Finance Committee on Oct. 6th, 2014

[Dr. Barry McLellan]

First of all, I want to build on something that Mr. Sculthorpe has already covered, which is that there's a close relationship between disorders like depression, stroke, and dementia. It's not well recognized, but if a person experiences depression, their risk of stroke and dementia increases. If someone has dementia, the risk of stroke and depression increases. These are closely related, so there does need to be a very coordinated approach to dealing with diseases of the brain and mind.

With respect to working together, we cannot in this environment afford redundancy. We cannot afford to have a situation in a country like Canada where we don't know what's happening in Vancouver and where work at Sunnybrook is not being shared nationally to make sure we get the best future bang for our buck. Our proposal in fact is building on networks that already exist. I highlighted the excellent centre that's in Vancouver right now. There are strengths in Calgary. There are strengths in other centres in Toronto.

Going specifically to your question, being successful in treating dementia is dependent on our being coordinated, on having a network of researchers and ensuring there is a strategy that's known by all.

[Andrew Saxton, Conservative, North Vancouver, BC]

Thank you very much.

I'd like to turn to Hope Air.

Very quickly, what are the main challenges you're facing right now? Will the increase in fees for carry-on bags, checked bags, and that sort of thing also affect what you're trying to do?

[Douglas Keller-Hobson]

Increased fees always do; hence, we're asking for this specific legislative change here, which would actually reduce fees. We partner with all the airlines. There are very close relationships. Just as we're advocating today for assistance here to help vulnerable families, I'm doing exactly the same with our airline partners as to whether we can get them to waive certain fees. Again, sometimes our donors pick up additional costs if the families themselves cannot.

Today's request here, though, is very direct and will certainly add more flights.

[The Chair, Conservative, James Rajotte]

Thank you, Mr. Saxton.

Mr. Brison, please, for your round.

[Scott Brison, Liberal, Kings—Hants, NS]

Mr. McLellan, you've spoken of the potential of this brain sciences centre in terms of breaking down barriers and creating a more collaborative platform for research. I would add to your list as well the work being done at the Dalhousie Medical Research Foundation and the Irene MacDonald Sobey chair for Alzheimer's research, with Dr. Sultan Darvesh, and also some of the work done by Dr. Kenneth Rockwood.

Are there other barriers to collaboration in terms of this kind of research and perhaps even issues around commercialization, ownership, and IP? In addition to direct funding of your initiative, are there other areas we should be looking at to break down the barriers that may be impeding collaborative results?

[Dr. Barry McLellan]

First of all, I will acknowledge that there is significant strength in eastern Canada as well, and specifically Dalhousie. Our researchers right now are working with teams there collaboratively. I don't want there to be a message left today that there is not existing collaboration in our country.

With respect to barriers, one approach that's used at Sunnybrook, which we believe is a model that others should emulate, is treating those with disorders of the brain and mind together. Helping to destigmatize mental illness is a major undertaking right now in our country. By having individuals who have depression in the same clinic area as those who may have dementia, or stroke, or other diseases of the brain, is a major step forward. We believe that cooperative model within organizations is important.

I have already mentioned the importance of networking to make sure we have collaborative research taking place not only across the country but across the world.

With respect to commercialization initiatives, we're starting to make progress in certain clusters across the country. We very much favour the cluster environment, where we can bring together those with public and private sector expertise and interest. We believe that by having a strategy around disorders of the brain and mind, we'll be better positioned to capitalize on commercialization opportunities, as I mentioned, growing jobs and companies.

[Scott Brison, Liberal, Kings—Hants, NS]

Thank you very much.

Maureen O'Neil, welcome back to the committee.

Your funding is running out. According to your submission, six of your projects reduced health care spending in the provinces by more than your total budget between 2006 and 2013.

Is there another organization in Canada doing what you're doing today, in terms of developing this research and sharing it with the provinces?

[Maureen O'Neil]

No. In fact, what we're doing is actually not research but really working with people on the front lines and helping to bring evidence of what does make a difference to them, but more importantly, bridging the divides across provinces.

Canada has both a great strength and a great weakness in that the primary responsibility for health care is with the provinces, but we have very few vehicles for innovations at the provincial level in delivery of care to be shared across the country. What we are able to do is provide support to teams who are juried in, who want to share in particular areas, to get the kind of assistance that is required, and also the opportunities to share one with the other.

[Scott Brison, Liberal, Kings—Hants, NS]

This would be disproportionately important for smaller provinces that don't have the bandwidth to garner this sort of best practice model.

[Maureen O'Neil]

Exactly, it's very important.

For example, in the Atlantic all four provinces agreed that they would work together to look at ways of improving the care for people with chronic conditions, COPD, diabetes, mental health, etc. Ten regional health authorities are working together. I think this is a first that the four Atlantic provinces agreed they would combine to look at doing things differently to find better ways of actually delivering health care now.

This is delivering health care in the here and now. It's not as adventurous as what we're hearing about from further down the table on looking ahead, but it is dealing with problems that people have right now, and helping to put into place solutions that we know about right now.

[Scott Brison, Liberal, Kings—Hants, NS]

Thank you very much.

