Health Committee on May 11th, 2020

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

Ms. Benard, I can't go into the origins of the CHSLD situation in two and a half minutes, but you've put your finger on a problem that has had structural effects on the organization of care in our CHSLDs. You talked about underfunding and, in particular, the fact that the increase in health transfers has been reduced from 6% to 3%. That's one of the great lessons of this pandemic. Experts tell us that a weakened system means that, when such a medical situation, such a contagion, occurs, weaknesses and problems emerge catastrophically.

I'm doing the same analysis as you. I think the years of delay in funding have had a structural effect on a temporary situation, the pandemic. It is said that more than 80% of deaths are occurring in long-term care centres, particularly in Quebec. This is serious. I agree with that part of your analysis. I think it would be complacent not to draw the conclusion that we must find funding that exceeds system costs, which are at 5%.

Personally, I presume that everyone in the system is benevolent and caring and that they have done what they could despite the underfunding. That justifies nothing.

How would a national standard make a difference because what is needed is money on the front lines, not a system of organization or normativity that will be a drain on the government's finances?

Why is there a need for a standard, and if there is a need for standards for public long-term care facilities, what are they?

[Melanie Benard]

Thank you for your comments.

I'm glad we're in agreement on the issue of funding.

I think the question was what the role would be for standards. If we just need increased funding, why would we need standards? I would say that we need to have some consistency. People across the country need to know they can rely on a certain standard level of care.

Of course, there is a huge role for the provinces in terms of the delivery of that care, but to meet these basic standards is something that, as I said, we'd see under the Canada Health Act for other areas of health care.

We're calling for similar standards to be in place for long-term care and home care.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Thériault.

We'll go now to Mr. Davies for two and a half minutes, please.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Dr. Dorian, we've heard that one of the gaps the COVID-19 crisis has exposed as well is the chronic drug shortages which occur at all times but have been particularly pronounced here in British Columbia. They've limited refills on all prescriptions to 30 days.

I'm just wondering what you could tell the committee about your experience with drug shortages, if any, in your field of expertise.

[Dr. Paul Dorian]

This will have to be entirely anecdotal. I'm not aware.... I apologize again for coming back to data, but we don't have any really solid data on the full spectrum of drug shortages.

In my own practice, I work out of St. Michael's Hospital in Toronto. I've had more than a handful of situations where the medication I've prescribed was unavailable at the pharmacy that issued the previous prescription. We asked them to look around at other pharmacies. They couldn't find the medication. These were cardiac medicines and I was asked to think of a substitute. Often the substitute medications are not as effective.

We're not talking about generic versus non-generic. We're just talking about medication type A versus medication type B. It is happening. I'm not sure within the cardiac realm that it's been a situation where the medication was completely unavailable in any place. We've had relative shortages inside hospitals. We've had information from our hospital pharmacy that we need to be very careful on the use of certain in-hospital medications, particularly some pain-killing medications used in anaesthesia, medications used in acute cardiac care, but I don't have any information to tell you that this has resulted directly in patient harm. It's just something that we need to be very careful about in terms of future planning.

[Don Davies, NDP, Vancouver Kingsway, BC]

Ms. Benard, there has been a bit of a question about what relationship universal, single-payer public pharmacare might have to the present COVID-19 crisis.

I leave last words to you to explain to the committee why you think there's a connection.

[Melanie Benard]

Sure. Thank you.

As I mentioned in my testimony, we've seen millions of Canadians losing their jobs during this crisis. Since the majority of people who do have drug coverage have it through private insurance through their employer, people have now lost that coverage, in addition to people trying to function on reduced incomes as well.

All these problems have been exacerbated during this crisis which makes this need for universal, single-payer public pharmacare all the more urgent.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies.

Thank you to all the committee members for all the great questions. Most particularly, thank you, witnesses, for sharing so much of your time with us today and also your expertise.

I'd like to advise the committee that for our meeting on Wednesday, the Canadian Association of Retired Persons will be added to the panel. They will be sharing the time slot with the Council of Senior Citizens' Organizations of B.C., so this won't add on any time.

Thank you everybody.

The meeting is adjourned.