Evidence of meeting #8 for Health in the 43rd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was ensure.

A video is available from Parliament.

On the agenda

MPs speaking

Also speaking

Theresa Tam  Chief Public Health Officer, Public Health Agency of Canada
Tina Namiesniowski  President, Public Health Agency of Canada
Stephen Lucas  Deputy Minister, Department of Health
Siddika Mithani  President, Canadian Food Inspection Agency
Catherine MacLeod  Executive Vice-President, Canadian Institutes of Health Research

3:30 p.m.

Liberal

The Chair Liberal Ron McKinnon

I call the meeting to order.

This is the eighth meeting of the House of Commons Standing Committee on Health. Today, pursuant to Standing Order 108(2) and the motion adopted by the committee on Monday, February 24, 2020, the committee begins its study on the subject matter of supplementary estimates (B), 2019-20, and of the mandate of the Minister of Health.

I am pleased to welcome our panel. We have the Honourable Patty Hajdu, Minister of Health. We have Ms. Catherine MacLeod, executive vice-president of the Canadian Institutes of Health Research. We have Dr. Siddika Mithani, president of the Canadian Food Inspection Agency. We are also expecting Dr. Tam and others, who are delayed. We will introduce them in due course.

I understand the minister has an opening statement.

Normally we have 10 minutes, but I understand from the clerk that you will be a bit longer than that, and I think that will be fine. Please go ahead, Minister, and thank you for being here.

3:30 p.m.

Thunder Bay—Superior North Ontario

Liberal

Patty Hajdu LiberalMinister of Health

Thank you very much, Mr. Chair.

Hello to all my colleagues from all side of the House. It's great to be here.

I will try to keep my remarks within the 10-minute allotment so that we have ample time for conversation, and I want to thank everybody for your thoughtfulness.

First of all, I am excited to talk about my mandate and to be here with my incredibly hard-working officials: Dr. Stephen Lucas, who just joined us as the deputy minister of health; and Tina Namiesniowski, who is the president of the Public Health Agency of Canada.

Also, arriving just as I am announcing her is Dr. Tam, who most of you should know and if not—

3:30 p.m.

Voices

Hear, hear!

3:30 p.m.

Liberal

Patty Hajdu Liberal Thunder Bay—Superior North, ON

Yes, go ahead and give these officials a round of applause because they have been working full out for Canadians for several months—well, obviously longer than that, but most intensively on the coronavirus for several months.

Catherine MacLeod, who the chair has already introduced, is the executive vice-president of the Canadian Institutes of Health Research, and Dr. Siddika Mithani is the president of the Canadian Food Inspection Agency.

Of course, as you all know, I will turn to them for more technical answers as necessary, but I think first it would be appropriate if we start our conversation with the coronavirus or the COVID-19 outbreak.

As you know, and as I have been saying for two and a half months, this is a situation that is very fluid. It has been evolving across the globe, and we see it is evolving very rapidly here in Canada as well. The number of cases in Canada and around the world continues to increase, and globally now there are more than 100 countries affected. I am sure you all saw that the World Health Organization has declared that this is a pandemic. However, that is not shocking to us because we have been acting as if it had this potential in the early days, and certainly over the last several weeks and months we've been working to prepare Canada for a worst-case scenario.

We obviously see rapid change globally and indeed as we see this week, in terms of new cases and the kinds of stories you're all reading in the newspaper, Canada is clearly not immune in the case of a global pandemic. In full disclosure, I spent nine years in public health, and pandemic and epidemic are always part of the conversation no matter what you do in a public health agency, but I think it's at times like these that we see how important it is to have a strong, coordinated approach to health care and public health in a country.

Public servants at all levels of government have been working extremely long hours to protect Canadians. I want to recognize them for their dedication and professionalism in the face of this international health threat.

I'll say it again in English because I think it's super important to repeat. This is the face of the leadership team that has been managing the coronavirus crisis, but behind them are hundreds, if not thousands, of health professionals who are working incredibly long hours with them. I am enormously grateful for the amount of work that people have been putting in on this issue to protect Canadians.

The Public Health Agency of Canada is working closely with provinces and territories to ensure there's a consistent, evidence-based approach to addressing this crisis. At the federal level, we're conducting national disease surveillance and providing guidance on public health measures.

I have weekly meetings with my provincial and territorial health counterparts. I have worked closely with health ministers of the most severely affected provinces on an as-needed basis. We have each other's phone numbers and we talk to each other as situations arise.

