Debates of May 2nd, 2006

Interparliamentary Delegations

[Bryon Wilfert, Liberal, Richmond Hill, ON]

Mr. Speaker, pursuant to Standing Order 34(1), I have the honour to present to the House, in both official languages, the report of the Canadian delegation of the Canada-Japan Interparliamentary Group respecting its participation at the 14th annual meeting of the Asian-Pacific Parliamentarians Forum held in Jakarta, Indonesia, from January 15 to January 19.

[Francine Lalonde, Bloc, La Pointe-de-l'Île, QC]

Mr. Speaker, pursuant to Standing Order 34(1), I have the honour to present to the House, in both official languages, the report of the Canadian delegation of the Canada-Europe Parliamentary Association on its participation in the meeting of the Political Affairs Committee of the Parliamentary Assembly of the Council of Europe held in Ottawa, Ontario, from October 23 to 26, 2005.

Child Care

[Keith Martin, Liberal, Esquimalt—Juan de Fuca, BC]

Mr. Speaker, it is a pleasure for me to present a petition to the House of Commons. The signatories of this petition point out that 84% of parents are both in the workforce and that 70% of women with children under the age of six are employed.

Therefore, the residents of Ontario call upon the Prime Minister to honour the early learning and child care agreement.

Citizenship and Immigration

[John Maloney, Liberal, Welland, ON]

Mr. Speaker, pursuant to Standing Order 36, I rise in the House today to present a petition from the constituents of Welland riding.

The petition calls upon Parliament to lift barriers that prevent refugees from reaching Canada; provide national leadership to address the causes that force people from their homes and prevent them from returning; reform Canada's justice and refugee and immigration system to ensure full access to due process and fundamental justice; speed the immigration process for reuniting refugees and their families; and take further measures to help newcomers integrate into Canadian society.

Child Care

[Anita Neville, Liberal, Winnipeg South Centre, MB]

Mr. Speaker, I have the honour to present two petitions on behalf of many residents of the city of Winnipeg.

Both petitions call upon the Minister of Human Resources and Social Development to honour the early learning and child care agreement signed with the Province of Manitoba. To not move forward with this agreement would have profound implications for children in the province of Manitoba: 1,600 spaces lost in the city of Winnipeg, 700 in rural Manitoba and over 60 in northern Manitoba. This would have a profound impact on families in the city of Winnipeg.

I am pleased to table this petition.

Questions on the Order Paper

[Tom Lukiwski, Conservative, Parliamentary Secretary to the Leader of the Government in the House of Commons and Minister for Democratic Reform]

Mr. Speaker, I ask that all questions be allowed to stand.

[The Speaker, Liberal, Peter Milliken]

Is that agreed?

[Some hon. members]

Agreed.

The House resumed from May 1 consideration of the motion that Bill C-5, An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts, be now read the second time and referred to committee.

Public Health Agency of Canada Act

[The Speaker, Liberal, Peter Milliken]

The last time this bill came before the House, the hon. member for Québec had the floor. She has 14 minutes left to finish her speech.

The hon. member for Québec.

[Christiane Gagnon, Bloc, Québec, QC]

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.

Whereas:

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.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I think the member may have a misunderstood. The agency does not create new powers, as the member has suggested. It is a re-allotment of powers that already exist under the Minister of Health.

The member talked about the agency being autonomous. The agency is not autonomous. Employees will continue to be public servants and there will be accountability through the Minister of Health.

The member talked about jurisdictional issues. Although I agree that the provinces have jurisdiction over health, and the Conservative Party is certainly very sensitive to that, there are some jurisdictional areas where everyone in Canada can benefit by working together. The Public Health Agency of Canada is designed to deal with such cases. For example, if there were, heaven forbid, a pandemic influenza we would need to have a coordinated effort throughout Canada to deal with the issue. In fact, we would need a coordinated effort throughout the world.

