Canadian Prime Minister Paul Martin pledges health care push

Apr 16 2004

Official Statement

A century ago, a great banquet was held just a few blocks from Parliament Hill. It was a different time.

The walls were decorated with Union Jacks. The air was thick with smoke from cigars and pipes. The women in attendance wore white gloves. And Sir Wilfrid Laurier was at the rostrum.

The Governor-General stood, the Leader of the Opposition stood - everyone stood and applauded when the great Liberal prime minister boldly declared that the 20th century would belong to Canada.

We are one hundred years removed from that night and those words, but the sense of national optimism is no less grand in our time.

We know who we are and what we want to do as a nation. The unity of our country is strong. We have social programs that are the envy of so many others.

We are rich in cultural diversity. We have a balanced budget, a feat matched by no other nation of the G8. We are active in bringing peace and freedom to troubled parts of the globe.

Today, Laurier's confidence echoes in every corner of this vast land, but the world has changed. For us to succeed in this generation, it is not so much that the 21st Century will belong to Canada as it is Canada that must belong to the 21st century.

This will not come to us simply for the asking. We must work for it. The world is smaller now, the challenges more pressing, the obstacles more formidable.

Opportunity is less likely to be found; instead, it must be made.

What does this mean for us as Canadians? It means that in all our pursuits, settling for good enough is not good enough.

We must push ourselves as a nation to be the very best we can, because the world will indeed challenge us.

Government is not exempt from the realities of modern times. It too must push to be the best it can be for Canadians. That's why, even though we have been in office only a short time, we have brought significant change to the way Ottawa works.

Change in terms of restoring the influence of members of Parliament through free votes and an increased role in the appointment of senior officials; change in the way government monitors and controls its expenditures; change in the way that government is accountable to Canadians.

This is what government must do. We identified a problem: the democratic deficit. And we took immediate action by implementing transformative change.

Let me pause here for a minute. Transformative change. What does that mean? To me, it means a fundamental shift in approach and direction, it is not stop-gap measures imposed incrementally.

It requires a determined focus and a relentless drive. But the reward is tangible results, progress you can see and gauge.

Let me give you another example. Let me take you back almost a decade, back inside the Department of Finance, where work was underway on the 1995 budget.

Simply put, Canada's finances were a mess. A succession of governments had for almost 30 years attempted to tackle the problem with incremental measures.

The result was a government that had borrowed so much that it found itself having to answer first to its creditors and only second to the needs of its own people.

That's when we knew it wouldn't be good enough just to reduce the deficit. We'd have to eliminate it. And to do that, we'd need to cast aside old approaches, old assumptions, and conventional wisdom.

Well, that's exactly what we did in the '95 budget. It was controversial, and it was tough.

But in a few years it brought us a balanced budget, a diminishing debt load and the ability to deliver the largest tax cuts in Canadian history.

Most importantly, it brought us the capacity to determine our own future, to make our own choices and we've never looked back.

Well that was then and this is now.

The challenges facing government are different today, but I believe we must adopt the same bold approach.

We must be focused and unyielding. We must challenge the status quo. To that end, we have determined that, among the many important missions and responsibilities of government, there are five areas in which we must proceed with particular vigour, creativity and urgency.

Five areas we will pursue as overriding priorities.

These: - health care, learning, Canada's aboriginal peoples, our communities large and small, and our role in the world - are areas in which quite simply we must break new ground.

In pursuing these goals we will remain committed to fiscal prudence. But this does not mean that we are helplessly constrained.

By undertaking aggressive expenditure review - as we are already doing - by reallocating resources and taking advantage of the new revenues presented by economic growth, the fact is we will be able to marshal the funds we require to bring about real progress on the issues that matter most to Canadians.

Ours will be a progressive, responsible approach. And it will get the job done! It will reflect an understanding that the Canada of a decade hence is being formed in the choices we make today.

Any discussion of our government's priorities must begin with health care, for there is no other issue of such vital and visceral significance to Canadians. Nowhere does government interact with people in a more meaningful and consequential way.

Most of us have experienced anxious moments waiting in a hospital emergency room. Many have endured the uneasy wait for diagnostic tests. Some have spent long nights staring hopefully at monitors in the Intensive Care Unit.

Every day in our hospitals pass moments that alter the course of human lives. This is when people need their governments most.

So what do we want? We want reform. Reform that starts and ends with a mind to patients and their families.

Reform that makes doctors, nurses, and other health care professionals available when needed, and where needed.

Reform that ensures timely access to quality services that improve health outcomes.

Canadians want and need reform that ensures that diagnostic tests, surgeries and treatments are governed by need, not rationed by waiting.

We need reform that makes it absolutely certain that our system of publicly funded, universally available health care, a program that was introduced when many baby boomers were just becoming adults, will be there for their grandchildren and beyond.

