Health Committee on Dec. 4th, 2018

[Darlene Jackson]

I've been thinking a lot about that. One of the criticisms is that so many people go to the emergency department or Health Sciences Centre with issues that are not true emergencies. There is probably merit in that. Those clients are better served being seen at perhaps a quick care clinic, a walk-in clinic or even an urgent care facility, but those facilities are miles away. For someone who is marginalized and who lives on a very small income or lives on the street and has no income, getting two blocks from the Health Sciences Centre out to the Grace Hospital or over to St-Boniface is monumental. They have nowhere else to access health care. That's why they're presenting where they are.

If we're going to say that they need to access health care in a different area, then we have to support their getting to that area. Maybe we need a shuttle bus. I don't know what we need, but we need to ensure that those clients are receiving care. If they can only get to HSC emergency, that's where we need to provide care for them.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

What specific policies, programs and initiatives need to be put in place to prevent this happening to vulnerable people?

My question is to James.

[James Favel]

Again, I think the biggest issue that I'm coming across is the poverty in our community. People can't afford to get out of the community. They can't afford to go places and that needs to be addressed.

This discussion is fantastic, but if we don't address the underlying poverty issues, when people get out of prison, they're going to relapse, so they're going to go back to what they know. They don't have enough money to survive and that's the only way they know, so you're going to have drug dealers come out and they're going to go right back to it.

I've seen homeless people in my community and ask them, “Why are you homeless today?” They say, “It's because we don't have a bank account”. If you don't have a bank account, you can't get your EI cheques direct-deposited. They're homeless. We're talking about 20-year-old kids that are homeless like that because of these rules that we have. We need to address those rules. There needs to be more money for these kids, when they finally come out of something like that. The one volunteer who I'm dealing with right now was clean and sober for 11 weeks, but she was stifled. She was stuck in her apartment and she couldn't go anywhere, so she relapsed.

There needs to be more sports and more things need to be available. There has to be programming available. It has to be easier.

[The Vice-Chair, Conservative, Marilyn Gladu]

Excellent.

Now, we'll go to Mr. Davies for three minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Thanks, Mr. Favel. I mentioned earlier that substance use and addiction ought to be treated as a health issue, but I think you're also raising the point that it has to be treated as a social justice issue as well.

Does anybody on this panel think that criminalizing drug use is helping the situation?

[James Favel]

Not a chance.

[Don Davies, NDP, Vancouver Kingsway, BC]

Nobody.

Ms. Blyth, it's my understanding that crystal meth is ingested in a number of different ways, but primarily it can be smoked and snorted as well.

You've mentioned that you're one of only two locations in North America—I think the other one is in Lethbridge—that permits clients to smoke drugs or inhale in a supervised setting. What are the barriers? Why aren't more consumption sites allowing inhalation of drugs? Can't you die from an overdose inhaling or smoking?

[Sarah Blyth]

Yes. It's actually quicker. If you have fentanyl in it, it ignites. The chemistry that's involved just makes the person immediately overdose, so they just drop immediately from smoking.

Yes, we're one of two. Surrey is getting one soon. The one that's in Edmonton is a state-of-the-art facility. What we do is really quite simple. I think you've seen it, but it's a little wooden tent and there's outdoor air coming in, so it's simple.

What was your question? I've lost my train of thought.

[Don Davies, NDP, Vancouver Kingsway, BC]

I guess I'll phrase it this way. I know InSite, which allows supervised injection, is federally approved. They don't allow inhalation. Are there any supervised injection sites in the country, which are regulated by the federal government, that allow inhalation?

[Sarah Blyth]

No. I think that we need to get more of those. I know that there's the one at St. Paul's. They're having issues with people that are now becoming injection users. Their tolerance goes up, so they want to be overseen because they're having overdoses from smoking. That's not good at all.

There are really simple solutions to it. I think they're very cost effective.

[Don Davies, NDP, Vancouver Kingsway, BC]

In British Columbia, I know there's been a provincial public health emergency declared by the chief medical officer. Given what you're seeing on the ground and the scope of the problem, do each of you or any of you think that the federal government should declare this a public health emergency?

[Sarah Blyth]

I've been saying that from the beginning.

[Darlene Jackson]

Yes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Do you have any opinion? I'm seeing everybody nod.

Dr. Eyolfson was commenting on the policy foibles of Ontario and Manitoba, saying that these governments are putting their heads in the sand.

So far, our Prime Minister and health minister have both unequivocally ruled out decriminalization and regulation of drugs to ensure safe supply. They've refused to declare this a public health emergency, under the federal Emergencies Act, and the federal Liberals—despite $19 billion in deficit spending and $14 billion just allocated to corporate tax relief in the fiscal update last week—have provided no substantial increase to address the necessary massive increase in treatment funding.

Are there any comments on the federal government approach? Are we on the right track or do we need that fundamental shift?

[Sarah Blyth]

InSite has a place upstairs that's called Onsite, which people don't really hear about. People go in and out of there and back onto the streets. The fact is that we just have no place for people to go on demand. I would agree with everybody at the table here that the person who wants treatment usually comes to me in a very desperate situation, saying, “Hey, you know what, I'm ready for treatment.” They're crying. They look like they're ready to go. They've been sleeping in the alley. It's over.

That window is only for that period of the day. You can't say to them to go and use drugs for another two weeks and then we'll find them somewhere—if we can find a place for them. Then, when they do get in, they go through the system for a week and come out again, because some of the programs are so short. Then they're back in the alley, and who sleeps in an alley without doing drugs? Nobody, I mean, it's just impossible in the cold and snow. It just doesn't happen—

[The Vice-Chair, Conservative, Marilyn Gladu]

I'm sorry, but that's your time.

We do have time for one more round of questions for maybe six minutes each.

We'll start with Dr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you again, Madam Chair, and thanks to all of you.

In regard to our federal government's record, would you agree that our steps to decrease the barriers to safe consumption sites that previously existed have been helpful?

[Sarah Blyth]

Yes.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Okay. Thank you.

Ms. Jackson, I agree with what you're saying. Again, in my time in the ED, we saw a lot of things that were not emergencies. The emergency department was not the appropriate place to go, but it was the only place to go. It could be for anything from “I need a prescription refill because my doctor is on holiday” to “My wife gambled away my money for prescriptions and where am I going to get them?” Right now, particularly for the acute intoxications and for those who are in crisis, it's really the only place to go.

The Victoria hospital has already been converted to urgent care. They don't take ambulances. It was in the news just this week that the Concordia Hospital—I believe very soon—will no longer be accepting ambulances. Is there capacity in the remaining emergency departments to deal with this adequately?

[Darlene Jackson]

I don't believe so. The Concordia Hospital's emergency department will be closed in June. They'll have an attached walk-in clinic. I do not believe that the three emergency departments in Winnipeg are going to be adequately staffed and will able to handle all the emergencies.

We already know that the Health Sciences Centre and St-Boniface Hospital are seeing 30% more patients than was ever anticipated that they were going to see with hospital closures. Those facilities are in desperate shape. Their emergency departments are in crisis.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

I understand that Seven Oaks is still operating an emergency department for the time being.

[Darlene Jackson]

Yes, for the time being.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

When I worked there, it was the second-busiest hospital in Manitoba. The emergency department saw more people than St-Boniface Hospital, and with it not being a teaching hospital, the doctors also handled all the emergencies and the wards. At three o'clock in the morning, there was one doctor for the emergency department, intensive care and all the wards.

[Darlene Jackson]

Yes. They're still one of the busiest. It's still very busy there.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Would you expect that closing that department will cause even more problems?