HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Monday, May 29, 2000

• 1534

[English]

The Chair (Mr. Lynn Myers (Waterloo—Wellington, Lib.)): Ladies and gentlemen, I think we'll begin.

While we're awaiting the minister, and we have Mr. Dodge and Madame Fortier here as well, there are a couple of motions we have to deal with and we have another motion with respect to expenses for witnesses for the tobacco regulations. I'm wondering if we could deal with the outstanding motion, and that was number two of Mr. Mills with respect to commencing a study on all related problems surrounding the state of health care in Canada. Could we deal with that at this point?

Mr. Thompson, you had the floor.

• 1535

Mr. Greg Thompson (New Brunswick Southwest, PC): Thank you, Mr. Chairman. I appreciate that.

Mr. Chairman, as you know, I spoke on and on and on at our last meeting, much to your chagrin, but I think I was making the point that we've had some difficulty with the chair and the leadership of the chair, and as a result I think the committee has been floundering.

Mr. Chair, I think I've made most of my points. I'll probably have a chance to make more on the second motion as it appears before this committee, so at this point I would like to yield the floor to my colleagues on the committee. I think their interventions would be appreciated at this time.

Thank you, Mr. Chairman.

The Chair: Thank you very much.

Any further discussion? Mr. Reed Elley.

Mr. Reed Elley (Nanaimo—Cowichan, Canadian Alliance): Thank you, Mr. Chair.

I believe that along with my colleagues Mrs. Wasylycia-Leis and Mr. Thompson—and I'm not sure of the Liberal members of the committee, because they change quite frequently—I am the longest-serving member on this committee for this House. I've always felt it was important to have continuity on these committees. I know that's not always possible because we have lots of committees to cover, but I have felt that there was a good deal of sense in having continuity on committees. So out of two and a half years of experience of sitting on this committee, I have for a...

The Chair: Order.

Mr. Elley, do you want to continue, please?

Mr. Reed Elley: Thank you.

An hon. member: There are cameras in the room, Mr. Chairman.

The Chair: Yes, I'm aware of that.

I think, Mr. Rock, you're prepared to wait until we're finished with this business?

Hon. Allan Rock (Minister of Health, Lib.): Of course.

The Chair: Thank you very much.

Mr. Reed Elley: I have for two and a half years been sharing with my colleagues and pleading with my colleagues on both sides of the table to allow us to study something that I believe is the most important issue facing Canadians today. In all of the polls that are being taken, when Canadians are asked what is the most pressing issue facing Canada today, they say to me and to those people who are taking those polls, it is the deteriorating health care system of Canada.

It seems to me, then, that if we have this kind of public outcry about our system and concern for our system, the committee that has been elected by the people to have an overview capacity of our health care system in this country should be taking with utmost seriousness all of the views of Canadians across this country and, as parliamentarians, listening to them.

We have a parlement, and the meaning of parlement is a place where we speak on behalf of Canadians. Therefore it seems incumbent upon this committee that we should be going to every part of this country and listening to Canadians, hearing what their concerns are, engaging in conversation with health care professionals, speaking with government officials who administer health care and the delivery of health care in the provinces, and as a committee becoming fully versed with the problem so that we can speak intelligently about the most serious problem facing Canadians.

I don't think there's a member on this committee who, if we got into a room together one on one, would not say that this is the most serious problem facing Canada. But when it comes to this kind of forum—and I lay it out on the table, as some of my other colleagues have, and have even made motions that we as a committee start to do this—we are consistently turned down. And I do not understand that. It's either blocked at a ministerial level or it's blocked at the party politics level, but we are not doing what I believe we are charged with the responsibility to do. Just as late as a couple of months ago, I brought this to the floor of this committee again, and it was turned down by the Liberal majority, and I find that very sad.

So once again we have brought to this committee a motion asking that we do this very thing. It's not that we feel the other more personalized aspects of health care in this country, and the studies we have done on them, are not important; of course they're important. But let's face it, if the collapse of the system is imminent or the system is in deep trouble, then all of these other things that we could and have studied in the past will not be able to get the support and the funding and the help they deserve to continue on as part of the whole health care system of Canada. So my plea—

• 1540

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): I have a point of order, Mr. Chairperson.

The Chair: On a point of order, yes, Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: With all due respect to my colleague from the Alliance, I'm wondering if we could put this discussion on hold. I would hazard to guess that the minister probably only has a fixed period of time for our committee. This is the first time we've seen him in a year, and I hate to miss the opportunity to question him. I'm wondering if there's any way we can revert to other business after this session.

The Chair: Were you soon winding up, Mr. Elley?

Mr. Reed Elley: Yes, indeed, Mr. Chair, I was. I appreciate the opportunity to talk on this, as a long-standing member of the committee. I appreciate what my colleague has said. We do need to question the minister. We don't see him too frequently, so we need to do that. So I don't know if any of my other colleagues have anything to say, but I would ask that we would search our hearts and we would vote.

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): We should hear the minister first, and after that we could follow up with yours.

The Chair: Hold on a moment, Mr. Ménard.

Mr. Reed Elley: I'm just finishing, so I would ask that we search our hearts and that we vote for this motion.

The Chair: Thank you.

Mr. Mills, quickly.

Mr. Bob Mills (Red Deer, Canadian Alliance): As the mover of the two motions that we have to vote on, I would be more than happy to hear the minister while he's here. I think it's important that he hears what his committee feels as well. I would only do that, though, under the condition that we make arrangements to carry on with these motions after he leaves, that we possibly, if we have to, have extra sessions, cancel our witnesses for tomorrow, whatever the chair can do. I feel it's important we deal with these two motions.

I would like to have a legal opinion as to whether, if we agree to this, we will in fact come back to exactly where we are at this point in terms of dealing with these motions. We do not want to deal with these motions next month, next year, whatever.

The Chair: I think, Mr. Mills, in fairness, that's very wise counsel. We're doing tobacco tomorrow, and Wednesday and Thursday and Monday as well. As soon as that's out of the way, we'll come back exactly to this point, with your agreement. That's what you're suggesting, right?

Mr. Bob Mills: I'm suggesting that we hear the minister—

Mr. Reed Elley: And that we stay here until we...or if there is nobody else ready to speak, we can vote on it right now.

Mr. Bob Mills: If we want to carry on with those two motions, I'm quite prepared to do that as well, if that's what the majority want to do.

The Chair: All right, motion number two is on the floor. Let's call the question.

Mr. Bob Mills: I simply wanted to reiterate where we were at with that. As the mover, I have already spoken of course—

The Chair: Okay.

Mr. Bob Mills: —but perhaps I could simply say that the minister himself says that our health care system is not sustainable, that the status quo is not an option.

Mr. Ted McWhinney (Vancouver Quadra, Lib.): On a point of order, the question has been called. We can't debate it here.

The Chair: I think we're now on the question. Calling the question, does anyone want a roll call?

[Translation]

Mr. Réal Ménard: Could I ask you to read the motion again? Is this the motion on the health system?

[English]

The Chair: The motion is that the Standing Committee on Health immediately commence a study on all related problems surrounding the state of health care in Canada. Any questions?

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Mr. Yvon Charbonneau (Anjou—Rivière-des-Prairies, Lib.): Mr. Chair, before you count...

[Translation]

The Chairman: Mr. Charbonneau.

Mr. Yvon Charbonneau: Mr. Chairman, I would like to apologize. I thought you had put the question on the motion concerning mental health, but it was really the motion on the situation of Canada's health system, which I have not sufficiently examined. Of course, I am in favour of the motion on mental health, but not in favour of the second.

[English]

The Chair: Okay, we'll make that adjustment.

Mr. Greg Thompson: I have a point of order. Mr. Chairman, this is an example of how the committee is out of control. How do you change your vote on an item as important as that? Obviously the government members aren't paying attention.

So, Mr. Chairman, I would suggest that once the vote is cast, you can't simply change your mind based on which way the wind is blowing or directions from the chair. I'm not sure that legally, if you wish, under the rules of Beauchesne's, the member can change his vote.

Mr. Ted McWhinney: On a point of order, a member has the privilege to change his vote before it is announced.

Mr. Bob Mills: It was announced.

Mr. Ted McWhinney: No, it was not announced.

Mr. Bob Mills: Yes, it was. We heard it over here.

Mr. Ted McWhinney: You did not. Did you hear it...

The Chair: No.

Mr. Ted McWhinney: That's the end of it.

The Chair: No. We're not going to get into a great debate here. Mr. Charbonneau—

Mr. Bob Mills: The rules according to—

The Chair: Mr. Mills. Mr. Mills—

An hon. member: I think you're right, Mr. Mills.

[Editor's Note: Inaudible]

Mr. Ted McWhinney: —

The Chair: Mr. McWhinney, please. Order.

Mr. Greg Thompson: Mr. Chairman, I'd like to make one point, if I could. Because we have a lot of fill-ins on the committee, we should obviously check to make sure their papers are in order so in fact their votes can be valid—those who voted either way, Mr. Chairman.

The Chair: Yes, I've already done that, Mr. Thompson. The papers are in order. But we'll have the clerk double-check that.

In the meantime, Mr. Charbonneau has indicated that he voted in error, and we will record that. So the motion is defeated. It's a tie, and my vote defeats it.

(Motion negatived—See Minutes of Proceedings)

The Chair: Having said that, we'll go on. Is there a lot of debate on item three?

Mr. Bob Mills: Now there is.

The Chair: What I would like to do, then, very quickly, while we still have the option, is have the committee approve an operational budget of $86,500 to cover expenses for witnesses appearing on the committee's studies on mental health and on tobacco regulations.

[Translation]

Mr. Réal Ménard: On a point of order, Mr. Chairman.

[English]

The Chair: Point of order first. Go ahead.

[Translation]

Mr. Réal Ménard: We are all here to do our work as parliamentarians. The Minister is here and I suggest that we immediately cease discussing any other consideration to be able to start questioning him on his department's allocations. We will get back to the motion before us and the committee's future work later on. These matters are too important for us to feel rushed. The Minister is here for the first time in a long time, and we all have questions for him. Let's start putting our questions.

[English]

The Chair: This is really administrivia. This is really administration. This is really quick. If I can get a mover and a seconder, we can proceed. It's to pay the witnesses.

[Translation]

Mr. Réal Ménard: We have to discuss our work. We can't pass this motion before discussing our work.

[English]

The Chair: It's to pay the witnesses.

Mr. Bob Mills: Point of order.

The Chair: Mr. Mills.

Mr. Bob Mills: Mr. Chairman, you did mention at the last meeting we had that in fact if we couldn't get to finish those motions, which we started over a week ago, in fact we may have to delay the witnesses and not incur the expense of those witnesses' coming until we could solve the issues of this committee.

So now we're approving the expenses. Has something been done to delay those witnesses from coming tomorrow? What's happening?

The Chair: We're starting with the witnesses beginning tomorrow, after the minister. This is what I'm hoping will happen. We'll hear the minister now and then we'll deal with the expenses. On your advice, we'll put over the whole issue on number three.

Mr. Reed Elley: No, we don't want to do that. We want it handled today.

Mr. Bob Mills: It should be handled today or immediately, at the earliest convenience.

The Chair: All right. Then after we hear the minister, we'll do the expenses and we'll do item three.

[Translation]

Mr. Réal Ménard: Agreed.

[English]

The Chair: Madame.

Mr. John Finlay (Oxford, Lib.): Mr. Chairman, as a point of order, please, or a point of information—

The Chair: Yes. Sorry, go ahead.

