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House of Commons Hansard #39 of the 37th Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was provinces.

Topics

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1 p.m.

Canadian Alliance

Rob Merrifield Canadian Alliance Yellowhead, AB

Mr. Speaker, the member is absolutely right. The provinces are the front line deliverers of the services. People cannot tell me that home care is the same in downtown Toronto as it is in what we could say is the outback of Saskatchewan, the remote areas of Saskatchewan. From that perspective, provinces have the ability to deliver on their mandate and be much more in tune with what needs to take place. The caveat here is that we cannot and should not allow the provinces to take federal money without some accountability measures.

The provinces should be asked how will they spend those dollars to force measurable outcomes that will drive efficiencies and sustainability into the system as we move forward into the 21st century. We say there should be a collaborative approach. If we do not go there, the mandate of the federal government will not be followed. We must be mindful that the mandate for the federal government is accountability.

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1 p.m.

NDP

Dick Proctor NDP Palliser, SK

Mr. Speaker, often in the House we are treated to or forced to endure from members of the party this member represents lectures about how they are the only folks who follow public opinion and the grassroots in the country.

I wonder if the member would comment on the fact that in today's newspaper we read that two-thirds of Canadians have a high level of support for the Romanow report. The company that did the survey said that “Canadians have formed a 'working consensus' in favour of Mr. Romanow's report”. Basically they have said that this is right prescription for medicare. The working consensus is widespread. It is a majority in every province and in every population group, and this also refers to income level and age.

Would the member in his answer also tell us where the efficiency and the sustainability are that he keeps alluding to in the private sector? Mr. Romanow said throughout the report that he could not find it.

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1:05 p.m.

Canadian Alliance

Rob Merrifield Canadian Alliance Yellowhead, AB

Mr. Speaker, as for listening to the public, we have to be careful about knee-jerk reactions of a public that may be sort of wrapping their heads and their ideas around this report. It is not really important whether they agree with the report or not. What really is important is whether the government is going to implement anything coming out of the report. That is the real test of whether we are or are not going to get health care reform in this country.

On the other question of private sector sustainability, Mr. Romanow said, “Show me the beef”. He was shown the beef from a private clinic, Brian Day's clinic in B.C., where a number of orthopedic surgeries and other surgeries are done. Mr. Day said he showed him the beef when he proved that he could do it in 60% less dollars and more efficiently, and Mr. Romanow did not eat it. I think there is an ideology problem and that is why Mr. Romanow came out where he did.

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1:05 p.m.

NDP

Judy Wasylycia-Leis NDP Winnipeg North Centre, MB

Mr. Speaker, I am very pleased to be able to participate in this debate and to very clearly indicate on behalf of all my colleagues in the New Democratic Party our opposition to the motion from the Bloc.

With due respect to the members of the Bloc, we want to say today that the motion is not based on fact and is very destructive and hurtful to the possibilities we have before us in terms of the future of health care.

The motion is clearly, word for word, identical to the motion that was proposed by the Péquiste government in the assembly just this past week. It is--

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1:05 p.m.

An hon. member

Supported by everyone.

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1:05 p.m.

NDP

Judy Wasylycia-Leis NDP Winnipeg North Centre, MB

Yes, as the member says, it is supported by all in that assembly.

My point is that this does a great disservice to the possibilities we have as a Parliament to deal with this very difficult issue and to go forward with possibilities that before now were not there.

We all know that in fact the relations between the federal and the provincial governments have become very dysfunctional. We are as concerned as the members of the Bloc are about that dismal relationship and the absolutely arbitrary, unilateral mode of operation by the federal government. We share those concerns, but we want to say that the report by Mr. Romanow does not in fact give permission to the federal government to continue that kind of destructive course of action. It opens up the possibilities for us to begin anew, to re-establish a working relationship between the federal government and the provinces and territories.

With the Bloc coming out so quickly off the mark and the PQ government coming so quickly out of the gates to condemn Romanow, I worry that in fact we will lose the opportunity, this one last opportunity, to build something new, fresh and constructive.

I do not want to condemn the work of the Bloc, because it certainly has come to the House with a great number of ideas, but I want to say that I think the motion today is hurtful, it is destructive and it is not based on the facts as we know them from the Romanow report.

I also want to say that it is just as destructive for the Bloc to come forward with the motion as it is for members of the Liberal government to immediately condemn discussions about how to negotiate with the provincial governments. I condemn just as much the Minister of Industry coming out two days ago saying that there is no room to talk with the provinces and that the money will be put on the table and the provinces can take it or leave it. I condemn that as much as I condemn the initiatives by the Bloc and by the PQ government, as well as the extremely hasty and unhelpful remarks made by the premiers of British Columbia, Alberta and Ontario, all of whom, joining with the privateers of our health care system, want to put the nails in the coffin of medicare before the government comes out with a plan to put into effect the blueprint provided by Roy Romanow.

