March 26, 1968

LIB

Allan Joseph MacEachen (Minister of National Health and Welfare; Minister of Amateur Sport; Leader of the Government in the House of Commons; Liberal Party House Leader)

Liberal

Mr. MacEachen:

Mr. Chairman, I have a very brief statement to make in this connection. As the hon. member for Peace River mentioned, I had the occasion over the week end when out west to meet a number of groups of Indians, and my words had a very calming effect on the groups I met there. I hope they will have the same effect this afternoon on this committee of supply.

I wish to make a very brief statement. Hon. members and others have raised the question of services in the divisions of Indian and northern health, and I promised hon. members that I would review the situation and make a statement. I would like to do so at this moment.

The government has had an opportunity to review the matter of Indian and northern health services raised by hon. members and others. As has been mentioned before, the funds made available for these services in the estimates for the fiscal year 1968-69 are greater than those of the current fiscal year. I can also assure hon. members that services now being provided will be continued in the coming fiscal year and will not be permitted to deteriorate.

If in the coming year it becomes apparent that the level of medical services currently being provided cannot be at least maintained, taking into account population growth and rising costs, the government gives the assurance that funds will be provided for this purpose. My officials have been asked to review all directives to ensure that it is quite clear that in the next fiscal year individual Indians and Eskimos will receive the same 27053-508*

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Supply-Health and Welfare consideration and treatment by the department with regard to health services as they have received this year.

The Indian and northern health services directorate is checking with its regional directors to ensure that any directives which may have emanated from them and which do not pursue this policy will be amended so that any misunderstanding about this matter will be quickly cleared up.

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PC

John George Diefenbaker

Progressive Conservative

Mr. Diefenbaker:

Mr. Chairman, the minister referred to any directives that did so emanate?

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LIB

Allan Joseph MacEachen (Minister of National Health and Welfare; Minister of Amateur Sport; Leader of the Government in the House of Commons; Liberal Party House Leader)

Liberal

Mr. MacEachen:

Yes.

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PC

Walter Gilbert Dinsdale

Progressive Conservative

Mr. Dinsdale:

Mr. Chairman, we were interested to hear the statement of the minister on this important subject. I think the first question asked about this matter was on March 7 last. At that time I suggested to the minister that if it was his intention to curtail health services to our native Canadians, as had been indicated from many sources, he was placing the wrong stress on priorities. We also urged that the minister should make a statement immediately so the confusion that had been referred to by the hon. member for Northwest Territories and the confusion that was reflected across the country might have been dissipated immediately. Unhappily the minister has chosen to wait until the eve of the implementation of the cut-backs before making a statement that will help to clarify the issue.

[DOT] (3:20 p.m.)

My question arose because of a debate that had taken place in the council of the Northwest Territories during the latter part of February, when members of council as well as the director of northern health services, Dr. Butler, indicated that substantial cut-backs in health services were contemplated. This course was being pursued in the face of the drastic health problems confronting our Eskimo and Indian population and was bound to bring serious protests such as those we have witnessed during the past few weeks.

The minister's statement today was brief. I only hope it has removed some of the specific that were outlined in the directives that were sent from the Department of National Health and Welfare across the country. I want to read excerpts from some of these directives, and I want to get the minister's assurance that the policy has been changed; because I think if we are going to deal with the protests that have been aroused, not only in this house

8066 COMMONS

Supply-Health and Welfare but amongst the Indians and groups of citizens in every walk of life, we have to have assurance that the recommendations that went out from the offices of the health and welfare department have been rescinded.

I should like to refer to a directive that went from the Department of National Health and Welfare Edmonton office on March 4, which reads in part:

The basic policy of our department is that there is no statutory federal responsibilty for our department to provide funds for personal health care service for Indian people.

Is this still the attitude of the minister? As the right hon. member for Prince Albert pointed out yesterday, while there might not be a statutory provision there is certainly provision in the treaties, particularly treaty No. 6, the so-called medicine chest provision, which has operated until this directive was issued a few weeks ago.

Then the memorandum went further and stated:

This year our resources to assist Indian people toward payment of medical care costs, hospitalization, transportation to and from medical centres, pharmacist accounts is being reduced and our department will assist only in those instances where the Indian people can demonstrate that they do not have private resources, cannot obtain assistance from their band or from a provincial welfare or health agency.

I trust that the statement the minister made today has reversed that decision, which is quite contrary to the principles of justice and morality in so far as the treatment of our first citizens is concerned. In this memorandum there was even a note with regard to tuberculosis, one of the great killers of our native population. I read this from page 2:

With respect to control of tuberculosis, our instructions read as follows:

From April 1, 1968, it will be necessary to share increasingly with provinces the control of tuberculosis.

