Debates of Feb. 4th, 1999

Supply

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, I know the hon. gentleman well and I am going to gently suggest that notwithstanding his enthusiasm for sovereignty, the premier of Quebec has reaffirmed his support and partnership in Canada with regard to our health care system. This is an extraordinary achievement and it shows that Canada is unified on the importance of our health care system to all Canadians.

The second matter the member made a query about was with regard to dollars. Possibly when the member sees the press conference that was given some two hours ago and reads the reports he will find out that the premiers had the best meeting they have ever had with the Prime Minister. They agreed upon dollar commitments and timeframes and they are unified in their position to defend our health care system.

Finally, about interfering in health, the member will well know that the federal government has a role to play in enforcing national standards. The transfer of any moneys from the federal government under the laws of Canada are only to be applied for hospitals and for physician services on the ratio of two-thirds to one-third.

[The Acting Speaker (Mr. McClelland)]

The hon. member for Hochelaga—Maisonneuve has one minute to put his question, and the reply should not be over a minute either.

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

Mr. Speaker, there is a limit after all.

Will the hon. member agree that Quebec was not only deprived of money that it should have received, but that it is totally unacceptable for the federal government to get involved in health?

Could the hon. member send me, through you Mr. Speaker, the part of the Canadian Constitution where it says that the federal government has the power to do that? I would appreciate it if he could show me where it is provided in the Canadian Constitution that the federal government can get involved in the health sector. Have him send us a copy of the Constitution through you, Mr. Speaker.

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, the simple fact is that the premier of Quebec on behalf of all of the people of Quebec entered into and signed the agreement today supporting, along with all of the provinces and territories, the principles of that health accord.

There is no question about the interference matter raised. The premier is not concerned about interference. The premier understands that the roles of the provincial governments and the federal government are established under our Constitution and that the Canada Health Act prescribes the role of the federal government in terms of national standards and national policies in protecting the principles of the Canada Health Act.

Quebec is in. Get used to it.

[Hélène Alarie, Bloc, Louis-Hébert, QC]

Mr. Speaker, the provinces have had exclusive jurisdiction and authority over health since the 1867 Constitution Act was passed, leaving the federal government with the responsibility to legislate in the areas of food and drugs, criminal law, quarantine and marine hospitals.

The provinces have been vested with the legislative powers relating to hospitals, the medical profession and the practice of medicine, including costs and effectiveness, the nature of the health care system and the privatization of medical services.

Yet, even though the Constitution Act, 1867 is clear on this, particularly sections 92(7), (13) and (16), the federal lawmaker has been using its inherent spending power to set national standards for provincial medicare programs. It is thus imperative to limit this federal spending power, hence today's motion:

That this House urges the government to respect provincial jurisdiction over health care management, to increase transfers to the provinces for health care unconditionally, and to avoid using budget surpluses to encroach upon the health care field.

All the premiers at the meeting in Saskatoon last August called on the federal government to restore the transfer payments it had taken for itself since 1994 so that they could do something about the widespread needs making themselves felt in the health care system. They called for $6.3 billion, of which $1.8 billion, and therefore over $1 billion for health alone, is Quebec's share.

The federal government has now balanced its budget and is even getting ready to build up a huge surplus estimated at between $12 billion and $15 billion, largely through provincial cuts, to health in particular.

From the beginning, the Bloc Quebecois has been fighting to have the money cut from Quebec's transfer payments restored.

Today, all the premiers were told that they would get back a small portion of what they were asking for to help them with health care costs. This is a far cry from the initial demand of last August, but we are running out of steam and have agreed to accept this paltry amount, which is our due, because it has been offered without any conditions, and Quebec has defended the interests of Quebeckers well on this score. It will be in a better position than anyone else to know which parts of its health care system are most in need of funds.

I would now like to go back to the federal government's interference in provincial affairs, because the Constitution Act, 1867, clearly sets out which are federal and which are provincial areas of jurisdiction.

The federal government is returning to the provinces only part of the billions it cut but, in its constant quest for visibility, apparently has millions to spend on new programs, such as a national home care program. The Liberal government is denying the provinces the right to opt out with full financial compensation for home care. This is a bit like what is happening with the millennium scholarships.

