SCYR Committee Meeting

SUB-COMMITTEE ON CHILDREN AND YOUTH AT RISK OF THE STANDING COMMITTEE ON HUMAN RESOURCES DEVELOPMENT AND THE STATUS OF PERSONS WITH DISABILITIES

SOUS-COMITÉ DES ENFANTS ET JEUNES À RISQUE DU COMITÉ PERMANENT DU DÉVELOPPEMENT DES RESSOURCES HUMAINES ET DE LA CONDITION DES PERSONNES HANDICAPÉES

EVIDENCE

[Recorded by Electronic Apparatus]

Wednesday, May 2, 2001

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[English]

The Chair (Mr. John Godfrey (Don Valley West, Lib.)): Ladies and gentlemen, committees, like certain branches of the church, work on the principle that when two or three are gathered together, providing one of them is a member of the opposition—that's not the way the churches function—we may begin. If anybody thinks they're here for the subcommittee on disabilities, it's across the way, and conversely we'd like them to come back if they belong to us.

We will expect members to drift in, as they do. We try to program them by making things start at 3:15 p.m. But this has been only a mild success to date, I would say, as a strategy.

Let's remind ourselves where we are in our discussions. Last week we had a very useful discussion to acquaint members with the early childhood development agreement, which was put in place last September, and it was led by Marta Morgan, the Acting Director General of Social Policy for Human Resources Development Canada, who's back with us this week. She very usefully, with her colleagues from Health Canada, updated us on the position we are in today.

That was for an agreement that covers the whole of Canada. Now that we have this understanding of the general agreement, the questions we're asking ourselves today are, first of all, where do the first nations fit into an early development strategy, and indeed into this agreement? Secondly, what is the cluster of services, which the Government of Canada, through various departments, whether it's Indian Affairs or Health Canada or HRD, makes available to aboriginal communities?

I hope that's what the witnesses think they're here for. Does that sound familiar? Does that sound reasonable?

Dr. David Fransen (Director General, Centre for Healthy Human Development, Population and Public Health Branch, Health Canada): You weren't kidding. This really isn't the one on disabilities.

The Chair: No. But we're flexible.

Dr. David Fransen: It will be soon.

The Chair: We keep being reminded that we should always have the disability lens. So in that sense, maybe a little bit, yes. But Carolyn Bennett is meeting next door.

I have a number of names in front of me, and maybe what you could do is introduce yourselves. Have you picked a batting order here?

Dr. David Fransen: We have indeed, Mr. Chair. We have a carefully scripted presentation. And just to make sure that everyone stays awake at this end of the table, we've made it so that it's not going to be linear in any way; it's going to bounce around.

The Chair: I see.

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Dr. David Fransen: But we do have an order, and it will become evident to you as we go through it.

The Chair: Perfect.

Why don't you begin, David Fransen.

Dr. David Fransen: I'll just introduce myself, because my colleague from Indian Affairs and Northern Development, Kathleen Campbell, will begin the actual presentation. I'm David Fransen, the Director General of the Centre for Healthy Human Development at Health Canada, where the childhood and youth division is located.

Ms. Kathleen Campbell (Director General, Social Policy and Programs, Socio-Economic Policy and Programs Sector, Department of Indian and Northern Affairs): I'm Kathleen Campbell, Director General of Social Policy and Programs, Indian and Northern Affairs. I drew the straw that said I was introducing the presentation.

I thank you for inviting us to speak to you about the children's programming and about aboriginal children. You noted that last week Marta did a presentation to you on the early childhood development. I think today we'll talk about the context of this initiative for aboriginal children generally and for first nations children on reserve in particular.

As you know, we haven't yet concluded the overall strategy, but we'll bring you up to date insofar as we can on the strategy as it relates to aboriginal children and first nations children.

My colleagues from Health Canada will speak first on some of the demographic issues that challenge the policy work relating to aboriginal children, and about the federal and provincial responses to these challenges, particularly with the FPT agreement announced last September. Then I am going to speak about the children's programming on reserve and put those remarks in the context of the government's programs and commitments regarding Gathering Strength, the national children's agenda, the national child benefit, and, most recently, the Speech from the Throne.

I'll turn to my colleagues from Health Canada.

[Translation]

Ms. Nicole Ladouceur (Director General, Program Policy, Transfer Secretariat and Planning, First Nations and Inuit Health Branch): Thank you, Kathleen.

Good afternoon, Mr. Chairman. I will be making my presentation in French. My name is Nicole Ladouceur and I am Director General, Program Policy, Transfer, Secretariat and Planning, First Nations and Inuit Health Branch at Health Canada.

As my colleague has explained to you, I will first give you some demographic information on the Aboriginal population in Canada. Before beginning, however, I would just like to say that when we talk about the Aboriginal population in Canada, we are referring to First Nations, Inuit, and also other Aboriginal people living off the reserves and in northern communities across Canada, including Metis.

I will start by giving you some demographic statistics on the Aboriginal population, and then I will go on to talk about certain socio-economic indicators which are very useful for understanding the situation of Aboriginal people in Canada.

Demographically speaking, the Aboriginal population of Canada is very young. Aboriginal children are the fastest-growing population in Canada. Over the next two decades, the Aboriginal population is projected to grow 1.7 times faster than the overall Canadian population.

Aboriginal people represent 4.5% of the Canadian population, a percentage that has doubled over the last 15 years.

The Chair: Just a moment, please... I think we are having some visitors. This is wonderful.

[English]

Come on in folks.

[Translation]

Come in.

[English]

There is such a number of them that...let me just interrupt. I suspect this is the Forum for Young Canadians. Yes. How am I doing? Pretty good. Come on in. My golly. Is this children and youth at risk? I hope that applies to none of you. Keep coming. As soon as the last one comes in, I think I'll tell them about the hearing devices or translation devices.

Welcome to the Forum for Young Canadians. If you would fill up seats as you can.... There is no point in standing; there are chairs along the side. Do the best you can. Fill right up.

[Translation]

I do apologize, Ms. Ladouceur, but we have to make the most of such an audience.

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Ms. Nicole Ladouceur: That is quite all right. Thank you. It is important. Thank you, Mr. Chairman.

When we speak about Aboriginal demographics in Canada, we would also like to point out that children under six years of age represent 16% of the population, whereas in the general Canadian population, children represent approximately 8%.

In short, there are approximately 96,000 Aboriginal children living in Canada, forming approximately 10% of the Aboriginal population as opposed to 8% for children in the overall Canadian population. We are talking about a large population here, and one which is growing very rapidly. These children fall well below the national standard, however, when we look at development indicators and socio-economic factors.

Aboriginal children have to meet major challenges. For example, Aboriginal children are far more likely to do badly at several levels. First of all, infant mortality is two to three times higher than the Canadian norm. As well, the rate of infant mortality due to injury is four times higher than the national average. The rate of fetal alcohol syndrome and fetal alcohol effects may reach 20% in Aboriginal communities, or in other words, as high as one person in five. As well, First Nations children on- reserve are taken into care at four times the rate of other Canadian children. In 1999, 5,985 children were taken into care. Finally, one third of Aboriginal children under 15 years of age live in a lone-parent family, twice the rate within the general population, and this goes up to 40% in the urban environment.

