Evidence of meeting #34 for Human Resources, Skills and Social Development and the Status of Persons with Disabilities in the 43rd Parliament, 2nd session. (The original version is on Parliament’s site, as are the minutes.) The winning word was pandemic.
A recording is available from Parliament.
Liberal
Kate Young Liberal London West, ON
You have a big job ahead of you. You mentioned some other countries that we could learn from regarding long-term care standards. Who has the gold standard in the world?
Director, Health Policy Research, National Institute on Ageing
I would wish to say that I can always point to one country that has it right. I'm particularly a fan of Denmark in the way they have actually thought about an entire continuum of care approach. They're thinking about how they can really focus on wellness and prevention and how they enable technology, as I'm sure my colleague, Alex, can speak about as well. It's also how they think about really supporting people to age in their own homes, where they want to be. They don't have many of the issues that we have.
People say that Denmark is a small country. Sure, it's a small country, but it is a smart country that has really been proactive in how they have approached aging.
In terms of the creation of standards, there are a lot of variable practices around the use of these things. We're going to be studying what's being done around the world, so we can rob and duplicate the best ideas to create standards that will be meaningful for the Canadian paradigm.
Liberal
The Chair Liberal Sean Casey
Thank you, Doctor.
Thank you, Ms. Young.
Ms. Chabot, you have the floor for six minutes.
Bloc
Louise Chabot Bloc Thérèse-De Blainville, QC
Thank you, Mr. Chair.
I want to thank both witnesses. My first question is for Dr. Sinha.
First, I can understand the desire to study the practices in Denmark, in particular, or in other parts of this region of Europe, where family and social programs are very important issues. In any case, Quebec has drawn heavily from these practices in order to implement a number of social policies, particularly in the area of early childhood education.
I also agree that our seniors, in general, want to grow old in their own homes. This was true before the pandemic, and the pandemic has certainly strengthened that feeling. Obviously, the reason for this is the isolation that they experienced in nursing homes. However, nursing homes and long-term care facilities will always play a role in the organization of services, even though we know that the number of hours of care required for admission has increased dramatically. There must be a balance between the two.
I was troubled by what the Auditor General said in her report regarding the Public Health Agency of Canada. You also released a report on the pandemic, and I wanted to ask you about that. The Auditor General said that, prior to the COVID-19 pandemic, the Public Health Agency of Canada hadn't updated all the pandemic plans or tested plans together with the provinces and territories. The report states that better preparedness could have minimized serious illnesses, overall deaths and social disruption among Canadians as a result of a pandemic.
Are you troubled by this report?
What solutions should we implement to be better prepared? What more proactive measures could have helped lower the high death toll among seniors?
Director, Health Policy Research, National Institute on Ageing
Thank you very much for that question.
This is what we're finding when we look at reports, not only at the federal level but also at the provincial and territorial level. We're seeing from many of these reports that Canada as a whole, and in many of our jurisdictions, was not as well prepared for this pandemic as it could have been. I think partly it may have been that we didn't anticipate, after SARS, for example, that something like this could happen, especially in our long-term care homes. SARS was something that was isolated to certain cities in particular and more to something in hospitals. We've never seen something that's happened on this scale in congregate care settings for older people.
This really reminds us that at all levels of government, whether it was the federal, provincial or even the municipal government levels, for example, there were things that needed to be done. There were things that we needed to anticipate. I think there's a role that all three levels of government could have done better to better prepare themselves for the pandemic.
In partnership with the Canadian Red Cross, the NIA published in December clear guidance, 29 evidence-informed recommendations, that really speak to a public policy, but even a citizen-based level of things we could do as a country to be better prepared to support older Canadians in emergency and disaster response.
Again, what we are seeing is being echoed at many levels, in many reports, that these are things we can do with good-quality planning, with clear pandemic preparedness plans.
As with my comments earlier, as this pandemic was evolving, I think the challenge was when we said that this was a provincial and territorial matter, these issues were all of national significance. I feel that there is a role...that we could have better clarified or made sure that we enabled groups like PHAC or CIHI to have a mandate to say what the guidance is that needs to occur to better support these settings.
There's stuff that could have been done before, that needed to be done during, and hopefully from all of this, we'll learn what all three levels of government should be doing better to avoid the same issues next time.
Bloc
Louise Chabot Bloc Thérèse-De Blainville, QC
Thank you.
