Bill C-5 (Historical)

Public Health Agency of Canada Act

An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts

This enactment establishes the Public Health Agency of Canada to assist the Minister of Health in exercising or performing the Minister’s powers, duties and functions in relation to public health. It also provides that the Governor in Council may make regulations respecting the collection and management of public health information and the protection of confidential information, including personal information. It also makes related and consequential amendments to certain Acts.

Public Health Agency of Canada Act

[Réal Ménard, Bloc, Hochelaga, QC]

It has public transit and the Outgames, as the hon. member for Laval so rightly informed us.

It became apparent in Canada that the royalties system was not conducive to establishing a domestic research industry for bio-pharmaceuticals. At the time, this was a demand by the brand name drug industry, the one doing the research, which was mainly located in Montreal. The generic drug industry was copying in a way and not doing a whole lot of original research. These days I know that has changed somewhat.

I was the health critic. This was a good time in my life. It was stimulating and I had the pleasure of working on the same committee as the hon. member for Laval. We got up in the morning and saw each other in committee. Those were wonderful years in our lives—a great time in my life. All that to say that the brand name drug industry was originally located in Montreal and was calling for a properly protected public patent system.

The President of the Treasury Board was still just a baby then, but he will certainly remember that the Mulroney Conservatives had introduced Bill C-91, which was warmly received throughout Canada and Quebec and which, at the time, gave patent protection for 17 years. International rules have changed. This has increased to 20 years.

All that to say that when it comes to patents, epidemics or research, we understand that the federal government wants to intervene because this is their responsibility. However, when the federal government takes steps to intervene in matters of public health, there is a slight problem, a failure to respect jurisdictions. This is going too far and we would have liked members of the Conservative caucus from Quebec to rein in the government by telling it there are no prerogatives more sacred than health and education.

Just remember Maurice Lenoblet Duplessis, the illustrious member for Trois-Rivières. It is a tradition in Trois-Rivières to elect illustrious, talented members and I am here to say that this tradition continues. Maurice Lenoblet Duplessis set up the Tremblay Commission, which called for full respect of the jurisdictions of health and education.

Why did the federal government table a bill to create the Public Health Agency of Canada? I would like to point out that, for the past two budgets at least, there has been a considerable allocation of resources. I saw that the Public Health Agency of Canada was given $665 million in the 2004 budget and that its resources have been growing.

This is extremely troubling because, clearly, the Public Health Agency of Canada will want to do some nation building in the area of health care, as we all know. We in the Bloc Québécois are perceptive, astute and wise enough not to be fooled by the government's ploy.

I remember that in 1997, then Prime Minister Jean Chrétien, the member for Shawinigan, created the National Forum on Health. At that time, I was a young MP in this House, high-spirited, energetic and confident about the future. I told my caucus that the Liberals were going to use the forum to do some nation building and would barge into health care. I was not far off.

[An hon. member]

Not Jean Chrétien.

[Réal Ménard, Bloc, Hochelaga, QC]

I do not wish to call up bad memories for the House. However, it is a fact that it was Prime Minister Jean Chrétien who created the National Forum on Health—that he chaired himself— which allowed citizens from across Canada to have their say.

The idea to create the Romanow Commission stemmed from that forum. This commission of inquiry, which was not a royal commission of inquiry, no longer wanted there to be 10 health care systems. It recommended there be only one. It even went as far as proposing that there be a common procurement policy for drugs and a single order form, under the federal government's responsibility.

Health care is something that is highly visible. The Bloc Québécois cannot let the Conservative government get away with this. I hope that we can count on the vigilance of the President of the Treasury Board and that he will tell his government that health, particularly public health care, falls under provincial jurisdiction.

I salute the President of the Treasury Board, a progressive man in his caucus. I know that, in terms of ideology, he is a dove. Within the government, there are hawks, there are doves and there are night owls. However, I will not comment on that.

That said, Premier Charest—who lacks backbone somewhat when it comes to defending Quebec's interests—is a man who has sometimes been rather complacent about the Conservative government. Premier Charest used to be a Conservative MP. Once when this House was in committee of the whole, there were two Conservatives. Things have changed. That was the will of the people, and the Bloc Québécois respects democracy. Regarding the Public Health Agency of Canada—and I invite the President of the Treasury Board to pay attention—Premier Jean Charest, who was the member for Sherbrooke, said that Quebec had created its own health structures.

As I mentioned earlier, Quebec has the Institut national de santé publique. Quebec has created its own health structures, and they work. These structures will cooperate with the ones that are put in place, but duplication is out of the question.

That is the real question. How can we think that a public structure with a $665 million budget will not be tempted to dominate, to sprawl and to intervene in jurisdictions that are not its own?

I remember well the years when the Liberal government reduced health transfers and the provinces were in serious trouble.

