Mr. Speaker, over the decades, Canadians have made a series of defining decisions.
They were decisions about much more than some government program. They were decisions about what kind of country we wanted to be. They were the decisions that led to Medicare.
Today, it falls to us to take the steps necessary to safeguard that great legacy, to sustain and strengthen our health care system today and for the future.
Canadians do not need to be convinced that health care is a priority.
They worry about crowded emergency rooms, about understaffed wards, about waiting lists for tests and for treatment. They worry about the costs of paying for services or drugs that are not covered.
The short-term pressures and problems in our system must be dealt with. At the same time, we must plan for the longer term.
The Minister of Health has put it very well:
"What we must strive for is a people-centred system in the truest sense, one that ensures the right care by the right provider at the right time in the right place -- at reasonable cost."
That is why the first major investment we made when it was clear that deficit elimination was at hand was to raise the annual cash floor of the Canada Health and Social Transfer -- the CHST -- from $11 billion to $12.5 billion.
Today, with the books balanced we are able to do more. As the Prime Minister wrote last month in response to a letter from the premiers, and I quote:
"Our collaborative work on a renewed health partnership and on a new social union partnership more generally, along with increased health funding, will reassure Canadians that governments are working together to address their health and other social needs."
Mr. Speaker, today we are announcing a significant increase in transfers to the provinces to support health care and a number of other initiatives which strengthen the federal government's contribution to Canada's health system.
Over the next five years, we will invest an additional $11.5 billion through the Canadian Health and Social Transfer.
$2 billion in new cash will be received by the provinces in the first year, continuing in the second.
In the third year, this will rise to $2.5 billion and remain at that higher level for the fourth and fifth years.
This means that cash transfers under the CHST will increase from the current $12.5 billion to $15 billion within three years -- by 2001-02.
This will bring the health component of the CHST to the level it was before the period of restraint in the mid-1990s.
Furthermore, flexibility will be given to the provinces to determine the timing of when they receive these funding increases over the first three years, so as to best enable them to meet the particular health needs of their citizens.
Mr. Speaker, the $11.5 billion in additional cash together with the value of tax transfers, which will also grow over this period, means that total CHST transfers will reach a new high by 2001-02.
Furthermore, while this is a substantial investment, it is by no means the end of the story. As our financial flexibility increases in the years ahead, health care will continue to be very much one of the key priorities for further action.
Mr. Speaker, in addition to the new funding we have just announced, we have also worked with the provinces and territories to renew all major fiscal arrangements for five years, and to do so on a fairer basis.
Mr. Speaker, we are renewing and strengthening the Equalization program.
This program reflects the shared commitment of all Canadians. It provides provinces that are less well off with the resources they need to provide reasonably comparable public services, including health care, to their people.
That is why Equalization was one of the few programs left totally untouched when virtually all other spending was reduced as we grappled with the deficit challenge.
Two weeks ago, legislation was tabled to renew the program with improvements.
Over the next five years, Equalization payments are projected to total more than $50 billion. This is considerably more than the provinces received over the past five years -- in fact, $5 billion more.
Moreover, official estimates at the time of the last budget indicated that we would be providing the provinces with $8.5 billion in Equalization this year.
However, the latest data indicate that payments this year will now total $10.7 billion, $2.2 billion more than projected in the 1998 budget.
And next year, Equalization payments will be $600 million higher than projected.
In summary, as a result of increased CHST funding and higher Equalization, more money will be available for public services, including health care, throughout the country.
For example, from now to the end of the next fiscal year, in March 2000, as a result of the increases in the CHST and higher Equalization payments $4.2 billion in new cash will be made available to the provinces.
Mr. Speaker, the continued vitality of Equalization depends upon the willingness of Canadians to share Canada's prosperity. This requires that all Canadians be treated fairly and equally.
In 1990, the previous government limited the growth in transfers to Ontario, Alberta and B.C. for social assistance and social services. This has meant, on a per capita basis, residents of those provinces have not received as much as residents of other provinces from the CHST.
