Debates of Nov. 2nd, 1995

Department Of Health Act

[The Acting Speaker (Mr. Kilger)]

We now move on to the next stage of the debate on Bill C-95. For the next five hours, members will have a maximum of 20 minutes to make speeches, and 10 minutes for questions or comments.

[Bernard Patry, Liberal, Pierrefonds—Dollard, QC]

Mr. Speaker, first, I want to congratulate the minister sponsoring that bill. She has strongly and successfully defended the principles championed for half a century by the Liberal Party, while developing Canada's health care system. Over the years, medicare was threatened many times, sometimes from one quarter, sometimes from another.

True to the tradition upheld by her illustrious predecessors, the minister has just repelled the most recent attacks on medicare, and all Canadians are grateful for that.

This Liberal government is proud, and deservedly so, of all the pioneers who saw to the proper development of medicare. Successive Liberal governments improved the system, so as to preserve its soundness and effectiveness. This is why Canada now enjoys a health care program that is second to none, both from a technical and a social standpoint. The quality of our health care remains unsurpassed. Equal access for all is also guaranteed to the fullest extent possible.

Social development is contingent upon health. A healthy nation is a productive nation. It can enjoy those things that make life worth living, it stands a better chance of being happy, and its people can build a strong nation.

One of the ever present challenges faced by the health department is to find which policies and programs can best contribute to the health and well-being of Canadians.

Without taking anything away from Canadian health professionals, I want to congratulate the Minister of Health and Health Canada for giving priority to essential programs such as disease prevention and health promotion.

In the past, preventive medicine meant things like vaccination, which practically eliminated afflictions like smallpox, diphtheria and poliomyelitis for previous generations. Today, sophisticated tests and equipment warn us about dangers and allow Canadians of all regions to add many years of good health to their lives.

Twenty years ago, a Liberal minister of Health, the hon. Marc Lalonde, published a working paper entitled A New Perspective on the Health of Canadians which was to have an impact on health systems across the world. It was a visionary document for the time. It is comforting to see that so many aspects of Mr. Lalonde's vision have been realized thanks to the department whose name we are discussing today.

Many fundamental elements of the health system we know today came out of the Lalonde paper. The preamble to the Canada Health Act which mentions the social, environmental and industrial causes of diseases was also inspired by that document. The causal factor model which the National Forum on Health is now studying also comes from the Lalonde working paper.

According to A New Perspective on the Health of Canadians , and I quote: ``When the full impact of environment and lifestyle has been assessed, -there can be no doubt that the traditional view of equating the level of health in Canada with the availability of physicians and hospitals is inadequate''. The document predicts appropriately that, to improve the health of Canadians in the future, we will have to clean up the environment, reduce risks we expose ourselves to, and improve our knowledge of human biology.

This is the source of the reasoning in favour of social well-being, which is at the heart of this new bill, as members will note. This is the source of the arguments against tobacco and excessive alcohol consumption, which underlie Health Canada's tobacco demand reduction strategy, and the activities of the Canadian Centre on Substance Abuse.

This is the source of the arguments in favour of health research, which are guiding Health Canada in its laboratory work, and the Medical Research Council in its operation; the latter does not report to the department but to Parliament through the health minister. This is the source of the argument that everyone is responsible for his or her own health and must keep sufficiently fit to ensure his or her own well-being. As the members are aware, responsibility for the promotion of physical fitness was given back to Health Canada.

From now on, it is incumbent upon the health department to encourage Canadians to stay physically active throughout their lives because physical activity is essential to good health. Health Canada helps many organizations make physical activity more accessible and readily available to all Canadians in general and to the disabled in particular, because the latter are probably the ones who need it most and have to overcome the most obstacles in that regard.

With the reorganization of the health department-the main reason for introducing Bill C-95-another determining factor relating to the health of Canadians is being added to departmental operations. Product safety in now being transferred from the former Department of Consumer and Corporate Affairs to the Department of Health. Product safety does indeed come under the broader field of health protection. Accidents in the home and on the job are major causes of death and injury for people between 5 and 35 years of age. Because of such accidents, we have people who can no longer live a full life, economic losses and an increase in medical and hospital bills.

A lot of these accidents involve consumer and household products. Health Canada is responsible for the enforcement of the Hazardous Products Act. This act deals with the sale, the advertisement and the importation of certain hazardous products and ensures that consumers are well informed about the risks associated with the misuse of other products.

Before I conclude, I want to raise a point we seem to forget when we talk about what contributes to improve the health and welfare of Canadians. The provinces are of course responsible for providing health services to the public, but some health problems know no provincial boundaries. Their causes are deep-rooted in the social fabric of our nation.

