House of Commons Hansard #16 of the 37th Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was health.

Topics

Health Care System
Government Orders

3:45 p.m.

Liberal

Jerry Pickard Chatham-Kent—Essex, ON

Mr. Speaker, I have had the opportunity to talk with my constituents and with health care professionals in my riding. What I heard was that our health care system was under a tremendous amount of financial stress. The system is short on health care professionals. The system needs many adjustments and changes. We need to come up with a plan to make certain that we have long term care and sustainable funding to ensure that the Canadian health care system serves the public well.

Quite frankly, I hope the debate is not only on where the money comes from. I heard my colleague across the way and I realize he certainly has his viewpoint but I do not think the debate should focus only on whether new taxes are created or whether other things are done. Consultations with the public are most important. Through the consultations by Mr. Kirby and Mr. Romanow we are arriving at a point where we can see a lot of things that need to be done, a lot of actions that need to be taken in the health care system.

I, and I believe every Canadian, have no doubt that there will be extra expenses if we are to tackle the system properly. Making sure that we do have those dollars in place will be very important. However let us also look at some of the shortfalls of the system right now.

It used to be in a rural community we would hear about the lack of doctors and areas that are totally underserviced. I come from an area in Chatham--Kent Essex that is as highly underserviced as any area in this country. That is a real disaster for all of us. When we do not have doctors, nurses or health care professionals that we need to deal with patients, it is very critical. However it is not just the rural communities any more. We are short of doctors in some of our major areas like Toronto, Vancouver and Montreal.

We need to look at a system where we can have the number of health care professionals trained and in practice in this country, not just doctors, by the way, but let us look at nurses. Let us look at all other health care delivery service people that we have in the system. We are totally underserviced. The opportunity in the future does not seem to be as bright as it should be either. Where will those doctors come from? Do we have the numbers to deal with those issues? I do not believe so.

One of the reasons a lot of the consultation and work that has been put in place is to try to deal with not only financing, but numbers of health care professionals.

How do hospitals get stable funding and make sure they can plan for not only today but for five or ten years down the line? How can they be sure that the administration in our hospitals is provided with the tools it needs in order to deliver proper, adequate health care to people coming into the system?

How do we deal with the cost of drugs, which seems to be escalating over time and in fact is putting more and more stress on our system every day? Are there means by which we can look at those extra costs and deal with them in a more adequate, better way?

From my point of view, from my constituents' point of view and from the point of view of the health care professionals with whom I have spoken, obviously more money needs to be put into the health care system but we also need to deal with many other issues in the health care system that will make our system the system that we want it to be.

I have no question that the Liberal government, every person in the House and all Canadians want to make sure that we put a health care system in place that will serve everyone well. The problem obviously is that we focus our debate on who will pay the bills. We focus our debate on who is wrong and who is right. We focus our debate on most of the wrong things.

When I hear that Canada does not pay its fair share in health care, I wish we would stop that type of debate and start looking at what is the past record, what have been the expenditures? Are we living up to our obligations to the people who are electing us? Are we moving that agenda forward, or are we playing petty politics on funding issues and not really looking at a system that needs some repair, that needs a cash injection, and that needs a lot more support and thought to go into it?

I am a disappointed in what I am hearing at times. We must have institutions in this country that will train nurses and doctors, that will put professionals with the proper tools and skills in small communities. In my riding the town of Tilbury is a good example. Tilbury has been searching for a doctor for years to replace the doctor who was in the community. There are outreach programs. There is funding to recruit doctors. There are all kinds of activities going on. We have not been as successful as we can in dealing with that.

I have heard of systems where doctors would set up practices in different communities to help with the building, the material, and the professional equipment that is required, but to no avail because there are not enough doctors trained in the communities.

We can look at the systems as they are changing. We have clinics in many of our communities today. Those clinics will have people come in with colds and other problems from nine in the morning until four in the evening and the doctors in those clinics can deal with those patients quite quickly.

