1976-02-17

ROUTINE PROCEEDINGS


Mr. Adrien Lambert (Bellechasse):: Mr. Speaker, pursuant to Standing Order 43, I ask the unanimous consent of the House to move a motion dealing with an important matter of pressing necessity.
Since the producers of manufacturing milk have experienced for the past months a loss of income as a result of amendments to the dairy policy, I move, seconded by the hon. member for Richmond (Mr. Beaudoin):
That the Standing Committee on Agriculture be asked to consider immediately the dairy policy of the government and report to the House as of March 15, to enable the Minister of Agriculture to make the necessary amendments to the dairy policy on the basis of demands from milk producers.


Mr. Speaker:: Order. The House has heard the motion of the hon. member. Under the provisions of Standing Order 43, this motion requires the unanimous consent of the House. Is there such a consent?


Some hon. Members:: Agreed.


Some hon. Members:: No.


Mr. Speaker:: There is not unanimous consent, the motion therefore cannot be put.



SUPPLY AND SERVICES


Mr. Leonel Beaudoin (Richmond):: Mr. Speaker, under the provisions of Standing Order 43, I ask for the unanimous consent of the House to discuss a very urgent and important matter.
In view of the serious financial difficulties of the Lockheed Aircraft Company with which the government of Canada is negotiating following the decision to buy 18 Orion aircraft for nearly $1 billion, and since this American aeronautical company has been shaken up by great scandals over bribes offered to politicians from various countries to obtain contracts, a situation which can paralyze the company fairly soon and create prejudices for the
government of Canada, I move, seconded by the hon. member for Champlain (Mr. Matte):
That this House immediately discuss the schedule of payments under the Canadian contract as well as the next negotiations of the government with Lockheed Aircraft Company concerning the questions being asked on the integrity and viability of this company, to encourage the government of Canada to be very careful and reserved so that they do not bear the consequences of the still greater difficulties this American company could have soon.


Mr. Speaker:: Order, please. The House has heard the terms of the motion of the hon. member. Pursuant to Standing Order 43, this motion requires the unanimous consent of the House. Is there unanimous consent?


Some hon. Members:: Agreed.


Some hon. Members:: No.


Mr. Speaker:: There not being unanimous consent, the motion cannot be put.



ORAL QUESTION PERIOD


Hon. Robert L. Stanfield (Leader of the Opposition):: Mr. Speaker, I have a question for the Prime Minister arising out of information given in the House yesterday by the Minister of Finance to the effect that it is the intention of the Anti-Inflation Board to refer cases to the administrator and hence open up the appeals procedure only in those instances where a party to a settlement or an agreement has indicated an intention not to comply with the ruling of the Anti-Inflation Board. Is the Prime Minister prepared to review this rather perverse situation, which means that no appeal from the Anti-Inflation Board is available except to those who are prepared to act in defiance of the Board? Is the Prime Minister prepared to review this so that appeals will be open to those seeking appeals without requiring defiance of the board?


Right Hon. P. E. Trudeau (Prime Minister):: Mr. Speaker, I will have to take notice of the question. I do not have a copy of Hansard here. I was not here when the minister made his statement yesterday. I will have to increase my understanding of this matter before answering the question.

February 17, 1976
Oral Questions


Robert Lorne Stanfield: Well, as a former minister of justice and a man who has written with considerable passion on the subject of equality before the law and due process of law, what is the understanding of the Prime Minister now as to the appeal procedure with regard to the anti-inflation program? Is an appeal open, or is it circumscribed, as the Minister of Finance seemed to suggest yesterday?


Pierre Elliott Trudeau: When I was minister of justice this law had not been passed, and I would have to take notice of the question.


Some hon. Members:: Oh, oh!


Mr. Diefenbaker:: Ask Castro.


Robert Lorne Stanfield: I am disappointed that the Prime Minister has not been sufficiently interested to ascertain what is going on.


Some hon. Members:: Oh, oh!


Robert Lorne Stanfield: I do not blame the hon. gentlemen opposite for being a little upset about this question. I would not like to apologize for it either.


Some hon. Members:: Hear, hear!


THE CANADIAN ECONOMY
Robert Lorne Stanfield: Mr. Speaker, may I ask the Prime Minister when we may expect some information about the decision of the government regarding the export levy which the Minister of Finance indicated would have been settled last week but could not be settled then because the Prime Minister and part of his cabinet were out of the city? Can the Prime Minister indicate to the House when we may expect a decision of the government on a matter of such vast importance to our export industries, and indeed, to our whole economy?


Mr. Speaker:: Order, please. It is only with the greatest reluctance that I ever interfere with a question of the Leader of the Opposition; however, I really have no way of seeing a question on export development as supplementary to the original question on the subject of appeals under the statute. Unless there is some connection-


Robert Lorne Stanfield: I accept your ruling, of course, Mr. Speaker. I only entered that field because the Prime Minister did not seem to know anything about the first one I mentioned.


Some hon. Members:: Hear, hear!


ANTI-INFLATION BOARD ESTABLISHMENT OF RULES OF PROCEDURE FOR APPEALS- BASIS FOR FEDERAL COURT DECISION IF EVIDENCE ON APPEAL CONFIDENTIAL
Mr. G. W. Baldwin (Peace River):: Mr. Speaker, I was going to pursue this line of questioning with the Prime Minister so he might get some on the job training, but if the Minister of Finance would be kind enough to answer, I will ask him. There is a limited period of time for appeals from decisions of the administrator to the appellate tribunals. As there have been no rules of procedure, no publication of the form of notice of appeal required by the statute, when will this be done so that prospective appellants can know how to comply with the procedure laid down in the act?


Hon. Donald S. Macdonald (Minister of Finance):: Mr. Speaker, the Minister of Justice has responsibility for convening the tribunal, which has already been established. I would suggest that any party which feels it might like to launch an appeal should do so by addressing itself to the acting chairman.


Gerald William Baldwin: A supplementary question. Foregoing the opportunity to deal with the Minister of Justice, as the Minister of Finance is one of the ancestors of this bill of doubtful parentage, may I ask what assurance he can give to the House that the rules for presentation of evidence and the practice and procedures will be consistent with those of a judicial body in so far as appeal practices are concerned? In particular, as the hearings of the tribunal can be held in camera, on what basis could a federal court-proceedings of which are held in public-give a decision if all the evidence is to be held in confidence?


Mr, Macdonald (Rosedale):: The federal court would in due course have available the full record of the hearings at the appeal tribunal. In the case of evidence of a confidential nature-as frequently occurs in cases under the Restrictive Trade Practices Commission-it could decide to take certain evidence before it and I presume would do so.


DECISION IN IRVING CASE-POSSIBILITY OF INTERVENTION BY CABINET
Mr. T. C. Douglas (Nanaimo-Cowichan-The Islands):: Mr. Speaker, my question is for the Minister of Finance regarding the decision of the administrator in the case of the Irving Pulp and Paper Company which adversely affects the employees and imposes a heavy financial penalty on the employer. In view of the>
fact that section 24 of the Anti-Inflation Act empowers cabinet to intervene in respect of the decision of the administrator, may I ask the minister if the government intends to intervene in this matter with a view to re-examining any aspect of the administrator's decision?


Donald Stovel Macdonald: Mr. Speaker, I made it clear that I have no intention at this point of recommending to my colleagues that any intervention be taken against this decision. The administrator has obviously given careful attention to these facts, and in particular to the fact that the parties went ahead knowing
February 17, 1976

what they were doing would be contravening the guidelines, it seems to me the administrator's decision is entitled to be supported.


REQUEST FOR CHANGES IN APPEAL PROCEDURE
Thomas Clement (Tommy) Douglas: A further supplementary, Mr. Speaker. In the Globe and Mail of January 29, the Minister of Finance is reported as having made statements to the press indicating that there may be some amendments to the Anti-Inflation Act which would give trade unions the same right of appeal as that enjoyed by the corporation and to remove the necessity of breaking the law in order to get a case before the administrator. I would therefore ask the minister if the government is prepared to introduce two amendments. First, an amendment to provide for the appeal by any party affected by a decision of the Anti-Inflation Board to the administrator and second, an amendment which would allow any person affected by the decision of the administrator to appeal directly to the appeal tribunal?


Donald Stovel Macdonald: Mr. Speaker, what I said on that occasion, in response to the question of a reporter, was that we would give consideration to that point of view to which the hon. member has referred. As I said in response to a question yesterday, we will of course be prepared to give consideration to an amendment of that kind if it appears it would be necessary.


DATE OF APPOINTMENT OF INDEPENDENT APPEAL TRIBUNAL
Thomas Clement (Tommy) Douglas: A final supplementary, Mr. Speaker. Since the government has not yet appointed the permanent appeal tribunal, which I can well understand in view of the fact the legislation is drafted so cleverly that no one is likely to get a chance to appeal, and since the government has set up an acting appeal tribunal made up of one civil servant and two former civil servants who, with all respect to the gentlemen in question, would not be considered by anyone as being an independent and unbiased body. How soon is the government prepared to appoint an appeal tribunal which will be independent and appear to the Canadian people as being a body unprejudiced, unbiased and divorced from the government bureaucracy?


Donald Stovel Macdonald: Mr. Speaker, in my judgment the three appointees in question are unprejudiced and unbiased. They have been good servants of Canada and the imputation against them involved in the hon. gentleman's question is totally unjustified.


Gerald William Baldwin: They will go back to the civil service when they have finished.


Donald Stovel Macdonald: The tribunal has been established, as the hon. member said. My colleague has proposed that when amendments come forward, the responsibilities of this particular tribunal should be given to the tax appeal board for this purpose. The board would, therefore, be able
Oral Questions
to discharge these responsibilities in addition to those which it has under the tax act. That, I believe, will be in accordance with the views often expressed by the hon. gentleman's leader, that there should not be an increase in the bureaucracy in this regard, which seems to make sense.


Gerald William Baldwin: You are afraid to get a judge.


Donald Stovel Macdonald: It seems to make sense to put the matter under the tax appeal board for this purpose.
If I may answer the imputation made by the hon. member for Peace River against the tax appeal board, let me tell the hon. gentleman that they are a devoted and very capable group and I reject totally the suggestion implied in his imputation.


Gerald William Baldwin: You are afraid to get a judge.


Some hon. Members:: Shame!


Gerald William Baldwin: The people on the government side are experts in shame. The whole party is shameful.


AGRICULTURE
Joseph Adrien Henri Lambert: Mr. Speaker, I wish to put a question to the Minister of Agriculture.
Considering that for some months industrial milk producers have been suffering financial losses which in turn unbalance many producers' budgets, is the Minister of Agriculture willing to present the government's dairy policy around March 15, in order to give the producer's union enough time to indicate their views on such policy before the beginning of the dairy year which will begin on April 1?


Hon. E. F. Whelan (Minister of Agriculture):: Mr. Speaker, we met with representatives of the dairy farmers of Canada yesterday. The program will be announced as soon as possible, although I cannot promise the hon. member that it will be very soon. The dairy farmers of Canada know what they must do.


Joseph Adrien Henri Lambert: Mr. Speaker, I wish to ask a supplementary.
As the minister just said to the House that he met with representatives of the dairy farmers, and as representatives of industrial milk producers made representations to some members of parliament and as it would be in the interest of Canada, of industrial milk producers and of the dairy industry in general that such policy be known as soon as possible, can the minister make a little effort to present this policy before the last day of March?


Eugene Whelan: Mr. Speaker, the main difficulty for industrial milk producers of Canada stems from the world surplus and from surplus production in Canada. We have not

February 17, 1976
Oral Questions
cut back subsidies, as some people say. We are still paying the same amount of money for the proper amount of dairy products, including industrial milk. As I said, we will announce the program earlier, if we can.


ANTI-INFLATION BOARD SUGGESTION THAT A CHANGE BE MADE IN APPEAL PROCEDURE
John George Diefenbaker: Mr. Speaker, my question is directed to the Minister of Justice. I am sure he has followed what has taken place with greater care and more attention than the Prime Minister has; therefore I direct my question to him. If it be true that it requires the publication of the rule that has been made in order to bring on an appeal, as the Leader of the Opposition suggested, does the minister not think that a change should be made in this regard, because what has happened smells of much of the worst in Star-Chamber.


Pierre Elliott Trudeau: You are against the monarchy!


Hon. Ron Basford (Minister of Justice):: Mr. Speaker, I apologize to the right hon. gentleman, but I was a few minutes late getting into the House. I did not hear his leader's question, so I am not aware of the subject to which it relates.


Some hon. Members:: Oh, oh!


John George Diefenbaker: The answer is very proper. The minister is always here. He was not present to listen to the Prime Minister show his entire ignorance of what is happening.


Some hon. Members:: Hear, hear!


Some hon. Members:: Oh, oh!


John George Diefenbaker: Mr. Speaker, these interrupters do not know that there is a rule of law. They do not realize that. I ask the minister if he will look into this situation, for on the face of it it smells of deep injustice. It cannot be justified in any way. Will the minister immediately bring before the House the regulations providing for appeal and in general the terms thereof as required by the statute? As it is now, civil servants order, civil servants determine and the courts do not know what the facts are because they are confidential. Surely the minister, the keeper of the Queen's conscience, will do something to protect the individuals of Canada.


Stanley Ronald Basford: Mr. Speaker, I am sure that both the Queen and the Prime Minister are quite able to look after their own consciences.


Some hon. Members:: Hear, hear!


John George Diefenbaker: Don't associate them together, having regard to the Prime Minister's statements.


Stanley Ronald Basford: Although the right hon. gentleman did not state it, I take it he is referring to appeals under the Anti-Inflation Act. The rights of appeal of parties are set

out in the Act and in terms of the Federal Court Act. If there should be further clarification required for the guidance of parties as to the conduct of appeal, I am sure that the chairman of the appeal tribunal will indicate those.


NATURE OF NOTICE IN WRITING AND FORM PRESCRIBED FOR APPEAL
John George Diefenbaker: Mr. Speaker, provision is made for the appeal in Section 31(2) which reads;
An appeal to the Appeal Tribunal shall be instituted by filing with the Tribunal a notice in writing in a form prescribed by the rules made pursuant to subsection 27(2).
Those rules have not been promulgated in any way. Will the minister now tell the House what is the nature of the notice in writing and the form prescribed by the rules that has to be followed in order to make an appeal or is the minister unaware of the form?


Stanley Ronald Basford: Mr. Speaker, the procedures for appeal will be made known shortly and in such a way as not to prejudice any of the parties wishing to make an appeal.


INDUSTRY
Mr. James A. McGrath (St. John's East):: Mr. Speaker, I wish to direct my question to the Minister of Industry, Trade and Commerce who I understand has just returned from the salubrious area of Come-By-Chance. What steps does the government of Canada propose to take to prevent this major oil refinery, which is such an important employer in the Atlantic provinces, from going under?


Hon. Donald C. Jamieson (Minister of Industry, Trade and Commerce):: Mr. Speaker, I want to thank the hon. member for giving me notice. It is a fact that I held some meetings over the weekend with interested parties and talked to others on the telephone from Ottawa. It is not clear at the moment whether any action by any federal agency would be capable of preventing certain steps which are already in train and have been taken by some of the main parties, including for example, the government of Newfoundland and the ECGB financing agency in Great Britain. I will be meeting with Premier Moores later today here in Ottawa. Undoubtedly this subject will come up. My colleague, the Minister of Energy, Mines and Resources, in response to a question, indicated that some initiatives have been taken as a result of his actions to keep an eye on the situation. About the best I can tell the hon. member now is that we are very close to all the parties concerned and as soon as something emerges which might make it possible for the federal government to assist we shall consider it in the most sympathetic way imaginable.
February 17, 1976


James Aloysius McGrath: In view of the prospect of this plant having to close down, albeit for a short time, say two years, what plans does the government have to find alternative employment for the 500 employees, many of whom are the minister's own constituents?


Donald Campbell Jamieson: This is one of the matters I discussed with some of the workers concerned over the weekend. It was only, I believe, on Friday that the government of Newfoundland suggested the establishment of a federal-provincial task force. I indicated at that time that we would be quite prepared to co-operate in the establishment of some group through which we could determine what alternative sources of employment might exist. I want to say, however, in fairness and honesty to the workers in the area-and the hon. member will, I think, appreciate this- that finding four or five hundred additional jobs will not be the easiest thing in the world to do in the short run. But we will certainly do what we can.


ADMINISTRATION OF JUSTICE
Mr. Eldon M. Woolliams (Calgary North):: Mr. Speaker, I should like to ask the Prime Minister a question. I addressed a question in his absence to the Solicitor General concerning the proposed government bill to abolish capital punishment. I want to ask the Prime Minister whether the answer given by the Solicitor General, as reported in Hansard at page 10,870 represents government policy. The hon. gentleman said:
There will be a government bill to which the government will be committed but members of this House who are not with the government will be free to vote on it as they see fit.
Is that the free vote the government proposes?


Pierre Elliott Trudeau: The whips will not be on for the purpose of this vote.


Eldon Mattison Woolliams: May I put a second question to the Prime Minister? In light of the fact that the cabinet will not have a free vote-only backbenchers will have a free vote-how does the right hon. gentleman reconcile this situation with a free vote? Because that sounds about as free as a hog on ice.


Some hon. Members:: Oh, oh!


INDUSTRY
Mr. F. A. Philbrook (Halton):: Mr. Speaker, my question is for the Minister of Industry, Trade and Commerce and it relates to a recent statement by officials of the United Auto Workers' Union with reference to Douglas Aircraft. Is it true that the federal government will provide financial
Oral Questions
assistance which will permit the company to postpone lay-offs indefinitely? How long is "indefinitely", and how will this work?


Donald Campbell Jamieson: If I had the answer to all those questions I would be a very happy man. The position at the moment is that there was a proposal by McDonnell-Douglas to post lay-off notices affecting between 400 and 500 workers on Friday of last week. I met with officials of the company and as a result they agreed to postpone those lay-off notices indefinitely. As to how long "indefinitely" is, it is exactly what the word says. We are not sure. In the interim we are trying to find additional work for the plant in Toronto which will help, at least, to prevent these lay-offs taking place.
I undertook to try to get some answers within the coming week. We are looking at a number of solutions which may appeal to the company and which may lend themselves at least to giving us enough time, perhaps a year, in which to determine what role, if any, the company might play in the restructuring of the aerospace industry.


PERFORMING ARTS
Mr. David MacDonald (Egmont):: Mr. Speaker, my question is addressed to the Secretary of State and it concerns the film policy announced last August with application to the major film chains, Odeon and Famous Players. The minister indicated at that time that performance with respect to the quotas would be monitored and the results published regularly by CFTC. May I ask when we can expect to see some figures published as to the effectiveness of this new quota system? Can the minister tell us, also, when the actual contracts or agreements were signed and when they will be made public?


Hon. James Hugh Faulkner (Secretary of State):: The
contracts themselves are still under negotiation. I hope the negotiations will be concluded this week. The monitoring of the quota is in place and I believe published results will be available on a quarterly basis, but I would have to confirm that impression.


POSSIBILITY OF INVESTIGATION OF FILM DISTRIBUTORS BY COMBINES BRANCH
David Samuel Horne MacDonald: In view of the action recently taken by some of the major Canadian film makers-Pierre Berton, F. R. Crawley, Allan King, Gordon Pinsent and a number of others with a view to getting a combines investigation launched by way of a formal petition to the Minister of Consumer and Corporate Affairs with respect to the monopoly situation which prevails in the exhibition of films in this country, may I ask whether the minister has conferred with his counterpart on this subject and whether he has taken any appropriate action

February 17, 1976
Oral Questions
to investigate or to inquire from the leading distributors [English]
whether or not the conditions referred to do, in fact, exist?	COMBINES


James Hugh Faulkner: Mr. Speaker, that seems to be quite a separate approach to the problem and it is in the hands of my colleague.


COMBINES
David Samuel Horne MacDonald: Perhaps, then, I might ask the Minister of Consumer and Corporate Affairs whether he has had a chance to study this submission from the film makers, and in view of the interest taken in the possibility of a monopoly situation can he tell us whether he has responded to the petition or whether he has instructed the Combines Investigation Branch to launch a full inquiry?


Hon. Andre Ouellet (Minister of Consumer and Corporate Affairs):: Mr. Speaker, the hon. member surely knows that when appellants publicly declare they are requesting an inquiry, the administrator is naturally bound to initiate such an inquiry and assume his responsibilities pursuant to the act.


DATE OF INTRODUCTION OF PART TWO OF COMPETITION BILL
Mr. Lome Nystrom (Yorkton-Melville):: In view of the fact that the report confirmed what we in this Party have been saying for years about corporate concentration and high profits in the food industry, can the minister give the House a definite date by which he will introduce the second part of the competition bill or any other legislation which might deal with the recommendations contained in the study? Can he be specific as to a date?


André Ouellet: As soon as possible, at the beginning of next session, Mr. Speaker.


EXTERNAL AFFAIRS
Mr. Donald W. Munro (Esquimalt-Saanich):: Mr. Speaker, before addressing my question to the Secretary of State for External Affairs I hope I might be allowed to pay tribute to those dedicated and courteous public servants in the consular division of the Department of External Affairs, as well as in Guatemala for their tireless efforts to locate Canadians missing in Guatemala and to reassure worried relatives in Canada.


CONSUMER AFFAIRS
Lorne Edmund Nystrom: Mr. Speaker, my question is for the Minister of Consumer and Corporate Affairs. It arises from the report, commissioned by the Food Prices Review Board, pointing out that there is a high correlation between excessive profits and corporate concentration in food chains. What specific steps does the minister responsible intend to take to roll back prices in the seven cities which were designated as the cities in which the outlets were making excessive profits, namely, the four cities in the West along with Thunder Bay and St. John's?


André Ouellet: Mr. Speaker, I am in the process of studying this report. I have asked some of my department officials to examine more particularly the points of emphasis in this report. As for excessive profits I shall take up the matter with my colleague who is in charge of the Anti-Inflation Board.


Some hon. Members:: Hear, hear!


Donald W. Munro: My question is this: in order to avoid a recurrence of some of the communications problems which revealed themselves during the earthquake disaster, has the government taken any steps to set up a standing emergency helicopter force which might fly to stricken countries in case of need in order to improve internal communications in such circumstances. Also, has any effort been made to enlist the support of Canadian ham radio operators so as to improve communications between Canada and stricken countries? I know ham radio operators are ready, willing and able to co-operate.


Hon. Allan J. MacEachen (Secretary of State for External Affairs):: As to the first point, the hon. member made a constructive suggestion recently that we might make a helicopter, or a number of helicopters, available to the Guatemalan authorities. We investigated that proposal and found that in the circumstances the airport facilities in Guatemala could not service more helicopters than were in use at that particular time. Therefore any contribution that we might be willing to make would, in the circumstances, be redundant.
I believe that the suggestions he has made with respect to emergency preparedness in future situations are con-
February 17, 1976

structive and I will certainly have them examined and, if feasible, acted upon in the department and in CIDA.


DATE OF RECOGNITION OF NEW GOVERNMENT OF ANGOLA
Mr. Claude-Andre Lachance (Lafontaine-Rosemont):: Mr. Speaker, I wish to put a question to the Secretary of State for External Affairs.
Could he tell the House whether the presence of Cuban shock troops in Angola makes up a major obstacle to the recognition of the government of the People's Republic of Angola and, if not, does the minister expect to announce recognition at an early date, because the MPLA controls more than 80 per cent of the territory and several countries of western Europe announced their intention to do so?


Allan Joseph MacEachen: Mr. Speaker, I hope to have an announcement to make on that subject within a day or so.


POST OFFICE
Hon. W. G. Dinsdale (Brandon-Souris):: Mr. Speaker, my question is for the Postmaster General. Arising from the interim injunction granted last Friday by Mr. Justice John O'Driscoll of the Ontario Supreme Court preventing the Toronto CUPW executive from interfering with the rights of members of the union who crossed the picket line during the strike last fall to attend a membership meeting last Sunday, and also restoring the suspended members' right to vote and accept nomination for office, would the Postmaster General inform the House whether this injunction also protects the rights of 170 members of the Ottawa Local who find themselves in a similar position?


