Health Committee on April 26th, 2021

[The Chair, Liberal, Ron McKinnon]

I call this meeting to order. Welcome, everyone, to meeting number 32 of the House of Commons Standing Committee on Health. The committee is meeting today to study the emergency situation facing Canadians in light of the COVID-19 pandemic, specifically, today, examining the collateral effects of the pandemic.

I would like to welcome our witnesses.

We welcome Dr. Louis Perrault, cardiac surgeon and president of the Association des chirurgiens cardiovasculaires et thoraciques du Québec.

With Blue Door Support Services, we have Michael Braithwaite, chief executive officer. With Huntington Hills Community Association, we have Rick Lundy, general manager, and with S.U.C.C.E.S.S., we have Queenie Choo, chief executive officer.

We will now invite the witnesses to give their statements.

Dr. Perrault, you have the floor for six minutes.

[Dr. Louis Perrault, Cardiac Surgeon, Montreal Heart Institute, and President, Association des chirurgiens cardiovasculaires et thoraciques du Québec]

Do you want this in English or in French, or does it matter?

[The Clerk of the Committee, Mr. Jean-François Pagé]

You can speak in the language of your choice, because we have the interpretation service. You can speak French if you want.

[Dr. Louis Perrault]

I am also comfortable speaking in English.

Let's do it in English.

Thank you for having me at this meeting.

As the chair said, I'm the president of the Quebec association of cardiac surgeons. I've been there for three years. I have been a practising surgeon at the Montreal Heart Institute for the last 25 years.

This is not going to last six minutes, but obviously I'll be open to questions.

Having a quarter-century perspective on the health system, I can diagnose accurately what happened during the pandemic, especially with non-COVID patients with cardiovascular disease.

What we saw in the beginning was that a lot of room was made in case the hospital system became overloaded. For many weeks and months, patients were not operated on at the normal rate. Emergencies were basically the only kinds of operations we did. This had a consequence on our waiting lists.

Most of the hospitals in the province of Quebec have waiting lists. We try to have a percentage of patients outside of acceptable delays within lower than 10%. This is a calculation based on safety. If this is greater than 10%, we're taking chances, because it's very hard to predict what's going to go on with cardiovascular disease.

During the pandemic, even though we weren't at 10% before but most likely around 20%, the percentage of patients outside of acceptable delays for surgery rose to 40%, and sometimes 45%. This is basically playing Russian roulette. Oncology is important, but in cardiovascular disease we're fighting against sudden death and sometimes it's very hard to predict the course of the disease. This is one of the points I've made: a very large increase in the number of patients outside of acceptable delays.

The second thing is that patients not having access to cardiovascular care meant that some of them waited and waited at home, and then showed up at the hospital in an unstable situation, in a worse position than they would normally have been in. What happens in those cases is that they obviously have more complications and they stay longer in the hospital if they survive. This brings about greater resource utilization and less room for other patients, including COVID patients in the ICUs, and so on.

The third consequence is that, again, patients not having access to diagnostic procedures show up at a later stage, they have more severe disease and their chances of recuperation and, for example, going back to work are lessened. Normally they would have come in with a mild heart attack, but if they come in with a more severe one, they lose function and they become heart failure patients. They become a burden for our system that would not have happened had they been treated promptly with the right timing.

Some of the problems we're raising now on the long-term consequences of the pandemic are chronic problems related to underfunding, at least in the cardiovascular arena. Definitely there's going to be a backlog of operations. In that, I'm thinking of heart surgery but also cardiology, because these are the same patients. I believe we have to react urgently and consider long-term investments, because some of the problems we are facing right now have been going on for 20 years or more and have never been addressed properly.

Are there any questions?

[The Chair, Liberal, Ron McKinnon]

Thank you, Doctor.

For our next witness statement, we'll go to Blue Door Support Services.

Mr. Braithwaite, please go ahead. You have six minutes.

[Michael Braithwaite, Chief Executive Officer, Blue Door Support Services]

Thank you very much for the opportunity to speak with you today.

My name is Michael Braithwaite. I'm the CEO of Blue Door, an agency that's been working for close to 40 years to take care of our most vulnerable through housing help and employment initiatives in York region.

