Debates of May 13th, 2003

Supply

[Hélène Scherrer, Liberal, Louis-Hébert, QC]

I would like to conclude in one minute.

[The Assistant Deputy Chair]

I will allow the hon. member to take her minute, because you are eating into her time again.

[Hélène Scherrer, Liberal, Louis-Hébert, QC]

Madam Chair, quite simply, the point I was trying to make—and I think the speech was really quite interesting—was to say how important prevention is and how important it is that money be set aside to invest in physical activity and healthy lifestyles.

I would like the minister to comment on this, on the amounts that have been allocated in future budgets, on her commitments in this regard, to see whether, in fact, this is also a priority for her.

[Rob Merrifield, Canadian Alliance, Yellowhead, AB]

Madam Chair, I rise on a point of order. My point of order is that when I was speaking and there were points of order it came off my time directly. My point is that if the hon. member had 10 minutes, I would suggest that the clock was used up prior to that.

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

She's more than used it.

[The Assistant Deputy Chair]

The clock is still running so there are five minutes left on the government side. The hon. Minister of Health wanted to answer a question.

[Anne McLellan, Liberal, Edmonton West, AB]

Madam Chair, I just want to refer to what the hon. member had to say about prevention and the importance of healthy living. Let me just briefly say that this is a key priority for my department, because I do believe that we need to invest more money in the front end of health care.

There are two reasons why. One is that there is a better quality of life for everyone if they are healthy and if they are committed to wellness. Also it will help us sustain our health care system. We have to put more attention and more dollars into the front end, into keeping people well, into preventing disease. That is why my department is working with provincial and territorial colleagues around the development of a pan-Canadian strategy as it relates to healthy living.

The first tranche of that healthy living strategy will focus on good nutrition, physical activity and healthy body weights, because we know that those are the foundations of a healthy lifestyle. They are the foundations for a healthy society. Without that, we will continue to see adult diabetes increase and obesity increase. We have seen the pages of the paper these past few days. We see the challenge of obesity with our young people.

That is why the whole area of healthy living and wellness is so important, and it has to become more important to all of us. It has to be inculcated as part of our culture when we think about health and healthy living.

[Bonnie Brown, Liberal, Oakville, ON]

Madam Chair, a meaningful examination of the estimates will show one key figure which is not explained very well, because it is a single line and it is a transfer. It is a $55 million increase to the Canadian Institutes of Health Research, the Government of Canada's premier agency for health research. Its budget is now $617 million, more than double the amount it had at the time of its creation in the year 2000. Canadians are justified if they ask what they are getting in return for that money.

There are several ways to look at this. One of the ways is to simply look at the evidence in the recent outbreak of SARS. Funding to Canadian researchers working in areas directly relevant to SARS was acknowledged in a paper in The New England Journal of Medicine on March 31, and Canadian researchers at the B.C. Cancer Agency were the first in the world to sequence the genome of the suspected coronavirus that causes SARS. This was all fueled by the analyses that were carried out on samples and the great work that came out of the Winnipeg National Microbiology Laboratory. This sequencing is a critical first step in learning how to prevent and treat this disease and other infectious diseases.

The CIHR is providing $500,000 for research that will respond rapidly to the challenge of SARS and is also undertaking longer term initiatives to address infectious diseases. That is just one recent example of that particular budget line in the estimates.

The Minister of Health has led this team, from the federal government's role, of provincial, municipal and federal workers on the SARS front. However the people of Canada should know that it was the funding for research, which is such a large part of the federal government's strategy, under the health umbrella that was underpinning the success of our experience with the SARS outbreak. Despite the deaths, it could have been worse and we should be very proud. I for one am very proud of our minister and her role in that particular situation.

Perhaps the minister would like to tell us of another piece of research of which she is particularly proud.

[Anne McLellan, Liberal, Edmonton West, AB]

Madam Chair, the hon. member makes a very important point around the importance of research. The CIHR is the successor research institution from the Medical Research Council of Canada. In fact it takes a new approach, an approach that is being modelled around the world. It is not only strictly medical research as traditionally understood. It brings together, for example, social scientists, the integration of the social sciences with biomedical research and with economic research. We are getting a better sense of what we mean by health and health care, and what is important to have a health society.

We are also making phenomenal progress in attracting bright Canadians back to this country and keeping the best here in our universities and our research institutes to do great work like the work that was done in this country on SARS.

For example, work is being done by one of the institutes as it relates to the whole question of metabolism, healthy body weights and obesity. It is so easy to say that we know we should eat good things and exercise but that is not good enough. What does that mean in terms of individuals? What does it mean for individual categories of people within our society? In particular, what does it mean for young people? The research being done in areas of body weight and obesity will be so important for our future health and our ability to sustain our health care system.

