I call this meeting to order.
Welcome to meeting number 24 of the House of Commons Standing Committee on Health.
Today we will meet for two hours for a briefing from officials to begin our study on children's health. This meeting does not count toward the six-meeting minimum with witnesses, set earlier this year.
The meeting is taking place in a hybrid format pursuant to the House order of November 25, 2021. Per the directive of the Board of Internal Economy of March 10, 2022, all those attending the meeting must wear a mask, except for members who are at their place during the proceedings.
Please refrain from taking screenshots or photos of your screen.
In accordance with our routine motion on informing the committee that all witnesses have completed their required connection tests in advance of the meeting, I would now like to welcome our witnesses who are with us this afternoon for this briefing.
From the Department of Health, we have Jocelyne Voisin, assistant deputy minister in the strategic policy branch; Kendal Weber, assistant deputy minister of the controlled substances and cannabis branch; Alfred Aziz, director general of the office of nutrition policy and promotion, health products and food branch; Karen McIntyre, director general of the food directorate, health products and food branch; and Celia Lourenco, director general of the biologic and radiopharmaceutical drugs directorate, health products and food branch.
We have with us from the Public Health Agency of Canada, Candice St-Aubin, vice-president of the health promotion and chronic disease prevention branch. From the Canadian Institutes of Health Research, we have Tammy Clifford, vice-president of research, learning health systems.
Each organization will have up to five minutes for an opening statement. I'll ask the Department of Health to begin.
Ms. Voisin, welcome to the committee. You have the floor.
Mr. Chair and members of the committee, thank you for inviting Health Canada to appear today. We are pleased to be here. I won't introduce my colleagues, since the chair has already done so.
Children's health and wellness is a critical issue with potential life‑long impacts. Your study will help inform future work in this important area of public policy.
The past two years have been difficult for children and youth, with school closures, social isolation, and loss of extra‑curricular activities.
COVID‑19 has shown us the need to build more sustainable and resilient health systems.
The government is also concerned about substance use‑related harms. The government remains committed to leading a whole‑of‑society approach to address the overdose crisis.
The pandemic has caused the cancellation or delay of nearly 700,000 medical procedures, including for children. We also know there will be a shortage of medical professionals over the next 10 years, including a shortage of pediatric health care providers. In recognition of these challenges, a $200-billion, one-time top-up to the Canada health transfer was provided to provinces and territories to address backlogs for health care services this year, along with $4.5 billion in top-ups to the CHT provided during COVID previously.
Primary care providers play a meaningful role in children's physical, mental and social needs, and are really at the nexus of the health care system. However, we know that many Canadians have a harder time accessing this care in a timely manner. Budget 2022 provides funding to enhance student loan forgiveness for health professionals working in underserved rural or remote communities, where this access is even more difficult, to ensure that Canadians receive the health care that they deserve where they live.
The budget also expands the foreign credential recognition program to help 11,000 internationally trained health care professionals per year get their credentials recognized more quickly in Canada.
Dental health, as you know, is also a key aspect of Canadians' health, and it is especially important for children as they grow. To address gaps in access to dental care, the government committed $5.3 billion over five years, starting with children under 12. That will be implemented in 2022.
The pandemic has highlighted mental health and substance use issues in children and youth. The government has launched a number of free tools for Canadians, including the Wellness Together Canada online portal, which provides 24-7 access to mental health services for Canadians. We also provide funding through the mental health promotion and innovation fund to support community-based programs that promote mental health in children and youth. Improving mental health and addiction services for youth and young adults is also a priority of the common statement of principles, which sets the frame for the bilateral agreements that flow funding to provinces and territories to improve these services.
Public education and awareness efforts are fundamental to achieving the government's objective of protecting public health and safety, especially for youth. The government has invested in prevention campaigns that include engaging youth and young adults on the risks and harms of substance use, guidance on ways to reduce harms and ways to recognize and counter substance-use stigma.
We also recognize that, for many Canadians who require prescription drugs to treat rare diseases, the cost of these drugs can be exorbitant. Health Canada is working with stakeholders and health partners to develop a national strategy on drugs to treat rare diseases.
In addition, we recognize the important role that healthy eating and nutrition plays in preventing chronic diseases and contributing to long‑term health for children. Significant progress has been made on this issue, including improvements to nutrition labelling and the food supply, and releasing a new Canada Food Guide.
To conclude, I would like to thank the committee once again for the opportunity today to speak to these issues at the beginning of your study. Your work will help point the way to the supports needed to ensure that children and youth can thrive in Canada.
Thank you very much.
Mr. Chair and honourable members, thank you for inviting me today for this important meeting and to have a conversation on what we're all very interested in seeing—the results of this study.
COVID-19 has had an impact on everyone in some way, regardless of age. This includes a significant and unique impact on children and youth. COVID-19 has also highlighted the resilience of communities across Canada. To support this resilience, our federal community-based programming in health promotion and chronic disease prevention demonstrated innovation on the ground in order to continue to offer a range of supports and services to promote positive health behaviours and build much-needed protective factors.