For Canadians to enjoy good health, their basic needs must be met. They must have a job and a reasonable income and be able to care for their families. This is where the federal government plays an important part. It must help to maintain a viable economic structure so that these goals can be reached.

The Jobs and Growth government agenda will greatly contribute to improve the health of Canadians. We can expect positive economic results from the deficit reduction, which will help to improve the health of Canadians. We all stand behind Health Canada in this cause. These are the reasons why I wholeheartedly support Bill C-95.

[Hedy Fry, Liberal, Parliamentary Secretary to Minister of Health]

Mr. Speaker, I want to take this opportunity to comment on some of the things the hon. member for Macleod had to say in his speech. I notice the hon. member is not here.

[The Acting Speaker (Mr. Kilger)]

I wish to remind the hon. parliamentary secretary that it is not within the norms of the rules of the House to make reference to the absence of any member,

particularly when we are all aware of the constraints put on our time at different periods.

[Hedy Fry, Liberal, Vancouver Centre, BC]

I apologize, Mr. Speaker. I would like to comment on the statements of the hon. member for Macleod. With all due respect to William Shakespeare, methinks the hon. member doth protest too much in his speech when he continued to repeat over and over that the Reform Party did not mean to have a U.S. medical system, that the third party supported medicare.

The hon. member repeated this and repeated this to make a point. However, with respect, I would submit that rhetoric and repetition of words mean nothing when the actions following the words are supporting a two tier medicare system that would definitely dismantle Canadian medicare as we know it.

The hon. member spoke about waiting lists.

[The Acting Speaker (Mr. Kilger)]

I seek some clarification from the hon. parliamentary secretary.

I recognize that the member for Macleod spoke prior to the last speaker who was a member of the government side and to whom the question and comment period is designated. I appreciate comment can be made about a previous speaker and then, in terms of relevancy, the member goes back to the intervention of the last spokesperson, the member for Pierrefonds-Dollard. I ask her to get to the comments of her colleague, the last speaker on the floor of the House.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Mr. Speaker, I would like to comment on medicare and on the way the system is to be restructured. It would deal, as my hon. colleague said just, with some of the structural changes that are necessary to move the system into the 21st century.

The cost of medicare and the changing of some of the ways that the system works, as I said in my speech and as the hon. member just reiterated, have to do with the fact that there are national concerns and a national interest in a new national Department of Health.

Research covers a broad spectrum. There are local areas of research and local areas of health promotion and prevention that must come from the provinces because they deal specifically with issues concerning regional problems, regional environmental issues, and regional and local differences that need to be addressed.

Across the spectrum there are broader issues concerning the whole spectrum of health facing all Canadians. It is efficient and effective for the federal government and for national health to take these issues into consideration. It is effective in that the data collection in one place creates a cost efficiency and a base where everyone can co-ordinate and use the information as they need it, rather than have duplication of service and duplication of information gathering in 12 different areas such as would come about if we allowed each province and each territory to repeat, to duplicate and to reinvent the wheel. They would deal with the broader issues of health care, promotion and prevention that cut across provincial boundary lines and have nothing to do with specific regional and local interests.

There is a specific role for the Government of Canada in research, promotion and programs pertaining to low risk babies. It is common to all Canadians; it is not specific to any one province.

If we are talking about efficiencies and appropriateness of care and appropriateness of effort, we need to focus on them, and it is appropriate for the federal government to do so. It is more appropriate for the federal government to do it than for provinces, as I said before, to deal with it individually. When the ministers of health met in the past they all agreed that it was a very real role.

In terms of safety it is much easier as drugs, devices and foods come into the country for one agency to assess and to deem whether or not they are safe. Goods and services travel across the provinces and therefore go to every person as far away as Prince Edward Island and Vancouver Island. Therefore safety should be carried across Canada so that there is one level of safety and it is not spottily done in different areas of the country.

The national interest of health and the need for a national Department of Health are not intrusive. It is an appropriate way for the federal government to look after safety, health promotion and prevention.

[The Acting Speaker (Mr. Kilger)]

I would only like to know if the hon. member for Pierrefonds-Dollard has any comment to add to those that were made on his speech.

The hon. member for Pierrefonds-Dollard has the floor.

[Bernard Patry, Liberal, Pierrefonds—Dollard, QC]

Mr. Speaker, I thank the parliamentary secretary to the minister of Health. I submit that today's motion is very important because it is a positive move for health. Prevention will get a renewed importance and the department of Health will assume responsibility for certain regulations, like the one on hazardous products and other similar products, and also for fitness.

I personally think that the future of health in Canada is prevention. We talked a lot about health care, but before things get there, there is prevention. That is the objective of the bill and I am proud of it.

