House of Commons Hansard #115 of the 36th Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was federal.

Topics

Privilege
Routine Proceedings

3:30 p.m.

Liberal

Bob Kilger Stormont—Dundas, ON

Mr. Speaker, I regret that I was not present but I understand, and I stand to be corrected if I am in error, that my colleague may have charged that as the chief government whip I would have lobbied or given instructions to government members on how to vote on a private member's bill under his signature. If that is the correct interpretation, I want to unequivocally deny such an accusation in this instance or in any other instance affecting Private Members' Business.

Privilege
Routine Proceedings

3:30 p.m.

The Deputy Speaker

The Chair may be wrong but I do not think that was the nature of the allegation.

There are documents that were referred to by the hon. member for Wentworth—Burlington which I think he alleged were the ones that were used to influence the thinking of members of parliament. I do not recall from anything I have heard him say that any of those documents emanated from the chief government whip.

As I said, I think it is appropriate that we review the documents. I know the chief government whip may want to look at them as well, but I think a member of the government may wish to respond to this. We will give time for that to happen.

We will take the matter under advisement at this time and we will deal with it when there is some indication of the availability of a response and when we have had an opportunity to review the documents that have been presented.

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

Supply
Government Orders

June 15th, 2000 / 3:30 p.m.

Reform

Inky Mark Dauphin—Swan River, MB

Mr. Speaker, I listened carefully to my hon. colleague's speech on health care. As we all know, the quality of health care really went downhill when the Liberal government made all the cuts back in the early 1990s. Would the hon. member accept responsibility for all the cuts that were made to the health care system which created the situation that exists today?

Supply
Government Orders

3:30 p.m.

Liberal

Larry McCormick Hastings—Frontenac—Lennox And Addington, ON

Mr. Speaker, we on this side of the House accept the responsibility of fixing a system that needs to be enforced. We ask for co-operation from all colleagues in this House to take the politics out of health care and to fix the situation.

This gives me an opportunity to thank the people of the beautiful town of Chesterville for their hospitality this past Monday. Chesterville is in the beautiful riding of Stormont—Dundas—Charlottenburgh where the government announced the investment of $50 million into the innovation fund for rural and community health and an additional $11 million for the projects under telehealth. This is so very important. Telemedicine is necessary to help fix the situation with respect to health care in rural and remote communities.

Supply
Government Orders

3:30 p.m.

Reform

John Duncan Vancouver Island North, BC

Mr. Speaker, we have had much debate today on health care, the subject of the official opposition supply day motion.

I would like to ask the hon. member for Hastings—Frontenac—Lennox and Addington about health in a more general way. It relates to the fact that when people think about medicare and health care services, most often they are thinking about physical health, but in actual fact what has happened in Canada has been a tragedy in terms of mental health care services.

There has been a shrinkage of resources. What the provinces have been able to secure from the federal government, if there has been a prioritization, it has been away from mental health care services. There have been some very tragic examples recently of what has happened. People with obvious and known to themselves mental health problems have been crying out for help but have not been able to receive it. Consequently they have carried out criminal acts.

Supply
Government Orders

3:35 p.m.

Liberal

Larry McCormick Hastings—Frontenac—Lennox And Addington, ON

Mr. Speaker, I have something of interest for the member's riding.

There was an announcement made on Monday this week about rural Canada. It would certainly apply to beautiful Vancouver Island.

A new system has been set up to deliver an ultrasound service into northern Alberta, probably about three hours north of Edmonton. The technology is now available to transfer the ultrasound images from the town via satellite, across the Equator and back into the clinic in Calgary.

We sat in Chesterville and all Canadians were able to watch the ultrasound images being transferred. A doctor who specializes in interpreting these images received them and sent them back to the doctor in the home town. It saved the patient travel time of three and a half hours to have the ultrasound tests conducted. Also, in front of Canada and with television coverage, an hon. member of this House said everyone wanted to know if it was a boy or a girl, but someone in northern Alberta said the mom and dad did not want to know. We all have to work together to address health care.

