Evidence of meeting #57 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was need.
A recording is available from Parliament.
12:25 p.m.
Conservative
Laila Goodridge Conservative Fort McMurray—Cold Lake, AB
Thank you, Mr. Chair.
I will switch gears a little bit once again, and I'm going to start with Ms. McKinney.
In some of the wraparound supports and services you provide, do you guys do anything to help attract more appropriate and culturally sensitive prenatal care so that kids get the best start from the very beginning?
12:25 p.m.
Executive Director, Under One Sky Friendship Centre
We don't here, specifically.
One of the things that we did do was that we partnered with Horizon Health. We now have a nurse practitioner who comes to us and is available to many of our folks who come to the friendship centre. That was a big help for us. We noticed that most of the time it's moms with young children who are going to her.
One of the things we are hoping to build is a birthing centre, right here in our new building that we are hopefully going to have within two and a half years. That way our families can come and be able to do those things traditionally with a really good health care provider, while going back towards midwives and doulas and delivering babies in a more traditional way.
We have many people who are pretty excited about that. I believe that, at the friendship centre in Halifax, they had their first child born there, which was pretty exciting.
What we realized is that many of our families who are struggling with health or mental health issues will hesitate to go to mainstream services. The reason for that is the amount of judgment they face. Sometimes it might start off as a small, insignificant health issue that will grow because it's not getting addressed, since they are not going for help.
They will come here. We are trying to provide medical services here at the friendship centre, so that they don't have to go into mainstream services. There are some things for which they will have to go to specialized services, of course, but it's to get them comfortable to come here, because of what they're facing in some of these institutions they're going to.
One of the things we're working really hard on is cultural sensitivity training for the medical profession here in New Brunswick, because people are hesitant to reach out. It's not always safe for indigenous people, culturally.
12:25 p.m.
Conservative
Laila Goodridge Conservative Fort McMurray—Cold Lake, AB
Thank you. That's spectacular.
I think that if more organizations did things like that to have culturally sensitive approaches to child care and child birth, we'd be in a very good spot.
I used a midwife in my first pregnancy, and I'm intending to use a midwife again with the current pregnancy that I am in. I think it can be a very good option for people who are low-risk. As you pointed out, when the choice is between no prenatal care and prenatal care with a midwife, I think that's a great idea.
To switch gears a little bit, again, Ms. McKinney, what other services would you like to see come into friendship centres like yours and across the country to specifically assist children in getting the care they need?
12:25 p.m.
Executive Director, Under One Sky Friendship Centre
After-school programming and anything to do with education. Our kids have to go to mainstream schools. I don't know what it's like across the country in other places, but here, the highest level you can go to in community is grade 6—there may be one or two first nation communities that have grade 8—and then they're going into mainstream school. One of the things we really want to develop is after-school programming so that the kids can come here.
Right now we have a head start program. I'm hoping that everybody's familiar with the aboriginal head start in urban and northern communities. That is a federally funded program that has been around for 27 years now. We have one. I think everybody should have one. The beauty of the head start program is that it embraces the entire family. It's not just about them dropping off the kids and going on their way. We embrace that whole family. That's what's really important around delivering programs and services to vulnerable populations.
The mainstream will take a child, and they are just going to deal with the child. We don't operate that way. That's why it's so significantly important. If you have a child with autism spectrum disorder, you have a family dealing with autism spectrum disorder. It's not just about the child.
These are the programs that we're working really hard to develop, but of course we're under-resourced. We don't have enough capacity to do that. We're working hard around being able to deliver some of these programs. I have a wish list that's 20 miles long of programs that I wish I could deliver.
The need is growing faster than we can provide the services, because the population is growing. We also have two universities here in the city of Fredericton, so we have indigenous people coming from across the country to attend university. They're bringing their families with them. Their first point of contact is often our friendship centre. They may have been familiar with a friendship centre wherever they came from, so the first place they hook up to is a friendship centre.
We're hoping that we can have more head starts. There's one in New Brunswick. I say that because somebody should be embarrassed and ashamed that there's only one head start in New Brunswick. There's only one in Nova Scotia. There's only one in Prince Edward Island. We have three in Newfoundland and Labrador.
These are early intervention programs because we embrace the whole family. That's the model that we try to use. It's not just about dividing people up into whatever they need, whether it's mental health or food security. It's a holistic approach to most of what we do.
12:30 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you, Ms. McKinney.
Next we have Mr. Jowhari, please, for five minutes.
12:30 p.m.
Liberal
Majid Jowhari Liberal Richmond Hill, ON
Thank you, Mr. Chair.
Colleagues, my apologies for not joining you in the room. I am recovering from a cold, and I just wanted to make sure that you all stay safe.
Dr. Skarsgard, thank you for your testimony and the same to all the other witnesses.
