Bonnie Brown

[Committees of the House, June 3rd, 2002]

Mr. Speaker, I have the honour to present, in both official languages, the third report of the Standing Committee on Health.

In accordance with its order of reference of Monday, April 15, 2002, your committee has considered Bill C-53, an act to protect human health and safety and the environment by regulating products used for the control of pests, and the committee agreed on Wednesday, May 29, 2002, to report it with amendment.

[Cystic Fibrosis Month, May 7th, 2002]

Mr. Speaker, I am pleased to remind my colleagues and all Canadians that May has been declared Cystic Fibrosis Month.

Cystic fibrosis is a deadly genetic disease affecting primarily the respiratory and digestive systems, with the most devastating damage taking place in the lungs. Approximately 1 in every 2,500 children born in Canada has the disease and yet there is no known cure.

The cystic fibrosis foundation has made substantial progress over the past 40 years. In 1960 the median age of survival for a child with the disease was just four years. Today the median age of survival has increased to over 30 years. I congratulate the Canadian Cystic Fibrosis Foundation for its achievements.

I ask members to please join me in extending our best wishes for a successful Cystic Fibrosis Month to patients, their caregivers and those who are searching for a cure.

[International Aid, March 22nd, 2002]

Mr. Speaker, we are all aware of the international conference now being held in Mexico. Will the Minister for International Cooperation inform the House what steps the Government of Canada is taking to ensure that our commitments toward international development are met?

[Afghanistan, March 22nd, 2002]

Mr. Speaker, yesterday the Minister for International Cooperation announced that Canada is providing $30.2 million to Afghanistan. These funds are for priorities such as education, health, nutrition and child survival and are the first phase of the $100 million that the minister pledged in January at the Tokyo conference on Afghan reconstruction.

Canada is supporting human rights, gender equality and strong governance. We are making sure that girls are returning to school and that women are involved in their country's reconstruction from grassroots initiatives to governmental reform. We are funding de-mining activities as well as promoting peace and security.

The needs of Afghanistan are complex and call for a comprehensive approach. That is why the projects announced yesterday focus on both immediate humanitarian needs and on laying a foundation for longer term reconstruction efforts.

The women and men of Afghanistan can count on Canada to support them as they face the work of rebuilding their society.

[Supply, February 19th, 2002]

Mr. Speaker, I cannot be responsible for decisions made by the government during the 1980s. I do know that there was a moment in time when there was an agreement made for bloc funding. I believe the provinces asked for it so they would have more of a free hand in dispensing their moneys among their various human service programs. No matter what spin the member opposite puts on the recent agreement called the health accord, the premiers did sign it and emerged sounding quite pleased with the agreement they had made.

[Supply, February 19th, 2002]

Mr. Speaker, the member's suggestion has to a large degree been taken up by the government. About 15 months ago the premiers and the Prime Minister signed an agreement on health care funding that was to last five years.

This is another reason it is surprising that the premiers are suggesting they are not getting enough money. They agreed to a five year amount to be doled out on an annual basis. Now they are saying it is not enough. They say they need another $7 billion or so.

Long term sustainable funding is the goal of every program the Government of Canada administers, whether it is funding for the arts, the CBC or health care. Health care is the most important of all these. However as fiscal stewards of the nation's treasury the government must always be responsible. To go beyond five years would not be totally responsible.

[Supply, February 19th, 2002]

Mr. Speaker, I agree that the percentage has changed considerably over the years. At the beginning it was 50%. However since the beginning of medicare there have been a series of agreements with the provinces. In most cases either the provinces proposed and the federal government agreed or the federal government proposed and the provinces agreed to differing percentages than there had been at the outset.

The public probably wonders why it happened. If the provinces are complaining now, why did they agree to the earlier sums? I cannot go into exact detail but my understanding is that the provinces traded money for power. Each time they took less money they obtained more jurisdiction and a freer hand in deciding how to spend the money. There was a tradeoff and the provinces agreed. It is a little late for the provinces to come back and complain about a system based on agreements they signed.

[Supply, February 19th, 2002]

Mr. Speaker, that is the position of many provincial governments and some of the opposition parties. However it neglects to include the spending the tax room we gave to the provinces several years ago in the form of tax points.

If one includes the tax points and the money generated by them, the federal contribution rises to somewhere between 31% and 33%. I do not accept that 14% is the federal contribution to health care.

[Supply, February 19th, 2002]

Mr. Speaker, I will be sharing my time with the Parliamentary Secretary to the Minister of Health.

I welcome the debate because health care is a topic of concern for Canadians today. Unlike the previous speaker I am never intimidated by the member for Hochelaga--Maisonneuve although I respect his talents and oratorical ability. Unlike the last speaker I am not breathless about the debate because I am confident in the progress the Government of Canada is making in co-operation with its provincial partners in the health care field.

Canadians want to know the dollars being spent on health care will ensure they get the care they need when they need it. Canadians know accountability is the key to good governance. It is implicit in the contract between the government and the citizens that funded programs will effectively meet intended objectives.

However accountability requires that governments have good information. I will take a few minutes to describe briefly not only the commitment of the Government of Canada toward improved accountability and reporting but the measures we are taking to ensure more and better information will be available in future to allow us to fully meet our commitments.

