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Two senior members of Canadas Upper Chamber reflect on their careers in
the Senate and the role of the Upper Chamber in Canadas political life.
The interviews were conducted separately in June 2007 by Karen Schwinghamer
of Senate Communications. Sharon Carstairs is a Liberal senator from Manitoba.
She is Chair of the Special Committee on Aging. Senator Wilbert Keon
is a Conservative Senator from Ottawa. He is Deputy Chair of the Standing
Committee on Social Affairs, Science and Technology and Chair of its sub
committee on Population Health.
By way of background can you describe your early life and any impressions
you had of the Senate before your appointment?
Senator Keon: I graduated from medical school in Ottawa and undertook further
studies in general surgery at McGill. I specialized in cardiac surgery
at Toronto and then did my final research training at Harvard. I wanted
a research career. When I came back to Canada, the people at Harvard helped
me with my initial application, it was successful at the Medical Research
Council and I was funded for several years.
I started the Heart Institute in Ottawa with two people my assistant
and I shared an office. I left with a thousand people, several of them
leading scientists in the world. When I turned 55, I started thinking
about how I was going to retire. I did not want to be doing heart surgery
when I was older and losing my coordination. I wanted to retire when I
was doing my very best.
I actually knew the Senate quite well before I was appointed. When I was
a boy growing up in Ottawa, I knew a number of senators. When I came back
from studying at Harvard, I relied on senators to help me stickhandle the
politics to get the Heart Institute up and running.
Three senators George McIlraith, Orville Phillips and John Connolly kept
my requests on the agenda both in Ottawa and in Toronto.
When the opportunity to come into the Senate presented itself in 1990,
I accepted. I was not sure whether I would stay or not, but I came. It
was a total surprise.
Senator Carstairs: I am a teacher by profession. I taught for 20 years
in schools in Alberta, Manitoba, as well as in Massachusetts. My father
had been a politician and I grew up in political life so I always thought
it was a very challenging and very rewarding profession.
I decided to enter provincial politics in 1984 and started at the top by
becoming Leader of the Liberal party in Manitoba. I was elected to the
Manitoba legislature in 1986, and was re-elected in 1988 and 1990. I resigned
as Leader of the party in June 1994 and became a senator.
Politics was a relatively easy choice for me and I do not regret having
made that choice. But I can understand why some women today choose not
to make that choice, because they have seen invasiveness of the political
arena into their personal lives. When I began it was a time where there
was less engagement of family members in politics and there was less engagement
of a persons political life into their personal life.
Because of my background I knew the Senate fairly well. I had arrived on
the Hill for the first time in the Fall of 1955, so I was aware of the
traditions of the Senate. I knew the halls, I knew the layout, I had been
in the Chamber for Speeches from the Throne.
Before my appointment I had several calls with the Prime Minister. The
first one was to see whether I wanted the appointment, because I had indicated
in the past that I did not want to come to the Senate because my father
had been in the Senate for 25 years, and I did not like the distance that
it had created between my mother and my father. I was not prepared to
accept a lifestyle like that. It was only after my husband had taken early
retirement and agreed that he would come with me wherever I was, that I
agreed the Senate would work for me.
Having served on a number of committees, which ones stand out in your mind?
Senator Carstairs: I actually had not even been sworn in, when I agreed
to sit on the Special Committee on Euthanasia and Assisted Suicide, which
reported in 1995. It was an issue that fascinated me and that is how I
got to know Senator Keon. That made me recognize the importance of special
committees. I am a great fan of these studies. You can concentrate full-time
on a particular topic.
I did my subsequent study on palliative care through a sub-committee of
the Standing Committee of Social Affairs, Science and Technology, but it
was really almost like a special study. I also sat on the Special Committee
on Drugs, and had to leave when I became Leader of the Government.
Senator Keon: When I first came to the Senate I served on Legal and Constitutional
Affairs. That was the beginning of Meech Lake, and they were going to reform
the Senate at that time. With the defeat of the Charlottetown Accord that
piece of work collapsed.
One major report that I worked on was the Life and Death report of the
Special Committee on Euthanasia and Assisted Suicide. We looked at the
whole phenomenon of end of life.
I moved to Social Affairs, Science and Technology because I wanted to push
the agenda on a number of things, including creation of the Canadian Institutes
of Health Research (CIHR) and the Canadian Foundation for Innovation. Those
things occurred, and I was also supportive of a number of things the National
Research Council was doing.
When Senator Sharon Carstairs wanted to do a study on palliative care,
I joined her on that. Then Social Affairs undertook the first major public
health study. Michael Kirby was the chair and Marjory LeBreton was Vice-Chair.
