Rob Merrifield

[Speech from the Throne, October 2nd, 2002]

Madam Speaker, it is a privilege and a pleasure for me to speak in response to the throne speech as the hon. member for Yellowhead and as opposition health critic.

As Parliament resumes, the minds of Canadians are on the state of the beleaguered health care system. What they see and what too many Canadians have experienced is a system that is under decay and under a tremendous amount of stress. Look at the strikes going on from coast to coast right now, or the acute problems with wait times, which are absolutely phenomenal, or the nursing shortage or human resources problem.

On the nursing shortage we can say that projections for growth in that field are such that we will need 113,000 new nurses by 2011. That will hinder patient care in tremendous ways, ways in which we have no idea at the present time.

When we look at how we are doing in comparison with other OECD nations, we see that we rank 18th when it comes to access to MRIs. We are 17th in CT scanners and 8th in radiology equipment. It is no wonder and no surprise that Canadian confidence in the health care system is decaying and waning at the present time.

An example of this is that in 1988 a study was done and 43% of Canadians said that they thought the system was fundamentally flawed. Last year the same study was done again and an astounding figure of 77% came forward. Clearly the patient is ailing.

The Liberal health care legacy of underfunding and neglect has come home to roost. The Prime Minister and the former finance minister presided over the massive cuts in the middle of the 1990s and the consequences of that action at the time are being felt now in today's health care system.

The Prime Minister and the former minister of health announced the Romanow commission almost two years ago. It was a desperate attempt by the Liberal government to just buy more time. That is exactly what happened. Then they sat back and comfortably waited while somebody else tried to do the dirty work and wrestled with the tough problems of reforming the health care system. We are waiting for the report in November of this year.

It is not the first time we have seen this action by the Liberal government. We remember the National Forum on Health in 1997. Its report sits on the proverbial shelf collecting dust. We can see that this is a ploy the government has used once before.

There are some things the Liberal government does do well. It studies health care. We asked the Library of Parliament how much money had been spent by the Liberal government since 1993 just to study health care. A figure of $243 million came back. The Liberal government has shown a grave lack of leadership when it comes to health care over the last 10 years. All the problems I just mentioned lay right at the feet of the Liberal government. Nobody else can take responsibility for them.

The health highlight of the throne speech was the announcement of the forthcoming first ministers conference early next year and the necessary federal funding that would have to go into investments in the long term security of our health care system. I say better late than never, but did we really need a throne speech for that announcement?

Most of the other health care items offered in the throne speech consisted of vague promises on health protection, prevention and aboriginal health. Many of these are just recycled ideas. We have heard them many times before in previous throne speeches. We could go through the last eight or ten throne speeches and there are similarities in all of them.

Here is just one of the examples. I quote, “The government will take further action to close the gap in health status between aboriginal and non-aboriginal Canadians”. That is a worthy goal, but we have heard that many times before. It is no wonder the aboriginal community is thinking that this government speaks with a forked tongue on that.

Some alarming numbers came out earlier this week. They show that the rate of diabetes among first nations peoples is two to three times that of the Canadian population as a whole. The amount of tuberculosis on native reserves is eight to ten times higher than for the Canadian population.

The government should acknowledge that its current aboriginal policies are failing. It should announce firm targets for improving aboriginal health and life status.

I was particularly concerned about the government's pledge to speed up drug safety approval. We have a drug problem in the country and it is a serious problem. Up to 10,000 Canadians die each year because of avoidable prescription drug reactions. Up to 46% of our seniors receive at least one inappropriate prescription per year.

The Vanessa Young inquiry cited a number of problems in Health Canada's drug safety regime. The minister's rebranded Marketed Health Products Directorate still cannot remove drugs from the market.

Do not get me wrong. We are not opposed to bureaucrats working faster or more efficiently to speed up drug approvals. There are some very good benefits in that. However this is clearly a matter of the cart going before the horse and announcing faster drug approvals before adequately addressing the drug safety concerns that we have across this nation.

