Debates of May 29th, 2024

Department of Health—Main Estimates, 2024-25

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Mr. Speaker, this is the other thing that Ms. Last-Kolb wrote in her email to me. She said, “Every family I have met, [their] child died in a home, many in [their] family home or apartment where family helped care for them. The only family I know whose son was homelessness actually [overdosed] in treatment.”

I checked on this, because I was curious to see if her experience with her colleagues and peers in Moms Stop the Harm reflected the national data, and in fact it does. I did not realize this, but many or in fact the majority of overdoses happen to people in their homes.

I wonder if the minister could comment on why it is so important that we do not drive substance users to the shame of using alone and how, in fact, using stigmatizing language can actually do just that.

[Ya'ara Saks, Liberal, York Centre, ON]

Mr. Speaker, again, it is so important that we take a compassionate and holistic approach to what is a public health crisis, not a criminal one.

The majority of overdose deaths are individuals dying alone. We need to be able to get them out of the shadows, out of the places where they are hiding, and get them to safety. We need to get them to harm reduction centres, whether it is safe consumption sites or drug checking, where they can be offered primary care, where they can be offered options, choices, so that they live.

When we use stigmatizing language, people turn in on themselves. They hate themselves. They need compassion. They need us to see them. We need to meet the moment with health services and compassion.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Mr. Speaker, as I was looking at the current statistics on who is dying from toxic drug poisoning here in this country, I was really surprised to find that two-thirds of them are young men. In fact, of those young men, 30% to 50% are employed in the skilled trades sector. It strikes me as ironic that the Leader of the Opposition speaks a lot about standing up for the workers, when in fact those very workers are being poisoned through a toxic drug supply.

Does the minister have anything to say about the world of unions and workplaces on this?

[Ya'ara Saks, Liberal, York Centre, ON]

Mr. Speaker, this gives me the opportunity to say that we have met our workers on the front lines of the toxic drug supply with the “ease the burden” program, because we know that we need to work with our workers to keep them alive and get them to health.

[Mario Simard, Bloc, Jonquière, QC]

Mr. Speaker, every single year, the Quebec government allocates roughly 43% of its total budget to health care. If 43% is spent on health care, that means the other 57% of its entire budget has to cover all of its other government responsibilities, including education, the fight against poverty, housing construction, infrastructure, municipalities, support for businesses and so on. Members can see what I mean.

I wonder if the Minister of Health recalls that when the medicare system was first introduced over 50 years ago, the federal government covered 50% of all costs. Today, it is estimated that it covers about 23%.

Does the minister not think that the federal government is backing away from health care funding?

[Mark Holland, Liberal, Minister of Health]

Mr. Speaker, our health care system has changed enormously, and it requires all governments to work together in a spirit of co-operation. That is why the federal government has invested nearly $200 billion in health care, including in Quebec, and not just for nurses, hospitals or doctors. We have also made other investments, including for dental care. It is important that we work together.

[Mario Simard, Bloc, Jonquière, QC]

Mr. Speaker, I sympathize with the minister. I am willing to talk about working together, but the numbers still speak for themselves. The federal government's share of health funding sits at just 23%.

There is a recurring phenomenon that has been very well documented in the Canadian federation, and that is the fiscal imbalance. The minister may have already read the report by Yves Séguin, a Liberal minister from Quebec, which covers this problem in depth. What is the fiscal imbalance? It means that the federal government's revenues tend to grow faster than its spending. The opposite is true for the provinces, whose spending tends to grow faster than its spending, particularly because of the explosion in health care costs.

The Conference Board analyses come to the same conclusion: If the federal government does not make massive investments in health care, the provinces' finances will not be sustainable come 2035. We will be getting the same type of report from the Parliamentary Budget Officer year after year, on an ongoing basis, indicating that if the federal government's share of health care costs is not increased, in the long term, by 2035, the provinces' finances will not be sustainable.

Does my colleague feel that the federal government is doing enough in terms of health transfers?

