June 23, 1960

PC

Henry Frank Jones

Progressive Conservative

Mr. Jones:

In speaking on the subject which I intend to discuss now for just a moment, may I say that I ordinarily would have raised it later on the estimates, but I am not quite sure that it neatly fits into any one particular category. I refer to the matter of household chemicals. Before asking the minister the question I have in mind, however, and in view of the great amount of attention which has been paid by the members of the C.C.F. group to the Saskatchewan medical care plan, I think I should say just a word about that situation. -

Much has been said about it except who is to pay for it. On June 13 I asked the Minister of Finance whether the premier of Saskatchewan had as yet approached him for federal assistance to help pay for the Saskatchewan medical care program. That question was received with cries of anguish from the hon. member for Assiniboia.

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CCF

Douglas Mason Fisher

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

Mr. Fisher:

Derision, not anguish.

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PC

Henry Frank Jones

Progressive Conservative

Mr. Jones:

"Derision", says the hon. member for Port Arthur; but yesterday the hon. member for Assiniboia did exactly what I have mentioned. As reported on page 5268 of Hansard he said:

The Canadian government should come forward now with a federal prepaid medical care act by which the federal government would co-operate with any provincial government prepared to embark on such a prepaid medical care program.

That of course is a clear call for federal aid for the Saskatchewan medical care plan.

The point I wish to draw to the attention of the minister, and my principal reason for rising at this time, is the serious situation in my view which has arisen because household chemicals are not properly labelled as to whether they are dangerous or poisonous. Many of them do not have described on the label antidotes which would provide for emergency treatment where children or even adults might take these kitchen chemicals by mistake. It is my opinion that something should be done about this problem.

In the Saskatoon Star-Phoenix of June 13 appeared the headline "Coroner warns householders against household poisons", and the article under that headline sets forth the sad case of a two and one half year old boy who died of poisoning as the result of getting to a can of household chemical labelled "RX.15",

containing plant food. Apparently there was not an antidote on the can or any suggested course of emergency action. I am not suggesting, of course, that this child would be able to read the label, but certainly the parents might have been in a position to take action which could have saved the boy's life. In certain cases, I am advised by medical people, when children take substances like this that may be poisonous, if a finger is stuck down the throat or if they are given some mustard emulsion the poison may be regurgitated and the child saved. But in this particular instance the child unfortunately lost his life.

Mr. Chairman, I would urge that some action be taken to deal with this particular problem. I think it is necessary action for the protection of children and people in general in the home. It is not always possible to have a doctor immediately available, and often emergency action is required. Even when a doctor is available the doctor cannot be expected to have at his fingertips the antidote for every type of household chemical. The case I have described is by no means an isolated one but one which has occurred time after time in this country, and surely we should call for action to bring about a remedy to this problem.

I do not know whether this responsibility lies solely upon the Minister of National Health and Welfare or whether the Minister of Justice should be called upon to assist in providing a remedy under one of the acts for which he is responsible. But I would suggest that the Minister of National Health and Welfare might very well take this problem unto himself and discuss it with such members of the cabinet as may be necessary in order to bring about action whereby packages of household chemicals are labelled and indicate whether or not they are poisonous. Also they should have on the label the antidote and the required emergency remedial action in case the substance is taken by human beings.

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PC

George Stanley White (Government Whip in the Senate)

Progressive Conservative

Mr. While:

Mr. Chairman, I do not intend to delay the deliberations of this committee for very long, and I think I can finish by a minute or two after one o'clock.

First of all I wish to commend the minister for his able administration of the department, and I want to compliment the hon. member for Quebec West for his very sound contribution to the deliberations of this committee this morning.

The reason I rise at this time is to bring to the attention of the minister and the committee a certain amount of consternation which was aroused among my constituents, as well as, I feel, many other people in the province of Ontario, when it was mooted in

Supply-Health and Welfare the press that the cost of hospital insurance in the province of Ontario would be increased by 10 per cent. Ontario residents are not unaware that prior to the commencement of hospital insurance, hospital rates were increased considerably. I am not prepared to say the percentage, but there was quite a considerable increase percentagewise. The residents of Ontario were sold the hospital insurance plan simply because the cost of hospitalization was getting to the point where many citizens of the province felt that unless they had a hospital insurance plan of some kind they certainly could not afford hospitalization.

So I rise to protect an increase in hospital insurance rates, and I do so also because we were told that this was going to be an economical method for the people to obtain insurance. We hear a good deal today from certain quarters about monopolies; there is a lot of complaint about monopolies on the part of companies. But the worst monoply in my estimation is a state monopoly, something against which you cannot legislate, something against which you cannot argue. It is a bureaucratic monopoly, and that I am certainly against.

If hospital rates could be increased by 10 per cent after one year without any protest from the people paying the rates, what is to hinder them being increased another 10 per cent two or three years hence? This leads to sloppy administration on the part of hospitals, and I do not think we want that.

I want to commend the hon. member for Quebec West for his plea that we evade at all possible cost what is spoken of as state medicine. I believe it is quite possible for the medical profession-and I am certain they are engaged in doing so-to work out a prepaid plan that will be acceptable to all Canadians. Then the medical profession can go on with their very worth-while work and the ill can have the doctor of their choice. Bureaucracy in the treatment of the ill is something which I personally have no wish to see.

Mention was made of annuity plans and the possibility of being able to transfer from one job to another or from one industry to another the pension plan that was commenced at an earlier date. All these pension plans are commendable, but let us look back 20 years and see what has actually happened. We must examine the value of the dollars people contributed to pension plans some years ago, and recognize that it bears no resemblance to the 50-cent pieces they draw out today. That is what inflation does. If we are going to witness a continuation of the galloping inflation that has gone on since 1945 we will witness

Supply-Health and Welfare a corresponding decline in the incentive for people to save and the ultimate destruction of all incentive so to do.

I thank the committee for its indulgence.

At one o'clock the committee took recess.

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AFTER RECESS The committee resumed at 2.30 p.m.


PC

Philip Bernard Rynard

Progressive Conservative

Mr. Rynard:

Mr. Chairman, I intend to make only a few brief comments this afternoon, because the field has been fairly fully covered. One comment I will make is that we are going to have more and more hospitalization costs in the future as an increasing number of our population will be people over the age of 65. In the light of medical statistics it is interesting to glance around this chamber and realize that 30 out of every 100 people in this or any other group in the country owe their lives to the miracle drugs and serums and vaccines that have been developed in the last 50 years. I have only to list a few of the significant discoveries in this field to illustrate my point.

In the early 1900's, I believe in 1906, diphtheria antitoxin was developed. This was followed by the development of typhoid fever vaccine. It is important to remember that during the time of the Boer war more people lost their lives as a result of this dread disease than lost their lives in active service. It is significant to remember, too, that the war of 1914-18 could not have been fought on the scale it was if typhoid vaccine had not been discovered.

Coming to the twenties we find that on this continent, in the city of Toronto, there was discovered one of the most important findings in the history of medicine, insulin. This is an injection of pancreas that has extended the lives of many people and enabled them to live a full life span. Those of us who are old enough to be able to look back to the time before the discovery of this drug well remember those afflicted with diabetes who had poor, frail bodies and enormous appetites, and who could not pass a pail of water or a pump without pausing for a drink, and will be grateful that this is a disease now under control.

In 1928 significant advances were made by Minot and Murphy, working in a laboratory in Chicago, with respect to the discovery of the anti-pernicious anaemia factor, from liver and stomach. This represented another great victory by science in the field of human welfare.

Then came the discovery of the sulfa drugs and their derivatives in 1935. May I remind

hon. gentlemen that dagenan and sulfa derivative was worked out after more than 600 attempts. Hundreds of scientists have worked diligently in laboratories in their search for the elusive materials that would cure human ills.

