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Decentralized Democracy

House Hansard - 162

44th Parl. 1st Sess.
February 16, 2023 10:00AM
  • Feb/16/23 1:01:01 p.m.
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Madam Speaker, well, we have to be somewhat careful. Again, I used to be the health critic in the Province of Manitoba. Even the NDP supported, indirectly, the privatization of health care. I can sit with the member and expand upon that. At the end of the day, the most important thing we have to recognize is how to prevent a two-tier system. That is the greatest fear. We need to ensure that the managing of health care, which is absolutely critical to its survival, is conducted. From my perspective, the real issue is that we never, ever support, publicly, a two-tier system. I think that is what we should be striving for, more than anything else: keep it free and accessible, keep the portability, and maintain those five fundamental principles. That is absolutely critical. We need to make it very clear that we would not tolerate a two-tier system.
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  • Feb/16/23 1:02:16 p.m.
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Madam Speaker, I am pleased to hear our Liberal colleague say that it is up to the provinces to ensure the sound management and administration of the health care system. However, what he said about members of the Bloc Québécois is rather frustrating and offensive. He said that the Bloc members were flipping out. The Bloc Québécois is defending Quebec, and it joined the Government of Quebec in asking for $6 billion in health care transfers to meet needs. We are getting $1 billion, so that is what the Bloc is upset about. Can my colleague explain why he said that the Bloc Québécois is flipping out?
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  • Feb/16/23 1:02:51 p.m.
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Madam Speaker, I defended the Province of Quebec. Every year, for the 19 years that I sat in the Manitoba legislature, Ottawa is always asked for more money for health care. We did not hear the provinces complain when there was a tax point shift, when Ottawa said there would be a reduction in cash transfers in favour of a tax point shift. The provinces did not complain then. At the end of the day, provinces and municipalities always want to have more money. We need to ensure that there is adequate federal funding, and the $198-billion, 10-year commitment is just that. We are there at the table. That is why the provinces have signed on, because they have recognized that this is the type of money that is going to make the difference in providing the quality care that Canadians have from coast to coast.
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  • Feb/16/23 1:03:52 p.m.
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Madam Speaker, while I was listening to my colleague's speech, I heard him talk about the importance of mental health. While the Liberals have been in power for eight years, they have failed to act on a mental health transfer. In fact, a mere 18 months ago, they ran on an election platform about creating a Canada mental health transfer and yet, in 18 months, we have seen nothing. We have seen less than nothing. We have seen absolute crickets and silence from the minister, leaving people to wait simply with the empty promises that maybe someday it might possibly happen. Does the hon. member support having those mental health transfers, as was campaigned on and promised in the Liberal platform, actually come to light?
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  • Feb/16/23 1:04:47 p.m.
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Madam Speaker, the member opposite, along with many of her colleagues, needs to read other things outside of just the Conservative notes that are being provided. If the member genuinely believes that we have not been investing in mental health, she can go onto the portal and she will find that we have spent $180 million on a portal that is providing mental health services directly from Ottawa. That program has reached over two million Canadians. The Conservatives do not even know what they are talking about when it comes to health care because, at the end of the day, they do not see and believe that the federal government plays a role in health care.
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  • Feb/16/23 1:05:47 p.m.