Mr. John Finlay: —has motion one been dealt with?

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The Chair: It's been defeated. Now motion two has been defeated.

Mr. John Finlay: You see, I wasn't at previous meetings. My colleague was talking to me about motion one, and I was going to ask for your clarification. Which motion are we voting on, one or two?

The Chair: We already voted on motion one.

Mr. John Finlay: I didn't know that, and I don't know whether Mr. Charbonneau knew that. Mr. Chairman, I'm sorry, but you didn't make it very clear. I should have asked my question. It would have saved all this problem. Thank you.

The Chair: Thanks very much.

Did you have a point of order, Mr. McWhinney?

Mr. Ted McWhinney: Yes. Before the committee decides on its agenda, I would suggest that rather than putting the minister through what I think is the embarrassing situation of having a time limit hanging over his head, you schedule this as the first item of business on a meeting that you will specify, that the committee will specify. In other words, I think it's undignified to say it will happen if and when the minister concludes. He may well need five hours. He might need five minutes. So I would say schedule it as the first item of business on a particular day, the next free day.

The Chair: That's a good suggestion. It goes back to what Mr. Mills was saying before, and that is that we're hoping to be through the tobacco regulations by Thursday, June 8. Why don't we set aside that meeting as the time to deal with these motions? Can we have a motion to that effect?

Mr. Ted McWhinney: I will move to that effect.

The Chair: The motion is made by Mr. McWhinney and seconded by Mrs. Redman.

Do you have a question?

[Translation]

Mr. Réal Ménard: I can feel the Minister is getting fidgety and that he would like to answer our questions. What prevents us staying here after our exchange with the Minister to settle the questions such as the motion suggested by the Canadian Alliance and the future work of this committee? The Minister will be here until 5:15 or 5:30 p.m. and we can debate it then.

[English]

The Chair: I understand, Mr. Ménard, and that's exactly what I'm doing, the fail-safe. We'll try to do it once the minister's gone, and if not, we'll come back on June 8 to finish up.

Mr. Ted McWhinney: My motion is very specific, that we table the motion for a particular date. I'd be prepared to go—

The Chair: All right, Mr. McWhinney. We'll call the question on Mr. McWhinney's motion to set aside June 8 for a meeting.

We'll have a recorded vote. Mr. McWhinney is moving June 8. I'll call the question.

[Translation]

Mr. Réal Ménard: On a point of order. There can't be any motion as the necessary 48-hour notice was not given.

[English]

The Chair: You need unanimous consent. Thank you for pointing that out, Mr. Ménard.

We're going to take the time after the meeting. We'll start, and then we're going to go to June 8 to finish, if we need it. Is everyone agreed on that?

Some hon. members: Agreed.

The Chair: Thank you very much.

Mr. Rock, the Minister of Health, if you would, please.

Mr. Allan Rock: Mr. Chairman, someone observed that I'm not here very often. If I'd known you had this much fun at your meetings, I'd be here on a regular basis.

I do appreciate the chance to be before you on estimates. Let me first of all introduce the officials who are with me. David Dodge is the deputy of the department, and Marie Fortier is the associate deputy minister. With me as well are assistant deputy ministers and other officials who will be able to respond to some detail of questions that might arise.

I'll speak very briefly to open, because I know members are anxious to get to questions, and

[Translation]

as Mr. Ménard has already pointed out, I'm getting fidgety in my chair here and I am burning...

Mr. Réal Ménard: Do you want another chair?

Mr. Allan Rock: No, it is quite adequate for the time being, but we will see.

First, I would like to thank the members of the committee for the work they have done during the last few months. You have examined many interesting and important matters. Someone has said that you were not involved in the real questions we are concerned with, but that's not true.

[English]

You have helped us enormously with important questions, including the whole policy of the Government of Canada toward encouraging a higher rate of organ donation in this country. You have provided elaborate recommendations with respect to natural health products that we're now carrying forward into implementation. Recently you reviewed the projet de loi, the statute, with respect to the creation of the Canadian Institutes of Health Research. Bill C-13 is now adopted and we're on the verge of announcing the president and governing council so the institutes can open their virtual doors. Tomorrow you'll take on tobacco regulations, which are becoming increasingly important.

• 1555

Of course I've asked that you consider the issue of mental health. I'm surprised that the suggestion would be made that it's not an important subject, because in fact—

The Chair: Order. Quiet. We have the health minister speaking right now.

Mr. Bob Mills: Will he be on our—

The Chair: He did not interrupt when you were speaking. I suggest that out of courtesy, you do the same.

Mr. Allan Rock: Mr. Chairman, I just want to emphasize for the committee that more than a quarter of Canadians experience one or another form of mental distress or psychiatric difficulty during their lifetimes. Much of that goes undiagnosed and untreated. If you take into account the costs of the treatment and the costs of those who must live in anguish without treatment, it's a very considerable problem. It's estimated that in 20 years, depression will become the second leading contributor to the burden of disease worldwide.

Mental health is often regarded as the orphan of the Canadian health care system because it's not paid any attention. I hope this committee will regard it as a subject of sufficient significance, that it will help Canadians understand the nature and extent of the problem and what we can do to deal with it more effectively.

Let me say in summary that there are really three broad aspects in that book of estimates you have in front of you that involve Health Canada. The first is our function in terms of health protection and promotion. The second is our responsibility in relation to first nations and Inuit. The third has to do with our role with the provinces in developing health care policy.

[Translation]

Mr. Chairman, I would like to briefly address these three aspects. The first part has to do with the protection and promotion of health. It includes our efforts to provide to everyone, groups and communities, in short, all Canadian men and women, the information and tools they need to make enlightened decisions on health. It also includes what we have done to prevent and reduce the threats to our health through the regulation of food, pharmaceutical and other products that may have an influence on our health.

[English]

The estimates you have before you had $256 million over the four coming years going to the Health Protection Branch so we can continue to rebuild it, so we can develop a stronger scientific capacity, greater disease surveillance, more biotechnological regulation, and the re-evaluation of pesticides.

[Translation]

The second part has to do with the health of the First Nations and the Inuit. The Canadian government has an important responsibility to ensure that the members of the First Nations living on reserves as well as the Inuit populations have access to health services. This is one of Health Canada's responsibilities.

[English]

In the budget of 1999, the so-called health budget, $190 million was set aside for first nations health, particularly the development of home and community care in first nations communities. In this past budget of February, $100 million was added to the budget of the Medical Services Branch to better enable it to do its job. Some months ago, I announced a diabetes strategy, which will entail the expenditure of $115 million over five years, $58 million of that for aboriginal communities in relation to the diabetes affliction.

Mr. Chairman, a third element of Health Canada's overall role has to do with medicare renewal. As you know, I'm working with provinces toward the sustainability of medicare in an effort to protect the principles of the Canada Health Act while modernizing our health care system. We're working toward a plan so that Canadians can be reassured that it will be there for them in the future.

I acknowledge, Mr. Chairman, that more federal money should be devoted to health care. I'm an advocate of more federal spending in health, increasing the transfers to the provinces, but I suggest that should come coupled with a plan where we're acting in common to make sure the money is spent to produce not just a more expensive health care system but a better health care system.

• 1600

I suggest also that in all of this—in health protection, in first nations health, and in medicare renewal—the Government of Canada has a role to play, in some cases a unique role.

For example, in the area of research, as a result of the work you've done on CIHR, the Institutes of Health Research will soon get into business. Next year their budget will be $500 million annually, more than twice what it was just two years ago, and $80 million has now been set aside for innovations in health information technology with the provinces. We have spent $150 million over the last three years in the Health Transition Fund to fund pilot projects and demonstration projects throughout the country to help us better understand which innovations will be successful in improving access to quality care.

We've opened the Canada Health Network, setting aside some $32 million to create and fund one of the unique websites available on the World Wide Web, with access to reliable information about health and health care.

[Translation]

In conclusion, Mr. Chairman, I would say that the Canadian government recognizes the importance that all Canadian men and women attach to health. We are determined to do our part with our partners from the provinces and territories, through a common effort, to reinforce the health care system and improve the quality and accessibility of health services. We are opposed to a two-speed system. We insist on a one-speed system, but a system going ahead full speed.

Thank you, Mr. Chairman.

[English]

I would be happy to answer any questions that you or colleagues may have.

The Chair: Thank you very much, Minister Rock.

Mr. Dodge and Madame Fortier, you're here as well to answer any additional questions as appropriate.

Ladies and gentlemen of the committee, as you know, it's under Standing Order 81(6) that we are hearing the minister, and certainly it's the order of the House of Tuesday, February 29, of this year, that we are considering the main estimates, as we know them, votes 1, 5, 10, 15 and 20 under health. That's really why we're here today.

Mr. Mills, lead off, please, if you would.

Mr. Bob Mills: Thank you, Mr. Chairman.

I'd like to welcome our guests, certainly, and I appreciate their being here. I would hope that they would make the calls as frequent as possible so that as questions arise in health care we could get answers to them.

I want to say a couple of things before I get to my questions. One, we are not saying that mental health is not important. It affects a lot of Canadians. All of us know people who are affected by it. The motion was to get a subcommittee to deal with it—that is what was critical—while we dealt with the big issues of health care, of which mental health would be one, of course.

As well, of course, certainly from our party's perspective, a two-tier health care system is not acceptable, not desirable, not supportable, and Canadians don't want it. So we would not entertain that type of system. We're saying we have one now, but that's not what Canadians approve of.

Now to questions. First of all, I believe cooperation with the provinces is critical. You've said that yourself in words, and yet constantly you continue to go after the provinces, whether it's a drive-by smear or whether it's constantly in the House going after the Harris Tories, or even side comments about Romanow and Tobin.

The point is that federal-provincial cooperation is critical for health care to work. Why do you continue to go after the provinces instead of coming up with cooperative ideas? Instead of going after Bill 11, why not say, look, it's something you're trying; the system is not working; we have to try new things; you're trying this, Mr. Klein, and if it works, we'll use it, but if it doesn't work, we'll boot it out?

I don't understand your approach. Words say one thing and actions another.

Let me tell you, at a farmers market two days ago, when talking about... You know, among the people who were opposed to Bill 11, you undid any of that opposition, if that was your intent, by introducing the health police to police Alberta and Albertans. Certainly you have guaranteed Mr. Klein massive re-election in the next provincial election.

• 1605

My second question is with regard to the modernization of the Canada Health Act. You say you want to protect it. I say it's not working. We don't have an accessible health care system when 200,000 people are on wait lists, when people are...

I have a letter from a lady who saw her doctor and who has to wait until April 11, 2001, for her appointment with a specialist. That's not accessible health care. Something's wrong. It's broken. It needs to be fixed. When you wait six months for an MRI, or when you have cancer diagnosed and you wait three months to get treatment, that's not accessible health care.

It's not portable. Quebec isn't part of it. A lot of hospitals, as I've been visiting them, have told me that if you come from Quebec, they want to see your money first. It's not universal. It really varies according to where you are in this country, and it certainly isn't comprehensive. Many things are not part of that.

I would like to know this. When you say you're going to protect the Canada Health Act, is that the Canada Health Act as it is not working today or do you have some plan, somewhere, to modernize the Canada Health Act?

In terms of dollars, in 1993 the federal government transferred $18.8 billion; that went to $12.9 billion; today it's at $14.5 billion; and it's going to $15.5 billion. If you had kept it at the levels of 1993, the provinces would have had $36 billion more to spend over that ten-year period. I don't see why you say you're giving more money to health care, because it's just not there, and the figures don't say that.

