Grant Hill

[Tobacco Products, March 19th, 1997]

Mr. Speaker, there is no doubt the government's role in manipulating nicotine levels in cigarettes is plain. Agriculture and Agri-Food Canada funds the scientists and the tobacco companies tell them what to do.

Did the health minister know this was going on and why did he not stop it?

[The Budget, March 18th, 1997]

Mr. Speaker, I will be splitting my time with the hon. member for Edmonton Southwest.

Each time I stand to speak on the budget, I try to judge it from the perspective of the last little baby I delivered before I came to the House of Commons. Zachary was a cesarean section and he was my last enjoyable duty in the hospital. When he was delivered, Zachary owed the federal government a debt of $16,400. Lightheartedly I tell my patients that when I was taught to deliver babies, to make them cry I patted them on the bottom or patted them on the feet. I made Zachary cry when I whispered to him that he owed the federal government $16,400. The poor little guy blubbered for a week.

Today Zachary, who is almost four years old, owes the federal government just under $22,000, as does every man, woman and child in Canada. I find that unacceptable. I have listened to cheer leading on this issue from the other side. I would like them to face Zachary. I would like members opposite to sit down with Zachary and explain to him that on his behalf they spent his money. They did not ask his advice, they did not give him any choice in the matter. Every grandma, every grandpa, every parent and every child in Canada today should sit down with this cheer leading crew across the way. I would like to give them that opportunity. I guess they will get the opportunity in the upcoming election and I relish that opportunity.

What does the budget document say on health care? It follows on a promise in the red book that medicare would be protected and a National Forum on Health to make sure health care is going in the right direction. The national forum presented its conclusions not so long ago, and its conclusions were trumpeted far and wide. There is enough money in the system. Use the money more efficiently. Improving the health of our children is a wise investment. Those were the things that were headlined across this land.

However, a little issue was missed. When they said there was enough money they also said there needed to be this cash floor of $12.5 billion. The forum presented information which was fairly liberal. They never did say that the floor, according to the government of the day, was going to be $11.1 billion. There is a discrepancy. It is a little discrepancy. It did not get much play in the press. I do not know why. I can only guess.

In the budget document on sustaining and improving our health care, I found a reinvestment in medicare. There is a reinvestment of $300 million over the next three years to be used for new initiatives. Here is how that $300 million will be spent.

Over three years $150 million will be spent for new projects in home care and drug coverage. Interestingly enough, the health minister seems to glom on to some of these. He wants to direct them to his riding.

There will be $50 million for a health information system; computers to follow and judge whether we are doing the right things in health care.

There will be $100 million in increased funding for community action for children.

That is great. That is $300 million over three years. I saw the headlines: "Good news from the protectors of medicare". I ask a simple question. Do they think all Canadians are stupid? Does anybody not remember the $3.9 billion in reductions to medicare that are coming in the next three years? Only in light of today's government could we have a $300 million reinvestment in medicare offsetting a $3.9 billion reduction.

What are the results of those reductions? We heard them not so long ago in Ottawa where there were major hospital closures. We heard them as well in Toronto where there were major hospital closures. A couple of weeks ago Alberta confirmed that the General Hospital would be closed for good. There are hospital closures in the maritimes. There are hospital closures in Saskatchewan and Manitoba. In Quebec there are hospital closures. Il y a la fermeture des hôpitaux là également.

Waiting lines are on the rise for urgent, non-elective care. We are falling behind in technology. We have 1.1 MRI machines in Canada for 100,000 people and in Germany they have 3.4.

Here is what Canada's nurses say about the budget as it relates to health care. This is not partisan, political stuff, this is from Canada's nurses: "In the 1997 budget the federal government has thrown away a valuable opportunity to demonstrate its supposed support for Canada's publicly funded health care system. Federal cash transfers for health will now decline until the next century, despite the fact that the finance minister's target of spending no more than 9 per cent of GDP on health has been reached. The federal government has stated that it unequivocally supports a publicly funded health care system, but is failing to provide the funds to genuinely support this system".