The memorandum even applied to mental

illness, and reads:

It will be necessary from April 1, 1968, to cease active case finding among Indians.

Then on page 3 of the memorandum I read this:

Budgetary controls will be imposed on physicians providing services to Indians. It is to be hoped Indian people resident on reserves would not continue to be excluded from the Alberta health plan, as I understand they are at the present time.

The implication there, of course, was that the burden is to be thrown to the provincial governments. In addition I received a directive that went out to each of the chiefs of the

DEBATES March 26, 1968

band councils across the country. These directives contained the same specific instructions that health services were to be curtailed. The one that went out from the district national health and welfare office in Manitoba on March 6 reads as follows:

Due to the financial crises faced by the government of Canada, it has been necessary for parliament to curtail the funds allowed to the Department of National Health and Welfare.

I hope that impression has been corrected as well, because it was not parliament but the government of Canada that was curtailing the funds. As the hon. member for St. Hyacinthe-Bagot reminds me, it was the Liberal government. These are the specific instructions that were received by the Indian chiefs and councillors across the country which resulted in the unhappy protests we have heard all across the nation during the last few days.

The latest meeting took place in Winnipeg last night. I had intended to be present at that meeting, where an overflow crowd of more than 200 citizens met to protest the government's action. As I say, I had intended to be there but unfortunately the N.D.P. filibuster in Ottawa kept me away from that meeting. We were not able to get first hand information of what took place, but radio reports indicated the people were protesting as strongly as the various Indian groups across the country over the inequity and injustice of this change in health program.

What happened, of course, resulted from the typical lack of communication between the various departments of this government, as well as the complete failure to consult with the provincial authorities upon whom the minister and the Department of National Health and Welfare were trying to unload the burden of health care for Indians. This is one of the great areas of neglect in dealing with our native Canadians at the present time, the lack of communication and the lack of consultation.

I asked the minister of Indian affairs if he had been aware of the directives, but he knew nothing about them. He is the minister responsible for protecting the interests of our Indian and Eskimo population. It is little wonder, Mr. Chairman, that the Indians persist in their view that a credibility gap exists and that the white man speaks with a forked tongue. I hope we might open consultations and negotiations with the provinces so that if there is a desire on the part of Ottawa to shed this traditional obligation, it will not be done in an arbitrary way but will be the

March 26, 1968 COMMONS

result of what the Prime Minister used to call co-operative federalism. Consultation has been repeatedly requested by the premiers of Alberta and Manitoba. I hope that to avoid further fiascos of this kind, meetings between Ottawa and the provincial governments on Indian affairs will proceed at the earliest possible opportunity.

[DOT] (3:30 p.m.)

I urge too that the committee on Indian affairs be reconstituted so that it can come to grips with some of the problems that have been brought into the limelight as a result of this piece of government foolishness during recent weeks. The parliamentary committee on Indian affairs has not met for over a year. It was supposed to be reconstituted, and the promise was made that it would be reconstituted at an early date in the session now under way. I have a Canadian Press dispatch before me dated March 18, 1967 which reads as follows:

The Commons Indian affairs committee agreed Friday to call officials of the St. Lawrence Seaway Authority before it to answer Indian complaints that the seaway did not live up to agreements under which it acquired reserve land nearly 10 years ago.

Chairman Milton Klein (Lib.) Montreal-Cartier, said that if complaints the committee heard last month were true, and he thought they were, "this situation is scandalous.*'

The article went on:

Most of Friday's session was spent discussing the need for visits to Indian reserves across the country.

As I say, Mr. Chairman, this article was written over a year ago. Yet we wonder why the Indian population is disenchanted.

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CCF

Thomas Speakman Barnett

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

Mr. Barnett:

Mr. Chairman, would the hon. member permit a question in connection with the remarks he has just been making? Does he not recall that the committee actually had laid on a schedule of visits to reserves in British Columbia which for some unknown reason was suddenly cancelled?

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PC

Walter Gilbert Dinsdale

Progressive Conservative

Mr. Dinsdale:

Yes, Mr. Chairman. This is the point I am making. If the Indians resort to whining and complaining, as the minister of Indian affairs accuses, then they have every reason to do so because their fundamental problems are not being dealt with by the present government.

Although there were no specifics we were pleased to hear the minister's announcement.

I only hope the action that follows will not result in further accusations of "double talk"

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Supply-Health and Welfare on the part of the government, which has led to the spirit of disillusionment and which, as I have already intimated, causes our Indian friends to say: "White man speaks with forked tongue".

