House of Commons Hansard #17 of the 39th Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was quebec.

Topics

The House resumed from May 2 consideration of the motion that Bill C-5, An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts be read the second time and referred to a committee.

Public Health Agency of Canada Act
Government Orders

10 a.m.

Bloc

Claude DeBellefeuille Beauharnois—Salaberry, QC

Mr. Speaker, I am pleased to participate in today's debate on Bill C-5, An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts.

I have some serious concerns about Bill C-5.

I was a social worker in Quebec's health and social services network. For the past three years, I worked in a nursing home and long-term care facility for the elderly. Such facilities have a high risk of influenza and other viral epidemics. I found that the regional public health authority acted competently and expertly to prevent and respond to epidemics. I am convinced that Quebec's response strategy is effective and rigorous, and that it meets the needs of Quebeckers.

Given that the Government of Quebec has the expertise and works with all parts of the Quebec health network, the Bloc Québécois believes that the provincial government should establish its own priorities and create its own action plan according to world-wide objectives developed by organizations like the WHO.

I do not share the opinion of a certain colleague from another part that Canada cannot have 13 different strategies and action plans. I believe that every province can create its own plan that corresponds to the particular activities and characteristics of its territory, particularly regarding prevention strategies for problems such as obesity, diabetes and injuries.

I do not believe that creating or changing the status of the current agency to coordinate the action of the provinces is necessary. I am not saying it is not necessary to coordinate what the provinces are doing in matters of public health. As the Parliamentary Secretary to the Minister of Health said, viruses do not have boundaries.

It is important to protect the health of our citizens. However, I wonder about the means proposed and described in Bill C-5. In this bill, we see that the agency will have its own portfolio and that the main administrator will be accountable to the Minister of Health while still remaining impartial and non-partisan.

The detachment of the Public Health Agency of Canada from Health Canada worries me. I fear that significant amounts of money will be allocated to that agency rather than be transferred to Quebec and the provinces, which have jurisdiction over this.

Quebec has to be able to fund its priorities in prevention and health promotion. These priorities may not be the same elsewhere, in all the other provinces.

Having worked in Quebec's health and social services network, I have seen that the application of “wall to wall” programs does not always help in achieving objectives. This centralist formula being imposed on us is far from being unanimously accepted in Quebec.

The Premier of Quebec, Jean Charest, said in January 2004, on the matter of the possible implementation of the Public Health Agency of Canada that:

Quebec ... has created its own structures in these two areas and they work. They will work with those that will be created, but duplication is out of the question—

That is precisely what the government is proposing to us today: duplication of services to the public because, once again, it is interfering in one of Quebec's jurisdictions.

The federal government keeps bringing in more structures in the area of health. After the National Forum on Health in the 1990s and the Health Council of Canada, now they are adding the Public Health Agency of Canada.

The Bloc Québécois, together with the Quebec government, objects to the federal government's desire to interfere with health care in Quebec. How the Quebec government organizes and provides care and establishes priorities for health care and social services is strictly its business.

This does not rule out cooperation and coordination among the provinces.

Consider the contradictions of this Conservative government, which says one thing then proposes to do the opposite.

In a speech on May 1, the Parliamentary Secretary to the Minister of Health, citing the Speech from the Throne, said, “The government is committed to building a better federation in which governments come together to help Canadians realize their potential”. However, barely two weeks ago, his boss, the Prime Minister and only official spokesperson for the government, stated that the only federalism he would engage in would be open federalism, federalism that respects the areas of provincial jurisdiction and in which the federal government's spending power is monitored.

Thus, in order to make this Conservative concept of open, cooperative federalism a reality, we are presented with a Liberal bill, a bill that comes directly from a government that Canadians removed from power during the last election. This Liberal bill allows Ottawa to interfere once again in an area of jurisdiction that belongs to Quebec and the provinces, this time under the guise of public health.

To justify this interference, reference is made to the SARS crisis that hit the Toronto area in 2003. In his remarks to this House, the Parliamentary Secretary to the Minister of Health said that the SARS crisis “launched an important discussion and debate about the state of public health in Canada”. That is true, he is absolutely right. However, he forgot to mention that, at the time, all stakeholders in Quebec agreed that, had this crisis hit Quebec instead of Ontario, it would never have developed to the extent it did in Toronto. Why? Because Quebec's public health services already had an action plan in place for use in the event of such an emergency in that jurisdiction. Not only did Quebec have an action plan, but the human resources required had also been defined. That is why.

