“Quebec is in charge of running its own health care system. Since I became health critic, other parties, senators, and lobbyists have been pushing hard to hand health care powers over to Ottawa because they say it would be easier. I do not agree with centralizing those powers.”

“Madam Speaker, the people who turned on their televisions last night saw us debating. If they tuned in this morning, they would see that we are still here. I say that for those who think we do not do a lot of work. Extended hours, when we finish in the early hours of the morning, means that we need to use our notes to ensure that we stay on topic. With respect to Bill S‑5, I must remind the House of Quebec’s responsibility in delivering health care services. To me, that is clear. For the past few weeks, I have been the Bloc Québécois health critic. I have never seen so much pressure from the Conservative Party, senators, the government party and lobbyists to centralize health care powers in Ottawa. Every time, I am told that it would make things so much easier.”

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“I want to split speaking time with my colleague.”

“Madam Speaker, I rise on a point of order. My colleague is a generous woman. I am sure she would be willing to share her time with me.”

“I will vote against this health data bill unless it is changed. Sharing health data is important, but Ottawa should not tell the provinces how to manage health care. Quebec is already building its own digital health system. The bill must state that Quebec is in charge of its own health care, and Ottawa should send us health funding instead of rules.”

“Madam Speaker, setting aside any knee-jerk reaction I might have as a Quebec sovereignist to Ottawa’s centralizing tendencies, there remains the broader issue of administering care and, above all, administering health care. I fully recognize that the sharing of information is critically important in health care. We need to be able to prevent epidemics, understand population movements and anticipate the long-term effects. I fully understand the importance of having an accurate picture of the public health situation. Take HIV/AIDS, for instance. In a study currently being conducted by our committee, officials from the Public Health Agency of Canada told us yesterday that they were having difficulty compiling data on the current situation in Canada. That is why I encourage the provinces to work together and, with Ottawa’s support, establish an effective framework for information sharing and exchange. Quebec, whether as a province or as a country, has every interest in having access to reliable public health data at the North American level. That said, we should not ask Ottawa to dictate to the provinces how health care should be managed. Let us leave that to the provinces, public health agencies and health departments to determine together whether a common road map is the best way to collaborate. The ideal would be for them to pool resources and expertise, because responsibilities are shared and solutions are developed collaboratively. That is the beauty of sharing. Bill S‑5 could simply be based on a truly asymmetrical relationship and an uneven partnership, one that is more natural and in keeping with our federation. In this case, it is the means I am questioning, not the end. Federal legislation that forces us to take on a subordinate role tells Quebeckers that the federal government wants to be the master in their house, whereas we want to be masters in our own house. On this budget day, I would like to remind the House that “Maîtres chez nous” is more than a slogan. It represents the hopeful spirit of the Quiet Revolution, our collective drive as Quebeckers to assert ownership of the tools to build a modern, forward-thinking state that is committed to social progress. The Trudeau government essentially stole our ideas. One might say that it drew inspiration from ideas such as child care and pharmacare. What we are seeing from the current government is something altogether different. It is appropriating symbols of national aspiration and collective emancipation. That is profoundly insulting. When Quebec chose to take its destiny into its own hands, it did not wait for the federal government. It just did it. We have been proving that for decades. We built our own institutions, established our own frameworks and charted our own course. Now that the work is done, the federal government wants to tell us what to do. It should do the opposite and ask the provinces how this worthy objective can best be achieved. Instead, the same old reflexes persist. Unless the government is prepared, and this is important, to amend its bill to include a preamble stating that Quebec remains the primary architect of its health policies, we cannot support such a bill. It is worth noting that Quebec already has its own digital health information system, known as the Health Booklet. This system allows all Quebec patients to access their list of medications, medical imaging and lab test results, and the services they have received since May 2026. Quebec has begun rolling out digital health records in the Mauricie region, the Centre-du-Québec region, and the northern part of the Island of Montreal. This project will enable the Quebec health care system to gradually phase out outdated technologies such as—I am embarrassed to say—the fax machine, and contribute to the digital transition of Quebec hospitals. Going forward, patients will be able to access their medical information, appointment history and medical records through Mon dossier santé. If the federal government really wants to support health care, I have an idea: Release the money. Unfortunately, the federal government cannot manage our emergency rooms, our CLSCs, our labour relations, the delivery of care or the priorities of our health care system, so we have a request. Every single year, we ask for more money in the form of health transfers. We firmly believe that 6% a year, for a total of $14 billion over five years, is not too much to ask, given all the tax dollars collected by Ottawa. Yes, it is no secret that Quebec’s health care system faces challenges, but it is up to the Quebec government to make its own decisions in the best interests of Quebeckers, in consultation with stakeholders on the ground who understand the real needs. My riding of Laurentides—Labelle has three hospitals, the Mont-Laurier hospital, the Rivière-Rouge hospital and the Sainte-Agathe-des-Monts hospital. They have enormous funding needs. In all three cases, private foundations are stepping in to make up for the funding shortfalls. Why? It is because, unfortunately, the federal government is not doing its part. When it comes to equipment, it is quite remarkable that the community had to mobilize all its efforts just to secure access to an MRI machine, and even a CT scanner, only a few years ago. Rather than allocating funds for patient care, the federal government is just managing programs and telling others what to do. The federal government does not run a single clinic. Everyone has their own area of expertise. When I talk to people, I ask them whether they would prefer option A or option B. Option A involves adding another layer of administration to Quebec’s health care system. Option B involves Ottawa sending Quebec money so that we can provide care. Option B wins every time, both among health care professionals and among the public. People know that they pay more in taxes than what is transferred back to Quebec, so it is simple. Unless amendments are made, the Bloc Québécois will be voting against Bill S-5. I will conclude as I began it. The government needs to let Quebec and the provinces manage their own health care systems and make their own decisions. Yes, let us work in partnership, but not by making Quebec and the provinces subordinate. Let us not go further down the road of an imposed federalism. We have had enough encroachments on provincial jurisdiction. As I always tell my colleagues, whenever provincial jurisdictions are at stake, I will be relentless, and my answer will always be no.”

