Mr. Speaker, you are more generous this morning than you were during question period. You are giving me 14 minutes to talk about health. This is far too little, but I will take advantage of it anyway.
Yesterday I talked about the new bill for six minutes. Legally, it will give all powers to the new agency. To be sure, the agency is already operating.
Bill C-5 is a carbon copy of the Liberals' old Bill C-75, which died on the Order Paper. The Conservative Party has brought back to the table legislation to create a public health agency.
Yesterday I said that this bill will encroach on provincial jurisdiction. I would also like to remind the Parliamentary Secretary to the Minister of Health about the preamble to the bill, and to explain why the Bloc Québécois is concerned about certain prerogatives the government will continue to take advantage of in all health sectors. Allow me to read the preamble.
the Government of Canada wishes to take public health measures, including measures relating to health protection and promotion, population health assessment, health surveillance, disease and injury prevention, and public health emergency preparedness and response;
Whereas the Government of Canada wishes to foster collaboration within the field of public health and to coordinate federal policies and programs in the area of public health—
Whereas the Government of Canada also wishes to foster cooperation in that field with foreign governments and international organizations, as well as other interested persons or organizations—
This is the reason for the Bloc's concern about the mandate they will give to the Public Health Agency of Canada. It used to report to Health Canada. It used to be a branch within Health Canada reporting to the minister.
We see here the potential for infringement on provincial jurisdictions. In addition, we are well aware of the government's long tradition of infringing in health care. I would point out that some of the federal government's intrusions date back to the 1930s and it was clear then how the federal government infringed on provincial jurisdictions.
I will not go back that far, because I would need more than 14 minutes to set out the long list of intrusions. However, under subsections 92.7 and 92.16 of the Constitution Act, 1867, the sectors of health and social services are under the exclusive jurisdiction of Quebec and the provinces. Since 1919, Ottawa has increasingly intervened in them, going so far as to oblige Quebec and the provinces to meet so-called national standards and objectives.
Such is the attitude behind this legislation giving the Public Health Agency of Canada powers to invade provincial areas of jurisdiction through federal government initiatives in health sectors. The Constitution gives it jurisdiction over the health of the first nations and veterans. These are a couple of exceptions where there is no infringement.
The Constitution is not clear as to infringement in other provinces. It is based on more than just spending power, which is what has allowed the federal government to increase its major interventions.
The federal government first created the health department in 1919. In 1957, it adopted the Hospital Insurance and Diagnostic Services Act , in 1966, it adopted the Medical Care Act and in 1984, it adopted the Canada Health Act.
That act imposes conditions and criteria in respect of insured health services and extended health care services. Although we agree with those principles in the act, because Quebec applies them, we reject the federal government’s desire to interfere in the management of health care in Quebec.
If the other provinces want to do it, it is up to them to decide, but Quebec already has its networks, its way of doing things, and it also has health and social services institutions that meet the needs and that are under the authority of the Minister of Health of Quebec.
In Quebec, we have already established our own Conseil de la santé et du bien-être. It was not involved in the development of the new health council of Canada .
With the Public Health Agency of Canada, the Conservative Party continues to infringe on the jurisdictions of the provinces. We are a little disappointed with this. Some Conservative Party leaders, starting with the Prime Minister and including the Minister of Health, said that they were going to respect the jurisdictions of the provinces. This is a very bad start. They have adopted a Liberal initiative and made it a Conservative initiative, and it is an infringement on the jurisdictions of the provinces.
The mandate of the new agency is to take direct action in relation to health. It will focus on more effective efforts to prevent injuries and chronic diseases, like cancer and heart disease, and respond to public health emergencies and infectious disease outbreaks. It is clear why we are concerned and why we are not enthusiastic about this bill. If we had been told that more money was going to be allocated for health or, for example, that information was going to be exchanged to meet the needs that arose in a pandemic, we would have applauded.
I think that is going too far and that powers are being usurped that clearly do not belong to the federal Parliament. No health care institutions are managed here. And now we want to get involved in managing hospitals and issuing directives, rules or guidelines. That is more or less what the Liberals did; it is what the Conservative Party is now going to do.