When it comes to long-term, major health care programs, the patients are turned back to the family practitioner. The family practitioner then has a tremendous number of hours, a tremendous amount of work, and a heavy burden of individual patients who have diseases that require a long-term of care. Possibly the funding in those areas is not as good as the type of funding that a doctor might receive if he received payments for everybody coming off the street. He could deal with them in five minutes and bring the next patient in and deal with him or her for five minutes.

We must look at the role and the work that our practitioners are doing in practice as well. We must look and see if the clinics are serving our society well. Perhaps many of the long-term cases should be taken over in some other way. We should look at how the whole structure of funding to the medical community is put in place.

In Ontario there are projections that we will be short tens of thousands of nurses over the next 10 years and that is scary. When we start talking about the shortage of all kinds of professionals, not just in the medical field, but in all fields, we must be concerned where this whole system is moving.

I want to touch on funding to a small degree. It is critical that people understand that the federal government has been working very hard. It is my understanding that in the last four years we have increased health care spending by $35 billion. That is $35 billion put into the health care system that was not there before.

People have played with the numbers and they have not been accurate about those numbers in this debate. I have never heard anyone talking about all the types of transfers that go to the provinces and covering health care system costs. I can say without equivocation that our health care system is financed by the federal government at the rate of 40%. I believe all of the numbers, when we talk about transfer to the provinces, cash transfers, tax transfers, and equalization payments, would hear me out.

Health Care System
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3:55 p.m.

The Acting Speaker (Mr. Bélair)

Questions or comments? Resuming debate, the hon. member for Ancaster—Dundas—Flamborough—Aldershot.

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3:55 p.m.

Liberal

John Bryden Ancaster—Dundas—Flamborough—Aldershot, ON

Mr. Speaker, I would begin by saying that I have followed the debate today right from the very beginning and I heard the Leader of the Opposition speak first. I note that one of the techniques around here, if we want to find out what the opposite side's viewpoint on an issue is, is to listen to the leader and we will find everything else echoed by the subsequent speakers. I expect there is an exchange of information that enables subsequent speakers in the opposition to basically echo that which their leader said.

I listened to the leader's speech very carefully. I noted that despite 25 minutes of condemnation of rhetoric from the government's side, in fact the Leader of the Opposition made only two concrete suggestions in his entire speech which took about 35 seconds, each one of those suggestions. I would like to deal with them.

The first suggestion was that we should spend more money for health care. The federal government should put up more money and it should not raise any new taxes in doing so. That is very laudable but we do note that the opposition is asking the government to spend more money on defence and is asking the government to spend more money in a variety of areas. I do not know about the practicalities of what is suggested by the--

Health Care System
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3:55 p.m.

Canadian Alliance

Ken Epp Elk Island, AB

Mr. Speaker, I rise on a point of order. I need some clarification. Is the member rising on questions and comments or is he making a speech? The person to whom he should be directing his questions and comments has gone.

Health Care System
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3:55 p.m.

The Acting Speaker (Mr. Bélair)

The hon. member is actually making his speech. I asked for questions or comments a while ago after the hon. member for Chatham—Kent Essex spoke and nobody stood up, so we resumed debate with this hon. member, who has the floor.

Health Care System
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3:55 p.m.

Liberal

John Bryden Ancaster—Dundas—Flamborough—Aldershot, ON

Mr. Speaker, I always thought the whole point of this place is to exchange in a debate and so I am commenting in debate on the suggestions made by the Leader of the Opposition and all the subsequent members of the opposition.

To finish my thought, and hopefully without any further interruption, all the Leader of the Opposition said is to put more money into health care from the federal government but without raising taxes and he did not suggest how to get that money.

We learned from the member for New Brunswick Southwest that a minimum of $5 billion more is required for an infusion into health care, according to Senator Kirby's report, but in fact to cure the problems in health care delivery it is probably many billions of dollars more than that. I would submit that the answer is not more federal money and I am personally opposed to adding more federal money into the health care situation because I believe the savings and the money can be found elsewhere

That brings me to the Leader of the Opposition's second point. He suggested that we should consider the Alberta model of the private corporation delivery of health, in other words private clinics. The genesis of that point was the idea in Alberta that perhaps the public provision of health care delivery, which is usually by charitable non-profit organizations, could be more efficient if some of these services were provided by for-profit organizations, the idea being that the profit motive creates certain efficiencies.

