Bill C-239

An Act to amend the Canada Health Act (accountability)

This enactment amends the Canada Health Act to require provinces to implement an accountability framework in relation to the delivery of health services in order to qualify for a full cash contribution as part of the Canada Health Transfer.

Canada Health Act

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, the member is right that we do, but so did Stephen Harper.

Every government I am aware of, over the years I have been a parliamentarian, has talked about the benefits of Canada's health care system. I would challenge the member opposite to tell me of any prime minister who has not been boastful about health care to people who want to come to Canada.

Conservatives try to give the impression that immigration is causing the problems in our health care system. My understanding of immigration and our health care system is that a good percentage of the people who are providing care, whether it is home care services, long-term care, assisted living or in our hospital facilities, are first-generation and second-generation Canadians and permanent residents who have been living in and calling Canada home.

To come to Canada, people need to pass a health exam. There are medical requirements. If someone has cancer, they cannot come to Canada as a permanent resident. Let us not give a false impression that immigrants are the cause of problems in Canada's health care system.

In my home province, the Minister of Labour and Immigration, the Minister of Health Care and the Premier, all three of those individuals, say they want more immigration to Manitoba. This is not because it is crippling the health care system. If anything, it is complementing the health care system, so we need to be very careful. It is not me saying this; these are the provincial politicians responsible for the administration of health saying it.

We should all be considering what the member for Surrey Newton is saying to members of the House, which is that it is about financial accountability and whether there is a role for Parliament to assess that. I think he has done all of us a favour by bringing forward the legislation. I look forward to the debate and comments regarding the legislation.

What I do not support is when members of Parliament say that Ottawa has no role to play in health care. If they are saying that, then they truly do not understand the Canadian identity and what Canadians truly value. When we ask constituents what they love about our country, they will often mention our health care system. It is one of the distinguishing factors we have over countries like the United States and other G7 countries. Our health care is something we should be proud of.

All members of the Liberal caucus are very much proud of that fact, and we respect provincial jurisdiction to the nth degree. This is the reason we have ministers of health who have worked on health care accords and, through those accords, have worked to ensure more accountability.

I will now go back to the Trudeau era, when the Trudeau government made a $200-billion commitment to health care. I was with the former prime minister and the Premier of Manitoba at the Grace Hospital, where we talked about how Ottawa was going to have a profound and positive impact on health care delivery in the province of Manitoba because we were coming to the province with a considerable amount of money.

We recognize the role that the government plays in health care, whether we are talking about the former prime minister or the current Prime Minister, and we will continue to do that. Our new Prime Minister, who was just elected seven months ago, talks about the dental program for Canadians and how we are going to continue to support it. He is committed to advocating for the strengths of mental health. Many of my colleagues talk about the importance of long-term care. Liberals care about our health care system and will continue to care about it into the future.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Mr. Speaker, I rise to speak on behalf of the people of Similkameen—South Okanagan—West Kootenay on the issue of health care, specifically Bill C-239, an act to amend the Canada Health Act with respect to accountability. I would like to thank the member for Surrey Newton for bringing forward the legislation. It is a privilege for any member to bring forward their own legislation to be debated in the chamber.

The legislation before us seeks to establish an accountability framework for the Canada health transfer. Conservatives on this side of the chamber appreciate the member's efforts to bring in greater accountability. Indeed, all Canadians want health care dollars to be spent well.

However, members of the chamber are not elected to applaud good efforts; we are elected to study legislation in the context of the laws and measures we already have in place, to determine whether new legislation would add positively to these measures or only duplicate them. Unfortunately, the legislation before us would only add more bureaucracy to a health care system that needs more transparent accountability, and it would also fail to grapple with the government's own record on health care.

I do not doubt that the member's intentions with the legislation are to spur greater health care outcomes in our shared province of British Columbia. We all know it needs help. However, there is nothing in the legislation that would impose any requirement on provincial governments to improve health care outcomes. It would only require administrative work, duplicating work already being done. Ottawa already has a legacy of duplicating provincial regulations, adding red tape to systems and slowing down results. All we need is another layer of bureaucracy.

For example, the legislation seeks to amend the Canada Health Act. I would point out that paragraph 13(a) of the Canada Health Act already requires provinces to provide the federal Minister of Health with health care information to qualify for health transfers. Additionally, provincial and territorial governments submit health care data to the Canadian Institute for Health Information as well. There is nothing in the member's bill that indicates whether these are the data points he wants provincial governments to table with the federal government to qualify for health transfers.

If so, then the purpose of the legislation seems to be already covered by the Canada Health Act. If not, if it is different information that would be required, then that would only cause provincial health bureaucrats to spend more time collecting data for federal bureaucrats. That would be less time, not more, focusing on delivery of health care. Red tape does not buy more doctors or more health care workers.