As we saw with SARS, it started in Asia, went through the vast transportation systems that now exist and came to Canada. Influenza knows no boundaries or borders and we need to be able to deal with it. If we extend the logic of the member, there would be no coordinated plan within Canada. The Public Health Agency has developed the framework for a coordinated effort, plus it provides an authoritative voice that is not political and has expertise to deal with public concerns.

The preamble of Bill C-5 enforces the collaborative efforts between provinces, territories and the federal government. Does the member honestly believe that a 1918 influenza or another type of disease, such as SARS, is only restricted by borders? Does the member not agree that we need to have a coordinated effort? If the member disagrees, I would respect her opinion, but the government would disagree with that opinion because we believe we need to work together for the collective good.

[Christiane Gagnon, Bloc, Québec, QC]

Mr. Speaker, we have heard about the influenza problem and SARS. But the issue is bigger than that. We are not against the exchange of information. But the creation of the Public Health Agency of Canada will only increase the observation of certain diseases. The integrated strategy is more a matter of cancer, mental health and the Canadian Diabetes Strategy than influenza and SARS. This is what the prerogatives of the new Public Health Agency of Canada say. That is not what we are talking about this morning. We are talking rather about the broader view with respect to the new responsibilities. I know that Health Canada was supervising all that. All the integrated strategies have been added to that.

This bill also worries certain players in the health field. They want to know what sort of openness will be demonstrated regarding strategies against cancer, and in favour of mental health and improved quality of life.

Yesterday, an NDP member asked a Liberal colleague a question about a physical activity strategy. I do not think this question was off topic. I have read all the responsibilities that will be vested in the Public Health Agency of Canada to improve quality of life. These responsibilities include a social dimension. That is what it is all about.

Quebec already has such institutions. I wish to clarify what I said a while ago. It is the Institut national de santé publique du Québec that monitors the development of every disease. It has its own programs and works together with various institutions. All these networks in Quebec are among the partners of the federal government that will take part in the thinking process.

I know that the parliamentary secretary will be receptive to the figures I am going to quote. It is said that the Agency employs 2,000 public servants, including 1,202 from Health Canada. I do not know where the others come from. In all, 2,000 public servants will manage all the operations of this Public Health Agency of Canada. However, 1,614 public servants were assigned full time to improve the health of the first nations and the Inuit, and it has been a fiasco. They have been unable to stick to the program and be proactive in order to improve aboriginal health and quality of life. How are they going to manage to do as much for all Canadians with 2,000 public servants?

One may well wonder about the bureaucracy that might get out of control and eat up the budgets. Already $1 billion has been allocated to the Public Health Agency of Canada to implement all these actions.

There is plenty to think about. I am very eager for this bill to be referred to committee so that representatives of the health networks and the various governments concerned can be questioned. We will have to see whether it is possible not to perceive this bill as a huge non-functional bureaucracy that will have a hard time achieving the expected results.

My colleague talks about influenza. It is true we are very worried about it. Moreover, the government should be worried about the diseases that cross our borders. Still, as far as crisis management is concerned, each province should be able to make its contribution. We should do so, however, in some way other than this.

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, I rise today to speak to Bill C-5. I appreciate the opportunity to raise some points that I know that we will debate further in committee. In point of fact, there are parts of the bill that I think do not go far enough as opposed to going too far. I will be anxious to have that debate in committee so that we can see if those points we are talking about are synergistic with each other.

Canadians want and need to believe that their public health system can and will do absolutely everything it can to protect them and their loved ones from the kinds of tragic illnesses and tragic disasters that we think of when we think of public health agencies. Canadians want and need to know that and to know that their families will be safe.

When we look at the five components of public health, those mentioned by other members, disease and injury prevention, health promotion, health protection, health surveillance and population health assessment, I think there are some things that the bill has captured and I think there are some things on which the bill does not go far enough.

