Debates of May 18th, 2000

Supply

[Steve Mahoney, Liberal, Mississauga West, ON]

Mr. Speaker, while my colleague was attempting in a very articulate manner to answer the question we could hear cat calls coming across indicating that it was not enough. That is the mantra of the NDP. Perhaps that member should cross back into the NDP fold.

[Lorne Nystrom, NDP, Qu'Appelle, SK]

No, no.

[Steve Mahoney, Liberal, Mississauga West, ON]

He does not want her. I can understand. This is an interesting situation. I thank the NDP for putting the motion forward today. We owe it to all of our constituents to talk about the issue of health care, the issue of bill 11, the issue of whether or not it is enough, the issue of the tax points and the issue of cash transfers. It is very confusing. All my constituents want us to do is to fix the darn system. They do not care much about who is responsible.

Part of the difficulty, however, is that we have this convoluted mechanism called Canada whereby we have entered into agreements. Members opposite know full well that the federal government's role is to collect revenue from around the country and redistribute it to the provinces for various services.

We are not allowed to deal directly under the terms of the constitution and the agreement. It is up to us to provide a certain floor, ceiling or whatever. It is clearly up to the provincial governments to deliver the health care services to the people. All we need do to find out the difficulties is to have a loved one who is involved in it.

Since I am here most of the time, my wife and I, and my wife particularly, are going through the terrible experience of having a family member with a serious illness who is in and out of hospital. She is phoning 911 at three o'clock in the morning and frantically going to the hospital where she is being kept for two or three days and then discharged back into her home. Then it is 911 again and the ambulance costs. I am talking about this occurrence happening five or six times a month every month for the last several months.

We have tried to find out how we can put her into some kind of a care facility to ensure that someone is available to take care of her and can react to it. The waiting lists are incredible. We are talking years, unless one is in a position to do what the former Reform Party and current CA would have us do, that is simply privatize it all. Then if one has the money the waiting list disappears. We do not believe in that. I think this debate is all about a vision for health care.

The New Democrats should always be congratulated for the leadership that some of their former leaders, Tommy Douglas and others, showed in bringing into Saskatchewan and then on to the national stage the necessity for a health care system based on the five principles.

The first one is universality, which means that it is available to all regardless of financial status.

The second is accessibility, which means that we should be able within any kind of reasonable timeframe to access whatever health care is needed.

The third is comprehensiveness, an issue that I think the provinces are flirting with, never mind bill 11. When they start deregulating and decommissioning certain health care services from OHIP, in the case of Ontario, and start saying they will not pay for certain services, in essence they are flirting with damaging the comprehensiveness of the system. That is an issue I have not heard members talk about today. I think it is something we need to watch very carefully.

The fourth is portability, the ability for a Canadian from British Columbia, Nova Scotia or Ontario to access a comprehensive health care plan right across the country.

The fifth and final one is administration. What is the issue there? The issue is that if we do what some would do, if we do what Tom Long, the former leader of the former Reform Party and the former treasurer of Alberta who is a member of the former Reform Party, public administration goes out the window. I am sure hon. members get my point in using the word former.

Why is that important? Canadians know that there must be a sense of control in costs and in what kind of health care is being provided. If it is turned over to the private sector in a for profit scenario, I think we lose that control.

I want to talk about another issue. The New Democrats should be particularly interested in this one. There is a health clinic in my home of Sault Ste. Marie. It is a health clinic that operates on a capitation system. In a city of 80,000 with two hospitals there is also a health clinic. Capitation means it submits a roster, a list of the members of the health clinic, to the provincial government and the provincial government gives the clinic a cheque. It does not operate on the OHIP principle. It operates under capitation.

Who do we think built it? It was not the government. I can tell hon. members that no provincial or federal money was put into the health clinic in Sault Ste. Marie. It was built by the private sector, except that the private sector in this case happened to be the United Steelworkers of America. It was built by the union. It was built with its funds, with its membership money. It was done in the fifties and it was great. The reason I know a bit about it is that my dad was the national director of the union at the time it was built.

I often quote a man named Johnny Barker in Sault Ste. Marie who was a great union leader. He had one of the greatest lines that I like to tell NDP members they should remember. Johnny Barker once said “Don't let your bleeding heart run away with your bloody head”. It is a terrific quote and NDP members should think about it more often.

