SoVote

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

Feb/16/23 11:14:32 a.m.
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Madam Speaker, I would like to thank my colleague for the extraordinary work that he and his colleagues on the HUMA committee have done to ensure that there is modernization in the care economy, that wages keep up to the rate of inflation and that people are paid well for their essential work. That same day, I met with members of the SEIU to discuss not only some of the more troubling results of the pandemic, but also the reality that they are just not paid enough for their work. I am glad that one of the aspects of this agreement with the provinces and territories includes a provision of $1.7 billion to ensure there is a $25 minimum wage for those workers. They were very grateful for that. I was grateful for their insight and perspective in that meeting. It was extremely touching.

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Mr. Don Davies

Feb/16/23 11:15:23 a.m.
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Madam Speaker, my hon. colleague was relying on quotes, so I am going to share some quotes with him. Bernie Robinson, from the Ontario Nurses Association, said, “I fail to understand where the government thinks it's going to get the human resources to staff these private clinics other than by draining our already-taxed public system.” J.P. Hornick, from the Ontario Public Service Employees Union, said, “To improve access to care, public hospitals require staff and funding, both of which will be even further depleted with increased reliance on private clinics.” Finally, Dr. Bob Bell, former deputy minister of health in Ontario, said, “I totally agree with their desire to do more surgery by moving it out of the hospital into the community. But moving it to a for-profit model is simply dumb.” This is not about upholding the Canada Health Act. Why is the federal government not stepping in to make sure that the additional funds are not diverted by the provinces to private clinics, even if they are publicly paid for?

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Mr. Adam van Koeverden

Feb/16/23 11:16:20 a.m.
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Madam Speaker, I thank my friend and colleague for his collaboration. The quotes he shared were primarily from provincial organizations representing the workers in those provinces, which is important, but I think they were directing those comments to provincial governments. We heard from Canadian organizations, like the Canadian Medical Association, the Royal College of Physicians and Surgeons of Canada, the Canadian Nurses Association, SEIU Healthcare, The College of Family Physicians of Canada and HealthCareCAN, including Children's Healthcare Canada. This is a quote from the latter, which said, “We are incredibly pleased to see children's healthcare services identified as an urgent priority by the federal government. We look forward to learning more about earmarked investments for Canada's kids.” I re-emphasize the need to ensure that all of those funds are delivered equitably, universally and publicly, and that our system continues to have that and to be compliant with the Canada Health Act. I appreciate everybody's collaboration through the health committee process and look forward to more questions.

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Mrs. Rachael Thomas (Lethbridge, CPC)

Feb/16/23 11:17:19 a.m.
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Madam Speaker, the hon. member talked about the commitment of the Liberal government and its focus on health care. He said they are focused on care for “equity-deserving” groups. I am curious as to his understanding of equity deserving. Under a universal health care system, which is what this country has, who is not equity deserving?

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Mr. Adam van Koeverden

Feb/16/23 11:17:50 a.m.
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Madam Speaker, the concept of equity versus equality is one that is lost on some members of the House. It is important to note that some Canadians do live in disparate conditions. They live far away from hospitals and have less access to services, to resources and to a family doctor. We have to ensure that everybody has service and access to the exact same system, and we have to make sure outcomes are the same. Outcomes are what is important here. Certainly, it does cost more money to provide people with health care in rural, remote communities. It does cost more to serve somebody who is under-resourced, who has a lower income, and who deserves and needs a little more help.

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Mr. Stephen Ellis (Cumberland—Colchester, CPC)

