moved that Bill C-202, an act to amend the Canada health Act (nutrition services) be read the second time and referred to a committee.
Mr. Speaker, I am pleased to rise today to speak to Bill C-202, an act to amend the Canada Health Act. The bill is intended to amend the Canada Health Act by inserting the words “nutrition services”.
The Canada Health Act lists insured services, and nutrition services are not insured. We all know that dieticians and nutritionists are specialists in nutrition.
They promote the distribution and application of nutritional principles, advise on food choices and help prevent or treat the consequences of inadequate nutrition in people of all ages and groups from all communities.
They perform a professional function, whose aim is to promote health through healthy food choices. Their services are used in hospitals, sports centres, food markets, government and international agencies, medical clinics and educational institutions, to name but a few.
The public hears and reads a great deal about nutrition. The industry is constantly putting new products on the market or promoting particular ways of eating. Because of the difficulty to understand and interpret this information, people often turn to the dietitian nutritionist, someone who understands nutrition because of his or her university training in this science.
Dietitians and nutritionists in their concern to protect the public are worried about the quality of information disseminated about food and nutrition and want to warn people not to believe everything they read and hear.
Dietitians and nutritionists are experts in nutrition. All that is medically and nutritionally required falls within their field of specialization.
The reform of the health care system, the shift to ambulatory care and the subsequent redeployment of professionals increase the number of situations where the protection of the public and appropriate health care need to be improved and prioritized despite the economic climate.
Dietitians and nutritionists are in a good position to help people suffering from hunger. By linking their knowledge of foods with respect for others, they come up with creative ways of appeasing the hunger of thousands of people.
One of the places that comes to mind is the Dispensaire diététique de Montréal, which was established over 50 years ago and which has helped some 2,600 pregnant women in difficulty, a third of which were disadvantaged, and which established a model for effective dietary counselling in order to be able to answer society's greatest need: child poverty.
When children suffer from malnutrition, the first thing that springs to mind are health problems: anemia, underweight babies, delays in growth, deficiencies in nutritional elements such as calcium, iron, zinc and vitamins A and D, to name the main ones.
In addition, low birth weight is a risk factor in perinatal mortality and in physical and mental handicaps. It can also affect performance at school, reduced attention, fatigue and mood changes.
School programs also try to help young people from disadvantaged communities eat better. For example, milk has been provided in certain schools for over 20 years. Programs offering snacks, soup, low cost meals, food banks providing non-perishable items and nutritional education have been set up to help young people eat properly.
In another area, assessing needs, determining quantities and measuring effects on the organism are factors that must be taken into consideration in planning an expedition or athletic training.
For example, polar exploration requires very specific nutritional logistics. Everything has to be calculated. To ensure full nutritional value is obtained from prepared food and beverages, various factors must be taken into account: the explorer has to fight cold and wind, he will have long distances to travel, he will be carrying weight and the expedition may last a number of days, if not weeks.
This knowledge enables the dietitian or the nutritionist to be an invaluable partner in organizing such an adventure.
As mentioned earlier, dietitians and nutritionists are specialists in nutrition. They work to disseminate and apply nutritional principles, guide dietary choices and help prevent or treat the consequences of inadequate nutrition in groups of various milieu and individuals of all ages.
The dietitian's professional goal is to promote good health through proper nutrition. An ever-increasing number of individuals, businesses and organizations are utilizing the services of a dietitian. As members certainly know, the Canadian government recognizes them as a key resource in drawing up health policies such as Canada's food guide which provides guidelines for a healthy diet.
Historically the first nutrition programs were offered by the University of Toronto in 1902 and Toronto's Hospital for Sick Children was the first hospital to hire a professional dietitian in 1908.
In Canada there are two professional orders of dietitians: one in Ontario and one in Quebec. All the other provinces and territories have associations recognized by their respective provinces and territories. We must therefore conclude that the profession of these persons is recognized by their province but not by their country.
We will remember that, in 1992, at the international conference on nutrition in Rome, the participating countries, including Canada, supported a world declaration on nutrition and made a commitment to develop national nutrition strategies.
