I call this meeting to order.
Welcome, everyone, to meeting number 33 of the House of Commons Standing Committee on Health.
The committee is meeting today to study main estimates 2021-22: votes 1 and 5 under Canadian Food Inspection Agency; votes 1 and 5 under Canadian Institutes of Health Research; votes 1, 5 and 10 under Department of Health; vote 1 under Patented Medicine Prices Review Board; and votes 1, 5 and 10 under Public Health Agency of Canada.
I'd like to welcome our witnesses today.
Of course, we have the the Honourable Patty Hajdu, Minister of Health. From the Canadian Food Inspection Agency, we have Dr. Siddika Mithani, president. From the Canadian Institutes of Health Research, we have Dr. Michael Strong, president. From the Department of Health, we have Dr. Stephen Lucas, deputy minister. From the Public Health Agency of Canada, we will have Dr. Theresa Tam, chief public health officer; Major-General Dany Fortin, vice-president, vaccine rollout task force, logistics and operations; and of course Mr. Iain Stewart, president.
I know you're all frequent flyers with us, so indeed, welcome back to all of you.
I now invite Minister Hajdu to present her statement.
You have 10 minutes, please.
Thank you very much, Mr. Chair, for the invitation to return to committee.
As you mentioned, I'm joined today by officials from Health Canada, the Public Health Agency of Canada, CFIA and CIHR. We are here to update you on the main estimates for the health portfolio.
We know, as we continue to respond to COVID-19, that some areas in Canada have seen an increase in cases, some areas in Canada have had to apply additional public health measures and some areas in Canada have seen increased hospitalizations. We remain focused on one goal, and that's to help Canadians through COVID-19—to help provinces and territories reduce transmission in communities, to decrease the number of people getting sick, and of course to decrease the number of people ending up in hospitals and, sadly, passing away as a result of COVID-19.
We know that this is a lot of work on behalf of all levels of government, and indeed not just government but community organizations, unions, employers and everyone working together in a team Canada approach. The most important things for us to remain focused on now are to reduce community transmission, increase access to vaccination and make sure that we stay focused on increasing vaccine uptake. We need to make sure the vaccines are available to people in a variety of different ways so that they can access them when it's their turn.
I have to say that we've been so impressed by Canadians' desire to be vaccinated and their willingness to step up when it is indeed their turn. As we can see, as more vaccines have been arriving in Canada week over week, we are now a leading G20 country, the second in the G20 in terms of administering the first dose. That's good news, Mr. Chair, because we know that vaccinations save lives and reduce the spread in communities, along with the other things that we know all too well.
In terms of actual hard numbers, that means nearly 13 million doses of COVID-19 vaccines have been administered. I have good news, and it's reflected in case rates and death rates. Eighty per cent of those aged 70 to 79 and 86% of those aged 80 and over have received vaccination. I can tell you that there is a sense of relief, especially among people in those age groups who have felt so worried and so scared, and of course among the people who love them, that they are protected as provinces and territories work together to reduce transmission in communities.
Of course, as all of you in HESA know, Canada is focused on a population health approach to vaccination. What does that mean? It means using vaccination as a powerful tool to reduce cases in communities and to stop people from getting sick and dying.
We have two overarching goals: to stop the spread and to save lives. Because of this strategy, there are more Canadians protected now than a month ago. We are looking forward to a very busy month of May. This month alone, millions of doses will arrive in the country and go directly into arms through the strong partnership with provinces, territories, local public health officials and other really important partners like pharmacists and family physicians.
While vaccination programs are scaling up, we have to continue to be cautious and vigilant about following local public health guidance. That does mean the things that we know help prevent the spread of the virus. As we have learned, that means physical distancing; the wearing of masks, especially in crowded and indoor settings; being mindful of how and where people gather; really thinking of each other during this time; and continuing to pull together as Canadians to make sure that the entire community remains safe. If there's something I've learned, Mr. Chair—or been reminded of, I think is more appropriate—it's the importance of collective action to fight a virus like this. It's that we cannot do this alone, that communities can't do this alone, that people can't do this alone, but that together we can actually get a lot further.
