Carolyn Bennett

[Supply, November 18th, 2004]

Madam Speaker, I think it is going to be very important. To me, as strategy, we want as little trans fat in people's diets as we can possibly have. I think it is going to be extraordinarily important that the task force look at all the alternatives and that there also be a strategy: what, by when and how. If in the advice of the task force, the “what” is for a ban and the task force decides that in Canada because we need canola oil it should be at 3% instead of the 2% in Denmark, or whatever that is, we then need in place the strategies to have industry and whatever on side, such that it would be timed in a way that would be practical, doable and ultimately in the best interest of Canadians.

I think the labelling was step one. Now we will look to the task force and the parliamentary committee to determine what this next step ought to be.

[Supply, November 18th, 2004]

Madam Speaker, I am pleased for a number of reasons to have this opportunity to speak to the hon. members on the troublesome issue of trans fats.

First of all, this debate is one more means of raising Canadians' awareness of the ill effects of trans fats, since consciousness raising and education are an integral part of our mission to promote healthy eating.

Second, this offers me an opportunity to explain what the government is doing to reduce trans fat content in the food we eat and to confirm that there are already some encouraging results.

Finally, this subject goes far beyond diet alone. It is part of a far broader issue that is at the heart of my mandate as Minister of State for Public Health; the vital need to promote all aspects of health and healthy living.

I thank the NDP for initiating this extremely important debate because I know that all members share the goal of taking positive action to encourage Canadians to make healthier choices, including healthier food choices. I also know the member for Winnipeg Centre has taken a great interest in this matter.

I am happy to support the motion calling for the establishment of a multi-stakeholder task force to develop strategies for significantly reducing the level of trans fat in Canadian foods.

Accordingly, I would like to propose that the Standing Committee on Health should be consulted to the best possible composition of such a task force and its mandate. I will make myself available, as will officials of the department, so we can exchange ideas. I also suggest that the task force report to the Standing Committee on Health. This can become another example of how Canada's parliamentarians are an effective force for positive change when we work cooperatively.

I know there will a lot of views to be heard. Many people believe the simple answer would be to just ban trans fats but we know that effective long term solutions are complex. As Mencken said, “For every complex problem there's a neat, simple solution, and it is always wrong”.

We must deal with the trans fat issue in a complex and thoughtful way so we do not end up actually worsening the health of Canadians through our decisions, which is a real possibility if we rush headlong into a ban.

As the Minister of Health and many other members have correctly stated, dietary trans fat is an important public health matter because we now have scientific evidence that consuming trans fat increases the risk of coronary heart disease. The evidence indicates that trans fat increases the blood levels of LDL cholesterol, the bad cholesterol. It also decreases the levels of HDL cholesterol, the good cholesterol.

It is because of those effects that the organization that establishes dietary reference intakes for the U.S. and Canada, for example, the Food and Nutrition Board of the Institute of Medicine, recommended in 2002, “that trans fatty acid consumption be as low as possible while consuming a nutritionally adequate diet”. Essentially the same recommendation was made for saturated fats, although saturated fats increase both LDL and HDL cholesterol levels and therefore have a lesser impact on the risk of heart disease.

The Institute of Medicine noted, however, that the trans fatty acids are unavoidable in non-vegan diets and that to attempt to reduce the levels to zero would mean the elimination of dairy products and meats and this could result in an inadequate intake of protein and certain micro nutrients.

I doubt that we will hear contrary views to that finding today. I am sure we will find that there is a consensus which will emerge fairly quickly in this debate that we need to reduce the consumption of dietary fat as part of achieving the best possible health for all Canadians. Where we will differ is in how best to respond.

On a gram for gram basis, trans fats have a more negative effect on heart health than saturated fats. It has been estimated that Canadians consume on average about eight grams of trans fats per day. However they also consume an average of 27 grams of saturated fat. The Canadian consumption of saturated fat is almost four times higher than our consumption of trans fat and is way higher than recommended. It is just as important from a health standpoint not to significantly increase saturated fat intake in our desire to reduce the consumption of trans fat.

