Bill C-202 (Historical)

An Act to amend the Canada Health Act (linguistic duality)

User Fees Act

[Charlie Penson, Canadian Alliance, Peace River, AB]

Mr. Speaker, I understand the member's sense of urgency in wanting to get this passed today. We support this bill; however, I want to remind him that his government has approximately a year and a half left in its mandate. I do not see why an early election needs to be called. We need to be on record speaking to bills like this.

I am pleased today to support the bill. I have spoken to it many times in the past and have seen it evolve. I want to congratulate the member on his tenacity in championing this issue for several years.

Bill C-212 has changed quite a bit after going through the House of Commons and the Senate. Despite all of the amendments and the compromises, I believe the bill continues to embody the first steps to a fair and more responsive user pay system that better reflects Canadian democratic values. I truly hope that Bill C-212 would soon be put to a final vote, and that royal assent and proclamation would not be far behind.

User fees can be a responsible method of cost recovery for government services directed at specific clients and client groups; however, demands for fees can be and are sometimes abusive when there are weak controls. That is what this bill sets to correct.

In a democratic society, it is understood that fees charged by governments should reflect the actual cost of providing a service, which I am sorry to say has not always been the case. In addition, user fees should be set in coordination, conjunction and cooperation with all of the different groups that are subject to them, which seems to be a matter of common sense.

To say that Canadians deserve an accountable and transparent government must be more than just the chiming of the latest buzz words. It goes right to the heart of what we expect from a modern democracy. Empty rhetoric or window dressing will no longer do. Action and conviction are necessary and we must do the right thing in these kinds of cases.

Conservatives appreciate and hold in the highest regard the obligation of the state due to its vast power and authority over citizens to play fair. It is for that reason that the member for Medicine Hat introduced a similar private member's bill designed to reign in the power of the bureaucracy to charge for services in 1997, which was called Bill C-202 at the time. We are happy that the member for Etobicoke North has taken up this challenge to bring more accountability and transparency to the price charged for certain government services.

Expanded cost recovery had become a clear necessity during the early 1990s. We understand that; however, while the deficit is long gone, the user pay system still brings in over $4 billion to the federal coffers every year. Over 50 federal departments and agencies are currently levying over 500 different fees.

As responsible elected members, we must have a way to govern this mushrooming use of user fees, and respond to the serious concerns that a user pay system can and sometimes does take advantage of the users.

We agree with the member that safeguards and guarantees are needed. For example, greater parliamentary oversight should be required when user fees are introduced or changed. Increased stakeholder participation, including stakeholder impact and competitive analysis before fees, should be put in place.

Other long overdue changes would be: guaranteed performance standards for user pay services, annual reporting requirements for the government-wide user pay regime, and an independent dispute settlement process to deal with the complaints.

As I mentioned before, Bill C-212 has changed considerably from the version tabled by the member several years ago. In particular, the exclusion of crown corporations from these improvements is regrettable, which was the amended version coming back from the Senate, especially considering recent revelations that unscrupulous types can and have used the crown corporations to advance partisan political agendas and personal economic fortunes. The fact that crown corporations are no longer included makes that a bit of a problem.

Nevertheless, I believe this bill is a step in the right direction toward the struggle for increased government accountability and transparency. We may have to wait for a Conservative government to finish the job, which may not be that far away, but in the meantime we are happy to support Bill C-212.

Committees of the House

[Mauril Bélanger, Liberal, Ottawa—Vanier, ON]

Madam Speaker, I have the honour to table, in both official languages, the ninth report of the Standing Committee on Official Languages.

Pursuant to reference order made by the House of Commons on March 20, 2003, your committee has considered Bill C-202 and agreed, on Wednesday, October 29, 2003, to report its observations and recommendations to the House.

Pursuant to Standing Order 109, the committee requests that the government table a comprehensive response to this report.

This is a very important report for official language minority communities. The committee makes fourteen recommendations to improve access to health care for these communities.

For several years, we have found that, all too often, these communities lacked access to health care in the official language of their choice. Our recommendations seek to provide them with permanent and improved access to health care so that they too can benefit from the Canada health system, which is one of the best in the world. We realized that these communities have not always had such access. It is extremely important, if not essential, that the government provide a positive response to these recommendations.

Official Languages

[Robert Bertrand, Liberal, Pontiac—Gatineau—Labelle, QC]

Mr. Speaker, last March this House adopted a motion referring the subject matter of Bill C-202 to the Standing Committee on Official Languages.

Hon. members will recall that the purpose of the bill was to add a sixth principle to the Canada Health Act, namely the respect of linguistic duality. The report was to be produced by today.

Can the committee chair tell us what progress the committee has made on this?

Statutory Instruments Act

[Paul MacKlin, Liberal, Parliamentary Secretary to the Minister of Justice and Attorney General of Canada]

Mr. Speaker, I am very pleased to speak to the bill today, which relates to the important responsibilities that parliamentarians have to oversee the exercise of the delegated law-making powers.

For the past 30 years these responsibilities have in large part been discharged by the Standing Joint Committee for the Scrutiny of Regulations. It has performed an invaluable service to the House and to the Canadian public in its review of statutory instruments made under acts of Parliament.

The committee examines thousands of statutory instruments each year and carefully notes any concerns they raise in terms of the committee's review criteria. These criteria focus on legal concerns rooted in the rule of law and the Canadian Constitution, particularly the Canadian Charter of Rights and Freedoms.

The committee carefully and diligently pursues its concerns and deals with the concerns of the authorities entrusted with that power to make regulations and other statutory instruments.

One of the ways of ensuring that its concerns are addressed is through the disallowance procedure in chapter XIV of the standing orders of the House. These procedures have worked well. The government has complied with all eight of the disallowance resolutions adopted by the House.

I fully support the principles of parliamentary scrutiny of regulations underlying Bill C-205, as well as the need to recognize the disallowance procedures in law.

