Debates of Feb. 16th, 2023

Opposition Motion—Public Health Care Funding and Delivery

[Mark Gerretsen, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons (Senate)]

Madam Speaker, the reality of the situation is that the NDP have not used the Prime Minister's words in a true context in this motion. I do not think anybody in this House would disagree with the idea that we should be innovative when it comes to our health care system. It is the NDP who have taken the leap to assume that the word “innovative” meant privatizing health care.

According to the member's speech, the Prime Minister said it was a good thing to do. The Prime Minister never said this in terms of privatizing health care and going down the road that has been suggested by the provincial government in Ontario. The member said that other members should vote for this. How can he expect us to vote for something when he has clearly taken the words of the Prime Minister out of context in here?

[Jagmeet Singh, NDP, Burnaby South, BC]

Madam Speaker, let us look over the facts. We have some clear evidence in front of us. When the Prime Minister was asked directly about Doug Ford's plan to increase for-profit care, he called it “innovation”. He gave it the green light. Let us go even further. When Premier Doug Ford was asked about whether the issue of for-profit care was even raised, Doug Ford's response was no, that it did not come up at all in conversation.

It is clear through action and words that the Prime Minister is green-lighting for-profit care. However, it does not have to be this way. The government can choose to say that it was a mistake; it had flip-flopped but will flip-flop back the right way now to defend public health care.

Here is the chance for the members of this House to make clear where they stand. Do they defend public health care or are they for for-profit delivery of care?

[John Brassard, Conservative, Barrie—Innisfil, ON]

Madam Speaker, I recall what happened a year ago. I was opposition House leader when the coalition agreement came into effect between the NDP and the Liberals. It actually gave the NDP a lot of power. They could use this power right now if the leader of the NDP simply walked up to the third floor, to the Prime Minister's office, and said that he wanted this type of stuff to happen. Instead, he spends 10 minutes in this House railing against the Liberals, Conservatives and provincial premiers. If the leader of the NDP had any course of action at all, why does he not rip up the agreement that he has with the Liberals, force an election and let Canadians decide which health care vision is best for this country? They will decide: NDP, Conservative or Liberal.

Let us do this. The member could rip up the agreement and let Canadians decide.

[Jagmeet Singh, NDP, Burnaby South, BC]

Madam Speaker, it is very interesting that the Conservatives are talking about health care. We have not heard them say anything about health care for a number of weeks, and then their leader jumps in to say that they absolutely agree with the Liberal plan, which is not surprising because they believe in private care.

What we have done in this minority government as a fourth party is interesting. Looking at what we have delivered for Canadians, we doubled the GST rebate, putting nearly $500 in the pockets of 10 million Canadians. We delivered dental care for half a million kids across this country, and we delivered rental supports for nearly two million Canadians. We made that happen.

I am wondering what the Conservatives can point to. What did they deliver for Canadians in this difficult time? What did they deliver for Canadians in the pandemic? The reality is that they have done nothing. The official opposition of this country has done nothing to make people's lives better in what have been the most unprecedented, challenging times for Canadians. It is unbelievable.

[Mario Simard, Bloc, Jonquière, QC]

Madam Speaker, I agree with the NDP leader that the solution for improving our health care system is not privatization.

However, it is not predatory federalism either. It is not up to the federal government to dictate standards for managing the health care system. The only solution is to fight against the scourge of federalism, or the fiscal imbalance.

If the NDP leader is serious, what he can do is tell the federal government that he will not support its budget because it does not invest enough money in health. I am sure he would have had much more support in the House today if he had moved a motion along those lines, instead of trying to interfere in jurisdictions that do not belong to the federal government, but to the provinces.

[Jagmeet Singh, NDP, Burnaby South, BC]

Madam Speaker, I have spoken to Quebeckers who have run into major challenges with the health care system. The interesting thing is that when they speak about the challenges and the problem, they never talk about jurisdictions. They talk about the fact that they want all levels of government to resolve the problems with our health care system in Montreal, Quebec City and all the provinces. They told me that we must try to find solutions.

That is exactly what we are going to do. We are going to use our power to find solutions and help people.

[Jenny Kwan, NDP, Vancouver East, BC]

Madam Speaker, I am delighted to debate this very important motion. We are talking about health care and health care delivery. One of the things that Canadians cherish is our universal public health care system.

I will tell members a story of my own history. Our family immigrated here to Canada. At that time, when my parents got the green light to come to Canada, they also got the green light to go to the United States as well. They made the ultimate decision to come to Canada.