I want to say that the real failing in Parliament today is not the Bloc's motion, and it is not even the provincial governments or the privateers, it is the Liberal government's failure to come forward with a plan based on the Romanow recommendations, to put something on the table to provide a basis for discussion. Because we know what is happening: Without that kind of leadership we have exactly what we had before. We have a whole lot of people trying to advance their agenda and the interests of Canadians are the last to be considered.

It is long overdue for the Minister of Health to have come forward with some broad idea about the Romanow commission. It has been a week since Romanow reported. There is still nothing. There is a meeting tomorrow of the health ministers and there is not a slight indication about what the federal government intends to do. There is nothing but rhetoric, nothing but musings, nothing but saying, “We're open-minded”. It is high time the government actually came forward with something if we are really, truly serious about medicare.

There was a comment that my 13 year old son made following the Grey Cup game in Edmonton, the game that saw the Montreal Alouettes victorious over the Edmonton Eskimos, a game where the Minister of Health was present and involved in the start of the game.

My 13 year old son, Joseph, noticed that part of the proceedings and said to me “Let us hope the fate of health care in this country does not come down to a simple toss of the coin”.

Out of the mouths of babes, of children and young people come some of the most profound understandings. Clearly in this case I think children and Canadians everywhere understand what is at stake and understand that the government is failing us yet again by refusing to come forward with leadership, with plans and with an openness to discuss with all partners and all provincial governments how we can proceed together on a cooperative basis.

I want to calm down for a minute and try to talk a bit about the opportunity we have before us. Although I may disagree with the motion from the Bloc, I appreciate the fact that we have a chance to debate the Romanow report. Without the motion there would not have been an opportunity presented by the government of the day for us to do this. We are trying to get some time on the health committee agenda and that seems to be futile. At least we have one day to talk about Romanow.

It is the first opportunity we have had and it is a very important opportunity to discuss our future health care options and to talk about the fact, and let us be clear, that this has been the most significant investigation into Canada's health care system in decades. Whether we agree with it or not, at least one has to agree that this has been a profoundly important investigation and truly monumental in terms of its findings.

The work of the commission on the future of health care has been an investigation in the true sense of the word. It sought to uncover sound evidence on the viability of the options before us and it conducted that investigation with an open mind, exploring all options and providing the opportunity for all interested Canadians to participate in those discussions and dialogue.

The commission, as members from all sides of the House will know, collected independently commissioned information from all kinds of experts and advocates in the field. The member for Hochelaga—Maisonneuve likes to quote from one of them when it suits him, and that is the study by Queen's University entitled “Federal-Provincial Relations in Health Care”. I might suggest that the member read this report more carefully because the recommendations that he thinks are so good in this report of a few weeks ago are precisely the recommendations of Roy Romanow, where he talks about a cooperative approach to decision making and an end to the unilateral arbitrary ways of the past.

We know there were public hearings all over the country. There were public hearings in every centre in Canada. There were public hearings in Montreal and Quebec City. The people of Quebec had a chance to speak and their views, are reflected in this report.

The website of Romanow had 24 million hits in total. One could say four out of five Canadians actually had an impact in terms of registering their views with Roy Romanow. Canadians responded to this very forthright effort. We know that. They spoke out about the values that were most important to them, whether they were from Alberta, Nunavut, Quebec or Newfoundland, all with different circumstances but all with a common desire for equitable access to quality health care. They all saw that as their shared right as Canadian citizens.

One item on the must do list of priorities of Canadians was to make the system more accountable. They had experienced the harmful consequences of the Liberal government's lumping together of all social programs, health, post-secondary education and income, support all under one accountable hodgepodge of the CHST. I remind the House that the concept was engineered by the member for LaSalle—Émard, the architect of probably the most destructive social policy in the history of this country. Let us not forget that. He has some accounting to do to the House, especially given his prospects for leadership and ambitions for the future.

The people of Canada listened very carefully to the Auditor General's report to the House about how the federal government had no idea how the five principles of medicare were being implemented. They commented on how the government had failed in its self-imposed ignorance to enforce the act. They recognized, and I am sure the Bloc agrees with this, that the Liberals had proven themselves to be the Keystone Kops of health care in Canada today.

Canadians also witnessed the performance of federal, provincial, and territorial governments with respect to the $100 million medical equipment fund set up by first ministers to help meet, Canadians believed, the gap in access to diagnostic equipment and new technologies, created by this government choosing tax break giveaways over health investments.

They saw results that included lawn mower purchases over investments in medical equipment. We heard this from members from New Brunswick. Canadians want accountability built into our system. Mr. Romanow has done that by suggesting that we add a new principle to the Canada Health Act and that is the principle of accountability. That means accountability for everyone, not accountability of provincial governments but accountability to the people of Canada by the federal government as well as provincial and territorial governments.

