:
I call this meeting to order.
Welcome to meeting number 46 of the House of Commons Standing Committee on Health.
Today we will meet for two hours to consider the supplementary estimates (B).
Today's meeting is taking place in a hybrid format pursuant to the House order of June 23, 2022.
I will remind you that screenshots or taking photos of your screen of those participating virtually is not permitted.
In accordance with our routine motion, I'm informing the committee that all witnesses have completed the required connection tests in advance of the meeting.
Colleagues, could I have your attention? Once we get to 12 o'clock you're going to regret this extra couple of minutes of chatter, because you're going to want to question the ministers, I'm sure.
Okay. I've just gone through the preliminary remarks and I have indicated that witnesses have completed the required connection tests.
I would now like to welcome the ministers who are joining us for the first hour: the Honourable Jean-Yves Duclos, Minister of Health; and the Honourable Carolyn Bennett, Minister of Mental Health and Addictions and Associate Minister of Health.
They are joined by the following officials, who will stay with us for the entire meeting: from the Canadian Food Inspection Agency, Philippe Morel, vice-president of operations, by video conference; from the Canadian Institutes of Health Research, Dr. Michael Strong, also by video conference; from the Department of Health, Dr. Stephen Lucas, deputy minister, Heather Jeffrey, associate deputy minister, and Dr. Supriya Sharma, chief medical adviser; and from the Public Health Agency of Canada, Dr. Harpreet Kochhar, president, and Dr. Howard Njoo, deputy chief public health officer and interim vice-president, infectious disease prevention and control branch.
Thanks to all of you for taking the time to be with us today.
We're going to begin with opening remarks from each minister.
Minister Duclos, if you would like to begin, you have the floor for five minutes or less. Welcome to the committee.
:
Thank you very much, Mr. Chair.
I would like to thank you for inviting us to appear before the committee today.
We are grateful for this opportunity to talk about our work in the health portfolio and our financial overview for supplementary estimates (B) for 2022-23.
I am accompanied today by , Minister of Mental Health and Addictions and Associate Minister of Health, as well as: Dr. Stephen Lucas, Deputy Minister, Health Canada; Heather Jeffery, Associate Deputy Minister, Health Canada; Dr. Supriya Sharma, Chief Medical Advisor and Senior Medical Advisor, Health Canada; Dr. Harpreet Kochhar, President of the Public Health Agency of Canada; Dr. Howard Njoo, Deputy Chief Public Health Officer, Public Health Agency of Canada; Dr. Michael Strong, President, Canadian Institutes of Health Research; and Philippe Morel; Vice-President of Operations, Canadian Food Inspection Agency.
[English]
Before we address the issue at hand, our appearance here today also provides us the opportunity to share with you the latest information related to the shortages of children's and infants' analgesics.
Thanks to close collaboration with our industry partners, a record number of children's analgesics are currently being manufactured across the country, with some companies producing twice as many units as they did at the same time in 2021.
As an example of this increased production, during the month of November only, a total of 1.1 million units of children's Advil products from Haleon will have been made available for the Canadian market, which is a significant amount versus the typical November.
This is obviously good news for Canadians: Children's pain medication is being produced in large numbers in Canada. This increased domestic supply is in addition to the importation of more than one million units announced last week, distribution of which is currently under way across Canada.
An additional importation of around half a million units is scheduled for the next three weeks. As we continue to approve increased supply to community pharmacies and retailers, work continues to ensure pediatric hospitals are well stocked and in a position to manage the shortage.
We are also looking to find longer-term solutions with provinces and territories, industry and stakeholders such as pharmacies and children's hospitals, and we will continue to keep the committee apprised of the progress.
[Translation]
To the matter at hand today—supplementary estimates—the Government of Canada continues to address the long-term effects of the pandemic, and our budgetary needs reflect this, as I mentioned earlier.
At this time, we are seeking $3.41 billion for the health portfolio. Beginning with Health Canada, I am seeking an additional $1.9 billion. This funding will be used to address Canada’s ongoing COVID‑19 response, as well as ongoing health care issues.
It also includes funding to improve mental health supports and services, as well as funding to address the opioid overdose crisis and problematic substance use.
My colleague, Minister Bennett, will have more to say about those two issues in a few moments.
[English]
As part of supplementary estimates (B), PHAC is seeking an increase of $1.4 billion to its reference levels. This includes $118 million in new funding and $1.2 billion in reprofiles from 2021-22.
Through supplementary estimates (B), the Canadian Institutes of Health Research are also seeking an increase of $106.1 million. This investment will help implement the important clinical trials fund and provide funding to support the study of the long-term health impacts of COVID-19, as well as other important initiatives.
[Translation]
And finally, the Canadian Food Inspection Agency, CFIA, will see a budget increase of $19.5 million.
Overall, this increase will help the agency respond to the impacts of COVID‑19 on Canada’s food production and supply chain, as well as to the economic implications stemming from disruptions in employment.
[English]
In conclusion, our commitments as set out in our supplementary estimates (B) are a reflection of our most pressing health priorities. They demonstrate how we are taking action to protect and improve our health system for all Canadians.
Merci. Meegwetch.