The forties witnessed the discovery of penicillin. I well remember the first case in which I used penicillin. A shot was required every two hours and there was much pain involved. Hon. gentlemen will know that further advances have been made with respect to this drug, and it is no longer even necessary to take penicillin through a needle. It may be taken by tablet, and only one dose is required in a 24-hour period.

I have listed a few of the advances made by science over the years. Not long after the discovery of penicillin came the discovery of the new antibiotic drugs, the myocins; achromycin, terramycin, chlormycin, ilo-tycin and other derivatives that have saved countless human lives.

My friend the hon. member for Welland in his excellent speech dealt with his experience as a general practitioner. He recalled to my mind that in the early days when we were called out by a patient with pneumonia we went with the knowledge that one out of every five persons suffering from pneumonia was doomed to certain death. Today it is possible to go to a doctor and be cured of pneumonia within a few days. This in itself is of vast economic assistance to Canadians, not only in work hours saved but in eliminating hospital costs and in the prevention of suffering.

The speed with which many illnesses can now be retarded or cured results in decreased costs for many Canadians. The advances made -by science have also served to increase longevity in the population. As an illustration, may I point out that during the last 50 years the general population of Canada has increased two and a half times but that portion of the population age 65 years and over has increased four times in that same period. I do not have to point out that this will mean that there will be an increasing number of people in hospitals.

At the turn of the century, life expectancy was under 50 years. Today a child coming into the world can look forward to 70 years of life. This, however, is creating a problem in the field of employment and in other fields. For instance, the cost of hospitalization and welfare will continue to rise at a rapid rate as more people reach advanced age.

I suggest that it is not fair to put people age 65 and over suffering from chronic diseases in general hospitals along with persons who are under active, acute treatment.

I do not think you have to stretch your imagination very much to realize that the person who is acutely ill, whose life is hanging in the balance, will probably get the major share of the treatment, and that the older person with the chronic disease will not get the aggressive treatment that he would receive, perhaps, if there were a wing put on to that hospital where all those cases of people over 65 suffering from chronic diseases could be treated in accordance with what their condition demands.

I have only to recall to the committee that in 1920 I do not think there was a pediatric unit across Canada, if my memory serves me correctly. I well remember that when I was a student a few years later a pediatric wing was organized in the Kingston General hospital under Dr. MacGregor; and to tell you that the establishment of that pediatric unit as part of the general program of establishing chairs and professorships in our universities has cut our infant mortality so that today we can boast of life expectancy of 70 years for a child born in this country today is just to remind you of the results of our work in the field of pediatrics over the years.

I should like to suggest to you, Mr. Chairman, that the same principles and the same practice be followed by our hospitals today in the care of the increasing number of people in the geriatric class; that the same procedure be followed with chairs set up in universities and departments headed up with people concerned with the treatment of those older people. I think we would find that hospital costs would be cut considerably and that the people in the older age brackets would get better and more efficient treatment.

I wish to dwell on this for one more minute. There has been some talk about building separate units. I do not go along with that at all simply for the reason that we have to train medical students. Those medical students will be going out as general practitioners. They need all the knowledge of the treatment of those cases they can possibly get. I would remind you further that in the care of those cases certain drugs and certain types of treatment will be used, and the general practitioner will require to know about them. If they were put in separate units the tendency would be, in my opinion, to make the teaching inadequate.

I should like to dwell for a moment or two on the matter raised by an hon. member who said that only 200 British doctors had migrated to Canada and therefore conditions must be satisfactory in the old country. I have only this to say. When a doctor graduates from a university in another land and then comes to Canada, in most of the 79951-0-335

Supply-Health and Welfare provinces he is required to write another council examination. It is pretty difficult for a fellow who has been in practice a number of years to remember all the scientific theory that he was taught. The remark was made that there were 60,000 doctors in the United Kingdom. If my memory serves me correctly there are only 50,000. I know this is just an error in figures, but I do wish to point out that the figure of 200 is no criterion of the satisfaction or dissatisfaction of the doctors in Great Britain. The fact is that it is difficult to pull up your roots, go to another country and write examinations before you can practise.

I just bring this to your attention, Mr. Chairman. In Saskatchewan, where people are inclined to say "Here comes the golden age", according to statistics one third of the doctors practising in that province are from Great Britain. I am wondering why that province has such a high percentage of British doctors when the rest of the country does not have that percentage. Maybe there is an answer to it.

I am also wondering about this. The golden age which they talk about in the province of Saskatchewan is in a little difficulty, or was in a little difficulty, with the hospitalization plan; because Dr. Erb, who I believe is their minister of health, stated that something had to be done to cut down on these spiralling costs. It was suggested to him by the head of the college of physicians and surgeons of that province that perhaps a deterrent would have to be added to control hospitalization.

I am just giving these facts, not to condemn any plan that will give the Canadian people the best of care, because I am sure every hon. member would want to do that. I hope we shall never let politics interfere with the profession or with the training schools in the United States of America and Canada, the countries that have given us the highest standards of medical practice in the world today, that have given us most of the major discoveries in the last 50 years.

When we consider some of the places that are state controlled perhaps we should hark back and take Russia, as leader of the communist world. We can state that there has not been one major discovery in medicine or one major advance in the field of medical science come out of Russia in the last 40 years. I am not saying that we should not have forms that are changed a little from what we have today; that may be necessary in a changing world.

I do wish to refer to New Zealand as an example of socialized medicine. We hear people stating over and over again that 52

Supply-Health and Welfare per cent of the doctors there practise outside the hospitals and 48 per cent practise in the hospitals, all graduates of the same schools. The 52 per cent who practise outside are the have-nots and the fellows on the inside are the haves. Their social legislation brought them to the point where they were almost bankrupt. I talked to many of the doctors, both the ins and the outs, and I wish to tell you that I did not find any of them perfectly satisfied with those plans. I had the same experience in England where I talked to some gentlemen on the inside and some on the outside whose names I will not mention. The fellows on the inside were getting better pay. You would think they would be satisfied but they said, "No, we do not believe in any system that tends to downgrade the fellow who graduates from the same school we did and from that day onward is an outside fellow, as compared with the fellow on the inside". This is the answer to those people who say that this is the system, this is heaven. It is not. I ask the committee to weigh all the facts and not just be swayed by some written arguments to the end so that any change we inaugurate in this country will be right and proper and best for all the people.

I want to spend a minute on rising medical costs. The hon. member for Middlesex West spoke about this. We have been told some of the reasons why our people are living longer. We in the field of medical science are responsible for that. I think every doctor and scientist in Canada will surely take pride in that, but I also want to recall to the attention of the committee that many of those people have given gratuitously of their services on boards or as nurses receiving small pay and working 12-hour days. When I was in hospital in those days the nurses took their 12-hour shifts. I remember the dear old superintendent we had. She supervised everything. She made up her books at night, and if anybody was short or off she covered up. She had an 18-hour day. I remember the personnel, the nurses in training. I recall back to the days when some of them just got enough to buy their stockings and their shoes. If they got more than that they were lucky. We do not want to go back to those days, and I am not suggesting that we should.

I want to pause now to pay a compliment to that great group of nursing sisters and nurses of all faiths who did such a great job in those training hospitals and are still doing it. They have made a wonderful contribution. They gave us the care that has enabled many of us to be in this house today, and the drugs that were developed through a system of

individual enterprise that stimulated freedom of thought and action to its fullest extent.

So in conclusion, I say that the cost of hospitalization has risen simply because two thirds of that cost represents the cost of labour; that is the situation. Does anybody want to cut costs by decreasing the payment to labour? Only one third of the cost is made up in other ways.

