Debates of March 2nd, 2000

Supply

[Roy Cullen, Liberal, Etobicoke North, ON]

Madam Speaker, the National Forum on Health which was convened a couple of years ago did a vast amount of research. Experts in health care compared our expenditures in Canada. They looked at a variety of issues. They concluded that the per capita expenditure on health care in Canada was greater than most other countries with the only exception being the United States.

The parties opposite talk about the health care system in the United States. We all know the problems with accessibility which my colleague the Minister of Health and others have quoted. Not only are there problems with accessibility but there are the administrative costs in the United Sates. Because it is privately funded, many patients in hospitals and clinics end up filling out forms ad nauseam because the health care insurers are not anxious to pay the claims. Fully 30% of the cost of the health care system in the United States is administrative costs.

If the member opposite is going to quote new figures, he should also look at the expenditures we made in health care last year and this year. It was $11.5 billion last year and another $2.5 billion this year.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Madam Speaker, just to help out the Liberal member on the question raised by Reform, it is absolutely clear that this country spends—

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Madam Speaker, I rise on a point of order. How often do you have to stand in this House to be able to be recognized? You only recognize people within three feet of your chair. I am tired of this. This is not the first time this has happened. You only know three members by name in this House and those are the only ones you recognize.

[The Acting Speaker (Ms. Thibeault)]

A lot of members are interested today.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Madam Speaker, we have been up at this end of the House at least six times. Now listen this one out. You recognize about three people in this House. You have done it for the last three speeches. Is it not about time—

[The Acting Speaker (Ms. Thibeault)]

Order, please. First of all it is the privilege—

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Are you going to recognize the same three people over and over and over again?

[The Acting Speaker (Ms. Thibeault)]

Order, please.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

The truth is we have a point here as well and we have the right to bring it to the floor as well. That is why we are here. That is why we are elected. If you cannot do that, let us bring in a Speaker who can.

[The Acting Speaker (Ms. Thibeault)]

I ask the member to please listen to my reply. That is enough.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

This is not the first time that this has happened. How many times do I have to stand up in this House to be recognized? I have made my point. The next time, Madam Speaker, please give me the sense of fairness to recognize me and recognize someone else—

[The Acting Speaker (Ms. Thibeault)]

I remind the hon. member that it is the privilege of the person who is occupying the chair to choose whomever he or she wants to recognize. Right now I have recognized the hon. member for Winnipeg North Centre.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Madam Speaker, I am glad to hear that the Conservatives are interested in getting involved in this debate. I look forward to hearing what they have to say about universal public health care on which they have been particularly silent, perhaps given the previous Conservative government's record on this matter.

To help out the Liberal member in response to the Reform question, in fact Canada's expenditure in terms of health care as a percentage of our wealth is at about 9%. That is quite a bit lower than the 14% or more that is spent in the United States as a percentage of wealth. That is the best reason of all why we want to hang on to a public universally accessible health care system.

My question for the member is simple. We can argue all we want about tax points and what the share is but the fact is there is a shortfall of $4.2 billion in cash transfers. My question relates to the purpose of our motion. Will the government restore the cash that it took out of the system in 1995? Will the government commit to an immediate share of 25% and a long term commitment of a 50:50 partnership? Will the government finally live up to its seven year old election promise for national home care? Finally, will the government take every measure possible to stop private for profit health care?

[Roy Cullen, Liberal, Etobicoke North, ON]

Madam Speaker, the member opposite still has not got it. I thought I had made it quite clear that tax points are the same as cash. The hon. member continues to quote the cash. The reality is that the CHST funding has been fully restored to 1993-94 levels.

If we look at the United States, Americans comment on our system and we want to keep it that way. It is one of the principal tenets of the government. It is one of the principal tenets of our party. Canadians can be guaranteed that our government will continue its commitment to health care in Canada.

[Grant Hill, Reform, Macleod, AB]

Madam Speaker, I was going to approach the issue of international ranking in the middle of my speech today but just so we do not lose some of the audience, in 1993 Canada was in second place in international ranking. The member was accurate. The National Forum on Health did quote accurate figures.