As an aside, I noted in my research that Ontario has just received, in March 2006, a report recommending that it set up its own public health agency, something similar to Quebec's Institut national de la santé publique.

In a nutshell, it is because Quebec has put in place what is needed to face this kind of situation and because Quebec minds its own business, which we would very much like the federal government to do.

By espousing this Liberal legislation, the Conservative government is espousing at the same time the Liberal vision of Canada: Ottawa knows best and will impose its will from sea to sea.

How will a new agency or specific entity, call it what you want, with offices across the country help us deal with any potential flu epidemic? What will it change in real, concrete terms? I would like to know.

We have no problem with the federal Department of Health instituting prevention and emergency response measures in its areas of responsibility, such as screening at the border. Not at all, that is its job. But to have the federal government establish an agency and spend public money on a new structure duplicating one that already exists and is working well, that is a problem.

The government repeated over and over during oral question period that it is committed to the interests of taxpayers. This is a fine opportunity to show concern for them by using their money efficiently and effectively.

Can someone explain to me what exactly the staff of the new agency will do in the offices in Quebec that employees of the health department cannot do here in Ottawa?

I would like an answer to that question.

How will information on new public health threats be any better coordinated with the creation of the public health agency than it is now with the health department, whose job it is to coordinate this information? I would also like an answer to that question.

The Conservative government plans to set up a new entity, separate it from the health department, give it substantial funding and personnel and set up an office in Quebec and the other provinces, all in order “to identify and reduce public health risk factors”, as the preamble states.

I cannot stress enough that the fiscal imbalance is the cause of the biggest public health risk factor in Quebec: overcrowded emergency rooms. The proliferation of resistant nosocomial bacteria such as C. difficile in some hospitals is one of the biggest threats to public health in Quebec.

To address these problems, the Government of Quebec does not need a new federal agency in Quebec, it needs money. The problem is that the provinces and Quebec have the health and social services needs, but Ottawa has the money. The government should stop creating new structures. Quebec and the provinces are cooperating already. Quebec coordinates with the other provinces on public health. I do not think that creating a new agency will make things any better.

We have the federal government to thank for Quebec's underfunded health services. By its actions, the current federal government is doing everything it can to take up where the previous government left off. Emergency rooms will not become less crowded overnight. In my opinion, in addition to recycling a Liberal bill, the Conservative government is clearly also recycling the arrogance of the previous government, which tried only to penetrate further into areas of Quebec and provincial jurisdiction.

I would like to clarify another point. The preamble to Bill C-5 states that “the Government of Canada wishes to promote cooperation and consultation in the field of public health with provincial and territorial governments”. In his speech yesterday, the Parliamentary Secretary to the Minister of Health added that his government plans to strengthen its collaboration with municipal governments. While he was on the topic, why did he not tell us right away that the next step—under the guise of cooperation and consultation— would be direct interference in the administration of health facilities? Let us not forget that history repeats itself.

Let us talk about health services for aboriginals, which fall under federal jurisdiction. Services provided to first nations communities cannot be considered adequate, to say the least. This government should tread carefully; look where meddling in other people's affairs got the previous government.

The Bloc Québécois is committed to supporting the other parties in this House on issues that are in Quebec's interest. The government again plans to duplicate services and create a new structure whose only purpose in Quebec would be to spend public moneys for no good reason. We cannot support that.

That reminds me of the two anti-tobacco campaigns aired recently in Quebec.

In Quebec a campaign was launched to help people wanting to quit smoking by giving them the tools and a service to help them in this endeavour. While this was going on, the federal government flooded the Quebec media with ads giving a different message with a different telephone number and different contact information on the same issue. What wonderful collaboration and use of public funds.

In closing, I want to make one last point on the issue of direct communication with the public. In Bill C-5 respecting the establishment of the Public Health Agency of Canada, it stipulates that the chief public health officer “may communicate with the public, voluntary organizations in the public health field or the private sector for the purpose of providing information, or seeking their views, about public health issues”.

It is quite clear that with its independent administration and its offices spread out here and there, this agency will end up justifying its presence by regularly implementing communication plans for all Canadians, including those in Quebec. It seems clear to me that this type of duplication is counter-productive. It is not what citizens and taxpayers want. In any case, it is not the wish of the people of Beauharnois—Salaberry, whom I represent in this House.