Canadians recognize that tax dollars are limited and health resources are scarce. We must do everything we can to recognize the need for accountability in the delivery of health services to Canadians. Some provinces have built in to their own operations stringent accountability provisions. It is puzzling to say the least that they could, with straight faces, turn around and say that the federal government should not be accountable to its taxpayers for how it spends its money.

Short of ideology and political posturing, it is hard to grasp the logic of the complaints from the Bloc and others that somehow Ottawa will be directing provincial health decisions or that Ottawa bureaucrats will be put in charge. The Bloc likes to remind us that Mr. Romanow served as an NDP premier, a fact of which we are very proud of. Because of that experience, he has been very sensitive to jurisdictional questions. He has been absolutely sensitive to the issues being raised by the Bloc. Mr. Romanow has gone out of his way not to recommend dictatorial authority for the federal government. In examining the evidence and the challenges ahead, he has recognized that these issues are too big to be effectively dealt with individually by provinces or territories and that there is an active role to be played by Ottawa.

Mr. Romanow has said that a national effort is needed, not a federally controlled effort, built on national intergovernmental cooperative approaches, approaches that are a step beyond the parochialism of the past and the jurisdictional bickering while Rome or in this case health care burns. Provinces, territories and the federal government all claim to want to put the health needs of Canadians ahead of jurisdictional quarrelling and squabbling. Romanow's recommendations give us a chance to prove that.

Canadians would rather have their health spending accountable to public sources, including the federal government in Ottawa, than to multinational health corporations in New York or California. We certainly believe this is the feeling of the people of Quebec, les Québécois, as much as Canadians elsewhere. I challenge members of the Bloc to say otherwise.

Canadians spend more than $100 billion on health each year. That is big business and attractive to big health corporations seeking to expand their markets and their profits. However disappointing as it may be, it is not surprising to see the advocates of for profit health care trying to get a bigger chunk of that money by attacking the commission's recommendations and its work. Maybe that is not behind the Bloc's motion, but it is certainly something that must be put on the table today. The solid evidence based foundation upon which the Romanow commission has developed its recommendations has left for profit promoters with nothing but empty rhetoric that has no resonance with the informed Canadian public.

However that does not stop them. If anything, it has made them more desperate. We have seen that today in terms of the comments from Alliance members and we have seen it from the likes of Senator Kirby and others who are actively trying to discredit commissioner Romanow's work. In fact in unprecedented arrogance, they are trying to dismiss the wishes of Canadians as clearly and unambiguously expressed through the Romanow commission. This is very telling indeed. It is telling of the lack of influence that Canadians could expect from a corporate run health system.

Canadians have a choice to make about the vehicle to take us through to the future of health care.

Senator Kirby and his corporate pals want Canadians to buy into the private for profit model. They want us to do so based solely on the advertising, the manufacturer's brochure, about the smooth ride profit driven care will provide.

The Romanow commission, on the other hand, has checked all the consumer reports on for profit care. Private for profit care has been extensively road tested. Commissioner Romanow has checked the results in the United States, Britain, Australia and elsewhere around the world and the reports tell us that the wheels fall off, that this vehicle that may look great in the glossy brochure will not get us to where we want to go. Part of the deal we see is to agree that someone can siphon off the gas, the tax dollars, the very fuel we need to move forward.

Romanow has also found that the fine print on the contract says that when the wheels fall off, we cannot take the vehicle back because of international trade agreements. Romanow has not bought that and Canadians do not want to buy it.

Commissioner Romanow looked very carefully for the most effective way of maintaining the sustainability of our public health system. In his final report, he agrees with all of us in the New Democratic Party and so many Canadians that sustainability is not simply a matter of throwing more money at the problems. It requires a coordinated strategy to reduce the causes of poor health, to adjust health care delivery to the most efficient and to commit a stable, long term investment in public health services. Money alone, without a strategy to deal with Canada wide issues like health human resourcing, drug costs and the like, will lead us down a dead end road. These issues do not stop at city limits, at regional groupings or at, in particular, provincial and territorial boundaries.

We are Canadians in one country looking for one sustainable health care system that will serve all of us in good times and bad, no matter how much money we make, no matter where we live. We are looking to the government to chart a course based on the wishes of Canadians, expressed through Romanow.

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1:20 p.m.

Madawaska—Restigouche New Brunswick

Liberal

Jeannot Castonguay LiberalParliamentary Secretary to the Minister of Health

Mr. Speaker, I want to thank my hon. colleague for speaking from the heart.

I had the opportunity to work in the health sector for several years before being elected here. We often hear about medically necessary services. Should that be defined somewhere so that we know exactly what we are talking about, or should it be left open as it is at the present? Everyone argues about what should and should not be covered.

I would like the member to comment on this.

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1:20 p.m.

