Debates of Nov. 28th, 2006

Opposition Motion--Health Care

[Rob Merrifield, Conservative, Yellowhead, AB]

Mr. Speaker, I could not agree more with my hon. colleague with regard to home care. It is a major problem. It was a major problem back in the 2003 accord. That was a specific one. That accord had a date for when there would be national standards on home care. It was supposed to be accomplished by September of the following year. That date came and went and the Liberal government sat there and did nothing and wondered what was to happen. It is absolutely unbelievable that we saw no initiative, even when the Liberals sat down with the provinces, signed the accord, said that this was what it would do and then failed to complete it. The Liberals failed to even address it after that time period.

There is absolutely no question when it comes to home care, when it comes to individuals who need health care services, that they have to get it in an appropriate way.

We have to keep our seniors in their homes for as long as we possibly can and give them support services as long as we possibly can. That is where we have to go. We have to start thinking outside the box to know how to deliver that service in an effective way and understand the diversity between the vast geography of our country in doing so. If we do those things right, we will be able to accomplish what the hon. member has alluded to, which is to deal with our seniors in a respectful way in their homes. That is what we have to do.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, I am very happy to speak, especially after the chair of the Standing Committee on Health, who is a member of the government and therefore in a position of authority. I am particularly glad to speak to this motion on the Liberal opposition day. The motion reads as follows:

That...the Conservative government has broken its promise to reduce medical wait times and to provide the necessary funding and resources to achieve the goals of the first ministers’ accord on health care renewal.

We agree in part with this motion by the Liberal Party. It was a toss-up whether the Liberal Party or the Conservative Party was guiltier. In 10 years with the Liberals, the Canada social transfer sometimes missed the mark. The provinces were also struggling to reduce the deficit, at a time when the Liberal government had cut off the funding that would have allowed the provinces to meet the public's needs. Every province was fighting to reduce the deficit. I wanted to give a bit of background.

In Quebec, decisions were made. I am not here to judge the aim of those decisions, but they did let the public down. Many nurses were laid off, with the result that Quebec has a shortage of nurses today. This was done so that the province could meet needs with the money allocated to it. That is why we take a special interest in that part of the motion. But it is hard to know which of the two governments is responsible.

The Conservatives have been in power for just under a year, but from what I have seen, the Conservatives and the Liberals seem to be more or less on the same page when in comes to pursuing health objectives in provincial jurisdictions.

Yesterday I pointed out to the chair of the Standing Committee on Health that I found it somewhat contradictory to see a press release announcing a cancer program in Montreal that Quebec did not want to take part in. He said, rather ironically, that he could understand that Quebec only wanted the money. I would like to explain, once and for all, why Quebec wants the money. It does not want money for money's sake, just to have more in our pockets, but because the programs are already in place. I would like people to stop answering this question in such an arrogant and simplistic manner, which is the only way I can describe it.

Why not respond to Quebec's needs simply by saying, “Yes, it is true, Quebec wants the money and we can understand why because it already has programs in place”. Indeed, Quebec is often a leader in implementing a number of actions and it responds to the urgent needs of the people, especially in health matters.

As far as waiting lists are concerned, we know full well that the current government and the Parti Québécois would have had the same reaction. The outcome might have been different in certain respects, but the problem would have been addressed in order to truly meet the needs of the people. In Quebec, the entire population and the social and economic players know quite clearly and precisely how the government should behave toward the public. Every political party chooses its own objectives in various matters.

If I say we want the money, I do not want to feel intimidated. It is true that Quebec demands that provincial jurisdictions be respected. I am not the only way who says so, all the premiers of Quebec have asked for this. Health is a provincial jurisdiction. Furthermore, in the health accord signed by all the first ministers, a “Quebec clause” exists for Quebec's jurisdictions.

For example, on child care services and on wait times programs are being implemented and there are also reactions in the parliamentary commissions.

We have parliamentary commissions in Quebec for all these issues.

If other provinces do the same, even better. Members must rise in this House and say that this is what their governments want.

Why should we get bogged down in endless administrative procedures regarding the implementation of national programs for which there are often Canada-wide institutions that cost a great deal of money? Millions of dollars are spent on administrative costs.

I will cite only two examples, although I could give a very long list of the cost of all such agencies that oversee the entire Canadian population and all departments, in Quebec and elsewhere. If that suits all Canadians and the Canadian provinces except for Quebec, then good for them. We would understand and would not feel threatened or targeted unfairly.

Why should we contribute to funding the Public Health Agency of Canada, when the same agency exists in Quebec and carries out almost the same mandate? Our request is very simple. We should have a portion of the operating funds from the Public Health Agency of Canada, because it is not needed to supervise Quebec.

I am looking for my notes because I just mentioned the cost of the Public Health Agency of Canada. In the beginning, we all know that the Public Health Branch was within Health Canada. The two roles were divided with respect to all the public servants who work there. Thus, a budget of nearly $354 million was transferred, along with the equivalent of 1,164 full-time employees, to be precise.

Over the years, obviously, costs have increased, first, by $56 million with 385 more employees, then, by $76 million with another increase of 260 employees. Furthermore, some programs were eliminated in research and staffing related to hepatitis C. They decided to end the programs in an attempt to save $63 million.

There was an another increase in 2006-07: an additional $48.6 million and 190 employees; then a further increase of $34.9 million tied to the integrated strategy on healthy living and chronic disease, with another 120 employees.

In late 2006, the cost of managing the Public Health Agency of Canada is $506.6 million and there are now 2,000 full-time equivalent employees.

I am citing these figures because during the committee hearings I remember asking the new director of the Public Health Agency of Canada, appointed by the previous government, what the additional costs would be and how many jobs would be created. These figures were provided by the Public Health Agency of Canada and I wanted to compare them to the cost of my suggestion of transferring to Quebec the money used by the agency for administration and supervision, since Quebec already has a similar agency. For example, the $34.9 million increase in the envelope tied to the integrated strategy on healthy living and chronic disease for supervisory purposes. Why not give Quebec a portion of this money since it has the Institut national de santé publique du Québec? Its representatives also appeared before the committee to provide their input on the increase in obesity among Canadians and Quebeckers.