I am pleased to be here today to talk about a number of investments requested in the 2022-2023 supplementary estimates (B).
I would like to begin by acknowledging that we are meeting on the unceded traditional territory of the Algonquin people, who have been the stewards of this land and water since time immemorial.
[English]
I am pleased to be here, of course, with my colleague, Minister Duclos, and our colleagues from Health Canada, from the Public Health Agency and from CIHR.
[Translation]
While COVID‑19 has increased the number of people experiencing mental health problems, it has also made many of us more willing to talk about our own mental health.
[English]
We hope that this begins to reduce the stigma that remains a significant barrier to seeking care.
Since 2015, we have made historic investments to support mental health and to deal with problematic substance use, including the $5 billion to the provinces and territories to increase the availability of mental health care; $598 million for a distinctions-based mental health and wellness strategy for indigenous peoples; $270 million for the Wellness Together portal; $45 million to develop some national standards on the priorities I articulated by the provinces and territories; $350 million in the substance use and addictions program since 2020; and many other targeted investments on substance use and mental health promotion innovation.
The $5-billion investment through provincial and territorial bilateral agreements is currently providing $600 million of additional annual funding until 2027.
I am also pleased to say that the online portal, Wellness Together Canada, and its companion pocket app, PocketWell, which have specific funding included in the supplementary estimates (B), have assisted Canadians in getting the help they need both directly and as a stepping stone to receiving advice or finding more specialized care.
We know, sadly, that when so many Canadians need support, that support is still all too often out of reach. There is much more that needs to be done. Among other further actions, we will continue to engage with provinces, territories and stakeholders to invest additional funding through a mental health transfer.
The Standards Council of Canada, together with our provincial and territorial partners, is also developing national standards for evidence-based mental health and addiction services on the six priority areas identified with our provincial and territorial colleagues.
We are particularly encouraged by the incredible early progress of national standards for integrated youth services.
We welcome the CRTC's decision to approve the new 988 three-digit suicide prevention line, and we are working to ensure it has the capacity for a very successful launch next fall.
We want people to know that if they are struggling with thoughts of suicide, or know someone who is, help is available right now at 1-833-456-4566.
The toxic drug and overdose crisis continues to take a tragic toll on families, loved ones and communities. Our government will use every tool at its disposal to work with its partners to end this national public health crisis. Since 2017, we have committed more than $800 million to address the overdose crisis. We are taking concrete steps to divert people who use drugs away from the criminal justice system. This is a public health issue.
Approving B.C.'s decriminalization proposal for personal possession of small amounts of certain substances was an important step. So far, we have also supported 27 projects supporting a safer supply of drugs.
We must demonstrate to Canadians that we share their concerns and have been listening to those with lived and living experiences, the experts, and those on the front lines, to put in place evidence-based actions to address the parallel pandemics of mental health and the tragic ongoing toxic drug and overdose crisis.
[Translation]
I look forward to exploring this topic further by answering your thoughtful questions.
:
Thank you very much, Chair.
Thank you to both ministers for being here, and to your officials as well.
It is certainly an important time for Canada, with the health care crisis we have, not only in the delivery of health care but in mental health as well. Again, thank you for being here.
Minister Duclos, through you, Chair, if I may, the spoke very openly in the House of Commons about the 7,500 doctors, nurses and nurse practitioners that $3.2 billion was going to bring to this country.
The question is, where have we spent that money? How many of those doctors, nurses and nurse practitioners in each of those specific areas are actually here working on the ground now?
Thank you, everyone.
First, on the statement of what we've done until now.... As we know, COVID-19—although it's not over—is better than it could have been. That's, in part, because the federal government invested $72 billion to a large extent to support the safety and the health of Canadians. That is continuing through vaccination, rapid tests and access to treatments like Paxlovid.
Second is the additional $2 billion that was announced in the last budget to reduce the backlog in surgeries. That, obviously, comes through supporting health workers, nurses and doctors, hiring more of them, recruiting more of them and retaining more of them.
Finally, there are other measures that are supportive of the health workforce, including the $3 billion in long-term care, the $3 million in mental health care and the $3 billion in support to home care and community care services.
:
Thank you for that, Minister.
I guess the question was perhaps not clear. I didn't ask about COVID. I asked specifically about how many of the 7,500 doctors, nurses and nurse practitioners for $3.2 billion are actually working on the ground.
The spoke very clearly about these numbers in the House of Commons. I know you were there. I was there. I heard him say it in person. That's the question for which I'm looking for an answer on behalf of all Canadians and, perhaps, most specifically, on behalf of the 100,000 Nova Scotians without access to primary care.
Sir—through you, Mr. Chair, if I may—please provide the answer to how many of those actual health practitioners are on the ground.
Mr. Chair, I guess that answer is not forthcoming, unfortunately. That being said, maybe I'll try something different.
Wait times are an entirely different topic and an incredibly important topic here in Canada. I've had an opportunity to meet with some of our orthopaedic colleagues. There is no health care shortage of orthopaedic surgeons, I'm told, so they're able to perform these surgeries.
