House of Commons Hansard #66 of the 36th Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was health.

Topics

Privilege

10:05 a.m.

Liberal

Joe Fontana London North Centre, ON

Mr. Speaker, and members of the House of Commons, I rise on a question of privilege with regard to the premature release of a confidential document that was still work in progress at the Standing Committee on Citizenship and Immigration.

The member for Lakeland, who happens to be the vice-chair of the committee, issued a media advisory, which says:

OTTAWA, Thursday, 16 March 2000: At 3:30 p.m. today in Room 130-S Centre Block, Reform MP Leon Benoit, MP will hold a press conference to make the report of the citizenship and immigration committee public. This report titled, “Refugee Protection and Border Security: Striking a Balance” is marked confidential and has yet to be tabled in the House of Commons.

I note that in the House of Commons Procedure and Practice , chapter 20, at page 884 it says:

Committee reports must be presented to the House before they can be released to the public. The majority of committee reports are discussed and adopted at in camera meetings. Even when a report is adopted in public session, the report itself is considered confidential until it has actually been presented in the House. In addition, where a committee report has been considered and approved during in camera committee meetings, any disclosure of the contents of a report prior to presentation, either by Members or non-Members, may be judged a breach of privilege. Speakers have ruled that questions of privilege concerning leaked reports will not be considered unless a specific charge is made against an individual, organization or group, and that the charge must be levelled not only against those outside the House who have made in camera material public, but must also identify the source of the leak within the House itself.

It is not only a question of privilege for myself but especially for the members of the committee on citizenship and immigration who have worked very hard over the past two or three months, and on Wednesday or Thursday of this week continued to do that work, and, as I said, it was work in progress.

Unfortunately the member for Lakeland and his colleague decided not to participate in those meetings and hence have done this. I think this is an important question of privilege, a privilege that affects each and every member of the House. It is incumbent upon us, because we all cannot sit on each other's committees, that we do work on behalf of each other in these committees.

Therefore, until such time as the document is released to the House, it is rather unfair that the members of the House of Commons do not get to see these reports before they are leaked to the public and, in this case, with intent and purpose as reported by the news media.

I ask that this question of privilege be immediately referred to the Standing Committee on Procedure and House Affairs so that it can deal with this breach of privilege which I believe demeans the value of the House of Commons and the value of our purpose here. After spending the better part of yesterday talking about this institution and about how important and how respected it is, I think this is absolutely deplorable.

Mr. Speaker, I would ask that you immediately refer this breach of privilege by the member for Lakeland to the procedure and House affairs committee for a report back to the House to Commons.

Privilege

10:10 a.m.

Reform

Bill Gilmour Nanaimo—Alberni, BC

Mr. Speaker, before you give your ruling, I would ask that you give the member for Lakeland the opportunity to tell his side of the story in the House. I know there is another side to this story that I think you would want to hear.

Privilege

10:10 a.m.

Liberal

John Bryden Wentworth—Burlington, ON

Mr. Speaker, very briefly, I am a member of that committee. On the very day that report was released, which was an initial report, we were having deliberations and made several changes to the existing report, including an amendment that I moved.

What I am afraid of is that because the first copy of the report, which was not a final report, was released to the public, it will be very unlikely that the media and the public will see the substantial changes that were made. Not only is that not in the public interest, but again, it erodes the opportunities of members of parliament to make substantial changes and have them debated in a public forum.

Privilege

10:10 a.m.

The Speaker

I take very seriously of course this allegation of a breach of our rules, as the hon. member for London North Centre has claimed. At the very least, I will take the advice of the hon. member for Nanaimo—Alberni. The member of parliament for Lakeland has been named in this particular point of privilege. I would like to hear what he has to say about it.

This is not a report from the committee that is before the House, at least at this point. I believe we have a steering committee, which is the term that the member used and he will correct me if I am wrong, and this met in camera. That is one thing.

Second, I do not know that the committee itself has dealt with this issue.

Third, I do not know, and perhaps some of you would know, but did this actually take place, was a document used and was it indeed a document that can be identified by the members of the committee?

I have a couple of questions before I deal with this, at least at this point. I will hold it in abeyance at the very least until I hear what the hon. member for Lakeland has to say about this.

I see the hon. member getting to his feet. Does he have more information that he can give to the Chair?

Privilege

10:10 a.m.

Liberal

Joe Fontana London North Centre, ON

Mr. Speaker, I respect your decision to hear from the member for Lakeland, but I did want to answer three of your questions.

