Debates of Feb. 10th, 2005

Federal-Provincial Fiscal Arrangements Act

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Madam Speaker, I rise today to speak in favour of Bill C-39, but with some reservation.

We are pleased that after 10 years of cuts to the provinces for social spending, the Liberal government finally realizes that tax dollars should be spent on more than artificial debt targets and that Canadians want a balanced approach to financial management in Canada, an approach that protects and enhances the social safety net that helps define us as Canadian.

This funding formula will close the gap in funding identified in the Romanow report on health care. We welcome the end of reduced federal funding for health care and support the move to funding 25% of health care spending by government. It is about time. We cheer the Liberals' realization that costs increase over time and that base funding must increase, or in real dollars the amount of money available goes down.

The addition of an escalator clause in this agreement is very welcome; however, this agreement is missing an important element. Our system of governance in Canada is based on a series of checks and balances, but this legislation provides no check on how health care funding dollars are spent. Again and again, Canadians are telling us that they want to know where their tax dollars are paying for public health care and where those dollars are increasing the profits of private health care corporations.

Immediately after being sworn into office, the federal health minister said:

--what we need to do is stem the tide of privatization in Canada and expand public delivery of health care so we have a stronger health care system for all Canadians.

Since this agreement was signed in September 2004, health care advocates have been asking the health minister to affirm that the enabling legislation, when it comes forward, would include provisions to protect publicly funded and publicly delivered health care in Canada. There is nothing in this legislation to protect small communities and Canadians from for profit health care.

Since the actual agreement was made, I have been reading an analysis on the 10 year health plan. Again and again, I read how Canadians want governments to be accountable for the health dollars spent by Canadians, but they rarely get that accountability. This accountability discussion has been an ongoing issue. In 2000 the first ministers made a commitment to regular reporting and they indicated that it would be a process that allowed for third party verification, yet there are huge gaps in the data.

The last annual report from the Minister of Health could not indicate where money was being spent on the for profit delivery system, and in the report from September 2002, the Auditor General indicated that Health Canada is unable to tell Parliament the extent to which health care delivery in each province and territory complies with the criteria and conditions of the Canada Health Act. This is a serious shortcoming in this current piece of legislation before the House.

I want to quote from a paper written by Cindy Wiggins, a senior researcher from the Canadian Labour Congress. It is important that this is read into the record because this is how working Canadians see this agreement. It states:

The unified front maintained by the provinces during federal-provincial/territorial negotiations also has a significant downside for national social programs. Democratic deficits and provincial-territorial unity come at a cost. Dissent is muffled. Issues on which there is no consensus simply do not make it to the federal-provincial/territorial negotiating table, regardless whether such an issue is a key priority of the public.

We know provinces and territories have different opinions on the issue of for-profit care. Some provinces are ideologically committed to creating a role for the commercial health care sector. Some already have pursued this path. Others believe that a tier of commercial health care situated within the public system will do irreparable harm to the public, non-profit system and produce poor health care outcomes.

She goes on to say:

This issue has been at the centre of public debate around health care. Canadians are clearly opposed to for-profit health care and view it as a threat to Medicare. This issue was central to the conclusions of the Romanow Commission report. Because of the lack of consensus among the premiers, commercial health care and the threat it poses to Medicare was nowhere on the agenda of the September First Ministers' meeting. We can assume that this will be the same for other national issues, such as child care

As an example of the drive to use public dollars for private delivery, this morning CBC Radio was saying that provinces, especially Alberta, are already saying no to any child care program that directs money to not for profit centres, even though research has proven they provide better care than for profit centres. This is just an example of the public dollars going into for profit delivery.

Ms. Wiggins' paper continues:

The federal government played a role in the silence on commercial health care. For several years now, it has refused to enforce the Canada Health Act with respect to for-profit initiatives which violate the Act. As a result, Medicare has been left without a guardian and remains at grave risk.

I want to emphasize again that we welcome the closing of the Romanow gap, but throwing money at a problem and then refusing to be accountable for how that money is spent is absolutely wrong. While first ministers claim that this funding formula will put the health care system back on sustainable footing, the fact is there is no protection from for profit care and no accountability for how funds are being spent.

Again, from the Canadian Labour Congress paper:

The accountability measures in the agreement do not address this important sustainability issue. Accountability is in the form of reports on progress in areas covered by the agreement, such as wait times and home care.

Those are important initiatives.

Provincial jurisdictions supposedly must meet these reporting requirements as a condition for receipt of federal funds attached to the agreement. Report cards do not solve problems: they identify them. Provinces and territories are only responsible for reporting to citizens in their own jurisdictions - a provincialization of accountability for a national social program. Should provincial jurisdictions fail to meet the reporting requirements in the agreement, there are no consequences for such failure, making true accountability an illusion at best.

Canadians truly want to know where their health care dollars are being spent. Another area that the federal government needs to be accountable to Canadians for is protecting our public health care system from trade regulations. Canadians do not see our health care system purely as a business transaction, however.

Canadians see health care as an essential part of our identity, but when given the chance, the government did not negotiate an exemption for our public health insurance system. It did not exempt health care from World Trade Organization agreements.

