Health Committee on March 12th, 2021

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Thank you.

Through the chair, this is an area that I was personally involved in for many years prior to being in politics. In fact, it was under the previous Conservative government that we saw some of the cruellest changes to public policy, which resulted in spikes of opioid overdose deaths, a lack of supportive care, a lack of compassion in drug policy and the criminalization of many people who use substances. We've been taking steady steps to reverse those trends over the last five years, including by making sure that we could support safer supply centres, invest in safer supply centres, invest in programs that allow for safer consumption and community-based treatment, and restore harm reduction so that those people who are struggling with substance use and addictions know that people actually care about them and want them to get better.

We're working with provinces and territories to explore legal options for harm reduction. In fact, the Province of British Columbia has written to me recently to explore decriminalization.

We're going to continue to be there for Canadians and their families. This is a public health crisis, as you point out. It's something that we must continue to do as we see families struggling all across the country with substance use issues.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

The next question is for General Fortin.

We now have four vaccines in Canada, each requiring a different logistical infrastructure. Can you please update this committee on how you are working with the provinces and territories, and especially indigenous communities, on the logistics?

[Major-General Dany Fortin, Vice-President, Vaccine Roll-Out Task Force, Logistics and Operations, Public Health Agency of Canada]

Mr. Chair, thank you for the question.

We've been working quite extensively over the last three-plus months on setting the conditions for effective rollout, which started in December. We continue to build this so that we have an effective increase in capacity and an increased ability to deliver and scale up from April onwards, when more vaccines become available, into the millions a week, as well as additional 8° vaccines as they get added.

This week, a culminating event occurred when we had an opportunity to bring together over 170 participants to discuss the level of readiness, and we'll pursue some of that through bilateral engagements in the coming days.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Sidhu.

We will now go to Mr. Thériault for six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

Welcome, Madam Minister.

From our previous conversations, I imagine you have an idea of what I'm going to talk about today. I know you're not in an easy position. In fact, it is difficult to convince a Prime Minister of Canada to invest in health transfers. It is also difficult to convince a Minister of Finance to be proactive and invest in health transfers. However, I am reaching out to you today. My goal in our discussions today is to reach out to you. You know that I am cooperative by nature, as I demonstrated during the discussions on medical assistance in dying. So, perhaps after our discussions, you will have additional arguments. I will try to give you some figures that will help you convince your colleagues.

In fact, it has been established before this committee that, before the first wave of COVID-19, the health networks in Quebec and the other provinces were already weakened because of chronic underfunding. The pandemic hit, but we were not ready. The networks became even more fragile, to the point that two groups of patients are now affected by COVID-19: those who actually have COVID-19 and those who do not have the disease. By that I mean the people who have been offloaded.

So far, I'm assuming everything is fine and we are still in agreement, because in order to solve a problem in medicine, you have to diagnose it first. That's what I'm trying to do with you.

Do you know how many people have been offloaded in this way? Do you know how many cancer cases were offloaded in the first wave?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Mr. Chair, I want to thank the member for his constant advocacy for investment in health care. It is actually an important—

[Luc Thériault, Bloc, Montcalm, QC]

Madam Minister, I'm sorry but there is no interpretation.

I was just asking you if you knew the numbers.

[The Chair, Liberal, Ron McKinnon]

Excuse me, Mr. Thériault.

We will wait and get the interpretation corrected.

Mr. Clerk, could you please advise?

[The Clerk]

It should be okay now.

[The Chair, Liberal, Ron McKinnon]

Monsieur Thériault, your time has been stopped.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Minister, do you have any idea of the number of undiagnosed cancer cases that were offloaded in the first wave in Quebec?

Since it is not your department that provides these services, you probably don't know. So I'll tell you: there were 4,000 cases of undiagnosed cancer. The Canadian Association of Radiologists told us at the end of October that 80,000 people were waiting for MRIs. For CAT scans, 52,000 people were waiting. So you can understand that we have a serious problem. Between the first and second wave, we were not able to treat all of those non-COVID-19 patients.

When we have to offload, it is because our networks are already “sidelined,” as they say. So, in light of this, don't you think the provinces and Quebec are quite right to say that now is the time to give them some hope to restore their networks and avoid having undiagnosed cancer patients end up in the mortality column next year?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

The Prime Minister has been very clear that he's open to speaking about increased health transfers when the time comes, but right now we're all focused on getting through COVID-19.

I think we've also shown, as a federal government, that we'll spare nothing to get Canadians and provinces through this. The $19 billion is no small amount. It was for testing, tracing and data and for safer long-term care homes, including $2 billion for schools to protect students in schools.

