Debates of Feb. 19th, 2002

Supply

[Pauline Picard, Bloc, Drummond, QC]

Mr. Speaker, I thank my colleague from Hochelaga—Maisonneuve and I also congratulate him for the magnificent work he is doing as health critic for the Bloc Quebecois. I have worked with him lately on the standing committee that studied the new reproductive technologies. I want to take the opportunity afforded by the minister's presence to ask her to deal with the report on assisted human reproduction as soon as possible. We have been expecting a bill on this for years now. I thank you, Mr. Speaker, for giving me the opportunity to say these things.

The current government and its members often say that its contribution to health is not only 14%. We always hear the same arguments. They always talk about tax points and equalization payments. They add this to the percentage for the Canada social transfer.

I would like to elaborate on a few things. Tax points are not federal transfers for health care. As we know from all the studies that were carried out and from all the financial experts who reviewed the figures, the government had agreed to support the provinces and shoulder 50% of health care funding. It was mentioned earlier on.

Provinces made a commitment to maintain the standards and uphold the conditions set out by the government, but in 1993-94, the government reduced its contribution and nowadays it does not pay more than 14% of the costs, that is $14 for every $100 spent or 14¢ for every dollar spent. This is outrageous, especially given the higher costs faced by the provinces because of the aging population, all the new technologies and the cost of drugs.

Tax points have nothing to do with health transfers. In fact, they contribute to balance the tax positions in the federation, and this has nothing to do with the cash contributions under the Canada social transfer. The taxation power given under an agreement between levels of government is not to be considered a lifetime contribution to the tax revenues of one of the parties to the agreement. Tax points are not a federal government expenditure; they are not mentioned in the public accounts of Canada. That is what I had to say about tax points.

Moving on now to equalization payments, the federal government cannot use these payments to justify its withdrawing from health care funding. I have heard that argument twice already. I even heard the secretary of state talk about equalization. Let me remind him that equalization is totally different from other types of transfers and cannot be linked to the Canada social transfer. Equalization payments are unconditional and are simply added to Quebec's consolidated revenue.

So, his arguments do not stand. He should find other ways of denying that he is not even paying 14 ¢ for every dollar spent.

[Anne McLellan, Liberal, Minister of Health]

Mr. Speaker, I would like to take a few minutes to speak to the motion tabled yesterday in the House by the hon. member for Hochelaga—Maisonneuve.

Before returning to the specifics of my colleague's motion I would like to thank the hon. member for having raised this issue for discussion in the House today. I look forward to working with him on the Standing Committee on Health in the months ahead and all those who serve as critics.

The motion speaks to one of the great strengths of Canada's parliamentary system, that the House is one of our country's best forums to discuss issues that concern our citizens. It is not the only forum but it is one of the most effective and indeed one that can address concerns as they surface in the collective conscience of our citizens.

It is clear that real changes need to take place in health care but these changes cannot take place without open debate and discussion. More than just debating the matter in the House, we need other opportunities for vigorous and constructive dialogue in order that all Canadians have the opportunity to have their say.

I would like to address the issues raised directly by the motion: first, that our government has withdrawn from health care funding; second, that the federal government is attempting to invade provincial areas of jurisdiction; and third, that we are attempting to impose some kind of vision of health care on other levels of government.

These statements are totally false.

Health care is a priority for the government and we have shown it time and time again. Since balancing the budget, almost 70% of new federal spending has been for health, education and innovation. In support of the historic agreements reached by the first ministers in September 2000 on health care renewal and early childhood development, $23.4 billion in increased funding is being provided to the provinces and territories over five years. This is one of the largest single expenditures by any Canadian government in this country's history.

Of this investment, $21.1 billion is for the Canada health and social transfer, the CHST, and $2.3 billion is for targeted investments in medical equipment, primary care reform and new health information technologies. Provinces are receiving $2.8 billion more in CHST cash this year, bringing CHST cash to $18.3 billion. In 2002-03, that cash will grow to $19.1 billion, a $3.6 billion increase over 2000-01. By 2005-06, CHST cash will reach $21 billion, a $5.5 billion or 35% increase over 2000-01 levels. Total transfers to provinces, including the CHST and equalization, are growing to $45.3 billion in 2001-02, an all time high.

In addition, let me remind hon. members opposite of a further point relative to the first ministers' agreement of September 2000. The first paragraph of the joint communiqué underscored the respect for jurisdictional responsibilities. If I may, I would like to quote from that communiqué. It states:

Nothing in this document shall be construed to derogate from the respective governments' jurisdictions. The Vision, Principles, Action Plan for Health System Renewal, Clear Accountability, and Working Together shall be interpreted in full respect of each government's jurisdiction.

Let us take a look at federal involvement in health care in Canada.

The federal role of medicare has long been misunderstood. Many assume that our role is that of a banker cutting cheques to pay for the system. This is but one role of many. In fact, we are involved directly in five key areas. We are a prime mover of health research and of reliable health information. We promote healthier lifestyles for Canadians. We deliver health services to aboriginal peoples. We contribute to global health. As well, we are leaders in renewing medicare. In addition to these five key areas, we are working to ensure that drugs and consumer products are safe, effective and regulated. It is important that we are clear about our role in each of these areas, so let me touch on each of them briefly.

First is the promotion of health research and the provision of sound health information.

We are privileged to be living in a golden age of medical research. From the unlocking of the human genetic code to dramatic breakthroughs in nanotechnology and a greater understanding of the determinants of health, our world is being transformed at a staggering pace.

This fact has not been missed by our government. That is why we created the Canadian Institutes of Health Research, or CIHR, headed by Dr. Alan Bernstein. This collection of virtual institutes is revolutionizing how health research is conducted in this country. The CIHR's work is rooted in teamwork and partnership. Each is at the heart of Canada's proud tradition of scientific and social science research.

We have made significant new investments in CIHR, in fact, $75 million in increased funding for its 2002-03 budget, a new annual total of $560 million. Through this investment, we will develop the knowledge, understanding and insight that we need to undertake a program of continuous improvements to our health care system.

An important corollary to research is health information. Through the Canadian Institute for Health Information, CIHI, Canadians can count on getting important information on how to maintain and improve their health, but CIHI's work does not end there. It is also providing Canadians with information on the health care system itself. With this information, shared with the provinces and territories, we will together renew our health care system.

Health information is about getting to the root issues of health care. It is about getting facts, reliable facts, the kind of data that will help make the system more accountable to Canadians, the kind of information that will help effect meaningful change in health care. In September 2002, we hope to table the first performance measurement report on health care.