Today we will share the health portfolio's spending plans for the months ahead.
As you know, budget 2021 proposes significant investments in a number of health priorities, from increasing research and biomanufacturing to improving long-term care and continuing our investments—significant investments, I would say—in mental health and substance use supports.
These investments will help us finish the fight against COVID-19 and will help Canadians to see, in a healthier and more equitable way, a healthier future in their communities.
Maintaining Canadians' health and safety continues to be my priority—indeed, all of our agencies' priority—in the months to come. The main estimates I'm presenting today reflect this, and they outline the work we are doing to achieve these goals.
Over the next year, Health Canada will work with the provinces and territories to help improve health systems for all Canadians. This work includes measures to strengthen the health care sector through investments in long-term care and supportive care settings. We will also address mental health and problematic substance use through continued investments in home and community care and in mental health and addiction services, including specific investments to help Canadians during COVID-19.
I want to give a particular thank you to the many organizations that work with people who are struggling with a variety of mental health issues and a variety of problematic substance use issues. These community organizations and providers have been there for Canadians during this dreadful time, and their work is tremendously valuable to all of us.
Our world-class regulators will continue their work to get Canadians the medicines, vaccines and medical devices they need. That work includes creating a critical drug reserve to assist with COVID-19 treatments.
For the past year, the Public Health Agency of Canada has been focused on the pandemic response. Whether it's on vaccines, on research or on specific COVID-19 supports, the agency has been working day and night—all of the folks in the agency have been working day and night—to protect Canadians. This work will continue well beyond the pandemic.
The safety of our food supply is also always a priority in a pandemic, and of course beyond. The Canadian Food Inspection Agency protects Canadians from food safety risks, supports our food supply chain and safeguards the health and safety of people working in the food manufacturing and distribution industries. I want to thank all of the workers at CFIA for their ongoing work, oftentimes in very challenging situations, as we know. In meat packing plants, where there have been significant challenges to prevent the spread of COVID, I know that inspection agents and many other professionals have been working to make those workplaces safer and to keep food safe for Canadians.
After a year of living with COVID-19, the importance of investing in health and medical research, if it wasn't evident before, is now, Mr. Chair. The Canadian Institutes of Health Research is supporting Canadian research and researchers, and our investments will make sure that they have a strong and central role in ensuring that science returns to a place of prominence in government policy-making.
I am so relieved, Mr. Chair, that our government made those investments in 2015, after a decade of attack on scientists and researchers. We made those investments in 2015, and they turned out to be critical. We're going to continue to strengthen Canadian research through the CIHR, through the researcher community that they support, to make sure that we have access to the best evidence and the best science on a range of health issues.
Mr. Chair, my priority is Canadians' health and safety. As we face this wave of the virus, as we see the finish line, we know there's more work to do. The plans I'm talking about show what we have to do, how we have to invest and how we have to continue to pull together. I know that Canadians will get through this, but we have to work together to get through it so that we can save lives, stop the spread and protect Canadians' health throughout COVID-19 and beyond.
Thank you very much, Mr. Chair. I look forward to your questions.
As much as I, like everyone else, has been fixated on COVID for the last year or so, I actually want to ask the minister something that is related to COVID but not totally related to COVID, and that is the issue of money for substance abuse, drug addiction and the opioid crisis.
For those who don't know, Patty and I are the two members of Parliament for Thunder Bay, and I think we both share a background and a familiarity with the issue of substance abuse and the opioid crisis.
I, as a long-time doctor in the emergency room, saw a lot of cases of overdose over the years. They're a dime a dozen in the Thunder Bay Regional Health Sciences Centre, and Patty, I know, has worked with substance abuse programs and in setting those up in Thunder Bay.
We have a common interest in this. I think, moreover, that both of us found—at least I did, and I'm sure you have the same experience in going door to door—that some of the most passionate pleas were from people who asked us to do more in terms of addressing substance abuse and addictions, and to try to decrease the number of overdoses. I certainly met at least a few people who'd lost their children to overdoses, so this is a really important issue.
My understanding is that in the budget we've allocated more money to substance use and addiction programs, SUAP. Could you tell us a little more as to how much money it is, and where that money is going to be going?