NDP

Judy Wasylycia-Leis NDP Winnipeg North Centre, MB

Mr. Speaker, I appreciate the question about what to do with the term “medically necessary”. Roy Romanow looked at that very carefully throughout 15 months of consultations. I believe his recommendations address the concerns about the definitional problem around the term “medically necessary”. I believe that he proposes a very productive way to deal with this problem, which is in line with the concerns of provinces.

He proposes a coordinated national strategy to be addressed, to be a focus in terms of future work, through a national council on health care and a national drug agency as two examples of how one can coordinate efforts through all our jurisdictions, at all levels, and come up with broad standards, programs and provisions that will ensure that we are all operating from the same book and we are all basing our decisions on science and evidence.

I think Romanow recognizes that it is not for him or for politicians to define what is medically necessary. It is the work of professionals, doctors, nurses, health advocates, researchers and scientists to give us the evidence. It is the role of government to use the evidence in the most effective way. What has been clearly lacking is the federal government's refusal to actually provide that kind of leadership and coordination.

One of the most significant recommendations of his report is that there be a national coordinated strategy for something as basic as reviewing the safety, efficacy and cost effectiveness of drugs, something all premiers wanted when they met. The reason they took some of this action into their hands was the failure of the federal government to act.

Furthermore, he recommends a national formulary so we can work together and avoid competing among each other in terms of drugs being promoted by pharmaceutical drug companies, sometimes without reason and sometimes just because it means bigger profit margins.

We have an opportunity now to be very responsible and effective in our decision making. I would suggest that this recommendation is one of the most significant, in terms of the Roy Romanow report, and an area of top priority for the federal government.

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1:25 p.m.

Bloc

Réal Ménard Bloc Hochelaga—Maisonneuve, QC

Mr. Speaker, I would like to thank my colleague for her speech. As usual, it has that elegant leftist flair. With all due friendship, I am afraid that her wish for just one health care system in Canada is not possible.

In fact, the father of the health care system in Quebec, Claude Castonguay, pointed out the huge gap between the Clair report and the Romanow report. Can the member acknowledge that the situation in Alberta is not the same as in the Yukon and that the situation in the Yukon is not the same as in Quebec, and that the federal government is in no position to assess the needs of the people? That is why the Fathers of Confederation wanted health care to be a provincial responsibility.

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1:25 p.m.

NDP

Judy Wasylycia-Leis NDP Winnipeg North Centre, MB

Mr. Speaker, the beauty of the Romanow report is that it recognizes the reality of all of our experiences wherever we live in this country. It makes a point of ensuring that we adopt a system that allows for flexibility to meet the needs in each of our provinces and to help provincial governments meet the needs of their citizens.

The Bloc is all hot under the collar about the fact that Romanow is recommending two things: first, that the federal government increase its share of transfer payments in cash to the provinces to get us up to a minimum of 25% with a built in escalator clause so it grows as the economy and population grows. That is something I thought we were all in agreement about, yet the Bloc seems to have problems with it. That is something all provinces have asked for.

The second thing that the Bloc seems to have a problem with is the funding for innovating, upgrading and renewing our health care system so that it becomes community based, holistic, more cost effective, and based on prevention not on illness, community driven not institutionally based and so on. There are some wonderful recommendations on how to do that with flexibility for the provinces so that if they have a complete home care program in place they can take that money and put it to another part of the health care system. The Bloc seems to have a problem with that.

I fail to understand how something that ensures stability of funding and moves our system to a progressive innovative approach is negative and wrong. I would suggest the Bloc revisit the Romanow commission report and participate with Canadians and in fact citizens in its own province to use this opportunity and not lose this chance we have.

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1:30 p.m.

NDP

Dick Proctor NDP Palliser, SK

Mr. Speaker, I enjoy listening to my colleague from Winnipeg North Centre. I enjoy watching her as well, it is almost like watching an aerobic workout as she works her way through her remarks.

Implicit in the motion before us today is the idea that the Romanow report represents an intrusion into the right or ability of Quebec to manage its own affairs. Related to that, and I was referring to the poll earlier, it is particularly striking the high level of support of the Romanow report among Quebeckers, given the fact that political leaders from all parties in that province have been fiercely critical of it.

The vice-president of the polling company said that it appeared that Romanow and his group had struck a chord with the public in Quebec and perhaps had gone over the heads of some of those elites in that provinces.

I wonder if the member would comment on that please.

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1:30 p.m.

NDP

Judy Wasylycia-Leis NDP Winnipeg North Centre, MB

Mr. Speaker, I appreciate the question from the member for Palliser. I am glad I have been able to entertain him with my moving arms and energetic involvement in this debate. I hope it has not been too distracting.