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PC

Philip Bernard Rynard

Progressive Conservative

Mr. Rynard:

Mr. Chairman, I should like to address a few questions to the Minister of National Health and Welfare. First of all, in view of the fact that national medicare is coming into operation on July 1 I should like to know what is going to happen in regard to medical care for Indians in those provinces that are financially unable to go along with the federal medicare policy. For example, is the government of Ontario going to have to pick up the tab for all care for Indians after July 1? Under the present OMSIP regulations all Indians in the province in receipt of social security would qualify for medical care which is paid for by the provincial government. Those on low incomes

and the Indian is not a high income earner-would also have to receive subsidized medical care or the province would have to pay for the care in full. This is going to throw an additional burden on all provinces that do not adopt medicare if the minister does not pay to the province the medical care insurance premium in that province.

In addition, what is going to become of all the Indians in the province of Ontario, or in any other province for that matter, cared for by doctors who are under contract with the federal government? Incidentally, may I compliment the minister on the cheap rate he has obtained for most of these medical services. I recall one doctor telling me that he received the princely salary of $250 a month. This covers all services except those that are highly specialized. In this particular case the. reserve was 17 miles from the town where he' lived and he had to cross two miles of water-to get there. He answers calls seven days a-week, emergency calls, office calls and so on. There are almost 500 Indians on the reserve so it really constitutes a village. If in some [DOT] way or other the minister discontinues these [DOT] contracts, what will become of the Indians?

Second, does the minister not feel that in a great many cases these doctors should have * some relief? For example, they have no holidays, they cannot accrue time and they are [DOT] not on pension. In the province of Ontario OMSIP costs about $10 a month. If you divide 500 Indians into a salary of $250 a month in t the case I have cited, I think you will agree. .

March 26, 1968

Supply-Health and Welfare Mr. Chairman, that they are getting their services fairly reasonably. Figured out, it probably amounts to less than half the cost of medical insurance. I think the minister should consider this matter and discuss it with the provincial ministers of health in those provinces that are not implementing medicare.

On the whole, Mr. Chairman, hiring these doctors not on a fee for service basis but on a monthly salary has proven quite efficient. It has guaranteed the Indians services that they would probably have difficulty obtaining in view of the scarcity of medical doctors in Canada today. However, when the day comes for these doctors to retire or they are retired by the government, how is the minister going to guarantee medical services to Indians who are living a long way from any town? Even people living in cities today emphasize over and over again the difficulty of getting a doctor on a Saturday, Sunday or holiday. Most of them have to go to the hospital itself for treatment. This is certainly a backward step in the provision of service to the Indian people.

I should also like to ask whether the minister has had any communications with or met the presidents of medical associations, the universities, the medical schools and the provincial ministers of health about what can be done to keep medical shools in operation during the summer holidays. Canada is short about 2,000 medical practitioners, and this is a crisis indeed. There is simply no good reason why the Canadian people should put up with the medical services that exist today. As I say, over and over again we hear of people having to go to hospital emergency departments in order to get care at all.

I say this is not good enough. The Canadian people are financing our universities and medical schools, and I suggest they should receive the services to which they are entitled. If we took advantage of closed circuit television in our teaching schools we could produce one and a half times the number of doctors graduating today by operating our medical schools all summer. You just cannot blame the overworked doctor for the service people are getting today.

[DOT] (3:40 p.m.)

I am bringing this to the minister's attention because we have a medical crisis, and when one sees what has been done during the last three or four years one realizes that nothing much has been done to solve it. I also wish to ask, what is to happen to our Indians? Who is to pay their OMSIP premiums?

[Mr. Rynard.l

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NDP

Thomas Clement (Tommy) Douglas

New Democratic Party

Mr. Douglas:

Mr. Chairman, it is a tribute to the social conscience of the Canadian people that I am able to point out that not for a long time have we seen such a public outcry from all sections of the Canadian population resulting from the announcement that there are to the serious curtailments of medical services to Indians. I have received telegrams from the heads of the churches, from doctors, and from those who are interested in Indian and Eskimo problems. It is quite apparent that Canadians have been disturbed by the reprehensible action taken by the Department of National Health and Welfare in contracting or reducing the health services which are available to the native people of Canada.

I do not know of any question on which the government has waffled and dissembled more. Last Friday, in the legislature of Alberta, the premier of the province read a communication he had received from the Prime Minister in answer to a wire which Mr. Manning had sent to the Prime Minister complaining about the curtailment of medical services to the Indians. I have not been able to get the Prime Minister's reply, although I asked for it to be tabled. On orders of the day the Prime Minister intimated what was in the telegram. According to press reports the telegram intimated to Mr. Manning that everything would be cleared up to Mr. Manning's satisfaction, and to the satisfaction of everybody who was protesting the curtailment, once the Minister of National Health and Welfare had made his statement, and that the minister had not made his statement because he was being held up by members of the New Democratic party who were preventing the minister from making his statement.