Hon. Bryce Mackasey (Postmaster General):: Mr. Speaker, I am not too sure to how extensive a jurisdiction the decision of the judge applies. I know that in essence what he said was what I said in the House earlier, that there is a union constitution, that the constitution spells out the procedure whereby a person may be suspended, and that in his opinion this procedure had not been followed. The judge therefore granted an interim injunction until each and every person who had been suspended does have an opportunity to make his or her defence against suspension. It was based on his appraisal of the Toronto situation that he granted the interim injunction.
I have asked my officials knowledgeable of the situation whether or not this would require similar action on the part of a suspended individual in each and every local across Canada. I would hope that the Canadian Labour Congress, the responsible governing body for labour in this country, would look very closely at this decision of the judge and see whether in their opinion it is not time to introduce some degree of democracy into the trade union movement so that it is not always subject to a negative public press.
Oral Questions


CANADIAN BROADCASTING CORPORATION
Mr. Robert C. Coates (Cumberland-Colchester North):: Mr. Speaker, my question is for the Secretary of State. I wonder whether the Secretary of State would contact CBC radio and make a determination whether or not they have made a decision not to start their broadcast of the Progressive Conservative convention, to be held in Ottawa on Sunday at the Coliseum, until four o'clock in the afternoon, rather than at the beginning of the voting, as they did when the New Democratic Party had its convention and as they did when the minister's own party, the Liberal party, had its convention in 1968? Or are we going to have to suffer through a continuation of the policy of being shafted by CBC radio, as was so obvious during the 1974 election campaign?


Some hon. Members:: Oh, oh!


James Hugh Faulkner: Mr. Speaker, I will certainly look into that for the hon. member.


MANPOWER
Mr. Lincoln M. Alexander (Hamilton West):: Mr. Speaker, I should like to direct a question to the Minister of Manpower and Immigration. It is in regard to the recent decision by Ontario to put jobs before welfare and placing welfare officers in manpower offices in the province to help welfare recipients get work and to make sure they accept available jobs. This would have some impact on the job vacancy rate and the unemployment rate. I would ask the minister whether there are any special measures agreed on by the minister and his counterpart in Ontario to assist in helping welfare recipients get work and, even more important, making sure that they accept available jobs. If so, would the minister give us some indication what it is all about, or will he be making a statement in this regard in the very near future?


Hon. Robert K. Andras (Minister of Manpower and Immigration):: Mr. Speaker, I had not intended making a statement but I will be glad to elaborate in more detail when my estimates are before the committee in the not too distant future. I think this is an encouraging co-operative arrangement between my department and Ontario. Indeed, we have had similar discussions with other provinces- British Columbia and New Brunswick-and I believe it is a progressive move to provide people on welfare with placement services and counselling, as well in some cases as training courses, etc.
Oral Questions


UNEMPLOYMENT INSURANCE
[Stage Direction]
February 17, 1976

Lincoln MacCauley Alexander: A supplementary question, Mr. Speaker. I hope the minister also approves of the idea, as reported, of making sure that welfare recipients accept available jobs. This to me is an indication that perhaps the same thing could work with respect to UIC claimants accepting available jobs; this has certain merit. I wonder whether the minister is thinking along these lines, and is it his intention to bring in legislation making or forcing UIC claimants to accept available jobs?


Robert Knight Andras: Provision regarding availability for work and acceptance of suitable jobs is already embedded in the Unemployment Insurance Act, and is being monitored within the guidelines and regulations attributable to that legislation.


CONSUMER AFFAIRS
Léonel Beaudoin: Mr. Speaker, I have a supplementary arising from the question put by the hon. member for Yorkton-Melville to the Minister of Consumer and Corporate Affairs.
The report submitted by marketing expert Bruce Mallen for the Food Prices Review Board was tabled yesterday. It appears from it that Canadians are paying about 4 per cent too much for food and that this seems to result from the quasi monopoly which eliminates competition among the four major food retailers, namely Dominion, Weston-Loblaw, Canada Safeway and Steinberg. Is the minister now in a position to clear up this question or can he inform the House if he intends to implement the recommendation contained in the report to present legislation to enable the chain supermarkets to expand again, particularly where they already serve large areas ranging all the way up to 94 per cent of the market?


André Ouellet: Mr. Speaker, it is a very interesting suggestion which deserves study. However, I repeat what I have said earlier to the hon. member for Yorkton-Melville, that this report was handed down to the director of combines investigation so that he might study the section concerning the overly large corporate concentration.


national defence


STATUS OF MANITOBA CONTRACTS FOR ORION PARTS
Mr. Dan McKenzie (Winnipeg South Centre):: Mr. Speaker, my question is directed to the Minister of Nation-

al Defence. On December 1, 1975, in the Standing Committee on External Affairs and National Defence, he stated that $560 million of contractual work would be done in Canada in the manufacturing of parts for the new Lockheed Orions, and that $50 million of this work would be done in Manitoba. Can the minister inform the House what is the status of these contracts in light of the latest development-that the government may not be purchasing the Orions?


Hon. James Richardson (Minister of National Defence):: Mr. Speaker, none of the arrangements for industrial benefit are themselves in jeopardy; but, as the hon. member knows, the contract itself is in its final stages of negotiation by the Department of Supply and Services.


A. Daniel McKenzie: A supplementary question, Mr. Speaker. At the committee meetings the minister stated that the work "would be starting now", meaning December 1, 1975. He further stated that Standard Aero in Winnipeg will not have to wait but will start to get work now. Has Standard Aero actually started making parts for Orions?


James Armstrong Richardson: Mr. Speaker, until the main contract has been signed there will be no work for any companies in Canada.


POSSIBLE OPENING OF SUFFIELD RANGE FOR GRAZING
Mr. Bert Hargrave (Medicine Hat):: Mr. Speaker, I have a further supplementary question for the Minister of National Defence. It relates to the recent decision by the Department of National Defence to close the PFRA Suffield community pasture near Medicine Hat. In view of the fact that this decision means that approximately 5,000 head of breeding cattle will have to find new homes for summer grazing or be put on the market, I ask the minister if he will give immediate consideration to rescinding the departmental order in view of the recommendation from PFRA to his cabinet colleague, the Minister of Regional Economic Expansion, that this pasture should be operated as a permanent PFRA pasture and not on the present temporary basis.


James Armstrong Richardson: Mr. Speaker, the general practice over the years has been that the Suffield range was opened for grazing in emergency circumstances, particularly in a very dry season. As the hon. member knows, the grass crop has been excellent, so there has been no emergency and therefore it was decided not to open the range for grazing this year.


Herbert Thomas (Bert) Hargrave: Mr. Speaker, I have a supplementary question for the Minister of National Defence. Will the minister then indicate if he is now able to supply copies of the three reports I have requested in writing which deal with this very urgent situation and especially the report from the Minister of Regional Economic Expansion.


James Armstrong Richardson: Mr. Speaker, I will look at the hon. member's request and if it can be carried out it will be. I do not know what the reports contain.
February 17, 1976


INDIAN AFFAIRS
Mr. Stuart Leggatt (New Westminster):: Mr. Speaker, my question is directed to the Minister of Indian Affairs and Northern Development and arises from a series of questions that were asked concerning mercury poisoning in northwest Quebec. The Minister of National Health and Welfare indicated there were plans issued to provide alternate protein sources or alternate livelihood for those people, some 20 of whom now have symptoms of poisoning and at least three of whom have been confirmed as having the Minamata disease. Could the minister advise the House specifically rather than generally what he intends to do to provide a protein source for those Indians who now are reaching the fishing season and will have to find something to eat; secondly, what he intends to do to give those who depend so much on fishing an alternate livelihood.


Hon. Judd Buchanan (Minister of Indian Affairs and Northern Development):: Mr. Speaker, in reply to the question of the hon. member, it is my understanding that arrangements are being made for an alternate protein source. I am sorry that I will have to check and give the hon. member the details concerning the question. Alternate economic development. It is similar to the situation in northwestern Ontario, and it is a slow and difficult process to develop in these areas.


TESTING FOR MERCURY POISONING AT CAUGHNAWAGA RESERVE-REASON REPORT ON CEDAR RAPIDS NATIVES NOT RELEASED
Stuart Malcolm Leggatt: Mr. Speaker, the testing results at the Caughnawaga Reserve have now been released, showing the levels there. There are some levels as high as 11.7 parts per million which is well above the standard of .5 for Canada for example. The TB levels are also very high. Can the minister advise whether any testing is going on on the Caughnawaga Reserve on the potential of mercury poisoning in that area and would he also advise why the report on the Cedar Rapids Indians which was done last November has not yet been released to the public so that these Indians will know whether or not they are suffering.


J. Judd Buchanan: Mr. Speaker, I think the questions on the report should be directed to my colleague the Minister of National Health and Welfare. I think it will be found that fish is a relatively minor source of protein so far as the Caughnawaga Reserve is concerned. It is not like the other locations.


ADMINISTRATION OF JUSTICE
Mr.  R. Gordon L. Fairweather@Fundy-Royal: Mr. Speaker, this is a question for the Minister of Justice. It follows an earlier series of questions about the fairness of
Oral Questions
the appeal proceedings. Can the minister assure the House that the time for the appeal in the Irving pulp mill case will run from the date of promulgation of the procedures and not from the date of the administrator's order.


Stanley Ronald Basford: Mr. Speaker, I would not want to give that assurance without specifically looking at the wording of the act. As I indicated, the procedures will be laid down without prejudice to the parties and that will be very soon.


LABOUR CONDITIONS
Mr. Joseph-Philippe Guay (St. Boniface):: Mr. Speaker, my question is for the Minister of Labour. In view of the numerous requests I, and I am sure many other members of this House, have been receiving in respect of railroad workers and the Hall report, could I ask the minister if he could give us a progress report in this regard or tell the House when we can expect the report which is long overdue.


Hon. John C. Munro (Minister of Labour):: Yes, Mr. Speaker. I think the hon. member is referring to the question of pensions for railway employees and my advice is that Mr. Hall will have his report out at the end of February or toward the middle of March at the latest.


CONSUMER AFFAIRS
Mr. R. E. McKinley (Huron-Middlesex):: Mr. Speaker, I have a question for the Minister of Consumer and Corporate Affairs. It concerns the March 1 date which has been set for the regulations to be brought in with regard to labelling and packaging of consumer goods. I should like to ask the minister if he is giving consideration to extending that March 1 date so that retailers can use up more of the packages they have on hand? Second, I should like to ask him if small bakeries in small towns which cater only to the local trade and package their goods over the counter will be exempt from these regulations.


André Ouellet: Mr. Speaker, my answer to the first part of the question is no. As for the second part, arrangements will be made by the officials responsible for supervising the application of that act to facilitate the transition for the companies and spare them too many difficulties. On the other hand, where small companies are concerned which deal in cakes and bread, recommendations have already been submitted to their association with a view to finding some accommodation.

February 17, 1976
Oral Questions


NATIONAL PARKS
Hon. Marcel Lambert (Edmonton West):: Mr. Speaker, my question is directed to the Minister of Indian Affairs and Northern Development. Some weeks ago the minister was good enough to tell me that the intradepartmental parks department paper or report with regard to the moving of railway facilities from Jasper National Park would be made to the minister. Has he yet received the report? If not, when does he expect to receive it and to make it public?


J. Judd Buchanan: Mr. Speaker, I have received the report. I am just going through an analysis now. I will have a look at it. I do not see any reason it should not be made public virtually immediately.


Mr. Speaker:: Order, please. The hon. member for High Park-Humber Valley (Mr. Jelinek) rises on a point of order.


Mr. Jelinek:: Mr. Speaker, you will recall that on January 3, the day I departed for Innsbruck for the primary purpose of acquiring-


Some hon. Members:: Oh, oh!


Otto John Jelinek: -an even better understanding of the organization and procedures in preparation for the Olympics, I suggested that was something which the government should have done a long time ago.


Some hon. Members:: Hear, hear!


Otto John Jelinek: On that day the Parliamentary Secretary to the President of the Privy Council brought to the attention of this House statements I had made the previous evening during the adjournment proceedings, one of which referred to Your Honour. I would like to take this opportunity to put on the record that that particular comment of mine was an offhand remark and, that I had absolutely no intention of casting any reflection on the Chair. If, however, that remark was given a different interpretation by others, I should like to take this opportunity to apologize to you, sir, for the misunderstanding.


Some hon. Members:: Hear, hear!


Mr. Cossitt:: Mr. Speaker, I rise on a point of order which stems from a question I asked in the House two weeks ago on Monday of the Secretary of State for External Affairs. At that time I asked the minister if he could report to the House on reports that the Canadian embassy in Havana had been invaded by the Cuban police and that personnel and members of the press from Canada had been manhandled during the incident. The Secretary of State for External Affairs said he would look into the matter and report. Since 15 days have gone by, and the Prime Minister was there at the time it happened and is sitting right beside the

minister-if he does not run away-surely the minister could tell the House now exactly what happened.


Allan Joseph MacEachen: Mr. Speaker, I did look into the question raised by the hon. member and I discovered that, as is normal, Premier Castro had some security people with him on his visit to the Canadian reception. There were some slight misunderstandings which were rapidly cleared up.


Some hon. Members:: Oh, oh!



ROUTINE PROCEEDINGS


[Stage Direction]
Thirteenth Report of Standing Committee on Finance, Trade and Economic Affairs-Mr. Cafik.
lEditor's Note: For text of above report, see today's Votes and Proceedings].

[Stage Direction]
(Questions answered orally are indicated by an asterisk.)
Mr.   J.-J. Blais@Parliamentary Secretary to President of the Privy Council: Mr. Speaker, the following questions will be answered today: Nos. 3,330, 3,535, 3,644, 3,771, 3,883, 3,888 and 3,902.


Mr. Brisco: Has the Department of Finance considered allowing interest on first and second mortgages paid on a house in which the owner is resident, as a deductible item for the purpose of calculating personal income tax?


Mr.   Jacques-L. Trudel@Parliamentary Secretary to Minister of Finance: An amendment to the Income Tax Act to allow a mortgage interest deduction has been considered by the Department of Finance on a number of occasions and each time has been rejected. Reasons for rejection include the very high cost of such a deduction, the fact that it would discriminate between those who have mortgages and those who do not, and the fact that it would increase the demand for borrowed money, thus driving up interest rates.


Mr. MacDonald (Egmont): With reference to the recent agreement on Phase 2 of the PEI Comprehensive Development Plan, does the general objective spelled out in Schedule "C" represent a departure from the original aims of the Plan, especially in light of the absence of any reference to improved social conditions?
February 17, 1976


Mr. Cliff Mclsaac (Parliamentary Secretary to Minister of Regional Economic Expansion):: The reply for the Department of Regional Economic Expansion is as follows: No.


Mr. Clarke (Vancouver Quadra): Since 1972, have government contracts been awarded to Interimco Limited of Ottawa and, if so (a) by what department or agency was payment made (b) for what specific purpose (c) in what amounts (d) on what dates?


Hon. Mitchell Sharp (President of the Privy Council):: am informed by all departments and agencies as follows: No.


Mr. Matte: 1.	Since its inception, has the Department of Regional Economic Expansion offered subsidies to businesses for the purpose of promoting regional development in the Constituency of Champlain and, if so, what has been the annual amount?
2.	For each subsidy granted in the Constituency, how many corporations have accepted such offers?
3.	What was (a) the name of the corporation (b) the amount of the subsidy (c) the year it was granted (d) the number of jobs created?


Joseph Clifford McIsaac: The answer for the Department of Regional Economic Expansion is as follows: 1. Yes. Under the authority of the Regional Development Incentives Act (RDIA), the annual amounts offered were: 1971, $136,442; 1972, $387,106; 1973, $395,125; 1974, $219,200; 1975, $539,550.
2. Twenty five offers have been accepted.
3.	Estimated
Name of recipient	Incentive Grant	Year*	Expected Direct New JobsAdrien Vohl & Fils Ltee	$65,502	1971	32Antica Inc.	81,800	1975	24Caron Ltee	60,000	1974	50Charbon de Bois St-Prosper	32,000	1975	19Construction Marmico Inc.	41,940	1971	28D.P.M. Thibault Inc.	18,831	1972	11Enterprise Goulet Inc.	39,600	1973	17Eloi Moisan Inc.	22,940	1972	6Fonderie Gosselin Inc.	7,035	1972	9Gerard Crete & Fils Inc.	23,800	1975	9Godin Knitting Inc.	16,000	1972	14Groleau Inc.)	29,000	1971	52Groleau Inc.)	120,000	1973	40J. Ford & Co. Ltd.	95,500	1974	30Jos Paquin & Fils Ltee	62,950	1973	20La Chemise Hamel	37,000	1973	60La Compagnie Freneco Ltee	18,000	1975	4La Scierie Parent Inc.	383,950	1975	95Les Industries Zodiac	126,300	1972	28Les Produits Marcono Ltee	30,450	1974	8Pantoufle Mauricienne Ltee	33,250	1974	30Produits Labonte Inc.	20,275	1973	14Scotwell Industries Inc.	115,300	1973	50Skirt Togs Industries	174,600	1972	174Spliced Veneer Specialties	21,400	1972	32
Order Paper Questions
* The year indicates the year in which the offer was accepted and not necessarily the year in which payment was made.


Mr. Beatty: 1.	What is the nature of each and every form sent to businesses on a routine basis by the government including (a) the department or agency sending the form (b) the type of business to which it is sent (c) the type of information sought (d) the uses to be made of the information gathered (e) the regularity with which each form is sent to a single business (f) the number of businesses to which each form is sent?
2.	What measures, if any, are being taken by the government to reduce the amount of paperwork businesses are required to complete for the government?


Hon. Jean-Pierre Goyer (Minister of Supply and Services):: The Interdepartmental Committee on Forms Standardization reviews and standardizes governmental forms. This function is carried out for the purpose of creating greater economies of scale in the printing area. The Committee would not normally consider forms sent to businesses and has neither the manpower, the financial resources nor the requisite authority to solicit government departments to determine the nature of forms sent to businesses.


Mr. Lambert (Bellechasse): 1.	Between 1967 and 1974, what were the progressive annual increases of the assets of each chartered bank?
2.	In each case, what was the origin of such increases?


Mr.   Jacques-L. Trudel@Parliamentary Secretary to Minister of Finance: 1 and 2. The assets and liabilities of each chartered bank, broken down by categories in accordance with Schedule M of the Bank Act, are published monthly in Part I of the Canada Gazette, including the period 1967 to 1974.


Mr. Marshall: 1.	Has the Canada-USSR Joint Fisheries Consultative Commission been established and, if so, who are the two members appointed by the government?
2.	To the knowledge of the government, has the USSR appointed a fishery official to provide statistical information with regard to fishing operations in the North West Atlantic and, if so, what are his terms of reference?


Allan Joseph MacEachen: 1. The Agreement between Canada and USSR concluded December 22, 1975 provided for the establishment of a Joint Fisheries Consultative Commission to be composed of two Commissioners from each side. Both Governments are in the process of determining appropriate Commissioners to be appointed in the near future.
2. The same Agreement also provided for the appointment of a Soviet fisheries official in Halifax. This official has not yet been appointed by the Soviet Government.

February 17, 1976
Order Paper Questions


Mr.   J.-J. Blais@Parliamentary Secretary to President of the Privy Council: Mr. Speaker, if question No. 3,858 could be made an order for return, the document could be tabled immediately.


Mr. Bawden: 1.	How much will the government be spending in the current fiscal year for language training courses?
2.	How many members of the Public Service will participate in such courses?
3.	How many days were involved in public servants taking language courses?
4.	How many public servants, within their last two years prior to retirement have taken language training courses in the current fiscal year?
5.	What reason was given for the $36,000 loss by Statistics Canada through a language training contract for which no service was received?
6.	How many Statistics Canada employees were needed to meet the guaranteed minimum and how many actually participated in a language training course?
7.	What are the criteria for measuring the success of the language training courses?
8.	According to the criteria in Part 7, what percentage of public servants have successfully completed each grade of language training and have achieved an acceptable level of fluency in the language studied?
Return tabled.


Marcel Joseph Aimé Lambert: Mr. Speaker, during the past two days I have been making a study of the number of questions that the parliamentary secretary routinely asks the House to make orders for return. Then I looked at the questions to see what kind of answers were given. Unless there is some justification given in the House, I feel that they should not be made orders for return automatically, either because of the length of the answer or for some other reason. Those answers are buried in the office downstairs, and often they are the most embarrassing to the government.
I suggest that there be a change in the procedure and that the hon. member should explain why he is asking for the extraordinary procedure of making them orders for returns. It is only an exception to the request where an answer is written. Therefore, I think the House should watch this matter very carefully, and I would ask the parliamentary secretary to justify his reasons every time he asks for this procedure to be followed.


Mr. Blais:: Mr. Speaker, may I say, on that point, that we do not attempt to have a reply to a question made an order for return unless we feel-


Marcel Joseph Aimé Lambert: Unless the House feels.


Jean-Jacques Blais: -unless we feel that there is too much material to be printed in Hansard. We simply move to have the question made an order for return if the reply is voluminous. The hon. member is free to request, as he has
[Mr. MacEachen.l
done on a number of occasions, some explanation as to why, in a specific instance, there is need to make a question an order for return. I simply wish to indicate to him that in the past few days we have had a number of voluminous replies, even though they may have been partial answers to questions. In those instances it was justifiable to seek permission of the House to make them orders for returns, and that permission was always granted.
As to whether the answers are buried in the depths of this chamber, may I point out to the hon. gentleman that the hon. member who seeks a reply, whether the answer is printed in Hansard or made an order for return, receives a complete copy of the return upon its being tabled in the House. Yesterday I must have sought permission to get 12 replies made orders for returns, and I fail to see why in all instances I should enumerate the reason we wish to make orders for return in the case of answers, some of which are 40 pages long. I find it unjustifiable. The way we have proceeded in the past is reasonable. It generally has met with the approval of the House, and to my recollection the only one who has objected from time to time has been the hon. member for Edmonton West.


Mr. Speaker:: Order, please. The point has been raised many times before. It is the normal practice of the House that the parliamentary secretary should seek leave of the House that certain questions be made orders for return, to which the House must give its consent. It is the right of any member who feels aggrieved, either by the individual application of the practice in general, to withhold that consent. It has been suggested in the past that that procedure be altered. That suggestion, I hope by automatic process and with guidance from the Chair from time to time, has been passed along for the consideration of the Standing Committee on Procedure and Organization.
Until there is consensus forthcoming from the House on the need for a change in the procedure, it would seem that the practice must continue. If, however, any hon. member feels aggrieved either by the individual application of that practice or by the practice in general, he always has the right to withhold agreement to the request by the parliamentary secretary for leave of the House to make an individual order for return.


Jean-Jacques Blais: Mr. Speaker, I ask that the remaining questions be allowed to stand.


Mr. Cyril Symes (Sault Ste. Marie):: Mr. Speaker, I ask leave to move, seconded by the hon. member for Nickel Belt (Mr. Rodriguez), the adjournment of the House under the provisions of Standing Order 26 for the purpose of discussing a specific and important matter requiring
February 17, 1976

urgent consideration, namely, the immediate need for the government to amend the Anti-Inflation Act to provide for a right of appeal from a decision of the Anti-Inflation Board and/or the administrator to either party affected by such a decision, a necessity vividly illustrated by and urgently warranted in response to the decision of the administrator in the Irving Pulp and Paper case whereby one of the aggrieved parties, namely, the union, was accorded no right of appeal from a decision affecting the livelihood of its members, and the further necessity of preventing a total breakdown of the free, collective bargaining system throughout the economy by ensuring an equitable appeals process and the compelling need for the House to debate the necessity for such an amendment.


