Allan Rock

[Health, May 31st, 2000]

Mr. Speaker, we did not wait to have a health budget in February 1999. We did not wait to increase by 25% the transfers to provinces for health over the last four years. We did not wait to invite health ministers from across the country to join me at the table to talk about concrete action to save medicare.

The government has no lessons to learn from the NDP on health. The NDP has come into the House with no constructive ideas on how to change medicare. We will see to it that public medicare is safeguarded in this country.

[Health, May 31st, 2000]

Mr. Speaker, Madam Bégin did not suggest amending, she suggested new legislation, parallel legislation.

In fact, I met with her the other morning and we had an interesting discussion. She is a person whose views I very much respect. I reminded her that we are in the process of working with provincial partners to renew medicare to find an answer to make sure the principles of the Canada Health Act are respected as we go forward with a sustainable health care system.

We welcome good ideas from any source, and I will work with my provincial partners to make certain that we do what is right to keep public medicare safe in Canada.

[Health, May 29th, 2000]

Mr. Speaker, little by little and month by month Canadians are coming to understand the agenda of the tobacco industry to get new customers by focusing on young people. The documents released today indicate that has been going on for some time; that it was a deliberate strategy.

It makes it all the clearer that we have to continue, as we have done, with a strategy against the tobacco industry and against smoking through higher taxes as soon as possible and as much as possible, anti-smoking messages especially for young people and changes in labelling so that we have the attitude that smoking is not cool, smoking kills.

[Health, May 29th, 2000]

Mr. Speaker, the member should know that water safety and related issues are a provincial responsibility. If she has issues to take up with the level of regulation in Ontario, she should do that with the appropriate government.

I am surprised. The member is a hard working member of the health committee. She should know that from our estimates it is clear we are reinvesting some $256 million in the health protection branch of Health Canada. That is in addition to the $65 million last year for food safety at Health Canada. That is exactly the opposite direction that the Government of Ontario is going with its 30% tax cuts which are having a real affect on people.

[Health, May 29th, 2000]

Mr. Speaker, I am glad the member has given me the opportunity to point out to the House and to Canadians that this government extends its deep sympathy to the families and the community of Walkerton which have suffered so grievously over the last 10 days.

Health Canada has been very happy to work with other governments in providing expertise and surveillance, as well as emergency access to an experimental drug to help some of the people who are particularly ill.

If the hon. member is looking for some place where deregulation has caused issues to arise, she ought to look not here but at the Government of Ontario. That is where the questions are being raised.

[Health, May 19th, 2000]

Mr. Speaker, I will remind the House that in January I wrote to my provincial and territorial colleagues to suggest a meeting in May so that we could discuss needed changes to Canada's health care system and additional federal money to support a coherent plan to make improvements. Indeed we met earlier than that. We met in March and we plan to meet again.

I am waiting for word. We are working with the chair, the minister from Manitoba, to find an appropriate time for such a meeting.

[Health Care, May 18th, 2000]

Mr. Speaker, the member lauds the Canada Health Act. Now she ought to read it. If she does, she will find that we have already in the Canada Health Act the principles and the rules we need to safeguard medicare. What this government has said consistently and unconditionally is that we will use the powers in the Canada Health Act to protect the principles in the Canada Health Act. That is not true just in Alberta, that is true across the country.

[Supply, May 18th, 2000]

Mr. Speaker, I am familiar with that example. The member for Macleod will discover, if he looks a little more closely, that under those circumstances they are not permitted to charge for enhanced services at the same time that they are charging for insured services. They do not talk about overnight stays. The policy is not to create private for profit hospitals. There is room for innovation in Canadian medicare but there is a line that should not be crossed. Imperilling the principles of the Canada Health Act is something that ought not to be encouraged.

What is described in B.C. is not what bill 11 has provided for. Bill 11 expressly says that the private for profit facilities can charge for the enhanced services as well as the insured services. That is the crucial distinction between Alberta and the example that the Canadian Alliance is referring to in British Columbia.

[Supply, May 18th, 2000]

Mr. Speaker, whatever sympathy the member might inspire by going generally in the right direction on values, she forfeits through her overstatement and misunderstanding.

I take the member to suggest that enforcement means amending the act. I take the member to insist that taking action means introducing a bill to change the Canada Health Act. She is wrong. Taking action, protecting medicare and standing up for the principles means doing exactly what we have undertaken to do, which is to watch what is happening on the ground.

If those private for profit hospitals use the power to charge for enhanced services at the same time as insured services in order to restrict access only to those with the cash or give preferred access to those willing to pay more, that will be a contravention of the act and we will act. We have the power, the political will and the mandate.

The leader of the New Democratic Party has just suggested that the only kind of action she thinks is appropriate is to amend the Canada Health Act. There is no need to amend the Canada Health Act. The principles, the purpose and the powers are already there.

This House, this member and Canadians have the solemn undertaking of this minister, the Prime Minister and this government that, if necessary, we will use that power to protect those principles not only in Alberta but throughout this land.

[Supply, May 18th, 2000]

Mr. Speaker, I will be dividing my time this morning with the hon. member for Bruce—Grey.

