House of Commons Hansard #94 of the 43rd Parliament, 2nd Session. (The original version is on Parliament's site.) The word of the day was misconduct.

Topics

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

Conservative

Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON

Madam Speaker, near the beginning of her speech, the member mentioned that she has listened to the stories of victims who have come forth to her. What does she need to see and what needs to happen before she can recommend to a young woman, a daughter perhaps, that she enrol in the Canadian Armed Forces? What does she need to know has changed for her to recommend a woman to the Canadian military, with a clear conscience?

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

Bloc

Andréanne Larouche Bloc Shefford, QC

Madam Speaker, I thank my colleague for her question.

There are so many changes that need to be made. I spoke about the importance of restoring the confidence of young women who want to enlist in the Canadian Armed Forces. Obviously, what is happening right now with the cases of assault and everything that is being reported in the media is not encouraging these young women to enlist. Their confidence needs to be restored. They need to know that they will have access to an independent body and that their cases will be examined.

I also spoke about supporting survivors and how there is not enough recognition of the post-traumatic stress syndrome experienced by assault victims. It is important to implement the recommendations set out in the Deschamps report because it will restore young women's confidence.

Beyond that, another person testified that there were no rape kits on board a military ship. Obviously, those kits should be provided so that women know that they have a way to report an assault.

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

NDP

Brian Masse NDP Windsor West, ON

Madam Speaker, the government is not following through with some of its promises. How deflating is that for real change? If we use symbolism but do not act with specific measures and have consequences, what does that do for other people?

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

Bloc

Andréanne Larouche Bloc Shefford, QC

Madam Speaker, the interpretation is not working.

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

There is a problem with the interpretation.

Is interpretation working now?

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

Bloc

Andréanne Larouche Bloc Shefford, QC

Madam Speaker, I can hear the interpretation now.

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

I would like the hon. member to ask the question again.

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

NDP

Brian Masse NDP Windsor West, ON

Madam Speaker, if we have no significant consequences and just the symbolism the Prime Minister has shown, how deflating is that for real change and for the people affected and traumatized by what has taken place?

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

Bloc

Andréanne Larouche Bloc Shefford, QC

Madam Speaker, the member is right. We have to move away from symbolism and implement concrete measures to hold people accountable for their actions.

If the government is truly feminist, it must condemn these actions. People who commit sexual assault must actually get the punishment they deserve. They have to suffer the consequences of their actions, not in a symbolic way, but in a tangible way.

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:40 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

It being 5:44, it is my duty to interrupt the proceedings and put forthwith every question necessary to dispose of the business of supply.

The question is on the motion.

If a member of a recognized party present in the House wishes to request a recorded division or that the motion be adopted on division, I would invite them to rise and indicate it to the Chair.

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:45 p.m.

Conservative

Cheryl Gallant Conservative Renfrew—Nipissing—Pembroke, ON

Madam Speaker, we ask for a recorded division.

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:45 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

Pursuant to order made Monday, January 25, the recorded division stands deferred until Wednesday, May 15, at the expiry of the time provided for oral questions.

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:45 p.m.

Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Madam Speaker, I believe, if you seek it, you will find unanimous consent to see the clock at 5:59 in order to start Private Members' Business.

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:45 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

Is it agreed?

Opposition Motion—Allegations of Sexual Misconduct in the MilitaryBusiness of SupplyGovernment Orders

5:45 p.m.

Some hon. members

Agreed.

Federal Dental Care PlanPrivate Members' Business

5:45 p.m.

NDP

Jack Harris NDP St. John's East, NL

moved:

That, in the opinion of the House, the government should establish a federal dental care plan as soon as possible for Canadian families earning less than $90,000 per year who are not covered by a dental care plan, as an interim measure toward the inclusion of full dental care in Canada’s healthcare system.

Madam Speaker, I am very pleased to rise today in this virtual House to begin debate on this extremely important motion, which would establish a federal dental care plan for all Canadian families that earn less than $90,000 a year in family income and do not currently have a dental care plan. This would be an interim measure toward the inclusion of full dental care in Canada's health care system.