However, as I noted during the last session in the debate on Bill C-202, it gives rise to a number of concerns. These concerns have to do with how disallowed regulations are to be revoked, particularly the timeframe for revocation and the challenges it might pose for the making of replacement regulations to fill gaps that may be left by this revocation. I also noted concerns about ensuring proper public notice of revocation and extending the disallowance procedures to statutory instruments made by non-ministerial bodies.

Finally, I drew the attention of the House to the absence of a role for the other place in the disallowance resolution.

Today we have before us a proposal to substitute another bill for Bill C-205. I am pleased to say that the new bill addresses the concerns that I previously mentioned.

I would like to point out that the government is committed to ensuring that parliamentarians have an effective role in overseeing the exercise of delegated legislative powers. Not only has it implemented the eight resolutions under the existing disallowance procedures in the standing orders, the government recently amended the cabinet directive on law making, which is available on the website of the Privy Council Office.

The amendment addresses the treatment of concerns raised by the Standing Joint Committee for the Scrutiny of Regulations. It establishes a series of requirements for government departments, which is extraordinarily important in the process of governance.

They are to have one or more designated persons to whom the standing joint committee may address its inquiries. All inquiries are to be coordinated by a departmental tracking office to facilitate timely responses to all correspondence from the committee. Each department is to establish appropriate timelines for responding to inquiries. If a time line cannot be met, the committee is to be advised of the need for an extension. If an inquiry involves a legal issue, the department's legal services unit is to be consulted. Each deputy minister is to receive a status report from their departmental tracking office on a regular basis. A copy of the status report is to be provided to the minister's office.

I believe that these procedures will go some distance toward improving the government's accountability to Parliament on regulation making.

These steps that have been taken clearly demonstrate the government's commitment to the principles underlying the parliamentary scrutiny of regulations. It is extraordinarily important and I urge the adoption of the bill.

[John Reynolds, Canadian Alliance, West Vancouver—Sunshine Coast, BC]

Mr. Speaker, Bill C-205, an act to amend the Statutory Instruments Act, is designed to provide a statutory basis for the current disallowance procedure and to extend the application of that procedure to regulations made by persons or bodies, other than the governor in council or ministers of the Crown. The bill is consistent with recommendations made by the Standing Joint Committee for the Scrutiny of Regulations for the reform of the current disallowance procedure.

One aspect of the current disallowance procedure that has long been identified as problematic by advocates of better parliamentary control of delegated legislation is that it limits the possibility of disallowance to those statutory instruments that are made by the governor in council or by ministers of the Crown.

As a result, the considerable body of delegated legislation promulgated, for example, by the CRTC, the Canadian Transportation Agency or the National Energy Board is not subject to the disallowance procedure provided for in the Standing Orders. This is a consequence of the choice made in 1986 to implement the new disallowance procedures by means of amendments to the Standing Orders of the House of Commons rather than legislation.

In any event, it is clearly both logical and desirable that all statutory instruments subject to review by Parliament under the Statutory Instruments Act be subject to disallowance. There is no reason, either in theory or in practice, why a regulation made by the governor in council or a minister can be disallowed by Parliament while a regulation made by some other delegate of Parliament cannot.

The effectiveness of the current procedure also relies on the cooperation of the governor in council or the minister concerned to carry out a disallowance after it has been ordered by the House of Commons. In itself, an order of the House of Commons cannot affect the revocation of a regulation. The authority that made a disallowed regulation must still formally intervene in order to revoke that regulation following the making of a disallowance order. Putting the disallowance procedure on a statutory footing will allow Parliament to enact that a disallowed regulation will be deemed to be revoked and thereby streamline the disallowance procedure as well as improve its effectiveness.

On reviewing some of the interventions that have been made against this bill or its predecessor in the last session, Bill C-202, one is struck by the fact that many of the arguments put forward do not go to the principle of the bill, but focus on alleged perceived practical difficulties with the bill as it stands. In many instances these difficulties are more apparent than real. In any event, the objections that have been raised could easily be dealt with, if warranted, by means of amendments to the bill in committee.

We have heard a curious claim that for the Parliament of Canada to enact a statutory disallowance procedure might be incompatible with the principle of responsible government.

The reality is that the procedure laid out in Bill C-205 is entirely consistent with, and in fact promotes, responsible government by increasing the accountability of the executive branch to Parliament.

There are at least 12 parliaments in the Commonwealth, including provincial legislatures, that have adopted a statutory disallowance procedure. I believe no one would seriously suggest that these jurisdictions have turned their back on the principle of responsible government.

In addition, the Parliament of Canada has itself previously enacted a negative resolution procedure in some of its statutes. If the argument that was made was correct, those who are making it would have to conclude that the federal Parliament has already abandoned the principle of responsible government. Of course, this conclusion is absurd.

The purpose of Bill C-205 is to expand the scope of the current disallowance procedure so as to allow parliamentarians to exercise the same control over the making of regulations by all its delegates that it already exercises over the making of regulations by the governor in council or by a minister.

At present, regulations made by persons or bodies other than the governor in council or a minister are subject to parliamentary scrutiny by the Houses, acting through the Standing Joint Committee for the Scrutiny of Regulations, but the Houses are powerless to control these regulations through disallowance. This is an anomaly that needs to be corrected.

An attempt has been made to present the correction of this anomaly as involving an unwarranted parliamentary intrusion in the affairs of regulation makers. For example, in her intervention the Parliamentary Secretary to the Solicitor General drew attention to the fact that rules made by the courts--one of the three pillars of a democratic society--would fall under and be captured by Bill C-205. She then asked: “What about the separation of the judiciary and the government?”

Court rules made under statutory authority come within the scope of Bill C-205 because they are delegated legislation, just as they come within the scope of the existing Statutory Instruments Act because they are delegated legislation.

Bill C-205 is a bill to amend the Statutory Instruments Act and, as such, the provisions of the bill reflect the structure and organization of the statute it amends. If the possible application of the disallowance procedure to rules of procedure is problematic, it is the Statutory Instruments Act that should be amended to exclude court rules from the definition of “statutory instrument”. This is not something that is within the scope of Bill C-205.

