The member asked a question concerning the additional $2 million. That is contingent upon there being a surplus in January 2004 and then a decision being made between the finance minister and the Prime Minister as to whether or not we would be in a position to provide those additional dollars.
That was made very plain to the first ministers at the time of the agreement. Obviously we are looking at some nine months down the road. We have done a remarkable job in terms of the economic state of this country, but it is not for me to say eight months away from the date whether or not it is likely to happen. As the Minister of Health I hope that it does happen.
The member also raised the issue of aboriginal health. The total expenditures for 2003-04 in the main estimates are $1,588,000,000. The hon. member is right. It is a substantial part of the federal Department of Health's budget. The Government of Canada is strongly committed to the well-being of aboriginal Canadians and we know that aboriginal Canadians too often suffer from poor health. They are among Canadians who have some of the worst health. This is an issue we all need to take very seriously, the health committee does, and it is an issue that we all need to address.
I am pleased to say that we have received in budget 2003 an additional $1.2 billion over the next number of years to help us in terms of delivering health care to Canada's first nations and Inuit people.
The hon. member asked why a significant number of aboriginal people suffer from bad health, for example, chronic diseases such as diabetes. Adult diabetes is increasing at an alarming rate in our aboriginal communities. Part of it is the predetermination of health. Part of it is in terms of healthy living, good nutrition, physical activity, healthy body weight, and ensuring that kids have good nutrition, start healthy eating and good living habits at an early age. Part of it is education and information. And let us face it, part of it is poverty.
We know that the better off people are, the better their health will be. We must deal with these determinants of health. We must understand that until we deal with the social and economic conditions of poverty, it will be harder for aboriginal peoples to enjoy the same quality of health that other Canadians enjoy.
I want to reiterate the fact that we take our commitment to working with aboriginal peoples in improving their health very seriously. This is not just a health issue. It is also a predetermination of health issue. This means we must work across a broad range of federal departments including our provincial colleagues and local communities themselves.
I will look into the member's specific complaint in relation to the medical device which he outlined. I believe it is classified as a medical device within our department. I will certainly look into that for him. I apologize if he or his constituent have not received a timely response. I will take the matter up right away.
In terms of the provinces mismanaging the health care system, I do not think Mr. Romanow said that the provinces mismanaged the health care system. Mr. Romanow talks more positively, as we all do, about the importance of accountability on the part of all of us, whether it is the federal government, the provincial or territorial governments in ensuring Canadians know how much money is being spent on health care, where it is going, how it is divided between physicians, hospitals, and so on, and what we are getting for it. Are we getting better health outcomes for those dollars?
Mr. Romanow is encouraging all of us to do better in that regard. In fact, some of the provinces have been leaders in areas like the PIRC process and prediction indicators, where we are able to compare apples to apples across provinces and within provinces.
CIHI is a collaborative endeavour where information is provided to residents of provinces so they can make assessments concerning their health care system. The provinces are working very diligently in relation to accountability. Mr. Romanow is suggesting that we build on the good work that is being done to ensure that we are even more transparent and accountable.