Debates of Dec. 3rd, 1997

User Fee Act

[Monte Solberg, Reform, Medicine Hat, AB]

Yes, Madam Speaker. I certainly would like to wrap up.

I will address some of the issues that my friends across the way have raised with respect to Bill C-205 and their objections. It has been suggested that because the bill is broad in scope and that it would cover all kinds of agencies and crown corporations that it would make it extraordinarily difficult for the committees to be able to handle all of these things.

I think hon. members across the way are simply raising bogeymen. The fact is that 90% of these user fees would probably pass through largely unopposed and would be run of the mill decisions essentially rubber stamped. However, there are the 10% that Canadians have raised concerns about. In fact, hon. members across the way will remember very well the huge debate that we had in this country when the government brought in a user fee which was the immigration head tax. That is something that deserves parliamentary scrutiny. It is something that we need to have a discussion about before it is actually implemented.

Sadly, that is the sort of thing that we do not get under the current government.

In the Liberal's election campaign in 1993, I am sure hon. members across the way ran around with the red book. One of the things contained in that red book was how the government was going to empower committees. This would actually give committees something meaningful to do. It would actually allow them to give people some representation effectively when the government is proposing to tax them.

This would probably draw more attention to committees. There is no doubt about that. It would in fact attract people to come and lobby. There is no doubt about that and that is probably good. There will be people lobbying on both sides. It would allow a transparent process so that we could actually have the public allowed to see what is going on with respect to the increases in user fees.

I want to back that up by pointing out what the auditor general said in his 1993 report. He said: “Is the establishment of fees by order less open to abuse? If the regulatory process is followed there is a degree of transparency in how a price is established. If fees are established by contracts the process could be subject unduly to political and administrative considerations.”

In other words essentially what the auditor general is saying is that under the current situation where the bureaucracy can effectively contract with those people who use government services and set fees arbitrarily, it is open to political and administrative considerations.

We do not want that type of system in Canada at the end of the 20th century. That is something that belongs in a third world. That opens ourselves up to corruption and those sorts of practices. We do not want to have that in our country. That is why I am arguing strongly so the government can follow through on its election commitments to open up committees, to make them more powerful, to do things that are quite meaningful to people. This would be a wonderful opportunity for the government to do that.

I just want to emphasize again, because this was an objection raised by both speakers on the Liberal side, that 90% of these user fees would never run into opposition from people on the committee. People are not going to argue about the price of firewood if it looks reasonable. If all of a sudden it jumps by half or 100%, people may start to object. That is probably good.

We need to have that kind of mechanism in committee. We do not have it in the House of Commons. We need to have it at least in committee then ultimately in the House of Commons. Right now those things are allowed to go on unabated and Canadians are paying for these things directly from their pockets.

The hon. member across the way sent me a note saying “I thought the Reform Party supports user fees”. We do not have a problem with user fees. We agree with user fees. To us it makes sense that people who use particular services would pay for them and not the general public. What I would think would happen in a situation where everything was working correctly, as the users fees go up the general tax level should go down. That has not happened. Taxes have gone up too. That makes our businesses uncompetitive because they pay higher tax rates and they also pay these user fees.

For all of those reasons and many more I urge my friends across the way to reconsider their objections and work with me to ensure that the people at public accounts do actually start to implement some of the recommendations in Bill C-205.

[The Acting Speaker (Ms. Thibeault)]

Since no other members wish to speak and the motion was not selected as a votable item, the period allocated for the consideration of Private Members' Business has now expired and the item is dropped from the Order Paper.

Business Of The House

[Don Boudria, Liberal, Leader of the Government in the House of Commons]

Madam Speaker, if you were to seek it, I believe that you would find unanimous consent for the following motion:

That, notwithstanding any standing order or usual procedure, during the present sitting the House may receive a message concerning a royal assent and attend a royal assent after proceedings pursuant to Standing Order 38 have commenced, provided that, if the House has not attended a royal assent by the conclusion of the said proceedings, it shall not adjourn, but the sitting shall be suspended and shall be resumed for the sole purpose of a royal assent and provided that immediately after a royal assent or, if the Speaker receives information that no royal assent is to be granted this day, for the sole purpose of adjourning to the next sitting day.

