HESA Committee Report

Minority Report: Chronic Diseases Related to Aging and Health Promotion and Disease Prevention

Submitted by:

Libby Davies, NDP, Vancouver East; Djaouida Sellah, NDP, Saint-Bruno-Saint Hubert; Dany Morin, NDP, Chicoutimi-Le Fjord; and Matthew Kellway, NDP, Beaches-East York.

Introduction:

Federal leadership on health care is more important than ever, to renew, invest, and strengthen our public health care system. The Standing Committee on Health’s Report on Chronic Diseases Related to Aging and Health Promotion and Diseases Prevention illustrates an important body of research that pursues chronic disease related to aging, and addresses important issues in relation to health promotion and disease prevention.  However, the NDP believes that further recommendations are necessary to ensure greater accountability and innovation by the federal government in health promotion and disease prevention.  The NDP expresses its disappointment that so little progress has been made by the federal government on these critical issues.  The federal government must be a leader in establishing an effective plan that will spur health promotion and disease prevention for the benefit of all Canadians, no matter their age. 

Based on the testimony provided to the Standing Committee on Health, the NDP makes recommendations in three key areas: the health accords; health living; and healthy aging. 

The Health Accords:

In 2004, the federal, provincial, and territorial First Ministers agreed to a 10-year commitment to institute and achieve a number of priority reforms that would strengthen the Canadian healthcare system.  These reforms included a commitment to recognize home and primary care as cost effective means of delivering health care services.  The 2004 Health Accord also committed to a pharmaceutical strategy that would provide Canadians with the necessary medication for effective treatment.   

New healthcare delivery models such as home care and palliative care have proven to be less expensive than hospital beds, while keeping the patient in a much more familiar environment. In his 2002 report, Roy Romanow, recommended the establishment of a Home Care Transfer, which could be used to establish a national platform for home care services (Building on Values: The Future of Health Care in Canada, 2002). 

The 2004 Health Accord also included a pharmaceutical strategy aimed at reducing the cost of medications. Unfortunately, this proposal, which is mostly of federal jurisdiction, has gone nowhere. Such a plan would not only save our health care system billions of dollars each year, it would also help Canadians have better access to more effective drugs, especially the 23% of Canadians with chronic illnesses who cannot afford to fill their prescriptions (Health Council of Canada, How Do Sicker Canadians with Chronic Disease Rate the Health Care System?, 2011).

In December 2011, the federal Finance Minister Jim Flaherty announced unilateral cuts to the Canada Health Transfer, without any consultation with provincial and territorial counterparts.  The Parliamentary Budget Officer has noted that these cuts will short-change provincial and territorial health budgets by more than $30 billion dollars, forcing the provinces to cut vital services.  Premiers have taken a unified stance against this new arrangement, and called for the federal government to initiate discussions on a new Accord. 

Recommendation 1: The NDP urges the Minister of Health and the federal government to work with provincial and territorial counterparts to address and follow through on commitments laid out in 2003/4 Health Accords, with particular emphasis on the issues of home care and universal prescription drug coverage, including establishing a comprehensive home care, palliative care, and compassionate care strategy which will save costs in the long-run and improve the health of millions of Canadians.  The federal government must work with provincial and territorial counterparts to set out sufficient federal funds that establish measurable health care outcomes.

Recommendation 2: The NDP urges the Minister of Health and the federal government to commit federal funds dedicated to a renewed focus on community-based integrated primary health care, as the key to a more efficient and cost-effective use of health care resources.  Reform should include the creation of community-based health care services, delivered by multi-disciplinary health care teams. 

Healthy Living:

It is important to examine practices that effectively address chronic disease and encourage healthy living for Canadians in all stages of life.  These interventions can range from access to nutritious food, incentives for physical activity, educational campaigns, and eliminating socioeconomic or cultural barriers that may prevent Canadians from accessing care.  Of particular note is the lack of Conservative government’s lack of leadership on legislative initiatives that promote healthy living, including the regulation of sodium, trans fats, and sugars in prepared foods.  It is unacceptable that Canada is falling so far behind on fundamental public health reforms.  All of these initiatives must receive stable and adequate federal funding to ensure their effectiveness.  The federal government’s lead on preventative measures would lower the chronic diseases associated with aging and unhealthy habits. 

Recommendation 1: The NDP encourages the Public Health Agency of Canada and Health Canada to engage with their provincial and territorial counterparts to promote ethnic and cultural sensitivity.

Recommendation 2:  The NDP urges the Minister of Health and the federal government to implement a National Pain Strategy, built on the Canadian Pain Society’s framework for a National Pain Strategy.  This strategy should include provisions for multi-disciplinary health care teams to treat pain; timely pain management; dedicated pain-related research funding; and pain management education for health professionals and the general public.

