Health Committee on Nov. 22nd, 2007

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Thank you, Minister.

[The Chair, Conservative, Joy Smith]

Thank you, Minister, for your answers.

That brings this round of questioning to an end. We're going into our next round now. It is five minutes per party.

We will start with Madam Kadis.

[Susan Kadis, Liberal, Thornhill, ON]

Thank you, Madam Chair and Mr. Minister.

You talked about being responsible for your promises. Your party promised Canadians in the last election that it would implement a wait times guarantee, if elected. Almost two years later you've not fulfilled this promise. Your wait times plan represents a greatly scaled back wait times reduction commitment. Now provinces and territories only need a guarantee in one treatment area rather than in the five treatment areas. In fact, on the Prime Minister's website, the wait time guarantee has been taken off the list of priorities. It's very disappointing considering your government still hasn't fulfilled this promise.

Why have you not implemented the wait times guarantees in all five identified priority areas in every province and territory, which your government did promise it would do almost two years ago?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

If I could just have a few seconds to reply, certainly I disagree with the premise of your question.

We promised to work with the provinces and territories to establish patient wait times guarantees, and that's precisely what we've done. We led in our own areas of jurisdiction—wait time guarantees, first nation and Inuit areas, and pediatric health. Then we established guarantees in every province and territory through our partnership with the provinces and territories.

I think Madam will understand, based on her knowledge of the issues, that in health care you don't overturn the apple cart tomorrow. You walk before you run. I think it is prudent for us that our charge with responsibility for health matters is to roll out these guarantees, to measure them, to examine their effectiveness, and then we can keep moving forward. Certainly, this is a priority for our government.

[Susan Kadis, Liberal, Thornhill, ON]

Thank you, Minister.

I don't think Canadians will be able to walk or run if we don't adequately address the wait times issue for all the areas that you had promised, as opposed to just a scaled-back version. Cataract surgery wait times in Ontario have only been reduced by one day.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

That's not true at all.

[Susan Kadis, Liberal, Thornhill, ON]

This is my information.

The next area I'd like to ask you about is this, and I'm very concerned. Canadians were very disappointed and shocked to learn that the Canadian Health Network website was cancelled. Its usage, in the last year alone, had grown by approximately 70%. If your Healthy Canadians website, which you've talked about, is a better alternative, then why does your database fail to make any reference to the links between health and the environment, disease and poverty, or violence and gun control? There's no mention of issues such as genetically modified foods, sexual abuse, or mental health.

Minister, Canadians deserve to know all the facts about all these issues that affect their health to help them live healthier and to stay healthy, not just the ones your government deems ideologically acceptable. Are you going to reinstate this? Why are you funding information sponsored and controlled by your government and denying Canadians access to independent public information about their health?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

There's a lot in there that isn't true.

I know for a fact that my staffer saw dozens of links to mental health, for instance, on the Healthy Canadians site, which is healthyCanadians.gc.ca, or healthyCanadians.ca. I'm not sure your accusations are accurate.

Certainly, we'll take your commentary under advisement as we continue to improve the healthyCanadians.ca website.

[Susan Kadis, Liberal, Thornhill, ON]

But again, the website you're talking about is strictly government regulated, whereas the other is non-commercial, non-governmental information about health-related issues. It's a partnership. This can only be beneficial to Canadians. I'm sure it has been and will continue to be. You're basically pulling the rug out from under the issues of prevention, and you mentioned briefly before how important prevention is. This is about prevention, and there is no justification for actually taking away something that is so significantly important for the health of all Canadians. I'd really like to understand the justification for this, because I still haven't heard an adequate answer.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

May I just add parenthetically perhaps that again these are part of the mandated cuts that were passed by Parliament because of a Liberal budget. In this particular case, I agree with the previous government. This site has outlived its usefulness and it's time to move on. We're willing to move on.

[Susan Kadis, Liberal, Thornhill, ON]

Actually, the number of times people are accessing has increased by 70%, so it's actually the opposite. What you're doing effectively is capping and limiting the information that Canadians need to have maximum health.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

I disagree with you entirely.

[The Chair, Conservative, Joy Smith]

You have about 50 more seconds.

[Susan Kadis, Liberal, Thornhill, ON]

The area of e-health is an area that is particularly important. I know you have moved money from the e-health area. I'd like to hear a little more about what you're doing in the area of e-health, which I consider to be a vital, important link to the health and well-being of Canadians.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

I'm not quite sure what you're referring to. In terms of Infoway, we've added $400 million to the budget as a result of Budget 2007, which your party voted against. So I'm not sure what your question is relating to exactly.

[The Chair, Conservative, Joy Smith]

Your time is up, Ms. Kadis.

Thank you so much, Mr. Minister.

Mr. Tilson.

[David Tilson, Conservative, Dufferin—Caledon, ON]

Good morning, Minister.

I have a couple of questions to ask of you and the people who are with you.