Of course money is part of it. The system has to be properly funded. But reform does not begin with a dollar sign and end with a bunch of zeros.

The federal government has already committed $37-billion in new money to health care over five years. That represents a better than 8 per cent annual increase in spending. And I tell you today that we will invest more.

But here's the reality: Canada as a nation already spends more per capita on health than the great majority of developed countries, yet our outcomes, while good, are not discernibly better.

Guided by the work of Roy Romanow and many others who have studied the health system exhaustively, and fully involving health care professionals, who are on the front line. Canada needs real reform that delivers real results. Results that are measured and then reported transparently so that we all can see how well the health care system is working and where it needs improvement.

The challenge before us is to restore public confidence in the health care system and in our ability to fix it. To do so we will need to begin by demonstrating real progress in specific areas - the most visible symbols of the system's stress; the ones that too many Canadians are personally familiar with.

Any discussion of health care runs the risk of deteriorating into generalities. So let me be specific: We must reduce wait times. Canadians need to know, Wherever they live, how long it takes to get an MRI, how long it takes to see a doctor, to get needed hip surgery, and how quickly their child will be seen in the emergency ward.

And Canadians need to know how governments will bring those wait times down.

What can governments do to reduce wait times? Working with provinces and territories, we must find ways to resolve the shortage of medical providers that exists in too many parts of our country; we must open up medical spaces in our universities, both for young Canadians seeking entry, and new immigrants seeking qualification; we must determine an appropriately expanded role for nurse practitioners and other paramedical personnel; and we must ensure that our diagnostic facilities are adequate and fully utilized.

Working with our provincial and territorial partners, we must also build on progress being made in primary care renewal to ensure the right response by the right health care provider and we must work together to establish a program on home and community care services.

Why? Because appropriate home care will reduce the burden on acute-care resources, It will make better services available to Canadians and ultimately result in a less costly and more sustainable system.

because no Canadian should suffer undue financial hardship as a result of needed drug therapy.

Implementation of these important reforms will come as part of a 10-year plan that we'll seek to work out with the provinces and territories. We're finished with the year-to-year scramble for short-term solutions.

What the provinces need now is a long-term agreement that guarantees predictable, reliable funding. What we all need is a fundamental commitment to reform.

Medicare is more than just another government program. It is a statement of our values as a nation. That's why I'm going to meet with the premiers this summer - not just for lunch or dinner or over a weekend.

But for as long as it takes for us to agree on a long term plan for a health care system that is properly funded, clearly sustainable and significantly reformed.

Health care is this government's number one priority. We will come to an agreement with the provinces, because we must. We will implement a long-term plan, because we must. And because we must, we will provide a fix for a generation.

Let's talk now about learning. And let's start by putting its importance in context: We all understand that a strong economy is the foundation on which a successful society is built.

That's why we strive to reduce taxes and debt. That's why we invest in research and development, and why we endeavour to commercialize what comes of that R&D.

That's why we focus on securing trading partnerships around the world and keeping open the border with the United States.

That's why sustainable development cannot be only a pious wish, why it must be a fundamental pillar underlying the nature of economic growth.

And most critically, that's why we have to understand that competing in the 21st century demands a population geared to innovation.

Quite simply, Canada's educated talent pool must be among the deepest and the best available anywhere - for their sake and for our sake.

In some countries, it's not uncommon to hear a people speak of the need to restrict trade, to close borders to global competition.

Clearly a flawed approach - but the truth is that for us in Canada, it's not even an option. We are a nation of only thirty one million people.

We have no choice but to face global competition and we have no alternative but to win. And this is why we have to reduce the barriers to continuing education.

It's true that we are among the world's leaders in the percentage of people receiving a post-secondary education. But we must do better.

We must address the fact that we rank far below the United States in the percentage of students who achieve post-graduate degrees.

The federal government has an important role to play in post-secondary education, and it begins with access. We as a society cannot deprive people of opportunity simply because their families don't have money.

That's why last month's budget contained important down payments to address the issue of affordability. We introduced a Learning Bond for children of lower-income families.

We increased government matching funds for education savings. We improved the Canada Student Loans program.

We established a first-year grant to help students from low income families get through the initial gate and into the classroom.

That being said, we have a long way to go!

For example, we must recognize that as a nation we face a growing skills shortage - and that we must start talking about the openings for our young people who apprentice in the skilled trades.

In short, we've got to work with the colleges, with the unions and the industry sector councils, to find ways to enable young people to understand that education has many facets.

The last budget was the second major education budget in recent years, but it is only the beginning. We must understand that a Canadian's ultimate success in post-secondary education begins in earliest childhood, in fact prenatal to age six, when intellectual and emotional potential can be encouraged and nurtured.

Literacy must be fostered early. Those who require remedial assistance need to be identified early. And later on, Canadians must have access to a culture of continuous retooling, a philosophy underpinned by a series of life long learning initiatives that, overtime become a way of life.