But there is more: in its 1997 budget, the federal government announced that it would spend $150 million over three years on the health services adjustment fund to help the provinces set up pilot projects to provide home care or pharmacare, even though Quebec, well ahead in this area as in many others, already has its own programs.

Since the Constitution prevents the Liberal government from opening federal CLSCs in Quebec, it goes through the back door so it can interfere in areas under provincial jurisdiction, as it did 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, as planned in the 1997 budget, 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 going to offer the right to opt out with full compensation to the provinces that do not want those programs?

Finally, on June 18, the federal government renewed its commitment to the fight against breast cancer. The renewed federal contribution is set at $45 million for the first five years. The Minister of Health announced that the Canadian breast cancer initiative would be renewed and enjoy stable, ongoing funding of $7 million per year, as well as a whole series of measures in this area.

However, the breast cancer initiative of the federal government is duplicating Quebec's cancer control program that the former health minister, Mr. Rochon, and the president of the cancer advisory council made public last April. This innovative tool will be used throughout the province of Quebec and has become Quebec's cancer control program, whose theme is it takes a team to beat cancer.

Through its spending power, the federal government is getting involved in cancer control, which demonstrates once again that the Liberal government always finds money to duplicate the work of the provinces. And what about the national report card the health minister has announced?

Again, the minister seems to forget that, since the provinces manage health care services, they are in the best position to know what the health care situation is in their respective jurisdiction.

So, we urge the federal government not to use this annual report to penalize the provinces that do not want any part in it. Will we have the right to opt out?

Our political party will always defend the interests of Quebec. It seems to me that all the other Canadian provinces are not close to their people, since they are willing to accept the central government's interference in their area of jurisdiction. The health issue should have been an eye-opener. But what if it were a question of pride?

To be proud, one has to identify with one's people, which is quite easy for Quebeckers.

[André Harvey, Progressive Conservative, Chicoutimi, QC]

Mr. Speaker, I am pleased to take part in this debate, which I had the opportunity to do on several occasions today. Since the hon. member gave such a well thought out speech, I would like to convey my concerns to her.

Unless one is extremely doctrinaire, it is always possible to agree on a question of principle. The member just said that the Bloc Quebecois will defend the interests of Quebec. I am beginning to make a distinction between defending the interests of the Government of Quebec and defending the interests of citizens, in particular those I represent and the interests of outlying areas of Quebec, which an overwhelming majority of Bloc Quebecois members, people of quality, do defend.

My concern is that when there are requests for transfers for health, for instance, my past experiences in other areas make me wonder a little. For instance, in areas like employment where there have been massive transfers, the effects are still not felt in various regions in Quebec. There is almost no programming left relating to employment activities.

The problem we deal with in our region is also present elsewhere. If health funds are transferred to the Government of Quebec, I would like assurance from the hon. member that those funds will be distributed equitably among the various regions of Quebec. Based on the statistics, the region of Saguenay—Lac-Saint-Jean, among others, has a very serious deficit compared to other regions in Quebec, namely central regions like the Montreal area. The accumulated deficit is about $75 million. That explains why we face such serious problems.

In my region, we are no longer able to provide good quality health care to our citizens. There is cause for major concern when the population of a region can no longer obtain health care. Health care is a priority. We have to defend our fellow citizens on practical issues.

I agree with transfers to Quebec, but what concerns me is the way the Government of Quebec will transfer the money to regions. This is the concern I wanted to raise during this debate. I am grateful to my colleague from the Bloc Quebecois for having introduced this motion in the House and I hope that this will contribute to improving the way Quebec transfers funds to regions.

[Hélène Alarie, Bloc, Louis-Hébert, QC]

Mr. Speaker, I think the hon. member is hinting at interference in his question, since, once the funds have been transferred to the provinces, it is their job to manage and administer the money. I think the whole of Quebec is on the leading edge in several programs such as medicare, pharmacare and health care in local community service centres.

[An hon. member]

They are closing down hospitals.

[Hélène Alarie, Bloc, Louis-Hébert, QC]

As someone back there said, they are closing down hospitals. They are reorganizing, because provinces have suffered drastic cuts for many years. One cannot help but feel it when the health budget is cut by $1 billion a year in a province.

I think we would have been poor managers if we had not been careful to manage in the best way possible the little money we had left.

