Madam Speaker, I also rise to speak on the subject of private member's Bill C-202, an act to amend the Canada Health Act.
Given the respective roles and responsibilities of the federal and provincial territorial governments in the area of health care, I believe that amending the Canada Health Act may not be the best approach to address the concern of our hon. colleague.
As you are already aware, under the Canadian Constitution, the responsibility for health care lies with the provinces and territories. In other words, the provinces and territories are responsible for administering and delivering the health care that is available to Canadians.
This means that the provinces and the territories act as planners, managers and administrators of their own health care systems. In practical terms, this includes negotiation of budgets with hospitals, approval of capital plans and negotiation of fee agreements with medical associations.
The federal government, for its part by law, is responsible for the promotion and preservation of the health of all Canadians. Health Canada is responsible for bringing together parties on health issues of national and interprovincial concern.
The federal government also assumes the responsibility for setting national policies and for providing health care services to specific groups such as treaty Indians as well as Inuit. It is appropriate when describing federal responsibilities in health care to note what the federal government cannot do.
It cannot interfere in provincial territorial responsibilities as defined under our Constitution, nor can it be seen to be infringing on these responsibilities.
Bill C-202 attempts to require provinces and territories to provide nutrition service on an insured basis. As it is the provinces and territories that are responsible for matters dealing with the delivery of health services, to require that nutrition services be added to the list of insured health services would be perceived as an unacceptable intrusion on the provincial territorial responsibilities under our Constitution.
The federal government cannot and should not act unilaterally in an area of provincial jurisdiction. Any decision to extend the scope of the Canada Health Act requires extensive consultation and support from the provinces.
In 1984 concerns over hospital user fees and extra billing by physicians led to the passage of the Canada Health Act. This was achieved with all-party support. The federal government's aim in passing the Canada Health Act was to reaffirm its commitment to the original guiding principles expressed in the earlier legislation.
It was also to provide a mechanism to promote the provinces' and territories' compliance with the act's criteria, conditions and extra billing and user charge provisions.
In short, the purpose of the Canada Health Act is to allow Canadians reasonable access to necessary prepaid health services.
The provinces and territories have retained the responsibility of administering their health insurance plans under the Canada Health Act and for managing their respective systems. The management of health care personnel and related issues, such as the one proposed in Bill C-202, is also their responsibility.
The criteria of the Canada Health Act are known to most Canadians and regarded as the defining principles of medicare. The principles of public administration, comprehensiveness, universality, portability and accessibility are valued and cherished by Canadians who will not accept changes to them.
Poll after poll indicates great public support for these national principles. Even while discussions of health care reform are taking place, the values which are reflected in each of these principles are not being debated.
Provincial and territorial ministers of health share this support. We know that Canada's health care system needs to be modernized to ensure that all Canadians continue to have access to needed health services. This is of particular importance as delivery methods, as well as venues, change over time. However, governments at all levels have articulated their support for the five principles of the Canada Health Act.
Regardless of the reforms currently taking place, the principles of the Canada Health Act remain the cornerstone of our health care system.
I would like to reiterate that the provinces and territories may, at their discretion, provide insured services other than those covered by the Canada Health Act. Nutrition services may be offered as complementary health services.
Although the objectives of Bill C-202 have merit, to pass this bill would disrupt the historical distinction and balance between federal and provincial jurisdiction. It would infringe on the longstanding federal and provincial territorial relationship that has facilitated the creation of a health care system that is widely cherished by the Canadian public.
For this reason, although I recognize the value of nutritionists across Canada, this bill cannot be supported by the federal government.