Key examples of this include our community action program for children and Canada's prenatal nutrition program. These two long-standing agency programs serve children and families throughout project sites located across the country. They are well established. They are trusted. They are family-centric hubs within their communities.
These programs were able to pivot and lead pandemic response efforts. The efforts included important things like addressing food insecurity through the provision of food hampers, providing advice on sanitary measures and vaccinations, and addressing social isolation through quick adaptation of programs, including parenting supports, to new virtual formats.
We know that the pandemic has had a significant impact on the mental health of children and youth. Across Canada, or at least most of Canada, approximately one in five youth aged 12 to 17 years self-reported that their mental health was somewhat or much worse in the fall of 2021 as compared with before the pandemic. The Public Health Agency is taking action to address mental health concerns in children and youth by providing $14.8 million over 36 months to Kids Help Phone. This funding is helping to directly provide surge supports for mental health crisis services for children.
Further, through the 2022 fall economic statement, the Government of Canada announced a $50-million investment to boost the capacity of distress centres across Canada. These mental health services and supports reach children and youth where they are at, including those who may be at greater risk—racialized children, children living with disabilities, indigenous children and 2SLGBTQ2I+ children and youth.
It is not just the mental health of our children and youth that has been impacted. The recent Statistics Canada survey of COVID-19 and mental health indicates that some of the risk factors for adverse child experiences, child maltreatment and family violence have also increased during the pandemic. These risk factors include depression, stress, and alcohol consumption within the household.
Throughout the pandemic, families may have encountered issues accessing much‑needed services that support both the health and well‑being of their children and youth. For example, people on the autism spectrum and their families and caregivers have had limited access to in‑person supports. There have also been disruptions in education and personal routines, which have made it challenging to maintain social relationships with family, extended family and friends.
To mitigate the effects of the COVID‑19 pandemic, the Public Health Agency of Canada is leveraging the autism spectrum disorder strategic fund to support the development of projects to address existing and emerging priority needs. The goal of the fund is to provide tangible opportunities for Canadians on the autism spectrum, as well as their families and caregivers, to gain knowledge, resources and skills.
There remains much that we still need to know about the impacts of the pandemic on all Canadians, including children and youth.
With Statistics Canada, the Canadian Institutes of Health Research and the Offord Centre for Child Studies, the Public Health Agency of Canada is cofunding a new cycle of the Canadian health survey on children and youth to assess these impacts and to compare pre- and postpandemic on a range of outcomes, such as healthy living, mental health and healthy child development.
In addition, the agency is supporting other research and data collection, such as CANCOVID-Preg, a study led by the University of British Columbia and cofunded by the Canadian Institutes of Health Research. This national project is assessing the impact of COVID-19 on pregnancy and infant outcomes.
Lastly, the agency is also working with the Canadian Paediatric Society through the Canadian paediatric surveillance program to field a two-year surveillance study on post-COVID-19 conditions, also known as “long COVID”, in children and youth in Canada.
I've touched on only some of the ways the pandemic has impacted children, youth and families, and provided just a few examples of how the agency is working to help protect and promote health among this cohort. There are a number of other ways that children and youth are impacted, and many other resources that the agency offers.
As we continue to navigate our way through this pandemic, we will continue to invest resources and support the health of our children and youth across the country.
Thank you, once again, Mr. Chair and members of the committee.
Thank you very much, Mr. Chair, and thanks to the committee for convening this important study.
On behalf of the Canadian Institutes of Health Research, it’s a privilege to be here today. As Canada’s investment agency for health research, CIHR understands the power of research to improve the health and well-being of Canadians. Our enabling legislation, the CIHR Act, is explicit that this includes all Canadians, beginning with our children.
It is, therefore, a core responsibility of CIHR to support and build capacity for research in children’s health. This commitment is reflected in our investments in child health research, which have increased steadily over the last decade, totalling around $195 million last year alone. It is also foundational to the work and scientific leadership of CIHR's dedicated Institute of Human Development, Child and Youth Health.
Of course, as mentioned by my colleagues, much of our focus in the past two years—as an agency, as a research community and, for many of us, as parents—has been defined by the onset of an unprecedented health crisis. The health and social impacts of the pandemic on our children have been substantial and complex, driven by the illness itself as well as by the ramifications of the pandemic, including school closures, social isolation and decreased economic stability, among many other factors. As mentioned previously, the pandemic also limited access to health services, both urgent and routine.
It's for these reasons, since the onset of the pandemic, that CIHR has mobilized emergency research to understand and mitigate these impacts on our children and to support the recovery and resilience of children and their families. As a result, we are funding a broad portfolio of COVID-19 research to address key questions, gaps and emerging areas of concern in children’s health, including the impact of the pandemic response itself.
