Bill C-237

An Act to amend the Federal-Provincial Fiscal Arrangements Act and the Canada Health Act

This enactment amends the Federal-Provincial Fiscal Arrangements Act to provide that a province with a program whose objectives are comparable to those of a federal program in an area under the legislative authority of the province may withdraw from the federal program.
It also amends that Act and the Canada Health Act in order to exempt Quebec from the national criteria and conditions set out for the Canada Health Transfer.

Federal-Provincial Fiscal Arrangements Act

[Louis Plamondon, Bloc, Bécancour—Nicolet—Saurel, QC]

moved that Bill C-237, An Act to amend the Federal-Provincial Fiscal Arrangements Act and the Canada Health Act be read the second time and referred to a committee.

Madam Speaker, I am very proud to rise today to speak to my bill, Bill C-237, an act to amend the Federal-Provincial Fiscal Arrangements Act and the Canada Health Act.

The bill addresses the root cause of the tensions and disputes between the federal government and the provinces, Quebec in particular, and that is spending power. The federal government has given itself the power to tell Quebec what to do in its own areas of jurisdiction, under the pretext that it is transferring money to the province.

Canada is supposed to be a federation. In a federation, the two levels of government are equally sovereign, but not in the same areas.

Section 91 of the Constitution confers powers on the federal Parliament and section 92 confers powers on Quebec and the Canadian provinces. Federal spending that encroaches on provincial jurisdiction calls into question the division of powers and Quebec's autonomy. That is what spending power is. It is the power to tell the other what to do in areas that fall under its exclusive jurisdiction. Respecting Quebec and its autonomy is not a partisan game in Quebec, and this is not new.

It was during the creation of the welfare state, as it was known, when the government started developing various social programs, that tensions arose.

During the Quiet Revolution in the 1960s, Quebeckers clearly picked a side. They looked to the Government of Quebec to develop the social safety net, and they expected Quebec to be completely free to do that without having to take orders from Ottawa. Quebec Premier Jean Lesage's campaign slogan was “Maîtres chez nous”, masters of our own house, and that is what he was talking about. That is also what the great constitutional talks—Victoria in 1970, Meech Lake in 1987 and Charlottetown in 1992—were all about. In fact, that is what prompted me to get into politics.

When English Canada got itself a new Constitution without Quebec, I decided to make the leap. When I ran in 1984, I ran because I wanted us to be masters of our own house. It is for that same reason that I am now introducing Bill C‑237 38 years later.

The bill amends the Federal-Provincial Fiscal Arrangements Act in two ways.

On the one hand, it provides all interested provinces with the opportunity to opt out of a federal program that falls under the legislative authority of the provinces. In that case, the government can pay the province a transfer equivalent to the contribution that it would have received had it not withdrawn.

On the other hand, Bill C-237 adds that the government will only pay the contribution if the province has a program whose objectives are comparable to those of a federal program. This mechanism is quite similar to the one that exists in the Canada Student Financial Assistance Act, for example.

If a province has its own program and withdraws from the federal program, it receives the same transfer that it would have received had it not withdrawn. The transfer is unconditional and goes into the province's consolidated revenue fund, but only if it has a comparable program. It can be comparable, but it does not have to be the same. There is no requirement to respect standards or criteria or to allow interference in our affaires. We have a fair amount of control in this kind of relationship. That is not currently the case under this government or under previous governments.

Bill C-237 proposes a second amendment to the Federal-Provincial Fiscal Arrangements Act that applies only to Quebec. This amendment would exempt Quebec from the application of criteria and conditions set out by Ottawa in the Canada Health Act.

The federal government has announced that it plans to set conditions applicable to long-term care facilities, or CHSLDs. It is talking about a series of so-called national strategies, which we understand to mean “dictated by the federal government”, in such areas as mental health, seniors' health, reproductive health, pharmacare and dental care.

The federal government does not develop any services and, in fact, it would not be able to do so. The federal government does not deliver any services either, as it knows nothing about them. It will just transfer the responsibility to the provinces so they will do the work in its place. It is going to hire them like subcontractors, and it is going to use its spending power to tell them what to do.

Fifty years ago, Pierre Elliott Trudeau said that “there's no place for the state in the bedrooms of the nation”. Today, his son is saying that the state has its place in every room in the house, which is unacceptable to us. Our house is Quebec, and we do not want Canada deciding on the decor and furniture.

As I was saying, it is not a partisan issue in Quebec. I would like to quote Benoît Pelletier, Quebec's minister of intergovernmental affairs in Jean Charest's government, the same Jean Charest who is a Liberal in Quebec and a Conservative in Ottawa. It would be difficult to be any more transparent.

Benoît Pelletier said, “I have a great deal of difficulty in reconciling the values underlying the Canadian federation with the idea of a federal spending power that is in no way subject to the division of powers.”

The Séguin commission on the fiscal imbalance said the same thing: “The 'federal spending power' displays a singular logic in that the federal government intervenes every time in a field falling under provincial jurisdiction without having to adopt a constitutional amendment.”

The current government of François Legault, which was elected on an autonomist platform, is still calling for jurisdictions to be respected. Between autonomist François Legault and Jean Lesage's “masters in our own house”, it is very clear that Quebec does not want the federal government to tell us what to do in areas over which we have exclusive jurisdiction.

This is not a constitutional matter. It is, quite simply, a jurisdictional matter. The federal government does not manage the health care system and knows nothing about it.

In March, the Bloc leader held a press conference to demand that the federal budget include an increase in health transfers, with no conditions attached. He was accompanied by the entire Quebec health care community: unions, physicians' federations, various health care professionals, everyone. These people, the backbone of the health care system, are all asking for the same thing, and that is a boost in transfers, with no conditions.

These people make the health care system function, together with the Quebec government. The last thing they need is the federal government coming in and telling them what to do. This consensus goes far beyond the political parties in Quebec; it includes the entire health care community. I would like to reiterate that all the provincial premiers are unanimously asking for the same thing. That consensus is reflected in Bill C-237.

A few weeks ago, the Speaker ruled that my bill requires a royal recommendation. In other words, the House can vote on it at third reading only if the government agrees. We still have second reading, committee and report stage, which gives us several months to convince this government, which, I remind members, is a minority government.

Of course, the Bloc Québécois wants Quebec to be a country, but in the meantime, we want to be masters in our own house to the extent possible.

The Conservative Party campaigned on a platform of respect for provincial jurisdiction. The NDP had its Sherbrooke declaration, which supported Quebec's right to opt out. Together, the three of us can move Bill C‑237 forward. Today, I am calling on these three parties to do just that.

My people built a unique society on our part of the continent. Our distinct nature is evident in our language and our culture, but it is much more than that. Quebec has the highest rate of female labour market participation, the most advanced family policy on the continent, the best wealth distribution and the lowest poverty rates. Almost 80% of the population belongs to the middle class, compared to under 75% in the rest of Canada. How did we make that happen? We did it because we were free to do it. That is all there is to it.

The federal government wants to use its spending power to replace our freedom with conditional freedom. It cannot recognize the existence of a nation while simultaneously wanting to control it. Everyone here rejects that brand of paternalism toward indigenous nations, whose right to self-government we recognize. I expect the same level of respect for my nation, the Quebec nation.