A note of explanation. This is to suspend the House until we receive royal assent on Bill C-24 regarding Canada Post, after which of course the House will be adjourned.

Meanwhile, the House I believe would also consent to proceeding with what is normally considered the adjournment debate, although technically of course we will not be adjourned so that members can have the benefit of having the adjournment debate now.

I believe you would find unanimous consent for that unusual practice as well, if the House is willing to consent to that which I have just stated.

[The Acting Speaker (Ms. Thibeault)]

Does the hon. member have the unanimous consent of the House?

[Some hon. members]

Agreed.

(Motion agreed to)

A motion to adjourn the House under Standing Order 38 deemed to have been moved

[Gordon Earle, NDP, Halifax West, NS]

Madam Speaker, on October 7 I questioned the Minister of Health regarding concrete action the government needs to take to address the dramatic situation of aboriginal health as highlighted by a recent report from the auditor general.

Health is a matter of great concern for all Canadians. As Tom Irons, fourth vice-chief of the Federation of Saskatchewan Indian Nations, stated: “I firmly believe that no other issue so fundamentally relates to the survival of our people than health”.

The 1996 report of the Royal Commission on Aboriginal Peoples refers to the health status of aboriginal people as both a tragedy and a crisis. Health Canada statistics illustrate the extent of this tragedy.

Infant mortality for first nations is 1.7 times higher than the Canadian average. Life expectancy is seven to eight years lower on reserves than anywhere else in Canada. Infectious diseases like tuberculosis are 6.6 times more common among aboriginal peoples. The suicide rate among young people is up to eight times higher than the Canadian average.

These numbers are just the tip of the iceberg. Health and social conditions in aboriginal communities are disastrous and clearly unacceptable under Canadian standards.

The auditor general's report talks of abuses of prescription drugs having caused high dependency and even death among some aboriginal people. We may add to this list the ongoing lack of resources and medical staff in remote communities.

What is our government's response to this crisis? We hear a lot of words, talk of partnership and new programs, but little action. If aboriginal health is a matter of concern for this government, maybe the minister could explain why the federal government is reducing its budget allocation to health services on reserves.

The June 1997 expenditure plan from Health Canada shows a reduction of 2.9% of direct spending on aboriginal health programs between 1995 and 1996. Is the government hoping to improve the situation by reducing already scarce resources? As the auditor general rightly points out, it is necessary to establish a closer relationship between the government and aboriginal administrations in order to put forward solutions that address the specific realities of each community.

Aboriginal peoples have shown great energy and imagination in tackling health and social problems. Projects linking traditional healing practices and medical services have often proven very successful. Collaboration and partnership based on action between governments and aboriginal peoples is the first step toward addressing the dramatic situation in many aboriginal communities.

As the royal commission stated in its final report, this situation is the result of years of abuses and of paternalistic attitude that seriously damaged aboriginal self-esteem and sense of belonging, but transferring programs must not be done in a dump and run style so often employed by this government. It must be done in true collaboration with aboriginal communities to ensure that programs transferred are actually going to improve the health of aboriginal peoples.

Empowering the people involved is an essential step toward healing and creating conditions for a better future. I thus strongly urge the government to act on this and closely examine the royal commission and the auditor general recommendations regarding aboriginal health.

[Ovid Jackson, Liberal, Parliamentary Secretary to President of the Treasury Board]

Madam Speaker, it is my pleasure to respond on behalf of the Minister of Health to the member for Halifax West.

I wish to address the concerns which have been raised in the House over the findings of the auditor general's report concerning the delivery of health care services for first nations.

The auditor general says that some first nations people are concerned that Health Canada is taking a dump and run attitude in the transfer of health care programs to first nations.

I assure the House that the transfer initiatives are launched as a response to communities that are ready to assume greater responsibility for health care resources.

It is a process that responds to first nations and will occur at a time and pace of their choosing. There is no pressure on communities to take up the transfer.

