Health Committee on June 8th, 2016

[John Oliver, Liberal, Oakville, ON]

Thank you.

The investment in first nations' infrastructure, it's so great to see the funding going into nursing stations, drug and alcohol treatment centres. In addition to the infrastructure, are you able to find and attract health care professionals to staff the nursing stations and work in them? Are you also looking at that availability?

[Mary-Luisa Kapelus]

Yes, I'm happy to share with you that we actually have made some strides in that regard through our nursing recruitment and retention campaign. We've increased by 31 in three of our regions the number of nurses in recent hires in the last year, which is great news for us. It still remains a challenge due to factors, such as attracting these workers to the remote and isolated areas, but we definitely are making strides.

[John Oliver, Liberal, Oakville, ON]

Okay.

Also on potable water, it's obviously a critical issue. It's hard to believe that so many Canadians are living under boil water advisories and have been doing so for years. With that targeted infrastructure funding, are there fairly hard dates set for when you're hoping to see potable water provided to first nation communities?

[Jamie Tibbetts]

Yes. In the supplementary estimates there is about $25 million of renewal of funding for Health Canada work, the funding to first nation communities to do that inspection and to fund environmental health officers to look for contaminants in water. It is Indigenous and Northern Affairs Canada that actually funds and builds water treatment facilities, so you have that appropriate separation of duties between the health inspector and the builder and operator.

Indigenous and Northern Affairs, in a recent committee I was in, stated that they see the funding they have now will resolve the problems and build the appropriate facilities in all communities over the timeline of the federal water and waste water plan.

[John Oliver, Liberal, Oakville, ON]

I think every one of my colleagues around the table here would strongly encourage that to happen. Potable water is such a fundamental element of good health and is important for any community.

My other question is for CIHR. One of my colleagues will be asking some questions about the antimicrobial resistence and strategies there.

As you know, the health committee is studying a national pharmacare program. I was curious if you could reflect, Mr. Beaudet, on whether you feel that the outbreak of any microbial resistence is in part due to people not taking existing antibiotics properly. They may be starting a dose, feeling better, stopping, and starting again. We just heard recently that almost one in four Canadians are either not filling or stopping their prescriptions because of affordability. Do you think, as we move forward, a properly funded pharmacare program would help to avoid that from arising in the future?

[Dr. Alain Beaudet]

There is no question that this is part of the problem. It is not the only thing, as you well know, but it's certainly part of the problem. I think over-prescription is another huge problem, not being able to rapidly diagnose at point of care whether it's a viral antimicrobial infection with the result that the doctor will protect himself and prescribe an antibiotic where really no antibiotic should be prescribed. All of these things are part of the issue.

That is why we've decided to focus our latest investments into developing point-of-care diagnostics. We feel this is an area where we can make a real impact. Hopefully, it will work rapidly.

[The Chair, Liberal, Bill Casey]

Thank you.

Okay, we go to round two now. These are five-minute rounds.

Mr. Webber.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you, Mr. Chair.

Thank you all for your presentations. I had a lot of sticky notes in the estimates here and I threw a few away after your presentations because they were so clear.

There are a couple of questions I do have here, though. I don't know whether to give you the page number or what, but on page 2-27, there is the listing of transfer payments to first nations and Inuit health infrastructure. I know my colleague over here, John Oliver, talked about the nursing stations and the potable waters and contaminants. Is that part of this $92 million that is going to contributions for first nation and Inuit communities?

[Jamie Tibbetts]

Yes, if you're looking at the contribution page of $91,801,000, that is funding for what we call a social infrastructure program that is made up of two main things. It's not the water actually. It's $12.8 million for aboriginal head start on reserve program, which is to repair facilities. My colleague here can give much more detail on that. It is to repair facilities of existing children's programs on reserve. There is $82.1 million for major capital repairs, expansion, and new buildings that are going to be built, expanded, or repaired. They are mostly new builds, but there are some repairs as well.

[Len Webber, Conservative, Calgary Confederation, AB]

That's not specifically out of the health budget?

[Jamie Tibbetts]

We are funded to do that normally as well, but this is a 273% increase over our normal funding in these areas. It is part of the government's plan to stimulate the economy, but also to catch up on aging infrastructure that has been in great need. We have selected the top priorities that are ready to be done within this two-year window to have a positive impact.

[Len Webber, Conservative, Calgary Confederation, AB]

I'm happy about that. I have a strong background with the aboriginal communities, so whatever we can do to help them out, I'm pleased to see.

Back in the annex A-6, in vote 1a, there's a $53.56-million expense. I read the paragraph over and over again, and it's difficult to determine what exactly this $53.561 million is for. I can certainly read it out to you. I don't know whether you have it there.

It says, “Operating expenditures and...authority to spend revenues to offset expenditures incurred in the fiscal year arising from the provision of services or the sale of products related to health protection,” but it goes on to say, “payment to each member of the Queen’s Privy Council for Canada who is a Minister without Portfolio or a Minister of State who does not preside over a Ministry of State of a salary not to exceed the salary....”

It goes on and on. I'm confused.

[Jamie Tibbetts]

I'm not a lawyer, but I would be confused myself. As an accountant, I understand it because I've been around it for a long time. These are boiler-plate standard wordings put in main estimates to describe votes. Health Canada has three votes: an operating vote, a capital vote, and a grant and contribution vote.

[Len Webber, Conservative, Calgary Confederation, AB]

Sure.

[Jamie Tibbetts]

That one you just read, we call it the operating vote for short.

[Len Webber, Conservative, Calgary Confederation, AB]

The operating vote, okay.

[Jamie Tibbetts]

That is the legal definition of what the money can be spent on. It's basically for salaries, and O and M, or overhead-type expenditures that a department makes to run the department. The rest includes the minister's salary and car allowance. They put this wording in there, but it's really technical speak for our operating vote.

This main estimates includes $53 million. Of the $165 million we're receiving, $53 million of it is in operating the balances.....

[Len Webber, Conservative, Calgary Confederation, AB]

I'm intrigued. I would love to know what the minister and her staff are making.

[Jamie Tibbetts]

I love this stuff.

[Len Webber, Conservative, Calgary Confederation, AB]

What about expenses for cars and stuff? Can you break that down at all?

[Jamie Tibbetts]

In our main estimates, it's actually public.

[Len Webber, Conservative, Calgary Confederation, AB]

Sure, I know it is.

[Jamie Tibbetts]

We publish it in our public accounts. It's actually quite small. It's part of a heavily controlled minister's expense allowance.

[Len Webber, Conservative, Calgary Confederation, AB]

I'll ask one more if I have time.

[The Chair, Liberal, Bill Casey]

It'll have to be a short one.