Evidence of meeting #31 for Health in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was plan.
A recording is available from Parliament.
2:20 p.m.
Conservative
2:20 p.m.
Liberal
Marcel Proulx Liberal Hull—Aylmer, QC
Thank you, Madam Chair. Thank you, Minister, and thank you to all our witnesses for being with us this afternoon.
The Chair was correct when she said I have just joined this Committee, but that does not mean I am not concerned.
Minister, you said that more than 90% of First Nations communities have completed their pandemic plan. You also said that for Quebec, that percentage was 96%. Could you table that report with the Committee, Minister?
2:20 p.m.
Conservative
Leona Aglukkaq Conservative Nunavut, NU
In terms of the pandemic plans, I believe they're all posted and publicly available. In terms of the percentage where we had tested, I believe it was 96%.
2:20 p.m.
Liberal
Marcel Proulx Liberal Hull—Aylmer, QC
I am not convinced that it is already posted on the Internet. In fact, Ms. Woods did not seem to be at all certain that it is. So, once again, Minister, I ask that you table them with the Committee.
I have three questions that I would like to ask of the Minister, one after the other. That way, we will not waste any time.
First of all, what is the status of the information-sharing process with the provinces? Also, what is the situation as regards follow-up of results?
Second, Quebec has made a commitment to provide compensation for injuries or consequences associated with the vaccine. Since the government is responsible for approving the vaccine, can I assume that the federal government will also be offering compensation when there are injuries in other provinces of Canada, and that it will reimburse the province of Quebec?
Third, I am concerned about your meeting next week. You talked about all the public health and other experts who will be in attendance, but you did not mention general practitioners. You said there were three groups that are particularly at risk. Individuals between the age of 16 and 25, pregnant women and people with a predisposition. I obviously do not belong to the first two groups, but I do belong to the third. I will be seeing my GP on September 8. Has he been informed? Have you given briefing sessions to family doctors, and not just to the experts, so that they know what to tell their patients?
2:20 p.m.
Conservative
Leona Aglukkaq Conservative Nunavut, NU
The MOU on information sharing has been signed by 12 of the 13 jurisdictions. Quebec is in the process of moving through with its signature. The MOU on mutual aid has been signed by 12 of the 13 jurisdictions, and Quebec is still working on obtaining that sign-off.
In terms of the experts I spoke of earlier, that involves general practitioners, and we'll also be consulting a number of stakeholders on that in terms of developing the guidelines as we deal with the fall. Dr. Butler-Jones can elaborate a bit more on that. It also involves individuals from intensive care units, because that particular discussion from my department is to deal with the more severe cases, how to manage those. The results of that discussion will be shared with general practitioners across the country. The idea is to assist general practitioners and health care providers in managing the severe cases in the fall.
I'll pass it on to Dr. Butler-Jones to elaborate on that.
2:25 p.m.
Chief Public Health Officer, Public Health Agency of Canada
Certainly, information sharing between us and other jurisdictions has not been a problem.
There is a network linking the various authorities with respect to programs, recommendations, and the like. As the Minister noted earlier, the protocols binding the various authorities are now in place.
Furthermore, physicians, family doctors, nurses and members of other professional organizations are working with us to prepare instructions that will be passed on to members.
2:25 p.m.
Liberal
Marcel Proulx Liberal Hull—Aylmer, QC
Madam Chair, I didn't hear an answer in regard to a compensation plan.
And on a point of clarification, I understand the PMO refuses to release the particular report on the action plans.
2:25 p.m.
Conservative
The Chair Conservative Joy Smith
Dr. Butler-Jones, on the answer about compensation, could we have that? This is the first time this has come up, so I'm not aware of it.
2:25 p.m.
Chief Public Health Officer, Public Health Agency of Canada
In terms of a compensation plan, Quebec has a unique compensation plan among the provinces and territories, and it was implemented some years ago. No other jurisdiction has implemented that since. We have a different structure in Canada, so for whatever reasons, jurisdictions have not gone down that path.
In terms of a new vaccine and issues of indemnification, we're involved with the manufacturer on that, but it is not a compensation plan.
2:25 p.m.
NDP
Judy Wasylycia-Leis NDP Winnipeg North, MB
Thank you, Madam Chair.
I can't believe what I heard the minister say earlier in response to my question, that first nations people should simply go out and buy what they need in terms of flu supplies. We used to have an old expression about 30 years ago that said, what if day cares had all the money they needed to raise children, and the Senate had to hold a bake sale in order to pay for its offices and salaries? I find it absolutely appalling that first nations communities should have to hold a bake sale to raise money for flu supplies.
I appreciate, Madam Minister, that you are from an Inuit community and you've seen the conditions, but it sure doesn't seem to be applied in terms of what we're dealing with today. I've been to Iqaluit and Pond Inlet and Pangnirtung and Resolute Bay, and I know how much groceries cost and how hard it is to get those groceries. There isn't a Shoppers Drug Mart around the corner. There isn't a quick way out of a community.