The member has identified a key issue in this debate. Roy Romanow's recommendations were based on 15 months of consultations with Canadians who expressed their views and values directly to him. For the first time we have a complete reading of the opinions of Canadians without the obstacles posed by corporate elites or political leaders who are fundamentally opposed to the notion of the universal health care system in the first place. We have for the first time a wonderful reading of Canadians that should guide us every step of the way.

The problem that the Alliance has is that the values of Canadians, as reflected through the Romanow report, are not the Alliance's values and the members know that they are in a minority, not reflective of what Canadians want. They must come to grips with that because Canadians want a universally accessible health care system. They know that who owns the delivery of health care does matter because in the long run, it may lead to a non-system. It could lead to a patchwork of health care systems across the country where many would fall through the cracks.

What the government needs to do is take this valuable set of recommendations, come up with a blueprint and put it forward to the provinces. The government ought to be doing something along those lines tomorrow. It ought to be saying to the provincial health ministers that it supports the broad parameters of Roy Romanow. It should state that it believes that it can act on these areas immediately and that it will work together to flesh out the rest of the blueprint. That is the way to begin this process, break the log-jam and ensure that we do not lose this moment and do not lose medicare.

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1:30 p.m.

Progressive Conservative

Loyola Hearn Progressive Conservative St. John's West, NL

Mr. Speaker, I am delighted to have the opportunity to say a few words in this debate. I will be sharing my time with the member for Pictou—Antigonish—Guysborough.

The member for Palliser just mentioned that he enjoyed listening to my colleague. I certainly agree with him. He mentioned he liked watching her do her workout with her moving arms. I am telling him he is not the one within reach of those arms. I happen to be sitting right behind her. However, listening to her speak on health care issues is informative to all of us in the House.

I wish to refer to the motion that has been put forth by the Bloc. We have no real problem with the fact that provinces should have a major say in funding. We have no problem with asking the federal government to give the money to the provinces and having them decide how it is spent, as long as it is done in relation to the Canada Health Act and the principles of the act are adhered to. In fact, we have always advocated a sixth principle, which is stable funding to the provinces, and this we have not seen.

We have a tremendous amount of duplication in a number of areas throughout the country, health care being one of them. If the provinces, who are on the front line trying to decide how to use their meagre income, are influenced by decisions from someone from afar, we will see that duplication continue. In this case the provinces should have more input, as long as they abide by the proper health principles. Then we can all benefit from that.

In 1995 a change was made to how the provinces were funded. In 1995 the then minister of finance, in his wisdom, decided that the provinces would be provided with Canada health and social transfer payments, or CHST. These payments were on a per capita basis. We saw a severe reduction overall. From the best figures we have, it was around $6 billion a year. That means over the last seven years the provinces have lost $42 billion in health care funding.

Some provinces have been hurt more than others. People might ask, if we distribute money on a per capita basis, is that not the fairest way to distribute funding? Not necessarily. There is a basic infrastructure when funding is delivered. If a city has a large hospital and its population changes, one cannot necessarily go in with a power saw and cut off 10%.

We must also look at geography. It is much easier to deliver health care services in urban areas that have major infrastructure as well as the specialists involved, not only in health care but any system because people who have a choice migrate toward the major economic centres throughout our country for all kinds of reasons, personal, resource wise, family wise, whatever. No one could blame them for that.

However, the rural areas of the country are the ones that suffer. In the case of Newfoundland and Labrador, the method of distributing funding based on population has been a disaster. We are the only province with a rapidly declining population. Every other province in the country has a stabilized population or, in some cases, a rapidly increasing population. Over the last 10 years we have lost 40,000 people from our province. It might not sound like a lot in Ontario, but it is almost 10% of the total population of our province.

That means we have lost 10% of the funding. Let us look at the then minister of finance, the member for LaSalle—Émard, the person who wants to be the next prime minister, the person who now has all these grandiose ideas of how to improve all the systems, whether it be transportation, education, health care or whatever, throughout the country. This is the individual who cut social and health transfer payments to the provinces back in 1995. This is the person who sat by the Prime Minister for 10 years and nodded his head to everything that the Prime Minister said and did.

How can he now take himself away from the blame for the suffering that he put on the people of the country, particularly in relation to health care cuts? Newfoundland, Quebec and all the other provinces, especially those with large rural components where health care delivery is costly, have suffered tremendously because of the cuts by that minister in 1995.

Newfoundland losing 40,000 people meant that we lost almost 10% of the funding we would ordinarily get. We now get fewer dollars than anybody else, not on a per capita basis, because it is delivered on that basis, but in relation to need. We get fewer dollars than anybody else. The provinces all have increasing populations. We have a diminishing one. Not only do we get fewer dollars, but the people left behind are not the young, energetic, healthy people. They have gone to Alberta or to the Northwest Territories or to wherever they could find work, mainly because our fishery was shut down in 1992.