One of our foremost concerns, of course, has been the impact on children’s mental health. That is why CIHR has supported proactive research in child and youth mental health in the pandemic context, and, importantly, the mobilization of this new evidence for the health partners and decision-makers who can use it.
While creating new challenges, the pandemic has also magnified the disparities that persist in children’s health in Canada, including among indigenous children and youth. CIHR has, therefore, dedicated funding for indigenous children’s health research in the pandemic context, which takes a strengths-based and community-led approach to address the priorities of indigenous communities.
I should note, Mr. Chair, that CIHR's pandemic response is ongoing. In December, we announced $10 million for 70 projects focusing on the impacts of the pandemic on children, youth and families. We expect to see the outcomes of this research over the course of the year. In March, we launched the Canadian pediatric COVID-19 research platform, a collaboration and coordination hub for 16 pediatric hospital-based research sites across the country. CIHR is also hard at work, preparing to advance new budget commitments on the long-term impacts of COVID-19, including on children.
In discussing the pandemic’s impacts on children’s health, it's also important to recognize that some children requiring special medical care have been disproportionately affected by pandemic precautions and medical backlogs. For these families, new waves and COVID-19 variants are accompanied by difficult questions about delays in treatment, increased risk of infection, and the repercussions for their already vulnerable children.
Indeed, this only illustrates the many urgent areas of children’s health research and why it was imperative for CIHR not to sideline these priorities during the pandemic. That is why, parallel to the COVID-19 response, CIHR has continued to advance research across the entire spectrum of children’s health. I am pleased to report, for instance, that CIHR is moving swiftly to implement a new pediatric cancer consortium, stemming from budget 2021 investments.
In collaboration with the Graham Boeckh Foundation and other partners, CIHR is working to establish a pan-Canadian network of provincial and territorial learning systems for integrated youth services. This approach is transforming youth mental health and substance-use services by ensuring that youth have equitable access to a range of community-tailored and evidence-informed services, including primary care and peer support.
Earlier this year, CIHR funded a new training platform to prepare the next generation of perinatal, child and youth health researchers for careers both within and beyond academia.
Mr. Chair, these are only examples of the many research priorities in children's health that CIHR is championing. As we move forward, CIHR remains closely engaged with this community.
CIHR's Institute of Human Development, Child and Youth Health recently launched a new strategic planning process to identify core priorities for child health research for the next five years. We know that this is of prime importance to Canadians, and we will continue to work closely with our partners to promote and protect children's health through research and beyond.
Thank you very much.
Thank you, Mr. Chair, and thank you to the witnesses appearing here today. We certainly believe this is a very important study going forward for the health of Canadian children.
Ms. Voisin from the Department of Health, I have a couple of things to clarify. You talked about a $200-billion, one-time health transfer. I'm sure you meant $2 billion, but I just want to be clear on that.
Another thing you talked about very clearly included the 700,000 medical procedures in children that were lacking. Certainly, having just finished our study on human health resources in medicine and nursing, etc., we know there's a huge shortage of practitioners.
How are we ever going to make up these medical procedures that are missing with the number of practitioners who are able to graduate now? Is there a plan with the Department of Health to address that?
Thank you for the correction there. Indeed, it is a $2-billion top-up for the CHT.
On the question related to surgical backlogs, that 700,000 surgical backlog number is all surgical backlogs in Canada, including those for children. We do not have a specific number related to children's surgical backlogs. CIHI doesn't report that number specifically, although different associations have published numbers they have from their own members or children's hospitals.
Yes, the health human resource issues and challenges are a big contributing factor to those surgical backlogs. We know that provinces and territories are working on different innovative measures to address backlogs, including looking at different spaces to address surgeries.
In terms of health human resources, we're working very closely with the provinces and territories through our existing committees on measures to address HHR issues and challenges, including innovative ways to increase and accelerate the credential recognition of internationally trained health providers. Some provinces have very innovative models in place that other provinces are looking at implementing. We are working very closely with them on getting those best practices out there and in the space so we can integrate those internationally trained professionals.
We're also working on other ways to support the health workforce, such as leveraging technology, for instance, and providing mental health supports for health workers, given that retention is a key measure to make sure that we continue to have the health workforce we need.
The social determinants—and I think we refer to them often as communities or children at risk—have come very much to the front. A spotlight was placed upon it.
The Public Health Agency has worked with communities to try to address some of the issues around misinformation and disinformation for those communities that may be more at risk or more vulnerable, through programs such as the vaccine community innovation challenge, where communities themselves try to promote and create communication efforts in a language that represents or reflects the communities themselves, to try to increase uptake on some of those guidelines that the Public Health Agency has provided.
In addition, the Public Health Agency of Canada has currently put forward approximately $100 million over the next two or three years—and I'll have to come back with details in writing—to address mental health programming for those communities specifically.