The second key area of federal activity is promoting and protecting the health of our citizens. Whether it is nutrition information or tougher warnings on tobacco packaging, our work translates into helping our citizens live healthy lives.

Leaving aside the human cost incurred by disease and sickness, just imagine the savings we could realize in the health care system, the hospital beds we could free up, the tests and procedures we would not have to perform. We need to successfully cultivate a culture that makes the pursuit of health a public good and a private goal.

The third area for which the federal government has direct responsibility is the provision of health services to first nations and Inuit people. Just like the provinces and territories, we are undertaking a renewal process and we are facing similar challenges. Health professionals are in short supply and drugs are expensive, as are the technologies.

Just as the provinces and territories are wrestling with the pressures of delivering health care to aboriginals living in urban centres, the federal government addresses the challenges of delivering health care to those on reserves, often in rural and remote areas. That is why we are investing in programs to support early childhood development and in efforts to reduce the incidence and effects of fetal alcohol syndrome and to address sustainability challenges for the first nations and Inuit health care system.

Canada is a country with a unique global vision, and health care is among the issues that we are working to elevate to the international stage. That is the fourth area of federal activity about which I want to speak briefly.

We are working hard with other countries to develop a global vision of health issues to identify common goals and share common experiences. The tragic events of September 11 made many things clear to us. One of these is that all countries need to improve their surveillance ability, laboratory capacity, frontline responsiveness and stocks of necessary drugs. Canada needs to be prepared. That is why last year our government invested $11.5 million in measures to help improve Canada's ability to protect its citizens from any public health security crisis that may arise.

These measures, which will shore up our existing efforts, include the following: $5.62 million to buy antibiotics and chemical antidotes; $2.24 million for radiation detection and communications equipment; $2.12 million to establish a Canada wide network of laboratories equipped with the necessary materials to diagnose biological agents quickly; and $1.5 million for emergency response training for frontline staff, including laboratory managers, quarantine officers, federal occupational health officers and provincial emergency responders.

Let me speak to the fifth area of federal activity and that is of course the area in which we are a partner in the renewal of our medicare system. We heard recently from Roy Romanow's commission on the future of health care in Canada. It is clear that through its interim report the commission's work will generate public debate, and that is good. It is a debate that will allow all Canadians to participate in the shaping of the future of the health care system in this country. I look forward to these discussions, which will take place over the coming months.

I will not presume nor will I pre-empt the outcome of the commission's work, but in my view there are areas where the federal government and our provincial and territorial partners are acting now to modernize medicare. These include pharmaceutical management, primary health care renewal, health and human resources and information technology. I want to say a few words about each of these.

First, on pharmaceuticals, there is no doubt that we need to deal with the rising costs of pharmaceuticals. We need to determine whether the overall increase in utilization contributes to better health outcomes. A federal, provincial, and territorial agreement on a common drug review process is addressing some of these concerns and looking at new ways to share best practices in prescribing and utilizing pharmaceuticals.

With respect to primary health care renewal, the federal government has committed $800 million in a primary health care transition fund. This will help provinces and territories continue to build a primary care system of integrated health care teams.

With respect to health and human resources, we simply have to come to terms with the fact that Canada is competing for qualified doctors, nurses, technicians and therapists, not just with the United States but with countries around the world. We need to make sure that the revitalization of our health care system takes account of these new realities.

Finally, there is the importance of information technology in health care renewal. We need to continue to invest wisely, using technology as a tool so that we have the capability and capacity to address Canada's health care needs in the future.

As I indicated at the beginning of my remarks, the facts speak for themselves about the federal government's commitment to health care. We are committed to ensuring that it remains adequately funded and we are committed to ensuring that it is managed and administered responsibly and efficiently.

By continuing to work with our provincial and territorial partners, I have no doubt that we will achieve that goal. Whether it is sponsoring health research, generating reliable health information, promoting healthier lifestyles, delivering health services to aboriginal peoples, contributing to global health issues or modernizing medicare, our role in Canada's health system is vital, integral and unwavering.

I will say it again, our role in the canadian health care system is essential, complete and unchanging.

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

Mr. Speaker, first I would like to wish good luck to the Minister of Health in her new portfolio. I have the feeling she is quite willing to work with all of us. I do hope though that she will be a little bit more flexible than she was with regard to the Young Offenders Act.

The minister is a friend of mine but at time she can be somewhat stubborn, and in politics this is not always to our advantage. She should follow the example I am setting as far as being flexible and willing to cooperate is concerned. Quickly, I have three short questions for her.

Will the minister agree that when she was elected, back in 1993, the federal government was contributing 18 ¢ for every dollar invested in health care? Currently, it is 14 ¢. At the first ministers' conference in August 2001, the premiers, regardless of their political stripes, asked that funding be restored the 1993-94 level, with an escalation factor. I hope that she will start her new mandate in the House of Commons by stating that she will commit in cabinet and elsewhere to acquiesce to this request.

Second, will the minister recognize that under the Constitution service delivery is a provincial responsibility? She is a constitutional law professor and her career was in constitutional law. It would be interesting to see her lecture notes and hand out materials if we could have access to them. I am asking her to make sure she does respect areas under provincial jurisdiction.

Third, and I will end on this point, during the weekend I read the Kirby report from the other House and I would invite the minister to read the part of the report dealing with the costs of drugs. They are skyrocketing. Will the minister agree that the Standing Committee on Health should review the whole issue of drug costs? In March, I will have the opportunity to make a proposal to this effect.

[Anne McLellan, Liberal, Edmonton West, AB]

Mr. Speaker, I and this government respect the jurisdiction of the provinces. I think the hon. member was listening when I quoted directly from the agreement entered into by the Prime Minister and the premiers in September 2000 wherein it clearly stated that the renewal of the health care system would move forward co-operatively in partnership, but respecting the jurisdiction of the provinces and the territories.

The hon. member, if he is not aware, should know that since becoming Minister of Health I have made it plain that I want to work co-operatively with the provinces. I have said clearly and unequivocally that the provinces are the primary deliverers of health care in this country. They are on the front lines of the delivery of health care every day. It is my goal to work co-operatively with them to fulfill Canadians' objectives wherever they live, which is a high quality, accessible, publicly funded health care system.

In relation to the funding of health care, which was my hon. colleague's first question, let me say again that we have added substantial new cash to the CHST transfers going out to 2005-06; some $21.1 billion. In addition to that, we have put some $2.3 billion into specific targeted funds to help provinces achieve specific goals in relation to the renewal of their systems.

