Debates of Feb. 18th, 1999

Indian Claims Commission

[David Iftody, Liberal, Parliamentary Secretary to Minister of Indian Affairs and Northern Development]

Mr. Speaker, pursuant to Standing Order 32(2), I am pleased to table on behalf of the government in both official languages the 1997-98 annual report of the Indian Claims Commission.

Government Response To Petitions

[Peter Adams, Liberal, Parliamentary Secretary to Leader of the Government in the House of Commons]

Mr. Speaker, pursuant to Standing Order 36(8), I have the honour to table, in both official languages, the government's response to 11 petitions.

Committees Of The House

[Pat O'Brien, Liberal, London—Fanshawe, ON]

Mr. Speaker, I have the honour to present in both official languages the fourth report of the Standing Committee on National Defence and Veterans Affairs which relates to Bill C-61. This bill amends the War Veterans Allowance Act and significantly improves the Pension Act.

I would conclude by indicating that the well-known issue of compensation to merchant mariners has not yet been dealt with by the committee. By agreement it will be dealt with sometime in the near future, but we are reporting our vigorous discussions at this point.

Petitions

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, pursuant to Standing Order 36, I am pleased to present a petition from a number of Canadians including those in my own constituency of Mississauga South on the subject of human rights.

The petitioners would like to draw to the attention of the House that violations of human rights continue to be rampant around the world including in countries such as Indonesia. They also acknowledge that Canada continues to be recognized internationally as a champion of human rights. Therefore, they call on parliament to continue to condemn countries that violate universally accepted human rights and to seek to bring to justice those responsible for such abuses.

[Bob Speller, Liberal, Haldimand—Norfolk—Brant, ON]

Mr. Speaker, I rise today under Standing Order 36 to present petitions from a group of my constituents who are concerned about child pornography. They petition the Government of Canada to amend section 486.1 of the Criminal Code, and be enacted a specific exemption to an open court rule by excluding evidence of child enforced pornography.

[Tom Wappel, Liberal, Scarborough Southwest, ON]

Mr. Speaker, I have a petition signed by over 450 people from the community of Three Hills, Alberta. They pray that parliament enact Bill C-225, an act to amend the Marriage (Prohibited Degrees) Act and the Interpretation Act so as to define in statute that a marriage can only be entered into between a single male and a single female.

[Roger Gallaway, Liberal, Sarnia—Lambton, ON]

Mr. Speaker, I am pleased to present this morning a petition duly certified which calls for the abolition of the Senate of Canada.

This petition notes that there is a need to modernize our parliamentary institutions, that the Senate undermines the role of MPs in the House of Commons, that it costs taxpayers some $50 million a year, and that it is an undemocratic institution.

[Lorne Nystrom, NDP, Qu'Appelle, SK]

Mr. Speaker, I am also pleased to rise in the House to present a petition on behalf of 104 Canadian citizens representing 104 senators calling upon the House of Commons to abolish the Senate. The petition says among other things that the Senate is undemocratic, is not elected, is unaccountable, costs the Canadian people $50 million, and it undermines the role of members of parliament and therefore the Senate should be abolished.

Questions On The Order Paper

[Peter Adams, Liberal, Parliamentary Secretary to Leader of the Government in the House of Commons]

Mr. Speaker, Questions Nos. 138 and 139 will be answered today. .[Text]

Question No. 138—

[John Cummins, Reform, Delta—South Richmond, BC]

With reference to the neuro-psychiatric side-effects experienced by those taking the anti-malarial drug mefloquine (Lariam): ( a ) Of those Canadians administered mefloquine prior to the date of its licensing for general use by the Health Protection Branch in 1993, how many persons committed suicide or attempted to commit suicide and how many of these incidents were associated with alcohol use; ( b ) Of those Canadians administered mefloquine after the date of its licensing for general use by the Health Protection Branch in 1993, how many persons committed suicide or attempted to commit suicide and how many of these incidents were associated with alcohol use; ( c ) Of those members of the Canadian forces who were administered mefloquine since 1992, how many have attempted suicide or committed suicide; in what year; in Canada or abroad and if abroad name the country; ( d ) Of those members of the Canadian forces who were administered mefloquine since 1992 and attempted suicide or committed suicide, how many of these incidents were associated with alcohol use; ( e ) Has the Health Protection Branch reviewed the international experience concerning suicides, suicide attempts, and suicidal ideation associated with mefloquine use, and if so when, and what were the results and recommendations of the review, and what steps have been taken to implement the recommendations; ( f ) Has the Health Protection Branch reviewed the scientific literature with regard suicides, suicide attempts and suicidal ideation associated with mefloquine use and if so when, and what were the results and recommendations of the review and what steps have been taken to implement the recommendations; ( g ) Has the Health Protection Branch revised the administering instructions for mefloquine to include warnings regarding suicides, attempted suicides, suicidal ideation, or the combination of mefloquine and alcohol and if so when, and what action taken, and if not does it plan to do so and if so when; ( h ) Have the Canadian forces taken actions in regard to suicides, suicide attempts or suicidal ideation associated with mefloquine use or the combined ingestion of mefloquine and alcohol and if so what was the action and when was it taken, if not why not and when do the forces plan to do so; ( i ) Has the Health Protection Branch taken special steps to warn Canadian physicians of the hazards of combining mefloquine and alcohol, when were they taken, and if no action why not, and when does the Branch plan to act and what do they plan to do; ( j ) Have the Canadian forces noted or otherwise received letters, doctors reports or other complaints from military families of miscarriages or infant deaths where either the father or mother were administered mefloquine prior to or at the time of the child's conception?

