House of Commons Hansard #100 of the 37th Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was health.

Topics

Health
Private Members' Business

11:05 a.m.

Canadian Alliance

Garry Breitkreuz Yorkton—Melville, SK

moved:

Motion M-83

That the Standing Committee on Health fully examine, study and report to Parliament on: (a) whether or not abortions are medically necessary for the purpose of maintaining health, preventing disease or diagnosing or treating an injury, illness or disability; and (b) the health risks for women undergoing abortions compared to women carrying their babies to full term.

Mr. Speaker, I am pleased to be starting the debate today on the first piece of private members' business of the many I have introduced in the House which now will be votable. Nine years of work to make all private members' business votable has finally paid off and I wish to thank all my colleagues in all parties who made this change to our Standing Orders possible.

Today I am hoping to convince the majority of members of the House to support my Motion No. 83. The motion is very simple. It asks the Standing Committee on Health to fully examine, study and report to Parliament on two issues related to the delivery of abortion services in Canada. The first is to determine whether or not abortions are medically necessary as defined in the Canada Health Act. The second is to determine the health risks for women undergoing abortions.

Doctors take an oath to “do no harm”. I believe that government should take the same oath. We should hold the government to the same standard we would hold individuals and corporations, that is, we are all responsible for our actions and the damages they cause. If medical procedures are proven to cause harm, then precautions have to be taken. If medical procedures cause more harm than good, then we have to be even more careful in how we deliver these services under the Canada Health Act.

Let us start this debate with the health minister's position on abortion. On October 3, 2002, the health minister said in the Saint John Telegraph-Journal :

Our view is that obviously abortion is a medically necessary service, therefore it has to be insured whether it's performed in a hospital or a private clinic.

The minister's statement came as a complete surprise to me because I had a letter from Health Canada dated March 8, 2001, stating that there were no records in the department that would “provide evidence that abortions are medically necessary”. I immediately filed another access to information request asking for the new information the Department of Health must have to support the minister's statement, but on October 31, 2002, Health Canada once again responded that after a thorough search no records were located.

I was shocked that the Minister of Health would make such a clear policy statement for the government without having the medical evidence to support her claim, so I dug through my files looking for some justification for the minister making such a statement without medical evidence being immediately available in her department.

I found a memorandum dated March 30, 2001, sent by Health Canada in response to questions asked by members of the Standing Committee on Health during committee hearings held on March 13 and 15, 2001. The committee asked, “Does Health Canada have a list of what it considers 'medically necessary' hospital and physician services?” Health Canada responded and I would like to quote the response:

The comprehensiveness criteria of the Canada Health Act (CHA) requires that provincial/territorial health insurance plans insure all medically necessary hospital and physician services. Health Canada does not maintain a list of medically necessary physician and hospital services for the purpose of the administration of the CHA, although the definition of hospital services in the Act is very detailed. The federal government's position with respect to the determination of medical necessity has always been to leave the responsibility to decide what services are medically necessary to the provinces and territories, in conjunction with the medical profession.

Health Canada monitors provincial/territorial decisions to remove or add services to their lists of insured services on an on-going basis to ensure that there is no breach to the requirements of the CHA. The assessment of whether the deinsurance of a service by a province or territory is a breach of the comprehensiveness criterion generally takes into consideration whether the service is covered in other provinces or territories, and whether there is a consensus in the medical community that the service is effective for the purpose of maintaining health, preventing disease and diagnosing or treating an injury, illness or disability.

I remind everyone listening today that the health department's definition of which procedures it considers medically necessary is identical to the wording of my motion. This is because I took the definition for my motion right out of the Canada Health Act.

The Standing Committee on Health was told by the Department of Health that the responsibility of determining which medical procedures are medically necessary rests with the provinces and territories, so last summer we wrote the ministers of health in the provinces and territories. Only Quebec did not respond. Those that responded considered abortion to be both medically necessary and therapeutic, but also informed us that they had not conducted any risk benefit analysis with respect to the provision of abortion services delivered in their jurisdiction.

So in fact, nowhere in Canada were we able to find any medical evidence to justify the minister's conclusion that “obviously abortion is a medically necessary service”. If no government, federal, provincial or territorial, has completed a risk benefit analysis on abortion, how can it be claimed that all abortions are medically necessary and therapeutic? How can the federal government demand that all abortions be insured under the Canada Health Act if the government does not know what the risks are or if the benefits outweigh those risks? This question can only be resolved by independent research and analysis provided by medical professionals and reported to the Standing Committee on Health. This is why I introduced the motion and this is why the research is so essential to preserve the integrity of the Canada Health Act and its enforcement.

