Carolyn Bennett

[Supply, May 13th, 2003]

I have Gravol for you.

[Supply, May 13th, 2003]

Madam Chair, it is always a good time to look at health estimates and I think it is a good time for us to remind Canadians that we are ever vigilant in terms of getting value for their money when it comes to health. It has been an exciting year in terms of Canadians having an opportunity to speak and I think it was important for us to listen in the way we did. It really was about core Canadian values.

I think there are mainly four questions that will come out of this year of the cottage industry of commissions, particularly the Romanow commission. I think we understand that it is going to be extraordinarily important to understand that pieces of legislation will never protect the Canadian badge of honour in terms of our most treasured social program, that only when Canadians can have confidence in the system will they then be able to relax and not demand to pay.

What would be the strategy to restore the trust in the public system? I think we also then want to know what the strategy is to ensure that governments are accountable to Canadians. Do they know where the money is going? Do they know what value they are getting from the money? Are they getting healthier? Is the system getting fairer? As the minister knows, this is where we were dinged by the WHO in terms of the gap. Are we learning and investing in innovation to get a better system? Are we striking the right balance between treatment and prevention?

I think there is a third question Canadians have. How do we keep listening to them? If we do not want to have a commission every two years, how do we make sure that Canadians know that we will continue to listen to them, that we will continue to understand the trade-offs that they know must be made and that we will be able to continue to listen to their priorities and follow with a system that is relevant and responsive to their needs?

I think their fourth question is this: How do we keep more Canadians healthier longer?

In being able to answer that, I think the minister began tremendous work in her original work on the social union framework agreement. When the minister was in charge of it, I think all of us were thrilled with what came out of it in terms of transparency, accountability, asking citizens to set priorities and the ability to report to Canadians in a regular way. I think the first ministers accord then underlined how we would continue to do that.

Out of the first ministers accord, there are four areas that I think need to be interpreted and strengthened. On the minister's behalf, I would like to help her interpret them in the way I think that would be. In the recommendations, I think that this idea of Quebec council's on health and welfare with a new mandate would collaborate with the health council, but obviously I would hope that the minister, following the Quebec election, will now be able to re-engage the Quebec government with the ability to actually be full partners in the health council, including reporting on the performance of its health care system and health care in a pan-Canadian way that includes Quebec.

We want to make sure that in its statement the accord and the council would monitor and make annual public reports. We hope that means the council is free to report on anything relevant to the health of Canadians, not only that which is explicitly mentioned in the health accord.

We also are interpreting that publicly reporting through the FPT ministers of health obviously means that the council would be truly independent and a trustworthy council which reports publicly, leaving the governments the dissemination of the information to their constituents, but it must be a report that is transparent to all Canadians. Also, in including representatives of both orders of government, experts and the public, we assume that in the accord this means that although governments will select their representatives they will not be government officials, elected or non-elected; they will be government nominees who will act independently and are faithful to the terms of reference of the council, as the council of maritime premiers chooses its regional appointees.

I think that what Canadians expect from this council is an independent, trusted body that advises Canadians on the state of their health and on the performance of their health care system. The council must earn its moral authority by celebrating excellence, pointing out the opportunities for improvement and telling the truth. It must make recommendations, not policy. It has to be more than our collective conscience and the council must ask for good quality data and encourage a learning and collaborative culture that promotes ongoing dialogue.

We hope that what will be supported is a council that uses information of the same quality and reputation as that of Statistics Canada, that it will interpret that data with the rigour of the Auditor General and that it will make recommendations as important as those of the Bank of Canada. We think Canadians must see that the health council of Canada has an important mediating effect on the previous intersectoral tensions that have hindered the progress toward an integrated system of health maintenance and care in which the public good and cost effective, world class results are paramount. We think that the data coming from CIHI is good as it is, but we hope that the council will be able to commission the new data it will require and the research that is not currently available from places like the CIHR.

What we hope is that the collaborative culture that we have seen in this recent SARS outbreak could be practically bottled, such that we would never again see the spectacle that came out of that first ministers meeting where people actually were calling to deal with the next prime minister, those kinds of absolutely inflammatory statements. It has to be an ongoing relationship.

