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

[Diane Finley, Conservative, Haldimand—Norfolk, ON]

moved that Bill C-5, An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts, be read the second time and referred to a committee.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I am pleased to rise in the House today to begin debate on Bill C-5, an act respecting the establishment of the Public Health Agency of Canada. I thank the Minister of Health for providing me with this opportunity.

As we indicated in our Speech from the Throne, this government is committed to building a better federation in which governments come together to help Canadians realize their full potential.

By taking action on things that make us healthy or sick, through public health the Government of Canada can help Canadians make meaningful gains in their health, yielding benefits for our health system and across our economy and society. This piece of legislation represents a critical step in the government's effort to promote and protect the health of Canadians.

As members may know, in 2003 the outbreak of severe acute respiratory syndrome, or SARS, launched an important discussion and debate about the state of public health in Canada. I am pleased to say that my minister was a leading voice in the protection of Canadians during that crisis. SARS provided a significant wake-up call to all governments on the need to renew and strengthen public health in Canada.

Two subsequent expert reports, one completed by Dr. David Naylor and the other by Senator Michael Kirby, pointed to the need to establish a federal focal point to address public health issues. Specific recommendations included the establishment of a Canadian public health agency and the appointment of a chief public health officer for Canada.

In response to the recommendations in the Dr. Naylor and Senator Kirby reports, the Public Health Agency of Canada was created through an order in council. However, the agency currently lacks parliamentary recognition in the form of its own enabling legislation. Unfortunately, the previous government did not have the legislation proceed advantageously through the House, but I am pleased that this government will ensure that the legislation is brought forward and passed.

These reports also emphasized that understanding, preventing and managing chronic and infectious diseases, as well as promoting good health, is the key to a healthier population and to reducing pressures on the acute health care system.

In terms of its links to health issues, promoting good health or preventing illness helps to contribute to the sustainability of health care. Most disability or death in Canada is caused by a few leading chronic diseases such as heart disease, cancer, respiratory illness and diabetes. International examples have shown that by placing a greater emphasis on disease prevention, Canada could help alleviate the pressures from these diseases on the health care system.

Providing a statutory foundation would give the agency and the chief public health officer parliamentary recognition and would allow the agency and its staff to assist the Minister of Health in the exercise of the minister's powers, duties and functions in relation to public health.

This legislation is but one example of this government's commitment to protecting and promoting the health of Canadians. The Public Health Agency of Canada spends over $500 million in programs and services that benefit the lives of Canadians each and every day. These appropriations reflect the government's recognition of the agency as a federal focal point for addressing public health issues, as recommended by the experts. It also reflects the important level of the federal government in the issues of public health.

With its roots in the federal constitutional authority for quarantine at our borders and in the 1918 influenza pandemic, there is a clear federal role in coordinating a response to infectious disease outbreaks. From the start, there has evolved a clear role in surveillance, research and knowledge sharing, which can be seen in our lab work at the National Microbiology Laboratory in Winnipeg, Canada's only level 4 lab. Naturally, as Manitoba MPs, we are very proud of the virology lab and look forward to its continued success.

Over the past century, Canadians have increasingly called upon the federal government to take action on health issues of national interest. Efforts have developed to address HIV and AIDS and chronic diseases like heart disease, cancer and diabetes, as well as programs and activities that support early childhood development, active aging and community action on health.

This government recognizes that in order to have an efficient public health system and to protect public health in Canada, we need to continue to foster collaborative relationships with the federal, provincial, territorial and municipal governments as well as international organizations and public health experts. This is an objective that is clearly set out in the preamble of Bill C-5.

It is also why Bill C-5 does not expand the existing federal activities relating to public health. Rather, it simply confirms our existing federal role and creates a statutory foundation for the agency. Further, it responds to provincial and territorial calls for a federal focal point with the appropriate authority and the capability to work with them in preparing for and addressing public health emergencies.

As the federal focal point, the agency is able to link into worldwide efforts in public health and with institutions such as the World Health Organization so we can ensure that best practices can be applied to Canadian settings.

Additionally, the agency worked with the provincial and territorial authorities to establish the Pan-Canadian Public Health Network as a forum for multilateral intergovernmental collaboration on public health issues that respects jurisdictional responsibilities in the areas of public health. The network includes representation from all jurisdictions and is led by a council of senior public health officials, which is currently co-chaired by the chief public health officer and the provincial medical health officer in B.C. Through the council, the network also provides policy advice through conferencing with the deputy minister of health on public health matters.

The network also includes expert groups that focus on key issues around health, such as communicable disease control, emergency preparedness and response, Canadian public health laboratory surveillance and information, injury prevention and control, and population health promotion. There is also a one-time limited task force on public health human resources.

The network represents a new way of federal-provincial-territorial collaboration on public health matters. By facilitating intergovernmental collaboration through the public health network, the agency is also able to develop and draw on scientific knowledge and expertise in order to provide the best public health advice to Canadians. As we can see, the federal government has a well established leadership role in public health, working in collaboration with the provinces, territories and other levels of government.

Moving forward with the legislation at this time reaffirms the federal government's commitment to public health and underscores the important role that the agency and the chief public health officer will play in supporting a strengthened public health system in Canada.

Let me now turn to the actual piece of legislation, which contains three major elements that collectively will help to protect and promote the health of Canadians.

First, the legislation establishes the agency as an entity separate from Health Canada but part of the health portfolio. In practice, this means that the Minister of Health will preside over the agency and will have management and direction of it. It also means that the agency will assist the minister in exercising or performing his or her ministerial powers, duties and functions in relation to public health as set out in the Department of Health Act.

Having a separate agency within the health portfolio will bring greater visibility and prominence to public health issues, while at the same time supporting policy coherence across the health sector. With the complexity of public health issues and growing public health threats, it is important that the agency be integrated as a key player in the federal system.

Further, the departmental type model will allow the agency to be part of and influence government-wide policy discussions. This is of particular importance to support effective federal efforts on key public health issues, such as pandemic preparedness. For example, the agency developed in collaboration with the provinces and territories Canada's pandemic influenza preparedness plan which is recognized by the World Health Organization as one of the most comprehensive in the world. This model will also ensure continued ministerial accountability with respect to public health issues.

The legislation also sets out the unique dual role for the chief public health officer. This dual role reflects the consensus of the Dr. Naylor and Senator Kirby reports and responds to strong expectations of the public health stakeholders and Canadians that the chief public health officer should be able to speak to Canadians on issues of public health.

What does the dual role imply? First, as deputy head of the agency, the chief public health officer will be accountable to the minister for the operation and management of the agency. In this respect the chief public health officer will be expected to advise the minister on public health matters, giving the federal lead on public health a very influential role in the policy making process. Second, the legislation also recognizes that the chief public health officer will be Canada's lead public health professional with demonstrated expertise and leadership in the field.

As such the chief public health officer will have the legislative authority to communicate directly with Canadians, provide them with information on public health matters and to prepare and publish reports on any public health issues. The legislation also requires the chief public health officer to submit to the minister for tabling in Parliament an annual report on the state of public health in Canada.

The legislation, by conferring on the chief public health officer the status of lead health professional, enhances the credibility and authority not only of the chief public health officer but also the Government of Canada more generally on public health issues. As an impartial credible voice on public health able to communicate directly with the public, the chief public health officer is a visible symbol of the federal government's commitment to protect and promote the health of Canadians.

The ability to collect, analyze, interpret, publish, distribute and protect public health information is critical in managing and controlling disease and preparing for and responding to public health emergencies. The SARS outbreak showed clearly the importance of government having not only accurate information but also the ability and the means to access that information.

That is why the legislation includes specific regulatory authorities for the collection, management and protection of health information, to ensure that the agency can receive the health information it needs to fulfill its mandate.

Specifically, the provisions provide the governor in council with a regulation-making power, to regulate, on the recommendation of the Minister of Health, the collection and management of information relating to public health, including personal information. The information gathered by the agency will continue to be subject to the Privacy Act. Moreover, regulations made by the governor in council on the recommendation of the minister may contain provisions dealing with the protection of confidential information, including personal information.

That information is necessary for the effective functioning of the public health system, which is a lesson we learned during the SARS outbreak and which needs to be addressed before any other health emergency, such as an influenza outbreak pandemic. In light of this possibility the health information provisions in the proposed legislation are crucial to give the agency a clear legal basis for the systematic monitoring and surveillance needed to anticipate, prepare for, and respond to such an emergency in a timely manner.

These provisions are also needed to provide assurances to the provinces and territories that they can lawfully share information with the federal government. With such provisions, provincial and territorial ministries will have the certainty and clarity to confidently share health information with the agency. Having this power in the legislation is also critical to ensure that the collection and protection of health information is done in a manner that respects the privacy rights protected by the Charter of Rights and Freedoms.

Rest assured that the information provisions in the legislation reflect the government's concern for protecting the personal health information of Canadians. As regulations are developed, we will ensure the privacy of Canadians is respected.

My colleagues and I support the legislation as it represents a critical piece in the ongoing improvements this government is making to strengthen Canada's public health system. By giving the agency its own enabling legislation and making the chief public health officer an independent critical voice for public health, the government will not only bring greater visibility to public health issues or threats facing Canadians, it will be taking a step to renew and strengthen the public health system as a whole.

It will support the agency as it continues to promote and protect the health of Canadians through leadership, partnership, innovation and action, just as it has been doing since its creation. Ultimately the legislation will give the Public Health Agency of Canada a sound legislative footing to assist the minister to protect and promote the health of Canadians. The agency is meeting, and will continue to meet, the challenges and critical responsibilities that have been given to it by the Government of Canada.

I have appreciated the opportunity to start the debate on behalf of the Minister of Health on this important piece of legislation.

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, there are some other points I will raise later, but the member said that the public health officer will speak directly to the people. Given that the public health officer is responsible actually to the minister, how would the member envision that direct communication with the public if indeed the responsibility is through the minister? I assume the information that goes to the public would therefore first go through the minister. Has there been a consideration of that position being more independent?

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, the legislation actually deals with that point. The role of the public health officer is very similar to that of a deputy minister, with the major exception that the chief public health officer would have the authority through the legislation to speak directly to the public.

The other issue the member may be interested in is the chief public health officer will also have the ability to provide a report to the House on public health issues that he or she feels are important to Canadians. Canadians will be very pleased to have an independent credible voice if and when, but hopefully never, a pandemic occurred. This is something that did not exist when there seemed to be a lot of confusion on how to respond to the SARS crisis.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, I would like to ask the Parliamentary Secretary to the Minister of Health whether the new agency, the Public Health Agency of Canada, has more powers? Its role and mission are quite broad. How will the department meet all the expectations and carry out the whole mission set for it now?

We know officials were transferred, because 1,400 public officials were transferred from Health Canada to the Public Health Agency. Now, there are 2,000 officials, because the agency is operating, as we know. We are simply discussing the legislation that will give it its powers, the bill before us today. I would like to ask the Parliamentary Secretary of the Minister of Health whether, with all the powers this bill will give it, it will have more employees? I would say the answer is yes, in order to meet the provisions of the legislation.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, it is important to understand that this is a machinery piece of legislation. The powers that this legislation would help streamline already exist under the mandate of the health minister. If we had more time I could explain it in more detail, but one way to look at it is it would be a different way of allocating responsibility to ensure that if a pandemic strikes, we would be able to act quickly as a nation, including the provinces.

It is unique in the sense that the chief public health officer would have the ability to speak directly to Canadians. The powers to which the member was referring already exist. There would be no extension of powers per se. The powers are already within the mandate of the minister.

[Olivia Chow, NDP, Trinity—Spadina, ON]

Mr. Speaker, Toronto was hit by SARS a few years ago. There was a great deal of concern at that time as to what kind of protocol there would be at the airports. There seems to be different practices in different airports and very little collection of central information. In Toronto not only is there Pearson International Airport but there is a tiny airport that wants to expand its flights from not just within Canada but also flights from elsewhere. It gives me great concern that we would have airports that have different protocols and that, in my reading of this bill, the public health officer would not seem to have any jurisdiction over such agencies as airports.

How would the member envision this bill trying to stop this loophole so that we would have a clear protocol that is mandated by the public health officer so that we could be safe and secure? Not that there would be another SARS crisis, but we really should have clearly demonstrated regulations and standards in airports. How would the bill deal with this issue?

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, the member is quite right that there was confusion when SARS hit. I am pleased to say that the current Minister of Health when he was the Ontario health minister showed a great deal of leadership at that time and received kudos from all parties and stakeholders for his leadership.

To answer the specific question, the Government of Canada already has significant powers in the event of an emergency under the Emergencies Act and the Emergency Preparedness Act. Combining those two acts with the quarantine powers in the new Quarantine Act which was passed in the last session of Parliament and with this current bill would deal with any foreseeable scenarios. One has to look at the bill in conjunction with the other three acts that I have mentioned.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Mr. Speaker, I would certainly agree with the parliamentary secretary when he said that there is not much point in having a chief public health officer unless that person is prepared to speak to Canadians on important matters. This is the case in the United States where the equivalent position, the Surgeon General, heads up many important public health campaigns, such as the movement to stop drinking during pregnancy because it leads to fetal alcohol syndrome.

Here in this country a motion regarding putting labels on all alcohol beverage containers has been languishing because of Liberal inaction. Conservative members supported that motion which was passed almost unanimously by Parliament. I would like to ask the member if he will indicate to Canadians, who are waiting desperately for action on this issue, that he is prepared to have all alcohol beverage containers contain the wording that the chief public health officer of Canada warns everyone to avoid drinking during pregnancy.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, the issue that the member raises is a serious one. As health critic in the last session, we spent a lot of time looking at this issue in the health committee. We have a crisis with fetal alcohol syndrome and other ailments pertaining to alcohol related matters deal.

The Public Health Agency of Canada may look at an issue like this in conjunction with Health Canada. Extensive consultation took place in the last session of Parliament. The intent of the member's question is excellent. We need to deal with this crisis of drinking while potentially carrying a future person. There are lots of social consequences to that.

If the member would like to bring suggestions to the health committee, the stakeholders or myself, I would be happy to address it. However, I think the discussion today is on the broader issue of trying to set the machinery in place, so that there is a mechanism to deal with issues such as the member has raised but also a worldwide pandemic. I think that was the seed that brought the legislation to where it is today. I hope that members in the House of Commons will support the legislation, so we can deal with the potential of a severe pandemic or other public health concerns.

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Speaker, first, I wish to congratulate our new Minister of Health on the introduction of Bill C-5 because I believe it is his first piece of legislation as a federal minister of the Crown.

This bill, which would establish the Public Health Agency of Canada with a legislative mandate, was introduced in the last Parliament. The agency itself was created more than two years ago by order in council and was supported in its initial stages and first growth period through budget allocations approved by Parliament. This bill solidifies the agency as an integral part of the Canadian health network.

I am sure Canada's new Minister of Health, the member for Parry Sound--Muskoka, did not require much persuasion to introduce this bill. As Ontario's minister of health during the SARS crisis, he experienced both the need for and the desirability of a federal source of support, federal lab based scientific information, a federal communications capability, and federal international contacts. His own experience would lead him to a true appreciation of the Public Health Agency of Canada.

I am also sure the minister would want me to commend the former minister of public health, the member for St. Paul's, for her leadership on this file over the last couple of years. Her leadership gave birth to the Public Health Agency of Canada and that leadership nurtured it along to where it is today.

At this time I would also like to thank Dr. Butler-Jones for his dedication as the Chief Medical Officer of Health Canada and essentially the captain of the team of public health professionals at the agency.

As Canadians worry about new and frightening communicable diseases like SARS, the potential bird flu and others not yet identified, they can be encouraged by the capabilities of the Public Health Agency of Canada. Bill C-5 deserves the support of this House because our agency deserves to be secured for the future by an act of Parliament.

For many years Canadians have been concerned about the state of the health care system. They ask if it will accommodate them when they get sick and need care, and that is a legitimate question. A reading of history shows that public health measures have improved more people's health over time than any amount of care given after they have fallen ill. Clean water, sewage treatment and mass immunization projects, for example, have prevented more illness and death than anything else.

Let us pass this bill quickly, so that we can all focus on the public health challenges that face us. For example, we are witnessing a resurgence of tuberculosis with a local outbreak in the constituency of Churchill, Manitoba. Last week, officials from the affected community were unable to meet with those responsible at Health Canada and were shuffled off to officials at the Department of Indian Affairs who have no jurisdiction over health. I am totally confident that our new Minister of Health will attend to this matter quickly.

There is a deep concern in the north about the imminent arrival of so many outsiders, for example, workers for the Mackenzie Valley pipeline project and apparently about 2,500 members of the armed forces. People are particularly concerned about sexually transmitted diseases and some are actually referring to the pipeline as the new AIDS highway. It seems to me that we need to develop quickly a new set of public health strategies to prepare for this influx of people and to protect an already vulnerable indigenous population.

With the extreme weather events of the past few years, we have seen catastrophes like Katrina imperil people's health and even their lives. In addition to weather events, some people in B.C., for example, live on a fault line which could give rise to a serious earthquake. Apparently, hundreds of schools in B.C. are not built to earthquake standards. All these phenomena give rise to public health concerns. This House needs to be reassured that plans and resources are regularly updated to protect the health of Canadians.

Recently, some physicians have suggested that the biggest threat to the long term health and well-being of Canadians is the developing epidemic of obesity. This House will want to know what the minister is planning a response to this newly identified threat.

In addition, prescription drug therapy is increasing. Use has increased 47% in the last seven years. In 2004 there were 375,000 prescriptions from retail pharmacies alone, not to mention prescriptions dispensed within hospitals and other institutions.

The good news is that drug therapy is often replacing surgery and expensive hospital stays as the therapy of choice. The bad news is that adverse reactions to prescription drugs are estimated to represent about 30% of admissions to hospital, and that does not even take into account adverse reactions experienced by patients already in hospital.

We have experienced Vioxx, Celebrex and Propulsid and know of deaths based upon these drugs. It is becoming a fact that the sheer size of the population involved in the ingestion or injection of prescription drugs propels the clinical trials and the eventual approval of these drugs into an issue that could be considered as public health.

I support the establishment of the Public Health Agency of Canada, but I am also anxious to move beyond Bill C-5 in order to address some of the very real threats to public health that are emerging in Canada every day.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I would like to thank the member for her comments and support for the bill. The member spoke about bringing the bill forward and hopefully getting it through the House quickly. I am obviously very supportive of that as well.

I would like to ask the member, why did the previous government not act on this legislation earlier? It was two years in order in council and the legislation was tabled for first reading in November of last year. It did not even make it to second reading. This makes one question the commitment of the previous government to the Public Health Agency of Canada given that it had potentially up to 13 years to implement it and certainly five years after SARS.

Could the member tell us why it took so long for the previous government to even table the legislation?

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Speaker, the member opposite is questioning the commitment of the previous government to the agency and its work. In this place, it seems to me that the best way to measure commitment is to count the dollars that flow to ensure something happens.

The agency was created by order in council, but it was fully supported each step of the way. In other words, somebody was hired first to set it up and that somebody had to find space, and then rent that space or renovate it. That someone begins to hire staff. The agency did not appear out of thin air as a fully functional entity.

Therefore, there was some time between the actual creation of it by order in council and the assignment of moneys to it in ever increasing amounts to the point where there was an appropriateness for having a bill.

As far as the bill not getting past second reading, I would look to the member opposite and his party who voted against the government and brought down the House. Had his party not done this, the previous government would have delivered this bill.

Bill C-5 is exactly the same, word for word, as the earlier bill. I do not mind that. I am enthusiastic about what I hear from the other side in the same manner as the government seems to be so enthusiastic about its bill on bridges and tunnels, which is another identical bill. The government was so enthusiastic that about 10 of its members rose and sang its praises. Liberal bills are proving to be quite valuable. I appreciate the support members of the new government are giving them.

[Olivia Chow, NDP, Trinity—Spadina, ON]

Mr. Speaker, the former Liberal government certainly talked a lot about public health and the former health minister talked a lot about giving all grade 3 kids the opportunity to learn to swim so they would not drown.

We also heard a lot of talk about childhood obesity and the need to ensure there were programs in the schools to teach young children to know what kind of healthy food they should be eating and to ensure this food was accessible in schools.

We heard a lot of talk about cancer prevention but I saw nothing over the last few years in the way of a public health funding commitment in this area, funding that is desperately needed.

Clause 20 of the bill mentions an annual report. Aside from an annual report and some regulation capacity, what does the hon. member see in the bill that could give us hope that we would finally see some funding, whether it is for a food program in schools or helping kids to learn how to swim so there are no drownings, all of which has been talked about by many public health officials and the former minister of health?

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Speaker, I am encouraged by the interest the new member for Trinity--Spadina has shown in all these public health measures which she described and which the former minister did mention in some of her speeches.

However, learning to swim is usually the purview of the YMCA or the municipal government. Public health obesity programs are usually decided upon by more local authorities and even food programs in schools are usually not the purview of the federal government.

However I can understand the member's interest in those things because it represents activities of the level of government from which she came to this place. In fact, the role of the federal government, which is to transfer money to the provinces for those kinds of measures, both public health measures and health care measures, is our responsibility. The public health agency creates a framework for coordination and action, as described by the parliamentary secretary.

However we do not spend a lot of time in this place debating food programs in schools or learn to swim programs.

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, perhaps if we spent more time in the House debating food programs we would have fewer children in this country going to bed hungry every night and perhaps it would bring us a little closer to what is really happening in the homes on the streets that we live in all of our cities and towns.

The member who brought forth the bill has referred to this as a machinery bill. I understand the point that he is making. It is a mechanical bill to pull pieces together. However that does not in any way mean that it is not a bill that can show vision. It can be a machinery bill and show vision for the people of Canada about their public health agency.

I did not find much reference to interdisciplinary work with other ministries. If, for instance, tomorrow morning there were a nuclear spill, where in the bill does it say what ministries would take responsibility or how they would coordinate their responsibilities? Surely a number of ministries would have very significant life saving responsibilities in such a tragedy but I see no reference for the agency to be working cross government with other departments.

I was hoping that perhaps the member could either refer me to the part of the bill that I might have missed or explain to me how that could happen.

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Speaker, I was very interested in the member's comments about the need for vision. It was exactly that need for vision and the need for across the department coordination that led the last Liberal government to establish a new department called the Department of Emergency Preparedness and Public Safety because all these things have to do with public safety. In any such event as a nuclear accident or some such thing, it would be that minister and that department that would lead, and then all relevant departments would participate, the public health agency being one of those, and meetings would be convened with that set of ministers to each take on their own roles in solving the problem and guaranteeing public safety.

I take as a compliment her idea of this coordination and cooperation in a horizontal way, but I can assure her that one department would be in charge and one minister and that would be the minister of public safety and emergency preparedness.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, as the new critic for health, I join today's debate with interest. The bill proposes legislation that will give the new Public Health Agency of Canada all its powers. It is currently operating, but no legislation has yet given it its powers and responsibilities.

It must be noted that this is a bill that comes from the Liberal government. In February 2004, the creation of a public health agency was announced. The new agency was to ensure that Canada was well connected at the national and international level in health matters and that there was a network responsible for monitoring diseases and responding in an emergency. A budget of $404 million was attached to it. The Public Health Agency of Canada was under the responsibility of the Department of Health, and so $404 million of Health Canada’s budget was allocated to the new Public Health Agency of Canada. A further $665 million has been added to that budget. So the budget was increased. Employees who worked at Health Canada were transferred to the new Public Health Agency of Canada. It started with 1,400 employees. If I am wrong, I would appreciate someone correcting me. This new agency is operating at present, and there are now 2,000 employees working in the Public Health Agency of Canada.

The total budget is broken down as follows: $100 million to improve public health; $300 million for new vaccination programs; $100 million to improve the surveillance system; and $165 million spread over two years for other federal initiatives. That last point is cause for concern. What does that mean, “federal initiatives”? We do not have enough information to discuss this new $165 million that will be spent on new federal initiatives.

There is also a plan to develop strategies with the provinces and territories. This new Public Health Agency of Canada will have six regional offices, including one in Quebec City.

The new Bill C-5 that we are discussing today is an extension of the defunct Bill C-75, which was introduced on November 16, 2005. It also allowed the government to provide minimal details about the agency’s obligations, including submitting an annual report to this House. The new director of this new agency, the Chief Public Health Officer, will also have to report to Parliament in an annual report. The intention was to clarify the agency's mandate and obligations.

The bill also explained the reasoning behind the new agency. The idea was to have an autonomous body in an area that would no longer come under the government. The new agency is therefore much more autonomous. It comes under the authority of the Minister of Health, naturally, but it is separate from the government. The idea was to grant certain powers with regard to quarantine.

The same spirit underlying Bill C-75 is now found in Bill C-5. The Bloc Québécois finds it a bit suspicious that the new Conservative government is able to approve such a bill. I could quote the new Prime Minister and the Minister of Health. They said that there should be no more intrusions into areas of provincial jurisdiction and no further use of the provinces' spending authority. The Prime Minister made big promises in Montreal in front of the business community.

Yet he is able to agree to a bill that the Bloc Québécois feels will allow still more intrusions into areas of provincial jurisdiction.

The Minister of Health also made this promise. He said that respecting the provinces meant respecting areas of provincial jurisdiction and providing a framework for spending authority. The Minister of Health will not necessarily respect provincial jurisdiction. He even said that respecting provincial jurisdiction meant taking a bit more time to act. The Bloc Québécois would have liked it if the new government had taken the time to really analyse the impact on the provinces. We know that there is an act--

[The Deputy Speaker, Bill Blaikie]

I am sorry to interrupt the hon. member, but her time is up.

Pursuant to order made Thursday, April 27, 2006, the House shall now resolve itself into committee of the whole to consider Government Business No. 5.

I do now leave the chair for the House to go into committee of the whole.

The House resumed from May 1 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 now read the second time and referred to committee.

[The Speaker, Peter Milliken]

The last time this bill came before the House, the hon. member for Québec had the floor. She has 14 minutes left to finish her speech.

The hon. member for Québec.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, you are more generous this morning than you were during question period. You are giving me 14 minutes to talk about health. This is far too little, but I will take advantage of it anyway.

Yesterday I talked about the new bill for six minutes. Legally, it will give all powers to the new agency. To be sure, the agency is already operating.

Bill C-5 is a carbon copy of the Liberals' old Bill C-75, which died on the Order Paper. The Conservative Party has brought back to the table legislation to create a public health agency.

Yesterday I said that this bill will encroach on provincial jurisdiction. I would also like to remind the Parliamentary Secretary to the Minister of Health about the preamble to the bill, and to explain why the Bloc Québécois is concerned about certain prerogatives the government will continue to take advantage of in all health sectors. Allow me to read the preamble.

Whereas:

the Government of Canada wishes to take public health measures, including measures relating to health protection and promotion, population health assessment, health surveillance, disease and injury prevention, and public health emergency preparedness and response;

Whereas the Government of Canada wishes to foster collaboration within the field of public health and to coordinate federal policies and programs in the area of public health—

Whereas the Government of Canada also wishes to foster cooperation in that field with foreign governments and international organizations, as well as other interested persons or organizations—

This is the reason for the Bloc's concern about the mandate they will give to the Public Health Agency of Canada. It used to report to Health Canada. It used to be a branch within Health Canada reporting to the minister.

We see here the potential for infringement on provincial jurisdictions. In addition, we are well aware of the government's long tradition of infringing in health care. I would point out that some of the federal government's intrusions date back to the 1930s and it was clear then how the federal government infringed on provincial jurisdictions.

I will not go back that far, because I would need more than 14 minutes to set out the long list of intrusions. However, under subsections 92.7 and 92.16 of the Constitution Act, 1867, the sectors of health and social services are under the exclusive jurisdiction of Quebec and the provinces. Since 1919, Ottawa has increasingly intervened in them, going so far as to oblige Quebec and the provinces to meet so-called national standards and objectives.

Such is the attitude behind this legislation giving the Public Health Agency of Canada powers to invade provincial areas of jurisdiction through federal government initiatives in health sectors. The Constitution gives it jurisdiction over the health of the first nations and veterans. These are a couple of exceptions where there is no infringement.

The Constitution is not clear as to infringement in other provinces. It is based on more than just spending power, which is what has allowed the federal government to increase its major interventions.

The federal government first created the health department in 1919. In 1957, it adopted the Hospital Insurance and Diagnostic Services Act , in 1966, it adopted the Medical Care Act and in 1984, it adopted the Canada Health Act.

That act imposes conditions and criteria in respect of insured health services and extended health care services. Although we agree with those principles in the act, because Quebec applies them, we reject the federal government’s desire to interfere in the management of health care in Quebec.

If the other provinces want to do it, it is up to them to decide, but Quebec already has its networks, its way of doing things, and it also has health and social services institutions that meet the needs and that are under the authority of the Minister of Health of Quebec.

In Quebec, we have already established our own Conseil de la santé et du bien-être. It was not involved in the development of the new health council of Canada .

With the Public Health Agency of Canada, the Conservative Party continues to infringe on the jurisdictions of the provinces. We are a little disappointed with this. Some Conservative Party leaders, starting with the Prime Minister and including the Minister of Health, said that they were going to respect the jurisdictions of the provinces. This is a very bad start. They have adopted a Liberal initiative and made it a Conservative initiative, and it is an infringement on the jurisdictions of the provinces.

The mandate of the new agency is to take direct action in relation to health. It will focus on more effective efforts to prevent injuries and chronic diseases, like cancer and heart disease, and respond to public health emergencies and infectious disease outbreaks. It is clear why we are concerned and why we are not enthusiastic about this bill. If we had been told that more money was going to be allocated for health or, for example, that information was going to be exchanged to meet the needs that arose in a pandemic, we would have applauded.

I think that is going too far and that powers are being usurped that clearly do not belong to the federal Parliament. No health care institutions are managed here. And now we want to get involved in managing hospitals and issuing directives, rules or guidelines. That is more or less what the Liberals did; it is what the Conservative Party is now going to do.

The federal government covers one-quarter of total health care expenditures by Quebec and the provinces. At the same time, it wants to manage the entire strategy. This is not empty rhetoric that is based only on hearsay. Documents that I have in hand confirm the mandate, role and mission of the agency. That is what I challenged first. On the long list of infringements, I have seen information concerning the health care institutions that are now under the authority of Parliament.

We are therefore very concerned and we will have to debate this bill in committee. We will be hearing a variety of witnesses. They will probably tell us to add some qualifications to this bill. In our opinion, it goes too far. It creates a new public health agency that will be autonomous and therefore no longer part of the federal bureaucracy.

We know that Quebec has adopted traditional positions. This does not just come from the Bloc. These positions can be traced back to several governments. Maurice Duplessis also said that health was the exclusive jurisdiction of the provinces. The government of Daniel Johnson Sr. argued that everything that came under the heading of health was provincial jurisdiction.

This public health agency goes very far. In this bill, there is some openness with respect to certain illnesses, such as diabetes or some chronic illnesses, where a certain amount of control could be exercised. However, it goes much too far.

A third government, that of Robert Bourassa, also fought to stop the federal government's propensity to invade provincial jurisdictions. Jacques Parizeau's government often had to stand up to the federal government, which wished to take over certain responsibilities given to Quebec by the Constitution and entrenched in the legislation. Lucien Bouchard's government did the same. The Quebec government is asking that Ottawa transfer, unconditionally, the fair share of taxes sent by Quebeckers to Ottawa.

We are speaking about fiscal imbalance but we should now consider the matter of health.

This is going to create an enormous bureaucracy, as I will show in just a moment. Public servants will be released from Health Canada and assigned to the new agency. However, there probably will not be enough of them to carry out all the directives of this new agency.

Thus, the goal of this new bill is to limit the exercise of exclusive jurisdictions in the area of health care. I believe the government is heading in the same direction as it has with other measures.

I would also remind the House that the new premier of Quebec, Jean Charest, is also willing to cooperate with the federal government, as long as there is no duplication.

This new bill will provide a legislative framework for the new structure. This framework will authorize this new agency to encroach upon areas of jurisdiction that belong to the provinces.

Quebec already has all of these institutions. I will not list them all here today. Rather, I will speak briefly about the Institut national de santé publique du Québec. It costs Quebec $37 million and has a very specific mandate, of which I will quote a few lines.

Here is its vision:

The objective of the Institut national de santé publique du Québec is to be the centre of expertise and referral in matters of public health in Quebec. Its goal is to advance knowledge and propose strategies and interdisciplinary action for improving the health and well-being of the general population.

Here is its mission:

To support the Ministère de la Santé et des Services sociaux, regional public health authorities and institutions in executing their responsibilities, by offering its expertise and specialized laboratory and screening services.

This is more or less what the Public Health Agency of Canada aims to do: develop pan-Canadian strategies, at the expense of some strategies that Quebec has put in place with $37 million out of its budget. Why not give the provinces more money so that they can develop their own strategies and pool their expertise? This is not what the government means to do in establishing a legislative framework for the Public Health Agency of Canada. It goes much further than that.

