House of Commons Hansard #60 of the 38th Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was federal.
Jason Kenney Conservative Calgary Southeast, AB
Mr. Speaker, in the spirit of my own point of order, I need to correct the record. The Hansard transcript says that the Prime Minister said, “Syrians should be withdrawn from Lebanon”. I misspoke, Sir, when I said Libya. It is Lebanon. That is what the transcript says.
Points of OrderOral Question Period
The Speaker
I want to thank the hon. deputy government House leader and of course the hon. member for Calgary Southeast for raising this matter. I will look into the matter and come back to the House.
I appreciate the diligence of the member for Calgary Southeast in reading the blues and reading Hansard with such care and concern. I certainly will look into the matter. Whether this is such a dramatic change and will warrant intervention on the part of the Chair, I will have to decide after I have had a chance to look at the matter, and I will do so and get back to the House in due course.
Michel Guimond Bloc Charlevoix—Montmorency, QC
Mr. Speaker, it is my pleasure to submit a petition signed by citizens from the riding of Montmorency-Charlevoix-Haute-Côte-Nord, but also from the region of Quebec City. They believe that Canada's participation in all or part of the missile defence program would be contrary to their interests and values. They also ask Parliament to take action to oppose any participation by Canada in the U.S. missile defence program.
Maurice Vellacott Conservative Saskatoon—Wanuskewin, SK
Mr. Speaker, this petition adds to probably some tens of thousands of other petitioners at this point, and to hundreds of letters I have received in my office on the subject.
These Canadians are calling upon Parliament to support the traditional, historic definition of marriage. The petitioners urge Parliament to be careful in its deliberations on the bill before us at the present time. I table that for the consideration of the House.
Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON
Mr. Speaker, the petitioners recognize that traditional marriage is the best foundation for society, families and the raising of children and that it is the exclusive domain of Parliament to uphold the definition of marriage.
The petitioners, therefore, ask that Parliament define marriage in federal law as the union of one man and one woman to the exclusion of all others.
Mark Warawa Conservative Langley, BC
Mr. Speaker, I also rise with two petitions. The first one is from residents of my constituency of Langley.
The petitioners also ask that the House enact legislation to support the traditional definition of marriage as being between one man and one woman.
Mark Warawa Conservative Langley, BC
Mr. Speaker, my second petition is from petitioners across our country asking for Parliament to deem autism a medical essential treatment. The petitioners also ask for academic chairs to be set up at universities in every province to teach treatment for autism.
Charlie Penson Conservative Peace River, AB
Mr. Speaker, I have one petition today containing 25 signatures. The petitioners call upon Parliament to recognize the institution of marriage as being the lifelong union of one man and one woman to the exclusion of all others.
Raymond Simard LiberalParliamentary Secretary to the Deputy Leader of the Government in the House of Commons
Mr. Speaker, if Question No. 26 could be made an order for a return, the return would be tabled immediately.
Greg Thompson Conservative St. Croix—Belleisle, NB
With regard to the Atlantic Canada Opportunities Agency, what is the detailed breakdown of the projects it has funded for the Atlantic Innovation Fund Program, the Business Development Program, the Atlantic Trade and Investment Partnership Program, the Strategic Community Investment Fund Program, and the Entrepreneurship and Business Skills Development Partnership Program, from October 1, 2000, to October 25, 2004, including: ( a ) the name, address and type of the recipient business, post-secondary institution, research institute or community; ( b ) a complete description of each project; ( c ) the date(s) and amounts of the financial contribution(s); ( d ) whether each entity funded started to repay its financial contribution(s); ( e ) the name and constituency of the Member of Parliament or Minister who signed off on each project; and ( f ) whether the entity funded is still in business?
(Return tabled)
Raymond Simard Liberal Saint Boniface, MB
Mr. Speaker, I ask that all remaining questions be allowed to stand.
The House resumed consideration of the motion that Bill C-39, an act to amend the Federal-Provincial Fiscal Arrangements Act and to enact an act respecting the provision of funding for diagnostic and medical equipment, be read the third time and passed.
Pierre Paquette Bloc Joliette, QC
Mr. Speaker, I am pleased to speak to Bill C-39 because it shows the true nature of this Parliament. It is unfortunate, but despite the fact we have a minority Liberal government, the Liberals, as you know, have not lost any of the arrogance that has been their trademark for 9 or 10 years, under Mr. Chrétien and the new Prime Minister.
