April 30, 1974

LIB

Prosper Boulanger (Assistant Deputy Chair of Committees of the Whole)

Liberal

The Acting Speaker (Mr. Boulanger):

That will be considered a question of consideration rather than a question of privilege.

Topic:   GOVERNMENT ORDERS
Subtopic:   RAILWAY RELOCATION AND CROSSING ACT
Sub-subtopic:   PROVISION FOR PLANNING, ACQUISITION OF LAND, GRANTS, GRADE CROSSING ASSISTANCE
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PROCEEDINGS ON ADJOURNMENT MOTION


A motion to adjourn the House under Standing Order 40 deemed to have been moved.


HEALTH-SHORTAGE OF MEDICAL MANPOWER-GOVERNMENT ACTION TO ALLEVIATE

PC

Philip Bernard Rynard

Progressive Conservative

Mr. P. B. Rynard (Simcoe North):

Mr. Speaker, I want to follow up a question I asked the minister regarding the inequity in medical services across Canada and the methods of overcoming this problem. The minister was kind enough to state that he would talk to his counterparts in the provinces, as they were reviewing the matter, and would let me know what can be done. Surely this is the eleventh hour in respect of this matter and the answer should have been given long ago.

There are many areas across Canada without doctors. There are areas where nurses alone do the medical work hundreds of miles from any doctor. How can the academics come up with an intelligent answer when only the provincial registrars know the number of doctors under registration?

The establishment does not even know how many doctors are in active practice, part-time practice, occasional

April 30, 1974

locum-tenens, administrative positions, research and teaching, part-time teaching and practice, how many specialists are doing only referral work, private practice and referred work. How, then, can we know if we have too few doctors or too many doctors when we have no national figures compiled by the Canadian government or the Canadian Medical Association? In addition there are no official figures on the increasing number of older people in Canada, which means an increase in the workload on the doctors. Who has the figures in this regard?

The federal government brought in medicare to establish equality of medical care to the rich and the poor across this land. Just as in so many good intentioned schemes on the part of the government, the poor have suffered the most. The government has done nothing to cure uneven geographical distribution of medical care.

Medical schools have not dealt adequately with inequality of medical care and its uneven geographical distribution, or the over-production of specialists at the expense of training general practitioners.

Medical schools could have made dedication instead of academic qualification the number one requirement. Academic qualification means very little in respect of the kind of doctor who will be turned out in the field. In any event it would seem that a higher priority is given to academic answers than to judgment and dedication in the work field.

The powers that be state that without the immigrant doctors we would be worse off than we are now because many of these doctors serve in outlying areas. We certainly would be in an unthinkable position without all the foreign doctors who come to our shores to practice. However, more Canadian boys and girls should be admitted to our medical schools. We should not be stealing students from India and other countries which are much worse off than Canada. We should not be rejecting our own boys and girls. What kind of foreign aid is this? The Canadian students could be admitted and their fees paid, if necessary, if they are willing to serve in those areas which require medical practitioners. The minister says that we have over-production. He said that we have one doctor for every 633 people. How does he know this?

We are told that in the province of Ontario 25 per cent of all registered doctors do not practice medicine. I challenge the minister to give us accurate figures on how many doctors nationally are engaged in full general practice, part-time practice, administrative positions, government employment and so on. Yes, we have those academics who believe they can solve the problem by removing local hospital boards and administrators and putting in regional directors, by establishing clinics of about five persons and by establishing a quota system and a 24-hour service. What a day the bureaucrats would have and how expenses would skyrocket with doctors on salary administered by the bureaucrats! The bureaucrats apparently do not realize that in the area where I live and practice one can now see a doctor 24 hours a day just by going to the emergency department of the local hospital where a specialist is in attendance when necessary.

Adjournment Debate

How will the situation change? Only by having more doctors. Let us return to the statement that there is an ample supply of doctors in cities. If this were the case then medical services would be competitive and the people would have a free choice in respect of doctors. After all, the taxpayers are paying for these services and have that right of choice. If you do not consider your doctor to be satisfactory then you should have the opportunity to change to another. I always hope this will be the situation. After all, the taxpayer is a little closer to the doctor. He is not out of touch, as the Minister of National Health and Welfare (Mr. Lalonde) and the provincial ministers appear to be.