We have seen in recent years what happens when the confidence in a public health agency is shaken. During the SARS epidemic, which I know the Minister of Health has first-hand knowledge of, people in the greater Toronto area in particular were frightened for their lives. Their belief in this public health system was shaken to its very core. They did not believe that the public health system knew how to manage or was learning quickly enough and sharing that information across the country. Their faith indeed was shaken to the core.

I think more people died from SARS in the greater Toronto area than anywhere outside of Asia, if the information I have is correct. That is very frightening. At that time I talked to relatives and friends in Toronto. People did not send their children to school. They did not go to work. They were afraid to go outside their homes for fear of what was happening. On television, they saw people wearing masks, not that those masks indeed made a difference in the end, and we knew that. They were going to Home Depot or other stores buying up boxes and boxes of masks and shipping them back to Asia, hoping that it would help their relatives there, and they themselves were wearing the masks here. It was done out of fear.

Likely it was wasted money because it was not the kind of prevention that was at all successful, but it was done because people were so frightened and did not believe the health agency could cope with it. They were grasping for any straw that they thought would help keep them safe. We cannot ever see that kind of chaos in the system, where people do not believe there is leadership that will tell them what things to do to be able to stay safe.

I know that as a result of SARS there were submissions. There was the Naylor report and I know the Kirby report referenced this, but I also know that over the last number of years there have been officials of health agencies who have been warning that public health in Canada has many gaping holes that have not been filled and may put people at risk.

SARS was clearly the catalyst for the reports being done. By the way, the results quite matched, I think, and made recommendations for many of the same things, but it was not the first time that the government, primarily the former Liberal government, had heard that there were problems within public health and that indeed they had not been acted upon in the 13 years of the Liberal government. I think there is very good work being done at the municipal, provincial and federal levels around public health, emergency preparedness and a number of issues that the bill speaks to. That means there is a far greater awareness and people are working hard to make sure this does not happen again.

I give full kudos to everybody who not only has raised awareness but is working to bring people together to plan what happens when there is some kind of natural or unnatural emergency or disaster, but I think there are steps that would help this bill, since we have this first opportunity here, to show perhaps a bit more vision. I know it has been referred to as a “machinery” bill. I think there are other pieces that could cause this bill to show a bit more vision for Canada in terms of where the Public Health Agency is going. There probably are about five areas of concern that I would want to mention.

One of these areas of concern is the powers of the Chief Public Health Officer. The previous speaker spoke of these powers. I am probably going to take a different position on this, but it is clearly a point that needs to be debated. As for the powers of the public health officer, and I gather it will be the current person should the bill pass, in the bill the individual does not have authority over areas of federal jurisdiction such as airports, railways, military bases, et cetera. Why not? I think it is important that this individual has total responsibility for those clear areas. Planes do not change a protocol if they fly between Manitoba and Ontario. Trains do not change health protocols if they go from Alberta to British Columbia. There must be national standards of public health around transportation, support to aboriginal people, which again is a federal responsibility, and military bases as well.

Second, the Chief Public Health Officer is not given authority to act, which speaks to the previous speaker's point, when a province or territory is overwhelmed by a crisis or when that crisis transcends provinces. Again, bacteria, germs, SARS and avian flu, should it mutate, are not going to look at a map of Canada and say they cannot go there because there is a border. That is nonsense. Therefore, there must be an ability for the Public Health Agency and the Chief Public Health Officer to have that authority to cross all borders when that is necessary. Otherwise, we are going to put the public health concerns of Canada at risk if this cannot transcend geographical borders.

I want to speak to the issue of health protection for a moment as it relates to quarantine. In this bill, the Minister of Health is the person who is responsible for declaring a state of quarantine. In provinces, it is the public health officers who are responsible for declaring a state of quarantine. So why, at a federal level, would the Chief Public Health Officer not be the person who would, based on academic information and scientific research, be responsible for declaring quarantine? Why should it be the Minister of Health? That is a point we need to talk about and debate in committee. I am sure we will have that opportunity, but that is a disconnect between what happens in the provinces and what happens federally. I believe that it should be the Chief Public Health Officer.

