Evidence of meeting #19 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was booster.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Harpreet S. Kochhar  President, Public Health Agency of Canada
Jennifer Lutfallah  Vice President, Health Security and Regional Operations Branch, Public Health Agency of Canada
Theresa Tam  Chief Public Health Officer, Public Health Agency of Canada
Stephen Bent  Acting Vice-President, COVID-19 Vaccine Rollout Task Force, Public Health Agency of Canada
Howard Njoo  Deputy Chief Public Health Officer and Interim Vice President, Infectious Diseases Programs Branch, Public Health Agency of Canada
Cindy Evans  Vice-President, Emergency Management Branch, Public Health Agency of Canada

5:40 p.m.

Liberal

The Chair Liberal Sean Casey

No. The third round would be five minutes for the Conservatives, five minutes for the Liberals, then two and a half, two and a half, five, five.

Go ahead, Mr. Lake.

5:40 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

If we just do the five, five, two and a half, and two and a half, that takes us to six o'clock, which is when you said we would end anyway.

5:40 p.m.

Liberal

The Chair Liberal Sean Casey

Yes. We can operate under a reduced quorum as such.

You get the last word, Mr. Davies. Surely that's satisfactory.

5:40 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

That's delightful, Mr. Chair.

5:40 p.m.

Liberal

The Chair Liberal Sean Casey

Okay. We are now operating under a reduced quorum. No motions are allowed except for a motion to adjourn.

The next round of questions will be posed by Mr. Lake for five minutes.

5:40 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

Thank you, Mr. Chair.

In the original line of questioning by the Liberal member, she brought up mental health. I believe it was Dr. Tam who talked about some of the government spending on mental health in the recent budget. Just for clarity, exactly how much was committed in 2020-22 for the Canadian mental health transfer in the recent budget?

5:40 p.m.

President, Public Health Agency of Canada

Dr. Harpreet S. Kochhar

Dr. Tam, did you want to answer that?

5:40 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. Theresa Tam

On that, I believe I would have to consult Health Canada. That is not within the area the agency has responsibility for.

5:40 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

Just to be clear, nobody in the Public Health Agency knows how much was committed in the Canadian mental health transfer in the recent budget. In the Public Health Agency of Canada, nobody knows the answer to that...?

5:40 p.m.

President, Public Health Agency of Canada

Dr. Harpreet S. Kochhar

I think what we have information about is that there wasn't any specific-to-mental-health transfers, but there are mental health crisis support pieces over budget 2021 and other pieces that we have incorporated into the mental health support, for example.

5:40 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

Just to be clear, I have the Liberal platform from a couple of months ago, from when we had an election just a few months ago. It promises $4.5 billion towards the Canadian mental health transfer. In the costing of that platform, it's very clear—this is just a couple of months ago—that it promises $250 million for 2021-22 in the Canadian mental health transfer.

Am I making a mistake in reading the budget? Is that $250 million committed? It was just promised a few months ago in an election.

5:40 p.m.

President, Public Health Agency of Canada

Dr. Harpreet S. Kochhar

I think this would be something we'd have to discuss with our colleagues in Health Canada.

Mr. Chair, if you prefer, we can come back with a written answer on that one.

5:40 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

That would be great.

Could I just get some clarity? There was some questions earlier about policy decisions. Would a decision like this be a decision made by Health Canada or the Public Health Agency of Canada, or would this be a decision made by the cabinet—the decision not to fund $250 million for the Canadian mental health transfer that was promised in the Liberal election platform just a few months ago?

5:45 p.m.

President, Public Health Agency of Canada

Dr. Harpreet S. Kochhar

My understanding would be that this would be something that would be discussed in the cabinet. We provide advice on that.

However, I am not sure that I would be able to answer the question straightforwardly on that.

5:45 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

Okay. I have one final question.

In your knowledge of the NDP-Liberal agreement—and perhaps the NDP member who's at the table could answer this question—I'm wondering if the NDP members of the coalition, or whatever their agreement is called, agreed to this when they made their agreement, to not include the $250 million for the Canadian mental health transfer.

Don, do you want handle it?

5:45 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Sure. The answer is no.

5:45 p.m.

Conservative

Mike Lake Conservative Edmonton—Wetaskiwin, AB

Thank you. I'm done.

Thank you, Mr. Chair.

5:45 p.m.

Liberal

The Chair Liberal Sean Casey

Thank you, Mr. Lake.

Next we have Dr. Powlowski, please, for five minutes.

5:45 p.m.

Liberal

Marcus Powlowski Liberal Thunder Bay—Rainy River, ON

Thank you.

Dr. Tam, Dr. Njoo, Don and I have been at this for a long time.

