House of Commons Hansard #46 of the 40th Parliament, 3rd Session. (The original version is on Parliament's site.) The word of the day was tax.

Topics

Nuclear Liability and Compensation Act
Government Orders

5:10 p.m.

Conservative

David Anderson Cypress Hills—Grasslands, SK

Madam Speaker, I am glad the member has been following the committee, although she was not at it in terms of the discussion.

We need to point out that a number of the NDP amendments were accepted by the committee and they had to do with that. One of them involved reviewing the operator's liability limits.

The government was willing to work with the opposition to try to make the bill work. One of the amendments was that we would be willing to review operator liability limits. Actually there is a five year mandatory clause to do that. In terms of that, the government is certainly willing to take a look at the limit.

Again, as I pointed out, to say that there is unlimited liability in countries really becomes a concept that is meaningless, because at a particular point, insurance companies cannot provide insurance above a certain level. Clearly, insurance companies would provide insurance at any level as long as the premiums were paid, but at some point the premiums become unrealistic.

What we are trying to do, and we have heard a lot of testimony at committee about this, is to balance the interests of Canadians in the event of an incident. What would be the likely scenario if there was an incident? What kind of insurance compensation needs to be there? On the other hand, what is able to be achieved in terms of getting nuclear coverage at these installations?

I think that the limit of $650 million seems to set that middle ground. We had a lot of discussion about this at the committee, but in the end it was generally agreed that this is adequate and is good enough.

Nuclear Liability and Compensation Act
Government Orders

5:15 p.m.

Conservative

Mike Allen Tobique—Mactaquac, NB

Madam Speaker, I want to thank the parliamentary secretary, my colleague on the natural resources committee, for his comments today. There was a lot of discussion at committee, and this will be my fourth time dealing with the bill as a member of that committee.

There was some discussion about the liability amounts. The member is right in that there is an amount the insurance companies will cover. We even had testimony at committee which indicated that if that insurance was set at too high a level, what it could mean for the operators is that there would be a shutdown of the unit, which would lead to a stranded investment, which would lead into the ratepayers' pockets. I am sure that is what the NDP was hoping for anyway.

I would also like to ask the parliamentary secretary to elaborate on some of the amendments that were adopted in committee, because the last time was the first time that we actually adopted amendments. There were some very good amendments and some good discussion on not only the liability amounts, but some other things as well. Would he talk about some of the other major issues and testimony that we heard?

Nuclear Liability and Compensation Act
Government Orders

5:15 p.m.

Conservative

David Anderson Cypress Hills—Grasslands, SK

Madam Speaker, this is important because the bill has come to the committee a number of times and actually passed without amendment a couple of times. The last time we really wanted to try to work with the opposition and there were some amendments made. We had a lot of discussion and the committee seemed to work very collegially through those amendments. I would be glad to go through the half dozen amendments that were made.

Clause 22, for example, was amended to require that the minister review operator liability limits. We touched on this a minute ago. Actually that also requires that the minister take into consideration the nuclear liability limits in other countries, so the concerns that the NDP member addressed a few minutes ago are taken into account with that amendment.

Clause 69, for example, was added to provide that the first review of financial liability limits had to be completed within 15 months of the act coming into force. The government was not interested in sitting on it for years. If something was not going to be working properly, we were ready to review it and to change it. We think that the limits are good the way they are, but we are certainly willing to take a look at that.

Clause 22(3) was added to the bill in order to stipulate that the minister had to consult before he or she could change the financial liability limits, so the minister would have to go to industry and non-industry stakeholders and also, which is interesting, refer the matter back to the parliamentary committee. Once again the committee could come back into the discussion as it has in the past. I think that some of the members of the committee probably know as much about this bill as anybody in the country.

Clause 26 requires that the minister table the reinsurance agreements. There were concerns about the insurance and reinsurance agreements that are going to be in place for a number of different types of facilities. Those will need to be tabled before the House. They will need to be tabled with an assessment study concerning those agreements. Again we are trying to make sure that the insurance is in place, that it is valid, that it is adequate, and that any reinsurance agreements that are made are publicly available, people can see them and the assessments that have been done on them.

