April 8, 1957

PC

William Gourlay Blair

Progressive Conservative

Mr. Blair:

I know the provinces have to pay. If they do not pay for them, then it comes out of the estate. The moment a mental patient goes into a hospital the official guardian of the province of Ontario- I think he is the individual-takes over the estate. The hospital bills are paid out of the funds controlled by the official guardian. Therefore even if the province of Ontario does pay the costs they come out of the individuals-

Topic:   HEALTH INSURANCE
Subtopic:   AUTHORIZATION OF PAYMENTS FROM CONSOLIDATED REVENUE FUND
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LIB

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

Liberal

Mr. Martin:

The province pays almost 90 per cent.

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Subtopic:   AUTHORIZATION OF PAYMENTS FROM CONSOLIDATED REVENUE FUND
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SC

Solon Earl Low

Social Credit

Mr. Low:

May I ask the minister this

question. In his negotiations with the provinces, what position did they take on this very important matter? Did they request that mental illnesses be included with other illnesses and be covered by this hospital arrangement?

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?

Murdo William Martin

Mr. Marlin:

The provinces naturally tried to get all the money they could, but there has been no persistent demand after it was revealed by the provinces themselves in the conference that they are bearing almost 90 per cent of the cost. There has been no insistent demand for it.

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SC

Solon Earl Low

Social Credit

Mr. Low:

Am I to understand, then, that the provinces were satisfied with this formula?

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Subtopic:   AUTHORIZATION OF PAYMENTS FROM CONSOLIDATED REVENUE FUND
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?

Murdo William Martin

Mr. Marlin:

Naturally the provinces would like to get all the money they could; but

Health Insurance

as we went around the table and each province indicated the extent to which it was bearing that responsibility the demand was not persisted in by them.

Topic:   HEALTH INSURANCE
Subtopic:   AUTHORIZATION OF PAYMENTS FROM CONSOLIDATED REVENUE FUND
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SC

Solon Earl Low

Social Credit

Mr. Low:

I would like to carry this further. Is it possible that the official representatives of the provinces were told flatly that it was no use attempting to negotiate an arrangement such as has been proposed by the official opposition? Is that correct?

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?

Murdo William Martin

Mr. Marlin:

They were asked what they paid and they told us. I think that indicates the position.

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SC

Solon Earl Low

Social Credit

Mr. Low:

If the provinces themselves have made strong representations to the minister that mental illness should be included, and if they are very much concerned about the rising costs of treatment of mental illness, then it certainly would seem to me that I would have to agree completely with the arguments put forward by the hon. member for Lanark and others who have spoken this morning that this is a matter which-

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?

Murdo William Martin

Mr. Marlin:

The bill we are now discussing was passed out to every province two weeks ago. A year ago in the committee on estimates it was dearly pointed out that the provinces were now bearing those responsibilities themselves. It was pointed out that this legislation was intended to help individuals and not provincial governments in respect of their normally accepted responsibilities. The bill has now been sent to every province. We have heard from the province of Alberta. They did suggest a change in the bill with regard to authorized charges, but not one reference was made by that province or by any other province to this particular provision of the bill.

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CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

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

Mr. Knowles:

They knew it was no use.

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SC

Solon Earl Low

Social Credit

Mr. Low:

If right from the beginning they were told there would be no use in discussing it, I can understand why no reference was made to it. I cannot follow the minister's argument. Is it not true that my province already carries full responsibility for bringing the cost of hospitalization down to a certain maximum limit? The same argument could be used with respect to any illness. It would seem to me that this is just a question of the federal government having taken an adamant position and telling the provinces that this is as far as we are going to go, that they have to arrange their own affairs under this particular scheme being dreamed up. That is what it would look like to me.

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PC

Donald Methuen Fleming

Progressive Conservative

Mr. Fleming:

Why does the minister not be frank in the answer he gives the hon. member for Peace Paver? The provinces

Health Insurance

wanted the inclusion of patients in tubercular hospitals and hospitals for the mentally ill under the scheme, and the attitude taken by this government was to the contrary all the way through. The provinces have never acquiesced in this. They were simply told point-blank by the federal government that it would ignore such requests. There has not been any withdrawal from that position by any of the provinces. As a matter of fact, the minister and the government of which he is a member know perfectly well that if they would include the patients in hospitals for the mentally ill and hospitals for tubercular patients they would have more provinces coming in under the scheme, so we could bring it into effect much sooner. I do not think the minister has been at all frank in the statement he made this morning to the hon. member for Peace River.

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LIB

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

Liberal

Mr. Martin:

I give you the report of the committee set up to discuss this matter in Nova Scotia. I read from paragraph 53 of that report:

In view of the present uncertainty on this subject, your committee is of the opinion that mental hospital treatment at this time cannot be included in a hospital plan.

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CCF

Stanley Howard Knowles (Whip of the Co-operative Commonwealth Federation)

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

Mr. Knowles:

Has Nova Scotia agreed to the plan?

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PC

Walter Gilbert Dinsdale

Progressive Conservative

Mr. Dinsdale:

Mr. Chairman, would it be possible for the minister to inform the committee how much this new hospital provision will mean in increased assistance to the mentally ill?

Apparently the federal assistance at the moment is running around $7 million.

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LIB

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

Liberal

Mr. Martin:

There is no segregation of the costs in institutions and in general hospitals at the moment but, as my hon. friend knows, the disposition to develop psychiatric treatment in general hospitals is on the increase. Right here in the city of Ottawa we have, in two hospitals, two psychiatric wards, which incidentally are provided for largely at the expense of the federal government. This is a practice that is growing more and more. The vast majority of people receiving mental treatment of course, are in the provincial institutions.

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PC

Walter Gilbert Dinsdale

Progressive Conservative

Mr. Dinsdale:

Just on that point again, Mr. Chairman, do I take it from the minister's remarks that so far as increased assistance toward the hospitalization of the mentally ill is concerned, this bill we have before us will be of no consequence.

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Murdo William Martin

Mr. Marlin:

I did not say that. For every individual receiving this treatment in a general hospital it would be of very real consequence, but in respect of a mental institution which the government of the province is operating or providing for, it would not apply.

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PC

Walter Gilbert Dinsdale

Progressive Conservative

Mr. Dinsdale:

Yes, Mr. Chairman, but the minister-

Topic:   HEALTH INSURANCE
Subtopic:   AUTHORIZATION OF PAYMENTS FROM CONSOLIDATED REVENUE FUND
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April 8, 1957