Finance Committee on Dec. 1st, 2020

[Shaun Thorson]

I would agree that it is a skills mismatch or a skills gap. I think one of the reasons, as I mention in my brief, is that the apprenticeship system—how the system works and how that training takes place—is not necessarily understood by most Canadians, and parents and many influencers are still a little reluctant to promote skilled trades occupations to young people and to present them as a viable career option and a first-rate career option.

[Julie Dzerowicz, Liberal, Davenport, ON]

Thank you, Mr. Thorson.

I think that's my three minutes, so I'll go over to you, Peter.

[The Chair, Liberal, Wayne Easter]

Go ahead, Mr. Fragiskatos.

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

Thank you, Chair, and thank you to the witnesses.

My questions are for the CNA.

Mr. Villeneuve, thank you for your work, the work of the organization and the work of all nurses across Canada. I especially have in mind all the local nurses in London, Ontario, especially those at LHSC and St. Joseph's, but all nurses beyond that too.

I wanted to ask you about this, sir. I read the statement that the CNA put out yesterday in response to the fall economic statement that Minister Freeland read in Parliament. I did see that the organization spoke positively about long-term care and what the government said about that, about all the work the government has done to procure PPE, and on public health when it comes to indigenous communities. That work is ongoing and positive.

I did see a couple of points that stood out to me in the press release and that the government can further act upon. One is the mental health of nurses. Could you speak to that issue and your concerns there?

I wonder if you would elaborate upon something else that you mentioned today: virtual health care. What would you want to see the federal government do to address that possibility?

[Michael Villeneuve]

Thank you very much for the question.

The mental health state of nurses has been a concern from early on, first because of the fatigue, which we projected. Then, because of the moral decisions that were being made in other countries, they were pretty concerned about the challenges they were facing at points of care—physicians and others, too, but since we're speaking about nurses....

We did a survey at CNA of a group of nurses who reported before COVID that their mental health was rated as good or excellent. Eighty per cent of them rated that. It's down to about 45% at this point in the pandemic, so that's a serious change.

We're hearing every day about unbelievable fatigue. Also, there's the burden of watching people die with their families on the other side of a window. It's just compounded levels of grief and fatigue. There's no buffer in the system. There's no other group to come in and help take over, so I think they're pretty pressed.

One of the challenges we all face in this country is that you have to wait a long time for a lot of mental health treatment and you have to pay. We certainly hope that governments will do all they can to support access to mental health treatment for all health care providers—we can talk about society later—at rates they can afford or, if not that, then free.

On your second question about virtual care, as you know, there has been this giant barrier since time immemorial, and suddenly it was freed up, which is a very good outcome of the pandemic. Now we need to understand.... It seems to be working pretty well. In some places, 76% of primary care is delivered virtually.

Who is it working well for? Who has broadband and who doesn't? That's a serious problem. In my beautiful home in farmland here in eastern Ontario, I sometimes might as well be in Iqaluit. It's hit-and-miss. Even on these sorts of appearances, I worry if I will have broadband. If we want people to work at home and send pictures and videos of their problems to their doctors and so on, we really need a strong hand in expanding the access to broadband—

[The Chair, Liberal, Wayne Easter]

Thank you very much. I hate to end it so quickly.

Mr. Lemire, you have six minutes, and you will be followed by Mr. Julian.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

Thank you, Mr. Chair.

I would like to thank all the witnesses for their sensitivity to vulnerable members of society. It's an issue that came up in many of the opening statements.

My first question is for Mr. Villeneuve, of the Canadian Nurses Association.

The House of Commons is currently debating a motion put forward by the Bloc Québécois. The motion reads as follows:

That the House:

(a) acknowledge the extraordinary work of health care workers (including doctors, nurses and orderlies) during the COVID-19 pandemic, particularly with seniors but also with the general public;

(b) recognize the courage and sacrifices required from them and their families in order to be on the front lines;

(c) highlight the work of Quebec and the provinces in responding to the health crisis and note the direct impact on their respective budgets; and

(d) call on the government to significantly and sustainably increase Canada health transfers before the end of 2020 in order to support the efforts of the governments of Quebec and the provinces, health care workers and the public.

On September 18, the provinces jointly called on the federal government to significantly increase funding to help cover the escalating costs of delivering health care, particularly as a result of the pandemic. They are requesting an increase of $28 billion, which would raise Ottawa's share of health care funding from 22% to 35%.

Mr. Villeneuve, if health care ceased to be underfunded, would that address the bulk of your recommendations?

[Michael Villeneuve]

Certainly we would think it would go a long way. We believe it's about 22% now, and as you all will know, that has dropped through the years. What we're facing across society that concerns us the most in the short term is just the huge number of older folks.