One of the negative aspects of Canadian federalism is this sort of fiscal imbalance that can be created. The government can table a budget and cause fiscal destabilization of the provinces without any negotiations or any advance notice to the provinces.

From 1993 to 2001, successive Liberal governments completely starved the provinces. The provincial premiers—New Democrats, Conservatives, Liberals and people from the Parti Québécois—took a common stand and eventually won an agreement on health and restoration of the public money that the provinces had been cruelly deprived of.

As the leader of the government knows, the health system is critically short of money. This will be important, because initially, the federal government was to contribute 50% of program operating costs. Even with the agreement that the government of the current member for LaSalle—Émard signed with the provinces, the figure is not much higher than 25% or 30%.

As you can see, this situation is not acceptable. I hope the Conservative government will have the courage to table a bill shortly to restore the transfer payments.

I saw the Prime Minister yesterday on public television, for which all members of the Bloc Québécois have the greatest respect. I saw, on the CBC French network, that the Prime Minister wanted to flip flop on the issue of the fiscal imbalance and that he was preparing the provinces for the fact that the extent of the fiscal imbalance was not so bad, even though this Prime Minister had the nerve to go to Sainte-Foy during the election campaign and tell Quebeckers that his party would resolve the fiscal imbalance. And now that I see the Prime Minister getting ready to dither and go back on his word, I certainly hope I never have to rise in this House to say that the Prime Minister has broken his word and not made all the investments expected by Quebeckers, including the Premier of Quebec.

We saw yesterday on CBC French television how worried and anxious the Quebec Premier was that the Conservatives would not deliver the goods. It is at times like this that we realize how fortunate it is that the Bloc is here in this House and is vigilant. We will not abdicate our duty to be vigilant and to force the federal government to solve the fiscal imbalance problem. It is too easy for the Prime Minister to show up at Ste-Foy and make promises that he later disowns.

In short, Bill C-5 does not respect provincial jurisdiction and the creation of a public health agency is not necessary. As for epidemics, I will say that all the public health managers can have meetings. The expected cooperation could very well be coordinated through existing interprovincial mechanisms without creating a new structure with a $665 million budget.

The Quarantine Act already includes the necessary provisions. If ever the situation necessitates it, the federal government can invoke that legislation but we will not let the federal government do its nation building with the health issue. We will not let the Conservatives follow the tradition instituted by the Liberals, either. And I know that for the Conservatives the bible on health care is the Romanow report. We will not let the Conservative government invade Quebec's jurisdictions, particularly not jurisdictions as sacred as health and social services.

[The Acting Speaker, Royal Galipeau]

It being 1:30 p.m., the House will now proceed to the consideration of private members' business as listed on today's order paper.

At the next debate on Bill C-5, the hon. member will have 10 minutes remaining for questions and comments.

The House resumed from June 16 consideration of the motion that Bill C-5, An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts, be read the third time and passed.

[Diane Bourgeois, Bloc, Terrebonne—Blainville, QC]

Mr. Speaker, I would first note that I will be splitting my allotted time with the member for Berthier—Maskinongé.

Bill C-5 deals with the Public Health Agency of Canada. This bill is not something new. I would like to review its history. This bill was announced to us in December 2003 by the Liberal government, the previous government. In February 2004, that government said, in its Speech from the Throne, that it would be establishing what it said would be a modern public health system, by creating a public health agency that would ensure that Canada is linked, both nationally and globally, in a network for disease control and emergency response.

At that time, the agency was allocated $100 million to expand front-line public health services, as well as $300 million for new vaccination programs, $100 million to improve the surveillance system, and $165 million over two years for other federal public health initiatives.

Under the bill, the Public Health Agency was given the mandate of focusing on more effective efforts to prevent injuries and chronic diseases—like cancer and heart disease—and to prevent and respond to public health emergencies and infectious disease outbreaks. The Public Health Agency would also work closely with the provinces and territories to keep Canadians healthy and help reduce pressures on “our” health care system. This is how the text read at the time, in 2004, about the creation of this agency.

First, I want to say that Canada does not have a single health care system, and that this last statement clearly denied the unique aspects of the provinces’ health care systems, in particular the health care system of Quebec, which is solely responsible for managing health care within its borders. And so, at the time, when $100 million was made available to expand front-line services, there was a direct intrusion into areas under Quebec’s jurisdiction, because in Quebec, front-line health care is in fact provided by the CLSCs.

The agency was ultimately supposed to have the collaboration of six regional offices, one of them in Quebec. It was in November 2005 that the federal Liberal Health minister of the day tabled Bill C-75 creating this public health agency of Canada, a separate and autonomous agency which was granted immense powers. Fortunately, Bill C-75 died on the order paper when the election was called.

At that time, the Conservative government was against Bill C-75, because it was a Liberal initiative. Now the same bill is being tabled again, with a different name. Now it is numbered C-5. You will note that it is exactly the same bill.

