Evidence of meeting #5 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was money.
A recording is available from Parliament.
Conservative
Colin Carrie Conservative Oshawa, ON
Do they use street heroin, though, Mr. Kennedy? Or is it pharmaceutical...?
Deputy Minister, Department of Health
Mr. Chair, if it's helpful, we could share a bibliography with the committee on the various studies that have been produced.
In this case, I guess all I can do, as the regulatory authority, is to assure the committee that we made sure the stipulations in law were fully respected and that all the criteria were covered before the decision was made to issue the exemption under the CDSA.
Liberal
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you, Mr. Chairman. I'll try to get some short snappers in.
I've introduced a bill in two Parliaments now to have prominent labelling of sugar on the front of prepackaged foods. We know there's an epidemic of obesity. Is there any appetite in the department to move ahead with such a wise and necessary initiative?
Deputy Minister, Department of Health
What I would say is that we are concerned about sugar. I know parliamentarians are as well. The government has obviously made commitments. There is ample evidence that sugar consumption.... A little bit of chocolate now and then, I suppose, is a good thing, but over-consumption of sugar is not healthful and is something that needs some attention paid to it.
As a ministry, we have spent a lot of time looking at the experience of other jurisdictions, looking at all the various options that might be available to the government. Different jurisdictions have taken different approaches. There are various ways to measure sugar—
NDP
Deputy Minister, Department of Health
I can't get into the details of what we may have advised the minister or what the government may choose, but what I can say is that we certainly have looked at a variety of options, including front-to-back labelling. I can say that.
Don Davies NDP Vancouver Kingsway, BC
Thank you. I don't mean to be rude, but I have limited time.
On palliative care, Canada has been aging for a long time. There's been a need for investment in palliative care. With the soon-to-be-introduced physician-assisted dying legislation, palliative care is going to take on an increased role.
I can't find any specific allocation in this budget where the federal government is saying we're going to be adding funds to establish palliative care or increase palliative care services in the country. Is there such funding in the budget?
Deputy Minister, Department of Health
I would reiterate what the minister said, which is that the government has indicated that they first want to come up with a plan with the provinces and territories about what is going to be done, before the funding is allocated. Right now, we are actually talking to the PTs. There is a real interest on the part of our jurisdictional colleagues to look at palliative care as potentially a major priority for the funding for home care. We are having that conversation with the provinces, but as the minister said, the game plan is to talk about what we are going to do before we put the money on the table.
NDP
Don Davies NDP Vancouver Kingsway, BC
Okay.
I am going to be smart aleck about it, but that means the money is not there yet. I used to work for the teamsters and a lovely old teamster used to tell me, “You know, talk is cheap, but money buys whisky.” There is no money that is allocated to palliative care in this budget yet, for the next fiscal year.
Deputy Minister, Department of Health
Mr. Chair, I think that in our conversation with provinces, generally, if we wanted to use an analogy it would be more that if you are going to the bank and you are looking for an investment, the bank expects a business plan. In our conversation with the provinces and territories, we are talking not just about this area, but about Infoway, electronic health records, and a variety of other areas. The discussion is, look, we first have to have the business plan before we decide how much money is put on the table. The government has been very clear on its commitment to the $3 billion and to a long-term funding commitment, but we want to focus on what we are going to do before we start putting the money on the table.
NDP
Don Davies NDP Vancouver Kingsway, BC
That's the difference. With respect, there is a commitment made in words, but it is not budgeted for. I mean, money doesn't materialize out of thin air. You can't have three years of deficits, chart the paths, and indicate spending, and not have a penny of the $3 billion indicated anywhere. I have seen firm deficit figures for the next four years, which indicate that the spending commitments have been made and costed.
If that $3 billion is not budgeted for, where does it come from?
Deputy Minister, Department of Health
There are future decisions to be made, Mr. Chair, in future budgets.
NDP
Don Davies NDP Vancouver Kingsway, BC
Okay, so it is a future budget.
I have one other question I want to ask, quickly, about user fees.
There is no question that there is privatization in user fees in this country. In my own province, the election of the Saskatchewan Party, which has just opened private MRI clinics, indicates there will be further privatization. How much does the department spend, each year, on policing the Canada Health Act to ensure that provinces are conforming to it and that the federal government is actually returning, on a dollar-for-dollar basis, violations of the Canada Health Act?
Deputy Minister, Department of Health
Maybe the most productive way to do this would be to get back to the committee. I believe it was in the last two or three weeks—sorry, Mr. Chair, I don't remember when it was—that we tabled the most recent report, which has that kind of data in it in terms of what we have done about enforcement with respect to the Canada Health Act.
NDP
Don Davies NDP Vancouver Kingsway, BC
The shocking thing was that there were zero dollars for most provinces recovered back to the federal government, indicating that there are no privatization or user fees being charged to provinces. That is why I'm asking. I am trying to get a sense of how big of a commitment there is in the federal government to police that. Certainly the provinces aren't. If they don't know that the federal government is going to punish them by taking the dollar, which is the essence of the federal-provincial agreement, they are not going to be cracking down.
That is why I want to know how much money is being spent. I don't think that was in the report.
Deputy Minister, Department of Health
To be honest, I'll have to get back to you on that.
I think—just indulge me for 10 seconds—there is one piece of good news that maybe gets overlooked sometimes in these conversations. There is a lot of work Health Canada does collaboratively with jurisdictions to try to deal with some of these issues before they get to the point where the Government of Canada might be threatening to dock the funding that goes to provinces. In most cases, provinces have legislation governing their health care systems that is even more aggressive than the Canada Health Act in terms of the kinds of conditions in it.
We have a lot of cases where we work collaboratively with provinces to take issues off the table. I know there is a lot of focus on user fees and these sorts of things, but there is also a good story about the work we do collaboratively with provinces, where you have these instances and the provinces take action and remedy them. I think sometimes that goes unnoticed.
Liberal
John Oliver Liberal Oakville, ON
Thanks.
The minister has left, but I wanted to ask her about mental health in the health accord discussions, and where the focus was. I know you just talked about it briefly a few questions back.
The Mental Health Commission estimates that one out of five people suffers some kind of mental health episode. There is about $50 billion a year spent on that, yet it seems to be an area that we struggle with across Canada in terms of access and comprehensive care.
Does Health Canada have a view of the access to mental health services? Have you done studies looking at access and service across Canada under the lens of the Canada Health Act? Where are you at with that?
Deputy Minister, Department of Health
We certainly have done some work in this area. I know the Public Health Agency has, as well as CIHR. I think any one of my colleagues can probably speak to this.
This is an area where, frankly, more work needs to be done. The government committed to establish an expert advisory council to give us some guidance, and we're working with the minister to get that set up. It is a big priority in our work with the provinces and territories, but off the top of my head, I'm sorry, I can't give you a detailed list of the kinds of studies and so on that have been done.
I'd be happy to get back to the committee if that's helpful, but others may want to comment.
Chief Public Health Officer, Public Health Agency of Canada
We've been creating a suicide prevention framework and that should be released relatively shortly as part of the broader picture from the agency's perspective. We have a fair bit of work as well that's going on in mental health directly.
Liberal
John Oliver Liberal Oakville, ON
In terms of that health accord, that would be good to see or understand. I know that when the last accord was negotiated in 2004, there was a fair bit of focus on wait times and access in mental health, but in particular I'm thinking about child and adolescent mental health, such as eating disorders. My own experience in my own riding is that there are tremendous delays in accessing mental health services and huge frustrations for families, particularly for young Canadians.
Do you have any perspective on that or do you have a thought on how you will approach that in the accord?
