Status of Women Committee on May 25th, 2021

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Madam Chair, I think it's Mr. Angus still.

[The Chair, Conservative, Marilyn Gladu]

We have Mr. Angus again for two and a half minutes.

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

Thank you, Madam Chair, and thank you, Madam Mathyssen, for giving up time.

Mr. Haché, thank you for coming today. Again, when I talk to people in northern Ontario, there are still many deep questions.

I go back to these statements that you made to the students. You were looking at a balanced budget last spring, and then you had $10 million of additional expenses as a result of COVID. That makes sense. Every university and every community college I'm aware of has been hit hard. Everybody's been hit hard by COVID.

Who made the decision that the only option to get out of this was to go into bankruptcy protection? Who made that call? Who told you that it was your only option?

[Robert Haché]

Thank you very much for the questions.

First to provide some context, Laurentian has had the poorest financial health of any university in the province.

With respect to the decision, the decision was made by the board of governors of the university at the very end of January.

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

Okay.

Prior to that, though, when you knew you were getting into deeper and deeper trouble, did you go to Minister Romano or to the federal government to try to get some breathing room? This is about finding breathing room to work with your creditors. Did Minister Romano or the federal government tell you that you were on your own? Why were you not able to get that breathing room?

We're talking about an institution that is unique for francophones, for indigenous, for working-class northern Ontario. People come from all over the world to this university. I can't imagine they all just said, “Hey, well, whatever, we'll just see it all torn down.”

To get that breathing space, were you turned down by the province, and did you talk to the feds?

[Robert Haché]

Thank you again for the question.

In the months leading up to the decision to file, we indeed had extensive conversations with the Ministry of Colleges and Universities and with the minister's office—i.e., with the province. We also had conversations at the federal level about what could potentially be done.

I can't comment on the decision-making process on the government side. All I can say is that at the end we were left with no alternative—

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

Was that the reason you had to go into CCAA? Was it because at the provincial and federal level, they were not willing to help out an institution as important as Laurentian?

[The Chair, Conservative, Marilyn Gladu]

I'm sorry; that's the end of your time.

We'll now go with the remaining time. We have two minutes each for the Conservatives and Liberals. We'll start with Ms. Shin for two minutes.

[Nelly Shin, Conservative, Port Moody—Coquitlam, BC]

I'd like to thank the witnesses for being present today and helping us have this discussion on this very important topic.

I'd like to ask Ms. Ellen Blais how the COVID pandemic has impacted the services of midwives in indigenous communities.

[Ellen Blais]

That's a really good question. Thank you.

When I think about midwives being in community, certainly in the urban and some of the more rural areas, I believe there has been quite a bit of continuity of care. Midwifery services have continued programming. There were some initial issues around obtaining PPE for communities, but services have continued. There has been the same level of home births and hospital births that there were.

Going into a home for a birth, of course, requires that the families themselves don their own gear. However, it has been relatively stable. The issues have been with the ones who have to fly out for the births, which I mentioned earlier.

With some of the issues that have happened, I have heard that there has been difficulty finding housing or hotels when you have to fly south and to find places to stay when you're discharged from the hospital. Family members have not been allowed to come with you. There have been issues with blood products and things like that, which have not been able to stay stabilized when you have to travel thousands of kilometres away.

Some communities, I've heard as well, have not had any health care services in the first nations because of COVID and lack of human resources during that time.

[The Chair, Conservative, Marilyn Gladu]

That's very good.

Now we'll go to Monsieur Serré for the final question.

[Marc Serré, Liberal, Nickel Belt, ON]

Thank you, Madam Chair.

I thank the witnesses for being with us today.

Mr. Haché, I want to go back to local solutions. We have post-secondary institutions like Collège Boréal, Cambrian College and the Northern Ontario School of Medicine.

Do you have any suggestions to help us work together and find solutions to support Laurentian University?

There is no Ministry of Colleges and Universities at the federal level, as they are under provincial jurisdiction.

How will you work with the province and local communities to come up with a solution for the federal government, which is here at the table to help you?

[Robert Haché]

Thank you for the question.

As we've seen today, it's a resource issue. If it had sufficient resources, Laurentian University could continue to offer its midwifery program. It's just a matter of starting conversations with the federal government and provincial governments to generate the necessary resources. We may also need to work with our partners—

[The Chair, Conservative, Marilyn Gladu]

Excuse me. I think Ms. Hutchings said she couldn't hear.

[Gudie Hutchings, Liberal, Long Range Mountains, NL]

There's no translation, Madam Chair.

[The Chair, Conservative, Marilyn Gladu]

Could I have the clerk check on that, please?

[Robert Haché]

I could repeat it in English, if that would help.

[The Chair, Conservative, Marilyn Gladu]

I think—

[The Clerk of the Committee, Ms. Stephanie Bond]

Please proceed.

[The Chair, Conservative, Marilyn Gladu]

I think it's working again, so go ahead.

[Robert Haché]

I was almost done.

I was saying it's about resources and if you work with the provincial governments and with the federal government to generate resources, we could continue to offer a midwifery program, even at Laurentian University. It's about having the resources to make the program sustainable over the long term. We can also work with our partners at Collège Boréal, specifically with respect to French-language training, to find other solutions.