Concerns have also been raised in the House over the auditor general's findings with regard to prescription drug misuse among Canadian first nations and the slowness of Health Canada to respond to this problem, which the auditor general says the department has known about for 10 years.

Let me assure the hon. member that for the past 10 years Health Canada has been working to address the problem. The department has installed a comprehensive claim processing system across the country which deals with six million drug claims per year. It ensures that eligible clients receive drug benefits. By the end of the year the department will have installed a point of sale system in all pharmacies that will alert pharmacists to real problems such as harmful drug interaction and patterns that suggests misuse before the client has been given the drug.

In his report the auditor general agrees that this will address many of the problems of prescription drug misuse. In addition, a drug utilization review report has been developed which allows Health Canada to identify potential abuse situations for physicians, pharmacists and clients.

This system ensures that those involved can be alerted and appropriate follow-up action initiated to address situations where abuse is identified. I assure the member—

[The Acting Speaker (Ms. Thibeault)]

The hon. member for Dartmouth.

[Wendy Lill, NDP, Dartmouth, NS]

Madam Speaker, today is International Day of Disabled Persons. I would like to revisit the issue I brought to the attention of the House on October 28, on the first anniversary of a federal task force report on persons with disabilities, and that is the growing desperation of the disabled.

I will start by setting the stage for the task force. It was set up after the Minister of Finance eliminated the Canada Assistance Plan and instituted the CHST, no strings attached money to the provinces where health care, education and social services would all be fighting for the same dollars.

The Minister of Human Resources Development stated that he was planning to end federal responsibilities to the disabled and the families caring for them.

In the grand scheme of downloading and devolving, people with disabilities and the families caring for them, my own family included, were facing an anxious and uncertain future in this new world order: reduced resources, reduced protection, and reduced commitment in the areas of health care, education and social services.

The task force held out a ray of hope for all of us that the rights of the disabled would finally be dealt with by the federal government. The task force called for a Canadians with disabilities act. It recommended earmarked funds in existing programs, tax reforms and refundable tax credits. It urged the government to address the extra costs of living with disabilities.

The task force led people to believe that the very real issues of training, education and labour, the life issues of the disabled, would finally be dealt with. One year after it was tabled and where are we? The Liberals have only implemented 8 of the 52 recommendations, and I must say they were the easy ones.

Persons with disabilities and their services are under attack more than ever. The federal government is trying to ram through changes to the Canada Pension Plan Act, which will have the impact of cutting $1 billion in spending on CPP disability pensions by the year 2005. Disabled widows and widowers will have their combined survivor disability pension benefits reduced. Disability pensions will be harder to get and worth less.

Now with the CHST and cash strapped provinces having the discretion to spend money as they want, services to the disabled are dropping like flies. In the nation's capital there are two accessible taxis available on 24 hours notice. The para-transit service has been cut in half, and it was underfunded to begin with.

How are people supposed to go to work or to the doctor? How are they to visit their mothers? Attendant care is being slashed. People have to fight for the right to have a bath once a week. It is a farce to say that persons with disabilities have the same rights when supports are being withdrawn for them to participate at the most basic level.

What about protection under the law? With the sentence handed down this week on the murder of Tracy Latimer, the disabled believe they were sent an even stronger message, that their lives were somehow not worth as much as others. Tracy Latimer was disabled and she is now no longer with us.

It is time that we all took a very close look at the conditions facing the disabled in Canada. It is time the federal government finally acted on the recommendations of its task force.

On behalf of the disabled I urge the government to appoint a minister responsible for persons with disabilities and to introduce a persons with disabilities act. It is time to safeguard the quality of life for our most vulnerable citizens. Some 4.2 million disabled Canadians and their families are waiting and hoping that these issues will finally be addressed.

[Ovid Jackson, Liberal, Parliamentary Secretary to President of the Treasury Board]

Madam Speaker, I am pleased to speak on the subject of national pharmacare.

