Mr. Speaker, the opposition motion of the hon. member talks about a federal contribution of 16% to health care. In my view this is obviously not true. I think the hon. member knew that when he put forward the motion.
With respect to his arguments about the federal and provincial governments, the Government of Canada has made it clear that it is serious about setting a new tone and establishing a new working relationship with the provinces and territories built on respect, consultation and dialogue. This is very important to note. We hope the provincial and territorial governments will reciprocate.
Canadians have clearly told us that they are tired of seeing their governments fighting. As we approach a budget, the ongoing ads, after we recently committed $2 billion, are not in the spirit of what we are talking about here.
Canadians expect their governments to work together, not against one another, to address their pressing such as health care. The Prime Minister has said that he is committed to a new way of doing business. As prime minister designate, he met with premiers in Regina last November. Then as Prime Minister, he met with them again on January 30. At that meeting, all agreed that sustainability of the health care system was a top priority. The Prime Minister has committed to discuss this important issue at another federal-provincial ministers meeting this summer.
It is important that all governments focus on the desired outcome, a sustainable health care system. The meeting this summer will be about that. The Prime Minister has committed to that and we are moving toward that. We have been moving in that direction for some time.
The Government of Canada does not agree with the way the federal share of health care financing has been characterized. I think that is quite clear here today. A more accurate estimate of the current federal share of national public health spending is more than 40%, a share that will grow with the investments made under the 2003 health accord, which was not that long ago and for which $2 billion was recently paid out.
The Government of Canada's support for health care is substantial and growing. Last year the government committed to a five year $34.8 billion funding agreement. The Government of Canada has taken the necessary steps to ensure that an additional $2 billion will be available to the provinces for health care.
Cash transfers to the provinces will grow from $19.1 billion in 2002-03 to $28.1 billion in 2007-08. In fact cash transfers for health care and other social programs will grow at 8% annually on average over the five year period covered by the 2003 accord. This is substantially higher than the expected growth of federal government revenues over the same period.
If we were to look at a summary of increases in federal investments on health for the near future, it would look somewhat like this. The investment by the Government of Canada over the next three years will be $17.3 billion. Over the next four years, it will be $25.3 billion investment. Over the next five years, it will be $34.8 billion. Over the next eight years, the investment will be $70.1 billion.
In addition to that, as part of the 2003 accord, the Government of Canada, with the provinces, recently established a National Health Council to bring more accountability and transparency in the health care system across the country. The health accord took ideas from the Romanow report as well as from three provincial reports. This shows that the government looked at various ideas, and it listened to the provinces.
Hopefully, the National Health Council will also be addressing the reform issues that deal with problems of human resources, technicians, nurses, doctors. These issues also have to do with provincial reform and changes. I can speak of one example in Ontario, for instance, where we have over a thousand doctors with foreign credentials who are not practising, yet we have a shortage of doctors. There are other professionals who are unable to practise. These are provincial issues as well as federal and we must work on these things together. Therefore, accountability will be part and parcel in moving forward.
To continue to speak about the issue of income financing, no one speaks very clearly about the tax points. There is a great deal of myth about the tax points and what they mean. They are real cash. The value of the Canada health and social transfer tax points cannot be ignored since half the cash under the cost sharing regime was converted into tax points in 1977 by mutual consent. The provinces asked that they be given less cash and more space in tax points, which was done in 1977.
Now, of course, they want to forget that because they do not use that money, however they use it, and now increase the cash anyway, which we are doing absolutely. But at the same time we cannot leave out of the equation the whole tax point system and the amount of money that they represent because it is money that nonetheless goes from the government even if it is through tax points and deferred taxation.
The other is equalization payments the provinces received from the federal government. Again, this is not put into the equation very clearly. Equalization payments do not have a clear direction. They do not tell the provinces how to use the money but I would suspect a big chunk of that does go into health care. Again, that is an aspect of the finances that is not dealt with very clearly.
They also are not accounting for other federal contributions to the total public health spending, which is estimated at approximately $5 billion in 2003-04. These areas can include things such as the first nations health, veterans' health, health protection services, disease prevention, health information and health related research.
As well, through the tax system, the federal government provides support worth about $1 billion a year which includes such things as credits for medical expenses, disability, caregivers and infirmed dependants. This is not something that is very light. There are a lot of expenses beyond what is transferred directly to the provinces or in addition to that. Cash transfers to the provinces will grow from $19.1 billion in 2002-03, as I said earlier.
There are other issues. The issue of health care reform is something that was also discussed at the last meeting of the Prime Minister and the provinces and will be discussed again. Health and finance ministers were tasked to meet and to look at issues surrounding the sustainability of the health system leading up to a first ministers meeting this summer. They have been asked to work on these issues.