The new Public Health Agency of Canada will have the following components. There will be a chronic disease prevention and control centre. As for the agency's main activities and programs, there will be programs on risk factors common to chronic diseases, poor nutrition, physical inactivity and unhealthy weight. There will also be programs on specific diseases and problems associated with certain diseases, such as cancer risk factors and screening, as well as programs on mental health and the Canadian diabetes strategy. In addition, there will be prevention and contribution programs, even programs to combat obesity.

We are really concerned about this. I could name even more programs. The goal is health promotion, so the idea is to develop integrated strategies. That is one mission of the Public Health Agency of Canada.

Before I conclude, I am wondering about one thing. I have here a Treasury Board document about full-time equivalents. The Public Health Agency of Canada currently has 2,000 employees to manage its broad mission. Of this number, 1,714 are assigned to first nations and Inuit health. In my opinion, 2,000 employees is not enough. In a few years we will have a huge bureaucracy. The health sector has received an infusion of money because it lacked funding for 10 years. The reverse could also be true: in 10 years, maybe there will be no more money for the provinces because the government will have invested too much in bureaucracy.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I think the member may have a misunderstood. The agency does not create new powers, as the member has suggested. It is a re-allotment of powers that already exist under the Minister of Health.

The member talked about the agency being autonomous. The agency is not autonomous. Employees will continue to be public servants and there will be accountability through the Minister of Health.

The member talked about jurisdictional issues. Although I agree that the provinces have jurisdiction over health, and the Conservative Party is certainly very sensitive to that, there are some jurisdictional areas where everyone in Canada can benefit by working together. The Public Health Agency of Canada is designed to deal with such cases. For example, if there were, heaven forbid, a pandemic influenza we would need to have a coordinated effort throughout Canada to deal with the issue. In fact, we would need a coordinated effort throughout the world.

As we saw with SARS, it started in Asia, went through the vast transportation systems that now exist and came to Canada. Influenza knows no boundaries or borders and we need to be able to deal with it. If we extend the logic of the member, there would be no coordinated plan within Canada. The Public Health Agency has developed the framework for a coordinated effort, plus it provides an authoritative voice that is not political and has expertise to deal with public concerns.

The preamble of Bill C-5 enforces the collaborative efforts between provinces, territories and the federal government. Does the member honestly believe that a 1918 influenza or another type of disease, such as SARS, is only restricted by borders? Does the member not agree that we need to have a coordinated effort? If the member disagrees, I would respect her opinion, but the government would disagree with that opinion because we believe we need to work together for the collective good.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, we have heard about the influenza problem and SARS. But the issue is bigger than that. We are not against the exchange of information. But the creation of the Public Health Agency of Canada will only increase the observation of certain diseases. The integrated strategy is more a matter of cancer, mental health and the Canadian Diabetes Strategy than influenza and SARS. This is what the prerogatives of the new Public Health Agency of Canada say. That is not what we are talking about this morning. We are talking rather about the broader view with respect to the new responsibilities. I know that Health Canada was supervising all that. All the integrated strategies have been added to that.

This bill also worries certain players in the health field. They want to know what sort of openness will be demonstrated regarding strategies against cancer, and in favour of mental health and improved quality of life.

Yesterday, an NDP member asked a Liberal colleague a question about a physical activity strategy. I do not think this question was off topic. I have read all the responsibilities that will be vested in the Public Health Agency of Canada to improve quality of life. These responsibilities include a social dimension. That is what it is all about.

Quebec already has such institutions. I wish to clarify what I said a while ago. It is the Institut national de santé publique du Québec that monitors the development of every disease. It has its own programs and works together with various institutions. All these networks in Quebec are among the partners of the federal government that will take part in the thinking process.

I know that the parliamentary secretary will be receptive to the figures I am going to quote. It is said that the Agency employs 2,000 public servants, including 1,202 from Health Canada. I do not know where the others come from. In all, 2,000 public servants will manage all the operations of this Public Health Agency of Canada. However, 1,614 public servants were assigned full time to improve the health of the first nations and the Inuit, and it has been a fiasco. They have been unable to stick to the program and be proactive in order to improve aboriginal health and quality of life. How are they going to manage to do as much for all Canadians with 2,000 public servants?

One may well wonder about the bureaucracy that might get out of control and eat up the budgets. Already $1 billion has been allocated to the Public Health Agency of Canada to implement all these actions.

There is plenty to think about. I am very eager for this bill to be referred to committee so that representatives of the health networks and the various governments concerned can be questioned. We will have to see whether it is possible not to perceive this bill as a huge non-functional bureaucracy that will have a hard time achieving the expected results.

My colleague talks about influenza. It is true we are very worried about it. Moreover, the government should be worried about the diseases that cross our borders. Still, as far as crisis management is concerned, each province should be able to make its contribution. We should do so, however, in some way other than this.

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, I rise today to speak to Bill C-5. I appreciate the opportunity to raise some points that I know that we will debate further in committee. In point of fact, there are parts of the bill that I think do not go far enough as opposed to going too far. I will be anxious to have that debate in committee so that we can see if those points we are talking about are synergistic with each other.

Canadians want and need to believe that their public health system can and will do absolutely everything it can to protect them and their loved ones from the kinds of tragic illnesses and tragic disasters that we think of when we think of public health agencies. Canadians want and need to know that and to know that their families will be safe.

When we look at the five components of public health, those mentioned by other members, disease and injury prevention, health promotion, health protection, health surveillance and population health assessment, I think there are some things that the bill has captured and I think there are some things on which the bill does not go far enough.

We have seen in recent years what happens when the confidence in a public health agency is shaken. During the SARS epidemic, which I know the Minister of Health has first-hand knowledge of, people in the greater Toronto area in particular were frightened for their lives. Their belief in this public health system was shaken to its very core. They did not believe that the public health system knew how to manage or was learning quickly enough and sharing that information across the country. Their faith indeed was shaken to the core.

I think more people died from SARS in the greater Toronto area than anywhere outside of Asia, if the information I have is correct. That is very frightening. At that time I talked to relatives and friends in Toronto. People did not send their children to school. They did not go to work. They were afraid to go outside their homes for fear of what was happening. On television, they saw people wearing masks, not that those masks indeed made a difference in the end, and we knew that. They were going to Home Depot or other stores buying up boxes and boxes of masks and shipping them back to Asia, hoping that it would help their relatives there, and they themselves were wearing the masks here. It was done out of fear.

Likely it was wasted money because it was not the kind of prevention that was at all successful, but it was done because people were so frightened and did not believe the health agency could cope with it. They were grasping for any straw that they thought would help keep them safe. We cannot ever see that kind of chaos in the system, where people do not believe there is leadership that will tell them what things to do to be able to stay safe.

I know that as a result of SARS there were submissions. There was the Naylor report and I know the Kirby report referenced this, but I also know that over the last number of years there have been officials of health agencies who have been warning that public health in Canada has many gaping holes that have not been filled and may put people at risk.

SARS was clearly the catalyst for the reports being done. By the way, the results quite matched, I think, and made recommendations for many of the same things, but it was not the first time that the government, primarily the former Liberal government, had heard that there were problems within public health and that indeed they had not been acted upon in the 13 years of the Liberal government. I think there is very good work being done at the municipal, provincial and federal levels around public health, emergency preparedness and a number of issues that the bill speaks to. That means there is a far greater awareness and people are working hard to make sure this does not happen again.

I give full kudos to everybody who not only has raised awareness but is working to bring people together to plan what happens when there is some kind of natural or unnatural emergency or disaster, but I think there are steps that would help this bill, since we have this first opportunity here, to show perhaps a bit more vision. I know it has been referred to as a “machinery” bill. I think there are other pieces that could cause this bill to show a bit more vision for Canada in terms of where the Public Health Agency is going. There probably are about five areas of concern that I would want to mention.

One of these areas of concern is the powers of the Chief Public Health Officer. The previous speaker spoke of these powers. I am probably going to take a different position on this, but it is clearly a point that needs to be debated. As for the powers of the public health officer, and I gather it will be the current person should the bill pass, in the bill the individual does not have authority over areas of federal jurisdiction such as airports, railways, military bases, et cetera. Why not? I think it is important that this individual has total responsibility for those clear areas. Planes do not change a protocol if they fly between Manitoba and Ontario. Trains do not change health protocols if they go from Alberta to British Columbia. There must be national standards of public health around transportation, support to aboriginal people, which again is a federal responsibility, and military bases as well.

Second, the Chief Public Health Officer is not given authority to act, which speaks to the previous speaker's point, when a province or territory is overwhelmed by a crisis or when that crisis transcends provinces. Again, bacteria, germs, SARS and avian flu, should it mutate, are not going to look at a map of Canada and say they cannot go there because there is a border. That is nonsense. Therefore, there must be an ability for the Public Health Agency and the Chief Public Health Officer to have that authority to cross all borders when that is necessary. Otherwise, we are going to put the public health concerns of Canada at risk if this cannot transcend geographical borders.

I want to speak to the issue of health protection for a moment as it relates to quarantine. In this bill, the Minister of Health is the person who is responsible for declaring a state of quarantine. In provinces, it is the public health officers who are responsible for declaring a state of quarantine. So why, at a federal level, would the Chief Public Health Officer not be the person who would, based on academic information and scientific research, be responsible for declaring quarantine? Why should it be the Minister of Health? That is a point we need to talk about and debate in committee. I am sure we will have that opportunity, but that is a disconnect between what happens in the provinces and what happens federally. I believe that it should be the Chief Public Health Officer.

I would like to talk a bit about House surveillance and population risk assessment. There is no mandatory requirement for the provinces and territories to report to the federal government any communicable diseases present in their provinces, never mind any other disease patterns that we might be seeing, although I did not see this bill going quite that far. We could ask them to. We could ask British Columbia to tell us if it has an outbreak of mumps. British Columbia could agree to do so, or it could say that it is not prepared to share the information. I realize it is difficult, but it has to be mandatory.

In the last two weeks the papers have reported a huge outbreak of mumps particularly in the United States, but it is moving up into Canada. We have not seen an outbreak of mumps affecting teenagers in a very long time. We have learned information about the length of time the first immunization is effective. The first immunization that babies get is an MMR shot for measles, mumps and whooping cough. For many people the immunization is not lasting long enough and people are not getting a second one, so there is an outbreak of mumps among teenagers. That is information surely we would want to know federally in order to see a trend across the country.

I cannot speak with knowledge of other provinces in any significant way, but I do know that among first nations people and very much in downtown Vancouver, we are seeing a significant rise in tuberculosis. Tuberculosis is something we thought was gone from this country. In the late 1950s and early 1960s, in my very early nursing days, all the TB sanitariums were closed down because we had beaten it. We had figured it out. People were not getting it anymore. We could treat it immediately. There was no further need and we were not going to see it again, but we are seeing it again in growing numbers.

I want the federal Minister of Health and the Public Health Officer to know that we are seeing those trends across the country, so there can be a national strategy. I am not very comfortable with there being 13 different strategies on what to do if there is a tuberculosis outbreak, a mumps outbreak, or an outbreak of any other kind of communicable disease, particularly those that we thought we had eradicated, such as TB and mumps. They are not even new ones. To have a different strategy in each province would be very dangerous.

I want to mention avian flu. The B.C. Centre for Disease Control has just published a paper. It is concerned about avian flu. If it comes to North America there is every opportunity for it to mutate. At the moment people are not at risk, but we know that those kinds of infections mutate quite quickly, as is the case with many infections today. It can mutate so that humans can be infected by it. Everywhere across the country we see poultry and other birds being imported. A national strategy is needed. We cannot have 13 strategies on what to do about that.

It may go without saying that the agency must be resourced to do its job. I do not want to see an outline of what the Public Health Officer can do, all of the goals and objectives and just a document that will make me feel good because of what is in it. It needs to be properly resourced in order for the Public Health Officer and the people who work at the agency to be able to do their job, to collect the information that is necessary, to do the analysis of that information and to develop strategies that will protect all Canadians within this particular act.

The people in our country look to us for that protection. They deserve that protection. They deserve to know that it is being done and it is being done well, that it is being done in a coordinated way and that the Chief Public Health Officer has the power to take action. He or she should not have to go back to the minister.

I wondered out loud the other day whether consideration had been given to the Public Health Officer not having to go through the minister to present information either to Parliament or to the public, but could simply go ahead and publish a report, as can be done in many provinces. They do not need to go through the minister. They do not need to have someone's permission. They simply provide public information.

It would be interesting to have a discussion in committee about the independence of the Public Health Officer. I welcome the opportunity to discuss these matters in committee. I have had a chance to discuss them with the Parliamentary Secretary to the Minister of Health and I look forward to the chance to discuss them in committee.

The very basis of this must be that never again will we see the lack of leadership, the slow accumulation of information and the failure to share information that we saw with SARS or with avian flu, although that did not affect people, before people figured out what could be done. It was too late by then. People need to know immediately.

[The Deputy Speaker, Bill Blaikie]

Before I recognize the hon. Parliamentary Secretary to the Minister of Health on questions and comments, I would ask him to keep his eye on the Chair and not just speak directly to the member, so that I can tell him when he should be winding up.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, you took away my major excuse for going over time.

I congratulate the member on her post as health critic for her party. It was interesting to contrast the member's point of view with that of the Bloc member in a number of respects.

I have two questions for the member from the NDP. One is that the Bloc member suggested that jurisdictionally, in dealing with pandemics and other health crises, it is just up to the provinces. I wonder if the member would agree with the government's position that we need to have a collaborative effort and that there is shared jurisdiction in these types of situations between the provinces and the federal government.

I also wonder if the member could provide any insight into why it took the previous Liberal government so long to actually bring forward legislation. The agency had been created under an order in council for a number of years before the Liberals even tabled the legislation. Even when they did table the legislation, it was on the eve of an election. I wonder why the previous government dilly-dallied.

Perhaps the member could answer the questions on jurisdiction and dilly-dallying on the previous government's behalf.

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, I did mention early on in my remarks that long before the SARS crisis, public health officials in general had been raising the fact that there were problems with public health at a national level. The question about why people chose to bring forward or not bring forward something would most appropriately be directed to a Liberal member. What I do know is that SARS was not the first time that anybody had said there were problems with public health in Canada.

I am not sure if I have ever been asked about dilly-dallying. I am sure there is an official definition of that. What I do know is the problem was identified much earlier than the SARS outbreak and that it had been identified to the Liberal Party as a problem.

I think the member's first question was whether I would agree with the government that there were areas that were of national concern. We will see at the committee whether I agree with the government when we have had a chance to discuss this further.

I would say that outbreaks know no borders. Bacteria know no borders whatsoever. They do not know what country they are in, what province they are in or what city they are in. I do not think we can take the risk of drawing a line around that issue. There are many things in health around which we can draw a line around, no question. There is no question about that and I understand that, but around something like this, I think it is dangerous to people's health.

[Mario Silva, Liberal, Davenport, ON]

Mr. Speaker, I found the member for Surrey North very interesting to listen to and very informed. I am not surprised that she was a nurse in her former life. It certainly came across quite clear in her views and her understanding of the issue.

Bill C-5 is very similar to the bill that the Liberal Party had put forward, Bill C-75, which unfortunately died in the last Parliament. There are some things my party did move forward, such as the importance of putting in a minister responsible for public health and also putting into place the Chief Public Health Officer. That was a very important move and there was a focus.

I agree with the member that when a crisis hits, there are no borders. It moves across provinces and across countries and we have to act. I share her concerns as well that we do not need 13 plans, that we need one national plan that is coordinated.

I also share the member's assessment of what happened during the time of SARS. I was on Toronto city council at that time. It was a very frightening time to be in Toronto. The messages going out in the media were scaring people away from our city, that people were quarantined all over the place, that people were wearing masks to work. It was not necessarily the case. It was a time of great concern, but people still were quite brave and were going along with their daily lives. SARS certainly had a major impact on the economy of Toronto. Toronto is still suffering as a result of SARS and, of course, September 11. These incidents impacted quite severely on the economy of Toronto.

I would say to the member that there were things that the Liberal Party tried to move along in the last Parliament, particularly on the issue of public health.

Is there anything in relation to the Quarantine Act which she feels needs to be changed or added to, or is she satisfied with the Quarantine Act that was adopted in the past?

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, I am sorry, but I could not hear the last part of the member's question about the Quarantine Act.

[The Deputy Speaker, Bill Blaikie]

The hon. member for Davenport for clarification.

[Mario Silva, Liberal, Davenport, ON]

Mr. Speaker, the member briefly talked about the Quarantine Act. I do not think she raised any concerns. The act that was introduced in the last session of Parliament was somewhat a reform to an earlier act that had not been changed in almost 100 years. It is quite shocking that it had taken so long for the Quarantine Act to be changed, given the new evolving situations happening internationally.

Does the member have anything else to add to that? Does she think anything could be changed in the Quarantine Act, or is she satisfied with the present act?

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, I will be interested in the discussion at committee.

My current concern about the Quarantine Act is who declares a quarantine. In the provinces, the provincial medical officer of health can declare a quarantine based on scientific and medical information. There seems to be cognitive dissonance when we get to the federal level. It is not within the power of the public health officer to declare a quarantine. Why the difference?

[Dave Batters, Conservative, Palliser, SK]

Mr. Speaker, it is with great pleasure that I rise today to address this important bill, Bill C-5, an act respecting the establishment of the Public Health Agency of Canada.

Before I begin, I welcome the member for Surrey North to this place and thank her for her intervention this morning. I found her comments to be very informative. It is clear that she was a nurse before she came to this place.

She said that the health of Canadians is of utmost importance to members of Parliament. She commented on the SARS crisis in 2003 and how people were afraid for lives, especially people in Ontario and the GTA. She talked about the need for leadership, and I could not agree more.

The member for Surrey North may agree with me when I say the Minister of Health provided the leadership to the people of Ontario at that most difficult time. He has received a lot of praise for the work he did during that crisis. Canadians can take a lot of comfort in the fact that the Minister of Health will oversee the Public Health Agency of Canada and the Chief Public Health Officer. He will be at the helm, God forbid, should another crisis such as the SARS outbreak take place.

This important legislation is key to the implementation of the government's vision of a renewed and strengthened public health system for Canada. As we all know, preventing and managing chronic and infectious diseases, as well as promoting good health, is key to a healthier population and to reducing pressure on the acute health care system.

The legislation underlines the government's commitment to promote and protect the health of Canadians. It would not only bring greater visibility and prominence to public health issues, but it would also support policy coherence across the health sector.

The bill also responds to the recommendations made by Dr. David Naylor and Senator Michael Kirby in the wake of the SARS outbreak. In their report both Dr. Naylor and Senator Kirby recommended that the Government of Canada establish a new public health agency. Further, provinces and territories and public health stakeholders have called for a federal focal point to address pubic health matters with the appropriate authority and capacity to work with other jurisdictions in preparing for and responding to public health threats and emergencies.

The legislation responds to those recommendations by establishing a statutory footing for the Public Health Agency of Canada. It would establish the agency as a separate organization within the health portfolio. In this regard, the agency would support the Minister of Health in exercising his duties, powers and functions in public health. In doing so, the minister recognizes the importance of continuing to foster collaborative relationships with federal, provincial, territorial and municipal governments as well as with international organizations and public health experts. The preamble of Bill C-5 further reinforces the agency's desire to work in cooperation with the provinces and territories.

A key aspect of the Naylor and Kirby report was their recommendation to appoint a Chief Public Health Officer for Canada. Specifically, Dr. Naylor recommended that a Chief Public Health Officer head the new agency in addition to serving as an independent credible voice on public health nationally. The legislation responds to that recommendation by formally establishing the position of the Chief Public Health Officer. Specifically, the legislation confirms the position, duties and powers of the Chief Public Health Officer and recognizes his unique dual role as both the deputy head of the agency and Canada's lead public health professional.

As the deputy head of the agency, the Chief Public Health Officer will be accountable to the Minister of Health for the day to day operations of the agency. In this role the Chief Public Health Officer will support the Minister of Health in fulfilling his public health mandate. He will be expected to advise the minister on public health matters and to inform policy development in these areas, along with the deputy minister of Health Canada and other deputy heads within the portfolio.

As the lead adviser to the minister on public health matters, the Chief Public Health Officer will help to ensure that public health issues are well represented in the health policy making process. At the same time, provisions within the proposed legislation will ensure greater policy coherence across the health portfolio by reinforcing the responsibilities of the deputy minister of Health Canada for supporting the minister in coordinating efforts across the portfolio.

Further, as a deputy head within the federal system, the Chief Public Health Officer also has the standing to engage other federal departments on key public health issues. As one example of this kind of work, over the past several months Dr. Butler-Jones has been working closely with the deputy minister of Public Safety and Emergency Preparedness Canada and the president of the Canadian Food Inspection Agency to strengthen Canada's pandemic and avian influenza preparedness.

As the deputy head, the Chief Public Health Officer is also able to mobilize the agency's considerable public health resources to respond quickly to emerging threats to the health of Canadians. This departmental model gives the Chief Public Health Officer considerable responsibilities while ensuring continued ministerial accountability for federal activities in public health.

In addition to his role as deputy head, the legislation also recognizes the Chief Public Health Officer's role as Canada's lead public health professional, with demonstrated experience in the field. As part of this role and in response to the strong expectations of public health stakeholders and Canadians, the Chief Public Health Officer will also serve as a credible and impartial voice on public health issues.

To ensure his or her credibility with stakeholders and the public, the legislation would give the Chief Public Health Officer the authority to communicate directly with stakeholders and to provide Canadians with information on public health matters. I think that addresses one of the concerns the member for Surrey North, that the Chief Public Health Officer has the authority to communicate directly with Canadians. He or she would be able to prepare and publish reports on public health issues.

In keeping with the government's focus on strengthening accountability, the Chief Public Health Officer will also be required to submit to the Minister of Health, for tabling in Parliament, an annual report on the state of public health in Canada. This requirement will not only provide greater transparency to Canadians, but it will also support the government's direction for an increased role for deputies in strengthening government accountability.

As the House knows, Dr. Butler-Jones has been serving in the Chief Public Health Officer role since September 2004. He brings to this position a considerable background in public health practice and years of demonstrated leadership in the field, in government settings at all levels, as well as within the non-profit sector. The proposed legislation gives parliamentary sanction to office of the Chief Public Health Officer, confirms the appointment of Dr. Butler-Jones for the remainder of his specified term and gives him the legislative authority to speak out on issues of public health. The Chief Public Health Officer must be an impartial, credible voice on public health matters.

Stakeholders have made it clear that they expect the Chief Public Health Officer to be an independent voice, able to drive real change by speaking out on public health matters and issuing reports. Making the Chief Public Health Officer Canada's lead public health professional and ensuring that future chief public health officers have qualifications in the field of public health will help confirm this credibility with stakeholders and Canadians.

The credibility of the Chief Public Health Officer is also reinforced by the fact that he can communicate directly with the public and stakeholders and can report on public health problems and solutions. The Chief Public Health Officer's expertise, status and power to communicate make him a visible symbol of the federal government's commitment to protect and promote the health of Canadians.

The dual role of the Chief Public Health Officer is unique among deputy heads of departments at the federal level. We acknowledge that there will be a healthy tension between these two roles.

On the one hand, the Chief Public Health Officer will be an integral part of the health portfolio with direct responsibility for the operations of the agency, for providing advice on public health to the minister and for carrying out the policy direction of the government.

On the other hand, the Chief Public Health Officer will be an impartial spokesperson on public health with an interest in maintaining the scientific and ethical credibility of the office. For example, the Chief Public Health Officer can work with his provincial colleagues in the pan-Canadian public health network to receive information and advice. With the authorities granted to him in legislation, the Chief Public Health Officer can then communicate and provide Canadians with the best public health advice.

We see this dual role being inherent in the nature of the office, but one that is manageable and demonstrates this government's commitment to accountability.

It is also not without precedent, as Dr. Naylor has noted in his report that the chief medical officers in both Manitoba and British Columbia have the authority to communicate and act independently when they deem it to be in the best interests of the health of their citizens, while remaining accountable to the governments they work within.

More recent, in 2004 the province of Ontario made amendments to its legislation to grant the chief medical officer of health more independence.

In light of the many potential threats facing Canadians from a possible influenza pandemic, to combatting chronic diseases such as cancer, to dealing with the persistent challenges of obesity and other health risk factors, public health is an important priority of this government. As such, the government considers that the dual role attributed to the Chief Public Health Officer by the proposed legislation will ensure the attainment of the two policy objectives mentioned above.

The Chief Public Health Officer will be firmly situated within the health portfolio where he or she can advise the government and play a meaningful role in a coordinated government-wide response to ongoing and emerging public health threats and issues. At the same time, it is very clear that Canadians want and expect the nation's lead public health official to have both the necessary qualifications and the mandate to speak out on matters affecting their health.

Canadians can be assured that the government understands the importance of having a Chief Public Health Officer whose overriding interests must be the health of Canadians. I believe the legislation strikes the correct and necessary balance between the dual roles of a chief public health officer, ensuring that the office has the ear of the government and the independence to first and foremost be a servant of the public interests.

I would like to take a moment to thank Dr. Butler-Jones for the great work that he has done. He has an extensive background in public health. Most recently, he served as the medical health officer for the Sun Country Health Region in my home province of Saskatchewan, only approximately 100 kilometres from my home town of Estevan, Saskatchewan. Sun Country is located in Weyburn, Saskatchewan. The public health care of Canadians is in good hands with Dr. Butler-Jones.

[Keith Martin, Liberal, Esquimalt—Juan de Fuca, BC]

Mr. Speaker, I listened intently to the member's speech on a very important issue for all Canadians. As somebody who has spent quite a few years practising in the emergency department, I am obviously fully supportive of more resources going to the acute side of medicine because there is a definite need right now. Emergency rooms across the country are being choked and emergency health care professionals are overworked in the commission of their duties in our time of greatest need.

However let us project forward and look at what is happening in the country. It is very disturbing to know that our youngest generation could now for the first time have a shorter lifespan than our generation and older generations. We need to address the fact that public health issues, and usually small interventions do have dramatic effects, will be required in order to prevent problems and continue with the extension of lifespans and the quality of life. Water, food, the quality of food and water, and lifestyle issues have to be addressed.

I would submit the following to the hon. member and he can consider telling it to the Minister of Health. It is the small preventative issues that could work well. For example, the head start program, which would have been part of our early learning program, would have ensured that children had their basic needs met for the first six to eight years of life. This is probably the easiest and simplest way of actually having a profound positive impact upon the lives of children and adults. It ensures that children are aware of proper nutrition, activity and that parents and caregivers are able to spend quality time with children and interact with them over a prolonged period of time.

Those kinds of simple interventions have a very positive impact upon children's lives. Will the hon. member present to his Minister of Finance a proposal for supporting a national head start program, a national mental health care strategy and a national medical manpower strategy with the support of the provinces? Will he also look at adopting the findings of the Walkerton inquiry which were very good toward developing national standards for water quality? All of those things could have a profound positive impact upon the health of Canadians.

[Dave Batters, Conservative, Palliser, SK]

Mr. Speaker, I know the member opposite is a physician and certainly has very useful insight to add to this place and to this very important debate.

It is nice to see the support that the bill has, at least from two opposition parties, but I think the Bloc Québécois would support the spirit of it.

The member talked about lifespans and the fact that we face some very serious challenges right now in Canada in terms of public health. If some of these epidemics are not brought under control, things that are very widely accepted and well-known but the impact may not be well understood, such as heart disease, diabetes, childhood obesity, the need for lifestyle improvements and primary prevention measures, we could have lifespans on the decline in Canada and that truly would be a shame.

The member asked if I would take this to the Minister of Health. Absolutely. I am very proud to be serving on the health committee in this 39th Parliament. I look forward to working with other members of the committee who will look at this and other bills and see if improvements can be made. I will go to the Minister of Health and talk about everything we can do in terms of primary prevention in order to improve the health care of Canadians, to address things like water quality, as the member mentioned, and lifestyle modifications, a mental health strategy for the country and basic policies to address heart disease and diabetes.

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

Mr. Speaker, I have a question for the hon. member.

In Quebec we have the Institut national de santé publique du Québec. This institute specializes in research on various health problems. We have an entire organized health network: CLSCs, hospitals and so forth. Many services are organized to provide the public with appropriate health care.

I read an article recently that said the universities were getting deeper in debt. However, researchers just want to research.

My question for the hon. member is on the fiscal imbalance. During the election campaign the Conservative government said it absolutely wanted to respect provincial jurisdictions, especially those in Quebec with a view to independence. In Canada, a bigger budget is allocated to research. Could some research mandates be given to the Institut national de santé publique du Québec and some to the universities? That way Quebec's jurisdictions would be more respected. Furthermore, that is what the Conservative government promised to do during the last election campaign.

[Dave Batters, Conservative, Palliser, SK]

Mr. Speaker, Quebec has a number of high quality universities, as there are throughout the country, and federal dollars do flow down through the provinces to these universities for such research. This type of activity is something the government would encourage.

As the member knows, some very important work happens within the private sector in terms of research and development in the field of health care. However the member is absolutely right when he says that more work could be done in the universities in Quebec and throughout Canada.

It certainly is not the intention of the government, in introducing this legislation, to infringe in any way upon the provincial control or the provincial responsibility for health care. Clearly, that responsibility is well defined in our Constitution. What we are trying to do with the bill is to follow up on the recommendations of Dr. Naylor and Senator Kirby to provide some federal role which these individuals believe would benefit the health care of Canadians.

[Dennis Bevington, NDP, Western Arctic, NT]

Mr. Speaker, coming from the north, as I do, and being familiar with the conditions of health care in the northern regions, it is an overriding concern that crosses the country. In many cases, people in small communities and on reserves face very difficult health conditions and very limited resources to deal with them.

Having said that, I am interested in the Public Health Agency as a federal responsibility and how it will work. In our perusal of the legislation, it seems to indicate that the chief health officer would not have jurisdiction over aboriginal reserves or perhaps even over self-government arrangements that are constitutionally given through the federal government.

How does the member see the bill improving the life of aboriginal people on and off reserves? The chief health officer represents a very significant service that one would receive if one were under provincial jurisdiction. How does the member see that fitting with the federal responsibilities on reserves?

[Dave Batters, Conservative, Palliser, SK]

Mr. Speaker, I know the hon. member is a new member and I want to welcome him to the House.

I sat here this morning and listened to the member from the Bloc Québécois talk about the significant number of individuals working within the Public Health Agency of Canada who are devoted to the health care of our first nations peoples. That is a very positive step. Perhaps the member could look into those figures. I believe it was in a neighbourhood of 1,500 to 1,700 employees dedicated to first nation health and certainly a lot of work will be done both on and off reserves.

The member is concerned that the Chief Public Health Officer would not have standing or authority on reserves. In fact, the Chief Public Health Officer, under this bill, would be a deputy answering to the Minister of Health. I will give the member perhaps a couple of different scenarios.

Ultimately, the Minister of Health will have responsibility for what happens in terms of health care on reserves, such as in the case of an emergency, quarantines or containing a pandemic. The Minister of Health would do that, I would guess, in cooperation with the Minister of Indian Affairs and Northern Development. The Chief Public Health Officer, as a deputy, would work with other deputies within the Department of Indian Affairs and Northern Development to address the health care concerns of our first nations people.

[Olivia Chow, NDP, Trinity—Spadina, ON]

Mr. Speaker, the act to establish a Public Health Agency of Canada is a good first step. Health promotion, disease and injury prevention, and public health emergency preparedness response is a federal responsibility and a Public Health Agency is long overdue.

This agency would collect data, issue reports and coordinate various efforts. One of the goals of the Chief Public Health Officer is to identify and reduce public health risk factors.

We know that when children are overweight, they are likely to develop more health problems and illnesses. We know that when children grow up not knowing drownproofing, they could be in trouble if they are near water. We know that there is a public health risk when the environment is polluted. We know that there are ways to prevent and reduce the risks of cancer.

After collecting data, after consulting everyone, and after reports, annual reports and various reports, a Canada Public Health Agency must have the mandate to act. After knowing what the health risks are, the new Public Health Agency must also have spending power. Let me give an example. Children need good health and we know that it comes from food, for example. Right now there is a CAPC program that delivers some kind of food program to kids across Canada, but it is very much underfunded, not well understood and not well appreciated. Canada is one of the very few countries that does not have a national food policy.

Some 72,000 children in Toronto have nutritious snacks, hot breakfasts or lunches in community centres, schools and church programs. The federal government used to be a small partner with the Department of Health, but throughout the years the percentage of contribution has declined. There is absolutely no reason why a child in Montreal or Vancouver or Halifax should also not enjoy such a program.

We see that preliminary research, primarily from the United States, has found associations between households classified as food insecure and the health of young children in those homes. These associations included poor health child status; lack of iron; more frequent hospitalizations, which by the way costs taxpayers money; stomach aches; headaches; lower physical functions, including problems--now this is for children--with walking, running, doing chores; low energy levels, and we are talking about low energy levels in young kids; impaired social interaction skills; and emotional status.

