You have another minute.
Evidence of meeting #12 for Health in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was home.
A recording is available from Parliament.
Evidence of meeting #12 for Health in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was home.
A recording is available from Parliament.
5:05 p.m.
NDP
Djaouida Sellah NDP Saint-Bruno—Saint-Hubert, QC
Okay.
My next question is for Sandra Hirst.
What should be the priority for the renewal of the 2014 health accord when it comes to long-term care and home care, although there is no federal legislation on long-term home care?
5:05 p.m.
Executive Board Member, National Initiative for the Care of the Elderly
Yes, you're right. There is a national home care association, but it's primarily voluntary.
If emphasis could be placed on a national home care policy that recognizes and supports family members who want to give good care, but that doesn't assume they are the only care provider and that looks as well at the opportunity for family members to move an older adult across the country in a smooth transition, a national home care program would be exceptionally valuable.
5:05 p.m.
Conservative
The Chair Conservative Joy Smith
Thank you very much, Dr. Sellah.
We will now go to Mr. Williamson, please.
5:05 p.m.
Conservative
John Williamson Conservative New Brunswick Southwest, NB
Thank you, Madam Chair.
Thank you for being here today.
Ms. Garon, I have a question for you.
I see in the summary that there are 316 senior-friendly towns in Quebec and 563 of them in Canada. I would like to know why there is such a big difference.
Is it a matter of research or a matter of programs that don't exist anywhere but in Quebec?
5:05 p.m.
Principal Investigator, Research Centre on Aging, University of Sherbrooke, As an Individual
It is a matter of funding. Canada does not fund in the same way Quebec does. It's as simple as that.
Since this fall, Quebec has had a comprehensive program in place. That program is funded by the ministère de la Famille et des Aînés and a number of other departments, including, I believe, the department of municipal affairs, regions and land occupancy, or the ministère des Affaires municipales, des Régions et de l'Occupation du territoire, and the department of transport, or the ministère des Transports.
So, three or four departments are involved in this. They have put up money to fund projects, while the Canadian program consists of local initiatives.
Those initiatives come from the towns themselves. To answer your question, they don't receive as much support across Canada as they do in Quebec.
5:05 p.m.
Conservative
John Williamson Conservative New Brunswick Southwest, NB
Does the funding provided by the Government of Quebec come from the health care budget or from somewhere else?
5:05 p.m.
Principal Investigator, Research Centre on Aging, University of Sherbrooke, As an Individual
It comes from the budget of the ministère de la Famille et des aînés, which is actually made up of two departments, the department that deals with family matters and the one that deals with seniors' issues. The minister responsible for seniors, Marguerite Blais, implemented the Villes amies des aînés project in Quebec, an infrastructure that helps increase seniors' social participation. The department has released funds for that purpose. The funding is not huge; we're talking about $2 million for towns for seniors' participation in society as citizens and about $9 million to $10 million for infrastructure, as I was explaining earlier.
Despite the fact that the funding is not huge, I must say that a real trend has emerged. Currently, there are 316 towns involved, but I know that other towns are on a waiting list to participate in the program, However, there is no more money available. The best thing that could happen would be if the federal government were to provide funding for Canada. The town of Saanich, in British Columbia, is having a wonderful experience as are other places in English Canada. So it would be interesting to hear more about what is being done. However, those are local and not federal initiatives.
5:10 p.m.
Conservative
John Williamson Conservative New Brunswick Southwest, NB
I have a quick question for you. Why are you talking about a program that is working very well in Quebec and asking for a federal program for the rest of Canada? Why don't you talk to the other provinces?
5:10 p.m.
Principal Investigator, Research Centre on Aging, University of Sherbrooke, As an Individual
Actually, the Public Health Agency of Canada is doing a lot of work on knowledge sharing and is supporting Canadian towns. I think that the best way to check what is being done in the rest of Canada would be through that agency. Although I am a member of some national committees, I am still not familiar with how each province works. In addition, I know that this is a provincial responsibility. I know that a small program was just implemented in British Columbia, but I don't know how much money was earmarked for it.
5:10 p.m.
Conservative
John Williamson Conservative New Brunswick Southwest, NB
Thank you very much.
Dr. Poston, you mentioned the U.K. and their electronic records. I'd be curious to see if you could fill us in a little bit.
I read that the government there had pulled back. I'm asking this in part to determine the standard we're trying to achieve with this savings. Is it to take pharmacists out of the equation and have a system where it's between a patient and her doctor and these records? What's the role for a pharmacist? The pharmacists are still part of the equation. What's the point in spending so much money on a system that's not working particularly well?
