Finance Committee on Sept. 21st, 2017

[The Chair, Liberal, Wayne Easter]

Good morning. I call the meeting to order.

Pursuant to Standing Order 83.1, we'll deal with the pre-budget consultations in advance of the 2018 budget.

We have two panels this afternoon, and the first panel is here.

I believe you've been informed that we want you to try to hold your presentations to about five minutes so that we can have time for a good series of questions. The way we've restructured the room makes it seem as if you're almost on the other side of the island, if you're in P.E.I., but in any event, that's the way it is. There are a lot of people here.

We will start with the Association des collèges et universités de la francophonie canadienne with Ms. Bourgeois, who is co-chair and president, Mr. Mocquais, and Ms. Brouillette. Who will lead off?

[Lise Bourgeois, President, Cité collégiale, and Co-Chair, Association des collèges et universités de la francophonie canadienne]

I will start this off.

[The Chair, Liberal, Wayne Easter]

The floor is yours. Welcome.

[Lise Bourgeois]

Hello Mr. Chair, members of the committee, ladies and gentlemen.

On behalf of the board of directors of the Association des collèges et universités de la francophonie canadienne, or ACUFC, on behalf of my colleagues here and on my own behalf, thank you for this invitation to present our comments and recommendations in person, which for the most part are included in the brief we submitted in July for your committee's prebudget consultations for the 2018 federal budget.

Before I talk about the contribution that colleges and universities make to the productivity and competitiveness of businesses and Canadians, I will begin with a brief introduction of the ACUFC and provide an overview of the colleges and universities in Canada's francophonie.

The ACUFC represents 21 francophone or bilingual colleges and universities located in francophone minority communities, that is, outside of Quebec. The ACUFC fosters cooperation among its members, represents their common interests, and enhances their visibility, both in Canada and internationally. The ACUFC helps to carry out pan-Canadian collective projects, share resources, and consequently achieve significant economies of scale.

The colleges and universities of the Canadian francophonie have the dual mandate of offering programs of study, as does any post-secondary institution, and of promoting the sustainability of the communities their serve by contributing to the development of their human capital and to their cultural and economic growth.

Many of our post-secondary institutions are small and some are located in rural areas.

We offer more than 1,150 post-secondary programs in French.

In total, there are over 42,600 students enrolled in our programs. Our institutions produce more than 10,000 graduates each year, although that represents just 8% of all of the anglophone majority programs.

By training the highly-qualified and bilingual workforce of today and tomorrow, the colleges and universities of Canada's francophonie serve as ambassadors for the official languages, Canadian identity, inclusion, and the dynamism and vitality of these communities and the country as a whole.

Federal support for our educational institutions is therefore essential and must go beyond the funding initiatives designed for the anglophone majority, which are rarely tailored to or accessible to the minority, unless the government includes specific measures for the minority.

I will let my colleague Pierre-Yves Mocquais explain how the post-secondary institutions in Canada's francophonie help increase the productivity and competitiveness of business and Canadians and, above all, present our recommendation for the upcoming budget.

[Pierre-Yves Mocquais, Member of the Board of Directors, Campus Saint-Jean, University of Alberta, Association des collèges et universités de la francophonie canadienne]

Thank you Mr. Chair, members of the committee.

The most recent studies on the economic impact of our institutions illustrate the economic contribution of their thousands of employees, students and graduates, which is estimated at hundreds of millions of dollars for the respective provinces and for Canada as a whole.

Moreover, through the many partnerships between the universities, colleges and businesses, bilingual professionals are trained who meet market needs and foster knowledge, innovation and technology transfer to the private sector.

It is a well-known fact that bilingualism increases Canadians' productivity and competitiveness in the labour market, in Canada and internationally. According to research conducted by Rodrigue Landry, stronger French education leads to greater bilingualism. Mastering both official languages as well as the French and English professional terminology in a given field also enables Canadians to take advantage of opportunities in the development of francophone-dominated foreign markets.

Finally, according to a recent study by the European Institute of Business Administration, French is the world's third most important language of business and will be among the most widely spoken languages in the world by 2050.

Unfortunately, while French is expanding globally, we are seeing an erosion of the French language in Canada that is as serious as the deterioration of our roads and bridge infrastructure. This does not give francophone and Acadian communities the linguistic security to which they are entitled. This is clearly related to the state of federal funding for the official languages over the past 10 years. This has resulted in a marked decline. It is time to catch up and move forward.

