Bev Desjarlais

[Supply, May 11th, 2004]

Mr. Speaker, a colleague was chattering behind me saying “sports, sports”. Therefore, I say to my colleague, it has been mentioned that the involvement of young people and certainly all people in physical activity does improve their health.

I am the seniors critic. I am someone who has met with a number of seniors and quite frankly, I am someone who is on that doorstep, but I am not quite there. I actually do agree that it is crucially important that seniors and others have the opportunity for recreational activity. There is a severe lack of facilities for seniors in our system. It is crucially important that more infrastructure dollars go toward that. I would like the hon. member's comments on the recreational opportunities for seniors.

[Supply, May 11th, 2004]

Mr. Speaker, I know my colleague mentioned the lack of adequate services for disabled people within the health care system. In listening to what a number of Liberals have said, we would probably get an argument that the Canada Health Act does not specifically say that we have to provide those kinds of services. Maybe they are not medically necessary or they are not mentioned in the Canada Health Act.

There is certainly an understanding among most Canadians that when types of services are needed, we expect it to be delivered. How would she respond to some of the comments that came from the Liberal side about only reflecting what is absolutely in the Canada Health Act, somehow leading to a misunderstanding of what they see as medically necessary?

[Health, May 11th, 2004]

Mr. Speaker, if I were a Liberal MP being told by the Earnscliffe boys to pretend there is a big difference between the Liberal health policy and the Conservative health policy, I would be a bit nervous with a Liberal health minister who has no opinion on the growth of private, for profit delivery over the last 10 years.

Let us try another simple question. In the 1997 red book, the Liberals promised a pharmacare plan, but seven years later we are still waiting. Can the health minister explain why the Liberals chose to spend $100 billion on tax cuts instead of keeping their promise to help Canadians with prescription drug coverage?

[Health, May 11th, 2004]

Mr. Speaker, my question is for the Minister of Health. Given that the Liberal strategy is to yet again try to pretend there is a big difference between its health care policy and the Conservatives' health care policy, I am sure the health minister can answer a very simple question. However, I predict he will not answer a very simple question, because the real difference is between what Liberals say and what they do, but let us see.

Does the health minister condemn the growth of private, for profit delivery of health care that we have seen since the Liberals took office in 1993, yes or no?

[National Nursing Week, May 11th, 2004]

Mr. Speaker, May 10 to 16 is National Nursing Week.

Nursing Week is celebrated each year throughout Canada and the world during the week of Florence Nightingale's birthday of May 12. This week is an opportunity for all Canadians to express their gratitude for the hard work and important role that nurses perform, and also for the courageous manner in which they expose themselves to the risk in the provision of essential nursing care such as during last year's SARS outbreak.

While this week offers all the opportunity to recognize the vital role nurses play in our health care system, we should respect the contribution of nurses and other health care workers year round by ensuring proper funding, and fair and equitable employment conditions.

It is an outrage that we as a country continue to face significant shortages of nurses due to a decade of funding cuts to our health care system, coupled with the continued lack of a coherent strategy for stable funding from the federal government.

I would like to take this opportunity to thank all Canadian nurses for their hard work, often above and beyond their assigned duties. It is through their dedication and sacrifice that our health care system continues to be one of the best in the world.

[Supply, May 11th, 2004]

Mr. Speaker, it would be great if the government as a whole would make that statement and put some effort into ensuring that private for profit does not become the battle cry of the next election between the two parties.

My colleague mentioned a number of things. I just want to clarify some of those things with him.

He mentioned that the Canada Health Act did not envision all the things we are dealing with today within the health care system. That is absolutely true. I do not think people envisioned the rate of increase in new technologies and the increased costs being incurred by patients and the health care system. That is why we in the New Democratic Party have no problem looking into the Canada Health Act again and ensuring that it now addresses what Canadians see as their wish for a health care system.

The Liberals have in the past acknowledge that and promised in their last red book to implement pharmacare but here it is, seven years later, and we still do not have pharmacare. The Conservatives say that they will stand behind providing a pharmacare program. I am sure the Liberals will come out saying that as well but the reality is that it is not here.

