Debates of Feb. 16th, 2023

Opposition Motion—Public Health Care Funding and Delivery

[Bob Zimmer, Conservative, Prince George—Peace River—Northern Rockies, BC]

Madam Speaker, I have a daughter who is interested in becoming a surgeon, and she is pursuing that as we speak. However, I have heard many stories. Even 20 or 25 years ago, friends of mine tried to get into medical school in Canada and simply could not, yet they found places somewhere else outside our very own country of Canada or outside our province of B.C.

I have not heard this member talk once either about facilities to train doctors and nurses or about the gatekeepers who are controlling the applicants getting into our current system to become students and then to become doctors and nurses in our very own country. I am kind of curious whether she has a solution or has talked to those entities about possible solutions to fix that problem.

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Madam Speaker, there is talk about that in the study on the labour shortage in the care economy. About 15 years ago when I was living in Quebec, I was at a dinner and there were conversations around the table then. We knew 15 years ago that there were not enough spots and placements. That is a serious issue. The Liberal government has the opportunity to start working with those organizations and with the provincial and territorial organizations to lift that.

I want to point out, though, that we have known this was happening. People were sitting around tables talking about this 15 years ago and the Liberal government and the Conservative government before it did nothing about it.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

Madam Speaker, we agree with the substance of the motion, in other words, the need to strengthen our free universal public health care systems.

In Quebec, we watch these issues closely, but this is not the place to be debating them.

We see what is happening in Ontario and Manitoba, as well as the potential abuses, and I think there are some battles to be fought. However, the most important battle to wage, when we talk about staffing, working conditions and labour shortages, is getting the federal government to provide adequate funding to the provinces so that they can carry out their responsibilities.

Why did the NDP not call out the federal government's inadequate investment in the latest agreement with the provinces?

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Madam Speaker, I really appreciate working with the member at the HUMA committee. The member and I had worked alongside each other on the labour shortage study, and we had very similar thoughts, so I thank her for that.

The NDP members have been talking for a long time about the need for additional health care transfers and for the Liberals to make up for the deficit funding that the previous Conservative government pulled away. This is something that the New Democrats have been talking about for a long time. This is a failure of the Conservative government of the past and a failure of the Liberal government now.

[Adam van Koeverden, Liberal, Parliamentary Secretary to the Minister of Health and to the Minister of Sport]

Madam Speaker, it is an honour to rise in the House today to address the motion from the hon. member for Burnaby South and provide an update on our government's commitment to support and strengthen Canada's health care system. It is also a great opportunity to re-emphasize our number one priority, which is to ensure that our health care system continues to be publicly funded, universally available and equitably delivered.

Canadians are proud of our universal health care system, a system that is accessible to everyone regardless of their ability to pay.

However, this system is under pressure. The accessibility and universality of the system that we all rely on are under threat. We have all heard the devastating stories about the system failing us. There are for example the long waits at emergency rooms and the difficulty people have finding a family doctor, not to mention the years-long wait lists for consulting a specialist or to plan a surgery.

While many of these issues existed long before COVID-19, the pandemic has both exposed and worsened a number of systemic problems that must be addressed.

Canadians deserve a health care system that delivers results. That is why we are working with provinces and territories to increase funding in our health care system right across the country. Our goal is to ensure that all Canadians get the universal, accessible and high-quality health care they need and deserve when and where they need it.

Last week, the Prime Minister announced the Government of Canada’s proposed investment of $198.6 billion over the next decade, including over $48 billion in new funding for provinces and territories to improve health care services for Canadians.

I will speak more about how this investment is structured in just a few moments. It is about more than just money; it is a true investment in the health system that will yield tangible results for Canadians in the areas they care most about.

Before I go any further, I would like to say a few words about COVID-19 and the enormous pressure the pandemic has placed on the health system, resources and workers. It has been health care workers who have borne the brunt of the pandemic’s impacts, on the job, every day. From high patient workloads, to scarce resources to fear for personal health and safety, the pressure on health workers has been unrelenting for over two and a half years.

Last week, I had a chance to sit down with some representatives from SEIU, a labour union that represents a lot of workers in personal support and long-term care. The meeting quickly turned into one that was very emotional, because personal stories and anecdotes were shared. I do not mind saying for the House, and on the record, that everybody in the meeting was crying by the end of it. These people work so hard. They are so compassionate. They are there for society's most vulnerable, for our parents and our grandparents as they age. They are angels and saints, every single one of them.