Mr. Speaker:: Order, please. The hon. member yesterday put forward a very similar motion, and at some length I indicated that with considerable regret I was not able to accede to the request. With slight modification, with all due respect, the hon. member has repeated the application today.
It is the nature of the Standing Order that if circumstances change, then in fact not only is it possible for hon. members to bring forward for a second or third time an application under the same Standing Order, but on occasions in the past the Chair has invited hon. members to do so. However, where repeated applications are made one day after the other without any suggestion that the circumstances have changed in the interval, it is very difficult for the Chair not to regard that simply as an attempt to appeal on Tuesday the ruling of the Chair on Monday. I say that only by way of general admonition to the hon. member.
On the other hand, there is not substantial disagreement about the circumstances of the case, nor is there any disagreement on any side-obviously, by the nature of the questions asked again today-about the importance of the matter. Where there is fundamental disagreement between the hon. member and the Chair is whether Standing Order 26 ought to be used to reopen legislation which was passed recently by the House and which in its operation is perhaps aggrieving a substantial number of parties in the country. But in fact it is doing so by the operation of legislation which must, in the opinion of the Chair, have been envisaged when the legislation was passed by this House.
The difference between the hon. member and the Chair in this instance is that where pressure, as his notice of motion puts forward today, is for an amendment to that legislation, it is the opinion of the Chair that amendment ought to be sought in the way it is being sought daily, through questions and, presumably, in other ways which are open to hon. members to seek amendments to legislation.
However, where there is no indication that there is some dereliction in the performing of duties under the legislation, or some breakdown in it, I suggest, with the greatest respect to all hon. members using the question period, that the "late show" is available; that the estimates of the minister will be tabled, I understand, tomorrow, and the minister will be before the standing committee where he can be questioned in much more detail and in a much more continuing manner. There are a number of ways open to all
Non-Canadian Publications
hon. members to seek improvements and amendments to the legislation.
Where there is disagreement is that if the legislation which was passed by this House a short time ago is having precisely its intended effect, and parties are aggrieved by it, I do not see that that is a cause for the use of Standing Order 26. There is a fundamental disagreement between the hon. member and other hon. members and the Chair in that respect. However, that is the opinion the Chair holds, and this is the second consecutive day upon which the Chair has made that ruling.
If there is in fact some circumstance which alters the situation, the Chair is more than open to entertain further applications under the Standing Order. But I should repeat that where the allegations are, as they are in the notice of motion of the hon. member today and yesterday, that the legislation is having an effect which aggrieves certain parties but which is the intended effect of the legislation, it is the view of the Chair that that is not a ground for the use of emergency procedures pursuant to Standing Order 26, no matter how important that effect may be. There is no doubt, particularly backed up by the questions of hon. members again today, that it is an important area and that it is having a very serious effect. The only disagreement is about the use of Standing Order 26 in that particular situation.



GOVERNMENT ORDERS


[Stage Direction]
The House resumed, from Monday, February 16, consideration of Bill C-58, to amend the Income Tax Act, as reported (without amendment) from the Standing Committee on Broadcasting, Films and Assistance to the Arts.
Marcel Joseph Aimé Lambert: Mr. Speaker, I
adjourned the debate at ten o'clock last night. It is fortunate that there are no regulations in this bill to be implemented by a minister, thereby creating a serious situation, and we would certainly be as rough on a minister of national revenue if he were guilty of laches in preparing and presenting regulations. I think I have traversed all the arguments I wished to put forward to this House with regard to the amendment before us, and I seek the support of hon. members opposite and earnestly ask them to vote in favour of the amendment. On that note, we are ready for the vote.


The Acting Speaker (Mrs. Morin):: Is the House ready for the question?


Some hon. Members:: Question!
11014

February 17, 1976
Non-Canadian Publications


The Acting Speaker (Mrs. Morin):: Is it the pleasure of the House to adopt the motion?


Some hon. Members:: Agreed.


Some hon. Members:: No.


The Acting Speaker (Mrs. Morin):: All those in favour of the motion will please say yes.


Some hon. Members:: Yes.


The Acting Speaker (Mrs. Morin):: All those against the motion will please say no.


Some hon. Members:: No.


The Acting Speaker (Mrs. Morin):: In my opinion the yeas have it.
And more than five members having risen:


The Acting Speaker (Mrs. Morin):: Please call in the members.

The House divided on motion No. 6 (Mr. Friesen) which
was negatived on	the following division:	
(Division No. 109)
 YEAS Messrs.	
Alexander	Hamilton	McKinnonAlkenbrack	(Swift Current-	MitgesAndre	Maple Creek)	Muir(Calgary Centre)	Hargrave	MunroBaker	Hees	(Esquimalt-(Grenville-Carleton)	Hnatyshyn	MurtaBalfour	Holt (Mrs.)	NeilBeatty	Howie	NielsenBeaudoin	Huntington	OberleBrisco	Hurlburt	O'SullivanCadieu	Jarvis	PaproskiCaouette	Jelinek	Patterson(Villeneuve)	Johnston	RitchieClarke	Jones	Roche(Vancouver Quadra)	Kempling	RoyCoates	Knowles	(Timmins)
Cossitt
Crouse
Darling
Diefenbaker
Dinsdale
Dionne
(Kamouraska)
Ellis
Elzinga
Epp
Forrestall
Friesen
Gauthier
(Roberval)
Hamilton
(Qu'Appelle-Moose
Mountain)
(Norfolk-Haldimand)
Korchinski
Lambert
(Edmonton West) Lawrence MacKay MacLean Macquarrie Malone Masniuk Matte
Mazankowski
McCain
McCleave
McGrath
McKenzie
McKinley
++NAYS
Messrs.
Rynard
Schellenberger
Schumacher
Scott
Skoreyko
Smith
(Churchill)
Stanfield
Stewart
(Marquette) Stewart (Cochrane) Towers Wenman Whittaker Woolliams Yewchuk-82.
Allmand	Benjamin	CafikAnderson	Blackburn	Campagnolo (Mrs.)Andras	Blais	Campbell (Miss)(Port Arthur)	Blaker	(South Western NAppolloni (Mrs.)	Blouin	CaronBaker	Boulanger	Chr6tien(Gandcr-Twillingate)	Brewin	ClermontBasford	Buchanan	CollenetteBechard	Bussieres	CondonBegin (Miss)	Caccia	CorriveauCullen	Messrs. Lachance	MclsaacCyr	Lajoie	McRaeDanson	Lalonde	MilneDemers	Landers	Morin (Mrs.)Douglas	Lang	Munro(Bruce-Grey)	Langloisr	(Hamilton East)Douglas	Laniel	Nicholson (Miss)(Nanaimo-Cowichan-	Lapointe	NystromThe Islands)	Leblanc	O'ConnellDrury	(Laurier)	OrlikowDupras	LeBlanc	OuelletDuquet	(Westmorland-Kent)	PearsallEthier	Lee	PelletierFaulkner	Lefebvre	PennerFirth	Leggatt	PetersFleming	Lessard	PhilbrookFlynn	Loiselle	PinardFoster	(Chambly)	PoulinFox	Loiselle	Prud'hommeFrancis	(Saint-Henri)	RailtonGauthier	Lumley	Reid(Ottawa-Vanier)	MacDonald	RichardsonGilbert	(Cardigan)	RobinsonGillespie	MacDonald	RodriguezGoodale	(Egmont)	RooneyGray	Macdonald	RoyGuay	(Rosedale)	(Laval)(St. Boniface)	MacEachen	SaltsmanGuay	MacFarlane	Sauve (Mrs.)(Levis)	MacGuigan	SharpGuilbault	Mackasey	SmithHarquail	Maine	(Saint-Jean)Herbert	Marceau	StolleryHopkins	Marchand	SymesIsabelle	(Langelier)	TessierJamieson	Marchand	TrudeauKnowles	(Kamloops-Cariboo)	Turner(Winnipeg	Martin	WhelanNorth Centre)	Young-123,


James Hugh Faulkner: that Bill C-58, to amend the Income Tax Act, as reported (without amendment) from the Standing Committee on Broadcasting, Films and Assistance to the Arts, be concurred in.


Mr. Speaker:: Is it the pleasure of the House to adopt the said motion?


Some hon. Members:: Agreed.


Some hon. Members:: No.


Mr. Speaker:: I declare the motion adopted on division.


[Stage Direction]
Motion agreed to.
Mr. Speaker:: When shall the bill be read the third time?


Some hon. Members:: Now.


Some hon. Members:: Never.


Mr. Speaker:: At the next sitting of the House?


Some hon. Members:: Agreed.


Mr. Roy (Timmins):: Mr. Speaker, I rise on a point of information. Is there no debate on third reading?


Mr. Speaker:: The motion first put after the disposition of motion No. 6 was simply a motion for concurrence in the bill, which concludes the report stage. The next question was, "When shall the bill be read the third time?" Of course, without leave the bill cannot be read the third time
[The Acting Speaker (Mrs. Morin).]
February 17, 1976

until the next sitting of the House. Debate is, of course, possible upon a third reading motion at any sitting.


Jean-Jacques Blais: Mr. Speaker, through usual consultation the order of business will be Bill C-68.



MEDICAL CARE ACT


[Stage Direction]
The House resumed, from Monday, February 2, consideration of the motion of Mr. Lalonde that Bill C-68, to amend the Medical Care Act, be read the second time and referred to the Standing Committee on Health, Welfare and Social Affairs.
Mr. P. B. Rynard (Simcoe North):: Madam Speaker, I am amazed that the federal government should bring in a bill to limit doctors' incomes to a rate of increase far below the rate of inflation, particularly in view of the fact that they received an increase of only 4V2 per cent in 1971 and no further increase until 1974. That was a three-year interval without an increase. Then in 1974 they received an increase of 7.75 per cent, far below the inflationary factor. It is hard to believe that this child, national medicare, was brought in to give the highest quality of medical care to all individuals in Canada regardless of their resources or where they live. That any government dedicated to such high principles as the government of the late Lester B. Pearson-a Liberal government at that-could now, so hypocritically, attempt to destroy those worthy principles is hard to understand.
I believe doctors will continue to give the highest quality of medical care they are capable of giving, in spite of the efforts of politicians to lower and undermine the standard of medical care in Canada. Most doctors realize that the strutting politician of today occupies the stage of time for only a brief moment, after which he is gone, leaving the good or harm he has done as a tiny scar on the face of humanity. It is hard to conceive the reasons for which a government beset by scandals and under the table deals involving bookkeeping no auditor would ever pass, would have the temerity to bring in a bill affecting a group whose increase in pay has been far less lavish than the pay increase granted to its own members or its own increase in spending. The bill is wrong; the principle is wrong.
The cost of medicare is declining in relation to the gross national product. Hospitals, it is true, have been running into trouble-I give the minister credit for pointing this out-but they are running at a lower rate of inflation than the government. What is the reason for making health care costs the whipping-boy, the unwanted child of a government which has surely committed worse follies? I wish to quote a statement made by the Secretary of State for External Affairs (Mr. MacEachen) who brought this act into being. I do not in any way blame the Minister of National Health and Welfare (Mr. Lalonde) for the mess we have got into, though I wonder sometimes whether he has made the best use of the talents he possesses; whether he could not do more to influence his provincial counter-
Medical Care Act
parts and create an atmosphere in which the job could be done together. These are the words which were spoken by the former minister of health:
Health is not a privilege tied to the state of one's bank account but, rather, a basic right which should be open to all.
I want to put on record, too, the fact that at the federal-provincial conference held in July, 1965, then prime minister Pearson announced the federal government's resolution to provide financial support for provincially-instituted medical care plans. At that time he announced his government's intention to share 50 per cent of the cost of medical services provided the provinces met his principles-eligibility, comprehensiveness, universality, public administration, and portability.
The minister of national health and welfare at that time confidently estimated that the net cost of the scheme to the two levels of government would be $80 million. I should like to point out that the treasurer of Ontario, when made aware of the contents of the legislation, inquired prophetically, "What guarantee have we that within a few years from now the federal government will not dump the whole responsibility for this program on the province and close off or limit its contribution after it has obliged the provinces to embark on its slippery slope?" That was the statement made by Hon. Charles MacNaughton in November of 1968.
Basically, then, opposition to the federal government's proposal came from two camps and centred on two distinctly different concepts. The provinces maintained that the Medical Care Act represented a federal encroachment upon exclusively provincial jurisdiction. I wish to emphasize once again, though I have already made it clear on a number of occasion, that this program has now become a federal-provincial program and it was the federal government which made it so. This aspect was stressed by the provinces themselves after the federal government had entered the field. During the discussion which preceded the introduction of the program, the provinces also maintained that their priorities were distorted by the availability of federal dollars, that the program was untimely and uncalled for in light of other considerations and existing provincial health care systems, and that the provinces had very little control over administrative costs, procedures or priorities.
I would remind the minister, further, that when Hon. John Robarts, who was premier of Ontario, embarked upon this scheme he was forced into it by the federal government collecting from him, legally or illegally, the cost of the medicare program. Ontario had its own scheme. As to the implications of the bill before us, I would draw the attention of hon. members to a statement made by the Minister of Labour (Mr. Munro) in 1969. He said:
The cost of health services has risen so rapidly in Canada in recent years that three alternatives are imminent:
The standards of health care now available can be reduced, or
Taxes, premiums or deterrent fees can be raised even higher-
That was the second suggestion. I ask the minister why medicare was brought in if there was going to be a deterrent fee. This is exactly the reason it was brought in. That is number two of the premise. The third was as follows:
Ways must be found to restrain the growth of cost increases through better operation of the health service structure now in existence.
11016

February 17, 1976
Medical Care Act
That statement was made in 1969-seven years ago. I am not blaming the present minister; I have a great deal of confidence in him, and he is working very hard to do his job; but it seems to me he is having to take care, as it were, of an automobile which must be kept on the road somehow, though it is in extremely poor shape; he has to make the best of it, but his best is simply not good enough in the circumstances. At any rate, he and his colleagues have had seven years in which to do something about it, but they have preferred to ignore it.
Today we find hospitals which charge patients $50 a day being closed in rural parts of Ontario, while hospitals in Toronto charging $150 a day are still open. I ask the minister how he intends to deal with people who fall sick in areas where hospitals are closed. Has the federal government considered its priorities carefully? I also ask provincial governments whether they have reviewed their priorities in the fields of education, transport, and so on, because I think this whole matter has been handled very badly.
The former minister of finance, Hon. John N. Turner, maintained that the cost of health care had risen by almost 20 per cent compared with last year. He was correct-but what he discreetly failed to mention was that almost the whole of this increase was the direct result of escalating expenditures in hospitals, not medical care.
This is a bad bill, and I say that very emphatically. It is a direct attempt to introduce shoddy medical care into one of the highest standards of medical care in the world. It is an attempt to downgrade the quality of medical care. This bill will stand long after the anti-inflation legislation has gone. We all know inflation tends to have a run after controls are taken off, but this bill will stay on and only an act of parliament will remove it.
The minister was very proud when speaking to Senator Edward Kennedy the other day about the cost of medical care in Canada compared with the United States. I know the minister thought he was absolutely right, but I happen to have been in hospitals in the United States. I did some of my training in them, and these hospitals are doing research into many things that we do not do in Canada. They have a population of 220 million, yet they are doing far more research than we are, with a population of 22 million scattered across Canada. This is why their costs are higher. They are giving the world much more research than we are. So I do not think the minister's comparison was quite fair. I know he meant well when he cited the figures, which I know are accurate enough; but, as I say, things are done in United States hospitals that are not done in Canadian hospitals.
The minister must concede that no group has conducted itself as well as the medical profession. I suppose the government takes a look at the votes of the doctors and thinks there are only 30,000 of them. Since these votes are a drop in the bucket, they say, "Let the doctors squawk." This may sound very political, but the government is being even more political by bringing in this bill. It is also cutting research. It is cutting personnel in order to pay health care costs. It is sacrificing research now, when research would lessen health care costs in the future. Again I should like to refer to the United States which 
spends 20 times the sum Canada spends on heart research. A further tragedy is that there is less and less opportunity for bright graduates to find a position that enables them to do heart research in Canada.
Canada is not looking after its alcoholics, either. The minister spoke about costs. Some statisticians believe that alcohol is the number one killer, ahead of cancer and heart disease. Yet thousands of our alcoholics have to go to the United States for treatment, according to Dr. George Stra-chan of Sydney. The government lowered the drinking age, which in turn increased the number of alcoholics requiring treatment in our hospitals. I might point out that each alcoholic requires the services of five people, which means a tremendous cost in caring for alcoholics. Preventive medicine, properly applied, could cut the rate. Health care costs will definitely go up and at a faster rate in the future. Millions of dollars over and above what is being spent now will be required for research.
I am sure that the minister realizes that in Canada today we have an aging population. He knows as well as I do that any person 60 years of age or over requires three times the health care of a person of 20. This is why costs will increase; there is no way to stop it. We do not have sufficient food to feed the young population of the world, and the old people will suffer even more. The pattern of medicine has changed. The fastest growing group in Canada today is the elderly. I remember a few years ago a well known preacher stating that this was the age of youth, and at that time half the people in Canada were under the age of 25. What he forgot in his enthusiasm for the growth of youth, of course, was that the pill and scientific medicine had knocked this idea into a cocked hat. The over-60 age group is now the fastest growing group, and as a result we have created a socioeconomic problem. I emphasize that fact because I have heard no mention of it in the House or at medical boards, university meetings I have attended, and so on.
We have a new breed of patients of which we have only limited experience. I refer to those 50 years of age and over who suffer from degenerative diseases. They are not cured by a pill or an antibiotic, and they create new problems in medicine. This field of study is known as geriatrics. To deal with this ever-increasing problem we have one chair of geriatric medicine in one university in the whole of Canada, namely, in the city of London. I think I am correct in saying that. The only one I know of is at Western University, and even they had to go to Great Britain to get a competent professor. Every school of medicine should have a chair of geriatrics so that prevention and treatment could be effectively applied.
The reason three times as many people fall sick at 60 as at 30, people requiring three times the amount of hospitalization, is degenerative diseases. We are entering an age in Canada where we will require more and more hospital care to take care of our aging population. We are trying to bring down the cost of hospitalization by keeping these people working if possible. But we are learning that diseases affect the elderly a little differently, and in some cases much differently. This is why the government should be doing research and establishing chairs of geriatric medicine. This must be done if we hope to cut costs. I give the minister credit for his exercise campaign, and so on. How-
February 17, 1976

ever, he is not going far enough and is not getting to the heart of the question. He does not understand the problem. Having only one geriatric chair in the whole of Canada is ridiculous.
In the field of medicine, 60 years ago pediatrics was in its infancy. Today there are over 800 pediatricians in practice. Has this paid off? Let us look at the track record. About 50 years ago disease was the common killer of people up to the age of 40. By adopting the scientific approach of setting up chairs of pediatrics we have almost eliminated disease and today accidents are the most common cause of death of persons up to the age of 40. In addition, we have almost eliminated disease among children. This approach has so changed the span of life that life expectancy, which in 1900 was 45 years, is over 75 years today, putting more and more people into the old age group who are requiring more and more medical care. Again let me emphasize my point to the minister: how in the world are we going to cut costs if more and more people are getting sick?
Our aim must be to spend more money on research in order to prevent, later in life, degenerative diseases as much as possible. This means doing research to find the cause of cardiovascular and other degenerative diseases and preventing them. These diseases can only be prevented in infancy. Research into these diseases is being conducted now in Canada with the 20 to 30 age group, but this is far too late. In the Korean war it was found that 50 per cent of young people between 20 and 30 years of age were already suffering from coronary disease. This research must start in infancy, not at the age of 30 when 50 per cent of the people affected by the disease show evidence of arteriosclerosis in their coronaries.
This is a bad bill because more and more money, not less, is required to reach this group of people with degenerative diseases. More and more money must be spent on research so that we may well be able to prevent degenerative diseases and treat the ever-increasing number who are reaching the age of 60. Further, the bill will denigrate the quality of medical care in the have-not provinces. I do not want to see the minister stay with something that is sliding down the hill. I have quite a high regard for the minister. I do not want to see him sitting on something that is so bad. If he will look carefully at the statistics 1 have presented, I ask him how in the world there will be less sick people when we have these statistics concerning the aging population. What has he done in the last five years to stop the erosion of facilities which have been provided? We might look at what is happening in Ontario, where through the closing of hospitals people are being frightened to death. What is happening? I quote from an article by Dr. Munro:
Mr. Lalonde has stated that "relative to any other groups in society, doctors' salaries have remained the same since the introduction of medical care when they took an increase."
However, research by Ronald Neilson published in the Ontario "Medical Review" in the summer of 1975 shows they have declined.
In summary we can expect from looking at past behaviour and current trends that there will be increasing governmental interference in medical practice. There will be an increase in the number of administrators and administrative costs of hospitals and medical care. There will be increasing waiting lists for medical treatment and lowering of medical standards.
Medical Care Act
The standards of excellence in treatment in Canada and Ontario that the public has learned to expect will become less obtainable. There will be a progressive drift from Canada of those people in medicine who demand excellence as the criteria for their practice of medicine. Those people now entering medicine will rapidly become disillusioned.
Ultimately, the only people remaining or entering medicine and allied fields will be second-raters who accept less than the ideal. Patients will soon learn to accept these standards, as they have in Britain, because there will be little else obtainable.
There is no indication to show that Canada, or any other country, can produce a leader who has the moral guts and leadership to admit past errors, and more equitable system. "Politics", said Robert Louis Stevenson, "is perhaps the only profession for which no preparation is thought necessary".
In conclusion, I want to say to the minister that I have much hope for him. I know that in his mind and heart he knows he is not doing the right thing in this field. However, he has hold of a political machine which must be operated and he must do the best he can to patch it up. When he tries to get out of this by saying it is a provincial matter, he is evading the issue. This was squarely laid down by Lester B. Pearson and others. At the time the provinces were subjected to this they said that they should be allowed to run their own show. From that date on, the federal government must accept responsibility in respect of any province where the Medical Care Act and the hospitalization situation is in difficulty. So I say to the minister that there is no way he can evade his responsibility. I hope that on sober second thought, as he attends the conferences he has been talking about and meets the people from the province of Ontario he will remember his duty and the fact that the responsibility rests with the federal government.


