Evidence of meeting #84 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was certainly.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Theresa Tam  Chief Public Health Officer, Public Health Agency of Canada
Simon Kennedy  Deputy Minister, Department of Health
Michel Perron  Executive Vice-President, Canadian Institutes of Health Research
Marlisa Tiedemann  Committee Researcher

4:55 p.m.

Liberal

The Chair Liberal Bill Casey

Mr. Davies.

4:55 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

I would add just one point, and that is that we have to recognize there are two tangoing here, so it's not just the questioner. It is the answerer as well. The thing is, if you tighten up and get strict on the time period for questioning, then what will also happen is that we, as questioners, will tighten up on controlling the long, rambling, and sometimes completely unresponsive answering of the minister. That also has to be noted as well. I asked several questions that the minister simply did not answer. That's her prerogative, or maybe she decided to give an answer she liked.

4:55 p.m.

Liberal

The Chair Liberal Bill Casey

I don't know if you noticed, but the witnesses we've had that answered the shortest were the RCMP and the police. They are very short with their answers.

4:55 p.m.

An hon. member

Just give me the facts, madam.

4:55 p.m.

Liberal

The Chair Liberal Bill Casey

That's it.

We got the message. The chair has the message.

Yes.

4:55 p.m.

Deputy Minister, Department of Health

Simon Kennedy

Mr. Chair, I wonder if you might indulge me. I found a figure that Ms. Gladu asked for. I could read it into the record now, which would avoid my writing to the committee later.

4:55 p.m.

Liberal

The Chair Liberal Bill Casey

Fire away.

4:55 p.m.

Deputy Minister, Department of Health

Simon Kennedy

The figure that the government has put into home care in the current fiscal year is $200 million. The total amount for home care, mental health, and so on is $300 million. That money ramps up over the next 10 years, but the initial amount is $200 million this year.

4:55 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Does that include palliative care?

4:55 p.m.

Deputy Minister, Department of Health

Simon Kennedy

Palliative care would be within the home care amount of $200 million.

Thank you.

4:55 p.m.

Liberal

The Chair Liberal Bill Casey

We're going to suspend now for a few minutes. Then we'll come back and go into committee business, which we've already been in now for about 10 minutes.

4:55 p.m.

Liberal

The Chair Liberal Bill Casey

Okay, let's reconvene.

On our committee business, we have Mr. Davies' motion.

Before you get carried away or anything, Mr. Davies, I'm just going to read the motion so everybody knows what it is. I'm going to make some comments, because I've had discussions with the chair of the indigenous affairs committee, and even today we learned some things both from Mr. Kennedy and from the minister's statement.

The motion is:

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, 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.

I've had discussions with the chair of the indigenous affairs committee, and they intend to do this. They've done two studies already on it, and they want to continue. This is the third study.

Also, Mr. Kennedy just said a minute ago.... He wouldn't even answer a question about indigenous health, because that's all over to indigenous health. In her opening statement, the minister said, “Therefore, significant funding associated with indigenous programming included in these supplementary estimates will now fall under the purview of Minister Philpott.” It sounds like indigenous health is moving to the Minister of Indigenous Services.

Those are just my comments.

Mr. Davies, go ahead.

5 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Thank you, Mr. Chair.

I want to briefly review a bit of the record. I am going to quote from the meeting on February 17.

You said:

On another issue, I agree with Mr. Davies on indigenous health. It's come up from some members in talking to me. I haven't had any direction at all from the minister, by the way. I've not had one ounce of direction from the minister on this, and I'm pleased that we haven't. Eventually we will have, because there will be legislation, and hopefully she'll come here and make a presentation and tell us her direction, but nobody is trying to direct this committee. We're on our own, and I hope we stay that way. I appreciate that. I did talk to the Minister of Indigenous and Northern Affairs because the aboriginal issue had come up, and I wondered if it would be a problem for her if we did this. She said, “No, I'd love you to do a study on aboriginal health.” Just to let you know, she said that to me, and I was very pleased to hear it.

