April 10, 1957

CCF

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

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

Mr. Stanley Knowles (Winnipeg North Centre):

Mr. Speaker, can the Minister of Finance make a statement before this session

ends as to what the government intends to do regarding civil service salary increases?

Topic:   PUBLIC SERVICE
Subtopic:   SALARY INCREASES-INQUIRY AS TO POSSIBLE ANNOUNCEMENT
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LIB

Walter Edward Harris (Minister of Finance and Receiver General; Leader of the Government in the House of Commons; Liberal Party House Leader)

Liberal

Hon. W. E. Harris (Minister of Finance):

I do not think I can, Mr. Speaker, but I shall make inquiries as to the work being undertaken by the civil service commission in connection with the application.

Topic:   PUBLIC SERVICE
Subtopic:   SALARY INCREASES-INQUIRY AS TO POSSIBLE ANNOUNCEMENT
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HEALTH INSURANCE

AUTHORIZATION OF PAYMENTS FROM CONSOLIDATED REVENUE FUND


The house resumed, from Monday, April 8, consideration of the motion of Mr. Martin for the third reading of Bill No. 320, to authorize contributions by Canada in respect of programs administered by the provinces, providing hospital insurance and laboratory and other services in aid of diagnosis, and the amendment thereto of Mr. Knowles.


LIB

Elmore Philpott

Liberal

Mr. Elmore Philpotf (Vancouver South):

There was no discussion, Mr. Speaker, on second reading of this extremely important measure. It is quite possible there would not have been very much discussion on third reading except for the amendment moved by the hon. member for Winnipeg North Centre.

It seems to me that is a shame, for several reasons. I regard the hospital insurance measure, which is now to be passed, as one of the greatest national landmarks ever erected in this country. While I believe we are divided on the one small point raised in the amendment of the hon. member for Winnipeg North Centre, I think we are agreed on the substance of the bill. In fact one might almost use the terms of the famous advertisement for ivory soap, 99 and 44/100 per cent pure. So far as I can judge the sense of the house, the house is agreed upon 99 and 44/100 per cent of the bill as it now stands, and only disagrees on one small fraction of 1 per cent.

I submit, Mr. Speaker, that this is a great landmark of social advance in Canada. It seems to me that landmarks are of two kinds. There are the great historic landmarks which grow out of events of history, like the battle of the plains of Abraham, which decided that this great country was to be a bi-cultural country, a bi-national country, if you want to call it that, with neither conquered nor conquerors but two races of equal partners joining together to make this great Canadian nation. Or events such as the war of 1812, which decided for all time to come that this nation north of the 49th parallel was to survive as a free member of the then British Empire, and now the British commonwealth, as the beginning of what became the Canadian nation.

Or we could have events growing out of, we will say, the rebellion of 1837, an unhappy event in itself but one which brought great benefit to the Canadian people in all particulars save one, because one of the unfortunate aftermaths of that particular event was that our more belligerent Conservative friends in the city of Montreal objected to one of the terms of the settlement and burned down the parliament buildings as they were throwing rocks at the then governor general. The unfortunate result we see here most Monday mornings, because if it had not been for that unfortunate event the capital of this great country would have remained in Montreal and would not have been in Ottawa, and we would not have to hurry back from our week end vacations, as so many of us now do.

But, Mr. Speaker, there is a second type of landmark which I think is a more creditable type. It is the great landmark erected by good legislation, by advanced laws; landmarks which mark the product of political wisdom, social insight and crystallized national conscience. I submit, Mr. Speaker, that we never had a more constructive example of a great forward social advance than we have in this bill to which this parliament is giving third reading today.

I would note as examples of this great constructive social advance the setting up of the principle of responsible government after that tragic uprising of 1837; the great process of confederation that joined the scattered colonies of British North America into the Dominion of Canada in 1867. Perhaps the greatest political achievement of all, Mr. Speaker, was the final winning of equal status, I think mostly fought through, or certainly started by, the great statesman Mackenzie King, but finished by another great Canadian statesman, Right Hon. R. B. Bennett, who of course crossed the t's and dotted the i's of the statute of Westminster.