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Madam Speaker, it is quite boisterous in here. It is great to hear some lively debate about an issue that is probably one of the most important issues for our constituents, and that is health care. It is great to see that the federal government has been working collaboratively with all provinces and territories to come to an agreement. An additional nearly $200 billion in funding will flow from the federal government to the provincial governments and territories. It will strengthen and improve access to, and equatability of, our health care system for all Canadians. Usually, when I give a speech, I do not personalize it, because it is not about me, the member of Parliament for Vaughan—Woodbridge. It is about the residents back home. On health care, I want to share a personal story. I was born with a cleft lip. A derogatory term for a cleft lip or a cleft palate is harelip. We grew up in Prince Rupert, a town in northern British Columbia. My parents were newcomers, like nearly everyone in Canada other than indigenous peoples. At that time, they were not wealthy and were very hard-working. My mom worked as a dietician at a hospital and then later on worked at a cannery in northern B.C. My dad was a pulp mill worker, a carpenter and a labourer. I was born with a cleft lip, and I required a number of surgeries during the first 20 years of my life. Those surgeries did not take place in Prince Rupert. They took place in Vancouver. My mom would generally accompany me, and we would stay at a Ronald McDonald House or with family friends. I have memories of staying at a Ronald McDonald House in Vancouver 35 years ago. The Canadian health care system was there for me. There were approximately seven surgeries during my lifetime, up to about 18 years of age. Cleft lip surgeries are not the most arduous, but there is discomfort, there is being put under and there is a hospital stay. We never needed to pull out a credit card. My parents never had to worry about whether we had the money. They never had to worry whether they had to pay the mortgage, to put food on the table or to pay for their son's surgery. It speaks to the values that all 338 MPs inherently have with respect to our public health care system in Canada and that there is access for everyone. People do not need to worry about how much they make, where they are or who they are, because they have access. We need to maintain that. We have gone through COVID. We know there are surgery backlogs and there are stresses on the system. I keep thinking back to those trips from Prince Rupert to Vancouver with my mother. We did not need to worry about the access and the equatability. I am thankful that my parents came to a country where that was provided for them and for our family. It is something that we all value and we need to work toward. My mother worked her entire life. She is now in her early eighties and she needs a hip replacement. She has been on an urgent list in the province for approximately eight months, and we want to get that hip replacement done. We need to get rid of the backlogs. This agreement with the provinces and the territories is a very substantial step in removing those backlogs that were created because of a global pandemic, a once-in-a-hundred-year event. It is important for us to thank every health care worker in our hospitals, doctors' offices and ambulance stations who are taking care of us. We need to understand that the government fundamentally believes that all Canadians must have access to health care that is independent, that is publicly funded, and where people can get a family doctor. We need to believe in the principles of the Canada Health Act, that it ensures equitable and equal access to all individuals and that there is no two-tiered system. Canada's universal health care system is the pillar of our national identity. It is a pillar of my identity. It represents Canadians' ongoing commitment to the values of equity, fairness and solidarity to ensure everyone has access to medically necessary health care services based on their health need and not on their ability or willingness to pay. The only card a Canadian should need to present when they seek medically necessary care is their provincial or territorial health card, not their credit card. Our government has been vocal in supporting improvements in the health care systems, and yes, we need innovation to occur in our health care systems. In the city of Vaughan, we have a brand new $2-billion hospital, which was built over a number of years. It opened during COVID. The innovation that is demonstrated in that hospital is phenomenal. The quality of care that is offered is phenomenal. The people who work there are proud to work in that hospital. It is the first new hospital in Ontario in over 30 years. We need to continue assisting the provinces. Our government has been vocal in supporting improvements in the health care system. We are firmly committed to a publicly funded system and the principle that everyone deserves access to quality, accessible and universal health care. Our health care system is evolving. We will continue to work closely with our provincial and territorial colleagues to ensure that it does so in a way that respects the principles of the Canada Health Act and the interests of all Canadians. It is no secret that our health care system is facing challenges. We all hear it from our residents. We see it in the backlogs and in nurses being burnt out. We see it in not having enough family doctors. We need to fix it, and we are. The COVID-19 pandemic has not only brought to light the problems that existed previously in health care, but it has also exacerbated them. This is particularly true for diagnostic testing and surgeries, which are seeing record backlogs. There are very real problems, and Canadians expect their governments to work together to solve them. That is what we are doing, and that is what we have done with this agreement. Our government is making historic investments in our public health care system. The federal government will increase health funding by nearly $200 billion over 10 years. This includes an additional $49 billion over 10 years. Those investments will support provincial and territorial efforts