[Recorded by Electronic Apparatus]
Thursday, November 2, 1995
[English]
.0915 
The Chairman: I call this meeting to order.
Our problem is that there is a vote. The bell will go at about 10:05 a.m. The vote is on Bill C-61. It will be about 10:45 a.m. before we can get back, but then somebody else has the room at 11 a.m. I have to be in Montreal at 12:30 p.m. anyway, so we are going to have an abbreviated session. My apologies to the health officials, but it's the House of Commons that did this to you, not us.
This is just a first shot at this. We'll be hearing more from the health people later.
Before we go to the witnesses, committee members, we had intended to decide on our proposed two-day retreat at our 10:30 a.m. in-camera session, but we'll make that decision at the next meeting. We have some suggestions to make to you. They're all in the country, unfortunately, but it's the best we can do under the circumstances.
On to the subject at hand. I believe ADM Stanley and her people are aware of what we're up to here, so I won't take time to restate that. We're glad to have what looks like the entire Department of Health with us this morning.
Kay, please introduce the people who are with you.
Ms Kay Stanley (Assistant Deputy Minister, Health Promotions and Programs Branch, Health Canada): Mr. Chairman, I was ready for that. As you know, I have had many pleasant occasions to appear before this committee. I seldom come alone because I see this as an opportunity for members of the committee not only to meet some key people in the department, but also for key people in the department to demonstrate their competence before the committee.
The Chairman: We're not complaining; we're just noting your presence.
Ms Stanley: I have been joined by a number of officials who are associated with programs in which you have expressed an interest. Catherine Lane is director general, population health directorate. Esther Kwavnick is associate director, childhood and youth division. Brian Ward is director, childhood and youth division. Susan Beaubier and Michèle Bourque are program officers in the first nations and Inuit health programs directorate, medical services branch.
Two branches are represented here today. I know that you're meeting Kent Foster and others from the health protection branch at your meetings next week, so you only have half the department here this morning, Mr. Chairman.
At the conclusion of the opening remarks I would be pleased to bring you up to date on the departmental follow-up to the recommendations and objectives of the reports you previously identified, but I want to begin by saying a few words about the child development initiative, which was announced in May 1992. It is a five-year program consisting of over thirty distinct programs coordinated across five departments and agencies, namely the Department of Justice, the Royal Canadian Mounted Police, Human Resources Development, Heritage Canada and Health Canada.
So although we have a primary role with respect to programs concerning children, we have good interdepartmental collaboration here. At some point the committee may want to call representatives from those other departments as they continue their study in this area.
Most of the programs under the child development initiative have ongoing funding, but a few are time-limited. These programs are designed to address risks that threaten the health and well-being of children, especially those under six years of age.
I've just mentioned the key departments, but other departments have a strong interest in children. When I chair the interdepartmental committee related to this topic, there is also representation there from Status of Women Canada, Citizenship and Immigration, Foreign Affairs, Solicitor General and the Department of Indian Affairs and Northern Development.
The child development initiative is evidence-based. The results of child development research reveal that in health and social policy, as in much else, an ounce of prevention is worth a pound of cure, or to be metrically correct, perhaps I should say a gram of prevention is worth a kilogram of cure.
.0920
We know it is better to anticipate and prevent problems than to attempt to solve them after they have disrupted a child's life. As well, we have learned that attempting to solve a problem in one area alone, while ignoring a problem in another, decreases the potential for successful outcomes.
[Translation]
Through the Child Development Initiative, funding was provided to expand proven programs and to develop new responses where gaps existed in the following areas:
Prevention: Programs to reduce the incidents of childhood disease, injuries and death through better information on their causes and the effectiveness of prevention and treatment strategies, largely within Health Canada.
Protection: Programs to protect the children from threats to their well being, largely in the realm of the Solicitor General, the RCMP and Justice.
Promotion: Programs to improve the health and well being of children through disseminating information on care and nurturing and promoting values which stress the importance of children and effective parenting, largely in Health Canada, and some in Heritage Canada and Human Resources Development.
