Health Committee on Dec. 13th, 2016

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Minister.

Minister, as you know, increasing home care services to Canadians is a critically essential innovation for our health care system, and I'd like to ask you about it.

I'm going to quote from the 2015 Liberal platform, in chapter 1.

We will negotiate a new Health Accord with provinces and territories, including a long-term agreement on funding.

As an immediate commitment, we will invest $3 billion, over the next four years, to deliver more and better home care services for all Canadians.

Minister, as is crystal clear from your platform, the Liberals' commitment to $3 billion for home care was entirely separate from the health accord and was promised to commence in year one of your mandate. Here we are entering your second year in office. Canadians have not seen a nickel of federal money for home care, and you have tied the home care funding to the health accord negotiations.

Why have you not kept your election promise?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Thank you for the question.

You know we are committed to making sure that our investments in health will improve health systems across the country. It's well known that investing in home care will allow provinces and territories to get people the care they need in a more effective manner.

We are firmly committed to the $3 billion on home care. We wanted to do that in collaboration, of course, with our partners in the provinces and territories, and therefore we have included that in the negotiations toward a health accord.

I'm still optimistic that we will be able to wrap up those negotiations as quickly as possible, but it's taking some time to come to those arrangements. It's my very firm hope that we will finalize a health accord that will include the home care money. I think it's essential that we get that investment into the next federal budget, and certainly, if all goes well in my discussions with the provinces and territories, it will be there.

[The Chair, Liberal, Bill Casey]

The time is up.

Dr. Eyolfson, you have the floor.

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

Thank you, Minister, for coming.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Sorry, but could we make it a quick question?

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

I'll do a quick question, absolutely.

This question may be hard to answer, but it's not a long question in itself. Previously, when all the provisions of Bill C-2 were in place, there were concerns about an extended timeline to approve supervised consumption sites.

Can you comment in general terms on how removing these barriers is going to change the timeline for approval of a new site? How much time will be saved by these changes?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

That's an excellent question. What it speaks to is the fact that the current process is terribly onerous. It has made it very difficult to receive an exemption for the communities that really want these sites, and it takes a number of months.

Having said that, as I indicated earlier, it's generally not because the federal government is opposed to providing that exemption; it's often because the barriers to getting those sites approved rest on, for instance, the municipality getting zoning for the site and getting the work done to provide secure systems and so on. In many of the cases in which there's been a delay, it's because of actions that we are waiting for on behalf of municipalities, or sometimes provinces.

That said, one of our commitments under the new system will be to institute a service standard, an expectation as to the period of time that it will take. I would be happy to give you further information on that, but I think it's very important that we provide some assurance that we will deal with these expeditiously.

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

Thank you, Minister.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

I'm sorry that I have to leave.

As you know, I will always be available to respond to members' questions and I thank you for the time today.

[The Chair, Liberal, Bill Casey]

Well, I want to thank you for your answers. I want to thank you for answering our questions about the opioid crisis, and also for addressing Mr. Brown's questions. I can think of other ministers in the past who might not have been so open-minded as you are on that.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

These are important matters. Thank you for working on them.

[The Chair, Liberal, Bill Casey]

They are. We all agree.

We'll suspend for five minutes while we change tables and witnesses.

[The Chair, Liberal, Bill Casey]

We'll reconvene our meeting.

I welcome back our guests from the Parliamentary Budget Office. We are certainly looking forward to the testimony. I'm sure it's going to be very interesting.

We have Jean-Denis Fréchette, the Parliamentary Budget Officer; Mostafa Askari, assistant parliamentary budget officer; and Carleigh Malanik, financial analyst. We have Jason Jacques, director of economic and fiscal analysis, and Mark Mahabir, director of costing policy.

The point of the meeting is to get an update on our request to have an analysis of the national pharmacare program. We'd like to hear an opening statement of 10 minutes, and then we'll go to seven-minute questions.

[Jean-Denis Fréchette, Parliamentary Budget Officer, Library of Parliament]

Thank you, Mr. Chair.

Mr. Chair, deputy chairs, ladies and gentlemen of the committee, thank you for this invitation to appear to report on the work that has been done, at your request, to estimate the cost of creating and administering a national pharmacare program.

Preliminary terms of reference have been sent in advance to your committee, and we will be pleased to answer your questions if you need some clarification about the required resources, the timeline, or the methodology.

I would like to mention that to develop those terms of reference, my colleagues Carleigh and Jason have met and had discussions with many of the stakeholders mentioned in your motion. Mark and Carleigh have negotiated some potential agreements that will be required for obtaining appropriate data and information, and in the terms of reference you may note that the project will require two full-time analysts over an expected six-month period and that the total cost of data from various sources will exceed $100,000.

Although such an amount could be planned in the Office of the PBO's budget, it is worth noting that I do not have the signing authority for any amount exceeding that threshold of $100,000. In those circumstances, the Library of Parliament has to submit a request to the Speakers of the Senate and the House of Commons for their approval in principle to enter into such a procurement process. Of course, I do not know what the outcome of their decision might be, but I will have to take it into consideration for the future of this project.

Thank you, Mr. Chair. I'll stop here. We will be happy to answer all the questions you may have.

[The Chair, Liberal, Bill Casey]

That's the shortest opening statement we have ever had.

We're going to Dr. Eyolfson. You're up for seven minutes.

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

Thank you.

With regard to what you're talking about, the cost and full-time analysts, could you describe what other information you need from us as instructions at this point for costing the whole framework of the initial assignment?

[Jean-Denis Fréchette]

Is your question about what it will cost the PBO?

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

No, what I mean is with the study of—

[Jean-Denis Fréchette]

Oh, you mean the study itself.

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

Yes. What other information do you need from the committee at this point to proceed with the study?

[Jean-Denis Fréchette]

We don't need any more information for the moment. Those are preliminary terms of reference.

There's a reason that we mentioned preliminary terms of reference. It's that they may change over time, or we may see our methodology change, or the access to information that is required may not be available. The terms of reference that are in front of you are what we plan to do for this committee.

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

All right. You have said it would take two full-time analysts six months. Would you anticipate hat there might need to be an extension of that time, or do you think six months is an adequate time for this? Is that a too-loaded question?

[Jean-Denis Fréchette]

It's always the big question. It's the $100,000 question, I guess.

For the moment, that's what we're planning, but as we know, in the course of a project like this, which is complex and will require a lot of discussion with stakeholders and so on—the stakeholders being those who have the data that we need for the study—it may take a little bit more time.

We will certainly debrief you on a regular basis in status reports during the course of the study. For the moment, we're looking at June 2017 as the preliminary deadline.

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

All right.

At what intervals would we be receiving updates? Would it be monthly? Would it be every two months?

[Jean-Denis Fréchette]

Mostafa will answer.