We can choose virtually any area in Canada today and the CIHR has an institute working in that area, and the work is groundbreaking and world class.

[Loyola Hearn, Progressive Conservative, St. John's West, NL]

Madam Chair, I would like to let you know that I will be sharing my time with the member for Yellowhead.

[The Assistant Deputy Chair]

Before the hon. member continues, I will read what was agreed upon earlier.

--that there is agreement that, when the House is in committee of the whole on main estimates, the 20 minute speaking times will be assigned to parties and that each respective party shall assign speaking time to one or more members within that 20 minute segment.

There is no splitting of time between political parties.

[Loyola Hearn, Progressive Conservative, St. John's West, NL]

Madam Chair, I thank you for the clarification. Before I ask my questions to the minister, let me also register--

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

Madam Chair, I rise on a point of order. The member who has just risen has 20 minutes. He has indicated that he wanted to share it with the member for Yellowhead. Therefore, I ask for unanimous consent for him to share it with the member for Yellowhead.

[The Assistant Deputy Chair]

The House is its own master and so is the committee. Is there unanimous consent that the member share his time?

[Some hon. members]

Agreed.

[Some hon. members]

No.

[Loyola Hearn, Progressive Conservative, St. John's West, NL]

Madam Chair, I want to register my concern with what I see happening here tonight. It is bad enough to have to watch commercials during a good hockey game, but when we have to listen to commercials during the parliamentary process, that is a horse of a different colour.

The minister comes to the House once a year, if she happens to be the lucky or unlucky one to be chosen, to defend estimates. We will only be dealing with two departments. This gives members from all sides a chance to ask pointed questions on the minister's performance and the performance of her department. We listened to prepared speeches time after time from Liberal backbenchers praising up the minister--

[Geoff Regan, Liberal, Halifax West, NS]

Madam Chair, I rise on a point of order. I think that although there are different rules tonight than there are other times, I am sure the rule of relevance still applies. I do not see the relevance at all to the comments of the hon. member this evening to the questions at hand.

I do not think he has mentioned the word health as far as I know or any topic related to health. I think it is time he do so, that he gets to the point of the evening, that he talks about health care and gets to his question, rather than wasting the time of the House and those of us who are here at nearly 11:30 at night with nonsense about procedure.

[The Assistant Deputy Chair]

Let us be cautious in the language we use in the House. The hon. member has 10 minutes.

[Loyola Hearn, Progressive Conservative, St. John's West, NL]

Madam Chair, that is not a point of order as the Chair well knows. I have 20 minutes to use, as the members opposite did. We are in the situation we are because of lackeys like that. This is not the way to run the parliamentary process. I want to ensure that is on the record.

I have some questions for the minister. When we talk about delivering health care funding, will the minister tell us how she plans to deal with the provinces, particularly when there is inequity to begin with?

The province of Newfoundland and Labrador has a declining population, unlike any other province in the country. It also has an aging population. Because of that, fewer people require greater services, which means we get fewer dollars based on per capita. I know there are adjustments made and I want to have that clarified.

To add to the complication, the population is spread over a rough rural geography in the province of Newfoundland and Labrador. Consequently, a dollar that goes to Newfoundland and Labrador cannot get the same value as a dollar spent in many other parts of the country. How does the minister plan to deal with that inequity?

[Anne McLellan, Liberal, Edmonton West, AB]

Madam Chair, the hon. member is quite right to identify that virtually all the dollars transferred to provinces for health care, or in fact for most other areas, are transferred on the basis of per capita.

The hon. member I know is aware of the fact that there is an equalization program. In fact equalization is a commitment set out in our Constitution. Equalization is in place to help some of the poorer provinces in our federation to ensure that they are able to provide a minimum level of services for their respective populations

I know this does not meet the entire concern identified by the hon. member. There was a commitment made at the time of the first ministers meeting in February because a number of provinces put the issue of equalization. As we deal with funding per capita largely in the FMM, let us take a look at the equalization formula and see whether it is working. If it is not, how it can be revisited?

That commitment was made at the time by the Government of Canada. That review of equalization will take place. I think that is the best vehicle by which we can hope to deal with the kind of inequities which the hon. member has mentioned.

[Loyola Hearn, Progressive Conservative, St. John's West, NL]

Madam Chair, I agree with her that the equalization formula has to be revisited but I would rather see it sooner rather than later. It is not just in relation to health care and CHST funding that we want to deal with equalization. It is in relation to the clawback arrangements too that certainly punish a resource rich province like Newfoundland and Labrador.

