Mr. Speaker, it is difficult to begin to debate a bill and be interrupted by question period, but I will nevertheless summarize a bit what I said and then to on.
We are debating an act to establish the Department of Health and to amend and repeal certain Acts. I had said that, in fact, the bill was aimed at replacing the name of the Department of Health and Welfare by the shortened title of Department of Health.
Generally, not a lot of sections have changed, but in reading this bill, we realize that certain sections have been changed, repealed or added, only some. In some cases we see that the government, as a good government, is once again legitimizing its authority and is giving the Minister of Health authority to intervene yet again in areas that are under exclusive provincial jurisdiction.
I gave a brief history and I am going to summarize what I said to conclude with the clauses I mentioned earlier, which provide the powers of the minister, who may intervene in areas of provincial jurisdiction.
Under section 92(7.16) of the Constitution Act, 1867, and according to the courts, the sectors of health and social services are exclusively under the jurisdiction of Quebec and the other provinces. Since as far back as 1919, Ottawa has been getting increasingly involved in these sectors, forcing Quebec even here to comply with so called national standards and objectives.
As far as we are concerned, federal initiatives in the area of health and welfare, except for those dealing specifically with certain groups of people-members of the Canadian Forces, sailors, Indians, immigrants and prisoners-have no clear constitutional basis. They depend entirely on the federal government's spending power, which allows it to take many more major initiatives.
In 1919, the Department of Health was created and the first subsidies granted. In 1948, the national health subsidy program was introduced. In 1957, the Hospital Insurance and Diagnostic Services Act was passed by Parliament. The Medical Care Act was
passed in 1966, and the Canada Health Act, known as Bill C-6, in 1984. The Canada Health Act replacing the 1957 and 1966 laws set national standards and imposed requirements limiting the autonomy of Quebec and the provinces. Bill C-6 set out provincial obligations: universality, accessibility, interprovincial portability, public administration, and comprehensiveness. Failure to meet these criteria may lead the federal government to withhold transfer payments to the provinces for health care.
As early as 1926, Quebec denounced the federal government's interference in the area of health, and the reservations then expressed by the Taschereau government were reiterated by every succeeding administration. Health Canada has become so big that its 1995-96 estimates set aside $1.5 billion for operating expenditures-$347 million for personnel costs and $703 million for goods and services-and $6.9 billion for transfer payments. However, this contribution to the provinces, which is, as I was saying, subject to compliance with national standards, does not prevent the federal government from going ahead with its own health and welfare initiatives, as shown by the list I just gave you on the subject of duplication.
The 1991 national strategy for the integration of persons with disabilities, with a budget of $46 million over five years; the 1991 federal initiative against violence, with a budget of $136 million over four years; the new horizons program; the seniors secretariat; the national strategy to reduce tobacco use; the national drug strategy; the national AIDS strategy; the pregnancy and child development program; the children's bureau, the national forum on health. All these initiatives directly encroach on existing programs. Such cases of overlap and duplication cost a lot of money.
I would now like to make a few comments on the government's red book commitment with respect to the national forum on health. With respect to health, the federal government does not intend to cut any slack to the provinces, as promised in the fall 1993 election campaign, when its intention to hold a national forum on health, if it was elected, was made public.
The federal health minister made no secret of Ottawa's centralizing designs. During its election campaign, the Liberal Party of Canada released a document entitled "Creating Opportunity: The Liberal Plan for Canada", better known as the red book. Reference is made in this book to being committed to holding a national forum on health, and the way this commitment is worded hardly conceals the federal government's desire to take control over health care in Canada. Let me read you what it says. "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." If that is not the expression of a will to centralize, I do not know what is. "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."
