Debates of Feb. 4th, 1999

Supply

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

Mr. Speaker, I rise on the opposition motion before us.

I would like to address the role played by the federal government through the Canada Health Act which enshrines the principles and governs federal health transfer payments.

Under the Canadian Constitution the responsibility for health care delivery falls primarily under the jurisdiction of the provincial and territorial governments. They have the primary responsibility for the provision and the delivery of health care services to the people of Canada. The provinces and the territories have responsibility to plan, manage and administer their own health care delivery systems.

The federal government for its part by law is responsible for the promotion and preservation of the health of all Canadians. Health Canada is responsible for bringing all jurisdictions together to tackle the health issues of national and interprovincial concern. The federal government assumes responsibility for setting national policies and for providing health care services to specific groups, for example treaty Indians and the Inuit.

It is appropriate when describing federal responsibilities in health care to note what the federal government cannot do. It cannot interfere in provincial and territorial responsibilities as defined under our Constitution, nor can it be seen to be interfering in those responsibilities.

There is in this country a longstanding partnership between the federal and provincial and territorial governments with regard to health care. The enactment of the Hospital Insurance and Diagnostic Services Act of 1957 and the Medical Care Act of 1966 established the framework for this partnership between governments.

At this time the federal government provided cost sharing for medically necessary hospital and physician services in return for the adherence of provincial and territorial health insurance plans to the principles of a national program. Federal legislation, the Hospital Insurance and Diagnostic Services Act and the Medical Care Act, recognized the constitutional responsibility of the provincial and territorial governments.

Concerns over hospital user fees and extra billing by physicians led to the passage of the Canada Health Act in 1984. After a very heated and historic debate, this was achieved with all-party support, a unanimous vote in this House of Commons.

The Canada Health Act establishes certain conditions that the provincial and territorial plans must meet in order to qualify for their full share of federal health care transfer payments. These criteria and conditions, pillars of Canada's health care system, are: one, reasonable access to medically required services unimpeded by charges at the point of service or other barriers; two, comprehensive coverage for medically required services; three, universality of insured coverage for all provincial residents on equal terms and conditions; four, portability of benefits within Canada and abroad; and five, public administration of the health insurance plan on a non-profit basis.

In addition to the above criteria, the conditions of the act require that the provinces provide information as required by the federal minister and give appropriate recognition to federal contributions toward health care services in order to qualify for the federal cash contributions.

The act also discourages the application of extra billing or user charges through automatic dollar for dollar reductions or the withholding of federal cash contributions to a province or territory that permits such direct charges to patients.

In fact, the threat that user charges and extra billing would erode accessibility to needed medical care was a major impetus in the development of the Canada Health Act. The Canada Health Act was enacted to protect the fundamental principles of our publicly financed, comprehensive, portable and universally accessible system of health insurance.

The provinces and territories retained the responsibility of administering their health insurance plans under the Canada Health Act and for planning and managing their respective systems. This means that they, the provinces and territories, have the responsibility for negotiating with physicians. It means that they, the provinces and the territories, have the responsibility for establishing budgets for their hospitals, for the approval of their capital plans and for the management of health care personnel and all related delivery issues.

I believe the Canada Health Act has afforded the provinces sufficient flexibility to manage, develop plans and change the structures within their own systems and jurisdictions. For example, provinces at their own discretion may insure the services of health professionals other than physicians.

The Canada Health Act does not interfere with the provincial or territorial efforts intended to renew and improve health care delivery to make it more effective or efficient and more accountable to Canadians. The variations within the provinces and territories as they deliver health care demonstrate that the necessary and desirable flexibility already exists to respond to the different needs of Canadians in the different regions of the country.

The evolution of federal, provincial and territorial relations in health care has maintained a distinction in the federal, provincial and territorial roles in health care which are consistent with the Constitution's definition of jurisdiction. This is clearly stated in the preamble of the Canada Health Act, “that it is not the intention of the Government of Canada that any of the powers, rights, privileges or authorities vested in Canada or the provinces under the provisions of the Constitution Act, 1867, formerly named the British North America Act, 1867, or any amendments thereto or otherwise, be by reason of this act abrogated or derogated from or in any way impaired”.

Provinces and territories have affirmed time after time their support for the principles of medicare. The Canada Health Act is strongly supported by most Canadians and is regarded as the defining principles of medicare and the Canadian values of sharing and caring.

Poll after poll indicates great public support for these national principles. Even while discussions of health care structural reforms are taking place, the values which are reflected in each of these principles are still valid and are supported, I believe, by an overwhelming majority of Canadians.

Health care is a unifying factor in this country. When asked to rate the importance of a number of symbols of Canadian identity, health care topped the list with 89% of Canadians agreeing that it was a very important symbol.

Clearly the preservation of medicare is of concern to Canadians. Canadians, some 84% of them, rate medicare among the highest actions which makes them want to keep Canada together.

In conclusion, I wish to underline that the federal government has had in the past and will have in the future a legitimate role to play in health. The Canada Health Act is the foundation of medicare. It is an act which respects the primary responsibility of the provinces and territories for health care delivery. At the same time it binds this country together with its principles and has contributed to making Canadians among the healthiest people and the most envied people on this planet.

Mr. Speaker, I thank you and members of this House and particularly my constituents in the riding of Thornhill for giving me the opportunity to participate in this very important debate.

[Ghislain Lebel, Bloc, Chambly, QC]

Mr. Speaker, when I hear the hon. member, it strengthens my convictions as a sovereignist or, as the members opposite like to say, as a separatist, and I will try to pass those on to my five children and to my neighbours, because this is absolutely outrageous.

It is totally unacceptable to confine the provinces to a merely administrative role, while the federal government imposes its whims and dictates in the health sector. The hon. member says the provinces are primarily responsible for the management side of things. This is a partisan interpretation of the 1867 Constitution, and of the one the Liberals created for themselves, in 1981.

Under the constitutional division of powers, the provinces have exclusive jurisdiction over health, and the federal government has no business coming up with standards, concepts, principles and techniques. All these things come under the provinces' responsibility and this is what we are asking the government to recognize.

Under a constitution that has been truncated, manipulated and tampered with by courts that have always been appointed by the federalist parties in office, the federal government now has a taxation power that is perhaps five times greater than what it needs to look after its exclusive constitutional jurisdictions.

It is because the government is collecting too much money from taxpayers that it can brag and boast, set standards and principles, and subject the provinces to its dictates. This is what I find unacceptable.

I am asking the parliamentary secretary if she is sincerely convinced that she is working in the best interests of her country when she makes speeches such as the one she just delivered.

