Human Resources Committee on May 25th, 2020

[Gisèle Tassé-Goodman]

We don't necessarily have any answers. We mentioned to the Standing Committee on Finance in February and again on May 1, that it was important for the government to keep its promise. On September 18, it made a commitment to increase the old age security benefit by 10% for people 75 years of age and older.

Notwithstanding that, whether it is old age security or the guaranteed income supplement, we know full well that there are many women who receive these benefits, for all sorts of reasons. There are those who joined the paid workforce later in life, or those who stayed at home to take care of the children and the family. It is often women who are penalized in this regard.

Increasing the benefit by 10% would have resulted in an additional $729 per year. This is permanent help that we would have liked to have seen put in place rather than temporary help.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

We understand your request. Do you see this measure as voluntary? Currently, the maximum age for transferring an RRSP to a RRIF is 71. The percentage of the maximum withdrawal has been reduced, but you would like to see the age limit removed.

[Gisèle Tassé-Goodman]

We would like to extend the maximum age for the transfer to 75. We know there's a labour shortage at the moment.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

You're proposing to move it to 75.

[Gisèle Tassé-Goodman]

Exactly. Seniors are choosing to continue working and to help society. In this way, they socialize and mingle with the community. This has the positive effect of counteracting isolation. In addition to alleviating the labour shortage, there is a transfer of knowledge to the younger population in the work context.

We think there are huge advantages to deferring the transfer from RRSPs to RRIFs until age 75.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Chabot and Ms. Tassé-Goodman.

I now give the floor to Ms. Kwan.

Ms. Kwan, before you begin, could I ask all the witnesses, in responding to Ms. Kwan's questions, to please be sure that you hold your mikes so that we get good sound quality?

Go ahead, Ms. Kwan, for six minutes.

[Jenny Kwan, NDP, Vancouver East, BC]

Thank you very much, Mr. Chair, and thank you to all the witnesses.

To begin with on this question, with respect to establishing a national standard of care for seniors, does it not make sense for the government to utilize the Canada Health Act to begin that process? I've heard some of the witnesses say that. I'd like to get it clearly on the record from each of the witnesses. Is using the Canada Health Act to establish a standard of care not a good place to start?

Let's start with Dr. Sinha, please.

[Dr. Samir Sinha]

Sure.

People are looking to the Canada Health Act, but again, the Canada Health Act also is what we use for hospitals and physician coverages. Remember that at every provincial and territorial level, our hospitals are organized according to level, and they're funded in their own ways. While we have some national accreditation standards through an independent organization, that doesn't necessarily guarantee standardized funding and standardized care in what we have. What we do have standardized is a higher level of funding for publicly funded hospitals versus the care that's being provided in long-term care homes. From this come a lot of the systemic vulnerabilities.

The Canada Health Act could be a tool, but I think we first of all have to ask what the level of care is that we want to be providing. Then we can look at the tools, such as the Canada Health Act or other mechanisms that might be there and that we can employ.

[Jenny Kwan, NDP, Vancouver East, BC]

Further to that, then, wouldn't the level of funding be intrinsically tied to that issue as well?

[Dr. Samir Sinha]

Certainly. You could enshrine long-term care, and I would say long-term care as we define it at the NIA as that whole spectrum of home care and nursing home care, but again, what we did in the recent federal transfers was transfer $6 billion over 10 years with, in my view, limited accountability. We just had provinces agree to some general guidelines or metrics that I haven't seen reported, and I was appointed to many of the committees trying to create those metrics a few years later. That was one mechanism. The Canada Health Act could be a mechanism to absolutely guarantee more federal funding, but again, funding without clear guidelines and standards for what we need to do won't get us any further ahead.

[Jenny Kwan, NDP, Vancouver East, BC]

Oh, I would absolutely agree. Establishing standards would go with the funding and of course the accountability in terms of return. You can't just not tie all of those pieces together if we hope to get results.

Thank you. I'm going to move on to another witness.

I'll come to you, Ms. Tassé-Goodman, and ask you the same questions, please.

[Gisèle Tassé-Goodman]

As you know, health is a provincial jurisdiction, so this is delicate. Sharing best practices is certainly a good thing, but if the increase in the federal transfer to the provinces and territories were to return to 6%, as the FADOQ network is asking, we would certainly see an improvement in that area. The transfer increases by only 3% per year, so there is a shortfall. The population is aging at an accelerated rate, so the health transfer is all the more important.

Mr. Prud'homme may have something to add.

[Jenny Kwan, NDP, Vancouver East, BC]

I'm sorry—

[Danis Prud'homme]

Basically, we are asking for a comprehensive review. The World Health Organization has shown us that we must recast our health care system. Obviously, this means reconsidering how and where we treat people, where we want to invest and how much money we are prepared to spend on health care. A thorough review is needed.

[Jenny Kwan, NDP, Vancouver East, BC]

Thank you very much. I think there's no question that part of the problem that we have suffered as well is that there has been, I think, a reduction in transfer payments to provinces and territories, and that also has, I think, added to the challenges we're seeing today. I think, if anything, COVID-19 has really exposed the challenges we face today.

On the question of a process, it was suggested that we should embark on the process to look at what is needed and so on.

I wonder, Dr. Sinha, if you have any suggestions in terms of timeline, because one of the things that I worry about is that we'll study these things, and then nothing will happen, or that it's such a prolonged period that it's not really going to generate the results that we hope for.

[Dr. Samir Sinha]

In terms of a process and timeline, again, I was appointed to the ministerial advisory board on dementia. That was something set out in legislation with clear targets and guidelines, and we helped to establish the national dementia strategy last year. The key is, that could be a template, for example, as a way to say we need to have a clear mandate and we need to have clear goals, because otherwise you could study things forever and never see any results or meaningful actions thereafter. If we say that this is what the goals need to be....

But we need to have federal and provincial co-operation so that we're all involving ourselves together to say what the end points are and how we are going to organize this. Do we use the Canada Health Act or other mechanisms with accountability, and how do you bring that back? I think the immediacy can be figuring out those types of things, like guidelines, to help us get through this pandemic, which will be with us for at least the next 18 months.

We're going to see more challenges in our long-term care systems, but then also how do we start reorienting our system to become one that's more home-care-based and community-care-based, and frankly, more sustainable? We know that our long-term care spending, right now if we do nothing differently, is going to go from $22 billion to $71 billion by 2050, and while we talked about family caregivers before, we know that we're going to have fewer available in the future to meet the care needs, so our current caregivers will have to be 40% more productive to maintain the status quo, which isn't sustainable at all.

These are the things. We have the data. We have the knowledge. We've seen what other countries can do. It's just that we need a clear mandate, timelines, targets and dedicated funding that can allow that to happen in collaboration with the provinces, territories and the federal government.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Kwan.

Thank you, Dr. Sinha.

We have now reached the appointed hour. I want to take this opportunity to sincerely thank all of the witnesses for being with us this evening and for sharing their expertise. It will be of great value as we continue our work.

Thank you to all of my colleagues. We will see you again on Thursday evening.

The meeting is adjourned.