Too many residents in my community would like any health care at all delivered, because too often they see “Sorry, we're closed” instead. At South Okanagan General Hospital, there have been more than 35 random closures in just one year. Imagine someone driving to a hospital because their baby is sick, and it is suddenly closed because there are not enough doctors or nurses. Thousands of constituents do not have access to a family doctor. We hear the same stories from Princeton to Penticton, Osoyoos, Grand Forks and Castlegar.

What is the Liberal government doing for health care recruitment to fill these gaps in communities like mine? It has brought in international medical school graduates but then does not allow them to work in our health care system. According to the College of Physicians and Surgeons of Canada, at least 13,000 internationally trained doctors are currently in Canada but not working as doctors. Every year, hundreds of Canadians graduate from medical schools abroad but cannot access a residency training spot back home in Canada.

At the Standing Committee on Health, we recently heard of two cases. First, we heard from Dr. Therese Bichay, who immigrated from Egypt where she practised as a family doctor. She was approved as a priority candidate for immigration to Canada due to her medical training, yet when she arrived, she found the doors closed instead of open. She passed all required medical exams, had her credentials verified and completed the English-language proficiency exam. She is currently working as a physician navigator in the emergency department, yet she cannot work as a doctor. She even told me she would come to my region to be a family doctor, which is in desperate need of doctors.

We are in desperate need of family doctors in so many rural communities, including ours. The Liberal government has failed to support her and the thousands of internationally educated physicians across the country, who are qualified and ready to serve, yet are sidelined and ignored.

Second, we heard from Dr. Scott Alexander, who is Canadian and a doctor, but cannot be a doctor in Canada. He trained at the University of Queensland and even had a job offer from the Australian health care system. He could not get a residency in Canada, even though he spent hundreds of thousands of dollars on his education. He made the sacrifice to return to Canada anyway to work in the health sciences. We thank him for this, but he should be a doctor in this country. In his medical class in Australia, he had 60 Canadian colleagues, and 58 of those colleagues are now working as doctors in Australia rather than in Canada because of the barriers in this country that limit their ability to return home to practise.

This is a broken system that the Liberals have overseen for a decade now without reform. If the member sincerely wants to see better health care, and if he wants to see better health care delivery, he should perhaps seek better support from his own caucus rather than establishing a new bureaucracy. If this Liberal member's bill is made into law, what would be the result? It demands that, if a new type of provincial health care data, which is not clearly defined, is not filed with federal bureaucrats, a province may not qualify for a full cash contribution under the Canada health transfer. For me, this raises concerns about whether the federal government is seeking ways to reduce health transfers from provinces via the back door.

We know the Prime Minister himself recently told Canadians that they need to be prepared for sacrifices ahead of the federal budget. Health care should not be one of those sacrifices. The Liberals could, indeed, find plenty of their own wasteful spending and punishing taxes to cut instead. Conservatives will work to improve health care by implementing a national blue seal standard and working with the provinces to create a nationally recognized licence for health care professionals, enabling trained and tested doctors and nurses to work in our health care system, many of whom already live right here in Canada right now.

Conservatives have always, and will always, support a public health care system that Canadians cherish.

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

Mr. Speaker, I can tell you one thing: To me, this bill is deeply offensive and disrespectful. I am a social worker and a member of my professional order. I was a manager in the public health care system for years. One thing I know for sure is that, if my colleagues who work in hospitals, local community services centres and long-term care facilities heard what I heard today, they would be very angry about this disrespect and they would be loud about it. All health care workers are doing their best. They give it their all. Quebec has been through six health care reforms because we are trying to do more with less.

Here in the House, I am being told that this bill will impose standards and demand accountability. Who would create those standards? In Quebec, we are doing our best with the money we have. What I am hearing today is ludicrous. All health care professionals in the public and community networks are worn out because transfers are not keeping up. Municipalities and provinces have made their needs known. They are the ones responsible for providing the services.

Do our colleagues think that we are not troubled by the fact that not everyone has a family doctor? At the same time, Ottawa is not where things will get fixed. Ottawa will not tell the provinces what to do. It must provide the necessary financial resources to help the provinces. Each province has its own needs. The situation in Quebec is different from the situation in New Brunswick. We do not have the same resources or the same history, and our health and social services are organized differently.

I sincerely hope that I will not see a single member from Quebec supporting this bill. That would be the last straw. I want to speak my truth, so I will say one last thing: I have never wanted to leave the House for the country of Quebec so badly.

[The Deputy Speaker, Tom Kmiec]

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.