Our National Microbiology Laboratory is helping to confirm new cases of COVID-19 and conducting research to advance our understanding of the virus.

Last week I announced that the Canadian Institutes of Health Research is investing nearly $27 million over two years in coronavirus research. This investment will support research and diagnostic tools and candidate vaccines, as well as strategies to tackle misinformation, stigma and fear and to understand how this experience that we're all going through as a world, and particularly in Canada, will change our population's thoughts and behaviours.

That announcement has obviously now been surpassed by the announcement today of the additional $1 billion towards COVID-19 that will include a substantial commitment to additional research. It won't take us long to dispense that money to the incredible researchers we have across the country. One thing that I've been extremely proud of in being part of the Liberal government is investing in science, research and the capacity of researchers to rapidly begin trials and studies. In fact, the announcement today will ensure that the other great applications that we received will be able to move forward. I look forward to hearing more about that as those announcements come forward.

Ensuring access to vaccines and antivirals is a top priority. While there are currently no drugs specifically authorized to treat COVID-19, there are a variety of authorized treatment options that include general antiviral drugs that are being used to treat patients infected with COVID-19. Health Canada encourages companies and researchers with drugs that could be effective in the treatment to contact the department. Clinical trials can be authorized and established very quickly, particularly in urgent situations like this.

Health Canada is also leading federal workplace health initiatives to ensure regulatory preparedness and to provide occupational health and safety guidance to federal employees.

As Minister of Health, I'm focused on how this virus is affecting the health of Canadians and our health care system. However, there's more to it than that. The coronavirus 2019, or COVID-19, has already had a negative effect on the global economy. We must prepare for the possibility of a wide range of effects.

Last week the Prime Minister announced a new cabinet committee to oversee the federal response to COVID-19. This committee, chaired by Deputy Prime Minister Freeland, will ensure government-wide planning and proactive response to protect the health and safety of Canadians, to respond to impacts on workers and businesses, and to ensure that the government can continue to deliver its services to Canadians across a range of scenarios.

You can see by today's announcement that this committee is working incredibly hard and very quickly to ensure that we have those responses ready and available.

COVID-19 is a serious public health challenge, but we are working diligently to be ready. The government is working on all fronts to protect the health, safety and well-being of Canadians. We will continue to work with the provinces and territories, indigenous communities and leaders, businesses and community-level groups to minimize the health, economic and social impacts of this rapidly evolving public health issue. Of course, I will keep this committee informed of any new developments as they arise, as I have been doing with Canadians since the appearance of the virus.

Our response to COVID-19 illustrates the government's commitment to protecting the health and well-being of Canadians, one that I share deeply. While my mandate as Minister of Health is far-reaching and touches many important issues, obviously the coronavirus is taking an enormous amount of energy and time. I will reassure you that the other work is proceeding under the wise leadership of Deputy Lucas, and I appreciate the hard work of Health Canada to make sure that the items that are in my mandate continue to have a path forward.

As minister, I am leading the government's work to strengthen public health care for all Canadians. We're working towards a national universal pharmacare program so that Canadians can access the prescription drugs that they need without worrying about the cost. We've already strengthened our regulatory approach to pharmaceutical pricing, and this will help lower the prices Canadians pay for patented medicines and will make pharmacare more affordable. Budget 2019 provided support for Canadians who need access to high-cost drugs for rare diseases, as well as funding to create a Canadian drug agency, which will lower drug costs even further.

While access to medication is an essential element of health, Canadians must also have access to a doctor or a primary care physician when they need one. This is especially important when faced with an emerging crisis, as we are facing now. Our goal is to ensure that each and every Canadian has timely access to a family doctor or a primary health care team.

Because there can be no true physical health without mental health, we're working to set national standards for access to mental health services. It is incredibly important that Canadians have access to mental health services when they need them.

Canadians should also have better access to home care and palliative care. I'm pleased to say that we've made progress through the framework on palliative care in Canada and our supporting action plan, which aim to make home care and palliative care more accessible all across the country.

For some, having access to medical assistance in dying, MAID, is an important aspect of end-of-life care. As you know, a few weeks ago the Minister of Justice and I introduced amendments to the existing MAID legislation, and the proposed amendments are designed to make MAID more accessible to those who qualify for it, while ensuring that vulnerable individuals continue to be protected.

As Minister of Health, I'm also focused on addressing problematic substance use. As you know, Canada remains in the grip of a deadly opioid overdose crisis, one that has claimed the lives of nearly 14,000 Canadians since 2016. This crisis requires a comprehensive, compassionate and evidence-based response.

