May 22, 1939

CCF

Charles Grant MacNeil

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

Mr. MacNEIL:

Still I would put in a plea for the man who has not only a neurological disorder but at the same time some pathological condition, quite frequently found in combination. The emotional or nervous disturbance accentuates or aggravates the pathological condition. I had a case the other day of a man with definite entitlement for sinusitis and some other disability, but these entitlements were assessed negative. He had some condition described as hysteria, and there was a conflict in the medical opinion as to whether or not that was negligible. The whole case in combination was thrown into the discard, with the net result that the community must look after the man and his family, since he is totally incapacitated. I am urging that the department should give this man neurological treatment, in view of the doubt that exists in the reports of the neuropsychiatrists; and if they cannot cure him then his disability should be assessed according to the ratio established, particularly since he saw meritorious service in a field of war.

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?

Edward Guss Porter

Mr. POAATER:

I do not know that we can do any better than we have done. We have sent these cases to Doctor Penfield and to the Toronto psychiatry institute. I am not a medical man, as my hon. friend knows, but I do not think there ever has been a case where we have refused anything like a reasonable demand for treatment either in our hospitals by our own people or by experts outside. But I am sure my hon. friend knows of the very large number of people who just happen to have that mental slant, who are Derfectly normal in every other way but who have a fixed idea, a persecution complex, that they are not getting that to which they are entitled from the pension department, from the government, or from society. It is not only soldiers-

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LIB

Ernest Lapointe (Minister of Justice and Attorney General of Canada)

Liberal

Mr. LAPOINTE (Quebec East):

That is what I was going to say.

Supply-Pensions and National Health

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

Frankly I do not know what to do about it, except to send them to people who are specialists in that line. I am not capable of discussing this with my hon. friend or any other member of this house from the technical point of view, because I do not know enough about it.

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CCF

Charles Grant MacNeil

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

Mr. MacNEIL:

I do not want to labour the point unduly, 'but- as the minister knows, other disabilities have a certain degree of protection under the act. If a man enlisted and served in France and later was reported to have had a pre-enlistment condition of tuberculosis, we will say, no deduction is made from his pension in respect of that fact, under certain conditions. But if a man is discharged with a neurasthenic condition, or some psychopathic condition, and it is even suspected that he had a pre-enlistment condition, he is denied that protection under the act. I am anxious to ascertain from the minister what has been done to put that man on a parity with the man suffering from another disability. Surely they could be all treated on the same basis. When the chief neuropsychiatrist says there is a constitutional defect, that diagnosis is passed on to the pension commission, and usually the man is completely out of luck so far as the protection that exists in the act is concerned. Cannot something be done to place the man with a neurological condition on the same basis as the man who had tuberculosis or some other pre-enlistment condition for which he gets protection?

I have a great deal of sympathy for many of these cases. Undoubtedly there is something in what the minister says; some men have a persecution complex, but in the majority of the cases with which I come in contact the man has an actual disability to start with. That is, he is suffering from a pathological condition as well as from some emotional or nervous disturbance which adds to his disability. His sufferings are very real; he is not a malingerer in any sense of the word, nor do I think the departmental doctors suggest that. But if he is dealt with harshly by the pension commission, and then treatment or pension is denied, so that he is not given this protection of the act, the case becomes worse and worse, and he rapidly deteriorates as his anxiety becomes greater. So I suggest to the minister that if this situation were dealt with properly and adequately, not in a hard-boiled fashion, we might satisfactorily clear up some of this difficulty. At the present moment this problem exists in almost every community, and it is a problem confronted daily by those in the community who are charged with extending aid to ex-service men in distress.

I should like to have a statement from the minister as to what steps are being taken to place these men on the same basis as those suffering from other disabilities.

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

There is not much that I can add to what I have said already. My hon. friend strongly urged upon the committee that we should appoint a commission. Doctor Mathers of Winnipeg, Doctor Boyer of Toronto, and a number of the most prominent men in this profession in Canada, went into the whole question at the request of the department and presented a full and complete report. As I said before, I read the report, and I am satisfied that it was fair. The department has received instructions to continue along the lines laid down in that report. If anyone has any suggestion to make, I should be glad to present- it to the technical officers of the department.