This poor start in life results in very considerable socio- economic costs in the long term. For example, the cost of providing support for a child suffering from fetal alcohol syndrome or fetal alcohol effects is estimated at $1.4 million.

Our estimates show that 23% of First Nations children living on reserves have serious learning difficulties, which requires a considerable investment in educational services for children with special needs.

Thus, the Aboriginal participation will be critical for Canada's economic growth and social cohesion, and this is very important for us. For example, we estimate that Aboriginal people will make up 33% of the labour force in the province of Saskatchewan in 2025. Given these figures, you understand that it is very important for the government to introduce new measures and to continue those which have already been undertaken.

My colleague David Fransen is going to speak to you about the programs that you have set up to deal with these problems.

[English]

Dr. David Fransen: Thank you, Nicole.

My comments will address two dimensions of the aboriginal context: first of all, the federal-provincial-territorial, or the FPT dimension; and then secondly, a little bit about the activities of the federal government.

Today there is, in the FPT context, a political will for better conditions, significant investment, and, above all, a vision for the future in the sense of a comprehensive, integrated, community-based system of supports and services for very young children and their families.

The early childhood development initiative agreed to by first ministers last September committed all governments to improve and expand ECD, or early childhood development, programs and services.

First ministers also committed to:

work with the Aboriginal peoples of Canada to find practical solutions to address the developmental needs of Aboriginal children.

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As I think you heard in detail last week, under the ECD agreement reached last September, the federal government is transferring $2.2 billion to the provinces over the next five years, starting this past April 1.

Provinces and territories are actively planning their own individual ECD strategies, and many have already announced new investments in early childhood development, including investments in aboriginal children's early childhood development.

For example, in January, British Columbia announced $8 million to establish a system of ECD services in urban aboriginal communities.

Alberta recently announced its plans to continue to respond to the results of their own children's forum and task force on children at risk, emphasizing support in the early years and enhancing programs for FAS.

In April, Saskatchewan unveiled the details of its own early childhood development strategy, called Kids First, and through this initiative, intensive early childhood supports for vulnerable children in high-risk communities, including an emphasis again on FAS.

In Manitoba, in addition to expanding its already existing FAS/FAE programs, it recently announced the details of its prenatal program, called Healthy Baby. Through this program, all women, including those on reserve, with a net family income of less than $32,000 will be eligible for a maximum prenatal benefit of $81.41 a month. Information on basic nutrition and health is included with their cheques.

Currently, first nations children on reserve are not covered by the transfers that are being made to the provinces under the $2.2 billion CHST transfer.

In the context of the federal government, the challenges faced by first nations and other aboriginal children are enormous, and they remain a high priority for the government. There's an opportunity here for the federal government, working together with provinces and territories, to make a real difference for these children.

We believe the Government of Canada has an important role in supporting children and families at risk, including direct services for first nations and Inuit children, and support for aboriginal children living off reserve. This role is reflected in a range of ECD programs and services delivered by the federal government, both on and off reserve.

These programs for first nation and aboriginal children and their families have been developed on the basis of a strong body of knowledge about which interventions work, particularly for those children considered at risk of poor developmental outcomes. Research has consistently shown that there's a high return on investments in early childhood development supports and services and that integrated programs at the community level are the most effective.

At Health Canada, there are a number of community-based programs for young aboriginal children and their families, including Aboriginal Head Start, the Canada Prenatal Nutrition Program, and the Community Action Program for Children.

Aboriginal Head Start is operative in 280 sites on reserve and across urban and northern communities. It provides early intervention services to almost 11,000 preschoolers.

The Canada Prenatal Nutrition Program, which is managed jointly on a bilateral basis between the federal government and the provincial government where the program sites are located, supports pregnant women who face conditions of risk that threaten their health and the development of their babies.

The Community Action Program for Children, with 499 sites across the country, funds community groups to establish and deliver services that address the developmental needs of at-risk children up to six years of age. Here it's important to note that depending on the province, anywhere from 13% to 23% of the participants in either the Canada Prenatal Nutrition Program sites or the CAPC sites are aboriginal.

Also, as a first step toward developing a federal strategy on fetal alcohol syndrome, Health Canada is implementing a three-year, $11-million strategy to enhance FAS work in the areas of public awareness and education, training, early identification, and diagnosis.

The five national aboriginal organizations—the AFN, the Inuit Tapirisat, the Métis National Council, the Congress of Aboriginal Peoples, and the Native Women's Association of Canada—have been actively involved in issues relating to children and families. All of the organizations have provided valuable input to the development of the national children's agenda and have expressed keen interest in continuing their involvement in ECD.

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The federal government has supported them in the development of discussion documents that highlight the needs in their communities and their priorities for action.

Ms. Kathleen Campbell: I'm going to speak about first nations on reserve. Our responsibilities are pretty well limited to them. First nations have identified the care and nurturing of children as one of their highest priorities. We have often quoted from the Report of the Royal Commission on Aboriginal Peoples the statement “The future of our communities lies with our children, who need to be nurtured within their families and communities”. In our discussions with first nations, they often use this quote to re-emphasize the priority of children in their overall family and community life.

However, as you have heard, with the high rate of children taken into protective care, which we're saying is about four times that of off reserve, as was referenced earlier by my health colleague, it really is an indication that there is still a lot to be done, as are the high rates of FAE/FAS and, indeed, as the first nations often note, the rate of suicide. Therefore, in their discussions around the national children's agenda, the Assembly of First Nations identified several priorities for children. Among them are poverty, nutrition, injury, adoption, and suicide.

Some programs have been put in place, and they are beginning to show positive effects in addressing these issues. Among them I would place the national child benefit reinvestment program. I understand that you may be examining the national child benefit program more closely in the near future, so I'll not say too much about it here. But I would certainly welcome questions.

In the meantime I would like to highlight the fact that the national child benefit reinvestment component for first nations provides the flexibility and variability for first nations to design and develop innovative community-based programs that are culturally relevant, that respond to the specific and unique needs of the community, and that support the children and their families living on reserve. This approach has been a positive one. It has created a momentum within first nations communities to build on existing programs. We are getting this positive message not only from the rate of uptake of the program within first nations communities but also from the self-evaluations that several first nations are undertaking to assess the impact and effectiveness of their programming.

We are in fact getting a few strong messages from first nations relating to the effectiveness of on-reserve programming and our work with them not only on the national child benefit program but also on the other social program reforms we have been jointly undertaking under Gathering Strength.

I'd like to share some of these messages with you. First of all, the stovepiping of programs is a problem within first nations. First nations are relatively small communities, and they often face a myriad of programs with overlapping mandates and accountability requirements. Currently, for example, DIAND spends approximately $309 million on child and family services, which is reflective of the high level of children in care, and almost $49 million on national child benefit reinvestment programs. HRDC is investing $34 million in child care, and Health Canada is spending $25 million on the Aboriginal Head Start initiative and about $14 million on the CPNP.

