1967-06-21

Mr. Speaker:: Order. I have the honour to inform hon. members that I have received from the Speaker of the House of Representatives of Malta a resolution expressing sincere congratulations and affectionate greetings to the House of Commons of Canada on the occasion of our centennial.
I am sure hon. members will want me to reply on their behalf conveying our thanks for the thoughtful message from the representatives of the House of Representatives of Malta.


Some hon. Members:: Hear, hear.



CRIMINAL CODE AMENDMENT


Mr. Maurice Allard (Sherbrooke) moved: for leave to introduce Bill No. C-137, to amend the Criminal Code (Provincial Lotteries).


Some hon. Members:: Explain.


Maurice Allard: Mr. Speaker, the object of this bill is to amend the Criminal Code with a view to allowing provincial governments that so desire to provide for the payment, within the province, of increased family allowances and old age pensions through provincially organized and operated lotteries.
Motion agreed to and bill read the first time. [English]



QUESTIONS

[Stage Direction]
(Questions answered orally are indicated by an asterisk.)

Mr. MacRae: Is it intended to distribute to the children of servicemen in Europe or elsewhere outside Canada the centennial pins and medallions that the school children in Canada are receiving?


Hon. Judy V. LaMarsh (Secretary of State);: Yes. All Canadian school children in grades 1 to 13 will have received a centennial medallion whether they live in or outside of Canada.
The distribution outside of Canada is being done by the Department of National Defence and by the Department of External Affairs. The latter department distributes the medallion to the children of servicemen in the more isolated areas.
Centennial pins are distributed on request only.


IMMIGRANT AGRICULTURAL WORKERS
Mr. Bell (Carleion): 1.	Has the Department of Manpower and Immigration any plans to recruit immigrant workers for agriculture?
2.	If so, what is the nature of such plans?
3.	Of the immigrants who were admitted to Canada in 1965 and 1966 (a) how many were destined for the agricultural labour force (b) what percentage of the total immigration inflow for each of the two years did these represent?


Mr. J. C. Munro (Parliamentary Secretary to Minister of Manpower and Immigration):: 1 and 2. Farmers and others qualified in agricultural occupations are continually being recruited, when available as immigrants, in the normal activities of immigration offices abroad.
3.	(a) and (b)
Workers destined Percentage to agricultural of total employment immigration
1965	2,362	1.61966	3,153	1.6


HEALTH STANDARDS IN URANIUM MINES
Mr. Ormiston: Are the Canadian uranium mines which may be working on federal government uranium contracts required to adhere to the health standards set by the international commission on radiation protection?


Mr. Jack Davis (Parliamenfary Secretary to Minister of Energy. Mines and Resources):: All uranium mines in Canada are licenced by the Atomic Energy Control Board. Mining permits require observance of appropriate provincial regulations and of the Atomic Energy Control Regulations including Part VI

June 21, 1967
Questions
dealing with health. These regulations are based on the international commission on radiation protection recommendations and as these recommendations have been changed recently, the board's regulations are currently under review.


AMHERST, N.S.-RECOGNITION BY CENTENNIAL COMMISSION
Mr. Coales: Has the Secretary of State or the Centennial Commission decided to give special recognition to the unique fact that Amherst, Nova Scotia, is the birthplace of four Fathers of Confederation and, if so, what form will this honour take and on what date will it be bestowed?


Julia Verlyn (Judy) LaMarsh: There are no plans to commemorate Amherst, Nova Scotia, as the birthplace of four Fathers of Confederation, however, the Centennial Commission is assisting the Boy Scouts of Canada in organizing commemorative ceremonies at the gravesites of the Fathers of Confederation July 1, 1967. Thirty-seven ceremonies will be conducted in 19 cities. Descendants of the Fathers of Confederation will be in attendance at all but three of the ceremonies. Amherst, Nova Scotia, is among the 19 cities involved in the program. Miss E. L. Maynard, 353 Frank St., Ottawa, granddaughter of Robert Barry Dickey will lay the commemorative wreath.


LOANS UNDER FINANCIAL ADMINISTRATION ACT
Mr. Godin: 1.	Has the government made any loans during the past five years under section 82 of the Financial Administration Act?
2.	If so, to whom were these loans made, for what length of time, and at what rate of interest?


Hon. Milchell Sharp (Minister of Finance):: 1.	Yes.
2.	Loans during this period were made to the Farm Credit Corporation for purposes of administration expenses in respect of the Farm Machinery Syndicate Act as follows: (a) $50,000 on December 22, 1964, repaid on June 1, 1965 without interest, Vote 95d 196465 and (b) $75,000 on August 5, 1965, repaid on April 14, 1966, without interest, Vote 95c, 1965-66.


GRANTS TO CADET CORPS MEMBERS
Mr. Godin: 1.	Do members of cadet corps receive government grants?
2.	If so (a) for how many years have these .grants been in effect (b) what sum does each

cadet receive annually (c) is the government considering increasing this amount in order that it be in keeping with the budget for defence?


Hon. Leo Cadieux (Associate Minister of National Defence):: 1. Sea, army and air cadets do not receive pay and allowances as such. However, cadets who attend a six weeks summer camp receive a bonus of $100.00. Sea and army cadets may receive an additional $10.00 or $20.00 per year for prescribed standards in signalling or communications providing the standard of proficiency is maintained. In addition a number of cadets are receiving flying scholarships worth $545.00 each.
2. (a) Bonuses since 1948; flying scholarships since 1946. (b) See (1) above, (c) No.

LEVIS, P.Q., POSTAL DISTRIBUTION SERVICE Question No. 213


Mr. Caouelte:: 1.	What were the details of the last tenders submitted on April 19, 1967, regarding the combined urban postal distribution service at Levis?
2.	What were the names of the tenderers?
3.	What was the amount of each tender?
4.	Was the contract awarded?


Hon. Jean-Pierre Cole (Postmaster General):: I.	Tenders were called for a combined urban services mail contract at Levis. These were receivable up to 3:00 p.m. on Wednesday, 19th April 1967.
2.	Oscar Couture, 13 L'Abbaye, St-Romuald, 12 cents per item; Jean-Baptiste Carrier, 706 Commerciale, St-David, 131 cents per item; Roger Boulanger, 36-A Barras, Bienville, 15 cents per item; Bernard Raymond, 119 Ave. Roy, St-Lambert-de-Levis, 15 cents per item;
J.	-Jacques Picard, 7 Dumont, Lauzon, 17 cents per item; Paul-Emile Gosselin, 7 Ste-Anne, Lauzon, 20 cents per item; Denis Gosselin, 40 St-Gilbert, Lauzon, 22 cents per item; Guay Transport Enrg., 66 Samson, Levis, 24 cents per item; Maurice Letourneau, 346 St-Joseph, Lauzon, 24.8 cents per item.
3.	See No. 2.
4.	No. The contract will be awarded to the lowest tenderer who is able to meet the requirements of the service.


ELIGIBILITY OF NON-CANADIANS TO SEEK ELECTION
Mr. Sfanbury: At the date of the last general election, how many persons resident in Canada who were not Canadian citizens (a) were entitled to vote and seek election (b) were not entitled to vote and seek election?
June 21, 1967


Julia Verlyn (Judy) LaMarsh: I am informed by the Chief Electoral Officer as follows:
Amongst other qualifications, the Canada Elections Act requires an elector to be a Canadian citizen or other British subject. In the case of a British subject other than a Canadian citizen, he must have been ordinarily resident in Canada for the 12 months immediately preceding polling day. The act does not require an elector to specify whether he is a Canadian citizen or other British subject. Consequently, no information is available.


IMMIGRANTS FROM JAMAICA AND WEST INDIES
Mr. Fawcett: 1.	Does Canada have a certain annual quota of immigrants from Jamaica and/or the West Indies?
2.	If so, what is that quota?
3.	What procedure is followed in ascertaining the levels of education and employable skills of immigrants from the West Indies?


John Carr Munro: 1. No.
2.	Not applicable.
3.	The level of education and employable skill of an immigrant from the West Indies, or any other country, is ascertained from information provided by the person on his application, by documentary evidence submitted, as well as by means of a personal interview.
H.	M.C. DOCKYARD, HALIFAX, EXPANSION


Mr. McCleave: I.	Has the Department of National Defence plans to expand H.M.C. Dockyard, Halifax, on the land side in the next five years?
2. If so, what areas are involved?


Léo Alphonse Joseph Cadieux: 1. Piers 2 and 3 were taken over recently from the National Harbours Board thus resulting in the expansion of H.M.C. Dockyard, Halifax. There are no other plans for expansion of the dockyard site on the land side in the next five years. However, long term development plans may result in the removal of some of the older buildings and their replacement by modern new construction.
2. Not applicable.
Orders for Returns



QUESTIONS PASSED AS ORDERS FOR RETURNS


Mr. Allard: 1.	How many immigrants entered Canada in the calendar year 1966?
2.	How are they classified by countries of origin?
3.	How many were English speaking and how many French speaking?
Return tabled.


ASSISTANCE TO PROVINCES IN TECHNICAL TRAINING PROGRAM
Mr. Allard: 1.	For the fiscal year 1966-1967 under the terms of the Technical and Vocational Training Assistance Act (a) how many requests from each province for financial assistance in respect of capital expenditures for training facilities have been approved (b) what is the share to be paid by the federal government to each province as a result of these approved requests (c) how many requests from the province of Quebec have been approved and what was the federal contribution in each case (d) how many requests from Quebec have been rejected (e) how many requests from Quebec are still under consideration?
2.	In relation to the formula of equitable distribution among the provinces of federal contributions made under the terms of the Technical and Vocational Training Assistance Act concerning financial aid in respect of capital expenditures for training facilities, how much has the federal government paid or agreed to pay to each province, giving the sums in dollars, and in the percentage of the total sum which each province is entitled to receive under the terms of the said formula, and how much has the federal government yet to pay or agreed to pay to each province under the terms of this formula?
Return tabled.



MOTIONS FOR PAPERS

Mr. Albert Bechard (Parliamentary Secretary to Secretary of State):: Mr. Speaker, notices of motion Nos. 12 and 13 are acceptable to the government, subject to the usual reservations concerning confidential documents and the agreement of the provincial government authorities concerned.
Mr. Speaker, I ask that the other notices of motion be allowed to stand.


Mr. Speaker:: Subject to the reservation and conditions expressed by the parliamentary secretary, is it the pleasure of the house that notices of motion Nos. 12 and 13 be deemed to have been adopted?


Some hon. Members:: Agreed.

June 21, 1967
Inquiries of the Ministry FEDERALLY ASSISTED SCHOOL MILK PROGRAM
Motion No. 12-Mr. Ormislon:
That an humble address be presented to His Excellency praying that he will cause to be laid before this house copies of the exchange of correspondence between the government of Canada and the provincial governments since September 1, 1965, concerning a federally assisted school milk program.


[Stage Direction]
Motion agreed to.

[Stage Direction]
Motion No. 13-Mr. Ormision:
That an humble address be presented to His Excellency praying that he will cause to be laid before this house copies of the exchange of correspondence between the government of Canada and the government of Saskatchewan regarding the naming of any features, sites or facilities of the South Saskatchewan river development project.
Motion agreed to.


[Stage Direction]
On the orders of the day:
Right Hon. J. G. Diefenbaker (Leader of the Opposition):: Mr. Speaker, in facing the serried ranks of the cabinet, it is difficult to know to whom the question should be placed, but I assume it should be addressed to the genial Minister of National Defence. I should like to ask him two questions, the first of which is whether the government of Canada is doing everything it can in the interests of world peace to impress upon the President of the United States the imperative need of a meeting with Premier Kosygin in New York?


Hon. Paul Hellyer (Acting Prime Minister):: Mr. Speaker, in reply to this first question I can assure my right hon. friend and the house that the government of Canada is doing everything it can in the interests of world peace in attempting to bring together the four great powers to discuss the problems which are facing the world at this moment. The Prime Minister has made this position very clear and has already in private discussions with the leaders of some of our allies urged upon them the importance of the great powers getting together, preferably within the confines of the United Nations, but in any event getting together, to discuss the problems of the Middle East and how they might be reconciled.


John George Diefenbaker: May I repeat the first question. I did not ask anything about the Big Four meeting. I asked whether the Canadian government was impressing upon the President of the United States, Canada being one of the closest friends of the United States, the need of meeting with Premier Kosygin.


Paul Theodore Hellyer: I know that the Prime Minister discussed this question with the President earlier in the context of the Big Four meeting. I cannot say specifically whether there has been conversation in the last day or two following Mr. Kosygin's statement at the United Nations; but I will be glad to refer this question to the Prime Minister and to suggest that it would be desirable to urge upon the President the desirability of a meeting if it can possibly be arranged.


John George Diefenbaker: Thank you.


Mr. H. A. Olson (Medicine Hat):: A supplementary question, Mr. Speaker. It is reported that the Secretary of State for External Affairs had a meeting with Premier Kosygin very recently. Perhaps the minister could advise us whether the Secretary of State for External Affairs attempted to encourage a meeting between Premier Kosygin and the President of the United States at that meeting.


Paul Theodore Hellyer: I am afraid that I have no information in this respect, Mr. Speaker.


UNITED NATIONS
[Stage Direction]
On the orders of the day:
John George Diefenbaker: My second question is whether the minister will advise us as to the attitude of the government of Canada regarding the question in respect of the entire city of Jerusalem being within Israel? I ask that question because of the statement made today by Foreign Secretary Brown of the United Kingdom at the United Nations, and because of the interview reported this afternoon about the statement made in Paris by General de Gaulle.


Paul Theodore Hellyer: In respect of the second question, I think my right hon. friend will realize that I would not wish to comment on that matter, beyond reaffirming the position of the government that the question of withdrawal would in our
June 21, 1967



opinion have to be related to a settlement of the basic political issues of the Middle East.
I think this is the position of principle which the government has taken, and it is one which is very important if we are to reconcile the problems there in such a way that they do not result in a further conflagration in the years ahead.


John George Diefenbaker: Mr. Speaker, I must say that the minister deserves congratulation for the manner in which he answered both those questions.


Some hon. Members:: Oh, oh.