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CCF

Charles Grant MacNeil

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

Mr. MacNEIL:

The minister could have introduced an amendment to the act. Was there any specific objection on the part of the commission to the suggestion that was proposed?

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

I do not think there were any suggestions made to the committee.

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SC

John Horne Blackmore

Social Credit

Mr. BLACKMORE:

I should like to

commend the minister for the progressive attitude he has taken toward the suffering returned men of Canada. I think it can safely and honestly be said that the minister is earnestly trying to make better the lot of the returned man.

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

After that, I can forget a lot of social credit speeches. I sincerely thank the hon. member for those words.

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CCF

Charles Grant MacNeil

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

Mr. MacNEIL:

There have been appeals from the decisions of the pension commission. Will these be held up pending the enactment of the amendment to the act?

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

There is not an undue

number of cases. Matters are proceeding in the ordinary course; and if there is a little delay, I do not suppose anyone will object.

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Item agreed to. 227. Departmental administration, $112,295.


CON

Denton Massey

Conservative (1867-1942)

Mr. DENTON MASSEY (Greenwood):

Mr. Chairman, I should first like to thank the minister for his courtesy in permitting me to speak on this item on a matter^ which I believe strikes to the very foundation upon which our dominion is built. I refer to the matter of public health. I purpose spending such time as I shall take this evening in an endeavour to impress upon the government and hon. members of this committee that the lack of care is costing us annually in

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this dominion numberless unnecessary deaths, and that our neglect of public health is placing us in the position of being one of the most backward nations of the world in this regard. In the last month I have been in receipt of hundreds of letters which have proved to be enlightening communications to put it mildly. As a result of the deplorable conditions which these letters indicate, and in view of the public interest that has recently been awakened about this whole question of public health, I make no apologies to the committee for discussing this matter even at this late stage of the session.

May I first remind hon. gentlemen opposite that every statement I make and every figure I use has been gathered from the best possible authority on the subject. For example, I might mention the bureau of statistics, the Canadian welfare council, the Canadian medical association, and numberless other nationally recognized organizations or individuals who are in position to issue authoritative statements.

In 1937 the national income of this country was $4,576,000,000 in round figures or, to reduce it to a figure which we can all comprehend, $411 per capita. According to an article written recently by the Hon. G. M. Weir, provincial secretary and minister of education of British Columbia, out of our national income in 1937 we spent $165,000,000 on doctors, drugs, hospitals, dentists and other health services, or S15 per person.

In recent years medical science has made magnificent strides, and it has been clearly demonstrated that a substantial proportion of this expenditure is waste. We are spending a pound for care while we spend only an ounce for prevention. For example, in Ontario in 1937, of the total expenditure of $6,000,000 in round figures for hospitals, administration, et cetera, approximately $600,000, or 10 per cent, was spent on the prevention of illness through the provincial department of national health. Thus, in my own province in 1937 the provincial government spent 90 per cent for cure and 10 per cent for prevention.

We must realize that an amazingly large proportion of our population cannot afford the cost^ of any medical attention whatsoever An additional substantial percentage cannot possibly face the expenditures of a prolonged or serious illness. To again quote the Hon. G. M. Weir:

The available evidence shows that at least one-third, or more likely one-half, of all Canadians belong to families that have incomes of less than $1,000 a year. Certainly these people can afford little or nothing for medical care. . . . Only the members of our upper income group, say 2 million to 3 million Canadians at the outside, can buy private medical care without serious difficulty.

TMr. Massey.]

True, we may rejoice in the advances made by medical science in recent years and that it is now possible either to cure or to immunize from many of the hitherto supposedly incurable diseases; true, we may be deeply grateful to our doctors and nurses who have given gratuitously of their services to indigent patients; true, further, we may congratulate many of our health departments, municipal centres and philanthropic organizations upon the splendid work they have done, but at the same time we cannot dodge the fact that thousands die each year in this country from preventable disease simply because we have not made these life-saving and life-giving services efficient and practically available to our population. Let me quote once again from the article to which I have referred by the Hon. G. M. Weir as follows:

Cancer killed about 12,000 Canadians in 1937. At least one-sixth of these deaths might have been prevented.