To remedy this situation, the ACUFC recommends that the federal government increase its investment in the 2018-2023 action plan for the official languages and that funding be provided in the 2018 budget for three priority areas in particular. They are as follows.

First, we recommend strengthening and expanding the initial and ongoing training offered to health care professionals in all disciplines and at more post-secondary institutions throughout Canada. This requires an investment of $130 million.

Secondly, we are asking for better initial and ongoing training for legal professionals in both official languages in all areas of the law. This requires an investment of $76.5 million.

Finally, we recommend strengthening and enhancing the education and research programs at post-secondary institutions in the Canadian francophonie and their network initiatives in order to improve access to and flexibility in post-secondary education in French in Canada. This requires an investment of $17.6 million.

[Lise Bourgeois]

It is clear that the colleges and universities of the Canadian francophonie occupy a unique place and play a critical leadership role in the communities they serve and in Canada as a whole.

By supporting the colleges and universities of the Canadian francophonie, the federal government can achieve the productivity and competitiveness goals set out in the 2018 budget and fulfill its vision of official languages that prioritizes bilingualism and community vitality.

Thank you for the invitation.

My colleagues Mr. Mocquais and Ms. Brouillette and I will be pleased to take your questions.

[The Chair, Liberal, Wayne Easter]

Thank you.

I take it that your request totals about $225 million. Is that correct?

[Pierre-Yves Mocquais]

That is correct.

[The Chair, Liberal, Wayne Easter]

I'll go to Mr. Mueller of the Canada Green Building Council.

Members, I gather that the PDF is on your iPads, if you want to follow it.

Witnesses, you may see us looking at the iPads from time to time. Members are not playing games. All the submissions that you sent prior to mid-August are on the iPads. Thank you for that work.

Mr. Mueller.

[Thomas Mueller, President and Chief Executive Officer, Canada Green Building Council]

Thank you, Mr. Chair, for inviting me to speak to the finance committee today.

My presentation will be about the role of the building sector in a low-carbon economy and how the Government of Canada could consider activities in its 2018 budget.

We know that Canada can build a low-carbon economy and reach its 30% reduction target from the building sector by 2030 by focusing on three initiatives.

First is to invest in zero-carbon building standards for new federally owned and federally funded buildings. Zero-carbon buildings will ensure we create the building stock of the future that will continue to operate at a very low carbon performance.

Second, we think that creating opportunities, road maps, for targeted retrofit investments in each jurisdiction for federally owned and federally funded buildings is also a very important part. Without the retrofit of existing buildings, it would be very hard to reach our 2030 targets. It's also part of building a retrofit economy that will grow the economy and result in skilled new jobs in Canada.

Third is building investor confidence in Canada's retrofit economy, particularly in the commercial and residential sectors.

These actions will establish Canadian excellence in green building innovation, grow the economy through job creation, and increase productivity. Here are a few details.

First, the government has a role to play in mainstreaming zero-carbon buildings, since the government is one of the largest, if not the largest, building owner in the country. By adopting a zero-carbon standard for all new or leased federal buildings, the government would set an example and drive uptake of zero-carbon solutions in the commercial and institutional sectors. It would accelerate the commercial development of low-carbon goods and services and technologies.

It would also increase the confidence, and in a way, de-risk green building solutions for the industry. The government has done this before, starting in 2005, with the adoption of LEED in its green building policy. Also, down the road, it would create the conditions for widespread market adoption of zero-carbon technology in Canada and downstream export opportunities.

The CaGBC proposes to work with the federal government to adopt the zero-carbon building standard as a third-party standard and verification in new and existing federal buildings.

Second, as I said before, building retrofits are an essential part of reaching climate change targets by 2030. They're also the greatest opportunity to grow the economy and to create skilled jobs.

The council proposes to create and implement targeted, what we call “retrofit road maps” for each province and territory to optimize energy performance and incorporate on-site renewable energy systems to significantly reduce carbon emissions from existing larger buildings. These actions we are proposing would reduce carbon emissions from the large-building sector by 51%, overshooting the federal target of 30%.

The success of these carbon reduction activities will depend on a number of factors that are unique to each region and relate to existing building type, size, and age, and also the carbon intensity of the heating sources and the electricity grids. I'll just make this point. An identical building in Quebec with the same level of carbon intensity, if operating on fossil fuels, will generate 36 times as many carbon emissions than if it were operating on a clean energy source. That's where the opportunity is. Meanwhile in Quebec, there's a lot of clean electricity from hydro power.

