SoVote

Context: House Hansard - 162 - Feb/16/23

Feb/16/23 10:17:03 a.m.
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Is that agreed? Some hon. members: Agreed.

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Mr. Don Davies (Vancouver Kingsway, NDP)

Feb/16/23 10:19:21 a.m.
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moved: That, given that, (i) during the 2021 federal election campaign, the prime minister was harshly critical of the Conservative Party of Canada proposal to encourage “innovation” in the health care sector by expanding for-profit provision of publicly funded services, (ii) the prime minister has now dramatically changed his position and has lauded as ‘’innovation” Ontario Premier Doug Ford’s proposed expansion of for-profit clinics, (iii) for-profit clinics would poach workers from the public system and lead to longer wait times, (iv) there are multiple public reports of two-tier health care in Canada, where people are charged for faster access to care, such as family doctors or surgery, the House call on the government to: (a) express disappointment that the prime minister has promoted Ontario’s for-profit health plans as “innovation”; (b) ensure that recently announced health care funding is not used for the expansion of for-profit health care, but instead used to rebuild and innovate within the public system by hiring more staff and reducing wait times; and (c) enforce the Canada Health Act and immediately move to close loopholes that allow for the growth of two-tier health care in Canada. He said: Mr. Speaker, Canada's health care system is based on the principle of access to care based on need rather than ability to pay. A well-designed, well-funded single-payer system can provide fair, effective and high-quality care to make this a reality. Our public health care system is certainly facing some challenges, but the solution lies in strengthening our public health care system, not weakening it. If we introduce private funding, then need will come second to ability to pay. That would result in less accessibility, longer wait times and higher costs in the public system. It would also lead to increased administrative costs, in other words, more money for insurance companies and less money for health care. Introducing private payment prioritizes care based on ability to pay, not need. It leads to worse access and wait times, as well as higher costs in the public system. It also leads to higher administrative costs, which means less money for patient care. There is not only little evidence that private, for-profit investor-owned corporations can provide better quality care or reduce costs. In fact, there are many examples that show precisely the opposite. Those seeking to improve the quality, equality, access, efficiency and equity of health care services in Canada can do so by focusing on strengthening our public system rather than dismantling it. Proponents of privatization claim that increasing private pay and/or private for-profit delivery will reduce wait times, either overall or for those in the publicly funded system specifically; reduce costs to the public system; and lead to better health outcomes. There is perhaps no more serious and dangerous myth in Canadian politics today than that statement. I want to review the situation today and some of the factors that show this is not the case. Everyone deserves health care when they need it, no matter the size of their wallet. No one should need to wait in pain because there are not enough health care workers or because the wealthiest jump the queue. However, under successive Liberal and Conservative governments, today people are waiting in pain for hours, days or weeks, and sometimes months or years. Folks are losing their quality of life while they wait for surgery. In addition, health care workers are run off their feet, burned out and exhausted in every corner of this country. The Prime Minister could make things better for patients by hiring and rebuilding the public health system. Otherwise, he can contribute to making the crisis even worse by helping to fund for-profit schemes that will poach staff from the public system. We are not surprised the Conservative Party loves for-profit care. It will make billions for corporations and rich CEOs. This is right out of the Conservative playbook: starve a public service and use that as an excuse to hand it off to the private sector. A condition of federal health care funding should be investing to fix public universal Canadian health care, not funnelling funds and staff into for-profit facilities. New Democrats want health care to move towards more public delivery, not farther away from it. If new bilateral health agreements do not result in thousands of new health care workers in our public system, it will fail. Ottawa urgently needs to partner with the provinces and territories to help provinces train and hire more health care workers, respect current health care workers and pay them better, and recognize the international training of thousands of health care workers who are already in Canada and ready to work. During the 2021 election, the former Conservative leader said that “he would support provinces in introducing privately led health care ‘innovations’”. At that time, our current Prime Minister told Canadians this was evidence that a Conservative government would threaten Canada's public health care system, saying that the Conservative leader “believes in a for-profit, private health care system and he will not tell people what exactly he wants to do with that.” My, how things change once one is in office. The Prime Minister recently reversed his position by calling Ontario premier Doug Ford's private for-profit clinic scheme an example of “innovation”. Let us just quickly review the privatization plans by Conservative premiers across the country. Doug Ford has said that he wants to divert funding from his province's hospitals towards for-profit surgical clinics. His plan includes an expansion of private cataract surgeries, MRI and CT scans, minimally invasive gynecological surgeries, and knee and hip replacements. Ontario's plans to contract out to private for-profit clinics for cataract surgeries is expected to cost the government 25% more per surgery. Moving only hip and knee replacements to for-profit clinics will benefit owners, with an estimated windfall of half a billion dollars annually. The owners of Herzig Eye Institute, one of the top private surgery clinics that lobbied the Ford government to expand private cataract surgeries, have donated thousands of dollars to the Ontario Conservatives. In a recent throne speech, Manitoba premier Heather Stefanson announced her government's intention to seek out private partnerships to deliver health care. Saskatchewan is moving forward with plans to reduce its backlog of surgeries by privatizing certain procedures. In January, Alberta announced that it is contracting Canadian Surgery Solutions to perform more than 3,000 orthopaedic surgeries covered by the provincial medicare plan. Why are they doing this, and how are they getting away with it? There are several loopholes here, but I want to itemize one of them. There is a serious loophole in the Canada Health Act. As we speak, private clinics across Canada are advertising to prospective patients that within weeks they can get surgeries that typically take six months or more under provincial health plans. All the patient has to do is pay them $20,000 to $30,000, depending on the clinic. CIHI estimates that the average cost per joint replacement operation in public hospitals in Canada is $12,223, which means that the private clinics are charging patients roughly double what the surgery costs the provincial medicare system. To those who claim that private surgery is cheaper, one can tell right away that when one adds profit and extra administrative costs, diverting money to the private system will cost our public system more. Doug Ford says, “Oh, that is okay. We are still paying for it with public dollars”. Why would Canadians ever tolerate paying twice as much for surgery in a private system than they would in the public system? The Canada Health Act prohibits extra billing. This means that doctors are banned from charging patients more than the medicare rate for an insured service. However, private clinics are getting around that by operating only on patients from other provinces. Imagine the loophole in this country where, if one is in Manitoba, one can sell a private surgery to someone from Ontario but not somebody in Manitoba. This violates the fundamental principle of the Canada Health Act. It is a gaping loophole in our system. We are calling on the government to close that loophole right now if it truly cares about public health care as it says. It is not only those kinds of surgeries, though. Maple, a Loblaws-funded virtual care business based in Toronto, is charging patients $69 per doctor's visit or $30 per month for 30 visits per year if one wants to go bulk. In-person service would be covered by Ontario's public insurance plan. Ontario has insured virtual visits under OHIP, but Maple has found a way around the province's rules by connecting patients with a nurse practitioner or physician outside of the province. This is another gaping loophole. That is not to mention the odious practice that has been going on in this country for years, where people appear at private clinics only to be upsold. They come for cataract surgery but are told that if they want a better lens, they have to pay more. That kind of introduction of private pay and access to health care is a fundamental violation of the medicare system that Canadians hold so dear in this country. Let us talk about the evidence against privatization. A recent study led by Dr. Shoo Lee, a professor emeritus at the University of Toronto and former pediatrician-in-chief at Mount Sinai Hospital, looked at international experiences to determine what impact private financing would have on Canada's health system. That study found that private financing, both private for-profit insurance and private out-of-pocket financing, negatively affects the universality, equity, accessibility and quality of care. It is not just that study. A recent study of England's National Health Service found that as outsourcing to the private for-profit sector increased from 2013 to 2020, so did the rates of death from treatable conditions. I look forward to hearing any questions. Let us stand up for public health care in this country and make sure that every dollar of public funding goes to public health care in Canada.

