Indigenous and Northern Affairs Committee on May 10th, 2016

[Charlie Angus, NDP, Timmins—James Bay, ON]

Okay. Today is a deadline for implementing Jordan's principle, so there's no fund to respond to the Human Rights Tribunal, but there was under the Conservatives?

[Sony Perron]

I would say....

I cannot really answer your question the way you're presenting it. Today is the date for—

[Charlie Angus, NDP, Timmins—James Bay, ON]

Today is the deadline—

[Sony Perron]

To answer, we have taken some measures to be in a position to acknowledge the decision of the tribunal. Our staff have been directed to move away from the old definition, because the tribunal has been really clear about what the approach should be going forward.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Okay. But there's no fund set aside to implement?

[Sony Perron]

The envelope that was set aside up to 2012 is not there any more.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Looking at the Human Rights Tribunal ruling, a lot of the evidence was from child welfare, but a lot of it was also from your department. Looking at the evidence that was put forward by your own officials, there are some pretty disturbing statements. Tab 78 on gaps in service delivery to first nations children says that the denial of prescriptions that have been ordered by pediatricians is common. Who would make a decision to deny a child's prescription, or on what basis would such a decision be made, if a doctor has ordered it?

[Sony Perron]

I cannot really comment on the specific case that was behind the evidence that the person or witness brought to the attention of the tribunal. But I can probably ask Scott to give us a sense of what our rate of approval is.

[Charlie Angus, NDP, Timmins—James Bay, ON]

These these aren't individual cases; this is systemic. That's what they're saying. These are systemic issues, that children are routinely being denied prescriptions that have been ordered by pediatricians.

Tab 302, which Health Canada supplied to the Human Rights Tribunal, says that if a child with multiple disabilities requires a wheelchair, lift device, or tracking device, they're only allowed one of those items. If they opt for a wheelchair, they don't get a motorized wheelchair; it has to be an adult push chair. Is that policy, or is that what a bureaucrat decides?

[Sony Perron]

The level of coverage and the criteria for coverage depends on the nature of the handicap faced by the child. Each case is assessed case by case. If the service or the supply of medical equipment is required, it will be paid in full by the program.

There was some issue raised in the tribunal related to medical beds. We have resolved that issue.

[Charlie Angus, NDP, Timmins—James Bay, ON]

That was the one where the child was going to die and Health Canada said absolutely not, and the doctor paid out of his pocket.

I want to ask about one of the allegations that has come forward from testimony at our hearings—some very disturbing hearings. It's said that Health Canada is telling doctors to use only one catheter bag a day, which means they have to reuse them. I'm not a doctor and I don't know much about this, but the doctors say this causes recurrent infections, kidney disease.

Is that a decision made by a doctor at your office, or is that just because someone is crunching pennies here?

[Sony Perron]

I'm not aware of any directive about this.

Scott, I don't know if there is such a directive under medical supplies and equipment. I've never seen that, and I've been in this position for a number of years.

[Charlie Angus, NDP, Timmins—James Bay, ON]

That's a pretty serious allegation. Dr. Kirlew says that children are dying from childhood illnesses that are unknown elsewhere, such as rheumatic fever, because they're being prescribed Tylenol. When a child dies at a nurses' station from a lack of medical supplies, are there investigations done to find out why that child died?

[Sony Perron]

Yes, it's done whenever there is an incident, and not only in the case of death. When there is an incident, there is a protocol to review the incident, to review the charts, and to involve external parties in the review if needed. The objective is to understand the cause and to see if there is any responsibility on the part of the health provider in this context, and also to improve the process.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Dr. Kirlew stated yesterday in the newspaper that he's concerned, as a doctor, about the Hippocratic oath under non-insured health benefits, because he says that “I know the system is actually harming people”. I would think you'd want to look into that.

I'm running out of time here. The department states that Health Canada spent $300 million on mental wellness last year. This year's RPPs state that it's $270 million, so does that mean there's a $30 million drop in mental health programs, and what program would that come from?

[Sony Perron]

No, there is no reduction of spending on mental health. This is probably related to programs that are being renewed and will appear when we get to the supplementary estimates process.

[Charlie Angus, NDP, Timmins—James Bay, ON]

I'm told there are only 10 mental wellness teams for indigenous mental health teams across the country. First nations are saying they need 80. Can you confirm that there are 10 mental wellness teams?

[Sony Perron]

Based on the mental wellness continuum framework, we started to invest a couple of years ago in building mental wellness teams. This is a model that has proven to be effective. At this time there are 10 or 11 being funded throughout the country. This is in addition to local mental health services.

[Charlie Angus, NDP, Timmins—James Bay, ON]

We've been told that only $350,000 has been put into that first nations mental wellness continuum framework. Is that true?

[Sony Perron]

Last year we spent around $300 million on mental health.

[Charlie Angus, NDP, Timmins—James Bay, ON]

I know, but within that framework, I've been told that up to date, there has only been $350,000 put into that.

[Sony Perron]

I cannot comment. Part of the framework is also to manage the funding that is already in place for these programs and to realign them under the framework. This was the intent of that framework, but also to inform future investment.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Finally, going back to the issues that we're seeing from the doctors, the testimony at our committee about children left at a nurses' station for 13 hours crying in pain because they don't have pain killers, or children starting to suffocate because they don't have Ventolin, is pretty disturbing to me. If that is a common practice, wouldn't that be kind of like institutional malpractice?

How is that allowed to happen in a medical system in 2016?

[The Chair, Liberal, Andy Fillmore]

We're out of time, I'm afraid. Maybe you can get the answer in another question, if it's appropriate. Thanks.

The next question is from Rémi Massé.

[Rémi Massé, Liberal, Avignon—La Mitis—Matane—Matapédia, QC]

Thank you, Mr. Chair.

I would like to thank the witnesses for taking part in the committee's work. Your presence is greatly appreciated. Thanks also to your respective teams, who have worked very hard to enable you to participate in this exercise.

In 2013-2014, the annual budget of the Non-Insured Health Benefits Program was a little over $1 billion, a 7% decrease from the previous fiscal year. What are the reasons for these budget reductions, given that the needs are growing year over year?