Johnny Barker and my dad built the health clinic in the Soo. Some say it was a fight between Sault Ste. Marie and Hamilton. The reason it went to the Soo, they tell me, is that dad and Johnny Barker used to get together and drink the odd glass of pop. They got to be great buddies and they decided the clinic should go to the Soo.

Who knows what the reason was? However, do members know why it was so effective? It was because there was a large membership, which tragically does not exist there any more, that worked at the steel plant. There was a local community that could be harnessed. There was a membership that could be developed and brought in for health care services, and it worked.

I have tried to promote this idea in other communities. I went to the Chinguacousy Health Board in the city of Brampton when I was in the provincial house and suggested that it take a look at the model in the Soo. It is a terrific concept. It involves the community. It makes sure that health care is delivered. It was built with private dollars. It is operated on a not for profit basis and it truly works.

Instead of just putting their blinkers on and saying that under no circumstances will they look at anything, perhaps members of the NDP should take a look at what happened in Sault Ste. Marie. That clinic, which was built with union money, could be a model for many different communities around the country.

In the case of Chinguacousy I thought it made sense to get the CAW and Chrysler involved. Again a certain membership or a group of people could be identified to be involved. Perhaps the region of Peel could have been involved. Unfortunately it did not happen because people still had the grandiose idea that great new hospitals would be built.

We have a wonderful hospital in my riding, the Credit Valley Hospital. We call it the Credit Valley Hilton. Those days are over. We will not be building those kinds of facilities any more. We have to find new ways of delivering both in terms of medical services and in terms of the facilities in which they get delivered. We have to find new ways of doing it.

Instead of just fearmongering and pretending that none of this should be talked about, and that we should just amend the Canada Health Act and punish people, we need to look at news ways and new alternatives. They exist. I invite the NDP members to check the record, talk to the steelworkers and check out the operation in the Sault. I think they will find it is good advice.

[Lorne Nystrom, NDP, Qu'Appelle, SK]

Mr. Speaker, knowing the member's background and his affinity to the labour movement many years ago, is he not embarrassed about sitting in a caucus that is led by a government that has instigated the largest cutbacks in the history of our country in terms of social programs and health care?

The 1995 budget of the Minister of Finance was the most draconian budget in terms of cutbacks in the history of our country. This government almost makes Brian Mulroney look like a raving socialist in comparison, in terms of funding for social programs.

I wonder if the hon. member can tell the House whether or not he has lobbied the Minister of Finance and the Prime Minister to reverse their ways, to mend their ways and to open up the public purse and make sure there is more money going into health care.

I think he saw the statement yesterday as well that the surplus is now $11 billion more than the government thought it was going to be. It is $14.9 billion instead of $3.9 billion. The money is there.

What has this member done to lobby the Minister of Finance and the Prime Minister, or is he part of this great conservative trend in the Liberal Party that makes Brian Mulroney look like a compassionate socialist?

[Steve Mahoney, Liberal, Mississauga West, ON]

Mr. Speaker, I am probably what one would call a right wing Liberal. I make no apologies for that. In fact, not only am I not embarrassed, I am proud of a government that wiped out a $42 billion deficit and put this country into a sound financial position so that we can in fact deal with the problems in health care. Believe me, we will.

I am used to getting misrepresentation from some members opposite in the official opposition, but it disturbs me when a man of the quality of the member from Regina stands here and says something that he knows is patently false. To say that this government's transfer for health care is 13 cents is just not true. The member knows that in 1977 the federal government reduced its share of the tax base and gave the power to tax for that reduction directly to the provinces. They are called tax points.

The member knows that when we combine cash and tax points the amount being transferred is 33 cents. He says that it used to 50 cents. It was when it started. It was reduced because the provinces increased the number of items being covered down to 41 cents. The real truth here, and let us not play too much with numbers, is that it has gone from 41% down to 33%.

Yes, that needs to be increased. There is no question about it. We will work with the provinces. The one thing I can say is that this government is not about to hand blank cheques to Mike Harris and Ralph Klein so they can turn around and give 30% tax cuts to their wealthy friends without putting that money into health care. We are going to make sure it goes where it is needed.