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Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

Feb/16/23 10:29:38 a.m.
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Madam Speaker, I appreciate the motion brought forward by the New Democrats. I have always felt that a good, healthy debate and discussion about Canada's health care is long overdue. I welcome the idea of bringing the Canada Health Act into the debate. My question to the member is specific. When I was the health care critic in the province of Manitoba, I used to argue that one of the greatest threats to Canada's health care system was not only the issue of financial resources, albeit that is critically important, but also the way we manage changes. We could probably have a healthier health care system if we saw more provincial comparisons, learned the best practices and looked at ways to improve or manage the changes necessary to meet future demand in our health care system. Can he provide his thoughts on that?

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Mr. Don Davies

Feb/16/23 10:30:48 a.m.
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Madam Speaker, I do not disagree that provinces and territories should be sharing information and best practices, but the debate today is about national leadership. It is about the member's government and what it is going to do to help ensure that we not only protect but also strengthen and expand our public health care system. When the Prime Minister of the member's government is applauding a privatization plan by a Conservative premier in this country, that is not the kind of national leadership we need. We want the government to say plainly to Canadians that every additional dollar of health care funding in this country will go to strengthening our public health care system and not be diverted to private, for-profit care. That would make our public system worse. It would increase costs, extend wait times and make care for Canadians worse.