Mr. Peter Elzinga (Pembina):: Madam Speaker, I also appreciate the opportunity to say a few words in respect of Bill C-68. It appears to me that the government has shown very little interest in this debate. This is a matter of great concern to Canadians. Although members of the opposition are often criticized for their participation, I believe we have an obligation to point out what we feel are the negative aspects of legislation such as this.
I think this legislation is a prime example of the Liberal philosophy. First of all we saw the federal government badger the provinces to join the medical scheme and practically ram it down their throats. After successfully pushing the provinces into the program, the federal government wishes to limit the expenditures it will contribute to it. Once again we see how this government, which thrives on confrontation, operates. So often in the past it has used the big club, so to speak, to push its views down the throats of the provinces. We saw this in the area of natural resources through the Petroleum Administration Act and Petro-Can. Now we also see it in the area of transportation.
The Minister of Transport (Mr. Lang) has come down with a decree concerning what he will do in respect of the transportation system, without consultation with the various regions. I fail to see why the government does not consult more with the provinces in these pertinent areas if it ever hopes to achieve any harmony in the country. With regard to this specific piece of legislation, the federal government wishes to save a certain amount of money. That is understandable. I ask, however, why it does not look into the area of hospital costs, because my understanding is that approximately 80 per cent of the over-all

February 17, 1976
Medical Care Act
costs related to medical costs are consumed by hospital care or institutional care, while only 20 per cent of the over-all costs can be attributed to physicians' services?
I believe something is drastically wrong with our system when hospital costs are over $100 a day for room and board. This is an area which the federal government should investigate. It should investigate whether the amount it currently pays for high cost, in-hospital active treatment care in these cost-sharing agreements with the provinces could be reduced. I do not believe this bill covers hospital costs; it is applicable to only 20 per cent of the over-all medical costs of physicians' services. We must also ask ourselves whether control in this area is justified. I should like to quote from the brief of the Alberta Medical Association. In that brief the association points out the following:
Before examining the implications of the ceilings on federal contributions to Alberta, it is worth while to determine whether, in fact, control is justified. In his budget speech, Mr. Turner stated that last year federal contributions to the provinces in respect of the hospital and medical care insurance programs had to be increased 19.8 per cent over the previous year.
The Alberta Medical Association then went on to point out that the average per capita medical care costs for the ten major provinces rose only 5.9 per cent from the fiscal year ended March 31, 1973, to the fiscal year ended March 31, 1974. I hope the minister will respond to this question because I ask him to justify the large discrepancy in the figures. The federal government states that the contribution had to be increased by 19.8 per cent over the previous year, while the Alberta Medical Association points out that the per capita medical care costs for the ten provinces rose by only 5.9 per cent for the fiscal year. I ask the minister, in his statement at the end of this debate, to explain that discrepancy and tell us why there is a difference of some 14 per cent in the two estimates, that of the former minister of finance and that of the Alberta Medical Association.
I also ask the minister what type of over-all effect this bill will have on medical research. It appears to me that drastic cuts will have to be made in medical research. I think it is very important that we repeat some of the statements which were made earlier by hon. members in this debate, because most of what was said prior to my entry into the debate is crucial to the discussion on Bill C-68. The few further comments that I would like to make were well covered by one of my colleagues who cannot be with us today because of the illness of his wife, a classmate of 1974 who raised several excellent points. I should like to quote the hon. member for Oxford (Mr. Halliday) as reported on page 10499 of Hansard of January 30, 1976. He said:
It seems to be the concept and the philosophy of the government that the more control it can have over the individual, the more effective and better lives the people of Canada will have. This has been proven historically to be wrong over the centuries. Civilizations have gone down to complete failure and doom where this sort of situation has developed. I hope the government will see fit to begin to reverse its stand whereby it takes away all responsibility from individuals.
I think this bill exemplifies this government's philosophy according to which they know better what is good for the average individual than the individual himself. Our Prime Minister (Mr. Trudeau) has stated this repeatedly but, as the hon. member for Oxford said, this philosophy

has been proven to be wrong in the past. It is also my hope that the government will see the error of its ways and will reconsider the implementation of this bill. On Wednesday, January 28, our spokesman replied to the minister with regard to this bill. I feel that some of what he said should be repeated. The hon. member for Athabasca (Mr. Yew-chuk) said:
The present Liberal government which, unfortunately, is governing this country, has a long history of confronting various groups, whether they be provinces, professional groups, labour unions, business or private citizens. This bill represents once again a provocative confrontation with provinces and with professional groups involved in providing medical service to Canadians. The government's present attitude in this regard is shameful. This bill represents unilateral action on the part of the federal government. It is arbitrary and has been brought forward without meaningful consultation with the provinces. Indeed, it indicates a lack of concern for the opinions of provinces in matters concerning federal-provincial agreements.
The hon. member for Athabasca, who is our critic and our spokesman on these subjects, received limitless compliments on what he said with regard to this bill. I think he has proved his competence in this area, and I consider it an honour to be his colleague on this side of the House. It is interesting to note that even the leader of the NDP complimented our critic on what he said in the following words:
Madam Speaker, I should like to say regretfully at the outset that the Minister of National Health and Welfare (Mr. Lalonde) was not listening to the remarks of the hon. member for Athabasca (Mr. Yewchuk), and that is unfortunate because that hon. member has made one of the finest speeches on the subject of medicare I have hear anywhere, here in the House of Commons or outside ...
His speech was an extremely thoughtful and competent approach to this very serious problem . . .
Unfortunately, the minister paid not one bit of attention while that official spokesman for the opposition did such a fine job . . .
That is unfortunate, Madam Speaker, and it shows something of the attitude of the minister who ignored the official spokesman of the Conservative party just as he has ignored, during the past year, the provincial health ministers of every province.
When I was travelling through my constituency I came across a good friend who is a doctor from Fort Saskatchewan, Dr. Sheppard, who is a daily recipient of Hansard. He said our critic had made a fine contribution on behalf of the Conservative party. I think it is evident, especially in our region of the country, that this government thrives on confrontration. We hope to bring light upon this subject in the House of Commons, but unfortunately all too often what we hope to bring to the attention of the minister or the government falls on deaf ears.
In conclusion, Madam Speaker, I should like to pay tribute once again to our critic, the hon. member for Athabasca, by quoting from the statement made by the leader of our party when he spoke in the debate. As reported in Hansard of January 30, 1976, the Leader of the Opposition (Mr. Stanfield) said:
I was also unable to be present in the House when the hon. member for Athabasca (Mr. Yewchuk) spoke, but I read his speech with great interest. I thought it was a thoughtful and strong speech on the subject...
The hon. member for Athabasca said just about all there is to be said about the bill when he described it as an arbitrary, unilateral act by the federal government...
Here we see the government attempting to impose a ceiling unilaterally, not on the cost of medicare in this country but upon the federal government's contribution toward the cost of a program which the federal government itself has insisted that the provinces establish and
February 17, 1976

administer. Madam Speaker, surely treachery is not too harsh a word to use to describe conduct of that kind. There is no other word for it. I must say it is consistent with the behaviour of a government which seems to regard itself as in no way bound by its word.


Stuart Malcolm Leggatt: Madam Speaker, first of all I should like to say that I agree with the previous speaker regarding the remarks of the Conservative critic on the bill, and I would like to associate myself with the remarks of the former leader of this party, a man who knows a considerable amount about this subject. I think the speech of the hon. member for Athabasca (Mr. Yewchuk) showed a degree of sensitivity about medical care that his profession seems to be showing increasingly these days. I see he is blushing slightly, but I may have some things to say about doctors that he may not be so thrilled about.
In any event, I think the medical profession is maturing in terms of looking beyond the needs of the profession and toward the needs of the public in terms of the provision of medical services. The minister is one of the more sensitive and progressive members on that side of the House. That has been the consensus of people in the opposition for a long time. I strongly suspect that this bill is somewhat distasteful to the minister, but I think he is bound by the cabinet decision on the subject and I hope he will address himself to this question at some time. If he had his way, I suspect he would prefer to see the expansion of medical services in this country, and of the federal government's share in those services so that the objective of all of us to see that there is a standard of medical care in Canada which is the same in Newfoundland as in British Columbia, and the same in P.E.I. as in Quebec, is reached. But when the government abandons that position it is taking a step toward a kind of medical chaos which we see south of the border.
This bill is one of several which demonstrate a significant change in the philosophy of the government, the decision to cut back on CYC, LIP and OFY and all those programs which go along with the essential philosophy that we can no longer afford the just society and therefore will have to move in another direction which says "Let the devil take the hindmost."
This legislation does make provision for some increases in medical care. I think the figures are 13 per cent in the fiscal year 1976-77, 10.5 per cent in 1977-78, and 8.5 per cent thereafter. Then, as I recall, the legislation allows the government arbitrarily to set that portion which it is willing to share. It is the height of arrogance for a government which has a deficit of something like $5 billion to $6 billion this year to start dictating to the provinces about fiscal responsibility. It should be the provinces teaching this government to balance its budget. The provinces should be telling the federal government how to spend money.


Mr. Lalonde:: What about the deficit in British
Columbia?


Stuart Malcolm Leggatt: I would take the deficit we have now in British Columbia ahead of the one the federal government projects each and every year. British Columbia has a very
Medical Care Act
modest deficit compared with the one for which the minister is partially responsible in terms of some of the wasteful spending which goes on here in Ottawa. However, it is typical that the federal government feels it knows best in terms of spending money.
The hon. member for Nanaimo-Cowichan-The Islands (Mr. Douglas) pointed out that we have entered the second phase of the delivery of medical care. The first phase was to remove the financial burden, and we have done that very substantially. The second phase now is to get into those programs which will reduce medical costs, but initially we may have to increase some of our programming. In other words, we must enter the preventive area. We must provide care for the chronically ill in extended care units, properly shared by the federal government. We must consider life-style modification. There is a very interesting report in British Columbia, by Dr. Foulkes, entitled "Health security for British Columbians". Dr. Foulkes did a rather exhaustive analysis of current medical problems. I think this is the most recent major report on the subject. He pointed out that life-style modification through government advertising is at a very preliminary stage because life-style modification through commercial advertising, the promotion of alcohol, the promotion of cigarettes and the promotion of unnecessary drugs in society, is a fairly major life-style determinant.
The government has to redress that balance, not necessarily through censorship but we, as representatives of the people, should be out there balancing that prejudice in favour of bad health, and we should be out there pushing nutrition and a denticare program. A denticare program would be initially more costly, but in the long run there would be a reduction in the total social cost. It is just that it would be transferred from the private area into another area.
Another recommendation in the Foulkes report was routine examination for the apparently well. That would be provided through the use of the community clinic system. Again, the idea of a community clinic and the provision of medical services through a different style than through an independent doctor is one which should be embarked upon as a pilot project so that we could compare the effect of that kind of service we now have in the private medical sector. However, with this kind of legislation, provinces are going to be faced with the significant problem of how to raise money for new programs which obviously the federal government will not share.
The logical approach would be a deterrent fee. A deterrent fee is all right for somebody who makes the salary of a member of parliament, but it is not all right for someone at the low end of the income scale. A deterrent fee is a deterrent, presumably, for those seeking unnecessary medical attention. There are a few, but the number is much exaggerated because, in our society, if people are so upset with themselves that they have to get some kind of advice, surely we have a responsibility to provide at least that much service. I think many members of parliament find that a good number of their calls tend to be something of a catharsis for people who indeed may be in need of some consultation or help. I do not see any reason why that kind of service should not be provided.

February 17, 1976
Medical Care Act
In considering the situation which could develop from the abandonment by the federal government of its responsibility, or at least this step in that direction, it is interesting to look at the way in which medical services are provided in the United States. One of the things which makes me proud to be Canadian is the envy with which this country is looked upon by others with regard to the way we provide medical services. We have a long way to go, but at least there is a degree of sensitivity and civilization in seeing that those people who are poor and without adequate medical services are cared for. Somehow, that in a sense distinguishes the Canadian character and it is no coincidence that Senator Kennedy was here recently investigating the way in which we provide medical services.
I found it shocking that doctors in California thought it necessary to withdraw services because the premiums for their liability insurance were so high. In the state of California a person under the medical program can go to a doctor on a reduced premium system, but the doctor does not have to accept that person; so there are people in California crawling from one doctor to another asking to be taken as patients. There are a number of doctors who take them, and a number who do not. The good doctors who take them are flooded with patients under the medical program. That is not the kind of service we want for Canada, and neither does our medical profession.
I will not deal with the Saskatchewan strike because I think it raises issues which are unnecessary to dig over any more. Probably the parties in that dispute have learned something in terms of a humane and civilized approach. I do not think there is any need for the medical profession suddenly to go on salary or to become civil servants, but the profession and the government should examine the possibility, particularly for remote areas where there is difficulty in getting doctors, of community clinics and the provision of specialty services through the community clinic system. There should also, perhaps, be a lateral service so that a patient can decide whether he wishes to use the government community clinic or private medical services. That kind of pilot project is certainly worthy of examination.
With regard to cutting costs, we should examine the amount of equipment in private doctors' offices and the amount of intensive use it receives. There are many medical clinics in this country with laboratory and x-ray equipment receiving little use compared with equipment at the hospital level. There should be some thought given to the rationalization of the very expensive equipment which doctors have to buy and the total cost of medical services as a result. You do not have to get into this business of making a unilateral decision not to share the medical costs above a certain level. In British Columbia, a few pilot projects for home nursing care have started to cut medical costs. In this way people are released from hospital earlier and beds become available.
The reluctance of the medical profession to make home visits is understandable. It is much more convenient for a doctor to visit his patients in hospital, especially if they are all in the same ward. The fact is, however, that such a system is extremely expensive and the cost per hospital bed is high. Home nursing, with adequate care provided,

reduces the costs substantially, so the provision of additional delivery services does not always mean an increase in costs.
I think the decision unilaterally to refuse to participate in expanded programs-because that is really what the bill is about-exposes a philosophical departure by the Liberal party. It exposes the bankruptcy of the just society that was so successful in this country around 1968, and it exposes a level of pragmatism that disappoints those of us who have been proud of the health delivery system in Canada. I should like to be able to continue to point out, when I travel abroad, that Canada has a fine medical services system even though it needs improvement in a number of areas. We certainly are not leaders in the field when compared with some of the Scandinavian countries, but we have been proceeding in the right direction. I think this departure is something that the government will regret, Mr. Speaker.



PROCEEDINGS ON ADJOURNMENT MOTION


The Acting Speaker (Mr. Turner):: It is my duty, pursuant to Standing Order 40, to inform the House that the questions to be raised at the time of adjournment are as follows; the hon. member for Moose Jaw (Mr. Neil)- Government Administration-Government position on contribution to crop insurance fund; the hon. member for Winnipeg North (Mr. Orlikow)-Anti-Inflation Board- Reason for reducing amount of wage increase for University of Toronto library workers; the hon. member for Dart-mouth-Halifax East (Mr. Forrestall)-Penitentiaries- Maximum security psychiatric institutions-Status of institution proposed for Dartmouth.



GOVERNMENT ORDERS


[Stage Direction]
The House resumed, from Monday, February 2, consideration of the motion of Mr. Lalonde that Bill C-68, to amend the Medical Care Act, be read the second time and referred to the Standing Committee on Health, Welfare and Social Affairs.
Mr. Armand Caouette (Villeneuve):: Mr. Speaker, I decided to rise on this bill because I think it may enable us to understand the illness gnawing at the economic health in Canada.
February 17, 1976

Mr. Speaker, Bill C-68 aims at controlling the annual per capita cost increase of services provides under the health insurance or the medical insurance plan. In short, Mr. Speaker, the government wants to ration medical services under the pretext that they are too expensive. It is not because Canadians do not need health care, but because this care costs too much. It is not because Canadians are all in good health, but once again because the services are too expensive.
Mr. Speaker, a proverb says that good health is the greatest of riches. But the government says: Good health is fine, but only if it is not too expensive. This, in effect, Mr. Speaker, is what the government is saying to Canadians by introducing a bill such as this one.
The Minister of National Health and Welfare (Mr. Lalonde) said so very clearly in a speech he gave on September 15 last before the Richelieu Club of Montreal, when he stated:
The expansion rates of certain services, including those of the health care industry, are now above our means.
Mr. Speaker, the government therefore feels that it cannot afford to allow medical care to develop according to the needs of the Canadian people. All those who have studied this bill are concerned because they know that financial restrictions in this area will automatically affect the quality and quantity of medical care needed by Canadians.
Indeed, Mr. Speaker, here is what Dr. Grisdale, chairman of the Canadian Medical Association, stated to the Minister of National Health and Welfare in a letter written on December 10 last. He wrote and I translate as follows: Must we now consider that the main priority of the medicare program is now financial and that in the future, the program will be modeled according to financial requirements of the time and not according to medical criteria?
Mr. Speaker, I am convinced that this fear is shared not only by doctors but also all Canadians, and yet the government thinks it will contribute to right the present economic situation with Bill C-68. It hopes that by cutting down the expenditures made in the area of medical care, it will solve the problems that paralyze the economy of this country. In fact, the main effet of this legislation could be to make the area of medical care as disorganized and as badly off as the economic area.
Again, Mr. Speaker, the government does not see the real problem. It does not see the primary cause of all present difficulties. Yet, that cause is as visible and obvious as an elephant in a living room. The real cause of present difficulties lies in the economic and financial system in which we live.
Until the government is prepared to reform the present system, it will be faced with an unsurmountable obstacle. It is not by reducing health services that the government will improve the economic system. Nor is it by controlling prices and salaries with an army of public servants paid $50,000 a year that the government will solve the problem of inflation. Nor is it, Mr. Speaker, by letting hundreds of businesses go bankrupt that the government will improve the situation. No, Mr. Speaker. If the government really wants to solve the problems upsetting our economy, it will have to come to grips with the roots of the illness-the
Medical Care Act
monetary and financial system. Mr. Speaker, Social Credit-ers never hesitated to make their solutions known.
Ever since Social Crediters came to the House, the government never had any excuses for its lack of action. The government certainly realized that as long as there will be a gap between available production and the consumers' purchasing power, the economic system will remain wrong. The Social Crediters say that the purchasing power of the people should be increased so they can get the available goods and services, particularly health services and goods. Mr. Speaker, I mean available goods and services.
Indeed, no one would dare say that here, in Canada, we do not have the technical means to provide all Canadian citizens with first class medical care, according to everyone's needs. We have doctors, and on this subject, I would like to add something. We have doctors, but not everywhere. In the major areas, yes. But in areas like ours, no. We also have hospitals, as well as technology and drugs. What is missing, Mr. Speaker? As the minister said, we are short of money. It is not because of a shortage of doctors that the health minister wants to reduce medical care in Canada. The reason is not a lack of drugs either. It is just that he finds it too expensive. He believes that we cannot afford it. We could ask ourselves about the logic of such a reasoning. We have everything we need as far as competence, technology and drugs are concerned. However, we shall have to do without medical care. Why, Mr. Speaker? Because the minister tells us we do not have enough money.
The Social Crediters say that purchasing power, and availability of money must correspond to our physical capacity, our technical or physical means. A system in which we deprive people of medical care under the pretext that money is scare is absolutely ridiculous. However, this is what this minister proposes. He says that it is too expensive, that we have to restrain the extension of medical care even if doctors say that they could not give more care than they do now.
If we have the technical means and the doctors required to give a better service-and, as I said earlier, in some areas like larger centres there are doctors-the financial system should serve man and meet his needs according to our actual capacities and not our financial capacities. The Social Crediters want the financial system to be at the disposal of man and not the reverse. This makes the whole difference between the program of this government and the program of the Social Credit. This government does not want to change our financial system and prefers reduced medical care. They would rather attack the production system and drive companies to bankruptcy. And all this because it is too expensive for the financial system.
Mr. Speaker, I think that this government should consider seriously what Social Crediters have been proposing for several years. If the government changes the financial system it could solve the problems there are in that field and in the field of medical care. This problem is particularly acute in areas distant from larger centres. In fact, Mr. Speaker, it is very difficult for remote areas like Abitibi, Temiscamingue, Lac Saint-Jean, and the Gaspe Peninsula to get doctors. For instance, Mr. Speaker, I heard the
11022

February 17, 1976
Medical Care Act
minister say some time ago that there was in our area in 1968 one physician for 769 inhabitants and now there is one for 586 inhabitants.
Mr. Speaker, I would very much like to know where the minister has taken his statistics when you find only three general practitioners in a constituency of 12,000 people such as mine. No wonder that their patients must wait 15 days or more to get an appointment. Here is the best example I can think of. About a month and a half ago I wanted to have one of my children examined. I had to wait a month and a half for an appointment.
This does not mean that the physicians do not do their utmost to help the people, but since there are only three of them for 12,000 people, they are simply overworked. The case I have just mentioned occurred at Chibougamau, in the constituency of Villeneuve; at Senneterre, there is one physician for 8,000 people and in Lebel-sur-Quevillon, two for 7,000 people. Then the minister tells us that he wants to reduce expenditures.
Mr. Speaker, how can a physician be expected to give good service under those conditions? The minister also said a while ago that they were afraid to train too many doctors.
I enjoyed the remark of the hon. member for Roberval: Is he really afraid there may be too many physicians or is he concerned because this would reduce their earnings? But in areas such as Lake St. John, Abitibi, Temiscamingue, Gaspesie and the North Shore, I am not worried, because doctors will always be able to make a good living.
Mr. Speaker, I can assure you that in my area we could do with more doctors, I do not mean one, two or three, but a dozen to take care of the people I have mentioned. It is said that this happens in farming and rural centres, and I agree. But why should rural centres have to put up with such a situation and have no medical care, particularly in the field of surgery?
Mr. Speaker, I realize the statistics are erroneous because specialists and doctors serving the people are lumped together and sent to the large centres instead of being helped to settle down in our areas.
As I said a while ago, it always boils down to a matter of money. If doctors could get an isolation bonus as some others do, I am convinced they would be willing to settle and practice in remote areas like ours. Unfortunately, because the government gives priority to money matters over medical problems, it refuses to act and solve that serious problem. It would rather reduce medical services and thus deprive the population of some services rather than alter the financial system.
The quality of the medical services Canadians are entitled to must not be lowered. As long as the government tries to solve the problems by cutting down medical services, those services will deteriorate and the situation will worsen. The government should roll up its sleeves and attack the real problems, the urgent problems such as that of reforming our economic system.
Mr. Speaker, a while ago I said that the government does not want to help-at least, it gives no indication of wanting to do so-remote populations such as ours. Bearing in mind the fact that remote areas are faced with very serious problems at this time with regard to the quality of medical

services because of a shortage of doctors, and I am referring here to areas like Gaspe, northwest Quebec and Lake St. John, particularly the Chapais and Chibougamau areas. For several years, people in these areas have asked the minister concerned, either provincial or federal, whether it would be possible to provide those areas with doctors. The only answer they get is that this matter is within provincial jurisdiction. I agree that this is within provincial jurisdiction, but one could also ask, since the federal government is subsidizing programs within provincial jurisdiction, like the teaching of French, why the minister could not do the same regarding doctors. I believe that the whole population in my constituency, as well as the population in the constituency of Roberval and many others I am not aware of, would be enormously satisfied with the services they could get, and would be satisfied with the minister representing them today.


Mr. Gus MacFarlane (Hamilton Mountain):: Mr. Speaker, it is important to address ourselves to the subject matter of this bill. The minister has always been concerned about the health and safety of Canadians: he places great emphasis on health. I suggest that this is not the time for sheer opposition for opposition's sake. I know that some hon. members opposite who are personally interested in the health of Canadians and in the extension of medicare to the most remote areas of Canada have made interesting and valuable contributions to this debate. However, a number of opposition members have lambasted the government for proposing to bring in ceilings on the rate of escalation which will be recognized under the medical care program for the next several years. These hon. members do so on the grounds that this will represent a destruction of the standards of service built up, the reversing of co-operative federalism and, on occasion, even the undermining of confederation.
I would like to comment on these charges. These are the same members who continually insist that we should reduce government spending. However, it seems that in this case, because of the horrors of the woods and the ghosts in the closet, this government must overexpend or go further to chase away the demons. Reasonably complete information is now available on the experience in the ten Canadian provinces from 1971-72, the first full fiscal year of participation of all the provinces in medicare, to 1974-75. While final data is not yet available for 1975-76, such data as is available is compatible with the experience for the previous years. During this period, by far the largest factor affecting the increase in per capita costs of physicians' services was the increase in the number of physicians per 1,000 injured persons, which increased at almost twice the rate of increases in fee schedules and rather more than three times the rate of the population growth or the normal growth in utilization per capita of physicians' services.
A year ago, at the request of and in collaboration with the provinces, the federal government closed the door on unrestricted immigration of physicians from abroad through the device of assigning zero points for physicians as a class and requiring that physicians, like any other occupational group, show evidence of need through a firm
February 17, 1976

job offer or other device from the province in which they intended to locate. This measure has given the provinces a great measure of control in determining how many and what type of physicians they are prepared to admit from abroad, and also in what localities to permit practice. This is certainly not taking away from the co-operation between the federal government and the provinces in giving the provinces good and almost complete control in the development of the physicians in their provinces.
We have evidence of a substantial decline in the immigration of physicians from abroad during the latter half of 1975, and undoubtedly this trend will continue throughout the years to come, although it is obvious that any province which feels it needs additional physicians is free to permit their entry. This substantially reduced immigration of physicians, which immigration, at times had exceeded 50 per cent of the total increase in the Canadian supply since medicare, should have a substantial moderating effect on the rate of cost increase of physicians' services from now on. Because of this, and in view of the fact that proposed ceilings are by no means out of line with the actual historical experience in recent years when there was no ceiling on the federal contribution, the ceilings should not cause any particular problems to provinces in relation to meeting the necessary costs of physicians' services. This is particularly so because of the superimposition of the federal anti-inflation program which not only limits the rate of increase indirectly in fee schedules and other forms of physician remuneration, but also should have an ameliorating effect on the cost of overheads on the one hand and cost to consumers on the other which figure in fee settlements.
Fears have been expressed that the proposed ceilings will reduce the quality of medical care, but there is absolutely no reason why this should occur. As a matter of fact, the ceilings proposed for medical care are not as unrealistic as some critics have alleged, since the allowable percentage increase proposed for the fiscal years 1976-77 through 197778 is actually greater than the increase experienced from fiscal year 1971-72 through 1974-75. The ceilings will actually permit continuation of the present high level of medical care and even reasonable increases in doctors' incomes.
I would remind hon. members opposite that the estimated reduction in the federal contribution to the provinces under the first year of the ceilings proposed under Bill C-68 would amount to less than 2 per cent of the provincial estimates received prior to the anti-inflation program and, consequently, may well turn out to be somewhat less than that. It may well be that the federal share will still equal 50 per cent of the program costs. In any event, many opposition speakers have taken a rather remarkable turn in advocating that instead of attempting to restrain the cost of physicians' services, and indirectly of hospital services, the federal government should forge ahead in costsharing any health expenditure that any province is currently making. This is, surely, one of the most bizarre suggestions that I have encountered, considering all the cries for cuts we have heard and all the promises to reduce budgets by billions and billions of dollars, when we all know that in this area we cannot reduce beyond the point of no return. Even when we put it in a way that gives this House some manner in which we would have some say, some manner in which we would be able to predict what
Medical Care Act
might happen, members opposite cry for us to forge ahead in an irresponsible manner.
If taken literally, this would mean that the legislature of each individual province would have the prerogative of determining what taxes would be paid by the residents of every other province, since the federal government would be automatically drawn into cost-sharing any health expenditure that each province decided to make. This would be so even if the particular health expenditure was simply unique to the tastes of that particular province, whether it dovetailed in any way, shape or form with similar programs in other provinces, no matter whether it was available to all residents on uniform terms and conditions or whether it was something provided through subsidized private insurance arrangements on a restricted basis and with all sorts of deductibles or other limitations.
Quite obviously, only this Chamber can legislate taxes that apply to all Canadians or lay down conditions that will govern the payment of taxes by all Canadians. To follow this advice would not only be to create an open-ended program of totally unpredictable magnitude, but also to create a great, crazy patchwork quilt of arrangements in Canada with no guarantee of portability, interchangeability, accessibility or common cost experience which enable any type of sensible federal-provincial costsharing arrangement to be arrived at. As an alternative, we are proposing a logical extension of coverage, using the existing health insurance acts which guarantee universal accessibility, comprehensiveness, portability and non-profit administration within the areas which are determined. The government has already had numerous discussions with the provinces and determined those areas in which there is a high degree of consensus.
Advancing coverage in these areas will certainly maintain the national aspects of our program which are so essential for a mobile population. What is required is the firm commitment on the part of the provincial governments to adhere to the targets in respect of hospital, medical and other important services which they have outlined to departmental officials during the discussions that have occurred during the past year. With such commitments the federal government can foresee, to a large extent, its essential obligations. So can provinces whose costs are directly or indirectly influenced by the expenditures made by other provinces. If the federal-provincial partnership in health care, which in my view is so essential to Canada, is to survive there must be more than lip service paid on both sides to understanding and agreement as to the course which must be taken. This has not always been the case in the past, and I suggest that many of the sins have also been on the provincial side.
I sincerely hope that as a result of the renewed negotiations which we expect to occur in the near future, a more effective federal-provincial partnership will emerge which will safeguard the interests of the provinces and the federal government, as a result of which the health care system in Canada will make further progress to the advantage of all Canadians.