The first one is with respect to the cost of health care in this country. I understand you were a provincial minister, and part of this question may have to do with the delivery of health care, but there is such a thing as national policy and the national government's obligation to deal with this. The cost of health care has skyrocketed right across this country, so much so that we're spending more on health care than anything else, and particularly in the jurisdiction in which you were formerly the Minister of Health. But people demand health care and must have health care. There are all kinds of initiatives that the medical profession is taking.

My question has to do with other jurisdictions, as to whether your government is looking at other governments, other countries, other processes, and whether it's reviewing other processes, other systems, to see not only whether the system that those countries have is as good as ours but whether they are doing it more efficiently, so that perhaps with a meeting with provincial ministers some sort of national policy could be put forward.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

I think that's an important question, and sustainability of the health care system is certainly a debate that will not go away. I think it is important to examine other jurisdictions, being mindful of the fact, however, that there are certain unique characteristics in the Canadian health care system.

What I find in this debate is that there are a lot of people who produce reports on a weekly basis on the state of health care in our country, and sometimes what they try to do is cherry-pick. So, say, in France they do this well; why don't we do what they do in France? The problem with that is that France does a whole lot of other things that Canadians might find distasteful in their health care system or that certain elements of our health care system might find distasteful. I find it interesting sometimes that people say, well, France has more physicians per capita than Canada, which is a fact; they do. But they also treat physicians much more like employees rather than as professional partners in the health care system. So what I would say to the CMA or other interlocutors on this issue is that you can't cherry-pick; if you want us to go whole hog, say so. I suspect they would not.

So I think it is important to examine other jurisdictions. I'll just leave one more fact with you that I personally have been finding interesting. The U.K. government has spent billions and billions of pounds more on health care in the last few years as part of Prime Minister Blair and Gordon Brown's legacy. A recent report by the King's Fund, which some members of this committee might be familiar with, indicated that of all the additional spending—I think it worked out to something like 2% or 3% of GDP—in the U.K., 44% of it actually went to price inflation within health care rather than the actual delivery of more services to patients. That's the U.K. example. That's the age-old adage that more money, if spent unwisely, doesn't deliver better health care. It's how you spend the money to ensure increased access, better accountability, as Madam Bennett was talking about earlier. These issues that are extremely important to a properly functioning health care system.

[David Tilson, Conservative, Dufferin—Caledon, ON]

Are you developing any initiatives, or is the government developing any initiatives?

I understand the point you made, that you could look at one particular country and they may have a whole slew of other things that don't apply to us. However, no one likes to reinvent the wheel, and if someone is doing something better at a more economical cost....

Eventually, there will be no more money. We won't have any more money. It may be that there's an obligation on the national government to develop some sort of policy that could be recommended.

[The Chair, Conservative, Joy Smith]

Excuse me, Mr. Tilson, but there's less than a minute left.

[David Tilson, Conservative, Dufferin—Caledon, ON]

I'll stop there. Thank you.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

In our patient safety reviews, for instance, we're looking at what some other jurisdictions have done. On our product safety, which I know has been a hot topic in Canada over the last few months, certainly we're very much studying what other countries are doing and making sure that we have as good as or better solutions than they have.

Generic drug prices, electronic health records...these are all things where we're constantly doing reviews of what else is going on and seeking to make sure that our made-in-Canada solution is at least as good as or better than what else is available.

[David Tilson, Conservative, Dufferin—Caledon, ON]

Thank you, Madam Chair.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Minister and Mr. Tilson.

Monsieur Lévesque.

[Yvon Lévesque, Bloc, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Thank you, Madam Chair.

On page 5 of your document, Minister, you talk about funding of $2.1 billion for aboriginal people and Inuit. You have had many applications dealing with the needs of the aboriginal and Inuit nations. For example, there is a need for assistance for air transportation. These people have no roads and poor nutrition is a big problem, which leads to enormous health costs. There is also funding needed to repair homes and build new homes. Houses are overcrowded, and there are many cases of tuberculosis. There are also problems with drinking water and with garbage dumps, which are affecting drinking water sources because of global warming. This is happening in Nunavik and Nunavut. Unfortunately, I have not had an opportunity to visit the other territories.

Ghislain Picard, Chief of the Assembly of First Nations of Quebec and Labrador, was calling for more money to implement the 2007-2017 Quebec First Nations Comprehensive Plan on Health and Social Services. Ottawa knows the terrible health status of aboriginal people—and this is nothing new—and it knows that aboriginal people from these reserves have an average life span of six or seven years less than other Canadians and that their risk of developing tuberculosis is nearly 10 times higher than the Canadian average.

Given these troubling statistics, does the government intend to listen to the request for financial assistance from the Chief of the Assembly of First Nations and take immediate action to reduce the suicide rate, infant mortality and obesity among aboriginal children?

I will now allow the rest of my time to be used by my colleague.