I should not be told, with a smirk, that we are only after the money. This money would give the Government of Quebec some latitude enabling it to be even more proactive and to improve its human resources.

Today, we are talking about wait lists. Things do move slowly in some areas. That is the reality and I have experienced it. Someone in my family is waiting for intestinal surgery. She had it and is now connected to a tube and has been waiting for an operation for a year, because there is no room.

I know what it means to have to wait for surgery. Certainly, money is not the answer to everything, but if we want more effective strategies, then we need a little more money to pay people and support the public. We are not entirely wrong to ask for more money. Quebec's health minister is currently asking for more money for health in order to meet the public's needs.

Here again, this is not partisanship. The hon. member asked which of us was the more partisan. I believe that everyone is trying to make his or her point. But on the issue of health, the Liberals fell short of the mark for a number of years. The current government is taking the same approach to health, instead of realizing that there is the Quebec clause, looking at that clause and seeing what it can do.

You do not sign just any agreement or use just any words. You do not boast about understanding Quebec society and the Quebec nation. Recognizing Quebec as a nation also means working together to understand Quebec society. That means adopting strategies to meet all the public's needs. A person can distinguish himself or herself by developing a strategy faster than someone else.

The final report of the federal wait times advisor has been issued. The report contains many encroachments on provincial jurisdictions, particularly in Chapter 7. I will not go into this in detail, because the report runs to several hundred pages. I would just like to point out that the current government is still operating as the Liberals did. For example, the table of contents includes public education and contains the following items:

7.1 The need for a public education strategy 7.2 Who is "the public"? 7.3 How Canadians are informed about wait times and implications for a public education plan... 7.5 Factors to consider 7.6 Public education on key transformations

If that is not encroaching on fields of jurisdiction, I believe that many would agree with me in saying that once again it is a step in that direction.

I spoke of the costs of the Public Health Agency of Canada. There is also the Health Council of Canada, which, if my memory is correct, supervises the agreement reached in 2004. They established the Health Council of Canada. How much does it cost? In 2005, the Health Council of Canada cost $3.2 million. In 2006, there was a slight increase and it cost $4.8 million.

What is obvious is that each time there is a federal agency, all the money goes for administration. I am not sure that is the best way of doing things. I am a member of the Standing Committee on Health and I can tell you that Health Canada—which has a very specific mandate—and the Public Health Agency of Canada often fall short of the mark, and the answers to our questions are very feeble. I could give you some very specific examples. I am not sure that they follow the letter of all their assigned mandates, or that they do it in a very effective way. Often, they set out to cast a wide net but in practice achieve the opposite effect.

There is a news release on the effective management of expenditures by this government. They went looking for money. They want to lead by example and check the effectiveness of programs. During the committee meeting last week, the Minister of Health appeared before us and spoke of his generosity toward victims of hepatitis C. He boasted of the existence of a billion dollars for the victims of hepatitis C. However, that billion dollars has still not reached the pockets of those victims.

That is what I told him. I also said to him, “You can boast when you stop delaying and immediately provide a temporary fund so the victims of hepatitis C can have better support at all levels”.

There was much talk about waiting lists, but what is needed is action. I am not sure that either the Liberal government or the Conservative government that is now in power is capable of the best reactions or the best strategies for providing more support to the provinces.

I am not sure whether I made myself understood clearly in terms of the funds Quebec is asking for. In my opinion, what it is asking for is very justified and justifiable, particularly when a Liberal premier whose praises are constantly sung is asking for the same thing and his Minister of Health is asking for the same thing. This is not money being spent foolishly and simplistically, because this is money that will be used to be more proactive in the measures that the public of Quebec as a whole are calling for.

This also brings me to another point. Any talk of waiting lists opens up the broader issue of the fiscal imbalance. We know that the Conservative government is not capable of offering us a concrete roadmap for the direction that will be taken on the fiscal imbalance. The recent economic statement made very little reference to it.

If the Conservative government in power, which accused the Liberals of a lot of things, is going to be consistent, it will pay the fair value of this fiscal imbalance, the value that Quebec’s political spokespeople are calling for. That comes to $3.9 billion.

We understand that these are figures that have already been stated. Various political strategies have been used in order to throw us off the trail, but we know perfectly well that this is the amount we called for to be recognized and to solve the fiscal imbalance. Why? To put an end to the financial pressure on the provinces and on Quebec so that they can meet the challenges they are facing in a number of areas, in this case health care, but also in education and social programs. There is also the matter of equalization.

When that party was in opposition, it said that interfering in areas under provincial jurisdiction was not their cup of tea. Now, little by little, we are seeing that the Conservatives are not entirely prepared to meet the provinces’ demands when it comes to federal government interference.

Obviously, no matter what party is in power, the centralization of national programs is an objective that a majority of the members of this House will pursue, be they Liberals, Conservatives or even New Democrats. Nonetheless, Quebec’s wishes must be respected.

I know that I am going to vote for the bill introduced by the NDP, because it recognized that Quebec was entitled to opt out of a child care program and it recognized that $2 billion was being invested in child care services.

Quickly, I can show how the Conservative members frequently contradict themselves completely. I know that they have managed to scrape together $1.1 billion by making cuts to all sorts of programs. In non-core programs, they are going to save $4 million by eliminating funding for medical marijuana research. I do not know why they want to withdraw from that program. Apparently, it is because it falls within provincial jurisdiction.

I find it ridiculous for them to respect provincial jurisdiction when it suits them, but when it does not suit them, on the other hand, they do the complete opposite. This information comes from a press release give to us by this government.

We could entertain ourselves with the inconsistencies of the present government.

[Blair Wilson, Liberal, West Vancouver—Sunshine Coast—Sea to Sky Country, BC]

Mr. Speaker, I listened intently to the hon. member's speech. I have three points to bring up. One deals with the much talked about broken promises of the Conservative government, not only the broken promises on income trusts, but the broken promises on the patient wait time guarantees and the broken promises on dealing with a national strategy for autism.

Obviously health care is an important issue in Quebec, as it is in my riding of West Vancouver--Sunshine Coast--Sea to Sky Country and the province of British Columbia. Could the member tell me how Quebec is going to deal with this string of Conservative broken promises, the most important of which, I believe, is the broken promise to deal with health care on a national basis and to deal with health care and the wait time guarantees?