Feb/16/23 11:18:33 a.m.
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Madam Speaker, hopefully members of the House will begin to understand that using meaningless words is not helpful to Canadians. I am not sure how to exactly make that point because it seems to be lost on many people who come here and attempt to do business. What we do know very clearly is that the health care system we have, as mentioned very passionately by the former president of the Canadian Medical Association, is a system that is on the brink of collapse. Continuing to go on about grand ideas and priorities is in no way, shape or form going to operationalize any ideas in this country, which is really what we need. I guess, in the vernacular, we need people who are actually going to do something. Many groups have put forward great ideas about pathways, road maps and priorities, etc. There has been talk about a lot of money that is going to be spent, has been spent or should be spent. What do we have? We have a system that is no different. We know that after eight years of the Liberal government, we have people waiting and waiting. Very sadly, the waiting is now waiting until they are dead. This is the ridiculous and heartbreaking nature of a system that we in the House and the government, as I am putting the blame squarely at the feet of the Liberal government, have allowed to happen. People are literally dying in emergency rooms. That is the point where we need to begin to consider how to operationalize those things and what sort of leadership the federal government needs to bear to change the system. I was fortunate enough to have worked in the health care system as a family doctor for 26 years. Four of those years was serving our country in the military. Even way back then, we knew very clearly that there was a shortage of physicians. Part of the work that I was required to do as a physician was to go other bases around this country so that other physicians could have a vacation. That is a rotation that we did. As I transitioned from my miliary life into a practice in Truro, Nova Scotia, it became very clear that changes were happening in our health care system. Of course, as we all know, we have an aging population, which is felt more acutely perhaps in the Atlantic provinces and Quebec than elsewhere in the country, but at that time we also knew there was a dwindling of resources available, both financial and health human resources. I had the privilege and opportunity to be a part of the health human resource study that was done by the Standing Committee on Health. It was a decent study, but I am still not entirely sure that there is a pathway forward on how to operationalize the ideas. One of the things that makes me the saddest is understanding that the folks I had the opportunity to work with, and who continue to work in the system are, as we might say, burned out, tired, frustrated, angry and hurt. How do we begin to change that? If we do not look at the system as a whole and begin to look at ideas on how to change that and change it quickly, then we are going to continue down the same path. It does not really matter how much money we pour into the system. We must focus on the people who are the greatest asset of the system. I heard my colleague on the Liberal side talking about how data saves lives. I have to say it cuts right to my own heart to hear him say that data saves lives. People save lives. The doctors and nurses who are working on the front lines in emergency rooms and in small places across this entire country are the people who save lives. Does data help? Sure, it does. We have been talking about data strategies since I cannot even remember when, since the Stone Age, and we still have no real data strategy. We can talk about it all we want, but until somebody has the courage to begin to operationalize that and work collaboratively with provincial governments, we are never going to get to the point where anything happens. For me, in coming here for the last 18 months, that is the most frustrating. When do things happen in the government? When do things get done? Who does the work? We can have priorities and ideas and that kind of stuff. I am not saying that the Liberal government does not have priorities and ideas, that it does not put money toward things, but they are things that I do not necessarily agree with. I think that the other thing is that there is no work being done. When is something actually going to happen? When is Beau Blois, who is an emergency room physician in Truro, Nova Scotia, actually going to feel the difference, in an operational sense, of something that we are actually doing? We can, again, use all kinds of meaningless words and talk about things over and over again, but for that man, who also has a family, runs a business, and works very hard in our community, when is the operational rubber going to meet the road? When is something actually going to happen that is different? Until that point, we know that we will continue with this system, which lets down Canadians and Canadian health care workers. For me, having been in that position, that is something that makes me very, very sad. From a very personal perspective, I know that the people who are working in the system care deeply about their patients, and doing a good job, and they care very deeply about the system as well. They are aware of the difficulties in the system. They call every day with ideas and ways in which they believe that the system could