[The Chair, Conservative, Marilyn Gladu]

Thank you.

That's all the time we have. I'd like to thank our witnesses for their testimony, which will help us in our study.

We're going to suspend momentarily so we can do the sound checks for the next panel.

[The Chair, Conservative, Marilyn Gladu]

I call the meeting back to order.

Welcome to our study on midwifery services in Canada.

I'm very pleased to welcome our witnesses today. Each will have five minutes for their opening remarks.

From the Canadian Midwifery Regulators Council, we have Tracy Murphy, the executive director, and Louise Aerts, the chair.

From the National Aboriginal Council of Midwives, we have Claire Dion Fletcher, an indigenous registered midwife and the co-chair, and Brenda Epoo, also an aboriginal registered midwife and another co-chair.

From Regroupement Les sages-femmes du Québec, we have Josyane Giroux, president and midwife.

We will have all, eventually. We'll start with our guests from the Canadian Midwifery Regulators Council.

Louise, you can begin. You have five minutes.

[Louise Aerts, Chair, Canadian Midwifery Regulators Council]

Thank you, Madam Chair and members of the committee. My name is Louise Aerts and I am the board chair of the Canadian Midwifery Regulators Council.

I am speaking to you today from the unceded Coast Salish territory, represented by the Musqueam, Squamish and Tsleil-Waututh Nations.

I am pleased to have this opportunity to appear before the committee regarding your study on midwifery services in Canada.

The Canadian Midwifery Regulators Council is a network of provincial and territorial midwifery regulatory authorities. Collectively, we regulate the profession of midwifery in Canada. As is the case with many other health professionals, each jurisdiction has its own midwifery regulatory authority or college, which works to ensure public safety by setting registration requirements, setting and enforcing standards for safe and ethical care, and responding to complaints from the public about midwifery services. Midwives must register with the college in their province or territory in order to practise.

Midwifery is currently regulated in all jurisdictions in Canada except Prince Edward Island. Ontario was the first jurisdiction to regulate in 1993, followed by B.C. in 1998. Yukon is our newest jurisdiction to be regulated. This took effect in April of this year. The CMRC is now supporting P.E.I. as it works to regulate midwifery.

There are fewer than 1,700 practising midwives in Canada. Ontario has the most, with around 800 practising midwives. The next-largest jurisdiction is B.C., with 325. At the other end of the spectrum, there are 10 midwives in the Northwest Territories, six in New Brunswick and six in Newfoundland and Labrador.

I'd like to speak about indigenous midwifery from a regulatory point of view.

Indigenous students may take any of the recognized midwifery education programs in Canada and are eligible for registration in their jurisdiction through the regular channels. Further, Ontario and Quebec have laws that provide exemptions from registration for indigenous midwives working in their communities. In Ontario, the exemption clause has been enacted, but it has not yet been enacted in Quebec.

In B.C., the Midwives Regulation includes the ability to regulate a class of indigenous midwife. This also has not been enacted.

The CMRC's mission is to encourage excellence among Canadian midwifery regulatory authorities through collaboration, harmonization and best practice. Some of these recent efforts have included revised entry-to-practice midwifery competencies, common registration requirements, and a shared letter of standing and professional conduct. We are also working to harmonize self-assessment by midwives, indigenous midwife self-identification, labour mobility and emergency skills training certification.

The CMRC owns and administers the Canadian midwifery registration exam, the CMRE. All midwifery regulatory authorities except Quebec require applicants to successfully complete this exam prior to registration. Each year, 110 to 150 midwifery candidates write the CMRE. These individuals are from our Canadian baccalaureate midwifery education programs or bridging programs for internationally educated midwives.

As evidenced by these numbers, midwifery is a small professional group and is limited in terms of growth by the numbers of graduates entering the profession each year—i.e., under 150 across the country.

The CMRC was disappointed to learn of the closing of Laurentian University's midwifery program. This leaves only six baccalaureate midwifery education programs in the country, and only in the provinces of B.C., Alberta, Manitoba, Ontario and Quebec. The CMRC hopes that the Laurentian University midwifery program will be relocated to a new university that, like Laurentian, can provide instruction in English and French and serve the needs of indigenous students and communities.

Midwifery regulators in Canada are ready to assist in the creation of indigenous-led pathways for regulation or exemption. We ask that the committee consider ways to expand investment in indigenous midwifery, which includes creating diverse pathways to education.

Midwives play a vital role in the provision of equitable, accessible, culturally safe and high-quality health care. In some jurisdictions, temporary emergency registration has allowed eligible midwives to register quickly, on a short-term basis, to assist with the COVID-19 pandemic efforts. Further, some jurisdictions have issued public health orders that have expanded midwives' scope of practice to fill needs brought about by the pandemic.

Thank you for your time and consideration. I hope these remarks have helped you to understand the regulation of midwifery in Canada. I am happy to take any questions you may have.

[The Chair, Conservative, Marilyn Gladu]

Excellent.

We're going to continue, then, with Ms. Dion Fletcher for five minutes.