Community Action: Support to communities to develop programs to address potential health and social development problems of high risk children under the age of six years. Included is support to Indian communities on reserves and to Inuit communities to improve the physical, mental and social well being of Aboriginal children and their families, largely in Health Canada.
[English]
There is a growing body of evidence about what makes people healthy. These are identified as the determinants of health. I know the committee has already had some discussion around them. They include income and social status, social support networks, education, employment and working conditions, physical environments, biology and genetic endowments, personal health practices and coping skills, and healthy child development and health services.
Many of the programs under the child development initiative are focused on reinforcement of the determinants of healthy development. They can have a profound and positive long-term effect on the lives of children. These programs offer the best prospect of influencing the long-term future of society. The child development initiative is a good example of population health strategies. Members will recall at main estimates that population health strategies are a main business line for our department.
Investment in early intervention strategies for children is known to be one of the best investments society can make. It has been estimated, and we have data from the Senate subcommittee report on poverty in 1991, that the return on investment in such strategies is $7 for every $1 invested. Health Canada has a large and ongoing investment in community-based programs directed at young children, particularly those in disadvantaged conditions, including aboriginal children.
Two recently implemented initiatives that reinforce the determinants of health are the Canada prenatal nutrition program and the aboriginal headstart program. Both of these programs target those children most at risk and involve support of their families and the community in which they live. These are key components in ensuring healthy child development.
Evaluation is an important part of any health and social program, and the department is gathering data that will be analysed to determine whether the programs I have touched on are successful in meeting these objectives.
Let's talk a bit about future directions. I have only a few more words to say before we open it up for discussion.
There are more than 7.5 million Canadians under the age of 19, and children represent 28% of the total Canadian population. Of all families with children, 20% are lone-parent families, largely led by women. Over 1.2 million children live below the Statistics Canada low-income cut-off line, which is often used as a measure of poverty in Canada. In view of these statistics I must point out that most poor children live in two-parent families, and it is worth noting that many families require two incomes to match 1980 earnings.
.0925
[Translation]
We need to respond to effects on children, youth and families of the impacts of economic and social restructuring.
We need to respond to health, well being and safety needs of Aboriginal youth and families.
We need to ensure that health system renewal meets the needs of children, particularly among certain identified priority populations.
We need to advance the priority given to children within the determinants of health model.
We need to ensure sustainable promotion, prevention and early childhood approaches in partnership with various sectors and communities.
Good policies and programs for children, like parenting, require that we take the long-term view, that we are persistent in meeting our goals and consistent in our approaches.
Children's issues are everyone's issues. As a nation, we need to become engaged and passionate about ensuring that every child is given the best possible start in life, including the opportunity to become a secure and healthy adult.
[English]
I use the term ``we must'' in the broadest sense. I'm talking about you, the elected members of Parliament, the families and parents of the children involved, public servants such as those of us sitting at this end of the room, caregivers and all levels of government. I think, and I'm sure you will agree, that this is a collective responsibility.
Mr. Chairman, those are my opening remarks. The staff members will be pleased to enter into discussion. The committee has asked us to give some guidance on how to approach this particular challenge, and if we can be of help in any way, we stand ready at your service.
The Chairman: Thank you.
Mr. Szabo (Mississauga South): Dr. Robert Evans wrote about determinants of health. You listed a number of factors in your notes here. Would you agree that not one of those determinants is a 100% guarantee of anything that happened?
Ms Stanley: Yes, I would.
Mr. Szabo: So they're not absolute determinants. I want to make this point because we have to understand that we're talking about the probabilities of outcomes in all of this. These factors can occur in the formative years and they have linkages to the outcomes. Those linkages are probable, so that with poverty, for instance, the line shows very clearly that if you're poor, your health is not as good.
There's a direct relationship between income level and quality of health, but that doesn't mean poor people can't have good kids, and it doesn't mean that rich people can't have poorly adjusted children. So as long as everybody understands that....
You didn't mention anything about focusing on the first two or three years. Why not? There is immense physiological development going on at that point. Those are the critical opportunity periods.