to modernize the health care system. They will also help to ensure that Canadians have timely access to family health services; shorter waits for treatments, diagnoses and surgeries; and more mental health and substance abuse services across the country. The government will work with the provinces and territories to ensure those investments are used in the best interests of health care workers and patients, Canadians, in a way that represents and respects the principles of the Canada Health Act. Access to medically necessary services should always be based on health need and not on the ability or willingness to pay. To my New Democratic colleagues, the Canada health transfer has always been conditional on meeting the requirements of the act. We take that requirement seriously. We have taken the necessary action every time we have seen patients being charged fees for medically necessary services, and we will continue to do so. The Liberal government has been clear. Medically necessary health care must be covered by public health care insurance plans. If patients are charged inappropriately, the government will uphold the Canada Health Act and levy mandatory deductions to the Canada health transfer payments of provinces and territories that permit such charges. We levy these deductions to discourage the barrier to care that patient charges represent. No Canadian should have to choose between paying for groceries and paying for the medically necessary care that medicare is meant to provide. Since 2015, we made $105 million in deductions for provinces that authorize patient charges for medically necessary services provided in private clinics, and we will continue to do so every time that happens. For example, where provinces have not covered, or not fully covered, the cost of surgical abortion services, providing health care services in private clinics that lead to patient charges and the barriers to access they represent, this government has levied deductions to provincial health care transfer payments. Again, we must ensure these medically necessary health services are publicly covered. I am proud to live in this country. My family chose this country, and Canada chose us. I was born with a cleft lip and, because we were here, we never had to worry about paying a bill and my parents never had to worry about me getting the treatment I needed.
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  • Feb/16/23 1:16:02 p.m.
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Madam Speaker, I completely agree with my colleague that all Canadians, regardless of the size of their wallets, must have timely access to health services. That said, for 30 years, health transfers have been cut by every government in power. In Canada, and not just in Quebec, this has led to governments taking measures in crisis situations. That is how we ended up with a system that is stretched to the limit. It has also been constitutionally determined that in crisis situations the federal government must use its spending power to give an extra hand to the provinces, which it did. My colleague and I also agree on that. That said, the health transfers fall short of constitutional agreements. When will they be compliant, to ensure that our health care systems can fully serve the public?
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  • Feb/16/23 1:17:11 p.m.
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Madam Speaker, our government needs to work with the provinces and the territories to collaborate on our health care system and improve it. It is important that we work with the provinces to make sure we have a health care system that all Canadians have access to and that is properly funded. The $200-billion investment going into the health care system, in all provinces and territories over the next 10 years, including the additional $50 billion we put in, will go a long way in assisting and meeting those goals.
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  • Feb/16/23 1:17:56 p.m.
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Madam Speaker, one thing that has been really eye-opening for me through the deterioration of our health care system is talking to parents and hearing about how they are adjusting activities for their children to ensure there is minimal risk, because they do not trust that the health care system is going to be there if something goes wrong. It is a horrific reality that parents are facing in raising children now. The health care system is not meeting their needs. We know our health care system is overburdened and privatization will continue to make things worse. Can the member explain why the Prime Minister failed to raise a single concern with Conservative premiers' privatization plans at last week's first ministers' meeting?
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  • Feb/16/23 1:18:50 p.m.
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Madam Speaker, as many of us have young children at home, we know what it means to take our kids to the doctor or the pediatrician. We want to minimize the risk to our children. I empathize with any parent having to think about that. Our government believes in the pillars of the Canada Health Act. We will always continue to make sure they are heeded by all provinces and territories. We will continue to work with them to ensure that is the case.
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  • Feb/16/23 1:19:27 p.m.
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Madam Speaker, this is my first chance to speak in today's debate. I want to make it very clear that I will be voting in favour of the opposition day motion today. I am deeply concerned about the eroding state of our health care system, particularly the critical need to defend single-payer, universal, public, non-profit health care for all, as put forward in the Canada Health Act. The first speech in today's debate was a terrific speech by the hon. member for Vancouver Kingsway. He referenced that for-profit health care is being offered online by Loblaws. I want to put it on the record that we are seeing it in British Columbia from Telus and Shoppers Drug Mart. These are privatized systems. When will the federal government stand up and shut down for-profit health care in Canada?