That is why I urge all members to support my Bill C‑237 so we can have a little more mastery over our own house.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I totally disagree with the member's legislation, and I will expand on the reason why shortly.

My question for the member is this. Would he apply the same principles with respect to health in other jurisdictions? For example, the Province of Manitoba would often put conditions to the City of Winnipeg on issues that the City of Winnipeg is fully responsible for. With respect to education, we have school trustees and they are fully responsible for education. Would he apply those same principles to those jurisdictions?

[Louis Plamondon, Bloc, Bécancour—Nicolet—Saurel, QC]

Madam Speaker, my answer is very simple. It is well established in the Canadian Constitution that education and health are areas of provincial jurisdiction. Manitoba has full authority in education and health, as does Quebec. The federal government needs to stop meddling in these areas of jurisdiction.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, I thank my hon. colleague, the dean of the House, for his speech. It was interesting to hear him talk about the time when he first got into politics. Here we are in 2022 still having to demand that our areas of jurisdiction be respected.

This week I attended a summit on the dignity of seniors. I asked a question in the House yesterday about the importance of increasing their purchasing power, but beyond that, everyone at the summit was calling for health transfers. It is about time we took care of our health care system, our seniors and Quebeckers. Everyone agreed that we need to stop arguing and stop accepting transfers with conditions. They were clear that we need transfers without conditions.

Could my colleague comment on that?

[Louis Plamondon, Bloc, Bécancour—Nicolet—Saurel, QC]

Madam Speaker, I thank my colleague for the question.

That is exactly what I said in my speech. Quebec's entire health care community, like every premier in Canada, is calling for health transfers with no conditions because it is the provinces that manage the hospitals, that organize them and the work. The role of the federal government is clearly stated in the Constitution. It consists solely of transferring money to the provinces so that they can provide quality health care services. Seniors in Quebec and everywhere are calling for this. The entire health care community, including doctors, unions, and health care workers, is calling for transfers with no conditions.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Madam Speaker, I appreciate my colleague's speech on the interest of the people of our nation in taking care of the people of Quebec. As he said, the NDP agrees with allowing Quebec to opt out of new federal programs with financial compensation.

The problem with his bill is that he also wants to exempt Quebec from its obligation to honour the five principles of medicare.

Does my colleague realize that his bill opens the door to privatizing our health care system?

[Louis Plamondon, Bloc, Bécancour—Nicolet—Saurel, QC]

Madam Speaker, that is not how I see it. My bill simply says that the federal government will transfer the funds.

It will still be perfectly possible to uphold the principles in the Canada Health Act, since they are quite general. This does not open the door to privatizing health care.

Since this is a provincial jurisdiction, it is possible that a democratically elected government may decide that one part will go to the private sector, but let us be honest: Even though there is a Canadian law, private sector involvement in health care is widespread throughout Canada.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, as I indicated, this is a piece of legislation that I could never support in any sort of circumstance. I guess it is because, offhand, I believe that the constituents of Winnipeg North understand, appreciate and want the federal government to play a strong leadership role on health care in Canada.

I suspect there are reasons why the Bloc, which is a separatist party, wants to see Canada get away with health care, just as there are even separatists who exist outside of the province of Quebec. For me personally, and on behalf of a vast majority of the residents I represent in Winnipeg, I can say that Canadians love our health care system.

The Canada Health Act is one of the things that enables us to have a high sense of pride in who we are as a nation. It is often referred to as one of the things that makes us different from the United States and many other countries around the world. Because we are a caring society, we understand and appreciate the value of the health care system that we have today. Whether in British Columbia, Manitoba, Quebec, Atlantic Canada or in Northwest Territories, there is a basic understanding that health care services are going to be there for people.

My family, like millions of other families in Canada, is not just in one province. We live in other provinces. The heritage of my own family goes back to the province of Quebec itself. I believe that it is not unique to Winnipeg North, but that Canadians in every region of our country understand and appreciate the true value of a national health care system. Yes, it is administered by provinces. I know that. I used to be the health critic in the Province of Manitoba.

When the member says that all provinces want more money and they all agree, I have news for that member: They have been wanting more money every year for the past 30 years. Ottawa is more than just an ATM: Ottawa has a responsibility to Canadians to ensure that provinces and territories respect the Canada Health Act.

There are things that we can learn from the pandemic that I believe Canadians want us to look at. One of those issues is long-term care. We saw, during the pandemic, different provinces having different levels of difficulty. In some of those provinces, we had to call in the military. In other provinces, we used the Red Cross. In my own province, in fact in Winnipeg North, we can look at the Maples Long Term Care Home facility. Canadian politicians on all sides of the House, maybe not the Bloc but all other sides of the House, recognized that there were some serious issues in long-term care. I can say that Liberal members of Parliament understand what Canadians expect of their members of Parliament. Dealing with long-term care is one of those. That is why we see a very strong advocacy for standards in long-term care. It is because we care about what is happening with our seniors in care facilities.

We also care about mental health. If we do not do anything on mental health, some provinces will fall far behind. Some provinces might move a bit ahead. I would argue, again, that the national government has a very strong and important role to play on mental health.

We saw in this budget, with the support of my New Democratic friends, talk about expanding into dental care. We will see how that ultimately evolves.

I have talked for years now about the issue of pharmacare and the cost of pharmaceuticals. If we think about an individual who goes to the hospital, while people are in the hospital, they get free medication, but when they leave the hospital, they have to pay for it. Often what happens is that they cannot afford the medication, so they end up back in the hospital.

The idea of looking at best practices in different provinces and territories and trying to encourage and promote them in a national standard, I see as a good thing. Trying to marginalize the role of the national government does a disservice to who we are as a nation. I would recommend to those who would advocate that Ottawa should not play a role in health care to talk to some Canadians about it; I have. If they ask them what makes them feel good about being a Canadian, one of the most common responses members will get is “health care”. They will talk about the importance of health care, and justifiably so.

I am concerned about the backlog of surgeries coming out of the pandemic. Because of all the focus that was put on COVID-19 and the impact it was having on intensive care units and other facilities, a lot of surgeries were delayed or put off. We can imagine a person needing a hip replacement who already had to wait a considerable amount of time, or a person who had been diagnosed with cancer. These are very important issues for our constituents.

However, Bloc members are saying, “Who cares? It is not about Ottawa. All Ottawa does is pony up the cash and let the provinces take responsibility”, believing that all provinces will do that. I say shame on the members of the Bloc for believing that. Canadians, even some of their own constituents, recognize the value of Ottawa and the leadership role it can play in the delivery of health care services, even in the province of Quebec.

There are different provinces with different governments at different times, but I think Canadians want a health care system that will be there for them no matter where they live in Canada. Many people have moved to the province of Quebec from Manitoba, and I suspect vice versa. I believe that when we take a look at the needs that are there for health care, the federal government should not be sidelined. The federal government should be encouraged to continue to play that leadership role and look at different provinces.

When we want to talk about accountability on health care and the Canada Health Act, I will go back to the Romanow report of many years ago. There was the idea that as part of the five fundamental principles, we should add an additional one about financial accountability. I think we do need to see more financial accountability. I am glad that Ottawa looks at it from the perspective of saying, “Look, if we want to enhance mental health, one of the ways we could encourage that is to tag dollars to the provinces to facilitate and ensure that there is more investment in mental health.” Again, that is a good thing, contrary to what some of the separatists, whether from Quebec or other jurisdictions, want to see happen.

