Health Committee on March 28th, 2022

[Brenda Payne]

What I'd like to do is address the issue from a recruitment point of view for our rural areas.

We know, coming from the east coast, that we have lots of rural communities and that the community needs to be involved. One of the things we've learned over the last five years is that recruitment, particularly in more remote areas in our country, requires every level of government, including the municipality.

We've discovered that when we recruit people, we're not just recruiting them to our organization. We're recruiting them to our communities. We know, from history, that when we're recruiting a nurse, we have to worry about their husband being able to get employment. From a cultural point of view, we know that our providers need to have a sense of belonging. When we recruit internationally, we need to be culturally sensitive to the kinds of communities that will not only recruit but also retain folks.

One of the experiences I've had, which was extremely instrumental in moving and attracting folks to a rural community, was, with federal government funding, to provide some seed funding to try innovative strategies, for example in service delivery. The specific example I'm referring to is that the federal government provided some seed money to test out a rural palliative care program for our northern region in rural Nova Scotia. It then became a great service delivery model for both Nova Scotia and Prince Edward Island.

In response to your question, it's about having opportunities to test out innovative solutions that are particularly aimed at addressing the unique challenges in our rural communities throughout this country.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Wonderful.

I would challenge that this is a unique opportunity. Our northern communities often have really spectacular spaces, because they are exactly that: a community.

Do you have any thoughts on things the federal government could be doing to help establish better health care systems? You mentioned that one pilot project. Are there any ideas you have that the federal government could employ that would make health care better in our rural communities?

[Brenda Payne]

As all witnesses have said, because the delivery of health care is under provincial jurisdiction, the federal government should work very closely to address the issue.

We're focusing on recruitment, as well as retention and making sure that the workplace environments that folks are working in, regardless of the sector—inclusive of home care and aging in place—are appropriate and supportive. We give them the resources. We understand, again from a generational point of view, that work-life balance is so important.

What kind of strategies and what kind of opportunities do we have to test out some new solutions that are reflective of the different populations, both from a patient-client-resident perspective and for the providers we're trying to recruit? That covers not just nurses, but all health care providers and even some of the new positions that we've established in some of these teams.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

That's fantastic. Thank you, Ms. Payne.

Mr. Coletto, if you could perhaps answer that same question, that would be spectacular.

[The Chair, Liberal, Sean Casey]

Answer briefly, please.

[Sylas Coletto]

Absolutely.

I am a registered nurse. My spouse is a physician. We have spoken about moving up north to go and work in the northern communities. Honestly, we struggle. We have to search very hard to find the positions that we're looking for, to find resources to help us move, to find the additional education—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Mr. Coletto, you can come to Fort McMurray. I can guarantee you that we have an opening for both a registered nurse and a physician. I will get you those contacts. I would love to have you as a constituent.

[Sylas Coletto]

Thank you very much.

[Don Davies, NDP, Vancouver Kingsway, BC]

I have a point of order, Mr. Chair. Vancouver would like to make a bid as well.

[Sylas Coletto]

Okay, thank you. That's perfect. That's very kind of you.

[The Chair, Liberal, Sean Casey]

We'll go to Dr. Hanley, please, for five minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much. I'm going to put my hat in the ring for that bid as well.

I thank my colleague for speaking up for the north and for our rural areas. As a fellow northerner, I appreciate the advocacy.

There are so many questions and so little time. I'm going to maybe continue with Mr. Coletto for now.

Thanks for sharing your time and that really revealing frontline perspective. I wonder if you could just share briefly what keeps you going. What inspires you to stay in nursing as a career, despite all of the challenges that you relate?

[Sylas Coletto]

Thank you very much for the question. That is a monumental question.

I would summarize that it's made in hope. I have a great deal of hope that I can make someone's life better, or make their death better. I can facilitate them not coming back to the hospital if I can teach them an extra something. I can advocate for them at the very best level, so that they're getting the services they need. I believe I'm pretty good at my job and I can be the best patient advocate and do everything that I can for them.

It feels pretty darn amazing to have a patient's family say that I've made this passing or this hospital stay something that was very tolerable and the best that it could be. That's what I experience.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you for that.

I was pleased on Friday to be present at the University of Ottawa school of nursing for the announcement from the three ministers—Minister Duclos, Minister Bennett and Minister Khera—on the $2 billion to clear the backlog.

