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.