Public Accounts Committee on March 3rd, 2022

[The Chair, Conservative, John Williamson]

I'll need a 10-second answer, please.

[Christiane Fox]

With our 12-month supply we're in a much better position than we were prepandemic. I think we do our best to get to communities as quickly as we can. We also have to remember that some of these communities are quite remote. It's not like shipping the supply just to Toronto. It's shipping it to sometimes very isolated and remote areas.

[The Chair, Conservative, John Williamson]

Thank you.

Ms. Sinclair‑Desgagné, go ahead for six minutes.

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Thank you, Mr. Chair.

I want to begin by thanking all of our witnesses.

Like my honourable colleague opposite, I want to say that your work is very important and has been especially important in the most difficult moments. As we know, you work with more vulnerable populations, and they are often the ones who suffer the most during pandemics like the one we have been going through over the past couple of years. I thank you for your work.

Some of you may know this, but, in Quebec, when we talk about first nations, we do so from nation to nation. We have considered first nations as our brethren since 1603, since the Grande Tabagie de Tadoussac, when an alliance was established. According to some historians, that should actually be considered the founding year of New France.

But enough of the history lesson. My questions will mainly focus on the 2014 strategy, which has not been implemented. Stockpiles were not replenished in time, despite the strategy that was even developed by you.

I would just like to know what may have happened and why that strategy has not been implemented.

[Christiane Fox]

Thank you for your question.

We were able to recognize that, although the 2014 strategy was a hybrid one, we were exclusively counting on equipment from the Public Health Agency of Canada. Moreover, as we have seen since the beginning of the pandemic, there was a true shortage of equipment internationally.

If we look at the 2014 model and where we are now, the changes we have had to make have primarily consisted in not relying strictly on equipment percentage and what we received directly from the agency, but also in meeting needs by purchasing directly from the department.

It is also important to say that measures may not have been in place in 2014 for a daily review to be carried out. Now, a monthly review is done to determine what articles are in stock and what their expiry date is, and to really better understand what we have or don't have, so as to be able to meet needs. Unfortunately, the process has been more ad hoc than based on an automated system.

What we experienced during the pandemic and the recommendations we have received have given us an opportunity to review our methods. Before the fiscal year's end, in late March 2022, we are really entering the phase where this tool is starting to get tested. We will then continue to fine tune it to ensure that it meets not only the current needs, but that it will continue to meet needs going forward.

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

That's what I was planning to ask next. You were a step ahead of me.

We are seeing a difference of nearly 600,000 items between items that were accounted for in inventory stock tables and what was recorded. That is a lot of items after all.

If I have understood correctly, you are saying that those errors were due to the process and that they will not recur thanks to the new processes that have been set up.

[Christiane Fox]

That is our tool's objective, to better understand not only what we are purchasing and what we are doing in terms of contracts, but also what is being done in warehouses. That second initiative will help us.

We must not only be able to properly understand what is in the warehouses, but also have good knowledge of practices with a contractor who ensures that the way stocks are managed allows us to know what we have and enables us to keep articles in the department with a view to their distribution.

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

That's very good.

Mr. Chair, do I have about one minute left?

[The Chair, Conservative, John Williamson]

You have one and a half minutes.

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Great, thank you.

Ms. Fox, you are talking about the plan and tool that should be ready by late March 2022.

I know this is surprising to many people, but we are already in March 2022.

[Christiane Fox]

Yes, I know. Concerning the tool as such, we are carrying out a test, which actually has two components. One concerns outgoing personal protection equipment items and the other one concerns incoming items.

The test we do involves everything. That test will be done before the end of the fiscal year, and we will begin soon.

However, as you know, information technology systems must be tested. They also need strengthening. So we cannot just rely on the new system. We must work to ensure the system is good and reliable. As in any large project, there will be challenges. We must have strategies to address them. So that is the test we will start using at the end of the year.

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

So it is being implemented. That's great.

That will be all. Thank you.

[The Chair, Conservative, John Williamson]

You had only 15 seconds left. Thank you very much

Mr. Desjarlais, you have six minutes, please.

[Blake Desjarlais, NDP, Edmonton Griesbach, AB]

Thank you very much, Mr. Chair.

I often find these studies difficult, because I've experienced in many ways, like in the last committee meeting, what this work means in communities and on the ground.

Madam Fox, you have spoken quite highly about the work that's been done here, but there are tremendous gaps. The work of our committee is to identify these gaps and to ensure that you know of them, so please don't take anything I am about to say personally. I hope that it informs your work better and we can ensure that lives are saved, because lives were lost. My uncle died on reserve during COVID, 15 days after a request from the community went out for PPE.

That is someone's responsibility. They never got the services in time. They never got what was really needed so that the community could truly protect itself, and this isn't a new story for indigenous people. We've experienced this time and time again, whether it was tuberculosis during the residential school period—when Canada failed to act to protect my grandmother and my uncles, who died in that institution—or before that with smallpox. At times, it was deliberately brought to communities.