An hon. Member:: Ha!


Angus (Gus) MacFarlane: And it is important to remember, rather than saying "Ha!" three times in a row, that this
21419 - 614

February 17, 1976
Medical Care Act
minister has always given the program his highest priority and that with his kind of expertise it will be possible to say from this side of the House where we are going, and not where they think we should be.


Hon. Alvin Hamilton (Qu'Appelle-Moose Mountain):: Mr. Speaker, the bill before us today is one which has to do, really, with the government's attempt to combat inflation. If hon. members opposite care to listen to my observations, I think they will hear something which may be of use to them. What we are considering is, in effect, a panic-stricken effort on the part of a government which is facing rolling inflation whose consequences are endangering many government programs as well as the private security and peace of mind of most of the people of Canada. I say at the outset that the government had better listen to speeches such as that made by the hon. member for Villeneuve (Mr. Caouette) and think about them carefully, because what the hon. member was saying today concerning the needs of his people is applicable to every riding in this country.
The subject has personal interest to me-a painful one, too. I attribute the major cause of my defeat in 1968 and of being turfed out of parliament for four years to this very issue, and even though I can say, personally, that I was innocent, someone got on the CBC about ten days before the election claiming to be a Conservative and said that if the Conservatives got in in 1968, medicare would be stopped. As a result, four or five Saskatchewan MPs went down the drain in that election. That is one of the issues which sent us down to defeat. There were others, of course. I mention this as a warning to hon. members on the other side of the House.
In almost every country in the world, whether it be socialist or relatively freely organized, as is our western world, the question of medical care is probably the most sensitive area with which parliament can deal. In the western world we were slow to embark upon social welfare legislation. As for the type of programs we brought forward, we had to rush into them and that is the only excuse for much of the stupidity which has gone on in this area in North America for the last 30 years in connection with social programs.
I am glad to see in the Chamber today a minister who once held the portfolio of National Health and Welfare; I refer to the Secretary of State for External Affairs (Mr. MacEachen). I think we would be a witness to the truth of much of what I have to say. Perhaps when I have finished members on the other side will recognize the need to put pressure on the government in order to free themselves from the narrow considerations which guide the building of policy by virtually all governments in Canada when it comes to the subject of health care.
The bill before us has been described by many people who understand its details far better than I do as amounting to an opting out on the part of the government from its own program. The reason given by the government, in justification, is a legitimate one in their peanut brain. They think it is a way in which to reduce costs. They are frightened by the tremendous increase in the cost of all these openended programs which now account for 80 per
[Mr. MacFarlane.l
cent of the tremendous spending power of the federal government.
Some of us are old enough to remember the great enthusiasm in the United Kingdom during the war years when a nation sorely troubled by physical and economic dangers was fighting for survival. Some of us remember the excitement which went through the ranks of the troops as they heard announcements about "cradle to grave" social welfare programs which were being proposed at that time. They gave great hope not only to men and women in the services but to people in the civilian ranks of war. They encouraged a belief that a more equitable social order could be brought into being after the war. It was all going to be worth while.
I recall going back to Saskatchewan and witnessing the birth of the basic hospitalization plan-and I give full credit to the hon. member who now sits in this House on my left for being the father of that proposal. I believe he was aware that he was trying to get Saskatchewan to catch up with the western world by providing some form of egalitarian service in a field of vital interest to the people. I recall how the province of Saskatchewan undertook a statistical study in connection with the scheme, on the basis of which it was ascertained that out of every 1,000 people in the province, 66 received hospital treatment in the course of a year. Because the government was proposing to bring in a universal plan, it was thought likely that more people would take advantage of the plan, so in calculating the costs it was estimated that 100 people out of every 1,000 would go to hospital each year. If I am wrong as to any detail, I hope the House will pardon me, because I am trying to get an idea across.
Here was a government with great sincerity, and a firm sense of social purpose, trying to provide for the people of Saskatchewan no matter where they lived or how much they earned. They went into the legislation with honesty and sincerity. Yet within four years a great fear came over all of us who were watching the hospitalization scheme in Saskatchewan. I remember being called into a private meeting at which we were told about the rising costs of the scheme. An appeal was made to members in all parties to do our best to solve this problem of escalating costs in order to save the scheme. This was a private meeting. I recall a list of six causes of the overly large use of the plan. Within four years of the plan starting, instead of having an expected 100 per 1,000 going to the hospital each year, the figure was 326 per 1,000. At this rate of escalation, members of all parties knew the plan would be so expensive that it would put in great danger a scheme that everyone wanted.
The matter came up for debate in the house on a series of proposals to restrain and hold back these rising, open-ended costs. One unfortunate member of the legislature on the opposition side, in all sincerity reported to the House that in his municipality they once had a hospital fund, with so many mills on the tax bill to pay for it. When the people found out it was universal and that for the same number of mills everyone had free access to the hospital in the municipality, the number of people who decided to go the hospital was away above expectation, and as a result costs increased. They had to place a negative, deterrent fee
February 17, 1976

on each individual to bring back the cost of hospitalization roughly to what it was before.
If you can, Mr. Speaker, let your imagination visualize the scene. With roughly 50 members of the legislature, at least half of them, if not more, were trying to catch the Speaker's eye. They all wanted to say that this was not their view. My colleague from Nanaimo-Cowichan-The Islands will probably remember the scene. The Speaker gave the floor to the hon. member from Saskatoon, and he used a phrase that I will never forget. He said that he didn't care if he spent $1 million, he didn't want one sick person kept out of hospital in Saskatchewan. Up jumped the leader of the Liberal party, who said that the views expressed by the opposition member were not the views of the Liberal party. In due course an election came and that poor, unfortunate member was defeated.
I simply tell that story as a warning to members here. People want some form of universal medicare, unemployment insurance and accident insurance as part of the egalitarian movement in all countries of the world. Naturally we must be concerned about cost. This is why many of us have taken to wondering what positive way we can evolve to find a scheme that would take away none of the essential services, yet provide people with what they want. By this time some of us had access to figures relating to the United Kingdom scheme. The United Kingdom had brought in hospitalization and medicare with a great rush, without the infrastructure being present. The cost of the scheme had escalated 300 per cent to 400 per cent in the first two or three years. The question was whether all the people in the United Kingdom could afford these services, with the tremendous utilization of those services, with costs climbing at such a rapid pace.
Therefore, a number of us put forward a plan about which I will speak in a few minutes. This plan attempted to grapple with the problem of rising costs when you provide a needed service on a universal basis. Before I refer to this plan, I want to step ahead in time and say that the party that I belong to had come out for prepaid hospital services and prepaid medical services in Saskatchewan at our convention in Moose Jaw in 1936. When we formed the government in Ottawa in 1957 we started to look at the various proposals that we had and at the tremendous amount of detailed figures that were available. We agreed, as a government, to set up a royal commission which became known as the Hall commission. This was under the government of the right hon. member for Prince Albert (Mr. Diefenbaker). Having read and listened to a number of speeches in this debate, I get the impression that no member has gone back and examined the basic conclusions of the Hall report, as if it made no difference that it was the only definitive study in the history of Canada and that of other countries, including China and Russia, of such a medical scheme. Apparently no one wants to introduce that knowledge into the debate we are now having.
I would recommend that the views of people who were strongly for the principle of a universal medicare plan across this nation, as put forward in this report, should be remembered and that these views should be reread. They had in the back of their mind that they had to put forward a program that not only met the needs of the people but which also had a built-in control mechanism that would
Medical Care Act
keep costs within the capacity of the economy to pay. For example, they recommended that proposals be brought in across Canada in a series of stages. The first of these was diagnostic services, which I think were estimated to cost about $5 per person. In other words, as you introduce medicare, you first of all provide clinics in every community, rural and urban, to which people could go, get diagnostic treatment, find out what is wrong with them and then get the proper type of service. That was the first proposal.
There were many others, Mr. Speaker, such as setting up a scheme for training nurses and doctors. Various levels of accommodation were provided for all kinds of illness in all parts of the country. If this were done step by step, you would avoid the mistakes that were made in the United Kingdom. In addition, the commission had the benefit of the Saskatchewan situation. I am not quarreling with the sincerity of any member of a party in this House who has a common desire for a universal hospitalization scheme, prepaid medicare, and so on. I am simply saying that the time has now come to direct our thinking into what is going to destroy this scheme. I contend that what will destroy these open-ended schemes of ours is our failure to get at the driving motives of the people themselves.
As you listen to me, Mr. Speaker, I am sure you are thinking that the principle of universality creates a demand factor many times greater than any ordinary planning would consider normal. That is true. We see it today with unemployment insurance. At least half of those drawing unemployment insurance have discovered the technique of beating the act, and they are professionals at it. Yet every one of us here wants this security; we want to know that unemployment insurance is available if we become unemployed. How, then, do we provide the incentive not to abuse this type of open-ended legislation? Even though I am dealing here primarily with medicare, we have to look at the picture in its whole perspective. I am not going to go through all the recommendations contained in the Hall commission report. I am suggesting that the people whom I know are interested in saving these schemes look at the recommendations in that report to see whether, even at this late date, there is not something of value left.
I know time has passed on. We ignored the whole recommendation and plunged ahead with medicare. By means of this bill we are now trying to fight our way financially out of the situation. I suppose that a reading of the whole report would be redundant, but at least in doing so we would have an idea of the practical changes suggested at that time that would have avoided what we are presently facing. So I now come back to the second proposal put forward by the Diefenbaker government, which has largely been ignored by the economic historians. Certainly it has been ignored in this field of social services. My colleague, the hon. member for Prince Edward-Hastings (Mr. Hees), knows about this proposal.
Some of us who wanted to save these schemes and make sure they would work and would be schemes that we could afford, proposed a package which would include hospitalization, medical care, unemployment insurance and, yes, accident insurance-that must come. We would pay into

February 17, 1976
Medical Care Act
those schemes as we normally do, obviously on a reasonable actuarial basis. A certain amount of each payment would be set aside in what we would call the social fund to look after those who are chronically ill, chronically unemployed, or unable to cope with their social responsibility. The remainder would be placed in an individual fund for each individual.
If at the end of a worker's life, using the ages 20 to 65, the worker had not been unemployed too often, was not in hospital too often, was not sick too often but had just the normal amount, the excess of his payments into this fund, with interest applied at the normal rate, could be added, when he retired at any age he liked, to his old age pension. At that time it was calculated on the basis of 1958 figures. The calculation was that if a person was sick the average amount, unemployed the average amount, and had the average number of accidents, he could add $125 to his old age pension, which was then receivable at age 65. The amount added would be for the normal 60 per cent or 80 per cent of us who are not sick chronically. This would act as an incentive for people not to be coaxed into hospital or coaxed into a doctor's office too often. We know the percentage of people who use these schemes.
I recall the hon. member for Prince Edward-Hastings speaking on that proposal. I also spoke on it. All the people to whom we spoke about it were enthused. They said they would respond to such a proposal.
I for one am sorry that 12 or 13 years later nothing has been done. Here we are in this House facing the penalty for nothing having been done. If one would take a chart showing the amount of money spent in the last 15 years on these open-ended statutory items such as medicare, one would see the growing upward curve and one would understand what is terrifying the Treasury Board and the men who look at the finances of the nation. That is why the government says that we cannot cut government expenses, or that all that is left for us to cut is 20 per cent because the other 80 per cent is fixed.
I shall make a statement which I may not be able to qualify quantitatively. However, I suggest that on unemployment insurance, hospitalization, and medicare, without taking away a single necessary service to people needing them, the cost could be reduced on this type of package proposal by between 50 per cent and 60 per cent because what we have in this proposal is an individual incentive not to abuse this universal program. We would not get into the situation we are in now of having a negative deterrent.
In Saskatchewan when the hospitalization costs rose a new government was elected under the premiership of Mr. Thatcher. He put in a negative deterrent. I believe it was a few cents, or perhaps $1.50 or something of that nature, that was charged when a person went for a service. When we look at that individual negative deterrent introduced by the Liberal government of Saskatchewan we see that it was the sick person who suffered. That government was defeated. That was part of the reason for its defeat.
I give this warning to the government. I know that the members of the government have abdicated their responsibility as politicians and representatives of the people, and have turned the question over to the mandarins in the civil service. When the mandarins say "jump", members of the government do not say "which way", but rather "how

high?" In effect the mandarins are not told that, for survival purposes, in the mix the government would like them to consider some sort of proposal like this.
I know the figures I quoted for 1958 are many years obsolete. I also know that if you take the rate we calculated in 1958, together with the present figures, and take unemployment insurance which I think was 36 cents and is now $3.30, almost ten times higher, I would think at age 65 a worker would have $400 or $500 to add to his pension if those figures were interpolated forward. I do not have the machinery to do this calculation.
I would say to the government, particularly to its members who have backgrounds in this House before 1972, that they should remember the past, and that if they want to be reminded of the past there is a book written by an ex-cabinet minister by the name of Miss LaMarsh, called "A Bird in a Gilded Cage". I suggest they read this book written by the ex-minister of health and social welfare and see how she started out with great sincerity and idealism to bring in programs such as medicare, and then see what happened to her and who ran the show. They should read that history again and read who it was in the cabinet at that time who opposed medicare. Where are they today?
I ask this House not to forget the simple elementary rule that any nation that does not learn from its mistakes of the past has no future. This is the truth I am trying to put forward. We have made horrible blunders, and not with any lack of sincerity. Perhaps we thought we would win an election or two by using these things as promises. I say we must not let this program be endangered by the type of negative deterrent this bill represents. It is not an individual negative deterrent but rather the worst deterrent of all.
The provinces were pushed into this scheme in a brutal manner in 1968 with no controls on their expenditures, then a ceiling was put on, the government backed off, and when there is a problem in respect of hospitalization it will back off further. Before you back off and throw the load on to the provinces who have to face people because it is their responsibility, give a thought to alternative proposals which are constructive, I believe, which are worthy of consideration, and which get away from these negative deterrents.
In speaking on second reading of this bill I should like to say that those of us who are conscious that progress continues at different speeds at different times should realize that we should not be ashamed as members of legislatures and members of parliament of the progress we have made in the last 30 years. The progress we have made should not be endangered by our refusal to challenge the orthodox economics of people who can only think in terms of restrictions and negative controls. The human mind can produce ideas that can harness the positive and the good in people, and I think that the great majority of people in any nation-60 per cent or 80 per cent, I do not know-will respond to positive individual incentive to get these programs to work and to stay within their economic capacity.
The only person who has reason to fear it is a person who is so tied up with the idea that he wants the maximum pension when he quits work at the age of 65 that he would
February 17, 1976

rather die first than lose a nickel. You have to be pretty far gone to have that kind of philosophy. That is the only effective argument that can be used, but a great deal of work has to be done in doing the arithmetic. I think that all parties would support the government in that type of positive approach bepause these schemes, which the great majority of Canadian people want and accept as fundamental rights, will be destroyed if you let escalating costs climb and climb. You cannot nibble off 2 per cent savings here and 2 per cent there and save them.
When you re-read the speech of the hon. member for Villeneuve (Mr. Caouette) speaking for his 12,000 people in the bush in Quebec, you will realize that he is speaking for 22 million people across this country. This is how they will judge us if we allow this type of shortsighted, negative restrictions to be put through under this bill.
As I said earlier, I have a personal interest in this because of my own political defeats, and I warn hon. members that no matter how popular they may think they are in their ridings, if they touch the fundamental needs of their people they will not last very long.


Marc Lalonde: You are worried about the province of Ontario.


Francis Alvin George Hamilton: I am
worried about every provincial government which was forced into this scheme and which is criticized the same as is this government here. They have the same pyramidal civil servants who want to continue these programs in their own way. They are aware of other alternatives, and yet they do not support the ministers who do not speak for the people any more. Until we can impose our will on mandarins in the civil service who have these ideas, the end result will be that not only these programs are endangered but the very individual existence of members of parliament and cabinet ministers will be endangered.
No man is in greater danger in the cabinet than the Minister of National Health and Welfare (Mr. Lalonde) is today. He is bound to his civil service on matters of family allowances which he brought into the House, and he is bound to his civil servants with regard to this type of negative deterrent. But he thinks he will ride along forever. However, people have a way of catching up with these great men, and putting them on their knees to be humble again. All I can suggest is that when the term of the government is over, some of its members will remember that they were warned.
I should like to conclude by saying that no Canadian knowing the social history of this country, knowing the needs of the people, and knowing that inflation is not being fought with this type of measure-inflation is fought by attacking the basic causes of inflation, and the antiinflation Bill C-73 which we put through does not fight it- will respond in a positive way.
You have to get at the fundamental costs and there must be a control mechanism in the universal plan. The control mechanism must be an individual one under which the individual citizen and the whole country benefit from controlling the plan, and then the great majority of the people will respond. If we are to save these plans, this is what I think the course will be. I hope that the government
Medical Care Act
will take a look at this type of thinking, and then it will receive the support of all members of the House.


Mr. Robert McCleave (Halifax-East Hants):: Mr. Speaker, I appreciate the opportunity of filling in the time until the dinner break, and perhaps beyond it. The reason I wish to take part in this debate is that I have been a member of the House for some time, and when the minister presented the bill it raised some revulsion within me for the simple reason that I thought we were being asked to second-guess ourselves. I imagine that will be my principal point in this debate.
Over the years one is asked to judge on many particular points of legislation, to make an assessment of what the government does. In this case I can remember being asked to give my approval or my opinion as to whether we should have medicare legislation, which is now being implemented in this country. Before that I can remember fighting on the hustings for what I believe is the right of every Canadian, the right to the best health care possible.
When forced to look back at those days I cannot even recall what the arguments against were, because I think we had all made our points so well about ten years ago in the House that there should be proper medical care for Canadians and no persons should be ever allowed to suffer or forced to have every last thing they saved in their lives taken away because of illness. I believe that. I stand up here tonight almost in a state of bewilderment as to why there should be any restriction on that sort of thing because I really believe no one in this Chamber should ever have to go through the humiliation of having to sell everything, or try to sell everything he has in life to maintain his health.
There may be very few things we start with which will give us some kind of break in life, but I should like to think that we all started out from the gate with at least the right to health. I think that has to be important to the Canadian way of life. I know that each and every hon. member of the House who is listening to me will agree that there are things we can fall by the wayside on, but on health, no. We should be given a reasonably decent environment and a reasonably decent assurance that we do not have to fall by the wayside on health.
I am bothered because I thought we had decided, and decided well, that irrespective of party and the like, we had fought that battle, and it was over with. I really think this is a mistake which will haunt us for a long time. Suddenly we start to preach restraint, and this and that. If this is virtue, it should have been drilled into this House ten or 20 years ago, not now. This should not be happening at the last moment in some strange shape and form.
I object to this bill for that reason alone, but I also object to it for other reasons. I will present them as best I can, and then sit down at six o'clock. My first objection is that we made a statement in principle years ago, and now something has happened so that we are supposed somehow to negate, obliterate or water down the principle we adopted.
I suppose because doctors form a very successful part of the community they must somehow be singled out for what

February 17, 1976
Medical Care Act
they get out of medicare. That is wrong. I think doctors perform well in today's society, and I say that because I come from a community where there is one of the leading medical schools in the world, but there are also many people who have given themselves to the medical arts.
I suppose I should declare a certain self-interest at this moment. I have an uncle who was at one time the president of the Nova Scotia Medical Society. I have a son-in-law whose life's work is to try to cure cancer. He is a physicist. I now have that out of the way. Those two people are well able to look after themselves, so I do not have to go to bat for them anywhere in the land. However, their work is important.
I am informed by people in whose advice I believe that the cost of physicians' services as a percentage compared to the total federal expenditure has decreased from 3.9 per cent in 1971-72 to a possible or projected 2.9 per cent in 1975-76. This in itself would be a reason to say that the Minister of National Health and Welfare (Mr. Lalonde) has not proven his case beyond a reasonable doubt. In fact, he has not proved it at all, and he will have to do so before I accept the suggestion that what he is trying to do with Bill C-68 is popular, necessary or essential.
I say that doctors are underpaid, and I am not a doctor myself so I can make the statement perhaps much easier than almost anybody else in this Chamber who is not a doctor. However, I realize that some of the doctors here support me in that statement. As a matter of fact I think I have the acclamation of my good friend the Minister of National Health and Welfare, and he probably would stand up and say that yes, doctors indeed are underpaid.


Mr. Paproski:: He better or he won't get their votes next time.


Robert Jardine McCleave: Perhaps he does not need their votes, but he needs a certain amount of credibility in the community, and I suspect he will have to scout and fish for a long time before he finds it. I do not want to see doctors made some kind of whipping boys in this age when people are very concerned about prices and about how much their dollar is able to do for them. I think it would be invidious if we took doctors and made them whipping boys.
The final point I wish to make is one I made years ago on many occasions. I think we should treasure our intellectual resources. We should be happy to promote our universities, those who will be students and those who will be adding something in order to advance us in the field of scholarship, and if we take Bill C-68 at the value which the Minister of National Health and Welfare places on it and accept it, we would be taking steps backward and not forward. That would hurt us in every way, shape and form in our desire to have Canadians better cared for. I think it would be a step back, and not only a short step back but a long one.


Some hon. Members:: Hear, hear!


The Acting Speaker (Mr. Turner):: It being six o'clock, I do now leave the chair until eight o'clock this evening.
At six o'clock the House took recess.


