Health Committee on Feb. 17th, 2016

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

I think this is a great thing to take a look at. We do have to be cognizant of provincial versus federal jurisdiction with regard to what we're doing, but that being said, I think it would be very constructive for this group, if people are in agreement, to get Mr. Webber to put pen to paper to provide us exactly what he was talking about.

The awareness part, I think, is outstanding. It's definitely within our realm in the federal jurisdiction. There may be a couple of other items and suggestions, but this may give us some opportunity to have a comprehensive discussion on whether or not we move forward on this idea. My impression is that there seems to be some interest.

[The Chair, Liberal, Bill Casey]

I think we could have an impact.

[Len Webber, Conservative, Calgary Confederation, AB]

I'd be more than happy to do that. I have a file this thick, Mr. Chair, and I would be more than happy to put something down on paper.

[The Chair, Liberal, Bill Casey]

Why don't you give us a file about...this thick?

[Some hon. members]

Oh, oh!

[The Chair, Liberal, Bill Casey]

No, give us a summary. That's a good idea.

Are there any other comments?

Ms. Sidhu.

[Sonia Sidhu, Liberal, Brampton South, ON]

Last week I talked to an organ donor charity fund. They're saying that even though we sign a driver's licence for organ donation, the families don't know. Half the families of these people don't know. There should be an amendment so that they could ask one family member, who would then know that this person wants to do an organ donation. I think we lack that.

[The Chair, Liberal, Bill Casey]

Mr. Kang.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thanks, Mr. Chair.

I think there is a lack of awareness, a lack of education. After that bill, there was an organ donation drive in my community, in the Sikh temple. A gentleman took up the cause. Almost everybody he approached signed up for organ donation. I think the committee should look into the education part, on making Canadians aware that they can do this. A lot of people probably don't know that they can sign for it on their driver's licence. People are willing to do it, but there is a lack of awareness.

[The Chair, Liberal, Bill Casey]

Thank you.

Are there any other comments?

Okay, Mr. Davies, the floor is yours.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chairman.

When I was brainstorming big topical areas that I thought would be appropriate for the committee, I came up with a number of them. Of course we can't do all of them, so I'll read out the general list. Then I'll zero in on what I think would be an achievable agenda for the committee.

I thought we should study community care, home care, and palliative care. Sometimes those are connected and sometimes they're subjects on their own.

Mr. Oliver has already pointed out the area of prescription drugs and all the myriad issues around making sure that Canadians can get the medicine they need.

There's also aboriginal health. From my conversations with the analysts, neither this committee nor the aboriginal affairs committee has actually studied aboriginal health, at least not in quite a long time. I think that's something we could look at.

I'm concerned about privatization, user fees, and just general enforcement of the Canada Health Act. As federal politicians, it's our obligation to ensure that the principles of the Canada Health Act are respected by the provinces. We know there's litigation in British Columbia. I think a private MRI clinic has opened up in Saskatchewan, and Quebec has had some legislation about it as well, so that's another area.

I think antimicrobial resistance is an interesting issue that we would be wise to get a good handle on.

Electronic health records and virtual care are a part of our future that would be interesting for this committee to look at.

Finally, there are issues concerning our blood supply. We have an issue of paid donors at a for-profit clinic opening up in Saskatchewan. We have the Zika issue, where there may be concerns about our blood supply. I thought it would be interesting, basically 20 years post-Krever commission, to see how we're doing on that. We generally wait until there's a disaster or a public health emergency before we look at things.

Those are my issues. They could keep us busy for a decade.

I actually put these in the form of motions. Here's what I would suggest as a digestible process for the weeks and months ahead.

First, I found out that this committee completed a study on mental health in Canada. It was submitted to the House of Commons in May of 2015. That study required a report from the government that never came. It's an outstanding piece of business. I'm not casting aspersions; I think the election may have gotten in the way.

Here's the motion: That the Standing Committee on Health formally request that the Minister of Health provide a response to the Committee on the findings of the Mental Health in Canada study completed and submitted to the House of Commons in May 2015.

I think we as a committee should finish off that piece of business so that the good work of that committee is not left unfinished.

Next, I suggest that the committee start with a study on aboriginal health. I'll read my motion:

That the Standing Committee on Health study the status of health and health care within Indigenous communities in Canada, including status, non-status, on-reserve, off-reserve and urban Indigenous populations, with the objective of better understanding the particular health care needs of this population and the gaps in service delivery, review the effectiveness of the First Nations and Inuit Health Branch of Health Canada, and report its findings to the House.

As part of that, I respectfully suggest that it would be a great opportunity for this committee to put in an application to travel. I myself have never been to an indigenous community to look at health. I've never been to Iqaluit.

Mr. Chair, thank you for circulating the letter from the Honourable Larry Bagnell inviting us to Yukon, where I'm told that 25% of the population is indigenous.