As the member for Winnipeg Centre noted, Denmark did make the move of setting a maximum limit of 2% of trans fats in all fats and oils in food sold in that country. The Danish diet differs from the Canadian diet which contains greater amounts of animal fat and tropical oils. Since Denmark is a much smaller country and food production less centralized, products do not need as long a shelf life as they do in Canada. There is, therefore, the need for a stability provided occasionally by partially hydrogenated fats in some foods. Since these partially hydrogenated fats are the main source of trans fat, Denmark is in a position to restrict them without altering their diet.

The message here is that it would be wise and prudent to compare the circumstances and potential impacts in both countries before importing a measure that may work for one country but not for another. This will be an important job for the task force.

When reducing or eliminating trans fats in foods, it is extraordinarily important that we understand that we want the trans fats to be replaced by healthier alternatives. Setting this arbitrary limit on trans fats in foods without taking the time to identify appropriate alternatives runs the risk of substituting these highly saturated fats. It is important to ensure that the essential fatty acids, the omega 3 fatty acids, are there.

It is interesting to know that here in Canada canola oil is routine in many diets and is at a 3% level, which is 1% higher than the Danish level.

I think it will be extremely important for the task force to hear from all voices, including industry, to understand what would be the best practices and the best strategy to get to a healthy diet for all Canadians.

As a family physician, I helped my sick patients to get the best possible treatment, but I knew that my role was much greater than that. I also had the responsibility to counsel my patients on the choices that could promote and prevent diseases down the road.

Now, as the Minister of State for Public Health, I have a larger call to action. My goal is simply to keep as many Canadians healthy for as long as possible. My goal is to prevent injury and illness and to promote good health choices for the benefit of Canadians and for the sustainability of our health care system.

It was very gratifying, I think, for all Canadians to hear at the first minister's meeting in September the important plea by all the first ministers in terms of what it is going to take on health promotion, disease prevention.

It was impressive to hear them talk about trans fats, about the importance of immunization and about ways to prevent fractures in seniors. It is clear that they get it in terms of equating and keeping Canadians well as an imperative in terms of the sustainability of our health care system. We all know now that we must put the health back into health care.

Clearly, heart disease is a major chronic disease in Canada, therefore we must address its causes and tackle all the relevant determinants, including nutrition. Our thoughtful action on the trans fat issue is part of a much broader, complex strategy to foster health through healthy living.

I want to share with members some of the information about this strategy before reinforcing why I believe that a ban is not the best public approach to the dietary trans fat issue and why we think that the idea of a task force is extraordinarily important.

As is the case across our health agenda, the Government of Canada is committed to working with the provinces and territories and other stakeholders to improve the health of Canadians through attention to healthy living issues. The current basis for much of this work is in the integrated pan-Canadian healthy living strategy framework that the federal, provincial and territorial health ministers agreed to in 2002.

As part of this, the ministers agreed to work together on short, medium and long term pan-Canadian healthy living strategies that emphasize nutrition, physical activity and healthy weights. Our aim is to promote good health by reducing the risk factors and the underlying societal conditions associated with cardiovascular and respiratory diseases, diabetes and some cancers.

Within that, we have developed what we are calling Canada's healthy living strategy. That strategy identifies children and youth as a priority target population. It also identifies schools as one of the key settings for addressing health concerns. The agreement at the first minister's meeting toward a school health initiative I think was hugely important in that aim.

One way we will proceed in promoting healthy living and eating is by building on the already existing best practices. There is no shortage of great work going on through healthy living and healthy eating initiatives across the country. For example, in building the public health agency through my cross-country consultations I visited Prince George where I learned that Health Canada's $300,000 in funding was pooled into a fabulous healthy eating, active living alliance. Through that, it has community gardens, community kitchens and activation programs. It has actually parlayed the $300,000 into over $1 million along with rotary clubs and local businesses. It only makes sense that we follow the lead of initiatives like this to help Canadians to become more active, make better food choices and enhance their health.

