Shaughnessy Cohen

[Referendum On Funding For Abortions, May 27th, 1996]

Mr. Speaker, I am rising to speak on Motion No. 91 concerning federal funding support for abortion services on demand. I want to address the role of the federal government vis-à-vis the Canada Health Act with respect to determining insured health services.

As one of our greatest national projects, Canada's health care system is a defining element of Canadian society. Medicare has contributed to a quality of life that is recognized to be one of the best in the world. It also gives us a comparative advantage in the global marketplace.

I am happy to say, as I usually do, that the riding of Windsor-St. Clair and my community of Windsor had a great deal to do with that, starting with early insurance plans like Windsor medical and with the great vision of the Right Hon. Paul Martin, Sr.

The health care system represents the best of the Canadian spirit, reminding us of the good that we can achieve together. Medicare was introduced and developed by a succession of Liberal governments, providing a tangible example of the commitment of the Liberals to compassionate public policy.

The Liberal Party and the government remain firmly committed to the five fundamental principles of medicare as set out in the Canada Health Act: public administration, comprehensiveness, universality, portability, accessibility.

The one principle which I particularly want to focus on is comprehensiveness. At its most basic, comprehensiveness requires that provincial health care insurance plans cover all medically necessary services performed by doctors or in hospitals. The term medical necessity is a key concept. It is an integral part of the understanding and operation of the act. The term medically necessary is used in the Canada Health Act in conjunction with other conditions to assure Canadians that once a decision has been made that a service is medically necessary, then access becomes universal and on uniform terms and conditions.

In my view this debate is not just about abortion. This motion has much broader consequences than that. It is about which government is going to decide that any medical procedures are necessary. It is about whether our aging parents will have access to oxygen when their respiratory systems fail. It is about whether children and adults with disabilities will get the specialized support they need. It is about whether our constituents will have universal access to any medically necessary procedure.

Since the beginning of federal support for health care in 1957 through the hospital insurance and diagnostic services act, decisions regarding what is medically necessary have been left to the provinces to determine. This is consistent with the provisions of the Constitution. It makes sense because after all the provinces manage the health care system. The government does not do that and the man or the woman on the street does not do that.

The provinces work with the appropriate medical experts. They are delivering the service, they are closer to the patients. This means that decisions regarding medically necessary insured health services are up to the provinces and their medical associations or those whom they consult to decide.

I might add that there is a remarkable degree of congruence and consistency among all provinces and territories on this front. On the matter of health insurance coverage for services all provinces and territories, particularly for abortion services, have regarded them as medically necessary services and insure them on this basis. I emphasize that there is almost no service that is not medically necessary in some cases. These determinations have been made based on the context of the service being provided.

The government firmly believes that it is not for Ottawa to say that this procedure or that procedure must be covered. This responsibility is better left to the provinces and physicians who deliver services on a daily basis and who are aware of the circumstances under which they are delivered.

This approach stands in sharp contrast to what is happening in the United States where insurance companies are telling more and more physicians what they will cover, what they can or cannot do for their patients and even how to do it.

The Canada Health Act permits the determination of medical necessity at the point of delivery of the service. This approach is superior to developing a list of insured health services. Lists are simplistic and rigid. They result in some services being insured and others not being insured in all circumstances. They also invite a steady move to privatization especially if more and more services

are covered by private insurance because the government is out of them because it is not on the list.

Determining medical necessity at point of service is one of the greatest strengths of the Canada Health Act. This approach allows circumstances to vary from service to service. It is an approach that recognizes the medical condition of the patient. It is an approach that ensures Canadians receive services on the basis of need, not on the basis of ability to pay.

Since the beginning of medicare, medically necessary services have been made available without point of service charges. I cannot deny that fiscal realities have forced us to make some tough decisions regarding our health care system. There is still room to make our health care system more efficient.

Putting our universal and comprehensive health care system in place took commitment. Facing the challenges and finding solutions to problems which arose over the years took commitment. That commitment is still here today. It is a commitment that Canadians want and one that this government takes seriously.

We will ensure that Canadians continue to receive medically necessary services on the basis of need and not on the basis of their ability to pay. Access to services is based solely on the medical needs of the patient. Medical necessity, not how much money one has, should dictate access to medical services. Canadians expect that they will have medically necessary services available without point of service charges.

The federal government has an important role to play in ensuring that Canadians receive the care they need. What we can and will continue to do is to interpret the Canada Health Act as requiring coverage of all medically necessary services.

