2000-2001 Budget / Budget Speech |
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III. Major increase in health care resources
The rewards of our sound economic and financial management are thus being used according to the wishes of the people, one of which, and an important one, is a substantial increase in the monies earmarked for health care. We did it last year and we will do it again this year in order to maintain universal access without compromising the excellent quality of the services provided.
This means that we must heed the priorities created by demographic change and that we take into consideration improvements in medical technology and methods of treatment. We must also ensure that our health care dollars are spent as efficiently as possible.
(a) Injection of $2.7 billion in the health and social services sector
I am announcing today a major increase in resources devoted to health care and important measures to increase the system's efficiency. We are injecting an additional $2.7 billion immediately and, at the same time, implementing a series of measures to reinforce the workings of the health and social services network in the short and the medium term.
My colleague, the Minister of State for Health and Social Services, who will have greater resources to support the energy and talent she brings to the overwhelming responsibilities of her position, will announce the details of these measures over the next few days.
Greater funding for the network
An amount of $862 million is earmarked for network institutions to ensure adequate financing and enable them to balance their budgets.
A further $877 million is being allocated to finance the increases in salaries and other operating expenses that are required to maintain existing services. These services are now and will remain among the best and most complete in the world.
Increase and develop services
Today, we are going yet a little further in improving public services. We are providing an additional $747 million to increase public services and to develop new ones. In particular, we are financing the increased cost of the prescription drug plan and developing the services of Héma-Québec and services to identify and indemnify hepatitis C victims. We must also cut back on waiting lists, increase accessibility and improve network services.
Of this total, $21 million will be devoted to youth services alone. The Minister for Health, Social Services and Youth Protection, who is himself one of Québec's greatest experts on the matter, will use these funds to improve services for young people, particularly for foster families, youth centres and community organizations working to prevent suicide and substance abuse.
Acquisition of new equipment
In recent years, advances in technology have given rise to substantially improved methods of providing services. It is therefore important to invest in new equipment, especially in areas where the equipment has a direct impact on the accessibility of services. Today's Budget includes an additional $200 million for purchasing equipment in the health and social services sector.
This major investment program for medical equipment will make it possible to treat a greater number of patients in radio-oncology and hemodynamics for instance, and to improve the quality of care through the use of more modern equipment.
(b) A more efficient network to meet the needs of the people
All serious-minded people agree that money alone will not solve the problems of our health system. Not only must we make a substantial increase in the resources devoted to health care, we must also see that those resources are managed more efficiently and more rigorously.
My colleague will unveil the measures to be taken to improve the performance of the health care network in the near future.
(c) Dissipating the confusion surrounding the federal trust account
While on the subject of health, I would like to dissipate the confusion surrounding the $841 million deposited by Ottawa in a Toronto-based trust account.
It has become a Kafkaesque story, where reality and fantasy are intertwined, one feeding on the other. Allow me, as Minister of Finance, to remain in the realm of reality. Three points have been brought up.
- First, the matter of transparency. I would like to point out that it was not Québec who decided to put the money in trust, but Ottawa. And there was no secret about it. It was clearly indicated in last year's federal Budget. It was also Ottawa which entrusted the management of this money to a subsidiary of the Toronto-Dominion Bank.
At the express and immediate request of my department, the money was invested in Québec, in Hydro-Québec and Québec government securities. It is absolutely false to claim that the money is lying dormant in Toronto. As for the yield, it is about 5%, the going market rate for short-term investments.
It was also Ottawa that suggested withdrawals of $482 million in 1999-2000, $240 million in 2000-2001 and $119 million in 2001-2002. I hastened to incorporate these amounts in full into my Budget last year. Both Ottawa's and Québec's budgets were therefore transparent in this respect. You will all recall that Québec immediately denounced Ottawa's unfair treatment of Québec. I even gave the press, in the days following the federal Budget, a document in which the supposedly hidden funds were clearly indicated, in black and white. So everything was transparent.
- So why didn't we withdraw the $482 million as per the timetable suggested by Ottawa?
The answer is clear in today's Budget. Tax revenues were much higher than expected in 1999-2000. As a result, we were able to inject $782 million into the health care system immediately. This was much more than the $482 million in the federal trust account. So the health sector did not receive less money because of our decision, it received more. Had I acted differently, our accounting rules would have obliged us to put the money toward our debt rather than into the health sector, which was not what we wanted to do.
It will be remembered that all the experts approved this prudent policy. Now that the Budget information is available and accessible to the man in the street, I am sure everyone will better understand the choices we made, which were based on logic and good management.
Since the federal government seems to have taken a liking to making payments into trust accounts -- it has just announced that it will make more this year -- I am going to try to persuade my federal colleague at least to deposit the money in a financial institution chosen by Québec rather than in Toronto. I hope he will agree.
We would then withdraw the money in keeping with the interests of the people of Québec. There is now $1.4 billion in the trust account. I am announcing in advance that this money will be spent, and it will be spent in good time. Withdrawals will be made as follows: $420 million this year, $765 million next year, and $256 million the year after that. To withdraw all at once money that is supposed to cover three years, as some people have suggested, would be highly irresponsible and would contradict the most elementary principles of prudence. For that matter, almost all the provinces, Ontario and British Columbia first and foremost, are following this same line of conduct, dictated by simple common sense, and have not been criticized in the least for doing so.
It is only in a few weeks then, on April 3, 2000, the first working day of the new fiscal year, that we will withdraw the first $420 million, which will go into the health-care sector rather than toward paying off the debt. I believe, in my heart and in my soul, that that is what the common good and sound management require and I hope that my decision will be understood and approved.
- Finally, is it right to criticize Ottawa's health-care funding policy as all the provincial premiers do, Québec's first and foremost?
Here is another self-evident fact. Not only is there no guarantee that Ottawa's latest injections of funds into health care and social programs will recur, but also these funds represent only a drop in an ocean of needs and are dispensed with an eyedropper. All the premiers have been wearing themselves out decrying this situation for years.
We need to put into perspective the $1.4 billion Ottawa spends and the $159 billion Québec spends for the same period. In fact, the recent federal injection of funds would cover three days of operation in Québec's health and social services system.
We must keep our sense of proportion when assessing the central government's contributions and constantly bear in mind that the recurrent cutbacks by the federal government deprive us of $5 billion a year, every year. Québec alone spends seven times more than it receives from Ottawa. We are far from the siren song of the sixties that drew in our governments of the time with alluring promises of 50-50 cost-sharing.
The late-lamented Gérard D. Levesque, well known for his good nature, nevertheless had hard words for Ottawa and its withdrawal from the health sector. What he said then was true. It is even more so today.