Health Committee on Nov. 1st, 2023

[Luc Thériault, Bloc, Montcalm, QC]

Over how many years do you want those results, Minister?

[Mark Holland, Liberal, Ajax, ON]

—I think it's a good idea to check that using the data.

[Luc Thériault, Bloc, Montcalm, QC]

I'm sorry, I let you speak.

Over how many years do you want those results? Do you know how many reforms have been made to the health care system in Quebec since 1985? I know you don't know. There have been six, Minister.

There was the Thérèse Lavoie-Roux reform in 1989; the Marc-Yvan Côté reform in 1992; the Jean Rochon reform in 1994; then the Philippe Couillard reform in 2003; Gaétan Barrette introduced one in 2014; and now there is Christian Dubé's reform. They are trying to do more with less.

In 2023, you say that you want results. Do you think that all those governments, which tried to do more with less, did not want results, Minister? How are you qualified to examine those results? How many years are we talking about? Next year, if the results do not suit you, you could say that you are going to cut health transfers and that you will not sign an agreement.

[Mark Holland, Liberal, Ajax, ON]

It sounds like you're trying to pick a fight, and I'm looking for solutions—

[Luc Thériault, Bloc, Montcalm, QC]

I have other questions for you.

[Mark Holland, Liberal, Ajax, ON]

—and when I talk to the Government of Quebec and Minister Dubé, the conversations are very constructive. I think it is possible to find a solution in the spirit of cooperation—

[Luc Thériault, Bloc, Montcalm, QC]

The National Assembly has just unanimously told you to mind your own business. That is not a good relationship.

[The Chair, Liberal, Sean Casey]

Mr. Thériault, let the minister answer.

[Mark Holland, Liberal, Ajax, ON]

Health is a priority for everyone across the country.

[The Chair, Liberal, Sean Casey]

You have one minute left.

[Luc Thériault, Bloc, Montcalm, QC]

Because you put nothing on the table—you invested a $1-billion transfer at the end of the pandemic, when $6 billion should have been invested on a recurring basis—people are having trouble making the health care system work and getting it back on its feet.

The network must be robust enough so that a pandemic would never again put us in a lockdown situation like the one we experienced in Quebec. Seniors living in CHSLDs must never again be infected because of a lack of personal protective equipment. We must never relive such a catastrophe again.

Money is needed in the medium and long terms, and your meagre one-time transfer of $1 billion to Quebec will not solve this problem. In addition, the agreement signed covers a 10‑year period.

The worst thing is that it has been nine months and nothing has yet been signed with the Government of Quebec. In the National Assembly, unanimously and across party lines, you were told to mind your own business.

In my opinion, there is a problem.

What are your conditions? You have not stated them.

[Mark Holland, Liberal, Ajax, ON]

We are ready to work with the province of Quebec.

Billions and billions of dollars are available to improve the health care system in Quebec. That's the good news. The money is available. However, we need cooperation.

In fact, $131 billion is available for Quebec. That's huge. Our only condition is that we be able to ensure that there have been improvements in the system.

I think that's very reasonable.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Next, we have Mr. Davies, please, for six minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Congratulations, Minister, on your appointment, and thank you to you and your staff for being here tonight.

Minister, for-profit clinics across Canada are currently charging desperate patients tens of thousands of dollars for two-tier access to non-emergency surgery. The clinics are exploiting a loophole in the Canada Health Act that allows people to pay to jump the queue as long as their surgery is performed in a province where they don't reside.

In the last election the Liberal Party committed to strengthening the Canada Health Act to protect the integrity of our public health care system. Minister, will you act on that promise and act to close this cash-for-access loophole?

[Mark Holland, Liberal, Ajax, ON]

Thank you very much for the question.

I am concerned that, coming out of the pandemic, our health system was weakened. We asked an enormous amount of our health care workers, and coming out of it there were a huge number of health issues that resulted in backlogs and challenges for provinces and territories.