The federal government covers one-quarter of total health care expenditures by Quebec and the provinces. At the same time, it wants to manage the entire strategy. This is not empty rhetoric that is based only on hearsay. Documents that I have in hand confirm the mandate, role and mission of the agency. That is what I challenged first. On the long list of infringements, I have seen information concerning the health care institutions that are now under the authority of Parliament.
We are therefore very concerned and we will have to debate this bill in committee. We will be hearing a variety of witnesses. They will probably tell us to add some qualifications to this bill. In our opinion, it goes too far. It creates a new public health agency that will be autonomous and therefore no longer part of the federal bureaucracy.
We know that Quebec has adopted traditional positions. This does not just come from the Bloc. These positions can be traced back to several governments. Maurice Duplessis also said that health was the exclusive jurisdiction of the provinces. The government of Daniel Johnson Sr. argued that everything that came under the heading of health was provincial jurisdiction.
This public health agency goes very far. In this bill, there is some openness with respect to certain illnesses, such as diabetes or some chronic illnesses, where a certain amount of control could be exercised. However, it goes much too far.
A third government, that of Robert Bourassa, also fought to stop the federal government's propensity to invade provincial jurisdictions. Jacques Parizeau's government often had to stand up to the federal government, which wished to take over certain responsibilities given to Quebec by the Constitution and entrenched in the legislation. Lucien Bouchard's government did the same. The Quebec government is asking that Ottawa transfer, unconditionally, the fair share of taxes sent by Quebeckers to Ottawa.
We are speaking about fiscal imbalance but we should now consider the matter of health.
This is going to create an enormous bureaucracy, as I will show in just a moment. Public servants will be released from Health Canada and assigned to the new agency. However, there probably will not be enough of them to carry out all the directives of this new agency.
Thus, the goal of this new bill is to limit the exercise of exclusive jurisdictions in the area of health care. I believe the government is heading in the same direction as it has with other measures.
I would also remind the House that the new premier of Quebec, Jean Charest, is also willing to cooperate with the federal government, as long as there is no duplication.
This new bill will provide a legislative framework for the new structure. This framework will authorize this new agency to encroach upon areas of jurisdiction that belong to the provinces.
Quebec already has all of these institutions. I will not list them all here today. Rather, I will speak briefly about the Institut national de santé publique du Québec. It costs Quebec $37 million and has a very specific mandate, of which I will quote a few lines.
Here is its vision:
The objective of the Institut national de santé publique du Québec is to be the centre of expertise and referral in matters of public health in Quebec. Its goal is to advance knowledge and propose strategies and interdisciplinary action for improving the health and well-being of the general population.
Here is its mission:
To support the Ministère de la Santé et des Services sociaux, regional public health authorities and institutions in executing their responsibilities, by offering its expertise and specialized laboratory and screening services.
This is more or less what the Public Health Agency of Canada aims to do: develop pan-Canadian strategies, at the expense of some strategies that Quebec has put in place with $37 million out of its budget. Why not give the provinces more money so that they can develop their own strategies and pool their expertise? This is not what the government means to do in establishing a legislative framework for the Public Health Agency of Canada. It goes much further than that.
The new Public Health Agency of Canada will have the following components. There will be a chronic disease prevention and control centre. As for the agency's main activities and programs, there will be programs on risk factors common to chronic diseases, poor nutrition, physical inactivity and unhealthy weight. There will also be programs on specific diseases and problems associated with certain diseases, such as cancer risk factors and screening, as well as programs on mental health and the Canadian diabetes strategy. In addition, there will be prevention and contribution programs, even programs to combat obesity.
We are really concerned about this. I could name even more programs. The goal is health promotion, so the idea is to develop integrated strategies. That is one mission of the Public Health Agency of Canada.
Before I conclude, I am wondering about one thing. I have here a Treasury Board document about full-time equivalents. The Public Health Agency of Canada currently has 2,000 employees to manage its broad mission. Of this number, 1,714 are assigned to first nations and Inuit health. In my opinion, 2,000 employees is not enough. In a few years we will have a huge bureaucracy. The health sector has received an infusion of money because it lacked funding for 10 years. The reverse could also be true: in 10 years, maybe there will be no more money for the provinces because the government will have invested too much in bureaucracy.