Grant Hill

[Human Resources Development, March 28th, 2000]

Mr. Speaker, what we would like is for the rules to be followed in these programs. Let us listen to what the old HRDC minister said on October 9, 1997: “The Prime Minister has never lobbied or influenced me”.

We now have evidence that the PMO lobbied directly on this file. My question is simple. Was the old HRDC minister so worried that he had to protect the Prime Minister?

[Human Resources Development, March 28th, 2000]

Mr. Speaker, the Prime Minister intervened in the application for a grant made by a micro brewery in his riding. The financial experts said that the project was not cost effective.

Instead of canceling the project, why did the Prime Minister insist the grant be increased?

[Supply, March 17th, 2000]

Madam Speaker, to my physician colleague across the way, I think those are both very sensible suggestions.

First off, should the government be the one that delists services? In my view absolutely not. The delisting of services should be done by public input through professional bodies. The nursing and medical professions should certainly be involved. That is a very good and significant point. Of course delisting of services has been done without much input and I think in some cases very foolishly.

On the issue of accountability, the accountability in our health care system is not good. Here is my simplistic way of looking at it. As long as there is no interchange with the patient and the provider, it is free. There should at least be a bill presented to every patient for every service in Canada stating how much it costs, the date that it was received and the patient should sign for it. They would then look at the bill. They would have to pay one nickel of the bill. They would look at it and say, “An ultrasound costs $69.30 and I thought it cost about $5”. That is the sort of innovation on accountability which I think we need.

I think my colleague across the way knows full well that a lot of things are done in this medical system for legal purposes as well. I would like to address that.

[Supply, March 17th, 2000]

Madam Speaker, it is inaccurate to say that there has been no compensation planned for any of the victims. Half of the victims, those between 86 and 90, were promised a fairly substantial amount of money. Many were left out completely except for—and this is interesting—Ontario and Quebec have both provided provincial compensation for the victims who were left out.

The saddest thing to my mind is that this process had to go through what I consider to be legal wrangling rather than the way the compensation program was handled for HIV victims of tainted blood. There was no legal wrangling involved there. These funds were laid out and dispersed very quickly.

I have a couple of patients in my constituency who are so ill that I do not think they will see the compensation they have been promised. It is scant help to them to know that they will get some funds after they are deceased. It is one of those chapters in Canadian history that when it is all written down will be one of the saddest sagas in terms of our history. The regulators let these individuals down. The tests were available. Krever said that we should give them help. This is a dreadful saga in Canadian history.

[Supply, March 17th, 2000]

Madam Speaker, I thank the member for his question. I know he is as concerned about health care as are other members in the House.

Why do we have five specialists doing spinal fusion in Ontario? That is the real question. Why have we lost some of our best trained, most competent surgeons to Europe and the U.S.? The reason we have lost them is that the facilities we have here in Canada have fallen behind immensely. There are 1.1 MRI imaging facilities per 100,000 in Canada and 3.6 per 100,000 in Germany. This is a multifaceted concern. I would prefer to bring another five spinal fusion specialists to Ontario and set them up on this side of the border instead of on the U.S. side.

[Supply, March 17th, 2000]

Madam Speaker, this is a stakeholder driven issue in many cases. Specifically on the issue of what does the medical profession in Alberta, my association, think of this bill. They are split. They are asking for amendments to this bill to make certain that there are no concerns.

On the other issue of stakeholders, I will use a specific example of what is best for the patient. The nursing profession has a huge issue in terms of health care. Even the staff who clean the hospitals have a huge interest in this issue. If we just look at the administrative level, the hospital cleaners, and compare the hospital cleaning staff with the hotel cleaning staff who basically do the same job, the hospital cleaning staff is paid double what the hotel cleaning staff is paid. I only bring that up to say that we sometimes forget the patient and the patient should be the centre of our concerns on health.

[Supply, March 17th, 2000]

Mr. Speaker, thank you for giving me the opportunity to speak to the supply day motion. For those who are not really familiar with that, it is an opportunity for the opposition to set the topic of debate and to allow a firm vigorous debate on a specific issue. This is a Tory supply day motion asking for the federal Liberals to adopt a long term sustainable plan to address the crisis in health care.

Crisis is a strong word. It is not a word that I use lightly. Health care is under significant stress in Canada and having a debate on this issue is a good idea.

I listened to the Minister of Health today and he basically said that there is a plan in place. That plan requires some co-operation and some significant alteration so that we can have a sustainable health care system. Then he went on to say that funding was one component of that plan, innovation another component and co-operation the third component. I would like to talk about those three things one after another: the funding component for health care, innovation, and co-operation.

Where are we with funding? Figures can be used to disguise facts. On the issue of funding, the figure that matters to Canadians is the per capita spending on health in Canada which is lower in 2000 than it was in 1993 when the Liberals took power. They can take the figures any way they want.

