Debates of Feb. 19th, 2002

Government Response to Petition

[Geoff Regan, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Mr. Speaker, pursuant to Standing Order 36(8), I have the honour to table, in both official languages, the government's response to one petition.

Committees of the House

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

Mr. Speaker, I have the honour to present, in both official languages, the 14th report of the Standing Committee on Public Accounts on chapter 25 (Canadian Food Inspection Agency: Food Inspection Programs) of the December 2000 Report of the Auditor General of Canada.

I would also like to table the 15th report of the Standing Committee on Public Accounts on chapter 18 of the December 2000 Report of the Auditor General of Canada (Governance of Crown Corporations).

Finally, I am tabling the 16th report of the Standing Committee on Public Accounts on chapter 24 of the December 2000 Report of the Auditor General of Canada (Federal Health and Safety Regulatory Programs).

Pursuant to Standing Order 109, the committee requests that the government table a comprehensive response to these three reports.

Petitions

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

Mr. Speaker, I have the honour to present a petition containing several thousand names of people in St. Albert requesting the Parliament of Canada ban human embryo research and direct the Canadian Institutes of Health Research to support and fund only promising ethical research that does not involve the destruction of human life.

[Norman E. Doyle, Progressive Conservative, St. John's East, NL]

Mr. Speaker, I have a petition from over 300 people in St. John's and the Conception Bay areas who are requesting the Parliament of Canada to ban human embryo research and direct the Canadian Institutes of Health Research to support and fund only promising ethical research that does not involve destruction of human life.

I support the petition because the petitioners make the point that it is--

[The Speaker]

I think the hon. member knows that his views of the petition are not receivable at this time, perhaps in some other venue. I know he will want to stick with the rules in every respect.

Questions on the Order Paper

[Geoff Regan, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Mr. Speaker, I would ask that all questions be allowed to stand.

[The Speaker]

Is that agreed?

[Some hon. members]

Agreed.

Request for Emergency Debate

[The Speaker]

The Chair has notice of an emergency debate from the hon. member for Windsor--St. Clair.

[Joe Comartin, NDP, Windsor—St. Clair, ON]

Mr. Speaker, we are seeking an emergency debate on the ratification of the Kyoto protocol. As members will recall from question period yesterday, this has become an issue of great concern to Canadians. I would suggest this is as a result of issues and incidents that have arisen in the last week or ten days, in particular the incident between the Prime Minister and the premier of Alberta in Moscow and the proposal put forward by the president of the United States with regard to its program dealing with climate change and global warming.

As I mentioned, questions were asked in the House yesterday. Great concerns have been raised on both sides of this issue in the last several days because of the uncertainty as to whether Canada will proceed with the signing of the accord. On one side, people involved in the fossil fuel industry are gravely concerned about what it may cost them. On the other side, the industrial sectors, including the farming industry, the insurance industry, the tourism industry, and the list goes on, are concerned about the economical impact of global change on them.

In addition there is great concern for the health implications if we do not proceed with the Kyoto agreement and the impact it will have. I say that in relevance to my riding where we have a very serious health situation which has been impacted to some significant degree by transboundary pollution. This pollution would be alleviated quite significantly if we proceeded with the Kyoto agreement and the reduction of those emissions.

I believe there are grounds for this to be an emergency debate because there had been a good deal of debate on this issue which appeared to be inevitably leading us to signing the Kyoto agreement. However in the last several days a number of incidents have occurred which have changed that. The emergency debate would allow all parliamentarians to debate the issues and bring forward information as to where Canada could alleviate a great deal of the concern in the country.

[The Speaker]

The Chair has carefully listened to the arguments advanced by the hon. member for Windsor--St. Clair. While he has raised a very important issue, and I do not underestimate its importance, I am not sure he has met the exigencies of the standing order in respect of urgency in this case. Accordingly, I decline to order an emergency debate on the issue.

I note in passing that after today there will be five supply days remaining in the period to March 26. I believe the hon. member's party will have the next supply day and I am sure he will be pressing his case with his colleagues for inclusion of the subject matter in the debate on that occasion.

Supply

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

moved:

That this House condemn the government for withdrawing from health-care funding, for no longer shouldering more than 14% of the costs of health care, and for attempting to invade provincial areas of jurisdiction by using the preliminary report by the Romanow Commission to impose its own vision of health care.

Mr. Speaker, I will begin by indicating that I am going to be sharing my time, with leave of the House, with the hon. member for Charlesbourg—Jacques-Cartier.