Thank you.

The Chair: Thank you very much.

Minister Rock.

Mr. Allan Rock: Well, it's hard to know where to start with such a cresting waterfall of misinformation and misunderstanding.

Let me begin with the position of Mr. Mills' party. I understand one, or perhaps more than one, candidate for the leadership of Mr. Mills' party to be very much in favour—expressly in favour—of two-tier American-style medicine.

We have the views of Mr. Mills. Perhaps before we know the views of his party, we should await the outcome of the leadership campaign. If at least one of those candidates succeeds, he will be the charter member of a party that is formally committed to dismantling medicare in Canada and installing American-style two-tier medicine.

Mr. Bob Mills: I don't want to interrupt—

The Chair: But you are interrupting, Mr. Mills.

Mr. Bob Mills: With the minister's permission—

The Chair: Order.

Mr. Bob Mills: —I could straighten that one out for you. There is only one person—

The Chair: Quiet, Mr. Mills. Calm down.

Mr. Rock.

Mr. Allan Rock: In any event, a multitude of views are being presented by the Reform Alliance. We'll see how it pans out when they select the person they have confidence in to lead them.

It's also odd that Mr. Mills would declare his fealty to public medicare and single-tier health care in Canada when he supports Bill 11 in Alberta. He says it's something to do; you know, things are not going well, and at least this is something that can be done.

Well, Mr. Chairman, I think Canadians deserve a little more analysis than that. When you analyse it, as I explained during my speech in Calgary on March 10—I spoke at length on this subject—and look at the evidence coming from Alberta, it indeed demonstrates that private, for-profit delivery has occasioned longer waiting lists and higher costs, not the opposite.

So if you're looking for an answer, there's no answer on the merits. There's no good policy explanation for Bill 11. The question I had and many Albertans had is why would you go in the direction of private, for-profit delivery when it's shown to be more expensive and less efficient?

In fact, the Alberta Medical Association—hardly a radical group—the chief of medical staff in Edmonton, and the chief of medical staff in Calgary all said, please, do not enact Bill 11, but put the money instead in the public health care system, in the public hospitals, where we have capacity, because that's where we can most effectively deal with people on waiting lists.

Notwithstanding that, Bill 11 was adopted.

As far as health police are concerned, the Auditor General reported last fall that Health Canada should do more—invest more money, hire more people, and be more active—in monitoring what's going on not just in Alberta but also around the country. It's one thing for us to say we're here to protect the Canada Health Act principles, but it's quite another, when you look at what's happening on the ground...

• 1610

The Auditor General said we're not doing enough. In response to that, we've added $4.5 million to the budget of Health Canada for monitoring, on the ground, throughout Canada, compliance with the principles of the Canada Health Act. That's as true in Alberta as it is in every other province and territory, and that's what we're going to do.

The last point I would make is in relation to the transfers to the provinces. When we came to office in 1993, the total value of the transfer was $29 billion. This fiscal year it's going to be over $31 billion. I think that speaks for itself.

Mr. Chairman, there are difficulties with medicare. I've been clear in saying that we regard the status quo as unacceptable. We must change, innovate, improve. The principles of the Canada Health Act, however, are broad enough that this innovation can take place within public medicare. There's no need to betray those principles to make the improvements that are needed. I think that's the difference between Mr. Mills' party and my own.

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

Monsieur Ménard.

[Translation]

Mr. Réal Ménard: Welcome, Minister. Of course, any allusion to leadership takes on a special flavour coming from you, but that's not what I want to discuss with you.

I have five brief questions for you. You were honest enough to tell this committee that you were in favour of the federal government putting more money into health. Excellent initiative! You know that you have the support of all premiers without exception who wish transfer payments to be brought back to their 1993 level. Could you tell us, for example, if your Policy and Consultation Branch has made correlations? What information does your department have on the links that may exist between the cuts made since 1993 and the problems the provinces face in discharging their duties in matters of providing services? That is my first question.

Secondly, would you be kind enough to table the list of the Health Transition Fund projects? I think that some projects have already been started up. It would be interesting for the members of this committee to have some idea of what these amounts of money were used for by each of the provinces, insofar, of course, as these projects have already been initiated. This list of Health Transition Fund projects is mentioned concerning the adaptation of health services in the estimates.

I will put my questions to you in sequence and you can answer after. Page 43 of your document says you want to be involved in the development of a new legislative framework for pharmaceutical products. What were you thinking when you wrote that? Are you going to review the Patent Act? Does it have to do with the matter of publicity?

Now for my penultimate question. In your document, I saw that the court ordered you to set aside $855 million for the hepatitis C victims. You know that according to the analysis we will be undertaking on your work as Minister of Health, the hepatitis C matter is what stands out as the most lamentable aspect of your stewardship. You were very hard on the victims. You know that I am not very proud of you in that respect and that I am in total disagreement with your government's policies. I believe you could be helpful to this committee by explaining the optimisation of the $855 million set aside. How much money has been paid out to the beneficiaries to date?

My last question has to do with page 16 of your document where it says: "Health Canada has considered the development of the young child as a crucial sector for investment". What does that mean? Am I to understand that you are getting ready to intervene in a jurisdiction that is not yours? I am sure that you would not do that without mentioning it to us, but I'd like to have a bit more information.

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

Mr. Allan Rock: To begin with, Mr. Ménard asked me if I had any comments concerning any link that might exist between the federal budgets since 1993 and the changes or problems the provinces are having in the field.

I would like to remind you, Mr. Ménard, of what was said by Mr. Bernard Landry, Quebec's Finance Minister. He clearly said that the problems concerning our health care system were due to its management and organization and were not only attributable to money. In fact, Mr. Landry answered that question when he decided to let some $850 million sleep in a Toronto bank.

Mr. Réal Ménard: On a point of order, Mr. Chairman.

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Why don't you quote...

[Editor's Note: Inaudible]

[English]

The Chair: Monsieur Ménard, quiet. Settle down. The minister listened politely when you were speaking, and you will do the same. Quiet.

Mr. Rock.

[Translation]

Mr. Allan Rock: The money was transferred from the federal level to the provinces but in Quebec's case, Mr. Landry let $850 million sleep in a Toronto bank. When someone asked him why, he answered that the money was not the only answer to those problems and that it was a matter of management and organization and with that, Mr. Ménard, I totally agree.

Secondly, Mr. Ménard asked for a list of projects funded by the federal government through the health services restructuring program. I have the pleasure of announcing that we will be tabling this list very soon. I think it is available at our office, isn't it, Ms. Fortier?

Ms. Marie Fortier (Acting Assistant Deputy Minister, Policy and Consultation Branch; Assistant Deputy Minister, Home Care Development, Department of Health Canada): Yes.

Mr. Réal Ménard: Thank you.

Mr. Allan Rock: Thirdly, concerning page 43, I haven't the slightest. I will get back to that one after I have dealt with the two other points.

Fourth, concerning the $850 million for hepatitis C, we have already spent that money. It is now in the hands of the plan manager appointed by the court and the process to get the funds to the plaintiffs is being set up.

As for the others, we have offered $300 million to the provinces to treat the people affected outside of the period for which we offered the money. Quebec, to date, has refused to accept our offer. I find it curious—maybe Mr. Ménard might be able to explain why—that Quebec has refused money for the treatment of the sick.

Fifth, in our document, we alluded to the programs funded by Health Canada for early involvement with children: first, the Community Action Program for Children and, then, the Prenatal Nutrition Program. We are providing an amount of $125 million per year, for the two programs. We are providing this money to communities that the provinces and we have identified together. This money is very valuable because it makes it possible to provide services to young mothers, especially for single parent and low- income families, and to the children during the first years of their lives. That is very important.

Everywhere across Canada, we have hundreds of projects within the CAPC and the Prenatal Nutrition Program. These projects are more numerous in Quebec. They are programs that have really succeeded, with the agreement of the provinces, in dispensing services to the communities and the children.

[Editor's Note: Inaudible]

Mr. Réal Ménard: ...the new program for the children.

Mr. Allan Rock: No.

The Chairman: Mr. Ménard...

Mr. Allan Rock: Let's get back to the question on page 43. What is that, Ms. Fortier?

Ms. Marie Fortier: It is a series of amendments and regulatory refinements the Health Protection Branch is suggesting. The list is a long one, as you can see. It carries on to page 44. These are elements that will eventually work their way into the consolidation of the Act we're still working on assiduously.

Mr. Réal Ménard: I would like to have a last question as the time available to me is not yet expired.

[English]

The Chair: Monsieur Ménard, thank you very much.

[Translation]

Mr. Réal Ménard: My time has expired?

[English]

The Chair: Yes, it is, quite sufficiently. We'll be back to you, no doubt, in another round.

Ms. Wasylycia-Leis, please.

Ms. Judy Wasylycia-Leis: Thank you, Mr. Chairperson.

I'd like to thank the minister for coming this afternoon. He's had a chance to see that our committee doesn't function that well at all times. I know some people would blame the chair. I tend to blame the fact that we haven't, as a committee, been able to discuss the two major assaults on our health care system. One is our universal public health care system and the other is our health safety or health protection system. I think the frustration we expressed is at not having the opportunity to do that. In that context, we question why in fact you take the unusual step of submitting a letter to our committee to study a specific, very small part of the big issue. I think at this time we feel the need to talk about the whole—the threats to medicare and the threats to our health protection system.

• 1620

Having said that, let me just focus in on four questions for now. I believe I only have five minutes.

The Chair: You actually have seven.

Ms. Judy Wasylycia-Leis: I have four questions on each of those two areas. The first has to do with the health protection system. I raised that in question period today. I'm concerned about the whole deregulation and dismantling of our safety systems with respect to food safety, as I questioned you in the House.

It was brought to our attention today by the Canadian Health Coalition that in fact your promise back in October 1997 to recommission many of the food labs that had been temporarily closed down has not been followed through. In fact, as of today nine labs that were outlined by you as important for the whole area of food safety have not been recommissioned. When will they be recommissioned?

Related to that is the question of the $65 million you raised in the House again today, and the additional $200 million. There is no evidence of expenditure of that money. We have tried every way to get details. We have not been able to find out if that money is going to scientists, if that money is going to the recommissioning of labs, if that money is truly going for proactive health safety systems. So we need details on that. Maybe you could start by telling us how many scientists are being planned to be hired and how many labs will be recommissioned.

Let me stop at that point and come back to two other questions pertaining to the health care system, if I could.

The Chair: If we have time.

Ms. Judy Wasylycia-Leis: If we have time.

The Chair: Mr. Rock.

Mr. Allan Rock: Thank you, Mr. Chairman.

First of all, I don't think it's an unusual step for a minister to write to a committee asking it to direct its attention to a subject. In fact that's the way we asked the committee to look at two or three other important matters you've dealt with, including natural health products.

While I was sitting listening to your initial discussion, someone—I think it was Mr. Mills—called this “my committee”. I want to emphasize that nothing could be further from the truth. This is your committee. This is a committee of Parliament. It's a standing committee of the House of Commons. If this committee decides it wants to examine this or that subject, that's what it examines. I'd like to know why the member asks the minister what the committee should be doing. The committee is master of its own process.

We have strong representation from the governing party, but we have representation from other parties as well. I think it's up to you to decide what you do with your time.