Every member of the house, including the Prime Minister, knows perfectly well that when supplementary estimates are before this committee the government at its discretion can call any department it wants to. At any time last week the government could have called the Department of National Health and Welfare and the minister could have made his statement. The fact is that the minister has delayed making his statement, hoping that the storm would die down and that he could allow the department to pursue its original, intended policy of curtailing these services substantially.

The minister has never come clean with the house on this matter. Having been asked questions by the hon. member for Brandon-Souris and Northwest Territories and by

March 26, 1968

myself on Thursday, March 14, the minister said, as recorded on page 7608 of Hansard in the upper left hand corner:

I should like to say that the funds available for health services in the north for the forthcoming year will be as great as in the preceding year if not slightly greater.

Of course, to some extent that statement is misleading because the minister failed to take account of three factors: first, that in that period of time the cost of providing health services had increased substantially; second, that the native population had also increased considerably and, third, that the department, as I am told, overspent its expenditures for this purpose by about $400,000. For the minister, therefore, to assure the house that nothing unusual was happening because, to use his words, "funds available for health services in the north for the forthcoming year will be as great as in the preceding year if not slightly greater", does not answer the question whether the government is planning to curtail health services to our native people. If the minister had made the kind of statement then that he has made now he would have saved the native people of this country a good deal of heartache, the members of the house a good deal of time, and many in Canada much concern.

The minister's statement needs clarifying. Let there be no doubt about what the Department of National Health and Welfare intended to do. The minister was asked to table the directives that were sent out and he said he would consider that. I do not think he has tabled them yet. If he has, I have not seen them. The directives are interesting. I have in my hand a directive dated March 6, 1968, from the Department of National Health and Welfare, medical services branch, Manitoba zone. It is signed by Dr. K. Bridge, Dr. J. P. Harvey, Dr. E. Otke and Dr. A. Y. Eng. It begins by saying:

The federal government, as you know, has been forced to reduce many of its programs and the resources available for health services for Indian people has also been greatly reduced.

It goes on to say:

-we must ask all those Indian people and bands who have a source of income to pay for their own health services, namely:-doctors, druggists, hospitals, and to pay for their own transportation. If an Indian person cannot pay for such services, he should first of all request his band for assistance; if such assistance is not available from the band or provincial welfare agencies, the Indian person must obtain a statement from the welfare agency to the effect that he actually requires assistance to pay for personal health services and present this

Supply-Health and Welfare statement to a doctor, druggist, hospital before receiving service, otherwise the Indian person will be billed for such services.

Farther down the directive goes on to say:

Indian bands that have funds must make their own arrangements for the purchase of treatment services either by paying local physicians directly or by arranging to take part in medical insurance programs.

Another paragraph says:

The bands should establish health committees whose duty it would be "to determine what Indians of the band are medically indigent". These committees should meet at regular intervals in order to keep their records of indigents up to date.

The last paragraph but one says:

Medical services branch staff will continue to assist Indian people in improving their health as much as we are able within the limits of the reduced resources allocated to us. We would be remiss if we did not point out the problems facing us today and in the future.

Another letter sent out by the Manitoba zone of the medical services branch, Department of National Health and Welfare, also under date of March 6, 1968, says:

Due to the financial crises faced by the government of Canada, it has been necessary for Parliament to curtail the funds allowed to the Department of National Health and Welfare.

This is an interesting observation to come from that department because, so far as I know, parliament has not curtailed the funds. On March 6 parliament had not even discussed the matter of funds for this purpose. So the responsibility for any curtailment of funds must be borne by the government.

I have in my hand a memorandum sent out last November 23, 1967, signed by the director of Indian health services in the Department of National Health and Welfare. It is addressed to the chief, and says:

[DOT] (3:50 p.m.)

Dear Chief:

There has been some misunderstanding as to what Indians in our zone are entitled to medical services. I would like to make it quite clear that our Indian health services are for indigent Indians only.

Farther on the letter says:

Any indigent treaty Indian who has left the reserve for a year no longer comes under our jurisdiction. He becomes the responsibility of the provincial welfare department.

