Debates of June 12th, 2001

Main Estimates, 2001-02

[Larry Bagnell, Liberal, Yukon, YT]

Madam Speaker, I thank the member opposite for outlining a number of points.

The hon. member wanted to be asked a question on accountability. I will ask the question so that the member can elaborate further on the blank cheque to the provinces. In what ways could we make the provinces accountable or have them monitor health care? That is a good question. I would like to hear more of the member's suggestions.

Along with that, what does the member think in regard to the accountability of passing on that spending? Various provinces have passed on expenditures or transfers from the federal government in various amounts. Various provinces spend different proportions on health care. Some of the provinces will be in very good shape soon, such as Alberta, which I think will be out of debt soon.

Last, I am glad the member mentioned the point of recruitment. It is a very important point. I was glad to hear the minister mention some plans in that respect. However, I know the Alliance is interested in taxes and I am curious about something. Does the member think that because we have made the largest tax cut in Canadian history, although of course it could always be more, it will help keep health care professionals in Canada?

[Rob Merrifield, Canadian Alliance, Yellowhead, AB]

Madam Speaker, I thank the member for his questions. This gives me an opportunity to explain a little more about what I did not have time for in my presentation.

With regard to accountability, I think we miss the boat when we get bogged down by the question of whose jurisdiction it is, of whether it is a federal or provincial jurisdiction and whether the dollars are federal or provincial dollars. We have to understand that they are all taxpayer dollars from taxes paid by Canadians. That is what is so critical about accountability. Accountability does not come with that.

Accountability comes when we move Canadians, the users of the system whose hard earned dollars pay for a system of health care that they are so proud of, closer to the system and give them the opportunity, the education and the understanding to be able to access the system appropriately and to feel accountable to it. I believe that every time they access services they should have an account of what is paid on their behalf. The paradigm would suddenly shift. Instead of thinking that health care is just there and they can use it without any responsibility, they would then have an understanding of who is using it. Something else would happen: doctors will start treating patients a lot differently when they know that the patients know exactly what is being paid on their behalf.

I think that is how we start bringing accountability into the system. That could be a federal jurisdiction because it is a broad plank and a broad idea.

We will not solve health care problems with one silver bullet. If we thought one silver bullet would do it we would have used it a long time ago. We would have fired that bullet.

We have to start with a broad plank and then start building from there. That is how to bring accountability into the system.

In regard to taxes, we absolutely need to lower the taxes to hopefully give ourselves a little more competitiveness so that hard earned dollars go farther in this country. We have put a sign up that Canada is open for business, but will it solve the problem of the brain drain of our professionals going south? It is maybe a step in the right direction, but we have to do a lot more.

We make a fatal error in Canada with our human resources by not negotiating when physicians are going through the educational system. That is when they need our help. That is when they are vulnerable. We should negotiate then as to exactly where they will come out and serve, not after they get a degree. Any head of business will tell us that negotiations happen when both sides need each other, not when one side does things in isolation or afterwards. The brain drain is a big problem. Human resources is one of the major problems and it will not be solved overnight.

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

Madam Speaker, I have a very quick question for my colleague in the Alliance Party.

Where does his party stand on some of the controversial issues such as deterrent fees and user fees? What role should the federal government take to make sure those things do not happen in Canada? Is he in favour of national standards for health care whereby we are treated the same from coast to coast to coast?

He is from Alberta where there was the experience of bill 11 and all the protests in his province. It would be interesting to know where he stands on some of those issues.

[Rob Merrifield, Canadian Alliance, Yellowhead, AB]

Madam Speaker, I do not think I can answer that in one minute. It is very important.

I think we get suckered into a false debate in the country when there is a private-public debate. We have been suckered into that debate throughout the country. The member used the example of Alberta and bill 11. That is exactly what Alberta experienced. It ended up being a neutered bill. That is not the solution.

Regarding the absolute phobia about user fees, I do not think we have to go to user fees. I think we need to open up the books and bring Canadians closer to the system. The member mentioned user fees in a glib way and I am a little cautious about that. If user fees or some other incentives become necessary, I think Canadians will tell us. I do not thing it is something we should debate right now. We have to go plank by plank initially. Those are short answers and I could go on but my time is up.

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

Madam Speaker, I will be sharing my time with my colleague from Winnipeg North Centre who is the very eloquent spokesperson for the New Democratic Party on all matters concerning health care. I would not want to take more than half the time so that she has a chance to put our position on the record.

This is a very important debate we are having here this evening. I suppose there is nothing that defines us as Canadians in terms of our collective character and differentiates us from the Americans more than our national health care program. Canadians, when asked what they are proud of about Canada, will say many things but many of them point to health care and public health care is a very important part of that.