[Bill Casey, Progressive Conservative, Cumberland—Colchester, NS]

Mr. Speaker, it is certainly a pleasure to rise and speak to this motion today. I find the motion takes a strange direction. Rather than have a negative approach, why do we not have a positive approach? Why do we not say what we can do and not what we cannot do? Why do we not say what we need is to replenish the health care system back to where it was in 1994, or 1995 at least, rather than where it is now, where there is such a crisis in health care and no one knows whether they can get a doctor, whether the doctor who comes to their community is going to stay, whether he is going to leave and what is going to happen? It is the same with nurses and all other health care workers. It is a crisis.

If anyone thinks health care it is not in a crisis they are certainly operating under false pretences. It is clear to all of us. It is certainly clear in my riding where a site was prepared and the foundation laid for a new hospital years ago. They have been gathering information and money for seven years and are still in the planning stages for this hospital. We are still having trouble putting it together because of the reduction in transfers for health care funding from the federal government.

The federal government unilaterally began cutting health care funds when it was the number one issue. Health care is the one thing that ties the whole country together. Every region, every province and every culture depends on our health care system.

We have been proud of our health care system in Canada. It has been the model that many countries have used as the example upon which to build their health care systems. Then the Liberal government, which has always prided itself on having a social interest and a social conscience, just sucks the system dry. It has reduced funding steadily year after year and then makes these tiny, insignificant motions to try to pretend it has put money back into health care. However, it has not fooled anyone.

The premiers have not been fooled. They are all calling for health care to be the number one issue for the federal government to address. Every community is asking the federal government to re-invest in health care and to work with the health communities to come up with a better system to resolve the issue.

What happens when the federal government withdraws its funding? The provinces then have to explore other areas. They have to experiment. They have to become innovative. If the funding was back at former levels, the province of Alberta would have no need to do what it has done, and other provinces would have no need to explore the other innovative angles and efforts they are trying to experiment with now.

I come from a rural area in Nova Scotia that has a lot of small communities. We used to have several hospitals in my riding but they have continually been reduced. They have been turned into clinics, into senior citizens' homes or into something like that. Meanwhile, these communities are losing their health care system. When a community loses a hospital or a health care facility, or when a facility deteriorates and does not maintain its standards because it has no money, then the doctors leave. It is very important for doctors to maintain their practice and to have the ability update their technical knowledge and training.

Health care is a work in progress. A doctor never finishes training in health care, especially with the recent developments in technology, genetics, health care, medications and treatments. Today doctors have to maintain their ability to compete by continuing their education and everything else.

The doctors in my riding are faced with obsolete hospitals and equipment. The money is not there for the new technology and new equipment that is need to treat the patients and for the doctors to continue their training.

The waiting lists are incredible. A short time ago I visited one of the main hospitals in my riding. The hallways were filled with patients in beds waiting to get a room or just to get into the hospital. The waiting room was full of patients who could not get a doctor. When they did get a doctor he or she was a stranger.

For decades people had family doctors who they could become familiar with, get to know, feel comfortable with and trust. Health care is a very personal thing. Today people do not know their doctors because the doctors change so fast. When the doctors realize that the workload is too much and the responsibility too great they pack up and go somewhere else. They go wherever there is more money, less work, less hours, more people to share the burden and a much higher quality of life for doctors. We lose our health care workers. We lose our nurses. What I primarily run into is the loss of doctors, the turn over in doctors and the shortage of doctors.

In my job as a member of parliament, I deal a lot with Canada pension clients, Canada pension disabled clients, worker's compensation victims and people who need but cannot access the health care system. They cannot get the help from the doctors because the doctors do not have the time to deal with these issues. If it is not an urgent issue, the doctors will not deal with it. They deal with the patients who need help right away. Meanwhile, these people who are disabled and are applying for disability, or need help in worker's compensation or need specialists to qualify for pensions to which they are entitled, cannot get support from the health care industry because they are just too busy.

Recently I talked to a person who had a bad accident. The person is totally disabled with broken bones and organs that are damaged. He cannot get his doctor to write a report because the doctor is just too busy dealing with people who need care right now. I have asked the doctor on two occasions to write us a report. I do not tell him what to say, but we need a report from the doctor and we cannot get it. That goes on and on.

Just when patients get to know their family doctor, the doctor changes or moves. This creates a lot of stress for people, especially seniors and disabled people who have effectively educated their doctor about their problems, their ailments, their lifestyle and their situation, and then they have start all over again. When it happens again and again it becomes even more stressful.

All we can say about this motion is that it should be a motion to restore health care funding. That is the solution. Yes, other changes are needed but they are not going happen without the money to back up the innovative ideas that are necessary. There is no question about that.