They asked me to re-emphasize for the Prime Minister and the Minister of Health the importance of wages for those workers, and they were so grateful for the increases they saw in these agreements.

I take this opportunity to thank health care workers for their perseverance, professionalism and unwavering commitment to their patients, Canadians and people right across our country. Our government owes them a debt of gratitude for their continuing compassion, care and courage in these extremely challenging times.

Given the pressure they are under, it should come as no surprise that health care workers are exhausted and burnt out. Many have left the profession altogether. Those who remain are grappling with very challenging workplace conditions, leading to low retention and a lot of turnover. This is unacceptable.

Health workers are the backbone of our health care system. A crisis for health workers is a crisis for the whole system. They have taken care of us, they have taken care of our loved ones and we need to take care of them too.

Therefore, we, as governments, now find ourselves in the position to try to find ways to rebuild the health system so it can continue to be there for us now and into the future. This is a shared challenge. We have been working closely with the provinces and territories to identify actions that are needed to improve the health system, while adapting to the changing needs of Canadians.

Last week, federal and provincial leaders came together to discuss tangible actions that we could take now, which would help modernize the system and ensure results would be there for Canadians.

After months of discussions, including with patients, health workers and experts, our government has proposed a sound, reasonable and pragmatic approach to obtain concrete results for Canadians as well as our health care workers.

This past Monday, premiers across Canada announced that they had accepted this approach, and we welcome the opportunity to continue working with them to improve the universal, public health system on which we all rely.

Our government will increase health funding by nearly $200 billion over the next 10 years. This funding includes an immediate and unconditional $2 billion Canada health transfer top-up to address immediate pressures on the health care system, especially in pediatric hospitals and emergency rooms for long wait times for surgeries. This builds on previous top-ups that total $6.5 billion provided throughout the pandemic.

It also includes a five per cent Canada health transfer guarantee for the next five years. This is projected to provide an additional $17.3 billion over 10 years in new support. With this guarantee, the Canada health transfer is projected to grow by 33% over the next five years and 61% over the next 10 years.

It will also include $25 billion over 10 years to advance shared health priorities through tailored bilateral agreements that will support the needs of people in each province and territory in four areas of shared priority: family health services, health workers and backlogs, mental health and substance use, and modernization of our health system.

In addition, $1.7 billion will be invested over five years to support wage increases for personal support workers and related professions.

On top of this, we will continue to work with indigenous partners to provide additional support for indigenous health priorities. Notably, the government will provide $2 billion over 10 years for an indigenous health equity fund to be distributed on a distinctions-based manner with first nations, Inuit and Métis to address the unique challenges indigenous peoples face when it comes to fair and equitable access to health care services.

We will also provide an additional $505 million over five years to the Canadian Institute for Health Information and Canada Health Infoway. These federal data partners will work with provinces and territories on developing new health data indicators, among other efforts to use data to improve safety and quality of care right across Canada.

We have been very clear about the obligations under the Canada Health Act. We will work with provinces and territories to ensure our investments are used in the best interest of patients and health care workers in a way that respects the principles of the Canada Health Act to ensure access to insured services is based on health needs, and not the ability or willingness to pay.

Our investment supports work in shared priority areas that matter to Canadians, such as family health services, the health workforce, mental health and substance use services, and building a modern health care system. Helping Canadians age with dignity, closer to home, with access to home care or care in a safe long-term care facility is also an area of shared priority.

I would also like to speak for few minutes about each of our shared priorities and why they are important to Canadians.

The first priority is to improve access to family health services, especially in rural and remote areas and in underserved communities. Whether provided by a doctor, a nurse practitioner, a pediatrician or a multidisciplinary team, family health services are essential for effective, resilient, sustainable and equitable health care delivery, and yet more than 14% of Canadians over the age of 12 do not have a regular family health provider.

This gap affects us all. When people do not have access to a a regular family health service provider, they rely heavily on walk-in clinics and emergency rooms that are already overburdened. This needs to change. With this new investment, we will work with the provinces and territories to ensure timely access to comprehensive, integrated and person-centred family health services, including in rural and remote areas.

Our second shared priority is to support our health workers and reduce surgical backlogs. As I mentioned at the outset, health care workers made enormous sacrifices during the pandemic, and they continue to suffer the consequences of working in a system that is under strain. We need to invest in supporting and retaining health care workers. This includes training for recruitment as well as recognizing the skills of health care workers trained both in Canada and abroad.

