Libby’s speaks about federal action on chronic illness


House of Commons


November 21, 2012

Libby Davies (Vancouver East, NDP):

Mr. Speaker, I move that the eighth report of the Standing Committee on Health presented on Friday, May 18, be concurred in.

I am pleased to rise in the House today to debate this report. I will be splitting my time with another member.

I do find it much more valuable that we are debating this important report from the Standing Committee on Health rather than yet another time allocation motion that the government tries to push on the House. We have now had 29 time allocation motions, in addition to two closure motions, as well as other motions that were simply designed to limit debate in this House.

I am happy today that at least we are debating a report of substance that has to do with chronic diseases related to aging, health promotion and disease prevention. The report comes from the Standing Committee on Health and was tabled in the House in May 2012. This is much more substantive work than trying to deal with yet another time allocation motion from the government.

The report we are debating today deals with the very serious issue in Canadian society of chronic diseases as they relate to aging and to old people. The Standing Committee on Health had a very fulsome debate on this. We heard from witnesses from October 2011 to February 2012. We heard very credible witnesses who told us that chronic diseases cost the Canadian economy about $190 billion annually. The committee was also told that the treatment of chronic diseases consumes 67% of all direct health care costs, which is a staggering figure. How often do we talk about this issue and consider what the cost considerations are?

We need to have a health care system that responds to people’s health care needs but there is now a growing body of evidence that tells us that we need to manage how the system works and we need to manage a lot better on disease prevention and health promotion. If we did those two simple things, we would save the system billions of dollars.

We need to focus better on primary care. We need to ensure that people have access to a family doctor through a community health centre. We need primary care that focuses on a multidisciplinary approach to prevent people from having to go to the emergency room and stand in line for hours and hours or go through procedures that might have been prevented if they had community accessible, community based health care based on health promotion and disease prevention.

The committee heard from a number of witnesses but the report that finally came out was somewhat disappointing. As we have seen with a number of committees, the government members did everything they could to write a report on a sort of A-plus on everything they believe the government has done, in many cases, ignoring what witnesses said in terms of what actually needed to be done to improve the system.

I am very proud that, in this particular report, the NDP members on the committee also submitted a minority report and put forward what we believe were the clear suggestions and recommendations that came from the witnesses we heard.

I will take this opportunity to go through some of those very important recommendations that we have put forward.

First and foremost, we have to go back to the 2004 health accords. These were accords that were signed by the provinces, the territories and the federal government and laid out a plan for 10 years about how we would approach our health care system. They built upon the royal commission that was conducted by Mr. Roy Romanow and his report of 2002 that was called, “Building on Values: The Future of Health Care in Canada“.

If we go back to the health accords in 2004, we see that there were some agreements. A consensus was arrived at by the provinces, the territories and the federal government on what needed to be done to refocus the priorities of our health care system and to ensure that we were getting health care services and support to people earlier, instead of waiting for the onset and management of chronic diseases.

One of Mr. Romanow’s key recommendations in 2002 was to have a home care program. As we can see today, many seniors who live alone and do not have the necessary support often end up in emergency rooms or in acute care when they should be getting community-based support and care, including home care. It seems to me that these are very logical provisions that should take place. It was very disappointing for us when participating in the committee and the report that was done to find that a number of these key recommendations were ignored by government members and it was up to us to bring them forward. It was key to actually go back to the Romanow report and look at what he had so soundly put forward about what needs to be done, a key one being home care.

Another issue that was clearly agreed to by the provinces and the territories was to implement a national pharmaceutical program. We know that many Canadians are finding the exorbitant cost of prescription drugs becoming very unaffordable for them. One of the key indicators of rising costs in our health care system is the cost of prescription drugs. It was interesting to note that, in the 2004 health accord, there was an agreement that this would be worked on and we would come forward with some kind of national program that would ensure that prescription drugs were affordable and accessible. One of the most obvious things that could have been done was to ensure that all levels of government worked together for a bulk purchasing plan for prescription drugs. It has been estimated that would save us about $10 billion annually in our health care costs. We are talking about very big numbers here.