Since that time we have slipped to fifth place in the world. The U.S. is still at the top. We have been passed by Germany, Switzerland and France. The figures I am quoting are not completely up to date in terms of this day, but we are still dropping in terms of international comparison. For the edification of the member across the way, internationally we are not in second place any more.

As a physician, normally I would approach a debate on health care with a big smile on my face. When I came to parliament it was an opportunity for me to try to express what it is like to be a practising physician in Canada today. I could not express how much enjoyment that would give me. I felt I would be able to bring some common sense to the debate.

I have been really disappointed with the response of the government particularly on health care. I will talk about this in relation to priorities. If I were titling my talk, the title would be “messed up priorities”.

A significant budget was recently handed down. I want to compare what that budget did with grants and contributions in relation to spending on health care. My Liberal colleagues will leave because they do not want to hear this. I can understand their not wanting to listen to it.

I will not start from 1993; I will actually start from 1994 when it is fair to say that my Liberal colleagues had a responsibility for the spending in that year. In 1993 they had just been elected. I will not comment on the previous spending. In 1993 boondoggle prone grants and contributions—when I say grants and contributions, these are programs that can be misused—totalled just under $14 billion. The expenditures for health from that party totalled $7.5 billion. This is CHST cash for health; I am taking out the post-secondary education.

As we went along, the Liberals said there were terrible problems with the deficit, that they had to drop those important expenditures and they dropped them. The CHST component for health plunged from $7.5 billion down to $5.5 billion. That is the CHST cash component for health. What happened to the boondoggle prone grants and contributions component? It dropped a little, from $13.75 billion down to $12.5 billion.

Those were the priorities of the election ready Liberal crew. Boondoggle prone grants and contributions went as low as $12.5 billion. The health portion of the CHST went well down below $6 billion. Is that a messed up priority?

As the last member did, I am going at this from the financial component only. Let us count the tax points and cash. Let us compare 1993 with today. Let us do it per capita. What really matters to the Canadian public is how much money we have per person for transfers.

In 1993-94 before the cuts took place there was $636 per capita on the cash component. In 1999, the last year we have accurate figures for, the cash component was $483 per person in Canada. I will use the tax points in the broad figure. When they started there was a total of $28.991 billion in transfers. It dropped down to as low as $25 billion, and this year it is just again reaching the point.

In the interim, what happened to the per capita expenditures? Almost $30 billion was spent on foolish expenditures, stupid expenditures if I could be so bold as to use a stronger word.

The grants and contributions were mishandled. The audit told us that. In the Prime Minister's riding I call them Shawinigan shenanigans. There was a golf course, which was not a high priority. There were sawmill funds. A special friend of the Prime Minister's stepped up and said “We can get you funds”. He is being investigated because he is an unregistered lobbyist. There were funds for a lit fountain in the Prime Minister's riding, instead of emergency care, organ transplants and compensation for hepatitis C victims. We have RCMP investigations.

What did this budget do? It rewarded the minister of HRDC. It gave her more money. There was no mention of the problem, no retreat, no apology to the Canadian public and no commentary to the ministers of health for the provinces saying “We think grants and contributions are more important than health care”.

What is the role of the finance minister? He is the overseer of the public purse. We trust him to look at the overall expenditures of the government. We trust him to say that health care is a high priority. We trust that, as soon as funds are available, he will put those funds into health.

He sets the broad policy by funds available. What did he do? In the next four years there will be $2.5 billion. What does that mean per capita? It is $83 per capita. If we only consider the health component, it is half of that, or $41.50 per capita for health. That is the figure to which I would like the public to pay attention, the per capita expenditures of the federal government for health.

This is not apples and oranges; this is a specific comparison. If we look at 1993 and we look at 2000, we will not be impressed.

The Prime Minister should lead by example. When he was on this side of the House he said that if there were problems in a department there would be no excuses. There would be no way the minister would get out by blaming somebody else. There would be no cover-ups. The minister would take the responsibility. His responsibility, in my view, would be to remove incompetence from his cabinet.

It is obvious that medicare is under stress. I will go over the three big reasons for that. The debt the country undertook in the last 20 or 30 years is robbing us of a lot of money which we would normally put toward our social programs. Interest payments on the debt amount to $35 billion or $40 billion a year. That debt is a significant reason our health care system is under stress.