Why did they make that decision? It is because Canada has universal public health care. That is the reason why so many immigrants choose to come to Canada and make Canada their adopted home.

I will tell members how important that was in our case. I come from a family of eight. We are not wealthy by any stretch of the imagination. There are six children within our family. Living in Hong Kong, my parents knew that there was no way they would be able to continue to raise a family with six children. I, particularly, was a sickly kid. I was sick constantly.

Every typhoon season, I swear, I had bronchitis. My mom would be worried sick, and she would be carrying me on her back to take me to the hospital. She would constantly take me to visit the doctors, to get medication, to get the help that I needed. They knew, my parents knew, that this was not sustainable. They could not afford it.

When they moved to Canada, the one thing that saved our lives, that saved my life, was that access to health care. My parents were making minimum wage. In fact, my mom, when we first came, made $10 a day as a farm worker to support a family of eight. That is how we survived.

Going to see a doctor was never a worry because it was free. That is what makes Canada so great.

What are we talking about now today? We are talking about premiers across the country, Conservative premiers, who want to privatize health care, who want to create a two-tier system, to say to people that, if one has money, one can access health care, get first in line and cut the queue. What is wrong with that picture?

It is not the Canada we envision, that we choose to come to, yet we have a Prime Minister who flip-flopped on his perspective.

He was clear to say, in the 2021 election, that he would not support two-tier medicine and that he would not support for-profit health care. He did not say that this was what he was going to do when he got into government, that he would see it as “innovation”.

What has happened? My goodness, in 2023, he has flip-flopped. Now he is saying that what Doug Ford's strategy to go forward to deliver health care for Ontario, a move in the direction of privatizing health care and expanding private clinics, is innovative.

The Prime Minister said that this was innovative. There is nothing innovative about that. That is putting people in a situation where they cannot access health care when they need it or where they need it.

When we talk about health care, what are we talking about exactly? It is about our well-being, every fibre of who we are and how we exist. If we do not have health, we have nothing.

That is why we must stand to protect public universal health care against this erosion that these Conservative premiers, Doug Ford, Danielle Smith, I can go on, want. All of these Conservative premiers are wanting to head down that road. It is the wrong direction. It is not what Canadians want.

If we look at our Conservative colleagues, where are they? Well, they want to go down that path exactly. Why? It is because it benefits their friends.

If we look at the information, even on an economic basis, it makes zero sense to do private health care expansion. It actually costs the system more money. Not just for the individual, but it costs all of us more money. It is an erosion of our collective well-being.

In British Columbia, we have walked down this path before. We had Dr. Brian Day with the expansion of Cambie clinic. They wanted to expand it. They wanted to go in the direction of private health care clinics for surgeries and other health care services.

The matter was brought to the court and the court ruled that it was an erosion of Canada's public health care system and that it would cost the system more money. It was a violation of the Canada Health Act, and it was struck down. The court decision did not allow the Cambie clinic to proceed. It went all the way to the Supreme Court on a constitutional argument. The court refused to hear it and said it was a no go.

Did anybody learn from that? No. Premiers have lined up, and they are going down that track to say we need to privatize health care, which will hurt Canadians, knowing that right now, more than anything, we need to put every effort into our communities to support people. We need to support people in our communities, support our health care workers and expand the public health care system. We are not doing that. The Conservatives are not going down that track. They are looking to see how we can expand private health care.

The Prime Minister is so disappointing. It is so disappointing for him not to stand up and say, “No, that is not innovation. This is not the track that we are going to go down. We are going to fight tooth and nail to support public health care.” There is an opportunity here to make it right.

One thing my mom taught me long ago was that, if someone knows they have done something wrong, they should correct it and learn from that mistake. There is an opportunity for the Liberals to do exactly that. Our motion today gives them that opportunity.

We are calling for the government to close the loophole within the Canada Health Act and say no more. We want the government to say we are not going to have this debate anymore, we are not going to go down this track, and we are going to stop it. The way to stop it is to close that loophole in the Canada Health Act.

Furthermore, the government, with health care spending and the transfer of dollars to the provinces, can also say to the provinces and Conservative premiers that, if they think they are going to use this money to go in the direction of privatizing health care delivery, that is not what the money is for and it will not allow that to happen. The government can do that. The government has the authority to do that. It can put teeth in its words and stand by them.

Together, we can continue to build the Canada health care system and not allow for the erosion that so many Conservatives are attempting to sneak in with their pursuit of an agenda. If they were successful, what would that mean? It would mean that people who need the services the most would not be able to get it because they do not have the money or the wealth to access those services.