[Stage Direction]
AFTER RECESS

The House resumed at 8 p.m.
Mr. Andrew Brewin (Greenwood):: Madam Speaker, I do not often intervene in debates on medical health. There are others more qualified and experienced in this field. I do believe, however, that this is one of the most important pieces of legislation to come before this parliament. It affects very many of my present constituents, it will affect more in the future, and many more who will be living in my constituency when I am no longer around. For that reason I am glad to contribute to the debate on Bill C-68 which is to amend the Medical Care Act.
The reasons for our position on the bill are well known. To begin with it embodies cuts in health care. If there is one field in which economies may well turn out to be short-sighted and counterproductive, it is this field of health care. The Health of the people of Canada is obviously one of Canada's greatest assets, and any so-called economies that have the effect of depriving Canadians of health care services would be a false economy indeed.
There was a time when the Liberal party proudly acclaimed as one of its contributions to the nation the legislation by which parliament assumed 50 per cent of all insured services provided under the agreement. In addition, the federal government contributed roughly 50 per cent to hospital and diagnostic services. These measures were and are important to hundreds of thousands of Canadians. They were, of course, pioneered by the CCF in the province of Saskatchewan, but the Liberals boasted- and I think perhaps justifiably-that it was their legislation that provided the means of procuring a decent standard of health care for all Canadians from Bonavista to Vancouver Island. This symbol, and it was more than a symbol, of Canadian unity will be shattered by Bill C-68 which we are asked to approve.
The 50 per cent rule is to be replaced by maximum contributions in the federal field and diminishing contributions in percentage amounts. The effect can only be to impose heavier burdens on the poorer provinces and deprive some of the citizens of those provinces of medical services that are urgently required.
In the budget of last June the then minister of finance gave notice of the eventual termination of federal contributions to hospital and diagnostic services. I know that these services are not covered by the bill we are discussing, but are related to it. This bill shows how the wind is blowing. It gives notice of the threat hanging over the heads of the provinces, even if some new agreement is eventually negotiated. The minister's announcement was made eight months ago and I understand there have been no negotiations with the provinces to replace the former agreement.
That raises the subject of health care programs to which the federal government makes no contribution by means of cost sharing. I am referring to programs like pharmacare, home care, and programs for supplying medical appliances. Their cost to the provinces is about $1.5 billion, and will rise to $2 billion. We hope the federal governement will negotiate cost-sharing agreements with the provinces and
February 17, 1976

assume some responsibility for these programs. I ask, when is this to happen?
Negotiations on new methods of cost-sharing have been under way for years. In 1971, the Department of National Health and Welfare proposed a new arrangement for sharing medical and hospital expenses. Basically the proposal was that the federal contribution would be based on the amount payable in a base year, and increased according to percentage changes in the gross national product on a per capita basis. A joint study by the provinces showed that most would experience a serious shortfall in revenues under this proposal and subsequent modifications.
In January, 1975, the federal government again tried to obtain agreement on a new formula for cost-sharing. None was reached. Instead, at the urging of the provinces, a committee was established to study the inclusion of other health services under cost sharing. The work of this committee was sabotaged by the June budget and the limits placed on federal contributions in Bill C-68.
The provinces boycotted a proposed meeting of federal and provincial officials in Victoria, in August. I understand that the minister toured the provinces in September, in hopes of getting the provincial ministers back to the negotiating table in January or February. The minister recently told us that there is to be a federal-provincial conference in April, but did not say what would be discussed. I want his assurance that he will discuss a plan to replace the cost-sharing agreement affecting hospitals and as cost-sharing arrangements for programs at present borne entirely by the provinces.
Why is this legislation necessary if medical service costs and doctors' fees are major items of cost? Is the government not confident with its own anti-inflation policies? I understand that the Manitoba Medical Association agreed to keep fee increases within guideline limits, on the assumption other medical costs would be effectively restrained. I understand that the minister said the government would take into account provincial legislation to enforce the wearing of automobile seatbelts, which would minimize the number of injuries, and other, similar cost saving measures. I think Manitoba and Ontario have already enacted seatbelt legislation. How will that change the minister's plans?
Clearly it is desirable to cut costs where possible. But there is a danger of cutting them at the wrong places, at the expense of the old, the ill, and others who need medical and special preventive services access to which should be a matter of right.
I submit that this legislation is backward, regressive, and turns away from sound principles which the federal government and the Liberal party adopted. I hope parliament will review it at a serious conference with the provinces, after which a better scheme could be worked out.
It is not my job at this stage to discuss savings which can be made in federal expenditures. I am firmly convinced that savings which deprive Canadians of the best health services available are false economy, wrong, and often cruel. I therefore urge parliament to reject this measure.


Mr. Ross Milne (Peel-Dufferin-Simcoe):: Madam Speaker, may I reply to an argument raised by several hon. members opposite, particularly by the previous speaker,
Medical Care Act
that this bill represents an arbitrary, unilateral decision by the federal government, a decision reached without consultation with the provinces.
I submit that negotiations regarding the revision of health insurance legislation and federal-provincial costsharing have been going on with the provinces more or less continuously for about five years, since 1970.
The provinces have been long aware that the federal government deemed it necessary to place some sort of restriction on the open-endedness of our health program. Indeed a number of provinces indicated that they were in favour of such a course, as they had found it difficult to meet their part of their financial obligations. This became increasingly evident during the last two years when, as mentioned, costs of hospital insurance rose almost 45 per cent over the previous level. The urgent economic situation which led to many stringent measures in the June budget and which, incidentally, had an impact far beyond the health field, forced the federal government to take action at that point in time. It is true that the provinces were not apprised of the specific budget measures prior to their announcement in this House but, as hon. members know full well, it is customary not to divulge specific budget provisions prior to their presentation in the House of Commons.
There were two measures in the budget which had to do with our health insurance programs. The first gave five years notice of the federal government's intention to terminate existing agreements under the Hospital Insurance and Diagnostic Services Act after the conclusion of the five-year notice period, in 1980. The second placed a ceiling on the rate of escalation of the medical care program which would be accepted for sharing purposes during the next several years. I stress that the measure placed a ceiling on the rate of escalation. It constitutes neither a cutting back nor a freezing of the program. It seeks to control the rate of escalation of costs incurred in the medical care program.
I am sure most provincial ministers were not surprised at the serving of notice under the Hospital Insurance and Diagnostic Services Act. It had become apparent from discussions of the last several years that this program could not remain open-ended. Indeed several provinces had suggested possible approaches to capping it. It must be noted, however, that the Hospital Insurance and Diagnostic Services Act and regulations can only be changed by mutual agreement, and any one province could block the incorporation of changes favoured by the remainder.
Although theoretically the present agreements could be amended without notice being served, it would be unrealistic to expect unanimous consent by the federal and provincial governments. With notice served on the present agreements, an up-to-date act, taking into account all the tremendous changes which have occurred in the health care picture in Canada during the 23 years that will then have intervened between the passage of the act and its replacement, will certainly follow.
There was really very little reaction from the provinces about serving notice under the Hospital Insurance Act. No question. There was a rather stronger reaction to the announcement of the ceilings on the Medical Care Act, but

February 17, 1976
Medical Care Act
this has become much less pronounced since the anti-inflation program was implemented. The provinces had certainly been aware from the negotiations preceding the budget announcement that a commitment on their part to restrict higher cost services, both hospital and medical, at least in relative terms, as the population grew would be a clear condition of the federal government's sharing in any additional areas. In fact the resumed discussions which had begun in January, 1975, were based upon a provincial offer to consider restraining growth of the high cost areas in return for additional federal sharing in lower cost areas.
I believe that the provisions of Bill C-68, as amended, are consistent with the principles agreed to at the January, 1975, conference of health ministers and indeed should facilitate negotiations that were anticipated at that time. Progress in the negotiations to the point of the budget announcement was such as to indicate that the provinces were committed to the principle of restraining the growth in high cost services and determined to inaugurate lower cost but equally effective programs and services where possible.
I should also say that the amendments which have been introduced at second reading stage were a product of direct consultation with the provincial ministers. In that sense the charge that the bill represents a unilateral decision of the federal government is a misstatement. The new amendments provide the mechanism for renewed negotiations whereby new insured services can be shared under the Medical Care Act and not be subject to the ceilings for a period of at least three years. The federal government has taken the necessary positive steps to ensure that any agreements reached with the provinces on the basis of the agreed principles can be brought into being.
Rarely in the history of our confederation have the provinces acted in unison. To suggest that the federal government should only act when all ten provinces can agree, in effect suggests that nothing should ever be done. Over the past few years individual provinces themselves have often acted unilaterally, for example, in wage and fee schedule negotiations or in introduction of new programs to the detriment of other provinces. Frequently we have seen wealthier provinces, such as British Columbia or Ontario, make wage settlements with health workers which severely imperilled other provinces, particularly the poorer ones, because of the resulting increased pressure for wage parity or equal benefits.
Once a precedent is set the domino effect carries it across the country, particularly in a highly-structured hierarchical-type system such as the hospital field. Such decisions are generally made without regard for the economic impact, either on other jurisdictions or on the country as a whole. One need only recall recent statements by the premier of Saskatchewan who has stated that his province will opt out of the federal anti-inflation program partly because it wishes to re-establish parity with nurses' salaries in neighbouring provinces. I am not condemning his approach because he is in a difficult position, but surely any measure which the federal government can take which discourages or slows down the leap-frogging or whip-sawing effect of wage, salary or fee negotiations between provinces can only be to the benefit of us all.

In conclusion, I listened with great care and interest to the excellent speech this afternoon by the hon. member for Qu'Appelle-Moose Mountain (Mr. Hamilton). He made some excellent points. I want to assure him and others opposite that neither myself nor the government have changed our commitment in any way to universal health care, nor lessened our concern for high level health care for all Canadians. It would not be responsible financing if we did not look at the escalating costs. Surely in the delivery system we should be able to effect some new efficiencies. If we can deliver the same level of health care for less cost, in the future it will be possible to deliver even more health care for those dollars.


Mr. John Wise (Elgin):: Mr. Speaker, let me say at the outset that it is indeed a pleasure for me to address the House this evening on such an important topic as the Medical Care Act. No doubt some of what I have to say will be in conflict with the previous speaker. Perhaps that is understandable. I wish to state that it is good to see the Minister of National Health and Welfare (Mr. Lalonde) in the House throughout this debate.
I must admit to finding myself in somewhat of a difficult position due to the quality of that most comprehensive address delivered by my colleague, the hon. member for Athabasca (Mr. Yewchuk), in this very House on Wednesday, January 28. He covered the ground concerning Bill C-68 so extensively that there is not really a lot more to be said without becoming somewhat repetitive. However, I do feel that there are some key points concerning this bill that do bear repeating, and perhaps the odd argument that has not been previously brought to light.
First, we must consider the shameful and shabby manner in which the federal government has chosen to treat the ten provincial governments. It is hardly news that the federal government has made a unilateral and arbitrary decision to draft and present this legislation which so affects the provinces. It is hardly news that provincially related legislation is prepared with next to no negotiation with those most concerned. It is not news, of course, because this kind of action is standard practice for the government. What we see here is simply another tiresome and increasingly frightening example of the heavy handed approach of the government in its dealings with the provinces, with this House, and with the people of Canada.
We first heard that there would be negotiations with the provinces. There have been none-talk, yes; negotiations, no. It is just not possible that real negotiations could have taken place. The ten provinces are all dead set against this legislation, and are most upset that they have not had a say in its formation.
We now hear that there have been and will continue to be consultations between the two levels of government. At least that is the present posture of the federal minister. If consultations mean calling together all interested parties and then proceeding to tell them what is to be done despite their unanimous opposition, then I suppose there have been consultations. I have no doubt that future consultations on the further ways and means of operating this legislation will be conducted in the same manner.
February 17, 1976

The provinces no longer trust the federal government. This is a most serious situation in a country like Canada whose very existence depends on a system of co-operative federalism. The House has seen ample evidence of the opposition of the provinces to this bill. Statements have been entered into the record from nearly all provincial ministers of health at one time or another during this debate. I do not propose to quote them further at this time. We have all heard them, and the obvious question still lingers; in the face of such unanimous opposition, why is this bill still before us now? Why has the government not taken the honourable course and withdrawn Bill C-68?
The federal government will no doubt say that it is an attempt to cut government spending, and that health care has become too expensive. That is a sham argument, and we all know it. I will have more to say later on the relative costs of health care. But, regardless of costs, the bills still have to be paid, and if not federally then provincially, and if not there, then where? By the ordinary people of Canada, of course.
Before I continue further, Mr. Speaker, I would like to make one point abundantly clear. I do not stand against the reduction of federal government spending. On the contrary, I am very much for it. What I am against is the prevailing approach of the government, an approach which is sweeping and indiscriminate in nature, and which in this particular case is succeeding only in transferring the financial load to the already overburdened backs of others. It represents, as well, another example of the government choosing to cut back in the wrong area of expenditure. The government is lackadaisical in its approach, thus failing to get to the heart of its spending difficulties. There are several other areas of government expense which could be cut back drastically without causing harm to the provinces or to the general health of Canadians. The singling out of the medicare program by the imposition of spending ceilings is a truly incredible piece of folly.
I do not propose to become embroiled in a debate over general government spending practice at this time, Mr. Speaker. That is reserved for another occasion. For the edification of members opposite, however, I might refer them to the recent report of the Canadian Chamber of Commerce on this very subject. It contains a wealth of worth-while advice on this subject which the government would be wise to accept.
Allow me to return briefly to an earlier statement-that the provinces no longer trust the federal government. Why should they, for they have been cheated? The very presence of Bill C-68 before us is a clear indication of that. Ordinarily I do not like to use such strong language in the House. In this particular instance, however, there is no way round it. The provinces have been cheated, and even as I say it I have an uneasy feeling that the real sting has yet to come.
The provinces were dragged into medicare against their collective wishes, even though assured that the federal authority would pay its way. They were led down the garden path, so to speak, and are now faced with the unhappy though not altogether surprising prospect of having the rug pulled out from under them. One cannot
Medical Care Act
help but wonder just how far the Liberal government would really like to go on this matter. Is this just the first step to an eventual opting out of the program altogether? Some provinces fear this may be the case and, if it is, then it is the duty of the minister to tell us so right now.
The government is guilty of yet another transgression. I refer to the publicity surrounding Bill C-68. Press reports about this legislation and projected costs in the last budget speech have misled the public by combining medicare and health insurance costs and then picking out the medicare program for specific action. The inference is that increased medical care insurance costs are the major factor in escalating health care costs. This is clearly not the case, and the government is fully aware of it. The proportion of our gross national product spent on medical services in Canada has in fact declined from 1.3 per cent in 1971-72 to 1.1 per cent in the 1975-76 forecasts. The average annual payment increase incurred by the federal government is less than 12 per cent, well below the average yearly increases in over-all federal spending.
It should be noted, Mr. Speaker, that opposition to Bill C-68 is not restricted to the provincial governments, but that such groups as the Canadian Medical Association and the ten provincial medical associations stand firmly against it. The Canadian Medical Association takes the justifiable position that these arbitrary budget controls will produce definite hazards for Canada's health care delivery system. They state that the budget controls will have the effect of restricting the availability of health care to the point at which it would have to be rationed. Obviously such an action could endanger the quality of medical services available to Canadians.
In a letter to the minister, a letter which has apparently been ignored, Dr. L. C. Grisdale, President of the Canadian Medical Association, says:
The permanent cost increase ceilings proposed will result in the rationing of medical care; the cost increase ceilings will inhibit, if not prohibit, the introduction of new medical procedures and make it impossible for them to be made available to all Canadians who would benefit from them. This will be particularly true for those Canadians who live in less wealthy provinces-frequently those areas where improvements in the health care delivery system are most needed.
The effect on the 'have-not' provinces is particularly significant. Since the introduction of medicare, these provinces with less developed health care systems have benefited from the federal-provincial cost sharing formula. The imposition of a ceiling on federal contributions will deprive these less wealthy provinces of further opportunity to improve the level of medical services in their communities. It will be impossible to evolve a uniform program of equitable availability and quality.
As has been noted previously by many of my colleagues, the CM A resents the sledgehammer approach of the government. Surely the Minister of National Health and Welfare is aware that increases in medical costs have been less, on a percentage basis, than have increases in most other areas.
Let us examine more closely some of the figures involved. The increase per capita of medical care costs in Canada from 1971 to 1972 averaged 6.9 per cent. At the same time the average increase per capita of the gross national product at market price was 12.8 per cent. The consumer price index during the same period rose 7.9 per cent, while average weekly wages and salaries in the industrial sector rose by about 8.5 per cent. Obviously,

February 17, 1976
Medical Care Act
then, the increases in per capita medicare costs have been lower than in most key areas of the economy.
The medical profession has exercised restraint in the setting of its own fee structure over the past several years. Indeed they have been one of the few organized groups to act in such a responsible manner. Over the past five years Ontario physicians co-operated with the Prices and Incomes Commission and held 1971 fee increases to 4.5 per cent. At their own expense they commissioned a study of the medical profession in Ontario in order to enhance its functioning. Also, an increase in the fee schedule, expected by the members, was deferred at that time.
One of the recommendations of this study was that changes in fee schedules be negotiated with the provincial government. This has been done, and in the face of inflation extremely modest increases of 7.75 per cent for 1974 and a meagre 4 per cent for 1975 have been accepted. Yet this group, undoubtedly eligible for catch-up, is now being dealt with more harshly than the average group of working Canadians. Unlike wage and price controls, which one assumes to be temporary, the income restrictions inherent in Bill C-68 will last as long as the bill is in effect. To think otherwise would be to distort the realities of the situation.
A letter I received from the Canadian Medical Association states:
There is as well a further reason why we are opposed to Bill C-68. Its very introduction infers an untruth, i.e. that it is necessary to control unwarranted increases in the costs of medical care. In fact, such increases have been modest, particularly when they are compared with increases in other component parts of the total health care bill. Is it ethically defensible to introduce legislation which could well inhibit the introduction of new life-saving but costly medical procedures?
That is a question to which we on this side of the House have been giving serious consideration. It is a question which merits a more serious response from government members opposite. Elsewhere in the same letter the Association's support of worth-while provincial programs is expressed, as is its concern for the quality of health care delivery. Allow me to read one brief but significant paragraph:
We have encouraged the provincial government in its support of nursing homes as an alternative to hospital bed care. We have encouraged our provincial government in its experimentation with different methods of paying for medical care, including new methods of organizing groups of physicians and paramedical personnel to determine efficient patterns of payment and of practice. If some of these patterns prove to combine efficiency with good quality care, we will be the first to promote them with our members. Surely, the reduction of moneys available can have no other result than to endanger quality, by imposing untried methods of health care delivery just because they are cheaper.
As we are all aware, Madam Speaker, there still exists a critical shortage of doctors in this country. Many rural areas and out of the way communities do not have a general practitioner to care properly for the sick and otherwise attend those in need of medical attention. Citizens of these unfortunate areas are often forced to travel many miles to find competent medical treatment, often at times when it is inadvisable for them to do so.
Yet in the face of truths such as these the government does not take adequate steps to encourage more needed young people to enter the medical profession. In fact just

the opposite now appears to be true. Bill C-68 will certainly do nothing to encourage the practice of medicine as a career. It will likely accomplish just the opposite. Shortages will probably increase, service will no doubt decline, and valuable research will go undone. The health of many Canadians may soon be seriously affected. I hope that the government is prepared to accept this responsibility.
It is not often that I cannot see at least some redeeming aspects to a piece of legislation brought in by the government, but there is no redeeming aspect to Bill C-68. The bill is totally without merit, and in my opinion serious consideration should be given to its withdrawal.


Marcel Joseph Aimé Lambert: Madam Speaker, on January 28, the Minister of National Health and Welfare (Mr. Lalonde) made a rather detailed and I think precise statement on the history of medical care in Canada. But although some of my colleagues and some members on the government side made a few remarks on parts of the minister's statement, I think that until now all members have failed to discuss it. Since I have in hand the English version of the minister's speech, I shall read it in English and continue my remarks in that language, because all the reports I have here are in English and despite all my efforts, I think the translation would suffer. [English]
The minister spoke frankly on a subject that has elicited a great deal of comment, a lot of it emotional, by people who, if they would only admit it-ax times I might even put myself in this category-were not sure of their facts. I have tried to be as careful as possible in dealing with this subject to eliminate what I consider has always been a danger in many speeches made in this House, and that is gut emotionalism which does not always resolve questions at issue.
I should like to refer to something the minister said as reported at page 10407 of Hansard. He was discussing the doctor-to-patient ratio. He said:
In 1968 the doctor-population ratio was 1:769. By 1974 this ratio had become one doctor to 586 inhabitants.
He took some satisfaction on behalf of the medical services plan from the fact that this had surpassed the ratio of one doctor per 650 population that the 1964 Hall Commission on Health Services had set as its goal in 1991. The minister went on to say this, and I must confess my absolute astonishment at the naivete that has been displayed by the minister and his senior advisers in accepting this reaction:
In fact, at the moment there is concern among some people-including doctors themselves-that we might be heading towards a surplus of doctors. In fact, we may have reached or surpassed that point already in some specialties. Governments themselves have become concerned about the rate of growth in the number of doctors and measures have been taken to restrict immigration.
The last part of that sentence is the important part. I say, Madam Speaker, that that is the most absolutely rotten tripe. The executive of the Canadian Medical Association has apparently had some influence on the minister and some of his political advisers. They have placed themselves among concentrations of doctors in major metropolitan centres where doctors, inflated by the prestige and, shall I say, the incomes derived from specialties, have succumbed
February 17, 1976

to what I as a layman, reflecting the attitude of the population, consider to be a development that is contrary to the public interest.
The more lucrative specialties have concentrated themselves to the extent that in a province like Ontario many, if not most, of the specialists have opted out of medical care. They now bill the patient with their fee and the patient is reimbursed on the basis of the agreement reached with the Ontario Medical Association. And the average patient then pays a premium.
In the province of Alberta that is not quite the case. There are not so many who have opted out. The doctors have agreed-


Mr. Rodriguez:: Things are always different in Alberta.


Marcel Joseph Aimé Lambert: Let me tell the hon. member for Nickel Belt (Mr. Rodriguez) that the doctors of Alberta have agreed to an increase in their fees within the income guidelines. That shows the responsibility of those doctors and of the government of that province in regard to health care costs.


Mr. Baker (Grenville-Carleton):: Go back to sleep, Rodriguez.


Marcel Joseph Aimé Lambert: Frankly, Madam Speaker, I have never been more astounded by some of the representations I have received from individual doctors and from the Canadian Medical Association, whose former president, now a minister in Ontario, had the unmitigated gall, and I think foolishness, to say, according to press reports, that there were too many foreign students in Canadian medical schools, particularly Toronto. Of course some of them are so chauvinistic that anyone who is non-Caucasian in appearance becomes a foreign student.
Many students have parents of foreign origin whose skin is not white, but their intelligence and other attributes exceed all too often those of some of their native Canadian-born colleagues. They are prepared to work a little harder and dedicate themselves to their university preparation with a greater degree of sincerity. I regret the unseemly spectacle of some months ago when the former President of the Canadian Medical Association lumped together Canadian-born of non-Caucasian origin with the foreign born, and presumably non-white, as foreign students, and therefore presumably undesirable in Canadian medical schools.
All I say to the members of the profession is that if they endorse the actions of their former president, shame and double shame! I say also to the minister, shame and double shame on him because he has accepted this sort of thing. In his statement he says that curbs have been imposed on the immigration into Canada of foreign trained doctors.
Let us look at how many doctors there are in Canada, how many graduates we have had annually from our Canadian medical schools since 1971, and how many physician immigrants we have had admitted to Canada since that time. I also have some statistics, thanks to my colleague from Mackenzie, who placed a question on the order paper as to doctors practising in Canada. The answer of
Medical Care Act
January 23, 1975 also shows the net loss of Canadian trained doctors to the United States. In addition I have had provided to me by the Canadian Medical Association the estimated cost of training a doctor in Canada for his total career. According to these statistics we can show how nonsensical the restriction has become.
I think the testimony of every one of my colleagues, and of every one of the minister's colleagues who represents a rural population will show whether Canadians are overserviced or over-provided with doctors. Let them go to any small town any place outside of the major metropolitan centres and ask the doctors who are there, and ask the nursing superintendents in the local hospitals, those little 30-bed hospitals, what the difference of one doctor means.


John R. Rodriguez: Ontario is closing them all now.


Marcel Joseph Aimé Lambert: Ah! The member is trying to make political capital out of that. I will tell the hon. member for Nickel Belt that in the past 15 years across Canada, in respect of hospital and school construction, all that was necessary was "ask and you shall receive." Some of the older hospitals should be closed. Prodigality was rampant in this country in the past 15 or 20 years in respect of many of the things built. They were monuments to the glorification of certain hospital boards.


An hon. Member:: And certain governments.


