Health Committee on Nov. 29th, 2022

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

The answer is twofold.

First, we have been providing an enormous level of support throughout COVID-19: the $72 billion just for health and safety; the eight out of every 10 dollars that the federal government paid out to support the efforts of provinces and territories; the recent increase in the CHT; the 10% increase in the CHT in March 2023, the $9 billion—$3 billion for mental health, $3 billion for home and community care, $3 billion for long-term care. That's all there, in addition to $2 billion to reduce backlogs in surgeries and treatments that we announced just a few weeks ago, which is making a big impact now in the ability for provinces and territories to look after workers and patients.

We've done a lot, but the Prime Minister said that we need to do more. That's why we made that announcement prior to the conference in Vancouver.

You would have been proud of that, too, Marcus.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I have a question for Dr. Bennett about the amount of money going for mental health and substance abuse.

I know we make decisions that are evidence-based, so supposedly we're doing the right things. We believe in harm reduction. It should be working. However, having recently gone to Vancouver—where Don Davies and Gord Johns are from—it's hard to see that things have gotten better. Hastings Street is awful. It looks like a slum from a third world country, and I've lived in a lot of third world countries.

Thunder Bay has, apparently, a higher-per-capita overdose rate than Vancouver does.

What can you say in order to encourage us that things are, in fact, getting better, that our money is, in fact, getting well spent?

[Carolyn Bennett, Liberal, Toronto—St. Paul's, ON]

I think focusing on the Downtown Eastside has been a real problem, and we've been very upset with the video coming from the Leader of the Opposition. Even Ben Perrin, the previous public safety adviser to Stephen Harper, said that no public figure should use real human misery as a backdrop for a political pitch. It is using them as props to peddle snake oil, and it's disgraceful.

For us to use that stereotype when so many of the people dying are construction workers, people in natural resources or people who've had psychic pain or physical pain who were cut off from their medication and who go to the street for their drugs and are using alone and dying alone.... It's really important that we help them. Those are the sons of Moms Stop The Harm. Those are the people we are losing.

We watched that mom in Sudbury put in number 245 and number 246 of the little crosses of all the sons and daughters who have died in the overdose crisis there in Sudbury. This is across this country. It is extraordinarily important that the harm reduction of methadone, suboxone, sublocade and dilaudid and all of those things.... It is really important, but it is about changing our minds.

As we said last week during National Addictions Awareness Week, this is about creating a community of compassion. You cannot underestimate the 42,000 overdoses that were reversed at a safe-consumption site. Those 42,000 people would have been dead.

This is terrible. It's about the toxic drug supply, but it's also about understanding addiction, which is physical. When people are seeking medicine to not be dope sick, it is very, very misguided to think that a one-size-fits-all approach is going to work. We're doing everything we can to stop this national tragedy.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Bennett.

Thank you, Dr. Powlowski.

To both ministers, that concludes two full rounds. We kept you longer than we were supposed to, so we are grateful for your patience in staying on. We're grateful for your making yourselves available and being so patient with us.

Thank you so much.

Colleagues, we're going to suspend for about three or four minutes, just to let the ministers carry on, and then we'll continue on with officials.

[The Chair, Liberal, Sean Casey]

I call the meeting back to order.

The officials are with us and were introduced at the outset of the meeting, so we're just going to continue on with questions until about 12:45, at which time we'll have to stop in order to formally adopt or not adopt the supplementary estimates. There's a series of votes that we need to undertake, so we'll stop at about 12:45 to do that.

Next up is Dr. Ellis for five minutes.

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

Thank you, Chair. Thank you to the officials for continuing to be here today.

These are certainly important questions that we want to continue to try to have answers to.

I mentioned previously when the the ministers were here that the CMA president talked about how we have a system that is on the brink of collapse. I certainly would be more forceful with my words. I think we're in a system that's collapsing around us.

Sadly, as we've heard from the minister, there hasn't been an answer with respect to the promise of the Prime Minister of this country for 7,500 doctors, nurses and nurse practitioners. We may go ahead and say this isn't the purview of the federal government, but guess what. It was the Prime Minister who said that.

Unfortunately, there doesn't appear to be any answers with respect to how many of those folks are actually on the ground.

Dr. Lucas, if I might ask you that particular question, exactly how many of the 7,500 doctors, nurses and nurse practitioners have been hired?

[Dr. Stephen Lucas]

Mr. Chair, I'll start by recognizing the incredible contribution that health workers have made through the pandemic and continue to make, and the challenges that they're facing, as Dr. Ellis noted and Dr. Lafontaine has spoken about in his role as CMA president.

As Minister Duclos noted, as part of its focus on a priority to work with provinces and territories in the health system, the government committed $2 billion to support clearing backlogs. Through that, they're recognizing that a critical element of that is support for hiring health workers.

Under the direction of the federal, provincial and territorial health ministers, officials have been working to support methods to retain and recruit, to support better data and planning, and to innovate in care models to support health workers, including increasing recruitment and supporting internationally educated health workers. This work continues.

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

Thank you.

Through you, Chair, if I may, Dr. Lucas, could I ask your department to specifically table with this committee how many of the 7,500 doctors, nurses and nurse practitioners have been hired to date with the $3.2 billion that has been pledged?

[Dr. Stephen Lucas]

Mr. Chair, we're happy to follow up with a report on information about health workers in the country.

This is an area where we're working closely with provinces and territories, the Canadian Institute for Health Information and other health stakeholders.

