Debates of Nov. 23rd, 2004

Supply

[Greg Thompson, Conservative, St. Croix—Belleisle, NB]

Mr. Chair, I noted that earlier this month the Canadian Institutes of Health Research announced its funding. I think it totalled around $187.5 million this year. Of that $187.5 million, Atlantic Canada only received $4.8 million and the province of New Brunswick, my home province, received only $243,000. If we do the percentages, that is less than one-tenth of one per cent. Why the dismal amount for the province of New Brunswick?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, CIHR of course in making decisions about funding is an arm's length body. It is not influenced by politicians, nor should it be.

There are peer reviews for applications. This is not the only funding that comes from CIHR. There is a total of $752 million for the year. I would be happy to take a look at other research grants that have been provided by CIHR across the country and provide the hon. member with a breakdown.

I was in St. John's, Newfoundland. I was in Halifax. I visited medical faculties in both of those towns. There are some impressive--

[The Deputy Chair]

The hon. member for New Brunswick Southwest.

[Greg Thompson, Conservative, St. Croix—Belleisle, NB]

Mr. Chair, the government of the day appoints that council. The minister should look at some of those political appointments that were made, because truly they do not reflect the wishes of Atlantic Canada. There is a level of unfairness in that funding, aside from what the minister has pointed out.

There is one other point I want to bring up tonight. It was spelled out in today's Ottawa Citizen . Our health critic, the member for Charleswood--St. James--Assiniboia, really went after the minister a couple of days ago on the hep C payment issue. The government has been very negligent on that, in fixing those dates where many of the victims were obviously left outside of the original package, the only package that we know. When the minister responded he basically suggested that our health critic lacked compassion and was trying to use the victims of hepatitis C to score political points. That is way over the line.

I believe that the House and the member, particularly this side of the House, is entitled to an apology from the minister for making those kinds of callous remarks, especially to an individual and a party that have worked so hard for some fairness and sensibility on that whole funding issue.

If members recall, I was the first member of Parliament in the House in 1998 who suggested full compensation, followed by the critic for the Reform Party at that time, Grant Hill. We have a record of standing in the House and demanding fair and compassionate treatment. Why would the minister use that kind of language when referring to our health critic yesterday in this place?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, the hon. member is a member of Parliament and so am I. We deal with each other on an equal basis. The hon. member misled the House yesterday with respect to the state of those funds. That is why I said he should stop politicizing the issue. It is a very sensitive issue.

[Greg Thompson, Conservative, St. Croix—Belleisle, NB]

Mr. Chair, that is absolutely unfair and untrue. The minister should be completely ashamed of himself for making remarks like that. We know what the government has done on this issue. It has stonewalled the House. Compassion is simply not part of the equation. The Liberals made a calculation. They miscalculated. They were told from 1998 forward, even by Justice Krever, that they were making a mistake not to compensate all victims. For the minister to suggest otherwise is not even reasonable. It is completely unfair.

The onus, the responsibility for this fund is clearly at the doorstep of the government. In my opinion, the minister should divorce himself from those kinds of partisan remarks. It is the responsibility of the opposition in the House to keep the government responsible, make it responsible and force it to do the right thing.

Why will the minister not stand in his place and simply do the right thing, admit his mistake, and admit the mistake that the government made in 1998 with the original package in compensating only some victims and not all the victims, completely ignoring Justice Krever?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, it is absolutely correct that we are doing the right and responsible thing by extending the possibility of hep C compensation to all of the victims pre-1986 and post-1990. We have said all of the options are available. We have said there is a mandate. We have said this is the right and responsible thing to do.

All I am saying is let us not politicize it. We all know what happened. These were very difficult issues. Lots of tears were shed by the victims and by people in the House on all sides of the House. This is a very important issue. Let us not politicize it. That is all I am saying.

[Lloyd St. Amand, Liberal, Brant, ON]

Mr. Chair, by way of background, Brant is the fourth largest riding in the province of Ontario with respect to population. Some 115,000 individuals reside in my riding.