Only $2 billion of the $6 billion available for wait time changes has now been deployed. We do know very clearly that folks who are awaiting total joint arthroplasties are often not able to work, which is creating difficulties for their families, and those on the wait lists need medications, etc. It would appear that would be an easy deployment of more of those funds. Can you please tell me what the government's opportunity is going to be there for deploying the funds specifically for total joint arthroplasties?
Mr. Chair, we heard about a Canada mental health transfer in the 2021 platform of the Liberal party. None of that money was deployed in budget 2022, and none of it was deployed in the fall fiscal update.
Can you give us an update, sir? The country wants to know when this mental health crisis is going to be addressed and when the money is going to be deployed. We still see that the finances are not being deployed out there. Canadians are hurting. They need to be served by this government. There's money out there that your government, sir, has committed. That money is not being deployed.
The questions that need to be answered, of course, are “when?” and “why?”
Thank you, Minister Duclos and Minister Bennett, and all the officials who are appearing at the health committee today.
My first question is for Minister Duclos.
Minister, I see the funding to support new national women's health research, which is an initiative to advance research in high priority areas.
COVID-19 highlighted the importance of health research and innovation.
Can you tell us the importance of investing in women's health research and what our government is doing?
:
Thank you very much, MP Sidhu.
Not only do I appreciate that question, but I think my colleague Carolyn will also appreciate it very much. CIHR is a key federal institution that supports not only research on diseases but also research in support of patients, families and caregivers. We often speak of diseases. More importantly, we want to speak of the importance of supporting those living with different diseases. That includes mental disorders and all of the impacts that these disorders and diseases have, like I have said, on families and communities.
There has been a total investment of $414 million in 965 research projects since March 2020. Many of them focus on COVID-19, but many others focus on mental health and substance use support needs of Canadians across our country, in particular through the difficult time that we've seen in the last two and a half years.
Again, there's a great level of support on the part of the federal government, but, more importantly, there have been immense efforts by researchers and scientists across the research community in Canada, which we not only want but need to celebrate on every possible occasion, including today.
Sonia, first of all, I think most people around this room would know of your significant work and considerable success in moving forward with a framework for diabetes in Canada. We're grateful to you and to all the other partners, leaders and experts who have supported that framework that we tabled on October 5, just a few weeks ago.
That framework is important and is also complementary to other investments and efforts we're making, including the release and implementation of Canada's new food guide, which we know is key to helping Canadians eat healthier and live healthier.
Just a few weeks ago, we also announced important front-of-package nutrition labelling, which is going to be of great help by informing Canadians of the type of healthy food they might be able to purchase in a grocery store and to encourage the food industry to reduce the levels of sodium, sugar and fat in the food that people rely on to live their lives.
Again, MP Sidhu, Sonia, thank you for your leadership on that. We're quite fortunate to be able to support that leadership.
:
Yesterday we had a very exciting announcement. We were able to demonstrate that all 13 jurisdictions have come together to understand that this model of integrated youth services that was led by the Foundry in British Columbia, the hubs here in Ontario as well as Aire Ouverte in Quebec....
The idea that you can get the most appropriate care by the most appropriate person at the most appropriate place and at the most appropriate time means that, all of a sudden, things such as peer support.... Those with lived and living experiences are able to make it feel safer for young people to come. They get primary care. They get a social worker, a psychologist or an addiction medicine person helping with their education, getting a job and housing, all in one place, with an integrated record.
The exciting thing is that yesterday we were able to announce that the CAMH and CIHR will not only be working on these evidence-based models but also creating the evidence as we go to be able to demonstrate what works and what doesn't. I think this is a huge leap forward in how we actually deliver integrated services to Canadians instead of this patchwork quilt of non-systems that was a huge challenge to youth in the past.
Ministers, welcome to the committee.
My question is for the Minister of Health.
To further optimize the resources of the health care system, Quebec has had, over the past 20 years, the Castonguay-Nepveu, Rochon and Clair commissions, and the Rochon, Couillard, Barrette and Dubé reforms.
Despite this, according to some Liberal parliamentarians on Parliament Hill, Quebec and the provinces have value-for-money problems and have not made all the required efforts, thus justifying the imposition of conditions for health transfers.
In light of these facts, is that also your position?
:
Minister, I see you are avoiding answering my question, but I accept your answer.
I will now move on to another issue, which is the taxation of medical cannabis. The reason I am turning to you is because you are the Minister of Health, former president of the Treasury Board, and a highly qualified economist.
Most prescription drugs are normally exempt from GST, QST and excise tax. However, medical cannabis products are subject to completely different taxation, as all taxes apply.
Have your department and you, as an individual, begun to think about the tax treatment of cannabis prescribed for medical purposes?
:
There are two elements to this question. The first one is more the purview of my colleague the Minister of Finance, who I'm sure you will want to ask about the taxation of all products, including medical cannabis.
From the perspective of the Department of Health, our goal is obviously to protect people's health and safety. I think we can be proud, although nothing is perfect, of the substantial progress that has been made over the past few years in Canada. The legalization and regulation of cannabis has provided thousands of people, including young people, with greater protection from the effects of the illicit market in terms of the supply of cannabis.
