Joe Volpe

[Drinking Water, November 6th, 1997]

It is not a lie. It is the deputy minister of Health in Quebec who is responsible for maintaining communications with the federal Department of Health.

[Drinking Water, November 6th, 1997]

Mr. Speaker, why would the Minister of Health remove a piece of legislation which addresses the health of Canadians and for which he and his department have sought and received positive responses, I might say, also from the—

[Drinking Water, November 6th, 1997]

Mr. Speaker, we can keep going on this, but it is the practice of the Department of Health like all other federal departments to consult with their provincial counterparts when there is legislation before the House.

Both the federal Department of Health and the department of health in Quebec were in communication. There was consultation which indicated there was no problem with the legislation.

The Minister of Health for Canada is responsible for the health of Canadians, and that is the ministry or the department which consulted to ensure that the legislation received the appropriate—

[Drinking Water, November 6th, 1997]

Mr. Speaker, I have difficulty understanding feigned outrage.

We have already admitted there was correspondence with the minister of health in Quebec. The Minister of Health of Canada has done what he is required to do, consult with his counterparts.

The letter from the ministry of health in Quebec indicated there was no problem with the legislation then before the House, legislation which the Bloc chose to ignore in the last parliament and which is substantially the same as Bill C-14 in this Parliament.

We are operating in the jurisdiction over which we have authority and that is all the legislation represents.

[Drinking Water, November 6th, 1997]

Mr. Speaker, the hon member well knows there is a letter from the minister of health of Quebec, the Minister of Health's correspondent in Quebec.

Correspondence and consultation took place. There was an exchange of letters. There was an indication by the minister of health, in an area that is under the competence of the Minister of Health of Canada, that there was agreement. Consultations took place and the result is a piece of legislation that we see as Bill C-14 today and that was before us in the last parliament—

[Euthanasia, November 4th, 1997]

Mr. Speaker, I am pleased to respond to the hon. member regarding the antimalaria drug lariam mefloquine and its availability to the Canadian Armed Forces in Somalia.

As he knows, lariam has been and continues to be used and recognized worldwide as one of the most effective drugs for the prevention and treatment of a form of malaria resistant to most other antimalarial drugs. Estimated at over 2 million deaths each year, malaria is one of the world's greatest killers.

Prior to its marketing approval in 1993, lariam was available to travelling Canadians through an open access clinical trial, referred to as a safety monitoring study. The study provided Canadians with early access to a drug where few alternatives were available and monitored potential side effects of the drug in the interests of patient safety.

In 1994 Health Canada took immediate and affirmative action when media reported claims of several incidents where lariam may have been involved in Somalia. The Department of Health requested the sponsor to provide all information and adverse drug reaction reports as required under the safety monitoring study.

According to Health Canada directives, researchers involved in clinical studies and attending physicians are bound to report without any exception any significant adverse reaction to drugs. The results of the monitoring study on drug safety, combined with recent information in scientific literature, confirm the prescribing information approved by Health Canada for Lariam.

The decision to use Lariam as a first choice therapy is a matter of responsibility for the patient. It is for the prescribing physician to decide in consultation with the patient whether a drug's potential benefits outweigh the risks.

I am sorry I could not answer.

[Pharmacy Awareness Week, November 4th, 1997]

Mr. Speaker, I am pleased to tell the House and all Canadians that November 3 to 9 is Pharmacy Awareness Week.

Various activities will take place in communities across Canada to promote the fact that pharmacists are experts on the use of medications.

This year's theme is “A healthy partnership—You and your pharmacist. Finding solutions together” stresses the idea that health is a shared responsibility. Pharmacists and the public are key partners in Canadian health care services.

Pharmacists can also be partners with other health care groups in finding solutions to health care problems.

This week is an opportunity for all Canadians to learn how their pharmacist can help them improve their health.

[National Shipbuilding Policy, October 29th, 1997]

Mr. Speaker, this is a great place because you can get rhetoric and fiction or you can listen to parliamentary secretaries and get fact and reality.