Recommendation 3: The NDP urges the Minister of Health and the federal government to implement the recommendations laid out the June 2006 report of the Trans Fat Task Force, entitled TRANSforming the Food Supply, which made several recommendations on the regulation of trans fats, to lower or eliminate the amount of trans fats in prepared foods.  Similarly, we urge the Minister to implement the recommendations of the July 2010 report of the Working Group on Sodium Reduction, which put forward the Sodium Reduction Strategy for Canada, to reduce the sodium intake of Canadians.

Recommendation 4: The NDP urges the Minister of Health and the federal government to work with provincial and territorial counterparts to implement federal legislation similar to Quebec’s Consumer Protection Act, which has successfully limited the impact of advertising to children. 

Recommendation 5: The NDP encourages all levels of government to commit to increase the total public health spending on health promotion, physical activity, and sport to 5% annually (from current level of 0.9% in 2011-2012 fiscal year).

Recommendation 6: The NDP urges the Health Canada to change food labeling regulations, so that nutritional info appears on the front of the package.  The important nutritional information (such as sodium and fat content) should be highly visible.

Recommendation 7: The NDP recommends that the federal government change the Children’s Fitness Tax Credit from non-refundable credit to refundable credit.  A refundable Fitness Tax Credit should also be established for adults. 

Recommendation 8: The NDP urges the Minister of Health and the federal government to recognize the impact that socio-economic factors have on a person’s ability to make healthy lifestyle decisions. Access to healthy foods is limited for people affected by poverty or living in remote areas, notably, the First Nations and Inuit communities. Subsidized local fresh produce would improve access to a healthy diet. 

Recommendation 9: The NDP urges the Minister of Health and the federal government to reconsider its decision to reduce the funds allotted to the Federal Tobacco Control Strategy as tobacco is the leading cause of preventive diseases, disability and death, costing more than 4 billion in annual health care costs and causing 37, 000 deaths annually.   

Recommendation 10:  The NDP urges the Minister of Health and the federal government to invest more in healthy living for First Nations communities.  Witnesses have made it clear that First Nations constitutes a segment of population that face increased adverse health outcomes than the average Canadian citizen.  First Nations health is a federal responsibility that must be taken seriously.

Healthy Aging:

A National Strategy on Healthy Aging is an important part of the federal government’s health promotion and chronic disease prevention initiatives.  As witnesses stated, as Canadians age, they are more likely to have complex health care needs, living with more than one chronic condition.  A National Strategy on Aging would take a broad perspective, necessary to address the complex health needs of older adults, alongside strategies on home care, long-term care, and palliative care.

Recommendation 1: The NDP urges the Minister of Health and the federal government to work with provincial and territorial counterparts to develop a long-term strategy based on national care standards, affordability, and accessibility.  This strategy would assess the need for affordable and accessible long-term care in Canada, and commit funds to meeting this need. 

Recommendation 2: The NDP calls on the federal government to establish tax credits and grants for care givers, including: a) increasing the EI Compassionate Care Benefit and changing its current criteria to be allow more care givers to be eligible for this credit, and b); create a refundable tax benefit for the medical expenses incurred by care givers.

Recommendation 3: The NDP encourages the Minister of Health and the federal government to work with territorial and provincial counterparts to develop a National Strategy for Healthy Aging.  This strategy should include an emphasis on health promotion and disease prevention through the promotion of healthy lifestyles; support for formal and informal caregivers; address the determinants of health; facilitate better access to health services, and allow people to access care home for longer.

Mental Health

Federal efforts to improve the health of Canadians must include mental health initiatives.  Witnesses frequently told the Committee that maintaining one’s mental health is a key part of a healthy lifestyle, and that addressing mental health issues can be critical to restoring the overall health of an individual.  The Mental Health Commission of Canada recently released Changing Directions, Changing Lives: The Mental Health Strategy for Canada, which outlines a framework for all levels of government to work to improve mental health services in Canada.

Recommendation 1: That the Minister of Health and the federal government work with provincial and territorial counterparts to implement the recommendations made by the Mental Health Commission of Canada in their Mental Health Strategy for Canada and provide federal funding towards implementation efforts. 

Conclusion

The NDP believes that these recommendations will address the concerns expressed by experts in the fields of healthy living and aging.  The NDP believes this report adds to the Standing Committee on Health’s report on Chronic Diseases Related to Aging and Health Promotion and Disease Prevention; setting out concrete recommendations which will strengthen health care services across Canada and allow Canadians to lead healthier lives for longer.  It also demonstrates the role of the federal government to lead the way, to create a more cost-effective public health care system that better serves Canadians throughout their lifetime.