Like the vast majority of Canadians, I believe in the importance of health care and national programs. I am glad that we have seen under this administration record-high amounts of dollars being delivered to provinces in order to provide health care. We are talking about a record amount of dollars. Historically, never has a government invested more dollars in health care than this current government. We have health care agreements with all of the provinces, which is something that has not been there for a number of years.

This is a government that is committed to Canada's health care system, and I am very proud to be a part of that.

[Shelby Kramp-Neuman, Conservative, Hastings—Lennox and Addington, ON]

Madam Speaker, I am extremely pleased to be here today to rise and speak to the private member's bill of my hon. colleague for Bécancour—Nicolet—Saurel.

I want to take this opportunity to thank our dean of the House for his service to our nation. It is a great honour to be able to address the hon. member. I was six years old when he was elected to this place and, I will note, as a Progressive Conservative.

I would like to say to him that his constituents, Quebec and Canada thank him for his years of dedicated, effective and thoughtful service.

That being said, he has 337 members gunning for his job, myself included.

If I ever do have the pleasure of serving as long as my hon. colleague, that would put me at a very young 80 years of age in this place. It is perhaps divine providence that I am the official opposition shadow minister for seniors.

To get to the point at hand, transfer payments are an essential component of Canadian federalism.

As such, I can certainly appreciate any member's efforts to increase payments for their constituency. It is a massive part of what we are all sent here to do.

My hon. colleague has had the honour and privilege of serving in this chamber for over 37 years straight, so he knows the rules of this place and he has surely had the opportunity to introduce and speak to many bills.

My concern today is not with the approach taken by our hon. dean of the House, who I think is only doing his very best to care for his constituents. My concern is with his method.

One rule in particular, as I am sure we are extremely aware, because the Speaker ruled on this recently, is that private members' bills cannot propose the expenditure of public funds or tax-raising initiatives unless they have a royal recommendation.

Standing Order 79(1) states:

This House shall not adopt or pass any vote, resolution, address or bill for the appropriation of any part of the public revenue, or of any tax or impost, to any purpose that has not been first recommended to the House by a message from the Governor General in the session in which such vote, resolution, address or bill is proposed.

I may be ignorant to the goings-on behind the scenes, but to my knowledge, this particular piece of legislation has not received the required royal recommendation.

My good friend from Winnipeg North, the Parliamentary Secretary to the Leader of the Government in the House of Commons, rose on a point of order to share his concerns about the content of this bill. In his opinion, this bill was actually a spending bill.

The Chair said the following in response to the point of order.

I reviewed the bill, and I have reached the following conclusions concerning the impact on the royal recommendations.

Section 1 of the bill provides that Quebec need not apply the conditions set out in paragraph 24(a) of the Federal-Provincial Fiscal Arrangements Act in order to obtain the amounts referred to in subsection 24.1(1) of that act. Section 3 of Bill C-237 provides that Quebec receives the full monetary contribution provided for in the Canada Health Act without being subject to the various grant conditions set out in that act. In other words, the result of the mechanism proposed by Bill C-237 would be to exempt Quebec from having to fulfill the conditions to which it is currently subjected in order to receive the Canada health transfer, which originate in the Federal-Provincial Fiscal Arrangements Act and the Canada Health Act.

[Translation]

The member for Bécancour—Nicolet—Saurel argued that these changes have no financial effect in terms of either the amounts or their destination. However, these changes would amend the terms and conditions initially attached to the Canada health transfer, which were approved by Parliament.

On this, page 838 of the House of Commons Procedure and Practice, third edition, states:

A royal recommendation not only fixes the allowable charge, but also its objects, purposes, conditions and qualifications. For this reason, a royal recommendation is required not only in the case where money is being appropriated, but also in the case where the authorization to spend for a specific purpose is significantly altered. Without a royal recommendation, a bill that either increases the amount of an appropriation or extends its objects, purposes, conditions and qualifications is inadmissible on the grounds that it infringes on the Crown’s financial initiative.

As the member for Bécancour—Nicolet—Saurel indicated in his intervention, the bill seeks to exempt Quebec from the application of the Canada Health Act. Thus, after analysis and in keeping with the precedents, including the rulings by Speaker Milliken on May 8, 2008, and by my predecessor on December 6, 2016, the Chair is of the opinion that the implementation of Bill C-237 would contravene the conditions initially provided for in the royal recommendation. Accordingly, the Chair is of the view that Bill C-237 must be accompanied by a royal recommendation.

As it stands now, this bill does not have a royal recommendation. Unlike my hon. colleague from Bécancour—Nicolet—Saurel, I am new to the House. I may not be as aware of how things work in this place, but I think is it safe to assume that, if a royal recommendation has not yet been given at this stage then it will not be given later.

We all know how this will play out. As it stands now, this bill cannot and will not be put to a vote at third reading.

I want to use the closing portion of my speech to reiterate that my objection to this bill is rooted in the manner through which it was brought before the House. I want to reiterate that I know my hon. colleague from the Bloc is a tireless advocate for the people of Quebec, as is evidenced by his electoral record. I will go so far as to say that his constituents are lucky to have him. His knowledge, experience and record of service are quite literally uncomparable with those of any member of this place.

That being said, the rules of Parliament are the rules of Parliament. Our Standing Orders are our Standing Orders. They explicitly lay out the rules and regulations under which we operate, and based on the Speaker's decision, the future of this bill is crystal clear. It is a spending private member's bill that does not have a royal recommendation. As such, I will not be voting for it.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Madam Speaker, I am pleased to rise in the House to speak to the bill sponsored by the hon. Bloc member for Bécancour—Nicolet—Saurel, the dean of the House. I am a little older than my Conservative colleague who just spoke. I was 11 years old when my Bloc colleague was elected for the first time.

I agree with much of what was said earlier, and I will focus on three points.

We agree on the first point that successive cuts to provincial health transfers have seriously eroded the quality of services. We still see the impact of that today. These cuts began with the Harper Conservatives, but, as members will recall, they continued with the Liberal government in 2015. The provinces thus find it extremely difficult to provide good services. I believe that all of us in the House must agree that serious corrective action must be taken with regard to provincial transfers.

The second point is about the provinces' right to opt out of new federal programs they do not agree with and receive financial compensation. Obviously, we agree with the right to opt out, which I find extremely important. Ever since the Sherbrooke declaration, the NDP has always argued in favour of respecting the Quebec nation's right to make its own choices and of respecting an asymmetrical vision that would allow Quebec to opt out of new federal programs with financial compensation and then set up an equivalent program or some other program in line with the province's priorities. We recognize the power to opt out with financial compensation because Quebec is a nation.

However, I was very surprised that my Bloc Québécois colleague's bill gives that power to all the provinces. That is overly generous. I am a little concerned about the consequences this might have in the case of provinces that have traditionally or repeatedly elected Conservative governments, which could cut or opt out of a new social justice program or better universal health care services that would benefit people from all walks of life, including seniors, people with disabilities and people with special needs.

We support the right to opt out with financial compensation, which could apply, for example, to a project that the NDP really cares about: a universal public pharmacare plan.