Health Canada set up a steering committee to prepare a national strategy on nutrition, and the committee presented its report providing strategies on nutrition for new directions in health in the spring of 1996.
The document on the subject of nutrition as a source of savings for the health and social services network issued in June 1997 by the Ordre professionnel des diététistes du Québec indicates that good nutrition is very cost effective and that it rapidly improves the health of those who are sick, cuts medication and the risk of complication, shortens the length of hospital stays and reduces the rate of return to hospitals and transfers to chronic care centres.
A look at the particular needs of the most vulnerable groups, including pregnant women and elderly persons, indicates that nutrition is indeed a source of significant saving for the health and social services network.
People aged 65 years and over have twice as many chronic health programs as those in all other groups in the population as a whole.
Chronic illness and physical disability combined with a reduced appetite seriously affect seniors' nutritional balance. The result, among others, is a greater risk of infection, dehydration and osteoporosis.
The effectiveness and efficiency of health care could be significantly improved through early nutritional examination of people at risk, through special nutritional intervention and a joint action by all decision-makers and interveners.
We should remember that the population aged 65 years and over has almost doubled in the past 30 years, and the proportion continues to grow.
Persons aged 65 years and over on the average have twice as many chronic health problems as the population as a whole. Reduced mobility often leads to difficulties in obtaining and preparing meals. A number of social factors also effect seniors' health, including loss of a spouse, retirement, isolation and insufficient income.
Because they eat less, seniors have a hard time meeting nutritional requirements for vitamins and minerals.
It is acknowledged that during chemotherapy and radiation treatments for cancer, multiple alimentary distresses can affect the individual's appetite and quality of life.
This is why good nutrition is essential to keeping the immunity system healthy. Malnutrition, even low level, may upset this immunity balance.
Of the people displaying malnutrition on leaving the hospital, 29% are rehospitalized unexpectedly within the three months of their leaving.
Appropriate nutritional action provides the most appropriate treatment of protein-caloric malnutrition in seniors preventing their return to hospital in the short term.
An American experiment, in which elderly persons were fed nutritional meals at home, shows that it is possible to reduce the number and the length of infections as well as the number of hospital stays and medical complications. It should be noted that the annual cost of this service amounted to the cost of a single day's hospitalization.
In another area, everyone has heard of osteoporosis, the deterioration of bone which may result in very severe fractures.
Osteoporosis patients must pay continued attention to the way they eat. Dietary intake of calcium and vitamin D is a decisive factor in prevention and treatment.
One can conclude that all of these physical difficulties, linked to a loss of appetite, can significantly affect the balanced diet of seniors, who can then become weaker and weaker. They become more vulnerable to infection, do not have the reserves to heal fast and therefore they need more health care services.
It is obvious, as many studies have indicated, that well adapted and timely nutrition services can help to limit the costs of health services, by reducing the number of days spent in hospital, prescriptions and medical examinations and by delaying or even avoiding admission to an institution.
Now, let us talk briefly about cardiovascular diseases, the main cause of death in Quebec. These insidious diseases develop throughout a period of at least 20 years and are linked to our lifestyles.
Risk factors on which we can have some kind of influence are hypercholesterolemia, high blood pressure, smoking and an inactive lifestyle. A single one of these factors doubles the risk of disease, two of these factors quadruple it and three multiply it by eight.
Strokes are the main causes of brain damage among adults. This alarming trend can be altered.
In 1995, the Massachusetts dietetic association released a study that showed that nutrition is the most effective and least expensive initial approach to the treatment of patients with low or moderate hypercholesterolemia.
According to another American study carried out in 1987 among patients with high blood pressure who were taking hypotensive drugs, in 50% to 69% of all cases, nutrition can replace hypotensive drugs during the first year of treatment.
In conclusion, my purpose today is not to convince members of the great value of the services provided by this group of professionals. We are all convinced of that value. In practice, however, this group whose national association has over 5,000 members, over 90% of them women, is not recognized by the Canada Health Act.