Those are the projects tailored to racialized communities, indigenous communities, children with disabilities and those living with disabilities, etc., to try to have targeted investments within those communities that are more at risk.
We certainly know that the COVID-19 pandemic has had a great impact on people with autism spectrum disorder, as well as on their families and caregivers, by limiting access to in-person supports, disrupting education and personal routines, and making it challenging to maintain social relationships with family and friends.
In order to address what we see as potentially a wider gap or wider data gap with respect to the health impacts of COVID-19, PHAC is investing $2 million specifically over three years to collect additional second-cycle data for the CHCSY, for data specific to that group—those living with autism.
As well, the Public Health Agency provided $75,000 to the Autism and Intellectual Disability Knowledge Exchange Network, or AIDE Canada, as it's called, to develop a COVID-19 resource hub to share up-to-date, trusted information related to COVID-19. It's specifically tailored to Canadians with autism spectrum disorder, as well as their families and caregivers.
In budget 2021, we provided $15.4 million, of which $7 million is new funding over two years, to start this year. We're working collaboratively with provinces and territories, families and stakeholders on the creation of a national autism strategy. We are looking forward to coming back and speaking more on this—
Thank you very much, Mr. Chair.
My first question is for you, Ms. Weber, as it concerns your field of activity. I'd like to talk to you about the movement of certain narcotics.
Before marijuana was legalized, the federal government, through the Department of Health, granted permits for growing marijuana for personal and medical use. However, the mayors of rural municipalities in my riding, such as Saint‑Colomban, Mirabel and Sainte‑Anne‑des‑Plaines, whom I would like to say hello to in passing, are noticing that the use of these permits is being abused. It seems difficult to control. It seems that permits are granted very easily and that very little medical evidence is required. There seems to be abuse, high production and resale. Obviously, these substances are circulating and being used by young people as well.
I'd like to know whether now that marijuana has been legalized by the federal government, the Department of Health intends to review the regulations for the granting of these permits, to avoid the kind of problems I just mentioned.
Yes. Previous to my time with the Public Health Agency of Canada and the Government of Canada, I worked in early learning and child care directly, as well as for NGOs representing the wellness of children and children's rights.
With regard to the impact, this is something we're still looking at. This is something the Public Health Agency of Canada is taking seriously. We're trying to ensure that we're investing in surveillance and surveys with partners at Statistics Canada and in the research that's happening, led by colleagues at the Canadian Institutes of Health Research, on what the impact is of COVID-19 on children and youth, in particular.
As we know, the impacts are felt across the life course. Certainly, it's felt by seniors, as well as adults, economically, socially and with mental health more broadly, but when it comes to children and youth, it will require additional research and additional surveillance and analysis.
Unfortunately, it would be pre-emptive of me to address any of those questions, but it is, again, something we're looking forward to returning to when we have a bit more information on what exactly those impacts are.
I wanted to go into vaping in my last couple of minutes here. Again, with the vaping, we're looking for a three-year review. It was May 23, 2018, so can we expect to see that one?
We saw such a drastic doubling of the usage of vaping among young people between...I think it was 2017-18, and then 2019. Can you give us some update on what is happening now, what the statistics are now? I have to say this was devastating to school boards and to cities that knew this wasn't to be sold legally in Canada, hadn't been authorized by Health Canada, yet still was widely available for sale.
I can tell you that in my community of Port Moody-Coquitlam, there are kids getting hurt at school, passing out at school, ambulances having to come because of their consumption of nicotine, which is really heartbreaking. I'm sure on the public health side, we don't want a next generation of nicotine-addicted kids.
Can you share with me what's happening on that, and on the three-year review?
The first thing is that we have launched the three-year review of the Tobacco and Vaping Products Act.
I'm getting a bit of an echo, so I hope you're not.
We launched the legislative review of the Tobacco and Vaping Products Act earlier this year. We posted a consultation document for a couple of months. We've collected comments from a number of stakeholders, such as industry, Canadians, provinces and territories, consumers, health educators and public health. We're reviewing that input, and then we'll be coming out with a report and next steps on the outcomes of that legislative review.
The interesting thing about the legislative review on the TVPA—the Tobacco and Vaping Products Act—is that it happens every two years. As we finish this one, we will be kicking off the second review next spring. The focus of this first review has been on vaping.
Your questions on vaping and children are so important. Results from the 2021 Canadian Tobacco and Nicotine Survey indicate that vaping rates among Canadian youth have stabilized. The vaping rate was 13% among Canadians 15 to 19 in 2021. Now, that's not to say that we need to let up or that this is good news, because previously, as you noted, we saw a rapid increase, with 14% reporting past 30-day use compared to 6% in 2017. That was from 2017 to 2019, but in 2021, we have seen it stabilize.
I have a couple of observations that could account for that. We put in place promotion regulations that prevented youth from inducements to use vaping. There were prohibitions around where there could be promotions. They couldn't be visible to youth in the media or in physical locations. We also put in place nicotine concentration levels. That was a couple of years ago, where we put the max in at 20 milligrams per millilitre.