I have been in a number of meetings with the province of British Columbia and the premier of B.C. to deal with health care issues in B.C. We are having a conversation right now with British Columbians to get to the root of the problem. The question I have for the hon. member is this: what specifically is Quebec going to do to deal with this broken promise of the Conservatives on their wait time guarantee?

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, Quebec has its own plan. I will not go into detail about Quebec's plan, but I know that the province has been very proactive.

Reacting would mean pressuring the government to fulfill its obligations under the agreement signed in 2004, which promised $41 billion for the entire population of Canada and Quebec and $5.5 billion to reduce wait times. We must ask the government to finally keep its promise about wait times.

Quebec is managing its own wait times, but the funding is not there. I would even say there is a shortfall in the agreement signed with Quebec for the entire health file. There is a lot of catching up to do. We are waiting for the government to take meaningful action to address health issues and especially to address the fiscal imbalance. Quebec has acted on wait times by creating several working groups. Quebec is doing something about wait times.

The ball is in the government's court. We know that wait times are one of the federal government's five priorities. We are watching closely. The government cannot make promises and then break them.

[Rob Merrifield, Conservative, Yellowhead, AB]

Mr. Speaker, I would like to ask my hon. colleague a question or two. She went on and on about a number of different issues. I think she referred to me in part of her dialogue. I believe there is a communication breakdown, but I will talk to her about that a little later. She thought I said one thing when actually I said something else, but that is not what my question is about.

My question is about her idea of the broken promises with regard to her province. I wonder just how much she really believes in her province, because when the 2004 accord was signed, all the provinces, including Quebec, signed on to that accord, which was for $41 billion over a 10 year period with the onus and the responsibility of dealing with wait times as a provincial jurisdiction. The only time the federal government should have to exercise a wait time guarantee is if the provinces have failed to comply in providing those wait times for those individuals.

Can my colleague tell me if the province of Quebec is going to fulfill its mandate, which it agreed to in the 2004 accord and which is to make sure that medically necessary services are provided for their citizens?

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, the hon. member has touched on a very sensitive point, indeed. I know the Quebec government signed that agreement, but it was not pleased to do so. It only signed so the entire population would not be penalized. It is not up to the federal government to tell us what our objectives should be, which is why Quebec refuses any conditions on funding.

It seems to me that our sensitivity is being mocked here this morning. I do not understand why my colleague brought this up. He knows very well that Quebec is very sensitive about all its programs, especially when it comes to provincial jurisdictions. The last government and previous governments all adopted this attitude. This is precisely why Quebec institutions are so strong, active and proactive in many areas, particularly health care and education. We try to correct things when the time is right.

For our child care alone, we should have been paid for all the analyses done in Quebec. The government refused on child care, but we wanted it to apply to the entire Canadian population. The conditions were therefore accepted, but not necessarily with pleasure. We would have preferred to have no conditions. However, we did manage to have the Quebec clause, which returns the money to Quebec to help the population.

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, I will read for members from the election platform of the Conservative Party. It is from the press conference of December 5, 2005. It stated:

The concept of the Guarantee is that patients must be able to receive treatment in a medically acceptable maximum time for a publicly insured service. If this [service] is not available in their own area, they must be given the option of receiving treatment at another hospital or clinic, even outside of their home province.

It appears that the government made a promise during the campaign and in the throne speech, a promise which says that notwithstanding the delivery of the service, there is this other problem about how if it cannot be delivered there, there is an additional cost to transport not only the patients but their families to some other clinic or institution in another place in their province, to another province or even to the United States.

That costs new money, I believe. I wonder if the member could advise the House as to whether or not her party believes that this guarantee that was promised does in fact require additional funding that should go to the provinces, including Quebec, to meet that promise.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, the answer is yes. We know very well that it would entail additional costs for all the provinces and Quebec.

That also applies in other cases. I would like to make a connection to another matter that has nothing to do with wait lists: approval of breast implants. The answer we were given is that the federal government approves them and then it becomes a provincial responsibility. The provinces will have to pay for the surgical follow-up that may be required as a result of the use of these implants. We know full well that they are harmful to women's health. Thus, the provinces will have to take care of their own problems.

That is more or less what we heard in committee.

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, as a member of the health committee, I know the member has worked for many years providing support to that committee. The committee has issued a report with regard to fetal alcohol syndrome or the fetal alcohol spectrum of disorders. I wonder if the member could tell the House whether or not the health officials, as directed by the government, have been sufficiently responsive to the urgency of addressing a strategy for FASD, or whether she believes that the provinces in fact need to take the lead because Health Canada simply is not doing the job.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, my colleague is posing the question to a member from Quebec. I think it would be more appropriate for the provinces to take up this challenge because the issues are perceived differently. The strategies could be adapted depending on how the situation is interpreted.

In committee, I do not believe that fetal alcohol syndrome has been a priority. I also believe that we will not be dealing with this issue in the next few months. We have a rather packed agenda. We are currently examining the problem of obesity. We cannot yet speak about the content of this report. However, I think that a lot of the discussion and issues are in provincial jurisdiction. We will see what the outcome is and what recommendations will be made by the parliamentarians sitting on the committee.

The educational component is definitely a provincial responsibility and I think that goes for fetal alcohol syndrome as well. Some people would like to establish a national education program. I believe that the provinces should be responsible for this matter.

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, the New Democratic Party has, since its inception, and the CCF before that, put health care first. It is not a partisan issue. It does not come up from time to time. It does not come up only during elections, before elections or as some crisis hits the health care system. It is a part of the founding of this political party. I believe I am speaking to this motion without attempting to make health or wait times a partisan issue.

However, I will talk about what I think are some of the significant challenges around the fact that this wait times guarantee has not been met.

When the Conservative government was elected, I believe Canadians had certain expectations on what the wait times guarantee would mean. I do not think that what the people of Canada have seen is in any way what they expected to see given the focus and the priority that was placed upon health care and patient wait times guarantee by the government. I do not think the Canadian people see the commitment or the political will to move this agenda along.