We have another pending closure coming up this spring. We are being told the cod fishery that has kept a number of communities alive in totality, that has subsidized the income that others would have from other fisheries, is being taken away. As I said this morning, we were crippled in 1992, we can be killed if this present decision is made, and we have the House telling us it is not an emergency.

The people who are left behind are the older people, the people who require more health care funding than those young, healthy people who had to go elsewhere to seek employment. We get fewer dollars to spend on a population that has greater need, and because of our geography we have to deliver these services over a rough, rugged, rural area. So the input from the government to Newfoundland is significantly less when it comes down to the amount of money that each person would receive in relation to the services provided because of the cost of delivering the service to our province.

That was the gift to us from the then minister of finance. Then, when the provinces, because of the burden that was put on them with the downloading by the government, have to turn around, because all of them are involved, and fill in the gaps, every other service in these provinces, especially in the poorer ones, is diminished. Money that should be going into education is not going into education. Money that should be going into infrastructure is not going into infrastructure. It is not there. It has to go into health, which is a priority for all of us.

We have another study, the Romanow report, one more study on top of all the others. Even though we admit there are a lot of good things in the Romanow report, especially as they relate to funding drug care payments for people who need the cost of drugs subsidized so badly, we look at home care services, which certainly is the best bargain that government could provide and needs to be focused on and assisted. But we also had the LeBreton-Kirby report that perhaps is of more substance than the Romanow report.

There is just so much to be said. If we do not move on these reports, then what is the good of having them at all? But if we do not move properly, it is just as well not to move.

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1:40 p.m.

Liberal

Jerry Pickard Liberal Chatham-Kent—Essex, ON

Mr. Speaker, I was intrigued by my colleague for St. John's West in his commentary about our previous finance minister and his track record.

It seems to me that I have a little longer memory of history. I remember a fellow by the name of Michael Wilson and I can remember a prime minister by the name of Mulroney, who continuously, from the time they were elected in 1984 and until 1993, overspent $40 billion a year, year after year.

Why did Paul Martin have to look at the books and straighten out some major problems? It has to be because--

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1:45 p.m.

The Acting Speaker (Mr. Bélair)

The hon. member knows that he should refer to the former finance minister.

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1:45 p.m.

Liberal

Jerry Pickard Liberal Chatham-Kent—Essex, ON

I am sorry, Mr. Speaker.

Why did the finance minister of the day have to correct what was happening? It was clearly because a government, a Conservative government, by the way, had the same theory that the member for St. John's West supports today, a theory that had driven the country into such debt that we had a terrible time trying to deal with it.

The question is not whether we should we have made changes. The question in my mind is this: Why did the Tory government of the day almost bankrupt the country and leave us with very little resources outside the billions required to pay down the debt and the deficit?

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1:45 p.m.

Progressive Conservative

Loyola Hearn Progressive Conservative St. John's West, NL

Mr. Speaker, let me give the hon. member a lesson in history and economics.

The Tory government left power in 1993 with a deficit of $43 billion. However, when that Tory government came into power, the deficit that it inherited from the Trudeau era was between $36 billion and $38 billion of that.

What happened? During the years that the Tories were in power history will show and Hansard will show that the Tory government, even though it was high in debt, did not try to balance its budget based on cutting from the people who needed help, based on cutting health and education funding.

What did the Tory government do when it ran a deficit and interest rates were at 23%? It still did not cut social payments. The Tory government developed a plan to address the deficit. The plan included free trade and it included the GST, two topics that those members over there benefited from. They campaigned against bringing in such programs. They got elected on that basis. They deceived the Canadian public and then benefited from free trade, the GST and, because of that, the lower interest rates--

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1:45 p.m.

The Acting Speaker (Mr. Bélair)

Order, please. We have somewhat deviated from the subject at hand.

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1:45 p.m.

Bloc

Antoine Dubé Bloc Lévis-Et-Chutes-De-La-Chaudière, QC

Mr. Speaker, speaking of management by the federal government, I would ask my colleague for his opinion.

I mentioned that, in 1994, there was $8 billion in unpaid taxes; in 2000, $1 billion was lost in human resources; in 2001, $400 million in income supplements were not paid to seniors; in May 2002, there was the sponsorship scandal, and now it seems that the cost of the firearms registry is almost up to $1 billion.

Does he think that the government deserves the criticism that he just expressed?

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1:45 p.m.

Progressive Conservative

Loyola Hearn Progressive Conservative St. John's West, NL

Mr. Speaker, my colleague is so right when we look at what has been done. I talk to seniors. I am picturing one couple and it could bring tears to my eyes. The gentleman has developed Alzheimer's. The only consolation they had was that they could drive out to their little cottage on weekends. The costs of the drugs he required, which are not covered by health care, were so great that they had to sell the car in order to be able to buy the drugs. No longer could they travel out to the little cottage.

