HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Tuesday, April 4, 2000

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[English]

The Chair (Mr. Lynn Myers (Waterloo—Wellington, Lib.)): Ladies and gentlemen, we'll bring this meeting to order.

As you know, we had a steering committee meeting—it seems like some time ago now—with respect to future business. I wanted to report to you what transpired at that meeting. We had a very good discussion.

It seems to me—and correct me if I'm wrong, those of you who were there—that we did not really reach conclusion. We talked about a number of items, and some of these will appear today. In fact they are under “Future business”, the items as listed.

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I'd like to take just a minute to look at some of the things we talked about, and indeed some of the things we didn't, that are now before us. It's all found in this book, by the way, so you can actually follow through.

You'll recall Monsieur Ménard had the September 8, 1999, letter with respect to the blood supply and blood donation system. Ms. Wasylycia-Leis was later, November 1, with respect to the Canada food safety system. And Mr. Elley was a little bit beyond that, on November 8, with genetically modified foods.

I should note the agriculture committee is proceeding, as per Madam Alarie's motion, with a specific look at genetically modified foods as they pertain to labelling only. When the blue ribbon panel reports—that is, the blue ribbon panel put together by the Minister of Health not so long ago—that will in fact be referred to this committee. At that point it would be appropriate for us to take a further look at genetically modified foods as well, and perhaps even look at what the agriculture committee discovered in their labelling study.

You'll recall that Mr. Elley's letter of November 8, 1999, also talked about aboriginal health. Monsieur Ménard on December 13 talked about cigarette smuggling and the network and issues related to that. Mr. Harb had a motion, M-468, regarding chronic fatigue syndrome. That came to us on February 11.

Mr. Elley, on March 14 of this year, gave notice regarding the minister's appearance on the main estimates and plans and priorities, and on March 15 Mr. Elley submitted a letter with respect to the ailment noted.

Again, on March 31, Mr. Elley gave notice of a motion with respect to the state of health care in Canada. And finally, recently Ms. Wasylycia-Leis submitted a letter pertaining to the Auditor General's report on federal support of health care delivery.

You'll recall that also on our plate, so to speak, is the Minister of Health's letter dated February 21 this year and his request with respect to mental health.

Having said that, in terms of overall review, perhaps I could start by asking the parliamentary secretary, Monsieur Charbonneau, to speak to any or all of these items, and specifically to the letter dated February 21 with respect to the minister's request.

Mr. Paul Szabo (Mississauga South, Lib.): On a point of order, Mr. Chairman, is there anything at all from the steering committee with regard to any of these items that is going to be useful to this committee, or are we in fact starting from scratch?

The Chair: As I said at the outset of this meeting, my report to you today is that in fact we did not reach consensus. We're here today to—

Mr. Paul Szabo: Not on anything?

The Chair: Nothing.

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): No, nothing except the friendship and that everybody appreciates everyone.

The Chair: Yes, we appreciated everyone.

[Translation]

Mr. Charbonneau, you may proceed.

Mr. Yvon Charbonneau (Anjou—Rivière-des-Prairies, Lib.): I would like to start by raising a number of arguments in support of placing this proposal to examine the issue of mental health on our agenda. Admittedly, the request initially came to us from the minister and some may claim that the committee doesn't necessarily have to answer to the minister's wishes. However, we shouldn't discount this proposal either just because it comes from the minister. Having said this, I think that we can forget for a moment the signature on the letter, consider the proposal and decide whether or not we should proceed with this study.

Mental health is an issue often relegated to the sidelines. Although there are organizations that represent persons suffering from a mental illness - I'm thinking in particular of the Canadian Mental Health Association - the mentally ill generally do not have the opportunity to come here and relate to us their problems and living conditions. They must rely on intermediaries to do that. Persons suffering from other illnesses or in other circumstances can arrange to come and relate their experiences to us. Anonymity is often the fate of persons with mental illnesses who are relegated to the fringes of society.

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Let me sum up my position on this issue. Both the federal government and the provinces incur spending in this area. We recognize that the provinces have responsibility for this and all other health care issues. However, questions such as integrating mental health into Canada's overall health care system, research into this field and information on problems related to mental health can be broached from a federal perspective, with full consideration for respective jurisdictions. This is an issue that concerns all levels of government. An article published in the March 20 edition of Montreal's La Presse noted the following:

Hochelaga forgotten in the treatment of mental health problems among young persons; “It makes no sense to ride around in a Cadillac in Rosemont, and to walk the streets in Hochelaga- Maisonneuve”.

This problem seems to be prevalent in the regions which are well known and represented by some of the people seated at this table. The aim of the study that we are proposing to carry out would be to gauge the extent of the problem and increase the general awareness of those who have responsibility for such matters in their respective jurisdictions.

I would remind colleagues who were not present at our last meeting that our discussions focused on two subject: GMOs and mental health. We also discussed smoking and I will come back to that subject later on. The well-publicized subject of genetically modified foods has been assigned to another committee for study. Therefore, I propose that we look at the issue of mental health, a subject no one ever discusses. That's precisely why I think it's important we talk about it. Another committee is going to study GMOs and therefore, I think we should study mental health. This is not to say, however, that this is the only subject of interest, which brings me to my next point.

