Health Committee on Nov. 30th, 2017

[The Chair, Liberal, Bill Casey]

We're in public now.

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Chair, those with good memories will remember back to the first meeting that we held where motions were moved.

[The Chair, Liberal, Bill Casey]

That's the very first one, way back.

[Don Davies, NDP, Vancouver Kingsway, BC]

Yes, back in 2015.

I remember I moved four motions at that meeting, one was on pharmacare. I moved a motion on studying antimicrobial resistance. I moved one on community health care. I moved one to undertake a study on the status of indigenous health and to report those findings to the House.

I would move that our next major study be one on indigenous health in Canada. I'll briefly explain my reasons.

I think our last meeting was instructive. We heard a little bit of evidence about the really disturbing state of oral health in our indigenous communities. We heard a little bit—I can't remember the statistics—but unsurprisingly, the state of oral health among our indigenous people in this country is significantly lower than the state of oral health for Canadians at large.

I've done a bit of research. Life expectancy for people living in first nations communities is currently five to seven years less than for other Canadians. Tuberculosis rates are 31 times the national average. Suicide rates are five to seven times the national average. That's just picking three representative health indicators—one on mental health, one on young people, one on tuberculosis, a very treatable and in fact even preventable illness—and of course life expectancy being the ultimate measure of health. I think it's a fair comment to make that it wouldn't surprise me if across the board, indigenous health lags behind the health of non-indigenous Canadians on every major measure.

The other reason I think this is really important is it's one of the core areas of health that is within federal jurisdiction. This is something we have direct responsibility for. The Prime Minister set the tone for this very early on stating that no relationship is more important to his government than that with indigenous people.

I think, colleagues, in terms of health as a subject in Canada, there is probably no issue more in need, more crying out for attention than that of the state of health of our indigenous peoples in this country.

Finally, I would say that this committee has done no travelling whatsoever. I think it would provide an opportunity for us to do some travel. We only have about 20 months before the next election, so we don't have a lot of time, but I think the opportunity to travel, particularly to some northern communities, some remote communities, would be very instructive. I've been on committee travel before. Some of it's a waste, but some of it is extremely moving and very informative.

If this committee went to a remote community to see what a health clinic or nurses station actually looks like—I've never been; I don't really know—I think it would be really be informative.

I'm going to move, for all those reasons—it's been on the docket for a long time, so it has the advantage, while not determinative, of having sat there for the last two years—that we move to undertake a study on the status of indigenous health and to report the findings to the House. I'm at my colleagues' pleasure in terms of when we start it, but I would suggest that be the next major study that we start in February or March.

[The Chair, Liberal, Bill Casey]

I appreciate the motion, but you kind of hijacked my agenda. Before we go to that, I just want to go through the things we have to do before we get to a new subject. If that's okay with you, I'll just go through those things.

We still have a few meetings before the pharmacare study is finalized. That's when we come back. We are going to have Bill C-326, drinking water guidelines. It has already been referred to us, so we have to fit that into our schedule sometime. I think it's April, or we have 12 months to do that one. We have to do a study on drinking water before April. Then we have private member's motion M-132, on federally funded health research. We have to do that within a year, just so you know.

We have, coming sooner or later, Bill S-228, which is going to be really interesting. That's food and beverage marketing to children. We have Bill S-5 which is anticipated to come. That's on tobacco packaging. It is going to be another interesting one.

Those are just things we have to do, and then we should talk about a new subject, as Mr. Davies has proposed. Actually, indigenous health was the next one on the priority list that we originally established way back when we had 17. We knocked it down to priorities and that was the next one, along with home care and palliative care, and organ donation, after that.

Now I'm going to go back, and I'm sorry to interrupt you, Mr. Davies—

[Don Davies, NDP, Vancouver Kingsway, BC]

That's okay.

[The Chair, Liberal, Bill Casey]

—but I appreciate your allowing me to go through that. I just wanted to bring you up to date, because we do have quite a few obligations that we have to deal with.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair. That's very helpful to know.

The one thing I would leave to the business that we have to deal with as a committee is the timing of it. I just think that we should resolve as a committee to make that our first study that we're going to do on our own initiative. I agree that legislation from the House takes priority, so we'll have to deal with that, and Bill S-5, for sure. I think it's at second reading. It hasn't been moved on the order paper yet.

Some of the private members' bills, like the one on drinking water, we have to do by April. The other one, on health research, we have a year, and quite honestly, I don't know how many meetings. That actually duplicates some of the pharmacare study that we had. It does touch on ways to make drugs more affordable, so I personally would not be in favour of devoting very much time to that study. The motion doesn't say how many meetings we have to have. We could have one meeting. We could have a couple of meetings on it. However, I think it's important for this committee to be masters of its own business. What we move as a subject to study should be a reflection of what we think is an important issue, and again, I just can't think of one that's more important than indigenous health.

[The Chair, Liberal, Bill Casey]

Mr. Oliver.

[John Oliver, Liberal, Oakville, ON]

I don't disagree with Mr. Davies, but I have a comment about process for us as a committee. Then I have a couple of other ideas for research on top of what has been suggested.