Quebeckers strongly support the idea of creating such a plan. A recent CROP poll on this issue found that 73% of Quebeckers surveyed said they were in favour of such a plan. Among NDP voters, support rises to 85%. Among Liberal voters, 80% agree with the idea. Among Conservative voters, 79% agree. Even 66% of Bloc Québécois voters support this. The vast majority of voters, even in the Bloc, therefore agree with a universal public pharmacare plan.

I hope we can come up with a concrete solution, because people know that prescription drugs are too expensive. People cannot afford all the prescription drugs they need, and they sometimes even cut their pills in half to save money.

People know that the cost of prescription drugs imposes a heavy burden on their supplemental coverage when negotiating collective agreements. People know that better access to prescription drugs will improve everyone's health and reduce hospital costs because there will be fewer sick people.

If this type of plan is created as part of a new federal program, but Quebec is unable to reach an agreement with the federal government, it could opt out. The financial compensation it would receive would be put towards Quebec's current plan, which is decent but could be improved. It is a hybrid public-private program that is extremely expensive for companies, workers and the government because of the cost of the drugs that hospitals have to buy in order to provide care.

Up until that point, the bill is relatively good.

However, as progressives with a deep-rooted commitment to public health care, we have a big problem with the second part of the bill. This part of the bill amends the Canada Health Act “in order to exempt Quebec from the national criteria and conditions set out for the Canada Health Transfer”.

Let us go over those five conditions. Universality means that everyone is entitled to medicare. Comprehensiveness means that the necessary medical services are covered by the public plan. Accessibility means that the fees cannot be a barrier to accessing care. We do not want to go backward to a time when people had to choose between paying rent or going to the doctor. People should be able to access care with their health card, not their credit card. Portability means that if we travel to another province, we are still entitled to receive care there through a comparable public plan. Finally, public administration means that the hospitals and the health plan have to be managed by a public non-profit organization.

Exempting Quebec from these five conditions, these five values that are essential for the men and women on the left, as well as for progressives, would open the door wide to privatizing health care, which would be an appalling step backward for the least fortunate people in Quebec, for the working class and for unionized workers.

I do not understand how the Bloc Québécois can move forward with such an idea without realizing the collateral damage and consequences that it may have. Being masters in our own house, that is fine. Making good decisions, that is fine. Removing the key requirement for maintaining a public health care system, however, is something I find extremely worrisome and dangerous.

I want to speak on behalf of all Quebeckers who value a public health care system: They can count on New Democrats and the NDP to defend their values, because we will absolutely not back down.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, we on this side of the House have enough faith in our nation that we do not need know-it-all Ottawa and its federal shield to guarantee that medicare remains public. We have faith that we can do it ourselves.

From what I understand, and the member for Winnipeg North did the best job explaining this from the government's perspective, the other parties see the relationship between the federal government and the provincial governments, in this case the Government of Quebec, as a boss-employee relationship. The boss demands accountability from the employee and sets conditions. A mere employee could decide to privatize the entire system but still needs the boss, in this case, paternalistic Ottawa. That is what I am seeing. We said that the NDP's position is centralist, and we have just seen proof once again.

When the member for Winnipeg North was talking, he was speaking on behalf of the government and he said that he was defending his nation, “our nation”. That is all well and good, but what about our own nation, the Quebec nation? Some time ago, the House recognized Quebec as a nation. What does that mean? How is the government walking the talk? How is it following through on its recognition?

In this Canada, is my nation only free to follow the rules and instructions set out by know-it-all Ottawa? That means a one-size-fits-all approach from coast to coast to coast, with the same criteria and the same methods. However, our nation is different and has its own special characteristics. Nevertheless, we were told no, that we have to fit into the mould. That is what we saw and what we are seeing more and more.

The government member pointed out that the separatists are the ones who want this. I would like to remind him that, yes, we are separatists, but then so is the rest of Quebec, because there is a consensus on this issue. Indeed, in the federation and federalism, there are powers and jurisdictions, and they must be respected. The various Liberal governments who have sat in Quebec City have asked for the same thing: Jean Charest, his minister Benoît Pelletier, Liberal finance minister Yves Séguin, as well as Coalition Avenir Québec, and of course, the Parti Québécois. Quebec's health care sector is no different. There is a unanimous consensus, and everyone knows it.

As my excellent colleague from Bécancour—Nicolet—Saurel said when he introduced Bill C‑237, health care funding was originally split 50-50. In the 1990s, the government started cutting, and ever since then, health care systems everywhere have been ailing. This is a serious problem.

Ottawa is not contributing its fair share, and now that things are not going well, Ottawa is telling the provinces and Quebec that they should be doing things a certain way. Fundamentally, the problem is that Ottawa is not respecting provincial jurisdictions and is contributing less than it can to the system.

I thank my colleague for introducing Bill C‑237 in the House so that we can debate it. Can Quebec exist in Confederation, have a chance to do things its way, and have its freedom? The question is, is this a federation made up of several nations and will the Quebec nation be able to do things its way without Ottawa constantly bossing it around? That is really all this is about, and I thank my colleague for getting us to this point.

I think we need even more freedom than what is being asked for here, but this would be significant progress. I can see my colleague, the dean of the House, nodding in agreement.

What did the government say when we proposed that Quebec have a little more autonomy? It talked about standards for long-term care facilities, pharmacare managed by Ottawa, dental care managed by Ottawa. The government said it was Ottawa's responsibility to make sure it all worked. It said—

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

For dental care, it is about paying the bills, not giving—

[An hon. member]

There is no debate.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Alexandra Mendes]

I would remind hon. members that this is not a discussion and that the hon. member is giving his speech.

The hon. member for Joliette may continue.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, I would remind the House that even if the bills are paid, dental care is part of the health care system and therefore a provincial jurisdiction. This is therefore not the place for that debate.

We are all for people receiving dental care. It makes no sense that people cannot afford dental care or have to choose between oral health and food or rent because they do not have enough money. By the same token, we want seniors to be well cared for in long-term care facilities, and we want everyone to benefit from pharmacare. If we want to talk about that, I invite my hon. colleagues to step down and run for the National Assembly or their legislative assembly to talk about this legislative measure in the right place. The role of members of the House of Commons is to determine whether we will provide them adequate funding or not.

According to my notes, the government member said that, with this bill, all we are trying to do is reduce the central government's power.

He is talking about the national government, but for us, our national government is the National Assembly in Quebec City. He spoke about weakening the federal government's role, even though it continues to overstep and expand its reach. To do things in its own way, our national government in Quebec City tries to work within its areas of jurisdiction as established by the Constitution.

We now see Ottawa cutting its share of funding and increasing the number of standards. That is exactly what the government member told us. That was his direct response. What is then Ottawa's vision in the face of my nation's right to exist? The federal government will continue to suffocate us with standards and keep shoving them down our throat. This means my nation will not exist on its own, it will have to become part of the whole. As we saw in the budget, if we want to discuss funding, we must first discuss standards. It is about standardization. There is therefore less room for my nation in this federation.

The member was talking about hip surgeries. Is it up to Ottawa to be talking about hip surgeries when this falls under the jurisdiction of Quebec and the provinces? It makes no sense. It is pretentious and paternalistic. As I was saying, this is a boss-employee relationship. This is not just coming from separatists. Quebec's entire health care community has rejected this.