Certainly one of the concerns we talked about in Charlottetown is the growth in for-profit operations. You're absolutely right. We have an obligation under the Canada Health Act to protect the public nature of our system and to make sure that it stays public. In the conversations in Charlottetown, with all of the health ministers, I was able to reiterate that and talk about a need to push out the privatization that we see in the system.

[Don Davies, NDP, Vancouver Kingsway, BC]

I'm sorry. I'm keeping really close track of the time, because of some important questions.

My next question is that the federal government sounded the alarm in 2021 over a rapid increase in youth vaping in Canada, and it proposed to regulate the sale of desirable flavours. However, two years later, Health Canada has shelved the proposal, apparently walking away from further regulating flavours, and they've left it up to the industry to regulate itself.

Can you explain why the government is refusing to act, while big tobacco uses vaping flavours like cotton candy, mango and berry to hook a new generation of children on nicotine?

[Mark Holland, Liberal, Ajax, ON]

Let me acknowledge the concern. When I was the executive director at Heart and Stroke, I was one of the first out warning of the dangers of vaping and the need to have controls. The companies that are in the business of selling nicotine, which was really what this is about, were looking for another delivery mechanism. Seeing the increase in the youth population is deeply concerning to me, as are the flavours you're talking about.

I want to validate the concern and say that it's something we're actively looking at and working on and that I will get back to you on.

[Don Davies, NDP, Vancouver Kingsway, BC]

Minister, I want to congratulate your government for recently agreeing to launch an expedited review of Canada's breast screening guidelines through the Canadian task force on preventive health care.

Up to now, for several years, experts, patients, physicians and researchers have called the current guidelines “outdated” and “dangerous” and have called for the immediate intervention in the review process. They've noted that problems with the existing guidelines are driven by a strong anti-screening agenda by task force leadership and the persistent use of 60-year-old studies. We note that recently Ontario noted that women aged 40 to 49 who have mammograms are 44% less likely to die of breast cancer than those who don't.

Minister, what steps, if any, is your government taking to address those concerns?

[Mark Holland, Liberal, Ajax, ON]

It's an important question. I'll turn to Heather Jeffrey, if I could.

[Heather Jeffrey, President, Public Health Agency of Canada]

Thank you very much, Mr. Chair, for the question.

We believe that the issue of breast cancer screening and guidelines is really of paramount importance to Canadians. That's the reason we put in place a knowledge exchange forum that took place with scientific experts from across the screening continuum to bring their experience to the table as well as those with lived experience of breast cancer.

We've opened a portal to allow all researchers and Canadians in general to contribute the latest research. The review panel for the task force is currently doing an expedited review of the guidelines and is considering all the evidence, including the latest real-time evidence. They will return with a decision.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Many health practitioners, Minister, small business owners and consumers from across Canada have expressed serious concerns to this committee that the government's proposed labelling requirements and new fees for natural health products will result in increased costs, serious harm to the sector's financial viability and jobs, and reduced choice for Canadians. They also complained of a lack of adequate consultation.

Minister, will you consider a pause on the regulatory changes until the natural health products sector is fully consulted and on board with any systemic changes?

[Mark Holland, Liberal, Ajax, ON]

Let me say first that, within the natural health space, we are committed to keeping Canadians safe. It is essential that Canadians know what is in the products they buy. It is essential that false and misleading claims are not allowed to be pervasive. It's particularly concerning when so many products are making claims in the space of cancer and in the space of cardiovascular disease. These are for very vulnerable people who are being misled about products that aren't going to help them. It's imperative that people not make profit off of people's pain. It's imperative for us to take action in that space.

If I can, Mr. Chair, I want to quickly talk about the attack on Dr. Sharma as the chief medical officer of this country. It is unacceptable. If we are going to deal with information, attacking officials is totally inappropriate, and I will not stand—

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

I have a point of order, Chair.

[The Chair, Liberal, Sean Casey]

Go ahead, Dr. Ellis.

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

I'm guess I'm wondering. The great arbiter of our committee has never asked one question about pharmacare. He's deeply in their bed on pharmacare. I'm just wondering why he's not talking to the minister about pharmacare.