Health Committee on Nov. 27th, 2023

[Anna Roberts, Conservative, King—Vaughan, ON]

Thank you, Mr. Chair.

My question is general. I'm not sure who wants to answer it.

In our province of Ontario, I've met with numerous international doctors who have passed their boards and, unfortunately, can't practise. I know from speaking to residents that there is a lack of services. I'm not sure who wants to take this question.

What solutions or issues, if any, do you hear about, and how can we improve them? I don't think it's just an Ontario issue. I think it's across Canada. Can someone respond to that?

[Cindy Moriarty]

Thank you for the question.

I don't believe there's anyone on the panel who has the specific knowledge for that question. We can take it back.

I can tell you that, in some of the other issues we're representing, our focus is really working with providers to improve their capacity and knowledge to deliver services properly, and not on recruiting other health care workers or looking at workers with foreign credentials. I believe the committee recently did a study on health human resources, and there should be a separate response to that.

However, we can take that back, if it would be helpful.

[Anna Roberts, Conservative, King—Vaughan, ON]

One of the reasons I'm asking that question is that I recently met with a constituent who was very upset about the fact that she had to wait so long to get a mammogram, because of the wait and the timelines, and to get an appointment with a doctor who specializes in her particular cancer. By the time she got in to see the doctor, the cancer had progressed to stage three.

How, then, can we protect women if we don't have the capacity to serve them? That's my concern.

I don't know who wants to take that.

[Cindy Moriarty]

Thank you for that.

It's hard. I can't see my colleagues in the room. If anyone's putting their hand up to answer, I'll step back, but I think that's something we'll have to take back.

I just want to recognize that these are challenges not just for women but for everyone in the health care system. I think we're all aware of some of those anecdotes in our own lives and among our friends. It's a bigger challenge in terms of health human resources.

There are efforts under way. The federal government is working with provinces and territories looking at initiatives and different efforts. I just don't have the depth of knowledge to speak about those with any authority.

[Anna Roberts, Conservative, King—Vaughan, ON]

If we look at Canada as a whole, is there one province that would be an example to the entire country, which does provide services in a much more efficient manner and could be adapted to other provinces?

[Cindy Moriarty]

I could take that question back.

There may be some good examples in one area or another area. Sometimes these examples are more localized. They're not even province-wide. One challenge is the diversity of how health care systems are delivered across the country and the various focuses or priorities.

There isn't one province in particular that, as a whole, has this figured out and sets the example for the others.

[Anna Roberts, Conservative, King—Vaughan, ON]

I'd like to ask this of Dr. Clifford.

What is the percentage of women with health issues like cancer or mental health issues, as opposed to gender...? If we look at transgender, what is the percentage?

I'm just trying to understand where we need to focus. Could you help me understand that?

[Dr. Tammy Clifford]

Thank you so much for that question.

I wish I had the number right on the tip of my tongue or at the front of my head. I'm happy to bring that number back to you. It's a critically important question, and I'm so glad that you brought it forward here today. We'll get that information for you.

[Anna Roberts, Conservative, King—Vaughan, ON]

Thank you.

For my next question, I heard from Cindy that a lot of funds have been provided through Health Canada on different research projects.

Which one was the most successful as far as the research goes? Have we come up with anything? For example, I know we keep praying for cures for cancer and heart disease. Is there any area of research where we've really excelled?

[Cindy Moriarty]

I would turn to my colleagues at CIHR.

I also wonder, Annie, if you want to speak to the breast cancer screening guideline work.

[Dr. Tammy Clifford]

Not to throw the ball over to my colleague, Dr. Kaida, but I know this is right in her area of research.

I'll pass it over to you, Angela.

[Dr. Angela Kaida]

Thank you so much for that question and for an opportunity to share success stories as well.

I do think that we have a really robust women's health research community here in Canada. I would say that we have a few really shining examples of research informing practice that leads to health outcomes. There are examples around HPV vaccination and HPV screening. There are examples around sexual dysfunction and sexual pain, and how that research is implemented to transform health outcomes for women.

We also have really successful examples of women-centred HIV care and the provision of care services for women and gender-diverse people living with HIV. I would estimate that as recently as 10 years ago, we really did not have a robust evidence base that could inform clinical practice.

There are many other examples, but I want to assure you that we have some really shining success stories of women's health research in Canada that are being implemented to lead to tangible changes in women's health and women's health care.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Kaida.

Next we're going to Ms. Sidhu, please, for five minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

Thank you to all the witnesses for being with us. Thank you for the hard work you are doing.

My first question is for Cindy Moriarty.