We are promoting healthy living through collaboration among governments and other stakeholders and through action at the community level.

Solutions have to be multi-pronged and designed to achieve their intended results, which is what we have done on the trans fat issue.

In January 2003, Canada became the first country in the world to require the mandatory declaration of the trans fatty acid content of foods on the labels of prepackaged foods. I think that has gone a long way to helping the health literacy of Canadians on the whole issue of trans fats and what some have said, that Canadians are way ahead of us.

Most foods will be required to have this declaration by December 2005. These labels help consumers make healthy food choices and limit their intake of trans fat. Already this move is leading to many food companies in Canada lowering the trans fat content of their foods.

Why did we not impose a regulatory limit or a ban on trans fats? Because through our broader public health lens, we realized that forcing industry to eliminate trans fat content in the absence of widespread healthy alternatives could have health implications that are equal to or worse than those of trans fats. In short, a ban could result in the worsening of the risk of cardiovascular disease if the alternatives were not well articulated. Many of the current alternatives would reduce the amount of trans fatty acids but at the same time would increase the amount of saturated fatty acids, which are also a risk in coronary artery disease. I have to say that I cannot ban butter, eggs, and cream.

It is extraordinarily important, too, that the education, the health literacy and the civic literacy around these issues continue. Appropriate healthy alternatives to fats and oils high in trans fats are not yet readily available, so we are taking a smart and measured approach. Health Canada will monitor the trans fatty acid content of the major sources of trans fats in the diet to gauge the effectiveness of the nutrition labelling program and we will continue to help the industry find healthy alternatives. We will obviously await the work of the task force as well.

The department is also working with the food service industry to encourage reduction of trans fats in the food served by restaurants and other food service establishments. Of course, the department is continuing with many public education awareness initiatives to inform Canadians about the importance of reducing their intake of trans fats and we also know that today's debate is extraordinarily important to that as well.

Informed consumers demanding healthier food choices will provide much further impetus for food companies to reduce or eliminate their trans fats. We assume that the companies do not want to manufacture what Canadians do not want to buy. We are just beginning, but we are confident that our approach will pay off with healthier foods and healthier Canadians.

In the words of Elizabeth Blackwell:

We are not tinkers who merely patch and mend what is broken...We must be watchmen, guardians of the life and health of our generation, so that stronger and more able generations may come after.

This is our mission as guardians of public health: to make thoughtful and wise decisions today that will help Canadians enhance their health and their lives in the future. We cannot act in shortsighted ways that may produce ill health or disease tomorrow by unintended consequences. A ban on trans fat foods could produce these unintended negative results and we owe it to ourselves and future generations to make wise decisions that will enhance public health over the long term.

I eagerly await the work of the Standing Committee on Health and of the task force, and then the deliberations of the Standing Committee on Health after that.

As the guardians of public health, we need to make wise decisions today in order to help Canadians to improve their health and quality of life. We cannot allow ourselves to take a shortsighted approach, which is liable to be harmful in the long run.

Banning trans fats could have negative consequences. It is in our interest and that of coming generations to make informed decisions that will improve people's health in the years to come.

[Health, November 17th, 2004]

Mr. Speaker, I want to reassure the member that Canada has a comprehensive pandemic influenza plan which the World Health Organization has called a best model for other countries.

Today the Minister of Health and our chief public health officer for Canada were at the WHO in New York to launch the next phase of the global public health intelligence network. This made in Canada early warning system gathers and disseminates the reports of public health significance in real time on a 24/7 basis, in seven languages, at the Public Health Agency of Canada. The earlier we know about public health risks, the better prepared we can be.

[Drug Strategy, November 5th, 2004]

Mr. Speaker, I think the hon. member knows that we have had for a long time in this country a centre for drug abuse. There is indeed ongoing monitoring, trying to make sure that people live healthy lives.

There is going to be an increase in the drug strategy because we want to protect our kids and try to keep all Canadians healthy for as long as possible. We are committed to that and that is what my job is.