We saw this arrogance when we found out that Bill C-39 was not consistent with the special agreement signed with Quebec at the conference on health. As a matter of fact, Bill C-39 contained only one mention of a specific agreement with Quebec, in clause 25.9. Also, Quebec was not specifically excluded from other requirements in the bill, like the Canadian Institute for Health Information or the dedicated funds. Bill C-39 showed once more this arrogance of downplaying the importance of a specific agreement with Quebec. The agreement was quite clear. I will have the opportunity to deal with this later on.
I mentioned at the start that Bill C-39 shows the true nature of this Parliament because the Liberals, even though they are a minority government, seem unable to suppress this arrogance towards Quebec and this Parliament. Fortunately, the Bloc Québécois and its members in this House immediately sounded the alarm and sent a clear message to the government and the whole Parliament that the bill was not consistent with the intent and the letter of the special agreement with Quebec. Thanks to this intervention, especially by the member for Verchères—Les Patriotes, the Bloc Québécois critic for intergovernmental affairs, and despite the reluctance of the government, we were able to pass an amendment, and Bill C-39 is now consistent with the intent and the letter of the agreement. We think the bill is now quite acceptable and we will support it.
Just imagine what would have happened had the Bloc Québécois not been here. Bill C-39 would probably have been passed unchanged, and Quebec would have been penalized. This goes to show how important it is to have members who stand for Quebec's interests first and promote an exciting collective project--the sovereignty of Quebec.
I mentioned that it cannot be by chance that the government brought forward the original draft of Bill C-39 without taking into account the specific agreement with Quebec, because that agreement was very clear. For the benefit of people watching us, I would like to cite it. In the specific agreement with Quebec, there was a very clear written statement:
--resting on asymmetrical federalism, that is, flexible federalism that notably allows for the existence of specific agreements and arrangements adapted to Quebec's specificity--
Quebec will apply its own wait time reduction plan, in accordance with the objectives, standards and criteria established by the relevant Quebec authorities--
The Government of Quebec will report to Quebeckers--
It could therefore not be any clearer than what I have just read. However, the Government of Quebec, even though it is led by federalists, knowing the reflexes of the federal government, particularly when Liberals are in power, even had the following disclaimer added at the end of the communiqué, to ensure that there would be no confusion possible, and I quote:
Nothing in this communiqué shall be construed as derogating from Quebec's jurisdiction. This communiqué shall be interpreted as fully respecting its jurisdiction.
Members will understand that we were quite surprised to see that, in the original draft of Bill C-39, there were not more references to the clause 25.9 in terms of that specific agreement. Let us recall that, when that specific agreement was signed, for a few days, people believed there really was a new approach on the part of the federal government, which the Bloc Québécois leader, like MNA Louise Harel, had called asymmetrical encroachment.
The federal government was therefore agreeing, in this specific agreement, to respect Quebec's jurisdiction over health issues, as set out in the Canadian Constitution. It was however an innovative approach. In the recent years especially, with the fiscal imbalance and the Liberal government's tendency to impose a federal presence in all areas of Quebec's and the other provinces' jurisdiction, particularly if there was some sort of visibility or political points involved, this asymmetry in terms of intrusion seemed to be a step in the right direction.
Unfortunately, this respect of Quebec's jurisdictions lasted only a few days. Nothing new there. As I was saying, the defence of the 1867 Constitution caused an outcry in Canada. The member for Verchères—Les-Patriotes was talking about that. The former finance minister, Mr. Manley, condemned that. All the dyed in the wool Trudeau supporters told English Canada that the direction we were taking posed a threat to Canada's unity. Since then, we have seen no new asymmetrical intrusion initiatives since the one made at the health conference.
Moreover, a few weeks later, during the funding conference, the federal government unilaterally decided to restrict the conference to the issue of equalization. It announced the amounts available, right at the start, saying that the formula that had been unilaterally imposed before the latest elections would continue to be used. It dealt with none of the provincial concerns, particularly those of Quebec.
When we saw the first draft of Bill C-39, which did not take into account the distinct nature of the agreement entered into at the health conference, the member for Verchères—Les-Patriotes asked a question on February 10, 2005, of the Parliamentary Secretary to the Minister of Health in order to alert the Minister of Health to the fact that there was no explicit reference to the specific agreement with Quebec, except, once again, section 25.9, which was clearly inadequate.
The parliamentary secretary answered that the member's concerns were not justified. We were heading toward a dead end. You will recall that, at second reading, we had opposed Bill C-39. Given the inadequate reference to the specific agreement with Quebec, we could not have supported it.