I would like to draw your attention to a more specific aspect. I read and listened to various speeches by colleagues in this House. There was a great deal of discussion about health prevention in terms of epidemics and pandemics. However, I noticed that there was less discussion about health promotion. An expert in this area knows that it is important for local communities to identify their problems and to find solutions that will work in their areas.

Take obesity, for example. In my area, we decided to fight child obesity by approaching cafeterias in secondary schools, convincing them to offer more nutritious foods, and thus help youth develop better eating habits. We did not talk to youth about diet or try to make them feel guilty. In terms of promotion, we know that individuals are not always solely responsible for their health given that their environment and everything around them also have an impact.

In Quebec, we have made choices. There are campaigns to prevent obesity, to reduce the number of low birth weight babies, and others. We have our own way of communicating with our communities and, what is important, we have a decentralized approach. Each community can promote and work on improving the health of Quebeckers. This is done at the local level. Naturally, everyone does not just do what they want, leading to chaos. We are bound and guided by broad directives issued by the Institut national de santé publique du Québec. It provides instructions and directives to each of the 16 regional branches in Quebec.

This is my first speech in the House and I would like to conclude by stating that I hope to discuss my concerns with the parliamentary secretary. Above all, I would like to impress on him that we believe that the public health agency, as proposed, is not the best means to protect and promote the health of Quebeckers and Canadians.

Public Health Agency of Canada Act
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10:20 a.m.

Charleswood—St. James—Assiniboia
Manitoba

Conservative

Steven Fletcher Parliamentary Secretary to the Minister of Health

Mr. Speaker, I welcome the member to the House.

The member has made many misstatements and misrepresentations of the truth. We know the Bloc's agenda is to break up Canada but that is not good for the people of Quebec or of Canada. This is turning into a classic example why that is the case.

Pandemics do not respect provincial borders or international borders. However, in her comments the member seems to suggest that pandemics do respect provincial borders. I will let the people of Canada and Quebec make their own assessment on that.

The member said that there was no need for the federal government to play a role and that somehow we were creating more bureaucracy. In fact, Health Canada and the health minister are ensuring that, within the powers and with the resources that exist, we are better streamlining them in order to deal with a crisis. The member seems to neglect that fact.

In public health, the provinces and the federal government have a joint responsibility, although the provinces do have direct responsibility for hospitals and health services.

I will give one of many examples where this member's argument falls apart. Within public health, we have a national microbiology lab in my home city of Winnipeg which is Canada's only level 4 lab. This lab is routinely called upon to support provincial health authorities detecting potential disease outbreaks. The lab has world experts and facilities to test for these kinds of deadly disease outbreaks. No such lab exists in Quebec.

Is the member suggesting that the people of Quebec should somehow go without the services this lab provides? That may be the Bloc's point of view, perhaps, but the Government of Canada's point of view is that the health of Quebeckers is just as important as the health of all Canadians, which is why we invested a billion dollars in pandemic preparedness in this week's budget.

Why does the Bloc Québécois philosophy put the health of Quebeckers in jeopardy, particularly in regard to the level 4 microbiology lab in Winnipeg ? What is Quebec going to do? It needs those services. It is important that Canadians work together to protect each other because Canada is about mutual support.

I ask the member to comment on the microbiology lab and how Quebec would deal with that without the Public Health Agency.

Public Health Agency of Canada Act
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10:25 a.m.

Bloc

Claude DeBellefeuille Beauharnois—Salaberry, QC

Mr. Speaker, I thank the parliamentary secretary for his question. I do believe that my remarks were misunderstood. I said all along that were not against collaboration and cooperation. On the contrary, we think it is important to work together in a joint effort. We do not want structural duplication, increased bureaucracy, wasteful spending and overlapping.

Even though we want to become a country, we know that we do not live in isolation. We live in an era of globalization. I think Quebec has the ability and expertise to manage its own action plan, as do the other provinces. That does not exclude what is currently in place.

Let us take the avian flu, for example. The WHO has given directives to all the countries of the world to prepare for an eventual avian flu pandemic. The WHO gives directives to Canada, which in turn gives directives to the provinces, and each province, including Quebec, puts in place its own action plans at the national , regional and local levels.

We do not want to be isolated and work alone. We want a real partnership, real cooperation that respects our jurisdictions.