When COVID-19 hit our sector, in order to stay safe we had to lower capacity, which meant we were serving fewer people in need. While the pandemic has hit everyone really hard, it's been especially hard on our region's most vulnerable, and we knew we had to respond. From talking with some of the seniors we support and the families, we knew that they were afraid for their health and wellness and were unsure of the future, and many of them still are.

With the help of the provincial and federal funding our region received, we were so fortunate to work with the extremely talented and hard-working team in our region, as well as our amazing community partners—one of which is 360°kids, and you'll hear from Clovis today—to quickly build solutions to house and support those in need, and we had to move fast.

One example of that, actually, is that we were able to repurpose a Parks Canada home that had been vacant for a number of years. Shortly, it will house two families with long-term, affordable and supportive housing, again, past the pandemic and into the future. As well, we were able to repurpose spaces in our current emergency housing space to regain capacity and add new supportive housing for senior men.

There is a lot to celebrate in our sector moving forward, but there's still much work ahead. A lot of people are still hanging on, but as they use up the last of their savings, they're going to have to make a choice between food and housing, a choice that no Canadian should ever have to make.

We need to work hard and invest in preventing people from experiencing homelessness with investments in income supports and building new and deeply affordable housing with supports. I say “deeply affordable”. A definition of affordable right now is 80% of market value, and that's far too high for many people experiencing homelessness.

We also must make sure that our most vulnerable have easy and quick access to health care, an important part of helping people experiencing homelessness acquire and retain housing.

Lastly, we must push forward on the need for a housing strategy for Canada's urban, rural and northern indigenous people, something that was missing from our most recent budget.

We have seen during the pandemic how quickly our sector can move if provided with the right supports in a timely manner. We saw how thousands were housed really quickly, something that normally would take us years and years. We did it quickly by acquiring hotels and being innovative, working together to make sure that people had housing.

We urge the government not to lose this momentum and to keep building on it moving forward. We're grateful to the federal government for its continued support and for its pledge to end homelessness by 2030. It's shown us the political will and has provided us with the resources to keep our most vulnerable safe for the long term.

On behalf of Blue Door, our region and our country, I will say that we're truly grateful. We're excited about the possibilities for new and affordable housing as we move towards a country where everyone has a safe place to call home, as everyone should.

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Braithwaite.

We go now to Huntington Hills Community Association.

Mr. Lundy, general manager, please go ahead, sir, for six minutes.

[Rick Lundy, General Manager, Huntington Hills Community Association]

Thank you very much for having me today.

I'm here representing four different organizations. I'm the general manager of Huntington Hills Community Association. I'm president and founder of Minds Over Matter mental health society. I am founder of Open Arms patient advocacy society, and I'm the president of Mothers Against Drunk Driving in Calgary.

The first area I would like to talk about is in the community, and that's with Huntington Hills. We at Huntington Hills are an outlet for many human service areas—we were up until recently. We had a lone parent network, a parent link and a north central resource centre for all of the north of Calgary. In these programs we help families, especially single parents, find the resources they need and to get tools and go through programs to be the best parents they possibly can. For homelessness, homeless and low-income individuals in northwest Calgary, we help them get the resources they need for the basics of life. We also have a school care program here, so we deal with a lot of the little ones in society as well.

Our mental health organization is called Minds over Matter mental health. We deal with seniors, cultural groups, businesses and organizations and children and youth.

I am the president of Mothers Against Drunk Driving, and I have been for the last couple of years. We bring awareness to drinking and driving as well as preventative measures to stop or slow down impaired driving and victim assistance for those individuals who have been affected by drinking and driving as well.

Looking at what COVID has done in the community, here at the community association we deliver food and basics to single moms and seniors. I've had first-hand experience dealing with seniors. The thing I can say first and foremost is that many seniors have talked as I'm delivering their food—because I've done it myself—of the fear of not knowing how they're going to get their next meal and the fear of not knowing how or when they're going to get the resources they need to survive. A lot of these seniors don't have any other family or friends to do it. They're relying on a community association to deliver food.

The second thing is the lack of resources. In dealing with these three human resources that we did, the biggest problem was connecting people with food banks. I had one individual come in, and he was from Africa, just new to the country, and he had no food or diapers for his family. We had to try to find resources for him. Unfortunately, during COVID, those resources weren't even open. He phoned me back and he commented on the fact that he left messages at the numbers we had given him, and nobody got back to him. There was a huge concern, not only about getting individuals these resources but also the accessibility wasn't there. There was a lot of fear in those individuals as well.