I do not wish to speak ill of any of the suggested topics of discussion, because they are all important in some way. Like some of my colleagues, I too would like an update on item d), that is all of the problems associated with tobacco, including cigarette smuggling. I would be interested in broaching the subject, bearing in mind that draft regulations have been made and are scheduled to be reviewed. I would like witnesses to report to us on the situation and to share with us their views on the tobacco issue.

Inevitably, at some point this year, we will need to meet with the minister to discuss his department's budgetary estimates. Granted this is routine business, but we must nevertheless take this into consideration because it is part of our mandate.

One issue seems to come up repeatedly. Moreover, it was on the committee's agenda last year. I'm referring to chronic fatigue syndrome and fibromyalgia, issues raised by Mac Harb and which have since been the focus of a private member's bill. At some point in time, I think we need to consider this topic. Since becoming parliamentary secretary, I've received numerous letters and urgent requests that we study this question which is always relegated to the back burner. Apparently, many persons suffer from this illness which goes unrecognized. Since many people are talking about it and the subject keeps coming up, I think we need to take a closer look at the problem.

I will stop there.

The Chairman: Thank you very much.

[English]

Thank you very much, Monsieur Charbonneau.

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I'm now going to go to Mr. Elley and Mr. Ménard and then we'll carry on.

Mr. Elley, please.

Mr. Reed Elley (Nanaimo—Cowichan, Canadian Alliance): I just want to get some direction from you, Mr. Chair. When do you want us to bring in the motions that are usual for this committee, like the one on the appearance of the minister on the main estimates? When would you like us to bring in those?

The Chair: What I wanted to do first was get a sense of where we're going. I'd like the discussion to take place now and then maybe a few minutes after that discussion has taken place we can start having motions.

Mr. Reed Elley: We can bring those kinds of things in. All right. I want to keep on your agenda here.

Before I go to talking about what the parliamentary secretary has said, I do want to register some deep concern about the fact that this committee has not met since February 16. That's 48 calendar days, 29 sitting days of the House. During that time, if you've been looking at the newspapers and reading what's going on, looking at the television as to what's going on about health care issues in this country, we have had some very important things happen.

We've had the introduction of Bill 11 in Alberta. We've had the federal budget come down with its references or non-references to health. We've had the Ontario confirmation of 11% funding by the federal government for public health care. The polls are telling us that 55% of Canadians clearly indicate that health care is their number one priority. We've had the second anniversary of the hepatitis C package, with nothing having been done in terms of the victims. I could go on. I have a list of about 12 things here that we have somehow in a sense missed while we have not been sitting for 48 calendar days and 29 sitting days of the House.

Quite frankly, I find that unacceptable. I don't know if there's an explanation for it, but if we're elected here to do the business of Canadians and part of that important business is their number one priority, then we should have been meeting. I'll get that off my chest. I'm concerned about it.

In terms of the parliamentary secretary, I must categorically state right now that I do not believe mental health is a sufficiently important subject for me personally to be here sitting discussing at this committee week after week, day after day, when there are so many other important subjects in health care. I want to go on record right now that I will not be sitting here discussing mental health.

If it has to go to other, further obstructionist things that we sometimes have to do to make our points, then those points will be made. I hate to be obstructionist, but I do not feel it would be in the best interests of this committee and Canadians to be studying mental health, which is a provincial jurisdiction, at this point in time. We should stay out of it.

Having said that and gotten that off my chest, I have to come down to the fact that the number one concern of Canadians is the health care system of this country. We who are charged with the responsibility of monitoring the health care system of this country should be seen as proactive in discussing with Canadians and bringing people together, acting as facilitators to do something about this problem. When we refuse to study the health care system of this country, we are in effect saying we don't have anything to say about it. I don't think that's the message we want to be giving Canadians. Quite frankly, I think that's where our priority lies, and I would hope the rest of the members of the committee would feel so also.

The Chair: Thank you very much, Mr. Elley.

[Translation]

Mr. Ménard.

Mr. Réal Ménard: I have three comments. In spite of the Parliamentary Secretary's emotional appeal and well-intentioned references to Hochelaga—Maisonneuve, a neighbourhood that I obviously know very well, I have to say to him that if mental health and CLSC representatives were here today, they would be telling us that the federal government is largely responsible for the current funding crisis because, as everyone well knows, it was the federal government that reduced in a cavalier way transfer payments to the provinces. The problem has nothing to do with the lack of expertise to provide services. The issue is more a lack of funding.

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I'm concerned that the government is merely using its majority to devise a make-work project for the committee. The government appears to have employed the strategy of pulling this topic out of a hat. We have been meeting for the past year and the subject of mental health has never come up before. Now the minister has written us a letter asking us to define mental health and determine which federal government program can best address mental health concerns.

How does this concern the federal government, as a provider of services? If the federal government's strategy is to devise make- work projects for the health committee, then government members are going to find themselves talking to one another because opposition members will stay away. I won't take part in any such proceedings and we will find another forum in which to decry the real problems affecting our health care system. That's my first comment.

Secondly, I think this committee can do some very important work. Two or three issues are very much on the minds of Canadians and Quebeckers. I support Mr. Elley's motion that the committee examine the state of the country's health care system. As parliamentarians, we could look at the financial assistance the provinces require, consider the advisability of restoring transfer payments and examine the various problems associated with modernizing the health care system. Obviously, we must not lose sight of the fact that health care delivery is a provincial government responsibility. However, since it controls the public purse, the federal government does have a role to play in health care, in my view.