Let us look at our debt paydown and compare it to other countries. Australia was in trouble with its debt. It looks like Australia will have its debt paid down in three years. If the U.S. continues on its track, in 11 to 12 years its debt will be paid down. Where are we in our debt repayment program? If we continue like we are going, our debt will be paid down in 150 years. If I delivered babies I would have to be here for six generations to see that take place. That is a significant issue for our health care system.

There are other big problems. We have an aging population. The baby boomers who will be coming through the system will create a big bulge. What we are doing today is not sustainable and the health minister has finally recognized this. He is saying that the status quo is not good enough. That is a tough thing for a health minister to say, because that can raise all kinds of spectres of terrible things happening. The status quo is not good enough.

When I started my practice, organ transplantation was something that was done experimentally. I now see people having such things as hip replacements, extending their useful lives for 15 to 20 years. Those are very expensive things that were never even thought of when I started my practice. MRIs and ultrasounds were experimental. Now, although they are expensive, they are valuable and they do extend people's lives.

This is not an academic discussion. This is not a financial discussion. This is really and truly a discussion about individuals. I wish we could stop talking about the system and start thinking about the patient. If we could do that I think we would have a much better chance of fixing the system.

The future of medicare, frankly, is in doubt. There are long waits, inferior technology, anxiety and brain drain. Some of our finest nurses have left the country. They were turned away from secure jobs because the funding was not there.

I hesitate to go into the finances of this problem because it sounds like that is where my interests lie. That is not where my interests lie. However, I hear comments from the health minister which are inaccurate and I want to raise them. He says that we spend $60 billion in Canada on the public component of health care. What he omits to say is that our total expenditure on health care is touching on $90 billion.

I share the concerns of my NDP colleagues who fear privatization, who fear the U.S. style of health care. That is not the way to go. However, they should recognize and accept that 30% of our health care dollars in Canada today are private. There are many things which are not covered by medicare, such as plastic surgery, cosmetic changes and, in some provinces, sex changes. There are new technologies, such as new prostate therapies, which are not covered. Some of them should not be covered and maybe some of them should be, but 30% today is private.

When my colleagues raise the spectre of two tier American style health care I ask them only to do one thing: look at the balance of the world, look at Europe, look at Scandinavia, look at all of the other industrialized countries and find a country other than the U.S. to compare us with. Compare us in terms of private versus public expenditures on health and compare us with Europe. There is no other industrialized country in the world that has given the public purse the monopoly on health care.

I will return to the comparison of international expenditures. To be accurate, this is 1997. It is not today. The latest figures are not available to us.

Let us compare Canada in terms of its public spending, taxpayer funded spending, on health care. We are 10th in the world and falling. My colleagues ignore that completely. Other countries are spending more for public health care than Canada.

Let us take France as an example. France is in third place, spending 7.1% of its GDP on the public component.

Where is Canada in private expenditures? We are in seventh place, at 2.8%. Fifth place overall, 9.2%; tenth place in public, 6.4%; seventh place in private.

Like my colleagues in the NDP who fear the U.S. style of two tier health care, I do not like it, but let us look at the innovative changes that have been taking place in Europe. Look at those and ask if there is something we can learn in those jurisdictions, because I think we can.

What has been the response of the provinces to this budget in relation to health? There has been a pretty vigorous denunciation.

Personality conflicts and politics aside, what do the Liberal provincial governments in Canada have to say about this budget? I can sum it up. I will sum it up by giving it a thumbs down.

Is it all just about a political battle? I do not think so. I think that it really and truly is because the provinces are faced with dealing with an aging population. They are faced with dealing with a population that is rising in numbers. They are faced with dealing with this new technology.

What has been the federal health minister's response? He says that money is not the only thing; it is one component, but we need physically to go at this with new proposals. Now there is a point on which we can agree: new proposals.

What are his proposals? He says that we need to have national pharmacare and that we need to have national home care. His promise is that, if the provinces will come along, he will fund 50%.