In recognition of the issue of the overlapping programs and the fact that sometimes many of them have more similarities than differences, DIAND, Health Canada, and HRDC have undertaken to work closely together to pragmatically combine and harmonize our programming as much as possible. We're beginning to feel like we're joined at the hip, as a matter of fact.

Second, the harmonization of programming on reserve with the provincial programming off reserve is also a challenge. As provincial social programs evolve to take into account changing provincial priorities, so must programming on reserve evolve to ensure that there is not too great a discrepancy in the access to programming.

However, at the same time first nations communities want to ensure that the programming in their communities reflects their goals, values, and priorities, and this is a direction we have supported through our Gathering Strength initiative.

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The third issue is the ownership of programming. The ownership of programming provides a very strong motivation to achieve results. In general when people have a sense of ownership of a program, they have a commitment to achieve the objectives of the program, instead of being tempted by the challenge of beating the rules of imposed administrative guidelines. This has often been the practice in the past where we have imposed guidelines and then compliance, as opposed to a sense of ownership of the programs themselves. This ownership can be achieved by working closely with first nations in establishing the goals and policy parameters for social programs, not to mention the articulation of the program guidelines themselves.

The fourth issue is accountability. The word “accountability” is used a lot these days. Accountability is critical not only to the federal government.... Accountability is not very popular, either.

Some hon. members: Oh, oh!

The Chair: They're voting with their feet.

Dr. David Fransen: Can we go?

The Chair: You have to stay.

Ms. Kathleen Campbell: Accountability, however, is critical—

The Chair: No matter what they do.

Ms. Kathleen Campbell: —not only to the federal government but also to first nations themselves. In order to develop and run effective programming, first nations need the feedback that results-based accountability can give them. This means not only a focus on the financial accountability but also feedback on the impact of programming.

To this end first nations have noted that they need a more effective data and statistical system, one that will give them the feedback they need in the context of their own communities' goals, values, and priorities. DIAND and Statistics Canada have been discussing with the Assembly of First Nations the potential for the creation of the First Nations Statistical Institute, which could begin to provide the necessary infrastructure.

We'll now get to the actual issue we were brought here to talk about, and that is future policy direction. The federal government is working with first nations in a number of areas to improve social programming in general and also to focus on the effectiveness of programs for children. We have income security reform; the child and family services national policy review; the national child benefit reinvestment program; and, as noted earlier, the harmonization of the above programming with the Aboriginal Head Start initiative, child care, and early education programming.

The 2001 Speech from the Throne made three commitments: to work with first nations to improve and expand early childhood development programs and services in their communities, to expand the Aboriginal Head Start program significantly, and to work with aboriginal communities, provinces, and territories to combat fetal alcohol syndrome.

The three federal departments represented here at the table are working on a federal early childhood development strategy for first nations and aboriginal children that is in line with these commitments. That work is going on right now, and we hope we will be able to return to your committee in the very near future to speak further about the details of that strategy.

We would welcome your questions.

The Chair: Ms. Morgan, welcome back.

Ms. Marta Morgan (Acting Director General, Children's Policy, Department of Human Resources Development Canada): I have nothing to add, but thank you.

The Chair: Thank you very much.

Just to remind members of the committee, the idea was that we would be focusing generally on the early childhood development deal for the balance of this parliamentary session and then working more intensively on aboriginal children and youth starting in September or October.

But we thought that since the two files came together through the ECDI file, it was important that we give an early indicator of where these things come together, and that's the purpose of today's meeting.

Mr. Bailey.

Mr. Roy Bailey (Souris—Moose Mountain, Canadian Alliance): Thank you, Mr. Chairman.

In other committees I serve on, I always want to make sure I understand the definitions and the terminology we use. I'm referring basically to the two terms we have used interchangeably here, that is, “first nations” and “aboriginal”. When the group of first nations veterans appeared before us, they made it clear what each one meant. For another group in another committee it was a little different. I'd like to have your definition so that we're singing from the same song sheet as far as the definitions are concerned. It's a big world out there, and I'm afraid that some of the definitions vary from province to province.

The Chair: Ms. Campbell, I suspect.

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Ms. Kathleen Campbell: I think the important difference in this particular context, because we're talking about social programming, is on reserve and off reserve. We use the term “first nations on reserve” to refer to those people who are on reserve and “aboriginal” for the larger context of first nations, status Indians, the Inuit, and the Métis, who live primarily off reserve.

Mr. Roy Bailey: Thank you very much. I'm glad you clarified that because it makes a difference indeed.

The three departments to which you refer—are those HRDC, Health, and DIAND?

Ms. Kathleen Campbell: Yes, that's right.

Mr. Roy Bailey: I'm really interested in this field, and I've been at this for more years than I want to mention. But one of the difficulties I first encountered when we had our...the reserves were, and I use the quotation, “Indian”, “the agent type” of control. Now we have evolved into a slightly different type of control. But now, by what the minister has to say, we're going to go into—and I hope that will be the case by this fall—a new redesigning of the Indian Act.

With that comes a statement—I don't know which one of you mentioned it—and that is accountability. Your programs, from my experience in working in this field, would be facilitated with much greater ease if that legislation were in place at the present time. Therefore, you will probably hear me when this legislation comes up because I have a great deal to say about the accountability, which particularly in your work would certainly facilitate the program and the delivery of the program without a lot of unnecessary interference. I know that exists at the present time.

I just want to tell you—and I don't want to monopolize this—that I'm very, very concerned that this bill become a reality because we must move with this bill now. It's long overdue.

Thank you for that, for now, Mr. Chairman.

[Translation]

The Chair: Ms. Guay.

Ms. Monique Guay (Laurentides, BQ): Good day, everyone.

Ms. Ladouceur, I have some questions for you. First of all, would it be possible to get a copy of the presentations you have given?

Ms. Nicole Ladouceur: Yes, but I do not have a document in French. I was reading my own notes. If it is the figures you were interested in, I could...

Ms. Monique Guay: Yes, I would very much like to have to figures.

Ms. Nicole Ladouceur: ... send them to you when I get back to my office. I would have to make sure that they are easier to read, since my original document is in English.

Ms. Monique Guay: Perfect.

Ms. Nicole Ladouceur: I will send them to the clerk.

Ms. Monique Guay: Yes, that would be fine. I would like to look at the percentages you mentioned. We can see that the Aboriginal population does indeed have problems which are different from those of other groups. I would also like to know whether there are differences between Aboriginal people in Quebec and those in the rest of Canada, and see how it works. I know that there are certain Aboriginal communities in Quebec which have really taken themselves in hand and are using many Quebec programs for Aboriginal children and families in the area of prevention and so on. Would you have this information at the present time?

Ms. Nicole Ladouceur: No, but I can certainly send it to the clerk.

Ms. Monique Guay: You must have something on this. It would be useful for us to see what goes on in Quebec and also elsewhere, to see what works well.