On the question of the Health Protection Branch, I did hear the question in the House today. As I said in the House, we are reinvesting. There was a period when there were cuts in the Health Protection Branch during program review, when government spending in general was being reduced. When I became minister some labs were scheduled to be closed. I stopped their closure. At least I stopped the ones that hadn't already been closed and sort of put a moratorium on those closures until more could be learned about where we should go.

I appointed a science advisory board of eminent distinguished scientists who are giving me regular advice on what we should do to get the right science capacity in Health Canada. We're budgeting and spending money in order to meet their recommendation that we add to the scientific capacity in the department to do the job we need to do.

Let me make a point here that I think is important. We're not determined to go backwards and re-create the labs of the 1950s or the 1960s. We want to go forward and create the labs we're going to need in the future. Interests change, priorities change. Just because the Canadian Health Coalition thinks we should re-create the labs of the past does not mean it's good policy, Mr. Chairman.

Ms. Judy Wasylycia-Leis: Well, in your press release you stated there were 11 labs you would be reinstating.

The Chair: Ms. Wasylycia-Leis, please.

Ms. Judy Wasylycia-Leis: Sorry. I guess it wasn't clear.

Mr. Allan Rock: What we have to do, it seems to me, is make sure we have the capacity to deal with the issues of the future, not the issues of the past.

The Canadian Health Coalition should also know that we're going to have peer-reviewed research in the future, so that scientists within the department will be justifying to their peers the way they're spending their time, their efforts, and the public's money in lab work.

As to the details of how the $65 million is reflected in the estimates, I might ask the deputy to identify that for Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: A point of order, Mr. Chairperson.

The Chair: Let's have the answer, and then you have another one.

Ms. Judy Wasylycia-Leis: Okay, thank you.

• 1625

Mr. David Dodge (Deputy Minister, Department of Health Canada): Mr. Chairman, we would be happy to provide the committee with a detailed work plan with the additional amounts and our planned hiring over the next two or three years—not only hiring of new people but replacement of some of the older people who will be retiring—and our shift from areas that were of major interest in the fifties and sixties into those areas of high priority for the 21st century.

The Chair: That will be useful, Mr. Dodge. Thanks very much.

Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: The point of order I was going to raise was that I obviously wasn't clear in my question to the minister. I wasn't talking about projects that someone else had suggested be reinstated. I was talking about the minister's press release of October 1997, when he said that 11 labs, including those to do with genetically modified organisms, herbicides in foods, fungicides, detection of additives, dangerous bacteria, and so on, would be reinstated, recommissioned. Nine of those labs have not been. So my question is why not, and when will they be?

My other question had to do with the whole question of our medicare system. This may be my only chance to ask the minister any more questions in the committee. It has to do with the statement he made, as I understand it, to the Friends of Medicare that NAFTA will in fact kick in if Bill 11 is proclaimed. I would like to know if he has a legal opinion he could provide us with, and if he could let us know why he's proceeding without taking further action on Bill 11 in terms of the NAFTA implications.

Related to this whole issue is the 12-point privatization agreement, which we've raised in the past and haven't had any clear answers on.

Back in November we had a committee meeting. I asked the question and did get an answer back from staff in the department saying, yes, there were actual discussions between federal and provincial officials, that there were concerns from the federal government about principle 11, but those issues were resolved, and in fact the federal-provincial players came to an agreement and the agreement was passed.

So my question to the minister is, now that we know the full ramifications of that 12-point privatization deal, will he reconsider those points, and will he give us some assurances that in fact he might revisit them and lift them and rescind them?

The Chair: Thank you very much.

Mr. Minister.

Mr. Allan Rock: On the subject of the 12 principles in Alberta, there was no agreement between the Government of Canada and the Government of Alberta. We've made that clear.

We've also made clear, Mr. Chairman, that nothing on that piece of paper will stand in the way of our enforcement of the Canada Health Act. Nothing diminishes the principles of the Canada Health Act. Nothing reduces the authority of the Government of Canada to enforce them. So that document will not stand in the way of our protecting medicare. Alberta can publish the principles it likes; the principles of the Canada Health Act are those that govern us, and we will make sure they are respected.

In terms of NAFTA, we don't publish government opinions. It's not the practice of the Government of Canada. But I did speak to this, and I said that we've examined NAFTA and Bill 11 and came to the conclusion that the dire threats, or the dire concerns, that were expressed by some of the opponents of Bill 11 were not borne out, that in fact we could not find in NAFTA or in Bill 11 evidence that its mere adoption would require other provinces to open their systems to competition from foreign companies to deliver health care. So there was nothing in NAFTA that justified our taking action in relation to Bill 11.

I read the opinion of Mr. Appleton. I respect Mr. Appleton, who is a good lawyer. I read it carefully more than once. Mr. Appleton does not say either that the adoption of Bill 11 will result in every other province having to open up its health system to private enterprise.

What Mr. Appleton points out is that under chapter 11 of NAFTA there's a possibility that if, as has now occurred, Bill 11 is adopted and if foreign firms compete for the contracts to deliver services, after the next election in Alberta when the Liberals are in power and they repeal Bill C-11, then there may be a claim by those foreign firms for compensation under chapter 11. That is a possibility Mr. Appleton has identified, and I think that's an interesting point. But beyond that, I don't think the NAFTA argument can be shown to have the substance that some have claimed.

I believe that responds to the questions that were put.

The Chair: Thank you very much.

Ms. Judy Wasylycia-Leis: And the labs.

The Chair: Ms. Wasylycia-Leis, I'm sorry, we've already used up more than the minutes—

Mr. Allan Rock: Mr. Chairman, on the labs—

The Chair: Yes, of course.

Mr. Allan Rock: —let me get you a written response and find out which labs have been reopened and which haven't.

• 1630

The Chair: Great. Thank you.

Mr. Thompson.

Mr. Greg Thompson: Thank you, Mr. Chairman.

After that last comment on the next election in Alberta, maybe the minister might have his mental health examined. That's my only cheap shot of the day, Mr. Minister.

I just get the feeling that the federal government is out of sync or pattern or step with the provinces when it comes to health care. The reason I say that goes back to the 1997 election and promises made by, I guess, your party, red book two, the Prime Minister, whatever, in regards to the introduction of some new programs, specifically pharmacare and home care. I think in and of itself no one would disagree with that, but what we're hearing from the provinces is that there is no cooperation there, obviously, because they're under siege back home, trying to support primary care, the core givers of primary care.

So they're saying “Listen, we've got new programs. Talk to us first, but don't throw something out there that we can't handle.” And again they go back to the cuts—and I often refer to them as draconian cuts—that the government took after the 1993 election.

It seems to me that the atmosphere, Mr. Minister, was poisoned, not by you specifically but by your government, following the 1993 election, because those cuts were very much unilateral and very much directed at the provinces, and that has led to this poisoning of the atmosphere. Now the system is under crisis, particularly, Mr. Minister, in the poorer provinces, and I want to remind you that I come from one of those poorer provinces. There is a great disparity in this country between what's happening in downtown Toronto and what's happening in rural New Brunswick, as an example, and we could say the same thing for rural Manitoba or even rural Ontario. I suppose you could even suggest that.

Anyway, Mr. Minister, what I'm moving to is this dichotomy between the rich and the poor, rural and urban. It appears as if you're at a point where you can actually get all the players in the same room to talk intelligently, to discuss in a cooperative fashion where we fix it, because it comes back to this finger-pointing. I point at you and you point back at me, and at the end of the day nothing happens. I would just remind you that you've been there for seven years, but it seems as if the situation is getting worse in terms of cooperative agreements between the provinces, and the federal government heading off in directions that the provinces don't want to go and can least afford.

I'll stop there, Mr. Chairman. I might have a minute or two to conclude, if you're willing. I know you're quite generous today. Thank you.

The Chair: Thank you very much.

Mr. Allan Rock: Thank you, Mr. Chairman.

I'm not by nature a partisan person—

Some hon. members: Oh, oh!

Mr. Allan Rock: —although I'm learning.

Mr. Greg Thompson: Please don't mention the $42-billion deficit. I've heard that for seven years.

Mr. Allan Rock: Mr. Chairman, I have to tell you, it's very difficult to sit here and listen to Mr. Thompson complaining about the cuts that were made necessary—

[Editor's Note: Inaudible]

Mr. Greg Thompson: ...$42 billion.

Mr. Allan Rock: Cast your mind back to 1993 and what it was we all heard at the doors when we were campaigning: we've got to get that deficit under control. What was it we heard in the fall of 1993? Order number one for the Government of Canada, newly elected, was to avoid bankruptcy, avoid the World Bank and the International Monetary Fund coming in and putting us into receivership.

Mr. Greg Thompson: That's the same old story, Allan.

Mr. Allan Rock: It may be the same old story, but it's the truth, Mr. Chairman. We had to restore fiscal sanity to this country after nine long and arduous years of Conservative mismanagement.

Now, let's get that out of the way, but it had to be said. You have to live with that—

Mr. Greg Thompson: Okay. Thank you, sir, for getting that out of the way. Now let's get into some real meat and potatoes.

The Chair: Mr. Thompson, please, just listen.

Mr. Greg Thompson: I'm sitting too close to the minister just to pass all of this up, Mr. Chairman.

But thank you again for your intervention.

The Chair: You've now asked a question; at least I think it was a question. It seemed to be just a statement—

Mr. Greg Thompson: This is like a drive-by shooting or a drive-by—

The Chair: Do you want to listen or do you want to keep talking?

Mr. Greg Thompson: No, I would love to listen, please.

The Chair: Then why don't you do precisely that.

Mr. Allan Rock: All right, let's get on to the other elements of the question.

As to new programs, Mr. Thompson speaks about home care as though it's some kind of—in fact some of the premiers described it as a boutique, as though it's some kind of hobby horse of mine or a pet project. In fact, Mr. Chairman, every province in this country—some more than others—is investing very considerably in home and community care.

• 1635

I was in Shediac, New Brunswick, not long ago. I met with 30 nurses before they went out on their morning shift in what they call the extramural hospital—home and community care. Mr. Chairman, they begged me for a more robust federal role in home and community care. They asked for more federal support for home and community care.

In Grand Falls, New Brunswick, no more than a month and a half ago, I met with a group who said to me that their single greatest gap was financing for home and community care. They spoke to me about the unequal standards across the country and the great need, and they asked me to work with the Government of New Brunswick to try to meet it.

I know there are a lot of urgent problems in the primary care sector. I know we face a range of challenges, from a shortage of doctors and nurses and not enough information technology to a renewal of medical infrastructure, but home and community care is an increasing and an important element of health care in Canada.

Mr. Chairman, I'm now in conversation with all of the provinces to talk about the whole of this agenda and to find ways in which the Government of Canada can work cooperatively with the provinces to address these needs.

Mr. Thompson and Mr. Mills made reference to the acrimony between certain governments. I don't think we should take the Government of Ontario as being typical. They seem to be determined to be unpleasant. They buy ads, spending money that could much more readily be spent for MRI machines to relieve some of the waiting lists you talked about. They're almost determinedly unpleasant in federal-provincial relations.

That's not true of all the provincial governments. I met last week for a couple of hours in Vancouver with Minister Michael Farnworth of the British Columbia government. I spoke on the telephone recently with the ministers of health of Alberta and Manitoba. I recently met with the ministers of health of P.E.I. and Nova Scotia to pursue an agenda of constructive change.