LABOUR CONDITIONS
[Stage Direction]
On the orders of the day:
Mr. T. C. Douglas (Burnaby-Coquillam):: Mr. Speaker, in the absence of the ministers responsible I should like to direct my question either to the Acting Prime Minister or to the Minister of National Health and Welfare who is the cabinet representative for the province of Nova Scotia. In view of the fact that reports from Cape Breton indicate that the Sydney steel plant lay-off has now passed the 1,200 mark, which for a community of this size is a crisis of major proportions, could I ask whether the government has reached any final decision with respect to the representations made by the Nova Scotia delegation last week for advances to enable the steel company to stockpile soft steel until such time as the market makes full employment possible again?


Mr. Speaker:: Order, please. The question cannot be asked of the Minister of National Health and Welfare in his capacity of cabinet representative for Nova Scotia. I believe it can be directed to a responsible minister or the Acting Prime Minister.


Paul Theodore Hellyer: Under the circumstances, Mr. Speaker, I think the best thing I can do is take the question as notice.


John George Diefenbaker: Mr. Speaker, I should like to ask a question arising out of the question just asked. I do not like that distinction of differentiating between ministers, some responsible and others irresponsible.


Some hon. Members:: Oh, oh.
Inquiries of the Ministry


John George Diefenbaker: I would ask the Acting Prime Minister whether a communication has been received from Mr. D. A. McKay, president of the Louisbourg Board of Trade, insisting that the part of the S and L line from Broughton Junction to Louisbourg be included with the rest of the Cumberland Railway property in the Cape Breton Development Corporation bill. If such a message has been received, will it receive the attention of the government before the bill comes back for continued consideration?


Paul Theodore Hellyer: Mr. Speaker, I have not been made aware of the receipt of the message. If it has been received I can assure my right hon. friend that it will be given consideration at once.


Thomas Clement (Tommy) Douglas: Mr. Speaker, I have a question supplementary to my previous question. May I ask whether in view of the very serious situation at the steel mill at Sydney, Cape Breton, the Acting Prime Minister would request the Minister of Industry or the Minister of Finance to make a statement tomorrow as to what action the government intends to take to meet this critical situation?


Paul Theodore Hellyer: I will be glad to pass along the request, but there are some difficulties. As my hon. friend knows, the ministers are now engaged in very important discussions and it may not be physically possible for them to give this matter the consideration it deserves between now and tomorrow. But I will certainly pass along the request.


Thomas Clement (Tommy) Douglas: Would the acting minister give the statement tomorrow?

Mr. Robert Muir (Cape Breton North and
Victoria): Mr. Speaker, my question is directed to the Acting Prime Minister. It is in reference to the time element that he mentioned a moment ago and is supplementary to the question asked about steel.
In view of the fact that the delegation from Sydney in connection with the steel situation met with the Prime Minister and with some members of the cabinet one week ago today, and in view of the fact that the Minister of Industry advised me on Friday last that, to use his words, "we are working on it", could the minister not assure us that there will be a statement made tomorrow about the very serious lay-offs of so many workers from the Sydney steel plant?

June 21, 1967
Inquiries of the Ministry Hon. Paul Hellyer (Acting Prime Minister):
Mr. Speaker, I wish I could give that assurance, but I cannot without knowing whether or not it is physically possible. I will certainly bring the representations that have been made and the urgency of the situation to the attention of the minister.




[Stage Direction]
On the orders of the day:
Mr. Heath Macquarrie (Queens):: Mr. Speaker, I have a question for the Acting Secretary of State for External Affairs. Can he advise us whether representations have been received from authorities in Anguilla requesting political affiliation of that island with the Dominion of Canada and, if so, can he advise what consideration is being given to such a request?
Hon. Paul Hellyer (Minister of National
Defence): I will have to take that question as notice.


EXTERNAL AID
[Stage Direction]
On the orders of the day:
Mr. Andrew Brewin (Greenwood):: Mr. Speaker, I should like to address my question either to the Acting Prime Minister or, if he is a little weary of answering questions, to the parliamentary assistant to the Secretary of State for External Affairs.


An hon. Member:: He is not here either.


Francis Andrew Brewin: The question is: Has the government received from the secretary general of the United Nations a report from Mr. Michelmore, the commissioner general of the
United Nations Relief and Works Agency, stating that the supply of food for the refugees in Palestine and other neighbouring countries is critically low, and does the government contemplate action in respect of this emergency?


Paul Theodore Hellyer: Mr. Speaker, I am not aware of any such report but I did check, just before coming into the house, about the food situation in the Middle East and I was assured that there is no shortage of the basic foodstuffs. The report is that these are in adequate supply, but that the critical problem at the moment is distribution. In so far as distribution is concerned, the Canadian government is making inquiries 
to see how we can assist in improving the distribution methods. I understand that, in addition, cash is required for certain items. However, the fundamental and basic rations are in adequate supply.


Francis Andrew Brewin: May I ask the Acting Prime Minister a supplementary question? Has it been called to the attention of the government that in this report it is stated that at the end of the next three weeks there will be a lack of food affecting a million Arab refugees in the Middle East unless immediate action is taken?


Paul Theodore Hellyer: Not having seen the alleged report I cannot say, but the information I gave was in respect of the immediate situation. I can tell the house, however, that the officials of the Canadian government are looking into this whole question and are preparing a paper for the government, which I understand wiE be ready tonight or tomorrow, and which wiU receive the sympathetic consideration of the government, if not tomorrow then very soon in any event.


AIR TRANSPORT
[Stage Direction]
On the orders of the day:
Mr. S. J. Korchinski (Mackenzie):: I have a question for the Minister of Transport but in his absence I should like to direct it to his parliamentary secretary and ask him whether, in view of the apparent shortage of travel space on Air Canada and other air lines, and the apparent inadequacy of raE accommodation, the government would not consider consulting officials of these transportation media with a view to coming up with some solution, especially in this centennial year when many visitors are travelling to Expo and other places. Could consideration be given perhaps to the use of other air lines, as was done at the time of the Air Canada strike earlier this 3^ear, so as to provide better accommodation for the travellers?


Mr. J. A. Byrne (Parliamentary Secretary to Minister of Transport):: Mr. Speaker, I am sure the minister is aware of the very serious situation which has developed and he is doing everything possible to alleviate it. However, I will bring this very important question to his attention.


Mr. Starr:: Why bring it to his attention if the hon. member is sure he is aware of it?
June 21. 1967


Mr. George Muir (Lisgar):: I have a supplementary question for the parliamentary secretary. Would he be able to inform the house when the additional service of the Canadian Pacific Airlines will be inaugurated?


James Allen (Jim) Byrne: Mr. Speaker, the vice president of the Canadian Pacific Airlines was in my office yesterday-


Mr. Nielsen:: Was there enough room in there for the two of you?


James Allen (Jim) Byrne: -and if I recall correctly he did say he would expect to bring this service into operation some time in August or September. However, this was not confirmed as there was some difficulty about obtaining aircraft deliveries.


Mr. Robert McCleave (Halifax):: Mr. Speaker, I have a supplementary question for the parliamentary secretary to the Minister of Transport. As one of those who has travelled on so many milk runs of Air Canada that the sour cream is starting to bubble out of my ears, would the parliamentary secretary again ask the Minister of Transport whether he would make possible a truly trans-Canada air line system by allowing Canadian Pacific Airlines to operate flights in the maritimes?


Mr. Speaker:: Order. The question is much too large in scope to ask at this time.


EDUCATION
[Stage Direction]
On the orders of the day:
Mr. H. W. Herridge (Kootenay West):: Mr. Speaker, I wish to address a question to the Acting Prime Minister. It deals with education, a subject in which I know the minister has had a great interest for the last year or so.
Has the Acting Prime Minister any information to give the house with respect to the decision of Canada's education ministers at a closed meeting in Toronto yesterday to form a Canadian council of ministers of education with a secretariat of 35 permanent staff, and to recommend the creation of a national ministry of education?
Inquiries of the Ministry


Paul Theodore Hellyer: Mr. Speaker, no information on this subject has come to my attention.


SURVEY OF RETAIL PRICES TO ASCERTAIN INCREASE
[Stage Direction]
On the orders of the day:
Horace Andrew (Bud) Olson: Mr. Speaker, I should like to address a question to the Registrar General, who I understand has assumed some additional responsibilities for consumer affairs. The day before yesterday, in response to a question I had asked the Minister of Finance, the minister answered, in part, that the government is determined that the advantage from the removal of sales tax on drugs will be passed on to the consumer. I wonder whether the minister can advise the house whether or not he or his department are taking any steps to survey the retail price of drugs to ascertain if any increase in price takes place between now and September?


Hon. John N. Turner (Registrar General):: Mr. Speaker, I made some mention of this last Friday when speaking in defence of my estimates before the committee. Officials of the Registrar General's department will be examining the competitive forces in the drug industry very closely during the coming months, as well as their effect upon prices to the consumer. I said last Friday, and I say again, that the effect of the removal of the sales tax and the lowering of the tariff, while beneficial, will necessarily be limited. Upon receipt of the final report of the special committee on drug costs and prices the matter was referred immediately to my departmental officials and other interested departments, and has since been given intensive study. We will be looking at the price range very closely during these summer months, and any further announcement about legislation in this connection will be made in the autumn.


Horace Andrew (Bud) Olson: A supplementary question: Can the minister advise the house whether to date this intensive survey which has been carried on by his officials indicates whether or not there has been any increase in the price of drugs since June 1?


Mr. Speaker:: Order. I think this is the type of information that should be given by way of statement on motions, not by way of an answer to a question.

June 21, 1967
Inquiries of the Ministry TELEVISION


TORONTO, ONT.-REQUEST THAT APPLICATION FOR ADDITIONAL OUTLET BE WITHHELD
[Stage Direction]
On the orders of the day:
Mr. Reid Scott (Danforth):: Mr. Speaker, I wish to ask a question of national importance which affects especially southern Ontario, and I direct it to the Secretary of State. In view of the continued attempts by the television representatives in Barrie to sneak into the Toronto market by the back door, will the minister assure the house that no new television outlet, to serve the 2 million people of metropolitan Toronto, will be permitted without an open hearing being held at which all interested applicants may be heard and considered, and at which the interests of the 2 million viewers of the area may be protected.


Julia Verlyn (Judy) LaMarsh: Mr. Speaker, the hon. member has been wearing a cloak of some sort of independence, and in this instance is insulting me and the Board of Broadcast Governors. I should like to let him know, if he is incapable of reading the legislation, that applications are made by interested people, as these individuals are entitled to do, to a Board of Broadcast Governors which has been duly appointed but which is not otherwise influenced in any way by the government or any member thereof.


Some hon. Members:: Oh, oh.


Julia Verlyn (Judy) LaMarsh: When the board makes its report I shall know exactly what the hon. member knows about that application.


Reid Scott: A supplementary question, Mr. Speaker. Might I address a courteous question to the minister. As she knows, everybody in southern Ontario-


Mr. Speaker:: Order, please. The hon. member is entitled only to ask a supplementary question.


Reid Scott: In view of the fact that any such decision by the B.B.G.-


Some hon. Members:: Question.


Reid Scott: Really, Mr. Speaker, I do not understand the sensitivity of some hon. members on the opposite side. I know that this is a sensitive problem.


Mr. Speaker:: Order, please. Will the hon. member ask his question.


Some hon. Members:: Question.


Reid Scott: How can I, Mr. Speaker, with these rapid-fire remarks that are coming at me.


Some hon. Members:: Question.


Reid Scott: I shall return to my usual form-


Mr. Speaker:: Order, please. The hon. member should remember that we have 30 minutes only today, and the way he is going he may use most of it. If he has a question, I suggest that he ask it.


Reid Scott: Mr. Speaker, in view of the fact that-


Some hon. Members:: Question.


Reid Scott: I stand subject to correction, but considering that such decision must be approved by the cabinet, before any new outlet is authorized, can we have the assurance of the minister that any cabinet minister at least will ensure that a fair hearing is given to applicants making applications before any new television outlet is opened in this important area.


Julia Verlyn (Judy) LaMarsh: Mr. Speaker, I think that my hon. friend, who is not a resident of or representative of the people of southern Ontario-as indeed I am,-should be aware that the B.B.G. will make its recommendation, under law, to the cabinet. The cabinet will then, as it has in every instance except one so far, very probably affirm whatever that decision is. In the whole history of the B.B.G. there has been only one instance of a reversal, and that was in the public interest. I would ask my hon. friend to realize that members of his party are not the only individuals in Canada who are primarily motivated by the public interest.


Some hon. Members:: Hear, hear.


Mr. Speaker:: Order, please. Has the hon.
member another supplementary question?
Will he kindly resume his seat.
He has asked one supplementary question, and I suggest that this exchange is developing into a debate rather than an exchange of questions and answers.


Mr. Churchill:: That is because of the minister's replies.


Mr. Speaker:: I suggest that we go to another question.


Reid Scott: I am sorry, Mr. Speaker, but I rise on a question of privilege.
June 21, 1987

I cannot permit that kind of discourteous answer.


Some hon. Members:: Oh, oh.


An hon. Member:: Sit down.


Mr. Speaker:: Will the hon. member kindly state his question of privilege.


Reid Scott: My question of privilege is that I have been told by the minister that apparently I do not represent anybody in southern Ontario; I cannot permit that. Nor can I permit the cavalier and discourteous attitude which has been shown to the people of southern Ontario-


Some hon. Members:: Oh, oh.


Reid Scott: -by the minister's reference.


Mr. Speaker:: What the hon. member has said up to now does not show that his personal privileges as a member of parliament have been affected. This is the only basis on which he might raise a question of privilege.


Reid Scott: Apparently we cannot expect honest, courteous and decent answers from the minister.


Some hon. Members:: Oh, oh.


DOMINION DAY
[Stage Direction]
On the orders of the day:
Hon. R. A. Bell (Carleton):: Mr. Speaker, as the Secretary of State is imbued with her usual geniality, may I ask her if she would indicate the arrangements which have been made for the participation of the public in the July 1 centennial celebrations on parliament hill when Her Majesty the Queen is to be present. Can the minister state what will be the anticipated role of hon. members of the Senate and House of Commons?