In an effort to increase the number of graduates the federal government should pay the university so much per graduate and increase the amount paid in respect of every medical student who practices in an outlying district. This would increase the output per university. The university could give the doctor a temporary certificate which would become permanent after five years of general practice. After all, courses at medical schools are expensive. The expense per year in respect of Ontario universities is about $6,000 per student. Five years in general practice would equip a doctor very well, and if he cared to go on he would become a much better specialist. Alternatively, loans could be considered for a needy student which would be forgiven in five years if he qualified. Or a straight tax incentive could be given.

If the government is as concerned as it appears to be, the problem of supplying Canadian graduates to understaffed medical areas could easily be accomplished by these methods, instead of by pushing the immigrant doctor into these areas. After all, it is not quite fair to take from the underdeveloped countries the cream of their crop because such people are badly needed in these areas. India has one doctor for every 6,000 people. I wonder what the situation would be had we not sponged all these immigrant doctors, one half of whom have come here in the last ten years. The influx of doctors from outside Canada between 1950 to 1960 was one-third of our registered doctors per year, and from 1960 to 1970 it was one-half of our registered doctors. Just a little over one-third were registered to practice in the province of Ontario. Those doctors on the whole practised good medicine. Most were from Great Britain, the USA, Europe and India, and they made a great contribution not only in the teaching field but also in the actual field of practice.

Next to immigrant doctors from Great Britain was the American physician. We will always remember names like Penfield from the United States, Austin from Guys Hospital, Miller from Edinburgh and Melvin from Aberdeen- all great teachers. What would medicine in Canada have been without them?

Let us stop this arbitrary nonsense now. We have grown up. The Canadian people have a right to know facts, not platitudes or guesses. They are paying the cost, something that sometimes the academic establishment forgets. People expect to be able to see a doctor when they are sick. They have that right.

Topic:   PROCEEDINGS ON ADJOURNMENT MOTION
Subtopic:   HEALTH-SHORTAGE OF MEDICAL MANPOWER-GOVERNMENT ACTION TO ALLEVIATE
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LIB

Otto Emil Lang (Minister of Justice and Attorney General of Canada; Minister responsible for the Canadian Wheat Board)

Liberal

Hon. Otto E. Lang (Minister of Justice):

Mr. Speaker, as the hon. member knows, the question of the supply of physicians is one presently under active consideration. It

April 30, 1974

Adjournment Debate

was discussed at the recent meeting of federal and provincial ministers of health in February, at which time a consensus was reached on the necessity of achieving certain objectives: first, a better balance between the requirements for physicians of all kinds, taking into account the role of allied health workers and the two sources of supply, Canadian medical schools and immigration; second, to give a higher priority to Canadian students aspiring to a medical career and to Canadian graduates wishing to practice in Canada; third, to promote a better distribution of physicians' services, particularly to serve rural areas as well as to relate specialty training to community needs. In the minister's view, well co-ordinated measures must be taken to achieve these objectives, considering the particular circumstances in each province.

Some of the options to be considered include physician quota systems by regions, restrictions on immigration, and appropriate medical school enrollment. Physician quota systems are being considered by certain provinces in conjunction with other measures to regulate the supply of health manpower.

The hon. member is also undoubtedly aware that new regulations have recently been drafted which have the effect of limiting applications in occupations which have no general demand for them in Canada unless they are destined for pre-arranged employment, or there is a demand for this occupation in a certain location in Canada and the applicant agrees to proceed to that location.

The federal government will be meeting with the provinces to determine better their manpower needs in the medical profession. We believe that, for the present at least, these measures can do much to assure a proper flow of doctor immigration and protect opportunities for our own qualified Canadians entering this profession.

Subsequent to the hon. member's question of March 27 the Minister of National Health and Welfare (Mr. Lalonde) received the report on the planned intake of Canadian medical schools that he mentioned in his answer of that date. Between 1966 and 1972 the number of physicians graduating from Canadian medical schools rose from 881 to 1,292. This increase in output is expected to continue until 1976, and then level off at nearly twice the output of 1966; that is, at over 1,700 medical graduates per year.

Further, we are creating a reserve capacity to produce many more physicians if necessary. It is estimated that by 1982 the output of Canadian medical schools could be increased by another 23 per cent, to cover 2,100 physicians per year.

Having said all this, may I conclude simply by stating that the government shares the hon. member's concern that all Canadians have access to equitably distributed and high quality health services at reasonable cost. For this reason it is actively involved with the provinces in the review of physician supply.