I would also like to speak in support of my motion calling for a study of the tobacco issue. I know that the federal government has launched civil proceedings and there is a great deal that we could discuss. For instance, I suggested that we consider the role played by cigarette manufacturers in setting up a smuggling network. We could call in witnesses. The RCMP and the Non-Smokers' Rights Association are well acquainted with the facts of this case and many people are experts on the subject. The committee could attack the various marketing strategies employed by cigarette manufacturers. I know that the Health Minister is very concerned about the whole smoking issue. Our committee could do some very important work in this area.

Mr. Chairman, I hope that you won't take advantage of your government's majority position to turn this committee into a kindergarten class and to have it study subjects that are of no interest to the opposition. If you do that, I repeat that you're going to find yourselves all alone because the opposition parties will seek out other ways to get their message across.

The Chairman: Thank you very much, Mr. Ménard.

[English]

Ms. Wasylycia-Leis, then Mr. Szabo.

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): I just want to make three points. First of all, let me agree with Reed in his comments about the time that has lapsed since we last met as a committee. I think he makes a very important point. I hadn't realized it was actually 48 sitting days. That is an incredible amount of time that has passed when we could have been doing some serious work around this committee.

Mr. Chairperson, I think we're looking for an explanation as to why this committee didn't meet when in fact there were numerous suggestions for short-term projects we could have undertaken on a weekly basis that didn't require a consensus at the steering committee level around the long, bigger research project study we would undertake.

In fact, you will recall, Mr. Chairperson, that on at least two previous occasions, we discussed the need to have the minister before the committee, the need to have officials before the committee over the performance report, the need to discuss the estimates, and the need to have the Auditor General for any one of his several reports pertaining to the health care field. It was suggested at that time, I believe by you, Mr. Chairperson, that these recommendations would be taken seriously and put on our agenda as times could be set up and arrangements made. It was indicated to us that we really didn't need to make motions at the time because this would just happen.

I guess the real concern and the question is why in the last month we didn't have a chance at least to meet with the Auditor General or officials from the department, even if the minister was busy or preoccupied or even wanting to avoid the health committee because of the controversial issues on his plate right now. I'm sure the Auditor General could easily have been scheduled. I'm sure health officials could be called any time. There's a whole month of work we could have been doing to cover off those areas of concern while we came to some consensus around the major research topic of this committee for the latter part of this year.

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I also share the concerns expressed by both my colleagues from the Bloc and the Reform about the way in which this committee has been manipulated, and used and abused, by the minister. My sense is it's probably a fairly unusual development at the committee level in Parliament to have the committee always be dictated to by the minister, to have all of our suggestions put to the side every time the chairperson walks in with a letter from the minister telling us what to do.

So a part of our concerns today is not entirely related to the subject matter. It's also related to the way in which democratic principles are being bypassed every time we come together. I think what we're saying is we'd like an opportunity to genuinely come together with issues of concern and to ensure that some of those issues are addressed from time to time and not always put to the side, dismissed and buried.

I think we're losing members daily. I know there are at least three members who used to sit around this table who refuse to come any more because they feel that this committee is useless, a waste of time, and that in fact we're being used for political purposes by somebody—the government, the minister, who knows?—but that this is not a proper functioning of a committee. It is not all in keeping with the traditions of the committee structure in Parliament.

I also think our concern with the recommendation is not that mental health is not important and not that it may in fact involve both federal and provincial, and aboriginal or first nations communities, in the whole resolution of this problem. The question for most of us I think is, how can we take a piece of this big issue, divide it, carve it up, and deal with just a fraction of the issues before us when there's this huge crisis in medicare, when we know there are issues in terms of funding of health care, there are issues of enforcement of the Canada Health Act, there are issues of privatization getting steam in this country, the obvious developments in Alberta around Bill 11 and in other parts of this country, when there are all kinds of developments that are scary, that are ominous, and that really do beg this committee to look at, consider, and make some contribution to the process?

One of the questions I always have is, why does the Minister of Health not see this committee as a valuable resource? He has this incredibly difficult problem on his plate. He's obviously not getting a lot of support from the Prime Minister at this point. He was left, it would appear, to hang out to dry when it came to the last federal-provincial ministers' meeting. Here's a committee he could work with in terms of coming up with ideas, building a base of support, getting some momentum, and looking at some creative alternatives, yet he never seems to consider that as an option.

So there's a bit of a sense that this meeting today is almost surreal. It's like there's no relationship between the reality we deal with on a day-to-day basis and what is being foisted upon this committee. I think what we'd like is an opportunity to have a role in the big issues of the day.

I'll stop there. My final question would simply be to ask for clarification as we plan our agenda. Is there any other legislation you anticipate coming forward from the Minister of Health that would be sent to committee? Are the regulations for the tobacco packaging initiative coming to this committee any time soon? Was there, with respect to genetically modified foods, around which there was considerable interest by this committee, any attempt by you, Mr. Chairperson, to convey that sense to those talking about a joint committee between agriculture and health? Is that totally out of the question?

That comes to my final point, which wraps it all together. It's very disconcerting to open up a newspaper like the Western Producer and hear that the health committee is being asked by the health minister to study GM foods. That's obviously not the case, but there is something going on in terms of the minister putting out signals, and I think it feeds into this notion that the minister sets the agenda and this committee just rubber stamps everything the government puts before us. It may not be accurate reporting, but certainly it's a symbol of just what is wrong with the way this committee functions today.