First, it was not a steering committee. It was a full committee of the citizenship and immigration committee that was undertaking the work of preparing its report. My colleague from Wentworth—Burlington has indicated that we had moved certain amendments and wanted to publicize the report on Monday or Tuesday.

Second, yes, there was a confidential draft report that was produced. That was the report that was leaked at the news conference held by the member for Lakeland yesterday at 3.35 p.m. Upon witnessing the news release, which was on CPAC and the internal communication devices of the House of Commons, I immediately tabled the notice with the table officers. Yes, it is a document that was being prepared by the full committee of citizenship and immigration and was released in its unamended form yesterday at 3.30 p.m.

Privilege

10:15 a.m.

The Speaker

That would leave us with at least two things to consider. First, absolutely, I am going to hear from the member for Lakeland. Second, has this been dealt with in committee? If it has not been dealt with in committee, we in the House usually deal with these matters when there is a report from the committee as a whole.

Those are the factors I am going to consider, not before I make a decision, but before I even consider making a decision I would like to have those things in place.

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10:15 a.m.

Progressive Conservative

Greg Thompson Charlotte, NB

moved:

That this House condemns the government for its failure to provide Canadians with a long-term, sustainable plan to address the crisis in our health care system, and its continued failure to work with the provinces to ensure funding formulas consistent with the founding principles of our health care system to provide Canadians with timely and equal access to quality health care.

Madam Speaker, I appreciate the opportunity to debate this issue today and I want to read into the record the very motion which you have just read:

That this House condemns the government for its failure to provide Canadians with a long term, sustainable plan to address the crisis in our health care system, and its continued failure to work with the provinces to ensure funding formulas consistent with the founding principles of our health care system to provide Canadians with timely and equal access to quality health care.

I cannot stress enough the importance of this motion and this debate. I will be splitting my time with the member for Richmond—Arthabaska, who will be moving an amendment to my motion.

I want to talk about the pillars upon which our health care system is built, the principles of our health care system. There are five of them: universality, accessibility, comprehensiveness, portability and public administration.

We have to look at the motion very carefully. I know that we could be attacked on some approaches to this, because in the motion we are not talking about turning the clock back to the 1960s. We are not suggesting that. It is the year 2000 and circumstances obviously have changed from the fifties when universal health care was first introduced in Canada.

We realize full well that we cannot turn the clock back and we are not suggesting that we go back to the 50:50 funding arrangement. It would be unrealistic to suggest that, and we are not suggesting that. We are suggesting that the government has to pay attention to this issue and has to do something. It has to take a leadership role.

I want to mention another important thing. We have a good system in Canada and we do not want to lose it. We have to acknowledge that. We have to move beyond the finger pointing.

I was reminded once in the House that when I point at you, Madam Speaker, or anyone across the way, including the health minister, who I am glad to see is here today, I have three fingers pointing back at myself. I mention that because we are in this together and we have to find a way to solve the problems that we have in our health care system. It is not simply pointing over there and then pointing back at ourselves. Too much of that has gone on for years and years in this country.

Our health care system is a deal for Canadians. We have a good system upon which we have to build. We have to preserve it.

Let us take a look at what we spend in terms of our GDP in Canada versus other countries, realizing that we have a system which includes everyone. No one is left outside our system. We have a universal system. We want to protect the universality of our system.

In Canada we dedicate approximately 9% of our GDP to maintaining a universal health care system which includes every Canadian. By comparison, the United States dedicates approximately 14% of its GDP to a system that leaves out, at a minimum, 40% of the population. Truly, the taxpayers are getting a deal. I think most of us have to stand in our place and acknowledge that.

Where I think we have fallen short in recent years is on the federal side, in terms of its responsibility to the provinces. I mentioned at the outset that when universal health care was introduced the funding formula required that 50% be paid by the federal government. There will be arguments over figures on this issue. Most people would accept that the funding formula now on the federal side is about 15%. The government could argue that it is 20% or more, but let us accept the fact that it is 15%.

I hear members opposite saying that it is 33%. Let us move beyond that. I do not want to get into a rancorous back and forth. I want to hear some intelligent debate today.

Regardless of what that percentage is, the fact is that by the year 2004 $30 billion will have been extracted from the system on the federal side of the equation. Most of the provinces cannot live with that. What they are saying is, if the federal government wants them to adhere to the principles of the Canada Health Act, they need more money.

Madam Speaker, I am going to ask my colleagues to tone it down a little. I know it is difficult for you to hear it, but from where I am standing I can hear it. I do not mind the debate, but please allow me to concentrate on my debate and members opposite can take it outside the House. Please add another minute or two to my speech, Madam Speaker. I will inflict more pain on them if they do not quiet down.

