Mr. Speaker, it is a pleasure for me to speak on this very important piece of legislation, Bill C-39, an agreement worked out between the provinces and the federal government. It is the third accord we have had since 2000. We have had the 2000 and 2003 accords and now this 2004 accord, all giving money back to the provinces, money that was ripped out of the provinces' hands unilaterally by the government. In fact, the Prime Minister of this country is the only individual politician, provincial or federal, who has ever taken money out of health care over the last decade.
It is amazing to see the numbers put before us and to hear the rhetoric that I just heard coming from the government side here a few minutes ago, with the government side talking about this being all about accountability and transparency. I would like to explain why it is about neither of these.
What it is about is an amount of money going back into the health care system, which we agree with. In fact, the numbers that are put forward, the $41 billion put forward in this health accord, are closer to our numbers. They are very much identical to our numbers for the first six years, but are only half of what the Liberals promised in last year's June election. During that election, the Liberals were not being honest with the Canadian public with regard to the number of dollars available for health care, nor were they honest about the number of dollars they were going to give to health care.
As for the numbers that are here, thank goodness they are twice what was promised. These numbers are what the provinces asked for and what we suggested during that election. It is interesting to note that during the election we were criticized because we said that we would have to increase taxes before we could fulfill the promise we made to the Canadian people during that campaign.
All that aside, it is time to put our swords on the table and deal with health care in a non-partisan way, but before we can even get into a debate on health care we have to understand the situation of health care in this country.
This was not a fix for a generation, as was trumpeted by the Prime Minister. He went across the country and said that this is what we had to do, that we needed a fix for a generation to put health care on a sustainable course. Before we can do that, we have to understand that health care cannot be fixed in the next 10 years. The pressure will not even start to hit our system with the intensity that it is going to until we get to 2020, 2030 and up to about 2040, where it will begin to peak.
The pressure will intensify from now until that period of time because of the demographics and the baby boomer population that is going to hit the system. The baby boomers will be consuming large amounts of dollars during that period of time as they become elderly. It does not matter which area we want to look at in our health care system. Whether it is pharmaceuticals, cancer, Alzheimer's or heart disease, we can talk to any of the organizations across this country and they all will tell us that the high costs of these treatments, plus the numbers of patients afflicted with these kinds of diseases, including HIV-AIDS, are going to intensify over the next significantly short period of time and will continue to intensify over the next 40 years.
Therefore, how we sustain our health care system during that 40 year period becomes the true debate. Until we understand what is coming at us, we cannot possibly even start to open up an honest debate on health care.
If we are going to paint the picture honestly, and that is what I think we should do here, it is not only demographics that will inflict a significant blow on and a challenge to our health care system, but it is the obesity situation we have within our country. We have surveys showing us that almost 20% of our students are overweight, almost 8% of them at obesity levels. These individuals will be hitting serious problems, whether it is diabetes or heart and stroke problems, in their thirties, not in their fifties, sixties and seventies. When we couple this with the demographics we are headed into in our health care system, when we understand what is about to hit us, we see very clearly that the challenge will intensify because of more than just an aging population.
There has been talk of a fix for a generation. That is what the member and the Prime Minister have suggested, but we have been given nothing to change the dynamics and the paradigm of health care. We must do this. We must look not just at the health care system, which is crisis management, but upstream much further, and we must start talking about preventative health care.
Back in the early seventies, we had television advertisements stating that a 30 year old Canadian was not as fit as a 70 year old Swede. That is very much the case today. We see an epidemic of obesity in our population, which suggests that we have to do much more than crisis manage our health care if we are to sustain it over the next 40 year period.
We have talked about what is coming. However, what does the health care system look like today? Emergency rooms are absolutely crowded. Patients cannot see doctors or they wait for unbelievable amounts of time to see them. Some of them are reported as having passing away in emergency rooms while waiting for a doctor. A significant number in our population cannot obtain a family practitioner. I think 3.6 million individuals are without a family practitioner at the present time, and 2.4 million of those have given up trying to find a one. We have some very serious problems.
Let us compare Canada to some of the OECD nations, which it is important to do when it comes to diagnostics. Let us talk about MRIs. That seems to be what people like to talk about when discussing diagnostics. We do not rate very well. We rate 13th out of 20 for MRIs and 16th out of 21 for CT scanners. When we look at our health are system, we can see we have a significant problem with trying to access services.
In the papers yesterday and on headline news last night, it was reported that six doctors walked away from their practices in small town Quebec. With the amount of stress on the family practitioners and the nursing population, we can understand full well why we have these kinds of problems. We have a shortage of human resources. People have to understand that our health care system is 75% to 80% human resources.
We are told that 100,000 nurses will be leaving or retiring over the next five year period. There are only a little over 300,000 nurses in Canada today. A third of them are over the age of 50, and the average nurse retires at the age of 55. We have a crisis when it comes to the number of nurses.
To talk about nurses for a second, we have to understand that the most unhealthy workplace in all of Canada is in the hospitals. Nurses are the ones who take the most number of sick days off of any occupation in Canada. That is because of the stress they are placed under by the amount of work we ask them to do.
I was at a meeting last week with the nurses on the Hill. They explained to us that if they were asked to work beyond 55 to 60 or 65, we would have to create an environment for them so they could function well within that job. To do that, we will have to provide some relief and help for them. It is not only about paying them more dollars.
