Debates of June 7th, 2005

Supply

[Lynne Yelich, Conservative, Blackstrap, SK]

Mr. Speaker, I will be sharing my time with my colleague from Hastings.

“You have cancer”. Those are three simple words in the English language that no one wants to hear. Those are three simple words that have often, too often, altered the course of the lives of numerous Canadians and turned them upside down. Those three words too frequently have devastating consequences and are the equivalent to a death sentence.

The words evoke for many such an overpowering and paralyzing fear that people are often unable to utter the words. In the next 20 years it is estimated that 1.45 million Canadians will hear those words. One of those people could be a spouse, a parent, a sibling, a best friend or a child.

Cancer knows no prejudice. Cancer knows no boundaries of religion, ethnicity or language. Cancer knows no boundaries of size or shape. Age and gender does not matter. Social status and financial income does not matter. It can affect anyone. Everyone is frightened by those three words.

For all the ramifications that those three simple words have on one's physical health, it is paralleled by the destruction it wreaks on the mental health of individuals. The moment people learn they or a loved one has been diagnosed with cancer is indelibly etched in their lasting memories. Those affected are never the same once they hear those three simple words. The time and relationships we have with those around us have new meaning. We mull over questions that, up until that point, rarely entered our mind. People do not really ponder the essence of their existence as during the period when it could potentially end.

After being diagnosed, for many the aggressive treatments that will likely follow--radiation, chemotherapy or surgery--only serve as additional anguish. The assortment of side effects that result from these treatments--fever, nausea, hair loss, vomiting, infections and extreme fatigue--effectively make the search for the cure as difficult as the diagnosis.

The impact of those three simple words is not restricted to individuals. The diagnosis has ramifications for their loved ones, especially their families. The diagnosis creates a ripple effect that inevitably causes increased stress and tension as circumstances advance beyond control and as the physical changes are mirrored in changes in familial relationships. Families debate who to tell, what to do next, what will happen if. Families try to cope in order to provide the individual with the necessary emotional support and hope to combat the fear that those three simple words instil.

To quote Dr. Barbara Whylie, chief executive officer of the Canadian Cancer Society, “Cancer wounds everyone in our society”.

The leading cause of premature death in Canada, cancer silences 68,000 Canadians each year, taking 950,000 years of potential life from families and loved ones. According to the Saskatchewan Cancer Control report in 2004, in my home province cancer claims the lives of 2,215 loved ones annually. Additionally, primarily due to an increase in lung cancer deaths, the number of cancer deaths per year among females has increased 39% since 1983. However it is about to get much worse.

According to Dr. Whylie, we are on the verge of an unprecedented cancer epidemic in Canada. Over the next three decades it is projected that nearly six million Canadians will hear the three simple words, “You have cancer”, and worse, half of them will die from it. We likely will intimately know someone or, indeed, even be one. How do we explain this increase?

First, as Canada's aging baby boomer population grows older so will the risk of getting cancer.

Second, as Canada's population expands there will be, as a consequence, more cases of cancer diagnosed. The financial cost of the impeding onslaught of cancer diagnosis, while secondary to the immense emotional strain for those affected, is, nevertheless, staggering.

In the next 30 years those three simple words will cost the public treasury nearly $176 billion in direct health care costs and more than $248 billion in lost tax revenue. Furthermore, it is estimated that during this period, Canada could potentially lose approximately $14 billion due to lost productivity from Canadians diagnosed with one of the most common cancers: lung, breast, prostrate and colorectal. Canada must act now and implement a strategy to prevent such a national tragedy.

The House should heed the advice of the World Health Organization and comply with the resolution passed this past May calling on all member states to work with WHO to develop and implement a comprehensive cancer control program. Such programs have the potential to save thousands of Canadians from the experience of hearing those three simple words.

Over the past decade countries, like Australia, New Zealand and the United Kingdom, have developed and funded national plans to combat cancer.

In 1985 the European Union launched an ambitious program entitled Europe Against Cancer, aiming to lower the number of deaths caused by cancer by 15% in the year 2000. The program was implemented with the cooperation of experts, cancer charities, health professionals and national civil servants, primarily focusing on the areas of prevention, screening and education.

Although this ambitious target was not met throughout the EU, a report published in the Annals of Oncology indicated a 10% reduction was achieved in cancer deaths in males and an 8% decrease among females.

Moreover, a handful of EU countries, such as Austria, Finland, Italy and Luxembourg, actually managed to reach or come very close to the 15% reduction goal.

However Canada lags shamefully behind other states with respect to creating a cancer control program. Dr. Whylie has stated:

Canada is one of the few nations in the developed world that has failed to implement a strategy for cancer control.

We are now paying for that failure with our very lives--

--the Canadian approach to cancer control is inconsistent, flawed and driven by political expediency rather than medical realities.

Cancer prevention in Canada is pathetically underfunded and fragmented.

All of this must change and must change soon.

It is imperative that the federal government provide leadership to implement and fund the Canadian strategy for cancer control. The strategy, a wide ranging and coordinated approach to cancer control in Canada, would make certain that we are prepared to meet the unprecedented cancer epidemic about to strike Canada.

The Canadian strategy for cancer control would be a national strategy aimed at bringing about a sustained, coordinated, comprehensive and collaborative approach required to combat the coming cancer epidemic.

Each province would be permitted to independently construct its own unique cancer care management system from a basis of national data and knowledge gathered from across the country and shared by all.

Timely and state of the art information regarding cancer would be accessible to all Canadians regardless of their location. Moreover, the strategy would decrease repetition, fill in gaps and ensure scarce resources are shared.

However the success of a national strategy is dependent upon the federal government advancing a coordinated and targeted approach to cancer care.

We must always be cognizant of the fact that this is a matter of life and death. Indeed, in the time that has elapsed since I commenced my remarks someone in Canada has succumbed to cancer and another two have heard those three simple words, “You have cancer”.

[Marcel Gagnon, Bloc, Saint-Maurice—Champlain, QC]

Mr. Speaker, I just heard a speech that gives me an opportunity to react. We are discussing a very important and serious motion, although at the same time, I would not want the people listening to us to become too depressed.

Cancer is indeed something we talk about more and more. Life expectancy is steadily increasing, and we will therefore hear even more about it in the future. I can tell you that I number among those who have been stricken. Three years ago, I learned that I had cancer. Four other members close to me also learned that they had cancer over these three years, and all four of us, myself included, have managed to beat it.

That does not mean that more research is not needed. I just wanted to add this personal experience. At this very moment I can think of someone, whom I know very well, who learned around noon today how serious her cancer is and what will have to be done. This word should therefore not terrify us. Cancer must be beaten and it can be. I agree that the motion before us today could increase the possibility of preventing these illnesses.

This also gives me an opportunity to ask my colleague a question. We are speaking about the importance of the fiscal imbalance. When speaking about a matter as important as what we have here today, we must realize that it is more than high time for the federal government to give the people who are responsible for health the money that they need. Health is at the heart of an important issue. This is true as well of education and other things.

The motion that we are discussing today asks the federal government to take the place, to a certain extent, of the provinces, but it should, instead, be asking the federal government to return the money to the people who have a mandate for health care. It should be going in that direction, and then we would move more quickly toward the achievement of our objective.

