Mr. Speaker, I am honoured to rise in this House as the representative of the people of Sudbury and also as Canada's Minister of Health to expand on a number of themes raised in the speech from the throne.
On October 25 Canadians from across this country sent a clear message to politicians that there are certain principles, policies and programs which must be maintained as part of our national heritage and our national fabric.
Fundamental among them is our national health system which for many Canadians represents the essence of our unique experience as a country.
Our health system remains the envy of people around the world. Many Canadians are watching with interest as our American neighbours wrestle with the many problems of upgrading their own health system. In a way the debate south of the border has served to heighten awareness in Canada of our own system, one that we may have come to take for granted.
I am fully aware of the financial pressures on our health care system. We, as Canadians, face a number of critical choices if we are to preserve and improve the health system which we all cherish.
The challenges to our health system are daunting. We cannot isolate health issues from other public policy issues: economic, social, environmental and even political. As governments at all levels search for ways to ensure development and growth, I say look to the health system, look to the health of Canadians. A healthy Canada will be a wealthy Canada. The reverse is true as well, I might add.
Can a child who has not had a proper meal or proper rest absorb the mass of information required to prepare for the economy of the future? Can a worker who is dependent on alcohol or a prohibited substance produce at his or her full capacity? Can we deny Canadians access to the research and treatment breakthroughs in the health field which could improve their overall quality of life?
The health of Canadians is something that is precious to this country and so is the health system that has developed to support it. When we have something precious we must protect it. This government and this minister fully intend to protect the health system in Canada for all Canadians.
Our approach is straightforward. We intend to improve the current system, not by some radical shift in the fundamental principles, but by the development of creative solutions to the problems that have arisen as the system has grown and evolved. I call this approach creating value while maintaining values.
That means that we will stick to the five principles of the Canada Health Act which have served Canadians so well over the past quarter century.
Let me repeat what those five principles are since many members are new to this House and because the principles are so important to the debates which inevitably will ensue over the months ahead.
First, universality-Canada's health system must be for all Canadians.
Second, portability-the benefits of our system must be available wherever in Canada our residents choose to live.
Third, comprehensiveness-it must include all medically necessary services.
Fourth, accessibility-no Canadian should be deprived access to the health system, and that means no user fees. This government cannot accept any measures which amount to a tax on sickness.
Fifth, public administration-the health of Canadians represents an important national asset and it must be administered overall on a non-profit basis by the public sector.
Even with these principles firmly entrenched there is still considerable opportunity to improve the overall health system. Since the health system is such an important national asset it is essential that we bring Canadians together to work co-operatively to renew and enhance it for the future.
There is considerable agreement that we need a more cost-effective and efficient health system and about what it should look like in the future. However there is little agreement about how we get there. These are not easy questions and they require a national dialogue to generate the necessary consensus to improve the health care system.
This is the thinking behind our announcement to create a national forum on health to be chaired by the Prime Minister of Canada.
The Prime Minister's personal involvement signals just how important we consider this issue to be for our national well-being.
I know that some Canadians have grown tired of all the consultations, special task forces, and other mechanisms established by the previous government to examine issues ad nauseam. We know Canadians appreciate their health care system, we know they strongly oppose user fees, and we know they are looking to the federal government to continue to play a major role in the health system.
Let me assure you that this government is listening and acting upon these messages. We do not want to duplicate existing mechanisms for co-operation. Instead, we wish to create a focus for a national discussion on a health strategy for Canada which encompasses all the various viewpoints, including those of the ultimate users.
We understand that the federal government is not the only government responsible for the health of Canadians. We cannot and will not go it alone. That is why I will be discussing this important initiative with my provincial colleagues when we meet in Ottawa on February 8 and 9.
I want to emphasize at this point that I am fully aware that health spending represents on average 30 per cent of provincial budgets and that provincial governments have made very significant efforts to come to grips with challenges in this area.
The national forum will provide an opportunity to highlight the issues and the difficult challenges all governments face. It will also help improve the climate for change.
However, governments at all levels cannot and should not bear the full responsibility for the health of Canadians. The medical profession, health care providers, the research community, the pharmaceutical and other health related industries, employers, employee organizations and consumers have important roles to play.
We hope that the national forum on health will raise the knowledge level of Canadians on a number of issues, many within their own control, and educate the general population on the possibilities as well as the challenges. Yes, individual Canadians also have a role to play. While health is a collective responsibility, it is also an individual responsibility.
We are each our own personal health managers. Many of our personal choices will determine the extent of our health and our quality of life. By bringing together all the participants from governments to individual users in this renewal exercise, I truly believe our health system can gain without pain.
One area where I believe that there is substantial potential for co-operation is in the field of health awareness. Right now, all levels of government are engaged in awareness programs on such issues as substance abuse and AIDS. Improved co-ordination among federal, provincial and territorial program areas would certainly lead to more efficient messaging and give all Canadians greater return on their health investment.
Where I live in Sudbury, northern Ontario, the health needs and the available services vary from those in downtown Toronto, Montreal or Vancouver. But a good idea developed in Sudbury or for that matter in Moncton or Red Deer can be of value to all Canadians wherever they live. There are plenty of good ideas out there in Sudbury and in every region of Canada. Let me give hon. members a few examples.