Canada's nurses are not politicians. They are the people who deliver the services. That is what they think of this budget.

It is always easy to criticize. I do not believe in criticizing without presenting solutions that are different. What would Reform do differently during the same three year period when we are going to have $3.9 billion taken away and $300 million given back?

Reform would reduce the deficit to zero by changing both the size and the function of the federal government. It would reduce grants and subsidies to business. It would take selected crown corporations off the public purse completely. It would reduce international aid while Canada is broke. It would rip up the MP pension plan which is grossly unfair. Reform would do all this to pump $4 billion per year back into medicare and secondary education. It would do that to repair the Liberal damage and the damage of those cuts.

The results will have Canadian nurses smiling again.

The national forum on health would have its $12.5 billion cash floor. Most important, the patients who are today waiting in lines with inferior equipment and in pain would be treated sooner. There is actually choice on the scene today when it relates to medicare in Canada. It is an alternative to the old view of the Tories, the Liberals, the NDP, of big government, big programs, big spending and big taxes. It is called the fresh start.

I will give a couple of examples of wasteful spending specific to health care because they lie in the riding of the Minister of Health. Here are some examples that Reform would get rid of: $122,654 for golf carts in the health minister's riding paid for by the taxpayers of Canada thanks to you know who; $33,000 to the Cape Breton Yacht Club. Yachters need that money according to the Minister of Health. What did Nova Scotians ask for instead? They asked for the emergency department at the Windsor hospital to be left open. They asked that the Wolfville hospital not have to charge patients for bandages, syringes and painkillers, which is what is happening today.

To my colleagues across the way when they cheerlead about this budget and the results that they have seen, I ask them to remember Zachary, the little boy who has gone from $16,400 indebtedness to the federal government to just below $22,000 in the course of this Parliament's sitting. They are happy with that performance. I am not. I look forward to meeting with them on the platform to specifically ask them to look into Zachary's eyes. If I were in their place I could not.

[Tobacco, March 17th, 1997]

Mr. Speaker, I disagree. I will quote a research arm of this government. This is what the research is doing: "Overall these lines have improved yield and grade quality and will contribute greatly to the economic well-being of who? The tobacco companies".

The new tobacco bill has a proposal in it that would allow this government to control nicotine levels. We thought, frankly, that it would lower it. What has it done? Research that will raise it.

The tobacco companies lost the battle on ads. It looks like they have won the war on addicts. Why?

[Tobacco, March 17th, 1997]

Mr. Speaker, the tobacco companies say they do not manipulate nicotine in tobacco products. We have found out that they do not need to. Agriculture Canada is doing that very thing by searching out and researching strains that raise the nicotine level in those strains.

The Liberal government is directly implicated in this search. Why the double standard?

[Hospital Closures, March 7th, 1997]

Mr. Speaker, maybe the health minister could then explain how Harris has cut the hospital beds in New Brunswick, Nova Scotia, Saskatchewan and Alberta?

These cuts are the direct responsibility of the Liberal government. Maybe the health minister should listen to what Dr. Tony Wade, president of the New Brunswick Medical Society, thinks about the Liberal's attack on health care. He stated: "I don't need a dictionary to know that they spell abandonment".

Can the health minister tell Dr. Wade of New Brunswick why the Prison Art Foundation gets $100,000 that should go to the hospitals in New Brunswick? Explain that.

[Hospital Closures, March 7th, 1997]

Mr. Speaker, this week I had occasion to visit two of the Ottawa hospitals that are slated to close, the Montfort and the Riverside.

In the case of the Riverside, it is closing because the Liberal government chose to give its entire budget, $97 million, to a corporate buddy, Bombardier. How can the government possibly justify its choice of corporation subsidies over Canadian hospitals?