[Lynne Yelich, Conservative, Blackstrap, SK]

Mr. Speaker, I thank the hon. member for sharing his story because that is exactly what my speech was about. At this time someone is probably receiving the news that he or she may have cancer and at this time someone is dying of cancer. More and more cancer is being diagnosed, and yes, there are more successful treatments, but there have been increases in many different types of cancer and diagnoses.

On the fiscal imbalance, I am not thinking of this as something solely for the provinces but something that is national so we can share information. Cancer has no boundaries so we cannot have each province creating its own databases and research without sharing it. We need everyone to work together on a national strategy so that then each province can perhaps deliver the services.

We are not just talking about delivery. We are also talking about research, science and the diseases that have no boundaries. As a country, we need to be a leader, as other countries have been, in creating a national strategy. I do not think each province can handle the magnitude of what that would entail.

[Daryl Kramp, Conservative, Prince Edward—Hastings, ON]

Mr. Speaker, I would like to thank the member for Blackstrap for sharing her time with me this afternoon.

The health and safety of our citizens must continue to be the number one priority for the government, a position which I endorsed from the first day I started campaigning and I will continue to endorse until the last day I serve in the House. I have and I will continue to be committed to achieving better and more accessible health care, not only for the citizens of Prince Edward County, Prince Edward--Hastings but for all Canadians.

I would love to stand in the House here today and declare to all Canadians that Parliament has served them well, that we have the situation under control, that their health care is of the finest quality, that it is equally accessible to all and that it is in capable hands. Sadly, that just is not the case.

We do have some measures of health care that are performing well, but by and large, the lack of definitive direction in our health care system is causing widespread inequities and failure. In my riding of Prince Edward--Hastings, for example, we have approximately 15,000 citizens without access to a family doctor and we have among the highest rates of cardiac problems, strokes, aneurysms and cancer in Canada.

Yet I like most Canadians listened when our Prime Minister, prior to an election, promised over $40 billion. He said that would just simply solve the problem for the decade. The reality is that no amount of spending, promised or real, will solve the problems facing health care unless there is a real plan on how to deliver measurable results with a clear guarantee of accountability.

There is an old adage that comes to mind, which I believe offers a rather simplistic overview of the strategy that we must follow, and that is “Plan your work and work your plan”. We have many wonderful health care professionals who are so dedicated to the well-being of society, yet they are stymied and shackled with a system that is overly bureaucratic, overworked, duplicitous and inefficient. Why? Because there is no overall blueprint or plan on how to work effectively and cooperatively.

There remains great disparity in the quality of care in our country. That is not acceptable. Health care professionals are suffering burnout. That is not acceptable. Our health care system, which was in the top three in the world, a source of pride in service, now is rated in the high twenties to early thirties. That is not acceptable.

Before arriving in Ottawa as a member of Parliament, I had the wonderful opportunity to serve as president of the Madoc chapter of the Canadian Cancer Society. I learned first-hand how important a strategy was in combatting diseases such as cancer. My friends at the Canadian Cancer Society, Hastings-Prince Edward County unit, are eagerly anticipating a national strategy which they can finally implement at the local level.

I note with interest that the Canadian strategy for cancer control has called for a nationwide cancer prevention strategy. Yet in 12 years the Liberal government has yet to implement a national strategy for cancer, mental health and heart and stroke.

Today we are discussing this Conservative supply day motion that declares a national strategy is needed to reduce human suffering and economic costs related to cancer, heart disease and mental illness. The motion is by no means intended to clear all the ills in our health care system, but it will serve to set the tone and the direction for planned accountability and measurable improvement.

In my brief time today, let me try to put a few numbers to this needless human suffering.

Despite spending $14 billion per year in Canada last year, 710,000 Canadians are living with cancer. In the past 12 months alone, an estimated 140,000 have been diagnosed with some form of a disease and almost 70,000 will die from it. That is more people than live and exist in many of the ridings in this country.

Mental health statistics are equally troubling, with over 4,000 people committing suicide in Canada each year, including many of our young and vulnerable. As we know, there are countless thousands of suicides that have gone unreported.

Depression, mental illness, is projected to be the most expensive cause of loss of workplace productivity due to disability by the year 2020. Cardiovascular disease accounts for over 70,000 deaths per year and costs the economy over $18 billion a year just unto itself. The long term cost of cancer, of mental illness and cardiovascular diseases will run into the hundreds of billions of dollars.

Since I first arrived in Ottawa, I have been waiting for the government to produce for Canadians a health care plan, a framework, a legitimate plan that will improve the system in a coordinated, organized strategic fashion. Instead, I have watched when the Liberals have signed deals in an ad hoc manner and when they have signed one-off deals with the provinces. Yet when they continue to either promise or throw more money at health care without any real long term strategy or plan, the Liberals unfortunately appear to be more clearly concerned with the optics of political photo ops than with discernible human results. I emphasize that positive results will only occur when there is a solid direction and a solid plan.

As Canada is one of the few developed countries in the world without a national action plan for mental health and heart disease, I respectfully ask my colleagues on all sides of the House to place the people ahead of the politics and to endorse, with enthusiasm, this Conservative initiative, this Conservative motion to establish a clear national strategy and a timeframe to implement such.

Millions of Canadians in our ridings depend on this. I honestly believe it is time that Parliament places its priority on the health and safety of all Canadians.

[Robert Thibault, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I want to thank the hon. member for his excellent presentation.

I understand when the member talks about having a strategy for health care, in all areas of health care. I want to take him back a bit and invite him to consider and comment on this.

His comment on the one-offs, on the federal-provincial deals and whether it constitutes a plan is debatable. If we look back to last year, 13 jurisdictions were brought together. Ten provinces, three territories and first nations negotiated what was needed in health care across the country over the term.

We are looking at a 10 year plan with $41 billion. In working our plan and planning our work, I ask the hon. member to consider this. We have established benchmarks on wait lists and have set aside $5.5 billion for that. Provinces will report annually on the plan. We have timetables on different elements of the plan, for example, a national pharmaceutical strategy.

On the accountability side, while provinces will be reporting, we also have the Canadian Institute for Health indicators and the health council of Canada will bring all this together in a national perspective.

We also have two parliamentary reviews planned within the 10 year strategy, within the 10 year commitment by the federal government and the 13 jurisdictions. By doing that, we agree that perhaps the evolution will not be perfect. At these milestones, we will have to see if we need to reorient, and that is where Parliament comes in.

We look at the question of health human resources, which are a big part of the plan. The member is absolutely correct. In a lot of ridings, including mine, there is a lack of medical practitioners and professionals, whether they be technicians, nurses, pharmacists or otherwise. There is a need, but within the plan there is money and a plan to work with the provinces and the provincial jurisdictions to return more seats in medical schools. He may remember, as I do, when these seats were turned back in nursing school.

They are in the strategy, in an organized fashion.

[Daryl Kramp, Conservative, Prince Edward—Hastings, ON]

Mr. Speaker, in response to the hon. member on the other side of the House, we have a little something in common. We are relatively close to the same age. That puts us almost into the baby boomer status. This poses a real problem.

