Health Committee on Feb. 19th, 2020

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you to my colleague for that.

I appreciate that we want to put some sort of parameter on this. Typically, the way the committee has worked is that we pass the motion, we decide on a study, and it's open to the committee at any time to determine when we've heard enough evidence.

I'm unable to agree to six meetings at this early stage for two reasons. One is that an enormous number of stakeholders would be interested in this: physicians, dentists, dental hygienists, dental assistants, patient groups, special-needs communities that have unique needs when it comes to dental care, indigenous groups, hospitals, and health economists, so we can hear what other countries do. Six meetings would, without question in my mind, be far too few.

I think it's really hard to estimate at this point, so I would rather just keep it open, and then it's always open to the committee to get it started. Once we hear from enough witnesses, we can revisit this at any time and determine that we don't want to hear any more witnesses. I think the goal of the committee should be to make sure we have a good look at this and that we've heard from everybody we think we need to hear from, as opposed to picking an arbitrary number.

I do think this committee would be a substantial one. I can see that. We took two years to study pharmacare. I can't remember, and I don't know if the clerk or analysts can tell us how many meetings we had on that. Also, we may even want to travel. Who knows? We may want to visit a jurisdiction that has dental care.

I wouldn't want to hamstring the committee, but I want to make it clear that I also don't want this to go on forever. I understand we have lots of other issues, so it's not my intention to drag this out, but I think this would be one of the issues. This would be a study where we could do some really good work like we did on pharmacare.

I will end by repeating two things. It's rare that we have an indication from the government in a throne speech and a mandate letter of what is essentially direction for us. Although we're masters of our own agenda, of course, we've been given direction by the government that it wants us to look into this. Therefore, to put such a small number of meetings to this.... I mean, we had three meetings on the coronavirus, and we've seen how you just scratch the surface of an issue, and in that case it is temporal, discrete, unique issue that's pretty tight. I think something like dental care would take significantly more meetings than that.

I would rather vote against this motion, keep it open, and as we schedule meetings, just keep very alive to how the witnesses and evidence are coming, and when we feel that we've had enough, we can pause and proceed to write a report at that point.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Mr. Thériault, you have the floor.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

At this point, I'm wondering more about the procedure.

Mr. Davies took the floor and talked about his motions. Am I to understand that we're going to take turns explaining all of the motions we want to present to you today, and then we'll prioritize them in our study?

If not, will they be prioritized according to the votes and the order in which we vote on all these motions? If that's the case, I wish we could have had an opening presentation first rather than proceeding on a first come, first served basis. I just want an explanation of procedure. There are still five different motions here. I have tabled three, and I am sure there will be more to come.

How will we operate, and when will we set priorities? Will we have time to do all of this in one meeting?

[The Chair, Liberal, Ron McKinnon]

There are a number of ways we can proceed as a committee.

Certainly, Mr. Davies has moved his motion, so that is the business before the committee at this moment.

I think it's important that we at least choose a starting study right now so we can get the witnesses and our work plan organized and can start doing something.

As for putting forward our ideas of what studies we should conduct, I think that's great. I would really like to see us adopt at least one study to start with now, but certainly look at all of them. We could adopt more than one motion now, but we then have to prioritize which ones we go forward with now.

Does that answer your question?

[Luc Thériault, Bloc, Montcalm, QC]

It answers it in part.

I understand that, procedurally, we could have a vote on the first motion.

Are we then going to move on to another party, which is going to move its motion as well, or do we feel that Mr. Davies' five motions need to be dealt with before we can move on?

My question also relates to that; it's not clear.

[The Chair, Liberal, Ron McKinnon]

It's really up to whoever gets the floor at the time as to whether they want to carry on with new motions or discussion. I would suggest to Mr. Davies that it would be helpful if we go from the NDP to another party, you know, and do them one at a time, but that's really up to who gets the floor at the end of the vote.

Next on the list, we have—

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

On a point of order, is it not the subcommittee's role to review and determine which priority we would have? Not today, but the subcommittee would meet afterwards to determine what motion they want to follow or what study we go to. Then they come back to us and present it to us. The subcommittee, which is made up of the Liberals, Conservatives, the Bloc and...that is where to have that discussion.

[The Chair, Liberal, Ron McKinnon]

That's certainly an option that is available to us, and it's up to the committee to decide if that's how we want to proceed.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

I'd assume that this is the way the procedure is. Is that not policy? I would assume that this is exactly the way it was done for—

[The Chair, Liberal, Ron McKinnon]

It's up to the committee to decide that.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

I would think that we would present the motions and then the subcommittee would sit down where they can debate and determine which one would be the best. That's the way that I think it should be put forward.

[The Chair, Liberal, Ron McKinnon]

Well, that would be something you could propose as a motion at the appropriate time.

Ms. Jansen.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

I was just wondering about this. There are so many good motions that Mr. Davies has set out. I'm just concerned that if we leave it open-ended it will be very easy to lose track of time, and then we won't be able to talk about vaping, for instance, which is obviously very critical.