Our national health insurance system is close to the hearts of Canadians. It is something too precious to tamper with on a piecemeal basis. This is why the federal government cannot support this private member's motion. Supporting this motion could jeopardize the principles of the Canada Health Act. It could jeopardize the constitutional authority of the federal government and the provincial governments. More important, it could jeopardize the health of Canadians.

[Criminal Code, May 16th, 1996]

For 11 years I, unlike the member who is heckling me, prosecuted criminal code offences for the crown attorney of the county of Essex. During that time I prosecuted an awful lot of impaired driving charges. I would venture a guess that in most jurisdictions crowns, particularly that operate in provincial court, do more impaired driving trials than almost anything else.

Every once in a while cases arose which required flexibility in terms of sentencing. In the case of a simple impaired driving that flexibility is not there. There are prescribed minimums and those minimums have to be followed and in all cases of impaired driving there are some prescribed minimums. There are cases where there is an impairment but where there are other factors involved.

I give an example which has been much heralded in the media which comes out of Windsor and Essex County. We recently had an example of quite creative sentencing. I say with some pride in my community that the criminal bench there deals in a creative way very often with problems. It is the case of Kevin Hollinsky. Mr. Hollinsky is a young man who was out drinking one night with his friends. He drank, he drove and on the way home there was an accident and both of his friends were killed.

The parents of both of these victims came to the court to support Kevin Hollinsky and during the sentencing process the judge decided to accede to a request by defence counsel for a long period of probation and a community service order.

As a result, Kevin Hollinsky embarked on a remarkable community education campaign throughout Windsor and Essex County which members of the Windsor police force, probation officers and others who are very experienced in this area said resulted in a remarkable odyssey and remarkable result.

Last summer in Windsor and Essex County there were no incidents of injury or death as a result of impaired driving among young people. Had there been a minimum penalty of seven years Kevin Hollinsky would have been in jail during that period of time and one wonders how the community would have benefited from that. Instead he has educated hundreds of young people and brought home to them in a very serious, personal and emotional way the disastrous results of the behaviour of drinking and driving.

It is misleading to suggest, as some members have, that judges are flippant in their sentences, that faced with a conviction of impaired driving causing death they routinely slap people on the wrist; the suggestion I heard here today.

The government takes these problems very seriously. We have taken steps to ensure sentences are more consistent across the country. We did this in Bill C-41, which members opposite including some who spoke today opposed on other grounds.

We define principles of sentencing. Sentencing is there to denounce unlawful conduct, to deter the offender and other persons from committing offences, to separate offenders from society where necessary, to assist in rehabilitating offenders, to provide reparations for harm done to victims or to the community, and to promote a sense of responsibility in offenders and acknowledgement of the harm done to victims and the community.

A seven-year mandatory minimum sentence does not meet those requirements of the law. A seven-year minimum mandatory sentence is a quick fix which is intended only to punish. I would suggest that with the principles entrenched in the Criminal Code, we do not need to spell out for judges the minimum that should be imposed in particular circumstances. Instead, we have given them the guidance to exercise their discretion.

I also believe very strongly that we cannot support ad hoc amendments to the code. When the government proposes code

amendments after comprehensive study and consultations we are criticized for singling out certain provisions for amendment rather than undertaking more fundamental reform. These very same members have done that with us.

This amendment seeks to impose a minimum on a single provision of the code, impaired driving causing death. However no similar amendments are proposed for other offences, for example impaired driving causing bodily harm, criminal negligence causing death or bodily harm, dangerous driving causing death or bodily harm. It is not a comprehensive approach. It is a quick fix. I cannot support the proposed amendment.

[Criminal Code, May 16th, 1996]

Mr. Speaker, I am pleased to have the opportunity speak on Bill C-201, which provides for a seven year minimum sentence for impaired driving causing death.

I share the concerns of the hon. member who sponsored the bill with respect to the problem of impaired driving and I also share the concerns of my constituents of Windsor-St. Clair who see impaired driving as a serious problem.

I see problems with this bill, one of which is its focus on punishment rather than on more efficient and productive forms of deterrence.

The Criminal Code was amended with respect to impaired driving in 1985. At that time the charges of impaired driving causing bodily harm and impaired driving causing death were added to allow for more serious penalties in cases in which injuries or death resulted from impaired driving.

In the case of impaired driving causing bodily harm the maximum is 10 years, and causing death the maximum is 14 years.

At the same time other charges are available to the crown where there is a death involving the use of a motor vehicle and alcohol or drugs. The dangerous driving sections and the criminal negligence causing death sections of the code carry major maximum penalties. It is not uncommon for these sections to be used where alcohol or drugs have been involved in a motor vehicle accident.