According to Dr. Bruce Aylward, who is a Canadian physician, epidemiologist and assistant director-general of the WHO, pregnant women, babies and children face some of the gravest consequences from all forms and impacts of climate change, such as heat and air pollution. Do you all agree with this statement?

What research and work has been done through the health portfolios on the impact of climate change on women's health?

[Cindy Moriarty]

Thank you for the question.

I'm not familiar with that work by the WHO. It doesn't surprise me. Pregnant women, kids and babies are more vulnerable, generally, to a number of conditions.

This is fairly new work, in terms of looking at the impact of climate change. It's something the department is looking at, as we looked at sex- and gender-based analysis. It's considering the impact of climate change while developing programs and policies. It's relatively recent, so I don't have an example. We've been doing sex- and gender-based analysis for years, so we can point to past work that has reached some result. I don't have a specific example for you with respect to climate change.

I don't know whether any of my colleagues around the table are better positioned to answer that.

[Sonia Sidhu, Liberal, Brampton South, ON]

Dr. Kaida, do you want to add to that?

Please, go ahead.

[Dr. Angela Kaida]

Thank you so much for that question. It's such an important question. I am aware of that report.

I will share that, from a CIHR perspective, absolutely, the gender dimension of the impacts of climate change is a priority for us. I can speak about a few recent funding opportunities CIHR has held to support research by our research community in this area.

One funding opportunity was a response to the chief public health officer of Canada's report, “Mobilizing Public Health Action on Climate Change in Canada”. There was a funding opportunity put forward by several of our institutes that asked our research community to address the priorities raised in the chief public health officer's report around climate change and to integrate sex- and gender-based considerations, of course, within that research.

That's a fairly new funding opportunity. It was launched in 2022. We are carefully and eagerly following the work of these researchers to inform our evidence base around how climate change is impacting women, girls and gender-diverse people here in Canada, as well as globally.

[Sonia Sidhu, Liberal, Brampton South, ON]

Dr. Kaida, I also want to add that we know that evacuation in B.C. and across the Canadian north interrupted crucial care. It led to stress for pregnant women. It caused serious high blood pressure. It can also impact their whole health.

What perinatal health measures are we taking? Are we making any programs for that? What measures is the government taking on that?

[Dr. Angela Kaida]

Thank you again for that great question.

I'm going to comment briefly and then invite my colleague Dr. Clifford, or Health Canada, to comment further.

I know we funded research around the Fort McMurray fires that documented what happened in terms of health outcomes and health consequences, as well as the recovery period. I am not familiar at this time with the specific findings related to perinatal health, but I can certainly look into that and get back to you with some specific responses.

I'll open that up to my colleagues, as well, in case they have additional information.

[Dr. Tammy Clifford]

I would like to address that.

I'm sorry. Go ahead.

[Suki Wong]

I'm sorry. I didn't mean to take your turn, but I want to speak about what Health Canada is doing in the area of perinatal mental health.

We recently funded a study with Women's College and Dr. Simone Vigod to look at conducting a study on perinatal mental health, in order to identify treatments and clinical guidelines for practitioners, not just for pregnancy and the perinatal aspect but also for postpartum as well.

Dr. Vigod has just started this work. She's talking to stakeholders and people with lived experience, in order to look at how she can develop culturally safe, evidence-based clinical guidelines.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Wong.

Thank you, Ms. Sidhu.

Ms. Larouche now has the floor for two and half minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you, Chair.

Mr. Morgan, you spoke at the end of my first round of questions and now I’d like to follow up with you.

Following in the footsteps of countries that implemented women’s health strategies in recent years, including Australia, New Zealand, Scotland and England, is the Canadian government considering renewing its women’s health strategy? If so, is there a timetable for doing so? Fairly briefly, what can you tell us about what’s happening in countries that now have such strategies?

[Cindy Moriarty]

Thank you for the question.

At the moment, there is no plan to renew the Women’s Health Strategy. What makes Canada very different from other countries, as I imagine you know, are jurisdictional challenges. The provinces and territories are responsible for the delivery of health services. So there’s a limit to the federal government’s power and influence.

I’d also like to mention that I worked on the Women’s Health Strategy, back in the day, at Health Canada, and the issue of women’s health was primarily a concern for those who were responsible for it. It was considered a separate issue. It wasn’t something that was integrated into all the programs, services and policies for which we’re responsible today.

With the evolution of gender-based analysis, our approach changed. Instead of a specific strategy, we expect every activity, policy and law, whatever it may be, to take into account the needs of women, non-binary or trans people, among others, as well as the differences between all groups.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Ms. Moriarty. During my next turn, I’ll return to the issue of jurisdiction, as a matter of fact. I’ll also have questions for Mr. Morgan.