While making that argument, the parliamentary secretary was probably not aware that in its 10th report of the second session of the 33rd Parliament, 1988, the scrutiny committee informed both Houses that it would not scrutinize the rules of procedure made by courts intended to have the same degree of independence as that guaranteed by the Constitution to superior courts. The committee took that decision nearly 15 years ago out of its sensitivity to the principle of the independence of the judiciary.

Given that court rules are also subject to examination by Department of Justice employees under the Statutory Instruments Act, it is the subjection of those rules to the control of the Department of Justice employee that might properly be said to breach the “separation of the judiciary and the government”. In these circumstances, any concern about the separation of the judiciary and the government might be better directed to the current practice of the government than with regard to the parliamentary procedure proposed in Bill C-205.

It is interesting to note that on more than one occasion the House has been assured that the disallowance procedures of the Standing Orders process have worked well. If anything, this should be an argument in favour of adopting Bill C-205, but more fundamental, those who use this argument to justify the status quo are overlooking the fact that the statutory disallowance procedure proposed in Bill C-205 is not put forward because the current procedure has not worked. It is put forward because it is necessary to adopt legislation to expand the scope of parliamentary control of delegated legislation to include all instruments that are now subject to parliamentary scrutiny. As has been said by others, this purpose simply cannot be achieved by the standing orders and requires a legislative approach.

Thirty years after the enactment of the Statutory Instruments Act the benefits that have accrued from our scrutiny of delegated legislation are indisputable. Effective parliamentary scrutiny, however, requires effective parliamentary control. A step in the right direction was taken in 1986 and I believe the time has come to complete the process and to eliminate the gap that now exists between scrutiny and control of delegated legislation.

This is what Bill C-205 proposes to do. Full parliamentary control of delegated legislation with such exceptions as are warranted represents a meaningful and significant reduction of the democratic deficit. More than 30 years after the enactment of the Statutory Instruments Act it is believed that the time has come for the Parliament of Canada to give itself the means to ensure full democratic control of federally delegated legislation.

I congratulate my colleague from Surrey who has put forth the legislation. I trust when the House has to vote we will all support it like we should.

Canada Health Act

[The Deputy Speaker]

Pursuant to order made on Wednesday, March 19, the House will now proceed to the taking of the deferred recorded division on the amendment to the motion at second reading stage of Bill C-202 under private members' business.

(The House divided on the amendment, which was agreed to on the following division:)

[Alan Tonks, Liberal, Parliamentary Secretary to the Minister of the Environment]

Mr. Speaker, discussions have taken place among all parties, as well as with the member for Ottawa--Vanier, concerning the taking of the division on Bill C-202 scheduled at the conclusion of private members' business later this day and I believe you would find consent that at the conclusion of today's debate on Bill C-202, all questions necessary to dispose of the motion for second reading of the said bill be deemed put, a recorded division requested and deferred to Thursday, March 20 at the end of government orders.

[Jeannot Castonguay, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I rise today to discuss the goals of Bill C-202, which was introduced by my colleague, the hon. member for Ottawa—Vanier.

The bill clearly stems from a concern for the future of linguistic minorities in Canada. I want members to know that the federal government shares this concern in every respect and supports official-language minority communities.

On March 12, 2003, and as a result of the commitment it made, in particular in the September 2002 throne speech, the federal government tabled its action plan on official languages, a concrete measure on behalf of official language minority communities.

The Prime Minister and the Minister of Intergovernmental Affairs have announced the new Official Languages Action Plan, which I shall refer to as the action plan in this speech.

This action plan includes a $119 million plus investment in health care, to implement positive steps such as the retraining and retention initiative for health professionals and a community networking initiative designed to improve access to services provided to minority communities in both official languages.

In addition, Health Canada reallocated a total of $30 million from its Primary Health Care Transition Fund to improve access to services for official language minority communities.

The government strongly supports linguistic duality in Canada and the action plan clearly shows its commitment for the future.

The plan includes an accountability framework setting out how the commitments and obligations under the Official Languages Act are to be met.

The government is clearly committed to meeting its responsibilities, in addition to defining mechanisms for coordinating the policy and the new measures included in the action plan, meaning that Health Canada and official language minority communities will have real means of improving access to health care services.

Improving access to health care for official language minority communities and ensuring their viability are major priorities for Health Canada.

Health Canada's commitment is clear and has been demonstrated in many ways already, namely:

by funding various projects within these communities on its own initiative or in partnership with Canadian Heritage;

by funding the “Santé en français” forum in Moncton in November 2001, during which the francophone advisory committee made its report public;

and, finally, by funding various projects within these communities, on its own initiative or in partnership with Canadian Heritage. More than $13.6 million has been allocated to official language minority communities over the past three years. This funding, taken from existing programs, was a response to requests made by the communities.

The action plan on official languages will help support the development of French and English language minority communities and will make health care services more accessible to them in their official language.

The action plan is proof of the federal government's support for official language minority communities. This action plan respects provincial and territorial jurisdictions and requires these governments to contribute to improving access to health services for official language minority communities in their own language.

As members know, under the Canadian Constitution health is primarily the responsibility of the provinces and territories.

In other words, the provincial and territorial governments are responsible for the development and delivery of health services to Canadians.

This means that provincial and territorial governments are responsible for the planning and management of their own health care systems.

As for the federal government, it is committed, through the Canada Health Act and the action plan on official languages, to promoting and protecting the health of all Canadians.

I remind everyone that we must never forget that the Government of Canada cannot get directly involved in a provincial or territorial jurisdiction. Nor should it infringe on provincial and territorial jurisdictions.

The federal government cannot and must not act unilaterally in a shared provincial jurisdiction. Any decision to broaden the scope of the Canada Health Act requires extensive consultations with the provinces, and the agreement of all governments.

In Canada, there is a long-standing tradition of partnership and cooperation between the federal, provincial and territorial governments in the health sector.