I would like to talk a bit about House surveillance and population risk assessment. There is no mandatory requirement for the provinces and territories to report to the federal government any communicable diseases present in their provinces, never mind any other disease patterns that we might be seeing, although I did not see this bill going quite that far. We could ask them to. We could ask British Columbia to tell us if it has an outbreak of mumps. British Columbia could agree to do so, or it could say that it is not prepared to share the information. I realize it is difficult, but it has to be mandatory.

In the last two weeks the papers have reported a huge outbreak of mumps particularly in the United States, but it is moving up into Canada. We have not seen an outbreak of mumps affecting teenagers in a very long time. We have learned information about the length of time the first immunization is effective. The first immunization that babies get is an MMR shot for measles, mumps and whooping cough. For many people the immunization is not lasting long enough and people are not getting a second one, so there is an outbreak of mumps among teenagers. That is information surely we would want to know federally in order to see a trend across the country.

I cannot speak with knowledge of other provinces in any significant way, but I do know that among first nations people and very much in downtown Vancouver, we are seeing a significant rise in tuberculosis. Tuberculosis is something we thought was gone from this country. In the late 1950s and early 1960s, in my very early nursing days, all the TB sanitariums were closed down because we had beaten it. We had figured it out. People were not getting it anymore. We could treat it immediately. There was no further need and we were not going to see it again, but we are seeing it again in growing numbers.

I want the federal Minister of Health and the Public Health Officer to know that we are seeing those trends across the country, so there can be a national strategy. I am not very comfortable with there being 13 different strategies on what to do if there is a tuberculosis outbreak, a mumps outbreak, or an outbreak of any other kind of communicable disease, particularly those that we thought we had eradicated, such as TB and mumps. They are not even new ones. To have a different strategy in each province would be very dangerous.

I want to mention avian flu. The B.C. Centre for Disease Control has just published a paper. It is concerned about avian flu. If it comes to North America there is every opportunity for it to mutate. At the moment people are not at risk, but we know that those kinds of infections mutate quite quickly, as is the case with many infections today. It can mutate so that humans can be infected by it. Everywhere across the country we see poultry and other birds being imported. A national strategy is needed. We cannot have 13 strategies on what to do about that.

It may go without saying that the agency must be resourced to do its job. I do not want to see an outline of what the Public Health Officer can do, all of the goals and objectives and just a document that will make me feel good because of what is in it. It needs to be properly resourced in order for the Public Health Officer and the people who work at the agency to be able to do their job, to collect the information that is necessary, to do the analysis of that information and to develop strategies that will protect all Canadians within this particular act.

The people in our country look to us for that protection. They deserve that protection. They deserve to know that it is being done and it is being done well, that it is being done in a coordinated way and that the Chief Public Health Officer has the power to take action. He or she should not have to go back to the minister.

I wondered out loud the other day whether consideration had been given to the Public Health Officer not having to go through the minister to present information either to Parliament or to the public, but could simply go ahead and publish a report, as can be done in many provinces. They do not need to go through the minister. They do not need to have someone's permission. They simply provide public information.

It would be interesting to have a discussion in committee about the independence of the Public Health Officer. I welcome the opportunity to discuss these matters in committee. I have had a chance to discuss them with the Parliamentary Secretary to the Minister of Health and I look forward to the chance to discuss them in committee.

The very basis of this must be that never again will we see the lack of leadership, the slow accumulation of information and the failure to share information that we saw with SARS or with avian flu, although that did not affect people, before people figured out what could be done. It was too late by then. People need to know immediately.

[The Deputy Speaker, NDP, Bill Blaikie]

Before I recognize the hon. Parliamentary Secretary to the Minister of Health on questions and comments, I would ask him to keep his eye on the Chair and not just speak directly to the member, so that I can tell him when he should be winding up.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, you took away my major excuse for going over time.