First of all, thank you for talking about the crisis of opiate overdose and of substance use overall. I know that you spent many years in emergency rooms in Thunder Bay, so I think that we would probably have worked with some of the same individuals who struggled with substance use over many years.
I am extremely proud of this government in restoring harm reduction to the Canada drug strategy, and restoring what I would say is compassion to an approach of working with people who use substances. Of course, the work that we did through the SUAP—and I'll let Deputy Minister Lucas speak about the specific amount of money—and the work that we've done with providing supports to communities is, I think, the most critical in terms of supporting people who use substances. The money goes directly to community-based organizations that are working on the ground. In some cases, they are integrated with the community and know exactly how to protect community members so that they don't die and we can save lives. Then we can alleviate suffering.
I know, Dr. Powlowski, that you saw a lot of that in the years that you were in emergency rooms. These are folks, in many cases, at that scale of problematic substance use, who are really suffering. They're traumatized individuals. They're often long-standing problematic substance users.
I'm very excited that budget 2021 continues our investment in innovative mental health projects and substance use programs that are community based. As you know, we have a commitment to transferring billions of dollars to provinces and territories and working on mental health standards. All of that is important, but I think that getting money to community groups that are looking at new ways of finding folks and supporting folks is really important.
It's also really important to draw a distinction between the previous government's approach to substance use and ours. The previous government thought that it could criminalize its way out of this problem, that it could throw people who were struggling and suffering in jail and that this would solve the problem. That government in fact intentionally removed harm reduction from the Canada drug strategy and penalized groups that were actually working in communities.
As a matter of fact, I received funding from the Health Canada folks—not me personally, but the Thunder Bay District Health Unit—to do the Thunder Bay drug strategy. It was a real challenge to get that money, because at that time the Harper Conservatives did not even want the health unit to talk about alcohol or prescription opiates.
Can you imagine that, Dr. Powlowski? What do you think are the two main problem substances in our community? It's those two things. Health Canada officials worked really hard with the public health unit to make sure that the application could be funded and that we could have a community-specific drug strategy, and it is saving lives.
Maybe, Dr. Stewart, you could speak a little bit about the SUAP funding and our commitment to ongoing mental health and substance use treatment that is community grown and community delivered.
In 2020-2021, the figure was $1,619,967,785. The funding is now $1,253,906,530. That is a reduction of 22.6%. If you want to champion basic research, you should at least make provision for the same budget and not repeat the errors of the past.
We could go on arguing for ever but I don't want to waste time. The figures have been published and come from the analysts of the House and the Library of Parliament. The figures are good.
Officials from the Federation of Medical Specialists of Quebec and the Canadian Medical Association, cardiovascular surgeons, hematologists, oncologists, gastroenterologists and radiologists have all come to tell us that dark clouds are gathering on the horizon.
You have provided money to deal with the pandemic. You often talk about an amount of $19 billion for COVID-19 patients. However, non-COVID-19 patients are going to end up in a precarious situation.
All those doctors came to tell us that, in the next 10 years, we will see the results of the offloading and the lack of diagnostic tests, and that the mortality rate will increase by 10% per year. From a medical point of view, they are talking about the two most frequent causes of death in Canada, cancer and cardiovascular disease.
From an economic point of view, costs are going to explode. If recurring investments are not made starting immediately, which is the very reason for the health transfers, we are going to be paying a lot more tomorrow and the day after tomorrow, not to mention the human drama that will ensue.
What are you waiting for to do your share? The provinces are investing $200 billion and the federal government is investing $42 billion. What we are asking from you is an additional amount of $28 billion.
You spent $340 billion last year. This year, you anticipate spending $154 billion. Are you not tempted to transfer those $28 billion as a matter of urgency, so that we can immediately start dealing with the patients who do not have COVID-19?
I'll just say that one of the world-leading experts on infectious disease that we are so fortunate to have is Dr. Theresa Tam. Thank you, Dr. Tam, for your hard work over the last many months and indeed for your expertise.