It all boils down to the fact that the government has reduced the funding to the provinces and then tells the provinces that they have to honour the Canada Health Act but does not give the leadership nor the funding.

How many months, years and times has the issue of health care been brought up in the House of Commons? The Minister of Health continues to say that they are working on a plan and that they need ideas and leadership. The ideas and the leadership are supposed to come from the government. It blames everybody else for the problem but itself.

The fact of the matter is that the problem starts right over there with the Department of Health and the Minister of Health because they will not make the commitment to health care, which we have always had in this country, to maintain the health care system of which we have been so proud for so many years. It is not complicated. All the government has to do is to restore the funding to 1993-94 levels and most of these problems will go away.

I do not disagree that health care is changing really fast. Technology, medications and treatments are changing at lightning speed and they have to be baked into this whole process, but without the money that will never happen. Until the government makes a fundamental decision to re-fund health care, all these ideas that the minister speculates about will never see the light of day without the funding, the research, the development, the technology and the tools to work with.

We are siding with the premiers of all the provinces. I do not remember this ever happening before, but all the provinces have now united in one stand and are demanding that the federal government restore the money to health care that it has taken away over the years. I have never seen this happen on any other issue, not immigration, not transportation, not anything except health care. The federal government should listen to the premiers and respect what they are saying because it is actually the provinces that deliver the health care.

The provinces and the provincial ministers of health understand the problem and they know what the solutions are. They are calling on the federal government to restore health care funding. It is not complicated. They are on the front lines of this whole debate. They know what the problem is and they know how to solve it. They have spoken very clearly with one voice.

I just hope that the federal Liberal government will get the message to stop stalling and to do something. Day after day, week after week, month after month, year after year there are two issues in the House that get stalled, one is the health care issue and the other is the helicopter issue.

Time and time again the federal government says that it is developing a plan and exploring the options. The Minister of National Defence has now said that the file is moving. Is that not what he has said?

[An hon. member]

A top priority.

[Bill Casey, Progressive Conservative, Cumberland—Colchester, NS]

The minister said that the helicopter situation is a top priority. I think he is now saying that the file is moving. Well, it is moving awfully slowly.

It is the same with the health care file. The government talks about solving the health care problem but it does absolutely zero about it.

The problem is simple: Just listen to the premiers of all parties in all the provinces because they are the frontline people. They are the ones who have to deal with the actual health care system. It is a simple as that. If it would just do that, the problem would be solved. Mr. Speaker, I am depending on you to tell them to do that.

[Gordon Earle, NDP, Halifax West, NS]

Mr. Speaker, I was quite interested to listen to the member, a fellow Nova Scotian, who spoke about some of the health care problems which we experience in the province of Nova Scotia. He certainly outlined many of them well.

He spoke about the waiting lists in hospitals and delays because of the lack of funding in the health care system. Those illustrations support the motion we put forward because we are suggesting that public funds not be allowed to move out into the private realm and the for profit hospitals. Public funds should be maintained within the public system. We should strengthen, maintain and keep this system of publicly funded health care.

I would be interested in hearing the hon. member's views on another aspect of health care which is very important to this entire picture of the health care system. That is the issue of pharmacare, one thing which we feel is very important.

I have witnessed it in my province and many seniors have spoken to me that quite often they need certain medications but cannot afford them because of their fixed incomes. Sometimes they either go without their medication or stretch it out in a way that is unrealistic according to how it has been prescribed. If they are supposed to take it three times a day, perhaps they will end up taking it once a week. They figure they can make the prescriptions last longer because they just cannot afford their medication.

I am wondering if the hon. member has any comments on that aspect of the health care system. There is a need for the government to put funding into a national pharmacare system to aid our seniors who have given so much of their lives to our communities. It is time that we helped them.

In particular, in our province the provincial government has moved to the extent that it costs the seniors more for their pharmacare program. It has increased the amount that the seniors have to contribute to the program.

Would the hon. member comment on that aspect of the health care system?

[Bill Casey, Progressive Conservative, Cumberland—Colchester, NS]

Mr. Speaker, the hon. member does make an excellent point. Our party's main point is there has to be a stable funding program on a long term basis, a program which will allow the departments of health in the provinces to have a long term plan. This is not an industry or a business that can have a six month plan or even a five year plan. The planning has to go much further than that. To do that the government has to provide stable funding.