As we have discussed, we would love to think that we could move the fed-prov relationships into something like the VISA model, where feuding financial institutions are able to come together on a common IT program, a common governance and even decide what colour the card is. It is amazing to think that if feuding financial institutions can do this we are unable to do this as a country.

It is important that the federal government go to the table, as the minister said, as the fifth biggest provider of health care in this country, with our own problems in aboriginal health, the military, veterans and correctional services, and we go there to share best practices and to learn from one another. The council is not to be big brother. It is not to be a watchdog. It is to be a place where positive--

[International Aid, May 2nd, 2003]

Mr. Speaker, preventable disease kills millions of children every year in developing countries. We know that immunization and vitamin A programs can prevent these tragedies.

Could the Minister for International Cooperation inform the House of what Canada is doing to ensure that the children in developing countries are protected?

[United Nations, May 2nd, 2003]

Mr. Speaker, last Sunday I hosted a town hall at Beth Tzedec Synagogue on the United Nations, Canada's legacy and responsibility for the future. I was pleased to welcome my colleague, the MP for Mount Royal, and Professor Andrew Cooper from the University of Waterloo. The presence of the Right Hon. John Turner, Rabbi Gunther Plaut and Rabbi Frydman-Kohl was a special testimony to the importance of the debate and the ongoing commitment of all the impressive engaged citizens of St. Paul's.

Canada's strong support for the United Nations cannot be unconditional. We must speak out strongly for reform. We cannot accept an organization that allows Libya as the chair of its human rights commission, the disgrace of the Durban conference and agendas that single out nation states such as Israel and give exculpatory immunity to offenders such as China and the Congo.

Professor Cotler said that if the UN did not exist, we would have to invent it. He urged that we immediately address the suggestion for an organization of democracies within the UN to work toward a more effective and just institution.

[Severe Acute Respiratory Syndrome, April 28th, 2003]

Mr. Speaker, I will be sharing my time with the member for Vancouver Centre.

The debate tonight is hugely important in that what we should be getting out tonight is a good news story. This disease, which we knew nothing about a couple of months ago, is now under control because of the kind of learning that has happened in the trenches of health care and the kind of cooperation that has happened between all levels of government in an unprecedented way.

The sad story tonight is the politics that have gone out of control and the disappointing lack of responsibility that we have seen in terms of mixed messages as to whether people should be scared or not scared. What actually happens when fear is augmented is that we end up with empty Chinese restaurants in Montreal because people are scared.

This is a story that is disappointing in terms of what actually is the role of an opposition and the role of leadership candidates in the party. This has really not helped. Fearmongering does not help. Frankly the media is not helping by the pictures it chooses to put in the papers. It is not helping when the CBC actually puts out a directive of a travel advisory to its employees. We actually have to first understand the facts. When a cabinet minister can call this a national emergency or an epidemic when it is not, it is extremely dissatisfying.

When the leader of the NDP can write an op-ed piece that actually questions a previous medical officer of health, Dr. Richard Schabas, and makes one think that the leader of the federal NDP knows more than the previous medical officer of health and questions, do we hope Dr. Schabas is correct or do we put in place a plan. It means do we hope he is correct. Of course he is correct. He is dealing with the facts.

What has happened over the last couple of weeks is a miracle in terms of what our health care workers on the ground have done. We have seen unprecedented cooperation between the ground and the medical officers of health for Toronto, Dr. Sheela Basrur, Dr. Jim Young and Dr. Donald Low.

There was an opinion piece in the Toronto Star by Rick Anderson, a previous policy adviser for the Reform Party, lamenting the approach of politics to this. He actually was quoting Tony Clement, the minister of health for Ontario, about our Minister of Health, saying “Anne's there day after day asking always what more Ottawa can do to help. She's easy to work with, responding positively to suggestions”. That was said by the Ontario minister of health.

One would never have thought after the first ministers meeting that we could get this kind of commendation to actually the way that the politicians working on this file know what has been working well.