Topic:   PROCEEDINGS ON ADJOURNMENT MOTION
Subtopic:   HEALTH-SHORTAGE OF MEDICAL MANPOWER-GOVERNMENT ACTION TO ALLEVIATE
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GRAIN-REQUEST THAT FEED GRAINS BE MARKETED BY WHEAT BOARD

NDP

Lorne Edmund Nystrom

New Democratic Party

Mr. Lome Nystrom (Yorkton-Melville):

Mr. Speaker, on August 1 of this year feed grains in this country will be going on to the open market. This is a policy put forth by

the Minister of Justice (Mr. Lang) who is in charge of the Wheat Board, despite the fact that the farmers on the prairies are very much opposed to it.

The wheat pools, the Farmers Union, the farmers involved in the co-operative movement, and most farm organizations across the prairies are opposed to putting feed grains on to the open market. In the last few months I have received many letters on this topic, many petitions signed by farmers in my area, as well as having many conversations with individual farmers, not just from my area but from right across Saskatchewan.

On April 2 of this year I moved a motion in this House that had been suggested by many of the farm organizations, namely;

That this House support the principle of orderly marketing and instruct the government to maintain the Canadian Wheat Board as the sole marketing agency for feed grains.

Unfortunately that motion did not carry. Later in the agriculture committee members of my party put forward another amendment, namely that the committee go on record as advocating that the Canadian Wheat Board be the sole marketing agency for feed grains in this country. Every single Conservative member of the committee voted against the motion and that is why I am pursuing this matter tonight.

A few days after April 2, I put a question to the Prime Minister (Mr. Trudeau) and the Minister of Justice (Mr. Lang). To the Minister of Justice I put the question that, in view of the fact that prairie farmers were so upset with his proposal would he withdraw it and maintain the Wheat Board as the sole marketing agency for feed grains? He would not give that commitment despite protests from the prairies. When I asked the Prime Minister, he refused to intervene on behalf of farm organizations and prairie farmers.

I have a letter from the hon. member for Lisgar (Mr. Murta) which puts the Conservative Party on record as encouraging the minister to put feed grains on the open market.

1 think this matter is of vital importance to the farmers of this country who fought for years for the formation of the Wheat Board so that it could act as an orderly marketing agency for them. It took a war, a depression, hard times and many, many farm bankruptcies to get the Wheat Board established. Now we are seeing feed grains taken away from it. Farmers are afraid that this might be the first step toward dismantling it and be the end of orderly marketing in this country.

That is something that this party will not tolerate and that farmers' unions, wheat pools, co-operative organizations and almost all farmers on the prairies will not tolerate. They remember the open market, the grain exchange, the grain buyers in Winnipeg and the fluctuations in price. They would sell grain at a particular price, and when they got it to market the price had changed. They do not want that again. They do not want to work to a gamble by dice in the casino. It is immoral that such a thing should happen and this party will not tolerate it.

April 30, 1974

People who play the commodities market speculated in flax and rapeseed last year. I read of one person who said that by investing $1,000 in flax and buying on margin, a million dollars could have been made in the last year and a half. This is the sort of thing that will happen if feed grains are placed on the open market. The farmers do not want to see that happen after all their work.

I think, Mr. Speaker, it should be the policy of this country to market all grains through the Canadian Wheat Board. Why should farmers have to speculate? They are already speculating with the weather. We should have orderly marketing in this country, which in the long run would help the consumer because of stability of production and prices.

My time is up, Mr. Speaker, so I will anxiously await the Minister of Justice's announcement that he is going to withdraw his proposal and keep the Canadian Wheat Board as the sole marketing agency for feed grains. I know that is what he is going to say so I shall take my seat.

Topic:   PROCEEDINGS ON ADJOURNMENT MOTION
Subtopic:   GRAIN-REQUEST THAT FEED GRAINS BE MARKETED BY WHEAT BOARD
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LIB

Otto Emil Lang (Minister of Justice and Attorney General of Canada; Minister responsible for the Canadian Wheat Board)

Liberal

Hon. Otto E. Lang (Minister of Justice):

Mr. Speaker, I regret to see the hon. member for Yorkton-Melville (Mr. Nystrom) fall into a pattern that was fairly common to certain members of his party in days gone by, those who associated themselves with the leadership of such groups as the National Farmers' Union in the Saskatchewan area and who discredited that movement. The technique is the one adopted by the Stalinists and the followers of Hitler, that of putting up a straw man and then saying that is a horrible thing and everybody should be against it.