The last issue is the $7 to $1 figure. Eventually we'll have to understand where you spend the $1 that gets you the $7 benefit. What are you suggesting? What do you think are the areas of investment? Theoretically, if poverty is one of the biggest contributors to poor health, could it in fact be that the $1 should be spent in social programs?
.0930
Ms Stanley: Thank you very much. I'm always conscious of not taking up too much time with opening remarks, so I deliberately did not get into the data and the information with respect to the first few years, but the member may know that in a previous life I was an early childhood educator. Much was written about the life script and how even when children first arrived in formal education in kindergarten or grade 1 at five or six...if you talk about formative years being birth to eight, much of the life script was already written before they entered the formal school system. This puts us back into a focus on the work were doing in terms of prenatal nutrition.
There's a lot of research that supports the things we're doing on this subject, including Sheldon White's work at Harvard. We need to look at the health of young women and pregnant women if we really want to talk in the full context of determinants in health.
I did not wax eloquently about my support for the formative years, but I think I have probably said this at one time before this committee.
Catherine, you may want to comment on the investment reality and the interconnectedness of much of the work that we're doing.
Ms Catherine Lane (Director General, Population Health Directorate, Department of Health): Thank you, Kay. I think your first question was bang on. The other point I would make about it is that, no, it is not any one determinant; it's all of them taken together that seem to make a difference. There are some that seem to make more of a difference than others, but it's the basket, if you like, of determinants that are important.
With respect to investment, I think that, again, you were bang on in asking where we should spend the dollar. We hope it's one of the things the committee is going to look at and give us some guidance on. We certainly have some ideas. We believe it should be spent on the prevention areas, on - as Kay has indicated - the formative years. That's why our prenatal nutrition program is so important. If you don't have a health baby, you're unlikely to have a child who is going to grow up to be mentally and physically healthy, and therefore...etc. So it does start very early.
We have found certainly in the work that we're doing, therefore, that the money spent on the prevention, the money spent on the early stages of children, and the money spent in community supports are incredibly important. So that's a good place for this dollar to be invested as well. Is it better to have it invested in, as you say, income support as opposed to community supports? That is a difficult question. We think again, which shows in the work we've done, that it's as important to spend it on some of the community supports and some of the preventative areas that I've talked about.
Mr. Szabo: Just to finish, Mr. Chairman, do you have any research background or knowledge of the importance of parental bonding and secure attachments?
Mr. Brian Ward (Director, Childhood and Youth Division, Population Health Directorate, Department of Health): Yes, we do, both in Canada and the United States, and the longitudinal work that is now thirty years in length suggests that one of the major predictors of health pathways in life is the presence and active participation of a single adult in the early life of a child, both as a guardian and as an advocate. This work is eloquently spoken to in Canada by Dr. Paul Steinhauer of the Sick Children's Hospital in Toronto, and the longitudinal work on which some of this is based is by Dr. Emmy Werner from the University of California and her pioneering study.
I should say that under the child development initiative, Canada is undertaking one of the most significant longitudinal studies yet undertaken. It's being operated by HRDC and it is an in-depth regular sampling of many thousands of families in considerable detail through in-home surveys.
.0935
The first field study has been completed. The data has not been analysed yet. This will be repeated over and over. It should give us after twenty years - unfortunately for those of you who are now here in the House - many better answers to the questions you're posing. But we will have some good data probably by this coming spring.
Mrs. Hayes (Port Moody - Coquitlam): Thank you all for coming today. I'm new to the committee, so it's interesting to see the health officials here. I'm as pleased to see you as anyone here, I'm sure.
I have a couple of questions that refer to some of your material. On page 3 of our copy of your presentation, you were saying that you're gathering data on some of the approaches:
- Evaluation is an important part of any health and social program. The department is gathering
data that will be analysed to determine whether the programs I have touched on are successful in
meeting their objectives.
I'd also like to ask you whether you know the percentage of health dollars spent on preventative measures, particularly on the children's initiatives that we see here. Could you give me the figure for all departments, if you know it.
Ms Stanley: Thank you, Mrs. Hayes. I too am pleased to see you. I'm delighted that you're here. I know of your interest in this area. I think it's kind of a natural fit that you would be questioning us with respect to our programs.