When we completed that we undertook the mental health study, where Senator
Kirby chaired and I was Vice-Chair. We took time out in there, because
I was serving on three of the major post-SARS committees, and we did a
Senate report on SARS, mostly because I was very anxious that we get the
public health agency created.
What factors make for an effective committee?
Senator Keon: You have to look at the problem from every angle, comprehensively.
Be sure you use state-of-the-art science. Try and avoid anecdotal information.
Try to avoid emotionally motivated persuasions. If you can lay out the
study in very clear terms, it will take wings and will fly. It will get
support. Many people look for an excuse to stop something. It is much
easier to stop things and difficult to create things.
The Chair has an important role to play. He or she must keep the committee
motivated and keep the study itself interesting. Try to allow members
to see clear daylight. Where are they going? What can be achieved? What
good can come out of it?
I think you have to select witnesses who can be true contributors and then
strive to maintain the focus. You have to have a broad spectrum of information.
In the initial stages, you consult with experts to see what they have got
and then in the final phase of the study, you have to test all this on
the public. That is because people in the ivory towers have great ideas
on paper, but sometimes, some little worker in a community can tear their
ideas to shreds, because they are just not practical.
Senator Carstairs: I think the biggest challenge for a committee chair
is trying to keep the debate interesting. It is always a challenge working
with staff to make sure that the witnesses that you are bringing forward
have something new and different to say something to challenge the mind,
something to appeal to their sense of success and without that, you can
not achieve it. It is important to try and watch the faces of senators.
Listen to their questioning. What are the issues that are of interest
to them?
If I am having a witness who is an academic, then I expect that person
to be able to give me chapter and verse of the latest work that is being
done in the field that he or she represents.
We also need witnesses who are actually working in the field, and who give
us anecdotal evidence sometimes anecdotal evidence can be very powerful
about a situation that is impacting on a senior, which can then be superimposed
upon seniors as a whole.
We had some good storytelling at the last session, where the witnesses
described situations that made us understand that there are living, breathing
human beings out there, and we have to address their concerns.
In the final analysis all you can do in terms of the Senate is to put the
ideas forward and to speak about them publicly as often as you are given
the opportunity to do so. It is actually those delivering the programmes
who will see the immediate accomplishment. It was interesting with palliative
care. People will frequently come up to me and say you have made a difference.
I can sit back and say if I had not been there, if we had not drafted
those reports, if I had not given those speeches, if I had not crisscrossed
the country, the movement would not be happening.
You have to take your satisfaction in knowing that there is some work going
on not as much as you would like, but some going on and that as a result,
you have made a difference.
You are both very interested in issues relating to health. What are some
of the key issues in the health sector at present and for the immediate
future.
Senator Keon: Public Health has to be one of the priorities because I
think it is the only instrument we can use to solve the health problems
of the country given the resources we have. We are spending far too much
on health for what we are getting out of it. We have overbuilt our hospital-doctor
system, and we have neglected our community services system.
We have neglected public health promotion and prevention; and we have not
targeted the problem health populations and dealt with them. Instead,
we keep coming at the problem from 30,000 feet, with universal programs,
when we do not need the universal programs. We only need the programs
for the people who are experiencing bad health.
Of course, the health care system is a determinant of health, but it is
only one of the determinants of health and it counts for very little in
the overall health status of the population. To produce a healthy population,
you have to eliminate poverty, at least poverty as it affects nutrition,
and you do that by providing adequate housing and particularly, educational
facilities.
You have got to modify the top dozen or so determinants of health. There
is no point in spending tens of millions of money in treating diseases
that are totally preventable.
It is incredible that people will not take responsibility for their own
health. I experienced this in my previous life. Somebody would come in
who was hypertensive or obese and getting no exercise, a chain smoker,
and he or she wanted a heart operation. They would get the heart operation
because if they did not they would be dead in a couple months.
But you say to these people, if you want to get 20 years out of this, here
is what you have to do. Large numbers of them will not do it. They will
come back, lie down, and have the operation over again in three or four
years, rather than get involved in the promotion of their own health.
So it is a very hard sell, and it can only be sold by somebody who has
been there on the other side and done it all and who is in a position to
deliver the message the way it has to be delivered.
Senator Carstairs: I am currently Chair of a Committee on Aging. Having
been a long-term advocate of palliative care, it became clear to me that
dying issues were not the only concern of older people in our community.
There is a clear connection between looking at aging as a general concept
and the palliative care aspect of aging, so one really fit into the other.
Among other things I would like to see a caregiver pension benefit that
would allow people in their 40s and 50s to perhaps take some time away
from their jobs, which they may be willing to do, but then not to have
them suffer a penalty 10 years down the line or 15 years down the line
when they want to collect their CPP. I hope that we can make some recommendations
along that line.