Again, nothing is perfect and there is still room for improvement, but we can be quite proud of what has been done over the past few years.
I want to discuss the youth issue with you. Currently, in Canada, there is an object circulating called the cannabis wax vape pen. It is a small coloured object that looks like a pen and that does everything to attract the eye of teenagers, while being discreet, even almost undetectable, since the vapour that emanates from it is odourless. It's used to consume liquid cannabis extracts that, when distilled, reach THC levels of up to 99%, well above the regulatory level of 30%.
Are you aware of this problem? What is currently being done to address this complete violation of current regulations?
I'll be splitting my time with my colleague, Gord Johns, the NDP critic for mental health and addictions.
Ministers, officials, thank you for being here with us today.
Minister Duclos, I would like to start with you if I could. The provinces of course are claiming that the federal government is only paying about 22% of health care costs in Canada. Do you agree with that number, and if not, what number do you think is more accurate?
:
Today marks two years since one of my staff members lost her brother Ryan to toxic drug poisoning after he was unable to access treatment. Every day more families receive tragic, life-altering news because their loved ones don't have the supports they need.
Minister Bennett, at this committee on June 15, I asked about investments in supports for people who use substances or who are in recovery. You spoke about the substance use and addictions program, saying, “We know the SUA program is hugely successful and oversubscribed. We will get that money out the door, and if we need more money, we'll go get it.”
This month I received a response to a question on the Order Paper demonstrating how oversubscribed the program is. After two calls for proposals, only 14% of the funding sought has been granted. The response mentioned funding availability as a reason for not selecting projects, as well as a list of 138 projects being kept in an inventory for future consideration.
It's clear that we need more money to provide the supports that people need. When are you going to “go get” the money?
I want to thank the ministers and all the senior officials for being here in committee. It has been a long time since we met in person.
[English]
Minister Bennett, I also have several questions for you.
To start, I think there's been some recent confusion regarding politicization of the approaches to addressing the toxic drug crisis, which we know requires an array of responses along a spectrum of prevention, health promotion, harm reduction, access to clinical treatment services, including opioid agonist therapy, other clinical supports, adequate social supports, access to treatment and recovery for those who are ready.
Also, may I mention legislative actions such as those we've accomplished with Bill , which addresses unfair mandatory minimum policies and modernizing drug policy, including, ultimately, decriminalization of personal possession of illicit drugs?
As an MP, I represent the Yukon, which is still struggling in the opioid drug crisis but nevertheless has made some substantial gains in a number of these areas.
My first maybe very quick question is, how much should we rely on values alone versus evidence in determining drug policy or, for that matter, any health policy?
Minister, I have the privilege of co-chairing with Senator Stan Kutcher the all-party mental health caucus. We met just yesterday, actually, and were presented with data documenting the mental health effects of the pandemic on Canadians.
Another one of the themes we've discussed is how we can build mental health literacy. That's, to me, familiarity with the terms and principles of mental health and mental illness, so that we can all be better equipped to maintain good mental health and to prevent, recognize and respond to mental illness when it occurs. That's whether we are members of the public and citizens, parliamentarians, health care providers or patients.
I'm wondering if you could speak to the importance of supporting better mental health literacy and what role we can all play in improving that.
:
Firstly I want to thank you and the all-party mental health caucus, which worked so hard on that handbook for mental health literacy for all parliamentarians and our teams. It has been hugely important that people are using the right words and are able to understand their feelings and describe their feelings, but also know how to navigate themselves or their loved ones to help.
I think that when we look at stigma, the best way to replace stigma is with education. When we raise the mental health literacy of our population, we can understand that we've been asking the wrong questions. It's not, “What's the matter with that person?” It's, “What happened to that person?” in terms of being trauma-informed.
Is what we are giving culturally safe, or is it a high barrier because people have been treated badly before and are afraid to reach out for help?
If we could do more on mental health literacy in the curricula of all the schools across the country.... It has been the goal of Dr. Kutcher that when we have health classes, there are mental health classes, too, so that people are able to be in touch with their feelings, so that stress for an exam isn't an anxiety state and so that the grief after someone has died is not a depression.
What are normal emotions, and when do those normal emotions tip over into the kind of illness that requires treatment?
Mr. Duclos, in a number of municipalities in Quebec, and probably in the rest of Canada, as well, there seems to be a fairly substantial slippage in terms of medical cannabis cultivation licences. I hear about this frequently from elected municipal officials. It is even believed that, in some cases, criminal organizations are now using licences for criminal purposes.
I'm not asking the officials, I'm asking you. What level of priority are you giving to this problem? As minister, what concrete steps have you taken? Now that cannabis has been legalized, marketed and regulated, is there less and less need for licences? Without abolishing licences, should the rules be tightened quite substantially?
:
That's a great question.
Let me first quickly remind you why medical cannabis has become so important in recent years. It's mainly because, prior to the legalization of cannabis, it was the only way people could have access to cannabis. Moreover, this right had been recognized by the courts. That's why this way of obtaining cannabis for medical purposes was recognized and continues to exist now.
With the legalization of recreational cannabis, things have changed a lot. As I mentioned earlier, the situation in terms of health, safety and youth protection, in particular, has improved significantly.