On your recommendation number four you specifically said:
...our children need governments to encourage and fund innovation that specifically benefits child health. This should span the spectrum of discovery research, implementation science, AI, health technology assessment and regulatory approval so that we are continually improving care and health outcomes for children while introducing efficiency that will drive value in health care.
Dr. Skarsgard, can you unpack the recommendation, specifically the whole spectrum that you talked about, within the perspective of one of the leading children health issues that we are dealing with in Canada?
12:30 p.m.
Member, Pediatric Surgical Chiefs of Canada
Sure. Thank you very much for this question.
I'm fortunate to have, on this panel of witnesses, people who can speak much more scientifically and eloquently about the discovery research, the biomedical research, realizing that Canada has traditionally funded a spectrum of research from biomedical to health services research. I'm just trying to cover the waterfront with that statement.
My expertise would be most appropriately applied to the latter half of those priorities, at the end of that sentence. I think that artificial intelligence has great promise for children's health. I think making that a funding priority should be very clear to everybody on this call.
The last two, health technology assessment and regulatory approval, are things that really hit home for me as a practising surgeon, because much of the technology and many of the surgical devices that we use in children really are off-label—meaning, unregulated uses of technology and devices that were developed for adults. That presents challenges from the perspective of Health Canada in the sense that we are not allowed to get into this country some devices that are the standard of care for children's surgery everywhere else in the world, particularly in the United States.
That problem is not unique to surgical devices but also to pediatric medicines. It relates to the fact that the market for some of these—in my instance, surgical devices—is so tiny, even when you extrapolate it across Canada to 16 children's hospitals. For the companies that make this technology, it's just not worth the expense of getting it approved in Canada.
This was really unveiled in the pandemic when we had supply chain issues, and we simply could not get diagnostic tools into Canada. It forced some of these regulations to be fast-tracked.
I would just highlight that this is a deficit in our care. I think it is within the control of this group and others to allow greater consideration of medicines and devices that are proven safe and effective in other jurisdictions, particularly with the FDA, and to see ways to get them into the hands of care providers, who are uniquely interested in applying that device that is approved for use in children.
12:35 p.m.
Liberal
Majid Jowhari Liberal Richmond Hill, ON
Thank you.
I see a number of other witnesses today are nodding their heads as you're speaking and responding.
The floor is open to all of you, if anyone wants to add any comments.
Go ahead.
12:35 p.m.
Full Professor, Institut national de la recherche scientifique, As an Individual
Yes, regarding that last point, I would add only that this is good not only for devices and medication but for vaccine development. We've seen that during the pandemic. We're really dependent on the proper evaluation of vaccines by Health Canada. We need to move in a very efficient manner. To rely on other jurisdictions to speed up the process is something that I think was done in that situation, but it needs to be expanded probably to developments of other biomedicals, vaccines or for cancer, so that we don't reinvent the wheel every time.
Of course, there are always going to be some specific needs and country-centric jurisdictions, and things like that. The main scientific problems stay the same. You don't have to redo the whole thing every time, I guess.
12:35 p.m.
Liberal
Majid Jowhari Liberal Richmond Hill, ON
I know I'm out of time, but may I ask for the chair's indulgence? I would like to hear from Dr. Grandvaux. Could you give us 30 seconds of additional time? I would really appreciate it.
March 21st, 2023 / 12:35 p.m.
Professor, As an Individual
The transition from research to translation or application in children is also a place where we could make the same comment about weakness. A major improvement could have been made for RSV infections, but it was blocked because we needed a company to make something special that didn't exist for children. The market is too small, so it was blocked. With specific funding, we could solve the transition and have children-specific treatments that are in the research pipeline but that we cannot apply because of these limitations.
12:35 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you, Dr. Grandvaux.
Mr. Thériault, you have the floor for two and a half minutes.
12:35 p.m.
Bloc
Luc Thériault Bloc Montcalm, QC
Dr. Skarsgard, you talked about a crisis in human resources. Can you outline the various reasons for this crisis? We have some idea of the reasons in Quebec. We have a number of problems retaining staff.
Was this situation anticipated and was there proper planning? Did faculties of medicine foresee it? Is the quota system excessive? Moreover, if we decide to limit quotas further, that will require a lot more money because those people will have to be trained.
In short, what are the main reasons that people are leaving certain fields of medicine? The loss of those people will clearly have an impact on certain aspects of medical practice.
I would like you to tell us about some of those causes.
12:40 p.m.
Member, Pediatric Surgical Chiefs of Canada
Thank you for the question. It's one that has a complex answer, depending on which component of the human health resource team you are talking about. Realize, again, that we're focusing on child health teams.
We've spoken quite a bit about the need for more nurses. I will highlight, in passing, some of the other areas. At Children's Allied Health, there are respiratory therapists, physiotherapists, occupational therapists and child life specialists. All of these people are very specially trained and have skills specific to the care of children.