I think, Mr. Speaker, a great constructive forward event perhaps not sufficiently appreciated by a sufficient number of people in this country was the rounding out of the concept of the Dominion of Canada by the admission of Newfoundland into this federation after so many years of separation. But I submit, Mr. Speaker, that no greater social landmark has ever been erected in the Dominion of Canada than we are helping to erect today in the final passing of national health insurance legislation. I am candid enough to say that all parties in the Dominion of Canada have contributed to this happy event.

On the estimates of the Minister of National Health and Welfare last year I made some remarks, and I think all hon. members will recall that the hon. member for Winnipeg 82715-213i

Health Insurance

North Centre described what I said at that time as a provocative speech. Naturally I was trying to show that Premier Frost and the Ontario government were in the key position in Canada to make or break the success of this thing. Having said that most frankly at that time-and I think I was right when I said it-I should like to say right now that I think the enlightened Conservative premier of Ontario, Hon. Leslie Frost, has rendered a great national service in helping to break the log jam that had existed in regard to hospital insurance.

I am sure my hon. friends of the Social Credit party will agree with me to this extent, but they will also agree that I am not an indiscriminate admirer of all of the acts of the Social Credit government of British Columbia. However, at this time I want to pay my tribute to Premier Bennett and the Social Credit government of British Columbia for having been the first in Canada to come under this agreement, and thereby set an example for all the rest. That applies not only to Premier Bennett but to the Social Credit premier of Alberta, Mr. Manning, and the C.C.F. premier of Saskatchewan, my good and honourable friend Tommy Douglas; and last but not least in the line-up so far is that rather remarkable statesman, that ambidextrous politician, that man of many parts, Hon. Mr. Smallwood of Newfoundland, of whom we have heard much good already and of whom much more good will be heard before we are finished.

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

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

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

Mr. Knowles:

Will the hon. member permit a question?

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

Elmore Philpott

Liberal

Mr. Philpotl:

At the end of my speech. But, Mr. Speaker, in paying our tribute to those who have contributed in playing the role, shall we say, of a proper lieutenant, let us also be honest enough and candid enough to give the proper share of credit to the master builder of this social advance, the Minister of National Health and Welfare.

I am frank to admit that the Minister of National Health and Welfare was not the first man to think of the principle of health insurance. I find that as far back as 1906 another great Liberal had this to say, and I will give my authority later:

The state must increasingly and earnestly concern itself with the care of the sick and the aged, and, above all, of the children. I look forward to the universal establishment of minimum standards of life and labour, and their progressive elevation as the increasing energies of production may permit.

I do not think that Liberalism in any circumstances can cut itself off from this fertile field of social effort, and I would recommend you not to be scared in discussing any of these proposals just because some old woman comes along and tells you they are socialistic. If you take my advice, you will judge each case on its merits. Where you

Health Insurance

find that state enterprise is likely to be ineffective, then utilize private enterprises, and do not grudge them their profits.

That was uttered in 1906 by a very great Liberal who is still a great Liberal, Right Hon. Winston S. Churchill, the venerable British statesman. But, Mr. Speaker, if we want to find the true architect of the great reform which we are helping to enact today we would of course have to go to one of the greatest, and I think one of the most unappreciated, leaders of our century. I refer to our late and revered prime minister, Right Hon. Mackenzie King. I believe this country and for that matter any other country has never produced a more constructive statesman than Right Hon. Mackenzie King.

When I was trying to prepare some notes for this particular effort today I sent to the library to obtain a copy of Mr. King's book, which lays the foundation of this legislation of which we are completing one stage today, and I was forcibly struck by what an unappreciated man is this great figure whom Bruce Hutchison so aptly called "the incredible Canadian". He was not only a masterly statesman but he was a very smart politician, as people in this chamber well know; and he was a great social planner.

