Debates of March 20th, 2000

Supply

[Lynn Myers, Liberal, Waterloo—Wellington, ON]

Madam Speaker, the hon. gentleman makes a very good point. I think that we as a government have shown repeatedly that we are prepared to go the extra mile.

It is interesting. The Reformers are talking about $1.5 billion today. We put in $2.5 billion. They should be supporting the budget. They should have been supporting the budget, instead—

[Myron Thompson, Reform, Wild Rose, AB]

Tell the truth.

[Bob Mills, Reform, Red Deer, AB]

Liar.

[The Acting Speaker (Ms. Thibeault)]

Order, please. Resuming debate, the hon. member for Kelowna.

[Werner Schmidt, Reform, Kelowna, BC]

Madam Speaker, I would like to advise you that I will be dividing my time with the member for Esquimalt—Juan de Fuca.

I would like to address the motion which is before the House. For the edification of the member who just spoke and the one who preceded him, I would like to read the motion which we are debating. It reads as follows:

That this House calls on the Minister of Finance to increase the Canada Health and Social Transfer by $1.5 billion and forgo the $1.5 billion increase to federal grants and contributions in this year's federal budget.

I wish sincerely that the two members who just spoke would have read the motion and debated it, rather than talking about something which they know very little.

I would like to address a number of the accusations that were made. I will do so implicitly, as I proceed through my speech, but I want to focus my attention on three perspectives of this motion and I will explain why it is before the House.

First, health care is more important to Canadians than increasing grants and contributions. They want health care to be the number one priority.

Second, I want to address the lack of internal audits from the various departments that are in the grants and contributions business.

Third, I want to look at the boondoggle in HRDC.

Before I do that I want to underline that the purpose of this motion, the intent of this motion and the content of this motion is not to suggest that there should be no money in grants and contributions, but rather to not increase grants and contributions.

According to the budget, there will be a $1.5 billion increase in grants and contributions. We believe and respectfully suggest to the Minister of Finance and the Prime Minister that instead of putting that money into grants and contributions it go to health care.

Let us be abundantly clear that this is the motion. That is our purpose. That is the direction we wish to go.

People in Canada, hon. members included, want health care. We want a good, sound, solid, defensible, sustainable health care system, one which will look after our needs, one which will look after the needs of our families, our children and our grandchildren.

There are a lot of things about the health care system that are excellent. We have wonderful servants in the health care system, health care workers who know their jobs well and who are true professionals. We have excellent people in the research field and I commend them for the work they are doing, but all is not well in our health care system.

I would suggest that one of the difficulties in the health care system is in its administration. There is duplication. There is duplication as far as the federal and provincial governments are concerned. There is duplication in the respective municipal organizations and administrative structures that exist in the various health regions and hospital boards.

There is a tremendous turf war that is going on within the health care system as well, among the nursing professions, the specialists, the medical personnel and the various other professions. There are turf wars being fought at the expense of the health care system and the recipients of the health care system are not benefiting from them.

Something needs to be fixed. I will not do that and I do not think it is the government's job to do it. The important thing is to recognize that something needs to be done to fix the system so that the delivery of the health care system is as efficient and as effective as it possibly can be. Very closely allied to that is the business of money. We have had tremendous technological advances which we need to pay for. There are very expensive procedures and very expensive machines. The adaptation of technology costs a lot of money. We need to pay for that.

At this point I cannot help but look at the history of this government. There were a lot of statements made a moment ago about how much money the government put into the health care system. I want to read into the record exactly what has happened.

In 1993-94, the year the Liberal government took office, there was some $18.8 billion transferred to the provinces for health care and social services. In 1994-95 it was reduced by $100,000 to $18.7 billion. In 1995-96 it was reduced to $18.4 billion. In 1996-97 it was $14.8 billion, a reduction of $3.6 billion. In 1997-98 it was $12.5 billion, a further reduction of $2.3 billion. By this point there was a tremendous reduction.

In 1998-99 it remained at $12.5 billion. Then in 1999-2000 it was increased by $2 billion to $14.5 billion. In the 2000-01 budget, which we just received, it was increased by $1 billion. That is what we are being told.

If we add those figures we discover very quickly that the amount of money which is being added to the transfers is actually less than the amount taken out. What kind of business is that?

We are coming to the House and saying, instead of increasing grants and contributions, why does the government not take that increase and put it into health care? Does that not make a lot of sense? That is exactly what we ought to be doing. That is what we are talking about and that is why we are concerned.

On one side we hear about all of these wonderful things that have been done by putting all of this money into the health care system. Some money has been put in, but what the government forgets to say is how much was taken out. That is where it lies. That is where the dignity and the respect of the government comes into question.

Why does it not tell the whole story? Why does it tell only half of it? Why does it tell only that part which sounds good? Why does it not tell the people the rest of it? Does it think that doctors do not know what has happened? Does it think that medical professionals do not know what has happened? Does it think that the administrative districts of the hospital systems do not know what has happened? They know exactly what has happened. Ask the ministers of health and the provincial premiers what has happened. They know what has happened.

It is all very well for the government to say “That is not what really happened”. Look at the bank accounts. If the premier of Ontario has money left in his bank account, good for him. He will spend it in a way that is far more effective than the minister who says that health care is some kind of big black hole.

I want to move a little further into the area of grants and contributions. First, we need to recognize that some of the biggest winners in this year's budget are: the environment, which received a 35% increase; HRDC, which received a 30% increase; industry, which received a 29% increase; Canadian heritage, which received a 28% increase; ACOA, which received an 18% increase; citizenship and immigration, which received an 18% increase; and finance, which received an 11% increase. How is this money being spent? That is really important. We have had one audit presented to the House which showed a very damning picture as to where that money went.