I'm going to ask Esther Kwavnick to address the issue of evaluation and other members of the team to answer the second question on percentage of dollars spent on prevention.
I should also, just to make sure that the committee is consistent with current terminology, state that we no longer have a children's bureau in Health Canada. We've gone through, in accordance with our business lines, a major reorganization within my branch. Even the branch's name has changed. It's now health promotions and programs branch. Because of the need for a continuum of work with respect to children and youth, we now have formed the childhood and youth division.
The functions that were carried on by the bureau previously have now been consolidated in the childhood and youth division. Both Brian Ward and Esther Kwavnick are here from that particular division.
I'll ask Esther to respond to the question on evaluation.
Ms Esther Kwavnick (Associate Director, Childhood and Youth Division, Department of Health): Thank you very much. The major impacts and overall effects of this CDI program have yet to be assessed in its formal way.
The final evaluation of the initiative is currently taking place. We hope to have results at the end of the fiscal year in terms of the impact of all of the components of the initiative.
.0940
The evaluation will assess three issues: continued relevance, success, and cost-effectiveness. We already know through informal feedback that a number of the program activities that were initiated in the initial stages are already demonstrating success and positive impact of the initiative. For example, the post-partum parent support program is now in all provinces, reaching over 80% of births. We know that through that program there has been an increase in the take-up rates in terms of breast feeding and the support that is there through the hospital and the community health system.
The informal feedback in terms of CAPC, which is the Community Action Program for Children, has pointed out how supportive the participants in these programs feel in terms of the activities they're involved in. The feedback has suggested that the program and projects have contributed to improving parental practices and have increased the socialization skills of the children.
With regard to some recently implemented initiatives, the Canada prenatal nutrition program and the aboriginal headstart program, both will have a rigorous evaluation framework as part of their component. We are trying something quite interesting with the Canada prenatal nutrition program with respect to the evaluation framework. Essentially we are bringing together projects to guide the department in terms of what they think are important evaluator indicators for success with respect to projects that are being provided through that initiative.
Ms Stanley: Because of their work with first nations, the medical services branch may also want to give you some input with respect to evaluation.
Michèle.
Ms Michèle Bourque (Program Officer, First Nations and Inuit Health Programs Directorate, Medical Services Branch, Department of Health): Thank you. I wanted to say that the medical services branch is under an evaluation process as well and we expect the results at the end of March. So an evaluation of the community-based programs is taking place too.
Ms Susan Beaubier (Program Officer, First Nations and Inuit Health Programs Directorate, Medical Services Branch, Department of Health): I would like to add something with regard to the Canada prenatal nutrition program, where Esther highlighted the innovative approaches we're taking to the evaluation component. MSB works very closely with HPPB to try to keep our evaluation aligned, yet have the opportunity to have the flexibility to do some of the evaluation process in a different fashion according to first nations and Inuit needs.
We too have some consultative groups that are giving us direction on how best to gather information on the same indicator, but with a different approach, possibly, so that we have the communities on side and we are getting the information we need to report back.
Ms Stanley: Mr. Chairman, you never asked about percentage groups. I won't touch that thing; I'll let somebody else look after it.
The member asked about percentage spent on prevention. It turns on how one defines prevention. There's $548 million spent on the child development initiative, the Canada prenatal nutrition program and the aboriginal headstart program. I could say that's all prevention or I could say that part of it is prevention and other parts have to do with maintenance of a certain level of healthy child development and so forth.
It's a very hard thing to isolate prevention when you're talking in a holistic way about healthy child development. If the committee could help us in that and give us some guidance, we would certainly attempt to do that.
Mrs. Hayes: I won't pretend to give you guidance on that myself, but that's certainly something we could look at.
I have another question that is topical. Certainly, in child care and child development there's an overlap between the federal and provincial authorities and their interest in it, with welfare and so on and so forth.
.0945
Do you have some guideline as to who is involved in what? Is there communication between the two levels of government? Is there any initiative within the department to review those processes to see if they can be streamlined and hopefully made more efficient and more effective for everyone?
