Mr. Speaker, I rise today to speak on Bill C-95, an act to establish the Department of Health and to amend and repeal certain acts.
The main change brought about by Bill C-95 is the change in designation from Department of National Health and Welfare to Department of Health. I welcome this opportunity today, because this bill speaks volumes about this government's intention to further centralize and strengthen its powers despite its pre-referendum rhetoric about decentralizing.
On the face of it, this bill looks completely innocuous, technical, minor and inconsequential. Yet, some provisions of this bill could have a major impact on the exclusive provincial jurisdiction over health care.
I will go over them rapidly because my colleagues from the Bloc Quebecois have already reviewed significant health issues since the beginning of the Canadian confederation. Just the same, it is imperative, in my opinion, to bear in mind what, obviously, this government tends to forget, and that is that, under the constitution, health is an exclusive provincial jurisdiction.
Everyone agree on this. How can certain provisions of this bill be justified in that context, I wonder? I am referring in particular to clause 4, which states that:
4.(1) The powers, duties and functions of the Minister extend to and include all matters-relating to the promotion and preservation of the health of people-
(2)-the Minister's powers, duties and functions-include the following matters: a ) the promotion and preservation of the physical, mental and social well-being of the people of Canada; b ) the protection of the people of Canada against risks to health and the spreading of diseases; c ) investigation and research into public health- d ) the establishment and control of safety standards-for consumer products- e ) the protection of public health on railways, ships, aircraft- f ) the promotion and preservation of the health of the public servants and other employees of the Government of Canada; h )-the collection, analysis, interpretation, publication and distribution of information relating to public health; and i ) cooperation with provincial authorities with a view to the coordination of efforts made or proposed for preserving and improving public health.
These are provisions which are far-reaching and whose legal implications are difficult to foresee. This is especially worrisome since part of these are new provisions which were not found in the former act, that is to say the act respecting the Department of National Health and Welfare.
This bill reveals the federal government's will to centralize, as do other facts. I refer you in particular to the red book published by the Liberal Party of Canada, which called for widespread consultations on health care in the form of a public forum. I quote from page 80 of the red book: "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". These sentences speak for themselves and clearly show the Liberal Party's intentions even before they came to power.
In June of 1994, the Minister of Health announced the creation of this forum. Though its own Minister of Health, Quebec vigorously denounced this initiative and refused to take part in this exercise. And Quebec was not the only province that registered a protest. To this day, no province is a participant in this forum.
A few days before the referendum, some federal spokespersons changed their tune in order to win. They were focusing on change, decentralization, and powers to be negotiated with the provinces. What is happening now? Exactly a week after a significant vote that clearly revealed Quebecers' desire for change, we in this House are debating a bill that brings us back to the sad reality. No change can be expected from the current government.
The government has no intention of relinquishing any of its powers, despite what it said before the referendum. I hope that the minister will fully comply with clause 12 of the bill, which reads as follows:
- 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.
Mr. Speaker, allow me to give a historical overview of the legislation and of the federal government's interference in the area of health care. First, let us not forget that section 92.16 of the Constitution Act gives the provinces overall jurisdiction over health issues on their territory, by providing the following, and I quote: "-generally all matters of a merely local or private nature in the province".
Moreover, subsections 7, 13 and 16 of section 92 recognize the provinces' jurisdiction over hospitals, the medical profession and practice, as well as health care, on their territory.
Health is clearly a provincial, not a federal responsibility. However, the federal government has always managed to interfere in that sector, either through legislative measures such as the Food and Drug Act, or indirectly through its spending power.
Such interference has often generated tension and conflicts between the central and provincial governments. Quebec has certainly been the one denouncing most often and most directly Ottawa's interference in its field of jurisdiction. In 1919, the federal government established the health department and gave it the authority to provide grants.
In 1945, during a federal-provincial conference, the federal government proposed the establishment of a national health care program for which it would assume total responsibility. It should be pointed out that, in those days, after the war, the federal government exercised almost total control over the primary fields of taxation.
In 1948, a national health grant program was set up. In 1957, the federal Hospital Insurance and Diagnostic Services Act was passed, followed in 1966 by the Medical Care Act. The Canada Health Act was then passed in 1984, after a long debate and a lot of criticism. The central government had decided to legislate to ensure that health care and services that were medically necessary would remain accessible, available to all and free.
