Mr. Speaker, this afternoon, we are considering Bill C-95, an act to establish the Department of Health.
This bill contains a number of disturbing clauses, and the Bloc members who spoke before me in this debate pointed out that the provinces will have to pay close attention to how the federal health minister implements these clauses, because they give the federal government an opportunity to encroach on an area of provincial jurisdiction.
I think that our concerns are totally justified; I would like to go beyond the clauses themselves and look at how the Department of Health has been positioning itself for some time now.
As hon. members will recall, in the throne speech almost two years ago, the government announced the national forum on health with great fanfare. What has happened since then?
I would like to think about this because I think it puts the bill before us in a special light and allows us to express a number of reservations with arguments that everyone can understand better.
This forum on health officially started its operations on October 20, 1994, under the chairmanship of the Prime Minister and the vice-chairmanship of the Minister of Health. The mandate of this forum is to improve the health of the Canadian people, increase the effectiveness and efficiency of health care services, and make recommendations to help the government achieve these goals.
We should point out here that the federal government does not miss any opportunity to interfere in the area of health. The federal government therefore decided to participate in the debate and even to initiate the consulting process to assess the Canadian health system, despite the fact that this is an area of exclusive provincial jurisdiction, while setting future priorities in order to improve the quality of health care.
The federal government is making a lot of claims. As you will recall, it turned down the request by provinces to participate fully in the work of the national forum on health. Instead, the Liberals decided to let the provinces attend the forum but only as observers.
How, I ask you, could the federal government disregard the main stakeholders in the area of health, namely the provinces? On September 27, 1994, the current Minister of Labour, who was then Quebec's Minister of Health, told La Presse : ``The federal government's conduct does not make any sense. How can they contemplate reviewing the health care system without the partici-
pation of the provinces, which must provide the services. It is simply unacceptable".
Senator Thérèse Lavoie-Roux said, in the other place, on May 31, 1994, that the government was headed in the wrong direction by overlooking the role of the provinces. She said, and I quote: "Are the provinces not considered major partners? Why were they not invited to participate in the forum? Does the leader find it appropriate for the government to be acting unilaterally on a matter of provincial responsibility?"
Needless to say that the federal government went ahead with its national forum on health, in spite of the strong objections of the key players in the health sector, namely the provinces.
On October 21, 1994, during question period, the Prime Minister said, and I quote: "We in Canada cannot afford to lose our health insurance system because we did not take the time to plan for the future".
That statement from the Prime Minister is telling in more ways than one. First, the federal government sets itself up as keeper and promoter of the quality of health care services provided to the public. According to the Prime Minister, it is thanks to the federal government if the health care system, as it exists, is the pride of Canadians.
Following a meeting with provincial officials in Victoria, the health minister said, in a press release: "The October 15 date is final. However, I believe we can reach an agreement to end extra-billing by clinics to cover essential medical services. It was never my intention to penalize the provinces, but I firmly intend to preserve and to protect Canada's health care system".
Meanwhile, the federal government is careful not to mention the dramatic consequences of its financial withdrawal which, for Quebec alone, will have resulted in a shortfall of over $8 billion between 1982-83 and 1994-95. That is a lot of money, considering that the government claims to be the keeper of health care in Canada.
The government is also trying to give the impression that it is the only one able and willing to propose efficient solutions to solve the thorny issue of funding for our health care system, as it currently exists. The federal government goes so far as to assume the responsibility of defining priorities to preserve the future of quality health care services.
The Prime Minister's statement shows to what degree the federal government sees itself as the "great thinker" regarding Canada's current and future health care systems, as well as the one which can ensure that it remains accessible, free and universal.
Let me quote an excerpt from a document on the federal-provincial perspective prepared by Thomas Duperré on behalf of Quebec's commission of inquiry on health and social services: "By using several programs gradually put in place over the years, the federal health department tends to give itself overall responsibility for health and social services, and it does not hesitate to describe itself as the main architect of the implementation and smooth operation of Canada's health system. It should be noted that, for the Canadian government, health services (and, to a lesser degree, social services) in this country form, to a large extent, a nationwide system. Indeed, Ottawa sees provincial governments as mere health care providers, and provincial programs, which never seem to form a global structure, as mere elements of the national system. Provinces, and particularly Quebec, sometimes find it hard to understand the federal government's attitude in the health and social sector. This is because they forget that, rightly or wrongly, the central government gives itself a much larger role than the one provided in the constitution".
Nevertheless, it is obvious that the provinces constitute the ideal sociopolitical agent for health system reform. According to the distribution of powers under the 1867 Constitution Act, only the provinces have the power to create, deliver and administer health and social services to the public.
Let us look at the example of the various actions undertaken by the government of Quebec to transform, modify and improve the health system over the past ten years. Let us think of the Rochon Commission, which took a critical look at the entire health system in Quebec. Each component of the system was placed under scrutiny and a number of groups involved in the health field spoke before public Commission hearings, in order to make known their concerns, their anguish, and their suggestions for improving the irritants inherent to the system.
After this brief review, I hardly need point out in connection with Bill C-95 that the provinces and Quebec are the ones best placed to intervene directly and knowledgeably in the system of health care and services. Who better than the provinces to know what the true issues are, and what solutions are required, to keep the health system accessible, universal and free of charge?
The better solution by far would be to hand over to the provinces all taxes earmarked for health care, allowing them to provide their populations with appropriate and suitable health services. Interaction between the provinces would result in agreements to ensure the delivery of services that, while homogeneous and equivalent,
were tailored to the specific requirements and means of each province, Quebec in particular. I shall close on this note,Mr. Speaker. Thank you for your kind attention.