The Bloc Québécois proposed amendments to Bill C-39, in line with the accord signed in September. First, we reincorporated in the bill the fact that the funding made available by the Government of Canada will be used by the Government of Quebec to implement its own plan for the renewal of Quebec's health care system.
Those who have been following the politics of Quebec for the past few years, know that there have been many studies to reform the health care system, just as in a number of Canadian provinces. First, there was the Rochon Commission, then the Clair Commission. The reforms are now well underway. The so-called expertise of the federal government in this domain is not needed at all. It manages only a few veterans hospitals, which are constantly being criticized.
Second, in our approach regarding the amendments to Bill C-39, we made sure that the Government of Quebec would be accountable to the population of Quebec. We excluded any hierarchical relationship where the federal government thinks that it is supposed to decide on the validity of the actions of the Government of Quebec. The Government of Quebec is accountable to the nation of Quebec, to the people of Quebec only. When elections take place, Quebeckers express their view of government management of health care and many other things.
So our second concern was about the Government of Quebec informing its own population of the progress achieved in the pursuit of its goals.
The third aspect is the Health Commissioner of Quebec being responsible for reporting to the Government of Quebec on Quebec's health system. The Canadian Institute for Health Information should not, therefore, be informing the public on advances by the Government of Quebec, the health department and the other players in the health care system, with respect to the concerns of the public and issues such as the modernization of our health system. These issues must take a number of challenges into account, in particular the challenge of demography, which, as you know, is linked to the aging of our population.
There obviously will be cooperation with Canadian Institute for Health Information. Though it was never a problem, it should have been made clear that Quebec's Health Commissioner was responsible for reporting to the Government of Quebec and, through it, to the public on the state of health care.
This amendment we moved was adopted by the committee. As I mentioned, the original version was unacceptable, but we will support the amended version of Bill C-39.
I mentioned that the concept of asymmetrical federalism, which is in fact asymmetrical interference, was very short lived. To prove it, I point out that on October 26 of last year, at the conference on the provinces' financial situation, which covered more than just health, which had been the only subject of conference in September, Ottawa decided unilaterally that equalization would be the only item on the agenda. The federal government said right at the start what amounts would be available and announced that not one cent more would be added to equalization and that the formula used in its calculation would remain unchanged. I remind you that the formula had been imposed unilaterally by the federal government a few months before the last elections. Moreover, the Prime Minister refused once again to admit that there was a fiscal imbalance and spoke only of fiscal pressure on the provinces knowing full well that the situation is a lot worse.
I repeat that that asymmetrical interference or asymmetrical federalism, as they called it, did not last long. We saw it during today's question period. There is still no agreement on parental leave despite an agreement in principle signed before the elections. There is still a gap of about $200 million between the positions of the federal and Quebec governments. Here again, we can see the federal government's hard line attitude common in its relations with Quebec.
So the problems go well beyond the area of health. Let me give you another, more regional, example. As you know, there is a crisis in the tobacco industry. It is a totally understandable crisis considering anti-tobacco campaigns. Being a non-smoker, I support those campaigns. But the fact is that there was a sharp decline in demand for tobacco. Moreover, the three major tobacco companies decided to stop buying tobacco in Quebec to concentrate their purchases in Ontario.
The region that I represent, namely Joliette and Lanaudière, was home to virtually all tobacco farmers. Out of the 57 who were in business three years ago, fewer than a dozen continue to produce a small amount of tobacco, trying, naturally, to diversify their operations, production and crops, and only three intend to continue growing tobacco to meet the demand of independent manufacturers like Lépine cigarettes and other manufacturers operating in first nations reserves.
This is therefore an emergency. Tobacco farmers need assistance to switch from one type of crop to another, such as Chinese cabbage or kiwi; anything that can grow in sandy soil ought to be considered. Anyway, these growers need assistance.
Like parental leave, this assistance was announced a few days before the election. Electoral democracy is good after all. A few days before the election, approximately $70 million in assistance was announced. That was many months ago, yet we are still waiting for the terms and conditions of this aid package for tobacco farmers in Quebec and Ontario to be defined.
It would appear, and this is more serious, that assistance for the 57 tobacco farmers in Quebec, 95% of whom are in the Lanaudière region, is being blocked by a dispute between Ontario farmers and the provincial government of Ontario.