Ms Stanley: The member may be aware that currently there is a major exercise under way led by the deputy ministers of health to look for efficiencies in the system. Our regional directors general and the regional directors from the health promotion and programs branch are looking at all of Health Canada's programs, with their provincial and territorial counterparts, to find those efficiencies in the system. That is a work in progress.
I think we're on very solid ground in this particular area of public policy because the very nature of the community action program for children is rooted in the community. We have joint management committees in each of the provinces and the territories that have representatives of the provincial government, representatives of first nations in some cases, and our federal officials, who sit down, decide on the priorities and make determinations of where the best investment could be made to ensure it is not duplicating something already happening that is being provided by either a provincial social services ministry or a provincial health ministry.
The recommendations that come forward to the minister under the community action program for children are, by the very nature of their development, filling gaps, strengthening and complimenting existing programs and are not running parallel or duplicating work already under way.
We used that same mechanism, the joint management committee under the direction of this government, when we moved into the prenatal nutrition area, to once again make sure the investment of federal dollars was not duplicating or diverting or altering some of the very good programs already under way, fostered and funded by provincial authorities.
Do other members want to comment with respect to that?
I think we have a good case example of best practices in terms of federal, provincial and territorial collaboration in this particular area. We would be quite pleased to give the member information about how the joint management committees function.
Michèle.
Ms Bourque: I want to add that one of the program principles of the first nations and Inuit component of this program is that the initiative is not intended to duplicate existing programs but to build on existing infrastructures. It also encourages coordinations and linkages with other programs, such as some of the alcohol and drug abuse programs and that sort of thing.
For instance -
The Chairman: Excuse me. I'm sorry. You've already used up your time. We like to be fairly informal about this, but you've been going for about thirteen minutes now. And it's going to be more so, so stick around.
Ovid and I have a couple of questions. I have no other people on my list at the moment.
Ovid.
Mr. Jackson (Bruce - Grey): Mr. Chairman, I'll try to keep it brief and go right to the point.
In our Canadian societies we have what I call a circle of disparity in which people get trapped. You hear quite often about people who are on welfare through three or four generations. Part of the problem is that they're born into certain situations and they become trapped because their early training does not mirror that of a middle-class, upright teacher. They go to class and maybe they're foul-mouthed and they speak out, so they get put in the sandbox, they get trapped, and pretty soon they drop out of school and we have problems with them.
.0950
You spoke a lot about your post-natal care. You spoke to some degree about some of the determinants. For instance, you spoke about the presence of a single adult in the child's life, a grandparent or someone like that. Notwithstanding that, in a lot of cases the child is in a bad environment but collaboration with that one person is an example, and the child picking up life skills from that person is what brings that person.... Maybe one out of ten kids might do that.
Can you tell us what programs you have? I know you have some programs - I've seen some in my community, for instance - where you have a kind of library. People bring their kids in and they share books and records about childbirth and how to read to the child early on. How many programs do you have in that category, and how effective are they at reaching that particular part of the population?
Mr. Ward: Thank you for the question. We approach this in two ways. We actually have programs on the ground that support organizations such as the parent resource centres that you're speaking of through the community action program for children, often in association with other initiatives such as prenatal nutrition. Those programs offer direct assistance and involvement of parents in the environments you suggest.
We also have some programs that are more national in scope. They support local efforts, although they do not offer direct services. They are information programs for parents. We've done a number of things in this area. One of them was a very successful collaboration with Chatelaine magazine and Today's Parent called ``For the Love of Kids''. We know over three million copies have been distributed through voluntary organizations at the community level. For example, boards of education now give it to new children and their parents as they enrol in school.
That is combined with some of the work done in our strengthening families program, which uses television, video and other information. In the province of Quebec, the program M'aimes-tu? has been one of the vehicles through which we've been looking at parenting messages.
So this is a combination of on-the-ground, good involvement of parents with their children and the provision of useful tools for parents and community organizations from the national level.
Mr. Jackson: Do you have a method of evaluating that to see if we are in fact cutting down on those people who are at risk?
Mr. Ward: Every individual program has its own evaluation to see if it's doing what it's supposed to and meeting the particular goals.