I want to say at the outset that I am very proud of the role my party historically played in terms of getting health care into the country. I remember the debates when I was a teenager. At that time there was the great doctors' strike in 1961 in Saskatchewan when health care came in. The premier at the time was the CCF premier, Woodrow Lloyd. The CCF of course was the predecessor of the New Democratic Party, the NDP. I remember the fear among a lot of people at that time when all the doctors in the province went on strike.

I remember the then leader of the opposition, Ross Thatcher, protesting that the legislature was not called back to deal with the issue. He actually kicked the doors of the legislature. In the political history of our province there is a very famous picture of the Liberal leader, who I would say was a very conservative Liberal leader, kicking the doors of the legislative assembly.

However, that was really the opening of the floodgates for national health care in the country. Not long after that we had the appointment by prime minister John Diefenbaker of the Hall commission under Emmett Hall. It recommended a national health care program based upon the Saskatchewan model, which was a publicly administered, single payer type of system in the province of Saskatchewan.

Under the prime ministership of Lester B. Pearson, and under Paul Martin Sr., who was a minister at that time, and through the pressure of Tommy Douglas and the NDP caucus in the House of Commons at that time, we finally got national medicare in the mid-1960s in Canada.

The Liberal Party first promised national medicare back in 1919. It took from 1919 until the mid-1960s to actually become a reality in the country. That is how slow these Liberals move, at a snail's pace or like molasses in January. It was the prodding and pushing and the role played by Saskatchewan that made this a very popular idea right across the country.

Finally the time came when the political support was there and the public opinion was there. The federal government finally moved, under what was a very progressive Liberal government under Lester B. Pearson, quite the contrary to what we have today. Today we have the most conservative Liberal government in the history of our country. I am sure we would all agree with that if we compare it to the governments of Lester B. Pearson and Pierre Trudeau. In many ways this government is more conservative than Prime Minister Brian Mulroney's Conservative government was between 1984 and 1993.

In the mid-1960s we finally got medicare in this country. We finally got a national program. We finally got a single payer system in this country that is now the envy of many people around the world.

What did the Liberal government do in its budget? In February 1995 it took an axe to medicare. It cut medicare and transfers to the provinces. It cut them so radically that every province in the country was suffering.

I am proud to say that the government of Roy Romanow, who is now head of the commission on medicare, was the only provincial government, contrary to what my friend in the Conservative Party said a few minutes ago, that backfilled dollar for dollar the loss of federal dollars from the provincial budget and the provincial caucus to maintain what we had in our province of Saskatchewan.

However, those cutbacks have hurt the system very severely. We had the health care accord of September 11, 2000, right before the election, which injected more federal money into health care, but even under that accord we are still well behind where we would have been if the cutbacks had not come in 1995.

Just three weeks ago we had a economic statement by the Minister of Finance. In that economic statement he announced that we had $15 billion in unexpected surplus in the country and that every penny of that surplus was applied to the national debt. If we had a system like some of the provinces do, where we had a special fund set up into which this surplus money would go, then those of us in parliament could have a national debate as to where that money should be allocated.

If we had polled the Canadian people as to whether or not they wanted all of that $15 billion put into the national debt or whether they wanted some of that put into health care, education, the farm crisis, infrastructure or the aboriginal problems in this country, I am sure that the Canadian people would overwhelmingly and massively have told us to spend a huge portion of that on the health care and educational problems the ordinary people of this country face. However, that did not happen. It did not happen because that is not the priority of the government across the way.

When it comes to debating the estimates, debating supply, it is very important for us to remind the government and the ministers across the way that they made a decision, first, to cut back radically on health care, putting many strains on the system and putting many parts of the country into crisis. Now, when we have the funds to do better, when we have this $15 billion surplus, the government chooses to put every single penny of that surplus to paying down the national debt. That is on top of announcing last fall before the election, in another economic statement, that there would be tax cuts of $100 billion for the Canadian people, many of those tax cuts helping wealthy people and the big corporations of this country that do not need those cuts.

Again, a large percentage of that money should have been spent in health care and education and on the human deficit in this country. In 1995 when those cutbacks were made, when people fought against the deficit that had been run up, mainly by the Tories, by accepting the cutbacks in the social programs, there was the creation of a human deficit in Canada. Now that we have some fiscal dividends it is the people of this country who should reap some of those benefits through health care programs, education and social services as we fight and combat this human deficit.

The two biggest failures of the government across the way are the environmental record of this country and the gap between the rich and the poor, which is once again growing instead of narrowing. A large part of that is due to the cutbacks in social programs in Canada and health care is a very important one.