I would like to see us have a federal engagement in supporting home care
services. It is not the federal governments responsibility to deliver
those services - that is a provincial responsibility, but the federal government
does have the luxury of having the money to grant to the provinces to develop
special programs, and homecare is one of those that I think we need to
be much more proactive on.
I think a national strategy coming out of the federal government, which
sets some parameters of the care that can be provided, and then some dollars
to flow with those parameters could make a significant difference, particularly
in those provinces where they are already at have-not status.
If you could start from zero, what would Canadas health system look like?
Can we focus on caring rather than curing?
Senator Keon: Our health system is not a system it is a sickness response
way of life. If we let thousands upon thousands of people become ill for
various reasons, we definitely do not have an affordable system.
If I were allowed to build a medical system in Canada, I would begin on
the ground. I would put a community health and social service in place
for every 50,000 people. I would loop them to the Public Health Agency,
to the medical information systems, and the info-highway so that we could
have an adequate collection of data and storage of data.
Each one of those community health centres would be a little research module.
They would plug into the community hospitals and the tertiary and quaternary
care centres. And for illness, people would have access through the community
health centres, and have their illness dealt with quickly and efficiently,
become rehabilitated, come back into the community, then continue to use
the community health centre.
Some of them would have terminal disease, and not survive; some would have
recurrent needs for sophisticated facilities. I would try and put the
emphasis on health promotion, thus reduce the numbers of preventable illnesses.
Senator Carstairs: I think we need a medical system that takes into account
that a hospital is not the only model that has care delivery. What about
the person who has a chronic condition, or is badly arthritic and needs
help with food, and with movement and with care within his or her home.
If we do not provide that help to people, then two things happen. Either
they end up in long-term personal care homes, or they end up back in the
hospital, which are the most expensive forms of health-care delivery.
If we move to a caring society, we are going to free dollars from the acute
care system and move it into the more caring form of delivery. The problem
is, that most Canadians do not understand that that movement could take
place and that it can take place.
That is where I think the federal government has a real role and I think
the federal government can begin by giving the monies directly to that
side of the health care system, could move the society towards a more caring
society, rather than just an acute system of health delivery.
In our federal system the obstacles to solving these problems seem almost
intractable. What can be done about this?
Senator Keon: I think the universal solution to barriers between levels
of government and barriers in society is the superbly developed plan.
Nobody can argue with a proposal that has been carefully planned, carefully
researched and that makes sense every step of the way achieve positive
results.
Senator Carstairs: I think focus is the key. When I became Minister with
Special Responsibility for Palliative Care, I knew that I had three things
I wanted to accomplish, and I was able to accomplish those three things.
We had 40 or 50 ideas we wanted to work on, but I said, we have got three
years to do this. If we can get three ideas into fruition, then we will
have achieved as much as we possibly can.
It turned out that we were able to do two or three other things, but because
we never lost sight of the three things we wanted to accomplish, which
was more research dollars, the compassionate care program and the education
of physicians. By focusing on those three things, with everything else
becoming an addition to, but not an essential, we were able to move the
agenda forward.
There is much discussion of Senate Reform these days. How do you see the
Senate evolving in the future?
Senator Carstairs: First of all I must say that there are many things
the Senate does well. For the most part, I think we do legislation well.
I think we tend to look at the details of legislation in far more non-partisan
ways than the other place does.
We have a certain lens that we look at it with, and people will say, that
is the minority lens, and it is, but it is also the lens of not having
to get elected. It is the lens of let us make sure this is the best piece
of legislation we can make it into, and not be overly concerned about interest
groups who may or may not have an impact on our election if we do it that
way. There is an enormous freedom that senators have that members of the
House of Commons never ever have.
The second thing I think we do well is special studies, both within structured
committees and outside. Although the governments of the day will rarely
admit it, some of their ideas eventually do come from these studies. The
mental health study was a perfect example of where you are seeing effective
change from that study.
The third thing, which I think very few people know, is the special causes
that senators take on. Joyce Fairbairns done fabulous work in literacy.
Former Senator Landon Pearson has done fabulous work on the rights of
children. Senator Terry Mercer works on all kinds of fundraising causes.
Senator Jim Munson has worked on autism. If you look at an active senator,
almost all of those senators have a cause. They are doing something in
the community for a particular issue that is moving that agenda forward.
As far as reform is concerned I am very much in favour of term limits.
I think that eight years is probably too short, but a twelve-year term
limit would have suited me fine.
I think we have to change the way senators are appointed. I am not sure
what the ideal situation would be there. I happen to like the appointment
process with names coming forward from the provincial governments, but
I could easily be swayed to alternative positions if a better idea came
forward.