One of the real problems we face, of course, is that, in terms of seeing a broad change in the status of children, it's pretty difficult to suggest any one program or even a combination of these programs in and of themselves is contributing to it.
In these programs we set out to serve as many people as we can with a certain level of quality in the service, and when we do the feedback these programs are well-supported in terms of what the clients are telling us. We have to deduce that they are making a positive contribution.
Again, the best marker on this is going to be the longer-term longitudinal studies that we put in place. Maybe we can, through them, isolate particularly important variables. We track those things as best we can. I believe that over the long term, with a sustained effort, we will see changes and improvements. We do know the programs are well-used and the materials are widely distributed. There seems to be a client acceptance of our materials.
The Chairman: I'll put my questions quickly and then I'll go to Bernard. I believe mine are brief and to the point.
Kay, on page 3 of your statement you mentioned that the return on investment was seven to one. Is that based exclusively on U.S. data, or is there a Canadian component to that data? The issue is, what's the Canadian experience on that?
.0955
Ms Stanley: Yes.
Brian, do you want to comment, because there is a Canadian....
Mr. Ward: That data that surfaced on the seven to one was a very rigorous study done by a group in Michigan that specializes in this kind of evaluation for a quality program dealing with young children pre-school. It was sufficiently rigorous that the American Senate and House have used this as a sort of benchmark measurement of what the savings are for the investments put in.
It's a quantifiable amount of what makes some reasonable sense, because the results of these programs were showing improvements in things such as how many years a young person stays in schools. It has improved. How many years later does a young person get married and will be in that community normally? It's a bit later. How many times do they get involved with the justice system? It's fewer. So all of the normal variables seem to be heightened and some of the ones that take people off regular pathways seem to be lessened. Then those are quantified.
Is it a good one? I think it is useful.
The Chairman: I'm sorry; this is why politicians and bureaucrats have such trouble in communicating: because politicians ask the questions clumsily and the bureaucrat doesn't answer.
The question was simply: what's the Canadian content here?
Mr. Ward: We have nothing that's exactly the same as that study, no.
The Chairman: So you're saying that this was based on American figures.
Mr. Ward: It's based on an American program. That's right.
The Chairman: I'm sorry to cut you off, but we're under the gun and we have two or three other people to whom I have made commitments.
That was a specific question. I have a couple more specific questions, to which I would like specific answers.
You're changing all your names in the department. Could we get a new organizational chart, Kay, so we know the score-card?
Ms Stanley: Absolutely, Mr. Chairman, and it's done because it's a much more rational approach to dealing with overarching issues. I think you'll see that when I send that to you.
The Chairman: Also, I think Susan and Kay made reference to the review process. Will we get our hot little hands on the evaluation results when the time comes?
Ms Stanley: Yes.
The Chairman: When does the time come?
Ms Lane: As Susan indicated, theirs are out in March. We should see some first results as well coming around March, April. We'll get them to you.
[Translation]
Mrs. Picard (Drummond): I'm going to pass up my turn, Mr. Chairman, because I do not have enough information to ask questions now.
M. Patry (Pierrefonds - Dollard): I have a very simple question: The Health Programs and Services Branch of Health Canada administers 13 programs which are part of what you call the ``Child Development Initiative''. In addition, you have the Canada Prenatal Nutrition Program.
Given that good baseline data is essential in order to evaluate outcomes, could you provide the committee with the data on the current health status of Canadian children that your branch uses to establish its various initiatives?
Ms Lane: That depends on the programs, because they are obviously different from each other and the baseline data used for each is different as well. But we can give it to you.
M. Patry: Good. You can give it to the committee?
Ms Lane: Yes.
Mr. Patry: Thank you. That's all for now, Mr. Chairman.
The Chairman: Have you finished?
[English]
Mr. Patry: That's all.
Mrs. Hayes: Can I get the data from the federal-provincial...? You said you have some description of what goes on now and what the guidelines of the interaction are. Could I have that? I suppose that maybe the committee would like that as well, particularly if you can give us direction, even within our own communities, as to how best to find the people who are involved at that level.
