Mr. Speaker, before getting into the opposition motion from the Canadian Alliance members, I wish to point out that today is the last day of work of someone whose dedication in helping us with our parliamentary duties has been extraordinary.
I am referring to Pierre Ménard, who has worked with the Bloc Quebecois since 1993. I am sure that all members of the House will want to thank him, because we all have colleagues who work behind the scenes to help us to do a better job as parliamentarians.
Pierre Ménard is someone with a solid legal background, who is well versed in parliamentary procedure, who has a very keen sense of humour, and who is charming. I want to tell him that we will miss him very much.
I am sure that all my colleagues share these sentiments, particularly the members for Chambly, for Beauharnois—Salaberry and for Repentigny.
This tribute is not intended, however, to distract from the extremely serious and urgent business of debating in this House the federal government's responsibility in the crisis facing the provinces.
I would like to begin with two cautions. The first is that we believe that the provinces should be responsible for the health care system. We believe that the problems facing the provinces obviously have a lot to do with the question of money and transfer payments.
In no way does the Bloc Quebecois believe that we should cut corners in examining the re-organization of the system.
Before going into detail, I wish to tell hon. members that I met with some hospital administrators a few months ago, the ones for CHUM and for Maisonneuve-Rosemount. I understood clearly that the problem was not solely financial. It is mainly financial, however, because if the provinces do not have all the resources they should in order to be able to re-organize the health system, the debate will remain extremely theoretical.
That said, I will offer one example of how the network can be reorganized. Does it make sense that there can be 30, 40 or 50 different collective agreements within one health facility, and that the person who puts down salt when there is a winter storm is not the same one to shovel or clear the entrances to the hospital?
Does it make sense that there is such fragmentation in the health community that, when one person could perform two or three different jobs, at present this takes four, five or six people? We are able to figure out that service delivery needs to be re-organized along with the way the system operates.
The basic reality is that demographic and technological pressures and drug costs will confront all provinces, whether Quebec, Newfoundland, British Columbia or Saskatchewan, and despite their greatly different political leanings, with the same reality: that 4%, 5%, 6%, even 7% more will have to be invested yearly in order to provide exactly the same services.
I would like to show hon. members the factors that contribute to the pressure on the health system. Now we have not just seniors, but increasing numbers of older seniors. In French we call these the “fourth age” as opposed to the third.
It is not exception to run into people in our ridings who are 85, 90 or 95 and in relatively good health. These are the “old elderly”, those aged 80 and over.
Since people are living longer, they want to continue living in their own environment. This presents a challenge in terms of home care. This presents a challenge in the way society will organize itself to keep people in their natural surroundings, and I will come back to this.
Quebec has a larger population of people aged 65 and older than do other societies. I have some figures that will provide food for thought for the member for Repentigny, who has a good crop of grey hair himself.
In 2011, the number of people 65 years of age or older will have increased by 60% since 1991. The increase in the number of those 85 years of age or older is even more striking. Their numbers will increase by 84%. We might be tempted to think this is far off. We might think 2030 is beyond reach, but 2030 is just round the corner. In 2030, 25% of Quebecers will be 65 years of age or over.
My colleague, the member for Beauharnois—Salaberry, an eternal optimist, has just whispered a very relevant point to me. In 2030, Quebec will be sovereign, but that fact in no way changes the need to organize and consider how we can give our seniors the best services possible.
When we compare things in Quebec with the way they are in Germany, Canada, France and England, we realize that what sets Quebec apart is the rate at which its population is aging.
Proportionally, Quebec's population is aging twice as rapidly as the population of European countries. This means that the percentage of people turning 65 or more will be demographically greater here than in Europe. This will take place at an accelerated rate that is unknown in countries such as France, Germany and the Scandinavian countries.
I also want to mention another reality. The upward pressure on the health budget is around 4% to 5% annually. This means that, by the year 2002, if we want to provide exactly the same services, if Quebec wants to provide exactly the same range of services as it does in 2000-2001, the National Assembly will have to increase its health budget by 4% to 5%.
If we look at this figure, and my colleagues are anxious to do so, we realize that demographic growth accounts for 1.3%, technological change for 1% and inflation for about 2% annually.
But there is a natural growth of 4% to 5% in the health sector. Mr. Speaker, if I asked you, since you are mentally alert, to tell me the rate of Quebec's collective growth, you would have to say 2.5%. Therefore, if we do not restructure Quebec's health system, we will find ourselves in a situation where the National Assembly, the government of Quebecers, will have to allocate more money for health than it can, based on the collective wealth indicator. This is what is disturbing.
This is why the Premier of Quebec, one of the best ever to have held the position, said, in response to Jean Charest in oral question period, that it was not possible for Quebec's health care budget to be open-ended. It is not possible. No government in the world can operate that way and neither can Quebec.
