Evidence of meeting #166 for Finance in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was poverty.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Harriett McLachlan  Deputy Director, Canada Without Poverty
Michèle Biss  Coordinator, Legal Education and Outreach, Canada Without Poverty
Peter Bleyer  Executive Director, Canadian Centre for Policy Alternatives
John McAvity  Executive Director, Canadian Museums Association
Bob Laidler  Director, Museums Foundation of Canada, Canadian Museums Association
Amanjit Lidder  Senior Vice-President, Taxation Services, MNP LLP
Mark Kerzner  Past Chair, Board of Directors, Mortgage Professionals Canada
Paul Taylor  President and Chief Executive Officer, Mortgage Professionals Canada
Massimo Bergamini  President and Chief Executive Officer, National Airlines Council of Canada
Jennifer Kim Drever  Regional Tax Leader, MNP LLP
Blake Richards  Banff—Airdrie, CPC
Kim Rudd  Northumberland—Peterborough South, Lib.
Sally Guy  Director, Policy and Strategy, Canadian Association of Social Workers
Catherine Kells  President, Canadian Cardiovascular Society
Gigi Osler  President, Canadian Medical Association
Michael Villeneuve  Chief Executive Officer, Canadian Nurses Association
Joelle Walker  Director, Public Affairs, Canadian Pharmacists Association
Scott Marks  Assistant to the General President, Canadian Operations, International Association of Fire Fighters
Peter Fragiskatos  London North Centre, Lib.
Fred Phelps  Executive Director, Canadian Association of Social Workers

11:10 a.m.

Director, Policy and Strategy, Canadian Association of Social Workers

Sally Guy

Would you like to add something?

11:10 a.m.

Fred Phelps Executive Director, Canadian Association of Social Workers

I would add this. When I looked at social work I saw that the last time there was a sector study was in about 2005, I believe. It's not part of this submission but we have asked for and been looking at another sector study that looks at the number of social workers across Canada serving the populations. Independent of a caseload study, we'd be looking at how many social workers are actually there and actually providing services. Overwhelmingly, over 70% of the social workers surveyed say their caseloads are beyond their ability to manage, and we really have no national snapshot or standards when it comes to how many children should be on a caseload.

We can when it comes to Veteran Affairs. We can set national standards, which I think is 25:1. We can do that. I think it's time we actually started to put children first, if we're going to look at how to maintain children out of care. A report just came out of Manitoba today.

11:10 a.m.

NDP

Peter Julian NDP New Westminster—Burnaby, BC

I'm actually going to have to cut you off there. Thank you very much. I did want to go to Ms. Osler.

Ms. Osler, you've indicated the shortage in funding. A few years ago when the former government capped the funding to the health care system, we knew this would cause problems. The current government has continued that same process. You've been very eloquent in talking about what the impacts have been to Canadians waiting for care and not getting adequate health care. To what extent would funding for home care, for pharmacare, make a difference as well in terms of more effective health care outcomes, but also providing more support for Canadians?

11:10 a.m.

President, Canadian Medical Association

Dr. Gigi Osler

Thank you for the question.

Certainly pharmacare and home care are pieces of the puzzle. What we're recommending in terms of the demographic top-up to the Canada health transfer would be broader than that. If you look at health care spending, say, for Canadians under the age of 64, you see it's about $2,700 per year. If you're 65 or older, it's about four times that. When you look at that as a whole with an aging population, you see it needs to be a multi-pronged or multi-faceted approach to look at the needs of our aging population.

Home care is part of it. Pharmacare will be part of it, but also consider that the top-up would help to alleviate some of the greater issues we're seeing in the health care system today, like emergency room wait times or elective surgeries getting cancelled because there are no beds in the hospital. Yes, it is addressing the seniors' population, but there are going to be downstream effects throughout the whole health care system.

11:15 a.m.

Liberal

The Chair Liberal Wayne Easter

Thank you.

We'll have to move to Mr. Fergus.

11:15 a.m.

Liberal

Greg Fergus Liberal Hull—Aylmer, QC

Thank you very much, Mr. Chair.

My question is for Ms. Walker, from the Canadian Pharmacists Association.

Thank you very much for your presentation.

It is rare for an MP to ask a question to which they don't know the answer, but I do have one. It pertains to your position on the excise tax on cannabis products.

