Mr. Speaker, I am pleased to participate in today's debate on Bill C-5, An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts.
I have some serious concerns about Bill C-5.
I was a social worker in Quebec's health and social services network. For the past three years, I worked in a nursing home and long-term care facility for the elderly. Such facilities have a high risk of influenza and other viral epidemics. I found that the regional public health authority acted competently and expertly to prevent and respond to epidemics. I am convinced that Quebec's response strategy is effective and rigorous, and that it meets the needs of Quebeckers.
Given that the Government of Quebec has the expertise and works with all parts of the Quebec health network, the Bloc Québécois believes that the provincial government should establish its own priorities and create its own action plan according to world-wide objectives developed by organizations like the WHO.
I do not share the opinion of a certain colleague from another part that Canada cannot have 13 different strategies and action plans. I believe that every province can create its own plan that corresponds to the particular activities and characteristics of its territory, particularly regarding prevention strategies for problems such as obesity, diabetes and injuries.
I do not believe that creating or changing the status of the current agency to coordinate the action of the provinces is necessary. I am not saying it is not necessary to coordinate what the provinces are doing in matters of public health. As the Parliamentary Secretary to the Minister of Health said, viruses do not have boundaries.
It is important to protect the health of our citizens. However, I wonder about the means proposed and described in Bill C-5. In this bill, we see that the agency will have its own portfolio and that the main administrator will be accountable to the Minister of Health while still remaining impartial and non-partisan.
The detachment of the Public Health Agency of Canada from Health Canada worries me. I fear that significant amounts of money will be allocated to that agency rather than be transferred to Quebec and the provinces, which have jurisdiction over this.
Quebec has to be able to fund its priorities in prevention and health promotion. These priorities may not be the same elsewhere, in all the other provinces.
Having worked in Quebec's health and social services network, I have seen that the application of “wall to wall” programs does not always help in achieving objectives. This centralist formula being imposed on us is far from being unanimously accepted in Quebec.
The Premier of Quebec, Jean Charest, said in January 2004, on the matter of the possible implementation of the Public Health Agency of Canada that:
Quebec ... has created its own structures in these two areas and they work. They will work with those that will be created, but duplication is out of the question—
That is precisely what the government is proposing to us today: duplication of services to the public because, once again, it is interfering in one of Quebec's jurisdictions.
The federal government keeps bringing in more structures in the area of health. After the National Forum on Health in the 1990s and the Health Council of Canada, now they are adding the Public Health Agency of Canada.
The Bloc Québécois, together with the Quebec government, objects to the federal government's desire to interfere with health care in Quebec. How the Quebec government organizes and provides care and establishes priorities for health care and social services is strictly its business.
This does not rule out cooperation and coordination among the provinces.
Consider the contradictions of this Conservative government, which says one thing then proposes to do the opposite.
In a speech on May 1, the Parliamentary Secretary to the Minister of Health, citing the Speech from the Throne, said, “The government is committed to building a better federation in which governments come together to help Canadians realize their potential”. However, barely two weeks ago, his boss, the Prime Minister and only official spokesperson for the government, stated that the only federalism he would engage in would be open federalism, federalism that respects the areas of provincial jurisdiction and in which the federal government's spending power is monitored.
Thus, in order to make this Conservative concept of open, cooperative federalism a reality, we are presented with a Liberal bill, a bill that comes directly from a government that Canadians removed from power during the last election. This Liberal bill allows Ottawa to interfere once again in an area of jurisdiction that belongs to Quebec and the provinces, this time under the guise of public health.
To justify this interference, reference is made to the SARS crisis that hit the Toronto area in 2003. In his remarks to this House, the Parliamentary Secretary to the Minister of Health said that the SARS crisis “launched an important discussion and debate about the state of public health in Canada”. That is true, he is absolutely right. However, he forgot to mention that, at the time, all stakeholders in Quebec agreed that, had this crisis hit Quebec instead of Ontario, it would never have developed to the extent it did in Toronto. Why? Because Quebec's public health services already had an action plan in place for use in the event of such an emergency in that jurisdiction. Not only did Quebec have an action plan, but the human resources required had also been defined. That is why.
As an aside, I noted in my research that Ontario has just received, in March 2006, a report recommending that it set up its own public health agency, something similar to Quebec's Institut national de la santé publique.
In a nutshell, it is because Quebec has put in place what is needed to face this kind of situation and because Quebec minds its own business, which we would very much like the federal government to do.
By espousing this Liberal legislation, the Conservative government is espousing at the same time the Liberal vision of Canada: Ottawa knows best and will impose its will from sea to sea.
How will a new agency or specific entity, call it what you want, with offices across the country help us deal with any potential flu epidemic? What will it change in real, concrete terms? I would like to know.
We have no problem with the federal Department of Health instituting prevention and emergency response measures in its areas of responsibility, such as screening at the border. Not at all, that is its job. But to have the federal government establish an agency and spend public money on a new structure duplicating one that already exists and is working well, that is a problem.