I will go on to quote Mr. Anderson who said:

Behind-the-scenes efforts seem uncharacteristic of politicians, especially to the cynical and hungry media who cover politics. But solid and steady support for front-line, round-the-clock efforts of thousands of health professionals is probably just what the SARS doctor ordered. Certainly more helpful than political grandstanding and self-promotion.

He further states:

If and when Toronto completely contains SARS, it warrants treatment as a success story, a saga of prompt response, quickly marshalled resources and collaboration across professional, jurisdictional and bureaucratic lines. Not the sensationalistic [opportunistic?] “vacuum of leadership” cry arising this week from the usual suspects, and from a few who may know better.

It is disappointing that we now have a crisis of confidence in the system when actually it is so important that every single Canadian know that those of us who live in Toronto are going about our business every day. We are not wearing masks. It makes me feel that even in terms of someone who has never been a cheerleader for the provincial government in Ontario right now, that I myself would have walked up to Ernie Eves and asked him politely to take the mask off his face before he spoke on University Avenue last week because we knew that optic would be bad and that no one would hear what he had to say. Again, it is the kind of cooperation we should have had and that I wished his handlers had at that time.

When Professor Harvey Skinner, the chair of the Department of Public Health Sciences at the University of Toronto, says that the mounting evidence is that the SARS virus is under control in Toronto and when the headlines are signalling that we have won the battle, it is extraordinarily important to understand that the prime enemy is fear.

He has elaborated many times that the two concepts to understanding the public's fear of a health condition are perceived threat and control. First, he feels that it is important to acknowledge that maybe we were not perfect in dealing with the perceived threat. Confidence will be the most important thing and the unknowns are the most inherently scary.

What we did not know about this virus at the beginning has meant that the learning has had to take place in the trenches. What has been learned every day in Toronto from those health care workers in terms of incubation and in terms of appropriate quarantine measures and safety precautions for health care workers has been a work in progress. It has been a culture of learning and of disseminating information. That has been the important role of the federal government.

It is important for people to understand, as Dean Naylor once said to me, that his job as the Dean of Medicine at the University of Toronto is the same relationship with departments as is the federal role in our relationship with the provinces. It must be one of coordination in synergy and harmonization, and a conscience. It means that our job cannot be command and control from the centre, particularly with these new emerging conditions where the learning is happening in one locus. Our job is to make sure that the best and the brightest are brought together to actually share information and implement and use the new knowledge.

I think we have learned a little bit on the communication file that we could have done better. As Dr. Don Low said this morning, by publishing cumulative data it unfortunately means that the graphs are always going up. If we were better able now to publish data on new cases we would perhaps be better able to reassure Canadians that the new cases are definitely going down. If we were able to disaggregate the data to the hospital acquired infections and the community based infections, we could show the World Health Organization and anyone else who wants to listen that this is definitely a disease that is in hospitals. This is not a disease out in the community as the CDC came to our defence after the WHO ruling last week.

The CDC was very clear in its alert that it was a hospital problem in Toronto and that the community control of the disease was well done. Everyone will learn from what Toronto has done. It will be our job together as Canadian politicians to tell that story. We have to ensure that in the next chapter we can go forward having taken note of the lessons learned and having tried to ensure that everything we have done puts in place some of the most important things that all of us are fighting for in health reform.

We know that 1% of health care dollars is not enough for public health. With the provinces downloading and public health being downloaded to municipalities the municipalities are having to decide between TB inspection and potholes. That is not the way to run a public health system. I think the downloading from the provinces to the municipalities has been the problem. We as the federal government need to look at this.

The Montreal media is starting to question whether mega hospitals are a good idea. When we see a hospital such as Sunnybrook in Toronto having to shut down its urgent care and all of those processes maybe we do need a more distributive model or a more federated model for our hospitals.

I think the main take home message from this has been that the collaborative approach we have learned from this is better than anything we could have predicted from the first ministers meeting. It is about the need for an integrated system and a learning culture. I hope we will go forward in a constructive manner and put the politics away.