I congratulate the member on her post as health critic for her party. It was interesting to contrast the member's point of view with that of the Bloc member in a number of respects.

I have two questions for the member from the NDP. One is that the Bloc member suggested that jurisdictionally, in dealing with pandemics and other health crises, it is just up to the provinces. I wonder if the member would agree with the government's position that we need to have a collaborative effort and that there is shared jurisdiction in these types of situations between the provinces and the federal government.

I also wonder if the member could provide any insight into why it took the previous Liberal government so long to actually bring forward legislation. The agency had been created under an order in council for a number of years before the Liberals even tabled the legislation. Even when they did table the legislation, it was on the eve of an election. I wonder why the previous government dilly-dallied.

Perhaps the member could answer the questions on jurisdiction and dilly-dallying on the previous government's behalf.

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, I did mention early on in my remarks that long before the SARS crisis, public health officials in general had been raising the fact that there were problems with public health at a national level. The question about why people chose to bring forward or not bring forward something would most appropriately be directed to a Liberal member. What I do know is that SARS was not the first time that anybody had said there were problems with public health in Canada.

I am not sure if I have ever been asked about dilly-dallying. I am sure there is an official definition of that. What I do know is the problem was identified much earlier than the SARS outbreak and that it had been identified to the Liberal Party as a problem.

I think the member's first question was whether I would agree with the government that there were areas that were of national concern. We will see at the committee whether I agree with the government when we have had a chance to discuss this further.

I would say that outbreaks know no borders. Bacteria know no borders whatsoever. They do not know what country they are in, what province they are in or what city they are in. I do not think we can take the risk of drawing a line around that issue. There are many things in health around which we can draw a line around, no question. There is no question about that and I understand that, but around something like this, I think it is dangerous to people's health.

[Mario Silva, Liberal, Davenport, ON]

Mr. Speaker, I found the member for Surrey North very interesting to listen to and very informed. I am not surprised that she was a nurse in her former life. It certainly came across quite clear in her views and her understanding of the issue.

Bill C-5 is very similar to the bill that the Liberal Party had put forward, Bill C-75, which unfortunately died in the last Parliament. There are some things my party did move forward, such as the importance of putting in a minister responsible for public health and also putting into place the Chief Public Health Officer. That was a very important move and there was a focus.

I agree with the member that when a crisis hits, there are no borders. It moves across provinces and across countries and we have to act. I share her concerns as well that we do not need 13 plans, that we need one national plan that is coordinated.

I also share the member's assessment of what happened during the time of SARS. I was on Toronto city council at that time. It was a very frightening time to be in Toronto. The messages going out in the media were scaring people away from our city, that people were quarantined all over the place, that people were wearing masks to work. It was not necessarily the case. It was a time of great concern, but people still were quite brave and were going along with their daily lives. SARS certainly had a major impact on the economy of Toronto. Toronto is still suffering as a result of SARS and, of course, September 11. These incidents impacted quite severely on the economy of Toronto.

I would say to the member that there were things that the Liberal Party tried to move along in the last Parliament, particularly on the issue of public health.

Is there anything in relation to the Quarantine Act which she feels needs to be changed or added to, or is she satisfied with the Quarantine Act that was adopted in the past?

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, I am sorry, but I could not hear the last part of the member's question about the Quarantine Act.

[The Deputy Speaker, NDP, Bill Blaikie]

The hon. member for Davenport for clarification.

[Mario Silva, Liberal, Davenport, ON]

Mr. Speaker, the member briefly talked about the Quarantine Act. I do not think she raised any concerns. The act that was introduced in the last session of Parliament was somewhat a reform to an earlier act that had not been changed in almost 100 years. It is quite shocking that it had taken so long for the Quarantine Act to be changed, given the new evolving situations happening internationally.

Does the member have anything else to add to that? Does she think anything could be changed in the Quarantine Act, or is she satisfied with the present act?