I find it completely absurd that producers in Quebec are being taken hostage in a situation that is totally out of their control. Naturally, for the federal government—and that is what we were told by the parliamentary secretary in response to a question I put to him last week—the same solution has to apply to producers both in Ontario and in Quebec. Consequently, until an agreement has been reached with Ontario farmers, no money will be made available to the farmers in Quebec.
Their situation is totally different, though. These farmers in Quebec have already stopped growing tobacco or started efforts to quickly switch crop production. To conclude this brief aside, I want to emphasize that the funding problems facing these tobacco farmers is largely due to the fact that tobacco companies have forced them to replace their dryers just two years before they decided to stop buying any tobacco in Quebec.
They need help for converting their land because switching from tobacco to asparagus does not just happen in one season. Often it takes five years before production becomes efficient. They are also burdened by debt, which they are unable to amortize with financial institutions in the region.
As I was saying, this asymmetrical approach was nothing more than a virtual approach, which did not even last long enough for the ink to dry on the separate health agreement. The government no longer mentions this approach. Again, refusing to acknowledge the fiscal imbalance makes it impossible to find a definitive comprehensive solution to the funding problem. This is so for Quebec, but also, unfortunately, for many other provinces. However, the federal government has been much quicker and much more generous with provinces such as Newfoundland and Labrador and others over the past few weeks, while Quebec has to continue to struggle.
As I was saying, the agreement on health does not solve the fiscal imbalance problem. It is like taking an aspirin to try to get rid of cancer. I will give some figures, although the hon. member for Verchères—Les Patriotes already gave some earlier. Nonetheless, if I have time, I would like to go into more detail.
The specific agreement on health provides Quebec with approximately $502 million more this year, out of a budget of $20 billion. Consequently, this fresh federal input represents only 2.5% of the Quebec budget, or about 9 days of operation. That is just for health, so what they have done is the equivalent of helping Quebec meet its health care responsibilities for the equivalent of nine days.
The federal government boasts that it is getting close to the 25% target the Romanow report recommended for health and social funding. When we look at all social spending, that is education, social assistance, the areas covered by the Canada social transfer, which is now, as we know, divided into a transfer for health and one for social programs, it is obviously far from that 25% figure. Especially because, as far as equalization payments are concerned, the results have not been what might had been expected, that is, a new formula that is fairer, more stable and more generous to the provinces needing these federal transfers.
In fact, after the October conference on the provinces' financial difficulties, which eventually shrank to nothing more than a conference on equalization, Quebec will end up with a mere $300 million more in equalization payments.
Overall, in its “generosity”, this government will have transferred $800 million more to Quebec this year, whereas the shortfall—according to the Government of Quebec, or its finance department—is in the order of $3.3 billion. As a result, the shortfall for Quebec, as far as fiscal imbalance is concerned, is still $2.4 billion.
We must therefore hope that the federal government, with its fabulous surplus of $9 billion last year—this year, some $11 billion or $12 billion—will, in the budget to be tabled and debated starting next Wednesday, get its act together and find some definitive solutions by transferring the $2.4 billion Quebec still lacks to resolve the extremely serious problem of fiscal imbalance.
Michel Guimond Bloc Charlevoix—Montmorency, QC
Madam Speaker, I greatly enjoyed what my colleague from Joliette had to say, particularly his little aside on the problem faced by farmers producing flue-cured tobacco in his riding and the greater Joliette area. As a member from Quebec, he certainly educated me on the problem of switching from one type of crop to another.
I especially appreciated his saying that a farmer cannot stop growing tobacco one year and immediately start growing asparagus the next year. Apparently cultivating asparagus takes four or five years to develop. I have friends who are asparagus farmers on L'île d'Orléans, in my riding, so I have some idea what the hon. member is talking about.
Let me come back to the focus of his presentation, the government's lack of recognition of the fiscal imbalance.
We know that the Bloc Québécois fought for amendments during the negotiations among the three opposition parties following the Speech from the Throne. We managed to get the government to pay us lip service and recognize the fiscal imbalance.
By the way, just as a reminder on this Friday, the person who contributed the most to developing the concept of the fiscal imbalance, who put a figure to it and recognized it, is Yves Séguin, Quebec's former finance minister. We sovereignists recognized it a long time ago. We must acknowledge the work done by Mr. Séguin, the author of the Séguin report, which recognized the fiscal imbalance.
Now, I would like my colleague from Joliette with his economics background to explain a little further about the shortfall in Quebec caused as a direct result of the fiscal imbalance. He said it was over $2 billion, if I recall correctly.