Now, because it also refused to enforce accountability and to stem privatization in health care, the government leaves the door open to our health care system being decimated by multinational corporations moving in to provide for profit health care. This is just another example of big box credit card medicine and it is not a route that Canadians want us to go.

One area not mentioned when the Liberals talk about health and human resources is the leeching away of good talent to the private sector. Every private MRI that opens increases wait lists because it must take qualified people away from the public sector. There are simply not enough health care workers out there to staff a public system and a private one, and certainly not health care professionals. We need a pan-Canadian health and human resources strategy that truly identifies the serious shortages that are coming up in the health care professions and we need to act on that now.

Furthermore, the government is moving far too slowly on a pharmacare plan. The cost of drugs is now second only to hospital costs and slightly higher than the amounts we pay to doctors.

Last night in the House we had the first hour of debate on private member's Bill C-274 presented by my colleague, the member for Windsor West. It has a real plan to ease some of the spending crunches that provinces are currently facing with drug costs by reforming the system of patents and allowing generic drugs to enter the marketplace sooner. This is a critical issue as well. The Liberals could have made these changes already, but they have introduced regulations that maintain the status quo and will not help Canadian families access cheaper drugs to keep themselves healthy.

In closing, in view of the lack of accountability from this particular bill and the creeping privatization, we need to have an open and public debate to shine the light on the decisions that were made behind closed doors at the first ministers meeting in September. It is absolutely critical that we have a full review at the committee level on the issue of accountability.

[Larry Bagnell, Liberal, Parliamentary Secretary to the Minister of Natural Resources]

Madam Speaker, I thank the member for her very reasoned approach and I appreciate a lot of the things she said. I would like to elaborate that the federal funding was never 50% on health care. We paid 50% of certain costs in the past, but there was never a total of 50%. If members want to see the exact calculations, some do not have the figures at their fingertips, they are on the finance website. Depending on which of the health care items we put forward, it could be 33%, 37% or 40% today.

I am glad the member brought forward the point about human resource strategy because there are elements of that in our deals with the provinces. I am glad she brought up patents because I have been fighting that battle with her colleague and I am quite supportive of changes, although the regulations we proposed are not the status quo. The regulations that exist now are the status quo and we want to change them.

Hopefully the member will support the Prime Minister's effort to ensure that the discussion with aboriginal people took place before the main discussion on health care because that was an important item that had to be looked at. It was looked at and progress was made. The Premier of Alberta suggested that to keep the system funded and sustainable there needs to be some sort of mix of both private and public or the system will bankrupt. I would like her to comment on the premier's views.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Madam Speaker, I agree with the human resource strategy. It is absolutely essential and I suggest that we need to go further than is indicated. I met with the College of Family Physicians this morning. It clearly indicated that unless we deal with it expeditiously in a coordinated fashion, we are going to be in real trouble with human resources over the coming years.

On aboriginal health, I have one of the largest first nations communities in British Columbia in my riding. Aboriginal people welcome being included in any solutions that are dealing with aboriginal health. It is absolutely essential that aboriginal voices are at the table when we are developing strategies to deal with aboriginal health. They must be at the table in a meaningful way, not just for consultation but able to give meaningful input.

When it comes to a mix of private and for profit, I would argue that as we are providing funds into for profit health care we are actually pulling money out of the public system. As soon as we introduce an element of profit I would wonder why we could not be spending that for profit money in the direct delivery of publicly funded and publicly delivered health care. Canadians have been very clear that they want a publicly funded and publicly delivered health care system that remains accountable.

[Keith Martin, Liberal, Parliamentary Secretary to the Minister of National Defence]

Madam Speaker, I thank the member from Vancouver Island for a number of her comments. Health care is something that we are all seized with because there are two things happening in our society that are clashing and in fact threaten to rupture all of our social programs. That is why we have been consumed by this issue, because it matters so much in a blood and guts and life and death situation for so many Canadians.

Our aging population and our increasingly expensive medical technologies are putting such a demand on the health care system and our social programs that they threaten to rupture them. With the amount of money we actually have to pay for them it is going to be extremely difficult, if not impossible, to meet those demands.

We have to ensure, as she quite rightly said, that we improve the accountability of the system to ensure that we get the best value for the taxpayers' dollars. I remind her that there is only one payer: the hard-working Canadians who pay taxes.

How do we accomplish that? What the government has tried to do and is doing is to come out with the bill, an element of which is how we will work with the provinces to put in that accountability so that we do get the best dollar value for Canadians. I encourage her to put forward her comments and her input to the Minister of Health. I am sure he will appreciate that.

On the issue of private health care delivery, I want to remind the member of one salient fact. The Canada Health Act talks about us having a public payer system. It does not say anything about the delivery mechanism. In fact, as she knows, the vast majority of health care delivery in Canada is private. Physicians, physiotherapists and pharmacists are all private, for profit deliverers, so that is not the issue.

Here is what we are all trying to do. Here is what the Minister of Health is trying to do. We are all trying to work with the provinces because they are the managers of health care. As a federal government, as the member for the Bloc correctly said, we do not have the jurisdiction to manage health care, but we are working and want to and will work with every single province and every single minister of health to ensure that every Canadian has high quality access to health care. It is one of the most difficult things we have to do, but it is one of the most pressing.