When I think of all the great social and political thinkers of the past two or three centuries-Adam Smith, who left such a deep mark on the thinking of the eighteenth century; others like Marx, who left such an unfortunately deep mark on the thinking of the nineteenth century; and other social thinkers of the twentieth century like John Maynard Keynes and Major Douglas-I submit that Right Hon. Mackenzie King was a deeper political thinker and a greater politician than any one of them. In substantiation of that statement, Mr. Speaker, I defy any man to read Mackenzie King's masterly work entitled "Industry and Humanity" in the light of what we are enacting today and not agree with my conclusion that Mr. Mackenzie King saw very clearly a whole generation before his time the relationship that exists between what I have called in this chamber the welfare state as against the warfare state.

Let us consider these words of Mackenzie King which appear in the prefatory note of his great work "Industry and Humanity" completed on October 3, 1918, more than one month before the end of the first great war. Mackenzie King concludes the foreword to his book with these words:

One of the aims of the book is to show that the war, in the last analysis, is but the expression upon a world scale of conflicting forces also at work in the relations of industry.

Mr. Mackenzie King in the book to which I have referred develops at some length the

thesis posed by Louis Pasteur in the year 1888. On page 5 of Mackenzie King's "Industry and Humanity" he quotes Louis Pasteur as follows:

Two contrary laws seem to be wrestling with each other nowadays: the one, a law of blood and of death, ever imagining new means of destruction, and forcing nations to be constantly ready for the battlefield-the other, a law of peace, work, and health, ever evolving new means of delivering man from the scourges which beset him. The one seeks violent conquests, the other the relief of humanity. The latter places one human life above any victory; while the former would sacrifice hundreds of thousands of lives to the ambition of one.

I submit, Mr. Speaker, that the master architect of the legislation which we are considering in its final stages today was our great leader Mackenzie King, who at page 345 of his book to which I have referred and in regard to the legislation we are passing today said:

Social insurance, which in reality is health insurance in one form or another, is a means employed in most industrial countries to bring about a wider measure of social justice-

I submit the following words to the consideration of my good friend the hon. member for Winnipeg North Centre:

-without, on the one hand, disturbing the institution of private property and its advantages to the community, or, on the other, imperilling the thrift and industry of individuals.

It is for this reason, Mr. Speaker, that I submit it was Mr. Mackenzie King who was the great architect of all the welfare measures which have come into being over the past generation, since the time he wrote that book.

In answer to the rather shallow and somewhat unfair criticism, shall I say, which we sometimes hear from people who say, "Well, if Mackenzie King wrote it all down in a book in 1918 why have we not accomplished these things long ago", I would reply that Mackenzie King was writing a book about a system which had to have time to be built up step by step and stage by stage. As he himself said before the introduction of the national health grants, which have done so much to make possible firm foundations for the act we are passing today, those health grants were the necessary preliminary to health insurance when we were able to attain it.

The legislation we are passing today rounds out one more full circle of the admirable legislation which has been built up stage by stage in this country, complementing such measures as family allowances, which were not always approved by all parties in this house; old age pensions, which certainly were not instantly approved by all parts of this great dominion, for I believe it took 11 years before all the provinces would agree to come in even on a partnership basis; old age

security measures, crippled civilian pensions and all the other welfare measures with which we are all familiar. I submit that the greatest advance of all is the advance we are registering today in the enactment of the first stage of national hospital insurance.

I say that, Mr. Speaker, despite the fact that perhaps even in the next few months there will be sharp things said in the heat of the election. The very lifeblood of a democracy is elections, and elections are meaningless unless there are keen debates and sharp controversies. I would think everyone in this chamber would know that the last man in this country to shrink from controversies is our Minister of National Health and Welfare.

Those of us who have sat here even for the past four years and have seen day after day the sharp razor-edge questions asked by the hon. member for Winnipeg North Centre and others of our genial friend the Minister of National Health and Welfare cannot help but admire the skill with which the minister has replied. I have sat here and enjoyed the expression on the face of the hon. member for Winnipeg North Centre as the minister has replied to his questions. The hon. member for Winnipeg North Centre thinks up the sharpest and most difficult questions he possibly can; and when he receives one of the masterly, politically brilliant answers from the Minister of National Health and Welfare there is no man in the entire house who enjoys it more than the hon. member for Winnipeg North Centre, because he is watching a master politician at work.