Let me address this issue from another point view, that of internal audits. I discovered that since January 1, 1994, which is close to the time the government took office, there have been no audits performed that we know of in the Department of Finance, which received $250 million, and none in National Defence, which received $1.44 billion. Industry Canada had one audit in April 1995 and it spent $3.19 billion. Justice had no audit and it spent $1.63 billion. The Treasury Board, which had the smallest grant, $82 million, had two audits.

That really is a frightening situation. Billions of taxpayer dollars are being spent. Where are they going? How are they being used? These are very critical issues.

Let me give the House another example. The Minister of Human Resources Development rose in the House and referred to Kelowna as having received some $37 million in grants from her department. I looked at the numbers on the list. One of the entries was for a $7.6 million grant to an aboriginal management group. What did I discover when I checked into it? The money did not go to Kelowna. It went to nine different aboriginal bands, but Kelowna was identified as having received the money.

The Business Development Bank of Canada received $250,000 from HRDC. When I questioned the regional director on where the money went and why it went to the bank, he said that it was a mistake and that it should have been recorded as having gone to Kamloops.

[The Acting Speaker (Ms. Thibeault)]

It is my duty pursuant to Standing Order 38 to inform the House that the questions to be raised tonight at the time of adjournment are as follows: the hon. member for Acadie—Bathurst, Employment Insurance; the hon. member for Frontenac—Mégantic, Human Resources Development.

[Roy Cullen, Liberal, Parliamentary Secretary to Minister of Finance]

Madam Speaker, the member for Kelowna discussed various spending initiatives in the budget. One of the things he glossed over in his presentation was the fact that direct government program spending by the federal government this year compared to 1993 when we first took office was down $4 billion. At the same time, in the last budget the Canada health and social transfer was completely restored to the level it was at when we took office in 1993.

If the member would reflect upon this he would see that this has been demonstrated in the government's commitment to transfers to the provinces, which includes the Canada health and social transfer. If equalization payments were included, he would see that transfers are up to about $40 billion.

If we look at the direct spending trends since we took office and brought the deficit under control, we find that our spending increases have kept pace with inflation and the demographic growth in the population, and that is it.

When the member throws out these percentages of direct program spending he masks and distorts the real picture. The government's direct program spending is significantly down from 1993 when we first took office, and our transfers have been completely restored, if one includes the tax points, which in an honest debate one must do.

[Werner Schmidt, Reform, Kelowna, BC]

Madam Speaker, I was wondering how long it would take before somebody would raise the tax point issue. The point is that the discretionary cash has remained constant in a variety of areas, so the tax points really do not adjust to the full measure which the member has suggested.

I would like to address a more important part of this issue, and that has to do with the balanced budget. The hon. member, in an almost sanctimonious tone of voice, suggested that the Liberals balanced the budget, thereby licking the deficit, and what a wonderful job they have done. It is pretty easy to balance the budget, simply by increasing taxes. That is not hard to do, and the Liberals have done that.

There have been some 37 tax increases since the Liberals took office. If governments keep raising taxes they are ultimately going to get to the point where they will have a balanced budget, and the Liberals have done exactly that. But who balanced the budget? The taxpayer; not the good spending of the government.

Let us not forget that the Liberals have paid nothing down on the debt, or if they have it was a minuscule amount. About $42 billion is taken out of the treasury each year to pay the interest on the mammoth debt. Think of what could be restored to health care if we did not have to pay that tremendous service charge. And if there should be a shift in the interest rates, imagine what would happen with $580 million with an increase of 1% in the interest rates. That is a little better than $5 billion. Look at what that would do.

This is not idle talk. We need to do this through the reallocation of resources that we have. We do not want to throw more and more money at these things. That is what is happening. We are increasing the money where departments have shown that they are not totally responsible. We want to put it into health care which is where the people of Canada want it and where it is needed.

[John Cannis, Liberal, Parliamentary Secretary to Minister of Industry]

Madam Speaker, I am really confused. The member said earlier that there are fundamental problems in our health care system in administration and duplication. Is he saying that even though we put so much money into the system we should put more money into the system as opposed to fine tuning and eliminating duplication? Is more money going to add more duplication? Is that what he is saying?

[Werner Schmidt, Reform, Kelowna, BC]

Madam Speaker, I am not surprised with the history of the member that he would be confused. He has always been confused. I raised two points. Number one, there is an administrative problem that has to be fixed. Number two, more money should be put into the system. I mentioned specifically technology and other things. These are not necessarily the same thing. They are mutually exclusive or certainly can be treated and should be treated separately.

[Keith Martin, Reform, Esquimalt—Juan de Fuca, BC]

Madam Speaker, I am very happy that my party has put forward the motion which calls for $1.5 billion to be put back into the CHST. Let us not forget that this is not only for health care but is for education and welfare transfers too, in particular education and health care. We have been fighting for this for such a long time while the government has been gutting the two principal social programs that Canadians rely upon.

We are not asking for new money. We are asking for money to be taken away from grants and loans that the government gives to organizations through HRD. We, and in particular the member for Calgary—Nose Hill, have demonstrated very clearly that the money has been wasted. That is only the tip of the iceberg.

Let me show what the government is also doing. The amount at HRD was $1 billion, but let us look at the Export Development Corporation where the government has $22 billion of taxpayers' money in outstanding loans of which $2.8 billion has already been declared deadbeat. The government gave $2.8 billion of taxpayers' money to corporations. For example, it was given to despotic rulers where there is no accountability and for environmentally appalling and stupid programs that have no measure of success.