The curtailment of services has not been confined to cases where no indigency is involved. It has been applied to personnel and also to the facilities which provide health

March 26, 1968

Supply-Health and Welfare services for the population. Dr. Gordon Butler, who appeared before the council of the Northwest Territories as a witness, is quoted as saying the following on February 20:

Severe cuts are necessary to make up $250,000 of wages for medical personnel. Federal grants fall into two categories-operations and salaries. A shortage of funds for salaries means money will have to be trimmed from existing operations. Every frill will have to be cut out from the program. Under the present budget I have to treat 175 T.B. patients with the same money I would need for 115. Trimming will take place through closure of a ward in Inuvik; reduction of the medical staff at Inuvik and Frobisher; withdrawal of a dental officer at Inuvik; closure of the Fort Laird nursing station; elimination of 75 per cent of visiting specialists.

I think the minister owes the committee a much more definitive statement than the one he has made this afternoon. Are these cuts referred to by Dr. Gordon Butler to be reinstated? Does the government still intend to close a ward in Inuvik? Is there to be a reduction of the medical staff at Inuvik and Frobisher? Does the government intend to dispense with the dental officer at Inuvik? Is the Fort Liard nursing station to be closed? Has the government decided to reduce visiting specialists by 75 per cent?

I can understand why the council of the Northwest Territories was thrown into consternation when these statements were made by Dr. Butler. I think the council, the members of this committee and the public generally will want some assurance from the minister this afternoon that the curtailment of services will now be reversed and that there will be no contraction of medical and other health services to the native population.

I was glad to hear the minister say that the same standard of services will continue. I want to be clear about what the minister means by this. Is he saying that the same level of services will be maintained in the coming fiscal year as in the past? This is what we need to know. The hon. gentleman told us that as much money will be spent or even slightly more. That does not answer the question. Estimates for a health service cannot be considered on the same basis as estimates for running an office; they cannot be estimated accurately to the dollar. What the department has to do is to determine the level and extent of the health services it will provide and attempt to estimate the cost of providing such a service. But if an epidemic occurs, or there is a greater amount of illness in that year than in another, the estimate must be revised.

Those who provide health service for Indians and Eskimos in the northern part of Canada cannot say to applicants: We are sorry, we have used up all the money the government has allocated; you must help yourselves.

I notice that in the Winnipeg Free Press of March 11 Mr. Shaun Herron, in one of the articles he wrote on this matter, said:

The word is out to officers of the service that anyone responsible for exceeding budget figures will be in serious trouble. It should be understood what this means in human terms.

I agree with Mr. Herron. If it is true that the word has gone out from the department to the government's health services in the north that people will be in trouble if they exceed the amount of money allocated, then the government will find itself in serious difficulty having jeopardized the lives of many of the people who are committed to its care. The government may allocate certain funds to this service and it is true they may be as large as they were in the previous year. But if a child is sick, if a community needs increased medical services, if a greater amount of hospitalization is required, then the medical officers of the department cannot say to the Indian and Eskimo people: We are sorry but we have used up our allotment for the year; you will have to get along as best you can.

Allocations for health and medical services must be flexible. They must approximate what the department thinks is needed, but I wish to get an assurance that apart from any sums of money the minister may be asking parliament to approve today there will be no diminution in the level of service, no reduction in the standard of service, no discontinuation of any of the health services which have been in operation in the past.

The directive I read a few moments ago raises a much more fundamental question, one which we have no time to discuss fully today. It is: what is the responsibility of the federal government with respect to medical care for Indians? The right hon. member for Prince Albert raised the matter yesterday on the orders of the day when he spoke of treaty No. 6 under which the Indian people consider they were given a commitment. This commitment was that a medicine chest would be kept at the house of each Indian agent in case of sickness among the Indians. They have taken this as a commitment that all treaty Indians are entitled to the health services which they require.

March 26, 1968

[DOT] (4:00 p.m.)

I know there has been a great deal of dispute as to the legal obligation which rests upon the federal government with respect to medical care for Indians, but I submit, that there is also a great deal of legal dispute with reference to land claims, and these have not been settled. I reject the federal government's right to settle either of these legal questions unilaterally. Until the matter of land claims has been settled and the people of this country are satisfied that the Indians have been treated fairly and equitably with reference to their land claims, the government has no right to change the rules with respect to health services for the Indian people.

We all hope the day will come in Canada when the Indian people will have received sufficient education and will have been absorbed into the mainstream of Canadian life, will have jobs and incomes and will have health services like other people by being able to make their contributions to a provincial or national medicare plan. Until that is true, until the Indians are able to earn wages comparable with those received by their fellow Canadians, until they are able to finance their way, I maintain that the federal government has a very definite responsibility with respect to health services for the Indian people.