[Penny Priddy, NDP, Surrey North, BC]

Mr. Speaker, I will be interested in the discussion at committee.

My current concern about the Quarantine Act is who declares a quarantine. In the provinces, the provincial medical officer of health can declare a quarantine based on scientific and medical information. There seems to be cognitive dissonance when we get to the federal level. It is not within the power of the public health officer to declare a quarantine. Why the difference?

[Dave Batters, Conservative, Palliser, SK]

Mr. Speaker, it is with great pleasure that I rise today to address this important bill, Bill C-5, an act respecting the establishment of the Public Health Agency of Canada.

Before I begin, I welcome the member for Surrey North to this place and thank her for her intervention this morning. I found her comments to be very informative. It is clear that she was a nurse before she came to this place.

She said that the health of Canadians is of utmost importance to members of Parliament. She commented on the SARS crisis in 2003 and how people were afraid for lives, especially people in Ontario and the GTA. She talked about the need for leadership, and I could not agree more.

The member for Surrey North may agree with me when I say the Minister of Health provided the leadership to the people of Ontario at that most difficult time. He has received a lot of praise for the work he did during that crisis. Canadians can take a lot of comfort in the fact that the Minister of Health will oversee the Public Health Agency of Canada and the Chief Public Health Officer. He will be at the helm, God forbid, should another crisis such as the SARS outbreak take place.

This important legislation is key to the implementation of the government's vision of a renewed and strengthened public health system for Canada. As we all know, preventing and managing chronic and infectious diseases, as well as promoting good health, is key to a healthier population and to reducing pressure on the acute health care system.

The legislation underlines the government's commitment to promote and protect the health of Canadians. It would not only bring greater visibility and prominence to public health issues, but it would also support policy coherence across the health sector.

The bill also responds to the recommendations made by Dr. David Naylor and Senator Michael Kirby in the wake of the SARS outbreak. In their report both Dr. Naylor and Senator Kirby recommended that the Government of Canada establish a new public health agency. Further, provinces and territories and public health stakeholders have called for a federal focal point to address pubic health matters with the appropriate authority and capacity to work with other jurisdictions in preparing for and responding to public health threats and emergencies.

The legislation responds to those recommendations by establishing a statutory footing for the Public Health Agency of Canada. It would establish the agency as a separate organization within the health portfolio. In this regard, the agency would support the Minister of Health in exercising his duties, powers and functions in public health. In doing so, the minister recognizes the importance of continuing to foster collaborative relationships with federal, provincial, territorial and municipal governments as well as with international organizations and public health experts. The preamble of Bill C-5 further reinforces the agency's desire to work in cooperation with the provinces and territories.

A key aspect of the Naylor and Kirby report was their recommendation to appoint a Chief Public Health Officer for Canada. Specifically, Dr. Naylor recommended that a Chief Public Health Officer head the new agency in addition to serving as an independent credible voice on public health nationally. The legislation responds to that recommendation by formally establishing the position of the Chief Public Health Officer. Specifically, the legislation confirms the position, duties and powers of the Chief Public Health Officer and recognizes his unique dual role as both the deputy head of the agency and Canada's lead public health professional.

As the deputy head of the agency, the Chief Public Health Officer will be accountable to the Minister of Health for the day to day operations of the agency. In this role the Chief Public Health Officer will support the Minister of Health in fulfilling his public health mandate. He will be expected to advise the minister on public health matters and to inform policy development in these areas, along with the deputy minister of Health Canada and other deputy heads within the portfolio.

As the lead adviser to the minister on public health matters, the Chief Public Health Officer will help to ensure that public health issues are well represented in the health policy making process. At the same time, provisions within the proposed legislation will ensure greater policy coherence across the health portfolio by reinforcing the responsibilities of the deputy minister of Health Canada for supporting the minister in coordinating efforts across the portfolio.