Public Health Agency of Canada Act
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10:25 a.m.

Bloc

Luc Malo Verchères—Les Patriotes, QC

Mr. Speaker, first I want to congratulate my colleague from Beauharnois—Salaberry on her excellent maiden speech in this House.

While people in her riding are hard hit by business closures in the manufacturing sector as companies often transfer their operations to emerging countries, would the member for Beauharnois—Salaberry not have preferred to speak today about the implementation of an effective program to help older workers affected by massive layoffs, instead of a bill creating an agency that obviously intrudes into Quebec's jurisdictions?

Public Health Agency of Canada Act
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10:25 a.m.

Bloc

Claude DeBellefeuille Beauharnois—Salaberry, QC

Mr. Speaker, I thank my colleague for this important question.

To begin, I would answer that, just yesterday, I received three distress calls from textile workers in Huntingdon. They were all in tears and some of them were even suicidal. They reminded me of our role and responsibilities as government members. They also reminded me that the Conservative government will not commit to creating, as soon as possible, an income support program for older workers. I am referring to men and women aged 58 or 59. They are often couples who worked in the same factory. They often have low levels of education and are now suffering from mental health problems.

Creating an agency is not going to improve their health and prevent their problems associated with psychological distress.

Public Health Agency of Canada Act
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10:30 a.m.

Saskatoon—Rosetown—Biggar
Saskatchewan

Conservative

Carol Skelton Minister of National Revenue and Minister of Western Economic Diversification

Mr. Speaker, my colleague talked about the whole issue of the new public health act and what she feels is the most important part of the act for her riding. Is there anything else she could add to this important new bill?

Public Health Agency of Canada Act
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10:30 a.m.

Bloc

Claude DeBellefeuille Beauharnois—Salaberry, QC

Mr. Speaker, I thank the member for her question.

When members speak for the first time in the House on a particular subject, especially newly elected members, they take the time to read on that subject and to consult their constituents. As a matter of fact, yesterday, I consulted a senior executive in a rather important health care institution located in the most densely populated part of the Montérégie region, in my riding. This public health specialist told me that, after reading this bill, she saw nothing in it that would improve the health of Quebeckers or Canadians. We are already doing what this bill proposes to do. I do not see how this new agency will put forward new solutions. It will just confuse people who will be the target of different health promotion campaigns on the same issues.

There is often a tendency to want to put in place Canada-wide promotion programs. We live in a vast country and each community has its own characteristics. Even in Quebec, response strategies in public health are not the same in the Gaspé Peninsula as in the Montérégie region. We constantly need to adapt our strategies.

In my opinion, the existing agency within Health Canada is acceptable and seems to work well. I do not see why there should be any other agency.

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10:30 a.m.

NDP

Jean Crowder Nanaimo—Cowichan, BC

Mr. Speaker, I am pleased to rise in the House today to speak to Bill C-5. As many of us in the House are aware, the Public Health Agency has been in operation for some time, and this is the enabling legislation.

In the context of dealing with the Public Health Agency of Canada, I went to the Public Health Agency's website and reviewed some information that is important for the context of the debate in the House.

The mission for the Public Health Agency is to promote and protect the health of Canadians through leadership, partnership, innovation and action in public health. As many members have noted, the Public Health Agency is responsible for a number of different aspects of public health. In part, it is mandated to respond to public health emergencies and infectious disease outbreaks. Specifically, there are a number of branches that have been set up to deal with this issue. I will address two of those branches in my speech today.

One is the branch for infectious diseases and emergency preparedness. I have a quote from the website. It states:

The Branch enables the prevention and control of infectious diseases and improvement in the health of those infected. Staff prepare for and are ready to respond to public health emergencies, 365 days a year. Examples of specific challenges are HIV/AIDS, pandemic influenza preparedness, health-care acquired infections such as C-difficile...

I will speak specifically about infectious diseases.

The other is the branch for health promotion and chronic disease prevention. Again, on its website, it states:

The Branch works with stakeholders at all levels to: provide national and international leadership in health promotion, chronic disease prevention and control; coordinate the surveillance of chronic diseases and their risk factors and early disease detection; create and evaluate/measure programs addressing common risk factors and specialized issues focussing on special populations (seniors, children)...

In the context of several things that have happened in Canada over the past years, it is important to talk specifically about pandemics.