That said, there is always room for improvement. There is an important opportunity to take advantage of, and that is the review of this piece of legislation—
:
Thanks for the question.
Yes, indeed the national community of safer supply has been struck and is advising the government, as is Shannon Nix in her part of Health Canada.
I don't know whether Heather wants....
I'd be happy to let you know the members of that committee and the work that is being done.
I think the community of safer supply is working hard with those who are prescribing, but I think, Gord, you and I know that the coroner's report in B.C. is extremely troubling. Only 30% of the people who died of opioid overdose were actually diagnosed with opioid use disorder.
I think we know we have to go further than just a prescriber model.
The last question is for the Minister of Health.
Minister, Canada's rising food prices are hurting families that were already struggling. Nearly a quarter of Canadians report going hungry due to costs and two million children across the country are now at risk of going to school hungry.
Across the country in the last election, both the Liberal Party and the NDP pledged to invest $1 billion to establish a national school nutritious meal program to ensure that no child is forced to struggle through the day on an empty stomach. We know nutrition is a key part of health.
Can you confirm when that funding will be in place and when Canadians can expect a national school nutritious meal program?
It is totally appropriate and appreciated that you point to healthy eating as an important social and physical determinant of healthy living and healthy being. That's why, as you've signalled, we did commit to doing more when it comes to providing healthy meals and healthy snacks to children, particularly those whose families can't afford to do that with the current circumstances and the pressures of the cost of living.
This is a commitment that involves several ministers. It is an important one to the . My other minister, , who is the Minister of Families, Children and Social Development, is also a part of the effort.
We look forward to working with you in making sure that we can make progress on that important support that children and families in Canada need to remain healthy.
:
Thank you very much, Mr. Chair, and thank you to all of the witnesses for being here today.
Minister Bennett, I believe the last time we talked was earlier this month at the breakfast event put on by the Canadian Institute for Public Safety Research and Treatment, or CIPSRT, which based at the University of Regina. As I'm sure you're aware, CIPSRT was established about five years ago with a $5 million funding grant, which runs out at the end of the fiscal year.
Through you, Mr. Chair, I would like to know if the government has any plans to fund CIPSRT moving forward.
:
Okay. It's good that you're working on it, but is there going to be any plan for actual funding?
The reason I'm asking is that they are starting to run out of time. They are bound by the ethical code of conduct for mental health research, which says that if they're going to allow new subjects to enter the program, they have to have enough time for them to complete the program. That means they will not be able to accept new subjects past Christmas. If you look at the calendar, Christmas is coming up soon.
So I'm wondering, for the people at the University of Regina who may be tuning in today, what they should be doing. Should they be winding down operations because there will be no funding moving forward, or should they be ramping up operations? When are they going to know about their futures?
:
Thank you very much, Minister.
Again, through you, Mr. Chair, I guess what Canadians are expecting is some action. The meeting with the provincial ministers really ended in failure. Somebody walked away from the table. It depends on which press you read who it was: you or them.
The finger-pointing needs to be done. Canadians want action. The system is failing them. Your government, sir, is failing them, and Canadians see no action whatsoever. What are you doing, specifically?
:
Okay. Thank you, Marcus.
You would have loved to be there, too, Marcus—
Some hon. members: Oh, oh!
Hon. Jean-Yves Duclos:—because between health ministers, we spoke of things that matter to Canadians, like access to a family doctor. You're a family doctor; you know what it means. Access to mental health services in the appropriate manner and at the right time is most important to Canadians. Reducing backlogs in surgeries and treatments.... A million surgeries have been delayed because of COVID-19. Our health workers are struggling to catch up with those backlogs, but the current circumstances make it very difficult for them to do so if all of those viruses that go around....
By the way, one way to protect the health workers is to be vaccinated. I know everyone around this room believes in vaccination. To be vaccinated against the flu, against COVID-19.... It's not perfect, but it works. It saves lives, and it protects the health of patients and also the mental and physical health of our workers.
We have good news, therefore, and you would have been so happy to see, Marcus, that everyone was on the same page. Unfortunately, the premiers asked my colleagues, the health ministers, to stop speaking about results and the health outcomes that matter to Canadians, and all they talked about was dollars. Dollars, although they are necessary, are not enough to generate the outcome that Canadians need to seek. Sending dollars to finance ministers is not my job, and it's not Carolyn's job either. It is not our job here at the federal government. We're here to support Canadians, and we want to support, in the process, our colleagues the health ministers.
You would have been very happy to see this, except for the fact that we were not able to speak openly about the great conversations we had in private.
First, we have been providing an enormous level of support throughout COVID-19: the $72 billion just for health and safety; the eight out of every 10 dollars that the federal government paid out to support the efforts of provinces and territories; the recent increase in the CHT; the 10% increase in the CHT in March 2023, the $9 billion—$3 billion for mental health, $3 billion for home and community care, $3 billion for long-term care. That's all there, in addition to $2 billion to reduce backlogs in surgeries and treatments that we announced just a few weeks ago, which is making a big impact now in the ability for provinces and territories to look after workers and patients.
