Health Committee on Feb. 24th, 2020

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

Certainly.

That, pursuant to Standing Order 108(2), the committee undertake a study on primary care models, and updated models on team-based care, including, but not limited to (a) demographic gaps amongst Canada’s physicians; (b) access to a family doctor or primary health care team; (c) hospital wait times; (d) federal, provincial/territorial roles; (e) urban and rural Canada; that the committee report its findings and recommendations to the House; and that, pursuant to Standing Order 109, the committee request that the government table a comprehensive response to the report.

[The Chair, Liberal, Ron McKinnon]

The amendment to the original motion is the part following the word “including”. Okay? We're speaking to the amendment now.

Is there any discussion on the amendment?

Ms. Sidhu.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Can you or the analysts clarify, is it population-based when he said “urban and rural” and that it would be “demographic” based? I am asking because Brampton has 700,000 people, but has fewer staff and health care services than.... So when we are studying this as population-based, will that be addressed in this model?

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

Very much so, because the reality is that there's a big difference between rural and urban areas. But could we also define it into “rural and suburban”, I guess I'd call it, the suburbs type of thing, where we have those different demographics? I think it would include all of those avenues and places like Brampton that are in the GTA and have melded into one big city.

[The Chair, Liberal, Ron McKinnon]

Mr. Thériault, you have the floor.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Chair, my question is more technical. We say “not limited to,” but the first points are very general. If we don't limit ourselves, then I don't understand what we're looking for in these general points.

I'm a little surprised that we want to conduct this type of study, when we know perfectly well that the issues with access to front-line health care are related to the lack of funding for the provinces and Quebec. Health transfers have decreased and, if this continues, we'll end up with $0.18 per dollar, when at one time the rate was $0.50 per dollar.

I know that my colleagues are acting in very good faith. When my colleagues express concerns about issues with front-line health care in their part of the country, I can completely relate to their concerns and I understand them very well. However, the provincial and Quebec governments are in the best position to provide these services, and they have the expertise to do so. They want larger health transfers, in order to reach the rate of $0.25 per dollar.

You want better access. However, it seems that we don't necessarily need a study to know that there are issues with access to front-line health care.

Was my speaking time established? I didn't realize that.

[The Chair, Liberal, Ron McKinnon]

I'm trying to keep the discussion on the amendment. That's a much broader...it's a valid and legitimate comment, but we're trying to decide whether we amend the motion in the way that Dr. Kitchen has proposed.

Is there any discussion on the amendment?

Mr. Van Bynen.

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

Thank you. As you know—

[Luc Thériault, Bloc, Montcalm, QC]

Excuse me, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

I'm sorry. I didn't mean to cut you off.

[Luc Thériault, Bloc, Montcalm, QC]

I understand your clarification, but I'll finish up with one or two sentences. Is that okay?

[The Chair, Liberal, Ron McKinnon]

Absolutely.

[Luc Thériault, Bloc, Montcalm, QC]

Okay.

I was saying that we could look at many other things that are under our jurisdiction, instead of interfering with the jurisdictions of the territories, provinces and Quebec. We know perfectly well that all the premiers of the provinces and Quebec agreed, not too long ago, in a meeting with the current government, to call for a 5.2% increase in health transfers.

Let's start with this. We have a budget coming up. We'll then conduct studies to find out why the money, if the provinces receive this 5.2% increase, creates issues with access to primary care.

Mr. Chair, you'll appreciate the fact that I won't be supporting this amendment.

[The Chair, Liberal, Ron McKinnon]

Okay.

Mr. Van Bynen.

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

Thank you, Mr. Chair.

I was a hospital board member for Southlake hospital for nine years. I became very acutely aware of the increasing financial pressures that our hospitals are seeing. I'm also aware that there are many alternative care models being pursued. I think there's a huge value in this committee pursuing this study to take a look at what the best practices are.

[The Chair, Liberal, Ron McKinnon]

Let's get back to the amendment.

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

I support that and the entire motion. I think it helps to define it.

[The Chair, Liberal, Ron McKinnon]

Mr. Kelloway.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

Very quickly, just to go back to some points that have been made, my experience in health care is not as a physician or a primary health care official, but certainly as a community leader and volunteer. From my personal interactions with people in my riding, I think they understand the distinction between provincial and federal responsibility when it comes to health care.

At least in my own belief and from my own standpoint, I think it's incumbent on us, as my colleague has said, to not just look at financial models that perhaps need to be looked at more diligently, but also at alternative methods of primary health care, community-based health care and a combination thereof that focus on team approaches and that may be doing quite well in a little place called L'Ardoise in Cape Breton. Shouldn't we know about that? Shouldn't we talk about that? Shouldn't we socialize that?

I just wanted to give some reference to my original motion. Thank you.

[The Chair, Liberal, Ron McKinnon]

We are trying to talk about the amendment and not the original motion.

[Mike Kelloway, Liberal, Cape Breton—Canso, NS]

That's understood.

[The Chair, Liberal, Ron McKinnon]

Are there any more comments on the amendment?

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

I support the amendment fully. I really want to add my voice in support of Mr. Van Bynen's comments.

I just want to say that health is an interesting issue, and if anybody understands the Constitution, I'd like them to sit down at some point and explain it to me, because I'm still trying to understand it.

[Some hon. members]

Oh, oh!

[Don Davies, NDP, Vancouver Kingsway, BC]

I say this because health care is one of those odd areas where there is shared jurisdiction and split jurisdiction. Frankly, it's academic because it has never put constraints on what this committee studies, in any event. Look at the kind of things we've studied, like concussions. We studied LGBTQ2 health in Canada.

The federal government clearly has jurisdiction over the health of indigenous people and every aspect of health that applies to indigenous people, from diabetes to concussions to their access to primary care.

The work of this committee, I believe, is always relevant and can be applied to provinces, so I just want to say that I very much support the amendment, and I also support the main motion.