[Mental Health Support Network of Canada, April 28th, 2003]

Mr. Speaker, I want to bring to the attention of the House and all Canadians the excellent initiative of the Mental Health Support Network of Canada. This group of 12 organizations, including the Canadian Red Cross, the Canadian Psychological Association, the Canadian Psychiatric Association and the Canadian Medical Association, have developed information sheets for both the public and health care providers to help us all with the stress and anxiety associated with the recent SARS outbreak. These fact sheets provide simple advice on how to recognize the signs and symptoms of SARS. They provide tips for coping strategies to help manage the associated stress and provide advice on how to talk to children about SARS.

The Mental Health Support Network of Canada advises Canadians that, while SARS is of great concern, the vast majority of us are not in danger. Based on what we know at this time, the best thing all of us can do for ourselves and our families is to carry on with our normal daily routine.

The member organizations are working hard to provide clear information tools to help Canadians cope with the concerns they may have regarding SARS. These information sheets are available through the Internet at www.cma.ca.

[Assisted Human Reproduction Act, April 10th, 2003]

Mr. Speaker, it is imperative that we proceed on both avenues of research. We cannot know which will bring the results that we all want in terms of the cures for these diseases. As a lot of members have said, even though adult stem cells do have some promise, there is no question that researchers themselves know the potential of embryonic cells to make all kinds of cells is imperative to moving forward on the kinds of disease entities that we need the most. We must go forward.

I will ask my hon. colleague this later but I do not think there was one stem cell researcher in Canada who testified and said that we should stop doing embryonic research because they were so satisfied with the progress they were making on adult stem cell. Every researcher to whom I have talked, even those researchers working in the adult stem cell area, are absolutely clear that we must proceed on embryonic research if we are to bring to fruition the kind of breakthroughs in the diseases we have.

I understand there was one researcher from the United States, from some religious college of something, who was found to testify differently. However I have every confidence that we must proceed on both kinds of research to get to the much needed cures.

[Assisted Human Reproduction Act, April 10th, 2003]

Mr. Speaker, I am not as knowledgeable about the various clauses as the member for Mississauga South. However, I believe that throughout the bill it is totally prohibited to create an embryo for any other purpose than reproduction. I have been reassured from every legal opinion sought that it is well covered in the bill.

On the issue of criminal acts, as the hon. member knows, my amendments which did not pass in the House were to move all of the donor items, sperm, egg, as well as gestational carriers, from the prohibited part of the bill into the controlled act part of the bill because I did feel that it was totally possible to regulate it. It is less than 2,000 pregnancies a year in Canada. We could have done it in a regulation and with a licensed clinic. The doctors who did the work would be at a huge risk to lose their licences to practise medicine or lose the licence for their clinics.

I feel that the idea it actually is criminal, and to the people donating, or the couples themselves, is something that I have felt strongly about since the royal commission. I will continue to try to get it out of the Criminal Code.

[Assisted Human Reproduction Act, April 10th, 2003]

Mr. Speaker, with due respect to the hon. member, as a family physician for 25 years, I can say that there are not tons of babies to be adopted. I will quote from Dr. Patrick Taylor, who said in the Globe and Mail :

Because virtually no babies are available through children's aid societies, private adoption fees are high, and international adoption costs more than $25,000. In a country that prides itself on egalitarian principles, such options are often out of reach for the average person.

There may be older children to adopt, but it does not matter because this is not about why not just adopt. This is about a couple who wants to have a child of their own biological genetic line, and the grandparents also want that, and they want to make sure that all possibilities to do this have been exhausted.

I implore the hon. member to try to find a baby to adopt in this country. There are difficult children in orphanages. There just are not babies. Why are Canadians in trouble in Guangdong province? They have been over there trying to adopt a baby from China. There are the babies in Romania as well. If it was easy to adopt here, Canadians would not be spending up to $40,000 to try to adopt.

The most insulting thing one could ask one of these couples is why they do not just adopt. I wish the hon. member for Saint John would have a private conservation with one of those couples and say that to their faces.