Julia Verlyn (Judy) LaMarsh: I should be very happy to do this. It will be somewhat lengthy but, if I might be forgiven, speaking about the matter in this house is the best way to get the information to members of the two chambers, who I regret have not been informed by the appropriate authorities which, in turn, are not responsible to the Secretary of State's department.
Having only just received this information, I wish to say this: The information is that on the morning of July 1 there will be two
Inquiries of the Ministry events; both of these are to be held, so far as possible, on the main lawn outside the parliament buildings. The first is a service of thanksgiving and dedication which will be conducted by leading clergymen of eight representative faiths in the presence of Her Majesty the Queen, and will be followed immediately by a parliamentary ceremony in which the Speakers of the House of Commons and Senate will present loyal addresses to Her Majesty, and to which Her Majesty will reply.
That morning program will commence at 10.30 a.m. and should end at about noon. All invited guests, which include the wives of members of both chambers, the judiciary, all privy councillors-not only of either chamber-will be asked to be in their seats by ten o'clock.
This is to be a parliamentary occasion and members and senators will be seated on the main platforms which will be erected on either side of the stage which has already been set up at the main steps. Their wives, the diplomatic corps and all other invited guests will be accommodated in chairs at ground level in front of the main platform. The dress for invited guests, all of whom I believe have now received their invitations, is directors' or lounge suits for men and afternoon dress and hats for ladies. I think it is particularly important for members of the Senate and the House of Commons to realize that this is an occasion on which they are playing host to 1 the head of their state, the Queen of Canada, and they are all expected to be in attendance. Her Majesty will be in full regalia. The general public is welcome to occupy the space on the lawns themselves, and though for this particular occasion no seats have been provided, platform facilities have been designed to provide the public with as clear and unhampered a view as possible.
Should the weatherman fail to co-operate on our one hundredth birthday the entire morning ceremony will be held inside. The same guest list will apply, but unfortunately this would mean that the public cannot be accommodated. In order to overcome this, however, indoors or out of doors the morning program will be carried in its entirety by the Canadian Broadcasting Corporation.
In the afternoon, parliament hill will be given over to what I hope will be the biggest birthday party Canada has ever seen. With the exception of special arrangements for crippled, blind and retarded children, there will be no guest list-except for the people of


Some hon. Members:: Oh, oh.


Julia Verlyn (Judy) LaMarsh: This will be no disappointment to hon. members who naturally would not expect to be included among the aged and infirm.
Every attempt is being made to provide an opportunity for the people of Canada as they come to the national capital to meet Her Majesty, or at least to see her, and every attempt is being made to provide every opportunity for the people's representatives in both chambers of the parliament of Canada, and their wives, to meet Her Majesty.
Although it is not my responsibility, I apologize to hon. members of both chambers, and to their presiding Speakers, for the fact that this information has not been widely distributed earlier, but I would ask hon. members to remember that they are in fact the hosts for this occasion. Notwithstanding the undeniable demand of their own constituents who have sent them here to represent them, they are in fact representing the people of Canada by receiving in their own name the Queen of Canada, and X ask them to be present accordingly.


Some hon. Members:: Hear, hear.


THE CANADIAN ECONOMY
[Stage Direction]
On the orders of the day:
Mrs. Grace Maclnnis (Vancouver-Kings-way):: Mr. Speaker, I have a question I would like to ask the Registrar General. Could the minister indicate why the price of a 10 pound bag of sugar has risen in Canada's third largest city from 95 cents at the beginning of June to $1.12 at the present time?


Mr. Speaker:: Order, please. Orders of the day.

The house in committee of supply, Mr. Batten in the chair.


DEPARTMENT OF NATIONAL HEALTH AND WELFARE
[Stage Direction]
1. Departmental administration including recoverable expenditures on behalf of the Canada Pension Plan and $500,000 for health grants and
June 21. 1967
[Stage Direction]
welfare grants, under terms and conditions approved by the Treasury Board, for research and demonstration activities in the field of mental retardation, $4,127,000.
The Chairman:: Order. House again in committee of supply. Estimates of the Department of National Health and Welfare for the fiscal year ending March 31, 1968. Vote No. 1 will be found on page 338 of the blue book. The details are on page 341. Shall vote No. 1, carry?


Hon. A. J. MacEachen (Minister of National Health and Welfare):: Supply-Health and Welfare operating the health services program which reflects mainly the acquisition of equipment to support my department's contribution to the International Joint Commission's study of water pollution in the great lakes system and to improve our capability for research in the important fields of air pollution and radiation protection; a $400,000 increase in funds available to the provinces for commitment under the general health grants program. The cash required for payment in this fiscal year is, however, forecast at $1.1 million less than last year.
This broad picture of the department's proposed expenditures for 1967-68 focuses attention on the introduction of several new programs. Each constitutes a significant step toward a comprehensive health and welfare service for the people of Canada and I would, therefore, like to report on their development.
About 700,000 Canadians or 57 per cent of the 1,240,000 old age security pensioners are now receiving the guaranteed income supplement. Some 430,000 are receiving the full $30 supplement and the average for those receiving less than the maximum is approximately $18.95 per month. From this experience my department is now forecasting expenditures of $240 million in 1967-68.
The administration of this program has been handled by the staff of the old age security directorate of the department with the addition of a corps of casual employees for the initial steps of mailing, receiving and processing applications. The local offices of the Canada Pension Plan, National Revenue and the Unemployment Insurance Commission were made available to assist pensioners in making application.
The Canada Assistance Plan, enacted by parliament on July 15, 1966, to have effect from April 1, 1966, is a comprehensive measure for sharing the cost of public assistance and welfare assistance with the provinces and municipalities, with a view to encouraging the provision of adequate assistance and the improvement of services that have a preventive and rehabilitative emphasis. The act emphasizes the need for adequate assistance to be provided to persons in need and gives special emphasis to the development of welfare services which have as their object the lessening, removal or prevention of the causes and effects of poverty, child neglect, or dependence on public assistance. It thus goes beyond the concept of assistance as such and places major emphasis on the importance of prevention and rehabilitation.
[Mr. MacEachen.l
During the year a great deal of the time of the welfare branch has been devoted to the development of regulations and agreements and, after extensive consultation with the provinces, regulations under the plan were adopted on January 26, 1967. Agreements were forwarded to the provinces for signature in February and to date nine provinces have entered into agreements and it is expected that the agreement with the remaining province will be concluded in the very near future.
The Canada Pension Plan began operation on January 1, 1966, when the initial contributions became payable. The first retirement pensions were paid in January of this year and, as of April 30, there were 4,449 Canadians receiving retirement pensions. It is estimated that, by the end of 1967, 18,000 Canadians will be receiving this pension and, by the end of 1968, 40,000. This indicates the advances being made with this most important program and I should like to take a little time to outline major areas of progress to hon. members.
The organization of the Canada Pension Plan administration has progressed to the point where 37 district offices of the administration are open on a full time basis. In addition, services are provided as required in 89 local offices of the Unemployment Insurance Commission and the Department of Manpower and Immigration. By combining the offices of these three agencies, we are able to provide a nationwide network of service to the public.
Work is proceeding within the Canada Pension Plan administration on survivors' benefits which are scheduled for payment for the first time in February, 1968. Current planning involves an intensive and detailed study of all provisions in the legislation relating to these benefits, drafting of regulations, the adaptation of certain procedures already developed for administration of retirement pensions, the development of procedures unique to survivors' benefits and a specialized training course for staff in the administration of this important aspect of the Canada Pension Plan. Further planning and organization in relation to the administration of disability pensions, effective in May, 1970 will proceed on schedule.
The Pension Appeals Board has been established, with Hon. Paul Emile Cote, Judge of the Superior Court of Quebec, as chairman and hon. Mr. Justice Alfred Monnin,
June 21. 1967

Court of Appeals of Manitoba, and His Honour, Judge M. L. Tyrwitt-Drake, County Court, Victoria, British Columbia, as the other members. I would add that the Pension Appeals Board has been designated by the government of Quebec to be the review commission under the Quebec pension plan.
Contributions received throughout the calendar year 1966 totalled more than $566 million. It is interesting to note that this compared with the actuarial forecast of $425.7 million and that the major reasons for the difference were that the forecast was based on a lower level of average earnings and on a higher rate of unemployment than has actually occurred. Costs of administering the plan by the Department of National Health and Welfare, the comptroller of the treasury, the Department of National Revenue, the Department of Public Works and the Unemployment Insurance Commission are estimated at $10.7 million for the fiscal year 1966-67 and $13 million dollars for the fiscal year 1967-68.
[DOT] (3:30 p.m.)
It will be recalled that the Health Resources Fund Act was passed in July, 1966 to supplement the government's proposals for a medical care program. The health resource program has retroactive effect to January 1, 1966 and provides for payments to the provinces of up to 50 per cent of the reasonable cost of acquiring, constructing, renovating and equipping a health training or research facility. A fund of $500 million is now avail-ble for a carefully phased program extending over a 15 year period.
Preliminary programs for the development of health training facilities over the next five years have been submitted by the provinces. The newness of the health resources program has resulted in many of these programs containing very tentative information on the amount and timing of costs to be incurred with respect to individual projects. Indications are, however, that claims against the fund will approximate $30 million in 1967-68 as is shown in the estimates. Projects totalling some $16 million of contributions from the fund have been approved to date.
The start of the medical care program is scheduled for July 1, 1968 and there is, of course, no amount included in these estimates for contributions to the provinces. However, since the passage of legislation, departmental
Supply-Health and Welfare officials have continued consultation with provincial officials and a federal-provincial conference was held several weeks ago. From all indications it would appear that the provinces are proceeding with the necessary action to complement federal legislation, thereby making possible a nation wide system of prepaid medical care.
Let me now refer to the subject of mental retardation. As one of the top ranking causes for disability among all age groups, mental retardation is regarded as a major national health, social and economic problem. It is responsible for immeasurable and prolonged frustration and loss to the retarded individual's family as well as a great loss in economic output to society.
The government has recognized that mental retardation is of national concern and warrants increased financial support for programs specifically designed to prevent and alleviate this disability.
Several avenues have been explored to date. For example, under our grants to welfare and related organizations program, the annual contribution towards the administrative and general costs of the Canadian Association for Retarded Children started at $5,000 in 1959-60 and has been increased over the last few years to $40,000. This annual, unconditional support is equivalent to an income of 5 per cent on an investment of $800,000.
Through the program of the Department of Manpower in conjunction with the provinces it is expected that a large sum will be made available for the capital construction aspects of some of the crusade projects undertaken by the Canadian Association for Retarded Children. Some of the crusade projects relate to vocational training, although I believe that negotiations are still going forward and final decisions have not yet been made.
Finally, in order that a comprehensive and effective approach may be made to the solution of both health and welfare aspects of problems related to mental retardation, a health and welfare research and demonstration grant has been established under which a sum of $2,500,000, is to be made available over the next five years. The beginning of this grants program is indicated under vote 1 of my departments estimates, by the inclusion of $500,000.
In this regard, I should like to pay a tribute to the Canadian Association for Retarded Children for the leadership and imagination shown in the crusade lauched to improve the lot of those Canadians affected by
June 21. 1967

Supply-Health and Welfare mental retardation and to encourage research into this serious health and welfare problem.
In conclusion, I should like to say that the estimates for 1967-68 on which I have been commenting reflect the continuation of a vigorous pattern of growth which has made the department of National Health and Welfare increasingly important and vital in its impact on and involvement with the people of Canada. In the past 22 years expenditures of the department have increased almost tenfold from $295,600,000 in 1946-47 to the estimated $2.8 billion which is now being considered by this committee.


Mr. Rynard:: Mr. Chairman, I should like to compliment the minister for his lengthy remarks in respect of the various activities of his department and for indicating to us what has been done, what he thinks has been done and what he hopes to accomplish. There has been considerable legislation passed in respect of health and welfare in the last three years, although some of it has taken a long time to implement, such as the medicare plan. I realize there have been problems, for example the lack of funds, and this can be readily understood when one considers that we are faced with the second greatest deficit, perhaps the greatest before the year is over, in peacetime. This has been accompanied by the highest cost of living and the highest taxes in our history.
Perhaps some of these measures should have been delayed. For that reason, I should like to ask the minister to give us an indication about legislative priorities. The minister also referred to the Canada Assistance Plan and other social welfare legislation.
I do not believe there has been a yardstick devised in respect of the sharing of costs which has been acceptable both to the federal and provincial governments. Let me illustrate my point. In the province of Ontario, as well as in others, the minimal income groups are covered by medical insurance. The provincial government pays 50 per cent of the costs and we find the federal government does not enter the picture and pay the other 50 per cent. I have drawn it to the attention of this house on more than one occasion that another group of our citizens, representing about 30 per cent of our population require medical coverage that they cannot finance. Why does the government not help the provinces in this regard? If the minister is as sincere as he sounds, and as I think he is, it seems reasonable to expect the federal government would do something in this regard rather than continue this wasteful duplication through


bureaucratic practices that does not touch those marginal people when they are ill.
I should like to ask what has happened so far as the Canada Assistance Plan is concerned. We have set up boards which act as tribunals to which people can appeal if they feel they have been badly treated. I want to put on the record a case which came to my attention of a woman who had suffered severe physical and psychological trauma a few years ago. According to the manpower branch she is unemployable and certified as such. She is too old and unsuitable for retraining, yet this woman is not eligible for benefits under the Canada Assistance Plan. She has applied and has been refused. We may have the best social legislation in the world, but if it founders in a morass of bureaucracy it is not only useless, it is expensive.
Let me give another illustration of the jungle of bureaucracy in which the government finds itself. I received a report of a man who is 64 years of age and who served in two world wars. He did not get out of Canada during the last one but he was with the Queen's Own Rifles in Newfoundland training troops there for overseas duty. This man became paralysed after a stroke. He could not talk or get out of bed. His Ontario hospital insurance ran out and he was told he would have to get out of the hospital. At that time the case was drawn to my attention and I referred it to the Ontario Hospital Commission. They felt that something could surely be done.
o (3:40 p.m.)
But all that was done was to tell this man to go home, where his wife was ill and waiting for a bed in hospital. This is an example of how well some of the programs have worked. The Ontario Hospital Commission said this man was a veteran and came under the Department of Veterans Affairs at Ottawa. They said the department should look after him since he was in the first world war. This fellow could not speak. He had lost his papers and number. Remember he was also in the second world war. When this matter was taken up with the authorities they said he had never been out of Canada. He was in Newfoundland, Mr. Chairman, and Newfoundland was not part of Canada in 1942, 1943, 1944 and 1945.
I bring this case to the attention of the minister to point out the loopholes in the hodge-podge welfare legislation that has been brought before this house and passed. I do not
June 21, 1967