Pierre Paquette Bloc Joliette, QC
Madam Speaker, I would like to thank the hon. member for Montmorency—Charlevoix—Haute-Côte-Nord for his questions and comments on tobacco farmers. The issue is not well enough known, unfortunately. Every time we have a chance to talk about it, we can put a little more pressure on the government to settle the matter finally.
He is right. In my opinion, Mr. Séguin did a great deal, first to get the concept of the fiscal imbalance recognized and then to explain the size of this imbalance and the solutions that could be applied.
In a way, we have made considerable progress in this debate. We all remember what the Quebec federalists said when we first talked about the fiscal imbalance. And yet, the concept was not invented by the sovereignists. The first person to mention it was Jean Charest, now Premier of Quebec, when he was opposition leader. Some people, including some editorial writers close to the Liberal Party of Canada, have said that it is a concept invented by sovereignists to promote sovereignty.
No one now denies the existence of the fiscal imbalance, except perhaps the federal Liberal MPs from Quebec. Last week, I read an article by Claude Piché, an economic reporter with whom I rarely agree. This time, however, on the eve of the budget, he was also calculating his expectations in terms of corrections to the fiscal imbalance.
Perhaps I will mention a few figures. Just now I pointed out that the negotiations in recent months concerning fresh transfers of money to the provinces, to Quebec in particular, only came to an additional $800 million, while the shortfall is estimated—according to Mr. Séguin of the Quebec government, of those federalists who often but not always have the interests of Quebec at heart—at $3.3 billion. Thus, if the gap is $3.3 billion, and $800 million of fresh money comes in, $2.4 billion is still needed in order to correct the fiscal imbalance.
I have a few figures for the current year, 2004-05. The amount transferred before the agreement, or the various agreements, was $14.150 billion. Now, with the new funding that has been announced—here I am not speaking only of Quebec, but of all the provinces—funding of $2.125 billion, the new total for funding is $16.275 billion.
Provincial spending on health is $83.133 billion. That means that the federal government's share in health care funding is only 19.6%. We are a long way from the 25% Romanow recommended. That is a shortfall, just in health, of $4.5 billion, which the provinces would be getting if the federal government were assuming 25% of health care costs, but are not.
Since the agreement is spread over 10 years, it could be said that things will be better in 10 years. Nonetheless, the calculations that were done—I did not do them, it was the Conference Board which published its report in August 2004—show that after all the agreements, this 23.8% share of health care funding will remain unchanged, if health care expenses increase at a limited pace.
We see that, if nothing is done to resolve the fiscal imbalance, despite the agreements on health and equalization—and the health accord is a relatively positive measure, as I said, but does not go far enough—the fiscal imbalance will continue to grow. The financial problems experienced by the provinces and Quebec will get worse.
While the federal government is paying down its debt—and I remind the House that in recent years, an additional $60 billion was misappropriated, from both the employment insurance fund and excessive taxation by the federal government, to pay down the debt—the provinces are having trouble balancing their budgets. A number of them are running a deficit. So, this ensures that the provinces and Quebec will continue to see their debt spiral.
I repeat again that there is no logic either financially or in terms of services, because the provinces and Quebec pay a much higher interest rate than the federal government. This means that money is being taken from those paying significant interest on their debt, and the federal debt, which has a lower interest rate, is being paid off. Financially and in terms of services, there is no logic to this.
We must remember that a fiscal imbalance means fewer health care and educational services. This will not fix itself over time.
For example, when a child is living in poverty because the federal government has cut employment insurance and does not want to transfer the money to which the provinces and Quebec are entitled, via the social programs, that child is the one to pay the price. If the federal government does not remedy this in five years, that child will have lived in poverty for five years, and the impact will be life long. This is something the bureaucrats in Ottawa just do not get. When a jobless person does not get benefits, the situation will never be remedied, because the economic and social insecurity of today will have an impact for the rest of his life. Child poverty has the same effect.
Every time the federal government puts off solving fiscal imbalance, social and democratic and service levels are affected. The harm done will never be remedied, even if we do manage to force the government to remedy the situation.
I will point out, before closing my remarks, that it is also a problem of democracy, if legislative assemblies, the Quebec National Assembly for instance, do not have the necessary resources to translate their decisions into concrete action. Parental leave is an excellent example of this. Since 1997, the Government of Quebec, whether Parti Québecois or Liberal, has had this more generous and more accessible parental leave on its books, but the National Assembly is incapable of implementing a democratic decision that reflects the will of the people of Quebec. We are dealing here with a real democratic deficit caused by fiscal imbalance and by the federal Liberals' lack of desire to correct it.