We also need to look to the future with better workforce planning. We can do this with improved health care service data with respect to our workforce and by seizing opportunities to scale new models of care to directly address these key barriers. This includes streamlining foreign credential qualifications and recognition for internationally educated health professionals and advancing labour mobility, starting with a multi-jurisdictional recognition of health professional licenses.

As the member of Parliament for a diverse community of people who come from all over the world to make Canada their home, this is a personal priority for me as well.

Third, we want to improve access to mental health services and substance use services for Canadians. Right now, one in three Canadians say that they are struggling with their mental health. It is clear that there is no health without mental health. It is as integral and important to our needs as physical health.

That is why we are working to provide Canadians with a multidisciplinary system of care, one that integrates mental health services and substance use services right across all of those shared priorities with provinces and territories. This means better access to mental health and substance use services in the community as part of publicly funded care.

For example, by better integrating mental health services within family health teams, we can strengthen access to needed mental health supports for all. We will ensure that every Canadian and those who need referrals can get them in a timely manner.

Next, we need to work together to modernize the health system, which means improving the way we collect and manage health information. This will be foundational to achieving progress, because data saves lives.

Let me explain what I mean. Better access to health information is essential for health workers to provide safe and high-quality health care, regardless of where in Canada patients might live or happen to be when they need care. Think of a nurse or a doctor who cannot see a patient's medical history, including any medications he or she is on, allergies the patient might have or tests that have taken. In an emergency situation, this can be very dangerous.

Many of us have had the frustrating experience of being referred from one health provider to another only to be asked to repeat our medical history over and over again or take same tests multiple times, all because medical records were not shared in a modern manner. This is inefficient and results in duplication and increased costs.

That explains why we need to modernize the health system with standardized health data and digital tools. Canadians should be able to access their own health information and benefit from it being shared between health workers across health settings and across jurisdictions, providing a seamless experience for the patient while respecting their privacy.

To access the federal funding announced last week, we are asking provinces and territories to adopt common standards on how health information is collected and shared. This commitment will include an agreement to develop and use comparable indicators through the Canadian Institute for Health Information.

These commitments will improve the efficiency, the quality and the safety of patient care, provide decision-makers with more complete pictures of the health care system and help manage public health emergencies.

Finally, we are committed to helping Canadians age with dignity, closer to home and with access to home care or safe long-term care. Many seniors want to remain in their homes as long as possible, but they lack the support they need to do so safely.

Collaborative work is under way with provinces and territories to help them support access to home care and long-term care. This includes existing investments of $6 billion for home and community care. The investment we announced last week will also include an additional $1.7 billion over five years to support wage increases for personal support workers and related professions. That was so important, and it was highlighted to me by the workers from SEIU just last week.

Investing in these five areas of shared priorities will help repair the damage caused by COVID-19 and ready the health system for future challenges.

We recognize each province and territory faces unique challenges. That leads me to the next point on the bilateral agreements.

Provinces and territories will have the flexibility to tailor their bilateral agreements to meet the unique needs of their populations and geography. The health needs of Canadians are diverse across our country. Yukoners, New Brunswickers and Islanders all need something perhaps a little different. These agreements will also include action plans to ensure real progress is made and measured.

On the Canada Health Act, each bilateral agreement will need to reinforce common core principles. The first among these is our shared responsibility under the Canada Health Act. This means governments must ensure that medically necessary services are provided on the basis of need, not one's ability or willingness to pay.

In Canada, all people should need to get health care is their health card, not a credit card. It also means that under the act, where there is evidence of patient charges for medically necessary health services, such as for abortion services, mandatory deductions to the Canada health transfer payments of a province or territory must be taken. There is a precedent for this.

As the Prime Minister pointed out last week, the Canada Health Act requires that governments protect, promote and restore the physical and mental well-being of residents of Canada and facilitate reasonable access to health services without financial or other barriers.

Governments must also ensure equitable access to health care services and that such access is supported by a strong public health care sector.

Next, the bilateral agreements we negotiate would reflect our joint commitment to health equity and reconciliation with indigenous peoples. We will work together to ensure indigenous peoples across the country are able to access quality and culturally safe health services, which are free from racism and discrimination, anywhere in Canada.

Finally, agreements would also support improving equitable access for other underserved and equity-deserving groups, including Canadians living in rural and remote areas, as well as those living in official language minority communities.

