Health Committee on June 7th, 2018

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Thank you so much, Mr. Davies, for your question.

As I've indicated, we recognize that Canadians pay way too much for drugs, and that's why we are moving forward with the implementation of the advisory council on the implementation of pharmacare. We recognize that Dr. Eric Hoskins is very well positioned to chair this committee, and we have instructed him that we want to make sure he presents us with options regarding a national pharmacare program and what that could look like.

We have no preconceived ideas as to what that is going to be—I have no preconceived idea, as well—but we certainly want him and the council to come forward with options, including on the implementation of the way forward, because we certainly want to make sure that we get this right, given that we have 13 provinces and territories as members of a federation. With respect to our council members, and also our chair being the former health minister of one of our major provinces, they certainly recognize the challenges that we could meet going forward.

We certainly want to position the council to provide us with the information we need on the implementation plan, and we don't want to wait. We want to make sure that the committee gets out there.

On the board members, as I have indicated, I am hoping to be able to make the announcements in the very, very near future. Dr. Hoskins himself has already been in the process of meeting with provincial and territorial health ministers.

[Don Davies, NDP, Vancouver Kingsway, BC]

I have limited time. My question was what do you think.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

As I—

[Don Davies, NDP, Vancouver Kingsway, BC]

My question was what your opinion is. Do you agree?

There are different ideas, and I'll turn to another idea. Your colleague the finance minister, Mr. Morneau, less than 24 hours after announcing the federal advisory council on pharmacare rushed to clarify that he isn't looking at implementing a universal pharmacare plan, but rather a “fill-the-gap” strategy. By the way, that is exactly the strategy this committee recommended not to pursue.

Here is what he said:

So you said “a national pharmacare strategy”, not a national pharmacare plan. Those are two very different things. We recognize that we need a strategy to deal with the fact that not everyone has access, and we need to do it in a way that's responsible, that deals with the gaps, but doesn't throw out the system that we currently have.

My question, Minister, is this. One of your colleagues very clearly is rejecting a single-payer universal system in favour of one that is gap-filling. I'm curious. As health minister, shouldn't you have a position on this? Shouldn't you be telling Canadians what your view is, what you're fighting for at the cabinet table?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

I am going to be very clear that I am encouraging our advisory council to continue to have a national dialogue with Canadians and experts in this field. I've made it very clear that I have no preconceived idea as to what the outcomes of these options are going to be.

I am going to be very clear. We have made it very clear from the onset that there is no preferred option that we are looking at right now. We want the advisory council to provide us with the work, and we also want the advisory council to build on the good work this committee has done. I say that very honestly. I recognize that this committee has done tremendous work over the past year—

[Don Davies, NDP, Vancouver Kingsway, BC]

I appreciate that.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

—and we certainly want the advisory council to build on that work, as we move forward.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

I want to move to the issue of opioids, because you made a reference to it. Minister, in British Columbia overdose deaths spiked again in March, reaching the province's second-highest monthly total to date, according to the B.C. Coroners Service. That is the second-highest month on record, second only to December 2016. We also know that last year over 4,000 Canadians lost their lives. Some estimate that we're on track to exceed that, with maybe as many as 6,000 Canadians dying from overdoses this year.

At the Liberal Party's convention in Halifax this year, your party's grassroots voted overwhelmingly in favour of decriminalization and medical regulation as a means of responding to drug overdose deaths. In response, a coalition of 200 organizations, researchers, policy experts, including former Liberal leader Bob Rae, and others impacted by the opioid crisis, wrote your government an open letter urging you to “be the progressive government you promised to be, choosing human rights and evidence-based policy over ideological relics.”

The letter went on to say:

We need you to listen to our voices as we call for the essential next step: decriminalization. The example of Portugal and other European countries illustrates that this policy works.

We ask you to prevent thousands of more unnecessary deaths by supporting this resolution.

However, you and the Prime Minister have both responded unequivocally, ruling out acting on that resolution.

Minister, given the severity of the opioid crisis, and given that we expect as many or more deaths this year as any other, why won't your government even consider the evidence-based proposal of decriminalization and medical regulation of drugs?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

I've made it very clear at many events and committee appearances that the opioid crisis is a file that we have certainly been doing a lot of work on, and one that keeps me up at night.

I indicated in my opening statements that my first tour was in the Downtown Eastside of Vancouver, where I had an opportunity to meet with many front-line service providers and people with lived experience who shared with me differing points of views.

