Health Committee on April 11th, 2016

[Simon Kennedy]

At this point we're still talking to the PTs.

I think this is an area where we know, for example, that for a lot of Canadians, the first expert they see when they're dealing with mental health issues is their physician, so there are issues around what kinds of tools and training physicians might have. There's the issue of what kinds of specialists are part of the system and maybe could get coverage under provincial health insurance, and there are acute issues around suicide.

There's a whole variety of areas that one could focus on. That's the conversation we're having with PTs now: we have to start somewhere so what are the areas we want to drill down on first? I'm not in a position now to say that we're going to pick these three. We're still having that conversation.

[John Oliver, Liberal, Oakville, ON]

The Mental Health Commission had six strategic directions they had identified. I don't know whether that's being brought to bear in the health accord discussions, but one of them was the concept of care across lifespan.

Again, I'm thinking of younger Canadians and building school systems and community support looking at that lifespan situation. Is Health Canada focusing on those six directions in some of those areas?

[Simon Kennedy]

The Mental Health Commission is very important foundation for us, a very important piece of work as we work with our colleagues in the provinces on what to do. Even at Health Canada we've adopted the national standard of Canada for psychological health and safety. We're actually rolling that out across the whole department. There's a lot of good work that the commission has done in their report. We're on board and we work with them very closely.

I can't tell you now what kinds of pieces will fit into an eventual accord with the provinces, but they're definitely a key player that we're working with.

[John Oliver, Liberal, Oakville, ON]

We've talked a bit about palliative care as home care, but as I knocked on doors and talked to people in my area, there was significant fatigue for caregivers who did not feel they were getting adequate home care support.

Does home care in terms of those home deliveries fall under the Canada Health Act in terms of the definition of comprehensive and what's included in it? Where are you with discussions around enhanced home care at that table?

[Simon Kennedy]

What we have seen with the PTs generally is that all jurisdictions are undertaking work to try to modernize and reform their health care systems so that they are sustainable and that they continue to provide good services to citizens.

As you and other members would know, we have a system that, when it was established, was built largely around physician services and hospitals, so it's a system that's really built around specialized institutional and relatively high-cost care. It delivers great service if you have an acute need or you need that kind of service. However, the result is that, for folks who are aging or have a chronic condition, providing that care in the community or home would actually be considerably cheaper. It's literally like $1,000 a day as against $100. It's a small amount.

Generally speaking, all jurisdictions are looking at how we shift that out of the high-priced institutional care into home and community settings. The conversation we're having with them as part of the health accord is how the Government of Canada can really support that shift and take advantage of what provinces and territories are already trying to do to make the system more sustainable, which is to have more home care, more community care, and high-priced institutional care where it's needed but isn't for everybody. You don't need to be in the hospital bed, necessarily, depending on the kind of condition you have.

That's the way we're trying to fit the commitment of the government into the discussion with the provinces.

[The Chair, Liberal, Bill Casey]

It's 5:30, and it's time to bring this to a close, but I have a question on research that I'd like to have some thoughts on.

A few years ago, I was helping the Canadian Cancer Society develop a plan to attract research funds. I'm from Atlantic Canada. We did a research study by province. The federal research money that goes to cancer research is very inconsistent. Atlantic Canada, if I remember correctly, gets an average of $2.40 per person. Two provinces get over $9 per person. Another province gets something like $7 per person, and for the rest of them it's awful low. But in Atlantic Canada, we have some of the highest rates of colon cancer, some of the highest rates of melanoma, and some of the highest rates of cancer fatalities amongst women.

What can the provinces who do not get an equal share of federal research money do to access an equal amount of research money per person?

[Dr. Alain Beaudet]

As you know, most of the research money, in fact all of the research money that we're disbursing, is disbursed on a competition basis. Obviously the provinces that have large infrastructure and can attract more researchers will get a larger share. It is a competition. It's best people, best ideas.

You're absolutely right, though, that for research, particularly when it comes to research that will be directly applied to improving care and access to care, there must be a way to ensure that there's more uniformity across the country. It's why we are partnering with our provincial counterparts and the ministers of health of the provinces and territories on the major initiative that the minister was referring to earlier, the strategy for patient-oriented research. That is focused on the type of research that will bear directly on the integration of research results into better care, better practices, and also will directly involve the patient in the elaboration of the research priorities and research strategies.

The provinces have really responded extremely positively to that. All provinces, actually, are investing monies in this endeavour, which we have committed to match. We're matching the funds that the provinces are willing to invest in this venture. It has allowed us to some extent to redistribute, if you will, among the jurisdictions that have fewer researchers and help them build capacity to develop research that's immediately applicable to care.

[The Chair, Liberal, Bill Casey]

You actually hit the nail on the head there. The provinces that get the money build the capacity, so then they can access more money. But then the provinces that don't have the capacity are turned down because they don't have the capacity. They didn't get the money to build the capacity. At any rate, we'll talk about this again.

I want to thank all the presenters very much for coming and providing answers. We look forward to your coming back.

Yes...?

[Len Webber, Conservative, Calgary Confederation, AB]

I would like to propose a motion, Mr. Chair, with regard to the minister providing answers to the questions that she had said she would get back to us on, as well as the department. I'd like to propose a motion that we get written responses to the questions that were promised to us.

[The Chair, Liberal, Bill Casey]

Fair enough.

All in favour of the motion that we get written responses to the questions asked?

[Len Webber, Conservative, Calgary Confederation, AB]

And in a timeline as well, Mr. Chair, of perhaps two weeks.

[The Chair, Liberal, Bill Casey]

Well, I wouldn't want to put that on, but let's—

[Len Webber, Conservative, Calgary Confederation, AB]

I'd like to put a timeline on. Otherwise it could take a year.

[The Chair, Liberal, Bill Casey]

Is there any debate or comment on that?

[Nick Whalen, Liberal, St. John's East, NL]

I'd like to propose an amendment to the motion to remove the timeline.

[The Chair, Liberal, Bill Casey]

I think we can count on an answer in a timely fashion.

Let's ask her for the written answers. If we don't get them, then we can move another motion. Is that okay?

All in favour of the motion to get written answers?

[Some hon. members]

Agreed.

[The Chair, Liberal, Bill Casey]

Are there any against ?

[Len Webber, Conservative, Calgary Confederation, AB]

I'm against. I would like to see a timeline on there, but obviously I'm outnumbered and I respect that.

[The Chair, Liberal, Bill Casey]

I'm sorry, Mr. Webber, did you just vote against your own motion?

[Voices]

Oh, oh!

[Don Davies, NDP, Vancouver Kingsway, BC]

That's on YouTube.

[Len Webber, Conservative, Calgary Confederation, AB]

I voted against the amendment. That's what I voted against.

[The Chair, Liberal, Bill Casey]

That's all right. I expect we'll get answers.

Thank you very much.

The meeting is adjourned.