Health Committee on Nov. 1st, 2023

[Mark Holland, Liberal, Ajax, ON]

Minister Saks, the minister responsible for mental health and addictions, will be here in about an hour.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Ellis.

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

Thank you, Mr. Chair.

That was absolutely useless.

[The Chair, Liberal, Sean Casey]

Next, we have Dr. Powlowski, please, for six minutes.

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

Let me say, as a doctor who's worked 35 years, I can't answer those questions precisely either.

Let me ask you a question about something you already brought up.

[Some hon. members]

Oh, oh!

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

I have the floor, guys.

[The Chair, Liberal, Sean Casey]

He has the floor, please.

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

An issue that I think we did pretty well in addressing in a non-partisan fashion in an earlier study this year was the health workforce shortage. That was the shortage of doctors and nurses. A strong recommendation, coming not just out of that study but out of at least one other study, was to make it easier for foreign health graduates—doctors, nurses and other allied health professionals—to get licensed in Canada.

From what you said, out of the Charlottetown agreement, there is some progress. For example, there's a national licensure, which, yet again, was something we heard about over and over as something that was in our best interest. It would also make it easier in other ways for foreign-trained health professionals to get licensed here in Canada.

Where do we go from here to get to that end? Certainly, in my riding, we have places like Atikokan, Emo and Rainy River that have been short on doctors. A lot of places were short on nurses for a while. What are the next steps, and when do you foresee there will actually be more health practitioners out there?

You're welcome to answer yourself or ask one of your staff to answer.

[Mark Holland, Liberal, Ajax, ON]

Thank you, Mr. Chair.

I would like to just take this opportunity to say to the members of the health committee that these are incredibly difficult and complex issues facing this country. How we engage each other—the way in which we have conversations—matters. Any good conversation involves the attempt to understand one another and one another's perspectives. I don't believe that there is anybody on this committee who wants another opioid death. I don't believe that there is anybody on this committee who wants to see anybody suffer in this country at all in any way.

It is the objective of our health system to try to tackle the complex issues that are in front of us. I would suggest that in health, more than any other space, the need to put aside partisanship and to have level conversations is important. I appreciate the opportunity to be able to say that.

With respect to health workforce issues, we have to approach this from a myriad of different directions.

The first is to go back to that point around collaboration. I think that the meeting we had in Charlottetown was incredibly significant in that we were able to set aside our differences, our partisanship, and talk about solutions. I think that the commitments that were made around—as I talked about—retention, about that 90-day service standard and around national licensure were really huge items to move the needle.

We also talked about how we can accelerate recognition of foreign credentials and how we can continue, while respecting our WHO guidelines, to be able to immigrate folks faster to be able to have more folks here to deal with this. I look at a place like the Nova Scotia College of Nursing, which is doing phenomenal work to streamline its approval processes and is doing phenomenal things to meet the challenges it's facing there.

I think that, through collaboration and working together, we can not only get through this crisis but also, with the centre of excellence, manage it so that we don't wind up in a position of crisis again.

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

Can you give any timeline before we actually see people appear on the front lines?

[Mark Holland, Liberal, Ajax, ON]

I think that you're seeing it now. The bilateral agreement that was signed with British Columbia is a tangible example of addressing workforce issues—with British Columbia laying out its plan and us being a part of it. The other bilateral plans are doing that. You're seeing us work with the provinces on the items I stated. You're seeing action now, and you're going to be seeing steady improvements over the coming days and months.

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

The second thing I want to ask you about is WHO's new treaty on pandemic preparedness, which is being negotiated. The first draft is out.

I found the first draft very exciting, with a number of provisions that I thought were very progressive. One of those was a requirement that countries contribute annually to the fund to assist poor countries in meeting their obligations under the treaty. A second thing would be a benefit-sharing provision whereby any products that were made from the genetic sequencing of any new virus would be shared between countries, and 10% of any products would go, free of charge, to the WHO, with an option for a further 10% to be sold at affordable prices to the WHO.