We must protect Canadians from lethally potent and illegally produced synthetic drugs, such as fentanyl. These psychoactive substances are now found in communities across the country and are the main cause of overdoses.

We must also tackle the root causes of substance use and addiction, such as mental illness, trauma and pain. This includes the experience of stigma, which unfairly marginalizes people and prevents them from getting help. Through our public education and awareness efforts, we are working to end the discrimination experienced by people who use substances to make it easier for them to get the care they need and deserve.

Managing the health risks that Canadians face doesn't stop at opioids. We continue to be concerned by the number of young Canadians who vape, and we've taken action to restrict the promotion of vaping products where it can be seen or heard by youth.

We continue to play an active role in mitigating the impact of drug shortages on Canadians, working closely with provinces and territories, manufacturers and others in the supply chain so that Canadians have access to the drugs they need.

We are taking action, both domestically and abroad, to address the growing public health threat of antimicrobial resistance. This year we will release the pan-Canadian action plan on antimicrobial resistance, which is being developed in collaboration with provincial, territorial and non-governmental partners.

My mandate also includes health promotion. This is an area I know quite a lot about as a former health-promotion planner. As part of this work, I'm collaborating with the Minister of Canadian Heritage to implement a pan-Canadian concussion strategy and to raise awareness for parents, coaches and athletes on concussion treatment. This includes the concussion protocol harmonization project, a comprehensive evidence-based approach to addressing concussions wherever they occur.

Canadians living with autism spectrum disorder have diverse and often complex needs. To address these needs effectively, we need to have everyone involved, from all levels of government to service providers on the front lines, to families. That's why we're working collaboratively with all of these stakeholders towards the creation of a national autism strategy.

Research is essential to the work in the health portfolio and is the foundation of our evidence-based approach.

Earlier, I mentioned our recent investment in coronavirus research. This is just one example of our commitment to understanding the health challenges that we face.

For example, budget 2019 provided $2.4 million over three years for research on plasma donation by men who have sex with men. This builds on ongoing efforts to reduce barriers to blood and plasma donation. We're also working to ensure that sex, gender and diversity factors are included in research initiatives and providing additional funding for grants to study issues that intersect with race, diversity and gender.

I'd now like to speak to the expenditure authorities of my portfolio.

If approved by Parliament, these supplementary estimates (B) will provide the health portfolio with an increase of $34.1 million in spending authorities. This represents an increase of 0.6%.

Let me begin with Health Canada, which has a budget of just under $2.7 billion. This will increase only slightly with the supplementary estimates (B), and we're not requesting any new funding at this time. However, some funds are being transferred from the department to better support government health priorities.

Next, the Public Health Agency of Canada is seeking voted authorities of $13 million and transfers of $1.8 million. This new funding will go towards initiatives that address a number of key priorities, including dementia, health challenges faced by black Canadians, the drug-overdose crisis, and health data collection for the Métis nation.

I will turn now to the Canadian Food Inspection Agency.

In 2019-20, this agency is expecting to receive an increase of $3.8 million. The funding will be used in part to lead a cluster of science-based departments and agencies in renewing the Government of Canada's science infrastructure. Funding will also go towards the planning and design of the new Centre for Plant Health in Sidney, British Columbia. This centre will conduct research into diseases affecting fruit plants and trees.

Finally, I'd like to talk about the Canadian Institutes of Health Research, or CIHR, which is proposing an increase of $15.1 million. Of this, $2 million in new funding will go towards the B.C. Women's Hospital and Health Centre, as part of a recently announced $10-million investment in research to eradicate cervical cancer in Canada. In addition, $12.4 million is being transferred to CIHR from the Natural Sciences and Engineering Research Council for the Canada research chairs program. This is a tri-agency initiative to attract and retain a diverse community of researchers.

Everything we do within the health portfolio is aimed at protecting the health and well-being of Canadians. We are committed to doing our job efficiently and effectively.

This includes working with the provinces and territories to strengthen the publicly funded health care system so that Canadians can access high-quality services. I look forward to working with this committee and with all my colleagues in the House of Commons to ensure that we keep meeting needs.

Thank you for the opportunity to speak to you today, and I'm very pleased to take your questions.

3:45 p.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you, Minister.

With that, we will go to our first round of questions, starting with Mr. Jeneroux, for six minutes, please.

3:45 p.m.

