Status of Women Committee on April 4th, 2019

[Dr. Kiran Rabheru]

I'm a physician as well. I'm a family doctor and a geriatric psychiatrist. I co-chair the Canadian Coalition for Seniors' Mental Health. We've just put out program that we call the Fountain of Health. We focus on basically three things: brain health and wellness, which have to do with social isolation; physical health; and, keeping your mind and brain active. Those are the three areas that we need to focus on to keep people well.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

The one thing that I would also like to ask you about is along the lines of what are those barriers to the integration. I have literally tens of thousands of seniors in my riding. I hear about things as simple as transportation costs, but I'm confident in saying that there is probably a laundry list of other issues.

I live in a large rural riding. We have particular challenges with regard to seniors being able to integrate into social programming. Outside of transportation costs, do you have other recommendations for those of us here at committee and for the government on how that can be overcome?

You're going to have about 15 seconds.

[Margaret Gillis]

I'll do this very quickly.

I come from government, and when I was in government I was involved in creating something called the age-friendly communities program. There's a checklist that exists for that. Some of the issues you've just talked about are on that checklist.

I'll give you an example. On social participation, you need to make sure that venues for events and activities are conveniently located, accessible and well lit and, also, easily reached by public transportation. That might be a problem in a rural area, but there are ways around that if you look at community support.

If you think about something like transportation, there's a whole list here, including making sure first off that the costs are accessible, particularly when you think about older women and the poverty levels that we're talking about. I can leave you with that list if that's helpful.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Yes.

[Margaret Gillis]

There are a lot of great examples there for all levels of government.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

That would be very helpful. Those are the things that we're looking at in the committee. Thank you very much.

[The Chair, Conservative, Karen Vecchio]

That's excellent. Thank you very much. We're now going to pass the floor over to Anne Minh.

You have seven minutes.

[Anne Minh-Thu Quach, NDP, Salaberry—Suroît, QC]

Thank you, Madam Chair.

I want to thank the three witnesses for being here.

I have a question for Ms. Scott, from the CCPA.

You mentioned the issue of access to medication. I participated in the Beauharnois-Salaberry seniors round table in my constituency. People were saying that seniors had trouble accessing medication, which can be quite expensive. Even though we're in Quebec, certain medication is difficult for some seniors to afford. As you were saying, the salaries and pensions aren't very high.

It's also a very rural area. Seniors don't necessarily have a car or access to transportation to travel to the hospital or to run errands, as my colleague said.

You spoke briefly about the universal public drug coverage system. What can you tell us about this type of system? Is there a model elsewhere that could be applied in Canada? Do you know of any studies that support this model?

[Katherine Scott]

The cost of medication certainly is a pressing concern for many seniors, just in reviewing their histories....They may or may not have private coverage. There are huge gaps in terms of what the public system covers. As a consequence, seniors who are facing high rents or transportation challenges and the like have precious few dollars to devote to medication. It remains a paralyzing concern for many.

I believe you're talking about a national pharmacare program. It's a critical piece of infrastructure and is really a huge gap in the Canadian health care system. Proportionately, it does detrimentally impact seniors to a greater extent. Our organization has been advocating for a universal single-payer health care model.

We understand that there's an interim report out from Dr. Hoskins and that the government itself is looking at a model and putting it forward. We would encourage, from our own research, support of a single-payer universal system in order to provide a foundation for everyone, as opposed to a “fill in the gaps” system, which was I guess another proposed model. I'm happy to follow up with our particular recommendations around the financing of that and put you in touch with my colleague who did that economic modelling.

[Anne Minh-Thu Quach, NDP, Salaberry—Suroît, QC]

Can you describe the economic benefits of this model?

[Katherine Scott]

I'm sorry that I don't have all the details at hand, but certainly the proposal we put forward suggests that, in terms of economic costs, it delivers the largest number of benefits to the largest number of people. It certainly is a more efficient model and obviously takes advantage of steps to create a national formulary and the like.

There are many studies. Certainly, some of my colleagues in our provincial offices are looking at the increasing cost of medication as it disproportionately affects older women. We really strongly recommend that action in this area would have a profound impact on seniors' quality of life.

[Anne Minh-Thu Quach, NDP, Salaberry—Suroît, QC]

Thank you.

My next question is for Ms. Gillis.

Let me tell you about an organization in my constituency. The Haut-Saint-Laurent regional county municipality is the second poorest municipality in Canada. There's an organization in the municipality that helps seniors in particular. The organization is called the Un coin chez nous multi-service community centre and is headed by Guy-Julien Mayné. As he explained, the main issue in rural areas is isolation. You also mentioned isolation. It's often caused by a lack of transportation.

