Finance Committee on May 20th, 2021

[Dr. Ann Collins]

Between Monsieur Villeneuve and me, we have outlined the many needs of Canadians that will be required to be met as a result of the pandemic and aging and the state of pre-existing health care systems prior to the pandemic. Again, we implore the federal and provincial governments to come together in a co-operative and collaborative fashion to discuss those needs and what we'll need to meet those needs moving forward. We look to do whatever we can to engage and to support that collaboration.

[The Chair, Liberal, Wayne Easter]

Thank you, all.

We will have to go to Mr. Julian, followed by Mr. Kelly.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Thanks so much, Mr. Chair.

Thanks to our witnesses for coming with such compelling testimony today, and we hope that you and your families continue to stay safe and healthy during this pandemic.

I'd like to address my first questions to Dr. Collins, Mr. Villeneuve and Madam Hamza, and give our deepest condolences for the doctors and nurses who have died during this pandemic and express our gratitude for the incredible bravery and dedication of Canada's nurses and doctors during this unparalleled health crisis. It is something that all Canadians profoundly appreciate, and we know that many have given their lives. Our condolences go to each and every one of those members of your organizations and their families.

We had compelling testimony in the previous panel that over $50 billion every year goes to the ultra-rich and big corporations because of tax cuts, loopholes, and a tax system that is simply broken down.

All three of you have offered compelling reasons why we really need to prioritize health care funding for primary care, for long-term care and the debacle we've seen there, and for mental health care.

Is it not fundamental that we prioritize health care funding and that we put in place a tax system so that everyone pays their fair share and we actually have the wherewithal to put in place the funding for the needs that you have so clearly identified are absolutely essential to meet in the coming years?

[Dr. Ann Collins]

Thank you, Mr. Julian, for your well wishes. They are very gratefully accepted on behalf of the CMA.

I'm not an economist. I'm not a tax expert, but I am a family physician and I think that there is no question that the pandemic has fully laid bare the many deficiencies that exist in our health care system. Again, 5 million Canadians are without a family physician. In my province of New Brunswick and in neighbouring Nova Scotia, 100,000 people are on a no-doctor list.

I don't think Canadians are going to let this rest. The importance of health care is so critical. Good health care is critical to a strong and robust economy, and so again we applaud the government for the measures taken in budget 2021 and we look forward to honouring the commitment to primary health care teams and family physicians, who are so critical to the life of a good health care system.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Mr. Villeneuve.

[Michael Villeneuve]

Thank you very much, Chair.

I'll just add quickly that, again, I'm not an expert on what the tax system should be, but of course we would support a fair, equitable tax system.

What we would put on the table is a reminder that we want to provide the best possible care for the best value, and many of the things that we do costs more than they need to. If you think about those 63,000 people who didn't have a long-term care bed because there were only 200,000 beds and there were 63,000 more people, it's not like they don't get care. They go to emergency. They go to the hospital.

Dr. Collins was talking about people who don't have a doctor. They go to expensive places to get that care and they're often sicker and it takes longer, so we believe that a different sort of look at funding health care systems could ensure that we, in a sense, keep people steps back from moving to the more expensive places and use the tax dollars more wisely.

I hope that is helpful.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Yes, it is.

Now I would like to come back to the issue of public universal pharmacare. That was a commitment the government made in the last election. It has abandoned that in this budget and his budget bill, as you well know. The proposed Canada pharmacare act was killed in the House of Commons a few weeks ago by the votes of government MPs.

I know that Canada's nurses were front and centre in supporting the drive for public universal pharmacare and that there are 10 million Canadians who have no access to drug plans, and so I ask how important is it to put in place public universal pharmacare so that Canadians can actually get the medications their doctors prescribe and stay in better health and away from emergency rooms?

[Michael Villeneuve]

For the Canadian Nurses Association, it's absolutely essential. We've been talking about it for decades. The concern is that it's even things like people's metering out their diabetic medicines, for example; because they're so expensive, they can't use them all effectively each day. We are particularly concerned that we've had a long focus historically on covering catastrophic drug expenses, AIDS drugs and so on. However, if you don't have $50, $50 is catastrophic for you if you're in that space. It's really important, we believe, for people across Canada to tackle this and get pharmacare done.

[The Chair, Liberal, Wayne Easter]

Ask a very quick question with a very quick answer this time, Peter.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

I'll ask the same question of Dr. Collins. Many doctors, of course, also have been extraordinarily supportive of public universal pharmacare. The bill was killed. The government has dropped the commitment. Do Canada's doctors believe it's important and essential to expand our health care system to include public universal pharmacare?

[Dr. Ann Collins]

The CMA supports federally funded essential medications as a start to be scaled up. There is no question that doctors and patients every day struggle to find the right medication at the right cost, and unfortunately, in some instances, the right cost is never achieved. Again, with the loss of jobs during this pandemic, it's not just our seniors who are affected by this. We're now seeing many younger Canadians having to make difficult choices about whether they buy their medications or buy groceries.

