengths and weaknesses of proportional representation,
in international experience and the implications it could have in
the Canadian context.
I want to sincerely commend the hon. member for
Regina—Qu'Appelle for his commitment to improving Canada's
electoral system and for bringing this important issue to the
House. I do not know what members will do with the issue in
terms of the actual motion. I am certain that somewhere in the
future there is a further study envelope of proportional
representation to see how it might be adapted or used in Canada,
and if there is a substantial consensus that would develop to do
that in the House.
Mr. Ted White (North Vancouver, Canadian Alliance): Mr.
Speaker, I would like to start by saying to the member for the
government side who just said that referenda are divisive, what
could be more divisive than a government with 100% of the power
with only 38% of the vote ramming its agenda down the throats of
the people?
Referenda are never divisive because people have the discussion
and they all accept the democratic outcome.
1815
That having been said, I would also like to congratulate the
hon. member for Regina—Qu'Appelle for bringing this issue before
the House. However, I would say to him right at the beginning
that it is highly unlikely, as I think he realizes, that the
government would do anything with the motion, mainly because the
history of changes to electoral systems indicates that the these
things happen only during a time of crisis.
He mentioned that Germany, for example, since the war has a
different system. He mentioned the Scottish system. Obviously a
big change there allowed that new system to be introduced. In
New Zealand, an example I know a lot about, it only happened
because of the crisis in the financial system there which caused
a huge reorganization of government. That was what led to the
change to MMP down there.
The only thing I can think of that would happen in Canada which
would cause such an upheaval would be a Quebec separation, for
example. It would cause such a disruption to our electoral
system that it would probably result in some serious looking at
some other systems. That would be a terrible way for us to get
to that point.
In talking about the motion before us it is flattering in the
way that the motion is very similar or very close to Canadian
Alliance policy, formerly Reform Party policy. The policy of the
Reform Party, as I said, is very similar except that we would put
the referendum or the decision-making to the people of Canada.
Instead of a committee of the House looking at the alternatives
and saying this is the one it favours and then asking the people
of Canada in a referendum if this is what they want, we would
take the decision-making fully 100% to the people.
The reason we reached that position within the Reform Party and
now the Canadian Alliance is that we had many people who brought
resolutions to our party conventions promoting one form of
proportional representation or another. Whether it be straight
proportional or the single transferable ballot, there are many
different versions. The people who brought these motions forward
were very firmly wedded to their particular form of proportional
representation. It was very difficult to have any sort of
meaningful debate on the floor of conventions.
We set up a task force to look at the alternatives. We had all
the people with the different forms of proportional
representation come before the task force to promote their views.
We concluded that we would have to adopt a system similar to the
one used in New Zealand to reach the consensus there.
Instead of choosing one of the forms of proportional
representation being promoted by our members, we would give the
job to Elections Canada to conduct an education process for the
people of Canada across the country from coast to coast to coast
for about a year, informing them how the different forms of
proportional representation worked. Then we would have a
referendum, first to find out if people wanted to change the
system based on the information they had. If they did, we would
have a second vote to indicate which form they would choose.
That is exactly what happened in the New Zealand case. I would
like to go into a bit more information about the choices given to
the people in New Zealand. Incidentally I should mention an
interesting spinoff effect of what happened in New Zealand. The
voters in New Zealand chose mixed member proportional, a system
where the house is divided in two. Half of the members are
elected under the first past the post system that we have in
Canada. The other half are selected from a list based upon the
proportion of vote received by each of the parties.
In New Zealand the parties have to get 5% in order to get any
members into the house. In the last two elections in New Zealand
there have been 30 or more parties on the ballot, but only four
or five have managed to get into that grouping above 5% to
actually get members in the house. The interesting side bar
spinoff that has occurred is that with mixed member proportional
some of the members in the house do not actually represent
ridings because they are selected from the list.
How would we address them in the House? We could not say the
member for Regina—Qu'Appelle because if he is a list MP he would
not necessarily represent a riding. They had to change the
standing orders in New Zealand to refer to members by their
names. It really begs the question why we have to refer to one
another by our ridings in the House? There was no good reason to
retain that rule in New Zealand and they scrapped it. Everybody
calls one another by their names now.
1820
I have pages in front of me from the documentation that was sent
to every voter in New Zealand in order to have the discussion
take place over a 12 months period. The booklet described the
various forms of proportional representation that could be
selected by the voters.
