Interventions in Committee
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Kathleen Cooper
View Kathleen Cooper Profile
Kathleen Cooper
2015-06-18 15:48
First of all, to tell you about the Canadian Environmental Law Association, we're a non-profit public interest organization specializing in environmental law. We're also a legal aid clinic within Ontario. We provide legal representation to low-income individuals and vulnerable communities.
Then we have law reform priorities, and in setting our strategic priorities, one of those is environment and human health. In deciding within that large topic how to set priorities, we take a population health approach, the same as Health Canada, the Public Health Agency of Canada, and public health agencies everywhere do. You set priorities by focusing on issues where large numbers of people are potentially or directly affected or where you have serious outcomes.
You can't get much more serious than a known carcinogen where there's strong science. Radon, as I'm sure you're going to hear later as well, is in a class by itself compared to most other environmental carcinogens. That's why we've focused on radon.
I'm going to speak today to a report we prepared last year, “Radon in Indoor Air: A Review of Policy and Law in Canada”. I believe you've been circulated the media release that was issued the day we released the report. That's all I was able to have translated given the time pressure of meeting with you today.
We canvassed policy and law across Canada at the federal and provincial levels and looked at jurisdictions and roles. We focused on public buildings and building codes, looked at other relevant provincial policy and law and the associated common law, and made a number of recommendations, but I'll focus today on just the recommendations we made with respect to the federal government.
Overall, our findings were that Canadians need better legal protection from radon. We found a patchwork of inconsistent and mostly unenforceable guidance.
For the federal government, we found that really important leadership has occurred, and Kelley Bush from Health Canada will provide some details on that for you today, although we definitely made recommendations for more that can be done. At the provincial and territorial level, where actually most jurisdiction lies, we found a wide range of laws that need to be updated or that contain gaps or ambiguities. There's very limited case law, which points to the need for improving a law or for law reform. I won't get into detail on what's been done at the federal level on radon, although the report does, because Kelley will be doing that for you later on.
Just in summary, under the national radon program there has been very valuable research, testing, and mapping of high -radon areas. The guideline for indoor radon was updated in 2007. The national building code was updated with respect to radon provisions, there's a certification program for radon mitigators, and there has been a national campaign to urge the testing by Canadians of their homes. It's recommended that every home in Canada be tested.
We recommended, to build on that important work, that there really is a logical next step here. Through the work of the Green Budget Coalition this past year, we recommended a tax credit for radon remediation. We recommended that the Income Tax Act add a tax credit for radon mitigation of up to $3,000 for individual Canadians, so long as it's done by a certified expert under the national program. That was not included in the budget, although we think it's still a very good idea. We had some very positive response from the federal officials we spoke to about it.
We also recommended that there be clearer messaging about radon, and that we use words like “radiation” and “radioactivity” because they are accurate and are what people understand more in terms of the risks of radiation and radon. We also recommended that there be better data sharing nationally between the federal government and the provinces and territories in terms of the testing that's done, along with the sharing of information that's paid for nationally, and that information be available publicly.
In terms of recommendations for federal action as well, we note that the David Suzuki Foundation report that came out just last month says the World Health Organization has recommended a lower level of 100 for indoor radon. Currently, our federal level is 200 becquerels per cubic metre. We definitely supported that recommendation and recommend that the federal government reduce the indoor radon guideline to 100.
The other two areas I want to touch on that are relevant to your investigation here have to do with the Canada Labour Code and the need to update it as well, and also the need for improving the uptake across Canada of the naturally occurring radioactive materials guidelines, the NORM guidelines. I'm going to speak to those two areas now.
Under the Canada Labour Code, there is the only legally enforceable limit for radon in Canada that's broadly applicable, but it's only for federally regulated workplaces and it remains at an outdated level of 800 becquerels per cubic metre. We think it should be brought down to the federal reference level of 200 becquerels per cubic metre to begin with, and we think that level should come down to 100 becquerels per cubic metre. On the updating of that level, apparently what was going to happen in 2015 now sounds like it's going to happen in 2016, so it would be great if your committee recommended speeding up that process.
In terms of the NORM guidelines, these are guidelines that were prepared by a federal-provincial-territorial committee. We interviewed occupational health and safety inspectors across Canada and found a lot of confusion and uncertainty about workplace radon rules or whether the NORM guidelines apply. In fact, they apply to every workplace in Canada. In any indoor space that is a workplace, including the room in which you are sitting, those guidelines apply.
However, it's a reactive, complaint-driven system. Inspectors get few or no complaints because there is a lack of awareness, so they don't take enforcement action. Also, some inspectors didn't think that radon was an occupational health and safety issue at all. They said that enforcement action was unlikely because the only agreed-upon levels for radiation are those for radiation-exposed workers. That is just not accurate, so we've made recommendations in response to that situation.
Turning to the recommendations we made with respect to the Canada Labour Code, as I've mentioned, it should be brought up to date swiftly. It's out of date by many years and still at that level of 800 becquerels per cubic metre.
