June 28, 1956

LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

I always rely greatly on what my hon. friend says, but I am sure that if he will look at the Ontario nursing act he will find precise provisions to cover these cases. We may have some difficulty but, if so, we will have to bring it back for amendment.

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CCF

Alexander Malcolm Nicholson

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

Mr. Nicholson:

The minister has the

advantage of legal training. While the hon. member for Prince Albert seems to be satisfied, I would ask the minister to clear up for those of us who have not been through law school the distinction between 2 (a) and 3 (a), so we will not have any trouble in explaining this to lay people.

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

Subclause 2 (a) and subclause 3 (a) are not to be contrasted. Subclause 2 (a) simply says the following are excluded, while 3 (a) says that if individuals are in homes for special care, notwithstanding the above, they may be included provided they come within the definition in subclause 4 which defines what is a home for special care.

Unemployment Assistance

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PC

Owen C. Trainor

Progressive Conservative

Mr. Trainor:

This provides that if the money is paid by the province or the municipality directly to the hospital, the institution is not eligible. When it is paid to the individual, then the institution becomes eligible. It seems to me that this will greatly encourage the use of subterfuge on the part of municipal and provincial governments, which might switch from a method of financial support directly to the institution to the individual, and in that case the individual would be required to pay directly to the institution.

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

This is not a scheme to provide assistance to the individual. If a province did what my hon. friend suggests of course we would have to point that out to it.

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CCF

Frederick Samuel Zaplitny

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

Mr. Zaplitny:

Subclause 4 defines the

meaning of homes for special care. I should like a further -clarification of that subclause which reads:

In this section, the expression "homes for special care" means nursing homes, hostels for indigent transients, homes for the aged, poor houses, alms houses and hostel facilities provided for the aged within housing projects constructed under the National Housing Act.

Do the words "within housing projects constructed under the National Housing Act" refer to the whole subclause or only to what comes after the word "and" in the third line of the subclause?

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

After the word "and".

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CCF

Frederick Samuel Zaplitny

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

Mr. Zaplitny:

They do not refer to any words before that?

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

No.

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PC

Thomas Miller Bell

Progressive Conservative

Mr. Bell:

If that is the answer to the question perhaps the draftsman might decide to put in a comma after the word "almshouses" just to clarify the subclause.

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

I think that is a good suggestion. I may say that was put in at the request of Saskatchewan where they have some of these homes.

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PC

Ellen Louks Fairclough

Progressive Conservative

Mrs. Fairclough:

I am still concerned about the remarks the minister made earlier with regard to chronic cases. When he was replying to the hon. member for Comox-Alberni he said that chronic cases would be taken care of under clause 4(3) (a), which reads:

An agreement may include as unemployment assistance costs-

And then later:

-and who would not normally be cared for in general, acute, chronic or convalescent hospitals-

Then the agreement in section 8(a) (iv), which is the long paragraph to which I drew the minister's attention earlier, says in part:

-together with any payment made to or on behalf of such person, who is-

Unemployment Assistance

And then later:

(iv) a charitable organization; except that there may be included-

And further down:

-provided further that said inmates are not such as would normally be cared for in general, acute, chronic or convalescent hospitals.

Both in the bill and in the agreement it specifically sets out chronic cases as being ineligible, whereas the minister told the hon. member for Comox-Alberni that such people would be taken care of under this bill.

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

I said they would be taken care of under the hospital insurance proposal. When the hospital insurance proposal was announced there was some question as to whether it included chronic and convalescent patients as opposed to acute patients, and I pointed out at the time that it was intended to cover chronic as well as acute cases. I was referring to the hospital insurance act of British Columbia and to the proposal made by the federal government for hospital insurance. I was not referring to chronic cases under this bill; I was referring to the chronic cases under the hospital insurance provisions of a particular province.

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PC

Ellen Louks Fairclough

Progressive Conservative

Mrs. Fairclough:

Chronic cases are not taken care of under this legislation?

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

Chronic hospital cases are covered by the act dealing with hospitals, but this legislation does not deal with hospital eases in a nursing home or who may be having special care. There may be the special case of an individual who is chronically ill and who is transferred to a proper institution. There are some borderline cases like that, but this bill is not intended to cover people who are in convalescent or chronic care hospitals. I think the best example would be St. Mary's hospital in London which is one of the outstanding and more recently constructed chronic hospitals. This act does not cover people in that institution. That is a hospital under the hospital act of Ontario and would be covered under the hospital insurance proposal that we have in mind.

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PC

Ellen Louks Fairclough

Progressive Conservative

Mrs. Fairclough:

Yet the care of these

people in these hospitals is undertaken by the provinces.

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LIB

Paul Joseph James Martin (Minister of National Health and Welfare)

Liberal

Mr. Martin:

Not necessarily; not in the

hospital I am thinking of. If there are indigent patients they are taken care of in Ontario by the municipality with assistance by the province, but that is assistance given for medical care. This is assistance given for welfare generally and not for medical care.

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PC

Ellen Louks Fairclough

Progressive Conservative

Mrs. Fairclough:

Does the minister then mean that in the costs that are tabulated by the provinces under section 6 of the agreement, those costs which relate to medical or hospital costs, if they are assumed by the municipality or provinces as the case may be, will not be included?

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?

Murdo William Martin

Mr. Marlin:

That is right.

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PC

Ellen Louks Fairclough

Progressive Conservative

Mrs. Fairclough:

Under provincial care

for these people-

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June 28, 1956