We continue to work with the provinces and territories to ensure that Canadians have access to health services in both official languages. In fact, the action plan on official languages helps make health services in their own language more accessible for francophones and anglophones in minority communities.

The action plan's accountability framework is the concrete expression of our commitment to these linguistic communities, and it ensures that Health Canada will fulfill its responsibilities to improve access to health care services for official language minority communities.

In order to reaffirm the government's commitment, I move, seconded by the hon. member for Beauséjour—Petitcodiac, the following amendment:

That Bill C-202, an act to amend the Canada Health Act (linguistic duality) be not now read a second time but that the Order be discharged, the bill withdrawn and the subject matter of the bill be referred to the Standing Committee on Official Languages to report back to the House on or before October 31, 2003.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, I am pleased to speak today on Bill C-202, introduced by my colleague, the member for Ottawa—Vanier. I congratulate him on his initiative.

The purpose of his bill is to amend the Canada Health Act in order to take linguistic duality into account. It would mean that the provinces would, as soon as possible, in cooperation with the facilities of the province that offer health services, develop a program ensuring access to health services for members of the province's anglophone or francophone minority and, in so doing, take account of the human, material and financial resources of each facility and the social, cultural and linguistic characteristics of the members of the public served by the facility.

The result would be that this would be placed entirely in the hands of members of the province's anglophone or francophone minority.

Like those of my colleagues who have spoken in the House on this bill, I acknowledge that the principle being pursued by the hon. member for Ottawa—Vanier is a laudable one. The means he is using to achieve that principle, however, are not necessarily either desirable or optimal.

I do not believe that a Canadian law relating to health, an area of provincial jurisdiction, is going to go over very well with the people of Quebec.

In Quebec, we took a different approach, by passing bill 142 in 1986, which guarantees access to health care services in English throughout Quebec. Initiatives have already been taken in Quebec, and they have worked.

Like my colleagues, the members for Repentigny and Hochelaga—Maisonneuve, I do not believe that this country is bilingual, nor do I think that it can be. The efforts that have been made to make it bilingual have not produced the desired results. I would like to point out that only Quebec and New Brunswick have passed legislation on bilingualism and have demonstrated any real will to provide bilingual services to their residents.

Even though members here have been critical, at times, of bilingualism in Quebec, I believe that Quebec is ahead in this area and that it has demonstrated and continues to demonstrate that it is very open when it comes to applying its laws.

While the principle may be laudable, this is not, as we see it, the right way to achieve the objective.

Also, the Canada Health Act, passed in 1984, was another example of interference by the federal government in an area of provincial jurisdiction. We will never accept any further intrusions into provincial jurisdiction.

Let us not forget that the Canada Health Act was passed at the very end of Pierre Elliott Trudeau's regime. Even though all of the federal political parties supported it, all of the provinces were against it. This new legislation would again encroach on provincial areas of responsibility.

I understand that the purpose is to provide French services for francophones living in minority communities. However, amending the Canada Health Act by making payment of the full cash contribution under the Canada Health and Social Transfer conditional, is not the solution. It is akin to blackmail.

It could have the effect of delaying or compromising care provided in different institutions, either in Quebec or in the provinces. It seems to me that all of the provinces should respect the principle of linguistic duality.

If negotiations and exchanges were proposed instead, which could be accepted by the federal government and the provinces, then we would be more inclined to support them over provisions contained in a federal act.

Personally, I recognize the provinces' right to determine how health care services will be delivered to their residents. I do not think that amending a federal statute, which would apply from coast to coast, will help us reach that goal.

Health care is a very complex sector that is facing significant cost increases with regard to the delivery of services, especially those related to the aging population.

Since it is specified in the bill that the province “shall take account of thehuman, material and financial resources”, it is very possible that such amendment would never be implemented because there would be no financial resources available.

The member for Ottawa—Vanier knows how important the promotion of the French language is to me, but I am not sympathetic to his fight for linguistic duality as represented by his proposed amendment to the Canada Health Act.

Therefore, I must tell him that the Bloc Quebecois will not support this bill mainly because it would mean allowing further federal intrusion into provincial jurisdictions. It is very difficult to talk about health and bilingualism in political terms but we often have no choice but to face that reality.

In conclusion, I congratulate the member for Ottawa—Vanier on his fight for bilingualism and I invite him to find other avenues than further intrusion in provincial jurisdictions to achieve that objective.

[Scott Reid, Canadian Alliance, Lanark—Carleton, ON]

Mr. Speaker, I am rising to speak to Bill C-202.

I would like to begin by making a brief mention of my colleague, the hon. member for Ottawa—Vanier, the man behind this bill. He is a man of good will and great intelligence, a real spokesperson, who has distinguished himself in his battles for the Franco-Ontarian minority community to which he belongs. I have a great deal of respect for him as a spokesperson for his community.

I am therefore sorry that I must oppose this bill. I will explain why I am opposed.

Let me start by reviewing the bill's provisions. It would add linguistic duality as a sixth provision of the Canada Health Act. There are currently five provisions in the Canada Health Act which the act states must be provided in provincial health services in order to receive federal funding. Those provisions are: portability, universality, accessibility, comprehensiveness and public administration. If any of those provisions are not followed then the result is that the federal government is supposed to, under the provisions of the Canada Health Act, withhold funding from provincial health spending. That means that the Canada Health Act can only be enforced by reducing the amount of money available for health care in this country.

That is a very blunt instrument for ensuring better health care. It means that the Canada Health Act ought to be used, and not be enforced through the reduction of funds, only in the most severe cases where some practice is so outrageous in its restriction on the health care rights of Canadians that it would result in a genuine loss of health care benefits. Otherwise, the enforcement itself would result in lesser qualities of health care, longer waiting lists and, in general, poorer health indeed. If it were enforced too strictly and too many funds withdrawn one could not unreasonably expect that there would be some fatalities caused by the over stringent enforcement of the act. Therefore, we must be extraordinarily cautious how we apply this law and how we consider rewriting the law.

