Elinor Caplan

[Health Care, February 15th, 1999]

Mr. Speaker, the Prime Minister and the Minister of Health have said repeatedly that health care is a priority for this government. I encourage the member to be in the House tomorrow when the budget is read at 4.15 p.m. Then she will see that the words of the Prime Minister and the Minister of Health are reflected in the budget that will be tabled.

[Criminal Code, February 11th, 1999]

moved:

Motion No. 2

That Bill C-247 be amended by adding after line 9 on page 3 the following new clause:

“2. This Act comes into force on a day to be fixed by order of the Governor in Council.”

[Criminal Code, February 11th, 1999]

Mr. Speaker, as all members in the House have acknowledged, the federal government has been concerned with the issues of cloning and germline genetic manipulation for some time.

In 1993 the report of the royal commission on new productive and genetic technologies recommended banning these practices and bringing forward a regulatory environment. The government followed up immediately with a call for a moratorium on these and other practices in 1995. That moratorium is in place and exists today.

As a result of Bill C-47, the government understands the concerns that Canadians have about the variety of egregious technology, those things that we are worried about, not just cloning and germline genetic manipulation.

We acknowledge the widespread desire for a comprehensive regime to govern the unacceptable and regulate the acceptable technologies.

The committee discussed Bill C-247.

There is general agreement in principle that human cloning should be banned. That was originally in the government Bill C-47 and recommended by the commission that was established. There are many days in this place where I think all members would like to have a clone of themselves so we could be in two places at the same time. That is a joke. We know that the idea of having a complete replica of any human being, not just in this place but anywhere, is not only scary but it is the kind of serious ethical dilemma that we are all very clear on.

I want to be very clear that we do not support the ability to clone humans. We support a ban on human cloning. At the same time, in speaking to this amendment before us today, we recognize that this is a very complex issue. What is proposed in this bill is a Criminal Code prohibition. What we believe is required and what this amendment points out is that we need not only prohibitions but a regulatory regime.

What concerns me is the amendment that has been placed today by the member for Drummond because it points out that we have concerns, as I believe she has, with the original wording of the bill. We do not want to, for example, stop research on those technologies that I referred to as acceptable, the kind of technologies that would lead to a perfect match for bone marrow to cure leukaemia or a perfect match of a valve to fix a heart or the perfect match of an organ.

I therefore say to the member and to all members that the fact that this amendment has been placed at this time in the House is of great concern to me. We have to think very carefully before we try to frame complex legislation by amendment in this House of Commons.

I have received communications from experts in this field following the discussion at committee. Dr. Arthur Leader, professor of obstetrics, gynecology and medicine, the chief of the division of reproductive medicine at the University of Ottawa, and president of the Canadian Fertility and Andrology Society, would like to appear before the committee to express his concerns and reservations.

In speaking to this amendment I believe we cannot support this amendment at this time without having further discussion and debate of the implications that it would have on this very important topic.

[Supply, February 4th, 1999]

Mr. Speaker, as I said in my remarks, health has been a shared jurisdiction in this country. The federal government very clearly respects the role of the provincial and territorial governments to plan, to manage, to administer and to deliver health services within their jurisdiction.

The Canada Health Act clearly defines the criteria, the principles and also the conditions upon which federal funds are transferred to the provinces. This partnership is one which I believe is supported overwhelmingly by a majority of Canadians across the country. It binds the country together. I think that any party in the House who attempted to scrap the Canada Health Act would be punished on election day by Canadians because we value Canadian medicare. We value the Canadian approach to delivery of health services. We value the foundation of the Canada Health Act which says that we share and we care for one another, that access to needed health services is not dependent upon one's financial status and that if one is sick in Canada we will care for them.

The federal government has a very clear and defined role and responsibility in the area of health promotion and disease prevention. The federal government has a very clearly defined role in the delivery of services to specific groups of people whom I mentioned in my remarks. Those people, as an example, are the Inuit, our first nations and other groups. We also have a responsibility to bring together provincial and territorial leaders, as is occurring today, to discuss issues of national concern, national priority. As we know, health care is a national priority for this government and health care and health care issues are a concern for people across this country.

