Finance Committee on Oct. 5th, 2010

[The Chair, Conservative, James Rajotte]

Thank you, Ms. Baxter.

Thank you, Ms. Hall Findlay.

Mr. Paillé, your turn.

[Daniel Paillé, Bloc, Hochelaga, QC]

At first, I thought it was a publicity move by the Liberal Party, but it turned out well.

I am very attuned to all the concerns of the Canadian Hospice Palliative Care Association and the Canadian Association of Retired Persons. In each of your third recommendations, you both address the issue of informal caregivers.

In another life, I participated in training for a network of caregivers. It involved the most famous case in Quebec, that of the late Gilles Carle and Chloé Sainte-Marie. There is also the case of Claude Léveillée right now. These people are known. They were already somewhat prominent figures. In their case, it is possible to raise a lot of money.

According to your recommendations, it is necessary to put more focus on hiring attendants. The Canadian Hospice Palliative Care Association, for example, suggested employment insurance benefits. However, the person cannot have a job. I think you talked about that. That leads me to wonder whether most people who become informal caregivers had a job previously or whether the person being cared for had a job but lost it.

Furthermore, there is the whole issue of hiring attendants. We know full well that the people being looked after require a lot of care. They sometimes need to be moved, from one place to another. There is also the consideration of the necessary accommodations. It was suggested that refundable tax credits be created to cover all the modifications made to cars, beds, homes, bathrooms and so forth.

I am not sure whether you have recommendations for the government in that regard. It has to do with taxes. I would very much like to consider anything that is possible at the tax level, while ensuring jurisdictions are respected. As we know, the federal government imposes a lot. Health and social services are the responsibility of Quebec and the other provinces. We just need to keep that in mind.

Ms. Eng, what are your thoughts on that?

[Susan Eng]

Thank you very much for the question. I very much appreciate it.

In fact, our caregiver strategy has three parts to it.

The first part, of course, is financial support, for which we are grateful for the announcement.

The second part is workplace protection, making sure that people's jobs are waiting for them when they go back, because oftentimes people have to take time off suddenly, without much notice, for extended periods of time, and repeatedly. So we look for workplace protection. The federal government has a role in providing some leadership, but it is a provincial jurisdiction for workplace protection.

The final piece is almost as important, and it is asking that the health care system actually facilitate their work, that is recognize their work, provide some training, offer some information, provide respite care. Frankly, that would cost very little, in fact very little compared to the financial support that is also necessary. The whole issue of home care, of course, relies heavily on family caregivers, and friends and neighbours as well, but also on the people who work in the business in providing the care, who are often low-income workers, we fear, without adequate training, and there have been some instances with that.

I think this whole area requires a lot of conversation to make sure that we are aware of how bad it can get. People tend not to talk about these issues. As the palliative care association mentioned, one of our problems is that in this country we don't like to talk about the end of life. We congratulate the Province of Quebec for engaging and initiating the conversation. It's much needed.

If we start to look at it from the perspective of the family that needs this kind of support, we realize where the gaps are. Some of the gaps are essentially there because people don't know where to turn when the situation arises. Even that much information is something that every level of government has some responsibility in providing, and it would not cost a lot of money. So all of these things are extremely important.

In terms of extending support for medical equipment, renovations, the renovation tax credit was helpful and was used for people who had to rehabilitate their homes for use for mobility challenges as well. But in addition to that there are whole categories of equipment that are not covered by the tax credit. We need to look at that entire category to make sure that all you need in order to make the end of life peaceful for people has to be addressed.

[Daniel Paillé, Bloc, Hochelaga, QC]

Thank you.

[Sharon Baxter]

Many of the people who are taking time off to care for their dying loved ones are indeed working. The average caregiver is a 35- to 65-year-old; it's predominantly women, and more often now men, but in that age group. Obviously, there are senior citizens who are caring for their spouses, and that type of thing, who aren't in the income piece. But there are a number of shortfalls within the EI-based program, too, for people who don't qualify for EI. So we need to really look at a full spectrum of programs and balance it between them.

One of the reasons why we invited Mike here today is to talk a little bit about the industry's role in it. GlaxoSmithKline is a corporation that actually provided their own compassionate care benefit--which predated the federal government's program--in 2003, where they allow 13 weeks' leave for their employees, because their employees were showing up either disengaged or were phoning in sick. There were lots of reasons why, as employers, they needed to do that. So they created their own benefit.

I think in order to have this debate over the next 10 years, industry is going to have a clear voice in this, because they are the employers of many Canadians. So I think we're hitting the tip of the iceberg, but we're really going to have to engage in a very innovative type of debate over the next 10 years on how we're going to support family caregivers.

The last thing you mentioned was about personal support workers. They're referred to in the health care sector as the unregulated workers. As more and more physician tasks are being handed off to nurses and being handed off to personal care workers, we really need to invest in retention, recruitment, compensation, and training for them. They're often poorly trained and terribly compensated.

I think we really need to look at all these areas of our health care system, because they are important. You can't expect the backs of Canadian families to do it all. We really have to balance it.

[The Chair, Conservative, James Rajotte]

Very quickly, Mr. Sangster.

[Michael Sangster]

Very briefly, I just want to applaud the association for the work they've done. They have actively sought out and engaged industry to be a part of this discussion and be part of the solution.

I liked your question. I like the comments about workplace protection, but they've actually gone out and actively engaged, and they are constantly meeting with large industries, with small industries to have those discussions about how this is going to play out over the future, because it is going to be a challenge for all of us. So I applaud your question.

[The Chair, Conservative, James Rajotte]

Thank you.

Thank you, Mr. Paillé. That is all.

Mr. Menzies, please, for seven minutes.