Then we also put out a consultation last summer to seek views on further restricting the promotion of flavours in vaping products to tobacco and mint flavour. I want to just be clear that we currently have prohibitions around confectionery flavours, dessert, cannabis, soft drink and energy drink flavours. This most recent consultation is looking at fruit flavours and others that exist.
Those are a couple of measures I wanted to share.
You're correct. What we are seeing through analysis conducted by Statistics Canada, particularly as it relates to physical activity, is that physical activity levels have dropped, certainly from the fall of 2018, which was prepandemic, to the fall of 2020.
In the fall of 2018, 50.8% of youth reported that they met physical activity recommendations within the week prior to reporting. However, in the fall of 2020, only 37.2% indicated that they had met those recommendations. If this decrease becomes pervasive, we can certainly anticipate that it will have some public health consequences.
The drop was primarily a result, obviously, of the significant decrease in the school base, but also in leisure physical activities, like sporting events, etc. You've certainly talked about issues around obesity. We are monitoring that through various child surveillance activities here within the Public Health Agency of Canada.
Thank you, Mr. Chair, and thanks to the witnesses.
When we're talking about some of these important programs, I like to ask my questions straight up. Do we have a “blank”—whatever that program is—and how is it performing?
I wrote down a few notes here. Do we have a suicide prevention hotline, which we passed unanimously in Parliament about 550 days ago? I know the answer to that, so we won't use time on it. The answer is no, at this point.
Do we have a national autism strategy? That's been discussed since, I think, the Senate did a report in 2007. In 2017, there was a fairly specific budget ask that the government rejected. Here we are in 2022, so the answer is no, we don't have a national autism strategy.
I want to focus on this question. Do we have a Canada mental health transfer? That was promised in the most recent election campaign by the government. It promised very clearly in 2021-22, the last fiscal year, that it would deliver $250 million and that in 2022-23, the budget year we are in right now, it would deliver $625 million.
I noticed in the testimony that several of you have commented on budget amounts that have been allocated for specific programs. This is very specific. Was any of that promised money—the $250 million for last year and the $625 million for budget 2022—actually in the budget?
Thank you to all the witnesses for appearing today. It's been very interesting testimony so far.
I'm going to go first to Mr. Aziz again, on the subject of the challenges with rising food costs, particularly in the north. I know we have a nutrition north program, but, given the challenges, especially through the pandemic and with rising costs, I wonder, Mr. Aziz, if you could comment on how we can ensure access to nutritious food choices, especially of fruits and vegetables, and a variety of food choices, and how we continue to ensure access, particularly in rural northern and remote communities.
Okay, so we'll look forward to that response.
We know that before COVID-19 we had a situation across our country in which hospitals operated on good days at 95% capacity and on other good days at 130% capacity, which is often referred to as hallway health care.
The provinces have asked for somewhere in the neighbourhood of $28 billion to $38 billion to help them catch up and address some of that. I think the misspeak in your opening comments, Madame Voisin, was maybe some hope for some of the provinces when they heard a $200-billion increase in transfers, though I think that may have required a longer budget conversation in the House.
I think that getting a look at that breakdown would be incredibly helpful, but it also has to be done in consultation with the provinces. They are looking for those increases. I'm just wondering if there's any framework for upcoming discussions, specifically with respect to allocations of funds to address the issues that we've seen arise with children as a result of COVID-19, when the first ministers gather for conversations about health transfers with the federal government.
I appreciate that answer.
I guess I'd just say, with respect to stable and predictable funding, that the provinces asking for $28 billion and getting $2 billion not in the form of ongoing funding, but just as a perhaps strings attached, perhaps not, one-time announcement in the budget when they're looking for an ongoing conversation.... The has said the conversation that they're looking for can happen after COVID-19, which we know persists. I think that with respect to stability and predictability and our responsibility to respect the make-up of this country and the provinces' right of jurisdiction over health care, it's important that we actually collaborate and that the government collaborate with them.
Unfortunately, with that, I think I ate up the rest of my time. Again, I want to thank all of the officials for taking our questions today. I look forward to the response with respect to that breakdown from the study on the needs by the provinces.
I'm a little unprepared here, because I didn't think it was my turn.
My question is for the Department of Health, and Ms. Voisin.
You mentioned in your testimony that the government had committed money—here, I hope I'm quoting you correctly—to help 11,000 foreign graduates to be more quickly credentialed. By way of explanation, you said that many provinces have been innovative in finding ways to more quickly license foreign graduates. The department was looking at how to get out the best practices of some of these provinces. I wonder if you can elaborate on that.
As you may or may not know, the committee has been studying this issue quite recently. Obviously, licensing for more foreign graduates is a good way of addressing the shortage of health care professionals. Can you tell us what are some of the innovative practices of some of the provinces that we're looking to emulate? Do you know?