A study of 21,000 U.S. children found that if there was food insecurity among kindergarten children, even if the kids were not from poor families, it hurt their academic performance in reading and math for boys and girls and there was a decline in social skills among boys when followed to grade 3. Those of us who are worried about bullying and safety, all of those issues, we must first think about the public health risk when kids do not have the right food to eat.

The study also looked at older children from 6 to 12 years of age and noticed that there was anxiety, aggression, psychological dysfunction, and difficulty getting along with other children. The parents had poor physical health, feelings of anxiety, loss of control, family dysfunction and psychological impairment, regardless of income status. A feeling of shame or embarrassment about not being able to feed oneself or one's children can also promote social exclusion, a feeling of isolation from neighbours and the community at large.

The British House of Commons, through the public health agency's promotion, is debating a children's food bill, as we speak, which would legislate a number of changes to optimize a child's diet, nutrition and health. It has widespread support and the endorsement of 150 national organizations in England.

A Canadian child's food bill, coming from the recommendation of the Public Health Agency, could support and implement visions proclaimed by many federal charters and conventions that we have declared in the past.

I notice that the former Minister of Health has joined us. We talked about a national plan that would see all children in grade 3 learning drownproofing. The same principle of public health applies. After all, Canada is surrounded by water. We have tragic drownings of Canadian children and young people. That can be prevented if they knew how to swim or, as a bare minimum, knew drownproofing.

After all the studies, reports and gathering of data, a national government has the responsibility to establish a general plan with standards and provide funding, so local community organizations and municipalities or provinces could cooperate and deliver programs. No, we should not be delivering programs, but certainly community agencies from the grassroots up should be provided the kind of support, so they can take the data from the Public Health Agency and do something with the annual reports.

Approximately 68,000 people in Canada will die this year from cancer. It is estimated that one in three will be diagnosed with the disease during their lifetime. We know that some cancers are caused by pollution and environment depredation. Sarnia, Ontario residents, for example, have higher rates of cancer. That is because of the local activities of petrochemical companies. My colleague from Windsor tells me that local residents have a high rate of thyroid disease and cancer, which occurs because of environmental depredation.

Environmental health activists point to the fact that about 500 new chemicals are being used in commercial processes each year, on which no or minimal information is available to consumers. As our ecosystem becomes more permeated with chemicals from agriculture, industrial and residential uses, so do our human systems, especially that of our children. I hope the Public Health Agency would disclose information on products and the contents in food to consumers, so that we can regulate food safety.

At the turn of the century, a public health agency noticed that polluted water leads to bad health. As a result, purification systems were set up. It was also a public health agency which noted that kids grow up with bad teeth if they do not lead very productive lives. As a result, in my city of Toronto, there are dental clinics for kids and seniors who cannot afford to have their teeth fixed privately.

It is very important that as we set up this Public Health Agency, with a Chief Medical Officer, that the agency be given the responsibility to act.

Lastly, I want to echo what my colleague said earlier, that the SARS crisis illustrated that we must have a clear protocol and a place where all the data can be stored. Information available in Vancouver should also be available in Toronto or Montreal. We must expand the mandate of the agency, so it would cover airports and rail lines because we live in a global environment and the transportation corridors are extremely important. It is very important that the Public Health Agency have a mandate over airports and rail lines.

I look forward to working with the Public Health Officer and hope that some of the areas that we already know about could be prevented and that the bad health of Canadians can be acted upon. If not, setting up the agency will really be just a paper exercise. We will have many reports and a lot of coordination, but no real action.

[Brian Masse, NDP, Windsor West, ON]

Mr. Speaker, I want to ask my colleague a question regarding Bill C-5.

One of the things she mentioned in her speech was the environmental contaminants issue. In this chamber in 2002, I presented a motion on environmental contaminants and human health. It looked to create an investigative body that would go to hot spots where we know that cancer rates, for example, or other contaminant issues that are linked to environmental pollution are problematic for those communities. It would look at ways to take remedial action and investigations as well as introduce some best practices to lower the actual percentages of either the cancer rates or other types of illnesses.

In my area, we have respiratory diseases. We have a significant pollution problem from the United States and from our own industries that cause health problems. We actually have some benefits that could be introduced through remedial action.

It is important to add a prevention element to this as well because some of the issues that we deal with, related to disease as well as contaminants, could be done in the forefront by preventing those things in the first place. My question to the member is, how should that envisioned role be part of public health in terms of lowering our costs and, most important, improving the lives of our citizens on a daily basis in order to extend their lives?

[Olivia Chow, NDP, Trinity—Spadina, ON]

Mr. Speaker, one of the goals that is identified in Bill C-5 is very clear and it is in writing. It says that the Chief Public Health Officer will “identify and reduce public health risk factors”.

There have been many reports that connect environmental depredation with a higher risk of cancer, whether it is asbestos, pollutants, airborne pollutants or substances that are in the food or water. Those really have health risks.

It is critically important that we label our food. Many European countries do that, but Canada does not. We do not know what is in some of our health care products or beauty products that we use. I know there are other products that kids are exposed to that have chemical ingredients that are a cancer risk.

I certainly hope that this Public Health Officer would have the power to say to the government that we know this is a risk and that is why we must take action.

[Rod Bruinooge, Conservative, Parliamentary Secretary to the Minister of Indian Affairs and Northern Development and Federal Interlocutor for Métis and Non-Status Indians]

Mr. Speaker, some of the member's points are well taken. I can speak specifically for the aboriginal community in relation to food and diet. There are clear specific issues throughout the north and throughout Canada concerning diabetes.

However, I will not insinuate perhaps the direction she might be thinking in terms of how to mitigate the circumstances of diet. I would offer that there is a certain degree of government overaction in some areas. I know there needs to be education. I will use smoking as an example. Clearly we know that second hand smoke is something that is very detrimental to people in the immediate vicinity of smokers. That was the biggest reason why there has been such an initiative across Canada to bring about the regulation of smoking. However, in terms of diet, I think education is the right approach.

I would ask the member, what would be her intention in terms of her party and herself in helping to mitigate this issue?

[Olivia Chow, NDP, Trinity—Spadina, ON]

Mr. Speaker, I have seen food programs in schools in very depressed neighbourhoods where there is a lot of food insecurity and low academic performance. With a small investment at the local level and from the businesses in the neighbourhood through fundraising efforts, but also from the government, a CAPC program was initiated, which again is a federal program, and I have seen the academic performance of children rise dramatically.

Do not take my word for it. Take the word of principals, teachers and parents. As the parents come together to cook and provide a decent hot breakfast for their kids, they learn life skills. As the kids learn to eat proper food, rather than all the junk food they see on television, and which is more expensive by the way, they are able to have much higher productivity in life.

As a result, the families do a lot better. I know that in some of the aboriginal communities there is a lot of depression and a teenage suicide problem. I cannot help but wonder whether a program that is run by the elders working together and financially supported by the government would have dramatic results.

I certainly have seen it in some communities. I know that it is not a top down solution. It should be done by the people themselves. We only have to present a general guideline and leave it alone, and allow the communities to come up with the program because every community is different. It should come from the grassroots up and should be organized by the people themselves. I have seen dramatic improvements in the health of children and the health of the entire community, including their families.

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

Mr. Speaker, I want to congratulate my colleague on her presentation. In her comments she spoke a lot about programs on smoking and food programs in schools.

I am from Quebec where CLSCs, or local community service centres, have been set up. These centres have a truly local approach to dispensing services to deal with tobacco addiction, AIDS prevention, nutrition, child care and much more. I have a hard time understanding why the federal government is giving itself the responsibility of designing prevention programs. This is one of Quebec's jurisdictions.

I would like to know what the hon. member has to say about that.

[Olivia Chow, NDP, Trinity—Spadina, ON]

Mr. Speaker, I have no intention of saying that the federal government should take charge of these programs. Absolutely not. I do not believe it should take charge of these programs. The federal government has the responsibility to look at the health results. Also, the federal government has the responsibility to have the funding available so that the Quebec government can then, through transfers to the health agencies or the community organizations, provide this kind of support. Quebec already has very good programs that are community based. The last thing we need is the federal government meddling in them.

However, I know that a lot of those agencies are struggling for funding. I know that they do a lot of fundraising with the private sector, which is good too, because it brings the community together, but they are struggling for funds. That is what I am talking about. I am not talking about jurisdiction or a top-down solution, because we have seen it messing up programs that work very well. A top-down solution does not work because it is not the closest level of government.

This does not mean that the federal government should not have the responsibility of public health. It does not mean that it should not provide funding for the Quebec government to provide the kind of funding that is working quite well in Quebec and hopefully in many other parts of the country outside of Quebec.

[Larry Bagnell, Liberal, Yukon, YT]

Mr. Speaker, I have a very short question. The member mentioned carcinogens in chemicals. I wonder what her views are on the recent and fairly famous program by Wendy Mesley which suggested that the Canadian Cancer Society and others were spending far too many resources on prevention and not enough on fighting the government's allowing of carcinogens in all sorts of products in society.

[Olivia Chow, NDP, Trinity—Spadina, ON]

Mr. Speaker, I have seen that program, several times in fact. The program also mentioned that a lot of the beauty products in Europe, for example, are labelled with what is in the products and that some of the products we use on ourselves cause cancer.

We need to have that information. Some of those chemicals should be banned. I think we all have a role in preventing cancer rate increases, especially among young people. Taking those steps would be extremely important. We need labelling so the public knows. Also, we know that some products cause cancer. Some of them should be banned.

[Rob Merrifield, Conservative, Yellowhead, AB]

Mr. Speaker, this is my first opportunity to speak in the House in this new session. I want to say again just how much of an honour and privilege it is for me to represent the wonderful people of Yellowhead. I cannot acknowledge it enough. I am always in awe of the awesome responsibility they have given me and the honour I feel in representing them, so I stand to proudly represent them.

I also want to say how important today's piece of legislation is. As we are speaking about it today, I want to lend my voice to some of the consideration of the legislation as it goes through the House. I want to talk about why I think it is important.

I have talked about this. We have seen exactly what has been going on with regard to this legislation. It has been an order in council since 2004 and now we are actually bringing it into the House in order to put it into legislation. It comes out of Canada's SARS experience. As well, I will talk a bit about the possible pandemic of the avian flu and whether it is or is not.

Let us get to the agency itself and what we are really talking about. We are basically talking about prevention and how we prevent health crisis situations from happening. In Canada in the last 40 years, our experience has been more about looking at crisis intervention. When there is a health crisis, people usually go to hospitals or doctors and try to find an intervention to somehow alleviate the crisis. This is not necessarily about doing that. This is about doing something before that happens.

Not only do we have to look at public health with regard to a potential pandemic or something like a SARS infection, but we have to do that in all of our health considerations, whether it is cancer, heart, diabetes or arthritis. There has been tremendous advancement in the things we can do in the area of prevention before we get into a crisis situation. If we are going to sustain our health care system in the 21st century, we are going to have to begin to be very serious about being far-sighted with regard to the health of ordinary individuals in Canada.

When it comes to this agency and protecting the public health side of things in Canada, we go through monitoring, testing, analyzing, intervening, informing, promoting and preventing until something actually happens unexpectedly, just as we saw recently in Toronto and Vancouver with the SARS situation. When we realize that a good part of what actually happened there could be prevented and that it can be very costly if it is not prevented or dealt with, then we realize that we in the House have a responsibility to do everything we possibly can on behalf of Canadians to prepare them for those situations.

This was brought home with what happened after SARS. The Kirby report talked about it, and many have talked about the Kirby report, its implications and what it recommended. It was also followed with Dr. Naylor's report, a national advisory committee report on SARS that specifically talked about what we could learn from that disease. This is what has come out of that. It is a recommendation that we actually do something with regard to prevention so that not only can we talk about the federal government and its responsibilities, but we can also understand the responsibilities that provinces and territories have with regard to this whole area of preventing individuals from getting into these crisis situations and what we can do to protect ourselves and prepare ourselves for what might be coming.

I want to spend a minute or two talking about the SARS situation, because there is a lot we can learn from what has actually happened. I want to discuss it because the Naylor report talked a lot about what the province did and what the federal government did not do. I would like to explain a little of what the government's responsibility was at the time and what perhaps did not happen.

Before SARS happened, it was Canada that actually exposed it to the world when it realized what was happening. The virus was present in Asia, in China in particular, and it was actually Canada's surveillance that alerted the World Health Organization to the problem.

It is interesting to note that Canada alerted the World Health Organization, and yet when there were two cases of SARS, one in Vancouver and the other in Toronto, they were handled completely differently and had completely different results. Officials were alerted to the case in Vancouver because the individual came from Hong Kong. All hospitals in Canada were supposedly aware of this infectious disease. In Vancouver, it instantly was treated as an infectious disease. Because of that, there was not one death, because of the way the hospitals handled it and intervened at that time.

I am not blaming the medical people at all for what happened in Toronto. I understand full well what happened. The point is this. When SARS was diagnosed in the Toronto hospital, it took medical staff 24 hours before they really understood what they were dealing with. With everything that flowed out of that 24 hour period of time, there were 44 deaths in the Toronto area. The World Health Organization put a travel advisory on the Toronto area and as a result of individuals refusing to travel to that city it suffered an economic loss of $2 billion. That was the fallout.

We can see that the timing and the way we prepared in those two cases was absolutely critical to the fallout with what actually happened with regard to human deaths and economic costs.

So why is it so important to show leadership? Because, in regard to leadership, one area reacted differently from the other. I am not blaming anyone. I am not saying that anyone was at fault. I am saying that what we should do is learn from the experience and, in this agency, understand that preventing this from happening again is critical. We should be aware of the fact that many experts around the world claim that another SARS or another pandemic is going to happen in the future. This is very valuable. What we are doing prior to this is actually critical.

No country in the world should be more prepared and more understanding of what is actually going to happen than Canada. After all, we had SARS in our country. It left another nation and came into our country. Because of that, we saw a human toll and an economic disaster. It was when the World Health Organization recognized that we were also actually guilty that we realized Canadians could have potentially transported this virus to the United States, Australia and perhaps other countries in Europe, so the World Health Organization had no option but to put out a travel advisory.

What was our responsibility in the House at that time? Our responsibility was where our jurisdictions lay. First of all, importing and exporting and individuals arriving in Canada or leaving Canada fall under federal jurisdiction. At the time of the SARS outbreak, I had the privilege of being the senior health critic for my party. I have always seen health care as a non-partisan issue. We should approach it in a non-partisan way. We can go and play politics with other issues, but when it comes to health care, we should not. We cannot afford the time. We cannot afford the economic costs. We certainly cannot afford the political fallout from it.

In that case, I wanted the then minister of health to understand the importance of SARS and to take an aggressive approach in dealing with it. Before question period, I told the minister what actual question I was going to ask her in the House. I wanted her to reply in a way that would throw some light on the situation and push her toward a leadership position. I have never done that since, and it was the first time I did. I did it because SARS breached all political party lines. I was disappointed with the results I got when I saw what the provinces were doing.

The member for Parry Sound--Muskoka, now the Minister of Health, was the Ontario minister of health when the SARS outbreak occurred. He took the lead on SARS. When the travel advisory was put out for the city of Toronto, he actually went to Geneva to fight it, to say that the travel advisory should not have been put on Toronto, and actually, the travel advisory was placed on Toronto after SARS had been contained and controlled in the Toronto area.

As it was not the federal minister of health who acted in an aggressive way, in a quarterback way, we saw the disconnect between the federal responsibility role and the provincial responsibility role. Therein lies the reason that we absolutely need to get the lines of communication straight. We need to do everything we possibly can to ensure the Public Health Agency and the Chief Public Health Officer have clear directions and guidelines set out as to what should happen and who should be in charge if this were ever to take place again. We know that it probably will. It is just a matter of time.

I mentioned earlier the avian flu. We had some experience with what we thought might be the avian flu in the lower B.C. mainland, in the Fraser Valley area where we had to eliminate a number of poultry because of it.

There is good news and bad news on the avian flu side of it. The bad news is that in 2005 we had 95 cases worldwide and 41 deaths. However, since January 2006, and we are only a third of the way into the year, we have had 61 cases and 37 deaths worldwide. We have seen the avian flu actually spread into Europe, into Africa and into Asia Minor. Most of the world has experienced some of what is potential in this virus. The experts are telling us that we are very close to receiving it here in North America. We know it is spreading.

What we do not know is whether the virus will mutate into a pandemic. The experts are divided on that. It has been around for a couple of years. Some of them say that a virus never sits stagnate. It is always mutating and when it is mutating it could easily trigger to mutate between human to human contact. If that were to happen we would be sitting in a potential pandemic situation. That potential is always there and it is escalating as times goes on.

Another group of scientists are saying that the longer this virus is out there and it has not mutated the less chance it actually will mutate.

I am not trying to raise alarms, other than to say that there are things we know and there are things we do not know. The thing we know is that it is spreading. The thing we do not know is whether it will be the next pandemic. However we had better be prepared in either case. Therein lies why it is so important for the bill to pass. We can debate it in the House and try to fine tune it as much as we possibly can so that we are prepared for whatever might happen.

A perfect example of this happened in the health committee last year. Some of my colleagues who sat on that same committee are here in the House. It was when the avian flu and the pandemic began that the Tamiflu was said to be the anti-viral that could help prevent and actually cure individuals with avian flu and we had a glut internationally of wanting to acquire the Tamiflu. The pharmaceutical officials came to the committee and we talked about Tamiflu and whether we were prepared. The Chief Public Health Officer was there and we were able to discern whether or not we were doing the appropriate thing. At least we had some experts who we could go to be able to discern as parliamentarians whether we were as prepared as we could be for what might or might not be transpiring.

As it has turned out, we have some Tamiflu in Canada. Whether we have enough or not we could still debate, but whether it is actually a product that can do the job if the virus mutates is another question. We know that if the virus mutates, the Tamiflu may not work at all.

Nonetheless, we have a professional, the Chief Public Health Office, in case something like this happens. The number one advantage of having a medical officer who is an expert is that he is not a politician. The last thing we want in a crisis situation is anyone who has a political bent. In saying that, we must understand that the responsibility of the federal minister of health is to be able to deal with the situation and deal with the agency.

It is important to have someone who is a professional in the health field because it puts the public's mind at rest knowing that a professional, whose area of expertise is medicine and not politics, is dealing with a potential pandemic. It gives me comfort knowing we have Dr. David Butler-Jones who has his mandate to follow this internationally and nationally, is able to educate our doctors and front line nurses, and is able to make teams of individuals prepared and ready to deal with a pandemic if and when such an event were to happen.

The agency would do more than just prepare us for any kind of a potential pandemic. It also would be looking at chronic diseases of all kinds. We now realize that chronic disease is the number one cause of death and disability in Canada. We need to do whatever we can to prevent and stop the progress of these chronic diseases. This leads us into the physical environment in which individuals are involved. We know that 60% of the determinants of the health of the population relate to physical environment as well as the social and economic environment. These are areas that we should not overlook and the agency will have the mandate to deal with them.

We could get into the specifics of the agency and talk about whether it should be inside or outside Health Canada but what we need to have is an agency that is focussed on its mandate. We do not want to take a shotgun approach or water it down in any way, shape or form. It is a wise way for the legislation to go forward, which is for the agency to be outside of Health Canada, that it deal with its mandate and, specifically, that it be able to communicate with the population in case of a very serious situation. I am very much in favour with the way this has been drafted. It is the right way to go.

It is important that the agency report directly to the minister. I look forward to annual reports coming back to the Department of Health because it is important for this body and the politicians who are here to have public responsibility and public reporting of what that agency is actually doing and whether we are preparing the country for what may or may not be happening.

The legislation is long overdue. SARS hit in 2003, a long time ago, and, thank goodness, it was not the pandemic and that we have not had one since. We have had some time but there is a striking difference between the past government and what we are seeing in how we actually bring this forward because it is all about leadership.

Later today we will be introducing our first budget but this legislation that is now on the floor will be driven through very quickly. I am looking forward to committee where we will be able to flesh this out to see if there are any problems with it in any other way and then to move it on and enact it as soon as possible, giving our confidence to Dr. Butler-Jones, our Chief Public Health officer, because this is very important for us to do. It is important for us to do everything we possibly can to ensure that we and all Canadians are prepared and this legislation would do all of that and more. This is the beginning of an exciting chapter in the history of Canada and it prepares us well for the 21st century and beyond.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, I remember SARS and I remember the response that we were able to give as a government in terms of appointing the first ever minister of state for public health and appointing Dr. David Butler-Jones as the Chief Public Health Officer for Canada.

My question for the member concerns the response we have had over the past few months in terms of the insecurity that our first nations Inuit and Métis people are feeling in terms of their responsibility in preparing for a pandemic or a potential SARS outbreak on reserve. Could we prove that germs do not respect borders and could we put in place a public health network for the 13 jurisdictions? The reason people on reserves are feeling so insecure is that no one seems to know whether it is the First Nations Inuit Health Branch or the Public Health Agency that will be helping plan for a pandemic on reserve.

[Rob Merrifield, Conservative, Yellowhead, AB]

Mr. Speaker, I have the greatest of confidence in Dr. Butler-Jones. I think my hon. colleague was very instrumental in choosing him. Not only did we have great respect for him when he appeared before committee, but some of the best conversations I have had with him were actually at the airport because we fly an awful lot and we usually sit and chat for a half hour or more when we get to the airport. I believe he is doing a very credible job.

My argument is: Why did it take so long? It was almost a year and a half after the SARS outbreak before the actual appointment of a chief medical officer.

With regard to the first nations, they do have serious problems. We have $9 billion to $12 billion a year of federal money going to reserves where we have third world conditions. I believe this gets to some of the root of the problem. It is leadership. Somebody has to play quarterback, not only in a SARS situation, where we saw no federal leadership at the time of SARS, but the same sort of thing has to happen with first nations. I believe we need some strong leadership on and off reserve to ensure we streamline the activity with preparedness for any kind of a pandemic or potential pandemic on those reserves.

I cannot answer directly what is actually happening at this specific time. I just know that there has to be some strong leadership. I have a great amount of trust in not only our Minister of Health but also our Minister of Indian Affairs and Northern Development to give that leadership and to ensure things are being dealt with on reserve. I have a lot of confidence that is going to take place.

Dr. Butler-Jones would have to be the person who answers the question as to exactly what is happening on those reserves with regard to public health, as he does with preparing front line workers, nurses and doctors right across the country. I am assuming that is being done. I am looking forward to the health committee starting so we can have reports, ask those exact questions and get more thorough answers.

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

Thank you, Mr. Speaker.

In its report on federal transfers to the provinces, the commission on fiscal imbalance said that the federal contribution, proportional to social spending in Quebec, ought to decrease from 20.4% in 1993-94 to 13.9% in 2005-06, representing a reduction of nearly seven percentage points in just over seven years.

My question is for the hon. member. Instead of encroaching shamelessly on fields of provincial jurisdiction, should the Conservative Party not act on its commitment and restore the transfer to the 1994-95 level, giving the money to federal granting agencies in Quebec and the provinces? They could then conduct their own health research through their universities and their own research institutes.

[Rob Merrifield, Conservative, Yellowhead, AB]

Mr. Speaker, I have heard the Bloc member ask that question of other members on this side with regard to jurisdiction. I would suggest to him that it is not the province of Quebec, the province of Ontario or any other province that has the jurisdiction to deal with airports. Importing and exporting people to and from Canada comes under federal jurisdiction, which is why the Quarantine Act is federal legislation.

One of the problems we had in dealing with SARS was when it came to jurisdictions in dealing with a pandemic or potential pandemic. It is not that we should be threatening or that a province should feel any threat that its jurisdiction is being trampled upon. The bill does not do that at all. It actually complements what is happening in the provinces. It would help them to prepare, deal, train and monitor what is actually happening in the province so that there can be a seamless system and a system that is dealt with, not only at the airports and the public health agencies within the provinces, but that they are all working together as a team.

That is the Canada that I believe in, the Canada I believe we need and that is the way we need to deal with a pandemic, whether it is nationally or internationally. I would encourage my colleague to not be so protective or so phobic about provincial jurisdiction because I do not believe the bill or the agency would contravene anything that is happening in the provinces.

[Bill Siksay, NDP, Burnaby—Douglas, BC]

Mr. Speaker, I enjoyed listening to the remarks of the member. We are debating establishing the mandate for the Public Health Agency and the Chief Public Health Officer of Canada, but there are concerns about whether there are enough financial and human resources to fulfill that mandate as set out in the bill. The Canadian Medical Association and other key stakeholders have raised concerns about the resources that are available to do this important work. Could the member comment on that?

[Rob Merrifield, Conservative, Yellowhead, AB]

Mr. Speaker, I have seen the comments from the Canadian Medical Association. They come at it from a human resources perspective. Whether there is ever enough money for human resources, I do not know when enough is enough. They may be valid to some degree because we have a human resources crunch in medicine, not only in Canada but around the globe. It is very important that we understand that. I have never heard from Dr. David Butler-Jones or anyone from the agency.

The questions of the shortage of our resources with regard to the mandate of the agency are good questions to bring up in committee. We can ask those questions in due course, but I have not sensed that is a consideration at this time.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, the people of Yellowhead are very fortunate to have such an excellent member of Parliament. As the member mentioned, he was the health critic of our party at the time of SARS and did an outstanding job in that role.

It is interesting that the government has brought forward the legislation even before bringing forward its budget, particularly when it took so long for the previous government to act. Would the member comment on his experience with the commitment of the previous government on this legislation? Why did this government act so swiftly when the other government seemed to dilly-dally.

[Rob Merrifield, Conservative, Yellowhead, AB]

Mr. Speaker, as I mentioned in my speech, it is all about leadership, or the lack of leadership. That was the problem with the last government. It led by polls and not by directive. I think Canadians are starting to understand that this government is very directive and solid on leadership. That is why the legislation is in the House before the budget. It is important legislation and it should have been done two or three years ago.

It is now before the House. Let us get it to committee and get it enacted. That is what needs to be done, and I believe we will make that happen. It is refreshing to see a government that has this kind of initiative.

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, Bill C-5 is of paramount importance for the future autonomy of the provinces in the field of health.

With 9,146 full-time-equivalent employees, including 8,833 for the department alone—excluding the health institutes, the Review Commission and the Patented Medicine Prices Review Board—and a budget of $3.35 billion, Health Canada cannot even manage to attend appropriately to its own responsibilities. Yet it is doing its utmost to trespass in the fields for which Quebec and the provinces are responsible. The federal government’s intervention in health should be confined to its areas of responsibility. We are referring among other things to aboriginal people, the armed forces, veterans, approval of new drugs and assessment of toxic products.

Quebec alone is responsible for policies and management relating to the health services and social services available to its population.

The federal government claims that its health mission is to help Canadians maintain and improve the state of their health. In reality, its responsibilities are basically to assist with health funding through transfer payments to the provinces and Quebec, to offer services to certain groups such as aboriginal communities, veterans, military personnel, inmates of federal penitentiaries and the RCMP, and also to exercise control of new drugs. To better impose its vision, however, Health Canada employs more than 9,000 full-time-equivalent employees, and 4,561 of its 9,146 employees are assigned to health protection and promotion, and only 1,529 to aboriginal health.

From 1998-99 to 2002-03, the increase in positions related to aboriginal health was feeble compared with the increase of personnel in fields liable to cause intergovernmental controversy. The most marked increase is in the sector of health promotion and protection, which rose from 506 to 4,561 full-time-equivalent jobs.

Money is spent on aboriginal health, but not enough is being done. The infant mortality rate is twice as high in first nation communities as in the population at large. The life expectancy of registered Indians is seven years less than that of the general population, and their suicide rate is two to seven times as high as that of the general population.

How can they justify phenomenal amounts to promote and protect health when services for first nations are so poor?

In her March 30, 2004 report, the Auditor General of Canada blew the whistle on Health Canada, which does not have a comprehensive program to protect citizens against the risks associated with medical devices. I could mention breast implants, medical devices that proved defective but which had still been approved by Health Canada or that were available even without its approval through its special access to health products program in cases of an emergency or for life-threatening conditions, even though the federal government had promised to institute such a program more than ten years ago.

How can the federal government justify so many intrusions into health when it is incapable of doing a good job on one of the few tasks that really do fall within its jurisdiction in this area. I am speaking of the hospitals under federal jurisdiction.

Health Canada is also in charge of managing three hospitals that serve aboriginal communities.

First there is Norway House Hospital in Manitoba. It is for the Cree and serves 6,000 people. In 2002-03, Health Canada gave it $3,500,429. Apparently $3.5 million is also spent annually on transporting patients to Winnipeg; that is a lot of money for transporting patients. This hospital is in such decline that RDI did a report on it in late 2003. RDI reported that one of the only two physicians working full time in this hospital described it as worthy of a third-world country. That is terrible.

There are also the Percy E. Moore Hospital in Manitoba, which Health Canada gave $3,028,048 for 2002 and 2003, and the Weeneebayko General Hospital in Ontario, which the department gave about $11.5 million for 2002 and 2003. Ontario also funded this hospital to the tune of $3,932,000.

Although Health Canada is in charge of aboriginal health, aboriginals have a smoking rate that is more than twice the Canadian average, an obesity rate that is twice as high as that of Canadians in general, a diabetes rate that is three times as high as that of Canadians 55 years of age or more and six times as high as that of Canadians 35 to 54 years old. In addition, many older members of the first nations do not get the home care services that they need.

What is more, Health Canada does not even manage all the federal hospitals. In fact, some federal government hospitals are managed by Veterans Affairs Canada, National Defence and the Solicitor General. Quebec and the provinces are the only instances with the authority to assess health services needs. Despite this evidence, Health Canada causes duplications and encroaches on the jurisdictions of Quebec and the provinces. The most flagrant example: the Canada Health Act “establishes the criteria and conditions related to insured health care services that the provinces and territories must meet in order to receive the full federal cash transfer contribution under the Canada Health and Social Transfer”.

The federal government appears virtuous by imposing standards when it is not even able to manage properly the few hospitals it has. Let us not forget drug regulation, which is another Health Canada responsibility. Health Canada's approval procedures for new drugs can be quite lengthy. The federal government has often promised to speed up the regulatory process to provide quicker access to drugs. However, Health Canada seems unable to engage in a quick and thorough assessment of the products.

This situation also exists at the Natural Health Products Directorate where more than 12,000 products are currently waiting to be assessed, thereby depriving thousands of people of products that are for the most part inoffensive and could greatly improve their health.

The Patented Medicine Prices Review Board Canada Performance Report for the period ending March 31, 2003, states that only 35 people or “full-time equivalents” are employed with a budget of roughly $4.2 million. That is quite expensive. Nonetheless, Health Canada allocates $802.2 million to its health promotion and protection policy.

The department should do more to address the gaps in approving new drugs instead of putting its energy into interfering in the jurisdictions of Quebec and the provinces.

Despite all these flaws in its own jurisdictions, on December 12, 2003, the Liberal government announced the creation of the Canada Public Health Agency under Health Canada. In the Speech from the Throne on February 2, 2004, the Liberal government said:

The Government will therefore take the lead in establishing a strong and responsive public health system, starting with a new Canada Public Health Agency that will ensure that Canada is linked, both nationally and globally, in a network for disease control and emergency response.

On September 24, 2004, Paul Martin officially inaugurated the Public Health Agency of Canada by appointing Dr. David Butler-Jones as the first Chief Public Health Officer for the agency that had been established in Winnipeg.

The Public Health Agency of Canada is funded out of the $665 million promised in the 2004 budget to strengthen the public health system in Canada and the $404 million provided to the Population and Public Health Branch of Health Canada.

The agency therefore has $100 million for increased front-line public health capacity, $300 million for new vaccine programs, $100 million for improved surveillance systems and $165 million over two years for other federal public health initiatives.

Let us come back to surveillance systems. We have recently heard about this on television.

An English language program did a report on airports in Canada, and more specifically Pearson airport. We saw how easy it was for anyone to get through the security systems with anything. In Canadian airports, you could just as easily get through with anthrax as with a bomb, especially at Pearson airport. If we really want to do surveillance, employees have to be trained to do it properly. Unfortunately, we saw in the past that this was not the case.

The Public Health Agency’s mandate is to focus on more effective efforts to prevent injuries and chronic diseases, like cancer and heart disease, and to respond to public health emergencies and infectious disease outbreaks. The PHAC would also work closely with the provinces and territories to keep Canadians healthy and reduce pressures on the health care system.

And yet as recently as last week the Canadian Cancer Society was telling us that, in its opinion, research was paramount. It is not more bureaucrats that we need, it is money going directly for research, with as few intermediate layers as possible. The more complex the bureaucracy, the less money is used for the purposes for which it is intended.

