Mr. Speaker, I listened with interest to the comments of the Minister of Health. Our objectives are very similar. We in the Reform Party are happy to see that finally the government has decided over the last two years to put money back into research.
Our objectives are the same in trying to strengthen research. We recognize that research is the backbone of our economy. It gives Canadians a cutting edge to provide not only our citizens but also people around the world with a better, safer, healthier future.
I also want to compliment Dr. Henry Friesen for the work he has done. He has been innovative in trying to merge or change the Medical Research Council from what it was into a new, dynamic unit which will ensure that more money is put into the cutting edge of research rather than swallowed up in bureaucracy.
We in the Reform Party are happy to say, as far as we can see at this point, that it will also provide an opportunity to revamp research units to make them more effective. It also links up existing research units across the country. Those linkages enable people in the scientific field to be work more effectively. Having previously worked in research, I can say that effort is welcomed to be sure.
We will support the bill up to committee. If the bill will improve the health and welfare of Canadians, research in Canada and make sure more money will be put into the hard edge of research rather than into the bureaucracy, then we in the Reform Party will support it because it is a good thing. If the accountability is there then we will support it. However, we want to hear from the specialists and the researchers.
Of course, we do have some concerns. One of those concerns was lobbed by a very well respected scientist in the country, Dr. John Polanyi, our 1986 Nobel Laureate. Dr. Polanyi made a very good point. He and other researchers around the country fear that research will be industrialized, that the only way individuals will be able to get their research funds is through a small group of people at the top who will dictate to them what they can and cannot do. I am sure the minister fully recognizes that this is not a healthy thing in research. No one wants it.
When I met with Dr. Friesen, he assured me in the context of the structure now that there would be peer review, that the money that would be spent would go to the most effective corners of research and that there would be outside, independent analysis on an ongoing basis as to where the research funds would go. We support that. At the end of the day we, and I hope the government does too, want to make sure that taxpayers' dollars in research, as in everything else, will be used in the most effective fashion possible.
In the organization of the CIHR it was stated that 95% of the moneys would be used for the hard edge of research and at a maximum 5% of the money would be used for bureaucracy. That is a good thing. We will make sure that the government holds up to that promise. It is most important that the money gets down to the hard edge and is not swallowed up by a bureaucracy.
I must admit that when I looked at the organizational structure, my fear was that would be exactly what would happen, that the organization being put forward was just another effort by the government to create a large bureaucratic structure that would swallow up a large amount of money at the expense of the hard edge of research. Our fear was that the extra money that was put into research would not go into research but would go into developing this rather grand bureaucratic scheme.
However, in speaking with Dr. Friesen, many of the people on the advisory boards will be volunteers selected from their peers. They will be the best of the best so that they can select, advise and channel our research funds from the federal government to make sure we get the best bang for the buck.
Whatever happens with the CIHR, it should be an arm's length institution so that the scientists who work there and scientists across the country will be able to do the basic research that is so important in developing groundbreaking findings in which Canada has historically been a world leader.
We need that basic research and it needs to be supported. It is not immediately obvious to those who work in research that their findings and their work will actually lead to an economic benefit in the short term. That is not what research is about.
It is true that much of the money that is invested has to have an economic benefit. We have to show effect and responsibility for taxpayer dollars, but there is a balance. On the one hand we have to make sure that the money goes to the type of research which will accrue a benefit, but on the other hand we cannot disallow or prevent the basic scientific research that exists in this country which will enable us to make those large groundbreaking research efforts in the future. Our concern is whether that will be allowed.
Our other concern is that we must ensure the independence of researchers. We must ensure that they have the intellectual independence and freedom to pursue the study and groundbreaking research that is inherent to the university setting.
Another option the government has in the industrial research setting is to provide the tax incentives which will enable industry to do that research.
One of the things that Reform has always said is that because of the high taxation levels the government imposes upon the corporate sector it is not able to do the required research. When we speak to the people who want to do this research they say “We would love to do the research but we cannot do it because our taxes are so high. Furthermore, we cannot retain the top notch scientists that we need”.
The Minister of Health explained that he wants to retain those people. Reform believes that we should retain those people. They are some of the best and brightest in Canada and in the world. In fact, almost 10% of our population lives south of the border, not only because of the money but because of the opportunities that are provided within those research institutes. These people go south because they have an opportunity to live and work in cutting edge environments. It is not because they have more money in their pockets, although for some that is certainly a benefit. More importantly, as researchers, in their hearts they truly believe they can do more for humanity by working in an environment where they have the tools which enable them to be the best they can be.