I want to hearken back to SARS and what happened in Toronto and how that terrible event impacted so heavily on so many people, the workers, businesses, and the tragedy for families who lost loved ones. As a result of that, an inquiry was commissioned and it resulted in something that we all refer to as the Naylor report. I want to go back to the conclusions of the Naylor report and the specific recommendations that were made.

The summary of the Naylor report talks about the fact that SARS killed 44 Canadians, caused illness to hundreds more, paralyzed a major segment of Ontario's health care system for weeks and saw in excess of 25,000 residents of the GTA placed in quarantine. Those impacts still reverberate in that community. The report went on to talk about the fact that the national advisory committee on SARS and public health had found that there was much to learn from the outbreak of SARS in Canada, in large part because too many earlier lessons were ignored. The report states:

A key requirement for dealing successfully with future public health crises is a truly collaborative framework and ethos among different levels of government. The rules and norms for a seamless public health system must be sorted out with a shared commitment to protecting and promoting the health of Canadians.

On and on it goes. Toward the end of the report, it states:

Until now, there have been no federal transfers earmarked for local and P/T public health activities. Public health has instead been competing against personal health services for health dollars in provincial budgets, even as the federal government has increasingly earmarked its health transfers for personal health service priorities.

In that context, one would have hoped that there would have been significant movement. Instead last year, on November 3, 2005, the public health officials came before the health committee to talk about a couple of issues, one I will address shortly when I talk specifically about first nations and public health.

In the context of pandemics let me refer to something that Dr. David Butler-Jones brought forward to the committee. In part it was in response to a question that I asked about the fact that there were challenges in light of communication, capacity and the federal plan specifically had earmarked timeframes around vaccinating all Canadians in four months, in two waves.

The question I had put to Dr. Butler-Jones was whether we had the ability to obtain a domestic supply of a vaccine if one is developed, because it does depend on the strain, and whether we had the physical capacity in communities to vaccinate all Canadians in four months. Keep in mind that we had the SARS crisis that talked about coordination in response. Dr. Butler-Jones in 2005 said, “In terms of capacity, it is very variable in this country. But it is something the public health network and working with my colleagues, the deputies in the provinces and the ministers to ministers, in terms of how we can continue to build that capacity”. He talked about the money that was allocated in the budget. This is not that we were able to do this, but he talked about continuing to work with the provinces and territories in terms of rebuilding the capacity that was lost at the local level over the last decade, as we had been so focused on hospitals and less on the public good of public health.

That was in the fall of 2005. We still have gaps in our capacity to respond to a pandemic in this country. In the context of sending the bill to committee, I urge that this information be addressed.

In the past year we were able to go through a flu season without needing that kind of response in place, but it is a ticking time bomb. We need to have the capacity in this country to address that situation.

I also want to speak about chronic disease and disease prevention specifically in terms of aboriginal communities. There is an aboriginal peoples round table report on the Public Health Agency website which contains a number of recommendations. Regarding operational strategies for a public health agency, it states that an agency should consider:

The need to avoid a melting pot approach to aboriginal issues which might disregard distinctions between aboriginal peoples.

Agency needs to be sensitive to cultural differences in public health, which means that some approaches can seem foreign or counter-cultural.

The importance of engaging aboriginal women as leaders in community public health issues. Aboriginal women should be consulted on the formation of good models of health delivery.

Strategies to address the public health issues of aboriginal peoples who live off reserve.

The report goes on to talk about specific investments that are required:

The need for training nurses and public health professionals to serve northern and remote communities -- particularly Inuit who would like to become nurses;

The need for cross-cultural training for nurses who are often unable to take such training because of the demands of their work;

The need for investments in capacity so that first nations communities are better able to respond to outbreaks of infectious disease; and

The need for support to address public health crises in many communities, including mould in housing and potable drinking water.

There were other public health issues that were specifically raised. Participants also raised concerns about specific public health issues, including that Inuit need help facing particular public health concerns relating to lower life expectancy, mental health, tuberculosis, and the challenges of keeping health care providers, such as nurses, in the communities. They also indicated that first nations communities need help addressing problems such as the prevalence of diabetes among first nations people and the high rate of suicide in communities such as those in northern Ontario.

In talking about suicide, after I was elected for the very first time, my first official duty in my community on July 1, instead of celebrating what a great country this is, was attending the funeral of a first nations youth who had committed suicide a couple of days before. He was 19. This is a crisis in many first nations communities.