Marcel Joseph Aimé Lambert: The demand for which was initiated by many of the colleagues of the hon. member. Let him not stand up "holier than thou." His ears have already flopped down to his shoulders from the weight of his halo.
Now, Madam Speaker, from our statistics-and I must confess here that I am a little bewildered by the results as I see them.


Joseph-Phillippe Guay: You are right on.


Marcel Joseph Aimé Lambert: The hon. member for St. Boniface-


Joseph-Phillippe Guay: I paid you a compliment.


Marcel Joseph Aimé Lambert: You know, Madam Speaker, the chief government whip this afternoon was constrained to ask the Minister of Labour whether he had music with him. If he would ask a question now he might get the information. Instead of that the hon. member had to bellow out. That is his chief capability. In any event in 1973 Statistics Canada gave out our latest figures which show that there were 36,095 active physicians in Canada. If hon. members want the information I can give the breakdown in respect of provinces as to these figures. I can go back to 1969 as a matter of fact. In 1973, just to show the disparity-


Mr. Roy (Laval):: Nineteen seventy-three!


Marcel Joseph Aimé Lambert: I will tell the hon. member that I think we should have something later than 1973. Stats Canada cannot give us anything better than 1973. However, I will tell the hon. member that in so far as a so-called socially backward and maligned country like

Medical Care Act
South Africa is concerned, its 1975 year book which appeared last week on my desk has statistics all the way to June, 1974.


John R. Rodriguez: We do not read it.


Marcel Joseph Aimé Lambert: That is right; the obstinately blind refuse to read. All I say is that in this area I think we are not as well served by Statistics Canada as we should be, because in this debate when considering the number of active physicians in Canada we should have figures more recent than 1973. As a matter of fact it is even better than that; it is not only Stats Canada. My source of information is actually the health manpower planning section of the Department of National Health and Welfare in its publication of February, 1975. That is how far out of date the minister's own section is.
When we talk about the number of physicians in Canada this includes all active civilian positions including interns, residents, and physicians employed by federal and provincial governments as well as pharmaceutical companies. It also includes those working as full-time teachers or researchers. There are very few, if any, who might not be counted in this definition, so I presume it might include physicians in the uniform of the armed services.
In 1973 Newfoundland had 605 physicians, Prince Edward Island 105, Nova Scotia 1,353, New Brunswick 677, Quebec 10,150, Ontario 13,726, Manitoba 1,597, Saskatchewan 1,186, Alberta 2,526, British Columbia 4,120, Yukon 18, Northwest Territories 29, and unspecified as to their provincial affiliation 3, making a total of 36,095.
In 1975, according to the Canadian Medical Association, there were 1,572 graduates from Canadian medical schools.
Then we looked at how much it costs to produce a graduate medical student. I tried to get the statistics from various universities and from the CMA as to what it costs per student per year of study, and there was such uncertainty and such variation in figures that nobody wanted to venture a hard figure, so I left it alone. However, CMA has indicated a very rough estimate, but it should be knowledgeable about this.
It was estimated that the total cost of medical school for a doctor in Canada is in the neighbourhood of $150,000 per student; in other words it costs about $150,000 to produce a graduate doctor here in Canada. Of that amount the medical student will pay approximately 10 per cent in fees because I think the medical studies, as do others, are paid for approximately 85 per cent from government contributions, 10 per cent from student fees, and 5 per cent from grants and scholarships. This is information that I have obtained over a number of years from the federation or association of Canadian universities in testimony before committees of this House.
Further, we have been able to ascertain that the Canadian Association of Medical Colleges quoted a 1974 U.S. study which found that in 1972-73-there has been a change because of inflation and I must counsel hon. members about this change-in the United States the cost was approximately $12,650 per year per student. Considering that a doctor normally takes about six years to graduate to

the point of internship, this would represent around $75,000 per annum in 1972-73. I am subject to correction here because these are rough averages, but in any event it shows that it costs more in a Canadian medical school to produce a doctor than it does in the United States, because there is no way that the estimate today of $150,000 translated back to 1972-73 would in any way compare with the figures I have given with regard to the United States. There is some appreciable percentage difference. It may be 10 per cent and it may be as high as 20 per cent, but there is a distinctive margin between the countries.
Now here comes "la bete noire" of the minister, the CMA, and many others. In 1969 there were 1,347 immigrant doctors who came to Canada, in 1970 there were 1,113; in 1971, 987; in 1972, 988; in 1973, 1,170; in 1974, 1,080; and in 1975 on the basis of a preliminary estimate, 825. These are the statistics obtained from the Department of Manpower and Immigration in reply to my colleague, the hon. member for Mackenzie (Mr. Korchinski), in their answer of May 30, 1975. He put his question in January, 1975.


Joseph-Phillippe Guay: You are all mixed up.


Marcel Joseph Aimé Lambert: No, there is no mix up
because it is the department which has given the figure of 825 on the basis of a preliminary estimate for the year 1975.
We have gained so many doctors by graduation from medical school: in 1975, 1,572 doctors at approximately $135,000 per individual in cost to the public. This comes to $212,220,000 to train our own Canadian medical graduates. That was the bill for the graduating class in 1975, that is, the public contribution. It was more if we consider their 10 per cent in fees, or another $15,000 individually, which means another $22,500,000 or thereabouts. What about the 825 doctors who came into the country? We did not pay one blessed red cent for their training, but the cost of training an equivalent doctor-


Joseph-Phillippe Guay: What is it?


Marcel Joseph Aimé Lambert: The hon. member for Niagara Falls (Mr. Young) will have an opportunity to make his speech.


Mr. Young:: Madam Speaker, I wish to rise on a question of privilege. The hon. member has referred to me, but I made no comment during his speech.


The Acting Speaker (Mrs. Morin):: Order, please. This is far from a question of privilege.


Marcel Joseph Aimé Lambert: If the hon. member is so keen to identify himself, he may speak. I apologize to my friend, the hon. member for Hamilton Mountain (Mr. MacFarlane), whom I know better under a more familiar name.


Angus (Gus) MacFarlane: I accept anything you have to say about me.


Marcel Joseph Aimé Lambert: I apologize to the hon. member. I recognized him gratuitously. He should bow and thank me for indicating to his constituents that at least he was in the House during this debate.

Now the cost of educating 825 foreign doctors, if we undertook it, again using the $135,000 cost of producing a doctor, would come to $112,377,000. I am using rough figures, but even if there are errors of approximation of anywhere from 3 per cent to 5 per cent in the over-all total, will the hon. member say that the comparison is unjustified? Let him come up with a speech to criticize this in principle.
Having received 2,397 doctors into Canadian society in 1975 at a total cost of $212 million to Canadians, surely hon. members will realize that our net cost for the provision of continuing medically trained personnel-and by that I mean physicians-is not quite halved, but at a rough estimate is cut back by something over 40 per cent.
The minister has said that we must place a curb on the number of doctors coming into this country, and in fact the Minister of Manpower and Immigration (Mr. Andras) says that any doctor coming into the country must have that manpower form 1234. A bell is rung with an offer of employment, unless of course the doctor has sufficient funds, perhaps $100,000 or $125,000 in capital.


Angus (Gus) MacFarlane: How do you get that?


Marcel Joseph Aimé Lambert: The hon. member for Hamilton Mountain (Mr. MacFarlane) asks how I get that. I get it from direct letters, and if he wants I will show him the letters from the ministry showing that doctors coming to Canada now must have an offer of employment which is approved by Manpower.


An hon. Member:: That is the same with everyone else.


Marcel Joseph Aimé Lambert: Why?


An hon. Member:: Why should they be special?


Marcel Joseph Aimé Lambert: Who is going to hire the doctor for the small town in northern Alberta or for the small towns of the rural areas in Ontario? Not the government.


An hon. Member:: The provinces.


Marcel Joseph Aimé Lambert: Oh, is that what the hon. member thinks? Is that going to provide doctors from out of the country, from the United States, doctors trained at Trinity, Dublin, or one of the great teaching hospitals of London, or some of the Chinese doctors who are, frankly, more capable with one hand tied behind their backs than many Canadian trained doctors?


Mr. Parent:: My seatmate is a doctor.


Marcel Joseph Aimé Lambert: I could take him out and introduce him to some of my friends.


Gilbert Parent: If he ever operates on you, you've had it.


Marcel Joseph Aimé Lambert: I hope I will never have to defend the hon. member for St. Catharines (Mr. Parent) in a traffic case. He is very eloquent from his seat.


Mr. Pelletier:: Oh, oh!
Medical Care Act


Marcel Joseph Aimé Lambert: I wish the hon. member for Sherbrooke (Mr. Pelletier) would talk to some of his eminent friends from the medical faculty of the University of Sherbrooke, a good medical school.


Irénée Pelletier: I have, and that was the best part of your speech.


Marcel Joseph Aimé Lambert: The hon. member has only parochial knowledge. They will not dispute my general conclusions, but I will say that on the basis of the restrictions on immigration with regard to medical graduates from the United States, Great Britain, Ireland, India, the Philippines, and Hong Kong, we are depriving many if not most of the rural areas of Canada of medical services.


Joseph-Phillippe Guay: The vice premier of Alberta would not do that. Dr. Horner wouldn't do it. You are wrong, and you know it.


Marcel Joseph Aimé Lambert: He is not in medical practice. He has nothing to do with this. I am simply saying that I do not care whether the decision was made by the Minister of National Health and Welfare or the provincial ministers of health, and when some of my contemporaries in the city of Edmonton, who are specialists enjoying fat cat practices in the hospitals, say that we should put a curb on the immigration of doctors, I must say that my language becomes very violent. I then offer to take them out and show them where and how that is wrong, and a number of them reasonably take a different attitude.
Because that was the main point of my speech I should like to hear the hon. member who is a physician tell me that I am wrong, that the CMA, the department of health and the department of education-


Frank A. Philbrook: Mr. Speaker-


Marcel Joseph Aimé Lambert: If the hon. member has something to say against me, let him make a speech.


Frank A. Philbrook: Mr. Speaker, I wonder if the hon. member realizes that I have already made my speech. If he attended the house a little more regularly, he would realize that.
While I am on my feet, I wonder if the hon. member would permit a question.


Marcel Joseph Aimé Lambert: I will take it at the end. There are many opportunities for the hon. member to make more speeches with regard to this bill, and I invite him to do so, on this particular point.
I asked the minister the other day whether he would have his officials take into consultation not only opposite numbers of bureaucrats and others with regard to the control or the re-examination of health delivery costs, and I asked him to take in not just doctors-particularly not the doctors who put people in hospitals, because it seems to me that that is too easy-but that when it comes to controlling costs in hospitals and appropriate supervision, medical superintendents, administrators and particularly supervising nurses should be called in so that they can say when patients should be discharged.


Joseph-Phillippe Guay: Hear, hear! That is the point.

Medical Care Act


Marcel Joseph Aimé Lambert: I am a little worried, because when the hon. member for St. Boniface agrees with me I have doubts as to whether I have a valid point. The other point I should like to put up for examination here in central Canada-and here I am open to correction-is the manner of practice in Ontario, which seems to me a very high cost method of operating medical services. Here in the city of Ottawa if I have an ingrowing toenail- or, as a better example let us say I feel ill at ease and have a pain inside-


An hon. Member:: Now you know how we feel.


Marcel Joseph Aimé Lambert: Mr. Speaker, the hon. member should see a neurosurgeon as he is suffering from softening of the brain.


Walter David Baker: That's because he is sitting on it.


Marcel Joseph Aimé Lambert: If someone in Ottawa feels in need of medical service, even though he may have a friend who is a general practitioner or a friend who is a surgeon, it is still likely that he will have to be referred to another doctor. There has to be that double contact. Strangely enough the first contact is paid for by the Ontario Health Insurance Plan as well as the doctor ultimately consulted.
In my province of Alberta there exists generally what is known as clinic practice, with some specialists gathered around major teaching hospitals. An individual goes to a clinic, is examined by a general practitioner and is referred, within the clinic, to a specialist in the group. Only one fee is charged unless in specific cases reference is made to an outside independent specialist.
In Ottawa, unless an individual has the inside track, it can take three or four weeks for a doctor to see him. That does not happen in group practice.


John R. Rodriguez: Come and see me.


Marcel Joseph Aimé Lambert: I should like to see those members of this House who are doctors speak out in this regard and tell us whether we as laymen are right or wrong in our estimates of what it costs for the average individual to see a doctor in most provinces.


Some hon. Members:: Hear, hear!


Mr. Deputy Speaker:: Order, please. I regret to interrupt the hon. member, but without the unanimous consent of the House, he cannot continue his remarks.

Is there unanimous consent to allow the hon. member to complete his remarks?


Some hon. Members:: Agreed.


Marcel Joseph Aimé Lambert: Mr. Speaker, I want to thank hon. members sincerely for their courtesy and I shall try not to abuse it.

The last point I should like to make considering the type of health care-the hon. minister may feel a bit skinned but I will be glad to hear his ultimate response-


Marc Lalonde: I have been the first one to propose you carry on.


Marcel Joseph Aimé Lambert: That is fine. I hope the patient does not die. I think we want to look at the type of health care that is provided. I realize some of the provinces do not have the resources, but this is an area for a great deal of co-operation and study between the federal and provincial governments.
It is unfortunate that in some provinces patients are kept too long in active treatment hospitals and at a great cost. The reason for this is usually a lack of convalescent or chronic care beds. I realize it is not within the capability of all provinces to provide the services in the correct proportion, but it is one area that should be examined if we are concerned about the swiftly escalating cost of the delivery of health services. I suggest it is an area ripe for potential savings.
In the area of home nursing services some provinces have commendable programs and I hope the Ontario program is not adversely affected by proposed cut back. The Victorian Order of Nurses, in Ontario as elsewhere, is one body that has provided admirable service in this field at very low cost. It should continue and be encouraged as a model of service that can be provided under an ideal health care scheme.
Secondly, there should also be a conversion, not a closing of some of the large hospitals.


An hon. Member:: What about Frank Miller?


Marcel Joseph Aimé Lambert: I am not knowledgeable, nor is the hon. member, of the factual Ontario situation. I have seen conversions of some of the older hospitals in Alberta-although not since 1971-into convalescent or chronic care hospitals. They have been modernized at a reasonably low cost per patient and do fill a real need.
I have not seen auxiliary hospitals in Ontario. These occupy the gap between active treatment hospitals and the nursing homes. Physicians are on call and patients who require constant care are usually transferred to active treatment hospitals so the overhead expenses are not high. A lot of additional service rendered comes from volunteer groups in the community.
It might be a good idea for the provinces to provide extensive nursing home facilities where people could be taken care of but not treated for actual illness. The cost to the government is low in these places because the patient bears most of the expense. The fee generally does not amount to any more than it would cost the patient to live in a one room cold water flat or a basement room or, as an unpaid babysitter as happens in far too many cases. They are able to live in greater dignity and comfort in a nursing home.
I thank hon. members for the opportunity of speaking at this length. On the question of the provision of doctors I do not believe a case can be made to restrict the immigration of qualified doctors to Canada. As I have pointed out, there
February 17, 1976

are still many fruitful areas for co-operation in the field of public medical care.
There can also be fruitful consultations with regard to the length of time people have to spend in hospitals, and these should not be just with the CMA. They are the people who put people in hospitals and unfortunately, most of the time say when they are to come out. If the health plan is in difficulty, that is where a lot of the responsibility lies. I also say that administrators of hospitals, nursing supervisors, and nursing staff should be consulted about the length of hospital stay.
Knowing how the health care system was forced on the provinces, I can only say that the minister has approached this difficult problem with a battering ram. For that reason I, at the moment, withhold my consent to the passage of this bill.


John R. Rodriguez: Mr. Speaker, I was glad to hear the hon. member for Edmonton West (Mr. Lambert) standing up for immigrant doctors. It is too bad his party will not let an immigrant businessman run for its leadership.


Some hon. Members:: Hear, hear!


John R. Rodriguez: However, I did not come here this evening to talk about Tory politics. The Tories have their own problems this week end.


An hon. Member:: Why did you come here?


John R. Rodriguez: I came here to pour coals on the head of the Liberal government for seeking to pass Bill C-68. This bill seeks to amend the Medical Care Act and to limit the increase in federal contributions to help meet the rising costs of the provinces. The bill imposes maximum yearly percentage increases in federal contributions. The increases are to be 13 per cent in 1976-77; 10.5 per cent in 1977-78; and 8.5 per cent after 1978. Keep in mind that under the present Medical Care Act the federal government pays 50 per cent of the cost of a province's medical care program. There is no federal funding for home nursing, denti-care, prosthetic appliances, and pharmacare. Many provinces fund these programs entirely on their own. Poor provinces cannot afford these services.
Keep in mind that the federal act provides for the addition of these services. Interestingly, the government has not added one of these services since the passage of the act in 1968. Many provinces, particularly poor ones, have been unable to extend services under the act. Any services they try to implement cost them plenty of money as they have no control over the collection of income tax.
We, in Canada, have taken for granted many of the programs we fought years to achieve. We fought hard for free collective bargaining and thought we had won that fight, only to see the government pass Bill C-73, thereby destroying free collective bargaining with its wage controls.


An hon. Member:: What bill are you talking about?
Medical Care Act


John R. Rodriguez: We fought for the right of our children to a decent, basic education, and won that fight. My party, especially, fought hard to give Canadians a decent standard of health care. We thought we had won that battle; then we find that the Liberal government brings forward a bill which will take away that hard-won right. It is doing it by cutting back federal contributions to medicare. We have seen the government destroy our collective bargaining process; now it is trying to destroy the medicare program it initiated in 1968 and encouraged the provinces to join.
I know the Minister of National Health and Welfare (Mr. Lalonde) runs around smiling like a Cheshire cat, purring that if we are to reduce health costs we must improve our life styles and environment. He criticizes the provinces for not introducing seat belt legislation which will cut down the cost of treating automobile accident injuries, and for not discouraging the consumption of alcohol and cigarettes; yet he travelled to Israel on the jet of one of the biggest liquor barons in North America.


Some hon. Members:: Shame!


John R. Rodriguez: He also suggested that the provinces should embark on programs of preventive medicine. No doubt he is correct. No doubt health costs can be reduced if we reduce hazards in the work place. But the federal government has a responsibility in the area; it cannot get off the hook so lightly.
It is true that health costs could be reduced if the provinces reduced health hazards. As I say, the federal government too has responsibilities in the area. What has the government done to improve our lifestyles and environment? Where are the tough, strictly enforced standards for air and water quality which the Department of the Environment should have developed?


Walter David Baker: They are non-existent.


John R. Rodriguez: Why do we have high levels of arsenic emission in the Northwest Territories, and evidence of mercury poisoning among people living there? Why, for that matter, are unsafe conditions permitted in the uranium mines at Elliott Lake, which are under the jurisdiction of Atomic Energy of Canada Limited? Why is the government not enforcing the law and ensuring safe conditions in the uranium mines? Who is to compensate workers who have developed silicosis? Who will pay the shot for maintaining their families?
It is all very well for the minister to go around the country smiling and telling the Canadian people they must improve the environment and their lifestyles. The government can do much to improve health care; it could introduce programs of preventive medicine. But it has not done this. Instead, it inflicts on this country this particular bill.
Where can one see evidence of the model health and safety programs which federal departments and Crown corporations ought to implement? Where is the evidence of information programs for the country's industrial workers, which could warn them of potential hazards on the job? Where is the evidence of research into such hazards, and research with regard to preventive programs?

February 17, 1976
Medical Care Act
The recent speeches of the minister have been self-congratulatory. In them he has mentioned the thoughtful study which his department released just before the 1974 general election entitled "A New Perspective on the Health of Canadians." If the minister had actually read the study he would have noticed that it talks about preventive medicine programs being necessary if we are to improve significantly the health of Canadians. But in order to do this we need to devote more resources to health care. We need more paramedics, more clinics, and alternate care facilities, pharmacare programs to reduce costs and remove income barriers to needed drugs, etc. In other words, we need health care programs which Saskatchewan, Manitoba and B.C. have provided on their own. If the federal government were serious, were concerned about the health of Canadians, it would shoulder the costs of these programs.
Let's look at it this way: The federal government is trying to make the provinces conscious of the rising cost of medical care. But the provinces know this very well. They must pay 50 per cent of the increased cost, without access to income taxes. Not only must provinces pay their share of the costs of the medical care program; they must pay the total cost of services not covered under the act. That cost the provinces $1.5 billion in 1975.
The federal government is determined that the provinces must pay more. It argues that by putting a ceiling on contributions it will provide an incentive for provinces to cut their own health costs. Placed in this position provincial governments will have to increase provincial sales taxes, cut medical care services, or charge user or deterrent fees. Any one of these alternatives is regressive, and would constitute a reduction in health care for Canadians.
In Ontario, for example, we see how the provincial Tory government is coming to grips with the problem. First it implemented seat belt legislation. Now the Ontario health minister is running around like the grim reaper, as he was described by the Ontario Liberal leader, with a coterie of press people in tow, announcing grandly that this hospital will close and that hospital will close.
It is interesting to note that in every case there was no consultation with the community. There was no consultation with the personnel in the hospital to be closed. Incidentally one hospital in my constituency was closed. There was no consultation about that action. It was completely arbitrary. That is one of the detrimental aspects of this kind of legislation. It forces the hands of the provincial governments.
With this kind of ad hocery afoot, one group of Canadians will suffer most. There is no question about it. It is those who lack money, those who lack economic power, the poor. It is a well known fact that those who have little money, the poor, have the poorest health. Indeed it was primarily because of this fact that a Liberal Senator, David Croll, a man most sensitive to the needs of the poor, in response to the June announcement that the government would cut back on this said, and I quote:
It is wrong in concept; it is divisive in practice and in my opinion it is wrong, wrong, wrong, a thousand times wrong.
The cost of Medical care has gone up, but that does not mean the provinces stand condemned as wasteful. In a

report by the Geneva based International Social Security Association no let up is seen for rising expenditures on sickness insurance. They say in their report, and I quote:
... mankind is increasingly beginning to regard medical care as an absolute necessity, a belief fostered by the rapid progress of medical science....
The reasons for the spending increases are complex, but include several basic ones in most developed countries:
Here are those factors:
The majority of populations are in the older age brackets and older people tend to consume more medical goods and services than do the younger age groups.
Medical consumption is regarded as a priority need that must be satisfied at any cost, regardless of income level.
Medicine has gone through a "complete upheaval" in the last 50 years, becoming both more effective and more expensive, and people appear prepared to pay the increased price.
Medical care is becoming more and more specialized and often caters to the individual rather than to the masses.
For example, the introduction of systems for the electronic examination of heart patients has increased the cost of hospital treatment. Every year in the U.S. 15,000 patients receive a cardiac pacemaker that costs $1,500 and has a life expectancy of about three years. Now, a pacemaker has been developed with a nuclear battery than can last 10 years, but costs $5,000. The report says this means that every year 15,000 Americans may be paying $75 million for heart pacemakers alone.
The association says that doctors tend to contribute to increasing medical cost. Because they have a wide range of means of diagnosis and treatment at their disposal, practioners tend to consider that their duty toward a patient demands that every form of examination and treatment that may be of use to them should be applied, even if the prospect of success is small.
Should the government be putting the screws to medicare in this fashion? The only answer that we in this party can come up with is absolutely no. The other question which we must face is: what should the federal government be doing? In the Department of National Health and Welfare publication "A New Perspective on the Health of Canadians" it was suggested that if the health standards of Canadians were to improve and in the long run be made less expensive, it would be necessary to start spending more money on preventive medicine rather than just providing programs to patch up the damage. It does not look as if the people on the benches opposite have been reading the publications of their own departments. Or perhaps they simply do not care. They will be able to afford doctors.


An hon. Member:: Oh, oh!


John R. Rodriguez: Don't worry, I get my practice.


Mr. Gilbert:: He runs around the riding.


