moved:
Motion No. 1
That Vote 1, in the amount of $1,268,024,342, under HEALTH— Department—Operating expenditures, in the Main Estimates for the fiscal year ending March 31, 2002 (less the amount voted in Interim Supply), be concurred in.
Mr. Speaker, it is an honour to take part in the debate tonight with respect to the main estimates of the government, particularly as they relate to Health Canada.
May I say at the outset that as Minister of Health and speaking on behalf of my colleagues in government and those professionals with whom I work at Health Canada, we never forget that we in our own generation are custodians of an achievement of enormous value, the Canadian health care system.
It is an achievement that is more than simply a government program. It is a national undertaking that reflects the values and priorities of Canadians. We are committed to strengthening, to preserving and to promoting that system. That is the purpose for which we ask for the resources that are included in the main estimates.
As we discuss Health Canada and Canada's health care system, perhaps the most important point of departure and the matter I would first like to mention in addressing this issue in the House tonight is the agreement that was reached among the governments in the country just a few months ago with respect to the present state and the future of Canada's health care system.
A few months ago we negotiated with the governments of the provinces an agreement on the future of our health care system. Last September, the Prime Minister signed an agreement with the provincial premiers which contained two key elements, the first of these being more money.
We have added considerably to the federal transfer payments to the provinces so that they will have the resources on hand for health care delivery. In fact, we have added 35% over the next five years to the transfer payments to the provinces.
These considerable amounts will put the provincial governments in a position to meet their responsibilities in the coming years for providing on the ground health services throughout the country.
The second key element was the areas on which we reached agreement in order to improve and strengthen our health care system. Clearly, our system is facing major challenges at this time. As a government, we have agreed on some significant steps in order to face these challenges.
Whether it is with respect to the shortages of doctors and nurses, whether it is with respect to finding new and innovative ways of providing frontline services to Canadians in communities where they live, whether it is with respect to renewing equipment available in the health care system, or broadening the accessibility of home and community care, or increasing the use of information technology, or promoting health as opposed to simply curing illness, all of these key elements were included in the agreement reached among governments just a few months ago.
I can report to the House that since last September, as Minister of Health I have worked with my counterparts across the country to make sure that we pursue the common ground we have reached, that we act on the agreement of last September and carry forward toward its objectives.
Apart from the cash transfer, apart from the elements of agreement, apart from the work we are now doing in common, there are other aspects of last September's entente that I would like to draw to the House's attention and report upon.
There were three targeted funds where the Government of Canada committed specific amounts to particular purposes. The first was a targeted fund of $1 billion for new equipment.
We earmarked $1 billion for this. This amount was made available to the provinces to renew Canada's medical facilities. It was distributed on a per capita basis, and is now in the hands of the provinces.
Since last September $1 billion has been available to the provinces to purchase MRIs, CT scans, new X-ray equipment, lithotripters, surgical suites, whatever it is in the way of medical equipment that might be needed on the ground.
In Ontario, for example, my own home province, that amounts to almost $400 million that has been available since last September to be used by provincial governments in buying new equipment. It is ironic that we would have read recently about the shortages of MRIs here in Ottawa or elsewhere in the province when the provincial government has access to almost $400 million and has had for some months. Naturally we urge our provincial partners to use that money for the purpose for which it was intended and apply it toward the purchase of new medical equipment to meet the needs of Canadians wherever they may live.
The second targeted fund of the three was $800 million which we made available to fund innovative new practices in making frontline services available. What that means is access to doctors and nurses by Canadian families where they live and when they need those services.
We are used to the system of family physicians practising in private offices on a fee per service basis so that during business hours during the week they are there to see patients. However, we all know that the need for a physician when someone is ill or injured does not end at the close of the business day. We also need to have access for families in the evenings, overnight and on the weekends. It is for that reason that the country has been moving toward different ways of making primary care or frontline services available, such as community health centres, shared practices, looking at new ways of paying doctors, and having teams of doctors and nurse practitioners to respond to community needs.