actually be changed to make it better. I think that the shame of it all is that after eight years of the Liberal government, all we get is more ideas and planning and priorities and meaningless talk that does not operationalize anything. I know what is going is happen today. Somebody on that side of the House will chirp at me to say, well, it is the provincial government and I am talking about jurisdictional issues, and guess what happens? Absolutely nothing happens. That is the sickest part of it all. We can talk about this until we are blue in the face, but until somebody actually does something that creates an opportunity for change and operationalizes something, nothing happens. That leaves the emergency room doctor, Dr. Beau Blois, still doing what he is trying to do, even though he works very hard and many hours in a multitude of different health care settings in my area. Another guy that I have worked with for many years, Dr. Wayne Pickett, works in four or five different emergency rooms around rural Nova Scotia. Why does he do it? He does it because there is a need. He has tremendous skills. He is a compassionate doctor, and I would be happy to have him, if I needed the work, work on me any day. That being said, how do we change the life of the Dr. Wayne Picketts of the world? How do we change things so that, in an operational sense, we can see change on the ground, so that the Mary Smiths and whoever we want to talk about, the Ednas of the world, get care? How do they realize that they not have a family doctor any more and they are having a difficult time getting their prescriptions refilled? How do we also then take virtual care and make it a reality? We have had conversations about virtual care, but if we go to the doctor and all we do is see them on a screen and nobody is there to examine us, how do we know that what we have told the doctor is right, that it is actually the case? How do we rectify the fact that using virtual care is significantly increasing the amount of diagnostic imaging that needs to be done? Why is that? It is because the doctor, instead of actually seeing us and examining us when we have a sore arm, says, “Well, I guess your arm is sore, and that is unfortunate, so let's get an x-ray done.” Whereas, if we had an experienced practitioner, someone could actually see us to examine us and then realize that maybe we do not need an x-ray done, that we have another problem. These are things that we are facing. When we think about it, we have an electronic medical record in Nova Scotia. I think that is worthwhile explaining, because I am not entirely sure that everybody understands how this might work. If I have an electronic medical record in my office, and I am working in the emergency room and one is my patient, then I can look at their records. If I have an electronic medical record, and somebody else comes whose family physician has the same electronic medical record, in the emergency room, I cannot look at their electronic medical record. It does not make any sense. Until we take these very practical problems and decide to make a difference, all we are going to do in the House of Commons is speak meaningless words that fill up Hansard. Those are some examples of very practical things we could do. I am not being particularly critical, but I think we have a decent system in Nova Scotia. I know it is similar across the country. There are people struggling to get blood work done. It takes a long time to book an appointment. We now have a combination of systems that is difficult for seniors to access because it is computer-based. How do we rectify those things? How do we help seniors in our communities who are struggling with that? When we look at those things, we know there are significant issues that need to be operationalized. I realize that the default in this grand institution we are in is to say something is a provincial issue. We do not have leadership here. We need to begin by looking at innovative ideas and how we can tie them together from province to province, and if we have a crisis in this country, we know that it is possible to show significant federal leadership, which sadly does not happen now. I am going to shift gears a bit and talk about mental health. There has been a lot of talk about mental health and not much done about it. We know that since the pandemic, one in three Canadians has suffered significantly with their mental health. We also know that the Liberal government has put together studies which would suggest that 25% of Canadians not being able to access mental health care is a reasonable number. I think it should be zero. There should not be anybody out there who struggles to access mental health care. In this country, the greatest country in the world, we allow that to happen, and that is a travesty. That is absolutely unacceptable. What is at the heart of that? I think there are a few things at the heart of it. It is a reflection of the state of this country. The sad state is that everything is broken. People feel defeated. They do not feel like they have hope. They do not feel like they have a future. They do not feel like they have a voice. When people feel like that, we have to reflect on how that makes us feel inside as people. How does that make us value ourselves and our contributions, not just to our families but to our country and communities? How do we invigorate people so they can actually feel like they are contributing to this country and get that wonderful feedback