The bill provides for some things that seem completely unobjectionable. I will read one of the parts of the law and it would be hard for anybody to object to this in principle. The proposed bill states:

12.1(b) the provincial health insurance plan shall offer insured health services in the language spoken by the members of the anglophone or francophone minority of the province, taking into account the organization of human, material and financial resources of the province's facilities that offer such services and, where applicable, in accordance with any program ensuring access...

That does not seem unreasonable. However, in the case of a piece of legislation like this it is necessary to take a step back and ask why is it only francophone and anglophone minorities that would get this kind of protection?

Let us think very carefully. In this place we have the right to speak either English or French and to have translation provided and documents provided for us because we represent the two largest language groups of the country, and the two languages that have always been in use in this country.

However, when we are talking about a life and death service we must take a somewhat different attitude. If we do find, as we do indeed, in parts of this country that there are large numbers of people who speak some other language and are really not capable of speaking either French or English, it seems reasonable to try to provide those life and death services, emergency medical services for example, in their language.

My colleague from Surrey Central made this point quite eloquently when he spoke of his own constituency, which has the largest Indo-Canadian community in the country. He pointed out that there are 35,000 people in Surrey Central for whom Punjabi is the mother tongue and 18,700 people in his constituency who use Punjabi as their home language. Many of those people would be fluently bilingual in English, but many would not. Something similar is true in Toronto for the large Chinese community, for the Chinese community in Vancouver, and one could go on and point out a number of other very substantial language groups.

There is a precedent here. In the court system there is a common law right that if individuals are involved in a court case either as plaintiffs or defendants and are incapable of speaking the language, translation services will be provided so that the goings on would not be a mystery. And that applies not merely to English and French speakers but also to speakers of any other language.

Something similar ought to be provided where possible. When people come to a hospital for emergency services, they are frequently not in the best mental state. They are often stressed out. These are often not the conditions that would cause persons who are struggling to know either of Canada's official languages to be able to speak and convey clearly what their problems are and indeed to understand the information provided by service providers who do not have the capacity to speak their language.

That is one reason I think this is not a good piece of legislation for us to propose.

The other reason relates directly to what my hon. colleague from Ottawa--Orléans was saying in his comments. He talked specifically about the Montfort Hospital and how this relates to the Montfort Hospital. I listened with interest as someone who is a former patient of the Montfort Hospital. A few years back I was there for an operation. I was very satisfied with the service I received.

I think this piece of legislation deals very specifically with the case of the Montfort Hospital. Probably there are two or three other hospitals in Canada where this might apply. I am thinking of the hospital in Sainte-Anne-de-Bellevue and perhaps a couple in northern New Brunswick. What relates to these hospitals particularly is the following part of the proposed law, which I will read:

As soon as possible, the province--

--the provinces that are bound by this law--

--shall take action to ensure that the management of any facility in the province that offers insured health services is placed entirely in the hands of members of the province's anglophone or francophone minority, where the number of users from the anglophone or francophone minority is sufficient to warrant that action.

To be honest, I simply cannot see the value of this. The point of health care is to provide good health care. The point of placing someone in the role of being an administrator of health care services is to find the person most capable of providing those services, regardless of the community to which they belong and simply using merit as the principle.

I would not want to see, and unfortunately because of the way the Canada Health Act is written this inevitably would happen if it were added to the law, a situation in which the federal government would be forced, if it were to comply with the Canada Health Act, to enforce this provision of the law by withholding funds from the provinces because the administrators at various hospitals who had been appointed by the provinces were not people of the appropriate linguistic or ethnic group. That would be a very unwise thing to place in our law, given the nature of the Canada Health Act and the way it is administered. That is a very substantial problem with the law.

I want to say something else in relation to the whole question of conditions under the Canada Health Act. Perhaps we took a wrong turn when we put the five conditions in the Canada Health Act the way we did.

There is really one fundamental condition that ought to apply under the Canada Health Act. That is if the federal government is to provide money and it attaches conditions, the one condition ought to be simply that no Canadian can be deprived of quality services at an equal level to those provided by our public system to all other Canadians due to inability to pay and, I think the point has been quite well made by my hon. colleague, due to an inability to speak the relevant language of the provincial majority. I would say if one is to include that secondary right regarding languages, that right ought to include those individuals who cannot speak the majority language of the province or the other official language.

Delayed health care is health care denied. Health care that cannot be delivered due to a lack of capacity to communicate is also health care denied. That applies not merely to francophones and anglophones, but to all Canadians regardless of their linguistic background.

[Eugène Bellemare, Liberal, Ottawa—Orléans, ON]

Mr. Speaker, I am pleased to rise today to take part in this extremely important debate on respecting Canada's linguistic duality in health care.

Many hon. colleagues have spoken, and opinions vary. My colleague, the hon. member for Charleswood—St. James—Assiniboia, talked about what Bill C-202 means to Manitobans. I would like to talk about the implications of this legislation for Franco-Ontarians.

The community I represent is very familiar with the debate on linguistic rights and health care. I would even say they are all too familiar with it. Most of my hon. colleagues know that Franco-Ontarians have had to fight tooth and nail over the past six years to assert their rights in health care. I am talking, naturally, about Montfort.

We learned a lot during the Montfort saga. I can only hope that the memory of this fight will force us to recognize the importance of Bill C-202. We cannot take our linguistic rights for granted: we must constantly defend them. We must be vigilant. We must add the sixth principle, to respect linguistic duality, to the Canada Health Act.

I want to repeat the chronology of events in the Montfort saga to illustrate the importance of learning from the past.

Six years ago, in February 1997, the Ontario Health Services Restructuring Commission announced the closure of the Montfort Hospital, Ontario's only French language university hospital. Imagine the impact of that decision on the francophone community: no more hospital for francophones; no more on-the-job training for our health care professionals. From now on, everything would be done in English, would be translated, or would be done elsewhere than in Ottawa. This was a disastrous decision for our community.