The hon. member says we should have feed grains in the open market notwithstanding the fact that we have pointed out time and time again that there is no question whatever that the bulk of feed grains, as presently being marketed, will be changed in any way. The bulk of feed grains will be sold through commercial channels under Wheat Board control. They will continue under Wheat Board control. The Wheat Board will exercise the full and complete control which is evident now.

He also says he is in favour of orderly marketing. I tell him I am as much in favour of orderly marketing as he is; but I will do more about it-I will see it happen. Any proposal in relation to feed grains that we have made includes maintaining full control of the Wheat Board over the movement of the grain. The board must also know where the grain is going, from where it has come, and, therefore, what can be done with respect to marketing. We shall make sure that the board retains full knowledge.

The hon. member asks farmers whether they are in favour of orderly marketing. I say that I am as well. He says that the Wheat Board should be retained as the sole marketing agency for Canadian grains. I say to him that it is not now the sole marketing agency, never was, and never can be, as neighbour will sell to neighbour and grain will move about on the prairie regions.

That is the source of his problem. He and the NFU socialists who lead that organization-I refer only to the leaders and not to the rank and file-agree that equity in pricing is desirable in our current handling of feed grains. They then put forward proposals which will not create equity in pricing. We are looking at certain proposals and have looked at modifications of them in the year of discus-

Adjournment Debate

sions which is just coming to an end. We are at the point of decision. We are looking at proposals which will maintain in full the control of the Canadian Wheat Board over the export market, the quality of grains, and over bulk movements in the market. The board will retain the control it presently exercises. The only thing in question is the domestic market and how to obtain equity in pricing within the prairie region for farmers who buy grain there to feed animals and for farmers in other parts of the country who also buy their grain there.

The hon. member says he knows how farmers stand on this issue. Quite recently he raised another issue. He was sure he knew where the farmers stood on it. I am referring to the rapeseed plebiscite. He thought it was a simple, straightforward issue. It turned out that the farmers were seriously divided, but, on balance, were in favour of maintaining what he called the open market system for that particular product.

I do not doubt that one or two years from now the hon. member will admit that all his fears and doubts meant nothing, as usual, and will have to agree that we produced the policy which is best for the prairie farmer and for Canadian agriculture as a whole.

Topic:   PROCEEDINGS ON ADJOURNMENT MOTION
Subtopic:   GRAIN-REQUEST THAT FEED GRAINS BE MARKETED BY WHEAT BOARD
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AIR CANADA-ALLEGED LAY-OFFS OF EMPLOYEES IN VIOLATION OF COLLECTIVE AGREEMENT-GOVERNMENT ACTION

PC

A. Daniel McKenzie

Progressive Conservative

Mr. Dan McKenzie (Winnipeg South Centre):

Mr. Speaker, my remarks tonight will be brief and to the point. They centre on Air Canada's recent violation of their collective agreement with the unions. I am referring to the lay-off early last week of some 4,800 employees by Air Canada as a result of the airport firefighters' rotating strikes. While this strike is now over and most Air Canada employees are back on the job, the lay-off was in violation of a collective agreement and is indicative of the disastrous manner in which this government deals with strikes in the public sector.

On April 23 in this House I asked the Minister of Transport (Mr. Marchand) the following question concerning the lay-offs:

As Air Canada has laid off some 4,800 employees and these lay-offs have been labelled as a complete violation of the collective agreement, what action will the government take to rectify the violations of the agreement by Air Canada management?

The parliamentary secretary to the minister answered, in part, that:

-the unions involved can follow the grievance procedure provided for in the collective agreements. However, Air Canada does not feel it is in violation of any provisions of the collective agreements.

This is the type of answer one would have expected from a government whose transportation policy is, to quote the minister, "a mess". What the government is saying is that if the unions do not like the lay-offs they can file a grievance. What sort of an answer is this for the 4,800 who were laid off without pay? This attitude almost precipitated another strike in Canada, this time by air line pilots. The pilots felt, as do I, that Air Canada's lay-offs were a contravention of a collective agreement.

As many of us know, Air Canada employees, especially those at Dorval, have much to grieve about. With regard to

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April 30, 1974

Adjournment Debate

these layoffs, Air Canada's management clearly ignored the longstanding principles and precedents relating to seniority, resulting in a violation of the contract; that is, in staff reduction of the lead mechanics, without normal options. For example, article 12 on page 53 of the agreement states clearly as follows: first, that the principle of seniority shall be based upon the principle of preference consideration for employees with long service and, second, that seniority privileges, as governed by the provision of this article, shall be a factor in reduction of forces. As well, page 65K of the agreement states that staff reductions will be made strictly on the basis of seniority.