[Elinor Caplan, Liberal, Thornhill, ON]

Mr. Speaker, as I said in my remarks, health has been a shared jurisdiction in this country. The federal government very clearly respects the role of the provincial and territorial governments to plan, to manage, to administer and to deliver health services within their jurisdiction.

The Canada Health Act clearly defines the criteria, the principles and also the conditions upon which federal funds are transferred to the provinces. This partnership is one which I believe is supported overwhelmingly by a majority of Canadians across the country. It binds the country together. I think that any party in the House who attempted to scrap the Canada Health Act would be punished on election day by Canadians because we value Canadian medicare. We value the Canadian approach to delivery of health services. We value the foundation of the Canada Health Act which says that we share and we care for one another, that access to needed health services is not dependent upon one's financial status and that if one is sick in Canada we will care for them.

The federal government has a very clear and defined role and responsibility in the area of health promotion and disease prevention. The federal government has a very clearly defined role in the delivery of services to specific groups of people whom I mentioned in my remarks. Those people, as an example, are the Inuit, our first nations and other groups. We also have a responsibility to bring together provincial and territorial leaders, as is occurring today, to discuss issues of national concern, national priority. As we know, health care is a national priority for this government and health care and health care issues are a concern for people across this country.

Therefore, it is very appropriate for us in the House today to reaffirm our respect for provincial and territorial jurisdiction. We do that, but at the very same time we acknowledge the important role that the federal government has played through the Canada Health Act, and the acts before it, in establishing medicare, a model for health care delivery unique among the countries of the world and one which has helped to make Canadians among the healthiest and I believe among the most envied people on this planet.

[Grant Hill, Reform, Macleod, AB]

Mr. Speaker, it was a fascinating discourse from my colleague across the way.

The question that is being asked here is, should the government be able to put new conditions on health care spending. The Bloc members have made it very plain. They have asked:

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.

I want to say initially that the problems with medicare are not unique to Canada, they are worldwide. They are actually a little worse here in Canada because of our debt problem and the interest on the debt which gobbles up a fair amount of funding that could go to social programs. But worldwide we have aging populations. We have new technology and new procedures that are really quite expensive and were never dreamed of when medicare came into being. Here in Canada we have a medical legal system that requires defensive practice which increases the costs of medicare. We really have fairly restrictive policies in Canada when it comes to a safety valve.

Although this has been done a host of times, I would like to recapture what has happened over the last few years with medicare. The Liberals promised to protect and enhance medicare in the red book. They very quickly thereafter went through some cuts which were substantial; $16.5 billion in cumulative cash which would have gone directly toward these social programs, so important they say to the public, since they took office. They hid those cuts under the Canada health and social transfer.

I give the Liberals a bit of respect on this issue. They are crafty. They are really quite sneaky in the way they did this. It escaped largely the public's attention because the reductions were not specific to health. It has only been very lately that the public has become aware that the federal government pays less for medicare than do patients out of their own pockets.

Those words came from the federal Minister of Health, that Canadians from their pockets or private insurance pay today more for health care than does the federal government. I say, judge them not by what they said, but judge them by what they did. In other words, their actions speak much louder than than their words.

It is easy to compare Canada with other countries. We dropped from second to fourth in the world in per capita spending on health care and that is directly related to those cuts. It is also interesting that Canada is now the 23rd lowest out of 28 countries in the OECD in terms of public spending for health care. In the last two years 1,400 of our most useful health practitioners have left to go elsewhere.

These statistics really do not tell the story. The 200,000 patients on the waiting line do not talk at all about the pain, the inability to work, the inability to function and the denial of timely care.

I received a letter this morning from a Manitoba women. She was diagnosed with possible bladder cancer. She needed an MRI. The waiting list for the MRI in her province was too long to be medically acceptable. Her sister who lives in Burnaby, B.C. spent $2,500 of her money and the woman had her MRI a day later. The diagnosis was cancer. The treatment was therefore available to her in a short period of time.

This is a question that I pose to my Liberal colleagues, who have escaped the criticism because the provinces received it: Did their cuts have anything to do with that woman's inability to get her MRI in a timely fashion? She has figured it out. She said plainly in her letter “I know that the federal government has a responsibility here”. She also knows that Manitoba is spending more on health care today than it was in 1995, as is Ontario.

I listen to my colleagues say “Those hackers in Ontario have ruined the health care system”. Because of these cuts there have been significant changes. But today Ontario spends $1.5 billion more in health care than it did in 1995. Liberal government cuts to Ontario alone have totalled $3 billion. Every province in Canada, but for Quebec and New Brunswick, today is spending more on health care than in 1995, in spite of those cuts. That is a fascinating indictment. The provinces know where the important programs are. I still do not know why they were cut.

The parliamentary secretary said that Canadians are comfortable with health care and that they value this program more than anything. It is true. But there is a very recent change in public attitude on health care. This is a warning for my colleagues across the way. There have been three polls conducted in the last five months since October 1998.

The Harvard School of Public Health and the Commonwealth Fund have being conducting polls in the Commonwealth now for a good length of time. In their recent poll 20% of Canadians said that on the whole the system works pretty well and that only minor changes are needed to make it better and 56% said that there are some good things in our health care system, but fundamental changes are needed to make it work better. This is the worrisome one: 23% of the Canadian public said “Our health care system has so much wrong with it that we must completely rebuild it”. Let us compare that with 10 years ago. Ten years ago the exact same question was asked. At that time 56% said minor changes, 37% said major changes, and only 5% said it needed a complete rebuild. Are they biased? It is the Harvard School of Business. They are American.

What did a recent Angus Reid, CTV, Medical Post , Chatelaine poll say? Seventy-three per cent of Canadians said that the health care system in our country has worsened over the last five years. Most interesting was that they figured out the cause: 55% said the government was at fault.

One may say that the Angus Reid poll was biased and asked very skewed questions. However, another poll was just done by Pollaro. This was done for the Coalition of National Voluntary Organizations and Merck Frosst Canada. The first question asked: Is medicare fine? Four per cent of Canadians said it was fine. The second question asked: Does it need a minor tune-up? Thirty-seven per cent said it needed a minor tune-up. The third question asked: Does it need major repairs? Forty-five per cent of Canadians said that it needs major repairs. The last question asked: Does it need total rebuilding? Twelve per cent said yes.

If we propose a solution for Canada that has anything to do with innovation or looking at fresh thinking we are called an enemy of Canada. The public, however, is going to drive this debate. This will not be driven by politicians, by the medical profession or by the bureaucrats. The patient will come first.

The government's solution is to put conditions on health care funding.

