Mr. Speaker, it is a pleasure to participate in the debate this afternoon on Bill C-5, the Public Health Agency of Canada act.
This is legislation that my New Democrat colleagues and I want to support. We will be working hard on this legislation and our health critic, the member for Surrey North, will be working hard on it at committee to improve it, but we are happy that the legislation is before Parliament.
It was a resurrected bill from the 38th Parliament, Bill C-75. I have to say, given the last exchange we just heard, that both the previous government and the current government deserve some credit for moving forward on a public health agenda. The previous government did in fact institute the position of minister responsible for public health and did appoint the Chief Public Health Officer, Dr. David Butler-Jones. The member for St. Paul's, who spoke earlier today, spoke enthusiastically about the work of public health in Canada. He was the first minister of public health.
The current government deserves credit for giving it a high priority, for formalizing the agency through this legislation and for putting the bill forward so early in this Parliament. I think there needs to be some joint credit on this issue.
The genesis of the legislation was probably the SARS crisis, which a number of members spoke to earlier in the debate. SARS affected Toronto in particular. Outside of Asia, I think Toronto was the major area that SARS affected. It shook up people in Toronto and in Canada fairly significantly to say the least. Their faith in our system their faith in our ability to deal with a major infectious disease was shaken.
Canadians want to know that their families are safe. They want to see that there is an ability for health care professionals to coordinate their activities. They know that there are dedicated teams of health care professionals. We saw that during the SARS crisis where people came together under very difficult circumstances, where, in some cases, their own lives were in danger. They worked very hard and in very creative ways to address SARS.
Canadians want to know that kind of cooperation and those kinds of skills are coordinated and effectively utilized all across the country during those kinds of crisis points in our health care history. The SARS crisis demonstrated clearly the need for a national coordination of public health issues.
A national advisory committee on SARS and public health was struck after the SARS crisis. It was chaired by Dr. David Naylor and it made many recommendations. I think this legislation flows directly out of those recommendations.
It is good to have something tangible on the agenda of this Parliament and something tangible to deal with the concerns of Canadians with regard to infectious diseases and to deal with the concerns of health care professionals who have to attack those infectious diseases.
I have a real bias when it comes to talking about public health and that bias is to increase the influence of public health nurses and public health professionals in government, in our health care and in our social systems.
Before I was a member of Parliament, I worked in the community of Burnaby for 18 years. I was always impressed by the approach that public health care nurses took to dealing with issues in our community. Public health care nurses have a particular skill set that brings something crucial to almost every discussion in our community. They bring very specific health care skills through their nursing training. They have particular people skills that are not always evident in every professional group. Public health care nurses are particularly good at analyzing the context of crises and problems in our community. Public health care nurses have shown that they are excellent organizers. In fact, I cannot think of better organizers in our community than the public health care nurses who serve Burnaby.
In my experience, if we are looking for someone at a community meeting to work on a community project or for someone to cut through the rhetoric and get to the core of an issue, that person is more likely to be a public health care nurse than any other professional in the community. They also have a particular understanding of grassroots organizations. Because they deal with people who are experiencing health problems or who are experiencing the problems that lead to health problems, they really understand what is going on in the community. I think they are actually grassroots experts in many ways
Public health care nurses take a holistic approach to solving problems in our community. They do not limit themselves to specific health issues. They go to environmental issues and other social issues, like poverty, to understand the importance of public health in the community. They draw connections between all of the issues that face the communities. They would draw connections between the environmental, between human rights issues and between poverty issues to come up with a holistic approach to solving a health problem. That is very typical of the entire profession and the entire professional group. These are people who bring broad experience and know how to apply that and know how to organize around that experience.
That is something that is needed more in this place. I remembered this morning that a former colleague, the former member for Hamilton Mountain, Marion Dewar, a former mayor of the city of Ottawa, came out of a public health background. I think one of the reasons for her success in her political life was from the expertise she gained there. We need to integrate that perspective into government.
In the future, I would be happy if we saw more public health care nurses in this place. A few less lawyers and more public health nurses would be a good thing in my opinion.
Public health care has five tenets: disease prevention and injury prevention, health promotion, health protection, health surveillance and population health assessment. Those five tenets are very important but they are often the flip side of our health care system where we are dealing with the more acute and treatment issues in health care.
