Mr. Speaker, I rise in the House today to speak in favour of the motion presented.
On March 27, 1998 the federal government, the provincial governments and the territorial governments announced financial acceptance and assistance to people infected with hepatitis C during the 1986 to 1990 period. Yesterday the Government of Ontario offered compensation for pre-1986 individuals and is exploring possible legal avenues to require the federal government to meet the responsibility for its share of the total hepatitis C costs.
The provinces, territories and the Red Cross were the operators of the blood system in the 1980s. The provinces and territories are also responsible for the operation of their health insurance plans and the delivery of health care services. The federal government is the regulator of the blood system. This role has recently been confirmed and clarified by Justice Krever in his final report. In addition, the federal government has taken a leadership role in rebuilding what was clearly a flawed system by acting to ensure the emergence of new forms of governance in this area and new forms of risk management.
In addition, far from abandoning its responsibilities in the area of blood and blood system management, the federal government has taken a leadership role in negotiating the emergence of a new blood system with a new governance structure. As part of this effort, the federal government felt a responsibility to turn its attention to the issues of the past. Following the release of the final report of the Krever commission, it took upon itself the role of leading the settlement of hepatitis C claims in the 1986 to 1990 period.
In doing so it moved to accelerate the settlement of claims from victims for this period and to smooth the transition for the new blood system. This government has been consistent, forward thinking and diligent in its efforts both to help victims and to reassure Canadians about the future of the blood system.
In redesigning the system and in dealing with the issue of hepatitis C, the government has had the benefit of many conversations with consumer groups and others. There has been extensive consumer involvement in both processes. The Minister of Health has met on many occasions with representatives of groups such as the Canadian Haemophilia Society and the Hepatitis C Society of Canada. These consultations have been a source of many new ideas. Their importance has been recognized in the decision to involve consumer groups in the negotiated court approved settlement process announced on March 27. As a government we will continue to do so in the interests of all Canadians.
I want to speak about the New Zealand experience. New Zealand has a no fault accident compensation scheme. It came into force in April 1994 and the relevant act was amended in 1982 and again in 1992. Originally the scheme compensated for all injuries resulting from any accident without any regard to fault, including medical misadventure. While original the no fault scheme was relatively generous, in 1992 it was changed. Amendments were introduced to exclude hepatitis C infections from the list of compensation events because it did not meet the standards established for medical accident or something that was severe within a period of mishap and therefore rare.
In the same year changes in program administration led to lump sum awards being replaced by an independence allowance for non-financial losses of up to $38 Canadian per week tax free.
The New Zealand Hemophilia Society obtained an extension for hepatitis C claims until June 1995 but as of that date New Zealand's no fault scheme no longer covers hepatitis C infections.
I draw the attention of the House to the independence allowance cited above, in particular the $38 per week. This is not a large amount of money. No fault schemes like this one strike a balance between the range of conditions that can be factored into the scheme and the affordability of it. In the evolution of New Zealand's scheme awards, though they cover a range of conditions they became small and common types of mishaps with gradual onset and chronic impacts like hepatitis C and have therefore as a result disappeared from that scheme. We should perhaps take this history of New Zealand into account.
Equity requires inclusiveness and inclusiveness limits affordability unless benefit levels are driven down to very low levels as in New Zealand's case.
When equity is put aside and the focus is only on the specifics of a particular diagnosis, there is capacity to contemplate higher level awards as in the case of Ireland. Sooner or later a scheme that runs on these grounds will face the challenge of its own internal inconsistencies, and there will be a tendency to drive out certain specific high cost conditions by redefining the basis on which the no fault scheme applies.
At the end of the day, unless policy and program are carefully designed, one is left with a no fault scheme that applies to severe and rare conditions and is characterized by benefit levels that are small marginal add-ons to income. We need to note that is certainly most important.
While Justice Krever documented these various scenarios in some detail, his report contains little analysis of the incentive structures around the world with both for cause and no fault schemes.
Canada like most other countries has much more experience with for cause schemes than with no fault schemes. While there are many calls to reform the justice system, the details of tort law are sufficiently worked out that courts can render justice when cause and effect are well defined.
The federal government and its partners in the March 27 announcement placed relevance on just these processes to render justice in a very sensitive area. As to no fault, there are serious and important issues of equity that will have to be addressed in this area before a sustainable scheme can even be possible. Doing no fault on the fly is a recipe for disaster, I would suggest, especially in the medical area.
Even in New Zealand where it gave no fault a sustained effort, the problems have been numerous and the administrative difficulties immense over the years.
If Canada is to proceed down the no fault route it must be on the basis of a sustained debate about the merits of no fault in many areas and a careful analysis of the many implications that no fault carries. We will not head up the blind alley New Zealand has travelled, at least I would hope not.
Today in New Zealand commentators are pointing ironically to Canada as an example of how things could have been done differently on hepatitis C. Canada's leadership has been recognized abroad.
One of the most important parts of the national debate about blood has been the involvement of consumers in the process. Their input remains critical to the refinement of our policy. Ministers in this government, especially the Minister of Health, had extensive consultations with representatives of groups affected by the blood crisis, as did ministers in other jurisdictions.
The consumer perspective was an integral part of the process of negotiation and consumer representatives were apprised of developments throughout the process. Representatives of groups such as the Canadian Hemophilia Society and the Hepatitis C Society of Canada met regularly with a variety of politicians and their views were fed into the process at various points. This will continue. It will be an integral part of the process and I support that.
The blood system is ultimately about people, altruism and equity, not federal-provincial relations, not partisan politics, not political advantage. As soon as we come to realize this we will all be better off.