That federal act had the effect of imposing on the provinces the obligation to comply with these principles, in spite of budget cuts that the central government would make in transfer payments to the provinces for the health sector. The federal government also gave itself the power to impose monetary penalties on non-complying provinces. That act establishes national standards, namely, as I said, the universality of services, accessibility, transferability from province to province, public management and comprehensiveness. If these standards are not met, Ottawa can withhold its transfer payments for health care.
Based on the 1995-96 budget, Health Canada will spend some $1.5 billion to operate the program and some $7.4 billion in transfer payments. This department funds, among other things, the integration of people with disabilities, the fight against domestic violence, the new horizons program, the Seniors Secretariat, the fight against smoking, the national anti drug campaign, the national AIDS strategy, programs on pregnancy and child development, the Children's Bureau and the national health forum.
I have always supported a health insurance scheme that is universal, free, provincially administered, funded by our taxes and available to all. I do not support a system with two tiers: one for the rich and the other for the poor. I am, for example, concerned about what is happening in the United States, which does not have a public health scheme, preventing millions of people from having access to proper health care. Health, in my opinion, is people's most precious possession. This is why we must protect this system, and make preventing disease and promoting health our priority.
Naturally, with Canada's and Quebec's aging population, health care costs more and more. But services must not be rationed, nor cuts made unjustifiably. Unfortunately, Canada's entire health care system is in an acute state of crisis. Since the program's inception in 1977, the rate of growth of its funding has not kept up. This has meant a shortfall for the provinces. For example, in 1986, the federal government cut the rate of growth of transfers by 2 per cent. In 1989, the indexing factor was reduced by 1 per cent. In 1990, Bill C-69 froze transfers at the 1989-90 level for a two-year period. In 1991, the federal government extended the freeze another three years. All this time, the Liberals were vigorously criticizing these cuts.
Now that they are in power, they have totally changed their position and continue to nibble away at the Canadian health system. Scandalous.
It must be pointed out that, between 1977 and 1994, Ottawa's contribution to the health system dropped from 45.9 per cent to
33.7 per cent, and Quebec and the provinces have had to absorb this 10.6 per cent shortfall, with great difficulty.
The forecasts for 1997-98 indicate that the federal share of funding will be 28.5 per cent. Total cuts for Quebec alone are $8 billion dollars. To this must be added the $308 million reduction for 1995-96 and the $587 for 1997-98 in the Canada social transfer.
Is this what the flexible federalism of the Liberal government means? The only thing it is decentralizing is the deficit.
My fear is that these cuts will lead to the end of the health system as we know it. I am against social program cuts, as I have stated in this House on numerous occasions, particularly cuts in health programs through the drastic reductions in transfers to the provinces.
I support the campaign by the Canadian Labour Congress, the CLC, to save the Canadian health system. This coming December 5, the leaders of that organization will be here to meet some of the ministers and members as part of their campaign. The same battle is being waged in Quebec by the FTQ.
As a sovereignist, I voted Yes on October 30 because of my conviction that we in Quebec can build a more just society, a more egalitarian, more humane society. I am concerned about the Liberal Government's lean to the right, its blind cuts in unemployment insurance, social assistance, old age pensions, postsecondary education and so on. I am concerned about the antisocial orientations, with their lack of concern for what becomes of the least advantaged members of society, developed by the governments of Ralph Klein in Alberta and Mike Harris in Ontario, both Conservative governments.
In addition, I am greatly concerned about the right-wing, sometimes ultraright philosophy of the Reform, particularly when it comes to immigration, firearms control, cuts and the battle against the deficit.
The British Columbia NDP government's decision to refuse social assistance to anyone who has not been in the province for three months concerns me.
So, nearly all of English Canada is aligning along the most conservative of lines. In my opinion, the federal government ought to show some compassion, understanding and generosity towards our poor and needy fellow citizens. Canada has the means to protect the unemployed, the welfare recipients, the sick and so on.
My wish in closing is for the federal government to do everything necessary to preserve the health system in Canada.