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

Petitions
Routine Proceedings

12:10 p.m.

NDP

Judy Wasylycia-Leis Winnipeg North Centre, MB

Mr. Speaker, I am privileged to be able to present a petition signed by hundreds and hundreds of citizens of Winnipeg and Manitoba who note that on November 24, 1989, the House of Commons unanimously resolved to end child poverty in Canada by the year 2000.

They also note that since that time the number of poor children in Canada has increased by 60%. They call on parliament to keep its promise and on the federal government to introduce a multi-year plan to improve the well-being of Canada's children.

Questions On The Order Paper
Routine Proceedings

March 17th, 2000 / 12:10 p.m.

Elgin—Middlesex—London
Ontario

Liberal

Gar Knutson Parliamentary Secretary to Prime Minister

Mr. Speaker, I ask that the remaining questions be allowed to stand.

Questions On The Order Paper
Routine Proceedings

12:10 p.m.

The Speaker

Is that agreed?

Questions On The Order Paper
Routine Proceedings

12:10 p.m.

Some hon. members

Agreed.

The House resumed consideration of the motion and of the amendment.

Supply
Government Orders

12:10 p.m.

Liberal

Dennis Mills Broadview—Greenwood, ON

Mr. Speaker, the Progressive Conservative Party today put a motion on the floor of the House condemning the government for its failure to provide Canadians with a long term sustainable plan to address the crisis in our health care system. First of all I will say that I reject the opposition motion and then I will put forward a plan that I think is central to the renewal and the revitalization of the health care system in Canada.

The national food plan which I am putting forward is something I have been working on with my colleagues in the greater Toronto caucus and my colleagues in the western and rural caucuses. We have been working on this idea for a few months and today we begin the campaign to promote it.

I feel it is important to put this idea forward in parliament because there is no greater fundamental to a healthy society than a healthy food system. We need a healthy food system which works for the benefit of all Canadians. If we do not have a food system that works as well as it can, then we cannot achieve our goals in continually working to build and strengthen a healthy society.

Key to our health is the food we eat. Fundamental to the food we eat is the quality, the affordability, the safety, the access and the security of that food.

Before I move into the details of a national food plan, I want to recognize an organization that has contributed a lot to developing this idea, FoodShare of Toronto. Debbie Field and her team understand the importance of a healthy food system to a healthy society. The team works each day to make sure that low income families, seniors and children have access to nutritious, affordable, safe and high quality food. They distribute the good food box to thousands of residents throughout Toronto. We salute them for their work.

Food is a key determinant of our health as a society and the production, distribution, ownership and control of our food system is something which my colleagues and I are very excited about presenting today through a national food plan.

We must begin with the source of our food, and of course that is the farm. I begin by discussing that source and the beleaguered state of the family farm in Canada. I will describe the loss of our processing sector and conclude by outlining some of the key components.

The farm crisis in the country is real. Never during times of prosperity have we seen a farm crisis of this magnitude. Some people blame the farmers. The message is that farm incomes are low because farmers are doing something wrong. Today the reality is that farmers are growing chick peas and lentils, they are raising wild boar, they are using genetically engineered seeds and high tech seeding equipment, but for all of this investment and innovation farmers have been rewarded with the lowest net farm incomes since the 1930s.

The farm crisis is hitting farmers all around the world, so that when one looks at the worldwide nature of this crisis it is hard to believe that our Canadian farmers are to blame or that our farmers alone can solve the problem. We must be aware that farmers are not the entire agricultural community. Farmers are one part of the larger agri-food sector, which includes input manufacturers, food processors, meat packers, restaurant owners and others.

Just think about the food processing sector. From milling to malt, from pasta to beef packing, foreign ownership and control of our food processing has been increasing. The global agricultural system is not serving our farmers as predicted nor is it serving the Canadian economy. It is not serving Canadian consumers either. For example, the price of corn has not changed in 20 years, but the price of corn flakes has tripled. Wheat prices have not changed either, but bread prices have tripled. This says something about the efficiency of our farmers.

Canada's farmers are so efficient that they can produce food for the same prices they did 25 years ago. In contrast, processors and retailers have tripled the prices they charge for their services.

Canada's food system, indeed the world's food system, while working to the benefit of some, is not working to the benefit of everyone, least of all family farms. The main reason I believe that we are in this position is because we do not have a national food plan. A national food plan is central in renewing the health care system of the country.