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Mr. Robert Kitchen (Souris—Moose Mountain, CPC)

Feb/16/23 10:31:40 a.m.
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Madam Speaker, I thank the member for Vancouver Kingsway for his presentation and for speaking on this. I know he is very well aware that there is a difference between federal and provincial health care. The majority of health care in Canada falls into the provincial jurisdiction. He sort of alluded to this, but could he provide his thoughts on whether we need to sit down, look at the Canada Health Act and consider that section straight off the bat? Do we need to address that for Canadians?

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Mr. Don Davies

Feb/16/23 10:32:17 a.m.
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Madam Speaker, we absolutely need to open up the Canada Health Act, but we need to do it for the purpose that the NDP is talking about today. This is to close the loopholes that are allowing private, for-profit care to creep into our system. Right now, we have a shortage of doctors in our hospitals. We have a shortage of nurses in this country. Staff are burnt out at every hospital. How can it possibly be a positive development to allow private clinics to drain people from that system and then allow access based on private access to care? We have to add profit and administrative costs to the system. By the way, the United States pays 31¢ out of every dollar to administration. In Canada, we pay under 2%. Administrative costs are much higher in the private system. If we drain those workers, what is going to happen to the wait times in the public system? Obviously, they will get longer. We need to close the loopholes to make it clear that all publicly insured services in this country are delivered in the public health care system. Let us build up our public system. Canadians deserve to have timely access to world-class care. They are not getting it now. New Democrats will continue to make proposals so they can get that.

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Mr. Luc Desilets (Rivière-des-Mille-Îles, BQ)

Feb/16/23 10:33:30 a.m.
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Madam Speaker, it is very nice to hear my colleague speaking French. His accent is excellent. I would like to once again remind him that Quebec and the provinces are the ones responsible for the health care model. The Supreme Court clearly ruled in that regard in Chaoulli. It stated that a person who is waiting for surgery cannot be banned from using private health care. What does my colleague think about that?

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Mr. Don Davies

Feb/16/23 10:34:47 a.m.
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Madam Speaker, I respect my hon. colleague's position. Actually, health care has been ruled by the Supreme Court of Canada to be a shared jurisdiction in this country. We cannot even find the words “health care” in our Constitution. The provinces have jurisdiction over the establishment and maintenance of hospitals and also regulation of the professions. The federal government has its spending power; the criminal law power; and peace, order and good government. We will not fix health care in this country. By the way, I do not think Canadians care about jurisdiction. What they care about is that, when they get sick and they need care, they can go to their public system and get timely access to world-class care. That is going to take all levels of government working together to deliver it.

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Ms. Bonita Zarrillo (Port Moody—Coquitlam, NDP)