Supply
Government Orders

3:35 p.m.

Reform

Inky Mark Dauphin—Swan River, MB

Mr. Speaker, I will be splitting my time with the member for New Westminster—Coquitlam—Burnaby.

I am pleased to speak to the health crisis in Canada. I want to speak from the Manitoba perspective. Having actively been involved with this issue for many years in Manitoba, I can certainly tell the House that Manitobans are not happy campers when it comes to their health care services.

The cuts from the federal government have had a huge impact on all the people of Manitoba. The whole health care system in Manitoba had to be reconfigured to deal with the drastic cuts the government made to the tune of about $24 billion in the early 1990s.

It forced the provincial government to centralize the health system. It is sad that this was forced upon the Gary Filmon government. Unfortunately it may have been one of the factors that cost him the last election because people are still angry about the health care delivery system in the province of Manitoba. As a result we now have a number of regional health authorities who are unelected and appointed by politicians. It is another political game which we have to put up with.

What did I do about this, going back six or seven years? At that time I organized a provincial health meeting with municipal and aboriginal leaders to deal with the health crisis. We had a forum on health. We asked the then Manitoba minister of health, Darren Praznik, to appear before the angry delegates and he did. He found himself in a very difficult situation. He had been appointed to that position about a month prior to the meeting.

Unfortunately all the municipal and aboriginal leaders attacked the province of Manitoba and blamed it for the problem, which in essence was wrong. I can see with 20:20 vision in hindsight that the blame should have been put squarely on the federal government. In fact, no one even wanted to hear that the problem was created by the federal government. Can you believe that, Mr. Speaker? We still need to place the blame on the government that created this problem in the first place, the federal government.

Today the problem still exists. People are still not happy with the system that is currently in place. There are still long waiting lines. There are still shortages of beds. There are overcrowded clinics. Doctors are overworked. In other words, we need to remind Canadians how this big problem started in the first place. It all started with the big cuts at the federal level.

I would like to talk about a client central health care system that exists in my riding of Dauphin—Swan River, the Hamiota District Health Centre. It has been around for at least 50 years.

How do we measure the health of a community? Do we look at the number of medical office visits and days of hospital care and assume that greater activity indicates better health? Or is the reverse true? Current priorities in Canada's health care system are contested by community health centres which nurture health as a positive attribute to be protected, restored and enhanced.

Medical health centres are not new. Most of the dozen or so in Manitoba are unique in scope, ranging from a single specialized service to the Hamiota District Health Centre, the classic example of a comprehensive integrated centre. Located in southwestern Manitoba, the HDHC has been around since 1974. It provides a broad range of services geared to community needs, limited only by available means.

I would like to pay tribute to Dr. Ed Hudson who in 1945 took over his father's practice in Hamiota. His father, Dr. E.D. Hudson, began his practice in 1907. Dr. Ed Hudson is still actively involved in helping to deliver quality health care. Between his horses and the health centre, he certainly keeps busy in his senior years.

The Hamiota District Health Centre began with a belief in the health centre potential for improved quality of care. The providers of that care know the satisfaction of delivering care programs that are effective but definitive assessment is difficult. An evaluation concentrating on results of programs is limited in scope.

The 1972 white paper on health policy states, “a health system must also be judged by the numbers of people who in fact never succumb to disease or accidents or social distress”. A method of measuring quality of care is elusive.

Cost saving efficiencies were envisaged. There is the co-ordination of care by many disciplines, resulting in decreased numbers of diagnostic tests, the pooling of supplies and equipment, and more efficient use of physical facilities. There is the ability to use the most appropriate care provider in patient care and the appropriate level of care for the patient. There is the freeing of physicians to use their time and expertise more efficiently in preventive care and health promotion to reduce hospital stays. There is the use of home care, mobile meals and support services to reduce hospital patient days. There is the economy of using only one administration and one governing board in an expanded system of care. There is the active involvement of the community in establishing support for the programs and identifying needs.