I'm talking about professionals. I don't have specifics. I'd have to get back to you with this model in Ontario, but it's just one illustration of an innovative model, so, if there are professionals coming into the country who want to get credentialed as nurses, for instance, but that process takes time, then they can still work in the health care system as they work toward getting those credentials recognized from the colleges and regulating bodies. I don't have specifics about which type of profession that is.
Another example, for instance, is creating matching solutions between organizations that are supporting those foreign-trained professionals coming into the country and organizations where they are seeking to get more support and working with regulatory bodies to look at streamlining that process for them.
In terms of your question related to the government's investment, that's for the foreign credential recognition program, which is led out of Employment and Social Development Canada. That program provides support for programs that, for example, do training support for internationally trained health professionals who come into the service—navigator services, for instance—and help internationally trained professionals to understand the system and how to better get credentials.
Those are just a couple of examples.
My question is for Ms. St‑Aubin, but I will provide a brief preamble first.
I'm a researcher myself. The academics and researchers I work with tell me that it was because of the lack of hospital capacity, particularly in Quebec, that schools had to be closed earlier. Schools are obviously under provincial jurisdiction. As a result, the early closure of schools could have had a significant impact on children’s mental health and learning.
As Ms. Voisin said, one way to increase hospital capacity is to increase funding. I have a hard time understanding why there is this kind of unease when we try to delve into this issue, particularly when we ask questions about what we know about the health consequences on children not going to school.
Ms. St‑Aubin, is the Canadian Journal of Public Health a serious publication?
In the absence of an answer, I will tell you: yes, it's a serious publication.
In only five minutes, my assistant and I found the research done on this topic in 2022. There is this article, for instance:
“What is the effect of school closures on learning in Canada? A hypothesis informed by international data”.
I took me two seconds to find this.
Here's a second example of an article:
“Understanding and attenuating pandemic-related disruptions”.
This is the only time you'll hear a Bloc member speak English.
Voices: Ha, ha!
I'm interrupting you, but you'll understand that it's very difficult for a parliamentarian to get clear answers.
The truth is that the issue is one of funding and hospital capacity. Countries with higher hospital capacity, such as Switzerland, were able to wait longer before closing schools. Here, during the pandemic, it was repeated ad nauseam that one of the reasons for confining people was to protect the health care system.
I will close with an editorial comment. I deplore this kind of code of silence that exists in the federal government and in the federal Parliament on health funding and the Canada health transfer. This has been the case on your side and on Ms. Voisin's side, and I deplore it.
Financing is the crux of the issue. However, it seems that all those who manage health care systems in Canada and ask for unconditional funding are wrong, because their requests are being dodged. The federal government would be the exception, but it is obviously unaware of any recent research findings on the subject.
Thank you very much.
I'm finished, Mr. Chair.
There's some feedback here.
I can certainly speak to that. This has been a very significant problem that we're facing. In Canada, as you probably are aware, we do not manufacture infant formula. However, the issue is not related to general infant formula. It's related to babies who have inborn metabolic disorders as well as babies with allergies to proteins in milk. The shortage is really focused on those particular products.
As you may have heard in the news, we're happy to hear that the Abbott manufacturer, which is a very large manufacturer of these products in the U.S., has just recently opened on Saturday. We should be seeing some progress in that area.
However, Health Canada has been working very closely with the industry, with the provinces and with the distributors of these products to ensure that infants who need the products have been getting access to them. We will continue to do that.
Thank you again, Mr. Chair.
I'm going to start by expressing my appreciation to all of you. In my last round of questioning, I'm sure Ms. Voisin particularly would know I was not communicating directly with her, but to someone else who hopefully would be watching, some of whom might be staff members or MPs in the room right now.
I'm not going to apologize for being impatient when it comes to mental health, particularly kids' mental health. I'm not going to apologize for being impatient when it comes to kids who are experiencing increasing suicidal thoughts and when we're dealing with a raging opioid crisis.
When it comes to a lack of services for people with developmental disabilities, particularly people with autism, the impact of inaction on diagnosis and early intervention and education, and eventually participating in the workforce, and all of those different things, we should, as members of Parliament, be impatient about these things. Hopefully, the communications we have here drive action on some of these things. The Canada mental health transfer is a great place to start, and the suicide prevention hotline is a good place to start.
I'm going to turn my attention back to autism, though, if I could.
The government funded the Canadian Academy of Health Sciences—I think that's what it's called—study of a national autism strategy. I know it was chaired by Lonnie Zwaigenbaum, who is a global autism research rock star, and included phenomenal stakeholders, including many autistic Canadians.
I think the report that was put forward was over 400 pages. I'm wondering if someone could give us a bit of an overview or summary of what might have been in that report.
Is anyone here able to do that?
Chair, I'm more than happy to provide a bit of information, and of course provide anything in writing as well, if this is not sufficient.