[Quarantine Act, October 22nd, 2004]

Mr. Speaker, in the Speech from the Throne, the Government of Canada's objective was to modernize the legislation on health protection.

From the Naylor report to budget 2004, from the creation of the Public Health Agency, to the recent first ministers and health ministers meetings, the government has demonstrated its clear commitment to enhancing and protecting the public health of Canadians.

While the current health protection system has served Canadians well, the time has come to update and integrate our existing laws into a stronger, comprehensive and flexible public health system, precisely what Dr. David Naylor, as well as the Senate committee which studied SARS, recommended we do.

The amendment of the Quarantine Act is the first of a series of improvements such as the public safety agency act that the Government of Canada wants to introduce to reinforce our public safety system.

With the SARS crisis we had to face the fact that our current legislation is outdated. The existing Quarantine Act has remained largely unchanged since the adoption of the first Quarantine Act in 1872, a time when automobiles and jetliners were the subject of science fiction.

Needless to say, times have changed. We live in an age where people move from continent to continent in hours and days rather than weeks or months, often in airplanes and ships whose confined spaces provide a perfect breeding ground for highly communicable diseases to spread.

We now acknowledge that our planet all of a sudden has become very tiny. Infectious diseases move like wildfire across the planet. Germs do not respect borders, so we know that we will face repeated threats to public health in the future.

Among the many hard lessons learned from the experience of SARS is the need to strengthen our quarantine legislation to help prevent the introduction and spread of both emerging and re-emerging communicable diseases.

As a response to concerns about the spread of communicable diseases, we decided to move forward immediately with new quarantine legislation. The legislation before the House today delivers on our pledge to correct many of the problems brought to our attention by the recent events such as SARS which underscored how fast and how hard diseases can hit our health care system and our economy.

The government understands how important it is to address the gaps in readiness. In budget 2004 we pledged $165 million to establish the health emergency response teams and enhance surveillance. We have also created a new department of Public Safety and Emergency Preparedness.

Now, with Bill C-12, we will replace the outdated quarantine legislation with an improved and modern Quarantine Act so that we can better protect Canadians from the importation of dangerous communicable diseases and ensure Canada can meet its international obligations to help prevent the spread of diseases beyond our borders.

The modernized act we propose has a new focus on airline travel and would provide the Minister of Health with additional abilities. For example, he could divert an aircraft to an alternate landing site if it is necessary to isolate passengers. He can establish quarantine facilities at any location in Canada and order that carriers from certain countries or regions of the world not enter Canada if there are serious concerns that such an arrival may threaten the public health of Canadians. He would be able to close Canadian border points in the event of a public health emergency. The proposed act also lists many more communicable diseases for which Canadian officials could detain departing passengers.

While these measures would only be used in rare instances where circumstances warrant, these changes are essential if we are to keep pace with emerging infectious diseases and protect the health of Canadians.

I want to ensure parliamentarians that Canadians' privacy rights are guaranteed. While the updated act authorizes the collection and sharing of personal health information, the authorization to do so is limited to what is required to protect the health and safety of Canadians. That is what citizens clearly want. They want the assurance that we are taking every possible precaution to prevent the spread of communicable diseases that could put their personal health and the welfare of their communities at risk.

The new version of the Quarantine Act will give us an additional level of protection by providing solid, flexible and updated legislation that will allow us to react more efficiently to current and future health risks, while ensuring adequate protection of human rights.

The scope of the Quarantine Act is limited to ensuring that infectious diseases are prevented from entering Canada or being spread to other countries. It will not affect interprovincial movement. We continue to work with our provincial and territorial government partners regarding the quarantine measures that can be taken to control the spread of infectious disease within and between provinces. In this regard, I would like to express our appreciation for the FPT special task force on public health which models a clear approach to mutual aid, information sharing and collaboration.

Canada is a responsible partner of the global public health arena. The updated act is aligned with Canada's obligations under the World Health Organization's international health regulations. The updated act, the creation of the public health agency of Canada, the appointment of the first chief public health officer and the Canadian pandemic influenza plan are all complementary steps in the Government of Canada's strategy for strengthening Canada's public health system. These innovations ensure better communication, collaboration and cooperation among partners as well as better clarity about who does what and when.