[Assisted Human Reproduction Act, April 10th, 2003]

Mr. Speaker, it is with pride that I rise to speak to Bill C-13. The Government of Canada is providing much needed leadership by putting in place the legislative framework to ensure consistency in the measures governing assisted human reproduction for the one in six couples who have trouble beginning their families.

We hope the bill will finally lay to rest the fact that there have been charlatans, people who have preyed on some of our most vulnerable families in terms of promising them the world and delivering literally nothing.

The bill must go forward so that families trying to have a family can do so knowing that their safety, privacy and health will be taken into consideration, and that it will be conducted in a safe and ethical framework, which is what the bill does.

We must reaffirm the three objectives of the bill: to help couples build a family without compromising their health and safety; to prohibit unacceptable practices, such as human cloning; and to make sure that related research in infertility treatments and serious disease take place within a regulated environment.

It is imperative that all potentially beneficial research take place in a tightly regulated environment which is what the bill would do. The bill places Canada in line with the measures taken in many other industrialized countries. I think it is comprehensive, integrated and draws on the best practices and experiences from countries around the world. It is the result of extensive public consultation across Canada and it reflects a consensus on some of the most complex and challenging issues facing our society.

People must also understand, regardless of what commentaries have been made in the House, that the bill effectively bans cloning. The lack of scientific knowledge reflected in some of the speeches in the House was really upsetting to me. For people in the House to think that the bill does not prohibit unauthorized research on human embryos and that it would allow cloned embryos to be implanted in the embryonic stage and harvested, is just nuts.

The idea that we have parliamentarians talking about creating humans from mitochondria just actually lets us know that they have no idea of science. As I get to the end of my remarks, I want people to understand that it gives me some concerns about the need for a scientific understanding by members of any proposed agency for the conduciveness of the bill in terms of the research.

As a family physician I have always been impressed by the poignancy of the plight of the infertile couple. It is a medical problem, an emotional problem and a social problem but it is one of the few problems where people are told to get over it and forget it. However in my experience as a family physician, people cannot and do not get over it. The desire to have a family that is biologically related is huge. We need to ensure in everything we are doing in terms of progressive legislation that we do not have the unintended consequence of sending people, which is a normal instinct, underground or to the United States.

Ever since the royal commission's results came out I have had serious concerns about using the Criminal Code for issues regarding women and their bodies. I believe the Criminal Code should be used with respect to cloning and the scientists.

However, when it comes to the relationship between a woman, her physician and the specialists dealing with this, I have serious concerns about the donors in this bill. I personally will work on that as the bill goes to the Senate and in its review in three years.

It is interesting that the bill has had such a long gestation. I think Valerie Lawton's comprehensive article in the Toronto Star reminded us that the royal commission's report on reproductive technologies was titled “Proceed with Care”. It has been 10 years since that 1,300 page report resulting from consultations with 40,000 people and only now are we starting to fill that legislative void.

There is no question that the bill has been tough. As Ms. Lawton pointed out in her article, the opinions on the bill are sharply divided. The pro-lifers, the people who have trouble conceiving babies the usual way, children conceived in laboratories, ethicists, fertility doctors, sperm banks, researchers and the people suffering from diseases that could one day be treated or cured because of the research involving embryos, all have very different points of view. Therefore it has been very difficult to proceed in this way, to find effective compromises and a proper legislative framework.

It is important that the research on stem cells continue, both on embryos and on adult stem cells. I do not think one researcher in Canada has told us that we should not move forward vigorously on both files, that we cannot put all of our hopes on adult stem cells when it is very clear that at the present time there is so much promise in the embryonic stem cell lines.

We must continue to remind ourselves, as there has been this big debate around stem cell research, that the bill is actually about helping couples who need help. The bill is about assisted human reproduction. It is about creating a safe and ethical environment for couples having trouble getting pregnant.