Is that not eerily familiar to a promise that was made back in the 1960s? I remember it well. The federal government said it would fund 50% of medicare. The provinces said “That is a pretty good deal. We will buy into that”. Then the funds started drying up.

Why would the provinces enter into any program with a federal government which pulled the plug on funding soon thereafter? They are not stupid. They can remember. I am not surprised that the provincial response has been one of great hesitation.

I am going to talk for a moment about a subject which we might say is not exactly covered here. I am going to talk about hepatitis C. As the previous health critic for our party, I fought vigorously for hepatitis C compensation for all victims of tainted blood. I do not get a chance to speak of this daily, as I did for a long time, but I want to bring it up today.

There has not been one penny in compensation from the promise made by the government to hepatitis C victims. Not one penny has gone to them. It has been two years. Who is happy? The lawyers are happy. The lawyers who have been involved in this process are real happy because their funds are going up. The victims' funds have not been disbursed.

The government chose the wrong mechanism. It chose a legal argument, rather than saying that if the regulators had failed it had a responsibility and would transfer funds to those poor souls who were injured. It chose a legalistic mechanism. That legalistic mechanism was wrong.

I will never forget Joey Haché, a young man who came to the House. He stood here and said “I am going to be the Prime Minister's conscience”. He continues to be the Prime Minister's conscience. He rode across the country on a bicycle to raise awareness for hepatitis C.

I cannot help but think, in the order of priorities, what do the grants and contributions in the billions of dollars to get elected have to do with Joey Haché and the victims of hepatitis C? They have nothing to do with Joey Haché. I am profoundly disappointed that the victims have not been taken care of.

The debate on health care is here whether we like it or not. There are people who will tell us not to look at anything related to private insurance and not to look at anything related to the comparison of the most efficient use of resources. I simply say that today in Canada we do not have a one tier system. Our system is at least three tiered. We have a tier for the average Joe, we have a tier for the athletes and the politicians and we have a tier for those who are plugged into the system.

There are people who can leave and quickly get services outside this country. That tier is one which I want to capture and keep here in Canada. I want those individuals to feel that they have the highest quality of care here in Canada, if the wait is too long here in Canada.

The debate on medicare can turn into a slanging match. I think it is fair to say that there is a fear in Canada of the U.S. style of medicare. That is a fear which I share.

Let us look at Europe and let us get a Canadian made solution to make this program sustainable. If we do not, we are going to be criticized forever.

[The Acting Speaker (Ms. Thibeault)]

Before recognizing the member for New Brunswick Southwest, I would like to let him know at this point that I do not appreciate the words that he used before nor his conduct, and it is not the first time. I would hope that under other circumstances the member would come to me and maybe we could resolve the problem if there was such a problem. At this time, if he has a question to ask, the floor is yours.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Madam Speaker, I think if you check the record my words were very conducive to the language we normally use in the House. I was upset by the fact that this has happened time and time again. However, I will get on with the question.

I have one simple point I want to make to the member for Macleod. Is there some symbolism here in the sense that the Parliamentary Secretary to the Minister of Finance was the person who shared his speaking time with the Minister of Health? Does that not send us a message?

Does the member not get a sense that there is a sort of tug of war going on between the Minister of Health and the Minister of Finance in terms of who really sets the agenda for the health minister?

What I am saying, in a sense, is that a leadership race appears to be taking place on the front benches of the government side. It also appears that the finance minister is winning this war at the expense of the health minister and at the expense of ordinary Canadians.

Before I sit down, I do want to congratulate the member for his reference to the hepatitis C victims. We should be talking about that very issue more than what we are today, but I am glad to hear the member mention them. They do need our help.

[Grant Hill, Reform, Macleod, AB]

Madam Speaker, I have had lots of time to get to know the member who just rose in his place and recognize that he has a great interest in the health care system as well.

It would be fair to say that there is a tug of war going on. There is a leadership battle going on, which is pretty evident to anybody in the country who is watching the debates.

I do not think it is inappropriate for the Parliamentary Secretary to the Finance Minister to follow the health minister. There is a significant financial component to this issue.

