Debates of May 29th, 2024

Department of Health—Main Estimates, 2024-25

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Madam Chair, does the minister believe that recovery from addiction is always possible?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, it may take many pathways to get to recovery. That is why comprehensive approaches—

[The Deputy Chair, NDP, Carol Hughes]

The hon. member.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Madam Chair, is the minister satisfied with the current availability of drug rehabilitation and or treatment programs?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, those would be health services, which fall under the jurisdiction of provincial health services. We will always support them.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Madam Chair, the NDP-Liberal government has spent over $100 million to date on so-called safe supply. How much is the government spending on beds in recovery centres?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, over $200 billion in health care agreements include mental health and substance use supports. I would ask the member to ask each jurisdiction how much they are spending.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Madam Chair, again, how many beds would $100 million have bought?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, that would be the purview of the health services of the province. I encourage him to ask his local jurisdiction.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Madam Chair, has the minister heard the statement from the RCMP that nearly two-thirds of their detachments serve communities that do not have drug rehabilitation or treatment programs available?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, mental health services are part of the $200 billion in bilateral agreements, and over 30% of those agreements are dedicated to mental health and substance use.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Madam Chair, it is always a pleasure, an honour and a privilege, of course, to rise in the House and to speak tonight at the committee of the whole to the main estimates.

I am grateful for the opportunity to speak about dental care and the current work being done by our government to improve dental care or oral health care for all Canadians and approximately the nine million Canadians who we know do not have insurance, but who need to be able to visit their oral health care provider or dental care provider when they need to.

Although inflation is easing and interest rates have stabilized, many Canadians are still struggling with the cost of food, housing and other essentials. That leaves some people having to make difficult choices about how to spend their money. Sometimes important expenditures have to be put on hold, including dental care. Faced with difficult financial choices, too many Canadians have had to postpone or forego important dental care or procedures. This can have wide-reaching impacts, including more expensive treatments and worsening health outcomes.

To support the provinces and territories in the delivery of services, our government is committed to working together with them to improve health care for all Canadians. Underpinning these priorities is the principle that every Canadian should have access to health care services, regardless of who they are, where they live or their ability to pay. With this in mind, we are working on several fronts to expand access to key services, including making oral health care more available and more affordable for more Canadians. Having access to quality oral health care plays an important role in not only our oral hygiene, but also our overall health. Regular visits to the dentist can help reduce the risk of tooth decay, gum disease and a number of serious health issues, including stroke. Unfortunately, too many Canadians have been going without these regular checkups.

The information that we have from Statistics Canada indicates that there are many obstacles to oral health care, the main one being financial. One in four Canadians avoids going to a dental professional because of the cost. That is one-quarter of Canadians who have to make the difficult decision to go without dental care and whose health could be affected by that.

It bears repeating this in English to really drive the point home.

One in four Canadians, Madam Speaker, does not visit a dental provider because of cost. That is a fourth of Canadians who have had to make the difficult decision to go without dental care and whose health might be impacted because of it.

We know that cost is not the only thing preventing Canadians from accessing quality dental care. There are many other obstacles, such as living in a remote community, having limited mobility or specific needs, cultural barriers and not being aware of the need for preventive care.

This also affects children. Tooth decay is the most common, yet preventable, childhood chronic disease, not just in Canada but around the world.

Our government is committed to improving access to dental care across the country. This is why it has made, and continues to make, significant investments in oral health care, which is an essential part of overall health. The first phase of our approach started in December 2022, when we launched the Canada dental benefit. Thus far, 439,000 children have benefited from this program, with applications open until June 30.

Budget 2023 announced an investment of over $13 billion over five years, starting in 2023-24, and $4.4 billion ongoing, to implement the new Canadian dental care plan, or the CDCP. By the time it is fully implemented, the CDCP is going to help make dental care more affordable for up to nine million Canadians who do not have access to dental insurance and who have an annual adjusted family net income of less than $90,000.

In addition, May 1 marked a significant milestone in oral health care in Canada. The first million seniors covered under the CDCP were able to start receiving the dental care they need. A Newfoundlander and Labradorian was the very first senior to receive care where the costs were covered by the CDCP. That is exciting. An online application portal is now open for potentially eligible seniors, 65 years of age and above, to apply to the CDCP, and that is just the beginning.