In terms of a public health framework for first nations communities, the First Nations Health Bulletin, Winter-Spring 2006 talked about work that the Assembly of First Nations is doing in the context of many communities across Canada. It is raising a number of issues including some of what we call the social determinants of health. We must not just talk about health promotion. We must talk about the social determinants of health. The bulletin refers to high rates of unemployment, lower educational opportunities, poor housing and overcrowding, lack of basic amenities such as running water and indoor toilets. These are but a few of the social issues that contribute to the poor health in first nations communities.

The bulletin stated that it is essential that a community have access to information about itself. We know that knowledge is often power. When we do not have adequate information to talk about the health in communities, then we do not have the tools to help us develop the appropriate public policy to address these issues. That is not available in many circumstances, largely due to the dysfunctional surveillance systems for first nations health.

It goes on to say that the recommendations proposed in the public health framework take into consideration the distinct communities that first nations represent across Canada. This points to the fact that we cannot have a one size fits all approach to public health in first nations and aboriginal communities from coast to coast to coast.

The Assembly of First Nations put out a bulletin on May 3, 2006. I will quote from this because I think the words should come from the people it directly affects. The headline is “Federal Budget Ignores Health Crisis in First Nations Communities” and it states, “Assembly of First Nations National Chief Phil Fontaine said it is alarming to see a complete absence of funding in the federal budget to address urgent health crises faced by first nations communities such as those faced by Garden Hill First Nation in Manitoba and Kashechewan First Nation in Ontario. It is ironic that the first government saw fit to invest in epidemics of tuberculosis, HIV-AIDS in developing countries, while many first nations are living with these diseases and there is no new assistance for them”.

To give a little more context, this is Canada. This is not a developing country where sometimes, sad but true, people come to expect high rates of infant mortality, tuberculosis, HIV-AIDs and diabetes. Let us talk about the reality in first nations communities.

In 2000 the life expectancy at birth for first nations populations was estimated at 68.9 years for men and 76.6 years for women. That represents a gap of 7.4 years and 5.2 years respectively with Canadian populations. The gap in the potential years of life lost between first nations and Canadians was estimated in 1999 to be three times greater on injuries, almost double on endocrine diseases, such as diabetes, and more than double for mental illness. In 1999 the first nations suicide rate was 27.9 deaths per 100,000. The Canadian suicide rate was 13.2 deaths per 100,000. There is a litany of these pieces of information. It is shameful that we need to talk about them today in the context of a country as wealthy as Canada.

I will briefly touch on pandemics as I know I will run out of time and I still want to speak about tuberculosis and diabetes. Pandemic readiness in first nations communities is not where it needs to be. In a paper by Dr. Gideon for the Assembly of First Nations, she specifically talks about the fact that there are gaps in the training plans, that many first nations communities have had the opportunity to develop these plans, but have had no ability to test the plans, that there is still inadequate training around drinking water and sewage plant management, and that there are still no formal discussions or written protocols between Health Canada and the provinces and territories where much of that action will need to happen.

I need to turn my attention in the time I have remaining to the crises around tuberculosis and diabetes within first nations communities in this country. I want to talk about Garden Hill specifically. In 2001 the incidence of tuberculosis disease in first nations communities was on average 10 times higher than that of the Canadian population as a whole.

Between 1975 and 2002 there was a significant decline in the number of cases and incidence of TB among first nations. The most positive impact was achieved by 1992. This is despite the first nations insured health benefits branch tuberculosis elimination strategy implemented in 1992 with the goal of reducing incidence of TB disease in the first nations on reserve population to one per 100,000 by the year 2010. Over the last 10 years there has been limited improvement in further reducing the incidence of TB among first nations, especially in western provinces.

This is in the context of the first nations community, the Garden Hill Reserve, with 3,500 where only 4% have access to running water. There are 20 cases that have been reported in the area. The first case went undiagnosed for eight months. There was a critical need to move on clean drinking water, on sewage, on adequate health care resources in the community.

The community is calling for community-wide testing. We must act. This is Canada. People should not be facing the spread of tuberculosis in their communities in this day and age.

I want to turn now to diabetes. Friday, May 5 marks National Aboriginal Diabetes Awareness Day. Diabetes walks are being held in my own community to attempt to shine the light of attention on this crisis.