Thirty years of experience seems to support all these tenets. Controlled spending has to date precluded any unapproved deficits that would become the responsibility of the municipalities of the district.

The centre lacks the information and statistics required to do a self-evaluation or a comparative one, but has co-operated with governments in several assessment surveys and questionnaires. Results of research, if any do exist, have never been publicized.

Quite apart from statistics but evident to a visitor to HDHC is an atmosphere no one had predicted. Staff morale is exceptional.

The current position is to devote half a day per month to a strategy meeting to critically assess the role in terms of efficiency, effectiveness and goals. It is expected that gains in health care in the next decade will be in preventive care, with emphasis on nutrition, health promotion, physiotherapy and occupational therapy, as resources are geared to keeping people well.

The expansion of existing programs or the introduction of new ones in times of fiscal restraint are largely matters of trade-off between priorities. The flexibility of the system is conducive to change to improve care and to respond to community needs.

Turn of the century health care in rural Manitoba was delivered by the dedicated and selfless family medical doctor. As the century closes we find a burgeoning multiplicity of health disciplines in a tangled web of administration by government departments, subsidized public offices and private agencies. The system has grown without plan or co-ordination in an expensive add-on fashion which encourages health care professionals to concentrate on protecting the turf of their own specialty, competing for limited resources and denying any vision of total care.

One health worker suggests “I am sure if I were to start all over again in health care there would be no doubt as to the direction it would take. Interdisciplinary health care management would be the only way to go”.

Wishful thinking, you say, Mr. Speaker? Perhaps, but this small community in Hamiota, Manitoba, has found it to be possible. I would invite hon. members, if they have the time this summer, to visit this place to see how client-centered health care takes place.

I would like to close by quoting from a letter that was sent to me from the Council of Chairs of the Regional Health Authorities of Manitoba. The letter reads in part:

Every day, members of the RHAM see the serious effects that cuts in federal transfers are having on our national healthcare system. The significant decline of public confidence in our healthcare system is compelling evidence that Canadians feel the system will not be there for them and their families when they need it. Federal/provincial/territorial co-operation to build a truly accessible, integrated, client-centered continuum of care is essential to restore the confidence of all Canadians in our health care system.

Supply
Government Orders

3:45 p.m.

Liberal

Rey D. Pagtakhan Winnipeg North—St. Paul, MB

Mr. Speaker, is the hon. member aware of the increase in spending through the CHST, the Canada health and social transfer, to $11.5 billion in the previous budget? As well, the last budget increased spending by an additional $2.5 billion, for a total of $14 billion over a period of about five years. Is he aware of that? Does he not consider that to be significant spending for health?

Lastly, I would like to ask the member if he is in favour of private health care for profit, yes or no? If not, does he support the privatization bill in Alberta which could lead to the very situation of a two tier health care system in the future?

Supply
Government Orders

3:45 p.m.

Reform

Inky Mark Dauphin—Swan River, MB

Mr. Speaker, our health critic indicated this morning in his speech that we are not in favour of a two tier health system. We have said that over and over again. I do not know why the member opposite keeps asking the same question about a two tier, American-style health care system. We are opposed to that.

I agree that we need to put money back into the system. The Liberal government indicated in its budget that over five years it will put money back into it, but it seems to have forgotten that it took out more than $24 billion. That is what I said in my speech.

Many of the problems we have today stem from the day when the government made that huge cut. I do not blame the government for all of the problems that exist, because there are increasing demands on the system, but certainly that is what started the problems and the crisis we have today.

Supply
Government Orders

3:50 p.m.

Reform

Paul Forseth New Westminster—Coquitlam—Burnaby, BC

Mr. Speaker, I only have 10 minutes to speak to the motion of my caucus, the Canadian Alliance, which states:

That this House recognize that the health care system in Canada is in crisis, the status quo is not an option, and the system that we have today is not sustainable; and, accordingly, that this House call upon the government to develop a plan to modernize the Canadian health care system, and to work with the provinces to encourage positive co-operative relations.