I thank the hon. member for mentioning the initiative of bringing the health round table together. It is a start.

However, what happened 12 years ago? We have a group going through the baby boomer years. By 2008-09, we are into crisis in this country. We have millions of people who will stop becoming productive citizens. We will not pay as much tax. There will not be as much income coming into the government, yet the demands will be dramatically increased on our health care system. We are coming to that age when all those calamitous diseases start to take hold.

We have a little too much talk coming out of the government and not enough activity and action. I am thankful that an initiative has been started. I believe we need more than an initiative. We need a national strategy. It has to be the number one priority for the government.

We can no longer sit and suggest that some day, some time, this problem will reveal itself and we will get over it. We have a disaster in the making. The government must recognize that a national strategy must be implemented immediately, that all the stakeholders must come to terms with the fact and we must get on with the job.

[Robert Thibault, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I will be sharing my time with the Minister of State for Public Health.

Mr. Speaker, I am pleased to provide my hon. colleagues with more specific information on the measures taken by the government to prevent and treat diseases and illnesses that affect the lives of many Canadians, including cancer, cardiovascular disease and mental illness.

These diseases are so common in Canada that I think there is not one person in this chamber who has not been affected, either themselves or their families, by cancer, cardiovascular diseases or mental illness. These are the diseases of our 21st century society. We are not alone in facing the challenges they pose. Countries all over the world face them also.

They challenge us because they are diseases that result in part from the way we live, what we eat, how active we are and whether we smoke. This means that as a government, which is committed to the well-being and good health of its citizens, we have to encourage Canadians in healthy choices in their day to day lives and we have to try and shape society so that the right choices, the healthy choices, are the easiest ones to make.

To succeed, we have to adopt an approach that takes us into homes, communities, workplaces and schools. We also have to work in partnership with other departments, jurisdictions and non-governmental organizations.

The government is currently working on achieving these objectives. Our strategy, which is focussed on healthy lifestyles and chronic illness, is based on promoting health and prevention through healthy diet and physical activity. This strategy highlights the conditions that are conducive to poor eating habits, inactivity and excess weight.

What impact will this have on cancer?

In Canada, the incidence of cancer is increasing as the population ages.

In 2005 alone, 150,000 Canadians will be diagnosed with diagnosed with cancer. Seventy thousand of those currently living with cancer will die.

The 2005 budget sets out $300 million over five years for a strategy focussing on healthy living and chronic disease, aimed at promoting healthy lifestyles and preventing chronic diseases such as cancer. The strategy leads the way in prevention, early identification and management, in order to reduce these staggering figures.

The budget also allocates $10 million to the Terry Fox Foundation for cancer research to mark the 25th anniversary of Terry Fox's Marathon of Hope.

Through the Canadian Institutes of Health Research's institute on cancer research, major organizations and agencies that fund cancer research are coming together to coordinate a united strategy response for cancer control. In 2003-04 the Government of Canada supported this effort with an investment of $94 million.

The human element of cancer alone justifies such an investment by the government. Nonetheless, we must also recognize the financial burden caused by the disease. In 1998 alone, cancer cost Canadians over $14 billion and we expect this figure to continue to rise.

What about cardiovascular disease?

Like cancer, cardiovascular disease is very much preventable. We know what the human cost is. The cost of cardiovascular disease to our health care system is also enormous. It is estimated to be about $7 billion annually and is a huge strain on Canada's health care system. In addition, another estimated $12 billion in indirect costs such as lost income and productivity are attributable to cardiovascular disease for that year.

This is why the integrated strategy on healthy living and chronic diseases is so important. The same risk factors can make us vulnerable to cancer, to heart attacks and to strokes.

Canada's Public Health Agency will be working with provinces, territories and stakeholders to put in place innovative and integrated approaches which address the prevention of chronic diseases, including cardiovascular disease, and will address the common risk factors that we know too well: being overweight, eating an unhealthy diet and being physically inactive.

The government has also played a lead role in Canadian activities in favour of cardiovascular health, in addition to its involvement in other activities such as the Healthy Heart Kit, the Canadian Coalition for High Blood Pressure Prevention and Control, and guidelines for hypertension screening. As well, it has worked in conjunction with the Chronic Disease Prevention Alliance of Canada.

There is another issue that the government is working to address, a health issue that, due to the related stigma, is devastating in its impact on individuals in society. I am talking, of course, about mental health and mental illness.

We are aware that there is still much to be done in connection with mental health in this country. Our well-being as a society and our public health system require us to pay particular attention to mental health issues.

I know that the Minister of Health has made mental health his main priority. In particular, he has appointed a special advisor, the hon. Michael Wilson, and mandated him to examine this issue in the workplace, and has called for the creation of an interdepartmental task force for better coordination of mental health policies in the federal government.

The healthy living strategy, which has the support of provincial and territorial partners, will help us develop a coordinated approach to address mental health issues. While the healthy living strategy currently emphasizes nutrition, physical activity and healthy weights, these cannot fail but have an impact on overall health, including mental health. We cannot separate body and mind when it comes to physical health.

The same is true for mental health. That is why mental health has been identified as a potential area of emphasis for subsequent phases of the healthy living strategy.

Poor mental health and mental illness, like other chronic diseases, are a burden for the individuals and families affected.

The federal government recognizes these ill effects and is concentrating its efforts on conditions that are liable to foster good mental health as well as those liable to trigger or aggravate mental illness. These conditions are particularly present in the work place, which is why the Minister of Health has recently announced his support of research into mental health in the work place, with an investment of $3.2 million.

Chronic illnesses such as cancer, cardiovascular diseases and mental illnesses are not new to our society, but they demand new approaches from us. We know that they are preventable for the most part, and we know that to prevent them we must be innovative and focused.

We will continue to work in conjunction with the provinces and territories, as well as major health-related organizations. If we are to be effective, we must couple our determination with compassion. By so doing, we will achieve our goal.

I was listening to an earlier speaker talking about his riding having high incidences of cancer and cardiovascular disease. We have a number of those ridings and communities around our country, some in my province, including my riding. If we look at why, inevitably we are going to find work related, industry related and environment related activities.

In the Annapolis Valley, an area with no stacks and no heavy industry, we have one of the highest concentrations of low level ozones anywhere in the world, because of its geography and the harmful emissions in other parts of our country and the country south of it. I think we have to consider all elements when we look at the question of these diseases and healthy living in general and we have to include the environmental element.

On the strategy, the $41 billion we put into health care is important. The money we put into research is important. The strategy specific to diseases suggested by the member for Charleswood St. James—Assiniboia is important. The environmental side is important. Social conditions are important. I think we need to have a fully integrated approach at all levels: social, physical and, of course, workplace.

[Steven Fletcher, Conservative, Charleswood—St. James, MB]

Mr. Speaker, it is very disturbing that the Liberals suggest one thing and do another. There has been talk this morning about $300 million for the chronic disease program, but the fact is that what we are asking for is a commitment that the government fund and implement the Canadian strategy for cancer control. I have yet to hear the minister, the parliamentary secretary or any other person of influence in the government say yes, they will fund the strategy.

This morning the minister dodged questions and implied that disease specific strategies are not the way to go, yet there is a disease specific strategy when it comes to diabetes. This is demonstrated to work throughout the world, in New Zealand, Australia, the U.K. and so on, and yet the minister does not recognize that.