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

Mr. Speaker, the hon. member is a physician. He listened very carefully to my colleague in the Reform Party make a very eloquent and, I might say, one of the best speeches I have heard in the House. He

listened to his recital of the tragic case of Stephanie. The member must have had many patients who endured terrible pain and suffering because essential services were not available to them since the Canada Health Act rationed essential services.

The Minister of Health has often said in the House that we must provide Canadians with access, access, access to essential health care services and that we in the Reform Party were espousing ideas that would somehow limit that access. How is access served better when we have increasing costs, an aging population and increasing demand? When demand on our limited resources is actually increasing, how will we provide individuals with access to essential health care services?

We want to amend, not destroy, the Canada Health Act to enable private clinics to exist and to enable private services to be provided to Canadians. Only private moneys would be exchanged in the private clinics. Not a single dollar of taxpayers' money would be spent in the clinics. We would have a system that provides for greater access for all Canadians regardless of the care than what they have now.

How will our plan somehow destroy health care in the country when we will give better access to all Canadians regardless of their income?

[Bernard Patry, Liberal, Pierrefonds—Dollard, QC]

Mr. Speaker, what struck me in the speech made by the member from the Reform Party, before my colleague made his comments, is that he told the House that the Canadian health care system is one of the best if not the best in the world and that he did not want in any way a health care system based on the American model.

I think that having private clinics, as suggested by my colleague, would be the beginning of the end of our health care system as we know it in Canada and the birth of a two tier system, one for the rich and one for the poor.

I am well aware of cases like the one mentioned by the member for Macleod, the case of Stephanie. Such cases exist in every riding in this country, but I think that, at the present time, the provision of essential services is good. Of course there is room for improvement in the area of essential services, and these improvements must be made through prevention. I think that, without prevention, we will have problems in the future. But prevention is an essential part of our government's vision of health care, and that is the direction we are going to take as we move toward the next millenium.

[Suzanne Tremblay, Bloc, Rimouski—Témiscouata, QC]

Mr. Speaker, I rise today to speak to Bill C-95, an act to establish the Department of Health and to amend and repeal certain acts. To begin with, I feel I must remind my fellow citizens that health is a provincial jurisdiction.

Pursuant to subsections 92(7) and 92(16) of the Constitutional Act, 1867, and according to the way the courts have interpreted these provisions, it is clearly established and acknowledged that health and social services are exclusively a provincial jurisdiction.

Yet, federal interventions in matters of health are numerous and have been going on for a long time. As a matter of fact, since the beginning of this century, the federal government has passed the following acts concerning health: in 1919, the government established its own health department and gave its first grants: in 1948, the government launched a national health grants program; in 1957, it enacted the Hospital Insurance Act; in 1966, it enacted the Medical Care Act, and in 1984, the Canada Health Act which sets out the federal principles of the Canadian health system.

The Government of Quebec has always condemned the interventions of the federal government in matters of health. In 1926, the Taschereau government was the first to protest against federal interference in health issues. Since then, every Quebec government did likewise.

As the years went by, all this intrusion by the federal government became increasingly expensive for the taxpayers of Canada and Quebec. Ottawa was able to be generous since it was paying its expenses with the provinces' money or with borrowed money. That is what put us all in debt.

I will remind members that, in World War II, the central government in Ottawa used the war effort as an excuse to encroach upon personal and corporation income taxes. Up to then, these taxes were collected exclusively by provinces. This supposedly temporary measure is still in effect today.

The federal government clearly gave in to the temptation to control more and more, without giving back to the provinces the tax powers they had before the war. It decided instead to grant subsidies provided programs created by the Canadian government were implemented.

Such a control of tax revenues allowed the federal government to constantly centralize operations thereafter, which caused untold duplication and shameful waste of public funds. Worse still, to stay in office, several generations of federal politicians distributed gifts which created a burden of debt for future generations of Quebecers and Canadians.

At the present time, and despite the fact that it is clearly operating in a provincial area of jurisdiction, Health Canada looms large: its operating budget is more than $1 billion in 1995-96, while transfer payments to the provinces are $7 billion for the same year.

The federal government has never indicated that it intends to loosen its grip on the Canadian health system. Indeed, during the 1993 election campaign, the Liberal Party of Canada said in its red book, and I quote: "The role of the federal government should include the mobilization of effort to bring together Canada's wealth of talent and knowledge in the health care field. This is a societal

issue in which every Canadian has an interest. The federal government must provide the means to ensure that Canadians are involved and informed, and can understand the issues and the options".