Straight proportional is where everyone is elected on the basis
of the proportion of the vote from lists that are provided by the
parties. Then we have the supplementary member system under
which most of the members, perhaps about four-fifths, are still
elected on first past the post and about one-fifth or one-quarter
of the total would be elected based on the proportion of the
overall share of the votes. It can be a very complicated system
in terms of allocating the votes to the parties, because how do
they decide who will be on the list of members who get elected
under the proportional system.
As mentioned by the government representative there are
different ways of doing that. Sometimes it is a party list
selected by the party brass, for want of a better word. Sometimes
it is more democratically selected, perhaps by members of the
party going through some sort of nomination process to get people
on the list. A third way would be for people to argue in
elections in an open nomination process pretty much like the
first past the post system.
Under the supplementary member system usually there is very
small representation from the smaller parties so they still tend
to get a dominant larger party in the house. That was not the
system that the New Zealand people chose.
Then there is the preferential voting system which is not truly
proportional but ensures that the winning candidates get more
than 50% of the vote. The person marking the ballot would mark
their first, second, third and fourth choices. When they count
all the first choices on the ballot, if the candidate who is in
the lead does not get over 50% then the candidate receiving the
bottom number of votes gets knocked off. Then all the second
choices from those ballots get added in, counted again, to see
whether one of the candidates gets more than 50%.
These are complicated ways of doing things but they are a little
more democratic than what we have. I mentioned that was used in
Australia. That system is also used in the Canadian Alliance,
formerly the Reform Party, to select the national counsellors who
run our party between elections.
Another system that is pretty complicated is the single
transferable vote system. It is very similar to the preferential
voting system but it involves having numbers of members
representing one riding. It could be anything from three to
seven members in one riding. It is used in Tasmania. Whilst I
cannot show the House the examples I have here from the Tasmanian
elections, it does allow a variety of smaller parties to get
involved in the house itself.
Then we have the mixed member proportional system which I
mentioned was finally chosen in New Zealand. The party list
system there is actually chosen by the party brass because it
really wants the opportunity to ensure that it has skilled people
selected to come into the house. For example, my colleague who
was here in the last parliament, Herb Grubel, the member for West
Vancouver, is a very accomplished economist. He might, for
example, be put on a list so that a party would make sure that it
had those sorts of skilled people brought into the house.
I guess the bottom line here is whether or not I would recommend
to my colleagues that they support the motion presently before
us. I pointed out that the one flaw perhaps is that the decision
on the type of system would be made by the committee and it would
only be the final decision given to the people of Canada.
However, in reading the motion carefully I get the impression
that there might be enough flexibility at committee to actually
manipulate that a bit and for the committee to recommend what I
am talking about, which would be that we cannot quite make up our
minds which would be the best, that there are so many good
advantages we want to put the whole package to the people.
On that basis I am certainly recommending support of the motion.
I will be supporting it myself. In conclusion, once again I say
congratulations to the member for Regina—Qu'Appelle for bringing
this important subject to the House of Commons.
1825
[Translation]
Mrs. Madeleine Dalphond-Guiral (Laval Centre, BQ): Mr. Speaker, I
am pleased to rise to speak today in the debate on Motion
No. M-155, introduced by my NDP colleague, the member for
Regina—Qu'Appelle.
I am grateful to him for this motion, since it gives us the
opportunity to debate an important question that I will look at
from three angles.
First, can democracy be improved? Second, is the electoral
process a component of democracy? Third, could proportional
representation serve to improve democracy?
Members will have understood the importance of this debate,
since it involves thinking about parliament as the favoured
place of the democratic expression of a country.
To my first question, “can democracy be improved”, I have no
hesitation in answering yes. Our electoral system is of course
democratic. However, it is not perfect, since it promotes the
hegemony of the majority party. I must quote a 19th century
author who wrote “Truth, laws, rights and justice depend on 40
rumps that rise among 22 that remain seated”.
How many governments have been elected and will be again, even
though a strong majority of electors do not want them elected?
In the present system, the person getting the most votes is the
person elected, and the party with the most seats forms the
government.
Tough luck for the tens of thousands of voters who have no voice
in parliament.
Everyone remembers the 1993 federal election, which robbed the
Conservative Party and the New Democratic Party of party
standing in the House of Commons.
To my second question, “is the electoral process a component of
democracy”, I answer yes as well, since it enables the public to
choose the person best able, in their opinion, to represent
them. If they are wrong in their choice, they will try to
correct their fire a few years later in another election.
The last question focuses on the value of proportional
representation as an instrument likely to improve democracy. To
this question, I answer yes, but on certain conditions.