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The Chair: Thank you very much, Ms. Wasylycia-Leis.

I'll get to Mr. Szabo in a minute. After him I'll ask Monsieur Charbonneau to speak directly to questions about what's coming down the pipeline in terms of legislation.

But I do want to comment briefly on one point you made about the importance of genetically modified foods. I really did press the case in terms of how important that was from a health perspective, never mind an agricultural perspective as well. I know Mr. Charbonneau and others did as well, but unfortunately I believe it was the Bloc who were most intent that it not happen. That was unfortunate, but I guess they had their reasons. Madame Alarie and the leadership of the Bloc Québécois had their reasons, I'm sure. I'm not party to them, but perhaps you can privately discuss it with Monsieur Ménard at some point.

Having said that, Mr. Charbonneau I think will maybe give us a little bit more insight in terms of what we can get. I'll hear Mr. Szabo first and then we'll get Mr. Charbonneau to respond.

Mr. Szabo.

Mr. Paul Szabo: Thank you, Mr. Chairman.

First of all, I think we can all agree that there are some issues that the committee has to schedule and should schedule quickly: the estimates, the minister coming, etc.—all those items that are here. They're boilerplate, they're things we do annually, and we should schedule them. I hope that maybe someone can put down some dates and let's make a commitment, and I hope we can do that quickly.

It's been interesting to hear the discussion about what we should be doing. I suppose pragmatically we can continue to play political roles and we can use the committee for our political purposes, or we could seek some consensus about whether or not the committee, understanding the realities of committee, can find something that everybody can share and that everybody can get enthused about, to do some work on a matter where we have a shared value.

There are so many things to talk about. I think it's a little bit too ambitious to suggest that we can simply be the experts in the health care system in Canada and somehow be in the loop when we're not. That is emerging and happening on a day-to-day basis with the provincial and federal representatives. There is a timetable. By the end of the year, not only will they have the game plan, they will also have probably an agreement in terms of the longer-term sustainable funding for health care.

I respectfully think it might be a little difficult for us to get in that loop and have an influence through the committee formally in sufficient time. I think we have to look to the other mechanisms we have through our activity in the House and through our parties. I think that's where this belongs.

So being pragmatic, I would think it's a little bold to just say there's an overall crisis of health and we can do something. I'm sure we can, but certainly not in the timeframe that's available to us.

I understand we have a panel on the GMO, and I was very interested in doing GMO right away. I thought it was something we should step up to the plate on. Let's learn about it. Let's look for an opportunity. I think strategically the government had to make a decision on this and said we need some expertise and we need somebody to put something on the table, so that when it does come through this panel—it's almost like having a motion on the table—we can at least focus ourselves and maybe be more productive. I'll accept that.

Aboriginal health has already been studied by this committee in the past. I think we did a very good job. We travelled across the country to deal with aboriginal health issues. They continue to be problems, but at least the committee has made an attempt.

The thing I wanted to cut a deal on is.... Maybe I should just apologize for encouraging the minister when I did. I wouldn't discount mental health as being a make-work issue. In all sincerity, I've been pushing on related issues for six years now as a member of Parliament on areas to do with mental health, under the umbrella of things like fetal alcohol syndrome. Fetal alcohol syndrome is the leading known cause of mental retardation in Canada. It costs the system some $3 billion to $4 billion a year for that source alone, not even looking at the ancillary costs.

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One development occurred in the fall that really gave impetus to interest in the general mental health picture. It started with the fact that 35% of the homeless in our country are people who suffer from mental health problems. But secondly, we found out, from Manitoba and Saskatchewan, that about 50% of the inmates in our jails suffer from fetal alcohol syndrome or other alcohol-related brain damage.

Mental health is a very sensitive issue, and I know the NDP member here knows a lot about it. You don't make jokes about sanity. You don't use those words lightly, because there's a lot of pain in our world. Of the people in Canada, 30% have or have had mental health problems. It's not only a pain they have to bear; it's a pain that ripples through their own families.

When you have such a tremendous impact on our justice system, our health care system, and our community services system, the reality is that we can't afford to simply be narrow-minded and say it's provincial, it's sort of federal, or whatever. I think we have an opportunity to do something.

Over the Christmas break I penned this monograph on fetal alcohol syndrome. I want members to know particularly that this issue is a lot bigger than anybody ever realized. This has been the raison d'être of dozens and dozens of groups of volunteer organizations across the country for years. They're crying out for an opportunity to inform Canadians.

Just this weekend I received from Health Canada a copy of an Environics survey that was done. The work was done in January, and they found that awareness levels on mental health issues and things like FAS were much lower than they ever estimated. Just to give you an example, only 10% of the people knew that FAS had something to do with brain problems. The vast majority thought it was a physical problem, an addiction to alcohol once the child was born, or withdrawal from alcoholism, just like withdrawal from drugs. The ignorance level was absolutely amazing.

Even more important than just the people who have mental health problems is the fact that we have many people in our society who are responsible for their care. There are teachers, health care givers, social givers, etc., who have to be informed about the realities and how to deal with people with a broad variety of mental health problems. There are the traditional approaches in everyday life, but you cannot treat a person with mental illness the same way. You can do it a thousand times and all that will do is prove....