All agree that sustainability is not just about money but about reforming the system as well, and this is very important to look at. I believe that reform is a fundamental piece of the puzzle in the sustainability of our health care system. The fee for service system we have now, for instance, is too costly and does not provide a holistic approach which includes preventive health care.
In Beaches—East York, I am proud to say that we have a very successful community health care centre where doctors are paid a salary. They are on call 24 hours a day, 7 days a week, helping to keep people out of our crowded hospital emergency rooms. The centre staff also includes a nurse practitioner and a nutritionist.
This rounded approach to the delivery of primary health care will mean a much healthier society and a more sustainable system in the long term. While delivery of health care falls within provincial jurisdiction, we must work together to ensure that reform takes place in order to guarantee a sustainable healthy public and a universally accessible system.
All agree that sustainability is not just money. It is important to look at all aspects of health care. If we do not do that, we will not be able to address the issues.
First ministers committed in the accord to reforms in the areas of primary health care, home care and catastrophic drug coverage. First ministers also committed to enhancing access to publicly funded diagnostic and medical equipment and to the development of an electronic health accord.
Those are areas that the ministers, when they met with the Prime Minister last time, agreed to work together on and to report next summer as part of the package that was agreed upon to reform the health care system in an overall context.
Let us talk about home care. If we are looking to the future we can clearly see that the demand for home care services will increase and not decrease. Many families will want to care for their loved ones at home to maintain their quality of life and dignity. Addressing these shortages of home care will go a long way to alleviating the stress in hospitals and emergency rooms, as well as the costs associated with long term acute and palliative care.
Equally important, the stress levels and demands experienced by caregivers themselves will soon be approaching critical levels and will create even more stress on the health care system as the existing caregivers grow older or develop health problems of their own. In effect, home care should not be seen as a separate category of care but as a key part of the health care system.
To gain the most from home care services, we need to ensure the natural continuum of care. We need to move ahead with concrete actions for a truly national program. This should include the recognition and appropriate compensation for our home care workers and support and incentives for families who provide the necessary care. This is a whole area of services on which, as we understand it, ministers are supposed to be meeting to discuss in order to prepare for the summit this summer.
First ministers directed health ministers to work on additional reform initiatives in such areas as patient safety, health human resources, technology assessment and innovation and research. These are very critical areas that we must look at.
Finally, the Government of Canada, in addition to spending in the various areas that I have just mentioned, has other programs in the area of public health. As we know, the Prime Minister recently appointed a minister responsible for public health, a position that did not exist before. She has been mandated to establish the Canada public health agency that will address public health risks and coordinate a national response to health crises. She has also been mandated to appoint the chief public health officer for Canada.
Other programs that the Government of Canada funds are tied to the issue of health care as well. Early learning was flagged by the prime minister's health forum of 1994-95 I think, and to the health cost of the future. If a child between the ages of zero to six receives proper nutrition, we will have a healthier child and a healthy child is a well adjusted child. The government and I fought very hard to increase the child tax benefit to ensure that child poverty would be eliminated in our country. We also wanted early learning for children, stimulation and well-adjusted children. This is an area that does go to assisting and bringing down the costs of the health care system, as well as looking at the whole issue of physical activity, which is part of the new public health minister's responsibility.
We have heard on the news lately of the problem of overweight children and society in general, the issue of physical activity and nutrition is very critical. It is part of our responsibility, together with the provinces, to ensure that we have a healthier society in the long term.
Funding for the national crime prevention program that the government funds also goes to the same long term savings in the health care system. Preventive care is very important. We cannot just look at primary care that is needed now and is very important, but also long term care.
The national pharmacare program is something that I understand the ministers will be looking at and discussing this summer when they get together to look at the sustainability of the health care system, the catastrophic cost of drugs and to assist Canadians with the cost of drugs. I believe the Canada Health Act, as such, should cover the cost of drugs, especially catastrophic drug costs.
When we look at all the various commitments and partnerships that exist between the provinces, the territories and the Government of Canada in all areas of public health, such as aboriginal health and all the various funding mechanisms that exist within our country, the picture is not as clear as everybody would like to make it.
We are talking about a very complex area, an area where we must work together to ensure that our system is sustainable. I strongly believe that our primary health care has to be reformed. We need to look at home care because that will free up a lot of space in hospitals and also ensure that people have dignity at times of need in their lives.
The provincial and territorial premiers, as well as the Prime Minister, have been mandated to discuss those things now to get ready for this summer.
The summit was held and two other meetings have been held since then. We have transferred $2 billion. Yes, a budget is coming up but we have not addressed the reform issues which will be addressed this summer. Once that is done I presume we will have an additional accord that will take us the distance in the long term.
However we must address those issues before we start talking and, to some degree, being blackmailed by ads just because there is a budget coming up. Negotiations should not be done in that way. That is not the spirit in which the Prime Minister started his discussions with the premiers.