I would like to inform the House about the government's plans with respect to a national pharmacare program. The National Forum on Health pointed out that Canadians were fortunate to have a world class health care system. Medicare, as we know it, gives universal access to medically necessary hospital services without financial barriers. This system has served us well over the last number of years both in terms of the health of the population and the competitiveness of the Canadian economy.

The national forum told us that we should preserve what we have. It also told us that in order to preserve it we should consider doing a number of things. One of those things was expanding medicare to include other medically necessary services such as home care and drugs.

The federal government intends to pursue the examination of the future directions recommended by the national health forum to serve Canadians. As outlined in the speech from the throne on home care we said that we would take measures to support Canadians by responding to the expanding needs for home care and community care. We will develop a national plan, timetable and fiscal framework for providing Canadians with better access to medically necessary drugs.

This means the federal government recognizes that our country would be better served with an ideal pharmacare and drug system. We can do better with respect to the services provided. We can do better with respect to the use of prescription drugs, compliance and prescribing. We can do better with respect to integrating the health care system and allocating resources among drug therapy, hospital therapy and medical therapy.

Medically necessary prescription medicines are a vital element of health care. They are of relative importance compared with other elements of health care.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Madam Speaker, I questioned the Minister of Health on October 1 with regard to the promise on pharmacare in the Liberal red book.

In the question to the Minister of Health I alluded to the election campaign and the promise to introduce a pharmacare program for all Canadians. I proceeded to quote from the red book two and I will quote now from page 75 of the Liberal election platform:

We will work with our provincial partners to ensure that all Canadians have access to medically necessary drugs within the public health care system. The federal government has a role to play in bringing together provincial and territorial partners and a range of other interests to develop a national plan and timetable for introducing prescription drugs into the medicare system.

I guess the only response the minister could make was that he would consult with his provincial counterparts. That is not good enough. I contend it was an election promise simply for the purpose of getting elected. The minister and the Liberal government had no idea of how to implement such a program. I have lots of evidence to back me up on this, that it was nothing more than election rhetoric. The cost of doing so is astronomical, is well beyond the present government's ability to pay.

Presently in Canada we spend $10.8 billion annually on drugs. Out of that $10.8 billion about $5 billion is for prescription drugs. So the question is, how will the government come up with $5 billion, knowing full well that there are financial restraints on the government.

It did not stop there. When the present minister was first appointed to cabinet in his new role as health minister, I guess he could not resist the idea of going back at it. I quote from the Ottawa Citizen of June 12 which states: “Canada's new health minister promised yesterday to preserve medicare and perhaps even expand it with universal pharmacare and home care programs”. That was long before he had the opportunity to realize what he had said and what he would have to do, again because of the cost.

The Minister of Health has found out and he comes back to it in every single answer in the House with regard to the pharmacare program that he has to consult with the provinces. Indeed he would have to consult with the provinces because there is a hodge-podge of programs across this country provincially with regard to pharmacare and none of them are the same. In other words we have 10 provinces and every one of them has a different policy with regard to pharmacare. Some provinces have a very good system of pharmacare for seniors and some provinces do not. Some provinces have a pharmacare program for people below a certain level of income.

The point I am making is that the minister and the government had no idea what they were promising in 1997 with regard to the pharmacare program.

[Ovid Jackson, Liberal, Parliamentary Secretary to President of the Treasury Board]

Madam Speaker, medically necessary prescription medicines are a vital element of Canada's health care system. They have increased in relative importance compared to other health care sectors. Look at what we can accomplish today with drugs that before had to be dealt with through surgery or worse yet, had no treatment available. I am thinking here of the advances we have made in substantially reducing the need for ulcer surgery and the advances we have made in treating mental illness.

It is time for us to start talking about how we are going to ensure that Canadians will have access to health care. We are now just beginning this dialogue.

The federal government does not have a ready made national pharmacare program cooked up in Ottawa's back rooms. The Canadian health care system is a partnership and the federal government will be exploring a national approach to pharmacare in true collaboration with the provinces and territories. A new federal-provincial-territorial working group is beginning a process. Stakeholders must also be involved in the dialogue.