I think it is well known that Canadians are very proud of their health care system. Our national universal publicly funded medicare system is a point of national pride. It is a defining element of our society. When we ask people in public opinion polls, they treat it as a national treasure. Indeed, it is a national treasure. It provides equal care. Regardless of social status, income or where in the country people live, they are entitled to care by our health care system without using their credit card to use their health care card.

We have a significant gap in that system because oral health is one of the most unequal aspects of health care in Canada, as most dental care is not covered by any public insurance plan. In fact, those with the highest levels of oral health problems are also those who have the greatest difficulty accessing oral health care due to cost.

About 35% of Canadians have no dental care plan at all, and more than 20% of Canadians avoid going to the dentist because of the cost. It puts them in a situation where other aspects of their health becomes affected. Left untreated, poor dental hygiene is linked to many other serious conditions, such as cardiovascular disease, dementia, respiratory infections, diabetes complications, renal disease, premature births and low birth weights. There are a whole series of diseases that are affected by a lack of proper dental care.

The evidence is very clear that dental care and oral health care are part of health care. They ought to be considered not as an add-on to a system but as a part of that system. The situation in the last year and a half due to the pandemic has become even more urgent. We have seen millions of Canadians lose jobs over the last year, and with them they have lost their health care benefits, including dental care. There are, of course, many people who never had any health care or dental care to begin with.

Of our young people, 30% have no access to dental care. These are young adults who are no longer covered by their family plan or who never had a plan in the first place. We are seeing emergency rooms across the country feel the full weight of COVID-19, yet every nine minutes, someone visits an emergency room in Ontario for dental care when who that person really needs to see is a dentist.

Also, a recent study at McGill University showed that those with poor oral hygiene are far more likely to experience more severe systems of COVID-19. Shockingly, patients with gum disease are more than three and a half times more likely to be admitted to intensive care, four and a half times more likely to require a ventilator and, sadly, almost nine times more likely to die from COVID-19 compared to those without oral health and gum disease issues.

The plan we wish to put in place is extremely important because a large number of Canadians would benefit from it. The estimates are that almost seven million people in Canada, who are currently not covered by a dental plan and cannot afford to pay the cost, would be covered. That would include more than half of Canadians who have low incomes, more than half of seniors who are age 60 years and older and 30% of young adults. More than a quarter of the women in our country would benefit from this plan because of the income test.

Children with poor oral health are almost three times more likely to miss school due to dental pain than those with good oral health. Some of the stories I heard, the feedback I received from people when we first started talking about this as New Democrats in our election campaign in 2019, are heartbreaking. The feedback I received is astonishing.

Robin from St. John's East said, “I needed a root canal, which would have cost $1,500. Since I didn't have dental coverage, I was unable to have this procedure done, which resulted in having the tooth extracted. This has had dire consequences on my mental health. As someone who works with vulnerable populations, I see the pain both physically and mentally they endure because they cannot afford dental care. The government often talks about the importance of mental health, and access to oral health is a major part of this.”

Charmaine says, “This is so late in coming, but better late than never. We absolutely do need dental coverage here in Canada. So many people are suffering with pain, humiliation, low self-esteem, depression and poverty. There aren't too many employment options for a person with 'dental illness'.”

Jen is a chronically underemployed disabled single mother who says, “I've been forced to choose my child's dental care over my own on many occasions. I've been forced to borrow money and to pay for costly emergency extractions and X-rays. Basic dental procedures should be covered by the government, especially for children. No one should have to suffer dental pain due to poverty in this country. ”

There were many comments like these heard since the beginning of the discussions about this particular program, a program that is absolutely essential to people's health.