It just seems to make sense that you look at some of the issues around the conditions on reserves--for which you have full responsibility--especially since under your government conditions have deteriorated, poverty has grown, and people have less and less access to the kinds of supplies you're talking about.
In fact also, as I understand it, some nursing stations don't even have the ability to give out Tylenol. We're talking about basic supplies that are needed in the event of a pandemic that could hit in less than a month from now. Yet you're still telling me that people should go out and buy the supplies.
I will repeat that in French. I have given this a lot of thought, because I took part in an event to raise money to fight the flu. No community or reserve should have to raise money, or depend on charity, to cover its flu-related expenses.
My questions are simply these. Are you going to stop putting this lens of a middle class suburban family on the situation, start looking at the real conditions, and start addressing the needs in first nations and Inuit communities? I want to know specifically, if this thing hits tomorrow, how many reserves, how many first nations and Inuit communities, will know who to call? Can they get to a place and get the supplies that we're now trying to provide for them? Can they pick up a phone and call emergency?
2:25 p.m.
NDP
Judy Wasylycia-Leis NDP Winnipeg North, MB
How do they get access to the information they need to respond on behalf of their communities?
2:25 p.m.
Conservative
The Chair Conservative Joy Smith
Could we give the minister some time to answer a few of those questions?
Madam Minister.
2:25 p.m.
Conservative
Leona Aglukkaq Conservative Nunavut, NU
Thank you, Madam Chair.
First of all, under this government we've increased transfers to the provinces and territories for health care by 6% again this year, which the member voted against.
The other point is that we've also transferred an increased budget for the delivery of health care to first nations communities, which was in the budget and which the member, again, voted against.
In terms of the question related to the remote communities, I know full well what it's like to live in a remote community, and there are some inaccuracies in the picture you paint. In terms of the stores, there are supplies in the stores in remote communities, Tylenol and so on.
That being said, I want to commend the communities--first nations communities, as well as the mayors in most communities--who have gone out of their way to communicate with their residents on H1N1. It takes a lot of work, dialogue, and partnering with communities to get that information out.
I also want to commend the communities that are fundraising to assist people who may not be able to afford to purchase hand soap. As individual citizens we purchase hand soap. Does the health care insurance program provide a bar of soap? That's a question we need to ask.
In terms of providing communities with the medical supplies needed to respond to H1N1, the nursing stations in every community are equipped to respond to H1N1. The question was about this kit. I have no idea what's in the kit. Even in terms of whether what's in the kit is effective, again, we can't respond because we don't know what's in the kit, nor were we consulted when that decision was being made.
Thank you.
2:30 p.m.
NDP
2:30 p.m.
Conservative
The Chair Conservative Joy Smith
Thank you so much, Madam Minister.
Could we call to order for just a minute? This has been going so well up until now.
Madam Minister, I want to thank you so much for coming today and answering the questions that are so important to all of us on this committee.
We're going to suspend for two minutes to ask the first panel to come in. This is the panel: the Assembly of First Nations; from the Government of Manitoba, Dr. Joel Kettner; the Assembly of Manitoba Chiefs; Inuit Tapiriit Kanatami; Manitoba Keewatinowi Okimakanak; and the Prince Albert Grand Council. So we'll suspend for two minutes.
2:35 p.m.
Conservative
The Chair Conservative Joy Smith
Please could we get started now. We do have a lot of business to go through today and a lot of wonderful opportunities to speak with our very learned witnesses.
I want to welcome our esteemed guests: Dr. Joel Kettner, welcome; Grand Chief Ron Evans, it's so nice to see you today; Glen Sanderson; Gail Turner; Elizabeth Ford; and of course, our very distinguished Grand Chief Sydney Garrioch.
Because we have a variety and quite a number of guests, I'm going to start with the Assembly of First Nations. Do we have the Assembly of First Nations here?
There are some witnesses missing. One group is missing.
2:35 p.m.
A voice
Mr. Atleo is not here.
2:35 p.m.
Conservative
The Chair Conservative Joy Smith
Okay. I'm going to start with the Assembly of Manitoba Chiefs, Grand Chief Ron Evans. You have three to five minutes for a presentation.
We're going to have each of the presenters give a presentation of three to five minutes. When you see the light go on, you'll know that you're getting near your time. Then we'll go into the questions and answers.
Grand Chief Ron Evans, would you please begin?
2:35 p.m.
Grand Chief Ron Evans Grand Chief, Assembly of Manitoba Chiefs
Thank you.
Good afternoon. My name is Ron Evans. I'm the Grand Chief of the Assembly of Manitoba Chiefs. I would like to thank the standing committee for the invitation to be here to speak on this very critical issue that has had a significant impact on the first nations of Manitoba.
I'll like to introduce Glen Sanderson. He's the senior policy analyst at the assembly who is our lead on this H1N1 issue.