The government repeated over and over during oral question period that it is committed to the interests of taxpayers. This is a fine opportunity to show concern for them by using their money efficiently and effectively.
Can someone explain to me what exactly the staff of the new agency will do in the offices in Quebec that employees of the health department cannot do here in Ottawa?
I would like an answer to that question.
How will information on new public health threats be any better coordinated with the creation of the public health agency than it is now with the health department, whose job it is to coordinate this information? I would also like an answer to that question.
The Conservative government plans to set up a new entity, separate it from the health department, give it substantial funding and personnel and set up an office in Quebec and the other provinces, all in order “to identify and reduce public health risk factors”, as the preamble states.
I cannot stress enough that the fiscal imbalance is the cause of the biggest public health risk factor in Quebec: overcrowded emergency rooms. The proliferation of resistant nosocomial bacteria such as C. difficile in some hospitals is one of the biggest threats to public health in Quebec.
To address these problems, the Government of Quebec does not need a new federal agency in Quebec, it needs money. The problem is that the provinces and Quebec have the health and social services needs, but Ottawa has the money. The government should stop creating new structures. Quebec and the provinces are cooperating already. Quebec coordinates with the other provinces on public health. I do not think that creating a new agency will make things any better.
We have the federal government to thank for Quebec's underfunded health services. By its actions, the current federal government is doing everything it can to take up where the previous government left off. Emergency rooms will not become less crowded overnight. In my opinion, in addition to recycling a Liberal bill, the Conservative government is clearly also recycling the arrogance of the previous government, which tried only to penetrate further into areas of Quebec and provincial jurisdiction.
I would like to clarify another point. The preamble to Bill C-5 states that “the Government of Canada wishes to promote cooperation and consultation in the field of public health with provincial and territorial governments”. In his speech yesterday, the Parliamentary Secretary to the Minister of Health added that his government plans to strengthen its collaboration with municipal governments. While he was on the topic, why did he not tell us right away that the next step—under the guise of cooperation and consultation— would be direct interference in the administration of health facilities? Let us not forget that history repeats itself.
Let us talk about health services for aboriginals, which fall under federal jurisdiction. Services provided to first nations communities cannot be considered adequate, to say the least. This government should tread carefully; look where meddling in other people's affairs got the previous government.
The Bloc Québécois is committed to supporting the other parties in this House on issues that are in Quebec's interest. The government again plans to duplicate services and create a new structure whose only purpose in Quebec would be to spend public moneys for no good reason. We cannot support that.
That reminds me of the two anti-tobacco campaigns aired recently in Quebec.
In Quebec a campaign was launched to help people wanting to quit smoking by giving them the tools and a service to help them in this endeavour. While this was going on, the federal government flooded the Quebec media with ads giving a different message with a different telephone number and different contact information on the same issue. What wonderful collaboration and use of public funds.
In closing, I want to make one last point on the issue of direct communication with the public. In Bill C-5 respecting the establishment of the Public Health Agency of Canada, it stipulates that the chief public health officer “may communicate with the public, voluntary organizations in the public health field or the private sector for the purpose of providing information, or seeking their views, about public health issues”.
It is quite clear that with its independent administration and its offices spread out here and there, this agency will end up justifying its presence by regularly implementing communication plans for all Canadians, including those in Quebec. It seems clear to me that this type of duplication is counter-productive. It is not what citizens and taxpayers want. In any case, it is not the wish of the people of Beauharnois—Salaberry, whom I represent in this House.
I would like to draw your attention to a more specific aspect. I read and listened to various speeches by colleagues in this House. There was a great deal of discussion about health prevention in terms of epidemics and pandemics. However, I noticed that there was less discussion about health promotion. An expert in this area knows that it is important for local communities to identify their problems and to find solutions that will work in their areas.
Take obesity, for example. In my area, we decided to fight child obesity by approaching cafeterias in secondary schools, convincing them to offer more nutritious foods, and thus help youth develop better eating habits. We did not talk to youth about diet or try to make them feel guilty. In terms of promotion, we know that individuals are not always solely responsible for their health given that their environment and everything around them also have an impact.
In Quebec, we have made choices. There are campaigns to prevent obesity, to reduce the number of low birth weight babies, and others. We have our own way of communicating with our communities and, what is important, we have a decentralized approach. Each community can promote and work on improving the health of Quebeckers. This is done at the local level. Naturally, everyone does not just do what they want, leading to chaos. We are bound and guided by broad directives issued by the Institut national de santé publique du Québec. It provides instructions and directives to each of the 16 regional branches in Quebec.
This is my first speech in the House and I would like to conclude by stating that I hope to discuss my concerns with the parliamentary secretary. Above all, I would like to impress on him that we believe that the public health agency, as proposed, is not the best means to protect and promote the health of Quebeckers and Canadians.