There is an economic cost too for the lack of dental care. According to the Canadian Dental Association, poor dental health and oral diseases not only cause pain and long-term health concerns for individuals but account for over $1 billion in lost productivity in Canada per year. Almost 40% of Canadians have been taken away from normal activities because of dental complaints. There are 2.3 million school days and 4.2 million work days lost annually due to dental visits or sick days for dental problems. There are also expenses for emergency room visits for people coming in with dental pain when they really need a dentist.

When we talk about dental care being part of health care, many people ask why it is not already covered under the dental care system. There is an astonishing answer to that a lot of people perhaps are not aware of. In 1964, the Royal Commission on Health Services formed the original framework for Canada's public health care system.

In its final report, the commission called for the inclusion of dental services as part of a health care plan, but it noted the shortage of dentists was so acute at the time that it would be impossible to implement a universal system. However, it did suggest at the time it was imperative to establish a public dental care system for children, expectant mothers and public assistance recipients, which could be scaled up as resources expanded. At the time, this was called one of the highest priorities among all its proposals, in addition to regular health care, but unfortunately it was never established.

Today the situation is quite different. We have plenty of dentists, we have orthodontists and other providers in the dental and oral care system, but we still do not have universal dental care. In Canada, 94% of spending on dental care is private and only 6% comes from government programs. This is the second-lowest level of government spending on dental care among OECD countries, ranking even worse than the United States.

We are proposing a program that would provide dental care without premiums for families with family income of $70,000 or less. For those with incomes from $70,000 to $90,000 per year, there would be a sliding co-pay system.

This proposal would be administered by the federal government or by the provinces and territories upon agreement, and the minimum basket of services would comprise annual diagnostic services, including examinations and radiographs; preventive services, which are very important, including scaling, polishing and fluorides; restorations, including fillings and crowns; endodontic services, including root canal treatments; and various other services that would be required, including oral services and extractions; orthodontic services, including non-cosmetic braces; and the various other associated services that are part of this program.

It has been fully costed by the Parliamentary Budget Officer, and this has been available publicly since October 2020. It would cost about a billion and a half dollars per year. This is a lot of money, but when we look at what the government has spent on special programs in the country in the last year, it is certainly affordable. There may be some upfront costs of about $3 billion because of pent-up demand and untreated diseases that already exist that would have to be looked after, but this is a doable plan.

This is something that can be put in place now. It can be done through the support of Parliament; legislation can make it possible. It is part of what has to be done to deal with a significant lack of equality in this country regarding access to an important part of health care. It is a problem that we can fix and we must fix.

I implore all members of Parliament, each of whom has access to excellent health care and dental care benefits through the House of Commons, to vote in favour of this motion. As I said, it is a problem that we can and must fix.

I want to pay tribute to my colleague, the member for Vancouver Kingsway, who will be speaking to this motion later on today. He has put forth a similar motion in the House, but mine came first in the draw. I am glad to say that it will be a votable motion if we get to debate it at another time. I want to thank my hon. colleague for his work on this issue and for seconding my motion today.

Federal Dental Care PlanPrivate Members' Business

5:55 p.m.

Bloc

Kristina Michaud Bloc Avignon—La Mitis—Matane—Matapédia, QC

Madam Speaker, I thank my colleague. I really admire him, and I am grateful for his work.

I know not everyone is lucky enough to have good dental health or the means to pay for it.

As we all know, health care is the responsibility of the provinces and Quebec. We often talk about that in the House.

Does my colleague believe it is up to the provinces and Quebec to take action on this and ensure that all our residents can take care of their dental health?

Last I heard, the provinces and Quebec were asking the federal government to boost health transfers to 35%, which would enable them to implement this kind of program.

Federal Dental Care PlanPrivate Members' Business

6 p.m.

NDP

Jack Harris NDP St. John's East, NL

Madam Speaker, as we know, the Canada Health Act covers a lot of health care but not dental and oral care. Health care is administered inside of Quebec under the Canada Health Act, and dental care is not any different from that as a health care matter. We expect that any program of this nature would be similarly administered by a province, and that would be guaranteed along with all other aspects of health care.