It is important that this debate is around embryos that are left over after tormented couples decide they have had enough of an extraordinarily invasive and difficult time with in vitro fertilization, that they will not do any more cycles and there are a couple of eggs left over. It is, therefore, with their consent that they would, in this bill, be allowed to decide whether these embryos will go to the laboratory to be used to find cures for the difficult diseases like juvenile diabetes and muscular dystrophy, or whether that same frozen embryo goes into the basket. It is pretty clear. I think women and their partners have every right to choose whether those frozen embryos go toward saving lives and curing diseases.

As we look at the important parts of the bill and the overall benefits that exist in the bill, I want to comment on some of the issues that I hope will be dealt with in the Senate or at the review stage of the bill. We must realize that legislation such as this has to be made responsive and relevant to the emerging needs. The existence of an agency will help but, with the experience in England, the agency must be able to anticipate and move with the science, it must be able to comment and it must be able to regulate the emerging science.

I am a little concerned at the moment that the makeup of the agency precludes the people that know the most about this area. Patrick Taylor's op-ed piece in the Globe and Mail which says that war is too important to be left to the generals is a very interesting concept. Even members in the House have been so confused by the science. We need to ensure that the people on the agency have the scientific background to be able to interpret the information coming to them. Otherwise they will be at the mercy of the people briefing them when it comes to making those ever important decisions.

The infertile community is worried that the board of the agency could be constituted of people who do not understand what their problems have been. The reality is that a ban of gestational carriers or donors would mean that they would have to either go underground or go to the United States.

It is really important as we move on a registry that we move on the kinds of things that could really help. We must also have people who have had experience with adoption. In that way we can learn from their adoption experience and help couples move forward. There is a need for updated medical information in such a registry. We need the capacity to do this in an open way and in a way that will enable the tracking of genetic information and social information in terms of the offspring of the pregnancies.

I am worried about the word “mandatory” in reference to counselling which is in the bill. As a family physician who did a lot of this kind of counselling, I am worried for the couples who do not have a family doctor. I am worried about the capacity, even in a community like Ottawa, where there are only a couple of psychologists that are available. I am worried that we will pre-empt the ability of couples to get the help they need if we are too strict about the definition of counselling in the bill.

I am concerned in the interpretation that even couples who use their own eggs and/or their own sperm, in the technicality of the bill would be forced to go to counselling, even when the genetic material is their own. I am also concerned that anybody undergoing this sort of procedure in terms of assisted human reproduction would have to register in a registry even if it is their own eggs or their own sperm. I think that is an invasion of their privacy and I hope that will be dealt with in the regulations.

It is extraordinarily important as we move forward that the people for whom this bill is intended, the one couple in eight couples, feel they have been listened to. Some of the toughest moments in my practice have been when I have had to tell someone of a diagnosis that will mean they will never be pregnant, whether it was Turner's syndrome or cancer.

The double whammy of a bad diagnosis plus the inability to ever consider being pregnant cannot be emphasized too much. It is totally underestimated and is a huge secret in terms of the actual torment couples in our country go through. I have to think of when those women realize they are not pregnant again after all they have been through to try to have a pregnancy.

Husbands would sneak into my office without their wives knowing. They wanted me to know how tough it was on their wives, how tough it was on their families and how their wives were not able to function at work in the ongoing difficulty in trying to have their own biological children. It is very easy for people to say, “Get over it. Turn the page. Get on with your life”. That has not been my experience as a family physician.

I think that people who wanted to adopt would have adopted before going through the kinds of procedures that couples are going through, those who have chosen to try to have some sort of pregnancy of their own genetic line. It is not a luxury for these people. It is a medical problem they face. We as Canadians should support this extraordinarily important wish of these couples and help them to become parents and grandparents.

The bill is an important first step. I think it is comprehensive. I think it has done an important job in this legislative void. I think everyone will work to try to make it better both in the Senate and in its review in three years.

I also hope we will get the agency up and running as quickly as possible so that the much needed research is not delayed. I hope as Canadians we will start to have a better understanding of the extraordinarily large part of our society that is having trouble getting pregnant.

I will be proud to vote for the bill. I still hope that one day we can do a better job for the infertile community. I also hope that all members of the House will see how important this is and will get behind it and support the bill.