That was February 17, 2016. On February 22, 2016, our subcommittee met, and that's where we prioritized some issues. We came back with five issues, which included pharmacare, antimicrobial resistance, community care, blood supply, and one other issue. We've done all of them except home care and aboriginal health. On March 7, 2016, this committee adopted the subcommittee's report, formally adopting those five priorities. There is no question that this committee has already adopted the priorities we set forth.

On the question you raised about whether we can or should undertake this study, as you have long stated—and very correctly, Mr. Chair—in these committees, we are masters of our own affairs. We don't take direction from anybody—not the minister, not other committees. There is nothing that prevents us.... I think it's important for my colleagues to understand that whether or not any other committee is studying something, that's not a barrier to our undertaking a study if we want, although it might be instructive.

Number two, I checked with Charlie Angus, our critic, and he told me that no motion has been made before the indigenous.... You said you spoke to the chair of the committee, Mr. Chair, but—

5 p.m.

Liberal

The Chair Liberal Bill Casey

She is my seatmate.

5 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

—my understanding, unless I'm mistaken, is that no motion has been made before the indigenous affairs committee to study aboriginal health. We have an outstanding motion that has been here for quite a long time.

I wanted to mention one or two other things. Mr. Oliver mentioned a couple of concerns last time. He was wondering whether we were duplicating what the indigenous affairs committee studied up to now.

I have a copy of its report, “Breaking Point: The Suicide Crisis in Indigenous Communities”. The focus of the report was on suicide. I think the committee did look at some of the social determinants around that, for sure, but it was not looking at broad health indicators of indigenous people in this country at all.

The second concern was whether the federal government has jurisdiction over indigenous people when they're not on reserve. I could find the actual information, but my understanding and information is that absolutely the federal government retains jurisdiction over indigenous Canadians wherever they are in the country. So I don't think those are barriers.

The final question remains of whether we should do it.

I think I mentioned last time that the average life expectancy of first nations people in Canada is five to seven years less than the Canadian average. That is the number one health indicator: life.

Number two, the rates of tuberculosis are 37 times the national average. In terms of mental health issues, the suicide rate among indigenous people is five times higher. We know that there are chronic problems with diabetes, with obesity, and with a range of health issues that arise from living in poor housing and not having access to clean water.

The Prime Minister has said that no relationship is more important to this government than that with first nations. I would like to take him at his word on that.

I think that, as a health committee, if we're looking at studying health in this country, we should start with the single largest group with the biggest challenges facing their health and start to tackle the causes of this, broadly speaking, the real experience that they're having, and what recommendations we can make to the government to address them, as the health committee. I would respectfully suggest that it is our number one priority as a health committee, and we have many important issues that come up.

As I said last time, this committee has done zero travel. We have not left Ottawa. I don't think you can understand real health care problems in this country without actually getting into communities and experiencing it a bit. Particularly, that's the case in first nations communities.

Just at the last meeting, we had representatives of the health department tell us that the oral health of first nations is quite appalling. We know that studies were ordered to be done within the health department that looked at comparing services indigenous people have in remote communities versus other non-indigenous communities in remote communities. They weren't done.

I was really disturbed to see a report today of a young woman who committed suicide in Attawapiskat. She was 13 years old. Leaving aside the suicide and mental health component of it, when you read the story of this young woman, this young girl, it's an absolute microcosm of everything wrong with the health care system and indigenous people in this country. She lived in a house with 20 people. There was a mould problem in the house, and she had asthma. It was exacerbating her asthma. The sewage system backed up, so they were living in this house with the smell of raw sewage, which impacted her health in other ways. She was not able to access health care for her specific conditions. All of this led to a situation of despondency and depression, causing her to take her own life. I don't think that story is uncommon.

For all those reasons, this committee's prioritization, the priority the government has given to indigenous health, the crying need in this country to study....

Even if, by the way, the indigenous affairs committee does choose to study some aspects of health, I don't think that's a reason for us not to do it. Perhaps we can even join in some way. We could coordinate our services, because it's such a broad area that neither committee is going to be able to cover everything in health.

I'm sure the indigenous affairs committee will be looking at other things, perhaps the legal structure, perhaps constitutional issues, perhaps provincial or federal.... They could be looking at other areas that are specifically of interest to the indigenous affairs committee that we wouldn't be looking at as the health committee.

