Can you hear me now, Dr. Dumont?
Evidence of meeting #45 for Health in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was point.
A recording is available from Parliament.
Evidence of meeting #45 for Health in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was point.
A recording is available from Parliament.
1:45 p.m.
Medical Director and Family Physician, Lu'ma Medical Centre
I can hear you now, yes.
1:45 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Mr. Chair, I'm wondering if I could have that time back.
Dr. Dumont, I was asking if you could perhaps describe in a bit more detail what impact you've seen on your patient population, namely urban indigenous people, over the course of the pandemic.
1:45 p.m.
Liberal
The Chair Liberal Ron McKinnon
Mr. Davies, I did stop your time for you to re-ask the question. I will start it again now.
1:45 p.m.
Medical Director and Family Physician, Lu'ma Medical Centre
I very much appreciate the opportunity to answer that question. It's been an exceptionally difficult time for our patients, especially for indigenous people living off reserve. I do work as well with the Musqueam First Nation doing on-reserve primary care. I think the pandemic has been especially difficult for indigenous people off reserve, because they haven't had the same opportunities to safely stay home and safety quarantine. Many of our urban families are living in very crowded environments. This shows up in the data. We've seen higher rates of infection, higher rates of hospitalization and higher rates of death among indigenous people living off reserve. I believe that's all across Canada, but it's certainly true here in B.C.
I'm sure the committee is aware of the recent “In Plain Sight” report in B.C. It's a report into indigenous-specific racism in the health care system here in B.C. This is certainly not a situation that's unique to B.C. Health care spaces are in general a very difficult place for indigenous people to access at a baseline. There is, unfortunately, still very much a culture within health care spaces that is very toxic and not very welcoming for indigenous people. Many of us don't have a sense of safety walking into these environments, be it a walk-in clinic, an emergency room or a community health centre to seek the care we need. Add to that the burden of the pandemic and the difficulties of accessing care safely from an infectious disease point of view, and it's meant that a lot of our patients are even further isolated from the care they need.
I would say that it just further increases the need for centres like ours to be able to provide that culturally focused care, that safe care. The majority of our health care providers are indigenous. The ones who aren't are very strong allies who have had cultural safety training and have developed those trusting relationships with our patients too. We've been doing certainly more virtual care and trying to do more safe outreach care to our patient population. We are working very hard to vaccinate as many people as we can in the community. Certainly, it's been an exceptionally difficult time over the last 15 months.
1:50 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you.
Dr. Dumont, you used the term “culturally informed” care. I'm wondering if you could describe to us a little bit more what you meant by that.
1:50 p.m.
Medical Director and Family Physician, Lu'ma Medical Centre
I used the term “culturally safe” care. The reason I mention cultural safety specifically is that it places the interpretation of and sense of safety from the patient's point of view. That's a very important distinction. We've talked in the past about cultural competency as a concept of learning about some of the historical factors that affect indigenous people accessing care. That competency is a necessary component to that education for all health care workers, but it's not complete.
Again, cultural safety is a concept that takes that a step further and places the perspective more on the patient's side as far as how they feel in that interaction. It basically means that we have a responsibility as health care providers to make sure that the interactions we have with our patients, the procedures we conduct and the care we provide are all done in a manner that, first of all, helps the patient feel safe, feel cared for and feel free of discrimination. It's a place where they feel they can build trust.
We spend an enormous amount of time, especially early in our interactions with patients and their families, on making sure that it is a safe space and on building those trusting relationships off the start so that they have that sense of trust coming to the health care system. We see that as fundamental. That relationship really is the intervention at the beginning, when we're getting to know them.
1:50 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
I know that historically we have had a very physician-based care model. I think we're now increasingly aware of the importance of allied health professionals to provide a whole approach to patient care.
At your clinic, you have incorporated some novel and creative uses of people like elders and uses of indigenous traditions and ceremonies as a way of treating people with mental health issues, I think. Can you maybe elaborate a little bit on your clinic's experience with that?
1:50 p.m.
Medical Director and Family Physician, Lu'ma Medical Centre
Absolutely. We partner with indigenous elders and traditional healers. They are part of our team. They are hired on and are full members of our team. We know from patients themselves and their families, but also from research, that the inclusion of elders on primary care teams improves mental health outcomes, not only subjective scores in terms of depression and anxiety going down but also a reduced risk for suicide and a reduced risk for involvement in the criminal justice system. There are a number of benefits.