It's a nice way for a committee to.... First of all, we stay within Canada; second, we actually get on the ground and get out of Ottawa and start gathering some information and evidence about the subject first-hand. I think given the priority that Prime Minister Trudeau has placed on the relationship with first nations and given that this issue has not been studied by this committee, it would be a good place to start.

That study would probably take several weeks to even get organized. We would have to get witnesses and all of that. In the meantime, for the next week or two, I suggest, second:

That the Standing Committee on Health request a briefing from Health Canada officials on the 2015 Canada Health Act Annual Report and the status of Canada's health care system.

We could perhaps all benefit from having a briefing from department officials on the most recent annual report and having a chance to ask some questions. I think that could probably be organized for next week.

Issue number four is something that is happening in other committees. I was substituting in the fisheries committee yesterday, and we did this. The motion is:

That the Standing Committee on Health request that the Minister of Health appear before Committee at the earliest opportunity to discuss and answer questions concerning her mandate letter.

I recognize that ministers are busy and I certainly don't want to inconvenience Minister Philpott. However, I think we could invite her to come, recognizing that it might take a while. It would be nice to have her appear before the committee to give us her views and priorities from the mandate letter. It would give us a chance to ask some questions of her.

That's where I'll stop. I had some other issues that I think we could also request. I'll finish with number five. That's something else we could do in the meantime if we're organizing a report. The motion is:

That the Standing Committee on Health request a briefing from officials of the Public Health Agency of Canada, and Canadian Blood Services, on the status of the Zika virus outbreak, the health threats of this disease for Canadians, and the current efforts by the Public Health Agency of Canada and Canadian Blood Services to address the public health implications of this virus.

I'll end there by saying that I know the mosquito is not here in Canada, but the WHO has called this a global health concern. They anticipate 4,000,000 cases next year. Hawaii has just declared a public health emergency. The U.S. is now putting out an alert that this may be transmitted sexually. We don't really know the causal effects or whether it's related to microcephaly or not. Already we're seeing some conspiracy theories popping up on the Internet. Some people think it's Monsanto's fault.

I point this out because the epicentre for this is Brazil, and the Olympics are in Rio this summer. The whole world will be sending a large contingent of people to Rio, and there will be a large contingent of Canadian athletes.

We've had a couple of cases of Zika in Canada. There was an Ontario woman who had to go public to get the testing that she felt she wanted. I think she was pregnant. Of course, the microcephaly affects pregnant women or women who may be considering getting pregnant.

That gives us a couple of briefings to get before the committee relatively soon. It gets a request to the minister out while we get organized on what I think we should study as a first issue, which is aboriginal health in Canada.

[The Chair, Liberal, Bill Casey]

You have about two or three motions there.

[Don Davies, NDP, Vancouver Kingsway, BC]

I can deal with them one by one if you like.

[The Chair, Liberal, Bill Casey]

Could we deal with those after we get all the subjects on the table?

[Don Davies, NDP, Vancouver Kingsway, BC]

Absolutely.

[The Chair, Liberal, Bill Casey]

Thank you. You had a busy week off.

Mr. Ayoub.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

If I may, I'll speak in French just to balance it a little bit, and if I can practise my English, that would be great.

I am interested in two demographics: seniors and younger people—families and children. When it comes to home care for seniors, I would like to know what is being done elsewhere in Canada. In Quebec, certain medical procedures are carried out. We increasingly want our seniors to stay at home. Home care is one way to give them some autonomy, so that they can stay at home longer.

My experience as a mayor allowed me to see those kinds of requirements. People would come ask how they could avoid going to residences, where everything is included, and stay in their community. They live longer, can be in better health and want to stay at home. I am very interested in this issue. What is the outlook for the future regarding this type of care? I would like to know what is being done elsewhere in the world and what the best practices are. What practices could we borrow and implement in Canada?

Attention deficit hyperactivity disorder, or ADHD, is another topic I am very interested in. That disorder was identified several years ago. Children who have been diagnosed with it are prescribed many drugs. That seems to be a modern-day disorder. I am very interested in knowing how it has evolved and how it varies with age. Children are being treated at younger and younger ages, and the treatment continues later on. We don't know when it ends. There are many drugs involved, leading to high costs. I would like to hear from experts on the topic and find out what is being done elsewhere. Is this situation unique to Quebec and Canada, or is it happening everywhere?

Finally, I am very sensitive to what Mr. Webber announced about organ donation. Every province already has programs in place. We will be able to find common ground on how to deal with this issue.

I assume it will be difficult to choose among all the interesting topics available to us, but we will have to do so and start somewhere.

Thank you.

[The Chair, Liberal, Bill Casey]

Are there any comments on those thoughts?

Mr. Darshan Singh Kang.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

I'm catching my breath a little bit.

I just want to echo a couple of points here.

I think we should re-examine the Health Council of Canada. We should look into that and return to the original Health Council of Canada recommendations to ensure Canadians have the means to be engaged to provide input to the government on the operation of our health care system. As well, we should reinstate some of the Health Council of Canada's specific mandate to continue assisting Canadians and different levels of government with regard to various concerns for the nation's health care system.