The Bloc Quebecois says no to such conditions, as do Albertans and Reformers. It has nothing to do with the Constitution. This is an issue that affects those who use health care services. A change is needed in Canada.

I support the Bloc Quebecois motion and I hope the Liberals will as well.

[Pauline Picard, Bloc, Drummond, QC]

Mr. Speaker, I wish to thank my Reform Party colleague for his excellent speech.

I am wondering about the government members. Why are we not hearing more from them during the question and comment period? What I think is that they do not have it in them to defend their own system. They would rather slip it past us, as my colleague said earlier, cloaked in the more palatable Canada social transfer, and tell us, as the Minister of Finance did, that the new transfer will give the provinces much greater flexibility in running their own health systems.

When it comes time to make cuts, they slash the Canada social transfer by $6 billion annually. Then they tell us they will give some of the money back. They tell us that they can see that the provinces are perhaps having a little difficulty running the health care system. They will be good guys and give some of the money back, instead of cutting $49 billion—for that is what it would have been in 2003. They have changed their minds because that is what the opposition parties, medical bodies and the National Health Forum want.

They told us they were going to put some of the money back but that is simply not true. I would like my Reform Party colleague to tell us what he thinks of the federal government's tactics.

[Grant Hill, Reform, Macleod, AB]

Mr. Speaker, as far as I am concerned, the problem with the federal government cuts is that they were made unilaterally, that their impact was immediate and that the provinces were not consulted. This is why the provinces are putting up a united front on this issue.

In a huge country like Canada, it is hard to reach unanimous agreement, but we did it in this area. There is also unanimous agreement among service providers, physicians, nurses and other health professionals. They all want clear, visible and unconditional funding for health care.

It is up to the provinces to provide those services, and this is not why the federal government is involved in this area of jurisdiction. This statement is quite clear and I will be supporting it.

[Bill Blaikie, NDP, Winnipeg—Transcona, MB]

Mr. Speaker, I am pleased to speak on behalf of my caucus today on the Bloc motion, which I will read for the record:

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.

I listened very carefully to what my Bloc and Reform colleagues had to say. I do not want to suggest that I did not listen carefully to what the government had to say. In any event, there is much I agree with in what they had to say about the effect of federal cutbacks on health care services in the various provinces, and much that I agree with in the outrage and disapproval they expressed about those cutbacks and the way in which the Liberal government got away with doing severe damage to our health care system without really paying a price or even acknowledging or having acknowledged just what it is that it has done over the last few years through the removal of several billions of dollars from the health care system which cumulatively is well beyond several.

The figure used by my Reform colleague was something in the neighbourhood of $16 billion. It is very large. Any other government that had done the same thing would certainly have paid a higher price than this government has been asked to pay so far. I say “so far” because I think eventually the Canadian people will realize what is going on here.

I differ with the Bloc on its motion. It is not a motion that the NDP can support. I differ with my Reform colleague in his expression of support for the motion. The Reform spokesperson said that the Bloc motion talks about not having any new conditions on health care spending. I am sorry, but that is not what the motion says.

The motion says “to increase transfers to the provinces for health care unconditionally”. It does not say increase transfers to the province for health care without any new conditions. It says “unconditionally”.

Had the motion said what it says but nevertheless went on to affirm the Canada Health Act and the need for nationwide standards, national standards when it comes to health care, it might have been a motion that would be supportable. However it does not do that.

I listened very carefully to both the Bloc spokespersons and my Reform colleague. Neither one of them ever uttered the words Canada Health Act. Neither one of them ever uttered the words national standards. I do not think this is a coincidence. I think we see here an alignment between—it is no secret—the Bloc and the Reform parties when it comes to matters of provincial jurisdiction, particularly with regard to health care and a position mutually held with respect to the role of the federal government in health care. It is not a position that is held by the New Democratic Party. We could not bring ourselves to vote for a motion that in any way called into question implicitly or explicitly the continuing role of the Canada Health Act and the continuing need for national standards when it comes to medicare and health care. We will vote against the motion.

It was interesting to listen to the government spokesperson on this matter going on and on about the Canada Health Act. I support the Canada Health Act. I was here at the time it was created. I sat on the health and welfare committee when the bill went through and remember that whole process very well.

There are two things I have to say to the Liberals in this regard. First, they were dragged into the Canada Health Act kicking and screaming. It took four years of work in parliament exposing the problem of extra billing by physicians and the proliferation of user fees in the health care system that was happening at that time to finally get the Liberal government to act on the eve of the federal election in 1984. The Canada Health Act was passed in April 1984 and the election was called in July of that year.

The Liberals were dragged into the Canada Health Act kicking and screaming by their own acknowledgement. A memoir written by then Liberal Minister of Health Monique Bégin gives credit to the NDP for, in her words, waging guerrilla warfare against her in the House of Commons and forcing her to act. Those were her own words in her own book about the role of the NDP at that time. I will not go into who was the health critic at that time.

It is one thing to listen to the Liberals go on about the Canada Health Act and how much they stand by it. However Canadians should be reminded that this was something at the time that was not done wholeheartedly. In the closing hours of that debate on the Canada Health Act I remember saying as the NDP health critic that no amount of principles, no amount of standards enshrined in the Canada Health Act or anywhere else, rhetorically, would save medicare if there were not sufficient funding and that without sufficient funding medicare would slowly fade away. This is indeed what is happening. This is the heinous political crime being visited upon Canadian history by the Liberals.

It is a terrible irony when we think of how much credit they like to give themselves. The other day I think it was the Minister of Finance who was saying how it was the Liberals who brought in medicare. Actually the Liberals first promised medicare in their election platform of 1919 and by 1966, some 47 years later, they had finally delivered on that promise in the context of a minority government where the NDP held the balance of power and after medicare had been pioneered and all the dirty work had been done in Saskatchewan by Tommy Douglas and the NDP.

Do not give us that hokum about the Liberals having anything to do with the beginnings of medicare or hospitalization for that matter which in my reading of Canadian history actually became law under a Conservative government and not a Liberal government.

The Liberals are by their fiscal actions slowly, and in recent years not so slowly, starving medicare to death. My Reform colleague pointed out polls that show Canadians are increasingly anxious about their health care system, that they have less and less confidence in Canada's health care system. It is not surprising because there has been a deterioration in service. The evidence is there anecdotally, empirically and in every respect.

Every one of us knows someone who has been in the hospital in recent years or months. They all have stories to tell. They all have stories about dedicated health care workers, about people working very hard, but they also have stories to tell about gaps in the system thanks in many ways to the cuts that have been visited upon our health care system.