Jean Crowder NDP Nanaimo—Cowichan, BC
Madam Speaker, I rise in support of Bill C-39. The NDP has already indicated its support; however, I am compelled to speak about the fact that there is a lack of accountability in the bill.
In order for Canadians to have continued confidence in our health care system, they need to know how and where their money is being spent and what the results are. This is not a lone voice in the wilderness that is calling for accountability. It is supported by any number of sources. I will quote from a number of different documents.
The first is the “Health Care Renewal in Canada: Accelerating Change” document put out by the Health Council of Canada. The council is quite unequivocal in its statements around the need for accountability. It starts out by talking about the fact that governments are making significant investments in health care and how Canadians will know whether the money is being spent on health care renewal. The council goes on to talk about the fact that money is important. I will quote directly from the document:
Inform Canadians as to whether the increased investments in health care are supporting the change governments have agreed to implement--
The council stated:
We believe the public has a right to know how the money has been spent across the country.
It will report about this in its annual reports, but it is very clear to the council that there is a fundamental issue attached to the question of money, how it is being spent, what the results are, and what is being achieved.
The next document is quite an interesting one. It is called, “Principles for Governance, Management, Accountability and Shared Responsibility” and was put out by the Canadian Health Care Association and the CCAF. Their opening statement is actually a quote from an address by the Prime Minister at the first ministers meeting on September 13, 2004:
When it comes to health reform, Canadians expect real and meaningful accountability. They deserve to know what they should expect--and what they are getting.
The document lays out some key principles around what we expect out of accountability.
As the minister pointed out earlier today, we are spending significant amounts of money in health care over the next 10 years. Surely Canadians deserve to know how that money is being spent.
One of the things the CCAF and CHA outline is that health system partners need to demonstrate commitment to public transparency and accountability. They do this by explaining to and involving the public in what they plan to do, how well the system is performing, and the implications of both. Surely these are the elements of good practice in any kind of respect. They then go on to outline areas of responsibility. Under public accountability and involvement, the CHA and CCAF outline a principle which states:
Health system partners need to demonstrate commitment to public transparency and accountability. They do this by explaining to, and involving the public in, what they plan to do, how well the system is performing, and the implications of both.
Again, this is a fundamental principle on how Canadians need to have access to how Canadian tax dollars are being spent.
They go on to talk about how these things might be reported. Again, these are principles. These are non-profit bodies that are talking about principles in terms of accountability and transparency. They talk about reporting principles and standards being key to the integrity and utility of reported information and a prerequisite for fair comparison and benchmarking. They state:
Principles and standards may be issued as a pronouncement by the requiring party, or developed cooperatively. Regardless of how they are developed, these reporting principles and standards should be commonly understood and consistently applied.
To me that means there is an agreement on what we should be reporting, and it should be clearly understood by all parties, including the Canadian public.
On the first ministers health care agreement the Canadian Health Coalition actually issued a report card in September 2004. Under the accountability and reporting aspect of the report card the government was given a D . The coalition said that the agreement is based more on trust and an assumption that the public will hold governments to account. We are talking assumptions here.
Since the weak accountability facilitates privatization by stealth, Canadians will have to be diligent to ensure real accountability. Medicare is still on life support, not from lack of money, but because of weak controls on where and how the money will be spent.
The Canadian Health Coalition is talking about the fact that what we really need to do is follow the money. The CHC did a detailed analysis on the 10 year plan to strengthen health care. I will quote from the document on accountability and reporting to Canadians. I talked about the fact that the agreement is based on trust. The document states:
It is no coincidence that the governments with the most resistance to meaningful accountability (Alberta, Quebec and B.C.) are the ones determined to transfer the delivery of insured health services over to commercial, for-profit health care corporations. Proponents of private, for-profit health services do not want public funds accounted for or traced but this is what true accountability requires. Canadians don't realize that current accountability requirements in federal legislation are being ignored by the federal government. Under the Canada Health Act, the Minister of Health has a statutory duty to monitor, report and enforce compliance with the five criteria of the Act. The Minister's annual report to Parliament on the Canada Health Act consistently fails to identify, report and stop privatization initiatives underway in several provinces. This poses a serious threat to the integrity and viability of Medicare.
