Health Committee on March 21st, 2022

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Ellis.

Thank you, Minister Duclos.

Next is Mr. Jowhari, please, for five minutes.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Mr. Chair.

I'd like to welcome both ministers to our committee. I'm going to start with Minister Bennett.

Minister Bennett, in your opening remarks, you talked about the $45-million investment for national standards. As my colleague MP Sidhu was following up, in an announcement on March 14, you talked about the Standards Council of Canada and the fact that they will be working with various stakeholders.

Can you explain to me how these standards are going to help with the following? We know the investment in mental health as part of a total health transfer is an area of interest for a lot of us. We know that there are a lot of gaps in the timelines and the delivery of the services. A lot of the constituents in my health community council are talking about transparency, accountability and regular reporting, as well as benchmarks that right now we don't have, whether they are against some of the leading countries or even nationally here.

Can you explain to us how these standards are going to help us? Thank you.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

Thank you for the question. I very much enjoyed meeting with your council as well. It's a pretty knowledgeable group.

It is a process. People know what the standards are on blood pressure or what's appropriate for cancer. I think what people don't feel is that we actually know what is the appropriate treatment.

One of the things that are most exciting for me—as I continue to talk about the most appropriate care in the most appropriate place by the most appropriate provider at the most appropriate time—is that throughout COVID we have also seen that the most appropriate place may be virtual. Up until now, the medical community and the mental health community haven't had as much experience with or even a way of paying for virtual care, until COVID.

What we're saying is that developing the standards means that Canadians will know what the appropriate care is, and they can ask for it. They can ask their family doctor or their nurse practitioner to get it. The other exciting part is that we are seeing a stepped care model in which, for maybe the strongest families, the families are just being coached, or it may be that it is peer support or it can be co-treatment with a family doctor and a mental health provider, a social worker, a psychologist or a psychiatrist.

What was really interesting last week, when we did the round table on perinatal mental health, was that from the study of Dr. Vigod, of the 40 people needing perinatal mental health care, only two ended up needing to see the specialized psychiatrist. The rest were helped with other levels of care, so that's the kind of thing.... I think some people think it's not appropriate care unless they get to see a psychiatrist. We know that there are many other mental health providers who are skilled at various other aspects of mental health and substance use treatment.

I think the standards won't mean anything on their own unless Canadians know what they are in terms of mental health literacy, health literacy and all those things that we as parliamentarians are working on.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Minister.

In your mandate letter, you're mandated “to establish a permanent, ongoing Canada Mental Health Transfer to help expand the delivery of high-quality, accessible and free mental health services, including for prevention and treatment.”

How are these standards going to help you with the delivery of this mandate item?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

Thank you.

The standards are almost like the pillars on which we build a mental health and substance use strategy for the country. This gives us a “what by when and how” in terms of a strategy, and then the transfers will be based on that.

Going across the country on the transfer, I think the words I've heard the most have been “think child care”. People want there to be expectations around data collection, evidence and outcomes.

That is again something we will negotiate with provinces and territories as we are working with them now on a mental health strategy.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Thank you, Mr. Jowhari.

Mr. Thériault, you have the floor for two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

Mr. Minister, for the record, I'd like to say one thing about molnupiravir. Right now, approximately 22 countries have approved this drug, including the United States, Mexico, Morocco, Great Britain, Germany, Denmark, Italy, Indonesia, Slovenia, Serbia, Australia and Japan, through patent waiver agreements. It seems to me that we should speed up the process a little to give our workers on the ground, that is, our physicians, a variety of treatment options in certain cases.

Also, Health Canada held a public consultation from March 8 to May 7, 2021, to highlight the multiple problems associated with personal production of medical cannabis. All levels of government have taken exception to the regulations because they lead to issues related to overproduction and misuse of the program, overprescribing by physicians, limited inspection authority for police forces and a shortage of Health Canada inspection officers, resulting in insufficient inspections.

All stakeholders agree that the government needs to overhaul the medical cannabis licensing program and enhance its inspection and enforcement measures. The program has been in place since 2018. It is 2022, so it's been four years.

What steps have been taken so far and what are you going to do in the next few months to address this issue?

[Jean-Yves Duclos, Liberal, Québec, QC]

The good news, as you probably already know, is that the Cannabis Act requires the Canadian government to review it. That will be done by March 2023, I believe. The process is already under way. We will be making announcements in the near future to strengthen the consultation process.

As you suggested, we need to take advantage of the fact that we currently have a much stronger legal and regulatory framework then we had at the time. This framework helps us ensure that cannabis is consumed in a safe manner and environment and that we can avoid all the pitfalls and damage caused by the illegal environments that exist and sometimes proliferate, particularly those associated with organized crime.

We will have more activities and investments to, as you mentioned, ensure that the Cannabis Act and the procedures associated with it are improved over time.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Minister and Mr. Thériault.

Next, we have Mr. Bachrach for two and a half minutes.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Thank you, Mr. Chair.

I'd like to pick up where I left off with Minister Bennett, talking about the toxic drug crisis. In May 2021, as you know very well, the City of Vancouver finalized its application and final proposal to Health Canada for a section 56 exemption under the Controlled Drugs and Substances Act to decriminalize simple possession of illicit substances. We're approaching a year since it submitted that proposal, yet there still hasn't been a decision. At the same time, we're seeing deaths from this crisis rising every single month.

Do you feel that the delay in rendering a response is acceptable? Can you confirm by what date Health Canada will have a response for the City of Vancouver?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

Thank you very much for that. There is also the proposal, from the fall, from the Province of British Columbia. There is a view, I think, from the province that if there could be one for the whole province, it would be in the interest of the province and the simplest thing to do, rather than having separate plans for different municipalities. We hope they can work together to resolve this. We want to make sure there can be a successful implementation.

With the kind of training that Vancouver has done with the police force, we're getting there. I think we're almost there, and—

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Minister, if I may, it sounds like you're saying that the ball is in their court, and that the province and the City of Vancouver need to resolve some differences before Health Canada is willing to make a decision.

Is the City of Vancouver's proposal being actively considered? Will there be a decision? When will that decision come?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

You're quite right. We have to render a decision on each of them separately, which we will do. We are moving very close to that point.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Is there a timeline for a final decision?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

The timeline is when we're satisfied that this is going to be successful and implementable.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Thank you, Mr. Bachrach.

Next we have Mr. Lake, please, for five minutes.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

Thank you.

Minister Bennett, does Canada currently have a 24-7 suicide prevention hotline?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

As you know, there is a line that people can call, the national hotline. There's a separate one for first nations, Inuit and Métis. At CAMH, they are working on that kind of support across the country. Different—

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

Yes, there is a line. I'm curious if you, off the top of your head, know what that phone number is.

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

I do not.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

It's 1-833-456-4566, for anyone who might be watching and wants to know what it is.

Do you know what the proposed three-digit number is, off the top of your head?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

It's 988.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

You know this one off the top of your head, but, clearly, you don't know the other one. Does that tell you something about the importance of a national three-digit suicide prevention hotline?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

We are working very hard. It was a unanimous vote in the House of Commons, Mike, as you know. We're working very hard.

CRTC asked to have a bit more time on the consultation because of persons with disabilities. We hope that the consultation will finish this month.