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

William Gourlay Blair

Progressive Conservative

Mr. Blair:

Such innocence. Do you see the halo?

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

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

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

Mr. Knowles:

Is that intended as a compliment or not?

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

Elmore Philpott

Liberal

Mr. Philpoii:

I regard it as a supreme compliment because I regard politics as the supreme science, or art, the art of good government, which is what the Minister of National Health and Welfare gives us.

Now, Mr. Speaker, there is one more point I would like to deal with before I come to the objection raised in the amendment of the hon. member for Winnipeg North Centre. I regard this plan for national hospital insurance as a superb example of good government. I believe it represents the completion of eight years of concentrated effort by as expert a staff as there is in any country of the world, a staff at all times inspired, led, and directed by the Minister of National Health and Welfare.

There are some good things in this legislation which I believe even the hon. member for Winnipeg North Centre and those other

Health Insurance

ringside critics of the opposition have not yet perceived. Take for instance the provision that at some appropriate time it is planned to extend the diagnostic services to people being treated in out-patient clinics. I happen to have taken a very modest part in the laying of the foundations of the Canadian arthritis and rheumatism society, of which I was the first president in British Columbia. We would never have been able to support our work but for the health grants we were able to obtain by the co-operation of this government, but we did start, I think, without a single dollar of financial resources.

That society has now extended its work so that according to the official report which I have before me, in the last year 6,784 people received direct services from the society's professional staff. The total number of patients at the end of December 1954 was 2,012. Four thousand seven hundred and seventy-two cases were opened for service during the year and 3,983 cases were closed, leaving 2,801 cases on the rolls at the close of 1955. These figures do not include patients treated by the Saskatchewan division, for which comparable statistics are not available. It goes on to say that 81.7 per cent of the cases closed during the year were classified as either being much improved, that is to say 40 per cent; or improved, 41.7 per cent, while 18.3 per cent were classified as unimproved or worse at the time of closing.

The point I want to make is that arthritis and rheumatism are diseases which cause untold damage and misery to literally hundreds of thousands of people in this country. We have demonstrated time and time again that if arthritic patients get proper diagnostic service in the first stages of their disease, its worst crippling effects can be almost entirely avoided. And I would like to stress that it is clearly implied in the bill as it stands that at the right time in the future these diagnostic services will be made available.

I come now to the small difference among the members of this house about one measure. I think even the hon. member for Winnipeg North Centre will concede me at least this much, that I am just as anxious to get this legislation through soon and effectively as he is. I submit to him and to the other members who have made this objection that after the most serious contemplation of the point raised, it is my opinion that they are wrong, first on a matter of principle.

I believe our Prime Minister laid down a profoundly important principle in what I now call the St. Laurent formula, with the extension into the provincial field of federal services which have never before been given

Health Insurance

to the provinces. We who sit in this house know very well that the British North America Act was written with the conditions of 100 years ago in mind; we know that the needs of our country require constant change and progress. We know, as the hon. member for Saskatoon has so often pointed out, that there is need in so many cases for more federal participation in things which have hitherto been considered exclusively the responsibility of the provinces.

As the Prime Minister so clearly pointed out on another matter a couple of years ago, any government in Ottawa takes a very great moral responsibility when it decides to spend in one province public money raised from the taxpayers of all Canada, in a field where the jurisdiction is not clear; where there has been no change in either the letter or the spirit of the British North America Act, and where there has been no general agreement upon such steps. I submit that in the St. Laurent formula, as I call it, in which the Prime Minister insisted that we were going to make these changes in the spirit of the constitution, there must be first agreement by the parliament of Canada to go ahead, and second there must be agreement by a majority of the provinces of Canada representing populations constituting more than a majority of the people of the country.