[Criminal Code, March 6th, 1997]

Mr. Speaker, I have listened to the speeches today and I must admit that the arguments are seductive. I listened to the member for Burnaby-Kingsway say that very few people in Canada would require these mechanisms.

I have up to date research from a country that has practised euthanasia and assisted suicide. This study from the Netherlands is brand new research which I received last week. This discussion has engaged the Netherlands for some 20 years. Although it is not legal, for about 10 years in the Netherlands there have been no sanctions against euthanasia and assisted suicide, if certain criteria are met. These are the criteria that the Netherlands required for euthanasia or doctor assisted suicide to take place.

It must be voluntary. It must be a well informed, well considered request. There must be a persistent wish to die. There must be in the patient intolerable and hopeless suffering. The procedure requirements are such that another physician must be consulted so that not just one doctor is involved. Finally, a report of the case must be sent to the coroner's office. Those are the tight, nice strict criteria that doctors in the Netherlands must follow.

What has happened in Holland? I am going to be selective in the information I give here. The information is quite vast. About 2,000 people per year have been euthanized in the Netherlands following those criteria supposedly.

In the survey of the family physicians in this study it was found that 9 per cent of those individuals had on one or more occasions deliberately terminated the life of a patient without the patient's explicit request. Let us round out the figure to 10 per cent. About 200 people per year are euthanized in Holland, and I am being very specific, without the patient's consent.

One of the first criteria for euthanasia was that it must be voluntary, then well informed, then well considered, then a persistent wish to die, intolerable and hopeless suffering. For 200 people in Holland none of those things existed. A physician, by himself or herself, decided that the quality of life was no longer worth living. It is the only country in the world where there is this sort of experience.

I believe that the criteria were well meant, were well discussed, were well laid out and failed. The colleagues of mine in the Netherlands who debated this, set down very strict criteria. They failed. They flopped.

I am going to give two examples of how I think this path is the wrong path. The first one is from my own practice experience. I had a terminal cancer patient in hospital. She was suffering all the bad things at the end of life. She said to me in the evening: "Doctor, could you just give me something to end my suffering?" I said to her: "I anguish for you. I feel for you. My heart goes out to you. I think we might be able to find an alternative". I talked to the nurses on the station telling them my patient was really down. "We need to change her medication. We need to alter her treatment. Instead of giving her shots, we need to give her some

intravenous medication". We changed the palliation that I had been giving her. My palliation was not good enough.

I got the nurses to stay with her. She needed some personal support that night. Then I phoned her family and said: "Grandma is really, really tough tonight. Could anyone from the family please come and be with her. She needs some support". Things did settle down. The medication worked better and she was no longer suffering so badly and I went home. When I went back the next day to the hospital I found her sitting up, playing chess with her nephew. This was a different woman over this span of time.

The next day she said to me: "Dr. Hill, thank you so much for not listening to me two nights ago". From that I took it her plea to me was based more on depression and intolerable pain. The change I had made was a palliative change.

I will give another example that is much worse. It is from the Dutch experience. A doctor I know had a compatriot with an 85-year old patient with congestive heart failure, treatable only in a hospital and needing a shot of a medication called Lasix. She did not want to go to the hospital because, she said, they performed euthanasia on 85-year-olds in that place. The physician promised to look after her, so she agreed to go to the hospital.

She received her shot of Lasix which makes the kidneys more effective. She voided all this extra fluid in her lungs and felt much better the next day. It was a Friday and her physician was off duty. He had left to do the normal things a doctor does on weekends.

He returned on Monday to find that the covering physician whom he did not know well had needed a bed for a younger patient. He just went down the list and found the 85-year-old and determined that she was the least likely to live a worthwhile life. Members know the rest of the story. She was gone on Monday when he got there.

He will never be able to face what he did. He had promised her that she would be fine. The best intentions, the best safeguards and the best ideals did not work for that 85-year old individual. It was the wrong way to go.

