Health Committee on Jan. 18th, 2022

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

That's not bodies.

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

They have been able to not only recruit but also maintain...and, equally important, to provide them with the working conditions they deserve to look after so many others.

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

Those are people who are already there, sir. Is it fair to say that you do not know how many people have been hired that you promised?

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

These people are being looked after because they need to look after so many others. That is why we were so pleased to add another $25 billion in our campaign to make sure that those significant investments would continue over the short and longer terms.

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

I guess you are just refusing to answer my question. I appreciate that.

Do you know that the emergency room wait times in Canada are the worst in the OECD? Do you have a plan to change that, sir?

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

Not only do we obviously keep increasing and investing through the Canada health transfer, but we also added another $11 billion just a few years ago to look after the mental health and the home care services that seniors and many others across Canada need. We got another $63 billion during COVID-19 to look after the emergency health care needs that the provinces and territories are faced with. We are adding more resources as we exit from the crisis and eventually repair the damage that the crisis has created.

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

Do you know how many ICU beds we have in Canada, sir?

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

I will tell you that it differs across provinces and territories, and it has been sustained, fortunately, because of the strong collaboration between the provinces, territories and federal government.

I've had six recent meetings with my health ministerial colleagues. This is an important way to collaborate and to look after the needs that so many across Canada have right now in the current crisis.

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

Sir, are you aware that Canada has the lowest number of hospital beds? We rank 29th out of 33 states in the OECD. Are you aware of that, sir? It's simply a yes or no answer.

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

We are aware of two things. First, not only was it a challenge before COVID-19, but obviously that challenge has also increased during COVID-19. That's why we're continuing our efforts with the provinces and territories not only to exit from COVID-19, which is a key priority now, but, as I said earlier, also to repair the damage created by the crisis.

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

I'd like to go back, sir, to find out—

[The Chair, Liberal, Sean Casey]

No. You're out of time, Dr. Ellis.

Thank you so much.

Dr. Hanley is next for the Liberals, for six minutes.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you very much, Mr. Chair.

I thank the minister and all of the witnesses for being able to appear today. Among Dr. Tam and other witnesses are previous colleagues from my role as CMOH, from the beginning of the pandemic up until recently.

Recognizing that people are tired—certainly health providers and public health and clinical services are tired—I would like to focus a question on surge support, which you mentioned in your opening comments. Could you talk about the types of human resource surge supports that have been provided through the pandemic? Where do you see those supports having been effective? Where do you think there may be improvements in surge supports to build upon?

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

Thank you very much, Dr. Hanley.

Brendan, if I can call you Brendan, we have had the fortune of having you on board for the last few weeks and months. On behalf of everyone in Yukon, I would like to thank you for what you've done during COVID-19—for all of the expertise and experience you're bringing now to Ottawa to serve your community, and for assisting with the important work we now need to do to exit from COVID-19 and repair the damage and build for the longer term.

In terms of surge support, I will turn briefly to my deputy minister. We've had a number of important opportunities to provide surge support to the provinces and territories based on their needs, which have changed and evolved over the last 22 months.

DM Lucas, would you like to provide examples of surge supports that we have provided to the provinces and territories?

[Dr. Stephen Lucas]

Certainly.

I would note that the Government of Canada has invested $150 million in support to address a humanitarian workforce problem, working with non-governmental organizations such as the Canadian Red Cross. The Canadian Red Cross now, with the support of the Government of Canada and working with the provinces, is supporting vaccination in a number of provinces, including Nova Scotia and clinical support in Manitoba. The government has a roster of federal nurses who have agreed to support the provinces, including Prince Edward Island, and is looking to support in Manitoba as well.

Of course, the Canadian Armed Forces have provided support through the Rangers in a number of first nation communities, as well as in deployments, such as the deployment in Quebec now to support vaccination. We have worked with the provinces and territories, and our ministries of immigration, refugees and citizenship and of employment, development and social services to support international medical graduates with foreign credentials to allow them to help out.

We are working collaboratively with a range of partners to support the surge needed to provide clinical support, vaccination support and support for testing, as well as contact tracing through the great work done by Statistics Canada, which has supported over 10 provinces through the course of the pandemic.

Thank you.

[Brendan Hanley, Liberal, Yukon, YT]

Thank you. If time permits, I'll go on to another question.

[The Chair, Liberal, Sean Casey]

You still have a couple more minutes, Dr. Hanley. Go ahead.

[Brendan Hanley, Liberal, Yukon, YT]

Okay. Thank you very much.

This question is about long COVID. I wonder whether you, Minister, or Dr. Lucas might comment on the potential impact of and preparations for the health care impacts of those affected by long COVID.