Canada's health care system is facing a major challenge. As Canadians, we all count on the system to take care of us and the people we care about. We expect it to be there when we need it.

We are at a critical juncture. There are cracks in the health care system, and they are getting wider. Now we have to act fast to save the system we all cherish.

Provinces, territories, stakeholders, care providers and the Government of Canada all have to work together to fill those gaps before these problems get even worse.

Last week, we came together and took a giant step forward. There is still much work to be done, but with that approach, the one that our government has proposed and the premiers have now accepted, we are pointed in the right direction and we have a clear path ahead of us.

Our government looks forward to working with the provinces and the territories in the weeks to come so that we can move forward together. Canadians are counting on us.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, my hon. colleague and I sat through a study of the human resources crisis in health care. He knows, as well as I do, there is a screaming conclusion: Human resources are finite. The same pool of doctors, nurses and other health professionals currently working in the publicly funded system would be pulled from that system to work in the privately funded system.

He knows that a parallel private system reduces the incentive to work in the public system, as health care workers may be paid more in the private system despite caring for less complex patients. That is the process known as cream skimming. The reduced capacity in the publicly funded system leads to worsening wait times for those who cannot access the private care.

Could the member explain why he does not agree with New Democrats that additional federal funds should be conditioned on going to the public system? He knows that if that money is diverted to the private system it would simply extend wait times and deepen the crisis in the public system.

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, first, I would like to thank my hon. colleague from Vancouver Kingsway for his collaboration on the health committee.

I agree with him, and I will re-emphasize our number one priority. Health care in Canada should remain, and always be, publicly funded, universally available and equitably delivered to all Canadians. I was in the health committee as we heard from nurses unions, doctors, experts, academics, patients and people all across the ecosystem of the health care sector. I heard those exact same anecdotes.

I would lean in on quotes from some of those experts following the announcements last week, including, but certainly not limited to, Dr. Alika Lafontaine, the new president of the Canadian Medical Association. He said, “Today’s commitment by the federal government to significantly increase health transfers to provincial and territorial governments is an important step to stabilize and transform our health care systems.” It is all about repairing and preparing.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, I note that in my colleague's words there is a lot of talk, but where is the action?

My colleague mentioned that mental health is health. We have heard that a lot from the Liberal government in the House of Commons. We also know there is $4.5 billion of commitment in the Canada mental health transfer, which has not been sent, and we know there is a mental health crisis.

When is the government going to get down to business and do something about the mental health crisis that exists in this country?

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, I will not apologize for my speech being full of words. I am sorry if it was difficult to follow. It was full of words the hon. member could not hear, because he was speaking to one of his colleagues for the entire time I was speaking. If he had been listening, he would have heard the anecdotes that I shared from various organizations.

I shared that one of our prime priorities is to support Canadians who are suffering from mental health and from addictions.

[Some hon. members]

Oh, oh!

[Adam van Koeverden, Liberal, Milton, ON]

I will leave it at that, as the hon. member continues to heckle me from across the way.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I am going to interrupt to advise members that, unless they have the floor, they should not be yelling across the way or trying to have conversations.

Questions or comments, the hon. member for Drummond.

[Martin Champoux, Bloc, Drummond, QC]

Madam Speaker, I congratulate my colleague on his speech.

The motion before us deals with a matter that is clearly not a federal jurisdiction, but a provincial one. Health care systems fall under the jurisdiction of Quebec and the provinces. I listened to the speech by my colleague that covered a lot of things, which, once again, are the exclusive jurisdiction of the provinces.

We are still somewhat in shock as a result of the agreement on health transfers reached between the federal government and Quebec and the provinces. There is an explanation for this. In a way, it is like someone who walks for such a long time in the desert that they really crave a good meal. However, they are certainly not going to turn down a glass of water. The federal government offered a pittance and the provinces accepted on bended knee, if I can use that expression.

I have a simple question for my colleague. The federal government considers itself to have an important role and responsibilities in health care, and I would like to know how many hospitals it manages, outside of Canadian Forces hospitals. I would like to know how many doctors, nurses and health staff the government has to hire as part of its usual responsibilities.

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, I want to thank my hon. colleague for his question and his attention to this very important issue.

However, I must mention that responsibility for Canada's health care system is shared between the two levels of government, meaning provincial and federal. The cost of the health care system is the responsibility of both orders of government. That agreement is also the result of co-operation between the two orders of government. Quebeckers, Ontarians and British-Colombians are all Canadians. This problem affects all Canadians.