Then someone mentioned the high cost of drugs. There is one drug item I might mention which was used in this hospital that I selected at random, the cost of which represents only 4.5 per cent of the total cost of these lifesaving drugs. These drugs can save you anywhere from one week to four weeks of hospitalization in cases of pneumonia and other diseases. I remember the cases of appendicitis that we used to see in which the appendix had ruptured, and now as a result of these drugs such patients may be out in a week. These are the contributions these drugs have made to us.

There are one or two other things upon which I should like to dwell for a moment. The first is disabled persons; I noticed that someone referred to them. I want to say that in my opinion the examination policy respec-ing disabled persons by both provincial and federal governments may be wrong. I am not saying it is, but I am wondering about this policy. I recall a case in which I was interested during the time the hon. member for Essex East was minister. This was a difficult case, and this fellow was positively entitled to a pension. The pension was turned down by Ottawa. I knew the case well, and I knew it was grossly unfair to turn down the application for pension. I am wondering, therefore, whether we should perhaps take a long look at that situation and eliminate the doubling up on these examinations.

The other thing about which I want to speak is the provision of adequate shelters in our hospitals. I am wondering if this is being done. This thought occurred to me when we were talking about shelters the other day. It appears as though we are going to have to make preparations, such as the construction of shelters, for a long time to come. If that is true I am wondering whether we are looking at this problem realistically. Perhaps these shelters should be built in when hospitals are constructed, and perhaps they should even be built into houses constructed under the National Housing Act; because I am sure everyone will admit that it appears the need for them will not be removed in the foreseeable future.

The next thing about which I am wondering is our training of medical personnel. I just

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I960


want to leave a few figures with hon. members. As has been mentioned before, we in Canada are not managing only with our own graduates but with the help of graduates from other countries. In the United States today they have in their hospitals over 8,000 interns who are foreign born. I am not giving any statistics for Canada. The Minister of National Health and Welfare might have them, but I have not. I know that we would not be able to run our hospitals the way we are today if it were not for the fact we have in this country a great many graduates from British and other universities. I think we should look at that, too, in order to assure ourselves that this country will provide the proper medical care. In conclusion may I say that any criticisms I have made have not been in the nature of destructive criticisms. They have been made for the purpose of stimulating interest in this problem in order that the people of Canada may continue to get the best medical care in the world.


CCF

Douglas Mason Fisher

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

Mr. Fisher:

Mr. Chairman, perhaps other members have noticed what I thought was a very significant development in the discussion of these estimates. The minister began by giving what amounted, in the main, to a rebuttal of the report by the House of Commons estimates committee which examined the Department of Health and Welfare. When I say "rebuttal" I mean it in the wide sense rather than in the sense of a direct confutation.

Today we had one of the earlier speakers, the hon. member for Calgary South, who is chairman of that committee, get up and make a rebuttal of the minister's rebuttal. I do not draw attention to this to particularly underline anything in connection with the department, but I think it is a significant parliamentary development. There has been a large grey area in so far as the rights and powers of parliamentary committees are concerned. I was not a member of this committee, but I thought it did as good a job as a committee could do in analysing the estimates of the department. I thought its report was vigorous and direct, and it was certainly understandable in so far as the average member was concerned.

I knew, from talking to some of the civil servants in the department, that the department's reaction to the report was to say the least rather strong. One could expect to get from the minister, therefore, a reflection of the bureaucratic feelings toward the committee's report. It seems to me that a house committee, even if the civil servants and the 79951-0-335J

Supply-Health and Welfare minister concerned react against its recommendation and against the policy considerations it entertains, should stimulate the department. In my opinion there is inertia on the part of the administration at times which must be overcome, and I think much of the stimulation will come from parliamentary committees that will face up to an analysis and perhaps make some overbold suggestions and criticisms. I believe this committee is to be congratulated, and I think the hon. member for Calgary South should be congratulated very strongly for standing up today to rebut the minister's rebuttal.

The comment I wanted to make about the minister of this department would be much the same as the comment made by other members. The few times I have had anything to do with the department he was most agreeable. Unfortunately he has not been able to find a solution to the largest constituency problem I have in connection with health and welfare matters. I refer to the problem of one of my constituents who writes letters on a weekly basis to me, to the minister, to the Prime Minister, to the Leader of the Opposition and to almost everyone in Ottawa in connection with a marvellous invention he has in the field of health. I wish the deputy minister would tell me how we can satisfy this dissident gentleman in my riding who has a magic invention which, when applied to the shoes of all Canadians, would cure so many of the ills to which they are subj ect.

In trying to assess the stature of a minister, Mr. Chairman, I think all of us have tended to look at his predecessors holding that post. We all know that the urbane gentleman, the hon. member for Essex East, was the minister of national health and welfare. The distinction I draw between him and the present minister is that as minister, the hon. member for Essex East was much more ambitious in a political way, in terms of looking for political promotion and going right to the top. I have a feeling that the present Minister of National Health and Welfare has no ambition to be prime minister or anything like that.

You may wonder, Mr. Chairman, what particular distinction I am trying to arrive at. It is this. I think the hon. member for Essex East, as minister, because of his ambition was constantly trying to expand, if you wish, or blow up his role as minister of national health and welfare and make it appear as one of the major posts in government, an extremely important one. I believe he achieved that to quite an extent. The only comment I would make about the present minister, giving him credit for his lack of

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Supply-Health and Welfare over-all ambition to reach the summit, is that he should not be so quiet or so passive in his relationships with his more ambitious, thrusting colleagues in the cabinet as to allow the department to shrink in stature.

I was interested in the committee's comments on the amount of printing being done by the Department of National Health and Welfare. I have always found it difficult to become enthusiastic about these publications, but I would be willing to accept the minister's argument that he has gone into the matter thoroughly and feels that the amount of publications is justified.

I hope he will continue to be tougher and tougher with the Queen's printer, because if ever there was an agency in the government charging -too high prices to the departments for the services provided, I think the Queen's printer is an example. I have raised this matter in the house with the Minister of Citizenship and Immigration, who is responsible for that particular branch, and I think it still holds true that the system under which the Queen's printer tends to give a blanket price under which there is no volume discount-that is, no discount to the department-if it happens to come up with a best seller or something that really moves or for which there is a great demand, is a rather unbusinesslike practice, to say the least. I think it would be a great encouragement to departments in connection with their publications if there were some kind of volume discount, and if we had a more flexible policy in so far as printing is concerned.

I do not know how far one could go in doing printing on a direct basis as between government departments, in certain kinds of publications, and private printers. But from this procedure I think you would get a stimulation in terms of design and some greater level of competition as between the standards of the Queen's printer and those of the private printers. This is a minor aspect of the minister's department, but this is a problem that ranges through all the departments in their relations with the Queen's printer. It is not an organization of the government in which I at least, as a member looking at it, take a great deal of pride.

The hon. member for Vancouver-Burrard, who is well known for his interest in sports and who returned last winter with that lovely tan after his visit down to the Olympics in the Sun Valley area, was off on his kick about a Canadian advisory sports council or a Canadian sports council. I have spoken to this argument of his before, especially when his resolution had a day's debate. I admire the fervour with which he, the hon. member for York Centre, the hon. member for Calgary

South and the hon. member for Hamilton South, who is an ex-footballer, are pushing their efforts in this regard. I pointed out to the Minister of Labour yesterday how amusing was the story in the Toronto paper about the expressed feeling of this small volunteer group that the cabinet was not taking too seriously their suggestions about a sports council because of serious unemployment in Canada. The newspaper went on further to say that it is perhaps arguable that Canada will always have serious unemployment, and that this consideration should not be a deterrent to creating this council.