That's true. We did provide $1.6 million to the Canadian Academy of Health Sciences. You are correct. It was a broad and inclusive evidence-based assessment on autism. Many Canadians participated through multiple venues—the autistic community, caregivers, those living on the spectrum and parents, etc.—to try to inform the development of a strategy. It was 400 pages, and we are currently looking through the multiple areas of interest. There was an economic component that was further explored, as well as the social component. Access to services was very much a part of the conversation and the information that was put forward.
Building on this, though, the Public Health Agency of Canada is also continuing to engage with provinces and territories, indigenous people, etc., through various mechanisms to build on this report that's come forward. We'll be organizing a national conference on November 15 and 16 in an effort to build consensus, or at least come to ground on some of those key priority areas of action that the member has so eloquently flagged in his interventions.
Thank you very much, Mr. Chair, and thank you to the officials for all the hard work you've been doing over the past two years. We appreciate that.
We have been talking about COVID-19 a lot and the impacts on the broader society, but I am glad that we're focusing in on children, given that children are naturally some of the most vulnerable people in society and don't often get invited to the decision-making table. I'm glad that we're focusing on this for a little while. My questions are going to focus on health and fitness, food nutrition and physical activity, those sorts of things.
Mr. Aziz, I see that you're online, and you and I have had a couple of discussions on this very important topic. There are three plans that I would like to focus in on, the national school food program, front-of-pack labelling and ending marketing to kids. Could you just elaborate on that and perhaps update us on any current initiatives being undertaken to help young Canadians and their families maintain healthy and physically active lifestyles?
I'll just note before I pass it along that the vast majority of children in Canada get most of their physical activity at school, and there's also a great opportunity to make sure that they get a healthy meal at school as well and improve the quality of the physical activity that they get at school. Please outline, if you could, some of our initiatives as a government and some of the work we've done to date on those.
Sure. I'll speak mostly to the importance of healthy eating for children and some of the initiatives we're undertaking under Canada's food guide. I'll defer to my colleague, Ms. McIntyre, to talk specifically about front-of-package labelling and marketing to kids, and then Ms. St-Aubin to talk about some of the work on physical activity that falls under the mandate of the Public Health Agency of Canada.
We all know that good nutrition and healthy eating from a young age are fundamental to promote the healthy development of children and to reduce the risk of diet-related chronic diseases. We know also that childhood and adolescence are a time for learning and shaping food skills, attitudes and eating behaviours.
We also know that COVID-19 has really disrupted the routines of children and families and affected their meal choices and eating patterns. Health Canada pivoted to help people in the early days of the pandemic by adapting our messages to the new public health reality. In March 2020, we launched an at-home campaign to promote food skills and provide tips on healthy meals at home in order to help families eat healthily during this challenging time. To also help encourage healthy eating from childhood into adulthood, Canada continues to focus its efforts on finding effective ways to increase the reach of the food guide by promoting it directly to children and youth.
For example, over the last two years, we have established new youth engagement groups to promote awareness of the food guide through peer-to-peer engagement, and to seek their advice on how to make food guide resources more relevant to them. We launched social media campaigns targeting youth, including the first-ever Government of Canada TikTok challenge in March 2021, which encouraged teens to build food skills and share their own healthy snack ideas.
We tested immersive social marketing in schools across the country to raise awareness of food marketing, with a larger rollout being planned for online modules for the fall. We incorporated new child- and teen-specific food guide branding to make healthy eating information more appealing to these age groups, and as part of our work to promote food skills, we collaborated with stakeholders, including the University of Guelph, on a study designed to make it easier to cook healthy, plant-focused meals at home, with a particular focus on families.
We are also working to stimulate—
Thank you for that. Yes, we agree that physical activity and healthy eating are a priority, and they certainly can reduce the risk of chronic disease.
We are working across sectors right now to ensure that we are promoting good health and well-being, which are key issues with the latest phase of the COVID-19 pandemic.
I also just want to highlight areas such as Wellness Together Canada or the Hopewell app. They have components in addition to mental health and substance use that also provide free physical activity resources to support Canadians in this area, because maintaining a healthy lifestyle is really critical.
We also have a $20-million annual fund to support community-based initiatives, called the Healthy Canadians and Communities Fund, which is improving health behaviours and addressing the health inequalities that we also have addressed—have flagged here in this conversation today—among those priority populations that are maybe at greater risk of developing chronic disease. That really supports those common risk factors like physical inactivity, along with healthy eating and tobacco use, etc., that are often associated with chronic diseases such as diabetes, cardiovascular disease and cancer.
Thank you, Mr. Chair, and thank you, Mr. Barrett.