“We need health data to make progress and save lives, but control matters. The federal government should not keep all the data to itself. We should trust the provinces and territories to collect their own data, and then share it together.”

“Madam Speaker, my colleague is right to a large extent. Indeed, without data, how can we act? Scientists say that they want to do more, but that we have decades of data to compile before we can make changes. That said, it matters who has the control. Consider, for example, a father who tells all his kids that he is going to manage everything and keep all the information to himself. We prefer self-determination. We believe that each of the children, the provinces and territories, should be trusted and provided with whatever they need to obtain that data. Then, these data can be pooled together to save lives.”

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“Every premier asked for more health care money, but the federal government did not give it to them. If the government truly wants to build a strong country, it should listen to the provinces.”

“Madam Speaker, I would like to take this opportunity to say one thing. We often hear about the desire to build Canada strong, about development and about the need to work together. I find it hard to understand why, when all the provincial and territorial premiers spoke out so loudly, forcefully and unanimously to say that they needed health transfers, it all came to nothing. It would have been such a great opportunity to show that the government does indeed want to build Canada strong.”

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“Quebec has not agreed to federal health plans because health care is under Quebec's control. We will not support this bill unless it clearly states that Quebec stays in charge of its own health care system.”

“Madam Speaker, when the pan-Canadian interoperability roadmap was announced, it was noted that: Quebec has not signed any agreement with the federal government and is not bound by the conditions related to the document entitled “Working together to improve health care for Canadians”. Quebec remains fully committed to exercise its own responsibilities within its exclusive jurisdiction over health care and has not adhered to the pan-Canadian strategies concerning human resources, data and virtual care and mental health and intends to retain its full autonomy with regard to planning, organization and management of its health system. Quebec remains open, however, to share information and best practices with other governments in these areas. The minister said earlier that she has the power to decide whether or not to impose the order in council. What I understood from my colleague’s speech is that, unless the government explicitly states in the preamble to its bill that Quebec remains in charge of its health policies, she will not support the bill.”