Therefore, it is very appropriate for us in the House today to reaffirm our respect for provincial and territorial jurisdiction. We do that, but at the very same time we acknowledge the important role that the federal government has played through the Canada Health Act, and the acts before it, in establishing medicare, a model for health care delivery unique among the countries of the world and one which has helped to make Canadians among the healthiest and I believe among the most envied people on this planet.

[Supply, February 4th, 1999]

Mr. Speaker, I rise on the opposition motion before us.

I would like to address the role played by the federal government through the Canada Health Act which enshrines the principles and governs federal health transfer payments.

Under the Canadian Constitution the responsibility for health care delivery falls primarily under the jurisdiction of the provincial and territorial governments. They have the primary responsibility for the provision and the delivery of health care services to the people of Canada. The provinces and the territories have responsibility to plan, manage and administer their own health care delivery systems.

The federal government for its part by law is responsible for the promotion and preservation of the health of all Canadians. Health Canada is responsible for bringing all jurisdictions together to tackle the health issues of national and interprovincial concern. The federal government assumes responsibility for setting national policies and for providing health care services to specific groups, for example treaty Indians and the Inuit.

It is appropriate when describing federal responsibilities in health care to note what the federal government cannot do. It cannot interfere in provincial and territorial responsibilities as defined under our Constitution, nor can it be seen to be interfering in those responsibilities.

There is in this country a longstanding partnership between the federal and provincial and territorial governments with regard to health care. The enactment of the Hospital Insurance and Diagnostic Services Act of 1957 and the Medical Care Act of 1966 established the framework for this partnership between governments.

At this time the federal government provided cost sharing for medically necessary hospital and physician services in return for the adherence of provincial and territorial health insurance plans to the principles of a national program. Federal legislation, the Hospital Insurance and Diagnostic Services Act and the Medical Care Act, recognized the constitutional responsibility of the provincial and territorial governments.

Concerns over hospital user fees and extra billing by physicians led to the passage of the Canada Health Act in 1984. After a very heated and historic debate, this was achieved with all-party support, a unanimous vote in this House of Commons.

The Canada Health Act establishes certain conditions that the provincial and territorial plans must meet in order to qualify for their full share of federal health care transfer payments. These criteria and conditions, pillars of Canada's health care system, are: one, reasonable access to medically required services unimpeded by charges at the point of service or other barriers; two, comprehensive coverage for medically required services; three, universality of insured coverage for all provincial residents on equal terms and conditions; four, portability of benefits within Canada and abroad; and five, public administration of the health insurance plan on a non-profit basis.

In addition to the above criteria, the conditions of the act require that the provinces provide information as required by the federal minister and give appropriate recognition to federal contributions toward health care services in order to qualify for the federal cash contributions.

The act also discourages the application of extra billing or user charges through automatic dollar for dollar reductions or the withholding of federal cash contributions to a province or territory that permits such direct charges to patients.

In fact, the threat that user charges and extra billing would erode accessibility to needed medical care was a major impetus in the development of the Canada Health Act. The Canada Health Act was enacted to protect the fundamental principles of our publicly financed, comprehensive, portable and universally accessible system of health insurance.

The provinces and territories retained the responsibility of administering their health insurance plans under the Canada Health Act and for planning and managing their respective systems. This means that they, the provinces and territories, have the responsibility for negotiating with physicians. It means that they, the provinces and the territories, have the responsibility for establishing budgets for their hospitals, for the approval of their capital plans and for the management of health care personnel and all related delivery issues.

I believe the Canada Health Act has afforded the provinces sufficient flexibility to manage, develop plans and change the structures within their own systems and jurisdictions. For example, provinces at their own discretion may insure the services of health professionals other than physicians.

