Mr. Speaker, I will be dividing my time this morning with the hon. member for Bruce—Grey.
I welcome the opportunity to address the House, as Minister of Health, on an issue of such current and continuing priority. I acknowledge the importance of the motion which the hon. member for Halifax has put before the House of Commons today. The issue is of fundamental significance because the way a nation chooses to provide for health care services to those who are sick speaks directly to the values of that nation.
In our case, the values of Canadians are reflected and codified in the Canada Health Act. Although the Canada Health Act was written and adopted many years ago, its principles are as relevant now, as important now and as necessary now as they were when the statute was first written.
Public medicare in Canada has allowed us to provide health care services to our citizens in a way that is socially fair, while at the same time putting in place a health care system that is economically efficient and is a competitive advantage in the business world to our businesses when they compete with those of other nations.
Let me say at the outset that we, on this side of the House, share the concerns that have given rise to the motion which is presented today on behalf of the New Democratic Party. While we share those concerns, our strategy in dealing with them differs from that proposed by the leader of the NDP. Simply stated, there is no need to amend the Canada Health Act to deal with the concerns that have been raised. The Canada Health Act already contains both the rules and the penalties to enable the Government of Canada to ensure compliance with its principles. They are already in the Canada Health Act.
I would like to point out that, as Minister of Health for Canada, it is my responsibility to monitor the health systems of the provinces and territories in order to ensure that they meet the criteria and conditions of the Canada Health Act. If there is an infraction, I am required by the act to consult the provinces or territories in question.
Over the years, a number of potential problems of non-compliance have been resolved by negotiation, without having to invoke the penalties provided by the Canada Health Act. If negotiations failed, however, the Government of Canada has the power to withhold funds from the provinces.
I want to emphasize that this power is not simply theoretical. It is not just a rule written on paper. This authority has been exercised a number of times in recent years. For example, between 1984 and 1987 the Government of Canada withheld about $245 million from seven provinces that permitted user fees and/or extra billing.
In 1992 to 1993 the Government of Canada withheld funds from British Columbia in respect of extra billing arising out of the dispute between the provincial government and the B.C. medical association.
In 1995 our government deducted payments from four provinces that charged facility fees for medically necessary services at private clinics.
In each case the principles of the Canada Health Act, without being amended, had been contravened and in each case the Government of Canada acted.
In the context of bill 11 I have both spoken publicly and written directly to the Government of Alberta to express my concerns with that legislation. Indeed, I asked the Government of Alberta to amend bill 11, and I expressed the view that while on its face bill 11 does not contravene the Canada Health Act, by allowing private for profit facilities to both provide insured services and to charge fees for enhanced services bill 11 creates circumstances which could be used to contravene the principle of accessibility in the Canada Health Act. That is the real concern.
When we combine that with the fact that the policy of the Alberta government contemplates overnight stays in private for profit facilities, which takes private for profit further than it has so far gone in the country, we asked the Government of Alberta to amend its legislation. It did not. As a result, one week ago today, in a ministerial statement, speaking on behalf of the Prime Minister and this government, I said in the House that because Alberta has gone ahead with this legislation, which we thought was ill-advised, we would do the following things.
First, we will deem these private for profit facilities, as they are called in bill 11, hospitals within the meaning of that term in the Canada Health Act. The practical consequence of that is that charging anyone for any part of an insured service will be considered a violation of the Canada Health Act and will attract the penalties provided for in that statute.
Second, in response to the concern expressed by the auditor general last year that Health Canada does not have the resources to monitor and enforce the act, we are increasing considerably the capacity of Health Canada to do just that, and, as we have watched in the past, we will watch carefully to see if these private for profit hospitals imperil the principle of accessibility, contravening the Canada Health Act. If they do, as we have done in the past, we will act. We will exercise the power of the Government of Canada under the Canada Health Act and do what is necessary to protect medicare.
Clearly, we have the will and the means to ensure that the Canada Health Act is respected. We are going to ensure that the principles set out in the act are respected in Alberta and elsewhere in the country.
Let me be perfectly clear: this government would not like to merely to play the role of referee. We would much prefer to work in partnership with our provincial colleagues.
Let me say a few words in closing about medicare renewal. Like almost every other developed country in the world, Canada is going through the process of improving and adapting its health care system to meet the pressures of our current time: an aging population, the increased cost of drugs and technology, and changes in the way in which medical services are delivered on the ground.
We have an enormous advantage in this country because we have the best health care system in the world. Our challenge, indeed our duty, is to renew medicare in a way that is consistent with our principles and to overcome the problems of the shortages, the waiting lists, while staying true to our basic principles.
While the federal role of enforcer which we are discussing today is crucial, simply enforcing the rules is not by itself sufficient to achieve the medicare renewal that must be undertaken. It will require much more. It will require more federal money for health care transferred to the provinces. It will require hard work with the provinces to develop common goals and priorities to know that additional money is going to support a plan that will produce better health care for Canadians. It will require our listening to the health care workers, the doctors, the nurses and others, so that they are involved and a part of the process, and not excluded. It will involve hearing the public, its concerns and its priorities.
I have started a process with my provincial partners toward medicare renewal. I have invited them to come to the table with me and talk about a plan for this purpose. It is to that process and that purpose that I am unconditionally committed.
We will succeed. We must succeed. Canadians expect and deserve no less.