Health Committee on Feb. 28th, 2008

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you.

You also said that both physicians and nurses are prepared to participate in the process. All professionals want to contribute to the creation of a rigourous system that works the way it should. You even went so far as to suggest that adequate compensation should be given to professionals who prepare these reports, as a means of confirming available information.

Are professionals who do report compensated for it? And, what do you think would be adequate compensation, so that all the information to be collated effectively?

[The Chair, Conservative, Joy Smith]

Dr. Haggie.

[Dr. John Haggie]

Currently under the system in the province in which I practise, which is Newfoundland and Labrador, it only compensates you for face-to-face patient contact at a provincial level under the care plan. It is not unreasonable, I don't think, to adopt a graduated approach. If you have to spend a lot of time and effort providing copies of your charts, perhaps even looking up blood work and these sorts of things to provide information, that time and effort should be recognized.

At the other end, if you have a user-friendly reporting system that literally takes two seconds to do, which will then trigger, say, an audit or an assessment by a centre of excellence somewhere to look at prevalence, that's a different thing. You can make a case that this doesn't warrant anything like that level of remuneration.

As a general principle, it would be unfair to my colleagues in practice if I didn't say that any effort they put in should have some kind of compensation.

[The Chair, Conservative, Joy Smith]

Thank you very much.

I think we're running out of time now. It's a quarter to the hour and we have to go to the two pieces of business we agreed to when the committee started. But I want to say a special thank you to all the witnesses who came today. Your presentations were very insightful. We went a little long on some of the answers because you brought such great new information.

We will now go to committee business.

I will ask Ms. Wasylycia-Leis to please move her motion before we proceed with the debate.

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

I so move my motion as presented.

I don't need to speak at length about this. It's similar to the motion I presented at an earlier meeting. It has been pared down to simply refer to the annual report and to request that the Minister of Health appear before this committee as soon as possible in order to deal with this report, and then to report back to the House.

[The Chair, Conservative, Joy Smith]

Can we have it opened for discussion?

Mr. Fletcher.

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

Thank you, Madam Chair.

I think we know how this is going to turn out, but just for the record I'd like to say that the minister has appeared in front of the committee several times already, or has offered to do so. He will be appearing presumably for estimates. Beyond what has already been committed.... Just for the committee's information, he's extraordinarily busy. So if this motion does go through, it may be some time before he is actually able to come forward on this topic.

If the committee wishes to pass the motion, it's certainly the committee's prerogative. But we already discussed a similar motion at the last meeting. It was defeated and should stay like that. Therefore the Conservative members will be voting against the motion simply to keep things consistent with what has already been agreed upon.

[The Chair, Conservative, Joy Smith]

Madame Gagnon.

[Christiane Gagnon, Bloc, Québec, QC]

Madam Chair, I wish to express our concern in this regard. Where health care is concerned, we have the Quebec clause as to how the motion should be interpreted. This may suggest that the Minister of Health should get directly involved in health care matters in the provinces. I want this to be included in the motion because it is consistent with the position taken by the Quebec Minister of Health—namely, that nothing is to be interpreted in a way that would interfere with Quebec's jurisdiction. That is the intent and the will of the Government of Quebec.

I don't know whether this would result in the provinces being given directives. If it only refers to exchanges of information, I have no problem with that. In any case, I think we could take advantage of the Minister's visit to ask broader questions, rather than limiting ourselves to the Canada Health Act alone. We could ask him about rare diseases, for example, or ask him to give us his impressions of our report. However, as regards the health care or drug insurance schemes, Quebec retains exclusively responsibility for planning, organizing and managing health care services in its area of jurisdiction.

This motion was moved by a member of the New Democratic Party whom I respect for her values and her contribution to discussions of the health care system and other policies. However, her propensity for excessive centralization is tantamount, as far as we are concerned, to non-respect of provincial jurisdiction, particularly as regards health care services.

I just want to make that point so that, if we do pass this this morning, that can be done based on the direction I have just laid out. Thank you.

[The Chair, Conservative, Joy Smith]

Madame Gagnon, just to clarify everything, you want that amendment put right into this motion? Is that what I'm hearing you say?

[Christiane Gagnon, Bloc, Québec, QC]

Yes.

[The Chair, Conservative, Joy Smith]

Okay, is there any discussion on this particular amendment that you'd like to engage in at this time?

I'm going to give it to the clerk because her French is far better than mine.

[Christiane Gagnon, Bloc, Québec, QC]

Try it. It's funny.

[The Chair, Conservative, Joy Smith]

That would give you some amusement today, I'm afraid.

Okay, go ahead.

[The Clerk of the Committee, Mrs. Carmen DePape]

It reads as follows:

We are in favour of the motion tabled by Ms. Wasylycia-Leis, insofar as the traditional interpretation of the Canada Health Act prevails — namely, that where health care matters are concerned, Quebec is accountable only to its citizens; nothing should be interpreted in such a way as to derogate from Quebec's jurisdiction; Quebec has clearly expressed its determination to exercise its own responsibilities; the Government of Quebec considers the health care system and the Quebec health care scheme to fall within its exclusive jurisdiction. Thus it has sole responsibility for planning, organizing and managing health care services in its area of jurisdiction, based on Quebec's legislative and regulatory framework.

[The Chair, Conservative, Joy Smith]

Mr. Fletcher.

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

We all understand what the separatists' agenda is and--

[Christiane Gagnon, Bloc, Québec, QC]

I'm sorry, Mr. Fletcher, but they are not separatists. That is the will of the Government of Quebec, represented by a federalist Liberal Party. I don't like…

[The Chair, Conservative, Joy Smith]

Excuse me, Madame Gagnon.

Mr. Fletcher.

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

I don't think any federalist party could support that motion outright. I think if you're going to do what the NDP member wants to do, you have to accept the motion, but with that amendment, I think any federalist party should be very concerned about it and should vote against it.

[The Chair, Conservative, Joy Smith]

Mr. Thibault.

[Robert Thibault, Liberal, West Nova, NS]

Well, I fail to see when the amendment begins in those paragraphs. I fail to see how it changes or how it relates to the motion by Madam Wasylycia-Leis. Therefore, I can't support it.

As far as the principles she's enunciating go, some sides of those I agree with, and some I have some trouble with. That's a whole other matter of debate. But as it has no relationship to the original motion, I can't support it.

[The Chair, Conservative, Joy Smith]

That being said, then I have to rule that it's inadmissible, because it doesn't relate. Your arguments are well taken at this time, Mr. Thibault.

Having said that, we're back to the motion. Let's take a vote on whether or not we're going to accept--

[Robert Thibault, Liberal, West Nova, NS]

I haven't spoken on the main motion.

[The Chair, Conservative, Joy Smith]

If you would like to do that, please speak on the main motion.