Where do we go from here? I think we have a very good system. We have a very important system. We have a system that many Americans would like to see emulated in that country. Some 40 million Americans are not covered by health care or medicare at all. We have a system that is based on the concept of a single payer, that is, the provincial governments, with the help of the federal government, pay the health care bills in the country.

There is the system of public administration. In that system of public administration we know there is some flexibility in terms of some things being private. Hospitals will sometimes privatize or contract out the food service, the catering service, the laundry service or some other services. However, it is important within that context that everything be publicly administered.

Unlike the member from the Canadian Alliance in Alberta, to me this debate is not irrelevant in terms of public versus private. It is extremely important that we keep a public system, a single fare system and have it publicly administered on behalf of every Canadian. If we do not, we will create a chequerboard health care system with the richer provinces having a better system than the poorer provinces. We could end up like some countries in the world, such as the United States, where wealthier people, because of the thickness of their pocketbooks, have access to a better health system than the ordinary citizens.

It is extremely important that we keep that system publicly administered in a single tier system for every Canadian.

We also have to develop a pharmacare program so that the price of pharmaceutical goods and drugs is not a deterrent for people when combating an illness. We also need a good home care program. In both these cases the federal government should provide some leadership.

I conclude by saying we have to maintain national standards for home care, for daycare and pharmaceutical care. Within those national standards we have to have the flexibility of the administration of a system by each province that fits their unique characteristics.

[Roy Cullen, Liberal, Parliamentary Secretary to Minister of Finance]

Madam Speaker, the member for Regina—Qu'Appelle has stood in the House before and talked about this very negative option as he sees it, and that is paying down the debt is not a realistic option.

We still have over $550 billion of debt. In 1995-96 the debt to GDP ratio, that is the debt in relation to the size of the economy, was about 71.2%. It is now around 55%. The norm would be somewhere around 40% or thereabouts.

When we look at investing in social programs, the government last September at the premiers conference invested some $21.4 billion in health care, post-secondary education and other social programs, which was the largest single investment the government ever made.

The $15 billion that automatically went toward paying down the debt at the end of the last fiscal year was the surplus. The member for Regina—Qu'Appelle is a member of the finance committee. I am sure he knows the procedure that whatever the surplus is it goes to paying down the debt. That will save taxpayers $2 billion a year in debt service charges. That will mean more resources are freed up to invest in health care and post-secondary education, to cut taxes and to invest in innovation, training and skills development.

Why has the member such an aversion to paying down the debt? We still have a debt in Canada of about $550 billion which is far too high? Why is he so negative on paying it down?

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

Madam Speaker, my answer will be very short. I have nothing against paying down the debt. The debt has gone down from 71% of GDP to 55% of GDP, as the parliamentary secretary said. It is going down very rapidly.

I am talking about balance. There will be a tax cut of $100 billion over five years. There will be $21 or $22 billion going to health care and social services over five years, and a big hunk of money going to the national debt.

If we look at any poll, Canadians have said overwhelmingly that there is not a balance and that more money should go to health care, education, social services, infrastructure and the farm crisis. In other words, it should go into a people's agenda. That is the only place where I differ from the parliamentary secretary. It is a matter of priorities and balance.

[Rob Merrifield, Canadian Alliance, Yellowhead, AB]

Madam Speaker, the member made mention in his address that the government in the mid-nineties took an axe to the health care portfolio. I made mention of that in my remarks as well. I also made mention of some of the repercussions which we are suffering now. I think we concur on that and we have to guard against that ever happening again. That is why we are suggesting we have a long term plan for the finances of health care and that we have a sustainable five year budget so that can never happens again.

The member suggested that all we really need to save the health care system is to throw more money at it. If that is not the case and I misinterpreted that, exactly what would he see as some of the solutions for health care?

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

Madam Speaker, I did not say that the solution was to throw more money at it. We need more funding to sustain the system and make sure it is equalized across the country with national standards.

The Romanow commission is looking at ways of enhancing and making medicare more cost effective and beneficial for the Canadian people. There are efficiencies that I hope we can find to put into the system. However throwing more money into the system is not the answer, but we need enough money to make sure they system is sustainable in terms of the hospitals, salaries for doctors and nurses.

I think any independent analyst would say that the cutbacks were just too severe in 1995. It pushed many of the provinces deeper into debts and deficits. Many provinces closed hospitals and cut back on their systems. I think the government went too far at that particular time.

Part of the problem is extra federal funding, but part of the problem is making sure we are more efficient in terms of delivering a health care system.