As part of the new health transition fund, $150 million over three years was announced in the last budget, the Minister of Health will be co-hosting a national conference on pharmacare with the Minister of Health for Saskatchewan. This will be an important step in our discussions on a national approach to pharmacare.

The development of a national approach to pharmacare will be collaborative. It will not happen overnight. It will not be done by the federal government alone. It is must be done—

[The Acting Speaker (Ms. Thibeault)]

The hon. member for Waterloo—Wellington.

[Lynn Myers, Liberal, Waterloo—Wellington, ON]

Madam Speaker, I was somewhat surprised recently when United States President Bill Clinton was unsuccessful in getting backing from Congress to give him a so-called fast track authority to negotiate expansion of the North American Free Trade Agreement. I wondered where that left Canada.

The federal government worked tremendously hard to ensure that the Canadian economy continues to have solid foundations.

Accordingly, I believe that Canada must be diligent in ensuring that we follow our own agenda to further trade liberalization in the Americas. There is tremendous trade potential in this hemisphere for Canada. It is important that with the global economy becoming more and more interconnected that we do not watch from the sidelines.

Rather, we need to pursue with vigour trade agreements and investment co-operation agreements which will be beneficial to Canada and to all Canadians.

Will the parliamentary secretary outline precisely what Canada intends to do to continue to seek trade agreements with countries in our hemisphere?

[Julian Reed, Liberal, Parliamentary Secretary to Minister for International Trade]

Madam Speaker, while we are naturally very disappointed in this recent development, I assure the House it is not going to slow us down one minute. We will continue to pursue our trade liberalization agenda in Latin America with or without a fast track in place in the U.S.

By the year 2000 this area will have a population of nearly 500 million and a gross domestic product of $2 trillion. Canadian business representatives are bullish on the region.

The achievement of more open markets through the free trade area of the Americans, as we call it now the FTAA, remains a top priority. Fast track is not a technical requirement for the negotiations to begin. It is, however, a signal of U.S. commitment that many FTAA countries are looking for.

We understand that the U.S. administration intends to resume its effort to obtain approval for fast track in the new year. We hope for a successful result in time for the Santiago meeting.

Complementing the FTAA, Canada is also proceeding with our trade dialogue with the Mercosur group of countries, Argentina, Brazil, Paraguay and Uruguay. Canada's annual exports to this market are about $1.5 billion and Canadian investment there has reached $6 billion. We hope to put in place a framework for our trade and investment relations with Mercosur during the upcoming Team Canada visit to the region.

In January, as my hon. friend knows, the prime minister will lead a Team Canada mission to Mexico, Brazil, Argentina and Chile. These three initiatives are aimed at expanding the links Canada has already established with key partners in our region.

[The Acting Speaker (Ms. Thibeault)]

Pursuant to order made earlier, the motion to adjourn the House is deemed withdrawn and the sitting is suspended to the call of the Chair.

(The sitting of the House was suspended at 7.03 p.m.)

The House resumed at 10.15 p.m.

Message From The Senate

[The Deputy Speaker]

I have the honour to inform the House that a message has been received from the Senate informing this House that the Senate has passed the following bill: Bill C-24, an act to provide for the resumption and continuation of postal services.

A message was delivered by the Usher of the Black Rod as follows:

Mr. Speaker, The Honourable Deputy to the Governor General desires the immediate attendance of his honourable House in the chamber of the honourable the Senate.

Accordingly, the Speaker with the House went up to the Senate chamber.

And being returned:

[The Deputy Speaker]

I have the honour to inform the House that when the House went up to the Senate chamber the Deputy Governor General was pleased to give, in Her Majesty's name, the royal assent to the following bill:

Bill C-24, an act to provide for the resumption and continuation of postal services—Chapter No. 34.

[The Deputy Speaker]

Pursuant to order made earlier this day, the motion to adjourn the House is now deemed to have been adopted. Accordingly, this House stands adjourned until tomorrow at 10 a.m., pursuant to Standing Order 24(1).

(The House adjourned at 10.27 p.m.)