I want to ask the member just one question. Tommy Douglas made it very clear that he did not have a problem with and in fact supported private, for profit deliverers giving health care. What does she say about that when Tommy Douglas, the father of the NDP, said that he would support this in the mix of trying to ensure that Canadians get timely access to quality health care in our country?

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Madam Speaker, before I get to the member's final comment, I want to address the facts about what we need in a health care system. I agree that we have an aging population and we will have some serious problems if we do not deal with it, so I would encourage the government to actually develop a strategy that includes the social determinants of health and looks at health care in a much broader way than is currently done in looking primarily at acute care and primary care. We really need to encourage the system to be innovative and creative and to look at prevention. What we really want to do is stop people from getting into the health care system. When we look at things like the social determinants of health, that goes a long way toward that strategy.

With regard to Tommy Douglas, a number of years have gone by since Tommy Douglas and the party of the time took great strides in making sure that Canada had a national health care system. As they were making a transition from no medicare into something that was difficult for many people to get their heads around, he was making statements in the context of that day and age. I think that if we go out to the public in this day and age, we will hear the public clearly saying that it wants publicly delivered and publicly funded health care. Some 40-odd years later, that is what I think Canadians want.

I would encourage the Minister of Health to include in the Canada Health Act something to actually prevent for profit delivery. It currently does not.

[Peter Julian, NDP, Burnaby—New Westminster, BC]

Madam Speaker, the comments by the member for Nanaimo—Cowichan in this extremely important debate on the future of health care were very thoughtful. I was particularly touched by her comments around the possibility of big box, credit card, for profit health care coming to Canada given that the Liberal government has not applied for a WTO exemption on health care.

We already know that a number of the more right wing provincial governments, such as what we have seen in British Columbia, are moving in that direction. We have also seen the tragic consequences of this in the United States. The most expensive health care system in the world leaves 60 million Americans with no health care coverage at all. As we know from a study just last week, more than half the bankruptcies in the United States are caused by this lack of having a solid public medicare system.

My question to the member is the following given that Canadians are very concerned about this and given that, as in most areas, the Liberal government has not responded to Canadians' interests but has been more interested in Bay Street's interests than main street interests. Now that the member is the new health critic for the New Democratic Party, has she seen any movement from the government to actually respect Canadians' wishes to maintain a strong and viable public health care system?

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Madam Speaker, leaving the trade issues aside, Bill C-39 in part certainly is moving in the right direction in terms of reaffirming our commitment to a public health care system in Canada. If we could build in the accountability measures and the publicly delivered not for profit measures, I think many of us would feel far more comfortable.

We have not seen the kinds of initiatives that we would like to see from the government in terms of protecting our public health care system. We have certainly seen creeping privatization, with private MRI clinics and a number of other issues coming up on which the government is not actually acting. It can take any number of years for measures to be brought forward under the Canada Health Act. They just do not get dealt with in a timely fashion.

We would encourage the government to actually enforce the regulations that are currently available and to look at tightening up that loophole.

[The Acting Speaker (Hon. Jean Augustine)]

Is the House ready for the question?

[Some hon. members]

Question.

[The Acting Speaker (Hon. Jean Augustine)]

The question is on the motion. Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

[An hon. member]

On division.

[The Acting Speaker (Hon. Jean Augustine)]

I declare the motion carried. Accordingly, the bill stands referred to the Standing Committee on Finance.

(Bill read the second time and referred to a committee)

Quarantine Act

[Mauril Bélanger, Liberal, for the Minister of Health]

moved that Bill C-12, an act to prevent the introduction and spread of communicable diseases, be read the third time and passed.

[Carolyn Bennett, Liberal, Minister of State (Public Health)]

Madam Speaker, in today's modern era, emerging and re-emerging public health threats do not respect borders. This we know first hand from our recent experience with SARS.

With advances in technology, rapid air travel is now common practice in the daily lives of individuals, replacing the days of long voyages on ships. The new age of jet travel is paving the way for increased population mobility and has accelerated the rates in the spread of disease on both a domestic and an international front.

A serious communicable disease can spread to any part of the world within 24 hours, which is less time than the average incubation period of most diseases.

This new reality regarding the health of migrants is becoming a growing transborder problem with many public health ramifications, including effects on the social and economic fibre of our society.

While the existing health protection system has served the interests of Canadians well, the time has come to update our laws and to integrate them into a public health system that is stronger, more comprehensive and more flexible, precisely as recommended by Dr. David Naylor and the Senate Standing Committee on Social Affairs, Science and Technology following the SARS crisis.

Lessons learned from SARS forced Canada to face the fact that our current Quarantine Act is outdated in the public health realm. The existing legislation had remained largely unchanged since the adoption of the first Quarantine Act in 1872. Hence, there is an urgent need for updated legislation to mitigate the heightened risk of global disease transmission and to support public health practices in modern times.

Although Bill C-12 serves to modernize the Quarantine Act, it is only one tool in Canada's public health toolbox. The creation of the Public Health Agency, the appointment of David Butler-Jones, Canada's first Chief Public Health Officer, and the Canadian pandemic influenza plan are all essential elements of the government's strategy for strengthening Canada's public health system.

Public health is a shared responsibility. While the provinces and territories bear the responsibility for protecting public health within their borders, the federal government has a constitutional authority for quarantine at Canadian points of entry and departure.

