Mr. Speaker, I am delighted to speak to this important measure. The motion is:
That, in the opinion of the House, the Prime Minister of Canada should hold annual First Ministers' Conferences.
It is so trite. Of course I wish to say that I will be supporting that motion, but I want to go much further than that.
I am delighted to be the official opposition critic for health. In that particular context, I want to illustrate why this is so important. We have a crisis in the funding and the creation of innovation in our health care system, yet the Prime Minister's lack of leadership and lack of willingness to meet with provincial and territorial counterparts is very telling.
This is a multibillion-dollar industry. The health care program in Canada is something Canadians are justly proud of. When asked in surveys over and over again, Canadians recognize this is a signature part of our Canadian identity. The father of medicare, former premier Tommy Douglas, set up the first of these programs in the country, and of course, it has been adapted at the federal level. We have to sustain that signature program of the federation.
To do so, we need leadership at the highest level. To do so, we need to have a Prime Minister who deigns to meet with the Council of the Federation, something the Prime Minister, in his platform that brought him to power, said very clearly:
Support the important contribution the Council of the Federation is making to strengthening intergovernmental and interprovincial cooperation, expanding the economic and social union in Canada, and advancing the development of common standards and objectives of mutual recognition by all provinces.
What happened? Apparently there is a meeting of the Council of the Federation here in Ottawa, and the Prime Minister cannot find the time to go. What happened to that promise? What happened to the promise to the Canadian people, the respect, of which my colleague from Hamilton Centre spoke, for a sovereign government within its sphere? That has apparently disappeared.
We live in a vast, very decentralized federation called Canada. There are many powers that are shared, some that are given to the provinces in section 92 of the Constitution Act, 1867, some that are given to the federal government, and some that are not mentioned, health being one of them.
The Conservatives seem to think that a few meetings at the deputy level and a few meetings perhaps with the ministers responsible once in a while is okay. They seem to think that what some people have called “chequebook federalism” works, where they just do a transfer of money and suddenly that is all we need to make a dynamic system like health care function in such a vast and complicated country. All the experts say that if they believe that, they are wrong.
We need to find ways the federal government, using its spending power, can incent the kind of behaviours we need to sustain our precious health care system.
We have a law called the Canada Health Act, which was passed unanimously. It has several core principles: public administration of our health system, comprehensiveness, universality, portability, and accessibility. Those are nice words. How do we make those words translate into action? How can we afford a program, with an aging population, and the need for new services, expensive pharmaceutical care, home care, and long-term care? How do we do that without having a dialogue with the provinces at the highest level to figure it out? Apparently, the Conservatives do not think we need to do so. We do.
The Leader of the Opposition has committed that no less than twice a year there would be meetings with all the premiers, not one-offs with various premiers, which seems to be the style of the current Prime Minister. Rather, in a respectful way, they would sit around the table and dialogue about these serious problems. I am simply using health as one illustration of the kinds of problems we need to solve as a country and as a federation.
The Canada Health Act is lovely, with those principles I mentioned, but does the federal government enforce it? Non-compliance is rampant. User fees and private clinics seem to be in absolute contrast to what the principles suggest, yet people are not doing much about it. Are there penalties to address those, or sanctions, as expected, as any law that should be enforced would suggest? No, there is no attempt to enforce those conditions on user fees, extra billing, and private clinics. Indeed, we have a case that is in the B.C. Supreme Court in March that will go on for months. It will deal with private clinics and whether they are okay under our Canada Health Act. Is the federal government involved? Is the Prime Minister interested?
The Canada health transfer is a block transfer that gives money to the provinces and territories to deal with the health care system. It is tens of billions of dollars. In 2004, the government made a 10-year commitment to something called a health accord. That expired last year, on March 31. It was $41 billion over 10 years.
One day in 2011, the then-minister of finance came into my community of Victoria and said that they were not going to do that anymore. They were not going to fund it the way it was funded before, with a guarantee of a 6% health care funding increase. He said that it would end in the 2016-17 fiscal year, conveniently after the next election.
The Conservatives only committed to a floor of 3% in that document. Henceforth, as the population grows, as the aging population grows, and as pharmaceuticals get more expensive, there will not be enough money. Effectively, the critics have pointed out, there will be a $36-billion cut in health care costs going forward. As I said, coincidentally it will be just after the next federal election.
This is a problem. Canada needs a national pharmaceutical strategy. We started one, but it was scrapped. We need a continuing care plan that integrates home care, facility-based long-term care, respite care, and palliative care. We need a universal public drug plan. We need adequate and stable federal funding, including the old 6% escalator to deal with the growth in our population. We need innovation.
Why am I mentioning this in the context of the debate today? It is for a very simple reason: it is one of the signature programs of our federation, and we need to sustain it. We need leadership from the Government of Canada. We need the Prime Minister to take an interest. All the premiers are fixed on this crisis facing us, the “grey tsunami”, as it is called, of the aging population.
We need innovation. We do not just need more money, although we do need a commitment to the escalator we had in the old health accord. We need a commitment to stable, long-term federal funding, and we need a government that enforces the Canada Health Act. However, we also need a Prime Minister to sit down with his counterparts at the provincial and territorial level on a regular basis for a checkup on this signature program.
Canadians are so proud of the Canada Health Act. They are so proud of our medicare system. When asked, they continually tell us that it is one of the things that makes them most proud as Canadians. We could lose all of this if we do not have this kind of dialogue at the senior level.
I hear the government members saying that they meet lots of times and that they have ministers who meet. It is called executive federalism, where the deputies get together and chat. I absolutely respect that and understand that it is a necessity in various programs, including those for health. However, we need leadership from the top.
Leaving it to a number of officials to deal with is not going to cut it. Canadians want to see their Prime Minister engaged with the provinces on this issue. I have had people come to my office from the Canadian Health Coalition, Canadian Doctors for Medicare, and other leaders in my community saying that we have a crisis coming. The Council of Canadians has also spoken passionately about this, yet what do we hear from the government? In 2011, it announced unilaterally and with no dialogue that it was going to throw the health accord out, not renew it, and no longer commit to a 6% escalator, despite everyone saying that the need is there.
People are asking if we are going to be able to sustain this. The jury is out on that question, but one thing is clear. If we had dialogue at the highest level, at the Council of the Federation, with the Prime Minister, in good faith and with the respect my colleague from Hamilton Centre mentioned, we could solve this. Canadians have rolled up their sleeves and solved things before.
We had a crisis with the Canada Pension Plan and we fixed it. We decided as a country, federally and provincially, that we would put more money into it, that we would deal with what was going to be a crisis if we did not address it, and we fixed it. We can fix medicare as well, but it needs leadership and respectful dialogue.
To think that the Prime Minister will refuse to meet, when the members of the Council of the Federation are right here, should shock all Canadians. When they look at the problems, of which this is just one example, they will see the self-evident need for us to agree with this motion to have that regular meeting between the Prime Minister and the Council of the Federation.
Our leader has committed to that no less than twice a year. The government is apparently not doing it.