We've done a lot, but the said that we need to do more. That's why we made that announcement prior to the conference in Vancouver.
You would have been proud of that, too, Marcus.
:
I have a question for Dr. Bennett about the amount of money going for mental health and substance abuse.
I know we make decisions that are evidence-based, so supposedly we're doing the right things. We believe in harm reduction. It should be working. However, having recently gone to Vancouver—where Don Davies and Gord Johns are from—it's hard to see that things have gotten better. Hastings Street is awful. It looks like a slum from a third world country, and I've lived in a lot of third world countries.
Thunder Bay has, apparently, a higher-per-capita overdose rate than Vancouver does.
What can you say in order to encourage us that things are, in fact, getting better, that our money is, in fact, getting well spent?
:
I think focusing on the Downtown Eastside has been a real problem, and we've been very upset with the video coming from the Leader of the Opposition. Even Ben Perrin, the previous public safety adviser to Stephen Harper, said that no public figure should use real human misery as a backdrop for a political pitch. It is using them as props to peddle snake oil, and it's disgraceful.
For us to use that stereotype when so many of the people dying are construction workers, people in natural resources or people who've had psychic pain or physical pain who were cut off from their medication and who go to the street for their drugs and are using alone and dying alone.... It's really important that we help them. Those are the sons of Moms Stop The Harm. Those are the people we are losing.
We watched that mom in Sudbury put in number 245 and number 246 of the little crosses of all the sons and daughters who have died in the overdose crisis there in Sudbury. This is across this country. It is extraordinarily important that the harm reduction of methadone, suboxone, sublocade and dilaudid and all of those things.... It is really important, but it is about changing our minds.
As we said last week during National Addictions Awareness Week, this is about creating a community of compassion. You cannot underestimate the 42,000 overdoses that were reversed at a safe-consumption site. Those 42,000 people would have been dead.
This is terrible. It's about the toxic drug supply, but it's also about understanding addiction, which is physical. When people are seeking medicine to not be dope sick, it is very, very misguided to think that a one-size-fits-all approach is going to work. We're doing everything we can to stop this national tragedy.
:
Thank you, Dr. Bennett.
Thank you, Dr. Powlowski.
To both ministers, that concludes two full rounds. We kept you longer than we were supposed to, so we are grateful for your patience in staying on. We're grateful for your making yourselves available and being so patient with us.
Thank you so much.
Colleagues, we're going to suspend for about three or four minutes, just to let the ministers carry on, and then we'll continue on with officials.
:
Thank you, Chair. Thank you to the officials for continuing to be here today.
These are certainly important questions that we want to continue to try to have answers to.
I mentioned previously when the the ministers were here that the CMA president talked about how we have a system that is on the brink of collapse. I certainly would be more forceful with my words. I think we're in a system that's collapsing around us.
Sadly, as we've heard from the minister, there hasn't been an answer with respect to the promise of the of this country for 7,500 doctors, nurses and nurse practitioners. We may go ahead and say this isn't the purview of the federal government, but guess what. It was the Prime Minister who said that.
Unfortunately, there doesn't appear to be any answers with respect to how many of those folks are actually on the ground.
Dr. Lucas, if I might ask you that particular question, exactly how many of the 7,500 doctors, nurses and nurse practitioners have been hired?
:
Mr. Chair, I'll start by recognizing the incredible contribution that health workers have made through the pandemic and continue to make, and the challenges that they're facing, as Dr. Ellis noted and Dr. Lafontaine has spoken about in his role as CMA president.
As Minister Duclos noted, as part of its focus on a priority to work with provinces and territories in the health system, the government committed $2 billion to support clearing backlogs. Through that, they're recognizing that a critical element of that is support for hiring health workers.
Under the direction of the federal, provincial and territorial health ministers, officials have been working to support methods to retain and recruit, to support better data and planning, and to innovate in care models to support health workers, including increasing recruitment and supporting internationally educated health workers. This work continues.
Welcome to the officials.
I'm going to start with Dr. Lucas.
At a very high level in these supplementary estimates, they are asking for about $25 billion in votes. It's broken down among areas: indigenous reconciliation, immigration and strategy and COVID-19 funding, as well as the cost of public servants' salaries.
I want to focus on COVID-19. My understanding is that supplementary estimates (B) are asking for about $4.8 billion in funding for measures related to COVID-19. Can you tell me to date how much, with this additional $4.8 billion, would be the total spend or what we are planning to spend on COVID-19?
:
Mr. Chair, I'll speak in part to that from a Health Canada perspective and turn to Dr. Kochhar to speak from a Public Health Agency perspective.
Certainly the supplementary estimates do include important investments to support our work on COVID-19.
On the side of Health Canada in particular, it includes statutory funding of nearly $1.8 billion to support the acquisition of rapid tests. To date, we have acquired over 800 million rapid tests to support Canadians across the country in all regions, of which 560 million have been acquired this year and provided to the provinces and territories, not-for-profit organizations and others to support communities across the country.
We also have support in the estimates to support our work on the regulatory system to ensure expeditious review, ensuring the safety, efficacy and quality of vaccines and treatments for Canadians.