I cannot cover the scope of the problem at this time, but I can briefly say that we must first understand that medicare is the constitutional responsibility of the provinces. The federal government, through the Canada Health Act, controls a declining portion of the funding in exchange for the famous five principles.

As predicted at the start of medicare, the principles have been abandoned by all governments, yet the hollow phrases are fought over for the political advantage of posturing before the public about what party or government is more caring, wiser, and therefore should be trusted and supported by the voters.

The principles are: accessibility, portability, universality, comprehensiveness, and public administration. However, we must look at the five principles of the Canada Health Act and question if they are working.

Concerning accessibility, in the nineties there was an increase in people waiting for care. In 1993 the average wait was 9.3 weeks, but in 1998 the average wait was 13.3 weeks, an increase of 43%. Patients wait months to see a specialist. There is a huge shortage of technology that is available in other countries but is spread thinly in Canada. People are dying because they cannot get timely access, or they suffer needlessly.

What about portability? This supposedly means that every Canadian has the right to be treated anywhere in Canada. However, Quebec patients outside Quebec are required to pay upfront because the Quebec government did not sign the portability agreement and cannot be counted on to pay up.

I am told the reverse is even worse, about a person from B.C. who gets sick in Quebec and about how that person is seemingly discriminated against in the Quebec system. In other words, the interprovincial payment system is full of problems.

Next we have so-called universality. There are great shortages of services in outlying areas of Canada, far beyond the expected concentration of special services in regional centres. Where one lives, how and where one acquired the medical need and one's personal legal status all undermine universality because these affect what one gets from the system.

What about comprehensiveness? That has never been followed from the beginning. Each province has a different list of things that are covered and those that are not. As the pressure has mounted, provinces have been forced to delist services. In other words, there is no operational, national working agreement of core services. Consequently, Canada does not have comprehensiveness.

Finally, what about public administration? Most of it is public, in theory, except that there is a lot of contracting out that goes on for efficiencies such as computer services and financial support, and the labyrinth of personal cash payments for services mixed with tax dollars. As well, about 80% of total public spending for health care is consumed by labour costs for doctors, nurses and administrators.

Public administration of the complexities of medicare should be held accountable for cost and efficiency, but since there is no real competition how do we know what is happening?

The main point of a recent national study was the huge list of things that the system really did not know, could not account for or measure. In other words, medicare is administratively in the dark.

Dr. Heidi Oetter outlined the situation eloquently when she said in the Vancouver Sun :

This is the year I turn 40. It is a reflective year, a time to take stock of the past and ponder the future. When I was 20, I chose to stay in British Columbia and finish my education at the University of British Columbia's faculty of medicine. When I was 30, I chose to stay in Canada, unlike many of my classmates.

Since then, I've participated in more committees than I care to count, provincially and federally, to try and make Medicare work. Sadly, as my fourth decade comes to a close, I have to publicly say Medicare is decaying rapidly, and if we don't act now, its future is bleak...

Each new discovery, medication, diagnostic machine or operating device is expensive. For example, the additional equipment to do laparoscopic gallbladder removals—the cameras, TVs and laparoscopes—typically costs $100,000. The new neurosurgical equipment that will use computers to assist in brain surgery will cost upwards of $1 million. A magnetic resonance imaging machine (MRI) costs $1 million. B.C. has nine MRIs and should have 18...

In reality, it is difficult to fund research and new technologies when the Medicare system cannot even keep up with today's demands. Already we have medications and new technologies that Medicare simply cannot afford. Three times last year I referred patients to the United States, not to avoid the long Canadian waits, but to obtain a service that just was not available here. There now is better technology with improved outcomes for the public, but it's so expensive that Medicare cannot provide it.

I doubt my parents' generation will accept anything less than the best for the management of their heart disease, diabetes, cancers and chronic illnesses. Yet, my boomer generation, by sheer numbers alone, will challenge the sustainability of Medicare, as we age into our costliest health consuming years...