wonder that the minister wants to have a guaranteed income established because that will be the only way out of this jungle in which he finds himself. What happened to this man? They refused to treat him as a veteran. They said he did not qualify to enter Sunnybrook because he had not been out of Canada.
Then I called the local welfare department which finally took over the case and this man is today under custodial care. I bring this case to the attention of the minister to point out that there was a failure, not only at the provincial level but at the federal level as well. There was also a failure at the local level of communication. We have not much to boast about when a man who is defenceless, cannot get out of bed and cannot even talk, is treated in this way. I would point out that this man enlisted in the first world war when he was in his teens.
1 could tell the minister about dozens of other cases where the same problem has arisen. It is because of these problems that the other day the minister of welfare said we will have to set up a system or committee whereby these people can be interviewed and assisted when refused help. What is wrong with the local authorities, the provincial governments and the federal government? Is there no co-operation or co-ordination so that a man will have his case fairly appraised? This type of wasteful bureaucracy must not be permitted. We in this country may be well off, but we are not that well off. We cannot afford all this duplication and waste, and at the same time pay the high costs of administration. I have referred specifically to this government but I suppose all governments are doing the same thing in a smaller way. We added 12,000 civil servants to the bureaucracy last year. There comes a time when bureaucracy should no longer be enlarged. Very soon we will have more chiefs than Indians, more civil servants than taxpayers.
I wish to spend a few minutes dealing with the problem of mental and tuberculosis hospitals. I ask the federal government why they categorize a man as a second class citizen because he is a mental patient. Is it not about time that in this Canada of ours we regarded a mentally ill person as being in the same category as a person who is physically ill? Just as many beds are occupied in this country today by the mentally ill as the physically ill. The federal government, despite all its magnanimity and its great welfare programs, will not provide assistance for the care of the mentally ill.
Supply-Health and Welfare
There are many blind areas in our welfare programs. The attitude toward the mentally sick is one of them. Why is the stigma of a second class citizen attached to a person who unfortunately becomes mentally ill? A mentally ill person is just the same as any other ill person. The only difference is that he becomes nervous and emotionally upset, instead of requiring his appendix to be taken out or having some other medical problem. The same thing applies to our tubercular patients, who fortunately are becoming less in number. It would not cost a great deal of money to include the cost of care of the mentally sick and our tubercular patients. The cost of a bed in a mental hospital is approximately one third of the cost of a bed for the medically ill or the person requiring surgery.
In this connection, I make a plea on behalf of the provinces. In the province of Ontario expenses rose 25 per cent last year. The federal government, with all the taxing powers it has, last year had an increase in expenses of only 14 per cent. I have a great deal of sympathy with the provinces. It is sometimes said the provinces are creating problems by saying they are not being fairly treated. This is a very good illustration of the fact that they are not being fairly treated. At the provincial level, expenditures are increasing much faster than they are at the federal level.
We must also remember that administrative costs fall entirely upon the province that administers the program. The federal government says it shares these costs of welfare 5050. This is not so, because administration is entirely an expense of the province. The federal government will not even be sharing medicare costs 50-50 with the province of Ontario. It will be contributing much less than 50 per cent.
On the subject of psychiatric care in Canada, Dr. Alex Richmond said there was the greatest need to see that these people get adequate care, not only from the standpoint of the federal government accepting its share but in helping to get these people rehabilitated as quickly as possible. The longer a person stays in a mental hospital, the less his chance of complete recovery.
Then, there is the problem of alcoholism. About 2 per cent of the population today suffer from alcoholism; the number is around 400,000. Should not the costs incurred in treating these unfortunate people be shared equally by the federal government, which obtains very large sums of money in the way of
June 21, 1987

Supply-Health and Welfard taxes from the sale of alcohol? Last year more alcohol was sold in this country than ever before. I ask, should the federal government not also assist people suffering from other forms of addiction?
I ask the Minister of National Health and Welfare why he does not go a little further than his predecessors and accept some responsibility in these fields. The treatment of these people should be accepted as a federal responsibility under a shared program. These people are Canadians; they are sick, and need treatment. With regard to shared programs, those provinces which have not the necessary funds with which to match the contribution of the federal government should be helped.
Then there is the crisis in the shortage of doctors. Not one medical university this year is providing a summer course. We will admit about 1,000 medical students to university this fall. The other day at Atlantic City the American Medical Association went on record as saying that the doctor shortage in the United States is very critical. They called for more schools. They accepted over 20,000 applications in this respect. You do not need to be a mathematician, Mr. Chairman, to figure out that this is 20 times the number we are accepting. You do not need to be a mathematician to know that the population of the United States is 10 times greater than that of Canada. On the same basis we should be accepting just double what we are, namely, 2,000.
What is being done to solve these problems? The lack of action on the part of the government is what alarms me. Has the minister taken cognizance of these problems, or does he stand back like Ferdinand brushing the flies off his back.
[DOT] (3:50 p.m.)
When the minister brought in the medicare legislation it was his responsibility to bring in measures to aid the provinces in producing doctors because the provinces by themselves do not have the resources to do it.
Dr. Jones stated the following in speaking about the health resources fund:
Honesty compels me however to agree with the dean of every Canadian medical school and with practically every minister of health in this country, that the amount is grossly inadequate, and the fact that after two years only the very initial expenditures have been made gives point to my comments about difficult administration.
We hear nothing about the personnel to operate the hospitals. Are we to have a group of empty buildings with nobody in them? What is the use of putting up buildings if we
[Mr. Rynard.i
do not fill them with personnel and equipment? I say to the minister that it is too bad that nothing was done to ensure that our Canadian medical schools would operate this summer. I disagree entirely with the minister's opinion that we will have a sufficient number of doctors, and I challenge his statement.
Dr. Dawson stated, after a good deal of exploration across this country and after having interviewed many medical schools, that it would be necessary to bring into this country 500 doctors per year. The Hall commission report is now some years old but its recommendations have not been carried out. I want to point out to the minister that a great responsibility lies on his shoulders because he himself admitted that the implementation of medicare will increase the workload of the doctors. I agree with him.
I should like to deal now with the question of priorities in medical care, and I thank the minister for being good enough to send me his speech in which he mentioned this subject. I want to ask him, who will allocate the priorities? Who will say in what category one is to be placed so far as medical care is concerned? Is some receptionist going to decide whether or not one's appendix is to be taken out or whether one can afford to wait, two, three or four months for a doctor's care? If the minister will suggest that the emergency departments of hospitals will do it, let me tell him that they are now overloaded and overworked. There are fewer interns in the hospitals across Canada than there have been for years.
I was very interested in another point which the minister mentioned. He said that general practitioners practising in rural areas will be quite satisfied with their lot. They will be paid for the work they do and they will like living out in the country. I will tell the minister that I have had the occasion to speak to some of these doctors who told me they were having some problems. The nearest hospital is often 20 miles away and they average three or four cases in hospital because the doctors in the town are too busy. There is an insufficient number of interns in the hospitals, and yet when these doctors put in claims for mileage on their income tax forms the Department of National Revenue refuses to acknowledge them. Is one hand working with or against the other. What is the minister doing about this situation? I agree with him that we need more doctors in rural areas.
June 21, 1967

There is another point which I should like to reiterate, that is the acute shortage of doctors in this country. In the United States there are just under 300,000 doctors practising. In Canada we have just under 20,000 practising doctors.
It was pointed out at a meeting in Atlantic City the other day that an acute shortage of doctors existed in the United States. Here we are letting things ride because if we wanted it badly enough, our medical schools could have been operating this summer. Somehow or other the minister could have used his powers of persuasion, and I do not think it would have taken much persuasion, to convince the doctors of the necessity of operating the schools this summer. They could operate at increased pace, using buildings that would be empty, and instead of graduating doctors after six years they would do so after four. Dr. Evans, the head of the medical school at McMaster University, even said they could graduate a doctor in three years. He said this was a necessity, but even at that he stated we will not be able to fill the gap. I note that the minister is quoted as saying that everything will be fine here and we will have all the doctors we need in 1971 or 1972. I wonder who is right because the United States has a dire shortage of doctors and yet they have one doctor for every 750 people while we have a doctor for roughly every 1,000 people. In view of the fact that 50 per cent of our doctors are specialists we must assume there is a doctor for every 2,000 people in Canada.
I believe that things must be made a little more attractive for the general practitioners here, and the government should work in conjunction with the provincial governments and with the universities to ensure that Canadians receive the medical care which is required. I tell the minister in all frankness that 85 per cent of all illnesses can be looked after by a general practitioner, but today 50 per cent of our doctors are specialists and 50 per cent are general practitioners. The minister should consult the provinces and the universities on these very points which are so vital to Canadians so that they can obtain the best use of medical man power.
I do not believe it is right to give the people medicare and to assure them they will get all the medical care they will require when and how they like it. This would be gross misrepresentation on the part of the minister because he himself admitted it may be necessary to establish priorities in medical care. All this is very puzzling to me because I know how long some people have to wait
Supply-Health and Welfare before they can see a doctor, and yet the minister will increase the workload of the doctors without ensuring that more of them will be available.
I hope the minister and the government will face this situation squarely because it is my guess that the flow of immigration will be reduced substantially. I do not think that the European countries will continue to graduate doctors for the purpose of sending them here. Here in Canada it costs approximately $50,000 to graduate a doctor. If Great Britain and the other European countries continue to send their doctors over here, they will be giving us a real asset. I hope they do, but I doubt it.
There is another interesting point which I would like to make. What does one do if one wants to bring a doctor from Great Britain or another European country? I put this question to a government official the other day and I was told I could go to a local immigration office and ask them about it. This is the biggest farce I ever saw. One has to go to an immigration office to get a doctor to practise in a given area or to help out in a clinic. Surely, the problem of the shortage of doctors is important enough to warrant the establishment of a liaison between the Departments of National Health and Welfare and Immigration so that it would be sufficient to deal with only one department and one would not have to wander around in a maze of bureaucracy trying to get a doctor to come over to Canada.
I believe there was much sense in what the attorney general of the province of Ontario had to say. I know he was criticized and I do not agree with all he said.
[DOT] (4:00 p.m.)
However, there was quite a lot of common sense in what he said. He noted that the provinces got together in confederation and that the federal government was the central power. But why would not the idea of bringing together the provincial ministers of health to discuss their needs, their plans and the great shortage of doctors today be appealing? Would not this advice be worth while.
I mentioned research and the necessity for more research. Dr. Thomson, who was president of the Canadian Medical Association, stated that the health resources fund provided a pittance compared with what we really need. The matter which concerned him most of all, Mr. Chairman, was how to staff the structures that the fund, spread over 15 years, builds, after it has been equalled dollar for dollar from provincial funds-that is, if the provinces can find the funds. The minister
June 21, 1967

Supply-Health and Welfare will recall that the Hall report called for a drastic increase in the supply of doctors, nurses, technicians and paramedical personnel who are required to provide adequate medical care, and this before medicare is instituted. Yet the government does nothing to bring this about. The scheme has now been put into operation and as Dr. Thomson said, the fund has provided a mere pittance.
Another aspect of the research problem is this. In order to have good teachers in the field of research you must have research-minded doctors. The medical research council is receiving just about half the amount recommended in the Gundy report. There is talk about reversing the brain drain, but I should like to see the statistics in this regard because I do not think that the drain is all that heavy. I have seen very little evidence of it. But how can we possibly bring our doctors back when we are spending a mere pittance on research.
I would call to the minister's attention that the Minister of Industry, speaking in Paris, said that 2 per cent of the gross national product should be put into research. But what do we find, Mr. Chairman? Two per cent would provide an amount of $1,200 million for research, whereas today we are spending, as the minister knows better than I, less than $26 million-about $25,800,000. As I say, this is less than half the amount that the Gundy report stated we must spend if we are to provide the doctors, personnel and trained medical students we require. This is rather pitiful in view of the situation in which we are.
Many towns across Canada have no resident doctor. As we sit here in this house more and more towns are being deserted. In the long run this is going to prove expensive because we are increasing the load on our paramedical services, ambulances and so on, who have to take care of people without their own doctor. When the doctor lives nearby most of this cost is offset. Not only that, when an ambulance is called the patient is sure to be taken to hospital which taxes the emergency department.


The Acting Chairman (Mr. Tardif):: Order. I must advise the hon. member that the time allotted to him has elapsed.


Some hon. Members:: Continue.


Paul Tardif: Does the committee give unanimous consent to allowing the hon. member to continue?


Some hon. Members:: Agreed.


Philip Bernard Rynard: I appreciate the courtesy of hon. members in allowing me to go on, and I will speak for only a few minutes. I am interested in this question. I know the minister personally, and although he is a very fine fellow I am wondering whether he does have all the information that he should have. He must have been talking to a different group of fellows from those I talk to because most of the people I speak to refer to the dire shortage of medical personnel. Just the other day I heard of one man who died, I am sure, because he did not receive prompt care. There was no one available to care for him.
Another big problem in our hospitals today is this. Some people have to go to the emergency department of a hospital because they are unable to obtain the services of a doctor. People arrive in a new city and are unable to find a doctor to treat them because the doctors themselves are overworked. Therefore if they get sick they go to the emergency department of a hospital. The emergency departments of all hospitals across Canada, of which I am aware, are overloaded; the staffs are overworked and inadequate in number to do things they are supposed to do.
We can slough this off and say that the situation will correct itself and that things will be all right in a few years. But in passing through this house a medicare bill, it is not only the right of the minister but his solemn obligation to see that the people of Canada get the best medical service possible. In this vein I close. The situation is a very serious one, and I am reminded of Nero sitting fiddling while Rome burned.


