Health Committee on April 28th, 2009

[The Chair, Conservative, Joy Smith]

We'll have Dr. Ouellet.

[Dr. Robert Ouellet]

Well, I think Dr. Padmos answered most of the first question, and I was going to talk about IT and the connection, but I will speak a little bit more on your second question about long-term care or home care.

I think we need to invest, in Canada, in long-term care, because for almost 30 years the big problem we have in hospitals--and you've heard that--is chronic patients taking acute beds, and this shouldn't be like that. In Ottawa, today, there are 135 patients in the hospital that are chronic patients in a 900-bed hospital. That's awful because there is a cost to that. We need to invest in long-term care so that those patients can be outside of the hospital, where it costs much less. They will probably have better service, because when you're waiting in an acute bed in a hospital, you don't have the same kind of service that they have in the long-term care program or even in home care.

So maybe with the money they are putting into infrastructure, there could be some money for infrastructure in long-term care in Canada. We need that.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Ouellet.

I'm sorry, I'm going to have to go to the next questioner because our time is out, and that's Ms. Davidson.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thanks, Madam Chair, and thanks very much to our presenters here this afternoon.

I just want to take this on a bit of a different tangent, perhaps.

In some of the other meetings I've been at over probably the past year with different professionals in the medical profession, discussing HHR, and with our experiences in my own community with trying to attract physicians, in particular, one of the things that has been said repeatedly is that there are enough resources in this country and there is enough money; it is just horribly mismanaged and underutilized. I'm not sure any of you might agree with that statement, but I want some comments on it.

Kaaren, you talked about the underutilization of nurses, in particular. How receptive are other disciplines to re-utilization of different people within the medical field? We're talking about more than doctors and nurses; we're talking about the whole health perspective.

Would anybody like to comment on those issues?

[The Chair, Conservative, Joy Smith]

Ms. Neufeld.

[Kaaren Neufeld]

Thank you very much for the question.

As you've probably gleaned from the conversation here, the receptivity to working together is growing, and I think it is growing significantly around that whole notion of collaborative care. It's interprofessional care and support workers who need to provide that care, so there is an understanding of the need to look at the full picture.

When the Canadian Nurses Association brings out its next forecast report on May 11, we will talk about some of the policy changes we think can be implemented to address the issue at hand in terms of the shortage, and many--

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Can I ask you something else if you're bringing that report out? If the issue of how there can be a better utilization of the resources we already have is not identified, how can we truly identify the shortage?

[Kaaren Neufeld]

We're talking about a shortage in terms of continuing with the model of care we currently have. If we continue with a model of care that is highly focused on hospital acute care, specific providers, small entry points into the system, then we're going to be short.

If we start looking at new models of care and innovative ways of practice, like home care--moving more of the care into the community and home--national pharmacare programs, as well as looking at the impact those changes will make, we can see how we can much more effectively and efficiently use the current resources we have.

[The Chair, Conservative, Joy Smith]

Mrs. Davidson, you have another minute.

[Patricia Davidson]

Dr. Ouellet, please.

[Dr. Robert Ouellet]

I think you're absolutely right. We are putting a lot of money into our system. We have a lot of resources, but we're maybe not using them properly. There was a study showing that Canada is 30th out of 30 countries for the money we invest and the results we get. There is room for improvement.

And we're trying to do that. It's part of our project to fund hospitals differently--instead of block funding based on activity. There would be an incentive to do more or to be more efficient. When we say “to do more”, it's not that people will work more than they do but that they will be working more efficiently. That's the big difference.

We all agree on having collaborative care. We need to do that because we have a shortage of doctors and nurses. We need to work together. We're completely in agreement with that. We just have to see how it can work.

There are many initiatives that are working right now, and we have to keep going.

[The Chair, Conservative, Joy Smith]

Ms. Fréchette, I think you wanted to make a comment on that, and then we're going to have your closing comments. Our time is just about up.

[Danielle Fréchette]

Thank you.

I think everyone agrees that folks want to work together. But everyone is working at a breakneck pace. Because everyone is focusing on meeting the needs of patients, there's not enough time to really sit back and look at how we can improve the system and spend our dollars more wisely. That is why I think everyone has come today with a unified ask for an observatory, where we can dedicate some resources and talent to optimize on what we know we can do best and how we can do it better and together.

[The Chair, Conservative, Joy Smith]

I want to thank the witnesses very, very much for coming today. Your comments are invaluable. You'll find this is a really good committee. This committee works together extremely well. We may have our differences of opinion from time to time, but this is a very collaborative committee. Your comments are taken very seriously. They are discussed, and we're trying to put them in policies in a very relevant manner.

We're just about finished. I want to do two things.

Ms. Wasylycia-Leis, could you quickly bring your motion forward?

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Madam Chairperson, there have been discussions with all parties and I believe you will find unanimous consent to introduce the following motion:

That the Chair of the Standing Committee on Health, following consultations with representatives from each of the recognized parties, convene meetings of the Standing Committee on Health to discuss the outbreak of Swine Influenza at regular intervals as necessary.

[The Chair, Conservative, Joy Smith]

Do I have unanimous consent of the committee?

[Carolyn Bennett, Liberal, St. Paul's, ON]

I'd like the chance to speak first.

[The Chair, Conservative, Joy Smith]

I'm sorry, Dr. Bennett, go ahead.

[Carolyn Bennett, Liberal, St. Paul's, ON]

I would like it on the record that this is not to replace the regular briefings we have committed to and that we have by e-mail. I also want to make it clear, in terms of weekends and our availability as members of Parliament, that whether it's through the clerk or through the minister's office, there be a way of getting in touch with members of Parliament should the situation change and we require a briefing. I just want to make sure that this doesn't supercede the excellent beginning we've had, in terms of the briefings yesterday and today, and that we go forward.

This bulks this up a little bit in terms of being fleet of foot. Then we will have to decide, on each of these meetings, whether they're in camera and whether there is certain sensitive information for which we would have to be sworn.

I just want to make sure that this is our consent in theory. But in practice, I'd really like to get some of this sorted out with the minister's office in terms of the good beginning we've had.

We were concerned this morning, as I said, that there seemed to be a bit of push-back, so I am really firm that if we, as Liberals, agree to this, we don't want to be going backwards from the way we have begun.

[The Chair, Conservative, Joy Smith]

I think that is fully understood and agreed upon in this committee.

Monsieur Malo, you wanted a moment. No comment? Okay.

Is the committee in agreement with Ms. Wasylycia-Leis's motion?

(Motion agreed to)

[The Chair, Conservative, Joy Smith]

Thank you.

I want to remind you that there is no meeting on Thursday, but those meetings on the swine flu will be ongoing as we need them.

Thank you again to the guests.

The meeting is adjourned.