so they know they did that? What are the other things in mental health that are important? There are a few things. Certainly, we have heard from counsellors and psychotherapists to know that the Liberal government is still charging GST on their services, which is a burden. We know that it would be a very easy fix to allow counsellors and psychotherapists to not charge GST on their services, which would then allow a greater number of Canadians access to the services they deserve. What about mental health funding? To the people who are listening to what we are doing today, they know that in the 2021 platform of the Liberal government, it said it was going to fund a Canada mental health transfer up to the tune of $4.5 billion. Here we are, and year after year goes by. We had the fall economic statement. There is another budget coming up to talk about more money. I have to mention something. I was on the MAID committee, and its members wanted to talk about funding. I said, “Great, let us talk about funding. Where is the $4.5-billion Canada mental health transfer?” The member opposite had the audacity to say it has been transferred. Everybody in the House knows that not one penny has been transferred under the Canada mental health transfer. If it were not so incredibly gut-wrenching, nauseating and inappropriate, it would actually be funny because the member said that maybe we transferred it under another name. Why would it be under another name? The government announced a $4.5-billion project, and it wants me to believe that it transferred that money under another name. That is baloney. That is shameful. Now, here we are, and Canadians are suffering. I heard my colleague across the way say he realized that Canadians were suffering with their mental health. If the Liberals have committed the money, why do they not just send it to the provinces and allow them to do things? What we will hear from the government is a strange thing, and I want to be clear on it. The Liberal government is going to tell Canadians that it does not want to transfer the money because it wants the provinces to be accountable for it. The wasteful Liberal government is holding back money that could help the mental health of Canadians because it wants accountability. It wastes money on everything every day and it does not want to help people with mental health. I find it absolutely and shockingly ridiculous that we are even hearing this type of retort from my colleagues across the way. We have had eight years of the current Liberal government and what do we have to show for it? Perhaps some statistics might be helpful. When someone goes to see their family doctor, and the doctor realizes it is something they cannot take care of themselves, they send the patient to a specialist. The specialist may recommend some treatment. I do not know if members know the number, but the wait time is six months. That is the longest it has been in 30 years. What is perhaps an even sadder statistic is that five million Canadians do not have access to primary care, with perhaps 130,000 in my own province of Nova Scotia. We know there are 1.228 million people waiting for procedures in Canada. We could also look at diagnostic imaging. For folks out there who may not know what that means, it is CAT scans, MRIs and regular X-rays. We know those wait times are the longest they have been in forever. What else do we know? We know we have drug shortages in this country. We brought Health Canada and the minister to the health committee to talk about the shortages of pediatric ibuprofen and acetaminophen, and what answers did we get? We got absolutely none. They said they were going to work on it and maybe get some in, but we know that when people go to their pharmacies, the cupboards are still bare. What else do we know? We know there are critical drug shortages of every pediatric oral antibiotic that, if I was working as a family doctor, I would prescribe for children with bacterial infections. We know that every one of them is short. As I said previously, we also know, from the words of Dr. Katharine Smart, former Canadian Medical Association president, that we are in a system on the brink of collapse. What else do we know? After eight years of the Liberal government, we know, as I mentioned right off the top, that people are dying in emergency rooms around this country. Somebody died in my own riding in Amherst in the emergency room, a lady named Holthoff. It is a sad state of affairs. There are no words to describe that. Those are things that should not be happening in Canada. We know, after eight years of the Liberal government, that the Prime Minister refused to meet with premiers. When he eventually met with them and gave them a package, he said, “Here is your money. Hit the road. I don't want to hear any of your talk about this anymore.” We know there is a significant crisis in the health care system, and we know that right now it is borne on the backs of the folks who continue to work on it, folks whom I have had the privilege and opportunity to work with. We know that if we do not operationalize our ideas in this great House, nothing is going to change. That is the sad concern I have: that nothing is going to change and we are going to continue down the same path we are on. We need to have great leadership in this country, and right now we do not have it. I will end with an interesting take on this. If someone wants a solution to health care, they should elect a Conservative government.

