Health Committee on Oct. 3rd, 2024

[Tim Fleiszer]

I think the short answer is no. I absolutely agree with you.

I'm a season ticket holder for the Habs, and I go to the games with my kids. They ask a lot of tough questions. It's very difficult to watch two NHL players fighting on TV and then, in the same breath, turn around and tell my kids they need to take care of their brains. It's a very awkward conversation.

What I'd love to see in sport, as the leader and the pinnacle of the sport, is the league taking a tougher stance on brain injuries and looking at things like fighting.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I'll give you another example. This one is when an Ottawa Senators player had an open-net goal. He went right up to the goal and shot it in, and then Morgan Rielly from the Leafs went and cross-checked him in the head because he was hot-dogging. Sheldon Keefe, the coach of the Leafs at the time, said it was deserved and the guy was hot-dogging. I heard nothing in response to that. I didn't hear the NHL criticizing that. I didn't hear sports writers criticizing that.

Is that not the kind of thing we ought to be discouraging? I don't want my kid getting cross-checked in the head and figuring it's justified because they were hot-dogging. Do you have any comment on that one?

[Tim Fleiszer]

Again, children absolutely watch pro sports and absolutely take their direction from pro sports.

When you're talking about adults participating in a sport.... Our organization, in particular, has autopsied a number of former NHL players and found CTE in the brains of players like Stan Mikita and Henri Richard, who were not just enforcers, but skilled players. It is absolutely a hockey issue.

Look, hockey is wonderful for all kinds of reasons, such as personal development, which is why I have my children participating in it, but we absolutely have an awkward misalignment in terms of messaging between the National Hockey League and minor sports. I'd love to see that corrected.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

How do you bring together your concern for head injuries and concussion and letting your kids play hockey?

[Tim Fleiszer]

Later this year, a month from now, we will have Marty Walsh, who's the head of the NHLPA, in Boston. He'll be making some interesting announcements about the NHLPA.

It's great to see the players starting to think about and consider this more, not just for their own health, but for the example of kids.

[The Chair, Liberal, Sean Casey]

You have time for a short question and a short answer.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I noticed you mentioned that your kids play hockey and soccer, but not football. You played football. Why don't they play football?

[Tim Fleiszer]

They play flag football. Again, football is a wonderful sport and it is wonderful for personal development. I had an outstanding experience playing the sport.

I just want to be clear that our message is not that kids should not be participating in sports. Kids should be playing more sports. They should be more active. However, kids don't need to be tackling each other at six years old. They can play flag until they're teenagers and their bodies are better able to handle it.

Football has done a really good job of limiting contact in practice. You've seen that in the last two CBAs in both the NFL and the CFL. You've seen a new kickoff introduced this year. Our data was that 30% of brain injuries were happening at kickoff, so it's great to see the NFL starting to address that. We've consulted with high schools and actually suggested the elimination of kickoffs in high school to try to help kids' brain health.

There are certainly ways we can practise and play these games much more safely than we have.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Fleiszer.

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

[Luc Thériault, Bloc, Montcalm, QC]

Ms. Beauchamp, I know you talked a bit about this already, but I would like to know more about your research objectives. I read somewhere that you want to create targeted, technical and immersive research tools.

Could you tell us where you are in your research?

[Miriam Beauchamp]

Yes, of course. I am always pleased to talk about our work.

First of all, a lot of my research focuses on very young children, babies and preschool children. Today we have talked a lot about concussions from sports, but I want to remind the committee that head injuries occur at all ages. Children up to the age of five actually have the highest rate of head injuries, comparable to the rate in young adults. We are not talking about teenagers or older adults, but very young children. This fact is not well known, and I am not referring to head injuries from sports. They are the result of falls. Children fall down stairs, from change tables, grocery carts or scooters, for instance.

So a lot of our work focuses on this subgroup that has long been overlooked. We are very far behind in our knowledge about the effects of such injuries on very young children. So we are in the process of establishing initiatives compatible with Bill C‑277. Just last week, we launched a website with educational tools to raise awareness of this problem and to help people detect the signs of concussion in young children. The website also provides information about treatment, of course, which requires parents to help these very young and vulnerable children in their recovery.

We are also establishing digital health tools. For school-aged children and teens, our approaches are based on tools such as virtual reality and educational games, because we know that young people today have to be engaged by tools that are interesting to them. Those are the treatments and interventions we use for their rehabilitation, together with clinicians who have an overview of recovery in young people.

[Luc Thériault, Bloc, Montcalm, QC]

Do you think that—

[The Chair, Liberal, Sean Casey]

Thank you. That's all the time we have.

[Luc Thériault, Bloc, Montcalm, QC]

Perhaps someone else could continue, in that case. I wanted to ask the following: Do you think the medical community is aware of your work?

[The Chair, Liberal, Sean Casey]

You have—

[Luc Thériault, Bloc, Montcalm, QC]

If someone could give Ms. Beauchamp their speaking time to answer the question, that would be great.