One of the reasons for this that might cause people to wonder is that one of the Conservatives' five priorities during the election campaign was to work with the provinces to establish a patient wait times guarantee. People saw that as being one of the Conservatives' priorities and whether they voted for them or not, they expected that to happen because that was the promise.

When they hear the Prime Minister talking about being pleased that his government has made progress on all five priorities, from cleaning up the federal government, to cutting taxes, cracking down on crime, supporting families and strengthening our country at home and around the world, they may be great, but where did health care go?

When the government talks about its five priorities, why has it stopped talking about the patient wait times guarantee? Has it fallen off the table? Has it been recognized that there is no plan in place whatsoever on how to approach it or is there no political will and courage to carry it out? I do not know but I do know that Canadians are asking themselves those kinds of questions.

I have a friend with a back problem who had to wait seven months for spinal surgery. This happened after the election. Every day for those seven months she hoped the promise of the guaranteed wait times within a reasonable time, depending upon when the illness, disability or diagnosis, would come through. She does not have full recovery and will probably never have full recovery. However, she would have had full recovery had she had her surgery earlier. However, lying in pain for seven months on a bed or a chesterfield and not moving created a whole series of other problems, as well as further damage to her spinal problem.

I do not think it is any great wonder that Canadians are wondering about this promise.

While I support the motion, I find it ironic that the motion was brought forward by a Liberal member of Parliament, a member of the health committee. Where do we think these wait times came from? They did not develop overnight. They came from 13 years of the Liberals not taking any action on wait times. When they did take action it came at the very last moment when it was clear that we had an enormous crisis across this country and it was shortly before an election was on the horizon. They only waited 12 years to do something about the growing wait times and all the factors that contribute to wait times.

There are factors that have played into the increase in wait times where the government could have and should have taken earlier leadership, or is still to take leadership, that would have made a significant difference in the quality of lives of many Canadians, both adults and children.

Earlier someone referenced the recent dollars for foreign-trained, immigrant doctors. The dollars will go toward rewriting the curricula and looking at the context of the tests or exams with the possibility of rewriting them, and that is a good thing. However, although foreign doctors can take the extra courses and write the exams, the real barrier for them and the one thing that was missing from the announcement is that they cannot get residency positions.

If we were to go to the Lower Mainland of British Columbia and ask foreign-trained doctors what Canada has done to help them, they would say that it has allowed them to drive taxicabs. About every third or fourth taxi driver in the Lower Mainland is a foreign-trained physician, many of whom have made their way through the existing curriculum. It is fine to be looking at the exams and rewriting them but if these foreign-trained doctors cannot get residency positions, it does not matter because they will never be able to practice.

In that announcement or that concern about health and human resources, of which physicians are only one piece of course, there was no money for residency positions. I understand that many residency positions go to the medical students who have gone through the medical schools in their provinces. That is fair enough. They should have a chance for residency positions. I am not suggesting for a moment that they do not deserve that. However, there should be an expansion in the number of residency positions available, which is the piece in that announcement that was missing. If everything in that announcement happens, it still will not produce more physicians unless there are residency spaces. This is action that is missing a piece. This is a promise to foreign-trained doctors that will be broken because they will not be able to get residency positions.

One of the biggest things we could do to help with wait times would be to provide a national home support program or ensure that each province has some standards around home support. Across this country, from coast to coast to coast, the standards as to whether one gets home support are very different. Seniors who apply for an extended care facility or for long term medium care facility cannot get in because there are no housing initiatives for anything but private long term care. Some seniors, who could perhaps stay in their homes much longer than they currently do if they had help at home, can no longer get the help they need and therefore their physicians must admit them to the hospital. Once they are in a hospital they have first priority when an opening becomes available in an extended care facility. What does that do? It just backs up the entire system.

People talk about the crisis in emergency rooms but the crisis in emergency rooms is simply a domino effect backward. No beds are available because the people who are in the beds do not need to be there. They should be someplace else but there is no place else for them to go.

I understood the Conservative member to say that the Liberal opposition had done work on home support, that it had researched it and had some initiatives but that nothing came from them. I think he said that was in 2003 but this is 2006. Since January, what have the Conservatives done to either renew some of the oppositions' initiatives, if those were good initiatives, or to develop initiatives of their own? This is another way the government is driving up wait times in this country.

I want to speak for a moment to aboriginal health. The wait times for aboriginal people are also part of the pressure on wait times. We know that many aboriginal people are at risk of other health problems, diabetes among them, because aboriginal health has not been attended to in a manner that would have really made a difference in their quality of health which drives up wait times additionally.

I know that 10 out of the 623 reserves have a pilot project on wait times for prenatal care. I am not certain of the lessons we will learn from that project, although I am sure we will learn some, but there is an irony in picking wait times for moms.

We know that good prenatal care is absolutely critical, although the aboriginal people I speak with talk far more about the fact that women do not go early enough due to the lack of transportation to get them there. What happens then is they go back into a community like Kashechewan where health care for aboriginals is appalling because of all of the social indicators that have not been attended to due to the lack of action on the issue of aboriginal health.

That is a broken promise to aboriginal people and certainly not the kind of movement needed on patient wait time guarantees, although I am very pleased for those 10 out of 623 reserves involved in the pilot project. I do not think that is the kind of wait time guarantee action that was expected by Canadian citizens.

One of the things that would make the biggest difference in wait times is that of innovation. There is innovation in wait times going on across this country, not because of the government but in spite of the government. Are wait times going down? Yes, they are. Wait times are going up in many provinces, but there are many examples of excellence which have not come about because of the government.

I was fortunate enough to have my motion pass in the health committee to establish a database of innovation on how to reduce wait times. People from across the country could look at this database and see examples in P.E.I., British Columbia, Alberta, Manitoba or wherever of how hospitals, sometimes very small hospitals, had been able to reduce their wait times. Why should we reinvent the wheel when people could simply look at a database? That would make a big difference for people.

That motion was passed by the health committee. So what? Nothing has happened. Innovation will make one of the biggest differences in wait times. I am pleased that it was passed by the health committee, but I am concerned about what happens after something is passed by a committee. It seems to go to some ether land where it is never to be heard of or seen again.

Recently, at least two private facilities have opened. One is a hospital with operating rooms, et cetera, and there is a story about a private emergency room opening in a hospital in Surrey, British Columbia or it has at least gone through a change in zoning.