The member talked about working with stakeholders, but the Canadian Cancer Society and many of the other cancer groups have indicated that they have not received the support they have asked for from the government and in fact have been misled and led down the garden path.

Not until today, when the Conservative Party motion, my motion, was brought forward, has the government paid any kind of attention to this. I wonder if the member could tell us whether the government will support the Conservative motion and follow through on it. Yes or no?

[Robert Thibault, Liberal, West Nova, NS]

Mr. Speaker, when I rose in the House this morning, I congratulated the member for Charleswood St. James—Assiniboia for bringing this debate forward and for his motion. I can tell him that I certainly will be supporting his motion. I think it is very important.

The question that the debate always and invariably ends with is how to achieve this. I think we all support the principle of what the member brings forward. I think that what he brings forward is the first concern of Canadians and that is health care. I thank him for using the time of the House for such an important issue.

I also remind him that there are many other ailments for which research and strategies are needed. We have to look at the comprehensive approach. We have to look at all our resources and how we will bring them to bear. There is no doubt that the questions of mental health, cancer and cardiac care are primary.

[Pat Martin, NDP, Winnipeg Centre, MB]

Mr. Speaker, I want to take this opportunity to ask my colleague from West Nova for the view of his party, the ruling government side, on the issue of cancer causing, asbestos laden Zonolite insulation.

Given that our colleague from Charleswood St. James—Assiniboia has given us the opportunity to raise cancer in its broader context, I note that we have this glaring threat staring Canadians in the face. Over 350,000 homeowners have cancer causing asbestos Zonolite insulation in their homes. The government has expressed no interest at all in introducing measures to assist homeowners to test for and remove this known carcinogen.

I will ask my colleague from West Nova about this. By what reasoning can the government say it is taking steps to preclude cancer from environmental causes if it ignores the most glaring example anywhere in the country, which is in people's own homes?

[Robert Thibault, Liberal, West Nova, NS]

Mr. Speaker, I do not profess to have too much expertise on this matter, but it is my understanding that the risk comes from how it is installed and whether there is some leakage of it into the environment. I know that the minister is quite concerned, as is the Minister of Labour and Housing. I think the questions would be more appropriately put to the Minister of Labour and Housing. I will put forward the member's concerns to the Minister of Health.

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

Mr. Speaker, the hon. member raised the matter of a national strategy to fight disease. I agree with him. A real strategy is vital in order to demonstrate what, when and how.

We began with the integrated strategy on healthy living and chronic disease and the Canadian diabetes strategy.

It was very exciting last year to hear the first ministers talk about prevention promotion in the same sentence as the sustainability of our cherished public health system. The first ministers focused on three things: an integrated disease strategy; choosing some public health goals for Canada; and school health, which is probably the best place to focus on these modifiable risks.

As Canadians, it is important for us to understand that it is time we put the health back into health care. We have to recognize that the health of Canadians will not be solved in just one government department. It must involve all government departments across all jurisdictions.

We also have to work on the determinants of health, such as poverty, violence, the environment, shelter, equity, and education. When we look at the numbers based on those determinants we find that there are unacceptable disparities in health outcomes.

It is hugely important that we put together the modifiable risks that are common for heart disease, cancer, lung disease and many other diseases. We could do much better by using an integrated strategy rather than parallel strategies disease by disease.

The Prime Minister showed leadership in establishing the Public Health Agency of Canada and by putting in place a Chief Public Health Officer of Canada. He has actually begun the work on getting back to what Tommy Douglas said would be the ultimate goal of medicare, which is to prevent disease before it occurs rather than just patch people up once they are sick. This is about what David Butler-Jones, the Chief Public Health Officer of Canada, calls the moral responsibility, that we all have to prevent the preventable.

We want to ensure that as we move forward that no one in this country gets cancer who need not have and no one gets heart disease who did not need to. It is important that we prevent all kinds of lung disease and that we put in place a society that prevents and supports people's mental health such that they end up not in trouble.

Every year in Canada more than three-quarters of deaths result from one of the four groups of chronic diseases: cardiovascular; cancer; diabetes; and respiratory. Half of all Canadians have a chronic disease. Risk factors leading to these diseases, such as physical inactivity and unhealthy eating are growing. Health disparities between population groups are growing, as is the burden of preventable diseases, disability and death.

These diseases are highly preventable. The World Health Organization has found that 90% of diabetes type II adult onset is preventable; 80% of heart disease and 30% to 50% of cancer is preventable by changes to the risk factors such as smoking, physical inactivity and healthy eating. It is not simply a matter of individuals changing their own habits to prevent the onset of disease or improve their health once they have a disease. It is a matter of changing our entire society so that the healthy choices are the easy choices to make.

The best example of the comprehensive approach to risk factor reduction is tobacco control. The percentage of the population who smoke has changed radically over the last three decades. Individual actions have been complemented by the efforts of government, NGOs, health professionals and researchers who offer one on one interventions, supportive community programming, social marketing, tax policy, regulations and legislation.

This is an example of how a strategy can really work. In 1985, 35% of Canadians smoked. In the past year only 20% smoked. We know that smoking reduction has had a tremendous effect on heart disease, lung cancer and the other affected diseases.

There are two different approaches. Comprehensive strategies to address chronic disease and injury can be divided into two categories. One is the integrated strategy that the first ministers asked us to focus on. Those address more than one risk factor of one disease at once. The other is the specific, those that focus only on one risk factor or disease. Health Canada and the Public Health Agency have been working in both of these areas. This is consistent with the approach endorsed by the WHO.

The disease specific strategies for the major chronic diseases of diabetes, cancer and heart disease are at various stages of development. To date, only one, the Canadian diabetes strategy, has had any significant investment by the federal government at $30 million annually.

National strategies are done by collaboration among governments and a wide variety of stakeholders. It is envisioned coordinated action from upstream to downstream, taking and promoting health, preventing the onset of disease, finding it as early as possible, treating it and preventing it from getting worse, and caring for the people dying of the disease.

These strategies will also complement the development of a health and environment agenda. As we debate this motion today we must understand that having a Canadian strategy for cancer control will be extraordinarily important as it is the leading cause of premature disability in Canada.

We acknowledge the collaborative work of the coalitions on the strategy for cancer control. We now have to ensure that proper investments are determined to ensure the effective focus on prevention promotion and also in actually determining the causes of certain diseases. We are interested right now in how second-hand smoke may actually be involved in the incidence of breast cancer. It is important to be able to figure out causes, then move to prevention promotion, as well as early detection and management.

We must focus on things that we already know we should be doing better, such as mammography. It is unacceptable that the majority of Canadian women over the age of 50 are still not getting a mammogram even though we know it can affect their length of life.

As the fabulous Ian Shugart said to me this morning, there are some things we know we are doing, some things we know we are not doing, some things we know we are doing but we do not know enough about, and some things we just do not know. We have to look into all of this with the appropriate research so that we always fund what works and stop funding what does not work. We need a capacity for real surveillance to put together the pieces around cause, determinants, risk, as well as where it overlaps with heart disease.