You're all public health experts. I'm not telling you this story for your knowledge but for some of the people in the committee room who aren't familiar with this story.

Every public health class probably starts out with this story of London during the 1800s. There is a cholera epidemic and Dr. Snow, this very wise doctor, decides that instead of treating people, we should prevent them from getting sick. He puts a lock on this well in the middle of London, and thereby stops this cholera epidemic.

That's used as the example of how prevention is so much better than treatment. It's a lot more efficient. It's cheaper. It's a better way of doing things.

Using public health, so far we've done an excellent job by using things like vaccinations and social distancing. I have to say, with the Public Health Agency of Canada leading us, the Canadian people have done very well. We've had a third of the death rate of the United States, and about half the death rate of countries like France, Italy and Germany, by using those public health measures. However, I think it's come at a cost. It's certainly come at a cost in terms of the national debt and in terms of mental health. It's come at a cost in terms of civil strife.

I wonder—and I'm asking you this question—whether we ought to start looking at changing direction. We've whipped the public health horse about as hard as we can whip it. Maybe we have to start changing direction, in terms of trying to place measures that prevent people from getting really sick. That means protecting the elderly with third doses or fourth doses of vaccines, if necessary.

The other thing is possibly doing better in terms of treatment. We have pretty good treatments in terms of Paxlovid and remdesivir, which really aren't being used that much. The public largely doesn't know about them, and people don't know that if you're high risk and you get sick, perhaps you should get treatment.

We've maybe come full circle. Normally public health is cheaper and a better way of addressing a problem, but perhaps we're starting to look at treatment as becoming almost the cheaper thing to do.

I'd like to ask your opinion about that. Should we be doing more in terms of treatment, protecting the really vulnerable and worrying maybe a little less about the costly public health measures?

5:45 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. Theresa Tam

Thank you for the question.

At this period, two-plus years into the pandemic, with vaccines in hand, even though we're still learning about it, I think there's a much better chance of getting that balance. That's what the chief medical officers across the country are trying to do. They're trying to balance the impact of the pandemic, but also trying to reduce the negative impacts of some of those measures. I think the easing of public health measures is occurring across the country, with a view that unless it's really, really necessary, you're going to rely on the least restrictive of those public health measures, like mask wearing, etc., in order to reduce the impact.

Treatments do play a role in reducing severe outcomes and preventing those with the highest risk, who may not respond as well to vaccines.... It is a complementary measure. However, vaccines remain, I think as a preventive tool, one of the most important aspects of our ongoing management of COVID-19.

5:50 p.m.

Liberal

Marcus Powlowski Liberal Thunder Bay—Rainy River, ON

I take it from what you're saying that you do believe the treatments are important. Do you have any comment as to whether we're using them as effectively as we could? Certainly my experience, as someone who occasionally still does clinical medicine, is that the vast majority of people don't seem to know about them, and certainly accessing them has not been very easy.

5:50 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. Theresa Tam

Yes, the broader health system is learning how to do implementation. Of course, from a federal perspective, we have done our leadership work in procuring the vaccine and leveraging partners to provide guidance on how best to use the medication.

Implementation is not easy, because you have to get the medication into people really fast and people have to get a diagnosis, but we're seeing innovation across the country. You've heard about Quebec getting it through pharmacists' being able to prescribe. Other provinces are making sure that the physicians who look after those at highest risk, for example, people who have certain types of cancers and other chronic medical conditions, know how to access those medications.

I've been encouraging members of the public who are at higher risk to find out, at the local level, how they can access the medication ahead of time, before they need it.

We will get better at it as the doses continue to arrive.

5:50 p.m.

Liberal

The Chair Liberal Sean Casey

Thank you, Dr. Tam and Dr. Powlowski.

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

5:50 p.m.

Bloc

Jean-Denis Garon Bloc Mirabel, QC

Thank you, Mr. Chair.

Dr. Powlowski just spoke eloquently about prevention. However, to carry out prevention, you need medical staff, and to have medical staff, you need resources.

These resources have been largely taken up by COVID‑19 patients in recent years. Provinces have been forced to triage because of the lack of resources and, in some cases, people have even been denied access to doctors, particularly in order to prevent chronic diseases.

Does the Public Health Agency of Canada consider the lack of provincial staffing to be a public health issue?

5:50 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. Theresa Tam

Maybe I'll start. Health Canada is playing a lead role in terms of convening provinces, territories and our ministers in talking about health human resources. Those are probably one of the top priorities of the discourse and discussion with the provinces going forward, including credentialing and getting an international medical workforce trained and recognized.

All of that is extremely important, and I just want to say that it is not just the health care workforce but also the public health workforce writ large. That is probably one of the most critical questions and challenges for the health systems in Canada.