I represent a city riding, but I come from the Lower St. Lawrence, a region even more remote than the region represented by the hon. member for Saguenay-Lac-Saint-Jean. We will not argue about the regions. There too, there were organizational problems in health. Still, I think every region in Quebec has been well served with what we had at our disposal.

A bit more money will be put in, and I am sure we are very aware of the needs of our population. So much so that no conditions have been made for to the transfer of funds to provinces. So, every province knows its own needs, glaring needs. We are reminded of them every day and they will be met, I am sure of that.

[Antoine Dubé, Bloc, Lévis, QC]

Mr. Speaker, I am pleased to take part in this debate.

I too would like to say a few words to the member for Chicoutimi, who just spoke, even though the member for Louis-Hébert has responded very well to his comments.

I would like to remind my colleague from Chicoutimi of the words spoken by his former leader, who is now leader of the Quebec Liberal Party. On May 7, 1997, he said, and I quote from Le Devoir “Forget Lucien Bouchard and Jean Rochon; the person who is really responsible for hospital closures and the deterioration of our health care system is—”. I cannot mention his name in this House, but he is the present Prime Minister of Canada. Those were the words of the former leader, of my colleague for Chicoutime, and I think he still has respect for him.

Jean Charest went on to say: “Mr. Bouchard, Mr. Harris, Mr. Filmon, Mr. Klein and all the other premiers are forced to manage the federal government's unilateral cuts”.

What the member said about the Saguenay-Lac-Saint-Jean region may be true. It is true that cuts were made everywhere. He also said that it is a matter of transfers, but I think—and I am sure he will agree—it is an issue that should be discussed in the Quebec National Assembly. I wanted to remind him that the cuts were decided upon there.

Today, the federal government agreed to give back some of the transfer payments, but apparently the amount given back does not even come close to what was taken away. Since 1994, the Liberal government slashed transfer payments to the provinces for health, education and welfare by $6.3 billion a year. If we split that amount among the three areas, it means $1 billion a year for Quebec alone.

We will see the figures within hours or days, but we are far from the final count. One step has, however, been made in the right direction, or in other words a small step back toward the way things used to be.

Transfers to the provinces are at their lowest level—pending adjustment—in 20 years. Cash social transfers from the federal government are today where they were 15 years ago, or in other words $12.5 billion. At the time of the federal election in 1993, the level was $18.8 billion. This means a unilateral reduction of $6.3 billion yearly, or 33% in less than 4 years.

Taking population growth and the cost of living increase into account, social transfers have not been this low for decades. That is why I say that, in 1996, social transfers amounted to $386 per head. That figure is 45% lower than the 1985 record level of $706, and 43% lower than the 1994 level of $678.

An illustration of the concrete meaning of $1 billion to Quebec is necessary here. One billion dollars is 20% of the cost of all Quebec hospitals. It means closure of half the hospitals in the Montreal region. It is the cost of 370,000 hospitalizations. It is the pay of half of the nurses in Quebec. It is the cost of all of Quebec's CLSCs, which is $924 million. It is twice the cost of all services to youth, which is $500 million. It is a sizeable amount.

I know that a number of members are making reference, but I would like to speak of the impact that will have on the Quebec City and Chaudière—Appalaches regions. I may be using the same figures my colleague from Lotbinière will be citing shortly, but, for example, the cuts amount to $103 million for the Robert-Giffard hospital. They represent $76.4 million for Quebec City's Hôtel-Dieu hospital; $12.3 million for the Saint-Joseph-de-la-Malbaie hospital; $72.1 million for the Laval University hospital; $29.5 million for the Charlevoix hospital; $54.2 million for the Saint-Sacrement hospital; $66.4 for the Laval hospital and $71.7 million for the Saint-Fançois-d'Assise hospital.

On the other side of the river, in the beautiful region of Chaudière-Appalaches, there are a few examples. There will be a shortfall of $63.7 million for the Lévis Hôtel-Dieu hospital; $31 million for the Amiante region hospital; $14.7 million for the Montmagny Hôtel-Dieu hospital and $30.1 million for the Beauce-Etchemin hospital. That is a lot.

Often, when billions of dollars are bandied about people do not understand the whole impact, but I know that people currently working in the hospitals—the doctors, nurses, technicians, those looking after the patients—realize what the cuts mean in day to day terms and have known this for a number of years.