Mr. Sculthorpe, for the Heart and Stroke Foundation funding, you're seeking to support indigenous peoples health initiatives. Given that the federal government is responsible for overall investments in aboriginal and first nations health care, and we can pay now or pay later, have you done some analysis of what kinds of savings to the federal government this $50 million per year would render in the future?

[David Sculthorpe]

On this program, no, because the suite of initiatives we would be bringing to the communities to pick and to massage, to make it work for their needs and their desires would be slightly different for everyone.

I can tell you that when you get into the programs we have today, such as the hypertension program, where we drop the blood pressure by a significant and statistical amount, they do reduce the health care costs and the death rate over the short, medium, and long terms going forward, and we have all those numbers. We also know that coming out of the B.C. program with the greenhouses, the quantity of fresh vegetables that are grown and available goes up significantly. So on a program-by-program basis, we know.

[The Chair, Conservative, James Rajotte]

Thank you, Mr. Brison.

We'll go to Mr. Keddy, please.

[Gerald Keddy, Conservative, South Shore—St. Margaret's, NS]

Welcome to our witnesses. We're having a very good discussion today, with lots of questions being raised.

My question is for Mr. Keller-Hobson from Hope Air.

You're the only registered nationwide charity that provides free flights for people who cannot afford the cost. I think you stated there have been somewhere around 85,000 free flights since 1986. Congratulations on that.

I think most of us around the table are sympathetic to your ask, but I'm not certain how we can drill down to find a way to do it. You're looking to really get around the air travellers security charge of $7.12 a flight. It's impressive that this would give you a lot of extra flights across the country; an additional 230 flights I think was the number you used.

It would be a legislative change. How can government do that and treat one charity differently from another?

You need to help us.

[Douglas Keller-Hobson]

Yes.

When the legislation was implemented, it was clearly established at that time that vital medical flights were to be exempted. That was always the spirit of the legislation. It caught up in 2007 with the next amendment, when it was really discovered and then advocated that Hope Air was not an air ambulance service but still was vital for medical appointments.

Now we're looking at it again, more than seven years out. I take the view that the intent and spirit of the legislation is very clear. It applies to all Canadians in that scenario, through charities. It's time for us to continue to look at our legislation and keep up with changes in society. Here Hope Air has changed its business model. It considerably grows more, and we put a considerable amount of money back into the airline industry through our purchases. A simple act like this would, I think, deliver good results.

[Gerald Keddy, Conservative, South Shore—St. Margaret's, NS]

Thank you.

This question is for the Heart and Stroke Foundation.

You've put some numbers forward. The health care costs of heart and stroke, dementia, and other similarly related diseases are somewhere around $35 billion per year, rising to somewhere around $200 billion by 2040, which is a frightening number.

You have a great reputation and a good record—a 75% decrease in heart and stroke deaths—and I think a fairly reasonable ask. How do we meet that ask, and how do we seek out partnerships from business and the provinces, as well? Have you done that, or is that a possibility?

[David Sculthorpe]

We're a not-for-profit.

[Gerald Keddy, Conservative, South Shore—St. Margaret's, NS]

I understand.

[David Sculthorpe]

We raise all of our money through door-to-door donations, Jump Rope for Heart, corporate partnerships, major gifts, and direct mail. We work very hard on building corporate relationships. In 2011 we unified into one foundation across the country to enable better partnerships with national corporations, because our relationships were all provincial, and to become much more efficient and effective and to have more mission impact. We're seeing tremendous results from that.

We do believe our corporate support will grow, but it's a very small amount relative to what every Canadian gives to us. As I said in my opening address, almost two million Canadians donate $40 or $50 to us, and a few give us a lot more money, but that's a small part of our fundraising.

[Gerald Keddy, Conservative, South Shore—St. Margaret's, NS]

I guess it's the immediate costs versus the costs coming in the future if we do nothing.

[David Sculthorpe]

When we get into the prevention business, that's always the debate we're faced with: whether we spend a dollar now to save it over the long term. We believe in the prevention area for dementia. When we see those numbers, we can do nothing but make the choice to try to prevent the disease today, because those numbers will swamp us in the future, and we know the issue and the concern.

My father had Alzheimer's for almost 10 years and passed away. We know how much strain and stress that puts on a family and on society.

[Gerald Keddy, Conservative, South Shore—St. Margaret's, NS]

Very quickly, Ms. O'Neil, you're looking for $10 million over five years. You're seeking ways to improve health care, and I think that's a noble idea, and there's room to do it.

One of the frustrations I have as a member of Parliament is the lack of coordination. You mentioned that the four Atlantic provinces are starting to work together. Good for them. It was a long time coming. But there's a lack of coordination among the provinces on things as rudimentary as one simple pharmaceutical buy for all provinces and all territories.

What holds that up? Why can't we do that in Canada?

[The Chair, Conservative, James Rajotte]

Could we have just a brief response, please.

[Maureen O'Neil]

I don't have the answer to that question on pharmaceuticals. I think Dr. Klasa is working hard on lobbying to have that happen.

[The Chair, Conservative, James Rajotte]

Do you want Dr. Klasa to respond briefly?