The CHC goes on to state:
We expect the Canadian Institute for Health Information and the Health Council of Canada to include in their data collection and analysis a breakdown, by mode of delivery of health care services specifically, for-profit and not-for-profit. A full public accounting would expose unfavourable comparisons between private for-profit and public not-for-profit....Citizens need an accountability mechanism which is independent and in the public domain. The Health Council of Canada could grow into that role with public pressure and direction. The first task for the Health Council must include tracking every single dollar of public funds in health care in order to monitor how much is going to investor-owned private for-profit health care, home care, and long-term care and the health outcomes and financial performance achieved. Canadians must also insist that the federal Minister of Health correct the deficiencies in monitoring, reporting and enforcing the Canada Health Act.
It is clear that there is a reluctance by the government to report on the dollars that are being spent, because it is en masse for profit delivery that is creeping throughout Canada.
One of the things that is fundamental in the Canada Health Act and one of the program criterion is public administration. It is a fundamental criterion for receiving funds under the Canada Health Act. The act itself states:
In order to satisfy the criterion respecting public administration,
(a) the health care insurance plan of a province must be administered and operated on a non-profit basis by a public authority appointed or designated by the government of the province--
In the prebudget consultation to the report on the Standing Committee on Finance, which is talking about health care and how money is spent, I quote:
Several witnesses spoke about specific aspects of the Canada Health Act. While witnesses generally support the principles contained in the Act, there was concern that some of the principles are not being respected and that information provided to Parliament is not accurately indicating the degree to which privatization initiatives are underway in several provinces. In particular, it was recommended that the ministers of Finance, and Health fully enforce the accountability mechanisms in the Canada Health Act and that provinces/territories be required to provide information on the mode of delivery of health care services, in particular for-profit and investor owned versus public and not-for-profit.
This is from the prebudget consultation which was clearly calling for more accountability. Yet when we look at Bill C-39, any mechanisms for accountability are absent from that bill. It is very cold comfort to hear that there will be a review done in 2008. That is like slamming the barn door shut after the horse has escaped.
We are talking about some of the pillars around public administration and the issue that we are not able to look at the impact health care dollars are having and where they are being spent. In my own province we have a current P3 under way and the government cannot tell me that this is a for profit situation.
We have an organization called Access Health Abbotsford, which is a consortium that includes the Dutch bank ABN AMRO, U.S. health giant Johnson & Johnson and Sodexho, a French cleaning and food services company, that will be responsible for the design, construction, financing and maintenance of the hospital that is being built in Abbotsford. Surely that is a for profit organization, which seems to be very dismissive of one of the key pillars of the Canada Health Act.
How will Bill C-39 protect Canadian taxpayers from that kind of creeping privatization. There are certainly any number of questions about the quality of for profit health care. Again, independent studies have been conducted and established on these kinds of private health care delivery.
Canadians deserve to know how the money invested in health care is being spent. Canadians are very passionate about their health care system, and they want to continue to see a publicly funded and publicly delivered health care system.
We are asking the Minister of Health and the Prime Minister to honour their commitments. In the minister's own words, he stated after being sworn in:
I can tell you that 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.
Those are very strong words. It would be shameful if the government did not live up to its commitment around that.
I will go on and repeat the Prime Minister's words because they bear repeating. He made a commitment around real and meaningful accountability. He said was:
When it comes to health reform, Canadians expect real and meaningful accountability. They deserve to know what they should expect--and what they are getting.
Surely stating that Canadians deserve to know what they should expect and what they get talks about accountability. It should be one of the fundamental principles in the bill. It is glaringly absent.
I would urge that we quickly put in mechanisms to deal with the accountability, so Canadians have some confidence in where their health dollars are being spent, and that we can proudly stand up and talk about the fact that we have a publicly funded and publicly delivered health care system.
Bill Siksay NDP Burnaby—Douglas, BC
Madam Speaker, the member raises a crucial point around the question of accountability in our health care spending. I agree with her that this is a glaring omission from the legislation, particularly when we look at the kind of feedback that she quoted from the Canadian Health Coalition, which generally gives the government a “D” when it comes to accountability in health care spending in its past efforts. It does not give us much confidence for the future.
I also agree with her when she raises the serious concerns about for profit health care, especially in our home province of British Columbia. It always boggles my mind when we talk about for profit health care. Just the very nature of for profit health care introduces a major new expense into the system that we do not currently have.
Profit is a huge expense to the health care system, to any system. Taking profit out of the system, constitutes a major and significant new expenditure. I have real problems with that.