If the hon. member is suggesting that funding continues to be a pressure and that it will continue to be an issue around the sustainability of our health care system, of course it will be. I know that as well as anyone. My department is the fifth largest provider of health care services in terms of dollars because we are responsible for aboriginal first nations and Inuit health. I face many of the same challenges that my provincial and territorial health minister colleagues face.

I am not naive enough to come here today and suggest that funding is not a shared challenge for all of us. Of course it is. We know that. We will work in partnership with the provinces and the territories to ensure that we are able to sustain the system.

I think we have all acknowledged that the cost of drugs is a significant issue. The whole question of pharmaceuticals was part of the accord entered into by the Prime Minister and the premiers in September 2000. We are doing much common work together in terms of getting a handle on not only the increased cost of drugs but the utilization of drugs and whether we are actually getting sufficient benefit in terms of improved health outcomes for that increased utilization.

These are all very important issues for our health care system. I know I will have the opportunity to engage my colleague who cares very much about these issues both here on the floor of the House and in the Standing Committee on Health in the weeks and months ahead.

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

Mr. Speaker, the minister has quoted from the accord adopted in September 2000 between the Prime Minister and the premiers of Canada. I would like to quote from a statement made by those same premiers in August 2001 and ask for her interpretation of this statement. Part of the statement reads:

At a September 2000 meeting of First Ministers, the Prime Minister made an offer toprovinces and territories that included partial restoration of the Canada Health andSocial Transfer (CHST). While this September 2000 federal announcement was generallywelcomed as a first step and provided some short-term relief from the pressures facingprovincial and territorial governments, the measures taken fell considerably short of thePremiers’ position.

The premiers went on to indicate that the current share of federal funding was 14% and set to decline and that it would be a minimal position for them to have the federal government start at 18%.

Does the minister accept the premier's interpretation? Are they right in terms of their assessment of federal funding? Does she acknowledge the difficulties posed for provincial governments in trying to keep pace with the demands on their health care systems? Does she acknowledge and is she considering their request for transitional funds to help meet the needs between now and the time that the Romanow commission reports in November 2002?

[Anne McLellan, Liberal, Edmonton West, AB]

Mr. Speaker, I certainly acknowledge, as I did in response to my colleague from Hochelaga--Maisonneuve, that the provinces and territories are under pressure in relation to the financing of health care. As I have indicated, so am I in the delivery of that part of the health care system for which I am responsible.

I think that speaks to the importance of the renewal of our health care system. I am not one of those who believes that we necessarily start the discussion around the renewal of health care by demanding more money. We need to determine whether we are receiving value for the dollars that are being spent and whether there are things we can do in our health care system that not only provide better health outcomes but in fact provide us with cost savings.

If we look at one of the specific funds that we put in place, $800 million to help provinces move forward with pilot projects in relation to the renewal of their primary health care delivery systems, this speaks to an acknowledgement of the fact that we need to try new models of delivery, we need to see whether we are getting value for our dollars and we need to see whether there are efficiencies that can come from a refashioning or renewal of our primary health care delivery mechanisms.

Of course we are all under financial pressures. However, before we put more new dollars into our health care system, over and above those already pledged, we need to take a long, hard look at our system, which is what Romanow and others are doing, to determine where the money is being spent, whether we are getting value for that money and how we can move forward in terms of a comprehensive renewal of our system which speaks to its sustainability, not only in the context of affordability but in terms of its long term objectives and its acknowledgement of the fact that health care at the beginning of this century is different than it was even 30 or 40 years ago.

[Bernard Bigras, Bloc, Rosemont—Petite-Patrie, QC]

Mr. Speaker, first, I wish to inform the Chair that I will split my time with the hon. member for Argenteuil—Papineau—Mirabel.

I am pleased to address the motion of the Bloc Quebecois that was tabled by the hon. member for Hochelaga—Maisonneuve, which is adjacent to my riding. The motion reads as follows:

That this House condemn the government for withdrawing from health-care funding, for no longer shouldering more than 14 per cent 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.

This motion is of course a long one and it includes several words. However, it should clearly be stated from the outset that it has two objectives. The first one is to demonstrate how the federal government has, in recent years—and this is what I will attempt to demonstrate here—opted out of a service which, in the minds of Quebecers, is essential. How can we explain that the federal government has made such drastic cuts to its contribution to health in recent years?

I also want to discuss the whole issue of related provincial jurisdictions. As the hon. member for Hochelaga—Maisonneuve said earlier, it is rather surprising that the Minister of Health, who is herself an expert on constitutional law, does not understand once and for all that the recommendations of the Romanow commission, which deal among other things with provincial jurisdictions, are totally unacceptable. It is regarding this aspect that, in the ten minutes that I have, I will try to convince those who are listening.

Before getting to the core of the issue, it is important to go back in time to understand how this tax imbalance has its origin in Canadian history. As we know, way back in 1942, the provinces, including Quebec, willingly decided to take part in what was called the war effort by agreeing to transfer, in the case of Quebec, a number of tax points on a temporary basis. I insist on the term “temporary”, because over the years, the federal government seems to have forgotten that this transfer was only for a particular time in our history, that is during the war.

At that time, the federal government assumed the right to collect personal and corporate income tax. No problem so far. The provinces, including Quebec, totally agreed to that until the war ended in 1945, when the time came for them to get these tax points back. The federal government said “No, we are keeping them. We are not giving them back to the provinces”. It kept accumulating the money and refused to transfer the tax points back to the provinces as initially planned in 1942.

This is why, later on, Quebec introduced its own taxation system, which was considered double taxation, to be able to provide services to Quebecers.

At the same time, the federal government was passing an increasing number of legislative measures, particularly in the area of health. Let us not forget our history.

In 1957, the hospital insurance program was established. In 1966, the Medical Care Act was passed. From 1957 on, each time the federal government interfered in an area under provincial jurisdiction, Quebec reacted. Quebec passed its own legislation because we believe that health is a provincial responsibility. While the federal government passed legislation on hospital insurance in 1957, Quebec introduced a hospital insurance plan in 1961. While the federal government passed its Medical Care Act in 1966, Quebec introduced its own health insurance plan in 1970.

So, historically, Quebec has assumed its constitutional responsibilities every time. This being the case, the government decided to contribute to the health system by funding 50% of health costs. But there was a string attached. The federal government said: “You have to comply with the five principles of the Canada Health Act. So, we give you 50% but you have to respect certain principles, including universality, accessibility, portability, public administration and comprehensiveness”. The federal 50% is conditional upon respect of these five principles, which are in the federal legislation.