For nearly 20 years there has been a federal-provincial territorial committee on group purchasing of drugs and vaccines whose efforts have resulted in real savings to our health care system. When one member changed the method of supply for measles, mumps and rubella vaccine from dealing directly with
the supplier to bulk purchasing through this group, they realized a 68 per cent saving.
Three Ontario schools, including Laurentian University in Sudbury, are establishing undergraduate programs in midwifery which are expected to save money by reducing the number of prenatal doctor visits while providing pregnant women with quality care in the community.
Unique to Quebec are the local community service centres which provide locally-based health care in an effective and client-friendly manner. All of these programs are good examples of what I call spending smarter.
By placing existing innovative programs within a more coherent framework and by bringing together creative people with those who must administer and those who must use the system, I believe we can generate even more ideas which can add value to the overall health framework in Canada.
International comparisons show us that we do not have to spend more to produce a better overall health system for Canadians. For example, thousands of Canadians are sent every day for medical treatments of various kinds. But how many of those treatments are really evaluated to see if there are effective and better alternatives? I believe that there is tremendous potential for savings in our health system by doing a proper evaluation of what currently exists.
I believe that women's health requires special attention. One of our specific initiatives, as outlined in the red book and the speech from the throne, will be the creation of a centre of excellence for women's health.
Traditionally the health system has been regarded as gender neutral, but most adult women and adolescent girls can give vivid examples of how the system has a strong male bias. The women's health issue is an area which I believe urgently needs more research as the recent forum on breast cancer so dramatically highlighted. I must add that this is a personal priority of mine.
Let us face it, there are basic biological differences between women and men. Gender does have an impact on the distribution of many diseases across the population. Yet many clinical trials of drugs and other treatments under-represent women in their samples or exclude women completely. Not only is it bad policy, it is bad medicine.
Women do have special conditions, from osteoporosis to menopause, and they merit equal attention from research to treatment, to care and prevention. We have to move the health system forward in this regard, not to the detriment of anyone's health but to the benefit of everyone's health.
Again, we have many ideas in this area from the establishment of specific research goals to the development of programs for groups such as immigrant women and aboriginal women whose particular needs have not always been adequately served by the health system.
Any discussion of women's health must establish the connection between violence in the family and the overall health of the woman, her children, and others living in the household. My colleague, the Minister of Justice, has overall responsibility for this critical area, but my department continues to play an important role with respect to family violence prevention through building partnerships with non-governmental organizations and the provincial and territorial governments. We will develop a national strategy to address the various aspects of women's health, and my department will work diligently, again in close co-operation with our partners, to pull together all the pieces of this gender puzzle.
The establishment of centres of excellence for women's health is only the first step in a solution. What we really need is the basic research and raw data on which to base our future programs and policies.
Preventing illness is just as much a health care responsibility as curing it. One of the unique biological functions of women is childbirth. Our government is committed to enhancing the support system for this important period of a woman's life by creating a pre-natal nutrition program for women at risk. In Canada there are between 350,000 and 400,000 pregnancies a year. Of these, 10 per cent of pregnant women are at risk because of poor health and malnutrition. Poor nutrition is a risk factor for low birth weight in newborn babies. In turn, low birth weight is the determining factor in about two-thirds of all deaths among newborns. Those who survive are at greater risk of developing serious and chronic disabilities.
The costs of this can be startling. For the 21,000 babies who have an unsatisfactory birth weight, the immediate costs of medical care can be as high as $60,000 per infant. As their lives progress they face higher risks of poor health and developmental difficulties which could sentence them to a life of poverty.
What is the cost of preventing such a fate? We believe that it runs in the range of $300 to $400 a pregnancy, depending on individual circumstances. Again, good health policy is sound economic policy.
Healthy children are also very much at the heart of a program we proposed for aboriginal families living off reserve in urban centres and in large northern communities. The aboriginal head start program would provide enriched programs for young children and include such important elements as nutritional counselling, physical activity and child care.
However, it also involves parents as both leaders and learners. The program would be designed and managed by aboriginal people at the community level and would be sensitive to both cultural and linguistic realities. We anticipate committing $10 million to this program in its first year, to be expanded to a total of $40 million in its fourth year of operation.
Successful head start programs can help reduce some of the effects of poverty by stimulating a desire for learning, by entrenching a positive self image and by providing for social, emotional and physical needs of these at risk children.
If successful-and I am very positive it will be-this program could be extended to other Canadian children in need.
Children are the future of our country and their well-being is everyone's responsibility. Healthy, confident children can develop and grow to their potential and all of us benefit.
In the early sixties, when I was a secretary in a doctor's office, I had to collect the outstanding accounts. I know first-hand how medical bills can paralyse a family. It has as much devastation as any debilitating illness. It is the reason why I am so set against user fees. In my mind, compassion must always come first. Without it we are simply turning health into another commodity to be traded and bargained for. That is not my way. In my world people, from newborns to seniors, come first. I pledge to this House that the people aspect of health will remain the driving force behind all of our thinking.
In the months ahead it is our intention to work with all Canadians to make an excellent health care system even better. Canadians should expect no less and this government will make it happen.