Specifically, the bill seeks to address those five tenets of public health care. Where that is evident is if we look to the preamble of the bill specifically. In the preamble we see that by undertaking the establishment of the Public Health Agency, that the government wants to take public health measures, including measures relating to health protection and promotion, population health assessment, health surveillance, disease and injury prevention and public health emergency preparedness and response seriously. Those relate directly to the five tenets that I just noted.
We also see that the government wishes to foster collaboration within the field of public health and to coordinate federal policies and programs in the area of public health. The agency is:
--to promote cooperation and consultation in the field of public health with provincial and territorial governments;
The agency is:
--to foster cooperation in that field with foreign governments and international organizations, as well as other interested persons or organizations;
We have heard many times today how viruses, bacteria and disease do not respect any border, let alone international borders and provincial borders and how this kind of coordination is very important in the public health area.
Finally, from the preamble, it states:
--the creation of a public health agency for Canada and the appointment of a Chief Public Health Officer will contribute to federal efforts to identify and reduce public health risk factors and to support national readiness for public health threats;
The preamble says it all and it shows why the bill is so important and why it is so important to Canadians. We need to recognize that this is a significant step forward, that there are specifically focused public health measures in the federal government, is something that is perhaps overdue and it is a measure that I think we can all enthusiastically support.
We need to have confidence in the leadership in public health and we need to have confidence in the structure of public health in Canada. This will fill a gap that has existed for some time.
Earlier this morning, my colleague, the member for Surrey North, the NDP health critic, talked about some of the concerns that we have in this corner of the House with regard to the bill. I will just go through six of the concerns that we would like to outline.
The first one, which I raised earlier today and we have had some discussion on this afternoon, is the question of the resources that will be dedicated to the agency and to the important tasks of the agency. We have heard that there is concern out there that there are not enough financial resources nor not enough human resources available to do this important work. A group like the Canadian Medical Association and other stakeholder agencies have raised that issue. I do hope, maybe even today in the budget that we will hear later today, that we may hear a commitment from the government to ensure the resources are there, if necessary, to do this important job.
We also have raised the concern that the Chief Public Health Officer is not given authority over other areas of federal jurisdiction such as airports, railways and military bases, as well as the health of aboriginal people. We need to ensure, given infectious diseases often spread through our transportation system, as we saw with SARS, that the Chief Public Health Officer has the a mandate to deal with health concerns in those areas.
Also, there is an important role for the Chief Public Health Officer in correctional services in terms of harm reduction around drug use and the spread of diseases like HIV-AIDS and hepatitis in the prison system. We know that is a public health issue. It is not only concentrated in the correctional facilities. Prisoners get released and they go back into the general population. Therefore, the health of folks who are incarcerated in our prison system is of concern of all Canadians.
We are also concerned about the power to enforce the Quarantine Act. Under the current system, and this bill would not change that, the power would remain with the Minister of Health. In other jurisdictions the power around the Quarantine Act rests with the provincial public health officers. This seems to be a bit of a disconnect between the provincial system and the federal system. It is probably something that merits attention in the committee.
The Public Health Agency is also not given authority to act when a province or a territory is overwhelmed by a crisis or when a crisis transcends provincial and territorial borders. As I mentioned earlier, we know that viruses, disease and bacteria do not respect borders created by people.
Our fifth point is that the Public Health Agency is not given authority to impose mandatory reporting of diseases by the provinces and territories. Part of the health surveillance mandate is to assess risk in the population. We cannot have a system where we have 13 different strategies. We need to have the ability to control a communicable disease outbreak. This morning my colleague discussed the current outbreak of mumps in North America, specifically in the United States, but also in Canada. Also, the re-emergence of tuberculosis is a major health concern in many of our cities across Canada. We have to ensure that there is the ability to coordinate and that someone is looking at the overall picture across Canada. We cannot have 13 different strategies to address these important issues of communicable diseases.
Finally, our sixth concern is to ensure that the Chief Public Health Officer has some modicum of independence from the Minister of Health. We think there is an important role for independence of this officer and that he or she should have the ability to run with the issues within the mandate of the officer and to take the initiative, as seen fit, to promote the important mandate of the agency. I know my colleague, the member for Surrey North and the NDP health critic, will be raising this when the bill gets to committee.
This is very important legislation. We strongly support getting it to committee and moving on this. We know how important it is to the public health of all Canadians. We know it has been an important response to a major health crisis in SARS. We want to ensure that we do not delay, that we take the appropriate action to follow up on both that crisis and the recommendations made by those who we asked to study this. We should get on with the work, get it into committee and get the bill enacted.