Over time, as the years went by, we became aware that the federal government has never hesitated to cut its share of funding. Two programs were created: established program financing and the public insurance program, which evolved into the Canada health and social transfer. It is the principal federal contribution to health care, but also funds our post-secondary education system and what might be termed health and social services, welfare.

The problem arose when this real imbalance set in, when the federal government got out of funding. I would like to review a few figures.

In 1993-94, 22% of health care spending in Quebec came from the federal government. In 2005-06, it will be 13%. While the health care needs are in Quebec and in the provinces, while the provinces are required to provide services, and are prepared to fulfill their constitutional responsibilities, the federal government is taking advantage of a situation to tighten its purse strings and refuse to provide the funding required to respect the five principles laid out in federal legislation.

I would also like to remind the House that in 1983, 28% of Quebec's revenue came from federal transfers. In 2000-01, transfers account for only 16% of Quebec's revenue. The federal government's transfer contribution is shrinking yet the needs are growing and. more specifically, the Quebec government spends two-thirds of its budget on health care, education and social services.

We can try to predict, we can try to project and assess what share of spending will go toward education and health in 2010-11. We are forecasting that 85% of the Government of Quebec's budget will go to these three areas.

The needs are increasing, but the means to fund these services is diminishing. This is fairly curious, because in order to find a solution to this backing away from fiscal commitments, this tax imbalance, the government has nothing better to propose than creating a commission. It established the Romanow commission, whose recommendations included interfering in the provinces' areas of responsibility.

If the federal government wishes to solve the problem of health care for the provinces for once and for all, it has to provide the required funding. We must give the provinces the financial resources they need to provide services. Then, we will find solid and sustainable solutions to the health care problem in Quebec.

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

Mr. Speaker, I have a question for the Bloc Quebecois member. I will start with the problem we raised earlier this morning. My colleague from Winnipeg—Transcona emphasized that this motion was a bit weird and somewhat difficult to understand as far as the constitutional division of powers and responsibilities is concerned.

My French is not the best and I hope the member understood what I said. I would like to ask the member if the reason for the motion and the wording of it is more political than anything.

Certainly we would think that all Canadians, including Quebecers, want some accountability in terms of money that goes into health care. We are talking about scarce dollars and basing the statement on the knowledge that people are willing to invest more in health care, but they demand accountability.

It would seem from media reports that the sovereignist government is in trouble in Quebec. It may be choosing to fight its electoral future in the next provincial election on the health care issue.

This is what I understood from an article published in Le Devoir today. The journalist quoted Mr. Landry as follows:

“When we talk about sovereignty, we talk about health”, said Premier Landry at the opening session of the PQ national council meeting. He could have added “and the opposite is also true. When we talk about health, we talk about sovereignty”.

Is that the reason for the motion? Is there not a sense in Quebec, as there is in the rest of the country, that we need a national system, that we need federal dollars and that we need some accountability over those dollars?

[Bernard Bigras, Bloc, Rosemont—Petite-Patrie, QC]

I am glad to answer my colleague's question because she seems to assume that Quebec is the only province faced with the health care issue.

The fact that this is really a systemic problem proves that there is no connection with what she just said about sovereignty or anything else. There is an obvious funding problem in the provincial health care system.

To convince my colleague, it is estimated—and I urge her to take notes—that the shortfall in Quebec is $1.7 billion annually, and $875 million in health care alone.

Do you have any idea what that means in terms of doctor and nurse positions? This $875 million means that 3,000 doctors and 5,000 nurses could be hired to ensure that Quebecers can count on health care services that respect the five principles entrenched in the federal act.

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

Mr. Speaker, I congratulate the member for Rosemont on his excellent speech. We hear more and more about the determinants of health. We hear that, to live longer, people must live in an environment that is conducive to their personal growth, an environment that is conducive to a healthy lifestyle.

I would ask my colleague to explain to us the correlation between longevity and the Kyoto protocol.

[Bernard Bigras, Bloc, Rosemont—Petite-Patrie, QC]

Mr. Speaker, this is good timing since this issue is very much at the forefront. We have to realize that we must deal with the root causes of the problems we are experiencing in the area of health, which obviously include health care funding, but other problems also.

We have to understand that addressing issues such as climatic change and the reduction of greenhouse gas emissions in Canada will be beneficial to our health to finally understand that environment must be a priority. When 85% of Quebec's budget goes to health care, there is only 15% left for other budget items, including the environment, and that is totally unacceptable.

[Mario Laframboise, Bloc, Argenteuil—Papineau—Mirabel, QC]

Mr. Speaker, first, for the benefit of Quebecers and Canadians who are watching, I would like to say that today is the Bloc Quebecois' opposition day. My colleague, the member for Hochelaga—Maisonneuve moved this motion. It simply means that the Bloc Quebecois blames the Government of Canada, the Liberal government, for paying only 14% of health care costs, while trying to divert attention by creating the Romanow commission, whose mandate is to report on the state of the state of health care in Canada.

This is a diversionary tactic, and that is what my colleague tried to express in his motion. It is hard for those who are watching, for Quebecers, to understand this.

Every day in the House, we hear ministers, such as the Minister of Finance or the Minister of Health, tell us that the federal government is investing more in 2002 than it did in 2001. It is hard to understand, but it is possible to defend their position. Indeed, if we take the evolution of federal transfers in Quebec, in 2001-02, the federal government will invest $4.5 billion in transfers, all fields combined, in health, in education and in social services. The amount that will be allocated for health will be $2.35 billion, invested by the federal government or given in cash transfers for health care in Quebec.

In 2002-03, it will be the same amount. It is already planned. Agreements have been negotiated. We should remember that the federal government keeps boasting about a negotiated agreement with the provinces. It always boils down to the same thing: take it or leave it. The amounts have already been announced.

For 2002-03, it will be $4.5 billion; for 2003-04, it will be $4.6 billion; for 2004-05, it will be $4.8 billion; so it will be the same amount for 2002 and 2003. Two years in a row, the government will pay the same amount, namely $2.35 billion for health, or a little bit more than it paid in 2000-01, but a lot less than might be needed as a result of health care expenditures.

In Quebec, health care expenditures are increasing by $875 million a year. My colleague for Rosemont—Petite-Patrie gave a very articulate explanation of this earlier. It amounts to a 5% increase in the health care annual budget in the province of Quebec. In the other provinces across Canada, we see similar increases simply due to an aging population, longer life expectancy and the arrival of new drugs on the market. Governments are investing more and more money in health care.