Clause 37 was amended regarding the advertisement of the public tribunals. In case of a public incident, there will be tribunals set up in order to make the judgments about compensation and those kinds of things. We simply made it easier for people to know that this is going to be taking place. Newspapers were added as a media outlet. That is a small amendment but one that is important, because people get so much of their information from newspapers.

This government has shown quite a willingness to open up the bill and to allow the opposition members to have their input into it. We look forward to working with them over the next few months as we move the bill to committee and hopefully on to completion.

Nuclear Liability and Compensation Act
Government Orders

May 13th, 2010 / 5:15 p.m.

Liberal

Geoff Regan Halifax West, NS

Madam Speaker, as Yogi Berra once said, “It's déjà vu all over again”. We are back with this bill that the House has seen a few times.

I am a bit surprised in a sense to be speaking to this bill today. Six months ago I was under the impression, at least as far as the House was concerned, and I do not want to speak for the other place of course, that it was a fait accompli. Once the committee had worked out amendments to the bill and agreed to pass it in committee, I thought the chances were very good that it would come back and pass at report stage and third reading and then go off to the Senate.

However, we had something called prorogation as members may recall. For some reason the Prime Minister decided he was not that keen on too much democracy, that the House should not sit for a while and Parliament should be prorogued.

It is becoming clear that while the Conservatives want us to believe this bill is a priority, their actions make a mockery of that kind of assertion. After all this is the third time they have tried to update Canada's Nuclear Liability Act and they do not seem to be in that much of a hurry. The first time was a few years ago with Bill C-5, and we heard how important it was.

Nuclear Liability and Compensation Act
Government Orders

5:15 p.m.

Conservative

David Anderson Cypress Hills—Grasslands, SK

Be nice now.

Nuclear Liability and Compensation Act
Government Orders

5:15 p.m.

Liberal

Geoff Regan Halifax West, NS

My hon. friend is making some comment, but I cannot quite understand it. I guess it was humorous because his colleague from Tobique—Mactaquac enjoyed it. I am glad to see they are enjoying themselves.

We heard how important it was at that time when they brought this bill in as Bill C-5. Those comments were repeated last year with Bill C-20. Now we are dealing with Bill C-15, the latest incarnation of the government's nuclear liability legislation, and the same arguments are being echoed. It is almost as if there are ghosts in here, there are so many echoes. We will see how far it makes it this time.

Canadians will recall that two years ago it was politically convenient to jettison this legislation so Conservatives could break their own fixed date election law and force a vote before they had to admit how badly they had mismanaged the country's finances. As we learned, they had put the country into deficit before the recession even began by their decisions in terms of spending and tax cuts that they could not afford. We had a deficit last year of $54 billion and who knows how much in the current year.

Last December the nuclear industry was quite excited when the bill was introduced, when it passed second reading, when it went to committee where it was approved and then reported back to the House. Industry stakeholders thought that after many years the bill would become law. Of course the Prime Minister panicked over the prospect of having to tell Canadians the truth about Afghan detainees and promptly prorogued Parliament to protect his political assets. Nuclear liability legislation became collateral damage to that decision in the government's ongoing battle to suppress the truth. It is really part of the government's ever-expanding Conservative culture of deceit.

However, now we start again from square one. We heard the parliamentary secretary tell the House how important the legislation was to the government and how significant it was to Canada's nuclear industry. That was quite a performance, deserving of some sort of Prairie Oyster award or something like that.

The bill would provide much needed update to industry standards to ensure stability and protection for Canadians. Hopefully this time the Conservatives can put the needs of the nation ahead of their party interests and actually enact the legislation, not prorogue the House, not break a fixed date election law, or whatever.

Bill C-15 would replace the 1976 Nuclear Liability and Compensation Act and establish a clear regime in the event of a nuclear accident. While we pray that never happens, the recent events in the Gulf of Mexico remind us we need to always be prepared, as my son the Boy Scout would say.

One of the key changes in Bill C-15 would be to increase operator liability from $75 million to $650 million. That is a significant increase but some ask if it is enough. The last time the legislation was before us the government claimed that $650 million was all the Canadian insurance industry could bear. That is why it would not entertain going higher to $1 billion, for example.