[The Chair, Liberal, Sean Casey]

Your three minutes are up. Thank you, Mr. Thériault.

Mr. MacGregor, please, you have two and a half minutes.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Thank you very much, Mr. Chair.

I'd like to turn this question to Elisabeth Pilon.

Ms. Pilon, thank you so much for recounting your personal journey through this.

When you look at Bill C-277, there are requirements as a part of this national strategy to promote information and knowledge sharing, specifically with respect to brain injury prevention, diagnosis and treatment, along with rehabilitation recovery. There is reference to national guidelines, which would include recommended standards of care that reflect the best practices that are out there.

However, there is also a requirement to develop and provide enhanced and integrated mental health resources for persons living with a brain injury. All of these are legislative requirements of a national strategy that the federal Minister of Health has to develop with provincial and territorial counterparts.

You've told a very personal story about what it was like with the lack of resources that you had, and the long journey you've had to go through. If this kind of strategy, with these kinds of requirements, had been in place at the time you needed it most, what difference would that have made for you personally? Can you speak about people who are just beginning their journey right now and what kind of difference it would make for them as well?

[Elisabeth Pilon]

Thank you, MP MacGregor.

I imagine it's about being informed at the moment of injury. At the time, there was a maximum of eight physiotherapy sessions at the hospital. If you advocated with your family practitioner.... Most family practitioners, apparently, didn't know about it at the time, so I did that. I imagine being at the hospital and having all those doctors in emergency and my family practitioner being informed about what those potential collaborations could be, such as referrals to physiotherapy in an ongoing way, or perhaps referrals to a case manager or a system navigator to help me figure out what to do. Do I quit my job, if I can't do it? What if my doctor is saying I should go back? I imagine having someone to talk to who could help me make sense of what decisions I should make and what the consequences of them may be, and having connection to mental health supports that maybe I don't have to pay out of pocket for.

The sky is the limit on how we can collaborate among different practices, especially if we do so nationally so that there is a best practice standard of care we can all aim towards.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Pilon.

Next, we have Mr. Dalton for five minutes.

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Thank you very much to the witnesses for their important testimony. It's valid. It's appreciated.

Ms. Biagioni, I'm a member of Parliament from British Columbia. Thank you for the work you do in the province.

Health care is under a provincial umbrella. Obviously, we're talking about a national framework, which is very important. From your perspective, doing the work in B.C., how are you finding trends in head trauma and brain injury as far as supports, wait times and treatment go? Are things improving? Are things getting worse? Are they kind of stagnant? Where are things at?

[Janelle Breese Biagioni]

That's a very good question.

What is challenging is that we are discovering the vast number of ways brain injury happens, such as intimate partner violence. Dr. Paul van Donkelaar's study shows that, for every NHL player who suffers a concussion in the game of hockey, 5,500 Canadian women suffer the same type of brain injury. Whether you're in B.C. or Ontario, if you are one of those women and have never had medical support, never been to the hospital and never asked about head trauma, you're not going to get those supports.

That's the challenging piece we have right now. Yes, things are improving in some ways. We have smaller associations coming together to provide the community services and supports that we know work. However, they're not funded. They don't have core funding. Our provincial associations don't have core funding. It's about trying to keep up with the discoveries we have now in terms of how brain injury is happening. Often, I feel like we're running up and down the dam, trying to put our finger in there to stop it from exploding.

I think that's our bigger challenge right now. We're becoming aware. We can't become unaware of how these brain injuries are occurring.

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Thank you very much.

I was a teacher for many years, and then I was elected as an MLA. Then I went back to teaching for a while, and there was more information on brain injury. I saw it impact our young people and old people alike.

I have a question for Ms. Beauchamp about research.

Would you say that a lot of progress has been made internationally in your field of research? Have there been a lot of advancements in treatments?

[Miriam Beauchamp]

Yes, of course, there is a lot of progress.

I have been a researcher for 15 years. Compared to when I was at the postdoctoral level, there is a big difference now in what is recommended, said and known about head injuries. In my opinion, people sometimes think that the research is progressing so slowly that it isn't having any effect, but that is not the case. In a few years, we can find effective treatments and start to apply them quickly.

Investing in research is really worthwhile. We need that research. In recent years, we have seen very rapid advances in head injury research. Applying that research is part of the scientific process. When we can prove that a given intervention or treatment works, we also use science to decide on its application, that is, to demonstrate whether it is useful in a clinical setting or not. That is what research and science are all about.

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Thank you very much.

In Canada, I believe we have 20,000 or 30,000 physicians and 30,000 or 40,000 nurses from other countries who cannot work in their field. I have met a number of them who are specialists.

I am a Conservative MP. My party is proposing “Blue Seal” certification, a standard national professional exam, in order to quickly issue licenses to professionals.

Do you think that would be helpful, even in your area of specialization?

I see that my speaking time is definitely up.