Between 2001 and 2005—for the next four years—transfers to Quebec will only increase by $300 million while annual expenditures in health only will increase by $875 million.

Considering the way health care expenditures and federal transfers to the provinces are increasing, by 2004-05, the federal share will drop to only 13% of health care expenditures in Quebec.

The situation is the same in the rest of Canada. The government of Ontario has released an ad using pills to show what the governments are paying: 86 pills for Ontario and 14 for the federal government. It is the same in Quebec: 86% of health care is paid by the province and 14% by the federal government.

My learned colleague from Rosemont—Petite-Patrie showed that when medicare was established in Canada, it was half and half, 50-50.

Last fall, in Victoria, the premiers of all the provinces—including the PQ government of Quebec, the Conservative government of Ontario, and the Liberal government of British Columbia—made a unanimous request. They all requested the same thing: that the federal government increase its contribution from 14% in 2001-02 to 18%. Under the agreements the federal government is imposing on the provinces, it is supposed to drop to 13% by 2004-05. So, with this unanimous request, the provinces are urging the federal government to raise its contribution to health care funding from 14% to 18%.

What I find ironic is to hear the finance minister tell the House—and he may be partly right—that he is increasing the federal government's contribution, but it can never match the increase in health care costs. This is the harsh reality we have to face.

As I said earlier, in the next four years, the federal government will be increasing its transfer to Quebec by $300 million, while health costs will rise by $875 million a year, for a total increase of close to $3.5 billion. The federal government will only increase its contribution by $300 million, which means that its share of the funding will go from 14% of health costs in 2001-02 to 13% in 2004-05.

That is how the finance minister always manages to pull one over on Quebecers and make them believe that he is increasing the federal government's contribution. But its share of the funding can never match the skyrocketing health care costs, and that is normal. New technologies are developed, and new drugs are put on the market. People are living longer and that is a good thing for all Quebecers and Canadians. But still, the costs of health care are increasing by 5% a year, while the federal funding, all things being equal, will be decreasing if we do not urge the government to wait no further before making huge investments in Canadian health care services.

Today, in her speech, the Minister of Health told the House that she does not deny these figures. In fact, we have yet to hear a minister challenge that percentage of 14%. Even the finance minister never denied it. He just keep telling us “We are investing more this year than we did last year”. True, they will keep making small increases, but health care costs will rise by 5% a year. That is how things stand. The federal government will hand out the money bit by bit, while the costs keep skyrocketing.

The minister candidly told us today that she has other fish to fry, that she has more than transfers to the provinces to deal with. Of course, she deals with prevention and research, at a cost of $580 million, and with information on food and on cigarette packages. She also deals with the health services provided to the first nations because, as she said, she is the one paying for the services provided to the first nations and the Inuit. She co-operates with other countries on research. She also deals with the renewal of health care in this country and with the Romanow commission. She deals with modernization and invests $800 million in the renewal of the basic system.

However, all this does not put any more money in the federal health care system or in each of the province's health care systems. These amounts are all spent for other activities, including research. It is all very good, but research yields results. New drugs and new technologies are being developed. However, there is nothing to guarantee that Canadians and Quebecers will have access to these new drugs simply because we are not being given any money to buy them. There is money for research, but none to buy the new drugs. This is what the Canadian government is doing.

Of course, they pride themselves on investing in the health care system. They say “Look, we are taking care of you”. They are indeed taking care of us, but the funding for the universal system we used to have is being lavished on the Romanow commission.

I will repeat here the four preliminary recommendations to make sure that Quebecers and all Canadians hear them well. The choices offered by the Romanow commission are as follows. First, public investment should be increased, which means that more money should be invested in the medicare system. That would be normal. Second, costs and responsibilities should be shared, which leads to the adoption of user fees. They will look into the possibility of having Canadians pay user fees on top of income taxes. Third, the role of the private sector should be increased, which would open the door to the private sector. And fourth, the delivery of health services should be reorganized to try and make the system more efficient without putting more money in.

Once again, my colleague's recommendation is totally relevant. We condemn this government for contributing only 14% and for establishing a phoney commission whose recommendations will not help the sick men and women from Quebec.

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

Mr. Speaker, I will try again to ask a question in French. It may be possible that members of the Bloc did not understand the question the first time.

We, in the NDP, totally agree with the spirit of this motion, which states that we should condemn the government for withdrawing from health care funding, and no longer shouldering more than 14% of the costs of health care. We totally agree with that position.

The problem for us lies with the other part of the motion.

In particular, the part that says to blame the government:

--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.

We have a problem with that part of the motion because it raises two questionable ideas. The first questionable part of the motion is that the Romanow commission sets forth a particular direction in terms of federal-provincial jurisdiction when, as we talked about earlier, the Romanow interim report puts all options on the table and suggests that Canadians, including Quebecers, ought to express their views about the future of our health care system.

The other questionable part of the motion is that it suggests there is some vision being imposed by the federal government on the country. Our question today has been what vision? Where? That is the problem. We do not see a vision. It is sitting back letting our system become privatized, creating a patchwork of health care systems across the country without any sense of direction or plan for the future.

Is it not the case that Quebecers would, as would all Canadians, be concerned about having a say in terms of the future of our health care system, that they would want to see an end to federal-provincial feuding and that they would want to seek some co-operative approach that would lead us to solutions of the very problems that are emerging today?

That is the question I am putting to my colleague.

[Mario Laframboise, Bloc, Argenteuil—Papineau—Mirabel, QC]

Mr. Speaker, I will try to fully understand my colleague's question.

Obviously, from a constitutional point of view, it is clear that if the federal government had always paid 50% of health costs, as was agreed when the universal health care system was introduced in Canada, we would not be having this discussion today. That is the simple fact of the matter.

Obviously, all that Quebec is asking is this: “If you are unable to provide adequate funding for health care, as is now the case, give us back our tax dollars so that we can pay for it ourselves. Once again, you are unable to deliver”. That is the sad reality of Canadian federalism.

The provinces are looking after health care and are doing a tremendous job. They have a problem of inadequate funding, and the federal government collects half of the taxes. More than half. We have had discussions with the Minister of Finance, who tells us: “Is it a little less than half, or a little more than half?” He should just give us back our taxes and we will look after health. There will be no constitutional debates or wrangling. All that we are asking for is the return of our tax dollars, the money that Quebecers pay in taxes to the federal government. All that we are saying is this: “Give us back these tax dollars and we will look after health. Things will be fine and we will perhaps get along much better”.