Despite the lack of medical evidence to support the minister's view that all abortions are medically necessary, the government still enforces the Canada Health Act quite vigorously against some provinces that do not provide abortion services as dictated by the federal government. For example, the minister of health for Newfoundland and Labrador, Mr. Gerald Smith, MHA, in his letter dated August 22, 2002, wrote:

I understand that the decision to pay for the health costs in connection with abortion procedures in this Province largely came as a result of views expressed by the federal government that abortions are medically necessary services under the Canada Health Act and should be covered by the provinces. Indeed, for a period of time some transfer payments from the Federal Government were withheld from this Province because the Province did not cover the full cost of abortion services.

Media reports last fall revealed that the Province of Nova Scotia had been penalized by Health Canada since 1995 for failing to pay the facility fee at the Morgentaler abortion clinic in Halifax.

How can the government ensure that abortion services are enforced equally in all provincial jurisdictions or provided equally to women in each and every province, as Dr. Morgentaler is demanding, if it does not have the medical evidence justifying that all abortions are in fact medically necessary and therapeutic and that the medical benefits outweigh the risks in all cases being insured under the Canada Health Act?

The Standing Committee on Health needs to hear Dr. Morgentaler's views on why he feels it is important for the health of the mother to conduct an abortion as early as possible in the pregnancy and how the health risks for the mother increase as the pregnancy progresses. Even Dr. Morgentaler appears to agree that at some point during the pregnancy the risks for the mother of having an abortion would outweigh the medical benefits.

The committee also has to hear from front line health care providers such as the Canadian Nurses for Life, who wrote a letter to each one of us dated November 18, 2002, that clearly stated “Abortion is not a medical necessity”. The Canadian Nurses for Life went on to say:

As members of the most populous health care profession, we are well aware of the necessity of conserving our health care dollars. We are there on the front lines of health care twenty-four hours a day, seven days a week. We are uniquely involved in every aspect of caring for our patients and as such are able to distinguish the need for medical information when we see it.

The standing committee should also hear from the Canadian Physicians for Life, who wrote to the Prime Minister on October 7, 2002, stating:

Women's health is being harmed by abortion, without their knowledge or consent. Available studies make this clear and the politics of abortion is keeping this information from women--they are not fully informed before they make their choice for abortion.

The letter goes on to list a number of the more serious risks of which women contemplating an abortion should be informed, including increased risk of breast cancer, post-abortion emotional trauma, and loss or impairment of children through premature delivery in subsequent pregnancies.

The Health Canada response to the standing committee also stated that another factor in determining the medical necessity of a medical procedure is “whether there is a consensus in the medical community”.

Another issue for the health committee to examine and report on to Parliament is whether or not such a consensus exists and how the consensus was determined. The letters from Nurses for Life and Physicians for Life would seem to indicate that there is not a consensus.

I would like to quote from a secret memo I received under access to information. The subject of the memorandum to the minister was a letter to Dr. Henry Morgentaler. Page 6 of the document states, and I quote:

Abortion is recognized as a medically necessary insured service in all the provinces and territories. Under the Canada Health Act, all medically necessary health services (physician or hospital) must be insured, and access to these services should be provided on uniform terms and conditions. In 1995, the federal policy on private clinics came into effect requiring provinces paying the physician fee for services provided at private clinics to also pay the facility fee. Three provinces (Alberta, Newfoundland and Nova Scotia) were penalized for not paying the facility fee at private abortion clinics. While Alberta and Newfoundland have since resolved the situation, Nova Scotia remains in non-compliance. New Brunswick, Manitoba and Prince Edward Island were not penalized under the clinics policy because clinic abortions were not deemed to be an insured service in these provinces. Quebec was not penalized because it was paying the physician fee plus an additional $40 facility fee for abortions performed in private clinics. Quebec's position was that any additional charges to patients were for non-insured services (e.g. counselling).

Clearly this shows the confusion that exists in regard to the medical necessity and insurability of abortion. It is obvious that a consensus does not exist in the provinces either. Maybe this can explain the inconsistency in enforcement of the same violation in non-compliant provinces.

It is obvious from this one government document alone that every jurisdiction would benefit from having the medical evidence necessary to prove when and where a medically necessary procedure can be provided at the lowest risk to the health of the mother.

I believe that every province should insure counselling for mothers so they are completely and fully aware of all the risks associated with having an abortion and the alternatives to having an abortion. This counselling for mothers concerning the risks would also have to be based on sound medical evidence that does not appear to be available at either the federal or the provincial level.

I have not had time to go into all the medical evidence that is being debated across the country, but I have another quote that shows there is risk to having an abortion. In response to Order Paper Question No. 151 dated April 24, 2002, Statistics Canada reported, and I quote:

Statistics Canada has only a limited amount of data and research on the death rate after a pregnancy. Statistics Canada also annually publishes data on deaths and death rates, including maternal mortality, defined as deaths caused by complications of pregnancy, childbirth, and the 42 days following termination of a pregnancy. Of the 329 maternal deaths that occurred from 1979 to 1998, seven deaths had an underlying cause of complications from abortion.