If the quality of our health care system runs down, if we have waiting lists as we do and if people spend days on gurneys in emergency wards, sooner or later it is only a matter of time before enough Canadians say that they want to have some private alternative to this service and do not want to be completely dependent on a service that is going down, down and down.

That is the crime the Liberals are visiting upon medicare and upon our country. They are creating the conditions for the privatizers who have never gone away. The big health care insurance industry is still out there and still licking its wounds from its defeat in the sixties. It is not that long ago as politics go. It sees its opportunity, and it is an opportunity being created by the federal Liberals. They ought to be ashamed of themselves for creating that opportunity.

They certainly should not have the nerve to stand in the House as they do from time to time—the Prime Minister, the Minister of Finance, the Minister of Health and others—and pretend they are the great defenders and saviours of medicare. If they do not do a complete turnaround in this regard, and if the Canadian people do not make them do so if they do not choose to, it will be the Liberals and no one else that go down as the political party that destroyed medicare.

[Gérard Asselin, Bloc, Charlevoix, QC]

Mr. Speaker, I have to say from the outset that I am very disappointed that the New Democratic Party has chosen not to joint the rest of the opposition to force the federal government to give back to the provinces the money it has taken from them.

When the present Liberal government decided to cut transfer payments, mainly for health care, it did not ask Quebec, Ontario or any other province what kind of cuts it should make. They were not consulted.

The government slashed transfer payments to the provinces, forcing Quebec, Ontario and the other provinces, still trying to achieve zero deficit, to impose radical health reforms, the results of which we see today. But, first and foremost, the primary responsibility belongs to the federal government. Quebec is still paying $28 billion in taxes to Ottawa, but receiving less and less services.

Of course I am very disappointed that the NDP has decided not to support the Bloc Quebecois on this issue, especially since it claims to represent the extreme left wing in this House. That party claims to be the great democrat, to speak on behalf of workers. It has ties to the labour unions. As a matter of fact, the workers of Quebec and Canada are the ones who use our health care system more and more. The demands of the Bloc Quebecois are supported by central labour bodies. I think the extreme left wing is not a good place to be in Parliament.

I want to ask my colleague from the NDP the following question: does he not think that the federal government should give back to the provinces, unconditionally, what it took from them, and let each province manage its own health care system?

The members of the National Assembly of Quebec are not a bunch of boy scouts. They are not a bunch of losers. They are capable of managing and they have a mandate to do so. I think responsibility for health care management belongs to the provinces, and the federal government should give them their money back so they can manage in a fair and equitable manner the health care services that Quebeckers and Canadians are asking for.

[Bill Blaikie, NDP, Winnipeg—Transcona, MB]

Mr. Speaker, I will resist the temptation to talk about whether the Bloc is as identical to the NDP as it sometimes claims.

I have made this argument before that its support of free trade agreements and other things like that in my view go against the interests of workers.

The nationalist movement in Quebec has always been a bit of an ideological grab bag. We know that. What unites it is its nationalism, in this case its view of the need for Quebec to separate from the rest of Canada. Having said that, I acknowledge there are many social Democrats in the Bloc Quebecois and we work with them when we can.

To the question was raised by the member, we are opposed to unilateral cutbacks by the federal government in federal transfers to the provinces in respect of provincial jurisdiction. That is why we would have been in favour of a Bloc motion that talked about arriving at a social union with respect to health care that prevented unilateral cutbacks by the federal government and that perhaps even talked about the mutual setting and enforcement of national standards. But there is nothing like that in the motion.

Instead the Bloc member did not say anything about the Canada Health Act. The member still did not talk about national standards pointing out, regrettably, the difference between ourselves and the Bloc when it comes to this question.

For us medicare and its preservation and the idea of national standards is a bottom line. That is all there is to it. Any motion which calls that into question is unsupportable.

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

Mr. Speaker, I would like to talk about the motion put forward by the Bloc Quebecois. I will explain later on what led my colleagues in the Bloc to move this motion.

As I have already told the Bloc critic, I am going to do a little bit of nit-picking. I get the impression this motion was prepared in some hurry, on the eve of the first ministers' meeting in Ottawa.

This motion is not the best the Bloc has ever moved. It is incomplete. They use the word “unconditionally”, but what they say and what they mean is not the same thing. What they mean is this: without any new condition related to the social union. They should have spelled this out.

The message we get is: without any new condition, but under the existing rules. The Bloc did not do its homework as well as it should have. There is something missing. They wrote the motion in a hurry.

Since the budget will be brought down soon, Bloc members thought “Here, we should be dealing with health care”. However, they do not mention any amount. Do they want to have $6 billion more for the provinces or $2 billion? Should it be over two, three, or five years? Do they want to restore funding to its former level in one shot or over a five year period, as the health ministers said last year?

We do not know the answers to these questions, and the Bloc has nobody but itself to blame for that. They will have to say they will do a better job drafting a motion the next time.

However, I think our New Democratic friend went a little far. I do not know whether he got the order not to support the Bloc any more, but I think he went a bit far in saying “We cannot support the motion because it goes against this and that”.

I think my New Democratic colleague has gone a bit far in his analysis in an effort to justify his refusal to support the Bloc Quebecois motion. We are going to support the Bloc Quebecois motion and we could perhaps help them write future motions for opposition days, if necessary.

In the future, I think the drafting could be a little more professional. Here again, I disagree with my New Democratic colleague, who said “We will not support that because it does not honour existing agreements”. I think this is going a bit far too.

I would like to say why we are debating this today. The budget is of course coming up in a few weeks. The provinces, Quebeckers and Canadians have called for more money in the health care system. The Liberal government has reduced its deficit by doing two things: cutting transfers to the provinces and taxing people an additional $20 billion or $25 billion. The federal government spent nearly $35 billion more than in 1993-94. It is spending more.

If there are surpluses, somebody somewhere coughed up more money. As far as conditions are concerned, we agree with most Canadians that new conditions cannot be imposed on the provinces for health transfers. This is the federal government's idea. Just this morning I was telling one of my colleagues in the Bloc Quebecois that this did not make sense, especially since the government is not behaving properly on the EI issue.

If every new dollar transferred to the provinces has to go to health, by the same token could we say that every new dollar paid into the EI fund has to go to EI and not end up in the government's coffers? As you can see, this could backfire.

What we know, and I think this was the main reason for the Bloc Quebecois' motion, is that there is a first ministers meeting in Ottawa today. This thing about conditions came up after the Saskatoon agreement. In a letter, the federal government said “Accountability now requires you to make a commitment to put every new dollar transferred toward health care and to publicly state how happy you are that the federal government is giving you money, and that all is well and the Prime Minister is a nice guy”.