At least 550,000 persons in Canada are suffering from venereal diseases. This, in spite of the fact that syphilis, which is responsible for about 10 per cent of all insanity, and for much heart disease, blindness and infant mortality, can be practically wiped out, as Sweden has proved.

During 1936, 53,000 people were patients at some time in Canadian mental hospitals. Many of them would never have seen the inside of an institution if preventive work in mental hygiene had been adequate.

In 1937, 16.675 infants under one year of age died in Canada, or 76 per 1,000 births. With proper health services the rate need not have been higher than New Zealand's rate of 30. Thus we lost needlessly about 10,000 infant lives per year.

In 1937 more than 1,000 Canadian mothers lost their lives in childbirth. "Need Our Mothers Die?" asked the Canadian Welfare Council in a bulletin published three years ago. The answer is no-that half of our maternal deaths, or 500 a year, are preventable.

Respiratory tuberculosis took a toll of almost 5.500 lives in Canada in 1937, or 49-3 per

100.000 of population-a needless waste of about

3.000 lives, for the tuberculosis death rate can be reduced by 50 per cent at least, as Saskatchewan's rate of only 26-5 per 100,000 in 1937 indicates.

Death rates are higher among unskilled than among professional workers. In 1931 and 1932, labourers, coal miners, metal miners, and workers in mineral-products manufacture had death rates nearly twice as high as were found among certain professional classes better able to purchase adequate medical services.

Children of families on relief showed a 30 per cent greater loss of time from school because of illness than children of middle-class families, according to a recent national health survey in the^ United States. No doubt a very similar condition of affairs exists in Canada.

No greater indictment can be made of our terrible lack of willingness and readiness to safeguard the future than is made by such statements from so eminent an authority as Mr. Weir. We must realize that there is no uniformity throughout Canada in the activi-

Supply-Pensions and National Health

ties of health departments and medical units. To illustrate what I mean, in the city of Hamilton there has been no death from diphtheria since 1932, and yet in the province of Quebec there is an average of three deaths every four days from this same disease. Further, the number of deaths from tuberculosis, and the number of maternal deaths vary widely not only from one municipal centre to another but from one province to another, and this, I fully believe, clearly indicates the unfair handicap that we place upon the low wage-earner or the indigent, and their families, by depriving them of the medical counsel and services so necessary for the maintenance of health and life.

Let it be noted that in 1937 the following number of deaths from tuberculosis per 100,000 of population wras recorded in the nine

provinces:

Quebec 72-1

Nova Scotia 69'6

New Brunswick 68'0

British Columbia 66-4

Prince Edward Island 54-8

Manitoba 46-0

Alberta 33-9

Ontario 31'0

Saskatchewan 26-5

A maximum variation per 100,000 population from province to province of almost 300 per cent! The number of maternal deaths shows an even wider variation. In the city of Saskatoon, for example, the number is 13-9 per 1,000 live births, while in Vancouver it is only 2-9, and Halifax 2-5-a variation of over 500 per cent. The infant deaths per

1,000 live births are, for example, 297 in the city of Three Rivers, as against 73 in Sherbrooke, 68 in Halifax, 38 in Hamilton, 41 in Calgary and 24 in Galt.-a variation of nearly 1,300 per cent! All of which indicates, Mr. Chairman, the lack of uniformity in our methods of dealing with this problem of public health, which is a national problem in effect and in essence. There is no more vital problem.

Let me refer to an article by one of the world's great authorities on nutrition, Sir John Boyd Orr, which appeared a short time ago in The Listener. He concludes the article in these words:

The future of a country depends not so much upon trade or wealth or even armaments, as upon the health and happiness of the people, and the physique and vigour of the race.

It must be obvious to us that twenty years from now, whether we are a vigorous, virile country, or decadent and decaying, depends directly upon the health, the care and the feeding of the expectant mothers, the nursing mothers, and the children of the present. It is appalling that we can be so blind to

