Evidence of meeting #103 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was access.
A recording is available from Parliament.
Obstetrician Gynaecologist, St. Michael's Hospital, Toronto, As an Individual
I actually don't believe that it is currently available in Atlantic Canada, but it should be.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
I think it is in Halifax, but that's okay.
To you, Dr. Simpson, if I could, for the benefit of the analysts and Canadians watching, could you give a few examples of the disparities between male-related and female-related surgeries and the pay inequities? I think that would be very helpful.
Obstetrician Gynaecologist, St. Michael's Hospital, Toronto, As an Individual
Sure. Building on some research that we had done previously, a group recently looked at procedures across Canada and the remuneration for procedures that are more commonly performed on male patients compared to female patients. These would be things like a hysterectomy compared to the removal of a prostate, for example.
It was pretty consistent across all provinces and across all of these procedures that procedures on women are remunerating at a much lower level. This is payment to the surgeon for these procedures.
What we can do, in terms of trying to promote more pay equity for surgeons and also ensuring that we're delivering the best care to our patients, would be to look at these procedures and promote pay equity across provinces to ensure that the sex of the patient does not matter when making these remuneration decisions. It's a very complicated issue, but I think that's a very simple thing that could be done as a first step to promote pay equity.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Thank you, Dr. Simpson.
You've done some research on that. Could you send that and table it with the committee, please?
Obstetrician Gynaecologist, St. Michael's Hospital, Toronto, As an Individual
Yes, I'm happy to send it along.
We have research looking at the gender pay gap between male and female surgeons across Ontario, and also referral patterns, which can be partly attributable for these differences in pay. I'm happy to share those papers with you.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Thank you for that.
Dr. Anan, I'll go back to you.
We talked a fair bit about the availability of services in rural and remote parts of the Maritimes. One of the things you didn't highlight was talking a bit about reconstruction, which is often an important part of breast cancer recovery.
Can you talk a bit about the availability of that?
Medical Oncologist, As an Individual
Yes, certainly.
The first obstacle is not having enough plastic surgeons to begin with. Part of a plastic surgeon's practice would be a private practice and cosmetic surgery, and in rural areas, that is not something that is in high demand, basically. What has been happening and what my patients are facing are due to the lack of enough plastic surgeons.
Ideally, you should plan for the actual surgery, with the general surgeon performing the mastectomy, to happen at the same time as the reconstructive surgery to get the best cosmetic outcomes and minimize the downtime for the patient. It should be the standard of care, but unfortunately, it's not right now due to the lack of enough plastic surgeons, which, unfortunately, adds to the negative mental effects of having to deal with a mastectomy and having a flat chest for God knows how long until you have your plastic surgery.
Conservative
Stephen Ellis Conservative Cumberland—Colchester, NS
Thank you.
I have just one quick question for the folks from the Canadian Cancer Society.
Nicotine pouches have become easily available in Canada and are legally available to minors and, of course, to women, and that's been since the summer. The Minister of Health promised to reverse that decision and make it right.
What's the progress on behalf of Canadians with respect to that decision?
Senior Policy Analyst, Canadian Cancer Society
Thank you, Dr. Ellis and Mrs. Goodridge, for your public statements on this. You were very concerned.
B.C. and Quebec now only allow them to be sold in pharmacies behind the counter. We need national action, essentially, throughout Canada. In those two provinces, they can be sold to kids underage.
We're concerned by the delays. There should be action as soon as possible so that these tropic breeze and berry blast products, which are very popular and attractive to girls and boys, are not sold in that way.
February 15th, 2024 / 12:25 p.m.
Liberal
Élisabeth Brière Liberal Sherbrooke, QC
Thank you, Mr. Chair.
I want to welcome all our witnesses and thank them for joining us for this important study.
An article published in La Presse on February 8 raised the concerns of women waiting for a diagnosis. We know that things don't start to happen until a diagnosis has been made. An action plan and treatment are then put in place.
However, when the tests have been done and the results are not forthcoming, it raises a lot of questions. What would be the impact of a cancer diagnosis? Could the cancer get worse while awaiting diagnosis? Will it be too late? Who will be able to help?
Do you find that these women are being left on their own? What about the time period between testing and diagnosis?
Director, Advocacy, Canadian Cancer Society
That's a very good question. Thank you.
I think it really speaks to that mental health component, because we know that when you hear the word “cancer”, it can completely change your life and your family's life. We need greater mental health supports and for individuals to not fall through the cracks while they are in this very delicate time, waiting to receive whatever the next step of their journey is. It's a role that we all can play together, whether it's the different levels of government or community organizations such as ours.
We're very fortunate at the Canadian Cancer Society to be able to provide a cancer information helpline. That is a lovely phone line for you to call and speak with, usually, a previous oncology nurse or social worker. They'll be able to talk you through all of these things and help direct you to various support services that might be available in your community, because we've had a lovely conversation here about how important receiving care in your community is. The service is available in over 200 languages.
That's just a practical example of the ways in which we can all work together, because that mental health component is absolutely paramount, as you've clearly identified. It's absolutely an area that we need to keep talking about and keep bringing up over and over again, because it does not just go away.