Also, when you look at palliative care, I noticed in the report by the Library of Parliament that it hasn't been studied for a long time, not in the 41st or the 42nd Parliament, and the federal government is supposed to be taking a leadership role in this. I think Patty Hajdu even mentioned that people are suffering, so in thinking about it, let's find some kind of limitation so that we can ensure we get to these other issues as well.

[The Chair, Liberal, Ron McKinnon]

Is that a point on the amendment?

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

On his amendment of saying let's keep it... Yes. That's right.

[The Chair, Liberal, Ron McKinnon]

Okay.

Are there other comments on the amendment?

We have Mr. Fisher.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

I'm not going to support the amendment based on the facts you spoke about. I don't think we want to handcuff ourselves on this.

I think it's important that we sit down and flesh this out to see where that leads us, so I won't be supporting the amendment on this particular one, but I would say that if we can at least get to the end of this meeting today knowing full well what our first study is agreed to be, then we can set the wheels in motion and figure out who we will bring in for witnesses.

[The Chair, Liberal, Ron McKinnon]

Mr. Kitchen.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you.

In response to the comments, the idea here, the concern we have, is that we have a study that.... I agree that it could be very expanding and have a lot of information, and that there are a lot of people we could have witness-wise, not only for testimonials from patients, but also from those who are involved, which is the main thing. The problem we have is that if it's left open, that allows for it to take up a significant amount of time. Taking up that significant amount of time then results in the fact that we don't get a report out, that we don't get a response and that we end up looking at this....

Let's take, for example, what happened in the last government on pharmacare. They took two years to study pharmacare. They came up with a report after two years. By the time it came out, we had an election call, so nothing actually came out of that. The damage we have here is that if we do that here, without putting a time frame on it.... Maybe we can tighten the scope of what we're going to look at in that area and then bring back another issue later, but if we leave it wide open and there's suddenly an election, we run the risk of (a), not getting the report done or (b), getting it done but it never gets tabled.

[The Chair, Liberal, Ron McKinnon]

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

I have a few things.

To Mr. Thériault's point, I'm totally comfortable with dealing with each party at a time with the motion. I gave notice in advance as a courtesy to my colleagues. I didn't have to; I could have just moved them here, but I sent my motions in advance so we'd have a broad selection of some of the issues. I don't expect to deal with each one of mine. I moved the first one on dental care. I've just read into the record the other issues that are of interest, but I think after we're done with the vote on dental care, I'm happy to take turns with parties putting forth the motion they want.

As you pointed out, Mr. Chair, I also think that we can do both things. By the end of this meeting we can choose one study, but I think the purpose of this meeting is for the committee to consider a number of issues, pass motions on them as they feel necessary, and then refer them to the subcommittee, which can then determine what order to do them in. Of course, my suggestion of proper procedure is that the subcommittee would report back to the main committee, which would listen to the recommendation and vote on them.

I think we can also accede, Mr. Chair, to your request. We can choose one of the issues that we may decide on, because we may pass three, four, five studies here, and then we can decide how we're going to schedule those.

With respect to the last comment about the timing, we completed the pharmacare report within two years, and we had a further two years of government. These are big, meaty issues. We're talking about the comprehensiveness of our Canada health care system. These things should not be proceeded with lightly or quickly. I would point out that dental care was mentioned in the 1960s after the Hall report. It was intended to be part of Canada's health care system along with pharmacare. There's a lot to look at with this.

With my final point, I'm going to reassure everybody again. There's nothing to stop any member of this committee at any time from moving a motion when we're in the dental care study, and saying, “I think we've heard enough and I'd like to move towards consideration of the report.” That can happen after six meetings, eight meetings, 10 meetings or 20 meetings. I just don't think we know enough about the issue to put a number on it now, so I agree with Mr. Fisher about that.

[The Chair, Liberal, Ron McKinnon]

Mr. Van Bynen.

[Tony Van Bynen, Liberal, Newmarket—Aurora, ON]

Thank you.

Mr. Chair, I'm more interested in getting the report done well than getting it done quickly, so I think the quality of the report needs to be our primary focus. I think I just heard from Mr. Davies that we do have the option of determining what the next steps would be after each meeting, so there is some degree of control.

The other question I have is with respect to the other items. Do we have a process for prioritization? I don't think we can do them all. How are we going to land on which ones we will proceed with, and what order will we pursue those?

[The Chair, Liberal, Ron McKinnon]

Again, that's up to the committee to decide. Do we want to defer the bulk of those decisions to the subcommittee? In terms of getting a study done well, I think it's up to us to get the right witnesses and ask the right questions. We have excellent analysts who, in my experience, always do a great report.

Ms. Jansen.

[Tamara Jansen, Conservative, Cloverdale—Langley City, BC]

Coming from the business world, I'm very concerned with doing something with no timeline. Without a timeline it's impossible to ensure that we not only get a report, but a quality report. Once again, I agree with you. We need a quality report. There's no doubt about that, so a good focus would be excellent. With a broad motion like this, with no focus and no timeline, I can imagine it would difficult.