[Ted Menzies, Conservative, Macleod, AB]

Thank you, Mr. Chair, and thank you to our witnesses for appearing. I have just one word of caution to those who appear here. Ms. Eng, you represent somewhere around 300,000 retired individuals, and yet your reflection that.... I'm not sure whether it's your political stripe, but I don't think you're reflecting your entire membership when you refer to the Liberals as a “government in waiting”. I personally take offence at that, and I'm sure some of your membership would as well. We've seen other uncosted promises from the Liberal government—the $2 million long-gun registry that ended up as $2 billion—

[Some hon. members]

Oh, oh!

[Ted Menzies, Conservative, Macleod, AB]

Mr. Ted Menzies —so their math is a little tough.

I'm sorry to interrupt the ad campaign on behalf of the Liberals.

Mr. Sangster and Mr. Baxter, you have touched my heart today. I was with my premier, Ed Stelmach, about ten days ago at the Foothills Country Hospice in Okotoks. It is an incredible facility, but there is not enough of them. I had toured the facility before it was ever opened, thinking I would never be able to go back there because I would be imposing on families. But we were invited back and we were invited into one of the rooms. I met with someone who turned out to be one of my constituents. They come from all over Alberta to this centre, which was built mostly with volunteer dollars.

I certainly hear the need and the concerns about who funds it when it's up and running. Correct me if I'm wrong, but I think Alberta is funding about 70%, and 30% is....

After that, of course, we went to a fundraising gala, where we opened our wallets, of course. Certainly, it's a necessary part.

I struggled with this myself; we've all gone through this as families. The people who staff these are incredible people, and they need help. I don't know how they do it. I asked them, and they say they accept this as a gift that God has given them, to be able to help these people die with dignity.

How do we balance this federal-provincial...? Whose role is it, and how do we fund it? How do we balance that?

[Sharon Baxter]

In the Blueprint for Action, we've actually recommended.... There is this “betwixt and between” about whether it is a provincial or a federal responsibility, what the role is, whether the federal government can even have a role in this. We feel strongly that there is a role around leadership and best practices and opening the debate. One of the areas we have put into the blueprint is not a federal-provincial-territorial committee on palliative care, but a task group that is federal, provincial, territorial, and community, to start the dialogue around how we're going to get to innovative solutions. That is one of our recommendations, and I think it makes sense to have that debate.

It is complex in terms of funding. One of the things around hospice care is that only in Ontario, Quebec, and Alberta are they funded through any provincial government funding.

[Ted Menzies, Conservative, Macleod, AB]

I'm sorry, which governments are they?

[Sharon Baxter]

Ontario, Quebec, and Alberta. Most of the other hospice programs are relying solely on charitable donations. All of them rely a lot on charitable donations—between 30% and 70%; it depends on the community's response. They're marvellous programs, and the people who work in them are marvellous, so we really need to start to look at these.

Truthfully, they are saving the health care system money, because people are dying in another way. We have to look at the system as a whole and look at the savings, and not just at quality of life but economics too.

Mike, do you want to continue?

[Michael Sangster]

Yes.

I know, Ted, that you were paying very close attention to my opening remarks today, and I encourage all of you to do what Mr. Menzies did: take a moment and visit one of these hospices. That's why I'm involved as an individual today and not as part of my day job. They truly are miracle workers every day in your ridings, and they're worthy of an hour of your time to understand what they're doing.

[Ted Menzies, Conservative, Macleod, AB]

We thought you were there installing phones.

This is to Ms. Barnes, if I have some time left, Mr. Chair.

Is it two minutes? Thank you.

Another thing that has touched me personally is your presentation. Some of my colleagues know that I have a niece who is deaf—not born deaf, but who went deaf before she gained speech. We learned a lot through that process. She has a cochlear implant that doesn't help. She went through a lot that wasn't able to help her. She doesn't speak and she doesn't hear, partly because of struggles with the deaf culture. It took so long to diagnose her. A lot of people don't like to talk about the deaf culture in our society, but it's there. Some people see it as a gift, and some people don't want someone who is without hearing to ever be able to communicate. How do we get past that struggle?

[Gillian Barnes]

Again, I think calling for a universal program to identify these children at birth may help in that identification, in early intervention, and in involvement of the parents and community, to help these children—and eventually adults—assimilate into society.

[Ted Menzies, Conservative, Macleod, AB]

Here again we struggle with health care being delivered provincially, funded through the health transfers. What sort of a strategy do we as federal legislators put forward to make sure it's effective, to help these young people who are falling through the cracks?

[Gillian Barnes]

I believe that equal access, no matter where you reside—

[Ted Menzies, Conservative, Macleod, AB]

And we don't have that now?

[Gillian Barnes]

We don't have that, no. The provinces of Alberta, Manitoba, Saskatchewan, and Newfoundland do not have this program in place, so children living in those provinces do not have access to this sort of screening and this sort of early identification of hearing impairment.

[Ted Menzies, Conservative, Macleod, AB]

What percentage of hearing loss is disease-caused and what percentage is a handicap from birth? Do you know those numbers?

[Gillian Barnes]

We have three to five infants per thousand who are identified with some degree of hearing loss.

[The Chair, Conservative, James Rajotte]

Okay. There will be time for another round. Thank you.

We'll hear from Mr. Szabo, for a five-minute round.

[Paul Szabo, Liberal, Mississauga South, ON]

Thank you very much.

I want to deal with wind energy, with the first green witness we've had. I want to know more about it. There are three elements about the money you're asking for, but what I really want to know is what the state of the technology is now and where it fits in the scheme of the range of possibilities of other alternative sources of energy, and what your prognosis is about what role it's going to play over the long term in terms of Canada's energy requirements.