We have a problem in this country. It is a funding problem which we cannot walk away from. The federal government cannot walk away from it.

In the recent budget there was mention of $2.5 billion going back into the system. That $2.5 billion sounds pretty good, but let us put it into perspective. The $2.5 billion supplement, as it is called, will not to be added to the cash floor of the CHST. It will go into a third party trust which will be split between education and health care. It is the prerogative of the provinces to spend it where they will.

If we assume that the provinces will be spending all of that money on health care over the next three years, in my home province of New Brunswick, once the money is sorted out and its percentage is taken in, it will have exactly $5 million this year to spend on health care. That would keep our system running for one day. If we said that half of the money has to go to education, we would be running the system for half a day. It just shows how little attention the government paid to this issue in the federal budget.

That is what led me to believe, from the day the minister presented his budget in the House, that it was not an election budget. It is reminiscent of a former prime minister by the name of Mackenzie King. He was a political genius, but he always created an artificial crisis, knowing full well that he could solve it sometime down the road. In other words, at the right moment he could solve the political problem which he himself created. That is what I see happening in this case. The government today has the wherewithal to solve the problem, but it is not going to solve it now. It will solve it six months or a year from now, leading into an election. The government would call it political opportunity. There was a lot of political opportunity in the budget which was presented. We should not be surprised if the government comes up with a last minute reprieve.

It is easy to talk about what the government is doing wrong, but it could easily point across to us and ask “What would you do?” Let us talk about what we would do.

In March 1999 Joe Clark, the leader of our party, stated that we would bring together the provinces, the territories, health care professionals and others to establish contemporary national goals and objectives for our health care system, negotiate acceptable national standards, and create a reliable system to assess performances and generate a common information base on what Canadians expect and need in health care so that we can measure and foresee the demands for services.

Those are only a few of the things we could do. The other thing we could do, of course, is to provide more education for Canadians on better health practices, move to reduce the number of smokers in Canada who account for 25,000 deaths a year, and move on the technology side.

I know my colleague will continue this debate, driving home some of the points and concerns that he has. I look forward to the debate.

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10:25 a.m.

Progressive Conservative

André Bachand Richmond—Arthabaska, QC

Mr. Speaker, my colleague was so clear, and what he said was so clear, that no questions are asked of him in this House. This proves that people are silent when faced with the truth. I am extremely proud of my colleague.

I must admit that I am not an expert number cruncher, like the future leader of the Liberal Party, the Minister of Finance, but we do need to address the key figures. After two major recessions, in the late 1980s and early 1990s, the government made cuts, but not in its own finances. Its main cuts were to the transfer payments to the provinces.

It is said that 60% to 70% of the effort to fight the deficit was focused on transfer payments to the provinces. There was another 5% to 8% in program cuts. And then there was some $35 billion in increased taxes that went into the government's coffers.

After the latest budget by the Liberal Party leader-in-waiting, we are told that the federal government is a 30% partner in health. It has to be remembered that that 30% figure dates from the time the future Liberal Leader brought down his budget. That was before the provincial budgets.

Our colleagues ought to wait for all of the provinces to have brought down their budgets. They will then see that the federal percentage will drop to about 15% or 20%. We will wait for the final outcome.

When the future leader brought down his budget, the figure was 30%. But with the Quebec budget, the federal participation will go down to pretty well what it was before the leader-in-waiting's last budget.

Money is a problem, yes, but I believe we all agree that there is also a problem of principle. In the future Liberal leader's last budget, we were also told there would be a conference with the ministers of health of all of the Canadian provinces.

On this point I think the Minister of Health is right. I think he wants to meet his counterparts in the provinces quickly, and we congratulate him on that. It is important. This government needs to do more of this: work more in partnership and not announce programs without consulting its partners on it. This is co-operative federalism. In fact, it is even more that that: it is respect for others, which they were a bit short on.

However, the Minister of Health, unfortunately for him, was ordered by his Prime Minister, the future former leader of the Liberal Party, who said “There is no hurry before fall”. Why? For a number of reasons. The main reason is to wait and see what the provinces will each do with their budget, their reinvestment in the health sector.

At that point, the federal Minister of Health will be able to come along and say “Finally, you do not need money. Your investment is three, four, or five times higher than mine. So you have no funding problem. You have a program problem”.

The danger is that the federal Minister of Health will come along with program ideas. With transfers not back in balance, with federal participation, after the provincial budgets, at between 15% and 20%, maximum, but not 30%, the minister will arrive—because he wants to be an important player, even though the game is not quite in his field of jurisdiction, depending on the program—with program ideas.