If the government is hard pressed for money it seems to me the last place that there ought to be any curtailment or any cheeseparing is in carrying out our obligation to provide health services for the Indian and Eskimo people. The government, of course is trying to curtail expenditures, and that is understandable. Last night the Minister of Transport said that those who voted against the tax bill automatically voted to cut expenditures. I do not want to get into a debate on that but I remind the government that the members of this party put proposals before it which could have raised more money than it is raising at the present time without increasing taxes on the income tax payer. We said that by implementing some of the recommendations of the Carter report the government could actually have cut income taxes by making some of the freeloaders pay the taxes from which they are now exempt.

If the government has to curtail expenditures there are other places it might look than at this rather meagre sum which we are spending on our native people. The other day the government indicated that we are going

Supply-Health and Welfare to overhaul and re-equip four destroyers at a cost of some $50 million apiece. This is an item that might be re-examined in the interests of economy. Further, one strongly suspects that some of the military planes we are purchasing from the United States will be obsolete when we get them. The government might re-examine these purchases. Some $215 million is going into that expenditure.

The point I want to make is that if the government must reduce expenditures, in the name of decency and in the name of justice the last place we ought to reduce them is in our expenditures for the most defenceless and helpless group in our society, the Indians and the Eskimos whom we have treated shabbily enough in days gone by. Let us not make them the first victims of any economy measure the government must carry out.

Therefore, Mr. Chairman, when the minister is replying I ask that he give us the assurance his statement this afternoon means that there will be no reduction in the level of services or the standard of services and that there will be no closing or discontinuance of any of the health services and health centres that are now in operation. If we can get that kind of assurance then I think all the furore that has been kicked up over this problem will have been worth while. I think that the people in all parts of Canada who have protested against this proposed curtailment in health services for our native people will feel their protests have not been in vain.

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RA

Henry P. Latulippe

Ralliement Créditiste

Mr. Latulippe:

Mr. Chairman, I will be brief.

Indian affairs have been discussed as well as improvements to be made in our economy to meet more and more the needs of the Indians. We are not against the Indians but we would like to help everybody.

I feel, Mr. Chairman, that during this session and since the Liberals took office, not much thought has been given to the family which is the basis of our society. No protection has been given to the family but it has been taxed in all kinds of ways: sales tax on building materials and goods, direct and indirect taxes. The family is faced with one of the most serious problems in our history: the lack of money.

Mr. Chairman, the rate of family allowances, established at $6, $7 and $8 per month in 1944, has remained at approximately the same level, while the cost of living has

March 26, 1968

Supply-Health and Welfare multiplied by four, eight, twelve and even fourteen.

Mr. Chairman, it is illogical that in a country like Canada which produces in abundance, a reasonable purchasing power cannot be distributed to the families, which would enable them to live, to flourish, to get what they need as far as housing, food and clothes are concerned. Families are deprived because they do not have the necessary purchasing power, and instead of being provided with more, it is deprived even more.

The goods are there, but the families who go into the stores to buy cannot use up all that is produced. In fact, stores restock themselves faster than families can empty them.

Mr. Chairman, it is illogical, in a country such as ours, to do nothing for the families, the mothers and especially society's future generations.

If there were no families, Mr. Chairman, we would have no federal, provincial or municipal governments, nor any institutions. All those institutions are in existence because there are families. Do you think that society, the government and institutions would continue to exist without the family? We should lead the way and enable the family to live decently, with the help of all the technological progress accomplished in past years.

Mr. Chairman, twenty years ago, in 1948, the Canadian government could carry on its administration with a $2,195 million budget, while paying a $6 monthly family allowance for children six years old. Today, in 1968, even with a budget of approximately $10 billion, a child of six is still entitled to a $6 monthly allowance. Since our budget has increased fivefold, family allowances should be raised accordingly to $30 monthly. I am adamant on this point, it is only logical. It is also one of the prime requirements of social justice and the recognition of human rights, as recommended by the Universal Declaration of Human Rights adopted by the United Nations on December 12, 1948, that is, twenty years ago.

Mr. Chairman, 23 years ago, that is in 1945, Canadian national production amounted to $12 billion. Today, in 1968, it is worth $68 billion, that is more than five times that of 1945. In 1945, we paid $6 a month in family allowances for a child six years of age in his normal home. Today, in 1968, we are still paying $6 a month for a six-year old child, in his normal home, $60 or $80 a month in a foster home; and over $120 a month in an orphanage or in a reformatory.

In 1944, the year the government adopted the Family Allowances Act, the members' indemnity was $4,000 a year, including expenses. Today, that indemnity has reached $12,000 a year, plus an additional $6,000 for expenses, while six-year old children still get the same rate in family allowances, that is $6 a month. We deemed it advisable to increase our indemnity and our allowances with the increase in national production, but we have neglected to do the same thing for family allowances.

