Mr. Speaker, I thank the NDP for bringing the motion to the floor of the House. It is the most important issue affecting Canadians today. While we have a different way of getting to our end point, our end point is the same. We want to make sure that all Canadians have access to health care when they need it and not when the bottom line allows it, which is contrary to the situation of today.
We must recognize that we have a problem. What are we asking for? The problem is that the demand on our health care is exceeding and stripping our ability to supply the resources. That is why provinces like Alberta and Ontario are looking at ways to ensure that their people, their citizens, will get health care when they need it.
Speaking personally as a physician I can tell the House that too often Canadians are not getting the health care they need. For example, people in the province of Quebec are waiting 14 weeks for essential cancer treatment. It is the same situation as in the province of British Columbia. Some are being forced to the United States at a cost that is far greater than what it would cost in their own provinces. Why? It is not because the provinces do not want to provide the system but because they simply do not have the money to do it.
Right now every tenet of the Canada Health Act is being violated. I will just go through them for the House. On the issue of accessibility, is waiting 14 weeks accessible health care for essential cancer treatment? Is waiting six months for open heart surgery accessible health care?
The first day I walked into my hospital at Christmas when I worked for a week, I did not think it was fair that 12 out of 14 beds in my emergency department were filled with patients waiting to get into the hospital. They were not geriatric patients but people waiting to get into the ICU because they had unstable angina. There were patients with compound fractures, sick children who needed admission to the hospital for investigation, and many other people.
Why? It is because we do not have any beds. Why? It is because the hospital does not have any money to open hospital rooms. It does not have money to pay for nurses. That is why people are not getting accessible health care.
The next day we had a disaster. A bus full of children was hit by a logging truck. Only two of them were critically injured. Let us imagine if more were injured. We would have been in a situation that I do not even want to comprehend.
I would like to speak to the myth of universality. Quebec has not signed on. Although 90% of the people of the province of British Columbia have done, so some 10% of people have no health care.
On the issue of portability, can people take the same health care from one province to another? In theory, yes, but in practice they cannot because different things are covered in different provinces.
On the issue of public administration, one-third of all health care dollars spent in the country today comes from the private sector, from people's pockets.
People do not have access to home care. They do not have access to dental services. They do not have access to certain drugs or only have access if they have dollars in their pockets. The nonsense portrayed by members on the other side who say that we have a single tier system is absolute bunk. We have had a multi-tier system for years and it is getting worse.
As I mentioned in my earlier question, the population is aging. The cold hard reality is that the number of people aged 65 will double in the next 30 years. People use 70% of health care dollars after the age of 65. As they get older, the number of people who are working declines. This means the tax base declines substantially. As our demand goes up, our tax base goes down. We have more expensive technologies today than we had in the past and that will be the case in the future.
The discrepancy between supply and demand will widen. Who will be hurt but the poor and the middle class? The rich will always have an opportunity to purchase their health care when they need it. They will go south or will have connections so that they can jump the queue.
Let us talk about facts and not rhetoric. We have to put politics aside. For too long the health care issue has been used as a political football by members on various sides. Hide behind the Canada Health Act and we are looked upon as the great white knight that will defend the health of Canadians. Try to propose alternative solutions and we are labelled and branded as enemies of the state. Nothing could be further from the truth.
Not a person in the House wants an American style health care system. Everyone in the House is committed to a health care system that enables all Canadians to have access to services when they need them. The question is how do we do it. If we recognize the facts I just mentioned then we must recognize that we need more money in our system. As other members have mentioned, we need to do other things, but the cold, hard reality is that we need more funding. That funding will not come from tax dollars that we will be able to raise now or in the future. Therefore, how do we get the money?
I will speak personally. If we amend the Canada Health Act to allow private services to strengthen the public system, not detract from it or weaken it, we will be able to access some of those resources. Canada is among a small family of countries including Cuba and North Korea that do not allow private services to occur by legislation? What a great group to be in.
If private services are used intelligently and have proper restrictions placed on them to address the issue of manpower so that medical personnel are obligated to work, say, a minimum of 40 hours a week in the public sector, Canadians will have access to the medical personnel they require.
