Mr. Speaker, I am pleased to be able to speak once again to Bill C-18, which was introduced as Bill C-95 before the recent prorogation of the Houses. The bill's purpose is mainly to establish the federal Department of Health. It also amends and repeals certain other acts.
Such a bill is absolutely unjustified. There is no reason to pass such a measure since health is exclusively a provincial jurisdiction. It is crystal clear in the very constitution the government wants to impose on Quebecers. I said it before, I say it again and I will go on saying so. It seems hard to understand, but health is an exclusive provincial jurisdiction.
With its spending power, the federal government retains the possibility of interfering in all areas of provincial jurisdiction as it pleases and without consideration for the distribution of powers guaranteed in the Constitution. To prove my point, I quote Alexander Galt, one of the Fathers of Confederation, who stated that the distribution of jurisdictions as described in the British North America Act of 1867 did not give provinces enough money to enable them to properly administer their areas of jurisdiction.
Alexander Galt's comments leave no doubt as to the initial intentions of the Fathers of Confederation as well as of another author of the 1867 act, who said that eventually the provinces would become nothing more than big municipalities under federal supervision and largely dependant on the central government.
It might be difficult for some to admit today that this might have been the goal of those who thought up the British North America Act. Difficult to believe that the act which gave birth to Canada provided, even at a very early stage, for an increased centralization of powers in Ottawa.
The point of my little aside was to show that, contrary to what some would have us believe, nothing has changed. We can see that the same centralized approach giving the present central government an overwhelming importance is permeating not the discourse, heaven forbid, but the actions of today's main federal leaders. The best example of this can be found in the health care area in which the federal government has continuously interfered in an increasingly more persistent way. Bill C-18 before us today is a case in point.
The Constitution Act gives the provinces general jurisdiction over health care by including generally all matters of a merely local or private nature in the province. Anyone can read this under subsection 92.16. Moreover, subsections 92.7, 92.13, and 92.16 of the same act give the provinces exclusive power over hospitals, the medical profession and the practice of medicine as well as health care in general in the province. I might add that this is an area of exclusive provincial jurisdiction because it pertains to property and civil rights.
Accordingly, it seems clear that health is under provincial, not federal jurisdiction. However, the federal government has been intruding in this area for many years now, and in various ways. The Hospital Insurance and Diagnostic Services Act, the Medical Care Act and, more recently, the Canada Health Act, which combines the other two and sets so-called national standards, show clearly what this federal government thinks about shared jurisdiction.
The will or temptation to intrude on health is not new. It goes back to the end of the second world war. The federal government
had taken over all main taxation areas to make sure it would control most of the taxes normally levied by the provinces.
At the end of the war, the federal government had a bright idea: instead of returning powers of taxation to the provinces, why not redistribute the money through grants subject to standards it would set. This was a clever way to intrude even more in aareas under provincial jurisdiction, at a time when it seemed that the Privy Council in London, which then played the role now assigned to the Supreme Court, wanted to limit the federal government's centralizing tendencies.
Since then, the federal government has been using established programs financing to transfer money to provinces for health and post-secondary education. The amounts given to provinces under that program are transferred partly in cash and partly in tax points.
Transfers were computed from expenditures for a base year, 1975-76, and were supposed to be indexed on the average GNP per capita over the last three years. Basically, since its implementation in 1977-78, established programs financing has been characterized by a unilateral partial withdrawal on the part of the federal government.
Implemented in 1977, the established programs financing structure has remained unchanged. However, for the last ten years or so, its intended rate of increase has not been respected. This is where the shortfall for provinces and Quebec in the area of health comes from. This is a good example of the damage that a government can do when it refuses to acknowledge that it cannot substitute itself to other levels of government everywhere.
In 1986, the federal government reduced the growth rate of transfers by 2 percentage points, which means that health expenditures had to grow 2 percentage points less than the GNP. That was the start of a long series of cuts in payments.
In 1989, there was another cut in the indexing factor of 1 percentage point, which meant that by now growth in health expenditures had to be 3 points below the growth of the GNP.
In 1990, Bill C-69 froze transfers at the 1989-90 level for an anticipated period of two years, regardless of inflation, when actual health costs were continuing to rise.
In 1991, the federal government announced that it was extending the freeze for another three years. During most of this sad period for health care, the opposition party was outraged. It clamoured that this could only lead to ruin for the heath care system. Yet, that same party, now the government, continues to weaken the system.
The result is that between 1977 and 1994, the federal contribution to health care went from 45.9 per cent to 33.7 per cent, a drop of 10.6 per cent that Quebec and the provinces had to deal with to the best of their abilities. Unfortunately, forecasts for 1997-98 indicate that the federal share will drop to 28.5 per cent.
Over the years, as Ottawa withdrew from health financing, it is almost $8 billion that Quebec alone did not get, that the Quebec government had to manage to find elsewhere. We can add to that amount the cuts expected in the Canada social transfer, that is $308 million for 1995-96 and more than $587 million in 1997-98.
According to a study by the C.D. Howe Institute, from 1988 to 1992, while spending for transfer payments remained unchanged, spending for other federal programs increased by 25.5 per cent. Consequently, cuts in health transfers to the provinces went to reduce the federal deficit. The federal government went on spending too much, while telling the provinces to tighten their belts.
The leeway the Canada social transfer is supposed to give is in fact nothing but an opportunity for Quebec and the provinces to decide for themselves where they will make cuts to make up for this unilateral withdrawal. That is the vision the present Liberal government has of decentralization. That is what it means when it talks about flexible federalism. Thanks, but no thanks. We are not interested.