Existing federal powers under the Quarantine Act are outdated. They do not reflect the changing face of emergency preparedness and response in the 21st century. That is why we are moving forward immediately with new quarantine legislation that will give the government the means to cope with and control disease outbreaks and ensure better communication, collaboration and cooperation among public health partners.

The scope of the new proposed Quarantine Act is limited to ensuring that serious communicable diseases are prevented from entering into Canada or being spread to other countries. It will also mitigate the risk of future threats to public health at home and beyond to our international partners.

The new act respects shared federal, provincial and territorial responsibilities in public health. Further, the Government of Canada will continue to work with our provincial and territorial partners to prevent and control the spread of communicable diseases within and between jurisdictions.

The modernized act we have proposed has a new focus on airline travel and will provide the Minister of Health with additional authority. For example, Bill C-12 would enable the minister: to divert aircraft to an alternate landing site if necessary to isolate and contain a public health threat; to establish quarantine facilities at any location in Canada; to order a carrier to not enter Canada if there are serious concerns that the arrival may threaten the public health of Canadians; or to close Canadian border points in the event of a public health emergency.

The proposed legislation offers greater flexibility with respect to the types of communicable diseases for which travellers coming into or leaving Canada may be detained by Canadian officers.

Bill C-12 protects privacy rights and maintains an appropriate balance between individual freedoms and the public interest. While the amended act allows the collection and sharing of personal health information, this is limited to what is necessary to protect the health and security of Canadians.

In addition, the bill enables Canada to assume its responsibilities as a partner in the area of global public health. The amended act is aligned with Canada's obligations under the World Health Organization's International Health Regulations.

Overall, this legislative reform initiative reflects the government's commitment to strengthening Canada's public health system. By introducing Bill C-12, the Government of Canada is responding to the call from Canadians to do more to protect the public from unnecessary health risks.

Further, the newly proposed quarantine act is responding to the calls of experts in the public health community to modernize the legal tools for preventing the import, export and spread of serious communicable diseases, while affording individuals full protection under the Charter of Rights.

In conclusion, I wish to express my gratitude for the hard work of the Standing Committee on Health. As the Minister of State for Public Health, I strongly support Bill C-12. This, as a federal legislative tool, is a critical measure in the establishment of a comprehensive pan-Canadian public health system and paramount to protecting the health and safety of Canadians.

[Réal Ménard, Bloc, Hochelaga, QC]

Madam Speaker, it is always a pleasure to see you in the Chair. I know that you have things well under control.

If I may, I would like to put a few questions to our colleague and friend. Incidentally, I knew her predecessor very well, the former member for St. Paul's. He was a phlegmatic person, who had a lot of composure and a bit of a British temperament. He was my friend and I know that the hon. member opposite is also my friend.

I have three questions to put to her. The Standing Committee on Health spent many hours working very hard because, as we know, the Quarantine Act dates back to the 19th century. It really needed to be modernized. Let us not forget also that, in the 19th century, ships were the primary sources of communicable diseases, since they were the main means of transportation. Today, the most important provisions of the bill deal with aircraft.

I would like to get the opinion of the minister who, as we know, is a doctor, regarding the issue of compensation.

We know that the bill allows the minister to designate any place in Canada as a quarantine facility. The Bloc Québécois took into consideration the jurisdictions of the provinces and proposed amendments on this issue. I want to ask the minister about her views on the issue of compensation. In light of this power held by the minister, our fellow citizens could conceivably be stranded for 24, 48 or 72 hours and prevented from getting back to their workplaces. Does the minister not think that it would have been advisable to include some compensation formulas?

I also want to ask her if, as a doctor and a parliamentarian, she can express her views on the list found in the schedule and review with us the various diseases found on that list.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Madam Speaker, the Bloc Québécois member has a good question regarding the issue of compensation. I think he is well aware that this issue requires greater flexibility and that each case should be reviewed on its own merits.

We think that sometimes it may be a small, very obvious compensation that would be negotiated. Sometimes it may be on a grand scale, such that everybody will be able to contribute their opinions on something like this. Obviously there are many times where it will be a public facility and many times it will differ from situation to situation.

We hope this kind of approach will not be in the letter of the law but will be something that is free to be negotiated situation by situation, not only with the Minister of Health but among the provinces and territories which often will be the ones that have the best opinion as to what place to use.

As the member knows, public health is really done from the bottom up and our job is try to facilitate the best possible decisions based on the people on the ground who know best.

The kinds of diseases that the member is asking about are communicable diseases that could put the public health at risk. During the SARS outbreak we did not have a name for the disease and we did not even know the incubation period. It was called severe respiratory syndrome because we did not have a clue what it was or how it was transmitted. We are hoping this bill today will help us with not only the diseases that we know now, but with the diseases yet to come.

The problem of new and emerging diseases and this interest between animal health and human health, we know that 80% of these new and emerging diseases come from animals. They are known to vets. We are doing everything we can to examine these new diseases, as well as dealing with the ones that we know so well and are listed as communicable diseases right now.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

Madam Speaker, my colleague from the Bloc raised an important question that we are concerned about relating to compensation. Not only can conveyances be held up but a hotel, an arena or a curling rink could be commandeered for an extended period of time by Health Canada. The current bill before us says that the minister “may” compensate.