I thank the members from the Conservative Party for their speeches and for showing up in such large numbers, considering that this an important evening of debate for their party. I do not think that a royal recommendation is required for Bill C‑237. I will not have the time to speak to this in great detail, but, essentially, we are not asking for new funding to be allocated. We are asking for the existing funding to be reallocated. This is not about allocating the money to another objective. When Quebec has a comparable program, the money is transferred and, presumably, it will be used to fund the same service. We are not adding anything or diverting the funding. Therefore, in my opinion, a royal recommendation is not needed in this case. I have good arguments in support of this.

First, I would like to point out that the bill presented by the dean of the House does not require any new spending. Second, it does not change the transfer amounts, nor does it change the names of the recipients or how the funding is allocated to them, and it does not change the purpose of the transfer. For example, the Canada health transfer will still be dedicated to paying for health care. The same is true for other transfers that are allocated to a province if it has a program whose objectives are comparable—that is the key word—to those of a federal program. It does not force the executive's hand, which retains the latitude and discretion required to transfer the funds. That prerogative remains in place. The executive will decide whether the province has a comparable program and will determine whether the province is complying with the conditions set out in the Canada Health Act.

Finally, precedents are on my side. I do not have time to go into detail, but there have been many bills that have changed the normative framework without having any financial implications per se. None of them required a royal recommendation.

In the end, the House recognized my nation, which speaks French. Now it must follow through on that recognition. The government is attempting to do so in a modest way, to follow through on this recognition in a modest way with a modest bill.

What we are hearing is that all the federalist parties are going to vote against it. That gives us a good idea of our options for our collective political future.

[Shafqat Ali, Liberal, Brampton Centre, ON]

Madam Speaker, I am pleased to participate in today's debate on this private member's bill, Bill C-237, an act to amend the Federal-Provincial Fiscal Arrangements Act and the Canada Health Act. As proposed, this bill would do two things. It would allow any province to withdraw from a federal program in provincial jurisdiction if comparable programs exist, and it would exempt Quebec from the criteria and conditions that must be met in order to receive a full cash contribution through the Canada health transfer.

Before I get into the concerns that the government has with these amendments, let me very quickly provide a little history of the Canada Health Act. The act was passed unanimously in the House of Commons in 1984 and represents a broad consensus among Canadians and their federal, provincial and territorial governments that access to insured health services should be based on medical need and not one's ability to pay.

Since then, the act has been considered the gold standard of federal spending power being used to set national objectives in an area of provincial jurisdiction. The act, in conjunction with the Federal-Provincial Fiscal Arrangements Act, does so by establishing broad criteria and conditions that provinces and territories must fulfill to receive full cash contributions under the Canada health transfer. Provincial health insurance legislation and regulations, including those of Quebec, meet and in some cases go beyond the requirements of the Canada Health Act.

That leads me to the first concern our government has with this proposed legislation. By accepting this legislation and exempting Quebec from the Canada Health Act's conditions, we would weaken the foundation of Canada's universal health care system. The act establishes the objectives and values underlying universal health care. For provinces to receive full Canada health transfer payments, provincial health insurance programs must be in compliance with five broad principles: universality, portability, comprehensiveness, accessibility and public administration. Provinces have not requested that these conditions be repealed.

Moreover, I would like to remind the hon. member from the Bloc Québécois that since the creation of the Canada Health Act, Quebec has broadly complied with the act's principles. Indeed, the discretionary penalty provisions of the act, which give the government discretion to withhold the Canada health transfer contributions from provinces in contravention of the five principles, have never been used.

There have been some instances of non-compliance in Quebec and other provinces, with respect to extra billing and user charges, where mandatory deductions under the Canada Health Act have been applied.

It is also important to note that the principle of asymmetric federalism renders the proposed amendment to the Federal-Provincial Fiscal Arrangements Act unnecessary for Quebec. As part of the 2004 Health Accord, the federal government and the government of Quebec signed a bilateral agreement on asymmetric federalism.

Under this agreement, Quebec supported the overall objectives and general principles set out by first ministers while respecting Quebec's desire to exercise its own responsibilities in planning, organizing and managing health services.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Alexandra Mendes]

The time provided for the consideration of Private Members' Business has now expired and the order is dropped to the bottom of the order of precedence on the Order Paper.

The House resumed from May 5 consideration of the motion that Bill C-237, An Act to amend the Federal-Provincial Fiscal Arrangements Act and the Canada Health Act, be read the second time and referred to a committee.

[Richard Martel, Conservative, Chicoutimi—Le Fjord, QC]

Madam Speaker, I am very pleased to rise in the House this evening to speak to the bill introduced by my colleague from Bécancour—Nicolet—Saurel.

As we know, we are here in the Parliament of Canada, a parliament where members' work usually revolves around national challenges and co-operation between the federal and provincial governments. Every day or nearly every day, our work reflects the fact that we are fortunate to be part of a family of 10 provinces and three territories that comprise this country.

My colleague from Bécancour—Nicolet—Saurel has a slightly different vision. He does not see Canadians as members of his family, but rather as neighbours and friends. His bill reflects this reality, and I find it disappointing that this bill is not inclusive and forgets the other regions of Canada. After all, if what he is proposing is good for Quebec, then surely it would also be good for the rest of the regions in Canada.

I personally am convinced that we can hope for the best for our fellow citizens when we all work together and combine the strengths of all the regions of Canada to address the challenges faced by North America as a whole.

Having said that, I understand some of what my colleague is proposing in his bill. This initiative would leave the federal government with no choice but to think carefully, and for purely political reasons, before interfering in any provincial jurisdictions.

I am referring to the arrogance of the Prime Minister who, first of all, still refuses to meet with the provinces to discuss health care funding and, second, is proposing a dental plan without consulting the provinces and without considering that such a program already exists in most provinces.

We on this side of the House cannot understand why the Prime Minister is ignoring Canadians who have sent him a very clear message that they have had enough. We cannot believe that the Prime Minister can be so out of touch with Canadians. We think that delusions of grandeur could be preventing him from seeing the reality all around him.

Considering the challenges facing health care funding, the federal government must do everything in its power to prevent duplication of services and funding. The federal government's revenues are both huge and limited at the same time. Moreover, Canadians already pay enough taxes, even if the Prime Minister does not think so. Millions of Canadians are suffering, but considering what he says and does, he seems convinced that their complaints are exaggerated.

The time for the Prime Minister's insipid speeches is over. It is time to find solutions for health services in Canada. If a province, whether it is Quebec, Alberta or any other province, proposes an idea to provide a health service in a more economical, more innovative way that preserves very good quality of service, the federal government has to show some flexibility and work with the province for the good of the population.

I would like to address another point, the importance of maintaining health care services of the highest quality. We often hear that Canada's health care system is one of the best in the world, but we all know that we can and must improve it. Bill C‑237 mentions programs with comparable objectives, but says nothing about the quality of the service. Quebeckers demand better quality of service and, as citizens of our beautiful province, deserve better service.

I do not understand why, in preparing his bill, the Bloc Québécois member did not include details setting out the importance of maintaining quality. I believe him when he says he wants to defend the priorities of Quebec. This is one of the most important priorities and he has left it out. I do not understand that.

