Let us continue, Mr. Munter.
Evidence of meeting #32 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was pediatric.
A recording is available from Parliament.
Evidence of meeting #32 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was pediatric.
A recording is available from Parliament.
12:05 p.m.
President and Chief Executive Officer, Children's Hospital of Eastern Ontario
Ha, ha! There are other witnesses with things to say, you know.
12:05 p.m.
Bloc
Jean-Denis Garon Bloc Mirabel, QC
Yes, but this is so enjoyable.
Mr. Munter, you are a health care manager. Today we are considering a bill that supposedly pertains to dental care and that will have two effects. First, it will give parents a benefit of a fixed amount, regardless of the amount spent on dental care. Secondly, in exchange for the benefit received, the parents will have to fill out some Canada Revenue Agency forms and be audited. Meanwhile, Quebec has a universal system whereby a parent takes their child to the dentist, the child receives dental care, and the parent leaves the dentist's office with a bill of zero dollars.
Do you think that could be considered as a type of insurance? In terms of effectiveness, is it reasonable to give parents $650 for a cleaning that costs $50, rather than reallocating that money to actual care, and asking parents to fill out Canada Revenue Agency forms, or improving the existing programs in the provinces that are effective?
12:05 p.m.
President and Chief Executive Officer, Children's Hospital of Eastern Ontario
I have not read the bill. I have—
12:10 p.m.
President and Chief Executive Officer, Children's Hospital of Eastern Ontario
Yes, I believe you, but I have not had the chance to review how the program will be implemented. It is an interim program, from what I understand.
You are right, in principle. In Ontario, we have the Healthy Smiles Ontario program, but access is very limited. I do not have the exact figures, but as I recall it is limited to people with a family income of $30,000 or less. One way to expand access to the program would be to increase funding. So that would be an investment in an existing structure.
That said, I do not think that is the real question. The real question is—
12:10 p.m.
President and Chief Executive Officer, Children's Hospital of Eastern Ontario
All right, let me ask you a question then. That is allowed.
Which is the best option: improving an existing system or doing nothing?
12:10 p.m.
President and Chief Executive Officer, Children's Hospital of Eastern Ontario
Giving families something is better than not giving them anything, if those are the only two options.
12:10 p.m.
President and Chief Executive Officer, Children's Hospital of Eastern Ontario
In Ontario, we have a system and we could improve it. That would make things much easier for families and for health care organizations.
12:10 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Munter.
Mr. Davies is next for two and a half minutes, please.
12:10 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Just for the record, of course the $650 payment to families—and there are two of them—is an interim bridge measure to hold families until the permanent dental program is in place. I think that's important to note for the record.
Let me get this right.
Mr. Squires, Dr. Drake, Mr. Munter, you've painted a terrible picture of delays and backlogs for diagnostics and surgeries, particularly for our children. You've all sort of, in one way or another, stated that these were exacerbated by COVID, which of course indicates that they pre-existed COVID, and you've given figures on that.
I'm just wondering if you could give me a general context. What was the initial cause of these backlogs? Have we always had backlogs in surgeries and diagnostics? If not, when did it really start?
That speaks to me of a structural problem that has been developed over time. I'd like to know if you could give us a bit of a description of when it started and what caused it, so that we could maybe try to get some structural solutions on the board.
12:10 p.m.
Chief of Surgery, Hospital for Sick Children
You're absolutely right. There have always been backlogs in the health care system for both adults and pediatrics that go back for decades, and in most pediatric centres, around 20% or 30% of the patients were beyond their recommended treatment. The pandemic had a major hit on these backlogs because, as the CIHI data has shown, there are 600,000 procedures that have not been completed compared to how we were doing before. That's an enormous number of surgeries. They accumulated because the hospitals were shut down, and it took a long time to ramp up, and now many hospitals can't get back up to 100% because of the current health human resource issues.
