May 31, 1946

CCF

George Hugh Castleden

Co-operative Commonwealth Federation (C.C.F.)

Mr. CASTLEDEN:

I agree with the minister in his remark this evening that our greatest problem is one of education. Where education is at its lowest ebb we have some of the worst records of health, and that bears out what he said. Where there is ignorance* we have fear, and where we have knowledge a lot of that fear disappears. There cannot be healthy people when the people are filled with fear. I recognize some of the difficulties of the minister in the operation of his department when there are nine provinces in each of which there is a department of health, and then more or less over and above these is the federal department. Would the minister explain how he decides how far his services shall go within each province? How does he spread his services? Does he spread the services in each province according to its need or according to the requests that have come in from the provincial governments, or does he carry on a sort of over-all service available to the provinces if and when they want it?

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LIB

Brooke Claxton (Minister of National Health and Welfare)

Liberal

Mr. CLAXTON:

I am afraid it would have to depend on the kind of service that was considered. If it were in connection with venereal disease control, then there is provision for the allocation of money and medicines on an agreed basis with the provinces.

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CCF
LIB

Brooke Claxton (Minister of National Health and Welfare)

Liberal

Mr. CLAXTON:

If it is staff, then the family allowances staff, for example, is the staff which is necessary to do the job within each province. With regard to food and drugs laboratories, and inspection, the staff is located at points where they can do the job best through the country without regard to provincial boundaries. Apart from these two, we have not any staffs generally scattered through the country.

Supply-Health and Welfare

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CCF

George Hugh Castleden

Co-operative Commonwealth Federation (C.C.F.)

Mr. CASTLEDEN:

I wondered, because I noticed that outside of the welfare branch, which I presume is doing most of the work with regard to the family allowances, the health branch have some 197 of a staff on a temporary and permanent basis, exclusive of Ottawa. The department has seen fit to put one temporary member of the staff in Saskatchewan. I did not hear Alberta complaining of the fact that they have only four. I could not understand why it was that the staff had been spread in a somewhat inequitable way.

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LIB

Brooke Claxton (Minister of National Health and Welfare)

Liberal

Mr. CLANTON:

These would be food and drug inspectors.

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CCF

George Hugh Castleden

Co-operative Commonwealth Federation (C.C.F.)

Mr. CASTLEDEN:

They do not require them in Saskatchewan? Is that the idea?

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LIB

Brooke Claxton (Minister of National Health and Welfare)

Liberal

Mr. CLAXTON:

It is generally related to the population and activities of various kinds in the provinces, particularly in centres where food is manufactured and distributed. If the hon. member assures me that there is one in Saskatchewan I will take his word for it.

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CCF

George Hugh Castleden

Co-operative Commonwealth Federation (C.C.F.)

Mr. CASTLEDEN:

I have the department's report.

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LIB

Brooke Claxton (Minister of National Health and Welfare)

Liberal

Mr. CLAXTON:

I would not think there would be more than one there.

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CCF

George Hugh Castleden

Co-operative Commonwealth Federation (C.C.F.)

Mr. CASTLEDEN:

In your own report, which was issued this year, there appears at page 73 a list of the health branches in the various provinces. This shows that Nova Scotia has a total of sixty-four employes; Manitoba, twelve; British Columbia, forty-seven; New Brunswick, twenty-two, and Quebec, twenty-eight. They are spread out in that way, and it does seem rather inequitable, not that I am finding a . great deal of fault with the minister; but if he is carrying on separate services with regard to laboratory work and drugs, finding out whether drugs and medicines are up to standard or whether these people are working in connection with the provincial governments on their educational work or whether it is a matter of seeing that the physical fitness programme is being carried on in the provinces, or whatever the function is, then there should be a more equitable distribution.

There is the problem of industrial diseases. Of course, that does not affect Saskatchewan to the same extent as it does others, but there must be the same problem of nutrition and the educational work that is to be carried on should be required there. I suggest that the department should have someone there keeping in contact with what the province is doing. Saskatchewan has an ambitious programme of health. They are taking the lead

in the Dominion of Canada. At the present time the government is providing free medical services, free hospitalization, free medicine, and, where required and recommended by the medical men, free dental care for 25,000 people in the province who are old age pensioners or dependent under the children's allowance act of the province. If the present plans of the province materialize, for a small fee they are going to be given to every person, young or old, rich or poor in the province. I think that is something to which the present department of health could give a good deal of assistance in the way of advertising to show the people of Canada what can be done.