What we suspect is that, thankfully, this letter will finally be taken out of the package put before the provincial premiers, the territorial leaders and the Prime Minister this morning. It called for a commitment from the provinces to agree that future transfer payments would be put toward health.

It is in that context that, today, they are discussing the conditional transfer of any new money that may be transferred. But we have to monitor what is going on right now, because—as I said earlier—we have reason to believe, based on what we heard here and there, that the issue of the social union, and more specifically health, will be discussed today. Will the amount of money be set today? I do not think so, because it would look very bad if the Minister of Finance were to officially allocate money for health before bringing down his budget, in a few weeks.

It seems the federal government will be giving back between $2 billion and $2.5 billion, over a period of two to three years. Whether it will be over two years or three, and whether the amount will be $2 billion or $2.5 billion is what is being negotiated right now. But, the decision will surely only be announced in the budget, not today.

So, negotiations are taking place today on the social union, and more specifically on health, on the Saskatoon agreement and on a new federal offer made yesterday. That offer provides, among other things, that rules would be set regarding the new transfers for health, but that there would also be a right to opt out, jointly funded programs, and so on.

What is dangerous though is that, in spite of what is going on in the four areas of the social union, namely social services, education, social assistance and health, the federal government is prepared to keep its sword of Damocles dangling over our heads, that is its direct spending power. This power means the federal government can spend directly when the money goes to individuals. If the money goes to the provinces, there is a right to opt out, as in the case of health, pharmacare or jointly funded programs.

Where the danger lies in the health care field, and one of the reasons we are going to support the Bloc Quebecois motion, is that we do not want any new conditions. We need to go further still and say that we are not in agreement with the federal government's having direct power to intervene in the daily lives of the people in health, education, social services and social assistance. There is a danger of this becoming a stumbling block today. I hope people will be able to agree that this administrative agreement, which is negotiable—not a constitutional change, merely an agreement that dates back only about five years, it would appear—will be something that can evolve and continue to be viable, so that we can avoid having a repetition of the millennium scholarship situation, or in other words direct federal programs in the areas of health, social assistance and education.

It is important to restrict the federal government, particularly a Liberal one, because the Liberals want to control everything, unless it gives them problems. Then they give it to the provinces, but they want to control the rest so that they can show the flag. I have absolutely nothing against the Canadian flag, I am a federalist. However, propaganda does not serve the interests of the people, only those of one group.

Health is about the public interest. The average Canadian should be the government's first consideration when it makes decisions.

Statistics are all very fine and well, but individuals have to be the priority in the decision-making process. In addition to the revenue and expenditure columns in the federal government's budget, there should be a third equally, if not more, important column representing the people who live in this country, in Quebec, in Ontario, and throughout Canada.

It is time for an increase in health transfers. It is time for the ground rules to be clarified. There are disputes about jurisdiction. It is time that a serious look was taken at the political, administrative and even legal aspects of the situation so that a start can be made on simplifying the entire jurisdictional process in this country.

We will be supporting the Bloc Quebecois motion. It is slightly incomplete, but we will be supporting the Bloc Quebecois and almost all the opposition parties who are asking the government for more health care dollars, without new conditions, and without delay.

[Gilles-A. Perron, Bloc, Saint-Eustache—Sainte-Thérèse, QC]

Mr. Speaker, perfection might be found in the way my friend from Richmond-Arthabasca speaks, but just like his NDP colleague from Winnipeg-Transcona he does not know how to listen and hear to perfection. He should have listened to the speech by the member for Drummond who said that the Bloc Quebecois had absolutely nothing against the five principles of medicare.

My colleague said we should get our money back without any precondition. I also would like to remind my learned colleague from Richmond-Arthabasca that in the late 1980s and up to the beginning of 1993, when his party was in office, on the other side, it was next to perfect. And then in 1993 perfection dropped to two members.

In conclusion, I would like to say this: at no time in his speech did he mention the right of the government to interfere in, control or put its nose in the way Quebec manages its affairs. Whether he agrees or not, he did not say so and made no mention of their accomplishments. I would like him to elaborate further on this.

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

Mr. Speaker, I listened carefully to what the hon. member for Drummond had to say and that is why we will be supporting the motion, because of the clarifications she provided about conditions. Therefore we will support the motion because of the explanations she gave us.

On the issue of perfection, it is true that our government was almost perfect. People have a hard time believing in perfection. That is why they chose to teach us a lesson in 1993. Having said that, I simply want to remind the House that the then government started in 1984 to increase transfers to the provinces by $6 billion.

Hard times during the 90s forced the federal government to freeze its expenditures. However, between the election of the Mulroney government in 1984 and the freeze it had to establish during the 1990 crisis, $6 billion were added to provincial transfers for health and welfare.

This is near perfection. What is clear to us and what you can find out if you read our platform—and I am sure you have read it and learned it by heart—is that what we are proposing for the Canadian pact goes further than what is in the social union agreement. We are even more in favour of respecting provincial areas of jurisdiction than the current federal government.

If your copy of our platform is a bit the worse for wear I would be quite happy to provide you with a new one.

[André Harvey, Progressive Conservative, Chicoutimi, QC]

Mr. Speaker, first I wish to congratulate my colleague from Richmond—Arthabaska for the quality of his presentation. He has restored the historical dimension of the issue and has also showed that he has a vision for the future.

There is one word which could have remedied not the weakness but, let us say, the imperfection of the motion. I am not afraid of the word imperfection because perfect people are always more disturbing than imperfect people. Maybe we should have used the word “re-establish” instead of “increase” unconditionally because we are not asking for an increase but for the re-establishment of what was there previously.

Instead of having a theoretical debate, I would like to mention that in my own region, indeed in several other regions in Quebec, health care is an issue of concern for all people. There are not many people in Quebec who are not aware of the present situation in the Saguenay-Lac-Saint-Jean region.

We obviously agree with the unconditional re-establishment of health care budgets, but I am concerned about transfers to provincial governments—let us say we speak here about the Quebec government—because regions don't always get the benefits they deserve. In my own region, in the area of social services including health care, we are still getting much less than we are entitled to given our population.

I take the opportunity of today's debate to point out to my colleagues in the Bloc Quebecois that while they are asking for everything to be transferred to Quebec, in the regions we have a problem not with the Government of Canada but with the Government of Quebec because of its unfair allocations between various regions of the province.

This is a very serious problem, and to show how serious it is, I will quote from a story published this morning, not two years ago, but this morning. One hundred and sixty doctors, dentists and pharmacists in my region have said: “Mr. Bouchard can push around his ministers, deputy ministers and experts, but he has no power over us. He should have thought about that before”. That is the reality we live in. In our region, we are not even able to get adequate health care.

