Health committee  Thank you for the question. It's one that has a complex answer, depending on which component of the human health resource team you are talking about. Realize, again, that we're focusing on child health teams. We've spoken quite a bit about the need for more nurses. I will highlight, in passing, some of the other areas.

Health committee  Sure. Thank you very much for this question. I'm fortunate to have, on this panel of witnesses, people who can speak much more scientifically and eloquently about the discovery research, the biomedical research, realizing that Canada has traditionally funded a spectrum of research from biomedical to health services research.

Health committee  I can't say that the surgical chiefs have directly, but through our strong collaboration around advocacy with Children's Healthcare Canada, I know that there have been some conversations at the level of provincial nursing colleges trying to create more seats for nursing and then specifically trying to incentivize a diverting pipeline of nurses who then go on to dedicate their careers, as your wife did, to that of child health.

Health committee  It's a really good point. I think it speaks to the need for an increased capacity and strengthened relationship of the public with primary care and family doctors. That really should be the source of advice for families, particularly if they're seeking or need specialty care. In terms of trying to create capacity and create confidence in communities in community health capacity for children's services, I think part of that is a partnership of children's hospitals with those communities and with the providers in those communities where there is a sense, whether from branding or even just presence....

Health committee  We have operating rooms at B.C. Children's Hospital, and, for example, at Sick Kids and other larger children's hospitals in Ontario. I know less about Alberta, but we have children's operating rooms that are fallow. They are empty. It relates to the fact that we aren't able to staff them.

Health committee  No, definitely not. These are specialist surgeons who may not focus their practice on children, but certainly can provide care for children. These would usually be children who are older, like teenagers, who don't have comorbidities that would require the care of children's specialists.

Health committee  I think we need targeted funding for children's health care with the transfer payments to the provinces. We need co-operation in planning within the provinces between, as I mentioned, the children's hospitals in the community that really target the building and retention of child health care capacity.

Health committee  Thank you very much for the question. That figure of 65% out of window requires some interpretation, because in some reports it reflects completed cases. An operation gets done and comes off the wait-list, and we are also interested in how long those children waited to have surgery.

Health committee  In my hospital and in the discussions we have with the other chiefs of surgery at the other children's hospitals, it's nurses. It's nurses who keep our ORs and our recovery rooms open and nurses who staff hospital beds, particularly in critical care areas. We can have a child waiting for surgery, we can have a room and we can have a surgeon and an anaesthetist, but without a nurse to staff a bed for that child to go to after surgery, we can't start that case.

Health committee  There is if we aggregate provincial data. We used to have an organization through what is now Children's Healthcare Canada that kept track of national data. We rely now on provincially aggregated data, so the data that I provided to you is self-reported from children's hospitals.

Health committee  I do think it would be helpful, as would more national co-operation. Child health, still, is a provincial responsibility. With greater integration across provinces—sharing of what's working and what's not, dealing with some health human resource pipeline issues, sharing technology and technology assessments so that we can drive the approval of pediatric-specific devices more effectively in Ottawa—I think there's great opportunity for national collaboration in data sharing and in operational management.

Health committee  I would say that we didn't actually create a lot more capacity. Rather, we shifted the capacity that we had to those priority areas that you mentioned. We certainly do have some capacity-building strategies that include consistently opening additional ORs, running ORs later in the day and even trying to run operating rooms on weekends—doing elective surgeries on weekends.

Health committee  I did provide some figures that show that our current wait-list is about 3,800 patients. That's double what it was before the pandemic. It's important to realize that a wait-list is just a number. What you're not capturing in that number is the percentage of children who are waiting beyond their wait-time target, which is really important for some of those developmentally timed surgeries, like surgery for scoliosis or for cleft lip and pallet.

Health committee  Certainly. Thank you for the question. One of the other witnesses very eloquently described the impact of COVID-19 on children. In the children's hospital perspective, it was something where we really didn't know what to expect and what impact it would have on children. We did learn some things about transmission to children, but really, in terms of comparative impact to adult health services, we did not see children dying in children's hospitals, as we did adults in the adult hospitals.

Health committee  Thank you for this question. What you described really highlights what I think is the next challenge in children's services planning by the provinces. That is to really make sure we are using existing capacity in the most effective and efficient way, so that we limit children travelling to an urban tertiary or quaternary children's hospital.