Health Committee on Dec. 12th, 2024

[The Chair, Liberal, Sean Casey]

I call this meeting to order.

Welcome to meeting number 146 of the House of Commons Standing Committee on Health.

In accordance with our routine motion, I'm informing the committee that all remote participants, with the exception of Dr. Hanley, have completed the required connection tests in advance of the meeting. We will have Dr. Hanley's issues resolved before we call on him to speak.

We're going to skip over the budget.

Pursuant to Standing Order 108(2), the committee is commencing its study of the subject matter of the supplementary estimates (B), 2024-25.

I'd like to welcome the panel of witnesses joining us today.

We have the Honourable Mark Holland, Minister of Health. He has a team of officials accompanying him. From the Canadian Food Inspection Agency, we have Diane Allan, associate vice-president, policy and programs. From the Canadian Institutes of Health Research, we have Dr. Tammy Clifford, acting president. From the Department of Health, we have Eric Costen, associate deputy minister. From the Public Health Agency of Canada, we have Heather Jeffrey, president; Dr. Kerry Robinson, acting vice-president, infectious disease and vaccination programs branch; and Linsey Hollett, assistant deputy minister, regulatory operations and enforcement branch.

Thank you all for being here, albeit somewhat delayed.

You're very familiar with how things work here, so I'm just going to hand it over to you, Minister. Welcome to the committee. You have up to five minutes for your opening statement.

[Mark Holland, Liberal, Minister of Health]

Thank you very much, Mr. Chair.

Yes, I was hoping...we had made a request to come here before the supplementary estimates. Nonetheless, it's a very important conversation to have. I thank you, Mr. Chair, for having us here today.

You referenced a number of officials. I want to take a moment to thank them for their extraordinary work on behalf of the country. It is my very deep and great privilege to have an opportunity to work with them as they work to serve Canadians.

I'm going to talk at a high level, if I can. We're in a moment of incredible consequence for health care in Canada, and it is wonderful. I've had an opportunity over the last couple of months, as I do all the time, really, to go and talk with stakeholders, particularly about the optimism within the health sector about the transformation that's possible.

I just came back from Alberta on Friday, where I had a conversation with Adriana LaGrange about the possibility of working together, finding solutions and being able to talk about common language. We have a lot of differences, but one of the things, when you look at the transformation that must occur in our health system, is that there are a lot of areas of commonality that are really worth focusing on.

About 70% of chronic diseases and illnesses can be prevented. Most of what fills our hospital rooms and hospital beds doesn't need to be there. Having an effective response to prevention not only makes sense as a matter of health outcomes, but fundamentally makes sense economically. It's something that can unite us, whether or not we are thinking about social justice and health outcomes or we're thinking about productivity.

I have to say that around the federal-provincial table, the positivity and the efforts to set aside partisanship and find common ground have been deeply heartening. I had a conversation with Jeremy Cockrill, who's the new health minister in Saskatchewan, about that, which was very positive. A conversation with Michelle Thompson was very positive.

I look forward to talking to the committee in that spirit and to take your questions in that spirit, because we've been able to do some really important things.

Let me start with dental. At the most recent update, 93% of providers are participating. Now, you might recall that some folks said we weren't going to have anybody sign up, so 93% is pretty fantastic. Manitoba is leading the pack now, with nearly 100%. In fact, we have to redefine 100%, because people who we didn't even know were providers have come forward.

In terms of the number of people who have received care, we're at 1.25 million, and that's in just over seven months. In a year, three million registered, so I'm very excited for these next cohorts.

I mentioned dental to start because it's such an important area of both primary care and prevention. It's also an example of Parliament working together in the spirit of collaboration. I see Peter Julian, and I want to recognize Don Davies in the work that was done. It's difficult to find common ground and ask constructive questions about how we can help Canadians, but that's what they expect us to do in a minority Parliament.

Now we're moving forward on the pharmacare agreements, which are also the product of co-operation in this chamber. Those agreements are going to apply to diabetes medication and devices, as well as contraceptives.

It was wonderful to stand at a podium on drugs for rare diseases with Adriana LaGrange as she made the commitment that Alberta is ready to move toward signing it. I very much believe that all of these agreements can be signed over the coming time.

One of the areas I'm really hoping we can focus on today, Mr. Chair, is Bill C-72. I'm not aware of anybody who's against the connected care legislation. This is legislation that will absolutely save lives.

If you talk to Teri Price about the experience of her brother Greg and the problem with fax machines and data not being transferred and a system that doesn't have interoperability, you'll hear that these problems place lives at risk, block pathways to care and are some of the greatest frustrations for physicians.

I understand that there are a lot of things going on and there are a lot of concerns, but here's an example of how we can come together. There are lots of things we can disagree on, but on this one, I'm aware of no province and no territory that's opposed and I'm aware of no political party that's opposed, so I would ask for parliamentarians' assistance to pass this bill. It will save lives and improve our health system. I'm not aware of anybody who's opposed to it, so hopefully, we can spend some time on that.

I would say in closing, Mr. Chair, that I appreciate these conversations. I hope I'm afforded 20 seconds of context. I love playing Jeopardy!, but this is an important conversation that we need to have on the future of health care in this country, and it is certainly deserving of more than staccato two-second questions.

I look forward to the opportunity to illuminate, and to have a conversation on, the ways we can work together to the betterment of our health system.

[The Chair, Liberal, Sean Casey]

Thank you very much, Minister.