John R. Rodriguez: I run around the riding trying to get Liberals to feed it.
Early diagnosis through health centres is absolutely imperative. If we can identify early a cause which results in silicosis for a miner and can correct that cause, it will certainly be a relief to the taxpayer in terms of the medical program. We can certainly identify symptoms early in children. Take, for example, mental illness and emotional disturbances. With early identification and treatment we can save the taxpayers a lot of money.
The government is interested in saving money in health care, but does it do those things? No. We only have to see what it does with these people. It brings them to court,
February 17, 1976

locks them up, and puts them in solitary confinement when they do not conform. They are not exposed to treatment. I suppose shortly we will hang them. No attention is being paid to that area. It is easier to bring in this kind of a bill and say let the provinces sink or swim.
There certainly ought to be convalescent centres. It costs Canadian taxpayers as much as $200 per day to maintain a chronic case patient in an active treatment hospital. It would be cheaper to put that person in the Carleton Towers at $30 or $40 a day. There would be a saving to the Canadian taxpayer. But we do not do that. We say the funds are not available.
Those who are the poorest in this country can never get into convalescent centres. Therefore we have these chronic care patients in active treatment beds, at great expense to the taxpayers.
The use of paramedics would reduce the reliance on doctors. In many of the northern parts of my constituency we could certainly use paramedics. We would not have to transport a patient to an active care hospital at great expense to treat him. No work has been done in the area of paramedics, but it would certainly cut down on the cost of using doctors.
We have not done anything in the area of cottage hospitals where minor surgery is done, with the patient staying in his own community where he can be cared for by his family. Much minor surgery could certainly be carried out in a cottage hospital; such a system has worked well in other parts of the world.
Again, we provide no dental care programs for children across Canada through which dental problems could be identified and corrected early. If such programs were put into effect, medical costs generally could be reduced. In poorer provinces which cannot afford to support such programs on their own, such childhood complaints are left unattended until eventually they prove very costly. But the government ignores reasonable solutions. Take the oil situation, for example. It thinks it can crank up the price and thus cause people to use less. This seems to be a Liberal approach-if you can make the cost of a commodity or service prohibitive the demand for it will be reduced. But who are the ones who suffer? Who are the people which the government seems to want to punish? In this case it is the users of the health service.
Where else could the government cut the costs of health services? There is one obvious way, but it is hard to expect a Liberal government, or indeed a Tory government for that matter, to act along these lines. In Ottawa the majority of lung-related diseases are due to smoking. In my riding, the majority of lung-related diseases are due to living near the smokestacks of INCO and Falconbridge. And the first thing that happens, whenever corporate profits look as though they might just possibly be dipping, the first thing to be curtailed is expenditure on anti-pollution equipment. That is the first thing to go out. There is one nice thing, though.
The International Nickel Company is acting on this matter, and it gives me pleasure to say that in my riding it has now raised its smokestack 1,200 feet into the air. As a result, I understand the sulphur fumes coming out of that
Medical Care Act
stack lately are falling here in Ottawa. I am happy about that. I hope these fumes will invade the brains of members opposite. I bet you dollars to dimes you will see them taking action fast because they will be receiving the benefits of that pollution.


An hon. Member:: It got to you.


John R. Rodriguez: I see I have touched a tender spot in the sensitivity of members over there.
There might be something else the government could do in its own backyard affecting its own employees. Perhaps it could become a model employer. In the public service in 1974-75 there were 22,218 accidents costing directly more than $7 million. Out of the figure I have mentioned, more than 10,000 people were injured in the department of that friend of labour, the Postmaster General (Mr. Mackasey). Almost 7,000 of those injuries were disabling, and the total cost was $3.5 million. That doesn't include the health costs, but I have a feeling a lot more money could be saved in that area if the government really cared to save money by starting up an industrial safety program among its own employees.
There is another question which arises when I consider a proposal such as we have before us. We look around the country, Mr. Speaker, and we are amazed at our priorities. We marvel. It is interesting to note that the country can find the resources to build a one billion dollar Olympic set-up. To do what? We can spend $100 million to secure 1,500 athletes for two weeks. We can do this without batting an eyelid, for the sake of somebody's ego tripping. I do not understand the mentality of Liberals. It is quite clear they have a false sense of values. I realize that this touches a sensitive issue.
An hon. Member You voted for the Olympics.


John R. Rodriguez: We did not. If the hon. member for St. Catharines (Mr. Parent) wishes to make a speech I will certainly yield the floor to him.


An hon. Member:: He is good at interrupting.


John R. Rodriguez: He is good at interrupting, not at speaking. He had better go and take a poll among his constituents.
Where are our priorities? We can find dollars to put on a fantastic Olympic spectacle, and no doubt we shall be paying for it by having an Olympic lottery for the next hundred years. But we cannot find the money to provide health care services.


Angus (Gus) MacFarlane: That's not true.


John R. Rodriguez: Where are we going to find it? We shall all have to find it.


Angus (Gus) MacFarlane: Because you shout louder does not make it true.


John R. Rodriguez: They say preparations for the Olympics are moving ahead on schedule, moving toward an improvement in the muscles of a very small group of Canadians. But sometimes I wonder about our mental health. When we pick up the papers today it seems to me we are con-

February 17, 1976
Adjournment Debate
stantly reading about cases of people going off the deep end because of the pressures which modern society generates. The government should reorganize its priorities.
The hon. member for Nanaimo-Cowichan-The Islands (Mr. Douglas) called the bill a law of the sea bill-women and children first. We can add one more category to that list and say: women, children, and sick folk. The government took on the 65 year-olds when it amended the Unemployment Insurance Act. It took on the lower income families when it cut off the indexing of the family allowances. Now we see it cutting back its responsibility for medical care. It is determined to destroy the program of medicare which was built with great success, by a provincial socialist government in this country.
May I call it ten o'clock, Mr. Speaker?


BUSINESS OF THE HOUSE
Mr. MacLean:: Mr. Speaker, I should like to ask the spokesman for the government if he can confirm the business we shall be discussing tomorrow.


Marc Lalonde: Tomorrow we shall be concluding, we hope, third reading of Bill C-58.



PROCEEDINGS ON ADJOURNMENT MOTION

[Stage Direction]
A motion to adjourn the House under Standing Order 40, deemed to have been moved:

Mr. Doug Neil (Moose Jaw):: Mr. Speaker, up until a few moments ago the Minister of Agriculture (Mr. Whelan) was in the Chamber. I am disappointed he has left because I am directing my remarks specifically to him.
On February 9, 1975, as reported at page 10742 of Hansard, I asked the President of the Treasury Board (Mr. Chretien) the following question:
Mr. Speaker, my question is for the President of the Treasury Board. In view of the fact that under th Crop Insurance Act the federal government is committed to a certain level of contributions based on the number of farmers covered; in view of the fact that the crop insurance section has estimated that the required federal moneys for 1976 will be about $62 million; and in view of the announcement by the minister that the amount of the federal contribution will be cut by about $10 million, reducing the contribution to $52 million, can the minister advise what will happen if the required contributions by the crop insurance board exceed $52 million, and will he advise further when the government plans on obtaining additional funds, or will it renege on its commitments?

The President of the Treasury Board replied:
Mr. Speaker, this question is rather technical. I do not think I can give an answer at this time, but I think that all sectors of the economy, including this one, must participate in the federal government's restriction program.
Subsequently the President of the Treasury Board was good enough to write to me advising that if federal costs exceeded $51,900,000 the requirements of the Crop Insurance Act would be honoured.
In the January 24 issue of the "Report on Farming", Mr. Glenn Gorrell, an official of the federal crop insurance board, is quoted as saying:
-we're just trying to encourage them (the crop insurance boards) to sell a minimum of insurance.
"This is a good time to take a hard look at crop insurance, because benefits seem to have escalated beyond costs. Are we restoring out of pocket costs to the farmer, or guaranteeing a profit?" he asked.
It is interesting to note as well that on February 9 the Parliamentary Secretary to the Minister of Agriculture (Mr. Pelletier) in the adjournment debate stated that the Minister of Agriculture had written to the provincial ministers of agriculture explaining the reasons for restraint in the expenditures of the crop insurance program for 1976-77. It seems rather inconsistent that in his final paragraph the parliamentary secretary should state that it remains the intention of the government to support the crop insurance program as a primary means of assistance to producers who suffer severe crop losses as a result of natural hazards.
Since its inception the crop insurance program has become increasingly popular with the producers of western Canada, and each year sees an increase in the number of participants. Recently the various provinces in the prairies got together and decided to equalize their coverage in the prairie region. I think one could safely compare the crop insurance program with the unemployment insurance program which we have in Canada, because the crop insurance program provides the producer with a reasonable income to carry on in a year when he has suffered either partial or complete crop loss as a result of natural hazards. It is a program which is open to all producers, and a cut back in federal expenditure on this program can only lead to the shifting of the burden to the provincial governments, or to a reduction in the coverage that is available, or to a limit on the number of participants in the program. Will the provinces be required to turn to applicants who want to participate in the program and say, "We are sorry, we have not got sufficient money to allow you to participate"?
Since I came here in 1972 the Minister of Agriculture has always held himself out as a friend of the farmer. He spends a great deal of time travelling around the country telling the public what he has done to assist the farmer. I find it very difficult to understand that he personally would be party to any reduction in a program that was set up to assist the farmers in times of distress, and I would certainly like to hear him say publicly that he personally agrees with any cutbacks in the program.
We recently passed a grain stabilization bill, but of course this was presented to the House by a different minister because of the divided responsibility in the field of agriculture. At the moment I do not hear the government indicating any intention of cutting back on the con-

tribution to that program. However, it may be that in a year or two the government will find that the stabilization program is costing it more than it anticipated, and in the interests of restraint will start to cut back on that program. Quite frankly I am disappointed at the Minister of Agriculture not standing up for the western grain producer and making other cabinet members aware of the importance of agriculture to Canada.
There is no question but that the government must exercise restraint in its spending, but quite frankly when you consider many of the government programs and expenditures, there are many areas where cuts could be made which would create little or no hardship. I am reminded of the $88 million expenditure for language training facilities at a Canadian Forces base in the province of Quebec over the next three or four years. One need only examine the latest report of the Auditor General for further examples.
Agriculture is not only vital to Canada but is vital to the whole world in this time of population explosion and starving millions. The farming industry must remain viable. It can remain viable only if the government supports the programs which it brings into effect on a longterm basis. It is the responsibility of the Minister of Agriculture to see that the programs receive the support of the government. Only time will tell whether the minister is known, or will remain known, as a friend to the farmer.


Irénée Pelletier: Mr. Speaker, before giving the official answer of the department, I wish to say that I am extremely surprised by the comments that have just been made by the hon. member for Moose Jaw (Mr. Neil), when he said that the Minister of Agriculture (Mr. Whelan) takes very little interest in western farmers' problems.
I believe that the minister has shown on several occasions his concern for agriculture in Canada, not only in the western provinces, but in Quebec, in the Maritimes and throughout Canada. I consider the hon. member's comments that the minister does not seem to be concerned by these problems as totally unjustified, useless and making no sense at all.

I am surprised to see this question before us again tonight. As the House will recall, this matter was discussed on February 9, just one week ago, when it was raised by the hon. member for Okanagan-Boundary (Mr. Whittaker). There is nothing further that can be added to what was said last week. I would, therefore, refer the hon. member opposite to page 10779 of Hansard wherein this subject was fully discussed. In addition, the President of the Treasury Board (Mr. Chretien) has advised me that he sent a letter to the hon. member in which the facts were once again placed before him.
As the hon. member was advised on these occasions, a letter was sent to all provincial ministers of agriculture. Provincial officials are continuing discussions with officials from Agriculture Canada. Until these discussions result in a mutually satisfactory agreement it will remain impossible to advise of the precise manner in which this decision will be implemented. Nevertheless I can assure
Adjournment Debate
the House that the requirements of the Crop Insurance Act will be honoured.

Mr. Speaker, the hon. member opposite has raised questions about agriculture in the world, its importance, and so on. I think that when dealing with a matter such as the one he raised tonight, that is crop insurance, it has nothing to do with the world population, or with anything else. He should have dealt mainly with crop insurance. If one wants to deal with everything happening in agriculture, with anything at all, no answer can be given. If the hon. member is not satisfied with the answer given to him, this is because he has asked this kind of question three or four times within two or three weeks.
The minister has given an answer, he is concerned with what happens not only in eastern and western Canada, but throughout the country. He met with provincial minister of agriculture and public servants, to get this program to work. Therefore, I hope that they will finally begin to understand.


ANTI-INFLATION BOARD-REASON FOR REDUCING AMOUNT OF WAGE INCREASE FOR UNIVERSITY OF TORONTO LIBRARY WORKERS
Mr. David Orlikow (Winnipeg North):: Mr. Speaker, when the Prime Minister (Mr. Trudeau) first announced his so-called anti-inflation program, members of the NDP opposed the proposal made by the Prime Minister and have opposed it ever since. We said then that the program would not work, that it would be inequitable in its application, and that while it might control wages it would certainly not control prices or profits. Even we did not realize how correct we were and how quickly the truth of what we were saying would be demonstrated.
On February 10 I asked the Minister of Finance (Mr. Macdonald) to explain why, despite the fact that in the debate in the House and in explaining the provisions of the legislation in the committee the minister had said that people making less than $3.50 an hour would be exempted from the 10 per cent maximum increase in wages and salaries, the Anti-Inflation Board scaled down the terms of the agreement reached between the Canadian Union of Public Employees on behalf of its members working in the library at the University of Toronto and the University of Toronto. The minister simply replied that he would discuss the matter with the board, but of course there have been no explanations from the minister and no change in policy by the Anti-Inflation Board.
Let me put on the record very briefly what the case is about. The union and the University of Toronto reached an agreement after a 20-day strike, under the provisions of which employees at the bottom of the wage scale at the University of Toronto working in the library would get an 18.5 per cent average increase in their wages. The wage increase to employees at higher rates was substantially lower.
The university refused to implement this agreement which they had negotiated because the Anti-Inflation Board advised them that the maximum it could agree to

Adjournment Debate
was a 12.2 per cent increase. This was because the board ignored the fact that the minister had said that people earning under $7,000 a year could get more than 10 per cent. This was also despite the fact that the wage earned by people at the bottom end of the scale working at the library of the University of Toronto was $5,771 a year, and that the increase which they negotiated of 21.3 per cent would leave them with a paid rate of $6.92 Vi cents an hour, or $355 a year below the figure permitted by the regulations if the whole increase which the union negotiated with the University of Toronto had been implemented.
I say that the board ignored the guidelines as laid down by the minister which, in my view, it had no right to do. It did that at a time when the board was consistently awarding, to other groups of employees, substantially more than the 10 per cent to 12 per cent permitted under the guidelines. The teachers in Norfolk county in southern Ontario reached a one year agreement which gave them a 34 per cent increase, but the board reduced it to 24 per cent. In Renfrew county the agreement called for 29 per cent, but the board reduced it to 23 per cent. I could go on and on talking about what has happened to teachers. Teachers are getting in the neighbourhood of 20 per cent.
To show how ridiculous the situation is, the union exercised a right which it had under the provisions of the Ontario labour relations act to call for arbitration. Under section 37 of that act the arbitration board which it provided for has the duty to look into the case and to make a finding which is binding on both parties. Today that board made a finding: it directed the university to implement the wage adjustments as outlined in the collective agreement to the extent that it is permitted by law to do so. What law? These people are governed by provincial law; they are provincial employees. They have argued that the federal government has no right to set their wages until the legislature of Ontario passed legislation, which it has not done.
In the moment or two which I have left let me compare the tough attitude of the Anti-Inflation Board with its attitude with regard to price increases and profits. On February 5 the Ottawa Journal reported that the AntiInflation Board was going to issue tough directives governing the profits made by banks. That is not surprising when one realizes that in the three months ending October 31, 1975, the after tax balance of revenue of banks, which was the equivalent of after tax profit, rose by 87.5 per cent from the year earlier. This is permitted, but the Anti-Inflation Board was going to issue a very tough series of regulations.
One day later, before the regulations were ever promulgated, the Montreal Gazette carried a front page story saying that the Anti-Inflation Board regulations limiting banks were expected within a few days but were likely to be a watered down version of restrictions contemplated last month. One banker said the industry screamed bloody murder over the initial proposals. Apparently the board accepted the industry's protests against inequities after negotiations involving the Canadian Bankers Association and the banks.
That is the kind of inequity about which we have protested from the day the Prime Minister announced his program, and I suggest to the parliamentary secretary, who has the unenviable job of explaining this matter, that it is that kind of unfair rough justice the government has

talked about so much which has so alienated the working people of the country.


Mr.   Jacques-L. Trudel@Parliamentary Secretary to Minister of Finance: Mr. Speaker, I do not necessarily accept the first part of the statement made by the hon. member for Winnipeg North (Mr. Orlikow). I think he was quite correct when he stated that the minister would carefully review the question and submit it to the Anti-Inflation Board. That part I do accept. Some of his other statements were incorrect when he was assessing the situation when he took part in the debate when it was first introduced.
With regard to the point raised in the question by the hon. member I should like to say that the Anti-Inflation Board at its meeting of January 14, 1976, reviewed the collective agreement between the University of Toronto and the Canadian Union of Public Employees Local 1230, library technicians. I believe that is the concern expressed by the hon. gentleman.
The agreement was reviewed by the Anti-Inflation Board in light of its decision to approve an increase between the arithmetic formula in instances where an historical relationship has existed with another group or groups of employees. The board was satisfied as to the existence of an historical relationship between bargaining units in the Toronto area. However, the board considers that the historical relationship would be maintained if compensation increases were provided within the permissible limits defined by the formula behind the arithmetic guidelines. Therefore, the Anti-Inflation Board concluded that it could accept increases in total compensation of up to 12.2 per cent for CUPE local 1230.


David Orlikow: You don't believe that nonsense, do you?


Mr. Trudel:: I did not interrupt the hon. member when he spoke, and I wonder if he would have the courtesy to listen. It should be noted that such an increase would be within the limits of the anti-inflation guidelines for this group and applies to a total average increase in compensation for the group.
Part 4, division 1, section 43(2) on page 41 of the regulations reads:
.. . the compensation of an employee in any guideline year may be increased-(a) to $3.50 per hour, or (b) $600 or, where the compensation is paid for less than a year by an amount that bears the same proportion to $600 that the period for which the compensation is paid bears to a year, whichever results in the greater increase.
The application of increases for this group which would average up to 12.2 per cent does not preclude certain individuals within the group receiving increases in compensation of up to or even higher than $3.50 per hour or contravene in any way section 43(2).
Employees who receive a total hourly rate of compensation of less than $3.50 may, along with all other members of this group, receive a maximum average increase of up to 12.2 per cent. If this amount does not bring their total compensation to $3.50 an hour, the employer may proceed to do so within the necessity of costing in the additional costs to the permissible maximum.

I think if the formula is understood by the hon. member he will realize it allows that group to get the relief they are seeking.


PENITENTIARIES-MAXIMUM SECURITY PSYCHIATRIC INSTITUTIONS-STATUS OF INSTITUTION PROPOSED FOR DARTMOUTH
Mr. J. M. Forrestall (Dartmouth-Halifax East):: Mr. Speaker, I appreciate the hon. parliamentary secretary remaining in the House this evening and taking time from being with his family in order to respond on behalf of the minister.
My question is a fairly straightforward one which I raised on behalf of residents who, if present plans go ahead, will find themselves living in proximity to a maximum security psychiatric institution.
I raised this matter to ascertain what the status of the planning and consultation is with the province of Nova Scotia and the city of Dartmouth. When the matter came to light a couple of years ago it was understood there would be full consultation. It has become apparent in recent days that planning for the institution has advanced in a number of significant ways and without consultation with officials of the city of Dartmouth-unless our distinguished mayoress has failed to take into her confidence the aldermen for the ward concerned.
There is no question of the need for updated and secure care and treatment facilities for-and I have consulted a dictionary with respect to the correct phrase and it is expressive-the criminally insane or those who have been committed by the courts for a variety of disabilities.
It was my understanding at the outset of discussions about the location of such an institution-and there is no doubt that it is required-that it would be located in close physical proximity to the existing Nova Scotia hospital structure. I was led to believe it would not be necessary to go outdoors or use transportation to remove people who required psychiatric care from the hospital to the new institution. In other words, it was understood that a tunnel or hallway, or some other means, would be used which would combine the requirements of a maximum security psychiatric institution and those of the federal penitentiary service. It is now my understanding that the institution is to be located about three quarters of a mile away from the Nova Scotia hospital. The hospital has, of course, for many years housed people convicted by the courts who required psychiatric or psychological care and confinement. Now we have the spectre of the new institution being at some distance from the Nova Scotia hospital, which incidentally is one of the best in eastern Canada. This raises the question of security in the transportation of patients.
The questions I want answered this evening, Mr. Speaker, are these: Has the province been consulted? I assume the answer is yes, because the land is provincial. Has Dartmouth been consulted; if so, to what extent? What assurances will be given with respect to the security of the residents of the area? The proposed plan indicates that there are to be residential properties on at least three sides of the proposed maximum security institution.
Adjournment Debate
What security is involved in the transportation of prisoners from the maximum security institution to the Nova Scotia hospital, for care and treatment? Is it contemplated that existing facilities of that institution will be used to treat inmates of the maximum security institution? Will this mean an additional burden, in terms of beds and patients, for the Nova Scotia hospital?
What plans does the government have to advise and consult with the residents directly affected? In other words, what is the status of the consultations and planning? It is important to know as some plans have, sort of, been leaked to the public. It is essential to know what consultation has taken place so that the fears of the residents can properly be answered. The answers to such questions can allay the fears of the residents of the area. Mr. Speaker, again I appreciate the parliamentary secretary's attending in the House this evening.


Mr. Hugh Poulin (Parliamentary Secretary to Solicitor General):: Mr. Speaker, the hon. member for Dartmouth-Halifax East (Mr. Forrestall) has raised a matter which is of great concern to himself and to residents of the area he represents. The matter comes under the Department of the Solicitor General and it is the policy of the department to consult both with provincial and municipal officials. I hope that I can assure the hon. member that the province has been consulted.
If the hon. member were in my position he would see why, up to this point, there has not been complete consultation with Dartmouth, nor at this time consultation with the residents. Consultation with the municipality and the people will take place, if that is the wish of all parties, before any site is chosen for the new penal institution. In fact, in many cases penitentiary officials engage in public meetings in order to explain to local groups of citizens the plans which the penitentiary service is considering for their area.
This co-operation between federal and provincial officials is evident in all facets of correctional services. For example, in some areas, including Nova Scotia, federal officials use provincial jails to house some of their inmates. This is done in cases where it is beneficial to move the inmate and at the same time represent no threat to public safety.
With respect to plans for regional psychiatric centres, may I state the following: the Canadian Penitentiary Service plans to provide for the operation of a regional psychiatric centre in each of its five regions of Canada, namely, Atlantic, Quebec, Ontario, prairies, and Pacific. One centre is now in full operation at Abbotsford, British Columbia, for the Pacific region. One centre is now under construction in Saskatoon, Saskatchewan, for the prairie region. Approval in principle has been obtained from the Treasury Board for the construction of three more such centres, two of which are planned to replace the obsolete physical facilities now in use in Kingston, Ontario, and in Laval, Quebec, and the third to be constructed in the general area of Dartmouth, Nova Scotia, to serve the Atlantic region.
Since early 1975, various meetings were held in the Atlantic provinces between the federal and provincial governments concerned. As a result it was agreed that a

Adjournment Debate
psychiatric centre was to be planned for construction in the province of Nova Scotia, to meet the needs of the Canadian Penitentiary Service and of the four Atlantic provinces, as indicated by them. The province of Nova Scotia was agreeable to this project. Subsequently meetings were held with representatives of the Department of the Attorney General of Nova Scotia for the purpose of defining the requirements of the penitentiary service treatment facilities and of defining a preferred geographical location best suited for this purpose, such as close proximity to existing professional treatment resources, namely, universities, professionals and semi-professional support.
Subsequently it was agreed that the federal and provincial departments of public works would co-operate in identifying potential sites for the location of the proposed centre. As an example a site was identified at Elbow Lake, and as a result of consultations with the municipal authorities this proposal was abandoned.
At present the federal and provincial departments of public works are considering two other sites and propose to consult municipal authorities as soon as the Department of the Solicitor General has had an opportunity to study the report of the Department of Public Works and has determined a possible course of action for consultations with the concerned governmental authorities.
With regard to the other questions that the hon. member raised, we attempt to find those answers for him. 1 see my time has run out. I cannot continue at this time.
Motion agreed to and the House adjourned at 10:33 p.m.

Wednesday, February 18, 1976