The Government of Canada wants to encourage provinces to pursue these innovative new approaches. It is for that reason we have set aside $800 million in the primary care fund which we are providing to provincial governments to fund innovative new ways of meeting these frontline needs.
We have now blocked out the criteria with respect to how that money will be provided to provinces and the objectives we are trying to reach in making it available, and I believe it is going to be a source of improved services in the years ahead.
The third dedicated fund from last September is $500 million to encourage the adoption of new information and communication technologies in health care. What does this mean? It means two things.
First, it means telemedicine to make the services and the opinions of specialists available to Canadians in remote or rural areas. It means telemedicine so that there can be teleconsultation in psychiatric services. It also means teleradiology, taking an X-ray or an MRI in the northern part of a province and transmitting it digitally to an expert or a specialist in a major urban centre where it can be read.
The second purpose is electronic patient records so that no matter where we travel in the country our medical information is available to health care professionals who need it to provide us with services. If we are ill or injured, God forbid, and arrive at a hospital, information about our case which is taken by the emergency room physician, the admitting doctor, the family doctor, the specialist, the home care worker or the pharmacist can all be shared in one electronic record that is instantly accessible.
That way we would avoid the repetition of tests and the repetition of the history. We would avoid miscommunication between patient and provider. We would make sure that everybody is aware of things such as allergies that the patient might have.
This is the way of modernizing health care, of making it better for Canadians, and these targeted funds will help to do that.
The last element of the September agreement that I want to report to the House on has to do with accountability. I believe we are all in agreement on all sides of the House that we have to be accountable to taxpayers for the moneys we spend. In health care that is no less true, yet in health care there has never been a systemic way of looking at the outcomes in the health care system to assess whether taxpayers are getting their money's worth. It is for that reason that the agreement among all governments provides that starting in September 2002 there will be regular reports to Canadians that measure the performance of the health care system and tell Canadians in plain language on a regular basis how it is doing.
That means that on indicators such as accessibility of frontline services 24 hours a day, 7 days a week, accessibility of home and community care, and readmission rates of hospitals to test whether they are discharging patients too soon, we will be measuring what happens and reporting to Canadians regularly. That will provide a way for Canadians to know how this health care money is being spent, now at $100 billion a year in Canada, and it will provide a way for us to determine where the weaknesses are in the system so they can be addressed.
Let me add just one other matter. During the election campaign of last fall the government also undertook to create a citizens' council on quality care, which means taking the quality control function out of the hands of government and putting into the hands of Canadian citizens. It means creating a council to which we will appoint Canadians from across the country who will monitor the regular reports we make to make sure they are objective, complete, accurate, readable and usable by average Canadians in their homes. It means a citizens' council on quality care which will itself report on how the health care system is doing and will monitor quality in health care services. That is an important way in which we will make the health care system accountable to Canadians.
Before I conclude let me touch upon just a few other things we are working on at Health Canada which members will see reflected in the estimates before the House tonight.
Let me first touch upon health research. This is an area where the Government of Canada has long been seen to have a unique responsibility. Since the 1930s when we created the Medical Research Council, research has been a federal domain. Provincial governments are also active but the federal role has been recognized and respected.
Two years ago we replaced the Medical Research Council with the Canadian Institutes of Health Research. The House adopted Bill C-13 to create the institutes. Since the adoption of that legislation a year ago much has happened. We have appointed the president, Dr. Alan Bernstein of Toronto. Dr. Bernstein and his board of directors have been hard at work. They have named the first 13 institutes, the original slate of institutes. There are now institutes of health research on everything from cancer to mental health to diabetes. These 13 institutes each have appointed scientific directors. Those scientific directors, with their advisory councils of experts, are putting together strategic research plans.
At the same time as we have created these institutes, the Government of Canada has more than doubled the amount of money that we make available each year for health research. It is now over half a billion dollars and I can tell the House that it is on a trajectory upward, so that we can meet our commitment to Canadians to double in the course of the coming years the amount that this country spends on research and development.