But the federal government continues to keep our taxes—this is the reality—and to tell us: “We are going to send a commission across Canada to take another look at how the health care system could operate in Canada and in Quebec”. In Quebec, there are no problems. We are able to talk. We had the Clair commission. We held our own discussions. We know what sort of health care system we want. All that we are asking is that the federal government give us back our money and worry about the rest of Canada. It is as simple as that.

[Sarmite Bulte, Liberal, Parliamentary Secretary to the Minister of Canadian Heritage]

Mr. Speaker, I will be sharing my time this afternoon with the member for Kitchener Centre, the Parliamentary Secretary to the Minister of the Environment.

I am pleased to have the opportunity to rise today to take part in the Bloc Quebecois opposition day motion, but I will not rise in support of the motion and condemn the government. In fact, what I will do is speak of the new and innovative ways in which the government is working with the provinces and the territories to improve our health care system. I will concentrate on talking about the dispute avoidance and resolution process that was talked about today during question period.

The Government of Canada is not interested in imposing its own vision of health care on provinces and territories. Clearly provinces and territories have the constitutional authority to manage and deliver health care in their respective provinces and territories. However the Government of Canada firmly supports Canada's publicly funded health care system, a system which ensures that all Canadians have reasonably timely access to appropriate health services, that Canadians are able to access these health services regardless of where they live and that access is based upon medical need and not the ability to pay.

Canada's universally accessible, publicly administered health care system is a cornerstone of the Canadian way of life. It is something of which Canadians are proud and speak with pride. In essence, medicare reflects some of what is best in Canada: a sense of community, compassion, and caring about each other's welfare.

These values also are embodied in the principles of the Canada Health Act, principles of universality, accessibility, comprehensiveness, affordability and public administration for insured hospital and medical services. These principles ensure that every Canadian receives the necessary hospital and physician services that they need.

In creating such a health care system, we have ensured that never again will any Canadian family be bankrupted because a member of their family is hospitalized or go without physician and hospital services because they lack the resources to pay for the care they need.

Canadians want to see their governments working together to ensure that their publicly funded health care system, which they so value, will continue to deliver the high quality services that Canadians have come to expect.

Members will recall that in September 2000, the first ministers responded and agreed to a health action plan. It was a proud moment in the history of the government. The government affirmed that the key roles of the publicly funded health system in Canada were “to preserve, protect and improve the health of Canadians” and ensure that Canadians had reasonable, timely access to an appropriate range of health services based on their needs and not on the ability to pay.

In support of that health action plan and the government's long term commitment to ensuring quality health care for Canadians, the Government of Canada committed to invest more than $21.2 billion toward health over five years. In addition to that sum of money, the health action plan also included $2.3 billion in federal funding to address jointly agreed upon priorities of upgrading hospital and diagnostic equipment, of better access to doctors, nurses and other frontline health practitioners and of making better use of information and communication technologies.

After the health action plan, this commitment was reaffirmed by the Government of Canada in the 2001 Speech from the Throne. This funding was fully protected in budget 2001 despite the economic slowdown and we will see the federal contribution to health care reach an all time high this year.

As well, this September, for the first time, as a result of the health action plan of the first ministers, governments will report to Canadians on health system performances. This will be achieved by governments using a common set of indicators. The report is a significant move by governments toward improved accountability to their citizens on how their health dollars are being spent.

Governments are working together to ensure that the Canadian health care system will be sustainable in the future. Canadians expect to have timely access to high quality health care today as well as tomorrow. Canadians want their governments to work together to protect and strengthen their health care system.

The Government of Canada is committed to working collaboratively and cooperatively with the provinces and territories in developing a common vision of health care. This has been demonstrated by the first ministers' agreement on a health action plan and continues to be demonstrated in the development of a Canada Health Act dispute avoidance and resolution process.

The Canada Health Act establishes national standards related to insured health care services that the provinces and territories must meet to receive full payment under the Canada health and social transfer.

There is considerable flexibility under the Canada Health Act for provinces and territories to manage and deliver their own health insurance plans. The Government of Canada recognizes that one potential area for intergovernmental disagreement is the interpretation of the Canada Health Act. We are working with the provinces and territories to develop a dispute avoidance and resolution process for the act.

The conception of a Canada Health Act dispute avoidance and resolution process began in February 1999. The Government of Canada, nine provinces and the territories agreed on a new framework to strengthen Canada's health and social programs to better meet the needs of Canadians.

In the spirit of mutual respect and cooperation the Government of Canada signed the social union framework agreement with the provinces and territories. This agreement committed governments to work collaboratively to avoid and resolve intergovernmental disputes while respecting the legislative provisions of the governments involved. The section of the framework related to dispute avoidance and resolution, and provided guidelines for the development of the process in the areas of intergovernmental initiatives.

It was agreed that the dispute avoidance and resolution framework would apply to intergovernmental commitments on mobility, intergovernmental transfers, the interpretation of the Canada Health Act principles and, as appropriate, on any new joint initiatives between the federal government and the provinces and territories.

Work on the development of a Canada Health Act dispute avoidance and resolution process was initiated when the conference of ministers of health met in the fall of 2000. This collaborative work is to result in a process that is consistent with the commitments made by governments in the social union framework agreement while respecting the federal government's obligations under the Canada Health Act.

Since then the Government of Canada and the governments of Alberta, Saskatchewan, Ontario, and Newfoundland and Labrador have been working together to develop a process that is appropriate to addressing intergovernmental differences related to the interpretation of the Canada Health Act principles.

All governments have committed to support the principles of the Canada Health Act and to work in partnership to protect and strengthen our publicly funded health care system. Governments are striving to develop a mechanism that is simple, efficient and transparent. Cooperating and working in collaboration to both avoid and resolve intergovernmental differences is in the best interests of all Canadians. However, the best way to resolve a dispute is to avoid it in the first place.

It is important for a Canada Health Act dispute avoidance and resolution process to have an appropriate balance between avoidance activities and dispute resolution activities. This is a balance that the Government of Canada is working to achieve in collaboration with the provinces and territories.

The Government of Canada believes that it can reach an agreement on a Canada Health Act dispute avoidance and resolution process. The federal government is working diligently with the provinces and is making steady progress. A Canada Health Act dispute avoidance and resolution process can be achieved if governments continue to work together in the spirit of collaboration and co-operation.