Feb/16/23 10:35:34 a.m.
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Madam Speaker, the pandemic was hard on Canadians. It was particularly difficult for health care workers, including nurses, doctors, personal support workers, long-term care workers, maintenance staff, and so many others. For three years, they have been on the front lines of this pandemic with no relief in sight. The government called them heroes, but those accolades have not been backed up with tangible investments in pay, working conditions or mental health supports. It is absolutely unacceptable that investments in mental health have not come to frontline workers, including health care workers, when the Liberal government is sitting on $4.5 billion of unspent mental health dollars. I remind the government that this needs to change. Today, we are talking about the privatization of health care in Canada. The Liberals' recent health care negotiations with the provinces have not produced change or protections. The solutions that Canadians were expecting to hear to improving their access to care in this country did not come to fruition. Canadians did not hear of plans to address the staffing shortages of doctors or nurses. As Tim Guest, the CEO of the Canadian Nurses Association, said, “While CNA is encouraged by the federal government’s commitment to prioritizing health-care workers, the need for a pan-Canadian health human resource (HHR) strategy and urgent action to address critical nursing shortages were not clearly addressed.” The current Liberal government must address the human resource crisis in the care system in Canada immediately. The Prime Minister has an opportunity to make things better for Canadians by working with the provinces and territories to hire and rebuild the public health system and its human resource sector. Alternatively, he can continue to make the crisis worse by funding for-profit schemes that will poach staff from hospitals and the public health care system that all Canadians rely on. I remind the Liberal government that allowing for-profit care to take over Canada's health care system is not only a contravention of the Canada Health Act, but also a costly project for Canadians, both in dollars and in lives, as the hon. member mentioned earlier. We have only to look at the catastrophic outcomes in private long-term care during the pandemic to see that. The courts are also warning us of the folly of private health care. The Supreme Court of British Columbia looked at the impact of private, paid health care in its 2020 ruling on the Cambie case and found that “...the introduction of duplicative private healthcare would lead to increased costs and diversion of human resources, which would be contrary to the purpose of the provisions to preserve and ensure the sustainability of the universal public healthcare system.” This decision was upheld by the B.C. Court of Appeal in 2022. In its ruling, the justice found that suppressing all private care is necessary to ensure that access to medically necessary care is based on need and not on ability to pay. It also stated, “The introduction of even small scale duplicative private healthcare would create a second tier of preferential healthcare for those with the means to either acquire private insurance or pay out-of-pocket once their benchmark was exceeded.” That is worrisome. No Canadian should have to fight for equal care in this country, but that is exactly what privatization, for-profit care, does. It is not just me saying this. It is the law of the land saying it. This is why it is imperative that the new bilateral health agreements result in thousands of new publicly funded health care workers to fix and support a growing sector of our economy, the care economy, where one in five Canadians already works. If the federal government cannot facilitate this in the agreements, they will be a failure. The current nursing shortage has certainly proven that a lack of human resources in care is past critical levels. I will mention again that it is affecting the mental health care of caregivers. Dr. Katherine Smart, the former president of the Canadian Medical Association, said: What we're learning is more than alarming. It's potentially catastrophic. Time is of the essence. More than a quarter of practising physicians claim low rates of overall mental health. Recent figures show that 20% of front-line health care workers have thought about suicide. A crushing 6% have planned an attempt. A crushing 6% have attempted suicide, and we know that it has happened. The Liberals need to get to work to assist in solving the shortage of doctors and nurses in this country. As the leader of the NDP pointed out, when the Prime Minister took office, there was a shortage of 5,800 nurses. Things are now five times worse. Dr. Smart said that over 50% of physicians and medical learners reported high levels of burnout, compared to prepandemic levels of 30%. Moreover, nearly half of physicians reported that they would likely reduce their clinical hours. Canadians cannot afford any more reductions in access to doctors. With that in mind, I am going to take a moment to highlight, for the Liberal government, news from the labour shortage study out of HUMA this year. The report holds critical testimony outlining solutions that would improve working conditions for health care workers, attract and retain health care workers, and allow for a pan-Canadian human resource plan. These solutions come from health care professionals who know the problems in the system. I would note that not one of the solutions presented in the study was to jeopardize the public health care system by introducing private, for-profit care. Here are eight of the recommendations. First, “work with the provinces, territories and other stakeholders to promote the alignment of educational and training opportunities in health care and other care economy sectors...”. Second, “in collaboration with the provinces and territories, expand training and upskilling capacity for high demand industries, skilled workers, the care economy [and] health care workers...”. Third, “work with the provinces and territories to remove barriers to labour mobility in the health care sector, including through the interprovincial/territorial coordination of regulation and licensing requirements.” Fourth, “support access to care in rural and remote communities by providing further incentives for in-demand health care professionals to work in these communities, including through tuition assistance, loan forgiveness, or tax benefits...”. Fifth, “consider offering additional permanent residency pathways to temporary foreign workers with in-demand skills or experience, including in the care economy...”. Sixth, “review the Foreign Credential Recognition Program with a view to determining how it can better support efficient foreign credential recognition for internationally trained health care professionals.” Seventh, “review compensation and benefits for care economy workers under its jurisdiction with a view to ensuring decent work and a regionally competitive wage; and further, that it work with the provinces and territories to improve working conditions for other workers in the care economy (including but not limited to migrant workers, and those in non-standard employment) and provide adequate compensation, basic health benefits, paid sick days, and workload management.” Eighth, “consider establishing a national Care Economy Commission to develop, implement and monitor any workforce planning strategies for the care economy, including a centralized health care human resources strategy...”. These are the real solutions to the health care crisis. These are the real solutions that would benefit people over corporate profits, and these are the real avenues to solving the human resource challenges in health care. I am going to quote Michael Villeneuve, the former chief executive officer of the Canadian Nurses Association, who said: Canada needs targeted federal funding to help health care systems train, retain, recruit and improve education and working conditions...The federal government has an important convenor and coordinator role to play. It needs to work together with provinces and territories on both short- and long-term strategies. Maintaining the status quo cannot be an option. In closing, at the same time that the Canada health system is on the verge of collapse, workers are burning out, fatigued and taking early retirement. More federal investments are needed. As economist Armine Yalnizyan has been saying loudly, labour needs are set to rise due to an aging population. She says, “...there is no more pressing labour market issue than how we prepare the Care Economy for the decades of population aging ahead...” The federal government needs to take on this challenge and stop wasting time on for-profit corporations and privatization-hungry premiers trying to breach the Canada Health Act that belongs to all Canadians.