Our goal is to help ensure that significantly more Canadians achieve a post-secondary level of learning and training, and that significantly more of these Canadians move on to pursue post-graduate degrees, and ever-improving skills development during their careers. This will help more people lead better lives. And their individual success will lead to our greater achievement as a nation.

Canada's aboriginal peoples represent the fastest growing segment of our population. They make up the youngest group in our society.

Aboriginal children represent an important part of our future. Yet theirs is collectively a story of promise untapped and promises unfulfilled.

Decades of well-intentioned government policies have been enacted to insufficient benefit.

Our goal is to reverse that path.

The federal government has undertaken many initiatives - on health care, on housing, on early childhood education and recently on clean water - but we're dealing with problems that can't be solved simply by writing a cheque.

We must be smart enough to do things differently. Let me give you an example of what I mean:

Increasingly these days, young Aboriginals are moving to our major centres in search of a job and a better life. Think of the culture shock: a young person from a small and remote reserve arriving alone downtown in a major city.

How could we possibly be surprised to discover that so many have trouble making the adjustment.

If young Aboriginals are coming to the major cities, and they are in large numbers, we have got to make it possible for them to succeed - we've got to remove obstacles and create opportunities, and we will.

In short - If helping hope to thrive and opportunity to flourish is needed on reserve, it is also needed in the inner city.

We will work to remove obstacles and create opportunities for Canada's Aboriginal peoples. We will help hope to thrive and opportunity to flourish.

Because those are the components of an enduring human equation: hope plus opportunity equals success on reserves as well as in the city.

To achieve measurable progress, it is clear that new approaches are necessary, from all sides.

Government must put an end to the paternalistic approach that embodies too much of its activities.

Aboriginal Leadership must now deliver on the principles of open, and accountable government.

True progress starts with a full partnership, and with all the rights and responsibilities on both sides that partnership entails.

That's why I have asked Aboriginal leaders from across the country to come to Ottawa this coming Monday to sit down with more than 20 government ministers and me.

This will be an important summit. Its message must be that the changes we all want to see will not be measured in rhetoric, they will be measured in meaningful improvements in quality-of-life indicators - better health care and housing. And in the essential economic indicators - more kids finishing high school, more going to university, more successful Aboriginal businesses, all of which lead to more economic development and greater self sufficiency.

Quite simply, we need a new beginning - let it be this Monday.

Let me turn now to the places where we live.

As a government, we've already made a priority of helping communities find new sources of predictable, long-term funding - from our biggest cities to our smallest towns. By giving municipalities full relief from the GST, we'll be handing over $7-billion to them during the next decade. We see this as an important beginning.

But it can only be the beginning. The fact is our municipalities are on the front lines of every social problem and economic opportunity in the country.

The problem is they are working off a 19th century blueprint for a 21st century economic reality. Therefore, the federal government will ask the Premiers and municipal leaders to start discussions on how our cities and towns should be provided with the resources they need.

We'll be talking about more innovative partnerships that would enable us to better deal with the huge infrastructure deficit the country and its municipalities confront.

And we'll be talking about the gas tax, and we'll be doing that before the end of this year.

Our major cities are the focal points around which economic, social and cultural innovation take place. As they go, so does the country.

That's why we are committed to making available for the benefit of cities and communities new predictable, long-term sources of revenue.

But there's more to it than just money. It's a coming to grips with the reality of how as a country we must organize ourselves to face the future.

A community is where every government program of every level ultimately meets the citizen.

When we talk about ensuring clean air and clean water, when we talk about housing for low-income families, when we talk about care for children, for senior citizens or those with disabilities, when we talk about the need to address greenhouse gas emissions or to clean up brownfield sites - when we talk about immigration and our need for more people, when we talk about the need to fight racism - these are issues of great national importance, and we'll address them far more wisely and comprehensively if the federal and provincial governments do it hand in hand with municipal governments, for these are the people who know their communities best.

When I was in Toronto two weeks ago for the transit announcement, I talked of the weight of responsibility now being borne by our biggest cities. They are our signatures to the world. As they succeed, so do we.

So today let me mention our smaller municipalities, whose problems of urban gridlock may not be as acute, but whose need for economic development may well be greater.

I have spoken with a lot of leaders in the smaller communities of our land.

They understand that innovative agricultural, mining and forestry sectors seeking to develop value-added products, are crucial not just to regional but to national development.

They understand that high tech and R&D are essential to their ability to grow their economies and that all of this is crucial if their children are to come home creating economic opportunities in the places they were raised.

This is why it's crucial that we help these smaller communities address their most pressing issues by giving them the tools to help themselves.

This is why we must ensure that research and development is supported in regional universities as well as in our biggest and why we must encourage the flow of venture capital into the regions and the economic clusters they engender.