It brings me back to the days when I was a kid on my mom's back. She carried me for miles to go see a doctor because we could not afford it. We just have to look to the United States to see what is going on. People make movies about these things. We see movies of desperate parents trying to access health care, and when they cannot access it, what do they do? They are forced to take unimaginable actions, such as commit crimes they do not want to do or engage in robberies. Movies are made about these things.

This cannot be allowed to happen. We do not want people to make those kinds of movies about Canada. We want people to make movies about Canada that say how great our system is, what universal health care means and how it protects everybody.

We need to come together to do this work. We need to invest in our health care system, and when people want to take it down the wrong track, we have to stop them dead in their tracks and say, “No way, no how”—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Questions and comments, the hon. parliamentary secretary to the government House leader.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I will go back to the days when I was the health critic in the province of Manitoba and the NDP was in government. We had a situation where privately owned clinics were provided business through public doctors, as all doctors are publicly compensated. I wonder if the member and the NDP would see that as a negative thing. Was the provincial NDP wrong to be dependent on private clinics, which would provide all sorts of blood testing, for example? Is that the type of privatization the national NDP opposes? Could the member expand on that? Is there any role at all for private clinics or non-profits?

[Jenny Kwan, NDP, Vancouver East, BC]

Madam Speaker, the member knows very well that what we are talking about is for-profit health care. He knows very well why I cited the example of the Cambie clinic. What Dr. Brian Day wanted to do was expand surgery, for example, and charge people tens of thousands of dollars to access surgery. In that process, he was going to raid health care workers in the public system to staff that approach.

The member knows very well that doing that hurts our system overall. He knows very well that it erodes our public health care system. The member knows very well that it is a violation of the Canada Health Act.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Madam Speaker, I noticed there was a stark absence in the member's speech of a reference to the NDP record on health care in Saskatchewan. That record includes the closure of 52 hospitals in one year, and the closure of 13 long-term care centres in one year, which also meant that probably around 1,000 health care workers were put out of a job.

Could the member comment on the record the NDP has, which has contributed to people not trusting the NDP in Saskatchewan? They will not for a long time because of the record the NDP had of abandoning rural Canada.

[Jenny Kwan, NDP, Vancouver East, BC]

Madam Speaker, let us look at the whole picture.

The member should know what was happening during that period with the federal government. It was a Conservative government. With the Liberals and the Conservatives, it is the same old story; they are about the same. They starve provinces of federal health care transfer dollars, so people are forced to try to make ends meet.

What we need to do, of course, is properly fund provinces and territories in the delivery of health care. We also need to close all the loopholes for premiers who want to go down the track of privatizing health care. By the way, it was the B.C. NDP government that stopped private clinics, and the people who wanted to go down the private health care track, in the courts.

[René Villemure, Bloc, Trois-Rivières, QC]

Madam Speaker, I thank the NDP member for her passion, spirit and ardour.

She has good intentions. However, I have to say that she showed a serious lack of discernment. Quebec would not be subject to such a plan. I think that her ideology is completely overshadowing the debate and that she believes that anything connected to the private sector is automatically evil. Could she please show some discernment?

[Jenny Kwan, NDP, Vancouver East, BC]

Madam Speaker, I note the condescending comments that my colleague shared about my speech. It is not passion that I speak about. This is about our health care system and how it impacts Canadians.

The member should know, and if he does not know, he should look it up, that the courts have made a clear decision that going toward private health care is a violation of the Canada Health Act. Going in that direction is an erosion of our public health care system. It hurts people in their access to health care, and it is not the path forward.

[Leah Taylor Roy, Liberal, Aurora—Oak Ridges—Richmond Hill, ON]

Madam Speaker, before I start, I would like to say that I will be sharing my time with my colleague from Kingston and the Islands.

I am pleased to rise today to discuss the shortage of health workers in Canada and the actions the government is taking to address the issue.

First and foremost, our government supports our national health care system, which is central to Canadian identity.

It is my privilege to recognize the extraordinary contribution and sacrifice that health care workers in Canada make every day to provide Canadians with the health care services they need.

I would like to begin by thanking to all health care workers in particular.

The COVID-19 pandemic has shown what we can achieve when all levels of government work together alongside regulators, educators, health care providers and their representatives. We worked together across jurisdictional boundaries and professional designations to provide care to all Canadians and address the needs of our most vulnerable.

