Debates of Nov. 19th, 1998

Privilege

[The Acting Speaker (Ms. Thibeault)]

There being no other comments on this question of privilege, the Chair will take all comments under consideration and get back to the House.

The House resumed consideration of the motion; and of the amendment.

Supply

[Grant Hill, Reform, Macleod, AB]

Madam Speaker, for those watching TV today the Bloc has put forth a motion. This motion is one where the Bloc directs the debate and is asking for some money to be put back into the health care system.

This is a fascinating debate because how often do we see the provinces in Canada united. Every province in Canada is calling for some funds to go back into our health care system. They have basically said that unilateral federal actions are unacceptable. They have also made a unified call to reverse medicare cuts.

It is very difficult to get unanimity even in one party. I note that there are individuals from a host of parties who have joined in this call.

Why have they in fact united in this way? I will try to be absolutely non-partisan in my comments by suggesting that health is important individually for each of us. Nothing has more import for our loved ones. Ill patients do not care how, when, what or where the funds come from for their care. They simply want good and timely access to cost effective care when they need it. They are quite annoyed by jurisdictional or party arguments on this subject.

Why has the public expressed this degree of concern on health? While I have been a member of the federal government the public has watched funding drop from $18.7 billion to $11.1 billion. According to my math that is $7.6 billion in cash that was designed to go to the provinces for health care. I call that the free fall of funding.

I listened to a couple of colleagues on the other side of the House say that there has been a reinvestment in medicare. I would like everyone to know what that reinvestment means. It means that in the free fall of funding it did not go to $11.1 billion. The government pulled the rip cord and just before we slammed into the roof top it stopped the funding reduction at $12.5 billion.

A young student in elementary school would be able to calculate that we did not drop down quite as far as we were intending to go. We stopped at $12.5 billion and that is not an increase in funding to medicare. That is pulling the rip cord before medicare is finished.

Some other things have happened during my tenure in the House. I came here in 1993. I left my surgical practice to try to bring my viewpoint to the medicare debate. We have lost 1,400 trained Canadian physicians in the last two years to other jurisdictions. We paid for, we looked after and gave them all the advantages, and they chose to leave this country. They are lost to us.

During that same time span we dropped from number two in the world when it comes to spending on health to number five. Waiting lists, which were really quite small in 1993, have grown until we now have at any one time in Canada around 190,000 people waiting in pain. The drop in public spending is 3.1%. We are talking about billions of dollars.

Interestingly enough, in terms of confidence of the Canadian public in our health care system in 1993—and this question has been asked for years—55% of Canadians rated health care as excellent to good. Asked the very same question with the very same words today in 1998 and 29% of Canadians are willing to say that our system is excellent to good. We certainly have a change in the confidence level of the public.

It is instructive to talk about individuals. I get a lot of individual stories about people who are concerned. Today I will tell two stories.

The first story is about a fellow from Saskatchewan who contacted me two weeks ago. He had been healthy all his life. He is in his mid-fifties. He was diagnosed with a sore on the back of his tongue. It was biopsied and came back as cancerous. It luckily did not spread. He went to the nearest big centre in Saskatchewan and because it was a severe problem he was referred immediately to a surgeon. Canadian health care still does pretty well on major issues like this in terms of immediacy.

The surgeon said he needed a radical neck dissection, a dissection of all the nodes in his neck. He wanted someone with some experience in the area because it was major surgery. He was told that he would lose his voice, that he would need a feeding tube and that he would probably never be able to swallow again. The surgeon he had been referred to said that he did about one of these operations a year. The man felt he would like to have someone with more experience than that. He found there was no one available to him in a reasonable time span. He was told he needed to have the surgery within six weeks.

During the six weeks he tried to find someone in other provinces. He tried to find someone in Ontario but was unable to do so. There was no one available to him in British Columbia. He heard there was a surgeon who could do this surgery in the U.S. at the Mayo clinic, so he went there. He said that he was not a wealthy man or guy with a lot of resources but that he valued his life more than anything. He found a surgeon who did about 30 of these operations a year, almost one a week. The surgeon, who was vastly experienced, said that he would not have to remove his voice box or put him on a feeding tube. He told the man he was pretty sure he could get him fixed without those terrible side effects.

The man came immediately back home and said that his system said we would be looked after here but that it did not look as if he could be looked after here. He was asking to go elsewhere and wanted health care to look after him if he went to the Mayo clinic. The answer was no, that he would need to have surgery in Canada. He chose to go to the Mayo clinic with his own resources. He spent a huge amount of family money that could best go elsewhere.

He had successful surgery at the Mayo clinic. I am very thankful for that. He can still talk. He is not on a feeding tube. He is able to swallow and he is back home. To my mind the fellow was let down by our health care system in terms of the waiting list he would have to go through at home. Having to go elsewhere out of the country says to me that the system is not acceptable for this man.

I will now talk about a fellow from Ottawa who visited me last week. This gentleman is a little older than the first man I mentioned and is diabetic. He had something that sounded much less serious. He had an infection in his toe. Diabetics lose some of the blood supply to their feet and are susceptible in that way.

In May he went to the diabetic foot clinic in Ottawa. He was told there was not enough space in the foot clinic and that he would have to go to a private clinic where there were significant costs. He could not afford that so he was told to take antibiotics and that he would be able go to the public clinic in October. By the time October came around he had very nearly lost his toe from a simple infection. He treated his toe with an antibiotic which made no difference and he felt he had to wait.

That relatively minor problem could have literally become serious. He should have been able to see somebody sooner but he was turned away. He was probably too shy to know that he should have gone back to his family physician.

On one hand there was a fellow with a very serious problem who was able to see a specialist but could not get treatment. On the other hand was a fellow with a relatively minor problem but with such a long wait the problem could have been much worse.

Because health is so important I cannot imagine why we would not simply say let us look at any solution. Really that is what I would hope the government will do.

If there are extra funds available is there any room now to put some of those funds into health care? In that way I listen very carefully to the government in response.

Opposition parties criticize and look for faults but on this topic we should not just do that. We should be constructive. We should be looking for solutions.

So what I tried to ask is who is calling for some more health money other than politicians who are always looking for an advantage. I picked up a few who are asking for exactly what the politicians are calling for. Maybe they have more credibility than politicians.

I looked at the nurses association of Canada. I am holding up a document that names virtually every health group in Canada. They are all biased too, we might say. They are trying to look after their own interests, trying to put more loot into the old pocket. All those nurses are just looking after their jobs.

Okay, so we will set aside those individuals but what is the public asking for? What do the patients want? I go back to my statement that they really just want timely care and they do not really want arguments about where that timely care comes from.