Canada does not provide that now. What I hope the Minister of Health will do is speak to his colleague the Minister of Finance and say “Cut your taxes”. If we cut our taxes, the corporate and industrial worlds will be able to engage in the research that will help Canada move forward. By doing so, we will improve our economy, retain our best and brightest, reduce our brain drain and strengthen our economy.
Another thing the Minister of Health needs to look at, and this is related to the research aspect, is the situation in health care in Canada today. We have had a debate recently on this issue and I think it is important to put it into context.
We talk about the basic humanity of health care, and about preserving, maintaining and ensuring that Canadians get the health care they need. However, the cold hard reality is that in 1999 Canadians are not receiving it. We have a two tiered system of health care in Canada today. There are those who receive health care and those who do not. Every tenet of the Canada Health Act is being violated. It is a myth to say that we will support the status quo because the status quo is killing Canadians.
One of the principles of the Canada Health Act is accessibility. That principle has been broken. Having 200,000 people on waiting lists for surgical procedures is not humane. It is not good health care.
If the minister wants to do something about it he needs to talk to the Minister of Finance and say “Return the $21 billion you took out of health care so that Canadians can get the health care they need when they require it”.
The second principle is universality, but we are not all covered. In fact, 84 essential procedures were delisted within a period of eight months in 1997. That is continuing to occur in the provinces because the provinces do not have the money to pay for what is demanded.
Reform recognizes the cold, hard reality. We have a situation today that is different than when the Canada Health Act was formed in the 1960s.
The Canada Health Act has noble, important principles that we would like to support. In fact, we do support them, but the reality is that in 1999 the situation is different. We have an aging population. The population of those over the age of 65 will double in the next 30 years. These people use 70% of our health care dollars.
Among OECD nations Canada consistently ranks in the lowest third for medical technology because governments do not have the money to buy new technology, to buy the MRIs that will give Canadians the health care they should be getting.
The minister likes to talk about publicly administered health care. The cold, hard reality is that in 1999 the federal government only supplies 11% of health care. For every health care dollar that is spent the federal government only contributes 11 cents. Fifty per cent comes from the provinces and 30% comes from the private sector.
That means that people who have the money will get physiotherapy. If they have the money they will get home care. If they have the money they will get new drugs. If they do not have the money they will not get those things.
As a physician I have worked with these people. It is cruel and inhumane to watch a sick, elderly spouse take care of a sicker spouse without the help of home care because they do not have the money to pay for that home care.
We have cut into the muscle and bone of health care in Canada today. Patients are being discharged earlier and sicker. Who pays the price? It is the sick patient, the poor and the middle class who pay.
We would like to see the principles of the Canada Health Act strengthened, but we have to look at the reality of today. We have to ensure that the poor and the middle class have accessible, affordable, universal health care where we can get the best bang for our buck.
Money does not grow on trees. That is the reality. It is easy for people to say that anybody who opposes this wants an American style two tier health care system. That is utterly false. There are no members on either side of the House, particularly members of the Reform, who want an American style two tier health care system. Everyone in the House abhors that with every bone in their body. That would mean that people could not get health care, in particular the poor and the middle class, because health care would be determined by the money they have.
There are 200,000 Canadians on waiting lists who are suffering. It is inhumane to tell a person of 70 years, who may only live for five more years, that they have to wait a year before they can get their hip replaced because of the waiting list and there is no money to pay for it. That person will spend 20% of their remaining life in severe pain. That is not humane medicine.
That is not what Tommy Douglas wanted. That is not what the Canada Health Act is about. The Canada Health Act does not support that. We do not support that. I am sure that every member in the House does not support that.
I encourage the Minister of Health to ask Dr. Friesen and other scientists to look at what we in the Reform Party would like to do. We have to see the reality of today: an aging population, more expensive technologies and fewer people working to pay the taxes that will provide the base for public health care. We want to strengthen our public system and we want to look at the best models to do that.
Let us not throw the baby out with the bath water. Let us not criticize provincial premiers like Mr. Klein who is not satisfied with thousands of suffering Albertans on waiting lists. He wants to find ways to make sure those people get health care when they need it. If the Minister of Health wants to get on his high horse, rip out $21 billion from the provinces and tell Premier Klein that he cannot provide health care for people on waiting lists, then damn him. It is the people out there who are suffering.