[Lynn Myers, Liberal, Parliamentary Secretary to Solicitor General of Canada]

Madam Speaker, I would like to congratulate the member for Regina—Qu'Appelle. He made some very good points. I believe he feels as passionately about the health care system and about making sure it is universal, acceptable and accessible for all Canadians.

However, I would like to ask him a question with respect to Roy Romanow, a pre-eminent Canadian who I believe was a brilliant choice on behalf of the government. The Prime Minister of course made that appointment, which I think stands in good stead for all Canadians.

Was the member optimistic or pessimistic on Mr. Romanow's appointment and what he would do in this very important study? It is my understanding that he will cross Canada and consult with stakeholders, Canadians and other interested parties on this very important area. Before he answers I would like to say I am very optimistic.

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

Madam Speaker, Mr. Romanow has been a friend of mine since 1967. I just spoke with him yesterday, and I am sure he will do an excellent job and make a valuable contribution like Mr. Emmett Hall did back in the 1960s.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Madam Speaker, I have been trying to contain my feelings and save up for this opportunity. Now there is only 10 minutes to put over six months of concerns on the record.

I would like to focus on two areas pertaining to Health Canada. There are two pillars of health care in the country today.

The first pillar is our national health insurance system which is the envy of the world and a model that ensures access for all citizens on a universal basis to accessible, quality health care that is now facing serious decline and erosion.

The second pillar is our national health safety system which emerged out of the thalidomide crisis in the 1950s and has served Canadians well over the last several decades. It is also under serious threat from underfunding and lack of leadership by the government.

In both cases these pillars of medicare are crumbling. They are crumbling because of Liberal government neglect, lack of leadership by the present Minister of Health and a failure to ensure that some allocation of funds from this budgetary year, which is showing a $15 billion surplus, be allocated to those very important cornerstones of Canadian public policy.

We are not only dealing with a lack of adequate resources and a failure of the government to put a pittance of the $15 billion surplus toward these important areas, we are also dealing with a government that has failed to show leadership and provide national standards and national direction in two fundamental issues facing Canadians today.

The minister in his comments this evening was quick to point out with some pride the $21.1 billion contribution by the federal government following the September 11, 2000 accord for health care. However, the minister failed to point out that we are talking about $21.1 billion spread out over five years to cover health, education and social services. We are talking about a restoration of funds by the federal government to bring us up to 1994 levels which ensures that the federal government is involved to the tune of 15%, a long way from the 50:50 division that existed in the past for medicare.

Not only is the government failing to ensure our medicare model is sustained and supported, it is contributing to the erosion of that system and allowing, through its passive response and inaction, the slide toward privatization and yes, two tier health care.

The minister this evening stood in the House and tried to suggest he was making great progress by announcing a performance report, which would come into effect in the year 2002, and a citizens council on quality health care. These are two ideas which we will not sneeze at. They are important contributions to the debate, but they do not address the need for action. They do not address the concerns raised by the Canadian Federation of Nurses Unions when this organization pointed out the government promised, with the September accord, to deal with the nursing shortage.

The government promised to deal with the drug pricing problems. It promised to deal with home care, and there has been no action. It has failed to address the Canadian Nurses Association recommendation for some contribution toward a recruitment strategy to deal with the crisis that is looming for all Canadians and the fact that at this rate we are in all likelihood going to face a shortage of 113,000 nurses by the year 2011.

The government has failed to deal with the suggestions from the Canadian Health Care Association that called upon the government in March of this year to allocate significant new resources to ensure we dealt with the shortfall of health care professionals and help provide the kind of quality care Canadians needed and deserved.

The government has not deal with the recommendations of the Canadian Medical Association that presented to the government a comprehensive document entitled “Looking at the Future of Health, Health Care and Medicine”.

The government has not dealt with the serious problems facing Canadians in terms of accessing necessary medications. It has not dealt with the recent report in March of this year by the Canadian Institute for Health Information which pointed out that almost six million Canadians had inadequate insurance for prescription drugs, or that 10% of the population had no drug insurance at all and another 10% were under insured.

The minister has not dealt with the concerns that are at the root of our erosion of medicare and will not commit to fulfilling promises made long ago to have a national home care plan, a national pharmacare plan and a major reform at the primary care level.

We need resources now to ensure that we can sustain medicare and reform it in terms of the community based preventative health care model we are talking about.

The second pillar pertains to health protection. We raised serious questions about mad cow disease in the House this week. The answer from the minister was appalling and needs to be addressed.

I would like to point out that on April 4, we asked questions of Health Canada officials pertaining to mad cow disease. Specifically, I asked if it was possible that deer and elk killed on our highways were slaughtered, rendered and entered into the feed that went to live animals? Dr. André Gravel said there was a remote chance. I also asked if it was possible, under present regulations, for cow blood to actually get into the feed that went to live animals. Dr. Gravel said yes.