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

That's an excellent question, Brendan, and I'll turn in a moment to DM Lucas. It also points to the importance of protecting each other, and that comes with vaccination. As members of Parliament, we have not only a role to play but also an example to set for all other Canadians that vaccination is key to protecting ourselves against not only current COVID but also long COVID, which is something about which we still know too little.

I'll turn to DM Lucas for more precision on that.

[Dr. Stephen Lucas]

Thank you.

Mr. Chair, I would note that certainly something we are learning about COVID is that it has some enduring effects. The World Health Organization has estimated that 10% to 20% of the people who have had a COVID-19 infection could experience one or more symptoms past 12 weeks after the initial diagnosis, and there are some studies that suggest this number could be higher. It is an area of active research through the Canadian Institutes of Health Research, which have in total invested across this and other areas of COVID-19 research about $300 million and which have focused considerable effort on working with clinical researchers, public health experts and others to better understand, identify and develop treatment approaches for impacts such as long COVID.

This will be a sustained level of effort. I think the Canadian Institutes of Health Research have launched a call for research proposals to further understand this with an additional $119 million in research to support that work.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Lucas.

Thank you, Dr. Hanley.

It is the Bloc Québécois' turn.

Mr. Thériault, you have six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you very much, Mr. Chair.

I'd like to thank all the witnesses and the minister for being with us today so that we can take stock.

Mr. Minister, I have question that has lingered since the first wave. From the outset, experts determined that the chronic underfunding of health care networks over the past 30 years had weakened health care systems and our networks to the point where the pandemic would break the weakest links. That is what we have seen.

All along, we have been hearing from the Prime Minister that the issue of substantial recurrent funding, or health transfer payments, will be addressed after the pandemic. We are now in the fifth wave. Right now, the situation is so severe and the contagion is so extraordinary that doctors are being sent to give medicine or clean up patients.

You have invested from time to time, no one can argue with that. However, you know very well that the provinces and Quebec need predictability to fix this fragile system and that we need to make the system more robust. All public health decisions have an impact on our lives, including treatment delays and being unable to treat a cancer patient because the system is stretched too thin. But here we are in the fifth wave and the pandemic has been going on for two years.

What is keeping you from making structured investments that will allow Quebec and the provinces to plan ahead and invest?

In Quebec, we're talking about $28 billion. When I look at $340 billion and $28 billion, I don't understand why the government insists on not settling this immediately. Quebec could use this additional $6 billion to rebuild its network.

What are you waiting for? Is it going to take a sixth or seventh wave for you to address health transfers and pay your fair share to enable substantial recurrent funding for health care systems?

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

Thank you very much for your question, Mr. Thériault.

You have indeed just summed up the health care challenge that we already had before COVID‑19 across the country, including Quebec. It is a challenge that we knew would grow over time, with more frequent chronic illness, and obviously the aging population, which also includes aging health care workers, the rising cost of medication and technology, which carries both benefits and challenges for managing and delivering health care. All of this further amplifies the challenges with COVID‑19.

As you mentioned, the Government of Canada has been there during the COVID‑19 pandemic, investing $63 billion in either cash or transfer payments to support health care and safety alone. That's on top of the $280 billion in direct support to families, workers and businesses. We were there before and throughout the crisis, and we are still here, as shown by the recently announced Pfizer treatments and the large quantity of vaccines that continue to come into the country and are being paid for by the Government of Canada. We are also getting the rapid tests out there even faster.

So we are still here and we will continue to be over the long term.

[Luc Thériault, Bloc, Montcalm, QC]

With all due respect, Mr. Minister, this is not the first time you have given me that answer, but it's a basic question.

Of the $63 billion you mentioned to me, $42 billion are transfer payments already scheduled each year. You decided to increase health transfer payments by only 4.8% in 2022‑23, while system costs rose by 5.2%. You are keeping indexation at 3%. So all in all, that means you are investing under $3 billion in substantial recurrent funding in the system.

Quebec and the provinces need to be able to plan and rebuild their health care networks. To do that, they need to know how much recurring leeway they will have. Right now, some patients are not being screened for cancer. We are still expecting more and it will cost billions of dollars because we can't treat those people right now.

What are you doing for patients who don't have COVID‑19?

If you refuse to invest and settle the issue of health transfer payments, you are responsible for the non-COVID patients who are not being treated at this time.

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

I’m going to make two clarifications, if not corrections, to quickly respond to what you just said, Mr. Thériault.

I know that you have the best intentions and are interested in the numbers, like me, but let’s be very clear on the figures. The $43 billion for the Canada health transfer still exists. That's on top of the additional $63 billion we spent during the pandemic, the $11 billion in transfers for mental health and home care, the $25 billion we pledged during the campaign, and the $30 billion in direct transfers to the provinces and territories—