I totally agree with the member, by the way, that there has to be a substantial increase in transfers for health care. We should get back to the kind of numbers and percentages we had before.

Federal Dental Care PlanPrivate Members' Business

6 p.m.

Green

Paul Manly Green Nanaimo—Ladysmith, BC

Madam Speaker, I thank the hon. member for this excellent motion. The Green Party has long supported adding a dental care program to our universal health care system. It is so important that we take care of people's teeth. Why exclude this part of a person's body from health care?

The hon. member outlined a number of savings and benefits to the economy from having a dental program like this. I wonder if he could speak about the health benefits and other implications. When people have problems with their teeth, we know it affects their health in other ways, and I wonder if the member could speak to that issue.

Federal Dental Care PlanPrivate Members' Business

6 p.m.

NDP

Jack Harris NDP St. John's East, NL

Madam Speaker, I want to thank the member for his support for this motion.

He uses the words “added on”, and I am afraid I do not like that. Yes, this is a short-term patch, but it is part of health care and really should be considered as a part of that. The member is right to talk about the health benefits. They are probably more important in many respects, because they have to do with a person's self-esteem. If people have bad teeth, they can have difficulties eating and digesting food, and that leads to other problems. If they put off getting dental treatment, it can get worse and cause other diseases, as I mentioned in my speech.

In many cases, it can disfigure people, it causes stigmatization and it has social and employment implications as well. A whole raft of problems are associated with a lack of health care for oral issues, the same as it would have been before we had medicare. People who were sick and could not afford to get treatment did not get treatment. They got worse and they did not have very productive or happy lives. The same thing applies to dental care.

Federal Dental Care PlanPrivate Members' Business

6 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Madam Speaker, as my hon. colleague knows, I moved the same motion forward.

He raised the issue of class. It is not just that there are 12 or 13 million Canadians who do not have dental insurance; it is who those people are. They are primarily indigenous people, women, single parents, young workers, low-income Canadians or seniors.

I wonder if he could spend a moment telling us about the social justice component of this health care measure.

Federal Dental Care PlanPrivate Members' Business

6 p.m.

NDP

Jack Harris NDP St. John's East, NL

Madam Speaker, it is very clear that this is part of a great divide in our country. It is very clear that a large number of people are deprived of proper health care which causes significant problems. They are defined by race, class and the lack of opportunity. Unfortunately, on top of that, it makes life more difficult for them, and it has to be fixed. There is a major social justice component, and I hope everybody sees that when it comes to a vote today.

Federal Dental Care PlanPrivate Members' Business

6:05 p.m.

Liberal

Francis Drouin Liberal Glengarry—Prescott—Russell, ON

Madam Speaker, I am pleased to rise today to participate in the discussion on dental care for Canadians.

The government remains committed to its promise to work with Parliament to study and analyze this issue. Both the 2019 Speech from the Throne and the 2019 Minister of Health's mandate letter committed to support Parliament in studying and analyzing the possibility of a national dental care program.

Across the country, many Canadians have coverage for dental care through private employee health benefit plans, while many others are supported by government programs. According to the Canadian Institute for Health Information, $15.9 billion was spent on dental services in Canada in 2018. Of this, 55% was covered through private insurance plans, 39% was paid out of pocket, and 6% was publicly funded by a variety of federal, provincial and territorial government programs.

We know that three-quarters of Canadians visit a dentist at least once a year, which is higher than the OECD average. Canadian wait times for dental care are amongst the shortest in the world. According to the results of the 2018 Canadian community health survey, over two-thirds of Canadians reported having dental insurance that covered all or part of their expenses. Approximately two out of three Canadians report having no dental needs.

Despite these figures, there is also evidence that many Canadians face cost barriers to accessing care. Approximately one-third of Canadians are uninsured, and 22% of Canadians, roughly 6.8 million people, have avoided visiting a dental professional due to costs. Those with dental insurance are more likely to have visited a dental professional, although 14% of Canadians with dental coverage have still reported avoiding dental care due to costs.