I welcome the opportunity to address the House, as Minister of Health, on an issue of such current and continuing priority. I acknowledge the importance of the motion which the hon. member for Halifax has put before the House of Commons today. The issue is of fundamental significance because the way a nation chooses to provide for health care services to those who are sick speaks directly to the values of that nation.

In our case, the values of Canadians are reflected and codified in the Canada Health Act. Although the Canada Health Act was written and adopted many years ago, its principles are as relevant now, as important now and as necessary now as they were when the statute was first written.

Public medicare in Canada has allowed us to provide health care services to our citizens in a way that is socially fair, while at the same time putting in place a health care system that is economically efficient and is a competitive advantage in the business world to our businesses when they compete with those of other nations.

Let me say at the outset that we, on this side of the House, share the concerns that have given rise to the motion which is presented today on behalf of the New Democratic Party. While we share those concerns, our strategy in dealing with them differs from that proposed by the leader of the NDP. Simply stated, there is no need to amend the Canada Health Act to deal with the concerns that have been raised. The Canada Health Act already contains both the rules and the penalties to enable the Government of Canada to ensure compliance with its principles. They are already in the Canada Health Act.

I would like to point out that, as Minister of Health for Canada, it is my responsibility to monitor the health systems of the provinces and territories in order to ensure that they meet the criteria and conditions of the Canada Health Act. If there is an infraction, I am required by the act to consult the provinces or territories in question.

Over the years, a number of potential problems of non-compliance have been resolved by negotiation, without having to invoke the penalties provided by the Canada Health Act. If negotiations failed, however, the Government of Canada has the power to withhold funds from the provinces.

I want to emphasize that this power is not simply theoretical. It is not just a rule written on paper. This authority has been exercised a number of times in recent years. For example, between 1984 and 1987 the Government of Canada withheld about $245 million from seven provinces that permitted user fees and/or extra billing.

In 1992 to 1993 the Government of Canada withheld funds from British Columbia in respect of extra billing arising out of the dispute between the provincial government and the B.C. medical association.

In 1995 our government deducted payments from four provinces that charged facility fees for medically necessary services at private clinics.

In each case the principles of the Canada Health Act, without being amended, had been contravened and in each case the Government of Canada acted.

In the context of bill 11 I have both spoken publicly and written directly to the Government of Alberta to express my concerns with that legislation. Indeed, I asked the Government of Alberta to amend bill 11, and I expressed the view that while on its face bill 11 does not contravene the Canada Health Act, by allowing private for profit facilities to both provide insured services and to charge fees for enhanced services bill 11 creates circumstances which could be used to contravene the principle of accessibility in the Canada Health Act. That is the real concern.

When we combine that with the fact that the policy of the Alberta government contemplates overnight stays in private for profit facilities, which takes private for profit further than it has so far gone in the country, we asked the Government of Alberta to amend its legislation. It did not. As a result, one week ago today, in a ministerial statement, speaking on behalf of the Prime Minister and this government, I said in the House that because Alberta has gone ahead with this legislation, which we thought was ill-advised, we would do the following things.

First, we will deem these private for profit facilities, as they are called in bill 11, hospitals within the meaning of that term in the Canada Health Act. The practical consequence of that is that charging anyone for any part of an insured service will be considered a violation of the Canada Health Act and will attract the penalties provided for in that statute.

Second, in response to the concern expressed by the auditor general last year that Health Canada does not have the resources to monitor and enforce the act, we are increasing considerably the capacity of Health Canada to do just that, and, as we have watched in the past, we will watch carefully to see if these private for profit hospitals imperil the principle of accessibility, contravening the Canada Health Act. If they do, as we have done in the past, we will act. We will exercise the power of the Government of Canada under the Canada Health Act and do what is necessary to protect medicare.

Clearly, we have the will and the means to ensure that the Canada Health Act is respected. We are going to ensure that the principles set out in the act are respected in Alberta and elsewhere in the country.

Let me be perfectly clear: this government would not like to merely to play the role of referee. We would much prefer to work in partnership with our provincial colleagues.

Let me say a few words in closing about medicare renewal. Like almost every other developed country in the world, Canada is going through the process of improving and adapting its health care system to meet the pressures of our current time: an aging population, the increased cost of drugs and technology, and changes in the way in which medical services are delivered on the ground.

We have an enormous advantage in this country because we have the best health care system in the world. Our challenge, indeed our duty, is to renew medicare in a way that is consistent with our principles and to overcome the problems of the shortages, the waiting lists, while staying true to our basic principles.

While the federal role of enforcer which we are discussing today is crucial, simply enforcing the rules is not by itself sufficient to achieve the medicare renewal that must be undertaken. It will require much more. It will require more federal money for health care transferred to the provinces. It will require hard work with the provinces to develop common goals and priorities to know that additional money is going to support a plan that will produce better health care for Canadians. It will require our listening to the health care workers, the doctors, the nurses and others, so that they are involved and a part of the process, and not excluded. It will involve hearing the public, its concerns and its priorities.

I have started a process with my provincial partners toward medicare renewal. I have invited them to come to the table with me and talk about a plan for this purpose. It is to that process and that purpose that I am unconditionally committed.

We will succeed. We must succeed. Canadians expect and deserve no less.