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Mrs. Julie Vignola (Beauport—Limoilou, BQ)

Feb/16/23 11:38:31 a.m.
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Madam Speaker, one of my biggest fears is that our systems, whether it be the health care system or any other Canada-wide system like the agricultural system, will become Americanized. Allowing indiscriminate access to the private sector would make our health care system more like the American system. That would not be good for the middle class, as it would lead to excessive debt. We agree on that. Having said that, if opportunities to rely on the private sector have opened up in recent years, it is because successive Liberal and Conservative governments since the Jean Chrétien government have not provided sufficient health transfers. If my colleague's budget were 28% to 32% short over a 30-year period, would he be able to manage a crisis, if one came along? That is the reality in the health care system.

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Mr. Stephen Ellis

Feb/16/23 11:39:39 a.m.
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Madam Speaker, I thank my colleague for her question. We can talk about money in the House all day if we want to, but until we begin to operationalize things, we are not going to see any change. I think one of the worst things we could possibly do in Canada is start comparing ourselves to an American system. We know that the American system is based on private care. We know that people do not have access. We know it is very costly. The United States spends more money on health care than anybody else in this world. To think we need to allow our system to collapse more than it has and adopt an American-style system would be a disservice to all Canadians.

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Ms. Lisa Marie Barron (Nanaimo—Ladysmith, NDP)

Feb/16/23 11:40:27 a.m.
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Madam Speaker, I thank the member for sharing some of his experiences working as a family physician, and specifically what he has seen regarding the need for mental health supports for Canadians. I worked in mental health and addictions prior to becoming a member of Parliament, and I saw the impact on our mental health services of a two-tired system, a private-public system. I saw the many ways in which this system provided supports for those who had the funds and left behind those who did not. I am wondering if the member could share with us today whether he agrees that moving toward a privately funded health care system would exacerbate the exact problems we are seeing in our mental health systems. This is instead of moving forward to increase supports for Canadians in need.

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Mr. Stephen Ellis

Feb/16/23 11:41:19 a.m.
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Madam Speaker, there are two things I need to point out. I have spoken at length about the $4.5-billion Canada mental health transfer, which has not happened. The other thing we need to talk about is the Liberal Prime Minister, who talks about privatizing Canadian health care and claims it is innovation. Everybody has heard that in the media. I think it is a travesty. There are two points, as I said. We have a Liberal Prime Minister who is talking about private care as innovative, and we have a Liberal Prime Minister who refuses to transfer $4.5 billion to those who need it the most with mental health issues.

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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 11:42:03 a.m.
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Madam Speaker, the member opposite asked a lot of questions, and this has become a really disappointing trend from the Conservatives. It is a lot of slogans and no solutions or proposals for a better system. There are no recommendations, just a lot of slogans with no substance at all. Canadians know they cannot trust the Conservatives on health care. Their hidden agenda is not hidden at all. There are examples across this country of Conservatives continually privatizing health care and ensuring that private clinics can deliver care to Canadians. That is why our government has had to rescind money. There are actually consequences for Conservative governments that have been doing that, in particular those in New Brunswick and Alberta. Over $100 million has had to be pulled back because of contraventions to the Canada Health Act. My question to the member is very clear: How can Canadians trust the Conservatives on something so precious and important as health care?

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Mr. Stephen Ellis

Feb/16/23 11:43:06 a.m.
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Madam Speaker, when we look at things in the House of Commons, the Liberal government has done absolutely nothing after eight years. We have had eight years of increased wait times, eight years of no access to primary care and eight years of refusing to transfer $4.5 billion through the Canada mental health transfer, which the Liberals created themselves. We have had eight years of inaction. We have had eight years of increasing burnout among the people whom I spoke very passionately about. We do not have slogans over here. I do not think I said one slogan in my entire speech. I think the other very important thing we need to understand is that we need to do something about this. This is a crisis. We need leadership, and on this side of the House, that is what we have. We have leadership. We have ideas. We do not need to give the government our ideas. We need to oppose the absolute inanity of the ideas it has when it brings them forth and they are not going to serve Canadians. That is our job. I understand that the parliamentary secretary does not like that or does not understand it, but our job over here is to stand up for Canadians and oppose the crazy ideas members on that side of the House have.

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Mr. John Brassard (Barrie—Innisfil, CPC)

Feb/16/23 11:44:28 a.m.
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Madam Speaker, to hear the member for Cumberland—Colchester is almost like getting a playing lesson from a pro. He is a former medical doctor who is intimately aware of the system. This is as opposed to a playing lesson from a former kayaker. I sense his frustration. It is a frustration that many Canadians are feeling. We are hearing news today about doctors with foreign credentials. Canadian doctors who are foreign trained are unable to come back into this country to practise. They number in the thousands. What role can the federal government play in ensuring that doctors with foreign credentials, many of them Canadians, can come back into this country and work with provincial governments to ensure that we build up our capacity in the health care system and have those health care professionals work in Canada?

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Mr. Stephen Ellis

Feb/16/23 11:45:24 a.m.
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Madam Speaker, I think it would be inappropriate to give all of our plans away to the government since it clearly has no ideas of its own. I think that would be unfortunate. What we know very clearly is that there are immigrants who have come to this country, internationally trained medical graduates, who are unable to work in our system. What we need to do is look at the exact skill sets they have. There is a vast need across every health care human resource sector in this country, and we need to understand exactly how to help those folks fit into the system we have. We know that the training system either does not have the capacity or perhaps, although I am not entirely sure, does not have the desire to train these folks to get to the standard we have, which is very high here in Canada. We also know that Canadians who have trained abroad need to be allowed to come back and show that the skills they have learned in other countries, such as Ireland, are of value to us here in Canada. They would play a fantastic role in our health care system and would be able to provide the care that Canadians so desperately need. We also need to know very clearly what happens when somebody comes here from another country. We cannot have country X losing a doctor and Canada not gaining a doctor. Not giving a place in this country to somebody the immigration system has brought to Canada as a physician is a travesty and is very hurtful to the immigrants coming here to help us.