On this opposition day, the motion put forward by the Bloc Quebecois is basically asking that transfer payments to the provinces be restored. I take this opportunity to commend the hon. member for Drummond, who has been our health critic since the 1993 election. I am qualified to do so, especially since I worked with her for 18 months before being reassigned to industry and regional development.

Time and time again I witnessed attempts by the federal government and the health department to interfere, not only through the funding cuts we are condemning today, but also with unacceptable bills.

We will recall for example Bill C-47 on new reproductive technologies. We could mention other areas and the broad area of health, with bills like C-14 on drinking water. We all know what happened on the hepatitis C issue. I think it is good to remind the House of the facts. At the insistence of the hon. member for Drummond and Bloc Quebecois members, settlements were made, although they are still incomplete. As we know, those infected before 1986 are not eligible for compensation.

At the health committee, the hon. member for Drummond and myself could see this sort of thing happening almost on a weekly basis. And it went on. There was this foundation that funds health research, to which payments were made directly, but efforts are made to go over the heads of provincial governments and deal directly with universities and even private scholars. As I said, this is still going on.

I have been attending every meeting of the Standing Committee on Industry and, because some proceedings are held in camera, I am not at liberty to mention specific issues; a report is to be tabled on Monday. In recent days, we saw all the attempts made by the federal government to invade the health sector, allegedly to protect the interests and health of all Canadians.

This is why I think the Bloc Quebecois did a good thing today. Its motion came at a most appropriate time, when the premiers and the Prime Minister are negotiating on this issue and others, including social union. Indeed, an agreement was reached regarding the recovery of part of the transfers.

The issue of social union was also discussed. An agreement was reached to recover transfers. It is still acceptable for health, and I know that my colleagues discussed this issue, but attempts have been made to set new standards, new conditions, again in an effort to get involved in what is—as we know—essentially a provincial jurisdiction.

I used to sit on the human resources development committee. This experience makes me say that there are two different mentalities in our country. Today's agreement, the so-called agreeement on social union, was ratified by nine anglophone provinces. It does not bother them to see the federal government get involved in their affairs, as long as they get the money. In Quebec, we think differently.

There is a consensus in our province, and I hope the leader of the opposition in Quebec City will act in a manner consistent with what he said when he was here, and that he will support the position defended today by the Premier of Quebec, Mr. Bouchard.

[Jocelyne Girard-Bujold, Bloc, Jonquière, QC]

Mr. Speaker, I would like to take this opportunity to join my colleague, the member for Lévis-et-Chutes-de-la-Chaudière, in thanking our colleague from Drummond for all the information and support she has been providing the Bloc Quebecois. She has helped us improve every piece of legislation dealing with health care we have debated in this House over the years.

If we had not had people like the Bloc Quebecois members here in the House of Commons, Quebec would have been penalized ten times more. We are dealing with people who do not consult, take money that does not belong to them out of people's pocket, and use it to reduce their deficit and drive us further into poverty.

Our colleague from Chicoutimi keeps on saying “With this deal it has just signed, I am not sure the Quebec government is going to reinvest this money in health care and redistribute it among the regions”. The cuts the federal government made to health care transfer payments to the provinces created a $38 million shortfall in the Saguenay—Lac-Saint-Jean area. This is a lot of money, $38 million, this is not peanuts. This is money it took out of our own pockets.

It said “We do not want to know, you deal with it”. We in Quebec had made the move toward ambulatory care. We were going to get health care under control.

But the federal government would not let Quebec do its own thing. It said “Let us play a dirty trick on them and cut $38 million”, which is what it did in my area alone. This was a contemptible move on the part of the federal government.

This was not a gift from the Government of Canada to the Government of Quebec. It represented only a third of what they owed it. I think they should give us back the two thirds they still owe. Since 1993, the federal government has cut provincial transfer payments by $6.3 billion. This affects the Government of Quebec. The battle is not over. Quebeckers are proud. We listen to our people. We are attuned to what every member of Quebec society thinks. We are proud of what we are and we are proud of our desire to become a sovereign nation.

I would like to ask my colleague, the member for Lévis-et-Chutes-de-la-Chaudière, if he too, in his region, has heard equally contemptible examples of what the federal government has done to the Government of Quebec.