Finally, the third recommendation is that we need to build investor confidence to engage the private sector in investing in building retrofits. We know that the returns on investment.... The council has over 300 million square feet of existing buildings in its LEED program. The investor confidence project, or the ICP, is a standardized framework for risk assessment and verification of building retrofits.

We have found, through consultation with government and the industry, that performance uncertainty after the retrofit is one of the big barriers in the industry.

This would unleash investment and help to grow the retrofit market. It would provide commercial investors and building owners with confidence in project engineering, performance outcomes, and financial returns.

We are currently piloting this project with the MaRS discovery centre in Toronto, and we propose that the federal government embed the ICP, the investor confidence project, as a requirement in the low-carbon economy fund, the Canada infrastructure bank, and the national housing strategy. These are three great opportunities to support retrofit in buildings.

I would like to finish by reiterating that our recommendations will drive the low-carbon economy while contributing to sustainable economic growth and mitigating the effects of climate change. By adopting the three recommended initiatives, the Government of Canada will secure economic and environmental benefits that extend across the Canadian economy. It would do this, first of all, by spurring innovation within Canadian companies. We already see that happening, but through further investment it could be broadened a great deal. It would also do this by further developing leading expertise and technology in Canada’s green building and clean-tech sectors. Canada is already a leader in these sectors, but with further investment, this leadership could be expanded and make Canada more competitive globally.

It would enable the growth of Canadian small and medium-sized enterprises, because in that sector we see a lot of activity, and it would also create export opportunities for Canadian products and services in the growing, global, green building marketplace. That marketplace is growing exponentially year over year, with about 75 countries having active green building markets, industries, and councils.

Finally, retrofits and our other recommendations will benefit Canadians by creating healthier, more productive environments to live and work in. There is mounting evidence that green buildings are also healthy buildings that contribute to the overall mental and physical health of Canadians in our schools, workplaces, and our homes.

Thank you very much.

[The Chair, Liberal, Wayne Easter]

Thanks, Mr. Mueller.

We will now turn to Ms. Hollihan and the Canadian Counselling and Psychotherapy Association.

[Kim Hollihan, Deputy Chief Executive Officer, Canadian Counselling and Psychotherapy Association]

Thank you, Mr. Chairman, for the invitation to present to the committee.

Good afternoon, honourable members.

On behalf of the Canadian Counselling and Psychotherapy Association, or CCPA, it is my pleasure to be here today to discuss our recommendations to support the federal government in its efforts to increase productivity and competitiveness in the Canadian economy. CCPA is a national bilingual association representing the collective voice of over 6,200 professional counsellors and psychotherapists. Our association promotes the profession and its contribution to the mental health and well-being of Canadians.

Investments in areas related to mental health and mental illness are vital to the general welfare of all Canadians, particularly given that mental illness will impact one in five individuals in their lifetimes. Despite the incidence of mental health issues in the general population, people with mental health needs face multiple barriers accessing services. These barriers in turn result in adverse consequences for the Canadian economy. In 2011, the annual productivity impact of mental health problems in the workplace was estimated to be over $6 billion.

The key to any successful business is its workers. By ensuring employees have access to the services and supports they need, businesses can maximize productivity and competitiveness.

We believe the following recommendations will assist the federal government in addressing barriers related to the accessibility of mental health services.

First, CCPA recommends that the federal government include counsellors and psychotherapists as an eligible expense in the public service health care plan. We understand that mental health claims account for nearly half of all health claims among federal public servants. Including counsellors and psychotherapists as approved service providers will increase access for those in need and can have a positive economic impact as well.

Wait times for mental health services are a considerable problem with potentially negative consequences for those seeking help. Adding counsellors and psychotherapists to the mental health care continuum will reduce wait times, increase early intervention, and minimize the need for specialist care for preventable, chronic conditions. The need for more expensive treatments down the line can be reduced, resulting in long-term savings in our health care systems.

I would like to emphasize that CCPA is not suggesting that counsellors and psychotherapists replace other mental health professionals. Like many of our health and mental health partners, we advocate for appropriateness of care: access to the right care from the right provider at the right time. We believe that the addition of a fully qualified resource makes appropriateness of care more attainable.