All governments are committed to adhering to the principles of the Canada Health Act. These principles represent a common vision of a publicly funded national health care system which all governments share. Governments can best strengthen and preserve medicare by preventing and resolving Canada Health Act disputes in a fair and transparent manner. Canadians expect and deserve nothing less.

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

Mr. Speaker, I would like to ask a question about the dispute resolution mechanism that members of the Liberal Party have been raising throughout this debate. I would like clarification about the use of such a mechanism because it has been raised in the context of alleged dereliction of duty or an alleged breach of the Canada Health Act in cases where there may be a clear cut and dry breach of the Canada Health Act.

In cases where the infraction is clearly a breach of the Canada Health Act and the government has felt reluctant to act because of the pressure of a provincial government, let us say Alberta, is it the decision of the government to enforce the Canada Health Act and thereby lever the provisions with regard to funding in order to do that? Or, is it the decision of the federal government to institute or begin a process of dispute resolution which may prolong a provincial dereliction of duty in this regard or prolong an infraction under the Canada Health Act?

The Roy Romanow commission listed that concern in its interim report. This mechanism could become a way in which to avoid dealing with the serious issues we have in front of us and that fall in the grey area of the Canada Health Act. Would the hon. member care to comment on that?

[Sarmite Bulte, Liberal, Parkdale—High Park, ON]

Mr. Speaker, I thank the hon. member for her question. One of the first things we must realize and what is important to accept in this dispute resolution process is that the process itself balances avoidance activities and dispute resolution activities.

I must tell members that when I first heard about this dispute resolution process I was surprised it had taken us so long to come to this point. I have practised law for many years. Having been a litigator and involved in litigation for many years it was not until the latter years of my practice that we developed an alternate dispute resolution system in Ontario. It took the burden off the courts and forced the parties to the table to negotiate. Before there could be litigation the parties had to sit down with the ADR, as it was called in Ontario, and go through the process.

We have forced parties to the table at a much earlier time instead of prolonging the litigation. That successful example has been implemented in the Sports Canada program and the different sporting associations where there were problems with athletes related to doping charges or allegations on whether they qualified at a certain time. This now must go to the dispute resolution system.

This is the way of the future. This is what brings parties to the table instead of litigating and throwing accusations back and forth and having wonderful shots in the papers attacking the federal government or the provinces saying there is no co-operation. We are forced to come to the table. This is a specialized system which, as the Minister of Health said today during question period, we are close to bringing forward. It is a great advancement that is long overdue.

[Karen Redman, Liberal, Parliamentary Secretary to the Minister of the Environment]

Mr. Speaker, it is indeed a pleasure to rise today to speak to the opposition motion regarding the health care system.

I do not think there is a single issue that I have heard more about since I came to the House in 1997 representing Kitchener Centre. We on this side of the House welcome this opportunity to debate with the opposition on something that is so important to all Canadians.

We recognize the very high priority that Canadians place on our health care system. It makes me very proud to remind the members opposite that the government places that same priority on Canada's health care system. Let me remind the opposition of a few key facts about health care in Canada.

First, overall health care spending reached $102.5 billion in 2001. That is equivalent to 9.4% of our gross domestic product. Let me point out that this is quite in line with other OECD nations. There has been a great deal of rhetoric about the rapid growth rate in spending on health care in Canada. As a nation we are spending virtually the same proportion of our GDP on health today as we did a decade ago. Public investments in health care have remained stable as a proportion of GDP as well. Clearly we are not falling behind. More important, our health outcomes, measured by indicators such as life expectancy and infant mortality rates, are among the very best in the world.

It is important for us to recognize that over the past 25 years health care spending in Canada has shifted. In 1975 hospital services accounted for 45% of total health care expenditures. Now this sector represents 31% of total spending. This shift can be attributed to advances in technology such as diagnostic tests which can now be provided outside of the hospital setting. The majority of surgery is conducted on an outpatient basis rather than requiring lengthy hospital stays, as was previously the case.

As well, 27 years ago spending on drugs accounted for 9% of total health care spending. It now rests at 15%. Why? There has been an increased utilization of drugs and we have seen a rapid introduction of new drugs that can offer treatment for a great many conditions.

Any way we cut it, health care is an important issue for Canadians. Canadians are telling us that they are concerned about how long they wait to see a doctor when their child is sick, about how long an elderly patient will wait for space in a long term care facility or about how Canadians in rural and remote areas of our country will receive the care they need when they need it.

Canadians are also tired of having their governments pointing fingers at each other and bickering over health care. Canadians want their governments to work together to ensure that they will have the access to the care they need when they need it and where they need it. That is why we are working with our provincial and territorial counterparts on difficult issues with respect to health care. This is best exemplified by the first ministers agreement on health which was reached on September 11, 2000.

Let me remind the opposition that all premiers and territorial leaders agreed with our Prime Minister on a common vision for health care for Canadians. They also agreed to work together to support our health care system and to address key priorities to renew health care services. For these same reasons, in April 2001 the Prime Minister announced the commission on the future of health care in Canada. The work of the commission builds on a consensus regarding health care that was reached back in September 2000. It is from this basis that much collaborative federal, provincial and territorial work has indeed been undertaken.

In support of the September 2000 first ministers agreement and the priorities identified by those first ministers, the Government of Canada committed $21.1 billion in new cash in the Canadian health and social transfer over five years, beginning in the year 2001-02. This additional funding consists of an $18.9 billion general increase to the CHST in support of health and $2.2 billion in targeted funds for early childhood development initiatives.

In addition to increasing the CHST, to encourage and facilitate health care renewal in the provinces and territories the Government of Canada in September 2000 made significant investments in three targeted areas reflecting the agreed priorities: $1 billion over two years for medical equipment; $800 million over four years for the Primary Health Care Transition Fund which will accelerate and broaden primary health care initiatives across the country; and a $500 million fund to support, through an independent corporation, investment in information technology and communications such as electronic patient records.

In a past life I sat on a district health council representing regional and municipal governments. These are exactly the kinds of initiatives we at the grassroots level recognized as being in need of attention and funding. The government is following through with leadership as well as dollars.

Since the first ministers' agreement in September 2000 we have accomplished a great deal in several key areas such as pharmaceuticals and health information technology. The Government of Canada together with the provinces and territories reached an agreement on a common drug review process and new approaches to prescribing and improving the utilization of pharmaceuticals. Canada Health Infoway Inc. has been created and work is proceeding to develop electronic patient records and other innovative information technology applications.

