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Bill C-497

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2nd Session, 36th Parliament,
48-49 Elizabeth II, 1999-2000

The House of Commons of Canada

BILL C-497

An Act to amend the Federal-Provincial Fiscal Arrangements Act (prevention of private hospitals)

      Her Majesty, by and with the advice and consent of the Senate and House of Commons of Canada, enacts as follows:

R.S., c. F-8; R.S., cc. 22, 39, 44 (1st Supp.), cc. 7, 15, 26, 28 (2nd Supp.), cc. 9, 11, 31 (3rd Supp.), cc. 7, 33, 35, 46 (4th Supp.); 1990, c. 39; 1991, cc. 9, 10, 38, 51; 1992, cc. 1, 10; 1993, cc. 28, 34; 1994, c. 2; 1995, cc. 17, 24, 28, 29; 1996, cc. 8, 11, 18; 1997, c. 10; 1998, cc. 10, 19, 21; 1999, cc. 11, 26, 31

1. The Federal-Provincial Fiscal Arrangements Act is amended by adding the following after section 19:

Private hospitals

19.1 (1) The definitions in this subsection apply in this section.

``enhanced minor surgical procedure''
« intervention chirurgicale mineure améliorée »

``enhanced minor surgical procedure'' means a prescribed minor surgical procedure that requires an extra payment by a patient and is

    (a) an improved or more expensive form of the procedure that is not offered in a public hospital in the province as a procedure paid by public funds, or

    (b) available to the patient at an earlier time than would be available at a public surgical facility

``prescribed minor surgical procedure''
« intervention chirurgicale mineure prescrite »

``prescribed minor surgical procedure'' means a surgical procedure prescribed by the Governor in Council to be a surgical procedure that is minor and that does not normally require an overnight stay;

``private hospital''
« hôpital privé »

``private hospital'' means a facility that

    (a) is privately owned;

    (b) is operated for profit;

    (c) performs

      (i) medical services, or surgical procedures other than prescribed minor surgical procedures, where such services or procedures do or would normally require an overnight stay, or

      (ii) offers an enhanced minor surgical procedure; and

    (d) receives payment or part payment for the medical services or surgical procedures it performs from public funds or from a patient who has the right to obtain reimbursement of all or part of the payment from public funds.

Deduction if private hospitals operate

(2) In order that a province may qualify for a full cash contribution referred to in section 14 for a fiscal year, the laws of the province must not permit the establishment of private hospitals in the province.

Certain facilities excepted

(3) Subsection (2) does not apply to a hospital that was operating as a private hospital on or before the date on which the Canada Health Act came into force.

2. (1) Subsection 20(1) of the Act is replaced by the following:

Referral to Governor in Council

20. (1) Subject to subsection (3), where the Minister, after consultation in accordance with subsection (2) with the minister responsible for social assistance or health care, as the case may be, in a province, is of the opinion that the province does not or has ceased to comply with section 19 and the province has not given an undertaking satisfactory to the Minister to remedy the non-compliance within a period that the Minister considers reasonable, the Minister shall refer the matter to the Governor in Council.

(2) Paragraph 20(2)(a) of the Act is replaced by the following:

    (a) send by registered mail to the minister responsible for social assistance or health care, as the case may be, in the province a notice of concern with respect to any problem foreseen;

3. Section 21 of the Act is amended by adding the following after subsection (1):

Provincial laws not complying

(1.1) Where a referral of a matter under section 20 is made on the grounds that the laws of a province do not or have ceased to comply with subsection 19.1(2) by the beginning of a fiscal year that commences after January 1, 2001, the Governor in Council shall, by order, direct that the cash contribution to the province for a fiscal year be reduced by the amount the province has paid to private hospitals in the province, either directly or by reimbursement to patients who have paid private hospitals, in respect of the fiscal year, or the amount that in the opinion of the Minister, the province will pay to private hospitals for the fiscal year,

Non-
compliance in prior fiscal year

(1.2) Where a referral of a matter under section 20 is made on the grounds that a province received a cash contribution without deduction in respect of non-compliance with subsection 19.1(2) in respect of a particular fiscal year that commences after January 1, 2001, but the Minister is of the opinion that the province did not comply with subsection 19.1(2) for all or a part of the particular fiscal year, the Governor in Council shall, by order, direct that the cash contribution to the province for the following fiscal year be reduced by the amount that, in the opinion of the Minister, the province paid to private hospitals for medical services or surgical procedures for the particular fiscal year, or the part of the particular fiscal year that the province did not comply with subsection 19.1(2), as is the case.