I can quote my own constituents on the issue. I have polled them and it was fascinating. Thinking there would be a free vote on the issue I did a quick poll. I asked: "What do you think of doctor assisted suicide?" The poll came back with 55 per cent in agreement.

When it became obvious I had more time and it would not be a sudden thing, I polled my constituents in a much more specific way. I laid out the options of palliative care, the options that are available, and the switch in my constituents was dramatic. They no longer supported doctor assisted suicide when it was educationally explained to them.

My stand was very plain to them on both surveys. I am against doctor assisted suicide from my personal experiences and my view from international experience. It is the wrong way to go and I do not support any move toward doctor assisted suicide. I will do everything in my power while I am in the House to move down the road toward palliative care, the road toward care for those who are dying rather than snuffing them out.

[Health Care, March 6th, 1997]

Mr. Speaker, when the health minister voted for the Liberal cuts he voted for the closure of the hospital in Sudbury. He voted for the closure of the Wellesley. He also voted for a closure of the hospital in Thunder Bay.

Why does the health minister not stand up in the House of Commons and publicly admit that the cuts he voted for are closing hospitals across the land and they are in fact a Liberal legacy?

[Health Care, March 6th, 1997]

Mr. Speaker, I wonder if we could table our parliamentary document to show what the fresh start really says about health care-$4 billion back into it, by the way.

The new hospital closings in Ontario are being announced today. Yet the Liberal government continues to give, for example, $323,000 to the Canadian wine development program and $300,000 to friends at the Shawinigan Industrial Centre. It is straightforward. That money should be going back into hospitals.

Why does the Liberal government continue to waste health care dollars by subsidizing business and its corporate buddies instead of putting money into hospitals?

[Tobacco Act, March 6th, 1997]

It was self-interest for sure.

France sought to ban all tobacco advertising effective in 1993. There was a huge outcry from sponsorship groups. FISA, the group that governs motor sport throughout the world, organizers of the Grand Prix circuit, announced the French Grand Prix of 1993 would be withdrawn.

The French Grand Prix is the longest running grand prix in history. To those people in France the grand prix is extremely important. The threat occurred before the law was passed in 1993. The sponsorship ban in France went through. The 1993 French Grand Prix was held. The 1994 French Grand Prix was held. The 1995 French Grand Prix was held. The 1996 French Grand Prix was held. The 1997 French Grand Prix will be held devoid of tobacco sponsorship.

Exactly the same argument was made about jobs for advertisers and the advertising industry, that there would be a huge withdrawal of funds to the advertising industry and jobs would be lost. My colleague in the Bloc is concerned and rightfully so for jobs in the advertising industry. I have testimony saying that 22 per cent of the labour force working directly in the outdoor advertising industry would be lost. It is a big deal.

The president of the Outdoor Advertising Association of Canada wrote to a marketing magazine. Tobacco advertising had been banned in Canada and he wrote:

The ad ban under the Tobacco Products Control Act was arguably one of the best things to ever happen to our industry. It drove our members to develop other advertising categories so that today packaged goods, not tobacco, are our largest spending group. The loss of tobacco revenues has been completely recouped and then some.

We are being given a bill of goods from self-interest groups. Let me refer to the issue of the shopkeeper bearing all the onus. When a youngster goes into a shop to buy cigarettes and is sold cigarettes the shopkeeper is fined. I have listened to the shopkeepers at home. They are quite concerned that their businesses will be wrecked and that there will be cigarette inspectors throughout the country.

I tried hard to amend the bill to put some onus of responsibility on the youth who broke the law. I wanted a small fine for the 15-year old who went into the shop to buy cigarettes. It would be a slap on the wrist: "Don't do that. It is illegal". That was my one attempt to amend the bill. I was not looking for procedural wrangling. I tried to make that little attempt but it was unsuccessful.