With our characteristic sense of responsibility as the opposition, we are calling upon the government, and all parties in this House, to support this motion. It is presented by the Bloc Quebecois, but could equally be from all the provincial premiers, who have been discussing health at every annual meeting of first ministers for the past three years.

Each of them, regardless of political stripe—whether Conservative Bernard Lord of New Brunswick, or the New Democrats in western Canada—indeed all premiers are calling for the righting of an extremely worrisome situation for all those who believe in the viability of a public health system. What they find so disconcerting is the federal government's backing away from its commitments.

The members of the House of Commons in the 1960s, following the Pearson government's report that was published under the guidance of Ms. LaMarsh, laid the foundations of a public health system. If we checked, we would see that, at that time, the lawmakers' intention was to set up programs with costs that were shared equally, 50-50 by the federal government and the provinces that adhered.

The Bloc Quebecois motion is extremely clear. Right now, the federal government's contribution is 14 cents per dollar. This goes to show just how much the legacy of Lester B. Pearson is being betrayed, the legacy of those who believe in state intervention—and I recall, for example, that in 1968, the Liberal slogan was “a just society”—of those who believe in a just society, we must ensure that all have access to a viable, public, universal, integrated health care system. This just goes to show the paradox in which we find ourselves.

The federal government is calling on the provinces to fully comply with the Canada Health Act, with its five principles, yet the government itself, when it comes to funding and the commitments made in the early 1960s, is breaking both its word and the commitment it made.

It must be said loud and clear. We are betting today that, in the end, there will be a pledge of common sense, and that all parliamentarians, regardless of their political stripes, will support the Bloc Quebecois motion.

Let us make a little history today. I remind those listening that in 2000, all of the premiers called for a study. They asked their public servants from their ministries of finance and health to look into the major trends that would develop in the health care system in the coming years. They discovered three things.

First, if all of the provinces wanted to provide the exact same services that were available the previous year, they would have to add 5% more to the health and social services budgets. We know that the health care system will grow at a rate of 5% per year over the next ten years, at least.

In the study that was commissioned—not by the Bloc Quebecois or the Parti Quebecois; this is not a debate on the national issue, nor a partisan discussion—all public officials from each of the health and finance ministries came to the conclusion that health costs will increase by 5% in the coming years. A breakdown of this 5% can be made. We know that population growth accounts for 4.7% of this 5%, the consumer price index for 1%, while 1% is due to various factors, including the procurement of medical technologies and the changes that are being felt at the infrastructure level.

This is so worrisome that, with regard to this issue, the premiers commissioned a study entitled “Understanding Canada's Health Care Costs”. Let me quote from this study, which says:

Operating health expenditures for Canada are currently at close to $54 billion. Even with moderate changes in the pattern of service delivery—

So, if we do not change everything, if we do not revolutionize service delivery, even with moderate changes in the pattern of service delivery, it is anticipated that fundamental factors such as growth, the aging population, inflation and the cost of existing programs should trigger an increase of about 5% in health costs. This is the most important aspect of the study commissioned by the ten premiers.

This means that the expenditures of the provinces and territories regarding health costs will total $67 billion within the next five years, and $85 billion within the next ten years. Ten years is a very short period of time. When it comes to planning for an issue as important as the health system, administrators do it at least on a three if not a five year basis.

Members can imagine the situation the provinces are in. In Quebec, for example, $17 billion is spent on health care. Our province is not the one that spends the most and not the one that spends the least. It is in the fair median. But without some support, without some input into the re-establishment of the Canada social transfer, the provinces will never be able to meet this growth challenge, which has been diagnosed by each of the provinces.

Last night, when I was on the train, I was reading the submission made — the member for Joliette will be pleased about this —by the Centrale des syndicats du Québec. This is not the CSN, but I know about the unassailable co-operation that has always been prevailing among labour movements. Here is what was in the submission from the Centrale des syndicats du Québec, that is the former Centrale de l'enseignement, if I am not mistaken, which changed its name a year or two ago.

I think this is quite relevant. Here is the quotation:

At their August meeting, the premiers agreed to ask the federal government to re-establish, by 2004-05—therefore in two fiscal years—its contribution to health, education and social program funding, through the Canada health and social transfer, at the same level as iin 1994-95, when the Liberals came into office, and this government was funding 18% of the costs, and also to implement an appropriate indexing mechanism.