You're absolutely right, MP Van Bynen. I'll just say that this government firmly believes that science and research investment—not just in the context of a pandemic, by the way, but certainly accelerated by it—is incredibly important to the health and safety of Canadians. In particular, health research helps unlock many mysteries, reduces suffering and helps Canadians have healthier lives now and into the future.
That's why we've made historic investments of over $10 billion since 2015. We had a long ways to catch up after the previous government and the ongoing attacks on science, both from a financial perspective and from a destruction of evidence perspective, if you can believe it, Mr. Chair.
We're been working with provinces and territories. We've been leveraging the expertise of virologists, immunologists and other experts all around the country who have stepped up—many times in voluntary ways—to help the Government of Canada and the provincial governments have the best possible response to COVID-19. We led a rapid and unprecedented response to COVID-19 through the CIHR. I'll never forget that early announcement in February of 2020 in Montreal with some of my colleagues. That was within weeks of COVID-19 appearing on the world stage. Obviously, it took just several weeks to get in order.
Of course, budget 2021, if passed, would provide a further $2.2 billion to grow our domestic life sciences sector.
It is really about an ongoing and sustained investment, Mr. Chair, in research, science, the science community and in generating that next crop of researchers and scientists. The many investments we've made through my colleague 's department, ESDC, focus on ensuring that Canadians have access to post-secondary and integrated learning opportunities that will foster the next crop of researchers.
Thank you very much.
That's such an important observation. What we do at the community level matters, so understanding communities and the limitations families have in safely isolating was a very important to our government early on. We knew that communities would do the hard work if they had the financial resources in place to provide spaces for folks who couldn't isolate well.
I'll use a personal example from my own community of Thunder Bay, Ontario. Dr. Powlowski will recognize this. When we had a significant surge a while ago, it was indeed among a group of people who are very marginally housed. When people think of folks who are experiencing homelessness, they often think of absolute homelessness—that there are shelters and nothing else. However, we know that people intersect with family and have roommates. There are all kinds of situations, because people are essentially trying to avoid shelters. They are really a last resort in someone's life.
Very quickly it became clear that our community's spread was being driven by folks who were very vulnerably housed and that what would help the community was isolation housing, so that if someone was living in a situation with multiple family members or roommates and couldn't physically isolate, they would have the space to do so and would be supported to stay in place. Of course, just sticking someone in a room isn't good enough. They need to have access to food and in some cases medical support and counselling, as well as the variety of other things they need in their day-to-day lives. People also need to be monitored if they've come into contact or are sick with COVID-19, because their condition can worsen.
When I say that COVID-19 is a lot of work, that is just a snapshot of the kind work that communities are putting in to help protect vulnerable people and stop the spread. Isolation housing has been an important part of that.
We allocated $100 million to municipalities and health regions so they could in fact have space to do the hard work but not worry about the money that it would cost to rent, clean and staff locations. It's another example of the federal government stepping up for local communities to help them stay focused on community transmission.
I can, MP Kelloway. I do want to congratulate Nova Scotia for their very rapid action on putting out cases of COVID-19. That's exactly what helps communities when provinces take quick action the way Nova Scotia has.
I have to say hello to Minister Delorey, who was the minister of health. I worked very closely with him, and he was really proactive. Hello as well to Minister Churchill, who is now working on the file, and of course Premier Rankin. Their leadership has been really a model not just for Canada but for the world. In fact, they have realized that they cannot allow community spread to continue, that the best marker of safety is less COVID, and that when there is less to no COVID is when you can actually see these outbreaks and you can see when cases are growing, so I just want to thank them.
As you know, MP Kelloway, we have been there for the Province of Nova Scotia as well as all other provinces and territories—for example, through the safe restart agreement, providing billions of dollars for preparing for resurgence. The testing that Nova Scotia is now becoming famous for as well—extensive testing; rapid testing; testing pilot programs; making sure that anyone who is experiencing illness or that a public health unit that needs to test contact has the capacity to do that—that is federal government funding. There are federal government tests, by the way, that we have provided free of charge to provinces and territories.
There's also data capacity. Data is a huge component in managing and tracking COVID-19. The ability to put together those webs of how people interact, who is coming in contact with whom, and really tracking how the virus is spreading has been essential. Of course, we supported provinces with that.