For once, the Liberal Party kept its promise. On June 29, despite the opposition of all the Canadian provinces, the Minister of Health announced the establishment of the National Forum on Health. The mandate of this forum was, first, to develop a vision of what the Canadian health system would be in the 21st century; second, to promote dialogue among Canadians and Canada about the health system; and third, to define the priorities for the future.

Jean Rochon, the Quebec minister of health and social services, wrote to the federal health minister on October 14, 1994, to remind her of this:

The mandate of this forum is an encroachment by the federal government in a field which essentially falls under provincial jurisdiction, and that is unacceptable. The clearly stated objective of your government, which is to give the forum a mandate to define future priorities, in the context of health care reform, and to define the means to that end, is a direct intrusion in provincial governments' affairs. This is something that cannot be hidden behind the consultative nature you ascribe to the recommendations that would come out of this forum.

Mr. Rochon further wrote that Quebec had not waited for federal leadership to adapt its health care system to today's needs and that he had already held major consultations with Quebec population.

The Quebec minister of health and social services reminded the federal minister that the cuts made in transfer payments to provinces with regard to health were not the best action a government could take to preserve and promote a health care system in Canada.

Those major cuts are a threat to the very principles advocated in the federal health act.

At the same time as the federal government was seeking to encroach on a provincial area of jurisdiction, it was unilaterally and drastically reducing its funding for health programs in the provinces of Canada.

In the spring of 1995, the National Council of Welfare, an organization whose role is to advise the health minister, warned her against such action and said: "It would be extremely hypocritical to reduce contributions to the provinces while raising the standards required of them".

But that is exactly what the government is doing right now. We should recall that when the finance department created the so-called EPF program providing transfers to provinces for welfare, health and post-secondary education, it was agreed that transfer payments would be indexed to the rate of growth of the Canadian economy.

Since 1986, however, the federal government has been cutting back constantly on those payments to reduce its deficit. It has been doing so unilaterally, without taking into consideration the provinces' capacity to pay. Between 1982 and 1995, it saved $8 billion on medicare alone, at the expense of Quebecers. Because of this shortfall, Quebec had to raise taxes to offset the federal withdrawal from funding.

A study by the C.D. Howe Institute has shown that, while spending for established programs financing remained stable between 1988 and 1992, other federal program spending rose by 25.5 per cent. In other words, the federal government told the provinces they should tighten their belts while it went on spending freely and increasing its deficit.

The lack of stability in the federal contribution to medicare is a serious problem. Payments are frozen, reduced, or deindexed at the whim of the finance minister and his financing requirements. There is no longer an agreed upon financing formula. The amounts are set unilaterally and arbitrarily by the federal government, irrespective of the real costs of the provincial programs.

This constant variation in funding, always downward, has become a nightmare for everyone involved in the health field.

What is more serious is that the Minister of Finance appears oblivious to the fact that he is playing not only with columns of figures but with the health of the men and women of Quebec and of Canada.

Last February, in his last budget, the Minister of Finance chose to once again reduce transfers to the provinces for health. As a result, Quebec will have to absorb a shortfall of $650 million for health and social services alone, in 1996-97, and 1.9 billion in 1997-98. One of the benefits of federalism, no doubt.

In the spring of 1995, the National Council of Welfare made the following comment on the planned cuts to funding Canada's health programs: "The projects announced in this budget-would have the probable consequence of bringing about the dismantling of a national system-of social services it took us a generation to build up".

The Minister of Health for British Columbia had the following to say about these cuts:

"Last February's budget which cut transfers to provinces for health-has forced provinces to look at unpalatable cuts that threaten medicare".

If the Canadian health system were really so dear to the heart of the Minister of Health for Canada, she would have followed the lead of her colleague from Notre-Dame-de-Grâce and opposed her government's last budget, which attacked social programs. She would have stood up at the cabinet meetings where these decisions were made, and would have held up against the Minister of Finance's figures the pressing needs of the Canadian people for quality health care. The Minister of Health could have suggested that the government seek its resources from the rich, with their numerous tax shelters, starting with the list of the generous bankrollers of the Liberal Party, and not forgetting the Minister of Finance's companies.

But that is not what she is doing. Today, she introduced a bill that perpetuates the federal government's control of health care, an area over which the provinces have exclusive jurisdiction. Paragraph 2(a) and paragraph 2( b ) of clause 4 could easily be used by the federal government to interfere even more with the administration of health care in Canada.

The bill before the House today is hypocritical to the point that in clause 12 we read, and I quote:

Nothing in this Act or the regulations authorizes the Minister or any officer or employee of the Department to exercise any jurisdiction or control over any health authority operating under the laws of any province.

When as a result of its budget cuts, the federal government drastically reduces funding for health care in the provinces, it affects the way authorities operating under the laws of a province function by reducing their capacity to maintain a level of services commensurate with the needs of the citizens of Quebec and Canada.