[Irek Kusmierczyk, Liberal, Parliamentary Secretary to the Minister of Employment]

Madam Speaker, I thank my hon. colleague for his fine speech and his fine leadership on the issue of advancing health care.

We have to support the heroes who make our health care work. I had a chance to meet some of those heroes two weeks ago, when PSWs representing SEIU visited my office. They shared with me the incredible stories of the challenges they face, and of their incredible sacrifice and service above self.

Can my hon. colleague speak to some of the concrete investments this plan will make for the health care heroes who make our health care system work?

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, I would like to thank my colleague for the extraordinary work that he and his colleagues on the HUMA committee have done to ensure that there is modernization in the care economy, that wages keep up to the rate of inflation and that people are paid well for their essential work.

That same day, I met with members of the SEIU to discuss not only some of the more troubling results of the pandemic, but also the reality that they are just not paid enough for their work. I am glad that one of the aspects of this agreement with the provinces and territories includes a provision of $1.7 billion to ensure there is a $25 minimum wage for those workers. They were very grateful for that. I was grateful for their insight and perspective in that meeting. It was extremely touching.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, my hon. colleague was relying on quotes, so I am going to share some quotes with him.

Bernie Robinson, from the Ontario Nurses Association, said, “I fail to understand where the government thinks it's going to get the human resources to staff these private clinics other than by draining our already-taxed public system.”

J.P. Hornick, from the Ontario Public Service Employees Union, said, “To improve access to care, public hospitals require staff and funding, both of which will be even further depleted with increased reliance on private clinics.”

Finally, Dr. Bob Bell, former deputy minister of health in Ontario, said, “I totally agree with their desire to do more surgery by moving it out of the hospital into the community. But moving it to a for-profit model is simply dumb.”

This is not about upholding the Canada Health Act. Why is the federal government not stepping in to make sure that the additional funds are not diverted by the provinces to private clinics, even if they are publicly paid for?

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, I thank my friend and colleague for his collaboration.

The quotes he shared were primarily from provincial organizations representing the workers in those provinces, which is important, but I think they were directing those comments to provincial governments.

We heard from Canadian organizations, like the Canadian Medical Association, the Royal College of Physicians and Surgeons of Canada, the Canadian Nurses Association, SEIU Healthcare, The College of Family Physicians of Canada and HealthCareCAN, including Children's Healthcare Canada. This is a quote from the latter, which said, “We are incredibly pleased to see children's healthcare services identified as an urgent priority by the federal government. We look forward to learning more about earmarked investments for Canada's kids.”

I re-emphasize the need to ensure that all of those funds are delivered equitably, universally and publicly, and that our system continues to have that and to be compliant with the Canada Health Act. I appreciate everybody's collaboration through the health committee process and look forward to more questions.

[Rachael Thomas, Conservative, Lethbridge, AB]

Madam Speaker, the hon. member talked about the commitment of the Liberal government and its focus on health care. He said they are focused on care for “equity-deserving” groups. I am curious as to his understanding of equity deserving. Under a universal health care system, which is what this country has, who is not equity deserving?

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, the concept of equity versus equality is one that is lost on some members of the House. It is important to note that some Canadians do live in disparate conditions. They live far away from hospitals and have less access to services, to resources and to a family doctor. We have to ensure that everybody has service and access to the exact same system, and we have to make sure outcomes are the same. Outcomes are what is important here. Certainly, it does cost more money to provide people with health care in rural, remote communities. It does cost more to serve somebody who is under-resourced, who has a lower income, and who deserves and needs a little more help.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, hopefully members of the House will begin to understand that using meaningless words is not helpful to Canadians. I am not sure how to exactly make that point because it seems to be lost on many people who come here and attempt to do business.

What we do know very clearly is that the health care system we have, as mentioned very passionately by the former president of the Canadian Medical Association, is a system that is on the brink of collapse. Continuing to go on about grand ideas and priorities is in no way, shape or form going to operationalize any ideas in this country, which is really what we need. I guess, in the vernacular, we need people who are actually going to do something.

Many groups have put forward great ideas about pathways, road maps and priorities, etc. There has been talk about a lot of money that is going to be spent, has been spent or should be spent. What do we have? We have a system that is no different.