I think every hospital has experienced this differently. We're 150% above where we were prior to the pandemic. There are always going to be patients on waiting lists. That's to be expected, but the idea is to get as many of them as possible treated before this recommended date.
All I can say now is that it seems to everybody that this is out of control. We have teenagers waiting for spine surgery who wait two to three years for their operation while their spinal curvatures increase. We have other patients who are limping around with a dislocated hip who can't have their hip repaired because we can't bring them into hospital.
What seemed to be not ideal but manageable has become, I think, a crisis. To deal with this problem, we have to increase our volumes well beyond what we did before, because of this backlog. That is the struggle. How do we do that when we are limited by the number of personnel, the number of operating rooms we have, and honestly, pushing the health care workers who have been phenomenal during this two and a half year period. They're tired. They're burnt out, and yet we're asking more and more from them. That's our problem.
12:15 p.m.
Conservative
Laila Goodridge Conservative Fort McMurray—Cold Lake, AB
Thank you, Mr. Chair.
Thanks to all the witnesses.
I'm going to start with Alex Munter.
I was looking at your Twitter feed. You were talking about something yesterday that is very top of mind for me as the mom of a little dude who is teething: the shortage of pain medication for babies and children that we're experiencing across the country. I don't think enough is being done to address this issue, specifically by the Government of Canada.
I'm wondering if you have any suggestions as to what the government could or should do to try to get through this.
12:15 p.m.
President and Chief Executive Officer, Children's Hospital of Eastern Ontario
I hear you on the teething. I have a four-year-old, so it's a recent enough memory. You have my empathy.
It is a concern. It is one of many supply chain problems we're facing, from a supply perspective. I'm told by our pharmacists that the result of ramping up production should be evident in four to six weeks.
We at CHEO and experts from other children's hospitals have worked with the Canadian Pharmacists Association to develop some guidelines, supports and information for families, in particular—some workarounds, in terms of using, for example, adult Tylenol, ibuprofen and infant formulations on older kids.
I think the warning—
12:15 p.m.
President and Chief Executive Officer, Children's Hospital of Eastern Ontario
Let me finish, because there's a real warning here: Don't try this at home. Pharmacists are extremely helpful and they will work with you to help you make the calculation and make sure this is done in a safe manner.
12:15 p.m.
Conservative
Laila Goodridge Conservative Fort McMurray—Cold Lake, AB
Thank you.
I saw the recommendations that came out and I think that's great. I tried giving my one-year-old Tylenol instead of the Motrin we normally give him and it all came right out, because he doesn't like the taste of the infant Tylenol. I can't imagine trying to give him a compound of adult Tylenol and having him actually consume it. That's just my experience.
I see Dr. Doan shaking her head quite a bit.
I was wondering if you could possibly add to this. What can the federal government do, in your opinion, to try to get through this issue?
12:15 p.m.
Clinician Scientist, Department of Pediatrics, University of British Columbia, As an Individual
I agree with what's been discussed.
I think one issue is the right dose for the right person in the right formulation. We have been using a lot of the infant formulation for older children for convenience. With my immigration background, I think you just have to conserve and use what you absolutely need to, when you need to. Guidance on when to use infant formulation and when to teach our older children to swallow tablets is one way, as well.
I've had kids in the ER who would drink down the whole infant bottle, because they won't swallow a tablet, and the dosage is such that you will consume the whole bottle in one shot.
12:15 p.m.
President and Chief Executive Officer, Children's Hospital of Eastern Ontario
Mr. Chair, if possible, I would add something in terms of what the federal government could do.
Three-quarters of medication used on Canadian children has never been tested on Canadian children, because we do not, in this country, have a regime of pediatric clinical trials. In a place like CHEO or SickKids where you have specialized pediatric pharmacy, the safety risks are contained, but it is a concern.
One recommendation of Children's Healthcare Canada is, in fact, to establish—as is the case in Europe and the United States—a regime to ensure there is broader research and clinical trialing of a medication before it is used on kids.