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Mr. Adam van Koeverden (Parliamentary Secretary to the Minister of Health and to the Minister of Sport, Lib.)

Feb/16/23 10:45:25 a.m.
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Madam Speaker, I would first like to commend the hon. member for Port Moody—Coquitlam for her work on labour shortages in the care economy. I appreciated all the quotes she used to re-emphasize what I believe are common characteristics and shared priorities with respect to these investments in the health care system going forward. I would also like to share a quote from Dr. Alika Lafontaine from the Canadian Medical Association: Today’s commitment by the federal government to significantly increase health transfers to provincial and territorial governments is an important step to stabilize and transform our health care systems. The emphasis being placed on primary care, health workers’ support and the modernization of health care is welcomed. I would ask my hon. colleague, who has done considerable work on this, how she would react to all the positive quotes that I have here from SEIU, the Canadian Nurses Association and the CMA? They all seem very pleased. Why is the hon. member not pleased?

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Ms. Bonita Zarrillo

Feb/16/23 10:46:27 a.m.
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Madam Speaker, I was not going to share this today, but I will. My mother is 77 years old and she went into an emergency room recently in Alberta because she was having trouble with her eyes. The emergency room doctor treated her, but sent her off-site to a private clinic and told her she would benefit from some additional things. My mother paid $5,000. She is a 77-year-old woman. When my mother walked into the waiting room on the day of her surgery, there were, she told me, dozens of people over the age of 75 sitting in that area. She paid $5,000 to have additional surgery on her eyes. When she went into the operating room, she thought she was getting the doctor whom she had spoken to in the emergency room. It was not until she went back for her second visit that she was told that was not the doctor who did the surgery. She was not told, and she still has not seen that doctor.

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Mr. Bob Zimmer (Prince George—Peace River—Northern Rockies, CPC)

Feb/16/23 10:47:31 a.m.
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Madam Speaker, I have a daughter who is interested in becoming a surgeon, and she is pursuing that as we speak. However, I have heard many stories. Even 20 or 25 years ago, friends of mine tried to get into medical school in Canada and simply could not, yet they found places somewhere else outside our very own country of Canada or outside our province of B.C. I have not heard this member talk once either about facilities to train doctors and nurses or about the gatekeepers who are controlling the applicants getting into our current system to become students and then to become doctors and nurses in our very own country. I am kind of curious whether she has a solution or has talked to those entities about possible solutions to fix that problem.

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Ms. Bonita Zarrillo

Feb/16/23 10:48:25 a.m.
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Madam Speaker, there is talk about that in the study on the labour shortage in the care economy. About 15 years ago when I was living in Quebec, I was at a dinner and there were conversations around the table then. We knew 15 years ago that there were not enough spots and placements. That is a serious issue. The Liberal government has the opportunity to start working with those organizations and with the provincial and territorial organizations to lift that. I want to point out, though, that we have known this was happening. People were sitting around tables talking about this 15 years ago and the Liberal government and the Conservative government before it did nothing about it.

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Ms. Louise Chabot (Thérèse-De Blainville, BQ)

Feb/16/23 10:49:14 a.m.
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Madam Speaker, we agree with the substance of the motion, in other words, the need to strengthen our free universal public health care systems. In Quebec, we watch these issues closely, but this is not the place to be debating them. We see what is happening in Ontario and Manitoba, as well as the potential abuses, and I think there are some battles to be fought. However, the most important battle to wage, when we talk about staffing, working conditions and labour shortages, is getting the federal government to provide adequate funding to the provinces so that they can carry out their responsibilities. Why did the NDP not call out the federal government's inadequate investment in the latest agreement with the provinces?

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Ms. Bonita Zarrillo

Feb/16/23 10:50:07 a.m.
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Madam Speaker, I really appreciate working with the member at the HUMA committee. The member and I had worked alongside each other on the labour shortage study, and we had very similar thoughts, so I thank her for that. The NDP members have been talking for a long time about the need for additional health care transfers and for the Liberals to make up for the deficit funding that the previous Conservative government pulled away. This is something that the New Democrats have been talking about for a long time. This is a failure of the Conservative government of the past and a failure of the Liberal government now.

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Mr. Adam van Koeverden (Parliamentary Secretary to the Minister of Health and to the Minister of Sport, Lib.)