There is a national leadership role for the government to play regarding the issue of privatization. Provinces must be held accountable and clearly British Columbia paid a $72,000 fine last year. There is not enough accountability with the privatization of health care. Where is the accountability with the fact that privatization violates the Canada Health Act? Where is the accountability regarding the standards? There are some stories about some very bad experiences people have had in some, and I only say some, private health care facilities.

The government has a national leadership role to play in research. It cut the medical marijuana research program. The physicians who are prescribing medical marijuana for patients who need it as a result of nausea or dealing with what is a debilitating or very often terminal illness need more research around what an appropriate dosage is and over what period of time. Now that research is gone. Those physicians are either left saying they will not use it any more or they will use it with the information they have, which is not currently as adequate as they would like it to be.

The government has not taken up its role on national strategies, although I see the national cancer strategy was announced. I am waiting for the national strategy on autism. If we can do it on cancer, we can do it on autism. As I said, the government has not taken up the national leadership role regarding accountability.

The last thing I will mention is prevention and promotion. The biggest thing that we can do, if we do nothing else, is prevention and promotion.

I do not want to find a better way to deal with wait times, bring wait times down, but have just as large a percentage of patients in 10 years time. We must have good prevention and promotion which is always the poor sister of health care, provincially, federally, wherever.

Yes, the health committee has prepared a report on childhood obesity, fetal alcohol spectrum disorder, but where do the reports go? We agree and pass these reports, and they disappear and nothing happens. Perhaps something happens, but I do not know how we figure that out because there is no mandatory action as a result of that.

Good prevention and promotion today is the most significant thing that we could do to bring down wait times in the future. Yet, that is what is focused on the least by the federal government and the provincial governments as well.

I will support the motion with the irony of where the motion comes from after 13 years of allowing wait times to grow. I expect courage and political will on the part of the government to take action and not to have its legacy be a legacy of broken promises.

[John Cannis, Liberal, Scarborough Centre, ON]

Mr. Speaker, I want to make a comment and then I will ask the member for Surrey North a question. In the member's presentation she referred to the previous Liberal government having done nothing.

I thought that she was being a bit unfair. I know she was not a member of the chamber at that time. I want to remind the member that in 1996 the provinces came to the then Liberal government and asked for about $1.5 billion to shore up the health system. Let me assure the member that the Liberal government at that time went ahead and gave the provinces the money.

Then, in 1997 I believe it was, the national forum on health, after the study, came to the former Liberal government led by Prime Minister Chrétien and said that it needed about $2.5 billion to shore up our health system. I remind the member that at that time all the premiers gathered in Ottawa, and the prime minister and the Liberal government said that we would give them the money, providing they assured us and signed on the dotted line that the money would go strictly to health care.

Instead of $2.5 billion, the Liberal government having put its finances in the right direction, gave the provinces $3.5 billion. The only province that did not sign on was Quebec under Premier Lucien Bouchard. He only wanted the money to do what he wanted to do with it.

I remember Premier Harris from the Conservative Party in Ontario and Premier Klein from Alberta stood with Prime Minister Chrétien and applauded and appreciated the money. This money was going to take care of our health system.

The problem I had at that time was that Premier Harris took the money and spent about half a billion dollars, of which Ontario's share was $1.2 billion, and paid severance packages to nurses. Today we are still trying to replace those nurses.

The member talked about a national leadership role. I agree with her. Would the member agree that the time has come for us to standardize health care right across the country?

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, we are debating wait times today and the things that are the drivers for wait times, so perhaps in signing on the dotted line there should have been a more extended or expanded version of accountability. Was that health care money expected to go to building hospitals or paying salaries? What was the accountability and how would that actually reduce wait times?

I think that all of us recognize that when we talk about accountability, we have to be very specific with whomever is the recipient of dollars about what the government expects to see back in the area of accountability.

I do not know, as a result of those dollars, whether the Liberal government at that time was able to say that as a result of it putting those dollars out, wait times were to be reduced by x. I think it is a lesson in the specificity of accountability. However, I do take the member's point.

[John Cannis, Liberal, Scarborough Centre, ON]

Mr. Speaker, we are getting on the same page with the member for Surrey North. This is where the problem lies. We take our premiers seriously and when we come to the table we agree. That is what has happened and maybe this is a lesson for us to be looking to the future of how we put these negotiations with the provinces together.

The member talked about accountability. We go to the table. Mr. Romanow brought forth the most in-depth study and recommendations of which the former Liberal government, as stated publicly not only met but exceeded. The concern we have is that the premiers or the provinces are going to take these funds now over 10 years and we have to sit back. This is why I ask her again, does she believe that maybe the time has come for the federal government to update, revise, and clamp down on our relationship with how health care is delivered in Canada?

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, across this country people do not have necessarily the same care because from province to province to province people need different things. However, there should be an equal level of access for the needs of individual provinces, there should be something that says whether we live in Newfoundland and Labrador or Haida Gwaii, that depending on the needs of our particular communities, we will have access.

I would not want to say that every province should have exactly the same standard if we are talking about very specific standards, but people should have standards regarding the equality of access to the care needed by each community.

[Dave Batters, Conservative, Palliser, SK]

Mr. Speaker, I listened with interest to the member's speech. She is a member of the health committee and I have enjoyed her interventions on that committee as well.

I brought up a point the other day at the health committee so this will not be a surprise to the member. I am from the province of Saskatchewan where under its NDP government we have the highest patient wait times in the country. That may be a surprise to members in this chamber and people watching at home. We have the highest surgical wait times and the highest wait times in terms of waiting for a diagnostic test.

I have a couple of questions for the member. Will the member join with Canada's new federal government in working with her provincial NDP cousins in Saskatchewan to help reduce those patient wait times? What kind of explanation does she offer for Saskatchewan, being the birthplace of medicare, to have the longest health care wait times in the country?

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, I would work with any province regardless of its political leadership to reduce wait times, whether it is New Democrat, Liberal or Conservative. It matters not to me in reducing wait times.