I think we can do it, and I think we will do it, Mr. Chairman. Don't take the Mike Harris approach as being typical. It's not. A lot of provincial governments out there are very anxious to work with us toward constructive answers to these problems. That's the agenda I'm interested in, and that's what I'll concentrate on in the time ahead of me.

The Chair: Thank you very much.

Mr. Szabo, please.

Mr. Paul Szabo (Mississauga South, Lib.): Thank you, Minister, for appearing before us.

I want ultimately to get to the National Forum on Health, which I think produced one of the most important documents for the assistance of Parliament in terms of priorities and planning.

Recently I came across some statistics that show that the Canadian and United States governments spend approximately the same percentage of GDP on health care. Canada is slightly lower, but they're roughly equal in terms of the government contribution. The real difference lies in the amount of money spent by individuals, the private spending on health care. Canadians spend 2.5% of GDP on health care. In the United States it's 8.5%. So in total, public and private spending on health care in the United States is about 15% of GDP, and in Canada it's about 9% of GDP. These are 1997 numbers.

Interestingly enough, when you go down the list of Canada, the U.S., Germany, France, Italy, Spain, and the U.K., Canada's life expectancy in 1997 was 79 years of age, the highest life expectancy of any of those countries. For the United States it was 76 years of age, the lowest life expectancy of any of the G-7.

I go back to the National Forum on Health. There were two very important things in there for me. One was the observation of the importance of investing in children. That's very important, and it has helped me in some of my work.

Even more significantly, and Madame Fortier well knows, one of the most critical observations made by the National Forum on Health was that there appeared to be enough dollars in the system but we weren't spending them very wisely. When you consider how many dollars are being spent and how it might translate into healthy outcomes for Canadians, it appears that more money is not necessarily translating into greater life expectancies and generally better health outcomes.

At the end of 1996, a two-year study done by experts and commissioned by the Prime Minister, who was the honorary chair, told Canadians, we think there's enough money here but it's not being spent wisely. How is it that we knew in 1996-97 that this dollar thing had to be addressed, and yet today it seems to have just blossomed into the whole essence of the discussion on health care? Why are we talking about dollars? Why aren't we talking more about the priorities and planning to continue to improve the health care of Canadians?

• 1640

Mr. Allan Rock: I think the question, Mr. Chairman, touches the very heart of the issue we face, and it's very well put. In fact, if you go down the list, you'll find that Japan spends even less percentage of GDP, 7%, and their life expectancy is even higher than ours. So spending doesn't necessarily correlate with health.

I think one of the reasons America spends so much more non-public funding for health care is administration and overhead. The fact that we have a single-payer system, where only the government provides the money, reduces the cost enormously. In the multi-payer system in the States, where you have Blue Cross and other insurers, they have the expense of rating the population and determining risk and deciding whether or not to pay a claim. The cost of administration, billing and collecting, is huge.

A professor from the States was in Toronto last year for a conference I was at, and he said there was a hospital in Boston, Massachusetts, with the same number of beds as there are in the Toronto Hospital. The hospital in Boston had 317 people in the billing and collection department, and the hospital in Toronto had 17. That was the difference between them.

Time and again economic studies have demonstrated that our system is an economic advantage for our businesses because it's so cost-effective and efficient.

Coming to your point about the forum, I agree with you about the report. Just after I became Minister of Health, I asked the forum to reconvene so that I could meet them and talk to them about it. They came together in the summer of 1998. I asked them about this statement that there was enough money in the system and it was just a matter of management. At my request they took another look at it, and in the fall of 1998 they gave me a letter saying that in fact demand, inflation, and increased costs were such that more money was required, and that was the foundation for our health budget of February 1999. I should provide you with a copy of their letter, which was really an addendum to their report.

Your central point, if I may say so, is that it ain't just the money, it's how you spend it. It's how you organize your health care system. It's how you deliver your services. That's why I have consistently said on behalf of the government that we're delighted. I want to see more federal money in health care for a number of important reasons. I think it's needed. I think to maintain our moral authority we should be a bigger contributor. I'd like to see that money go to encourage the kind of innovation that's needed.

But what I've consistently said on behalf of the caucus and the government is not just more money for the sake of it, but let's couple more money with a coherent, intelligent plan as to where it's going to go to make a real difference, the kinds of things you're talking about, Mr. Szabo.

That means different ways of organizing and delivering primary care. It means strengthening care outside the hospital. Twenty-five years ago almost half of all health dollars were spent in hospitals. Now it's less than a third. Those people go somewhere. Too often they go home to an empty place if they're not lucky enough to have a family member to look after them. So there's the provision of home and community care, better use of information technology to provide the sharing of information about patients among providers and to link the fragmented parts of the health care system, more doctors and nurses, more specialists, more health care workers generally, and the renewal of health infrastructure. These are surely the priorities, and if we're going to manage better, putting these together and putting them on the ground as quickly as possible in a coordinated way should be our objective.

I'm not a provincial minister of health. I'm the federal minister of health. I respect the provincial jurisdictions, and I don't want to manage their health care systems. I have troubles enough of my own. But I'd like to make sure that our money goes to help those provincial ministers broaden and accelerate the innovations they've already started so that we can have a better organized system, deliver health care better, and couple dollars with good management to produce a better result.

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

The Chair: Thank you very much.

We'll now move to round two. We're very cognizant of the fact that you have to leave at 5 o'clock. So in three-minute rounds, we'll try to get in as many questions as we can.

We'll go to Mr. Elley first, then to Ms. Redman and Mr. Ménard.

• 1645

Mr. Reed Elley: I have loads of questions, of course, but only three minutes.

I want to thank the minister for being here today. We do appreciate his being here. It's part and parcel of the working relationship that we should have together.

From time to time, Mr. Minister, you have said that you want to be seen as the protector of the principles of the Canada Health Act. Indeed, you should be seen as that; it's part of your government's responsibility. Just a few minutes ago, you talked about a “coherent, intelligent plan”, which I suspect would be part and parcel of protecting those five principles of the Canada Health Act.

I have two questions. First, in my home province of British Columbia, it has been a common practice over the last number of years, both in this present government there and the previous one that I know of, for them to send their Workers' Compensation patients who have knee injuries to a private clinic in Alberta for treatment. They do that, of course, because they want to get those people back into the workforce and stop paying the Workers' Compensation money. To me, that is a direct violation of the Canada Health Act's principle of accessibility. I believe it's queue-jumping. I would like to ask you why you have allowed that to take place if you're the protector of the Canada Health Act.

The Chair: Thank you.

Mr. Rock.

Mr. Allan Rock: Mr. Chairman, the Canada Health Act contains an express provision exempting Workers' Compensation cases from its application.

Mr. Reed Elley: I would ask you another question, then, about portability. Why has the Province of Quebec—and I believe other provinces in Canada, from time to time—been allowed to simply reimburse other jurisdictions at the going rate, in this case, of the per diem of the Province of Quebec when their citizens are in other provinces' hospitals? They will not pay the going rate of that province. Why is that allowed to happen? It seems to me that this violates the whole question of portability.

Mr. Allan Rock: My understanding of the practice is that services are provided and then governments, between themselves, settle up their accounts. As to the amounts that are paid, that's left to discussions between provincial governments.

Mr. Reed Elley: And you have no role to play in that at all?

Mr. Allan Rock: Well, so long as the citizens of Canada can get access to the services across the country, the principle of the Canada Health Act is respected. What discussions there are between provincial governments as to the manner, method or amount of payment are between them.

Mr. Reed Elley: However, if I were to bring this to the attention of one of your “police”, would they investigate that for me and take it to you?

Mr. Allan Rock: Well, when you—

A voice: Only if the service wasn't provided.

Mr. Reed Elley: Is that what your people in the field are to do?

Mr. Allan Rock: The deputy is talking about how, if the service isn't provided, then we'll get involved, but ordinarily the provincial governments deal with this directly between themselves.

Mr. Reed Elley: Do I have any time left at all, Mr. Chair?

The Chair: No, you don't.

Mr. Reed Elley: That's a pity. I wanted to ask what the plan was.

The Chair: Thank you very much.

Ms. Redman.

Mrs. Karen Redman (Kitchener Centre, Lib.): Thanks, Mr. Chairperson.

Minister, in a previous question you talked about innovation. I have to tell you that this committee had the opportunity to study Bill C-13, which is the bill for the Canadian Institutes of Health Research, and I find it really an exciting initiative.

Coming from Kitchener-Waterloo, which is an area that is not only designated as officially underserved medically but also has two universities in its community, I know that the Canadian Institutes of Health Research were really welcomed by those communities, not only as a way to bring about medical research but also as a way to attract the best and brightest, to keep them in Canada, and then see research and innovation stay in Canada. I'm wondering if you can flesh out a little bit for us how we see those institutes doing all of those things.

Mr. Allan Rock: Well, as you know, because you not only considered but improved the act with the modifications you proposed, the institutes are unique because they deal not only with medical research, as has been done since the 1930s in Canada, but with health research. They will seek to cluster or connect people who are investigating everything from the biomedical dimension of health and disease in the laboratory, looking at molecules and examining their interaction, through to clinical research, where they test the effects of different treatments or therapies on the patient population, through to those who are doing research in terms of services, to find out how we can better respond to treatment needs in different ways. Fourth, there are those who are looking at health determinants, examining what it is about lifestyle or diet or the environment that has an impact on health.

• 1650

No other country has undertaken this kind of coordinated attack on health research in the same way, and it has captured the attention of the world. I can tell you that I've heard from health authorities from literally around the world who are wanting a copy of our statute, who are wanting to get at the work that lies behind it. Of course, the work comes from the research community itself. This was not imposed by government. This approach was inspired by scientists.

I'll give you an example that will bring it to life. We're seeing an increasing incidence of Alzheimer's disease in the population. Once the institutes are up and running—and there will no doubt be an institute which, in whole or in part, will be devoted to aging and the illnesses of aging—if they look at Alzheimer's through the institutes, they will be able to look at all aspects of the illness.

Biomedically, what are the mechanics of the disease? How does it start in the brain? Where does it come from and where does it go? What are the physical effects? Clinically, what courses of treatment are most effective? Is it pharmaceuticals? Is it some other intervention? Can surgery help? What about replacing glands or other sources of hormones? Third, what about health services? What's the best way of dealing with the Alzheimer's patient? In the community? In an institution? In the hospital? And lastly, there are health determinants. What is it about our environment, if anything, that is leading to an increased incidence of Alzheimer's? What is about diet or lifestyle that can contribute to the problem or prevent it?

All of this work will be going on in a coordinated way, with each of the investigators sharing the information, with a higher level of overall funding, and working toward an acceleration of discovery through coordination.

Mr. Chairman, that's never been done before in a structured way. The research community is naturally very excited about it. I believe it's going to make a real difference in the quality of health research, and ultimately in the health of Canadians.

Mrs. Karen Redman: Thank you.

The Chair: Thank you very much.

[Translation]

Mr. Ménard.

Mr. Réal Ménard: I have three brief questions and a comment.

The local press in the Saguenay mentioned the establishment of a national health centre. I can send you a copy of the article. I would like the Minister to say something about that.

Second, do you think that your government has responded honourably to recommendation No. 1 of the Krever Commission?

Third, what percentage of the federal government expenditures goes to each one of the provincial health systems? You will remember that when the CAP was set up, the health systems were to be funded equally by the federal government and the province. Since then, we get the impression that a considerable disproportion has occurred between the responsibility the provinces must shoulder compared to your government's.