We have a large aboriginal population in the riding, some 22,000 individuals are of aboriginal background, and some 11,000 reside on the very proud Six Nations of the Grand. It is an area that some months ago the Minister of State for Public Health visited and impressed the good, proud residents of Six Nations of the Grand.

I am privileged to represent those persons. How heartening then it was to hear in the Speech from the Throne the commitment on the part of the government and the Prime Minister to advance the cause of aboriginal issues, including the health conditions under which many aboriginals live.

Within Brant riding on the Six Nations of the Grand, the population lives in a relatively affluent fashion and it is relatively upscale. The sad reality is that their conditions are quite substandard compared to what the rest of us enjoy. Their health conditions are substandard. How heartening it was as well to read about the Prime Minister's first post-election trip to Canada's north to re-acquaint himself firsthand with the plight of the first nations communities in this country.

During this session, we are covering a range of important health issues facing all Canadians. I wish to ask the Minister of Health about aboriginal health. I will eventually get to my question. By way of background, the reasons are obvious to anyone who can read the statistics, why this is an important health issue.

On the one hand, the state of health for aboriginal people in Canada has been improving over the past 20 years in certain important areas or respects. For example, life expectancy is increasing even if it is still between five and seven years less than is the case for other Canadian men and women. Infant mortality rates, thankfully, are going down. Even so, no one who has any knowledge of the area could or would claim that the health of aboriginal people is nearly as good as the health of the rest of the Canadian population.

The record of substandard health conditions is clear, especially when it comes to some high profile health problems. I was not surprised to learn, for instance, that type 2 diabetes affects first nations and Metis people more than the general Canadian population. I was not surprised to hear or read about that, but I was very surprised to learn that it affects first nations and Metis people at a rate three to five times higher than the rest of us.

Rates continue to increase among the Inuit. I know rates for infectious diseases are often higher, 10 times higher in the case of tuberculosis. Perhaps most unhappily, there is the scourge of suicide especially among aboriginal young persons. The suicide rate of first nations youth is five to six times higher than the national average. For Inuit youth, it is 11 times higher. This makes suicide the single greatest cause of injury related deaths for aboriginal people.

When I look at the estimates, it is very clear how quickly and efficiently the minister's department is putting abundant money and a lot of people into improving aboriginal health right across Canada.

For instance, we see that the forecasted expenditures for the first nations and Inuit health branch of the minister's department are just over $1.7 billion for this fiscal year according to the adjusted main estimates. The largest chunk of that $1.7 billion is going to community health programs. The second largest portion is allocated to the non-insured health benefits program, which covers pharmaceuticals, vision care, dental care, transportation services, and a lot more for about 750,000 status Indians and eligible Inuit.

All of that background leads me to my question. When the first ministers met to discuss health care in September 2004, there was also a meeting with aboriginal leaders. At that meeting the Prime Minister announced a series of commitments, namely, $700 million in new funding to address aboriginal needs across Canada. I would ask the minister, what exactly will happen as a result of the agreement reached in September?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, first of all let me reiterate what the hon. member has just said and what the Prime Minister said. There is no question that we have, as a society and as government, not done a very good job of aboriginal health. We have not done a very good job on aboriginal issues generally.

It is important. That is why the Prime Minister held a round table summit with aboriginal leaders in April this year and then tasked us, different ministers of education, health and other sectors, to hold sectoral table discussions on these issues. I am pleased to say that the discussion on health has already taken place in Ottawa with about a hundred experts and aboriginal leaders coming together to discuss these issues.

The $700 million is in addition to the $1.6 billion the hon. member just referred to. This is over the next five years. Out of that, $200 million would enable governments and aboriginal communities to better integrate and adapt health services with other systems. It is important that we do that.

The next $100 million would assist in the training of aboriginal human health resources to improve recruitment of aboriginal health care workers, adapt health curricula, and improve retention of health workers.

The remaining $400 million is for upstream investments with respect to diseases such as diabetes, issues such as suicide, and the promotion of health among the aboriginal people of Canada.

