Health Committee on Feb. 7th, 2012

[The Chair, Conservative, Joy Smith]

All against going in camera?

[Libby Davies, NDP, Vancouver East, BC]

I'd like a recorded vote.

[The Chair, Conservative, Joy Smith]

The motion is defeated. Sorry, the motion is carried.

We'll go in camera.

I'll excuse the witnesses, please, and we'll deal with the motion. Then we'll bring you right back in.

[Proceedings continue in camera]

[Public proceedings resume]

[The Chair, Conservative, Joy Smith]

Mr. Lizon, you're next.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you, Madam Chair.

Thank you, witnesses, for coming this morning.

I would like to continue on injury prevention. Before I ask the question I'll make a comment.

I think that parents are becoming more and more protective of their children. I remember growing up, and at a very young age I was looking after myself; I was playing. I have children, and I have grandchildren now. Honestly, if I saw them doing what I did when I was young, I think I would really have a heart attack or something.

I understand we have to work and do everything to prevent injuries, especially in young people, but don't you think we're walking a very fine line, and by overprotecting children we're making them less independent? How do you balance this?

You mentioned safe playgrounds or safe places, and wearing helmets. I ski, and I see young people skiing wearing helmets. There are a lot of accidents on the ski hill, not necessarily related to the lack of equipment but due to speed and in many places overcrowding. How do you deal with that?

[Rebecca Nesdale-Tucker]

I agree with you that balance is very important.

We want people to know the real risk, the actual risk. For example, a child won't learn a lot from having their hand burned, so let's look at it head-on. In skiing and snow sports we want kids to wear helmets, but we have a standard in Canada that hasn't been regulated yet that could provide additional measures of safety. On the provincial and territorial levels we could regulate that helmet use and look at the reduction in collisions too--the overcrowding you talked about. So it's not just one factor like a helmet; it's also the entire environment and the supervision of that environment.

We don't want to overprotect children and limit them from playing and learning, but we want to have healthy and safe environments for them to do that. I don't think there's a positive learning outcome from a broken neck or a severe brain injury. We want to keep kids aware of how they can protect themselves, and then keep them on positive risks--risk-taking to better themselves in society, rather than risks that could harm their bodies for a lifetime.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you.

Dr. Kershaw, in your slide presentation I liked your story about the beaver. However, I don't like beaver dams, because I have to stop, get my stuff out of the canoe, and carry it over the dam. So I don't have really good feelings about beaver dams.

On one of your slides you mentioned that life causes problems related to a squeeze on kids under six. You list school failure, pregnancy, high blood pressure, coronary heart disease, and diabetes. In my view, they are all related to lifestyle, and lifestyle does not necessarily depend only on a squeeze. Can you elaborate on this?

[Dr. Paul Kershaw]

This slide summarizes a range of studies that show what it means for Canadians when they come to school at age six and are vulnerable, either physically, socially, emotionally, or in terms of their ABCs and one-two-threes. It summarizes a range of studies showing that early vulnerability relates to a range of social problems, like school failure or criminality, or health issues later on in life. Then the question is, what causes that early vulnerability?

I think we have to be careful to not just describe this as a lifestyle, as if there's some life that parents today are choosing, and it's those bad decisions of individual parents. That would mean that today we have a generation of parents who are just worse than they were a generation ago. There's very little evidence to suggest that's the case, but there's a ton of evidence to show that so much has changed from the mid-seventies to today.

Those changes include the fact that wages are going down, in particular for men, so even though we have way more adult time devoted to a labour market, households don't have any more income if you control for inflation. Income doesn't stretch further than it did in the past because housing prices are so much higher. Then people need to take on an additional mortgage to pay for things like child-care services that allow one or both parents to be in the labour market.

If we want to address these things on the screen, we need to get our family policy right.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Kershaw.

We'll now go to Dr. Morin and Ms. Quach. You'll split your time, with Ms. Quach first.

[Anne Minh-Thu Quach, NDP, Beauharnois—Salaberry, QC]

I think that I had one minute left to wrap up my comments. So I will use that minute and then yield the floor to Mr. Morin, who will use his five-minute period. Thank you.

Mr. Kershaw, I found your presentation very interesting. I continued reading while you were talking. You also tackled social determinants of health. We know that the daycare program and the local community service centres have greatly contributed to improving the situation in Quebec.

What do you think the federal government's priorities should be? Which health determinants should it invest in?

[Dr. Paul Kershaw]

This is a really good question. The federal government could pick any one of the three policy changes I propose, but given the way federal-provincial relationships work right now, it would make most sense to intervene on the new mom and new dad benefits, because currently a lot of that happens through employment insurance. Then of course provisions would need to be taken to make sure that the advance policy decisions that Quebec has already taken don't get penalized for their early action. So that would be one place, the new mom and new dad benefits.

I think as provinces go down the road of doing more on child care and employment standards, you would need the federal government to take seriously how we improve our national child benefit supplement to make sure that, as hours are changing for some families, that doesn't compromise their after-tax income, and the national child benefit supplement is a really easy way. You could triple that and you could end poverty for kids under age six.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

I am going to let my colleague ask her other questions. I know that she had several. So I am going to let Ms. Quach have my floor time.

[Anne Minh-Thu Quach, NDP, Beauharnois—Salaberry, QC]

Thank you.

Let's talk about childhood injury. There are many individual rules for each type. Once again, the federal government needs to get involved in order to establish Canada-wide standards. How could the situation be improved in the most effective way that would also be the most easily applied to all the provinces?