A point was raised by the hon. member for Winnipeg North Centre which was amplified by the hon. member for Red Deer, when he said he could see no good reason for objecting to going ahead at this time when there are only five provinces signed up. I submit there is a very excellent reason and that it is the soundest of all reasons in a great federal union such as Canada. We would, in my opinion, be setting an extremely bad and extremely dangerous precedent for the future.

Since we have been considering a lot of hypothetical cases here today, let me put this hypothetical case to the hon. members of the house. I happen to believe in, as I know some other members of this house do, not only the kind of old age pensions we now have but also compulsory contributory annuities along the lines of the United States social security scheme. I might mention that all members of the all-party committee in 1950, including the hon. member for Eglinton, agreed unanimously that this dominion did not as yet have the constitutional jurisdiction to move into that field.

Now let me ask hon. members this question. Suppose we were so ill-advised as to accept this amendment which has been moved, I think without due thought, by the hon. member for Winnipeg North Centre.

Suppose we should say that we ought to make these changes in the spirit of the constitution, if the Dominion of Canada and a certain number of provinces representing the majority of the people of Canada agreed; let me show you what a dangerous position we would be getting ourselves into. We would be getting ourselves into the position where at some future time, when a dominion government wanted to make some change, all that would be necessary would be for that government, plus the two big governments of Quebec and Ontario, to put that change through.

Therefore I suggest that the St. Laurent formula is a far superior formula, and one which will stand for all time.

I come now to the tail end of my speech. I was trying to think of some way to make this matter clear to the hon. member for Winnipeg North Centre and I consulted some of my friends who sit around me. They said to me: "It is too bad that Stanley is not a poker player."

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

Gordon Minto Churchill

Progressive Conservative

Mr. Churchill:

How do you know?

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

Elmore Philpott

Liberal

Mr. Philpott:

I think that both the hon. member for Winnipeg North Centre and myself perhaps suffer from the handicap that we are not as expert at that game as some other members of the house.

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

An hon. Member:

Is the minister a poker player?

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

Elmore Philpott

Liberal

Mr. Philpott:

One hon. member who sits very close to me and who is one of the best liked and shrewdest members of the house said to me: "If you want to explain to Stanley why he is betting on something that is so unsound tell him that he is betting on a four-card straight, a bobtailed straight and tell him that a full house beats a bobtailed straight any time."

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

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

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

Mr. Knowles:

Explain.

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

Elmore Philpott

Liberal

Mr. Philpott:

I will be glad to explain. So far as the Minister of National Health and Welfare, who has brought this whole plan to the stage it has now reached, is concerned, the hon. member for Winnipeg North Centre should not try to tell his grandmother how to suck eggs.

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

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

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

Mr. Knowles:

Is the minister my grandmother?

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

Elmore Philpott

Liberal

Mr. Philpott:

If anybody can tell the Minister of National Health and Welfare how to surmount obstacles, I should like to see the man. I call the Minister of National Health and Welfare-I know he will take this as a compliment-a mixture of Machiavelli and maple syrup. When there was a log jam at the United Nations and for six full years

they were not able to break the blockade and overcome the snag we all know what they did-they called in the Minister of National Health and Welfare and he put through a package deal.

What we are putting through today is a package deal. We on this side of the house certainly cannot accept the unwise amendment moved by the hon. member for Winnipeg North Centre because he is betting on a bobtailed straight and the Minister of National Health and Welfare is out for a full house. The hon. member for Winnipeg North Centre can get some of his colleagues to explain to him what I mean when I say that the Minister of National Health and Welfare is out to lay down a royal flush whereby every one of the ten provinces from coast to coast will be taking part in this great scheme.

This is probably the last speech I will make in the house before dissolution.

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

Some hon. Members:

Hear, hear.

Topic:   HEALTH INSURANCE
Subtopic:   AUTHORIZATION OF PAYMENTS FROM CONSOLIDATED REVENUE FUND
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April 10, 1957