The other question that I wanted to ask the minister perhaps should be brought up under one of these other items. That is, among the important features of any health scheme are the medical men and social service workers and those who carry on the educational work, particularly in the preventive field. In that connection I was just wondering whether the minister could tell us if any encouragement is given in regard to the training of medical men throughout Canada. During the war special grants were made, I believe through the Department of Labour, for the training of these people. In peace time we still require these medical men; Canada is still short of trained people in these fields, particularly in the field of preventive medicine. We are looking forward to the day when we shall be paying our medical men to keep the people of Canada well, and when we shall give them proper remuneration for that work. Those of us who lived on the western prairies during the hard years of the drought saw the medical men doing splendid work, giving everything they had and getting very little for it. The idea of paying our medical men to keep us well seems to me a much sounder principle than to have people who become ill unable to pay their medical men and feel themselves not in a position to call them. Would it not be much better for every person to know that whenever they become ill they may call in the doctor and receive proper hospital and medical treatment irrespective of their ability to pay at the time? Very often the poorest families are the largest, and that is where care is needed and where we find the least money per capita being spent on the service most required. If the minister is aiming to establish a healthy Canada, it seems to me he will have to face that problem, of setting up within this country a form of state medicine under which our medical people will be paid to keep us well.

Supply-Health and Weljare

Some of the figures across Canada in regard to certain diseases are alarming. Already in this debate statements have been made concerning health conditions among our Indians. When I think of some of the treaties that were signed with our red brothers, in which we said we would take care of them; then when I read some of the records in regard to the deathrate per 100,000 of population from tuberculosis in the various provinces, I hang my head in shame when I reflect what these people must think of those who made such promises to their forebears. For instance, I see that in Manitoba the death rate from tuberculosis is 1,421 per 100.000 among the Indians as compared with twenty-four among the white people. In Alberta it is 1.249-7 as compared with eighteen among the white people. The rate for all Canada is 757 among the Indians and forty-five among the white people. -

The infant mortality rates in Canada, too, are such that we should hang our heads in shame. I notice that in some of the eastern provinces the rates are very high; and if this department is going to carry on an educational programme to better that condition, I should be quite satisfied to see only one of the minister's representatives in Saskatchewan and all the rest distributed throughout the other provinces where they are needed to carry on this work. The province of Alberta has, I think, four representatives of this department of the 197 in Canada outside of Ottawa. The infant mortality rates reveal that the figures for Quebec city are something like three times as high as those for some other cities. According to the report of the department, the rate in Vancouver and Calgary was twenty-nine, and it goes up from that figure as you go across Canada, taking in Hamilton, Victoria, London, Toronto, Saskatoon, Halifax, Ottawa, Regina and Windsor, where the rate is forty-six. The figure for Saint John, New Brunswick, is fifty; for Winnipeg, fifty-two; for Montreal and Verdun, sixty-one; for Three Rivers, seventy-one and for Quebec city, 104. Surely some big problem is involved there which will have to be faced, and I hope that in the course of his remarks the minister will inform the committee as to what plans he has in mind to deal with this situation.

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PC

Donald Methuen Fleming

Progressive Conservative

Mr. FLEMING:

Last evening, Mr. Chairman, I ventured several observations, to which the minister replied. If I may do so without wearying the committee I wish to go back to one or two of those matters, because in the

course of the last few minutes I think we have had light thrown on the answers given me by the minister last night.

First, I suggested that there was a distinct lack of information in the estimates as they have been laid before the house. I pointed out that we do not have before us the actual expenditures for the fiscal year ended March 31, 1946, at a time when we are being asked to approve estimates amounting to tremendous sums of money. Last evening I was told by the minister that the information would be forthcoming in due course in the public accounts. How many months must pass before the public accounts will be available we do not know, but certainly it will be long after the estimates now before the committee are disposed of. The public accounts will not be of the slightest assistance to us in reviewing the estimates now before us.