So, what do I want for my birthday? I would like to see further serious public debate on the issues as we have some serious decisions to make. We have to ask: “How much will we spend on Medicare? How will we fund new medicines and technologies? How do we decide what is necessary? What will our spending priorities be?...Our reality is that Medicare is decaying and is at risk of imploding. So, let's talk sustainability”.

Dr. Heidi Oetter is a practising family physician in Coquitlam and chair of the British Columbia Medical Association General Assembly.

What can we do, especially for those who really care about health care rather than health politics? We can be very watchful of the motives and the understanding of those who rant and derisively point the finger, saying “Someone wants two tier, American-style health care”. All agree that Canadians want great health care that is provided fairly and without catastrophic personal cost.

The constitution of Canada gives the provinces jurisdiction over social services, including health, education and training, and social assistance. We need to respect our constitution and refrain from intruding into the provinces' jurisdiction, including the formulation of social policy. Is Quebec listening?

The public sector now spends about $60 billion on health. A cheque the size the premiers want would boost that sum by a little more than 5%. Their report says that at a minimum “health spending could increase by close to 5% per year during each of the next 27 years”. The premiers estimate that by 2026-27 health expenditures will be 247% higher than today. That prospect is not sustainable.

We believe all Canadians should have access to quality health care regardless of their financial situation. We need to provide greater freedom of choice because it raises standards. The needs of patients must come first in the delivery of health care services, before restrictive union contracts and administrative empire building. We must work co-operatively with the provinces so that they have the resources and the flexibility to find effective approaches to the financing and management of health care.

We should not be afraid to allow the greatest freedom possible to Canadians in their choice of natural health products. We need to introduce restrictions only on those products that the government can clearly and scientifically demonstrate to be harmful. With the right incentives we can learn to manage for health rather than for sickness.

We can fix the national economy for real growth through tax reduction and spending reallocation so that we nationally can create the wealth to pay for the medicare economic challenge and create a reliable long term funding base.

The provinces are calling for $4.2 billion, and we need to grow it, rather than borrow it from the next generation. We can bring standards and independent auditing for greater transparency in the delivery of health care. We can initiate relations with the provinces to support and co-operate, not punish. We can examine and challenge the traditional roles of administration to get better efficiency and productivity. We can become more patient focused with the timely use of comparative measures. We must give evaluative tools to patients so they can make the local system more accountable and responsive to them.

The Canadian Alliance believes that families should get the best health care when they need it, regardless of their ability to pay.

Our plan to address the issues will only work if Canadians accept the need to innovate and change through co-operation rather than coercion, local adaptability rather than condemnation of others.

We can change the present dismal picture and place ourselves in the top one-third of OECD countries for health care, with no waiting lists, services that are not in jeopardy of being delisted, reversing the brain drain and ending the shortage of health care providers through wise incentives rather than defensive, punitive rules and barriers.

Who we are as Canadians and our standard of living will depend largely on the quality of our health care system. Instead of resisting change, we need to embrace it to solve the challenge of medicare in our time.

Supply
Government Orders

4 p.m.

Liberal

Alex Shepherd Durham, ON

Mr. Speaker, it is a pleasure for me to engage in the debate today on health care.

I had the privilege of hosting a health care forum in my riding only a few weeks ago, so I am very familiar with some of these issues. In attendance were the former Ontario deputy minister of health, some of the leaders of our hospitals, some primary care workers and some home care workers.

We are now having the debate in the House. Members have talked about money. They seem to think that the simple solution is just to put more money into health care and suddenly all the problems will go away.

Members will be interested to know that the health care workers themselves, while they of course would like more money, made the statement that it was not about money. Indeed, Canada is the fourth highest spender on health care in the world. We spend 9.6% of our GDP on health care, $86 billion a year. I have heard members of the Alliance, surprisingly enough, who are so cost conscious, say that maybe it should be 12%. I was quite incensed by that.

One of the conclusions of the health care forum that I put on was that we could not continue to put money in the top of this thing because it was not coming out the bottom and it was not being delivered to the patients.