One glaring omission in the throne speech was the mention of the government's plan of dealing with the possible bioterror attack. Last year the government promised to obtain the smallpox vaccine for every Canadian. The government still has not obtained that vaccine. Where is the long-range plan that the government promised Canadians? By the way, where is the reproductive technology bill that was also promised? It met the same fate once before of dying on the order paper, so it is not the first time that has happened.

Canadians could be forgiven for having expected some leadership on health care this week from the government. However on most fronts, they were very sorely disappointed.

The government will soon be reviewing the recommendations of the Romanow report. As it prepares to do so, the official opposition should offer some principles and proposals that would guide its deliberations.

The Canadian Alliance is clear about its values on health care. Our policy states our commitment to ensuring that “timely, quality and sustainable health care is available to every Canadian, regardless of their financial means”.

The Canadian Alliance supports adequate, stable funding and transparent funding for health care. More funding will be required to shore up our ailing health care system and to place it on a firmer footing for the years and decades ahead. I am pleased to see an acknowledgment of this in the throne speech. However the federal transfer for health care has only now surpassed what it was back in 1993 and 1994. In the meantime, we have a population growth of 8% and an increase of over 15%, and our population is also growing older at the same time. Therefore, the federal government's contribution is 14¢ on every dollar right now. That is a far cry from the fifty-fifty split of a generation ago.

In putting more funding into health care, the government should resist its natural urge. Guess what that is? To raise taxes. Canadians do not want to pay any more taxes. Believe it or not, we would not want to see the finance minister jump from that Peace Tower. However, the government has chopped $25 billion from the CHST, but has left $16 billion a year in questionable grants and contributions. This is all about priorities or the lack of them.

It must be noted that more money, in the absence of other reforms, is not a viable or long term solution. This has been the recognition of many of those who have taken a look at our health care system over the last couple of years, whether it be Fyke, Mazankowski, Clair, Kirby or Romanow.

In return for more funding there must be a greater accountability of how that money is spent. The government must use this opportunity of another cash injection to encourage health reform and efficiencies.

We also reiterate the call for stable funding for health care. To prevent the kind of unprecedented, unilateral cuts inflicted by the Prime Minister and the former finance minister in the mid-nineties, we must entrench the commitment in the Canada Health Act for stable funding.

The Canada Health Act needs to be modernized. All five of the act's principles are routinely compromised. Moreover, there is a growing recognition that the act does not make provisions for important contributions such as quality, timeliness, sustainability or accountability. New provisions need to be added in the act.

The delivery of health care has changed dramatically since the act was passed in 1984. Through the development of new technologies, drug therapies and new treatment options, what constitutes medically necessary needs to be revisited in an era of new medical technologies and those therapies. A view of the scope of the services covered under the public system should be undertaken as a viable component of the first ministers consultation after Romanow.

I want to address the controversial issue of the private involvement in our public health care system. The provinces should have the maximum flexibility around health care delivery within a universal health care system, and I stress within a universal health care system.

The Canada Health Act discourages private payment of medically necessary health care services but does not prohibit nor does it discourage private delivery of those services. What is important is not who provides a service but that the service is provided and that it is provided in a timely and a quality fashion regardless of the individual's financial means to pay.

As our leader pointed out yesterday, the government monopoly is not the only way to deliver health care to Canadians. The federal health minister cannot stop the provinces from acting within their jurisdiction nor should she. Let me be clear. No province, no federal party, including the Canadian Alliance, is calling for a private parallel system.

Finally, the government owes it to Canadians to act quickly and responsibly once the Romanow commission report is called. Health care reform is too important to place on another waiting list. The government should act within 90 days after receiving the Romanow report.

Health care is the number one public policy priority of Canadians. It is clear that our system is in need of renewal. Health care requires innovative ideas and approaches in order to address the pressing challenges of increased expectations, escalating costs and aging population.

The Canadian Alliance will continue to engage the government in vigorous debate on the reform of the health care in this country. We will work--

[Health, October 1st, 2002]

Mr. Speaker, the throne speech did not address problems of addiction, over-prescription or medical errors in primary care.