The government has given away $2.8 billion of taxpayers' money through the Export Development Corporation. Who runs the Export Development Corporation? Pat Lavelle, who has been a friend of the Prime Minister for 40 years.

That is what we have a real problem with. We put the motion forward to deal with some of the money that is being wasted by the government. We are not asking a lot. We are asking that $1.5 billion out of the $2.8 billion the government has frittered away, given away or the $1 billion from HRD, be put into health care and education. Members across party lines recognize an urgent cash infusion is needed.

The health minister likes to talk about innovation, ideas and improving our health are system. That is all very well but the fact is that those beautiful words are not going to put a single patient into a hospital bed. It is not going to give patients the care they require. They are only words. The health minister on March 17 said in the House:

It is obvious that the status quo, the current situation is unacceptable. One can see the problems that exist everywhere: waiting lists, overcrowded emergency rooms, shortages of doctors and particularly certain specialists, and shortages of nurses.

We all agree that those are part of the problems but none of the words coming out of the health minister's mouth are going to actually solve those problems. That is a real tragedy.

This is not an academic exercise. It is a matter of life and death for all the people who rely on their publicly funded health care system to get the care they require.

That is why we hope the government will support the motion. It will give health care professionals, hospitals and other caregivers the urgent and emergent financial resources today. It will help them care for at least some of the people who are on extended waiting lists, who are suffering today. We hope the government will deal with that.

Part of the issue of solving a problem is to understand what the problem is. Looking into the crystal ball and at the situation today, we see that there are more expensive technologies, an aging population and the supply and demand of resources will widen as time passes. As time passes it will get wider and wider.

The people who will suffer are those who depend on our publicly funded health care system, i.e., the poor and middle class because they do not have an option. The system which they have come to believe is the best health care system in the world unfortunately may not be there for them when they need it. Numerous examples across the country demonstrate that.

Another situation we ought to realize is that if we stand and say we defend the Canada Health Act and say nothing more, then we really are being disingenuous. All five principles of that act, which are good principles, are being violated across the country. How do we make sure that we have a Canada Health Act that ensures accessible and affordable health care in a timely fashion for all people in the country regardless of the amount of money they have?

That in essence is what the Canada Health Act is all about. It was never meant to be all things to all people. The people who put it together recognized very clearly that it is an unsustainable act in and of itself. That is why the provinces and many medical associations disagreed with it and opposed it when it was put together but it was rammed through by the government of the day. I think they meant well to do it because the principles are good. We would like to ensure that the basis of those principles will be pushed forward.

What do we need to do? We need to recognize that the Canada Health Act is a permissive and inclusive document that involves freedom of choice. That is what it was meant to be and we ought to go back to that rather than ensure it is a punitive measure.

When we talk about funding, one-third of all funds come from private services. We must recognize that today in 2000 there is a two tier system in the country. The people who cannot afford the drugs, the physio or the home care do not get it. Those who cannot afford the dental care which was excluded cannot get it. It is all very important for people's health care.

Let us look at ways in which we can have a sustainable health care act for all people. Some money needs to be put in. We recognize we have a finite pie. That is why this motion came about.

Let us look at building a new Canada Health Act that takes the wonderful principles of the original act and ensures that the affordable, accessible and comprehensive health care system for central services that is portable for all people will be there. That is eminently doable.

Let us ensure that the feds and the provinces sit down and talk. It is a great mistake for the Prime Minister to say to the provinces, “We are not going to talk”. I think the Prime Minister's pollster, Mr. Marzolini made it very clear that the government is vulnerable on the issue of health care. The Prime Minister must call together his Minister of Health and his provincial counterparts to sit together and deal with specific aspects of health care today.

The issue of prevention needs to be discussed. In 1997 the House passed a motion concerning the national headstart program. That program which extends across justice, health care and HRD would be incredibly cost effective for the taxpayer if it were implemented. It would give children the basic necessities required in order to be self-actualized individuals and to become productive members of society. It has been proven to work. The Minister of Labour was a champion of it early on. She has done incredible work. It would save billions of taxpayers' dollars and would improve the health and welfare of Canadians from coast to coast.

We need to talk about how we can develop new ways of funding to ensure that private services do not weaken the public system but rather strengthen it. It is a reality today. Let us make sure that we do not have an American style health care system.

One of the problems in the debate today is that people are saying that if it is not the Canada Health Act, then it must be an American style health care system. It is completely disingenuous to say that the whole debate on health care distils down to what we have today in Canada compared to the American style health care system. That is bunk.

We can build the best health care system in the world by using our own brains, our experience and models that exist around the world.

We talk about a national drug strategy. What we are doing now does not work. We need to look at models in northern Europe and innovative models in other parts of the world that have brought together work treatments. They ensure that drug abusers are off the streets and become employable members of society so that their drug problems, their medical problems, can be treated.

Lastly is the issue of medical manpower. This country has a shortage of over 500 doctors a year. We are going to hit a brick wall in the near future. We will not have enough physicians. With respect to the nursing situation there will be a lack of 112,000 nurses in the next 12 years.

I ask members on the other side to reflect on this critical situation. A brick wall is on the horizon and we are going to slam right into it if we do not address the situation right away.

In closing I ask members of all political parties to support this motion. It is a fair motion which will put $1.5 billion back into the system for health and education. It will give the provinces some urgent funding for these two critically important programs.

