House of Commons Hansard #66 of the 36th Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was provinces.

Topics

SupplyGovernment Orders

12:30 p.m.

Reform

Grant Hill Reform Macleod, AB

Mr. Speaker, thank you for giving me the opportunity to speak to the supply day motion. For those who are not really familiar with that, it is an opportunity for the opposition to set the topic of debate and to allow a firm vigorous debate on a specific issue. This is a Tory supply day motion asking for the federal Liberals to adopt a long term sustainable plan to address the crisis in health care.

Crisis is a strong word. It is not a word that I use lightly. Health care is under significant stress in Canada and having a debate on this issue is a good idea.

I listened to the Minister of Health today and he basically said that there is a plan in place. That plan requires some co-operation and some significant alteration so that we can have a sustainable health care system. Then he went on to say that funding was one component of that plan, innovation another component and co-operation the third component. I would like to talk about those three things one after another: the funding component for health care, innovation, and co-operation.

Where are we with funding? Figures can be used to disguise facts. On the issue of funding, the figure that matters to Canadians is the per capita spending on health in Canada which is lower in 2000 than it was in 1993 when the Liberals took power. They can take the figures any way they want.

Anybody listening to the Minister of Health today would have heard what he said about the federal share of publicly funded health care dollars. The figure that he took out of the document which he quoted was the federal share of publicly funded dollars. He said that the taxpayer funded component of health care in certain provinces that get equalization payments is relatively high. Every single province that he quoted was a provinces that gets equalization payments. He used figures as high as 60% plus in those provinces as the share of publicly funded dollars.

The figure that matters to the individual in the street is not whether equalization, other means, tax points and whatnot fund health care in the maritimes. What matters to Canadians is the share of per capita dollars that the federal government is spending. Is it spending a share that allows it to call the shots? In fact in much of Canada it is not.

The figure I am using now is the federal cash share of overall health care spending. In those cases it is down in the neighbourhood of 12%, 13%, 15% in those provinces that do not have equalization payments.

Those figures are in the document that the minister quoted from. I say let us stop fooling with the figures and let us talk about the one that really matters, which is the per capita expenditures of cash from the federal government.

Health care has a couple of other big problems. I will not ascribe blame on this issue. Waiting lists have grown. We have fallen behind in technology. We have an aging population. The minister has finally stated publicly that the status quo is not sufficient and on that issue we agree.

The issue of funding is one which the public needs to be aware of. The motion calls for sustainable funding. The motion calls for predictable funding. The motion calls for, in my estimation, some buildup of the funding as the population ages more and as inflation comes along.

I do not see anything of that kind of commitment from the federal government. In fact, none of the funds that have been promised in the last few years are certain. None of the funds are growing with inflation or with aging. They can be lowered and raised at will by the health minister, by the finance minister and by the Prime Minister. That is the funding component. Much of what we say in the health care debate is on the issue of funding. That is a component which needs to be discussed. I believe the funding needs to be predictable. I believe the cash funding needs to grow with both aging and inflation.

Innovation is the second big topic I want to address. The minister has said the status quo will not do and we agree. Stated very plainly his solution is that Canada needs universal home care and universal pharmacare. That is the minister's solution. This is the innovation the Minister of Health has specifically spoken of. He said to the provinces “Join us and we will pay 50% of universal pharmacare and universal home care”.

I remember the promises that came from a health minister which got medicare started who promised then “Join us in medicare and we will fund 50% of the cash needed for health care”. That promise was broken. In my mind, is there any wonder that the provinces are somewhat hesitant to go down this road when we already have visible problems with our health care system.

The third area I want to talk about is co-operation. The minister's own words were “We need to co-operate. We need to have a discourse on this that is free of partisan commentary”. Then he turned around and said that we need to get rid of any proposals that suggest two tier Americanized health care. That is a fair comment and one which I share. Two tier American style health care has no merit for Canada.

Let us look at the provincial efforts at innovation and co-operation. The provinces are ready to look at alternatives. In fact Quebec has been sending a number of its patients to the U.S. for cancer therapy. That is an alternative that has been looked at by Quebec. In fact B.C. has done exactly the same thing. That does not seem to me to be a made in Canada solution for our health care problems.

On the issue of public administration, one maritime province has chosen to administer its health care system with a private concern. This fits with the principles of our health act.

