Health Committee on Nov. 16th, 2011

[The Chair, Conservative, Joy Smith]

We'll now go to Mr. Gill.

[Parm Gill, Conservative, Brampton—Springdale, ON]

I'm actually going to pass my time to Ms. Block.

[The Chair, Conservative, Joy Smith]

Ms. Block.

[Kelly Block, Conservative, Saskatoon—Rosetown—Biggar, SK]

Thank you very much, Madam Chair.

I would like to also thank our witnesses for join us again today. I appreciate the fact that you believe the work we're doing is very important, and we agree with you.

I would like to direct some of my questions and time to Ms. Cooper. I know that you came and shared a little bit of your personal story with us, as someone who's been living with chronic pain since you experienced a workplace accident, I think in the mid 1980s. I would like you to have an opportunity to refresh our memories a little bit about your own personal experience, and tell us a little bit about the Canadian Pain Coalition, if you wouldn't mind.

[Lynn Cooper, President, Canadian Pain Coalition]

Thank you very much.

My story is really quite typical. I was injured 25 years ago, and I dealt with the health care system in my province of Ontario, which was not prepared to support me or my health care professionals with the necessary acute care management, which might have prevented the situation from going chronic—but definitely not in the treatment of the chronic pain.

Twenty-five years later we have made some inroads, but not very many. We know that the gold standard, if you will, for the management of chronic pain is multi-disciplinary, which means that you would possibly have medications with the involvement of your physician and/or have a physiotherapist, an occupational therapist, or someone who can help you learn to live with your pain—perhaps a psychologist using cognitive behavioural therapy.

Along with that intervention from the medical system, we have to involve the individuals who have the pain problem and get them very active in their pain care. We can no longer be passive.

Part of the problem is that most Canadians don't understand the difference between acute pain and chronic pain. Acute pain is the temporary pain that lets us know there's a problem and that we might have to seek medical assistance. Chronic pain serves absolutely no purpose to the body at all. This is what creates the suffering.

We need to involve everyone in this model. It is about the lifestyle changes I was able to make, including exercise, diet, and rethinking what my life was like with pain and how I was going to keep it productive. I found the Canadian Pain Coalition, which is an amazing organization that from the very beginning has fought to bring in the people with the problem, to bring a voice to the pain. And if you look at me now, you wouldn't know I'm sitting here in pain. If I had to give my pain level on a scale between zero and ten, or the worst pain I've ever had, I would tell you that I'm at a seven right now because of the travelling I've done.

What the coalition has done with the Canadian Pain Society is to create a national pain strategy for Canada. We will have that finalized at the beginning of January. We are going to launch that national pain strategy at a Canadian pain summit here at the Chateau Laurier down the street on April 24, 2012.

The idea behind the national strategy is that it's a policy document meant to inform all provinces about the changes necessary within the health care system to support our health care providers and people with pain. We're looking for all Canadians to endorse this as of the beginning of January.

[The Chair, Conservative, Joy Smith]

Thank you very much.

Your time is up, Ms. Block.

We'll now go to Mr. Morin.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you.

I have only five minutes and many questions. I ask that the witnesses keep their answers short. My first question is for Ms. Laurent.

In your presentation, you talked about home care. Based on your expertise, do you think that the next accord in 2014 between the federal government and the provinces should include the progress expected and the objectives concerning home care so as to hold the provinces accountable for investments and thereby move home care services forward?

[Régine Laurent]

It is clear to us that home care is lacking in Quebec. With the population aging, the only way to go is to further increase investments in home care—I'm saying “care”, but I should be saying “home support”. I apologize.

It's true that the home support budget must be increased. However, the existing needs in Quebec must also be outlined. I'm not against your idea, but I'm afraid that one amount will be earmarked for home support and another one for prevention.

Is that not what you're saying?

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

I'm just talking about criteria. We know that the 2004 accord set out objectives for the provinces in terms of improving surgery wait times. I was thinking of something similar for home care.

[Régine Laurent]

Okay. Now I follow what you're saying.

We would definitely need something like that in Quebec. That initiative should be expanded; in other words, it should also include prevention and anything else that can be done in the community to support people at home. I am talking about support, with an acceptable quality of life. We would really benefit from that. I have been stressing prevention for a while because I believe in it very much. We, as professionals, believe in it. There is a major shortcoming in prevention when it comes to all health care services. That shortcoming is even more significant in the case of seniors, especially in terms of medication.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you.

