Debates of Dec. 9th, 2015

Supplementary Estimates (B), 2015-16

[Lisa Raitt, Conservative, Milton, ON]

Madam Chair, I would like to remind the hon. minister that there was a budget commitment made by his government to balance the budget in its final year. In doing so, it is my understanding from the mandate letter of the President of the Treasury Board that he needs to conduct a cost-savings analysis within the government and find $6.5 billion in savings. I would like to know whether the minister plans on asking the President of the Treasury Board to red circle his department to ensure that no cost cutting will take place within his department during this cost-cutting endeavour.

[John McCallum, Liberal, Markham—Thornhill, ON]

Madam Chair, I have no intention of proposing that. The costs that are proposed are clearly enunciated in the estimates. In order to achieve the savings that are mentioned, all branches of government will need to make a contribution of some kind. I have had experience in this kind of exercise myself.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Madam Chair, given the many refugees arriving here in Canada from the Syrian region with unique health needs, what are the total expected costs associated with providing health care to these over 25,000 individuals that the minister announced are arriving in 2016, and over the next four years?

[John McCallum, Liberal, Markham—Thornhill, ON]

Madam Chair, one can break that down by location. In terms of the cost overseas for immigration medical exams, doctors' exams, blood tests, X-rays, etc., it amounts to $6 million. In terms of the health services that may be needed, interim lodging will cost $5.3 million. In terms of supplementary estimates for the interim federal health program itself, that cost is $6 million.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Madam Chair, the minister did not answer my question. I am looking for what the health costs will be for those individuals and some of the things that were not included, such as mental health costs, infectious disease costs, chronic care costs.

Are those things allocated in the minister's total estimates from now for those individuals who are coming forward?

[John McCallum, Liberal, Markham—Thornhill, ON]

Madam Chair, I suspect I did answer the question, which was about health expenditures. I gave three, and the addition of the three is the sum of the federal health expenditures.

However, once the refugees get here, either immediately or within three months, they come under provincial care. The provincial expenditures are not included in the federal estimates.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

I also want to be clear, Madam Chair. As the minister has stated before that the provinces would be responsible for any care taking place, my understanding is that in the interim federal health program, those would be covered by the federal government. Is the minister saying the provinces now cover them, or is it the federal government, or are the costs being shared? What is the answer to that?

[John McCallum, Liberal, Markham—Thornhill, ON]

As I have made clear in various statements, Madam Chair, we are extending the interim federal health care, including the extended services. The provinces will pick up the health care once a person signs onto provincial health care, but the federal government will continue to pay for the extended services.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

What coverage is the minister providing, Madam Chair? How many weeks of extended coverage is he covering, so our provincial and municipal counterparts know how many weeks that will be?

[John McCallum, Liberal, Markham—Thornhill, ON]

Madam Chair, we provide the income support, including the extended health coverage for up to a year.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Madam Chair, what are the specific cost provisions, as I mentioned before, for those things once refugees are on Canadian soil, in terms of mental health and chronic care provisions? Who would be providing compensation to the provinces after the 12 months, or would that not be provided?

[John McCallum, Liberal, Markham—Thornhill, ON]

Madam Chair, my understanding is that that would not be provided.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Post-traumatic stress disorder is not something that we care for within 12 months, Madam Chair. Is the minister saying then, in contradiction to what he said a few moments ago here in this House, that he will not be providing that care after 12 months, even though it is a chronic disease that we expect these individuals to have suffered because they are coming from a war-torn country.

Post-traumatic stress frequently is not gone in 12 months. I do not think we can expect that. Are the provinces then taking on that burden?

[John McCallum, Liberal, Markham—Thornhill, ON]

Yes, Madam Chair.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

With respect to that, Madam Chair, health care providers, including psychiatrists, psychologists, and mental health physicians across the country, are already extended.

Where does the minister expect to find the individuals today to take care of individuals who will be arriving here in Canada as early as this month or January? Where would those individuals come from? Are they reallocated from local hospitals or from other provincial jurisdictions?

[John McCallum, Liberal, Markham—Thornhill, ON]

I am not sure I quite caught that, Madam Chair, but as to the questioning on why the provinces should bear the cost of health care, it is partly because health care is under provincial jurisdiction. We already pay for the transfers. It is also because, as I have said a number of times, this is a national project where every government and every Canadian should step up and bear his or her share of the costs.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Madam Chair, there are only so many psychiatrists and psychologists in this country. Some of them will be reallocated to take care of Syrian refugees, starting as early as this month or next month.

Which Canadians will be giving up their care to make sure that these individuals receive their care? How will we also be training additional individuals to make sure that the refugees are taken care of?

[John McCallum, Liberal, Markham—Thornhill, ON]

Madam Chair, a lot of these costs are governed by the Canada social transfer.

I think the member should share the welcoming spirit of so many Canadians towards these refugees, rather than using language that tries to pit refugee against Canadian, whether in terms of psychiatric care or social housing.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Again, Madam Chair, my question for the minister was not about cost. My question was about health care professionals. We have only so many health care professionals in this country. Where are they being reallocated from? Are they coming from local hospitals? Are they coming from the provincial jurisdictions? Where are these individuals being found to take care of Syrian refugees, which we all do agree need that care because they will be suffering from post-traumatic stress?

[John McCallum, Liberal, Markham—Thornhill, ON]

Madam Chair, I think the member overstates the situation. The 25,000 is a large number to bring in in a short time, but it is a very small number relative to 35 million Canadians, relative to 1 million refugees brought in to Germany, and relative to the 10% of the population of Jordan that consists of refugees.

If the member is pretending that this is such an enormous burden for Canada to absorb—

[The Deputy Chair, NDP, Carol Hughes]

The hon. member for Simcoe—Grey.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Madam Chair, I am not disagreeing with him at all. I think we should be welcoming refugees, and we are welcoming many into my own constituency.

However, I want to be clear. Maybe I can reformulate the question. Does the minister anticipate increased wait times for Canadians and Syrian refugees for access to mental health care services with this anticipated influx?

[John McCallum, Liberal, Markham—Thornhill, ON]

Madam Chair, I know that the member tries to dress her comments up in pretty garb, but it still appears to me that implicitly, directly, or indirectly, she is pitting Canadians against refugees by the implication that they will deprive Canadians of mental health care and housing, etc.—

[The Deputy Chair, NDP, Carol Hughes]

The hon. member for Simcoe—Grey.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Madam Chair, I want to be clear. I think all Canadians want to make sure that Syrian refugees, Iraqi refugees, and Canadians are well taken of.

My question is how will we do that? What are the costs associated with doing that? Will we be asking the provinces to train more individuals? That would be outstanding, and I think all Canadians would welcome that. Will we, as a federal government, be training more individuals and paying for that training?

What exactly is the plan to make sure that the care of both Canadians and our new Syrian refugee colleagues who are coming here is provided for? What is the plan? What are the costs? Where are health community resources being reallocated for the immediate need and in anticipation of the long-term need?