[Antoine Dubé, Bloc, Lévis, QC]

Mr. Speaker, I have heard similar comments. In our riding offices, we hear all kinds of horror stories, people talking about personal experiences with regard to that.

I would like to go back to the issue of difference. I still say there are two countries within this country. In our work and in our discussions with members on the other side of the House and from other parties on this subject, we can see how important it is for Quebeckers to maintain jurisdiction over health, education, and so on. We feel this is important. We are always faced with a perception that we can respect because they may not have read the same history books as we have, and vice versa.

They think—and I am also saying this to those who are listening—that the federal government is the superior government, followed by a second level, the provincial governments, and finally by the municipalities. The spirit of Confederation in 1867 put all governments on the same level. They were meant to have different responsibilities and to act together. That is no longer the case today.

The federal government, with its spending power, uses the money. After achieving surpluses, as mentioned by the member for Jonquière, the federal government can now rectify the situation. However, those billions of dollars that were taken away from Quebec and the other provinces have resulted in unthinkable situations, including the one in the Chaudière-Appalaches region. That is the example that always comes to mind.

It is a difference in perception to think, as my colleagues from the other parties do, that the federal government is the superior government, the big government, with the provincial governments being inferior governments.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, it is a pleasure to talk today about health care but I am saddened that yet again we seem to be talking about turf.

The motion is filled with words about turf and not about the welfare of Canadians. Words like jurisdiction, unconditionally, encroach and health care field actually mean that we refuse to discuss what is most important to Canadians individually but also to Canadians' role in the international field.

I would like to talk to this motion from two perspectives.

Canada on the international stage when sitting at a meeting with other countries with the Canadian flag in front, needs the ability to be responsible for the kind of health care delivered across the country.

Mr. Speaker, I forgot to mention that I will be sharing my time.

Canadians across the land need to know that when they are represented internationally they will not be embarrassed. Canadians hold their health care system with huge pride. They have expressed that medicare is their badge of honour.

Canadians feel that fairness in the delivery of health care across the country is the most important thing to them. They do not think the size of somebody's wallet should determine where one stands in line for a required procedure. It is extremely important to remember that the provincial responsibility has been for the management and the delivery of health care, but the federal government has always had a role in health care promotion and prevention.

Prevention is the most important thing we can do for our health care system. It must not and can never be separated from actually what is the vision and values of health care for the country. It is integral to doing a good job in health care.

The federal government has always had an important fiscal component in health care. The central vehicle of this has been the CHST. The CHST has been an important lever in terms of a cash transfer. Up until now it has been our only way of insisting on the provisions of the Canada Health Act which are actually essential to the security and confidence that Canadians have in the system.

Public administration, comprehensiveness, universality, portability and accessibility are important aspects to Canadians but as I have said before, unfortunately the Canada Health Act says nothing about quality.

Canadians risk losing confidence in their health care system. It is imperative that the federal government has a way of ensuring high quality care. That begins with an understanding and co-operation in terms of measurement.

It is thrilling that today with the social union talks we have begun discussing things like accountability. I remember last summer when the Minister for Intergovernmental Affairs first mentioned in terms of the social union talks the word accountability. A lot of us were thrilled that there was the beginning of a discussion on how we ensure to Canadians that it is not the federal government checking up on the provinces but it is a matter of both levels of government being able to report to Canadians on how these outcomes are being done.

Today we see in the document things like achieving and measuring results, monitoring and measuring outcomes of social programs, sharing information and best practices, something we know we need to do in order to find the savings. Just giving money is never going to be enough, unless we can ensure that health care is delivered in a collaborative way where all the provinces get to share their good ideas with one another and professionals get to determine what are best practices and a cost effective way of spending the money.

Today we have publicly recognized the respective roles and contributions of all levels of government. But we also know that when funds are transferred from one government to another for the purposes agreed upon it is extraordinarily important that this not be passed on to the residents in some other way. We need to make sure that the dollars for health care are spent on health care and that they are spent wisely on health care.

Involving Canadians in some sort of vision exercise is going to be the most important thing we do. We have to ensure that there are effective measures for Canadians to participate in what it is they want and the ability of the federal government to make sure that it happens.

There are certain places within the provinces that do extraordinarily good things. The kind of standard that is now in Quebec in terms of home care is a model for the country. We should share that information across the country and talk about how we get that for all Canadians. Recently when we saw the B.C. outcomes in cancer, we were all a bit jealous and wanted to know what was being done. It is up to the federal government to be the clearing house to make sure those good ideas happen.