In summary then, municipalities are creatures of the provinces and we respect this. But as well, municipal governments, large and small are real and mature players in the national give and take.

This must be recognized in the way the federal government deals with them.

The achievement of great national objectives requires that everyone be at the table.

This is why we are working with the provinces to ensure that communities have a say when national decisions that affect them are taken - not because it's in their individual interest but because it's in our collective interest.

Making our communities great places to live isn't only an altruistic mission - it's an economic imperative. And it's among the most direct ways to improve the quality of life of Canadians.

Finally, our role in the world. Here, too, Canada must belong to the 21st century.

The government is currently undertaking a wide-ranging International Policy Review, the results of which will be made public this fall. Without pre-empting its conclusions, there can be no doubt about our goal: to ensure that the Canadian perspective grows in influence on the global stage.

For that to happen, old habits must be broken. Turn your thoughts to the Cold War.

We knew who the enemy was and where they lived. We could predict the front line, and no conflict was ever closer than a full ocean away.

This is not the world we live in today, where the unexpected is to be expected. From the regional instability of failing states to the intensification of infectious diseases, we must be more vigilant close to home and we must be prepared to do more far from home.

What does this mean? It means in a world where our adversaries are unpredictable and difficult to identify, we can no longer view our security through distinct, domestic, continental and international lenses.

In an age of indiscriminate carnage perpetrated by small terrorist cells, today's front line stretches from the streets of Kabul to the rail lines of Madrid, and on through Manhattan to the cities across North America. The conflict is not 'over there'. There is no longer a major problem in the world that does not affect us.

Our approach to Canada's security must reflect this altered reality. Canada's presence in Afghanistan has all the hallmarks of the new type of operation that the Canadian Forces will be expected to lead.

It's a multilateral mission aimed at reviving a failing state for humanitarian reasons but also so as to deny it to terrorists. Elements of defence, diplomacy and development are woven tightly together in the fabric of the mission. This will serve as the model for Canada's involvement in the international crises of the future.

We want to be a people that helps secure and keep the peace in troubled nations, so we will design and fund a military that's capable of doing the job.

We want to be a nation that's involved in institution building. That is why we are creating the Canada Corps to marshal Canadian skills combined with the energy and idealism of young people to help nurture democracy and the rule of law in fragile states.

Our strategy to raise Canada's voice in the world is premised on the plain fact of growing global interdependence.

That is why we must think beyond the G8 - why we must include as full partners in the dialogue such emerging powers as China, India and Brazil.

There can be no solutions for tomorrow's challenges of environmental sustainability, liberalized trade, financial stability and peace and security unless these nations are at the table.

This is why the government of Canada has been advocating for a Leaders G20, to build on the success of the Group of 20 finance ministers that was established in the wake of the Asian financial crisis.

At the same time, we are determined to maintain and advance our most important association - the one we share with the United States.

Because it is so central to our respective interests, we must develop a more sophisticated relationship based on informed dialogue, shared values and respect for our differences.

All politics is local. The United States is no different than any other democracy. For example, it is US regional interests in congress that have led to the stalemate over softwood lumber and BSE.

That's why we're establishing a new secretariat in Washington - one that will facilitate invaluable contact between elected representatives in our two countries, helping to forge closer ties among federal and provincial members of Parliament and their congressional counterparts.

Canada is a sovereign independent nation. We are ambitious and resolute. We are confident of our place in North America and the world.

We are cognizant of the benefits of multilateralism, of the need for reform of many of the great international institutions including the United Nations.

We are cognizant that for too many people the benefits of globalization are a myth seen through eyes closed by disease, famine and war - we are cognizant that we can make a difference, and that we will make a difference.

There can be no greater manifestation of our sovereignty than to seek to leave the world a better place than we found it.

Ladies and gentlemen, these are our priorities. In many of the five areas just mentioned, the provinces have the primary jusrisdiction. We respect that.

Some may see this as a reason to scale down our efforts. We see it as an opportunity to foster a new co-operative partnership.

To prove to Canadians that their governments share the goal of achieving real progress on the issues that matter most.

To prove to Canadians that their governments understand that the Canada of the future, is being be formed by the actions and priorities of governments today.

When Wilfrid Laurier stood before the nation in 1904, he could not have known the success Canada would achieve in the century to come, the progress it would realize, nor the valour it would demonstrate.

But he was a man of great vision, and he embodied the progressive beliefs that have been integral to our national accomplishments.

"I am a Liberal," he said early in his political career. "I am one of those who think that everywhere, in human things, there are abuses to be reformed, new horizons to be opened up and new forces to be developed."

Laurier knew, as we do today, that new horizons are not opened up overnight. Thus the realization of our goals lies ahead.

But the vision is now.

A nation able to meet the challenges of an uncertain time. A people who followed a path of change to an ever strengthened nationhood.

Thank you!