Faster drug approval is a notable goal and in fact there are some health benefits for that, but the government is putting the cart before the horse when announcing faster drug approvals before dealing with drug safety.

How many deaths are acceptable to the minister? Is it 10,000, 15,000, 20,000? What is the number?

[Health, October 1st, 2002]

Mr. Speaker, up to 10,000 Canadians die each year because of prescription drug reactions. Every year just under half of our seniors receive at least one inappropriate prescription. Prescribing errors account for over one-third of drug-related hospital admissions.

The throne speech announced faster drug approvals. Why did it say nothing about drug safety?

[Pest Control Products Act, June 12th, 2002]

Mr. Speaker, it is a privilege to address some of the concerns the Canadian Alliance has with regard to Bill C-53, the pest control management legislation.

This is a very important bill and one which the committee worked on for a long time. It is important to many Canadians from different perspectives. The legislation has three main intentions. The Canadian Alliance generally supports those intentions to strengthen health and environmental protection; to make the registration system more transparent, which is very important; and to strengthen the post-registration control of pesticides. We agree with these.

The Canadian Alliance agrees that safety and environmental issues are very important to Canadians. Health and environmental concerns must be at the forefront of Canada's pesticide registration regime.

Bill C-53 looks at the ten times safety factor and the thousand times safety factor. Whatever the factors are and whatever decision making goes into the bill, we have to ensure they are based on science and not based on emotion, half truths or misinformation. We must have the facts before we make a decision. Once we have the facts it becomes easier to make a proper decision.

We welcome the formal commitment to protect the health of infants, children and pregnant women. This is a given in the bill.

One of the disappointments of Bill C-53 is the way it was brought into the House and how it went through committee. At the initial stages of discussion on how it should be brought into parliament it was felt there should be a joint committee of agriculture, perhaps international trade and health. We are dealing with an issue that goes across more boundaries than just health. It has significant implications for international trade and for the agricultural community. We had hoped that would have taken place at the beginning but because it did not, we see some flaws in the bill which need to be addressed.

This legislation has not been worked on since 1969, some 33 years ago. It is high time it was modernized and brought up to speed. It is very important to incorporate modern risk assessment concepts and entrench the current practices into law. It is important to account for the new developments in pesticide regulations around the world and to reflect the growing concern for the health of children and others.

Looking at the legislation from a farming or forestry perspective, agricultural practices have changed considerably in the last two decades. Agriculture is an industry that is evolving probably faster than many others. We are seeing a greater reduction in the use of pesticides in agriculture and for very good reasons. I have yet to meet a farmer who likes to use pesticides. Farmers use them as a tool to solve a problem they may have and they need to be competitive with our neighbours to the south and others around the world. It is very important to understand that fact as we look at Bill C-53.

Two amendments were put forward at committee with respect to the renewal period for this legislation. It was to be reviewed not in 33 years as was mistakenly done in the prior legislation, but in five years as stated in one amendment or 10 years as stated in another. The committee settled for seven years. That is okay. At least it is not 33 years. We know that in seven years there will be another review of the legislation.

What disturbed me and others on the committee is who would do the review. An amendment came out of committee stating that the legislation should go back to a House of Commons committee and not be sent on to the Senate. That was overturned by the minister. This legislation could be reviewed in seven years by an unelected, unaccountable arm of the Prime Minister and not by a committee of the House of Commons. We have great concerns with this. Is that a true review of a piece of legislation? The committee amendment was overturned by the minister and we have serious concerns about that.

We were pleased to get some amendments through at committee. One was the harmonization of pesticides and the review of pesticides from the OECD nations and other countries. Harmonization is very important in order to be competitive with some of our trading partners. This could avoid many of the costly duplications when pesticides are registered. Newer and safer products would get into our marketplace more quickly than in the past. Some products have been held up for as many as 20 years.

The inefficiencies in the PMRA absolutely need to be addressed.

There are many shortcomings in the bill. The preamble completely ignores the value of pesticides to Canadians

It is not that we put pesticides out for our health or because we are trying to do anything other than good for Canada. There is a lot of good that comes out of the use of pesticides. Unfortunately that is not recognized in the bill. It helps us to be competitive, although we do have to recognize that health and safety come first and on that we agree.