But before briefly describing those conditions, I would like to
give a few figures.
A UN study listed 174 countries according to their degree of
human development. Of the 64 countries said to meet the criteria
for superior human development, 34, or just over 50%, have a
proportional representation system. The percentage drops to
33.5% for the group of countries considered to have an average
level of human development, while in the last group of countries
only one in four has proportional representation.
In short, the more developed a country is, the greater the
likelihood of proportional representation. In fact, of the 174
countries, 66 elect their parliament proportionally—the less
developed a country is, the less this is the case.
However, it might also interest the House to know that, of the
222 political systems listed in 1997 by the International
Institute for Democracy and Electoral Assistance, only 64 elected
their parliament using a first-past-the-post system.
A hard look at other countries obviously requires that some
serious thought be given to this topic, since fewer than 30% of
them elect their parliament based on the number of votes.
Is proportional representation a panacea for democracy? What
are its advantages and its disadvantages?
In Esprit des lois, Montesquieu wrote “The love of democracy
is the love of equality”. A century later, in his Du Contrat
Social, Jean-Jacques Rousseau associated the notions of liberty
and equality, saying “If we seek to find precisely what
comprises the greatest good of all, that which must be the goal
of any system of legislation, it will be found that this can be
reduced to two principal objects: liberty and equality. Liberty,
because any individual dependency takes away an equivalent amount
from the strength of the body of the state; equality because
liberty cannot exist without it”.
Proportional representation seems to work in favour of a better
women's representation in parliament.
1830
It cannot be mere happenstance that, if any country has more
than 20% of women MPs, it is one which uses proportional
representation. In Sweden, Norway, Finland and Denmark, the
proportion of women varies between 33% and 40%, while it is a
mere 12% in the United States. The same conclusions apply to the
figures for minority groups.
There is one other interesting element. The rate of popular
participation is also higher, no doubt because the individual
citizen has the assurance that his vote will be worthwhile.
While the single constituency single ballot system, known as
first-past-the-post system, promotes government stability, one of
the disadvantages of proportional representation is, no doubt,
the instability it can generate, with all the political,
economic and social consequences that may follow. This
disadvantage is not insignificant. It does not take much
imagination to see that a parliament with 30 parties sitting in
it could, at times, be a bit of a circus.
Another not insignificant aspect is the lessened importance of
the elected representative's link to his riding. We all know
people who vote for the man, as we say. In my case, they vote
for the woman. It is the candidate's personality that, for some
voters, makes all the difference.
With a proportional vote, the party's program takes precedence.
It is easy for voters to believe that the person elected from
their riding will represent their party rather than themselves.
The Bloc Quebecois considers it worthwhile to hold a serious
debate on the various types of voting, including proportional
representation. One element seems fundamental, however, and
that is recognition in the debate of Quebec's uniqueness.
Since 1993, the Bloc Quebecois has been a federal party devoted
to the interests of Quebec. We are the first case, but who here
can say that our situation will always be unique, a sort of
artifice without real importance? Everyone knows how interests
differ from coast to coast.
The advantage of proportional representation is to give the
difference a fair place. Because we rightly consider that our
difference as a people warrants respect in the electoral
process, I move:
That the motion be amended by adding, after the word
“proportional” wherever it appears in the motion, the words “by
province”.
In closing, I would express a hope that democracy may end up
resembling the portrait Jules Romain painted of it:
A democracy is first a way of life in which people dare to talk
to each other of important things, all the important things, in
which they feel entitled to speak as adults and not as disguised
children.
This comes from his work about men of goodwill, which I claim we
all are.
[English]
Mr. John Bryden: Mr. Speaker, I rise on a point of order.
There is a chance that there might be a minute or two left in
this debate. I have some, I think, very relevant and, I would
like to think, important things to say. Is it possible, rather
than have my speech cut off after a minute or so, that we see the
time for Private Member's Business as being completed?
The Acting Speaker (Mr. McClelland): As a matter of fact
I will just have time to propose the amendment, provided that it
is in order, and then debate will be terminated for the day. I
will not be calling on the member for Wentworth—Burlington today
in any event. The motion is receivable.
When the bill next comes before the House the debate will be on
the amendment.
1835
The time provided for the consideration of Private Members'
Business has now expired and the order is dropped to the bottom
of the order of precedence on the order paper.
ADJOURNMENT PROCEEDINGS
[English]
A motion to adjourn the House under Standing Order 38 deemed to
have been moved.