We need a plan that will safeguard the family farm, maintain Canadian ownership of our strategic food processing sector; one which will create jobs, protect food safety and ensure that farmers receive a fair share of the consumer's grocery store dollar. We need a food plan that puts the needs and interests of farm families and the urban families who eat the food at the forefront of our concerns.

First, we need to maintain Canadian control of key industries. Canada is about to lose its railways. We may also lose control of our grain companies. We are down to one company that is making tractors in this country. It is outrageous with the land mass we have and our commitment to agriculture that we may soon cease to make our own tractors.

Former Conservative Alberta Premier Lougheed recognized that in a recent speech when he said “Democratic control requires control over one's economy”. We are losing that control. We must take immediate and decisive action, both with regard to agriculture and the larger Canadian economy.

We must act now and immediately to renew the Competition Act. That act must assess large investments in Canada on the basis of their effects on Canada's farmers and Canada's food production system. To remain within the parameters of existing and international trade agreements we must use the tax system to create incentives for broad based co-operative ownership of vital food processing companies, co-operative ownership by Canadian farmers and consumers. This would ensure that these companies remain Canadian owned and controlled. This is central and this is related to the redesign and reconstruction of the health care system in this country.

With regard to our railways, the federal government should examine its options under the existing trade agreements. Canadian railways transport our food, serve remote communities, act as a link in our national defence system and transport Canadian minerals and forestry products. Surely when it comes to key strategic infrastructure such as our railways the Canadian government has options other than merely watching helplessly as those companies pass from Canadian hands.

Another component of our national food plan would be to ensure that farmers receive a fair share of the consumer's grocery store dollar or the restaurant dollar. There are several ways to do this. As a first step, one which will cost little or nothing, I would propose legislation which requires that every grocery item bear a prominent label listing the farmer's share of the retail price. I believe that Canadians would form a new understanding of the farm income crisis if they were reminded every day that the farmer gets only a nickel from the $1.40 loaf of bread and only 14 cents on a $15 case of beer.

I want to salute a former minister of agriculture who is in our Chamber today, the hon. Ralph Ferguson, for all the tremendous work he has done on “Compare the Share” in Canada. It has just been unbelievable. We challenge the grocers of Canada to deal with the challenge of giving the farmers their share.

The linkage between food and health care is undeniable. Because I have only had 10 minutes today, I want to refer listeners to our website, www.nationalfoodplan.com, because I am hoping that Canadians will realize that as we rebuild the health care system we must have a sound system for food in this country.

Supply
Government Orders

12:25 p.m.

Progressive Conservative

Diane St-Jacques Shefford, QC

Mr. Speaker, I listened to the member speaking about the health care system and nutrition. We know that a good diet is necessary to prevent disease. This is prevention, and I agree that it is important for future generations.

But are there any solutions for those who are sick right now, those who are waiting in emergency rooms, those for whom there are no beds, the sickest members of our society? Does his government have any solutions for existing problems?

This is very serious and if the necessary action is not taken today, we will no longer have a health care system ten years from now. I would like my colleague's comments on this.

Supply
Government Orders

12:25 p.m.

Liberal

Dennis Mills Broadview—Greenwood, ON

Mr. Speaker, I appreciate the question from the member for Shefford.

First, I have been listening to the debate in the House today and I listened last week when we talked about challenging the renewal of the health care system. It seems to me that the debate has always emphasized that the Government of Canada should simply write cheques to the provinces. I do not believe that is the way to go. As we design a new health care system in this country, those issues around prevention, causing Canadians to become more physically fit, would reduce health care costs dramatically.

Surgeons appeared before the committee last year and they told us that for every 10% of Canadians who increased their physical activity we could decrease health costs by about $5 billion annually.

The importance of nutritious, healthy food is a challenge in the country because, by and large, we are all insensitive to the issue.

As we begin this exchange and the resolution of our health care system, it is important for the government to send signals to the provinces that prevention must be very high on the list. I believe that in the area of prevention called the food we eat, we have to repair and rebuild our food source, and that is the family farm of this country. I appeal to the member from the Progressive Conservative Party to join us and help us build a national food plan which will be the envy of the world.

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Government Orders

12:25 p.m.

NDP

Dick Proctor Palliser, SK

Mr. Speaker, I listened with interest to the member's comments. My concern is that we are seeing more and more of our country being taken over by foreign investment. It has jumped sixfold in the last couple of years.

I do not disagree about writing cheques, but I wonder whether anybody will be able to write a cheque in this country because all of the profits and all of the good jobs will be south of the line.

Supply
Government Orders

12:25 p.m.

