Mr. Speaker, I am pleased to speak on Bill C-18 sponsored by the Minister of Health. It is an act to establish the Department of Health and to amend and repeal certain acts. The substance of the act is ostensibly to take into account the reorganization of Health Canada to operate now as Health Canada as opposed to health and welfare.
There subsequently have been some changes to the original bill. One had to do with ministerial responsibility. There has been an important motion made to amend Bill C-18 in a way that will continue to ensure ministerial accountability under the laws of Canada.
Canada has the best health care system in the world. That is undeniable. There are five principles of the Canada Health Act. One of those principles is universality: health care is available to all Canadians. I will speak more about that a little later on.
The second principle is public administration. The third principle is portability which means that people can receive the health care services they need regardless of where they live or where they travel in Canada. The fourth principle is accessibility. This ensures that health care is reasonably accessible for the important health
care needs of Canadians. The final principle is comprehensiveness. This means that our health care system continues to provide the broadest range of essential or necessary health care componentsto Canadians.
These are the five principles which the Government of Canada and the Minister of Health continue to talk about to the Canadian people. They also talk about its implications to Canada as a country.
There has been a lot of discussion about the possibility of things like extra billing, user fees or some other special arrangements but that is not the philosophy or the principles of the Canada Health Act.
The Canada Health Act and its five principles are a very important component of Canadian unity. They are principles which I believe have made probably the largest contribution to keeping Canada together and keeping it strong and united. It is a fibre that transcends all partisan politics, notwithstanding the comments just heard from the previous speaker.
The Canada Health Act represents an instrument of the Canadian government. It represents the principles that we want to share with all Canadians, features such as helping those most in need first. We want to make sure that under any circumstance Canadians will never feel alone when it comes to their health care and other social needs.
We want to make sure Canadians understand that in our health system, the best system in the world, they will receive health care not because they have money but because they are sick. That is a principle and a value of which I am very proud and about which most Canadians are very proud.
The previous speaker talked about long line-ups in hospitals and a number of other things. I want to comment briefly on line-ups in hospitals. I spent a number of years as a trustee for the hospital in my community of Mississauga, the Mississauga General Hospital, a 600-bed facility with an excellent, well-trained and well-qualified staff.
A tremendous metamorphosis in health care has taken place over the last decade. The changes within the health care system are substantial in that there was, as evidenced, a shift or a reduction in the average length of stay by patients in hospitals from somewhere in the neighbourhood of 7.2 days average to about 4.2 days. That represents a very significant efficiency, a productivity improvement and a savings to the hospital environment to deliver care.
During that period, the Mississauga hospital reduced the number of beds from some 600 down to below 500 beds. However, in terms of the statistics, the hospital continued to serve more patients than it did as a 600-bed facility. One of the critical reasons for that has to do with the shift in philosophy toward ambulatory care. It used to be that one would go into the hospital and prepare for a surgical procedure maybe a day or two in advance and stay a little longer. Now one goes in a little later, the day of surgery, and then goes home early enough to convalesce in one's home environment, which the medical profession has found to be a more conducive environment to the healing process. The other aspect of the shift to ambulatory care is basically for people to receive their services and then move out. All of this has resulted in substantial savings to the health care system over the years.
The funding of hospitals is a joint responsibility between the federal and provincial governments. Through the transfers to the provinces, the federal government funds a very substantial portion of health care costs but it is administered and managed by the provincial governments. Through that administration certain funds are granted for capital purposes as well as for operating budgets.
It is up to the provinces to deliver the capital and the operating revenue necessary under certain guidelines concerning which they have some discretion. However they have no discretion with regard to the five principles of the Canada Health Act.
The savings that were achieved over these many years as a result of improved technologies, of care giving and medicine, of the shift to an ambulatory based system and simply due to productivity improvements in the health care sector, went to benefit the provincial governments. As announced by the Minister of Finance in his first budget two years ago, changes were made in the transfers to the provinces with regard to the various elements of the transfers. It is now called the Canada health and social transfer.
The federal government never got benefit or credit for those savings or efficiencies within the health care system. They were all left to the provinces. This ensured they had the kinds of tools necessary to maintain, protect and defend the principles of the Canada Health Act. Now the government must make sure it is doing even better and will continue to do better with the limited dollars available for all spending purposes and for the health and welfare of all Canadians.
I would like to highlight a couple of features of the Canada health and social transfer. This instrument and the so-called block funding was created by a situation to do with the combined value of the cash transfers to the provinces as well as tax points, or the ability to tax at the provincial level.
One thing that occurred was that the cash component of those transfers was beginning to be reduced. In circumstances where provinces had violated certain principles of the Canada Health Act, the federal Minister of Health would have stepped in and after some review and time for correction, would have withheld certain
amounts of cash transfers to the province, until such time as the province desisted from a particular activity.