The Bloc Quebecois condemns this bill because it sanctions federal encroachment on provincial jurisdictions. Quebec has its priorities in the health care sector and should have the right to manage those priorities, in accordance with the present Constitution. This bill does not mention providing adequate and stable funding for health care. The minister has abdicated her responsibility in this respect and bowed to the imperatives of the Minister of Finance.

This bill constitutes an attack on the provinces while failing to deal with any of the pressing problems of the health care sector, so much so that even the most ardent federalists have decided to fight the initiatives of the Minister of Health.

The Ontario Health Minister, Conservative Jim Wilson, stated on September 19 that it was necessary to fight the federal government's insistence on dictating to the provinces its interpretation of the principles that should be the foundation of the health care system, and I quote:

"The federal government should be fought on principle for dictating its interpretation of medicare to the provinces".

That same day, Ralph Klein, the Conservative Premier of Alberta, also condemned the federal government's lack of flexibility, and I quote:

"Marleau-does not send a good signal to Quebec. It says there is no flexibility within the Confederation".

In a joint press release after a meeting of Health ministers, the provinces declared that the federal government's insistence on making unilateral decisions on health care funding, on interpreting standards or setting arbitrary deadlines for consultations was not helpful at all.

Since the federal government is unable to provide adequate safeguards for the health of Quebecers and Canadians, since continuing cuts are the main threat to the health of Quebecers and Canadians, the federal government should withdraw from the health care sector and transfer to the provinces the fiscal resources that would enable them to do the federal government's job far more successfully.

[Dianne Brushett, Liberal, Cumberland—Colchester, NS]

Mr. Speaker, I did enjoy the hon. member's comments. I wish I could speak fluently enough in the beautiful French language, but I must speak in English. I am not good enough yet to carry on detailed conversations in French.

In health care, the needs of the people of Quebec are the same as those of the people in my province of Nova Scotia. All of the provinces have serious deficit situations and we have had to begin dealing with deficit reduction. I remind the hon. member that the province of Quebec has not attempted to reduce its deficit as the other provinces have done. This is a major concern in dealing with health care.

Another variant which occurs in the health care system is that some provinces give credence to many health care needs. For example, some of the provinces consider cosmetic surgery part of the health care program. Through the years in Nova Scotia we have had more than basic coverage in programs such as dental care for children, an excellent program covering dental care up to the age of 16.

What has happened under the broad umbrella of health care is the provinces have added on things encompassing more than basic health care. They cannot afford them. We have heard recently that

Quebec must close some 25 hospitals. This is not due to the federal government's cutbacks. This is due to the overspending and the additional encompassing programs which have come under health care.

What the federal government wants, and I ask the hon. member if this is not her desire too, is to preserve the health care programs for all Canadians as to basic needs, so that this is a very unifying factor for this country. Without the strong federalist approach to the health care needs, we will miss out.

[Suzanne Tremblay, Bloc, Rimouski—Témiscouata, QC]

Mr. Speaker, I would like to remind my colleague of a few things. First of all, I thank her for her question and comments. I wish to remind her that, between 1988 and 1992, established programs financing remained stagnant. Meanwhile, the federal government wasted money on other programs, resulting in a 25.5 per cent cost increase.

So when they tell me that we must cut because of the deficit, I say we must start by cutting waste in defence spending, among other things.

[Peter Milliken, Liberal, Kingston and the Islands, ON]

Ah, yes. The same old tune.

[Suzanne Tremblay, Bloc, Rimouski—Témiscouata, QC]

Funding for health care programs remained stagnant from 1988 to 1992.

[Peter Milliken, Liberal, Kingston and the Islands, ON]

You must calm down.

[Suzanne Tremblay, Bloc, Rimouski—Témiscouata, QC]

Let me speak, you, the hon. member across the way.

[The Acting Speaker (Mr. Kilger)]

Order. I simply wish to remind my colleagues from both sides of the House that they must always address their comments to the Chair. I think that members would even then be able to express themselves as forcefully as they need to. They must, however, always remember to address their comments to the Chair.

[Suzanne Tremblay, Bloc, Rimouski—Témiscouata, QC]

Mr. Speaker, fair enough, thank you for reminding me. Before saying what she said about Quebec, my colleague should get her facts straight. Quebec has made major changes to its health program.

Quebec may even have lost the referendum. One of the reasons why we lost the referendum may be the Rochon reform. So we made major changes in the area of health. Of course, Quebec provides health services that are not available in other provinces. For example, women can have access to abortion if they want to; other provinces do not offer this service. We have moved toward ambulatory care and reduced hospitalization time considerably. We have closed hospitals. We have modified the functions performed and services provided by some hospitals; some day hospitals now provide long term care and inpatient services.