Liberal

Dennis Mills Broadview—Greenwood, ON

Mr. Speaker, I feel that this is a very important question and I would ask the indulgence of the House to let me have a little more than 40 seconds to answer it.

The member has recognized a very important point, which is that the food processing sector in this country has reached a level of offshore ownership which, in my view, is quite scary. Foreign control is over 90%. We are going to have to enter a very rigorous debate on how we can stall and reclaim our control of these strategic industries within the guidelines of those trade agreements that exist. I know that the member thinks that would be a real challenge.

Mr. Speaker, this is critical for the way we go as a nation, so please let me answer this. I think that all of us in the House have to look at every clause in every one of those trade agreements and see how within those trade agreements we can use things like tax law and other instruments that we have to make sure that the trajectory totally changes on it and we reclaim it.

Supply
Government Orders

12:30 p.m.

Reform

Grant Hill Macleod, AB

Mr. Speaker, thank you for giving me the opportunity to speak to the supply day motion. For those who are not really familiar with that, it is an opportunity for the opposition to set the topic of debate and to allow a firm vigorous debate on a specific issue. This is a Tory supply day motion asking for the federal Liberals to adopt a long term sustainable plan to address the crisis in health care.

Crisis is a strong word. It is not a word that I use lightly. Health care is under significant stress in Canada and having a debate on this issue is a good idea.

I listened to the Minister of Health today and he basically said that there is a plan in place. That plan requires some co-operation and some significant alteration so that we can have a sustainable health care system. Then he went on to say that funding was one component of that plan, innovation another component and co-operation the third component. I would like to talk about those three things one after another: the funding component for health care, innovation, and co-operation.

Where are we with funding? Figures can be used to disguise facts. On the issue of funding, the figure that matters to Canadians is the per capita spending on health in Canada which is lower in 2000 than it was in 1993 when the Liberals took power. They can take the figures any way they want.

Anybody listening to the Minister of Health today would have heard what he said about the federal share of publicly funded health care dollars. The figure that he took out of the document which he quoted was the federal share of publicly funded dollars. He said that the taxpayer funded component of health care in certain provinces that get equalization payments is relatively high. Every single province that he quoted was a provinces that gets equalization payments. He used figures as high as 60% plus in those provinces as the share of publicly funded dollars.

The figure that matters to the individual in the street is not whether equalization, other means, tax points and whatnot fund health care in the maritimes. What matters to Canadians is the share of per capita dollars that the federal government is spending. Is it spending a share that allows it to call the shots? In fact in much of Canada it is not.

The figure I am using now is the federal cash share of overall health care spending. In those cases it is down in the neighbourhood of 12%, 13%, 15% in those provinces that do not have equalization payments.

Those figures are in the document that the minister quoted from. I say let us stop fooling with the figures and let us talk about the one that really matters, which is the per capita expenditures of cash from the federal government.

Health care has a couple of other big problems. I will not ascribe blame on this issue. Waiting lists have grown. We have fallen behind in technology. We have an aging population. The minister has finally stated publicly that the status quo is not sufficient and on that issue we agree.

The issue of funding is one which the public needs to be aware of. The motion calls for sustainable funding. The motion calls for predictable funding. The motion calls for, in my estimation, some buildup of the funding as the population ages more and as inflation comes along.

I do not see anything of that kind of commitment from the federal government. In fact, none of the funds that have been promised in the last few years are certain. None of the funds are growing with inflation or with aging. They can be lowered and raised at will by the health minister, by the finance minister and by the Prime Minister. That is the funding component. Much of what we say in the health care debate is on the issue of funding. That is a component which needs to be discussed. I believe the funding needs to be predictable. I believe the cash funding needs to grow with both aging and inflation.

Innovation is the second big topic I want to address. The minister has said the status quo will not do and we agree. Stated very plainly his solution is that Canada needs universal home care and universal pharmacare. That is the minister's solution. This is the innovation the Minister of Health has specifically spoken of. He said to the provinces “Join us and we will pay 50% of universal pharmacare and universal home care”.

I remember the promises that came from a health minister which got medicare started who promised then “Join us in medicare and we will fund 50% of the cash needed for health care”. That promise was broken. In my mind, is there any wonder that the provinces are somewhat hesitant to go down this road when we already have visible problems with our health care system.

The third area I want to talk about is co-operation. The minister's own words were “We need to co-operate. We need to have a discourse on this that is free of partisan commentary”. Then he turned around and said that we need to get rid of any proposals that suggest two tier Americanized health care. That is a fair comment and one which I share. Two tier American style health care has no merit for Canada.