this obvious fact, as is evidenced by our failure to tackle the problem in a national way. As I have said, not for a moment do I criticize the efforts, sincere, honest and efficient, that have been and are being put forward by medical health officers, philanthropic organizations, and, above all, by our doctors and nurses. The contribution that they are making is magnificent. Nor do I criticize the relief officers and officials who, in the vast majority of cases, are doing the best they can with the tools at their disposal, and under the handicap of insufficient funds to do the work they realize should and must be done. But why should it be that so large a proportion of our population who cannot afford any form of medical service whatsoever should have to depend upon either the gratuitous services of the physician, or the present limited facilities of the municipality or the province, or upon the philanthropy of well meaning citizens for their vitally necessary services? It is highly to be desired, of course, for us in this house to deal with matters of urgent importance such as unemployment, agricultural distress, defence, and other such national problems. But underneath any such consideration must be the fundamental assumption that we are dealing with a healthy, normal population. If we neglect our national health, then indeed are we paving the way toward the ultimate destruction of this nation, and it then makes little difference how we treat any other national problem.

Prior to the depression, the medical profession gratuitously and gladly served many individuals who were incapable of paying their medical bills, and the amount of free work was not excessive for any one physician. In recent years, since the depression, the need as well as the demand for gratuitous services has risen to such a degree that the majority of physicians are finding it difficult to earn even a modest living. The committee on economics of the Canadian Medical Association report that the volume of medical practice in 1932 was 63-5 per cent of the volume in 1929, and in 1932 the remunerative work was only 50 per cent as against 77-5 per cent in 1929. It is estimated that this situation has grown and is growing steadily worse.

Let it be noted, Mr. Chairman, that the unequal distribution of adequate public health services across Canada is indicated by the fact that death rates from preventable diseases in so many municipalities are much too high, and the authorities which I have consulted agree that at least one-third and maybe more of the deaths from these causes which now occur in Canada could be prevented. Let me illustrate again.

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In 1937 in Canada there were 329 deaths from typhoid fever, which represents a failure to apply our sanitary knowledge; 369 died from diphtheria, which can not only be cured but absolutely prevented; 6,750 died from tuberculosis, a figure that could be at least cut in half with proper medical services and proper nutrition. Infant mortality varied in the five-year period from 1931 to 1935, from 46 per cent per 1,000 live births in British Columbia, to 98 in the province of Quebec. It is shocking also to realize that the infant mortality for Canada per 1,000 live births, increased in 1937 over 1936 by ten-from 66 to 76-while deaths per 1,000 live births in New Brunswick, rose from 77 to 101, and in Quebec from 83 to 100, with an increase in every other province except one.

Then let us note this particularly: The

shameful wastage as a result of maternal mortality, which, in 1937, was 4-9 per 1,000 living births, represented the death of 1,067 mothers at the average age of 31. If the maternal mortality rate were reduced to three per 1,000 living births, which, according to the Victorian Order of Nurses is an easily obtainable figure for Canada, with adequate public health units established across this country, it would mean that the lives of nearly 600 mothers each year would be preserved to their families. Further, if the infant mortality rate for Canada as a whole were reduced to 55, which was the actual rate for Ontario in 1936, there would be 2,500 fewer deaths of infants, or an actual reduction of 20 per cent. Let me go one step further to illustrate the result of the variations in death rate consequent upon unequal distribution in medical and public health services as well as the lack of an adequate amount of public education in regard to health.

I stated a moment ago that in 1937 there were 6,750 deaths from tuberculosis in Canada, which is at the rate of 61 deaths per 100,000 of population. As the death rate from tuberculosis in Saskatchewan was in that same year 30 per 100,000, and in Ontario, 36, if we assume that the splendid work which is being done in Saskatchewan in regard to tuberculosis were to be extended across the dominion as a whole, the annual death rate from this cause would be reduced to, say 35 per 100,000, which would mean a saving on the basis of the 1937 figure, of 2,903 lives a year.

I have just mentioned the splendid public health work being done in Saskatchewan. In this province there are 78 rural municipalities employing full time municipal physicians, and 60 other municipalities employing physicians on a part-time basis to render medical services, especially to the indigent. Thus prob-

CMr. Massey.]

ably one-fifth of the rural population receives medical service under this scheme. Similar arrangements have been made as a result of the "municipal doctor system" of providing medical services in Manitoba as was discussed by Doctor F. W. Jackson, deputy minister of health and public welfare of Manitoba, in a speech in Washington in April of last year. I quote:

The municipal doctor usually provides a fairly adequate school medical service. Pre-natal care rm- expectant mothers is well looked after. There being no financial barrier between the mother and the physician, she seeks advice and any medical care she may require during the pre-natal period as well as at confinement. As a result maternal deaths in these districts have been negligible during the past four or five years. The^ maternal death rate in the areas organized since 1934 is 1-8 per thousand live births as compared to the provincial figure of 4-3. Another interesting figure is the crude death rate, the average for the last three years being in municipal doctor districts 7-74; whole province 8-43. . . . We have found over a period of five years that the per capita cost to the municipal corporations with municipal doctors for the hospitalization of indigent patients is approximately only one-half of what it is in municipalities where the medical services are supplied in the ordinary manner.