Conservative

Matt Jeneroux Conservative Edmonton Riverbend, AB

Thank you, Mr. Chair.

Thank you, Minister, and everyone here at the committee today.

I want to start first with you, Minister. We will continue to ask the tough questions in the House and here at committee, but you can absolutely continue to count on our support on this side of the table. You and I have had many personal conversations, and I certainly appreciate the opportunity to connect with you.

There are tough questions, though, Minister.

Right now, we're seeing a number of sports organizations—the NBA, the NHL—that are considering stopping events that have massive crowds. There are massive gatherings around the world where we're seeing that they are cancelling those events or crowd participation.

I was hoping that you could perhaps weigh in on when it gets to the point where the government, and essentially you and your team, stop these events, if that were the case here in Canada.

3:45 p.m.

Liberal

Patty Hajdu Liberal Thunder Bay—Superior North, ON

In a federation like ours, obviously we have a shared responsibility for those kinds of decisions with provinces, territories and local governments.

There are guidance documents for all planners, which are available on the Health Canada coronavirus website, with a link to the risk assessment tool. Those planners can work very closely with local public health units. Depending on the size.... Obviously provincial public health units are providing guidance. The federal government provides guidance, either as asked, to support those decision-making processes, or if there is a federal intersection, for example, if we funded the event, it's a federal event or those kinds of things.

The tool is quite comprehensive. It asks a number of questions around the kinds of participants and the set-up of the organization, and—

3:50 p.m.

Conservative

Matt Jeneroux Conservative Edmonton Riverbend, AB

Sorry, Minister. I don't mean to interrupt or to be rude. It's just that we're short on time.

As of today, the WHO has said, “we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction.” It has called for countries to take “urgent and aggressive” measures.

Has there been a discussion since the WHO's indication of the pandemic, in terms of large gatherings and events?

3:50 p.m.

Liberal

Patty Hajdu Liberal Thunder Bay—Superior North, ON

I will remind the members that we have been acting as if we were in a pandemic since the beginning. When we noticed the small cluster of illnesses in Wuhan, we knew that this was an issue of significant concern. Dr. Tam is an expert adviser on the World Health Organization committee that continually reviews the evidence. We have been having these conversations daily. In fact, we have a daily call to connect about the situation in Canada and what kinds of decisions we may be asked to make. I will also let you know that the decision around events is a shared one. It is a shared one with local.... You can imagine that local communities would be quite concerned if the federal government were to take those steps.

The decisions that we make are commensurate with the risk. That is why the risk assessment tool is so important. It provides a guidance to understand whether, for example, there is anybody with coronavirus in the community and whether or not the decision to cancel that event is commensurate with risk.

Dr. Tam, would you like to say a few words?

3:50 p.m.

Conservative

Matt Jeneroux Conservative Edmonton Riverbend, AB

Yes. Please, go ahead, Dr. Tam.

3:50 p.m.

Dr. Theresa Tam Chief Public Health Officer, Public Health Agency of Canada

The WHO did call this a pandemic today, but the key message is that all countries can still change the course of this pandemic by doing a number of things. I will go through them very quickly, but I believe we're already doing them.

First of all, they are asking countries to be prepared and ready, and we have been preparing since the beginning of this.

Second is to detect and then to protect the population, and to treat if necessary. I think the detection is very important. We have been setting up surveillance systems and laboratory testing since the start.

Third is to reduce transmission—maybe I will pause on that for a minute to talk about the mass gatherings—to innovate and to learn.

With regard to reducing the transmission, there's now this hashtag, which is #FlattenTheCurve. You don't want a pandemic to look like this, where it's inundating your health system. You want to flatten it and reduce transmission so that it goes down to a level where your health system can actually cope. This is where the individual case identifications that our provinces are doing right now are very important. They're identifying the cases, their contacts, putting them into isolation—

3:50 p.m.

Conservative

Matt Jeneroux Conservative Edmonton Riverbend, AB

Dr. Tam, I'm sorry to interrupt. I want to get back to that because that's certainly important, but knowing that I have only one minute left, I want to ask one more question, if I may.

We saw that the Prime Minister sent a letter to the premiers asking for a state of readiness. Obviously, we thought that would have happened earlier. Regardless, do we now have an accurate accounting of masks, beds, tests and ventilators that you, as head of the Public Health Agency, are comfortable with?

3:50 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. Theresa Tam

I co-chair the special advisory committee with the provinces and territories, and underneath is a logistics advisory committee. That committee has been gathering information from all jurisdictions, but it is up to each of the provinces and territories to define what they have and what their gaps and needs are.

