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.
I would like to start by mentioning that I am a social worker by trade. I have worked in the Quebec health and social services network for 20 years or so. During that time, I worked in a residential and long term care centre for seniors. In this kind of facility, the risk of contagion and epidemics is significant, the clientele being extremely vulnerable. All that to say that, professionally speaking, I am very sensitive to the public health issue.
I witnessed firsthand how competently and expertly the public health authority in my region can handle epidemics, particularly a flue epidemic. I realized that Quebec had an aggressive and efficient response strategy that meets the needs of Quebeckers.
Bill C-5, which is now back in the House, is essentially designed to solidify the agency as an independent administrative entity that is an integral part of the Canadian health network, by giving it a number of powers and appointing a chief public health officer.
In fact, Bill C-5, an act respecting the establishment of the Public Health Agency of Canada and amending certain acts, has put Bill C-75, introduced in November 2005 just before the 38th Parliament was dissolved, back on the legislative agenda. As I have said previously, by making this Liberal bill its own, the Conservative government is also adopting the Liberal vision of Canada: Ottawa knows best and will impose its views from coast to coast.
I think it is important to understand that, contrary to what it has said since it was elected, the Conservative government wants to make inroads into health, one of Quebec's areas of jurisdiction.
Is the government aware that Quebec has had its own Institut national de santé publique for eight years now, since 1998? It appears not, because if the government was aware, it would have inserted a provision in the bill at the outset to recognize the reality in Quebec and to recognize that the proposed Public Health Agency of Canada will duplicate services and cause confusion in Quebec.
To illustrate this, I invite all members to visit the Internet site of the Institut national de santé publique du Québec at www.inspq.qc.ca. I will provide some information that will help the members understand just how much confusion the establishment of this agency will create. The site says:
The vision of the Institut national de santé publique du Québec is to be the centre of expertise and reference centre for public health in Quebec. Its goal is to advance knowledge and propose intersectoral actions and strategies to improve Quebeckers' health and welfare.
In fact, when the Institut national de santé publique was created in 1998, the coordination of public health expertise in Quebec underwent a major reorganization. Achieving the institute's mission involves pooling and sharing expertise, developing research, disseminating and using knowledge and engaging in international cooperation.
In addition, in the field, the institute works to attain its objectives through various activities and specific services: advice and specialized assistance, research or development of new knowledge, training, information, specialized laboratories, international cooperation and knowledge exchange.
All Institut national de santé publique du Québec activities are part of a broad concept of public health, and aim for the highest possible quality standards.
To achieve the highest possible quality standards, the agency participates in three World Health Organization collaborating centres, including the Quebec WHO collaborating centre on the development of healthy cities and towns, the Quebec WHO collaborating centre for safety promotion and injury prevention and, finally, the WHO collaborating centre on environmental and occupational health impact assessment and surveillance.
By definition, a WHO collaborating centre must “—participate in the strengthening of country resources, in terms of information, services, research and training, in support of national health development”.
The preamble to Bill C-5 mentions that this proposed Canadian agency also plans to encourage cooperation in this area with foreign governments and international organizations, as well as with other interested organizations and individuals. Clearly, these functions will duplicate what is already happening in Quebec.
I understand that the government wishes to ignore this reality, but members of the Bloc Québécois were elected to talk about Quebec's reality, needs and distinct character here in the House of Commons. Do not be fooled into thinking that we are the only ones defending the interests of Quebeckers.
On May 11 during question period at the Quebec National Assembly, Jean-Pierre Charbonneau, member for Borduas and opposition critic for health, asked the health minister, Philippe Couillard, the following question, “Does the minister acknowledge that there is evidence of overlapping jurisdictions and that what the federal government is proposing is more than an exchange of information; that it is taking the place of the government that has the responsibility of applying Quebec's public health act and health and social services act? Does he acknowledge the overlap in responsibilities? Does he acknowledge that this is unacceptable? Will he tell us today that the Government of Quebec will strongly and completely oppose interference in jurisdictions that are strictly Quebec's in the area of health?”
Do you know what the health minister, Mr. Couillard, said? He said, and I quote:
He said, “Of course”, and he continued:
The proof is that we used legal recourse on the issue of the Assisted Human Reproduction Act and we are opting out—
Now listen to this.
—of every national Canadian strategy that will be introduced, for instance on cancer, mental health and health promotion. We will see what the final wording of the bill will be, if and when it is passed by the House of Commons.
This proves it is not just the Bloc Québécois that opposes such a bill; the Government of Quebec's health minister opposes it as well.
I suggest that, instead of creating new sources of conflict and overlaps in public spending, that money be paid directly to Quebec so that it can provide the health services the public has every right to expect.
Let us come back specifically to Bill C-5. In the preamble of the bill it says, “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”.
Does the current agency not already assume, for the most part, this role the government wants to give it in this bill?
I also understand that the agency already fostered consultation and cooperation with the provincial and territorial governments and that it already encouraged cooperation with foreign governments and international organizations, that it is headed up by a doctor and that it seems to have a large team of officials at its service as well as a hefty budget.
Why do we need to invent a new structure for Canada?
I seriously wonder if we really need Bill C-5, which has several elements that I find worrisome.