I'll turn to Dr. Kochhar to speak specifically to the public health side.
Mr. Chairman, what we are looking for is basically a $1.42 billion re-profile.
This is mostly focused on the COVID component, which is medical research and vaccine development, and which is again one of those core pieces where we are continuing to receive more bivalent vaccines. There are also logistics for vaccine distribution as we move the vaccines when we receive them from the manufacturers to the PTs.
Also, there is a component of the national emergency strategic stockpile in there.
Finally, there is some amount of testing, which is related to both waste-water surveillance and other testing that the National Microbiology Laboratory continues to do as such.
My next question is for the Deputy Minister of Health, Mr. Lucas.
Quebec recently released its 2022 policy on rare diseases, which focuses on three areas: awareness and training, access to diagnosis and promotion of research.
The mandate letter mentioned a national strategy on high-cost drugs. Recently, the , Alain Rayes, had to ask the minister about one of those drugs during question period.
I would like to know how this undertaking is progressing in the department.
On another topic, the Quebec government and Quebec physicians have called for a national breast implant registry, as implants can pose a significant health hazard to the population.
It appears that there is currently no registry for these medical devices and that this issue would fall under federal jurisdiction.
The committee will probably carry out a study on this soon, but I would like to know if this issue is being taken seriously.
Have any steps been taken to better protect women's health and keep a registry of these medical devices?
:
I'll start responding and then I'll turn to Dr. Sharma to contribute.
As we discussed last with the committee, and as Minister Duclos noted, efforts have been made to work with manufacturers to increase domestic production. Indeed, it's up a hundred per cent, as noted in the information pertaining to the 1.1 million units of Advil in November.
The additional 1.1 million noted in a report to the committee today pertains to the special importation of foreign-labelled medicine, including Tylenol.
We are continuing to engage with manufacturers to increase that domestic production on an ongoing basis, and—
:
Thank you very much, Mr. Chair.
I appreciate the time that you've provided us with today and all of the answers we've received to these questions. Thank you very much for being here, and thank you for what you've done to be able to produce these supplementary estimates.
My questions today will focus on kids. They won't be specifically directed to any official.
I think Canadians are sometimes concerned, and very rightly so, perhaps, with the way the Canada health transfer is set up and the federal government's ability to be able to target certain priorities. Specifically, I've been focused on children and on children's health care, particularly preventative health care, and trying to find ways as the federal government to have a positive impact on the health of kids in Canada.
We've seen through various reports that the health of kids in many respects is heading in a negative trajectory rather than in a positive one. We would like to think that in Canada, being a wealthy country with lots of resources, we should be able to do better. It's challenging, though, because many of those priorities are difficult to find in a document like supplementary estimates. Our funding goes to provinces in such a general manner.
Can you speak a little bit—this is for anybody who would like to—about the relationship the federal government has with provinces and territories and about how we can start setting some priorities so that we can tackle some of the biggest national issues our country faces with respect to kids?
:
Thank you, Mr. Chair. I will start, and then I'll turn it over to Heather Jeffrey to speak further.
Certainly, support for children's health is a key priority for Health Canada and the Public Health Agency and in work at the Canadian Institutes of Health Research, including work they've recently moved ahead on in terms of supporting research into pediatric cancer. We use federal responsibilities as well as convening to support other areas, including healthy eating through a tailored use of the Canada food guide; healthy living and active living as another key area to support communities and children's programs across the country, working with community groups; and a focus on pediatric medicine, as we've been discussing, certainly recognizing from a regulatory perspective that we need more targeted efforts on tracking pediatric medicines and formulations in Canada.
Importantly, to your question, one of the areas in which we're working closely with the provinces through targeted bilateral funding under the 2018 agreements on mental health and substance use is integrated youth services, where, as Minister Bennett noted, we've made significant progress across the country.
I'll turn to Heather Jeffrey to give you a little bit more information on that.
:
Integrated Youth Services, as Minister Bennett outlined, was an important priority area of the $5 billion in investments in mental health bilateral agreements that were made. That is ongoing.
She spoke as well to the fact that integrated youth services, which are really about receiving youth with peer counsellors who understand their living experience, wrapping them with the full suite of support services they need—medical, social, housing—and ensuring they have all the supports they need to get through their challenges....
We now have 50 operational sites as a result of those investments in our partnership with provinces, and there are an additional 60 under development.
We also know that youth need to be reached in different ways. Text and virtual online services, through Wellness Together Canada, have been very successful in reaching, in particular, LGBTQ+ youth and others who want to speak with others with the same experiences they are going through. An additional $15 million investment to Kids Help Phone is part of that to make sure that youth who are in crisis have someone to reach out to 24-7.
Moving on to vaccination, from the perspective of some of the most avoidable diseases like measles, mumps and rubella, as well as the flu, we've seen that some jurisdictions across the country have been a little more hesitant in their messaging in encouraging their populations. I am speaking particularly of very young children and the elderly.
Parents in my riding have been writing to me about their concerns that their children are more susceptible to some of these very avoidable diseases because of lower vaccination rates.
