Health Committee on May 6th, 2008

[Glenda Yeates]

Certainly one of the things we do know about MRIs and CTs is that there are increased volumes. There are significantly more scanners in place and operating now, and we do see significantly increased numbers of exams. In some cases that's because of additional machines that have been put in place. In other cases it's because those machines are working longer hours or they're machines that have greater efficiencies and can do more scans each hour. Whatever the combination, what we do know is that there has been an increase of some significance across the country in terms of MRI scans over the last number of years.

[Patrick Brown, Conservative, Barrie, ON]

I know in the case of my local hospital, the additional funding allowed them to go to a 24-hour service, which previously wasn't available.

In the ten-year health accord, I know there's a part of it on medical equipment. Could you touch upon the type of medical equipment that has been made available and how it is has contributed to wait-time reductions?

[Dr. Jeanne Besner]

A lot of that was MRIs, CT scans, and all the rest of that. I don't remember offhand the amount of money, but a significant amount of money that was invested in 2003 or 2004--I forget which, I think 2003--was specifically targeted at improving the amount of diagnostic equipment across the country. I think that's why we're seeing an increase in the numbers.

[Dr. Donald Juzwishin]

There has been a significant increase, as Dr. Besner has indicated. One of the really important questions to ask as well is are all of those particular diagnostic procedures appropriate or necessary?

Clinical guidelines around developing the indications for how to prioritize and how to actually undertake these in a much more efficient fashion is something the hospital you're probably speaking of is taking much more seriously as well, so things that are maybe not appropriate are not on that list. There have been some significant advances on that front.

I might also mention that tomorrow the Ontario cancer strategy, you'll be interested to know, is releasing their list of 38 indicators around cancer care in the province. Those indicators will be available to all of the public on the web.

I think there have been some great strides made with examples like that. The trick now is to advance that diffusion of activity to other parts of the country as well.

[Patrick Brown, Conservative, Barrie, ON]

Given these successes, I know I asked my local hospital what the challenges are. One of the challenges I was informed of is capacity. Did you find that to be a broad issue nationally? I know that with proposed surgery, the limiting factor in my local hospital is that they're always at 96% or 98% capacity, so it's very difficult to find space.

Has there been any thought given to how to meet this challenge around the country?

[Dr. Jeanne Besner]

I don't know.... Yes, everybody is dealing with capacity pressures and capacity issues, but do we have a pan-Canadian approach? Not that I'm aware of.

From a personal perspective, that's an area in which I work, and I think that a lot of our capacity issues are also related to how we work together. It's not only about not enough beds or not enough money or whatever. I think we need to start working very differently in order to address many of our capacity issues, and I think many organizations are doing that.

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you very much.

Monsieur Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you, Mr. Chairman. Thank you for being here with us this morning.

A document entitled "Health Care Renewal in Canada: Measuring Up?"—the question mark is interesting—states that it is not clear to what extent progress has been made in terms of the commitments and promised measures to deal with health-related problems faced by aboriginals people. And you actually alluded to this very clearly in your answers a little earlier, Dr. Besner.

When we considered this issue at a previous meeting, I asked the Department of Health to explain why there is no clarity around this issue, and I didn't really get an answer. However, you started to tell us members of your staff are currently in discussions with the department to clarify a number of commitments they've made and progress in terms of the various proposed measures.

Is a delay of five years normal for a commitment announced with such great fanfare, that is the question. Is it right that they should have to wait five years?

[Dr. Jeanne Besner]

I can't—

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Is that too long to wait?

[Dr. Jeanne Besner]

What you need to understand—

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

I'm talking about wait times in the health care system. Is a five-year wait—

[Dr. Jeanne Besner]

We're embarking upon our fifth year. You need to understand that we face quite formidable challenges. It's the first time that there has been a pan-Canadian strategy that focuses on cooperating in an attempt to meet set objectives. And that takes time. Our system is huge. And this doesn't happen overnight. I can't tell you whether it's normal or not. The process is underway, and that is better than nothing at all.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Do you play an influential role, compared with your other partners? Can you ask questions, and require answers? Is your role limited to waiting for reports to be sent to you, which you can then analyze and comment upon?

[Dr. Jeanne Besner]

I believe that we can have an impact—several of our reports have up till now—by giving examples of programs, of ways of doing things that have been successful in several areas of our country or elsewhere. We can give examples. Can we work with governments in order to have a direct influence? No, that is not our role.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Could you be more specific and tell us about some changes that you have made that were received with great enthusiasm and that were followed up with tangible steps?

[Dr. Jeanne Besner]

No, I could not say that... Nothing comes to mind immediately.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

All right.

Ms. Yeates, is your role limited simply to collecting information and presenting it in the form of graphs and charts in order to follow progress over time? Do you play a more proactive role in the implementation and application of different measures?

[Glenda Yeates]

Our role is to provide databases and information to contribute to the debate of those who manage the health care system and are making decisions for this sector. Therefore, for us this is important. We make no recommendations and we take no positions. We hope that the databases and information that we provide will be relevant. However, it is not our role to state an opinion.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Very well.

[Dr. Donald Juzwishin]

I can be very enthusiastic about the identification of the introduction of compassionate care. For those family members who may have a loved one, a friend, or relative who has become ill, we took the cause of promulgating and encouraging governments across Canada to look at introducing that, and through EI legislation it is now an option for people to actually take two weeks off work. Maybe it's not enough, that's true, but we are proud of having signalled the Canadian public and governments to the importance of that particular program.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you.

Thank you, Mr. Chairman.

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you.

Mr. Tilson.

[David Tilson, Conservative, Dufferin—Caledon, ON]

Thank you, Mr. Chairman.

I have a question for Ms. Besner. As I understand it, the Alberta and Quebec governments have never participated in the Health Council. So my question is how much, if any, of this has constrained your work?

[Dr. Jeanne Besner]

Although they are not members of the Health Council, they have both identified liaison individuals with whom we interact. The executive director of the Health Quality Council of Alberta, Dr. John Cowell, is our liaison to Alberta. In Quebec, although perhaps it's not quite as formal, we have had interactions with Dr. Robert Salois, who is their commissioner for health and social.... I don't know the exact title. We have been able to access the data that are published on the public websites in Quebec, so when we've done our reporting we have certainly used website data where we could make comparisons with other jurisdictions and so on.