To the witnesses, I have just a few comments. There's an interesting study from 2020, a UNICEF report, in which Canada ranks 30th out of 30 wealthy countries regarding children's physical health and 31st out of 38 countries with respect to children's mental health. We know very clearly that the children's mental health systems are stretched to their limits. There's a very interesting comment here from Children's Healthcare Canada that says—and I think this is very poignant:
We have normalized rationing and waiting for mental health services to the detriment of children, youth and families, while we know that early intervention pays lifelong dividends.
That is very poignant, as I said, with respect to children.
There are a couple of other interesting things around the data with respect to surgical procedures:
Data collected...by the Pediatric Surgical Chiefs in seven (of sixteen) children's hospitals shows that there is currently a waitlist of over 20,200 pediatric patients for elective and medically necessary surgery across surveyed children's hospitals.
The average number of wait-listed patients per hospital surveyed is 2,891; 49.3 per cent of surgery patients have passed the window for timely intervention. Many children are experiencing backlogs of up to one year for elective (essential) surgeries, and in some cases, wait times for pediatric patients have exceeded 24 months.
Why did I read all that? I think it's important that folks here at the committee know that data does exist, even if the government doesn't have it, and I think data sharing is certainly something that perhaps we should think about getting better at.
Where does that leave us in terms of children's health? Certainly we can talk about some of those high-profile things, but when you listen to some of the experts, what's important now in children is that their literacy and their numeracy—or, as we might have said in the old days, their readin', writin' and 'rithmetic—are, obviously, falling behind.
I'm curious to know whether CIHR has any evidence of that, and if they do, or even if they don't, what we are going to do about it.
Mr. Chair, if I might, you know, clearly Canada was falling behind before the pandemic, and I would say that we wouldn't need to spend much time or effort to understand that things have gotten only worse, not better. I guess the questions that then beg to be asked are, what are we going to do about it and when are we going to do it? How long are we going to study things before we go into action? The patient, unfortunately, is hemorrhaging on the table, and we're all watching it happen. What are we going to do about it?
That's for anybody who's in charge there. Department of Health, I would suggest maybe that's for you, or maybe it's for the Public Health Agency.
I wasn't sure it was directed at us.
I can speak to actions that are already under way. For instance, the government is already providing funding to the provinces and territories to improve access to mental health services—$5 billion over 10 years—and, as I said at the beginning, youth mental health services and integrated youth services are one of the priorities under the framework of those bilateral agreements. That work is already under way.
The federal government has also initiated Wellness Together Canada, which provides 24-7 access to mental health services. We have seen, through the pandemic, that while mental health has become a greater issue for youth, access to virtual mental health services has increased exponentially as well, not only through the federal government but also through provinces' and territories' really leveraging virtual services to support mental health services and access and exploring issues like peer-to-peer support and these integrated youth services models, examples of which are expanding across the country.
Many thanks. Perhaps I can start off with the research that CIHR is funding.
Budget 2021 committed $30 million for CIHR to fund targeted research into pediatric cancer. That funding is still active. We do not yet have specific projects or their results.
However, that being said, one of the very prominent opportunities that have arisen with this additional funding is the creation of a pediatric cancer consortium. The consortium is going to cover the entire cancer control continuum, from prevention to diagnosis, treatment and survivorship. What we envision is that this funding will improve the research pipeline, advance equitable access to care and, importantly, maximize the impact of research through knowledge mobilization.
Again, the funding opportunity that I mentioned just recently closed, so these applications are undergoing peer review and funding is expected to start this summer. I'd be very happy to come back to you and provide details as to the group that's been successful in being awarded the opportunity for the pediatric cancer consortium.
I wonder if one of my colleagues might be able to add something.
Candice, perhaps you would like to?
We recognize that for many Canadians who require prescription drugs to treat rare diseases, the cost of these medications is astronomically high. To help them get better access to those treatments, we're working with provinces and territories and other partners to move forward and develop a national strategy for drugs for rare diseases, to be launched in 2022—this year.
Budget 2019 proposed investing $1 billion over two years, starting in 2022-23, with up to $500 million per year ongoing, to help Canadians with rare diseases access the drugs they need.
We held virtual public and stakeholder engagement in early 2021, which concluded in March. This included patients with rare diseases and their families, parents and caregivers. They were invited to provide their views on a national strategy and participate in a public town hall. We got to report what we heard and summarize the key themes and the feedback that emerged during those consultations.
Building on that and recognizing the importance of ongoing engagement, we did a second phase of targeted engagements, comprising stakeholder roundtables, which took place over the last two months, April and May, to seek feedback on a draft framework for this strategy and further inform the development.
It would be in terms of the research that we fund across the board.
Again, one of the challenges, though, with CIHR in providing grants to researchers is that a grant, compared to a contract, doesn't necessarily have the same controls, if you will, in terms of what is delivered. In certain cases, the researchers themselves, for example, if they're doing research that is in a petri dish, may not be able to do that in the same way as someone who is doing population-based research. Again, you will see much stronger language coming from CIHR in terms of our expectations for an intersectional approach to research.