Mr. Speaker, I have listened to today's debate with great interest but one striking feature of the debate in the House today is that among those who have spoken in favour of this resolution, not one hon. member has confronted the true question at issue.
The true question is whether governments should make cash payments to those who are harmed through no fault of anyone but because of risk inherent in the medical system.
I intend in the few moments permitted me to deal with that question and to examine it. In doing so I urge all members to put aside the rhetoric, put aside the inflammatory words and the high sounding language of fairness and moral duty and instead confront the real question.
It seems the opposition parties have failed to confront that real question. They paper over that question because it is very tough. It is a very difficult question to answer. Ministers of health of this country came to grips with it some weeks ago and we concluded that we had a position on when governments should pay cash payments to those who are injured through no fault of anyone but because of risk inherent in the medical system.
The easy course, naturally, would be simply to pay those who are making a claim upon the government. Ministers of Health are custodians of Canada's health care system and we have a larger responsibility, a responsibility to show leadership on these tough questions and confront them directly, no matter how difficult they may be.
This issue is larger than just those infected with hepatitis C. Hon. members know that every year there are thousands of people in this country who are adversely affected by the health system through no one's fault but because there are risks inherent in it.
Last week researchers identified what they felt was a source of many deaths in hospitals every year because of adverse reactions to prescription drugs. This was brand new research and they said the figures in Canada are staggering.
We all know there are those who have adverse reactions to vaccines, anasthetics or to prescription drugs or who have high risk births delivering babies with brain damage who will need special care for a lifetime.
In the absence of fault, if it is a risk inherent in life or in delivering medical services, where is the obligation of governments to pay cash to those who are harmed in that way? That is at the root of this difficult issue. This is not the first time we have had to confront that issue.
In 1990 governments in Canada, because they were concerned by the rates of medical malpractice insurance by doctors and the number of claims for compensation, established a commission that was chaired by Dr. Robert Prichard who is now president of the University of Toronto. The Prichard commission was made up of distinguished Canadians, including the then dean of medicine at McGill University medical school, Dr. Richard Cruess, Madam Justice Ellen Picard of the Superior Court of Alberta who has written a definitive text on hospital and doctor liability, and Dr. Gregory Stoddart, one of the leading health policy analysts of this country. What did they conclude? They concluded in their recommendations the following:
We recommend the development of a no fault compensation scheme for persons suffering significant avoidable health care injuries.
We recommend that the general criterion for determining which significant medical injuries are compensable under the compensation scheme should be the test of avoidability. That is, the principal inquiry to determine if an event is compensable should be whether, with the benefit of hindsight, the injury could have been avoided by an alternative diagnostic or therapeutic procedure or by performing the procedure differently.
They specifically recommended that the same test be applied to those who are injured through the blood system. That is exactly what the ministers of health have done in this instance.
We looked back over the chronology of events and asked when was it, in all that happened, that these injuries were avoidable. So when is it that no fault compensation should be offered? History shows on the balance of the evidence that it was between January 1986 and 1990 that avoidable element occurred.
It is true to say there were tests here and there in different parts of the world and in different states earlier than that but broadly speaking, the evidence of those who know is it was by January 1986 that steps should have been taken. They were not. That is when the avoidable injuries occurred.
What should governments do about people before 1986?. What should we do about the victims who suffered the unavoidable injuries by virtue of risks inherent in the health system before January 1986? Among other things we should focus research on trying to find ways to treat and hopefully cure the infection. I have asked the chair of the Medical Research Council to take whatever necessary or appropriate to focus research priority on hepatitis C.
We must also do whatever we can to minimize risk in the future. We will be accepting the recommendations of Mr. Justice Krever in terms of the federal watchdog role, putting into place more elaborate controls over the safety of the blood system in the future. I will be coming back to this House with more particulars on the steps we are taking in that regard.
We must accept responsibility for that period when the injuries were avoidable. That is why we are contributing $800 million as a federal government to a compensation fund which will total $1.1 billion, more I hope if the Red Cross joins us, offered to those in the category who suffered injuries that were avoidable, 22,000 plus victims in that category. That was on the agenda because of federal leadership. It was only in the last year that the federal government put that agreement together among all the provinces.
It is easy today to suggest that we should simply write a cheque for all those who demand it. We are responsible for maintaining a public health care system in this country and it will not be sustainable if we simply pay cash to all those who suffer harm not through anybody's fault but because of risks inherent in the system. That is what happened here before January 1986.
When we hear the colourful language from the opposition parties today, when we hear them talk about our duty to the sick and the vulnerable, when we hear them talk about our moral duty, let us remember that as custodians of Canada's health care system we have no greater duty than to ensure that medicare is going to be there for those who are sick when they need it.
We have no greater moral responsibility than to safeguard medicare for the very hepatitis C victims who will require treatment as they develop symptoms and their condition deteriorates. We have no greater obligation of compassion than to ensure that our public health care system remains affordable and sustainable.
We shall not do it if we follow the course suggested by the other side because next month or next year there will be others who come forward with claims equally as compassionate, with demands equally as desirable, equally as emotional and they too will want money. Where will it end? It will end with governments paying out cash compensation regardless of fault to all who have an emotional claim and will end with a country unable to afford or sustain its health care system.
The moral high ground does not rest with those who urge that easy course. The true moral high ground is with those on this side of the House with the courage to stand and say we will take the tough decision on the difficult question we face. The true moral high ground rests with those in the government who will stand in their places next Tuesday and vote against this motion not because we are callous, not because we lack compassion, but because we are responsible for a public health care system that cannot and will not continue if we take the course the opposition urges.
I encourage all members of the House to consider the implications of this difficult and wrenching dilemma but to confront the real question that lies beneath it. Can we sustain our public health care system if we make cash payments to all those who are harmed by the health care system, regardless of fault, merely because of the risk inherent in the process?
Infection with hepatitis C through the blood system was just such an inherent risk before January 1986. As a result I say we should conduct research, we should do whatever we can to prevent such injury in the future, we should accept responsibility for the period when we should have acted, but I oppose this motion because it is not the proper policy.