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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/16/23 11:46:55 a.m.
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The hon. member for Longueuil—Saint-Hubert, for a brief question.

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Mr. Denis Trudel (Longueuil—Saint-Hubert, BQ)

Feb/16/23 11:47:00 a.m.
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Madam Speaker, this morning's debate is kind of schizophrenic. Everyone who got up to speak, no matter their political stripe, said there is a problem with Canada's health care system, that it does not make sense, that there are wait lists for surgery and mental health and that seniors are not getting the care they should be getting. Everyone agrees on that. People are practically unanimous in saying something must be done about it. True to form, the NDP moved a motion that does not belong in the House. We are going to spend a day wasting our breath because the things the NDP wants to talk about today are up to Quebec and the provinces. The Liberals have made their choice. They have decided not to be part of the solution. The provinces and Quebec asked for $6 billion, but the Liberals gave them $1 billion. Now they are merrily flinging numbers around as though they were fixing things. My Conservative friends have come to the same conclusion, but have they come up with the same answer? They have been pretty quiet about whether they would significantly increase health transfers to fix the country's health care system if ever—

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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Feb/16/23 11:48:01 a.m.
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I had asked that it be a brief question, and the hon. member took more than a minute. I will give the hon. member for Cumberland—Colchester the opportunity to respond.

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Mr. Stephen Ellis

Feb/16/23 11:48:11 a.m.
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Madam Speaker, I think it is very clear that in this country we need a few things. We need great leadership and we need great co-operation. I believe that in this country, we have the ability to solve this problem. If we all work together with the provinces, with great leadership from the federal government, as we will show on the Conservative side of the House when we take over government, we will be able to solve these problems. We are a co-operative group and will move forward on this issue very clearly.

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Mr. Mario Simard (Jonquière, BQ)