With respect to my colleague's bill, in an April 5, 2022, ruling regarding a point of order raised on March 1, the Speaker of the House expressed the view that Bill C‑237 must be accompanied by a royal recommendation and declined to put the question at third reading without this recommendation.

A royal recommendation is required for any private member's bill that involves spending, which, according to Speaker, is the case for Bill C‑237. If I understand correctly, the member for Bécancour—Nicolet—Saurel seems to believe that his bill does not entail any new expense. If the member really wants members of Parliament to support his bill, he should put some effort into proving the Speaker of the House wrong.

In closing, I would say to my Bloc colleague that, while the Liberals are trying to persuade MPs to vote against this bill, our ultimate goal is to ensure that all the provinces are well served by the federal government. Duplication and unnecessary spending must cease. Our new Conservative leader will put people, their pensions, their paycheques, their homes and their country first.

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

Madam Speaker, I rise in the House today to speak to Bill C-237. The NDP supports some aspects of this bill. However, it is surprising to see the extremely negative impact it would have on the universality of our health care system. I will come back to that in a moment. Considering the bill as a whole and all the detrimental effects it would have on the health care systems in Quebec and Canada, we will be voting against it.

I want to talk about the positive aspects of the bill first. The idea of making budget cuts to health care and health transfers was put forward by the Conservatives. It was irresponsible to make those cuts to the health care system, in our view. The only thing the Conservatives seem to want to do is to keep making cuts to public services. The impact these cuts have had on our health care system is being felt in Quebec, British Columbia and everywhere. That has really hurt our health care system.

There was a change of government in 2015. However, the Liberals continued to make cuts. The two traditional parties, the Conservative Party and the Liberal Party, do not understand that when we do not invest money in the system, the system suffers.

The NDP absolutely wants that funding restored, and an NDP government would do that immediately. We would ensure that the health care system receives the funding that Canadians across the country deserve.

As we have already said, the tax haven system that the Conservatives created with the help of the Liberals, and that the Liberals have allowed to carry on with the help of the Conservatives, costs us $25 billion a year. The government cannot claim that we do not have the resources required to fund the health care system. All we need is for the Liberals and the Conservatives to reduce their assistance to the banking system. All this does is help the big Canadian banks increase their profits.

Naturally, we agree on that aspect of the funding proposed in the bill.

We also agree with the second aspect, which has to do with the provinces' right to opt out of new federal programs it does not like and obtain financial compensation. That is part of the Sherbrooke Declaration, which the NDP has always stood for. We have been crystal clear about our stance on Quebec's right to opt out of new federal programs for years.

That second aspect of the bill was no doubt inspired by the NDP's work in the House of Commons, so of course we are in favour of it.

Let us now talk about the third aspect, which would have such a negative impact on the health care system that we cannot understand why it would be in a bill. Polls indicate that two-thirds of the people who vote for the Bloc Québécois want a national pharmacare system. They want that universality, but the Bloc's bill would change the five principles that are the foundation of our public health system.

Let us look at the five principles the Bloc wants Quebec to be exempt from even though the vast majority of Quebeckers support these principles. First, the principle of universality. The Bloc Québécois wants to cut that out so it does not apply going forward.

The principle of universality is one of the foundations of our health care system. Everyone agrees that each and every Canadian is entitled to medicare. It seems they want to abolish that principle. I do not know whether it is a misunderstanding or whether the Bloc Québécois wants to privatize our public system.

The second principle that the Bloc Québécois wants to abolish is the comprehensiveness of the system, which means that all medically necessary services are covered by the public system. This is another one of the foundations of our medicare in Quebec and everywhere else, including British Columbia. They want to get rid of this value.

As my colleagues may know, I have lived in Saguenay‑Lac‑Saint‑Jean, in the Eastern Townships, in Montreal and in the Outaouais. In all the years I spent in these various regions of Quebec, I never met anyone who would support the idea of eliminating the comprehensiveness of our public system.

The third principle that the Bloc Québécois wants to abolish is accessibility. It is a basic principle of our Canadian health care system and Quebec's health care system. By wanting to eliminate the accessibility of the system, the Bloc Québécois is once again going against the will of Quebeckers.

The fourth principle that the Bloc Québécois wants to abolish is portability. This is a very important foundation of our health care system. As we have already seen, it means that people can go to British Columbia and have access to that province's public health care system.

Yes, some improvements certainly are needed. It is well known that some provinces, including Quebec, have problems with the reimbursement of fees paid in other provinces. There was a case like this recently in British Columbia. The principle of the portability of health care must not be abolished; it must be improved. This means that Quebec and British Columbia must be forced to pay these fees promptly. This is an extremely important part of our system.

The fifth principle that the Bloc Québécois seems to want to abolish is the public administration of our system. Hospitals and health care plans must be administered by a public non-profit organization. This is also a fundamental value. I do not understand why the Bloc Québécois wants to abolish this principle of public administration of the system.

Of course, there is still room for improvement. We fully support an increase in health transfers. Furthermore, the NDP has always advocated for the provinces' right to opt out with full compensation.

However, we cannot support the idea of eliminating these five principles that are the cornerstones of the Quebec and Canadian public health systems. Those of us on this side of the House do not see that in a positive light. The NDP is a progressive party and, unlike other parties, we do not support the privatization of our public health care system. As we all know, the American health care system is private, and it costs far more than the public system. Tens of millions of Americans are being left behind by their health care system.

We must maintain our public health care system and always protect the five principles on which our health care system is based. The NDP will steadfastly and rigorously uphold these principles.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Madam Speaker, I will give an introduction to set the record straight because I have heard a lot of things this evening, things that are bordering on a lie. I am not sure whether it is a failure to understand or whether it is deliberate, but I am going to set the record straight.

First, I do not know if the member for Chicoutimi—Le Fjord is an unbridled sovereignist or if he is just pandering. He says he wants to defend Quebec's autonomy but that the federal government should put conditions on the health care system. The purpose of Bill C‑237 is not complicated. It is about ensuring that Quebec manages its own health system, without conditions imposed by the federal government.

Second, the member for New Westminster—Burnaby came up with all sorts of unbelievable things. Talk about the bogeyman. I am not sure if he is emulating the Conservative Party or if he really had nothing to say about the bill, but he thinks that the Bloc Québécois wants to privatize Quebec's health care system. That is not it at all. Where did he get that idea? I will explain the bill to him.

This bill is in no way an attempt to withdraw from the universal system. The bill is very simple and states that we want to withdraw from the national objectives of the Canadian health care system because we believe that Quebec is capable of administering and managing its own health care system. We do not need the federal government to tell us what to do, under the pretext that it administers a lot of health care systems in Canada.

The only health care systems that the federal government manages are those of the correctional institutions and National Defence. Aside from that, it is in no position to lecture Quebec. Hospitals in Quebec fly the Quebec flag. Quebec manages its own health care system. The federal government does not manage physicians and knows nothing about that. It is in no position to tell us what to do, what is good or what is not good.

Then, the member for New Westminster—Burnaby tells us that the Bloc Québécois wants to withdraw so that we can privatize the system. Come on. The federal government did not create the Régie de l'assurance maladie du Québec. The federal government did not implement the Quebec Act Respecting Prescription Drug Insurance. The Government of Quebec did all of that.

