Mr. Speaker, it is a real privilege for me to get involved in the debate today. One of the problems we all face in health care is trying to deliver in a timely and efficient manner a service that has increased dramatically in cost while attempting to deal with the multitude of problems Canadians see.
Through discussions I have had I believe most people in Canada wish to see a health care system: first, that they can count on; second, that delivers the service in a timely and efficient manner; third, that makes sure doctors and nurses are available where they are needed; and fourth, that offers people affordable access to the prescription drugs they need.
Canadians are finding major problems with health care. A large group of people do not have the health care services that should be afforded to them. In the area I live in thousands of people are without a family doctor because there are not enough doctors to cover all families. People go to clinics or hospitals for health services and they receive them. However there is a doctor shortage in rural Canada and in smaller cities. We do not seem to be dealing with the question as well as we need to.
There are many reasons for the doctor shortage. First, we do not have a proper number of facilities to train health care professionals. A great deal of change needs to occur in our training and approval process to make sure we have adequate health care professionals be it doctors, nurses or technicians.
Second, 10 to 15 years ago dramatically incorrect assumptions were made which led to the crunch on doctors and nurses today. Many older doctors in Canada had gone on and on with their practices and never retired. In estimating how many doctors we would need in the year 2002 it was not taken into account that many of these doctors would take retirement. As a result we are short in that field.
We did not take into account the number of specialists we would have in the system. Those who specialize in obstetrics or various illnesses have been taken out of the general practice system. As a result the numbers of doctors to carry on family practice has been limited dramatically.
A new phenomena today is that there are clinics in many areas. Many doctors operating in clinics may not be able to handle the long term illnesses of seniors or people with cancer or other debilitating illnesses which require long term care. As a result family doctors are being more heavily burdened with patients who have long term illnesses that take up a dramatic amount of time.
I do not think anyone anticipated the high cost of drugs and medication. If we look at our medical costs today we need to add up not only the costs of hospital care, clinics, family doctors and specialists but the extremely rapidly growing cost of medications. These add to the system as well.
What has happened between the federal and provincial governments is a fight over who pays the bills. In the House today this is one of the areas we are managing. However I hope the debate does not stay limited to who pays the bills and whose responsibility it is. Although these are important questions for all of us it is more timely and important to look at critical issues in our ridings that Canadians face and that we need to deal with.
In my riding of Chatham--Kent Essex there is a young man who requires bone marrow transplants. He is a 24 year old gentleman by the name of Patrick Oxley. Last summer he was diagnosed as requiring a bone marrow transplant. His sister is a perfect match for him but over a six month period the operation did not occur. He has been sent back to the Windsor and Chatham area. The doctors have suggested they will not go on with the operation. This young 24 year old man has no future unless an operation occurs because the disease is deadly.
In my estimation and I believe in the estimation of all Canadians the situation is not appropriate. It is not an issue that can be sloughed aside. We must deal with issues of health care costs and immediate on time delivery so young men like Patrick Oxley will have an opportunity in the future.
There are people in the United States who are willing to operate on Mr. Oxley. The price tag is $100,000 U.S. The community of Chatham--Kent Essex is trying to draw together funds and donations to send Mr. Oxley to Michigan for an operation. Our health care system should be looking after this young man. When he had a perfect match several months ago it should have been dealt with. It should have been a high priority for the Canadian health care system.
Others look on this with a great deal of criticism and stress. If we are not delivering service to Canadians we are missing the real traditional value of the Canadian health care system. It must be dealt with at a federal-provincial level and at all levels.
As an example I have pointed out that thousands of people in my area do not have family doctors because of the shortage of doctors. This means there are many problems in the system. How do we handle the problems? The federal government has taken a strong position in trying to deal with the issues. It has appointed an independent person in the name of Roy Romanow to go across the country, look as carefully as he can at the health care system and come back with recommendations for improvement. The federal government is taking the preliminary steps required to search out the problems.
Mr. Romanow has pointed out clearly in his approach that he is addressing the key themes he has organized his work around. He wants feedback from professionals and everyone across the country on how Canadian values can be reflected in the health care system and how we can do so within the Canada Health Act.
We need to look at sustainability and funding, both important elements in where the health care system goes from this day on. We need to look at quality and access. These issues are not only important today. They will be important to all Canadians in the future. We need to look at leadership, working together and responsibility. We have a responsibility to all Canadians for our health care system.
One of the problems we have as Canadians is the guidelines in the Canada Health Act. The guidelines are not administered by the federal government. The federal government's role has been to work with a health act which ensures all Canadians have basic access to a health care system and certain types of services.