Our role right now is to coordinate addressing those gaps, such as through bulk purchasing programs and so on, but they retain the actual numbers of what they have and tell us what they need further. I think that with some of the announcements this morning, there will be some support to go ahead with some of those purchases as well.

We account for everything, including PPE, lab supplies, ventilators and other equipment that jurisdictions might need.

3:50 p.m.

Conservative

Matt Jeneroux Conservative Edmonton Riverbend, AB

You're confident, though, that we have everything we need.

3:50 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. Theresa Tam

That's an ongoing assessment. This type of purchasing is not just one time. I think that with the evolution of the needs, some of the jurisdictions might say that they need some more of another thing. We're there to prepare, to be ready and to help with that purchase.

3:50 p.m.

Liberal

The Chair Liberal Ron McKinnon

Thank you, Mr. Jeneroux.

We go now to Mr. Kelloway for six minutes.

3:50 p.m.

Liberal

Mike Kelloway Liberal Cape Breton—Canso, NS

Thank you, Mr. Chair.

Hello, Minister. Hello, witnesses.

Thank you again for all the work you're doing on the coronavirus, but also for the other pressing work that you do on a daily basis.

Minister, a study of Nova Scotia health care reported that as of January 1, 2020, 40,000 Nova Scotians were in need of a primary health care team. Your mandate letter includes a commitment to Canadians that they'll have access to a primary health care team, something that will impact the communities I represent.

Can you update us on the progress of that commitment?

3:55 p.m.

Liberal

Patty Hajdu Liberal Thunder Bay—Superior North, ON

Thank you very much.

Coming from northern Ontario, I can tell you that.... I look at my colleague, MP Powlowski, who is a physician in northern Ontario and probably has more expertise than I do on what the demand is in northern Ontario, but it is certainly something that I hear at the door all the time. The struggle to access primary care is real, and it is more real in some parts of the country where there is a shortage of physicians or a shortage of primary care people.

It is at the front of everybody's mind. Obviously, we believe that every Canadian should have access to a primary care physician. I think a time like a coronavirus crisis or other kinds of public health crises drive home the importance of a public health care system that is accessible. The primary health care teams that we know are doing such a great job all across the country, obviously, feel very strongly as well that they need extra capacity to deal with the demand that people are saying they have.

This will require a partnership with the provinces and territories. As we have spoken about in responding to the coronavirus, everything we do in the health portfolio is in partnership with the provinces and territories. There's a jurisdictional responsibility for them to provide the care and for the federal government to be a partner in providing that care.

We have made significant investments, with close to $42 billion provided to provinces and territories this year through the Canada health transfer. That is a significant increase. It's nearly $10 billion more than what was provided in the last year of the Conservative government. They left office in 2015.

This is about stability, predictability and long-term funding that acknowledges the rising costs. We have an aging population, as you know. Things are more expensive. Salaries go up. We have to be reflective of the fact that costs rise, and we have to keep pace with those rising costs.

We're going to continue to work with the provinces and territories to reach that goal so that everybody has access to primary care. I'm looking forward to the innovation that's happening in this space all across the country. Many provinces are trying really neat things to deal with remote communities that have very poor access. As that develops, I will definitely come back and report more.

3:55 p.m.

Liberal

Mike Kelloway Liberal Cape Breton—Canso, NS

I'd like to change gears a little.

The wait times for mental health services in Cape Breton and mainland Nova Scotia—northeastern Nova Scotia to be exact—are around 300 to 424 days. That number grows each year, as mental health services become overburdened, while fewer doctors are available and even fewer services are offered.

Your mandate letter includes a commitment to standardize access across Canada for people to access these services, services that can take up to three years to access in communities in Nova Scotia. Again, this is something that is pressing on Cape Breton Island and in northeastern Nova Scotia. In the same vein as the first question, I'm just looking to get an update on where we are, particularly with mental health services, in relation to your mandate letter.

3:55 p.m.

Liberal

Patty Hajdu Liberal Thunder Bay—Superior North, ON

First of all, thank you for the very important question.

As far as we've come in terms of talking about mental illness, there's still such a huge stigma involved in talking about the fact that you, personally, might have struggled, or struggle, with mental illness or that a family member does, yet so many of us have a very personal story around mental illness, whether it's in our own family or someone else we love.

I want to acknowledge, first of all, how brave people are when they come forward and talk about that publicly and they share their story, because it actually empowers other people who are living with mental illness to share their stories as well.