This evening we have dealt with one aspect of the estimates of the Department of National Health and Welfare, namely the expenditure on publicity and information. The hon, member for Vancouver-Burrard has pointed out that this item holds such importance in the estimates of this department that it totals over half a million dollars. But when we come to the first item, and seek, for this committee of the whole, information which any intelligent committee ought to have before it undertakes to approve a request for another 150,000 under the first item concerning publicity and information, the minister is not able to furnish the committee with the expenditure under this item last year. Here it is May 34, two montns after the close of the fiscal year, and we are told that it is not within the power of the minister to tell this committee what the expenditures under this item were during the fiscal year ended March 31, 1946. As a new member of this house, I say that that statement shocks me. We are asked to vote $50,000 on this item alone, and over half a million dollars on similar items scattered throughout the items for this department. On this first item alone it is not within the power of the minister to give the committee this information. It would not have surprised me if the minister had said, "I have not this information before me, but I shall have it for the committee on Monday." But the minister did not answer that he did not have the information; he answered that the information was not available.

If the committee of the whole is to have to do business in that way it might just as well fold up and decide to pass these items holus-bolus. A lot of general information, is not of the slightest value. We are sent here for a

Supply-Health and Welfare

purpose; we are sent here to review estimates that total between three and1 four billion dollars. Are we not to be expected to apply even elementary business sense to a task of that kind? We asked for information about the expenditure last year under this item and we were told it is not available. We are now two months beyond the close of the fiscal year.

That is not all. Last night I suggested that it would be of -assistance to the house in discharging its duties in connection with these estimates if the House set up a committee of reasonable size which could get information first hand from the officials of the department. Surely the officials of the department are not made of fragile glass. They do not need to be insulated from members of parliament. Surely to goodness, we have a sense of responsibility and we can bear that sense of responsibility in mind when we are in committee. Why should it be so necessary to insulate these officials of the department from the members of the house, especially when it comes to seeking information which I say should be before us if this committee is to do its duty in connection with these estimates?

Last night I put forward the idea that there ought to be a standing committee on health, welfare and social security, which could review the estimates of this department, not with a view to depriving this committee of supply of its proper opportunities to consider the estimates but rather to supplement its work, to assist it and to get information first hand from the officials of the department. Apparently that was not approved by the minister. What do we find to-night? When the hon. member for Vaneouver-Burrard asked for information about these items, what was he told? In connection with the publicity items totalling half a million dollars he was told that they were put in-I think I am quoting the words of the minister-by the officials of the depatrment.

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LIB
PC

Donald Methuen Fleming

Progressive Conservative

Mr. FLEMING:

That was the significance of the minister's remarks as conveyed to me, and I made an immediate note of them. Would it not be a good idea for the members, not in any spirit of hositility-I do not want anyone to get that impression at all-but with a view to discharging our duty, to get information and to apply our intelligence based on that information to a review of these estimates to see whether they are reasonable and should be passed and approved. How can we do that when we do not get information, when we are told that these items were put in by the officials of the department?

I should like very much to have an opportunity of asking the officials of the department about the method by which they arrived at these substantial figures. I should like to ask them, what are the programmes, the well thought-out and carefully integrated programmes which they ought to have had in mind, yes even as far advanced as the blueprint stage, long before they asked the minister to take the responsibility of going before the treasury board and asking for substantial amounts of money under the heading of information and publicity? Would that not be the responsible course? Would that not be a course that would permit this House of Commons to do its duty?

A word in conclusion about the general attitude toward this and other items in the minister's estimates. I tried to make it perfectly clear last night that we of the official opposition attach the utmost importance to the work of this department. I think I indicated that we had the view that there are no two more important aspects of government administration than health and welfare. Therefore, let no one say that it is in any spirit of hostility to health and welfare that we approach our duty with regard to these estimates. I indicated last night, and I repeat now, that in approaching these estimates we want information. We want to be sure that what is asked for here will represent the soundest application of the taxpayer's dollar, that the taxpayer is going to get value in good administration of health and good administration of welfare services for the dollar he is being asked to pay.