We would have liked to have seen that amended to say that the minister “shall” compensate because there could be a huge loss to a private operator who had scheduled events cancelled and perhaps hundreds of people booked into a hotel that suddenly have to be cancelled, conventions and so on, that we are expecting the private enterprise owner to absorb in the interest of public health. Surely, if it is a public health concern, the government ought to have an interest in covering those conveyances. As a first question and as a supplement to my colleague from the Bloc, I wanted to raise that.

My second question is a follow up to the question on which diseases were mentioned. I remember some discussion at committee regarding the list of diseases, many of which are, according to the discussion from the experts, rather antiquated. The list contains diseases like tularemia; typhoid; yellow fever; the plague, which has not been around for centuries; measles; and Marburg hemorrhagic fever. There was some discussion with one of our experts, Dr. Donald Low, a respected microbiologist very much involved in the SARS debate, and I thought we would get some recommendations on updating that list.

Could the minister of state comment on why we are still faced with this new bill but with these antiquated diseases, many of which do not require quarantine with today's technologies?

[Carolyn Bennett, Liberal, St. Paul's, ON]

Madam Speaker, compensation would be on a case by case basis. It would not cover all the problem situations. Compensation may not be appropriate in the case of it being a shared responsibility of a community or whatever. We need to think about compensation but it has to be negotiated based on each individual case. We need flexibility with respect to what situations will be compensated. Who would be compensated would need to be negotiated.

After the SARS outbreak in Toronto it was extraordinarily difficult to figure out whether compensation should be extended to all of the people who were affected. Flexibility was needed in order to say who or when or why.

Obviously we will need some flexibility as new diseases are added. The trouble is that when specialists and experts get involved they have tons of opinions. We would have laughed at the word tularemia this time last year until there was a huge outbreak in hamsters in Winnipeg. That was the first issue the chief public health officer for Canada had to deal with in terms of the export of hamsters infected with tularemia, which could have been a public health threat.

We also had hoped that polio and smallpox would be eradicated. We need the flexibility to add or subtract from the list but it needs to be done in a very comprehensive way over time.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

Madam Speaker, Bill C-12 is an act to prevent the introduction and spread of communicable diseases.

I am pleased to stand today on behalf of my constituents and as a member of the health committee to discuss some of our concerns relating to this bill. We must recognize that the bill is updating the original Quarantine Act which dates all the way back to 1872. I think we were all in agreement that given the current realities, it was time to look at how a new act should be implemented.

The legislation covers a whole range of issues relating to transmissible and communicable diseases. It defines the powers of the minister. It gives details on designating analysts and officers at quarantine stations and facilities, on the designation of entry and departure points to the country. It has great provisions relating to obligations for arriving and departing travellers, duties to provide information, obligations to inform, how the traveller is to be informed, arrest without warrant, disinfestation of a traveller, and medical examinations. It is a very comprehensive list of events that could affect society in quite a broad way.

It talks about interpreters and public health authorities. It talks about conveyances, aircraft coming and going, a bus or a ship coming in, and reporting obligations. It talks about transporting cadavers and body parts or remains. It has a whole definition of powers, who has powers of inspection or warrant, standard dwelling places, public officer powers, relations between quarantine officers and environmental health officers, and compelling people to provide information.

There are a lot of aspects to this bill that Canadians would be interested in and which may in fact affect them greatly if the provisions in this bill are implemented.

One of the concerns I have is that a person who has a disease is actually isolated because of the disease, but a person who might have it is put into quarantine. Those terms are used differently; a person who actually has a disease is isolated, but a person who might have a disease is put into quarantine.

We went through the bill because ultimately the clauses in multiple places refer to if a person has or there is reason to think a person has a disease. We added in at least 27 places “or might have”. When talking about “or might have” a disease, that could include all of us here in the House. We never know whom we might have sat with on the bus coming here today, on public transit, on an aircraft or walking through a mall. We might have passed by somebody who had a sniffle. It might just be a cold but it might be something else.

I am concerned about the “or might haves” that are provided all the way through the bill. We are giving extraordinary powers to actually control civil movement, to confine people for extended periods. The hon. member for Hochelaga who raised the question a moment ago mentioned 48 hours, but people could be confined for up to a week without any evidence that they were actually sick. They have to have an examination but it could be a week before symptoms might show.

There are great fears and concerns today. In Toronto we saw the devastation SARS had on the economy. There were 55 people who succumbed to the disease and many thousands who were inconvenienced by the disease. We saw the impact on the community.

There is a lot of fear being spread today about diseases, whether it is the avian flu or the West Nile virus. We are concerned about how they might affect the public. We saw an example in the Fraser Valley where there was concern about chickens that were sick. The Canadian Food Inspection Agency killed millions of chickens in the Fraser Valley. A lot of them were not sick. Some of them were organic birds, separated some distance from the ones that were sick. Was it necessary to kill all those birds in order to contain that disease? Were these responses appropriate or were they not? The agriculture committee is having some discussion about this. There are officials here this week discussing that very issue.

We have concerns about how these provisions might be implemented. We all hope that the provisions in this legislation will rarely be used and maybe never be used. The provisions in the old act were not called upon to be used that often.