We know that after eight years of the Liberal government, we have people waiting and waiting. Very sadly, the waiting is now waiting until they are dead. This is the ridiculous and heartbreaking nature of a system that we in the House and the government, as I am putting the blame squarely at the feet of the Liberal government, have allowed to happen. People are literally dying in emergency rooms. That is the point where we need to begin to consider how to operationalize those things and what sort of leadership the federal government needs to bear to change the system.

I was fortunate enough to have worked in the health care system as a family doctor for 26 years. Four of those years was serving our country in the military. Even way back then, we knew very clearly that there was a shortage of physicians. Part of the work that I was required to do as a physician was to go other bases around this country so that other physicians could have a vacation. That is a rotation that we did.

As I transitioned from my miliary life into a practice in Truro, Nova Scotia, it became very clear that changes were happening in our health care system. Of course, as we all know, we have an aging population, which is felt more acutely perhaps in the Atlantic provinces and Quebec than elsewhere in the country, but at that time we also knew there was a dwindling of resources available, both financial and health human resources.

I had the privilege and opportunity to be a part of the health human resource study that was done by the Standing Committee on Health. It was a decent study, but I am still not entirely sure that there is a pathway forward on how to operationalize the ideas. One of the things that makes me the saddest is understanding that the folks I had the opportunity to work with, and who continue to work in the system are, as we might say, burned out, tired, frustrated, angry and hurt. How do we begin to change that? If we do not look at the system as a whole and begin to look at ideas on how to change that and change it quickly, then we are going to continue down the same path. It does not really matter how much money we pour into the system. We must focus on the people who are the greatest asset of the system.

I heard my colleague on the Liberal side talking about how data saves lives. I have to say it cuts right to my own heart to hear him say that data saves lives. People save lives. The doctors and nurses who are working on the front lines in emergency rooms and in small places across this entire country are the people who save lives. Does data help? Sure, it does. We have been talking about data strategies since I cannot even remember when, since the Stone Age, and we still have no real data strategy.

We can talk about it all we want, but until somebody has the courage to begin to operationalize that and work collaboratively with provincial governments, we are never going to get to the point where anything happens. For me, in coming here for the last 18 months, that is the most frustrating. When do things happen in the government? When do things get done? Who does the work?

We can have priorities and ideas and that kind of stuff. I am not saying that the Liberal government does not have priorities and ideas, that it does not put money toward things, but they are things that I do not necessarily agree with.

I think that the other thing is that there is no work being done. When is something actually going to happen? When is Beau Blois, who is an emergency room physician in Truro, Nova Scotia, actually going to feel the difference, in an operational sense, of something that we are actually doing?

We can, again, use all kinds of meaningless words and talk about things over and over again, but for that man, who also has a family, runs a business, and works very hard in our community, when is the operational rubber going to meet the road? When is something actually going to happen that is different? Until that point, we know that we will continue with this system, which lets down Canadians and Canadian health care workers.

For me, having been in that position, that is something that makes me very, very sad. From a very personal perspective, I know that the people who are working in the system care deeply about their patients, and doing a good job, and they care very deeply about the system as well. They are aware of the difficulties in the system. They call every day with ideas and ways in which they believe that the system could actually be changed to make it better. I think that the shame of it all is that after eight years of the Liberal government, all we get is more ideas and planning and priorities and meaningless talk that does not operationalize anything.

I know what is going is happen today. Somebody on that side of the House will chirp at me to say, well, it is the provincial government and I am talking about jurisdictional issues, and guess what happens? Absolutely nothing happens.

That is the sickest part of it all. We can talk about this until we are blue in the face, but until somebody actually does something that creates an opportunity for change and operationalizes something, nothing happens. That leaves the emergency room doctor, Dr. Beau Blois, still doing what he is trying to do, even though he works very hard and many hours in a multitude of different health care settings in my area.

Another guy that I have worked with for many years, Dr. Wayne Pickett, works in four or five different emergency rooms around rural Nova Scotia. Why does he do it? He does it because there is a need. He has tremendous skills. He is a compassionate doctor, and I would be happy to have him, if I needed the work, work on me any day.

That being said, how do we change the life of the Dr. Wayne Picketts of the world? How do we change things so that, in an operational sense, we can see change on the ground, so that the Mary Smiths and whoever we want to talk about, the Ednas of the world, get care?

How do they realize that they not have a family doctor any more and they are having a difficult time getting their prescriptions refilled? How do we also then take virtual care and make it a reality?