I am pleased to have the opportunity to give this House the government's plans with respect to a national approach to pharmacare.

One of the recommendations of the national forum on health was the expansion of medicare to include other medically necessary services such as home care and drugs. The federal government intends to pursue the examination of these future directions recommended by the national forum.

On drugs, for example, we will develop a national plan, a timetable and a fiscal framework for providing Canadians with better access to medically necessary drugs.

On pharmacare, the federal government recognizes that as a country we can do better with how we deal with prescription drugs in the health care system and with respect to the coverage that is provided; in other words, with compliance and prescription. We can do better with respect to integrating our health care system and in allocating resources among drug therapy, hospital therapy and medical care.

Drugs have become a medically necessary component of health care and it is time for us to start talking about how we are going to ensure that all Canadians have access to this care.

But the dialogue has just begun. The federal government has no ready made national pharmacare scheme secretly prepared in Ottawa. Canada's health care system is a partnership. The federal government is counting on working fully with the provinces and the territories to explore the possibility of pharmacare.

As part of the new health transition fund, $150 million over three years announced in the last budget, the Minister of Health will be co-hosting a national conference on pharmacare with the minister of health for Saskatchewan. This will be an important step in our discussions on a national approach to pharmacare.

The federal government wants to do what it can to promote optimal drug therapy for all Canadians and a national approach to pharmacare will make a significant contribution.

[Fair Wages And Hours Of Labour Act, October 28th, 1997]

Madam Speaker, the hon. member is quite right to place her concern where it is. Unfortunately her assessment of what the minister and the department have been doing is completely off base. Health Canada is acutely aware of the situation in British Columbia and recognizes the seriousness of the issue from both regional and national perspectives.

Vancouver's HIV epidemic among injection drug users is an emergency health crisis. It is a multifaceted health crisis that brings into play other illnesses such as hepatitis C, tuberculosis, alcohol and drug addiction and mental health as well as other factors like poverty, housing, transportation and access to services.

Health Canada will work in close co-operation with the Minister of Health of British Columbia and with the Minister of Child and Family Welfare Minister of that province, and also with other federal departments that are in continuous contact with the Vancouver—Richmond Health Council.

Health Canada is presently working on the creation of an interinstitutional task force including federal departments and various regional and national organizations, in order to implement measures to deal with the health crisis.

These groups will develop and implement a federal plan identifying the complete range of health determinants that are responsible for this crisis.

Based on discussions with provincial and local governments the federal response could include a range of activities such as developing new and innovative methods for delivering services and programs for populations at risk. I include among them aboriginal peoples, women, people with mental illnesses and youth.

It could include activities to broaden community support for HIV intervention and care issues including interest in and compassion for injection drug users and, finally, improving the co-ordination of services in areas such as addictions, mental health, social services, housing and medical care.

[Canada Health Act, October 23rd, 1997]

Madam Speaker, I rise to speak on this private member's Bill C-202, an act to amend the Canada Health Act. I compliment my colleagues for the initiative.

However, I want to address today the difficulty of reconciling the proposed amendment with the fundamental purpose and the intent of the Canada Health Act.

Let me say at the outset that I, and I think all other members of my party, are sympathetic to the concerns raised in the bill. Although the promotion of better nutrition is important, unfortunately the Canada Health Act, in my opinion, is the wrong instrument to achieve this objective. I hope to illustrate that over the course of this intervention.

The Canada Health Act sets out the broad principles under which provincial plans are expected to operate. The act establishes certain criteria that provincial plans must meet in order to qualify for their full share of the federal health care transfer payments. Federal transfer payments may be reduced or withheld if a province does not meet the criteria and the conditions of the act.

These critera are the cornerstones of Canada's health care system. They are: reasonable access to medically required services, unimpeded by charges at point of service or other barriers; second, comprehensive coverage for medically required services; third, universality of insured coverage for all provincial residents on equal terms and conditions; fourth, portability of benefits within Canada and abroad; and finally, public administration of the health insurance plan on a non-profit basis.