The public does for sure want a small government doing a few things well. The public does want wasteful spending weeded out. Because I said I would not be partisan I am saying these things as broad principles.

Does the public want forgiveness of other countries' debt when we have some shortfalls in health? I do not think so. Does the public want long waits for substandard services? I do not think so. But it wants co-operative federalism especially in health. It wants a dispute settling mechanism if there is disagreement. If the federal government says one thing and the provinces say another, the public would like to have a neutral dispute settlement mechanism. That is fair. All provinces are calling for that.

I suggest that Canada works best with co-operation. Medicare works best with co-operation. My plea today as somebody who did surgery, somebody who dealt with patients directly, is for us to think of the patients. My plea is to think of the sickness. My plea is to stop thinking of jurisdiction or political party or ideology. When the patient is happy and well Canada will be happy and well.

[Bonnie Brown, Liberal, Parliamentary Secretary to Minister of Human Resources Development]

Madam Speaker, I am very pleased to have this opportunity to address today's opposition motion concerning the Canada health and social transfer.

There is no doubt that health care is a matter of very high priority for Canadians. It is an essential thread in our national fabric, a source of pride and security for Canadians from coast to coast, in every region, province and municipality. It is truly a unifying force, one that highlights the Canadian commitment to mutual support and the one that distinguishes us dramatically from our huge neighbour to the south. As such, it is always an issue that deserves the full attention of the House and I thank the hon. member of the Bloc for proposing an immediate $2 billion increase in provincial transfers provided under the CHST.

There is no doubt that the long term security of Canada's health care system is a timely and relevant subject for debate. However, I must caution the hon. member that the motion he has brought before us today may actually do more to obscure or misdirect this important debate than to advance it. How does this motion obscure the debate? The answer to this question lies in the assumptions on which this motion and the opposition rhetoric around it are based.

First of all, we must remember that the fact that health care is a major priority of Canadians, even the major priority, does not mean it is their only priority.

I am sure that most of my hon. colleagues have received the same volume of public input as I have on the issue of lowering taxes. This, too, is of importance and the finance minister has made clear our commitment to ongoing tax reduction.

What about employment insurance premiums? Across Canada labour and employer groups have targeted EI reductions as a critical step in encouraging business growth and new jobs. In other words, they see employment insurance premium reduction as a priority.

There is another fundamental priority that Canadians have made clear in two federal elections. That is the continuing necessity to good financial management of and by the government itself. I see few if any voices saying that increased spending is more important than maintaining a balanced budget. Most Canadians remember too well the price we pay for relying on deficit spending, higher interest rates, lower economic growth and jobs lost. To them a key priority will be to avoid getting back into that vicious cycle.

The issue of priorities is neither simple nor self-evident and any debate that attempts to focus on a single need in isolation risks becoming simplistic and self-serving.

Let me again emphasize something said by all my government colleagues. We are committed to boosting support for health care but we will not do so through knee-jerk decisions that ignore the fiscal reality, the world environment and the proper role of government.

This was something the finance minister addressed in his October economic update before the House finance committee. He pointed out that our work as a government reflects a basic recognition of a vital fact, that the days of governments trying to be everything to everyone at any cost were over and that the need to have clear priorities to realize where government could make a difference and where it could not was essential. These are principles that must govern all policy making and debates such as this one today in the House.

Again let me remind my colleagues of what the finance minister said in his update. Given the volatile condition of many parts of the world economy, we are in a situation that calls for great care and caution and we must be realistic about the resources at our disposal. Today some seem to believe we have mountains of money to spend. We do not. They seem to feel we are now in a position where we do not have to continue to make careful choices. We do.

The minister pointed out what has happened to the average forecast of economic growth by private sector experts since only the beginning of this year. In January they were estimating nominal income growth of 4.7% for 1998. That has now been revised downward to 3%. For 1999 they were projecting 4.9% growth. That too is down to 3.5%.

What do these revisions mean for the size of the dividend as projected by the private sector? The answer is those projections would knock over $5 billion out of government revenues in 1999-2000.

Only a few months ago these forecasters were estimating a 1999-2000 surplus before any new budget actions of around $10 billion. The recent downward revisions would lower their estimates to around $5 billion, or $2 billion once the $3 billion contingency reserve we are committed to is subtracted.

At the time of our last budget many criticized us for being too prudent, too cautious, and we are receiving the same criticism in today's debate when we are attacked for not moving to immediately to increase CHST transfers. But the dramatic downward revision in private sector forecasts illustrates more clearly than anything why this government must stick to its careful approach to budget planning and why we simply cannot afford the risks associated with changing planning assumptions so drastically month by month.

This is not academic, some arcane point from economic theory. Consider the result if we had followed the advice of some not so long ago to take $9 billion to $10 billion worth of tax action, action they claimed we could afford.

We would now be heading for a substantial deficit.

Further, while we have noted that the downward revision to economic forecasts could lower the private sector estimate of the dividend to $2 billion once the contingency reserve is taken out, with all the uncertainty that exists worldwide it may well be that further downward revisions will occur.

In any event, it is clear the dividend in the next two years will be modest, much less than would be required to provide sufficient funding for the size of initiatives, on taxes and spending, that many are calling for. Clearly, careful choice in allocating that dividend will be required.

In his appearance before the finance committee, the minister said some would throw caution to the wind, saying maybe we will have the money. Maybe the dividend will be larger than we think, that it is worth the risk to cross our fingers and pray that things will turn out that way. In other words, it is time now, acceptable now, to set aside the careful and cautious approach we have been following.

He said “In my opinion that is the financial equivalent of reckless driving. You may not have an accident, but if you do you not only hurt yourself but you can sideswipe a lot of innocent people. The very reason we have met our targets, the very reason we are now able to say that despite the global economic crisis we are still on track not only to balance the books but to have a dividend, all of this is anchored in the caution we have applied from the very beginning”.

Clearly the finance minister was anticipating challenges such as today's opposition motion on the CHST. I think his explanation of why we must be cautious was right on.

The update also provided Canadians with a telling example of the type of spending dilemma we could develop if we only looked at single issues, health or taxes or debt, in isolation.

For example, some are saying we should implement a major personal income tax cut of an average of $600 annually per taxpayer. That would cost about $9 billion per year, not just this year but every year.

Some are demanding employment insurance premiums be reduced to the so-called break even level. That could cost more than $6 billion per year.

The provinces are asking that cash transfers be increased. Their proposal would cost another $6 billion per year, not just next year but every year.

Still others are saying we should mount a larger attack on the debt. That could cost, for example, another $3 billion per year.