Whether it is waiting lists or outcomes or how people are doing in early discharge, we have to measure the readmission rates, if we are going to boast about early discharge in terms of maternity for example. We need to know about hysterectomy rates and Caesarean section rates and birth weight. We are judged internationally as to how we are doing on things such as birth weight. It is not good enough that we leave the accountability for the provision of health care without holding our own valued responsibility to Canadians in terms of how the dollars are spent.

Traditionally the federal government has had some small direct spending ability. Today in the talks it was again articulated. Federal spending power should be used in making transfers to individuals and organizations in order to promote equality of opportunity, mobility and other Canada-wide objectives. When the federal government introduces new Canada-wide initiatives funded through direct transfers to individuals and organizations, it is going to give notice and co-operate with the provinces.

Look at our CAPC program. There are a lot of areas in Quebec where that is hugely welcomed and gratefully received. It is that kind of initiative Canadians have benefited from again irrespective of turf.

I implore my colleagues across the way to help us decide. There were social union discussions today. The next step must be to move to a proper vision exercise to decide together what kind of country this is and what are the values and the vision for this country. Then we must continue to co-operate in a way that is good for Canadians and accountable to Canadians.

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

Mr. Speaker, I acknowledge that my hon. colleague has put a great deal of sincerity in her speech, but there seems also to be fair bit of inconsistency.

First of all, for those who believe in this country called Canada—we are not among them, at least not as it operates now, and as we know it—it seems to me there ought to be an underlying principle behind their actions and their statements. That would be a minimal respect for the founding legislation of Canada, that is its constitution.

It is not because we are going to the offices of a charitable organization that we can get away with driving at 140 kilometers an hour on the highway, nor is it because it wants to help people that the federal government is entitled to interfere in any and all areas of jurisdiction.

It is paradoxical that the hon. member tells us in her speech that she wants to be proud of her health system when she goes abroad. This caucus reminds me of the movie The Silence of the Lambs , because it is quite docile and it does not offer much resistance to policies that deserve greater criticism and challenges.

If the member cares about other people, and I am sure she does because she is a good person, there are three things that she could promote in her caucus.

First, she could talk about the Canadian Human Rights Act abroad, because it is her duty to do so. Our country is one of the few that does not prohibit discrimination based on social status. So, if the member wants to talk about social justice and if she cares about other people, she can campaign, inside her own ranks, to get a real debate that would allow the inclusion of social status among the prohibited grounds of discrimination.

Second, should the member not pressure the Minister of Human Resources Development who just found out that there are people who are exploited in our society? Should she not press for improvements to the EI system?

Third, should she not press the government to give back to the Canadian provinces the money that it brutally stole from them?

These are three areas where the member could use her talents, her intelligence and her convictions to work in the best interests of other people.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, it is interesting again that some of my colleague's suggestions are things that would be a national standard. We need to be on the international stage showing that we are sticking up for these kinds of things, whether it is child poverty or accessibility to university. One of my constituents has seen McGill University documents courting Americans who will pay more but she cannot get her son into McGill.

There are national standards we want to see throughout this country. It is a matter of our sticking together and saying that it should not matter where we live in this country, that we are entitled to have good health care, good access to post-secondary education and good social programs. We are going to figure out how we measure that so that every Canadian, regardless of their postal code gets the same kind of care.

[John Bryden, Liberal, Wentworth—Burlington, ON]

Mr. Speaker, unlike my colleague who just spoke, I have little objection to this motion. For the most part, it is an excellent motion.

I point out that it says that this House urges the government to respect provincial jurisdiction in health care management. I heartily endorse that. That is precisely what is in the Constitution. I am sure that given the right conditions, all the provinces would certainly endeavour to manage health care in a proper fashion.

On increased transfers to the provinces for health care, I think I can speak for just about every member on this side that we would want to see more money go toward the health of Canadians. I am hoping in the budget that is coming out very shortly that the government in its wisdom will find more money for health care in the provinces. We must remember it is a provincial jurisdiction.

Finally, regarding using budget surpluses to encroach upon the health field, quite honestly I do not really know what that means. I certainly would not want to see the federal government encroach in any improper way on provincial jurisdiction.