Mr. Knowles:: Mr. Chairman, it is always a privilege to take part in the discussion of the estimates of the Department of National Health and Welfare. As usual, I have one or two complimentary remarks to make; however the minister will not be surprised if I say them quickly and get on with the meat of what I should like to say on this occasion.
I agree with the minister when he speaks of the tremendous importance of the Department of National Health and Welfare. I share his pleasure in noting that its progress, its growth and its development can be measured by the fact that its budgetary requirements have increased tenfold in the last two decades. This, I suggest, is not just an example of bureaucracy, of government spending gone wild; rather it is an indication of the demands that parliament, in the name of the people of Canada, has made for improvements in our social security program in this
June 21. 1S67

Supply-Health and Welfare stand in the way of people in the provinces getting this extra $30 under the guaranteed income supplement and continuing to get whatever the provinces want to pay to them by way of provincial supplementary allowance." That is what the minister said.
We have had many experiences in this area and I shall base what I want to say in this connection on an experience that my leader, the hon. member for Burnaby-Coquitlam, had with one of his constituents. I bring this matter up because the correspondence between the hon. member for Burnaby-Coquitlam and the minister of social welfare for the province of British Columbia makes the point very clear. This was a case where a person in British Columbia was drawing $75 a month old age security and $30 a month as an extra social allowance which was paid by the province of British Columbia. She applied for the guaranteed income supplement of $30. The minister told her, the application form told her, the instruction book told her, and the act told her that she could apply for the guaranteed income supplement although she was getting the $30 a month supplement from the province of British Columbia. But what happened?
Her case was assessed by officials in British Columbia, and in the end they cut her provincial allowance down to $1.65. As the result of this great, new piece of legislation this woman who had been getting $105 a month now gets $106.65 a month.
My leader, the hon. member for Burnaby-Coquitlam, did what all of us have done in our own cases. He wrote to the minister of social welfare of British Columbia, hon. Mr. Campbell, suggesting that it was improper for British Columbia to take this attitude; that, after all, the Minister of National Health and Welfare had made it clear that they were under no obligation to cut down on the provincial allowance because of what was provided in the federal legislation. The minister of social welfare for British Columbia wrote back to the hon. member for Burnaby-Coquitlam on May 19, 1967, and said this:
The quotation in your letter from my department's notice dated February 20th, 1967, is exactly as quoted. The province of British Columbia has on a number of occasions made representation to the federal government to ignore the guaranteed income supplement as income when determining entitlement to the provincial government supplementary social allowance. The result of this would have been that every recipient would have continued to receive the same amount of supplementary social allowance as he did prior to receiving the guaranteed income supplement.


It was the desire of British Columbia to continue the full amount of the supplementary social allowance paid to individuals prior to their receiving the guaranteed income supplement but the federal government refused to accept this request and stated that if the government of British Columbia ignored the guaranteed income supplement as income in determining eligibility for the provincial government supplementary social allowance that it would not share in this supplementary social allowance.
Does the minister see what he has done?


Allan Joseph MacEachen: Perfectly.


Stanley Howard Knowles: He has said that supplementary social allowances, as received in the provinces, do not count against the income test with respect to the guaranteed income supplement. In effect, the minister said that people could get both.
[DOT] (4:20 p.m.)
He says it is up to the provinces whether or not they continue, but then when a province like British Columbia says it wants to continue, but in the meantime has come under the Canada Assistance Plan, this minister says, "If you are going to expect us to share in this program under the Canada Assistance Plan we will not do it unless you include the guaranteed income supplement as income for the purposes of the Canada Assistance Plan."
I take the minister back to the debate on the Canada Assistance Plan. He told us time and time again that all that mattered was that people take a needs test, and the government was prepared to leave the decision on what the level would be to provincial governments. Yet here is a case where a provincial government says it wants to pay a higher amount but the minister, through his officials, says this cannot be done because of the terms of the Canada Assistance Plan.
The minister has been reasserting this principle in recent times. He made one of his many speeches recently in Winnipeg, on June 13, and when speaking about the Canada Assistance Plan and its needs test, which he claims is so much better than a means test, he said this:
The provinces may, of course, in their discretion, impose limits on the amounts to be paid to individuals or families or for specific needs. But I emphasize again, the federal legislation leaves it to the judgment and discretion of the provinces to determine what limits, if any, should apply.
This has got to be sorted out. The minister is still saying ex post facto that the federal government imposes no limit on the amounts that may be paid under the Canada Assistance Plan. Provided people take a needs test,
June 21. 1967	COMMONS
then the federal government will pay 50 per cent. But British Columbia comes back and says, "We were denied the right to pay these social allowances unless we included as income what is being paid under the guaranteed income supplementation program."
I suggest there are two things to note here. One is the inconsistency of the position taken by the minister, and the other is that we have here another example of the fact that this idea of imposing a means test or needs test on our old people just does not fit with the thinking of today, just does not fit with the affluence we are talking about, just does not fit with the so-called just or great society.
I call upon the minister to reconsider his whole position. I suggest that if we must maintain this needs test program on old age security supplementation for a while, then things such as those to which I have just referred should be improved. But I go further than that and say that what is necessary is to change the whole basis of this supplement and put it where we tried to get it last year, on a basis as of right, whereby the full $105 per month will be paid to all who are of pensionable age and over.
There are scores of examples like this. The minister boasts about the number of people who are getting guaranteed income supplementation. But my mail, and I am sure that of many other hon. members, is just full of letters from people who are humiliated by the tests they have to go through, who are disturbed and unhappy over the reductions that take place, and who are disturbed because they do not get any supplement at all. Then, when we get a case like this where a woman gets an increase of only $1.65 per month as a result of the $30 change, and finds she is caught in this straight contradiction between the minister of Social Welfare in British Columbia and the Minister of National Health and Welfare, then I say something ought to be done about it.
I have read hon. Mr. Campbell's letter in which he says it was Ottawa that said no, that they could not do it. That was dated May 19, 1967. Yet as recently as June 13, 1967, the minister was still saying in a public address that the federal legislation leaves it to the judgment and discretion of the provinces to determine what limit if any should apply. We will come back to this later during discussion of these estimates.
I would point out that on the order paper I have a private members' notice of motion dealing with the question of removing the 27053-114
DEBATES	1789
Supply-Health and Welfare means test from the $30 supplement, and I suggest to the minister that this is a piece of unfinished business with which he should be dealing without delay.
Now, Mr. Chairman, I want to say a few words about medicare, to which the minister and the hon. member for Simcoe East referred. I noted that the minister today said without any embellishment at all that medicare is to come into effect on July 1, 1968. Has he forgotten that tremendous victory he secured at the meeting of the Liberals at the Chateau Laurier some time ago, when he persuaded them that he would get something better than the Minister of Finance had proposed, that he would get written into the act a provision that medicare could come into effect on July 1, 1968, or earlier? He did not mention that today. He just knows that it is not coming into effect a day earlier than July 1, 1968.
I suggest, Mr. Chairman, that that particular amendment which the minister put into the act just was not worth the time it took to write it out. It had no meaning, no value at all. As a matter of fact, it is like another amendment he accepted. After much pressure from all the opposition parties in the house he accepted an amendment regarding paramedical services to make it possible for the government to agree with any one province, if a province so wished, to include other than medical services under the coverage of the medicare act.
There was no question about what that amendment meant, namely, that it could be done if only one province wanted to make the agreement. When this was discussed on a late show a few weeks ago the minister freely admitted that that is the wording of the law. However, in his answer to the question on the late show he said that the law says one thing but the policy of the government is another.
The law says it can be done if even only one province wants to make such an agreement, but the minister says the policy of the government is that it is not to be done until there is a consensus. The consensus has not been defined as to whether it means two provinces, five or six, or nine or ten. I suggest, Mr. Chairman, that this is not the way for this minister, or any other minister on that side of the chamber, to treat this parliament. We took him seriously in the debate on the medicare bill when these two amendments were put through. One was his own, his own idea, and the other he accepted from this side of the chamber. One was that medicare might come into effect earlier than July
June 21, 1967

Supply-Health and Welfare 1, 1968, and the other was that paramedical services, such as optometry and chiropractic services, and the rest, could be included on the basis of an agreement between a province and the federal government. It now turns out that this was just so much window dressing, just a case of being agreeable to get the bill passed.


Allan Joseph MacEachen: Does my hon. friend not recall that during that debate I stated to the committee that the only recommendation I proposed to make to the governor in council Was the inclusion of certain services provided by dental surgeons? It was clear at the time.


Stanley Howard Knowles: It is quite clear that the only service the minister had in mind at that moment was dental surgery, but it was also made very clear that the amendment as worded and put into the act did not require a consensus among the provinces for its terms to be carried out. It is this about which I am complaining, that the minister sells parliament a bill of goods by writing something into law and then says later, "That is the law. That is what can be done, but the policy of the government is something else. The policy of the government is not to act in this field unless we have a consensus." Mr. Chairman, we contend that this simply is not good enough. This is no way to treat parliament.
The minister has to give a lot more attention to this whole medicare proposition. I am sure he not only recalls his experiences in meetings recently with the Canadian Medical Association but he must also be reading the papers these days, and it must be pretty clear to him that the Canadian Medical Association is not exactly on the bandwagon in favour of medicare. The statements which are being made by the doctors about medicare do not auger well for the inauguration of this program. When one realizes the influence the medical people have at the local level and in the provinces, and when one realizes the efforts they are making, the minister may find that the program will not get off the ground as even he hopes it will. I think part of the reason for this is the delay which has taken place across the years. I believe part of it is because the minister is not as wholehearted in his determination about medicare as he ought to be. I believe right now he should be giving the fullest concentration he can to negotiations with the provinces and with the doctors in order to make sure that medicare will get off the ground certainly not later than July 1, 1968.

[DOT] (4:30 p.m.)
Mr. Chairman, all of us in this chamber have reason to be grateful to the medical profession. All of us have reason to be grateful to individual members of the medical profession. It seems to me, however, that they should realize that the parliament of Canada, representing the people of Canada, has spoken on this issue. The parliament of Canada has said that medical care is something which should be available to all the people of this country and that it should be paid for as provided in the act. This is no time for one group to try to sabotage this very important program.
I urge the Minister of National Health and Welfare to spend a little less time running around the country telling us how wonderful some of these programs are, for they are not as wonderful as he says. He should spend a little more time trying to make sure that the medicare program really gets going and really is the success we believe it ought to be. This should be his main preoccupation right now.
There are one or two individual matters which I should like to mention before my time runs out. These are things on which I hope we will have action at this session. I mention these because they come under the aegis of the Department of National Health and Welfare. I refer to the question of legislation on birth control and with respect to abortion. I realize the Prime Minister has made statements about these matters at political meetings outside the house. I realize also that he has included them in speeches he has made in the house. But still it seems so difficult to get from the government assurance that anything will be done.
The other night my colleague the hon. member for Vancouver-Kingsway asked the Minister of National Health and Welfare for a very simple statement. In fact, she simply asked whether he could tell us if this would be done at this session. The minister could not seem to find it in his heart or in his vocabulary to say yes. Instead, he used words which may or may not have meant something. This is a social problem which we ought not to play around with any longer. There is legislation in the Criminal Code which causes a good many people such as priests, ministers, doctors and social workers, to do criminal acts because of the way the legislation now stands. There is a similar situation with respect to abortion.
These are subjects which a few years ago could not be talked about in the House of
June 21, 1967	COMMONS
Commons. Surely, however, when one thinks of the danger which exists in so many cases to the health of expectant mothers we should be prepared to deal with this question. One of the points the government has made is that in this centennial session, in the fall at any rate, we will deal with some of these social problems. Another one is in the news now. There is a scoop, I suppose you would call it, about what the committee on divorce will recommend. I do not bring this within the ambit of the Department of National Health and Welfare, but I do urge the minister in his capacity as the minister of a department concerned with the physical and mental health of our people to put the prestige and pressure he has behind the demand for action in these fields.
I shall not take the time to repeat the speech I have had to make so often about the 30, 40 or 50 years it takes the Liberal party to get anywhere. I do hope that this will not be the story in respect of these social issues which the Liberals trot out at their conventions, at election time and in the speech from the throne. Let us have action on them at this session of parliament.
Now, Mr. Chairman, I believe I can refer to just one other subject and stay within the 30 minutes allotted to me at this time. I have been quite interested in the many references the Minister of National Health and Welfare has made, when he has delivered speeches around the country, to the broad question of a guaranteed annual income. I was looking forward to hearing about this in his remarks today, but I did not hear any reference to this matter. Certainly, however, this is a favourite of his in the speeches he makes when he is receiving honorary degrees and when he is speaking to various organizations and conferences outside the house.


Mr. Lambert:: Almost every day.


Stanley Howard Knowles: Not every day, but almost. He does it very nicely. I did not bring all his speeches, because the one made at Winnipeg covered most of these things. On June 13 he spoke at Winnipeg to the Community Welfare Planning Council. I can just hear his words ringing in that Cape Breton voice when he said:
But we are on the threshold of a new age, the cybernetic age, and its consequences may well presage more fundamental changes in our approach to social security. There are, for example, contemporary predictions, which are becoming more and more believable, that within a few years, 5 per cent of the population can produce all that society needs and work will become the privilege of the few.
DEBATES	1791
Supply-Health and Welfare
I suppose that "few" will always include those of us in parliament. Then the speech continues:
In simple, dramatic terms, the traditional, centuries-old link between work and income is being questioned. At the root of it all is the basic problem of how to make our nineteenth century distribution system cope with the productive machinery of the late twentieth century.
Then, after a couple of paragraphs in which he has a Munchausian reference he says:
These developments, these prospects and questions are the basis of a rising interest in the guaranteed minimum income as a radical-and realistic-solution to the problem of income distribution in the cybernetic age.
Despite the flowery nature of all that, I must say I agree that this problem of finding a basis for the right to live other than an association with work is one which will be upon us before we realize it. I agree that a guaranteed annual income is something to which we will have to come.
I should like to say first, let it not be the type of guaranteed annual income he tried to sell us in respect of the old age pensioners. First of all, the levels he had in mind did not represent a guaranteed annual income at all. Second, it is not a guaranteed annual income when it is paid to people only after they pass a needs or income test. A guaranteed annual income, if it is to be worth that name, should be a generous allowance which is sufficient for people to live on and, if it is too much, let some of it be taken back afterwards in the form of income tax.
The minister must recast his whole thinking on this issue. He must not try to sell us what he foisted on us last year in respect of the old age pensioners, if the guaranteed annual income is to mean what the words say and if it is to help solve the problem. I plead with the minister not to let this be treated the way the Liberal party treated old age pensions, unemployment insurance and medicare when it proposed these things in 1919- something good for two or three generations.
The minister is right in the flowery language he uses about the problems facing us in the field of maintaining our standard of living. The time to get to moving on a real guaranteed annual income program is now. But let it be adequate, and let there be no means test on it.
[DOT] (4:40 p.m.)
I thank the minister for the attention he has given to my remarks, and I hope he realizes that just because he got two or three
1792
June 21, 1967

Supply-Health and Welfare pieces oi legislation through last year his job is not done-it has only begun.