The minister appeared before the health committee on April 26 and pretended or claimed that he knew nothing about that and said that they were taking all necessary precautions. Yesterday in the House, the minister stood and said to all Canadians that Canada was BSE free and that they were taking all precautions.

That is not the case. The minister has not put all the facts before the Canadian public. He is not taking the necessary precautionary steps to ensure Canadians are protected from the very serious threat of mad cow disease or, if I can refer also to issues raised previously, mercury in fish, or salmonella poisoning or the uncertainty around genetically modified organisms in our food supply today.

The government has hacked and slashed our health protection branch starting in 1997 under the present Minister of Health. It has not fully restored our scientific capacity. It has not ensured that we have independent research. It has not taken steps to protect Canadians in all instances in terms of our food supply, the drugs Canadians need or any other area for that matter.

I raise all this not to engage in fearmongering as the government is so wont to classify it. I raise it because if we do not take steps now to deal with these threats we will pay a price down the road. We will pay a price in terms of human health and in terms of our agricultural industry. This is about protecting our farmers and the health of consumers. It is about trying to convince the government to act now before it is too late.

It is reprehensible for the Minister of Health to stand whenever he is posed a question and suggest that the opposition does not know what it is talking about, that it does not have all the facts and that everything is just A-okay. We know from many reports, especially the 3,000 page report just released by the minister's own departmental officials, about the problems of BSE and the potential threat of mad cow disease.

This is a serious, comprehensive study which suggests we do not know the incubation period for transmission of the pathogen and do not know the source of the problem. We do not know that cow's blood, gelatine or other animal products which are put into feed and then fed to live animals will not transmit the disease to human beings.

We are asking the government to look at this serious issue, take all precautionary steps and ensure we have regulations in place that protect Canadians at all costs. We are asking the minister to look beyond the inadequate advice he is getting from his own departmental officials and look to the world, to the European Union and to other countries that are now realizing the importance of taking all necessary steps to protect the food supply. We must ensure the health of Canadians is not threatened.

The two pillars of Canada's health care system, universal health insurance and our nationally acclaimed health safety system, have held the country in good stead. They have ensured Canadians have access to quality care and have protected Canadians against the worst threats in terms of tainted food, problematic drugs or unsafe water.

Surely that is the most basic thing the government can do. Surely this is the time and the opportunity for the government to invest a portion, just a portion, of the $15 billion surplus into quality health care and into the health, well-being and future of our citizens.

[The Acting Speaker (Ms. Bakopanos)]

I would like to make a comment, if hon. members will indulge me. We are dealing with estimates today.

[Peter Adams, Liberal, Peterborough, ON]

Madam Speaker, I understand your point, but an evening debate like this is a time when members can express themselves quite broadly and eloquently and can be more thoughtful than is often the case in the hurly-burly of normal debate.

I listened with great interest to what my colleague had to say and what her colleague from Regina—Qu'Appelle had to say. It seems to me we live in a confederation. The strength of a confederation is that we have jurisdictions where all sorts of things can be tried. If they are no good, others can learn and do not need to repeat the experiment. If they are good they can be applied by the whole country.

The member for Regina—Qu'Appelle gave the rightly famous example of Saskatchewan developing a health care system which proved to be good for the whole country. Similarly the federal government, in addition to taking ideas from the jurisdictions, can have ideas of its own and hopefully persuade the provinces to go along.

It seems to me the thing works well when it is clearly federal jurisdiction and the federal government has the wherewithal and the jurisdiction to do something. For example, it was this government that put every school, every kindergarten, on the Internet through the SchoolNet program. The provinces essentially were not involved.

In the case of Saskatchewan and health care, the province developed something and the Liberal government of the day saw it was possible. The other provinces realized it was possible and that they could implement it.

I will give some other examples. I think the member would agree that the child tax benefit is a remarkable program of the government and yet it has been clawed back, for example in my own province of Ontario, from the poorest children and families. The federal government appears able to do nothing about it.

The 2000 research chairs is an extraordinary program. No jurisdiction has a fraction of the number of research chairs we have. We discovered that universities sometimes cannot afford the research chairs because they are not getting the funds through the CHST or from the provinces to support them.

The Canada student loan program has been greatly improved. The millennium scholarship program is 95% income related and deals directly with student loans, yet most provinces with the exception of two are raising tuition fees.

Could my colleague comment on that? Where jurisdiction is clearly provincial or federal, things are very simple. In the most common cases jurisdiction is less simple. What are her thoughts with respect to that and health care which is the main topic of her remarks?