With what is going on now, following the fight against the deficit, reinvestment, primarily by the provinces, but a bit by the federal government, is still below the figures prior to the 1993-94 cuts. What we are saying is that we would like to talk about the health care system in general.

There are five basic principles that have guided us for years. There are funding problems, the population is changing. Because of increased costs due to inflation and population aging, it will take $2 billion in the health care system just to maintain existing services. So, to offset the costs of inflation and the aging of the population, the government invests $2 billion. This is the cost nationally of maintaining our health care at the same level.

What we are saying—Mr. Clark rightly explained it and my colleague appropriately pointed it out—is that there is undoubtedly a money issue involved in the four points mentioned by the hon. member.

If I give you more money, the choices that you will make will be different. Having money is not everything, but it is helpful. It makes it easier to decide and to plan. We are also asking for long term planning, not in an office in Ottawa, but with the partners in the federation, with the people who are associates and partners in the federation.

The four points that my colleague clearly presented and that Mr. Clark stated do not refer to money. Can we finally review what is going on in our health system? Should we add one or two principles to the five fundamental ones? Maybe. Should we clarify the principles that we have? Maybe. We should have a good debate.

We have to take the opportunity given to us by with what is going on with Bill 11 in Alberta. Some may condemn Bill 11 while others may applaud it, but at least there is a debate on this issue in Alberta. Why not take this opportunity to sit down with our partners and say “Here is what is going on”.

In the wake of the fight against the deficit and the problems in the health care system, is it not time to review this issue together? There are surely good ideas in Alberta. There are surely good ideas in Quebec and in Nova Scotia. There are good ideas everywhere, just like there are bad ideas everywhere. This is clear.

But why wait until the fall? Why would the Minister of Health not invite his partners and tell them “Listen, we will look at the overall situation. I will not come up with my new programs and tell you that I will give you money if you accept them. We will look at the system in general, at the fundamental principles. We will clarify and update these principles”. Why not do this?

I urge the Minister of Health to take this first step this spring and, in the fall, following any discussions that may be held during the summer, to come with solutions concerning basic principles, funding and perhaps programs that are more suitable or updated.

Let us not try to go at it backwards. Of course we think that transfers should be adjusted. That having been said, let us take this opportunity to discuss the problem in very broad terms.

The health system must not be used for political ends by people claiming that they want to defend it. I am referring, of course, to the federal government. This is a responsibility that must be shared by all partners.

When I look at what is going on in my home province, the local level is becoming more and more involved. Hospital boards are appointed by the local population. Then there is the issue of regional health boards. We are trying to involve the grassroots. This is a wonderful message to send the Minister of Health “Do the same thing. Involve the grassroots”. Perhaps not Edmonton, Sherbrooke or Victoriaville, but at least he could involve the provinces and territories.

I wish to move an amendment to the member's motion.

He is our only member in Manitoba, at least for the moment, so we need to take care of him a bit. I move:

That the motion be amended by adding after the word “House” the word “strongly”.

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10:35 a.m.

The Acting Speaker (Ms. Thibeault)

The question is on the amendment.

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10:35 a.m.

Liberal

Joe Volpe Eglinton—Lawrence, ON

Madam Speaker, I listened attentively to my two colleagues opposite whose concern for the health care system in the country is very genuine. It can only reflect our concerns.

I wonder if in expressing concern whether there is as well a method to address those concerns. What is the solution they would wish our government to follow? They have acknowledged in their statements that we have been very progressive in adding more and more funds to the Canadian health transfer. We have been very trusting of our provincial partners in the discharge of their duty with respect to health administration.

We found only last month that notwithstanding the social union we signed one year ago and notwithstanding the fact that the Government of Canada increased the transfers by $3.5 billion immediately last February 1999, with an additional $8 billion to follow, the provinces and in particular the province of Quebec took the additional money, as he said mettre plus de fonds dans les poches. Quebec took that money from les poches and put it into bank accounts and not to the service of the health care system which is in great need.

That province took $800 million. Instead of investing in health care, it invested in interest deposits. The province of Ontario thought it was a good example to follow and put roughly $600 million into bank accounts rather than invest in hospital restructuring and health care delivery.

These are difficulties that we have to address. Our colleagues opposite point out the obvious, that Canadians want a viable, vibrant health care system. I wonder what they would have us do short of the things we are doing. As we indicated in the last budget, we are willing to do even more. They should give us the bill, tell us what they would do, and we would look for the means to finance it.