Going into the mental health organization dealing with seniors, my specialty is seniors within this organization. In talking to these seniors, I know there is a fear of COVID. They're in the last years of their lives. They've been isolated. The isolation for seniors has been a huge problem as well. Pre-COVID, 6.2 million Canadians suffered from mental illness in this country. The numbers going forward will be staggering as will accessibility, because the biggest problem in mental illness is the lack of accessibility within mental health and mental illness.

In regard to Mothers Against Drunk Driving, you would think, with all the restrictions that government has put in place, that impaired driving would be substantially down. It is a bit down, but it's insignificant. Alcohol consumption and cannabis consumption during COVID is on the rise. We work with the Calgary Police Service, and the concern post-COVID is going to be impaired driving, because people have been sitting in their houses. That's going to be a bigger problem than it was before.

People are still drinking, and people are still driving. The amount of alcohol and cannabis consumption has actually increased. We just had a case last week of a 38-year-old who was drinking and driving and killed somebody. We're very concerned about where this is going.

Looking at the problems in the community, they're vast. We're an organization that knows the resources and understands the system, and we're having trouble accessing the system to get help for people in all the capacities that I mentioned earlier.

COVID has been devastating to this community, the community of Huntington Hills, which is in northwest Calgary. It's been devastating in terms of the mental health and mental illness that we're seeing, and I just don't know where this is going.

We had an economy that was challenged. Then we had COVID, and the accessibility of getting mental health resources for anybody—children, youth, seniors, single parents—is horrific. I feel very badly for individuals who are trying to get that help because it's just not accessible.

Thank you, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Lundy.

We'll go now to Ms. Choo.

Please go ahead. You have six minutes.

[Queenie Choo, Chief Executive Officer, S.U.C.C.E.S.S.]

Thank you very much.

My name is Queenie Choo, and I'm the CEO of S.U.C.C.E.S.S.

S.U.C.C.E.S.S. is one of the largest social services agencies in British Columbia, serving new Canadians, seniors and those in affordable housing. Thank you for inviting me to present to the committee today.

I am pleased to join you from the unceded territories of the Coast Salish peoples, including the territories of the Squamish, Tsleil-Waututh and Musqueam nations.

The COVID-19 pandemic continues to have an impact on S.U.C.C.E.S.S. and the community we serve. As a non-profit social service agency, we quickly pivoted our services to meet the evolving needs of our communities. For example, this includes offering supports to newcomers to navigate government benefits and systems; coordinating teams of volunteers to support seniors with grocery shopping, meal delivery and virtual phone visits; and of course, ensuring that seniors who reside in our long-term care homes remain safe and healthy.

We have also seen the impact on immigrants and racialized communities. Many are working on the front line as essential workers, often in multiple and low-paying jobs with less job security, which puts them and their families at higher risk of COVID-19. In addition, we have also seen a rise in anti-Asian racism. Recent research by Insights West indicates that 43% of Asian British Columbians have been on the receiving end of racism this past year. To be honest, the true number is probably much higher, as many people will downplay their experiences of racism and hate and will not report it. It is likely that many of you know family, friends, neighbours or co-workers who have experienced racism.

The dual pandemic of COVID-19 and anti-Asian racism has negatively impacted the health and well-being of immigrants and racialized communities. Many of the clients we serve at S.U.C.C.E.S.S., particularly Asian elders and women, are experiencing very real fears about their own and their loved ones' safety, not only from COVID but also from racism and hate. This has added to their stress and anxiety levels. We have received many calls from community members reaching out for support. At the same time, we know that there continue to be many community members who do not reach out for support due to stigma and language barriers.

There is so much work that needs to be done. I wanted to put forward a few thoughts for your consideration.

First, we need to acknowledge and examine the disproportionate impact of COVID on immigrant and racialized communities. To do this, we need to do a much better job of collecting race-based data in consultation with communities. We need to not only collect this data but also be open about how it will be used to make positive changes. My concern is always that we only collect data and it just sits in a report and nothing is done with it to make improvements to people’s lives.