I am wondering whether the consolidation of this agency is really necessary and whether it is in the best interest of taxpayers—an expression so dear to our Conservative government—to finance this administrative structure as a separate entity within the existing health care network.
I truly believe that this bill came about in direct response to the SARS crisis in the Toronto area in 2003.
In my view, the government thinks that this intrusion in health care, an area of jurisdiction belonging to Quebec and the provinces, is justified largely because of the serious and unfortunate experience with SARS in 2003.
We agree with the parliamentary secretary regarding the important debate on the state of public health in Canada triggered by the SARS crisis. Nevertheless, I would point out that, at the time, the various players in the Quebec health care system agreed that, if the crisis had happened in Quebec, it would not have been as serious as it was in Ontario. In fact, Quebec was ready. The well-established and well-structured Institut national de santé publique du Québec was there precisely to respond to that kind of event.
Quebec has an action plan ready to be carried out in the event of an emergency situation within its borders and it has well-established, responsible human resources.
Furthermore, Quebec has developed a public health culture and public health practices that are often cited as examples all over the world. Furthermore, the Institut national de santé publique du Québec was consulted for its expertise by members of the working committee from Ontario responsible for making recommendations regarding the creation of a health promotion and protection agency in Ontario. Their report was tabled in March 2006 and the agency should be created by 2007.
The SARS crisis in Toronto, in a sense, prompted the creation of that agency in Ontario. At first glance, the agency would seem to play the same role as the Institut national de santé publique du Québec.
In short, because in its area of jurisdiction Quebec has put in place what is required to respond to this type of crisis, because Quebec is rigorous and has developed remarkable expertise in its role as protector of public health, in addition to collaborating with the various players in this area, the Bloc Québécois does not feel it is necessary to give this status to the Public Health Agency of Canada, as provided for in Bill C-5.
I really do not see how the new status and the new powers of the Public Health Agency of Canada, which will have an office in Quebec, will help to better deal with a future influenza pandemic, for example. Each province must put in place its own public health structure, one that is well co-ordinated and well run.
I do not believe it necessary to squander large amounts of money on a heavier bureaucracy in order to establish and conduct coordination of provincial activities in the area of health promotion and prevention. I do not see how this agency per se will make it possible to react more quickly.
The parliamentary secretary to the health minister stated in May, and I quote:
—everyone in Canada can benefit by working together...if there were, heaven forbid, a pandemic influenza we would need to have a coordinated effort throughout Canada to deal with the issue.
He added that “we would need a coordinated effort throughout the world”.
The parliamentary secretary to the health minister leads us to believe that, at present, the provinces, territories and the WHO are not working together, and that Bill C-5 would solve this problem.
I would not want the parliamentary secretary to think that I am against collaborating and cooperating, or that I have anything against concerted efforts. I want him to know that what I am against is duplicating structures, creating another bureaucracy, unnecessary spending, duplication, and intrusion by the federal government in Quebec's areas of responsibility.
I am for better health protection for Quebeckers and Canadians while ensuring both efficiency and effectiveness. The most appropriate actors for this remain the experts designated by the provinces.
In Quebec, the public health action plans are coordinated by the director of the Institut national de santé publique, who is responsible for cooperating with his counterparts in the other provinces, federal officials and the WHO in the event of an epidemic or pandemic.
The problem is that people's needs in terms of health and social services are experienced in Quebec and the provinces, while the money is in Ottawa.
Take for example Quebec's ongoing planning activities in the area of health promotion.
In Quebec, every provincial, regional and local expert agrees that the top health promotion priority is addressing the problems of our overweight and obese youth. Allow me to quote the following:
The scope of this public health problem has prompted the Government of Quebec to identify obesity prevention as a government priority...The institute's work also contributes to the development of preventive interventions based primarily on changes to political, economic, socio-cultural, agricultural and food, and built environments that will make it easier to adopt healthy weight management behaviours while taking care not to intensify the excessive preoccupation with weight.
That is a rather concrete example showing that, in Quebec, we have identified among our health promotion priorities the issue of excess weight in our young people. The response methods selected and used are suited to the culture and values of Quebeckers.
If we visit the website of the Canadian agency, we can see that it too has national strategies dealing with weight and excess weight.
Thus, a Quebecker doing Internet research would come across a Canadian strategy and a Quebec strategy to battle excessive body weight. Personally, as a taxpayer and a citizen, I see this as a waste of public funds. Running a health promotion campaign involves all sorts of activities: brochures, flyers, radio and television ads. The federal government is spending money, and so is the Quebec government. This is a clear, blatant example that shows taxpayers that spending is being duplicated.
I have one more example. Even though I only have a minute left, I would like to take the time to provide one last example, which is about the fight against cancer.
These days, cancer is a very serious, increasingly common illness that affects many Quebeckers and Canadians. Quebec has its own strategy for fighting cancer. On the federal level, Canada has created its own national strategy. As a Quebecker, I find myself up against the same situation as in the other example I just gave. We are presented with two strategies, complete with different kinds of promotional and educational materials. This is another blatant example of unacceptable duplication of spending.
In conclusion, the Bloc Québécois is committed to supporting the other parties in this House when it is in the best interest of Quebec. However, we cannot support a project in which the government seeks to duplicate services and create new bureaucratic structures.