With respect to radon, we recommended that the federal-provincial-territorial radiation protection committee, which deals with far more than radon—it deals with a whole manner of radiation exposure issues—convene a task force for occupational health and safety inspectors across the country so that there is clarity and there is a more generalized consistent application of those NORM guidelines to ensure worker health and safety. The consequences of that inconsistent application are that you're going to have uneven worker protection across the country and the possibility that people are overexposed, both in the workplace and in their homes, if they happen to be unlucky enough to have high radon levels in both of those indoor locations where they live and work. Related to that, we made a range of recommendations about provincial labour codes, which I won't get into.
In another area of occupational exposure, with respect to radon mitigators, we also recommended that CAREX Canada, who you're going to hear from later today, undertake, with the Canadian national radon proficiency program, research and dosimetry monitoring for radon mitigators so that we can make sure their workplaces are safe as well.
Just to recap on the findings in this report and to recommend to you to take up some of these recommendations in your deliberations on this topic, we found a need for greater legal requirements rather than guidance in this area for several reasons, including the need to underscore the seriousness of the problem and to support public outreach messages by the federal government and by other organizations who you're going to hear from today, including the Canadian Partnership for Children's Health and Environment.
Also, there's a need for legal requirements to require testing in public buildings and to ensure public access to that information. As well, there's the need to correct that inconsistent response among both the public health and the occupational health and safety inspectors and to provide them with tools to take action with respect to radon. As I mentioned, we found limited to no case law under either statutes or common law. We also found that improving the law or law reform is a better remedy than costly and situation-specific litigation to resolve radon problems.
Then, as I mentioned, there's a need for specific federal government action, including updating that federal guideline and putting in place a tax credit to help Canadians undertake radon mitigation when they have high levels, updating that Canada Labour Code, and ensuring the NORM guidelines are applied.
We've calculated the health care savings from prevented lung cancer deaths. If all homes in Canada were mitigated to the level of 200 becquerels per cubic metre, you'd see more than $17 million a year in savings through prevented lung cancer deaths. It likely would be double that if you were to reduce the level to 100 becquerels per cubic metre. Then, of course, anyone who works in cancer will tell you that the indirect costs are five times higher than the direct costs, so a lot of savings are possible there, along with the avoidance of the pain and suffering associated with lung cancer.
View Cathy McLeod Profile
As my last comment or question, I certainly see both a federal and a provincial role. There were some comments in terms of the Canada Labour Code, and I'm just trying to get a sense of to what degree, because obviously the provincial and territorial ministers regularly meet with their federal counterparts. In your awareness, has this issue ever been discussed at those particular meetings?
Kelley Bush
View Kelley Bush Profile
Kelley Bush
2015-06-18 16:27
I can speak to what Health Canada has done there. We have gone to make a presentation about the revised guideline, and we follow up on a very regular basis. It is the intent to have the Canada Labour Code harmonized with our current Canadian guideline. It's just been delayed. The most recent information we have is that it's supposed to be updated by the winter of 2015-16.
View Ryan Leef Profile
View Ryan Leef Profile
2015-06-04 12:56
Thank you, Mr. Chair.
Thank you to all of our witnesses today.
Part of the purpose of our study is to expose some of the things that I think all of you gentlemen have clearly articulated today, which is a clear understanding on the part of the fishing community, outfitters, and organizations like yours that not only have the knowledge about what's going on in the fisheries ecosystems, but also invest your time and your financial resources, your volunteerism, and technical expertise into vibrant and healthy fish stocks.
On that point, thank you and congratulations. I hope there is some measure of success for all of us in undertaking this study, us, and that Canadians more generally will understand and appreciate the value of your organizations.
My first question will be for Mr. Lévesque and Mr. Bouchard. You noted, and if I've written this correctly, the damage of pleasure crafts to the river mouth and the reduction of currents leading to an increase in cyanobacteria in the area and, as you just mentioned, some of the migration of yellow perch. You also spoke a fair bit about the cormorant populations and a cull in that respect.
I see some overlap here between provincial responsibilities and federal support. I'm wondering if you can talk most specifically about some solutions around how to deal with the pleasure craft issue and the other things that lead to an increase in cyanobacteria. In other words, what solutions would you propose that would fall under the federal mandate to assist with improving the water pollution conditions in Lac Saint-Louis or Lac Saint-Pierre?
Marcel Bouchard
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Marcel Bouchard
2015-06-04 12:59
First and foremost, it's necessary to recognize that the federal government has the final say over laws and regulations that govern fisheries. We can't figure out why the province is able to make laws and regulations that would normally have to be approved by the ultimate fisheries authority, in other words, the federal government. How is it that the province can put in place such archaic regulations, regulations that don't make sense or contribute to the solution?
I'll give you a very basic example. When we're talking about farming, that is, of course, in the provincial domain, but when we're talking about shoreline erosion, especially along Lac Saint-Pierre as a result of navigation and pleasure crafting pollution, the issue is federal. Both levels of government clearly need to work together if the goal is to fix the problem at Lac Saint-Pierre. If that isn't the goal, all the government has to do is take a hands-off approach, since the lake is disappearing anyway. Within 50 years, Lac Saint-Pierre will be no more if we don't take the appropriate steps to save it. We're losing a real gem.