We are not asking for new money. We are asking that it be taken away from areas where the government has demonstrated a misuse of funds. We are asking that it be put into something that the public wants and which would be very helpful to members and people across this great country of ours.

[Svend Robinson, NDP, Burnaby—Douglas, BC]

Madam Speaker, I have a two part question for the hon. member for Esquimalt—Juan de Fuca.

The first part is in respect to his suggestion of two tier health care. He has been up front about this. He says that yes, there should be one tier for those who can afford to buy their way into it, a private health care system for those who can afford to buy their way into that, parallel to the public health care system. Of course we know that this would ultimately destroy the very fundamental principle of medicare, which is that one does not jump to the front of the queue based on the size of one's pocketbook.

The member has been very clear on that. I am not sure that all of his colleagues have agreed with him on that, but certainly he wants to run for leader of whatever the name of the party is, the Reform Party or some other manifestation, the new Canadian alliance, or CCRAP, or whatever it might be. He wants to run for the leadership of the party based on that principle.

As a doctor the member must surely recognize that in a time of shortages and scarcity in health care resources, and the member has talked about a shortage of nurses, a shortage of doctors, shortages of resources in the public health care system, that if we drain that already starved system of resources, if doctors are going into his private clinics, if nurses are going into the private clinics that the good doctor is prescribing, surely that will cause the public health care system to erode. It will weaken that system which is exactly what we saw in the United Kingdom.

Second and very briefly, does the member not recognize and understand that under the provisions of NAFTA, if we open up health care in Alberta under bill 11 to private health care providers as Ralph Klein is suggesting, that this will then mean that private health care providers will have access under NAFTA right across Canada? If we deny them that access they will be able to challenge under the provisions of NAFTA. They will be entitled to massive compensation under the provisions of NAFTA. This too will lead to the destruction of our universal health care system.

How can he stand and say that on the one hand he believes in medicare when on the other hand he is supporting a two tier health care system that will destroy universal health care in this country?

[Keith Martin, Reform, Esquimalt—Juan de Fuca, BC]

Madam Speaker, I am extremely happy the hon. member from the NDP asked that question because he is wrong on a number of counts, but he has also recognized the fact that we do have scarcity within our system.

We have a lack of resources. Somehow we have to ensure that a publicly funded health care system is going to have the resources to do the job. That is the bottom line. We have to put patients first. We have to put patients over politics.

First, the hon. member should recognize the scarcity which he articulated. There are not resources in the public system right now to do the job. Second, the situation will get a lot worse for the reasons I mentioned in my speech. Third, he has to recognize that today in Canada 30% of the services are provided by private carriers. We have a two tier system today.

My objective is to make sure the private services that are out there will strengthen the public system and not weaken it. I do not want an American system. I do not want a British system and I do not think we should have an Australian system. All those systems have distinct flaws. However I will speak to the hon. member about how a parallel system, if done properly, could actually strengthen the system.

He raised a very good question about manpower. I would refer to the aspect of ensuring that medical professionals must spend 40 hours a week within the public system. If that is done, it is ensured that the best specialists, doctors and nurses stay in the public system for at least 40 hours a week, as opposed to the system we have today where sadly many of them are going south of the border to be lost completely.

[Roy Cullen, Liberal, Parliamentary Secretary to Minister of Finance]

Madam Speaker, the hon. member from Esquimalt talked about the importance of health care and education. Canadians reflect that and the government has demonstrated that commitment last year with $11.5 billion to health care and this year with another $2.5 billion to the CHST.

The member opposite gave an example of nurses. In the province of Ontario where the health care system underwent severe restructuring the Ontario government laid off 10,000 nurses. Then a couple of years later it said that it did not have enough nurses and would have to hire some of them back. The budget of the province of Ontario for health shows a slight increase, but most of it is for restructuring costs. How can the member opposite talk about putting more funding into a system that is already in need of some repair managerially?

[Keith Martin, Reform, Esquimalt—Juan de Fuca, BC]

Madam Speaker, I do not dispute that management structural issues have to be dealt with. The population over the age of 65 will double in the next 20 years. Some 70% of health care is spent on those people with more expensive medical technology. My colleague on the other side knows very well that gap will widen dramatically.

Yes, some management changes have to be made. Yes, streamlining has to occur, but those changes are only minor in terms of the cost savings. The amount of money that will be required to pay for all that we ask, including home care, drugs and a litany of other issues, far exceeds that which exists in the pockets of the federal or provincial coffers.

[Jerry Pickard, Liberal, Kent—Essex, ON]

Madam Speaker, after listening to the debate today, one really wonders where we start in this story. From my point of view the fact is that Canadians think that the health care system needs change. I as one Canadian and all of my colleagues believe the same. Before I go very far, though, I want to make clear that I am sharing my time with the hon. member for Mississauga South, a very eloquent speaker. I want to make sure that he gets his time in.

Every Canadian believes that the health care system is in disarray. We have heard in Ontario, the wealthiest province in Canada, of people sitting in hallways unable to get service or to get a hospital room. We have heard of a shortage of doctors. We have seen small communities that do not have doctors. We have seen emergency rooms overloaded and unable to handle the calls coming in. We have seen flu epidemics and the doctors system unable to deal with that.

We at the federal level have been very concerned about that, particularly just after we decided to transfer $11.5 billion more to the provinces so that they could deal with these emergency situations. It is my understanding that many of those dollars ended up in the coffers of the Ontario government.

The Ontario government saw fit to take the money and spend a bit of it. It put $700 million into a bank account to raise interest rather than deal with the emergency for which the money was set aside. It drew the money out of the federal account and put it in a bank account to raise interest. When we are worried about an emergency we should deal with the public fairly and meet its needs.