Also, with regard to pharmacare, it recommended striking a national public pharmaceutical committee made up of non-partisan experts in the field of national drug plans. We should look into that. We should also look into bringing about national comprehensive bulk buying and pharmaceutical purchasing.

There's also the national mental health initiative. We should....

Then home care is very important.

Also, privatization is my concern. In Alberta, my colleague Len Webber knows there were musings by

Premier Klein about having a third way. There was a push to privatize health care and maybe have a two-tiered system or a three-tiered system. Who knows?

In any case, because the costs of health care keep creeping up, we are trying to find a quick solution. When I was at the doctor, there were 25 or 30 people waiting there. A gentleman came to me and asked why there wasn't a $5 fee to see the doctor. There were lots of people there with colds, sniffles, and all that, who didn't need to be there, so if there was a $5 fee, maybe half the people wouldn't be there. Those kinds of things have come up.

There is also the issue of costs for health care. Because our senior population is increasing, there are more pressures and demands on the health care system. We have to be looking into innovation and technology and how we could keep the costs down. Maybe the committee should bring in experts to look into that and curtail the costs for health care, because I don't think we can keep up, given the way the costs are going up.

Another thing is that we have many doctors from India, Pakistan, and other countries who are driving cabs, and we should look into how we can bring those specialists and doctors to work in the system. When I was in public accounts in Alberta, my suggestion was to let them work in the system with our Canadian doctors here. Let them bring them up to speed in two, three, or four years. Let's pay them some wages so they can make a good living and at the same time work in their profession. They can come up to speed. I'm talking about recognizing foreign credentials. That will, I think, ease the pressures on health care.

We should have incentives for the rural areas of the country, because lots of doctors don't want to go there. We should have some kind of incentive to balance it. Maybe new doctors would go for five or 10 years or whatever. I know maybe it's charged with challenges, but we should look into innovative ways to bring more doctors into the system so they could serve the rural part of the country.

I come from India, and there was a public system when I was growing up. We had clinics. Then, when we brought in the private system, the public education system and public health care system were a shambles. Therefore I think that as a committee, we should be looking into how we can keep costs down and keep health care public. I think once we open the door a little bit here for privatization, everybody will be paying through the nose.

I know what it is like back home. When somebody goes to a hospital, they say, “There's a window; go there.” Then the cost is maybe $200,000 or $300,000. It depends on the severity of the illness. They say, “Go there and deposit the money, and then we will look at you.” I'm afraid that if we open the door even a little crack for privatization, we may end up there.

That's all from me for now.

[The Chair, Liberal, Bill Casey]

Well, you caught your breath.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Thank you, Mr. Chair.

[The Chair, Liberal, Bill Casey]

Are there any questions or comments?

Mr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Mr. Chair.

I thought it would be interesting to study supervised injection sites. I know there was a recent meeting with Mr. Coderre in Montreal, and that's one issue he brought up with the Prime Minister.

We certainly do have a federal role. I think if these types of sites are going to be considered, we should look into how decisions are made regarding where they're located. In other words, how do they fit into community health and public health ideas at the local level? How do you get input from stakeholders so that if these are going to go forward, you have a willing community?

Maybe we should even look at the facts from the injection site they have in Vancouver. Is this actually something that is working? Is there some science behind it that we could take a look at? I think it would be very topical, and it's something we do have a role in.

[The Chair, Liberal, Bill Casey]

Very good.

Are there any comments on that?

Ms. Sidhu.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Actually, I want to talk a little bit about what Mr. Davies said about home care and palliative care to reduce gridlock in the hospitals. As baby boomers age, we need to do something about that. We need more home care services.

I want to give you an example of a 24-hour clinic. In Mississauga there's a 24-hour clinic, and it's just opposite the Trillium hospital. If you go to the hospital for minor injuries, it takes a long time. At the 24-hour clinic, you go there and you get treated. I think it lowers wait times, and also relieves the burden on hospitals. This is something I want to talk about with regard to home care and palliative care for older people. If we increase home care, there will also be an effect on hospital gridlock.

The second thing is that mental health is becoming a challenge. There are so many barriers. We need to address that. Depression also comes into that.

With regard to a pharmaceutical strategy, Mr. John Oliver explained that very well.

Diabetes is becoming an epidemic disease. Every third Canadian, I think, will have a diagnosis of some kind of pre-diabetes condition. Obesity is the main cause, so we need to look into that. We need more awareness.

We need to make some kind of strategy for family doctors. I'm not knocking any family doctors. When a person is pre-diabetic, we should do something about that. When one person becomes diabetic and goes untreated, the person can become a heart patient too, so we need to look into that.

Next is insulin. In some countries insulin is a life-saving drug. Why not in Canada? We should have that life-saving drug too. We should look into that too.

The last government was doing a study on wireless radiation and how it affects our health. We should look into that too.

That's about it.