Is there in fact some kind of mini battle going on between the finance minister and the health minister with leadership aspirations? It is pretty evident that would be the case. Would it allow health care to be pushed off to the side? I hope not. I cannot imagine anybody wanting to have a political future in the country who did not take health care seriously.

I object, however, to the use of figures that are inaccurate. I would debate the parliamentary secretary vigorously on figures that are outdated. I do hope that he will get updated figures when he comes into the House. If I have one objection, it would be just that. Updated figures would be really nice.

[Alexa McDonough, NDP, Halifax, NS]

Madam Speaker, the member for Macleod beseeched members of the New Democratic Party to accept the reality that private spending is now greater as a proportion of health care spending in the country than what the federal government is spending; in other words, what started out as a 50:50 partnership between the federal government and the provincial governments has now dropped to below 14%. The member for Macleod is absolutely right when he says that a big part of the spending on health care has now been shifted onto the shoulders of families who are sick. It is like a tax on the sick and the elderly.

I hope the minister understands why the New Democratic Party will not accept that as reality. That is as a very unhappy and unfortunate outcome of the federal Liberal government's withdrawal from its responsibility to adequately fund the health care partnership on a 50:50 basis.

The member speaks about how many of these additional expenses are paid for privately and that he accepts that. Does the member for Macleod accept the recommendations of the National Forum on Health which reported to the government prior to the 1997 election and urged that pharmacare costs be contained and that pharmacare and home care both be moved into place as part of the integrated universal public health care system? Clearly the government does not accept those recommendations, but does the spokesperson for the Reform Party on this issue in debate this morning accept it?

[Grant Hill, Reform, Macleod, AB]

Mr. Speaker, I believe in giving a direct answer to a direct question. No, I do not. I do not accept the fact that we should be moving toward new programs when the program that I consider to be the most important is at risk. I would fix medicare before I would branch off into other programs.

There is room for specific home care programs. The specific home care programs that I think the federal government should be looking at are to take people very quickly from the hospital, post-operatively with some of the new operative procedures we have, and have them cared for at home. This makes economic sense and it makes people sense.

Once again, I did not ask the NDP to accept the 30% private. I asked them to simply acknowledge the 30% private. We have a complete lack of frankness and openness on this subject.

I also ask the NDP to find me another country in the world that has a greater proportion of public-private or a lesser proportion of public-private and then compare them with how we are doing. Compare them in terms of waiting lines, technology and brain drain. If we do that we will walk arm in arm as it relates to this health care debate rather than having what I consider to be a slanging match.

I want a frank, open and honest debate and, except the position of the NDP that any change in private would be awful, I would like to make sure that the debate recognizes that there is 30% private today.

[Lynn Myers, Liberal, Waterloo—Wellington, ON]

Madam Speaker, I listened with some interest to the member for Macleod speak about a slanging match. What we heard in his speech was precisely that. He talked about stupidity, about things mishandled and about all the kinds of terms that one would expect better from the very people who said that they would bring a fresh start to parliament and a new way of doing business.

Despite the member's protestations to the contrary, he and his party are the very ones who would bring Canada to a two-tier American style health care system. Canadians reject this. They reject it out of hand and they reject it for all the right reasons. He can deny and deny this but the reality is that those Reformers opposite, those holier-than-thou's, are always on the bandwagon of wanting to bring in two-tier American style politics. Even when it comes to the 17% flat tax, their right wing soulmates, the Republicans in the United States, the evangelist rednecks, have rejected this kind of nonsense. Yet, there they are clinging to it like they so desperately want to do.

I say that Canadians see through that nonsense. They see through the Reform's flat tax nonsense. They see through its ridiculous two-tier American style nonsense. Those people who claim they want to bring a fresh start to parliament are the very ones who would bring it down. We on the government side will not have any part of it.

The hon. member is a physician. I was a medical orderly and put myself through university by proudly working as a medical orderly.

The Canadian Medical Association—and I read this exactly two days ago—said that we should put aside our partisan politics, put aside the petty kind of nonsense that the hon. member opposite was slinging around and that we should work together on something as fundamental and as important for all Canadians as our health care system.