Alberta has recently brought in a proposal to contract out using taxpayers' funds for some overnight surgery. This is an issue that has received vigorous condemnation from many Canadians. The health minister's response to this has been an uninvited visit to Alberta where he made a speech at the University of Calgary and his words today “This bill is bad policy”.

What exactly is Alberta's Bill-11? I have a copy of it here and I have gone through it carefully. Without supporting or criticizing the bill, I think we should at least know what it contains. I will read from Alberta's Bill-11 so the Canadian public will know what is in it.

It is called, and this is an antithesis for all those who criticize it, the health care protection act. I am going to go over the bill not from some esoteric perspective, but I will read from the bill as to what it has in it.

It commits Alberta to the principles of the Canada Health Act, well known to anyone involved in the health care system.

One other big principle is that this bill makes it illegal to operate a private hospital in Alberta. The words are so plain that no one can misunderstand: “No person shall operate a private hospital in Alberta”. It goes on to define what a private hospital is by saying exactly what a public hospital is. Only public hospitals will be allowed to provide the full range of hospital services, including emergency rooms, diagnostic and medical services, and major surgeries. It sounds pretty straightforward to me.

It goes on to talk about what the bill is designed to do, which is to allow overnight stay for what has traditionally only been done in day surgery facilities. Specifically a surgical facility allowed under this procedure would only provide a limited range of surgical services. It would not be a full service hospital. It goes on to state that only the College of Physicians and Surgeons, my college, can decide what would be provided and only it can accredit these facilities.

One of the big concerns about a private facility doing procedures in any part of the country is that queue jumping could take place. This bill specifically makes it illegal to queue jump. It also makes it illegal to charge facility fees for insured services.

One other argument against a private facility doing anything surgical in Canada is upgrading. In other words for example, someone would come to that facility looking for cataract surgery. The cataract surgery would be upgraded and made more expensive. In this bill that is specifically prohibited. It is specifically prohibited with fines.

It goes on to say that if a person chooses to upgrade a service such as a fibreglass cast or foldable lens for cataract surgery, it must be in writing, the cost must be shown and a person must sign in full agreement. The person can back out if he or she changes his or her mind. It goes even further to say that if an upgraded product or service is the only thing that is available, it cannot be charged for. Finally, unlawful charges can be recovered under this bill on upgraded surgical services.

The bill goes on to talk about uninsured services that can be done and are done in every single province of Canada. These are things like plastic surgery and new technologies that are not accepted yet under our Canadian health plan. These must be done in compliance with the Canada Health Act in this bill. These must be done only with a demonstrated need to the regional district that has contracted them out. The health authorities have to show that the contract will not harm the publicly funded system. They also have to show how they will benefit the public system.

The other concern is that this sort of process might well invite out of country facilities to come in and take up this new proposal. The only way this could happen would be for the public to approve it through their government and the reasons for authorizing such a facility will be made public. Any contract would be made public.

In my view, this bill clearly and plainly lays out the mechanisms whereby short term, what has been day surgery, can have an overnight stay.

The minister himself on bill 11 has been asked plainly by the Government of Alberta to rule on whether or not the bill complies with the Canada Health Act. He said that he will wait until all the potential amendments are made and all the regulations are in place before making his ruling on bill 11. Members will note that he has not once said that the bill goes counter to the Canada Health Act. He has said that in his opinion it is bad policy.

I want to go over the clinics in the country that are already functioning under the very same proposals that are expressed here. We have new techniques in prostrate surgery that are not paid for under medicare. Cosmetic surgery, the plastic surgery, is not covered under medicare. Therapeutic abortions; every single private facility in Canada that does therapeutic abortions is doing it under this type of proposal. New radiological techniques, the exploratory techniques like biopsies using imaging that we did not have when medicare started and new forms of cancer therapy are not covered under our medicare system.

Bill 11, by my reading, controls and regulates these new innovative therapies and frees up, if it works the way I foresee it, some hospital beds in the regular hospital system which will have significant benefits to the public.

The debate on such an issue, if it persists being the opening for a two tier American style medicare, is in my view doing no service to the medicare debate. This debate is coming whether or not any politician likes it. If the debate comes, will this idea be reviewed, critiqued and improved, then watched to see if it is successful or not, and removed if it is not and expanded if it is? I am convinced that the European countries that have already done this with their taxpayer funded health care systems, which are the equivalent to Canada's, have already shown that there are risks, that there can be gains and that we should at least be innovative.