Second, CCPA recommends that the federal government reinstate Canadian certified counsellors, or CCCs, to the list of approved service providers for Health Canada's first nations and Inuit health branch programming in provinces that have not regulated counselling psychotherapy. The decision to remove CCCs has significantly reduced appropriate universal access to mental health counselling services for indigenous peoples across the country.

Given CCPA's collective body of work specific to indigenous mental health and the rigour of our national certification program that has been in existence for over 30 years, we are confident in requesting the reinstatement of CCCs as approved providers of the FNIHB counselling benefit. Their reinstatement would support and help indigenous communities, families, and vulnerable individuals by increasing the availability of services and expanding the number of service providers.

Finally, we recommend that the loan forgiveness program for physicians and nurses be extended to university graduates of counselling programs. The program has worked wonderfully for providing incentives for graduates to work in rural, remote, and northern regions of Canada. We feel that, should the government extend a similar program to university graduates of counselling programs, this would attract and retain these much-needed professionals in communities that are at high risk with limited mental health services. The federal government could also consider grants, scholarships, and bursaries in exchange for a return-of-service commitment, wage incentives, a guaranteed minimum income, and/or tax credits for practising in remote areas.

Access to mental health care is a priority shared by federal, provincial, and territorial governments, as recently articulated in the common statement of principles on shared health priorities. We strongly believe that our recommendations will contribute to the common goal of improving access to mental health services and supports for Canadians and their families.

Thank you for your time and attention. I would be happy to take questions.

[The Chair, Liberal, Wayne Easter]

Thank you very much, Kim.

The Canadian Medical Association, Mr. Marcoux, president, and Mr. Feeley, vice-president, member relevance.

The floor is yours. Welcome, and thank you.

[Dr. Laurent Marcoux, President, Canadian Medical Association]

Thank you.

Hello ladies and gentlemen.

The Canadian Medical Association's 2018 pre-budget brief has been provided to you so I will not use our time rehashing our recommendations in detail. But I want to be clear: acting on the CMA's key recommendation—that the federal government provide targeted funding to support the development of a pan-Canadian senior strategy to address the needs of the aging population—is the defining challenge facing our nation today.

Canada's health care system is confronted with a growing and aging population with more complex and chronic health care needs. When our public health system was created about 50 years ago, Canada's population was just over 20 million and the average life expectancy was 71. Today, our population is over 35 million and the average life expectancy is 10 years longer.

Relying on acute care hospitals to care for our aging population is an ineffective use of health care dollars, and it is not sustainable. The demands on our system will simply become too great, and such an approach will fail both our aging population and the remainder of Canadians who must access the health care system in a timely fashion.

The CMA is delighted to report that Liberal MP Mr. Marc Serré has introduced a motion to establish a national seniors strategy in Canada. The motion was adopted by the House of Commons, and the Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities will now undertake a study on the topic.

By developing a national seniors strategy now, the federal government will help Canadians be as productive as possible in their workplaces and in their communities.

Implementing the CMA's recommendations as an integrated package is essential to stitching together the elements of community-based and residential care for seniors. In addition to making a meaningful contribution to meeting the future care needs of Canada's aging population, these recommendations will mitigate the impacts of economic pressures on individuals and jurisdictions across the country.

With strong leadership now, we can evolve our system and right our course. The CMA's pre-budget recommendations provide a clear roadmap to do so.

I must also call attention to the proposed taxation changes announced for consultation on July 18. I will not repeat all the points made in the thousands of letters, emails, and in the media over the course of the last two months. However, we must understand that this is a proposal of the most significant changes to the tax system in 45 years, and the CMA believes that a 75-day consultation is inadequate to deal with the scope of these changes. The unintended consequences for our members and for over one million other small business operators are worrisome.

We acknowledge the diversity of opinion and perspectives on this issue, including the support expressed this week by some physicians. What we can all agree on is that a comprehensive review of our tax system is required, and that takes time.

As Parliament resumes this week, our nation turns to its elected representatives for leadership.

Respecting and celebrating our health care professionals, be they nurses, doctors, therapists, counsellors or others, is a sign of great leadership.

With the serious challenges facing our health care system, it is critical that we discuss Budget 2018 and all other public policy matters within the context of Canadian values.

I will be pleased to take your questions.

Thank you.

[The Chair, Liberal, Wayne Easter]

Thank you very much, Mr. Marcoux.

From the Conference Board of Canada, Mr. Craig Alexander, senior vice-president and chief economist.

Mr. Alexander.

