Health committee  Good afternoon, everyone. Thank you for inviting me on behalf of CFNU. We represent over 200,000 nurses across the country. My name is Linda Silas. I am a proud nurse and a proud New Brunswicker. Thank you to the committee for doing this study. I remember testifying here on other issues.

Human Resources committee  Yes and no. Caregivers are often those who would naturally help the family or the elderly person. Any support in the form of tax credits helps them personally, but they do not decide to become caregivers in order to benefit from the tax credit. The key is making sure these caregivers have the training, education and support they need to take care of their family members.

Human Resources committee  Honestly, I can't tell you. We hear positive stories, but are they representative?

Human Resources committee  There's no issue on retention. It's almost the ghetto of where we go in health care, which is kind of sad, because as you heard from many of the speakers, seniors and the aging population are a richness in our country. We need to mix the professional help that is needed from doctors, specialists, and personal care workers with help from volunteers and family caregivers and make sure that everyone is working in a coordinated team—of course with the family and the senior leading the team—regardless of the cultural appropriateness of what is needed.

Human Resources committee  Yes. We had Dr. Pat Armstrong from York University do a paper for the council of the federation two years ago. It was all about building national standards for seniors care and having it be legislated. Let's be clear. The federal government will never deliver the care, but the federal government can deliver the standards that will be in each province and territory and can also have the clinical data available for everyone.

Human Resources committee  Thank you, Mr. Robillard. The reassessment of clients and their families is probably the greatest need observed by the country's nurses. All of the seniors are medically assessed and sent home, and then they are forgotten for weeks, months, or longer. That is when accidents happen, loss of balance, falls; people forget to take medication or are sent to emergency or readmitted to hospital, and the families scramble constantly.

Human Resources committee  There are two prongs here. If we look at pharmacare, it's, one, having a formulary that's based on the evidence. I'm scared every day to hear reports—and that's not a CNFU report, that's the Beers report—that 40% of the prescription drugs prescribed to seniors are inappropriate for them.

Human Resources committee  Mr. Chair and committee members, thank you for inviting the Canadian Federation of Nurses Unions to present to this committee. On behalf of close to 200,000 nurses who I represent, I'm very pleased to be here. As mentioned, my name is Linda Silas. I'm president of the federation and a registered nurse.

Health committee  The CIHI report of two years ago said that we were paying more for prescription drugs than for doctors. Now, the cost of physicians is a little bit more, but we're still talking about 30% and 32%. No, we wouldn't be paying more for pharmaceuticals than for doctors, because we would base our national pharmacare program on efficiency, science-based evidence, and prescription habits.

Health committee  As Ms. Yale said, the patients have to be at the centre, but they have to be given the right choice. It would still be based on what your physician or nurse practitioner prescribes and advises you to take. It would be based on the formulary if you want it to be universally accessible under.

Health committee  No. We work with them. It's like any other national agreement. There's a little astérisque excluding Quebec. I did say at a conference where Quebec was very well represented that we believe, because the numbers are clear, that Quebec would have to be included. They do not have a perfect system for covering medication in Quebec.

Health committee  Let's look at the Canada Health Act. We have one Canada Health Act for the 13 provinces and territories and the federal government, so all are there. What the provinces and territories have is the delivery of care. That is very specific. There's not one federal health minister that I've met over the years that wants to get their hands into the delivery of care.

Health committee  I started this job 13 years ago, and I have to say that negotiators then weren't as much in favour of a national formulary as they are today. With health and dental, if I look at all benefits, it's about 6% of payroll. When we look at it as negotiators, that 6% that goes towards providing health and dental and other allied services could be put somewhere else.

Health committee  They need help. There's not one province, one territory, that doesn't need help in health care. They're as frustrated as we are when they see that they have to handle this on their own. When 40% of your provincial budget is health care and more than 30% of that health care budget goes towards prescription drugs, there's a problem.

Health committee  The nurses union hasn't done any that. We have focused on the waste. However, the CMAJ did research just two years ago on the cost, and that's where it was between $1 billion and $4 billion. There will be more, and we'll focus there. To keep your nurses happy, I'll make sure that you get a little bag of nurses union swag for Christmas.