5:10 p.m.
Executive Director, Canadian Pharmacists Association
The main benefit is improved safety. You get rid of the badly written prescription. That's one of the obvious advantages. It also enables information to be transferred between health care practitioners. My colleagues here have talked about the challenges with patients getting moved between different parts of the health care system. An electronic health record would allow for continuity of care over that time.
5:10 p.m.
Conservative
5:10 p.m.
Conservative
John Williamson Conservative New Brunswick Southwest, NB
I have a question. Could I have 30 seconds on the U.K. system? You often give other members additional time.
5:10 p.m.
Conservative
The Chair Conservative Joy Smith
We don't have time. I'm sorry, Mr. Williamson. My apologies.
We'll now welcome Mr. Bruinooge to our committee.
It's your turn.
5:10 p.m.
Conservative
Rod Bruinooge Conservative Winnipeg South, MB
Thank you, Madam Chair. I'd be happy to provide some of my time to Mr. Williamson.
5:10 p.m.
Conservative
John Williamson Conservative New Brunswick Southwest, NB
Would you be able to address some of the problems they've been having in the United Kingdom?
5:10 p.m.
Executive Director, Canadian Pharmacists Association
I think the issue was that they wanted to create a large national system, with a mega-investment of funds, and they seem to have run into a variety of technological and structural problems. There are numbers of reports. I'll find them and make them available to you.
The interesting thing is that there are few places in the world that have been successful at this. Scandinavia is one. I don't know whether it's their sense of social justice, their public funding model, or Scandinavian discipline that's made it happen. There are not many good examples of where it has happened around the world. Galicia, in Spain, is another one, which is interesting, but I'll provide information to you that summarizes the U.K. situation.
5:10 p.m.
A voice
To the clerk....
5:15 p.m.
Conservative
John Williamson Conservative New Brunswick Southwest, NB
Yes, to the clerk, please.
Is it Mrs. Estabrooks or Dr. Estabrooks?
5:15 p.m.
Professor, Faculty of Nursing, University of Alberta; Canada Research Chair in Knowledge Translation, As an Individual
Doctor.
5:15 p.m.
Conservative
John Williamson Conservative New Brunswick Southwest, NB
Doctor? Excuse me, please.
Look, your report was interesting in terms of some of the almost jaw-dropping numbers, but I'm not sure what the solution is or what it is you're suggesting when you talk about an unregulated workforce. My experience with some of these centres is that people work hard, that they're over-worked, and that there is a lot of pressure, but I actually tend to think that a lot of these people are doing a pretty good job despite that.
When you talk about some of the difficulties, what are you looking for? What I'm trying to get at is, if there are deficiencies, having common standards is a good thing, but at some point, when does regulation begin to result in even fewer people being available to help people who are entering their sunset years?
5:15 p.m.
Professor, Faculty of Nursing, University of Alberta; Canada Research Chair in Knowledge Translation, As an Individual
Regulation isn't a panacea for everything. It's part of the solution.
One of the things that has happened to us in residential care is that the population has changed quite dramatically over the last decade or decade and a half, but the provision of care has changed hardly at all. People used to come to a nursing home and often stay for eight or ten years.
When we started our study five years ago, they stayed an average of 18 months. Four years later, they were staying an average of 12 months, so we're being quite successful in the community, but they're coming in very late in the trajectory so they're more complex, and we haven't changed the model. As a matter of fact, if anything, the model has become worse in many ways in terms of staffing, because the retention issue has become very big in nursing homes.
In Alberta, where I'm from, when the economy is as hot as a pistol it's very difficult to staff these environments compared to when it slows down, so it's very cyclical. The providers are doing the best they can, but we also have a mixed model of provider in long-term care that we don't have in the publicly funded acute care system. We have private for-profit, public, and voluntary faith-based organizations, so we have a number of models also mixed into this.
We think that if we could even count the unregulated workers, that would be a beginning. If we could look at minimum educational standards, minimum training standards, and if we could look at some kind of minimal re-certification standards or something analogous to that in the industry, it would help. It wouldn't solve everything, but it's a beginning.
If we could look at the sorts of standards that ought to be in place around.... We haven't really addressed end-of-life care in these organizations, which is a bit different from palliative care. A palliative care model can be very expensive, but nursing homes are end-of-life care environments now, and we haven't really addressed how that looks different from what we used to do for mom and pop 20 years ago in a nursing home.
There are a lot of things we can do without regulating ourselves and painting ourselves into a corner from which we can't escape. I mean, we have to be cautious about regulation.