The health minister has said that funding is one issue, that innovation is another issue and that co-operation is the third issue. I would ask my colleagues, as we enter this debate, to do this not with these, if you will, old-fashioned buzzwords, but by actually looking at the issues and reviewing the legislation, if new legislation and new ideas come forth.

I will end my commentary with another little issue and that is the issue of hepatitis C. I do not often get an opportunity any more to raise that issue. The poor patients in my own part of the world who were infected by tainted blood, those who have been covered by the compensation program that was agreed to by the federal government, have waited two years now since the program was announced. They have not received a nickel. The lawyers have now been paid substantial amounts of money. I believe that is one other indication that the victims do not have a very strong voice in this place.

I urge my colleagues across the way, who have a more potent ability than I to bring these processes to an end and to see those victims compensated, to get the health minister off the excuse track and onto the let us get this thing finished track.

The legal route was not the best way to see those patients cared for. I will not belabour this and criticize any further but this issue deserves immediate attention and is long overdue.

I conclude by saying that the motion asking for sustainable funding that is predictable and growing with inflation and with our aging population is one that I personally support. I ask my colleagues to reflect on whether or not any of the funding that has been promised is in fact permanent funding or could it be withdrawn at the whim of the health minister.

SupplyGovernment Orders

12:50 p.m.

Progressive Conservative

Rick Borotsik Progressive Conservative Brandon—Souris, MB

Madam Speaker, I will not say this very often, particularly with the official opposition, but I must say that I respect this individual member for Macleod as a physician. I respect him as a member of parliament and I appreciate the comments he made today.

Being a member of the medical profession, this member will recognize that there are a number of stakeholders within the health care field: the doctors in his profession, the nurses in the nursing profession and the employees in administration.

I ask the member, who is very close to the situation, how other members of his fraternity, those in the medical profession, feel about sustainable funding? I think I already know that answer.

I would also like him to answer a question about what his membership in the fraternity think about an expansion of the services that he talked about in bill 11 in the province of Alberta. Are they supportive or are they, like most members of society today, split on that particular issue?

SupplyGovernment Orders

12:50 p.m.

The Acting Speaker (Ms. Thibeault)

Before calling on the hon. member for Macleod, I would like to mention that there are several members wanting to ask questions. I would ask all of you to please be as brief as possible.

SupplyGovernment Orders

12:50 p.m.

Reform

Grant Hill Reform Macleod, AB

Madam Speaker, this is a stakeholder driven issue in many cases. Specifically on the issue of what does the medical profession in Alberta, my association, think of this bill. They are split. They are asking for amendments to this bill to make certain that there are no concerns.

On the other issue of stakeholders, I will use a specific example of what is best for the patient. The nursing profession has a huge issue in terms of health care. Even the staff who clean the hospitals have a huge interest in this issue. If we just look at the administrative level, the hospital cleaners, and compare the hospital cleaning staff with the hotel cleaning staff who basically do the same job, the hospital cleaning staff is paid double what the hotel cleaning staff is paid. I only bring that up to say that we sometimes forget the patient and the patient should be the centre of our concerns on health.

SupplyGovernment Orders

12:50 p.m.

Liberal

Paul Szabo Liberal Mississauga South, ON

Madam Speaker, the principles of the Canada Health Act are universality, accessibility, comprehensiveness, portability and publicly funded. The member well knows that.

The member needs to comment on the issue of accessibility, portability and comprehensiveness. As an example, in Ontario there are only five doctors who perform the procedure called a spinal fusion. Two of those doctors are in the Mississauga hospital in my own riding. The member would well understand that if private clinics were set up, even though they might be publicly funded to provide that, there would be a drain on the public health system to provide the human resources and medical resources, personnel and otherwise, to staff and equip these private facilities. It means that the accessibility and the comprehensiveness of the services available to the public at large would be reduced.

Since the experience in Alberta has shown that private health care is more expensive, has longer waiting lists and violates the spirit of the Canada Health Act, does the member not agree that these private clinic arrangements as proposed by bill 11 in Alberta would be inappropriate?

SupplyGovernment Orders

12:55 p.m.