In 1996, we began to address this disparity. Legislation was passed that would cut the per capita differences in CHST funding in half in four years time.
Today, we are moving much further and faster than that.
We are announcing the full restoration of equal per capita entitlements for all provinces -- and this will be completed in three years.
Mr. Speaker, the decisions we are announcing today are about much more than dollars and cents.
They are about a fundamental choice Canadians have made about the kind of society in which we want to live.
The fact is, in response to the health care challenge, some have said the answer is easy. Eliminate equal access. Make wealth status, not health status, the ticket to quality health care.
Well, to those who hold those views, let me say this. No, not now, not ever.
What we must always make clear is that the circumstances of the many, not the advantages of the few, will guide our decisions. For each and every Canadian, that means good health must never become captive to good fortune.
Our health care system is blind to income so that its eyes can focus on need. It must -- and it will -- remain so.
Mr. Speaker, as the Minister of Health has said, and I quote: "We spend $80 billion a year as a country on health care, and it is astonishing how little we know about what we get for that money."
Canadians have the right to know how their health dollars are being spent. They have a right to know if the quality of their system is improving.
Health care providers need the best information possible if they are to provide high quality care for their patients.
Governments, as well, need to know what's working, what's not -- and why.
This budget announces four major initiatives that will significantly improve the health information made available to Canadians.
These initiatives flow from the understanding on health and the Social Union Framework, and will be implemented in a manner consistent with both.
First, we are making an investment that will lead to valuable annual progress reports to the Canadian people. One will provide insight on the health of Canadians. Another will look at the health care system itself -- for example, the situation with regard to waiting lists, the most effective treatments available and the best use of resources.
Second, this budget provides funding to build a National Health Surveillance Network.
This network will be able to identify the outbreak of serious illness -- from salmonella to flu to tropical diseases -- so that preventive measures can be taken to manage and minimize their impact.
Third, the Canada Health Network is being established on the Internet. Canadians everywhere will have direct access to objective, reliable and up-to-date health information across the board -- from nutrition to breast cancer, Alzheimer's to diabetes.
Fourth, this budget provides funding for an important initiative to apply up-to-date information technology to the delivery of health services. For instance, this will include telehealth -- which holds extraordinary potential for the ability of doctors and nurses in rural and remote areas to communicate with the best specialists anywhere in the country.
Mr. Speaker, Canadians who live in rural and remote areas face unique problems. Innovations in community-based services are being developed across the country in response to their needs. This budget provides $50 million over the next three years to continue developing with the provinces promising strategies for rural and community health.
Mr. Speaker, we tend to focus, as we must, on the health care system -- on care and cure once we are sick. The question is, do we focus enough on the other half of the equation -- on preventing sickness in the first place? As has been said, health is more than health care.
This budget provides $287 million over the next three years for several initiatives relating to the prevention of illness.
For example, the Canada Prenatal Nutrition Program works to improve the health of women at risk to ensure they have healthy babies. Pregnancies put at risk by alcohol or drug abuse, family violence or other factors can have serious effects on children's lives.
Today we are announcing additional funding for this program over the next three years to enable it to reach the majority of women at risk.
Mr. Speaker, a healthy environment with clean water and safe food is critical to our health and well-being.
It is recognized that the programs we have in place to deal with toxic substances are far from adequate. This budget provides Environment Canada with the resources it needs to deal with that problem.
It also allocates additional resources to help ensure food safety in Canada.
Mr. Speaker, diabetes is a chronic health condition facing a great many Canadians, in particular Aboriginal peoples among whom it is three times more prevalent. This budget devotes important resources to addressing this serious situation.
In addition, health services for First Nations will be upgraded, through a separate $190 million over the next three years.
Mr. Speaker, research is at the core of a quality health care system.
Better research is about better health for Canadians. It is about our hope that with improved care and treatment -- prevention certainly and hopefully a cure -- that a woman will overcome the tragedy of breast cancer, that a grandfather will be spared permanent memory loss, and that a son or daughter will regain nerve functions following a devastating accident or injury.