Fortunately, the Franco-Ontarian community was quick to react. On March 22, 1997, one month after the commission's decision, that community rallied and unanimously asked the commission to reverse its decision. More than 10,000 people attended the rally to make their views known. The S.O.S. Montfort campaign had been launched just a few weeks earlier, but it was going full steam ahead with its slogan “Montfort, fermé: Jamais!”.

Later that year, the commission reversed its decision, but it did not do so in good faith. According to the new decision, Montfort would remain open, but several of its essential services, including emergency and special services, would be eliminated. This was, of course, unacceptable. Discussions continued for a year, without success. Finally, in August 1998, the community, represented by S.O.S. Montfort, went to court to plead its case.

Like every other Franco-Ontarian, I was glad to hear, in November 1999, that the courts had ruled in favour of Montfort. The Divisional Court of Ontario recognized that the closure of the Montfort hospital was unconstitutional. It was our first victory. I call it our “first” victory, because the Government of Ontario did not agree with the ruling and appealed it. Imagine. Ontario appealed the ruling. The community had to take up the fight again.

The Franco-Ontarian community persevered. There were great disappointments and memorable victories. It kept asserting its rights and was finally successful. On December 7, 2001, the Court of Appeal for Ontario confirmed the ruling handed down in November 1999.

Two months later, the Ontario government announced that it would not appeal that ruling. The Montfort hospital would not close its doors. Franco-Ontarians would maintain their right to health services in the official language of their choice.

The fight to keep Montfort has been long and hard. Let us keep that in mind. Why do we need to fight such battles to protect a right enshrined in the Constitution of our country, in the Canadian Charter of Rights and Freedoms?

There is one lesson to be learned from the battle over Montfort. We cannot rely on the government's good intentions. We need guarantees enshrined in the law of the land. As parliamentarians, we have to protect our official language communities. We need to add a sixth principle to the Canada Health Act, that of respecting Canada's linguistic duality in the delivery of health care services.

Let us vote in favour of Bill C-202.

[Greg Thompson, Progressive Conservative, New Brunswick Southwest, NB]

Madam Speaker, I am glad I was able to hear the member for Lac-Saint-Louis and his reflective comments that are always right on target as we would expect from the member. I appreciate him allowing me to have a few moments to reflect on Bill C-202.

I wish to congratulate the member for Ottawa—Vanier, but I will take some credit for helping the bill to the floor of the House of Commons. I am one of those who signed on in that process.

The intentions of the member are good. We are encouraged by what he is attempting to do. I do not have to remind the Speaker nor the House that I come from Canada's only officially bilingual province. This linguistic duality as it pertains to health care is something that we have been striving to achieve. We have had great success in New Brunswick. We would hope to see that across the country if the bill were passed by the House.

I will throw out some questions to the member. I know we will have another hour for debate. The member will most likely address those concerns and possibly already has.

Looking at the bill, this would in fact bring a change to the Canada Health Act by adding a sixth principle in respect to linguistic duality. I will read a summary of the bill so that my constituents back home will know exactly what the bill does. It says:

This enactment amends the Canada Health Act so as to ensure that payment of the full cash contribution under the Canada Health and Social Transfer is subject to the obligation for each province to respect the principle of linguistic duality.

This is what the bill would do as we understand it.

If we look through some of the language in the bill, and the member could speak to this, perhaps it has to be tightened up. In my opinion it has to be made more doable.

We are all attempting to change the Canada Health Act and add new principles to it. I know as a party the Progressive Conservative Party has suggested that the sixth principle of the Canada health Act should be stable long term predictable funding. Then the provinces would know in fact how much money they would have to deliver health care across the country. The provinces have not had this.

The reason I point that out is because we know what the Prime Minister and the federal government recently went through with the provinces in terms of this last health care accord and the difficulty of achieving an accord that everyone could agree with. I am saying this because there are still some financial restraints on the system.

Some of the phrasing in the proposed section 12.1(a) of Bill C-202 that I am not comfortable with reads:

(a) as soon as possible, the province shall, in co-operation with the facilities of the province that offer insured health services, develop a program ensuring access to health services for members of the province's anglophone or francophone minority and, in so doing, shall take account of the human, material and financial resources of each facility--

And so on. That is the concern that I have.

It appears to me as if the provinces could use that as an escape clause for not achieving the objectives that the bill wants to achieve. In other words, the duality issue is contingent upon their financial resources.

If those financial resources are not there, and in some cases they are not, the province simply could look at the amendment to the Canada Health Act and say that the bill states that financial resources of each facility have to be taken into account in order to offer linguistic duality. My concern is that they could use that against the bill. Maybe the member could speak to that.

Finally, proposed section 12.1(c) of the bill states:

as soon as possible, the province shalltake action to ensure that the managementof any facility in the province that offersinsured health services is placed entirely inthe hands of members of the province’sanglophone or francophone minority, where the number of users from the anglophoneor francophone minority is sufficientto warrant that action.

I just want clarification on that. I guess we need to have a definition of that word “sufficient”, because again we do not want to have the ability for a province to opt out, which we often see if we do not have tightly worded legislation. This is another concern that should be raised.

In terms of what the member is trying to achieve with the bill, we do support it. We are encouraged by the bill. We want to see this type of legislation enacted and endorsed by all provinces. Our only thought, when we get into that final hour of debate on the bill, is that the member could flesh out some of these details so that the bill will survive the close scrutiny it will come under in each and every one of the provinces. We support the bill in principle. Maybe the member might have a minute to sum up on some of those points we have made.

[Alexa McDonough, NDP, Halifax, NS]

Madam Speaker, I want to say at the outset that I do not want to spend a lot of time speaking about where I and my party stand on the private member's bill that is before us.

Nobody ever suggested that it would be easy to build a modern, progressive, bilingual, multicultural Canada, but I think we have seen a couple of examples tonight of how at least two parties in this Parliament, the official opposition, the Alliance, and the Bloc, make it extremely difficult to achieve. I have to say I am always puzzled by that, knowing and respecting the fact that there are very stringent laws to protect and reinforce the French language, and understandably so in Quebec. It always surprises me that there is so little interest in the whole issue of how to ensure that francophones outside Quebec also have their language, one of Canada's two official languages, fully respected.