On the pharmacare issue, the member brought up a really good point. Let me read from the Liberal red book two of 1997. “The Liberal government endorses pharmacare as a long term national objective”. I am sure the hon. member will be pleased to hear that. It goes on to say, “Some provinces are already developing a system of drug care. We will work with our provincial partners to ensure that all Canadians have access to medically necessary drugs within the public health care system”. The hon. member's problem will be solved because surely the Liberals will honour all their promises in the red book.

It goes on to say, “The federal government has a role to play in bringing together its provincial and territorial partners”. This is strange because it refused to meet with its provincial and territorial partners on the health care issue, but if it says so in the red book, it must be true.

[Greg Thompson, Progressive Conservative, Charlotte, NB]

Like the GST promise.

[Bill Casey, Progressive Conservative, Cumberland—Colchester, NS]

What else does it say? It is full of good promises.

“A new Liberal government will pursue a strategy, together with representatives of provincial and territorial governments”—why does it not do that—“health care service providers, private payers”—private payers, is that not interesting—“and consumers to address the fact that drugs have become an essential component of health care. We will develop with these groups a timetable and fiscal framework for the implementation of universal public coverage for medically necessary prescription drugs”.

I am pleased to put that on the record for the member. It answers his question. It is right in the red book, so surely the Liberals are going to develop a pharmacare program. The hon. member from Nova Scotia can sleep well tonight.

[John Bryden, Liberal, Wentworth—Burlington, ON]

Mr. Speaker, I am very delighted to rise in this debate because I have wanted to have my say about the problems with health care financing for some time. I think the debate has been skewed in the wrong direction. It is not a matter of giving more money to medicare, it is a matter of greater accountability.

I regret that my NDP colleagues are leaving the Chamber now as I begin a speech. They really ought to listen to it because it is not just a matter of throwing money at issues, it is a matter of creating the climate of transparency in corporations that deliver the health services to ensure that the money is adequately spent. What I am alluding to is the fact that hospitals around the country are some of the greatest users of taxpayers' money, something in the order of $30 billion to $40 billion a year. They are the prime deliverers of health care.

The difficulty is that hospitals are charities and charities are not governed by any meaningful legislation which requires them to meet the standards of corporate governance, standards of transparency. The result is that across the country we will find hospitals that vary in the quality of their financial administration and their ability to efficiently deliver health services. We are talking about billions of dollars of waste because we cannot see whether the hospitals are spending the money effectively.

What has happened with the cutbacks in health care, whether the cutbacks were done by the federal government or the cutbacks were done by the provincial governments during the mid-1990s, is a cutting off of the services rather than cutting back the administration. This was a phenomenon that occurred in the United Kingdom.

The United Kingdom went through a similar period when it tried to rein in the high costs of medicare. The British government cut back investments in its hospitals and what happened was an enormous cutback in nurses and nursing staff and of course the administrators remained. The Tony Blair government learned its lesson and in fact it is restoring many of the service personnel and cutting back on the administrators.

Mr. Speaker, you might ask what is he really talking about? Does he have any real examples? We do not have to go very far in my community to discover a real example of waste in the delivery of hospital services.

Next to my own riding is the Hamilton Health Sciences Corporation which last year posted a $40 million deficit. This coming year it is expected to post a $90 million deficit. Mr. Speaker, it has something very much to do with the failure of the board of governors or the failure of the hospital management to adequately inform the board of governors on the needs of that hospital and the proper functioning of that hospital.

Indeed, Mr. Speaker, there was a scandal not very many years ago at the hospital. The chief director was brought in at a huge salary.

[Steve Mahoney, Liberal, Mississauga West, ON]

They are all getting huge salaries.

[John Bryden, Liberal, Wentworth—Burlington, ON]

Oh, yes. Her salary was something like $400,000.

The point is, after a couple of years it was decided that she was not an efficient chief executive officer so the hospital let her go. It gave her a $1.8 million golden handshake. It absorbed in one fell swoop all the money that had been raised by the various hospital association charitable foundations. They are out there doing telethons raising money to try to buy x-ray machines and that kind of thing and that money goes to a golden handshake for an executive it is trying to unload. It is the same situation around the province.

In fact, in a recent article from my local newspaper it is suggesting that not only is the Hamilton Health Sciences Corporation in difficulty, but other hospitals are in trouble. The London Health Sciences Centre in 1999 ran an $18 million deficit. Mount Sinai and Mississauga Trillium hospitals were in an $11 million deficit and the Cardiff Valley hospital was at a $10 million deficit.

