moved that Bill C-284, an act to amend the Canada Health Act (conditions for contributions) be read the second time and referred to a committee.
Mr. Speaker, I am in the happy position today of being able to report to the House that a great deal of progress has been reached on this issue since I introduced this private member's bill. I understand that a protocol such as this bill would have provided for is more than just in the works. There may even be a document outlining the protocol in circulation for comment, although it is hard to pin that down.
I thought the best thing I could do at this point is give a bit of a history of the development of this issue leading up to the present and a few words about where I think it should go now. I thank the hon. member for Hamilton West for seconding the motion.
Many members of the House will be aware that firefighters have been lobbying for a long time for a national contagious diseases reporting protocol. They have their annual lobby on the Hill and they meet with many members of Parliament. This is one of the three or four items they have been stressing for a number of years now.
Firefighters and other emergency responders have been concerned about developing a protocol so that they could be informed if they were likely to have been in contact with a contagious disease in the course of their work and provided with the appropriate medical treatment and counselling in the event of exposure on the job.
In February 1992 NDP labour critic Joy Langan, the former member for Mission-Coquitlam, introduced a private member's bill that found an elegant solution to the constitutional problem which had presented itself with respect to this issue; that this was regarded as being in the provincial jurisdiction.
Her bill would have amended the Canada Health Act to make it necessary for provinces to set up their own protocol if they were to receive federal health funding. The idea was to use the federal spending power in health to establish a contagious diseases protocol in exactly the same way the federal spending power was used to establish medicare nationally and to establish other conditions for the receipt of federal transfer payments for health care. In effect the establishment of this kind of infectious diseases protocol would have been another national standard, so to speak.
Although the bill was never debated in Parliament there was all-party support for the idea among members. After negotiations the NDP at that time managed to get the matter referred to the Standing Committee on Health and Welfare.
The committee held hearings in early 1993 and tabled a report in June of that year. The committee recommended, among other things, that the federal government "encourage the provincial and territorial governments to develop and implement within their jurisdictions a protocol for post-exposure management and follow-up of emergency response personnel exposed to airborne and blood borne diseases". It asked the government to report back to the committee in one year on the progress in establishing such a protocol. This amounted to a substantial endorsement of the principles of Joy Langan's bill.
Although it was too much to ask that the federal bureaucracy actually fulfil the one year deadline set up by the committee, in September 1994 the Liberal government did hold a national symposium on infectious diseases and emergency responders which I attended in part as an observer in my new capacity as the NDP labour critic.
The symposium brought together provincial and federal officials as well as a wide range of stakeholders among emergency responders. The symposium heard very good reports on the development of a protocol in the province of Ontario in which an NDP provincial government at that time, responding to firefighter concerns, had taken the initiative. There was a lot of enthusiasm for its development and application in other provinces and territories.
I say with some pride this was not the first time an NDP provincial government led the way on such issues. By taking the initiative and by doing the pilot project it put pressure on other provinces and the federal government to do likewise. While we are talking about the Canada Health Act this is how we got our publicly funded health care system in the first place, medicare, when the Saskatchewan NDP government of many years ago did a similar thing in the sixties.
I tried to add to the momentum building for a national protocol by tabling a private member's bill early in this Parliament. It was very similar to Joy Langan's but added a section that would have improved the privacy concerns about the release of private medical information. That was one of the concern's about Joy Langan's bill tabled last Parliament.
Even with all this momentum building toward a national protocol, the two private members' bills by NDP members, reports by a House committee and a national symposium and the Ontario protocol, it appeared that in May the government was backing away from a national protocol. I remember asking the Parliamentary Secretary to the Minister of Health about the government's intentions in this regard. She appeared at that time to be washing the government's hands of the issue and she answered me only that health was a provincial responsibility, and that was the end of the matter.
However, the International Association of Fire Fighters, to its credit, kept up the pressure and in June of this year a meeting was held between federal and provincial health officials and other stakeholders in which a national protocol was agreed upon. I have yet to see the final version but it is my understanding the International Association of Fire Fighters was very satisfied with the results of that meeting.