Similarly, I always find it depressing that so many Alliance members say, and I do not want to say this applies to everyone, to heck with French or either of the official languages if there are in fact other language needs. Let me say very clearly how important it is to be responsive to those other language needs and nothing in this bill in my view in any way is insensitive to that. We have to be clear about what we are dealing with here.

It is a pleasure for me to speak this evening to Bill C-202, An Act to amend the Canada Health Act (linguistic duality).

My colleague, the hon. member for Acadie—Bathurst, a proud Acadian and a proud francophone, has already spoken in the House on this subject. Tonight, it is a pleasure for me to congratulate and thank the hon. member for Ottawa—Vanier for having proposed such an important initiative for official language minority communities.

This bill includes an important component for official language minority communities, that being linguistic duality in health care services for Canadians.

In this respect, this bill proposes a sixth health care principle. This principle states that Canadian provinces must respect the principle of linguistic duality in health care delivery.

Currently, the Canada Health Act includes five principles that regulate the delivery of health care. These are public administration, comprehensiveness, universality, portability, and accessibility. It is true that these five principles are often sorely tested by the current crisis affecting Canadian health care institutions.

The proposal in the bill is based on the participation of the provinces, which would receive the full transfer payment amount for health in order to respect the principle of linguistic duality within medical institutions.

The provinces must also entrust the management of institutions providing health care to people belonging to the provincial francophone or anglophone minority, where the number of users of the establishment warrant this.

In short, we are talking about linguistic rights. Official language minority communities would have the right to be served in their own language.

The provision of quality care is not just about the ability of medical professionals to provide care, help and advice, but also about their ability to understand and be understood.

This application of the bill is very feasible. Two provinces, New Brunswick and Quebec, have already taken steps in this direction with regard to their health care delivery.

I remember what was said about this in the last Speech from the Throne. I am quoting Her Excellency the Governor General, Adrienne Clarkson.

Linguistic duality is at the heart of our collective identity—It will support the development of minority English- and French-speaking communities, and expand access to services in their language in areas such as health.

In June 2001, a study on access to health care services in French, commissioned by the Consultative Committee for French-Speaking Minority Communities and supported by Health Canada, was done by the Fédération des communautés francophones et acadienne du Canada.

This study looked at the importance to the effectiveness of certain types of care received of being able to use one's own language. There was considerable research confirming this. Moreover, this study found that anglophones' accessibility to health care is three to seven times greater than of francophones, which is all to the good.

However, much still needs to be done in order for official language minority communities to be able to receive health care services in their own language.

The right to health services in one of the minority languages is not a privilege, but a right that should be ingrained in the mentality of this government and the provinces.

A person should be able to first, obtain health care in his own language, second, understand the directions of a health care provider and third, fully understand the care he is receiving or should receive. None of this should require an uphill battle. Canadians say all the time that access to health care is their number one priority. In my view, the language of communication is a major component of access.

In conclusion, I would like all parliamentarians in this House to imagine being in a hospital where no one spoke or understood theirr language. I guarantee them, they would go through all sorts of emotions and realize that they might receive care without knowing what will be done to you or what exactly their ailment is. Definitely something to think about.

I can only wish one thing in finishing this speech and that is: long live this bill.

[Benoît Sauvageau, Bloc, Repentigny, QC]

Madame Speaker, I am torn—strong words maybe—by this speech, but at least I understand the reasons behind the bill presented by my friend and colleague, the member for Ottawa—Vanier, with whom I had the pleasure and honour to sit on the Standing Committee on Official Languages, along with other colleagues here.

I do not object to the messenger or the message per se, but I will go a little further. When the member for Ottawa—Vanier asks us to amend the Canada Health Act by adding a sixth principle, namely linguistic duality, the goal is noble. My colleague's purpose in introducing this bill is also justified and justifiable.

Where I have a slight problem is with the desired results. We want to offer communities that live in a minority situation—let us call a spade a spade—offer Francophone communities in Canada services in their language, where numbers warrant.

Is the member for Ottawa—Vanier's approach of amending the Canada Health Act to meet this objective of offering services in French to Francophones the right one? The bill would add the following after section 12:

12.1 In order to satisfy the criterion respecting linguistic duality,

(a) as soon as possible, the province shall, in co-operation with the facilities of the province that offer insured health services, develop a program ensuring access to health services for members of the province's anglophone or francophone minority and, in so doing, shall take account of the human, material and financial resources of each facility—

Already we have a problem and this is the reason for the Bloc Quebecois' main objection to this bill. It says “as soon as possible, the province shall, in co-operation with the facilities of the province—”

In fact, it is right. It is the province that must establish the priorities. It is the province which, under the Constitution, under the Health Act, provides services to clients, patients, individuals, and the public. It is up to the provinces to define this.

The bill says “—the province shall, in co-operation with the facilities of the province that offer insured health services—”. In fact, this is a provincial jurisdiction.

Even if we circumvented that, which would cause us no end of pangs, but if we did decided to go ahead anyway, supporting Bill C-202 even if this is a provincial area of jurisdiction, the excuses we used are also available to the provinces. They could tell us, “We are taking into account human, material and financial resources, in not providing access to services as stipulated in clause 12.1”.

I know that it would be fallacious, a misuse of the bill as presented to us, but unfortunately I think these would be the excuses the provinces would come up with. When there is reference to sufficient financial resources and we know that there is a problem everywhere in Canada with health care funding, it seems to me that they will throw the argument of insufficient financial resources back at us.

If I may, I will point out that this bill would be hard to implement in Quebec, not because we are any better than anyone else, nicer, better looking or whatever, but because we have already given some thought to this. I would have liked to have heard some comments on this.

We in Quebec enacted Bill 142 back in 1986—when, I believe, the hon. member for Lac-Saint-Louis was in cabinet—guaranteeing access to health services in English throughout Quebec.