However, during a comprehensive study, which we heard about at the Standing Committee on Natural Resources, we learned that this was not quite the case. Hopefully, during this debate, we will hear some more about why the government feels that $650 million is adequate. Hopefully this time we will get a clearer and stronger answer. We have had a bit of an answer today. We need to hear more about that.

When the former bill went to committee, before it was killed along with the government's talk tough on crime agenda and other bills that the government claimed were so important before it prorogued and killed them all, all parties at that time did agree on a number of amendments that strengthened the legislation. I look forward to the committee's further study in the weeks ahead. My party and I will be supporting sending Bill C-15 to committee.

While the bill would provide much needed changes, the basic principles of the nuclear liability and compensation act will remain the same. Operators are absolutely and exclusively liable for damage. That is one principle. Operators must carry insurance. An operator's liability is limited in time and amount. Suppliers and contractors are effectively indemnified. All those are important basic principles.

According to the Department of Natural Resources, the new liability limit reflects a balance of considerations. It is looking at the question of risk and if it address foreseeable rather than catastrophic accidents and if the insurance reflects insurance capacity that can be available at a reasonable cost. It puts Canada on par with the liability limits in many other countries. It responds to recommendations made by the Senate Standing Committee on Energy, the Environment and Natural Resources.

Since this is the third time the House has seen this legislation, there is little need to address all of its details. Instead, I would like to note that despite the fact that the Conservatives consistently lack the legislative fortitude to actually see nuclear legislation completely through this process, at least they have not been too afraid to bring it to the House for debate. They brought it back after they prorogued for other reasons.

That is not the case for another key aspect of the nuclear industry, the sale of AECL assets. The government continues to hide its highly suspect plans for the outright sale of our world-class CANDU technology. I find that very disconcerting. Like Bill C-15, this is critical for the industry, but the Conservatives believe they can move without consulting the people most impacted, people directly involved in the industry, the employees of AECL and the industry itself.

The Conservatives believe it is okay to hide what they are doing from the same Canadian taxpayers who have invested hundreds of millions in this industry in recent years. In fact, they put the terms of this in the budget bill. Why would the decision of whether one sells a Crown corporation be in the budget bill? What place could it possibly have there? It does not make much sense.

It is not like this is the sale of a surplus filing cabinet or a used prime ministerial limo. We are talking about an industry that supports about 70,000 jobs, after all. In fact, a lot of those jobs are in the ridings of Conservative MPs. Like Bill C-15, the sale of AECL will impact a lot of jobs in a lot of Conservative ridings.

In order to encourage investment in our nuclear industry and to protect this sector and the jobs it generates, we are debating Bill C-15 as a way to provide legal and insurance certainty for suppliers and operators. However, while it is good to debate Bill C-15, the government has dropped a cone of silence over its privatization plans for AECL. Conservative MPs have been muzzled once again by the Prime Minister's Office.

Maybe we should not blame them, though. When people are so immersed in the Conservative culture of deceit, they may not recognize what is actually happening. Maybe they feel it is safer to bow to the wishes of the Conservative upper echelons who consider this industry an embarrassment and just want to get rid of it. They want to unload the CANDU technology. They want to unload AECL after many years of Canada being a world leader in the development of nuclear technologies. Things like medical isotopes were developed right in Canada. Canadians can be very proud of that. It is a shame.

There is even a story going around that we are about to sell off AECL to foreign interests because of a tantrum the Prime Minister threw when his ministers repeatedly bungled the medical isotope crisis. It is a scary thought that this is his reasoning behind this decision.

If the government really believes in strengthening the industry with legislation like Bill C-15, why is it not prepared to openly debate the outright sale of AECL's commercial assets? I do not know what Conservative MPs are telling those families in their ridings who rely on jobs in this sector, but I hope they will come to their senses on this one and insist that the government open up debate on this question.

Nuclear Liability and Compensation Act
Government Orders

5:30 p.m.

NDP

The Acting Speaker Denise Savoie

The hon. member will have approximately nine minutes when the debate resumes.

It being 5:30 p.m., the House will now proceed to the consideration of private members' business as listed on today's order paper.

Health Care System
Private Members' Business

5:30 p.m.