Let us look at the provincial efforts at innovation and co-operation. The provinces are ready to look at alternatives. In fact Quebec has been sending a number of its patients to the U.S. for cancer therapy. That is an alternative that has been looked at by Quebec. In fact B.C. has done exactly the same thing. That does not seem to me to be a made in Canada solution for our health care problems.

On the issue of public administration, one maritime province has chosen to administer its health care system with a private concern. This fits with the principles of our health act.

Alberta has recently brought in a proposal to contract out using taxpayers' funds for some overnight surgery. This is an issue that has received vigorous condemnation from many Canadians. The health minister's response to this has been an uninvited visit to Alberta where he made a speech at the University of Calgary and his words today “This bill is bad policy”.

What exactly is Alberta's Bill-11? I have a copy of it here and I have gone through it carefully. Without supporting or criticizing the bill, I think we should at least know what it contains. I will read from Alberta's Bill-11 so the Canadian public will know what is in it.

It is called, and this is an antithesis for all those who criticize it, the health care protection act. I am going to go over the bill not from some esoteric perspective, but I will read from the bill as to what it has in it.

It commits Alberta to the principles of the Canada Health Act, well known to anyone involved in the health care system.

One other big principle is that this bill makes it illegal to operate a private hospital in Alberta. The words are so plain that no one can misunderstand: “No person shall operate a private hospital in Alberta”. It goes on to define what a private hospital is by saying exactly what a public hospital is. Only public hospitals will be allowed to provide the full range of hospital services, including emergency rooms, diagnostic and medical services, and major surgeries. It sounds pretty straightforward to me.

It goes on to talk about what the bill is designed to do, which is to allow overnight stay for what has traditionally only been done in day surgery facilities. Specifically a surgical facility allowed under this procedure would only provide a limited range of surgical services. It would not be a full service hospital. It goes on to state that only the College of Physicians and Surgeons, my college, can decide what would be provided and only it can accredit these facilities.

One of the big concerns about a private facility doing procedures in any part of the country is that queue jumping could take place. This bill specifically makes it illegal to queue jump. It also makes it illegal to charge facility fees for insured services.

One other argument against a private facility doing anything surgical in Canada is upgrading. In other words for example, someone would come to that facility looking for cataract surgery. The cataract surgery would be upgraded and made more expensive. In this bill that is specifically prohibited. It is specifically prohibited with fines.

It goes on to say that if a person chooses to upgrade a service such as a fibreglass cast or foldable lens for cataract surgery, it must be in writing, the cost must be shown and a person must sign in full agreement. The person can back out if he or she changes his or her mind. It goes even further to say that if an upgraded product or service is the only thing that is available, it cannot be charged for. Finally, unlawful charges can be recovered under this bill on upgraded surgical services.

The bill goes on to talk about uninsured services that can be done and are done in every single province of Canada. These are things like plastic surgery and new technologies that are not accepted yet under our Canadian health plan. These must be done in compliance with the Canada Health Act in this bill. These must be done only with a demonstrated need to the regional district that has contracted them out. The health authorities have to show that the contract will not harm the publicly funded system. They also have to show how they will benefit the public system.

The other concern is that this sort of process might well invite out of country facilities to come in and take up this new proposal. The only way this could happen would be for the public to approve it through their government and the reasons for authorizing such a facility will be made public. Any contract would be made public.

In my view, this bill clearly and plainly lays out the mechanisms whereby short term, what has been day surgery, can have an overnight stay.

The minister himself on bill 11 has been asked plainly by the Government of Alberta to rule on whether or not the bill complies with the Canada Health Act. He said that he will wait until all the potential amendments are made and all the regulations are in place before making his ruling on bill 11. Members will note that he has not once said that the bill goes counter to the Canada Health Act. He has said that in his opinion it is bad policy.

I want to go over the clinics in the country that are already functioning under the very same proposals that are expressed here. We have new techniques in prostrate surgery that are not paid for under medicare. Cosmetic surgery, the plastic surgery, is not covered under medicare. Therapeutic abortions; every single private facility in Canada that does therapeutic abortions is doing it under this type of proposal. New radiological techniques, the exploratory techniques like biopsies using imaging that we did not have when medicare started and new forms of cancer therapy are not covered under our medicare system.

Bill 11, by my reading, controls and regulates these new innovative therapies and frees up, if it works the way I foresee it, some hospital beds in the regular hospital system which will have significant benefits to the public.