As a result I think it made many of us on this side of the House wake up. We woke up to the fact that the provinces run the health care system. They control the hospitals and medical spending. They control the institutions that train doctors. They have an opportunity to move an agenda which they are not doing.

My colleagues across the way are suggesting that we should transfer $1.5 billion from training areas and put it into health care. I would guess that is an honourable approach if $1.5 billion will solve the problem.

Many of us on this side of the House think there is another solution. We must sit down with the provinces to look at the problems in health care. We must decide how to train more doctors. We must decide how to provide more hospital beds. We must decide how research can take place.

The provinces are asking the federal government not to get involved in their administration. It is a tragic mess. The government will be blamed for not giving the provinces enough money, but they do not want to work with us in providing a system that will work across the country.

We on this side of the House believe very strongly that it is not just a money issue. It is far more than a money issue. It is an issue of proper planning and changing our approach. It is an issue of dealing with home care. It is an issue of dealing with drugs. It is an issue of dealing with doctors. All these issues must be discussed on a fair basis with the federal government, which is funding a tremendous amount of these costs. Yet once we turn the dollar over to the provinces we lose total control. We have no control at all.

Before we turn more money over I think it is critical that we sit down with the provinces to develop long term plans that will make sure Canada is going in a safe direction. We cannot look at the Ralph Kleins of this world who are creating their own disasters. They are pushing for privatization in the health care system which will inevitably leave the rich with the service and the poor with no service. We all know this.

We have been fighting the right wing element in the country for 50 years over these kinds of issues which says that we should give the service to the rich; if they can pay for it, let them pay for it. Then what does the poor get? What remains. No, that is not fair.

The Harris government is sending people for cancer treatment to the United States instead of spending the $700 million that is in the account on proper materials to provide this care. Harris is not a person to be trusted in this business. The frank fact is that our health minister has to sit down and work out a plan.

Let me turn to the Reform motion. It is an interesting one. Reformers are suggesting that we should take $1.5 billion and put it into health care. They are also suggesting that the $2.5 billion in the budget was not enough. The total money they are asking us to put in the budget for health care is $4 billion.

It was interesting to read the Reformer's solution 17 in their prebudget recommendations. They suggested that spending only increase by $1 billion in all programs in Canada. In other words, why after the election when people are talking about health care are they suddenly saying that we should spend $4 billion on health care alone when before the budget came out they had a position that the total spending on all programs in Canada increase by $1 billion? It does not make sense.

They asked for increased spending on the RCMP, increased spending on defence and increased spending on almost every federal program. They were asking us to put money here, put money there and put money over here. Now they are saying put $4 billion into health care when their whole approach was a $1 billion total spending increase in Canada. That appears to be a pretty big two-face to me.

Let us stop to think about the positions Reformers take. They come back week after week saying that their constituents told me to do this so they are jumping over here. Long term planning is something Reformers have never done, have never adequately faced the demands of and will never do accurately. That is why the Reform Party will never be the government of the country. Reformers bounce from pillar to post. They change with the drop of a hat. They never stay consistent with any of their policies, and yet they say that as somebody changes their mind their policies will change as well.

I have difficulty with what Reformers are proposing today. I have difficulty with one of my colleagues across the way stating that we have not put money into health care. Our total dollar spending in 1993-94 when we took government was $37 billion. This year with all expenditures put together it will be $39 billion. We have increased spending in health care and education by $2 billion since we have taken office. We cut initially but all the extra transfers coming back have increased that budget.

There is a twisting of the truth, and that is too bad. The reality is that federal and provincial governments need to sit down to work out the health problem in the country, and not do it by just sending money to the provinces.

[Inky Mark, Reform, Dauphin—Swan River, MB]

Madam Speaker, I listened closely to what the hon. member had to say. He tried to take credit for what the government has done in terms of spending. I would like to know whether the hon. member will take credit for the slashing of the $25 billion back in 1993 when his government came to office.

[Jerry Pickard, Liberal, Kent—Essex, ON]

Madam Speaker, I am really pleased to answer that question. Reform Party members used to be Tories, Conservatives. I remember Brian Mulroney led them. They were here in the House. They had the same right wing agenda then as they have today. They said day after day the Liberals tax and spend. That right wing party with its counterpart over there increased our debt three times in an eight year period. When they came in the debt was $168 billion. When they left it was over $500 billion.

Are we proud of cutting? Darn right, we are proud of cutting, because it had to be done. If we did not make the cuts, my children, my grandchildren and my great-grandchildren would have to pay for the overspending. It had to be done and there is no question about it.

The reality is that the folks across the way say one thing but do something different. They say “We are going to get the economy rolling correctly”. Everybody knows that it was not the Reform Party that had anything to do with straightening out the economy; it was good, solid Liberal policy. We straightened out the economy and now I am proud to be in the position of being able to make Canadian lives better.

[Christiane Gagnon, Bloc, Québec, QC]

Madam Speaker, I am wondering where the government member is getting his numbers. We know full well the health side of the Canada health and social transfer has been underfunded to the tune of $30 billion since the Liberals came to power.

This year, a meagre $2.4 billion was announced for the whole of Canada. This money will be held in trust and spent over the next three years.

I believe we do not have the same numbers. It all depends on the analysis one is looking at. If the situation is really that bad in health care, the thing to do is not so much putting more money in it as doing it in a different way from before. We need to put money in health care over a five year period, as the Bloc Quebecois suggested, we need stable funding.