It's nonetheless worrying to see that we weren't able to prevent this. What would you recommend? You spoke about the truth being revealed by your report, but how can we prevent a similar situation from happening again?
We are in the third wave of the pandemic. But it is not the only crisis. We see that the most vulnerable are often victims of such catastrophes. I believe you said it yourself in one of your reports. Whenever there is a catastrophe, such as a flood, it is the most vulnerable that are most at risk. The report states that there was a delay in putting measures in place, and we know that this was a big factor.
I believe your work is national in scope, so what would your recommendations be?
Director, Health Policy Research, National Institute on Ageing
The work of the Canadian Red Cross and the NIA, where we've come up with clear policy recommendations are things that I hope will be reflected in our new national long-term care standards. They will speak to emergency preparedness and pandemic preparedness. This is a mechanism where we can actually come up with national standards. We also have an obligation, as a federal government, to hopefully support the enforcement and the enabling of those standards at a provincial and territorial level.
Liberal
NDP
Leah Gazan NDP Winnipeg Centre, MB
Thank you, Chair.
My first question is for Dr. Sinha.
In the province of Manitoba and much of the western provinces, urban indigenous people, and particularly first nation communities, have had disproportionately high rates of COVID-19. This has also been true for Black communities in Canada.
Can you speak about how the social determinants of health have impacted particularly indigenous and Black seniors during COVID-19, and how the government can implement policies that acknowledge these injustices? I'd also like to include in this group veteran seniors and newcomer seniors.
Director, Health Policy Research, National Institute on Ageing
Many thanks for that question.
When we think about COVID, many people talk about it as being the great equalizer, that it touches everybody, but it touched certain populations, like our BIPOC populations, in particular, more so than others. There are a number of reasons, because it largely comes down to the social determinants of health.
When we look at the issues we have across Canada, we find that many of these communities are more likely to be economically disadvantaged, and they're more likely to represent essential worker populations, where they don't have the space or the ability to isolate in their own homes. They don't necessarily have access to jobs that have paid sick leave readily available to them.
We also know that, especially when you think about BIPOC seniors, for example, they're more likely to be living in intergenerational households and settings. This is why, especially in our indigenous communities in more rural and remote areas, there is a real concerted effort to say, “If COVID comes into our community, especially in homes where we have many people living in intergenerational situations, this can rip through an entire home very quickly.” We're seeing this in regions of Peel, Scarborough and Toronto, and many other urban settings.
The commonality here is poverty. The commonality is not having the mechanisms to allow people to isolate from each other when they need to, and to have access to paid sick leave.
We have to remember that the issues of racism and systemic poverty did not make COVID-19 the great equalizer, but really attacked these communities in particular.
NDP
Leah Gazan NDP Winnipeg Centre, MB
Thank you so much for that.
As I mentioned with our last witnesses, a guaranteed livable basic income, particularly for seniors.... Poverty kills and it costs lives. I really appreciate your comments around that.
My next question is for Dr. Mihailidis. Am I pronouncing your name right?
NDP
Leah Gazan NDP Winnipeg Centre, MB
Okay. I taught in university for 20 years, and every time a course would start, I would get nervous trying to pronounce names right. My great embarrassment every year was the start of a new course.
Many folks in my riding—you spoke about technology—do not have access to things like computers, cellphones or Internet. You talked about impacts of social isolation, something that has been a deep concern for me in trying to support particularly seniors in our riding through the pandemic, as I can't imagine how lonely one must feel living alone anyway.
Another issue is technological literacy for older adults. One thing I tried to get started in my community is a technology program, and maybe even student jobs. Students would train seniors on how to use technology.
As you indicated, these technologies are critical, especially during the pandemic, for social connections and for updates on pandemic restrictions. Can you speak about how the federal government should address this gap and this critical need for even the health of seniors?
Scientific Director, AGE-WELL
Thank you. I really appreciate that question. I also feel your pain at the start of every semester in class at the university.
It does come down to education and developing education programs that can be attainable by anyone, no matter where they live within the country. At Age-Well, for example, we are looking at various models, such as train the trainer models, working with organizations and partners like the Red Cross, which has the capabilities and the expertise in these types of educational models. It's really working with pan-Canadian and international organizations where we can then be developing the curriculum, developing the materials. Really, it becomes a turnkey solution around education and then this can be spread out.
