Madam Speaker, I rise to speak, at third reading stage, on Bill C-18, an act to establish the Department of Health and to amend and repeal certain acts.
I believe it is essential to remind my fellow citizens that health is a provincial jurisdiction under sections 16(7) and (16) of the BNA Act of 1867, and the interpretation given to it by the courts. It is clearly established and recognized that health and social services are exclusively under provincial jurisdiction. However, the federal government has often intruded in the health sector, over the years.
Since the beginning of the century, the federal government passed the following health legislation. In 1919, it created its health department and gave its first grants; in 1948, it put in place a national program of health grants; in 1957, it passed the federal act on hospital insurance, in 1966, the medical care act and, in 1984, the Canada Health Act that superseded the 1957 and 1966 acts.
Moreover, this act established the federal principles governing the Canadian health system, enacted national standards and, by the changes it imposed, limited Quebec's autonomy. Bill C-6 of 1984 set out the criteria to be met by the provinces, including universality, accessibility, portability, public administration and comprehensiveness. Otherwise, the federal government might withhold its financial contribution to health care.
The Quebec government has always condemned federal meddling in the area of health. In 1926, the Taschereau government-a good Liberal government, needless to say-was the first one to oppose federal interference in health care, and all successive Quebec governments have followed suit.
Although the health and social service system appears to have originated in Ottawa, it was only used as an excuse by the federal government to gradually encroach on an area of provincial jurisdiction. Every federal intrusion in health care forced the Quebec government to respond in order to regain full control and assert its determination to exercise its authority in an area under its exclusive jurisdiction.
Let me remind the House, for example, of two great moments in Quebec's history with respect to health care. In response to the Hospital Insurance and Diagnostic Services Act passed by the House of Commons in 1957, Jean Lesage, then the Liberal premier of Quebec and a former minister in Lester B. Pearson's federal government, set up Quebec's hospital insurance plan, which was approved by the National Assembly in 1961.
After the House of Commons passed the Medical Care Act in 1966, Robert Bourassa's Liberal government introduced the health insurance act, which was adopted by the Quebec National Assembly in 1970.
Over the years, the federal government's meddling cost taxpayers more and more money. Ottawa could afford to be generous as it was using the provinces' money or buying on credit through its own unlimited spending powers, which played a large part in getting all of us into debt.
May I remind the House briefly that, during the second world war, the federal government invoked the war effort to encroach on the area of corporate and personal income taxes, which was then under provincial jurisdiction. This measure, which was supposed to be temporary, is still in place. The federal government has clearly succumbed to the temptation of exerting greater control and, instead of giving back to the provinces the taxation powers they enjoyed before the war, granting subsidies linked to the establishment of federally approved programs.
By exercising such control over tax revenues, the federal government has been able to keep on centralizing, which caused untold duplication and shameful squandering of taxpayers' money. Worse yet, to make sure they would remain in office, generation upon generation of federal politicians distributed presents, even if it meant putting future generations of Quebecers, Canadians and, just for you, Madam Speaker, Acadians, into debt.
In the report of 1987 commission of inquiry on health and social services in Quebec, Thomas Dupéré wrote that establishing federal programs merely shifted to the federal level a debate that had already started at the provincial level and would have led to the same results over the same period of time, give or take a few months or a few years.
It is therefore pretentious to claim that, through its involvement, Ottawa has been an instigator in the social and health area. It would be more accurate to say that Ottawa's action was made much easier by the concentration of resources that took place at the federal level during the second world war. Ottawa took over the provinces' idea of developing a health care system. After the federal government made an about-face in 1945, refusing to give back the taxation it was supposed to have taken away from the provinces
only on a temporary basis, Ottawa had the means to act, to carry out its plans to encroach on exclusive provincial powers.
Today, in spite of the fact that health is clearly an area of provincial jurisdiction, Health Canada looms large. Its operating budget for 1995-96 is $1.5 billion, $347 million of which just goes to pay federal employees, from Newfoundland to British Columbia, to administer something that essentially comes under provincial jurisdiction and $703 million to procure goods and services for the department, while transfer payments to the provinces are $7 billion for the same year.
Altogether more than $8 billion is being spent in an area that comes under provincial jurisdiction. That is one quarter of the past year's deficit. When we look at all the departments where there is duplication, it is easy to imagine what how much money this government is wasting and to see how the current situation came about.
However, the federal government never indicated that it intended to loosen its grip on the Canadian health system. Also, during the election campaign, the Liberal Party of Canada wrote in the red book, and I quote: "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".
For once, the Liberal Party kept its word. Last June 29, even though all the provinces were opposed, the then Minister of Health announced the creation of the national forum on health. The forum was to define a vision of the Canadian health system in the 21st century, to promote dialogue between Canadians concerning their health system, and to set priorities for the future.
On October 14, 1994, Quebec's minister of health and social services, Jean Rochon, wrote to the federal Minister of Health to tell her, and I quote: "The mandate of this forum is an encroachment by the federal government in a field which essentially falls under provincial jurisdiction, and that is unacceptable. The clearly stated objective of your government, which is to give the forum a mandate to define future priorities, in the context of health care reform, and to define the means to that end, is a direct intrusion in provincial governments' affairs. This is something that cannot be hidden behind the consultative nature you ascribe to the recommendations that would come out of this forum".
Incidentally, Mr. Rochon, the Quebec Minister of Health, was recently congratulated for the courage he displayed in implementing the health reform in Quebec by one of his predecessors, Marc-Yvan Côté, who is well known to the Liberal Party of Canada, since it recruited him to be its chief organizer in Quebec, in anticipation of the next federal election.