One issue we want to talk about is the minor use products. The bill makes no provisions for minor use products. It is something that we tried to get through. A minor use of a pesticide is defined as “a necessary use of a pesticide for which the anticipatedsales volume is not sufficient to persuade a manufacturer to register and sell the product inCanada”.

It is a product for which very few acres are involved. It is not really economical to go through the regime that we have right now. Yet it is very important that we see some of these products on the market because they are much safer and much better.

It impacts the horticultural sector, the producers of fruits, vegetables, herbs and floral crops. These are small in comparison with many other crops in the country but it is a $4.2 billion sector. It is one of our fastest growing agricultural sectors. It is also very important to the pulse crops sector, which grows peas, beans, lentils and chickpeas. These are small acreage crops but it is very important that they be competitive particularly with our American counterparts.

What actually is happening with our American counterparts is something we should consider so that we are on the same footing. It will give us an idea as to how slow we are in bringing forward different products.

In 2000-01 the total number of minor use products that were registered in Canada was 22. Eighteen were for food use and four were for non-food use. During that same period of time in the United States, 1,200 different products were approved, 500 plus of which were approved for food use.

The government does recognize the importance of minor use but it is not in the bill. That is one of the problems we have with this legislation. The PMRA doubled its resources recently in being able to evaluate minor use. We are hoping that something can be done perhaps in regulations, however it should be in the legislation that is before us. It is very important.

Given the evidence that we have, why did the government not recognize that? The government recognizes it as being valuable but not valuable enough to put in the bill. That is something which disturbs us.

We can also talk about the reduced risk products. The bill makes no provisions for getting newer, safer reduced risk products into the marketplace. We need to expedite the review of these products. My colleague mentioned that the United States has had reduced risk categories and timelines for the last year. The timeline to get these products registered was approximately 35% less than conventional pesticides.

It does not matter what one's perspective is on this legislation, whether one believes we should ban all pesticides, and there were people who said that at committee, or not, the idea of timeliness for approving newer and safer products in Canada is very important. It does not matter which side one is on. We put forward amendments suggesting that the minister at least come up with a timeline, perhaps within a year after the bill is enacted, so that the industry would know how long it would take to approve some of these products.

It is certainly something that would hold the PMRA accountable to Canadians and to what it is mandated to do. We heard from many witnesses about the PMRA. There is one thing that was consistent. Nobody said anything good about the quality of performance of the PMRA. It is something the bill should recognize and try to address as one of the concerns.

The agriculture committee looked at the efficiencies of the PMRA. It called for an independent ombudsman and for the auditor general to review that agency with a view to making it more efficient. We are pleased that cosmetic pesticides are left in the hands of local municipalities because Canada has many diverse problems in different areas. The problems in the Northwest Territories are different than those in southern Ontario. It is important that the responsibility be left with the municipalities.

It is important that we have the bill before us now. It is 30 years late, but it is here. It will ensure that farmers have access to newer and safer products. It will also ensure that Canadians have access to safe and reliable food at a competitive price.

[Health Care System, June 11th, 2002]

Mr. Chairman, my questions are quite simple when it comes down to it. When we look at health care, we see some major problems. There is no question of that.

My hon. colleague talked about the Canada Health Act and the values of it. I think we bought into that as a nation and that is fine. However those five principles were set up in 1983-84 and the health care system has changed significantly since that time. We have a system now where the technologies have changed, drug therapies have changed and who delivers health care has changed. That act was set up really for primary care and only for primary care. The system has evolved so much more since then.

The obvious question is this. Does the Canada Health Act, which contains the five principles, need to be freshened up and does it cover all the bases to sustain a system that is affordable for everyone, regardless of their financial means, and that moves us ahead into the 21st century? Does it deal with time limits? Does it deal with accountabilities? Does it deal with quality of care and some of the things that we cherish and want to have in our health care system? This is why we are saying that the system must change from being system driven to patient driven.