I'm going to ask my colleagues to support my motion that you've already read out, basically to study indigenous health in Canada as our next major study undertaken by this committee.

Thank you, Mr. Chair.

5:05 p.m.

Liberal

The Chair Liberal Bill Casey

Dr. Eyolfson.

5:05 p.m.

Liberal

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

I agree wholeheartedly with the need for the study. I flew with air ambulance for 13 years and spent a lot of time going to remote northern communities. I've seen the appalling conditions that this population lives in and the state of the health and all the other services available to them.

However, what exists now, which did not exist when we first brought this up in February, is that there is a new ministry to deal with all of these services, the all-encompassing services. From chair to chair of the committees, that committee has expressed an interest in doing that.

I'm not saying this would be a barrier to it, but it may be an unnecessary duplication of services. Should their study start and it turns out that there is something that they are unable to do, or find that it would be best suited for us to do, then we could revisit this topic. But right now, I think given what has been stated from the chair of the indigenous affairs committee, the indigenous affairs committee is the most appropriate committee to study this.

5:10 p.m.

Liberal

The Chair Liberal Bill Casey

Mr. Davies.

5:10 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

I'm not 100% sure of it, but I'm pretty sure—and I stand to be corrected by this chair or the clerk—but for the new ministry that is headed by Dr. Philpott, which is handling that part of the health aspect of indigenous affairs, I don't think there is a ministry there and I don't think there is a committee.

As far as I know, Health Canada—and maybe the analyst can help us out with this—is still responsible for the delivery of health care to indigenous people. If it's not Health Canada, where has it gone? I don't think there is another department and I don't think there is another parliamentary committee?

Can someone help me understand that aspect?

5:10 p.m.

Liberal

The Chair Liberal Bill Casey

I can't help you. First of all, I haven't talked to anybody except the chair, who is my seatmate. I am really proud that in our committee we determine our own agenda. Nobody has talked to me, or I haven't talked to anybody other than the chair of the other committee.

Those are good questions, but I do.... Mr. Kennedy just wouldn't answer a question on indigenous health care because he said that's now in the indigenous portfolio. He just did that a minute ago. He wouldn't answer the question.

I don't know. I can't answer the question.

5:10 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

If I just might, Mr. Chair, it was unclear to me. First of all, one answer by a bureaucrat to one question should not be enough to derail our committee. I was unclear where that.... He was deflecting a question to some other department. I'm not quite sure, but I'm pretty sure that health care for indigenous people in this country has not been now delegated to the ministry of indigenous affairs.

I know there has been a split in terms of services. In fact, I'm not even quite sure what the split is in the government's indigenous affairs, but I don't think that health care has been taken away from Health Canada.

5:10 p.m.

Liberal

The Chair Liberal Bill Casey

I'm with Dr. Eyolfson on this. I do think a study should be done, whether it's us or the other committee.

Here is what the minister said in her opening statement. I underlined it when she read it. She said, “significant funding associated with indigenous programming included in these supplementary estimates will now fall under the purview of Minister Philpott.” These are health dollars under the Minister of Indigenous Services.

5:10 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

I am only finishing this. I realize there are other people to talk, but it's on the same point, Mr. Chair.

Yes. That may be, but Dr. Philpott is not the minister to whom the indigenous affairs committee reports, I don't think, and she has no ministry or department. It's a bit of a fuzzy area there.

5:10 p.m.

Liberal

The Chair Liberal Bill Casey

Mr. McKinnon.

5:10 p.m.

Liberal

Ron McKinnon Liberal Coquitlam—Port Coquitlam, BC

I was just going to comment that what I heard the deputy minister say was that an order in council or a memorandum had been signed that did, in fact, transfer this over to this other new ministry. As well, it is my understanding that the indigenous affairs committee doesn't report to a minister—and of course the minister reports, if anything, to the committee—but it will be related to that new ministry.

I'm very comfortable with what Dr. Eyolfson said and the priorities you mentioned from back in February of 2016. I wasn't here at the time, but the terrain has shifted since then. We have a new ministry. I'm very comfortable giving them the lead on this and seeing where they take it. I agree that it's an important study, but I will be voting against the motion.