Unfortunately, another Access to Information Act request to Health Canada drew another “no records” response when I tried to find reports documenting the total death risk for women having an elective abortion compared to that for women carrying their baby to term. There is also a long list of medical complications suffered by women undergoing abortions but I will leave that for others to itemize, or hopefully for the health committee to study to reveal and determine the extent of these complications and their impact on the therapeutic nature of providing abortion services in Canada.

In closing I would like to add that every argument I have made today was made on medical grounds, not moral grounds. I strongly believe that our laws should protect all life from the moment of conception. I recognize that the medical evidence gathered by the Standing Committee on Health may not support my strongly held belief, but I am willing to live with whatever the committee finds during its examination. I hope that every member of Parliament is prepared to do the same. I appeal to everyone voting on this motion to vote on the actual wording of the motion. I look forward to the debate that will be held over the remainder of this hour and in the second hour.

I ask the people of Canada to let their members of Parliament know how they feel about this, and I hope members will vote accordingly. This is an important issue, an issue that has not been debated in the House as long as I have been an MP. I appeal to members to listen, read the words of the motion and then vote accordingly.

Health
Private Members' Business

11:20 a.m.

NDP

Wendy Lill Dartmouth, NS

Mr. Speaker, I would like to ask the member a couple of questions. We know the Supreme Court struck down the Canadian abortion law in 1988. That may not have much of an impact on the member. I know the Alliance is not very fond of many of the rulings by the Supreme Court.

The member mentioned that he was concerned about abortion on medical grounds. We know the anti-abortion activists do not support abortions whether they are safe or not. I and people in the medical field have found no linkages between abortion and breast cancer. It seems to me that bringing in potential health issues at this point in time when they have not been proven is a bit of a red herring.

The opposition is trying to put this issue into the political realm when in fact is the issue not simply that the member does not support a women's right to choose an abortion, whether he believes it is a safe or an unsafe procedure?

Health
Private Members' Business

11:20 a.m.

Canadian Alliance

Garry Breitkreuz Yorkton—Melville, SK

Mr. Speaker, I want the members of the House to look at what I have put forward. The member is bringing in other issues which I do not want the health committee to examine at this point.

I am asking the committee to examine the health risks that are involved here. Many studies have been done, and I can get into some of those, but if the motion passes then it is up to the health committee to examine the health risks.

For years people thought smoking was all right. Doctors even thought there were benefits to smoking, that it protected people from harmful diseases. Doctors thought that if people were in contact with a patient who had an infectious disease that smoking would protect them. We have changed our minds after research indicated the risks. Maybe we will have to change our minds on this issue and begin to inform the public about the risks, just as we did for smoking.

This really is not tied in to what the Supreme Court ruled. The motion deals with the health risks of abortion. I wish we would confine it to that issue.

Health
Private Members' Business

11:20 a.m.

Canadian Alliance

Vic Toews Provencher, MB

Mr. Speaker, I too would like to direct my question to the hon. member for Yorkton—Melville.

I noted with interest that his motion is in fact focused on the health risks facing women who have undergone abortion. The motion does not mention the issue of whether the fetus constitutes human life, but restricts the examination to the health of the mother.

Because the motion focuses on the mother's health, I think each of us could support it. It would be in the best interests of women and women's health to have a discussion on that issue to make sure we are kept up to date on any developments in that respect.

Would the member elaborate more specifically on third trimester abortions and the concerns he may have regarding the impact these late abortions can have on a woman's health?

Health
Private Members' Business

11:25 a.m.

Canadian Alliance

Garry Breitkreuz Yorkton—Melville, SK

Mr. Speaker, there is a lot of evidence out there and it is in reputable journals. Studies have been done by many medical professionals.

I recently came across a list of some of the short term and long term effects of these abortions. First, with regard to infection, there was four times higher risk of infection than in the control group. With regard to surgery, there was a five times higher rate for those who had abortion in comparison to the control group.

The third study I saw was that hospitalization for psychiatric problems was five times higher for those who had an abortion in the third trimester than in the control group.

Several studies show an increased suicide rate; anywhere from two to six times higher than for women who carry their babies to term. Another study indicated uterine perforations, pelvic inflammatory disease and infertility were linked to abortion.

The sixth study I came across was that there was a pain higher than fractures, sprains neuralgia and equal to the pain of amputees in patients with cancer.

Some of the long term effects were an 85% increase in pre-term or low birth weights in babies and an increase in disabilities.