It is important that we do this right. That is why the health ministers of Canada got together three or four weeks ago and tasked George Smitherman, the minister of health from Ontario, and myself to co-chair the health ministers and work with the co-chairs of the aboriginal ministers, and develop a blueprint as to how we can more effectively utilize the resources that are available within that $700 million.

[Lloyd St. Amand, Liberal, Brant, ON]

Mr. Chair, I can say anecdotally that I attend the Six Nations of the Grand River Band on a regular basis, at least weekly. The residents there are very heartened and encouraged by what this Minister of Health and this Minister of State for Public Health are doing to eradicate health problems which those good people face.

I would like, by way of a follow up, to ask the minister about vaccines. With the commencement of flu season, we are reminded of the importance of being vaccinated against influenza. However, in a policy and operational sense, the issue seems somewhat larger than that this year. For instance, we are hearing some concerns about insufficient supplies of flu vaccine in the United States. The corollary question is, will we have enough here in Canada?

I am confident the minister can give us the latest information on the state of influenza vaccines. I would appreciate hearing about that. I would also like the minister to address a couple of other vaccine related topics. Over the past few years, we have heard stories or rumours now and again about the threat of a worldwide flu pandemic. This is obviously a serious concern to health experts.

I recall reading somewhere not long ago that more people died during the famous Spanish flu epidemic in 1918 and 1919 than died in the entire first world war that raged for more than four years. Obviously and thankfully, a lot has changed in the world of health since 1919. Our society has better ways to track the spread of a virus and to protect ourselves accordingly.

Even so, with travel being much faster these days, a global influenza pandemic could spread faster than ever, thanks to airline travel, instead of taking many days to spread when people customarily travelled the world by ship. I would like to know, how prepared is Canada for an influenza pandemic?

I would also like to ask the minister about smallpox and smallpox vaccine. I appreciate that smallpox has been eradicated around the world, but I understand there are concerns that it could come back, perhaps spread by terrorists, for example. Could the minister comment on these questions within questions?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, with respect to the vaccine issue, I am happy to say that this year we bought the largest number of doses of any year in Canada. We have vaccinated the largest percentage of Canadians ever to be immunized. We have immunized a larger percentage of our population than any other country in the world this year.

I understand that Dr. David Butler-Jones has been talking to his colleagues across the country. We believe that the vaccine supply in the public system may be sufficient. If there are any difficulties, obviously, they will work on those issues and they will deal with it.

With respect to whether or not we are prepared for a pandemic, we have preparations underway to deal with the kind of issue the hon. member talked about. Those preparations are underway under the leadership of the Public Health Agency of Canada under the leadership of Dr. David Butler-Jones. We are more prepared than we were at the time of SARS. I think all of us felt that we were not well prepared, but as a result of SARS, we are now better prepared than ever before and we continue to enhance our ability to deal with those issues.

With respect to smallpox, we have the number of doses required. In fact, we have the first generation vaccine that was tested during the smallpox epidemic and that vaccine is still good. It is in the possession of the manufacturer. It is going to be in our possession in the Public Health Agency of Canada shortly as we prepare to take charge. In terms of the smallpox issue, Canada is well prepared, perhaps even better prepared than most countries in the world.

[Bev Desjarlais, NDP, Churchill, MB]

Mr. Chair, I would like the minister to respond to a number of questions. I will be sharing my time with my colleague from Winnipeg North at some point.

Could the minister tell me how much the third party administrative costs are for the First Nations and Inuit Health Branch drug program? While the troops in front are looking for the answer, could he also explain to me why the First Nations and Inuit Health Branch would give money to a private agency for a nurse but would not give the first nation additional dollars to hire a nurse to be in the community full time?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, I would ask the hon. member to specify what particular situation she is talking about and where. I will be happy to get the information so that I can answer her with the specifics rather than in a general sense.

In a general sense, the hon. member is making the right point. If aboriginal organizations on the ground are prepared to deliver health care, then we should be assisting them in becoming self-sufficient. There is no question in my mind about that.

