Health Committee on March 23rd, 2023

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

Well, in each of the action plans with each of the provinces and territories, we know that mental health and substance use is a priority, and we will be working with them on adequate action plans to make sure mental health and substance use is part of each of the priorities—

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

Okay, so what oversight are we going to have, as Parliament, over the bilateral health agreements? Will stakeholders and people with lived experience of mental health and substance use concerns be consulted in the development of action plans?

When are we going to know what's in those agreements? You've said $25 billion over 10 years—that's $2.5 billion a year—in four priority areas. How are we going to know how much is going to mental health and when?

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

Well, that, I think, is what's exciting about this new approach, which is that the action plans will have...that all of your stakeholders can really try to influence the kinds of indicators. What should be measured? What's a reasonable target? How do we influence the federal and provincial governments in making sure those action plans are clear? The action plans aren't reporting to us, or even to parliamentarians. They're reporting to their citizens—

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

But they need to report to—

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

—and it needs to be transparent and accountable, and that's where we're going. They must post the action plan, report annually—

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

Okay, Minister. Our job is to hold you accountable—

[The Chair, Liberal, Sean Casey]

Thank you, Minister—

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

—and the Canadian Institute for Health Information is helping with those indicators.

[The Chair, Liberal, Sean Casey]

Thank you, Minister. We're trying to keep the answers to the same length as the questions.

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

Yes.

[The Chair, Liberal, Sean Casey]

Go ahead, Mr. Johns.

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

Okay. Is the federal government ready to step in and fill gaps created by provinces and territories that fail to put these dollars to mental health and substance use? Are you willing to do that?

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

These action plans will be negotiated with the provinces and territories. That means the priority areas—the indicators, the targets—will all be an agreement between the federal government and the province. We are insisting that mental health and substance use be part of each one, and then they will have to make that action plan transparent to their citizens. They will be accountable to their citizens—

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

I'm worried about transparency to parliamentarians, because our job is to hold you to account, Minister, to make sure the money is actually flowing to the communities. I'm concerned, because I'm not getting the answers around that.

Now, for community mental health services, harm reduction, support counselling, psychotherapy and other services, we know they remain out of the reach of millions of Canadians. Will we see meaningful investments specifically in these areas in the budget next week?

I want to quickly read an email I got from a constituent of mine. He wrote, “Our adult son unfortunately has become addicted to fentanyl. We have him in a treatment centre. It's very expensive. We've borrowed money from a family member to finance his recovery.” He may have to sell his house to pay for it. He asks if there's any financial help that might be available to him. We know the answer: No.

If his son broke his neck, he'd be getting covered. The universal health care system doesn't protect him. What do you have to say to his father? We know that Portugal went on a renaissance in terms of developing treatment on demand, so that they truly have a universal health care system now. When will we have parity between mental and physical health in this country? What do you have to say to this son's father? When are we going to have treatment for this young man? What a decision he has to make: whether he's going save his son's life or abandon him.

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

As we go forward, I agree: We actually have to get mental health and substance use treatment back in under the publicly funded system. It was—

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

It needs to be immediately—

[The Chair, Liberal, Sean Casey]

Mr. Johns—

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

—in the Canada Health Act that way, and now, with cost containment in the eighties and nineties, it moved out to the private sector and out to the charitable sector. We have to get it back in. That's why having mental health and substance use as part of primary care teams, having separate dollars that provinces and territories will be able to spend on the pathway to recovery.... We also need to make sure that people who've been in treatment have the aftercare, so that they're not going through a revolving door. That's why having a really integrated system is going to work, and I couldn't agree with you more that people should not have to pay for that.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Ms. Goodridge, you have five minutes, please.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Mr. Chair.

I'm going to ask very short questions that I will ask you to respect and give short answers to.

Very simply, I've talked to tons of people in recovery who've told me that when they were in active addiction, they didn't want safe drugs. They wanted good drugs. They would trade any prescription or any good, safe drugs they had to get better drugs. They say that safe supply is an absolutely bad idea that will make the problem worse. What do you say to these people?

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

I'm saying that 40 years ago, people said the same thing about methadone. Twenty years ago, people said the same thing about suboxone. We are moving, and more recently there are things like hydromorphone and Dilaudid. There are very good stories of people being able to get off fentanyl by Dilaudid, by acetylmorphine, that I saw in—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Minister.

Pharmaceutical companies like Purdue were sued, and doctors went to jail for their role in causing the opioid addiction crisis. What will happen, should pharmaceutical companies and doctors potentially be causing harm with this so-called safe supply? Will the same thing be happening 10 or 20 years from now?

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

Absolutely, and that's what the colleges of physicians and surgeons are doing. That's what the colleges of pharmacies are doing.

I want to say that in that anecdote and the clients I saw last week in Kelowna who were getting injectable diacetylmorphine, it is not possible to divert that. We actually have to do what it takes to keep people alive long enough to get to recovery.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

To shift gears a little, what evidence is available on the impact of the legalization of the recreational use of cannabis on health?

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

This is an ongoing study. I think, as we've said before, the use of cannabis in youth has not gone up—