My question is simple. Why does the member not come clean right here and now and say that he and his party will put aside the petty politics, put aside all that kind of nonsense and work together for the appropriate long term solutions that are necessary in order to fix the system? This is an underlying value of Canadians and this is something that Canadians want to see happen. Why will he not do that?

[Grant Hill, Reform, Macleod, AB]

Madam Speaker, the member opposite, who also cares about health care as surely as I stand here, needs to answer to his constituents why he chose grants and contributions over health care and why he chose to accept that. If he could explain that to his constituents, he would satisfy me.

There is no way that he and I will agree on whether or not those programs are reasonable. The Liberal government chose grants and contributions over health care. He would have trouble explaining that to me but maybe he can explain it to his constituents.

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

Madam Speaker, I am pleased to say that we will support the motion by the New Democratic Party because, in general terms, we think the issue of reinstating transfers for health care to the provinces is not a partisan issue and should be agreed on.

We are very impatient for the government to hear the appeals by all of the opposition parties and by the premiers, who met a few weeks ago in Hull under the capable leadership of the Premier of Quebec.

It is very important that all members take advantage of the NDP motion to truly take note of the extremely urgent nature of the situation. In the 20 minutes I have at my disposal, I will show that if transfer payments are not restored to their 1994 level, as requested by the provincial premiers, the situation will become critical and our fellow citizens will have good reasons to be concerned about the federal government's lack of sensitiveness.

I want to make sure that those who are joining us clearly understand the meaning of this motion. At one point, we feared that the NDP might get carried away and go for national standards, but I am pleased to see that it is not the case. I will summarize the motion and ask the NDP leader to pay a great deal of attention to this.

The motion is that this House calls upon the government to stand up for the Canadian value of universal public health care by announcing within one week of the passage of this motion a substantial and sustained increase in cash transfers for health.

Let us start with the beginning. Between 1994 and 2003, the period for which data are available, we see—as is often pointed out by the hon. member for Saint-Hyacinthe—Bagot, who is our finance critic and who has been holding the fort in a remarkable way since the Bloc arrived here—that transfer payments to the provinces will been cut by $33 billion.

The people who are listening to us must know that those who are telling us about co-operative federalism and who think that a federal-provincial conference was held to discuss these issues are wrong.

Callously, irresponsibly and without warning, the Liberals, who have brought us one of the blackest periods of federalism this parliament has ever known, decided unilaterally to cut provincial transfer payments. What happens when $33 billion are slashed? Zeros start showing up on the bottom line.

I remind the House that the provinces are responsible for providing services directly to the public.

I should mention in passing that the Constitution makes it very clear that it is not the federal government that provides services to the public. What is the federal government's role? My friend the member for Beauharnois—Salaberry knows. Its responsibility is limited to aboriginals—not that they are unimportant—and veterans.

The government cut provincial payments by $33 billion and the result was to threaten the delivery of services to the consumers who need them.

This is quite a remarkable state of affairs. Federal-provincial diplomacy has reached a point not often seen in recent years. All provincial governments, whether New Democratic, Progressive Conservative, or Parti Quebecois, are unanimous in their conviction that things have to be changed and are demanding that the federal government restore transfer payments.

As we know, Quebec has a very advanced health care system, which is a very valuable legacy of the quiet revolution. A few days ago, and I am sure the member for Beauharnois—Salaberry will recall—Claude Castonguay, who was one of the fathers of the health care system and no sovereignist, as everyone knows, appeared before the committee studying Bill C-20. He noted the originality of the Quebec health care system and expressed concern at the federal government's totally obstinate refusal to reinstate transfer payments.

I want to be very specific. When we speak of transfer payments, I want it to be clear for those watching us at home that it can mean health care, post-secondary education or income security.

A few weeks ago at the meeting held in Hull, the Premier of Quebec asked for roughly $1 billion per year for health care, just for the transfer payments. We agree, it should be annual. On this point, I want to be perfectly clear: this is for Quebec alone.

Between 1994 and 2003, $33 billion will have been cut. It was initially to be $45 billion, but then a few crumbs were handed back. Of the $33 billion annually for health, the Premier of Quebec sought the return of $1 billion for Quebec, at the premiers' conference. This billion dollars was traditionally split between health and the other transfer terms, that is education and income security.