We know that all the premiers said “The federal government must at least contribute 18% of costs through the health transfer”. At this time, this contribution is 14%. This would mean that it should be contributing $28.9 billion, instead of $21 billion.

I have enough time to deal briefly with the Romanow report. This report is a huge hoax. As I am speaking, I am ready to table, with the House's consent, a research report which I have obtained and which shows that eight provinces out of ten have already had working groups on this issue. In Quebec, it was the Clair commission. There have been commissions in eight provinces and, as a result of their reports, the situation is well known. The solutions for remedying the situation with regard to the delivery of health programs that would be appropriate for the needs of the population are well known. It is the funding that is lacking.

Who asked for the Romanow report? Could anyone in the House name a provincial premier, a health minister or a finance minister who asked for an exercise like the Romanow report?

Last week, I was reading Mr. Romanow's interim report. Four possible solutions were outlined. It was suggested that public investment should be increased. An adjustment of responsibilities was also suggested. The report also talked about increased privatization and a reorganization of service delivery.

To conclude, I want to say that, on this side of the House, we believe, as all ten premiers have asked, that the option the Romanow commission should recommend is for the federal government to restore its contributions to the health system to the level of those that existed in 1993-1994 and to the level of the commitments made in the 1960s.

That is essentially was our motion asks for, and we do hope that every member in the House will vote for the motion.

[Richard Marceau, Bloc, Charlesbourg—Jacques-Cartier, QC]

Mr. Speaker, it is always with some apprehension that a member takes the floor after a speech by the very eloquent member for Hochelaga--Maisonneuve. With his flair for striking phrases, his passion and rhetorical talent, he is somewhat intimidating for some of us. I will nonetheless try to face the music and share with you and colleagues in the House a few remarks on the important issue before us.

This debate today is not new by any means. By way of background, I would like to explain briefly the overall evolution of Canadian federalism. I may be anticipating my conclusion, but this evolution has been such that Quebecers in particular are now faced with a choice between full control over their own destiny or a Canada that is increasingly centralized, and a leveler of all differences.

As far back as 1942, Ottawa used the war effort as an excuse to impose tax agreements on the provinces. Through these agreements, Quebec, then under the prime ministership of Adélard Godbout, transferred tax points in good faith and stopped temporarily taxing the personal and corporate income in exchange for an annual subsidy.

From 1941 to 1947, Ottawa exercised virtually total control over taxation. Worse yet, when the war ended in 1945, Ottawa refused to hand back to the provinces the powers of taxation they had given it. This spectacular takeover of crucial, significant and vital sources of tax revenue was the beginning of a long centralization campaign by the federal government, a campaign that is still going on.

By exercising the financial powers of the provinces, Ottawa was able to collect a huge portion of the tax dollars and to take upon itself to interfere in areas of jurisdiction where it did not belong. It used its spending power to define Canada-wide standards that totally ignore the division of powers as set out in the 1867 Constitution.

Several successive Quebec governments of all political stripes, from Maurice Duplessis of the Union nationale to the Liberal Party of Quebec and the Parti Québécois, are responsible for setting up a counter-attack to stop Ottawa from interfering in areas where it did not belong.

In 1966, the Canada Health Act was passed, followed soon after by the Health Insurance Act in Quebec. And that is also when it was decided that Ottawa would pay 50% of the health care costs and the provinces, including Quebec, would pay the other 50%.

Since then, the situation has taken a bad turn. Ottawa is withdrawing from the transfer of payments to the provinces through the Canada health and social transfer. This is absolutely unacceptable. The federal health spending share, initially at 50%, has dropped to 14%. Those listening will no doubt agree 36% represents a significant reduction.

Members across the way tell us “Look at the latest investments made by Ottawa; we have put money back in the health system and we are doing what we have to”. Finally, what they are saying is that all is well in the best of possible worlds.

Let us have a look at that. It is true that in the 1999-2000 budget, the federal government put $3.5 billion in a trust fund, the share of Quebec being $840 million. In the 2000-01 budget, the federal government did create a new trust fund of $2.5 billion and in September 2000, another trust fund of $1 billion for medical supplies.