Mr. Coletto, you now have a big injection of money in your hands for the front line. Where would you put it?

[Sylas Coletto]

I would probably put it into public health, so that we can keep people out of the hospitals before they can even come into the hospital. The best form of medicine is preventative medicine, doing all the things to address the socio-economic status of people and the social determinants of health, and keeping them out of the hospital beforehand.

Our colleague Ms. Boniface is doing a wonderful job with occupational health, keeping them out of there completely.

Otherwise, if we had to allocate it toward the hospital system, maybe put it toward running campaigns to suggest that a nurse is not a punching bag. Just because you're having a pretty rough day, that does not mean you can take him or her to the grindstone and give them a really hard time. We have to work together here.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you. That funding was specifically for addressing the backlog of care, and I probably wasn't precise enough.

To your first point, it almost sounds like a planted question, since I'm a public health physician, so that's music to my ears, and I heartily advocate for that.

I want to move quickly to Ms. Boniface.

It's nice to see you again. I think it would be interesting to hear from you again about some of the lesser-known values of the OT profession and what it can offer, especially in the context of team-based care. Maybe you can talk a little bit about the role of OT in mental health support.

[Giovanna Boniface]

Absolutely. I guess all health care professionals have a unique value and approach to working with individuals. A cornerstone of occupational therapy is the person: who they are, what they do and what they want to do. It's this intersection of them, all the activities that matter to them, where they're doing them and their context.

Looking at support in mental health, there are a number of strategies that OTs work with related to the goals of the individual. It's always about what the person wants to do, really staying focused and true to that and working with that individual to look at the barriers to being able to do those things.

OTs are really looking at systematically breaking these tasks and the challenges down and then looking at how to overcome those barriers. The interventions can fall into broader themes related to education, relearning of skills and learning new skills—again, always focused on what matters most to the individual. Tapping into their passion and their desires is critical and key. Depending on where that individual is with respect to that mental health challenge, whether it's an in-patient or a community setting, it's always centred around what matters most to them.

The interventions can be very different. It's always about breaking barriers, overcoming those barriers, and life skills integration. If somebody is looking at going back to work—

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Boniface.

[Giovanna Boniface]

—there is some extremely strong evidence around supported return to work.

[The Chair, Liberal, Sean Casey]

Thank you.

Thank you, Dr. Hanley.

Go ahead, Mr. Thériault. You have two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

Dr. Champagne, you gave us the facts of the situation, and they were chilling. You raised important questions. How do we eliminate the delays in diagnosing patients—delays physicians have to deal with—and how do we meet people's needs? You said that standards for diagnosis, treatment and follow-up were already in place for the management of patients, and that what was really needed was a major injection of funding. You went even further, saying that one-off investments were well and good—better than a flick on the ear, as my grandfather used to say—but that the situation called for significant and recurring investments that make a real difference, basically health transfers. However, the government stubbornly refuses to deal with the matter of health transfers.

Given what you've observed, do you think the government's wait-and-see approach makes sense from a medical and economic standpoint?

[Dr. Martin Champagne]

The trajectory of a cancer patient involves chronic care punctuated by periods of acute illness. After being diagnosed, the patient needs adjuvant therapies, after which, the patient goes into remission. Patients who go on to experience a relapse require new and more intensive therapies. That episode is followed by a honeymoon period, when the patient once again goes into remission and so on. When you're talking about cancer care, one-time funding doesn't do the job because patients experience a cycle of acute and less acute episodes for years.

Significant and meaningful investments are needed. Our computer systems are outdated, which ends up costing us a tremendous amount of time. Say Ms. Boniface goes to a patient's home to provide care, I can't get access to that information. The technology exists, but our current system merely returns the same information that the nurses have collected, the patient's family status, telephone numbers and so on. Everyone is constantly duplicating the exact same data that have already been collected.

Significant and meaningful investments on the system side would result in time savings, not only for health care workers, but also in terms of equipment, ensuring a smooth flow of information. That is crucial, but it would clearly require huge investments on a national scale.

[Luc Thériault, Bloc, Montcalm, QC]

You need more robust systems.

It's also important that the funding reflect rising costs. The longer we wait, the more it's going to cost.

Is that right?

[Dr. Martin Champagne]

That's right.

[The Chair, Liberal, Sean Casey]

Your time is up, Mr. Thériault.

Mr. Davies, you have two and a half minutes.