The only word I have difficulty with in the motion is the word unconditionally. The motion suggests that the federal government should transfer billions and billions of dollars to the provinces for unconditional spending in health care. I have difficulty with that.

Currently the total cash and tax point transfer for health and social spending from the federal government to the provinces is about $26 billion. The difficulty is that any time any government, person or organization gives money to another organization to provide services there has to be some level of transparency and accountability. We have to know we are getting a return on the money we put out to an organization, a province or whatever.

I will give an example in my own province. I hope the Bloc members are listening. I cannot speak for the experience in Quebec because I do not live in Quebec; but I do live in Ontario and can say that there is a general feeling in Ontario that the transfer money coming from the federal government for social spending will not get to where it ought to be.

There are indications of this suspicion. A person came to my riding and described a billboard in Mexico which read “Invest in Ontario—Low Personal Income Taxes”. I do not know for certain but it leads to the suspicion that perhaps the Government of Ontario is using some of the money that is supposed to go to health care and other social fields for something else, which enables it to cut personal income taxes as indeed it has done. That is only anecdotal, but I have actual evidence that this general opinion is held by people in Ontario.

Every fall at fairs in my riding I hold opinion polls. I have four jars on a table. People are given four coloured beans and asked to pretend they are the Minister of Finance and have a $4 billion surplus. Each jar is separately labelled. One is labelled “Reduce the Debt”; the second is “Increase Social Spending”, the third is “Cut Taxes” and the last one is “Reduce the GST”, because I am still very opposed to the GST.

Just in passing, the results among 494 players at the Rockton Fair in my riding last October was 36% for reducing the debt, 30% for increasing social spending, 23% for tax cuts and 11% for reducing the GST.

Members will notice that the figure for increasing social spending is only 30% which seems to be very low, but I have to explain the context in which the question was put to the people who participated in the poll. I should also say that fall fair, one of the biggest in the country, attracts people from all over the province, from Toronto and the Hamilton area; it is a very large catchment area.

If I gave the four beans to persons who were to participate in the poll and said social spending, they would advance the bean toward social spending. However, if I said to them “Oh, just one moment. Remember that the federal government does not control social spending. If you put that bean into the jar for social spending, health and all the rest of it, remember that it is the Government of Ontario that will actually decide how that billion dollars will be used”, people would dart back as if they had touched something hot and would put the bean in another jar.

I watched the poll all the way through. I stayed there for the three days that it was carried out. Roughly half the people who would have put money into social spending changed their minds when they realized that social spending was an area entirely under provincial jurisdiction.

That raises the whole matter of what is wrong. If the public gives money to any organization and is uncertain about whether the organization will actually spend the money where it is supposed to, we have a problem. It is a problem that is easily fixed. The way to fix it is to require an agreement of the provincial government in which it assures the federal government that it will spend the money it receives from Ottawa on health care and agrees to demonstrate that it is spending the money in that way. In other words, there has to be some form of accountability. There has to be some form of transparency.

In the social union talks which concluded today I notice that one item agreed upon by the provinces—and I believe it also applies in the health care field—was the consent to a third party audit of money being received from the federal government and used by the provinces for health care. In other words, the actual spending on health care by a province would be audited. I will say, for example, Alberta keeps very careful track of how its health care dollar is spent. Why should all the provinces not do precisely that?

When we talk about unconditional we talk about no transparency and no accountability. However if we all agree that the money coming from the federal government is to be used on health, there should be no barrier by any province to disclosing in detail how the money is spent.

Quebec has one of the best freedom of information laws among the provinces. I hope the federal government would revise its own access to information law so that the provinces can look into the financial affairs of the federal government in the same way as we would hope the people of Canada and the people of Quebec can look into how money is spent by the province of Quebec on health care.

I do not see much problem with the motion. If I thought there was even a distant chance of getting unanimous consent I would move an amendment suggesting that we drop the word unconditional. If that were agreeable to the opposition I am sure we on this side would support the motion whole-heartedly.

I do not feel I should give my party whip a heart attack by moving a motion at this time so I will pass and ask the Bloc Quebecois to seriously consider amending the motion by taking out the word unconditional and I am sure it will get overwhelming support on this side for its motion.

[Pauline Picard, Bloc, Drummond, QC]

Mr. Speaker, I would like to comment on the speech just made by the hon. member.