Here is what I would propose to my colleague from Ottawa—Vanier: why do we not work together to promote interprovincial reciprocity agreements based on the principle of Bill 142, which Quebec enacted back in 1986, thereby respecting provincial jurisdictions and saying we merely want the reciprocity of what is the practice in Quebec?

If I wanted to make political hay with this—which I don't—I could draw a parallel with the Young Offenders Act and its implementation in Quebec. The desire was to make blanket changes, and this went over like a lead balloon in Quebec. It is not that we were opposed to preventing youth crime, that we had anything against virtue, or against young offenders, but merely that we had a different approach.

This bill affects me when it states that there will be blanket coverage. If we agree to that, first of all we would be recognizing the first five principles, which are not recognized in Quebec, although applied. If we are to recognize a sixth, we will have to recognize the first five. But what if a seventh, eighth or ninth were to appear later, what would we hear? “You agree with the first six, but not with the other three”. It is a sensitive issue.

In ten years, education might be a serious issue in Canada, it might be such a serious issue that the federal government may want to interfere in the area of education. If we accept it for health, because the situation is so serious, then we might accept it for the environment because it is also experiencing serious problems, just as we accepted for education. What jurisdictions will be left to the provinces? Will they have any areas of responsibility?

The goal my colleague, the member for Ottawa—Vanier, wants to attain is legitimate and worthwhile. We too want to attain this objective, which would allow French speaking communities to be served in their language.

What is Quebec doing, in concrete terms, to help? My colleague from New Brunswick is here. The University of Sherbrooke offers medical courses—he is a doctor, to boot—to students from New Brunswick so that francophones in that province can be served in their language.

There are interprovincial agreements. There is a willingness on Quebec's part. However, I do not think that the way to reach the objective of providing francophones with French language services is by adding a sixth principle. I think this approach sidesteps the problem.

It is perfectly legitimate to raise this for debate in order to propose another approach in the end, and I would like to invite my colleague to consider another approach.

For example, let me give him another suggestion. I was reading in his speech that he has waited five years to introduce his bill. It gives me no pleasure to tell him that we are against the bill, even though we espouse the principle that francophones should have more services in French.

However, I would propose another suggestion: Bill 142. There may be a few others that could apply here, but Bill 142 recognizes provincial jurisdiction. It recognizes that each province must provide, across its territory, services to minorities, in this case, in French.

It is important to remember that the Canada Health Act, created in 1984, has never been recognized. It is applied, but it has never been recognized in Quebec, because it intrudes into areas of provincial jurisdiction.

It is unfortunate to talk in political terms about an issue as sensitive as health, but we have to. I will remind the House that when the last two reports of the Commissioner of Official Languages were tabled, a journalist by the name of Elizabeth Thompson asked me the same question, “Do you want to subject transfers for health to the Official Languages Act?”

I can easily see a province like Saskatchewan, Manitoba or Alberta having its transfer payments in health cut, having problems with hospital waiting lists and so forth, even resulting in some deaths, and then being told that it is because they did not respect the Official Languages Act.

I think this is, I repeat, a sensitive subject, and simplistic solutions should not be provided for complex problems.

The committee is already looking at Part VII of the Official Languages Act. It could be very interesting to see how, in respecting provincial jurisdiction, francophone communities could be encouraged to obtain services.

If there is meddling in this area, I fear that, next, there will be meddling in the environment or education. It is unfortunately for this reason that we want to work to provide services, but in a different way that will, I hope, be as effective for those communities that are truly in dire straits as a result of the government's inaction.

[John Harvard, Liberal, Charleswood—St. James—Assiniboia, MB]

Madam Speaker, I am pleased to speak to Bill C-202 and I want to pay tribute to the member for Ottawa—Vanier, the sponsor of the bill. His work around the bill has been exemplary.

On behalf of all Manitobans I wish to express my support for Bill C-202 which would add the principle of respecting linguistic duality to the Canada Health Act of 1984. This sixth principle is a logical consequence of the Official Languages Act as it would ensure that the linguistic minorities of Manitoba would be entitled to health care services in the language of their choice, that is, English or French, the two official languages of Canada.

We forget too often that there are francophone communities west of Ontario. Some 45,000 francophones live in my home province of Manitoba. Saint Boniface is one of the largest French communities outside of Quebec. French communities in Manitoba are strong, well structured, and their contribution to the cultural, economic, and social development of our province is significant.

Since 1993 francophones in Manitoba have governed their own school board. The time has come to get the same rights in health care accessibility.

Health care in French is important for the preservation and promotion of Franco-Manitoban communities. Among the many arguments, a good communication between health care professionals and patients is absolutely essential. Many studies confirm the importance of the language in ensuring efficient health care service. Language related obstacles reduce accessibility to and the quality of health care.

The health care professional has to help, guide and advise patients. When communication is good, services are more efficient, there is no time wasted, results are better, and costs are reduced.

Francophones in Manitoba have been working hard for a number of years to ensure the delivery of quality health care and social services in French, but access is still very limited. When such services are offered, their capacity is restricted. The Government of Canada must respect its own constitutional obligations and support francophones by giving them quality of status and equal rights in the field of health care.

The Société franco-manitobaine, SFM, is the spokesgroup for Franco-Manitobans. In March 2002, a little less than a year ago, supported by nearly 50 francophone organizations, the SFM presented its view to the Romanow commission when it came to Winnipeg. The SFM asked Mr. Romanow to recommend to the government the addition of a sixth principle to the Canada Health Act.

Francophones want to see their constitutional rights guaranteed when it comes to health in Manitoba. The Société franco-manitobaine was in complete agreement with the document produced by the Fédération des communautés francophones et acadienne du Canada, “Health in French: Towards improved access to health care services in French”.

Voting in favour of Bill C-202 would definitely be an advancement of rights for official language minority communities in Canada and it would be an excellent way for the Government of Canada to reaffirm its commitment to enhance the vitality and support the development of Canada's francophone and anglophone minorities as recommended by section 41 of the Official Languages Act.

I am delighted to support Bill C-202 and I recommend it to all members of the House.