Would my colleague like to comment on the areas of the Canada Health Act that need to be spruced up? Perhaps she could comment as well on the sustainability of the system as well as the funding as one of the principles.

[Health Care System, June 11th, 2002]

Mr. Chairman, we could continue the numbers game but I do not necessarily want to do that. We have exhausted that. He can throw his numbers and I can throw my numbers and we will go nowhere. I am more concerned with where we are going with health care into the 21st century. I am most frustrated with what I see as a system that is focused on itself. Over the last number of years anyone who wanted to be able to talk about health care as a politician was slain at the polls. Would the hon. member and I agree on one thing, that the system must change to be patient driven rather than system driven?

[Health Care System, June 11th, 2002]

Mr. Chairman, I listened very closely to my hon. colleague's comments. I am a little confused. He suggested some numbers that may have been thrown around. If he wants to play the numbers game, let us play the numbers game.

The percentage of the health care dollars that comes from the federal government is only 14%. In some provinces it is less than that. It is down to as low as 12%. Some health ministers will say it is even less than that in some provinces. From the provincial side, it is up to 42% in some provinces. Looking ahead over the next five years, it will get to 50% and beyond. That is if we move things out to the next four or five years.

When it comes to responsibility from one jurisdiction to another, let us get serious about who is supporting health care. Is it the provincial governments or is it the federal government?

If the federal government is serious about doing what it says and recognizing that health care is the number one priority for Canadians, then it is time to put its money where its mouth is and to do something when it comes to putting dollars back into health care, but not just dollars because dollars alone in a dark hole will just evaporate. That is what we are discussing this evening. Even Mr. Romanow has suggested that we need to do more than just put dollars back in. This is a golden opportunity to sustain the health care system into the 21st century.

Where has the member been for the last 10 years as the government has run health care just about into the ground?

[Health Care System, June 11th, 2002]

Mr. Chairman, my hon. colleague briefly mentioned some of my concerns with regard to the way health care has been treated in the last decade. There is no question that seniors are fearful as they look ahead to discern whether health care will be there for them at the most vulnerable stage of their lives when they need and rely on it the most.

My observation over the last decade has been that if there is a political party in the House that should throw fear into Canadians with respect to health care it is the Liberals. Since they have been in power they have pulled money out of health care and watched it drift into crisis. We now have problem after problem. We have waiting lists and people who cannot get into the system. People are stuck on waiting lists while their muscles atrophy and their conditions worsen. Some people die while on the lists.

An interesting study was done in the United States recently about private hospitals. We should have a study in Canada about how many people die before they get to hospital.

Could my hon. colleague could comment on the crisis? Which party is throwing fear into seniors?

[Health Care System, June 11th, 2002]

Mr. Chairman, I listened intently to my hon. colleague's remarks, particularly with regard to seniors. He made mention of the fact that demographics are having an impact on Canadian society in terms of its health care system. The same can be said of countries around the world but particularly of Canada.

In the last decade we have been adrift in terms of health care. We have only been able to get away with it because the impact of the demographics has not yet hit. In the next decade we will see the percentage of people 65 and older increase. The amount of health care dollars they will consume, especially given the new technologies and drug therapies impacting our system, will also increase.

Is my hon. colleague as fearful as I am that the Liberal government that will play politics with health care again? As brilliant as the Romanow commission might be, is my hon. colleague afraid it may be used as a lever to win political gain rather than a way to sustain our health care system into the 21st century, which is what Canadians expect and deserve?

[Health Care System, June 11th, 2002]

Mr. Chairman, I agree with a lot of my hon. colleague's presentation but I am a little astounded. Her government has been in power for almost a decade and now the member is coming up with some of the things that we have been suggesting for many years. I appreciate hearing that.

My specific question relates to the fact that my hon. colleague is a physician. I have talked to many physicians who tell me that they could save the system $2,000 or $3,000 a week if there was an appropriate incentive.

I do know whether I blame physicians for this but I think one of their main concerns is with their liability as physicians. I wonder if there is something that might assist the system regarding liability. Could she comment on that?