My concern is that in today's environment of mobility, overzealous people may be concerned about something that inconveniences a lot of people who may not be ill at all and who may be held on suspicion and greatly inconvenienced.

There are powers for a screening officer without a directive from a quarantine officer to isolate a traveller. Police can arrest without warrant those who do not comply. People could be compelled to have an examination. They could be forced to have a health assessment if they might have a disease and forced to have a medical examination. That is not unreasonable if there is a serious concern. However they could be compelled to report to public health authorities.

Clause 26 concerns me. People might have a communicable disease or they might not and they could be compelled to have a treatment. It says that if a traveller has been in close proximity to a person who has or might have a communicable disease or is infested with vectors, the quarantine officer may order the traveller to comply with treatment or any other measure for preventing the introduction and spread of the communicable disease.

It worries me that people could be compelled to have treatment for something they might or might not have. Someone could come up with the notion that we should all be vaccinated with a new vaccine.

I just came back from Washington, D.C. the other day. There was an issue in the paper there about anthrax vaccines. U.S. military personnel are still being compelled to have anthrax vaccinations even though there was a court order to stop doing that because the vaccine had not been tested. There are very serious concerns about the safety of that vaccine and the FDA had not approved it.

There was a celebrated case in Canada. One of our own soldiers refused an anthrax vaccine. Some would say he might have been the smartest one in the group. The troops did not run into anthrax over there. If he has a good immune system, it may not have been a significant concern anyway, and there are very serious concerns about the effects of the vaccine on a healthy person's immune system.

I am concerned about compelling people to have treatment because they have been near someone who might or might not have a disease.

There are other concerns about compensation. We addressed those briefly in the exchange with the minister a moment ago. Clause 6 for example will require six and perhaps eight of our major airports to provide space free of charge. That includes fixtures, heating, electricity.

The airports at one time were run by the federal government but that is not true today. They are all run by airport authorities. Privately controlled airport authorities are having to raise their own funds for their expansion programs and for renovating their facilities. If the government is going to compel them to provide facilities, fixtures, heating and electricity without compensation, many of us in committee found that rather strange when those same organizations are paying very exorbitant rents to the federal government in order to use the space in the first place.

When we talked about compensation, we felt that if the minister was going to require the airports to cough up space for those facilities, the government should at least pay for what it requires them to produce. The airports already provide space for the Canada Border Services Agency, Citizenship and Immigration Canada, CFIA, Health Canada, the Air Transport Security Authority and the RCMP. All of that I gather is without compensation, while the airports are paying very expensive rents. It is a huge concern to the airports and airport authorities.

We mentioned in our questioning of the minister that the agency or the minister could take over a hotel, an arena or an auditorium to quarantine people if there was suddenly a need to contain people for an extended period of time and there is no provision to ensure compensation. It seems to me that fundamentally if it is a public concern, we should not drive a private hotel owner into bankruptcy because as a public good the owner was compelled to provide that facility for purposes other than what it was scheduled for.

There are a lot of concerns about compensation.

I am also concerned that many of the amendments we put forward at committee were disallowed because they had to have a royal recommendation. I understand the same thing happened yesterday when amendments were put forward to provide compensation in instances like the one we just mentioned. They were disallowed for the same reason. We as members of Parliament cannot introduce an amendment that would cost the government money.

As members of Parliament it seems to me that our role is to stand between the government and the people to make sure the laws that are coming in actually serve the public interest and protect the public from being exploited by the government. Some of us in the House still think that is our role.

In trying to introduce those amendments to the bill, we feel it is a valid concern to be raised to protect Canadians from activities by government, such as expropriating property without compensation. On this side of the House we actually believe in property rights, that citizens do have some rights and government should not expropriate their property or livelihoods without some form of compensation.

The bill talks about confining people. It talks about confiscating conveyances and cargo, aircraft and ships. We talk about issues of compensation.

There was another issue on which we brought forward an amendment, which I believe is still on the floor. Motion No. 11 would amend subclause 40(1). It has to do with a person being compelled to move a conveyance that may or may not be infected with vectors. We introduced this amendment to say that no person could be compelled to carry out an order under subclause 39(1) if doing so would expose them to danger as defined in subsection 122(1) of the Canada Labour Code.

That was to protect people where, for example, a quarantine officer might decide that a plane could have a disease on it which might just be a cold, but it could be something else, and the aircraft has to be moved. If the pilot is concerned that everybody has been quarantined and he has already come off the plane, he should not be forced to go back on that aircraft to move it. It could expose him to some risk that may put him out of circulation for some time to come. There may be another way to move a conveyance. That provision protects people from being compelled to perform a duty that may put themselves in danger.

The SARS episode a short time ago showed us the severe consequences of a rapidly spreading disease. It had a devastating effect on the economy. Perhaps the minister of state would correct me, but I understand there were about 55 deaths directly related to SARS. That figure probably is in the ballpark. There was a disruption to many thousands of people, to businesses and certainly to the entire health care system. It crippled the economy in the greater Toronto area for some time.

There are very serious concerns. On the other hand, I am concerned about a lot of media attention to diseases today. There is a lot of what some people might call fearmongering, particularly relating to the avian flu. We could perhaps include the West Nile virus. Ottawa city council passed an ordinance against using pesticides and herbicides in parks and areas where children might be exposed to these elements. That was overridden and we saw people spraying every little pond and pool of water because of the fear of the West Nile virus.