This is, I know, only the first draft. I know that this is just coming back to us, but would our country be supportive of trying to get such provisions, which I think many of us at this table feel are in our national best interest? We know that much of the threat, in terms of pandemics, will come from poor countries that don't have the facilities to detect and respond early on to diseases. These provisions would help poor countries do that. I think it's in our best interests. Is Canada willing to try to support that in further negotiations, with a view to perhaps having such provisions in the final version of the treaty?

Again, I know that Dr. Tam has an interest in international health too, and we have at least one other pediatrician, so maybe we could start with you, Minister. Then, if there is time, we could ask some of the others.

[Mark Holland, Liberal, Ajax, ON]

Thank you very much for the question.

[The Chair, Liberal, Sean Casey]

Dr. Powlowski hasn't left you much time. Take 30 seconds.

We're not going to be able to run that around the table unless it's in a future round.

[Mark Holland, Liberal, Ajax, ON]

Just very quickly I can say that I met today with the U.S. ambassador, and we were talking about how our two countries can work together to support international preparedness. It's so important that we work with our international partners to make sure that we're as prepared as we can be, and not only in Canada. Just today in question period, I mentioned going out to the facility in Laval that is being built by Moderna so that we can make domestic capacity.

However, as you say, we need to help other countries to make sure that they're also ready, not only to stop the death and the pain that would come from a lack of preparedness in those countries but also because we know that it keeps us safe. The international work we need to do is critical.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Mr. Thériault, you have the floor for six minutes.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

Welcome, Minister. This is the first time we have had the opportunity to talk to each other.

How would you describe your relationship with Quebec? Is it bad, good, very good, excellent?

[Mark Holland, Liberal, Ajax, ON]

Thank you very much for your question.

I think it's a good relationship. I had the opportunity to meet with the health minister, Mr. Dubé—

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, that's fine.

Earlier, you talked about going beyond partisanship. The National Assembly must have heard you. On October 23, you said that you wanted to conclude a bilateral agreement with Quebec as soon as possible. A week later, the response you received is a unanimous motion from the National Assembly telling you to mind your own business. Explain that to me. Is that a good relationship?

[Mark Holland, Liberal, Ajax, ON]

It's really not a matter of jurisdiction because it's about getting data from each province and territory. It is essential for Quebeckers, but also for everyone across the country, to see in the data the progress made by our health care system. That is essential.

[Luc Thériault, Bloc, Montcalm, QC]

Recently, you stated—and you just reaffirmed it—that negotiations with Quebec are not a matter of jurisdiction, but rather a matter of results. In short, you are saying that you want to measure the provinces' performance in their area of jurisdiction.

Ottawa and the Council of the Federation, of which Quebec was a part, agreed, and the Government of Quebec already knows its priorities: improve access to a family doctor, support health care workers, reduce surgical waiting lists, improve access to mental health and addiction services, and improve access to digital data on the state of the health care system.

Since Quebec is working on it, what is the problem, Minister? What are your additional conditions, given that Quebec is already doing all that?

[Mark Holland, Liberal, Ajax, ON]

There is no problem, but we obviously have to check the data for each province and territory. It enables us to see, for the benefit of the public, the progress that has been made. I think it's good for the province of Quebec. If it is possible that another country has the same indicator, the same data, then it is possible for people to see the progress made in their health care system. I think that's really good. That is the goal.

[Luc Thériault, Bloc, Montcalm, QC]

How qualified are you to provide performance indicators, given that you don't manage any staff at all? Are you at the Common Front negotiating table right now? Do you know how a negotiation of the Common Front goes? Do you know what impact that can have on a health care system?

[Mark Holland, Liberal, Ajax, ON]

Indicators and data are at the beginning. Eight of them are available, and those are the most important things to start with. It is very important to me that people be able to see the results. I'm wondering why that's a problem. If there is progress and improvements in the system—