I am going to quote from a press release by Chief Phil Fontaine who said, “Diabetes has become a disabling and deadly disease for many Canadians but first nations continue to suffer with a level that is three to five times higher. In order to better come to grips with understanding and treating this epidemic, the Assembly of First Nations is in the process of completing a three part first nations diabetes report card based on the Canadian Diabetes Association model. The report card will assess the current state of diabetes supports available to first nations people focusing on six areas: prevention; treatment; education; policy development; research; and surveillance. The first part of the report card will be released next month.”

The great tragedy of diabetes is that it can be easily prevented or regulated through diet and exercise, but when people live in poverty, making healthy choices is not an option when there is no access to affordable foods and safe drinking water.The press release goes on to talk about how in some communities entire families, from toddlers to grandparents, have diabetes.

This year the first nations regional health survey revealed that the average age of diagnosis among youth is 11 years, but there are also many adults who go undiagnosed and untreated until they suffer serious complications, such as blindness or loss of limb. The risk of developing type 2 diabetes can be reduced through healthy nutrition, healthy weight and regular physical activity. There are success stories in some first nations communities but there are also many tragedies.

The release goes on to say, “The great tragedy of diabetes is that it can be easily prevented or regulated through diet and exercise, but when you live in poverty, making healthy choices is not an option when there is no access to affordable foods and safe drinking water”.

There is a litany of information. For many decades first nations communities across this country have continued to plea with governments to ensure that the social determinants of health that are impacting on the health and well-being of aboriginal communities is addressed.

We have developed drinking water strategies and housing strategies and yet we still do not see a significant improvement in many aboriginal communities. What is the loss to this country in terms of people's ability to participate fully in their community life? What is the loss to the economic well-being of the community? What is the loss to the cultural vibrancy of the community when many elders and young people are contracting a disease that is entirely preventable?

Diabetes can be addressed through a comprehensive program that ensures there are adequate health resources in the community and adequate educational resources. These tools must be developed in conjunction with aboriginal communities to make sure they are culturally relevant and appropriate to the first nations community, because it is a diverse community from coast to coast to coast. These things must be put in place to address this crisis.

We saw events unfold in Kashechewan last year when the community was faced with a drinking water crisis. We are seeing an emerging situation in Garden Hill with a tuberculosis outbreak. I believe there are currently 79 boil water advisories in place in first nations communities.

This bill provides us with an opportunity to highlight some of these very serious issues facing first nations, Inuit and Métis communities, both on and off reserve. I would urge the committee to examine these issues in a very serious way and put forward some meaningful proposals developed in conjunction with aboriginal communities and their leadership.

It is critical that we make sure that access is available for all. We consider ourselves an equality country so let us make sure equality is in place. The time for action is now.

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10:55 a.m.

Liberal

Robert Thibault West Nova, NS

Mr. Speaker, I had the honour and privilege of serving with the member in the last Parliament on the health committee and I know of her resolve on these issues. While we may not always have agreed 100% on the way to solve the problems, we always participated very well, worked very well and shared the principles.

I am pleased that she has made a reference to TB, because I think it is one the areas of public health that we have to pay a lot of attention to. My father was a victim of TB. He lost a lung to TB, which probably contributed to his death at 49 years of age. There was an outbreak of TB in my community almost 40 years ago in which hundreds of people were hospitalized. High school children and children in intermediate school were hospitalized. They lost a lot of very important years at a very important time. I know people who spent seven, eight and ten years in sanatoriums because of tuberculosis.

There is currently a fear of an outbreak in my community. At the Yarmouth Regional Hospital, approximately 750 people had to be tested for tuberculosis. I know what anxiety and fear this puts into our community. I can only imagine what anxiety levels and fears there must be in native communities throughout this country where they have to live with this fear every day.

We know that with TB, fetal alcohol syndrome, juvenile diabetes, and especially adult onset diabetes, socio-economic factors play a large part in the opportunities for those diseases to manifest themselves and spread within those communities.

We know the disappointment there must be in those communities that the Kelowna accord has been scrapped by the government, with the loss of the opportunity they had for socio-economic improvement of those communities throughout Canada, especially in the northern communities, from one ocean to the two others, where they had reached an agreement with all the provinces to deal with the basis of the problems in those communities. That $5 billion investment, a great first step, has been scrapped.