Do we have a problem in health care? Yes, we do. We have a problem getting the newest technology. If we look at the waiting lists, we see that they are getting longer and, at the same time, we are paying more money for the system. There is definitely something wrong with the system.

We also see that our health care costs have been rising at the rate of about 5% a year and are scheduled, because of our demographics and our aging population, to continue to rise. People say it will rise as high as 6%.

Mr. Speaker, I do not have to tell you, as I know you have studied the economy quite a bit, but our economy is only expanding at the rate of 3% a year. In other words, health care costs are actually rising twice as fast as the economy is growing. Obviously, we cannot continue that because instead of talking about tax cuts, we would be talking about tax increases to maintain a system like that.

There is no question that we need some changes in the health care system but what changes are needed? Maybe some doctors are listening to this today and I do not want to offend them, but one of the comments I heard was that a normal doctor-patient ration is about 2,000 patients to 1 doctor. There are differences depending upon specialization and so forth, but as a general comment, as a quick working tool, based on the province of Ontario's population base, we should have about 5,000 doctors. In fact there are 9,000 doctors in the province of Ontario and I am told Ontario is screaming for more doctors.

What is the problem when we look at that quantitative analysis? One of the other members actually mentioned some of the structural problems. It would appear that many doctors are not engaged in the practice of medicine or, seemingly, not on a full time basis. In fact, it is thought that almost 40% of their time is taken up with administrative duties, such as filling in forms, pushing papers and so forth because of structural problems. By the way, these are structural problems that provinces have put in place.

I dare say that the whole question of malpractice also creeps into this, the question of how to protect oneself in public liability cases. This has created a big paper burden as well for the medical profession. The reality it that these structural problems have basically created a health care system which, quite frankly, is broken and is not working.

By the way, I will be splitting my time with another member.

We can agree on a number of things. First, I do not think we have full agreement about money. I hear politicians of all stripes saying “Another $4 billion on the table will solve all of our problems”. That is not so. If it were $4 billion this year, it would be another $4 billion year after year after year. It will never go away and the system will not get any better because we will not have changed the structural problems with health care.

What are some of the problems in health care as I perceive them? Some of them are that we do not have an integrated health care system. In many of the regions we do not integrate the health care system itself. In other words, when somebody gets sick at home and has to go to the hospital, a bunch of health care providers are involved in that: ambulance drivers, paramedics and so forth. In fact, by the time the person actually ends up in the hospital almost 40% of the costs have got nothing to do with health care workers.

How do we integrate those services to ensure a proper delivery of the system? What occurred to me is that in many parts of this country we do not have a fully integrated health care system. We are not using some of our best technology. We know that we are in a technological revolution but if we go to some of our hospitals, although we do see doctors working on computers rather than working on patients, we also see a lot of people pushing paper around. We also find that we cannot track patients. In other words, we do not have the simple technology of a health card with a computer chip on it that gives information on our health record when we travel from one place to another in this country. We have the technology to do that but we are not spending the money on the technology to make it more efficient. In that sense, we are not using the new technology available.

Because we have so much inefficiency within the health care system, we have also made choices on how we spend the money. We have spent money in areas where it is not very efficient and we have neglected to spend money on those things that are important, like investing in new technologies. I am not just talking about information systems, but also the newest equipment that we need to keep our people healthy.

There is no question that people are healthier today than they were 15 years ago. We would rather be sick today than 15 years ago. All the talk in the House about the health care system being a terrible system has been a little bit overexaggerated.

What are people looking for? They understand that the system is not up to speed. They also recognize that the Canadian population is an aging population and that this problem is just going to continue to get worse. The reality is that they do not really care.

When I had my health care forum, I was amazed that people did not care whether it was the federal or provincial government that was presenting the health care forum. All they wanted was somebody to take some leadership on this file, solve these problems and stop all the finger-pointing back and forth between governments about who is responsible for what. It is not about private health care as opposed to public health care. It is about how we can make the existing system work better.

There are some ways we can make the system work better. We must have an accountability framework to find out what people are concerned about in this country. People are concerned about getting 24 hour primary care. They are concerned about the long waiting lists that they are suffering in getting to see a specialist, in getting specific knee transplant operations, or whatever the case may be. We can define the targets.