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  • Feb/16/23 1:20:19 p.m.
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Madam Speaker, our government will continue to work with the provinces and territories so that all Canadians have access for their medical needs, access to a family doctor and they never have to pay with their credit card. We will ensure that we have a publicly funded, single-payer system that all Canadians will have confidence in, that all Canadians believe in and that represents the values we have as Canadians.
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  • Feb/16/23 1:20:55 p.m.
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Madam Speaker, it is a huge honour and privilege to rise today on the NDP motion that was brought forward by my good colleague, the member for Vancouver Kingsway, our NDP health critic. This is a critical debate because we are facing a pivotal moment in Canadian history. We have a universal health care system, but provinces are trying to circumnavigate the rules of the Canada Health Act by using loopholes to grow a two-tiered health care system in Canada. Today, we are asking every MP in the House to decide whether health care funding should be used to rebuild the understaffed public health care system or to set up for-profit corporations that will poach nurses and doctors from the universal health care system. I think Canadians know which side New Democrats stand on. We know that everybody in this country, despite what income bracket they fall into and what circumstances they have, deserves a health care system that is ready when they need it, no matter the size of their wallet. No one should have to wait in pain or suffer because there are not enough health care workers and not enough access. No one should have to wait longer because one's family doctor or surgeon is busy treating patients who can afford to pay cash. Under the Liberals, people are waiting for hours right now, in pain, in the ERs. Folks are losing their quality of life while they wait for surgery. The same health care workers that we lauded through COVID-19 and who had our backs are run off their feet, burnt out and exhausted. A surgical company owned by an investment firm is charging $30,000 for a surgery. Galen Weston and Loblaws, which own Maple, are charging $70 for a doctor's appointment and making a profit. These cash-for-care corporations are already draining doctors and nurses from our hospitals and family practices. The Prime Minister can make things better for patients by hiring for and rebuilding the public health care system. Otherwise, he can make the crisis even worse by allowing this circumnavigation of the Canada Health Act. He is allowing funding of for-profit schemes that are poaching staff. We are not surprised to hear that the leader of the official opposition, the Conservative leader, loves for-profit care. It is pretty clear: It will make billions for corporations and enrich CEOs, his friends. It is right out of the Conservatives' playbook to starve a public service; we saw that when they cut a third of Veterans Affairs and then used outsourcing companies, such as the big six that we are going to go after at the OGGO committee because of the NDP motion to do that. We also saw what they did with the Phoenix pay system. They got rid of the payroll staff, and then it turned into a boondoggle. Therefore, Canadians should know what is coming if the Conservatives come into power. They will use this as an excuse to hand it off to the private sector. The Conservative leader says that everything is broken because he wants to tear it down. That is exactly what he wants to do. The Prime Minister campaigned on stopping for-profit care, but then he did the opposite. He flip-flopped. He calls Conservative premiers out, but he actually refers to their for-profit corporate care as innovation. He does not actually call them out, and neither does the leader of the official opposition. We know that medical officials have been raising the alarm for months about our health care system, saying that it is on the brink of collapse. One in five Canadians cannot access a family doctor. We rank near the very bottom of the OECD in wait times for essential care and the number of physicians per 1,000 people. This has declined drastically over the last 25 years, as members know. A prepandemic analysis predicted a shortage of over 117,000 nurses in Canada by 2030. People are waiting for hours, in pain, in the ER; folks are losing their quality of life. Health care workers are run off their feet, burnt out and exhausted. We need to ensure that the recently announced health care transfer to the provinces is not used to expand for-profit health care. We have to have that assurance. Right now, Canadians do not have that. That funding has to be used within the public system to hire more staff and reduce wait times. Private, for-profit health care further increases wait times and reduces the quality of care as private corporations seek to cut corners. It is a fact. We can look to Australia, and I will get to that if I have time. However, we already have a two-tiered system in one area of the health care system, which is in mental health. Members know that I have spoken about that many times. I have kept members here very late at night every week for months on late shows to talk about that. We can see what the outcomes are for Canadians who need health care treatment and supports. Every member in this House knows a story about a constituent, family member or