The hon. member raised a very specific question. I would be happy to have an answer available for her. I would be happy to talk to her. In fact, if she wants me to table the answers--

[The Deputy Chair]

The hon. member for Churchill.

[Bev Desjarlais, NDP, Churchill, MB]

How fair the Chair is tonight, Mr. Chair. It is just excellent.

I will make the specifics available, but it is a situation that does not happen in just one first nation community. It is a situation that happens overall. Private agencies are paid at top dollar for nurses to go into communities. I know specifically that those first nation communities have asked for additional dollars to hire full time people to work in those communities and are not able to do so.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Since the member has brought it to my attention, Mr. Chair, I will be happy to look into that situation and provide a wholesome answer to the hon. member.

[Bev Desjarlais, NDP, Churchill, MB]

Mr. Chair, is the minister aware as to whether or not the medical services branch or the First Nations and Inuit Health Branch has ever bulk purchased in their history?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

My history is only four months long, Mr. Chair, but I understand there has been some bulk purchasing. I will be happy to get the details for the hon. member.

[Bev Desjarlais, NDP, Churchill, MB]

Mr. Chair, the minister was pretty adamant earlier on when he was being questioned that it was not something that was feasible. I have to admit, having known that medical services had bulk purchased in earlier years, I was quite surprised that his comment would be there.

It has been acknowledged that there may be instances when they cannot bulk purchase, but we all know that our reserve communities are pretty centralized. Although there are first nations persons who have the right to drugs through the plan, there are a lot on reserve communities where bulk purchasing could be done. It is my understanding that certainly the nursing stations would be able to bulk purchase.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, I understand that this is exactly where the bulk purchasing happened and it made sense.

[Bev Desjarlais, NDP, Churchill, MB]

Mr. Chair, that used to happen in nursing stations.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, that used to happen because it was obviously feasible and doable.

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

Mr. Chair, I appreciate the opportunity to ask the Minister of Health a few questions.

I want to begin with a question that I have been raising for three and half years now. It has to do with a labelling issue. The minister will know what I speak about and that of course is the motion passed by this House requiring labels on all alcohol beverage containers, liquor bottles, wine bottles and beer bottles, to warn women of the dangers of drinking while pregnant. This is important because of the need to help prevent fetal alcohol syndrome, which is such a debilitating condition, so costly for the individual in human terms and costly to all of us because of the supports that are required over the lifetime of that person.

I know that in the past his predecessors have said, “We are studying it”. That is one answer I have received. Another answer is, “We are not sure if it is going to work, so let us put our efforts into things that we think are going to work”.

This motion was passed so resoundingly by the House because it was felt to be one tool in our arsenal kit, one way to help prevent fetal alcohol syndrome. It was felt that even if we prevented one FAS situation, it would be worth it.

My question for the minister is, now that he has a fresh start and he is new to this whole area, would he give serious consideration to this idea and consider implementing this initiative and respecting the will of Parliament?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, this in fact is an issue that caught my eye when I got here as the Minister of Health. More particularly, when I was the attorney general in British Columbia, the chief justice of British Columbia took me aside one day and said to me, “Look, there are dozens of people appearing in the criminal courts of this province every day that probably were FAS affected and we should do something about it”.

When I got here I felt that I should take a look at it. I have been very interested in it. I am very supportive of the approach taken by the hon. member. In fact, I support the efforts of our own member for Mississauga South, who has introduced a private member's bill this sitting.

We are looking at this issue. I have been given all the arguments that have been made, as the member has just said. I will err on the side of making a mistake with respect to the charter but proceeding with this issue if I could, so there is a constant battle that is being waged on this issue in terms of the possible charter challenge that might exist.

But I want to make sure that we overcome it and that we overcome it with evidence if we can. I am working very hard on this issue.

I am sharing this with the member because this is an issue of public interest. It is not a partisan issue. When I tell the member what the real difficulties are, I want to make sure that we are able to work together across the aisle in reaching the destination that we want to reach, that is, to reduce the--

[The Deputy Chair]

The hon. member for Winnipeg North.