Starting in June of this year, adults with a valid disability tax credit certificate and children under the age of 18 will be able to apply to the CDCP. As of 2025, all remaining eligible Canadians will be able to apply.

This is the biggest social program in Canadian history, and we have been working with dental providers across the country to make it happen. This has been great work by all of us. We are proud to see that as of May 2, there are more than 7,500 providers, I think the number is actually more than 10,000 now, who have confirmed their participation in the CDCP and are now treating seniors who are eligible for the dental care plan. That number continues to increase every day. We are so grateful to these participating providers and to the providers who would rather not fully participate but who will still accept CDCP patients. We are happy that starting July 8, CDCP patients will be able to see any dental provider of their choice, as long as the provider agrees to directly bill Sun Life for services provided under the plan. This is to limit the out-of-pocket costs of dental care for their CDCP patients.

The CDCP will cover a wide range of oral health care services when recommended by a dental provider. This includes preventative care, such as scaling and cleaning, as well as other services, such as exams, x-rays, fillings, dentures and, yes, root canal treatments. The majority of services covered under the CDCP are now available. More will be added in November when services requiring pre-authorization, such as some kinds of dentures, crowns and major surgical procedures, will become available.

The CDCP is a national program being delivered and launched simultaneously in all provinces and territories to ensure equal opportunity for Canadians who do not have access to dental insurance, the nine million Canadians we know of.

Our government continues to engage with the provinces and territories on the interdependencies between the CDCP and the provincial and territorial publicly funded programs. Coverage will be coordinated not only to ensure there is no duplication, but also to ensure there are no gaps in oral health care. The important thing is that everyone, everywhere in the country, can receive equal dental care, no matter where they live.

Budget 2023 also announced $250 million over three years, starting in 2025-26, and $75 million ongoing to Health Canada to establish an oral health care access fund. The fund will complement the Canadian dental care plan by contributing to further reducing the obstacles preventing Canadians from accessing oral health care, including in rural and remote communities.

Health Canada will launch the first call for proposals under this fund this month. The call for proposals will give oral health training institutions an opportunity to present their ideas on how Health Canada funding might help them. For example, they may submit projects for addressing provider competency gaps that are contributing to obstacles to accessing care or for continuing to ensure that students receive the hands-on training they need to graduate.

A second call for proposals will be launched this summer. It will not be just about training institutions, it will focus on other obstacles to improving oral health care.

Budget 2023 proposes to provide $23.1 million over two years, starting in 2023-24, to Statistics Canada, to collect data on oral health and access to dental care in Canada. These data are crucial in helping governments devise policies that support access to dental care, that improve oral health outcomes for Canadians and that provide an effective work environment for oral health care workers.

In November 2023, Statistics Canada launched a collection of the Canadian Oral Health Survey. The aim is to collect information from Canadians on their oral health, including their ability to pay, challenges finding oral health services, experience with the oral health care system and care needs. Furthermore, Statistics Canada also launched the first survey of oral health care providers. Survey results will help us better understand the financial and operational characteristics of oral health care providers in Canada.

To the hon. Minister of Health, earlier last week, I visited a dental care provider in my riding of Vaughan—Woodbridge, Vellore Corners Dentistry. I met Peter, an 80-year-old senior who had proudly showed me his dental care card and, for the first time in many years, was going to his dental care provider and was very happy.

Can the minister update us on the progress of enrolling seniors and oral health care providers into the CDCP?

[Mark Holland, Liberal, Minister of Health]

Madam Chair, I share my hon. colleague's excitement. Hearing about Peter getting care and about more than 120,000 seniors across the country getting the care they need has been one of the great and extraordinary privileges of my public life, to be able to talk to seniors who are getting care, in many instances for the first time in a very long time, and the pride that comes to them. I have talked earlier in the committee about the numbers, and the member in his speech mentioned that we are over 10,000. We are over 10,500 now, and the number continues to grow with that new portal opening on July 8.