Could the member tell us her impressions of the socio-economic costs of cancelling the Kelowna accord?

Public Health Agency of Canada Act
Government Orders

10:55 a.m.

NDP

Jean Crowder Nanaimo—Cowichan, BC

Mr. Speaker, I know the member has been committed to addressing the very serious health issues both in his own community and in aboriginal communities across the country.

The Kelowna agreement was an effort to address the poverty gap that exists in first nations, Inuit and Métis communities. There is a disregard of the amount of work done over 18 months, of the amount of consultation and the very real participation of aboriginal communities across this country. To just rip up that agreement after all that work really leads to a sense of dismay.

The social determinants of health, which I spoke about earlier, have a real impact in terms of the incidence of disease in the communities. The agreement may not have been perfect, but it was a good step forward in terms of addressing that poverty gap in this country in first nations, Inuit and Métis communities.

It saddens us in the New Democratic Party, and certainly we have heard from communities across the country that there is a great deal of dismay that we will not be able to move forward as a House to address those poverty gaps around housing, education, violence against women and so many other issues. I would encourage this House to encourage the government to reconsider that.

Public Health Agency of Canada Act
Government Orders

10:55 a.m.

Liberal

The Speaker Peter Milliken

Following question period when the debate resumes on this matter, there will be about five and a half minutes remaining in the time allotted for questions and comments for the hon. member for Nanaimo--Cowichan. I propose now to move on to statements by members.

Public Speaking Awards
Statements By Members

10:55 a.m.

Conservative

Larry Miller Bruce—Grey—Owen Sound, ON

Mr. Speaker, it is a pleasure for me to stand in the House today and speak on behalf of my colleague from Simcoe—Grey about a talented young woman in her riding.

Laura Brayford is in the gallery today as she prepares to compete in the provincial finals for public speaking in our nation's capital. A grade six student at Alliston's Ernest Cumberland Elementary School, Laura is an accomplished public speaker.

From the classroom to the gym and through three levels of Lions Club competitions, she has been captivating audiences with the mythology behind one of the most recognizable childhood folklore characters, the tooth fairy. This should not be confused with the tax fairy; however, I am sure the experience is just as pleasant.

In her speech, Laura follows the natural progression of losing a tooth and what happens through customs in other countries. Judging by her collection of plaques and medals, quite a few people are interested.

On behalf of all the residents in Simcoe-Grey, my colleagues in the House and the Prime Minister of Canada, I want to wish her well in her competition tomorrow.

Asian Heritage Month
Statements By Members

10:55 a.m.

Liberal

Omar Alghabra Mississauga—Erindale, ON

Mr. Speaker, every year since 1993 Canadians have been celebrating the month of May as Asian Heritage Month. In 2001 the Senate passed a motion that confirmed its official recognition. This acknowledges the long and rich history of Asian Canadians and their contributions to Canada and the world.

Canada prides itself on being one of the most culturally diverse countries in the world. This diversity strengthens our country socially, politically and economically in unlimited ways. Asian Heritage Month is an ideal occasion for all Canadians to celebrate the beauty and wisdom of various Asian cultures.

Celebrations will be held in cities across Canada, including my city, the city of Mississauga. I invite all Canadians to take part in the festivities that commemorate the contributions and legacy of Asian Canadians, past and present.

I also call upon my colleagues in the House to join with me in congratulating all the volunteers and organizers who are working hard to ensure a successful celebration and in sending them our gratitude and appreciation.

Celebrating Excellence
Statements By Members

May 5th, 2006 / 11 a.m.

Bloc

Luc Malo Verchères—Les Patriotes, QC

Mr. Speaker, on April 29, three of our finest athletes in Quebec were inducted into the Olympic Hall of Fame.

Everyone will remember Sylvie Fréchette's performances in synchronized swimming. Her determination and grace won her a silver medal in Atlanta and a gold medal in solo in Barcelona, after she overcame tragedy in her personal life.

Also inducted was Pierre Harvey, one of only a few athletes to have competed in both the summer and winter games. With numerous world cup medals in cycling and cross-country skiing between 1975 and 1988 and four Olympic Games to his credit, he is said by many to be Quebec's best athlete.

Maurice Gagné, a respected athlete and trainer who is known as the father of speed skating in Quebec, was inducted into the hall of fame as a builder. Congratulations to these wonderful ambassadors.