I do not completely understand the situation. From what I understood, when a product has a drug identification number, there is no excise tax. You argued that the excise tax should be eliminated on recreational products and products that people get with a doctor's prescription. After October 17, however, their status could change.

Can you please explain your position? I find it strange that the Canadian Pharmacists Association would call for the elimination of the excise tax on a product without a drug identification number.

11:15 a.m.

Director, Public Affairs, Canadian Pharmacists Association

Joelle Walker

My position is as follows. We maintain that recreational cannabis and medical cannabis should be two completely separate cases.

A patient who—

11:15 a.m.

Liberal

Greg Fergus Liberal Hull—Aylmer, QC

One moment, please.

Mr. Chair, I can hear interpretation coming from a speaker somewhere and find it a bit distracting.

11:15 a.m.

Liberal

The Chair Liberal Wayne Easter

Somebody's earpiece is too close to one of these and that will screw the system up.

Go ahead.

11:15 a.m.

Director, Public Affairs, Canadian Pharmacists Association

Joelle Walker

I am also having trouble hearing you.

Our position is that, for patients who use medical cannabis and people who use recreational cannabis, these are two completely different avenues. Clearly, there will be no excise tax on products with a drug identification number, or DIN.

11:15 a.m.

Liberal

Greg Fergus Liberal Hull—Aylmer, QC

Yes.

11:15 a.m.

Director, Public Affairs, Canadian Pharmacists Association

Joelle Walker

Our position is not that patients who use recreational cannabis should be exempt from an excise tax, but rather that patients with a medical prescription who obtain their cannabis in accordance with the regulations should not have to pay the tax.

11:15 a.m.

Liberal

Greg Fergus Liberal Hull—Aylmer, QC

Those regulations date back to before cannabis was legalized. In other words, the scientific aspect was not completely standardized.

Are we in a transition period? Do you expect that, at some point, when the science is more clearly established and the medical value of these products is certain, things will be standardized so the excise tax will not apply to products with a DIN, but will apply to all other products?

This is not the same situation as for non-prescription drugs.

11:20 a.m.

Director, Public Affairs, Canadian Pharmacists Association

Joelle Walker

You also have to realize that patients use cannabis in many forms: there are oils, the dry product, as well as drugs approved by Health Canada. We think that medical cannabis should be maintained for those patients because they are not using it for the same reason as people who use cannabis recreationally. The government has said that it would maintain medical cannabis, according to the regulations, for five years and then evaluate how things are evolving. It is quite possible that, in the next five years, there could be more scientific evidence in support of certain treatments.

The reality is that patients are using it now. Our concern is that, once cannabis becomes legal, on October 17, they will not want to go to their doctor any more to get a medical prescription. We are afraid they will get their cannabis from the SAQ in Quebec, or other places in Ontario, for example, where those patients will not necessarily get the kind of clinical support that doctors and pharmacists can provide. Their use of the product will not be included in their medical profile. Establishing a different tax regime for each of these two groups will mean that patients will still be in a medical framework.

11:20 a.m.

Liberal

Greg Fergus Liberal Hull—Aylmer, QC

Thank you very much, Ms. Walker.

My next question is for Ms. Guy. My wife has a BA and an MA in social work, so I am quite familiar with the Canadian Association of Social Workers.

I would like to know whether you think loan forgiveness for social workers is enough to encourage them to work in the regions of Canada or in communities, especially indigenous communities, that are very remote from all infrastructure.

11:20 a.m.

Director, Policy and Strategy, Canadian Association of Social Workers

Sally Guy

Thank you very much for your question. I'm sorry, but I will answer in English.

11:20 a.m.

Liberal

Greg Fergus Liberal Hull—Aylmer, QC

That's fine. That is your right.

11:20 a.m.

Director, Policy and Strategy, Canadian Association of Social Workers

Sally Guy

In a blue-sky perfect world we would ask for all kinds of things, but we really felt that this was achievable, that this was a bite-sized piece, an achievable policy that we could actually get done that would really help people, especially young women in a female-dominated profession, to return home to these communities. If you want to talk to me after about things that we would like to incentivize social workers generally, there are things we would like to see.

I'm wondering, Fred, if there's anything else that you would like to add.

11:20 a.m.