I raise this from the standpoint that I believe a great deal of the impetus, with regard to the question of mental health, has to do with a little bit of work I've done and some other related issues on homelessness, etc. It's a focused issue. It's something I certainly could get excited about. I have no doubt we could learn a great deal and maybe have an opportunity to produce a report for our parliamentary colleagues that they will be able to use to inform Canadians about this very real issue.

We have to decide whether or not we are going to be productive as a committee. If the members are not interested in doing this as a committee, I certainly would be interested in participating in a subcommittee on the issue of mental health, if there were sufficient members to do it. We could call witnesses and educate ourselves, so we could in turn educate others about the broad impacts on over one-third of our population. It results in a significant cost and drain on our health care system.

I put that on the table to hopefully put a few things in perspective. I don't for a moment believe we have to do anything anybody tells us to do. I believe we should do something we collectively feel we want to participate in, get enthusiastic about, and are prepared to do a good job on and support.

I'm prepared and would like to do it on mental health, but only if members were prepared to support it. It's certainly something I'd want all parties to deal with.

The Chair: Thanks very much.

Ms. Redman and then Mr. Charbonneau.

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Ms. Redman, I'm going to finish off the discussion with that. Mr. Elley has some motions I suspect he wants to raise.

The minister has been requested to appear on the estimates, and we're still waiting for a reply on that. So that may be of interest to you. We have requested him to appear. We did pursue that.

Ms. Redman, please.

Mrs. Karen Redman (Kitchener Centre, Lib.): Thank you, Mr. Chairperson. I will try to be brief.

I haven't had the privilege of sitting on the steering committee, so as a member of this committee I now have an opportunity to speak to this.

I mainly agree with most of what Mr. Szabo has said. I think what I'm hearing from the members opposite are two issues. One may be a process and one may be on content. However, the ministers of health met with Minister Rock this past week and came away with a sense that the first ministers, the Prime Minister, and perhaps finance ministers needed to deal with this in a holistic way.

I will tell you that mental health—and I can only speak from the experience I have as a representative of Kitchener Centre—is a huge issue because it's largely going through what a lot of the health care delivery is going through in every other aspect. It is being deinstitutionalized in my province. Those people are finding themselves back in the communities, and the community resources are not there.

For us to infer that we can take on the myriad challenges that lay before health care is probably more than this committee can deal with effectively.

I have also petitioned the health minister on health care, because it's a huge issue in my riding. Whether you look at housing, health care delivery, or community services within that health care delivery, it is definitely a focus in my riding. Perhaps this is an illustration of looking at some of the forces that are happening in the macro picture, by choosing a substantive issue we can deal with.

The Chair: Thank you very much.

Mr. Charbonneau, if he's available.

A voice: He has a direct route to the minister.

The Chair: The pipeline is secure, I hope.

Mr. Charbonneau, sorry to interrupt your telephone call.

[Translation]

Mr. Yvon Charbonneau: I was only trying to better serve the committee, sir. The question concerned future legislation. The Standing Committee on Environment and Sustainable Development is now looking into the issue of pesticides. This study is likely to result in draft legislation or in an update of the regulations. However, it's one area that we could look at. I know someone asked the question earlier. The minister has already spoken out publicly about pesticides. He indicated that he awaiting the report of the Standing Committee on Environment to let us know what action would be taken.

Recently, a question was raised in the House of Commons concerning new reproductive technologies. You heard the response that was given, just as I did. The minister stated that consultations were under way and that when these concluded, draft legislation would be introduced.

A voice: Consultations have been ongoing for three years.

Mr. Yvon Charbonneau: You're asking me to tell you something that you already know. If you know the answer, don't bother asking the question in the first place. You know as well as I do what his answer was.

Therefore, to my knowledge, these are the legislative items that are coming down the pipe and that are likely to come before us at some point in the future. There's nothing in the works....

With respect to tobacco, we have some new regulations.

Mr. Réal Ménard: These need to be examined by the committee.

Mr. Yvon Charbonneau: Yes, but you were asking about upcoming legislation.

Mr. Réal Ménard: However, regulations....

Mr. Yvon Charbonneau: We have the regulations. We've had them since April 1.

Mr. Réal Ménard: However, the committee must be consulted on these regulations.

Mr. Yvon Charbonneau: That's quite possible. Earlier, I mentioned that the draft regulations on the tobacco initiative were ready and could be publicly reviewed by the committee.

Mr. Réal Ménard: This isn't an option. The committee is legally required to review the regulations.

Mr. Yvon Charbonneau: You may be right. I won't argue the point with you.

[English]

The Chair: I think we've laid out where we're going here. Having said that, we've had a very good discussion.

Mr. Elley, you said you had some motions. Why don't we proceed with those now?

Mr. Reed Elley: Thank you, Mr. Chairman.

I sent in a motion on March 14.

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Pursuant to Standing Order 81(4), I move that the committee hold meetings to consider and report on the 2000-01 main estimates for the Department of Health; that the committee invite the minister and senior officials to appear before the Standing Committee on Health on the following dates: March 28, which has already gone by; or April 11 or May 10 or May 17, but no later than May 31, 2000; that the minister provide information relating to the future expenditure plans and priorities of the department, especially those related to grants and contributions; and that pursuant to Standing Order 81(7) and (8), the committee consider and report recommendations on the future expenditure plans and priorities of the department no later than June 3, 2000.

The Chair: Thank you. I'll call the question on that.

Mr. Réal Ménard: No.