I had enough challenges explaining my own actions on reasons for them as the health minister in British Columbia. I would certainly not get into choosing to explain the actions or the statistics in Saskatchewan, but there are also high wait times in NDP provinces, in Conservative provinces and in Liberal provinces. I will work with any province regardless of its partisan or its political leadership to reduce wait times. I will do that with any partner who can come forward with the will and the courage to do that.

[Olivia Chow, NDP, Trinity—Spadina, ON]

Mr. Speaker, a recent report said that we absolutely need to pay attention to areas other than the five that are identified to reduce wait times. Also, we absolutely have to have an electronic system so that everything would be integrated. There should be a commissioner in each of the provinces, so that the patient would know and there would be an advocate to push for lower wait times. Children and mental health patients, and women especially, suffer greatly because they, by and large, have longer waits than others.

Could the member comment on those areas related to women, children, mental health patients, and other areas outside of the five priority areas?

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, on mental health, I think in my first speech in the House, when we talked about wait times, I said that I hoped they included both wait times for mental health and for people with drug and alcohol addictions. It is almost not worth looking at this because there are so few services available.

We know that not treating, and it is not only treatment but providing support as well, people with mental health needs is an enormous cost to our society, to families and to communities. We know we can provide support in the community, but we also know those supports have not been there. The reason normally given, and I have seen this myself, is that the resources—

[The Acting Speaker, Conservative, Andrew Scheer]

Resuming debate, the hon. member for Dartmouth—Cole Harbour.

[Michael Savage, Liberal, Dartmouth—Cole Harbour, NS]

Mr. Speaker, I welcome the opportunity to speak to the motion on the issue of the health care wait times and to the record of the government in this regard.

I want to thank my colleague, the member for Brampton—Springdale, for bringing this motion forward and for the passionate work that she brings to the health care file.

Health care remains one of the most important concerns of Canadians. Certainly, in my riding of Dartmouth—Cole Harbour it is a big issue and it continues to be. We are very fortunate in my riding to have a wonderful community hospital, the Dartmouth General Hospital, which I think is one of the best hospitals in the country, but it has felt the funding stresses and pressures of the health care system. That is an issue.

My riding also has some of the very great nurses and doctors in Canada. Jake O'Connor is the former Family Physician of the Year. Louise Cloutier is the president of the Canadian Medical Association. They have both appeared at forums that I have held in my community, open forums, inviting people to come in and talk about health care and about population health, health promotion. The previous member spoke to that as well.

I think it is one of the most important concerns of Canadians. It is one of those things that defines Canada, and yet is a source of ongoing debate. Perhaps only health care and the Constitution, as we saw last night, are subjects of such similar discussion, argument and interest in Canada.

In the last election the Conservatives put forward a number of proposals that they intended to provide Canadians. They reinforced these after the election as the five key priorities of the government.

One of them was to promise the GST cut. No legitimate economist in the country has suggested this makes any sense. It is a cut that disproportionately benefits the wealthy, does virtually nothing for the poor and takes $6 billion out of the economy, out of the spending power of the federal government. It robs the government of $6 billion that could be used to better serve Canadians, to increase the basic personal exemption, to perhaps increase the Canada child tax benefit, maybe even to reduce taxes or redress the health care needs of Canadians.

The Conservatives dismantled the national child care agreement, a move based on narrow ideology, one that hurts Canadians and one, I would suggest, that adds to ill health and does nothing to help the health of Canadians.

The federal accountability act, another one of their promises, has been riddled with problems.

Today we can add health care as a key area of concern of the government since January.

Let me look back at the previous government's efforts in the area of health care to provide some context. Just two years ago, the former prime minister, the member for LaSalle—Émard, met with the premiers and signed a historic agreement on health care in Canada.

In 2004 the federal government and the premiers agreed to a solution, resulting in billions of new dollars to the health care system over 10 years. Among the key parts, one of the things that was recognized in the agreement, was the federal government identified issues such as stable, predictable, long term funding and the provinces agreed. The provinces agreed to work together with the federal government to create home care and to develop a national strategy for prescription drug care. They also agreed the Canada Health Act would be respected and they would work on a national waiting times reduction strategy, which was identified as the number one health concern.

Specifically, the agreement signed by the previous Liberal government called for a $16 billion five year health reform fund for primary care, home care and catastrophic drug coverage; $13.5 billion in new federal funding to the provinces over three years; a $2.5 billion cash infusion; $600 million for information technical; and $500 million additional for research. Some $41 billion were committed to making health care more efficient and providing the provinces with the resources to fix health care for a generation.

The 2004 agreement focused on a national wait times strategy, a strategy with five key areas: cancer, cardiac treatment, diagnostic tests such as MRIs, joint replacements and cataract surgeries. As well, the agreement provided a deadline. The people to whom I spoke, whether it be the doctors in my community, like Dr. O'Connor, Dr. Cloutier and others, said that it was so important to get some wait times guarantees, but critically important was that we established benchmarks for wait times.

On December 12, 2005, provinces and territories set out the wait times benchmarks for five key areas: cancer, cardiac, sight restoration, joint replacement and diagnostic imaging.

Despite what we often hear in the House and the spin from the other parties, the previous Liberal government has nothing to be ashamed about on its record on health care, in spite of the enormous challenges that were presented. When we cleaned up the financial mess left to us by the Mulroney Conservatives, we invested in health care. We could only do so because the fiscal house was in order.

I have some other highlights of what our previous government did on health care.

In budget 2005 the Liberal government allocated another $5.5 billion over 10 years under the wait times reduction fund to assist the provinces and territories in reducing wait times.

In July 2005 the Liberal government announced the appointment of Dr. Brian Postl as the new federal adviser on wait times. He is working with federal, provincial and territorial governments to achieve commitments made in the 10 year plan. As a result of the 10 year plan, we were seeing some success in Canada.

In B.C. the median wait time for starting cancer radiation is less than a week. In Alberta the number of people waiting for open heart surgery has declined by 55% in two years. In Saskatchewan the Saskatoon health region's waiting list for MRI tests has been cut almost in half. In Quebec the number of patients awaiting cataract surgery has been significantly reduced by redistributing the surgeries to a much smaller number of facilities. In Ontario funding for an additional 42,000 medical procedures has been allocated under the province's wait times strategy.