Feb/16/23 10:50:55 a.m.
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Madam Speaker, it is an honour to rise in the House today to address the motion from the hon. member for Burnaby South and provide an update on our government's commitment to support and strengthen Canada's health care system. It is also a great opportunity to re-emphasize our number one priority, which is to ensure that our health care system continues to be publicly funded, universally available and equitably delivered. Canadians are proud of our universal health care system, a system that is accessible to everyone regardless of their ability to pay. However, this system is under pressure. The accessibility and universality of the system that we all rely on are under threat. We have all heard the devastating stories about the system failing us. There are for example the long waits at emergency rooms and the difficulty people have finding a family doctor, not to mention the years-long wait lists for consulting a specialist or to plan a surgery. While many of these issues existed long before COVID-19, the pandemic has both exposed and worsened a number of systemic problems that must be addressed. Canadians deserve a health care system that delivers results. That is why we are working with provinces and territories to increase funding in our health care system right across the country. Our goal is to ensure that all Canadians get the universal, accessible and high-quality health care they need and deserve when and where they need it. Last week, the Prime Minister announced the Government of Canada’s proposed investment of $198.6 billion over the next decade, including over $48 billion in new funding for provinces and territories to improve health care services for Canadians. I will speak more about how this investment is structured in just a few moments. It is about more than just money; it is a true investment in the health system that will yield tangible results for Canadians in the areas they care most about. Before I go any further, I would like to say a few words about COVID-19 and the enormous pressure the pandemic has placed on the health system, resources and workers. It has been health care workers who have borne the brunt of the pandemic’s impacts, on the job, every day. From high patient workloads, to scarce resources to fear for personal health and safety, the pressure on health workers has been unrelenting for over two and a half years. Last week, I had a chance to sit down with some representatives from SEIU, a labour union that represents a lot of workers in personal support and long-term care. The meeting quickly turned into one that was very emotional, because personal stories and anecdotes were shared. I do not mind saying for the House, and on the record, that everybody in the meeting was crying by the end of it. These people work so hard. They are so compassionate. They are there for society's most vulnerable, for our parents and our grandparents as they age. They are angels and saints, every single one of them. They asked me to re-emphasize for the Prime Minister and the Minister of Health the importance of wages for those workers, and they were so grateful for the increases they saw in these agreements. I take this opportunity to thank health care workers for their perseverance, professionalism and unwavering commitment to their patients, Canadians and people right across our country. Our government owes them a debt of gratitude for their continuing compassion, care and courage in these extremely challenging times. Given the pressure they are under, it should come as no surprise that health care workers are exhausted and burnt out. Many have left the profession altogether. Those who remain are grappling with very challenging workplace conditions, leading to low retention and a lot of turnover. This is unacceptable. Health workers are the backbone of our health care system. A crisis for health workers is a crisis for the whole system. They have taken care of us, they have taken care of our loved ones and we need to take care of them too. Therefore, we, as governments, now find ourselves in the position to try to find ways to rebuild the health system so it can continue to be there for us now and into the future. This is a shared challenge. We have been working closely with the provinces and territories to identify actions that are needed to improve the health system, while adapting to the changing needs of Canadians. Last week, federal and provincial leaders came together to discuss tangible actions that we could take now, which would help modernize the system and ensure results would be there for Canadians. After months of discussions, including with patients, health workers and experts, our government has proposed a sound, reasonable and pragmatic approach to obtain concrete results for Canadians as well as our health care workers. This past Monday, premiers across Canada announced that they had accepted this approach, and we welcome the opportunity to continue working with them to improve the universal, public health system on which we all rely. Our government will increase health funding by nearly $200 billion over the next 10 years. This funding includes an immediate and unconditional $2 billion Canada health transfer top-up to address immediate pressures on the health care system, especially in pediatric hospitals and emergency rooms for long wait times for surgeries. This builds on previous top-ups that total $6.5 billion provided throughout the pandemic. It also includes a five per cent Canada health transfer guarantee for the next five years. This is projected to provide an additional $17.3 billion over 10 years in new support. With this guarantee, the Canada health transfer is projected to grow by 33% over the next five years and 61% over the next 10 years. It will also include $25 billion over 10 years to advance shared health priorities through tailored bilateral agreements that will support the needs of people in each province and territory in four areas of shared priority: family health services, health workers and backlogs, mental health and substance use, and modernization of our health system. In addition, $1.7 billion will be invested over five years to support wage increases for personal support workers and related professions. On top of this, we will continue to work with indigenous partners to provide additional support for indigenous health priorities. Notably, the government will provide $2 billion over 10 years for an indigenous health equity fund to be distributed on a distinctions-based manner with first nations, Inuit and Métis to address the unique challenges indigenous peoples face when it comes to fair and equitable access to health care services. We will also provide an additional $505 million over five years to the Canadian Institute for Health Information and Canada Health Infoway. These federal data partners will work with provinces and territories on developing new health data indicators, among other efforts to use data to improve safety and quality of care right across Canada. We have been very clear about the obligations under the Canada Health Act. We will work with provinces and territories to ensure our investments are used in the best interest of patients and health care workers in a way that respects the principles of the Canada Health Act to ensure access to insured services is based on health needs, and not the ability or willingness to pay. Our investment supports work in shared priority areas that matter to Canadians, such as family health services, the health workforce, mental health and substance use services, and building a modern health care system. Helping Canadians age with dignity, closer to home, with access to home care or care in a safe long-term care facility is also an area of shared priority. I would also like to speak for few minutes about each of our shared priorities and why they are important to Canadians. The first priority is to improve access to family health services, especially in rural and remote areas and in underserved communities. Whether provided by a doctor, a nurse practitioner, a pediatrician or a multidisciplinary team, family health services are essential for effective, resilient, sustainable and equitable health care delivery, and yet more than 14% of Canadians over the age of 12 do not