Ultimately, this agency is to have six coordinating regional offices, including one in Quebec. In Quebec, however, we have had our own public health agency since 1998: the Institut national de santé publique du Québec. In fact, we already have our own action plan for bird flu. In that connection, the government has procured over 9.8 million doses of the antiviral Tamiflu for fighting the disease, and plans to increase its available stock to 11 million doses. We are well aware that this would probably not be enough to fight the bird flu virus if a pandemic were to break out. However, we are aware that we already have more of it than Canada has. We will therefore have a better chance of getting through it. In Quebec, we do things differently, and we want to continue doing them differently.

Because it is the Government of Quebec that has the expertise and that can direct all of the institutions in the Quebec health care network, we believe that it is up to Quebec to set priorities, to develop action plans for Quebec and to ensure that they are consistent with the global objectives developed by organizations like WHO.

The federal government has taken advantage of the fiscal imbalance—which it created itself—and the needs that the fiscal imbalance has created in Quebec and the provinces in their areas of jurisdiction, to multiply its intrusions in those areas by using its spending power. It would appear that the Conservative government is adopting this tactic.

Yet in a speech given as recently as April 21, 2006 in Montreal before a large audience—through which we heard about it—the Prime Minister boasted of his open federalism, saying: “Open federalism means respecting areas of provincial jurisdiction. Open federalism means limiting the use of the federal spending power—”

In the same vein, the Minister of Health said with regard to guaranteed wait times that we have to respect provincial jurisdictions, even if that takes a little more time to get things done.

One has to acknowledge that they are not “walking the talk”. We have always been very aware of the importance of health-related issues, particularly in light of the ageing population and the possibility of easily communicable diseases crossing our borders, as in the SARS episode in Toronto. However we are convinced that the formulation of plans for dealing with serious diseases is one primordial aspect of health care which must remain a provincial responsibility, especially when, as in Quebec, we have our own public health agency.

Furthermore, since the reduction of federal health transfers in 1994, health care has suffered from chronic underfunding. We consider the main problem to be the underfunding as a result of the fiscal imbalance, which deprives Quebec and the provinces of the revenue necessary to meet their responsibilities, thereby making it difficult for them to properly support their public health agencies.

Only the correction of the fiscal imbalance will enable Quebec and the provinces to better develop services to their populations in their fields of jurisdiction, and ensure that citizens have the proper tools to face the new public health challenges.

The Bloc Québécois considers the problems Quebec is experiencing today in its health system to have been caused in large part by the federal government, which effected a massive withdrawal from health starting in 1994-95. Those draconian cuts, of which my colleague was speaking earlier, at a time when Quebec was initiating health care reform, prevented the Government of Quebec from carrying through with its planned improvements and made any intelligent long-term planning to meet the needs of Quebeckers an illusion.

Whatever the party in power, Quebec governments have been denouncing federal intrusions in health for a very long time. I offer you a few striking examples.

According to the second government of Maurice Duplessis, formed by the Union Nationale, which sat from August 30, 1944 to September 7, 1959:

Quebec considers that the following areas are the exclusive jurisdiction of the provinces: natural resources, the establishment, maintenance and administration of hospitals, asylums and charitable institutions, education in all areas including university studies, the regulation of professions, including the entrance requirements to the practice of medicine and relations between patient and physician, social security, health and public hygiene—

Even Robert Bourassa, the leader of the Liberal Party, said the following after the failure of the Meech Lake accord:

Under the Canadian Constitution social affairs and health are irrefutably matters of exclusive provincial jurisdiction. Over the past 25 years, the Government of Quebec has carried out its responsibilities in a remarkable fashion and has provided quality administration in the sectors of health and social affairs. These successes are eloquent proof, and the people of Quebec are convinced of it, that Quebec would gain nothing from a new manner of sharing jurisdictions in these sectors. Up to now, they have been under exclusive provincial jurisdiction and, in the best interest of Quebeckers, will remain so.

Finally, Jean Charest said at a first ministers' meeting:

The first ministers addressed other issues, such as establishing a public health agency that could coordinate a national response to a crisis occasioned by an infections disease such as SARS. The two levels of government will look as well at combining their efforts in the event of a natural disaster. Quebec, warned Jean Charest, has established its own structures in these two areas, which are working. They will work with those put in place, but there is no question of duplication—

We in the Bloc Québécois share these opinions that there is no question of duplication or of setting up another health agency that would employ thousands of people and cost taxpayers millions of dollars for very little in return.

Only correction of the fiscal imbalance will ensure stable funding, enable Quebec and the provinces to further develop services for their inhabitants in their areas of exclusive jurisdiction and ensure that, in matters of health, the public receives proper care.

The government must reiterate its firm commitment to correct the fiscal imbalance. Today's budget must provide a clear indication of the government's intention to resolve the problem by giving the provinces and Quebec an initial portion of the increase needed in transfer payments for post-secondary education and social programs.

In the name of pan-Canadian objectives that negate the Quebec difference, the federal government is confirming that it wishes to interfere further in areas of jurisdiction belonging to Quebec and the provinces. The federal government’s responsibility is to provide adequate health funding, not just to propose new structures, like waiting list indicators, which do not solve the problem of under-funding.

Finally, because the federal government is interfering in the provinces’ areas of jurisdictions with its prevention and surveillance programs, with its Nursing Strategy for Canada, its Canadian Diabetes Strategy, its plan to combat an influenza epidemic and many other unilateral initiatives, health priorities get jostled.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I think the member may in part misunderstand what this bill is doing. First, it is not infringing on any jurisdiction. It is a machinery bill that organizes the responsibility that the health minister already has. In fact, in the area of public health there is some overlap in jurisdiction, particularly when it comes to peace, order and good government. Part of it is if there ever is a pandemic, there needs to be coordinated role.

The member talked a lot about Quebec in isolation of the world. I do not think Quebeckers or Canadians would accept that Quebec somehow would be isolated from a pandemic. This is why this bill is very important. It provides for a Chief Public Health Officer who is not a politician but someone who has expertise in public health matters, who would be able to address the concerns of all Canadians, including Quebeckers, when such a pandemic occurred. Quebec is only 100 metres away from where we are speaking today and to suggest that it is somehow isolated is incorrect.

Will the member accept that Quebec is not an island unto itself and there are circumstances where the provinces need to work together to ensure the protection of all their citizens? The Public Health Agency of Canada will do that without creating additional cost to bureaucracy but actually will streamline the government's response to a public health crisis. Would the member agree?

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, although I have often agreed with my honourable colleague on the Standing Committee on Health, I find myself forced to say no right now because, by instituting this agency, the federal government is displaying its arrogance towards the powers of Quebec and the provinces.

Also, we repeat that Quebec already has had its own Institut national de santé publique since 1998, and that this institution does not need a federal agency to do the same thing. We already take care of this, ourselves, in Quebec. Furthermore, it is not true that we are isolated.

We do things directly in Quebec. We do things differently. We do things by taking into account the aging population and the children we have. We do things because we are concerned about people in Quebec. We do things because perhaps our way of thinking is a bit more social than conservative, but we do things well.

[Keith Martin, Liberal, Esquimalt—Juan de Fuca, BC]

Mr. Speaker, I listened intently to the member's comments.

Regardless of where we live in our great country, we are all affected by health care challenges. That is the intent of the bill. Over the last few years Canada is the number one nation in the entire world in terms of SARS preparedness and SARS response. There is an extraordinary monitoring system within Canada. Our experts have travelled to the Far East to help the people there monitor and address their SARS challenges. We know those challenges quite well. We have done a great job in Canada. Our researchers and Public Health Agency experts, as the parliamentary secretary also knows very well, have done an outstanding international job on this. A world meeting was held last year in Montreal so that we could work with other countries to deal with that challenge.

Some of us put together an initiative which deals with type 1 diabetes. We are poised to close an incredible loop in our country, which is very exciting. It started with Banting and Best and the discovery insulin. We are now at the stage in research where we hope in the very near future to complete the genetic mapping for the genetic component of type 1 diabetes but also to identify some of the environmental factors and develop the technology to enable individuals to regenerate the islet cells in the pancreas which produce insulin.

The member and her party refused to participate in a bipartisan initiative to enable researchers to have a $25 million per year investment over five years. That would enable Canada to take the lead and be the first country in the world to ever cure a chronic disease.

There are thousands of people in the member's own province who suffer from type 1 juvenile diabetes. People are diagnosed primarily when they are children. The biggest increasing age group is between five and nine years. Our country has the third highest incidence in the world. How could the member look her constituents in the eye and say that as a member of the Bloc Québécois, she refused to participate in a binational, bipartisan initiative to ensure that our researchers in Canada, in Montreal, were able to have the tools to find a cure for type 1 diabetes? Why did she refuse to participate in this initiative? Why did she block the initiative for members from all political parties to unite in defeating this disease?

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, I thank the member very much for his question.

Last year, when the Minister of Health was confronted with the same problem and he was asked for $25 million over five years, the request was turned down. In addition, the money for juvenile diabetes was combined within various chronic disease strategies. Therefore I do not think that the member has anything to tell us about this subject.

Also, how does he think that the federal government can help people suffering from juvenile diabetes or any type of diabetes, when it is not even able to help the native people under its responsibility? These people suffer three times more from diabetes than other Canadians aged 55 and above. And seven times more people aged 35 to 54 suffer from diabetes. The federal government is not even able to take care of them. How can we expect it to be able to manage a pan-Canadian strategy on diabetes, when it is not even able to live up to its own responsibilities?

[Brian Masse, NDP, Windsor West, ON]

Mr. Speaker, one of the interesting avenues the bill might actually create is the investigation and mitigation of different health factors in terms of food products. I would like the investigation to involve the elimination of trans fats. The House of Commons voted to work toward the reduction and elimination of trans fats. The NDP motion was accepted in 2005. I would like to see that administered.

I ask my colleague from the Bloc, would her party argue that Quebec should have different standards for trans fats? Trans fats appear in baby food and a whole series of products that affect human health.

Especially given the industrial use of different manufacturing processes in the goods that people buy, it would be an advantage to lower trans fats and have standardized reductions of trans fats across the country. It would also pressure the manufacturing industries to immediately reduce or lower trans fats which would create better market conditions to attain a quicker result in the elimination of trans fats.

Having Quebec as part of that would make it a speedier process, or do the Bloc members actually believe that Quebec should have a different level of trans fats than in the rest of the country, than eliminating products or restricting products or allowing more that would have increased trans fats?

[The Acting Speaker, Royal Galipeau]

The hon. member for Laval has less than a minute to answer this question.

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, I would tell my hon. colleague that we are very aware of the problems caused by trans fats. These problems have already been discussed in the House. We support the principle of the bill on trans fats.

I would add that we are involved in the fight against trans fats. My own brother, who has been living in Alberta for 20 years, works for Frito Lay. It was the first company to get rid of trans fats in its chips. He is a Quebecker who is working therefore on getting rid of trans fats.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, today it is my privilege to speak to Bill C-5, an act respecting the establishment of the Public Health Agency of Canada.

I take very seriously the responsibilities the member of Parliament for Prince George—Peace River and chief government whip gave me when he appointed me as a member of the Standing Committee on Health. This is the first of many issues relating to health that I plan to address.

I am very pleased to speak about such an important service that benefits all Canadians, the Public Health Agency of Canada. I would like to address the reasons this agency was created, the reasons this agency is needed, and the reasons we need a Chief Public Health Officer. Finally I will address what the legislation will do.

The overarching theme of this legislation is the protection and promotion of the health of Canadians. The establishment of the Public Health Agency of Canada was in fact a response to the need to establish a federal focal point to address public health issues following the 2003 outbreak of severe acute respiratory syndrome, popularly known as SARS.

SARS was a blow to our health care system. Some experts have stated that only the heroic efforts of Ontario's front line health workers kept the deadly SARS outbreak from exacting a far heavier toll. The province's public health system was called into question. Internationally, the health of Canadians was also called into question for months after the outbreak when they travelled overseas. Even Canadians living abroad were sometimes questioned. Canadians demanded action.

Dr. David Naylor and Senator Michael Kirby each consulted with the health community and reported specific recommendations, including the establishment of a Canadian public health agency and the appointment of a chief public health officer for Canada.

As members are probably aware, our right hon. Prime Minister has great respect for provincial jurisdiction. That is why our government is committed to federal, provincial and territorial collaboration, especially in such an important project as the Public Health Agency of Canada. One way this cooperation is done is through the Pan-Canadian Public Health Network which was established in April 2005. Informal discussions with provincial and territorial public health authorities have indicated that they would like a federal public health focal point with the authority and capacity for effective collaboration, especially during emergencies. God forbid an emergency like SARS should ever resurface, but we will be prepared.

Consequently, the Minister of Health has made it clear that the legislation does not expand on the existing federal role in public health. Instead, the legislation simply provides the agency with its mandate to assist the Minister of Health in exercising his powers, duties and functions in public health. Nothing that the federal government is currently doing in public health has changed.

Although the Public Health Agency of Canada was created by order in council in September 2004, it lacked parliamentary recognition. As the House is quite aware, my party is about accountability. This legislation will give parliamentary recognition to the Public Health Agency of Canada and the Chief Public Health Officer. In other words, this is largely a machinery bill that will give the agency a sound legislative footing to support the Minister of Health in addressing public health issues.

For me, this is an area of grave importance. In my former role as mayor and warden, I served for many years on the local board of public health, including six years as chair of that board. I know first-hand the value of having a Chief Public Health Officer at the federal level which, in the time of a widespread emergency or pandemic, can coordinate an appropriate response in coordination with the provinces and territories.

A federal focal point to address public health issues will benefit the constituents of Sarnia—Lambton in many ways. As a riding with so many international border crossings to the state of Michigan, including the twin Blue Water Bridges, an international health emergency would be better contained and managed through a federal focal point, including a Chief Public Health Officer.

In the chemical valley, by which my riding of Sarnia—Lambton is popularly known, the main CN line carries many hazardous goods. In my hometown municipality of Plympton-Wyoming, we see an average of one train every 20 minutes carrying hazardous freight. The comfort of knowing there will be a coordinated effort with a federal focal point should an accident happen is important to me and my constituents. The Chief Public Health Officer will provide that comfort by way of leadership.

The legislation will establish a unique dual role for the Chief Public Health Officer. Why, some would ask, is there a dual role? The legislation recognizes the Chief Public Health Officer's unique status as the Government of Canada's lead public health professional as well as the deputy head of the agency. Let me explain. As deputy head of the agency, the Chief Public Health Officer is accountable to the Minister of Health and informs the minister on policy development. Additionally, the Chief Public Health Officer is Canada's lead public health professional with authority to communicate with Canadians and publish reports on any public health issue.

Not only does the legislation clarify the rules and responsibilities of the Chief Public Health Officer, but it also responds to both Naylor's and Kirby's recommendations that the Chief Public Health Officer have a degree of independence to speak out and issue reports on public health matters.

Threats to the health of Canadians will allow the Chief Public Health Officer to engage other federal departments to mobilize health resources of the agency. The Chief Public Health Officer must submit to the Minister of Health for tabling in Parliament an annual report on the state of public health in Canada, aiding the Minister of Health in his decision making as to what are the best measures to promote better health care for Canadians, and subsequently, improve patient wait time guarantees which is a priority of the government.

Therefore, as an impartial, credible voice on public health able to communicate directly with the public, the Chief Public Health Officer will be accountable to all Canadians while respecting the Privacy Act and the Charter of Rights and Freedoms.

A federal focal point will provide assurances to provinces and territories that they can lawfully share information with the federal government in light of a possible health emergency such as an influenza pandemic. Systematic monitoring and surveillance would be needed to anticipate, prepare for and respond to such an emergency in a timely manner.

The agency already maintains a national emergency stockpile system that contains everything from pharmaceuticals to beds and blankets for use in an emergency.

Additionally, the Chief Public Health Officer uses the public health network to get information from his provincial and territorial colleagues and with his authorities would be able to communicate and provide the best public health advice to Canadians in key areas such as pandemic preparedness and antiviral stockpiling. SARS has taught us all a valuable lesson in dealing with public health threats.

My several years of training through Emergency Measures Ontario have certainly taught me the value of having this national emergency stockpile system in place. It will be imperative in a pandemic situation that resources be available on a national level. In fact, the Public Health Agency of Canada has already strengthened the Canadian pandemic influenza plan by increasing its national antiviral stockpile and signing an agreement to develop a prototype H5N1 or avian flu vaccine.

Having a separate agency within the health portfolio is needed to deal with public health issues. Coherence on a national scale is what the legislation ensures when the health of Canadians is in jeopardy.

I support Bill C-5 and so will my colleagues. We want to bring greater visibility to public health issues. We made a commitment on this side of the House to improve our public health system. The legislation fulfills these objectives.

[Robert Thibault, Liberal, West Nova, NS]

Mr. Speaker, I welcome the member to the House. I am pleased to see she has been appointed to the health committee. I had the opportunity to serve on that committee for quite some time, and she will find it very rewarding.

I listened to her speak about what the bill would accomplish. It is reminiscent for me. I remember presenting the bill last year and going through part of the debate. She and some of her colleagues present it as if it were a new bill. The Public Health Agency was established by the previous Liberal government. The Chief Public Health Officer was selected in that process. The bill was introduced, the same bill that has been presented here, but it died on the Order Paper because the opposition chose to vote the government out to force an election without advancing the bill.

I hear members of her party suggesting that bill shows great leadership, that it is great advancement in the interests of the public health and that it is something new. Would it not have been in the interests of the public health six months ago to have advanced the bill and put it forward quickly, or are members of that party a little on the hypocritical side?

I also heard the comment that it was being presented before the presentation of the budget. There is nothing to put in the budget. The only thing in the budget could be a withdrawal of resources, and I hope the Public Health Agency is resourced properly and that Dr. David Butler-Jones and his staff have the available those resources. I look forward to that. I hope independence is given to the agency to operate on a pan-Canadian basis in cooperation with the provinces and with other agencies.

I have stated that I will support the bill. It is a good bill and I am pleased to see it has the support of the member.

A private member's bill, which recommended that national health products be treated as foods and not evaluated or listed independently and that personal care and hygiene products such as make-up and antiperspirants, deodorants and soaps be treated as food also and sold without any warning or under the same circumstances, died on the Order Paper. It was strongly supported by the member's party at committee last year. Does she intend to bring that one back? Could we expect to see that bill back with the same vigour that we see the Liberal bill brought back before the House?

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, the bill before us today is a very important bill for all Canadians. Whether the bill was before the House in some other form is not the issue. The issue is the fact that we all care very much about the public health of Canadians. The bill is before the House for discussion and passing. We have a lot of positive comments on it from all parties. The discussions at committee level will be extremely interesting, and I look forward to that.

Regarding the other question, we need to put the resources in place and I am quite confident that those resources will be there to address the issues that will come from the bill. The independence and the leadership that will develop as well from the bill are extremely important as we deal with the public health of all Canadians.

As far as the question regarding the private member's bill, I cannot answer that question. I do not have that knowledge. Perhaps one of my other colleagues on this side of the House would be able to answer it. Once the health committee sits, that is a question I can ask and we can definitely answer later. At this point I cannot answer the question.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, the member may be aware that any private member's bill that passes through the House will go to committee provided government legislation is dealt with first. I do hope there will be strong support for this bill.

The member made note that the previous Liberal government only brought its bill before the House a week before it fell, with the full knowledge that it would fall. Its legislation did not even make it to second reading, which questions the Liberal government's commitment to public health.

I congratulate the member on her appointment to the health committee.

My question for my colleague is this. How we can ensure that we get the message out to all Canadians, including those in Quebec and first nations people, that this government is firmly committed to public health where the previous government failed?

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, the government is definitely committed to improving the health of all Canadians. By bring this bill brought forward so early in our mandate, speaks well to that commitment. We definitely have made health care, including shorter wait times and other issues, one of our priorities. We know this has to be done in cooperation and collaboration with other areas of this great country. We need to discuss these issues with the provinces and territories. We also need to have discussions with municipal leaders, who also have a role to play in public health.

The fact that this government is extremely committed to moving forward on health care and that is extremely committed to taking a leadership role and to collaboration and cooperation should convince the Canadian public that we are very serious about health care in Canada.

[Jean-Claude D'Amours, Liberal, Madawaska—Restigouche, NB]

Mr. Speaker, I would like to draw my hon. colleague’s attention to an important aspect.

Addressing the question of the Public Health Agency of Canada is one thing, but pandemics are something else entirely. Also, in regard to another reality, we must be able to provide the people of Canada with food that, in my view, is worth eating.

Let us speak, therefore, of the example of dairy substitutes. This problem exists not just in my region but all across the country. We cannot even have products nowadays that are 100% dairy. We are forced to import dairy substitutes to make cheese and ice cream.

My position is clear in this regard. Would my hon. colleague agree that we should proceed in exactly the same way as the previous government, which is to introduce a bill that would improve things for Canadians by eliminating the entire question of dairy substitutes? This bill would both help our dairy farms and give Canadians some assurance that they are consuming very good quality products.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, there is no question that health care and our food supply are interwoven. Both are extremely important. We have said repeatedly that we need to have control of our food sources. We had this discussion during other debates on agriculture and the plight of our farming community across the country.

I agree with what the member has said. We need to have control of our food sources. We need to examine that. There are great links to public health issues, our food sources and our food supply, and I support those.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, it is with great pleasure that I rise to talk about Bill C-5, an act respecting the establishment of the Public Health Agency of Canada and amending certain acts.

The text of this bill is a carbon copy of Bill C-75, which was tabled in the House on November 16, 2005, by the former Liberal government. Bill C-75 was consigned to history when Parliament was dissolved on November 29, 2005.

This is a housekeeping bill because it creates the Public Health Agency of Canada and sets out its purpose and duties. I support it.

It is very important, though, to set the record straight on the proud accomplishment of the previous government in the rapidity in which it dealt with the SARS crisis in April of 2003. The minister of the day, Anne McLellan, immediately appointed David Naylor's committee to study what had happened. In November Naylor's report was released. In December the prime minister appointed the first ever minister of state for public health.

Very soon after that, in May of 2004, we were able to describe the new Public Health Agency of Canada, as well as the national collaborating centres that would study how to keep Canadians as healthy as possible. By September 2004 the Public Health Agency of Canada was created with an order in council and David Butler-Jones was appointed the first ever Chief Public Health Officer for Canada.

In April of the following year the extraordinarily important Canadian public health network was established, which would allow all 13 jurisdictions to plan public health together, recognizing that germs did not recognize borders and that the other epidemics of obesity, diabetes and other chronic diseases, as well as injury, could be much better planned by sharing best practices across the country and doing all of that together.

However, I remind the government of the extraordinarily important commitment all first ministers made at their meeting in September 2004, and that was to establish some health goals for Canada. I think it was extremely exciting for all Canadians to hear the first ministers speak to the initial goal of Tommy Douglas for medicare in Canada, which would be to keep Canadians as healthy as possible, not just patch them up when they get sick.

The first ministers talked about building rails so seniors would not fall. They talked about diabetes. They talked about the unacceptable gap in the status of our aboriginal peoples. Everybody understood that the health of Canadians could not be ameliorated only by looking at the health departments. Each of the ministers called upon all their departments and worked in collaboration with all jurisdictions to ensure that every government department understood its responsibility in keeping people well, not just patching them up once they got sick.

It is very worrisome for me today that the goals, which had been asked for and delivered this past September and approved by all health ministers, are no longer visible on the home page of the Public Health Agency of Canada. It is extremely important that we underline those goals, that the governments, particularly the federal government, work with all departments to reach those goals and move immediately on to the next step of deciding what each government department must do. Each jurisdiction needs to work together to ensure that Canadians stay well.

I would like to remind you about the Overarching Goal:

As a nation, we aspire to a Canada in which every person is as healthy as they can be – physically, mentally, emotionally, and spiritually.

Canada is a country where:

Our children reach their full potential, growing up happy, healthy, confident and secure.

The air we breathe, the water we drink, the food we eat, and the places we live, work and play are safe and healthy - now and for generations to come.

Each and every person has dignity, a sense of belonging, and contributes to supportive families, friendships and diverse communities.

We keep learning throughout our lives through formal and informal education, relationships with others, and the land.

We participate in and influence the decisions that affect our personal and collective health and well-being.

We work to make the world a healthy place for all people, through leadership, collaboration and knowledge.

Every person receives the support and information they need to make healthy choices.

We work to prevent and are prepared to respond to threats to our health and safety through coordinated efforts across the country and around the world.

A strong system for health and social well-being responds to disparities in health status and offers timely, appropriate care.

I ask the government to now, please, begin again, to work with all its departments, to work with the areas that we have complete responsibility for, the public service; our first nations, Inuit and Métis people; corrections; the RCMP; the military; all those people. We need to see what we are doing in each of those departments in our areas of direct responsibility to actually move forward on the indicators for these goals. As a result, we, as the federal government and as parliamentarians, can be proud of what we are doing in the areas that we have direct responsibility for. We must work together with the provinces to work on the indicators that they themselves will report on and will work toward across all government departments and all jurisdictions.

It is only in this way that we will be able to protect the sustainability of our cherished health care system. It is only in this way that we will understand the huge difference between health and health care. The Public Health Agency of Canada requires serious resources to be able to do this job. We thank and applaud the Chief Public Health Officer of this country, Dr. David Butler-Jones, and all the chief public health officers across Canada who are working so well together.

That means, however, that we must work with our partners within government and other jurisdictions in the same way. I would hope that in this budget this afternoon the $300 million that had been there and that should have been passed in the estimates on December 6 for an integrated disease strategy will be restored. I hope there will be resources in the budget for proper pandemic preparedness and resources for a proper information system that would allow us to collect data and to ensure that we are working every day in the best interests of Canadians and their health.

I look forward to the budget, I look forward to seeing the health goals process back up on the home page of the Public Health Agency of Canada. I hope that we, together, in a non-partisan way, will be working every day to ensure that as many Canadians stay as healthy as possible in order to sustain our cherished public health system.

[Judy Sgro, Liberal, York West, ON]

Mr. Speaker, I would like to acknowledge the excellent work that was done by my colleague, the former minister, on this particular issue. Certainly, she worked with a passion and I think we all owe her a huge debt of gratitude.

I am pleased to see that the bill is here today and that it is now moving forward. The government recognizes how important this work is and why we need to have this Public Health Agency.

The SARS epidemic that hit Canada had a huge impact on us all and we recognized our responsibilities as parliamentarians in the protection of all Canada and Canadians. I would like to ask the hon. member, when she looks over Bill C-5, is there anything else that is not in the bill? The regulations section refers to “may” not necessarily “do” when it comes to instituting the regulations. I wonder if she has any concerns over anything that has been left out of this bill that might need to be put in to ensure that the legislation is covering off all the bases.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, we knew that the bill was just the framework to establish the agency and to ensure that within the bill there would be the flexibility to go forward in terms of regulations. We would want the bill to go forward in a way that would be fair, transparent and would get the job done. I think that the bill does that job.

However, we also need to look forward to the kind of work that will done by the health committee. As we move forward on regulations we must ensure that everything that needs to be done is there. However, the main thing that we will need to fight for will be the resources to ensure this is done properly because way too many resources are proportionately on the health care side as opposed to keeping people well.

I hope that in the future we will be able to have a way of looking at all government department responsibilities for the health of Canadians. The World Health Organization is now talking about this kind of thing and we have seen it in Quebec. Perhaps we should look at a health impact analysis of all government policies and budget items to ensure that everything we do that has an impact on the health of Canadians is recognized. That will require a whole of government response and not just what is in the purview of the Public Health Agency.

[Pat Martin, NDP, Winnipeg Centre, MB]

Mr. Speaker, the member for St. Paul's was of course the former minister of public health. Does she think that the Public Health Agency perhaps may have dedicated more time to issues of preventative medicine had it not been preoccupied and seized with things like SARS, mad cow and Asian flu?

In other words, epidemics and pandemics seem to take the priorities and energies from the new Public Health Agency and leave very little time or resources to deal with things like banning trans fats, which I approached her with early on. She cooperated in dealing with that public health issue. There were issues like banning pesticides which her colleague from Ottawa used to push aggressively.

It seems to me that as a nation, in dealing with public health, we embraced the idea, but we were knocked off the game plan by unforeseeable things like SARS. Would the member care to comment on the dual role the agency could and should have?

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, that is an excellent question. I think the agency really has almost three responsibilities related to infectious diseases, chronic diseases, as well as emergency preparedness. That it is always seen as a zero sum game. If we actually need to be moving forward on infectious diseases or pandemic preparedness, it is seen as though we might be taking resources from another area.

I think that the job of the government is to move forward on all of these issues and to ensure that they are properly resourced. The $300 million that we placed in last year's budget on integrated disease strategy was, and we knew, only a down payment. We know that we need more money for that.

The member has dealt extraordinarily well with the issues relating to the epidemic of heart disease and the epidemic of obesity. How we actually look to the future on the issue of diabetes is going to be hugely important and must be dealt with as its own epidemic.

It is interesting that the New York State public health department has now designated diabetes as a reportable disease, meaning that even though it is not an infectious agent, it is a contagious agent that is social. We need to understand that pockets of diabetes can be tracked and can be dealt with in a public health strategy in the same way as we would deal with any other outbreak of a disease cluster. We must deal with it in that way. Otherwise, this will be the first generation of kids who will not be able to look forward to living as long as their parents and for that we cannot sit still.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I would like to thank the member for her comments and also wish the member success in any future endeavours she may have on a larger scale.

However, on the issue of the bill, the previous government waited until the dying days of the government to introduce this legislation. Looking at it from a historical perspective, it only received first reading after a number of years of being an order in council.

This government is acting swiftly to bring it forward and we appreciate the opposition's support. I wonder a bit however about the history.

As the former minister for public health in the previous government the member was very supportive of federal involvement in providing swimming lessons for young people. I wonder if the member still believes that the federal government has a role in providing swimming lessons.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, I thank the member for his support. He would need to take out a Liberal membership and I look forward to that.

In terms of the chronology, this was a very interesting project in terms of getting it from the order in council into an actual bill, but we are there now. As many of the speakers have said, this was a very challenging issue in terms of identifying the dual role for the Chief Public Health Officer of Canada to actually speak to Canadians as well as having deputy level status. That has been a hugely important first step and we are thrilled that this is coming forward. We are proud to support this bill.

Yes, I do think every kid in Canada should know how to swim. I hope the government is able to move forward on the healthy schools initiative in which all the deputy ministers of health and education across the country have come together to look at the kinds of things that we can do better together than apart. I hope that the swim to survive program of the Royal Life Saving Society is supported by as many jurisdictions as possible and I hope the Conservative government will help them do it.

[The Acting Speaker, Royal Galipeau]

Resuming debate. I recognize the hon. member for St. Catharines, who will be happy to know that this debate is about the Public Health Agency of Canada Act and not about floor crossing.

[Rick Dykstra, Conservative, St. Catharines, ON]

Mr. Speaker, I will keep that very much in mind.

First and foremost, this is my first opportunity to rise and address the House as a member of the 39th Parliament. I would like to take a moment to thank the people of St. Catharines and all those who worked so tirelessly in our community to allow me the opportunity to represent St. Catharines in the House of Commons.

It is a pleasure to rise and speak to this piece of legislation, one designed to improve public health in this country. The health care of our citizens, and particularly the people of St. Catharines, is an issue near and dear to my heart.

Members may know that my community is currently in the process of securing the construction of a new hospital. This hospital is planned to include a regional cancer centre and this new facility would provide state of the art health care for thousands of people in my community and allow newborns, such as Isaiah Thomas Dykstra, to get their lives started out on the right foot.

Of course we are not here this afternoon just to talk about new hospitals or the need for more family doctors. I am sure I will have plenty of time to address these issues in future debates.

As we indicated in our Speech from the Throne, our new government is committed to building a better country. We need a stronger federation in which governments at all levels come together to help Canadians realize their full potential. This includes working with the provinces and territories to protect and promote the health care of Canadians. This is why Bill C-5 is about taking action. It is a critical step in our new government's effort to promote and protect the health of Canadians.

My riding of St. Catharines is very close to our border with the United States. In 2003 when we were faced with the SARS outbreak, I watched at first hand the impact it had on the province of Ontario. As a Niagara parks commissioner, I saw the parks commission fall into a deficit position for the first time since World War II. The deficit was directly on account of the slowdown in tourism resulting from SARS. This speaks to more than just a financial deficit. It speaks to a deficit motivated by fear. That deficit represented the belief of many Canadians and Americans alike that their health and well-being were at risk.

What Bill C-5 represents is what we have learned. We have learned that we must be prepared to assist Canadians in the worst of times and we must be able to provide the international community with the assurance that we are able to protect the health and well-being of our citizens.

Providing a statutory foundation will give the agency and its Chief Public Health Officer parliamentary recognition. Dealing with health care and its issues is as old as our country itself. In 1867, Parliament was granted exclusive jurisdiction over quarantine and marine hospitals, while the provinces were granted exclusive jurisdiction over the establishment, maintenance and management of hospitals. Since that time, the federal government has had responsibility for quarantine at our borders and over the management of infectious disease outbreaks. This power has two branches: an emergency branch and a national dimensions branch.