Members may say that the problem is simply that they have a greater demand than they have the money to meet it. That is possible, but other hospitals around the country do run within their means.

So long as we cannot be sure, so long as we do not have the ability to thoroughly examine the decisions made by a corporation, made by a hospital or any kind of social services institute, so long as we do not have the opportunity to examine how they are making those decisions, we cannot be sure that they are running efficiently.

Indeed on a smaller scale, in Hamilton there was a classic instance that was the joke of all the social services providers a few years ago. If you recall, Mr. Speaker, the Harris government came in and said it was going to cut 20% off the bottom line of all the social services organizations that were receiving Ontario provincial funds. An organization in my riding absorbed that 20% cut by eliminating all the service staff and just retaining the administrators and it continued to function without delivering any services.

The reality is when we talk about cuts to health care we have to remember that we cannot do cuts to health care until we create the efficiencies. The reality is if an organization, whether it is a corporation or a non-profit organization or a charity, is running really inefficiently and we compare it against an organization that is running very efficiently and we cut 20%, the efficient organization is hurt and the inefficient organization is not touched, no problem, because it can absorb the cutback in its inefficiencies.

That is the situation. We have done nothing as the federal government and we have done nothing as the provincial government to correct problem. What we need to do is we need to have a debate here not about whether we should restore funding to health care, we should have a debate about how we can make health care delivery more transparent, how we can make it more accountable, how we can make sure that those executive officers are reporting correctly to their boards of governors.

I have known, and other members in this House will have had the experience as well, instances where politicians—oh, that word politicians—have been on the boards of directors of hospitals in their communities and they have not been able to get the salaries of their chief officers. They cannot get the information. They are told, “No, you cannot have that sort of information. That is confidential”. The difficulty as the situation sits right now is that every hospital and other charitable organizations that deliver social services are only as responsible as their letters patent that were originally formulated for them, and only as responsible as their boards of directors show due diligence.

One of the sad things about social services and charities that deliver social or medical services is that too often what happens is people get on the board of directors in order to have a credential or in order to have a place in society so that when they are at cocktail parties they can show what grand contributors they are to the community because they are on the cancer society or a hospital board or whatever you will, Mr. Speaker. But too often these people do not do the due diligence and they leave it to their executive officers and those executive officers are not of the very finest quality. We the public have no guarantee that our taxpayers' money is going to be spent efficiently.

There we have it, Mr. Speaker. It is so simple. Why can we not just do something in this legislature? I have to say I have been struggling with this issue about bringing transparency and accountability to not for profit organizations for four years no, maybe five years, and so far we have not come to grips with it. So far, although I will admit I have had some, shall we say, warmth of response from cabinet, still there has not been a commitment.

What is saddest of all is the fact that the very conservative government that we see in Ontario and elsewhere in the country but let us take Ontario as the example, is always saying that we must cut taxes, we must cut spending, we must be efficient. That is not the government that is demanding transparency of the very institutions that are absolutely swallowing up money right, left and centre and not giving us a guarantee that money is being used effectively.

In my view, it is something that we as a House should certainly address. We should try to look at the problem of bringing charitable organizations to account, particularly hospitals.

We have had a tradition, through the 1970s and especially the 1980s and early 1990s, that when we have a problem in society or a problem where people are not getting the care they deserve—and it is a serious problem, I will not argue that—we seem to think that it can be answered by simply throwing more money at it. I think the government has seen only too well, particularly in the case of the money that went to the Atlantic provinces to help the situation when the cod moratorium took effect, a clear example of where it was very difficult to simply fire money at a problem and solve it. The analogy to the health care delivery systems is apt.

If we really care about Canadians who are in need and who are not getting the services from the health system that they need, then we as a parliament should be moving as quickly as possible to create legislation that brings charities and non-profit organizations under the same level of transparency that now exists for for profit corporations.

I am sure the members opposite do not realize this, but the Canada Corporations Act, under which many hospitals and other charitable organizations are incorporated, provides standards of corporate governance only for for profit organizations. It provides standards of transparency only for for profit enterprises. It specifically excludes from those requirements non-profit organizations. We have a situation in which a large hospital, which may be spending billions of dollars, literally, does not come under the same type of minimum regulations or minimum requirements for transparency and governance that is required of a for profit corporation.