Next, we need to do more work to understand the short- and long-term impacts of racism. While we all acknowledge that racism is a problem, not enough is done to truly understand the far-reaching and intergenerational impacts of racism on people's health and wellness. We need to adopt an intersectional lens so that we understand how racism intersects with xenophobia, classism, misogyny and other forms of oppression.

There needs to be more sustainable funding to support the mental health and wellness of immigrant and racialized communities and particularly for culturally appropriate supports. We receive significant demand for our helplines and counselling services. We need more funding to keep up with the growing demand.

This isn't going away after COVID, which is why I say sustainable funding and not just one-off supports. We need to prepare for the long-term impacts of the trauma from COVID-19 and racism, particularly for those who have been on the front lines of the pandemic.

We all know that long-term care homes have been significantly impacted by COVID. There is an urgent need to develop national standards for long-term care to ensure the health and safety of seniors who experience high levels of vulnerability. At the same time, we need to ensure that these standards are inclusive of the needs and experiences of diverse seniors by considering culturally appropriate care.

We also need to support the sustainability of social service organizations and the people who work in the sector. They are critical to the health of communities. Many organizations have stepped up to the plate, pivoted their services and, quite frankly, have gone beyond the call of duty to support high needs in the community, all while dealing with falling donation levels and underfunding, as well as staff burnout. We need to ensure not only that these social service agencies survive the pandemic but that they are supported to enhance their capacity in order to respond to new community emergencies.

Thank you for your time. I hope that these are some insights that can be shared for your consideration.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Choo.

Thank you to all the witnesses for your statements.

We'll start our first round of questioning at this point with Ms. Rempel Garner.

Please go ahead for six minutes.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Thank you, Chair.

I only have six minutes, so for my questions, witnesses, could you please keep your answers brief?

First, I'll start with Ms. Choo. Thank you so much for the work your organization is doing to combat Asian hate. If you do have recommendations on how the government could implement some of the recommendations you talked about, please table them with committee.

Briefly, Mr. Braithwaite, I know that your organization runs a program called “INNclusion” for 2SLGBTQ+ youth. I'm just wondering if you have any quick observations or would be willing to table to committee any specific recommendations on addressing safety for LGBTQ youth during this time, given that many of them can't shelter at home.

[Michael Braithwaite]

Thank you very much for the question.

I think it's just about providing appropriate and affordable supportive housing. That's what we've done with INNclusion.

INNclusion is a very inexpensive way to do it. The organization is actually renting a home in the community, and we're working with partners who have expertise to wrap the right supports around LGBTQ2S+ youth moving forward.

I think you're absolutely right. Many youth, including 2SLGBTQ youth, are staying at home in unsafe situations. We just need to provide more options moving forward. We have about 25% to 40% of youth who experience homelessness identifying as being from this community. We just need to open up more, and it has to not be part of another housing program because the supports are a little different and specialized.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Thank you so much.

The remainder of my questions will be for you, Mr. Lundy. You mentioned your organization and sort of went through the breadth and scope of it. I think there's a perception that our community in northwest Calgary is a big wealthy community with all these big trucks and stuff like that. Do you want to talk a bit about some of the things you've seen during the pandemic in our community in terms of the impact of both the pandemic and the economic downturn, as well as any recommendations your organization has for the federal government in terms of recovery and support?

I know that the community associations across Calgary have really had a hard time raising revenues. Many of them are on the brink of collapse because they don't have the ability to run events or programs as usual, but also, the ancillary services you talked about are being used more and more. I just wanted to give you a chance to expand on that.

[Rick Lundy]

Thank you for the question.

Our community association, like others, as was just commented on, has suffered greatly due to COVID. Most community associations are not-for-profit organizations. We had done very well, up until COVID. Since COVID, it has been very difficult to run a community association.

Secondly, I think the programs that we do.... Some of them, due to government cuts—provincial government cuts—we don't do anymore, but we still have people coming through the door and trying to get help. It's shocking, the number of people who have shown up at our door and are desperate, and in desperation are trying to get help—

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Do you want to talk a bit about the impact of the provincial cuts on your programs?

[Rick Lundy]

We ran these three programs for 20 years and helped thousands of people. Unfortunately, government has cut funding to our loan parent, parent link and north central programs. Because the government cut funding, people are coming to us and asking, “Where do we go?”.