Just from a staffing point of view, it's made an incredible difference in terms of how we provide our medical care.
1:50 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. Davies.
That wraps up our round of questions. I think we have a couple of minutes for a quick snap round, if people are interested. There's not very much time, so let's give one minute per party, and I believe we would start with Mr. Barlow.
Mr. Barlow, go ahead please for one minute.
June 18th, 2021 / 1:50 p.m.
Conservative
John Barlow Conservative Foothills, AB
Thank you very much, Mr. Chair, and I'll be fast.
Mr. Chandra, I was surprised with the words that you used regarding the border closure. There's one thing I wanted to ask you. You were talking about this being baffling and bewildering, but in the supplementary estimates the Liberal government is asking for an additional billion dollars, with a “b”, for hotel quarantines. They've already spent $225 million.
Do you think it is a good investment to continue these hotel quarantines for an unspecified amount of time, if we shouldn't even have the border continue to be closed?
1:55 p.m.
Prof. Ambarish Chandra
It's absolutely not a good investment.
1:55 p.m.
Conservative
John Barlow Conservative Foothills, AB
You also mentioned the fact that if we're not going to open the border now, why bother opening it at all? I thought that was interesting.... It may never be open. Can you elaborate on that very quickly, if you don't mind?
1:55 p.m.
Prof. Ambarish Chandra
I realize now that it's easy to impose these restrictions and very difficult to lift them, but let's take the example of Australia. They've had borders closed since the start of the pandemic and now they're saying they're not going to open them at least until the middle of next year.
We'll see what effect that has in the long run in Australia, on the universities and their tourism sector and all of that, but I hope we don't treat the border so casually here. We just can't afford it.
1:55 p.m.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. Barlow.
We'll go now to Dr. Powlowski for one minute, please.
1:55 p.m.
Liberal
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Thank you.
Dr. Silverman, as you may know, I think 70-something of us members of Parliament recently signed a letter supporting the idea of waiving intellectual property rights related to COVID. This is being done at the WTO level.
Can you comment on that and what you think of the importance of that globally in trying to manage the pandemic?
1:55 p.m.
Chair and Chief of Infectious Diseases, Western University, As an Individual
I think it is the right thing to do. I think the experience from the HIV epidemic is that intellectual property rights really slowed the delivery of antiretrovirals. We do have large production facilities at several places in the developing world that could ramp up if intellectual property rights were waived. There can be mandatory licensing. This should not affect the companies because they can be produced for distribution in the developing world exclusively at cost.
There can be, with mandatory licensing, some compensation to the companies. It's the right thing to do and it would protect us by having rollouts in countries that, for the foreseeable future, will not be able to pay the market price for these vaccines.
1:55 p.m.
Liberal
1:55 p.m.
Bloc
Sébastien Lemire Bloc Abitibi—Témiscamingue, QC
Thank you, Mr. Chair.
I'll turn back to Mr. Lamarre.
On February 16, exactly four months ago, you testified before the Standing Committee on Industry, Science and Technology.
I asked you a question about the pitfalls to avoid. You responded that we shouldn't focus on a limited number of technologies based on individual concerns that aren't part of a global vision, and that we also shouldn't focus solely on the vaccine development chain without maintaining a strong basic research capacity.
We know that messenger RNA technology was developed through basic research over 40 years ago and that this technology is saving us today.
Have things changed on the ground in the past four months? Is the government keeping its promises?
1:55 p.m.
Full professor, Institut national de la recherche scientifique, As an Individual
Things are starting to move.
There have been individual investments in some small‑scale biotechnologies or pharmaceuticals. We've started to see the benefits. In Quebec City, Medicago is now conducting its phase 3 clinical trials. Other technologies have also received financial support in British Columbia and Alberta, for example.
However, much more investment is needed. I estimate that the Canadian Institutes of Health Research, or CIHR, budget for basic research should be doubled over the next 10 years.
1:55 p.m.
Bloc
Sébastien Lemire Bloc Abitibi—Témiscamingue, QC
Do you feel that a long‑term vision is currently being established?
1:55 p.m.
Full professor, Institut national de la recherche scientifique, As an Individual
I don't feel that way—