Mr. Speaker, it is a pleasure to rise to speak to Bill C-13, a bill which would create the Canadian institutes of health research.
As the member for Nanaimo—Cowichan and the deputy critic of health for the official opposition, the Canadian Alliance, I am pleased to state that we will be supporting this bill. However, before I go into the actual body of the bill and give a bit of a critique on the substance of it, I would like to say a few words about our health care system in Canada today.
If we look at the most recent opinion polls asking Canadians the question “What is the most important issue that you believe this country faces today?”, health care comes out on top. Health care is the most important issue to Canadians. Why is that? We do not have to look very long or very hard to see why this would be the case. Simply put, we have a health care system that is in crisis.
When we look at why the health care system is in crisis we can see that part of the reason is the lack of funds. While the provinces are responsible for the delivery of health care services, we can see that the majority of this problem rests with the federal government. Over the past five years it has cut back transfer payments to the provinces which would have supported the provincial health care systems by some $2.5 billion.
The government has made a great deal about the fact that it is going to put back into health care some $14 billion over the next four years. If I have done my math correctly, that still leaves a considerable shortfall.
This shortfall will be downloaded to the provinces, which will then force the provinces to prioritize their spending. They will have to take spending from other places, like education, road building and things like that, and they will have to put the money toward health care, which is the number one concern of Canadians across the country.
It puts the provinces in a tremendous dilemma. How will they prop up, fix or change a health care system that is in crisis when they do not have the money to do it?
If we think that there is a health care crisis now, wait for the next 10 years or so when baby boomers start to demand the kind of health care that is needed when people reach the age of sixty-five. We know what happens. That little bit of arthritis in the knee or the hip joint gets worse and pretty soon a hip operation is needed. Or, in the worst case scenario, the cough that is persistent turns out to be lung cancer.
As those things come on in later years as we grow older, we become more of a burden to the health care system. There are 9.5 million people who will put an incredible strain on the health care system. There will be a need for more facilities, more nurses, more doctors and more innovative research, all the things that go into making a good health care system.
Over the last number of years as the deputy health critic of the Reform Party, now the Canadian Alliance—and I am very proud that we have become the Canadian Alliance, with a huge mandate from reformers across the country—I learned a great deal about health and health care. I have come to have a deep admiration for the many people who operate and run our hospitals and our clinics: our very dedicated doctors, nurses and medical researchers.
We all know that care is not something which comes out of a bottle or a box. We simply cannot prescribe care. It is not something we can send by courier. It comes from within the people who interact and attempt to make life better for the patients in our health care system.
Time after time during the past number of years the federal Liberals have attempted to talk about health care in strictly monetary terms. The health minister or the finance minister will stand during question period and refer to the millions of dollars which they will put back into the health care system. Like the compensation package that was offered to the hepatitis C victims, we have not seen a great deal of it yet.
What they fail to acknowledge is that the Canadian people are not as gullible as the Liberals would like to think. Canadians know and understand that the Liberals have taken away far more than they have returned.
Let us examine some of the facts in a bit more detail. In 1993 when the Liberals took power the Canada health and social transfer per taxpayer was $1,453. In the 1999 budget the Canada health and social transfer was $1,005 per taxpayer. That means that the federal government is giving each province $448 less per taxpayer for health and social programs. That is a 31% drop in federal transfers to the provincial governments.
In fact, since 1966 when universal health care was introduced in Canada, the Liberals' financial commitment to health care has dropped from 50% to 9.4%. How can the system be sustained on that kind of funding? It cannot.
We know that health care delivery is a provincial matter. Unfortunately, paying for it has also become a provincial responsibility. The Harris government in Ontario pays more annually to health care in that province alone than Ottawa does for the whole of Canada.
Let me repeat that. Ontario pays more annually to health care in that province alone than Ottawa does for the whole of Canada. There is something deeply wrong with the Liberal commitment to health care with those kinds of statistics.
Taken as a cumulative total, in 1993 the Canada health and social transfer was $18.8 billion. In the 1999 federal budget, even with the so-called new money, the new total was $14.5 billion, a difference of $4.3 billion. That is money taken out of the national health care system. It represents $143 for each person in Canada today.
It is not just in dollars that the Liberals have failed. They are responsible for violating the universal health care system of this country in many ways.
We all know that there are five main tenets which make up the universal health care system: accessibility, portability, comprehensiveness, universality and public administration. While I could speak at length to all of them, I would like to give two examples of where the government has failed to meet these principles.
First, I would like to speak to accessibility. Where the system is to be equally accessible to all Canadians, the British Columbia NDP government, which has a pristine record of being in favour of a universal health care system, regularly sends it Workers' Compensation Board claimants with knee injuries to the United States or to a private clinic in Alberta. This amounts to nothing less than queue jumping, sanctioned by government, promoted and paid for by a quasi-governmental body. This sounds a lot like two tier health care, the same two tier health care which the government loves to rant against when indeed it is responsible for the creation of it.
