Log Cabin Chronicles

Old Quebec City

Photograph/John Mahoney

QUEBEC AFFAIRS

PETER BLACK

HEALTH SPAT

Quebec Premier Lucien Bouchard is quite right. Health is an area assigned to the provinces under the Constitution. Although good luck finding it.

Section 92 grants provinces exclusive power to legislate in relation to matters pertaining to "the Establishment, Maintenance, and Management of Hospitals, Asylums, Charities, and Eleemosynary Institutions in and for the province, other than Marine Hospitals."

It's not likely any of us in 1999 would recognize an eleemosynary institution if we stumbled into one, or can remember when the last time was a beaming provincial premier snipped the ribbon to open an asylum. The fact is the law of the land implies that these are items relating to people's well-being with which the province must deal.

Nowhere, though, does the Constitution specifically mention that all inclusive word "health."

While the Fathers of Confederation 132 years ago were quite specific in assigning jurisdictions to the provincial governments, they were less clear about how they would pay for them. At the time, in Quebec at least, public funding for hospitals and schools was a long way off from the popping of the Confederation corks. The all-powerful church was the sole supplier of what we now call health and social services, as well as education.

This was a situation that could not last long with a growing population in a gradually modernizing society. Without daring to go into the details of decades of mind-numbing federal-provincial horse-trading, what has happened is the federal government has over the years poured untold billions into programs in many areas of provincial responsibility which most provinces simply could not afford.

This federal intrusion, as some in Quebec and elsewhere would have it, has given Canadians what is still recognized as possibly the world's best health and welfare system, despite recent budget-cutting pressures. And now that the budget pressures on the federal level have eased, and Ottawa wants to return to the provinces some of money it cut in health care, we end up with a rehash of the Confederation debates, courtesy of the Bouchard government.

According to a Canadian Press report, Bouchard rejects the federal proposal of extra money for health with some strings attached because Quebec will never accept any federal intrusion into provincial jurisdictions such as health and education.

"The federal government is asking Quebec to give up its constitutional rights, to give up its autonomy in health matters," Bouchard said.

What the federal government is actually asking for is that the provinces respect national standards and provide proof that the new money will be channeled directly into health services. From Bouchard's point of view, though, such demands amount to provocative paternalism on Ottawa's part, and he has a point. Any move by Ottawa, real or imagined, to stick its toe across a certain line, is bound to get a reaction from a Quebec government, PQ or otherwise.

Only the hopelessly cynical would suggest that Bouchard's sudden reading of the Constitutional riot act is in any way timed to give his sovereignist credentials a boost for this weekend's Parti Quebecois national council meeting - the first opportunity party honchos have had to meet with their leader since the Nov. 30 election when an expected triumph became a defeat of sorts.

On the one hand, Bouchard has the party militants to appease, to show he is not about to submit to Ottawa's meddling; on the other, he has a population which wakes up daily to another flash fire sparked by funding problems in the health care system. This past week alone there was a nurses' walk-out in Quebec City, an emergency department desertion in Trois-Rivières and hot words exchanged about the hospital board amalgamation in Chicoutimi-Jonquière.

Bouchard will have to explain to the people why he is putting precious health care money at risk over a seemingly picayune question of jurisdiction. In the meantime, perhaps he'll spend a little time tending to the province's eleemosynary institutions where at least there Quebec's jurisdiction is clear.

CBC logo Peter Black is a writer living in Quebec City, where he is the producer of Quebec A.M. -- CBC Radio's popular English-language morning show (91.7 FM, 6-9, Mon.-Fri).


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