In the early and mid-1980s federal, provincial and territorial governments really turned their minds to impaired driving, acknowledging it was a serious social problem. They did this in response to concerns in their own communities. This was because of the cold, hard facts that people were not deterred by criminal penalties and that people and property were being destroyed by the activity of those who drink and drive.

The question of how to deter people from pursuing this decidedly undesirable activity resulted in a concerted effort by governments, non-governmental organizations and even by the beverage alcohol industry to tackle the problem. In this case the beverage alcohol industry should commended because, unlike the tobacco industry which consistently denies there is any health problem in terms of using its products, the beverage alcohol industry recognizes there can be a downside to the use of its products when the use is excessive or when it is combined with other behaviours.

The focus was in part on the Criminal Code at the time. The code was refined with increased penalties and with a range of additional offences to make it more flexible, but also with a range of devices to allow easier prosecution.

The provinces also took steps within their justice administrative powers and in their highway traffic management jurisdictions to deal with the problems. For instance, mandatory licence suspensions are standard on conviction and in some provinces vehicles are impounded for the period of the suspension.

Governments and non-government organizations and industrial groups entered into public education campaigns which research has shown had an effect on the way we view drinking and driving. Although I am sometimes critical of other parties for using

anecdotal evidence, I think it is useful here in this sense. I think we all know examples of anecdotal evidence which support the research I am talking about.

We all know people who today without any embarrassment simply leave their cars at home and take a cab when they are out for a big night on the town or who engage in negotiations with their friends to ensure they have a designated driver.

This change in the attitude toward drinking and driving has been a very effective deterrent, better than any changes in the Criminal Code. We know this from the research that has been done.

I know, however, this has not abolished the problem and I dare say that in spite of some people's desire for a quick fix we will not solve the problem completely. Someone will always have an extra drink and always think they can still drive.

I raise this point to corroborate my belief that punishment is not the only way, indeed not the best way, to deter people and that we are not necessarily in Canada on the wrong path. It is easy to seize on a fixed minimum penalty as a solution to our problem.

Let us look at the other side of the coin. Does a fixed penalty cause any problems in the process? We already know it is not the most efficient deterrent. What we also have consider is that the minimum sentence removes judicial discretion which is necessary to allow courts to take into account the facts of each particular case. I suggest minimum penalties and removing a judge's discretion should not be handed out easily or glibly.

[Hiv-Aids, May 9th, 1996]

Mr. Speaker, the member for Macleod the other day claimed that Bill C-33 will encourage a lifestyle that spreads disease, notably HIV-AIDS. The leader of the Reform Party has dismissed these remarks and supported them by saying that they are the opinions of a medical professional.

As a member of Parliament the member for Macleod has the responsibility to ensure public policy is based on fact, not on misinformation or fear. As a medical doctor he has the responsibility to speak to the research.

The research tells us that this disease affects men, women and children. The research says it is a preventable disease and that its sources are known. The research has taught us that responsible behaviour will help to control HIV-AIDS. The member for Esquimalt-Juan de Fuca, who is also a medical doctor, seems to understand this.

Misinformation from the member for Macleod will have more of an impact on the transmission of HIV than any of his imagined impacts of Bill C-33.

HIV-AIDS is a serious public health issue. Canadians are entitled to responsible, constructive comments from their MPs in the fight against the spread of AIDS. Canadians deserve better-

[Racism, May 1st, 1996]

Mr. Speaker, Windsor-St. Clair is a diverse riding. Many of our constituents came to this country knowing that the majority of Canadians treat one another with dignity and respect.

Recent events have served to remind us that we must remain vigilant against racism, even in the House. Could the Secretary of State for Multiculturalism please tell the House what the government is doing to combat racism in Canada?

[Justice, April 16th, 1996]

Mr. Speaker, my question is for the parliamentary secretary to the solicitor general.

Canadians want the various levels of government to simplify, co-ordinate and avoid overlap. In Windsor and Essex county we see through our American neighbours what violent crime can do to a society.

Is the government taking any steps to clear up jurisdictional overlaps in the criminal justice system to make it more efficient and to ensure that nobody falls through the cracks?

[Health Care, March 29th, 1996]

Mr. Speaker, the people of Windsor know firsthand the value of Canada's medicare system because they see the alternatives every day across the river in Detroit. They have concerns that the North American Free Trade Agreement might open medicare to competition from U.S. companies.

What assurances can the Minister of Health give Windsorites and all Canadians that our health care system is being protected from U.S. corporate competition?