I thank him for his information and his speech, but I was a little surprised, because he was initially almost in favour of the motion. But I am not surprised about how his speech ended, because I do not think his party would allow him to vote in favour of this motion.

I would simply like to set the record straight, because Liberals often try to minimize the importance of drastic cuts in the Canadian social transfer by telling us about tax points which have supposedly increased. This is totally false and I am pleased to set the record straight.

I have here a document that was produced by an economist, a tax expert, who knows how to set the record straight. As I am not an economist or a tax expert, I cannot go into the complex mechanics of federal transfers. But I can tell members that this claim is unfounded.

The federal government always brings back the argument of increased tax points. This is unfounded for two reasons: first, there is no relation between the value of tax points and the value of cash transfers.

But Liberals would really like the give the impression they have compensated for their cash cuts by giving more generous tax points. In fact, they have no merit, because the value of tax points is linked to the changing economic situation.

However, the level of cash transfers is determined only by the federal government. It is these transfers that have been cut. An important fact is that the value of tax points would have been increased by the same amount if the federal government had not slashed cash transfers, because there is no direct link between them.

Furthermore, and I will conclude on this, tax point transfers are not transfers, they are simply tax revenues like any others for the provinces.

[John Bryden, Liberal, Wentworth—Burlington, ON]

Mr. Speaker, if I had it my way no tax points would be transferred to provinces for any consideration. By assigning tax points to the provinces we have in effect lost control over federal spending on health care. With the tax points it is absolutely unconditional how provinces spend federal dollars.

If members opposite were to move an amendment to their motion to remove the word unconditional, I guarantee them absolutely that I would vote for their motion. I look forward to the time when they actually take out the word unconditional.

[André Bachand, Progressive Conservative, Richmond—Arthabaska, QC]

Mr. Speaker, it is always strange to hear a Liberal member say such things. We heard a lot today about accountability, about being responsible for expenditures, about the agreement, the fine print saying that from now on provinces are taking responsibility for spending the additional funds they receive, or will receive in the next budget, for health care.

He spoke about fairs in his riding and about how the money in the budget should be spent. They should do the same for employment insurance.

Is the member ready to make the same commitment that the provinces made for health care, and apply it to employment insurance, that every dollar paid into employment insurance stay in the employment insurance fund? It will be the workers who will benefit from it. Could the same philosophy not apply to programs that have an effect on the everyday life of Canadians?

[John Bryden, Liberal, Wentworth—Burlington, ON]

Mr. Speaker, I thank the member for his question. We have to recall that it was the Conservative government which managed to transfer these tax points to the provinces and essentially created the situation where the federal government lost control of federal spending in health care. That is very sad.

As far as employment insurance is concerned, we are talking about apples and oranges, as the member well knows, because we are talking about a situation in which the demand on the employment insurance fund is met by the money that is there.

I do not know what the member actually means. Would he increase the amount? Perhaps he is suggesting that we should cut employment insurance premiums. Perhaps that is what he is driving at. I am not sure, but I know it is not the same situation whatsoever.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Mr. Speaker, I will split my time with the member for Churchill River. I would also ask if there is unanimous consent for the debate to continue until private members' hour. I seek unanimous consent to have this debate continue until 5.30 p.m.

[The Deputy Speaker]

Is there unanimous consent for the proposition of the hon. member for Winnipeg North Centre, that the debate continue until 5.30 p.m. this day?

[Some hon. members]

Agreed.

[Some hon. members]

No.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Mr. Speaker, I regret that we do not have unanimous consent to have a full debate to 5.30 p.m. on this very serious issue. I will speak very briefly and will still share my time with the member for Churchill River.

We appreciate the timeliness of this debate. I thank members of the Bloc for bringing this motion before us today. As they will know from our previous speaker, we have serious concerns with the precise wording of this motion and with the spirit of the resolution.

I appreciate the timeliness of this debate given that we are debating this on the day that news of a potential agreement between the federal government and the provinces has been achieved and where there is some agreement around a supposed social union contract. It certainly gives us some encouragement to hear that there is a move afoot that takes us beyond jurisdictional wrangling and into the serious matter of how we together as Canadians can salvage our health care system and find a way we can build in the future a universally accessible, publicly administered health care system.