There's also all the PPE, MP Kelloway, that is being used in hospitals and community settings and health care settings across each province and territory. That's been purchased for provinces and territories by the federal government.
Then there are the additional supports—contact tracers, isolation centres and rapid tests, as you know. We continue to be there for provinces, including Nova Scotia, for whatever they need.
For me, what has really been very fulfilling, despite how challenging it has been, has been the personal relationships I have developed with other health ministers. Regardless of party, I might say, they know that the phone line is open. They all have my cellphone number. We speak on a regular basis about how things are going, what they need and where we can best support them at the federal level.
Through the chair, you're absolutely right. There are very few silver linings to COVID-19. Maybe that's just my perspective today.
One of the silver linings is that it really accelerated provinces' commitment to creating B-codes for virtual care and to empowering physicians across the country to use virtual care and be able to be compensated for providing virtual care. This a game-changer. It's a game-changer for places like Nova Scotia and my own home community or region of Thunder Bay—Superior North. I'm looking at Dr. Powlowski, who would have struggled to be able to provide care for patients in remote communities who maybe just wanted to talk to him to follow up. This is an ability, actually, for Canadians to get access to care. It obviously doesn't replace face-to-face care. I don't think anyone would expect it to, but it certainly can help get people access to primary care much more quickly.
Last May, we announced $240.5 million to support this work to enhance digital tools, such as secure messaging and digital video conferencing, for example, because confidentiality and privacy issues are very important in the context of health care.
We have signed seven bilateral agreements for virtual care with provinces and territories, including one with Nova Scotia. We have investments of over $98 million towards that.
Also, we immediately knew that this would create mental health stress for Canadians across the country, so we launched wellnesstogether.ca. This is a provision of a mental health service support for Canadians regardless of where they live that's available online through a variety of ways.
The neat thing is that Wellness Together is essentially reaching Canadians who, prior to this, maybe had a hard time reaching out for help, didn't have coverage for help or just hadn't thought about using mental health supports as a way to help with some dark moments in their life. I'm very thrilled to say that we'll be sustaining that investment over the next year.
I have a bit of a technical question. It would seem like Major-General Fortin might be the person to answer it, but this isn't really something he's been dealing with.
I know the government has agreed to deploy the army—at least, medical assistance teams—and the Red Cross to southern Ontario to help them deal with the large number of cases overwhelming the health care system there.
Question number one is this: What exactly are they going to do? My understanding is it's likely they have limited ICU capacity. I think the hospital in Kandahar had 10 to 20 ventilated beds. Certainly that's not going to make much of a difference in terms of stemming the number of people in ICUs. How are they going to be used?
Then the second thing is—and this is the important one for me—who determines what they're going to do?
Having been in contact with infectious disease doctors in Ontario in London, Oshawa, Markham and Stouffville, I know there are infectious disease people there who are eager to use the bamlanivimab that was purchased by our government is basically sitting on the shelves. They want to use it. They want to get it into people's arms. Exactly where the problem lies in doing this isn't totally clear, but one of the problems is having infusion sites. Certainly having tents with medics and/or nurses who could infuse them would certainly seem to me to be one way of addressing and trying to deal with the large number of people ending up in the hospital, when studies seem to indicate you need treat eight people as an outpatient to prevent one hospitalization. This is something we could be doing.
Now, who makes the decisions as to what those army units will doing? I kind of fear it isn't going to be as simple as the doctors asking the army for some help. It's going to be, well, the doctors have to talk to the hospital, which has to talk to the province, which has to talk to the science table, which has to talk to PHAC, and it will take months for any decision to be made. Who's going to make that decision as to what the army does?
One, what are they going to do? Two, who is going to determine what they can do? Three, how about using them to infuse monoclonals?
I wanted to start and then turn to President Stewart to talk about some of the exciting work we're doing in this area.
I will start by agreeing with the member that it's really important, especially as elected officials, that we're not in any way presenting, either knowingly or unknowingly, misinformation to Canadians, because they're counting on us. They're counting on us to be presenting them with accurate information and the right connections to the right resources. Government websites are always a safe place to find out information about the current research and science. Certainly, health care providers are another good choice; pharmacists are always available to talk through the pros and cons of vaccination and answer any questions.