Conservative

Cathy McLeod Kamloops—Thompson—Cariboo, BC

moved:

That, in the opinion of the House, the government should encourage and assist provincial and territorial governments, the medical community and other groups to lessen the burden on Canada's health care system through: (a) an increased adoption of technological developments; (b) a better recognition of the changing roles of health care professionals and the needs of Canadians; and (c) a greater focus on strategies for healthy living and injury prevention.

Madam Speaker, I am very pleased to rise in the House to speak to my private member's motion. It is a lengthy motion but it is a very important motion.

The purpose of this motion is to continue a very important conversation regarding our health care system. I would like to focus this conversation on three areas which have significant potential to lessen the financial burden on government and, more important, to improve the health of Canadians. These areas include: an increased adoption of technological developments; a better recognition of the changing roles of health care professionals and the needs of Canadians; and finally, a greater focus on strategies for health living and injury prevention.

Surveys currently indicate that Canada ranks health care as the second most important area of concern after the economy. They also take note when international benchmarking studies consistently report that our Canadian health care system's comparative performance is not ranked anywhere near the top in the OECD. I believe it is imperative for the government to reflect on what changes we can make while respecting our unique history and context.

This motion is about promoting a discussion on the appropriate role of the federal government as it relates to our health care system. It is about acknowledging that our needs have changed since the 1980s. It is about recognizing the worrisome, unsustainable, ever-increasing cost of our health care system on provincial and federal budgets, soon to be 50% and growing in most provinces and territories.

The Kirby report, the Health Council of Canada, the Canadian Medical Association and the Canadian Nurses Association, to name just a few, have scrutinized our system over the last few years and what has emerged is a remarkable consensus. An improved system is possible without compromising the founding principles of our Canada Health Act, such as universal access and sustainability. It will require transformational change with the patient's interests placed at the centre. It will require leadership, commitment and partnership from all stakeholders in the system.

I want to say unequivocally that this motion is not about two tier medicine or amending the principles of the Canada Health Act. It is not about interfering in the constitutional jurisdiction of the provinces and territories. It is about our responsibility under the Canada Health Act to encourage and to assist in providing the best system possible for Canadians.

As a brief aside, I personally believe that someday we should engage in a separate discussion regarding the Canada Health Act's very narrow definition of the continuum of care which currently focuses on physicians and medically necessary procedures in a hospital setting. Over time, as the amount of health services delivered outside these institutions and in the community has increased, the Canada Health Act has diminished with respect to ensuring coverage. This will result in an uneven system in terms of the continuum of care across the country. Perhaps we need to reflect on what basket of services should be included and excluded but that is a discussion for another day.

Health care needs are changing. The days of acute episodic care that typically required intervention by a physician or short-term support in hospital have changed forever. Young children with measles, ear infections and broken arms no longer predominate the practice of a physician. They are now faced with daily complex medical conditions requiring frequent long-term support, expensive medication and regular diagnostic monitoring.

Dr. Ross Reid, a prominent Kamloops physician, said:

We know the absolute number of patients is increasing as the population continues to grow and age. Elderly people need more surgery than young people. This holds true for all health services; persons 85 or older require 3 times the acute care, 12 times the community care, and 25 times the residential care of the rest of the population.

Chronic disease is now the principle cause of disability, the major reason for seeking health care and accounts for 70% of all health care expenditures. Although the aging population has contributed to these increases, the prevalence of chronic disease has risen in virtually every age group. Chronic diseases create large adverse, and underappreciated, economic effects on families, communities and countries. It is estimated that Canada stands to lose $9 billion in national income over the next 10 years from premature deaths due to heart disease, stroke and diabetes.

Our expectations of our health system have risen dramatically. Again, using Dr. Ross's examples, I take the case of Terry and his grandfather. When Terry's grandfather developed arthritis in the hip in the 1960s, he bought a cane and spent a lot of time watching TV. When Terry developed the same condition last year, he was scheduled for a hip replacement operation so he could continue to downhill ski.

In another example in the 1970s, 60 years of age was pegged as the upper age for consideration of coronary artery bypass surgery. In the case of Lucas, he has a good quality of life and last year he was successfully operated on at the age of 89. This is not to say that Terry and Lucas should not have been treated, just that the treatment options that Canadians are pursuing today represent a significant and costly change in practice.