This history has helped lead us to Bill C-5, a bill that allows for the establishment of the Public Health Agency of Canada and the confirmation of a Chief Public Health Officer. Our Minister of Health understands that. The minister witnessed the SARS tragedy at first hand and he understands the importance of granting the Chief Public Health Officer the authority to communicate directly with the public. The public health officer must be able to provide the public with information about public health, including enduring a health emergency. In my eyes, this is a key component of Bill C-5.

We all know that diseases do not respect borders. Therefore, it is imperative that our lines of communication be open, not only within our own borders but with our colleagues in other countries, including countries such as Australia and the U.K., which already have a chief medical officer in place.

In response and leading up to that, we are moving forward with Bill C-5, which is not only a measure to improve our ability to protect the health and well-being of Canadians, but a measure to show our neighbours and people throughout the global community that we understand the serious nature of public health threats as they exist in today's world. I can confirm that our new government is prepared to take the action necessary to protect our people and those who visit our country.

This notion of borders brings me to another interesting component of Bill C-5. As many hon. members will know, the Canadian health agency currently maintains the national emergency stockpile system. This system provides emergency supplies quickly to provinces and territories, including the necessary pharmaceuticals.

I feel I should take this opportunity to recognize the ongoing efforts of a small pharmaceutical company in my riding that is working tirelessly to break down the borders and help fulfill this mandate in the event of a flu pandemic. A small company by the name of Biolyse Pharma has been working tirelessly to develop a drug equivalent to Tamiflu in order to combat the avian flu. There are companies such as Biolyse that face many challenges, but their efforts should be commended across the country. I look forward to working with them.

I would like to make one final point. This bill is representative of what our new government is all about. It is focused, it is direct, and it does what it is supposed to do. Bill C-5 contains only a preamble and 24 clauses, but it is focused on protecting the health and well-being of Canadians. It delivers what Canadians expect: a stronger, safer and more secure health care system.

[Robert Thibault, Liberal, West Nova, NS]

Mr. Speaker, I would first like to welcome the member and colleague to this House. I hope that, like us all, he will find the time he spends here worthwhile.

I want to thank the member for his work. I am pleased to see that he supports this bill, which he calls very direct and indicative of the actions his government intends to undertake. I am pleased if it is, because it is our bill. It is a bill that we put forward. It follows the Naylor inquiry. It was formed by the governor in council appointment of the Chief Public Health Officer and the agency. I certainly hope that he will support me, as I have mentioned before, in asking his government to properly resource this agency.

One of the areas about which I have some fear is what I heard in the House earlier: that resources in the integrated disease strategy were being reduced. I have to take this as authoritative because it was not contradicted. This integrated disease strategy sought to work with the provinces, agencies and non-governmental organizations on the common causes of diseases such as cancer, diabetes, heart and stroke, all the other respiratory ailments and all these others that are out there in our country and that we are working together on. That strategy no longer appears on Health Canada's website.

In the House and during the campaign, I remember hearing the governing party talking about fully funding the Canadian cancer strategy. I support that and I believe it is a good idea, but part of that falls within the integrated strategy. The governing party has talked a lot about ethics. I believe it would be unethical, even hypocritical, to remove that funding, to not properly fund that integrated strategy. I believe it is important that we work together with all intervenors in our society, provincial, local and non-governmental, on the common elements of all these scourges on the health of Canadians and the public health of our nation.

I would ask the member to please comment on these points.

[Rick Dykstra, Conservative, St. Catharines, ON]

Mr. Speaker, I think the efforts need to be recognized. I think the member opposite does recognize the crystal clear fact that this bill is sitting in front of us today not because it was or was not defeated with the election call, but because it is a priority of this government. We can take one step forward in understanding that the reason it is here is the critical role it plays from this government's perspective, as it did when we were not in government. We certainly supported the bill then and we are now moving forward with it under the pretext of having it as one of the first bills introduced by this government.

Where I do question the perspective of the member opposite is that under the former Liberal government the bill sat for over a year without being passed or even considered. With all due respect, it was acted on, but never through government legislation. It was always a piece that stood to the side. With all due respect to the work and the efforts of those who work within the context of this agency, it was never recognized here in the House. I think we should applaud the fact that one of the first steps this government is taking is to make sure this bill is here in the House and is being debated and will of course be passed.

[Pat Martin, NDP, Winnipeg Centre, MB]

Mr. Speaker, I would like to ask my colleague from St. Catharines for his view on one of the most obvious public health concerns that we can do something about and that even in the context of this agency we could do something about, and that is the fact that Canada is still the third largest exporter and producer of asbestos in the world.

In fact, much of Canada is contaminated with Canadian asbestos. There is a recent outbreak that is being noted in the Cape Breton region of Nova Scotia, where public housing is being abandoned because of the Canadian asbestos in the walls. Yet the government continues to promote, support and subsidize asbestos mines; in fact, 120 foreign missions paid for by the federal government in 60 different countries by the Canadian asbestos industry, paid for by the government dumping this stuff into the third world.

Would he agree with me that his government should stop subsidizing this, should stop being merchants of death and contaminating developing nations in third world countries with Canadian asbestos? Would he agree that the asbestos industry should be shut down and that his government should stop subsidizing it in the interest of everyone's public health?

[Rick Dykstra, Conservative, St. Catharines, ON]

Mr. Speaker, I certainly cannot speak to the overall direction that our government plans to take with respect to the issue the member has put forward, but based on the energy and enthusiasm that he displayed in putting forward his question, I would love to sit down with him and talk about this matter further to get a clearer understanding of the direction he believes we should take. I certainly would endeavour to do that.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

Mr. Speaker, I listened with great interest to my hon. colleague from St. Catharines and appreciate his words on this important bill before us today.

I come from Kelowna—Lake Country, the home of Firestorm 2003, the national disaster. The fires of August and September 2003 saw 30,000-plus people evacuated from their homes safely. There were no fatalities. At that time, we fortunately had a regional plan, a provincial emergency plan, albeit with some flaws, but we learned a lot from it.

Of course, Mr. Filmon had a national name and there was a presence to his report, which helped solidify things with our B.C. fire chiefs. In that recommendation was the need for a coordinated approach. Specifically during the fire, our fire chief, Gerry Zimmerman, was the credible, trusted voice during that national emergency. That is definitely something we need during a national crisis.

I have a question for my hon. colleague. While professional leadership and integrity are required during a national health crisis, will this legislation allow the Chief Public Health Officer to be the top go-to person during such a health crisis?

[Rick Dykstra, Conservative, St. Catharines, ON]

Mr. Speaker, I think the member's question speaks directly to the legislation. When enacted, it will allow, in the case of a provincial and certainly a national emergency, our chief medical officer to indeed respond directly. In fact, this legislation enshrines that authority for the chief medical officer, giving him the authority to speak directly to the public about the crisis, to speak about the need to take action and the type of action necessary.

Let me add that over the past number of weeks I think the government certainly has shown that same type of leadership and dedication that our current medical officer has over the past year and a half that he has been in the position, and that in fact when it comes to times of crisis and need, the government will be there and the chief medical officer will also be there.

[The Acting Speaker, Royal Galipeau]

I will advise the hon. Parliamentary Secretary of Health that there are two minutes for both his question and the answer.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, my question for the member is quite simple. The member correctly pointed out that the previous government seemed to take a long time to bring forward this legislation. The current government is doing it in its opening weeks. I wonder if the member could elaborate on why public health is such a big priority for the government when it did not seem to be under the previous government.

[Rick Dykstra, Conservative, St. Catharines, ON]

Mr. Speaker, when it comes to priorities, this is the first of the five bills introduced that is specific to health care. It is interesting that it represents the number five, which is the five priorities that this government stands for. We are going to hear more about that this afternoon in the budget speech.

However, the commitment we have to health care waiting times and the commitment we have to implementing Bill C-5 shows leadership, shows direction.

The former government had 13 years to talk about how important these issues were. It had the opportunity to speak and, more important, act on the issue of providing good fundamental leadership when it came to health care and standing up for the five principles of the Health Care Act. It is not by coincidence that the number five plays a key role in why the legislation is before us. One of our five key priorities is health care, the five principles of health care in the Canada Health Act, and the fifth bill presented in the 39th Parliament regarding health care.

[Bill Siksay, NDP, Burnaby—Douglas, BC]

Mr. Speaker, it is a pleasure to participate in the debate this afternoon on Bill C-5, the Public Health Agency of Canada act.

This is legislation that my New Democrat colleagues and I want to support. We will be working hard on this legislation and our health critic, the member for Surrey North, will be working hard on it at committee to improve it, but we are happy that the legislation is before Parliament.

It was a resurrected bill from the 38th Parliament, Bill C-75. I have to say, given the last exchange we just heard, that both the previous government and the current government deserve some credit for moving forward on a public health agenda. The previous government did in fact institute the position of minister responsible for public health and did appoint the Chief Public Health Officer, Dr. David Butler-Jones. The member for St. Paul's, who spoke earlier today, spoke enthusiastically about the work of public health in Canada. He was the first minister of public health.

The current government deserves credit for giving it a high priority, for formalizing the agency through this legislation and for putting the bill forward so early in this Parliament. I think there needs to be some joint credit on this issue.

The genesis of the legislation was probably the SARS crisis, which a number of members spoke to earlier in the debate. SARS affected Toronto in particular. Outside of Asia, I think Toronto was the major area that SARS affected. It shook up people in Toronto and in Canada fairly significantly to say the least. Their faith in our system their faith in our ability to deal with a major infectious disease was shaken.

Canadians want to know that their families are safe. They want to see that there is an ability for health care professionals to coordinate their activities. They know that there are dedicated teams of health care professionals. We saw that during the SARS crisis where people came together under very difficult circumstances, where, in some cases, their own lives were in danger. They worked very hard and in very creative ways to address SARS.

Canadians want to know that kind of cooperation and those kinds of skills are coordinated and effectively utilized all across the country during those kinds of crisis points in our health care history. The SARS crisis demonstrated clearly the need for a national coordination of public health issues.

A national advisory committee on SARS and public health was struck after the SARS crisis. It was chaired by Dr. David Naylor and it made many recommendations. I think this legislation flows directly out of those recommendations.

It is good to have something tangible on the agenda of this Parliament and something tangible to deal with the concerns of Canadians with regard to infectious diseases and to deal with the concerns of health care professionals who have to attack those infectious diseases.

I have a real bias when it comes to talking about public health and that bias is to increase the influence of public health nurses and public health professionals in government, in our health care and in our social systems.

Before I was a member of Parliament, I worked in the community of Burnaby for 18 years. I was always impressed by the approach that public health care nurses took to dealing with issues in our community. Public health care nurses have a particular skill set that brings something crucial to almost every discussion in our community. They bring very specific health care skills through their nursing training. They have particular people skills that are not always evident in every professional group. Public health care nurses are particularly good at analyzing the context of crises and problems in our community. Public health care nurses have shown that they are excellent organizers. In fact, I cannot think of better organizers in our community than the public health care nurses who serve Burnaby.

In my experience, if we are looking for someone at a community meeting to work on a community project or for someone to cut through the rhetoric and get to the core of an issue, that person is more likely to be a public health care nurse than any other professional in the community. They also have a particular understanding of grassroots organizations. Because they deal with people who are experiencing health problems or who are experiencing the problems that lead to health problems, they really understand what is going on in the community. I think they are actually grassroots experts in many ways

Public health care nurses take a holistic approach to solving problems in our community. They do not limit themselves to specific health issues. They go to environmental issues and other social issues, like poverty, to understand the importance of public health in the community. They draw connections between all of the issues that face the communities. They would draw connections between the environmental, between human rights issues and between poverty issues to come up with a holistic approach to solving a health problem. That is very typical of the entire profession and the entire professional group. These are people who bring broad experience and know how to apply that and know how to organize around that experience.

That is something that is needed more in this place. I remembered this morning that a former colleague, the former member for Hamilton Mountain, Marion Dewar, a former mayor of the city of Ottawa, came out of a public health background. I think one of the reasons for her success in her political life was from the expertise she gained there. We need to integrate that perspective into government.

In the future, I would be happy if we saw more public health care nurses in this place. A few less lawyers and more public health nurses would be a good thing in my opinion.

Public health care has five tenets: disease prevention and injury prevention, health promotion, health protection, health surveillance and population health assessment. Those five tenets are very important but they are often the flip side of our health care system where we are dealing with the more acute and treatment issues in health care.

Specifically, the bill seeks to address those five tenets of public health care. Where that is evident is if we look to the preamble of the bill specifically. In the preamble we see that by undertaking the establishment of the Public Health Agency, that the government wants to take public health measures, including measures relating to health protection and promotion, population health assessment, health surveillance, disease and injury prevention and public health emergency preparedness and response seriously. Those relate directly to the five tenets that I just noted.

We also see that the government wishes to foster collaboration within the field of public health and to coordinate federal policies and programs in the area of public health. The agency is:

--to promote cooperation and consultation in the field of public health with provincial and territorial governments;

The agency is:

--to foster cooperation in that field with foreign governments and international organizations, as well as other interested persons or organizations;

We have heard many times today how viruses, bacteria and disease do not respect any border, let alone international borders and provincial borders and how this kind of coordination is very important in the public health area.

Finally, from the preamble, it states:

--the creation of a public health agency for Canada and the appointment of a Chief Public Health Officer will contribute to federal efforts to identify and reduce public health risk factors and to support national readiness for public health threats;

The preamble says it all and it shows why the bill is so important and why it is so important to Canadians. We need to recognize that this is a significant step forward, that there are specifically focused public health measures in the federal government, is something that is perhaps overdue and it is a measure that I think we can all enthusiastically support.

We need to have confidence in the leadership in public health and we need to have confidence in the structure of public health in Canada. This will fill a gap that has existed for some time.

Earlier this morning, my colleague, the member for Surrey North, the NDP health critic, talked about some of the concerns that we have in this corner of the House with regard to the bill. I will just go through six of the concerns that we would like to outline.

The first one, which I raised earlier today and we have had some discussion on this afternoon, is the question of the resources that will be dedicated to the agency and to the important tasks of the agency. We have heard that there is concern out there that there are not enough financial resources nor not enough human resources available to do this important work. A group like the Canadian Medical Association and other stakeholder agencies have raised that issue. I do hope, maybe even today in the budget that we will hear later today, that we may hear a commitment from the government to ensure the resources are there, if necessary, to do this important job.

We also have raised the concern that the Chief Public Health Officer is not given authority over other areas of federal jurisdiction such as airports, railways and military bases, as well as the health of aboriginal people. We need to ensure, given infectious diseases often spread through our transportation system, as we saw with SARS, that the Chief Public Health Officer has the a mandate to deal with health concerns in those areas.

Also, there is an important role for the Chief Public Health Officer in correctional services in terms of harm reduction around drug use and the spread of diseases like HIV-AIDS and hepatitis in the prison system. We know that is a public health issue. It is not only concentrated in the correctional facilities. Prisoners get released and they go back into the general population. Therefore, the health of folks who are incarcerated in our prison system is of concern of all Canadians.

We are also concerned about the power to enforce the Quarantine Act. Under the current system, and this bill would not change that, the power would remain with the Minister of Health. In other jurisdictions the power around the Quarantine Act rests with the provincial public health officers. This seems to be a bit of a disconnect between the provincial system and the federal system. It is probably something that merits attention in the committee.

The Public Health Agency is also not given authority to act when a province or a territory is overwhelmed by a crisis or when a crisis transcends provincial and territorial borders. As I mentioned earlier, we know that viruses, disease and bacteria do not respect borders created by people.

Our fifth point is that the Public Health Agency is not given authority to impose mandatory reporting of diseases by the provinces and territories. Part of the health surveillance mandate is to assess risk in the population. We cannot have a system where we have 13 different strategies. We need to have the ability to control a communicable disease outbreak. This morning my colleague discussed the current outbreak of mumps in North America, specifically in the United States, but also in Canada. Also, the re-emergence of tuberculosis is a major health concern in many of our cities across Canada. We have to ensure that there is the ability to coordinate and that someone is looking at the overall picture across Canada. We cannot have 13 different strategies to address these important issues of communicable diseases.

Finally, our sixth concern is to ensure that the Chief Public Health Officer has some modicum of independence from the Minister of Health. We think there is an important role for independence of this officer and that he or she should have the ability to run with the issues within the mandate of the officer and to take the initiative, as seen fit, to promote the important mandate of the agency. I know my colleague, the member for Surrey North and the NDP health critic, will be raising this when the bill gets to committee.

This is very important legislation. We strongly support getting it to committee and moving on this. We know how important it is to the public health of all Canadians. We know it has been an important response to a major health crisis in SARS. We want to ensure that we do not delay, that we take the appropriate action to follow up on both that crisis and the recommendations made by those who we asked to study this. We should get on with the work, get it into committee and get the bill enacted.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, in addition to those that do not respect borders, there is also the federal government which does not respect the borders of infringement on the provinces’ jurisdictions.

We know that the new agency, which is already in operation, but which is going to be given powers by Bill C-5, with its mandate and its mission, will not respect the “borders” of federal jurisdiction.

I would therefore have a question for the NDP member regarding the structures that will be put in place in order to fulfill this new agency’s entire mission.

There are currently 2,000 public servants to carry out this entire mission. The mandate is a broad one, it does not relate just to SARS or diseases and viruses that can be transmitted from one “border” to another, as the member said. It has much more to do with diseases such as diabetes, cancer and heart disease. We are well aware that a lot more public servants will be needed. Already, this agency has been given $1 billion to meet its responsibilities.

Does the member not think that this is an enormous bureaucracy that is going to be created, particularly in provinces like Quebec, which already has all the institutions to meet the needs and comply with global requirements in relation to health prevention and in the event of a pandemic or other diseases or viruses?

[Bill Siksay, NDP, Burnaby—Douglas, BC]

Mr. Speaker, the member and I probably have a different understanding of the jurisdiction and the importance of the federal government. That is probably a given in this conversation. However, she raises an important question about not creating an unnecessary new bureaucracy, which would be the wrong thing to do. We have to respect that some provinces have excellent measures in place in this area.

We often hear from her corner of the House of the good work that has been done in Quebec. We often hear about as Quebec being Utopia. I do not think it is always as good as it sounds, but there are some good models. The community health agencies in Quebec are an important model of health care delivery and preventive care from which we could all learn something. I wish we had a similar institution in my province.

However, we do not want to go around willy-nilly creating a new bureaucracy that is not effective. This is something that all of us in every corner of the House will be interested to follow to ensure that the agency does the work it is supposed to do effectively and efficiently.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I thank the member for his party's support. This is an excellent example where the Conservatives and the NDP can work together for the betterment of all Canadians.

Could the member comment on the fact that it seems to have taken the previous government forever and a day to introduce the bill, and nothing came of it, while this government, with the support of the NDP, has worked quite quickly to bring the bill forward? Does the member have any comments on the commitment, or lack thereof, of the previous government in the area of public health.

[Bill Siksay, NDP, Burnaby—Douglas, BC]

Mr. Speaker, to go back to where I began my speech, I want to recognize that the former Liberal government took some important steps in this area. I recognize that it established the minister of state for public health as an important cabinet position. It appointed the Chief Public Health Officer of Canada, which was important action to take.

I am glad the current Conservative government has given this bill high priority and put it fifth on its list of legislation in this Parliament. That is a significant thing to do.

Credit needs to be shared. I do not agree necessarily with the parliamentary secretary's position that there was no action. It would have been nice if the legislation had come to the previous Parliament and gone through, but that did not happen. To say the previous government did not take any important initiatives in this area, is wrong. At the same time, I do not want to take away from the initiative that the member's government is currently taking in this area.

We need to get on with this important work, get the bill to committee and get it through and enacted so the system is up and running as it should be.

[Raynald Blais, Bloc, Gaspésie—Îles-de-la-Madeleine, QC]

Mr. Speaker, I would like the New Democrat member to be a little more specific in regard to his fears about the bureaucracy. In his speech, or in the answers he gave just a few minutes ago, he referred to a fear, an apprehension in that regard. I would like to hear him speak to that subject.

[Bill Siksay, NDP, Burnaby—Douglas, BC]

Mr. Speaker, I am not sure I can be any more specific than I was in my speech. The reservations we have in this corner are not huge ones. I am not sure they are ones that cannot overcome even by further discussion at the committee and by further clarification on the roles of the agency and the Chief Public Health Officer and the relationships of that agency with the 13 other provincial and territorial governments in Canada.

That is what I heard from my colleague, the member for Surrey North, this morning when she spoke on behalf of our party as our health critic. I think these issues can be addressed in committee and worked out so we will have a clear understanding of the legislation by the end of that discussion.

[The Acting Speaker, Royal Galipeau]

It being 2 o'clock, we will now go to statements by members. There will be three minutes left in the period of questions and comments for the hon. member for Burnaby—Douglas.

The House resumed 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 second time and referred to a committee.

[The Speaker, Peter Milliken]

When the debate was interrupted, the hon. member for Burnaby--Douglas had the floor for questions and comments, and there were three minutes remaining in the time allotted for questions and comments.

The hon. member for Windsor West.

[Brian Masse, NDP, Windsor West, ON]

Mr. Speaker, Bill C-5 has a potential provision in it that could be very helpful. The NDP championed a motion, which was passed in the House of Commons, relating to the banning of trans fats. The member for Winnipeg Centre was a particular champion on this motion.

We know trans fats are in everything from children's baby food to regular types of packaged food. It is one of the things we can reduce, as a human health factor, through promotion, enforcement and regulations. Having an advocate for this through Bill C-5 would be an enhancement. Public policy could be shaped across the country that would improve wellness. More important, it could eliminate some of the risks factors on human health, which costs us on the medical side and shortens the span of life of our citizens.

What is the hon. member's opinion on how the bill might be able to tackle overall coordination and advancement of the elimination of trans fats and other types of human health issues that affect us on a regulation basis?

[Bill Siksay, NDP, Burnaby—Douglas, BC]

Mr. Speaker, I want to thank my colleague from Windsor for reminding us of the great victory we had in the last Parliament, as an NDP caucus, concerning the vote of Parliament and alerting all Canadians to the dangers of trans fats.

This Public Health Agency will have responsibility for health promotion and the ability to deal with the whole issue of trans fats in our foods. It has been something that has been lacking, frankly. We have not had the ability to focus, to give the kind of attention to the health promotion aspect of our health care system. We have often become bogged down in the important questions of health care and the more acute questions of the health care system.

The Public Health Agency and the Chief Public Health Officer will have an important role to play in promoting health and in dealing with issues such as trans fats. This legislation is very important on that issue as well.

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, I am pleased to contribute to the debate on Bill C-5.

Starting yesterday, the parliamentary secretary addressed the House on the bill. It is quite clear that the bill has the support of the House. It is a bill that was available in the last Parliament, but was not able to get through the full legislative process before Parliament was dissolved.

The summary of the bill states:

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.

In a brief paragraph, that is precisely what the bill does.

Oddly enough, the debate has become one about health issues, which are really important. It is really important to understand why the bill was first developed in the last Parliament.

I can recall in 2000 or 2001 having a private member's initiative in which I proposed that the Government of Canada establish the position of physician general of Canada. Members will be aware of the surgeon general in the United States. The physician general of Canada would be a parallel position. I specifically wanted to address the issue of the evolution of the roles and responsibilities of Health Canada, which were becoming so great that Canadians were having some difficulty finding out exactly where they would get information.

To visit the website of Health Canada is a very problematic exercise even today, because there are so many aspects to Health Canada. It does not surprise me that we are trying to put some focus, particularly as it relates to some of the more critical aspects of public health.

There was the SARS outbreak in 2003. This was probably the big wake-up call that was needed for parliamentarians. The SARS outbreak was particularly focused in the greater Toronto area, actually in Scarborough. A particular member had an area which was under close scrutiny. A lot of people were scrambling around trying to figure out what to do. There was the potential for a serious viral epidemic in Canada threatening the health of a countless number, who knows, thousands, tens of thousands, maybe even hundreds of thousands of people.

I can also remember looking at the websites of various departments to determine what they were doing in terms of the SARS issue. The Health Canada press releases referred to 18 different websites and 18 different departments. It was an indication that within Health Canada there were so many things going on. There were areas of controversy like the hep C issue, which certainly was a significant problem. There was an issue of where the focal point was for public health issues.

Canadians may wonder what public health issues are. Canadians will also recognize that there has to be a reason for the legislation. There has to be a linkage to the constitutional authority given to the Minister of Health.

As it relates to public health, the government obviously wishes to take measures in certain areas. These include health protection and promotion. There is a health protection branch already, but it is in need of that focal point as well.

The issue of population health assessment is another important area, as is health surveillance to ensure that we are vigilant about emerging problems and early detection of situations. There is as well disease and injury prevention. There is also emergency preparedness and response, which is where the SARS situation comes in. These areas are of significant importance to Canadians because they all relate to the umbrella topic of public health.

The Government of Canada also needs to have this focal point to foster collaboration within the field of public health, to collaborate and coordinate federal policies and programs in the area of public health, as well as to promote cooperation and consultation in the field of public health with provincial and territorial governments. It is extremely important that there be this coordination. I can think of a couple of examples where the absence of that coordination has caused some significant delays in progress on certain public health issues.

It is also fair to say that the public health issues transcend Canada's borders as well. It is important that we also foster cooperation in the field with foreign governments and international organizations, as well as with other interested parties and organizations. We did have one issue as it related to SARS which was the sourcing back to a province in China and the fact that there were significant delays in the reporting of the detection of the SARS related problems to the World Health Organization. This had a ripple effect of putting everyone else behind in terms of their ability to respond to this emergency situation.

There are many people who frequently travel internationally and Canada is a destination for many people from around the world. There is significant activity at our borders and airports. Equipment was put in at the airports to try to detect whether or not there might be some problems. This should come as no surprise.

As I listened to the debate yesterday and today, one of the things I noted is that the debate has basically become a broader discussion of health issues and their importance. We have talked about trans fats. The member for Yellowhead took us down memory lane with all the subjects that the health committee has dealt with over the last several years, ever since he has been on the committee. It gives Canadians an opportunity to appreciate the breadth of work that happens at committee and the importance of that work.

Bill C-5 indicates that the minister has the authority to set up committees. These committees are going to be paid and the bill sets out the Treasury Board guidelines, et cetera. It is rather interesting that it is in there. It is almost as though this actually does happen. It is under the general provisions clauses 13, 14 and 15.

Back when Allan Rock was the health minister I was advocating a private member's initiative relating to fetal alcohol syndrome. Allan Rock used to sit beside me at national caucus. There were press releases going out and all kinds of government documents on the issue of fetal alcohol syndrome. These documents were actually put together by committees of people who were responsible for that little area.

One of the principal statements the Government of Canada made at the time was that fetal alcohol syndrome is the leading known cause of mental retardation in Canada. What an ominous statement. It sure should get our attention. It is an interesting statement to make but this came from Health Canada and the statement was absolutely wrong. Fetal alcohol syndrome is not the cause of anything. It is the result. In fact, it is prenatal consumption of alcohol by the mother that is the leading known cause of mental retardation, yet Health Canada in its wisdom was putting out things like that.

It went further. Health Canada set up a coalition that included the Canadian Medical Association, the Canadian Nurses Association and NGOs representing all walks of life, including aboriginal people. It came out with what was called a joint statement which said the same thing, and this was some years later. It said that fetal alcohol syndrome is the leading known cause of mental retardation in Canada.

When there is a coalition of some 18 groups and organizations representing virtually everybody who has ever touched an issue and those groups still do not get it, we start to have some questions about whether or not committees have been charged with the proper instructions.

We saw the same kind of problem with another issue that came to the health committee. It was about health warning labels on alcoholic beverage containers, which again related to fetal alcohol syndrome. The government created a task force. It was a very broad task force. A lot of money was spent on that task force. It worked for a couple of years and came out with reports. There was glossy literature but what the task force did not have was any recommended strategies or solutions. All of the reports and documents were saying things like, “Here is where we have been. Here is the history. Here is how we got to where we are today and we are continuing to work”.

If more and more committees are going to be set up within Health Canada, or any other department for that matter, we have to be vigilant. If accountability is a hallmark word for this Parliament, then accountability also means that when committees are established, as this bill permits the minister to do, those committees should be charged to follow the full line of activity right though to strategy, recommendations and other proposals related to implementation.

When I first raised the issue of fetal alcohol syndrome with the then health minister, the hon. Allan Rock, he decided he was going to set up a national advisory commission on fetal alcohol syndrome. One night after being in the House most of the day, I went back to my office and there was a fax on my machine. I had met with the people in Health Canada who were going to set up the advisory commission and they wanted to send to me the terms of reference for its establishment.

It was the same as what I had seen before for another committee in another department. There would be one person from every province and territory. There would be a gender balance and other criteria. There would be people who were knowledgeable about fetal alcohol syndrome and they were going to do some work.

I did not think it was really necessary for anyone to know any more about fetal alcohol syndrome after all the work that had been done. I thought that maybe what we should have been doing was creating an advisory commission that would advise the Government of Canada, the Minister of Health and parliamentarians on strategies that may very well work to handle the situation where it has to do with behaviour. We cannot legislate behaviour but we can encourage good behaviour and maybe discourage behaviour that is not healthy.

I spent the whole evening rewriting the terms of reference and saying that when we set up committees, we need to have people whom we know have the experience and the expertise to deliver solutions. We need them to recommend solutions and strategies and have the basis so that there will be a buy-in for all the stakeholders.

I recommended a behaviouralist, a psychologist and an expert in federal-provincial relations because we do cross jurisdictions within governments. We needed marketing people and communications people. We needed people who could deliver a product and get the job done.

If we continue to boast, as this bill does, that the minister can set committees up on these various subjects that relate to public health, there is the risk that we could actually increase the bureaucracy of Health Canada but not necessarily deliver in terms of the priorities. I would think that the priorities for the Public Health Agency of Canada should be amplified further with regard to what those priorities are, or at least the minister has to articulate what those priorities are in terms of the most significant health risk to Canadians.

Under the regulations section of the bill, section 15(1) states:

The Governor in Council may, on the recommendation of the Minister, make regulations respecting

(a) the collection, analysis, interpretation, publication and distribution of information relating to public health, for the purpose of paragraph 4(2)(h) of the Department of Health Act;

It is a very broad provision. It is interesting that it says that “The Governor in Council may”. I am pretty sure they will and maybe we should say they shall.

I gave this little speech about doing legislation through regulations rather than in the bill itself.

When the health committee gets this bill it may want to consider whether there should be some provisos with regard to the issues of collection, analysis, interpretation, publication and distribution of information relating to public health because we can really get carried away we this stuff. I hope it is done in a way in which we are not trying to simply see who can produce glossy brochures and a whole bunch of very beautiful looking information but, rather, who will put together this stuff where it in fact is as a consequence of the work done by this new agency under the Chief Public Health Officer who will have the equivalent position of a deputy minister. However that activity has to be established within the legislation which really emphasizes the need that this is not work that we just do to keep people busy. This is work to deliver results.

I would think that, knowing the situation we had with SARS, and given the information we have on the high possibility of a pandemic and the fact that we have situations where there are not enough pharmaceuticals necessary, these are some of the priorities which the minister will have to engage this new officer to undertake.

I wanted to raise that because I do not think the bill by itself does justice to the urgency there is with regard to this new agency.

We have some major risks and threats to the public health of Canadians. Although there are a broad range of activities, I am hoping the bill would be the kickstart to establishing the necessary priorities so Canadians have the protection that is necessary for good public health and they can have confidence in this new agency.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I thank the member for his comments, particularly those around Allan Rock, but I think he may be dating himself. I remember seeing Mr. Rock on TV when I was in grade school.

[Robert Thibault, Liberal, West Nova, NS]

You were there until you were 23 though.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Yes, that is right.

With regard to the points raised by the member around committee work and so on, it seems that the member, courageously, may be challenging part of the record of the previous government as far as its effectiveness and efficiency.

I wonder if the member could clarify his concerns a bit more. He does seem to be out of step with comments made by other parties, including his own earlier on in the debate, in that the legislation was tabled by the previous government. We want to move expeditiously in bringing this legislation through second reading and then to committee.

Is the member indeed contradicting the comments of other parties?

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, no, that would be an unfair characterization of my comments.

The bill was before the last Parliament. I think all members would agree that it provides the foundation, the tools and the mechanism to work. The issue really comes down to how we use that foundation, those tools and that mechanism. I do not want to see any more committees.

The member knows that the last time I sat on our health committee, Dr. Butler-Jones came before us with a report that the committee had asked for and it turned out to be a report showing what had been done over the last number of years. However it gave us absolutely none of the feedback that had been directly asked for by the committee. That is unacceptable. I do not care which party is in government. I am a member of Parliament. I asked the question and I wanted an answer, as did the committee. As the member will recall, the committee, which received approval in this chamber to make the request, did not get the response that it requested.