Earlier you spoke about overlap. We need to be careful of this because it is not efficient. More is not necessarily better when we speak about programs. That is a fact. We have to be careful about this.

At the present time there are various programs. Ms. Campbell has spoken to us about them. Could you tell us a little more about the effectiveness of these programs and identify the most urgent needs which you foresee in the near future.

[English]

Ms. Kathleen Campbell: I think you have brought forward an important issue. We have...because the term “accountability” is used in so many different ways, and there is the financial accountability that I think hits the newspaper so often, but it is really.... What is of most value to first nations people and ourselves is really trying to assess the impact, the results, and the effectiveness of the program itself.

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There are a couple of challenges there. One is having the capacity within first nations themselves to do that kind of assessment. Under the national child benefit reinvestment program, we have several first nations that have begun undertaking self-assessment exercises, which develop the capacity within first nations to look at how their programs are doing vis-à-vis the goals established for the program. This has been quite successful in our participation with them.

The other issue has been the lack of data and statistics on reserve that can really effectively tell us, in the longer run, how effective some of these programs are. We are, as I noted in my remarks, now working with Statistics Canada in order to try to develop that baseline. We do have statistics from the various censuses, in the main for individuals on reserve, but that doesn't necessarily respond to some of the questions that really need a different kind of definition of statistics.

You might be talking about—I like to use the example of talking about a community of people. If you want to just use the basic data, for example, on employment or unemployment, to talk about the health of a community defined by a reserve, and yet most of the people, when they work, leave the reserve to work somewhere else and then return when they're unemployed, the unemployment statistic doesn't really speak to the overall health of the community. I think we have to take another look at those statistics and find out what they really are telling us.

[Translation]

Ms. Nicole Ladouceur: I can add a few words about health. I would agree with my colleague that we do have difficulties in obtaining reliable statistics, but I think efforts are being made in this area and have been for a few years now. There is progress, but it is slow. I could mention birth weight, for example, which is a very important factor in child development. The birth weight of Aboriginal children is still below the national average. Over the past two decades, however, statistics show that this weight is rising. The margin is being reduced. I feel, therefore that our programs are indeed having a positive effect.

We see the same thing in the case of infant mortality. There again, we see progress, even though we may feel it is a bit slow. We hope that with...

Ms. Monique Guay: ... with time, it will improve.

You have programs in the area of health and prevention for young people, but if you try to introduce these or other programs into Aboriginal communities and these communities do not want them, it will not move things ahead. It will not help. You will also have to have results and statistics if you are going to move ahead. Do you get good co-operation from the communities, are they receptive? Do you feel that people really want to take themselves in hand? I suspect that it is not the same for everyone. There must be some communities where it is more difficult than in others. But also other communities where things go better. Perhaps you could add to this.

Ms. Nicole Ladouceur: Obviously, the key to success is the partnership with Inuit, Indian and other communities. I would say that relations are currently very positive. I think that they have gone beyond the observation stage. We are all aware of the issues, and the communities are really showing their interest. In my opinion, our inability to respond adequately to requests is the biggest problem. I think that there are more requests than we can handle. But I do think that relations are very positive. It is up to us to pick up the challenge.

The Chair: [Editor's Note: Inaudible]

Ms. Monique Guay: What kind of disability are we talking about? Let me finish, Mr. Chairman. Are we talking about the number of persons, the number of programs or the amount of funds? Which capacity are you having a problem with?

Ms. Nicole Ladouceur: I think that the problem is due to resources.

Ms. Monique Guay: Resources in general?

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Ms. Nicole Ladouceur: Yes, in general. I think that the programs exist. Now, there are other equally important factors. Some communities are scattered across the country. This poses the problem of distance, of access to programs, etc.

Ms. Monique Guay: For instance, let us take a place like Iqaluit, with rather large Aboriginal communities. I went there several times in the past for another matter; at that time I was working for Environment. It is not easy to get things done in those communities. We need people on site, it is costly and we must be able to...

Ms. Nicole Ladouceur: Absolutely.

Ms. Monique Guay: ... to reach them. That is not easy because these are closed communities. I can understand the problems.

[English]

The Chair: Thank you, Ms. Guay. Mr. Tirabassi.

Mr. Tony Tirabassi (Niagara Centre, Lib.): Thank you, Mr. Chairman. I don't know who might field this question. Perhaps there are some unique obstacles in the delivery of these programs, but my question is about communicating exactly what the programs are and how they are to be administered so that indeed in the end the benefactors will benefit. I'm wondering how you do this. How do you follow that up? And once that's been done, how do you extract the success of your programs? How do you get the feedback?

Dr. David Fransen: Mr. Tirabassi, we're talking about three different sets of programs in a sense. We can all take a stab at that one.

Mr. Tony Tirabassi: Please.

Dr. David Fransen: I can speak first of the programs I'm involved with, the Community Action Program for Children, the Canada Prenatal Nutrition Program, and the Aboriginal Head Start initiative. Within Health Canada Nicole and I are both involved in those programs, but Nicole is responsible for the on-reserve portion and I am responsible for the off-reserve portion.

It's important to make a distinction between the Aboriginal Head Start initiative on the one hand and the other two, CAPC and CPNP, in the sense that the Aboriginal Head Start initiative is a program that we, Health Canada, manage together in the provinces with community-based aboriginal groups, and we establish provincial organizations but we work with the aboriginal organizations, less so with the provincial governments. In some cases, there are some relations with some of the provincial governments, but by and large our focus and our key organic relationship is with the aboriginal organizations.

In the case of the other two, CAPC and CPNP, we have actual joint management committees, JMCs, which have officials from Health Canada and officials from the provincial government who together are involved in the strategic planning around the site selection, where these programs' sites will be, and what the priorities for them will be.

That's a general strategic level management. In terms of the actual programs, though, and where they come from, the applicants are people within communities who make proposals that come in to Health Canada. We emphasize that they need to be coalitions of different groups, so that they represent not one single interest within a community, not one single organization, but the coming together of several. They make application to Health Canada. We then enter into agreements with them that are three-year contribution agreements and then they're managed on the basis of a very specific ongoing, regular weekly or monthly contact between the individual project site and the Health Canada program consultants who work together with the communities to help them through whatever kinds of problems they're going through on a regular basis.

You asked about evaluation. We are currently going through an evaluation. We have gone through a kind of process evaluation in the case of each of these programs as well as some preliminary work on impact evaluation. And in terms of what we do with that, which I think was your question—

Mr. Tony Tirabassi: That's right.

Dr. David Fransen: —and how do we feed that back, we have national workshops where we bring in sponsors from the programs to share with them the learnings, and we have regular training workshops with them. So there's an ongoing feedback loop, both at the local level, on a regular daily basis almost, and then periodic national events.

Again, I'm describing the off-reserve world if you will.

Mr. Tony Tirabassi: Yes.

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Ms. Nicole Ladouceur: I would add that the on-reserve world is very similar, although because it's more contained it's perhaps easier to see the impact of the work we are doing here or the provision of health services. In some instances, Health Canada on reserve is also responsible for the delivery of health services. We have four hospitals in the country. We have several nursing stations as well. We have the advantage in being on reserve of really being on site and working on a one-to-one basis.