Mr. Lalulippe:: Mr. Chairman, I am glad to have the opportunity to say a few words about the Department of National Health and Welfare.
There are great needs in the field of social welfare, because the Canadian people are not treated as they should be, in accordance with our production. As a matter of fact, our production is high in Canada, but consumption is inadequate, because we do not consume our production. If we want to consume our production, we must at all costs balance our economy, and I do not see any other means to do so than by giving the people, the consumers themselves, in short, the families, the required purchasing power to become the great consumers of our abundant production.
Mr. Chairman, 1 do not intend to mortify the government, or the hon. Minister of Finance (Mr. Sharp) or the hon. Minister of National Health and Welfare (Mr. Mac-Eachen), but I cannot let this opportunity go by without pointing out once again, to the house, the urgent necessity of ensuring national economic balance between the individuals, the families and the institutions which compose Canada.
When I say "between the individuals, the families and the institutions", I want to point out that families and institutions are merely groups of individuals, and that human beings only are gifted with life, have material, intellectual and spiritual needs. Indeed, families and institutions are merely instruments to produce and manage in the service of human beings.
Families and institutions as such do not exist, do not have a real life; our intelligence has created them to designate groups of human beings who live together as families, or work together as institutions.
As you can see, Mr. Chairman, only human beings have life and make up a nation, are divided into families and private and public institutions, for their needs of production or administration.
Therefore, when shall we finally understand that the human being is the fundamental unit of the nation, that it represents the basic unit of any economic administration of the nation of Canada, of the country, which we have the official mandate to administer appropriately, we the 265 members of parliament with the 102 senators of Canada?

When, some day, we have recognized in our mind and by our actions that we are responsible for the good administration of the welfare of all the human beings who make up Canada, the 20,400,000 Canadians who constitute the Canadian people, then, and only then, we will have achieved the purpose for which we have been elected, for which our electors have sent us to parliament, namely to prepare legislation for all human beings, with no exception.
If it is up to the Minister of Finance to supply the necessary funds to the Department of National Health and Welfare, it is also up to the Minister of National Health and Welfare to produce his accounts which means all the accounts necessary to the economic balance of Canadian men and women, in short the 20,400,000 Canadian citizens living on Canadian soil, saluting our Canadian flag, singing our Canadian hymn and who are proud to say they are Canadian citizens.
Mr. Chairman, if, once again, there are
20,400,000	Canadian citizens who make up Canada, who have the right to live decently in Canada in 1967, it must be admitted that there are only 7,400,000 who have an income from their labour or their capital. There are 13 million other Canadian citizens who have neither capital nor paid employment, who have no personal income and who consequently are dependants.
These 13 million Canadian citizens are all entitled to live in 1967 according to our Canadian standard of living. If these 7,400,000 adult citizens are strictly entitled to a vital minimum, this vital minimum is the responsibility of the Ottawa government and must be valued in dollars and cents, according to appropriate amounts and not in a ridiculous fashion or with an eye-dropper.
This vital personal right is the right of the human beings in society and must be paid or guaranteed by the state, by the national government, by the central government, in short by the government with the financial means whether money, credit or capital, whatever their definite or indefinite forms, known or unknown, visible and invisible.
The right to live thus implies a certain amount of money daily, monthly or yearly for each Canadian citizen who has no income from his labour or his capital.
This, Mr. Chairman, is a natural human right for those who believe in God. It is a right already recognized in our Canadian legislation under chapter 44 of the Statutes of Canada 1960, the Canadian Bill of Rights.
June 21. 1967

To be practical and logical, this individual right to live must be evaluated and appraised in dollars and cents as any other contract. The salary of labour is evaluated in a definite amount, not in vague terms. Interest on capital is also evaluated in exact terms clearly determined in a contract.
In the same manner, the right to live of citizens without personal income must be spelled out by the contracting parties, in the circumstances the federal government and the dependent citizens, represented by their 265 members in the parliament at Ottawa.
Such is our responsibility as members in this House of Commons, as representatives of the people, as representatives of every Canadian citizen, as representatives above all of the weakest citizens of the country, of those who do not have the ability to defend their own cause by personal means, of the unemployed, of those who have no personal capital.
It is not a matter of knowing whether the government has the means to pay or to guarantee this right to live to the 13 million dependent Canadian citizens, it is a matter of recognizing that the government has the strict obligation to do it immediately within the present context of the Canadian monetary, economic and political machinery on the basis of the present production capacity and the standard of living of Canadians in 1967.
It is as simple as that, as complete as that. And it will be the end of the war on poverty, misery, indigence, insecurity; the end of poverty. The lack of wealth will remain, but it will be more human, more decent, more social, more natural and more proper.
As soon as we have admitted our duty to pay or to guarantee that right to a personal life to those 13 million dependent children, students or adults throughout Canada, at a set rate per month according to the cost of living index, I am ready to wager with those hardest to please that it will seem easy to them and even pleasant to proclaim the law of the right to live for all the citizens of Canada who have no personal income through their capital or their work.
The return on capital, Mr. Chairman, remains; the salary remains for all of the 7,-
400,000	persons involved in the national production. But, there is simply added the right to life for every dependent citizen as a minimum and guaranteed purchasing power, for all persons who are unemployed or who have no capital. It is as simple as that.
Supply-Health and Welfare
Everybody admits that production is for the use of the population as a whole. Everybody admits that every living individual in Canada has a right to life. Now, in 1967, we have a population of 20,400,000, and the production of the 7,400,000 producing citizens totals more than $62 billion. So we get the following averages: $62 billion; an average of 3,000 per person. Population in 1967: 20,400,000 persons; an average of $15,000 per family of five.
This is our production, the total and effective production of Canada, Mr. Chairman. And when we are told that there is not enough money to help families or to pay adequate family allowances for Canadian children, well, Mr. Chairman, I suggest that we are not equal to the task, that we are in a situation entirely different from that which exists when we say that.
It is therefore obvious that the Canadian production in 1967 can provide all dependents with a vital guaranteed minimum, in accordance with the cost of living index, as well as all families, all heads of family and all students. We could even pay a reasonable allowance to the mothers who are unemployed but who also work for the community and are not rewarded for their work.
[DOT] (4:50 p.m.)
I do not wish to complicate the present discussion, but in my opinion the 13 million citizens in Canada in 1967, whether dependents, children, students or adults, should receive a stipulated monthly payment, and I think that in order to give our society and all Canadian families their due in a country where there is an abundance of wealth, we could use $8 billion out of a national product of $62 billion, which would leave a total of $54 billion for salaries and return on capital to be paid to the 7,400,000 Canadians who contribute to the national production.
I have all sorts of tables I could quote, but that would take too long. I do not want to take up all the time of the house. I would like to give the ministers and hon. members time to think about the social welfare we could provide for Canadian families trapped in an unjust system.
It is wrong for us to tolerate such a system and to allow families to live in destitution, poverty and insecurity, as we do now while spending millions and billions of dollars for all sorts of other things. The family is the basis of the whole structure of society and of public institutions. If there were no children, no families, there would be no society, no Parliament, and we would not have to pay family allowances.
June 21, 1967

Supply-Health and Welfare
If we do not believe in the family, Mr. Chairman, the birth rate will decline. Moreover, everybody agrees that the birth rate is declining in Canada. Why? Because these families have not the security they need, because they lack the means of obtaining suitable housing, enough room, for their children.
Nobody wants to rent houses to large families; they are unable to find housing.
So, we have much to do in that area, and I say once more that we must provide families with capital and the buying power needed to purchase the production of our economy, through science, through progress, through technology. Then, Mr. Chairman, we would be doing a great service to society and also to production, because to increase production we must also increase consumption.
And statistics prove that production in Canada is plentiful since, once again, we have a production of $62 billion and a consumption of $44 billion.
Large companies in Canada have also realized profits, they have capitalized $18 billion out of $62 billion of production. We have $18 billion of capitalization; $15 billion have been capitalized by large businesses and only $3 billion by the little people.
Mr. Chairman, there might be some exaggeration in our capitalization. It is not up to me to see to it but up to the Minister of Finance and Receiver General (Mr. Sharp). And the Minister of National Health and Welfare (Mr. MacEachen) should submit his bills to the Minister of Finance, so that the family may live reasonably well and properly in a country which is bursting with wealth.
If the 1967 production, in the amount of $62 billion, for a population of 20,400,000, guarantees, on the average, $3,000 per person, $250 a month, that is an average of $15,000 for a family of five (father, mother and three children) or $1,250 per month, and if such wonderful averages leave so many people in misery, in poverty, in insecurity, we must find the causes for such a poor distribution of such a large affluence.
When we see that, in 1966, out of a national production of $56 billion, 32 per cent or $18 billion was capitalized, and only $8 billion or 68 per cent of the production was consumed, while in 1944, 90 per cent of the production was consumed and only 10 per cent capitalized, it is indicated, I think, in order to see the trend of our national economy, to examine the same economic sectors at two different

stages far enough removed from each other: thirdly, mathematical proof of the economic trends.
The revision of the bank act in 1944 and in 1967-


Paul Tardif: Order. In order that the house may proceed to the consideration of private members' business, it is my duty to rise, report progress and request leave to sit again at the next sitting of the house. Agreed?


Some hon. Members:: Agreed.


Henry P. Latulippe: Mr. Chairman, may I call it five o'clock?


Mr. Deputy Speaker:: Order. The house will now proceed to the consideration of private members' business as listed on today's order paper, namely, notices of motions and public bills.


HEALTH AND WELFARE
Mr. David Orlikow (Winnipeg North) moved:: That, in the opinion of this house, the government should consider the advisability of including mental hospitals and tuberculosis sanatoria in the federal hospital insurance program (Hospital Insurance and Diagnostic Services Act) so that the provinces will have available sufficient funds to provide for adequate treatment of the mentally ill, those people suffering from tuberculosis, and the care and training of mentally retarded children.
[DOT] (5:00 p.m.)
He said: The motion which I move today is one which I have been moving for a number of years. The principle enunciated in this motion was endorsed by, and indeed the wording could have come from, the very fine report and recommendations of the Hall commission. In dealing with the problem of mental illness the commission said:
There must be an immediate end to the distinction that some still make in attitudes towards those who are mentally ill and those who are physically ill.
The commission points out that under the present terms of the hospital act, payment for the care of the mentally ill is excluded if provided in provincial mental hospitals but it is included if provided in general hospitals.
June 21, 19S7

They say further that they believe this policy of excluding the mentally ill is not in the public interest.
I want to deal with this point for a moment. The situation as it now exists has created a condition in which we have two types of treatment for the mentally ill. I am not suggesting for a moment that this was planned by any government nor that this was the intention of doctors or psychiatrists. However, if a person becomes ill and the doctor and the private psychiatrist, who are usually on the staff of a general hospital, whether it be the Winnipeg General Hospital or the Royal Victoria Hospital in Montreal or any of the hospitals in the larger cities in Canada, decide that the patient needs hospitalization, he can be admitted to the psychiatric ward of that general hospital. There he will get the finest of attention, the cost of which in any of our best hospitals is between $30 and $35 a day, and the entire cost for what we in Manitoba call standard care, is paid for by the government hospitalization program. I think this is as it should be.
Now, who are the people who usually see psychiatrists? They are people in the middle and upper income groups, people who are covered by non-profit medical insurance plans like the Manitoba Medical Service or P.S.I. in Ontario. If, on the other hand, a person who is in the lower income bracket, who, very often, does not have a doctor and who certainly does not frequent a private psychiatrist's office, gets sick, it is likely that he will be committed to the only place to which he can go, that is one of the provincial mental hospitals. In these hospitals the average cost of care per a day is not the $30 to $35 a day which we find in the general hospitals of the country but just under $8 a day. I suggest this is the kind of anomaly which should not be allowed to continue.
Having been in the provincial legislature of Manitoba, I have some concept of the difficulties which all the provinces have in meeting their tremendous responsibilities. The provincial governments, whether they be the "have" provinces such as Ontario and British Columbia or the "have not" provinces like Newfoundland or Nova Scotia, are having to find the money to pay for the cost of education, for a large part of the cost of welfare, and for part of the cost of hospitalization. The amounts of money which provincial governments have allocated for the treatment and care of the mentally ill in provincial institutions has risen very sharply.
DEBATES	1795
Mental and Tuberculosis Hospital Program However, 1 think it is obvious to all of us that there is a limit to what the provinces can do. What I am proposing in this resolution, and what the Hall commission has recommended very strongly, is that the mental hospitals be included in the provisions of the hospital insurance act so that the federal government would in effect pay for half the cost of the treatment of the mentally ill in hospital. What I am suggesting is not that the provinces should reduce their expenditures by half. I hope the federal government will adopt this principle, in fact I am certain they will if not now then in the not too distant future. I hope that in negotiations with the provinces the federal government will make it clear to the provinces that they are only prepared to extend the coverage for mental hospitals and for T.B. sanatoria if the provinces continue to spend the same amount of money as thej have been spending. So, in effect, what I am suggesting is that we double the expenditure which we make in this country for people who are mentally ill and who are required to spend time in mental hospitals.
I do not think there is any member of the house who will dispute the fact that there is a tremendous shortage of required facilities. I have brought with me today a couple of dozen, if not more, newspaper reports on this subject which I have accumulated. Here I have the Toronto Daily Star of January 19, 1967. A headline on the front page of that issue reads:	"Psychiatrist charges:	40 disturbed boys without proper treatment". I will read a couple of paragraphs from the article:
Forty emotionally disturbed youngsters have been kept in an Uxbridge training school in the past year without proper psychiatric treatment, a Toronto psychiatrist said last night.
Dr. John Rich, who Friday committed a 12-year-old boy from the St. John's Training School to the Ontario Hospital at Hamilton, said both institutions were "completely unsuitable".
Then, there is a story which appeared almost three years ago in the Winnipeg Tribune of September 11, 1964. The heading reads: "Nothing but jail for the sex offenders". I will read a short part of the article which reads as follows:
In Manitoba today, there are many men serving jail terms for crimes they couldn't help committing.
Wilbert X is an example: he's a sexual offender. He was convicted of gross indecency....
In sentencing him to the jail in Brandon, the magistrate said that he knew nothing would be done for this man in the jail in Brandon since they did not have the facilities.
June 21, 1967
1796	COMMONS
Mental and Tuberculosis Hospital Program There simply was no institution in the province of Manitoba which could handle the problems which this man had.
The statistics, of which there are many, give a graphic picture of the total situation in Canada. The Hall commission pointed out that 10 per cent of the population, about 1.9 million people, may be suffering from psychiatric and emotional disorders; that every day in Canada there are 69,000 people in mental institutions and that if you total the number in the year, there are 25 million days a year used in mental hospitals. The Hall commission estimates that mental illness accounts for almost 40 per cent of all hospital days, and in 1960 more than a third of all hospital beds in Canada were used for mentally ill patients. The figure has not changed much since that date.
As I have already pointed out, the cost of keeping and caring for a patient in a mental hospital is about a quarter of the cost of keeping a person in a general hospital. We get what we pay for. We get the kind of treatment, the kind of niggardly, miserable treatment, for which we pay. In the two provincial mental hospitals in Manitoba, the Brandon hospital and the Selkirk hospital, as of a year or two ago-I have not seen the most recent figures-there were more than 1,000 patients, and in each of these hospitals there were less than a dozen trained psychiatrists I remember when I was in the provincial legislature, and that was only five years ago, in one of the hospitals with 1,200 patients there were only three trained psychiatrists. If you keep in mind that one of them was the superintendent, who I am sure had a great deal of administrative work to do in the hospital, you can see, Mr. Speaker, that there was very little time for a psychiatrist to spend with individual patients. The result has been just what one might expect:	people stay in
hospitals for months, even years, when they could be at home if only they could receive individual attention.
[DOT] (5:10 p.m.)
The Hall commission laid down certain principles with respect to mental hospitals which I think we ought to keep in mind. They pointed out that there are severe shortages of psychiatrists, psychologists, psychiatric nurses and social workers in all our mental institutions. The commission recommended a crash program for training personnel in this field. There is no place where these people can be trained better, more easily and more cheaply than in our mental hospitals, but this cannot