If all that is added up, the total bill is $24 billion each and every year, and that is a long way from a complete inventory of the demands being made.

Adding up all the proposals would very clearly put the country back into a situation of serious chronic deficits, and I for one am not willing to go back to that country full of deficit and pain for Canadians.

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

Madam Speaker, I would not miss this opportunity to ask a few questions to the hon. member who, I think, belongs to the progressive wing of the Liberal Party. It is surely not by accident that she is parliamentary secretary to the Minister of Human Resources Development.

But there is what I would call a gap. I can hardly understand the hon. member's position, not because I did not listen to her speech, not because I am insensitive, but because I think there is a basic contradiction.

To begin with, when we were young—and of course we still are—and we were learning about federalism, we were told it was a political system characterized by two levels of government, both being independent. Thus, the situation is at the very least confusing.

Given the actual state of federalism in Canada, it is possible for the federal government to completely destabilize the finances of the provinces.

The issue here is the fact that they are cutting $42 billion unilaterally, without any consultation, in a totally cavalier fashion that is almost insulting, if not downright indecent.

If officials from finance, or human resources development, or other departments were here today, they would have to agree with the Bloc Quebecois's conclusion that, since the Liberals came to power, their budgets have taken $42 billion from the provinces.

This is serious and dangerous. I think it is almost unconstitutional. What this means is that because the government shamelessly deprived the provinces of funds they had budgeted and anticipated, that they expected to find in their own budget, we are now left in a position that generated poverty and where the Government of Quebec, for instance, found itself unable to deliver all the services it could have.

Of course, one must admit—and I think my colleagues will agree—that the Government of Quebec was nothing short of extraordinary in managing the province's affairs. Deep down, you are probably thinking of the $5 day care program and the tuition freeze. But had it not been for the Quebec government's unfailing determination, it could not have avoided major impending difficulties.

What would be really interesting today would be for all the premiers to endorse the consensus reached in Saskatoon. I see my colleague, the Minister of Human Resources Development, nodding in agreement. I hope he will be able to convince his cabinet colleagues. Usually, they listen to him very carefully. I am even told he sits quite close to the heritage minister.

That leads us to ask ourselves if we can expect the government party, backbenchers as well as ministers, to endorse today the consensus reached in Saskatoon. This consensus means that the government would immediately be prepared to authorize the Minister of Human Resources Development to transfer $2 billion to the provinces, because this amounts to the loss of revenues in the health transfer.

[Bonnie Brown, Liberal, Oakville, ON]

Madam Speaker, I thank my colleague across the way for his compliment in thinking I am part of the progressive wing in this House, a wing that I think he also belongs to. He and I have discussed many issues and we often agree.

In answer to his questions, he was talking about the cutting that was done by the federal government. I think it is fair to say that if it was painful to him, it was painful to everyone. Actually the main pain was borne by Canadians, but they wanted it done because it was their general wish to get the nation's fiscal house in order.

I must correct the hon. member in that the cutting to the provinces was not $42 billion. That is definitely wrong.

I remind him that Quebec, in its attempt to get its fiscal house in order, an attempt which we applaud, in its 1997-98 estimates announced its intention to cut health and education spending by 3.2% and 5.8% respectively. This cutting exercise, which is very hard to do when you are in government whether it be the federal government or the provincial government, has to be done. Governments around the country know it and that is why they are doing it.

I agree with the principle of federalism and I do not agree with the member's interpretation that we are being heavy handed. We have done everything we can to seek partnerships with the provinces to work together on setting priorities. In the long run I think he and I would agree that the role of government is most important when it takes care of the sick and the vulnerable.

[Jim Peterson, Liberal, Secretary of State (International Financial Institutions)]

Madam Speaker, I would like to follow in the vein of the member for Macleod. I believe in his own way he indicated that this is such an important issue that we must all treat it with a sense of responsibility to Canadians, with a sense of the responsibility that we have for looking after the health care of Canadians and the other needs of Canadians from coast to coast. I follow in that same type of non-partisan vein.

It must be recognized that when we came to power five years ago there was a $42 billion deficit.

The national debt exceeded $500 billion. We were forced to take measures to control the deficit and finally start reducing the national debt.

It was not easy at all. For our part, we began by reducing federal spending. It was clear that with $120 billion for all Canadian programs, we would be forced to cup spending, and we did with great difficulty. We cut expenditures by at least $15 billion, bringing them back to the level of spending reached just after World War II for federal programs as a whole.

Some of the cuts we made were to transfers to provinces. We replaced existing programs with the CHST. Of course, the result was that provinces had less money for things like education or health care.

Let us look at what we have done for Quebec. For the last five years, cuts for Quebec totalled $4,6 billion. That is true, but we did lots of other things. We gave an additional $2.1 billion in tax points. Equalization for Quebeckers, $1 billion more. Infrastructure programs, $650 million. Child tax benefits, $200 million. The innovation foundation, $800 million invested everywhere in Canada. There is also the sum of $1,8 billion over five years to raise the floor level of the CHST.

Quebec has not really lost much, and neither did the other provinces. When we dig a little bit deeper we can see the savings in the interest paid by Quebec on its debt. Quebec has really benefited over the past five years as far as transfers are concerned.

As I just said it was very difficult for us to cut transfers and programs for Canadians as a whole. However we have to admit our debt is now at 68% of the GDP.

Our federal debt is 68% of our GDP. Provincial debts on the other hand are only 26%. This means that out of every tax dollar paid to the federal government, 27 cents go to pay just the interest on our debt. At the provincial level this is only 13 cents. So I say, who is better equipped to share with us this necessity to put our fiscal house in order than the provinces?

Moreover, we have to admit that cut in transfers to Quebec was at the most 3% of its expenditures. However the province nevertheless cut its transfers to municipalities by 6%. It is exactly what Bernard Landry was saying at the National Assembly: “We must admit that we must do our share so that the Canada we have helped to put in debt can eliminate that debt”.

It is in this spirit that governments, whether federal or provincial, work for all Canadians. As the Prime Minister, the finance minister and the health minister said, we are going to contribute, in the next budget, to health care services for Canadians. That is the priority set out by our government which will respond to the needs not only of provinces, but of Canadians themselves, because we are talking about health care.

It must be recognized that the vast majority of health care expenditures, totalling about $80 billion a year, are the provinces' responsability. As the federal government, we recognize our obligation to contribute to the health care services for Canadians. That is why one of the first expenditures by our government was a $1.5 billion increase in health transfers.

We announced this would be our goal in the next budget. While we were facing this economic challenge, we increased expenditures in at least 10 or 11 areas of health care.

