Mr. Speaker, thank you for this opportunity to address the opposition's motion.
Canada's publicly funded health care system is a partnership between the Government of Canada and the provinces and territories. While the provinces and territories are responsible for the organization and delivery of health care services in their respective jurisdictions, the Government of Canada sets the national principles that provinces and territories must comply with to receive their full cash contributions under the Canada health and social transfer program. This shared role requires us to work in close co-operation with one another.
As members know, the federal health minister is the minister responsible for the administration of the Canada Health Act. This responsibility involves the monitoring of provincial and territorial health systems to ensure that they adhere to the criteria and principles of the Canada Health Act.
The Canada Health Act, passed by parliament in 1984, is the cornerstone of the Canadian health care system and forms the basis of medicare. This legislation affirms the Government of Canada's commitment to a universal, accessible, comprehensive, portable and publicly administered health insurance system. Canadians identify with Canada's health care system more than with any other social program in this country.
Health Canada's approach to resolving possible Canada Health Act non-compliance issues emphasizes transparency, consultation and dialogue. Our ultimate goal is to ensure that the underlying principles of our public health care system are protected for the benefit of all Canadians. In working with the provinces and territories, we are putting a much needed emphasis on making the health care system more accountable and responsive to Canadians.
In his 1999 report, the Auditor General of Canada recommended that Health Canada improve its capacity to monitor provincial and territorial compliance with the Canada Health Act. In response to this recommendation, Health Canada increased spending on the administration of the Canada Health Act by $4 million a year, up from $1.5 million a year. These additional resources have been targeted to enable the department to better monitor and assess provincial and territorial compliance with the act.
These resources are also being used to enhance the department's knowledge and understanding of provincial and territorial legislative frameworks for health insurance. To achieve these objectives, the Canada Health Act Division relies on the support of the six Health Canada regional offices.
Finally, these additional resources have been used to develop a new Canada Health Act Information System, which assists the department to better monitor and assess provincial and territorial compliance with the Canada Health Act.
I am glad to say that with the additional resources committed to improving the administration of the Canada Health Act, the Government of Canada's capacity to fulfill the expectations of Canadians has remained strong.
Under the Canada Health Act, all Canadians must have access to medically necessary health services on uniform terms and conditions. Canadians continue to attach a high importance to each of the five principles in the act.
The act itself comprises five criteria, two conditions, and two provisions. The five criteria of the Canada Health Act require that provincial and territorial health insurance plans be: universal, accessible, comprehensive, portable and publicly administered.
The Canada Health Act requires that the provinces and territories provide the necessary and required information to the Government of Canada for the purpose of bettering the administration of the act, and for reporting to parliament. Also provinces and territories are required to recognize the Government of Canada's contribution towards insured health services and extended health care services.
Finally, there are two additional provisions of the Canada Health Act. The first provision relates to extra billing by physicians. This provision prohibits direct charges to patients by physicians in addition to the amount they receive from the provincial or territorial health insurance plan for insured physician services. The second provision relates to user charges. Its purpose is to prohibit provinces and territories from allowing individuals to be charged for any other insured services.
The Canada Health Act serves as the Government of Canada's guarantee to Canadians that the health care system of this country will be safeguarded and secure. Canadians expect their government to continue to support and protect the values that they hold most dear.
As I mentioned earlier, the act is closely linked with the Canada health and social transfer payments. In order for the provinces and territories to qualify for a full cash contribution under the transfer, they and their health insurance plans must comply with the criteria, conditions and provisions set out in the act.
In September 2001, the Prime Minister announced a $18.9 billion increase in CHST cash transfers to the provinces and territories over the next five years, in support of health. For the fiscal year 2005-2006 alone, the sum total of CHST cash transfers will reach $21 billion, or an increase of about 35% above the current level.
It is through co-operative spirit and joint collaboration between the federal, provincial and territorial governments that the Government of Canada continues to be mindful and respectful of provincial and territorial governments, their mandates and our respective jurisdictional boundaries.
That is why, in the event of provincial or territorial non-compliance with the Canada Health Act, the act identifies a process that the federal minister must follow to try to resolve the issue. Through this process, the federal Minister of Health and her counterpart in the province and/or territory begin discussions about the potential violation. If non-compliance is confirmed and a resolution cannot be achieved through these negotiations, the federal Minister of Health may opt to invoke either of the sanction mechanisms of the Canada Health Act.
It is very important to know that the purpose of the sanction mechanisms is not to impose penalties on the provinces and territories, but rather to achieve compliance to the principles of the act.
The two sanction mechanisms allowed for in the act are the mandatory and the discretionary sanctions.
The mandatory sanction requires dollar-for-dollar deductions to a province's or territory's allocation of the Canada health and social transfer. This dollar-for-dollar figure is based on the amount equal to the charges in extra billing or user fees that have been charged to patients.
The discretionary sanction is imposed if the federal Minister of Health is of the opinion that a province or territory has not complied with one of the five criteria or the two conditions of the Canada Health Act. This would result in a reduction in the amount of transfer payments depending upon the severity of the violation.
To date, the discretionary sanction has not been used by the Government of Canada, the objective of the government being to resolve outstanding issues in a co-operative and collaborative manner.
It is important to remember that the Canada Health Act is a legislative framework of broad principles and criteria, which allows for flexibility in its interpretation and application. This act differs from other legislative frameworks because it is accommodating to the evolving changes and trends which are occurring in the health sector.
Contrary to what some critics of the Canada Health Act may say, the act is not a straitjacket. This does not preclude provinces and territories from implementing appropriate reforms. The Canada Health Act is broad in its interpretation, application and scope. Its purpose is to preserve the values embedded in our health care system, those of equity, accessibility and quality.
In this new century, the dynamics of the health sector are changing every day. There have been many shifts in health care, and reform has occurred across the country with respect to the provision and delivery of health care services. Canadians expect the Government of Canada to lead in the discussion around new ideas and alternatives in its approach to their health.
That is why, on April 4, 2001, the Prime Minister announced the launch of the Commission on the Future of Health Care in Canada, led by Roy Romanow. The mandate of the commission is to engage Canadians in a national debate on the future of Canada's health care system. This task is an important one in light of increasing complexities in the system coupled with the rising expectations of Canadians.
Canadians expect the Government of Canada to protect health care in this country as a symbol of their national identity. Work is continuing on monitoring, compliance assessment and reporting on the Canada Health Act. Health Canada and the provinces and territories are working diligently in developing a Canada Health Act dispute avoidance and resolution process.
The Government of Canada is committed to the principles and conditions of the Canada Health Act. Through renewed spirit and collective co-operation between the two levels of government in this country, Canadians can be assured that the Government of Canada will continue to sustain and strengthen their medicare system.
