Health Committee on July 7th, 2020

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Mr. Latimer, am I to understand that the responsibility should fall to the Public Health Agency of Canada? Should the agency manage, supervise and control this compilation of extremely essential information?

[Jeff Latimer]

I would not be comfortable. I think it's well above my decision-making authority to decide who in Canada should be collecting this data.

I will say that both organizations have the expertise, and we are working collaboratively to fill in the gaps.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

I am talking about the Public Health Agency of Canada. What is the other organization you mention?

[Jeff Latimer]

I was talking about the Public Health Agency of Canada and Statistics Canada, and we are working collaboratively with Health Canada as well. We are working with all three.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Thank you very much, Mr. Latimer.

Do I have any time left, Mr. Chair?

[The Chair, Liberal, Ron McKinnon]

You have about 40 seconds.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

I will be quick.

Mr. Jones, two weeks ago, the Standing Committee on Health asked the government to establish a way for security to be built into digital products and services from their design stage.

Does that seem realistic to you?

[Scott Jones]

I think it's very important, as I mentioned in my opening statements, to have cybersecurity designed from the start to understand what threats can be faced. Unfortunately, when we look at an application, typically we look at the benefits. We also need to look at how it can be misused from a cybersecurity perspective. I think we've made a lot of strides, certainly in the exposure notification system. Part of the team that's working on this is making sure that it is ready from the start and designed with cybersecurity in mind.

It's important that we continue to reinforce that it's not just the benefits of the technology. We also have to look at how it can be misused.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Thank you, Mr. Jones.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Desilets,

We will go to Mr. Davies.

Mr. Davies, please go ahead for five minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Thank you to the witnesses for being here.

Ms. Morris, my first question is to you.

Does CIHI currently collect national information regarding the availability of health care system resources such as ventilators, intensive care units and hospital beds?

[Kathleen Morris]

We do collect that information and we have quite detailed information on the patients who would be using these services. One of the challenges is that it flows a little more slowly because it's based on discharge data, so it's not available as quickly as we might like during a pandemic situation.

One of the things that we've done to address this issue is pull together data very quickly, working with the provinces and territories, to create a dashboard that looks at the supply of ICU beds and ventilators, the number of COVID patients who are using these resources and the number of people with other health concerns who need that type of care. We put that together and update it daily.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Do all provincial and territorial governments now provide CIHI with that information?

[Kathleen Morris]

Yes. There are a few small gaps, but in general we're getting good data flows from the provinces and territories.

[Don Davies, NDP, Vancouver Kingsway, BC]

Could you undertake to provide this committee with a list of that information? I'm curious, for instance, to know how many ventilators we have available in Canada, particularly if we face a second wave in the fall. Is that something you could provide to the committee?

[Kathleen Morris]

I believe that would be possible, and I will take a look at the.... The numbers change daily, but we will endeavour to bring you some of that information after the meeting.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

In response to calls for better demographic data to understand health inequities and COVID-19, in May CIHI released an interim race data standard, intended for use by any jurisdictional organization that decides to collect this kind of data. However, as you probably heard in the first panel and after that, many advocates have criticized this approach because it's voluntary. They say the federal government has a leadership role to play to ensure there's consistent pan-Canadian data, regardless of jurisdiction.

Since the current gap in information makes it impossible to target resources and care where they're most needed, should the federal government impose mandatory national standards with respect to the collection and sharing of socio-demographic data related to COVID-19?

[Kathleen Morris]

We believe that having as much detailed data available as possible is critical to understanding, planning and managing health services. We've worked for quite a long time with affected communities to develop what we call our equity standards. Those talk about income, sex, gender—a number of things—and they include race and indigenous status. They are important to really understand the situation and to plan services.

One thing we've learned through this is that while collecting the data is important, it's also very important that the communities that generate the data or are the subject of the data are comfortable with collaborating in the data collection. In many cases there are racialized groups in particular who believe that data collection has been used for purposes that have created difficulties for them. We believe that attitude is changing and that the benefit of data is clear. Our role is to provide the standards so that it's collected in comparable and clear ways and can be aggregated for good use.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Latimer, you've identified that one of the gaps is a lack of common data standards nationally. Do you also think there should be national mandatory reporting with respect to demographic information, such as race and ethnicity? I would note that we do know, and we heard in the previous panel, that in our census StatsCan does give a sample of 100,000 people who are typically asked those questions. Is it time to make that apply to everybody?

[Jeff Latimer]

I'm going to turn to my colleague Marc Lachance, who has the expertise to answer that question for you.

[Marc Lachance, Acting Director General, Diversity and Populations, Statistics Canada]

Good afternoon.

This is a very good question. Similar to our colleague from CIHI, Statistics Canada produces national standards. As you mentioned, the census is one of the major data collection activities in which we apply those standards. As a national statistical organization, Statistics Canada makes all those standards available. We develop them with communities and with experts. We also test them with the respondents to ensure that they understand those standards. As a result, we have standards that we can make available to other organizations. They're all available publicly. As mentioned, they are all trusted and used.

We are also working closely with our—

[Don Davies, NDP, Vancouver Kingsway, BC]

With respect, Mr. Lachance, the question is whether or not you would make it mandatory for all Canadians to be asked about race and ethnicity instead of only 100,000.

[Marc Lachance]

I don't think I understand the question about the 100,000.

As you know, in the census we do ask those questions to a certain ratio of the population. There are standards relating to ethnicity and ethnic origins. We also have visible minority questions. Those are the questions that we ask through the census, and also through other surveys.

Statistics Canada doesn't have the mandate to force those standards. We apply those standards to our surveys to ensure that the interoperability among our surveys is as good as the census and other population surveys we are administering, including the health surveys.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

[The Chair, Liberal, Ron McKinnon]

That ends round one. We will start round two now. We're going to cut back time on this round as well. The five-minute slots will go to four minutes. The two-and-a-half-minute slots, unfortunately, will have to go to two minutes.

Mr. Webber, please go ahead for four minutes.