View François Choquette Profile
Thank you, Mr. Chair.
I want to thank the two witnesses for appearing and for their testimony.
Mr. Morrice, you just talked about how important it is for municipalities and provinces to participate. What role does the federal government play in your initiatives? Actually, the question is also for Ms. Ryan.
Mike Morrice
View Mike Morrice Profile
Mike Morrice
2015-06-04 9:39
Thank you.
I will respond in English, if that pleases the committee.
The current role of the federal government is almost nil. That is to say that locally MPs in each of the communities have been very supportive. Certainly that's been the case in Waterloo region, and that's actually part of our assessment of communities across the province. We look at the municipality. We look at the political support at the federal and provincial level, and certainly we have MPs who are supporting strongly. Where that translates into federal programs for funding, for example, as I mentioned in my opening remarks, there is no current federal funding I am aware of that is going to any seven of the programs in which this currently operates. That's certainly a challenge.
In terms of the ideal state, I point to some of the support that's being provided provincially through funding agencies like the Ontario Trillium Foundation. Through the provincial government we just recently announced that the Ministry of the Environment and Climate Change has provided an initial $100,000 to the CoLab network, which allows us, as CoLab, to then incentivize our members to be able to provide them with support that they can leverage and build more support from. It's a one-off. It's certainly not our end game. We would like to be in a position to have a fund so that with that fund we could then say, yes, EnviroCentre has a business plan, let us write you a cheque, and again as you launch your program, as you get your first three members, your next 20 members.
That incentivizing we can't currently do, and we would be thrilled to have provincial and federal support to be doing work of that kind.
View François Choquette Profile
Thank you.
Ms. Ryan, I have the same question for you. I know that you have good partnerships with municipalities and the province. Can you explain the federal government's role?
Tracey Ryan
View Tracey Ryan Profile
Tracey Ryan
2015-06-04 9:41
Thank you. That's a very good question.
Similar to the previous answer, we generally are relying entirely on the province or the municipalities. The rural water quality program would not have the success it has without the commitment of the municipalities for longer than 15 years.
Where the GRCA does partner with the federal government it is through programs that come and go, through short-term funding, through any of the programs that the federal government has around eco-action, a variety of those types of things. We are applying right now for the 150th funding that came out for some capital works to improve our parks and infrastructure for the community. It is very hit and miss and when we can actually access those programs, when we qualify, when we have projects that are ready to meet the qualifications.... In some cases these may be capital works that are shovel ready or it may be targeted very much to species at risk, so through Environment Canada we apply each year to the habitat stewardship fund and successfully receive less than $100,000, which we then can make available to areas that do not have municipal support or adequate municipal support for some of those projects.
It is not consistent, but we try to leverage our other funds when available.
Thank you.
Karen R. Cohen
View Karen R. Cohen Profile
Karen R. Cohen
2015-05-28 15:56
Thank you.
Good afternoon, Mr. Chair and committee members. My name is Dr. Karen Cohen. I'm the chief executive officer of the Canadian Psychological Association or CPA.
CPA is the national association of Canada's scientists and practitioners of psychology. Approximately 18,000 psychologists are registered to practise in Canada. This makes psychologists the largest regulated, specialized mental health care providers in the country.
Psychologists are employed by publicly funded institutions inclusive of hospitals, family health teams, and primary care practices, schools, universities, and correctional facilities. However, with cuts to human resources in the public sector, psychologists increasingly work in private practice.
Their scope of practice includes the assessment and diagnosis of mental disorders and cognitive functioning, the development and evaluation of treatment protocols and programs, the delivery and supervision of treatment, and research.
We are pleased that in the 2015 federal budget the Government of Canada indicated its intention to renew the Mental Health Commission's mandate for 10 years. CPA has a long history of involvement with the commission from providing support for its creation, sitting on advisory committees, and providing input on past and current projects. This new investment will hopefully give the commission a mandate to implement the recommendations of the mental health strategy. The strategy scoped out the changes that Canada needs to make to enhance the mental health and well-being of its citizens. It's now time to make change happen.
The strategy called for increased access to evidence-based psychotherapies by service providers qualified to deliver them. We hope that the commission will work with governments and other stakeholders to move this important recommendation forward.
Research has demonstrated that psychological treatments are effective for a wide range of mental health disorders such as depression, anxiety, eating disorders, and substance abuse. They are less expensive than, and at least as effective as, medication for a number of common mental health conditions. They work better than medication for some kinds of anxiety. They lead to less relapse of depression when compared to treatment with medication alone. They lead to patients who better follow through on treatment, feel less burdened by their illness, and have lower suicide rates when used with medication for bipolar disorder. They help to prevent relapse when included in the services and supports for persons living with schizophrenia. And, finally, they reduce depression and anxiety in people with heart disease, which when combined with medical treatment, leads to lower rates of heart-related deaths.
