Mr. Speaker, this motion shows a misunderstanding of the process by which medical services are determined for funding. It assumes the federal government plays an active role in this determination. This assumption runs contrary to the spirit and the letter of the Canada Health Act.
This act respects the role of the provinces in the delivery of health services and recognizes that provincial health care systems must address the unique needs and circumstances of each province.
This allows each province and territory latitude to make necessary decisions. This also gives provinces and territories latitude in the application of the five Canada Health Act principles and the ability to make decisions consistent with their own priorities and capacities.
In January 1988 the Supreme Court of Canada, interpreting the charter of rights and freedoms, struck down the Criminal Code provisions involving therapeutic abortion committees. This removed all administrative apparatus associated with this procedure.
This decision invalidated the entire legislative scheme for limiting women's access to abortion, leaving the matter of abortion to be decided by women in consultation with their doctors.
The Canada Health Act requires that medically necessary hospital and physician services are insured. The operation of provincial health insurance plans and the delivery of health services to residents are within the purview and decision making power of the provinces and territories. In short, the provinces and their doctors will decide whether services are medically necessary. Provinces are then responsible for insuring and delivering these services to residents.
As a statement of federal policy, the Canada Health Act respects that the provinces must have flexibility in deciding how to best organize, finance and deliver health services. The federal criteria provide the framework, but it is the provinces and the territories that are responsible for these basic decisions.
This division of relative roles and responsibilities has given us the excellent health care system we have today. It is certainly one of the reasons the Canada Health Act received unanimous approval in the House of Commons in 1984.
The federal government's role in health financing has been instrumental in shaping our health care system while providing the provinces with the scope necessary for determining how best to allocate federal transfers to address the health needs of their populations.
It is important to consider what provincial flexibility really means in terms of the Canada Health Act. The provinces are responsible for deciding in partnership with their health professionals which services are medically necessary and which should appear on the list of insured services.
Each province receives its advice from licensing bodies as well as medical associations on a scientific and professional basis for these decisions. Each province has its own consultative mechanism. On the basis of such considerations, the various services have been determined to be medically necessary and therefore are insured in every province and territory in Canada.
The challenge that continues to face us is the prevention of unwanted pregnancies. We know the reasons women seek abortion include lack of information about or access to birth control measures or sex education. These can be addressed through research, education, counselling and other forms of assistance through organizations which provide information and support.
One of our goals must be to secure for Canadians the widest possible range of choices about whether and when to have children. Unintended pregnancy is a particularly troubling and frustrating issue since it is largely avoidable. Despite recent advances in education and accessibility of contraception, unintended pregnancy still occurs.
The heaviest burden of unintended pregnancy rests on those who are the most disadvantaged, the young, the poor and those without the support of a caring family. Youth are particularly vulnerable. We must make it a matter of high priority to educate our young people to be responsible. We must promote responsible behaviour. The importance of education and birth planning as well as policies and programs that inform Canadian families and reduce the need for abortions cannot be underestimated.
Health Canada will continue to make resources available where our limited funds permit for activities related to sexual and reproductive health issues. These include community based projects funded through the health promotion contribution program and grants provided to national heath organizations. It is important that government and voluntary organizations work together to respond effectively to health information needs, especially of high risk or hard to reach populations.
We recognize the federal government has the legal authority to conduct national referenda and that the federal government contributes to the funding of provincial and territorial health insurance plans.
However, we also recognize it is not within the constitutional authority of the federal government to dictate the specifics of the operation of provincial health plans. The federal government does not fund specific health care services or types of services on a national scale in the manner this motion suggests. Both as a matter of law and as a matter of policy the federal government would not intervene in the operation of provincial and territorial health insurance plans so long as the principles of the Canada Health Act are respected.
The government does not have any choice but to oppose this motion within the context of the Canada Health Act. The determination of what services to insure is a matter of provincial and territorial jurisdiction.