[The Chair, Liberal, Wayne Easter]

Thank you, all.

We are going to Mr. Kelly in a five-minute round, and he'll be followed by Mr. Fragiskatos.

Pat.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Great. Thank you.

I'll begin with Dr. Collins.

I'd like you to have an opportunity to expand on something you said in response to one of Mr. Ste-Marie's questions. You talked about the funding to deal with the backlog of surgeries and health care caused by the first and second waves. However, we are in a third wave that actually produced.... Thankfully, many more people are surviving in the third wave, but they are spending a great deal of time in hospitals. Do you have better numbers or any kind of data on the backlogs that exist because of this third wave?

[Dr. Ann Collins]

I do not have numbers for you. We did do our own study that said it would cost $1.3 billion to deal with the backlog of six procedures from the first wave alone. You can project and know that the cost of the second and third waves is going to be incredible. Doctors did scramble to get surgeries taken care of when there were fewer lockdowns, but it goes beyond surgery. We have seen patients delay their presentation to their physician if they have a family physician. We know that COVID patients who have—

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

I really appreciate that. Thank you.

If there was some information, I was hoping to get it, but we, obviously, still just don't know what this third wave is going to cost in that area.

I'm going to go to Ms. Mrozek.

We've heard at this committee leaders from a variety of different groups. We've heard from business, labour and academics, and there are plenty of pundits that support the principle of a national day care system. However, you're really interested in the focus that you have done on researching what parents think of this type of system. I wonder if you could elaborate on some of the questions that you put to parents because it seems to me that there are so many different concerns that parents have, and they're different in different areas. No doubt, parents are very concerned about the cost of raising a family, which works itself out in a variety of ways from housing to the cost and availability of child care. What have parents told you about the kind of child care that they want?

[Andrea Mrozek]

We did do a recent poll with the Angus Reid Institute asking about child care needs among parents and Canadians at large.

What we found was a diversity of responses. When presented with any array of policy options, parents accepted each option by a high percentage. For example, a refundable tax credit, yes, they're interested in that; money to parents, yes, they're interested in that; a national system, yes, they're interested in that.

My point, however, is that we didn't juxtapose the question of what a national system actually means on the ground—not in theory, but in practice—with actual dollar figures as to how much that would be for each child under a particular age.

We do attempt to ask what parents desire, and we faithfully represent what we find from our polling. There is a huge diversity in responses.

I still believe that given the money now, versus a pie in the sky type of system later on, parents would be more interested in the money now, especially, if I could refer to the point I mentioned before, given the supply side side issue of this not being as big a problem as we've been led to believe by activists for a national day care system.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Right, and we see that the needs of parents are extremely diverse, and you touched on that in your opening statements and how no family, it seems, has the same approach or idea of how they would like to balance their family life to ensure both that their children are raised safely and comfortably and they have the economic opportunity to participate in the workforce.

I am just about out of time, but are there any further comments on the diversity of needs that are out there?

[Andrea Mrozek]

We believe that parents are the best bet for their children, and that they are capable and competent of choosing the right kind of child care that works for them. That could be a space in a centre, it could be a home-based day care provider, it could be a parent in the home, or juggling schedules as our family has chosen to do.

Again, to try to account for all of this diversity and then steamroll over it in a national system that inevitably is not going to uniquely address those needs strikes me as striking a real blow against what we call the “ecosystem of care” that does exist and is diverse and very unique in allowing for families to work and care in the way that works for them.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Thank you.

[The Chair, Liberal, Wayne Easter]

Thank you, all.

We will turn to Mr. Fragiskatos, and then it will be Mr. Ste-Marie who is up.

[Peter Fragiskatos, Liberal, London North Centre, ON]

Thank you, Chair.

Thank you to all the witnesses.

Mr. Villeneuve and Ms. Hamza, it's very nice to see you both, again.

Mr. Villeneuve, in your testimony you spoke favourably about the budget and its focus on mental health.

I do remember your testimony many months ago, back in the fall, when you also spoke about the burnout that nurses were facing at that time as a result of COVID-19. You've mentioned it here again today.

In light of both of those things, I think it's especially positive that the budget does have this special focus on mental health and supports that would improve mental health services in Canada.

I do want to ask you a question about nursing, in general, as a profession right now. How worried are you about the problem of burnout as a result of COVID-19?

I am assuming, from your testimony, that it's only become worse in the past few months. Where do you see this going?

[Michael Villeneuve]

Mr. Chair, is the member comfortable if I let Aden answer that question?

[Peter Fragiskatos, Liberal, London North Centre, ON]

Yes, of course. Sorry, it was meant for either witness.

[Michael Villeneuve]

Okay, thank you.

[The Chair, Liberal, Wayne Easter]

Whoever wants to answer.

Go ahead, Aden, you're on.