While that money is useful for the Quebec health system, let us see what it truly represents. As a trade-off, the federal government insisted that five requirements be met. First, some funds are to be used for a specific purpose; this is what we call the “Ottawa knows best” attitude. Second, transfers made to provinces through these trust funds are a one-time payment, which means that there is no possibility of long term planning. As my colleague from Hochelaga—Maisonneuve mentioned, God knows that in the area of health there is a need to plan for the long term rather than to rely on band aid solutions. Third, once a province has spent all its share, it cannot get new funding from the federal government to maintain its spending level. Fourth, access to such funding to purchase supplies does not guarantee that Quebec will have the resources necessary to hire the personnel required to use these supplies. Fifth, as I said earlier, the creation of such funds makes budgetary planning more difficult.

This partial, incomplete, insufficient reinvestment by the federal government through trusts does not compensate at all the fiscal withdrawal practised by the federal government. I said that, from 1970 to 2000, Ottawa's share of expenditures decreased from 50% to 14%. Since 1994 only, the federal government's share of health expenditures decreased by 9 percentage points. Nine per cent in less than 10 years, that is completely unacceptable.

We are now getting into the political framework of all this. Only the Minister of Intergovernmental Affairs denies the existence of this imbalance. He is not acting in good faith. The federal government cuts health and education transfers. But let us return to the subject of today's debate, health. The federal government comes as a saviour and says “Look, I am giving you a little bit of money. Be content, even if instead of robbing you of $100 million, I take $25 million from you”. It is completely unacceptable.

It is really sad to see the federal government make savage cuts in health services, and act as a saviour afterwards. Some hon. members across the way say “It figures, it is mean separatists who say that”. But that is not true.

I would like to remind the hon. members that, when he was the rotating president of Canada's Premiers' Conference, Gordon Campbell, the Premier of British Columbia, also said, and I quote from a letter he sent to the Prime Minister of Canada on February 12:

Notwithstanding our ongoing efforts to contain costs, it is clear to all premiers that existing federal transfers to province/territories do not provide a sustainable basis on which to provide an improved quality health care to Canadians.

This is not a separatist refrain. All the premiers says so, unanimously. The funding put into health care by Ottawa is not enough to maintain the quality level that Quebecers and Canadians have a right to expect.

When even the leader of the Quebec Liberal Party, Jean Charest, agrees with the position of the Quebec government—and God knows that Mr. Charest's requests are usually very minimal; my colleague talked about an invertebrate's requests, and I agree with that—something is wrong somewhere.

In conclusion, all this brings us to the kind of shenanigan represented by the Romanow Commission, which, ultimately, can only result in more support for the policy of the federal government. Let us not forget who Mr. Romanow is. He is the one who, only 20 years ago, plotted with the prime minister in the kitchens of the Chateau Laurier, in Ottawa, to patriate the constitution against the will of Quebec. You cannot trust a man who sees Canada as a centralized country, a man who will not give any chance to the provinces, particularly Quebec, and will deny them the right to develop a health care system that could be original and different.

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

Mr. Speaker, I want to congratulate the hon. member for Charlesbourg—Jacques-Cartier on the excellent speech he has delivered. I do hope it will set an example for others in this House and will earn us all the support we need to correct this injustice.

Would the member be kind enough to remind the House of the considerable support we have for this motion, especially from the premiers?

Does he not think that, if the government were to vote against our motion, it would reinforce our belief in our 2000 campaign slogan, saying that the only way to defend Quebec's best interests is not by belonging to a Canada-wide party, but by relying on members of parliament whose allegiance goes to Quebec and Quebec alone?

[Richard Marceau, Bloc, Charlesbourg—Jacques-Cartier, QC]

Mr. Speaker, I want to thank my colleague from Hochelaga—Maisonneuve for his excellent question.

We have here, today, a situation quite out of the ordinary, with the Bloc Quebecois promoting a very broad consensus that has been reached not only in Quebec. As I said earlier, the PQ government, along with the Liberal opposition and the ADQ opposition, supports the position we are taking today, as do the premiers of all the provinces and territories.

This raises the issue of knowing how is it that a government which claims to be sensitive to the needs of ordinary people has totally ignored the repeated pleas of a vast majority of Quebecers and Canadians, if not all of them, to start reinvesting right away in the health care system which is sinking.

This is also the question I am putting to my colleagues opposite. How can they remain insensitive to the cries and pleas of their constituents who argue that it is about time Ottawa restored funding in health care sector to at least the 1994 level?

[Pierre Paquette, Bloc, Joliette, QC]

Mr. Speaker, yesterday during question period, we witnessed a display of what you mentioned about the government side acting in bad faith.

