Finance Committee on May 28th, 2026

[Dan Mazier, Conservative, Riding Mountain, MB]

No, I asked about two particular services, Dr. Burnell. Are all Canadians entitled to physiotherapy and counselling services under the Canada Health Act, yes or no?

You know the answer.

[Margot Burnell]

I am not sure that I do know the answer. I am not sure whether the Canada Health Act specifically discusses which allied health professional services would be covered within the hospital. Physiotherapy and the other are covered within communities. It is a common—

[Dan Mazier, Conservative, Riding Mountain, MB]

Well, they are not—

[The Chair, Liberal, Karina Gould]

Thank you, Dr. Burnell.

Thank you, Mr. Mazier. That concludes your time.

We'll continue now with Dr. Martin for five minutes.

[Danielle Martin, Liberal, University—Rosedale, ON]

Thank you, Madam Chair.

I would like to begin by making sure that the committee is aware that as a family physician, I have been a member of the Canadian Medical Association for over 25 years, so I do have links to that organization.

Thank you all for being here today.

I'd like to talk a bit about mental health and addictions, and I'll thank the CMHA for being here today and for their submission.

You pointed out that linking access to certain services with employment and private insurance in this country has posed a particular challenge for Canadians who live with mental illness and substance use disorders. I'm wondering if you could tell us a bit about what we know about the changing face of who those are in this country right now in the current economy.

[Sarah Kennell]

Thank you very much, Dr. Martin.

To add to your point, I'll start by saying that it's eight million Canadians. That's likely an underestimation in terms of those who do not have any form of private insurance, whether privately paid or provided through an employer. This means that for many of those allied health services, folks are looking to access free community services, which are limited, or have to rely on sometimes limited insurance benefits, knowing that the premiums can be high and that often the thresholds aren't sufficient to provide adequate support.

[Danielle Martin, Liberal, University—Rosedale, ON]

I'm sorry to interrupt, but my time is limited.

Can you talk a bit about the interplay between psychological therapy and pharmacotherapy? I'm not under the impression that the fund that you're proposing would address the need for access to prescription medications, either for substance use disorders, where the evidence is strong, or for mental health concerns.

[Sarah Kennell]

Absolutely. In the absence of a national pharmacare strategy or one that's comprehensively available across all jurisdictions, patients who do not have private employer-based insurance are paying out of pocket for those medications or talk therapy, counselling and psychotherapy. There are some free community resources available, but the wait-lists are long and the options are limited.

[Danielle Martin, Liberal, University—Rosedale, ON]

Thank you. I appreciate that. There's always more work to do to improve.

I have a question for Dr. Giles. Thank you for the very important work that rural physicians in Canada do to provide extremely important services across the country.

Could you speak very briefly to the role of virtual care? Specifically, what are the models that are useful in rural communities? What are the models that are not useful in terms of ensuring that Canadians living in rural and remote communities have access to the highest possible quality care, particularly with respect to primary care, but even more generally?

[Sarah Giles]

The models that work best are when we have physicians dealing with individuals who have an ongoing relationship. One-off consults are not the same as having a family doctor or nurse practitioner. We know this. When we have people working from a distance, they are often completely unaware of what the situation is on the ground—for instance, how far people might have to travel for a given investigation or blood work.

If it's not okay to do it in the city, it's not okay to do that rurally. Having virtual ER doctors might sound nice, but if they can't put in a chest tube, which you can't over a video conference, that is not an adequate replacement for a service. We need people with life-saving skills in the community.

[Danielle Martin, Liberal, University—Rosedale, ON]

Thank you very much, Dr. Giles.

A final question with my remaining time is for Dr. Burnell. The many ways in which we want to improve health care in Canada for all Canadians also involve changes for physicians in the way that doctors practise in the country. These changes include whether it's reducing wait times by participating in central intake, whether it's actually using electronic health records or electronic medical records that are interoperable, or whether it's participation in team-based care.

Can you speak a bit to what you think the CMA can do to help physicians be ready to participate in the kinds of changes that CMA is advocating for at the policy level?

[The Chair, Liberal, Karina Gould]

I'm sorry, but please provide a very brief response.

[Margot Burnell]

We can convene groups to help explore that. Tool kits for AI adoption and tool kits for lessons learned and successes in primary health care teams are two examples.

[The Chair, Liberal, Karina Gould]

That's great.

Thank you very much, Dr. Martin.

We'll conclude this hour with Mr. Garon.

Mr. Garon, you have the floor for two and a half minutes.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you, Madam Chair.

We're talking about health care a great deal. Since I manage my own time, I will take the liberty of making a comment, and it's important that the witnesses hear it.

I served on the Standing Committee on Health for over a year and a half. I just looked through the notices of meeting to see which medical associations and health professionals we had called to appear.

In a matter of seconds, I found emergency physicians, psychiatrists, family doctors, nephrologists, cardiologists, ophthalmologists, surgeons, orthopedists, people advocating for regional and rural interests, gastroenterologists, pulmonologists, dentists, osteopaths, homeopaths—obviously, whatever one may think of them—people who wanted Ottawa to invest in infrastructure, nursing associations that felt they were being treated unfairly by doctors, massage therapists who want to be recognized, psychotherapists who want tax breaks and physiotherapists.