[Peter Adams, Liberal, Parliamentary Secretary to Leader of the Government in the House of Commons]

I am informed by the departments of health and national defence as follows:

(a) There has been only one case reported in Canada prior to 1993 of a patient with a medical history of alcoholism experiencing two episodes of hallucinations, depression and suicide ideation while taking mefloquine for malaria prophylaxis.

(b) There have been four additional cases reported in Canada after 1993. Two cases of suicide and two cases of suicidal ideation have been reported. Of these, two were potentially associated with alcohol use.

(c) Of the Canadian forces members who were administered mefloquine since 1992, there has been one attempted suicide, Somalia 1993, and one suicide, Rwanda 1994.

(d) One.

(e) Health Canada continues to follow the adverse reaction profile of mefloquine but has not formally undertaken a review of the international experience concerning suicides, suicide attempts and suicidal ideation associated with mefloquine use.

(f) Health Canada has not formally undertaken a review of the scientific literature with regard to suicides, suicide attempts or suicidal ideation associated with mefloquine use.

(g) The product monograph for mefloquine has been revised twice subsequent to the issuance of the notice of compliance. There has been no revision to the product monograph relating specifically to suicide. Depression is a contraindication to use of the drug, product monograph revision of January 1997. The precautions section of the product monograph states that “During prophylactic use, if signs of unexplained anxiety, depression, restlessness or confusion are noticed, these may be considered prodromal to a more serious event. In these cases the drug must be discontinued”. Similar information is repeated in the adverse reactions section of the monograph and in the information to the consumer section of the monograph. With respect to mefloquine and alcohol, given that both mefloquine and alcohol are known to have central nervous system effects, in January 1995 a statement was included in the information to the consumer section of the monograph to read as follows: “It is best to avoid alcoholic drinks during treatment with Lariam”.

(h) Immediately following a 1995 report in the Canadian Medical Association Journal of a single case of a psychosis developing in association with excessive alcohol and mefloquine prophylaxis, the Canadian forces issued a warning message advising of this potential adverse reaction. Subsequently all deploying personnel are to be given a briefing regarding potential adverse effects of mefloquine and a warning against excess consumption of alcohol. In addition, alcohol consumption during Canadian forces deployments is closely regulated by the commanding officer.

(i) The product monograph is the official document used to inform physicians of the properties of drugs and the approved instructions for use. As indicated in response to part(g), the product monograph was updated to reflect current information available to Health Canada about mefloquine.

(j) The Canadian forces-Department of National Defence at the national level has had no reports of cases or complaints regarding miscarriages or infant deaths related to use of mefloquine in Canadian forces members. However, if such an event was reported to Health Canada through a dependant's doctor, we would not necessarily be informed.

Question No. 139—

[Jim Pankiw, Reform, Saskatoon—Humboldt, SK]

In each of the three previously recorded fiscal years, what has the government determined to be: ( a ) the total amount of federal tax dollars used to compensate Canadians whose firearms have been confiscated by the government; ( b ) the total amount of federal tax dollars given to El Salvador for use in a firearms buyback program; ( c ) the names of all countries to which federal tax dollars have been given for similar firearms buyback programs; and ( d ) the total amount of federal tax dollars spent to fund these initiatives?