Here is a brief comment. Your remark earlier regarding what Mr. Landry said was obviously an error. I know that the idea of quoting your own Minister of Finance perhaps make you more uncomfortable because you share an ambition. However, if you want to quote the Quebec Finance Minister, I would ask you as the intelligent man you are to quote him correctly.

Those are my three questions. I expect to receive a list of Health Transition Fund projects for each of the provinces. Can I have that today, Minister?

Mr. Allan Rock: Mr. Chairman, first of all, it was on page 1 of La Presse—they may have made a mistake, but it would be a first—that I read what Mr. Landry said. He allegedly said...

Mr. Réal Ménard: Don't say that.

Mr. Allan Rock: He said that the problems within our health system were not attributable solely to money, but also to management and organization. I memorized those words because I saw how important the statement was. And that is exactly what Mr. Landry said.

[Editor's Note: Inaudible]

Mr. Réal Ménard: ...240 million?

The Chairman: Please, please.

Mr. Allan Rock: That is the first time that I have ever agreed with him.

[Editor's Note: Inaudible]

Mr. Réal Ménard: —

The Chairman: Quiet.

Mr. Allan Rock: It was a remarkable occasion.

In the Saguenay—Lac-Saint-Jean, I had the pleasure of visiting Chicoutimi and Jonquière, a few months ago, to meet with scientists in the region. I met with a group of scientists and specialized doctors. They explained to me that there was considerable expertise in the region in three areas of health and research: genetic diseases, addiction and industrial accidents.

• 1655

They explained to me that they needed funding to support their efforts. They asked whether the government of Canada could help them to fund their research. I explained what the health research institutes are and I undertook to determine whether it would be possible to help them. Within my department, we have examined whether it would be possible to have researchers in an outlying region attached to one institute or another once they have been created by the board.

I therefore hope that the government of Canada will be in a position to help people in the regions develop their expertise and share their results with researchers elsewhere in Canada.

Secondly, regarding Mr. Justice Krever's first recommendation, yes, I think that we have respected it.

Thirdly, regarding the proportion that respective governments contribute to our health care system, I saw in the department a document stating the percentages for each province and I will send that to your office tomorrow morning.

Mr. Réal Ménard: You are such a dear.

[English]

The Chair: Thank you very much.

We have Monsieur Charbonneau, please.

[Translation]

Mr. Yvon Charbonneau: I have two questions, Minister. We'll get right to the point given the hour. I would like to give you an opportunity to tell us where we are at in the transition toward the implementation of health and research institutes: the appointment of a director general, the appointment of board members, the determination of the institutes. If that has yet to be done, when do you think it will be done? That's my first question.

Mr. Allan Rock: Mr. Chairman, I expect that the Prime Minister will be a position to announce the name of the chairs and the members of the board of the various institutes within the next few weeks. The bill has been adopted and is now in force. Within the next few weeks, we will have the list of members of our next board and we will know who the chairman is.

Mr. Yvon Charbonneau: As to determining where the institutes will be, what time horizon are we looking at?

Mr. Allan Rock: That is a decision that rests with the board. Let the board have their first meeting. Then, I intend to send a letter indicating my recommendations to the chair, once he or she has been appointed. That is a decision to be made by the board.

Mr. Yvon Charbonneau: Thank you for your response. As this question attracts a great deal of interest and expectation from all quarters, and we have all been receiving phone calls on the matter. We therefore want to be informed as to what is going to happen. So, the determination of the institutes is an aspect that will be dealt with by the board.

In my second question, I want to get back to these hundreds of millions of dollars that are available to the provinces. We hear of some $850 million for Quebec, and I know that the same applies to a certain number of other provinces.

What is problematic to some members of the opposition, Mr. Chairman, is that so much time is spent making demands upon the federal government, calling upon the Minister, the Minister of Finance, the Prime Minister and just about everybody else to have more money put at the disposal of the provinces, and then to realize that there are some hundreds of millions and perhaps even over a billion dollars that are safely tucked away in bank accounts, at the disposal of the provinces, in order to meet their needs. That is what they find annoying.

• 1700

In certain cases, and in a certain very well-known province, we weren't aware of this and we were very surprised to hear that some money was available to the province. The Minister of Finance of said province was aware of it but he also knew, because he is a man of great experience, that there are issues of reorganization which have to be considered.

I would like to hear from you, since you are here before us, whether there are any conditions attached to the use of to how these funds: $850 million here, several hundreds of millions of dollars over there, available left and right. Are these funds immediately available to them as soon as the provinces need them? There are waiting lists, there aren't enough specialists in hospitals, there aren't enough nurses, etc., we are told. And some of these provinces feel that they have to send some patients to the United States because the services do not exist here.

Now within these provinces, Quebec more specifically, could these sums of money be used immediately, or are they under some constraint to wait and wait because of some obscure regulation?

Mr. Allan Rock: First of all, there are no conditions attached to the money. Secondly, yes, the money is immediately available to all the provinces.

[English]

The Chair: Thank you.

The last questioner is Ms. Wasylycia-Leis, and then we'll wrap up.

Ms. Judy Wasylycia-Leis: Thank you, Mr. Chairperson.

I can't help but express some frustration with this afternoon's session around lack of details pertaining to this huge budget of the Department of Health. I'm tempted to ask the minister, if you'll pardon me, a question that was asked by someone else of me today, and that is, is the minister on autopilot when he makes a lot of pronouncements and recommendations, and then nothing ever is done to follow through on them?

My comment to the minister today in the House was, given what happened in Walkerton, surely we should all be learning some lessons from that and trying to see if our own systems are doing the job. Yet he was dismissive of those kinds of questions in the House today, and today he cannot tell us why his own directive to recommission eight important labs in terms of food safety hasn't been followed through by anyone in his department, after a whole year.

When the budget came down last year, $65 million was promised for food safety. We can't get one piece of information about how many scientists have been hired or how many labs have been recommissioned—no details. Yeah, sure, I'm going to get it from the deputy, just as I got, in October 1999, another list saying “Well, there are these plans spread over three years. We don't know where the staffing positions will go and we can't say who it will be, but that's the way it is.”

So what the heck are we supposed to take from this in terms of food safety? We can't even tell from this big, fancy book how much of this expenditure on health protection is going to food, drugs, consumer products, and the environment. There's no breakdown. There's no accountability. Why can't we at this point in time get some details so that we can make a proper assessment of whether or not this government, our government, is doing its job when it comes to health protection?

The Chair: Thank you.

Mr. Rock, you have the final word.

Mr. Allan Rock: Well, as the member has observed, we provided a book—

Ms. Judy Wasylycia-Leis: Yes.

Mr. Allan Rock: —which details the money that's being asked—

Ms. Judy Wasylycia-Leis: No, it doesn't.

Mr. Allan Rock: We've asked Parliament to appropriate money for all of those purposes, Mr. Chairman. The detail in that book is really quite considerable. The member has asked a specific question about nine labs, and I've undertaken to provide a detailed written response. The deputy has also said he'll provide details in relation to the $65 million from last year's budget and its allocation.

Mr. Chairman, surely what's clear here is that we are rebuilding the Health Protection Branch of Health Canada. The deputy and the associate deputy have reorganized the department so that it's a more rational division of responsibilities. They have asked for and I have asked on their behalf at the cabinet table for more money so that we can rebuild Health Canada's capacity. That money has been provided, and we are apportioning that money so that we have the strength and the depth to meet our responsibilities to Canadians in health protection.

I'll give you an example. One of the subjects of concern I know this committee has identified in the past is the time taken for drug approvals. We have brand-new pharmaceutical products. The innovators come to the department and ask for approval so that they can put it on the market. In the period from 1994 until about 1999, we brought the average waiting time before those new products were approved from about 44 months down to about 15 or 16 months. Then last year it started to go up again, to 17 or 18 months, and that was a signal that things were not going in the right direction, obviously.

• 1705

We examined the issue and found the applications were spending too much time in the in-basket, not being looked after. The deputy and officials created a plan to deal with that by identifying how many more trained people we'd need, what kind of different process we'd need to get through those applications more quickly, better use of electronic filing to avoid the paper burden, and more sharing of information within the department to accelerate the approval process. We went to cabinet and got more money. We're about to spend it for the purposes we identified to bring those averages down again and to get drugs approved more quickly.

That's the kind of thing we're doing, Mr. Chairman. Those are the kinds of changes we're making. We're not in this just to mark time. We're in this to make it a better Health Protection Branch.

I'll provide information to the honourable member. I'll give her all the details she wants, all the detail I can find. I'm not withholding it because I don't want to give it to her. I frankly can't remember the details on the nine labs she asked about. I'll find out what those details are and I'll furnish them to the honourable lady as soon as I can.

The Chair: Thank you very much, Minister Rock. We appreciate your time today for the estimates and the other questions associated with that.

Mr. Dodge and Madame Fortier as well, we appreciate your time. Thank you very much.

We're going to, as a committee, deal with the motions we indicated at the outset. I've sought further—

Mr. Réal Ménard: Can we have a break for five minutes?

The Chair: No, we'll carry through.

I sought further legal clarification with respect to item two. As it's now standing, it is in fact passed. So what we need is a motion. If we don't want item two to stand as is, we need a motion to rescind.

Motion two is that the Standing Committee on Health immediately commence a study on all related problems surrounding the state of health care in Canada. I have sought further legal clarification, and in fact that has now been carried, because you cannot change a vote. So as it is now, it's carried. If we don't want that, we need a motion to rescind.

Mr. Bob Mills: Do we have to give notice?

The Chair: Notice? Yes, 48 hours' notice.

Mr. Bob Mills: Okay.

The Chair: Seconded by Mrs. Redman. So we'll bring that back at the appropriate time.

Item three is that I be removed as chair.

Mr. Ted McWhinney: On a point of order, I have great respect for Mr. Mills—we were colleagues on the foreign affairs committee, and he was constructive and useful—but I'm puzzled by this motion, which comes in as an arrière-pensée to motions on quite dissimilar matters.

You're basically taking us back, with a motion without any specifications or particulars, to a Strafford and Laud type of procedure, the 17th century bill of attainder. I don't see how we can pass a motion in these terms. I would therefore—

Mr. Bob Mills: Well, we're going to have to meet, are we not, Mr. Chair?

Mr. Ted McWhinney: I was about to move therefore that the motion be not put as a procedural motion.

Mr. Bob Mills: You've been given notice and it stands.

Mr. Ted McWhinney: Well, the large issue is, is it constitutionally receivable? I don't think it is.

Mr. Réal Ménard: Well, you're wrong.

Voices: Oh, oh!

The Chair: Okay, let me think about your point of order for a minute.

On debate, Mr. Mills.

Mr. Bob Mills: Thank you, Mr. Chairman. I certainly—

Mr. Reed Elley: Are we debating this motion?

Mr. Bob Mills: We're debating this motion; is that not correct?

Mr. Reed Elley: On a point of order, Mr. Chair, I believe it is not proper for you as the chair, when this motion considers your position, to be in the chair. I think you should absent yourself from the chair while we're discussing this motion and have one of your colleagues take your place. I believe you'll find this is in order.

The Chair: I've given that some weight. It's up to me as to what I choose to do.

Mr. Reed Elley: Can we have direction from the clerk in terms of both Beauchesne and Robert's Rules of Order?

The Clerk of the Committee: I believe it is the chair's choice to delegate his position or to remain in the chair as it is debated.

The Chair: Okay, thank you.

Mr. Reed Elley: But he cannot speak to the motion.