How can the federal government encourage provinces and territories to be more proactive in encouraging their communities to get vaccinated for some of these diseases we didn't need to worry about as much a couple of years ago?
:
I will go at it in two ways. Certainly in terms of routine vaccine preventable diseases, I think COVID-19 has had an impact.
In the provinces and territories we've had very good discussions with the chief MOHs, and they do acknowledge there has been some slippage. Obviously because of public health measures over the past two years, some children haven't been able to go to clinics and get their routine vaccinations against measles, and so on.
However, we have been fortunate so far with historically higher vaccine coverage for what we call the “routine childhood vaccine-preventable diseases”. I think we haven't had many cases of measles reported, and even in the last year or so, since March 2021 until November 1 of this year, we have actually had three reported cases of measles to date. They're all imported and associated with travel.
It doesn't mean that we can rest on our laurels, and I think our provinces are continuing to do their quota to catch up with regard to routine measles and other childhood vaccine preventable diseases.
With respect to what's happening right now, and I think we all see it in the media, there's the triple menace of COVID-19 still being around and influenza and, especially for young children, RSV. I think it speaks to the fact that for the past couple of years there hasn't been the exposure to the viruses that might have been happening in previous years.
I think the message is that the federal government, and certainly with the provinces and territories, for which there are vaccines available.... At this point it is COVID-19 and now there are vaccines available for those six months and older, obviously as well as for influenza. You can also give those to children six months and over.
I would say that we want to continue pushing, supporting provinces and territories, be it with various campaigns, and also supporting what's happening at a local level to say that everyone should avail themselves, because if we can prevent ongoing transmission of both influenza and COVID-19 by using vaccine, as well as good public health measures at a personal level, continuing the use of masks, etc.—certainly in indoor spaces—and good hand hygiene, all of that is going to contribute to mitigating against transmission and protecting our children.
Thank you, Mr. van Koeverden.
To all of our officials, thank you so much for being with us. Thank you for all that you do to support Canadians and provide us with good and thorough information that's presented patiently and professionally.
We're going to move right to the votes now. You're all welcome to stay, but you're free to leave.
Thank you.
Colleagues, there are eight votes in all in the supplementary estimates (B) 2022-23. If I have unanimous consent, we can group the eight votes together. Absent unanimous consent, we'll deal with each one individually.
Do we have unanimous consent to group all eight votes together?
Some hon. members: No.
The Chair: I will now put the question on each vote separately.
Mr. Clerk, we'll have a standing vote.
CANADIAN FOOD INSPECTION AGENCY
ç
Vote 1b—Operating expenditures, grants and contributions..........16,128,427
(Vote 1b agreed to: yeas 7; nays 4)
CANADIAN INSTITUTES OF HEALTH RESEARCH
ç
Vote 1b—Operating expenditures..........6,377,773
ç
Vote 5b—Grants..........92,357,334
(Votes 1b and 5b agreed to on division)
ç
Vote 1b—Operating expenditures..........142,194,433
ç
Vote 10b—Grants and contributions..........28,201,095
(Votes 1b and 10b agreed to on division)
PUBLIC HEALTH AGENCY OF CANADA
ç
Vote 1b—Operating expenditures..........1,317,165,601
ç
Vote 5b—Capital expenditures..........11,150,000
ç
Vote 10b—Grants and contributions..........34,451,915
(Votes 1b, 5b and 10b agreed to on division)
The Chair: Shall I report the supplementary estimates (B) to the House?
Some hon. members: Agreed.
The Chair: Is it the will of the committee to adjourn the meeting?
I appreciate the suggestions from my colleagues to try to fit it in so we can get as much in as possible, but I think that you are putting the cart before the horse if we do it that way.
I think that specifically the bill on firefighters' cancer is something that deserves to have witnesses so that we make sure this is set up properly. I'm the member of Parliament for Fort McMurray—Cold Lake, and firefighters in my community saw what was an entire lifetime's worth of exposure to many of these carcinogens in a month's time, so I think it is incumbent on us not to try to rush through this just to rubber-stamp it.
I think this is a critically important bill. This is not about being obstructionist; this is about making sure that we are doing our due diligence as parliamentarians to ensure that the best possible legislation is going forward. Knowing that we do not have a deadline of the Christmas break ahead of us, let's plan for success rather than try to just jam everything in.
:
Okay, thank you, Mrs. Goodridge.
I'm going to come to you, Mr. Davies and Mr. van Koeverden.
First, the deadline is 60 sitting days from when it was referred to the House. With the two private members' bills, that takes us into late January or early February. We can request a 30-day extension, so, if we don't get it done before Christmas, we are looking at fairly soon in the new year. If we're talking about several meetings with witnesses, it's something that needs to be on our radar, albeit perhaps not immediately.
We have Mr. Davies and then Mr. van Koeverden.
Mr. Don Davies: Okay. Thanks.
The Chair: I see no debate. We're ready for the question.
Are we in favour of requesting a 30-day extension for the consideration of Bill and Bill before the committee?
All those in favour, raise your right hand, please.
(Motion agreed to [See Minutes of Proceedings])
The Chair: Is it the will of the committee to adjourn the meeting? I see consensus.
The meeting is adjourned.