have a regular family health provider. This gap affects us all. When people do not have access to a a regular family health service provider, they rely heavily on walk-in clinics and emergency rooms that are already overburdened. This needs to change. With this new investment, we will work with the provinces and territories to ensure timely access to comprehensive, integrated and person-centred family health services, including in rural and remote areas. Our second shared priority is to support our health workers and reduce surgical backlogs. As I mentioned at the outset, health care workers made enormous sacrifices during the pandemic, and they continue to suffer the consequences of working in a system that is under strain. We need to invest in supporting and retaining health care workers. This includes training for recruitment as well as recognizing the skills of health care workers trained both in Canada and abroad. We also need to look to the future with better workforce planning. We can do this with improved health care service data with respect to our workforce and by seizing opportunities to scale new models of care to directly address these key barriers. This includes streamlining foreign credential qualifications and recognition for internationally educated health professionals and advancing labour mobility, starting with a multi-jurisdictional recognition of health professional licenses. As the member of Parliament for a diverse community of people who come from all over the world to make Canada their home, this is a personal priority for me as well. Third, we want to improve access to mental health services and substance use services for Canadians. Right now, one in three Canadians say that they are struggling with their mental health. It is clear that there is no health without mental health. It is as integral and important to our needs as physical health. That is why we are working to provide Canadians with a multidisciplinary system of care, one that integrates mental health services and substance use services right across all of those shared priorities with provinces and territories. This means better access to mental health and substance use services in the community as part of publicly funded care. For example, by better integrating mental health services within family health teams, we can strengthen access to needed mental health supports for all. We will ensure that every Canadian and those who need referrals can get them in a timely manner. Next, we need to work together to modernize the health system, which means improving the way we collect and manage health information. This will be foundational to achieving progress, because data saves lives. Let me explain what I mean. Better access to health information is essential for health workers to provide safe and high-quality health care, regardless of where in Canada patients might live or happen to be when they need care. Think of a nurse or a doctor who cannot see a patient's medical history, including any medications he or she is on, allergies the patient might have or tests that have taken. In an emergency situation, this can be very dangerous. Many of us have had the frustrating experience of being referred from one health provider to another only to be asked to repeat our medical history over and over again or take same tests multiple times, all because medical records were not shared in a modern manner. This is inefficient and results in duplication and increased costs. That explains why we need to modernize the health system with standardized health data and digital tools. Canadians should be able to access their own health information and benefit from it being shared between health workers across health settings and across jurisdictions, providing a seamless experience for the patient while respecting their privacy. To access the federal funding announced last week, we are asking provinces and territories to adopt common standards on how health information is collected and shared. This commitment will include an agreement to develop and use comparable indicators through the Canadian Institute for Health Information. These commitments will improve the efficiency, the quality and the safety of patient care, provide decision-makers with more complete pictures of the health care system and help manage public health emergencies. Finally, we are committed to helping Canadians age with dignity, closer to home and with access to home care or safe long-term care. Many seniors want to remain in their homes as long as possible, but they lack the support they need to do so safely. Collaborative work is under way with provinces and territories to help them support access to home care and long-term care. This includes existing investments of $6 billion for home and community care. The investment we announced last week will also include an additional $1.7 billion over five years to support wage increases for personal support workers and related professions. That was so important, and it was highlighted to me by the workers from SEIU just last week. Investing in these five areas of shared priorities will help repair the damage caused by COVID-19 and ready the health system for future challenges. We recognize each province and territory faces unique challenges. That leads me to the next point on the bilateral agreements. Provinces and territories will have the flexibility to tailor their bilateral agreements to meet the unique needs of their populations and geography. The health needs of Canadians are diverse across our country. Yukoners, New Brunswickers and Islanders all need something perhaps a little different. These agreements will also include action plans to ensure real progress is made and measured. On the Canada Health Act, each bilateral agreement will need to reinforce common core principles. The first among these is our shared responsibility under the Canada Health Act. This means governments must ensure that medically necessary services are provided on the basis of need, not one's ability or willingness to pay. In Canada, all people should need to get health care is their health card, not a credit card. It also means that under the act, where there is evidence of patient charges for medically necessary health services, such as for abortion services, mandatory deductions to the Canada health transfer payments of a province or territory must be taken. There is a precedent for this. As the Prime Minister pointed out last week, the Canada Health Act requires that governments protect, promote and restore the physical and mental well-being of residents of Canada and facilitate reasonable access to health services without financial or other barriers. Governments must also ensure equitable access to health care services and that such access is supported by a strong public health care sector. Next, the bilateral agreements we negotiate would reflect our joint commitment to health equity and reconciliation with indigenous peoples. We will work together to ensure indigenous peoples across the country are able to access quality and culturally safe health services, which are free from racism and discrimination, anywhere in Canada. Finally, agreements would also support improving equitable access for other underserved and equity-deserving groups, including Canadians living in rural and remote areas, as well as those living in official language minority communities. Canada's health care system is facing a major challenge. As Canadians, we all count on the system to take care of us and the people we care about. We expect it to be there when we need it. We are at a critical juncture. There are cracks in the health care system, and they are getting wider. Now we have to act fast to save the system we all cherish. Provinces, territories, stakeholders, care providers and the Government of Canada all have to work together to fill those gaps before these problems get even worse. Last week, we came together and took a giant step forward. There is still much work to be done, but with that approach, the one that our government has proposed and the premiers have now accepted, we are pointed in the right direction and we have a clear path ahead of us. Our government looks forward to working with the provinces and the territories in the weeks to come so that we can move forward together. Canadians are counting on us.