On june 29, 1994, despite the objections of the provinces, the federal health minister announced the creation of this forum. To date, four work sessions have been held, and not one province is represented at this forum. The forum's mandate is to develop a vision of what the Canadian health care system will be in the 21st century; foster dialogue with Canadians concerning their health care system to ensure that, while respecting the general principles of the system and preserving its benefits, the renewal process under way will make the system better and lead to greater public health; establish priorities for the future and bring about a wider consensus on the changes that are required.
Following the invitation sent by the federal health minister,Mr. Rochon, Quebec's minister of health and social services, gave the following reasons, in a letter dated October 14, 1994, to explain why the Quebec government would not participate.
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.
That was the Quebec health minister's response to his federal counterpart.
Quebec's health minister also pointed out that Quebec had not waited for the presumed leadership of the federal government to undertake a reform, adding that important concrete measures had been taken, that an extensive public hearing process had enabled Quebecers to state their views and their needs, thus fostering a joint effort to define priorities and means of action, and that, in recent years, the federal government had made major cuts in its transfers to the provinces.
What we have here is yet another measure which demonstrates the federal government's intention to get involved in the health sector. Indeed, Bill C-95 includes provisions which clearly give the health minister a legitimate power to interfere, yet again, in fields of provincial jurisdiction.
If we look at these clauses, far from acting in good faith by withdrawing from this area that does not come under its jurisdiction, the federal government has every opportunity to gradually take over areas of provincial jurisdiction when it is in its interest. I am not saying that this is a major bill; it has been portrayed as harmless and inconsequential, but the reality is far different.
Subclause 4(1) of Bill C-95 sets out the powers, duties and functions of the Minister of Health. It proposes that the minister's powers extend to "all matters over which Parliament has jurisdiction relating to the promotion and preservation of the health of the people of Canada".
The Department of National Health and Welfare Act contained a similar provision. Parliament's jurisdiction over public health could cause confusion. This provision should be more specific.
The following clauses are more subtle. Subclause 4(2) lists the health minister's powers, duties and functions, including "the promotion and preservation of the physical, mental and social well-being of the people of Canada".
This provision would give the federal government the authority and legitimacy to interfere in an area of exclusive provincial jurisdiction.
Subclause 4(2) then mentions "the protection of the people of Canada against risks to health and the spreading of diseases". This does not appear in the original act that Bill C-95 would replace.
This would allow the federal government to move to protect the health and safety of the people in the name of national interest and of the power to ensure peace, order and good government. Paragraph 4(1)(c) places investigation and research into public health, including the monitoring of diseases, under federal jurisdiction.
This provision creates a problem, since clause 12 provides that "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". There is obvious confusion here.
How does Health Canada plan to ensure this continuous disease control monitoring without having access to the necessary information? According to the Act respecting health services and social services, health care institutions are health agencies governed by provincial legislation.
Is that really a problem? Does clause 12 effectively limit federal intervention in health matters or is it a mere front put up to reassure the provinces, a line that the federal government will have no qualms crossing if and when it pleases, as it has done in recent years?
Clause 4 may therefore be interpreted rather freely and broadly. There certainly is cause for concern about the real scope of this clause, which can be interpreted many different ways and ascribed many intentions. This is how, as usual, the federal government tries to expand into provincial areas of jurisdiction through a seemingly simplistic and innocuous project.
But no one is fool enough not to guess what it is up to. Bill C-95 is another fine example of the federal way of doing things: silently, without making any waves, because it knows full well that no one agrees with its handling of health care.
Needless to say that, for all those reasons and many more-that my colleagues will have the opportunity to raise later on-, we cannot support in any way Bill C-95. Mr. Speaker, before closing, I would like to table the following amendment to Bill C-95.
I move, seconded by the hon. member for Joliette:
That the motion be amended by deleting all the words after the word "That" and substituting the following: "this House declines to give second reading to Bill C-95, An Act to establish the Department of Health and to amend and repeal certain Acts, because the principle of the Bill does not provide for including in the Minister's powers, duties and functions, the power to award full and entire financial compensation to any province wishing to exercise fully its jurisdiction over health".