All of this at a time when the provinces are struggling with health care, and the population is aging. These groups—and you are part of them—were all asking for one thing: They were asking the federal government to impose specific conditions on transfers to the provinces so that their priorities and their groups would be given priority.

None of these groups that came to see us realized that, with this approach, they were harming the medical profession as a whole.

Health care is important. I’m the first to admit it. I am a chronically ill patient who needs to see my specialist often and who spends a lot of time in a chair getting injections. I know it’s important.

In this context where everyone is looking out for their own interests, demanding conditions for mental health and the sciences—all of which are important professions—how is it that, in your briefs and opening remarks, no group is asking the federal government to increase its unconditional health transfers so that these transfers keep pace with the costs associated with the system? How is it that this is not mentioned?

It's an open question.

[The Chair, Liberal, Karina Gould]

Is there anyone who would briefly like to answer that?

Ms. Kennell, go ahead.

[Sarah Kennell]

Thank you very much, Madam Chair.

From the mental health perspective in community-delivered care, we are not a professional association. We deliver out-of-hospital services that are not delivered by physicians. We know this is a gap. We know that 81% of Canadians—this is recent polling done by our organization—confirm that they want to see a continuation of investment into the mental health system. We know that Quebeckers are also part of the people who support that, and we know that Quebec has done an incredible job in this area.

[The Chair, Liberal, Karina Gould]

Thank you, Ms. Kennell.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Then, you're asking for conditions.

[The Chair, Liberal, Karina Gould]

Thank you, Mr. Garon.

That concludes the round of questions for this hour.

On behalf of the committee, I'd like to thank our witnesses for their time and contributions today. We will briefly suspend now, as we prepare for the next panel.

Thank you very much.

[The Chair, Liberal, Karina Gould]

Colleagues, we're going to get started. Welcome back to this meeting.

I'd like to take a moment to introduce and welcome our witnesses.

As individuals, we have Helen Alexandra Hayes and Céline Bak. From the Council of Canadian Innovators, we have Laurent Carbonneau, vice-president of policy and advocacy; and Daniel Perry, director of federal affairs. From Fintechs Canada, we have Adriana Vega, executive director.

Before we begin, I'd like to remind participants of the following points.

Please wait until I recognize you by name before speaking.

Those participating by video conference, click on the microphone icon to activate your mic, and please mute yourself when you are not speaking.

Those on Zoom, at the bottom of your screen you can select the appropriate channel for interpretation: floor audio, English or French.

Those in the room can use the earpiece and select the desired channel.

I would like to remind witnesses that committee members may ask questions in either French or English. If you will need interpretation, please take a moment now to prepare your earpiece and select the listening channel you need in order to take full advantage of the time allotted for questions and answers.

I will remind you that all comments should be addressed through the chair.

You will have five minutes for your opening remarks.

We will begin with you, Ms. Hayes.

[Helen Alexandra Hayes, As an Individual]

Thank you, Chair, and thank you to the committee members.

My name is Helen Hayes. I'm appearing today in my capacity as a fellow at Simon Fraser University's Morris J. Wosk Centre for Dialogue. My work at the centre supports the dialogue on technology project, which is the centre's flagship initiative on AI.

Prior to this, I held a series of posts at McGill University's Centre for Media, Technology and Democracy, most recently as its associate director of policy, where I led strategic policy work on AI and online harms. It's the combination of my experience in these roles that grounds my remarks today.

I'd like to begin with a simple proposition: The most important investment this government can make right now is in the conditions that make democratic governance possible. That means investing in the institutions, processes and forms of public engagement that allow Canadians to participate in the decisions that shape their lives. My remarks today are about why that investment matters, what happens when it's absent, and what becomes possible when governments choose to build it seriously.

We're living through a moment in which governments are being asked to make increasingly consequential decisions under conditions of economic, geopolitical and technological instability. AI is reshaping labour markets, education systems and public services faster than governments can adapt. Online environments are saturated with AI-generated content that makes it difficult to determine what information is trustworthy. With the growing concentration of technological power, Canadians have low confidence in the government's ability to regulate digital technologies.

Across almost a decade of my academic and practical work on technological change, I've learned that when people feel excluded from decisions about systems that shape their lives, governance begins to feel imposed rather than democratic, and trust in both the technologies and the institutions meant to govern them declines. This is especially true in decision-making about AI. Canadians have been told it is too technical or specialized to include them, but that logic fundamentally misunderstands what's at stake. These are not merely technical systems producing technical outcomes. They're systems that shape, and are shaped by, the social, economic and democratic conditions of everyone's everyday life.

Questions about AI are increasingly becoming questions about labour, education, privacy and access to information. Those questions can't and shouldn't be governed through technical expertise alone, simply because technology is involved. In my view, it's neither democratically sustainable nor normatively acceptable for technologies with such far-reaching social consequences to be governed without public representation.

Let me provide an example that works. Over the last eight months, I co-designed and led Gen(Z)AI, Canada's first national youth consultation on AI, which brought thousands of young Canadians together, both in person and virtually, to draft policy recommendations for the governance of AI systems.