Every Quebec leader, including the president of the federation of physicians, is calling for the restoration of health and social transfers to their previous level. This is a far cry from the $2.4 billion the government allocated in the last budget. What we are demanding is $4.2 billion a year, times five, which is at the most $21 billion.

Since the liberal government came to power, help to the provinces in the areas of health, education and income security has relentlessly been cut. Quebec ministers and the other provincial ministers had asked for a Canada social transfer to fund health. They had asked for more stable funding, instead of the iffy funding we are being offered with money held in trust for the provincial governments to spend.

It is very difficult for a government to plan good management when the Liberal government makes such cuts.

[Jerry Pickard, Liberal, Kent—Essex, ON]

Madam Speaker, the numbers I have come from official government documents. If the member has different numbers, she had better read the documents and get the proper numbers.

When we talk about cash transfers we are not talking about ad hoc programs. We put $11.5 billion last year into the budget to help the provinces with their financial situations, to put money toward emergencies and to solve problems. We added to that $1.2 billion this year. If we combine the $11.5 billion and $1.2 billion we end up with a huge increase over a two year period which is in the neighbourhood of 25%.

It is important to realize that no member on this side of the House has said that is the limit. The people on this side of the House have said “We have to plan”. We have to work with the provinces, which control the health budgets. We have to make certain that the dollars going in are utilized for the services Canadians need. That is important.

[Paul Szabo, Liberal, Mississauga South, ON]

Madam Speaker, I am pleased to participate in the debate on a motion which recommends that the government transfer $1.5 billion from HRDC to the CHST. It is an interesting motion because it brings to the table two very important subject matters.

First, I want to comment on the HRDC side of the equation. When this issue first came to the House there were a lot of numbers being thrown around. As time has gone on the numbers have been refined substantially.

I watched with interest a press conference with HRDC officials who were answering questions about the so-called 37 flagged files which had problems. Being a chartered accountant and having headed up an internal audit department in a large corporation, I know what is involved in an audit. I know about the planning and the due care and the checking that is done and the time that is associated with it. The HRDC officials described to the media and to Canadians that the work that had been done with regard to those 37 files was, in fact, not an audit at all. The reason it was called an audit report was that it came out of a department called internal audit. What it was, as they described it, were reports on visitations by HRDC employees who went to organizations that had received program funding. They looked at a file and saw what was or was not there. They had a little bingo card, checked off a few things and then they were on their way. By any criteria whatsoever, those were not audits.

The proof that they were not audits was that if audits had been done they would have made reasonable inquiries to satisfy the deficiencies they noted.

Subsequent to the flagging of those files, auditors were sent in. Based on the last report I saw, I understand that audits have been done on 34 of the 37 files and each and every one of the deficiencies noted by the visitations have been cleared.

We have to take some care about how we characterize the work that has been done in the internal audit area with regard to deficiencies. In fact, the deficiencies were apparent deficiencies and subsequently proved not to be deficiencies.

I look forward to the final report on the balance of the three audits to judge for myself whether funds were appropriately or inappropriately used. I have been assured, and Canadians should be assured, that in the event any funds which were transferred or provided to groups or organizations were inappropriately used, the government always has the option, and will exercise the option, to recoup the funds which were not spent properly or take collection actions through legal means. Canadians should have that assurance.

There are also ongoing RCMP investigations. Some of the work in other areas has led to questions and allegations have been made. The appropriate step is to ask the RCMP to do the work, and that has happened.

It should be pointed out that the allegations of mismanagement are not against the government. Rather, they are against the participants or recipients of the moneys. It is very important for members to understand that the RCMP is looking into allegations of mismanagement by third parties, not by the government.

I would like to cite a couple of examples of media spin. One example was Wal-Mart. There was a big story that Wal-Mart got a big grant. The facts are that a construction company got a grant to hire people to work on a construction site. They were constructing a distribution centre for Wal-Mart, which was going to have its products shipped through that centre. Wal-Mart did not get the grant, but it was convenient for the press and others to suggest that somehow it did. That was not the case.

There was also the case of McGill University. It submitted an application for $60,000, but it ultimately received $160,000. That was not because someone arbitrarily decided to give it extra moneys for some unknown reason. The additional moneys were advanced to McGill because the program it was proposing, on a small scale, was an excellent program and it was encouraged to expand it to provide a broader number of employment opportunities to people, which raised the amount of the grant to $160,000.

With regard to the McGill file, there also was an item of some $10,000 which was flagged. It was one of the 37. The proper documentation was not within the file. Subsequently the auditors found, to their satisfaction, proper documentation for each and every penny that McGill was advanced. There is another example which received quite a bit of play in the press, and yet once all of the facts were in, once people had done their jobs, the allegations that were raised were appropriately discharged.

I want to say that at this point I am not passing judgment on all of the files. Obviously we have not seen all of the information. However, it appears, with the substantive work that has already been done, that it is clear the government and HRDC officials, those important employees, are doing a good job of protecting the resources of the Canadian taxpayer, because the government does not have its own money.

I want to shift to the health care side, only because today I had lunch with Sir George Alleyne, who is an inspiration to a lot of people because of his work around the world. He was actually knighted by Queen Elizabeth. We spoke about the importance of our health care system. I wish he could address this Chamber to let us know about the state of health care around the world and how important it is that we have a value system associated with health care.

I raise this issue about a value system associated with health care because the National Forum on Health began in 1994 at the request of the government. Health care experts from across the country spent two years studying Canada's health care system and consulting with Canadians about what they wanted from their health system.