Despite this evidence, there are significant gaps in service and care when it comes to mental health. Canada has no parity in its public funding of mental and physical health care. Canada's mental health strategy tells us that spending on mental health in Canada has been measured at only 7% of total health spending. Psychological services are not covered by our public health insurance plans. Canadians either pay out of pocket or rely on the private health insurance plans provided by employers. Coverage through private plans is almost always too little for a clinically meaningful amount of service.
Erin Anderssen from The Globe and Mail hit the nail on the head this week when she wrote about this health crisis. She stated, “We have the evidence...Why aren't we providing evidence-based care?”
Access to treatment should not depend on your employment benefits or your income level. Those who cannot afford to pay for treatment end up on long wait lists, they have to depend on prescription medications, or they simply do not get help at all. If we want a health care system that will deliver cost and clinically effective care, then we must re-vision policies, programs, and funding structures through which health care is provided.
CPA commissioned a report by a group of health economists that proposed several models of delivering enhanced access to psychological services for Canadians. The report provides a business case for improved access to psychological services based on demonstrating positive return on investment and proposed service that yields desired outcomes. It looked at countries like the United Kingdom, Australia, the Netherlands, and Finland that have programs that make psychological services accessible through public health systems.
A 2012 report on the U.K.'s improving access to psychological therapies program says it has treated over 1.1 million people, with a recovery rate in excess of 45%. Some 45,000 people have moved off sick pay and benefits. Savings from the program in 2015 are estimated at £272 million for the National Health Service and £700 million for the entire public sector. By the end of 2016-17, the net financial benefit of the program is pegged at £4.6 billion and judged attributable to prevention, early intervention, and a reduction in absenteeism.
Mental disorders that are addressed promptly and effectively will yield a cost offset from their treatments. That can include fewer medical visits and interventions, and decreases in short- or long-term disability. On the other hand, untreated or undertreated disorders cost the workplace tens of billions of dollars annually.
Accessing needed psychological care affects people across their lifespan.
The May 2015 report from the Canadian Institute for Health Information showed that emergency room visits and hospitalization rates for children and youth with mental disorders have increased since 2006, particularly for those between the ages of 10 and 17 with mood and anxiety disorders. Use of psychotropic medications has increased as well. A 2011 report from the Canadian Policy Network and CIHI shows that the strongest evidence for return on investment in mental health involves services and supports that are geared to children and youth and that reduce conduct disorders and depression, deliver parenting skills, provide anti-bullying and anti-stigma education, promote health in schools, and provide screening in primary health care settings for depression and alcohol misuse.
Canada's population is aging and seniors will also face barriers to accessing necessary psychological care. While many of us will age in relatively good health, others will face a wide range of cognitive, emotional, and physical challenges that include dementia, depression, anxiety, chronic disease management, and end-of-life care. As many as 20% of seniors are living with a mental illness. Depression occurs in about 40% of patients who have had a stroke. Up to 44% of residents in long-term care homes have been diagnosed with depression and 80% to 90% have a mental illness or cognitive impairment.
Canada has taken some very important steps to improve the mental health of Canadians. Campaigns and public conversations deliver the message that Canadians can and should seek help for their mental health problems. Collectively, we are reducing the stigma of mental health and substance use disorders. However, only about one-third of Canadians seek and receive such help. While stigma may be one barrier, access to care is another.
It is time Canada walked the talk and made needed treatments and supports available. We need a health care system that is nimble enough to respond to the health needs of our citizens, deliver evidence-based care, and hold us accountable for care delivered. To accomplish these goals, innovation is needed.
The federal government has an important role to play in Canada's mental health. This role includes delivering care in jurisdictions under its authority, increasing or targeting mental health transfers to provinces and territories, and collaborating with provinces and territories in delivering effective innovations in health promotion, illness prevention, and health care delivery.
To ensure that innovations in mental health care delivery happen, the federal government can set up an innovation fund to assist provinces and territories in developing sustainable mental health infrastructure across Canada that will bring psychological care to Canadians who need it. The fund could, for example, be used by the provinces and territories to adapt the United Kingdom's improved access to psychological therapy programs here in Canada and to expand the role of primary health care in meeting mental health needs.
Finally, investment in research and training for students is also critical to the success of Canada's health system, the success of which will depend on its ability to effectively respond to the changing health needs of Canadians. While research into the biomedical causes and treatments of mental disorders is important, research into the psychosocial determinants and treatments is equally important. Like many more long-standing health conditions, mental disorders involve a complex interplay of biological, social, and psychological determinants and depend on a team of providers, services, and factors for their treatment and management.
Canada is poised to do better by the mental health of Canadians. The Canadian Psychological Association is very pleased to participate in this work.
Thank you for the opportunity to present to this committee
View Costas Menegakis Profile
Thank you, Mr. Chair.
Mr. Kurland, welcome back. It's always a pleasure to have you appear before us, sir, to share your extensive wisdom and knowledge on matters of citizenship and immigration with us.
Express entry is, of course, a form of automated decision making, as you know. I wonder if you could share with us your thoughts on this initiative thus far. Has it been successful?