We also know that income is not the only barrier preventing Canadians from accessing dental care. By the time they are adults, 96% of Canadians have been impacted by dental decay. It is largely preventable and disproportionately impacts, and more severely impacts, our most vulnerable populations. Those in rural communities, in particular age groups, such as young adults and seniors, those with disabilities and racialized persons, including indigenous people, face unique barriers accessing dental care.

In 2017, the Auditor General of Canada found that Inuit and first nations persons have nearly twice as much dental disease as the rest of the country. Further, the Canadian Institute for Health Information has found that day surgery rates for early childhood caries, which are generally preventable and treatable, were 8.6 times higher amongst children from neighbourhoods with denser indigenous populations.

We also know that oral health is an integral element of overall health. Poor oral health and inequitable access to dental care is connected with multiple health conditions and challenges, including chronic pain, diabetes, cardiovascular disease, respiratory disease and certain forms of cancer.

The Canadian Cancer Society advises that in overall cancer incidence in Canada, oral cancer ranks ninth in men and 13th in women. The trend line is increasing. Fifty-three hundred Canadians will be diagnosed with oral cancer annually, and nearly 1,500 will die from it.

Though I have spoken to figures that indicate access issues exist, this data is limited, often quite dated and not available equally across the country. We do not have comprehensive data on unmet dental care need at a national level, nor do we have a full understanding of the needs of various subpopulations.

This is why our government has committed to support a parliamentary study on the issue. In addition, to address data gaps, the government has partnered with Statistics Canada to design an oral health component for upcoming cycles of the Canadian health measures survey, funded by the Canadian Institutes of Health Research, and in collaboration with leading researchers from all 10 of Canada's university faculties of dentistry and experts from the U.S. and the United Kingdom.

The survey is scheduled to begin next year, although findings would not be available until 2024. Once available, this work would help to update our understanding of dental needs and will provide key information for those developing oral health programs and policies for Canadians.

In addition to improving data on dental care, the federal government continues to provide coverage for dental care services for certain groups of people.

Through the non-insured health benefits program delivered by Indigenous Services Canada, the government provided dental coverage for recognized first nations and Inuit. In the period between 2016 and 2018, over 420,000 clients received dental services through the non-insured health benefits program. In addition to this, the children's oral health initiative provides dental coverage for many first nations children under the age of seven.

The government also offers dental coverage through the employment benefits for federal employees, federal retirees, Canadian Armed Forces members and veterans, and RCMP members and veterans. In addition, it provides limited dental coverage for federal inmates and for some newcomers through the interim federal health program.

Alongside these government programs, all provinces and territories fund and manage their own dental care services. As part of their medicare programs, this covers medically necessary surgical dental services performed by a dentist in a hospital, when a hospital is required for the proper performance of the procedure.

All provinces and territories also provide additional dental coverage at their own discretion, though these programs vary greatly between jurisdictions and are often limited to select groups such as children in low-income households, people receiving social assistance benefits, people with certain disabilities and senior citizens. The specific eligibility requirements, the type of service included and the financial coverage levels vary greatly depending on the province or territory. At the same time, stakeholders have raised concerns about the rising dental costs coupled with stagnant financial limits for the public dental coverage programs, creating a barrier by asking dentists to absorb costs or turn patients away.

Provincial and territorial health care programs, including those with dental coverage, are supported by federal funding through the Canada health transfer, or CHT. The CHT is a key federal funding mechanism for supporting Canada's health care system, providing long-term, predictable funding to provinces and territories. Provinces and territories are free to decide how to allocate those funds in order to best address their individual health care priorities, including dental care and related services. The CHT is providing $40.1 billion to the provinces and territories this fiscal year. This will continue to increase each year, in line with the growth rate of the economy, with a minimum increase of 3% per year. Over the next five years, this funding to provinces and territories is expected to exceed $234 billion.