We also have our home and community care program, which again allows health providers to work on a one-to-one basis, for instance, with mothers who have just given birth, and to assist them in ensuring the child is getting appropriate care, and proper education, for instance, in terms of basic stimulation, etc.

So we do have that advantage of being on site, and in terms of assessment obviously the indicators are key, as I said in my opening remarks, in terms of assessing the results of the work we are doing, and in determining what adjustments should be brought to what programs and what communities. We do have a joint committee on health issues and we do meet on a regular basis with AFN, ITC, the congress, etc.

We also have regional offices throughout the country. And our regional offices again work closely with the communities. We often sit on the community health committees. There's a lot of discussion, of course, with elders, who also have a key role to play in terms of determining requirements for health services. So it's a very useful partnership in terms of establishing the positive fruition of our efforts.

The Chair: Thank you.

Ms. Davies.

Ms. Libby Davies (Vancouver East, NDP): Thank you.

First of all, I'd like to thank the officials for coming here today. But I also have to voice some sense of frustration that we've gone over this issue a number of times, and although today we're focusing more on aboriginal children, this little subcommittee has had many discussions about the early childhood development initiatives and what we'd like to see. It's a feeling of frustration in terms of the programs we see, and my main concern is that it's really such a patchwork.

I represent an urban riding where there's a very high level of aboriginal people off reserve. Vancouver East is probably second only to Winnipeg and very much concentrated in one area. So I'm very familiar with individual projects that get funding through Aboriginal Head Start, or CAPC, or the others you mentioned. They're all great. They struggle to keep up with the demand.

Relating it to the bigger picture, I was just reading some material from the Centre for Urban and Community Studies at U of T. They've done some analysis on what kind of commitment we'd need to make for early childhood development. They break it down by component. They're talking about $10 billion a year, and they relate it more to the European Union where they have guidelines that say in order to meet the needs of children, overall something like 1% of the budget should be dedicated to that.

In Canada, that apparently would be about $10 billion a year. Meanwhile, what we're looking at here is overall about $2.2 billion over five years. We have all this discussion about outcomes and accountability, and all of that, and it's all worthwhile. But a question I come to—and I realize it's probably not fair to put it to you because you're the officials, not the actual originators of the policy; you develop what you're told to develop. I was a bit blunt, but you know what I mean.

Dr. David Fransen: We're allowed a rebuttal, right?

Ms. Libby Davies: Yes, you're allowed a rebuttal. But you have your political parameters to work in, and we all know how that works.

If we look at accountability or outcomes, are there any measurements that would tell us, for example, the number of children who aren't getting services? All the focus is on the service and who got helped and was it a good service, which is fair enough. I don't disagree with that. But do we have anything that tells us the number of children—either universally or limit it to those who are considered to be at need—who are not receiving the services that are required? It seems to me that's really critical. That's one point.

• 1610

My second point is one of frustration, because I feel that the most important outcome is poverty alleviation, yet continually we have the child tax benefit held up as a great social program when in actual fact the poorest of the poor don't get it. It's clawed back.

Well, we do have this so-called reinvestment, but it seems to me that to take money away from people and then call it a great social program is really quite an interesting debate. I believe I read somewhere that even for aboriginals on reserve, the clawback happens as well. But I'm not sure about that. Maybe one of you could clarify that.

Again, are there any statistics or any measurements that show us whether we are actually alleviating poverty through some of these initiatives you've talked about today? If so, what kinds of measurements are you looking at, and how is that communicated to us as supposed policy-makers here?

The Chair: Ms. Morgan has had a pretty good ride today. Let's ruin her afternoon.

Perhaps you could talk a little bit about the latter, both the poverty statistics and the national child benefit, the clawback and all of that.

Ms. Marta Morgan: Sure. Actually, I'll take a crack at both answers and then pass it on to any of my colleagues who want to jump in.

On the first question of indicators of who is and who isn't getting services and what kinds of indicators we have, I think it's important to recognize that early childhood development in Canada and early childhood development data in Canada is at a fairly nascent stage.

The early childhood development framework initiative that was agreed to by first ministers in September put a huge emphasis on reporting to the public on child outcome, how kids are doing over time, how young kids are doing, and also on programs and services. All governments recognize that there needs to be an increase in programs and services, that they need to be better integrated at the community level—all the points that were raised were recognized in that initiative as important ones—and that we need to do a better job of being able to track and report on that. So governments are working together to put those systems in place.

This is an area where the basic data systems on programs and services are emerging along with the investments. We have fairly good information, for example, on one of the core areas of an early childhood development system, which is child care, where people have been talking about what the important indicators are, developing good indicators, and measuring and tracking over time.

But for many of the other areas, where the kinds of investments are more recent—for example, home visiting programs for newborns—the indicators themselves need to be developed and then the data collected. So over time we would hope that we would be able to develop nationally comparable indicators that would give a better picture for all of us in an integrated way of what's available and what needs to be done.

On the second question, as to whether we know what we're doing is alleviating poverty, I understand that some of us will be invited back in a couple of weeks to talk specifically about the national child benefit.

But on the issue of whether what we're doing is making a difference, again, these are long-term investments that show broad societal impacts over the longer term. We do see the trends in terms of numbers of families with children in low income going down. We see social assistance caseloads going down. These are all positive trends, largely due to economic growth and the fact that the economy is performing better and Canadians in general are doing economically better. But it takes time for good program evaluations of the sort that we're putting in place for many of these programs to be able to assess the impact of individual initiatives and the difference those are making.

Ms. Libby Davies: Could I have one small follow-up to that?

• 1615

there has been some more recent information on the child tax benefit. Even Mr. Battle, from the Caledon Institute, which I think is a fairly strong proponent of it, says that, in his opinion, the reduction in the statistics had more to do with the economy than with the child tax benefit. I guess the question is, when you talk about the long-term investment and that there's an improvement, what are we actually doing to mostly women who are on welfare, moving them into the workforce, where there may be some income support? Basically, it's not so much an anti-poverty reduction as it is a wage subsidy, for whatever period of time.

I really question the long-term investment and whether or not it truly is a poverty reduction measure. In many instances, we're basically forcing mothers with children back into the workforce into very low-paying jobs that may be really difficult to handle, in terms of being stressful, not being able to be with your kids, etc. I think this is very much a part of the debate that's going on.

Ms. Marta Morgan: Yes, and certainly the philosophy that underlies the NCB is that the objectives of reducing poverty and of encouraging participation in the labour force are mutually reinforcing, in the sense that the participation in the labour force for most families in most circumstances is the most likely way to get those families out of poverty over the long term. Without that, families are not likely to be able to be self-sufficient over the long term. So that is, clearly, one of the objectives and one of the ways that the initiative does try to get lone parents into the labour force, with the objective over the long-term of seeing their earnings increase, and their income and their attachment, and allowing them to get out of the low-income situation.

The Chair: Dr. Fransen.