Last Spring, the National Council of Welfare, an organization whose mandate is to advise the federal health minister, had this to say to the minister: "It would be extremely hypocritical to reduce contributions to the provinces while increasing the requirements they would have to meet". Yet, the National Council of Welfare is not known for its sovereignist leanings.
As I mentioned earlier, sections 92.7 and 92.16 of the British North America Act state that health and social services are exclusively under provincial jurisdiction. Yet, the federal government also has a health department.
Next year, it will cost taxpayers more than $1 billion, $1 billion wasted to do what the Government of Quebec and the governments of other Canadian provinces could very well do by themselves.
Moreover, this redundant department that employs more than 8,000 public servants allocates significant amounts for programs and projects that already exist in Quebec and in the other provinces. I can give you some examples from Quebec, where there is duplication in programs. Here are a few examples: the strategy for the integration of persons with disabilities, the family violence initiative, the new horizons program, the seniors secretariat, the program to reduce smoking, the anti-drug strategy, the strategy against AIDS, the pregnancy and child development program, the children's bureau, and so on.
It is this kind of duplication the federal government should have cut, instead of stubbornly trying to have its say in every area; the disastrous impact of this on government finances does not seem enough to make it face reality. It shifts the deficit onto the provinces by cutting transfer payments for health care, and people are paying the price.
There is another federal initiative shows the government's determination to meddle in health care without the provinces' consent: the national forum on health, aimed at taking a critical look at our health care system as a whole and proposing ways to compensate for the ever increasing costs in this area. According to several analysts, the federal government could even take this opportunity to tighten the criteria and requirements in the Canada Health Act. Moreover, every single province openly criticized the federal government's attitude, which in this instance is pushing aside those with legal jurisdiction over health matters.
In this regard, on September 27, 1994, the current Minister of Immigration told La Presse : ``The federal government's actions make no sense. How can it contemplate a review of health care plans without the participation of the provinces, which are responsible for providing services? This is clearly unacceptable''. I would be curious to hear the Minister of Immigration's current position on the national forum.
Another extremely wise comment on this Liberal government's failure to honour provincial areas of jurisdiction was made by Thérèse Lavoie-Roux, who, when she was still a member of the other place, asked why the provinces had not been invited to participate in the forum. "Are they not the main players in the area of health? Does the government leader think it is appropriate for the government to act unilaterally in an area that comes under provincial jurisdiction?"
Now, looking specifically at Bill C-18, it is clear that, instead of showing good faith by withdrawing from this area over which it has no jurisdiction, the federal government is doing its best to encroach little by little on provincial jurisdictions for its own benefit. This bill was not presented as a bombshell, as a megabill; it was presented to us as an innocuous and inconsequential bill, while in fact it is definitely not so.
Paragraph 4(1) sets out the powers, duties and functions of the health minister. It suggests that the powers, duties and functions of the minister extend to and include all matters over which Parliament has jurisdiction relating to the promotion and preservation of public health. There certainly is room for clarification here.
The following clauses are more subtle. Paragraph 4(2) lists particulars concerning the minister's powers, duties and functions, including the promotion and preservation of the physical, mental and social well-being of the people. The people in question are the people of Canada. This clause would give the federal government the authority and right to interfere in an area under exclusive provincial jurisdiction.
Paragraph 4(2) goes on to include the protection of the people against risks to health and the spread of diseases. There was nothing to that effect in the original act that Bill C-18 seeks to replace. This opens the door to the federal government stepping in to protect the health and ensure the safety of the people by invoking the national interest or peace, order and good government.
Paragraph (c) of the same clause provides that investigation and research into public health, including the monitoring of diseases, come under federal authority.
This creates a problem, since later on, in clause 12, it is stated that nothing in the 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.
How does the Department of Health intend to monitor diseases without having access to the necessary information? Under the Health Services and Social Services Act, health care institutions are governed by provincial legislation.
Is this a real problem? Does clause 12 adequately restrict federal involvement in the health care sector, or is it just a front to reassure the provinces, one that the federal government will easily remove at will, as it has done so effectively in recent years?
Clause 4 can certainly be interpreted in a very wide and generous way. We definitely have to wonder about the real meaning of this clause, which can be interpreted in several ways, and which may reflect a number of intentions.
It is typical of the federal government to use a seemingly simple and inoccuous bill to intrude on fields that come under provincial jurisdiction. However, nobody is gullible to the point of not seeing what is going on.
Bill C-18 is another typical example of the federal government's sneaky and quiet way of doing things, without making waves. It acts like this because it knows full well that no one agrees with its way of doing things in the health care sector. Instead of admitting that it is in the wrong and taking corrective action before it is too late, the federal government persists in a sneaky way, so that no one will realize what is going on until it is too late.
Clearly, federal interference in the health care sector has a very negative impact. It is also obvious that the federal government stubbornly refuses to recognize the fields that come under provincial authority and also continues to reduce transfers without
making national standards more flexible. We are headed towards the death of the health system as we know it.
No more sad claims that Canada holds the only insurance policy for a health system such as ours. Yes, we are proud of our health system; yes, we want to hang on to it and even to improve it; no, Canada is not an insurance policy for this system, far from it; and no, Quebec's sovereignty will not spell the end of our health system, quite the contrary.
The only real threat lies in the lack of vision of a federal government that no longer has the money to match its centralist ambitions and that should, as soon as possible, turn over full authority, including financial authority, in matters of health to the provinces, at least to those which have asked for it. The health of Canadians and Quebecers can only improve.
It goes without saying that for all these reasons, and for many others that I will raise at a later time, it is impossible for the Bloc Quebecois to support Bill C-18 in any way.