“My colleague speaks very well today. He must have gotten more sleep than I did.”

“Madam Speaker, my colleague has such a way with words. He must have slept longer than I did yesterday, even though we were together. Some hon. members: Oh, oh!”

“We will support this bill only if it protects Quebec's control over its own health care and shares data properly. Without those safeguards, it could take away Quebec's independence in health care.”

“Madam Speaker, we were together in the House. We did not sleep together. I want to make this crystal clear: If the necessary firewalls are in place, if our responsibility for delivering services is clearly protected and if data is shared, we will obviously say yes. Otherwise, there is too much margin for manoeuvre, and the autonomy of Quebec’s health care sector could be negatively affected by these orders.”

“I will not support this health bill unless it is changed. Health care belongs to the provinces, and Quebec has the right to run its own digital health system. This bill lets Ottawa overrule provincial laws if it does not like their rules. Ottawa needs to stop telling provinces what to do and instead send more money for health care without conditions.”

“Madam Speaker, before I start my remarks, I would like to note a recurring trend. We are seeing more and more bills here in the House that originated in the Senate. As members know, the time allocated for debate on a bill is not unlimited, so I find it somewhat curious that the government continues to place so many Senate bills on the agenda. Let me turn now to Bill S-5. As my colleague from Laurentides—Labelle said earlier, its objective is certainly commendable. No one can argue with it. Unfortunately, however, this bill reflects a familiar tendency to believe that Ottawa knows best, that Ottawa knows better than the provinces what is good for them in areas under their jurisdiction, and that Ottawa possesses more expertise when it comes to implementing policies. I must say, it is getting a bit tiresome. There is a major problem, as my colleagues have pointed out. Despite what the Minister of Health said earlier, nowhere does this bill explicitly recognize Quebec’s and the provinces’ exclusive jurisdiction over the organization of health care delivery or the fact that Quebec can choose to develop its own digital infrastructure. If the Bloc Québécois is to support such a bill, it must include an explicit recognition. I would like to point out that, as my colleague from Laurentides—Labelle said earlier, the Government of Quebec has already indicated its intention to deploy its own digital health infrastructure. Unfortunately, this bill in no way reflects the autonomy that Quebec claims with respect to health care. Moreover, to my knowledge, Quebec has not committed to following the pan-Canadian interoperability roadmap. The major stumbling block in Bill S‑5 is that it does not respect jurisdictions. To convince my colleagues of this, I will reread clause 7(1), which my colleague from Montcalm referred to earlier. I hope the Minister of Health will listen to us. The Governor in Council may, by order, make any provision of this Act or the regulations applicable in any province or territory if the Governor in Council is satisfied, after applying the criteria and the process provided for in the regulations, that the province or territory does not have requirements that are substantially similar to or exceed those established under this Act. What does that mean, ultimately? It means that Ottawa is leaving the door wide open to tell the provinces how they should act. That is why I said in my introduction that this is, once again, a form of centralizing federalism. I will not use the term “predatory federalism”, but this is yet another form of federalism that is heavily focused on allowing Ottawa to define what is right and what constitutes good health care within the provinces’ areas of jurisdiction. This is very clear, and I want to make that point clear to the minister. In theory, Bill S-5 might not apply to Quebec, as my colleague said, but we must still speak out against clause 7, which would allow the government, by order, to effectively override provincial laws in areas that fall under provincial jurisdiction. Unless the government is willing to amend its bill, I do not see how the Bloc Québécois can support it. At the very least, a preamble should be added that clearly specifies that Quebec remains in charge of its health care. However, today is budget day, and we are always happy on budget day. This bill gives me the opportunity to talk about something that is central to the Canadian federation, and we will see it reflected in the budget: the perennial problem of health transfers. If we want to fix health care, we need to solve the funding problem. Year in and year out, and during every election campaign, when Quebeckers and Canadians are asked what their priorities are, health care is usually one of their top priorities. I want to go back to the issue of health transfers because, in the great history of Canadian federalism and the injustices and inequities in relations between Quebec and Ottawa, one thing is glaringly obvious. I am talking about the infamous fiscal imbalance. For those who do not remember what that is, I will explain. The Government of Quebec delivers virtually all social services and, in fact, Ottawa delivers very few services. There is EI, but that is paid for by workers. There is OAS, which is a social program. Ottawa participates very little in terms of social programs, although it takes up 60% of the tax room. In the end, Ottawa always has much more money than its responsibilities require, while Quebec and the provinces never have enough because they have a smaller tax base. That is the fiscal imbalance in a nutshell. Instead of piling on more and more health initiatives, encroaching on an area under provincial jurisdiction, Ottawa should focus on making health transfers more predictable and unconditional. We will see whether there is any good news in the budget and whether health care transfers will live up to the expectations of Quebec and the provinces. Right now, if we look at the big picture, Quebec is spending about 42% of its total budget on health care. Back in the 1960s, when the public health care system was first established, 50¢ of every dollar invested in health care came from the federal government and 50¢ came from the provincial government. Today, the federal government’s share is estimated at barely 22%. That means that, for every dollar invested, 22¢ comes from the federal government. Quebec has to cover the rest, and the infamous fiscal imbalance comes into play, as I mentioned earlier. That said, 42% of the Government of Quebec’s budget is a huge share. That means that Quebec has only about 58% of its total fiscal capacity left to address essential priorities, such as education, poverty, infrastructure, municipalities and support for Quebec businesses. We have been fighting long and hard over health care transfers in Canada. In 1980, the Mulroney government made the first drastic cuts to health transfers. Then came the famous Liberal era, when there were budget surpluses. Where did those budget surpluses come from? They came from the recurring cuts Paul Martin made to health care. In the wake of the 1997-98 referendum, $2 billion in recurring funding was cut from the provinces. Jean Chrétien boasted to the G7 that he had balanced the budget, which is pretty cynical, really, because he got his surpluses by cutting transfer payments to the provinces. He added that he would not have to pay the political price for this, because the public believed—members may recall Lucien Bouchard’s shift toward outpatient care—that the governments of Quebec and the other provinces were to blame for the shortcomings in health care services. However, it was the federal government that had just insidiously cut transfer payments and that was not shouldering its share of responsibility for health care. It is budget day. I hope the federal government will see the light. It needs to put an end to the predatory federalism and accept its share of responsibility for health transfers.”