I was interested in this for the humour of it, and also because it indicated a certain amount of bravery. I think it is a fairly brave member of parliament who will rise in his place and express himself to the effect that even although there is serious unemployment, he thinks the government should go ahead with a project such as this. I suggest to the hon. member for Vancouver-Burrard, who is pushing this matter, and also to the minister that we have a genuine cultural lag in Canada in our attitude toward sports. If the minister wants to go into the matter in a sociological way I could give him bibliographies on it, although I do not think it is a topic of extreme importance.

However, we have the attitude that now we have finally reached the stage-and the Canada Council is an example of it-where we are prepared to subsidize through our government agencies musical and artistic endeavours, but we are still some way from the point where we are prepared to subsidize sports or sporting endeavours through the government; and this is the situation despite the fact that the Canadian people in the main are much more interested in sports than they are in the group of seven or in classical music.

When the Canada Council estimates were before the committee the hon. member for York-Scarborough tried to make the argument that there was no reason at all why a barber shop quartet was not as justified in getting support from the Canada Council in order to take part in that particular phase of cultural activity as was the Toronto symphony orchestra or the Ottawa philharmonic orchestra. I would not necessarily agree with the hon. member for York-Scarborough, but I was bothered by the headline reaction to this, indicating what a silly proposal this was. I put it down to the fact that there is, if you want to call it that, an educated elite in Canada who have reached the stage that they feel that fine painting, symphonic music and cultural things of that level are wonderful and fine-and more power to them-and they have an agency now in the Canada Council.

But I should like to point out to them and to the minister and to the hon. member for Vancouver-Burrard that our problem so far as sports are concerned is that the common denominator of the people are strongly for sports. Not only do they want their nation to be represented by good teams, but they want Canadians to have fine hockey teams at the Olympic games and they want us to express our national spirit by having a winner. Unfortunately the elite have not quite come to that point yet. What we really need is a Vincent Massey in the sports field. I do not know whether the hon. member for Vancouver-Burrard or the hon. member for Calgary South are going to be able to rise to that particular challenge, but I hope they will continue the fight.

It is rather disturbing to national pride to know that in so many fields of both team sport and individual sport in track and field we make such a poor showing. I tend to blame our very success in certain professional aspects of sport for our refusal to support on a government basis those elements of our sport that cannot be put on a professional basis. Because we have viable football leagues and hockey leagues, such as the National hockey league and the two professional football leagues, I think we tend to feel that the judging one makes as to whether a sport is worth while is based on whether it can be put on a commercial basis. Every country in the world which has a sporting thrust within its population has discovered that you cannot compete as amateurs on an international basis with any kind of professional organization.

I think the British experience in the sport of football is a fine example of that fact. There is not any question but that England and Scotland have the best professional football leagues in terms of the number of teams, the public response and everything else, but just because of the very selfishness of the professional set-up they are not able to field an international team, and so the disgrace is very great in Britain about their showing there. We have tended to have much the same kind of reaction in the field of hockey. I think the hon. member's argument for a sports council is a good one. However, I think we must have a great deal more educating before we are going to achieve it. As I say, we need a Vincent Massey in the sports field.

The question of a national fitness program as put forward by the hon. member for Lambton-Kent had a great deal of force behind it. The bothersome thing there is the pitiful way in which the last effort in that field collapsed. The National Physical Fitness Act, when it was introduced in 1944,

Supply-Health and Welfare came in with a fanfare of trumpets. This was to be the answer to the disturbing physical situation that had been discovered in the enlistment or recruitment for Canada's armed forces. We were to have an answer. The answer was to be this voluntary council with one permanent director and approximately $225,000 each year to go out to the provincial agencies to support this effort.

It broke down. I think it broke down, first, just because there was not enough money for each team, and second, because of the difficulty of working out something in this regard within our constitutional framework.

I suggest to the minister that if he is going to subscribe to a national physical fitness program that is going to be a real contribution he must look carefully at the failure of the previous effort. As I see the situation and as I read the speeches made when the scheme was introduced, as well as when the whole matter was discarded, the failure was based upon an inability to get all these agencies working for physical fitness. It seems to me that if something is going to be set up it needs to be much more centralized and should have much larger funds at its disposal than the last national physical fitness council had, and I think the provisions of the act should be broader and should give the federal government a larger role than it played before.

In saying this it is in almost diametrical opposition to what the minister said in his rebuttal to the committee report. The main thing which seemed to concern the minister in his rebuttal was that the committee was urging federal encroachment into a field which was primarily a provincial one. So far as the sports aspect is concerned, I suggest that our interests there are not provincial or local but national. I would tend to think that the same situation has been reached with regard to fitness. We have a crisis of a kind in the fitness field, as the hon. member for Lambton-Kent exposed very well. If the federal government is going to play any role at all I cannot see it being a mere liaison organization; it has to have something of real power. Like most people, Canadians respect money as far as power is concerned. There is no use going into such a field unless the government is prepared to spend considerable money in setting up a really strong organization.

The last point I want to make to the minister deals with the situation of the blind people in my constituency, who are quite dissatisfied with the present provisions of the act which the minister's department administers. I am not going into details as to what they want,, because I think the minister is very much aware of that, but I can assure him that from

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Supply-Health and Welfare my contact with the blind group in the lake-head area there is a unanimity of view on this matter which one rarely finds, to use a phrase, in pressure groups.

The hon. member for Simcoe East made a speech which I took to be an appeal to us to consider very carefully any moves to be made in the direction of medical schemes, and he generally extolled the worth of the medical profession and also pointed out the difficulty which the medical profession is having in recruiting people and developing its organization. Mr. Chairman, if I were a doctor I would be almost as concerned as I think politicians should be about the general low state of their reputation amongst the general public. As a matter of fact, I think those of us who are politicians are sometimes stunned on going around when we find how little we are appreciated; but recently I have heard more and more of the same kind of thing said about the medical profession. The picture is getting out into the land that they are money grabbers, graspers, people who will not make a call and who want only people who will come to their offices; that they want prompt payment of their bills, and so on. In other words the old charm and aura which hung over the medical profession have disappeared, and I think disappeared remarkably fast.

Because of this I think the public is perhaps much better prepared or much more prepared to want the kind of medical schemes which have been debated out in Saskatchewan and which are in existence in other parts of the world. As most hon. members know I support that type of scheme, and I am well aware that most of the doctors, certainly the ones of my acquaintance, feel at the moment that such a scheme is undesirable. I would suggest to those doctors that the only way they will save themselves from this kind of scheme is by doing something about the general reputation of the profession as a whole in the country.

I cannot put my finger on all the reasons why this should be. It was startling to me as a school teacher in contact with quite a number of students who want to go to university when I discovered how few of them were any longer interested in being doctors or dentists. I tried to find out why they were no longer interested in going into these fields. The standard answer-I do not know whether it is the right one-is not a question of money at all. It has nothing to do with the fact that more and more doctors are becoming employees. It is always the length and the cost of the training rather than any worry or concern about the kind of money they will

be making later. If this is one of the fundamental reasons why the profession is no longer recruiting, then it seems to me that the profession should be prepared to make some very strong recommendations to some agency somewhere which will be effective in righting this situation.

Mr. Chairman, I suggest that today the only way you can get young people to go into professions where further education is required beyond high school is to offer a very attractive set-up both in terms of scholarships and of-I was going to say easy courses, but I do not think it is that so much; the kind of course which is comparable in its length and toughness and difficulty with some of the other training carried out in universities.