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, the federal government covered more than 80% of the cost of the pandemic, an absolutely enormous cost. It was essential. This created an imbalance in the fiscal situations at the provincial and federal levels. Now, the provinces are in a good position to invest money in their systems. That is the case in Quebec. There is a decent health care plan in Quebec, which is a leader in many areas of health.

Given that we have invested nearly $200 billion, I would say the money is there, but it is not just a question of money. It is a question of transformation, of changing the way health care services are made available. It is also very important to prevent illness. That is the motivation behind our dental care plan. Access to drugs is absolutely essential as well.

[Mario Simard, Bloc, Jonquière, QC]

Mr. Speaker, we cannot accept that kind of answer. The pandemic was a unique situation, something that happens once a century. The government's action cannot be based on the pandemic.

A recurring theme, however, is the federal government's failure to take responsibility for the problems in the health care system. At the end of his career, Prime Minister Jean Chrétien openly admitted that he was able to reduce health transfers without paying a political price. That happens all the time. The provincial governments are forced to make budget cuts and adopt austerity measures to manage their health care system, while the federal government can balance its budget on the backs of the provinces. That is what happened repeatedly under Paul Martin's Liberal government, which made $2.5 billion in cuts in 1996 and 1997 and dismantled the entire health care system.

When my colleague talks about exceptional measures, like those that were implemented during COVID-19, I have a hard time believing him. What we need is for the federal government, which is rather absent these days, to recommit to the health care system.

I have a very simple question for my colleague. Does he agree that health falls under Quebec's exclusive jurisdiction?

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, first the member opposite says that health is an exclusive jurisdiction of Quebec, then the member says that the government needs to do more in the health field. In my opinion, the member's position is a little strange.

The funds provided to each province are subject to a minimum annual increase of 5%. These funds are not reduced; they automatically increase by at least 5%. Additional amounts are also paid under agreements specifically designed to improve the situation.

The problem with our health care system is not money. It is really about transformation. In times of transformation, it is vitally important that we avoid picking fights. Picking fights is easy. The right thing to do is to work toward achieving results in a spirit of co-operation.

[Mario Simard, Bloc, Jonquière, QC]

Mr. Speaker, I see that my colleague is unfortunately trying to avoid the question, since he is not answering, but I will answer for him. Health is the exclusive jurisdiction of Quebec.

He said earlier that it was not just about money. If it is not just about money, what is the federal government's purpose? All citizens of every province pay taxes to the federal government. A portion of these taxes is returned to the provinces through health transfers or transfers for social programs.

The problem is that the transfers are insufficient. They do not match the cost of the services we deliver. Not only that, but the federal government, which is not responsible for health, is interfering in the area of health without having jurisdiction over it. What I do know is that, with regard to health, the federal government has jurisdiction over indigenous people's health, military hospitals, Health Canada drug approvals and quarantines.

I would like my colleague to tell me how many national health policies or strategies there are. Do these policies or strategies involve anything other than prevention and awareness?

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, the federal government has a major role to play with the province of Quebec when it comes to health care. It is set out in our Constitution. It is important.

For example, there are common indicators in every agreement with each province and territory. Now Quebeckers will be able to track the province's progress by consulting the data. Each year, there will be a report that tracks progress using common indicators. It is absolutely essential to be able to track progress using data. Personally, I feel that is very important.

It is also important to have the ability to share information and data with each government. When I speak with Quebeckers, and with all Canadians across the country, I hear that they want results and co-operation. They do not want bickering or debates about jurisdiction.

[Mario Simard, Bloc, Jonquière, QC]

Mr. Speaker, I would simply like to remind the minister that a Leger poll showed that more than 80% of Quebeckers feel it is important for the federal government to respect jurisdictional boundaries. Accusing others of picking fights is easy to do in politics. Every time someone raises an objection, it is enough to just say they are picking a fight.

I have a question for the minister. Can he tell me how many hospitals the federal government runs and how many surgeries it does in those hospitals? I would like to know.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, it is not the federal government's responsibility to run hospitals, but it is the federal government's responsibility to work with the Government of Quebec. It is odd. The member says that the federal government must give money and do more, but also that it must get out of health care. Those two things contradict each other. This is an obligation that we have across the country, not just with the Government of Quebec, but with every province and every administration—

[The Speaker, Greg Fergus]

The hon. member for Jonquière.