There is the health services research fund, $65 million; health transition fund, $150 million; Canada health information system, $50 million; national HIV-AIDS strategy, $211 million; Canada breast cancer initiative, $35 million; aboriginal health initiative, $25 million; private health and dental insurance for the self-employed, $200 million over two years; increases to the Medical Research Council, $134 million; hep C, $1.2 billion. That does not take into account the Canadian Foundation for Innovation or the on reserve aboriginal head start programs.

In conclusion, I would say that during this difficult fiscal period, we have made health care a priority. We have put our money where our mouths are. We do care and at the same time by acting responsibly we have been able to restore the fiscal health of Canada.

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

Madam Speaker, the member thought he could get away with it, but it will not be that easy.

According to him, this government, of which he is a member, has done a very good job of managing public finances. This is questionable to say the least. I hope the hon. member will rise. I know he always speaks the truth but the problem is he does not always tell the whole truth.

This opposition day should allow those who are listening to understand that this government has helped destabilize other governments' finances. How can anyone find it acceptable that, year after year since 1993, provinces have accumulated a short-fall of $42 billion in services that they have become unable to provide to the public?

The hon. member, who is parliamentary secretary—I know he would like to be minister but for the time being he is only parliamentary secretary—says they had no choice but to cut. They had no choice but to put their fiscal house in order.

We agree on the first part, but we do not understand why this government did it by transferring responsibility to the provinces. Will the hon. member not admit that this is a rather dishonest way to do things? The situation is this: by cutting $42 billion in provincial transfers, this government has forced the provinces to face difficulties they had not anticipated.

Will the hon. member admit that this government could have cut elsewhere, that it should have spared some sectors? Cabinet ministers should have decided to spare some sectors.

The Government of Quebec has said the same thing. You are all aware of our optimism as to the outcome of the November 30 election, but I can guarantee you that this optimism will make us work to the very end. We will take nothing for granted.

But the fact is that the hon. member could have agreed to follow the Quebec government's example and say that all social programs, all programs to fight poverty by helping people go back to work and to improve living conditions for the disadvantaged, would not be cut.

It would have been most gracious and totally appropriate on the part of this government to say: “Cuts in provincial transfers are out of the question”.

I ask the hon. member what we have been trying to find out since this morning: Can he tell us before we adjourn whether an influent member of this government will acknowledge the consensus reached in Saskatoon and immediately give some money, $2 billion, to the provinces? That is what we are waiting for.

[Jim Peterson, Liberal, Willowdale, ON]

Madam Speaker, the maximum that was cut from annual transfers to the provinces was about $6 billion.

At the same time, one must admit that the provinces benefited from other transfers, including the infrastructure program, the child tax benefit and equalization. Quebec got $1 billion more with equalization, other transfers and lower interest rates. This was a major advantage in that they spent only 13 cents for every dollar in revenue whereas the federal government spent 26 cents for every dollar in revenue.

The member is wrong when he suggests that $42 billion was cut from provincial transfers. This is completely false. We have to be honest with people.

Although transfers were indeed cut, increased funding for other programs aimed at the provinces almost made up for these cuts. Provinces really benefited from our fiscal achievements.

In response to the hon. member's statement that we destabilized provincial economies, allow me to repeat what Bernard Landry said in the National Assembly: “We must take steps to help the country shed the debt we contributed to”.

[Bernard Bigras, Bloc, Rosemont, QC]

Madam Speaker, I will be sharing my time with my colleague, the new member for Sherbrooke, who won a victory we are very proud of.

I am happy to rise to speak to the motion we put forward this morning. Our demand is clear. We are demanding, on behalf of the Bloc Quebecois, that the federal government pay back the amounts it has cut from the transfer payments for health, education and social assistance. We are requesting that the House of Commons, and I quote from the motion put forward by the Bloc Quebecois:

—endorses the provincial consensus reached in Saskatoon on August 7, 1998, that the federal government must restore, via the existing provisions of the Canada Health and Social Transfer (CHST), its contributions to front-line health-care services, starting with a payment of at least $2 billion, given that the federal government has already recorded an accumulated surplus of $10.4 billion for the first six months of the 1998-99 fiscal year.

In fact, since 1994, the Liberal government has cut $6.3 billion from transfer payments to the provinces for health, education and social assistance. Quebec's portion of these cuts amounts to $1.8 billion, including $1 billion for health only. What does this $1 billion represent annually? Wait till you hear this, because the list may be a long one.

This amount stolen by the federal government represents, in Quebec alone, 20% of the cost of running all the hospitals in Quebec and the c1osure of half the hospitals in the Montreal region. I come from a Montreal riding and I can talk about it for a long time. This amount represents the cost of caring for 370,000 in-patients, the salaries of half the nurses in Quebec, the cost of running all local community service centres and twice the cost of all youth services.

Yet, the Prime Minister said, during the 1993 election campaign, and I quote:

Our program does not include any plan to cut payments to individuals or provinces, it is clear and it is in writing.

Once elected, the Prime Minister did not hesitate to break his promise. By merging all transfer payments to the provinces into the Canada health and social transfer, the government cut transfers and shifted to the provinces, including Quebec, the cost of the fiscal restraint policy.

It is unacceptable for the federal government to use the fact that the provinces decide how to allocate the money as a smoke screen to hide the damage done by its own decisions. Had it not changed the system and introduced the Canada health and social transfer, the Liberal government would have had more explaining to do with respect to the cuts in health care, especially since it reduced cash transfers for social services to their level of 15 years ago. Total transfers currently amount to $12.5 billion, which is a far cry from the $18.8 billion in 1993, when the Liberals were first elected.

My words are not too strong. It is unacceptable for the federal government to cut transfer payments unilaterally by 33% in less that four years. If you take into account the increase in population and cost of living, social transfers have never been that low in decades. In 1998, we have social transfers which are 45% lower than their record level of 1985 and 43% lower than their 1994 level.

Thus, within only one term, the Liberal government has virtually cut in half the federal contribution to health care and then it brags it has eliminated the deficit. The truth is it has not eliminated the deficit, it has transferred the debt to the provinces and to the sick who are affected by these cuts.

Besides, while cutting billions of dollars in provincial transfers for health and social programs, the federal Liberals never stopped interfering in the health sector, and in a heavy handed manner.

First, I will mention Bill C-14 on drinking water, that infringes upon health, natural resources and the environment, three exclusive Quebec jurisdictions. Moreover, this bill provides for national standards on the quality of drinking water, which is also a provincial responsibility.

That is not all. The Liberal government has proposed an overall policy on the management of new reproduction technologies. Once again, the federal government is interfering in provincial jurisdictions.

