Madam Speaker, I rise to speak on this private member's Bill C-202, an act to amend the Canada Health Act. I compliment my colleagues for the initiative.
However, I want to address today the difficulty of reconciling the proposed amendment with the fundamental purpose and the intent of the Canada Health Act.
Let me say at the outset that I, and I think all other members of my party, are sympathetic to the concerns raised in the bill. Although the promotion of better nutrition is important, unfortunately the Canada Health Act, in my opinion, is the wrong instrument to achieve this objective. I hope to illustrate that over the course of this intervention.
The Canada Health Act sets out the broad principles under which provincial plans are expected to operate. The act establishes certain criteria that provincial plans must meet in order to qualify for their full share of the federal health care transfer payments. Federal transfer payments may be reduced or withheld if a province does not meet the criteria and the conditions of the act.
These critera are the cornerstones of Canada's health care system. They are: reasonable access to medically required services, unimpeded by charges at point of service or other barriers; second, comprehensive coverage for medically required services; third, universality of insured coverage for all provincial residents on equal terms and conditions; fourth, portability of benefits within Canada and abroad; and finally, public administration of the health insurance plan on a non-profit basis.
In addition to the above criteria, the conditions of the act require that the provinces provide information as required by the federal minister and that they also give appropriate recognition to federal contributions toward health care services in order to qualify for federal cash contributions.
The act also discourages the application of extra billing or user charges through the automatic dollar for dollar reductions or withholding of federal cash contributions to a province or territory which permits such direct charges to patients. In fact, the threat that user charges and extra billing would erode accessibility to needed medical care was a major impetus in the development of the act.
The Canada Health Act was enacted to protect the fundamental principles of our publicly financed, comprehensive, portable, universally accessible health insurance system. I think everybody in this House would agree that these are laudable objections.
Our system of national health insurance, or medicare, as it is popularly known, is close to the hearts of Canadians and something too precious to tamper with for no valid reason.
Canadians support the five principles and feel that medicare is a defining feature of Canada. Time and time again, polls demonstrate high public support for medicare.
The amendments presented by my hon. colleague and friend, if adopted, would affect the definition of insured services under the act.
In short, this means that if Bill C-202 is passed by this House the provinces and territories would be required to provide on an insured basis to all of their residents nutrition services. This is not the purpose of the Canada Health Act.
The purpose of the Canada Health Act is to ensure that Canadians have access to medically necessary hospital and physician services without financial or other impediments. Moreover, Canada Health Act principles deal with the organization and delivery of health care services on the level of provincial and territorial plans.
The addition of nutrition services to section 2 of the act would be intrusive and interfere with the provincial-territorial responsibility for health services management.
Clearly the Canada Health Act is not the proper place to regulate matters such as nutrition services which properly fall under provincial jurisdiction and are better handled at this level. Even if the Canada Health Act were the appropriate place for such a provision it would probably not achieve its objective.
The act places conditions on payments to the provinces and territories and can reduce or withhold transfers if these are not met. It cannot dictate to a province or territory how to run its health care plan much less its institutions.
The federal government recognizes that provinces and territories have the primary responsibility for the organization and delivery of health care services and that they require sufficient flexibility to operate and administer their health care insurance plans in accordance with their specific needs and institutions.
This is why the flexibility inherent in the Canada Health Act has always been one of its strengths. Since the enactment of the Act in 1984, the federal government has always attempted to work with the provinces in order to make the act a viable piece of legislation. It could be dangerous to tamper with the provisions of the Act when they have received such wholehearted support.
If we want medicare to survive, we must be vigilant against blatant threats such as user charges.
I want to come back to the point that while nutrition is a serious concern the Canada Health Act is not the appropriate place in which to address this issue. As it stands now the Canada Health Act does not require that the services of nutritionists be provided on an insured basis. It does not forbid provinces and territories from providing coverage for these services as well.
For the federal government the decision to provide nutrition services as part of a package of insured health services should be left to the provinces and to the territories. This does not mean that the federal government has no interest in the nutrition issue. Quite the contrary. The federal Department of Health has always been involved in the promotion of good nutrition in Canada.
In 1992 Health Canada released Canada's food guide to healthy eating. The guide provides Canadians with information on establishing healthy eating patterns through the daily selection of foods. To date, and this will be of interest to colleagues in the House, over 21 million copies of the guide materials have been distributed. That means that every man, woman and child capable of reading in this country has a copy in his or her possession potentially.
The food guide then is currently serving as the basis for a wide variety of nutrition initiatives across Canada implemented by a broad range of partners including provincial, territorial and municipal governments as well as non-governmental organizations, consumer groups, the private sector and school boards.
The most recent national population health survey shows that more and more Canadians are taking steps to improve the quality of their nutrition. This is encouraging. I believe that it is important that we continue to support the efforts that promote the importance of good nutrition.
The proposal put forward by my hon. colleague and friend is very commendable.
However, it is in my opinion problematic in that it raises the problems I have outlined. That is why I cannot support the bill, regrettably.
Normally I would speak for much longer, but I see that my colleague wants to address the issue even further. Therefore I will relinquish my position now.