They will build on the expertise and strengths we already have in many areas of public health and communicable disease control to ensure Canadians are safeguarded by a seamless public health system throughout this country. Taken together, they will help ensure that Canadians are fully protected from the outbreaks of emerging diseases such as SARS and whatever else awaits us in the future.

Given that we cannot predict what the next infection will be or when it may surface, we need to be ready. We need this improved legislation now. By introducing a new and modern Quarantine Act, Canada will be better positioned to respond to any and all potential for threats to the health and well-being of our citizens.

It is clear that the health and safety of Canadians is a priority of the government. Canadians expect no less. I look forward to the work of the parliamentary committee to listen to the stakeholders and experts to help us make the bill as good as it can possibly be.

By passing the progressive bill that we are discussing today, within a larger public health strategy, I am convinced that we will not disappoint Canadians.

[Health, October 22nd, 2004]

Mr. Speaker, I am proud to report, in working with our provincial and territorial colleagues, all of the important improvements that we have made since the tabling of the comprehensive Naylor report a year ago that include the Public Health Agency for Canada, the new chief public health officer, as well as new surveillance guidelines, all of these things.

In fact, I invite the member and you, Mr. Speaker, to the new Public Health Agency next week. Dr. David Butler-Jones would be happy to explain it to everyone in person. Together we can all reassure Canadians--

[Quarantine Act, May 14th, 2004]

Mr. Speaker, it was a little over a year ago that Canada was confronted with a mysterious disease that would go on to claim the lives of 44 Canadians, temporarily cripple the economy of Toronto, and take an enormous toll on this country's public health workers and health care providers who worked valiantly to prevent the loss of more lives. What we came to know as SARS provoked a health crisis unlike any other we have seen in recent years. We made every effort to control the spread of the virus to protect the lives and livelihood of Canadians.

One of the first steps we took in the days immediately following the outbreak was to deploy Health Canada employees as quarantine officers to provide health assessments for travellers who appeared to be ill or who may have been exposed to the disease. We instituted health alert notices to advise travellers about its symptoms and the steps to take to protect themselves, as well as health alert notices with questionnaires to passengers on incoming direct flights from Asia where the disease originated. The health alert notices were also later available to rail and bus passengers in Ontario.

As effective as those measures were, we had to face the fact that our current legislation is outdated. The existing Quarantine Act has remained largely unchanged since the adoption of the first Quarantine Act in 1872, a time when automobiles and jetliners were the stuff of science fiction.

Needless to say, times have changed. We live in an age when people move from continent to continent in hours and days rather than weeks or months, often in airplanes and ships whose confined spaces provide a perfect breeding ground for highly communicable diseases to spread.

Infectious diseases move like wildfire across the planet today. Diseases do not respect borders, so we know that we will face repeated threats to public health in the future.

Among the hard lessons learned from the experience of SARS is the need to strengthen our quarantine legislation to help prevent the introduction and spread of both emerging and re-emerging communicable diseases.

We began that process last June. To address the immediate problems we faced, we amended the Quarantine Act to include SARS on the schedule of infectious and contagious diseases and to prescribe an incubation period of 20 days for anyone exposed to the virus.

As a result of the regulatory changes, quarantine officers were able to exercise the necessary control over people entering into or departing from Canada and suspected of having SARS but who were not taking the required precautionary measures. It was necessary to take these measures in several cases to protect the health of the public.

We knew, however, that much more had to be done to ensure we would be able to react quickly to other emerging, and often unprecedented, threats to public health. That is why we thoroughly examined the Quarantine Act. The quarantine provisions were included in a health protection legislative review, as part of a legislative renewal Health Canada had undertaken to achieve and maintain the highest standards of health protection for the benefit of Canadians, today and in the future.

We undertook extensive consultations this past winter with provincial and territorial government representatives, health professionals, industry, advocacy groups and members of the public, seeking their insights and advice.