To support the improvement of the oral health of Canadians and fulfill our international responsibility, the government works with partners and stakeholders nationally and globally, including organizations in the professional, regulatory and educational domains, such as the Canadian Dental Association and the Canadian Dental Regulatory Authorities Federation. We also collaborate with international health and dental organizations such as the World Health Organization, the FDI World Dental Federation and oral health authorities around the world.

These initiatives demonstrate that our government is playing a constructive role to support access to dental care for Canadians. We look forward to the outcome of the parliamentary work on this issue.

Federal Dental Care PlanPrivate Members' Business

6:10 p.m.

Conservative

Michelle Rempel Conservative Calgary Nose Hill, AB

Madam Speaker, it is a pleasure to speak to this motion. I also acknowledge the contributions of my colleague from Vancouver Kingsway on this issue. I serve admirably with him on the health committee.

As I have said before in debate on similar issues, income and ability to pay should not stop people from having access to needed treatments and care. This is a principle that every Canadian supports. It is something that sets our country apart from others as well, that whole principle of Canadians having reasonable access to the health care they need and deserve. The question becomes how do we deliver that?

We can all agree on the principle and the question then becomes how. This motion suggests one way, and I do have a few questions for my colleagues who are proposing it. I would need a bit more information before I would go to nationalizing dental care as the best way to achieve this outcome. My understanding is that the motion proposes to establish a nationalized dental care plan for individuals who are uninsured and with a household income of less than $90,000 per year.

While this is laudable, I am not sure the motion recognizes there are already a number of government-funded dental care programs that are specifically catered to help vulnerable groups, such as these persons, gain access to dental care. With regard to what is being proposed, I am wondering what gaps are being discussed and why this is necessary if programs like this already exist.

On the flip side of that, the motion and how it reads to me does not clarify how Canadians who already have a dental care plan through their employment, union, insurance or provincial government would be affected. I have raised this concern in a similar motion around a nationalized pharmacare system. For the purposes of this evening, let us talk about dental care coverage.

In my research, in 2018, according to Statistics Canada, approximately 65% of Canadians had access to dental insurance to cover all or part of their expenses. Then existing provincial programs filled in the gaps. The motion does not say how adequate that coverage is and where the gaps are with respect to what is needed to cover those gaps as well as what the additional cost would be to the provinces.

For example, Ontario has a government-funded dental care program that provides free routine dental services to low-income seniors who are age 65 and older, and for children and youth age 17 and under. In Alberta, Albertans can apply at an Alberta Health Services dental clinic for reduced fee dental care for families in financial need. In British Columbia, individuals who receive income or disability assistance are eligible to have basic dental cost coverage. Nova Scotia has the Nova Scotia children's oral health program that covers basic dental care services for children from birth until they are 15, and so on across the country.

At this point, it is incumbent upon me to bring up the element of jurisdiction as is always discussed in the issue of health care and health care programming. As I have just outlined, existing provincially funded dental care programs do exist across the country. I am wondering if a better course of action would be to get the federal government to enter into negotiations with provinces to mandate means-tested dental coverage for seniors and low-income residents who cannot access private dental care plans via their employer or through other means. Is that a better step one? I will try and provide some rationale for that.

To support this argument, the Canadian Dental Association has stated that while it advocates for improving access to oral health care, it believes the best way to achieve this is by improving the funding of existing public programs. I am wondering if creating another bureaucracy or nationalized program would be the best way to target Canadians who are most in need. Perhaps, the best way to understand those gaps and then address them is to enter into negotiations with the provinces in the manner I suggested above.

Health care delivery does have a large jurisdictional responsibility within the provinces, and while I believe federal and provincial governments should work together to address issues like this, we also need to ensure that the potential solution respects jurisdictions and unique regional challenges, which are a part of our confederation.

The other thing I am a little concerned about with the motion is on the cost. Now, I understand that the PBO has done some preliminary analysis, but when I read the 2019 cost estimate of election campaign proposals by the PBO, I saw there is a moderate level of uncertainty with cost estimates. This is due to assumptions about population growth, disease prevalence, utilization rate, inflation and the possibility that the new nationalized plan might cause existing public and private insurers to reduce or even cancel their coverage.

