Mr. Speaker, before beginning my speech I wish to inform you that I will split my time with the hon. member for Terrebonne—Blainville.
Today, we decided to debate an issue that concerns each and every citizen, without exception. Indeed, in the wake of the Romanow report, the Bloc Quebecois proposed the following motion, as amended:
That the federal government give the provinces the additional money for health unconditionally, with the promise of the provinces to use all of it for health care according to the priorities they have established and to provide an accounting to their residents.
As we know, this is an issue that people feel strongly about. There are two reasons why this debate is so emotional. First, if we all agree that the quality of health care affects all of us, it is because sooner or later, directly or indirectly, we will all be confronted with the reality of illness and, of course, with how we should ensure quality care.
Secondly, in this case, the federal government's interference in provincial jurisdictions is another contributing factor to the tension that exists in our debates.
However, the last thing we are going to do is get carried away by our emotions, because we want to be able to objectively lay out all aspects of the issue. It is in this spirit that, together, we will briefly examine the findings and the impact of the Romanow report on the future of health care.
If we take a pragmatic look at the society in which we live, we can see that the current problems with our health system are really just the tip of the iceberg. Two factors are exacerbating the current situation. The demographic decline of recent years, combined with the aging of the population, forces us to the following conclusion: while there will be a larger number of sick people, there will be fewer taxpayers to fund health care. Therefore, it is essential that governments reinvest in health.
Also, the budget cuts made in recent years to put our fiscal house in order have seriously affected the quality of health care in the various Canadian provinces. These are the findings. Now, what should we do?
As mentioned earlier, the debate deals with an area of exclusive provincial jurisdiction. If we were to oversimplify things, but we all know that we will not do that, we could tell the provinces that it is up to them to provide citizens with the best health care services their tax dollars can buy and to eventually reinvest in health care. Unfortunately, our everyday reality is a sad one, because of the fiscal imbalance between the provinces and the federal government.
In fact, all of the stakeholders, except for the federal government of course, recognize the fiscal imbalance and Ottawa's underfunding of health. For every dollar spent on health care, the federal used to contribute 50¢, but now its contribution is down to 14¢. The public is right to request additional money for health. In fact, the 1993-94 data on the Canada Health and Social Transfer indicate that the federal contribution accounted for 22.4% of health expenditures in Quebec. However, the trends and the forecasts indicate that it will have dropped below 13% by 2005-06.
These statistics leave no doubt in our minds. Health care is seriously underfunded, which is why we totally agree with a significant increase in health funding.
After 18 long months, Mr. Romanow seems to have arrived at a conclusion that everyone has known for many years. However, what does he propose to solve the problem?
First, the former Premier of Saskatchewan says that to fix the health care system, the federal government should inject an additional $15 billion over the next three years. In fact, these billions of dollars should be given back to the provinces in the form of federal transfers, since it is money that belongs to them. The provinces should be able to use this money to develop appropriate action plans that are tailored to the problems that each province is experiencing. Even though the problem of population decline due to aging is a pan-Canadian phenomenon, the fact remains that the provinces are dealing with specific situations that require distinct solutions to be developed.
I would not wish this on anyone listening, but if you were suffering from pneumonia, for example, and I were to give you money for you to purchase medicine, but I forced you to buy ointment and bandages with this money, it would not be of much use to you. That is what the Romanow report wants the federal government to do.
My experience from nearly four decades in nursing, first as a nurse and then as an instructor, has taught me that no one is better placed than people who work in health care to find the appropriate solutions to specific problems. It is certainly not up to the federal government to tell us how to use the money that belongs to us in Quebec. It is up to the Government of Quebec, together with health care stakeholders, to decide on the best way to use money allocated to health care.
Even though the Romanow report came to the conclusion that the health care system is underfunded, we must question the real usefulness of the report. In Quebec, we have known for a long time that it is critical that health care budgets benefit from more money, particularly through increased federal transfers, as was confirmed by the Quebec commission on health care and social services led by Michel Clair. The Senate also conducted a similar study, the Kirby report. Was it really necessary for the federal government to spend some $15 million to tell us, 18 months later, what we already knew, and, adding insult to injury, to recommend that the federal government have a role in administering that which is none of its concern?
This is where the fundamental flaw is in the Romanow report. Having recognized that the federal government needs to invest more in health care, Mr. Romanow suggests that Ottawa should tie future federal transfers to certain conditions on their use. No way.
How can a former provincial minister have the nerve to recommend that the federal government meddle in an area that is exclusively under provincial jurisdiction? The Bloc Quebecois is not alone in its indignation. The Quebec National Assembly gave unanimous support to a motion along these lines. The Quebec Federation of General Practitioners and the college of physicians have expressed regret at the federal government's attitude in wanting to impose conditions. The father of the Quebec health insurance system, Claude Castonguay, finds it unacceptable that the federal government is trying to interfere in provincial affairs. Finally, the public is wondering whether once again they will be the ones to lose the most in these virtually endless quarrels over jurisdictional boundaries.
To see the federal government toying with whether to impose or not to impose a Canada-wide action plan is not only disturbing but also insulting to the public and their elected representatives. The matter needs to be decided upon clearly and without hesitation: it is up to the provinces, and only the provinces, to decide what is the best way to administer health care budgets.
Instead, we have been treated this past week to some disconcerting position-taking by the federal Liberals. While the Prime Minister still maintains that he will look after reaching an agreement with the provinces, the Minister of Industry comes charging in and announces that the federal government ought to proceed without worrying about what the provinces think. With statements such as this, this blundering minister has once again missed the opportunity to close the gap up a bit between him and his colleague from LaSalle—Émard in the leadership race. In fact, his words are evidence of his total disdain for Quebec and of his lack of respect for jurisdictional boundaries.
We agree that the funds transferred to the provinces as a reinvestment in health must be allocated in their entirety to health care.
This is why the Bloc Quebecois motion specifies that the provinces must undertake to use all of the additional money for health care.
This assurance is, in my opinion, and that of the entire population, the only thing the federal government has the right to demand.