The last study showed that infertility due to retained fetal bone fragments was a factor and an increased risk of breast cancer of at least 30% and higher in women under--

Health
Private Members' Business

11:25 a.m.

The Acting Speaker (Mr. Bélair)

I am sorry to interrupt the hon. member but he was past his five minutes questions and comments.

Health
Private Members' Business

11:25 a.m.

Madawaska—Restigouche
New Brunswick

Liberal

Jeannot Castonguay Parliamentary Secretary to the Minister of Health

Mr. Speaker, the first part of the motion before us asks that the Standing Committee on Health to fully examine whether or not abortions are medically necessary for the purpose of maintaining health, preventing disease or diagnosing or treating an injury, illness or disability.

The Government of Canada attaches considerable importance to the surveillance of issues affecting the health of Canadians. In 1995, the department began developing the Canadian perinatal surveillance system, or CPSS, as part of a departmental initiative to fill the gaps in national public health surveillance.

The CPSS collaborates with Statistics Canada, the Canadian Institute for Health Information, provincial and territorial governments, health professionals organizations, advocacy groups and university researchers. Representatives of these groups and several international experts serve on the CPSS steering committee and its study groups.

The CPSS considers a health surveillance system to be a core system of ongoing data collection, analysis and interpretation on vital public health issues. Two issues related to public health surveillance, which greatly interest the CPSS and Canadian women, are the health effects associated with induced abortions and those associated with and full-term pregnancies.

There are no studies directly comparing the risks associated with induced abortions and those associated with full-term pregnancies in scientific journals. This can be attributed to the fact that Canadian women and their health care providers do not consider direct comparisons very important.

The physiology of pregnancy varies widely from one stage to the next. The risks associated with most undesirable events during pregnancy are, in all likelihood, higher later in pregnancy than at the stage when induced abortions are performed.

The close monitoring of undesirable events on health and the risk factors are more instructive in the case of induced abortions and full-term pregnancies. The department, thanks to the CPSS, has undertaken several important initiatives in this regard.

As far as induced abortions are concerned, the maternal health task force of the CPSS is looking thoroughly into the statistics on this provided by Statistics Canada. In addition to examining the complication rate as reported by Statistics Canada, the CPSS is examining delayed complications via a study on readmissions after discharge from hospital.

These efforts to link induced abortions in hospital with subsequent readmissions will further our understanding of the nature and frequency of serious complications connected to induced abortions.

As far as the health risks relating to pregnancy in general, the CPSS is involved in two pertinent initiatives. The first of these is a national study of maternal deaths, a first of its kind in Canada, which will attempt to examine all maternal deaths from 1997 to 2000, regardless of cause. A summary of the various provincial and territorial review processes for maternal death coupled with a study by experts on reported maternal deaths will be published by the department in 2004.

Fortunately, maternal deaths are still relatively rare in Canada, but the CPSS recognizes the need to monitor serious pregnancy outcomes that do not lead to deaths.

As a result, a study is currently under way to examine the profile of serious maternal morbidity in Canada. It will use surrogate variables including blood transfusions and admissions to intensive care to establish serious negative events involving pregnant women. These two initiatives will yield a more thorough knowledge of the risk factors and of the scope of serious outcomes affecting the health of Canadian women during pregnancy.

In short, a direct comparison of the health risks for women undergoing induced abortions and women going to full term does not necessarily represent the optimum approach. A careful monitoring of serious events for women's health at all stages of pregnancy will provide the basis for policies and programs designed to provide Canadian women with the safest possible perinatal health services.

The department is fully behind this effort with these initiatives for surveillance.

Health
Private Members' Business

11:30 a.m.

Bloc

Diane Bourgeois Terrebonne—Blainville, QC

Mr. Speaker, today we are debating a motion by an hon. member of the Canadian Alliance who declared in a press release on March 31 that his motion will be the first pro-life vote in Parliament in 12 years.

To my knowledge, this is the third time the hon. member for Yorkton—Melville has brought forward a motion to recriminalize abortion. In February 2001, I was the only feminist female member present in this House and if it had not been for the presence of the Bloc Quebecois, which opposed the motion, the hon. members would probably have had to take action. Later, last year, the same hon. member brought forward another motion and again, thanks to the Bloc Quebecois, the motion died on the Order Paper.

Today, I am pleased to see that once more, answering the call of the Bloc Quebecois, a number of my female colleagues from all parties are here, and I thank them for their support. My hon. colleagues are present in order to show the Alliance member that we have had enough of his stubborn insistence on bringing forward pro-life motions.

If the motion were passed by this House, it would compel the Standing Committee on Health to fully examine whether or not abortions are medically necessary services in accordance with the Canada Health Act and, as the hon. member says “everyone needs to know the health risks for the mother”.

