Health Committee on Sept. 22nd, 2022

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Thank you to all the witnesses for joining us today.

I also want to recognize that it's cancer awareness month.

My first question is for the Cancer Society. Cancer is one of the leading causes of disease-related deaths in Canadian children over the age of one month. Also, almost 84% of Canadians survive a cancer diagnosis after five years. This survival rate can be improved with new and better treatment.

Last year, the government launched the biomanufacturing and life sciences strategy with a commitment of $2.2 billion over seven years. I'm wondering if the Canadian Cancer Society can comment on how innovation in health care can improve patient outcomes.

[Kelly Masotti]

I can start with that.

We want cancer patients to have access to the best treatment in the location of their choice, so any additional funding from the federal government to support innovation, to support drugs and technology that will eventually help cancer patients in the location of their choice, is something that the Canadian Cancer Society is supportive of and thanks the government for.

Helena, I don't know if you want to add anything.

[Helena Sonea]

Not at this time, but thank you for the question.

[Sonia Sidhu, Liberal, Brampton South, ON]

The next question is for the Dental Association.

I know we have a broad topic today, primary care, which includes acute and chronic disease. Dr. Tomkins, we had a meeting in my office in Brampton, and I thank you for the work you are doing for all kids, the dental thing. The government is proposing a new Canada dental benefit for eligible families.

Do you see unique barriers for children seeking to access dental care in rural and remote communities? What should be done to improve equitable access so diverse populations can get access to dental care?

[Dr. Lynn Tomkins]

Thank you for that question.

Cost alone is not the only barrier for Canadians to access dental care, including children. We do appreciate this new program that's coming out. We feel that is a good start and look forward to continuing to work with the minister as we see things roll out.

Certainly, in remote and rural communities, there are challenges in terms of access, particularly with indigenous children, who sometimes live great distances from any centres that provide care.

We support all efforts to encourage dentists and dental staff to locate into remote and rural communities. As well, we are looking at building or creating surgical centres that are close to sites where the communities can access them, especially indigenous-led surgical sites, so children there don't have to be transported from Sachs Harbour down to Edmonton or Calgary to get their dentistry done.

We do appreciate any efforts, which could include things like loan forgiveness for dental graduates who are heavily indebted after leaving dental school, to encourage them to go to these areas.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

We also heard that unhealthy diet and negative health effects are not always evenly distributed across different populations in Canada. The Cancer Society also talked about a healthy diet and about saturated fat. We know we are already working on the front label packaging.

How can the federal government be more impactful so children can have a healthy diet and adopt that lifestyle? Would any witnesses want to comment on that?

[Dr. Lynn Tomkins]

Thank you for—

[Kelly Masotti]

I'm happy to jump in here to start. Thank you for the question.

Oh, go ahead. I'm sorry about that.

[Dr. Lynn Tomkins]

We're on the same page. I think we would like to see the healthy eating strategy complete the recommendations there.

In terms of dentistry and getting children to the dentist early, the Canadian Dental Association does advocate and recommend that children be brought to the dentist within six months of the eruption of the first tooth. That gives the dentist the opportunity to assess the child's risk of dental cavities and also to talk to the parents about healthy eating, healthy diet, brushing, flossing and so on.

I think early intervention and early meeting with the child and the family, because it is a family issue, would go a long way toward getting the child started on the right path.

[Sonia Sidhu, Liberal, Brampton South, ON]

Does the Cancer Society want to comment, please?

[Kelly Masotti]

Yes. Thanks for that question.

We are entirely supportive of the front-of-package labelling, and we thank the government for implementing this and moving it along. We would also echo the comments of the previous witness to encourage the government to implement all factors of the healthy living strategy.

The Canadian Cancer Society is part of the Stop Marketing to Kids Coalition. Both as part of that coalition and on our own, we wholeheartedly support the introduction of a ban on marketing to kids in any form. We're supportive of the new bill that's been introduced, Bill C-252. This bill is proceeding through the House, but on Health Canada's forward regulatory plan, it should not delay launching Canada Gazette, part I, on marketing to kids in the fall of 2023.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Sidhu and Ms. Masotti.