COMMUNICATION
Ms. Wendy Lill (Dartmouth, NDP): Mr. Speaker, it is my
pleasure to speak to the House today on the issue of newspaper
concentration.
On February 15 of this year, based on a query by the House
leader of the New Democratic Party, the Prime Minister said that
the government would study the concentration of newspaper
ownership in response to Thomson's announcement that it would
sell off most of its newspapers.
On May 1, given that Hollinger announced that over 300 community
papers and over 50 daily papers would be up for sale, I asked the
Prime Minister what the progress of his study was. I was stunned
to hear him say at that point that he really saw no need
whatsoever for a study any longer because it seemed that the
problem had cured itself. He said that if Mr. Black was selling
his papers, someone else would buy them and there would be less
concentration rather than more. The Prime Minister said that it
would be better to wait and see what Thomson will do with his
newspapers.
I would suggest that the government abandon its wait and see
policy on newspaper concentration and act now to re-establish a
healthy environment for Canadian and community owned newspapers.
I want to tell the Prime Minister that there are alternatives to
his wait and see policy but they have to happen quickly.
Yesterday I had the great pleasure of hearing Tom Kent present
to the industry committee an ongoing review of the Competition
Act. Mr. Kent headed the royal commission in 1980 which
recommended legislation to curb media concentration. That was 20
years ago. He said then and says now that the reason newspaper
concentration is dangerous to democracy is, quite simply, that
owners choose the viewpoint that rules their papers, that they in
fact are the ideological masters of their papers. This is fine
if there are dozens or hundreds of owners running hundreds of
newspapers, a wide teaming forum of diverse views, but that is
not the case in this country.
We have instead a spectacle of very few owners in control of all
the papers. Two companies, Hollinger and Thomson, have a
stranglehold on newspaper ownership, both weekly and daily. Lo
and behold, something happened. We are not exactly sure what but
some kind of economic force has intervened and newspapers are
once again on the block and up for sale.
I would like to join with Mr. Kent and urge the Competition
Bureau and the government to do something ambitious right now.
The government should amend the Competition Act to allow the
review of any purchase that would give a buyer more than 10% of
the Canadian circulation of a newspaper owned either in English
or French.
I would urge the government to create tax incentives that will
assist community groups, institutions, co-ops and groups of
investors to reinvest and rebuild community ownership of our
means of expression, rebuild the diversity of opinion which is in
fact democracy's oxygen and what we need to have a healthy
citizenship.
I urge the government and the Prime Minister to make the
necessary changes in the Competition Act during this very brief
window of time that it has to actually cause some real change in
the balance of ownership in our newspapers. I strongly recommend
that the government act quickly so that we can re-establish a
balance of diverse opinions in Canada.
Ms. Bonnie Brown (Parliamentary Secretary to Minister of
Human Resources Development, Lib.): Mr. Speaker, I think
there has been some kind of glitch in the proceedings. I believe
on April 4 the member opposite asked a question about proposed
telephone rate increases, and subsequent to that, I believe she
asked a question about the consolidation of newspapers.
However, in being drawn for a late show tonight, the question
that was drawn was her April 4 question which had to do with
telephone rate increases not newspapers. Am I correct, Mr.
Speaker?
1840
The Acting Speaker (Mr. McClelland): The parliamentary
secretary is quite correct. If she would like she can respond to
the telephone request and when the other comes up she can respond
to it then.
Ms. Bonnie Brown: Mr. Speaker, I want to assure the
member that affordable telecommunications services to Canadians
in both rural and urban areas across Canada is a fundamental
policy objective of the Telecommunications Act and it is key to
the government's program called Connecting Canadians.
The CRTC has taken a number of initiatives to ensure that
Canadians have access to a affordable, high quality
telecommunication service, including an explicit subsidy from
long distance carriers to support local telephone service which
particularly benefits high cost rural and remote areas.
The CRTC has mandated that the level of basic telephone service
generally available in urban areas must be provided in rural and
remote areas. The CRTC has ordered the incumbent telephone
companies to file service improvement plans to provide this level
of service in those few areas where it is not available. This
will mean significant investments by the telephone companies.
However, in the end it will eliminate party lines and ensure that
all Canadians can have access to the Internet without paying long
distance charges.
Until 2002 the CRTC has capped annual price increases for
residential service. Increases in residential rates are limited
to inflation on average, with a maximum allowable increase of 10%
on any particular local rate.
Under this price cap regulation, the telephone companies must
file with the CRTC annual proposals for price changes.