In 1988, the Supreme Court of Canada struck down the abortion law, arguing that it was unconstitutional because it contravened the charter of rights and freedoms. The abortion law, according to the charter, is contrary to the right to life, liberty and security of the person. The Supreme Court said in its judgment:

Forcing a woman, by threat of criminal sanction, to carry a foetus to term unless she meets certain criteria unrelated to her own priorities and aspirations, is a profound interference with a woman's body and thus an infringement of security of the person.

Since then, women in Canada have had the right to choose abortion as a means of ending an unwanted pregnancy. Thus, to revive the debate on this topic is to call into question the decision of the Supreme Court of Canada, and I strongly doubt that the members of the Standing Committee on Health are prepared to debate this decision.

The Canada Health Act, which sets out the general principles and conditions the provinces must respect in order to receive funding for health care services, stipulates that the provinces and Quebec must pay for all hospital and medical services that are medically necessary. However, the act does not define “medically necessary”, nor does it establish how that is to be done.

Each province, including Quebec, decides which medical services it must provide. The question of how far the federal government could go in applying national standards without interfering in provincial and Quebec jurisdiction is far from settled.

This is why the medical and hospital services that are insured differ in each province. This is why the practice of abortion also differs in each province and in Quebec. This situation has been denounced by the Canadian Abortion Rights Action League, which noted—and this is probably the conclusion that the Standing Committee on Health would reach—that the five principles laid out in the Canada Health Act are constantly being violated by the provinces.

The principle of transferability is violated when provinces treat abortion like plastic surgery and place it on the list of services that are not included in the interprovincial reciprocal billing plan. The principle of accessibility is violated when provinces, such as Prince Edward Island refuse to provide any abortion services, forcing women to go to New Brunswick and Nova Scotia to terminate their pregnancies.

Comprehensiveness as a principle is trampled when Nova Scotia, New Brunswick and Manitoba refuse to pay for a medically necessary abortion performed in an independent clinic instead of in a hospital. In New Brunswick, a physician is even reported as having threatened a woman to stop caring for her and her family if she tried to get an abortion.

Also, the public administration principle is denied when, following the merger of Catholic and secular hospitals, public institutions run by Catholics do not offer women any reproductive health services, like contraception and abortion.

Finally, the universality principle becomes totally inoperative when the availability of abortion services in hospitals varies between 0% and 35% depending on the location.

Therefore, asking the Standing Committee on Health to report to Parliament on whether or not abortions are medically necessary goes against the five principles set out in the Canada Health Act and against the decision by the Supreme Court of Canada, and would put the committee in the unfortunate position of interfering in a provincial jurisdiction.

As to the second part of the motion, concerning the “health risks for women undergoing abortions compared to women carrying their babies to full term”, this is a more insidious and biased part. For many if not most women, the decision to have an abortion is a difficult one and, for all, a painful experience. A majority of the studies as well as the official records of an international symposium on the subject show that an unwanted pregnancy is a crisis most often resolved through an induced abortion.

Following an induced abortion, most women feel relieved. Only a minority are emotionally or psychologically scarred; in fact, performed in appropriate conditions, induced abortions have fewer negative emotional effects than the birth of an unwanted child. As for guilt feelings, they basically depend on social context.

It is also incorrect to claim that abortion has serious consequences for the woman's physical health. Studies on thousands of women clearly show that the rate of complication in abortions is minimal. For early abortions, the risk is below 1% and clearly lower than the risk inherent in childbirth, which is the only alternative. There is no proof that there is an increase in sterility, or higher risks in later pregnancies, or a higher risk of breast cancer among women who have had an abortion.

Neither have there been more psychological problems found in women who have had abortions. The post-abortion syndrome is an invention of the anti-abortion camp. Women who are forced to give birth against their will—and their unwanted children—suffer more often from psychological or psychosomatic problems than women who have had abortions or who have children who were wanted.

The consequence of harsh laws is that abortions are carried out by unqualified people, that women suffer complications, that they are afraid to seek treatment, and that, often, too much time elapses before they find a way to get an abortion, especially for women without financial means, and that causes other problems.

When abortions are performed illegally and not by professionals, women are risking their lives and their health. In Canada, following the Canadian Abortion Rights Action League's hospital access report for women seeking abortions, it has been noted that only 17.8% of all Canadian hospitals perform abortions. In some provinces, hospital access to abortion simply does not exist. Many hospitals also make it difficult for women to access abortion, the hospital staff is unable to provide women with proper information, and the doctors and nurses prevent women from having access to these services.

In closing, I want to say that health care reforms and budget cuts directly threaten abortion services, and this is putting women's lives at risk. Such limitations on or the refusal to provide abortion services not only signify that the legal right to abortion is losing all meaning, but women are being denied total reproductive freedom.