My colleague also mentioned that some services would not be covered unless one was in an accident. I think this is the same in all provinces, but certainly within the province of Manitoba if there is an accident, whether it is a car accident or a work related accident, which is workman's compensation, it is a third party billing process through the health care system. These should not be dollars coming out of the health care system but as a third party liability.

However those costs often do get incurred by the health care system when, by rights, they should be handled by different service providers. That is already in place. I firmly believe that if it is a workplace injury it should be covered under workman's compensation.

I also want to comment on the fact that there is a schedule of payment for services, certainly within the province of Manitoba, and I would think the same in other provinces, where there is a maximum amount that can be paid for a particular service that a doctor performs.

If it is necessary to change the Canada Health Act to reflect the changing needs within the health care system so there is no longer the need for long hospital stays, as he said, and to provide medications when a person leaves, should we not be addressing those changes and including them within the health care system?

[Supply, May 11th, 2004]

Mr. Speaker, I challenge my colleague's figure of 90% of clinics operating on a for profit basis in Canada. I would love to see those figures because I find them hard to believe.

Can proof be presented that the delivery of health services through private clinics already in place will deliver 14% to 15% less cost to the taxpayer? Let us say the provinces make a decision to provide this through public delivery because it will be cheaper. Will my colleague acknowledge that this is what we should do with taxpayer dollars? Will he agree that we should use that other 14% or 15% to enhance services elsewhere, whether it be to provide more home care, or respite care or other types of health care services? Is that not a better utilization of taxpayer dollars than giving that 14% to 15% to for profit providers?

[Supply, May 11th, 2004]

Mr. Speaker, I will to allude to the fact that obviously my colleague from Mississauga South has a hard time understanding some the processes within the motion.

Without getting into that, I agree that patients want to be able to access the health service. Does the Conservative member believe that we should have a for profit system of health care delivery? My colleague from Mississauga suggests that when a doctor provides his services, that it is for profit. He is being paid to provide the service.

The for profit comes into play when a clinic operates so that there is a profit overhead apart from the cost of the physician's services or a nurse's services, or whatever. There is profit built into the equation, and the facts show that profit is usually around 15%.

Does my colleague believe that Canadian taxpayers should be paying for a for profit health care delivery?

[Supply, May 11th, 2004]

Mr. Speaker, I do not think there is any question that there may be cost savings within the health care system and that there needs to be some reform. I think Canadians have said loud and clear that they want the federal government to take a lead role in ensuring that the services are provided nationwide. The government will have to work out that partnership arrangement with the provinces.

In trying to clear the air on exactly where the government and members of the government stand, do they think it is all right to provide for profit delivery of health care services?

[Supply, May 11th, 2004]

Mr. Speaker, there is no question that governments are trying to promote the whole P3, the public-private partnership, approach as an answer. There is also no question, in my mind, that the reason they are doing this is so those dollars will not show on the books. The reality is that the Canadian taxpayers will ultimately pay more out of their pockets. That is the one thing they fail to mention when they talk about this. Over the long term, it will cost the taxpayer more and, quite frankly, it will be a lot more.

The same scenario will show in toll roads. It will show in the partnerships. In the building of hospitals, schools, any of those things, it becomes a much greater cost. The government can get away with saying it does not owe this much money because it is not on the books.

I just want to mention a couple of things that happen with the private for profit providers. Investors expect 15% profits annually. This is a U.S. survey. We do not have all the comparisons within Canada because no one has bothered to go ahead and do that. I mentioned already the significant time and money that has to be put into strategies for defence, marketing, insurance administration and bill collection, which drive up the costs.

There is also a necessity to compete. Imagine one hospital or one clinic competing with another so it gets all the business and, as a result, it increases the cost because there is a duplication of services.

Here is the clincher, and I do not think many people out there will doubt this any more, the prevalence of fraud among for profit providers in the U.S. has become a major cost factor. The cost of monitoring, suppressing and prosecuting such behaviour has become part of the administrative overhead associated with for profit providers.