Evidence of meeting #7 for Health in the 43rd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was services.
A recording is available from Parliament.
3:55 p.m.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Thank you, panel, for your presentations.
My question is for Health Canada.
You said that 62% of end-of-life patients receive palliative care, so there must be barriers. What kind of approach are you taking to remove those barriers?
3:55 p.m.
Sharon Harper Acting Director General, Health Care Programs and Policy Directorate, Strategic Policy Branch, Department of Health
Thank you for your question.
The action plan on palliative care, which was mentioned by Marcel, sets out Health Canada's approach to addressing those barriers. It includes activities to raise awareness about palliative care and end-of-life care planning. It includes activities to look at training for health care providers as well as supports for caregivers. It also includes activities to look at research and data to improve those across Canada. As well, it looks at underserved populations, areas of population that may not receive as much palliative care, for a variety of reasons. It also looks at palliative care received by indigenous groups and populations, including first nations, Inuit and Métis.
March 9th, 2020 / 4 p.m.
Liberal
Sonia Sidhu Liberal Brampton South, ON
You said that we know that some communities face cultural and language barriers that prevent them from accessing timely palliative care. To address this, Health Canada is supporting projects like an initiative to improve advance care planning to South Asian and Chinese populations in British Columbia.
Do you have any projects in Ontario as well?
4 p.m.
Acting Director General, Health Care Programs and Policy Directorate, Strategic Policy Branch, Department of Health
At this time, we have projects that are being planned but we do not have any other projects in Ontario to address populations like those in B.C. I can't say anything further at this point.
4 p.m.
Liberal
Sonia Sidhu Liberal Brampton South, ON
How much funding will be provided to stakeholders to support the implementation of the framework on palliative care in Canada?
4 p.m.
Acting Director General, Health Care Programs and Policy Directorate, Strategic Policy Branch, Department of Health
The $13 million that Marcel mentioned in his remarks is targeted funding that goes to national stakeholders across the country to implement palliative care activities.
4 p.m.
Liberal
Sonia Sidhu Liberal Brampton South, ON
What role do public awareness and education play in improving access to palliative care in Canada?
4 p.m.
Acting Director General, Health Care Programs and Policy Directorate, Strategic Policy Branch, Department of Health
Could you repeat the question?
4 p.m.
Liberal
Sonia Sidhu Liberal Brampton South, ON
What indicator will be used to measure progress towards the implementation of the framework on palliative care in Canada and Health Canada's action plan on palliative care?
4 p.m.
Acting Director General, Health Care Programs and Policy Directorate, Strategic Policy Branch, Department of Health
We are planning a series of indicators to address the action plan and how it's being implemented. We expect those to be available in fall 2020. There is also a parliamentary review that will require a report on palliative care in June 2020. Also Bill C-277 requires the minister to provide a follow-up report on palliative care in December 2023.
4 p.m.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Can you elaborate on how this money is being used by provinces and territories to improve access to palliative care in Canada? I know that, through budget 2017, the Government of Canada is investing $6 billion over 10 years for home care. As you said, 15% of people don't have access.
How are we doing this to support palliative care in Canada?
4 p.m.
Acting Director General, Health Care Programs and Policy Directorate, Strategic Policy Branch, Department of Health
Can I turn that to you?
4 p.m.
Associate Assistant Deputy Minister, Strategic Policy Branch, Department of Health
Sure.
As part of the “Common Statement of Principles on Shared Health Priorities”, provinces and territories were given a menu of potential areas they could invest in, in the area of home and continuing care, to improve the integration of home care with primary health care, to better support caregivers in terms of caring for people who are in the home, to strengthen the delivery and access to palliative care delivered in the home or the community, and also to address infrastructure challenges for home and continuing care, including hospices.
Provinces and territories are using federal monies for home care. It's $6 billion for projects in each of those areas. They had the choice about which of those four areas—or all four of them if they would like—to invest federal dollars in, and they're doing that. They have submitted to Health Canada their action plans, which detail exactly how that money is being allocated.
4 p.m.
Liberal
Sonia Sidhu Liberal Brampton South, ON
If someone wants information, I think having 24-7 access to health care is the best thing. We heard that Prince Edward Island is doing something, and B.C. is doing something. Why isn't the same thing happening in every province? Why are there differences?
4 p.m.
Associate Assistant Deputy Minister, Strategic Policy Branch, Department of Health
As in any area like this, where there's tremendous potential to expand service delivery and often inadequate resources generally to go as far as everyone would like them to go, you see really innovative projects and initiatives being started in different parts of the country and being scaled up elsewhere. I think this is what's happening here. Jurisdictions are starting up new projects. They are evaluating them carefully, and when they are shown to have a lot of value in improving access or efficiency in care delivery, then they are taken up by other jurisdictions and scaled up across the country.
We have national organizations that help to do that work with jurisdictions, including the Canadian Foundation for Healthcare Improvement, the Canadian Partnership Against Cancer, and others that are really trying to facilitate that scaling and spreading of good initiatives.
4:05 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you, Mr. Chair.
Ladies, Mr. Saulnier, welcome.
In the 2015 report “Access to Palliative Care in Canada”, an insert states that Canada ranks 11th in the international quality of death index.
First, could you explain to me what the quality of death index is?
4:05 p.m.
Senior Researcher, Health System Analysis and Emerging Issues, Canadian Institute for Health Information
Actually, this index was not created by the Institute, but by researchers at the Economist Intelligence Unit. The researchers used available data and developed a series of indicators to rank countries in terms of palliative care. They looked at whether countries had a national policy framework on palliative care. When they created the index in 2015, there were none.
They also looked at such factors as government investment in health care, resources for targeted training in palliative care, the availability of subsidies to support families and reduce the burden on informal caregivers, as well as access to opioid analgesics.
Various measures were available at the time. Since 2015, the situation has changed somewhat. As regards international comparison, I know that the OECD is interested in it. All developed countries have aging populations and palliative care is becoming an increasingly important issue.
I think there will be work to do in the future to improve international comparisons in palliative care.
4:05 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
What makes Australia and New Zealand stand out? What are their practices?
4:05 p.m.
Senior Researcher, Health System Analysis and Emerging Issues, Canadian Institute for Health Information
A number of the countries that stood out had placed a great deal of emphasis on a national strategy. Canada is a more decentralized country in terms of care delivery. Having a national strategy earned those countries many points.
4:05 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
It doesn't necessarily mean the care is better or worse. The quality of life of a dying person criterion is not related to this. Action taken and care delivery are not fully measured. They are very difficult to measure, aren't they?
4:05 p.m.
Senior Researcher, Health System Analysis and Emerging Issues, Canadian Institute for Health Information
International comparison is always a challenge. Again, this is a report from the Economist Intelligence Unit. I am not very familiar with the methodology that was used, but it provides a starting point.
4:05 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
Your report is quite complete and contains some very surprising data. For the past 50 years, palliative care has been identified as the gold standard for dying with dignity. Many industrialized or wealthy countries have not been able to provide access to palliative care, generally speaking.
What are your main recommendations? What needs to be done to ensure that, in 2020, we are at the forefront of making palliative care more accessible?
4:10 p.m.
Senior Researcher, Health System Analysis and Emerging Issues, Canadian Institute for Health Information
Is the question for me or for Health Canada?