As long as there is a cash component in the transfer to the provinces, the federal government has the opportunity to enforce the principles of the Canada Health Act. However, it was very clear that in time the cash component would disappear. In fact, the federal government would not have an opportunity to enforce the principles of the Canada Health Act.
As a result, the combination of various levels of transfers, not only for health but for post-secondary education and the Canada assistance plan, does provide some latitude where cash under all of the block funding will be available for an extended period.
Since that time the finance minister has also put in place as a result of the budget a new funding arrangement that provides an iron clad guarantee that the cash cannot fall below $11 billion.
Fiscal responsibility was an issue about which the previous speaker wanted to spend quite a bit of time talking. The federal government has shown a continued, strong and unwavering commitment to the five principles of the Canada Health Act and an unwavering commitment to ensure there is a cash component available to the provinces so they can continue to administer the health system and still respect the five principles of the Canada Health Act.
I want to make a comment about some other items, having been a member of the House of Commons Standing Committee on Health since January 1994. The committee has looked at a couple of areas and the member touched on them, for instance, cigarettes. The members of the committee looked at health warning labels on tobacco products, as well as plain paper packaging. There were a number of other initiatives which the committee has considered because of statistics, such as 40,000 Canadians die each year as a result of tobacco use.
These issues are important to Canadians. They want us to continue to look at ways in which we can provide cost effective health care and also shift the emphasis away from cures and remedies to prevention. That is the important issue.
Today Canada spends approximately 75 per cent of its health care dollars on curative or remedial approaches and only 25 per cent on prevention. It is becoming very evident that to continue spending money at those levels is unsustainable. Ways have to be found to shift those dollars into the preventive sphere so that savings can be achieved and the costs which will be incurred forgone if certain products are not used more responsibly in our society.
Tobacco is one of those products. Another which is very important to me these days has to do with alcohol consumption, and particularly the misuse of alcohol. My private member's Bill C-222 calls for health warning labels on alcoholic beverage containers.
A number of people have asked why I am doing this. The answer is painfully obvious to many Canadians. In fact, some 19,000 people die each year from alcohol related causes. Alcohol costs Canada approximately $15 billion in health care costs, social program costs, criminal justice costs and productivity. Fifty per cent of family violence cases are related to alcohol abuse. One in six family breakdowns are related to alcohol abuse. Thirty per cent of suicides are related to alcohol abuse. Forty per cent of automobile accidents are related to alcohol abuse. I could go on and on. Everyone knows how terrible it is in our society. The costs are very significant.
The direct alcohol related cost of some $15 billion is only a portion of it. The ripple effect and the impact on families and friends is far more than $15 billion.
Five per cent of birth defects are caused by alcohol consumption. There is a problem known as fetal alcohol syndrome. Medical expenses incurred during the lifetime of a fetal alcohol child cost Canadians approximately $1.5. million. Fetal alcohol syndrome costs Canada approximately $2.7 billion a year. Another problem is known as fetal alcohol effects. It is very similar to fetal alcohol syndrome, but it does not have the same physical effects. However, it occurs two to three times more than FAS.
This is the kind of thing at which the health care system has to look. We are talking about tens of billions of dollars in expenses because products are misused. People do not take care of themselves or they do not make positive lifestyle choices.
These are the things which are important to Canadians. They want to ensure that health care dollars are spent wisely and that we look at ways to save money on direct health care, as well as reducing the demand on the system so that we can ensure its long term sustainability for all Canadians for generations to come. That is the important message.
I have listened to other speakers. I understand the role of opposition members and that they have to be critical of the government. However, I do not understand how partisan speeches can be given in the House which talk about hypocrisy, duplicity, broken promises and cover-ups, and then attempt to talk eloquently about the blood commission.
The blood commission affects many Canadians. It is very tragic. I want all Canadians to know our blood supply system today is safe. Immediate steps were taken to ensure the safety of our blood supply system.
However, that does not relieve us of the responsibility to have an inquiry, the Krever commission, to look at all of the things that happened during that period to ensure we understand what happened, that we make sure there is nothing left to correct, to ensure there is no future risk to our blood supply system. Those are the things that are important.
Canadians need to have that confidence level. They need to have the feeling we are doing the right things. I do not think they got it from the comments made by the previous speaker who tended to suggest that somehow there were still problems here.
Anytime is a good time to get the facts right. If it takes more time to make sure they are right so we can have the correct information in order to make correct decisions, then I say we have to move on with this.
The commission is doing its work. The same can be said with regard to the Somalia case and members' compensation, which the member wanted to talk about. He showed a tremendous amount of frustration but I do not want to fall into that trap.
I simply want to reiterate for all members and for all Canadians that the Canadian health care system is the very best in the world. We are the envy of every other country. We have principles which the federal government is committed to defend and to protect. We will never leave any person in Canada without the protection of our health plan.
The principle all Canadians should remember is that in Canada health care will be available to you not because you have money but because you are sick. The Prime Minister has made that commitment. I trust the Prime Minister and I know Canadians trust the Prime Minister.