I've been asked to relay regrets from Chief David Harper, who was supposed to be here today. His mother had a heart attack. He had to be with his mother, of course, and he sends his regrets, so that you'd know.
2:35 p.m.
Conservative
The Chair Conservative Joy Smith
Grand Chief, of behalf of myself and the committee, would you please relay our hope that she'll get better very soon, and our understanding? We certainly look forward to seeing him sometime in the future. Thank you.
2:35 p.m.
Grand Chief, Assembly of Manitoba Chiefs
I'll do that.
The H1N1 virus is a world health threat that is affecting Manitoba first nations disproportionately in comparison to the general public. This is due to poverty, lack of access to home medical supplies, lack of access to health care, the lack of information about H1N1, overcrowded housing, and a lack of access to running water. Overcrowded living conditions are breeding grounds for the rapid spread of an airborne virus.
A second wave of the H1N1 virus is poised to devastate our communities. The Manitoba first nations have completed training on an incident management system to enable us to respond in a coordinated manner to the H1N1 threat and to act as nerve centres for each first nation. They will respond to local emergencies and will prepare for the fall flu season in respect of pandemic planning.
As an educational campaign, we printed and distributed H1N1 posters to 17,000 first nations homes and businesses in Manitoba. On June 24, 2009, under the direction of the AMC executive council, I requested that all Manitoba first nations declare a state of emergency on the H1N1 pandemic. This was done to ensure the safety of all first nations citizens during this upcoming crisis and to hold governments responsible and accountable for taking the necessary measures to fulfill their fiduciary responsibility towards first nations.
There is abundant reason to be concerned about the H1N1 virus threat in Manitoba, where 62% of the first nations population are under the age of 25. We know that the average age of confirmed H1N1 is from 12 to 17, that the average age of death is 22, and that 52% of those hospitalized were under the age of 19. We also know that pregnant women are the highest at risk and are four times more likely to be hospitalized.
In the first wave, we were ill prepared to deal with the impacts of the influenza. Our nursing stations reached surge capacity almost immediately. Thirty-seven first nations communities have health centres that do not provide any primary care. The nearest primary care is, on average, an hour's drive away.
In the last four months we have encountered challenges and obstacles while putting an intervention plan in place. On training, for instance, INAC and FNIHB were non-responsive to requests to train managers to set up the incident command centres until media reported that MKO had gone ahead with the training without any help from the federal government. We are continually stonewalled by tight-fisted financial decisions that ignore crown fiduciary responsibilities for health care. FNIHB, for example, delivered instructions to use health dollars for pandemic operations when they were already earmarked for other essential services.
We are discouraged by how quickly governments stepped up to prop up the hog industry from revenue losses because of the words “swine flu”, and then dragged their feet when we needed help. It takes extensive and necessary discussions and continual interventions at many different government levels to determine precisely who and what agency has the respective jurisdictional responsibility and, in some cases, the simple willingness to act in these important matters. As with all other jurisdictions in Canada and, for that matter, the world, we await the availability of a vaccine, but we are very concerned that the flu virus may well occur before the vaccine is widely available.
As a first line of defence, we have developed a medicine kit against H1N1, which the province and corporate partners are stepping up to pay for. We would like to think that the federal government would support such well-thought-out actions as opposed to raising both explicit and implicit criticisms and barriers. We have come to the conclusion that our best preparations may fall short of what is required, particularly because of our unique situation where many of our communities are remote and very poorly equipped.
We are absolutely amazed that the Government of Canada, even though it has a well-developed plan called “Annex B” for dealing with the unique situation as it relates to first nation communities, has not chosen to implement that plan. That particular lack of action is, in our view, totally unconscionable. My overarching concern in the matter of the H1N1 pandemic is that we are not ultimately addressing the very conditions that make first nations populations high risk.
As an economic factor, it is widely recognized that the maintenance of good health is more affordable over both the short and long term than dealing with chronic illness. Therefore, why is it that first nations continue to face the substandard community realities that have long been identified and well documented? Why are we not dealing with the physical conditions that simply continue to worsen, further increasing the risks of this particular pandemic, not to mention the already-present high risk factors of illnesses such as diabetes and obesity? What better opportunity is there to finally address the pervasive issue of living conditions on first nations communities than by addressing such a serious health issue?
It is entirely clear to me that the cost of dealing with these identified conditions of risk in a proactive manner would be an excellent investment in the present and future health of first nations. This investment would also address once and for all the treaty responsibilities of the Government of Canada with respect to the very unequal living conditions of first nations and ensure equality of access and resources over the long term.
Ekosani. Meegwetch. Masi-cho. Wopida. Thank you. Merci beaucoup.
2:45 p.m.
Conservative
The Chair Conservative Joy Smith
Thank you so much, Grand Chief.
We have with us National Chief Shawn Atleo. Welcome. We're very honoured to have you here.
Would you be so kind as to give your presentation now?
I would ask that all witnesses please stay within the five minutes, because we're very anxious to ask you some questions and get your feedback.
Thank you, Chief.