I look forward to working with all the partners and particularly with our provincial and territorial colleagues in looking at the dollars that are already being invested in tobacco strategies, the dollars already put aside for the wait list strategy that will affect both cancer and heart disease. We need to know what is there in the strategy for cancer, what is there in the integrated strategy and what is there in these other strategies around wait times and tobacco so we come up very quickly with a very comprehensive approach.

As we look into what the member outlined in terms of the needs around mental health, we need to focus on how the federal government needs to do a better job. The Minister of Health's appointment of Michael Wilson is absolutely brilliant in making us, as the Public Service of Canada, the best we possibly can be in terms of exemplary employers. We need to look at the mental health issue and what we will do interdepartmentally in the areas for which we have direct responsibility, our veterans, our military, corrections, the RCMP, as well as the public service.

It is important to move forward on developing a strategy on heart disease, although heart disease is probably the one thing on which we are doing a little bit better, because of the smoking and tobacco control. We have done groundbreaking work in Canada on cardiovascular disease prevention and control. It is important that we pass the 2005 budget so we can deploy that $300 million to the integrated strategies.

The 2005 budget further expands initial investments in the Public Health Agency of Canada and provides $300 million over five years for an integrated strategy on healthy living and chronic disease.

It is going to be extraordinarily important to work together with the provinces and the territories, with the voluntary sector, with all of the health care providers, and with the citizens of Canada who understand that they can have input on health policy as well. We want to move forward. We need to pass the budget. Then we need to work with our partners to get this done.

[Steven Fletcher, Conservative, Charleswood—St. James, MB]

Mr. Speaker, I appreciate the recognition that disease specific strategies are important and the way to go, particularly with cancer. I would point out that what the minister is saying actually contradicts what the Minister of Health has said, absolutely it does.

The Minister of Health spent 20 minutes this morning telling the House that disease specific strategies were not the way to go. He spent a considerable amount of time telling us that the chronic disease model was the way to go. He did not recognize the fact that the motion is asking for funding for the Canadian strategy on cancer control, which will be approximately $250 million over the next five years. Of the $300 million that the minister spoke about, $90 million has already been allocated. Already there is not the money we are talking about for the specific strategy.

Why is there a contradiction? Will the government fully fund and implement the cancer strategy that is outlined in the motion and allow the arm's length implementation of the strategy?

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

Mr. Speaker, I do not see any contradiction in what the Minister of Health and I said at all. We are saying that there had been work on individual strategies in the past. The first ministers, the ministers of health and the WHO have said we need to pause and develop an integrated strategy in order to find out what things we could all be doing together and then what things could only be done in a disease specific strategy.

Things like causation, early detection and some of the management pieces are there, but on prevention promotion we need to make sure that we are getting the absolute best effect for every dollar we spend on prevention promotion. That requires an integrated disease strategy foremost. We then need to work with the kinds of partners who have been involved in the coalition for cancer control in order to look at the kinds of things that are there and the things that need to be there.

It is extraordinarily important to understand that this must and will be done with our provincial and territorial colleagues. That is where it has to be. I have a sneaking suspicion that the Auditor General will not be interested in our putting it in any arm's length body.

[Lynne Yelich, Conservative, Blackstrap, SK]

Mr. Speaker, I am curious to hear what the hon. member has to say about mental illness in our youth. The statistics are staggering. It is estimated that 10% to 20% of Canadian youth are affected by mental illness. In Canada, only one out of five who need mental health services receives them.

I think of the parents of schizophrenic children who have come to us for help. Being the greatest disabler, it strikes more often in the 16 to 30 year old age group and they have nowhere to go. A national strategy should certainly be in place. Mental illness has been ignored not only in our province but across Canada. Where in Michael Wilson's work is this going to be addressed?

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

Mr. Speaker, we are looking to the initial Kirby report at the beginning as being a very good outline of where we need to be going in this country. We look forward to the final report in the fall.

The work that Michael Wilson will be doing with the Minister of Health is very much around the mental health efforts of the public service in this country and the role of the federal government with the people it directly looks after.

I hope the member will understand there is probably no more complex issue than mental health in this country in terms of not only the pure medical treatment but mainly around the supports and services that are required and the flexibility that is required to get people what they need when they want it. It will be together with our provincial and territorial colleagues and with specific help particularly working with our aboriginal peoples that we will design programs that really will help to change those unacceptable statistics around mental health.

[Tom Lukiwski, Conservative, Regina—Lumsden—Lake Centre, SK]

Mr. Speaker, it is a pleasure to speak in favour of the motion today to develop a national strategy for major chronic diseases such as heart disease, cancer and mental illness.

Some of these diseases have touched my family on a great many levels. About 40 years ago when I was just a very young man, my mother was stricken with cancer and after a valiant battle of about a year she passed away. That was my first experience with what cancer can do to an individual, to a body. It is without question one of the most insidious diseases known to mankind. It literally eats away at a person's body. To think that 40 years later we still have no real grasp as to what causes cancer and how to prevent it. It is something that is unfathomable to me.

I should say at the outset that I will be splitting my time with the member for New Westminster—Coquitlam.

That was my first experience with cancer itself. Two decades later, we had another incident in my family. My father, over a period of about two or three years, suffered two heart attacks, eventually came down with a stroke, which of course as everyone knows or should know is a form of cardiovascular disease. Ultimately he passed on after being incapacitated in a hospital for about two years. I saw his quality of life erode. He was an extremely active man. Both my parents were active.

To see the effects of these diseases on two vibrant individuals and to know that I was relatively powerless to do something to ease their pain is something that will never leave my memory. It is something that I feel strongly about. We need to be doing something to prevent these major diseases in every capacity.

My brother, who is only 13 months older than me, suffered a stroke about four or five years ago. It was a minor stroke luckily. He has basically fully recovered, but again this is something that stems from family history. One of the things we need to be looking at in our overall strategy to prevent these major diseases is the cause of some of the diseases. None of my family had all of the typical indicators of either heart disease or strokes. None of my family members were smokers, had high cholesterol or were overweight, all of which are typical indicators of people who may be ripe candidates for a heart attack. We did not have that.

The most personal, I suppose, and most closely related impact that heart disease had on my life was on January 12 of this year when I suffered a heart attack. It was one that was certainly unforeseen by me. I spent five days in the hospital. I am on medication now that probably will maintain my hopefully healthy and long lifestyle over the course of the next 30 or 40 years, but again, it was something that happened to me that was totally unexpected. I had no cholesterol problems to speak of and I certainly did not have a weight problem. My blood pressure, according to my cardiologist at least, was equal to that of a 16 year old well-conditioned athlete. Yet no one could possibly have predicted it other than the fact that I had a family history of heart disease.

I understand the effects that these diseases have on people's lives. I should add one humorous aside so people do not think my life is filled with tragedy. After my heart attack on January 12, it happened to be the same day that the leader of our party was coming to Regina. I actually met him at the airport around noon. He went on to one of his first events. I told him at that time I was supposed to go with him but I said that I would catch up with him later because I had to do something.

I checked myself into the hospital at which time I was told that I was right in the middle of a heart attack. I was taken up for surgery. I give great credit to all of the nurses and doctors, and my cardiologist who worked on me. In 14 minutes they had done an angioplasty and put a stent in my heart. It was an amazing procedure, but the humorous part of all of this was that the leader did not know anything about this until he found out later in the day that I had suffered a heart attack.