Reform

Grant Hill Reform Macleod, AB

Madam Speaker, I thank the member for his question. I know he is as concerned about health care as are other members in the House.

Why do we have five specialists doing spinal fusion in Ontario? That is the real question. Why have we lost some of our best trained, most competent surgeons to Europe and the U.S.? The reason we have lost them is that the facilities we have here in Canada have fallen behind immensely. There are 1.1 MRI imaging facilities per 100,000 in Canada and 3.6 per 100,000 in Germany. This is a multifaceted concern. I would prefer to bring another five spinal fusion specialists to Ontario and set them up on this side of the border instead of on the U.S. side.

SupplyGovernment Orders

12:55 p.m.

Reform

Darrel Stinson Reform Okanagan—Shuswap, BC

Madam Speaker, I have a problem with Canada's health care that has been bothering me for quite some time. It is with regard to what we have done with our hep C victims or rather what the government has refused to do for them here in Canada. We know many of them contracted this disease through our health care system and yet the government has refused to make justifiable payments to these victims. Some of them are desperately in need of care and funding and are in fear of dying.

I would like to know if the hon. member has any idea what he would recommend the government do with regard to these victims.

SupplyGovernment Orders

12:55 p.m.

Reform

Grant Hill Reform Macleod, AB

Madam Speaker, it is inaccurate to say that there has been no compensation planned for any of the victims. Half of the victims, those between 86 and 90, were promised a fairly substantial amount of money. Many were left out completely except for—and this is interesting—Ontario and Quebec have both provided provincial compensation for the victims who were left out.

The saddest thing to my mind is that this process had to go through what I consider to be legal wrangling rather than the way the compensation program was handled for HIV victims of tainted blood. There was no legal wrangling involved there. These funds were laid out and dispersed very quickly.

I have a couple of patients in my constituency who are so ill that I do not think they will see the compensation they have been promised. It is scant help to them to know that they will get some funds after they are deceased. It is one of those chapters in Canadian history that when it is all written down will be one of the saddest sagas in terms of our history. The regulators let these individuals down. The tests were available. Krever said that we should give them help. This is a dreadful saga in Canadian history.

SupplyGovernment Orders

12:55 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Madam Speaker, bill 11 contains an explanation of enhanced medical services. As a medical professional, does the member think it is reasonable that a government, which is as bent on privatization and thereby can delist services and move more and more services into the private sector, should be the same body that can decide what is an enhanced medical service? Does the hon. member think there should be some professional body that includes Canadians which would determine what is an enhanced medical service?

Can the member not tell us that there is an incredible need for accountability in the health care system? We are going to have to move into it before we can throw more money at it. It is clear with the amount of savings that Doug Angus and the health economists have said are already in the system at $7 billion a year that there has to be some ability to address the unnecessary surgery, unnecessary lab tests, unnecessary visits to the doctor in the present system. We must begin to deal with the accountability in the system before people can cry about underfunding.

SupplyGovernment Orders

1 p.m.

Reform

Grant Hill Reform Macleod, AB

Madam Speaker, to my physician colleague across the way, I think those are both very sensible suggestions.

First off, should the government be the one that delists services? In my view absolutely not. The delisting of services should be done by public input through professional bodies. The nursing and medical professions should certainly be involved. That is a very good and significant point. Of course delisting of services has been done without much input and I think in some cases very foolishly.

On the issue of accountability, the accountability in our health care system is not good. Here is my simplistic way of looking at it. As long as there is no interchange with the patient and the provider, it is free. There should at least be a bill presented to every patient for every service in Canada stating how much it costs, the date that it was received and the patient should sign for it. They would then look at the bill. They would have to pay one nickel of the bill. They would look at it and say, “An ultrasound costs $69.30 and I thought it cost about $5”. That is the sort of innovation on accountability which I think we need.

I think my colleague across the way knows full well that a lot of things are done in this medical system for legal purposes as well. I would like to address that.

SupplyGovernment Orders

1 p.m.

Bloc

Réal Ménard Bloc Hochelaga—Maisonneuve, QC

Madam Speaker, it is with great pleasure that I take part in this debate on the motion brought forward by our colleague from the Progressive Conservative Party.

