Mr. Speaker, I will split my time with the hon. member for Vancouver Centre.
Over the past 18 months, the Romanow commission has pursued an ambitious agenda based on extensive research and consultations that have allowed tens of thousands of Canadians, including Quebeckers, to express their views. The main message conveyed by these people is that the new federal money must be used to fund changes.
It was Einstein who said, “The definition of insanity is doing the same thing over and over again expecting a different result”. Canadians agree.
Today the Pollara poll shows that Roy Romanow's prescription for medicare reform has the support of two-thirds of Canadians. Pollara found that 66% of Canadians approved of the work of the Romanow commission.
Don Guy said, “Basically, they've said this is the right prescription for medicare”. It is not surprising.
As many commentators have noted, we can hear the voices of Canadians coming from every page of the commission's report. The report is as a result of the most legitimate consultative process in the history of Canadian royal commissions. The insistence upon transparency of the submissions and commissioned research and the utilization of every possible modern tool of citizen engagement, traditional hearings, web based consultations, as well as genuine deliberative models, have ensured that ideological arguments from the left or the right have been confronted with a sound metanalysis of the evidence and underpinned by resounding consensus of the values of Canadians for the important double solidarity between the rich and the poor and the sick and the well.
Canadians are fed up with the federal-provincial gridlock that has wasted, among other things, 1.8 million provincial health care dollars for TV spots and full page newspaper ads squabbling about who pays. They know that it is all their dollars and that they could have a fabulous health care system with less than 10% of the GDP. They want us to get on with it.
How do we move forward? How do we create the unstoppable momentum that will put all levels of government on notice, that it will be at their political peril if the first ministers meeting in January looks anything like previous ones. Canadians have never been clearer: they want medicare to work and they understand the trade offs necessary to ensure its sustainability. They want to know where the health care dollars are going and the value they are getting for the money. They agree that all levels of government must report to Canadians on the performance of the health care system, how it compares within Canada and internationally.
Canadians have been suffering through a crisis of confidence and a crisis of governance in health care. They want this fixed. Importantly, they are prepared to come on board in their triple role as empowered patients, effective advocates and engaged citizens. They want to help make it work. Canadians are not, as they are sometimes unfairly characterized, greedy and wasteful. They do not intentionally clutter up emergency departments, have unnecessary surgery, tests and drugs that lead to the call for medical savings accounts and user fees to curb their cravings.
The polling data has shown that Canadians want a strong federal role in health care. However, Mr. Romanow understands that federal leadership is very different from federal dominance. He proposes two brilliant solutions that demonstrate his sensitivity to the difference.
First, he devised a haggle free formula for health care funding that clarifies the responsibility of the federal government in perpetuity.
Second, he wants an innovative, intergovernmental mechanism, the health council of Canada, to evaluate the performance of the system and provide strategic advice on emerging issues by using the methodologies pioneered by the commission and the ongoing advice of a permanent advisory committee. The council would have: seven government members, two federal and five provincial; and seven civil society members, three from the public and four provider-experts. With citizens at the table, the finger pointing should become impossible.
At issue at the first ministers meeting will be whether we can begin the process of new collaborative relationships. I believe every person with any responsibility for health care in Canada, every single person in the trenches of health care, understands the huge advantage of a cooperative approach that will begin to address the gaps, duplication and incentives that could provide optimal health care for Canadians. We must ensure that the negotiators from all levels of government at next month's meeting include those who have some knowledge of the health care file. Simply sending finance and intergovernmental affairs officials will never work. Canadians should insist that the turfmeisters are excluded from the meetings and only those interested in real solutions are included.
We have been in pan-Canadian gridlock. Everything we care about in this country resides in at least three levels of government and three government departments. If the enormous pressure to get health care right enables us to listen to Mr. Romanow and respond in a creative way, this may be the opportunity to not only solve medicare, but to begin the process of wrestling this country back from a technical federalism that has lost the confidence of Canadians. A successful response to Romanow can refocus all levels of government on the public good and on working together to achieve our common goals based on our shared values.
Monique Bégin always tells the story of going to Trudeau's desk here in the House of Commons just before medicare came in. She said that she was really worried that the 10 provinces and organized medicine were against her. Trudeau asked her where the public stood. She said that the public was for it. He said then it was a sure win. She said that she did not find that to be obvious so she went to Jean who was the senior in terms of negotiations. She asked him what it would take to make the provinces understand, what was the language the provinces would understand? He said very simply, “Money”. She said that he was dead on.
Here we are 20 years later and the former Minister of Intergovernmental Affairs is now the Prime Minister and his friend, Roy Romanow, has just delivered the most important report of a royal commission since Monique Bégin supported the Royal Commission on the Status of Women.
The provinces still care about money and Canadians have never been clearer. They want medicare to work and they understand the trade-offs necessary to ensure sustainability.
This time we actually have four provinces in favour of it. Organized medicine is in favour of it and especially the young doctors are in favour of it. Two provinces, Newfoundland and Nova Scotia, are in favour of it, with a but. Three provinces, Ontario, Alberta and Quebec, are against it. British Columbia is against it, with a but.
As we said before these provinces may be well at their peril to be against the Romanow report. In fact with the provincial governments that are against, their citizens are in favour. Quebec is polling at 59%. Ontario is polling at 70%. British Columbia is polling at 69%. Mr. Guy said, “It appears that Romanow and his group have struck a chord with the public in Quebec and perhaps have gone over the heads of some of the elite in that province”.
Second year medical resident, James Clarke says that the implementation of Romanow's prescription will strengthen medicare and that failure to do so will undermine it.
The truly wonderful Dr. Mikhael from the Ontario medical residents has said, “We are calling on the governments of Ontario and Canada to work together to ensure adoption and implementation of the report in 2003”.
Tomorrow I will meet with my wonderful Good Health Through Good Governance Working Group at the Munk Centre. We have isolated three things to talk about tomorrow: accountability; infrastructure; health promotion and disease prevention.
It is quite clear that none of these can be done without collaboration across the country. Tomorrow when the health ministers meet I know they will understand the changes that have to take place and that collaboration is imperative.
As Charles Darwin said, it is not the strongest of the species that survives, not the most intelligent, but the most responsive to change. Money will not fix this alone. Canadians know we need accountability and the ability to share best practices from sea to sea to sea.
As regards the motion presented by the Bloc Quebecois today, Canadians said that they expect the federal government to play a strong role in our health care system. They want leadership, not an automated banking machine.