How do we deal with this emerging reality? As noted by the Canadian Medical Association, over the last number of years we have demonstrated improvements in quality and access to care without a dramatic change in costs. However, these stories often take the form of time limited pilot projects that have been applied in isolated programs and usually have not been adopted on a system-wide basis. We have yet to achieve the tipping point and this is especially true in the case of technological developments.

What could our health care system look like in 10 years with continued committed focus on an increased adoption of technological developments, better recognition of the changing rules of health care professionals and the needs of Canadians and, finally, a greater focus on strategies for healthy living and injury prevention?

The following are some examples of what health care might look like in a decade from now.

Jane is a 70-year-old patient with congestive heart failure. She has always lived in rural Canada and wants to continue to live near her family and friends. The nearest health facility is 100 kilometres away but the community now has broadband access. Each morning she connects to her small home monitoring machine that measures a number of her symptoms. The results are transmitted to her health care team and are monitored by a nurse with special expertise in congestive heart failure. Jane also receives direct feedback from the equipment on her results and understands the warning signs and the actions she must take. She has become increasingly comfortable managing her condition at home, deteriorations are dealt with rapidly and expertise is only a phone call away.

Since Jane started on this program, her hospital admissions have decreased dramatically and her quality of life has markedly improved. This scenario is not a fantasy but a current reality of care in the Kootenays. A recent evaluation of the program has shown significant improvement in both hospital stay and quality of life. This pilot initiative was funded by Health Infoway Canada and in the 2010 budget we have included $500 million so we have continued support for the implementation of the e-health strategy in Canada. This will be part of the many keys to our future sustainability.

In another example, Jim was diagnosed with a mental health illness in his early 20s. Although usually well controlled by his medication, there are times when he neglects to take his pills and he can quickly spiral downward. His primary care team is well-coordinated and includes a mental health clinician, dietician and family practice physician. The team also recently formalized a shared care relationship with a psychiatrist. There is one health record which is electronic and shared among all the practitioners. Jim also has access to his own health record through a secured Internet connection. The mental health clinician routinely supports Jim and is able to quickly identify when his mental health status is slipping and respond accordingly. Jim, therefore, has been able to maintain his job and home which contrasts dramatically with others with the same condition who do not benefit from this coordinated care.

A strong primary health care system, as illustrated in these examples, has been consistently associated with improved health outcomes and system performance at a national level. Seminal research by Dr. Barbara Starfield from John Hopkins University has effectively proven this link and also provided very interesting international comparisons. Using a team concept for primary care provision, we can dramatically reduce the burden on primary care physicians and improve outcomes for patients.

In addition, electronic patient records are imperative for proactive care of chronic disease. Patients and their families can and should be more fully engaged through access to their personal health records. As patients become proficient at understanding their conditions, including interpreting lab results, the concept of self-managed care will start to become the norm. Work by Dr. Kate Lorig, professor at Stanford University, has demonstrated the importance of patients and their families developing skills to become a full partner in their own team.

Across Canada, we are taking important steps on an improved primary care system and that work was significantly kick-started by the federal government's primary health care transition fund, but again, we have not yet embedded this within our health care system. Work done to date is best described as tinkering at the edges.

National Nursing Week is an opportune time to highlight one of the newest health care providers in our system, the nurse practitioner. Nurse practitioners are nurses who are able to provide a full range of primary care support. As increasing numbers of nurse practitioners enter our health care system, there are structural challenges around how to best integrate their skills into our system. A number of my own family members have a nurse practitioner supporting their health care delivery and have benefited from the unique approach to primary care service.

As everyone knows, many communities have a shortage of family physicians. In spite of this need, there is a limited mechanism to allow the nurse practitioner to provide additional support in these communities. Predominantly, this is provincial-territorial jurisdiction, but it must be noted that the evolution of the nurse practitioner is rooted in rural and remote aboriginal communities where we do have a responsibility. Canadians would benefit from a review of the role of nurse practitioners for groups we are responsible for, such as veterans, aboriginal communities, Correctional Service of Canada, and others.