This to me is the root problem of getting more people into the medical profession. As most hon. members know, the situation is much more serious in the dental profession than in the medical profession. We are getting to have a grave shortage of dentists, and most dentists are still very much more under a private enterprise set-up than are the doctors. I know the hon. member for Simcoe East is an employer of doctors, and as I understood an article I read recently, one third of the doctors in Canada are on salary rather than on an individual private enterprise basis.

This does not hold true as far as dentists are concerned. A very small percentage of dentists are employed; in the main they are self employed and in many ways comparable to lawyers and small business men. Yet it is a group which, as any one who looks at the income tax statistics can determine, is one of the higher income professional groups in Canada. Despite the fact that there is a good chance for individuality and working on their own as well as having a high income, the situation is not able to meet the challenge and in so many parts of Canada we are short of dentists.

The problems of recruitment in this field I think have to be part of the minister's concern, if not his responsibility; and if the professions themselves will not come up with answers, I think he has to try to find some of his own. All the medical schemes and dental schemes in the world, whether of the state or of the prepaid kind, are not going to be much good if we have not got the practitioners to work the schemes.

In conclusion, Mr. Chairman, I hope I have said nothing which would hurt the minister's sensitivities as minister. I reiterate that I think every hon. member of the committee appreciates the friendly manner in which he carries out his duties.

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LIB

Chesley William Carter

Liberal

Mr. Carter:

I should like to pay my word of tribute to the minister's department and his devoted staff, and to express my gratitude for the co-operation I have always received with respect to the problems I have brought before him. In particular I am very grateful for the assistance they gave and the interest they took in connection with the radiation problem which occurred in one of the mines in my area.

My purpose in intervening in this debate is twofold. First, I should like to support what the hon. member for Simcoe East had to say about disability pensions. There is no doubt that great progress is being made in achieving greater uniformity with respect to the administration of these pensions, yet there are still a large number of people who are subjected to unnecessary hardship because of the difficulty which arises out of the wording of the act, in particular the words which require a person to be "totally and permanently disabled".

In the light of the great advances which are being made almost every day in medical science these terms are no longer valid. In many cases what appears to be a permanent disability today may be curable tomorrow; what appears to be a total disability may be alleviated or reduced later on by new techniques, knowledge or appliances. Nevertheless, hardship exists as long as a person is disabled and prevented from earning his livelihood as a consequence.

I see no solution to this problem unless we change the wording of the act, or at least agree to place upon it an interpretation different from the one now being used. It seems to me that if a person has been disabled for six months and the best medical advice he can get agrees that he is likely to remain disabled for another six months, that should be regarded as total disability. There is no reason why such cases cannot be reviewed every year, or every two years, or even every three years. We have cases now where people have to remain in this state for years before they can get somebody to certify that they are totally and completely disabled.

The other problem I wish to draw to the attention of the minister is one which has to do with mental health. It seems to me that most of our efforts with respect to mental health have been directed toward the adult, and there is no doubt that great progress is being made not only in the direction of new drugs and new treatments but also with respect to the general attitude of the public toward mental illness.

The part of the problem which I emphasize today has to do with the children. I

Supply-Health and Welfare recognize at once the difficulty of this problem, because it ranges all the way from children who are slightly retarded to those who require custodial care. It seems to me that because this problem does flow over into the realm of education the federal government has tended to leave it to the provinces and to private groups. We know enough today to realize that the problem is too great to be handled properly in this way. It is too big to be handled by private groups, and in many cases it is beyond the resources of provincial governments. Even those provinces which in the past have been able to provide accommodation for these mentally ill children are being hard put to increase this kind of accommodation in accordance with the growing needs. In my own province we have no such accommodation at the present time, and we are finding it almost impossible to keep pace with the increase in the demand for expansion of present facilities, not to speak of being able to branch out in the direction of providing new facilities along the lines I have mentioned.

It seems to me that two things are necessary. First, we should have a complete survey made so as to know exactly how big this problem is. We should then find out not only how many children would fall into this class but how they can be divided into the different classifications. Once this is done I think it should be possible to work out some agreement with the provinces whereby those classifications which fall mainly into the realm of education can be treated on a basis different from those who require custodial care.

That is the field where I believe the federal government could take the initiative, and I would urge the minister to show the way in determining just how big the problem is, and in finding out just how many children require custodial care. I should like him also to take the lead in providing the necessary staff and accommodation for this latter group, because at the present time it is beyond the capacity of most of the provinces of Canada to do so.

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CCF

William Arnold Peters (Whip of the Co-operative Commonwealth Federation)

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

Mr. Peters:

I should like to say a few words on this subject, some of them having to do with the Clark report, which was brought in sometime ago. I believe the Canadian people have been promised that pensions would be raised in keeping with their needs, though we as a government have found great difficulty in financing the increase we made in old age pensions on the last occasion we made improvements. We believe this old age pension should be at least $75 a month, and we are also of the opinion that

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Supply-Health and Welfare it would obviate a great deal of difficulty if this were implemented under the present scheme.

I believe the government, when they set up the Clark commission, did so with the backing of the people in general who believed that an investigation of the pension schemes in other countries throughout the world, particularly in the United States and Britain, would be advantageous to the Canadian government in ascertaining how best to provide for the elderly citizens of Canada. One of the sad facts of political life is that though we set up commissions to investigate certain matters, and although these commissions come to conclusions with which we agree or disagree, it does not seem to make a great difference because nothing happens once the reports are presented. This is evidence of the fact that the government has given little consideration to the report. Upon receipt of a report the government should state why it cannot implement its recommendations.

I am sure the Prime Minister and other members of the cabinet will agree that in 1957 they wanted to increase the old age pension even more. A pension higher than $55 is needed. The old age pension is contributory in a sense. It may be the sole pension which a Canadian receives or it may be supplementary to an industrial pension. In any event the old age pension has some effect on pension plans throughout the country. The old age pension is payable on the basis of citizenship and length of stay in Canada. It should be made portable in an industrial sense. There should be a national pension plan which a worker could take from job to job, province to province, industry to industry. At age 65 he should draw a pension equal in value to at least half of his wages. Such a plan could be easily introduced and would be in keeping with the recommendations of the government's own commission.

We have unemployed over 40 years of age who are not accepted in other lines of work because it is not actuarially sound to accept people of that age under many existing pension plans. I believe I heard someone say that this may make a difference in Quebec and there may well be some people in that province who would be interested today. Everyone, including politicians, should have an opportunity of retiring on a decent standard of living without having to accept jobs on the basis of political patronage.

I recently heard of a new excuse advanced by industry for not employing workers. I spoke to a young lady who is disillusioned about the slowness of her promotion in a large Canadian company. After some persuasion her boss told her that the company

got in trouble for hiring her. The reason was that she was over-weight and therefore a poor risk under the company's pension plan.

We are not asking the government to give our senior citizens something for nothing. They should be able to take their pension from job to job and find employment up to or beyond age 65. The pension would be contributory or compulsory. If it were a national pension plan the government would have to administer it. Such a plan would make money rather than lose it. This must be so or else insurance companies would not be involved in this business. Administrative costs would be slight. The minister could assist his colleagues especially those concerned with national housing and public works. Money would be available as a result of a national pension plan for use in making loans for home construction.

Canada is not poorer than other countries. The United States is not better off and in many respects is much poorer. Canada has national resources, an expanding population and challenging opportunities. If other countries can pay higher pensions and make more money available to the citizens than we can it must be because we are not using our resources to the best advantage. We should examine the recommendations of the Clark report and make more money available to our senior citizens. This will enhance industrial harmony because industrial disturbances are caused by pension plans as presently operating. People grow dissatisfied with their work but cannot change jobs without losing their pension rights. Workers could make more valuable contributions to society if a national portable pension plan was in effect.