We have increased funds for medical health research. We have increased funds for health innovation. We have increased funds for various projects. We have discharged our responsibilities to those in our care. What would members suggest we do for those who come under the care of the provinces?

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10:40 a.m.

Progressive Conservative

André Bachand Richmond—Arthabaska, QC

Mr. Speaker, I would like to remind my colleague that, in the 1999 budget of the Liberal party leader-in-waiting, the money could be spread over x years. It seems that the provinces are being criticized for having kept some hundreds of millions of dollars over a period of less than one year.

I would like to ask my colleague how many billions are being kept in the bank at present. How much are we talking about? Is it $8, $10, $12 or $15 billion in the bank? Could you tell us how much? You could talk to your partners about it. You could perhaps find a solution.

We spoke of four items proposed by our leader that did not even mention money. One of the ways to find solutions is to quit doing what the hon. member has just done: province bashing.

As soon as possible, they say “Oh, let's attack the Minister of Health for Ontario. Its government is Conservative”. Or “What about the NDP Minister of Health of some other province? Let's attack him”. Or “The Minister of Health for Quebec is a separatist. Let's attack him”.

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10:40 a.m.

An hon. member

They even went after Brian Tobin.

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10:40 a.m.

Progressive Conservative

André Bachand Richmond—Arthabaska, QC

Yes. I believe it is a matter of attitude. A different way of doing things.

What is insulting, highly insulting, for those living daily with health problems, is that the future leader of the Liberal Party has said “We still have money, if you want it. There is still some left”. If so, put the money on the table, and maybe solutions will be found.

He has to put the money on the table. The federal government has billions in the bank that might make it possible to find solutions for all Canadians.

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10:40 a.m.

Etobicoke Centre
Ontario

Liberal

Allan Rock Minister of Health

Madam Speaker, I would like to begin by telling you that I will be sharing my time with the hon. member for Broadview—Greenwood.

This motion should be rejected. Although there is much in what was said by the hon. member for New Brunswick Southwest with which I agree, the motion is fundamentally flawed. The government is doing the very thing he is calling upon us to do by his motion today.

It is obvious that the status quo, the current situation is unacceptable. One can see the problems that exist everywhere: waiting lists, overcrowded emergency rooms, shortages of doctors and particularly certain specialists, and shortages of nurses.

It is also obvious that just investing more money will not solve these problems. Major changes in our ways of providing health care services are also necessary.

This is evidenced, as the hon. member for Eglinton—Lawrence mentioned, by the fact that certain provinces are not using some of the money given to them for health by the federal government.

Why? As Quebec Minister of Finance Bernard Landry explained a few days ago, it will take more than just money to face the problems in our health care system. This issue also involves management and organization.

We need two things if we are to deal with the issues in our health care system, if we are to save it, as the hon. member proposes, and if we are to improve the quality and access to services within the principles of the Canada Health Act. Those two things are: first, a long term plan on how to improve the way we deliver services to ensure timely access to quality care; and second, long term financing.

As the Prime Minister and the Minister of Finance have said, if that long term financing requires additional money from the Government of Canada, we will be there to do our part to support that long term plan.

I will first deal with the plan. The House knows that in January I invited ministers of health to join me at the table so that we could get all the ministers on one side of the table and the problems on the other and start working toward solutions and find out what we have learned from best practices, the pilot projects that many of the provinces have themselves put in place and the innovations that the provinces themselves have undertaken.

I have made it clear that I will not go to that meeting with a fixed agenda or a settled approach. We are open to ideas and proposals that the provinces themselves will bring forward.

Let me now deal with money.

The hon. member for Richmond—Arthabaska suggested that the federal contribution to our health care system is 13 to 15 cents per dollar. That is not true. The hon. member is mistaken.

The reality is that the Government of Canada contributes on average more than 33 cents to every dollar of public spending on health every year in the country. I will refer to figures produced by the Canadian Institute for Health Information which demonstrate that in New Brunswick, for example, the Government of Canada contributes 55 cents of every public health dollar spent every year. In Nova Scotia it is 47 cents. In Prince Edward Island it is 64 cents. In Newfoundland it is 52 cents. In Quebec it is 47 cents and in Manitoba it is 48 cents. A national average of 33 cents on every dollar of public spending on health in Canada comes from this government.

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10:45 a.m.

NDP

Judy Wasylycia-Leis Winnipeg North Centre, MB

Madam Speaker, I rise on a point of order. The minister is referring to documents that are not available to all members in the House. Would he agree to table those documents?