The Minister of Finance lied yesterday when he told us that the proportions concerning the—

[The Deputy Speaker]

Order please. I would ask the hon. member for Joliette to please withdraw his last remarks before carrying on.

[Pierre Paquette, Bloc, Joliette, QC]

Mr. Speaker, I withdraw my remarks.

The Minister of Finance misinformed the House in his comment on the figures quoted by the member for Saint-Hyacinthe—Bagot, who said that the federal government is going into individual taxpayers' pockets for close to 60% of its tax revenue while the figure for the Quebec government, which has assumed its responsibility for health and education in particular, is only 40%.

How can he explain that, on the government side, they keep trying to deny the facts in order to avoid a debate which is essential for Quebec and all of the provinces?

[Richard Marceau, Bloc, Charlesbourg—Jacques-Cartier, QC]

Mr. Speaker, I thank my colleague from Joliette for his excellent question.

I am simply flabbergasted by this refusal to admit the obvious. They do not want to recognize the facts, the figures, the real situation we are in, in order to avoid all debate on the issue.

If this debate takes place, if we examine the situation with regard to health care and the fiscal situation throughout Canada, we will realize that the main cause of the sorry state of health care in Canada is this government. We will realize that it is responsible for this mess we are in today, something it refuses to admit. That is why the finance minister and his colleague, the intergovernmental affairs minister, refuse to admit the truth and the obvious.

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Speaker, I will be sharing my time with the Parliamentary Secretary to the Minister of Health.

I welcome the debate because health care is a topic of concern for Canadians today. Unlike the previous speaker I am never intimidated by the member for Hochelaga--Maisonneuve although I respect his talents and oratorical ability. Unlike the last speaker I am not breathless about the debate because I am confident in the progress the Government of Canada is making in co-operation with its provincial partners in the health care field.

Canadians want to know the dollars being spent on health care will ensure they get the care they need when they need it. Canadians know accountability is the key to good governance. It is implicit in the contract between the government and the citizens that funded programs will effectively meet intended objectives.

However accountability requires that governments have good information. I will take a few minutes to describe briefly not only the commitment of the Government of Canada toward improved accountability and reporting but the measures we are taking to ensure more and better information will be available in future to allow us to fully meet our commitments.

In the February 4, 1999 Social Union Framework Agreement governments made a commitment to enhance transparency and accountability to constituents by achieving and measuring the results of their respective programs. This included: monitoring and measuring the outcomes of programs and reporting regularly on performance; sharing information and best practices to support the development of the outcome measures; working with other governments to develop over time comparable indicators to measure progress on agreed objectives; and publicly recognizing and explaining the respective contributions of governments.

As a nation we spend over $95 billion a year on health care, more than 9% of our gross domestic product. Yet near the end of the nineties Canadians had limited information to assess the performance of the health system. Policy makers and health professionals knew much less about health outcomes and the performance of the system than they needed to.

Oh yes, we knew a fair bit about inputs into the health system such as the amount of funding, where it came from, the number of professionals working in health, the number of person days spent in hospitals, et cetera. However we knew little about the outcomes we got for the inputs so we literally could not tell how efficient our health system was. We knew little about what happened after patients left hospitals. We did not know whether they left cured or uncured, in good shape or disabled, or whether they went back to their homes or to other care providers.

We knew little about the overall health of the population. We could not compare the health of the population in, say, 1997 with its health in 1987 because we had not had the foresight to keep a survey of population health active through the eighties and nineties. Nor could we compare the health of Canadians in Calgary with the health of those in Quebec City as we had not invested in surveys that could give reliable health information.

I am glad to report that we started to change that in the 1999 budget. We allocated $95 million over four years to the Canadian Institute for Health Information to strengthen its capacity to report regularly on the health of the overall system and to allow Statistics Canada to report on the health of Canadians. The institute will work with partners to identify which health indicators to measure, develop data standards, fill key data gaps, and build capacity to analyze data and disseminate information.

In September 2000 the first ministers reached an agreement that will allow Canadians to see how well their health system is serving them. The agreement will help all of us improve the delivery of health care services in Canada. It will build on and lend precision to the directions of the social union framework.

The first ministers agreed to report on indicators to improve accountability to Canadians regarding the performance of their health care system. The agreements respect the fundamental responsibility of the provinces to deliver health care in their jurisdictions. A performance indicators reporting committee chaired by the province of Alberta is working with existing committees to identify comparable indicators in 14 areas under three themes: health status, health outcomes and quality of service.