I will not stand by while the member for New Westminster—Burnaby spouts that foolishness this evening. He just made claims about something he simply does not understand.

[The Assistant Deputy Speaker, Carol Hughes]

The member for New Westminster—Burnaby on a point of order.

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

Madam Speaker, I think our colleague could give his speech without insulting everyone. If he has points to make he can do so in an appropriate manner, in compliance with the rules of the House.

[The Assistant Deputy Speaker, Carol Hughes]

I believe the hon. member is raising a matter for debate. In private members' business, there are no questions or comments.

The hon. member for Rimouski-Neigette—Témiscouata—Les Basques may continue.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

It is indeed a matter for debate, Madam Speaker. Foolishness refers not to the individual but to their arguments. That said, I suppose that, when someone has nothing to say, they can talk about tax havens and point out that they are nowhere to be found in this bill, which focuses on domestic objectives. If the member would like me to go over and explain the bill to him, I would be pleased to do so. However, he should not be saying that the Bloc Québécois wants to privatize the health care system with Bill C‑237. We have heard all sorts of things tonight, but I hope that will stay in the annals of the House of Commons because that is far from being the case. I will get back to my speech because I had prepared one, but when you hear something like that it is hard not to correct the record.

Bill C‑237 addresses a situation that has created friction and tension between the federal and the provincial governments ever since the Constitution Act of 1867 was passed. It is nothing new.

I am talking about respect for the division of powers between the two levels of government. Basically, according to the pact that was made at the time, in 1867, between the two levels of government, each respective area of jurisdiction should be equal and sovereign. This arrangement served to ensure that the priorities of the majority Canadian nation were not imposed on the minority Quebec nation. We are a long way from that today, in 2022.

For issues that directly affect people and the way they organize their society, jurisdiction was directly delegated to the provinces. These include things like health care, social programs, education and culture. For issues that are somewhat removed from the people or the internal organization of their society, the respective areas of jurisdiction were centralized directly under the federal government. This means things like monetary policy, international trade, border defence, and so on.

These terms are protected by the ironclad Constitution and the inviolable division of powers. Quebeckers accepted that agreement, but as I have said before and will say again, members of the federation are supposed to work together, not impose conditions, which is what we are seeing now. The government is using that to make political gains that undermine jurisdiction. It is taking over our child care system and trying to impose conditions on us. We cannot be sure it will transfer that to us. Next is health care. I bet that before too long there will be big federally funded parks all over the place. The government is going to take away all our power over social programs. That is this federal government's current agenda.

That is why we need to take a very close look at the relationship between both levels of government now, 155 years after the original agreement, the Canadian Constitution, came into effect. Inevitably, we will find that, for the past three generations, the federal government has been violating an agreement that goes back to the birth of the federation. I will explain this in a simple two-step process.

First, the federal government uses its taxing power to raise taxes higher than is required to fulfill its own constitutional responsibilities. In doing so, it also prevents Quebec and the provinces from using this tax room. This is called fiscal imbalance.

Second, the federal government uses its surplus profits, which it controls, to spend and create programs in areas under Quebec and provincial jurisdiction. In addition to controlling this money, which is normally intended for different areas and jurisdictions, it goes so far as to impose conditions on the transfer of funds. In concrete terms, this means that the federal government, the Canadian government, uses this practice to decide how Quebec society and the other provinces are set up. It also forces the government of Quebec and the provinces to implement the priorities of Canadians rather than the priorities of Quebeckers in areas under their own jurisdiction.

As I said, it is supposed to be a collaboration, not simply imposing conditions. In this case, Canada's vision and will are being imposed to the detriment of Quebec's will and vision. Quebec never agreed to become Ottawa's subcontractor. Nowadays, it is clear that Ottawa is interfering in areas of jurisdiction. It pays off politically, by the way.

There is unbridled interference going on in areas such as housing, education, family policy, day care services, the environment and taxation. Interference has become the federal government's hallmark.

The federal government has a strong tendency to use its power to spend money and surreptitiously exploit shared jurisdictions. The Bloc Québécois has had enough, which is why it decided to introduce Bill C‑237.

If passed, this bill will give Quebec and the provinces a way to counter this interference, which violates the constitutional agreement on which the country was founded. The original agreement is no longer being respected. Can we get this straightened out? We have no choice. We are being taken for fools. We have no autonomy anymore. We send our money to the federal government, but then it says it will not transfer the money unless we comply with its conditions.

In practical terms, Bill C‑237 makes two amendments. I urge my colleagues to listen carefully, because they have been saying all kinds of things about this bill. First, the bill will amend the Federal-Provincial Fiscal Arrangements Act between the government and the provinces. This will affect all of the provinces, not just Quebec. It will give all provinces the option of withdrawing from a federal program.

Furthermore, in the spirit of compromise, the government will provide matching funds to the province or Quebec, but only if the objectives of the program in question are comparable to those of the federal program. The program in the province or in Quebec does not have to be identical or even similar. It must be comparable. The funds are to be given unconditionally, without criteria and without any other form of interference.

I see that my time is up. I therefore invite the members to give Quebec and each province the freedom to make their own choices, by themselves and for themselves.

[Mark Gerretsen, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons (Senate)]

Madam Speaker, I am pleased to participate in today's debate on private member's bill, Bill C-237, an act to amend the Federal-Provincial Fiscal Arrangements Act and the Canada Health Act.

As proposed, this bill would do two things. First, it would allow any province to withdraw from federal programs in provincial jurisdiction if comparable programs exist. Second, it would exempt Quebec from the criteria and conditions that must be met in order to receive a full cash contribution through the Canada health transfer.

Before I get into the concerns that the government has with these amendments, let me very quickly provide a little history surrounding the Canada Health Act. The act was passed unanimously in the House of Commons in 1984. It represents a broad consensus among Canadians and their federal, provincial and territorial governments that access to insured health services should be based on medical need and not one's ability to pay. Since then the act has been considered the gold standard of federal spending power being used to set national objectives in the area of provincial jurisdiction. The act, in conjunction with the Federal-Provincial Fiscal Arrangements Act, does so by establishing broad criteria and conditions that provinces and territories must fulfill to receive full cash contributions under the Canada health transfer. Provincial health insurance legislation and regulations, including those of Quebec, mirror and in some cases go beyond the requirements of the Canada Health Act.

That leads me to my first concern regarding the proposed legislation. By accepting this legislation and exempting Quebec from the Canada Health Act's conditions, we would weaken the foundation of Canada's universal health care system. The act establishes the objectives and values underlying universal, single-payer health care. For provinces to receive full health care transfer payments, provincial health insurance programs must be in compliance with five broad principles: universality, portability, comprehensiveness, accessibility and public administration. Provinces have not requested that these conditions be repealed.

Moreover, I would like to remind the hon. member from the Bloc Québécois that since the creation of the Canada Health Act, Quebec has broadly complied with the act's principles. Indeed, the discretionary penalty provisions of the act, which give the government discretion to withhold the Canada health transfer contributions to provinces in contravention with these five principles, have actually never been used. There have been some instances of non-compliance in Quebec and other provinces with respect to extra billing and user charges, where mandatory deductions under the Canada Health Act have been applied.

