Mr. Speaker, at a time when we are considering the act to establish the Department of Health, the first question we could ask is: Why have a federal Department of Health? British North America Act says in section 92.7 and section 16 that health and social services are a provincial jurisdiction. So why did the federal government get involved in the health care sector?
To refresh our memory, I may recall that during the Second World War, the federal government obtained the right to collect income tax on a temporary basis, as they said at the time, to pay the country's war debts. However, by the end of the war, since people were now used to it and considering spending powers under the Canadian constitution, the federal government felt it would be useful to to continue to be involved in this area.
This led to the creation of several white elephants, to take action in areas for which the federal government had no responsibility. Today, the Department of Health is an interesting case in point. Quebecers and Canadians should know that for 1996-97, the annual cost of the federal Department of Health will be more than one billion dollars, which includes $347 million in salaries for staff and $703 million for goods and services, this in addition to administering $7.4 billion in transfer payments to the provinces.
We can see the insidious effect of what happened at the end of the Second World War, when the federal government, having obtained the right to collect taxes, returned this money to the provinces in the form of transfer payments. On the other hand, if every province had kept the right to look after health care, it would have been able to raise taxes so that citizens would know exactly what amount is spent on the health care sector and whether it is well spent. Unfortunately, that is not the model we developed in Canada. Today, we have a rather extraordinary situation where the federal government, while reducing its contribution to health care from year to year, nevertheless maintains national standards and
thus puts the provinces, with their responsibility for the day to day administration of health care, in an impossible situation.
The federal government says emphatically: no extra billing, but at the same time it denies the provinces the funding they need, and there is no reduction in the tax points the federal government collects.
The provincial governments are unanimously opposed to this state of affairs and are trying to do something about it. The federal government wants to create a Department of Health that would be a continuation of previous departments, but at the same time the government assumes the right to intervene in a number of sectors, and that is why we think this does not augur well for the future of Canada. In the months and years to come, important budgetary decisions will have to be made.
I repeat that if we have two bureaucracies looking after health care in Canada-and in fact there are not two, there are more, as many as ten or eleven, because each province can have its own department of health-there will be unnecessary spending, unavoidably. When they say: "The government has no more money, where could it cut spending, how will we determine our social options for the future?", the first place to look is where we have duplication.
Are there not areas in this sector that should not be the responsibility of the federal government? Should the federal government not withdraw and give the provinces the right to take care of a sector that is theirs under the constitution?
I would like to give a few examples of this encroachment. For instance, for the strategy for the integration of persons with disabilities, funding will be $46 million over five years, $46 million to be spent on the integration of persons with disabilities. If we consider the situation in Quebec, the province already has its Office des personnes handicapées which does the job, and here we see two governments involved in the same sector. Of course the whole $46 million will not be wasted. There is money that goes directly to people, to the client. But say this amount includes $5 million for administration costs. If only one intervener was involved, we could save that much and relieve some of the pressure on the federal budget, while services could be maintained quite adequately.
Another sector is family violence. A program was set up that would cost $136 million over four years. Again, this is a valid activity and government action is desirable, but the fact that two governments are involved undermines the effectiveness of these programs.
Say that in this case 10 per cent goes to administration costs, we could save $13 million. In the end, the same taxpayer pays the taxes. Whether he is paying municipally, provincially or federally, he always pays his taxes. So it is not surprising that those advocating decentralization so areas of jurisdiction may be recognized are critical of this sort of legislation by which the central government wants to impose its decisions on the provinces in areas where it has no responsibility, in areas where the provinces have constitutional responsibility.
Let us continue down the list of programs duplicating the action of the provincial governments. The new horizons program for seniors is another example of duplicate administration and duplicate bureaucracy. Members should see the forms the senior citizens clubs have to fill in to obtain these receipts. Often the administration costs for these programs equal what is paid out to senior citizens' clubs. This sort of thing is unacceptable, and people are rebelling. They want elected officials to clarify the situations.
Other examples include the seniors secretariat, the fight against smoking, the anti drug campaign, the national AIDS strategy, the children's bureau and, the best example of all, the national health forum.
Imagine. The federal government gave a team of experts a mandate to look at health management in Canada assessing the relevance of maintaining existing programs and of making change, but without the provinces taking part in the forum on health. This, for me, is the height of federal interventionism. From within an area of federal jurisdiction, a decision is made to interfere in an area of provincial jurisdiction, the provinces do not participate in the forum on health and no one has the patience or wants to do the negotiating necessary to have them there.
This means that, in the end, when the Prime Minister receives the report from the committee responsible for the forum on health, as its chair, he will be also be handed a total rejection by all the provinces of the report's conclusions.
We cannot ask people we have not included in the process to accept the conclusions reached. First of all, a determination should have been made of who ought to take part in the forum-was participation by the federal government really appropriate. Then, steps should have been taken to ensure that the provinces had a strong and appropriate voice that would have allowed them to address actual situations, because all the institutional networks are provincial.
These include hospitals, community health centres, shelters. Practical decisions are needed: reforms in individual provinces, the need to strike a balance between active treatment beds and extended care beds. At the moment, the provincial governments are bearing all the weight of the difficult decisions in this area, while the federal government, washing its hands of it, is reducing the funds it gives to this sector annually.
I will conclude on this point. When, in upcoming months it is looking for a place to save some money, one of the first could be the federal government bureaucracy enshrined in the Department of Health. How much can it save of the $347 million used to pay the salaries of officials working in the same area of activity as the provinces?