[Craig Alexander, Senior Vice-President and Chief Economist, The Conference Board of Canada]

Thank you very much, and thank you to the committee for the opportunity to appear and discuss how the government can help boost productivity.

This is a critical priority. Since the end of the Second World War, roughly 80% of the rise in the standard of living of Canadians has come from greater productivity. It fuels the economic growth that creates jobs and generates the income that lifts living standards, and it's this income that provides the tax base to pay for social priorities. However, Canada has a pressing productivity problem. Over several decades, labour productivity in Canada has slowed significantly, and in conjunction with an aging population, this is dragging down the country's potential pace of economic growth and creates significant restrictions on income growth and tax revenues. We need to do better.

What can the government do to foster better productivity growth? The most basic recommendation is running sound and stable macroeconomic policy. This includes public investments in key economic and social areas, such as infrastructure, health, and skills development. However, the spending and investment must be balanced with the need to keep taxes competitive and stable. Canada also requires prudent regulatory oversight, but the regulatory burden should be kept appropriate and stable.

Sound fiscal policy is about running balanced budgets over the economic cycle. On this point I would stress that the finances of the Government of Canada are in good shape. The country can afford deficits for a few years. Ultimately, however, sound fiscal policy means returning to balance. I would also emphasize that putting weight on the debt-to-GDP ratio as a fiscal anchor is inappropriate, because the government does not have control on the denominator, GDP.

Beyond sound macroeconomic policy, there are targeted options that might enhance Canada's productivity, which the Conference Board of Canada has identified in its research. To boost firm-level productivity, the focus should be on supporting fast-growing small and medium-sized businesses. Canada is a very easy place to launch a business, but many businesses have difficulty scaling up. In recent years, venture capital has been increased, but a strong case can be made that we need to put a greater priority on later-stage funding. More research is needed to understand truly what the barriers are to our fast-growing SMEs.

Capital investment can be a catalyst to greater productivity, but Canadian firms have been reluctant to invest in recent years. Productivity is picking up this year, but the pace of investment is still weaker than it ought to be.

An area for improvement is commercialization. Canada has very generous R and D tax credits, but is weak on commercializing that research. One suggestion for improvement is more funding for programs that bring researchers together with industry, like the grants from NSERC. We might consider more initial direct funding or loans for approved R and D projects, then complement that later with indirect support through tax credits. This is an approach that has been used in a number of other high-productivity countries, but the programs have to be structured properly.

Government procurement, if used strategically, can be leveraged to sustain growth in fast-growing SMEs. It can help encourage investment and growth. It can also help firms succeed in international markets. Trade agreements and policies that create more international trade boost productivity because firms face greater competition, and firms that face more competition tend to be more productive.

One factor constraining business investment is shortages of high-skilled labour, while at the same time there are still pools of underutilized labour in Canada. This raises the question as to how to improve labour market outcomes. The labour market is being transformed by an aging population, globalization, and technical change, so I think the first step is upscaling the labour force. This starts at birth and runs the entire life cycle of individuals. Canada should invest more in early childhood education. An imperative is to get the basics right, and that means improving literacy, numeracy, math, and critical skills.

There are groups of the population within Canada who are facing barriers to success. We desperately need better education outcomes for aboriginal and first nations people. This requires more funding to support indigenous learners. There are barriers that women face in the labour market. Women represent over half of post-secondary graduates, but they are under-represented in the STEM fields. Our research shows that experiential learning can be very impactful with skills development and entry into the labour market.

We need to expand funding for co-ops and apprenticeships, but again a gender lens is useful. Women are less likely to pursue apprenticeships than men, and this needs to be addressed to fully unlock opportunities.

In order to make progress in reducing the gender wage gap and the immigrant wage gap, funding should be made available to measure progress towards diversity targets, and diversity initiatives should have clear benchmarks. When feasible, progress should be reported publicly. Also, learners with disabilities need greater support, such as adequate accommodation, to achieve education success and workplace learning opportunities.

One major factor holding back firm productivity is weak innovation leadership skills and scale-up management skills. We may indeed have enough venture capital money, but venture capital is often about the mentoring of businesses and the development of the leadership and management skills to grow the businesses. As a result, we need to expand business education, and we also need that to be part of education programs across the board in some form.

Beyond the upscaling, the impact of demographics means that we need to raise immigration levels over time, but we need to do a better job of integrating newcomers into the economy. I would be happy to talk about policy options in that area in the Qs and As.