When I was on the health committee, officials who came before us said that only 1 in 155 people who contract West Nile virus have even a mild inconvenience, such as a fever, a cough, a cold, or any symptoms they could identify related to that disease. We have to wonder whether the heroic interventions that are being advocated by some are appropriate or whether they are excessive.

We are talking about viruses and pathogens. In the minister's opening remarks, she talked about the fact that today air travel moves people around much more quickly as opposed to the days when there was only surface travel and intercontinental travel took days and weeks.

However, there is quite a difference from being at surface level and being at 35,000 feet. Some of us in the House, especially those from the west and from the north, spend a lot of time on airplanes. Part of the difference is that the cabin pressure is much lower. The oxygen in the cabin may be as much oxygen as we have at ground level, but the pressure is not the same. They could not have ground pressure, one atmosphere, in the plane at 35,000 feet. It would blow the walls off the aircraft or it would be too heavy to fly.

The air pressure in the cabin is equivalent to about 700 feet of elevation. One of the privileges of travelling the long hours is we sometimes get to sit beside interesting people. I had an interesting discussion with an aeronautic engineer about this factor so I have some confidence in what I say. The problem with that is we need the atmospheric pressure to drive oxygen into our tissue. I am sure the minister would be willing to agree, or concede, that viruses work in anaerobic or hypoxic conditions. They have a great advantage over our immune system because our immune system is fuelled by oxygen. When we are on an aircraft, our heart rate is low, our respiratory rate is low and the cabin pressure is low.

We have talked about greatly inconveniencing air travellers by locking them up in an airport if they get off with a sniffle or with an elevated temperature. Maybe somebody ought to look at what we can do to reduce the threat to air travellers if they have a rapidly cycling virus, like the SARS virus, reproduce produces very quickly in their tissue when their immune system is at a disadvantage. That is where a long flight puts them at great disadvantage. If they were on surface travel, they might never have had the same complication with their immune system. However, this very rapidly cycling virus has advantage over their immune system, especially on long flights. We should look at this.

Perhaps it would be a good idea to give them more oxygen. That is not an expensive intervention. If people on the aircraft are ill, perhaps they could be administered more oxygen. Perhaps we could put a higher percentage of oxygen so the lower cabin pressure might not put them at as great a risk. Perhaps we could look at what we could do with the filtration systems. I know travellers today are very worried about breathing the air when somebody has a cough or a sniffle. Those of us standing in lines at airports know what this is like. If people have a bit of a cough or tickle in their throat and they cough, they can have a lot of looks coming their way, even though what they have is probably a minor affliction. People are very worried about it today. Perhaps we could look at installing UV-light systems in the duct-work, which would reduce virus transmission in passengers.

I hope someone is considering these options to make air travel safer.

As well as what I have suggested, members who travel long hours should take a little extra antioxidant vitamin before they fly, some Coenzyme Q10, or some extra vitamin C, or some pycnogenol, or some maritime pine bark, some good antioxidant vitamins before they travel. I know a lot of members take COLD-fx now. It is anti-viral and non-toxic. Taking a little of that when immune systems are at a disadvantage might be a good idea for a lot of our colleagues in the House. I notice a lot are suffering right now from coughs and sniffles. This is one thing that we might consider doing.

What about other ground level interventions that might really help? For example, I remember when SARS came out, the former minister of health came out trumpeting that there was no known cure for SARS. The minister of state just admitted that. We did not know what it was. That is why we gave sudden acute respiratory syndrome an acronym. However, we suspected it was a virus.

Why would we not consider using things that are known to be anti-viral? We have Top medical expert Dr. Rath from Germany asked why had not considered giving intravenous vitamin C. There is a good possibility that it might have saved all but the most severely compromised.

I hope other alternatives are being considered. We hope the provisions of this bill will not be implemented very often. We hope we can all work together to see that Canadians are safe when they travel.

[Réal Ménard, Bloc, Hochelaga, QC]

Mr. Speaker, I thank our colleague for his speech, which was often passionate, as we know Conservatives can be on certain issues. I will ask three questions of my colleague, a chiropractor by trade who, like myself, has followed the proceedings in parliamentary committee very closely. It is a committee, incidentally, which functions quite well and is relatively free of partisanship.

I would first like to ask what his party's view is on compensation. We know that a number of witnesses have said they would like to see the possibility of a per diem payment when a quarantine zone is established in Canada, even if it has to be established, of course, by regulation. I am not asking our colleague to tell us how much that per diem should be, but I would like him to speak to this all the same.

Secondly, this is a bill whose regulations, which will be made by order in council, are extremely important. Does he share my view that, as with the Tobacco Act to some extent, it is very important for parliamentarians to look at these regulations? We know that the regulations often determine the “operationalization” of a statute, and that it is increasingly common practice in this Parliament to ensure that hon. members can see these regulations in the end.

And third, can he tell us whether he considers Schedule 1 of the bill to be complete? If not, what other types of infections would he like to see in it?

[James Lunney, Conservative, Nanaimo—Alberni, BC]

Mr. Speaker, I know he is a person who has been committed in his service to the health committee for a long time, although committed almost sounds like a sentence.

