HESA Committee Report

Additional opinion of the Bloc Québécois

The Bloc Québécois would like to emphasize the importance it places on the issue of Canada’s health workforce. The Covid-19 pandemic has highlighted the difficult conditions experienced by these workers and it was only fitting that the committee study this issue in order to examine how the federal government can contribute, within the limits of its jurisdiction under the Constitution Act of 1867, to address the shortage of personnel in our healthcare systems. 

The Bloc Québécois would also like to thank all the colleagues, witnesses, and support staff who gave their time to this study. Without the dedication and commitment of all these parties, the completion of this study would not have been possible.

Respect for Jurisdiction

First of all, the Bloc Québécois would like to remind that the federal government must act in a manner that respects the jurisdictions of Quebec and the provinces. The Constitution Act of 1867 confers on the provinces the management of hospitals. As a result, healthcare personnel in these institutions are also under provincial jurisdiction. Additionally, professional orders are also under provincial jurisdiction. Considering these facts, we take issue with the recommendations in this report that give the federal government a role in the management of day-to-day operations of hospitals, in the training of the workforce, or in the remuneration formulas for the healthcare workforce. Consequently, because they are ultra vires, the Bloc Québécois does not support recommendations 2, 5, 6, 7, 8, 10, 11, 12, 13, 16, 17, 18, 19, and 20.

Asymmetrical federalism

On September 15, 2004, in the wake of the Canada Health Transfer agreements, the federal government acknowledged, alongside with Quebec government, in a press release that:

" Recognizing the Government of Quebec's desire to exercise its own responsibilities with respect to planning, organizing and managing health services within its territory, and noting that its commitment with regard to the underlying principles of its public health system - universality, portability, comprehensiveness, accessibility and public administration - coincides with that of all governments in Canada, and resting on asymetrical federalism, that is, flexible federalism that notably allows for the existence of specific agreements and arrangements adapted to Quebec's specificity"

The Bloc Québécois believes that any action taken by the federal government regarding healthcare must respect the principles of the asymmetrical federalism. Thus, the federal government must recognize that Quebec is making its own reforms and choices regarding its healthcare system and support its initiatives through the Canada Health Transfer.  

Fiscal imbalance

Finally, the Bloc Québécois would like to point out that the root cause of our healthcare system’s difficulties is linked to the fiscal imbalance that exists within the Canadian federation. The federal government's disengagement from healthcare funding does not allow Quebec and the provinces to offer the working conditions that all healthcare workers deserve. The Bloc reiterates that the federal government must increase federal transfers for healthcare and the Canada Social Transfer, as well to transfer tax points to the provinces so that they can carry out all of their social service missions in a predictable and sustainable manner.