That is why I am in favour of transfers. The Bloc Quebecois and the Conservative Party are often fighting here in Ottawa over matters of principle. In the area of employment, we were in favour of budget transfers, amounting to hundreds of millions. But go see what is going on now in that area since federal funds were transferred to be managed by the provincial government. We are getting less than 25 per cent of what we were getting before.

As for funds for regional development in my region, here is what some were saying this morning: “Those who believe that the new entity created by the government, the local development boards, the LDB, will remedy these shortcomings in leadership are sadly mistaken”.

There is not one area where the transfers to Quebec have benefited regions. I ask my colleague if he—

[The Deputy Speaker]

I am sorry to tell the hon. member that the time allocated for questions and comments has expired.

[Paul Crête, Bloc, Kamouraska—Rivière-Du-Loup—Témiscouata—Les Basques, QC]

Mr. Speaker, I am very pleased to speak today to this motion brought forward by the Bloc Quebecois, “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”.

This is not a purely academic debate, nor is it a debate pitting sovereignists against federalists. This debate is to demonstrate that, in the kind of system we have in Canada, we have to let the experts do the work if we want the system to work. We are not having this debate to go after the Liberal government. We are having this debate so that, at the end of the day, there is a reasonable amount of money in our hospitals for equipment and emergency rooms, in CLSCs for front line care, as well as for long term care and palliative care. Federal MPs all received a document this week in their office regarding funding for palliative care.

We are having this debate so there is money to address the problem of suicide, and we want this to be done within the existing framework, through the mechanisms that have been in place for a long time. Health care has been recognized as a provincial responsibility.

We want to avoid repeating the battles of the past. We want patients to spend the least amount of time possible in emergency rooms. To achieve that, the federal government must stop playing games, it must stop saying under what conditions it will put money into the system, how big the maple leaf will have to be for transfer payments. That is the reason behind this kind of motion.

Let me give an example. It is a good illustration of what can happen when you do not mind your own business.

Concerning the issue of the millennium scholarships, we have in Quebec our own loans and bursaries plan. All student associations and academics have acknowledged it is the best in Canada. We have opted out of the national plan in 1964 with full compensation, and we have outperformed everybody else. We may not be the best in every area, but in this case, we are.

The federal government has decided to yield to the whims of the Prime Minister and create the millennium scholarship program. This program is at cross purposes with the Quebec loans and bursaries plan.

The basic principles are being changed. The federal government claims its loans and grants system will reward excellence. In Quebec, the whole plan is based on the concept that we should give the students what they need for their living expenses. We do not want to see in other areas a replication of the intrusion we have witnessed in education.

When the federal government made cuts in health care, it did not try to achieve some visibility for those budget cuts. It made the cuts and told the provinces they would have to make do with whatever they got.

[Pauline Picard, Bloc, Drummond, QC]

Without condition.

[Paul Crête, Bloc, Kamouraska—Rivière-Du-Loup—Témiscouata—Les Basques, QC]

Yes, indeed without any strings attached. It let us deal with the cuts. Now we are faced with a situation that makes it clear that the federal government must make up its mind.

There are needs in all of the regions of Quebec. The Bloc Quebecois tour, under the leadership of the hon. member for Drummond, clearly demonstrated what, if $1 billion in surplus—though more than that is needed—was returned to the transfer payments, that would represent for each region. In our case, in the Lower St. Lawrence region, the figure would be $34 million.

I am most anxious to see the federal government let go of its bone, put the money back into transfer payments, into the existing mechanism, so that the people in my riding who are in hospitals, CLSCs, extended care centres, in all types of services, may have the oxygen they need, that extra room to manoeuvre that is so lacking at the present time.

I must disagree with the hon. member for Chicoutimi. I believe that both the present government of Quebec and the previous ones have done a number of good things for health care. There is a model in place in Quebec. There have been some accomplishments, the air ambulance for one, which allows people in the regions to be brought to major centres for the complex emergency surgery that may not be available elsewhere.

University experts in Quebec City and Montreal have helped develop a system for performing surgery by means of telemetry in the Magdalen Islands and the Gaspé. This shows there are successes. These are examples of things that are working.

It has been necessary to make cuts in the last few years. That is clear. But a large part of these cuts is the result of the federal government imposing cuts on the provinces. We got through that. Now the federal government has the money. It has the necessary money, because of its revenues and its spending power, to put money back into transfer payments. It is taking its time. Now that more money is available, a way has to be found to show that this money comes from the federal government.

And how should that be done? All the provinces have already said that, if the federal government wants them to spend the money on health, that is where they will put it. There is something wrong with the government's attitude. I think the best example of this is the Minister of Intergovernmental Affairs. This minister never misses a chance to set Quebec City and Ottawa at each other's throats.

Again yesterday, on the CBC, he told the Quebec premier who was elected barely two or three months ago, that he was not legitimate, that he was not accountable to him in matters concerning Quebec, but to Quebeckers directly. This double legitimacy argument has been dead since the Bloc Quebecois arrived in House. Since the Bloc Quebecois has been here, no one can say that the ministers know the absolute truth when they speak on behalf of Quebec. No one can say that. We are here to show that you do not have this double legitimacy.

The ultimate insult is that negotiations are going on with the leader of the opposition in Quebec City, who has just taken the political beating of his life, which he never expected, with the rejection of a significant majority of Quebec ridings. When the federal government negotiates in this way, it forces us to present motions like the one today to encourage it to honour the responsibilities of the provinces in managing health care, to unconditionally increase transfers to the provinces. Increasing them, means raising them.

There is no argument any more on whether the government should be condemned for the cuts. The people have understood that. I think the 1997 election proved an interesting lesson for all members of the House, especially us. Quebeckers had to understand where the cuts were coming from. Well we know that they are coming for the most part from the federal government.

Now that we have money come back to us, we are saying “Give us our share and use the mechanism already in place.” The Canada social transfer was meant to be unconditional. The Minister of Finance himself said, two years ago, that this was best because of the flexibility it afforded the provinces. Let them deal with the cuts. Now that there is money, we are saying “Let us deal with this money to be reinvested in health care.”

By letting the provinces make their own decisions, the federal government would show it is upholding its own Constitution. There is a fundamental problem with this Parliament. We in the Bloc Quebecois are sovereignists and we insist that this government at least uphold its Constitution. The Government of Canada is flouting the Canadian Constitution and trying to interfere and micromanage, as if it were an expert in health.

For instance, the Minister of Health recently announced a subsidy in the Montreal area. No one can deny this served its purpose, but can you imagine how much duplication it is causing with all the health services and mechanisms already in place? There must be targeted consultations. Fear not, we in Quebec can do our homework, and so can the other provinces, to see what kinds of services are required.