The federal government's role has also been to help finance the costs of health care across the country. Whatever is said and done it is important to realize that all governments, provincial, territorial and federal, must ensure the principles of the Canada Health Act are carried out. We must ensure all Canadians have an equal opportunity for good, decent health care. One of the fundamental privileges of living in Canada is access to good medical care, a privilege which has been built over the years by our forefathers and other people in the country.
The debate comes down to finances. That is a crass, hard way to look at health care. We must stop and think about the fact that we are missing something in the whole debate. If the debate is only about transfer payments to the provinces, agreements that have been made in the past, or blaming one government over the other we miss the important tenet that health care is for Canadians. All Canadians deserve the best health care possible. We must devise plans to move forward in the future.
I mentioned that the Romanow commission was one response the federal government had to move the agenda forward. It is a means of getting input from Canadians and coming up with an agenda to deal with health care, drug costs and all the issues that will be important to Canadians in the future. Over the short term we cannot say Mr. Romanow's report will have a major effect. It is not due until next December.
What have we been doing in the shorter term? It is important to point out to all Canadians that we worked with the provinces in last year's negotiations to put extra dollars into the health care system. In our 2001 budget we confirmed federal spending would be $23.4 billion more over the next five years than it had been for any period up to that point. We came up with an agreement which all provincial health ministers and premiers supported. It was supported by our Prime Minister, the House of Commons and the Minister of Health of the day. We attempted to inject a larger number of dollars into the health care system to make it go further and be healthier on a short term interim basis, the five year base, while giving us room to operate and find out what we need to do.
In his comments and direction Mr. Romanow said there were no sacred cows in the process. He said everything will be up for debate. He said everything will be there to make sure we have a system which will not only be functional but will deliver services to Canadians as need be.
We added $23 billion to bolster the costs of health care. What was the response from the provincial governments? I found it a bit problematic.
The response from the Harris government was “You're not giving us enough money”. It had just finished negotiating a deal with the federal government in which all provinces were included and the first answer from the premier of my province, Ontario, was that there was not enough money. He was not saying “We will match the funds that are going into the system” or “We will do everything we can with the resources that have been provided”, but was suggesting that Canada was not paying its full share.
I guess we can always look at different arguments and different points of view. I heard my former colleague, a gentleman from across the way, suggest that we cannot go back to a 1977 agreement and talk about tax points when we are talking about funding of health care. I do not know why we do not look back to the past and see how funding has occurred and look at the types of changes that have occurred in the funding of health care to see if we are being fair, adequate and honest with the Canadian public.
It is my view that when we reduced cash transfers to the provinces and handed them another vehicle by which they could raise that much money, plus it took into account increases over the years, we gave the provinces tremendous extra leeway in operating their own systems independently and doing it without as much need for cash transfers from the federal government.
I remember being elected and coming here in 1988. The buzz at that time was that we should make all transfers to the provinces on tax points. People were talking about not giving any cash transfers to the provinces any more but taking the whole cost of our social transfer, putting it onto tax points and allowing the provinces to operate independently. An obvious problem with this is that then the federal government gives up its responsibility to make sure all Canadians have fair and equal access to service. That is a problem.
I understand our colleagues from Quebec saying they would like all the transfers to go to Quebec, they would like Quebec to have a totally independent system and, as a result, they want to eliminate the federal government from health care. However, at the same time who guarantees that all people in all provinces get equal treatment in this country? Who would guarantee that all Canadians would have access to equal treatment in this country? That is problematic. That needs to be dealt with. It cannot be left to 13 or 12 independent bodies to decide how service is delivered, because we all know some areas are wealthier than other areas and therefore the wealthier areas would be able to afford a service that the poorer areas could not. That is not the Canadian way. That is not fair to all people. It is not what we see as a principle of health care in this country: how large one's wallet is and how much we can afford to make sure we deliver the service required.
Many issues have to be dealt with and I believe all issues within the health care system are critically important, but it seems to me that when people criticize someone they should have certain kinds of capabilities of analyzing what has happened in front of them. I do not know if most people realize that federal funding for health care in Ontario, and I am using the province of Ontario as an example at this point, is at an all time high. We have never funded health care in Ontario as much we do today. Federal funding for health care across Canada is at an all time high. People may argue about how it is being done, and that is true, but federal funding is at an all time high. I think it is important to realize that over 91% of the total increase in Ontario's health care budget this year comes from federal transfers, from the federal government. That is a pretty heavy cost for the federal government.
I believe the Ontario government has a problem. It has not looked very carefully at funding programs. It has directed its concerns toward tax cuts. Several other provinces may be looking at tax cuts as well, but generally we have to make certain that the basic services are there before we do tax cuts.