[The Acting Speaker (Ms. Bakopanos)]

I would like to indicate that I was not trying to steer the debate in any direction. Members are free to express themselves freely.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Madam Speaker, I know that. I know that you know I was talking about estimates and the budget and the fact that the government should have considered allocating a portion of the $15 billion surplus to health care to meet some of the critical issues I outlined in my remarks today.

I appreciate the very important question from the Liberal member across the away about innovations by the federal government that should be supported. I want him to know that the Liberal government has come forward with good ideas in a number of instances. I have indicated tonight that we do not quarrel with the idea of performance reports or a citizens' council dealing with quality health care. These are important ideas that should be advanced.

However I am concerned about where the government stops in terms of concrete action to deal with serious problems. I am concerned about its failure to keep promises pertaining to such basic issues as access to reasonably priced drugs, a universally accessible home care program and major reforms to primary health care. These are all issues the government said it would be innovative on but has failed to address.

The member raised the important issue of split jurisdiction and the problem of trying to advance these issues in the context of different agendas at the federal-provincial level. I recognize that point. However in terms of health care we are dealing with a willingness on the part of many provincial governments to make progress in the areas of pharmacare and home care. That is the case with my home province of Manitoba.

There has been a tremendous resistance or lack of courage by the federal government to take up and advance these issues in collaboration with provinces that are willing to co-operate. The example of innovation is relevant to the debate because Manitoba offers, and the Minister of Health knows this, model programs in the areas of pharmacare and home care.

Manitoba pioneered those ideas many years ago and they ought to be replicated across Canada. However that would take federal leadership and it would take money. Yes, it would take some of the budgetary surplus available to us today. It would also take a minister who is prepared to do battle if necessary with less than co-operative provinces. There is an interest that the present Minister of Health could tap into. He could move expeditiously on some of the key issues pertaining to the reform and renewal of medicare.

[Jeannot Castonguay, Liberal, Madawaska—Restigouche, NB]

Mr. Speaker, I would first point out that I am sharing my time with the member for Mississauga South. I am happy to contribute to the debate this evening.

Having worked for over 25 years as a surgeon in a rural community in New Brunswick, having worked in a hospital setting and with community health services for all those years, having had the privilege of sitting on the Standing Committee on Health with government and opposition colleagues, whom I got to know and appreciate, I must say I have the health of all Canadians at heart.

This is why I am opposed to Motion No. 1, which questions Health Canada's Vote 5 on the department's subsidies and contributions.

Is this opposition to the motion a way of saying that the approach to achieving the government's objective regarding health is not laudable? Nothing could be further from the truth.

Some members in this House like to claim that the Government of Canada is out of touch with the public that it serves. They like to suggest that the government is disconnected from the real needs of Canadians. This is far from the reality, and in more ways than one.

One of the most appropriate ways to demonstrate that we care about the health of Canadians is to look at the subsidies and contributions that Health Canada gives to community organizations and to its partners, the provincial and territorial governments. These funds meet real needs in the health sector and they allow us to explore new avenues to strengthen our health system. Currently, subsidies and contributions are given to partners that do productive work in this country.

The basic principle is that our government is taking measures regarding a large number of priorities in health, priorities that Canadians feel are important.

Our government is taking measures to provide to first nations and Inuit communities sustainable programs and health services that take into account the disparities and the threat of disease, so they can enjoy a level of health that is comparable to that of other Canadians.

Our government is taking measures to improve prenatal health and ensure that young children have the best possible start in life.

Our government is taking measures to help older children and teenagers who are pressured by their peers to smoke or to use drugs or alcohol.

Our government is taking measures regarding a number of priorities in community health that impact on people of all ages.

Our government is working to meet the needs of seniors.

However, our government knows that all these concerns need not be tackled strictly within government. The fact is that there are many groups already working in these areas. There are ways that we can work with the provincial and territorial governments. There are many organizations which are very familiar with their communities and which have the necessary expertise to deliver effective programs and services.

Our grants and contributions are investments in partnerships and success. I will, if I may, give a few examples of what I am saying.

First, there is the alcohol and drug treatment and rehabilitation program, or ADTR. This is a longstanding program designed to reduce the harm caused, as we all know, by alcohol and other drug abuse to individuals, to families and to communities.

Through this program, Health Canada provides funding to the provinces and territories in order to help them improve accessibility to effective alcohol and drug treatment and rehab programs. These governments use these funds to support direct treatment and rehab programs for persons with substance abuse problems, and to provide training to health professionals, as well as services in schools, rapid screening, and counselling.

Naturally, if we accept this opposition to the motion, the provinces and territories will no longer receive support for ADTR. The funding will no longer be there.