The Chair: Monsieur Ménard.

[Translation]

Mr. Réal Ménard: Mr. Chairman, when the steering committee last met, you undertook to obtain assurances that the Auditor General would appear before the full committee. This suggestion came from our NDP colleague and you promised to check to see when the AG would be available.

Appearances by the Auditor General and the Minister to discuss the estimates are a routine part of the committee's work. This is not something that we need to discuss separately. Can you tell us what your plans are?

The Auditor General has already appeared before the Standing Committee on Public Accounts to discuss two chapters in his report that focus on health. It would be truly incredible if the AG and the minister failed to put in an appearance before our committee in the coming weeks, regardless of which topics we decide to examine.

Do you recall making such an undertaking, in response to Judy's suggestion? Where do matters stand?

[English]

The Chair: First, I will repeat what I said a few minutes ago, and that is that we have sent a letter to the Minister of Health requesting his appearance. We have yet to receive a response from him.

Second, I did not commit to asking the Auditor General, other than to say that at the steering committee we would decide when and how best to proceed with that. I did commit to the fact that we would as a group discuss it. I can't on my own commit anyone to do anything. But what I can do and did was commit that this committee would discuss requesting the Auditor General to appear, and that's precisely what we're doing now.

Mr. Réal Ménard: Okay. Ask the question.

(Motion agreed to)

The Chair: So we'll write another letter to Mr. Rock based on what has been outlined.

Mr. Elley, do you have another motion?

Mr. Reed Elley: Yes, just to get us started, Mr. Chair, on perhaps whittling down what we'd like to see happen at this committee.

On March 31 of this year I wrote to the clerk and asked that this motion be put on the agenda for this meeting: that pursuant to Standing Order 108, the committee study and report back to the House by June 15, 2000, on the state of health care in Canada and that the federal and provincial ministers of health be invited to appear. I so move.

The Chair: Thank you.

(Motion negatived)

The Chair: Mr. Elley.

Mr. Reed Elley: That was all. Thank you, Mr. Chair.

The Chair: Thank you.

Monsieur Ménard.

[Translation]

Mr. Réal Ménard: Mr. Chairman, I have a question for the Parliamentary Secretary. Given that we haven't reached a consensus on tackling the issue of mental health, is there any other topic that the government would agree to consider? For example, would it be willing to consider my motion, which is on the books, calling for a review of marketing strategies, fraudulent practices and smuggling, under future business of the committee?

We have a choice. Either we adopt the motion on mental health, in which case the government will be going it alone because the opposition parties won't be participating in the debate, or we can come to an agreement on a topic? The government is also interested in the smoking issue. Couldn't we compromise so that we can all work happily together?

[English]

The Chair: Mr. Ménard, do you have a motion there, or are you just—

Mr. Réal Ménard: Oui.

The Chair: Are you moving one on tobacco?

[Translation]

Mr. Réal Ménard: Mr. Chairman, before I move a motion, I'd like to know what the chances are of it being well received. Is the Parliamentary Secretary favourable to the motion?

[English]

The Chair: It's sort of like having your cake and eating it too, I think. I'm not sure that's exactly—

Mr. Réal Ménard: No, no, no, don't say that.

The Chair: Yes, yes, yes.

[Translation]

A voice: In French, please.

Mr. Reed Elley: It's the same in French.

• 1655

Mr. Réal Ménard: I want to know if the government is amenable to considering a motion of this nature. Judy has expressed an interest in the subject and so too has the Canadian Alliance. Why not focus on a topic on which we can all agree?

[English]

The Chair: We have yet to determine that.

We try to work, Mr. Ménard, by consensus, as you point out. I know you're a very wily person. I understand that, and I understand you're very interested in getting your way in most things. However, at the end of the day this committee operates by democratic vote, and we'll see the way the vote goes accordingly.

But I'm not going to short-circuit Mr. Charbonneau. I think he has things to add here.

[Translation]

Mr. Yvon Charbonneau: I'm willing to consider a compromise that would satisfy everyone. I'm quite willing to do that, except that I don't see any effort by members to achieve a consensus on the mental health issue.

Mr. Réal Ménard: We mustn't waste our time on that subject.

Mr. Yvon Charbonneau: Then, where do you see a compromise? You want members to select your topic. You yourself have said so. That's not much of a compromise on your part.

Mr. Réal Ménard: To begin with, we need something more specific to work with. Exactly what does the government mean by mental health? What does the federal government do in the field of mental health?

Mr. Yvon Charbonneau: We considered possible terms of reference at the last meeting.

Mr. Réal Ménard: Yes, we did.

Mr. Yvon Charbonneau: You want me to be more explicit. I remind you and your colleagues who may not have been at that meeting that we did try and provide you with additional details. Perhaps you're not happy with that, but an effort was made. How is your motion explicit? It contains two paragraphs. We can approach the issue a number of different ways.

Mr. Réal Ménard: I was merely attempting to lay out some kind of framework for a future study.

Mr. Yvon Charbonneau: I want us to take the time to consider a mandate for the committee calling for a study of the tobacco question. I'm prepared to consider terms of reference, but these should be worded in such a way as to reflect the perceived needs of all of the parties represented on the committee.

Right now, you have decided what the committee's mandate should be. I'm not prepared to adopt your exact wording, but I am prepared to recommend that we look into this and decide together what our mandate should be. For instance, should we look at labelling and packaging and also at the draft regulations? You're proposing that we examine the situation that prevailed between 1991 and 1995. I'm not interested in recommending that the committee consider things that happened between 1991 and 1995.