The investment for PPE and vaccines—

[Luc Thériault, Bloc, Montcalm, QC]

I'm sorry, Madam Minister.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

—pays for all of the equipment, including rapid tests.

[Luc Thériault, Bloc, Montcalm, QC]

Excuse me. I understand that you can give me the list of one-time investments.

Health transfers are important. We need to put the health care system back on its feet in a sustainable way. Front-line workers are completely exhausted. There is a shortage and people are falling in action.

We are currently at the budget stage. Provinces, territories and Quebec need to be able to budget for how they will be able to recover these non-COVID-19 patients and how they will be able to invest in their system. We need to do more. It's not just the one-time dollars you give that are important. It's the recurring dollars that need to be there.

Do you agree with that?

It's a matter of the right time, and the right time is not tomorrow. We need to get these patients back as soon as possible to avoid a collateral disaster from COVID-19.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I'll just repeat that the Prime Minister has been very open to increased health transfers, but the focus now does need to remain on getting through COVID-19.

We've been there for the provinces and territories, clearly, with billions of dollars, with equipment, with vaccines fully paid for by the federal government, with extra support to come in and support in crisis situations. We'll continue to be there for the provinces and territories, including Quebec.

[The Chair, Liberal, Ron McKinnon]

Thank you.

We will go now to Mr. Davies. Please go ahead. You have six minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you for coming to committee, Minister.

Minister, do you acknowledge that the federal government has the power under the Emergencies Act to establish vaccination clinics?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

The Emergencies Act doesn't have specific designated powers in that granular way, but certainly we do acknowledge that we have a role to play if the provinces and territories need that support. We've been preparing to backfill any kinds of needs they have around vaccination.

[Don Davies, NDP, Vancouver Kingsway, BC]

Subsection 8(1) of the Emergencies Act says:

While a declaration of a public welfare emergency is in effect, the Governor in Council may make such orders or regulations with respect to the following matters as the Governor in Council believes, on reasonable grounds, are necessary for dealing with the emergency:

Paragraph (g) of subsection 8(1) says: “The establishment of emergency shelters and hospitals”.

Is it your testimony that your power to establish a hospital under a public welfare emergency would not include a vaccination clinic?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

That's not what I said. I said there wasn't a specific reference to vaccination clinics, but I also said that I don't think we need the Emergencies Act, quite frankly, to support the provinces and territories. We haven't had to use the Emergencies Act to date. The provinces and territories haven't wanted us to use the Emergencies Act, to be clear, and we have felt throughout that collaboration and support for PTs—provinces and territories—has been the best way forward.

That is exactly what we're doing.

[Don Davies, NDP, Vancouver Kingsway, BC]

As we know and we all hope, I suppose, millions of doses of vaccine are anticipated to arrive in Canada. Leaving aside that it is a near certainty that some provinces and territories will have some degree of difficulty administering vaccines quickly, the more important fact is that vaccinating Canadians as quickly as possible saves lives.

In your words, you said you would consider helping with vaccinations should the provinces need support. Are you going to wait until problems emerge and Canadians can't get access to timely vaccines, or are you going to be proactive and throw the federal government as a full partner to supplement provinces to ensure that Canadians get vaccinated as fast as they possibly can?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

The federal government is a full partner. Let me remind the member that we have purchased all the vaccines, we have arranged for their transportation, we have delivered them to the provinces and territories, we've worked on the readiness plans, and we've gone through tabletop exercises. We are preparing federal backstops if the provinces and territories have any challenges whatsoever in vaccinating their population.

I'd like to turn to Major-General Dany Fortin, who could speak a little more about those details.

[Don Davies, NDP, Vancouver Kingsway, BC]

That's okay. I'd like to focus my attention on you, if I can.

Minister, again you're going to wait until the provinces have problems. Is that really the best way to deal with this situation? The Prime Minister talks about a team Canada approach. Well, team Canada without a captain is missing a major partner.

Why doesn't the federal government proactively get involved with the provinces and supplement them with federally funded vaccination sites? Do you think any provinces will refuse that? Will they disagree with their citizens having access to more vaccination sites so that they can get access to vaccines quicker?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

I think the member maybe doesn't understand what I'm referring to when I say full collaboration and support. In fact, let me just reiterate. We purchased the vaccines. We delivered the vaccines. We worked with provinces and territories to ensure they had readiness to set up those vaccines. We've supported augmenting their data systems. We've been there every step of the way. We will continue to be there.

Major-General Dany Fortin interacts with every single province and territory to understand how they are faring with readiness, and of course we'll be there.