Rooted in historical necessity, allied professionals have provided care where there have been limited resources. For example, in our military the physician assistant has assumed a very important role as a team member in the provision of care for our men and women in uniform. In another case, the community health representative provides essential culturally appropriate services on first nation reserves. Further, dental therapists provide a hybrid of hygienist service, basic dental care and community prevention interventions.

Clearly, our federal government has a long tradition of creative uses of para-professionals in order to meet their community needs. I believe that these lessons have some value for the provincial and territorial governments as we look at the looming health human resource shortage.

In addition, pharmacists, dieticians, respiratory therapists and physiotherapists all provide great value to patient care. We must continue to be creative and flexible using their skill sets to best meet the needs of the patients and the communities they serve.

It is interesting to note that the health committee has reviewed health human resources in great depth over the last year and we look forward to tabling a report prior to rising in June.

The final area but certainly not the least important is a greater focus on strategies for healthy living and injury prevention.

At least 80% of premature heart disease, stroke and type 2 diabetes and 40% of cancer could be prevented through healthy diet, regular exercise and avoidance of tobacco products. Cost-effective interventions exist. The most successful strategies have employed a range of population-wide approaches, combined with interventions for individuals.

As stated by Dr. Andrew Pipe from the University of Ottawa Heart Institute at the recent health committee meeting, we need to make healthy living the easy choice. This is important whether it relates to diet, exercise or choices around tobacco. Through regulatory mechanisms, transparency and public education, it must be easy to make the right choice. In Canada, we are making good progress but we are not there quite yet.

Turning to injury prevention, as included in our March 2010 Speech from the Throne, we have made the commitment as follows: to prevent accidents that harm our children and our youth, our government will work in partnership with non-governmental organizations to launch a national strategy on childhood injury prevention. This pledge was greeted positively by all who understand the tragedy and the cost of preventable injury.

In conclusion, I have discussed some important measures in progress and also provided the context and imperative for serious discussion regarding the future of health care in Canada. This general discussion in the House is particularly timely with the expiry in 2014 of the accord reached at the first ministers' meeting on health care in 2004.

I submit that my three areas of focus have an important role to play in the future of a sustainable health care system. Fifteen minutes is a very short time to give a full account of these issues that are pertinent to this complex discussion but, again, this is part of an important conversation for Canadians. I hope I have the support of all members in the House for this motion.

Health Care System
Private Members' Business

5:45 p.m.

Liberal

Keith Martin Esquimalt—Juan de Fuca, BC

Mr. Speaker, I compliment the member on her speech.

As a health professional, I would like to ask her one thing. We have a massive problem in our country in terms of not having a national strategy for health care workers. I would like to ask the member whether or not she will ask her Minister of Health to put together a national strategy for health care professionals, so we know how many and where we need physicians, nurses and technicians in order to have the personnel to service our health system. Right now, one of the major problems we have is that as we get older, so too do our caregivers. We have a massive deficit and that deficit will grow as time passes.

Health Care System
Private Members' Business

5:45 p.m.

Conservative

Cathy McLeod Kamloops—Thompson—Cariboo, BC

Mr. Speaker, as the member might know, out of the accord and it has a very long name, but essentially it is a group that has been designed to look at the health human resources. We actually had the group at the health committee today. I was very impressed with how this group, in a collaborative way, of course acknowledging and recognizing the provincial-territorial jurisdictional issues, has started to share and work together. I think the very important work that the member talked about is being done by this particular group.

Health Care System
Private Members' Business

5:45 p.m.

Bloc

Nicolas Dufour Repentigny, QC

Mr. Speaker, I want to thank the hon. member. We have the privilege of sitting together in the Standing Committee on Health. I know that her work is very meticulous. Nonetheless, I have a problem with the motion as a whole, although its purpose is indeed commendable. The problem is political. This issue should be debated in the National Assembly of Quebec, the only assembly that represents the nation of Quebec.

When the Conservatives, like the Liberals, only propose national strategies, I have a problem with that. I take issue with it because this Conservative government, which claims to want to limit government involvement as much as possible, has said in every election campaign that it would respect provincial jurisdictions. It is doing exactly the opposite. I find that rather surprising.