In addition, our population is aging. At previous meetings, we talked about modifying people's physical surroundings, so that streets would be safer and people more physically active. All that promotes better human health and helps avoid falls. What do you suggest, Ms. Nesdale-Tucker?

The question is also for the Safe Kids Canada representatives. Ms. Fuselli, what do you suggest?

[Rebecca Nesdale-Tucker]

So here is one area in terms of regulations. You mentioned risks to children and safer environments. A lot of types of injuries are going down, which shows that some injury prevention is working. But there are some really high-concern areas—snowmobiles and ATVs, for example. So the federal government and Health Canada may want to look at that in terms of opportunities with helmets—for toddlers, maybe speed skating, ski, and snow, the whole range of helmets—but also ATV use by children. They're very heavy vehicles.

We ask children to wait until 16 to drive a car, for example, but younger children are on ATVs. They can flip over and cause crushing injuries that children cannot survive and go at speeds that children's small bodies aren't ready to handle. So ATVs and other vehicles of that nature are something the committee may want to consider.

[The Chair, Conservative, Joy Smith]

We were supposed to suspend at 10:15, and we have an extra motion that has just come up as well for committee business that we haven't discussed yet. But I'm going to extend the committee for five minutes just so that we can get a couple more questions in.

Is that okay with you folks? Okay, thank you.

Mr. Strahl.

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

Thank you.

I'll get my questions out there and allow the witnesses to respond.

My question follows on the comments of my colleague, Mr. Lizon. As a parent myself, I certainly take notice of the reports. You see in professional hockey a high level of awareness now on concussions. You read reports about how in minor football there are undiagnosed concussions all the time and how in soccer heading the ball is causing concussions. I played some of those sports, but for your own kids you're much more protective and you ask whether organized sports are worth it. You say your kid's not going to play in the NHL, so you wonder whether you want to put him in those risky situations.

So how do you balance between educating people on the risks while preventing people from saying their kid is just going to play Wii instead of playing active team sports or sports that would put them at risk? How do you balance those things? Maybe Safe Kids Canada could answer.

[The Chair, Conservative, Joy Smith]

Ms. Fuselli, if you have anything you want to say, just raise your hand so that I know you want to comment.

You do? I thought you might.

Maybe I'll start with Ms. Tucker, and then I'll go to Ms. Fuselli.

[Rebecca Nesdale-Tucker]

Certainly at ThinkFirst we want kids to stay active and safe, including in team sports. Some of it's the age-appropriateness of the risk strategies. We find that if you eliminate bodychecking at younger ages, as they have in the States, Ontario, and Quebec, there's a lot more safety.

We find that up to 25% of kids in a junior hockey league in a season could experience concussions. There are ways we can prevent this. We want to make sure there's a prevention of collisions. There's the “no hits to the head” rule at Hockey Canada. There are environmental, rule-based, educational, and equipment ways to mitigate these strategies. If the parents know them, and the coach knows them, and the kids know them at age-appropriate levels, this can inform safer play—and fun play. It's more fun to play when you're not injured, because you stay in the game longer, right?

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

Right.

[The Chair, Conservative, Joy Smith]

Ms. Fuselli, do you want to make a comment now?

[Pamela Fuselli]

Yes, sure.

I echo ThinkFirst's information. It's taking what is most effectively proven by evidence. In terms of best practices, it's not a one-size-fits-all. A good example is the helmet. A helmet on a head is a protective piece of safety equipment for someone on a bike or in a sport. For someone on a playground, it actually is a strangulation hazard. So we can't say that a helmet is a protective piece of equipment that you need to wear every day, all the time. We're not asking for measures that are outside the realm of what the evidence shows.

Also, as we learn more about diseases and about what causes different diseases, we adjust the treatment. The same is true in prevention. There were things we didn't know years ago. We didn't used to wear seat belts, for instance. Now we do.

All of the children who engaged in all of the things we did as children and who were injured or killed aren't here to tell those stories. It's all of us who did actually come through it okay who can say, “Oh, we used to do that as kids, and we were fine.” Well, we were fine, but a lot of children weren't. Now that we know the interventions that work, we can implement them. I think that is what has to be the focus.

The other focus is preventing serious injuries. It's not the bumps and bruises of regular play and life but the serious, life-altering injuries that we want to really pay attention to.

[The Chair, Conservative, Joy Smith]

Thank you.

Mr. Skinner.

[David Skinner]

Actually, probably one of the most pertinent things we deal with all the time is trying to find the balance between regulating on something and educating on something. There are two aspects to health and wellness and promotion. One is how to eliminate risks or how to reduce risks, and the other is how to promote the positive. So there's the negative and the positive.

From my experience, for example, I was writing the standard for child-resistant packaging for medicines back in the late 1970s and early 1980s. So we have child-resistant packaging as a regulated thing, to try to provide the consumer with something that will help them, but we find that child poisoning still happens. It's not because of the closures; it's because people leave open bottles out. So there's the whole education part. Without one, the other is never really very effective. You need them both.

It's the same thing on the promotion side. While you can talk about risk reduction, it's also actually the positive side. In an environment where we're trying to create regulations that might address how people can do better things for themselves, it's often really not necessarily the best tool; although regulation has its place there, it's a lot about promotion and communication. It's an environment where, I would say, self-care matters in the debate.

When that environment comes to the fore, then there's a lot better decision-making on whether or not to just regulate it, and then “out of sight, out of mind”, versus regulate it and communicate.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Skinner.

I want to thank all of the witnesses for coming today. Thank you for your patience at that interruption.

We do have quite a bit of business to get covered, and we only have until a quarter to the hour.

I'm going to suspend the meeting for one minute.

[Proceedings continue in camera]