I'll be honest: I'm the back end of the baby boom. I'm 62. There are a lot of folks who are 75-plus now who are going to need care soon, and there's no way, ever, that we're going to build what they estimate is 300,000 new beds. We're going to need to find some funding and great thinking to imagine how we are going to care for all those people. Where is that going to happen? Hence our recommendation, which is to take 22% of the $93 billion recommended by the Conference Board of Canada as a top-up to at least help to transition and provide better care in the long term—not just long-term care—for people in homes, communities, church basements and so on, so that we can try to get something of a handle on this, because it's happening right now. It's not a theory anymore; it's right now.

I hope that helps.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

Thank you.

My next question is for Mr. Saul, of Community Food Centres Canada.

Mr. Saul, are seniors representative of the clients who use food banks or community food centres across the country?

Let's say the government permanently increased the old age security pension by $110 a month beginning at the age of 65 and adjusted the guaranteed income supplement to avoid penalizing anyone. Do you think those are essential steps in reducing the use of your services by the senior population, to say nothing of reducing the poverty, anxiety and rejection experienced by seniors?

[Nick Saul]

I'll quickly respond, but I can't speak for the food banks. Community Food Centres Canada has a very different model that is more upstream and preventive.

About 27% of people who use our community food centres across the country are seniors. We're very concerned right now about them feeling isolated and lonely. There is no question that if we continue to put money into GIS, OAS, CPP, etc., it will have a very important impact on their status in terms of vulnerability. The data is really clear on this. If you put money into programs like the child tax benefit and seniors programming, it materially impacts food insecurity and reduces poverty in this country, which is what we should be doing. We're talking about using the current infrastructure that's out there, although we're also talking about building a refundable tax credit for working-age adults, but we have these systems in place, and if we put money into them, they reduce food insecurity and reduce poverty. It's pretty simple. There's a direct correlation between income and reducing food insecurity.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

My last question is for Mr. Bateman, of WaterPower Canada.

Right now, the House of Commons is studying Bill C-12, which does not set out any mandatory targets to reduce greenhouse gas emissions by 2030. The bill concerns Canada's commitments under the Paris agreement.

Mr. Bateman, do you think the federal government is taking the electrification of transportation seriously enough? What measures would you like to see in place to promote the industry's growth?

[Patrick Bateman]

Thank you for your question, Mr. Lemire.

It's an ongoing question, I think, with the fall economic statement and with the bill progressing through the House. It's something that we're watching very closely. Long-term, stable climate policy and electrification are two factors that are very important for our sector, and I think we'll continue to watch how that unfolds with great interest in the coming months.

[The Chair, Liberal, Wayne Easter]

Thank you all.

I'm turning to Mr. Julian.

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

Thank you very much, Mr. Chair.

Thanks to all our witnesses for being here. We hope that you and your loved ones are safe and healthy during this pandemic. It's very good of you to give testimony today that will hopefully form some of what we should see in a spring budget.

I'd like to start with you, Mr. Villeneuve. First, our thanks go to all the front-line workers and nurses across the country who have shown such courage during this pandemic.

I have three questions.

What you're calling for is an investment, the demographic top-up transfer, that is slightly less than the cutbacks we've seen over the last five years. I'm wondering whether that demographic top-up is in addition to restoring the full health care funding that was slashed by the former Harper government and continued by the current government. We've seen the impacts of that.

My second question is around long-term care. What do you think is needed? Should long-term care really come under the Canada Health Act as part of ensuring that there is publicly administered long-term care and long-term-care standards across the country to avoid the nightmare that we have seen repeated numerous times, often in private long-term care homes, over the course of the last few months?

The third is on the issue of pharmacare. We have Bill C-213 before the House of Commons, the Canada pharmacare act. MPs will be voting on it in February. It would provide the legal framework for universal, publicly administered access to medication. To what extent do you think, and do Canada's nurses think, it would be a good idea to have universal pharmacare to add to and strengthen our health care system?

Those are my three questions to start. Thank you.

[The Chair, Liberal, Wayne Easter]

I will interrupt for a second, Mr. Villeneuve.

Mr. Falk, you'll be next up after this round.

[Michael Villeneuve]

Thanks, Chair, and I'll do my best to answer the questions quite quickly.

CNA has a long-standing position in strong support of universal pharmacare and would be very pleased to see that go forward as a key piece of medicare.

I'll work backwards. You're asking a lot of me to remember three things.

With regard to long-term care, that whole sector has been not well treated at best, and at worst has been neglected. We have watched over several decades as the amount of acuity inside those places climbs at a level that, if you've not been in one, I think would shock you.

When I graduated, many of those patients would have been in a hospital with a registered nurse. As we've moved care out to homes and communities and long-term care, we have not shifted budgets, interests, professional supports, funding, leadership, training and all those pieces. Now we have a very well-intended workforce that is largely made up of unregulated providers doing their very best. We need a really big multi-billion-dollar investment in that sector to cast it anew. That would start with staffing, wages, physical plants. What happens in some of those places would never be allowed in a hospital.