We send them to other places, but unfortunately, the accessibility to those other places has been a big problem. People are not only desperate and fearful but they're really focused on getting help.

As was mentioned earlier, the disposable income in our area in northwest Calgary is not high. We have many low-income families, many rentals, and we were always desperate to find the resources needed for this demographic, but now it's even worse. When we send people to other organizations, due to the provincial government cuts, the doors are closed, or they're leaving messages three or four times.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Yes, and it's my understanding too that the programs that have been put in place to replace some of these have not been effective and don't actually reside in our community.

[Rick Lundy]

They do not. It's very frustrating because we help thousands of people, and because of provincial cuts, the provincial government is saying, “Hey, look at us, we've saved all this money.” The government is not giving the proper resources to this demographic at all.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

I know. Personally, I also find it very unfortunate.

[Rick Lundy]

It's very sad and heartbreaking.

As an individual, when we talk about mental illness, that aspect for us—for me—has been tremendous, knowing that at one time I had all these resources at the tip of my fingers.

I know the system better than most, because I deal with it in my mental health organization as well as my patient advocacy. I have trouble getting people the help they need. I can only imagine the horrific feelings and mental anguish of people who are low income or who have a language barrier and don't have the same accessibility as I do. They can't get the help.

It's about not being able to feed their families, not being able to pay their rent and not being able to do the basics that people shouldn't have to worry about.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Thank you, Mr. Lundy.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Rempel Garner.

Mr. Van Bynen, please go ahead, for six minutes.

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

Thank you, Mr. Chair, and thanks to today's witnesses for sharing their experiences with us.

I'm grateful for the opportunity to welcome Blue Door to this committee and to have its local perspective contribute to our study, so I'll be focusing my questions on Mr. Braithwaite.

At the last committee meeting, we started talking about homelessness in Canada, particularly during the pandemic. Blue Door has provided life-saving support and shelter for the vulnerable communities in York region for many years.

Michael, I congratulate you on the way you've been able to engage members of the regional government, convincing the police chief to sleep in cardboard boxes in the middle of the night. That kind of creativity has created a lot of community support.

Based on your experience over the last year, can you elaborate on the impact and the risks that homelessness groups have been experiencing, particularly with respect to a reluctance to seek out help out of fear of transmission? How are you able to cope with that?

[Michael Braithwaite]

Thank you. It's so nice to see you, Tony.

There's a lack of trust by people experiencing homelessness. There's not a lot of trust with systems to begin with. You'll see that with some vaccine hesitancy as well. There's a lot of fear in going into crowded spaces. Unfortunately, with emergency housing, emergency shelters, they're quite crowded sometimes. There's room sharing. There are spaces where they get together, where they eat, etc.

During the pandemic, of course, in order to stay safe, we had to have people eat in their rooms, which was social isolation. A lot of people would rather stay outside than be isolated for two weeks. We had fewer units.

We also had a transitional system—it was all for safety and made sense—where you'd have to isolate for 14 days, which was really tough, especially when you might have addictions or mental health challenges. You might have an alcohol withdrawal program or drug withdrawal program that you're working through, and you might not have access to that if you're isolated. It really opened up a lot of different challenges for people.

With regard to youth, there's a reason we have other types of separate emergency housing for youth, seniors, women. For youth to have to isolate with adults and families, they just weren't doing it. Youth weren't going inside. It wasn't a choice. They were just saying they were going to stay outside if that's the only possibility they had.

We did not end youth homelessness. We saw... I think it was 17% of youth accessing our transitional housing program to keep them safe.

The isolation piece is tough. There's a lack of trust and a lot of fear.

What we have to do is to be really innovative and creative, as we did with a vacant home in Rouge Valley park. Parks Canada has 44 vacant homes in Rouge Valley park in York region, and we can take those homes and make affordable housing for many years beyond this.

We did a 200 Doors campaign, where 10 organizations came together to work with landlords to see if we could access new rental properties. We were not looking for a break on rent but their being open to renting to vulnerable people. We really have to be creative in how we do that. It continues to be a challenge, but it's going to take innovation and creativity.

Also, we work with a lot of people to prevent them from losing the housing they have now, getting them—through the region—the rent supports they need so that they don't lose their housing and we don't have new people coming into homelessness.