That took us to the 2006 election. The Liberal government promised then that it would implement a Canada health care guarantee to ensure that Canadians had timely access to care. Included in that guarantee was a $75 million health care guarantee fund to assist patients and family members with travel and accommodation costs to a public facility in another province for quicker access to necessary medical procedures.

There were $300 million for regional centres of specialized care in university teaching hospital and $50 million for the Canada Health Infoway to accelerate wait list management technologies such as registries, booking systems and electronic health records.

That speaks to the initiatives of the previous government.

I will talk about an area of public health that is particularly interesting to me. When I contemplated running, one of the issues I made as part of my campaign was the issue of population health and healthy living health promotion. How do we keep people healthy? How do we focus on keeping people well, especially children, instead of spending all our time and money when intervention is required.

In truth, some say and I agree, that we do not have a health system, we have a sickness system. Our long term salvation is to turn it into a health care system. In fact, upon my election in 2004, it was for that among other reasons that I requested to be on the health committee.

Some steps are being taken. There is some very positive news. The creation of Canada's Public Health Agency, under the leadership of Dr. David Butler-Jones, is an important first step. As well as a focus on public health, SARS, West Nile et cetera, this agency has a mandate to improve the overall population health of Canadians. As well, the Public Health Agency is doing more research that looks at things like population health, health systems, demographic and regional issues in health.

This is particularly important to me, coming from Atlantic Canada. Outside of our aboriginal communities, which probably suffer the most from chronic disease, Atlantic Canada is next on the list in suffering from chronic disease.

Another very important step forward was the establishment of the CIHR, which has been a tremendously important move forward. It has paid dividends all across Canada, particularly in Atlantic Canada. In Atlantic Canada researchers, like Renee Lyons and Judy Guernsey, have done excellent research, focusing on areas like rural health, women's health and even health in Atlantic Canada and the particular challenges that it faces. I certainly hope that CIHR gets the increased funding, which it needs.

My Government of Nova Scotia was the first province in the country to develop and implement a department of health promotion. It has come forward with some very successful initiatives. I compliment Dr. Hamm, the former Progressive Conservative premier of Nova Scotia, for the work that he has done in this area. Healthy living and kids activities in schools have all been initiatives started in the department of health promotion in Nova Scotia.

We have other allies as well in the not for profit health sector. My own involvement with the Heart and Stroke Foundation over 10 or 12 years has showed me first-hand how much work it and other health charities can do. They are allies and I would suggest even leaders in healthy living.

In the long term, our seriousness in addressing chronic disease prevention will determine how well we can sustain our precious public health care system.

Another area that I think we need to put more time into across Canada is the issue of what causes illness. We know that poverty is number one in the incidence of poor health. Too many Canadians are living in poverty, and when we cut literacy programs, when we cut the social economy and when we cut the great organizations that work in mental health and the boys' and girls' clubs, we make it harder for Canadians to achieve good health, not easier.

Another key for me, and this is one I learned at first hand, is to better treat patients who have had a medical intervention. This means we need better home care, better palliative care, better pharmaceuticals, et cetera.

I had the circumstance in my life of having both of my parents die of cancer three and a half years ago. It was a sad time, obviously, for our family and our friends, but it was made much easier by the fact that my two sisters, who were living in Toronto, moved back into the family home and provided full time care for my parents as they died. We were all there with them when they took their last breaths. Shelagh and Brigid left jobs and moved home and it made a very big difference.

We have a large family and we are not rich, but we had the resources to be able to do that. My parents died at home in comfortable surroundings, in a comfortable bed, looking out a window at a scene that they knew, with their family around them. I think that is very important. It was a sad time, but to have my parents die at home was a privilege.

However, it is a privilege that not all Canadians can actually share. We had great nurses and respite workers, but in my own province of Nova Scotia I know of a family with two children with autism. The parents were getting two hours a week respite. That was cut off because their income had gone over the level that they were allowed, and that was only because they saved every penny they had for when those kids were there and they were not.

The system is not working. It brings up a system of two tier health care, not only public-private but among provinces, rich provinces and poor provinces. I believe the federal government has a responsibility to act in that area. We need to do more there as well.

I believe that federally we need to take responsibility. A lot of these are provincial areas of direct responsibility, but the federal government has a role to ensure, as much as possible, equal access across Canada.

I do want to commend the government for the commitment to the Canadian strategy for cancer control. This is our initiative that came out of the cancer community from people who were working in cancer, people in Nova Scotia like Dr. Andrew Padmos, who has now left Cancer Care Nova Scotia, Theresa Marie Underhill, and researchers like Gerry Johnson.

Many people have come together to say that we can actually make a difference in cancer. We need to take it a little bit out, at arm's length of government, and work with research agencies, do better surveillance and identify what research we need. I was proud last year in this House to vote for the implementation of the Canadian strategy for cancer control. I commend the government for following through on that last week.

I want to take a look at the Conservative record on wait times. In spite of the fact that we have to do more on health promotion and also treat people after they have been ill, right now we have the current crisis in wait times. In the 2006 election, the Conservative government promised to implement the patient wait times guarantee to provide timely access to care for patients within clinically accepted waiting times or to enable them to be treated in another jurisdiction by another provider.

In budget 2006, the Conservative government basically reintroduced the Liberals' 10 year plan to strengthen health care, as well as the original $41 billion investment to assist provinces and territories to improve their respective health care systems. In budget 2006, the Conservative government also reintroduced the wait times reduction fund.

On this side of the House, we remain committed to a strengthened and renewed public health care system. We believe that through reduced wait times we can ensure that our system of health care remains sustainable for generations to come. Until the last election, significant achievements in honouring our commitments were, I believe, under way. We will continue to work to ensure that the commitments set out in the 10 year plan are honoured. We will accept nothing less on behalf of all Canadians and in the interests of protecting our public system of health care.

In the 2006 election campaign, the Conservatives promised a wait times guarantee of their own. I am going to quote directly, if I may, from the Conservative Party platform and a press release of December 2, almost exactly a year ago. The Prime Minister, the then Leader of the Opposition, indicated:

I am pleased to announce that one of the first acts of a new Conservative government will be to sit down with the provinces to develop a Patient Wait Times Guarantee...We will bring all governments back to the table, not to bicker about more money, but to set wait time targets across the country, and figure out a plan to begin meeting them. That process will begin immediately after the election, and conclude in 2006.