The government should institute a superannuation plan to provide a fair and reasonable retirement fund in keeping with the earning power of an employee during his working years. The government could incorporate existing pension plans under a national scheme without disturbance to the plans now in operation.

We should examine the pension plan available to the hon. members of the House of Commons. Through the death of the provincial member of parliament in my riding it was brought to my attention that Ontario has a better plan than ours. I understand that at the last session of the Ontario legislature they amended their pension plan so that upon the death of a member his rights in that pension plan go to his wife as survivor insurance, and that consideration is given to his family.

It would seem that we in Ottawa are living in the horse and buggy days of long ago. It appears to me that our thinking is somewhat along the line of the old timer who said, "Let everybody worry about himself; I will worry about myself; I have been able to save a few bucks, I am looking after myself and to heck with everybody." This may be all right in some respects; it might have been all right in those days when it was possible to save. It seems to me that pensions in particular are one field in which we cannot look after ourselves any longer. Pensions we buy in the form of annuities and superannuation are very expensive and apply to a very limited number of people. The time has come when we should be able to devise much better systems of pensions for ourselves and for the Canadian people than we have at the present time.

We are not suggesting that we can finance this out of the present plan; we are not suggesting that at all. We are not only suggesting that the contributions and the amount paid be increased but also that there be a complete overhaul of the plan and a different method arrived at to supplement the contributions that it would be necessary to make for this type of plan. The government has an obligation to do this now. The old age pensioner should not be put in the position of having to wait for an election before he gets an increase in his old age pension.

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PC

Frederick Johnstone (Jack) Bigg

Progressive Conservative

Mr. Bigg:

Mr. Chairman, there are several groups of people in Canada who have no voice; they have no union and once in a while it becomes the honour of a private member like myself to stand up and espouse their cause. I speak of student nurses. This group is one of the neglected groups in all Canada. I say they have no effective voice. They do have a student nurses association in their own hospitals, which has no voice whatever. In fact if they stand up and say they should have a little pocket money, in some cases they are expelled.

The only one excuse for not paying these girls, as I understand it, is that the hospital believes that this would put out the lamp. Of course, they are referring to Florence Nightingale. Florence Nightingale was an English gentlewoman with considerable private means. She did light a lamp in nursing and it has not gone out yet. But there are literally hundreds of girls, the finest girls in Canada, serving long hours at what is at times a very disagreeable job, and I believe the highest rate of pay they get up to graduation is $12 a month. This may have been all right in the days when the R.C.M.P. rode across the plains on horseback for 50

Supply-Health and Welfare cents a day. But, as my hon. friend has just said, it is about time we got out of the horse and buggy days.

Those girls are giving a signal service to our people and are not being paid for it. I do not know why they should not be. The hospitals are hard pressed financially and the dominion government has come to the aid of the provinces and the hospitals during the last few years. I think we can do more and I think we shall have to earmark our help in this respect to make sure that it gets to the people whom we want to help, namely the student nurses. I speak with some authority because one of my daughters has just graduated. It is safe to bring this up because she has graduated and therefore we stand to gain nothing in our own family at the present time except that I have two more daughters. They may want to be nurses, but at the present time I can hardly recommend the training period to them on financial grounds.

I would suggest that perhaps a student nurse be given $12 pocket money during the first six months until she finds out whether she really wants to be a nurse. If she can stand the first six months in hospital she wants to be a nurse all right. I think we can afford to give her at least $1 a day to buy her nylons, or take herself to a moving picture so that she would not have to rely on a date with an intern. In the second year I suggest she is of more value and perhaps $45 a month might be a reasonable figure. In her graduating year, when she has already learned to be a nurse-she is just staying in hospital to pay for her first two years board I think $2 a day should be the minimum sum.

You will never get the nurses together; they are not unionized. You will never get them together in one body; they are too busy working. They have nobody speaking for them but I venture to say that everybody within earshot of my remarks has been in hospital and has been looked after by one of those wonderful girls. I think it was probably a shock to some hon. members to know that they did all that work for nothing. At the end of three years they are so fed up working for nothing, whether they admit it or not, that they rush off into marriage, they go south of the line or they quit nursing altogether.

There are no scholarships for nurses and yet they are our best young girls. A smart girl today in high school can qualify to go to university if she wishes without very much expense to herself. But if she wants to be a nurse she has to put in these three years of near slavery. This is a harsh word. I can call it nothing else.

Supply-Health and Welfare

There are a good many families in Canada who can no doubt afford to keep their daughters in nursing school for three years, but there are a great many more who cannot. Therefore I do not hesitate to stand up here today and start the ball rolling. I know that everybody who hears me will agree that this is a worthy cause. I expect the minister himself will be sympathetic to it. If we can rouse public opinion I think we will get a reform which is long overdue. I hope the minister and his department will carry the ball from here.

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PC

Jay Waldo Monteith (Minister of National Health and Welfare)

Progressive Conservative

Mr. Monteith (Perth):

Mr. Chairman, first of all I should like to pay my public respects to the hon. member for Essex East on the occasion of his birthday anniversary today. I might point out that he is one day older than me but, of course, many years older in his experience in this particular department.

I should also like to mention that I could not agree more wholeheartedly with his remarks concerning the ex-deputy minister of welfare, Dr. Davidson. I should like to repeat what I said at a testimonial dinner which was held by the department for Dr. Davidson on the night of May 30, to which the hon. member for Essex East was invited but happened to be out of the country at that time. I then labelled Dr. Davidson Mr. Social Security of Canada. I think this is most appropriate, and I cannot speak too highly of his service to the department and to the country in this capacity in the past number of years.

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LIB
PC

Jay Waldo Monteith (Minister of National Health and Welfare)

Progressive Conservative

Mr. Monieilh (Perth):

I should like to thank all hon. members who have spoken on these estimates for their very helpful remarks. There are undoubtedly some things I shall mention as I go along. I cannot cover all the items, but I should like to point out that in his remarks the hon. member for Essex East indicated that he wondered why I had not commented on certain remarks by officials and ministers in other spheres of government.

I do not believe that this is my particular obligation at the moment. I feel that all these items, such as portable pensions which many hon. members have mentioned, and with which I have some sympathy; the study of the Clark report which has been under way in my own department and is in the hands of a very competent committee in the department, are receiving study in one bundle, one might say. This includes the presentation of the Canadian welfare council which we have received for the past two or three years and which was particularly spoken to by the hon. member for Kootenay West. Other hon. members mentioned it as

well. Here again, these representations have been given close study and are being given a tied-in close-up look.

I believe the hon. member for Essex East asked what I might think about medical insurance. My remarks to the estimates committee on that subject are contained on page 13 of my brief, I am not sure of the actual page in the committee report. However, I am sure they cover the picture completely. Pages 31 to 41, by the way, of the same brief cover some of the problems and difficult considerations that have been gone into in connection with the Clark report.

The hon. member for Timmins spoke about the Saskatchewan medical plan. It seemed to me that there were other members of his party who mentioned this subject and who seemed to be fighting the Saskatchewan election over again.

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CCF

William Arnold Peters (Whip of the Co-operative Commonwealth Federation)

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

Mr. Peters:

It was not necessary.

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PC

Jay Waldo Monteith (Minister of National Health and Welfare)

Progressive Conservative

Mr. Monteith (Perth):

That was what I thought. I was just a little concerned about one intimation the hon. member for Timmins gave. Perhaps I am wrong, but I gathered that he might possibly do away with all charitable organizations, all voluntary organizations.