“Better data sharing is fine, but people need access to health care first. Past cuts to federal health transfers have made it harder for people to get care and harder for provinces to run their systems. The government should send more health care money to the provinces instead.”

“Madam Speaker, if somebody is getting their arm taken off, they are not going to worry about the pimple on their nose. In health care, having better data sharing is worthwhile. However, what people want is access to services. Unfortunately, what we have been seeing within the federation for far too long are cuts to health care transfers. This makes it more difficult to access care, and it makes it harder for the provinces to manage other areas under their jurisdiction. If my colleague wants to see results in health care, he should convince his government to invest as it should and to increase its participation through transfers. That is the best solution.”

“The federal government still does not pay its fair share for health care. This bill lets the minister force federal health rules on Quebec using regulations we have not seen. The minister claims she respects Quebec's powers. We want to add an amendment to the bill that protects Quebec's jurisdiction. I am asking my colleague if he thinks the government will accept our amendment.”

“Madam Speaker, my colleague was right to raise the whole issue of chronic underfunding in health care, the lack of federal funding, and the federal government’s fundamental inability to shoulder its fair share. Going back to the bill, under clause 7, which my colleague mentioned, the bill would apply, by order, to a province such as Quebec if the minister determines that Quebec’s existing measures do not meet the criteria. Whatever she wants to do, she will do by enforcing regulations that we have not seen, that we will never see, and that she can also amend at her discretion, by order. The minister told us that she respects the way things are being done in Quebec. My colleague argued that the preamble should explicitly state that the minister intends to respect Quebec’s constitutional jurisdiction. Can he tell us whether he is convinced that the minister’s commitment will lead to a willingness to accept an amendment proposed by the Bloc Québécois?”