We heard repeatedly that while the current health protection system has served Canadians well, the time has come to update and integrate our existing laws into a stronger, comprehensive and flexible public health system. That is precisely what Dr. David Naylor as well as the Senate committee which studied SARS recommended we do.

As a response to concerns about the spread of communicable diseases, we decided to move forward immediately with new quarantine legislation, while the remainder of the health protection legislation renewal continues as planned.

The legislation before the House today delivers on our pledge to court many of the problems brought to our attention by recent events such as SARS, which underscored how fast and how hard disease can hit our health care system. With Bill C-36 we will replace the outdated quarantine legislation with an improved and modern Quarantine Act so we can better protect Canadians from the importation of dangerous communicable diseases and ensure Canada can meet its international obligations to help prevent the spread of these diseases beyond our borders.

Where there are incidents of risk to public health, the act continues to allow for public health measures at Canadian points of entry such as: screening travellers entering and leaving Canada, whether by customs officials or detection devices; referring travellers to a quarantine officer who may conduct a health assessment, order a medical examination, vaccination or other measures, order the traveller to report to a public health authority, or detain anyone refusing to comply with measures to prevent the spread of the disease; requiring owners of public transport conveyances, such as jets or ships, to report an illness or death of a passenger before arrival in or departure from Canada; detaining either passengers or conveyances until there is no longer a risk to public health; and inspecting such conveyances and ordering their decontamination or destruction, if required.

As well, the modernized act we propose would provide the Minister of Health with additional powers. For example he could appoint screening officers, environmental health officers and analysts as well as quarantine officers; establish quarantine facilities at any location in Canada; take temporary possession of premises to use as a detention facility if necessary; and divert airplanes and ships to alternate landing sites. While these powers would only be used in rare instances where circumstances warrant, these changes are essential if we are to keep pace with emerging infectious diseases and protect the health of Canadians.

I want to assure parliamentarians that even though the legislation will allow for the collection of information for public health purposes, Canadians' privacy rights are guaranteed. While the updated act authorizes the sharing of personal health information, the authorization to do so is limited to what is required to protect the health and safety of Canadians.

This is what citizens clearly want. They want the assurance that we are taking every possible precaution to prevent the spread of communicable diseases that could put their personal health and the welfare of their communities at risk.

The updated Quarantine Act will give us an additional layer of protection by providing strong, flexible up to date regulations that will allow us to respond more effectively to ongoing and future health risks while ensuring adequate protection for human rights.

My colleague, the Minister of Health, and I are extremely proud of the legislation, a critically important first step forward in a series of improvements the Government of Canada is making to strengthen our public health system.

As hon. members know, in addition to the new health protection legislation, we are moving on multiple fronts, including the creation of a new public health agency for Canada, the appointment of the first ever chief public health officer, and the development of a pan-Canadian public health network founded in five regional centres of collaboration across the country.

These innovations ensure better communication and collaboration among partners and will build on the expertise and strengths we already have in many areas of public health and communicable disease control to ensure Canadians are safeguarded by a seamless public health system throughout the country. Taken together, they will help ensure that Canadians are fully protected from outbreaks of emerging diseases such as SARS and whatever else awaits us in the future.

Given that we cannot predict what the next infection will be or when it may surface, we need to be ready, so we need this improved legislation now. By introducing a new and modern Quarantine Act, Canada will be better positioned to respond to any and all potential threats to the health and well-being of our citizens.

It is clear that the health and safety of Canadians is a priority of the government. Canadians expect no less. With the passage of the progressive legislation we are debating today as part of the larger public health strategy, I am confident we will not let them down.

With the passage of the progressive legislation we are debating today as part of the larger public health strategy, I am confident we will not let them down. Thank you for your attention.

[Supply, May 11th, 2004]

Mr. Speaker, I share the member's concern. Really this is about confidence. Canadians need to know that over the next generation the health care system they cherish so much will be there for them when they need it.