I therefore urge the members of this House to vote in favour of the motion we have put forward to ensure that sufficient funding is made available as soon as possible for our hospitals—for equipment and emergency rooms—for local community service centres, for chronic and palliative care, for suicide prevention, for all those who are vulnerable in our society. It is not right to take them hostage. The federal government must take immediate action in this area. Hopefully, we will be heard on both sides of the House and a majority of Canadian members of Parliament will support our motion.

[Pauline Picard, Bloc, Drummond, QC]

Mr. Speaker, I thank my Bloc Quebecois colleague, whose riding I have trouble naming because the name is so long. I will begin by setting the record straight, before putting a question to the hon. member.

In the motion, the word “unconditionally” does not refer to the five tenets of the Canada Health Act. The Quebec government and all the other Canadian provinces have always cared about adhering to these five tenets in the Canada Health Act, as can be seen in the documents that we have.

The Canada Health Act requires the provinces to adhere to these five principles. In return, the federal government pledges to transfer the necessary funds through the tax system. The federal government is not giving us anything. The money is provided by all Canadians who pay taxes. The federal government redistributes the money collected in taxes, so that the provinces can manage their health care sector. Indeed, the provinces are responsible for managing health, through the new Canada social transfer set up by the federal government to provide, according to the Minister of Finance, greater flexibility in the management of the health, education and social assistance sectors.

The motion does not trivialize the five Canadian tenets. That is not its purpose. Its purpose is to urge the government to respect the division of powers, unconditionally restore transfers and make judicious use of budget surpluses.

I wonder if my Bloc Quebecois colleague could tell us again what it means to respect the division of powers.

[Paul Crête, Bloc, Kamouraska—Rivière-Du-Loup—Témiscouata—Les Basques, QC]

Mr. Speaker, I am very happy the record has been set straight because what our motion is asking is that things be done according to Canadian legislation.

The Government of Quebec has never asked that legislation be set aside. The five principles of the Canada Health Act are part of the legal framework within which we must work. This government has not always done so. This may explain why those on the other side are so nit-picking. They behave differently themselves.

Two years ago, the Minister of Human Resources Development had to make a decision regarding a legal advice which indicated clearly that if the minister used database matching to identify the unemployed who broke the law by travelling abroad, this would contravene the Privacy Act. This does not mean we should legitimise cheating but it must be acknowledged that the government may have things to settle on the issue. It has happened, on occasion, that this government was not very respectful of legislation passed by the Canadian Parliament.

Respect of jurisdictions, that of Quebec as well as Canada, is the best way to make sure that money is spent in the right place. This is our main goal. We do not have money to burn in that area. We do not have money to burn these days. We cannot afford duplication. We cannot wait to invest in the right programs.

This is also a cry from the heart. Money available from the federal government surplus could be invested in health care, using existing channels. If there is one single consensus in Quebec, it is that we do not want new programs. We want to strengthen existing programs. We want to be able to finance our hospitals, equipment, emergency services, CLSC's, or local community service centres, palliative care services and all our other support services, and we want to be able to pay our hard-working health care workers. We must be able to pay our workers decent salaries and to provide direct health services to the population.

This is the meaning of the motion we introduced in the House today. It aims at bringing the government to abide by its own Constitution.

[Pierre Brien, Bloc, Témiscamingue, QC]

Mr. Speaker, I too want to express my support for the motion moved today by the Bloc Quebecois.

It reads as follows:

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.

If one remembers what has happened since 1993, particularly in the earlier budgets that came out of this government and were tabled by the current finance minister, we have seen drastic cuts in many areas. Sure, we had a huge deficit, but what got hit the hardest were the cash transfers to the provinces. This budget item, which was around $18 billion, dropped to $11.5 billion a year.

The provinces lost over $6 billion in annual revenues which were used at the time to fund three types of programs: cost shared initiatives in health care, cost shared initiatives in education, and social assistance transfers.

The government, knowing it was about to make significant cuts—at the time we knew exactly what the government's contribution to health care, education, and social assistance was—decided to amalgamate all three programs into one now called the Canada social transfer. This same government, which now talks about transparency, accountability and visibility, and says that people need to know how much money it is contributing to health care, is the one that merged these programs to eliminate transparency. Why? The reason is rather obvious.

There were some massive cuts and the members on the other side of the House did not want to be blamed for cutting this much in education, and that much in health care or welfare. So they told the provinces: “We are cutting $6 billion. You can split that any which way you want between health care, education and welfare.” The federal government wanted to show what a good sport it was. They said: “The choice is yours, you get to determine what percentage of the cuts you want to apply to health care, education and welfare.”

Now that the transfer payments are about to be increased, the federal government knows that the first priority of Canadians will be health care. They would want each additional dollar they put in, over and above the $12.5 billion currently paid in transfer payments, to be made highly visible and transparent, so that the people of Canada can see that the federal government is reinvesting in health care. However, they were not so worried about visibility a few years back.

Let me make a suggestion. Maybe they could use billboards. They like them well enough since they have some Mediacom billboards set up permanently in Quebec. They practically own them. They could have huge billboards on the edge of towns and villages saying: “The federal government did not cut $6 billion in health care, but only $5 billion.” That way, Canadians would know that the government did not cut $6 billion a year. They would cut only $5 billion, since they are now talking about adding $1 billion, maybe a little bit more, to the current transfer payments.

Apparently this morning the Prime Minister found some more money and could put some more on the table. But the fact is that the level of transfer payments to the provinces has dropped from $18 billion to between $12.5 billion and $14 billion or $15 billion—a very optimistic scenario—in the next budget. The bottom line is that we still face significant cuts. This is something we should not forget, and I am somewhat annoyed by their new-found devotion to openness.

On top of that, premiers have made a clear commitment. They wanted to reassure the Prime Minister, so they wrote to him that they were committed to putting back into the system any new CHST money allocated to health care. But perhaps the Prime Minister does not think written commitments are worth much, when we consider what happened with the promises in the 1993 red book, but for some people, a signed letter still means something. So the premiers have signed a commitment that any transfer of money will go to health care.

The government keeps repeating that it wants to uphold the Canada Health Act. That piece of legislation is still in effect, and the premiers did not ask that it be repealed. It is still in effect. If the federal government puts money back into the transfer payments for health care, the Canada Health Act and its five central principles will continue to apply.

Where is this sudden fear that the provinces could violate the act coming from? There are very severe penalties for those provinces who do not respect the act. You know about that, Mr. Speaker. Alberta has had to pay the price for not living up to the conditions set out in the Canada Health Act.