[Department Of Human Resources Development Act, March 28th, 1996]

Madam Speaker, I am from Windsor which is a union town. The people of Windsor are watching the Reform Party very closely. Of course it does not have much hope there. It received about 4,500 votes in my riding in the last election. However, I heard by the grapevine that Reformers think they may have an opportunity there. Let me tell them that in the next campaign the Liberal members from Windsor will be sure to tell our citizens that the Reform Party wants to eliminate labour's only representative at the cabinet table.

I do not know why anyone should be surprised. The Reform Party stands opposed to most of the goals of organized labour.

Organized labour wants better conditions for working men and women. The Reform Party is opposed. Organized labour wants employment equity. The Reform Party is opposed. Organized labour, indeed all working men and women in Canada, want parity for men and women in the labour force. The Reform Party is opposed. Organized labour would like some form of protection during strikes, some form of anti-scab legislation. The Reform Party is opposed.

Reform just does not limit itself in its opposition to issues of specific concern to labour but issues of general concern in our society where labour has taken a lead. On the Canada Health Act and the principles of the Canada Health Act, Reform is opposed. On gun control, which Canadian labour spoke out clearly on, Reform is opposed. On Canada pension plan reform, Reform is opposed; it wants to eliminate CPP. On employment insurance reform, the Reform Party is opposed. On human rights amendments, the Reform Party is opposed. On humane and careful deficit reduction, Reform is opposed to that as well.

These guys, and most of them are guys, remain opposed to almost everything that this government has tried to do for the working people of Canada. Indeed we ought to change the name of their leader from leader of the third party to Dr. No when it comes to labour related initiatives.

I have a message for Dr. No. Working men and women in Canada are watching him. Indeed, working men and women in Windsor are watching him very closely. This motion is simply a symptom of the greater disease in the Reform Party, the disease I call the "I'm all right Jack" syndrome. What happens with this syndrome is they say: "I've got mine, I did okay and I am not responsible for anyone else". This government does not operate that way and it is just not good enough for us.

This government wants labour to have representation at the table when cabinet decisions are made and when policy initiatives are taken. It is important to this government to have someone there who has had experience in labour, who understands working men and women and who wants to do the best for them. It is important that this government has someone there particularly during this crucial period who will consult with and bring the views of labour to the table.

Who better could have been chosen but the former Minister of Labour and the present Minister of Labour? My colleague, the chief government whip, indicated some of his qualifications. One of the things he left out was that this minister's first job when we came to Canada was as a union organizer in the garment district in

Montreal. What better person could we have to speak for the working men and women of Canada at the cabinet table than this minister?

The human resources development department is one that I and others became familiar with during the last session of Parliament. I sat on that committee. It is a huge department. Frankly, it requires more than one hand at the tiller. It seems to me that when the Prime Minister took a hard look at the development of that department and how it was moving along, he was wise to single in on labour as the one area that needed special attention. As a result of that we now have this minister who has established himself well within the labour community and who is going to move forward with the kind of labour code and other initiatives that we require.

The powers of the Minister of Labour are not changing in terms of program statutes that existed prior to the human resources development act. The Minister of Labour will continue to be named in federal labour legislation, such as the Canada Labour Code, the Fair Wages and Hours of Labour Act, the Government Employees Compensation Act and the Non-smokers' Health Act which is part of that mandate.

The human resources act requires as well that the minister make use of services and facilities within the human resources development department and that he use employees from that department. This is not a case of the government creating a new department. This is a case of the government making sure that there is someone there, someone who is dedicating his attention full time to the concerns of the working men and women of Canada.

Why would Reform oppose that? I do not know. I suppose it was Dr. No's idea.

[The Late Charles Joseph Clark, March 25th, 1996]

Mr. Speaker, earlier this month Windsor lost one of its greatest citizens, Charles Joseph Clark.

Recently inducted into the Order of Canada, Charlie Clark was a fine lawyer, a community activist, a philanthropist and a businessman. He was indeed a great community leader, one to whom Windsor turned for counsel on many occasions such as when the local CBC station was threatened, when the casino became a reality and when we wanted to preserve our unique cultural and natural heritage.

Charlie Clark was also a mentor to many young lawyers, including the three current members of Parliament from Windsor.

I know all members will join me in remembering a great Windsorite, Charles J. Clark, and in offering our most sincere condolences to his family.

[Petitions, March 6th, 1996]

Madam Speaker, I have a petition which I am presenting on behalf of the hon. member for Windsor West.

The petition deals with the issue of corporal punishment of children and more specifically with section 43 of the Criminal Code of Canada.