.1000
Ms Stanley: There are actually two mechanisms I can provide information on: one is the joint management committee and the other is the aboriginal headstart initiative with its regionally based advisory committees, made up of members of aboriginal communities. Through the chair, we'll provide the modus operandi for both of those to the members of the committee.
Mrs. Hayes: That will be very interesting. Thank you.
The Chairman: We'll be getting a vote bell within five minutes or so.
I want to mention to the people from the department that we're grateful you came and we wish we had just a little more time this morning. I heard what the ADM said earlier, that you're available for other occasions, and I'm sure you'll hear more from us.
As a committee we're still feeling our way. We're rather excited about what we're doing, but we don't know a lot about what we're doing - at least I don't, so I'll speak for me. We're attempting to get educated to start with, and to that end we're proposing having a two-day session, where we isolate ourselves from the Hill and just focus on this particular issue. We see it as a very important challenge, and we hope we can make some contribution to it. That will depend on a lot of help, including from you people.
Before concluding, let me just say two or three things to the committee. We'll be meeting Tuesday at 9 a.m, at which time we'll hear from ADM Kent Foster of the health protection branch. We're going to spend an hour or so with the department people, and then we're going to go in-camera to deal with a couple of issues, including the question of our two-day session and some details concerning where we go, the format, and so on.
On Tuesday I will be appointing a subcommittee to deal with Bill C-95, which has been referred to the committee today by the House. It's the bill to amend the National Health and Welfare Act. I've asked Andy if he would consider chairing that subcommittee. I'd like by Tuesday, if possible, an indication from the Bloc and the Reform, our colleagues there, as to who they would like to name to the committee. I'm proposing that it be a four-one-one, six member committee, with four government members and one from each of the opposition parties represented.
Hedy will be on the committee in her capacity as parliamentary secretary, but I'd like an indication from another couple of people who might be interested. Would anybody, off the top of their head, like to let me know? Bernard? All right. We'll need one other, either now or by Tuesday, for that subcommittee, plus of course the two names from here.
Kay, you have the last word.
Ms Stanley: Thank you, Mr. Chairman, and I repeat my offer that we would be glad to help if there are times even in the working sessions that we can be of assistance.
In terms of how the committee can move the margins on this, in a time when there's a very difficult fiscal situation, it would be helpful for us to ensure that promotion, prevention and early intervention in partnership with all of those sectors out there remains high on the agenda. It's tough because the results aren't within a two- or a five- or sometimes not until a ten-year period. In the immediacy of looking at where we should invest our limited dollars, I would hope that the committee would certainly look to its role in ensuring that the promotion and prevention issues remain and that there be balance in our approach on this issue, because there aren't quick fixes, as you well know. Anyone who is a parent or has worked with children knows it's long term.
Just speaking on behalf of my colleagues, if the members of the committee could assist us in that way, we would certainly be using their report or their recommendations within the department and across departments always to put that card on the table with the same degree of zest as some of the research and some of the science around this particular issue. So it's a push or a plea for the social science side of the argument.
.1005
Thank you very much, Mr. Chairman.
The Chairman: Thank you.
That's the vote bell going now, so we should move.
Did you have something you wanted to say quickly, Paul?
Mr. Szabo: I wanted certainly to invite the officials that if they have.... We can't read a lot. We don't need books. What we need are people who have synthesized, etc. If you have any suggestions, readings, of a paper, really, the nuts and bolts, then that would be helpful. Certainly I'd be interested in getting a copy of that Chatelaine report, ``For the Love of Kids''. It sounds helpful.
The Chairman: Okay.
Ms Fry (Vancouver Centre): Mr. Chairman, there is a document called The Health of Canada's Children, which is a Canadian Institute of Child Health profile. It came out last year. The first one came out five years prior to that. It gives you the status of Canada's children's health so that you will have clear knowledge of where Canada's children are right now in terms of their health on every particular issue.
If you could give permission, Mr. Chairman, for every member to have it, it really would be -
The Chairman: If you recommend it. It's $35 a shot, so -
Ms Fry: I recommend it.
The Chairman: All right.
This meeting stands adjourned to the call of the chair.