I would like to say, in conclusion, that women are not defined only by their ability to reproduce and their status as mothers. The right to an abortion must be seen as an important factor in the emancipation—

Health
Private Members' Business

11:40 a.m.

The Acting Speaker (Mr. Bélair)

I am sorry to interrupt the hon. member for Terrebonne—Blainville, but her time is up.

The hon. member for Vancouver East.

Health
Private Members' Business

11:40 a.m.

NDP

Libby Davies Vancouver East, BC

Mr. Speaker, is it not ironic that all of a sudden the Canadian Alliance is interested in women's health? Is it not curious and interesting that all of a sudden it is concerned about upholding the Canada Health Act?

If we look back over the record in public debates that have taken place, the Alliance is the party that has consistently ignored issues and spoken out against equality, poverty concerns, charter rights and the status of women, in Canada, as well as globally. It has the worst record of any political party in Canada, and certainly in this House, of supporting women's rights, and now it is claiming that this is about supporting women's health.

I hope that a majority of members stand up in the House, particularly the women, and say that they see clearly what this is about. It is a thinly veiled attempt to use the hook, to use the smokescreen, of a health issue to drag us back into a debate that will undermine a woman's right to control her own body and health. That is what this motion is about and that is where it is leading us.

I am proud to say that the New Democratic Party is very clear on this issue. At our convention in September 2000 we updated our policies concerning reproductive rights and technologies. The NDP fully supports women's rights to control their own bodies and opposes the recriminalization of abortion. New Democrats are committed to protecting the interests of women in the development of new reproductive genetic technologies. We support a comprehensive reproductive health policy which would include a commitment to a woman's right to self-determination in every sense, including her right to decide whether or not to bear children.

We believe that a comprehensive reproductive health policy must include assurances that Canadians have equitable access to safe, effective, and publicly funded reproductive health services for women and their families. We believe that there should be a focus on family planning with adequate funding for educational programs and research into safe and effective contraception so that fewer women are faced with the painful decision arising from an unwanted pregnancy. We believe strongly that the establishment of non-profit women's community health clinics which provide a wide range of counselling and medical services, including abortion and accessibility to the full range of reproductive health services throughout Canada, must be implemented.

I was looking over some material for this debate today and one thing that struck me was how marginalized and alone the Canadian Alliance was on this issue. For example, a poll from November 2002 published in the National Post stated:

Support for a woman's right to an abortion has reached an all-time high in Canada, according to a National Post/Global National poll that found almost four of five Canadians, or 78%, believe women should have a completely free choice in the matter.

That was the Canadian public speaking and it certainly did not support the position that taken by the Alliance.

In 1988 the Supreme Court of Canada struck down Canada's abortion law, section 251, ruling that it was unconstitutional. The justices found that the law violated Canada's Charter of Rights and Freedoms because it infringed on a woman's right to life, liberty and security of person. That decision came 20 years after Dr. Morgentaler first performed an abortion in Canada.

I know Dr. Morgentaler is vilified by members across the way, but he has been a person who has shown his commitment to women's health and women's rights consistently, experiencing personal abuse and imprisonment. He has sacrificed much to bring this forward and I think he is a real hero to a lot of women.

It was in November 1989 that the government introduced Bill C-43, a Criminal Code amendment, which would have prohibited an abortion unless a physician found the pregnancy a threat to the woman's physical, mental or psychological health. Fortunately, it was defeated by the Senate. It actually passed in the House by a narrow vote, but was defeated in the Senate. Abortion is now treated like any other medical procedure governed by provincial and medical regulations, as it should be.

There are issues about services being accessible and available to women. In fact, there was a recent 75 page report from the Canadian Abortion Rights Action League, CARAL, which documented some of the issues and concerns regarding accessible services for women. It stated:

Despite being legal and covered under the Canada Health Act, abortion has been marginalized in Canada because of persistent attempts by anti-choice groups to politicize the procedure. Women have become victims of the bureaucratic “do-nothing” approach of medical associations and governments when they are discriminated against by “gate keepers” at hospitals who deny them medical services, anti-choice doctors who refuse to refer and politicians who place restrictions on access.

The member for Yorkton—Melville said earlier that his was a simple motion. It was about doing no harm and preserving the integrity of the Canada Health Act. I fundamentally disagree with what his motion is about in terms of where it would lead us. While there are issues clearly relating to the services that are needed for women, it is a very far stretch to have it come from this party in terms of its credibility in defending women's rights and women's health in this country.

I hope that all members will vote against this motion and focus instead on protecting women's health and women's rights. We should be focusing on issues to ensure that this medical procedure is available to all women in Canada should they need it and that they have the proper support and counselling. We should be focusing on issues of equality and dealing with poverty. That is what we should be doing. Approval of this motion will take us in a direction that is supported by the Campaign Life Coalition. It is clearly saying that the motion is the first parliamentary pro-life vote in 12 years. This is how it sees it. I say we should reject that.