When it comes to doctors, we have a significant problem. A decade ago, when the government took the money out of health care, the ideology was that the doctors drove the costs. Therefore, if we removed the doctors from the system, we would remove the costs. The Canadian Medical Association said at that time that if we did that, in a decade we would run into trouble. We are now a decade from that time and we are in serious trouble with a shortage physicians in the system. That goes back to the kinds of headlines yesterday. More are on their way.
We need 2,500 doctors per year to sustain our physician profession. At the present time, we only educate 2,200 of them per year. We have to understand that the problem is not just educating more of them. They have to stay and work in Canada where they are needed. We have a three-prong problem. When we look at the legislation, do we address any of them? I would like to look at the legislation and ask those questions.
The government has said that it has $5.5 billion to deal with the wait list problem. The money is in a separate trust fund, and over a 10 year period the provinces can draw down on that money whenever they like. It is quite ridiculous when we look at the legislation and see how that is done. Of those dollars, $4.25 billion of those dollars can be pulled down by the provinces immediately. Why set up a separate trust? We might as well just write them a cheque because that is exactly what they will do, draw down that money.
The money is to go into waiting lists. What does that really mean? What criteria is on that money? They are to apply it to wait lists. There are two chronic problems in the health care system, and that is the shortage of human resources, the nurses and doctors, as well as the long wait lists. How do we address it? There are no criteria for how we will address it. It is a provincial jurisdiction, and I think that is appropriate.
One of the good things about the legislation is it would not tie hands, as was tried with some of the other past accords, with regard to some of that money.
However, why not be honest? Why not just be clear to the population of Canada and the health care system. Why does the government not say that it will give the provinces the money and that they should use it where they see fit in order to help the system. However, it should not say that it has a great fix for the wait list problem, which is to put $5.5 billion into a separate trust fund that the provinces can draw down.
If we are going to be transparent, let us be transparent. If we are going to be honest, let us be honest with the numbers. No longer is there any room for playing politics in health care. What I see with this accord is it is not a fix for a generation. It is a way to buy another election. That is really what it will come out to be.
If members will remember, the 2000 accord came in just months before an election. The 2003 accord was an attempt, after the Romanow report, to do something. With regard to this one, the spin is to fix it for a generation. It has nothing to do with fixing a generation, it is to do with buying another election. We are doing it with taxpayer dollars and we are doing it in a very dishonest way.
The dollars need to be there. That is why we support the legislation. However, we have to do it in a way that is clear, honest and is not confrontational.
The other thing that is so dishonest with the legislation is the idea of a catastrophic drug coverage. This was supposed to be done long before now. In fact, with catastrophic drug coverage and home care, in the 2003 accord with the provinces there were performance indicators and a timeline as to when these were supposed to be triggered.
In this legislation, when it comes to catastrophic drug coverage, it is pushes it back, and not to 2006 when the other was supposed to be implemented. The only thing that will come forward In July 2006 is a report suggesting that we might be able to proceed with some sort of a catastrophic drug coverage plan.
When it comes to home care, it is the same thing. It is pushed back again in this accord.
My hon. colleague talked about $500 million to medical equipment. The last time that a fund was set up for medical equipment was in the past two accords. When we traced that money to find out whether it went to medical equipment, we found that much of it went to, what we would say, pretty marginal medical equipment like lawnmowers and ice cube machines. We thought that if it hit the headlines, the government would put in more accountability measures if it were to trigger and target a specific amount of money to go to medical equipment.
However, in the finance committee meeting this last week I challenged the Liberals on this. No further accountability measures have been established. The way the fund is set up in this legislation is exactly the same as the other one. If we do the same thing the same way, we can expect the same kind of results. It is unfortunate that we have to play these kinds of games with health care.
I could go on and on about the significant lack of accountability within the accord. I want to just say that there is some accountability, perhaps, and that will come from the Health Council, which was struck in the 2003 accord. The Health Council of Canada is probably our best hope for full disclosure from the provinces and the federal government, with regard to what happens with taxpayer money. Whether it is provincial money or federal money, it is all taxpayer money.
My suggestion, as we move forward into health care, is to stop this nonsense of playing politics with health care. We could not afford it before and we cannot afford it now. Yet we still see the kind of spins coming from the government side.
If the Liberals are going to be honest, the first thing they should do is stand up and apologize to Canadians for the way they have treated health care over the last decade. They should give that the money back. Then they should consider how they will work together with the provinces in a collaborative way to make it happen. They should look at how we will deal with the next 40 years in health care. They should look beyond the political cycle. Politicians like to work in four year cycles because that gets us elected.
We can no longer do that with health care. We cannot do it provincially nor can we do it federally. We need a paradigm shift. We have to get away from crisis management on health care. We need to start looking at how we deal with the needs of the individual patient ahead of the system.
We think we have a great system in Canada. The World Health Organization suggests that we are 30th in the world. Every time we get into a health care debate, somebody wants to promote an American health care system. Why would we do that? The Americans rate 37th in the world. However, 30 other countries are better than us. Why do we not take some of the examples from those countries and use them pattern a health care system that will be in the best needs of the Canadian population?
We have a good health care system, but we will be unable to sustain it on the course we are on. We have to do more than just come up with one-off accords that do not address accountability or the health of the nation. They deal with crisis management. We agree with the dollars in this accord, and we will support the legislation in that respect. We are frustrated about how we got here and we are frustrated that we have a government that is not more long-sighted than this legislation.