In his letter to the federal health minister, Mr. Rochon added that Quebec had not waited for the federal government to adjust its health care system according to current needs, and that extensive public consultations had already taken place.
Moreover, he reminded his federal counterpart that cuts in health related transfers to the provinces were not the best way for a government to protect and to promote health care in Canada.
Indeed, it is precisely these cuts that undermine the very principles stated in the Canada Health Act.
While the federal government was pursuing its efforts to take control over a field of provincial jurisdiction, it unilaterally and drastically reduced its contributions to provincial health programs. In that regard, in the spring of 1995, the National Council of Welfare, whose role it is to give advice to the Minister of Health, warned the government against such a situation, saying that it would be very hypocritical to reduce contributions to provinces while increasing the requirements they have to meet.
Yet, this is precisely what is happening. I should point out that, when the finance department created the program called established programs financing, through which transfers to provinces are made regarding social services, health and education, it was understood that such transfer payments would be indexed according to the growth in the Canadian economy.
Since 1986, the federal government has been using money from these transfers to contain its deficit. It made a unilateral decision, without any regard for the provinces' ability to cope. Between 1982 and 1995, it saved, at the expense of Quebecers, $8 billion in the health sector alone. This shortfall forced Quebec to increase taxes to make up for the federal withdrawal.
According to a study carried out by the C.D. Howe Institute between 1988 and 1992, while established programs financing expenditures remained stagnant, other federal program expenditures increased by 25.5 per cent. In other words, while the federal government was telling the provinces to tighten their belts, it continued to spend right and left and to add to the deficit and the debt.
This lack of stability in federal health expenditures is a serious problem. Expenditures are in turn frozen, reduced or de-indexed according to the mood of the finance minister and the cash requirements of his department. We no longer have a fixed funding formula approved by all the governments. Funding is unilaterally
and arbitrarily determined by the federal government, without any consideration for the real costs of the provincial programs.
This constant change in the funding level, which is always dropping, has become a real nightmare for those involved in the health industry. What is worse is that the finance minister does not seem to realize that he is no longer juggling only with figures now, but that he is playing with the health of the Canadian population.
Last February, in his latest budget, the finance minister decided to reduce once again health transfers to the provinces. In this area, Quebec stands to lose $650 million in 1996-97 and $1.9 billion in 1997-98. That must be part of the benefits of federalism. It is important to note that when a federal government member says that federalism is profitable, he means it is profitable for the federal government, but costly for the provinces which do not have as much leeway as they used to.
In the spring of 1995, the National Council of Welfare made these comments about the planned cuts to health care funding, and I quote: "The measures announced in this budget would likely destroy a national social services system that took a whole generation to build".
Here is what the British Columbia health minister said about these cuts, and I quote:
"Last February's budget which cut transfers to provinces for health has forced provinces to look at unpalatable cuts that threaten medicare".
If Canada's health minister was so concerned about the health care system in our country, he would have done what his colleague from Notre-Dame-de-Grâce did and would have opposed his government's last budget attacking social programs. He would have stood up in cabinet where these decisions are made and would have set the people's pressing needs for quality health care in Canada against the finance minister's figures. The health minister could have suggested to the government to get the money from those who benefit from many tax shelters, starting with the Liberal Party's generous financial backers, and not forgetting of course the finance minister's own companies.
But this is not what he did. Today, he is proposing to us an old bill that was severely criticized by all stakeholders at second reading, during the first session of this 35th Parliament. A bill that is nothing but rehash, a bill that perpetuates the federal government's interference in health care, an area-we will never say it enough-under provincial jurisdiction.
Subclause 4(1) of the bill describes the powers, duties and functions of the minister while subclause 4(2) spells out what these functions encompass and deals with the protection of the people of Canada against risks to health and the spreading of diseases. Having seen where that got us with raw milk cheeses, we can easily imagine that on the strength of these provisions the federal government would not hesitate to meddle further in the administration of health care in Canada.
The bill before us is hypocritical enough to state, in clause 12, and I quote:
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.
When provincial health funding is cut this drastically, there is direct interference in the operation of agencies operating under provincial authority, by reducing their ability to continue to offer a satisfactory level of services to the public.
The Bloc Quebecois condemns this bill, because it sanctions the interference of the federal government in areas of provincial jurisdiction. In the health field, Quebec has its priorities and must have the right to manage them independently, in accordance with the current Constitution. This bill does not talk about ensuring satisfactory and stable funding for health care. The minister has abdicated his responsibilities in this field and is taking his orders from the Minister of Finance.
This bill attacks the provinces to such an extent, without helping them to solve the pressing problems they face, that even the most ardent federalists have decided to fight the initiatives of the health minister. Ontario's Conservative health minister said on September 19 of this year that there should be opposition to the federal government's desire to dictate to the provinces its interpretation of the principles that should govern the health care system. That same day, Ralph Klein, the Conservative premier of Alberta, also condemn the federal government's inflexibility, with reference to the then minister.
In a joint communiqué, on the occasion of a meeting of health ministers, the provinces declared that the federal government's desire to take unilateral decisions with respect to health funding, the interpretation of standards, and the setting of arbitrary deadlines for the termination of consultations was certainly not helping to resolve the problem.
Because the federal government is not able to protect the public adequately against risks to health, and because its continual cuts constitute the main threat to the health of the people of Quebec and of Canada, the federal government should withdraw from the health field and transfer the corresponding fiscal resources to the provinces, allowing them to take over responsibility for this area with, at the very least, the same level of effectiveness as the federal government.