Dr. David Fransen: To respond to the first question, I don't think there's anyone on this side of the table who will disagree with the observation and the frustration that what we have is an inadequate patchwork, and that $2.2 billion is not going to address fully all of the needs.

I guess where we take some hope—and I apologize for not being here last week, so I may be repeating some points that were made last week—is in the architecture of the ECD agreement that first ministers committed to.

The four keys areas for action, as they're called in the agreement, and what I refer to as the four pillars, are not, if you look at them, programs. They're clearly not individual programs. They're program service areas—one around prenatal and post-natal, another around the child, him or herself, care and education, another one around the family, and another one around the community. So if you look at it as an architecture, and say that's it, ECD—early childhood development—ages zero to six, can there be anything that's missing from that? No. What the ECD agreement does is set out to fill each one of these pillars over time, and, as an initial instalment in that, we contribute $2.2 billion.

Now, we know that, relative to what the provinces are putting in, this is part of a contribution. It's primarily their responsibility. We want to contribute to it. We want to instigate some action in that area. But we can't determine for provinces what it is they're going to do. What we can do is over time begin to get a fuller picture of what is actually going on and use the information that comes from the reporting on baseline spending, on program indicators and outcome indicators. Over time we'll get to something that, hopefully, is going to be better than what we have today.

That's the hope of the agreement. That's the ultimate objective of the agreement. All the federal government may be prepared to commit is $2.2 billion after five years, or it may not. We don't know. But what we do know, I think, is that it's only with the improvement in reporting and some assessment against those indicators that we'll be able to move all of the jurisdictions who have to play in this field further down towards what will be a better coverage of the needs than what we have right now.

Ms. Libby Davies: To continue with the architecture analogy—

The Chair: Could we—

Ms. Libby Davies: Could I just ask a follow-up?

The Chair: A little teensy-weensy one.

• 1620

Ms. Libby Davies: If we continue with the architecture analogy, if we're trying to build a house and it has four pillars, we're limping along with half a room. It seems to me there has to be some sort of ability to measure how big the rest of the house needs to be, etc.

And so I get back to my question. Are we going to know how many kids aren't getting the services they need? Will that be followed? Will that be measured? Will we know whether or not we did actually alleviate poverty in whatever instances?

Is that not fair? Should we not be doing that?

Dr. David Fransen: It is a fair question. It is a fair objective. And I think we will know better in five years than we know today.

Will we have alleviated poverty?

Ms. Libby Davies: No, I know that. But at least if we've got some measures we will have a handle on that.

Dr. David Fransen: Yes.

Ms. Libby Davies: So you think in five years we might know?

Dr. David Fransen: Well, what I said was we will know better.

Ms. Libby Davies: Better in five years. Well that's even worse.

Ms. Nicole Ladouceur: If I may just respond quickly, in an imperfect or a cryptic fashion I think we understand the importance of knowing in fact how many children aren't.

For instance, Aboriginal Head Start, which is a key program on reserve, currently now is running in about 300 communities and is reaching approximately 7,000 children. Now there are 96,000 aboriginal children, about 16,000 of which are under six years. And so—

Ms. Libby Davies: This is on reserve now?

Ms. Nicole Ladouceur: On reserve. Absolutely.

Ms. Libby Davies: You're reaching 7,000.

Ms. Nicole Ladouceur: So we're reaching about 50%. I agree this is cryptic information, but I think as we develop the tools we need to get better statistics we'll be able.... I think as my colleague says, five years along the road we'll be in a better position, but I think we've started to gather that information.

[Translation]

The Chair: Ms. Guay.

Ms. Monique Guay: I would like to put a brief question to Ms. Ladouceur. What is the annual birthrate for aboriginals? Do we have statistics on that?

Ms. Nicole Ladouceur: Yes.

Ms. Monique Guay: What is the percentage?

[English]

A voice: The highest in Canada.

Dr. David Fransen: Twenty-seven births per thousand people.

[Translation]

Ms. Monique Guay: Thank you. I simply wanted that bit of information.

Ms. Nicole Ladouceur: It is twice the average Canadian rate.

Ms. Monique Guay: Twice the Canadian rate. All right.

[English]

The Chair: Mr. Bailey.

Mr. Roy Bailey: Coming from the province that has the highest percentage of first nations in Canada, I know some of the difficulties these organizations face in the delivery of their program. I also know of the fact that the first nations are highly mobile at the present time. In other words, they leave the reserve; they go to the city, and so on.

Your various programs are facing extreme difficulties because you're attempting to follow the individual. Is that correct? Having worked with this program, many times you will see a child receiving a program on the reserve. Then they move to the urban centre and there is no follow-up. So it's a tough time keeping track.

I really basically have two questions. Are you developing any type of program where the information on that particular individual somehow can follow them as they move to the different setting? If not—and I know that's a hard question—somehow you lose what you have invested.

The other question I have is that just before Christmas I spent quite a bit of time talking to a young graduate from the college of dentistry. We haven't talked about delivery of dental care as such. She provided me with a long detail of going on to a reserve and the difficulties she had. Given the fact that dental care is also the very best part of health care, I was taken aback by what she told me.

I had some experience in dental care when I was in a different occupation, because Saskatchewan had a dental program at our schools. I found out from that program that the people who had the poorest dental hygiene were the people who shouldn't have, and that was from people who run large dairy herds, but they—and I was referring specifically to the Hutterites—also consumed huge amounts of candy all year round.

• 1625

Ms. Monique Guay: That's good.

Mr. Roy Bailey: The point is that I'm really concerned about how you're going to keep track of these individuals because you're coming in contact with the social service deliveries within the provinces. Do you have a full-time...how do you communicate with all of these bodies?

The Chair: Imperfectly.

How do you communicate with all of these bodies—

Mr. Roy Bailey: Yes, how do you?

The Chair: —and how has the dental program been going?

Who wants to—

Ms. Kathleen Campbell: I can talk a little bit to the first issue. I can't talk to dental care.

I'll just talk generally, and one of the approaches that is important is giving the ownership and responsibility for programming back to the communities. Then the communities—and I'm sure you're aware—do keep track of their own. It's not the question of the federal government keeping track of everybody, but it's more a question of the first nations communities themselves keeping track of their own and making sure they do not lack the services as they move off reserve or move back onto reserve themselves.

We see our role in DIAND very much as trying to support them in being able to do that, making sure their communications with the provinces are adequate, that there is the kind of.... It's one of the issues behind the creation of the First Nations Statistical Institute, so it will have a legal framework so that they can do that kind of data transfer without abusing the privacy concerns of individuals in that case, too.

That's one of the ways we're looking at making sure there isn't that gap as people do move back and forth on and off reserve.

But I...dental care?

The Chair: You have nothing to say on dental care.

Ms. Nicole Ladouceur: The dental care program is in fact a program that we do administer, although not under my responsibility. Suffice it to say that it does fall under what we call non-insured health benefits. I believe Peter Cooney was here a couple of weeks ago to answer any questions on it.