The bottom line is that the federal government influences productivity growth through a vast number of channels. Getting the basics right means running sound and stable macroeconomic policy. The more sophisticated dimension to raising productivity is through targeted programs and initiatives.

The government has been clear that it wants to fuel inclusive growth. The constructive way to tackle this issue is to remove the barriers to success. Allowing Canadians and newcomers to realize their potential will ultimately raise living standards, which is the true goal.

[The Chair, Liberal, Wayne Easter]

Thank you very much.

Turning to the Canadian Psychiatric Association, we have Mr. Brimacombe, CEO, and Mr. Sinha, president.

[Dr. Nachiketa Sinha, President, Canadian Psychiatric Association]

Thank you, Mr. Chairman and honourable members, and good afternoon. The Canadian Psychiatric Association is very pleased to be with you this afternoon.

My name is Dr. Nachiketa Sinha, and I am the CPA president. I am joined at the table by Mr. Glenn Brimacombe, CEO of the CPA.

The CPA is a member-based voluntary professional association and is considered the national voice of psychiatry. We all understand the essentialness of one's mental health and its relationship to our quality of life, our relationships, and sense of belonging, as well as fulfilling our potential as a productive and contributing member of society.

To underscore this point, I have shared with the committee, as part of our written submission, a series of infographics that make compelling sense for the need to invest in a range of mental health initiatives. In our view, investments focused on mental health prevention and promotion, improved access to care, early diagnosis and treatment, and the availability of appropriate community services and supports can change the trajectory of someone who suffers from mental illness. We believe that the mental health of Canadians is integrally tied to the future prosperity of this great country and to the precondition that must be addressed to unleash the unlimited potential that is Canada. In short, mental health must be our first wealth.

When it comes to funding mental health services and support, the federal government has indeed made an historic choice by investing $5 billion over the next 10 years for mental health. The CPA strongly applauds the federal government for its leadership and foresight in focusing on a sector of the health system that has been systematically underfunded for decades.

To make this point even clearer, last week at our annual conference, the CPA conferred its highest civilian honour, the president's commendation, on the Prime Minister.

While $500 million per year for the next 10 years earmarked for mental health is surely an important step that will begin to provide needed resources to a system that is already stretched, the CPA, which is a member of the Canadian Alliance on Mental Illness and Mental Health, has called on governments to increase funding for mental health from 7% to a minimum of 9%, which, by our calculations, would require an annual investment by the federal government of $778 million. This would also see the federal government contributing 25% of provincial expenditures for mental health.

As we move forward, we hope that the federal government will continue to invest in mental health services and programs across the country. With the objective of accelerating the introduction of proven and/or promising mental health innovations, the CPA calls on the federal government to establish a five-year, $100-million mental health innovation fund. You may recall that the rationale for such a fund was clearly articulated by the Naylor health innovation report, and innovation is a point that is recognized by the “Common Statement of Principles on Shared Health Priorities” released by federal, provincial, and territorial governments a couple of weeks ago.

The CPA also recognizes that in many cases mental health research is often the precursor to new cost-effective innovations that are ultimately introduced into the health system. By investing in mental health research, we can accelerate the impact of evidence-based decision-making. Currently it is our understanding that the Canadian Institutes of Health Research devote less than 5% of grant-based funding to mental health research while the burden of mental health stands at more than 10%. Clearly more can be done.

We are aware of the government's intent to legalize cannabis in 2018. In May 2017, the CPA released its position statement, “Implications of Cannabis Legalization on Youth and Young Adults.” In short, the CPA recommends that Canadians should not be legally allowed to use marijuana until the age of 21 and that legislation should restrict the quantity and potency of that drug until they are 25.

While the CPA was not invited to appear before the Standing Committee on Health, despite our requests, there is a responsibility on the federal government to ensure that adequate resources are invested in the areas of public education, research, prevention, early identification, cannabis-cessation treatment programs, and advertising and marketing guidelines. The CPA stands ready to work with the government to protect the mental health of Canadians.

Finally, the CPA is concerned with the proposed changes by the federal government with regard to incorporation.

While we are supportive of the leadership role that the Canadian Medical Association and others have played, we are concerned that the proposed measures would only serve to exacerbate the already low number of practising psychiatrists, and in particular new psychiatrists who are looking to establish a practice in Canada.

Thank you again for the opportunity to appear before this committee.

[The Chair, Liberal, Wayne Easter]

Thank you very much to all the witnesses for their presentations.