The Quebec minister of health, Pauline Marois, a member of a government that is giving Quebecers very good government in the national assembly, has shown what these cuts to the transfers mean. What does restoring $500 million in health transfer payments mean for Quebec? The $500 million we hope to get on an annual basis for health represent one quarter of the operating budgets of Montreal's hospitals. This is not peanuts. It represents half of the budget for all of the CLSCs.

CLSCs, as I explained yesterday—I will be brief, but I apologize to those members who are hearing this for the second time—are an innovative idea in North America. They form a front line service available to citizens at each stage of their lives, from birth to burial, from perinatal care to home support services.

The $500 million represents close to half of the budget for all of the CLSCs or the total budget for home support services. This is where that money is important, and I will get back to this in a few moments.

Life expectancy is longer than ever before. We no longer just have seniors, but also older seniors. Quebec society is different from the others in that it is ageing faster. If we look at the various age groups, we can see that, proportionally speaking, Quebec society has more members who are 60 or more. Eventually, we will have more people 85 and over than other societies.

Let me give an example that will clearly show the situation. It will take 35 years for the proportion of Quebec's population aged 65 or more to go from 12% to 24%.

For all intents and purposes 35 years from now one-quarter of Quebecers will have reached the 65 and over category. It will take the rest of Canada 45 years to get to that point and Germany 65 years. The population of France, our motherland, the Republic, will be there in 65 years.

All this is not to show how erudite I am but to establish the link between the importance of restoring health transfers and the urgency of providing care to a changing clientele.

I come back to what we will do with the $500 million and the importance of seniors in our society.

The sum of $500 million would mean that home support could be continued. We know that Quebec has begun the shift toward ambulatory care, the goal of which is to provide services in a community setting. Hospitalization is avoided as much as possible.

I am sure that all opposition party members will agree with me that this $500 million we are demanding should be restored. I hope Liberal members will agree as well, but I must admit that we are not too optimistic.

This figure of $500 million is four times the annual budget of the Hôpital Sainte-Justine, a children's hospital. It is three times the budget of the Royal Victoria Hospital. It also represents, and this is important, one quarter of the cost of pharmacare.

We cannot say often enough how pressing this is. If, as parliamentarians, we were to close our eyes and ask ourselves what the public wanted most right now, the answer would be more federal funding for health. That is the simple fact of the matter.

I see some Liberal members who seem to be—

[Yvan Loubier, Bloc, Saint-Hyacinthe—Bagot, QC]

Asleep.

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

My colleague says asleep. I would have said lethargic.

What I want people to understand is that there are structural pressures on the system. I need to point out to hon. members that $500 million more would be required just to keep the system afloat, without any change in service delivery, without one single additional person receiving one single additional service, if in the year 2000 we were to decide that exactly the same services would be delivered in 2001. The natural growth of the system is 4%.

When we say that the number of seniors among the population of Quebec will keep increasing, this has a number of implications. I have researched this and will share my findings with the hon. members.

I see the parliamentary secretary is joining us. I trust, and I say this in the friendliest way possible, that we will be able to count on the hon. member for Anjou—Rivière-des-Prairies. He is my friend and I mean no disrespect, nor am I making any partisan remarks. I simply hope that we can count on him, as parliamentary secretary, to vote for this motion, since it is votable and that he will speak up very loudly to make this government restore the transfer payments.

If the Quebec Liberals do not speak up in this debate, we will have no other choice but to conclude that they are spineless creatures, doormats. But I do not wish to think such a thing, because there is still time for them to get hold of themselves.

Pressures on the system in 1998-99 resulted in 50,000 more people left on stretchers in emergency departments than in 1994-95. It will be no different in 2002-03. That is why more money needs to be put back into health.

As Pauline Marois has said, this does not prevent us from having a debate—in fact, she has called a summit on this—and it does not prevent us from rethinking the way we are going to deliver services. It is not true, however, that we can afford not to restore transfer payments for health.

We need to remember that this is our money. My colleague from Saint-Hyacinthe—Bagot is going to prompt me with the exact figure for the taxes we send to Ottawa.