Second, I would like to speak to portability. The universal health care system is not intended to penalize any province against another. Full and equal services are intended for all. However, the province of Quebec—and it is not the only malefactor—will only reimburse other provinces $450 per day for Quebecers who are in other provincial hospitals. The rate for a day of hospital care in Ontario is about $745. Based on this rate difference, Quebec owes millions of dollars to the other provinces. This goes on all the time across the country. The federal government allows this to take place and allows the violation of the principle of portability under the Canada Health Act.
In reality, who has created two tier health care in this country? The Liberal government. Our hon. colleagues across the way do not like to hear that, but when truth stares them in the face they have to admit it.
How does this affect you and I, Mr. Speaker? We are the ones who pay for this. When our knees get to the point where we have to have an operation, when the arthritis is too bad, what are we to do? What is the net effect of this loss of money to the system?
One of the first things that we see is the waiting time that many Canadians experience when they or a loved one needs a health care service. For instance, in 1993 if a person wanted to see a specialist, on average he or she would have waited 3.7 weeks to see a specialist in Canada. In 1998, five years later, the average waiting time would have increased 38%, up 1.5 weeks. Is that acceptable in a country which is purported to have the best health care system in the world?
Many of us may have experienced even longer waiting times, as these times vary from region to region and according to the specialist who is required. We have all heard the horror stories of the cancer patient who needs radiation treatment and is forced to wait 10, 12 or 14 weeks, and in some cases much longer, for treatment to begin.
I recently heard a gentleman on a radio talk show which originated in Vancouver at CKNW. The program spent a whole week on the health care system in Canada. This gentleman phoned in and told the very sad story of his wife who, at one point in her life, had been discovered to have a very small spot on her liver. The waiting time between the time she could get to a specialist and then eventually get treatment for her disease was so long that she died in the process. That is the sad story, repeated time and time again across Canada, because of the inadequacies of our health care system. It has to change.
It is at that personal level when it actually affects people that the federal government loses its credibility. While it looks at the money it has failed to recognize the human quotient. The cancer patient, the person waiting for an organ transplant, the elderly family member who is immobile and requires a hip replacement are people who have feelings. They may be in pain or their quality of life may have been diminished. They have family members, loved ones around them. They may be missing work and therefore unable to fully provide for their families and contribute to the economy both locally and nationally.
The real impact of the serious health care crisis in Canada is not just monetary. It is flesh and blood. As people are forced to new levels of stress, they are forced to make difficult choices for their loved ones.
There are lots of ways to split up the problem. We could look at the number of hospital beds that have closed. We could acknowledge the doctor shortage in rural areas, the inadequate pay level of nurses and the conditions that many of them work under. We could tabulate the tax level and the effect of the brain drain and losing some of our best and brightest medical people to south of the border.
However the Liberals will never acknowledge that this is a problem of their own doing. This is a problem they have created by wantonly cutting the Canadian health and social transfer and failing to keep the principles of universality without realizing the full effect upon the people who need to use the health care system.
As the official opposition we believe it is important to address all these issues, to get them on the table, and to have this huge consultation from coast to coast with medical people, with professionals, with researchers and with Canadians. We need to find new and better ways to cure the diseases that affect those around us: our loved ones, our friends, and in some cases ourselves.
As we enter the 21st century communication and technology are moving at an unprecedented pace. As we all know, it is now possible to do work, research and communicate worldwide through the benefits of Internet and e-mail.
This brings us directly to Bill C-13, a bill to create the Canadian institutes of health research. In spite of the concerns I have about the government's handling of health care, I acknowledge that this is a good step forward on behalf of the government, and that is why we support it.
The technology available today allows an individual or a small company the opportunity to work and communicate with a major university, a public institution or a private company. I believe the sharing of data, theories and information between large and small parties, regardless of location, has the potential to be of enormous benefit to all Canadians, and indeed citizens of the world.
While I support the bill I believe, however, that there are ways that the bill could be improved. We are always in need of improvement. Mr. Speaker, I am sure you would agree that you are not perfect. I am not perfect and none of the bills in the House are perfect.
I would like to draw the attention of the House to several issues. I believe the bill should have a new section, for instance, limiting administrative bureaucracy to a maximum of 5% of the total budget of the CIHR.
While the scandal continues over the HRDC grants and the damning audits pouring out of the department of Indian affairs, the EDC and other financial fiascos will undoubtedly be added to the list, it is imperative that transparent and accountable financial controls be placed upon all government spending.