In other areas such as primary health care and accountability, work is progressing in conjunction with our provincial and territorial partners. The continuing work on the health care system, based again on our agreed priorities, will renew and rejuvenate our most important national program which, as my colleague from Parkdale--High Park said earlier, helps define us as a nation.

What do all these facts and stories of collaborative work really mean for Canadians? They show that health care is a national Canada-wide issue and needs to be treated as such. They underscore that the first ministers' agreement of September 2000 was a joint endeavour agreed to by all premiers which continues to motivate collaborative work and renewal of health care. They prove that money alone could never ease the challenges the health care system faces. Perhaps most importantly, the first ministers' agreement demonstrated the will of all jurisdictions to work together to move forward on the renewal of the health care system. This is in the interest of all Canadians.

Committees of the House

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

Mr. Speaker, following discussions among the parties I think if you were to seek it you would find unanimous consent for the following motion. I move:

That the Standing Committee on Fisheries and Oceans be granted leave to travel from March 12th to the 20th, 2002, to Boston, Massachusetts, Nova Scotia, Newfoundland and Labrador, and Quebec, to continue its studies on the Canadian Coast Guard's Marine Communications and Traffic Services, aquaculture and fisheries issues, and that the necessary staff do accompany the Committee.

[The Deputy Speaker]

Is there unanimous consent for the parliamentary secretary to put the motion?

[Some hon. members]

Agreed.

[The Deputy Speaker]

The House has heard the terms of the motion. Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

(Motion agreed to)

The House resumed consideration of the motion.

Supply

[Jocelyne Girard-Bujold, Bloc, Jonquière, QC]

Mr. Speaker, I am pleased to speak today on the motion introduced by my colleague, the hon. member for Hochelaga—Maisonneuve. I want to congratulate him for taking this initiative. Here in Canada, it is time we knew what is really going on.

This motion reads:

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.

In the Bloc Quebecois, I am the critic for regional issues. I am very proud to tell you what this government is doing with respect to our regions. I want to take this opportunity to confound those who are using double speak and travelling throughout the regions of Quebec, trying to make us believe in the Bogey Man.

The facts are there. Since 1994, the Liberal government has cut $6.3 billion in provincial transfer payments for health, education and social programs. Of this amount, Quebec has suffered a cut of almost $2 billion, including $1 billion for health alone.

It is because of these cuts that the federal government was able to accumulate enormous budget surpluses. It is not thanks to the accounting abilities of the Minister of Finance, Mr. Flip-flop. It is easy to manage a bank when you only accumulate deposits without providing any financing.

Quebec is not the only province that is demanding to be reimbursed. All the provinces are united on this. Indeed, at a provincial health ministers' meeting in 2000, they had agreed to ask the federal government to increase its transfers to the provinces by 5%.

In August 1998, provincial premiers demanded that the federal government reimburse payment transfers taken since 1994. They demanded $6.3 billion from the federal government. Of this amount, Quebec's share is $1.8 billion, including $1 billion for health alone.

Even Jean Charest, the current leader of the Liberal opposition in Quebec City, agrees with Quebec's request. Here is what he said on May 7, 1997:

Forget about Lucien Bouchard and Jean Rochon. The person really responsible for the hospital closures and the deterioration in the health care system is the leader of the federal Liberal Party. Mr. Bouchard, Mr. Harris, Mr. Filmon, Mr. Klein, and all the other premiers, are forced to manage unilateral cuts.

I hope that I will not have to get out my dictionary to explain the meaning of the word unilateral. I think that those listening know what it means. I hope that the government does. It is fairly clear.

It is therefore rather pathetic to note that, on September 25, 1993, the Prime Minister of Canada said, and I quote “Our program does not include any plan to cut payments to individuals or provinces, it is clear and it is in writing”. He was talking about health. He said “Just like for the GST”. Need I say more?

One year later, the Minister of Finance, Mr. Flip-flop, had this to say “The next federal budget will contain deep cuts in funding to the provinces for health, social assistance and education”. Talk about talking out of both sides of one's mouth and quickly forgetting election promises. Less than one year later, the Minister of Finance said the exact opposite of what the Prime Minister had said. This does not surprise me. In the House, they do the same. It is a bit like the Tower of Babel.

Quebec is therefore out of $1 billion for health care. I would like to say a word of the impact on Quebec and its regions. This cut represents 20% of the costs of all Quebec hospitals, the closure of half the hospitals in the Montreal area, the hospitalization costs of 370,000 patients, the payroll of half the nurses in Quebec, the cost of all CLSCs or twice the cost of all services for young people. That is the impact of this cut. And they have the gall to say that we have lots of money, that we are rich. The federal government does not have to provide services. We do.

The federal government passes a bill, sets principles, and we have to obey. It does not have to take responsibility. We have to abide by the principles and spend the money, but it does not care about the grassroots. Our listeners should know—I hope the government does—that the regional board, or Régie régionale, in my area of Saguenay—Lac-Saint-Jean has released reports showing that the number of people who will soon retire is increasing.

Their numbers keep going up. We know that when we get older, there are health problems and special needs, and health care gets more expensive. This is the impact of a longer life, and we cannot help it. There is a minor ailment one day, and another one the next. But we need resources to provide care to those with health problems.

I will give a list to show what the $1 billion cut by this government could allow us to do in my own region, and more precisely at the Jonquière hospital. My own area, which represents 3.8% of the population of Quebec, receives $360 million from the Government of Quebec to manage the health care system. Now, 3.8% of $1 billion represents an extra $38 million. For example, this amount would allow us to double the budget of the Jonquière hospital, which is between $34 million and $35 million. This gives an idea of how much more services we could provide to the people in my region.

Here are other figures. The Mauricie—Centre du Québec represents 6.2% of the population of Quebec. Now, 6.2 per cent of $1 billion equals $62 million more for hospitals, local community service centres and child and youth centres in that area. These are only examples, but the figures are realistic. They are based on scales, which are presently on the table. This is what is happening at home and this is why people talk about prophets of doom. Federal Liberals or provincial Liberals from Quebec travel throughout the regions, saying “It is your fault if there are cuts in health care and if the system is not well organized”. People in my region and throughout Quebec will not be fooled by those who talk from both sides of their mouth. They are the ones to blame.

They should give us back money they took from us. Let us not forget that ultimately there is only one taxpayer. They should give us back the funds they had promised to give but have cut since 1993. They should give us back the missing $1 billion and we will no longer have problems. Finally, this government will give regions the money they are owned.

They must finally see the light and recognize that health is important. I believe that we no longer have the choice: health is an important thing.