Last month, after presenting those recommendations to ministers Miller and Solomon, along with a number of senators and MPs gathered there, I left convinced not only of the sophistication of the reasoning produced through the process but also of the appetite within government for democratic processes capable of producing that kind of reasoning consistently. Democratic societies will and should always contain competing values and visions of the future, but some may argue that this makes deliberative policy-making either unworkable or too slow for periods of rapid change.

In my experience, though, while people may not agree on every outcome of a process, they're often capable of accepting its legitimacy when they feel meaningfully included in it. In the long run, governance that's publicly trusted isn't slower governance: It's more durable and stable, and ultimately it's more effective. Applying this logic to the Canadian context requires institutional investment in democratic capacity, particularly for the governance of AI.

Therefore, in its 2026 budget, I urge the government to establish a permanent public deliberation capacity for AI and other emerging technologies, either within the federal government or through trusted arm's-length collaborators, to institutionalize the mechanisms through which Canadians are engaged on major technological and policy transitions. I likewise urge the government to prioritize the funding and institutional support of a standing national youth deliberation mechanism on AI and online safety, particularly in light of the government's stated commitments to youth engagement and technology policy.

In my view, by supporting these recommendations, this committee has the opportunity to invest in the health and democratic resilience of the country itself.

Thank you, and I welcome your questions.

[The Chair, Liberal, Karina Gould]

Thank you very much, Ms. Hayes.

We will continue now with Ms. Bak for five minutes.

[Céline Bak, As an Individual]

Members of the committee, thank you very much for this opportunity.

I am available to answer your questions about “why now”, and to conclude in French.

Canada's small and medium-sized enterprises are responsible for outsized employment, particularly during periods of disruption such as we are experiencing with AI today, and also for outsized exports, yet Canadian SMEs face a structural credit disadvantage that their advanced-economy G7 peers do not. It is documented and solvable, and the solution is before you today in the documents shared in advance.

What is private credit, and why does Canada need it? Private credit is not exotic or new. It is a necessary part of every mature and advanced financial system. It's a fast and cost-efficient complement to the banking sector. Private credit sits within the alternative assets class, along with infrastructure and private equity, including venture capital and real estate. These four alternative asset classes are the four pillars of institutional investment beyond public stocks and bonds.

Of the four alternative pillars, private credit is the most directly relevant to the main street economy and the one most conspicuously subscale in Canada. Critically, Canada doesn't need to wait for global private credit superscalers like Apollo, Ares and KKR to give itself the capital its main street economy requires to compete. Canadian SMEs are precisely the borrowers that a made-in-Canada private credit system would serve. We have the institutional capital, the financial expertise and the regulatory capacity. What we lack are scaled-up private credit managers.

Canada has built about $180 billion in private credit allocations through its pension funds and institutional investors, including insurers, but the limited scale of domestic private credit fund managers means that the majority, likely $90 billion to $140 billion, or 50% to 70%, is deployed into U.S. private credit markets rather than Canadian companies. Canadian capital is financing the U.S. main street, not our own. Similar capital leakage occurs in the U.K. to U.S.-based private credit fund managers. The combined annual leakage from Canada and Europe into U.S. private credit is between $190 billion and $340 billion. Canada's SME private credit gap is $311 billion below the G7 median, and it is the domestic face of the same structural failure coin.

The same gap that starves Canadian SMEs is the gap that makes Canada an attractive destination for redirected EU capital, if we build the system to receive it. The solution is that, over 10 years, we build a network of 25 federally connected regional private credit fund managers, directly lending to Canadian SMEs in quantities of $5 million to $25 million, targeting $100 billion in new SME credit in aggregate and approximately $30 billion in trackable EU foreign direct investment. These would be Canadian-owned, regionally anchored funds serving the borrowers that Apollo and KKR will never reach, such as the mid-market company in Saskatoon, the clean-tech manufacturer in Rimouski and the indigenous-owned enterprise in northern Ontario.

We propose two policy levers, both modest in cost. One is a $10-billion temporary sovereign guarantee covering the principal and interest in case of non-payment. The contingent federal liability for this would be $700 million, far smaller than the Canada Strong fund's $25-billion endowment and comparable in logic to CMHC's role in housing. This signals to European and Canadian institutional investors that Canada is a credible destination for redirected mandates. This guarantee would be either priced out or completely phased out after an initial period of three to five years.

Second is a $12.5-billion revolving liquidity facility, with loans up to $500 million per fund manager repaid at a 10-year treasury rate over 10 years, requiring a 1:2 private match. The costs would be repaid by participants. Eligibility for these facilities would be capped at fund managers under $50 billion assets under management, encouraging participation by emerging and indigenous institutions from all parts of Canada.

The Canada Strong fund has established the principle that federal anchor capital crowds in private and international investment for Canadian nation building. This proposal extends that model to main street.

Thank you very much.

[The Chair, Liberal, Karina Gould]

Thank you very much, Ms. Bak.

We will now continue with the Council of Canadian Innovators for five minutes, please.