We are going to have the budget before us before very long, we hope. What are we to be told by the Minister of Finance when w-e come to discuss taxes? I think it is fair to say that if the minister recommends any reduction in taxation he will say that that can be done only to the extent that we are prepared to spend less. If he does not recommend any reduction in taxes he will probably say that he could not do so because the house has insisted on large expenditures for certain services that are considered by the house to be necessary. Would it not be helpful to the Minister of Finance; would it not be helpful to ourselves if we weighed in the light of common sense and in the light of information, which we do not seem to have at the present time, these expenditures that we are being asked to pass?

The hon. member for Winnipeg North Centre, speaking of the duty and functions of this department to provide and disseminate educational information throughout Canada,

Supply-Health and Welfare

said that what we need is not less information, but more information. Those are true words, and if I might add to them I would say that what wre need is the best possible information. It is only when we get the best possible information that shall have the best application of the taxpayer's dollar. The minister has said, and rightly, that our health problem to-day is, in effect, to close the gap between what we know and what we do, that that is the way to meet the killers of humanity. I wonder how much this department is contributing to the elimination of those killers by this May "filler" issued by the department:

Better health and greater happiness for children are expected to result from wise spending of the family allowance it is stated by officials of the Department of National Health and Welfare, Ottawa. A family's basic needs include adequate food, clothing, shelter and medical supervision. Family allowance officials suggest that, when all these things have been provided, parents use what is left of their income on extras calculated to add zest to living.

Is it making the wisest application of the taxpayer's dollar, the dollar which the Minister of Finance may be trying to conserve when he brings in his budget, to tell the people of Canada to use the money paid out in family allowances to add zest to living? Is there a member of this house who thinks that is adding to the education or information of the people of Canada on necessary matters of health, to be told to use the remainder of the family allowances to add zest to living? I hope, Mr. Chairman, that is not a fair sample of the kind of publicity which is being issued by this department. I hope it is not a fair sample of the way in which the taxpayers are being called upon to contribute over half a million dollars to the publicity channels alone of this department.

I do not wish to prolong this discussion. I think the issue is perfectly clear. But I do want in all good part to say to the minister that we have important estimates of his department to review. We do not intend to approach them in any spirit of hostility, but we want to see the money spent wisely on health and welfare, and so far as we can be satisfied that the money is to be devoted to wise purposes we shall be back of his programme to a man. But we shall want a lot more information than we have yet been given.

I ask the minister now, with a week-end ahead of us, if before this committee proceeds to consider the detailed items of his estimates he will provide the house with information on all expenditures of his department for publicity last year; that is the fiscal 63260-132

year ended March 31, 1946, in all these branches in which we are asked to approve appropriations for publicity and information. In the second place, will he give the committee the expenditures made by this department during the fiscal year ended March 31, 1946, for publicity and information representing payments made outside of departmental salaries, that is to persons outside the department, and to whom these amounts were paid, and what the amounts were? I think the committee will receive that information with appreciation.

There has been enough said in all parts of the house, at least by those who sit on this side of the house, to make it clear to the minister that we want to see carried on a greatly extended programme of research. There is great hope in the realm of research, and if it comes to choosing between expenditures on research and expenditures on publicity of this kind I think it is the duty of the house to make it quite clear to the minister for his guidance and that of the government in future that we would rather see the money spent on research. Where money can be spent wisely on education, let it be spent, but spend it wisely.

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SC

Ernest George Hansell

Social Credit

Mr. HANSELL:

Mr. Chairman, this is the first time that I have spoken on this department. I can assure you I have listened with a great deal of interest to those who have preceded me. It seems to me that the one great plea that has been made by all speakers is that the function of the Department of National Health and Welfare should be widened in its scope, that it should become more effective, that we should have more research, that other types of health service should be set up, and especially should we try to facilitate the cure of those who are suffering from such maladies as arthritis, cancer and other diseases which are looked upon as being more or less incurable.

I rise to mention what may appear to be a rather tiny thing but one which some speakers have overlooked. I refer particularly to the security of those sufferers, perhaps incurable, who because of their financial circumstances are thrown upon either charitable institutions or perhaps upon their civic governments to receive assistance in the form of relief, which, after all, is a pittance, or else have to rely upon the good graces of friends or perhaps their relatives who are not in a position to keep them. I think we could all cite a good many such cases. The minister may feel that this does not primarily come within his department, but his department is known as the Department of National

Supply-Health and Welfare

Health and Welfare and the minister is due sooner or later to put through a measure of social security.