The state of our health care workforce has been described as a crisis, but with crisis comes opportunity. We can take a critical look at systemic shortcomings and make the kinds of transformational changes required to rebuild our health care system into the world-class system it once was.

Health care workers are the backbone of an efficient and sustainable health system. It is imperative that we take action to create safe, supportive and adequately resourced health care working environments that support the retention of existing workers and make health care an attractive career choice for professional support workers, nurses, nurse practitioners, physicians' assistants, nurses, doctors and all others who work in this system.

Our health care workers are at the core of our plan to support our public health care system. Just last week, I met with members of the Canadian Labour Congress in my office, three of whom were personal support workers from my area. They are passionate about their work and about the Canadians they serve. I shared with them the fact that my first job was as a personal support worker at a seniors home where my mother worked as a nurse. I understand the importance of the work they do first-hand and how much older Canadians and others who need assistance to get through their daily routines appreciate these hard-working individuals.

I am so proud that as part of the recent health care announcement, $1.7 billion has been allocated to provinces so they can increase payments for these personal support care workers. They deserve more than just our praise. They deserve an increase so they have livable wages. The SEIU, which represents many health care workers, said, when we put forward this announcement, that the “federal commitment of $1.7B for personal support workers and care workers like them who support our vulnerable loved ones...marks a giant step towards achieving the promise of $25 for all [personal support workers] across Canada.”

I would like to talk about nurses as well. I mentioned that my mother was a nurse. It was her career and she was very proud of it. They play a critical role in delivering health care services, shaping our health system, improving patient experiences of care and population health, and reducing the per capita cost of health care. This goes for our personal support workers as well.

Supporting these workers in our health care system and ensuring they can do their job properly means that our health care professionals can do a lot more and we can do a lot more with less. From the emergency room to the ICU, from vaccination clinics to public health units and from long-term care to mental health services, nurses and nurse practitioners provide dedicated care.

We know from several studies and surveys that there is a high vacancy rate because nurses are burned out. They are leaving their jobs or seeking to leave them. The pandemic has really made a dent in our nursing staff, our capability and the number of people who work in this profession.

We recognize the critical role they play, so in August 2022, we reinstated the role of federal chief nursing officer with the appointment of Dr. Chapman. This office is working to advance and champion initiatives that are priorities among the collective nursing community, including harmonized, efficient and safe approaches to integrate internationally educated nurses into the workforce.

We need all of the health care workers in Canada who have been educated around the globe to help deliver the services that Canadians so desperately need. The implementation of multi-jurisdictional registration will improve the mobility of nurses across Canada as well. The chief nursing officer supports the improvement of pan-Canadian nursing data to facilitate comprehensive workforce planning and evidence-based health care policy development.

Let me talk for a minute about mental health. Providing mental health services to our health care workers is incredibly important, not just for them but for all Canadians. We know that mental health is health. There is no differentiation. We have made a commitment, and as part of the ongoing negotiations, mental health services are going to be increasing.

I was proud to see that the Southlake Regional Health Centre has had a new facility built. Arden Krystal, the CEO, has done an amazing job. It is good to see that the funding this federal government is providing will allow provinces to deliver more and do more of what is in their jurisdiction. The CMHA is also in my riding. Rebecca Shields, the executive director, is doing amazing work. We are hoping to have one of the first mental health hubs in York Region.

We need mental health support for all Canadians to be provided in a way that allows them to get the help they need when they need it. We also need to provide this help to our health care professionals, who are right now suffering from burnout and whose help we desperately need. This is critical for the health care workforce around us that cares for us.

The Mental Health Commission of Canada has found that the ability of the health care workforce to undertake psychological self-care can reduce the moral distress that is leading to burnout. That is why we have invested $28.2 million in projects to address PTSD and trauma in frontline and essential workers. This is an investment in our health care workers and in the system.

We also collaborated with the Canadian Federation of Nurses Unions on a Wellness Together Canada initiative to explore new, targeted mental health resources for health care workers. It provides a dedicated text line for frontline workers and provides immediate access to supports. In addition, frontline workers can access free counselling and a range of self-guided programming on the portal at any time, at their convenience. As we know, for health care workers who constantly work shifts, having immediate access to online platforms is so important.

I would also like to talk about collaboration. The provision of health care in Canada is complex. As everyone in this House knows, federal, provincial and territorial governments, as well as regulators, educators and professional associations, all have key roles to play. No one player can address this crisis alone. We have to work together, and we are doing that. We respect that health care is a provincial jurisdiction, but we also know it is our role to convene and to provide leadership and funding.