The debate on such an issue, if it persists being the opening for a two tier American style medicare, is in my view doing no service to the medicare debate. This debate is coming whether or not any politician likes it. If the debate comes, will this idea be reviewed, critiqued and improved, then watched to see if it is successful or not, and removed if it is not and expanded if it is? I am convinced that the European countries that have already done this with their taxpayer funded health care systems, which are the equivalent to Canada's, have already shown that there are risks, that there can be gains and that we should at least be innovative.

The health minister has said that funding is one issue, that innovation is another issue and that co-operation is the third issue. I would ask my colleagues, as we enter this debate, to do this not with these, if you will, old-fashioned buzzwords, but by actually looking at the issues and reviewing the legislation, if new legislation and new ideas come forth.

I will end my commentary with another little issue and that is the issue of hepatitis C. I do not often get an opportunity any more to raise that issue. The poor patients in my own part of the world who were infected by tainted blood, those who have been covered by the compensation program that was agreed to by the federal government, have waited two years now since the program was announced. They have not received a nickel. The lawyers have now been paid substantial amounts of money. I believe that is one other indication that the victims do not have a very strong voice in this place.

I urge my colleagues across the way, who have a more potent ability than I to bring these processes to an end and to see those victims compensated, to get the health minister off the excuse track and onto the let us get this thing finished track.

The legal route was not the best way to see those patients cared for. I will not belabour this and criticize any further but this issue deserves immediate attention and is long overdue.

I conclude by saying that the motion asking for sustainable funding that is predictable and growing with inflation and with our aging population is one that I personally support. I ask my colleagues to reflect on whether or not any of the funding that has been promised is in fact permanent funding or could it be withdrawn at the whim of the health minister.

Supply
Government Orders

12:50 p.m.

Progressive Conservative

Rick Borotsik Brandon—Souris, MB

Madam Speaker, I will not say this very often, particularly with the official opposition, but I must say that I respect this individual member for Macleod as a physician. I respect him as a member of parliament and I appreciate the comments he made today.

Being a member of the medical profession, this member will recognize that there are a number of stakeholders within the health care field: the doctors in his profession, the nurses in the nursing profession and the employees in administration.

I ask the member, who is very close to the situation, how other members of his fraternity, those in the medical profession, feel about sustainable funding? I think I already know that answer.

I would also like him to answer a question about what his membership in the fraternity think about an expansion of the services that he talked about in bill 11 in the province of Alberta. Are they supportive or are they, like most members of society today, split on that particular issue?

Supply
Government Orders

12:50 p.m.

The Acting Speaker (Ms. Thibeault)

Before calling on the hon. member for Macleod, I would like to mention that there are several members wanting to ask questions. I would ask all of you to please be as brief as possible.

Supply
Government Orders

12:50 p.m.

Reform

Grant Hill Macleod, AB

Madam Speaker, this is a stakeholder driven issue in many cases. Specifically on the issue of what does the medical profession in Alberta, my association, think of this bill. They are split. They are asking for amendments to this bill to make certain that there are no concerns.

On the other issue of stakeholders, I will use a specific example of what is best for the patient. The nursing profession has a huge issue in terms of health care. Even the staff who clean the hospitals have a huge interest in this issue. If we just look at the administrative level, the hospital cleaners, and compare the hospital cleaning staff with the hotel cleaning staff who basically do the same job, the hospital cleaning staff is paid double what the hotel cleaning staff is paid. I only bring that up to say that we sometimes forget the patient and the patient should be the centre of our concerns on health.

Supply
Government Orders

12:50 p.m.

Liberal

Paul Szabo Mississauga South, ON

Madam Speaker, the principles of the Canada Health Act are universality, accessibility, comprehensiveness, portability and publicly funded. The member well knows that.

The member needs to comment on the issue of accessibility, portability and comprehensiveness. As an example, in Ontario there are only five doctors who perform the procedure called a spinal fusion. Two of those doctors are in the Mississauga hospital in my own riding. The member would well understand that if private clinics were set up, even though they might be publicly funded to provide that, there would be a drain on the public health system to provide the human resources and medical resources, personnel and otherwise, to staff and equip these private facilities. It means that the accessibility and the comprehensiveness of the services available to the public at large would be reduced.

Since the experience in Alberta has shown that private health care is more expensive, has longer waiting lists and violates the spirit of the Canada Health Act, does the member not agree that these private clinic arrangements as proposed by bill 11 in Alberta would be inappropriate?