So before looking at what is happening in the neighbour's backyard, I would invite the hon. member to look at her own province where, on the eve of the referendum, the Minister of Finance said he would no longer be able to control his finances if Quebec separated from Canada.

[Hedy Fry, Liberal, Parliamentary Secretary to Minister of Health]

Mr. Speaker, I want first to make a few comments on the hon. member's speech and then ask her a question.

The hon. member gave us a wonderful history of what has happened since 1919. At the end of that history, the hon. member mentioned it culminated in what we now know as Canadian medicare, which I hasten to say was enacted by a Liberal prime minister.

That medicare we know benefits all Canadians, including Quebecers. It is also the envy of the world. Every single survey and study that has been done has shown that 89 per cent of Canadians in every province, including the province of Quebec, believe it is something they would like to keep. It is important to them as Canadians. It is the most important thing we can possess as a country. In fact medicare and this history lesson led to something which is very positive and which Canadians still hold very dearly.

I also want to speak about the member's comment on the encroachment of the national health forum on provincial jurisdictions.

The forum is made up of members from every province, including the province of Quebec. The forum is made up of members of the public. It is not made up of people from government.

Perhaps the member could tell me whether she believes that the Canadian government does not have the right to speak to Canadian people in every province, which is what the forum is doing. The forum is not changing anything; the forum is having a dialogue with ordinary Canadians. Can the Canadian government not speak with ordinary Canadians? Something we promised in our red book was the ability to speak and to get input from Canadians, from real people and not just from government.

The hon. member speaks of cuts and interference in provincial jurisdictions. Health Canada's authority with regard to the Canada Health Act and with regard to medicare is a contractual one. The Canadian government signs a contract with provinces to receive money from the federal government. In turn, those provinces agree to the conditions based on getting that money.

The provinces do not have to accept any conditions, but then they cannot also accept the money because on a contract both sides

have an agreement. One side agrees to give money and the other side agrees to abide by certain terms. That is clearly what provinces do when they sign the contract.

Finally, the hon. member spoke of how cuts are affecting the provincial government's ability to provide services in Quebec. The Quebec government has a budget of $13.4 billion for health for 1995-96. That government made a cut of $565 million to its health care budget well before the federal government presented its cuts for 1996-97 within the Canada health transfers.

I ask the hon. member, why did her province's government make those cuts if it really needed money in the system? Why were there $565 million in cuts when the hon. member says that Quebec's health care system needs more money?

[Suzanne Tremblay, Bloc, Rimouski—Témiscouata, QC]

Still, Mr. Speaker, it is a sad day when you hear the kind of things we are hearing in this House. Attempts were made to convince the people of Quebec that there are no benefits to belonging to the Canadian confederation and, every day since we reconvened, evidence of a total lack of understanding of what is going on in this country has been building up. People are blind. Politicians are blind.

We are criticized, on the one hand, for not making cuts, and on the other hand, for making cuts too soon. I think that our government acted responsibly. An overhaul was required in the health care system, because funding cuts are expected. Shortfalls of $650 million one year and $1.9 billion the next year add up to nearly $2.5 billion over two years. It seems to me that the thing to do for a responsible government is to plan ahead. But where I find fault with this government across the way is when it decides to stop paying but wants to keep controlling everything anyway.

When I was young and lived at home, I lived by the rules my father had set because he was providing me with room and board. But when I moved into my own apartment and had my own money, I lived by my own rules.

When you stop paying, you lose the right to tell others what to do with their money. You have no right stealing a jurisdiction away from others and telling them: "Its is yours, but we can do what we want with it." So little sensitivity and understanding and so much arrogance, contempt and affront coming from you, Sir, is unacceptable, under the present circumstances. We have had it.

[The Acting Speaker (Mr. Kilger)]

Before proceeding with the debate on Bill C-95 I would simply ask colleagues in the House on both sides that we continue this debate in a respectful fashion. We had all hoped and set out to do that with great commitment when we first came to this House following the last federal election which brought us here together to this House of Commons in this 35th Parliament.

[Harold Culbert, Liberal, Carleton—Charlotte, NB]

Mr. Speaker, I am going to support Bill C-95. The Department of Health is very important. It is the department of drug certification, the department of product safety and the department of health act enforcement. It is the department of defence against disease, that common enemy of all Canadians.

From time to time hon. opposition members have criticized the Department of Health. They say it spends too much money. I say it is money wisely spent and not at all more than its responsibilities require. Consider the array of vital activity the Department of Health supports under its mission to help the people of Canada maintain and improve their health.