This is something that I think we have a responsibility to discuss, and it is the same principle as pharmacare. What would be the cost or potential risk of using a nationalized program? Would it displace coverage that Canadians already have through private means? I am not clear, from what is in the motion, if safeguards would be built in to prevent that from happening, or if the member is suggesting a full nationalization of the system and this is the first step towards that.

I raised this issue in the context of pharmacare with an example that I think many Canadians who live in Ontario would know. When Ontario tried to nationalize health care with OHIP+ under the Ontario Liberals, OHIP+ created coverage for 1.2 million Ontarians who did not have it before, but transferred 2.1 million Ontarians who already had private plans to a public plan that did not have the same level of coverage. I am concerned that, without having some prescriptive boundaries around ensuring that displacement of coverage does not happen, jumping to a nationalized model is perhaps not step number one, especially when that is coupled with the issue of jurisdiction.

There are a couple other things that I want to raise as well. Throughout the course of my parliamentary career, I have had many constituents who come in, new Canadians, who were concerned about the issue of credentialling, and one area of credentialling that I hear about over and over particularly is for the dental profession in Canada.

As I am sure everyone who is listening tonight is aware, it is very difficult to have dental credentials recognized in Canada. Of course, we respect professional associations, but I am wondering if we actually have an adequate number of dentists in Canada. Perhaps that is a reason why costs are being driven up. Is it supply and demand issue, and if we had more supply, would this still be an issue?

Listening to the speech from my colleague from the Liberal Party, he talked a lot about access to care in Canada. I am wondering if perhaps there was a bit more information on where the gaps are here, so we might have a better solution moving forward.

I am a Conservative. I think it is my obligation to provide a viewpoint in the House that suggests that maybe we do not always need to leap to more bureaucracy and government in every instance, but I do agree that the goal of providing access to care for dental services for those who are lower income or who might not have coverage is a laudable one.

However, I think that perhaps the better first step, as opposed to just moving towards a new bureaucracy, would be to work collaboratively with the provinces, respecting jurisdiction and looking at a means-tested solution, such as the one I provided, while simultaneously ensuring that there are safeguards in place for those who do have adequate coverage.

Federal Dental Care PlanPrivate Members' Business

6:20 p.m.

Bloc

Stéphane Bergeron Bloc Montarville, QC

Madam Speaker, you might say that no one can be against virtue and apple pie, and you are right, because everyone would love to have a universal dental care plan to rely, and it would be a good idea for the government to look into it.

The problem is that our NDP friends are thinking of either the wrong legislature or the wrong country. Like it or not, the Canadian Constitution is quite clear. Sections 91 and 92 of the Constitution Act, 1867, make it crystal clear that health is an exclusive jurisdiction of the provinces and Quebec. It has nothing to do with the federal government.

As far as health is concerned, the federal government is responsible for the health of indigenous peoples. Incidentally, and we talk about this often in the House, the federal government is absolutely incapable of providing indigenous communities with basic services. It cannot even provide a decent supply of clean drinking water. This is happening in the 21st century in a G7 country, yet my colleagues are claiming that the federal government has what it takes to interfere in an exclusive jurisdiction of Quebec and the provinces, namely health.

The federal government is responsible for military hospitals, the approval of drugs and quarantine, as we have seen in this pandemic. That is it.

In 2019, I was elected as the member for Montarville, but in a past life, I sat in the House from 1993 to 2005. During that time, I was always surprised to see our NDP friends constantly proposing things that interfered in the jurisdictions of Quebec and the provinces. They may not believe it, but they will never get the Bloc's support on these issues because we have the utmost respect for the jurisdictions of Quebec and the provinces. We are against federal encroachment on these jurisdictions.

Our friends in the NDP should at least go through the motions of acknowledging that their motions deal with a jurisdiction that belongs to Quebec and the provinces. They should at least acknowledge in their motions that certain provinces already have pharmacare and dental care initiatives.