The humorous part was that the next morning the newspaper reported that the leader of the PC Party was visiting Regina and a local member suffered a heart attack. I am not sure whether the media truly grasped the enormity of his visit or the enormity of my disease but, in any event, we both had a good laugh about that.

Because of the closeness of some of the diseases that have struck my family, I believe very strongly that we need to develop a national strategy for major diseases. That is what this motion calls for.

There has been proof around the world that if one develops a comprehensive national strategy, it works. We see examples in the U.K., Austria, Australia and Finland where those countries that have employed and created national preventative strategies for major chronic diseases, such as cancer and heart disease, the rate of incidents in those countries for these major diseases has gone down dramatically.

Yet, Canada has no such strategy. We have talked about it for years, but we have done nothing. I think that is, quite frankly, shameful. For this country, the greatest country in the world in my estimation, which is losing so many people every year to heart disease, cancer, to sit back and do nothing about taking positive steps that have been proven worldwide to be effective and that work, is shameful.

However, I take this opportunity to suggest that now we have an opportunity to put some funding, some real money into a national strategy that would work, that would prevent disease and treat those who have incurred disease in order to save lives. That is the bottom line. This strategy would have the effect of saving lives. I do not think that anyone could put an adequate dollar value on what it means to save Canadian lives. This is not something that we should be debating. This is something we should have done years ago.

Although it may be too late to save those people like my father and mother, it is not too late to save people in future generations. I do not want this for my own health, although that is very important to me, I want this for my sons. We have a family history of heart disease and cancer. I want my sons to live in an environment where they have a fighting chance to prevent those diseases before they impact and affect my sons, and my grandsons and granddaughters.

We do not know enough about cancer and we certainly do not know enough about heart disease to determine what causes these major diseases.

Everyone always thought that it was the indicators I had mentioned previously that caused things like heart disease, for example, if a person was overweight or had high cholesterol. Well, certainly, those are indicators. If people were smokers, that would cause them, in many respects, to have heart attacks and develop heart disease. However, those are not the only indicators. I had none of those. My family had none of those indicators. Yet, we still developed these major diseases. Why? No one can tell me that.

We need to develop a strategy that would bring together all the major stakeholders and organizations like the Canadian Cancer Society and the Heart and Stroke Foundation. We need to get them, in a coordinated fashion, to share information in order to develop ideas that would be communicated to Canadians across this country. We need this group to tell Canadians some of the things that they perhaps could be doing to prevent heart disease and cancer, and also to develop a research environment to answer the questions that we have long been asking. What causes cancer? What causes chronic heart disease?

This is not something that we should be sitting here and debating. We should all be coming together as parliamentarians and saying that it has to be done. Let us get it done. Let us put the funding forward. Let us not argue. Let us not debate. This is not a political issue. This is a matter of life and death.

[Paul Forseth, Conservative, New Westminster—Coquitlam, BC]

Mr. Speaker, Conservatives have put forward for debate the following motion sponsored by our health critic, the member for Charleswood—St. James—Assiniboia. The motion states:

That, given a national strategy is needed now to reduce the growing human and economic costs of cancer, heart disease and mental illness; the House call on the government to fully fund and implement the Canadian Strategy for Cancer Control in collaboration with provinces and all stake holders, and given that Canada is one of the few developed countries without a national action plan for effectively addressing mental illness and heart disease, the government should immediately develop and initiate a comprehensive national strategy on mental illness, mental health and heart disease.

Mental health issues can be addressed from enhancing our emotional well-being to treating and preventing severe mental illness and disorder. A supportive environment for maintaining and improving mental health is one that shows respect for personal dignity and fosters a sense of having control over one's life.

In Canada the planning and delivery of mental health services is an area in which the provincial governments have primary jurisdiction. The federal government, chiefly through the Public Health Agency of Canada, collaborates with provinces. They seek to develop coordinated and efficient mental health service systems.

Mental health is an important part of overall health. Just as we can care for our physical health in a variety of ways, we can take steps to maintain and improve our mental health, and that of our families and communities.

We are reminded that at least one in five people will be affected by mental illness during their lifetime. About 4,000 people will commit suicide in Canada each year. Depression will be the single most expensive cause of loss of workplace productivity due to disability by 2020. The need for care, treatment, rehabilitation, community integration and support programs and services far exceeds what is available in most communities.

Sadly, mental health promotion and prevention issues have been placed near the bottom of the priority list of health care initiatives of the government. The stigma associated with mental illness and the lack of public awareness about mental health issues prohibits open discussion and blocks a coordinated approach to finding solutions and help for the people who need it most.

Canada does not have a national information collection and reporting system to allow for the accurate estimation of the incidence and prevalence of mental illness or to evaluate mental illness and mental health programs, services and policies that are paid for by the taxpayer. There is no nationally organized mental illness and mental health research agenda in Canada. Canada, unlike most other developed countries, does not have a national action plan for mental illness and mental health.

We need to promote mental wellness through wise lifestyle choices and body fitness. We need to encourage all Canadians to take a proactive approach to life and their mental well-being. Good mental health provides us with the ability to positively deal with the stresses and challenges of life, and facilitates the utilization of the full range of opportunities to enrich our lives and those around us.

For far too long the stigma of mental illness has made the victims hide their mental suffering while society failed to adequately provide for their needs. However, times have changed. Today, like cancer and heart disease, mental illness is viewed as a chronic disease. It can happen to anyone and like other illnesses it can be treated successfully. People coping with mental illness and those who help to support them deserve care, acceptance and respect. They also deserve a fair share of health care dollars.

Mental illnesses touch the lives of all Canadians, exerting a major effect on relationships, education, productivity and overall quality of life. In fact, approximately 20% of individuals will experience a mental illness during their lifetime and the remaining 80% will be affected by an illness in family members, friends and colleagues. With sufficient attention and resources much can be done to improve the lives of people living with mental illness.

Various reports on mental illness in Canada have been designed to raise the profile of mental illness among government and non-government organizations, and in industry, education, workplace and academic sectors. They describe major mental illnesses and outline their incidence, prevalence, causation, impact, stigma, prevention and treatment. The policy makers will have to pay better attention in order to shape policies and services aimed at improving the quality of life of people with mental illness.

Researchers recommend the collation of existing data as the first step toward developing a surveillance system to monitor mental illness in Canada. We need more resources to study mental illnesses in Canada, so we can use good Canadian data that is currently available, such as, hospitalizations and mortality data, as well as provincial studies.

Hospitalization data has its limitations however. Many factors other than prevalence and severity of illness can influence hospital admissions and lengths of stay. Moreover, the majority of people with mental illness are treated in the community rather than in hospitals and many may not be treated at all within the formal health care system.

The use of modern medications has humanized responses to mental health care. Data from provincial psychiatric hospitals would provide additional insight., but these data are often unavailable by type of illness. We need quality information to begin to fill the gaps to provide a more complete foundation on which to plan and evaluate policies, programs and services for mental illness.