We also strongly believe in education applications within the community itself. For example, Age-Well has supported a couple of projects within indigenous communities. We're taking indigenous youth, who are then working with the seniors in those communities to teach them the literacy skills, and not just teach them the skills but to apply them, for example, in the role of digital storytelling.
These studies have been really fascinating, to see that once you give a purpose to it and connect the community by it, how quickly these skills can be developed and spread across the country.
Liberal
The Chair Liberal Sean Casey
Thank you, Ms. Gazan.
Next we will have Mr. Vis, please, for five minutes.
Conservative
Brad Vis Conservative Mission—Matsqui—Fraser Canyon, BC
Thank you, Mr. Chair.
Thank you to both of our witnesses for an excellent time together so far.
Dr. Mihailidis, you mentioned in your three recommendations that there was a 16% decline in R and D investment in Canada. What are the structural issues leading to such a decline and what can we do to improve it?
Scientific Director, AGE-WELL
The easy answer obviously is lack of funding that's been provided to our key national funding programs. Those are mainly the tri-agencies, so CIHR, NSERC, and SSHRC for the social sciences. The other issue we're seeing is the increased number of researchers. The number of Ph.D.s we're graduating across Canada has increased, and the number of individuals going into academic positions has increased as well, to the point now where it is becoming quite a crowded marketplace, so to speak. The two simple variables of increased demand and lower supply are causing a lot of these bottlenecks.
The big problem we're going to see, though, with COVID is that because all of the funding resources were directed towards COVID-based solutions and projects, which very much was the right decision to make, the problem is that other areas of research, whether health related or otherwise, are really going to see a gap in funding over the coming years. That's the big worry of the academic community.
Now is the time for increased investment in research in order to not just fund people but to bring us back up to the baseline that we were at several years ago, and to continue to fill the gaps. We're seeing this—
Conservative
Brad Vis Conservative Mission—Matsqui—Fraser Canyon, BC
Thank you. That's very helpful. I have a short amount of time.
Dr. Sinha, I appreciated some of your earlier testimony. Yesterday I skimmed through one of the NIA reports. In the national seniors strategy, one of the three underlying principles is value for money as it relates to taxpayer expenditures.
You briefly touched upon old age security in your remarks. I'm very interested to hear if any studies have been done on how we distribute the funds that are collected and given to seniors. As you likely know, the minimum threshold for a tax on OAS payments is about $77,000. However, I think you can receive OAS payments up to an income of $130,000, so high-income seniors are receiving OAS benefits from the Government of Canada. Over the course of the pandemic, it's been really clear that seniors on GIS, say, and lower-income seniors have been suffering greatly.
I'm wondering if your organization or any of the research you're doing at Ryerson has discussed the possibility of redistributing the amount of total funds for old age security, but targeting low-income seniors more with existing funds.
Director, Health Policy Research, National Institute on Ageing
That's an excellent question.
There was a bit of eyebrow-raising when we saw the announcement. It's great that we're recognizing that as we age, there are more expenses and that we're thinking about the group of Canadians who are 75 and older. They're more likely to have expenses for things like long-term care and things that challenge their ability to live independently, and we need to recognize that. However, if it had been my decision, I wouldn't have used the old age security mechanism to do that. I would have looked at the guaranteed income supplement.
In our original national seniors strategy, from prior to the 2015 election, we talked about poverty among older seniors and the importance of making sure that our guaranteed income supplement was better and fairer, especially for older women, because they're the ones who are most likely to suffer from late-life poverty. That was certainly a victory, because we saw some increases for single, especially older women as they aged and made improvements there.
As you said, the recent increases to old age security can benefit people with an income of $100,000 or more in older age. However, my bigger concern is the folks who are just making the guaranteed income supplement threshold. We need to think about better ways to support them.
Bridging this to the technology issues, one thing we worked on with Telus, for example, this past year was creating a new smart phone plan for only the 2.2 million seniors who are on the guaranteed income supplement. For only $25 a month, they get a smart phone during the pandemic. By doing that, they can use technology like the COVID Alert app and can participate in telemedicine and Zoom calls. This is, again, a way of thinking about how we bridge access to technology for low-income Canadians, not necessarily those who can afford it. That's where we're trying to challenge barriers with smart policy.
Conservative
Brad Vis Conservative Mission—Matsqui—Fraser Canyon, BC
Thank you both. I really appreciate your testimony.