Executive Director, Canadian Association of Social Workers

Fred Phelps

There's supporting northern education in the territories to ensure that social workers have programs that they can take within their communities, or access within their communities, so they can stay within their communities. I think this committee is well aware that when individuals leave their communities for education, coming back into the communities is extremely difficult.

We presented last year about a program at Aurora College in the north. The government was looking to eradicate that program and that would have had the intergenerational consequence of removing social workers from the north when we should be doing everything we can to encourage social workers to stay within their communities and be trained within their communities and serve their communities.

11:20 a.m.

Liberal

The Chair Liberal Wayne Easter

Mr. McColeman.

11:20 a.m.

Conservative

Phil McColeman Conservative Brantford—Brant, ON

Thank you, Chair, and thank you, witnesses, for being here.

First of all, Mr. Marks, I believe in your testimony you had said your request is for a renewal of a program that you've been providing, looking for $500,000 of funding. Am I accurate in hearing your testimony?

11:20 a.m.

Assistant to the General President, Canadian Operations, International Association of Fire Fighters

Scott Marks

The program was first created in 2009 and we got five-year funding. Since that time we continue to get renewals based on one- and two-year renewal periods. The last renewal brought us funding from April 1, 2017, and it will expire on March 31 of next year.

September 20th, 2018 / 11:20 a.m.

Conservative

Phil McColeman Conservative Brantford—Brant, ON

I'm not a permanent member of this committee, although I used to be at the start of this Parliament. I'm filling in today.

Having gone through pre-budget consultations previously something that's amazed me is the amount and size of what is asked of any government be it this government, our previous government, or any government. The asks as you do pre-budget consultation are just over the top unachievable. Let's put it that way. Of course, we sit here coming from our own frame of reference in our lives to be parliamentarians trying to determine value for money. When I hear a number of $500,000 to do a national program, it's such an infinitesimally small amount of money, and not knowing the scope of what you provide but listening to your testimony, it's amazing to me that it hasn't been renewed already. That being said, you're here advocating that it be renewed, and I would say when I think of the relationship most members of Parliament have in their own committees with the firefighters, most of us have a relationship somewhere along the line with that or with the firefighters in our own personal situations. It baffles me that it just isn't an automatic.

I appreciate your testimony, Ms. Guy, today with your what I would call rather modest approach of what is achievable. I'm not saying that to cast aspersions on anything from other people who are asking. They brought their priorities and they've thought them through and they brought them to this committee. But the reality, as I said, any government faces is the fact that it's a matter of priority, of sifting through everybody and all the asks and setting the realities.

I'm sad to say I was part of a lobbying organization back in the mid-1990s and we used to sometimes embellish our need. I'm just making that comment not so much to ask a question but to say, what are the things your organizations—and any of you can respond to this if you wish—can do and do well either for modest requests of government, and not just the federal government but perhaps the provincial and municipal governments if you do work with them, or do without funding, but something else that government supports could give you? Does anyone care to respond?

11:25 a.m.

Liberal

The Chair Liberal Wayne Easter

Dr. Kells, you haven't been on yet.

What will the money you're asking for do in the broader sense in terms of maybe being an example for the value for money in the system?

11:25 a.m.

President, Canadian Cardiovascular Society

Dr. Catherine Kells

You've really hit the nail on the head. That is exactly what we're trying to do in cardiac care.

Together, cardiac care and cancer are the leading causes of death, and the two situations together actually cost the Canadian taxpayers 80% of the health care dollars, which are spent on treating the burden of those two diseases.

For cancer, there is a reporting system. For cardiac care, we don't have a quality reporting system that is transparent and pan-Canadian, in all provinces. When a new technology comes out, the example would be the report I showed, transcatheter aortic valve implantations. It's a fancy new treatment. Every valve costs $25,000. It's really expensive. Currently, it's reserved for elderly people. We actually analyzed the results to see if this brand new, really expensive technology was working. Was it effective? How much money did it cost? Did the people really live longer? Did they feel better, and so on?

Over five years, the Public Health Agency of Canada put in approximately $7 million to get this system up and running so that we could answer those questions for all areas of cardiac care, whether it be heart failure or cardiac surgery. For a very small amount of money, $2.5 million each year, we can keep this system going. We can grow it and answer more questions such as why is it that indigenous people do poorly.

If we don't measure things, we can't see what's wrong and we can't then go look and find out why it's wrong. It's great value for money.