I would love to see these hon. members go back to their grassroots and explain that they want more federal government intervention. I would also like to hear what this government thinks of the Quebec clause in the federal-provincial agreement signed in 2004, which confirmed that Quebec's health system is different and different policies must apply. I want to remind the government that this is a provincial jurisdiction.

Health Care System
Private Members' Business

5:45 p.m.

Conservative

Cathy McLeod Kamloops—Thompson—Cariboo, BC

Mr. Speaker, I think I said very clearly at the beginning of my speech that it was absolutely about respecting provincial jurisdiction.

I do believe that we have lots of opportunity to learn from each other. We heard some very concrete examples about how Quebec had an observer role at our HHR table, and its representatives were sharing some of the very important things they do and the important learning from some of the things that happen elsewhere.

I would also like to talk about the role of Health Infoway Canada, which actually provides grants to all the provinces and territories. It speaks of that very important role regarding technological development and how technology will really be part of the sustainability of our future health care system.

Again, this has nothing to do with disrespect for provincial jurisdiction, but there are times when we need to learn from each other.

Health Care System
Private Members' Business

5:50 p.m.

NDP

Jim Maloway Elmwood—Transcona, MB

Mr. Speaker, I want to ask a question about electronic health records. For at least 10 years now it has been recognized that because of the substantial amount of medical errors that occur in our system, the electronic health record is a very important thing to develop. Certainly, under the Liberals, under Reg Alcock, there was a lot of money spent on electronic health records. I would sure like to get an update from the government as to where the electronic health record process is with this government.

Health Care System
Private Members' Business

5:50 p.m.

Conservative

Cathy McLeod Kamloops—Thompson—Cariboo, BC

Absolutely, Mr. Speaker, the electronic health record is imperative. I can speak with regard to my own community of Kamloops. It is a bit of a process to select an appropriate record that will assist physicians. They have gone through that process now and I am really proud to say that they have joined together as a large group in our community and are implementing it. Across the country it is at various stages, but we need to continue our progress on this very important matter.

Health Care System
Private Members' Business

5:50 p.m.

Liberal

Keith Martin Esquimalt—Juan de Fuca, BC

Mr. Speaker, I wish to compliment the member for introducing this motion. As a physician, it is a breath of fresh air to have health care finally discussed in this House.

I remember working in the emergency department and having to treat patients in the hallway. I remember having to airvac patients out of the town I was working in just because we did not have a health care worker, a technologist, who could do a CT scan on the person to identify potential problems.

Canadian society is in the process of slamming into a brick wall on health care because the resources that we have to pay for, what we ask for and need, are not there. As time passes, as our population ages, that gap between the supply of resources and the demands that we have on our health care system is simply going to widen. What has happened is that those who are least able to afford it are falling through the cracks. They are the ones who are being hurt by inaction. They are the ones who are going to be hurt if all we do is talk about things and fail to act.

We understand full well that the responsibility for health care is in the purview of the provinces, but nothing prevents the federal government from using its convening powers to work with the provinces that want to work with us, to get things done that we need to have done.

The fact of the matter is that we are constrained by a Canada Health Act that was good in its time but needs to be modernized. It cannot function and it cannot do what needs to be done. Our provinces cannot do what they need to do, if we are going to be constrained by the situation we have today.

If we look at the top 20 health care systems in the world, 17 of those health care systems are in Europe. This ridiculous discussion that we have, that if it is not ours it must be in the U.S., is a nonsensical debate. The real debate we should be having, and the answers we should be pursuing, is who has the best health care system. We need to just peer out toward Europe and we will find that 17 of the 20 best health care systems in the world are there.

What are their characteristics? The member, quite rightly and wisely, put technological development as one of her three requirements. If we look at Europe, it uses IT tools much more effectively than we do. We absolutely must be able to use IT tools to reduce duplication, reduce waste, and improve efficiencies in the system. It is ludicrous that we are so far behind the times.

The second point in this area that Canadians might need to know is that while we discover all these remarkable things in medicine, Canadians have access to them in a limited way. The reason for this is because provincial governments have to withhold or ration care and they cannot afford to provide the best care that is available, so the scientific discoveries that we are making are not available to the Canadian public because governments do not have the money to pay for them. There is this gap and Canada ranks somewhere in the 20th to 25th range in terms of access to new technologies by our citizens.