However, I must say that I am somewhat uncomfortable with the wording of the motion. First of all, I must say that we, in the Bloc Quebecois, recognize that the issue of health should be of concern to all parliamentarians. I will have the opportunity to get back to that later on. There are many factors which prompt us to wonder how services will be delivered and how the health system will be structured in the future.

However, the wording of the motion brought forward by the Progressive Conservative Party suggests that it is the responsibility of parliament to propose a national plan for our health care system. I think that is a mistake.

Like all my colleagues in the Bloc Quebecois, I would have been more comfortable with a motion asking that transfer payments be restored to their 1993-1994 level. Everyone knows that, to all intents and purposes, money that was supposed to go to the provinces was taken from them without their permission.

As mentioned many times by our colleague from Saint-Hyacinthe—Bagot, our finance critic, these funds to which the provinces were entitled but which they did not get total $33 billion.

Since the first health cuts in 1993-1994, Quebec alone has had to make up for a $6.5 billion shortfall.

SupplyGovernment Orders

1 p.m.

Reform

Darrel Stinson Reform Okanagan—Shuswap, BC

Madam Speaker, I rise on a point of order. We are discussing a very important function in Canada, our health care system. However, I do not see a quorum in here.

SupplyGovernment Orders

1:05 p.m.

The Acting Speaker (Ms. Thibeault)

We will check for quorum.

And the count having been taken:

SupplyGovernment Orders

1:05 p.m.

The Acting Speaker (Ms. Thibeault)

There is no quorum at the moment. Call in the members.

And the bells having rung:

SupplyGovernment Orders

1:05 p.m.

The Acting Speaker (Ms. Thibeault)

We now have a quorum.

SupplyGovernment Orders

1:05 p.m.

Bloc

Réal Ménard Bloc Hochelaga—Maisonneuve, QC

Madam Speaker, I invite all my colleagues to take their seat. I have prepared an excellent speech that I would like to dedicate to them.

SupplyGovernment Orders

1:05 p.m.

Liberal

Marlene Jennings Liberal Notre-Dame-de-Grâce—Lachine, QC

We are waiting for the popcorn.

SupplyGovernment Orders

1:05 p.m.

An hon. member

They keep on popping.

SupplyGovernment Orders

1:05 p.m.

Bloc

Réal Ménard Bloc Hochelaga—Maisonneuve, QC

Let us stay calm and continue. I know this is a difficult moment for the government members, but as my colleague said, they are waiting for the popcorn, and another colleague added that they must keep on popping. But let us move on.

Since 1993-94, $33 billion have been cut in the transfer payments. Members can imagine how destabilizing that must be for the provinces. I remind the House that, for Quebec, that represents a cumulative sum of $6.5 billion since 1993-94. On a yearly basis, that amounts to one billion dollars.

It is not insignificant that every premier, when they met at a conference here in Hull—

SupplyGovernment Orders

1:05 p.m.

Some hon. members

Oh, oh.

SupplyGovernment Orders

1:05 p.m.

Bloc

Réal Ménard Bloc Hochelaga—Maisonneuve, QC

Madam Speaker, could we have some order? I feel so upset. I am a sensitive man and I need serenity to be able to work.

SupplyGovernment Orders

1:05 p.m.

The Acting Speaker (Ms. Thibeault)

Order, please. I ask hon. members to listen very attentively with me to the hon. member for Hochelaga—Maisonneuve.

SupplyGovernment Orders

1:05 p.m.

Bloc

Réal Ménard Bloc Hochelaga—Maisonneuve, QC

Madam Speaker, I ask that the clock be reset. From disruption to disruption, one is bound to get thrown off one's trend of thoughts.

As I was describing how difficult the situation can be for the provinces that make budgets and have a constitutional responsibility to provide frontline services and restructure the health network. That is why I would have shown much more solidarity with the motion tabled by the Tories, amongst whom I have many friends, if reference had been made to restoring transfer payments.

There is no such reference, which suggests that this government, this parliament, may be responsible for national standards. We believe it is not.

I will digress for a moment, if I may, before getting to the bottom of this matter. Look at what is going on in health care. Under the constitution, the federal government has two main responsibilities. Because of its fiduciary responsibility toward aboriginal peoples, the federal government manages the health care system for the first nations. It also has a responsibility toward the military. One has to see the bad shape in which the health care system for these two groups is.