You mentioned a list of recommendations for transportation, and I want to hear them. In rural areas, seniors often have contact only with the people from meals on wheels, a service that provides food once a day and a few days a week. Transportation is extremely expensive, and there's no public transportation, apart from taxis. Most people who use these services are senior women. In fact, 75% of food services are used by women who live alone and in housing on which they spend over 30% of their income.

Do you have any recommendations or ideas for the federal government?

There isn't a range of federal programs, apart from the new horizons program. The new horizons program supports projects, but there isn't necessarily funding to ensure that community organizations can carry out their mandates.

[Margaret Gillis]

I think there would be a number of programs.

Again, I would start by suggesting that we look at options in other countries, because it's always best to see what has worked.

That said, we have some interesting federal programming for children in our country that came out of Canada's signing of the United Nations Convention on the Rights of the Child back in the early nineties. At that time, the government put together programs for at-risk children, and those exist all across the country in resource centres. I think there's a possibility of looking at how older people perhaps could be serviced by some of those programs that already exist. Now, again, it's a cost issue. As you know, you have to fund it.

One of the things those children's programs do in rural areas is that they look at ways to get children into their centres. Some of them have vans, for example, so there are models that exist in the country, and there's a model that exists internationally. I think there are ways that you could build on that.

[Anne Minh-Thu Quach, NDP, Salaberry—Suroît, QC]

You said that there are international examples. Can you name any of them? Do you have concrete examples?

[Margaret Gillis]

For international examples, you always look to the Nordic countries and to England, and to some programming in Australia. We could get back to you with some of those examples.

[Anne Minh-Thu Quach, NDP, Salaberry—Suroît, QC]

Yes, please.

You both mentioned federal transfers. We know that the transfers have been reduced from 6% to 3%.

Do you think that the transfers should be restored to 6% or to any other level needed to fill the gaps in home care, such as mental health care?

We're told that an increasing number of women aren't getting a dementia or Alzheimer's diagnosis, for example.

[The Chair, Conservative, Karen Vecchio]

Anne Minh, we're quite a bit over.

Could I have about a five-second answer?

[Katherine Scott]

Spending as a percentage of GDP in Canada is at relatively historic lows. I think there is fiscal capacity to increase support and spending for Canadian seniors—women in particular.

[The Chair, Conservative, Karen Vecchio]

Thank you very much.

Now, Rachel, you will have the floor for seven minutes.

[Rachel Bendayan, Liberal, Outremont, QC]

Thank you, Madam Chair.

I want to thank the witnesses for their excellent presentations.

I have a question for Ms. Gillis regarding access to justice.

Given that your presentation was in English, I'll ask the question in that language.

As a lawyer, I wonder if you can comment a bit on the increased incidence of fraud, in particular with regard to older women, and how the judicial system is able to support older women in accessing judicial recourse. It's extremely costly to hire lawyers. I wonder if you could comment a bit on access to justice and to legal representation.

[Margaret Gillis]

You've brought up two really great points there, the first point being the increase in fraud and the different ways in which fraud is happening, particularly with social media, and the ways in which the justice system needs to catch up with that, particularly with regard to the targeting of older people.

On point number one, absolutely, something needs to be done on that. We need to think that through a little more. Those are the kinds of things that the justice department, if we're talking about the federal government, ought to be looking at and thinking about. I don't know if they are right at the moment.

On the second part of your question in terms of accessing the system, we've heard what the levels of poverty are and we know right off the bat that people are not going to be accessing the system if they are living close to or below the poverty line. There's a whole issue in terms of how we access that. How do you get legal aid if it's available? Are they overextended for other issues?

It's a whole new frontier that you're talking about there. We need to be thinking about both how to stop it and how to support those who have already been impacted by it, through economic and other supports.

[Dr. Kiran Rabheru]

I'll just add one quick thing to that.

It's not just from outside. We actually have a saying in our business: “When there's a will, there's family.” It happens not infrequently. We see it a lot. We just have to be very protective of our aging population.

[Rachel Bendayan, Liberal, Outremont, QC]

Is there anything you'd like to add, Ms. Scott?

[Katherine Scott]

This isn't my area, but I am struck by how vulnerable seniors are. I say that as a daughter of two aging parents. I just lost my mother, and I'm just overwhelmed by the number of entreaties and so forth. I think that part of the challenge is that seniors are isolated. They can't work it through in communities. I was struck, as well, by the usefulness of seniors centres and hubs where people come together to problem solve, and by how, through those social connections, they actually are not as vulnerable to these sorts of things. They are able to share knowledge if they don't have family in town and the like, particularly online. Bringing seniors together is such an extraordinary strategy for tackling many of these types of challenges, so I would just add that.

[Margaret Gillis]

Yes. It's back to social isolation.