Mr. Chairman, in 1944, our old people in need could receive $20 a month from our governments. Today, that amount can now reach $105 a month, that is five times more.

[DOT] (4:10 p.m.)

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LIB

Herman Maxwell Batten (Deputy Speaker and Chair of Committees of the Whole of the House of Commons)

Liberal

The Chairman:

Order. I feel I have allowed the hon. gentleman to go as far afield as I can permit him to go. I think the remarks he is making now could not be considered appropriate under vote 20c. Vote 20c has to do with medical services. Perhaps the hon. member for Compton-Frontenac would confine his remarks to that particular topic.

Topic:   DEPARTMENT OF NATIONAL HEALTH AND WELFARE
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RA

Henry P. Latulippe

Ralliement Créditiste

Mr. Latulippe:

Mr. Chairman, I thought we were considering the estimates of the welfare branch. If we are dealing with medical care, that is something else again.

I shall therefore sit down, reserving the right to rise and speak on families in due time.

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NDP

David Orlikow

New Democratic Party

Mr. Orliliow:

Mr. Chairman, I do not know whether the minister is standing behind the curtain or has left on urgent business. I should like to tell him, however, that while we do not intend to prolong the debate unnecessarily the two-minute statement he made in which he assured hon. members that everything was of the best in all possible worlds is just not good enough. The directives which have been placed on the record by the leader of our party and by other members must have come from some place. Since top officials in charge of health services have said to Indian patients, to officials and to people involved in health services that the funds are to be cut and that past practices are not to be followed, before this item is passed the minister must explain in detail precisely why these statements have been made. If, as the minister says, there has been no cut-back in the amount available for

March 26, 1968 COMMONS

health services and indeed there is more money available than there was last year, why have the specialists who work for the department and the Indian patients unanimously come to the conclusion that in fact there is to be a sharp reduction in health services? I wish to advise the minister that despite the fact he is busy with other matters we will not let this item pass until we have specific answers.

I do not want to repeat everything that has been said but I do think we should take a look at the situation. At the present time government expenditures are going up very sharply and a former minister of justice, Mr. Chevrier, is on a special mission on behalf of the Secretary of State for External Affairs to the French speaking nations in Africa where he is promising very sharp increases in the amount of aid which Canada will give to those countries. I am not objecting to these increases in aid. I believe that Canada, one of the wealthiest countries in the world, ought to do more than it has done and is doing. However, at the same time that this policy is being followed we hear from the most important officials of the minister's department that the policy of the government, I presume on instructions from the minister, is that these health services are to be cut.

Let us keep in mind that we are talking about people whose health standards are not similar to those of the Canadian people as a whole. The health standards of these people are as poor or worse than those of the people who live under the worst conditions in Asia or Africa. Let us keep in mind also, as Dr. Butler, the regional director of northern health services in Edmonton, said in November, 1967, that we are dealing with a group of people where the death rate among children under one year of age is 63.8 in 1,000 persons while the death rate among these children for all of Canada is just 23.6. In other words, the death rate is three times as high in respect of these people than in respect of the people of Canada as a whole. I should like to quote what Dr. Butler said in an interview as reported in the Edmonton Journal of November 17, 1967. Despite what the minister told us, he said:

Health services in the Northwest Territories will have to be curtailed despite rising rates of disease and death.

The report continued:

He said a lack of federal funds "makes nonsense of any constructive planning" and that it appears health services "will be faced with this continuing problem for years ahead."

DEBATES 8073

Supply-Health and Welfare

The doctor stated a rate of 108 Eskimo infant deaths per 1,000 births bothers him and, although it has reduced appreciably over the past four years, it is still three times higher than the Canadian average. The territorial and federal governments share the cost of northern health services upon ratification of the federal territorial finance committee.

He said that shortages of federal funds occurred each year of the 1962-67 plan and that his office tried to avoid a repetition of the problem. A paragraph in the existing plan insuring federal funds had been deleted by the financial committee.

[DOT] (4:20 p.m.)

I think the minister should explain how Dr. Butler is wrong if he is. After all, Dr. Butler is the senior health officer of the department in the Northwest Territories. Although this has already been referred to, I should like to quote one line from a directive issued by the Manitoba zone of the Department of National Health and Welfare, medical services branch, on March 6, 1968. When we look at these directives we are not surprised that the minister constantly refuses to put them on the record. They make a mockery of everything he has said today and are an indictment of this so-called left wing Liberal who wants to give progressive leadership to the country as a whole. They show that there is no difference between a left wing Liberal such as the minister and a right wing Liberal minister. They are all the same when the chips are down and they cut what they are told to cut.