There are people who would try to polarize and poison this issue and prevent debate. When they say that we want an American style two tier health care system they are doing it for political advantage. Who pays the price? The poor and the middle class are not getting health care today and they will not get it tomorrow. We want to change that. We want to make sure that all Canadians have equal access to good quality health care and that there is enough money in the system to provide that health care.
If the minister wants to improve health care, I would suggest he do it through the CIHR. He could look at existing studies that have been done by Canadians on the head start program. If there is one fundamental thing that can be done to prevent many social ills, it is to look at an early intervention program using existing resources. I am talking about prevention, not the expensive management of problems.
There are models such as the Moncton program, in which the Minister of Labour was a leader, the Perry preschool program in Ypsilanti, Michigan, and the Hawaii head start program. What have they done? With a minimal amount of money, and with $6 saved for every dollar invested, they have reduced child abuse rates by 99%, they have reduced youth crime by 60% and they have reduced teen pregnancies by 40%. The benefits accrue all the way along. There is less dependence on social programs, less dependence on welfare and fewer kids dropping out of school. In my province of British Columbia 30% of kids drop out of high school. It is a recipe for economic disaster.
In May 1998 the House passed my private member's motion calling for a national head start program. Reform has given to ministers and the government a plan of action to save thousands of children's lives and to save the taxpayer potentially billions of dollars. I would personally like to see the ministers of justice, health, HRD and finance get together to look at adopting this plan. It has a 25 year track record. It is affordable to the taxpayer. It will save the taxpayer money. More importantly, it will save the lives of Canadians, especially our children.
That is what the government could do in its children's agenda. It could have this early intervention head start program for all Canadians, using existing resources. It could use the medical community at time zero. It could use trained volunteers in the middle, which is what they did in Hawaii. It could use schools for the first few years of schooling. That strengthens the parent-child bond, improves parenting, makes sure kids have their basic needs met and avoids a lot of the trauma that is so devastating to children when their brains are developing.
Current research shows very clearly that in the first eight years of life a child's brain is very sensitive. When a child is subjected to abuse, sexual abuse, drugs, the witnessing of abuse or even more subtle things such as improper nutrition, improper parenting, a lack of boundaries and discipline, then that child suffers intellectually and psychologically, which has a profound impact upon that child's ability to empathize, sympathize, cognate and have appropriate interpersonal relationships with other individuals.
One of the most devastating occurrences in the country today, particularly in some communities, is the issue of fetal alcohol syndrome. It is a hidden tragedy. It is the leading cause of preventable brain damage in children.
The average IQ of persons with fetal alcohol syndrome is 68. They cannot cognate. They cannot rationalize. They cannot understand. They cannot learn like we can. They are poisoned before they are even born.
The government has done nothing about that and it needs to do something about it. I have a bill in the hopper on that issue too. It is a way of preventing the devastation that is wrought on these children, a way of preventing them from having their brains poisoned so they will have a chance to grow up on a level playing field, to grow up to be integrated and productive members of society instead of never getting a leg up in society and never being the best they can become.
Another issue that the minister should look at, for which I place full blame on him and his colleagues, is the issue of smoking. In 1994, mere months after the government was elected to office, the Liberals reversed a trend in smoking that had been going on for the previous 15 years. For 15 years prior to that smoking consumption had been progressively going down. Yet because of a smuggling issue the government was faced with a problem, how to deal with the smuggling of cigarettes because of the different prices in Canada and the U.S.
How could it do that? The government had two options. The first one, which was proven to work, was to put an $8 per carton export tax on exported cigarettes. That would have cut the legs out of smuggling in cigarettes completely, as was proven in 1991-92.
The government also saw from that experience that when an export tax was put the tobacco companies, those purveyors of death said it could not do that because, if it did, they would leave town and be very angry.
Instead of doing the right thing, standing up to the tobacco companies and saying that it would put on an export tax because it is important to decrease smuggling, the government compromised the health and welfare of Canadians, particularly children, by dropping the tobacco taxes substantially and reducing the price by virtually 50% along with the provinces in central Canada. Now we are reaping what was sown in 1994.
In the last few years in Ontario there has been a dramatic increase in consumption. This is not news. In 1994 Health Canada warned the Minister of Health at the time that more than a quarter of a million children would be picking up cigarette smoking as a direct result of the government's decrease in tobacco taxes and that half those children would ultimately die of tobacco related diseases.