friend who is struggling, who has not gotten help or who did not get help, and the fatal outcomes that come with that in the worst circumstances. Right now, most mental health and substance use services are only covered by our universal health care system, if people can get access through that. Otherwise, they have to go to community-based mental health services, which are often chronically underfunded, and substance use organizations, which do not have the resources to deliver just-in-time treatment. Counselling, peer support, substance use prevention and treatment services are provided by these non-profits or by charitable donations and grants, and they just do not have the resources to keep up with the demand for services. The Mental Health Commission of Canada and the Canadian Centre on Substance Use and Addiction recently found that a third of respondents reported moderate to severe mental health concerns. However, fewer than a third of the people experiencing them accessed treatment. Among Canadians with problematic substance use concerns, under one in four access services. The report identified that the key barrier to accessing services was financial constraints. We know this is happening in mental health. The barrier is there. It is financial. We need to ensure that the people who are struggling can access mental health care regardless of their ability to pay. Canadians simply cannot be forced to rely on non-profits and private insurance, especially the many people who do not have private insurance. It is just not working. The average wait time for adult residential treatment for people who have substance use concerns is 100 days. That is far too long. In Ontario, 28,000 children alone are on wait-lists for community-based mental health services that range from 67 days to more than two and a half years. That is what a private-public model looks like: Children who are waiting up to two and a half years for help. A friend of mine just had a family member in treatment. He talked about how he could afford it, but he knows so many who cannot. Right now we also need a system that has built-in relapse, just-in-time relapse, so that the system is there to respond so someone can get into treatment should they need extra help. In this way, they can come back into the health care system if they are relapsing, which is part of recovery. We know that for people who are waiting too long for treatment, again because they cannot afford it, the privatization and lack of mental health and substance use supports are resulting in more overburdening of the health care system. I was at my own doctor, and I asked him if it was at adding pressure at his office. He said that 50% of the people coming through his office are needing either mental health supports or supports regarding substance use, and it is actually impacting his ability to help those with physical ailments. The government has not delivered its $5.3-billion promise on mental health. I was just talking to Judith Sayers of the Nuu-Chah-Nulth Tribal Council about the crisis that is happening in indigenous communities in my riding and about the need for rapid access, addiction resources and detox. It is not there. The cost to the system of not having these services in play is enormous. Members have heard me talk about the toxic drug crisis, the need for treatment on demand or just-in-time treatment, and the need for prevention, education, recovery and a safer supply of substances. These points are all critical. However, they need to be delivered through a universal system. Again, Australia introduced a parallel private system. One alarming statistic is that those in the lowest socio-economic group were 37% more likely to die of cancer than those in the highest socio-economic group. We have seen Ontario and Saskatchewan circumnavigating the system to bring in services. We have seen Veterans Affairs using a company owned by Loblaws to deliver services to veterans, and veterans are waiting while this is being outsourced. We are seeing the privatization. Right now, this is a critical vote. We are calling on each member of Parliament to decide: staff up to rebuild the public system and cut wait times or use public health care funding to set up for-profit corporations that would poach nurses and doctors. We know which side we stand on. It is the side of patients, Canadians and health care workers. We will continue to stand up and defend them against the threats that are coming right now because we see that the Liberals and Conservatives are not willing to defend public health.
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  • Feb/16/23 1:31:12 p.m.
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Madam Speaker, I disagree with the member's last comment regarding the Liberals not defending health care. Nothing could be further from the truth. It was the Liberal Party that brought in health care, whether the member wants to recognize it or not. The Liberal Party achieved the historic amount of funding that we see today. The Liberal government, working with the provinces and stakeholders, has now signed off on $198-billion-plus for the next 10 years to ensure that we have a national health care system, not only for today but for future generations. Specifically outside of the Canada Health Act and the financial resources that we are giving to provinces, what more does the member believe a national government could do, not in the NDP dream world but realistically, in order to ensure that we have a true national health care program?