As much as money is an issue, I think the member will recognize that a lot of the concern has been about our not having a real system. It has been a patchwork quilt of non-systems, with perhaps not as much emphasis on quality, appropriateness of care and a real integration of the way the system works.

I was pleased on my trip to and from Whitehorse this weekend to have read the book by Michael M. Rachlis, Prescription for Excellence . He makes a very good case that there may well be some need for additional funds but really we have to work hard on sharing best practices across the country and looking at results, the areas that are really getting good results.

Therefore I say to the member, I am thrilled that since the Romanow report we have been able to establish the Health Council of Canada. Michael Decter and his colleagues at the council have been able to tackle the really important issue around wait times.

As we look to the first ministers meeting with the Prime Minister, what they call that long, boring technical meeting, we will look at important things like the confidence around getting diagnostics and treatment and outcomes. We can share across the country where it is working better, where areas have certain needs and how we can get the best value for the money that we are spending.

I cannot resist explaining to the House that after seeing a National Post headline criticizing the Canadian system, I want everybody to look at the Fraser Institute survey and look seriously at why it would leave out the United States when it is trying to slam us. It is purely partisan and poor methodology. We cannot tolerate that kind of bad examination of our really fabulous health care system.

[Supply, May 11th, 2004]

Mr. Speaker, in my view, from the tabling of the Naylor report, to what was in the Speech from the Throne, to the dollars we actually got in the budget so that a chief public health officer could actually do his or her job, to what I have seen in my 32 consultations around the country, we are trying to make sure that in the job description for the chief public officer for Canada we have reflected the voice, relevance and responsiveness of what the people of Canada have said that they would expect of that person.

I am pleased to tell the member that we now have the job description and it includes a very significant piece of citizen engagement. We will be able to announce the committee within a few days to commence that really important search for Canada's doctor.

[Supply, May 11th, 2004]

Mr. Speaker, as my colleague the Minister of Health has clearly articulated, we are committed to the values that make the Canadian health care system one of the best in the world. In his speech the Minister of Health spoke about a comprehensive and collaborative system. I want to expand on this idea by speaking to the House about the balance of upstream and downstream in health.

Just as we are committed to a publicly funded and administered health care system, the government also believes that we must be proactive about the health of Canadians today and in the future. That is why we approach health from a holistic perspective. We understand that poverty, violence, the environment, shelter, education, equity are all about trying to keep as many Canadians healthy for as long as possible. This is absolutely pivotal in our vision for a long term sustainable system.

Shortly after I was appointed the Minister of State for Public Health, I was asked if public health was the opposite of private health. I have to admit I was little surprised at the question. Today I want to state publicly that absolutely a strong public health system for Canadians stands in stark contrast to the for profit health care that waits for people to get sick and then lets the market determine their costs and their access, leaving countless people out. This is indeed about the public good. It is about Canadian values. It is about those public health goals of health protection, prevention and promotion.

Canadians should be proud of the health care system they have created, a system founded on accessibility, universality and quality. Some have described it unfortunately as a sickness system that has too much focused on the repair shop or the tyranny of the acute.

Our recent experiences with SARS, West Nile and the avian flu have exposed areas of our system that need to be improved. Developing trends such as obesity and inactivity and health disparities tell us that more can be done and more should be done.

The clear consensus of the Naylor and Kirby committees last year, as well as that of other public health experts, is that the Government of Canada must act to demonstrate leadership in this field. We are acting.

The Speech from the Throne clearly articulated our commitment to public health and the federal budget has given us the means to move forward. We have committed in the budget over $665 million targeted at issues like the first ever national immunization strategy, building surveillance capacity through the Canada Health Infoway and supporting front line provincial and territorial capacity.

The immunization strategy is a perfect example of our commitment to proactive and preventive public health and investing in the system. It is also a splendid example of real federal-provincial cooperation.

In the 2004 federal budget the Government of Canada has committed to providing the provinces and territories with $400 million over the next three years to enhance their immunization programs and help relieve the stresses on local public health systems. Three hundred million dollars will be earmarked to support the national immunization strategy. It will support the introduction of new and recommended childhood and adolescent virus vaccines such that no longer will family physicians have to recommend a vaccine and then ask if the family can pay for it.