As for health programs, for home care, the Liberal government refuses to give the provinces the right to opt out with full financial compensation. On this issue, we see a replay of the millennium scholarship project. I want to remind the House that this is a $2.5 billion fund aimed at providing students with 100,000 scholarships of $3,000 each, based on merit.

I also want to remind the House of the consensus on this issue in Quebec. Since 1964, Quebec has used its right to opt out with full compensation. Quebec set up a financial assistance system for students in 1964. This is what we used the opting out with full compensation provision for. Our financial assistance system might not be the best in the world, but at least Quebec students graduate with half the debt load of their counterparts in the rest of Canada. This is exemplary. This is what one uses opting-out with full compensation for: to let the provinces run services they can manage better than the federal government.

That is not all. In its 1997 budget, the federal government announced a $150 million three year fund for health services adjustment to help provinces set up pilot projects to provide home care or pharmacare, when Quebec already had its own programs.

The Constitution prevents the Liberal government from opening federal CLSCs in Quebec. This is fortunate, because the federal government provides services through the back door, as it is doing now in education with the millennium scholarships.

Moreover the health minister is going to spend $50 million over three years to set up a national health information system and $100 million over three years to improve two existing programs, the community action program for children and the Canada prenatal nutrition program. Is it not ironic for the government to find millions of dollars to enhance its visibility when it refuses to reimburse the provinces for the shameful cuts they had to endure.

On September 7, 1998, the Minister of Health mentioned in his speech before the Canadian Medical Association that he wants to create a national report card on the health care system to assess, each year, the quality of health care in Canada. Once again, the minister seems to be forgetting that health care is a provincial responsibility and, therefore, the provinces are in a better position to know what the health care situation is in their respective jurisdictions.

In conclusion, we urge the minister to say right now that he will not use this annual report card to penalize those provinces that do not want anything to do with it. But, for the Minister of Health, anything is a good excuse not to give the provinces their money back.

That is why the Bloc Quebecois is fighting to help Quebec recover the money that was cut from its transfer payments and will continue to fight until Quebec is treated fairly.

[Jacques Saada, Liberal, Parliamentary Secretary to Solicitor General of Canada]

Madam Speaker, I would like an explanation. It is just a matter of logic, not politics, just logic.

The reduction in cash transfers to Quebec represents only 3% of the revenue of the Quebec government. From what I hear today, it seems that that was a wrong decision to make.

Without any notice, however, the Quebec government imposed the equivalent of a 6% budget cut for municipalities, which is double what the federal cuts were. Can somebody tell me where the logic is in all of this?

[Bernard Bigras, Bloc, Rosemont, QC]

Madam Speaker, it is pretty easy to explain. If the parliamentary secretary cannot understand, he surely must have a hard time managing his own personal budget.

It is quite simple: when a government has its tax base cut and ends up with less revenue, it can deliver fewer services. The fact is that the transfer payments to the provinces for health, education and welfare have been reduced by $6.3 billion. The Quebec government has seen its financial margin, its financial capacity, reduced and the Liberal Party, of which the parliamentary secretary is a member, is to blame for this.

[Stéphan Tremblay, Bloc, Lac-Saint-Jean, QC]

Madam Speaker, I would say, like my colleague, that it is quite fascinating to hear the questions from the members opposite.

In politics, especially here, in this House, I have to say that we see some rather amazing things. Politics is the art of managing our collective affairs, of organizing the ties that bind us together.

I notice that, sometimes, politics here is not really an art. The government sees that it has spent way too much money, that it has not taken good care of the nation's finances, and then it decides to try to eliminate the deficit. But when I say that politics is easy for the federal government, the only thing it has to do is to tell the provinces that they cost too much and that it will cut their transfer payments.

As a matter of fact, that does not come from me. The Prime Minister himself, when he was in France, said how easy it was in Canada to balance the budget simply by making cuts in transfer payments.

I know that a lot of people are not really familiar with politics, transfer payments or areas under provincial jurisdiction. About four years ago, I was one of them. Sometimes, when people watch the news and hear sovereignists say “no, this is an area under provincial jurisdiction”, it may seem somewhat difficult to understand.

But it is so simple and, at the same time, it shows us how difficult it is to run a machine like this government, because there are two governments that are competing not only in terms of programs, as my colleague from Rosemont was saying earlier, but also in the pursuit of fiscal balance.

When people ask what Quebec wants, all we want in the end is efficiency. I hope that when my constituents pay a tax dollar that it produces the best in services and in solidarity.

I know that a huge percentage of my tax dollar does not come back to the provinces. We know that it is within the provinces' jurisdiction to provide services directly to the public: health care, education and a social fabric.

So it is regrettable to see voters often criticizing the provincial governments. But we have to understand them. We have to see where that is coming from. It comes from here.

I have used up my time, but I will be back.

[Bernard Bigras, Bloc, Rosemont, QC]

Madam Speaker, I am very happy my colleague mentioned that the Prime Minister said recently that cuts to the provinces were the price to pay for a balanced budget.

Just to show how this government contradicts itself, I will quote what the Prime Minister said during the election campaign in 1993: “In our platform there are no plans to cut payments to individuals or to the provinces”. This is rather clear. It is in writing. These are the Prime Minister's own words.

Then he said cuts to the provinces were the way to a balanced budget. How contradictory!

[Serge Cardin, Bloc, Sherbrooke, QC]

Madam Speaker, before I start, with all I have heard in this House from the members opposite, I am more and more convinced of the advisability and relevance of our motion. There is an urgent need to invest in health care.

This motion is based on democratic, humanitarian and sound management principles. It is based first on a consensus reached by all the provinces in Saskatoon, on August 7, asking the federal government to give back transfer payments.

Another consensus was reached during pre-budget consultations held by the Bloc Quebecois throughout Quebec, where all the people asked the government to give back the money from transfer payments for health, education and social programs.

In asking that these amounts be reinvested in front-line health care services, we are also looking to the future. Health care is important. It is the basis of our society and our development.

This is also a matter of prudence, because we are prudent and we know how to effectively manage public funds. We are asking the government to do so in several instalments, without risking another deficit, because we in the Bloc Quebecois asked the government to pass anti-deficit legislation.

In 1994, the President of the Treasury Board told us he was able to reduce government spending by $18 billion. Today, we know that he could have saved twice as much. Imagine if he had done his job properly. We would have $9 billion more to reinvest in the Canada health and social transfer.

We see this government has no sense of priorities and responsibilities. It would rather cut the essential than the superfluous. In its effort to put its fiscal house in order, the Liberal government sacrificed the health of Quebeckers and Canadians.