Health Canada plays a major role in protecting the health of Canadians. This House has been preoccupied with paring back for some time, but hon. members know very well that certain demands on the system will not go away simply because budgets are cut.

Health threats allow no fiscal restraint. It is a challenge of the Department of Health to maintain an infrastructure that guarantees quality health care to Canadians in good times as well as in bad.

More than 2,000 people work in the department to protect the health of Canadians by regulating goods and services mostly under the Food and Drugs Act, but also under the air and water legislation.

Health Canada has an environmental responsibility to manage chemical and radiological hazards. Each year a way must be found and the resources must be provided to review 1,000 new medical devices before they reach the market.

Health Canada prevents or regulates the sale and advertising of dangerous products and warns consumers about those in circulation. With everything else on their minds, people do not want to be worried about those details in their daily lives. The department helps take that worry away.

Product safety is part of the larger picture in maintaining health. Accidents in the home and at work are a major cause of death and disability between the ages of 5 and 35, causing not only the loss of enjoyment of life but economic loss and heavy medical and hospital expenses.

Each year thousands of field inspections, almost 3,000 last year, are carried out among food and drug establishments. Each inspection leads to an average of five analyses of food, drug and medical devices, some 14,000 last year. The department is responsible for

the nutritional quality of food, for making sure that additives, agricultural chemicals and processing methods are safe.

In 1994 more than 77,000 tests of suspected illicit drugs were carried out. Health Canada administers the Narcotic Control Act. It also works to ensure that drug products which may be effective when used one way do not pose unacceptable risks in another way. All pharmaceuticals in use in Canada must be certified by the department. A revised drug certification renewal process is designed to improve protection of consumers and to increase their access to important new drugs.

Over the past year, investigations were conducted into 20 outbreaks of disease including TB, cholera, hepatitis B, hanta virus and the hamburger disease. We do not know enough yet about some emerging infections to be able to prevent or control them. Radio, television and the press report to Canadians every day on the gaps in our ability to track threats such as drug resistant bacteria and those surfacing viruses. The public is more knowledgeable than ever in history.

Health intelligence is shorthand for pooling awareness, information and understanding of health problems and approaches among various jurisdictions and health sector partners.

The Department of Health's laboratory centre for disease control is now strengthening Canada's health intelligence network. This initiative, which will include participation in a new global network designed to detect emerging diseases, is endorsed by the provincial governments. The provinces know that national leadership in this area is essential if we are to make the most cost effective choices among all available health technologies and options.

The path to the government's objective of getting more value for every dollar spent on health is paved by preventing illness before it starts and by promoting healthy living. Each dollar that goes to prevent ill health saves tens of hundreds of thousands of dollars in treatment costs.

Health intelligence is one of the tools used within the department to address perplexing and persistent issues, such as mental health, cancer, AIDS, family violence, heart and lung disease, and prenatal deprivation. The department supports research to determine what will enhance health. It then promotes these activities by education and awareness campaigns and by developing infrastructure and programs.

For instance, the department is at the penetrating point of a network of government programs for children. The clear understanding is that the future of children depends on critical input during the first year of life.

The government as a whole directs more than $15 billion annually to Canadian children and their families to support health and development. Health Canada provides a wide range of programs for children at risk of abuse or injury, social or physical diseases. This year its child development initiative includes a ground breaking childhood cancer information system and strategies to address children's mental health.

Hon. members have heard of the department's prenatal nutrition program to reduce the tragedy of infant disability due to poorly nourished mothers. This is a comprehensive effort that includes diet supplements as well as counselling in nutrition and lifestyle issues such as smoking, substance abuse, stress and family violence.

As we come to pass from one century to the next, we might reflect that when our great grandparents witnessed the last such passage, their average lifespan and that of their friends was many years less than ours. As recently as the 1930s the average lifespan of a Canadian male at birth was only 60 years. A baby boy born today can expect to live at least 25 per cent longer, the equivalent of an extra week per month, or 13 weeks annually, or 15 years of extra life. A female baby's longevity has been extended by 18 years.

Better nutrition, better housing, better working conditions, and better sanitation have been major contributing factors to our better health and longer lives. But also there are marvels of human ingenuity applied to the field of health. The cholera and typhus that assailed our ancestors was controlled. Our children were defended against smallpox, diptheria and polio by simple vaccination. We learned to deal pre-emptively with the ravages of syphilis and tuberculosis. In each we triumphed. We spared thousands of lives and prevented a huge loss to the productive capability of this nation. Billions of dollars have been saved in the cost of care.

The federal government spends many millions of dollars each year on health research and makes it available to all provinces, all hospitals and all doctors throughout Canada. The outcome of this research saves the lives of Canadians.