Anybody listening to the Minister of Health today would have heard what he said about the federal share of publicly funded health care dollars. The figure that he took out of the document which he quoted was the federal share of publicly funded dollars. He said that the taxpayer funded component of health care in certain provinces that get equalization payments is relatively high. Every single province that he quoted was a provinces that gets equalization payments. He used figures as high as 60% plus in those provinces as the share of publicly funded dollars.

The figure that matters to the individual in the street is not whether equalization, other means, tax points and whatnot fund health care in the maritimes. What matters to Canadians is the share of per capita dollars that the federal government is spending. Is it spending a share that allows it to call the shots? In fact in much of Canada it is not.

The figure I am using now is the federal cash share of overall health care spending. In those cases it is down in the neighbourhood of 12%, 13%, 15% in those provinces that do not have equalization payments.

Those figures are in the document that the minister quoted from. I say let us stop fooling with the figures and let us talk about the one that really matters, which is the per capita expenditures of cash from the federal government.

Health care has a couple of other big problems. I will not ascribe blame on this issue. Waiting lists have grown. We have fallen behind in technology. We have an aging population. The minister has finally stated publicly that the status quo is not sufficient and on that issue we agree.

The issue of funding is one which the public needs to be aware of. The motion calls for sustainable funding. The motion calls for predictable funding. The motion calls for, in my estimation, some buildup of the funding as the population ages more and as inflation comes along.

I do not see anything of that kind of commitment from the federal government. In fact, none of the funds that have been promised in the last few years are certain. None of the funds are growing with inflation or with aging. They can be lowered and raised at will by the health minister, by the finance minister and by the Prime Minister. That is the funding component. Much of what we say in the health care debate is on the issue of funding. That is a component which needs to be discussed. I believe the funding needs to be predictable. I believe the cash funding needs to grow with both aging and inflation.

Innovation is the second big topic I want to address. The minister has said the status quo will not do and we agree. Stated very plainly his solution is that Canada needs universal home care and universal pharmacare. That is the minister's solution. This is the innovation the Minister of Health has specifically spoken of. He said to the provinces “Join us and we will pay 50% of universal pharmacare and universal home care”.

I remember the promises that came from a health minister which got medicare started who promised then “Join us in medicare and we will fund 50% of the cash needed for health care”. That promise was broken. In my mind, is there any wonder that the provinces are somewhat hesitant to go down this road when we already have visible problems with our health care system.

The third area I want to talk about is co-operation. The minister's own words were “We need to co-operate. We need to have a discourse on this that is free of partisan commentary”. Then he turned around and said that we need to get rid of any proposals that suggest two tier Americanized health care. That is a fair comment and one which I share. Two tier American style health care has no merit for Canada.

Let us look at the provincial efforts at innovation and co-operation. The provinces are ready to look at alternatives. In fact Quebec has been sending a number of its patients to the U.S. for cancer therapy. That is an alternative that has been looked at by Quebec. In fact B.C. has done exactly the same thing. That does not seem to me to be a made in Canada solution for our health care problems.

On the issue of public administration, one maritime province has chosen to administer its health care system with a private concern. This fits with the principles of our health act.

Alberta has recently brought in a proposal to contract out using taxpayers' funds for some overnight surgery. This is an issue that has received vigorous condemnation from many Canadians. The health minister's response to this has been an uninvited visit to Alberta where he made a speech at the University of Calgary and his words today “This bill is bad policy”.

What exactly is Alberta's Bill-11? I have a copy of it here and I have gone through it carefully. Without supporting or criticizing the bill, I think we should at least know what it contains. I will read from Alberta's Bill-11 so the Canadian public will know what is in it.

It is called, and this is an antithesis for all those who criticize it, the health care protection act. I am going to go over the bill not from some esoteric perspective, but I will read from the bill as to what it has in it.

It commits Alberta to the principles of the Canada Health Act, well known to anyone involved in the health care system.

One other big principle is that this bill makes it illegal to operate a private hospital in Alberta. The words are so plain that no one can misunderstand: “No person shall operate a private hospital in Alberta”. It goes on to define what a private hospital is by saying exactly what a public hospital is. Only public hospitals will be allowed to provide the full range of hospital services, including emergency rooms, diagnostic and medical services, and major surgeries. It sounds pretty straightforward to me.

It goes on to talk about what the bill is designed to do, which is to allow overnight stay for what has traditionally only been done in day surgery facilities. Specifically a surgical facility allowed under this procedure would only provide a limited range of surgical services. It would not be a full service hospital. It goes on to state that only the College of Physicians and Surgeons, my college, can decide what would be provided and only it can accredit these facilities.

One of the big concerns about a private facility doing procedures in any part of the country is that queue jumping could take place. This bill specifically makes it illegal to queue jump. It also makes it illegal to charge facility fees for insured services.

One other argument against a private facility doing anything surgical in Canada is upgrading. In other words for example, someone would come to that facility looking for cataract surgery. The cataract surgery would be upgraded and made more expensive. In this bill that is specifically prohibited. It is specifically prohibited with fines.