It took the minister some nerve to get up and offer to the provinces a cost shared program for home care. I tell the minister, with all due respect “Sit down, calm down, shut up, we have heard enough. You have no business interfering in community health programs. Mind your own business and withdraw from this system”.

If the health minister wants to help, he can restore transfer payments.

Let us get that straight. For the first time in the history of mankind, the population on this side of the hemisphere—although I am not suggesting the situation is the same everywhere—is living longer than ever.

It is easy to understand that, in a society where people live longer, some will be in good health, but others will need more specialized care. This will put enormous structural pressure on our health care system. Let we give members a few examples that will help them understand.

Let us see how many years it will take before people over 65 represent 25% of the population instead of the present 12%. In other words, the time it will take before the group of people over 65 represents one quarter of the population.

In Quebec, it will take 35 years. In 35 years, one quarter of all Quebecers will be over 65. It will take a little longer in other societies like English Canada. It will take on average 45 years in English provinces. In Germany, it will take 70 years. In France, our motherland—in history books, they used to talk about Marianne—it will also take 70 years.

It is no wonder that Quebec is so vocal in this debate and so committed to it. The Quebec government will be facing, very shortly, challenges that may be less noticeable in European countries. If we want to provide quality services to our fellow citizens—and I must remind you, Madam Speaker, that you will be among the people who need those services, as well as a vast majority of MPs—now is the time to get our health care system ready to provide services to these people.

Various structural pressures are coming into play. We are $1 billion short in transfer payments for Quebec. This is not an insignificant amount of money. According to Premier Lucien Bouchard, who, it is worth repeating it, is the leader of a very good government for Quebecers, half of the $1 billion that the federal government should reinvest, put back in transfer payments should go to health care, and the other half to the other two budgetary items.

What would we do with this $500 million? Let me give a few examples. This amount of $500 million represents 25% of the budget of Montreal's hospitals.

I now want to give a personal testimony. During our week off, I met with hospitals' CEOs. I met with the CEO of the CHUM, Mr. Douville, as well as with the CEO of the Maisonneuve-Rosemont hospital, Mr. Ducharme, and I spent a good hour with them.

We looked at the situation in their respective institutions. Let me tell you that, at this rate, by the end of the fiscal year, which is very near, every health care institution in Montreal will end the year with a 10% to 12% deficit. I did not take the time to check in Quebec city, or even Jonquière, but I will one day, because I suspect that the trend is relatively similar.

What does it mean? It does not mean that the management is not good, not at all. If the same thing is happening in every hospital, it means there is a basic trend. Every health care institution will end up with a $10 to $12 million deficit.

Let us take the CHUM as an example. As we know, the CHUM is the result of the merger of Notre-Dame, Saint-Luc and Hôtel-Dieu hospitals. It has a $400 million budget, which is quite a lot. On this $400 million, the shortfall in the money managers need for their various programs and do not have will be $40 million.

Therefore, Quebec finance minister Landry is quite right when he says that it is not a matter of money. Yes, we need to think about how we are going to reorganize the health care system. In the medium term, however, for the next three, four or five years, it is clear that, without a significant injection of funds into the system, there will be problems.

The Government of Quebec, with its own money—the National Assembly has done its part—will inject $2.5 billion into the system in the next few years. This, however, will not be enough. We must not assume that the public is not upset, that they are not angry at seeing the government, with its surpluses estimated at between $97 billion and $137 billion—it could be more than $95 billion—doing nothing.

Year after year, our colleague from Saint-Hyacinthe—Bagot, the Bloc Quebecois finance critic since 1993, has made predictions and has never been wrong.

I know that the member for Louis-Hébert is closely following, like me, the career of our finance critic, the member for Saint-Hyacinthe—Bagot, and that he has never been wrong in his predictions. He is much better at it than the Minister of Finance. He has never been wrong in his predictions. He thinks the surplus could be over $95 billion.

It is this government's responsibility to restore transfer payments. There are many backbenchers in the Liberal Party. There is no shame in being a backbencher as long as one is strong and can stand one's ground. I ask them to add their voices to those of the Bloc Quebecois, the Progressive Conservative Party, the Reform Party and the New Democratic Party to put pressure on the government.

Liberal backbenchers cannot be content with being what Clémence Desrochers called backing vocals. I do not know if it means anything to members, but in a signing group, there are always the lead signers and the backing vocals.