The Canadian Institutes of Health Research are off to a good start. Around the world they are earning Canada a reputation for excellence. They are attracting the best and the brightest to stay in Canada or to return to Canada and do their health research here. I believe those institutes hold the promise of advancing the frontiers of medical and health knowledge and of accelerating the discovery of or treatments and cures for diseases and illnesses that afflict Canadians.
I might also report to the House with respect to some of the other initiatives in which we are now engaged.
The Speaker earlier tonight made a ruling with respect to Bill S-15 which has to do with tobacco. I would like to briefly mention what we are doing in that regard because tobacco is the number one public health issue in the country. Every year 45,000 Canadians die prematurely because of tobacco use. That is more Canadians than those who die annually as a result of car accidents, suicides, murder and alcohol combined. It is a tragic toll and we can do something about it.
Recent indications are that smoking rates are coming down in Canada but they are not coming down fast enough. There are troubling numbers about young people, especially young women, who are starting to smoke. We adopted a strategy with many parts.
The Tobacco Act, which the House enacted in 1997, increased taxes. Recently we brought taxes up on cigarettes because that helps, especially among youth who are price sensitive. We are making sure that the public is aware of the dangers of smoking by informing them of the health risks and about the strategies of tobacco companies that try to encourage people to smoke and continue to smoke.
We will continue to with the tobacco issue. Members will see that we are devoting $480 million in the course of the coming five years to this strategy, including major investments in media campaigns to increase the awareness among Canadians, especially young Canadians, of the dangers of smoking.
I would like to touch upon two or three other areas.
The availability and the quality of health services in rural areas has been a preoccupation of mine for some time. The fact is that almost one-third of our population lives outside the major centres. About nine million people live in communities of 10,000 persons or less. If we look at the demographics in rural and remote Canada, we find that the population generally is older than in urban centres. The health statistics are less encouraging. There are more illnesses and more injuries. Yet at the same time, where the needs are greater, services are often less accessible. Whether it is ambulances or emergency rooms, family physicians, nurse practitioners, specialists or equipment, rural Canadians do not have the same access as urban Canadians.
One of the grave concerns I have about two tier medicine in Canada is not between the rich and the poor, but between the urban and the rural Canadian. For that reason, two years ago I opened the office of rural health at Health Canada. Although we can say the delivery of health services is a provincial responsibility, and we respect scrupulously provincial jurisdiction, nonetheless it is a national challenge to ensure that the promise of the Canada Health Act is fulfilled for all Canadians, not just those who live in major urban centres.
We appointed as executive director of the office of rural health a physician who practised in rural Canada and a former member of the executive for the Society of Rural Physicians of Canada. We set about putting together a national strategy to deal with this challenge. We convened a national conference on rural health at the University of Northern British Columbia in Prince George. We set aside $50 million in budget 2000 to fund pilot projects at the rural level. We brought together people from across the country to work with us to find ways of making the accessibility of services more appropriate in rural Canada.
Part of the answer lies in telemedicine and using modern technology. That will help a great deal, but it is not the only answer. It is also a question of attracting physicians and nurses and keeping them in rural Canada. It is a question of overcoming the sense of professional isolation that often drives doctors away. This is something that we have to work on because we cannot abide a situation in which one-third of the population is denied access to quality care in Canada. Working with my provincial partners, I intend to continue in that regard.
In the few moments remaining I might simply mention the organs and tissues initiative with which members are familiar. The House committee on health made such good recommendations, all which I accepted. We are changing nutritional labelling to provide more information to Canadians about the foods they eat. We are making medical marijuana available on a compassionate basis for those who are ill.
Of course, we have the draft bill with respect to cloning and assisted human reproduction which I put before the health committee on May 3. That committee is working and will return with recommendations in the months ahead.
All of this is important, challenging and exciting work. I turn to it with a sense of obligation to the House and Canadians to make sure that we preserve and strengthen Canada's health care system.