As a parliamentarian, if I am going to be accountable for my work and the things that I am interested in, I am going to want to ensure that the tools that are available to us are used in a cost effective way and in a progressive way so that public health issues do find solutions for some of the problems that we face.

[Peter Julian, NDP, Burnaby—New Westminster, BC]

Mr. Speaker, I am pleased to make some comments on Bill C-5 and to ask the member a question.

I come from British Columbia where, as members know, an outbreak of avian flu two years ago devastated the eastern Fraser Valley zone of the lower mainland. We found at that time that the coordination among various federal agencies was done very poorly. This strain of avian flu basically mutated by a factor many times over 24 hours. It took many days to get test results back because of the lack of coordination at the federal government level. The quarantine lines were breached twice.

I am talking about an extremely serious situation that ended up being catastrophic. Seventeen million birds were exterminated. It was only because of the geographical isolation of that particular part of the Fraser Valley and the fact that there are eastward flowing winds that the catastrophe was averted beyond that. However it was still a catastrophe that had huge ramifications for citizens of that region of British Columbia.

We see four areas of concern with Bill C-5. First, the Chief Public Health Officer is not given authority over areas of federal jurisdiction, such as airports, railways and military bases. Second, the power to enforce the Quarantine Act remains with the Minister of Health. Third, the Public Health Agency is not given the authority to act when a province is overwhelmed by a crisis. Fourth, the Public Health Agency is not given authority to impose mandatory reporting of diseases by the provinces. We see those as loopholes and we are concerned about them.

I wonder if the member for Mississauga South shares those concerns.

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, the member will know that the position reports to the Minister of Health. I do not discount the significance of the example the member gave but it almost sounds like he wants to suggest that Health Canada somehow should be divided in terms of one being for the delivery of public health initiatives, as we have discussed under this bill, and the other basically dealing with the health care system and the Canada Health Act. That may be a debate for another day.

[Robert Thibault, Liberal, West Nova, NS]

Mr. Speaker, the member has done a lot of good work in the House and through committees on issues that we know very well, such as fetal alcohol syndrome. If we know them well it is because he has brought them to our attention. He is published on that matter. He has brought forward private member's bills that I hope will have an effect on the way the department operates and works toward those strategies.

When we look at the Public Health Agency we see two areas of interventions: in emergencies and pandemics, such as SARS and the potential of an impending bird flu. However we also have disease prevention and common health risks, fetal alcohol syndrome being one of the areas where the member has been working a long time on prevention.

We learned today in the House that on Health Canada's website there is no longer a reference to the rate of disease strategy, an investment of $300 million working in partnership with Canadians, with the provinces, with local authorities and with non-governmental organizations to reduce these disease elements and health risks that are common to a bunch of diseases, such as cancer, cardiac problems, pulmonary problems, diabetes and so on.

Would the member care to comment on how he would see us working through the Public Health Agency and with the Department of Health on all these elements?

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, that is the dilemma. If everything is a priority, then nothing is a priority. I would think that Canadians want to know that we are prepared for the big hit, whatever it may be, whether it is a pandemic, another SARS, bird flu or who knows what. Those kinds of things have the potential to kill a large number of Canadians. We need to tell them that we are going to deal with it.

We have already done much work in some of the other areas. It is not to belittle them. We must continue to work on all fronts but there are certain priorities we have to deal with.

Last week the Canadian Centre on Substance Abuse issued a wonderful report and I hope members will look at it. It was on the current situation with regard to the costs and the morbidity from misuse of tobacco, alcohol and drugs. If members have not seen that report they can read it on the CCSA website. It states that alcohol is the one area where we have not made progress. In fact, it states that binge drinking is one of the most critical causes of health problems among Canadians. This is consuming a large number of drinks in a short period of time on a periodic basis. It does not mean that a person is a chronic drinker. It could be one occasion. We are talking about billions and billions of dollars annually as a cost of this misuse of these drugs and the mortality from them, which makes this a significant priority for the new Public Health Agency.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, I rise in the House today to address Bill C-5, an act respecting the establishment of the Public Health Agency of Canada. If anything demonstrates the need for the position of a chief medical health officer at a public health agency to deal with these types of concerns, it has to be the former administration's response or, more appropriately, lack of response to a SARS outbreak that is behind the creation of this agency.

By acknowledging that the Public Health Agency of Canada was created in September of 2004 through orders in council, Bill C-5 represents housekeeping legislation from the last Parliament as the new agency lacks parliamentary recognition in the form of its own enabling legislation. As such, the legislation would provide a statutory footing for the Public Health Agency of Canada and gives the agency and the Chief Public Health Officer, the CPHO, the parliamentary recognition they need.

Canadians will recall that the previous administration, as part of the democratic deficit that led to its eventual defeat, routinely organized and reorganized federal government and then sought retroactive approval from Parliament after the fact. In one of the worst examples of the democratic deficit that existed in the House prior to the last election, this was done to provide a cabinet spot for the member for York Centre, who was encouraged to move from the hockey arena to the political arena. This was after his predecessor was encouraged to leave elected politics and took a patronage appointment to the other place to create a seat vacancy.

The proper sequence would have been for the appropriate legislation to come before Parliament. That should have been the case with this legislation. However, this is housekeeping legislation, as the new government works to restore the confidence Canadians will have in their public institutions.

As my colleagues have indicated, this legislation represents a key piece in supporting the federal government's efforts to promote and protect the health of Canadians. The need is there and I support that need.

As everyone may know, following the severe acute respiratory syndrome outbreak, known as SARS, there were discussions and debates on the state of the public health system in Canada. As a member of Parliament from the province of Ontario in the 37th Parliament, I participated in the emergency debate in the House on severe acute respiratory syndrome as an important independent voice.

It was clear from the outset, when SARS was first identified that leadership, was evident on the benches of what is now the government of today. My colleagues and I were very careful in our approach, allowing the old administration latitude on how it dealt with SARS. Our questions were constructed to provide information to the public. It would have served no purpose to unduly alarm the Canadian public or the international community.

In that regard, the Conservative Party was very responsible in its approach to the SARS crisis. The tragedy of that case was the total lack of leadership from the federal government. The people of Ontario suffered. First, there was the West Nile virus to scare away the tourists. Then, because of the incredible incompetence on the part of the old government, the World Health Organization, the WHO, issued a travel ban against Toronto, Ontario based on the lack of information it had at that time.

The tourism industry, which is important for jobs and our economy took a hit as a consequence. The economic losses to Ontario alone were in the hundreds of millions of dollars. If the province of Ontario, under the firm leadership of the new Minister of Health acting in that capacity for the province of Ontario, had not acted decisively and displayed the leadership necessary to control this spread of SARS, it is clear that Canadians could have been faced with a full-blown epidemic.

Canadians will probably never know how serious the threat to the health of Canadians SARS posed. What is unfortunate is that it took this crisis for the old government to finally grasp the need for a public health agency and a chief medical health officer. Canadians who watched the emergency debate on SARS were surprised to learn that Canada had a minister responsible for emergency preparedness. That minister, who had a mandate to deal with national emergencies, went missing and was totally invisible as the events unfolded regarding SARS.

Canadians should not be surprised to learn that the minister responsible for emergency preparedness at the time was the same individual who had the dubious distinction of shutting down the Emergency Preparedness College in Arnprior at precisely the time Canadians would have benefited from over 50 years of experience in training for emergencies and emergency first responders for Canada.

I had the opportunity to question Assistant Deputy Minister Jim Harlick, in committee, about the government reaction. In responding to a question from the member for Compton—Stanstead, Mr. Harlick stated the following:

We only have one minister at the federal level really designated as Minister for Emergency Preparedness although all ministers under the statute have responsibility for it.

Too many people being responsible led to the confusion where no one stepped up to assume the leadership that was needed in the SARS crisis. The Office of Critical Infrastructure Protection and Emergency Preparedness, OCIPEP, was described in the media as a secretive emergency agency and the decision to split up that office, which Bill C-5 effectively does in this legislation, will allow the Canadian public a clearer view of the role of the various government agencies and how we prepare for an emergency with clear lines of communication for people to understand who work in government also.

In the 9/11 budget, OCIPEP received $396 million to prepare for emergencies. For Canadians to understand why the old government was so inept at handling SARS, a look at the old administration's own internal analysis on how it responded to 9/11 as informative.

In the federal government's own internal assessment of how it responded to 9/11, it found the following. There were concerns with fluctuating requests, multiple players, problems with the available and capacity with ground transportation, with special blame directed at Health Canada. There was a lack of clear coordination within the Government of Canada. There was no declaration of a lead department, no standard coordination mechanism and a lack of clarity around OCIPEP's role.

The creation of the Public Health Agency and a Chief Public Health Officer is a direct response to that internal assessment.

The internal analysis then identified immediate steps to be taken such as properly trained personnel, the need for strategic airlift and the need to develop a permanent pie level interdepartmental body responsible for planning, directing and coordinating federal and national operations during a crisis.

The most scathing criticism was reserved for the $396 million that the OCIPEP received. This is the same agency, I remind Canadians, that discarded all its institutional memory on how to deal with an emergency when it made the decision to close the emergency preparedness college in Arnprior.

OCIPEP was characterized as having inadequate internal operating procedures and a workforce with little relevant experience or specialized training. These inadequacies generated confusion, slow responses and disappointed stakeholders. The OCIPEP assessment went on to confirm that Emergency Preparedness Canada had a limited capacity to maintain extended operations that would be required in a crisis.

The headquarter staff, many of whom have been OCIPEP for less than six months, displayed “a lack of knowledge and awareness of policy and operational procedures”. The new Chief Public Health Officer will have the expertise to deal with this crisis. I have no doubt that the next health crisis is waiting to happen and we will be better prepared for it.

As an example of what may occur when a potential threat is not properly identified and analyzed, just looked back to that great blackout of 2003. The old office of critical infrastructure, protection and emergency preparedness produced a threat analysis to Canada's infrastructure. Under the section “Impact and Accidental Threats on Canadian Critical Infrastructures”, it has this to say about power failures, and I quote from its website.

The North American hydro grid is more interconnected today than it was at the time of the Great Northeast Blackout. "This interconnectedness has increased the ability of the grid to withstand unexpected disruptions as managed by coordinated real-time monitoring across North America."...This work is therefore making the possibility of another massive blackout that would leave large areas of North America without power, remote.

In hindsight, it is now clear from this faulty analysis by OCIPEP that the federal government totally underestimated the potential threat to the power grid, just like it underestimated the threat from SARS. The OCIPEP assessment concluded, and I will continue to quote from the federal government's own internal assessment to handling emergencies, that the Government of Canada paid insufficient attention to emergency planning.

In many respects, Canadians were very lucky that SARS was contained the way it was. This is a disease that on average claims 4% of its victims. Imagine what would have happened if we had a disease such as smallpox, which takes 30% of its victims. If that had hit instead of SARS, the consequences would have been far more serious for the health of Canadians.

SARS was a disease that was unintentionally introduced at a couple of sites in Canada. Again, what would have happened if a contagion had been deliberately introduced, carefully planned so the infected persons went to several major cities across Canada or North America for that matter? A pandemic. There would not be enough people on this continent to battle against such a case of biological warfare.

A nationally coordinated plan with a clear and rehearsed protocol for all the relevant stakeholders and departments of government that would take in all the information from the World Health Organization is what Canadians can expect from this new agency.

We recognize that health care is a provincial responsibility, but responding to international health bodies like the World Health Organization is a requirement of the federal government. I am confident that this new agency will complement the role of health care in Canada and our ability to respond to the next health crisis in a timely manner.

[France Bonsant, Bloc, Compton—Stanstead, QC]

Mr. Speaker, Bill C-5 looks like a cut and paste of the bill the Liberals introduced last year.

During the election campaign, the Prime Minister said, and I quote: “A federalism of openness means respecting areas of provincial jurisdiction, keeping the federal government's spending power within bounds—”. From what I see, the government in office is creating a structure that will be another health monster.

I have a question for the hon. member. How is it that, with its openness and knowing that health is under Quebec's jurisdiction, the government is once again meddling in an area belonging to the provinces?

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, we recognize that health care is a provincial responsibility. The legislation and the formation of the agency will complement what the provinces are doing.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, the agency was created by an order in council and there was no legislative framework. The legislative framework that was brought forward in the last Parliament was done during the dying days of the government. However, the legislation is being brought forward in the very early days of the present government. Could the member explain why public health seemed to be such a low priority in the last government and such a high priority in the present government?

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, in the last Parliament, with the opposition as government, there was clearly a lack of leadership.

We are tabling the legislation and going forth, even before we present our first budget. We are showing that public health safety is definitely a priority with the government.

[Richard Nadeau, Bloc, Gatineau, QC]

Mr. Speaker, my question is for the hon. member for Renfrew—Nipissing—Pembroke.

During the SARS crisis, the Toronto region went through quite a difficult time. If I remember correctly, the World Health Organization made an announcement restricting travel to and from Toronto. It was not only up to the government of the day to ensure that travel was restricted.

Could we take this into account and show that this international organization actually did have an important word to say in regard to this crisis?

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, the responsibility to respond to the World Health Organization was and is that of the federal government. Because the federal government at that time did not respond to the World Health Organization, travel restrictions were put in place.

[Brian Murphy, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, I want to thank the member for Renfrew—Nipissing—Pembroke for her intelligent comments with respect to half of her comments. Those were the comments regarding the Chief Public Health Officer. The other half on the history of it and the partisanship should be left behind. This bill was ready to go in November. The opposition pulled the plug on the government and the legislation came down.

The other side should recognize that not every public health crisis was well handled by Conservatives. I was very involved as a mayor in water crises across this nation. I remember being in Ontario during the Walkerton crisis, which was not handled well by the Harris government, and many of whom have resurfaced in positions of power across the way.

On the important parts of my friend's speech, does she feel constructively that the Chief Public Health Officer and the agency created should look at issues that affect all Canadians, all municipalities, all communities, such as pesticide use, water crises, second hand smoke inhalation and tuberculosis which my friend from West Nova is dealing with in his riding right now? Are those topics that should be covered by the new agency?

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, the new Public Health Agency will have to look at a variety of different issues regarding health and protecting the health of Canadians. I agree with the member opposite that partisanship must be put aside. We must look forward. I look forward to the opposition supporting the bill.

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry, QC]

Mr. Speaker, does the member know that every administrative region in Quebec has its own public health authority? These administrative regions are united through a national public health authority. They have their own national health promotion and prevention objectives. Does she not think that Bill C-5 contradicts this and intrudes into Quebec’s jurisdictions in view of the objectives set for it and that the Department of Health and Social Services has adopted?

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, the Government of Canada recognizes the jurisdictions in the different areas of health and will respect the jurisdictions of health provincially and at the municipal levels. This legislation complements what the provinces and municipalities have done so far. Thus, they and I look forward to the opposition supporting the government's bill.

[The Speaker, Peter Milliken]

The House could resume debate on this matter, but given the time, I wonder if we might relax for a moment the proceedings. Is that agreed? I will not call anyone at the moment, but we will not suspend the sitting. We will just sit here for a minute.

Order, please. Since it is 4 p.m., the House will proceed now to the consideration of Ways and Means Motion No. 1 for the budget presentation.

The House resumed from May 2 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 second time and referred to a committee.

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry, QC]

Mr. Speaker, I am pleased to participate in today's debate on Bill C-5, An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts.

I have some serious concerns about Bill C-5.

I was a social worker in Quebec's health and social services network. For the past three years, I worked in a nursing home and long-term care facility for the elderly. Such facilities have a high risk of influenza and other viral epidemics. I found that the regional public health authority acted competently and expertly to prevent and respond to epidemics. I am convinced that Quebec's response strategy is effective and rigorous, and that it meets the needs of Quebeckers.

Given that the Government of Quebec has the expertise and works with all parts of the Quebec health network, the Bloc Québécois believes that the provincial government should establish its own priorities and create its own action plan according to world-wide objectives developed by organizations like the WHO.

I do not share the opinion of a certain colleague from another part that Canada cannot have 13 different strategies and action plans. I believe that every province can create its own plan that corresponds to the particular activities and characteristics of its territory, particularly regarding prevention strategies for problems such as obesity, diabetes and injuries.

I do not believe that creating or changing the status of the current agency to coordinate the action of the provinces is necessary. I am not saying it is not necessary to coordinate what the provinces are doing in matters of public health. As the Parliamentary Secretary to the Minister of Health said, viruses do not have boundaries.

It is important to protect the health of our citizens. However, I wonder about the means proposed and described in Bill C-5. In this bill, we see that the agency will have its own portfolio and that the main administrator will be accountable to the Minister of Health while still remaining impartial and non-partisan.

The detachment of the Public Health Agency of Canada from Health Canada worries me. I fear that significant amounts of money will be allocated to that agency rather than be transferred to Quebec and the provinces, which have jurisdiction over this.

Quebec has to be able to fund its priorities in prevention and health promotion. These priorities may not be the same elsewhere, in all the other provinces.

Having worked in Quebec's health and social services network, I have seen that the application of “wall to wall” programs does not always help in achieving objectives. This centralist formula being imposed on us is far from being unanimously accepted in Quebec.

The Premier of Quebec, Jean Charest, said in January 2004, on the matter of the possible implementation of the Public Health Agency of Canada that:

Quebec ... has created its own structures in these two areas and they work. They will work with those that will be created, but duplication is out of the question—

That is precisely what the government is proposing to us today: duplication of services to the public because, once again, it is interfering in one of Quebec's jurisdictions.

The federal government keeps bringing in more structures in the area of health. After the National Forum on Health in the 1990s and the Health Council of Canada, now they are adding the Public Health Agency of Canada.

The Bloc Québécois, together with the Quebec government, objects to the federal government's desire to interfere with health care in Quebec. How the Quebec government organizes and provides care and establishes priorities for health care and social services is strictly its business.

This does not rule out cooperation and coordination among the provinces.

Consider the contradictions of this Conservative government, which says one thing then proposes to do the opposite.

In a speech on May 1, the Parliamentary Secretary to the Minister of Health, citing the Speech from the Throne, said, “The government is committed to building a better federation in which governments come together to help Canadians realize their potential”. However, barely two weeks ago, his boss, the Prime Minister and only official spokesperson for the government, stated that the only federalism he would engage in would be open federalism, federalism that respects the areas of provincial jurisdiction and in which the federal government's spending power is monitored.

Thus, in order to make this Conservative concept of open, cooperative federalism a reality, we are presented with a Liberal bill, a bill that comes directly from a government that Canadians removed from power during the last election. This Liberal bill allows Ottawa to interfere once again in an area of jurisdiction that belongs to Quebec and the provinces, this time under the guise of public health.

To justify this interference, reference is made to the SARS crisis that hit the Toronto area in 2003. In his remarks to this House, the Parliamentary Secretary to the Minister of Health said that the SARS crisis “launched an important discussion and debate about the state of public health in Canada”. That is true, he is absolutely right. However, he forgot to mention that, at the time, all stakeholders in Quebec agreed that, had this crisis hit Quebec instead of Ontario, it would never have developed to the extent it did in Toronto. Why? Because Quebec's public health services already had an action plan in place for use in the event of such an emergency in that jurisdiction. Not only did Quebec have an action plan, but the human resources required had also been defined. That is why.

As an aside, I noted in my research that Ontario has just received, in March 2006, a report recommending that it set up its own public health agency, something similar to Quebec's Institut national de la santé publique.

In a nutshell, it is because Quebec has put in place what is needed to face this kind of situation and because Quebec minds its own business, which we would very much like the federal government to do.

By espousing this Liberal legislation, the Conservative government is espousing at the same time the Liberal vision of Canada: Ottawa knows best and will impose its will from sea to sea.

How will a new agency or specific entity, call it what you want, with offices across the country help us deal with any potential flu epidemic? What will it change in real, concrete terms? I would like to know.

We have no problem with the federal Department of Health instituting prevention and emergency response measures in its areas of responsibility, such as screening at the border. Not at all, that is its job. But to have the federal government establish an agency and spend public money on a new structure duplicating one that already exists and is working well, that is a problem.

The government repeated over and over during oral question period that it is committed to the interests of taxpayers. This is a fine opportunity to show concern for them by using their money efficiently and effectively.

Can someone explain to me what exactly the staff of the new agency will do in the offices in Quebec that employees of the health department cannot do here in Ottawa?

I would like an answer to that question.

How will information on new public health threats be any better coordinated with the creation of the public health agency than it is now with the health department, whose job it is to coordinate this information? I would also like an answer to that question.

The Conservative government plans to set up a new entity, separate it from the health department, give it substantial funding and personnel and set up an office in Quebec and the other provinces, all in order “to identify and reduce public health risk factors”, as the preamble states.

I cannot stress enough that the fiscal imbalance is the cause of the biggest public health risk factor in Quebec: overcrowded emergency rooms. The proliferation of resistant nosocomial bacteria such as C. difficile in some hospitals is one of the biggest threats to public health in Quebec.

To address these problems, the Government of Quebec does not need a new federal agency in Quebec, it needs money. The problem is that the provinces and Quebec have the health and social services needs, but Ottawa has the money. The government should stop creating new structures. Quebec and the provinces are cooperating already. Quebec coordinates with the other provinces on public health. I do not think that creating a new agency will make things any better.

We have the federal government to thank for Quebec's underfunded health services. By its actions, the current federal government is doing everything it can to take up where the previous government left off. Emergency rooms will not become less crowded overnight. In my opinion, in addition to recycling a Liberal bill, the Conservative government is clearly also recycling the arrogance of the previous government, which tried only to penetrate further into areas of Quebec and provincial jurisdiction.

I would like to clarify another point. The preamble to Bill C-5 states that “the Government of Canada wishes to promote cooperation and consultation in the field of public health with provincial and territorial governments”. In his speech yesterday, the Parliamentary Secretary to the Minister of Health added that his government plans to strengthen its collaboration with municipal governments. While he was on the topic, why did he not tell us right away that the next step—under the guise of cooperation and consultation— would be direct interference in the administration of health facilities? Let us not forget that history repeats itself.

Let us talk about health services for aboriginals, which fall under federal jurisdiction. Services provided to first nations communities cannot be considered adequate, to say the least. This government should tread carefully; look where meddling in other people's affairs got the previous government.

The Bloc Québécois is committed to supporting the other parties in this House on issues that are in Quebec's interest. The government again plans to duplicate services and create a new structure whose only purpose in Quebec would be to spend public moneys for no good reason. We cannot support that.

That reminds me of the two anti-tobacco campaigns aired recently in Quebec.

In Quebec a campaign was launched to help people wanting to quit smoking by giving them the tools and a service to help them in this endeavour. While this was going on, the federal government flooded the Quebec media with ads giving a different message with a different telephone number and different contact information on the same issue. What wonderful collaboration and use of public funds.

In closing, I want to make one last point on the issue of direct communication with the public. In Bill C-5 respecting the establishment of the Public Health Agency of Canada, it stipulates that the chief public health officer “may communicate with the public, voluntary organizations in the public health field or the private sector for the purpose of providing information, or seeking their views, about public health issues”.

It is quite clear that with its independent administration and its offices spread out here and there, this agency will end up justifying its presence by regularly implementing communication plans for all Canadians, including those in Quebec. It seems clear to me that this type of duplication is counter-productive. It is not what citizens and taxpayers want. In any case, it is not the wish of the people of Beauharnois—Salaberry, whom I represent in this House.

I would like to draw your attention to a more specific aspect. I read and listened to various speeches by colleagues in this House. There was a great deal of discussion about health prevention in terms of epidemics and pandemics. However, I noticed that there was less discussion about health promotion. An expert in this area knows that it is important for local communities to identify their problems and to find solutions that will work in their areas.

Take obesity, for example. In my area, we decided to fight child obesity by approaching cafeterias in secondary schools, convincing them to offer more nutritious foods, and thus help youth develop better eating habits. We did not talk to youth about diet or try to make them feel guilty. In terms of promotion, we know that individuals are not always solely responsible for their health given that their environment and everything around them also have an impact.

In Quebec, we have made choices. There are campaigns to prevent obesity, to reduce the number of low birth weight babies, and others. We have our own way of communicating with our communities and, what is important, we have a decentralized approach. Each community can promote and work on improving the health of Quebeckers. This is done at the local level. Naturally, everyone does not just do what they want, leading to chaos. We are bound and guided by broad directives issued by the Institut national de santé publique du Québec. It provides instructions and directives to each of the 16 regional branches in Quebec.

This is my first speech in the House and I would like to conclude by stating that I hope to discuss my concerns with the parliamentary secretary. Above all, I would like to impress on him that we believe that the public health agency, as proposed, is not the best means to protect and promote the health of Quebeckers and Canadians.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I welcome the member to the House.

The member has made many misstatements and misrepresentations of the truth. We know the Bloc's agenda is to break up Canada but that is not good for the people of Quebec or of Canada. This is turning into a classic example why that is the case.

Pandemics do not respect provincial borders or international borders. However, in her comments the member seems to suggest that pandemics do respect provincial borders. I will let the people of Canada and Quebec make their own assessment on that.

The member said that there was no need for the federal government to play a role and that somehow we were creating more bureaucracy. In fact, Health Canada and the health minister are ensuring that, within the powers and with the resources that exist, we are better streamlining them in order to deal with a crisis. The member seems to neglect that fact.

In public health, the provinces and the federal government have a joint responsibility, although the provinces do have direct responsibility for hospitals and health services.

I will give one of many examples where this member's argument falls apart. Within public health, we have a national microbiology lab in my home city of Winnipeg which is Canada's only level 4 lab. This lab is routinely called upon to support provincial health authorities detecting potential disease outbreaks. The lab has world experts and facilities to test for these kinds of deadly disease outbreaks. No such lab exists in Quebec.

Is the member suggesting that the people of Quebec should somehow go without the services this lab provides? That may be the Bloc's point of view, perhaps, but the Government of Canada's point of view is that the health of Quebeckers is just as important as the health of all Canadians, which is why we invested a billion dollars in pandemic preparedness in this week's budget.

Why does the Bloc Québécois philosophy put the health of Quebeckers in jeopardy, particularly in regard to the level 4 microbiology lab in Winnipeg ? What is Quebec going to do? It needs those services. It is important that Canadians work together to protect each other because Canada is about mutual support.

I ask the member to comment on the microbiology lab and how Quebec would deal with that without the Public Health Agency.

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry, QC]

Mr. Speaker, I thank the parliamentary secretary for his question. I do believe that my remarks were misunderstood. I said all along that were not against collaboration and cooperation. On the contrary, we think it is important to work together in a joint effort. We do not want structural duplication, increased bureaucracy, wasteful spending and overlapping.

Even though we want to become a country, we know that we do not live in isolation. We live in an era of globalization. I think Quebec has the ability and expertise to manage its own action plan, as do the other provinces. That does not exclude what is currently in place.

Let us take the avian flu, for example. The WHO has given directives to all the countries of the world to prepare for an eventual avian flu pandemic. The WHO gives directives to Canada, which in turn gives directives to the provinces, and each province, including Quebec, puts in place its own action plans at the national , regional and local levels.

We do not want to be isolated and work alone. We want a real partnership, real cooperation that respects our jurisdictions.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Mr. Speaker, first I want to congratulate my colleague from Beauharnois—Salaberry on her excellent maiden speech in this House.

While people in her riding are hard hit by business closures in the manufacturing sector as companies often transfer their operations to emerging countries, would the member for Beauharnois—Salaberry not have preferred to speak today about the implementation of an effective program to help older workers affected by massive layoffs, instead of a bill creating an agency that obviously intrudes into Quebec's jurisdictions?

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry, QC]

Mr. Speaker, I thank my colleague for this important question.

To begin, I would answer that, just yesterday, I received three distress calls from textile workers in Huntingdon. They were all in tears and some of them were even suicidal. They reminded me of our role and responsibilities as government members. They also reminded me that the Conservative government will not commit to creating, as soon as possible, an income support program for older workers. I am referring to men and women aged 58 or 59. They are often couples who worked in the same factory. They often have low levels of education and are now suffering from mental health problems.

Creating an agency is not going to improve their health and prevent their problems associated with psychological distress.

[Carol Skelton, Conservative, Minister of National Revenue and Minister of Western Economic Diversification]

Mr. Speaker, my colleague talked about the whole issue of the new public health act and what she feels is the most important part of the act for her riding. Is there anything else she could add to this important new bill?

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry, QC]

Mr. Speaker, I thank the member for her question.

When members speak for the first time in the House on a particular subject, especially newly elected members, they take the time to read on that subject and to consult their constituents. As a matter of fact, yesterday, I consulted a senior executive in a rather important health care institution located in the most densely populated part of the Montérégie region, in my riding. This public health specialist told me that, after reading this bill, she saw nothing in it that would improve the health of Quebeckers or Canadians. We are already doing what this bill proposes to do. I do not see how this new agency will put forward new solutions. It will just confuse people who will be the target of different health promotion campaigns on the same issues.

There is often a tendency to want to put in place Canada-wide promotion programs. We live in a vast country and each community has its own characteristics. Even in Quebec, response strategies in public health are not the same in the Gaspé Peninsula as in the Montérégie region. We constantly need to adapt our strategies.

In my opinion, the existing agency within Health Canada is acceptable and seems to work well. I do not see why there should be any other agency.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Speaker, I am pleased to rise in the House today to speak to Bill C-5. As many of us in the House are aware, the Public Health Agency has been in operation for some time, and this is the enabling legislation.

In the context of dealing with the Public Health Agency of Canada, I went to the Public Health Agency's website and reviewed some information that is important for the context of the debate in the House.

The mission for the Public Health Agency is to promote and protect the health of Canadians through leadership, partnership, innovation and action in public health. As many members have noted, the Public Health Agency is responsible for a number of different aspects of public health. In part, it is mandated to respond to public health emergencies and infectious disease outbreaks. Specifically, there are a number of branches that have been set up to deal with this issue. I will address two of those branches in my speech today.

One is the branch for infectious diseases and emergency preparedness. I have a quote from the website. It states:

The Branch enables the prevention and control of infectious diseases and improvement in the health of those infected. Staff prepare for and are ready to respond to public health emergencies, 365 days a year. Examples of specific challenges are HIV/AIDS, pandemic influenza preparedness, health-care acquired infections such as C-difficile...

I will speak specifically about infectious diseases.

The other is the branch for health promotion and chronic disease prevention. Again, on its website, it states:

The Branch works with stakeholders at all levels to: provide national and international leadership in health promotion, chronic disease prevention and control; coordinate the surveillance of chronic diseases and their risk factors and early disease detection; create and evaluate/measure programs addressing common risk factors and specialized issues focussing on special populations (seniors, children)...

In the context of several things that have happened in Canada over the past years, it is important to talk specifically about pandemics.

I want to hearken back to SARS and what happened in Toronto and how that terrible event impacted so heavily on so many people, the workers, businesses, and the tragedy for families who lost loved ones. As a result of that, an inquiry was commissioned and it resulted in something that we all refer to as the Naylor report. I want to go back to the conclusions of the Naylor report and the specific recommendations that were made.

The summary of the Naylor report talks about the fact that SARS killed 44 Canadians, caused illness to hundreds more, paralyzed a major segment of Ontario's health care system for weeks and saw in excess of 25,000 residents of the GTA placed in quarantine. Those impacts still reverberate in that community. The report went on to talk about the fact that the national advisory committee on SARS and public health had found that there was much to learn from the outbreak of SARS in Canada, in large part because too many earlier lessons were ignored. The report states:

A key requirement for dealing successfully with future public health crises is a truly collaborative framework and ethos among different levels of government. The rules and norms for a seamless public health system must be sorted out with a shared commitment to protecting and promoting the health of Canadians.

On and on it goes. Toward the end of the report, it states:

Until now, there have been no federal transfers earmarked for local and P/T public health activities. Public health has instead been competing against personal health services for health dollars in provincial budgets, even as the federal government has increasingly earmarked its health transfers for personal health service priorities.

In that context, one would have hoped that there would have been significant movement. Instead last year, on November 3, 2005, the public health officials came before the health committee to talk about a couple of issues, one I will address shortly when I talk specifically about first nations and public health.

In the context of pandemics let me refer to something that Dr. David Butler-Jones brought forward to the committee. In part it was in response to a question that I asked about the fact that there were challenges in light of communication, capacity and the federal plan specifically had earmarked timeframes around vaccinating all Canadians in four months, in two waves.

The question I had put to Dr. Butler-Jones was whether we had the ability to obtain a domestic supply of a vaccine if one is developed, because it does depend on the strain, and whether we had the physical capacity in communities to vaccinate all Canadians in four months. Keep in mind that we had the SARS crisis that talked about coordination in response. Dr. Butler-Jones in 2005 said, “In terms of capacity, it is very variable in this country. But it is something the public health network and working with my colleagues, the deputies in the provinces and the ministers to ministers, in terms of how we can continue to build that capacity”. He talked about the money that was allocated in the budget. This is not that we were able to do this, but he talked about continuing to work with the provinces and territories in terms of rebuilding the capacity that was lost at the local level over the last decade, as we had been so focused on hospitals and less on the public good of public health.