It must be said that, in the beginning, the Liberal government took advantage of the fiscal imbalance—which it created itself—to increase its intrusions in the field of health, particularly through the use of its spending power. The Conservative government seems to be continuing down the same road. And yet, last April in Montreal, the Prime Minister boasted of his open federalism, his federalism of understanding, saying that open federalism was a kind of respect for the fields of provincial jurisdiction, while also providing a framework for the federal spending power.

One could create a list of the federal government’s intrusions in fields of provincial jurisdiction, going back many years.

Under the Constitution Act, 1867, health and social services fall under the exclusive jurisdiction of the provinces, including Quebec. Yet from as far back as 1919, Ottawa has been intervening increasingly in those sectors, even forcing Quebec and the provinces to comply with so-called national standards and objectives, despite the fact that the Constitution Act states that health is a field of provincial jurisdiction.

I will cite the various laws we have been presented with since 1919: first, the creation of the Department of Health; in 1957, passage of the Hospital Insurance and Diagnostic Services Act; in 1966, passage of the Medical Services Act; and in 1984, passage of the Canada Health Act.

The 1984 Canada Health Act is the most flagrant example of encroachment. It imposes conditions and criteria in respect of insured health services and extended health care services, which the provinces and territories must respect in order to receive the full financial contribution under the Canada health and social transfers. In other words, if the provinces want to receive transfers, they have to accept the Canada Health Act.

Quebec agrees with the principles of this law, but refuses to allow the federal government to impose national principles and standards on Quebeckers. This would amount to prohibiting Quebec from making its own choices, when health is exclusively within the jurisdiction of the provinces, and of Quebec.

In April 2005, the Minister of Health at the time even questioned one province about the status of private diagnostic clinics, threatening Quebec and the provinces with a reduction of their share of the Canadian health transfer if they did not comply with Ottawa’s wishes.

The Bloc Québécois will always protest the federal government’s attempts to interfere in the management of health care in Quebec. We have our organization, our way of doing things and providing our health care and social services and we feel that it should be respected.

Then Roy Romanow proposed the Health Council. The result was an agreement between Ottawa and the provinces in February 2003. This agreement guaranteed federal reinvestment in health on certain conditions. The problem in health is that the provinces have so little money—there have been so many cuts at the federal level—that the federal government, which has money, has taken on the right to invest in health when this is not its jurisdiction.

Then there was the Public Health Agency of Canada, which we are discussing this evening. Within this agency, the federal government continues to impose its priorities for the sake of pan-Canadian objectives that deny Quebec's distinct character. In spite of the lack of Canadian expertise in the area, Ottawa wishes to play the role of coordinator of the actions of the various health systems. Quebec, however, already has its own public health agency, and has had it since 1998. This agency is the Institut national de santé publique du Québec. Quebec does not need the federal agency, which will duplicate actions in this area unnecessarily.

Mr. Speaker, I see that you are telling me I do not have much time left, so I will conclude my speech.

It should also be mentioned that all Quebec governments have been opposed to these federal intrusions in Quebec’s areas of jurisdiction. We need only think of the governments of Maurice Duplessis, Daniel Johnson Sr., Robert Bourassa, Jacques Parizeau, Lucien Bouchard and lately Jean Charest.

I hope that my colleagues will understand and respect the position of Quebec by not giving this House the mandate to vote in favour of Bill C-5.

[Guy André, Bloc, Berthier—Maskinongé, QC]

Mr. Speaker, it is obviously a great pleasure for me to speak on Bill C-5, An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts.

As you know, this agency has been in operation since the fall of 2004, but there was no legislation giving it the powers and responsibilities that it currently exercises. Accordingly, the bill we are considering today proposes, finally, to give powers to the new Public Health Agency of Canada.

Like my colleague, I hope that the Conservative members who were elected in Quebec on a platform of respecting areas of jurisdiction will vote against this bill.

When the former Liberal government created the Public Health Agency of Canada, it assigned it the mandate of ensuring that Canada was connected at the national and global levels, in health matters, and that there was a network responsible for disease control and emergency response. As well, the federal agency has as its mission to focus on more effective efforts to prevent chronic diseases, like cancer and heart disease, prevent injuries, and respond to public health emergencies and infectious disease outbreaks, as well as providing for other federal public health initiatives.

Clearly, when the Liberals established the Public Health Agency of Canada, they were once again confirming that they did not respect Quebec’s difference, by interfering massively in an area under the jurisdiction of Quebec and the provinces. By creating this agency, the federal government is showing its arrogance with regard to the powers of Quebec and the provinces, and insolently denying the unique aspects of the health care system of Quebec, which is solely responsible for managing health care within its borders.