By the way, it's perfectly normal for Canadians to have questions. These are new vaccines, and some people are anxious. Other people are very excited to get vaccinated, as we've seen around the country with lineups and folks very excited to take the vaccine when it's their turn.
Nonetheless, I do think, to your point, MP Van Bynen, that we have an obligation as visible leaders in our community to ensure we're not pushing misinformation in any way. I know that all of us want our communities to get back to normal, and that relies on people accepting vaccination when it's their turn and having the confidence to do that. It's very critically important to our economy and to the safety of Canadians that people get vaccinated. Saving lives and stopping the spread—that's the goal of this vaccination campaign.
I will just say it's exciting, because we have a special plan that we'll be announcing very soon to work with cultural communities and with under-represented communities to ensure that they get information in culturally appropriate ways, in language-appropriate ways, in communities, through educators that are sometimes health educators and other times community educators. That's very exciting. It's $53 million.
This is where I need Iain Stewart's wisdom. I understand we've increased the amount of funding available for that stream of funding because of the exciting uptake. What's great news is that there are so many Canadian organizations and stakeholders wanting to do this work with us.
Maybe, President Stewart, you can talk about the envelope of funding available that will be announced very soon.
Madam Minister, before the first wave, healthcare networks were already fragile and under a lot of pressure because of chronic underfunding. With the passage of time, the pandemic will have harmful, long-term, collateral effects on patients who do not have COVID-19. According to representatives of various associations, 94,000 patients in Quebec are being seen beyond the required timeframe. In oncology, we know that a delay of three or four weeks increases the mortality rate by 8% to 10%.
You have reached agreements and you have showed us the breakdown of the $19 billion you have allocated for patients with COVID-19. However, why did you not make the political choice to immediately inject money into the networks so that they can not only look after patients with conditions other than COVID-19, but also fill the breach and stop the bleeding caused by the exodus of employees, our human resources, because they are sick or they decide to change careers?
Soon, we will be losing trained people who have gained expertise in their areas. People are going to die. All because you made the wrong political choice. All the experts are saying that this is not justified either medically or economically.
Why did you make that choice?
Committee, that brings our questioning to a close. I would like to thank the witnesses, and the minister, of course. I'd like to thank you all and all of your staff for your 24-7 dedication and commitment to protecting the safety and well-being of Canadians. We do have some voting to carry out, so if you wish you may certainly withdraw.
To the committee, we have something like 11 votes to do. I'm wondering if we are able to do them in one fell swoop. It will require unanimous consent to conduct the votes in this way.
Do we have unanimous consent to do it in one fell swoop?
Some hon. members: Agreed.
CANADIAN FOOD INSPECTION AGENCY
Vote 1—Operating expenditures, grants and contributions..........$608,899,997
Vote 5—Capital expenditures..........$29,762,978
(Votes 1 and 5 agreed to on division)
CANADIAN INSTITUTES OF HEALTH RESEARCH
Vote 1—Operating expenditures..........$62,871,989
(Votes 1 and 5 agreed to on division)
Vote 1—Operating expenditures..........$1,141,052,704
Vote 5—Capital expenditures..........$17,505,187
Vote 10—Grants and contributions..........$2,538,934,868
(Votes 1, 5 and 10 agreed to on division)
PATENTED MEDICINE PRICES REVIEW BOARD
Vote 1—Program expenditures..........$17,580,493
(Vote 1 agreed to on division)
PUBLIC HEALTH AGENCY OF CANADA
Vote 1—Operating expenditures..........$8,219,228,533
Vote 5—Capital expenditures..........$26,200,000
Vote 10—Grants and contributions..........$426,771,816
(Votes 1, 5 and 10 agreed to on division)
The Chair: Thank you all. The estimates are passed on division.
Shall I report the main estimates 2021-22 to the House?
Some hon. members: Agreed.
An hon. member: On division.
The Chair: Thank you, committee, all of you, for your great questions today. Again, thank you to the minister and all of the witnesses for all that you do all the time. Thanks a lot.
With that, we are adjourned.