The Chair: No, I don't intend to speak to the motion.

Mr. Mills.

Mr. Bob Mills: Mr. Chairman, first of all, I believe, as the mover of this motion, it's fair that I explain to you what this is all about.

A person, to be chairman, has to have certain qualities, and some of us do and some of us don't. Certainly I doubt very much that I would be a person to be a chair of a committee, simply because I would have great difficulty playing the role that's necessary to be non-partisan, to stay out of the debate, to listen to all of the members equally, and to try to encourage, no matter what party they belonged to, the solution of the problem that particular committee faces. I would exempt myself from that ability.

• 1710

I believe you should exempt yourself from that position, because you have some of the same characteristics as I might attribute to myself. You are combative. You are not cooperative. You are not constructive in working out a constructive solution to a problem. You are certainly partisan. I base this largely on, probably, my six years or whatever experience with Bill Graham on the foreign affairs committee, where he made a point of showing leadership, of always working with members of all opposition parties, treating them fairly, equitably, and not in an antagonistic fashion but in a conciliatory one.

We had some hard-nosed things to deal with in that committee. We had times when we were very far apart on issues, and yet he always stayed above that. He always stayed above that jab, that little extra spear that he could put in, that little extra confrontation that he could create, in order to make that committee work. As a result, all of us worked. We respected his authority. We respected his position.

Certainly when my colleague came to me, who is basically responsible for the committee actions, and said “You know, I just think this committee is totally non-functional. It's not working any more. Members of the opposition are constantly being badgered. We're not having meetings”—and he'll go on to tell the details, because he was here—I certainly felt it was time that such a motion be put. After consulting some others, certainly listening to my honourable colleagues from the NDP and from the Bloc and hearing what they had to say, and seeing it in the newspaper, reading it in their comments about this committee being non-functional, I felt it was time to change this.

Canadians, 75% of them, say that this is the number one issue for them. So this committee, above all, should be dealing with those questions, should be showing some leadership, should be helping the minister. I believe, if we could get that working relationship, we could in fact provide some answers that Canadians are looking for. They don't care whether it's federal or provincial, they don't care whose issue it is, but they want solutions to the problem.

Now, I had not had much experience in this committee. You pointed that out very clearly to me. You said you were disappointed in me because I had taken on this role, and you antagonized me in the first ten minutes I was in this committee. I don't think that's your role. I don't think it's up to you to tell me what I should or should not be doing for two months, and saying that the opposition obviously had done nothing on health care. You forgot the two supply day motions, you forgot the number of statements or the questions that other members had asked. Immediately you went after me, so to speak, right at the first meeting I attended. Of course there are minutes of the meeting. We can read them, but I don't think there's much point in that. Why go back through that?

A good chairman would not have done that. A good chairman would have evaluated the members on the committee and said “We've got to get these guys to work together. We've got to neutralize some of the antagonism, some of the caustic comments.” Again, today, you saw that. There's not a respect there. Some of us can be chairmen, and some of us cannot be chairmen, because of our own personalities, because of our own backgrounds, because of our childhood, whatever. There are some who can and some who can't.

So, members of this committee, I put forward that our present chairman is not such a person, that he should be replaced and that we should ask the government to put someone in this place who could fill that role in the way I have described.

• 1715

That's why the motion is there. It's done honestly. It's done above board. It's not in any particular antagonism toward the chairman. We haven't been in a fight outside of this House or anything. I don't think we've ever met outside of this House. But seeing how this works, seeing what the other members have said, it just seems to me incumbent on us to do something about this.

This is the action, then, that we've gotten to. I really believe that if you want cooperation, if you want this committee to be functional in this most important area, we should settle this right now, pass this motion, and move on. I believe that will be good for us as parliamentarians, good for this place, good for Canada.

Thank you, Mr. Chairman.

The Chair: Thank you very much.

[Translation]

Mr. Ménard.

Mr. Réal Ménard: Mr. Chairman, first of all I would like to say that it's always a touchy issue to discuss the chairmanship and how the committee is run. I think that all of us, over and above our partisan leanings, hope to work well together. I think that I can say that since 1993, I haven't made any personal enemies. Even if I'm a little hyper sometimes when I put my cards openly on the table, I don't think that the debates ever have to become personal.

Furthermore, contrary to what Mr. McWhinney was saying, whose rigour has by the way always been an inspiration to me, I believe that it is the committee is prerogative to discuss how the chairman carries out his duties. With all due respect, I don't think that he has all the information required to assess the manner in which you have discharged your responsibility, since, perhaps because he has a very full schedule, he was not one of the members most often present at this committee.

That being said, Mr. Chairman, there is a problem as to how the committee is managed. I am among those who feel that the first question we must ask ourselves is the following: Do you share our point of view, namely that there is a problem as to how our work is being managed, and our relationship? Are you willing to take... I don't necessarily want you to leave per se, but I do want to have a guarantee that you will take appropriate measures and that you will be sufficiently sensitive—and I believe that you can be—to the remarks that colleagues will make to you so that you can perhaps adapt and make changes.

I am not expecting you never to be partisan, which is something I don't believe in. You belong to a caucus and I can understand that. What bothers me is the way that you direct the work of the committee, the fact that you are too controlling.

I'll give you an example of something that, I think, led us to the mess that we are in. When you introduced the letter from the Justice Minister concerning mental health, we were on our way to an agreement. We discussed the possibility of my meeting with the parliamentary secretary to find some way to work out the mandate. At the very end of our discussions, without notice and in a very cavalier and disrespectful manner, you put the motion to a vote, whereas we had agreed that I would meet with the parliamentary secretary and that we would try to work out a mandate. We had even identified the possibility of working on the tobacco issue. In acting this way, Mr. Chairman, you have lost a great deal of credibility. I want a guarantee that for the rest of the committee's work, we can count on you to bring us together. I know that being a committee chairman is not an easy job, that it means extra work, and that the extra work is unpaid, and that we all have a heavy workload.

Mr. Chairman, can we count on you to consider a certain number of factors that might ensure a more congenial working atmosphere within the committee? I believe that you will be the greater for it if you recognize that some things have to change. It is true that all members could be a little more disciplined, but the difference is that you are the person in charge.

You have a tendency to turn towards the console operator to cut us off. I have been here since 1993 and, as a member of Parliament, I must have sat on at least 15 committees. I have never seen anyone look as authoritarian as you do when you disagree with someone and decide to cut that member off.

It is that type of attitude which brings me to suggest that you should revisit your relationship with the committee members and the way in which you conduct the meetings.

• 1720

If you can guarantee that you are prepared to correct these irritants, then I think we can ask our colleagues from the Canadian Alliance to withdraw their motion and to continue to work with you until June. Let us say that you will be sensitive to that. Let us not be mistaken; if the government uses its majority to keep you on as chairman, it will have problems because we will not agree to work with someone in whom we have no confidence.

Everyone must make amends. I believe you should admit that, in the past, your approach has been much too directive and not sufficiently collegial. I'm not sure how my colleagues feel, but if you were to acknowledge that and agree to change those aspects of your personality that are somewhat abrasive, then, I would be willing to give you a new vote of confidence and work with you. I believe you should be modest enough to correct these irritants.

[English]

The Chair: Thank you very much.

Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: Thank you. I'll just make a few brief comments and then I have to leave for a 5:30 meeting.

I have a great deal of difficulty with the motion from the point of view of identifying one person as being responsible for the serious problems facing this committee.

I agree that this committee is dysfunctional. I've said this to the media. I think we're not working together as a group, setting our own agenda, and playing an important role in the whole health field. As I think through what is the cause of this problem, I can't say it's necessarily the chair. Like Reed, I've been on this committee since the beginning and we've gone through three chairs. I can't say that Lynn is any worse or any better than the other two we've had. I think the problem is not the chair. The problem is the way in which this committee is manipulated by the office of the minister. I don't know how else to put it.

When I raised the question today, the minister said we're our own masters, that we can do whatever we want. Well, how is it then that the only things this committee discusses are the things the minister suggests we discuss? He sends us a letter and we do it. How come there isn't any room to consider the other propositions that are put forward, some of the other recommendations that are made? We come down to what the minister suggests we should study and that's it.

If there is anything I'd like the chair of this committee to do, it's to feel that he has some independence and flexibility from that kind of control over our committee. Other committee chairs have done it. They've broken through that stranglehold by the government over this democratic process. If there's anything I'd like to say today, it's to give licence to the chair to break free from that misuse and abuse of our committee.

I am very frustrated with this committee, very frustrated. Time and time again we have come forward with recommendations, have made motions, and nothing ever goes forward unless it's something that the minister has established or deemed that we should study.

My question is to all of the Liberal members around the table. Why is that? Why is there no independence of this committee? Why don't we set our own agenda? What is the problem? Why do you feel you have to leap every time the minister says we should study something? Why don't you back up your committee chair and find a way that we can all feel we're playing a productive role in this committee?

When I was elected a member of Parliament, I thought the committee was supposed to be the epitome of democracy. I was told that this was a very important, vibrant part of Parliament, that committees had some flexibility in terms of setting agenda, that there wasn't the same partisanship, there weren't the constraints of Parliament imposed on the committee. None of that happened. In fact, it's just Parliament all over again and even worse.

So I'm very frustrated with the committee. However, I don't believe in picking scapegoats or blaming just one person for this problem. I think this is a systemic problem that has to be dealt with through our deciding as a committee to heave off the shackles of government interference and get on with doing the work that Canadians want us to do.

The Chair: Thank you very much.

Mr. Elley.

Mr. Reed Elley: I'm very sorry that it has had to come to this. Like Judy, I've been on this committee for two and a half or three years. I've been the vice-chair of the committee for three years.

• 1725

Quite frankly, Mr. Chair, I think there is a very strong role for you to play as the chairperson to achieve consensus. I've worked with three committee chairpersons, and quite frankly your predecessors had a much more consensual approach to the work of the committee.

We have only had one subcommittee meeting since you've been chair that I know of. In fact, this year our record of having meetings hasn't been great at all.

When I was elected as a member of Parliament, I came here to try to make a difference. We're all intelligent, committed Canadians who want to make this country a better place in which to live, and health care is a very important part of that whole fabric. I guess in the last little while I've been feeling that those of us in opposition are treated as if we have no brains, that we are not productive members of this committee.

Quite frankly—and I have to say this—it does stem in part from your performance in the House. It's very difficult for opposition members to come here and sit on this committee and give you cooperation and consensus when we're subjected to disrespect in the House. I have to say that because we believe this. I believe this. I think if we want to change that, there needs to be a different approach on your part and you need to work more with us as vice-chairs.

I know your predecessors would call me up from time to time and say this is what's coming down the pike, and we would talk about it. I would sometimes meet with them privately. And once in a while they would even allow me to take the chair. I know that's just a small thing, but it at least acknowledges that we are all part of this together.

Those are things I think we need to say to you. If this motion brings this out on the table so we can say it and get it off our chests and try to reach some kind of consensus about your leadership, then so be it. This is what is achieved, I hope. So I would say that in regard to this motion and hope you'll accept it in the spirit in which it's given.

The Chair: Thank you.

Mr. Szabo.

Mr. John Finlay: Mr. Chairman, a point of order.

The Chair: A point of order, Mr. Finlay.

Mr. John Finlay: It's now 5:30, and I don't want to cut off debate necessarily, but I was brought in here for this meeting, and we all have other things that have to be done about now. I'm wondering how long we should continue with this.