The hon. member for Jasper-Edson spoke, and I should like to thank him for his kind words concerning the operation of the hospital plan. There certainly are wrinkles still to be ironed out; we do not deny this. As I pointed out when we were before the estimates committee, there are certain possibilities under the Hospital Insurance and Diagnostic Services Act of which full advantage is not being taken. I was interested in his remarks concerning deterrent charges. I would just repeat one sentence from my opening remarks to this committee. It was to this effect: As to whether or not this type of co-insurance charge under a hospital insurance program has any deterrent effect, the department will be pleased to review the subject with the provinces concerned. This is just one of the aspects of the hospital insurance program which are being reviewed all the time.

The hon. member for Welland returned to his favorite topic. I would point out that actually there is a study being conducted in Ontario of fluoridation. I shall be interested in the report when it is forthcoming.

The hon. member for Lambton-Kent and the hon. member for Vancouver-Burrard spoke at some length about physical fitness. I certainly will be glad to examine the remarks of the hon. member for Lambton-Kent in greater detail. I know he has given a great deal of study to this important problem, as has the hon. member for Vancouver-Burrard.

Other hon. members, I believe, also mentioned the possibility of a Canada sports council. Incidentally I might say that I saw the pictures to which the hon. member for Lamb-ton-Kent referred at close range, and I think in some 30 years he has only varied in weight by something like one pound. I would not suggest that would apply to me.

The hon. member for Assiniboia suggested giving increases in practically everything, and again I gathered he was refighting the Saskatchewan election. I would suggest that we have lived up to our undertakings in the social welfare field.

There was a return requested by the hon. member for Bonavista-Twillingate, which I think is somewhat self-explanatory. The question was:

Has there been an Increase in social security payments between the fiscal years 1956-57 and 1958-59? If so, how much?

Then under No. 2 he asks:

How much of such increase is attributable to

(a) an increase in the number of recipients, and

(b) legislation enacted before June 21, 1957, and

(c) legislation enacted since June 21, 1957?

Under (c) I should like to point out that old age security has increased approximately $91 million as a result of legislation passed since June 21, 1957; old age assistance by $5,900,000; blindness allowances by $775,000; disability allowances by $4,900,000. Also under unemployment assistance the estimate in the return is approximately $250,000 monthly. Then, hospital insurance and general health grants, the amount paid as a result of legislation permitting the provinces to start their schemes on July 1, 1958 meant that there was an expenditure of $54,708,474 in 1958-59. Incidentally the change in the hospital construction grants resulted in an increase of $5 million. This is a small indication of the increases between 1956-57 and 1958-59 as a result of legislation passed following June 21, 1957.

The hon. member for York South had a very interesting suggestion that the department make grants toward housing for elderly people. I think possibly this would be better dealt with by the Department of Public Works because these loans are made through Central Mortgage and Housing Corporation.

The hon. member for Kootenay West certainly made quite a philosophical dissertation. I was very interested in some of his remarks concerning some of his personal problems and his ability to give very sound advice.

The hon. member for Calgary South, I think, rebutted the remarks made by the hon. member for Port Arthur who claimed that the hon. member had been making a rebuttal of my rebuttal. In other works, I think the hon.

Supply-Health and Welfare member for Calgary South was really making a rebuttal of the remarks of the hon. member for Port Arthur rather than of mine. I can only thank the hon. member for Calgary South for making the explanation he made and setting forth the simple fact that the department-myself as minister and the officials of the department-do not differ with the committee fundamentally in their findings but more in the way of approach in that we felt there were certain things which might appear to be interfering with what have always been considered to be provincial rights. We are always here, of course, to give advice and financial assistance in many areas. I should like to repeat what I said in my opening remarks, namely that we will keep a continuous review under way of our informational division.

Many hon. members have mentioned the problem of the blind and the disabled. These are under constant consideration. Last October, I think it was, we had a meeting with provincial ministers of welfare with a view to bringing up to date the regulations concerning these various assistance acts. These changes in regulation have been made through the justice department and have been agreed to by the provinces at this stage.

The hon. member for Quebec West mentioned several problems. I should like to thank him for his remarks concerning the World Health Organization and its extremely important work. He might be interested to know that the membership has now risen to 101 countries.

The hon. member for Burnaby-Coquitlam speaks, as always, after having given considerable thought to matters. I should like to thank him for his remarks concerning myself and the members of my department. He recommended the consolidation of all of our assistance acts. I recognize the problems in this particular matter and certainly will view his remarks with interest.

I would point out that, as he mentioned, the federal government has definitely offered to share the costs of constructing chronic hospitals on a per bed basis, the same as with any other hospital and also in the hospitalization of the chronically ill. All that would be needed to have the province of British Columbia have us share in this particular, namely in the hospitalization of the chronically ill, would be simply a request to amend the schedule of hospitals which would benefit from the act.

One item on which the hon. member for Burnaby-Coquitlam requested information was the exchange of research information with countries behind the iron curtain. Last March we had two representatives from

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Supply-Health and Welfare Canada in Russia in order to view the use of live polio vaccine in that country. That is one instance.

The hon. member for Saskatoon was interested in poison control or labelling. I should like to mention something about the poison control program in Canada. This program is established for the emergency treatment of children and others accidentally poisoned with household products including medicines. The food and drug director of my department has collected information about the potentially dangerous constituents of substances such as cleaners, soaps, fuels, paints, waxes and polishes often found in the home. This information and the composition of household medicines has been tabulated on cards. Incidentally, information on the methods for treating poisoning from the products listed was also put on cards. In 1957 sets of these cards were sent to provincial deputy ministers of health who selected the hospitals where poison control centres were established in the provinces. These centres used the information supplied by the department and have facilities and staff present at all times for the treatment of poison cases.

I should like to mention one or two statistics in order to point up what, in my estimation, is the root of this trouble. Having raised three children, at least to varying degrees of maturity, I know the problem involved. Up to April, 1960, 8,826 accidental poisonings have been reported, of which 56 per cent were due to medicines and 44 per cent were due to household chemicals. Almost all of these poisonings were of children under four years of age. I would point out that there are actually more than 170 poison control centres in Canada at the moment. I cannot help feeling that one of the gravest problems is simply ordinary care in keeping dangerous medicines and chemicals out of reach, in view of the fact that almost all of these 8,826 poisonings were of children under four years of age.

The hon. member for Middlesex East was worried about the reported increase of 10 per cent in hospital insurance premiums. I would point out that this is a provincial problem in that they decide how to collect their share of hospital expenses or operational costs. Whether it is done by current revenue -general taxes or sales taxes-or a general hospital tax or by premiums, the matter is up to the province. I must not leave the impression that we are not concerned with the increase in hospital costs. We are concerned, but these costs have been going up over the years.

I think the hon. member for Simcoe East gave a fairly direct answer in this respect.

I think it lies in the simple fact mentioned by the hon. member, namely that in 1920 there were no pediatric wings in Canada. Today's modern pediatric wings in many hospitals-possibly in practically all of them- indicate the great progress we have made. We cannot do this without some increased costs. Statistics indicate that the cost of operating hospitals had actually been increasing at something of the rate of ten per cent a year before hospital insurance came into effect.

The hon. member for Burin-Burgeo thanked the department for its assistance in the St. Lawrence mine radiation problem and I would like to acknowledge that appreciation. He is also concerned with the disability pension and the mental health problem, and he mentioned the education of mental children. I would like to point out that the William Anderson school for retarded children in Galt is the first new experimental school in this particular category, and I understand that as of this morning it has been indicated that property has been purchased for the extension of this project so that it will include students over 18. This is being done incidentally by private endeavour and the Kinsmen's club of Galt.

The hon. member for Timiskaming mentioned the portable pensions in which I said I have great interest. The matter of the members' pension I think is one for finance, not one which comes within the sphere of my department.