I do not think we should discount that particular suggestion. It is a legitimate suggestion and the Leader of the Opposition was careful to point out that it would still be public care, that everyone would be entitled to equal care. The question would only be if in some instances the health care delivery would be better delivered by a private organization.

I suggest however that before we ever get to that point what we need to do is to make the health care delivery institutions more transparent and accountable. We would save, if we did that, all the money we need, in order to upgrade the current health system.

Mr. Speaker, you may not be aware of this but the $75 billion of government money that goes out to the health care institutions to provide health care delivery is not managed in any way that is legislatively transparent and accountable to the public. Hospitals which spend billions of dollars are not under the Canada Corporations Act save as a regime of guidelines of corporate governance. They do not operate under legislated standards of corporate governance.

Consequently if we talk to senior health care professionals we find them telling us that there is no administrative standard governing hospitals or health care institutions all across the country. In other words, one hospital may be operating effectively. Another hospital may not be operating effectively but there is no interchange of ideas. There is no parent standard from the national government or even the provincial governments.

Even in research hospitals have their own institutes of research and there is no peer exchange of ideas in the research that these institutes do. In other words, we have a situation where individual hospitals may be running a research institute operating as a charity or receiving money from a charitable foundation but there is no peer review of the actual work they are doing, other than when they finally come out and produce a paper and there is no coordination of the actual practices.

I point out that this extends to health care delivery, this problem of transparency and accountability. The Canadian Institute for Health Information, which was created about eight years ago by the health ministers federally and provincially, has disclosed all kinds of problems in the health care delivery system which all has to do with the failure to keep proper records and exchange information.

I will give just one example of the Canadian Institute for Health Information. It found in its research that there is no Canadian data on follow-up procedures in hospitals. It also estimates that there are 10,000 infection and non-error medication deaths in hospitals. The error basically boils down to when a doctor or nurse prescribes the wrong medication and the person dies. Because we are not a society in which litigation surrounding our medical practices is the norm, as it is in the United States, these accidents occur and for years and years there has been no follow-up and no central collection of data on these accidents.

While we all would like to believe that we have some of the best health care delivery in the world in Canada, the reality is that because of the lack of transparency in major hospitals and other health care delivery systems, only now are we beginning to realize that perhaps our health care delivery is not anything like as efficient as we would like to believe.

The analogy is very apt. If that is the case in health care delivery, where there are huge inefficiencies because of the lack of reporting, the lack of transparency, the need to exchange data, the lack of public accountability, then it is easy to conclude that there must be the same situation with the delivery mechanisms of hospitals and other health care institutions. In other words, if one does not have to tell anyone what one is doing, there can be nepotism and every kind of inefficiency imaginable.

If the total bill is $75 billion dollars a year of taxpayer money going into health care delivery and we have no way of knowing how administratively efficient that health care delivery system is, then I would suggest that at the very minimum, at a 10% minimum, we would get $7.5 billion to add into the health care delivery system. I would say that is just a minimum.

Therefore it becomes a no win game. When the federal government gives money to the provinces and the provinces give money to the health care delivery systems or institutions, and even the provinces cannot be sure how that money is being spent, what happens anecdotally is we occasionally find a situation where money is going out, which hopefully was to go toward some sort of magnetic resonance system or some other important piece of hospital machinery, for lawnmowers and garden care.

That is precisely the problem. We could save the money. We could reform the health care delivery system. We could do it all without an additional cent of money, if we brought hospitals and health care delivery systems under the Canada Business Corporations Act, where they would be forced to conform to proper standards of corporate governance, and finally under the Access to Information Act, because I suggest that if transparency is good for government, it is also good for those institutions that spend government dollars.

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4:05 p.m.