I have a couple of other questions for the minister. One of the major concerns we have is looking after our senior citizens and those on fixed income. Quite often the drugs that some of these people have to use are not covered by our regular health care plans.

I will give one example. During a visit to one part of my riding, where we have a lot of senior complexes, I spoke to a couple who were probably in their late sixties or early seventies. They had not long retired. They were living in the city but belonged to a small outport where they had a summer cabin. Their joy in life was getting into their little car and going out to the summer cabin to be close to home, to see their friends and whatever.

The gentleman developed Alzheimer's. He was in the early stages and had been prescribed a drug called Aricept which was extremely expensive and not covered by the system.

The couple used up whatever savings they had. The drug was retarding the advancement of the disease to the point where he could still go out, visit the cabin, feel quite at home and he was kept in pretty good spirits. The cost of the drug however ate into their income and eventually the only option they had was to sell the car. By selling the car of course, they had no access to go to the cabin. It was one of the saddest stories I ever had to sit and listen to.

I am dealing with another friend very close to me who is suffering from Lou Gehrig's disease and also is using a prescribed drug that is in the experimental stages, maybe even pre-experimental stages and probably even being experimented on animals at this stage. It is extremely expensive but seemingly it works.

Consequently the family is only too glad to have this drug which seems to be at least retarding the advancement of the disease. It costs the family over $1,300 a month. If we picture an ordinary family going from day to day making a very ordinary living, how long can they keep going? The answer is not very long.

What are the answers to these situations?

[Anne McLellan, Liberal, Edmonton West, AB]

The hon. member raises a very serious question and one that we hope to deal with through that part of the first ministers agreement that talks about catastrophic drug coverage.

The hon. member has rightly identified that just as 40 years ago we did not want people to lose their homes or have to give up an important asset like a car or other savings to get access to a doctor or an operation in a hospital. Today we do not want people to have to do those things to have access to drugs that will either save their lives or make their lives more comfortable.

Therefore the commitment in the first ministers agreement is to have developed a catastrophic drug plan by the end of fiscal year 2005-06, the exact formula of which ministers of health have to work out. Mr. Romanow had a suggestion for a formula and Senator Kirby had a suggestion for a formula. They are not identical by any means.

Health ministers need to work out the formula by which we determine over what amount or what percentage of income or whatever it is, drugs would be covered by one's provincial health plan so we do not have the kinds of situations that the member has just identified.

Catastrophic drug coverage will become an important new part of our insured basket of services to deal with exactly the kind of situation that the member has just described.

[Loyola Hearn, Progressive Conservative, St. John's West, NL]

Madam Chair, the only unfortunate thing is that these decision making procedures take a long time and some people suffering from diseases do not have a long time. I do not know in the interim if there is some provision for special cases. It might be something that should be looked at.

I will put two more questions and I will let the minister answer, but before I do, I want to say I appreciate that the minister was here tonight and stayed until the end, despite the fact that she had to be embarrassed by some of her own people. Let me say to her there is no need for it, because the minister can take the hard questions and she has done a very good job tonight. She should have been left alone by those people.

My first question is in relation to home care. I have always maintained that the best value government gets for the money it spends is in home care. As people become a little bit older, perhaps they cannot look after themselves any more and they need somebody to come in to look after them. As long as they are healthy enough, they should be able to stay in their own home as long as they want to stay there. If home care cannot be provided, then they go to an institution or maybe a hospital where the costs are astronomical, where they are away from their friends, family and surroundings and no one is happy. Quite often they cannot afford to have people come in to look after them.

Government will pay the $70,000 a year to put them in a nursing home, but will not pay $20,000 a year to keep them in their own homes where they are healthy, wealthy and wise, as they say, because they feel much more comfortable in their own surroundings. The whole home care provision in our country has to be looked at. It would be cheaper for the government all around.

On the final question I would like the minister's comment because this is a pet peeve of mine. I am not sure whether or not the minister's department has ever checked into the ratio of money spent on those who are poorly educated compared to those who are better educated and have a better lifestyle. I bring this up because it ties in with education. I have been trying to say, and I have heard others, including a couple of leadership candidates, say recently that we have to invest more in education.

We have a choice. We can spend a lot of money helping those who are sick, out of shape, in institutions, in penal institutions, living a lifestyle where they have a meagre income and cannot eat properly or we can educate them so that they contribute to society rather than depend on society to help them, not through their own fault of course. We should invest up front to make education affordable.

Many young people in this country, if they do not live near a university and they do not have parents who can subsidize their--

[The Assistant Deputy Chair]

I am sorry to interrupt the hon. member, but we are already at 11:30 p.m. Unless I have the unanimous consent of the House for the minister to answer, I have to cut the debate totally. Is there unanimous consent for the minister to answer?