Mr. Chairman, undoubtedly I have not answered all of the questions of hon. members who have spoken, but I do feel that most of them spoke with the thought in mind of assisting the department and offering suggestions. We heartily accept these suggestions and will study them very closely. Again I would like to thank the committee and hon. members for the helpful suggestions which have been made.

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Item agreed to. National health branch- Health services, including assistance to the provinces- 243. Administration, $367,444.


LIB

Paul Joseph James Martin

Liberal

Mr. Martin (Essex East):

Mr. Chairman, first of all I want to thank the minister for his good wishes, and in anticipation of his anniversary tomorrow I would like to extend to him, and I think I speak for all hon. members of this committee at the moment, our very best wishes.

The minister has replied to a number of questions in the statement he has just made to which I directed his attention when I spoke briefly yesterday, but he has not answered

all the questions. It may be he is reserving some of them for some particular items as we come to them.

On this particular item of administration of the health services, which includes assistance to the provinces, there are a number of matters I would like to raise at this time. In the first place, the minister might give some indication of when the department will move into new and more permanent quarters. We would be interested in knowing what progress has been made with regard to planning and actual construction of the new administration headquarters in Tunney's Pasture.

The hon. member for Calgary South in his statement, a statement which had more than unusual importance because he spoke not only as a member of this house but as chairman of the committee on estimates, dealt with a number of points and indicated that while the objective of the recommendations made by the committee and the minister were the same, the methods to be pursued in the realization of those objectives were different.

One of the matters that the hon. member for Calgary South mentioned was the question of the shortage of hospital beds at the present time. The administration of the hospital insurance act requires for efficient operation the availability of the maximum number of beds, and while a great deal of preparation was made between 1948, when the national health program was announced and the passage of the hospital insurance act, in assisting the provinces in reducing then-bed shortage, it was never anticipated that those efforts could possibly succeed to the full in meeting the requirements.

I mention that because I want to indicate to the minister that I am not attributing any blame to the Department of National Health and Welfare for this situation. Nor am I blaming anyone, because I have in mind the tremendous strides which have been made in hospital construction over the past decade and a half in this country, the great contributions that have been made by governments on all levels, by voluntary organizations, individuals, nursing groups, the medical profession and so on. We have no reason to be ashamed at the results of this co-operative effort.

However, if I understood the minister correctly he took the position that the matter of a national survey of hospital bed capacity and of hospital bed needs was something that he did not feel could be initiated by the federal government. I agree with him that the direct responsibility is one for the provincial governments; but under the national health program it would seem to me that it

Supply-Health and Welfare would be open to the federal government to provide the necessary financial assistance which would make possible such a survey. Certainly such a survey of the national need at the moment is one that could not be accomplished by any provincial government except by a provincial government within the territories of that government. But what is needed is not only an assessment of provincial needs but an assessment of the situation in the light of the national interest.

It will be remembered that when the national health program was embarked upon in 1948 there was provided for at once the sum of some $600,000 which was to be expended by the federal government in cooperation with the provinces and which was provided for entirely out of the taxpayers' resources on recommendations of federal government policy for the purpose of making health survey grants to assist the provinces in assessing their health needs and finding ways and means in which they could be made. There was likewise provision made for what were then the eight annual grants to assist in the extension and development of provincial health services; and finally the annual grant to assist in hospital construction, the increase of which was provided for by the present government two years ago.

That survey is still available and undoubtedly the minister has examined and studied its contents. I would think that from that survey, which was exhaustive, it ought to be possible to draw certain deductions, not only as to provincial needs but indeed as to local needs of common bed capacity requirements. It is open to the minister, out of the $42 million now being voted, to provide funds which would make possible a survey and assessment of the hospital beds required throughout Canada.

I suggest to the minister that he give this matter further consideration to determine whether or not the provinces could be assisted in this way, and thereby run more efficiently the hospital insurance program which, as he said, is generally speaking, operating very efficiently now in all the provinces of Canada which have adopted the scheme. As the minister has said, there are, of course, some problems to be ironed out. It was to be expected that a scheme of such gigantic proportions would present difficulty from time to time, but looking back in retrospect and looking at the situation as it is today I think we have reason to be satisfied with the very satisfactory way in which, generally speaking, these schemes are operating.

Now I should like to ask the minister a further question, and I do this only because I am anxious to see hospital insurance extended in the one area where it is not now

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Supply-Health and Welfare available. I am thinking of the declared position of the premier designate of the province of Quebec with regard to hospital insurance. I hope the minister will lose no opportunity of seeing to it that his officials and, if necessary, he himself take every occasion to present to the new administration, if and when that is effective, the federal government's material in this regard so that in accordance with the wishes of the new government and of the people of that province, which must of course be the governing factor, there may be no delay in implementing for that province a program which we know to be so beneficial to the people in those provinces who are now able to take advantage of a hospital insurance scheme, and so that the province of Quebec can take advantage of a scheme to which its taxpayers, in so far as the federal contribution for existing schemes is concerned, may utilize these benefits.

I simply want to make one more statement with regard to this matter. I outlined our position on the subject of prepaid medical care. All the parties in this house on this side have taken their positions with regard to this important matter; a matter which, I think, will increasingly engage the attention of government and of the public generally. The minister referred to the statement he made on this subject in the estimates committee. As a member of that committee I recall that statement, but it seems to me it was of such importance that it ought to be made in this house where other hon. members who were not members of that committee would have the opportunity of learning the position of the government and, if they felt so disposed, of interrogating the government with regard to it.

For my part I regard the government's policy in this particular as unsatisfactory and as not giving the kind of leadership which I think a matter of such great importance requires. The initiative, I recognize at once, is a matter, as the minister said, for the provinces themselves. Under our constitutional arrangements that is an essential requirement. We cannot develop these schemes in a country like ours, which is based on the principles of federation and confederation, unless we recognize the division of jurisdiction. The federal government cannot do these things alone, and it seems to me it would be difficult for the provinces to do these things alone. But together, I am sure, the two senior levels of government can do something to deal with the problem of medical care in this country on a responsible basis, a basis that will recognize, as several medical doctors who are hon. members of this house have said, the principle of the traditional doctor-patient relationship, the principle of

free choice of doctor and the other principles which I believe at the moment are not in issue here. Those freedoms must be preserved.

(Translation):

I quite agree with the hon. member for Quebec West (Mr. Bissonnette) that there should be no restriction whatever of a patient's freedom to choose his own doctor, nor any attempt to impede the medical profession in the pursuit of its calling.

(Text):

I believe that this freedom of choice in so far as the declared positions of the parties are concerned is not actually in doubt. But we do have to face this point, and in facing it I want to say that I agree with those doctors who have spoken, that the medical profession, while it may have its point of view in this regard, and one must respect it-and I note with interest what the hon. member for Jasper-Edson had to say on this subject-I want to say that while I feel strongly on this subject, and while I feel that the basic consideration is the public interest and that we must see to it that Canadians are not denied the best medical care because of financial incapacity, I do not want anyone to think that by recommending prepaid medical schemes I was in any way reflecting on the medical profession.

But there have been suggestions here about the doctors, and I can only say that my own experience over 11 years is that Canada has every reason to be proud of the over-all objectives and contributions of the Canadian medical profession. We need only think of the work of the general practitioners and others -the family doctor, the man with the black bag-to realize this debt. I do not think we should allow an occasion like this to pass without-not rising to every incident requiring their defence-recognizing, as we should, the public service, the contribution, which the medical profession and other health workers make in our country.

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CCF

Murdo William Martin

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

Mr. Martin (Timmins):

I can recall last year that when questioned about the hospital insurance plan the minister stated that a considerable number of bugs had developed in the administration of these plans and I wonder if the minister could say what progress has been made to overcoming these difficulties.

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June 23, 1960