On November 1, 2022, the Government of Canada established a coalition for action for health workers. The coalition is composed of representatives from key groups, including nurses, doctors, personal support workers, colleges, universities, patients and equity-seeking communities. It is focused on identifying approaches to drive pan-Canadian action and progress on policy implementation informed by real-world perspectives, the perspectives of all of the parties who have come together to discuss these important issues. Provincial and territorial governments are at the forefront of health care, responsible for designing, implementing and managing their jurisdictional public health care programs, while we, as I said, provide leadership, convene governments and other stakeholders and provide funding support to the PTs.

On February 7, 2023, the Prime Minister met with premiers to discuss the actions needed to improve the health care system while adapting to the changing needs of Canadians. They also discussed shared health priorities to deliver results for Canadians and the importance of upholding the Canada Health Act to protect Canada's publicly funded health care system.

The investment of almost $200 billion over the next 10 years will accelerate efforts already under way in the provinces and territories. As part of accessing this funding, provinces and territories are being asked to streamline foreign credential recognition for internationally educated health care professionals.

I see my time is up. There is so much more I could say, but I just want to say that we are working with all of our partners to ensure that the additional money we are committing will bring the results that Canadians need and deserve.

[Jenny Kwan, NDP, Vancouver East, BC]

Madam Speaker, the hon. member referenced in her speech the importance of getting more health care workers into our system. In immigration, in fact, there are a number of nurses who have come to Canada, many of them as caregivers. They have written all the exams and passed them to become health care workers, for example nurses, in the system. The only thing preventing them from doing that job is their immigration status. They are only afforded a limited, employer-specific work permit, so they cannot work for anyone else, even though there are health clinics and hospitals lined up wanting to hire them.

First, does the member think that the Minister of Immigration should change the system to enable these caregivers to engage in their profession, which they have been trained for? Second, does she support the call for the government to regularize workers so they can get into the system and fill the job—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

I have to give the hon. member the time to answer.

The hon. member for Aurora—Oak Ridges—Richmond Hill.

[Leah Taylor Roy, Liberal, Aurora—Oak Ridges—Richmond Hill, ON]

Madam Speaker, of course we want all health care workers to be working in our system. This government is committed to that. It is up to the provinces and territories to license and ensure that they can work in the system. The system is set up. We have now reduced the Canadian work experience requirement from 24 months to 12 months so that more workers can get in and help.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, I thank my colleague for her speech.

I am sorry, Madam Speaker, but I can hear the NDP heckling. This is their day—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Can we ask the hon. member to please respect the fact that another member is asking a question?

The hon. member for Joliette.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, the federal government just announced health transfers to the provinces. It is giving them one-sixth of what they asked for.

I would like to ask my colleague if she thinks the amount announced by the federal government is enough to fix the provinces' health care systems. If so, why were Quebec and the provinces asking for so much?

[Leah Taylor Roy, Liberal, Aurora—Oak Ridges—Richmond Hill, ON]

Madam Speaker, my translation was not working, but I believe I understood the question sufficiently.

We have made a historic announcement. We are bringing forward almost $200 billion over the next 10 years, including almost $50 billion in new spending. The point here is that it is not only about the money; it is about ensuring that we get outcomes for Canadians. I believe that the conversations and bilateral agreements with the provinces and territories will ensure that we get those results for Canadians, and I think this is what matters to all Canadians.

[Mike Morrice, Green, Kitchener Centre, ON]

Madam Speaker, the hon. member for Aurora—Oak Ridges—Richmond Hill, at the end of her speech, started to talk about the element of the new agreement with respect to foreign credentialing, which is a real priority in my community as well, but she was cut off toward the end. Could the member share more about how the federal government specifically will be compelling provinces and territories to do more to ensure that foreign credentials are recognized here?

[Leah Taylor Roy, Liberal, Aurora—Oak Ridges—Richmond Hill, ON]

Madam Speaker, I agree with my colleague on this, as I do on many things. This is a priority for the government. Foreign credentialing, as we all know, is not the province of the federal government. I believe that during these ongoing bilateral negotiations with provinces and territories, this will be a key part of those negotiations, as we know that bringing all of those trained professionals into our health care system is essential to get the support of all the workers we can.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Madam Speaker, the Liberals are not great when it comes to climate change and the environment, but they are awesome at recycling. Of the $196 billion they announced, 75% was money that had already been announced. That is not much, considering what the provinces need.

Does my colleague realize that no matter what nice things she says about health workers and professionals, that will not make a significant difference and will not really fix the system she and her party helped break?