44th Parl. 1st Sess.
February 16, 2023 10:00AM
- 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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- 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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- 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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- 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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- 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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- 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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- 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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- 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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- 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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- 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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- 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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- 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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- 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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- 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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- Feb/16/23 12:00:06 p.m.
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Madam Speaker, I understand the difficulties my colleague has experienced in the health care system, but the major issue is one of funding and imbalance.
To fix that, the government should have listened to the provinces when they asked for an additional $28 billion to increase health transfers from 22% to 35%. That is what needed to be done, and the NDP still has an opportunity to do it. The budget will contain measures that the government proposes for health care, and the NDP just has to oppose them. We can re-establish a balance of power and force this government to invest in health care to meet the provinces' expectations, to meet the expectations of patients who are on waiting lists, and to meet the expectations of nurses, who are at the end of their rope. The NDP can still make a difference. They just need to grow a backbone and stand up to the Liberal government.
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- Feb/16/23 12:01:01 p.m.
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Madam Speaker, the Bloc seems to be of the impression, and I really disagree with this, that the only role the federal government plays is to provide provinces money, nothing more, to be that ATM machine. It is like having a system in Canada where data and information is irrelevant to health care, data such as having a three-month waiting list for a hip replacement in one province and a 14-month waiting list in another.
We have the Canada Health Act, which is there to ensure there is a national health care system that provides basic fundamentals in health care, the expectations that Canadians have. Some provinces might be more progressive than other provinces, but would he not agree we should be able to look at the different provinces and see those basic fundamentals that are prescribed in the Canada Health Act?
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- Feb/16/23 12:02:05 p.m.
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Madam Speaker, I would like my colleague to tell me how he can magically find solutions, here in the House, to wait times in the health care system. How can he magically do that when his government cannot even deliver passports on time, deal with irregular border crossers who do not have work permits, and help people who spend weeks waiting for their EI payments?
The Liberals should take care of the things they are responsible for and let the provinces manage health care. For the provinces to manage health care, they need the necessary resources, and the federal government is the one that has the fiscal capacity to do that. The government is shirking its responsibilities. It is as simple as that.
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- Feb/16/23 12:02:52 p.m.
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Madam Speaker, I say this with the greatest of respect, but there is a profound error in my colleague's comment, when he asserts over and over again that health care is a provincial responsibility in jurisdiction only. That is just incorrect. The Supreme Court of Canada said, “'Health' is not a matter which is subject to specific constitutional assignment but instead is an amorphous topic which can be addressed by valid federal or provincial legislation...”.
We know there are conditions attached because the Canada Health Act establishes them. When Quebec or any other province gets money, they agree to take that money on the basis of respecting five conditions of the Canada Health Act.
Is the Bloc Québécois in favour of two-tier private access to care? He says he is going to vote against our motion. Does that mean the Bloc Québécois is in favour of two-tier private care in our country, because that is what this motion is about today?
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- Feb/16/23 12:03:55 p.m.
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Madam Speaker, that trap was easy to see coming. I said earlier in my speech that that was what the NDP would say. It is easy. Populism involves using overly simplistic explanations to describe complex realities. They are saying that if we do not vote in favour of the NDP motion, it is because we are in favour of giving the private sector a bigger place in the health care system.
We will not be voting in favour of the motion and we do not support it because it directly infringes on areas of provincial jurisdiction. That sets a precedent, and we maintain—
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- Feb/16/23 12:04:28 p.m.
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We have to resume debate.
The hon. member for Rivière-du-Nord.
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