Today, we heard the member for Nanaimo—Cowichan ask the minister questions in question period around credit card medicine. I was not too impressed with his response. The minister stood up and said that he would defend the Canada Health Act. However, he was not very specific. We have not seen much action on that front.
I am not one to heckle much in the House. My colleague from Winnipeg heard that I came to that point today when the minister was responding. I asked rhetorically for the minister to show us his teeth behind his promise to enforce the Canada Health Act.
What does she think about the minister's response to her questions today about credit card medicine in Canada?
Jean Crowder NDP Nanaimo—Cowichan, BC
Madam Speaker, in question period, the minister's response was that perhaps I needed to turn up my hearing aid. I guess my response to that would have been, for what? To hear more empty promises around credit card medicine?”
However, on credit card medicine, again the Canadian Health Coalition's analysis around the first ministers health care agreement, and of course Bill C-39 is a result of it, was a D grade for stemming the tide of privatization, as well. Again quoting from the analysis, which is very appropriate. It states:
The First Ministers’ Health Care Agreement is silent on the question of for-profit delivery of healthservices. Indeed, the very day the agreement was signed the bold headline in the National Post read:“Privatized Care Keeps Expanding”.
The proliferation of investor-owned private, for-profit clinics and facilities acts like a viral infection inthe body of Canada’s public health care system. The for-profit health care virus cannot exist withoutfeeding off and damaging public bodies. Canada’s largest and richest provinces are laying thefoundations for a private parallel for-profit regime. This trend threatens the integrity and the viabilityof the public health care system. This is happening without any public discussion by First Ministers.Indeed, it is a plan whose objectives no politician dare utter in public.
It goes on to say:
The corporate virus infection in Canada’s health care delivery system may have been driven underground. However, it remains a serious threat as it can spread through stealth, deception, and lack of accountability.
I interject here to underline “lack of accountability”.
It goes on to say:
It flourishes in the dark but runs from the light of public scrutiny. You don’t stopthe spread of a life threatening virus by not talking about it. Instead, you first isolate and then treatand eradicate the virus light of public scrutiny. You don’t stop the spread of a life threatening virus by not talking about it. Instead, you first isolate and then treat and eradicate the virus. The proliferation of initiatives to privatize health care delivery undermines the letter (objectives) andthe spirit (purpose) of the Canada Health Act. It represents a significant threat to the publicly fundedhealth care system, in particular including the requirements that universal access to publicly fundedhealth care be provided on uniform terms and conditions to all insured persons.
I am quoting from Dr. Arnold Relman's testimony at the Kirby Senate committee. He states:
The facts are that no one has ever shown, in fair, accurate comparisons, that for-profit makes for greater efficiency or better quality, and certainly have never shown that it serves the public interest any better. Never.
Why do so many First Ministers and their officials show no interest in the facts, or the values uponwhich Medicare is built? The noticeable exceptions are Premier Calvert of Saskatchewan andManitoba Premier Doer, who both explicitly referred to not-for profit delivery of care. If Canadiansare gullible and listen to the true believers in the miraculous powers of the market to solvehealth care problems, we will pay dearly for the mistake.
That is a very clear indictment of the kind of creeping privatization happening in our health care system. Accountability measures need to be open and transparent so Canadians can see where their health care dollars are spent.
Dick Harris Conservative Cariboo—Prince George, BC
Madam Speaker, I listened to the member from the NDP. I have to ask this. Where was she between 1991 and 2000, when the NDP was in power in British Columbia? It was doing to health care exactly what that member is saying this government is doing. We saw the health care in British Columbia sink to its lowest point of delivering service and its highest point of waiting lists that that province or any province has ever seen.
How on earth does she expect Canada to operate on what she is saying when there are examples like British Columbia, an NDP government in those years, that totally were a dismal failure in the business of health care?
Jean Crowder NDP Nanaimo—Cowichan, BC
Madam Speaker, I am so pleased to get up and respond to that question. Let us talk about the fact that federal transfers to health care were continuously being reduced, crushing provincial governments with a debt load that was unbelievable.
If we want to talk about where the responsibility for those kinds of things lie, let us talk about where it really belongs. It started with Conservatives and then ended up with Liberals.
What we want to talk about is the fact that slashing and cutting does not ensure we have a health care system that remains on a stable footing.
Federal-Provincial Fiscal Arrangements ActGovernment Orders
An hon. member
It is amazing it survived at all with you guys.