[Peter Adams, Liberal, Parliamentary Secretary to Leader of the Government in the House of Commons]

I am informed by the Canadian International Development Agency and the Department of Justice as follows:

(a) The compensation file originated in 1994 with the passing of Order in Council No. 11 on November 29, 1994. OIC No. 11 identified a series of firearms as prohibited weapons effective January 1, 1995. Of the firearms that have been turned in under OIC No. 11, 47 of these were deemed to be eligible for compensation resulting in payments totalling $36,009.77. Most of these payments have occurred in 1995 or the early part of 1996. By fiscal year the payments were as follows: 1995-96, $31,613.56; 1996-97, $1,110.17; and 1997-98, $3,286.04.

(b) $296,509*.

(c) Mozambique.

(d) $120,000*.

It should be noted that through these Canadian International Development Agency projects, arms are not purchased for cash, but are exchanged for coupons donated by the business community that can be redeemed for various consumable goods, such as food and clothing.

[Peter Adams, Liberal, Peterborough, ON]

Mr. Speaker, I ask that the remaining questions be allowed to stand.

[The Deputy Speaker]

Is it agreed?

[Some hon. members]

Agreed.

The House resumed from February 17, consideration of the motion that this House approves in general the budgetary policy of the government; of the amendment; and of the amendment to the amendment.

The Budget

[Hedy Fry, Liberal, Secretary of State (Multiculturalism)(Status of Women)]

Mr. Speaker, it is with enthusiasm and pride that I stand today to speak to the budget that was tabled two days ago in the House, enthusiasm and pride because this is a Liberal budget. It is a Liberal budget because it has balanced all of the needs of the people of Canada in trying to find a way to reduce the debt and in trying to find a way to do progressive tax reform and in trying to find a way to look at building a new social and economic infrastructure for the needs of Canadians in the 21st century. That is what makes me proud.

What makes me even more enthusiastic about this budget is that as a physician this budget has focused on health. This budget has focused very clearly on something I know a great deal about.

I do not speak only as a physician. I speak as someone who for the last 20 years has been very involved in all aspects of health care: in the financing of health care; in understanding how the health care system works at the provincial level and at the federal level; in understanding and working closely on issues of health promotion and disease prevention; and clearly, as president of the British Columbia Medical Association, in understanding the issues that affect the providers of health. I have worked for many years with the other health care providers in this country. I think with due modesty that I know something about the health care system in all of its intricacies.

Why I am pleased about this budget is that we have done the very important thing of injecting some acute care into the health care system.

As a physician, and as a patient well knows, physicians are supposed to make accurate or as accurate as possible diagnoses. In spite of what we may hear from members of the opposition party, the health care system in Canada has not been in crisis and never has been in crisis. What the health care system of Canada has been—

[Some hon. members]

Oh, oh.

[Hedy Fry, Liberal, Vancouver Centre, BC]

I hear other members shouting. Obviously they do not understand the difference between crisis and acute care.

I am here to say that the health care system in Canada was not well and that it needed some acute care. It has been given that acute care. It has been given the immediate acute care it needed, which is to take care of the patient now for today and for the very immediate future. We have done this by infusing $8 billion over the next five years into the transfer payments.

In terms of acute care, we have also put in place a supplementary fund of $3.5 billion so that the provinces over the next three years in ways that they see fit for their needs can take money out of the trust fund to deal with some of the more acute issues that concern them in their provinces.

What is also important in this system is not only that the diagnosis has been made but the treatment has been started. First in the treatment of dealing with the acute care of the patient was to inject funds into the system.

Second, this budget puts $1.4 billion into systems, research, accountability and looking at how we develop best practices and how we create a more effective and more efficient health care system, one that will provide a high quality of care. That is the other component of caring for patients which doctors know all about.

That component is not only to give patients the medicine needed to make them feel better immediately, but it also ensures that in the long term the rehabilitation of patients will take place, that patients will be able, as time goes on, to get better and to build a sound basis for having a better quality of life. Patients will become stronger and be able over time to extend their lives. This is the sustainability component of the budget that is key.

People like Robert Evans from the University of British Columbia, a health care economist who has spoken for health care for over 25 years, has said over and over again that what the health care system needs is not just money, that the health care system actually needs to change the way we have been doing things.

The system worked very well for us in the 1960s and the 1970s and in part of the 1980s, but as with every system that works well we need to constantly be evaluating, to be evolving and to be able to meet the newer and newer needs of patients. Things have changed in Canada.

We have an aging population and brand new technologies. These things need to be taken care of, and not just with money. We must find ways in which we can use technology appropriately and wisely. We do not need a CAT scan on every street corner. We do not need new technology in every hospital in the country, but appropriate use of technology is important.

The $1.4 billion that will go into research and into building our system will help us how to do it better. It will assist the providers of health care, the administrators, hospitals and institutions to understand how to use technology better, to understand the things we need to do to give better and more effective care, and to deal with these issues a lot better than has been done in the past.