It's a non-insured health benefit, but aboriginals can either travel to an urban centre to receive dental benefits, and they will be reimbursed, or there are dentists who go, for instance, on reserve or who actually go on site. It is a program that we administer for aboriginals.

The Chair: Okay, I call chairman's prerogative here. I've got a few questions.

First, I just want to remind everybody—and I want to respond to something Ms. Davies said—that one of the reasons for the way we're conducting our initial meetings is to bring members of the committee who were not here previously up to speed. So while those of us who are veterans of this particular crusade know quite a lot about it, in some cases we're not starting from the same knowledge base. That's part of the rationale.

Secondly, the question I want to ask is about numbers. I was looking at the document, “National Child Benefit Progress Report” and in there the number of first nations children under 18 is listed at 176,000. Is that more or less right, Ms. Campbell? Does that sound right to you, roughly? In the ballpark? It wouldn't be crazy?

Ms. Kathleen Campbell: I'm sure it is if it was published.

Dr. David Fransen: There are 96,000 aged zero to six, so....

The Chair: What? There are 96,000 aged zero to six? Okay, that's the first question I have. If it's 96,000 for zero to six, then 7,000 is not 50% of 96,000? Right?

Dr. David Fransen: No.

The Chair: So it's—

Ms. Libby Davies: That's on reserve now.

The Chair: But I guess it's 50% of those who were....

Do you see what my problem is? It's 50% of those in communities that are served by those programs. It's not 50% of all zero-to-six aboriginal kids.

A voice: No.

The Chair: That's the first issue. I want to make that clear.

The second issue is on the national child benefit. It's interesting that the document I'm referring to says that, for example, the estimated number of children who benefit from the reinvestment—that's the community service part—is 54,000. But of the 176,000 kids from zero to eighteen, how many of them benefit from the national child benefit?

• 1630

Even Ms. Davies thinks that's a good question.

Some hon. members: Oh, oh!

Ms. Kathleen Campbell: We're talking about the application of the national child benefit on reserve at this point, are we?

The Chair: That's correct.

So how many of those 176,000 kids from zero to eighteen, through their families, are beneficiaries, and not through the reinvestment strategy, but in cash?

Ms. Kathleen Campbell: I'm sorry, I'd have to double-check the number. But in terms of the cash, in terms of the estimate for what national revenue is estimating in terms of the actual coverage, the number of people who have signed up for the benefit, I do believe it's 95%. But I will double-check on that number.

The Chair: Can you get that figure to us?

Ms. Kathleen Campbell: Yes.

The Chair: I think it's important to get these figures.

What we're really trying to do today is to understand how everything you do is going to fit into the future first nations component of the ECDI.

Presumably, Ms. Campbell hinted that there are negotiations within the government and we're not there yet. The first issue is, is there any sense of a timeframe by which the government will have sorted itself out?

Dr. David Fransen: Soon.

The Chair: How do you define “soon”? Or, as they used to ask Bill Clinton, what do you mean by “is”? Give us a range.

Ms. Kathleen Campbell: We've been anticipating that it would be soon for some time.

Some hon. members: Oh, oh!

Mr. Roy Bailey: That's nice.

Ms. Kathleen Campbell: So if we wanted to be a little more firm and not get caught up in false promises, we might say we would be looking at definitive announcements in the fall.

The Chair: All right.

Now let's come to some deadlines. Here's where I'm having a problem at the big conceptual level. We know that, first of all, all governments are committed to the ECDI for the populations that are within their jurisdictions. Right?

So we know that if we ask the Government of Ontario or the Government of British Columbia to do, first of all, the baseline, the measure of all current activities in the designated areas, by this September, we know who's responsible. We know that the first ministers have committed. We know which minister it is, usually, within the provincial government.

In the case of our government, because we're one of the signatories to this deal, who's responsible? The Government of Canada is collectively responsible, but which of you is on the line for providing the first line of information, baseline activities, on reserve for all programs? Who's responsible amongst you for that?

Dr. David Fransen: Just to be perfectly clear, there will be a federal report that will provide the data on all federal ECD spending. So there will be one. There won't be one for on reserve and one for off reserve. There will be one federal government report. The development of that report is obviously going to be an interdepartmental exercise that is being guided together by HRDC and Health Canada.

The Chair: So they are the joint leads on this file.

Dr. David Fransen: That is correct.

The Chair: They would also be then the joint leads on developing the indicators to get back. Because a year hence, all governments, including ours, will be responsible for developing comparable indicators so we can see how we're doing across the country.

Dr. David Fransen: Yes.

The Chair: Who's going to be responsible for that?

Dr. David Fransen: Again, HRDC and Health Canada are doing that together with others. Some other departments are more involved than others, obviously. But Marta's group and my own are taking the lead in doing the work on that, both within the federal family and then also in the negotiations with the provinces, working together with them.

The Chair: How do you then consult with the first nations about the development of those indicators that are going to be indicating things about them?

Ms. Kathleen Campbell: If we can talk about ourselves, DIAND being a cousin within the federal family—

The Chair: Not a black sheep, I hope.

• 1635

Ms. Kathleen Campbell: That's right, from time to time.

On the various programs there are indicators, which I think David was referring to as the responsibility of the individual departments, depending on what they are. We in DIAND are working together quite closely right now with Health Canada in particular, where they have a first nations health information system and we have a bunch of program data. Recognizing that we have to begin to translate this into baseline data on children, we're working together to try to make sure we're not overlapping too much in terms of requesting this kind of information from each first nation. We're also working with first nations through what may evolve into some sort of a first nations statistical institute, to engage them within each of the programs to express their vision on what the appropriate indicators are too.

I think it's only fair that they have a voice to say that something may be an important indicator, but in truth another indicator perhaps reflects their cultural values a little more and speaks more strongly to what they want to say about the success or non-success of the various programs.

As Marta was saying, this work is nascent, but we have undertaken a commitment to begin to develop the baseline for data. We are working within the federal family to make sure there is an equivalent baseline for first nations on reserve. I think somebody left us an open invitation to talk about things we don't have money for yet. That may be one of the things we'll find we don't have enough money for at this particular time, but we would have to develop the proposals around that to come forward to say exactly what we do need to do in that area.

The Chair: I want to understand this. According to this agreement, at the end of the day the indicators you develop after consultation with first nations have to be comparable. You have to be in a position as you go and talk to the provinces where you're going to be talking about the same kinds of indicators right across the country. While we may start from different points, is that where we have to get to?

Ms. Marta Morgan: Yes. I always find it helpful when thinking about indicators to think a little bit differently about outcome indicators and program indicators, which are both covered in the ECD initiative. The initiative asks for common outcome indicators, ones that are common across all provinces. That is what we would be working towards.

It may be that among those common indicators there are some that are more specific to aboriginal children, ones we arrive at based on consultation with first nations and other aboriginal people. Similarly, in terms of programs and services, we're looking for comparability with the recognition that different jurisdictions are actually beginning their investments or putting their first priorities in different areas, in different types of programs and services. You would expect that you would have a core of similarity there, and then you may have additional things that would be perhaps more applicable to first nations or other aboriginal people.