I do not like direct election. I think we would just turn into another
House of Commons. But I also do not like the concept that the Prime Minister,
on a given day, can wake up and say, hmm, I am making this person a senator.
That is how I was made a senator, and I do not think it is valid anymore,
in 2007. I think we have to make a change.
Of course, as a westerner, I feel very strongly about better representation
for the west.
Senator Keon: I would agree that the Senate does policy and long-term
studies very well. It does in-depth review of legislation very well at
the committee level. The Senate committees are excellent because they
are not rushed and they can take the time to do in-depth analysis of legislation.
Occasionally things go wrong, but no system run by human beings is perfect.
With that given, it is pretty much recognized that they really do excellent
work. There is no question about it, we improve legislation tremendously
in the long run.
I think the biggest problem with the Senate is the appointment process.
I do not think the Canadian public are satisfied with the fact that the
Senate can be used as a powerhouse for a political party, and a corollary
to that is that appointments are frequently looked upon as political favours.
So there has to be a different process for the appointments, but it does
require some real thought. The process I would favour would be some sort
of selection committee, which is a very old, traditional way of selecting
the right people for the right job. The classic example is university presidents.
An appropriate selection committee of some kind could seek out the people
who would be best suited for appointment to a geographic area, who could
maintain political balance, who could bring an area of expertise to the
Senate that is missing.
I personally have lived with selection committees all my life. It is a
process that I am very familiar with and a big believer in, because I think
the Senate should have the best people.
The Senate should represent all sectors of society politics, but not
overwhelming; academia; the arts; the social movements; the NGOs; science
in a broad base the health sciences, engineering sciences, all of the
physical sciences. That is not a complete list, but it is a flavour of
what the Senate should be in my opinion.
I am not a big believer in elections. Frequently, elected officials do
not bring to their office the experience and education that is required
to do the job well.
The Prime Minister has to be elected, various Ministers have to be elected.
I do not think twice about that. That does not mean the Upper House has
to be a copy of the Commons. The other problem with an elected Senate
is that we get into the situation that the Americans have. It has pretty
much subdued the House of Representatives and I think if we have an elected
Senate in Canada, it will have the same effect. It will subdue the Commons.
I think the whole thing has to be very carefully thought out.
The appointments could continue the way they are being made by the Prime
Minister, but the selection committee could provide the Prime Minister
with two or three alternatives for a given seat, and let him or her have
the freedom to make the ultimate choice.
How would you evaluate your career in the Senate and what have you learned
about life and politics as a result of your years there?
Senator Keon: That is a difficult question because success in the Senate
is usually looked upon as political success, and that was never really
important to me. In fact, I used to find it hard to stomach because I
was trying to be a scientist, where you dealt with truth objective information.
If you did not have mathematical proof or scientific proof, or overwhelming
anecdotal evidence, you did not go with it. But that is not politics.
I admire successful politicians, whether federal or provincial, regardless
of their political stripe. I admired their leadership qualities. I think
the two best examples are probably Trudeau and Mulroney back to back.
The medical profession, the scientific profession was very upset with me
when I came to the Senate. You did not get a lot of brownie points in medicine
and science for getting into politics. Many of them believe our time is
better spent serving in our own profession.
It is very difficult for me to tell you whether I will be satisfied when
I leave the Senate but I think I will.
I really have enjoyed life every step of the way. I was very fortunate.
I happened to choose the right profession. I was born to do what I did
as a heart surgeon.
My outlook on life has not changed. I thought from the very beginning
that anything was possible, and I still think that.
As for politics, we should be careful when we tinker with our model of
governance in Canada, because despite its faults, in principle, we do have
one of the best governance systems in the world. Yes, it can be improved
at every level, but we should be very careful as we move forward.
Senator Carstairs: I have learned that political movement is very slow.
That the changes you think should get made instantly just do not get made
instantly. That is frustrating. You see that something needs to be done
and you want it done instantly, and rarely, in politics, does that ever
happen. That is the toughest thing that you have to adjust to.
The best thing about politics is the opportunity that it gives you to explore
ideas, to meet people, to broaden your own horizons and interests. I think
politics does that more than any profession. It is a challenge, but it
is also fun.
I think that we have to do our best to pull together on issues that are
significant to Canadians. I engage in things that are non-partisan. I think
that is where I have changed in the last 13 years of my life.
I have done the partisan thing. I have been Leader; I have been the Deputy
Leader. I had to be partisan while I did that. Now I am more than delighted
to be out of that and into the areas that I can focus on, where I think
that maybe in terms of changes in our society, I can make a difference.
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