It goes on to say that if a person chooses to upgrade a service such as a fibreglass cast or foldable lens for cataract surgery, it must be in writing, the cost must be shown and a person must sign in full agreement. The person can back out if he or she changes his or her mind. It goes even further to say that if an upgraded product or service is the only thing that is available, it cannot be charged for. Finally, unlawful charges can be recovered under this bill on upgraded surgical services.

The bill goes on to talk about uninsured services that can be done and are done in every single province of Canada. These are things like plastic surgery and new technologies that are not accepted yet under our Canadian health plan. These must be done in compliance with the Canada Health Act in this bill. These must be done only with a demonstrated need to the regional district that has contracted them out. The health authorities have to show that the contract will not harm the publicly funded system. They also have to show how they will benefit the public system.

The other concern is that this sort of process might well invite out of country facilities to come in and take up this new proposal. The only way this could happen would be for the public to approve it through their government and the reasons for authorizing such a facility will be made public. Any contract would be made public.

In my view, this bill clearly and plainly lays out the mechanisms whereby short term, what has been day surgery, can have an overnight stay.

The minister himself on bill 11 has been asked plainly by the Government of Alberta to rule on whether or not the bill complies with the Canada Health Act. He said that he will wait until all the potential amendments are made and all the regulations are in place before making his ruling on bill 11. Members will note that he has not once said that the bill goes counter to the Canada Health Act. He has said that in his opinion it is bad policy.

I want to go over the clinics in the country that are already functioning under the very same proposals that are expressed here. We have new techniques in prostrate surgery that are not paid for under medicare. Cosmetic surgery, the plastic surgery, is not covered under medicare. Therapeutic abortions; every single private facility in Canada that does therapeutic abortions is doing it under this type of proposal. New radiological techniques, the exploratory techniques like biopsies using imaging that we did not have when medicare started and new forms of cancer therapy are not covered under our medicare system.

Bill 11, by my reading, controls and regulates these new innovative therapies and frees up, if it works the way I foresee it, some hospital beds in the regular hospital system which will have significant benefits to the public.

The debate on such an issue, if it persists being the opening for a two tier American style medicare, is in my view doing no service to the medicare debate. This debate is coming whether or not any politician likes it. If the debate comes, will this idea be reviewed, critiqued and improved, then watched to see if it is successful or not, and removed if it is not and expanded if it is? I am convinced that the European countries that have already done this with their taxpayer funded health care systems, which are the equivalent to Canada's, have already shown that there are risks, that there can be gains and that we should at least be innovative.

The health minister has said that funding is one issue, that innovation is another issue and that co-operation is the third issue. I would ask my colleagues, as we enter this debate, to do this not with these, if you will, old-fashioned buzzwords, but by actually looking at the issues and reviewing the legislation, if new legislation and new ideas come forth.

I will end my commentary with another little issue and that is the issue of hepatitis C. I do not often get an opportunity any more to raise that issue. The poor patients in my own part of the world who were infected by tainted blood, those who have been covered by the compensation program that was agreed to by the federal government, have waited two years now since the program was announced. They have not received a nickel. The lawyers have now been paid substantial amounts of money. I believe that is one other indication that the victims do not have a very strong voice in this place.

I urge my colleagues across the way, who have a more potent ability than I to bring these processes to an end and to see those victims compensated, to get the health minister off the excuse track and onto the let us get this thing finished track.

The legal route was not the best way to see those patients cared for. I will not belabour this and criticize any further but this issue deserves immediate attention and is long overdue.

I conclude by saying that the motion asking for sustainable funding that is predictable and growing with inflation and with our aging population is one that I personally support. I ask my colleagues to reflect on whether or not any of the funding that has been promised is in fact permanent funding or could it be withdrawn at the whim of the health minister.

[Highway Accident In Saint-Jean-Baptiste-De-Nicolet, March 17th, 2000]

Mr. Speaker, the pictures of yesterday's tragic highway accident near Nicolet are horrifying and terribly sad. Seven young children lost their lives in this terrible accident and others are in serious condition.

Accidents like this, particularly when the victims are so young, remind us just how precious life is.

There is nothing more painful for a parent than to lose a child and nothing can fill the void left within the family. Our prayers and thoughts are with all the survivors, as well as with the families and friends of the children who lost their lives. We extend our deepest sympathies to them all.

[Supply, March 17th, 2000]

Madam Speaker, one of the figures that is really difficult to argue with is the percentage of spending per capita. That is the figure that is accurate and reproducible.

I wonder if the minister would, from this document, because these figures are in this document, go to 1993 and look at the federal cash contribution per capita in Canada and compare that with the same figure, the cash contribution from the federal government per capita today. Those are the two figures that tell the tale. Because those figures are in that document, I ask the minister if he would present them to us.

[House Of Commons, March 16th, 2000]

Mr. Speaker, that does cut to the heart of the issue. It would in fact make me reticent to use legal counsel in the House. It would make me consider carefully going outside the House for legal counsel. I think it would be a shame if our legal counsel withered away, because surely they have the experience, they have the background, they have the abilities to look at all the legislative things in a way that legal counsel normally would not do.

I personally would be very uncomfortable having the two sides reviewing legislation in that way.