Richard Kurland
View Richard Kurland Profile
Richard Kurland
2015-05-28 10:02
The design is a successful design. Much was done in a relatively short period of time on the information technology side. There are growing pains. There are known stumbling blocks. For example, hundreds of passports disappeared electronically from CIC's express entry system. Those bugs are being worked out.
The latest news is that the provinces have aligned themselves with the express entry system, streamlining and electronically structuring their intake systems to mesh with the new federal express entry system. I did not think that so much could be accomplished in so little time. It is a work in progress, but my goodness, once again Canada is going to be a model to the world on this one.
Derryk Fleming
View Derryk Fleming Profile
Derryk Fleming
2015-05-26 19:48
I'd like to thank Brian right off the bat. He made three of the four main points that I wanted to express.
I'd like to thank the honourable members of all parties of the standing committee for allowing me this opportunity to speak.
In division 17, I believe that overall the legislation is reasonable and prudent. It will assist veterans and their families who have the most serious needs. It addresses their long-term financial security needs—although Brian did raise an excellent point there—it provides some measure of respite for their primary caregivers, and it establishes the critical injury benefit. Most importantly, it will do much to close the seam between a CF member's release and their accessing services through VAC in a much more proactive manner.
Those veterans most in need will be better looked after by this new piece of legislation. I believe strongly that the standing committee will act in the best interests of all veterans.
More work needs to be done in the transitioning of less seriously injured veterans. Priority hiring in the federal service is [Inaudible--Editor], as is the creation of Canada Company. Helmets to Hardhats also can play a vital and important role.
One area that hasn't been discussed and is a very important missing piece is the synergy between the federal government and the provinces. The provincial governments' ministries of colleges and universities have little understanding of the training and experience that a veteran brings to the workforce.
Recently, the British Columbia Institute of Technology has created a process of translating these skills for civilian accreditation purposes, but more colleges and universities in each separate jurisdiction need to be encouraged to follow suit.
Ideally, once a CF member is released both VAC and the member should have a clear understanding of the provincial accreditation that members would already have, guiding their retraining choices and entering into the civilian workforce much more quickly than starting at zero once again. The smoother the transition, the less strain on both the member and the family, and the resources needed to facilitate that transition can be achieved.
To accomplish this outcome requires [Inaudible--Editor] initiatives and diplomacy between the federal and provincial levels of government. It will not require vast sums of funding to accomplish this coordination. If successful, it will streamline the transition profoundly, however.
For the sake of brevity, I don't want to repeat some of the main points that Brian has already illustrated; they're actually much better than what I had written. But this is one missing piece, and if we're going to transition the majority of veterans who do not qualify as moderately or severely injured, we don't want to leave them out of the mix as well.
I thank you for the opportunity and respectfully submit, Derryk Fleming, 31 CBG Veterans Well-being Network.
View Stéphane Dion Profile
Lib. (QC)
Is it your sense that it should be provincial? Or do you care whether it's provincial or federal as long as it's done?
Emily Molnar
View Emily Molnar Profile
Emily Molnar
2015-05-25 16:12
We need both. I know right now that the BC Arts Council cannot support that entire endeavour, not even for Ballet BC, not for the entire province. We actually would need a partnership, and if the federal government would would be wonderful.
Fred Phelps
View Fred Phelps Profile
Fred Phelps
2015-05-14 15:32
Thank you, Mr. Chairman.
Thank you for the opportunity to present to this committee. My name is Fred Phelps. I'm the executive director of the Canadian Association of Social Workers. The CASW is a proud organization in the Canadian Alliance on Mental Illness and Mental Health, better known as CAMIMH. It is on CAMIMH's behalf that I present to you today.
CAMIMH is a non-profit organization comprising 16 national health care providers as well as organizations that represent individuals with lived experience of mental illness. It would be remiss of me not to acknowledge today that both the CPA and the Mood Disorders of Canada organization are also members of the Canadian Alliance on Mental Illness and Mental Health.
Established in 1998, the alliance provides collaborative national leadership to assure that individuals living with mental illness receive the services and supports they require for recovery. CAMIMH also advocates for government policies aimed at reducing the impact of mental illness on the Canadian population and economy, a negative impact estimated at more than $50 billion annually or almost 3% of GDP.
Our coalition's members span the entire spectrum of mental illness and care in Canada, representing patient groups and professional service provider organizations such as my own. As such, we have a unique and strong voice for the one in five Canadians living with mental illness and, more often than not, without adequate access to services to address those illnesses.
CAMIMH was exceptionally pleased with the recent announcement in Budget 2015 that the mandate and funding of Canada's Mental Health Commission would be extended for a further 10 years to 2028. The Mental Health Commission of Canada played the leading role in developing Canada’s first national mental health strategy. CAMIMH advocated for the establishment of the Mental Health Commission of Canada and has long pushed for its mandate to be extended beyond the originally funded 2017-18 timeline.