The second part dealing with health care professionals, and the member was again right to put this in, is that we desperately need a national health care workforce strategy. As we get older, our health care professionals are getting older as well. The average age of a nurse is about 42. The average age in some specialties in medicine, as a physician in my profession, is somewhere in the fifties. We cannot train a doctor in four years. It takes 12 years or more to train certain types of specialists.

We cannot easily reproduce them. We desperately need this strategy to be implemented with the provinces, not only for physicians and nurses but also for technicians and other health care professionals who are part of our team and who enable us to serve the public we treat.

The third area deals with healthy living and prevention. Last week I was privileged to attend the big Pediatric Academic Societies' conference in Vancouver. It is the largest of its kind in the world and 6,000 of the top pediatric scientists in the world were there. One of the big issues that was talked about, as the hon. member mentioned, is the epidemic of childhood obesity.

Dr. Tremblay from Montreal did a phenomenal study comparing Canadians from 1981 to today and his results were shocking. He found that from 1981 to today, the level of obesity has increased dramatically. Fitness levels have plummeted. Part of the reason is that the average Canadian child watches 40 hours of television per week or the child is in front of a screen playing video games. This is ridiculous. We were not designed to do this.

As a result, we are seeing chronic diseases that are now shifting lower and earlier in the demographics. Younger people are having higher incidences of type 2 diabetes and cardiovascular problems. The result of this is that it is putting a huge and increasing burden on our health care system, and that in combination with our aging population will essentially break the back of our health care system unless we act and act quickly.

One of the motions I introduced recently is very simple. Why do we not all advocate for parents to turn off the television sets and turn off the video games one night per week, just one night a week? Get kids out and active. If they are out and active, engaging in free play, they will be able to dramatically change not only their physical abilities but also their mental abilities.

We have found that we can now actually peer into the developing child's brain. We know that from the prenatal stage through the first five years of life we can have the most dramatic impact upon the trajectory of that child into adulthood.

Subject children to a loving, caring environment with proper nutrition, where they are subjected to being read to and actually reading books later on, and what happens is that the connections in the brain actually happen well. Conversely, subject children to violence and sexual abuse, where they are witnessing drug abuse and violence, and give them poor diets, the neural connections that take place happen very poorly.

As a result of that, because the frontal cortex and the lower parts of the brain are not connected well, we see a much higher incidence of drug use, juvenile crime, poor outcomes in school, more dependence on welfare, and poor social and economic outcomes.

It is essential that what we do in the first five years of life has a dramatic effect on the trajectory of that child. If the government wants to really do something in terms of reducing crime, for Heaven's sake, work with the provinces to enable them to have an early learning program for children, during the prenatal stage and through the first five years of the children. If we do that, it will have a dramatic and profound impact upon the life of those children.

Kids need free play. The other thing we can advocate in the public health aspect is to take kids to the library. Drop them off at the library, leave them there for an hour, let them roam the books, and let them use their imagination. If that is done, then they will have a chance to read. We know that literacy is one of the most powerful ways in which we can improve the trajectory of children later on in life.

These are simple things, inexpensive and easy to do. Also, kids who are plugged into TV sets and video games are not engaging in learning or having the imagination and the social skills they need to function well as adults.

That kind of free play and socialization may sound subtle in many ways, but it has to be done because those subtle interactions that take place enable the neuro connections and enable children to move forward and acquire the skills sets they need later on.

To summarize, in order to enable us to have a health care system that serves the public later on, which we must have, we have to work with like-minded provinces. We have to modernize the Canada Health Act. We have to bury our ideology. We have to pursue the facts and the science. The solutions are out there and we have to implement them. Talking is not going to save anybody's life. Only action will.

Second, we have to implement the national workforce strategy with the provinces. Again, let us ensure that we look at solutions that work. Let us look at Europe. Why does Europe have 17 of the top 20 systems? Let us look at their funding models, how they enable the governments and the private sector to work together, how they treat their health care workers, how they acquire and retain health care workers, and what they do in terms of prevention.

That package of solutions will enable us to ensure that our citizens, when they get sick, will have a health care system that will be there to treat them and will treat them well.