The unfortunate reality is that illness still exists. Diseases afflict us unpredictably and haphazardly. Most illnesses, especially the major ones, are blind accidents. We are only able to deal with them after they have made an appearance. We must use the methods of medical care for this.

In Canada fortunately, disease is not made twice tragic by having a sick person bear the cost of the treatment. Expenses are paid in full by Canada's comprehensive and universal medical insurance programs which pay family physician and specialist fees as well as the charges for tests, radiotherapy, chemotherapy, surgery and

hospitalization, any or all that are required. This system is a source of deep national pride.

Patients in some provinces were asked to pay the difference between what health care providers were charging and what their provincial health plan would pay. This practice became known as user charges. As well, some doctors were billing patients over and above the provincially approved rates. Extra billing and user fees were a serious threat to our national medicare system.

To stop this erosion the Liberal government of the day instituted the Canada Health Act in 1984. This established in law the five principles on which the system remains supported. Everyone is covered for all medical necessities. Access to care is on an equal basis. Coverage is portable among provinces. Administration and payments are handled by the public sector. It is this act that still governs the health care system that has evolved in Canada and which is the best health care system in the world.

It is the Department of Health that administers and enforces this act, this cornerstone of Canadian cohesion. It is this bill, Bill C-95, that positions the department even more surely to discharge its responsibilities so essential to our national interest. It is therefore my intention to vote for its passage which I trust will be swift.

[Ted White, Reform, North Vancouver, BC]

Mr. Speaker, I listened with interest to the member's speech. At one point in his speech he made the comment that sickness in Canada is not made tragic because the system pays for everything. I would like to tell a short story and ask a question of the member about that very aspect.

In 1989 a man I know noticed some blood in his stool so he went along to the doctor. The doctor said it looked pretty serious and that he would have to book the man in to see a specialist. It was going to take six weeks to see the specialist in Vancouver. That is not uncommon. Anybody who has been to a doctor and has had to go to a specialist knows that sort of waiting list is common in Canada. The man said to the doctor: "I am not prepared to wait six weeks for something that could be life or death. Give me the name of someone I can see in the United States because when it comes to life and death, I am prepared to pay".

The doctor said he would see what strings he could pull. The doctor pulled some strings and voilà, in two days the man suddenly received attention. It was not because it was fair that he jumped to the front of the line but because he made a lot of noise about it. He visits the specialist and the specialist says: "You really need an MRI to determine exactly the extent of the problem. It is going to take 10 weeks to get you an MRI at St. Paul's Hospital in Vancouver because there is not enough money to run it. It can only do five scans a day and only one of those is for anything other than cranial scans". If you have a cat that is sick you can take it to the MRI after hours and it can be scanned. You can pay for your cat to be scanned but you cannot pay.

This person said: "I'm not prepared to wait 10 weeks for an MRI. Give me the name of a place in the United States". The doctor said: "Okay, if you go down to Bellingham, St. Joseph's Hospital can do it for you. Let me call and make the arrangements". He called up and the man was offered an appointment the very next day, not 10 weeks, the very next day.

The man decided it was a little inconvenient the next day so went two days later. He was treated like a client, not a number. He was shown into the hospital. He was not even asked whether he could pay or not.

I know this is the truth because it was me. The man was not even asked if he could pay. He was invited into the hospital. He had his test. He had the MRI. The doctor said to him: "If you will have lunch and a cup of coffee, in two hours come back and we will have the report written up and all the pictures for you".

I had my entire tests done and was back in Vancouver in four hours with the results that would have taken 10 weeks.

The worse thing about that whole exercise was when everything had been done, and I had been given the package, they said: "How are you going to pay for this?" I had to pay $1,000 U.S. to St. Joseph's Hospital in Bellingham when I would rather have paid it to St. Paul's Hospital in Vancouver.

What sort of a stupid system is this? This is not rich and poor. It is life and death.

When the member says that the Canadian system does not make sickness tragic he should think a bit more about real cases. It is real. Luckily I had the choice to go across the border and pay $1,000 U.S. to save my life. The sick, despicable system that the government continues to support would have resulted in my death because of the waiting lists and no choice.

All that the Reform Party wants in the health care system is choice. That is all it is. It is not to deprive anybody of anything. If I had been able to spend that $1,000 at St. Paul's Hospital in Vancouver I would have subsidized an MRI for somebody else who could not afford to pay. That is the principle.

That is why the eye clinics in Alberta work so well. That is why the waiting lists are down. The people who have a little extra money and are prepared to go some other place reduce the waiting lists.

I would like to hear the member's comments about that and why he would support a system that would have resulted in my death.