CAMIMH and its members look forward to engaging with the government, the Minister of Health and, indeed, this committee on establishing the terms and objectives for the second decade of the Mental Health Commission of Canada’s mandate. Though we all agree that there has been much talk about mental health and mental illness in recent years, which is undeniably a good thing, what is needed now is to shift from talking into action. Moving from awareness to action means investments in policy development and, yes, financial resources dedicated to ensuring these vital objectives are met.
Today I am here to present four recommendations on behalf of CAMIMH.
First, as per recommendation 3.1.1 of the national mental health strategy, we would like to see a mental health innovation fund established at the federal level in the amount of $50 million to help foster and disseminate best practices currently taking place across the country.
While we know there are many pockets of excellence when it comes to providing Canadians with access to leading-edge innovative mental health services and programs, the reality is that there's a lack of national coordination and resourcing to ensure that they spread across the health system effectively and equitably. Though the delivery of health care services is largely a provincial and territorial responsibility, CAMIMH knows there is a catalytic role for the federal government to play when accelerating and adopting those proven innovations in mental health.
Secondly, to provide the leadership on workplace mental health, we recommend that the federal government implement the Mental Health Commission of Canada's national standard for psychological health and safety in the workplace—the standard—in a major federal department. In our view, the standard can play an important role in improving overall workplace health and increasing productivity.
While the standard is currently piloted by a number of public and private organizations under the auspices of the Mental Health Commission of Canada, our hope is that it will be widely adopted by public- and private-sector employers across the country. As the country's biggest employer, the federal government should lead the way. While the standard does not expressly address the needs of those working with mental illness, it does support a workplace environment in which all people can work to the best of their abilities.
Our third recommendation concerns the measurement and evaluation of mental health systems in Canada as a basis for improving quality. In the area of mental health, we need a set of system performance indicators to effectively assess and improve the performance of Canada's mental services and systems.
At present, there are no agreed-upon mental health indicators that provide a clear picture of how mental health systems are performing, particularly in terms of measures of access to and the appropriateness and outcomes of services. Additionally, where data is available, it focuses on acute care hospitals, and not community programs and services. This is unfair to people who need and receive services in communities, in the venues where many of Canadian mental health problems are most effectively treated and where, unfortunately, services are insufficiently covered by public and private health insurance plans.
While we are pleased to see that important work has been initiated in the area of mental health indicators and expenditures by the Mental Health Commission, the Public Health Agency of Canada, and the Canadian Institute for Health Information, work on mental health performance indicators needs to be advanced as a national priority to ensure accountability and results. CAMIMH is of the view that the federal government, working in close partnership with the provinces and territories, can play a groundbreaking role in terms of developing the national mental health performance reporting and quality improvement initiatives.
Finally, though health care delivery is constitutionally a responsibility of the provincial and territorial governments in this country, there are several large and under-serviced groups for which Ottawa is directly responsible—veterans, first nations, and RCMP members, to name a few.
Our final recommendation is to establish and implement a mental health strategy to better provide services to the populations for which the federal government has direct responsibility. Recognizing that the populations for which the federal government is responsible face unique mental health challenges and that the services currently provided are inadequate, the government has an opportunity to lead by example by providing a more robust set of mental health services to these groups, and can help demonstrate that in the long run, enhanced investment in mental health pays fiscal and economic, as well as social and human, dividends.
Our needs are great, but so are our resources. Canada is one of the most prosperous and fortunate nations on earth, yet too many of our citizens lack the mental health services they need. Increasing the availability of these services is a social and economic imperative we can no longer afford to ignore.
Thank you for your time. I look forward to any questions you may have.
J. Michael Miltenberger
View J. Michael Miltenberger Profile
Hon. J. Michael Miltenberger
2015-05-14 8:48
Good morning.
Thank you for the opportunity to share our views on the Canada Water Act Annual Report for April 2013 to March 2014.
In our review of the report, we did not identify any areas of significant concern to the Government of the Northwest Territories; however, we noted a shortage of detail relevant to the north in some sections of the report when compared with the descriptions for other jurisdictions, such as in the water quality and Canadian Aquatic Biomonitoring Network monitoring sections.
The Government of the Northwest Territories has a strong interest in Canada's basin-wide quality, quantity, and biological monitoring commitments, especially with regard to implementation of the Mackenzie River Basin Bilateral Transboundary Water Management Agreements, which I will talk about a bit later.
It is encouraging to see the work being done under the Canadian Aquatic Biomonitoring Network or CABIN program. The GNWT has a strong interest in broadening water monitoring to include monitoring of biological indicators. We see value in moving forward to complete the CABIN large river protocol so that such an approach could be applied to important rivers such as the Slave River. In addition, the GNWT has a community-based monitoring program that could benefit from adding a biological monitoring component.
Regarding monitoring, we note that while there is some information in the report, we'd be interested in more information regarding the joint oil sands monitoring program, particularly about the expansion of biological monitoring under this program into the Northwest Territories.
The report notes that many jurisdictions in Canada have water quality agreements. The Canada-Yukon Water Quality and Aquatic Ecosystem Monitoring and Reporting Memorandum of Agreement, which we understand is awaiting signature, is broader in scope than water quality. Such agreements may be an approach our government wants to consider.