Further, as a deputy head within the federal system, the Chief Public Health Officer also has the standing to engage other federal departments on key public health issues. As one example of this kind of work, over the past several months Dr. Butler-Jones has been working closely with the deputy minister of Public Safety and Emergency Preparedness Canada and the president of the Canadian Food Inspection Agency to strengthen Canada's pandemic and avian influenza preparedness.

As the deputy head, the Chief Public Health Officer is also able to mobilize the agency's considerable public health resources to respond quickly to emerging threats to the health of Canadians. This departmental model gives the Chief Public Health Officer considerable responsibilities while ensuring continued ministerial accountability for federal activities in public health.

In addition to his role as deputy head, the legislation also recognizes the Chief Public Health Officer's role as Canada's lead public health professional, with demonstrated experience in the field. As part of this role and in response to the strong expectations of public health stakeholders and Canadians, the Chief Public Health Officer will also serve as a credible and impartial voice on public health issues.

To ensure his or her credibility with stakeholders and the public, the legislation would give the Chief Public Health Officer the authority to communicate directly with stakeholders and to provide Canadians with information on public health matters. I think that addresses one of the concerns the member for Surrey North, that the Chief Public Health Officer has the authority to communicate directly with Canadians. He or she would be able to prepare and publish reports on public health issues.

In keeping with the government's focus on strengthening accountability, the Chief Public Health Officer will also be required to submit to the Minister of Health, for tabling in Parliament, an annual report on the state of public health in Canada. This requirement will not only provide greater transparency to Canadians, but it will also support the government's direction for an increased role for deputies in strengthening government accountability.

As the House knows, Dr. Butler-Jones has been serving in the Chief Public Health Officer role since September 2004. He brings to this position a considerable background in public health practice and years of demonstrated leadership in the field, in government settings at all levels, as well as within the non-profit sector. The proposed legislation gives parliamentary sanction to office of the Chief Public Health Officer, confirms the appointment of Dr. Butler-Jones for the remainder of his specified term and gives him the legislative authority to speak out on issues of public health. The Chief Public Health Officer must be an impartial, credible voice on public health matters.

Stakeholders have made it clear that they expect the Chief Public Health Officer to be an independent voice, able to drive real change by speaking out on public health matters and issuing reports. Making the Chief Public Health Officer Canada's lead public health professional and ensuring that future chief public health officers have qualifications in the field of public health will help confirm this credibility with stakeholders and Canadians.

The credibility of the Chief Public Health Officer is also reinforced by the fact that he can communicate directly with the public and stakeholders and can report on public health problems and solutions. The Chief Public Health Officer's expertise, status and power to communicate make him a visible symbol of the federal government's commitment to protect and promote the health of Canadians.

The dual role of the Chief Public Health Officer is unique among deputy heads of departments at the federal level. We acknowledge that there will be a healthy tension between these two roles.

On the one hand, the Chief Public Health Officer will be an integral part of the health portfolio with direct responsibility for the operations of the agency, for providing advice on public health to the minister and for carrying out the policy direction of the government.

On the other hand, the Chief Public Health Officer will be an impartial spokesperson on public health with an interest in maintaining the scientific and ethical credibility of the office. For example, the Chief Public Health Officer can work with his provincial colleagues in the pan-Canadian public health network to receive information and advice. With the authorities granted to him in legislation, the Chief Public Health Officer can then communicate and provide Canadians with the best public health advice.

We see this dual role being inherent in the nature of the office, but one that is manageable and demonstrates this government's commitment to accountability.

It is also not without precedent, as Dr. Naylor has noted in his report that the chief medical officers in both Manitoba and British Columbia have the authority to communicate and act independently when they deem it to be in the best interests of the health of their citizens, while remaining accountable to the governments they work within.

More recent, in 2004 the province of Ontario made amendments to its legislation to grant the chief medical officer of health more independence.

