Evidence of meeting #31 for Health in the 39th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was federal.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Elisabeth Ballermann  Co-Chair, Canadian Health Professionals Secretariat
Anne Wilkie  Vice-President, Head of Regulatory Affairs, Canadian Health Food Association
Marlene Smadu  President, Canadian Nurses Association
Paulette Tremblay  Chief Executive Officer, National Aboriginal Health Organization
Onalee Randell  Director, Department of Health and Environment, Inuit Tapiriit Kanatami
Antonia Maioni  Director, McGill Institute for the Study of Canada
Michael McBane  National Coordinator, Canadian Health Coalition
Brian Day  President, Canadian Medical Association
William Tholl  Secretary General and Chief Executive Officer, Canadian Medical Association

12:20 p.m.

President, Canadian Nurses Association

Dr. Marlene Smadu

Thank you.

The national pharmaceutical strategy is very important to the Canadian Nurses Association and to nurses in the country. I can't answer your question about what stage it's at. We know that the report came out in June 2006, but I'm not sure what the next stage is, though perhaps Lisa can add something. We have not been informed, so we're very anxious to know.

12:20 p.m.

Liberal

Susan Kadis Liberal Thornhill, ON

I would just ask you specifically, is there a federal partner? Do you have a federal presence in this particular case of the national pharmaceutical strategy, for example?

12:20 p.m.

President, Canadian Nurses Association

Dr. Marlene Smadu

Do we as an organization, do you mean?

12:20 p.m.

Liberal

Susan Kadis Liberal Thornhill, ON

Yes. What's happening with that? We can't seem to get that information.

May 27th, 2008 / 12:20 p.m.

President, Canadian Nurses Association

12:20 p.m.

Liberal

Susan Kadis Liberal Thornhill, ON

Is there a co-chair, and if so, who?

Mr. McBane?

12:20 p.m.

National Coordinator, Canadian Health Coalition

Michael McBane

From talking with them, provincial ministers of health seem extremely frustrated that they have a colleague in the federal government who doesn't even want to meet them. They don't even have regular meetings any more, and it's because the federal government will not come to the table with financial resources. They want to cut and run from health care.

We know the commitment has serious financial implications and that we won't expand pharmaceutical coverage without a federal financial contribution. That's why the process has stopped, because it's not a priority of the current government.

The perversion of all of this is that meanwhile the federal government is increasing the drug bill and refusing to share in the cost of paying those bills with the provinces with a federal-provincial agreement on pharmacare.

It's the worst of both worlds: they've violated the agreement to expand access to affordable medicine, and yet they're not prepared to share the costs of the rising drug bills. That's unacceptable. It's poisoning federal-provincial relations in every other health file as well.

12:25 p.m.

Liberal

Susan Kadis Liberal Thornhill, ON

You're saying, essentially, that the government is implying that they support the accord, but in fact are not doing so, in many instances.

12:25 p.m.

National Coordinator, Canadian Health Coalition

Michael McBane

That's right.

12:25 p.m.

Liberal

Susan Kadis Liberal Thornhill, ON

Do you have some general recommendations for the committee on what you believe would help to strengthen health care for Canadians, for our committee report?

12:25 p.m.

President, Canadian Nurses Association

Dr. Marlene Smadu

In our brief we talk about the importance of properly investing in technology in the health care system. We represent over 134,000 registered nurses in Canada, and if you go into the health care institutions, you'll know that we are far behind banking, retail, or even pizza delivery companies in terms of their ability to use technology appropriately to facilitate their work.

When we speak of the shortage of our numbers, we're talking about being short 113,000 registered nurses by 2016. The number is so large that people can't even get their heads around it. We've really focused our attention on saying that we have to do our work differently, that we have to design our work differently, that we have to ensure we're using the full health care team to their fullest scope of practice and that we're working in a collaborative fashion with the patient at the centre.