As to the kinds of indicators regarding child care, for example, you would imagine that most of them would be pretty similar. There may be some that talk about cultural specificity and learning and that sort of thing. That's the kind of thinking we're working on. Also, for provinces and territories, where they have programs and services that are really targeted towards aboriginal children off reserve, we would want to make sure that our indicators work with them as well and with what they are putting into place off reserve so there will be some consistency there.

The Chair: With the indulgence of the committee, can I just ask one of the last questions?

The whole purpose of the ECD ideal—the theology, which I think David Fransen reiterated—is that we know that things work best at the committee level when they are integrated, when they are inter-sectoral. The language of the ECDI ideal deals with that very specifically. Then David Fransen also described the application process for the program, which was to do with Health Canada.

• 1640

So my question is, if you're dealing with an aboriginal community of 500 people in a remote part of the world, and the Government of Canada and its family.... It has many family members who keep coming in with their programs—

Dr. David Fransen: First cousins, black cousins....

The Chair: Yes, whatever. So the question is, at both ends of it, that is to say at the federal end, how do you stay in touch with each other so that you are going with an integrated federal package into the 500-person village, from three different departments and maybe other departments? You could imagine something from the National Crime Prevention Council from Justice. It doesn't end there, does it? No. How do we at this end, at least at the delivery end, coordinate it? Then how do we organize? How do we conceptualize what happens at the community side?

You have 500 people who have things to do. They're not experts in grantsmanship and all this sort of stuff, and yet we want to give them the power to do the integrating on the ground, because only they can work out what the gaps are. They're really in the privileged position. If that's the intent of the ECDI for what we want on the ground, and we want that replicated community by community, large and small, aboriginal and non-aboriginal, how are we going to achieve that kind of integration? How are we going to achieve that kind of integration, both amongst you as departments and then on the ground, so that at the end of the day we will get the integrated bundle of services that you say works best?

Dr. David Fransen: I'll take the first stab at this and then invite my colleagues to add on, and backfill and correct me, because there's going to be a lot of all of those things required.

But the situation is even more complex than you describe, because you're talking about only part of the equation. What we're talking about here is the delivery of programs and services to children and the people who support them.

The Chair: As well as income to families, one might add.

Dr. David Fransen: As well as income to families.

Clearly we are one part of that equation, and not necessarily the largest part of that equation. Provincial governments have a very significant role to play here. We have a significant challenge to do the integration you're talking about within the federal family. Even within Health Canada, we can talk about how we do this. But then when you talk about programs and services coming from a variety of departments and wanting to work together with provinces, some of which are quite anxious to work together, others of which are less, it's a very significant challenge.

Would that we could sit here and say to you today that it is a seamless web of finely tuned instruments that are all well coordinated and delivered, but we all know in this room that it ain't that way. I think what we can say is that the pressure to do this, to move in that direction, is more intense now than I've ever experienced it. I think we are working very hard at doing that, and we do it at several levels.

First of all, we are doing it within town here in the sense of working much closer together than we have done in the past. Kathleen referred to us as being joined at the hip. We are now. We have been over the last while in the negotiation of the agreement and in the thinking of the implementation of it.

So what is it that you have? Where do you want this to go? How do we do this together? These are questions we're asking now with more fervour, if you will, than I think we've ever asked them before. So that's happening here in town.

At the community level it's the same thing. We're asking these questions now and looking for the way to do that. When you add in the provincial and territorial government dimension to this—

The Chair: Are you speaking now even of on reserve?

Dr. David Fransen: I'm speaking of on reserve as well, but I will invite people—

The Chair: Sure. That's fine.

Dr. David Fransen: —who actually know about that situation to talk about it.

The Chair: Keep making it up as long as you can.

Ms. Kathleen Campbell: This is his chance. If he can speak to it very well, it just proves we've been joined at the hip, you see.

• 1645

Dr. David Fransen: The last point I wanted to make, Mr. Chair, is that what is encouraging about the ECD agreement in terms of one of its very practical outcomes is that we now have provinces coming to us and saying, we want to sit down with you and work out the delivery—what it is you're doing, how you are allocating your resources, where you see yourselves going, and let's do this together. We've never had that before.

We've had it to some extent in individual programs. I talked to you about the joint management committees of CAPC and CPNP. Again across this country some of them work pretty well—provincial departments will sit down and will work at these things together—and in other cases, they don't.

But now you have provincial governments coming to us and saying, let's talk about the whole array of things that the federal government is delivering. We're going to put ours on the table, and we'll sit down, and let's work this thing out.

It's not simple. It's not going to be simple. But we're in this now in the sense of five years. We're hoping for this to be longer term, but we know that it's right now five years. To establish the bona fides to get beyond five years, we have to demonstrate some working together.

So there's the generation of that kind of activity that hasn't been there before.

Ms. Nicole Ladouceur: I think I might just add that David of course has referred to the drug management committees, which are already in place with respect to certain programs. But there is also a working group—federal-provincial-territorial—that does already exist on early childhood development implementation where those issues are raised. So it provides a forum to discuss those issues.

I referred, in response to one of the questions I think, that we have regional offices—getting back to the issue of on reserve but touching upon some of the comments Kathleen made—which of course work very closely with first nations organizations, the Inuit, etc., but also work very closely with the provinces. If they do not have weekly conference calls, they have monthly meetings.

As Kathleen was saying, there is a large aboriginal population that does reside on reserve. Some do not live on reserve but are very well aware of the programs that are being offered on reserve, for instance, as opposed to off reserve. So there is that communication among themselves, which then I think trickles up to the provincial level, to their own organizations.

So I think there are a lot of fora that currently exist to ensure that the communications in fact are quite open. So of course that puts pressure in terms of cooperation. But I do agree with David's point that there is pressure in terms of more horizontal working on these issues and certainly more cooperation.

Ms. Kathleen Campbell: Just to be a bit more specific about how I think that kind of integration can occur within first nations and on reserve, the key is really their community plans. We encourage first nations to make community plans that are reflective of the kinds of social program priorities that are in place, be it social welfare or in this case children.

We are undertaking to work with first nations to discuss how those plans can be best developed and to respect those plans when they are developed. I guess it is a question of encouraging or finding the means and resources to encourage first nations to undertake that kind of planning and join in that kind of joint process also.

The Chair: Thank you very much.

On behalf of the subcommittee, let me thank you very much for helping us. As I say, we will be seeing more of each other in the fall. We'll be seeing some of you sooner than that, as we look at continuing our early childhood development work.

Mr. Fransen.

Dr. David Fransen: Mr. Chair, just to say that we have brought along some information for members, if they so desire. One of these is the kit on fetal alcohol syndrome—fetal alcohol effects. This is something that I believe you launched last week. It is a package specifically designed for members. It may have been distributed to you already, so you may have them. But we have extras here.

I also have basic fact sheets on the three community programs that I talked about, Aboriginal Head Start, CAPC, and CPNP, and they're back here.

The Chair: Thank you very much.

The meeting is adjourned.