In light of the many potential threats facing Canadians from a possible influenza pandemic, to combatting chronic diseases such as cancer, to dealing with the persistent challenges of obesity and other health risk factors, public health is an important priority of this government. As such, the government considers that the dual role attributed to the Chief Public Health Officer by the proposed legislation will ensure the attainment of the two policy objectives mentioned above.

The Chief Public Health Officer will be firmly situated within the health portfolio where he or she can advise the government and play a meaningful role in a coordinated government-wide response to ongoing and emerging public health threats and issues. At the same time, it is very clear that Canadians want and expect the nation's lead public health official to have both the necessary qualifications and the mandate to speak out on matters affecting their health.

Canadians can be assured that the government understands the importance of having a Chief Public Health Officer whose overriding interests must be the health of Canadians. I believe the legislation strikes the correct and necessary balance between the dual roles of a chief public health officer, ensuring that the office has the ear of the government and the independence to first and foremost be a servant of the public interests.

I would like to take a moment to thank Dr. Butler-Jones for the great work that he has done. He has an extensive background in public health. Most recently, he served as the medical health officer for the Sun Country Health Region in my home province of Saskatchewan, only approximately 100 kilometres from my home town of Estevan, Saskatchewan. Sun Country is located in Weyburn, Saskatchewan. The public health care of Canadians is in good hands with Dr. Butler-Jones.

[Keith Martin, Liberal, Esquimalt—Juan de Fuca, BC]

Mr. Speaker, I listened intently to the member's speech on a very important issue for all Canadians. As somebody who has spent quite a few years practising in the emergency department, I am obviously fully supportive of more resources going to the acute side of medicine because there is a definite need right now. Emergency rooms across the country are being choked and emergency health care professionals are overworked in the commission of their duties in our time of greatest need.

However let us project forward and look at what is happening in the country. It is very disturbing to know that our youngest generation could now for the first time have a shorter lifespan than our generation and older generations. We need to address the fact that public health issues, and usually small interventions do have dramatic effects, will be required in order to prevent problems and continue with the extension of lifespans and the quality of life. Water, food, the quality of food and water, and lifestyle issues have to be addressed.

I would submit the following to the hon. member and he can consider telling it to the Minister of Health. It is the small preventative issues that could work well. For example, the head start program, which would have been part of our early learning program, would have ensured that children had their basic needs met for the first six to eight years of life. This is probably the easiest and simplest way of actually having a profound positive impact upon the lives of children and adults. It ensures that children are aware of proper nutrition, activity and that parents and caregivers are able to spend quality time with children and interact with them over a prolonged period of time.

Those kinds of simple interventions have a very positive impact upon children's lives. Will the hon. member present to his Minister of Finance a proposal for supporting a national head start program, a national mental health care strategy and a national medical manpower strategy with the support of the provinces? Will he also look at adopting the findings of the Walkerton inquiry which were very good toward developing national standards for water quality? All of those things could have a profound positive impact upon the health of Canadians.

[Dave Batters, Conservative, Palliser, SK]

Mr. Speaker, I know the member opposite is a physician and certainly has very useful insight to add to this place and to this very important debate.

It is nice to see the support that the bill has, at least from two opposition parties, but I think the Bloc Québécois would support the spirit of it.

The member talked about lifespans and the fact that we face some very serious challenges right now in Canada in terms of public health. If some of these epidemics are not brought under control, things that are very widely accepted and well-known but the impact may not be well understood, such as heart disease, diabetes, childhood obesity, the need for lifestyle improvements and primary prevention measures, we could have lifespans on the decline in Canada and that truly would be a shame.

The member asked if I would take this to the Minister of Health. Absolutely. I am very proud to be serving on the health committee in this 39th Parliament. I look forward to working with other members of the committee who will look at this and other bills and see if improvements can be made. I will go to the Minister of Health and talk about everything we can do in terms of primary prevention in order to improve the health care of Canadians, to address things like water quality, as the member mentioned, and lifestyle modifications, a mental health strategy for the country and basic policies to address heart disease and diabetes.