For Canadians it is very simple. We stand for the Canada Health Act. However, before that, we stand for needy Canadians who are currently suffering while the system is unable to respond.

I am concerned about the thousands who simply cannot find a family physician with which to establish an ongoing therapeutic relationship. That positive relationship factor alone is a great mental health backstop. The fact of folk developing a quality relationship with their family physician is an aspect of psychoprophylaxis.

Conservatives stand for each of the five principles of the Canada Health Act: universality, comprehensiveness, accessibility, public administration and portability. They are values and benchmarks. They must also not become custodial rules which become barriers to healing or the ability of Canadians to care for their neighbour and the hurting in our communities.

These principles are the essence of Canadian public health care. Although these ideals are not met every day, we can strive to do a lot better. New science and the innovations from our medical researchers and from innovations from abroad all must be allowed to be incorporated into daily care. We still have administrative policies that get in the way of helping patients and alleviating real suffering, where policy comes before care and bureaucracy comes before healing. Canada could do much better.

Our public system, taken together with our history, becomes a societal guarantee of access to health care on the basis of need and not ability to pay. We support public delivery and public pay. Canadians turned their backs on developing a fully privatized health care system some 40 years ago. We collectively try to care for each other. However, the socialists want us also to ensure that all suffer together and some even die, as long as one bureaucracy and one mode remains. We must never allow the system to be before people, for we know that socialism hurts people, especially in health care.

We do not have an American system and our innovations are not replications of that. The comparison is erroneous. Although the Americans have the world's best health care for many, it is not for all.

May we not slide down to where all can potentially get some care, but it is only mediocre and not internationally competitive in best practice. Nevertheless, we ensure that no one will ever go bankrupt in order to get care. The problem now is what kind of care and at what levels, especially for mental health services.

The Prime Minister has demonstrated in his own personal care situation that there is a role for private for profit care. Catholic hospitals, the Salvation Army and others have demonstrated the complementary role that private non-profit care can have as part of the mix. Again, the Prime Minister is the best example, that we can expand somewhat privatization and help keep our Canadian health dollars at home without doing away or hurting the Canada Health Act.

Living in Canada we never forget that we are rich beyond the imaginings of many in this world. The right to own private property, the private enterprise system, which allows private profit in business, and the promotion of competitive open markets has gone a long way to generate the wealth needed to pay for the health care that we want.

Our privileged position means that we can ask much of ourselves and our government, and rightly so. Our medicare system can be a social equalizer in a positive sense if properly managed. It represents Canadian conservative values of equity, of equality, of justice and compassion.

I am calling today for the Government of Canada to have the patience, tenacity and a long range view to learn from the world and have more resolve to improve our public system as compared to other countries. That means investing significantly in mental health services.

Conservatives have the plan and vision to see it through to completion, for the benefit of this generation and the next. The nation, Canadians, expect no less.

[Nicole Demers, Bloc, Laval, QC]

I am pleased to speak to my Conservative colleague's motion. Although I do not agree with the motion as worded, I understand the member's concerns. Talking about the health of Canadians and Quebeckers is always difficult. It is a traumatic and dramatic subject for families, children and parents. It is always difficult to talk about these things without involving individual people.

You know me now and know that I, myself, had cancer five years ago. I knew I could count on help from people around me, the health care system and community agencies, which could provide support and follow-up. Had I not been sure of that support surrounding me, I do not know how I would have managed.

I am one of the lucky ones who did not die from the disease. I can guarantee that, when it happened, the first few minutes and hours after such a diagnosis were very distressing. It is very upsetting.

As I was saying, there is support in Quebec. I got immediate support. As soon as the doctors realized that it was an extremely invasive cancer, they went into action. I started treatment within two weeks. I lost all my hair. I started intensive chemotherapy. I also had an operation and received radiation therapy. It took a year. I am all better now, thank you. As you can see, I am in good health.

All that aside, when we consider such things, we need to ensure that we have lots of support, as I had. We must ensure that people so afflicted get lots of support from their communities. To do this, we must ensure that the provinces—and not the federal government—have the money to develop strategies. If we wait for the federal government to develop a national strategy, we might miss the boat.

I want to give just a few examples to support my remarks.

In 1999, there was the fetal alcohol syndrome/fetal alcohol effects strategic project fund, implementing national FAS/FAE initiatives. In 2001, a situational analysis was done and a publication on FAS/FAE best practices was released. In 2003, the fetal alcohol spectrum disorder: a framework for action was introduced. In 2004-05, there were round tables to identify an alcohol and drug abuse prevention strategy. In June 2005—we just received this in the health committee—Health Canada has provided us with an overview of actions and another framework for action. Millions and millions have been spent and little action has been taken.

I could mention another example: the gun registry. Even though it is not part of the health sector—although it can affect the health of numerous individuals—not just millions, but rather $1.186 billion has been spent and nothing has been resolved to date.

As far as the federal anti-tobacco strategy is concerned, the 2004-05 budget was $22.22 million and the 2005-06 was $10.177 million, yet the problem is not solved. The amounts invested are being cut, yet the percentage of smokers among the Inuit is 72%, among the Métis, 57%, and among aboriginal people 56%. It is said that 54% of young aboriginals between the ages of 11 and 19 smoke, and 65% of those between the ages of 20 and 24 do also. These are very important strategies, but are not given all the attention they deserve.

In the Minister of Public Security's speech she referred to a fund for chronic diseases. That fund contains $300 million, and not one red cent has yet to be used to help eradicate such diseases as juvenile diabetes, cancer or any other.

First Nations health is something very close to my heart. As a woman and a mother, I find it is not being given sufficient attention. It may be mentioned frequently, but really only through lip service. That is an expression used often in English to mean that a situation is merely being talked about and nothing is being done to solve it.

In 2004-05, the budget allocated to aboriginal health was $3,166,300,000. Strangely enough, in 2005-06, that dropped to $2,855,685,000, notwithstanding the announced desire to help with First Nations health. Even Phil Fontaine, chief of the Assembly of First Nations, has said:

Instead of receiving more funding to finally make inroads towards improving our shameful health status and strengthening the role of First Nations governments in delivering health care, this budget actually claws back much-needed funding. For example, First Nations desperately depend upon the coverage provided by non-insured health benefits. This program will be cut by $27 million over the next three years.

According to the press release from the AFN:

The National Chief also noted that the budget included several other major cuts to First Nations health funding. These include the elimination of the First Nations Health Information System, co-owned by First Nations in Ontario, through cuts of $36 million over three years, and the reassignment of $75 million of the previously announced $400 million funding for upstream investments and enhancement programming as renewal funding for the aboriginal diabetes initiative.

These are only a few examples, but they show the importance of the provinces and territories themselves having power over the spending of the money needed to eliminate the diseases we have mentioned.

On the subject of strategy, I can talk about a national strategy in Quebec. A few years ago now, we began to fight these diseases. Of course there were difficulties to overcome and problems to resolve. However, the problems would be much smaller if there were no fiscal imbalance and if we had the funds the federal government owes us. We are short $55 million a week. With that kind of money, we could resolve all our people's health problems.

If all the provinces and all the territories had what is owed them, but denied them by the fiscal imbalance, there would be no need to discuss national strategies. What we have to remember is that whenever the federal government is asked for money for national strategies, they do not come within its jurisdiction or under its responsibility. The health care, education and child care strategies have to go back to the provinces. We cannot forget this.