I know there is an ongoing dispute about that. Some provinces would like more flexibility, but we are not here to question the act.

The federal government wants to increase its role. After starving the provinces and giving out new money today, it is obvious that the federal government has a strong desire to play a role in the planning of future health care services.

We understand why. The Liberals know full well that, with an ageing population, health care will become a very important issue in the future, a growing concern for Canadians. They say they want to play a role in this area to get closer to the people, ignoring the Constitution, ignoring traditions and also ignoring the fact that the provinces, including mine, Quebec, already have an infrastructure in place. We have a health department as well as regional health offices. We have developed an elaborate network of front line services, second line services, emergency services and CLSCs.

The network is established according to a plan. Of course, occasionally some people may question its structure. But we have to look at the big picture because priorities vary from one region to the next. One region may have more specialists in one particular branch of medicine, and the situation may be different in another region.

This planning is the responsibility of the Government of Quebec, which delivers health services. Now the federal government would like to implement its own priorities, and influence the services provided by the provinces. We would then find ourselves, if the federal proposal is implemented, with two governments, two types of priorities. A lot of new committees will be struck, public servants will be needed to make evaluations, statisticians will make comparisons, a dreadful bureaucracy will be put in place.

That is not what we need. What we need instead is people to do the hands-on work. If money were put into the transfer payments tomorrow, it would mean bigger hospital budgets, better nursing care, more physicians and specialists to be increased, if money were put back into the transfer payments.

If they start creating policies or implementing all sorts of mechanisms, we will end up with a new bureaucracy—and the federal government bureaucracy is already getting way out of hand—that will keep on imposing its will and trying to play a role in this area. This strikes me as contrary to what the public wants in the way of services.

Now I will draw a parallel with another matter, the millennium scholarships. Speaking of unconditional transfers, the federal government has decided to play a bigger role in education by allowing students to accumulate fewer debts, by offering them scholarships and so forth.

The federal government came up with a wall-to-wall solution, good coast to coast, by offering scholarships to post-secondary students. In Quebec the student debt load is far lower than elsewhere because tuition fees are lower. Of course we would like it be lower still, but compared to the other provinces it is far lower.

The first priority of our system would probably have been to put the money where it would have helped all students, not just a small group. The educational system is overseen and planned by the Government of Quebec. Citizens can pressure it, the government being answerable to its citizens.

The federal government has now decided that its priority was to reduce student debt. It plays a significant role with our taxes in order to show that its priority lies there. There is, perhaps, another priority to be considered for the moment. It may be the priority in the rest of Canada, but is not the priority of Quebec. We have not even enough flexibility to exercise the right to opt out, to take this money and assign it to other priorities in the educational system. There is something wrong when a government insists on defining everything.

We recognize the obsession with visibility behind all that, this obsession with appearing to be closer to the people so they would stop criticizing the government and become less sovereignist perhaps. I really do not know what is their underlying motive.

But it is wrong because it does not work. People want effective services. They pay taxes not to have governments and bureaucracies quarrel, but to obtain quality services. It is not so the federal government can fight for control of certain jurisdictions it gave up at the time the Constitution was drawn up.

In conclusion, I hope Liberal members will be less silent than they have been up to know in today's debate, that they will stand up a little and that they will be lucid and understand that the most effective solution in health matters is to pay out unconditionally the money intended for transfer payments in order to repair the error they themselves made.

[André Harvey, Progressive Conservative, Chicoutimi, QC]

Mr. Speaker, first of all, I want to reiterate our party's support for this motion.

[Caroline St-Hilaire, Bloc, Longueuil, QC]

You are on the right track.

[André Harvey, Progressive Conservative, Chicoutimi, QC]

We are indeed on the right track.

Our colleague just spoke of the obsession with visibility. Reference was also made to absolute truth. Here we have the President of the Treasury Board. With respect to visibility, I do not think that the PQ can point the finger at anyone in Quebec in that respect.

Think back to the floods, and the ice storm. This obsession with visibility was such that one wondered if the federal government had any involvement, yet it was footing 90% of the bill. Objectivity is required in a debate.

I have a concern. Support is expressed for the Bloc Quebecois motion, but there is all this squabbling on principle. For the most part, members of the Bloc represent outlying areas of Quebec. I do too. While squabbling on principle may have its merits, reality is catching up to us.

This morning is a case in point. An editorialist from my region, Rénald Boily, wrote “It is demonstrated on a daily basis in our region that the Bouchard government's move toward ambulatory care is becoming a move toward confusion.”

Richard Brantford, another editorialist, said “Ours is a region with a moribund economy.” That is the result of 25 years of PQ government in my region. That is what we have to show for it.

I have no objection to squabbling on principle, here in Ottawa, with the Bloc Quebecois. Let us transfer the funding for employment, regional development and health. But is my colleague not concerned about his region?

The problem is that, when funds are transferred to Quebec, they do not get to the regions. There are statistics to back this up.

[Pierre Brien, Bloc, Témiscamingue, QC]

Mr. Speaker, I am extremely surprised to hear the member for Chicoutimi make such a charge against the Government of Quebec when he himself had an opportunity to make his views known during the Quebec election campaign a few months back.

Everyone knows he was asked to run. If the Parti Quebecois is as bad as all that in his region, he had a chance to run for the provincial Liberal Party and to participate in this debate. I assume that he did not do so because he thought he had a better chance of hanging on here than running as a Liberal MLA in Chicoutimi. I will leave him to ponder that.

The shift toward ambulatory care has been mentioned because it is a very important reform. I do not want to go into this in any great detail because this is not the appropriate place for such a debate. Carrying out a large-scale and important reform in the midst of cutbacks is a very difficult thing to do and it is true that many regions of Quebec are suffering, his and mine both.

But I would remind him that the impact, in my region alone, of the federal government's health cuts amounts to $20 million annually. For us, an additional $20 million for health care would mean a stronger health care system and more services.

However much we want reforms, if one of our sources of revenue dries up, if it all but disappears, it is difficult to be completely successful.

They did the best they could with the resources they had at the time, but improvements have to be made. One of the ways to improve the situation would be for the federal government to correct the mistake it made by reducing health care funding. Do I think health services are managed perfectly in Quebec? No, there will never be a perfect system. However, I do believe that people are acting in good faith and we are headed in the right direction. Our first need is additional financial resources.

To conclude on the issue of the ice storm and federal visibility, I have no problem saying that the federal government paid 90 per cent of the bills. Nor do I have any problem saying that Quebeckers send more than $30 billion in taxes to Ottawa every year.

[An hon. member]

Oh, oh.