This evolution of the system is extremely important. That is key. This is something that Mr. Evans recently said very carefully. Every royal commission over the last 15 years that has sat in every province of the country has said the same thing. It is not money alone that will fix the system. We need to change the way the system works. We need to ensure that the system is more effective, that there are guidelines for good care, that we have appropriate guidelines for technology, and that we use the system far more wisely than we have been.

I am stressing the $1.4 billion. It is nice to point to the $11.5 billion that will be going into the health care system over the next five years, but what is more important is that little $1.4 billion. That will make the system work better. That will ensure what all health care economists who understand health care have been saying over the last few years, that we need to deal with the system.

It will turn the system around. It will make a better system for us. Let us not ever believe that we are spending too little money on health care. We are one country that has been spending far more of a percentage of GDP on health care than many countries in the world with far better outcomes than we have.

Fixing the health care system has to involve looking at outcomes and at appropriate ways of dealing with the system so that the outcomes will be achieved. It is about allowing people to monitor what we are doing.

We have talked about acute care. We have talked about the rehabilitation of the system. We have talked about putting the system back on track in a new way so that it can serve 21st century Canadians better. We also need to know that health care is more than just hospitals.

Health care is about preventing disease. Health care is about assisting those who are disadvantaged in other parts of the country and need health care and prevention. One thing that is going into the new health care budget is money for aboriginal people such as the Inuit people of the country who have had very bad health outcomes over past years. This will start to make those changes.

We need to talk about prevention. We are talking about the fact that over the last few years we have seen more and more low birth weight babies. One of the reasons for low birth weight babies has to do very clearly with mothers at risk, especially at risk of poor nutrition.

The new money going into the prenatal nutrition program is very important money. We will look at how to fix the outcome of low birth weight babies. It ties very clearly into the government's focus on helping children not only when they reach the ages of six and seven but when they are beginning to develop in the first three years of their lives and pre-birth when important developmental processes are beginning in the fetus.

The health care budget is more than just an infusion of cash into the system. It is more than just the infusion of immediate acute care needs for dollars. It is building a new health care system that will serve Canadians better.

We have said before that the system is not only made up of the people who use it. It is made up of the people around the country who provide care. One thing that is most exciting about the budget is the nurse program. Some providers will get the skills and tools they need to be able to build good information systems and to be able to assist them with good practices so they can provide health care.

It will also inject some much needed morale into the system. Nurses have laboured with very little thanks and very poor remuneration for the work they do. That is why nobody wants to go into nursing any more. The $25 million endowment fund will assist nurses to start recruiting. It will give them the skills and tools—

[The Deputy Speaker]

Order, please. Did the hon. member indicate that she was splitting her time?

[Hedy Fry, Liberal, Vancouver Centre, BC]

Yes, Mr. Speaker.

[The Deputy Speaker]

Then her time has expired, I am sorry to advise.

[Grant Hill, Reform, Macleod, AB]

Mr. Speaker, the member opposite spoke very eloquently about her background as a physician. She is a member of the Canadian Medical Association which has a comment to make on the budget as it relates to health care.

I would like her to comment on this particular perception of the budget. It is from Hugh Scully, president of the CMA. He says that the health care system is in an emergency situation now and that with the budget it has moved down to urgency status.

Why did the Liberals choose to take what was a monetary emergency in 1993-94 and turn it into a medical emergency? The CMA disagrees with her perception that medicare is in good shape today. It has gone from emergency down to urgency. What does she say to that?

[Hedy Fry, Liberal, Vancouver Centre, BC]

Mr. Speaker, I did not say that the system is in good shape. Let us be very clear about that. I said that the system was in need of urgent care.

What the hon. member across the way has been telling us over and over is kind of strange. Physicians are supposed to diffuse anxiety, help patients find a better way to get well and build a strong rehabilitative program for patients. Physician are not to panic, not to yell crisis, not to be a Chicken Little and say the sky is falling when it is not.

The medical association is saying that the system is in need of good acute care. We go to the emergency for good acute care. That acute care has occurred. This infusion of money into the system will help to give us the acute care we need. What is more important is that it will build a strong system for the future. That is what all health care economists like Robert Evans and many people across the country have been asking for.

Ten royal commissions across the country have said the same thing over and over, that there is a need to build new structures in the system. That is what the budget is doing. It is not just throwing money at the problem. We all know that throwing money at the problem will mean that in two year's time we will be asking for another $12 billion. That will not resolve the problem. As a physician the hon. member should know that very well.