It is also important to note that the principle of asymmetric federalism renders the proposed amendments to the Federal-Provincial Fiscal Arrangements Act unnecessary for Quebec. As part of the 2004 health accord, the federal government and the Government of Quebec signed a bilateral agreement on asymmetrical federalism. Under this agreement, Quebec supported the overall objectives and general principles set out by first ministers, while respecting Quebec's desire to exercise its own responsibility in planning, organizing and managing health services. This agreement has continued to shape the federal approach to bilateral agreements with Quebec, notably the 2017 agreement on home and community care and mental health and addictions services and funding.

Importantly, the asymmetric agreements with Quebec in the area of health care have been applied within the parameters of the Canada Health Act principles. For example, the communiqué from the 2004 health accord on asymmetric federalism that respects Quebec's jurisdiction states as one of its preambles, “noting that its commitment with regard to the underlying principles of its public health system—universality, portability, comprehensiveness, accessibility and public administration—coincides with that of all governments in Canada....” Stated differently, the government entered into asymmetrical health agreements with Quebec because the province already adhered to the Canada Health Act principles.

Historically, provinces other than Quebec have recognized the benefits of federal spending power. In 1999, all provinces except Quebec agreed to the social union framework agreement, which recognizes a set of social policy principles and ways to allow the exercise of the federal spending power in areas of exclusive provincial jurisdiction, provided that a majority of provinces agree.

That agreement recognizes, “The use of the federal spending power...has been essential to the development of Canada's social union.” Its continued use is important to ensure access to “essential social programs and services of reasonably comparable quality” for all Canadians, wherever they live or move in Canada, to promote their full and active participation in Canada's social and economic life.

It should also be acknowledged that the federal spending powers during the pandemic have delivered results for Quebeckers while continuing to recognize Quebec's unique place within the federation.

The government remains committed to working with the provinces and territories and key stakeholders to advance shared priorities for the health care system and to improve health outcomes for Canadians. One of those commitments, for example, is to ensure that Canadians who require long-term care get the services they deserve. To address this, our government has committed to providing up to $3 billion to support the provinces and territories in ensuring that standards for care are applied. The Canadian Standards Association and the Health Standards Organization are currently working to finalize national standards for long-term care by late 2022.

To summarize, we believe that Bill C-237 would undermine the government's ability to deliver health care results for Canadians if provinces are allowed to be exempt from the conditions laid out in the Canada Health Act. We also believe there is no need to amend the Federal-Provincial Fiscal Arrangements Act to allow provinces to withdraw from federal programs in provincial jurisdiction. The federal government has a strong record of establishing agreements that cater to Quebec's specific needs, such as the 2004 agreement on asymmetrical federalism that continues to respect Quebec's jurisdiction and falls within the parameters of the Canada Health Act.

For these reasons, and the others that have been mentioned, I would strongly encourage all members of the House to vote against this bill.

[The Assistant Deputy Speaker, Carol Hughes]

Resuming debate.

There being no further debate, the hon. member for Bécancour—Nicolet—Saurel has five minutes for his right of reply.

[Louis Plamondon, Bloc, Bécancour—Nicolet—Saurel, QC]

Madam Speaker, we are winding up debate at second reading of Bill C-237.

This bill gives the provinces the right to withdraw when the federal government creates a program that should be the exclusive jurisdiction of the provinces. I found the term “exclusive” in the Constitution. When we speak of exclusive jurisdictions, we are referring to matters that fall under the authority of either the provinces or the federal government.

The term “exclusive” exempts Quebec from the standards and conditions that the federal government imposes before providing funding for health care. There has been a consensus in Quebec for 50 years on this position, which is the basis for the major constitutional crises that have occurred over the years.

This week's debate is taking place against the backdrop of the election campaign in Quebec. On Monday, Quebeckers will go to the polls and will have to make a decision about many things. I am thinking of the health care system, which the pandemic demonstrated was fragile and underfunded. One party says there should be more privatization, another wants to make seniors' homes the priority and yet another is counting on existing public services, home care and long-term care centres.

This has been top of mind during the campaign, and on Monday, Quebeckers will vote and decide. Usually, when the public makes a decision, that is the end of it. No matter what choice the Quebec nation makes, Canadians will have to agree because Ottawa is imposing all kinds of conditions. It is imposing its own standards on us and wants us to adopt its priorities.

I am talking about health, but this is true in all sorts of areas, such as housing, education, family policy and taxation. In fact, it is true in almost all areas. That is what it means to be a minority, even though this House recognized that we were a nation by a nearly unanimous vote a few years ago. The Bloc Québécois wants the right to opt out of federal programs in areas that should be the responsibility of Quebec instead of Ottawa because we want to be masters in our own house.

When I introduced Bill C‑237, I hoped to advance the autonomy of Quebec. We are currently being led by a minority government. The Bloc Québécois wants Quebec to be a country, but in the meantime, it wants us to be masters in our own house to the extent possible. That is only natural. The Conservative Party campaigned on respecting provincial jurisdictions. The NDP has its Sherbrooke declaration, which supports Quebec's right to opt out. Between the three parties, we can move Bill C‑237 forward.

However, I was bitterly disappointed when we were debating this bill. The member for Rosemont—La Petite-Patrie says that he supports the right to withdraw, but only if Quebeckers adhere to the NDP agenda. The Conservative member for Hastings—Lennox and Addington says that she respects provincial jurisdictions, but only if the Liberals agree and grant a royal recommendation. If not, she is against the bill.

I want to point out that the Constitution gives exclusive powers to Quebec and the provinces. This means that the federal government must not interfere. This is set out in the Constitution that English Canada adopted, the Constitution that Quebec never signed. Now a Bloc Québécois member, a separatist MP, is standing up in the House and demanding that the federal government respect the Constitution. The Canadian parties are the ones not respecting it. It is all backwards.

However, it is not too late. Election platforms are not just documents to be used during an election campaign and then thrown away. I am appealing to the NDP and the Conservative Party to keep the promises they made to Quebeckers during the election campaign. Let Bill C‑237 move on to the next stage. That will give us time to convince the government to grant a royal recommendation.

If Bill C‑237 is passed, Ottawa will be free to do as it pleases in areas under its jurisdiction, just as Quebec and the other provinces will be free to act in areas under their jurisdiction.

Everyone would respect everyone else's jurisdictions. The key word is “respect”.

[The Assistant Deputy Speaker, Carol Hughes]

The question is on the motion.

If a member of a recognized party present in the House wishes to request a recorded division or that the motion be adopted on division, I would invite them to rise and indicate it to the Chair.

The hon. member for Bécancour—Nicolet—Saurel.

[Louis Plamondon, Bloc, Bécancour—Nicolet—Saurel, QC]

Madam Speaker, I request a recorded division.

[The Assistant Deputy Speaker, Carol Hughes]

Pursuant to order made on Thursday, June 23, the recorded division stands deferred until Wednesday, October 5, at the expiry of the time provided for Oral Questions.

The House resumed from September 28 consideration of the motion that Bill C-237, An Act to amend the Federal-Provincial Fiscal Arrangements Act and the Canada Health Act, be read the second time and referred to a committee.

[The Speaker, Anthony Rota]

Pursuant to order made on Thursday, June 23, the House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill C-237 under Private Members' Business.

(The House divided on the motion, which was negatived on the following division:)

Vote #185

[The Speaker, Anthony Rota]

I declare the motion lost.