Health Committee on March 9th, 2023

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Blackstock.

The final question for the panel will come from Mr. van Koeverden.

Go ahead, please, for five minutes.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you very much, Mr. Chair.

Thank you very much to all of the witnesses. This has been an extraordinary meeting and really, really helpful. I'm glad that everybody was able to come. It's nice to have people in person as well.

My first question is for Dr. Nuyt. If you'll indulge me, I'm curious about healthy living and sustainable eating habits for young people. As you've stated, there's been a rise in negative eating habits and eating disorders. I think it's incumbent upon us to recognize that situation and to make sure there's an increase in services available for people who are suffering from eating disorders, but I also want to get at the root cause of those and try to prevent them if they're preventable and support people with any type of a strategy that would help people develop good eating habits, feel more confident, feel a sense of belonging and reduce the stress and anxiety that lead to those sorts of negative behaviours. Can you tell us some strategies we might be able to support or employ that would support that goal?

[Dr. Anne Monique Nuyt]

There are two elements to what you brought. First are the unhealthy habits that in general are linked to obesity, because unhealthy diet in general is linked to fatty foods, etc. This is very much linked to socio-economic inequalities, and it goes back to everything my neighbour Dr. Blackstock said specifically for first nation children, but it's also for all children in Canada who need to have access to decent living conditions, including access to decent food and therefore healthy food habits.

The problems with anorexia and eating disorders that we've seen rise, especially during the pandemic, are also bringing us back to first-line care. Youth have to be well in their families, and they have to be well in their schools. It's not going to prevent everything, obviously, as I said—there will always be children who will need specialized care—but if we make sure that in the families, the parents are not always away working three jobs rather than just one and if at school children have the services they need, then we will prevent them from needing health care and coming to the hospital. Where are children? They're in school, so we need to take care of the schools. I'm here as a pediatrician telling you to also take care of the schools.

[Adam van Koeverden, Liberal, Milton, ON]

I'm happy to hear that, as we're working on a national school food program that will support food security at schools.

I have a question about food insecurity. We know that food insecurity is not about not having enough food; it's a poverty issue. I want to make sure I'm clear on that.

Is there a relationship between socio-economic status and disordered eating? That relationship between disordered eating and food insecurity must be very complicated as well.

[Dr. Anne Monique Nuyt]

I do not know the answer to that question. I think these are really two different topics.

[Adam van Koeverden, Liberal, Milton, ON]

Okay. Thanks.

Dr. Blackstock, I'll turn now to you. Next week I'll be on my way to an event hosted by Spirit North, which is an organization that does physical activity programs for indigenous kids. It's in Canmore, and a lot of kids are coming from other regions and first nations communities in and around Canmore. Have you had a look, and what are your views on making sure that not just indigenous kids in particular, but also kids who live in remote communities or other disadvantaged communities, have access to those really positive social experiences that lead to better outcomes?

[Dr. Cindy Blackstock]

It's huge. I mean, we forget about childhood and the importance of play, right? Sometimes we pay a lot of attention to all of these things like risks and everything else, but part of being a kid is actually having the time to play, and play is important to children's development. Making sure that children have access to all kinds of positive activities in rural and remote communities writ large is really, really important. Even in Jordan's principle, we're seeing communities develop programs that involve culture as well. You embed the culture in the sport or you embed the culture in the activity so that it's meeting a bunch of developmental needs for kids, and they get to have some fun.

[Adam van Koeverden, Liberal, Milton, ON]

That's really great. I love that. I'd like to end on a positive note.

We spend a lot of time in this committee talking about health care, which, as we all know, is a system by which we take care of sick people, ill people, and I also like to focus a little bit on health. If I have any moments left—

[The Chair, Liberal, Sean Casey]

You have about 10 seconds, if you want to say goodbye.

[Adam van Koeverden, Liberal, Milton, ON]

Would anybody like to address the precursors to the social determinants of health to ensure that we're not just focusing on taking care of sick people?

[A voice]

It may not be a 10-second answer.

[Dr. Anne Monique Nuyt]

Take care of the schools as well. Thank you.

[Dr. Cindy Blackstock]

I would say equality across the board in services.

[The Chair, Liberal, Sean Casey]

Thank you, everyone.

Thank you so much to our witnesses.

It strikes me, actually, as a little bit unfortunate, with such expertise in front of us, that we only had an hour and a half with you, but it was absolutely quality if it wasn't quantity. Thank you so much for being with us. I'm sure you can feel the appreciation in the room for your experience and expertise and the manner in which you answered the questions. It will undoubtedly be of great value to us, as I think we have one more panel—or is this it?

[A voice]

We have one more.

[The Chair, Liberal, Sean Casey]

There's one more panel before we issue drafting instructions, so we're almost there.

Thank you all. You are excused.

To the members of Parliament in the room, we have half an hour of some other business that we need to cover, so we're going to suspend now, but for probably just three or four minutes.

Thanks again so much to our panel.

We're suspended.

[The Chair, Liberal, Sean Casey]

I call the meeting back to order.

Colleagues, we have a couple of things on our agenda, and there's a notice of motion by Mr. Davies, who has his hand up.

Go ahead, Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

As I've given notice, I would like to move that pursuant to Standing Order 108(2), the committee conduct a study to investigate reports that the Minister of Health personally intervened with the independent and arms-length Patented Medicine Prices Review Board to indefinitely suspend reforms that would have saved Canadians billions on drug costs; that the committee invite the following witnesses, in addition to any further witnesses the committee may consider relevant: Hon. Jean-Yves Duclos, Minister of Health; Matthew Herder, former member, PMPRB; Mélanie Bourassa Forcier, former acting chair, PMPRB; and Douglas Clark, former executive director, PMPRB; that the committee report its findings and recommendations to the House; and that pursuant to Standing Order 109, the committee request that the government table a comprehensive response to the report.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Davies.

The next item on the agenda was Bill S-203, but I'm advised by the clerk that your motion is in order, so the debate is on the motion.

I recognize Mr. van Koeverden.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you, Mr. Chair.

I have an amendment to Mr. Davies' motion, and I'll read it.

I move that that pursuant to Standing Order 108(2), the committee conduct a study on the Patented Medicine Prices Review Board; that the committee invite the following witnesses, in addition to any further witnesses the committee may consider relevant: Hon. Jean-Yves Duclos, Minister of Health; Matthew Herder, former member, PMPRB; Mélanie Bourassa Forcier, former acting chair, PMPRB; and Douglas Clark, former executive director, PMPRB; and that the committee report its findings and recommendations to the House; and that pursuant to Standing Order 109, the committee request that the government table a comprehensive response to the report.

[The Chair, Liberal, Sean Casey]

Mr. van Koeverden, that doesn't sound like an amendment. That is actually identical to the original motion. Do you wish to amend the motion?

[Adam van Koeverden, Liberal, Milton, ON]

It's only slightly—

[The Chair, Liberal, Sean Casey]

What's different?

[Adam van Koeverden, Liberal, Milton, ON]

It's that we remove “to investigate reports that the Minister of Health personally intervened” and that we remove “to indefinitely suspend reforms that would have saved billions on drug costs”.

[The Chair, Liberal, Sean Casey]

Okay, so the witness list remains the same, but the scope of the investigation has changed.

Can you read up to the witness list again? That's the guts of the amendment.