We should see this motion for what it is in terms of where it is leading us. I am proud of the fact that our party and the member for Winnipeg North Centre, who is our women's equality critic, have done a lot of work in committee in terms of reproductive technologies in trying to protect women's rights and women's health. That is where the work has been done by our member and other members who are truly, genuinely interested in women's health and the protection of women's rights. That is where we should focus our attention, not on this Canadian Alliance motion that will drag us back into the dark ages and will create the kind of debate that is now long gone in this country.

As we see from the polls, Canadians have spoken out and said that they support a woman's right to choose. That is something that all members should support in the House.

Health
Private Members' Business

11:50 a.m.

Progressive Conservative

Norman E. Doyle St. John's East, NL

Mr. Speaker, I would like to say a few words on Motion No. 83. It calls upon the Standing Committee on Health to study and report to Parliament on the medical necessity of abortion for purposes of maintaining the health of a woman and preventing injury or disease as well as to study the medical risk of women undergoing abortions compared to women carrying a child to full term.

I want to congratulate the hon. member on raising this issue. It is a very important motion and one to which we should give very serious consideration. I support the motion because any serious debate on this issue is better than no debate at all.

Before 1969, as we are all very much aware, abortion was illegal in Canada. In 1969 the federal law changed to give legal status to abortions that were approved by a hospital's therapeutic abortion committee. Now if the committee decided that an abortion was necessary for the health of the mother, then the procedure was legal. Health was not specifically defined in law. As a result of that, committees had wide latitude in approving abortions.

However in 1998 the Supreme Court ruled that under the Charter of Rights and Freedoms laws regarding abortion were a violation of a pregnant woman's rights. What we essentially have today is abortion on demand, subject only to the usual restraints of hospital budgets and so on, or the availability of a local abortion clinic to carry out the procedure.

We all have different reasons in this place for supporting or rejecting this motion. It is no secret that I oppose abortion on moral grounds. I believe that life begins and is sacred from conception. However abortion is much more than a health issue. It is a moral issue as well but we are not being asked today to rule on the morality of the issue. We are being asked to look at forming a committee to report to Parliament on the medical necessary of abortion for the purposes of maintaining the health of a woman and to further look at the medical risks to women of undergoing abortions compared to carrying a child to full term.

As I mentioned, in 1998 the Supreme Court ruled, under the Charter of Rights and Freedoms, that laws regarding abortion were a violation of the pregnant woman's rights, and what we have today is abortion on demand.

I am under no illusions, as I am sure no one in the House is, that this debate today will result in restraint or prohibition being placed on the practice of abortion in our country. However those of us who believe that something should be done would support having the committee look at assessing the risk and asking that committee to report back to Parliament on the risk involved to the woman. The request of the hon. member is very reasonable.

Abortion was made a health issue by the federal government a number of years ago so that abortions could be regularized under the supervision of the medical profession. It was the Liberal large l , small l thing to do at that time. However once the new charter gave individuals more and more freedoms and more and more rights, it was only a matter of time before abortion became merely a matter of choice. It was no longer necessary to maintain a fiction of medical necessity around this whole procedure.

As members will remember, the former PC government tried to pass a bill back in 1989 that again would have put the medical profession back into the abortion approval process but it was defeated in the Senate. Had it passed, I fear the law may have very well been struck down by the courts anyway.

Surely the risk to a mother and to the unborn child must have some rights under law and under the Constitution of our country. The fact that the unborn seem to have no rights is at the core of the problem, but it is not really what the hon. member is asking when he requests that a committee look at the medical necessity of it.

I would certainly be in favour of striking a committee to look at the medical necessity of the whole procedure and allowing that committee to assess the risk. It is a very reasonable request by the hon. member.

Some faint-hearted people do not even want to assess the risk to the mother. We have to ask why. The whole issue of abortion has caused great division among people. Since 1968, when Pierre Elliott Trudeau introduced the abortion reform bill, abortion rights people and pro-life people have worked very hard to advance their causes.

I would imagine that people who would vote against this motion would be afraid that the rights of the individual to have an abortion would somehow go into reverse. Some would say as well that we are a more secular nation today and as a result should have greater freedoms. Others would say that because we have greater freedoms we are headed down a path that embraces the culture of death and that we are embracing the freedoms but we are failing somehow to exercise the responsibility. They feel that voting for the motion would somehow cause them to lose ground on the abortion issue generally.

The health minister claims that abortion is medically necessary. However what we should remember is that Health Canada has no studies to justify that kind of claim. If abortion is not medically necessary, I guess we would have to ask why taxpayer dollars are used to fund it.