I will return to what the Minister of Health erroneously said in a moment of what I would call confusion and delirium. I will come back to the money which is supposedly being held in trust and which Quebec has not used.
But I wish to say that there are structural pressures on the health system. We have the number: in 1999, last year, for example, emergency rooms saw 50,000 more cases than in 1994-95. Of these, 56% were people over the age of 75. This is where we begin to understand the demographic pressure. When emergency rooms are treating 50,000 more people and three-quarters of them are aged 75 and older, we can see why demographic pressure has an impact on health care.
I will give the example of radiation oncology. Oncology has to do with cancer. Well, the demand for radiation oncology, particularly for those aged 50 and up—baby boomers—is increasing. New cases of cancer are increasing by 3% annually.
The demand in cardiology is also increasing, particularly for those aged 50 and older. Obviously, more seniors are undergoing coronary bypass surgery. The number of heart surgeries is increasing by 3.6% a year.
Mr. Speaker, you are a good-hearted person. You are going to be very upset to hear that the number of angioplasties has increased by 260% over the past ten years. This has an impact on the health care system.
I was totally amazed to hear the Minister of Health, with his dulcet leadership-seeking tones, praising the health ministers' report.
A year ago, all of the ministers of health met together and came to exactly the same conclusion. What was that conclusion? That the federal government must return transfer payments to their 1995 level.
The ministers of health wanted to document what was going on in the various health systems, so they tabled a report. I would like all hon. members here in this House to understand that this report is over the signatures of Bernard Lord, Pauline Marois, the premier of British Columbia and Brian Tobin.
So the same conclusion is invariably reached, whether those involved be Liberals, Progressive Conservatives, New Democrats or Parti Quebecois: the federal government has literally robbed the provinces of their due. It has diverted funds. It has turned its back on its most basic of responsibilities.
I would like to share part of the report, beginning on page 16. I find the Minister of Health particularly hypocritical for praising this report without giving us any of its content. I feel obliged to share with hon. members the two main findings of this report, which are most critical of the government.
On page 16 we find:
Total provincial/territorial health expenditures in Canada increased from $11 billion in fiscal year 1997-98 to $55.6 billion in fiscal year 1999-2000, an average growth rate of seven per cent per year.
So, it is not just the provinces that failed to assume their responsibilities. It is not just the provinces that failed to put money into the health care system. From 1977, the year established program funding, EPF, was created, the cost increased from $11 billion to $55 billion.
There is a limit, however, to what the provinces can do. There is a lot of federal money and less provincial money.
At page 19 of this report, endorsed by all the provinces, by Brian Tobin, Bernard Lord and Pauline Marois, the figures are stunning. At page 19, the report by the health ministers reads:
Long before the CHST, years of federal transfer restrictions had significantly reduced the federal government's proportional share of provincial/territorial health care programming costs. The federal share, which stood at 26.9 per cent in 1977/78, had fallen to 16.3 percent in 1995/96 at the onset of the CHST.
The report indicates there was a 40% decrease. It went on to say:
The deep cuts accompanying the introduction of the CHST reduced this share considerably, so that it stood at just 10.2 per cent in 1998/99.
Over a period of 21 years, the percentage of health care funding assumed by the federal government dropped 62.1%. Is it acceptable that the federal government cut transfers to the provinces, especially transfers for the health care system, with impunity?
And then the Minister of Health rises in the House and says “In spite of all the harm that I have done to the health ministers and to the provincial health systems, I would like to act as if none of that had happened and invite my provincial counterparts to sit with me at the negotiating table, so that we can discuss together the changes that should be made to health and social services programs”.
The Bloc Quebecois believes that there is a prerequisite to the minister convening a meeting with his counterparts, namely the restoring of transfer payments for health.
If the government restored health transfer payments to their 1995 level, the provinces would receive $4.1 billion for health alone. Quebec's share should be $1 billion, including $500 million for health.
I will tell the members who are listening and the people who are watching the debates of the House of Commons what Quebec could do with this additional $500 million for health.
That amount is equivalent to more than one quarter of the budget for Montreal's hospitals.
The $500 million owed by the federal government to Quebec represents nearly half the budget for the whole CLSC network in the province.
The $500 million owed by this government to Quebec is almost the equivalent of the budget allocated to home support.
The $500 million is four times the annual budget of Sainte-Justine hospital for children. It is three times the budget of the Royal Victoria Hospital, and it represents one quarter of the cost of the prescription drug insurance plan.
I will conclude by saying that if this government is serious, if it really wants to take its responsibilities and help the provinces meet their obligation to maintain the health system and preserve its integrity, it has no choice but to immediately state its intention to restore transfer payments to their 1994-95 levels. Otherwise, it will mean—and voters will remember it at the next election—that this government is a hypocrite and talks from both sides of its mouth. It will mean that the government does not want to help the provinces with their problems in the area of health and social services. And Quebecers will remember that.