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  • Feb/16/23 1:32:19 p.m.
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First, Liberals need to stop the loopholes, Madam Speaker. They need to stop provinces from circumnavigating the Canada Health Act and offering privatization. This is creating a two-tiered system that we know is going to harm our ability to attract doctors and nurses to the universal public system and is not going to be affordable for others. They promised a mental health transfer of $5.3 billion, and that has not happened. There are no assurances in their agreements with the provinces that it is going to be delivered. All the member has to do is talk to the national organizations that are delivering mental health services in the two-tiered mental health care system, because that is what is going on. He also needs to maybe talk to some of the parents who have lost loved ones, who were in treatment or in the hospital and were punted because there were not enough beds for them. Maybe they took their own lives. Maybe he should talk to Moms Stop the Harm. The government needs to talk to them before it pats itself on the back. It needs to listen to them because that is who is calling for this action right now.
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  • Feb/16/23 1:33:20 p.m.
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Madam Speaker, I feel so sorry for my friend, who was trotted out like a slaughtered lamb for this speech. To give a speech about health care and being a New Democrat is ludicrous in my province. New Democrats actually ushered in the two-tiered health care system under Roy Romanow when they closed 52 hospitals in my province, and every hospital they closed was in an opposition member's riding. They fired 1,000 nurses and 500 doctors in the 1990s. Therefore, when they talk about two-tiered health care in Canada, they are the ones who brought it in. People could never get the same service in rural and remote Saskatchewan as they could in urban Saskatchewan. They closed the Plains hospital, which was one of the first hospitals built in the province in 100 years. They did not like the people who were going to it because those people did not vote NDP. The NDP has nothing to stand on when it comes to two-tiered health care in my province. They eviscerated Saskatchewan's health care system. That is why they will never be in government in Saskatchewan and why they will never be trusted to be the government of Canada.
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  • Feb/16/23 1:34:21 p.m.
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Madam Speaker, one thing we know is that Conservatives certainly cannot be trusted to stand up against Doug Ford, Scott Moe and Danielle Smith. They want to destroy Canada's universal health care system, which by the way, was brought in by Tommy Douglas, who is from Saskatchewan. It was the New Democrats that brought forward this motion today instead of a motion to remove the carbon tax for the seventh time. That is what Conservatives use their opposition days for as opposed to trying to protect health care for Canadians. They use their opposition days for motions that they could not enforce even if they were passed in this House. I am from British Columbia, which has a provincial carbon tax.
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  • Feb/16/23 1:35:04 p.m.
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Madam Speaker, I will just reiterate some of what I said before. I agree with my colleague. Wait lists for surgeries, children, seniors and people seeking addiction treatment are atrocious. This is true in Quebec too. Every day, we see images of wait lists in ERs. People cannot get adequate care in Canada, and that is an absolute disgrace. However, here we are spending yet another day wasting our breath because we cannot change anything about the things in my NDP friends' motion. That is all down to the provinces. However, there are changes we can make. I wonder why the NDP did not use its motion to tell the Liberals that the provinces asked for $6 billion and got $1 billion. Why not move a motion asking the feds to increase health transfers from $1 billion to $6 billion? That would shorten wait lists—
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  • Feb/16/23 1:35:59 p.m.
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I have to give the hon. member for Courtenay—Alberni enough time to answer. The hon. member for Courtenay—Alberni.
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  • Feb/16/23 1:36:07 p.m.
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Madam Speaker, clearly we are not satisfied with the amount of money that the government put on the table. It is far from what is needed. It has also not delivered on the Canada mental health transfer, which is absolutely critical. If we want to talk about solutions, we need to deal with the issues right in front of us. There is a mental health and substance use crisis in this country. It is an epidemic, and the government needs to respond like it is an epidemic. We have a motion today that is—
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