Finally, the report notes on page 17 that the MRBB tracked the progress of three bilateral water management negotiations, between British Columbia and Alberta, Alberta and Saskatchewan, and the Northwest Territories and Alberta.
I'd like to take this opportunity to update the committee on recent progress on bilateral transboundary water agreements, as well as on regulatory changes in other water initiatives in the Northwest Territories that are not included in the report.
I will turn first to the transboundary water agreement.
The transboundary water management agreement negotiations process between Alberta and the Northwest Territories is complete. The final agreement was signed on March 18, 2015. Input from aboriginal involvement and public engagement informed this final agreement. We're now working with Alberta to develop an implementation plan for the Northwest Territories-Alberta agreement. We're also working with aboriginal governments on an inter-governmental agreement to provide clarity on aboriginal government involvement and implementation of transboundary water management agreements.
The Northwest Territories and British Columbia intentions document and appendices—basically a draft agreement—are finished. We have completed aboriginal consultation and public engagement processes on these documents. British Columbia is still completing its consultation process. Once the intentions document for the Northwest Territories and Saskatchewan and the Northwest Territories-Yukon bilateral agreements are complete, further public engagement and aboriginal consultation will be done.
We met with the Government of Saskatchewan in late January 2015 to discuss the process and work required to negotiate a transboundary water management agreement for the waters along our shared border. Our government, the Yukon territory government, and other parties to the existing Yukon-Northwest Territories Transboundary Water Management Agreement met in late February 2015 to discuss the existing agreements and the next steps to renegotiating the existing agreement for the Peel basin.
We anticipate meeting with Saskatchewan in late spring 2015 to continue negotiating a transboundary water management agreement. We have officials in Nunavut today and tomorrow talking about the possibility of a similar transboundary water agreement to cover the whole boundary between the Northwest Territories and Nunavut.
As previously indicated and mentioned, our government is seeking a long-term commitment from Environment Canada to conduct water quantity, quality, and biological monitoring within the Mackenzie River basin to assess ecosystem health and support implementation of the transboundary water management agreements.
I'd now like to talk about water stewardship in the Northwest Territories. We recognize that the key to protecting such a precious resource as water lies in partnerships and collaborations with water partners, including those within our borders and those in neighbouring jurisdictions.
To address concerns related to upstream development and climate change, we developed the Northern Voices, Northern Waters: NWT Water Stewardship Strategy in 2010. The strategy was created to safeguard our water resources for current and future generations. It was followed by the Northwest Territories Water Stewardship: A Plan for Action 2011-2015.
We developed a strategy and action plan with the Government of Canada in partnership with seven aboriginal governments, and with input from numerous water partners and the public. Through many meetings with aboriginal leaders across our territories, as well as workshops with federal and territorial government departments, regulatory boards, non-governmental organizations, community members, academics and industry, we crafted the goals and visions for the strategy, along with the other core elements.
The vision for the water strategy is that the waters of the Northwest Territories remain clean, abundant, and productive for all time. The water strategy sets a common path forward for achieving effective water stewardship in the Northwest Territories. It is a key guiding document that identifies our approach to maintaining aquatic ecosystem health, involving communities in aquatic monitoring and research, and ensuring safe drinking water in the Northwest Territories. The strategy integrates western science and traditional local knowledge and is the basis for our mandate of negotiating transboundary water management agreements with other Mackenzie River basin jurisdictions.
I would like to conclude with some words on changes to water management and regulation in the Northwest Territories following devolution, which occurred on April 1, 2014. On April 1, 2014, the Government of the Northwest Territories became the primary land and water manager in the Northwest Territories. As the primary water manager, the Department of Environment and Natural Resources undertakes a number of water quality and water quantity monitoring programs, including programs that monitor sites in collaboration with communities. Our monitoring programs are designed to address identified community concerns and provide robust technical information for use in making sound resource management decisions.
The Mackenzie Valley Resource Management Act and the new territorial Waters Act define the legal authorities for water management. A co-management regime has been established. Regional land and/or water boards have defined authorities with respect to water licensing for various undertakings throughout the Northwest Territories. GNWT technical experts actively participate in regulatory processes, providing input and advice to land or water boards for their use in their decision-making processes. Data obtained through our water monitoring programs is provided to compliment data collected by project proponents and other parties. Our government has new authorities with respect to the approval of type A water licenses, and type B water licenses where a public hearing has been held. For activities on lands transferred through the devolution and final agreement, the Minister of Environment and Natural Resources must approve all type A water licenses and any type B water licenses where a public hearing was held. Type A water licenses are generally associated with larger projects of longer duration, for example, producing metal, a diamond mine, or an oil and gas production facility.