In the past we have boasted of our standard of living in Canada. But if we examine such figures as those I have placed upon Hansard to-night, we should be appalled at the lack of care we are taking of the health of our people and the awful wastage which has resulted and is resulting. Our record in regard to public health is by no means a proud one, to phrase it mildly. For example, in the statistics from twenty-six leading countries of the world in 1936, only four had a higher maternal death rate than had Canada, we being twenty-second in that list! Let me also draw to the attention of this committee that even though the expectation of life has been extended, the number of deaths in 1937 increased over those of 1936 by 6.800, and of this increase 2.200. or approximately one-third, were under one year of age, and 1,600, or approximately one-fourth, were between the age of one year and thirty years. In other words, we must realize that 56 per cent of the increase in deaths between 1936 and 1937 were among our children and young people under thirty years of age. We regarded it, and still do, as a ghastly tragedy that 60,000 young Canadians were killed in battle or died of wounds during the four years of the great war; and yet, in the four years from 1931 to 1934, 70,000 infants under one year of age died in Canada. Let me quote from The Lancet of June 13, 1931, page 1,279, from an article by Professor Blair Bell:

It seems almost incredible that every year one woman in every ten of those who bear children is to be more or less disabled or has

Supply-Pensions and National Health

to endure an operation to cure her injuries. Yet in the absence of exact figures this seems to be a conservative estimate. Besides probably many more bear in silence minor lesions which may prove fatal later.

May I refer now to a publication of the Canadian welfare council in 1935, entitled " Need Our Mothers Die?"

Over a five year average the complete toll of motherhood in Canada in order that 230,000 children may be born is the death of 1,100 to 1,400 mothers annually, the more or less permanent handicapping of another 23,000 mothers, and the impairment of health to a lesser or greater degree of another 22,000. And the stark, unescapable condemnation of the whole unfortunate story is that at least 50 per cent of this cost is unnecessary and preventable by means within our knowledge, control and capacity, if we have but the courage and determination to apply them.

It is shockingly apparent, also, Mr. Chairman, as one reads from medical reports and journals, that at least one-third of the women who bear children receive no pre-natal care, and that upwards of 20 per cent of the pregnant women in Canada are living in circumstances that may be described as very poor.

It is notorious that malnutrition during the pregnancy period has a direct bearing on the susceptibility to septicaemia and to still births, and it therefore may be assumed without question that, as the maternal death rate in areas where concerted efforts have been made to reduce it, has been reduced, where it has remained constant is as a result of pre-natal malnutrition or undernourishment of the mother. L'Assistance Maternelle, which has done such splendid work in the city of Montreal, financed largely from private contributions, reports that:

The great number of women seeking the clinic have never heard of pre-natal care, and come only for registration, but upon explanation of its value, their cooperation for examination and in the procedures laid down has been readily obtained.

Again let me refer to the Canadian welfare council's "Need Our Mothers Die?" where I read the following quotation:

In this group of causes-*

The exceptionally bad housing conditions, together with unemployment, poverty and a low standard of living.

there would fall that percentage of maternal deaths due to impaired health generally, and arising particularly out of conditions of disease and malnourishment of the young mother in her own childhood and adolescence.

I shall quote further from that pamphlet in just a few moments. It is notorious, Mr. Chairman, that in countries such as New Zealand, Scandinavia, and Holland, malnutrition is essentially unknown. And is it not

significant that the maternal death rates in these countries are among the lowest in the world? Surely we cannot ignore the fact that the undernourished female child of today is to be the young mother of to-morrow; and if we fail to provide adequate nourishment for her, we are undermining the very foundation of the nation itself.