Mr. Réal Ménard: Apparently, this is a reflection of your government's position where legal action is concerned.

[English]

“After” would matter.

The Chair: Yes. “After” is the key word.

Mr. Réal Ménard: Excuse me. I'm going to control myself.

The Chair: Thank you very much.

[Translation]

Mr. Yvon Charbonneau: Mr. Chairman, I refer to Mr. Ménard's letter of December 13 last which should clarify matters. Mr. Ménard wrote to ask that the committee consider the following proposed motions:

That the Standing Committee on Health do everything it can to enlighten the House on the role that Canadian cigarette manufacturers played in setting up a network to smuggle cigarettes to the United States between 1991 and 1995.

That the Standing Committee on Health evaluate the resulting shortfalls to the various governments affected.

I know that there was a serious problem back then, with grave repercussions. However, we're trying to come up with a current topic, one that can enlighten public opinion. In my view, revisiting the situation that prevailed between 1991 and 1995 is not a priority for us. It looks more like a fishing expedition to me and while that could prove to be interesting, I don't think it's very relevant at this point in time. I'm prepared to work on a mandate for the committee to study the whole issue of smoking.

[English]

Mr. Paul Szabo: I have a point of order, Mr. Chairman. Is this matter not before the courts? If it is, do you think it's really appropriate for us to somehow try again to get into the loop of something that is in fact before the courts?

The Chair: I think, Mr. Szabo, you make a good point, and I think you're right.

Mr. Réal Ménard: May I respond?

The Chair: No.

Let me say this to you, Mr. Ménard. I think you have a very valid point of discussion here, but I think Mr. Charbonneau's point about terms of reference being perhaps better framed is good.

If you want to bring it forth now as a motion, you're free to do so. You ask about where you thought it was going. I would suspect it might not go very far. But if you wanted to rework it and bring it back to a steering committee meeting we'll have after the two-week break, that might be a much more appropriate way to go. I'm not telling you what to do. I'm just giving you my best advice.

Mr. Ménard.

• 1700

[Translation]

Mr. Réal Ménard: Mr. Chairman, you know how conciliatory I am and how much I appreciate compromise. I have two comments. I'm prepared to sit down with the Parliamentary Secretary and rework my motion on smoking and tobacco. There are many other areas that we could focus on, for example, smoking among young people and the regulatory process. I simply want to point out that the whole question of smuggling has serious implications in terms of shortfalls in tax revenues.

Admittedly, the matter is now before the courts. Admittedly, with respect to part one of my motion, the US government has already instituted proceedings against certain cigarette manufacturers. However, in this case, your government is the one that wants to set the terms of reference of the study. Your government is the one that launched proceedings in 1991 and in 1995.

I'd like to make a suggestion, Mr. Chairman. Rather than table my motion at this time, I will work with the Parliamentary Secretary on a new one to be tabled at a later date. If he is interested in focussing on this topic, I'm prepared to reconsider the terms of reference.

[English]

The Chair: Well, we're certainly willing to look at it further at the steering committee after the week of the 24th, and I think your suggestion to work with the parliamentary secretary to see if terms of reference can be framed is a very wise one.

Monsieur Charbonneau.

[Translation]

Mr. Yvon Charbonneau: Conversely, since we are trying to reach a compromise of sorts, we could also undertake to consider the possibility of rewording the motion on mental health. Otherwise, I don't see a compromise here. We would simply be going with your motion, and discarding our own.

Mr. Réal Ménard: It is ultra vires.

Mr. Yvon Charbonneau: Or so you say.

Mr. Réal Ménard: It does not fall within your jurisdiction.

Mr. Yvon Charbonneau: You're speaking hypothetically.

[English]

The Chair: Gentlemen, gentlemen, we're going to come to—

[Translation]

Mr. Réal Ménard: What does the federal government do in the field of mental health?

[English]

The Chair: Monsieur Ménard, thank you very much.

Ms. Wasylycia-Leis, and then we'll come back.

Ms. Judy Wasylycia-Leis: This might not be the right time. I'd like to move my motion.

The Chair: Yes, please.

Ms. Judy Wasylycia-Leis: Okay.

The Chair: We have a vote, so we want to get this done.

Ms. Judy Wasylycia-Leis: And I understand, Mr. Chairperson, there will only be a two-minute bell before the vote at 6 o'clock, so....

The Chair: Yes.

Ms. Judy Wasylycia-Leis: I'd like to move that our next order of business be the November 1999 report of the Auditor General of Canada entitled “Federal Support of Health Care Delivery” and that the Auditor General as well as officials from Health Canada be requested to appear before the committee on this matter.

The Chair: Thank you very much.

I call the question. All those in favour? Opposed?

[Translation]

Mr. Réal Ménard: Is the Auditor General really going to make an appearance?

[English]

The Chair: It's defeated. Thank you.

Ms. Judy Wasylycia-Leis: You don't want the Auditor General before the committee?

Mr. Paul Szabo: No, it was passed.

Mr. Réal Ménard: I don't understand what's happened here.

Mr. Paul Szabo: I don't either. There were three votes over there and no votes over here.

The Chair: No, I saw five votes here. It was five to three.

Ms. Judy Wasylycia-Leis: Against?

