Thank you, Madam Chair and members of the committee.
CUPE is privileged to represent over 500,000 Canadians, 170,000 of whom work in all aspects of health care.
Our overarching comment today is under the umbrella of accountability. The 10-year plan, and indeed all medicare dollars, should be spent and accounted for in accordance with the Canada Health Act. Every year the annual report on the Canada Health Act falls short. Provinces don't report. There's page after page of non-accountability. For the Health Council of Canada, created to ensure accountability in the 10-year plan, with two provinces refusing to participate, we're not sure how the accounting or the accountability can hold true.
What's the evidence of our concerns on accountability?
One, since the 10-year plan was signed, the number of private, for-profit clinics delivering medically necessary services has doubled.
Two, in terms of illegal fees, some provinces—notably British Columbia and Quebec—are allowing private clinics to charge privately for diagnostic and surgical services, which are clearly necessary hospital services within the definition of your Canada Health Act.
Three, queue jumping. Some doctors get around the ban on user fees and extra billing by charging patients for uninsured services, which leads to queue jumping and potential conflicts of interest.
Four, commercialization is linked to the wait times guarantee debate. The 10-year plan approach to wait times in the federal government's model of care guarantees has hastened commercialization of medicare. Almost two years ago, the federal wait times adviser, Dr. Postl, issued his report. In our view, it has been all but ignored on the issue of wait times.
Five, public-private partnerships. There are 38 P3 hospitals under way in four Canadian provinces. Through this government's initiative, PPP Canada Inc., the federal government is actually pushing the P3 model in all sectors, including health care. We believe that P3 hospitals deserve immediate investigation and action by this health committee, the Auditor General, and the current Parliament.
Our recommendations, to close, are to enforce the Canada Health Act, a requirement of Parliament; establish a national long-term care program; implement a wait time strategy that guarantees public sector improvements, or, in short, follow Dr. Postl's advice; establish a national pharmacare program; create a national infrastructure fund to build and redevelop hospitals and long-term care facilities; follow through on the commitments made in the Kelowna accord and the “Blueprint on Aboriginal Health”; establish a national strategy to combat health-care-acquired infections; and finally, develop and implement a pan-Canadian human resources strategy to achieve better working conditions, training, upgrading programs, and wage parity to improve retention and recruitment across health care, which is another recommendation of Dr. Postl.
Thank you, Madam Chair.