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

The act also discourages the application of extra billing or user charges through the automatic dollar for dollar reductions or withholding of federal cash contributions to a province or territory which permits such direct charges to patients. In fact, the threat that user charges and extra billing would erode accessibility to needed medical care was a major impetus in the development of the act.

The Canada Health Act was enacted to protect the fundamental principles of our publicly financed, comprehensive, portable, universally accessible health insurance system. I think everybody in this House would agree that these are laudable objections.

Our system of national health insurance, or medicare, as it is popularly known, is close to the hearts of Canadians and something too precious to tamper with for no valid reason.

Canadians support the five principles and feel that medicare is a defining feature of Canada. Time and time again, polls demonstrate high public support for medicare.

The amendments presented by my hon. colleague and friend, if adopted, would affect the definition of insured services under the act.

In short, this means that if Bill C-202 is passed by this House the provinces and territories would be required to provide on an insured basis to all of their residents nutrition services. This is not the purpose of the Canada Health Act.

The purpose of the Canada Health Act is to ensure that Canadians have access to medically necessary hospital and physician services without financial or other impediments. Moreover, Canada Health Act principles deal with the organization and delivery of health care services on the level of provincial and territorial plans.

The addition of nutrition services to section 2 of the act would be intrusive and interfere with the provincial-territorial responsibility for health services management.

Clearly the Canada Health Act is not the proper place to regulate matters such as nutrition services which properly fall under provincial jurisdiction and are better handled at this level. Even if the Canada Health Act were the appropriate place for such a provision it would probably not achieve its objective.

The act places conditions on payments to the provinces and territories and can reduce or withhold transfers if these are not met. It cannot dictate to a province or territory how to run its health care plan much less its institutions.

The federal government recognizes that provinces and territories have the primary responsibility for the organization and delivery of health care services and that they require sufficient flexibility to operate and administer their health care insurance plans in accordance with their specific needs and institutions.

This is why the flexibility inherent in the Canada Health Act has always been one of its strengths. Since the enactment of the Act in 1984, the federal government has always attempted to work with the provinces in order to make the act a viable piece of legislation. It could be dangerous to tamper with the provisions of the Act when they have received such wholehearted support.

If we want medicare to survive, we must be vigilant against blatant threats such as user charges.

I want to come back to the point that while nutrition is a serious concern the Canada Health Act is not the appropriate place in which to address this issue. As it stands now the Canada Health Act does not require that the services of nutritionists be provided on an insured basis. It does not forbid provinces and territories from providing coverage for these services as well.

For the federal government the decision to provide nutrition services as part of a package of insured health services should be left to the provinces and to the territories. This does not mean that the federal government has no interest in the nutrition issue. Quite the contrary. The federal Department of Health has always been involved in the promotion of good nutrition in Canada.

In 1992 Health Canada released Canada's food guide to healthy eating. The guide provides Canadians with information on establishing healthy eating patterns through the daily selection of foods. To date, and this will be of interest to colleagues in the House, over 21 million copies of the guide materials have been distributed. That means that every man, woman and child capable of reading in this country has a copy in his or her possession potentially.

The food guide then is currently serving as the basis for a wide variety of nutrition initiatives across Canada implemented by a broad range of partners including provincial, territorial and municipal governments as well as non-governmental organizations, consumer groups, the private sector and school boards.

The most recent national population health survey shows that more and more Canadians are taking steps to improve the quality of their nutrition. This is encouraging. I believe that it is important that we continue to support the efforts that promote the importance of good nutrition.

The proposal put forward by my hon. colleague and friend is very commendable.

However, it is in my opinion problematic in that it raises the problems I have outlined. That is why I cannot support the bill, regrettably.

Normally I would speak for much longer, but I see that my colleague wants to address the issue even further. Therefore I will relinquish my position now.