We must provide Canadians with the best medical research possible for the 21st century, for if we are to improve one of the world's finest health care systems, we must be a world leader in health research as well.
This begins with good research infrastructure. That is why, in 1997, we announced the creation of the Canada Foundation for Innovation -- the CFI -- whose purpose is to modernize the equipment and facilities necessary to develop and test new ideas.
Already, exciting projects supported by the CFI are underway. For example, at the University of Manitoba, researchers are working to reduce the 30-per-cent rejection rate for kidney transplants.
Researchers at Carleton University and the Kingston General Hospital are co-operating to upgrade MRI machines so that they are able to detect breast cancer earlier than they now can.
In only two years, the CFI is becoming an essential building block for health research in Canada. Approximately 45 per cent of the awards granted in 1998 went to health related research infrastructure in hospitals and universities.
As we will see later in this budget, its funding will be enhanced.
Mr. Speaker, nurses have borne a great deal of the brunt of the changes in the health care system. They are working under tremendous stress. There are predictions of a major shortage, yet it is impossible to imagine a quality health care system of the future that does not include a much larger role for nurses -- in the community, in clinics, in hospitals, and in the home.
The Canadian Nurses Association has proposed that we create a $25-million research fund in order to enhance the leadership role that nurses deserve to play in the health care system of today and tomorrow.
This budget does just that.
Mr. Speaker, the nature of modern health research has changed dramatically. It now spans a wide variety of disciplines -- from genetics to nutrition, from microelectronics to the social and economic determinants of health -- each of which can contribute greatly to the other. Based on that reality, over the past year, Canada's health research community, under the leadership of Dr. Henry Friesen, President of the Medical Research Council, has come together to develop an exciting new approach.
They have proposed to create the Canadian Institutes of Health Research.
Through a series of networks, the CIHR would bring together the best researchers -- regardless of where they live in Canada -- in areas such as aging, arthritis, women's health, cancer, heart disease and children's health.
The Institutes would consist of networks which would draw together scientists across the full spectrum of health research -- from basic science to clinical research.
The CIHR would build on Canada's strengths -- the dedication of our biomedical researchers, the leading-edge work of our social science researchers, the high quality of our research facilities, the excellence of our national health care system.
It would transform those strengths into an even stronger coherent whole.
Researchers have only rarely been called upon to explore solutions together to national health challenges. Through the CIHR our health research capacity across various specialities and disciplines will now be linked more productively to the major health issues facing the country.
Furthermore, the CIHR reinforces Canada's capacity to become a world leader in new breakthroughs across the medical spectrum. It would begin to reverse the drain of those who leave to seek greater opportunity elsewhere. Rather than relying on imported discoveries, Canada would capture new economic benefits -- the new jobs -- that come from bringing such breakthroughs to world markets ourselves.
Therefore, we are setting aside $65 million in the year 2000-01 to support the launch of the new Canadian Institutes of Health Research -- an amount we are prepared to increase to $175 million the following year.
As well, $35 million is being provided in 1998-99 to the Canadian Health Services Research Foundation to support its participation in the CIHR.
In order to provide immediate new support for advanced health research, and to bridge the transition, we are also announcing an increase of $50 million in each of the next three years in the budgets of the three granting councils, the National Research Council and Health Canada.
Together, the increased funding for existing federal research organizations and the money being set aside for the CIHR will effectively make $225 million of new resources available for the objectives of the CIHR by the year 2001-02.
The combination of all the initiatives just announced is to increase the funding for health research by $550 million over the remainder of this fiscal year and the next three years.
Mr. Speaker, let me summarize the resources being devoted to health care in this budget. Over the next five years, the provinces will receive $11.5 billion in new cash through the CHST for health.
$6.5 billion of that will be made available over the next three years. During that same period, an additional $1.4 billion will be invested in health research and other means through which the federal government contributes to Canada's health system. This means almost $8 billion in new resources will be spent over the next three years on health care -- the largest new investment we have ever made.