That was in the fall of 2005. We still have gaps in our capacity to respond to a pandemic in this country. In the context of sending the bill to committee, I urge that this information be addressed.

In the past year we were able to go through a flu season without needing that kind of response in place, but it is a ticking time bomb. We need to have the capacity in this country to address that situation.

I also want to speak about chronic disease and disease prevention specifically in terms of aboriginal communities. There is an aboriginal peoples round table report on the Public Health Agency website which contains a number of recommendations. Regarding operational strategies for a public health agency, it states that an agency should consider:

The need to avoid a melting pot approach to aboriginal issues which might disregard distinctions between aboriginal peoples.

Agency needs to be sensitive to cultural differences in public health, which means that some approaches can seem foreign or counter-cultural.

The importance of engaging aboriginal women as leaders in community public health issues. Aboriginal women should be consulted on the formation of good models of health delivery.

Strategies to address the public health issues of aboriginal peoples who live off reserve.

The report goes on to talk about specific investments that are required:

The need for training nurses and public health professionals to serve northern and remote communities -- particularly Inuit who would like to become nurses;

The need for cross-cultural training for nurses who are often unable to take such training because of the demands of their work;

The need for investments in capacity so that first nations communities are better able to respond to outbreaks of infectious disease; and

The need for support to address public health crises in many communities, including mould in housing and potable drinking water.

There were other public health issues that were specifically raised. Participants also raised concerns about specific public health issues, including that Inuit need help facing particular public health concerns relating to lower life expectancy, mental health, tuberculosis, and the challenges of keeping health care providers, such as nurses, in the communities. They also indicated that first nations communities need help addressing problems such as the prevalence of diabetes among first nations people and the high rate of suicide in communities such as those in northern Ontario.

In talking about suicide, after I was elected for the very first time, my first official duty in my community on July 1, instead of celebrating what a great country this is, was attending the funeral of a first nations youth who had committed suicide a couple of days before. He was 19. This is a crisis in many first nations communities.

In terms of a public health framework for first nations communities, the First Nations Health Bulletin, Winter-Spring 2006 talked about work that the Assembly of First Nations is doing in the context of many communities across Canada. It is raising a number of issues including some of what we call the social determinants of health. We must not just talk about health promotion. We must talk about the social determinants of health. The bulletin refers to high rates of unemployment, lower educational opportunities, poor housing and overcrowding, lack of basic amenities such as running water and indoor toilets. These are but a few of the social issues that contribute to the poor health in first nations communities.

The bulletin stated that it is essential that a community have access to information about itself. We know that knowledge is often power. When we do not have adequate information to talk about the health in communities, then we do not have the tools to help us develop the appropriate public policy to address these issues. That is not available in many circumstances, largely due to the dysfunctional surveillance systems for first nations health.

It goes on to say that the recommendations proposed in the public health framework take into consideration the distinct communities that first nations represent across Canada. This points to the fact that we cannot have a one size fits all approach to public health in first nations and aboriginal communities from coast to coast to coast.

The Assembly of First Nations put out a bulletin on May 3, 2006. I will quote from this because I think the words should come from the people it directly affects. The headline is “Federal Budget Ignores Health Crisis in First Nations Communities” and it states, “Assembly of First Nations National Chief Phil Fontaine said it is alarming to see a complete absence of funding in the federal budget to address urgent health crises faced by first nations communities such as those faced by Garden Hill First Nation in Manitoba and Kashechewan First Nation in Ontario. It is ironic that the first government saw fit to invest in epidemics of tuberculosis, HIV-AIDS in developing countries, while many first nations are living with these diseases and there is no new assistance for them”.

To give a little more context, this is Canada. This is not a developing country where sometimes, sad but true, people come to expect high rates of infant mortality, tuberculosis, HIV-AIDs and diabetes. Let us talk about the reality in first nations communities.

In 2000 the life expectancy at birth for first nations populations was estimated at 68.9 years for men and 76.6 years for women. That represents a gap of 7.4 years and 5.2 years respectively with Canadian populations. The gap in the potential years of life lost between first nations and Canadians was estimated in 1999 to be three times greater on injuries, almost double on endocrine diseases, such as diabetes, and more than double for mental illness. In 1999 the first nations suicide rate was 27.9 deaths per 100,000. The Canadian suicide rate was 13.2 deaths per 100,000. There is a litany of these pieces of information. It is shameful that we need to talk about them today in the context of a country as wealthy as Canada.

I will briefly touch on pandemics as I know I will run out of time and I still want to speak about tuberculosis and diabetes. Pandemic readiness in first nations communities is not where it needs to be. In a paper by Dr. Gideon for the Assembly of First Nations, she specifically talks about the fact that there are gaps in the training plans, that many first nations communities have had the opportunity to develop these plans, but have had no ability to test the plans, that there is still inadequate training around drinking water and sewage plant management, and that there are still no formal discussions or written protocols between Health Canada and the provinces and territories where much of that action will need to happen.

I need to turn my attention in the time I have remaining to the crises around tuberculosis and diabetes within first nations communities in this country. I want to talk about Garden Hill specifically. In 2001 the incidence of tuberculosis disease in first nations communities was on average 10 times higher than that of the Canadian population as a whole.

Between 1975 and 2002 there was a significant decline in the number of cases and incidence of TB among first nations. The most positive impact was achieved by 1992. This is despite the first nations insured health benefits branch tuberculosis elimination strategy implemented in 1992 with the goal of reducing incidence of TB disease in the first nations on reserve population to one per 100,000 by the year 2010. Over the last 10 years there has been limited improvement in further reducing the incidence of TB among first nations, especially in western provinces.

This is in the context of the first nations community, the Garden Hill Reserve, with 3,500 where only 4% have access to running water. There are 20 cases that have been reported in the area. The first case went undiagnosed for eight months. There was a critical need to move on clean drinking water, on sewage, on adequate health care resources in the community.

The community is calling for community-wide testing. We must act. This is Canada. People should not be facing the spread of tuberculosis in their communities in this day and age.

I want to turn now to diabetes. Friday, May 5 marks National Aboriginal Diabetes Awareness Day. Diabetes walks are being held in my own community to attempt to shine the light of attention on this crisis.

I am going to quote from a press release by Chief Phil Fontaine who said, “Diabetes has become a disabling and deadly disease for many Canadians but first nations continue to suffer with a level that is three to five times higher. In order to better come to grips with understanding and treating this epidemic, the Assembly of First Nations is in the process of completing a three part first nations diabetes report card based on the Canadian Diabetes Association model. The report card will assess the current state of diabetes supports available to first nations people focusing on six areas: prevention; treatment; education; policy development; research; and surveillance. The first part of the report card will be released next month.”

The great tragedy of diabetes is that it can be easily prevented or regulated through diet and exercise, but when people live in poverty, making healthy choices is not an option when there is no access to affordable foods and safe drinking water.The press release goes on to talk about how in some communities entire families, from toddlers to grandparents, have diabetes.

This year the first nations regional health survey revealed that the average age of diagnosis among youth is 11 years, but there are also many adults who go undiagnosed and untreated until they suffer serious complications, such as blindness or loss of limb. The risk of developing type 2 diabetes can be reduced through healthy nutrition, healthy weight and regular physical activity. There are success stories in some first nations communities but there are also many tragedies.

The release goes on to say, “The great tragedy of diabetes is that it can be easily prevented or regulated through diet and exercise, but when you live in poverty, making healthy choices is not an option when there is no access to affordable foods and safe drinking water”.

There is a litany of information. For many decades first nations communities across this country have continued to plea with governments to ensure that the social determinants of health that are impacting on the health and well-being of aboriginal communities is addressed.

We have developed drinking water strategies and housing strategies and yet we still do not see a significant improvement in many aboriginal communities. What is the loss to this country in terms of people's ability to participate fully in their community life? What is the loss to the economic well-being of the community? What is the loss to the cultural vibrancy of the community when many elders and young people are contracting a disease that is entirely preventable?

Diabetes can be addressed through a comprehensive program that ensures there are adequate health resources in the community and adequate educational resources. These tools must be developed in conjunction with aboriginal communities to make sure they are culturally relevant and appropriate to the first nations community, because it is a diverse community from coast to coast to coast. These things must be put in place to address this crisis.

We saw events unfold in Kashechewan last year when the community was faced with a drinking water crisis. We are seeing an emerging situation in Garden Hill with a tuberculosis outbreak. I believe there are currently 79 boil water advisories in place in first nations communities.

This bill provides us with an opportunity to highlight some of these very serious issues facing first nations, Inuit and Métis communities, both on and off reserve. I would urge the committee to examine these issues in a very serious way and put forward some meaningful proposals developed in conjunction with aboriginal communities and their leadership.

It is critical that we make sure that access is available for all. We consider ourselves an equality country so let us make sure equality is in place. The time for action is now.

[Robert Thibault, Liberal, West Nova, NS]

Mr. Speaker, I had the honour and privilege of serving with the member in the last Parliament on the health committee and I know of her resolve on these issues. While we may not always have agreed 100% on the way to solve the problems, we always participated very well, worked very well and shared the principles.

I am pleased that she has made a reference to TB, because I think it is one the areas of public health that we have to pay a lot of attention to. My father was a victim of TB. He lost a lung to TB, which probably contributed to his death at 49 years of age. There was an outbreak of TB in my community almost 40 years ago in which hundreds of people were hospitalized. High school children and children in intermediate school were hospitalized. They lost a lot of very important years at a very important time. I know people who spent seven, eight and ten years in sanatoriums because of tuberculosis.

There is currently a fear of an outbreak in my community. At the Yarmouth Regional Hospital, approximately 750 people had to be tested for tuberculosis. I know what anxiety and fear this puts into our community. I can only imagine what anxiety levels and fears there must be in native communities throughout this country where they have to live with this fear every day.

We know that with TB, fetal alcohol syndrome, juvenile diabetes, and especially adult onset diabetes, socio-economic factors play a large part in the opportunities for those diseases to manifest themselves and spread within those communities.

We know the disappointment there must be in those communities that the Kelowna accord has been scrapped by the government, with the loss of the opportunity they had for socio-economic improvement of those communities throughout Canada, especially in the northern communities, from one ocean to the two others, where they had reached an agreement with all the provinces to deal with the basis of the problems in those communities. That $5 billion investment, a great first step, has been scrapped.

Could the member tell us her impressions of the socio-economic costs of cancelling the Kelowna accord?

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Speaker, I know the member has been committed to addressing the very serious health issues both in his own community and in aboriginal communities across the country.

The Kelowna agreement was an effort to address the poverty gap that exists in first nations, Inuit and Métis communities. There is a disregard of the amount of work done over 18 months, of the amount of consultation and the very real participation of aboriginal communities across this country. To just rip up that agreement after all that work really leads to a sense of dismay.

The social determinants of health, which I spoke about earlier, have a real impact in terms of the incidence of disease in the communities. The agreement may not have been perfect, but it was a good step forward in terms of addressing that poverty gap in this country in first nations, Inuit and Métis communities.

It saddens us in the New Democratic Party, and certainly we have heard from communities across the country that there is a great deal of dismay that we will not be able to move forward as a House to address those poverty gaps around housing, education, violence against women and so many other issues. I would encourage this House to encourage the government to reconsider that.

[The Speaker, Peter Milliken]

Following question period when the debate resumes on this matter, there will be about five and a half minutes remaining in the time allotted for questions and comments for the hon. member for Nanaimo--Cowichan. I propose now to move on to statements by members.

The House resumed 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 second time and referred to a committee.

[The Speaker, Peter Milliken]

The hon. member for Nanaimo--Cowichan had the floor before question period for questions and comments following on her remarks. I therefore call for questions and comments and recognize the hon. Parliamentary Secretary to the Minister of Health.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I found it interesting that before the budget the NDP raised concerns about the moneys that would be provided to deal with a pandemic. I trust since the issue was not raised post-budget by the NDP that this concern has been alleviated with the $1 billion committed in this budget to deal with pandemic issues. Incidentally, the Minister of Health will also be leading a provincial-territorial conference next week on pandemic preparedness.

My question for the member is twofold. I realize the member was on the health committee in the last session. First, I wonder if the member would comment on the fact that under the previous government it seemed that the bill did not get the attention it deserved. In fact, it never even came to a vote, whereas under this government the bill has been brought forward within the first 100 days. That certainly suggests quite a difference between the commitment of this government to public health and the commitment of the previous government, with our government being very keen on pursuing the matter whereas the other government seemed to delay. I would be interested in the member's comments on the previous government's commitment, or lack thereof, to public health.

The second question I have for the member deals with the Bloc's comments with regard to jurisdictional issues. The Bloc seemed to try to make the case that pandemics will respect provincial and other boundaries, whereas I think most reasonable people would agree that pandemics and other diseases do not respect boundaries and it is very important to have a public health agency in order to have a meaningful, deliberate and comprehensive strategy to deal with the challenges that may exist when dealing with a pandemic. A national agency would help do that.

Would the member comment on those two issues?

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Speaker, the parliamentary secretary raised a number of issues in his question. In terms of asking me whether I thought the previous Liberal government had fulfilled its obligations, obviously not, or I would not be raising these issues. However, I think it is incumbent upon the current government to also be aware of its obligations.

With regard to the comments around the budget, I was specifically raising issues with regard to first nations communities, the reason being that there still is a great deal of concern that aboriginal communities have not had the attention that is required around pandemic preparedness.

I am going to refer back to resolution 66 from the Special Chiefs Assembly of the Assembly of First Nations. I will not read for members the details of it, but they certainly are calling for an immediate infusion of funding for first nations communities around testing, around the need to fund technical coordination and assistance, and around the need to ensure for public health safety that aboriginal communities are included with provincial and territorial governments in discussions around coordination. It is a very complex matter.

What is critical, I think, is that any time we talk about a pandemic we need to ensure that aboriginal peoples are included at the table in those discussions so there is that coordinated approach, so it does take into account rural and remote communities. This is a critical issue.

I can see that the Speaker is signalling that I am going to run out of time, but let me say briefly that when we are talking about jurisdictional issues, I think we need to put those jurisdictional issues to the side and really talk about the health, well-being and welfare of Canadians.

[Joy Smith, Conservative, Kildonan—St. Paul, MB]

Mr. Speaker, I am pleased to rise in the House today to address Bill C-5, an act respecting the establishment of the Public Health Agency of Canada. As my colleagues have indicated, this legislation represents a key piece in supporting the federal government's efforts to promote and protect the health of Canadians.

As members may know, following the outbreak of SARS, there were discussions and debates on the state of the public health care system in Canada. Two subsequent expert reports, one completed by Dr. David Naylor and other by Senator Michael Kirby, pointed to the need to establish a federal focal point to address public health issues. Specific recommendations included the establishment of a Canadian public health agency and the appointment of a chief public health officer for Canada.

In response, the Public Health Agency of Canada was created in September 2004 through orders in council. However, it currently lacks parliamentary recognition in the form of its own enabling legislation. As such, this legislation provides the statutory footing for the Public Health Agency of Canada and it gives the agency and the Chief Public Health Officer the parliamentary recognition they need.

Beyond the benefits to Canada are the benefits that this agency will bring to Winnipeg and my riding of Kildonan—St. Paul. I intend to touch upon how the legislation affects Winnipeg, Manitoba, and also how the agency will rank against other institutions all around the world.

Winnipeg remains the location of Canada's only level 4 microbiology lab for human health and a world leader in research, training, commercialization and innovation in addressing the threat and impact of infectious diseases. However, the agency will continue to maintain offices, staff and expertise all across Canada, including its federal laboratories, its surveillance networks, its regional offices and national collaborating centres. What this means for Winnipeg is that we will continue to experience the benefits of our leadership in combating infectious disease.

With regard to how the legislation will affect Manitoba, the legislation does not expand on the existing federal role in public health. Nothing that the federal government is currently doing in public health has changed.

Rather, the legislation simply provides a statutory footing for the agency and gives it a mandate to assist the Minister of Health in exercising his or her powers, duties and functions in public health. The minister recognizes the importance of continuing to foster collaborative relationships with federal, provincial, territorial and municipal governments as well as international organizations and public health experts.

This is an objective that is clearly set out in the preamble of the bill. It is also why we have established the pan-Canadian public health network, currently co-chaired by the Chief Public Health Officer and the provincial health officer of B.C. The network is a forum for multilateral, intergovernmental collaboration on public health issues and it respects jurisdictional responsibilities in public health.

It is also important to note that the legislation does not explicitly define the functions and responsibilities of the agency. This was purposely done in order to provide the Minister of Health the necessary flexibility to assign powers, duties and functions in the area of public health, either to the agency or to Health Canada. This flexibility is further enhanced by not defining the term “public health” so that future governments will be left with the flexibility to define the federal role in public health in keeping with emerging issues and new challenges.

Both the American CDC and our Public Health Agency of Canada are part of their respective governments' health portfolios, working on core public health functions such as infectious disease control and prevention, emergency preparedness, chronic disease prevention and health promotion.

The CDC is not a separate departmental entity within the U.S. administration, but rather one of 13 major operating components within the U.S. department of health and human services. There are also some differences in the mandates of the two organizations. For example, the USCDC has responsibility for policy and programming on environmental health, occupational health and safety, and health information and statistics. In Canada, these issues are handled by Health Canada and other departmental agencies.

The director of the CDC in the U.S. reports to the secretary of the department of health and human services through the deputy secretary. In the U.S. the surgeon general, who has no direct connection to the CDC, has traditionally been the lead federal spokesperson on public health issues.

By contrast, Bill C-5 gives the Canadian Chief Public Health Officer a unique dual role. In addition to serving as deputy head of the agency reporting directly to the Minister of Health, the Chief Public Health Officer will also serve as Canada's lead public health professional, able to communicate directly with the public on public health issues.

I would like now to discuss the role of the Chief Public Health Officer, another critical element of this legislation.

One of the key recommendations from the Naylor report was not only the establishment of a Chief Public Health Officer for Canada, but that the Chief Public Health Officer head up a new Public Health Agency of Canada and serve as a credible, official voice on public health nationally. Actually, that is the deputy head; the minister heads it up. This legislation responds to his recommendation by formally establishing the position of the Chief Public Health Officer and recognizing this unique dual role.

First, as deputy head of the agency, the Chief Public Health Officer will be accountable to the Minister of Health for the day to day operations of the agency and will be expected to advise the Minister of Health on public health matters. Further, as deputy head, the Chief Public Health Officer has the standing to engage other federal departments and is able to mobilize the public health resources of the agency to meet threats to the health of Canadians.

In addition to deputy head, the legislation also recognizes that the Chief Public Health Officer will be Canada's lead public health professional with demonstrated expertise and leadership in the field. As such, the Chief Public Health Officer will have legislative authority to communicate directly with Canadians, to provide them with information on public health matters and to prepare and publish reports on any public health issue.

Stakeholders have made it clear that they expect the Chief Public Health Officer to be a credible trusted voice able to drive real change by speaking out on public health matters and issuing reports. Providing the Chief Public Health Officer with the authority to speak out on public health matters and ensuring that the Chief Public Health Officer has qualifications in the field of public health will help confirm this credibility with stakeholders and with Canadians.

This dual role of the Chief Public Health Officer may be unique, but it is not without precedent in certain provinces as it brings certain advantages. For instance, as deputy head, the Chief Public Health Officer has the standing to engage provincial ministries of health and work with the Canadian public health network to receive the best advice from his provincial and territorial colleagues.

At the same time, with the authorities granted in legislation, the Chief Public Health Officer is able to communicate with the Canadian public and provide them with the best public health advice on key issues.

I have spoken on how the legislation represents a critical piece in the ongoing improvements the government is making to strengthen our public health system.

By giving the agency its own enabling legislation and positioning the Chief Public Health Officer as a credible voice on public health, the government will not only bring greater visibility to public health issues or threats facing Canadians, it will have taken a key step to renew and strengthen the public health system as a whole.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Mr. Speaker, like the member for Kildonan—St. Paul, I think we have to be ready to respond to pandemics. However, since 1998, Quebec can count on the experts at the Institut national de santé publique du Québec. This institute has all the tools and the knowledge required to face new challenges in the area of public health.

Does the member not think that the government is making a mistake with Bill C-5? By creating measures for the whole country and ignoring the expertise that already exists in Quebec, the federal government shows no respect for the work Quebec does in public health.

[Joy Smith, Conservative, Kildonan—St. Paul, MB]

Mr. Speaker, public health is a shared area of jurisdiction. Provinces are responsible for hospitals and direct delivery of health care services.

The federal government can also play a role under this jurisdiction. I do not think it is duplicated. This is a very important agency. It is a very important initiative that needs to be formalized to ensure that Canadians all across Canada are protected. It does protect provincial jurisdictions, but it shares in collaboration with all provinces across our nation.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, this agency has been in existence through order in council for many years. There has been no legislative framework or legislative authority, which makes one wonder about the previous government's commitment to public health. The bill did not even make it to a vote under the previous government.

Would the member comment on the Conservative government's commitment to public health and the fact that the bill was introduced in the first 100 days of being in office, versus the previous government that did not even get the bill to a vote during its 13 years in office?

[Joy Smith, Conservative, Kildonan—St. Paul, MB]

Mr. Speaker, our government has been a government of action.

Everything that the Conservative Party stated in the election has come to pass almost within the first 100 days of our time in government. Canadians will be very buoyed and happy that they have a government in place that actually keeps its promises.

This very important agency reflects the health and welfare of all Canadians across our nation. It works in collaboration with the jurisdictions in the provinces. We now have a formalized mandate for the Chief Public Health Officer to give information to the public and to stand strong in terms of the public health of our nation.

This is a very important step. I must commend the Prime Minister for his timely implementation of Bill C-5. The bill formalizes the agency. I think it makes a big difference. It is not out there hanging in the air, it is permanent.

I look forward to the vote on the bill on Monday night. I encourage all members of the House to support Bill C-5.

[Pat Martin, NDP, Winnipeg Centre, MB]

Mr. Speaker, much of the work of the Public Health Agency obviously deals with infectious disease control, the outbreak of SARS, the possibility of mad cow or Asian flu for instance.

I am more interested in a different part of the mandate of the agency, and that is the issue of public health due to exposure to pesticides, asbestos, and other known health hazards that are among us. Our agency is relatively silent on those things. To be fair, perhaps it is that in recent years SARS and these other possible epidemics or pandemics have been top of mind issues.

Would the member agree that there is a role to play for the Public Health Agency to dwell on the bigger picture of public health for people's well-being and to relieve the burden on our health care system with a healthier population?

[Joy Smith, Conservative, Kildonan—St. Paul, MB]

Mr. Speaker, clearly this agency is important and it is being formalized through Bill C-5, as are the roles and responsibilities of the public health officer.

There are many issues that need to be addressed. We certainly look forward to working in collaboration with members opposite on all these issues.

I look forward to more discussion of things, such as the issues the member outlined.

[Claude DeBellefeuille, Bloc, Beauharnois—Salaberry, QC]

Mr. Speaker, could the member tell us what exactly would be the role of the Quebec office of this agency?

In concrete terms, what would that do to improve and better protect the health of Quebeckers?

[Joy Smith, Conservative, Kildonan—St. Paul, MB]

Mr. Speaker, this agency is extremely important. When it comes to Quebec or Alberta, we are a nation that sticks together and works together. Through the agency itself there will be collaboration by the Chief Health Officer and other members of the agency who work together to ensure that the health of Quebeckers and people all across the nation are addressed.

Not only that, but if and when there is an epidemic in any one of our provinces, we will work together as a country to ensure that the disease is under control. We are looking at problems that we have across our nation that we really never had before. I think that the formalizing of the agency is very timely. I look forward to working in collaboration with all members of Parliament, with the Canadian Public Health Agency and with our Minister of Health to ensure this happens.

[The Acting Speaker, Royal Galipeau]

The hon. member for Laval has the floor for a very brief question, and I do hope to see a question mark at the end of this question.

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, I certainly do not question the good faith of the member. I have had the opportunity to work with her and she does very good work. I am very happy to be able to ask her a question today.

With regard to cooperation, would it not be preferable that Quebec not have an office since it already has the Institut national de santé publique, which does an excellent job? That would reduce the risk of blunders like we saw this morning regarding an ad campaign—

[The Acting Speaker, Royal Galipeau]

The member for Kildonan—St. Paul.

[Joy Smith, Conservative, Kildonan—St. Paul, MB]

Mr. Speaker, again I will say that this national Public Health Agency works in collaboration with all offices and all departments in all provinces across our nation.

The member opposite is a representative from the beautiful province of Quebec and I know her concerns are centred around Quebec. I think as this evolves and is formalized, in the way it is being done right now, we together can ensure what is best for each and every one of our provinces. More important--

[The Acting Speaker, Royal Galipeau]

Order. The period for 20 minutes speeches is now terminated. Members may now speak for 10 minutes with 5 minutes for questions and comments.

I would like to ask members, especially during the period of questions and comments, to look at the Chair. I will give you signals as to how much time you have left so that we can share the time in an equitable manner with all members.

I now recognize the hon. member for Winnipeg Centre.

[Pat Martin, NDP, Winnipeg Centre, MB]

Mr. Speaker, I appreciate the opportunity to speak to Bill C-5 on behalf of the NDP caucus. I also want to recognize and pay tribute to the Chief Public Health Officer, Dr. Butler-Jones, a resident of Winnipeg and a resident at the federal virology lab in my riding, the only level 4 biological laboratory in Canada. It is a dubious thing to have a level 4 lab in the middle of a residential neighbourhood but we do not have time to dwell on that today.

Many of us were moved as we watched Wendy Mesley, on her program special, talk about her personal struggle with cancer. She made a very compelling point about public health in the process of that very personal exposé. Many of us have been led to believe, and it has been the prevailing wisdom, that if we have cancer it is probably because of something we did, such as we smoked or we did not take care of our personal health. In other words, and I say this with the greatest of respect, it has been a bit of a blame the victim mentality about the exploding incidents of cancer in our society.

I would like to put it to the House, through the context of this debate, that there is a secondary reasoning that we have to accept. It could be, and I argue it is to a large degree, our environment which is increasingly a chemical soup that we are exposed to. I say this as a way, I hope, of sounding the alarm and in the context of speaking to it for all of our benefit but within the context of public health.

The question I put to my colleague from Kildonan--St. Paul is in this vein. I recognize that the Public Health Agency has been preoccupied with infectious diseases, the SARS emergency and crisis after crisis, but I urge us, as MPs, and the Public Health Agency to be seized of our public health as it pertains to exposure to known harmful products around us every day.

In that light, I have put forward a private member's bill, which I hope to expand on at some other date, to ban the non-essential cosmetic use of pesticides everywhere. Over 90 municipalities have done this unilaterally. Ottawa tried and failed. I believe it should be a federal initiative because some smaller municipalities cannot stand up to the incredible lobby that hits them. As soon as they have the temerity to suggest that they might want to ban the use of cosmetic pesticides in their communities, the lawyers and the chemical producing lobbyists show up and, more or less, slap-suit them into silence or submission. It is a role that the federal government could play to help these communities.

The entire province of Quebec has done it. Community after community started banning it until the province recognized that was the will of the people and simply banned it.

Fifty per cent of the 200 million kilograms of chemical pesticides used in Canada every year is for non-essential use. That is the first point I would make.

The second issue concerns another dangerous carcinogen, a health hazard that we have within our ability to do something about and have turned a blind eye to, and that is the fact that Canada is still the third largest producer and exporter of asbestos in the world. The province of Quebec, where it is produced, has the highest rate of mesothelioma among women in the world and the third highest among men in the world. That is a cancer caused only by asbestos.

I used to work in the asbestos mines and I can say from experience that they were lying to us about the health hazard of asbestos then and they are lying to us about the health hazard of asbestos today. The Government of Canada should not be spending millions of dollars a year, as it does, subsidizing and underwriting the production of asbestos to dump into third world countries where there are very few health and safety measures and, what measure there are, are not enforced.

First, on behalf of Canadians and through the Public Health Agency, I would like the agency to be aware of and take action on the exposure to asbestos that continues to take place today in Canada, especially in the province of Quebec where the threshold limits are appallingly high and the exposure is epidemic. However it is also for the rest of us because Canada's bizarre affinity and affection for asbestos has led us to contaminate virtually the entire country, including the very buildings that we occupy here today.

I would suggest to the House that the asbestos industry is the tobacco industry's evil twin. It has been lying to us and putting us at risk for the better part of the last century and it continues to do so today. I ask the federal government to, for God's sake, stop supporting this dying industry and let the industry die a natural death.

The asbestos mine in which I worked died a natural death because no one wanted to buy this poison any more, except for underdeveloped third world countries. The whole European Union has banned all forms of asbestos. Australia, Japan and South Africa have banned it but not India. India is one of our biggest markets for dumping Quebec asbestos.

I know it is awkward for the federal government because it has just taken over the seat in Quebec that has all the asbestos mines, Thetford Mines. However, as a former asbestos miner, I ask the government to do the miners a favour and shut down these horror pits and do the rest of the world a favour and stop exporting this killing product. It is like exporting 1,000 Bopals every year. That is how cruel and negligent this is. The Public Health Agency should have a role to play in the broader public health and not just in the emergency preparedness for communicable diseases.

If members have not seen Wendy Mesley's special on CBC about her personal experience with cancer, they should make a point of seeing it. Those who have seen it, I ask them to reflect on this and consider that it is not just what we do and it is not always our fault that we get cancer. We are being poisoned and pickled by a chemical soup as we speak and it is irresponsible to allow that to continue. It is irresponsible to expose another generation to that type of chemical contamination.

It has been well researched in the post-war years that the use of chemical pesticides grew exponentially and, correspondingly, the incidence of certain types of cancers grew exponentially. We will never be able to prove the direct causal link between this particular chemical and that particular cancer, but we know enough now that the precautionary principle must prevail, especially when it is our children who are being exposed as they tumble around innocently on the lawns of the city park that was just sprayed with 2,4-D. We owe it to ourselves.

My bill calls for an absolute moratorium on the non-essential use of chemical pesticides until such time as one by one the industry can come before a parliamentary committee and prove to us that they are absolutely safe. It reverses the onus. It puts the burden of proof on the industry, Instead of us having the impossible task of trying to prove this chemical is dangerous, we want that company to have the equally difficult task of proving to us that the chemical is absolutely safe. It can then put it back on the shelves and sprinkle it around the countryside. I do not care what they do with it. That is one concrete thing we could do today that would substantially reduce the incidence of chemical related cancers.

In summary, there are steps we could take and, with our newly ratified changes to the Public Health Agency through Bill C-5, Parliament could actually make great use of our Public Health Agency by facing up to the reality that the asbestos industry is a corporate serial killer and it should be stopped in its tracks. We also can clean up our municipalities by stopping the cosmetic non-essential use of pesticides.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, the member pointed out that the virology lab in Winnipeg is in his riding. We have heard from the Bloc Québécois that Quebec is independent and that the Quebec public health agency does not need help from the rest of Canada.

The member mentioned that the virology lab is the only level four lab in the country. I wonder if the member would agree that the virology lab is an excellent example of many of why we need a national collaboration in dealing with public health.

[Pat Martin, NDP, Winnipeg Centre, MB]

Mr. Speaker, we are very proud to be the hosts of the federal virology lab, which, of course, has a Quebec connection. We were given the virology lab because the Mulroney government gave Quebec the CF-18 contract which we really wanted. We were the low bidder on the CF-18 contract that had to go to Bombardier because Bombardier is in Quebec. As a default, we received this disease factory plunked into a residential neighbourhood. I do not think it was that great a trade, frankly, but now that we have it we are proud to have it. It is part of a national strategy where we serve all of the provinces, including the province of Quebec, with their needs in analyzing infectious diseases.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

Mr. Speaker, I would like to correct the record. The Parliamentary Secretary to the Minister of Health says that Quebec does not need help or wants nothing to do with the rest of Canada. This is totally false.

Quebec has always been fully cooperative. We should not forget either that Quebec has its own health research university centres. What we said and what we are repeating is that Bill C-5 that is before the House today is directly interfering in provincial areas of jurisdiction. A federal government that manages only a few hospitals has no right telling the provinces how to manage their health care systems.

We need to set things straight. Today's debate is not about a war between Quebec and the rest of Canada. Rather, we are discussing the government's plan to put a health care system, a registry, a new level of public employees in each of the provinces. I do not think that we need this. That would be spending money for nothing.

I would like to hear the comments of my friend from Winnipeg Centre on this issue.

[Pat Martin, NDP, Winnipeg Centre, MB]

Mr. Speaker, there is one Chief Public Health Officer through the Public Health Agency, Dr. David Butler-Jones, who spends a lot of his time flying around the country serving in that function. Not only does he fly around this country, but he also flies internationally because the agency is part of a network internationally that monitors infectious diseases, whether it be SARS or the avian and Asian flu.