With respect to decriminalization, and to your question specifically, we recognize that decriminalization alone would not ensure quality control of drugs on the street. It certainly is not going to prevent all of the deaths that are happening.

We also recognize that Portugal's model is very different from the Canadian model. We recognize that in Canada the provinces and territories are the ones that provide direct services to clients. With respect to the federal government, we are not the ones that provide the direct service delivery. As a result, our government has taken a comprehensive, compassionate, and collaborative approach, working with the provinces and territories. Also, we are using all of the tools at our disposal to ensure that we can provide compassionate care to services.

As you are well aware, we have made several regulatory changes to ensure that medication replacement therapies are available for individuals. This year alone we have made methadone and diacetylmorphine available without doctors having to apply for class exemptions.

We are certainly moving forward in ensuring that we can use all the levers we have at our disposal to effectively deal with this.

The other thing, as well—

[The Chair, Liberal, Bill Casey]

I have to end that.

I am finding that all of the questions are long and all of the answers quite long too, so I would just caution you that if we could tighten up the questions and the answers, we could get more questions and answers in.

We have to move now to Mr. Oliver for five minutes.

[John Oliver, Liberal, Oakville, ON]

Thank you very much, Minister, for being here.

You've had a number of questions about national pharmacare, and I just want to say that it's certainly one of my passions. For me it's quite simple. No Canadian should be denied access to necessary prescription medicines because they can't afford them. We need to find a solution to that.

One of the reasons I entered the political sphere was to fight for this. As a member of this committee, I introduced this as a study topic to the committee back when we first started, and I was absolutely delighted that it was the unanimous decision of all the committee members to undertake this study. No member actually came forward with a motion. I was really honoured and delighted to see that happen.

I just want to emphasize the importance of pharmacare. I know Dr. Hoskins is studying the implementation of national pharmacare. Our study talks about universal pharmacare. To me, these are the same words describing a system of universal single-payer coverage for all Canadians.

There is a lot of pressure from insurance companies and drug companies. They're more interested in different solutions, like regulating the industry to ensure that all Canadians are covered. It leaves many of the fundamental weaknesses of the system in place.

Can you comment a bit more along the lines of Mr. Davies' questions around whether you really see a situation where we would just regulate that sector, or whether you really feel we are looking at implementing a national or universal pharmacare system?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Just to reiterate a few of my comments, as I've indicated, we have no preconceived notion of what a national pharmacare program can look like. We made that very clear with respect to the terms of reference that we provided to Dr. Hoskins and the future committee members. We made that clear, and Dr. Hoskins has been reading the report that you presented and tabled. He's already read it cover to cover, and he's made it clear that they are going to build on the good work that has been done here, which we certainly want to make sure of.

With respect to that, we certainly want to make sure that Canadians have access to prescription medication. Again, for the past few years, we've taken some measures to ensure that we can lower the price of drugs, and that's the responsible thing to do moving forward.

[John Oliver, Liberal, Oakville, ON]

Absolutely.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Now we're looking forward to the—

[John Oliver, Liberal, Oakville, ON]

My second question is in a different area. I chair the health research caucus. In my prior life, I sat on one of the CIHR allocation committees, and I saw the struggle that was happening with the health research community, particularly with the cuts that happened to health research under the previous government.

I was delighted to see the investment in CIHR with the 2018 funding. You mentioned it in your opening remarks. Can you talk a bit more about how you see the advantages of those investments for health research across Canada?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

I think all of us in this room can certainly agree that when we're developing good public policy, we certainly need to make sure that we can rely on science, good research, and good data. Our government has certainly been very clear that we believe in investing in people behind the next big ideas, and we certainly want to make sure that the appropriate investments are there for them to continue to do the good work that needs to get done.

Dr. Naylor was very clear about the funding that was needed in the report that he tabled; he certainly did not shy away from that. I was very pleased to see that in budget 2018 we made historic investments in science and research. I can tell you that over the past number of months, when I've been visiting different researchers, people have certainly been applauding the investments that have been made.

When we look at investments in budget 2018 with respect to CIHR, we certainly recognize that there is also $454.7 million over the next five years. That's $90.1 million per year, ongoing, for the Canadian Institutes of Health Research, to increase their support for fundamental research. We certainly recognize that a lot of work needs to be done not only to support the current generation of researchers but also to encourage the future generation of researchers; hence, the significant investments we have made.