Government members did not do the right thing and put on an export tax. Rather they comprised the health and welfare of every Canadian, particularly children. They put their tail between their legs and dropped the tobacco taxes, knowing full well that it would commit a quarter of a million children to smoking and that half those children would wind up with chronic obstructive pulmonary disease, early heart disease, peripheral vascular disease, strokes, numerous types of cancer and numerous other problems.
That is the legacy of what the government did in 1994. It introduced the single greatest devastating health care act to affect Canadians in the last 50 years.
The facts today are proving what we said in 1994. If the government wants to truly deal with smoking and kids, it will deal with education but it will also put tobacco taxes back where they were in 1994 and put an export tax of $8 on each carton.
This would accomplish two things. First, it would decrease consumption among kids and, second, it would cut the legs out from any smuggling initiative. That is what the government needs to do and ought to do, yet it has not.
Another issue I would like to raise is the issue of the manpower about which the CIHR need to warn the government very carefully and closely. We have a significant manpower shortage.
If we look at the nursing population, in the next 11 years there will be a lack of 112,000 nurses in the country. There are nurses today that have graduated, and I was asked last night why we do not hire more nurses. Why are they going down to the United States? They are going to the U.S. because governments do not have the money to provide jobs for them.
It is not that there is not a demand for them. There is a huge demand for them. As testimony to that are the 200,000 people on waiting lists, but the reality is that governments do not have the money to pay them. Therefore they are going south where they can try to get jobs.
Another issue is the area of medical specialties. We will have an enormous lack of medical specialists in the very near future: surgeons, internists and specialists in dialysis. This is what the government has to face and deal with now so we can train people to care for Canadians as we get older and to care for our children. This is a critical shortage that no one is talking about. The CIHR may want to warn the government of this impending disaster.
In summary, we will support the CIHR bill up to committee stage. We will be very interested in seeing what the government has to say about it and, more important, what the researchers have to say.
I would also stress that the government has to look at the reality of 1999. We have an aging population, more expensive technologies, and less money to pay for what we want. There is also a greater demand for things that are not covered today such as home care, drugs and dental services.
I might add that when the Canada Health Act was constructed the whole body was taken into consideration except for the mouth, the entry into the body. By ignoring that, a great deal of morbidity was caused among the poor and the middle class of the population who do not have the money for proper dental care. It is another unseen and silent problem within society today.
We also have to recognize today that we have a multi-tiered system. People who can afford it get the services. They queue jump or the rich go south of the border. Whereas the poor who would like to have physiotherapy when they are rehabilitating but cannot because they do not have the money, are forbidden to get it.
The Minister of Health continues to ignore that if people need physiotherapy, home care, certain drugs, or care that is essential to their health, they are actually prevented from getting it in 1999 because they do not have the money and it is not covered. The number of services not covered are expanding as time passes, and they will increase. The gap between what we demand of our health care and our ability to supply it will also widen.
Let us find a way in 1999 to live up to the ideals of Tommy Douglas, to live up to the ideals of the Canada Health Act, and to provide an affordable, accessible universal health care where no Canadian will be economically disadvantaged by becoming sick. We do not want that.
The reality today is that not only are Canadians waiting longer for surgery. It has become so appalling that in the province of Quebec many patients have to wait two months for radiation therapy for cancer treatment.
Can we imagine the shock of being diagnosed with cancer, with breast cancer or prostate cancer, and being told by a doctor that we will have to wait two months to get radiation therapy? Is that good care? That is not good care and no one in the House would support it. That is what is going on today. That is what we have in 1999.
The province of Quebec is so desperate, as is my province of British Columbia, that it is sending people south of the border at a cost that is far greater, five times what it would cost in Canada.
Premier Klein said that he would not accept the fact that Canadians were sick, that the poor and the middle class had their health care withheld, that they suffered and were sent to the United States where they had to pay five times what they should pay for service. Premier Klein is looking for a way to provide for the care of these people without destroying the health care system and to make sure they get care when they need it.
At the end of the day the only thing that really matters is sick people get health care when they need it. It should not harm them financially in any way. It should be affordable to the taxpayer. That is the common objective of the Reform Party, and I would suggest all members on all sides.
We must have the courage to move forward. We must have the courage to recognize the reality of today. We must have the courage to open our minds to dealing with new and innovative, modern and effective solutions to make sure that sick Canadians get health care when they need it. That is our objective as Reformers. I am sure it is the objective of members across party lines. We would like to see it happen and we would like to see it happen now.