What I understand to have happened between then and now is the federal and provincial governments have agreed to a protocol that would allow emergency workers to learn of any health risks they may have been exposed to in the case of significant exposure to blood borne infectious diseases.
I understand the agreement has built-in protections for the confidentiality of patients' medical records, setting up a procedure through which emergency response personnel who have had significant exposure to blood can contact the local medical officer who in turn seeks information from the hospital on behalf of the affected emergency personnel.
In June the federal government said it would release a document by mid-October. I understand from conversations I have had with the firefighters as recently as Friday that this has not yet been done. I also heard from officials in the health minister's office that at least they think there is a document in circulation for comment.
At this point in the development of this issue there seems to be some confusion. Perhaps whoever is speaking with the knowledge of what goes on inside the government today can clear this up. People feel progress has been made. It certainly appears progress has been made. We had the successful meeting in June, the agreement on a protocol. Firefighters have an understanding of what that protocol will be like. However, there is still no document which outlines the details of that protocol so that firefighters and others like me would be able to respond with some knowledge of what has actually been agreed upon and what the details are.
It would have been nice if that document had been released and in an obvious and available kind of way in mid-October. On the occasion of debating this bill we would have been able to talk about the details of the bill. If there were some constructive criticisms to make they could have been made here or they could have been responded to here. However, we are not in that position now.
Unfortunately with these kinds of things we will not be in this position ever again because the bill will be debated only for this hour; it is not a votable bill. Frankly, given there is this kind of progress, unless we are all being mislead in some way there is really no need for the bill to go to committee or for it to proceed. We do have a protocol but we are not able to comment on the details at this time. I invite members opposite who may be in the know to say more about this.
I do not mean to single this out for special praise or commendation, as there are others, but it is an example of how through the private member's process an issue can be advanced, an issue can be pushed, an issue can be kept on the agenda. Eventually the government finds itself in a position to respond because it feels it has to or it finally becomes convinced of the need to respond or it is one of those mysterious political democratic things where at a certain point something becomes acceptable and doable that seemed very difficult to accomplish only a short time ago or yesterday, as one hon. member has said.
I am very glad to see there has been this kind of progress. It is preferable to have happened in this way. We are in a debate now about the imposition of national standards and conditions through the use of federal spending power through the Canada Health Act. It probably would not have been the preferred route given the current political and constitutional climate, shall we say, to have invoked the Canada Health Act as a way of achieving this. Although if push came to shove that procedure was there and that was a way to have the federal government seized of the issue and putting the government in a position where it could not say there
was nothing it could do because this was matter of provincial jurisdiction.
I think federal spending power ought to be used in areas where it is important to delineate and to enforce national standards. In that respect I am sure I have some disagreement with some of my colleagues in the House.
I am attached to the Canada Health Act. I was here in the House when it was passed in April 1984. I was a member of the health and welfare standing committee which studied the bill. There are amendments and phrases in the bill which I moved myself. In my political judgment, the bill owes its existence in part to the pressure which we brought to bear on the government between 1980 and 1984. In fact, in her book Medicare in Crisis Monique Bégin openly credits the NDP for the role it played in pressing the government to bring in the Canada Health Act.
I raise all of this because now there is a different third party in the House, our Reform Party colleagues. I often see a stark contrast between what we called for when we were the third party and there was a Liberal government and what the Reform Party is calling for. We said to bring in the Canada Health Act and to eliminate user fees and extra billing. Now the third party in the House is saying: "Get rid of the Canada Health Act and let us not have national standards any more. Let us permit the provinces to do what they will". There are two competing visions of what is a national government.
One of my concerns today as we contemplate the vote in Quebec, is that regardless of the outcome, if I hear the Prime Minister and others correctly, even if there is a no vote we are on the verge of major decentralization. I urge my Liberal colleagues, no matter what changes may be undertaken in response to a no vote by way of decentralization, that what we achieved together, the NDP and the Liberal government at the time, on the Canada Health Act and the notion that when it comes to health care there are values, procedures and standards we all hold in common as Canadians wherever we live from coast to coast to coast, be held up and not surrendered in the wake of a no vote.