We have had conversations about virtual care, but if we go to the doctor and all we do is see them on a screen and nobody is there to examine us, how do we know that what we have told the doctor is right, that it is actually the case? How do we rectify the fact that using virtual care is significantly increasing the amount of diagnostic imaging that needs to be done?

Why is that? It is because the doctor, instead of actually seeing us and examining us when we have a sore arm, says, “Well, I guess your arm is sore, and that is unfortunate, so let's get an x-ray done.” Whereas, if we had an experienced practitioner, someone could actually see us to examine us and then realize that maybe we do not need an x-ray done, that we have another problem.

These are things that we are facing. When we think about it, we have an electronic medical record in Nova Scotia. I think that is worthwhile explaining, because I am not entirely sure that everybody understands how this might work.

If I have an electronic medical record in my office, and I am working in the emergency room and one is my patient, then I can look at their records. If I have an electronic medical record, and somebody else comes whose family physician has the same electronic medical record, in the emergency room, I cannot look at their electronic medical record. It does not make any sense.

Until we take these very practical problems and decide to make a difference, all we are going to do in the House of Commons is speak meaningless words that fill up Hansard. Those are some examples of very practical things we could do.

I am not being particularly critical, but I think we have a decent system in Nova Scotia. I know it is similar across the country. There are people struggling to get blood work done. It takes a long time to book an appointment. We now have a combination of systems that is difficult for seniors to access because it is computer-based. How do we rectify those things? How do we help seniors in our communities who are struggling with that?

When we look at those things, we know there are significant issues that need to be operationalized. I realize that the default in this grand institution we are in is to say something is a provincial issue. We do not have leadership here. We need to begin by looking at innovative ideas and how we can tie them together from province to province, and if we have a crisis in this country, we know that it is possible to show significant federal leadership, which sadly does not happen now.

I am going to shift gears a bit and talk about mental health. There has been a lot of talk about mental health and not much done about it. We know that since the pandemic, one in three Canadians has suffered significantly with their mental health. We also know that the Liberal government has put together studies which would suggest that 25% of Canadians not being able to access mental health care is a reasonable number. I think it should be zero. There should not be anybody out there who struggles to access mental health care. In this country, the greatest country in the world, we allow that to happen, and that is a travesty. That is absolutely unacceptable.

What is at the heart of that? I think there are a few things at the heart of it. It is a reflection of the state of this country. The sad state is that everything is broken. People feel defeated. They do not feel like they have hope. They do not feel like they have a future. They do not feel like they have a voice. When people feel like that, we have to reflect on how that makes us feel inside as people. How does that make us value ourselves and our contributions, not just to our families but to our country and communities? How do we invigorate people so they can actually feel like they are contributing to this country and get that wonderful feedback so they know they did that?

What are the other things in mental health that are important? There are a few things. Certainly, we have heard from counsellors and psychotherapists to know that the Liberal government is still charging GST on their services, which is a burden. We know that it would be a very easy fix to allow counsellors and psychotherapists to not charge GST on their services, which would then allow a greater number of Canadians access to the services they deserve.

What about mental health funding? To the people who are listening to what we are doing today, they know that in the 2021 platform of the Liberal government, it said it was going to fund a Canada mental health transfer up to the tune of $4.5 billion. Here we are, and year after year goes by. We had the fall economic statement. There is another budget coming up to talk about more money.

I have to mention something. I was on the MAID committee, and its members wanted to talk about funding. I said, “Great, let us talk about funding. Where is the $4.5-billion Canada mental health transfer?” The member opposite had the audacity to say it has been transferred. Everybody in the House knows that not one penny has been transferred under the Canada mental health transfer.

If it were not so incredibly gut-wrenching, nauseating and inappropriate, it would actually be funny because the member said that maybe we transferred it under another name. Why would it be under another name? The government announced a $4.5-billion project, and it wants me to believe that it transferred that money under another name. That is baloney. That is shameful.

Now, here we are, and Canadians are suffering. I heard my colleague across the way say he realized that Canadians were suffering with their mental health. If the Liberals have committed the money, why do they not just send it to the provinces and allow them to do things?

What we will hear from the government is a strange thing, and I want to be clear on it. The Liberal government is going to tell Canadians that it does not want to transfer the money because it wants the provinces to be accountable for it. The wasteful Liberal government is holding back money that could help the mental health of Canadians because it wants accountability. It wastes money on everything every day and it does not want to help people with mental health. I find it absolutely and shockingly ridiculous that we are even hearing this type of retort from my colleagues across the way.