I find myself quoting Conservatives far too often recently, which I do not find particularly endearing, but I am using quotes from earlier this year to talk about inaction or reverse decisions, whether that be on accountability or income trusts.

That is what the Prime Minister said back then. If one says it and puts it on paper, one has to live up to it. That is the fact. No one has yet seen a plan put forth by the government.

Let us contrast that to the 2004 election. Health care was a big election item in 2004 and a big election issue in 2006. We had the election in June 2004. By the fall, we had the 10 year plan to strengthen health care, about which people like Gary Doer, premier of Manitoba, said it was a positive step. The premier of Saskatchewan, Lorne Calvert, said, “I believe that tonight, with the plan that we have signed, publicly-funded health care in Canada, not-for-profit health care, is on a more firm foundation...”. Then minister of health for Alberta Gary Mar said, “I think we've got a good deal for Albertans”.

The president of the Registered Nurses Association of Ontario said, “This agreement removes any concerns about funding and expands universally accessible health care services”. Linda Silas, president of the Canadian Federation of Nurses Unions, said, “The promised dollars in the agreement are great news for patients. Forty-one billion dollars over 10 years more than covers the Romanow Gap in provincial health care costs and is an impressive federal financial commitment”. Roy Romanow said, “This is...a very positive step forward for reform. I have no doubt about that”.

The election was in June 2004 and there was action in the fall. This year we had an election in January with a promise by the end of the year and we have not seen it. There is no indication of how much the Conservatives' phantom plan will cost or how it will be implemented.

The Canadian government should probably issue a new press release indicating that it actually had only four priorities, because it is clear that reducing wait times has slipped off its priority list altogether. The current minister is MIA. Perhaps he believes that by laying low and avoiding the subject of health care altogether, Canadians might not notice, but they do. They notice when a party says one thing and does not come through on that promise, whether it is making cuts to seniors, to poorer students, or to women in minority groups, or whether it is a broken promise on not getting jobs for political friends or muzzling their members or kicking MPs out of caucus. Canadians do notice and they will have the choice to make their voices heard.

Liberals believe that we need to make the necessary reforms to keep our health care system sustainable and accessible to all Canadians so they can receive treatment in a timely fashion. We delivered much in the historic agreement in 2004. It is now time for the new government to do something to build on that record of achievement.

[Ed Fast, Conservative, Abbotsford, BC]

Mr. Speaker, I listened carefully to my friend's comments. Of course he was critical of the progress, or lack thereof, on wait times guarantees. However, I think the member will agree, given the fact that our government has only been in power for some 10 months, that it is somewhat ambitious for him to suggest that by now we should have solved all of Canada's health problems.

In fact, first I would remind him that we recently have implemented a pilot project to implement wait times for first nations. Then I want to remind him of his own party's record. In fact, over 13 years of Liberal government rule in this country, we saw $25 billion in cutbacks in transfers to provincial governments. Wait times doubled during those 13 years.

I have a question for the member. How is it that his government was unable to achieve wait times guarantees, unable to fund a national cancer strategy and unable to address autism in Canada during those 13 years, yet he expects our government to have solved all of the problems his government created in 13 years?

[Michael Savage, Liberal, Dartmouth—Cole Harbour, NS]

Mr. Speaker, my colleague mentions that the government has been in power for only 10 months. My heavens, it seems longer than that to most Canadians.

The situation that we inherited when we came into power compared to the situation that his party inherited this year could not really be more different. In fact, I do not think we could find another country that from 1993 to 2006 had such different economic conditions upon assuming office.

We came in with the Mulroney deficit of $41 billion a year, or higher, and we had to do something. The member may recall the headlines about Canada becoming a third world nation with a third world economy. We probably would not have a health care system today, a publicly funded health care system, if we had not improved and restructured the economy.

Were people hurt by that? Some people were hurt. My father was the premier of Nova Scotia at the time, but he understood, as those people did, that certain things had to happen to sustain the health care system. I am proud of the fact that as soon as the economy was in better shape, improvements were made. They were improvements that made a tangible difference in the lives of Canadians.

The member talks about 10 months. I would remind him that the election I talked about was in 2004 and in four months we had achieved a historic agreement that a number of premiers of all stripes agreed with. The Conservatives have had these 10 months and have done nothing.

[Olivia Chow, NDP, Trinity—Spadina, ON]

Mr. Speaker, between 1.9 million and 2 million Americans file for personal bankruptcy every year because of medical causes. We know that the cost of paperwork for health care in the U.S. is about $1,000 per person per year, while in Canada the figure is only $300. Obviously private health care is not efficient and is expensive, given that the U.S. spends 15% of GDP on health and Canada spends only 10%.

In May of this year, the Canada Health Act annual report had no report on the subject of private clinics in Quebec, Alberta and Ontario. It was appalling. There was no tracking of private health care services. I have a question for the member. How can Canadians strengthen our public health care system and lower wait times if the federal government refuses to monitor and enforce its existing legislation as it deals with privatized health care?

[Michael Savage, Liberal, Dartmouth—Cole Harbour, NS]

Mr. Speaker, I believe in a publicly funded and publicly delivered health care system. I mentioned that I have had a number of community meetings in my riding at which hundreds of people have come out to talk about health care. Those meetings are no holds barred; I tell people that they can talk about whatever they want. We have had people, including doctors, say to us that we need to look at new ways of delivering. We have had some people say that we should look at some increased aspects of private health care.

My own view is that there is absolutely no evidence that privately delivered health care is more efficient that publicly delivered health care. In fact, operation for operation comparisons between the United States and Canada indicate that Canada's system is more efficient than that of the United States. If someone were to come to me and say that we can make people in ill health better through a private system, I would say to let us have a look at the numbers. I have seen nothing to that effect.

I remain committed to a publicly funded, publicly delivered health care system, which I believe can work, is working, and can be improved upon, but it is the future of the health care system in Canada as long as we do those things that I talked about, which are to do everything we can to keep Canadians healthy, especially children, and provide better, more equitable and equal access across the country to things like home care, palliative care and pharmaceuticals. I believe in a publicly funded and publicly delivered system.