The Chair: I think your point of order is—

Mr. John Finlay: I think we should limit debate, and if we're going to have a vote, then have a vote. If we're going to go on and on and on, then I'm going to go on and on and on right out that door.

The Chair: Ms. Redman, point of order?

Mrs. Karen Redman: No. I would like to speak, if I may.

The Chair: Okay. I'm wondering if we shouldn't come back to June 7 for this, because there are other commitments.

Mrs. Karen Redman: Maybe it is a point. I'll go for a point of order then.

The Chair: Okay, point of order.

Mrs. Karen Redman: Not to jump queue on Mr. Szabo.

I would just like to really commend the opposition. What I'm hearing is some conciliatory middle ground.

I guess I would just like to say for clarification that Monsieur Ménard did offer the olive branch of withdrawing this motion. Personally, I commend him on trying to find a win-win solution to this. I'm wondering if perhaps when everyone has spoken we could go back to Mr. Ménard and flesh out that suggestion. To me, that seems like a good resolution to this for the committee.

The Chair: I think we're going to take a lot of time to do that.

In light of the other commitments, mine included, and I hear Mr. Finlay and others, I think what we need to do is adjourn this to June 7. I say at the outset that if we come to the end of the time, we would do precisely that.

Mr. Ted McWhinney: Unless Paul would take up the debate as clarification.

I thought Madame Wasylycia-Leis' position was close to Mr. Ménard's.

Bob, I think it would be helpful... I don't think it's a competition motion. You've made the points. Do you think you might withdraw at this stage? You have made the points very clearly. The chair will take notice.

• 1730

Mr. Bob Mills: Yes, I've been just listening, and obviously I hope the chair understands what everybody is saying around the room and certainly what my colleague across has said.

I've been used to olive branches. As Mr. McWhinney certainly knows, we've had lots of them. But I just feel the frustration of this committee as a new member of it. Yes, I'd be prepared to say that we could put that motion on hold and withdraw it, but I trust that it's going to make for a cooperative improvement and allow us to carry on and become more functional. If not, obviously there'll be more than just Mr. Finlay going to the door and it will be a pretty lonely committee here with only one party represented.

Mr. Ted McWhinney: Bob, I put it to you personally, would you take that initiative at this stage?

Mr. Réal Ménard: Can we have a point of order?

Mr. Bob Mills: The chairman obviously hasn't had an opportunity to speak, I think. I'd like to hear his comments.

Mr. Ted McWhinney: Maybe that conference would be best in private.

The Chair: Point of order.

[Translation]

Mr. Réal Ménard: Mr. Chairman, could we agree on the following point? Obviously, the Canadian Alliance will have to withdraw its motion, but I would like to make the following suggestion. You have heard what people have said and I think you are entitled to some time to think it over. I move that we adjourn the meeting. When we meet tomorrow, at 3:30, you may then tell us what you think about what we have said and how you intend to bring us together and do what is expected of someone in your position.

I'm prepared to give you the benefit of the doubt and to think that you will do your utmost to change things. I think we should all sleep on it. Let us meet tomorrow afternoon at 3:30. I am counting on your sensitivity and on your experience to say the right thing. We will then be able to continue our study of the tobacco issue, according to what our Alliance colleagues think.

Of course, if you want to be stubborn, which is something I do not expect, then we will have to vote on the motion. I know you are sensitive and open enough to return before us tomorrow afternoon and explain to us how you intend to ensure that we can all work together. I don't know how my Canadian Alliance colleagues feel about it, but we can reconvene tomorrow afternoon and give you an opportunity to express your feelings about what is being said today.

[English]

The Chair: I'm reluctant a little bit about tomorrow afternoon in the sense that we're so crowded with time. June 7 is what we agreed to at the outset.

Mr. Bob Mills: No, we didn't.

The Chair: I thought we did agree to that.

Mr. Bob Mills: No. I would like to hear Mr. Szabo too.

Mr. Ted McWhinney: I believe the committee remitted it to June 7.

Mr. Bob Mills: Nobody agreed to that.

Mr. Ted McWhinney: That's the procedure.

The Chair: We'll take that under 48 hours' notice. We'll bring that forward then at the next meeting when it's appropriate. That's a notice of motion that it be moved to June 7.

The Clerk: You would really need unanimous consent to delay debate on a motion that's on the table.

The Chair: Will we keep going today? Is that what we're doing?

Mr. Reed Elley: I think we should settle it.

[Translation]

Mr. Réal Ménard: Would you agree to meet at 3 o'clock instead of 3:30 and at that time tell us how you feel about what your colleagues have said?

[English]

The Chair: No.

Mr. Bob Mills: It could be done in 15 minutes.

The Chair: No. All right. Let's carry on then for a bit longer. Mr. Szabo.

Mr. Paul Szabo: I want to say for myself—I'll speak for myself—that this committee has been less enjoyable than any other experience I've had. And we have to stop. I think the motion is the proxy for I think all of us. We have to be more productive. I think there are more things we can do.

I was encouraged by the suggestion that maybe if there's a little give and take...and I think that's what's being asked of you, Lynn. Let's have a little bit of understanding. I don't think there are very many people here who don't want to see some change.

Mr. Elley raised a point that I think is useful. It has to do with performance in the House. And I think it bears examination on your behalf, because you are very active in the House and you will see how very smooth you are sometimes. I can see the whites of your eyes when you speak on the substance of what you're speaking of, but when you go on the partisan attack your eyes close to a squint and the finger starts to point, and it attacks the integrity of the House. If you watch in this committee, you can tell by your eyes when you've decided that you're tuning out and that you're getting angry with people. Body language has a hell of a lot to say about it.

• 1735

I think the committee wants to legitimately do some work. We are all very busy. We are very busy people and there are other places for us to be, so if we're going to spend the time here, we want to be efficient; we want to be constructive. We want to feel that our time has been well spent. If it's being wasted, then I know there are people on this committee who just refuse to come.

Quite frankly, it does get to the point where I believe that if there isn't a change in the chemistry of the relationships on this committee, members will just stop coming. This committee will not be able to process business. We won't be able to do the fundamental jobs that we're supposed to do.

I'm pleading with you, Mr. Chairman, to look at this very carefully and help us find a way to bring this whole embarrassing position we're in right now to a close by accepting the observations of your colleagues, I think collectively, that we're not doing as well as we should and we can do better. Let's start a fresh, clean slate. Let's start over again; let's start working. The steering committee has to do its work.

As soon as the steering committee fell apart and couldn't make a simple decision, we were dead. That's where it fell apart. I don't know what happened in those meetings; I'm not on the steering committee. But they have to work. If the steering committee is not going to work, this committee does not work.

I would like to suggest, and I know we all can have some comments... Listen, nobody's here to be best friends with everybody, but I think being respectful of each other and respectful of everybody's right to have an opinion, even if you don't agree with it, not to make commentary on everybody's...

Even the very first time we started this debate, Mr. Chairman, after the first speaker spoke, you interceded before the next speaker and pointed out three errors that the speaker had made. Look at the transcripts. I did. There's no need for a chair to tell somebody where they went wrong. They're entitled to be wrong. We have to respect everybody's right to be wrong sometimes. And it doesn't happen. This is about chemistry. Let's get it over with.

We could call the question now and defeat the motion—who cares?—but that doesn't fix the committee. I think the only thing that's going to fix this committee, Lynn—

The Chair: Mr. Chairman.

Mr. Paul Szabo: I think the only thing that's going to fix this situation, Mr. Chairman, is for you to agree with the general sentiment that there has to be a fundamental change in how things are handled.

It's simply a request, I think a heartfelt request... We don't want to be stuck in this mud any longer. It's hard enough; it's bad enough as it is, but I can tell you that the frustration level is now so high that we just want to get out of this. We don't want the press to be here reporting on our dysfunction; we would rather be able to just do whatever work we can to be productive.

I'm asking you, as one of your colleagues, to be a little sensitive to our needs as well, because it's important to us. We want to do our job, but we're in an environment now where that's not possible. So we need you to make a move. We want to hear a move. I'm suggesting that maybe we need a little cool-off and that before we start the next meeting, whenever we get together, whether or not it be tomorrow, we start off with a statement of your intentions as to whether or not you're prepared to make some changes in the whole way things are happening here, so that we all can better appreciate the work this committee does, and maybe be productive.

• 1740

I can tell you that if there is no such concession, this committee has not a hope in hell of doing anything until the summer comes and goes and you're made a parliamentary secretary just to relieve the committee of this pain. It's a shame, because we do have some business and I'm afraid that the business of the House, particularly these tobacco regulations, is going to suffer because we don't have a committee that's in a position to be able to do the business. I think we have to earn that respect, all of us, and I think part of it is going to have to be your being part of the solution.

I'll leave it at that.

The Chair: Thank you very much.

Mr. McWhinney.

Mr. Ted McWhinney: I think we should close the matter. I had originally given notice of a motion to defer this to June 7. I think the debate has been constructive and I did notice the changes of position, the modifications, that emerged with the Bloc and the New Democratic member.

Mr. Chairman, I believe you're a man who takes great notice of events and debates and I think there has been constructive dialogue. I would have preferred Bob to have acted on my suggestion. I think you've provided the opportunity for reflection and you should withdraw your motion, if that's your position—

Mr. Bob Mills: I have a point of order, Mr. Chairman.

Mr. Ted McWhinney: Well, no. I have the floor.

The Chair: He has the floor, actually.

Mr. Ted McWhinney: I'd permit a question, but I'm prepared to move that we vote on the question, that the question be put.

The Chair: We'll call the question in a minute.

Point of order.

Mr. Bob Mills: Yes, Mr. Chairman. After hearing Mr. Szabo and the other members, I am prepared to withdraw the motion. Certainly I would appreciate hearing from you tomorrow, in a five-minute...on how we're going to make this work.

I suggested in my presentation what I thought it would take and what I've been accustomed to in the other committee I've been on and Mr. McWhinney has been on. He knows what I'm talking about. That gives you 24 hours, and you can put a little thing together. It doesn't have to interrupt the tobacco hearings. We could then move on to make them a constructive part of what this committee does.

I'm prepared to withdraw that and ask you simply to make that statement to the committee so that we can get on with business. That's good for all of us.

(Motion withdrawn)

The Chair: I need a little more time than 24 hours, if that's agreeable.

Mr. Ted McWhinney: You're establishing conditions.

The Chair: That's a little—

Mr. Bob Mills: Sure, I can live with that. I would like you to do it before summer.

The Chair: Yes. I'll be happy to do it on June 7. I would like to meet with you, however, because you had conditions.

Mr. Bob Mills: Certainly.

The Chair: I would like to meet with Monsieur Ménard because he had conditions.

I'll be happy to do that and bring it back at the appropriate time, after the tobacco regulations are dealt with. But we do have that very important work to do, starting tomorrow. You can see by the agenda that in fact it's tight, almost crammed, in terms of what we have to do by way of the panels and individuals. So we need to get on with that.

It's agreed then that I'll speak to you and I'll speak to Monsieur Ménard, and we'll come back at the appropriate time with whatever—

Mr. Réal Ménard: And Judy.

The Chair: Yes, Judy too. I think that would be appropriate.

[Translation]

Mr. Réal Ménard: Can you tell us the names of the witnesses who will be appearing tomorrow?

[English]

The Chair: As for witnesses, beginning tomorrow, we are starting off with Health Canada and then moving to the tobacco distributors.

This meeting is adjourned. Thank you very much.