I do note, Mr. Marcoux, that you did mention the small business tax, which has come up since you presented your brief. That's fine. There likely will be questions on that, I'm sure, but we are holding hearings next week on that issue as well, in addition to pre-budget consultations. I just wanted you to know that, and whether you're a witness or not, there will be a button on the finance website to submit your remarks and we'll pass those on to the minister.

Turning to questions, then, Mr. Sorbara, we'll go to five-minute rounds.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Thank you, Mr. Chair. Thank you, everyone, for being here.

I'd like to go directly to the CMA, and your recommendation number three about the Canada caregiver credit, a credit we introduced in prior budgets. I thought it was something very powerful that a lot of Canadians would take up, given our aging population and the number of individuals who need assistance.

Have you estimated what the impact would be to go from a non-refundable to a refundable tax credit on finances, or even just the uptake in the number of people who would be able to utilize the caregiver credit?

[Dr. Laurent Marcoux]

Thank you for the question.

That is a very important question.

We recognize the importance of offering credits, but the whole health care system is actually in need of reform. As I said in my opening remarks, the Canadian health care system was designed to provide care at hospitals. A person may be suffering from three or four chronic illnesses. The need to stabilize those illnesses places tremendous pressure on health care institutions. Even the patients who are suffering from those chronic illnesses are not satisfied with the care. It is very difficult for them to go to the hospital and wait in emergency or on different floors. Moreover, this is very costly to the health care system.

We therefore recommend an overhaul of the health care system to bring Canada into the 21st century with a health care system that better meets Canadians' needs.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Thank you, sir.

I'll go to Mr. Alexander from the Conference Board.

Craig, I meet with a number of economists and friends in downtown Toronto, and I always ask this one question. What are the headwinds facing the Canadian economy in terms of productivity and competitiveness? The one recurring answer I get is demographics. That's usually the first one that pops up.

I would like to hear what you can offer up in terms of how can we do a better job of utilizing and integrating immigrants when they come to this beautiful country. Are there gaps that exist in income or occupation levels? I'd like to hear a few ideas from you. I think it would be great to put them on the record.

[Craig Alexander]

Sure.

At the moment, about 70% of our Canadian population growth is coming from immigration. The economy grows because either you have more workers or you use your workers more productively. When we think about the trend slowing in the Canadian economy, we realize that if we hold productivity constant and the aging effect takes place, what will happen is that growth will slow.

Canada is doing a very good job of bringing in additional newcomers, which is helping to offset some of the impact of the aging population. It's not going to be enough to stop the impact, because the baby boomer cohort is so large that you couldn't bring in enough newcomers to fully offset the impact.

The other dimension is that as you ramp up immigration and it levels, it becomes really important to make sure that you integrate the new immigrants correctly and effectively. One advantage Canada has is the enormous public support for immigration. This actually stands out for Canada, relative to many other countries that at the moment are much less welcoming to immigrants. There's a real opportunity for Canada to attract top international talent, because we're a beacon of light.

That being said, the integration is still not optimal. When we look at newcomers coming to Canada, we see a significant wage gap. The wage gap has grown over time.

What's interesting is that when you ask immigrants five years after they've arrived whether, given the challenges they're having in the labour market, they would do it again, 90% of them say yes, but when you ask them why, they'll say it's for their kids. That's not a good outcome. We need to be giving a good experience to the newcomers themselves.

I think there has been progress. Some of the changes in the immigration system that have been introduced in recent years have been helpful in improving integration. There are, however, things we could do. For example, the government might consider support for local immigration partnerships, immigrant employment councils, and other comparable initiatives that have demonstrated that they are effective and low-cost ways to improve immigrant integration. Groups such as TRIEC in Toronto are very effective and low-cost in improving integration.

The government could leverage technology more, so that when they are looking to come to Canada, newcomers can get a lot more information pre-arrival about where to get settlement services, where to get language training, about what is already there. There is a lot of support for newcomers. It has to be accessed.

We also might consider—and this is probably the most contentious—federally funded settlement services for selected temporary residents. For example, providing access to federal settlement support for international students who have identified that at the end of their program they plan to look for permanent residency could actually facilitate their integration.

Those are a few ideas.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

If you don't mind forwarding some of those ideas to the committee that would be wonderful.

[Craig Alexander]

The recommendations that I just noted are in my submission today, but I'd also be happy to provide more.