be done unless we are prepared to spend the amount of money required.
The Hall commission also called for increased funds for an expanded, co-ordinated program of research into the causes of mental illness and mental retardation. Mental illness is costing the people of Canada hundreds of millions of dollars a year in direct cost for the operation of our hospitals. There is also an indirect cost as a result of the thousands of people who are unable to work because of mental illness.
We are spending hundreds of millions of dollars on research, Mr. Speaker. We are doing research into how best to use our forests. We are doing research into how best to use our minerals. We are doing research into space exploration and into almost every field. The amount we spend on research in the field of mental illness is so small that one can hardly find the amount listed in the estimates for scientific research.
I am suggesting that if the federal government would participate in the hospital program in respect of the mentally ill, we could fairly easily commence the work on mental health research which is required.
Again, the Hall commission recommended that the hospital construction grant regulations under the health facilities development fund be amended to provide one half of the cost of construction of psychiatric wards in all general hospitals. It also recommended that henceforth all discrimination in the distinction between the mentally and physically ill in the organization and provision of services for their treatment, and the attitudes upon which these discriminations are based, be disavowed for all time as unworthy and unscientific.
In retrospect, Mr. Speaker, we can be critical of the federal government of the day, when it implemented the original hospitalization program and assumed 50 per cent of the cost of the program, for making the decision to exclude mental hospitals and T.B. sana-taria from the provisions of the act. However, I suppose I can understand this; the federal government knew that it was going to get into a program which would be very expensive.
Almost 20 years have past, and to a large extent the hospital building program has been met. I know that in some of the large cities such as Toronto, Montreal, Ottawa and Winnipeg there is still a shortage of hospital beds, but the bulk of the program has been implemented. I suggest that the time has long
June 21, 1967	COMMONS
since passed when the federal government should decide to include mental hospitals in the general program.
I want to close, Mr. Speaker, by putting on the record the views of Dr. Charles Roberts, who is now director of the Clarke Institute of Psychiatry in Toronto and who was for years head of the Verdun Protestant Hospital in Montreal. His views are reported in the Toronto Globe and Mail for January 11, 1966, and he had this to say:
A major frustration for psychiatric patients and workers is the conflict between statements that mental illness should be treated like any other disease and the refusal to make provisions to do so

Dr. Roberts said mental treatment should be included in hospital insurance programs. It has often been claimed since the program was introduced in 1957 that it was impossible to find the money at the federal level to include mental care, but since then there has been one of the greatest airport construction programs any country has ever undertaken; the trans-Canada highway has been financed and the St. Lawrence seaway has been completed. Hundreds of millions more dollars are being made available for universal old age pensions and the Canada Pension Plan.
I agree with Dr. Roberts. All of these things are needed. But so is an improvement in the facilities which are provided for the hundreds of thousands of people in Canada who are mentally ill and need assistance.


Mrs. Margaret Rideout (Parliamentary Secretary to Minister of National Health and Welfare):: Mr. Speaker, this is a subject which has been debated in this house on numerous occasions since the time when the Hospital Insurance and Diagnostic Services Act was placed on the statute books in 1957. It is a subject on which there is substantial agreement on all sides of the house in so far as the principle is concerned.
Speaking on the subject in July 1964, the former minister of national health and welfare pointed out during a federal-provincial meeting of ministers of health which had been held at that time that there had been general acceptance of the principle of integration of mental hospitals and tuberculosis sanatoria into the general hospital system. She pointed out, however, that because of the financial implications, the matter would have to be reviewed within the framework of the tax structure committee which was planned at that time. In fact, the following year the federal government agreed to consider this question along with other financial matters.
It seems to me that it might be helpful at this time to outline the circumstances in
DEBATES	1797
Mental and Tuberculosis Hospital Program which the mental hospitals were not originally included within the federal legislation; and, at the same time, to assess the extent to which psychiatric units in general hospitals are in fact providing insured services in connection with the treatment of mental illness. I will have a word to say later on the subject of tuberculosis sanatoria.
When the hospital legislation was introduced a decade ago, my colleague the Secretary of State for External Affairs (Mr. Martin), who was at that time the minister of national health and welfare, explained to the house the underlying consideration for the exclusion of mental hospitals. He pointed out that in the provinces there was virtually no financial barrier to care in mental hospitals by virtue of the fact that, for the most part, these institutions were provincially financed. At the same time, a very substantial proportion of the care provided in these hospitals was of a type which was custodial. The hospital program, on the other hand, was designed to remove financial obstacles to the acquisition of hospital care generally and to set up a hospital care program providing noncustodial services.
[DOT] (5:20 p.m.)
In initiating such a large program, therefore, it was considered at that time to be preferable to deal with general hospitals including the chronic, convalescent and rehabilitation institutions as a matter of urgency. The costs of hospital care were becoming unbearably burdensome both to individuals and to the hospitals themselves; and it was of utmost importance to take immediate measures to alleviate this situation. In excluding certain types of hospitals, the government had regard to the fact that a certain amount of federal support was already being provided through the national health grants program to mental hospitals.
I would remind hon. members that the hospital insurance program was, and still is, a very costly one and it was considered to be necessary, therefore, to set certain priorities with regard to the types of institutions initially to be included. There were precedents for exclusions which had already been established at that time by a number of provinces which preceded the federal government in setting up hospital plans. I should like to remind the house that the provincial hospital plans in Saskatchewan, British Columbia and Alberta which were in operation prior to the joint program all excluded mental hospitals. I
1798	COMMONS
Mental and Tuberculosis Hospital Program do not mention this fact in order to be critical of these fine pioneer programs; nor as an apology for the federal government's action in excluding them from the hospital insurance legislation. I am merely pointing out that the view held by the federal government ten years ago was a view which had been shared by other governments which were already in the field.
In the decade since the hospital insurance plan came into operation, great changes have taken place and medical science has brought about a veritable revolution in the treatment of mental illness. More and more psychiatric beds are being built in general hospitals. More and more care, particularly for acute cases, is provided in psychiatric units of general hospitals. There has been an upsurge of admissions in these units resulting from changing methods of treatment and in changing types of facilities being used to handle psychiatric patients. The number of admissions to psychiatric units in general hospitals is now almost equal to the rate of admissions to mental hospitals. This, of course, is due to the early discharge of patients from psychiatric units which provide short-term intensive treatment for the patient with a favourable prognosis.
The recent growth of psychiatric units in general hospitals is best illustrated by the fact that only 15 years ago the numbers of such facilities were negligible; by 1965 there were 64 such units including nine in federal hospitals. Within public general hospitals there has been an increase from 10 units in 1951 to 55 units at the end of 1965.
I have spoken particularly of the psychiatric units in general hospitals because, as hon. members are aware, this type of care is made available through hospitals participating in the hospital insurance program. Patients admitted to these units, therefore, receive normal hospital insurance benefits.
I do not wish to imply that because hospital insurance benefits are available to patients in psychiatric units of general hospitals that they should not be also extended to patients in mental hospitals. I merely wish to emphasize the fact that although mental hospitals as mental institutions are excluded from the definition of "hospital" under the Hospital Insurance and Diagnostic Services Act, this does not in any way exclude the treatment of mental illness when carried out in a participating hospital under the hospital insurance program.

DEBATES	June 21, 19S7
The exclusion of mental hospitals from the federal act is, of course, merely an exclusion from the shareable costs of hospitals toward which the federal government contributes; in no way need it affect provincial plans. In fact, from the outset, at least one of the provinces has included mental hospitals in provincial hospital insurance legislation and provides insured services in these institutions. It is true that the operating costs of these mental hospitals are not shareable with the federal government in the same way as the operating costs of other hospitals are shareable. But funds provided by the federal government through the mental health grant are, of course, provided with respect to these hospitals. Other provinces might very well provide similar programs if they wished to do so. Hospitals come within provincial jurisdiction and provinces may provide programs as they see fit.
A number of provinces have been realigning their mental hospital programs in such a way as to separate the element of custodial care from the element of treatment care, thus facilitating the identification of treatment services provided in these institutions. Such measures undoubtedly will facilitate the eventual integration of mental hospital services into the general hospital services plan. There is no reason at the present time why provinces should not extend provincial hospital insurance legislation so as to include these portions of mental hospitals in the general program.
In so far as tuberculosis sanatoria are concerned, the problem differs from that of mental hospitals. Changes in medical treatment of tuberculosis have effected a dramatic change in the types of facilities which formerly were used for patients suffering from tuberculosis. The tuberculosis sanatorium is, in fact, a disappearing institution. More and more of these hospitals are being closed or are being converted for use as chronic hospitals. In the course of time it is anticipated that there may no longer be maintained the now virtually outmoded institution known as the tuberculosis sanatorium.
The question of extending federal contributions so as to include mental and tuberculosis hospitals is a financial question and is precisely the type of question which is now being studied in depth, along with other federal-provincial financial arrangements, by the tax structure committee. It is because of this, and pending a decision as to the future of federal-provincial programs such as hospital insurance, that the government does not propose to
June 21, 1967

make any move at this time to include mental hospitals in the Hospital Insurance and Diagnostic Services Act.
As you are well aware, when the present government took office a new policy was announced with regard to established federal-provincial programs. In conformity with this policy, the federal-provincial tax structure committee was created by the federal-provincial conference early in 1964. The committee was charged with the task of conducting a joint review of the nature and extent of federal and provincial taxes in relation to the financial responsibilities which nowadays have to be carried out by federal and provincial governments. The following year we in this house passed the Established Programs (Interim Arrangements) Act concerning the operation of certain established federal-provincial programs. It set out necessary procedures to permit provincial governments to withdraw from certain shared cost programs. This "opting out", as hon. members are aware, was intended to enable provinces to assume sole responsibility for the operation of former joint plans. Among the programs directly affected by this legislation was that provided through the Hospital Insurance and Diagnostic Services Act.
In September, 1966, the Minister of Finance outlined further details of the federal government's policy effecting federal-provincial shared cost programs, outlining the principles and objectives of the government's approach to new fiscal arrangements. He pointed out that the shared cost programs, including hospital insurance, had contributed greatly toward social advances across Canada. But the provinces wanted more and more to assume full responsibility for operating their own programs. It was for this reason that legislation had been introduced to permit provinces to contract out, pending the development of more permanent fiscal arrangements.
[DOT] (5:30 p.m.)
At the same time the Minister of Finance made specific proposals to the tax structure committee for the withdrawal of federal participation in certain social measures, including the hospital insurance program.
I remind members of these measures because they bear so directly on the financial implications of any changes which might be made in existing shared cost programs. At a time when the future of the hospital insurance program is under review, having regard to revised federal-provincial financial arrangements, members must understand why 27053-1151
DEBATES	1799
Mental and Tuberculosis Hospital Program the government considers that no major change should be made in the basic program.
I wish once more to reassure the house that the government does not disagree with those who contend that the treatment aspects of mental hospital care should not be set apart from the treatment aspects of the care of any other type of illness or disability. The reluctance of the federal government to accept the proposal that an amendment should be made in the Hospital Insurance and Diagnostic Services Act so as to implement such a policy, is due solely to the financial implications of such a move at this time.