Then there are the programs in support of science, which is essential to an understanding of health risks. It is crucial to policy choices that will enhance Canadians' health. All of these are supported by research funding.

Let us take, for instance, research into atmospheric pollution in our cities. All of us realize that poor quality air is bad for people, but we need to know which components in air pollution are the most harmful.

We need to know whether this situation presents more risks for certain members of society such as children or seniors. With that information, governments, communities and businesses can make informed choices.

Health Canada funds research activities at the University of Ottawa in these fields. This budget category is what funds that research. These are areas of research which ought to make it possible to improve the rules and policies that impact on atmospheric pollution and to provide healthier air to the population of our cities.

In many other cases, we are pursuing broad initiatives in which our subsidies and contributions are combined to fulfil major commitments made to Canadians. Allow me to give an example.

Just last week, the government announced new support for eight health initiatives in rural British Columbia. This was a global announcement on subsidies and contributions. For example, some local and regional projects will benefit from funds provided through the HIV/AIDS strategy to target problems such as the care and treatment for people infected with the HIV/AIDS virus, or to prevent the spreading of the HIV/AIDS virus in these communities.

Some projects will benefit from the support provided under the community action program for children. We co-manage this program with the provincial and territorial governments. This is another example of federal-provincial co-operation through subsidies and contributions. And this co-operation will provide support for community programs and services that help children up to six years of age get a good start in life, be ready for school and improve their chances of having a healthy adult life.

There are already close to 450 projects across Canada under the community action program for children. Together, these projects are valued at more than $50 million. If the House accepts the motion, this will all come to an end.

I will conclude by pointing out that a large number of subsidies and contributions help shape Canada's future health system. The funding provided under that vote will be used for a number of telehealth initiatives across Canada, including in Quebec, Ontario, Atlantic Canada, western Canada and the north.

These projects serve as testing grounds for ideas on such matters as how health care organizations can exchange records on patients securely and effectively and on how to give people in remote regions access to the expertise available in the health care centres of our major cities.

We are even trying ways to link people receiving home care with organizations providing community services to enable them to use these technologies at home.

Allow me to give an example of the outreach project in Ontario. This project, which is being run in London, involves exploring a way to meet the need for psychiatric services in poorly served regions in southwest and northern Ontario. It will be achieved by linking four psychiatric centres to as many as 100 locations in the cities and communities of the first nations, by way of a video conferencing system. Examples of this sort are popping up all over Canada.

The fact is that subsidies and contributions are an essential part of the government's strategy to improve the health of Canadians. They enable us to support local organizations that share our commitment to a healthy childhood. They enable us to support major research efforts. They enable us to keep up with the new millennium.

This funding deserves the support of the House.

[Gerald Keddy, Progressive Conservative, South Shore, NS]

Madam Speaker, I listened with some interest to the member for Madawaska—Restigouche speak on the merits of the government and what it has done as a health care provider.

Since he is a member of the government I certainly understand that he would want to sing the merits of the government, but I just do not understand how he is able to do that.

Certainly I do not expect that the health care provided in his riding is much better than the health care provided in my riding of South Shore. In the village of New Ross where I live, we are 40 or so kilometres from the nearest doctor. People who cut themselves or get their hand caught in a piece of equipment have to hold it together as best they can until they can get to a doctor. There is certainly none in the community. There was when I grew up there. There was always a doctor there, but there are no doctors in rural Canada.

Members should not stand there and sing the praises of the government and what it has done to help rural Canadians and provide health care because it is just not there.

There is a question that I actually do want to raise now that members have finished singing the praises of the government. Now that they have finished, they can answer a question on a specific item. The item is one that was brought up earlier. It is a serious potential health hazard and I would go so far as to say that it is a serious health hazard now. It is bovine spongiform encephalopathy or BSE.

This is the hidden health care risk that Canadians face and that the government in particular does not want to recognize. It does not want to recognize the big issues and the real problems that it could face. This is the hidden health care risk. It is out there behind the scenes and we do not know just how quickly it is going to rear its ugly head.

We have chronic wasting disease in deer and elk. We have BSE potentially being spread from blood product, from beef and sheep and animal products that have not been prepared properly. We expect that it will be just as big an issue in Canada as it was in Britain unless the government is willing to be proactive and do something about it in a very proactive way, take a risk, spend some money, find out what the problem is and do something about it to protect our health care and protect our agriculture industry in Canada.

What will the government do about it? The government has done nothing so far.

[Jeannot Castonguay, Liberal, Madawaska—Restigouche, NB]

Madam Speaker, I thank the member for sharing his concerns. They are concerns I have as well, even if I sit on the government side. Furthermore, this is one of the reasons I ran for office. I will answer the second part of the question and come back to the first part later.