I have no doubt about the good intentions of my colleague who presented this motion. I know how important health is to him.

However, as I was saying, in Quebec, we have developed substantial programs meeting many of the needs of Quebeckers, for example the disease prevention, screening, investigation and diagnosis program. There are also programs pertaining to treatment, adaptation and rehabilitation support and end of life palliative care, in the case of cancer.

In Quebec as well—I am sure that it is the same in some other provinces—a number of major firms have recognized their social responsibilities and the importance of getting involved. For example, I will name just one Quebec company involved in cancer, which I know well. This company has invested a lot in the Look Good Feel Better program, which is run by the Canadian Cancer Society.

Sanofi-aventis invests millions of dollars every year to help women like me, who have been stricken with cancer, find ways of looking good and feeling better.

This is not just a federal government or national strategy question; it is really a matter of survival for existing programs in the provinces or territories. The government needs to give us the means by re-investing in the provinces and territories, by giving us back money that is rightfully ours so that we can do a better job of dealing with all the cancer-related problems, the cardiovascular diseases and mental illness problems.

The latter group of problems is also close to my heart. In my riding, a number of older people living with mental health problems are looking for housing. The population is aging, and it is becoming apparent that many people with mental health problems no longer have the special services that they used to receive. In the past, these people did not live as long and were taken care of by their families or lived in institutions.

Now with de-institutionalization, people who have mental health problems often live in places that were not intended for them. They often live in places where there are no tools to help them to live in dignity and with respect. They also have great difficulty adapting and finding a suitable environment. When they grow older, things become even more difficult.

Rather than investing in homes where these people could live better, the government confines them in residences with older people, much older people, with whom, unfortunately they have little in common, thereby sowing discord.

Instead of spending this money on a national strategy, I would prefer to allocate it to a strategy where it would be reinvested, where it would be given back to the provinces so that they could meet their commitments to their citizens.

[Robert Thibault, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I would like to thank the member for what she had to say and the goodwill she shows on the House of Commons' Standing Committee on Health.

Like her, I acknowledge that health is of course a provincial jurisdiction. I am just back from Saint John, New Brunswick, where professionals in the delivery of health services are getting together. There are three national, Canada-wide associations from all the provinces and all the territories, including Quebec. These people recognize the need to get together and see whether they have things in common on which they can work.

On the national, Canada-wide level, when you look at treatment, research and service strategies, there is a chance here to get together and develop strategies for avoiding duplication of research and development. This is an opportunity for people to familiarize themselves with the best practices in any province or community. People have to get together to exchange views. There can be coordination on the national level, with a view of course to the competencies in all the jurisdictions, in order to review the whole question of research and funding.

There are some provinces, territories or communities that might have fewer resources than others, less capacity to pay. That is true of the Atlantic provinces and it is often true of Quebec, to which the government provides financial transfers.

I think that the member should recognize the fact that when the 10 year health plan was developed, the Government of Quebec signed the agreement. It signed the accord.

Would the member not agree that there might be a way, regarding this national strategy—say for chronic illnesses for example—to have a national approach, a Canada-wide approach, which respects provincial competencies and jurisdictions of course.

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, I would like to thank the hon. member, my colleague on the Standing Committee on Health and Parliamentary Secretary to the Minister of Health.

Even if I have to say it 100 times, you know that we are against national strategies. Everything that is not a federal government jurisdiction should be considered a provincial or territorial responsibility, without condition. Apart from the health of Aboriginals, veterans and soldiers, health is just not a federal jurisdiction; it is a provincial jurisdiction. It is very clear, therefore, that I do not agree with any national strategy, regardless of what it is.

[Marcel Gagnon, Bloc, Saint-Maurice—Champlain, QC]

Mr. Speaker, once again, I appreciated the speech of my friend from Laval.

I do not know whether we will succeed some day in making the federal government understand that the funds it wants to distribute out the back door for all the services should go directly to the provinces.

My friend mentioned how much people depend on various services when they are sick. For myself, I had the same experience as she did. Between the detection of my illness, cancer, and the ultimate operation, there was a maximum of two months. When this time gets any longer, it is because of a lack of money, not a lack of competencies. When will the federal government get it through its thick skull that this money does not belong to it? This money belongs to the provinces, which have jurisdiction over the development of the health sector and the progress there.

I would like to ask my friend from Laval a question on Canada-wide plans. I was once agriculture critic. At the time, we were taken in by a Canada-wide plan to provide security for farmers. All the farmers in Quebec regret this plan. No Canada-wide plan really works.

I would like my friend to say more about the health care services available in Quebec to show how close we are to the people of that province.

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, I thank my colleague from Saint-Maurice—Champlain.

It must be said that some problems with health care in Quebec, which are the result of the fiscal imbalance, still need to be resolved. After numerous negotiations, the federal government has allocated $800 million to health care, but this is not enough to meet all the needs. Nevertheless, I believe that we have the best health care system compared to Canada and the United States. Europe, where the health care systems are quite different, is another matter.

Quebec has a community-based health care system, thanks to the CLSCs, community organizers, social workers, doctors and nurses. They work with the patients and are able to provide primary health care services.

We also have an extremely professional ambulance service. Now, people are taking courses to become even more professional and better able to save lives.

Our hospitals provide exceptional health care services, particularly in oncology and geriatrics. We have hospitals for different health care services. For example, studies in geriatrics are being conducted in Sherbrooke. The Laval hospital is considered one of the best hospitals in terms of oncology, neonatology and prenatal care. We provide truly exceptional care.

We also have a drug plan and health insurance. So, each individual pays the lowest possible amount for services that are supposed to be universal. However, as a result of the fiscal imbalance, people have had to start paying more because health care services cost too much.

Nevertheless, we still have the best health care services, at the lowest cost and community-based.

[Steven Fletcher, Conservative, Charleswood—St. James, MB]

Mr. Speaker, I would like to thank the hon. member for her comments; however, I fear that there may be a misunderstanding on what the Canadian strategy on cancer control entails.

The strategy does respect the autonomy of the provinces. It does respect the fact that the provinces are responsible for health care. It allows the provinces to opt in or opt out, whatever the case may be. It would not be administered by the federal government but by the stakeholders. It would be funded by the federal government, but that is it.

I wonder if the member of the Bloc would read again this cancer strategy of mine and pay specific attention to page 15 of the strategy. In light of this new information, and the fact that it is not a national strategy in the way it seems to be interpreted by the Bloc but a strategy that will benefit everyone who lives in this country, would the member be open to looking at it from that perspective?

[Nicole Demers, Bloc, Laval, QC]

Mr. Speaker, I read the text of this motion very carefully. That is why I objected to it so vehemently.

I am sure that if my colleague reread his motion, he would see that it says that:

—the House call on the government to fully fund and implement the Canadian Strategy for Cancer Control in collaboration with the provinces and all stake holders—

It does not mention provincial responsibility, but federal responsibility. If the hon. member would agree to take out that part, I think we could agree on the principle. Indeed, in principle, we certainly should have the necessary funding to meet the needs of our constituents.