If we allow a private system to work in parallel and separate so that there is no co-funding, we will ensure that people have a choice. If people want, they can access the private system or the public system. Ultimately the people on the private system will take pressure off the public system and there will be more money available within the public system on a per capita basis. The most impoverished people in the country who do not have a choice could then access the public system quicker than they could today.
Is it unequal? Yes, it is. I would argue it is better to have an unequal system that provides better access to health care for all Canadians than we have today, particularly the poor and middle classes. Then we would be on the right track. At the end of the day the only reason to change anything would be to ensure that the poor and middle classes have health care when they need it. There would be a better health care and better access than we have today. The government is certainly not doing that.
The government likes to trot out and say that it is defending the status quo. If a person in the province of British Columbia is injured while working he or she jumps to the top of the line in the public system. That is not fair. Public money should not be available so that a certain group, say the rich, have quicker access than the poor. If they are to legislate this area, and I personally advocate that they do, they have to ensure a complete separation. Not a nickel of public money, not a nickel of taxpayer money, would be used in the private system. A private system must be completely separate from the public. If we could do that we would get away from what has happened in England and in the United States where people can queue jump within a public system. I and every member of the House would completely and utterly oppose that to the end of our days.
We must also look at the issue of manpower. Within the nursing profession there will be a lack of 112,000 nurses in the next 10 years. In my profession, the physician population, we have an enormous lack of specialists, which will only get worse.
If one takes the case of nephrology, we will have an enormous lack of nephrologists, that is, kidney specialists, and as our population ages and as the case of end stage renal failure expands, we will have a greater demand for those specialists. Where will they come from? They will not materialize overnight. With the cutbacks at the universities we are not able to keep up with the physician or nursing populations that will be required in the future.
A colleague from my party made the very cogent observation that people are going south. Why are both nurses and doctors going south? It is not necessarily because they want more money, although certainly some of them do. It is because most of them are sick and tired of having to tell patients “I'm sorry, your surgery is cancelled today, it will be done in six months”.
No one wants to look into the eyes of a patient at 8 o'clock in the morning and have to say that the operation cannot be done that day because the OR has been shut down due to the hospital's lack of money. It is crushing for the patient. It should never ever happen in this country but it does.
We must talk about specific solutions to deal with this problem. We cannot hide behind the rhetoric any longer.
One sidebar and one potential economic opportunity for the solution I mentioned is that patients from the United States and international patients will be able to come to Canada and receive private sector health care. This would be an incredible boon in terms of job creation and it would generate billions of dollars to Canada's medical system. Yes, it would be a private system, but billions of dollars in our country generates thousands of jobs.
Why do we not allow that to happen? We do not allow it to happen because of a philosophical myth that the government continues to portray. If we do that we will be able to reverse the brain drain that has been occurring for so long, keep our medical professionals in the country, the doctors, nurses, techs and others, and we will have an infusion of capital into our medical system. If we do not do this, the situation we have today in the country, which is far less than desirable, will only get worse.
I ask members from all sides to please put aside the rhetoric. It is no use trying to scare the public by saying that the private sector is the demon that will destroy the public system. It could if it was not dealt with properly but we can channel a private system to ensure that it will strengthen the public system not weaken it. It is not difficult to do and it can be done.
If Tommy Douglas, a man I greatly respect, saw what we have done to our health care system today he would be rolling in his grave. He would be appalled because it was never designed to do what we are asking it to do today. It is not and never was designed to be all things to all people. It was designed to ensure that Canadians got their essential health care when they needed it.
Today, when we are asking for many other things, such as alternative medicine, home care, dental services and pharmacare, things that will cost billions of dollars, where will we get the money? The cold, hard reality is that we do not have it.
When the health minister starts trotting out solutions, such as 24-hour call lines and saying that geriatric patients are the reason hospital beds are full, is, to put it kindly, naive. It is true that there are some patients who occupy acute care beds. It is true that the geriatric population puts a great strain on the system. However, the people waiting in the emergency departments for a hospital bed are people who need ICU, people who need their fractures treated, people who have medical problems that are complex and simply cannot be treated at home.
The health minister likes to say that with technologies getting better, laparoscopic surgery patients will be able to go home earlier. That is true if it is done properly. What is happening now is patients are being discharged earlier and are sicker and the responsibility for their care is placed on the shoulders of families who do not have the wherewithal to treat them.