You brought up faculties of medicine and workforce planning that refers to the physician members of the provider teams at children's hospitals. This is a very significant challenge, because we are often recruiting for very targeted needs.
I'll give you an example. We have a challenge here. We're in need of an ophthalmologist who can treat a very specific and rare type of childhood retinal cancer. Where do you find those people? We don't train them in every province. They are trained internationally. One barrier to bringing them onto our faculty relates to physician licensure at the provincial level. There needs to be greater co-operation among the provincial colleges of physicians and surgeons to see how we can tap into this pipeline of expertise. It isn't created within Canada, but it exists in North America and internationally. We need fast-track ways of identifying a workforce need and then filling it through recruitment.
I hope that answers your question.
12:40 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you, Dr. Skarsgard.
The last question for today's panel will come from Mr. Davies.
You have two and a half minutes.
12:40 p.m.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you, Mr. Chair.
Ms. McKinney, I don't know whether you touched on this, but I'd like to probe a little deeper, if you did.
In January 2022, the New Brunswick Institute for Research, Data and Training and Under One Sky announced a partnership to study the impact the head start program has had on participating families and to examine inequities among the families who applied and the general population of New Brunswick.
Could you provide this committee with an update on that research?
12:40 p.m.
Executive Director, Under One Sky Friendship Centre
It's really early on and it took quite a bit of time to get all of the ins and outs of it to the province and to that department at the university.
We've partnered with the university on multiple research projects and we realize that, if we can do this and do it really well, we'll be able to use it across the country because we have 133 head start sites spread out across this country. It took a while for us, because we wanted to make sure that the integrity of our families and their children was protected.
We also kept the information from the children who were on our wait-list. In the beginning here, we were licensed for six children. Think about that for a minute—six children. We're now licensed for nine children. This is a huge population, but anyway.... We realized early on.... We kept our files for the children who didn't enter, so there is a possibility that we could do some comparisons once they get into mainstream schools as well.
As I said, it's still very early on in the process. I'm not a research expert on anything. I've been participating in a lot of research, but I'm not an expert. We have learned over the years through the Urban Aboriginal Knowledge Network that the data can be really useful for us to be able to leverage funding and resources.
We'll keep you posted if you're interested in that. We're very interested in how this could unfold for the head start program across the country, actually.
12:40 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you, Ms. McKinney.
Thank you to all of our witnesses.
As I indicated at the outset, this is the final witness panel for the children's health study. It's been a fascinating and varied course that we've taken through the various panels, so I guess it's appropriate that we end with one that was both fascinating and varied.
Thank you all for being with us. Thank you for being so patient in sharing your expertise. We wish you a good day and many thanks.
Colleagues, we're going to move now to committee business in public, unless the will of the committee is to do otherwise. I don't propose to suspend because, although the original plan was just a couple of housekeeping items, there are a couple of other items that are going to be raised.
I will ask you to deal with the housekeeping items first.
One is the study budgets that have been circulated to you. The other is simply a deadline for the submission of amendments on the private member's business that's coming to us next week. Is it the will of the committee to deal with these study budgets as a group or do we need to talk about...? Okay, I see at least some heads nodding.
Could I have a motion to adopt the project budget for the main estimates, which is Thursday's topic; for Bill C-252, which is coming before us next Tuesday; and for Bill S-203, which might be coming to us next Thursday unless something else happens today?
Is it the will of the committee to adopt these budgets as presented? Because we're in public, I think we actually need a mover.
Mr. Davies, do you care to move the motion?
12:45 p.m.
Liberal
The Chair Liberal Sean Casey
Thank you.
Is there any discussion or any opposition?
(Motion agreed to)
Thank you.
For Bill C-252, which is Ms. Lattanzio's bill that is coming to us next Tuesday, we are required to set a deadline for the submission of amendments because unrepresented parties also have a chance to propose amendments. I would like to suggest this coming Friday in order to have time to have them circulated.
Do we have the consensus of the room to set a deadline for the submission of proposed amendments as this Friday? I need a motion to set the deadline for Friday at noon.
Mrs. Goodridge, thank you.
Is it the will of the committee to adopt the motion?
(Motion agreed to)
Thank you very much. Those are the housekeeping items that I wanted to deal with.
I understand there may be at least one or two other motions. The floor is open.
Mr. Lake.
12:45 p.m.
Conservative
Mike Lake Conservative Edmonton—Wetaskiwin, AB
I believe today that we have unanimous consent for this motion:
That the Preamble, the long title and all clauses of Bill S-203, be adopted, on division, without amendment, and that the Chair report the bill to the House.
12:45 p.m.
Liberal
The Chair Liberal Sean Casey
We're in committee business, so the motion is in order.
Is there any discussion on the motion?
Go ahead, Monsieur Thériault.
12:45 p.m.
Liberal
The Chair Liberal Sean Casey
Okay.
Does the committee wish to adopt the motion on division?
(Motion agreed to on division)