This is what that directive says in part:

Due to the financial crises faced by the government of Canada it has been necessary for parliament to curtail the funds allowed to the Department of National Health and Welfare.

The minister says this is not true. Where did this directive originate and who authorized it? Let me read one sentence of a letter dated November 23, 1967, from Dr. S. Mallick, the zone director of Indian health services of the Department of National Health and Welfare, to the Sioux Lookout Indian Hospital. He said:

I would like to make it quite clear that our Indian health services are for indigent Indians only. It means those people who cannot provide for themselves, who have no jobs.

That has not been the policy of the department up to now. Up to now the department has provided medical services for many Indians who were not completely indigent. The minister says there is no change in policy. How did Dr. Mallick come to write this letter?

I have here a letter from the Manitoba zone of the medical services branch of the Department of National Health and Welfare dated

March 26, 1968

Supply-Health and Welfare March 6, 1968, addressed to all chiefs and councillors of Manitoba Indian bands. In part it says:

The federal government, as you know, has been forced to reduce many of Its programs and the resources available for health services for Indian people has also been greatly reduced.

In light of these statements how can the minister say that this has not happened? Let me put on record some information I received from a source which I am satisfied is reliable. I have not been able to get the original but I am assured that this statement is not exaggerated. I am informed that the director general of the medical services branch, Dr. Procter, wrote a long brief directed to hospitals and sanitaria which look after Indians who have tuberculosis, of whom there are a large number. In this brief Dr. Procter issued the following instruction and if it is true, and I have every reason to believe that it is, I cannot think of a more heartless or damaging statement. He said that if patients in the hospital are just spitting a little blood it is all right to send them home. Just give them some medicine to tide them over. That is a fine way in the year 1968 for the Canadian government to treat the original inhabitants of this country. These people have been sent to hospital for treatment for tuberculosis.

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LIB

Allan Joseph MacEachen (Minister of National Health and Welfare; Minister of Amateur Sport; Leader of the Government in the House of Commons; Liberal Party House Leader)

Liberal

Mr. MacEachen:

Mr. Chairman, I should like to ask the hon. member whether he will accept responsibility for the accuracy of that statement as a member of this house.

Topic:   DEPARTMENT OF NATIONAL HEALTH AND WELFARE
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NDP

David Orlikow

New Democratic Party

Mr. Orlikow:

Mr. Chairman, we have been asking the minister in the house-

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LIB

Allan Joseph MacEachen (Minister of National Health and Welfare; Minister of Amateur Sport; Leader of the Government in the House of Commons; Liberal Party House Leader)

Liberal

Mr. MacEachen:

Will he answer the

question?

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NDP

David Orlikow

New Democratic Party

Mr. Orlikow:

I will answer the question. We listened to the minister and the minister can listen to me for a moment.

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LIB

Allan Joseph MacEachen (Minister of National Health and Welfare; Minister of Amateur Sport; Leader of the Government in the House of Commons; Liberal Party House Leader)

Liberal

Mr. MacEachen:

Answer the question. You haven't the guts.

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NDP

Thomas Clement (Tommy) Douglas

New Democratic Party

Mr. Douglas:

Any man who has been running away from this question for the last three weeks should not talk about guts.

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NDP

David Orlikow

New Democratic Party

Mr. Orlikow:

Mr. Chairman, the question we are discussing today was raised several weeks ago, I think first by the hon. member for Brandon-Souris. It has been raised virtually every day since then and it is now more than two weeks since the matter became a topic of discussion inside and outside the house. We have asked almost every day that

the minister table these directives and every day we have been told that at an appropriate time the minister would make a statement explaining everything.

Today the minister made a two-minute statement. Did he table the directives from which the leader of this party quoted and from which I have quoted today? We have quoted from these directives which the minister knows he cannot table because they are too damaging to himself and to his government. The minister asks whether I will take the responsibility for the accuracy of the report to which I referred. Let me refer the minister to the fact that I obtained this information from the same people who gave us the directives from which we have quoted. I told the minister I could not quote directly from the report because the person who gave me the information said he did not have a copy of it.

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LIB

Allan Joseph MacEachen (Minister of National Health and Welfare; Minister of Amateur Sport; Leader of the Government in the House of Commons; Liberal Party House Leader)

Liberal

Mr. MacEachen:

Will the hon. member answer the simple question whether he will accept responsibility for the accuracy of the statement he attributed to Dr. Procter?

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March 26, 1968