Another big issue for my party and me was the regulations which put meat on the bones of the act. Over and over again I have lobbied for the regulations to be scrutinized by the whatever committee would be appropriate, which in this case was the health committee. I put those proposals, ideas and thoughts forward. I had hopes the minister would hear me out on the issue and the regulations would be scrutinized.

As it turned out, a Liberal member put forward such an amendment which through design or mess up was passed. I was told the scrutiny of regulations was against parliamentary tradition.

This is an historic occasion. It will not be noticed by the press or by those worried about tobacco. However as a health committee we

will receive the regulations, may do a study of them and make changes. I circle the word may. I sincerely hope the member who put forward the amendment gets huge credit for having done so. The scrutiny of regulations will take place by elected representatives and not just by order in council. That little one is great for me; it is my smile on the tobacco bill.

I must say a few words to my smoking friends, those people whom I tried all my life in my capacity as a physician to convince not to smoke. I hope they can stop. I have expressed words of advice. I know how tough it is. To that end I have looked at the cancer statistics.

I see the ads for cigarettes which try to convince young women: "You've come a long way, baby". I will talk about cancer of females for now. From 1970 to 1995 colorectal cancer has dropped somewhat. Ovarian cancer has stayed reasonably level. Stomach cancer has come down. Cervical cancer has come down. Cancer of the uterus has come down slightly. Melanoma has stayed static. However there is one cancer that has taken off like a rocket ship, cancer of the lung. It has gone from less than 10 per 100,000 to almost 35 per 100,000. It is the only female cancer that has taken off.

There is only one reason for this in our female population, in our young women, in our wives and in our daughters: "You've come a long way, baby. You've learned how to smoke". It is a shame. I hope this will be very evident to the young women.

The bill will soon go to the other place. I will watch with great interest certain of the individuals there, three very prominent senators: Michael Kirby, William Kelly and Roch Bolduc, all of whom are very intimately involved in the tobacco industry. They are on the boards of these big companies. I will watch them very carefully to see whether or not they will vote on these issues. If ever there has been a conflict of interest on a voting issue, there it is. I will watch with profound interest to see what happens. Will they abstain?

Before I came to Parliament I made a little promise to myself that if I were ever offered compensation for changing my mind on something I would not do it. That is a nice way of putting what I would like to say very strongly. I cannot say the word that I would like to say because it is inappropriate to use it in the House.

One night not so long ago I received a phone call. The person on the line said: "Doc, if you change your mind on this bill it will mean something to you personally in a financial way. If your party changes its mind on this bill funds will flow". I am making that announcement in the House of Commons today. I as a member of Parliament was offered compensation for changing my mind on this issue.

I have a lighthearted but not so lighthearted request for the tobacco companies. They are looking for things to sponsor. They are looking for areas to put their money. What if they sponsored funeral parlours? What if they put a little sign on every hearse saying that it is sponsored by the tobacco company involved?

I considered the approach taken on the bill. I thought it was the wrong way to go. I am still not sure the bill is perfect. I find flaws and holes in it.

When I went to Parliament the people at home said that I should try to be as non-partisan as I could and try to support legislative measures that would make a difference. For the 10,000 children per month who are taking up tobacco, half of whom will die prematurely, I say that the bill is imperfect but it is better than a vacuum.

I will reflect back on the first patient I had as a medical student. The fellow was a veteran. He was my very first assignment. I was a green, untrained medical student in the Mewburn pavilion at the University of Alberta. He had emphysema. He had smoked all of his life. He was dying; he was literally at the end of his life. He was on oxygen. I went to visit him day after day after day. I was getting to know what it was like to deal with a patient, to listen to somebody in distress and to watch him slowly slip away.

His last words to me were: "Doc, don't let the young kids smoke". He did not last much longer. I will never forget him. I will never forget his advice to me. In my judgment this legislation will help in the quest not to let the young kids smoke. Let me close by saying with memory of my first patient: "Don't let young kids smoke".