Health Committee on Nov. 29th, 2022

[Jean-Denis Garon, Bloc, Mirabel, QC]

Minister, I am sorry to interrupt you. I am not doing it out of discourtesy, but I want to manage my time well. I hope you understand.

After three commissions and five reforms, to justify your conditions for transfers, do you consider that Quebec has not made the necessary efforts to optimize its resources?

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

We are well aware of the context of your question. Indeed, what is happening now is even more complicated than what was happening 10, 20 or 30 years ago because the population is getting older, including the health care worker population, which is resulting in nurses and physicians leaving in large numbers.

The challenges we face are even more serious than those experienced a decade or two ago. For that reason, resources and efforts must be even greater and more sustained than we could have anticipated not long ago.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Minister, I see you are avoiding answering my question, but I accept your answer.

I will now move on to another issue, which is the taxation of medical cannabis. The reason I am turning to you is because you are the Minister of Health, former president of the Treasury Board, and a highly qualified economist.

Most prescription drugs are normally exempt from GST, QST and excise tax. However, medical cannabis products are subject to completely different taxation, as all taxes apply.

Have your department and you, as an individual, begun to think about the tax treatment of cannabis prescribed for medical purposes?

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

There are two elements to this question. The first one is more the purview of my colleague the Minister of Finance, who I'm sure you will want to ask about the taxation of all products, including medical cannabis.

From the perspective of the Department of Health, our goal is obviously to protect people's health and safety. I think we can be proud, although nothing is perfect, of the substantial progress that has been made over the past few years in Canada. The legalization and regulation of cannabis has provided thousands of people, including young people, with greater protection from the effects of the illicit market in terms of the supply of cannabis.

Again, nothing is perfect and there is still room for improvement, but we can be quite proud of what has been done over the past few years.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you, Minister.

I want to discuss the youth issue with you. Currently, in Canada, there is an object circulating called the cannabis wax vape pen. It is a small coloured object that looks like a pen and that does everything to attract the eye of teenagers, while being discreet, even almost undetectable, since the vapour that emanates from it is odourless. It's used to consume liquid cannabis extracts that, when distilled, reach THC levels of up to 99%, well above the regulatory level of 30%.

Are you aware of this problem? What is currently being done to address this complete violation of current regulations?

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

That's a great question, and it's about both the regulations and the need to enforce existing or upcoming regulations.

I will turn to deputy minister Lucas to give you an overview of how all this is done within the Department of Health.

[Dr. Stephen Lucas, Deputy Minister, Department of Health]

We have a team that enforces our regulatory frameworks.

The focus is identifying specific incidents or concerns. When that information comes to their attention, they follow up and work as appropriate in conjunction with law enforcement. Certainly this is an area they will have been focused on, and any illegal products are subject of to compliance and enforcement actions.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Is the cannabis wax vape pen, in particular, whose use seems to be increasing, part of events that have been reported to you concerning which efforts are starting to be made?

[Dr. Stephen Lucas]

I don't have any information on that specific issue. However, as I said, when we receive information that regulations have been violated, our team works proactively and in close collaboration with the police to enforce them.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Garon.

Next is Mr. Davies please for six minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

I'll be splitting my time with my colleague, Gord Johns, the NDP critic for mental health and addictions.

Ministers, officials, thank you for being here with us today.

Minister Duclos, I would like to start with you if I could. The provinces of course are claiming that the federal government is only paying about 22% of health care costs in Canada. Do you agree with that number, and if not, what number do you think is more accurate?

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

Here we have an example of a futile fight and a useful battle. The futile fight is on dollars, tax points and percentage points, because if we were to do that, we would need to recognize that since 1977, if you take into account both the cash transfer and the tax points transfer, 35% has been the norm and is still the norm now. The total support of the federal government for health care is about 35%. It went up during COVID-19 and it's back around 35% now. That's a futile debate, because it would suggest the federal government doesn't need to do more, but we said we will be doing more. That's why the useful debate, this useful battle, is how we are going to unite together and fight for health care workers and patients across Canada.

[Don Davies, NDP, Vancouver Kingsway, BC]

Do you subscribe to the theory that the federal-provincial cost share should be fifty-fifty?

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

That fifty-fifty comes from the law or a rule dating from 1960 or something of that sort, which—

[Don Davies, NDP, Vancouver Kingsway, BC]

Some of the best things come from 1960s, Minister.

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

I was thinking of you in particular obviously, Don.

But beyond that, at that time my understanding—and we can discuss this further if you want to—is that the federal government was paying only for hospital costs, but not any other costs. Obviously health care is more than just going to a hospital; it's having access to a physician, having access to a nurse. That's why the 50% is nonsense now because it was supposed to be that the federal government would only pay for the hospital costs. The federal government needs to assume responsibility beyond the cost of hospitals.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you. So let me move to that. At the recent health ministers meeting in Vancouver, you announced that the federal government was prepared to put more money into the Canada health transfer provided that the provinces agreed to two specified conditions.

Did you communicate how much money that would be, and if so, how much?

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

It's very good that you point to those two outcomes that we were hoping to share, because we had all agreed on them until just a few days prior to the conference. These were plans to support health workers and to modernize our health care system—supporting health care workers, because we all understand that it's the only way to support patients, and modernizing our health care system, because the use of data in our health care system is antiquated. We don't have a world-class—

[Don Davies, NDP, Vancouver Kingsway, BC]

Minister, I don't mean to interrupt. I agree with you on the conditions. My question is about the amount of money. You said you'd put more money in. I'm asking if you actually specified the amount of money you'd put on the table.

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

What we said, because the Prime Minister had asked me to say it, was that we were willing, and were hoping, to increase both the CHT and bilateral funding to provinces and territories to support the priorities on which we had all agreed until then—

[Don Davies, NDP, Vancouver Kingsway, BC]

Did you attach a number?

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

—meaning supporting health care workers with a pan-Canadian health workforce plan that was exceptional, built by the efforts of provinces and territories, may I say, and a data plan to make sure that people had access to their electronic medical records, for instance, and that health care providers could use data safely to care for their patients.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks, Minister.

I'll turn it over to my colleague now.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Today marks two years since one of my staff members lost her brother Ryan to toxic drug poisoning after he was unable to access treatment. Every day more families receive tragic, life-altering news because their loved ones don't have the supports they need.

Minister Bennett, at this committee on June 15, I asked about investments in supports for people who use substances or who are in recovery. You spoke about the substance use and addictions program, saying, “We know the SUA program is hugely successful and oversubscribed. We will get that money out the door, and if we need more money, we'll go get it.”

This month I received a response to a question on the Order Paper demonstrating how oversubscribed the program is. After two calls for proposals, only 14% of the funding sought has been granted. The response mentioned funding availability as a reason for not selecting projects, as well as a list of 138 projects being kept in an inventory for future consideration.

It's clear that we need more money to provide the supports that people need. When are you going to “go get” the money?