May I conclude these remarks with a few comments on nutrition, and then I shall make a suggestion as to the possible way in which the government might deal with this question of public health. I have in my hand an article by one who is regarded by many as the world's leading authority on nutrition, Sir John Boyd Orr. I quote:

There are other factors besides food which affect health. One of the most important of these is worry, and the psychological strain of working conditions in this mechanical age of hustle. Another important factor is bad housing. Bad housing causes both physical and moral deterioration. But there is reason to believe that the most important factor in the health and physique of children is their food.

. . . Recent tests seem to show that feeding is also an important factor in maternal mortality. All the indications are that if a diet fully adequate for health were made available to every mother and child in the country, the health and physique and the length of life of the poor would be brought nearer to the level found among the well-to-do.

In a recent interview in Toronto, Sir John referred1 to the work of Doctor E. W. McHenry, assistant professor of physiological hygiene in the Connaught laboratories of the university of Toronto. Sir John is reported as saying:

He has made a study of families in the low income group, making below $1,500 a year. And he has found that these people are eating only one-third of what they should be eating. They are not sick, but they are undernourished and when they are undernourished, he will tell you that their appetite is only three-quarters of what it should be.

Referring to the United Kingdom, and we have no reason to feel that the situation would] be any different here, Sir John Boyd Orr writes, in this article in The Listener already referred to:

It has been shown that as family income falls, the consumption of the natural foodstuffs of special health value such as fruits and vegetables, eggs, milk, butter and cheese, decreases. They show that the diet of the poorer half of the population is not up to the standard required for health, and the diet of our poorest class is so bad that it is deficient in nearly every respect.

. . . Recent scientific discoveries have revolutionized our ideas on the effect of food on health. ... The new knowledge tells us that in addition to satisfying hunger, food must contain a sufficient amount of a number of substances-about half a dozen vitamines, and about a dozen minerals-to keep the body healthy.

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Sir John goes on:

We now have an authoritative statement on what kind of diet contains a sufficient amount of these substances to maintain health. In 1935 the League of Nations set up an international committee to draw up a statement on food requirements. That statement has been approved by the leading scientific and medical authorities such as the Medical Research Council of Great Britain. . . . We now have a standard we can work to. We have a yardstick to measure diets and tell us how far they are deficient for health.

At once the question arises: As the state has assumed the responsibility of providing food for nearly a million of our citizens, and as there is beyond this number an unknown and extraordinarily large group who are in the low income brackets as a result of irregular or part-time work, should we not give the greatest consideration to such questions as those to which Sir John Boyd Orr draws our attention? If governments accept the responsibility of feeding a proportion of the population, should they not make sure beyond doubt that these wards of the state are supplied with food of a kind, quality and quantity to maintain health?

Let me refer hon. members to a brief prepared by the welfare council of Toronto and district on July 12, 1938, and submitted to the provincial government. It reads in part as follows:

The avoidance of heavy burdens in the future depends directly upon the wise policies, adopted to-day since the results of a faulty policy with respect to the needs of subsistence are likely to be an increasing crop of ailments and diseases, of rickety children, debilitated mothers and adult citizens of all ages defective in health or lacking in resistance to recurrent sickness. . . . The welfare council in Toronto within the past month has made a careful examination of the situation. The results of the comparison may be briefly stated as follows: The city of Toronto's scale of relief falls seriously short of that prescribed by each of the other standards quoted.

That is, those of the Ontario medical association committee on relief diets, the Canadian council on nutrition, and the League of Nations mixed committee on nutrition.

In order to bring the food allowance up to the level of the lowest of the three standards, an increase of 26 per cent in the weekly money grant would be required.

Then there followed a table showing that whereas the Toronto city relief for a family of five provides $6.35 a week, the Ontario medical association recommends $8.38 as a minimum; the Canadian welfare council, $8.09, and the League of Nations, $11.11. In other words, the food allowance in Toronto, which city I use only as illustrative, is about 57 per cent of what- it should be according to one of the most eminent nutritionists in the world, Sir John Boyd Orr, who is, of course, the

motivating spirit behind the League of Nations committee on nutrition. It is no wonder that such a man as Doctor Jean Gregoire, the deputy minister of health of Quebec, spoke as he did before the Canadian welfare council last May. He said in part:

We have a death rate from certain causes which is unworthy of civilized peoples . . . Ill health is costing Canadians in the province of Quebec $100,000 a year ... At least forty of the hundred who died per day in this province could be saved by the application of certain principles of hygiene.