It's important to remember that we've made the largest investment in mental health services in Canadian history, an unprecedented $5 billion over 10 years to the provinces and territories. It specifically targets improving the mental health services that the provinces and territories provide.

As you said, we're going to keep working on setting national standards, because what we know is that where you live oftentimes determines the quality of care you get or the variety of services you receive. As someone who has worked extensively in this area, I can tell you that it's incredibly important to me that people have access to services that meet their specific needs.

We know that oftentimes we can get acute services or maybe not preventative services, or vice versa, depending on the community. Those standards are going to be very important because it will give Canadians reassurances that, no matter where they live in the country, they will have access to services that are equivalent to the access of people who live in another part of the country.

I will come back and report to you on how we proceed. I'm looking forward to the meeting shortly with my provincial and territorial counterparts, where we'll get an update from them on the work they're doing on those standards.

Thank you.

4 p.m.

Liberal

Mike Kelloway Liberal Cape Breton—Canso, NS

Thank you so much. We look forward to that update.

4 p.m.

Liberal

The Chair Liberal Ron McKinnon

We go now to Monsieur Thériault.

Mr. Thériault, you have the floor for six minutes.

March 11th, 2020 / 4 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

Thank you, Mr. Chair.

I want to welcome everyone. Thank you for being here.

Minister Hajdu, you spoke of medical assistance in dying and the coronavirus.

During a study that we started on palliative care, experts came to tell us that palliative care—which falls under the jurisdiction of the provinces, including Quebec—should be provided in a somewhat more integrated fashion than what we call “curative” care. Furthermore, if we act proactively, we could implement palliative care quickly, so that people would have more access to it. Providing this care in the home would also create significant economies of scale.

This implies that health care providers must have the necessary funding to do their job.

You also announced funding today for the fight against the coronavirus. The Council of the Federation and Quebec have been asking the federal government for some time to restore the percentage of health transfers to 25% over ten years—it's really no big deal—but we aren't headed in that direction.

If the federal government had progressively increased health transfers starting in 2015, we would have already had $4 billion to deal with the coronavirus and to provide better home care, including palliative care.

Do you plan to increase health transfers?

4 p.m.

Liberal

Patty Hajdu Liberal Thunder Bay—Superior North, ON

I want to thank my colleague for the question.

It's a very good question, and I think it's comprehensive in that it, first of all, addresses the need to invest in health care on a regular basis. That addresses the rising cost of care, and I mentioned in my last response that this is exactly our intention. It's $49 billion this year, a significant increase, and that was specifically to help public health care start to adjust to the increasing costs all provinces and territories are facing.

I had an opportunity to meet with Minister McCann on Friday, and she is pleased with the work we're doing and looks forward to further conversations about how we could ensure that health care is strong and robust in Quebec as well as all across the country. As part of that, I think you're absolutely right. I think we take for granted, sometimes, the public health care system we have. Then, when there is a crisis like coronavirus, we realize that we should not be attacking, for example, local public health, which has been the case in Ontario, and things that are extremely useful in protecting the health of Canadians.

We will continue to make those investments and we will continue to work with the provinces and territories on escalators that are responsible and that meet the needs of Canadians. I'm looking forward to the meeting with my colleagues about transfers very shortly, in early May.

I will also say, in terms of home and palliative care, that there was an additional $11 billion directly funded to provinces and territories over 10 years for home and community care, and that includes palliative care. We know there's always more to do, and we know that better palliative care is something we hear about all the time. I certainly think this is an important step forward in that work.

4 p.m.

Bloc

Luc Thériault Bloc Montcalm, QC

You're aware that the system costs amount to 5.2%. The funding must be increased over a number of years if we want to reach that 5.2%. This would help us provide that care.

I'll now speak of the coronavirus in more detail.

You said earlier that, from the start, you've managed this crisis as if it were a pandemic. With all due respect, I doubt this very much.

Money can always be provided to help Quebec and the provinces manage the situation. However, the federal government must—and this falls under its jurisdiction—protect the public, properly identify cases and determine any restriction measures, particularly at the borders.

In that respect, the news isn't necessarily good, based on what we're hearing from the customs workers. Will you tighten up these measures?

Your current approach is to inform people and let them decide what they must do in terms of good practices to protect themselves.

When will the Public Health Agency of Canada take responsibility for tightening up screening measures and send clear guidelines to the Canada Border Services Agency officers working at the border?