The reporting committee works with various groups including Statistics Canada and the Canadian Institute for Health Information to provide policy advice to carry out the required development work on the indicators. The indicators will be used in performance reporting by governments beginning in September 2002. Each government is responsible for reporting on its own jurisdiction and ensuring its own appropriate third party verification.

The work is proceeding well and on schedule. The reporting committee has been successful in achieving consensus among the jurisdictions toward reporting indicators in each of the 14 areas by September 2002. The committee held a consensus conference in September 2001. The resulting proposal which identified approximately 60 specific indicators was endorsed by federal and provincial deputy ministers in November 2001.

Health Canada is a full partner in the program, not only because it is involved in direct delivery of health services to the aboriginal population but because of its support of a range of measures to ensure accountability across the full range of policies and programs for which it is responsible.

To improve accountability the federal government has embarked on a number of initiatives aimed at embedding the principles of results based management and fostering a continuous culture shift to outcomes oriented decision making. The initiatives are aimed at enabling Health Canada to meet the objectives of the Treasury Board's Managing For Results program.

Pursuant to the 1999 Federal Accountability Initiative, Health Canada is developing and using performance frameworks at a departmental and program level, strengthening the departmental evaluation function, and developing tools to enhance performance measurement.

The reporting committee process to report on health system performance this coming September relies heavily on information being generated by the investments we began in the 1999 budget.

Budget 2001 provided an additional investment of $95 million to ensure the Canadian Institute for Health Information in conjunction with Statistics Canada could continue to provide quality health information. The objectives are to: provide information to help federal, provincial and territorial governments meet their performance reporting commitments; provide the evidence base necessary for health care providers and managers to make informed decisions about health system renewal; provide the information necessary for Canadians to make informed decisions about their health; and expand the sharing of health information through a comprehensive approach to data dissemination that respects the privacy rights of Canadians.

The investment will ensure Canada continues to standardize, collect, analyze and disseminate essential health information. It will ensure the regular dissemination of timely and relevant information needed to enhance public understanding and debate about issues of health and health care. It will also provide invaluable support to those responsible for developing policies, designing and managing programs, and evaluating the effectiveness and efficiency of the $95 billion Canadians spend on health care every year.

[André Bachand, Progressive Conservative, Richmond—Arthabaska, QC]

Mr. Speaker, I have a question for the hon. member about the motion of the Bloc Quebecois member.

Does she recognize that, in fact, the federal government is paying only 14% of the overall costs of health care in Canada?

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Speaker, that is the position of many provincial governments and some of the opposition parties. However it neglects to include the spending the tax room we gave to the provinces several years ago in the form of tax points.

If one includes the tax points and the money generated by them, the federal contribution rises to somewhere between 31% and 33%. I do not accept that 14% is the federal contribution to health care.

[Bill Blaikie, NDP, Winnipeg—Transcona, MB]

Mr. Speaker, would the hon. member accept that 31%, which we will leave uncontested for the moment although it is contestable, is still a whole lot less, about 19 points less, than the 50% health care cost sharing in Canada used to be between the federal and provincial governments?

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Speaker, I agree that the percentage has changed considerably over the years. At the beginning it was 50%. However since the beginning of medicare there have been a series of agreements with the provinces. In most cases either the provinces proposed and the federal government agreed or the federal government proposed and the provinces agreed to differing percentages than there had been at the outset.

The public probably wonders why it happened. If the provinces are complaining now, why did they agree to the earlier sums? I cannot go into exact detail but my understanding is that the provinces traded money for power. Each time they took less money they obtained more jurisdiction and a freer hand in deciding how to spend the money. There was a tradeoff and the provinces agreed. It is a little late for the provinces to come back and complain about a system based on agreements they signed.

[Greg Thompson, Progressive Conservative, New Brunswick Southwest, NB]

Mr. Speaker, it was interesting listening to the parliamentary secretary. I have a question for her regarding one of the things we in my party entertained in the last election. It was rejected by the Canadian people, as one can see by the size of our caucus. However it is worth thinking about.

In addition to the five principles of Canada Health Act we are suggesting a sixth principle of predictable sustained funding. This would ensure we did not have a sporadic movement of funds, that there could be long term planning and that provinces could depend on the funding being there five or ten years down the road. It has to do with long term planning versus the short term planning we have seen by various governments over the years.

Could the hon. member comment on this sixth principle?