I cannot resist asking here if the Minister of Labour (Mr. Rogers), in the light of the figures which I have placed on Hansard tonight, will still call me "irresponsible" if I state again that "thousands have died from exposure, illness, starvation or lack of care." I wonder if the hon. member for Essex East (Mr. Martin) will still say that the one who makes such a statement is exposing himself to "ridicule." Of course my statement is true, shockingly true, and indicates that through the years there has been "lack of care" of the most priceless national asset that we have- our people.

It was a hundred years ago that a brilliant French-Canadian scientist, Savarin, stated:

The welfare of a nation depends upon the way in which it is nourished.

How true that is to-day. In many places in this dominion, as a result of lack of adequate health services, as a result of inadequate relief allowance for food, we are exposing at least one-third of our population to the perils resulting from malnutrition, preventable disease and curable disease. Surely one does not have to be dead to cease to be of value to one's country. Surely the effects of undernourishment and malnutrition undermine our nationhood as nothing else can. Surely the lack of proper available medical care is paving the way for a decadent nation.

Speaking in Washington last July, Mr. Charles W. Taussig, president of the American Molasses Company, and chairman of the advisory committee of the national youth administration in the United States, said in part:

The Lindleys touch upon this subject-

The health needs of youth.

in their recently published book, A New Deal for Youth. They call attention to what we have found to be a typical case in the youth administration. It is the record of a middle-western, industrial city where 1,800 boys and girls were given a thorough physical examination. Forty-three per cent of them were found to be unemployable by private industry because of their physical condition, but it was estimated that with corrective medical treatment this large portion of youth who were occupa-

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tionally handicapped because of physical defects could be reduced to 8 or 10 per cent.

We know a great deal more about preventing sickness than we do about preventing unemployment. Yet we courageously explore the economic field, of which we know little, and neglect the field that we have at least partially mastered.

. . . The annual toll of preventable illness measured in terms of money runs into billions. Progressive business will regard an adequate health service as a subsidy to industry, not as a burden.

There is no reason to believe that the situation in Canada is relatively much better. Our own dominion statistician, Doctor Coats, informs us that the estimate of the amount lost through illness and accident by all gainfully employed in 1931 was 840,000,000 in this country. This is merely a loss of wages and does not take into consideration the cost of lowered production from the point of view of the employer. The Minister of Labour himself admits that the situation in Canada is far from what might be desired, and I agree with him. But I ask him and I ask hon. members, what will it be in the not too distant future if we continue the wastage both through death and through loss of health, particularly among our youth, our unemployed, and our low income groups?

Speaking in the city of Toronto the other day, the Minister of Pensions and National Health (Mr. Power) is reported in the Toronto Daily Star as follows:

Major Power outlined the achievements of the federal government in health problems. Leprosy, once prevalent in New Brunswick, had been reduced until there are only twelve cases in Canada. The drug traffic has been curbed. The use of marihuana has been kept out of Canada. . . . Maternal deaths had been

reduced, he added, and in a comparatively short space of time the maternal death rate in Quebec had been reduced from 200 deaths per 100,000 to 76 per 100,000.

I am sure that all of us in this committee will rest comfortably now that we know that the minister has eliminated leprosy from Canada-

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

I did not say I did that at all. I am not responsible for everything. I said that many years ago leprosy was prevalent in Canada.

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CON

Denton Massey

Conservative (1867-1942)

Mr. MASSEY:

I did not mean, of course,

that the minister personally eliminated it.

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

There were fourteen cases when I came into office, and there are now twelve, if the hon. member thinks I have done anything.

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CON

Denton Massey

Conservative (1867-1942)

Mr. MASSEY:

I am sure also that we are more comfortable now that we know that marihuana is a drug under the narcotic act. I congratulate the minister upon these achievements.

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

I do not want to be congratulated if I have not achieved anything.

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CON

Denton Massey

Conservative (1867-1942)

Mr. MASSEY:

Well, the department of which the minister is now the head.

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May 22, 1939