With respect to BSE, the human form of which is known as Creutzfeldt-Jacob disease, this is a disease which has been known about for quite some time already. The problem right now is knowing whether so-called mad cow disease is the same as Creutzfeldt-Jacob disease. How is this disease transmitted? The answer is still not known.

I am very happy when I see our government investing substantial amounts in research and development to work on this very sort of problem.

As for doctors in the regions, it is true that there is a problem. Sometimes, I have a lot of trouble understanding, when I see that federal transfer payments to my province are not put immediately into health care. We do not know why.

I agree with the earlier speakers who said that the provinces must be truly responsible. The provinces must have the strength of their convictions and tell us what they are doing with the money that the federal government is transferring to them. If they cannot do that, we should look after the health care system for all Canadians.

[John Williams, Canadian Alliance, St. Albert, AB]

Madam Speaker, I have only a couple of comments after listening to the self serving drivel put forth by the Minister of Health and the member for Madawaska—Restigouche.

There are two points I want to talk about. He talks about helping with grants and contributions to deal with substance abuse. Let me tell the hon. member about substance abuse. Last week we dealt with the public accounts. A lady by the name of Lorraine Stonechild was at the public accounts committee telling us how her brother died of a drug overdose because he was given 300 prescriptions in one year, all paid for by Health Canada. Each and every one was paid for by Health Canada. It killed him because there is no control on Health Canada in how they distribute drugs, and substance abuse is rampant in the first nations because of it.

The member talked about air quality, but what about ground quality such as the Sydney tar ponds in Nova Scotia? The people are demanding that the government move them out of there because the place is making them sick, and Health Canada is doing next to nothing.

When will the government look after the first nations of the country? When will the government look after the people of Sydney, Nova Scotia? They deserve an answer to what the government and Health Canada are doing because they are killing them.

[Jeannot Castonguay, Liberal, Madawaska—Restigouche, NB]

Madam Speaker, with regard to the issue of drug overdose, I agree that there are problems. We often point a finger at the problem, but there are also many positive things about the health system.

A very important reason to invest in telecommunication technology to allow the various stakeholders in health to share information is precisely to try to prevent such unfortunate incidents.

As for the issue of ambient air, we should invest in this area. I would be dishonest if I commented on the issue of tar ponds, because I do not have any expertise in this area.

I can say that a lot of pressure is being exerted within our government to find solutions to this problem. We will continue to work to that end.

[Paul Szabo, Liberal, Mississauga South, ON]

Madam Speaker, I believe that report of the Department of Health on plans and priorities clearly demonstrates that Health Canada is focusing its efforts and its resources on the health priorities that make sense for the people of Canada. However, to understand these estimates, we must first understand the role the Government of Canada plays in our health care system.

We know that the delivery of health care services is almost completely under the jurisdiction of the provinces. They decide how services are to be organized. They negotiate with physicians and nurses and they set overall provincial funding levels.

The health of Canadians involves far more than just the delivery of health care services. The Government of Canada has a set of distinct roles that reflect its wide perspective. The funding provided in these estimates support the achievement of those roles.

One aspect of the basic operations of Health Canada is our health care policy. This involves many elements of co-operation with the provinces, the territories and the new territories in order to ensure that all Canadians have a health care system that works for them.

Much of that collaboration will be aided by the implementation of the first ministers agreement on health which was signed by the first ministers last September. By putting $18.9 billion more into funding over the next five years, we will go a long way toward revitalizing our health care system for the 21st century.

The Government of Canada did far more than just agree to increase health and social transfers. It set up three targeted funds: $1 billion for medical equipment, $800 million for innovation and reform, and $500 million to strengthen information technologies so that we can move ahead in areas such as tele-health programs that will allow people in remote areas to contact medical experts in large cities.

One priority that will be particularly interesting for Canadians, and these estimates will help support it, is the work that will take place with the provinces, territories and outside experts to define common indicators. It will mean that Canadians will be able to look to a consistent set of indicators that cover health status, health outcomes, and the quality of service across Canada.

I also want to note the funding for the new tobacco control strategy of $480 million over five years.

I also want to mention the investment in improving the health of our first nations and Inuit. This is a basic constitutional responsibility of the Government of Canada and it involves many elements.

I have many other points to make, but let me conclude. Canadians expect the Government of Canada to take a lead role on health issues and to take those responsibilities very seriously. That is precisely what the Government of Canada does.

[The Acting Speaker (Ms. Bakopanos)]

It being 10 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 Motion No. 1. Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

[Some hon. members]

No.