I see seniors who are charged hundreds of dollars for prescriptions and do not have drug cards to cover it. We are now suggesting to the Canadian people that if they need better health care they had better be prepared to pay for it. I suggest to the Canadian government that if it managed its budget properly and eliminated the billion dollar overspending on gun control and the costs of funding its friends--

SupplyGovernment Orders

1:45 p.m.

The Acting Speaker (Mr. Bélair)

Order, please.

Resuming debate, the hon. member for Pictou—Antigonish—Guysborough.

SupplyGovernment Orders

1:45 p.m.

Progressive Conservative

Peter MacKay Progressive Conservative Pictou—Antigonish—Guysborough, NS

Mr. Speaker, it certainly is a pleasure to rise and follow my colleague from St. John's, who I think has given an important history lesson with respect to how we got to where we are today.

The importance and the timing of the motion could not be better. I want to similarly congratulate my colleagues in the Bloc for having brought forward the motion. What it deals with is certainly the obligation that the federal government has to fund health care but as well the responsibility it has to respect the provinces' role in administering it, which is of course something that continues to escape most members, including the member opposite who is chirping right now.

The administration of health care within the Canada Health Act is certainly what Canadians benefit from collectively. Canadians expect and deserve to have the issue of health care financing addressed. The problem is that ever since the federal government slashed transfer payments to the provinces in 1995 those provinces have been frantically struggling to keep up with the growing demands of health care.

Health care now commands 54% of the entire provincial budget of Prince Edward Island and 47% of all program spending here in the province of Ontario. It is not an exaggeration to say that health care spending is crowding out the provinces' ability to focus on other issues such as income support, social services and housing. We see provinces struggling to keep their financial heads above water and they face the real possibility that some may fall back into deficit if the health care financing issue is not resolved.

In my home province of Nova Scotia, I am very proud to say that the Progressive Conservative government led by Premier John Hamm has balanced the budget, for the first time in 40 years. The government has had to make some very tough decisions, obviously, but it was backed into that corner by the fact that this federal Liberal government has been choking off the provinces by cuts to transfer payments.

The issue of fiscal imbalance is being quite hotly debated among economists. Let me quote from the caledon commentary from this past summer. Joe Ruggeri, of the University of New Brunswick, stated:

...if cost pressures in health care spending are moderate and CHST cash payments increase in line with the growth of nominal GDP, the provinces and territories as a group would experience potential surpluses in the future, but much smaller than federal surpluses.

There is not much encouragement for provincial finance ministers in this forecast, because this is really what I would describe as a best case scenario. It is based on health care cost pressures being moderate. We already know that this simply is not the case in most, if not all, provinces. In a number of areas such as drug costs, nursing care and home care, we have seen phenomenal increases in costs, and that is before we address the demographic challenges of an aging population.

My colleague from St. John's also referred to the very significant issue of out-migration from rural Canada, particularly in Atlantic provinces, I would suggest,and in fairness, in all provinces.

In my constituency of Pictou—Antigonish—Guysborough in Nova Scotia, hospitals, like all those in rural Canada, are under extreme pressure and strain. The Guysborough hospital, St. Martha's Regional Hospital in Antigonish and the Aberdeen Hospital are being completely put under the gun to try to provide basic health care services. They are doing their best by being innovative and original and in many cases just simply making do.

The other question that is still not being addressed by the federal government is the shortfall from the federal cutbacks of 1995, which was not restored in 2000. The impact of that shortfall continues to be felt by the provinces and is the very reason that they are feeling the pressures that we see in the health care system today, pressures that are being experienced nationwide.

My point here is that it is really difficult to address other significant social policy issues when these larger issues of health care financing and the fiscal imbalance between a federal and a provincial government are outstanding.

There were some very important points made in the Romanow report and it is a welcome addition to the national debate. The ability to quarterback and in some ways implement some of the recommendations is now clearly in the lap of the federal government. Its ability to do so is something that we in opposition, and I suspect many in the country, question, because of the proposed reforms requiring tight cooperation with the provinces and the ability of the federal government itself to help coordinate that effort, and knowing that it is really the architect of the disaster and that the health care crisis is a net result of the $25 billion that was taken out of the CHST.

It becomes a question of credibility. It becomes a clear question of how can we expect the federal government to play its important coordinating role as the cash cow, as the source of funding, when it is in essence the architect of this. The government is the one that has put the provinces in this position. Therefore it lacks credibility. It lacks any significant ability to rally around with the provinces. It is tantamount to a pyromaniac coming into a person's living room, setting a fire and then saying that he will call the fire department.

To come back to the important issue here, the clear intention of Mr. Romanow's report is to look at the health care issue. It was an engaging exercise. It was something that Canadians certainly took part in. There were 25 million hits, as I understand it, on Mr. Romanow's website, coupled with the significant effort to travel and consult. It cost $15 million. We can put aside the issue of how many MRI machines that could buy or how that money might have been spent on health care. Yet many of Mr. Romanow's recommendations touched on the area of provincial jurisdiction, which is the focus of the Bloc motion.