I'm going to be honest with you about your expectations. The rule we've followed, really, since I took the chair on this committee is that the witness gets as much time to answer the question as the person posing it takes to pose it. There is an entitlement to cut you off if you go longer than the length of the question. They don't have to exercise that. They're free to let you continue, but it is up to them, once you exceed the length of their question in your answer. I think what you will find is that if one party—perhaps the official opposition—tends to cut you off, another party will give you a chance to expand upon your answer in a subsequent time slot.

The rule I will be applying is the one I just explained to you. You will have as much time to answer it as—

[Mark Holland, Liberal, Ajax, ON]

It's more about the spirit. I appreciate your adherence to the rules, and I respect that, Mr. Chair, of course.

[The Chair, Liberal, Sean Casey]

All right.

We're now going to start in rounds of questions in the manner to which we have become accustomed. We'll begin with Dr. Ellis for six minutes.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thanks very much, Chair.

Minister, you talked about illness prevention.

Can you tell us how many Canadians, percentage-wise, are struggling to access fresh and affordable food in Canada?

You like the Jeopardy! questions, so there's number one.

[Mark Holland, Liberal, Ajax, ON]

I suspect you have an answer. I never quite understand why you ask me a question you seem to have an answer to.

Food insecurity is very serious. I hope we can take a second to talk about the answers to food insecurity. It has a devastating impact in first nations communities, and in rural and remote communities. It is a very difficult thing to quantify, because food insecurity takes many forms, whether it's access to fresh fruits and vegetables or access to food at all. We have food deserts. It's difficult to—

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Again, Minister, thanks very much. It's clear you don't have a clue about what the answer is. It's 32%, which is almost a third of Canadians.

Maybe this is the second Jeopardy!-type question you seem to love: Do you know how many Canadians are visiting food banks on a regular basis?

[Mark Holland, Liberal, Ajax, ON]

Well, it's far too many.

The question I would pose to you is—

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

No, you're not asking me questions.

[The Chair, Liberal, Sean Casey]

You have to give a little more time than that.

[Mark Holland, Liberal, Ajax, ON]

Sure I can. That's absolutely my prerogative. You don't have the opportunity, in a democracy, to tell me what I can and can't do, Mr. Ellis. You may not like it, but I'm saying—

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

That's not true.

[Mark Holland, Liberal, Ajax, ON]

I just spent five minutes talking about solutions. Do you want to talk about solutions for the issue you just raised, or do you want to play this game in which you're going to say some statistic? I'm not interested in that, to be honest.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

As a matter of fact, Minister, I know you don't know the answers, because it's well established, or you're too embarrassed to say, that two million Canadians access food banks on a regular basis because of your government's reckless spending.

Given that statistic, what about your temporary tax trickery? Why don't you enlighten Canadians as to the actual GST amount on things like fresh fruits and vegetables, and unprepared meats? What would that be?

[Mark Holland, Liberal, Ajax, ON]

First of all, on access to food banks and policies surrounding it, I deal with poverty. This is a government that, for the first time, set targets on poverty and has met them every single year. While we've seen too many people increasing in poverty, we see much lower levels than we did in 2015 when we had a Conservative government that never prioritized poverty or people living in food insecurity.

I would ask you what policies you have, Mr. Ellis, to address these issues. I can enumerate the policies that we have to deal with both food insecurity and food banks, and—

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Well, again, I'll interrupt you, Minister. Excuse me.

[Mark Holland, Liberal, Ajax, ON]

These are global issues, but as far as I'm aware, you have no policies on these ideas.

[The Chair, Liberal, Sean Casey]

Give the time to Dr. Ellis, please.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

It's interesting, because I would suggest that my job in the opposition is to hold you to account, not give you policies.

Please tell Canadians the GST amount—it's a simple answer—on fresh meats that need to be cooked, and fruits and vegetables.

[Mark Holland, Liberal, Ajax, ON]

I disagree. I was in opposition. Absolutely, when I was a public safety critic, I advocated changes in policies. You have advocated none.

If you're going to raise the issue of poverty and say you care about food banks, food insecurity or any such matter, having absolutely no policy that addresses those issues is irresponsible.

Anybody can simply criticize. I have a 10-year-old who can do that with Google—

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much, Minister.

It's very clear you do not understand that there is no GST on uncooked meats or on fresh fruits and vegetables, which directly relates to your temporary tax trick on behalf of Canadians, sadly.

Can you go on to perhaps describe the actual foods GST will be eliminated from with your temporary tax trick?

[Mark Holland, Liberal, Ajax, ON]

I'm here to talk about the supplementary estimates. You want to talk about....

Again, having no policies, why did you vote against the Canadian dental care plan? In your home province, 34,000 have accessed care in a program you said didn't exist. You said nobody would sign up for it. More than 90% of people have now signed up. Why do you oppose dental care for people? Why do you, a physician, not understand the importance of the primary care that dental care represents?

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

You know, it's interesting, Minister, because when you look at your temporary tax trick, it goes directly to your program with respect to dental care because, of course, on behalf of Canadians, you voted to remove the GST on candies, candy floss, chewing gum, chocolate, popcorn coated or treated with candy, chips, crisps, puffs, curls, sticks of popcorn, etc.

Could you tell me the benefit to the dental health of Canadians that your tax trick would provide?

[Mark Holland, Liberal, Ajax, ON]

You might recall that this same measure was suggested by Erin O'Toole as a temporary measure to give people relief and to give them a tax break, which is normally something that the Conservatives support, but you don't in this instance.

I will ask again what your policies are to deal with tooth decay. What are your policies? They are to cancel dental care. You would take dental care away from people. It takes some nerve to talk about sugar on one hand and to talk about axing dental care on the other. Do you want to talk about oral health? What is your policy on dental care, sir?