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Mr. Don Davies (Vancouver Kingsway, NDP)

Feb/16/23 11:07:59 a.m.
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Madam Speaker, my hon. colleague and I sat through a study of the human resources crisis in health care. He knows, as well as I do, there is a screaming conclusion: Human resources are finite. The same pool of doctors, nurses and other health professionals currently working in the publicly funded system would be pulled from that system to work in the privately funded system. He knows that a parallel private system reduces the incentive to work in the public system, as health care workers may be paid more in the private system despite caring for less complex patients. That is the process known as cream skimming. The reduced capacity in the publicly funded system leads to worsening wait times for those who cannot access the private care. Could the member explain why he does not agree with New Democrats that additional federal funds should be conditioned on going to the public system? He knows that if that money is diverted to the private system it would simply extend wait times and deepen the crisis in the public system.

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Mr. Adam van Koeverden

Feb/16/23 11:09:02 a.m.
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Madam Speaker, first, I would like to thank my hon. colleague from Vancouver Kingsway for his collaboration on the health committee. I agree with him, and I will re-emphasize our number one priority. Health care in Canada should remain, and always be, publicly funded, universally available and equitably delivered to all Canadians. I was in the health committee as we heard from nurses unions, doctors, experts, academics, patients and people all across the ecosystem of the health care sector. I heard those exact same anecdotes. I would lean in on quotes from some of those experts following the announcements last week, including, but certainly not limited to, Dr. Alika Lafontaine, the new president of the Canadian Medical Association. He said, “Today’s commitment by the federal government to significantly increase health transfers to provincial and territorial governments is an important step to stabilize and transform our health care systems.” It is all about repairing and preparing.

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Mr. Stephen Ellis (Cumberland—Colchester, CPC)

Feb/16/23 11:10:07 a.m.
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Madam Speaker, I note that in my colleague's words there is a lot of talk, but where is the action? My colleague mentioned that mental health is health. We have heard that a lot from the Liberal government in the House of Commons. We also know there is $4.5 billion of commitment in the Canada mental health transfer, which has not been sent, and we know there is a mental health crisis. When is the government going to get down to business and do something about the mental health crisis that exists in this country?

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Mr. Adam van Koeverden

Feb/16/23 11:10:55 a.m.
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Madam Speaker, I will not apologize for my speech being full of words. I am sorry if it was difficult to follow. It was full of words the hon. member could not hear, because he was speaking to one of his colleagues for the entire time I was speaking. If he had been listening, he would have heard the anecdotes that I shared from various organizations. I shared that one of our prime priorities is to support Canadians who are suffering from mental health and from addictions. Some hon. members: Oh, oh! Mr. Adam van Koeverden: I will leave it at that, as the hon. member continues to heckle me from across the way.

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