But everyone knows that physical and mental health is essential for individuals to develop personally and collectively so they can contribute to the social and economic health of their communities.

The Minister of Finance has a duty to Quebec and Canada. He has cut transfer payments by $6.3 billion. Now that the minister has a surplus, he is duty bound to restore health care funding. Instead, the minister is trying to dodge the issue by having us believe that there will be no surplus over the next three fiscal years, from 1999 to 2001.

I cannot understand why he will not restore transfer payments. He is so adamant that, in a moment of transparency, he clearly showed his lack of credibility, which has already been denounced by the Bloc Quebecois and other opposition parties as well as the Canadian Chamber of Commerce. For the fourth time, the auditor general questioned the government's financial statements.

In fiscal year 1997-98, we were to have a budget surplus of $5.9 billion. Yet, the Minister of Finance, intent on showing the lowest surplus possible, for fear of having to reinvest in transfer payments and give money back to the provinces, has intentionally changed the regular format of financial statements as of March 31, 1998.

The auditor general questioned the accounting methods of the federal government, as used in the last federal budget. He objected in particular to the way the millennium scholarship fund was accounted for. As we know, the $2.5 billion earmarked for the millennium scholarships have been included in the financial statements of March 31, 1998, which is contrary to normal accounting procedure and auditing standards.

The auditor general objected to that, but the minister of finance goes even further. He claims that this is simply an opinion, that there are other ways of looking at it.

The auditor general is independent, he is supposed to give an opinion based on accounting standards, auditing standards, and his judgment should never be challenged. Yet, this is exactly what the Minister of Finance is doing and he even backs up his position, that it is one opinion among many, by quoting an audit firm. No, this is the auditor general's opinion, and the only one he could express in the circumstances.

The Minister of Finance is, to a certain extent, showing what I would call his incompetence, because he does not know the difference between financial statements and a budget. He says it is normal to put these estimates in his budget, but these are financial statements.

When we see something like that occurring, when the auditor points out that some funds, $2.5 billion in this case, have been allocated in the financial statements to an institution that does not yet exist, in other words, to mere intentions, and that notes had to included to indicate that events will follow, we realize that the finance minister went overboard, but what is worse is that he is challenging the opinion of the auditor general.

The finance minister is sticking to his guns. He maintains that the surplus should not exceed $3.5 billion. However, the Conference Board thinks the surplus will be closer to $10 billion, the Mouvement Desjardins estimates it will be close to $15 billion, and we, in the Bloc, believe that it is heading for $15 billion. Even the public servants now estimate that it will reach $10.4 billion.

Of course, the government is now back pedalling and trying to convince us that there is some economic uncertainty, which is precisely why we want the payments to be made over a period of a few years. If there is uncertainty, it comes from elsewhere, not from Quebec nor from the other provinces. The uncertainty is created by the federal government, which can cut provincial transfers at any time.

A billion dollars is a lot of money for the regions. In Estrie, one billion dollars in health means $41 million that the people do not have, and the potential closure of such important centres as the university's geriatric institute, the Centre de réadaptation de l'Estrie, and the Centre Notre-Dame-de-l'Enfant, because of $41 million in cuts in a region that has already been pretty hard hit by federal government cuts.

We are asking the federal government to reinject its duly identified budget surpluses into health, education and social transfers.

In order to proceed more cautiously, and to spare us insecurity and uncertainty, it would be preferable if the $2 billion were paid back in tax points rather than in transfer payments.

This is a suggestion that ought to be looked into, because one never knows. If it is just in transfer payments, we know that at any hour, or on any day in the year, the federal government can turn up and cut it out from under us. It is the Liberal government, then, that is creating the uncertainty.

[Odina Desrochers, Bloc, Lotbinière, QC]

Madam Speaker, I am very pleased by the comments of the hon. member for Sherbrooke, since he is in a position to see what this government has been doing for the past few years.

We know what the auditor general thinks of the finance minister's behaviour. We also know how the provinces are reacting to that behaviour. They all condemn that way of doing things.

I want to ask the hon. member for Sherbrooke if he has a word to qualify the minister. How does he see him? Does he see the minister as being competent, incompetent, a bit lost, unrealistic?

I leave it up to him to answer.

[Serge Cardin, Bloc, Sherbrooke, QC]

Madam Speaker, the minister may be incompetent. Based on what I referred to earlier, one would think so. What is more serious though is that the minister is rather sneaky. Why does he insist so much on minimizing existing surpluses? Is he again hiding something from us? How many initiatives such as the millennium scholarship foundation will he come up with? It is anybody's guess.

So, there is a combination of incompetence and obvious lack of transparency.

[Stéphan Tremblay, Bloc, Lac-Saint-Jean, QC]

Madam Speaker, I have one comment to make following the speech by my colleague, who mentioned many interesting facts.

First of all, it is very important to note that my colleague is himself an accountant. Therefore when he speaks about the finance minister's accounting practices, I trust him fully. When the auditor general himself questions the way the finance minister applies accounting standards, we have every right to wonder.

My colleague also talked about millennium scholarships. I have worked on this issue, and I can say I have seen all kinds of weird things. First, education is an area under provincial jurisdiction. It is an area of jurisdiction over which Quebec has full authority. What is the federal government doing with its surplus, the result of cuts to the provinces? What it takes with one hand it gives back with the other in an area over which it has no jurisdiction. I find this totally absurd.

I believes it lowers efficiency. I said earlier that one of the problems with federalism is that it leads to competition among governments; they compete with their programs. The Prime Minister himself acknowledged this measure was aimed in part at increasing federal visibility. I had asked the question of the Prime Minister, who replied “When we send a cheque to students, we want them to know where it comes from”. It is sad to play politics that way.

I could say a lot more about the millennium scholarships, especially the fact that the management of something public is being entrusted to a private body. I wonder where democracy is going. The democratic deficit and eroding political power are things that concern me a lot, as I tend to see them in terms of globalization of the economy.

But when, in this chamber, elected representatives are voluntarily renouncing their powers, I think we have some serious problems.

I know this is not what this debate is about, but I wanted to point this out because when I hear about this it makes my hair stand on end.

The other point raised by my colleague is a crucial one. It deals with the physical and mental health of individuals, of our fellow citizens. The education and health services we provide them with are very important indeed.

I am running out of time, which is unfortunate, but I will conclude by saying that, in a democracy, it is extremely important that every citizen be able to point the finger at those responsible for the cuts. Right now, in most of the regions in this country, the people do not know if they should point the finger at the provincial or at the federal government, because in the end the cuts always seem to come from the next level up. And this, in my mind, undermines democracy.