[John Oliver, Liberal, Oakville, ON]

There was an excellent session held by Ovarian Cancer Canada. They're a bit worried that they're not going to line up properly with that funding. If I may, I would like to ask you through this forum to give special consideration to Ovarian Cancer Canada to ensure that there is some federal funding to support ovarian cancer research.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

If I may just comment on that, I did have an opportunity this week when they were on the Hill to meet with them, and we had a very good conversation and exchange. I asked my staff to follow-up with their agency and the work they do.

[John Oliver, Liberal, Oakville, ON]

It has such a high mortality rate, and from a gender lens of the research allocations, I really do hope that we can focus on it, somehow. I know it's a tough one.

Thank you.

[The Chair, Liberal, Bill Casey]

I would second that motion.

Now we're going to go to Ms. Sidhu for four minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Minister, and your department for being here today.

I want to echo Mr. Oliver's comment. I thank you for taking a leadership role in giving more funding for research, but we always need more for ovarian cancer. We need to look into that.

My concern is that two weeks ago MP Marc Serré and I held a town hall for seniors in my riding. I heard a lot of concern from seniors in my riding. What is your department doing to help seniors? Seniors are facing more challenges, so what is your department doing to help seniors?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Thank you so much, Ms. Sidhu, for your question and your work. Thank you also to Marc Serré for his work on the issue of seniors. I recognize it's a passion of his as well.

Our government certainly recognizes that seniors are one of the fastest growing populations in our country. I come from New Brunswick, and when we look at our demographics, we see that New Brunswick has the oldest population in the country. With that come opportunities, but certainly some challenges as well.

In budget 2017, we were very pleased that we were able to invest $6 billion in the area of home care and palliative care services. In the area of mental health care, we invested an additional $5 billion. We certainly can't forget that many of our seniors need access to mental health services as well. The rate of mental health issues is about one in four in seniors.

Coming back to home care, we certainly recognize that seniors want to stay home as long as possible, so it's truly important to make sure that we don't only invest in bricks and mortar, buildings, and nursing homes. We also have to look at different service delivery models to perhaps provide seniors with the additional support they need to stay in their homes even longer. I'm very pleased that provinces and territories have agreed to a common statement of principle with respect to where that money would be invested. We've been able to successfully negotiate several bilateral agreements with provinces and territories on where those moneys will go. That's number one.

Also in budget 2018, I was pleased that $75 million was put aside for a pilot project to look at aging as well, and investments will be made in that area to look at different models, in order possibly to transfer those types of models to other provinces.

Furthermore, I want to add that the Public Health Agency of Canada has developed some guides and tools to allow cities to put in place age-friendly cities for their seniors. I'm from Moncton, New Brunswick. I'm very proud to say that we are an age-friendly city. They provide information to municipalities—towns and cities—to see what can they do to make their city more age friendly, whether it's by having buzzers on the door, making sure that sidewalks don't have big lips on them, or whatever the case may be. Those are some really neat initiatives of the Public Health Agency of Canada.

I also have to add that the Public Health Agency does some work as well in the area of data collection on elder abuse. Oftentimes, that's not an area we speak about a lot, but we certainly recognize that the rates are high. We need to have a better pictures of exactly what that looks like. Public Health is collecting data and finding ways to better address the issue of elder abuse.

Finally, as I've indicated, with respect to mental health, we want to make sure that services are in place, so targeted funding has been in place for that. We certainly can't forget the area of health research, so we look at funding that has been put forward through CIHR and other groups with respect to brain health initiatives and the rest of it. Significant investments have been made in that area, because we certainly recognize that our population is growing older. We have to make sure that we understand the challenges of today but also the challenges of tomorrow.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

[The Chair, Liberal, Bill Casey]

I'm sorry, but we have to move on now.

We're going to start our five-minute round now with Mr. Webber.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you, Mr. Chair, Minister, and all who are here today.

I'm going to ask you again, Minister, some questions on Lyme disease. We already know about the three pillars, the conference, and the framework that was developed a couple of years ago, so please do not use up our time with that information on it.

My question is regarding the three pillars, which are surveillance, education and awareness, and guidelines of best practices, but there is no fourth pillar, Minister. That pillar would be support, help, and treatment for those already suffering from Lyme disease.

Minister, the Liberal government spent twice as much money on the temporary hockey rink outside Parliament as they did on Lyme disease research. There is no support for Lyme patients, so Minister, what are you doing? Why is there no help for the thousands of Canadians suffering from Lyme disease today?