What do we have to do as a government? Unfortunately, or some may say, fortunately, we do not administer the health care system. We are simply the givers of money. People are fed up with that kind of attitude. It is not about giving money. The federal government must re-impose a vision of health care in this country. That vision must be from sea to sea to sea and it must be based on basic standards that people find acceptable.

When we put the money on the table we are going to say that we are putting it on the table but under certain conditions. The conditions will be that these objectives may not be met today, but that over a period of time we must see progress in creating a better health care system or there will be no more money.

Maybe some of the provinces will not buy into this accountability network. We must also get the provinces working together. The provinces must have their own permanent registry system so that they can determine best practices between provinces. One of the other members talked about the inter-transfers between provinces not working well. The sharing of best practices between provinces does not exist. The sharing of medical records does not seem to exist. We have to do these fundamental things in order to have a better health care system.

I believe that is what the Canadian people want. They want to stop this silly debate that we are having in the House and in the media about money, money, money. This is not just about money. It is a much more difficult problem to solve. We have it within our power to solve it. That is the vision that this government has going forward.

Supply
Government Orders

4:10 p.m.

NDP

Louise Hardy Yukon, YT

Mr. Speaker, I was listening very closely because I think the whole idea of accountability is an important one. My focus would be on accountability toward the health of Canadian citizens, not necessarily a focus just on money. I do not know if that was what the member was pointing to.

I think we should have accountability and integration. I was one of the MPs at the ecological summit. We heard reports from various doctors saying that to have better health for Canadians, we have to integrate our food, our agriculture, our environment department and our health departments. We cannot exclude any of them or look at them independently because when it comes to our health, they are interconnected.

Along the lines of preventative health, our health care system should include naturopathic doctors. That has not been done. These doctors have to get a bachelor of science degree. They have to train. We have an eminent institution for naturopathic medicine in Toronto. The doctors have to train there for three more years and then they have to specialize. They are doctors in their own right. We should be able to connect with them as well as with our medical doctors and have that integrated to add to the health of our community.

I keep hearing that we cannot just throw money at it. Nobody is saying that we should just throw money at it. That is not happening. Medicine and care is labour-intensive. People cannot be left sick and alone. There has to be money for primary care. I would like the member to respond to that.

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Government Orders

4:10 p.m.

Liberal

Alex Shepherd Durham, ON

Mr. Speaker, I respect some of the things the member for Yukon has said. Indeed, our definition of health care, if we expanded it, although I think it has expanded, most people, if asked about health care, would include naturopathic medicine even though traditionally it has not been included.

Her concerns about the doctors recognizing naturopathic medicine goes beyond that. I know in my own province, my own audiologist, who grew up in New Brunswick and has a three-year university degree, cannot prescribe a hearing aid without a doctor signing the certificate. This is ridiculous. These are structural problems that would exist within the purview of the provinces.

While I understand what the member is saying, I have heard her party say that we should simply restore the funding to health care. I do not think that is all that is needed. I think we want to do more than just restore or increase the funding to health care. We want to go beyond that to an accountability framework.

Supply
Government Orders

4:10 p.m.

Progressive Conservative

Loyola Hearn St. John's West, NL

Mr. Speaker, when the hon. member was speaking, he talked about certain targets. When we talk about the infusion of money needed into the health care system, quite often we hear people say that the best bargain we have in health care is in proper home care and in such things as personal care homes, which really cost very little in relation to keeping the same individuals in major nursing homes or hospitals.

However, the government seems to hesitate putting adequate funding into programs where we can keep individuals in their own homes and in their own communities where they will be happy, where they will have their own families and where the cost to government would be minimal in comparison to putting them into different institutions. The people who are charged with caregiving are given a meagre sum to carry out their work. It is almost minimum wage.

I just wonder what plans this government might have or what the member's idea would be in relation to developing a health care system where everybody plays a part and those who are involved in caregiving—