My next question is also for you. You talked about informal caregivers and compassionate care benefits. The Government of Canada is currently providing benefits that I feel are insufficient. I would like to know what you think about that. Do you think that the benefits are insufficient and that the government should increase them?

[Régine Laurent]

Yes, I really think that the government should increase the benefits. Taking into account that informal caregivers are predominantly women, our interpretation of the facts leads us to believe that the benefits would be much higher if men were the ones providing that kind of care.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Ms. Wilson, do you believe that the federal government should launch a national strategy on mental health? It's a big question, I know.

[Kimberley Wilson]

In 2012 the Mental Health Commission of Canada will be releasing its national strategy. I think that's a really important starting point. The role of the federal government in rolling out that strategy will be even more important, because the commission doesn't have the ability to lobby and advocate. It'll be really important for the federal government to be committed to implementing the strategy in the provinces, and in the federal jurisdiction as well.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you.

Dr. Turnbull, do you believe that the federal government should do more to support community health centres?

[Dr. Jeffrey Turnbull]

The federal government can certainly play an essential role in developing national standards and structures and in supporting innovation. Community health centres are a vital part of a new community-based strategy for long-term, home-based care for chronic disease management. I must say that from our polling, the public also expects it.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Do I have any time left? I have about a minute?

[The Chair, Conservative, Joy Smith]

You have 30 seconds.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Okay. My last question is for Ms. Laurent.

You talked about palliative care. We know that assisted suicide is currently a hot topic. What do you think about assisted suicide? Parliament will soon tackle that issue, and I would like to know what you think right away.

[Régine Laurent]

We talked about that last year before the parliamentary committee in Quebec. Here is our position. First, we want a public debate. Second, we carefully explained that, at this time, there aren't any real palliative care services designed specifically for seniors. So, before further examining the matter of assisted suicide and other issues, we need to look at whether we can provide real palliative care to seniors right now. We take for granted that, if someone is 84 or 85 years old, they will die. That's not true. There are people who need palliative care. We asked that palliative care be provided to elderly people.

We were even more adamant in asking for palliative care for children as well. We think that's important. In addition, someone at the Sainte-Justine University Hospital Centre is investing a lot of effort into explaining just how important palliative care is. Palliative care for children is different.

Therefore, we want current palliative care to be strengthened in order to meet the needs. In addition, we want a public debate to figure out what that means. For instance, what is an acceptable life?

[The Chair, Conservative, Joy Smith]

Thank you. We'll now go to Mrs. Block.

[Kelly Block, Conservative, Saskatoon—Rosetown—Biggar, SK]

Thank you, and I want to thank my colleagues for giving me an opportunity to follow up with some questions.

I'm going to direct them to Ms. Cooper. I want to follow up on your observations from your own experience over the last 25 years. The federal government has, I believe, played a leadership role in working with the provinces and territories in promoting and supporting our health care system and innovation within the system. In fact, the Canadian Institutes of Health Research made pain, disability, and chronic diseases a strategic research priority following consultations with stakeholders. They have provided more than $96.7 million in funding for research on pain, including chronic pain, since 2000.

You mentioned that you will be launching a national strategy in April 2012 and that it will involve all provinces. In developing this national strategy, have you come across any best practices in the provinces that would feed into what your strategy on chronic pain is going to be?

[Lynn Cooper]

The strategy we have come up with will inform the provinces and help them create their own pain strategies within their health care systems. At present, British Columbia has a fairly active strategy and Quebec is coming along with the work it has done. But many of the other provinces are still not recognizing chronic pain as a chronic disease and thus are not implementing the necessary strategies. The strategy is meant as a higher-level document. From that we will need to drill down to create the necessary strategies.

[Kelly Block, Conservative, Saskatoon—Rosetown—Biggar, SK]

In follow-up, your strategy will first highlight the need to have a strategy and encouraging provinces to develop one? Will your organization be providing the provinces with some of the best practices you have pulled together?

[Lynn Cooper]

Yes, the best practice is the multi-disciplinary approach. Across Canada we have some multi-disciplinary pain clinics. However, the wait list for those clinics can be as much as three to five years and they don't serve enough individuals. So we would be looking to bring the community into play and to have multi-disciplinary treatment and management of chronic pain happening there, as opposed to confining the services to the pain clinics—although we need those too.