The Chair: Yes.

Ms. Judy Wasylycia-Leis: You defeated it?

The Chair: Do you have another motion, Ms. Wasylycia-Leis?

Ms. Judy Wasylycia-Leis: Yes, sure. I'll try it this way.

Mr. Reed Elley: On a point of order, Mr. Chair, I think you may want to revisit that. I think there's some confusion as to what we just did. I think Mr. Szabo has a point.

The Chair: Is there a problem?

Mr. Paul Szabo: I didn't see too many votes indicated by members during that—

The Chair: Okay, let me ask it again. All those in favour?

Mr. Paul Szabo: Maybe you want to just repeat for everyone what it is we're voting on.

The Chair: We're voting on calling the Auditor General. I think that's clear. All those in favour?

Mr. Paul Szabo: For that report?

Ms. Judy Wasylycia-Leis: One little report, yes.

The Chair: All those in favour?

[Translation]

Mr. Réal Ménard: But I thought we'd already agreed that the Auditor General would appear before the committee.

[English]

The Chair: Opposed?

There you go. It's carried.

(Motion agreed to)

An hon. member: That's better.

The Chair: Thank you very much.

Mr. Réal Ménard: Mr. Szabo, we need you.

Voices: Oh, oh!

The Chair: He'll soon be taking his seat across the aisle, no doubt.

Ms. Judy Wasylycia-Leis: Mr. Chair, on a point of order, could I make the suggestion that we in fact invite the Auditor General next week so that we don't waste any time? Can we do it next week?

The Chair: Subject, I think, to his availability. That's usually the way it's couched.

Mr. Reed Elley: That's understood.

The Chair: We'll move on that.

Do you have any other motions, Mr. Wasylycia-Leis?

Ms. Judy Wasylycia-Leis: Not at this point.

The Chair: Not at this point? Well, you too are being wily today.

Mr. Réal Ménard: Now it's time to go vote.

The Chair: Hang on.

Mr. Elley.

Mr. Reed Elley: Well, Mr. Chair, in the spirit of adding some—

The Chair: Compromise.

Mr. Reed Elley: —well, food for thought in terms of possible compromises here, I still think you're going to have a hard time getting the opposition to study mental health.

Mr. Szabo had an interesting suggestion. At one point he said he'd be interested in studying the issue of mental health in a subcommittee. There's some relevancy to that, and I think there may be members on this committee who feel very passionate about it and would like to be part of a subcommittee to study mental health.

• 1705

At the same time, I felt there was some general agreement here amongst us about the importance of GMOs. The agriculture committee has in a sense taken some of the wind out of our sails, because they have this committee going and they're going to study the issue of labelling. However, that still leaves the huge issue of safety of GMOs somewhere in never-never land. I do think that is a part of the subject we as the health committee should be taking a look at.

So maybe we can have two subcommittees, one on GMOs that studies their safety and another on mental health. Then you'd get the full committee working.

The Chair: Mr. Elley, I couldn't agree with you more about the importance of GMOs. It really is an important topic. However, we have a blue ribbon panel in place that will be reporting in June to this committee. I think we need to wait and hear what they report, and at that point the timing will be much, much better for us to proceed.

I agree with you that the agriculture committee is looking at a very narrow portion. It's up to us, however, as the health committee, because we are working in the best interests of health for all Canadians, to take a look at the overall impact of GMOs, and that we will do. So I genuinely wish that instead of having a subcommittee that might in fact be less weighted, we hold off and proceed at the appropriate time, because I genuinely believe it is a very huge, important area.

Mr. Ménard, hang on for a minute.

Mr. Charbonneau, do you want to bring forward a motion on mental health?

Mr. Réal Ménard: The vote is on Bill C-22, your government bill.

The Chair: Thank you very much. Excellent.

Mr. Charbonneau.

[Translation]

Mr. Yvon Charbonneau: Before I bring forward a motion, I have a question. Is there a meeting of the steering committee scheduled any time soon?

[English]

The Chair: It will be scheduled after the break.

Mr. Yvon Charbonneau: After the break.

Mr. Réal Ménard: We're going to work together.

[Translation]

Mr. Yvon Charbonneau: Has the agenda or future business of the committee already been decided, or will it be decided by the steering committee?

[English]

The Chair: No, no. We came to a stalemate at the steering committee. That's why it's here today.

So I'm assuming you're going to bring forward a motion on mental health.

[Translation]

Mr. Yvon Charbonneau: Then I move that the committee do a study of mental health and other related issues, as set out in the proposal submitted.

[English]

The Chair: Thank you.

Mr. Réal Ménard: We're worried about compromising health care.

The Chair: Yes, that will come later. You'll work it out with him later.

Mr. Réal Ménard: No, I don't want to study this subject now. You know that.

The Chair: Then vote accordingly, Monsieur Ménard.

Mr. Réal Ménard: But if you table this motion, you will work only with the government side. The members of the opposition will be absent. You know that.

The Chair: I understand what you're saying.

Mr. Réal Ménard: All right.

The Chair: I don't take well to intimidation, thank you.

Mr. Réal Ménard: No, but we don't want to have the government intimidation, and that's what we're trying to do. You know that.

The Chair: I call the question.

(Motion agreed to)

The Chair: Are there any other motions to come before this committee?

This meeting is adjourned. We'll meet Thursday to discuss the work plan, the Auditor General, and mental health.