But those things take tools. I know there was a question asked earlier about what kinds of tools. I just came back from the World Health Assembly in Geneva, and there probably weren't ten people in the room, representing 194 countries, who didn't have Palm Pilots or BlackBerrys or cellphones. You will not find those being used by nurses; they are not available to nurses in the health care system.

For a very easily available technology and a relatively small investment, we could make people's work more manageable. They would be able to work to their full scope of practice, using their nursing knowledge.

12:25 p.m.

Liberal

Susan Kadis Liberal Thornhill, ON

And it would also cut down on adverse drug reactions—

12:25 p.m.

President, Canadian Nurses Association

12:25 p.m.

Liberal

Susan Kadis Liberal Thornhill, ON

—which is something this committee has been examining in another study as well.

12:25 p.m.

President, Canadian Nurses Association

Dr. Marlene Smadu

Yes.

There's lots of research to show that when you have electronic health records, appropriate access to information, and appropriate technology, you will make work better, you will increase the quality, increase the patient safety, and ensure better patient outcomes.

12:25 p.m.

Liberal

Susan Kadis Liberal Thornhill, ON

Thank you.

Ms. Maioni.

12:25 p.m.

Director, McGill Institute for the Study of Canada

Dr. Antonia Maioni

If you are going to start investing in electronic health records, then the federal government had better step up to the table to cut some cheques, because that is the most expensive investment you can make in a health care system.

It is also probably in the long term the most effective way of using your money in long-term investment. But until we get electronic health records or some kind of sense to the mess we have, we're not going to be able to confront the realities and the real challenges of the future.

12:25 p.m.

Conservative

The Chair Conservative Joy Smith

Thank you, Dr. Maioni.

Now we'll go to Mr. Tilson.

12:25 p.m.

Conservative

David Tilson Conservative Dufferin—Caledon, ON

Thank you.

Some of the witnesses have suggested that some of the provinces haven't been pulling their weight. One witness—I can't remember which one—said the federal health minister hadn't pursued that.

I would like some of you to talk more specifically about that. If my assumption is correct, then what evidence is there that some provinces aren't pulling their weight, and which ones are they?

Anyone?

12:25 p.m.

Secretary General and Chief Executive Officer, Canadian Medical Association

William Tholl

I guess what was being referred to is the most recent Wait Time Alliance report, where it basically said that there was progress across the board, but differentially from one province to another. All you need to do is look at that—I could give it to you. It basically gives a score.

12:25 p.m.

Conservative

David Tilson Conservative Dufferin—Caledon, ON

I have that.

It's simply that one of the witnesses had said that some provinces were not pulling their weight. It was one of you two; I can't remember which one. Everybody is denying it. All right.

I'll move on to another area, Madam Chair, and that is the issue of home care. The 10-year plan committed governments to provide first dollar coverage for certain home care services: one, short-term acute home care; two, short-term community mental health care; and three, end-of-life home care.

Can any of the witnesses comment on whether various governments, the federal, provincial or territorial, have reported progress in providing the home care services?

I'm not doing very well here.

12:25 p.m.

National Coordinator, Canadian Health Coalition

Michael McBane

I would comment that the accord's agreement on home care is extremely narrow and very inadequate to the home care needs of Canadians. That's contributing to serious problems with access to hospital services. If you can't give people access to home services, they're going to land in the hospitals.

The accord is very, very weak on home care. We need national home care standards, to raise them up, and you don't get national standards from provinces.

12:30 p.m.

Conservative

David Tilson Conservative Dufferin—Caledon, ON

You're saying the provincial governments haven't provided any progress. Is that what you're saying?

12:30 p.m.

National Coordinator, Canadian Health Coalition

Michael McBane

No, they've met the limited goal of the two-week post-acute care, but we've narrowed the goals so much. We're not talking about comprehensive home and community supports in the accord; it's only a two-week period. We've met that. But now we need to get on with the full continuum of home care.

12:30 p.m.

Conservative

David Tilson Conservative Dufferin—Caledon, ON

Does anyone else have a comment?

Yes.