There is a focus as well on the need for a strategy and the need for an allotment of money for specific areas. What we saw in other reports like the Kirby-LeBreton report that originated in the Senate and the Mazankowski report was a significant addition and contribution to this debate. What those other reports did that the Romanow commission report does not is they left open the issue of public funding of health care being enhanced by private sector participation by buttressing the public health care system, of course always done within the principles of the Canada Health Act. We will be watching what the current government does with the recommendations of all of these reports.

The constitutional division of powers must always be respected. The provinces have already balked at the issue of strings being attached. We are open to the idea of redefining and clarifying the principles of the Canada Health Act. We will closely scrutinize details of the definitions put to Parliament by the government.

As for the subject of the motion before us today, there is no disagreement from us about the fact that the current federal government is not doing its share in health care funding. We absolutely agree with the call for stable federal funding. During the 2000 election campaign my party proposed to add a sixth principle to the Canada Health Act, that is, one of stable funding for health care. We see now that the government is contemplating doing this. We know it is not opposed to poaching ideas; it has made a living out of doing that.

Our colleagues in the other place recently released the latest chapter in their study on the state of our health care system. Their conclusions, presented simply and straightforwardly, were that we need funding and structure. The health care system is not sustainable. If funding problems are not addressed and if serious reforms are not implemented, the system will continue to fail Canadians.

Our colleagues did not stop there. Rather than dance around the difficult issues, they have provided the government with concrete options to save our health care system, something that I would suggest is lacking in the Romanow report.

When it comes to the question of funding and the tool of funding, we are quite prepared to consider unbundling the CHST in the interests of transparency and accountability.

Finally, we do not object to a pan-Canadian agreement which includes provincial jurisdictions which are negotiated by the provinces and not dictated to by Ottawa.

We cannot emphasize enough that without stable funding, all of the other principles of the Canada Health Act are undermined.

Postcards for PeaceStatements By Members

1:55 p.m.

Liberal

Jerry Pickard Liberal Chatham-Kent—Essex, ON

Mr. Speaker, I want to recognize the efforts of grade six students from Queen Elizabeth School in Leamington, Ontario.

During Veterans Week in November, these grade six students, under the direction of their teacher Paul Forman, participated in the Postcards for Peace initiative. Each student took the time to write letters of thanks and appreciation to the men and women of Canada who served or are currently serving, calling them brave, calling them heroes, telling them, “We are proud of you and what you have done for our country”.

These efforts are testimony that our students are being taught good Canadian values and history. In times of peace, I think that is great.

I also want to take the opportunity to wish all the veterans and members of the armed forces, both at home and abroad, a safe and happy holiday season and the very best in the new year.

Queen's Jubilee MedalStatements By Members

December 5th, 2002 / 2 p.m.

Canadian Alliance

Deborah Grey Canadian Alliance Edmonton North, AB

Mr. Speaker, I recently had the great honour to award the following constituents of Edmonton North with the Queen's Golden Jubilee medal for their outstanding contributions to our community: Jim Acton, Kirk Bevis, Bill Bonner, Tom Braid, Lisa Clyburn, Martin Garber-Conrad, Marcel Hemery, Louis Ho, Rev. James Holland, Gerald Marshall, Lori Reiter, Shelley Tupper, Harry Vandervelde, Sandy Walsh-Schuurman, Ron Zapisocki, Auxiliary Constables Gloria Sawchuk and Brent Palowy, Lieutenant-Colonel Pat Stogran, and Marc and Marley Léger.

Marc's medal was awarded posthumously for his ultimate sacrifice as one of the four Canadian soldiers killed in Afghanistan. His wife Marley is an example of hope, poise and perseverance in the face of tragedy and loss. She is celebrating her birthday today. Although this will be a difficult day for Marley, I want her to know that there are many of us who are thinking of her.

Congratulations to everyone, and happy birthday, Marley.

Jean DupéréStatements By Members

2 p.m.

Liberal

Gérard Binet Liberal Frontenac—Mégantic, QC

Mr. Speaker, yesterday I heard the sad news that Jean Dupéré, the major private employer in the region, a great and unwavering defender of chrysotile asbestos, and an expert on mining, died at the age of 57.

Full of ideas, and a man of action and conviction, he loved to get things moving. He left an indelible mark with his expertise, know-how, determination and commitment. The region never would have survived the asbestos crisis without him. He was a great man and he will always be recognized as a model of determination. He fought tirelessly until the end.

The Frontenac—Mégantic community joins me in extending our sincerest condolences to his wife, Michelle Dupéré, his sons Mathieu and Simon, his daughter Catherine, and his many friends and loved ones.

I thank the Chair for allowing me to express my feelings and condolences here, in the House of Commons.