I ask you, Mr. Speaker, at the very minimum, let us bring non-profit organizations and charities under the Canada Corporations Act when they incorporate so that they at least have a minimum level of transparency, accountability and standards of governance. At least let us do that. We would save billions. The federal government would not have to add to the transfers for health care, the provincial governments would save money and all Canadians would benefit.

[Steve Mahoney, Liberal, Mississauga West, ON]

Mr. Speaker, I listened carefully to my colleague's remarks. I find it quite interesting that CEOs of major urban hospitals, particularly in the Greater Toronto Area, are paid amounts of money that are really quite surprising. They are paid $400,000 to $600,000, which is four to six times the amount of money that CEOs of entire municipalities are paid. I think his point about transparency and the need to look at it is well taken.

I am a little concerned, however, about the comment that could be taken as castigating all volunteers. It is my view that many of the people who sit on hospital and charitable boards, as well as those who work in the community, do so out of dedication and commitment to the community, not simply so they can talk about it at cocktail parties. Would the member agree with that?

[John Bryden, Liberal, Wentworth—Burlington, ON]

Mr. Speaker, the member is right. It is always dangerous to make sweeping statements. There are a great many volunteers in all types of social and medical service delivery charities.

The problem is that hospitals have under their control enormous amounts of money. I think the thing we have to be concerned about is that people who volunteer for these boards must remember that when they volunteer for them they are shouldering a very high responsibility. I would suggest, with great respect to the many people who do volunteer for such organizations, that they should not volunteer unless they are prepared to make the commitment and to put real energy into it.

On the other side of the coin—and I think this is where there is a fundamental problem—too often people get on these boards with only the very best of intentions, but they do not bring to the job the kind of cynical rigour that is sometimes needed by the boards of directors of large corporations which are managing huge amounts of money.

We need to change the Canada Corporations Act. We need to set standards for the boards of directors to ensure that they will understand very clearly what their responsibilities are and realize that if they take on that appointment they do so with the full knowledge that they have a responsibility that is exactly equivalent to, say, running the Steel Company of Canada, or Dofasco, or any other large corporation, and perhaps even more so.

In the case of organizations that deliver our medical services—and we all need and cherish the ability to have free services for all Canadians—this is a heavy responsibility and one which people who serve on these boards of directors can never take lightly.

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

Mr. Speaker, no amount of speech-making about the faults of others, whether they be hospital executives, hospital management or provincial governments, such as we have heard from the Liberal member who just spoke, can absolve this federal government of the fact that it was responsible for the single most massive reduction in federal transfer payments to the provinces for health care that this country has ever seen.

That is the root of all evil. The lack of that money is the root of all evil when it comes to our health care system. It is what has put hospitals, emergency wards and other health care facilities in this country in the situation they are in today. It is what has set up premiers like Mike Harris and Ralph Klein, who, for ideological purposes, would like to privatize our health care system. They are using the federal reductions as a cover for their philosophical agenda.

The massive reduction in 1995 came on top of a systematic withdrawal of the federal government from funding for medicare that began in 1982 under a Liberal government. It was under one of the budgets of Allan MacEachen in which the first unilateral withdrawal of funding took place, and the first shattering of the federal/provincial fiscal partnership that medicare represented.

From then on, every single federal government has proceeded to unilaterally withdraw more and more money from medicare, particularly in 1995, the crowning glory of cutbacks that the current Minister of Finance brought in, until we arrived at a point where the federal government now feels that it does not have the moral authority to act, even when a province like Alberta has done something which is so clearly a threat to the spirit and the future and the practice of medicare.

Why does it feel it does not have that moral authority? Because of that systematic reduction, culminating in 1995, which puts the Minister of Health in the pathetic position of only being able to say to himself—and here we perhaps give him more credit than he is due—that he might want to act but he feels he cannot because the federal government has ruled itself out by being a government that only contributes somewhere between 8 or 13 or 15 cents on the dollar, depending on whose figures are believed.

There was a time, in 1984, in the context of a previous threat to medicare that developed through the proliferation of extra billing by doctors and the charging of user fees by provinces, when a previous Liberal government and a previous Liberal health minister, Monique Bégin, was able to act. Though it took a while to make them act. It took a lot of pressuring by the NDP at that time.