[Serge Cardin, Bloc, Sherbrooke, QC]

Madam Speaker, in the 15 seconds I have left, I would like to say that health is not simply the absence of disease.

Health is the possibility given to individuals to develop fully, physically as well as mentally. Investments in social programs, education and health help keep people healthy and therefore productive in their communities.

[John McKay, Liberal, Scarborough East, ON]

Madam Speaker, I will read the motion which I thank the hon. member opposite for bringing. It states:

That this House endorses the provincial consensus reached in Saskatoon on August 7, 1998, that the federal government must restore, via the existing provisions of the Canada Health and Social Transfer (CHST), its contributions to front-line health-care services, starting with a payment of at least $2 billion, given that the federal government has already recorded an accumulated surplus of $10.4 billion for the first six months of the 1998-99 fiscal year.

The effect of the motion is to increase the CHST by approximately $2 billion.

There is a block transfer that already occurs of about $26 billion in tax points and cash to the provinces. The expectation is that over the next few years that will increase to about $28.5 billion.

While the cash floor remains static, the tax point portion is increasing and it increases quite dramatically for some provinces, particularly the province of Ontario, which is where I am from.

The other beauty of the CHST is that it addresses a long-standing grievance of some of the provinces, particularly the more prosperous provinces, that they were not getting a fair share of the transfer on a per capita basis. Over the course of the program, namely into the year 2002, that inequity in distribution on a per capita basis will in fact be addressed.

This brings me to the Ontario situation because that is the province from which I hail and about which I care deeply.

Ontario has received a reduced portion of the cash transfer. For Ontario that translates this year as a reduction of approximately $1.2 billion. The amount of $1.2 billion on its overall budget of $50 billion roughly translates into something in the order of 3% to 4%. That is what it means to Ontario, a reduced cash floor of the CHST of about 3% to 4%. When that is compared with the ill advised tax cuts it is in fact a negligible amount of money.

The philosophy of the reformatory government in my province is such that it puts tax cuts ahead of almost anything, including, I would argue, fiscally conservative and sound principles like reducing the debt, or even getting a handle on the deficit, both of which it has ignored. It has ratcheted up the debt over the course of its mandate to something in the order of $30 billion. That amount on an overall annual budget of $50 billion, to my way of thinking, is somewhat less than prudent fiscal management.

This is why increasing the CHST, particularly to the province of Ontario, in my view, is somewhat problematic. Our problem, from a federal government standpoint, is that we cannot trust it. We can get no real assurance that even if we were to agree to a $2 billion transfer, or Ontario's portion of that $2 billion transfer, that it would be applied to where we think the Canadian people want it applied, namely, to medical services.

Our fear is that it will simply go to backfill ill-conceived tax cuts. We cannot see how this will go to the legitimate needs of the people of Ontario.

I wish to let you know, Madam Speaker, that I will be splitting my time with the hon. member for Thornhill.

I would also like to tell a story about how these policies have played out on the ground in my riding. These are ill-conceived policies. This story is about how Ontario's housing policy contributes to homelessness, how its medical policy puts people on the street who should never be put on the street and for whom there is no private market alternative. It is naive in the extreme to think that the private market would pick up some of these people. It is also a story about how Ontario has devastated our hospitals.

The nation was transfixed with the death of a police officer over the course of the summer. The death of that particular police officer occurred in my riding. It was a tragic event, but let me explain the background.

The two women who are accused in that matter were initially residents of a medical facility in Toronto. With the cutbacks they were put on the street. Because my riding houses approximately 1,000 homeless people every night, who are largely there due to dubious government policies, these women ended up in my riding. Shortly thereafter they were transferred to another facility in St. Catharines, but for reasons best known to them they returned to the riding on that fateful night.

These are people who are in need of medication. These are people who should not be on the street. They came to the riding and went to the local hospital. They had a psychotic episode. They refused treatment. When they left the hospital they walked 150 metres across the street and are now accused of murdering that police officer.

To give some graphic illustration of why this is an intersection of such vicious social policies, I will tell the House about this particular hospital. This hospital is situated very close to the 401. It was originally designed for trauma. The expectation was that with a freeway there would be trauma incidents.

When the ambulance driver came to service the bleeding police officer, who was probably almost dead at that point, he made the decision that that hospital had inadequate resources and that he would not drive 150 metres across the parking lot, but would drive the ambulance another 25 minutes to downtown Toronto in order to help the police officer.

This is a vicious intersection of a policy regarding homelessness, a policy regarding rental, a policy regarding how medical facilities are staffed and funded. These are the reasons that we in Ontario feel very uncomfortable about transferring any additional funds to the Government of Ontario because we are not satisfied that the moneys will be used for what they were intended. These are very problematic issues for members from Ontario.

Health care is important to the government. The very first thing the Government of Canada did once its fiscal house was in order was to increase the cash floor for the Canada health and social transfer. This move marked the end of cuts and signalled the priority we place on health care.

In the government's economic statement the finance minister said that the concerns related to the strengthening of medicare will be addressed. He said no one can take on the challenges of a new economy while preoccupied with the availability of basic health care, no parent of an ill child and no child of an aging parent.

I have tried to put this matter of quality of care in context and the assessment in the proper context. This means making our system more responsive to and responsible for Canadians. The government has made it clear that health care is a very high priority. The Prime Minister has said that the federal government intends in our next major reinvestment to deal with the subject of health. The Minister of Health is committed to working in collaboration with all the provinces, including Ontario.

Canada Small Business Financing Act

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

Madam Speaker, I rise on a point of order. I regret to inform the House that an agreement could not be reached under the provisions of Standing Order 78(1) or Standing Order 78(2) with respect to the report stage and third reading stage of Bill C-53, an act to increase the availability of financing for the establishment, expansion, modernization and improvement of small business.

In accordance with the provisions of Standing Order 78(3), I give notice that a minister of the crown will introduce a time allocation motion at the next sitting of the House for the purpose of allotting a specified number of days or hours for the consideration and disposal of proceedings at these stages.

The House resumed consideration of the motion; and of the amendment.

Supply

[René Canuel, Bloc, Matapédia—Matane, QC]

Madam Speaker, I heard my colleague twice repeat a statement I would not consider very well thought out. I almost wanted to say that it was a bit preposterous. He said that, if the government sent money to the provinces, and Ontario in particular, the Government of Ontario would misuse it. What he said for Ontario goes for Quebec and the other provinces. How can he say such a thing?

You too, Madam Speaker, no doubt reacted within yourself as well. Ask anyone to say who is better able to manage public funds. The answer is those closest to the public. Everyone agrees, except the hon. member. In his opinion if the government sends money to the provinces they can waste it as they like.