Liberal backbenchers are what Clémence Desrochers, a great humorist from Quebec, called backing vocals. They must not be content with playing second fiddle; they must express the concerns of Quebecers and also of people from the other provinces because, I will say it again, there is great unanimity with regard to health care issues.

I want to give other examples of what we would do with the $500 million that the Premier of Quebec could invest in the health care system as soon as he got it. This represents the budget of almost a quarter of Montreal's hospitals or half the budget of the whole CLSC network in Quebec.

Members know that the CLSCs are a rather unique model that we have in Quebec. People from all over the world or at least from North America come to Quebec to learn more about the CLSC network because it is a unique example of a network totally focused on the community, particularly for front line services.

What do we find in CLSCs? We find of course all the services relating to young children, specialized services for people living through a crisis, and support services for community organizations. It is therefore important that CLSCs be an effective and adequately funded network, to continue to provide services to our fellow citizens.

I want to be very clear: the $500 million we would have if transfer payments were restored would be fully used. That amount is the equivalent of the whole budget for home care services.

This is a critical component of the contemporary analysis that must be made of our health care system. We can be sure that people will no longer agree to grow old outside their community. When people get older—regardless of the community in which they live—their expectations and needs remain the same: they want to grow old within their natural community.

This is why Mrs. Marois and, before her, Mr. Rochon, her predecessor, who is an MNA from Quebec City, a colleague of the hon. member for Louis-Hébert, made the wise decision to move toward ambulatory care.

What is ambulatory care? It means telling people “You are going to hospital for an operation, but you are going back home, back to your community, as soon as possible. There are people, particularly from the CLSCs, who will help you stay in your community, in your home”. This approach involves costs.

I have here some figures which I can give about the rise of costs for Quebec to maintain home care services. Members will see that it is a huge budget item.

I will have the opportunity to come back to this. I know I still have a lot of time. Should I run out of time, knowing how generous the Chair is, I shall borrow some from her and pay her back next week.

The $500 million could be put to good use. It is four times the annual budget of the Sainte-Justine hospital for children. It is more than three times that of the Royal Victoria Hospital, and it represents one-quarter of the cost of the prescription drug insurance plan.

I say in all friendship to Liberal backbenchers that the Bloc Quebecois will not give up. We will continue to ask for health transfer payments until they are restored. I am volunteering, with the support of my many colleagues here today, to travel to every region of Quebec in May.

I will visit the riding of Louis-Hébert, Lake Saint-Jean, Laval. I will even visit your riding, Madam Speaker, if you invite me. I am aware of your tradition of generosity and hospitality. We will explain to Quebecers why it is important to invest additional resources in the health system.

I also want to address another very important issue, that is, what is happening in emergency rooms. They are often a reflection of what is going on in hospitals. It is equally important for people to understand that local community service centres are on the frontline, but that when there is a true emergency or a need for extended health care, they should go to hospitals.

I have discovered some extremely interesting things that help us to understand the structural pressure that the system has to bear.

Last year, there were 50,000 more people brought in on stretchers to emergency units in Quebec than in 1994-1995. We cannot, on the one hand, acknowledge the aging of our society and, on the other hand, think that people will not ask for health care in various locations where it is provided.

For Quebec only, and I suppose the situation is not much different in Alberta, Saskatchewan or elsewhere in Canada since the whole population is aging, there were 50,000 more people brought in to emergency units. Of that amount, 80% were 65 or older.

In conclusion, it is not up to this government to establish national health standards. The best way that this government and parliament can help people who need health care is to restore transfer payments in health care to their previous level.

I urge all members, New Democrats, Reformists, Progressive Conservatives as well as Liberal backbenchers to join the Bloc Quebecois in putting pressure on the government so that in the days to come there will be additional money for provinces.

This is the challenge we have to meet. This is the duty we have to carry out. This is the best thing we can do in the days to come.

SupplyGovernment Orders

1:20 p.m.

Progressive Conservative

Rick Borotsik Progressive Conservative Brandon—Souris, MB

Madam Speaker, I will ask a question of my hon. colleague so he can use some of the three minutes that he lost for the quorum call.

SupplyGovernment Orders

1:20 p.m.

Liberal

Murray Calder Liberal Dufferin—Peel—Wellington—Grey, ON

Did the Conservatives call for a quorum?