We have had eight years of the current Liberal government and what do we have to show for it? Perhaps some statistics might be helpful.

When someone goes to see their family doctor, and the doctor realizes it is something they cannot take care of themselves, they send the patient to a specialist. The specialist may recommend some treatment. I do not know if members know the number, but the wait time is six months. That is the longest it has been in 30 years.

What is perhaps an even sadder statistic is that five million Canadians do not have access to primary care, with perhaps 130,000 in my own province of Nova Scotia. We know there are 1.228 million people waiting for procedures in Canada.

We could also look at diagnostic imaging. For folks out there who may not know what that means, it is CAT scans, MRIs and regular X-rays. We know those wait times are the longest they have been in forever.

What else do we know? We know we have drug shortages in this country. We brought Health Canada and the minister to the health committee to talk about the shortages of pediatric ibuprofen and acetaminophen, and what answers did we get? We got absolutely none. They said they were going to work on it and maybe get some in, but we know that when people go to their pharmacies, the cupboards are still bare.

What else do we know? We know there are critical drug shortages of every pediatric oral antibiotic that, if I was working as a family doctor, I would prescribe for children with bacterial infections. We know that every one of them is short. As I said previously, we also know, from the words of Dr. Katharine Smart, former Canadian Medical Association president, that we are in a system on the brink of collapse.

What else do we know? After eight years of the Liberal government, we know, as I mentioned right off the top, that people are dying in emergency rooms around this country. Somebody died in my own riding in Amherst in the emergency room, a lady named Holthoff. It is a sad state of affairs. There are no words to describe that. Those are things that should not be happening in Canada.

We know, after eight years of the Liberal government, that the Prime Minister refused to meet with premiers. When he eventually met with them and gave them a package, he said, “Here is your money. Hit the road. I don't want to hear any of your talk about this anymore.”

We know there is a significant crisis in the health care system, and we know that right now it is borne on the backs of the folks who continue to work on it, folks whom I have had the privilege and opportunity to work with. We know that if we do not operationalize our ideas in this great House, nothing is going to change. That is the sad concern I have: that nothing is going to change and we are going to continue down the same path we are on. We need to have great leadership in this country, and right now we do not have it.

I will end with an interesting take on this. If someone wants a solution to health care, they should elect a Conservative government.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Madam Speaker, one of my biggest fears is that our systems, whether it be the health care system or any other Canada-wide system like the agricultural system, will become Americanized.

Allowing indiscriminate access to the private sector would make our health care system more like the American system. That would not be good for the middle class, as it would lead to excessive debt. We agree on that.

Having said that, if opportunities to rely on the private sector have opened up in recent years, it is because successive Liberal and Conservative governments since the Jean Chrétien government have not provided sufficient health transfers.

If my colleague's budget were 28% to 32% short over a 30-year period, would he be able to manage a crisis, if one came along?

That is the reality in the health care system.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, I thank my colleague for her question.

We can talk about money in the House all day if we want to, but until we begin to operationalize things, we are not going to see any change.

I think one of the worst things we could possibly do in Canada is start comparing ourselves to an American system. We know that the American system is based on private care. We know that people do not have access. We know it is very costly. The United States spends more money on health care than anybody else in this world. To think we need to allow our system to collapse more than it has and adopt an American-style system would be a disservice to all Canadians.

[Lisa Marie Barron, NDP, Nanaimo—Ladysmith, BC]

Madam Speaker, I thank the member for sharing some of his experiences working as a family physician, and specifically what he has seen regarding the need for mental health supports for Canadians.

I worked in mental health and addictions prior to becoming a member of Parliament, and I saw the impact on our mental health services of a two-tired system, a private-public system. I saw the many ways in which this system provided supports for those who had the funds and left behind those who did not.

I am wondering if the member could share with us today whether he agrees that moving toward a privately funded health care system would exacerbate the exact problems we are seeing in our mental health systems. This is instead of moving forward to increase supports for Canadians in need.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, there are two things I need to point out. I have spoken at length about the $4.5-billion Canada mental health transfer, which has not happened. The other thing we need to talk about is the Liberal Prime Minister, who talks about privatizing Canadian health care and claims it is innovation. Everybody has heard that in the media. I think it is a travesty.

There are two points, as I said. We have a Liberal Prime Minister who is talking about private care as innovative, and we have a Liberal Prime Minister who refuses to transfer $4.5 billion to those who need it the most with mental health issues.