I suggest that Bill C-13 should contain directives that the governing council must ensure that no more than 5% of its annual budget is directed toward administrative expenses, using definitions that are normally applied to departments by the treasury board.
I believe, if handled appropriately and based upon the positive results received through research, that the CIHR should strive for partial or complete self-sufficiency based upon funds raised through new medical technology, through the use of patents, licensing, copyrights, industrial designs, trademarks, trade secrets or other like property rights held, controlled or administered by the CIHR. There exists the opportunity for the Canadian institutes of health research to recoup a portion of the public dollars invested in research institutes. It is a novel idea. Imagine a government agency that actually recovers financial resources rather than simply spends them.
I also believe that it is an opportune time to ensure that the selection of the research that will be funded through the CIHR will be based upon scientific merit. The allocation research funding should be based upon the validity of the project, not on the basis of employment equity groups or one province versus another. Funding should be upon merit alone.
If the goal of the CIHR is to strengthen and ensure that we have improved health for Canadians through more effective health services and products and a strengthened Canadian health care system, there must be a transparent and accountable process using standard acceptable accounting procedures. The research must be valid and likewise the financial accountability must be clear as well.
I also believe that this act and the Standing Committee on Health itself missed an opportunity to strengthen the section of the bill dealing with ethics. Topics such as biomedical research, reproductive technology, gene therapy advancements and other future ethical issues will be a part of future medical research.
While not all solutions may be determined now, the framework for an ethics board will provide future direction. The preamble should state that it will take into consideration ethical issues with special attention to the highest value and dignity accorded to human life. This is an issue that will be fraught with contention in the future and a resolution process should be included.
As we have witnessed most recently with the HRDC debacle, political patronage cannot and must not be part of the decision making process. The research that is done must be seen to be without political interference. The decisions must be seen as being valid and necessary and with the broad based support of Canadian medical researchers. Without this support the CIHR will only be viewed as another Liberal slush fund.
The CIHR should be subject to a parliamentary review every five years. While I support the premise of the CIHR, there may come a time in the future that it needs to be revisited, revised, modernized or perhaps eliminated together with something better that comes along. That is exactly what we did with the Canadian Alliance. We now have the opportunity to ensure that we undertake such a review on a regular basis.
If the CIHR remains the most appropriate venue for conducting health research then we should endorse the program and ensure that it continues. If it can be improved we need to take the necessary steps to improve it for the next five years. We should always look ahead to the future, never looking backward.
As with any organization consistency is appropriate. However I also believe that positive gains could be made by bringing in new council members. By having a maximum of three terms for each council member, there is sufficient time to ensure consistency over the long term and yet allow a regular planned turnover of council members, thus ensuring a steady influx of new thoughts and ideas. Furthermore, for the same reasons I believe each member of the advisory board should serve a term of no more than five years and a maximum of three terms.
If the CIHR is to begin and remain non-political, I would support the premise that all governor in council appointments be ratified by the Standing Committee on Health by a two-thirds majority. The accountability process must extend to all aspects of the CIHR. In order to achieve this level of transparency the membership should be ratified by more than just the government majority on the Standing Committee on Health. Such appointments should move beyond the partisan politics of the House and ensure that the health of all Canadians is maintained.
Another aspect of transparency should extend to the companies and individuals that grants and resource funds are allocated to. At no time should there be a connection between members of the governing council, institute chairs and the recipients of the resources. To do otherwise does not ensure that the allocation remains transparent. Canadians are demanding full government accountability.
In order to achieve financial accountability and transparency through the CIHR I believe the report of the auditor general should be made public, for without public accountability all the measures in the world are for nought.
With the use of the auditor general and his reporting mechanism to all Canadians we can be assured that the highlights and low lights of the financial accountability of the CIHR will be seen by all.
My final point on the bill is to enshrine a method of rebuttal within the CIHR. The governing council should develop a subcommittee that can act as an ombudsman for complaints brought forward by researchers or their private sector partners. We all recognize that disagreements will occur. Rather than wait for a problem to arise, let us put a dispute resolution process in place. It would take so little effort now, and yet the bill does not contain this kind of allowance.
I am in favour of the intent of Bill C-13. I believe the bill has the potential to partially address the problems of our medical brain drain. We need to be sure to attract and keep our best and brightest. Our loss of these people is definitely some other country's gain. We cannot allow this to continue.
Of course a major part of this problem involves taxes. However I will save that particular part of my argument for another day. Bill C-13 is an improvement over the Medical Research Council. Throughout the committee hearings we heard from numerous medical and associated groups which asked that the bill be passed at our earliest convenience, and I agree with their comments.
The bill could be better, as any bill could be better, but the comments I have offered today could improve Bill C-13 in the future. In the broader perspective the Canadian Alliance and I personally are very happy to support the bill.