I have talked in the House, as well, about when I was in Vanier meeting with denturists and talking to the seniors that they are meeting. In one instance, there was a woman who had the same pair of dentures in her mouth for 41 years. All that was left were plastic plates, which she used to crush food. Hearing that denturist talk about fitting, this week, a new pair of teeth in that woman's mouth and what that is going to mean to her sense of dignity and to her health is absolutely extraordinary.

Whether it is Peter or, just a few days ago, I saw Raphael getting care, this is happening, and we are going to make sure that we do the same thing for pharmacare.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Madam Chair, one of the key attractions of the CDCP program, and I very much like the way we have implemented the program, is that it is using a benefits provider, Sun Life, which, as we know, is well established here in Canada, with literally tens of thousands of employees across this country. It is also now providing the flexibility, on July 8, to oral health care providers to actually direct-bill when a client comes in.

I wanted to ask the minister, in terms of the way that the program is being designed and laid out, how we are seeing the full ramp-up of oral health care providers joining the system and utilizing the program for their patients, and just how critical a piece of our overall health care system the CDCP program is.

[Mark Holland, Liberal, Ajax, ON]

Madam Chair, I remember meeting a hygienist a couple of weeks ago, and she said that she keeps looking for all the paperwork and the administration that she was told was going to be so hard to do and that she keeps looking behind her computer or waiting for somebody to come in and tell her she is doing something wrong because it has been nothing but easy.

In fact, she was saying to me that it is easier than the private insurance plans that she has been dealing with. That is a common refrain everywhere. We are hearing from providers that once they try it, they see just how easy it is. Part of the evidence is that once we get a few providers in a region, there is an explosion of providers as they talk to each other and they see just how easy this program is to work with. We almost have all denturists participating, which is fantastic, because that means that seniors are getting the dentures they need.

We have a really phenomenal uptake in hygienists. Hygienists are going to play such an important role, and I would really encourage people to consider using a hygienist because often, particularly in rural or remote places or in seniors' homes, hygienists can go directly to a population in need and can be able to serve them, and then simply refer them, if there is a need for a dentist. In a lot of instances, one does not even need to see a dentist. One just needs to get one's teeth cleaned. We are going to make sure that we are there for everybody as we continue to expand this plan. I am looking forward, next month, to seeing it open up to those under 18 and to persons with disabilities.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Madam Chair, it is just so exciting. When I drive up one of the regional roads in my riding in the city of Vaughan, Weston Road, there are three billboards put out by dentists. I took pictures of them and put them up on my communications material, pointing to dentists in my riding accepting the Canadian dental care—

[The Deputy Chair, NDP, Carol Hughes]

The time is up. I am going to give the hon. minister a couple of seconds to respond.

[Mark Holland, Liberal, Ajax, ON]

Madam Chair, I am so excited as well, and we are going to see more and more of that across the country. We are going to make sure everybody gets the oral health care they need.

[Luc Berthold, Conservative, Mégantic—L'Érable, QC]

Madam Chair, I will be sharing my time with two other colleagues.

My questions are for the Minister of Mental Health and Addictions. After the spectacular failure of hard drug legalization in British Columbia, will the minister finally admit that this pilot project was sadly a fatal mistake?

[Ya'ara Saks, Liberal, Minister of Mental Health and Addictions and Associate Minister of Health]

Madam Chair, just to correct the member, decriminalization is about possession. It is not the legalization of illicit drugs.

[Luc Berthold, Conservative, Mégantic—L'Érable, QC]

Madam Chair, no matter what terms the minister uses, was this a pilot experiment that sadly turned fatal? Will she admit her mistake?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, the pilot continues, I am happy to inform the member, with the amendments requested.

[Luc Berthold, Conservative, Mégantic—L'Érable, QC]

Madam Chair, can the minister tell us how many people have died since the possession of small quantities of hard drugs was legalized?

[Ya'ara Saks, Liberal, York Centre, ON]

Madam Chair, the numbers for the past year were about 2,500 in the province of B.C. from the toxic drug supply.

[Luc Berthold, Conservative, Mégantic—L'Érable, QC]

Madam Chair, is the minister aware of the City of Montreal's plans to urge the federal government to legalize simple possession of hard drugs?