[Mario Simard, Bloc, Jonquière, QC]

Mr. Speaker, that is a very interesting answer. The minister just said that the federal government does not run any hospitals. He just said that the federal government has no expertise in the procedures performed at hospitals. In his previous answer to me, however, he said that we need data on the procedures being done in hospitals. He wants data on something that is not within his purview. The only thing the minister should do is transfer the funds requested by the provinces.

I would like to remind him that, during the last negotiation, all of the provinces asked that health transfers increase from roughly 23% for all provinces to 35%, which did not happen. The fiscal imbalance and the problems caused by health care underfunding, including fewer nurses and frontline workers, will persist because the federal government is determined to do what it does best, which is to meddle in a jurisdiction that is none of its business and create programs that make for good PR, yet deliver no help to the people of Quebec or the provinces.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, we need nurses, doctors, dentists and all sorts of initiatives in health care. The member starts out by saying that, but then he asks that the government not take action and that it jump ship. It makes no sense.

The government also has a responsibility under the Canada Health Act. We are responsible for ensuring that people across the country, including Quebeckers, can access the health care they need. The act is clear on this. It is our responsibility. We must not dictate priorities to the provinces, but we must work in a spirit of co-operation. That co-operation certainly exists with Quebec's minister of health. Mr Dubé is very responsible.

I absolutely respect Quebec's areas of jurisdiction, but we have a shared responsibility and I respect that too.

[Mario Simard, Bloc, Jonquière, QC]

Mr. Speaker, it is really quite astonishing. The minister just said that he respects provincial jurisdictions. However, when it comes to pharmacare and dental care, the Quebec government has repeatedly said that these are inexcusable intrusions into Quebec's jurisdictions. Not only are these inexcusable and unenforceable intrusions into our areas of jurisdiction, but the government is going to create a need, only to turn around and underfund it in order to get out of this situation and balance its budget, as it constantly does when it comes to health transfers.

I get the impression that the minister might not grasp all the nuances involved in health care, including the fact that it is a provincial responsibility. The federal government's only job is to transfer the money without getting involved.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, one thing is absolutely unacceptable and that is the fact that, for many years, people across Quebec have not had access to dental care. If the Government of Quebec wants to manage that program, I have no problem with that. That is doable, but it is absolutely essential that everyone in Quebec be able to access dental care.

Why is the member opposite not working with me toward that goal? Minister Dubé had no problem with that. Why does the member have a problem with it?

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Mr. Speaker, I will not be sharing my time. I will mainly be directing my questions at the Minister of Health. My colleague from Courtenay—Alberni will ask the Minister of Mental Health and Addictions some questions later.

The minister just gave all Canadians some good news, I think. Some 120,000 seniors have already received dental care. How many of them are Quebeckers?

[Mark Holland, Liberal, Minister of Health]

Mr. Speaker, there is good news.

Quebec has the highest take-up rate in the country. That is absolutely amazing. That being said, the regional statistics are not available yet, but they will be soon.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Mr. Speaker, I would also like to know the figures for British Columbia.

How many seniors have already received their membership cards and been approved for the program? Once again, how many of those people are in Quebec and how many are in British Columbia?

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, the take-up rate among dentists in British Columbia is quite high as well. I will check the figures for each region. I do not have them right now, but I will be able to provide that information soon.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Mr. Speaker, does the Minister of Health have, on the ministry website, a count-up clock so that all Canadians can see the number of people who are taking advantage of this new program?

Of course, the NDP, having worked hard to get this to fruition, are very proud of the pickup that we have seen in the first few weeks.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, in the first order, I want to thank the member and his caucus for their extraordinary work on this. I think it is exactly what Canadians expect us to do: to work together and to get results.

I think that is an excellent idea. It is something that we are investigating and something I know the member has raised with me before. I think it is important that Canadians be able to see those details in hard numbers.