The Canada Health Act does not interfere with the provincial or territorial efforts intended to renew and improve health care delivery to make it more effective or efficient and more accountable to Canadians. The variations within the provinces and territories as they deliver health care demonstrate that the necessary and desirable flexibility already exists to respond to the different needs of Canadians in the different regions of the country.

The evolution of federal, provincial and territorial relations in health care has maintained a distinction in the federal, provincial and territorial roles in health care which are consistent with the Constitution's definition of jurisdiction. This is clearly stated in the preamble of the Canada Health Act, “that it is not the intention of the Government of Canada that any of the powers, rights, privileges or authorities vested in Canada or the provinces under the provisions of the Constitution Act, 1867, formerly named the British North America Act, 1867, or any amendments thereto or otherwise, be by reason of this act abrogated or derogated from or in any way impaired”.

Provinces and territories have affirmed time after time their support for the principles of medicare. The Canada Health Act is strongly supported by most Canadians and is regarded as the defining principles of medicare and the Canadian values of sharing and caring.

Poll after poll indicates great public support for these national principles. Even while discussions of health care structural reforms are taking place, the values which are reflected in each of these principles are still valid and are supported, I believe, by an overwhelming majority of Canadians.

Health care is a unifying factor in this country. When asked to rate the importance of a number of symbols of Canadian identity, health care topped the list with 89% of Canadians agreeing that it was a very important symbol.

Clearly the preservation of medicare is of concern to Canadians. Canadians, some 84% of them, rate medicare among the highest actions which makes them want to keep Canada together.

In conclusion, I wish to underline that the federal government has had in the past and will have in the future a legitimate role to play in health. The Canada Health Act is the foundation of medicare. It is an act which respects the primary responsibility of the provinces and territories for health care delivery. At the same time it binds this country together with its principles and has contributed to making Canadians among the healthiest people and the most envied people on this planet.

Mr. Speaker, I thank you and members of this House and particularly my constituents in the riding of Thornhill for giving me the opportunity to participate in this very important debate.

[Health And Safety, February 3rd, 1999]

Mr. Speaker, I am aware of the TV program to which the member refers. In fact Health Canada takes its responsibility for the health and safety of children very seriously.

A process has been initiated to bring in regulations for bunk beds. We are in the process now of consulting with the Canadian Standards Association and hope that those regulations will be in place perhaps as soon as the spring.

[Hepatitis C, February 3rd, 1999]

Mr. Speaker, as the member opposite knows and everyone in this House knows, we have taken our obligations very seriously. We have implemented all 17 recommendations that Justice Krever directed toward the federal government. Further, we have added an additional $125 million to ensure that the blood supply in Canada is safe for all Canadians.

[Hepatitis C, February 3rd, 1999]

Mr. Speaker, we have taken this issue very seriously. Negotiations are under way and $1.1 billion is on the table to satisfy the lawsuits that are before the government. We are assured that those negotiations are under way at the present time. We hope to see a satisfactory conclusion in the very near future.

[Canadian Executive Service Organization, December 8th, 1998]

Mr. Speaker, I rise to acknowledge the contribution of three constituents from the riding of Thornhill, volunteers of the Canadian Executive Service Organization.

John Martin spent four weeks in Kyrgyzstan at the request of the state procurement agency. This agency had no practical experience in purchasing or simple procedures from which to operate.

John worked closely with the state agency, developing a training program for agency members and a centralized purchasing unit to reduce costs by bulk purchasing.

John and Gertrud Schmied spent five weeks in Russia working with a company that processes soybeans in Krasnodar.

Working with this company to develop a chain of fast food stores and cafes, John designed an organizational chart, job description formats, a performance evaluation form and a sales productivity measurement plan.

Last year the volunteers of the Canadian Executive Service Organization provided almost 23,000 days of assistance to developing nations, emerging market economies and Canadian aboriginal communities.

[Division No. 299, December 7th, 1998]

Mr. Speaker, yes, thank you very much.