This brief examination of parts of the agreement shows the longstanding principles related to seniority of Air Canada employees. The basic union agreement has over the years guaranteed the protection of seniority rights, and any new interpretations deriving from letters of understanding, and so on, clearly should not override basic principles. Something is wrong when men with over 30 years' experience are laid off. Such layoffs create morale problems. Surely poor morale is a sufficient .enough problem within Air Canada. This loss of rights only serves to further lower morale and standards.

Furthermore, the addendum letter of understanding, page 93 of the agreement, was a result of union concern over discriminatory practices; for example, the company retaining managers and clerical staffs on duty while reducing union staff. I am not saying that there should never be layoffs. Obviously they are an economic necessity in certain strike situations, but they should be conducted according to agreements and longstanding practices. One has to wonder why only union employees were laid off and not foremen and supervisors. Is there a two class system of layoffs? If so, what protection does this give the little guy?

That which I have discussed to this point is, as I mentioned, merely a small example of the manner in which Air Canada and the entire government handle labour relations. Witness the recent rash of strikes by public employees. First the airport firefighters, then the river pilots and postal workers. While the pilots did not walk off the job, the air traffic controllers plan to very shortly.

What does all this say? Well, to me and most other Canadians it says that a definite communications barrier exists between the federal government, the Treasury Board and their employees. This is especially pronounced in the Department of Transport. The government does little to deal with labour problems until it is confronted with a crisis situation-for example, strike. Then the government acts.

In light of this recent plethora of strikes and the accompanying government inertia, the idea of a public interest disputes commission is indeed a sound one. No wonder, it is a Conservative idea. The present methods of dealing

with labour problems in the country seem to have failed dismally, for we are guaranteed at least one postal, air or rail strike annually. Such a commission could deal with labour disputes not only in the government sector but in all areas of public services. The feasibility of establishing such a body should be given serious consideration by the government so as to minimize these labour disputes that tend to disrupt the country.

Topic:   PROCEEDINGS ON ADJOURNMENT MOTION
Subtopic:   AIR CANADA-ALLEGED LAY-OFFS OF EMPLOYEES IN VIOLATION OF COLLECTIVE AGREEMENT-GOVERNMENT ACTION
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LIB

Joseph-Phillippe Guay (Parliamentary Secretary to the Minister of Transport)

Liberal

Mr. Joseph-Philippe Guay (Parliamentary Secretary to Minister of Transport):

Mr. Speaker, may I say in the first place that the government does not negotiate agreements between Air Canada and its employees, and never has done so. The Canadian Airline Pilots Association and the Canadian Airline Flight Attendants both have collective agreements with Air Canada. As a consequence of a walk-out by firefighters, Air Canada was faced with the situation of having a great many employees with no meaningful work to perform. Under these circumstances, certain employees were placed on off-duty status.

A similar situation occurred in 1971 when the air traffic controllers went on strike. Air Canada has recognized the hardships created for its employees by third party strikes and has established a policy which has the full support of the Canadian Airline Employees Association and the International Association of Machinists and Aerospace Workers.

Briefly, the policy is that, in the event of a third party strike affecting Air Canada's operations, where meaningful work is available the company would try to keep employees on the payroll. Where employees had to be placed on off-duty status, the company would, on application by an employee, grant a week's compensation which could be repaid by cash, payroll deductions over three months, subsequent overtime, or, in some cases, vacation credits. This policy would be reassessed at the end of each succeeding week of a third party strike. Neither CALPA nor CALFA find this arrangement satisfactory, as they feel the company should continue to pay salaries in such a situation.

Provision is made within the respective collective agreements for third party arbitration of differences. This is an inherent part of the collective bargaining process. Air Canada, on legal advice, is convinced that it has not violated any of the provisions of the collective agreements. If the employees in question are convinced that Air Canada is incorrect, their agreements provide a means of recourse to them, one which is not only legal but is their right.

I am sure all members of the House will agree that where collective agreements are in force between Crown corporations and their employees, and when well-established means of settling differences are available, it would not be proper for the government to intervene on behalf of either party.

Motion agreed to and the House adjourned at 10.39 p.m.

Wednesday May 1, 1974

Topic:   PROCEEDINGS ON ADJOURNMENT MOTION
Subtopic:   AIR CANADA-ALLEGED LAY-OFFS OF EMPLOYEES IN VIOLATION OF COLLECTIVE AGREEMENT-GOVERNMENT ACTION
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April 30, 1974