Mr. Perron, go ahead for six minutes.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Thank you, Mr. Chair.

I thank the witnesses for joining us.

I want to greet those I did not have an opportunity to greet in the beginning.

Ms. Wilson, in your remarks, you talked about child care and the importance of having speech language pathology or audiology services early on for screening purposes, among other things. You clearly mentioned that a transition fund was necessary to enable the provinces and territories to do their work.

Could you quickly explain your views on this, please?

[Dawn Wilson]

Thank you very much for the question.

What's really important is that there be awareness building about the need for early intervention. We know that the early intervention into speech and language problems is essential to child development services, and without that early intervention, the speech and language problems are further delayed.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Would you say it's urgent that the federal government increase health transfers to the provinces and that decisions be made locally to guarantee those health services? You mentioned daycare. This also affects education.

[Dawn Wilson]

Yes, and we applaud the federal government for its investment in the day care deals. We absolutely believe that the deployment of those day care deals is imperative, because we can work directly in day care settings with early childhood educators.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Thank you very much. I'm sorry to rush you, but my time is limited.

I, too, commend the government for investing in that and, more importantly, for respecting Quebec's jurisdiction by giving it the right to opt out with compensation.

Dr. Ungar, in your opening remarks, you mentioned that various factors are interrelated, like education and family. You also spoke of a domino effect and social repercussions.

In a few words, do you believe that health care needs are the same across the country or do you believe that it's important to consider regional specificities?

[Dr. Michael Ungar]

Definitely. In fact, that's what we look at when we look at patterns of coping or resilience in populations. We look at very specific cultural and contextual needs due to geography, language, cultural heritage and, of course, histories of trauma, whether it's refugees coming into the country or otherwise.

It is always a question, in a sense, of getting out of this pattern of thinking that we can solve individually focused problems. As a simple example of that, polio is going up, not because we don't have vaccines but because we don't have sociologists addressing the problems.

In other words, we need to get out of this idea that.... For instance, our Social Sciences and Humanities Research Council, which funds humanities and social science research, is separate from our Canadian Institutes of Health Research, which funds all the health research. If anything, we have learned that we need to be thinking more about individual populations and their particular needs in more systemic ways.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Okay, thank you. So, you're saying that we need to focus specifically on communities and their own unique needs.

I'm sorry to interrupt you, but I see that my time is running out fast. I'd like you to answer yes or no: It's important that decision‑making be decentralized to provide services tailored to communities—is that accurate?

[Dr. Michael Ungar]

It's more yes than no—yes.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Thank you very much.

Dr. Tomkins, you said that it was important that the money be used for oral health and that public funds be allocated to it. You are undoubtedly aware of the issues around health care falling under provincial jurisdiction and the federal government holding the purse strings. I will also point out that the request is unanimous, it's not only coming from Quebec: All 10 provinces are asking for a 35% increase in health transfers so they can invest the funds in this area. I'd like to know if you support that request.

Furthermore, as I understand the current version of Bill C‑31, an individual will be able to submit a dental care receipt for any amount, and automatically get $650. So, if a parent submits a $100 receipt for a cleaning, there won't be any control, any way to know if the remaining $550 is used for oral health. Are you concerned?

I'd like you to answer my two questions quickly, please.

[Dr. Lynn Tomkins]

In terms of the funding for and access to dental care, we look to see much more dialogue going on between the provinces and the federal government. In terms of how the money is going to be used, I think Mr. Boissonnault said that it's going to be on the honour system. We hope that Canadians are going to use the money so that children can get in to see the dentist for their care.

This is one reason why we're pleased that it's coming. This is being rolled out in stages, so there is the opportunity for intergovernmental dialogue so that the patients who are seeking to receive the care are not caught in the middle. This is going to be an ongoing discussion between the federal and provincial governments.

As I've said before, I'll talk about dentistry, but I'll leave politics to the politicians.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Thank you very much.

It's therefore important that decision‑making be decentralized—

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Perron. Your time is up.

Next is Mr. Davies, please, for six minutes.

[Dr. Lynn Tomkins]

I'd say it's important to continue the dialogue so that we reach the ultimate goal of making sure that kids get to the dentist.