Mr. Gaston Isabelle (Gatineau):: Mr. Speaker, it affords me great pleasure to take part in this interesting discussion on the notice of motion introduced by the hon. member for Winnipeg North (Mr. Orlikow), whom I admire very much because he is a druggist by profession. As a matter of fact, after hearing him discussing and reasoning at the meetings of the special committee on drug costs and prices, I must say that he has retained all the sympathy and compassion he had when he served in his chemist's shop the patients who trusted him with their medical prescriptions.
The purpose of this motion is to determine whether the federal government should consider the advisability of including mental hospitals and tuberculosis sanatoria in the hospital insurance program, so that the provinces will have available sufficient funds to provide for adequate treatment of the mentally ill, those people suffering from tuberculosis, and the care and training of mentally retarded children.
That was an important question-and it still is-when the hospital insurance system was initiated around 1957, and, as circumstances have changed, I do think that it is now necessary that those two important services to the mentally ill and persons suffering from tuberculosis be included in the hospital insurance legislation.
It was still important, even at that time, as I have just mentioned, for in January 1957, during the debate on the hospital insurance legislation, the hon. member for Winnipeg North Centre (Mr. Knowles) asked the Minister of National Health and Welfare whether the federal government had made provision for the fact that it could consider the case of mental hospitals and sanatoria.
The Minister of National Health and Welfare answered and I feel that he summarized the philosophy of the government-that
June 21. 1967
1800	COMMONS
Mental and Tuberculosis Hospital Program this proposition was generous and complete and that the government did not intend to include mental hospital and sanatoria cases being treated in other hospitals for the simple reason that the provinces already assumed such responsibilities. But the T.B. and mental patients would be cared for in general hospitals which would come under the provisions of the hospital insurance legislation.
And as the hon. member for Winnipeg North (Mr. Orlikow) said earlier, I do not think that someone has suffered as a result of such conditions, because even patients are taken care of in the mental wing of general hospitals and the legislation to which he referred did not necessarily make any distinction for that type of patients.
And, as I said, if this had been done at the time, the government could have, through its hospital insurance plan, subsidized the provinces and as we know, the main purpose of an hospital insurance plan is to reimburse the individual for part of his hospital expenses. However, I agree with the hon. member for Winnipeg North that this principle must be abandoned now in view of the inquiry carried out by the Hall Commission on health services and I am sure that all agree on the recommendation of this report which states:
The estimates of the cost of hospital care have been developed; the first, based on the continuation of existing trends and programs, the second based upon our recommendation that mental and tuberculosis hospital care should be integrated as quickly as possible into the general hospital program and brought within the scope of the Hospital Insurance Act.
But since 1950, and particularly since 1955, let us say in the past ten years, it may be said that the provision of physical facilities, rehabilitation programs, specialist personnel, the practice of medicine in general, the administrative knowledge, all have played a part in making the general hospital the center for diagnosis, treatment and rehabilitation for illnesses of all kinds.
The consequence of these developments-
I am still quoting from the Hall report:
-has been that patients are treated in multipurpose general hospital rather than in special hospitals and that the chronically ill are cared for in public hospitals rather than in proprietary nursing homes or municipal homes as in other countries.
As I said at the outset, medicine has evolved considerably in the past ten or fifteen years to the point where psychiatric hospitals have changed their administration and treatment methods-several psychiatric hospitals have been converted to other types of hospitals and the patients have received intensive rehabilitation; this has freed a number of


beds in these hospitals. Furthermore, clinics have been established to follow up patients who no longer need to spend part of their lives between the four blank walls of a miserable institution such as psychiatric hospitals used to be. You have to know them to talk about them.
Through such clinics, patients may see a ray of sunshine and have some hope in life.
We also have, to our great surprise, through the improvement of the concept of treatment for tuberculosis patients, noted that several sanatoria were forced to close because they were completely empty. We have also noticed that the number of T.B. patients in Canada has decreased. We know also that, as a result, the construction of sanatoria has nearly decreased to zero.
We can also say that the change in hospital care for mental diseases-I am referring to nursing care which required an extensive stay in those institutions-into active care with a much shorter stay, has resulted, according to projections, in a decrease of over half a million days of care in relation to the number projected in this plan. That reduction cannot be obtained without more costly diagnostic, treatment and rehabilitation services, provided by public general hospitals.
If we stop briefly now to see what will be the projection of our economic development between 1961 and 1991, or let us say over a period of 30 years, even if we are in 1967, with regard to general population, we notice that in 1991, it will reach the fantastic figure of 35 million, that is an increase of 93 per cent. On the other hand, the active population will go from 6.5 million to 13 million people, which means an increase of 101 per cent. As to employment, the number of workers will go from 6 to 12 million, that is an increase of 108 per cent. The actual gross national product, according to the figures in terms of 1966 dollars, amounted to $57 billion and, in about 20 years from now, it will soar to $113 or $133 billion.
[DOT] (5:40 p.m.)
On the other hand-and that is rather interesting-the average number of hours of work per week per person will fall from 41.5 to 33.9, that is an 18 per cent reduction, and the number of unemployed, with regard to the active population, will decrease from 7.2 per cent to between 4 and 5 per cent. As we can notice, we will have an extraordinary development, provided the Canadian economy is directed in a sound way and is well administered, in the private as well as the public sector.
June 21, 19S7
COMMONS DEBATES	1801
Confronted with this vital problem which private and public industry will have to face, we will need all the necessary skills to achieve this economic expansion of Canada. It is also important to conclude that this economic growth will require more extensive medical care than what we are in a position to provide today, and this in the best interest of the people.
The projected expenditures I mentioned will increase. There is no doubt that expenditures will increase because new and better equipment will be purchased, and more of it, and particularly because hospital care and every hospital bed will be put to better use. Those expenditures are always made on a projection of thirty years or so, as I have just said.
The increase-and this is very important-or the decrease of expenditures for health services in all countries is directly related to the health of the people. Either the health services are poor or they are excellent and available to all. In the first case, there would be an increase in unemployment, the national output would slow down or decrease and expenditures for health services would increase sharply. There is no need to explain why. On the contrary, in the second case, the cost of health services will be such that it will either prevent or necessitate a decrease in some of those services.
Always according to this projection, we must realize that the cost of the services provided in Canada under the present hospital insurance plans, excluding medical and dental care, will rise to $67 per capita at the end of 1971. This cost was $31.97 per capita in 1961, $54 in 1966 and, as I just said, it will rise to $67 in 1971, in view of the progressive increase. Taking into account the new health services which will be in operation in 1971, an increase of only $17 per capita is projected, which represents a normal increase of some hundreds of one per cent, for our experience since the 1930's shows that the cost of such services is increasing at the rate of a fraction of one per cent per year over a period of 20 or 30 years.
Canadians, let us say now spend a little less than 5 per cent on medical care. Our present services, together with the new services proposed, in other words the extension of the present hospital insurance plans and the medical care program advocated by the government which we hope will be implemented by all the provinces on July 1, 1968, will produce an increase of barely 2 per cent
Mental and Tuberculosis Hospital Program around 1971. This increase will probably diminish shortly after 1981, because health services will reduce unemployment-according to the principle I stated earlier-and raise the level of national productivity, which will lead to a reduction of these health services.
In conclusion, allow me to quote the last paragraph of the chapter on the projection of health expenditures in the Hall report:
-a comprehensive health care program would involve, by 1971, an additional sum of $466 million as compared with the $4,015 million Canadians are likely to spend in any event in that year, or a further 11 per cent.
Even though that figure may seem fantastic, I sincerely believe that such an additional expenditure of $466 million would enable us to make more effective use of the health resources of the country to the benefit of all Canadians and would be the most worthwhile investment in the productivity and well-being of the Canadian people.
This is an outline of the projections for the health and economic schemes that the government of Canada will offer to its population before 1981.
We have demonstrated that if the services provided by general hospitals have increased normally and that if the days spent by patients in hospitals, nursing homes and psychiatric hospitals have decreased considerably, although the per capita cost has risen regularly, but acutely, it would still be normal to follow the recommendation of the Hall report, which states that psychiatric and T.B. hospitals should come under the Hospital Insurance Act of Canada. But we had to wait many years to allow for the re-adjustment of science and, especially, we had to wait and see whether the operation would withstand the test of time. Now that the tests are over, now that we know where we are going in the field of psychiatry, tuberculosis, and health, it is normal to proceed with integration, in order to ensure a good management of public funds.
This is what I wanted to say on the motion brought forward by my colleague from Winnipeg North (Mr. Orlikow).


Mr. H. C. Harley (Hallon):: Mr. Speaker, on rising to take part in this debate this afternoon, I should like first to congratulate the mover of the private members' notice of motion, the hon. member for Winnipeg North (Mr. Orlikow). As he mentioned, he has presented this motion previously, although I think in somewhat different form. I took part
1802	COMMONS
Mental and Tuberculosis Hospital Program in the debate on several occasions and I am pleased to do so again today.
When I say that his motion is in a slightly different form, I should point out that I believe when it was first presented he restricted his motion to the consideration of people suffering from tuberculosis and mental illness. Since that time I think he has added the care and training of mentally retarded children. I have no complaint to make with his addition, because certainly we are all aware that today there are many children in Canada who need such care and attention. There is a great shortage of hospital beds and care facilities for these people. I would have thought that the hon. member might have left off the word "children" and just said "people suffering from tuberculosis and mental illness and the care and training of the mentally retarded".
Before I pass on to discuss the other subjects with which I should like to deal more fully, I might say that I believe all of us are aware of the various workshops which have been set up for mentally retarded adults. I believe there are two in my riding. These workshops provide shelter and training for these retarded adults until they can be trained to the point where they can take their place in society, usually under the guidance of families or friends. These workshops, however, do train these people to do various jobs according to their ability.
We have heard from the parliamentary secretary why, originally, the two diseases, tuberculosis and mental illness, were excluded when the Hospital Insurance and Diagnostic Services Act was passed.
[DOT] (5:50 p.m.)
We listened to the reasons given and I wondered why these were excluded. I think one of the considerations that must have been weighed at the time was that in 1957 these diseases were considered chronic. I include the mentally retarded, to which the hon. member has made reference. These were diseases that required a great deal of treatment over a long period of time, and, generally speaking, a long period of hospitalization in a tuberculosis sanitorium or mental institution.
Fortunately, with the progress being made in medical science at the present time this situation is rapidly changing. Both of these diseases are treated a great deal differently than they were in the past. The patients are being more adequately and efficiently treated as outpatients in the hospital setting rather than inpatients.

DEBATES	June 21, 1967
We are all aware that the incidence of tuberculosis is the same as it always has been. I noticed that the Canadian Medical Association, at its meeting a year ago, spent some time expressing the opinion that the incidence of tuberculosis was as high as it always has been. Certainly, the time of treatment is much less, and much less in hospitals because a great deal more time is being spent treating patients as outpatients, often with weekly injections of streptomycin, or putting the patients on various kinds of oral medicines. As has been mentioned, the beds in sanatoria are emptying. As an example, in 1953 there were 18,977 beds devoted to the care of tuberculosis. In 1962 this number had decreased to 10,673, and in 1963 to 8,500. The latest year for which we have any figures is 1964, and there were less than 8,000 beds devoted to tuberculosis patients. In something over ten years there has been a decrease of just less than 10,000 beds devoted to the treatment of tuberculosis.
As the parliamentary secretary mentioned, generally speaking this does not mean there has been a reduction in the number of beds devoted to medical care, because many of these have been devoted to the care of chronic and incurable patients. In keeping with the reduction in the number of beds and the length of time for the treatment of tuberculosis, the federal tuberculosis control grant, which in 1962 was $3,500,000, has fallen in 1966 and 1967 to approximately $2 million. One of the reasons tuberculosis cannot be treated in general hospitals openly like any other disease, including mental disease, is that a certain percentage of these cases are highly infectious, and to do so might give rise to the spread of tuberculosis through the general hospitals. We are pleased that although the incidence of tuberculosis remains the same, the death rate has actually declined by 83 per cent since 1951.
I should like to say a few words about mental disease. It is apparent from the figures available that mental disease is either increasing or is being treated at an increasing rate. Certainly, we have far better diagnosis of mental disease than we ever had in the past, and the diagnosis is much easier to carry out now because the treatment available either to the general practitioner or the psychiatrist is a great deal more effective than it ever has been.
In 1962 we had 83 mental hospitals with something like 67,000 beds devoted to the care of the mentally ill. In 1963 there were 87 mental hospitals with something over 68,000
June 21, 1967

hospital beds devoted to the mentally ill. This does not represent the true number of patients who are suffering from mental illness as many psychiatric patients are under general hospital care. At one time I believe there were many mentally ill patients admitted to general hospitals under a different diagnosis, where these patients could be rapidly treated. Now, as a result of changes in the Hospital Insurance and Diagnostic Services Act, we are actually admitting them for mental hospital care as psychiatric patients.
Today in Canada more than 60 general hospitals have organized psychiatric units with
2,000	more beds than were devoted ever before to the care of the mentally ill. This gives us well over 72,000 beds in Canadian hospitals devoted to the care of the mentally sick. As the hon. member said, I think this represents almost half of the hospital beds in Canada devoted to this illness.
For some years now the mental health grant has been stationary at approximately $9 million. I hope the government will see fit to increase this amount so that a greater amount of money can be spent on research in respect of mental illness. We are all aware that one of the first breakthroughs, if you wish to call it that, in the treatment of mental diseases was the discovery of the drug L.S.D., about which we hear a great deal in the press and elsewhere at this time. L.S.D. is able to re-
Business of the House
produce the symptoms of the mental disease schizophrenia. It is obvious that when we can reproduce symptoms of a mental disease by the use of a drug, we have come a long way
toward finding a treatment for that particular disease.
I have every sympathy for the private member's notice of motion now before the house. Certainly if we are to expect the general public to treat tuberculosis, mental disease and mental retardation like any other disease, we must expect the federal government to do the same thing.
May I call it six o'clock, Mr. Speaker?


Mr. Speaker:: Order, please. Is it the wish of the house that I call it six o'clock?


Stanley Howard Knowles: No; put the question.



BUSINESS OF THE HOUSE

Allan Joseph MacEachen: Mr. Speaker, tomorrow we will consider the estimates of the Department of National Defence. If we should complete
those tomorrow we will call the estimates of the Department of Labour and continue with those estimates on Friday. If those estimates should be completed we would then call the Cape Breton Development Corporation bill.


[Stage Direction]
At six o'clock the house adjourned, without question put, pursuant to standing order.
[Stage Direction]
Thursday, June 22, 1967