For example, my colleague from St. John's East, who moved this motion, should know that Newfoundland provides dental coverage. However, my colleague, for whom I have a lot of respect, does not acknowledge this fact, and it breaks my heart to have to tell the House that I cannot support his initiative.

As long as the New Democrats keep coming up with one motion or bill after another that would have the federal government interfere in a jurisdiction that belongs to Quebec and the provinces, we will be forced to tell them that it will not work. We will never be able to support this kind of initiative. They need to at least try to acknowledge in their centralizing statements that this is not a federal jurisdiction and that the provinces already have such initiatives.

For example, Quebec has had its own dental care program since 1974. Children are covered in Quebec, and social assistance recipients have been covered since 1979. There are other programs, such as the one in Newfoundland.

If only our colleagues in the NDP would offer even the slightest acknowledgement that they are making a mistake by proposing health care initiatives and that they are infringing on provincial jurisdictions. Perhaps my colleagues in the NDP, and my colleague from St. John's East in particular, are simply in the wrong legislature. Perhaps my colleague from St. John's East should be in the House of Assembly in St. John's. Perhaps our colleagues in the NDP should be serving in their own respective provincial legislatures, not in the House of Commons, if they want to interfere in jurisdictions that belong to Quebec and the provinces.

Perhaps they are simply not in the right country. The Constitution clearly states that health, among other things, is not a federal jurisdiction. They are either in the wrong legislature, or in the wrong country, or both. They will have to fix that little problem.

Dental care for children has been covered in Quebec for 40 years. Debates about whether to extend or restrict dental coverage and eye care have been held in Quebec. These are healthy debates, and they take place where they are supposed to, in the National Assembly of Quebec or in provincial legislatures. It is not up to the federal government, let alone the NDP, to tell the provinces what they should do in their own jurisdictions. That is what Jean Chrétien's government did, and he did not even try to hide it. He clearly stated that the federal government would set the standards and that the provincial governments would have no choice but to implement them. The federal government wants to turn the provinces into mere service providers for the public. It wants every decision to be made in Ottawa. Too bad, but that is not how Canada's Constitution was designed.

Essentially, the problem is that not only has the federal government continually violated the Constitution, but it has broken its promise. When a health care plan was first agreed upon from coast to coast to coast, the federal government was supposed to pay for 50% of it. Now we are down to about 23%. Quebec and the provinces are covering the difference. It is no wonder that Quebec and the provinces are not in a position to offer dental coverage.

I am addressing my NDP colleagues and my colleagues from other political parties. If the federal government were to respect the consensus of Quebec and the provinces and increase health transfers, Quebec and the provinces might have the flexibility to expand their basket of services to include dental care. The federal government is stubbornly refusing to invest in health care. That is the bottom line. We are told that because we are in a pandemic, this is not the time to discuss health transfers. Somehow, now is the time to discuss a national child care plan, elder care and camping, but it is not the time to discuss health transfers when we are in the middle of a pandemic. There could not be a better time to discuss health transfers.

However, the deficit announced in the budget is around $354 billion for fiscal year 2020-21. Curiously enough, that is $28 billion less than the amount announced in November's economic statement. How can there be a $28-billion difference when we know that that figure is virtually identical, almost to the penny, to the amount that the provinces and Quebec have been calling for to top up the federal health transfers?

It is almost as if the federal government is giving itself leverage to pressure Quebec and the provinces, so it can ram its initiatives and interference in child care, senior care and whatever else it likes down their throats. The Liberals and the NDP are always in favour of encroaching on areas under the jurisdiction of the provinces and Quebec, but that is not how things should work.

I will therefore respectfully state that the priority is not to create new federal initiatives or new encroachments. The priority is to transfer more money to the provinces. That would give health care professionals some breathing space and enable them to upgrade their equipment and infrastructure so that they can provide the public with better services, including dental care.