I had several cases brought to me last year, one that I am particularly well acquainted with. This young woman was afflicted with infantile paralysis, and it was found, after some considerable treatment through the programme of the Alberta government, that nothing much could be done for her because the disease had gone too far. She is one of ' the finest types of young women I have ever met. Her mother is a widow. This young woman wrote to me and said, "Mr. Hansell, what am I going to do? Is my widowed mother to keep me for the rest of my life?" That is only one case, but I am certain that it could be duplicated thousands and thousands of times in Canada.

I had another case of an epileptic woman. Her mother and father were on the old age pension. She said, "My only help is from my mother and father." I speak for these people because, while these cases may not be so numerous as others, and they are scattered throughout the length and breadth of this land, they have no organization. It is almost impossible for these incurables to bring into existence an organization that can present their case and mobilize public opinion behind them. Yet I suppose there is not a member of parliament sitting here to-night, or sitting anywhere else on this Friday night, who is not just as anxious about these cases as I am. I think we are all agreed that something should be done for them, and I plead on their behalf that something should be done for them. I know I have the support of parliament. I would ask the minister what he is prepared to do for them. Are they still to be considered as indigents, a word that has fallen into miserable disrepute? Are they to be considered as relief recipients, another term that has fallen into disrepute? Surely our country and civilization are worth more than that. I ask the minister what he or his government is prepared to do for these unfortunate people; I do not know what his answer is going to be.

Nearly everyone who has spoken to-day has raised his voice on behalf of patients afflicted with cancer, arthritis and rheumatic diseases. I am not going to repeat their pleas; I would just, add mine as one more voice, one more pleading voice, perhaps a "still small voice" that is "crying in the wilderness", but surely 245 voices all crying in the same wilderness should bring forth some results.

rMr. Hansell.]

I was particularly interested in the speech this afternoon .of the hon. member for Lethbridge. I really think he put the minister on the spot. As he was speaking I fancied he was a mind-reader and could almost tell beforehand what the minister's reply would be. When the -minister rose to reply to these pleading voices, I thought he was floundering around, probably because the hon. member for Lethbridge had stolen some of his thunder. When the minister had finished his reply I wondered whether I dared send out Hansard to these people who had written in asking us to lift our voices on their behalf. I could imagine the young woman whom I have referred to as an infantile paralysis case, the paralytic girl I have in mind, and a host of others getting copies of Hansard, looking at the index to find the Department of National Health and Welfare, turning over the pages anxiously to see what the government was going to do for them, and then reading the minister's speech.

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LIB
SC

Ernest George Hansell

Social Credit

Mr. HANSELL:

Yes, and my remarks too. What a disappointment they would have! I believe they would put Hansard aside and say, "Well, I suppose we shall have to await another election for a few more promises, and perhaps by the time I am an old woman"- or, an old man-"I may get an extra few dollars." It seems to me that that is all the minister's answer amounted to.

I appreciated what the hon. member for Lethbridge said as to what was the source of the minister's trouble, and I am confident that he was right. All of us want our people to be healthy; all of us want clinics to be established and research to be proceeded with. But it costs money. That is where the "sticker" is, and let us admit it; the minister does not know where to get the wherewithal to finance these projects. He said that the solution offered by this Social Credit group is a solution of "funny money." I believe Hansard will record that he made that statement- "funny money"-and of course he was not going to use that and put the economy of Canada into, I think he said, a "jackpot" or something like that.

Let me ask him one or two questions. How does he know that the money we would propose to get is funny money? And how does he know that if he used a few million dollars of national money, issued without debt to the taxpayer and the country, he would upset our

Supply-Health and Welfare

whole economy or put it into a jackpot or a cocked hat or whatever term he wants to use? How does he know?

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SC

Ernest George Hansell

Social Credit

Mr. HANSELL:

My suggestion is this, try it and see. I am not saying that he should go to the Bank of Canada and say, "Mr. Banker, give us a billion dollars"; I am asking him to go there for a few paltry millions. We have been talking throughout the war years in terms of billions. Let him go and ask for $5,000,000.

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CCF

John Oliver Probe

Co-operative Commonwealth Federation (C.C.F.)

Mr. PROBE:

Let him make it a little more than that.

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May 31, 1946