In the February 4, 1999 Social Union Framework Agreement governments made a commitment to enhance transparency and accountability to constituents by achieving and measuring the results of their respective programs. This included: monitoring and measuring the outcomes of programs and reporting regularly on performance; sharing information and best practices to support the development of the outcome measures; working with other governments to develop over time comparable indicators to measure progress on agreed objectives; and publicly recognizing and explaining the respective contributions of governments.

As a nation we spend over $95 billion a year on health care, more than 9% of our gross domestic product. Yet near the end of the nineties Canadians had limited information to assess the performance of the health system. Policy makers and health professionals knew much less about health outcomes and the performance of the system than they needed to.

Oh yes, we knew a fair bit about inputs into the health system such as the amount of funding, where it came from, the number of professionals working in health, the number of person days spent in hospitals, et cetera. However we knew little about the outcomes we got for the inputs so we literally could not tell how efficient our health system was. We knew little about what happened after patients left hospitals. We did not know whether they left cured or uncured, in good shape or disabled, or whether they went back to their homes or to other care providers.

We knew little about the overall health of the population. We could not compare the health of the population in, say, 1997 with its health in 1987 because we had not had the foresight to keep a survey of population health active through the eighties and nineties. Nor could we compare the health of Canadians in Calgary with the health of those in Quebec City as we had not invested in surveys that could give reliable health information.

I am glad to report that we started to change that in the 1999 budget. We allocated $95 million over four years to the Canadian Institute for Health Information to strengthen its capacity to report regularly on the health of the overall system and to allow Statistics Canada to report on the health of Canadians. The institute will work with partners to identify which health indicators to measure, develop data standards, fill key data gaps, and build capacity to analyze data and disseminate information.

In September 2000 the first ministers reached an agreement that will allow Canadians to see how well their health system is serving them. The agreement will help all of us improve the delivery of health care services in Canada. It will build on and lend precision to the directions of the social union framework.

The first ministers agreed to report on indicators to improve accountability to Canadians regarding the performance of their health care system. The agreements respect the fundamental responsibility of the provinces to deliver health care in their jurisdictions. A performance indicators reporting committee chaired by the province of Alberta is working with existing committees to identify comparable indicators in 14 areas under three themes: health status, health outcomes and quality of service.

The reporting committee works with various groups including Statistics Canada and the Canadian Institute for Health Information to provide policy advice to carry out the required development work on the indicators. The indicators will be used in performance reporting by governments beginning in September 2002. Each government is responsible for reporting on its own jurisdiction and ensuring its own appropriate third party verification.

The work is proceeding well and on schedule. The reporting committee has been successful in achieving consensus among the jurisdictions toward reporting indicators in each of the 14 areas by September 2002. The committee held a consensus conference in September 2001. The resulting proposal which identified approximately 60 specific indicators was endorsed by federal and provincial deputy ministers in November 2001.

Health Canada is a full partner in the program, not only because it is involved in direct delivery of health services to the aboriginal population but because of its support of a range of measures to ensure accountability across the full range of policies and programs for which it is responsible.

To improve accountability the federal government has embarked on a number of initiatives aimed at embedding the principles of results based management and fostering a continuous culture shift to outcomes oriented decision making. The initiatives are aimed at enabling Health Canada to meet the objectives of the Treasury Board's Managing For Results program.

Pursuant to the 1999 Federal Accountability Initiative, Health Canada is developing and using performance frameworks at a departmental and program level, strengthening the departmental evaluation function, and developing tools to enhance performance measurement.

The reporting committee process to report on health system performance this coming September relies heavily on information being generated by the investments we began in the 1999 budget.

Budget 2001 provided an additional investment of $95 million to ensure the Canadian Institute for Health Information in conjunction with Statistics Canada could continue to provide quality health information. The objectives are to: provide information to help federal, provincial and territorial governments meet their performance reporting commitments; provide the evidence base necessary for health care providers and managers to make informed decisions about health system renewal; provide the information necessary for Canadians to make informed decisions about their health; and expand the sharing of health information through a comprehensive approach to data dissemination that respects the privacy rights of Canadians.

The investment will ensure Canada continues to standardize, collect, analyze and disseminate essential health information. It will ensure the regular dissemination of timely and relevant information needed to enhance public understanding and debate about issues of health and health care. It will also provide invaluable support to those responsible for developing policies, designing and managing programs, and evaluating the effectiveness and efficiency of the $95 billion Canadians spend on health care every year.

[Black History Month, February 7th, 2002]

Mr. Speaker, February is Black History Month and therefore an opportunity for all of us to recognize the important contributions and achievements of African Canadians both historically and today.

Through a variety of activities, organizations across the country will help to: highlight the achievements of black men and women; dismantle stereotypes; and provide role models for young black Canadians. We officially recognized Black History Month in the House through a unanimous vote in 1995. We know that black Canadians have been making important contributions to Canadian society for over 400 years. They have been a part of many milestones in Canadian history.

I am sure that my colleagues in the House will join me today in recognizing and celebrating February as Black History Month.