I do not know about each individual province but I do know there is only one national agency and one chief officer. The National Institute of Public Health in Quebec is linked intricately with this Canadian agency.

[Mike Wallace, Conservative, Burlington, ON]

Mr. Speaker, it is my pleasure to speak to Bill C-5, which provides the statutory framework for the Public Health Agency. As well, Bill C-5 establishes the position, the powers and the duties for the Chief Public Health Officer.

In my discussion today I will talk about why I think this legislation is important. I also want to comment on whether public health needs a national voice and whether we are actually interfering with provincial jurisdiction. I will be dealing with these questions throughout my discussion.

Public health is a field of health care that is often out of the spotlight until there is a crisis. Let us face it, most of us take our public health needs for granted. We all assume that the water coming out of the tap is safe to drink. We all assume that when we go to a restaurant, the facilities are clean and the food is safe. We all assume that our immunization system protects us from communicable diseases, including tuberculosis.

However, when there is a crisis, the interest in public health suddenly comes into focus. In a crisis, our public health care professionals and the public health care system become the centre of attention. In a crisis, Canadians deserve, want and should get solutions and answers, and they should get them immediately.

In my previous job as a regional councillor in the region of Halton I experienced first-hand the vital role public health plays in the lives of my constituents. I appreciate its importance and firmly believe the Government of Canada has a role in gathering information, providing advice and responding to emergencies in public health.

Canadians expect their federal government to care about their public health needs. The past outbreak of SARS and in my area the introduction of the West Nile virus have been two important public health issues in my riding. Public health officials have played a key role in informing the public on the risks and actions that people need to take to protect themselves.

Public health in today's environment is facing a number of challenges, including the potential of a pandemic influenza outbreak. Our Public Health Agency can play a vital role in preparing and preventing such an outbreak in all parts of Canada. A planned and coordinated effort will help prevent a Canadian public health crisis in the future and our Canadian Public Health Agency should be at the forefront of this effort.

Members of the public expect the government to provide them with the necessary information to protect them in a timely and accurate manner. I see this as the key role for the Public Health Agency. The agency is and will continue to be the catalyst for information sharing and will be the central clearing house for public health data as it relates to trends and issues facing public health in this country. I support this important role for this agency, as we can work cooperatively with the provinces and our municipal partners in preparing and responding to public health threats.

Not only will this agency be the connection for public health in Canada but it will also be a key link in the public health issues and best practices that are facing other nations around the world. The agency will work closely with other important international health agencies, such as the World Health Organization.

I also support having a Chief Public Health Officer who will be the lead spokesperson on public health issues at the federal level. We need a credible spokesperson who has the trust and faith of the Canadian public. The bill will make the Chief Public Health Officer the deputy head of the agency and accountable to the Minister of Health. The Chief Public Health Officer will use his or her expertise to assist in policy development in public health.

In addition, the Chief Public Health Officer will also be required to submit to the Minister of Health for tabling in Parliament an annual report of the state of public health in this country. The Chief Public Health Officer will have the authority and expertise that is needed to give Canadians confidence that our public health concerns are being addressed.

Are we interfering in provincial jurisdiction? I say no. I view the Public Health Agency as complementary.

I took it upon myself to contact the public health doctor for the region of Halton, Dr. Nosal. I asked his advice on whether he felt that an additional level of scrutiny of information was important. He told me directly that he and his colleagues throughout Ontario believe it is important to have a national voice in public health.

As a regional councillor, my personal experience in public health issues included SARS. A hospital in the community of Burlington was closed to the public during the SARS outbreak. Constituents called me in tears. They could not get into the hospital to see their loved ones. They wanted to know what was happening. It was something new for us. Information was not as available as we would have liked it to be. We got the answers, but if at that time there had been a national agency that had that type of information on how to respond to emergencies and to a crisis that could have been shared with other communities and provinces, then we would have been able to react in a quicker and more efficient manner.

Another public health issue which I think is more localized for me but could occur in other parts of the province and country is West Nile virus. It is a virus carried by mosquitoes. It tends to grow in stagnant water and can cause a public health issue.

We had a major reaction in Burlington on what to do about West Nile virus. Would it not be great if we had a national agency that could act as a clearinghouse to provide information so that all public health agencies across the country would how we handled the issue, what worked and what did not. Then if it became an issue in another parts of the country they would be able to react quickly to those issues.

That is why I believe we are not interfering with any provincial jurisdiction. What we are doing is standing up for the health of Canadians everywhere.

In addition, there was a study done on whether there was a need for this agency. There was a full consultation with experts in the field and public health stakeholders and they all agreed there was a need and desirability for a national public health agency. In discussions with our provincial and territorial partners, they indicated a need for a federal public health voice. They indicated a particular need for federal involvement in emergency situations.

This legislation does not expand the existing role that the federal government plays in public health. The legislation simply provides the agency with the mandate to assist the Minister of Health in exercising his or her powers, duties and functions in public health.

Of course we want to work cooperatively with our provincial, territorial and municipal partners. In addition, the agency will play an important role with international organizations and other public health experts around the world. Public health threats to Canadians often have no borders.

In conclusion, the Public Health Agency of Canada and the Chief Public Health Officer deserve our support. Whether it is preparing for a pandemic influenza outbreak, maintaining the national emergency stockpile system, consulting with other international organizations, or responding to other public health crises, Canadians can be reassured that the federal government takes public health seriously.

I look forward to supporting the bill all the way through the legislative process.

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, the bill provides in the regulations that the new Chief Public Health Officer is able to form committees to collect, analyze and distribute information. I am not sure whether the member has any knowledge about what has been going on within government in terms of setting up these ad hoc committees to look at things, but I do know the health committee had an unfortunate encounter with one such task force looking at alcohol misuse, and particularly questions that the committee raised with regard to fetal alcohol spectrum disorders. The member will probably know that it is an important issue.

When we talk about the new agency, it will have to have some priorities. Members throughout the House have talked about a number of areas of public health promotion and protection but when it gets down to it, I would think that Canadians want to ensure the significant risks to public health ought to be dealt with first. Does the member agree?

[Mike Wallace, Conservative, Burlington, ON]

Mr. Speaker, I think that based on our government's response to a number of issues facing Canadians, we are very keen on setting priorities and following through on priorities, as we said we would do in the election. We are delivering on them now. I do not see any difference in the way we operate here. Once this is in place from the legislative perspective, and as members know the agency is already up and running, it is appropriate to determine the public health priorities of Canadians. This can be done through consultations involving the Ministry of Health, the public, members of the House and the health committee. Those public health priorities should be the priorities for that organization. We need to take advice from the experts in the field, including the Chief Public Health Officer and the other public health agencies throughout the country on what the priorities are for individual provinces and territories. Once those are set it would be ideal for us to follow through on them.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Speaker, earlier the parliamentary secretary had talked about the $1 billion that was set aside for pandemic preparedness, so I checked the document to see if the word “aboriginal” was anywhere in it and it is not, on pandemic preparedness.

What are the department's plans with regard to the specific requests that have been put forward by the Assembly of First Nations on testing, staff training, and sewage and water?

[Mike Wallace, Conservative, Burlington, ON]

Mr. Speaker, I obviously do not have the answer to that specific question.

I just want to say again that once this legislation is in place, priorities should be addressed in terms of what the issues are. Whether it be clean water, emergency preparedness, or something else, those things should be dealt with and we look forward to the input of all the parties on those issues.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, to clarify for the NDP member, actually the 2006 budget provides for $450 million to improve water and housing for on reserve educational outcomes and to assist aboriginal women and children. The budget also firms up to $600 million for aboriginal housing off reserve and in the north.

With regard to my question for the member for Burlington, we have heard a lot of rhetoric from the Liberals, but here we are within 100 days of our party forming the government and we have brought forward Bill C-5 and the Liberals were not even able to bring it to a vote. I wonder if the member could comment on the contrast between the previous government and this government's commitment to public health.

[Mike Wallace, Conservative, Burlington, ON]

Mr. Speaker, I am proud of this government's ability to move very quickly on the public health issue. I think it is important to Canadians.

Canadians will judge this government on its ability to act quickly and get things in place.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Mr. Speaker, although I have spoken in this House a few times since my election on January 23, I am privileged to do so today, for the first time in the context of a debate, on behalf of my constituents in Verchères—Les Patriotes. However, I would have preferred to do so under different circumstances.

The Speech from the Throne states, and I quote:

All too often, the strength of our federation is compromised by jurisdictional squabbles that obscure accountabilities and prevent governments from working together in the best interests of Canadians.

This new government will take a new approach.

This same government is now proposing a bill that is has merely been cut and pasted from a Liberal bill, one that in no way respects the constitutional jurisdictions of Quebec and the other provinces. That is Bill C-5, which permits the government to set out the minimum obligations of the Public Health Agency of Canada.

Before reminding you why the Bloc Québécois opposes this bill, since this is my first speech in the House and just to put a smile on my face for a moment, I would like to sincerely thank my constituents from Verchères—Les Patriotes for the confidence they have shown in me and in the Bloc Québécois, confirmed once again during the last election. I promise to listen to the concerns of my fellow citizens with just as much dedication as my predecessor, Stéphane Bergeron, and to ensure that they are voiced in this House.

I would also like to thank the Bloc Québécois members in Verchères—Les Patriotes, who have given me the honour of representing the ideas and ideals of our party. Although the nomination race was lengthy, it allowed me to establish solid relationships with many party members, and the nomination evening, I can assure you, will be etched in my heart and memory as one of the greatest moments of my life. I would like to recognize my fellow opponents: Marc-André Veilleux who, with the support of his wife, children and family, conducted a great campaign, and Frédéric Brossard-Lemerise, who gave his first political speeches. We have all been there, and it is a major step to take. I must also thank Lise Lavoie, my election campaign manager, Louis-Marie Pilote, my official agent, and their team of volunteers who spared no effort and who, in honouring their commitment to making Quebec a sovereign nation and sacrificing the quality time they could have spent with their families at Christmas and the New Year, greatly contributed to the success of this election.

Finally, I would like to share with you the debt of gratitude I owe my family—my father and grandmother at the top of the list—for the unfailing support they have always shown and continue to provide day after day.

I did say that would put a smile on my face. Unfortunately, it was short-lived because I must now return to Bill C-5, a bill that, let us not forget, was presented by the former government and scorns the Quebec government's sole authority over health care in Quebec.

Need I remind the House that although none of the parties in this House except the Bloc Québécois seem interested in respecting Quebec and the provinces' exclusive jurisdiction over health, Quebec governments have always intervened to ensure that this constitutional guarantee is fully respected? I could find any number of quotes from Maurice Duplessis, Robert Bourassa, Jacques Parizeau or Lucien Bouchard on the matter.

Is it clear that the creation of this agency will cause the governments of Quebec and the provinces—the only governments that have the structure and the tools in place to provide adequate health care—to lose hundreds of millions of dollars?

It is understandable that this type of legislation would appeal to the sort of government that used the surplus generated by creating the fiscal imbalance to interfere in areas in Quebec and provincial jurisdiction. But I have a hard time understanding why a government that claims to want to end this kind of disrespectful conduct toward other duly elected governments would want to introduce it again.

How can the Minister of Health, the adoptive father of this bill, find this bill acceptable when he said, in reference to guaranteed wait times, that we have to respect provincial jurisdictions, even if it takes a little more time to get things done?

How can the Prime Minister, a disciple of open federalism, support this bill when he stated in Montreal on April 21 that open federalism means “respecting areas of provincial jurisdiction, keeping the federal government’s spending power within bounds”?

We are disappointed to see that this government says one thing but does another.

We are not opposed to this bill because we do not care about people's health. Quite the contrary. The Bloc Québécois has always been concerned about health issues, especially public health, a crucial aspect of health that includes both prevention and development of plans to deal with serious diseases.

The Bloc Québécois also recognizes that there is a lack of funding for health. In fact, the Bloc Québécois feels that the main problem is underfunding related to the fiscal imbalance that deprives Quebec and the other provinces of the revenue they need to carry out their responsibilities and, as a result, makes them less able to properly support their public health bodies.

The Bloc Québécois feels that correcting the fiscal imbalance will enable Quebec and the other provinces to further develop services for their people in their areas of jurisdiction and ensure that everyone has the right tools to meet the new public health challenges.

The Bloc Québécois feels that only correcting the fiscal imbalance and providing stable funding will enable Quebec and the other provinces to further develop services for their people in their areas of exclusive jurisdiction and ensure that their citizens receive proper health care.

In his budget the Minister of Finance informed us that he will address the fiscal imbalance. I hope the government will keep its word and remain firm in its commitment to resolve this impediment to a healthy democracy in Quebec and the provinces. If it is sincere, this government will indicate to us quite quickly the process it will negotiate with the provinces and the deadline it has given itself. It goes without saying that given the complexity of this issue, a short deadline would be preferred in order to achieve concrete results by spring 2007.

Since I am taking a few moments to talk about restoring fiscal balance, I want to remind the government that this cannot be done without including the $807 million the federal government owes Quebec in 2007 for cancelling the child care agreement.

In closing, I want to reiterate that the federal government's responsibility is to provide adequate funding for health and not to propose new structures—such as indicators for waiting lists—that do not solve the problem of the under-funded health care system. This government should listen to its good friend Jean Charest who, in reference to the Public Health Agency of Canada, said last January that Quebec had its own structures and that they were working.

Since 1998 Quebec has had the Institut national de santé publique du Québec, which does not need a federal agency that will perform the same duties. Why create unnecessary duplication?

Since it is the Government of Quebec that has the expertise and that can intervene in all the institutions of Quebec's health network, it is up to that government to establish its own priorities and action plans and include them in the framework of global objectives developed by agencies like the WHO.

I thought, quite naively, that arrogance had left this House with the Liberal government. The establishment of this agency proves the contrary. If, however, Canadians really want it and Quebec's refusal to have Canada-wide objectives imposed on it harms Canada's development, like our colleagues from other parties in this House are saying, would it not be better for us to move forward as good neighbours in two sovereign nations?

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, the member talked about jurisdiction. In fact, public health is a shared jurisdiction. We are not talking about the direct delivery of health care in hospitals or otherwise.

I wonder if the member could comment on the virology lab in Winnipeg. If the member believes that each province can do everything completely independently, then he must believe that each province should have its own virology lab. I ask the member where he will get the expertise, moneys and other support in order to do that. If he does not believe that, then he must believe that there is a shared responsibility on behalf of everyone in the Canadian federation to work together to protect the public from pandemics and deadly diseases.

I assume the member therefore needs to change his position and support this public health act, because there are synergies that can be gained by working together as Canadians.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Mr. Speaker, I thank the parliamentary secretary for his question.

I totally agree with him. Indeed, we must work together to be better equipped to respond to pandemics of deadly diseases. However, this does not mean simply working together here in Canada, with Quebec and the other provinces. We must all work together on a global level.

It is the WHO that establishes guidelines for the various stakeholders in the world to guide them in their choices and in the development of their own policies.

In Quebec, we have an institute, the National Institute of Public Health. It works quite well. Of course, it calls on capabilities from outside Quebec. However, it is this institute that determines the guidelines for Quebec, since it knows its people best.

[Robert Bouchard, Bloc, Chicoutimi—Le Fjord, QC]

Mr. Speaker, I would like first to congratulate my colleague from Verchères—Les Patriotes for his very interesting speech. He clearly emphasized that Quebec wants its areas of jurisdiction to be respected.

I also heard the comments from representatives of the Conservative federal government about the Public Health Agency of Canada. I remember some of them, particularly that this is a federal central organization that collects and analyzes data for all of Canada. However, as the member for Verchères—Les Patriotes said so brilliantly, health is a responsibility that comes under the jurisdiction of Quebec and the provinces.

I would like to ask a short question to my colleague. Could he explain to us very briefly the contradiction that exists between what the Conservative government is saying about this open federalism with its respect for provincial areas of jurisdiction, and Bill C-5 on the establishment of the Public Health Agency of Canada?

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Mr. Speaker, I thank my colleague from Chicoutimi—Le Fjord for his question.

Indeed, this is quite strange. On the one hand, different government ministers and stakeholders are telling us about the place that the government wants to give Quebec and they assure us that it will now respect the provincial areas of jurisdiction. On the other hand, as soon as this House resumed its work, the government presented us with Bill C-5, which provides for the establishment of a Canada-wide public health agency.

A public health agency in Canada might create confusion in Quebec. Who would now be the main spokesperson? We, in the Bloc Québécois, consider that it is the Institute--

[The Acting Speaker, Royal Galipeau]

I am sorry to interrupt the hon. member, but we must pursue the debate.

The hon. member for Hochelaga now has the floor.

[Réal Ménard, Bloc, Hochelaga, QC]

Mr. Speaker, I am pleased to speak about a bill that is actually a rerun of a bill introduced by the previous government. The wording is exactly the same.

Clearly, the political landscape has changed. My friend the parliamentary secretary, who was formerly in opposition, is now enjoying life in the government. We can imagine just how proud he is to be a parliamentary secretary, and we wish the best of luck to him and his whole team in their new duties.

I know that within him is a man who has deep respect for provincial jurisdictions and that his autonomist streak is just waiting for an opportunity to come out. That said, we must be very, very aware that, frankly, this bill is insultingly paradoxical.

If this were a bill about epidemics and quarantine or about patents and trademarks in the health field, all the Bloc Québécois members would agree that the government is fully within its jurisdiction.

But how can the government have the gall to introduce a bill on public health in this House? The very title of the bill is potentially offensive and shows no respect for provincial jurisdictions.

What is public health? Often, it consists of treatments for citizens. Public health often means a vaccination strategy. Who gives vaccinations? Not the virology lab in the riding of our colleague, the parliamentary secretary.

Of course, the Bloc Québécois members are not so simple as to think that viruses have borders. That is not our philosophy. That is why we want cooperation across Canada, across North America and around the world, as the member for Verchères—Les Patriotes stated.

However, where we part ways with the government is on the need for an agency with roughly $665 million in funding to handle this cooperation.

The government has a very clear urge to engage in nation building. When the Conservative government, the Tories, introduce a bill on the Public Health Agency of Canada, they are giving a nod to the Romanow report.

The Liberal's propensity to intrude and centralize was familiar to us; there is nothing new about that constitutional philosophy. But I find it surprising that the Conservatives are making the same kind of calculations in terms of nation building.

Why is there a Canadian public health agency? It was established because all governments are getting the same polls and realizing that, for the vast majority of our fellow citizens, health is the top priority.

At the time when the Liberals took office, back in 1993-94, and reduced transfer payments from $18 billion to $12 billion, with the inherent risk this had of destabilizing the provinces' public finances, health was less of a concern for the federal government.

Let us not forget that it took three conferences of federal, provincial and territorial first ministers, be they NDP, PQ, Liberal or Conservative, it took a totally airtight, monolithic coalition of provincial premiers to get the federal government to put money back into health care. This resulted in an accord providing $41 billion over 10 years, with the federal government's contribution being 18¢ on every dollar, whereas 25¢ were expected.

That is to say that the Public Health Agency of Canada exists for a political reason.

The reality is that, if ever there is, God forbid, a crisis such as a pandemic, actual help will not come from the virus laboratory in Manitoba, but from the CLSCs in Quebec and front-line services in Ontario or British Columbia. Those are the players working closely with health and social services, as my colleagues mentioned this morning.

We cannot support the establishment of the Public Health Agency of Canada. We know too well the cascade of events the federal government would put us through. Incidentally, the Public Health Agency of Canada took over a number of programs. I would not want our fellow citizens to think that the agency is only involved with issues relating to viruses and immunization. The Public Health Agency of Canada took money earmarked for administering HIV, AIDS and cancer programs and a number of other strategies.

The Government of Canada wants to engage in “nation building” through its health care system. I am willing to bet you, Mr. Speaker—a pint of beer or a glass of wine, if you have more refined tastes, which I'm sure you do—that the government is going to table a bill concerning a national pharmaceutical strategy. It wants to institute a common purchasing policy for all provinces and a common pharmaceutical formulary. We are heading down a slippery slope in terms of health.

Fortunately, the voice of the Bloc Québécois can be heard in this House. We would remind you that creating the Public Health Agency of Canada is no more effective nor does it respect provincial jurisdictions any more than Canada Health Act. The Canada Health Act proposes principles that are very familiar to us all, including universality, a public system, accessibility and a transferrable system.

Sovereignty is a very promising and liberating prospect for the future of Quebeckers. In a sovereign Quebec, if it were up to the Parti Québécois, the National Assembly would adopt legislation that would include the principles found in Canadian legislation. What would be different would be the actor, the one who votes on the budget and provides health care services.

I am fast approaching forty, Mr. Speaker. Did you say I had one or two minutes remaining?

[The Acting Speaker, Royal Galipeau]

Two minutes remain.

[Réal Ménard, Bloc, Hochelaga, QC]

You are too kind, Mr. Speaker.

The paradox lies in the fact that the federal government wants to enforce a law while not having any expertise in how to deliver the services in the field.

When I was health critic, I read a report every year that the member for Québec will now make a point of reading to obtain up-to-date information. In this report, Quebec or other provinces are criticized for not providing some service that ought to be provided, as if the federal government should have a say in the delivery method for health services.

We will not be duped by this series of events, this escalation that the government is preparing. We will not accept that the federal, Conservative government engage in nation building, as did the Liberals, with the health file. We will be the jealous, scrappy and uncompromising guardians of the prerogatives of the Government of Quebec. Fortunately, in this House, the Bloc Québécois is there to make the voice of Quebec heard. We will continue to do so under any circumstance.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, part of being a nation is ensuring that all its citizens have security, good order, good government, peace and good public health. This is a machinery bill that will allow the Government of Canada to do that. In fact, there is no change in power or jurisdictional issues. This is all within the powers that already exist with the federal government.

The member talked about jurisdictional issues. There is an explicit federal rule in controlling infectious diseases at our borders, something with which the Chief Public Health Officer would deal. There is no expansion in any way, shape or form of the federal role in provincial jurisdictions.

The member talks about an independent Quebec. However, there are synergies in working with all Canadians. Another example of that is the virology lab in Winnipeg. The virology lab provides many services for people across Canada, including Quebeckers. If we carry the member's logic to its natural conclusion, he would expect each province to have its own lab, which is hugely expensive, and there are not enough human resources to staff such labs.

Would the member admit that synergies are to be gained by working together and that all Canadians, including Canadians who live in Quebec, benefit from having a coordinated and deliberate strategy?

[Réal Ménard, Bloc, Hochelaga, QC]

Mr. Speaker, I thank my colleague for his question.

Like him, I was present at the committee when Dr. Butler-Jones presented the agency's role. I am sure my colleague will agree that this is not an administrative reorganization. If it is indeed an administrative reorganization with a $650 million budget, then we have a problem with the appropriate use of public funds.

This agency was the product of a report the federal government received following the unfortunate SARS crisis. From a humanitarian perspective, we must work together under all circumstances, particularly in cases of natural or public health disasters. I think Quebeckers support that.

What we are saying is that we do not need this agency. The European Union, for example, wants to share information, but the fact that Great Britain has a virology lab or a lab to study certain diseases does not mean that Belgium or other European Union countries cannot have one too.

My colleague, the parliamentary secretary, is arguing from a false premise. If the premise is false, the conclusion will be too. We want to be involved in this issue. We are saying that, except for its responsibility for quarantines, the federal government has no business developing service delivery plans. That is what the new agency plans to do, it will get $650 million to do it, and its budget will grow over the next few years.

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, I agree more with the parliamentary secretary. We are really talking about the public health of Canadians.

Does the member feel, notwithstanding there will be an agency established, that this agency should not have such a free reign to try to do all things at the same time, but rather should establish a critical list of priorities and assure Canadians that the most important priorities will be dealt with by the agency in its early days?

[Réal Ménard, Bloc, Hochelaga, QC]

Mr. Speaker, the Canadian agency is taking over an administrative branch that existed at Health Canada. Moreover, it is taking over programs that are managed by Health Canada, a number of which are related to diseases that are already known.

The Bloc is not questioning the relevancy of working together. We believe that the centre of decision making, coordination and of policy should not fall to Health Canada, and certainly not on the federal government.

[Paul Dewar, NDP, Ottawa Centre, ON]

Mr. Speaker, it is a pleasure to stand in the House to speak to such an important bill with such an import role.

As my colleague from Winnipeg stated, there are many aspects to health that we need to confront directly and if we do not do it from a national perspective, then the health of all Canadians will suffer.

I want to touch on a number of issues in Bill C-5 and the role of the Chief Public Health Officer. If we take a look at what Canadians suffer from in terms of health concerns, we need to a lot more in the area of prevention.

My colleague already referenced the importance of what we put into our environment. We must ensure that what we put into our environment does not make us ill and later on requires us to use health services that are costly and scarce. It makes no sense if in the end those illnesses could be prevented.

Pesticides is an area that my colleague talked about and one which I have been active on in my own community. When we look at the pesticides that are put into our environment without any concern for the health of our children and those who are most vulnerable, it seems to me that we have a lot of work to do. As the member mentioned, there presently is a model in the province of Quebec where the cosmetic use of pesticides will no longer be allowed. I think that is something all provinces should be looking at. I am hopeful that when the bill is passed that the Public Health Agency will look at the Quebec model.

I would also like to look at the additives that we put into our food source. Today I spoke in the House about the importance of recognizing those persons who work in the public service and who have blown the whistle, not because they were trying to rock the boat but because they were looking out for the public good.

We recently had the mad cow or BSE crisis. Canadians should know that there were men and women working in the veterinary branch of Health Canada who cited the concerns around BSE two years before the crisis hit. We know the costs that were borne by those in the agricultural community. Many people lost their livelihood and many went through incredible turmoil in their own lives.

We also have a concern around the health of Canadians in general. Why? It is because our food source was contaminated. Our own officials within Health Canada, who blew the whistle on BSE, said that rendered beef cannot be fed to cattle. This is exactly what was happening.

We knew this information and had this information but there was no coordinated effort to deal with it. In fact, the recommendations that came forward were the recommendations that the premier of Alberta cited. What did the premier say? He said that we should be testing more of our cows, that we should not be feeding rendered feed to cattle and that there should be more money put into this jurisdiction.

In fact, the same thing happens presently and had been happening in Japan and Europe. Why? It is because those countries had gone through this crisis.

I think the role of having someone looking over the national concerns of public health is absolutely critical for the reasons I have mentioned when we look at the mad cow crisis. This could have been avoided. We could have responded to that crisis more quickly and more sensibly. The health and welfare of Canadians would have been put first and foremost.

Other areas in terms of prevention where I think we have failed and need to do more is on how we prevent persons who are living at the lowest margins from becoming ill. We know the key indicators of health when we take a look at where people live, what kind of housing they have, what access they have to health care, what kind of nutrition they have and what kind of food sources are available to them. We know that access to recreation facilities is important. People must be allowed to participate fully and not, with all due respect, the little bit that was given in the budget. We need to go much further than that so all our citizens can participate in a healthy, vibrant, active life.

Those are the things we need to be put on the table. This kind of purview by the Public Health Officer would allow for health promotion to take place so that we could truly get into preventing some of the ailments Canadians suffer from.

My background is that of a school teacher and I have seen, exponentially, the rise in asthma. At the school where I taught, only one or two students had asthma. If I were to go into any classroom in Canada today and asked how many kids had asthma, I would find that at least three or four students would put up their hands. Why is that? It has to do with the quality of our air, along with some other concerns.

What have we done to prevent the poor quality of our air and deal with pollution? We obviously have not done enough. This needs to be looked at through a national lens. I hope the Public Health Agency can look at this kind of thing and, in doing so, will offer some recommendations that will have some teeth. We do not want to see a report that just gathers dust like the Romanow report sadly did. We want to see a report that has efficacy, that will be heard, not just something that is tabled.

When the bill goes through committee it will be interesting to look at other jurisdictions to see if there are ways in which this will not just be a reporting mechanism to the Minister of Health, but that the recommendations have some teeth so that they will have traction and efficacy and that the health of Canadians will benefit in the end.

We just have to turn to what has happened in the past with reports from auditor generals or other royal commissions when really good work was done but, sadly, not enacted. I hope the scope and the efficacy of the public health office will be something that is not just seen as symbolic but something that will be action oriented.

I want to touch on an area that is near and dear to me, and that is the area of mental health. This is Mental Health Awareness Week. I believe most Canadians are aware of the fact that it is an issue that has been stigmatized for far too long. I would like to see provisions put into the Canada Health Act so that we can take this issue seriously. Hopefully it will become one of the primary focuses of the Public Health Agency. This area has been stigmatized for far too long. It requires resources so that Canadians can have an active, healthy participation in their respective communities.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, early in his comments the member touched on what the Bloc member had to say. I would just like to get the member's view on the importance of working as a nation in the area of public health, while ensuring that we do not intrude into any areas that the federal government has no power, to ensure that people throughout Canada, including Quebeckers, have the access to public health that they deserve. The member may want to talk about the virology lab which is an excellent example of where the nation's resources were pooled together to create a better good for everyone within the nation.

I wonder if the member could discuss the importance of working together as a people in the area of public health.

[Paul Dewar, NDP, Ottawa Centre, ON]

Mr. Speaker, I think it is absolutely critical that we share resources, in that we put our resources together to affect the health of all Canadians.

I must say that if I had had more time I would have spoken about disabilities and putting in a disabilities act, which is also important, but I will save that for another time.

When we look at what Quebec has done, we not only need to look at the fact that we should have national scope but we need to look at where things have been done right. I know my constitutions are envious of the community health centres in Quebec and to the extent it has been done in Quebec and in Ottawa Centre. We need to look at best practices and use those best practices in all provinces. I think the community health centre approach is the way to go. Quebec has done it, bar none. As I mentioned in my speech, we also need to look at best practices like the banning of cosmetic use of pesticides.

I quite agree with the member that we are better off when we put all of our resources together to positively affect all of our health services. When we see health issues that do not respect borders, we need to do that and the more we can the better.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Speaker, I want to touch on a specific issue mentioned by the member in terms of the public health responsibility around access to clean air and clean water.

A first nations community on the shores of the St. Clair River in southern Ontario is surrounded by industry. The community has significant health problems as a result of water and air contamination.

I wonder if the member could speak specifically to how important it is to have the Public Health Agency oversee these kinds of impacts on our communities.

[Paul Dewar, NDP, Ottawa Centre, ON]

Mr. Speaker, it really is critical that we look at the air we breath, the water we drink and the environment that surrounds us.

I would hope that this office and the officer would be able to, as I mentioned before, have some efficacy in terms of being able to go into a community and act on people's concerns about not having potable or drinkable water for decades. The fact is that they need something to be done right away. It would be similar to a local medical officer being able to file a report that commissions the local municipality to act directly.

It would be interesting to see if we can find a way to have that done at the national level, whether it is a national purview, but I am not talking about going over jurisdictions. However we need to ensure that access to drinking water is paramount.

To be honest, I do not think most Canadians are aware or maybe they are becoming aware of the water crisis in this country. Some of it came out of Walkerton and Kasechewan most recently, but I think Canadians are aghast and quite surprised at the fact that in Canada, where we have access to fresh water, we still have people who are not able to drink and access clean water.

I think it is an excellent point and I hope it is incorporated.

[The Acting Speaker, Royal Galipeau]

Is the House ready for the question?

[Some hon. members]

Question.

[The Acting Speaker, Royal Galipeau]

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, Royal Galipeau]

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

[Some hon. members]

Yea.

[The Acting Speaker, Royal Galipeau]

All those opposed will please say nay.

[Some hon. members]

Nay.

[The Acting Speaker, Royal Galipeau]

In my opinion the yeas have it.

And more than five members having risen:

Pursuant to Standing Order 45, the division stands deferred until Monday, May 8, at the ordinary hour of daily adjournment.

The House resumed from May 5 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 second time and referred to a committee.

[The Speaker, Peter Milliken]

The House will now proceed to the taking of the deferred recorded division on the motion at the second reading stage of Bill C-5.

[Jay Hill, Conservative, Prince George—Peace River, BC]

Mr. Speaker, I believe that if you were to seek it you would find unanimous consent to apply the results of the vote just taken to the motion now before the House, with Conservative members voting yes.

[The Speaker, Peter Milliken]

Is there unanimous consent to proceed in this fashion?

[Some hon. members]

Agreed.

[Karen Redman, Liberal, Kitchener Centre, ON]

Mr. Speaker, Liberals in the House will be voting for the motion.

[Michel Guimond, Bloc, Montmorency—Charlevoix—Haute-Côte-Nord, QC]

Mr. Speaker, Bloc Québécois members will oppose this motion.

[Yvon Godin, NDP, Acadie—Bathurst, NB]

Mr. Speaker, members of the NDP will be voting yes on this motion.

[André Arthur, Independent, Portneuf—Jacques-Cartier, QC]

Mr. Speaker, I vote in favour of this motion.

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

Vote #4

[The Speaker, Peter Milliken]

I declare the motion carried. Accordingly, the bill stands referred to the Standing Committee on Health.

(Bill read the second time and referred to a committee)