NDP

Yvon Godin Acadie—Bathurst, NB

Mr. Speaker, I feel it is a cheap shot when to say that a hospital bought a lawnmower to cut the grass in front of the hospital. What does he want the hospital to look like? Does he want to have hay in front of the hospital and bring in horses and cows to clean it up?

Is it not because the federal government has made cuts and is only paying 14% of the costs of health care? If we had the 50% like we used to have, I would like to see the difference in each province of our country, instead of leaving the burden on the provinces to look after the health care of Canadians.

The federal government has a responsibility, and I believe where the Liberals went wrong was when they made the cuts in 1994. They should stop talking about the lawnmower because we still need that grass to be cut. We are not going to put horses in front of our hospital to eat the grass.

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4:05 p.m.

Liberal

John Bryden Ancaster—Dundas—Flamborough—Aldershot, ON

Mr. Speaker, I would rather worry about lives than how long the grass is. That aside, the fundamental point here is this. Do not ask for more money. Do not put more money out before knowing how that money is being spent. We cannot see how hospitals and these institutions are spending money. The losses, when we talk about $75 billion, must be enormous. I do not see why any institution in this land should be afraid of transparency and accountability, especially as it will save lives and money at the same time.

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4:05 p.m.

Progressive Conservative

Greg Thompson New Brunswick Southwest, NB

Mr. Speaker, I want to go a little further than the member who just spoke when he talked about the lawnmowers, the woodworking equipment and so on that had been bought for hospitals. I agree that that is a necessary part of making a hospital presentable and in running it. However, the member did not explain this and I know he knows this. I guess it is the lack of time to go into the detail. However the point that I think we want to make is that came under the special technology fund, where the federal government put somewhere in the order of $250 million to $500 million on new technology.

We are talking about transparency and I fully agree with the member. These programs have to be measured very carefully and there has to be total transparency. However, when a lawnmower qualifies for new technology spending, what does that tell us? It is a no brainer.

I agree fully with the member in terms of transparency. The Auditor General has mentioned the same thing. We will be talking about putting more money into health care, and to his credit Senator Kirby said the same thing, that new money--

Health Care System
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4:10 p.m.

The Acting Speaker (Mr. Bélair)

I have to give time to the hon. member for Ancaster—Dundas—Flamborough—Aldershot to respond.

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4:10 p.m.

Liberal

John Bryden Ancaster—Dundas—Flamborough—Aldershot, ON

Mr. Speaker, I thank the member for New Brunswick Southwest for correcting the remarks of the New Democratic Party member for the record.

I want to make a point that, when it comes to transparency, we have to bear in mind that the salaries of hospital administrators are huge as well. The chief administrator for Hospital for Sick Children makes $500,000 a year. There is nothing requiring the CEOs, the paid executive staff of the hospitals, to even report the truth to their board of directors. There is this gap of information.

In the end transparency and accountability is the way to go. We should really look at the possibility of extending legislation like the Access to Information Act to institutions like hospitals. They should have nothing to hide. They should be open for public scrutiny and it would save lives.

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4:10 p.m.

Liberal

Dennis Mills Toronto—Danforth, ON

Mr. Speaker, I will be sharing my time with the member for Bonavista--Trinity--Conception.

First, I want to congratulate the committee led by Senator Michael Kirby and the committee led by former premier, Roy Romanow for all the work that they have be doing over the last year in advancing the debate on this issue, which essentially stamps the character of our country. If there is a defining issue that makes Canada so special, so unique on the world stage, it is our universal health care system. I believe that all of us in this room want to do everything we can to ensure that the universal health care system is enshrined.

A few weeks ago I was talking to one of the doctors in one of the hospitals in my riding in downtown Toronto, the East General Hospital. He was complaining about the lack of MRI equipment and staff. He brought to my attention that in Toronto a dog, a pet, could get access to an MRI machine faster than a person who was in desperate need of an MRI. I am not against pets. I have over 10,000 pet owners in my riding. I totally celebrate and do not want to take anything away from pets or that community. However the priorities in Canada are wrong when pets are on MRI machines before patients, human beings.