Even if you are through your care journey, there's still always that “what if?” in the back of your mind: What does that mean for me five years from now or 10 years from now? How does it impact my children and their potential complications? There's a lot we can be doing together.
Liberal
Élisabeth Brière Liberal Sherbrooke, QC
Thank you very much.
I was involved for several years on the board of directors of a hospice in my riding, in Sherbrooke, called La Maison Aube-Lumière.
The hospice has cared for young mothers whose life expectancy was less than three months. It provides support for the family, particularly for young children who may find themselves orphaned.
I'd like to hear your thoughts on the importance of supporting families after the death of a loved one.
Director, Advocacy, Canadian Cancer Society
Thank you very much for highlighting this incredibly important part of the care trajectory. The cancer continuum is so vast. I think that mental health piece includes grief and bereavement.
We know that Canadians with cancer are three times more likely to receive palliative care. There's so much more that we can be doing.
I really appreciate the opportunity to talk about hospice beds. There are not enough hospice beds in facilities across the country. The Canadian Cancer Society in October released a report that really distinguished the gaps across jurisdictions.
The best practice, as identified by the auditor general in Ontario and others, suggests that we should have seven hospice beds per 100,000 people. By our count, which was at the end of May 2022, there are only approximately four beds per 100,000 people. That does not take into account at all the challenges that are faced in rural and remote communities and in community care provided in one's setting of choice. I should say, to be fair to British Columbia, its numbers are much better.
We were so pleased that Health Canada did have that report back in December on the progress that we are making in palliative care in this country. There's a lot more that can be done, though, specifically around grief and bereavement.
We are asking the federal government to dedicate $7.5 million over three years to improve national data and standards for palliative care; to develop a national atlas that maps out where services are located across the country; and to invest in research, education and training as it relates to palliative care delivery.
Liberal
The Chair Liberal Sean Casey
Thank you both.
We will continue with Ms. Larouche.
You have the floor for two and a half minutes.
Bloc
Andréanne Larouche Bloc Shefford, QC
Thank you very much, Mr. Chair.
The questions that were asked earlier about research made me think of a news story that came out this morning.
My question is first for you, Ms. Simpson, because you talked a lot about research, polycystic ovarian syndrome, robotic surgery and hormone therapy. This is all based on scientific research. We agree on that.
This morning, Radio-Canada published an article under the headline “A generation of researchers lost due to lack of funding”.
It reads, in part:
A hundred or so researchers from all walks of life joined forces in a letter sent to federal minister François-Philippe Champagne, calling on him to take immediate action to restore Canada's place among the world's scientific research leaders.
A hundred or so researchers is a significant number. Among the researchers are people in the health field, including a neurosurgeon whose testimony is included in the letter.
Today, we are talking about women's health. We know that research is crucial and that some cancers, particularly ovarian cancer, are still far too deadly. In short, research is essential.
Ms. Simpson, what is your opinion on this open letter and this call to the Minister of Innovation, Science and Industry, François-Philippe Champagne?
I'll start with Ms. Simpson because she touched on the issue of new technologies, but if anyone else would like to answer my question, I invite them to do so.
Obstetrician Gynaecologist, St. Michael's Hospital, Toronto, As an Individual
Thank you for that question. I would love to hear from my co-panellists on this as well.
Yes, there have been significant reductions to research funding. I think if we're really going to stay competitive with research on an international level, then we need to restore this funding for all cancer types. Today, the focus has been largely on the disparities in the study of cancers for women's cancers. It's really making up for the historical gaps that we've experienced in research in women's cancers by increasing funding in this specific area.
I don't know if anybody else wants to comment.
Director, Advocacy, Canadian Cancer Society
I can comment.
We were fortunate to meet with some stakeholders last week around this concept of postgraduate students who are choosing to leave the country because there is not enough support for them to develop their research further. A lot of those decisions are being made because there is no financial support for them to stay, or, if there is support, it's not much. How does that impact their career trajectories?
We really need to be making larger investments in terms of early-career researchers. We absolutely would support an investment of that type.
Liberal
NDP
Heather McPherson NDP Edmonton Strathcona, AB
Thank you, Mr. Chair.
I was very interested in what you were saying about hospice beds and access. I know you provided an answer, but I'm wondering if you could share that report with the analysts so that they could include that. I would love to know where Alberta stands on that.
Could you perhaps tell me where Alberta stands on that?
NDP
NDP
Heather McPherson NDP Edmonton Strathcona, AB
I was also struck by the comments I heard from all of the witnesses on testing and the implications for children. I know that, for me, colon cancer is hereditary, so there are impacts of being able to do that.
Perhaps I'll start with you again, Ms. Sayani. Right now the health care system—we are hearing—from coast to coast to coast, is in free fall. Frontline workers are overworked. The system is very at risk at the moment, yet we know how important the identification of cancer is. I know that in Alberta, it's very difficult to get a colonoscopy. You wait a very long time.
What are the implications of this collapsing health care system on cancer treatment for women?