One of their most important observations was that health care costs had risen disproportionately to the marginal improvement in health status. They gave the example that from 1975 to 1993 real per capita health expenditures increased from approximately $1,100 to $2,000 per capita. That was according to Health Canada in 1996. They concluded that spending more money on health care costs does not necessarily lead to better health. That is the crux of the issue.

The experts which the Parliament of Canada engaged to look at our health care system came to the conclusion and the direction that parliamentarians should all be aware that spending more money does not necessarily translate into better health.

The value question which I am sure Sir George would want to tell us about has to do with what Canadians want from their health care system. In looking through the annex documents to the National Forum on Health I found some interesting points. They said that an opinion formed with relatively little engagement or with poor information would be less stable in the long term than one formed under conditions of high engagement and good information.

What they were saying was that we have to work together with the provinces and with Canadians to determine what the value system is that should be underpinning our health system. It is not simply a matter of throwing more money at the health care system and saying “Keep doing what you are doing”. The important thing is to determine whether we are getting good value for our money.

I have many more points that I would like to raise, but I will highlight what Canadians said to the National Forum on Health on what their various values were for our health care system. The first and most important was efficiency in the system. Second was the quality of access. Third was the performance on results. Fourth was prevention. Fifth was freedom of choice. Sixth was a compassionate system. And seventh was flexibility within our health care system.

I believe the important thing for Canadians to know now is that the Minister of Health has undertaken to meet with his provincial counterparts to have the dialogue necessary to start the process of determining how our health care system can be reformed to meet those values which Canadians hold so dearly. Once those ministers have agreed, then we will be able to come back to parliament and determine how we can establish sustainable funding for Canada's health care system.

[Lee Morrison, Reform, Cypress Hills—Grasslands, SK]

Madam Speaker, the hon. member for Mississauga South gave a rather impassioned defence of HRDC. I can readily understand his sensitivity with regard to that particular department. However, the motion, if he would look at it, has nothing to do with HRDC. It is a general motion and it deals with grants and contributions from all departments. It concerns a $13.5 billion pot of pork. It is not all pork. There are probably some useful programs. However, too much of it is for friends of the party opposite: SNC-Lavalin, Bombardier, all of the old friends. By the way, I am not speaking of EDC; I am talking about outright subsidies. I know the hon. member is well aware of them and could probably reel them off as fast as I could.

These are parties which over the last eight years have given some rather substantial amounts of money to the Liberal Party. I have the numbers here. SNC-Lavalin during the seven years from 1992-99 contributed $295,817. Bombardier during that period contributed $447,615 to the Liberal Party of Canada.

We do not believe it is fitting or proper that the $13.5 billion grants pot be further augmented by the $1.5 billion that is listed in the current budget document to build up the slush. We say take back that $1.5 billion which has not actually been allocated for any particular program yet. It is just a big sum of money which the government wants to give for grants and contributions. Take that back and give it to health care where it is really needed and where the people of Canada really want it. Be a little less generous with this pork-barrelling stuff at least for a year or two. That is all we are asking. It is a pretty straightforward motion.

[Paul Szabo, Liberal, Mississauga South, ON]

Madam Speaker, I wish the member were aware that what he is saying is that the government has broken the laws of Canada under the Canada Elections Act with regard to requiring kickbacks in exchange for moneys. Every member of parliament is subject to those rules. If there were any strings attached with votes or any other conditions, they would be committing a criminal offence. If the member has any evidence of criminal wrongdoing on behalf of the Government of Canada or any member of parliament, it is his duty to report it to the Chief Electoral Officer.

The member mentioned some companies, SNC-Lavalin and Bombardier. He did not mention Nortel. How about Pasteur-Merieux-Connaught? Many of these very successful companies have received substantial amounts of money in grants and contributions from the taxpayers of Canada. What he did not say is how much they generated in terms of jobs and new economic growth for Canadians so that more people are working and paying taxes and have the dignity of work.

For instance, under the technology partnerships, Pasteur-Merieux-Connaught is now involved in substantive health research with regard to cancer. Under the technology partnerships it got a substantial amount of money but it was only 25% of the project funding. It came up with the other 75% and it provided jobs for some of the top health researchers in Canada with regard to cancer research.

I believe the member has done a disservice to this place by giving half the story.

[Inky Mark, Reform, Dauphin—Swan River, MB]

Madam Speaker, I will be sharing my time with the hon. member for Surrey North.

I am pleased to take part in the debate on the motion which calls on the Minister of Finance to increase the Canada health and social transfers by $1.5 billion and to forgo the $1.5 billion increase to federal grants and contributions in this year's federal budget. It is important to say that we do not suggest slashing all federal grants and contributions, only that we forgo the increase contained in this year's budget.

The government must listen to the people. Health care is on the minds of all Canadians. How many times have we heard that health care is the number one issue? I want to concentrate on the state of health care in the province of Manitoba and my riding of Dauphin—Swan River.

Canadians must not forget that we are talking about the mess our health care system is in because of what the Liberal government did in 1993. We must not forget that it was the Liberal government that slashed $25 billion from the health and social transfer when it first came to power. It is ironic that the Liberal government wants to fix the health care system, yet it was the same Liberal government that created the problem.

Today federal cash transfers cover just 10 cents on the dollar. In 1997 federal dollars covered 19 cents on each dollar spent on health care. In fact by 2003-04 the Liberal government will have slashed out of the health and social transfer a total of $35 billion. Let me paint a picture of how this $25 billion reduction when the Liberals first came to power affected Manitoba and my riding of Dauphin—Swan River.

