Mr. Chairman, I came to lend a helping hand to my friend and colleague, the member for Hochelaga—Maisonneuve.
It is a pleasure to participate in this extremely important take note debate on the future of our health care system, and more specifically on what we commonly call the Romanow commission.
First, I would like to stress the fact that, whenever the government decides to create a commission, it chooses with great care the person who will chair that commission. The government knows that the philosophy and the ideology of that person will naturally play an important role in the findings of the commission.
The Prime Minister has chosen Mr. Romanow, a New Democrat as we know, and a former Premier of Saskatchewan. We know and we often see, in the House, that the NDP strongly supports centralizing social powers in Canada; it is keen on national standards and believes that “Ottawa knows best”. The ideology of that party is one of centralization. The New Democratic culture has been left its mark on Mr. Romanow. That was my first point.
Second, Mr. Romanow, as we know—and incidentally, this happened 20 years ago this year, the anniversary was celebrated very well—, was a major player in the recent history of Quebec and Canada, when he schemed with his friend, the current Prime Minister, in the kitchen of the Chateau Laurier, to patriate the Constitution in spite of Quebec, in spite of what Quebec wanted.
These two elements demonstrate Mr. Romanow's vision: first with respect to the place of Quebec, in particular, but also to the role of the provinces in the Canadian federation.
Mr. Romanow published an preliminary report, as has been said many times in the House. From the outset, Mr. Romanow stated that Canadians do not want a 10-tiered system. He was alluding to the provinces and to Quebec.
Clearly, his philosophy is that there should only be one system in Canada, and that this system must be managed in Ottawa, this system, the philosophy, the elements, and that decisions must be made in Ottawa instead of being left to the provinces.
This also demonstrates the vision whereby there can only be one vision. This is the Canadian vision, which scorns any different ways that the other provinces, and obviously Quebec in particular, may want to proceed.
In its preliminary report, the commission completely disregarded Quebec's jurisdiction. This is something we know and we must repeat over and over. As sovereignists, it becomes tiring to have to repeat it to people who should know their constitution, since they claim to be defending it. Health is under the jurisdiction of the provinces. Health is under Quebec's jurisdiction.
How can we accept this vision of one single health care system where everything would be decided here in Ottawa? In fact, and I quote from page 43 of the report:
—governments may need to step back fromtheir traditional perspectives, decide what is in the best interests of the healthsystem overall—
This is code for saying that the provinces should abandon any hopes of autonomy and any hopes for specificity in order to fit a mould that will be cast in Ottawa. This is what this passage means.
In the preliminary report of the Romanow commission, it is already clear what direction he is headed in and what his philosophy is. We see the desire to build a uniform Canada, one that is increasingly centralized and standardized.
The preliminary report of the Romanow commission also sets out and recognizes the problem of the instability of health funding and opens the door to partial privatization of health services. It proposes a framework which assumes the standardization of health care systems in Canada and clearly tackles issues which come under the exclusive constitutional jurisdiction of Quebec.
As members know, the Government of Quebec quite rightly boycotted the proceedings of the Romanow commission because it thought it pointless. Quebec has already held its own commission to study health care and social services, the Clair commission, which tabled its report in January 2001. This report proposed tangible, specific solutions adapted to the needs of Quebec and Quebecers and it respects their health care needs.
Speaking of needs, this is an opportunity to uncover what could be seen as a bit of bad faith on the part of the federal government. Federal funding to Quebec for health care, through the Canada health and social transfer, stands at 14%. This means that for every dollar spent in Quebec today, 86 cents come from the Government of Quebec and only 14 cents come from the federal government. This contribution was slated to drop to less than 13% in 2005-06.
I hope that the minister will ask me some questions about this. I would be delighted to provide explanations and I hope that she will listen closely, as she can do.
In 2000-01, federal transfers represented only 16% of Quebec's revenues, dropping from over 28% in 1983-84.
The additional federal health transfers deposited in trust also pose many problems. The federal government boasts that it has transferred money in trust to the provinces. But it is requiring that the monies transferred be used for specific purposes. They are one-time payments and Quebec does not necessarily have the resources to hire the staff needed to use the medical equipment.
This one-shot payment in trust is not working well. This serious fiscal problem which has the Government of Quebec and, through it, all Quebec taxpayers in a stranglehold is so real that, in 2010-11, it is estimated that about 85% of Quebec's program spending will go the education, health care and social services.
What does that leave for the environment, culture, foreign affairs and recreation? When 85% of a budget goes to these basic items, it does not leave much leeway. The federal government is deliberately applying this fiscal stranglehold on the provinces.
In this two-fronted attack on Quebec's autonomy, the first front being the fiscal imbalance—and I will come back to that—and the second being the administrative centralization required by the social union agreement signed in 1999 by all provinces, except Quebec of course, and the federal government, how can the latter justify such blackmail with regard to the funding it provides, when its share of health care costs has shrunk to 13% and its share of education costs has shrunk to 8%?
Since my time is running out, I will conclude by saying that the fiscal imbalance that undermines the autonomy of the provinces and of Quebec, and this is a deliberate decision on the part of the federal government, is jeopardizing the social and economic choices of Quebecers. In the end, all the decisions could be made in Ottawa. This is the danger that Quebec is facing. This nation building process undermines the desire of Quebecers to be different, to do things their way, to have their own culture and their own identity.
The shortfall in Quebec is estimated at $50 million a week, or $2 billion a year. If this fiscal imbalance were corrected, Quebec alone could hire over 3,000 physicians and 5,000 nurses.
For the people of Charlesbourg—Jacques-Cartier, these sums represent $24 million for the current fiscal year alone and $78 million by the end of fiscal 2004-05.
These are practical measures, and this is what the federal government should work toward instead of listening to what the Romanow commission wants, which is a uniform health care system across Canada.