Most of the telephone companies are proposing increases to be
brought in over two years. In some cases, the companies are
seeking approval for the maximum allowable increases in areas
where the disparity between the cost of providing service and the
price of service is the greatest. In Bell's territory, for
example, most rural customers pay less for telephone service than
urban customers even though the cost of providing them service is
higher.
It is worth noting that, according to the OECD, Canadians
continue to enjoy among the lowest telephone service rates in the
world and the lowest—
The Acting Speaker (Mr. McClelland): I am sorry, the
parliamentary secretary had two minutes when she actually started
the response after the explanation.
[Translation]
HUMAN RESOURCES DEVELOPMENT
Ms. Angela Vautour (Beauséjour—Petitcodiac, PC): Mr. Speaker, I
am always delighted to address the House on behalf of my
constituents.
On May 8, 2000, I put a question to the Minister of Human
Resources Development. I submitted to the minister that:
—the counties of Albert, Petitcodiac, Hillsborough and Salisbury,
are part of an urban economic zone, when they are in fact rural
communities with high rates of unemployment.
I asked the minister to tell the House when she was going to
begin the consultation process. I also reminded the minister
that workers needed an answer before next fall.
Under subsection 18(2) of the EI Regulations, employment
insurance regions must be reviewed at least every five years.
Finally, this week, consultations began.
[English]
I was very happy to see that Hopewell Cape, Alma,
Riverside-Albert, Fundy, Salisbury and Petitcodiac had been
included in the new rural zone. I will explain why this move was
so important.
I will give the House the example of Alma, which has Fundy
National Park, and Kent county, which has Kouchibouguac National
Park. The employees at Fundy National Park, who were doing the
same work as those at Kouchibouguac National Park, needed 655
hours to qualify for employment insurance with a duration of
about 15 weeks, while workers at Kouchibouguac National Park
needed only 420 hours for a maximum of 32 weeks. That created
quite an injustice between the communities.
Unfortunately this spring people working in Albert county,
Hillsborough, Petitcodiac and Salisbury, which were zoned in with
urban regions, went four months without income because of the
1996 legislation which shortened the period.
1845
I would like to thank the government for correcting some of this
injustice. We have to thank it when it does something good and I
did see something good happen this week.
However, two communities were excluded from the rural zone in my
riding. That is going to cause these communities quite a lot of
hardship. The two communities that have been excluded are Elgin
and Hillsborough. We have statistics from 1996 which show that
those communities were at 17.8% unemployment. I strongly
recommend to the minister that these two communities be taken
into consideration during the consultation. Both Elgin and
Hillsborough have very high rates of employment.
For example, if it stays as proposed, workers from Hillsborough
and Elgin will be working in Hopewell Cape. Working side by side
in the same industry, one worker will need 420 hours to qualify
for maybe a period of 32 weeks, while the other worker working
next to him or her will need over 600 hours to qualify for maybe
a period of 15 weeks.
I think the government is on the right track in solving the
injustice created by the economic zones that we had before. It
now has a chance to make it fully correct and just for everyone.
I certainly hope that the minister will take my recommendations.
I am sure the mayors and community leaders are going to be
putting forth recommendations also that those communities be
included in the rural zone where they should be.
Ms. Bonnie Brown (Parliamentary Secretary to Minister of
Human Resources Development, Lib.): Mr. Speaker, as the
member has noted, a review of the employment insurance economic
boundaries is now under way. These reviews as set out in the
regulations must be conducted every five years. They are
conducted because just as the national unemployment rate changes
over time, local and regional unemployment rates also change. We
need to ensure that the system reflects local unemployment rates
and remains fair.
These boundaries are set out fairly and are based on four
factors: the urban-rural split as in the case of the member's
riding; the homogeneity of the labour market; the geography; and
the reliability of employment.
We have issued a proposal for public comment. The member has
suggested that part of her riding is happy with that and part of
it is not so pleased. We have put that notice in the Canada
Gazette starting May 13. The opportunity for the member and
the public to comment will last for 30 days.
The EI commission has reviewed the economic zones and members of
parliament of all parties have now been briefed on the proposed
changes. The commission has every intention of having the review
finalized by the summer of this year. I encourage the member
opposite and her constituents to put their views forward within
the 30 day period. I am sure they will be taken into
consideration.
The Acting Speaker (Mr. McClelland): The motion to
adjourn the House is now deemed to have been adopted.
Accordingly, this House stands adjourned until tomorrow at 10
a.m., pursuant to Standing Order 24(1).
(The House adjourned at 6.47 p.m.)