On the question of compensation, we talked about that in terms of conveyances already, and airports, hotels, et cetera. The form of compensation is a measure of accountability. When we give great powers to officials to inconvenience and affect public activity, we need to be careful that there are some accountability measures.

Specifically, I believe, the hon. member is referring to compensation for individuals. It concerns me when we have an official who may be overzealous. I have had some run-ins with officials who are rather zealous in applying their responsibilities, such as the CFIA in my own riding, for example, sometimes overriding the edge of what is reasonable for people to respond to in another area of responsibility. I am concerned that if there is no measure of accountability, these things can be applied because they are driven by other agendas, fear, “might be” or “what if”, rather than reality. I certainly felt that we should explore whether some mechanism of accountability could be applied.

If people are sick and confined, we expect they are receiving good care and the public is being protected. We understand that. However, if they are not sick and are inconvenienced for a week or held back, then there is a very serious reason to be concerned about that, and maybe they should be compensated.

The regulations need to be reviewed by the health committee, as we have in other areas like reproduction technology. We want to review those regulations.

As far as appendix 1, the minister has the power to add or to subtract diseases to that list. There are many on it that probably should not be on it. We could probably have a more refined and tighter list, according to some of the experts from whom we heard. I am not aware that there are others that should be added at this time, but it is something that should have been updated. I think it is a little antiquated.

[Russ Powers, Liberal, Ancaster—Dundas—Flamborough—Westdale, ON]

Mr. Speaker, prior to coming to the House, I put on hold an over 25 year involvement in laboratory medicine, both in a university and hospital setting. I am intrigued by the comments of the hon. member for Nanaimo—Alberni.

The question that prompts me, and it is probably a straight out question, is it the total legislation with which the hon. member has problems or are there some elements of it with which he has problems?

A lot of the emphasis he raises has been with regard to the potential fiscal penalties. Being actively involved in a clinical setting, the ramifications of the SARS epidemic, where I am located, were clearly felt to be within the broad sweep of that international gateway. We were very appreciative of the measures that were clearly imposed upon us by the federal government and the province of Ontario to mitigate the spread of that infectious disease. As a result, we instigated measures to reduce the impact.

Perhaps the hon. member is in a position to answer the question.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

Mr. Speaker, I know that as an authority in his own right in laboratory medicine and procedures, his question is a genuine one. I am sure for people who were involved in that arena during that period, as he was, it was a life changing experience and one that nobody will likely to forget in a hurry, and probably not too keen to repeat.

My problem with the bill is not that we do not need to take measures. It is that we ensure that the interventions we take are the most appropriate ones. I am concerned that there are possibilities of mitigating the risks that are even under utilized and under investigated.

Some of the possibilities which I just raised such as oxygen, et cetera , with pathogens being more active in anaerobic environments, I raised with Dr. Low, a very well respected microbiologist. Frankly, it went right past him. He did not engage seriously with that. I think it is because all his research is at ground level, one atmosphere. When people work in one arena, they sometimes do not think about other possibilities.

In the oxygen area, I think we might have some great advances to reduce the morbidity of disease. Rather than going to draconian measures to restrict everybody, if we caught those people with low cost intervention, that might prove to be more effective, and we might obviate the need for some of the more serious interventions advocated by the bill.

[Réal Ménard, Bloc, Hochelaga, QC]

Mr. Speaker, it will be my pleasure, in the next 20 minutes, for this is in a way the mandate I have set for myself, to speak to you about this exciting Bill C-12, the first version of which had been introduced by the minister of Foreign Affairs and used to be known as Bill C-36. Our television viewers—and we know that there are many at this hour—will no doubt be happy to learn that the number attached to bills corresponds to the order in which they are introduced in this House. So that means that this is the 36th bill being introduced by the government.

Those clarifications having been made, let us talk about the Standing Committee on Health. And I will take the opportunity here to thank my party for entrusting me with responsibility for health. After all these years, I derive a certain satisfaction from being the dean of the Standing Committee on Health. I believe I am the youngest in terms of age, but the dean in terms of seniority, since I have been there since 1999. As the hon. member for Longueuil—Pierre-Boucher knows, I have been through the great debates on labelling, tobacco products and so forth. So I have some experience, let us admit, on health issues.

The quarantine bill is rather technical, and we might think that it does not have much to do with human rights. But that would be wrong for, as I will show, the committee wanted to amend some 30 clauses—now I am getting the attention of the member for Marc-Aurèle-Fortin—to introduce a concept that has a very specific legal meaning, namely reasonable doubt.

The member for Marc-Aurèle-Fortin used to be a penal law professor at the Université de Montréal. I know that his courses were popular: just one exam, no term papers, reasonable jurisprudence. He was a sought-after professor and he also served Quebec well in his various ministerial capacities.

That said, in regard to the quarantine bill, legislation from the 19th century—I think that only the member for Glengarry—Prescott—Russell could actually refer to this period from memory—the legislation has not been reviewed very often. The way diseases are spread is no longer the same. We will remember that ships were the main means of transportation in the 19th century. Now, as our transport critic knows, people travel by plane. There are trains, too, maybe, in some places, but the main means of transportation remains—