We really have to look into all the possibilities that exist to reinvigorate our health care system before we spend another five cents. I agree with the member for Ancaster--Dundas--Flamborough--Aldershot. The notion of us just automatically transferring another $5 billion, $6 billion, whatever the number is, without going through the system line by line ensuring that we are operating at our capacity at our maximum potential for efficiencies would be irresponsible. I am definitely against a dedicated tax.

We have missed a lot of opportunities in improving the health care system and improving the efficiencies in the health care system. I would like to bring one specific area to the attention of the House which we talked about four years ago.

A number of us in the House and in all parties chaired a committee on the importance of physical fitness and amateur sport in Canada. We had some of the best doctors in our country appear before us. They brought to our attention that of all the G-7 countries, we were the worst in terms of physical fitness; we were right at the bottom. They said that only 29% of the people in our country spent an average of half an hour on physical fitness in a day. They brought to our attention that if we could move that number from 29% to 39%, a 10% increase, then we could save $5 billion a year in health care costs. That is where we should be looking.

What disturbs me about this specific idea given to us by experts is that we have let four years slip by. We have missed four years. Let us be conservative. If in three of those four years we had fully mobilized the will of the country, we could have saved around $15 billion in our health care system. That would have more than looked after what Senator Kirby has recommended in his committee report.

I personally have a view about just transferring money. I do not know how this $5 billion has been calculated. It seems very strange to me. It is a number that I sometimes find hard to absorb. It seems there is the idea we would just throw more money at it without doing a line by line check not just of efficiencies but also of what are the areas of prevention we could take advantage of.

One idea is in the area of physical activity. That is a savings of $5 billion a year. My goodness, what if we could get to a point where 50% of our nation exercised 30 minutes a day, walked for 30 minutes a day? Just think of the savings. This would all go to our capacity to sustain our universal health care system.

The second point I want to put on the table is also in the area of prevention. In my community in downtown Toronto there are many communities that use alternative therapies such as shiatsu therapy and acupuncture. There are all types of therapies in the area of prevention that could save millions and millions and possibly billions of dollars for our health care system.

There are certifiable statistics showing that 10% of our country's workforce is clinically depressed and only one-quarter of 1% of that 10% is diagnosed. The cost to our health care system of 10% our workforce being clinically depressed is staggering.

We have to get in to the whole realm of prevention. To get prevention exercises moving forward costs money, but it does not cost billions to prick the conscience of Canadians and get them involved in a national exercise when collectively they know they have a responsibility to do their part in order to sustain our health care system.

It would probably cost us about $100 million a year in promotion and mobilization. I would invest $100 million if I thought it could save $5 billion. Experts have given us this advice time and time again in committee. I am sure the Secretary of State for Amateur Sport will deal with this issue in even more detail when he speaks on Wednesday.

I applaud that we are having this debate. I do not like the idea that it is only 14% or 16%. I do not think Canadians really care about that. They want to know that we have come up with an action plan that we can get on with right away. I would like to see a very focused effort in the whole area of prevention.

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4:20 p.m.

Canadian Alliance

Rob Merrifield Yellowhead, AB

Mr. Speaker, I listened very intently to the hon. member's comments.

I am a little disturbed that he said to get on with the plan. I have not seen the plan yet. Canadians have not seen the plan. It would be quite interesting to see what the plan is. The government passed it off to Mr. Romanow for a two year hiatus that Canadians cannot afford.

It seems that the bulk of the member's comments were about preventive health care. If we want to see if someone means what he is saying, then we should find out where his feet are on the issue. The government talks the good talk about preventive health care, but it pulled the rug out from under the Participaction program, as an example. If the government is really serious about prevention and looking after our youth and having a nation that is dealing with preventive health care, then why has it not reinjected the dollars to put that program on its feet again?

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4:20 p.m.

Liberal

Dennis Mills Toronto—Danforth, ON

Mr. Speaker, I can answer that excellent question in a very specific way. Over the years Participaction has done a fantastic job. It appeared in front of our committee.

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4:20 p.m.

An hon. member

Then why did you pull the money?