In terms of our process, I think the last time we all submitted topic lists, we took them to the subcommittee. The subcommittee went through them in detail and came back with a recommendation on the priorities and timing of them. Rather than having individual motions right now on what's most important and what we should be proceeding with, I think we need to let all members have a say. We're starting our second half of our work, get them in and then prioritize them at the subcommittee and then bring them back here to the committee for final recommendations. I think that's a bit more thorough rather than going one by one.

Having said that, there is a motion on the floor, I think.

[The Chair, Liberal, Bill Casey]

Did you actually make a motion? Okay.

[John Oliver, Liberal, Oakville, ON]

I have two other potential topics, if I could introduce them.

One is pandemic planning. We don't have to go back very far to remember H1N1 and the significant shortage of antivirals that were available at that time. People were queueing, and there was concern across Canada about that shortage.

I don't know right now what...there hasn't been a significant viral concern lately and our eyes are off it, so it might be a good time to consider our pandemic plan. Do we have sufficient capacity to produce antivirals if they're needed as the next pandemic comes forward? That's one we could probably do a fairly quick study on.

The second one is a women's mental health issue, particularly focused on eating disorders. From my own personal experience, advertising and healthy body images is a really important topic particularly for young women who suffer from eating disorders. Some other jurisdictions have moved forward to require statements in advertising when a human image has been modified or computer modified, so that there is an awareness that the image is not of a normal human shape.

I thought there should be something around eating disorders, around women's mental health, with a focus on advertising. Is there a way for us to begin to look at a national direction around advertising?

[The Chair, Liberal, Bill Casey]

Ms. Sidhu.

[Sonia Sidhu, Liberal, Brampton South, ON]

Mr. Chair, last spring this committee agreed unanimously to the motion for two meetings for the study of diabetes. This is an important issue that needs to be discussed in this committee. If there is time before June for two meetings on that, it would be appreciated.

[The Chair, Liberal, Bill Casey]

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

I'm just thinking that there is no end to interesting topics that are worth studying. There are hundreds of them, and they're all good suggestions.

For me, in terms of process, we don't have the topic for our next major study. We're coming to the end of pharmacare and we don't have a major initiative set. We were to come to this meeting to start thinking about that, so I think it's appropriate to move motions at this meeting.

I was struggling to understand the federal component of John's suggestion until he talked about advertising, so I understand there is a federal tie-in there.

Again, I'll say that the virtue of indigenous health is it's a complete federal responsibility squarely within our responsibility. I'm going to move that we at least agree in principle to study that.

I'm okay on where you fold it in timing-wise, because we're going to have to be quite flexible on when it starts. This may take the better part of a year to get the eight, 10, or 12 meetings that we will probably need for it. We may not even finish it by the next election. I think it would send a really strong signal to the indigenous community, and again, it's completely reflective of the government's priorities of making a priority of the indigenous relationship.

I'm going to move that we have a vote on that, and that we determine whether this committee wants to study indigenous health.

[The Chair, Liberal, Bill Casey]

Ms. Gladu, on that subject.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Yes, I just have a clarifying question for Mr. Davies.

I understood that the committee had put a priority list together of all the things you want to study. Pharmacare was one of them, as was antimicrobial resistance, etc., and I think indigenous health was on that list.

My question is, was that the next priority on the list?

[The Chair, Liberal, Bill Casey]

My information is that the next one was indigenous health, and the one after that was home care and palliative care, and the next one after that was organ donation, but it was almost two years ago that we did that.

[The Chair, Liberal, Bill Casey]

Mr. Van Kesteren.

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

Chair, there is another study I would like to see, and indirectly I guess it ties into Mr. Davies' study.

To my knowledge I don't think there has been—with the possible exception of some jurisdictions in Europe—anybody who has had the boldness to take on the sugar industry. I would love to see a study on sugar, because so many of these issues that we're talking about—the study on diabetes, women's mental health and eating disorders, so many of them, and indigenous health.... We've all travelled to places like Iqaluit and we've seen the poor health habits that become part of first nations people.

I would love to maybe tie into that and just talk about sugar. There are those now who are saying that sugar is even more dangerous than smoking. It's something that nobody seems to want to tackle but I'd sure like to do it.

[The Chair, Liberal, Bill Casey]

Mr. Webber.

[Len Webber, Conservative, Calgary Confederation, AB]

I'm back to our first few meetings where we had our subcommittee meeting as well to discuss what we wanted to study. Of course, indigenous health was on that list and apparently it's the next one up, so I would support Don Davies' motion with respect to that, if he is next on the list of our own studies here.

Then we would continue on down that list that we had agreed to back so many years ago, two years ago as you mentioned, Mr. Chair.

[The Chair, Liberal, Bill Casey]

You're heading for organ donation, aren't you?

[Len Webber, Conservative, Calgary Confederation, AB]

Well, I just think that now, all of a sudden, are we going to change things? I know there are a lot of important issues out there now—definitely diabetes and sugar and such—but we have a list and we've been patient in the organ donation community, anticipating this occurring sooner than later, and now to change that list, it is a little bit disappointing if that's what's happening.