It is very disheartening to look into the eyes of an 80 year old woman who is taking care of her 85 year old spouse who is sick, sicker than she is I might add. Both are ill but she is forced to deal with this. We need to look at other ways not only from the funding perspective, which I focused this speech on, but also into some other intelligent ways of dealing with various problems.
One issue is to take a cold, hard look at administration. In some hospitals administration has expanded dramatically. That needs to be cut down. On the issue of the geriatric population, I can only implore the health minister to look at the experience of Saskatchewan. It has incorporated a very intelligent program, an outreach program that has brought geriatric people with medical problems into centres where they have had basically one stop shopping. Many of their health care problems have been treated and dealt with there so that they can go home. The bottom line is a higher quality of health care for them, a higher quality of life, which is the most important, and also the saving of millions of dollars to the health care system. We need to look at that.
It is disingenuous to claim that by defending the status quo and by just saying that we need to make changes without expressing what those are only enables this issue to go around in a big circle once again. The only way we will solve this is for the health minister to bring together his provincial counterparts and say “We can't allow this to occur any longer. We've got to stop the political nonsense and start putting patients first”.
As I said at the beginning of my speech, too often patients have been put last on the list of priorities but politics have been put as the prime priority because it has been far too attractive to stand and defend the status quo and say limply that we want to have changes without addressing it.
We need to look at experiences in other countries. If we look at the European experience, they have allowed private services to occur but also support the public system.
We also need to look at prevention. I proposed a national headstart program in the House in 1997 which passed. It was on models in Moncton; Ypsilanti, Michigan and in Hawaii. An integrated approach to that would save billions of dollars and save thousands of children's lives. It is a practical and pragmatic approach. I know the Minister of Labour has been leader in this in her town of Moncton. I commend her for the outstanding work that she and her husband have done for many years. However, this motion, although passed, has been moribund because the government has failed to act.
I have said to the Minister of Health, the Minister of HRD and the Minister of Justice that they should get together with their provincial counterparts and look at all the programs they have that deal with early childhood intervention. They should rationalize these program, throw out what does not work, keep what does and have a seamless integrated approach for our children that starts at the prenatal stage and deals with the medical community at time zero, deals with the mentorship program that has worked in Hawaii and also the school system up to the age of eight. If children grow up in a loving and secure environment where their basic needs are met, they will have the greatest chance of growing up to be productive and integrated members of society.
This morning I filmed for my television program an outstanding young woman who has a program called the Sage project here in Ottawa. For roughly $7,000 she educated 550 immigrant children who did not know how to speak English. Those children have all gone on to post-secondary education and all of them have done well. Some of these children were on the lowest socioeconomic rung in our society. Many of them come from impoverished backgrounds and abusive situations, but the beauty of it is that she has focused on the basic needs of children. By using volunteers, she has managed to save the lives of 2,000 children in Ottawa by giving them a head start. She has done this with no government money and only a few thousand dollars. It is a model that can be used all across this country.
I implore people to contact my office or the young lady in charge of the Sage project so they too can us that model. It is an outstanding project that helps people learn English. It could also be expanded to all children.
The best way to deal with prevention is to start even before a woman becomes pregnant because then we could address issues such as fetal alcohol syndrome, which, incidentally, is the leading cause of preventable brain damage in our country today.
I have worked in jails, both as a guard and as a physician. I can tell the House that the number of people in prison suffering from FAS or FAE is epidemic. This is irreversible brain damage. The average IQ of these people is 67. Their cognitive functions are impaired and their learning functions are impaired. They have emotional difficulties and cannot function properly in school. They are ostracised. Many, unfortunately, turn to crime. They are often in home situations that are less than desirable. They have a one way ticket to a life that none of us would wish upon anyone.
This is a preventable problem and I do not hear a peep from the other side. I implore, plead and beg the ministers on the other side to use the head start program, listen to their cabinet members, look at the three models I have described, Moncton, Ypsilanti and Hawaii, and work with members from across party lines to do what they said they would do for kids. They should use existing resources to employ the head start program. The House has adopted it, supported it and passed it. They should do it for our children and do it now.