Let us just look at what goes on here. Earlier, he mentioned transfers. He seemed to think it was nothing. This is another terrible thing he said. When the government cuts transfers to the provinces, very often no mention is made of it, and very often the cuts happen during recess. It looks alright, no one sees it.

On the other hand, when a little money is given back to the provinces, you may be sure that the Canadian flag will be flown and press conferences held to say that everything is fine. The government pulls out all the stops to restore its reputation.

However, the people in my riding of Matapédia—Matane are suffering. Unemployment there is very high. Why? Because the belt is being tightened so much. I always say that when the tap is partly shut off, there is no water down below. For years, the federal government has been shutting off the tap bit by bit and not entirely honestly. At this point, people at home and in other ridings are suffering terribly.

I have a question for my colleague. Will he have the decency to say that the cuts really hurt the provinces?

[John McKay, Liberal, Scarborough East, ON]

Madam Speaker, I appreciate the question. Ontario had its CHST cash moneys reduced something in the order of 4% vis-à-vis the overall budget.

What the hon. member needs to know is that in 1995 the federal government provided 19% of the budget for Ontario. In 1996 it provided 19% of the budget for Ontario; also with 1997 and 1998.

The overall percentage stayed exactly the same. Where the viciousness of these social policies comes into play is a philosophical commitment to reduce taxes in priority to all else.

When that happens, I argue that the federal government has its overall supervisory responsibility for this nation to fix the province with the responsibilities as set out in the Canada Health Act, to adhere to those principles and to make those principles for each province.

If someone goes from Prince Edward Island to Quebec to Ontario to British Columbia, they can expect a level of health care that is universal and accessible, et cetera. That is the role of the federal government.

When the federal government cuts back transfers but in percentage terms it is exactly the same, I argue that it is the viciousness of the policies of this government that creates these horrible intersections which result in tragedies for our citizens. I will not speak for Quebec. I will simply speak for Ontario.

[Elinor Caplan, Liberal, Parliamentary Secretary to Minister of Health]

Madam Speaker, I am very pleased to have the opportunity today to rise in this debate. I think there are some very important facts that Canadians watching this debate should remember.

It was a Liberal government that originally brought in medicare in Canada. It was a Liberal government in 1984 that brought in the Canada Health Act under the leadership of Monique Bégin. That act was passed in the House in a rare vote of unanimity. All members supported that important and incredible act.

In 1993 it was this Liberal government that inherited a $42 billion deficit and a growing debt that was threatening the fiscal health and the economic prosperity of the country.

If it had not been for the prudent fiscal management and the important commitment to the health of Canadians, we would not be in the position today to be debating what we will be doing with the surpluses being generated because of that prudent and important fiscal management.

This Liberal government has seen the elimination of the deficit and a balanced budget emerge. We also know that as prudent and responsible fiscal managers, we cannot ever again put on blinders and not look at what is happening around the world and not ensure our policies are right for today and for tomorrow.

Ensuring the fiscal stability of our country through prudent economic policy must remain a priority, particularly in these times as we see crises around the world, sometimes referred to as the Asian flu, the desperate situation in Russia and the concerns in Latin America and South America.

I want to make it absolutely clear from my perspective that health and health care and sustaining medicare, which all Canadians cherish, are priorities of the government. The reason I gave that very short history lesson is that people on this side of the House are not newcomers to that position. We have been staunch supporters of Canadian medicare. In 1993 the Prime Minister, during very difficult economic and fiscal situations, that very difficult and challenging time, established the national forum. The first recommendation of the forum was that the floor for transfers to the provinces under the CHST be established at $12.5 billion. That is exactly what the government did. We listened to the national forum, we took its advice and we raised the floor, adding $1.5 billion to the transfers to the provinces.

Many people watching this debate may not understand how this works or what the federal role is, so I would like to take a minute to explain it. Medicare is a partnership and the federal government has a role not only in helping to fund it but to leave the debate in ensuring that medicare is strong and secure and accountable to the people of this country.

The health and social transfers in 1998-99 will amount to $26 billion to the provinces and territories in support of health care, post-secondary education, social assistance and social service programs. This block funding gives the provinces flexibility. However, what is often overlooked in the House is that the CHST is a combination of dollars, $12.5 billion, and tax points, which too often people overlook in their calculation of the federal contribution to medicare.

We know that as it stands today, the Canada health and social transfer, with a floor of $12.5 billion, will increase by some $7 billion additional to the provinces until 2002-03.

We all know that as a result of the important decisions taken by the government and the decisions taken by provinces across the country there is a need for further investment in health care, in medicare and in the health of Canadians.

The Minister of Health said it best in a speech in Whitehorse: “The complex problems that confront health care in Canada will not be solved by dollars alone. The point is not simply to spend more but to spend more in a way that will produce better results”.

That is why as we look to the future, as we ensure money is invested in the health care and the health of Canadians, we have a responsibility to work with the provinces to make sure there is greater accountability and greater transparency in the use of those dollars. I speak now from an understanding to focus the services we deliver at the provincial level on patient needs and that we take care of people through that whole continuum of care so they do not fall through the cracks as too often happens today.

Simply throwing money, as suggested today by the motion, is not the right approach. The right approach in my view is for the federal government, through discussions with the provinces, to talk about the need for greater integration and greater accountability, accountability in the way of report cards to Canadians, letting people know how this non-system of ours really works or does not work in some cases.

Simply throwing money at it is not going to fix it. As the minister said, we have to make sure that the dollars we invest give us the results we seek. We all know it is important that future investments restore the confidence Canadians have always had in our medicare.

I saw an article in the newspaper just this week that said that U.S. doctors, nurses and health care providers are at the Canadian embassy and are rallying around Canadian medicare. Their message to Canadians is very clear and that is not to be so quick to trash what we have. They say to look south of the border where there are 43 million people with no access to care and over 100 million people with inadequate coverage. They are spending 40% more than Canadians. They are spending almost 14% of their gross domestic product.

If ever there was a lesson to learn, it is to make sure that we invest properly and do not listen to the Reform Party which would take us down the road to the American style of medicare where people pay and do not have the coverage for the services they need. We know that is the Reform policy. That is not the policy of this government.

I know that the people of Thornhill, the people of this country believe that the federal government has an important role in ensuring that medicare is there for future generations. They also know that this has to be done in a thoughtful way, not to simply throw money into the air outside of the budgetary process because we think things are looking good, or to throw away any fiscal prudence and respond to the political whims and desires of members in the House who change their tune on a moment's notice.

We stand steadfast behind medicare. We always will. We will ensure it is there for Canadians.