It has been a bit of a rerun for those of us who were there at that time. The NDP pushed the Liberal government to do something about health care. The Tories at that time were silent, in the same way that the Tories and the Canadian Alliance members are silent today with respect to protecting our health care system.

At least the minister of health at that time eventually acted and brought in amendments to the legislation that governed medicare in the country. It was not always called the Canada Health Act. It was the medicare act and there was another act. Those two acts were brought together and made into the Canada Health Act, which provided penalties for provinces that allowed the things which the federal government saw to be a threat to medicare.

The government has admitted that what is going on in Alberta is a threat to medicare. The difference is that this time we have a Liberal government that does not have the political courage, the political will, or whatever we want to call it, to act in a way that previous government did.

When the history of medicare is written, and when the eulogy for medicare is given some day, we hope not, but if it is ever given, they will point to this parliament, this Minister of Health and this Liberal government as the one federal government that not only should have done something about bill 11, but should never have done what it did in 1995, which created the context for bill 11 and all the other attacks on medicare that we have seen since that time.

Is this really a surprise? The Liberals like to take credit for medicare, but maybe they will not be so high and mighty about medicare from here on in because let us remember that they really only act when they perceive that they have to act. Only in this case they have even lacked the will to do that.

I am referring of course to the fact that the Liberals first promised medicare in 1919 to the people of Canada. When did they deliver? It was 1967. There is always a bit of lead time with Liberal promises. If we calculate the time between 1919 and 1967 we could figure out when those promises about pharmacare and home care will be lived up to. We just have to calculate the lead time that always exists between Liberal promises and delivery. Of course, some things are never delivered.

What we see here is part of a larger pattern that I do not have time to go into, unfortunately. However, medicare is one of the things that people value. It is on a list of things that have been under attack by the government. I think of medicare, the CBC, the CNR and Air Canada. I think of a lot of different public sector institutions, things that we have done through the agency of government, through the agency of public ownership. These things have been systematically undermined and destroyed by the government.

In recent days we have seen the reticence on the front benches to act with respect to the CBC. We see a lack of will when it comes to medicare. The government already sold out the CNR a long time ago, in one of the greatest acts of quizzling economics I have ever seen, and it finished the job on Air Canada that the Tories started. It has allowed the whole country to be bought up week after week by foreign corporations. It is not a record of which I would be very proud.

Despite all the great cheering that goes on in question period whenever a Liberal cabinet minister gets up to deliver one of those—I am not sure what to call it. I am trying to think of something polite. I certainly would not call it an answer.

I was astounded at the member who spoke before me, albeit he pointed to some legitimate problems that exist with respect to how hospitals are run and the way some provinces behave. However, the way the federal government acted in 1995, the way it has continued to act now that we have a surplus by not restoring full federal funding to medicare, and the way the Minister of Health has refused to act decisively with respect to bill 11 all adds up to a strong condemnation of the Liberal government with respect to health care.

All we have asked in this motion is for the government to do what is its responsibility to do with respect to medicare and what is within its constitutional jurisdiction. It can put conditions on the spending of its own money. It can say to the province of Alberta that it will not transfer money to that province if it allows for profit hospitals to provide insured services. It is within the power of the federal government to do that.

We say that it is against the spirit and the intent of medicare and of the Canada Health Act. If the Minister of Health does not agree with us about the current act, he should do what we have asked him to do today and change it, change the Canada Health Act as former ministers of health have done and create an entirely different situation.

We know when we are getting to the Minister of Health because he gets up and says that we do not have any ideas and that we are not putting forth any suggestions. We have put forward suggestions with respect to restoring federal funding so he has the moral authority to act and also with respect to innovation.

For years we have been talking in this place about how medicare was only the first step and that the next step was to develop a more preventive, community oriented model. Now we have suggested dealing with problems with respect to high drug prices and the provision of pharmacare and home care. I am just getting started on the way the Liberals sold out the low cost of drugs with their—

[The Deputy Speaker]

I know the hon. member will not want to get started on drugs because we have run out of time.

It being 5.30 p.m. it is my duty to interrupt the proceedings and put forthwith every question necessary to dispose of the business of supply.

The question is on the amendment. Is it the pleasure of the House to adopt the amendment?

[Some hon. members]

Agreed.

[Some hon. members]

No.

[The Deputy Speaker]

All those in favour of the amendment will please say yea.

[Some hon. members]

Yea.

[The Deputy Speaker]

All those opposed will please say nay.

[Some hon. members]

Nay.