Feb/16/23 11:48:44 a.m.
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Madam Speaker, I want to say that I will be sharing my time with my mentor, the member for Rivière-du-Nord. I think that having a discussion about the role of private health care is a great way to distinguish between certain ideological positions. On the one hand, there are those who think of themselves as social democrats or progressives, even if the latter term is a bit overused. On the other hand, there are people who have more of a neo-liberal vision, inspired by classical liberalism, where positions are often structured around an idyllic vision of the market; it is all about the market. When we talk about the role of private health care, these divisions always come to the fore. I say this because we, in the Bloc Québécois, tend to define ourselves as progressives, as social democrats, much like NDP members do. For example, one way to try and define progressives, social democrats, is to look at some of the struggles that have taken place. I am thinking about the fight for better wealth distribution, allowing for equal opportunities, which is more structured by the state. I am thinking about the struggles that women and the labour movement face. I would even say that a progressive is someone who defends secularism. I doubt my NDP colleagues would agree. Indeed, the issue of state neutrality often comes up in discussions about progressivism. What I am getting at is that Quebec is probably one of the most progressive societies in Canada. Look at the choices that Quebec has made. Child care was put in place in 1997. Canada has just implemented it, more than 20 years later. The same can be said of parental leave and pharmacare. In my opinion, Quebec's government and society is a bit more progressive than Canada. That is Quebec's choice. I would like to make a distinction. I see what the NDP is trying to do with this motion. The Bloc Québécois will be voting against it, but when we do, members will say that the Bloc Québécois is not progressive and that it is in favour of more privatized health care. However, that is not the case. That explanation is too simplistic. I do not want to accuse my NDP colleagues of populism. We know what populism means. It often involves using overly simplistic explanations to try to describe complex realities. Health care in Canada is a complex reality. The fact that we are against this motion does not necessarily mean that we are in favour of giving the private sector a bigger place in the health care system. I want to point out that the difference between the NDP's progressiveness and the Bloc Québécois's is that the NDP's progressiveness involves a centralizing, predatory federalism. I want members to remember that. I do not want to use any bad words, but we have to call a spade a spade. It is a federalism that is always trying to infringe on provincial jurisdictions. When I take a closer look at the NDP motion, what I ultimately see is paternalism, but I will come back to that. Ottawa thinks it knows best. We, the legislators in the House here in Ottawa, are supposed to explain to the provinces how the health care system works and we are the ones who see things clearly. That is basically how the NDP motion reads to me. This motion is also pretty Ontario-centric, and I will simply point out in passing that it is yet another illustration of the fact that the NDP is rather disconnected from Quebec. Let us move on quickly to the next thing. What should my colleagues have done if they truly cared about the health care issue? They should have tackled the main problem, which is a structural one. The problem that we face today is a structural one, where health care is affected by the financial withdrawal of the federal government. Guess what? The fiscal imbalance has provided extensive documentation of this withdrawal. If my NDP colleagues were serious, they would have looked at the issue of fiscal imbalance and at the federal government's withdrawal. Here is an example. In the 1990s, in 1996-97, the federal government made ongoing cuts of $2.5 billion to provincial transfers. Lucien Bouchard was premier of Quebec at the time. He had to deal with these cuts, which completely destabilized Quebec's health care system. His critics were quick to paint him as a neo-liberal politician because he made cuts to health care. However, at the same time that he was creating a $5 child care system and implementing a family policy, he was being strangled by the federal government and forced to cut health care services to the public. That is the kind of predatory federalism that I was talking about earlier. I am coming back to the fiscal imbalance because I would simply like to provide the definition that really speaks to me. It is the one that was included in the Séguin report. It states that the provinces' spending structure is such that expenditures grow faster than the economy, while those of the federal government grow at roughly the same pace. Furthermore, when it wants to adjust its spending, the federal government can just unilaterally cut transfers to the provinces, without any political fallout. “Without any political fallout” worked for Paul Martin in the 1990s. He balanced his budget on the backs of the provinces. Who paid the political price? It was the various premiers and health ministers in Quebec, who were held responsible for the shortfall in the health care system because Ottawa choked the resources. The NDP's response to something like the fiscal imbalance is to say that funding for the provinces should come with conditions. To me, that is quintessential predatory federalism. I did not make up that term. It came from a health minister from Quebec who was a Liberal and had absolutely nothing to do with sovereignists and separatists. The fiscal imbalance has been documented in a fairly impartial manner. I am thinking in particular of the Conference Board of Canada, which has shown in many studies that if nothing is done by 2030-31, the provinces will collapse under the weight of deficits, while the federal government will be swimming in surpluses. The Parliamentary Budget Officer has also demonstrated this many times. When I look at the NDP motion, I see direct interference in provincial jurisdictions. Health is not the purview of the House of Commons. Naturally, in Quebec and other provinces, governments may take approaches that are controversial, but that is democracy. If people are not satisfied with the actions of their legislatures, they can run for a seat there. If health care is the real concern of my NDP colleagues, they can stand for election in Quebec, Ontario, Saskatchewan or Manitoba and tackle the health care system. That certainly does not fall to the House of Commons. I want to conclude by highlighting the predatory federalism we can see in the NDP proposals. Imposing national standards on long-term care facilities is interference. Hiring health care workers is interference. Investing in mental health and preventing the use of private health care, which is the basis of their motion, is again interference. To add insult to injury, if the New Democrats had done their homework, and I am sure my colleague from Rivière-du-Nord will elaborate on this, they would have looked at the Chaoulli decision and realized that if they want to go against the provinces in the delivery of health care, they have two options. One option is to use the notwithstanding clause that they condemned last week in the debate on one of our opposition motions.

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

Feb/16/23 11:58:59 a.m.
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Madam Speaker, I agree on the progressive policies in Quebec. I have said many times in the House that I benefited from the very first $5-a-day child care when I lived in Quebec in 1998, but I also want to point to when I had my second child in Quebec in 2003. At that point in time, C. difficile was in the hospitals. I did not get a meal delivered to my room because there was not enough staff. I needed to rely on my spouse to ensure I was fed during the two days I was in the hospital. When we look at the long-term care outcomes and the deaths through COVID in Quebec, these are the realities about which we are talking. This is about a lack of staff, a lack of funding to have adequate staff, and reliance on the free market is no way to fix these problems. Does the Bloc agree that we need to have an all-hands-on-deck fight to ensure we have the human resources in the health care system across our country?

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