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

Thank you very much.

Through you, Chair, if I might, to follow up with respect to that, Dr. Lucas, can you actually tell me how many international medical graduates have been hired in this country in the last year?

[Dr. Stephen Lucas]

Mr. Chair, I don't have that information offhand.

Provinces and territories have that information through their own processes. We can work to provide a report based on information from the Canadian Institute for Health Information and other stakeholders on internationally educated medical graduates and other health professionals.

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

Thank you very much.

Through you, Chair, if I might, would you agree, Dr. Lucas, that international medical graduates are going to form a significant part of our response to the terrible crisis that's ongoing for recruiting more health care providers in this country quickly?

[Dr. Stephen Lucas]

Mr. Chair, I would indicate that there is a broad recognition of the support needed across all health professions, through existing health professionals trained at institutions across Canada. Provinces and territories, working with those institutions, are seeking to increase enrolment and recruitment. As in past years and decades and looking ahead, internationally educated health professionals, including many who are here in Canada, need support to go through the credential recognition process. They can contribute in health professions, as indeed is the case now, and will contribute in the future to the health workforce in Canada.

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

Thank you very much.

Through you, Chair, I think I have time perhaps for a little bit more.

Your government committed specifically to an autism strategy from a federal lens.

Can you please comment on the autism strategy?

[Dr. Harpreet S. Kochhar, President, Public Health Agency of Canada]

Mr. Chair, we have been working on developing an autism strategy based on the engagement and information that we had collected through our constant work with provincial, territorial, indigenous and other stakeholders.

We have also focused on putting together a specific workshop or a specific meeting, which happened in the middle of November, just to make sure that we have collected all the information so that we could get that robust strategy in place. This is something that we will be able to finalize by spring 2023.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Kochhar and Dr. Ellis.

Next is Mr. Jowhari, please, for five minutes.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Mr. Chair.

Welcome to the officials.

I'm going to start with Dr. Lucas.

At a very high level in these supplementary estimates, they are asking for about $25 billion in votes. It's broken down among areas: indigenous reconciliation, immigration and strategy and COVID-19 funding, as well as the cost of public servants' salaries.

I want to focus on COVID-19. My understanding is that supplementary estimates (B) are asking for about $4.8 billion in funding for measures related to COVID-19. Can you tell me to date how much, with this additional $4.8 billion, would be the total spend or what we are planning to spend on COVID-19?

[Dr. Stephen Lucas]

Mr. Chair, I'll speak in part to that from a Health Canada perspective and turn to Dr. Kochhar to speak from a Public Health Agency perspective.

Certainly the supplementary estimates do include important investments to support our work on COVID-19.

On the side of Health Canada in particular, it includes statutory funding of nearly $1.8 billion to support the acquisition of rapid tests. To date, we have acquired over 800 million rapid tests to support Canadians across the country in all regions, of which 560 million have been acquired this year and provided to the provinces and territories, not-for-profit organizations and others to support communities across the country.

We also have support in the estimates to support our work on the regulatory system to ensure expeditious review, ensuring the safety, efficacy and quality of vaccines and treatments for Canadians.

I'll turn to Dr. Kochhar to speak specifically to the public health side.

[Dr. Harpreet S. Kochhar]

Thank you.

Mr. Chairman, what we are looking for is basically a $1.42 billion re-profile.

This is mostly focused on the COVID component, which is medical research and vaccine development, and which is again one of those core pieces where we are continuing to receive more bivalent vaccines. There are also logistics for vaccine distribution as we move the vaccines when we receive them from the manufacturers to the PTs.

Also, there is a component of the national emergency strategic stockpile in there.

Finally, there is some amount of testing, which is related to both waste-water surveillance and other testing that the National Microbiology Laboratory continues to do as such.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Dr. Kochhar.

You were talking about the research and vaccine development. I also noticed that we're earmarking $732 million to support public health measures in developing countries.

Do any of the officials have any idea of what the scope is?

[Dr. Harpreet S. Kochhar]

The information on that component is mostly related to our efforts to really provide those ancillary aspects for vaccination. Where we donate the vaccines, we also provide them with ability to have other aspects, such as syringes, needles and other components.

Also, there is a piece that continues to be focused on how we can assist them with their own capacity-building so that we can reduce any variants of concerns or interest originating from that component. That's an investment to really focus on that.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you.

There is also about $400 million for border and travel measures and isolation sites. Can any of the officials comment more specifically around the travel measures, the border and travel measures? I'm interested in knowing where this $400 million is being spent.

[Dr. Harpreet S. Kochhar]

This is the $400 million that was asked for the border measures that have been taken away as of October 1, but we are finalizing most of the contracts that were in place for mandatory random testing, compliance and verification and so on, so we're tying it up.

However, this $400 million will not be used completely. We will again want to make sure that we have tied up the rest of the contracts, and then the rest of the money will not be utilized as such. That was a supplementary ask earlier, during the time going up to December of 2022.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Jowhari.

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

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

Thank you, Mr. Chair.

My next question is for the Deputy Minister of Health, Mr. Lucas.

Quebec recently released its 2022 policy on rare diseases, which focuses on three areas: awareness and training, access to diagnosis and promotion of research.

The Minister of Health's mandate letter mentioned a national strategy on high-cost drugs. Recently, the Member of Parliament for Richmond-Arthabaska, Alain Rayes, had to ask the minister about one of those drugs during question period.

I would like to know how this undertaking is progressing in the department.