These are the types of communities we are dealing with. They are communities that are trauma-informed by those experiences.

I remember growing up with stories from my kôhkom and cimošôm about how scary it was when the Indian agent would come with a medicine chest and they were uncertain as to what was in it, but they were even more afraid of what wasn't in it. Many of these nations have signed treaties with Canada, asking for a guarantee for health like the medicine chest clause.

The medicine chest clause is something that every treaty group in this country wanted to ensure Canada understood clearly. I have heard from Treaty 6, Treaty 7 and Treaty 8 that, on this clause, Canada failed to uphold its obligations to ensure they had the proper resourcing as per the treaty that's been guaranteed.

I really appreciated my colleague from Quebec's mention of nation-to-nation relationships. There is a lot that Canada can learn from that framework. In my community, in Alberta, we didn't have that support. We didn't even have the ability to protect our elders.

A part of this I want to mention.... I'll spread this out over a few rounds, but in particular in the report, your action plan states something that I found to be a glaring discrepancy with what the Auditor General asked for. I am looking at your action plan that was provided in response to report 11. On page four of 14, there is an action item response to what the Auditor General requests to engage first nations communities in staffing processes. You and your ministry have reported the response to that action, in item 2.1:

Working with the Nursing Leadership Council, and the Nursing Retention and Recruitment Steering Committee, ISC will examine its current recruitment model....

Does the deputy minister think that's satisfactory for engaging with first nations communities in staffing processes?

[Christiane Fox]

I would start by saying that everything we do is in partnership with indigenous leadership across this country. When we talk about our response to COVID, it was never just ISC nursing staff. There were always first nations health pandemic response teams. There were mobile mental health units that were first nations-led, working side-by-side with our ISC nurses and physicians. There were multiple tables that were put in place, not just for the response in terms of PPE but in terms of vaccinations and the “Protect Our Elders” campaign.

This is what I would say. First, I would offer my condolences to you on the loss of your uncle.

The second thing I would say is that we cannot do these hiring practices independently of our discussions with communities. As the goal of this department is the health transfer of services, it's empowering communities to take that on. Part of their short-term strategy is to try to fill gaps and then the important work that we're doing on long-term strategies to have indigenous students in post-secondary institutions—

[Blake Desjarlais, NDP, Edmonton Griesbach, AB]

Deputy Minister, I'm asking specifically about the action plan. Can you make mention of 2.1 of your action plan, which states, “Working with the Nursing Leadership Council, and the Nursing Retention and Recruitment Committee”? Why not respond directly to the Auditor General when they say to engage first nations communities in staffing processes? Why not make that an action item?

[Christiane Fox]

Maybe we can be more precise, but it is part of the action item. It is part of our talent acquisition and management. They are central to it, and it's not limited to our nursing staff. We do that even for our senior executive team. We have indigenous leadership on the interview board, so it is absolutely something that we take on board. It is absolutely something that we are building into our hiring practices for the department.

[Blake Desjarlais, NDP, Edmonton Griesbach, AB]

Thank you very much.

In regard to this consultation work, you mentioned that there were mobile working units, and I think you said there were 18 and upwards of 80 staff. This country has a massive geography of indigenous peoples, and you know as well as I do that these staff are unable to accommodate the true need for these services across the country. Would you recognize that there's a tremendous amount of work that still needs to be done to ensure that this is truly satisfactory, because this isn't satisfactory?

[Christiane Fox]

I want to clarify that we have 862 nurses working for us. The 18 were specific to medical health officers, like Dr. Anderson in Manitoba whom we worked very closely with on the pandemic.

I want to make it clear that the 18 are physicians. Is that enough? No, this is the network that this department has, and that network works with more provincial and territorial health experts along the way. I don't want to make it sound like it's just the 18. It's part of the network that we have within this department. These are physicians. Those physicians also work with others. We have nursing supports and we have our contract surge.

[The Chair, Conservative, John Williamson]

Thank you.

Mr. Patzer, you have five minutes.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Thank you very much. I'm going to start with the Auditor General's office.

There are many instances throughout the report where it references the allocation of scarce resources COVID‑19 interim response strategy, and it specifically references that they would provide 2% of bulk purchases to Indigenous Services Canada. Do you have any dollar amounts for what that 2% ended up costing, in terms of actual dollar value?

[Andrew Hayes]

I don't have numbers for that.

I would mention that, with the other report we provided, we talked about the fact that the market was very dynamic through the pandemic, and prices would have fluctuated all the way through the pandemic, including up until now.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Right, but does that number exist? Do you have that number somewhere else, so you could table it with the committee to give us the total dollar figure?

[Andrew Hayes]

We wouldn't have an up-to-date or accurate dollar figure for that, given that our work on this report and the other report was completed in early 2021. In order to get that information, we would need to also engage with Public Services and Procurement Canada to have a more up-to-date number.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Is that something you think you could get and table with the committee? I think that would be a relevant thing to have.