In the 2003 federal budget $45 million over five years was allocated to pursue this national immunization strategy. With these investments we have begun strengthening key federal infrastructure programs for addressing immunization issues such as vaccine safety, surveillance of vaccine preventable diseases and immunization coverage, procurement processes and professional and public education.

The strategy will result in an enhanced national collaboration on immunization issues; improved monitoring and control of vaccine preventable diseases; better vaccine safety monitoring and response to safety concerns; more affordable vaccines; improved security of the vaccine supply; increased public and professional confidence in vaccines and immunization programs; and better information on which to base policy decisions related to immunization.

Additionally the funds will support a forum for discussion and exchange of information on immunization with provincial and territorial jurisdictions and other stakeholders in order to improve the safety, effectiveness and efficiency of immunization programs in Canada.

The national immunization strategy will address a number of challenges currently being faced by all jurisdictions. It will allow federal, provincial and territorial governments to work in partnership to improve effectiveness and efficiency and toward equitable access to immunization programs in Canada. It is a proactive investment in the future and wellness of our children.

We are confident that this and our other investments will strengthen public health care capacity across Canada, ultimately contributing to a stronger and more responsive public health system for the future.

In addition to this, we are following through on our announcement in the Speech from the Throne to create a public health agency of Canada. Using Health Canada's population and public health branch as a foundation, the agency will be a focal point for federal efforts in the areas of public health emergencies, chronic and infectious disease prevention and control, and will also promote population health and wellness.

The agency will be key in building on the existing relationships with our counterparts in the provinces and territories as we work toward the ultimate goal of making Canadians among the world's healthiest people. It will also be key in representing Canada and working with international health organizations, such as the World Health Organization and the Centers for Disease Control in the United States.

We are also moving forward with the appointment of the chief public health officer of Canada. The chief public health officer will manage and lead the agency, providing clear federal leadership on public health. He or she will be the national spokesperson in public health emergencies. He or she will be seen as the country's doctor, someone whom Canadians can count on for accurate and timely public health information.

Finally, we are developing a pan-Canadian public health network that will ensure coherence and collaboration across all jurisdictions and structures, a truly integrated public health system for Canada. We are in the process of establishing an action plan for this network. We are confident that it will lead to a more robust public health partnership.

The network will be founded initially in five centres of collaboration, one in each region of the country. Each centre will be a champion for a component of public health and will build on the already existing expertise in each particular area. These centres will be national resources for the benefit of all Canadians. We are confident the network will strengthen federal, provincial and territorial collaboration and increase public health capacity in all jurisdictions.

I should mention that we recognize the role of our partners in this integrated public health strategy. The public health system must be built on a strong common purpose and respect the local wisdom and local knowledge to get the job done.

Provinces, territories, local authorities, various other stakeholders and the citizens themselves are the real experts on the challenges and opportunities in their own communities. They have a key role to play in relation to emergency response, disease control and prevention, and health promotion. It is absolutely essential that all stakeholders and citizens have a chance to contribute to the development of our public health strategies.

Over the last few months I have met with numerous public health stakeholders across the country on a broad range of public health issues. Their input has been invaluable to our vision on a way forward for public health in this country. I have also met internationally with the World Health Organization, the U.S. Centers for Disease Control and public health experts from the United Kingdom and the European Union.

As we talk about the health care system in Canada, we remain committed to continuing to foster this interaction.

I am personally committed to ensuring that citizens and stakeholders will be embedded into the very DNA of this new agency. They will play a role in all future public health strategies.

Together with my colleague the Minister of Health, I have provided tangible examples of the government's commitment and vision for a comprehensive strategy on health in this country, one that values the preventive, proactive and educational pieces as much as it values a responsive health care system that will be there when Canadians need it.

Building on the voice of Canadians, we are confident that we are taking the right steps to ensure that citizens get the public health care they deserve and more important, that as many Canadians stay healthy for as long as possible.