This was a very key recommendation that the NDP put forward in this report on chronic diseases because we understand the need to address some of the inequities in the system and some of the incredible costs that people are facing, for example, with prescription drugs. It is something that needs to be worked on. It is an area of work where we have seen the federal government basically walk away. If we look at the agreements in the accords from 2004 and examine what has taken place since that time, the most obvious and glaring thing is the fact that the federal government has basically abandoned the recommendations and the agreements that were made in that accord. Is it any wonder that we are now facing higher and higher costs for chronic diseases because we are not paying attention to what it is that we need to do in our health care system and we are not paying attention to what was actually agreed to in 2004?

It has been very disappointing to see the failure of federal leadership in this field. Not only have the Conservatives not shown the leadership that is required on the accord, but then we had an incredible situation last year where the Minister of Finance unilaterally came out with a funding formula for health care that, as we know from the Parliamentary Budget Office, will shortchange the provinces and territories by over $30 billion in the long term. This is very shocking information. The fact that it was unilateral is usually a matter of discussion between the provinces, the territories and the federal government in terms of what those health transfers will be. The fact that the Minister of Finance made a unilateral decision and then the Minister of Health and the Conservative government as a whole basically said that it was not the federal government’s business, that it was up to the provinces to decide what do.

I want to be very clear in the House that we in the NDP understand that health care is a federal responsibility under the Canada Health Act. We understand that there has been a very strong role for the federal government. It is absolutely correct that the provinces deliver health care, but the role that the federal government plays in terms of transfers and of showing leadership to bring about agreements, such as we saw in the 2004 health accord, this has been a very important role for the federal government to play. The fact that now we have a Conservative government that has completely abandoned this responsibility presents us with a very serious situation.

I want to end by saying that one other area of the report that we highlighted was the lack of action by the federal government on the recommendations that came from the working group on sodium reduction. I want to mention this because it was really shocking to see that there had been an expert advisory group, the provinces and territories had even agreed and, lo and behold, it was the federal government that disbanded the group, moved away from the recommendations and basically abandoned its leadership.

I am very proud to say that we in the NDP have now tabled Bill C-460, which, if approved, would implement the sodium reduction strategy that was put forward in good faith and worked on for so many years. Again, this is a very critical issue around health promotion and disease prevention. It is an issue that affects those with chronic diseases. This was a very important recommendation in our report, which we will continue to work on.

Mr. Speaker, the NDP launched a national campaign in September of this year. We are now going across the country, consulting and speaking with Canadians in public health forums. We are holding expert stakeholder meetings. We have had an incredible response.

It is really quite ironic. We face a government that has refused to talk to Canadians about health care. It has walked away from the table. The government does not consider health care its responsibility, yet the response that we are getting out in local communities and in the polls from the Canadian Medical Association is that the number one issue for Canadians is for the federal government to take leadership on health care. The government is going in the complete opposite direction from what Canadians want. What we are hearing from Canadians when we go out in our public forums and talk with people is that this issue of drug costs and how high and unaffordable they are for so many people is something that is now very serious.

We even have situations where, for example, a cancer patient in New Brunswick who is paying an average of $60,000 for cancer drugs is being urged to move to British Columbia where those costs would be covered. We can see the inequities across the country. There are provinces that are working very hard, such as Nova Scotia and Manitoba, to deal with this but it is not within the framework of a national collaboration around drug costs.

The member is right when she raises this as a very specific question, because it is one of the key concerns that Canadians have. It is really very bothering to me that there is so much that the federal government could easily do from an economic point of view of saving billions of dollars and also from a social equity point of view in terms of making sure there are not these inequities in our health care system, yet the government has walked away.

The report that we are debating today is an opportunity for us to focus the limelight on these key questions and to make it clear that there is a progressive vision for health care in this country, and it is coming from the NDP.