The whole sector needs a discussion. We need to frame what we expect as Canadians to get as we age, starting at home so that we don't have to go to those places, and right through to end-of-life care.

On your first question, I'll try to be as quick as I can. If I understand you correctly, we took the figures calculated by the Conference Board of Canada, which was the $93 billion over 10 years, and took a 22% cut of that, so it's somewhere around $13 billion in the first five years, up to a total of $21.1 billion over 10 years. We approached it that way, if that helps answer your question.

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

What I hear you saying as well, as many people have said, is that we need to work on the revenue side to build up the resources to make these investments. That means taxing billionaires, tracking down overseas tax havens, making the giant web companies pay their fair share of taxes. That's how we create the fiscal ability to do these things.

Thank you very much for that.

Mr. Saul and Ms. McNicoll, I have two things regarding the disability tax credit and people with disabilities generally.

What percentage of people going to the community food centres are people with disabilities? You stated very clearly that we need to make the DTC refundable. The reality is that most people with disabilities aren't on a DTC. Do you have any recommendations about how to increase access so that everybody with a disability across the country can actually access the disability tax credit?

[The Chair, Liberal, Wayne Easter]

Give a fairly tight answer if you could, folks.

[Sasha McNicoll]

About 22% of people who go to community food centres are on disability support.

It's quite a difficult credit to get. Sometimes you have to do your taxes and then you get a tax credit. A lot more is involved in this. Anything the federal government can do to simplify that would be great for these people.

I think you'd find a lot more people signing up for it if they could get that $1,300 a year. I think about 1.5 million people could potentially get it, but they don't. Those two things would help: simplifying it, and then making it refundable.

[The Chair, Liberal, Wayne Easter]

Thank you all.

We are turning to Mr. Falk, who will be followed by Mr. Fraser. We're into a five-minute round.

[Ted Falk, Conservative, Provencher, MB]

Thank you, Mr. Chair.

Thank you to all our witnesses for your presentations and for the good work and advocacy that your associations represent.

Mr. Villeneuve, you've talked about the mental health of your front-line workers, of nurses in particular. That concern is ongoing, especially with COVID. They're concerned if they've caught COVID or they're going to get it, and they're working on the front lines.

If we had rapid testing, how would that help the mental health of your nurses and of your front-line workers? What do you see for its future?

[Michael Villeneuve]

I think we're learning a lot about that; it's a very promising practice.

I think for sure it would help workers on all the front lines, including the grocery store, to have a test that we could turn around quite quickly. There certainly is a concern from nurses about getting COVID. In reality, places like hospitals, where things are pretty tight now around PPE, are some of the safer places to be. It's more on the margins. It's in home care and some of those places that we hear that concern.

The mental health issues we're hearing are somewhat bad—there's no question—but it's an awful lot about compounding grief and absolute fatigue. There are nursing homes where people haven't left for 14 days in a row of 12-hour shifts. It's a human fatigue issue. A lot of the fear around wondering if they're going to catch it is the fear that they are going to transmit it to their family. We're hearing those issues. I think everything governments can do to get us rapid testing as quickly as possible would be good.

[Ted Falk, Conservative, Provencher, MB]

Great. Thank you for that answer.

Mr. Saul, you spoke briefly about the work you do with your community food centres. I know you're not working on the front line, but maybe you've heard stories from your front-line workers. Could you comment on the benefit that individuals have received with the CERB, or how that has impacted the people who service your facilities? What has the impact been? Has it been a good thing or has it been a negative thing? From what you're hearing, how has that money been used?

[Nick Saul]

CERB has been a lifesaver. We would have been hit with a tsunami of desperate people in our community food centres.

The irony of CERB is that it's completely highlighted how inadequate our social support systems are. CERB is about $2,000 a month, as you know; if you get that over a year, that's the poverty line: $24,000 a year for a single person. As I mentioned in my remarks, CERB gives you two or three times more than any social assistance rate across this country. You'd have to be making about $21 per hour full time to get the same on CERB as you would on EI. I think CERB has been very important in stabilizing people's lives to be able to land in an okay position and then start to try to figure out how to rebuild.

It has been critical for our work. I think we would have been completely smashed if there hadn't been those kinds of income supports. There has been a bit of emergency relief via food, but without those income supports, it would have been trouble.

[Ted Falk, Conservative, Provencher, MB]

Thank you.

Mr. Bateman, you mentioned in your brief that the regulatory burden is significant for your industry. We know that hydroelectricity is the cleanest, greenest power we have here in Canada. Could you comment a little on the regulatory burden from the Fisheries Act and also from the Navigable Waters Act?