It is important to point out that while this was an initiative of the former Liberal government, the new Conservative government has decided to reintroduce the same bill. It is now number C-5. By bringing forward the same bill as the Liberals, the Conservative government shares the vision of the federal Liberal Party: Ottawa knows best, and Ottawa will impose that on the entire country.

Just as the Liberal government used the fiscal imbalance it had itself created, as my colleague from Terrebonne—Blainville was saying, to continue interfering in the jurisdictions of Quebec and the provinces by using its spending power, so the Conservative government now seems to be continuing that tactic for the same purposes.

This new government, however, claims in its speeches that it is practising open federalism that respects the jurisdictions of the provinces. It is not respecting Quebec when it brings forward a bill like this. The discrepancies between word and deed are glaringly obvious.

Plainly, and contrary to what it has said since it was elected, the Conservative government is not reluctant about invading areas under Quebec’s jurisdiction, like health. It is as intrusive as the Liberals. Since it is a more right-wing government, we might even be more worried by this.

In my opinion, Bill C-5 raises a number of concerns that explain why we oppose it.

Not only does it have an arrogant attitude towards Quebec and the provinces, but the federal government has created a new health structure. The Conservative government must know that since 1998, Quebec has had its own national public health institute, and it does not need a new federal agency. Since it was created, Quebec’s Institut national de santé publique has monitored pubic health trends, prepared prevention programs for the Quebec public and advised the Government of Quebec when the government is developing new health programs.

So it already does what the Public Health Agency of Canada is supposed to do under this bill.

The Bloc Québécois feels that since the Government of Quebec has the expertise and deals with the institutions in the health care system, it is the government that should determine the priorities and develop action plans in its own territory, making them compatible with the global objectives developed by the World Health Organization, for example.

For 20 years I worked in the health care system as a social worker. I was therefore able to see for myself all the skill and expertise that Quebec’s public health care system brings to preventing and dealing with epidemics, for example, through vaccination campaigns against meningitis, as we had a few years ago, in which the CLSCs did a tremendous job, or all the prevention and intervention programs developed by the CLSCs, community organizations and hospitals. We have the necessary health care expertise and do not need the federal government to interfere.

I saw that Quebec’s strategy was very effective and, most importantly, met the needs of Quebeckers. I do not think, therefore, that there is any need for this new agency. It will only duplicate what is already being done by Quebec and the provinces, in particular by the Institut national de la santé publique du Québec.

Instead of interfering in the jurisdictions of Quebec and the provinces, this new government should set as its priority the provision of adequate funding for health. Duplicating a system that already exists in Quebec is not the way to solve the central problem of our health care system, that is to say, under-funding.

If the federal government really wants to help improve our health care system, it should fix the fiscal imbalance instead and give Quebec and the provinces the means they need to develop and further improve the services they provide their populations in their areas of jurisdiction and ensure that, when it comes to health, their populations have the tools they need to deal with the new challenge facing public health care.

By its massive cuts to health transfers in the 1990s, the federal government endangered Quebec’s health care system. It is obvious that the cruel cuts to federal transfers helped destabilize the system because the Government of Quebec finds itself now in a financial situation that makes long-term planning very difficult.

Our health network in Quebec is under enormous pressure. Our aging population requires more and more hospital care, surgery, geriatric services and cancer services, not to mention home care provided by the CLSCs and proximal care provided by our community organizations. We need funding for our health network.

Instead of creating an agency that already exists in Quebec and can provide services tailored to Quebeckers' needs, despite underfunding problems, the federal government should quickly correct the fiscal imbalance so that the provinces can develop their respective networks to ensure that their citizens will be well served. The people in Quebec and the other provinces are entitled to health services, not duplicated programs and repeated interference.

[Diane Bourgeois, Bloc, Terrebonne—Blainville, QC]

Mr. Speaker, to start, I have a comment and then I will have a question.

My comment is that there are so many intrusions by the federal government into provincial jurisdictions that it has practically become a shameful disease. That is what it has come down to. That is my comment.

I would like to ask my colleague what is behind all this? Why does the federal government have to table Bill C-5 and what is the solution?

[Guy André, Bloc, Berthier—Maskinongé, QC]

Mr. Speaker, as a former colleague I have known for several years would have said, what we are talking about here is nation building.

I believe that, in order to justify its role and its existence, the federal government feels it must build the Canadian nation and create a system that, unfortunately, duplicates what is already in place. This is unfortunate for the people, because health care needs are enormous. We need all available resources to meet the people's needs. Neither our population nor our country can tolerate this duplication.

[The Acting Speaker, Andrew Scheer]

Is the House ready for the question?

[Some hon. members]

Question.

[The Acting Speaker, Andrew Scheer]

The question is on the motion. Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

No.

[The Acting Speaker, Andrew Scheer]

All those in favour of the motion will please say yea.

[Some hon. members]

Yea.