Informal and professional provincial pollings in Alberta, Saskatchewan, Ontario and New Brunswick have shown majority support for de-funding at least some abortion procedures. Not that the comparison is valid anyway but childbirth is safer than abortion. I think any medical individual would have to agree with that, especially when we consider the growing body of research on the physical and psychological effects of abortion on many women, for example, infertility, breast cancer, a greater risk of suicide, higher rates of substance abuse, depression, social dysfunction and so on.

Calling upon the Standing Committee on Health to fully examine, study and report to Parliament on whether abortions are medically necessary for the purpose of maintaining health seems to me to be a very reasonable request by the hon. member, and I support him in that.

Health
Private Members' Business

Noon

Canadian Alliance

Jason Kenney Calgary Southeast, AB

Mr. Speaker, I am pleased to join in debate on this important proclamation brought forward by my colleague from Yorkton--Melville.

I would like to read into the record once more the motion since some of the debate has strayed quite radically from the wording and intent of the motion. Motion No. 83 states:

That the Standing Committee on Health fully examine, study and report to Parliament on: (a) whether or not abortion;s are medically necessary for the purpose of maintaining health, preventing disease or diagnosing or treating an injury, illness or disability; and (b) the health risks for women undergoing abortions compared to women carrying their babies to full term.

It is very evident to all of us that this is a motion concerned with women's health and concerned with the prudent use of scarce medicare funds to ensure that they are being directed toward medically necessary and not those that are medically unnecessary.

I would like at the outset to point to an experience I had as a member of the Standing Committee on Finance of the House last year when a witness appeared before us, Marilyn Wilson, the executive director of the Canadian Abortion Rights Action League, the principal advocate of the abortion licence in Canada. In her presentation to the finance committee she stated that “the vast majority of abortions performed in Canada are done for socioeconomic reasons”.

I found it very instructive that the principal advocate of the abortion licence in Canada felt that the vast majority of the procedures performed were not related to a health indication and certainly she did not argue they were medically necessary for reasons of prevention of disease, or maintaining health, or diagnosing or treating an injury, illness or disability, but rather for social and economic reasons.

Of course I was not particularly surprised because, as we have heard from other members in the debate today, those who advocate the absence of any kind of regulation of the procedure in law believe that it is an elective matter. It is not a health matter, so much as an elective procedure sought for social and economic reasons.

That is why there is interesting and useful grounds for health committee hearings on this question. Perhaps the health committee could invite before it Marilyn Wilson to expand on the Abortion Rights Action League's view that this is a social and economic and not a health care procedure. Perhaps the health committee could invite Dr. Henry Morgentaler before the committee, who in an article in the 1970s indicated that fewer than 1% of abortions were done for reasons of grave health. Perhaps the committee could invite the former minister of health of the province of Alberta, Shirley McClellan, who once said that pregnancy was not disease. Perhaps the committee could invite as testimony the people from the Government of Saskatchewan, which in 1991 held a referendum on this question where 64% of the electors and a majority in every single electoral district voted to de-insure medically unnecessary procedures in this regard.

Therefore I think there is very deep and wide evidence which could be heard by the committee to determine whether the medicare dollars directed toward financing what appears to be a medically unnecessary procedure could instead be directed toward life-saving procedures perhaps procuring MRIs, hiring more nurses, increasing acute care beds.

At a time when we are looking at very scarce and shrinking dollars for medical procedures, this is a thoughtful motion which deserves the support of all thoughtful members.

Health
Private Members' Business

12:05 p.m.

The Acting Speaker (Mr. Bélair)

The time provided for the consideration of private members' business has now expired and the order is dropped to the bottom of the order of precedence on the Order Paper.

The House proceeded to the consideration of Bill C-28, an act to implement certain provisions of the budget tabled in Parliament on February 18, 2003, as reported (with amendment) from the committee.

Budget Implementation Act, 2003
Government Orders

12:05 p.m.

The Acting Speaker (Mr. Bélair)

First, I would like to read a ruling on Bill C-28, an act to implement certain provisions of the budget tabled in Parliament on February 18, 2003.

There are 19 motions in amendment standing on the Notice Paper for the report stage of Bill C-28.

The Chair will not select Motions Nos. 1 to 3 and 5 to 7 because they could have been moved in committee.

The Chair will not select Motions Nos. 4, 8, 12 and 16 because they were defeated in committee.

All remaining motions have been examined and the Chair is satisfied that they meet the guidelines expressed in the note of Standing Order 76.1(5) regarding the selection of motions in amendments at the report stage.

Motions Nos. 13 to 15 and 17 to 19 will be grouped for debate and voted upon according to the voting pattern available at the table.

I will now put Motions Nos. 13 to 15 and 17 to 19 to the House.