The first thing which occurred was that it forced the province to look at other ways of cutting its costs. When the money does not come from the feds, obviously it does not have the money to spend. People got fired; they lost their jobs. People received less service. Quite a negative situation was created and all the people of Manitoba were very upset. Beds closed and hospital services were reduced.

The province did not know what to do. It reorganized the whole system. It cut out all the existing boards, put them into huge new boards and then had the audacity to make political appointments to those boards, which did not do our former Tory government in Manitoba any good.

The whole issue of health care helped the current NDP government get into power. Health care of all things. That is because it was very important in the minds of all Manitobans and certainly was important to the residents of my riding of Dauphin—Swan River.

I spent a lot of time working on the health care issue. Being a municipal leader at that time I had lots of town hall meetings. I organized a provincial meeting of municipalities and the aboriginal community so they could sit down and discuss what the issues were and try to get the provincial government to deal with all the shortcomings that people had to deal with. Obviously nothing happened other than that we created a lot of criticism. The province did not really move in that direction. The problems still exist today.

At this time I would like to read a letter that I received from the Regional Health Authorities of Manitoba, Council of Chairs. This group collectively represents all the health authorities in the province of Manitoba and wrote me this letter:

The Council of Chairs and Manitoba's Regional Health Authorities work together to ensure that all Manitoba's residents have the access they need to high quality health services.

As part of our commitment to ensuring access to needed healthcare services, the Regional Health Authorities of Manitoba is a member of the Canadian Healthcare Association (CHA), the national federation of provincial and territorial hospital and health associations. Through its provincial and territorial members, the CHA federation represents over 1,000 organizations covering the broad continuum of care. These organizations employ approximately one million healthcare providers and serve Canadians across the country. They are governed by trustees who act in the public interest. CHA's mission is to improve the delivery of health services in Canada through policy development, advocacy and leadership. The provincial and territorial members of the CHA federation are committed to ensuring that all Canadians have access to comparable healthcare services wherever they live.

Every day, members of RHAM see the serious effects that cuts in federal transfers are having on our national healthcare system. The significant decline of public confidence in our health care system is compelling evidence that Canadians feel the system will not be there for them and their families when they need it. Federal/provincial/territorial co-operation to build a truly accessible, integrated client-centred continuum of care is essential to restore the confidence of all Canadians in our healthcare system.

Provincial and territorial members of CHA federation believe that the federal government must act to ensure access to comparable health services for all Canadians regardless of where they live. The CHA brief presented to the House of Commons Standing Committee on Finance recommended that the federal budget focus on health care by:

1. Raising the cash floor of the Canada Health and Social Transfer by $2.5 billion immediately.

2. Applying a growth factor of the cash component of the CHST.

3. Adding $1 billion to launch a national home and community care program to improve access to the broader continuum of care.

It is essential that, as our healthcare system adapts to change, the devolution of resources away from hospitals must not imperil access to the needed healthcare services that they have traditionally provided.

Health reform must include investment in and augmentation of all parts of the continuum of care as we work toward an integrated, client-centred continuum of care. Adequate, sustainable federal funding and federal/provincial/territorial co-operation are both essential for this to happen.

Today we have heard members say that throwing money at the health care system is not the issue and perhaps not the solution. But the reality is that the money taken out of the system back in 1993 caused the problem we have today. Therefore money is one of the solutions. No doubt we all agree that people need to sit down and talk and work collectively to look at all the options, including the options being expressed in the Alberta legislature at this time.

It is ironic that people do pay for their health care. There are lots of services. In fact the CHA indicated there are many medically necessary services in Canada that must be paid for out of pocket by the people who require them. A recent report by the Canadian Institute for Health Information noted the shift from public to private spending for health care in Canada which has been going on for years is steadily increasing past the 70:30 ratio. The OECD standard is 75:25. This passive privatization of our health care system is a reality of health care today in Canada and not just a possibility of the future. It has worrisome implications for access to needed health care services for some people.

The current problem that we are experiencing is because of the $25 billion reduction by the Liberal government back in 1993 when it came to power. Government members have to recognize and accept that fact. It is time to put more money back into the health care system. Canadians deserve it.

[Roy Cullen, Liberal, Parliamentary Secretary to Minister of Finance]

Madam Speaker, I thank the member for Dauphin—Swan River for his remarks and the very interesting readings he made.

I found it interesting that he talked about the need for more money in the health care system. Certainly the government has restored all the transfers. We could go over the same old stuff. No matter how often we say it, the opposition parties will say that we have not, but in fact the CHST has been totally restored to the 1993 levels.

We had to reduce the federal transfers to eliminate a $42 billion deficit. In fact if we had not dealt with federal transfers which consisted of something in the order of 40% of our total federal budget, it would have been very difficult if not impossible for us to eliminate the deficit completely. We did reduce the transfers but they have now been completely restored.

Let me give the example of the province of Ontario. The Ontario government under Mike Harris reduced income taxes by 30%. Reducing taxes is another good agenda item. We have been doing more of that now that we have topped up health care. If we look at the Harris Conservative government in Ontario, the first reduction in taxes it made was 30% and then it has gone on since then. If the Ontario government had reduced taxes by 25% instead of 30%, just five percentage points, it could have totally restored and topped up the federal transfer reductions that the government passed on to the province of Ontario.

When we talk about where the priorities are, rather than move from 30% tax cuts to 25%, the province of Ontario decided to let health care slide somewhat. Now it is coming to us and saying that we should be putting more money back in when it is actually still sitting on money that we gave it last year which has earned interest. About half a billion dollars is still sitting there not being utilized.

I would ask the member to reflect on that and maybe he could comment on it.