Type B water licenses are generally associated with smaller projects of shorter duration, such as an advanced mineral exploration project or an oil and gas exploration program. Recent legislative changes to the Mackenzie Valley Resource Management Act have introduced legislative timeframes for ministerial decision-making with respect to water licenses. The minister has up to 45 days following receipt of a board recommendation to render a decision. The minister may, however, under legislation, extend the decision period for an additional 45 days, corresponding to a maximum of 90 calendar days. The first type A water license approved by me as Minister of Environment and Natural Resources occurred on April 24, 2014, 22 days after receiving the board recommendation. Since April 1, 2014, nine type A water licenses have been approved.
My final comment would be of a broader nature. As we talk about a national energy strategy in Canada, I want to once again make the point that you cannot talk about a national energy strategy without talking about some type of national water strategy, because the two are inextricably linked, almost without exception. So as we once again have that national debate, we have to keep in mind that with hydro, with the water for oil and gas development, with the water required in nuclear plants, the two are linked.
Thank you.
View Stephen Woodworth Profile
Does the Government of Canada have any continuing role in some of the transboundary water negotiations that you were mentioning earlier with British Columbia, the Yukon, and Alberta, for example? Is it a partner in those negotiations?
J. Michael Miltenberger
View J. Michael Miltenberger Profile
Hon. J. Michael Miltenberger
2015-05-14 9:13
There are two things. The federal government has a continuing role with the broad agreement in the Mackenzie River Basin Board, which enables bilateral agreements to be negotiated. They currently chair that. It's a board that needs revitalizing, because the ministers haven't met since 1997.
In regard to the transboundary agreements, they are between the particular provincial and territorial jurisdictions. The federal government, and mainly Environment Canada, of course, plays a critical role in its broad national obligation to do the monitoring of water quality and quantity issues. I talked a bit about that in my comments. They have a critical role there, and then they have a critical role on the board, where they are a key player. The federal government was instrumental, in fact, in pulling the Mackenzie River Basin agreement jurisdictions together to get this agreement signed.
View Stephen Woodworth Profile
Excellent. Thank you.
Mr. Miltenberger, I was interested in your comment that you are looking for a further agreement with the Government of Canada for water quality and quantity monitoring in the Mackenzie River basin. I'm not sure what role the Mackenzie River Basin Board has in relation to water quality and quantity monitoring.
Can you help me out with that?
J. Michael Miltenberger
View J. Michael Miltenberger Profile
Hon. J. Michael Miltenberger
2015-05-14 9:14
The Mackenzie River Basin Board Transboundary Waters Master Agreement was signed by all the involved jurisdictions, including the federal government. That agreement enabled the setting up of the board. It also triggered the responsibility to negotiate these bilateral agreements.
Since 1997, things had been pretty well dormant. There was only one bilateral that was negotiated, in about 1999; that was between the Yukon and the Northwest Territories. It's only been in the last three years where there has been a concerted, intense effort to get the bilateral agreements negotiated and the concern about the water has mounted.
The federal government has a key role at the Mackenzie River Basin Board level. They have a key role in all of the jurisdictions—Saskatchewan, B.C., Alberta, Northwest Territories, Yukon—because they have some very important water monitoring infrastructure that we were looking to make sure stays there as we move forward. They talk about including biological indicators, making sure that the networks and their infrastructure are expanded to do that. We will also be putting our resources into the mix with them as well.
The other critical point with these agreements is that we now share all that information across the Mackenzie River basin, which is one of the biggest basins in the country. It gives us a much more comprehensive look at baseline data in terms of water quality issues, water quantity issues. We're moving to groundwater, air monitoring, all these very critical areas.
View Stella Ambler Profile
Thank you, Mr. Chair.
Thank you, Dr. Fox and Mr. Miltenberger, for appearing to help us in our discussion and study of the Canada Water Act.
Mr. Miltenberger, I'm interested in your comments about water stewardship, in particular the 2010 strategy with regard to the conservation of water. I'd like to ask about those partnerships that you listed.
I'm wondering if you could tell us a bit more about those partnerships, how it works in practice, whether it's the Government of Canada, aboriginal groups, or NGOs. What kind of partnerships are we talking about? How do they better enable you to do your work in the area of water stewardship?
J. Michael Miltenberger
View J. Michael Miltenberger Profile
Hon. J. Michael Miltenberger
2015-05-14 9:24
Northern Voice, Northern Waters was a critical piece of work for us and it involved the federal government. I have it here on my desk. My signature is on it and former Minister Chuck Strahl's. It was a critical document that gave us the political licence to move forward. While there are two public government signatures on here, the development of the strategy involved all the aboriginal governments up and down the valley and in the Northwest Territories, plus the public, of course.
It's very comprehensive and that set the basis for the negotiations that have subsequently followed with the transboundary agreements.
View Cathy McLeod Profile
This leads me to the Public Health Agency of Canada.
You talked about doing some significant work in terms of data collection. It sounds like we might be heading in a good direction. What are your challenges still around appropriate data collection?
Kimberly Elmslie
View Kimberly Elmslie Profile
Kimberly Elmslie
2015-05-12 16:00
As with most national data collection, we are always challenged by identifying comparable data across the country. For that reason, we work with our colleagues in the provinces and territories on developing specific indicators so that we can all collect the data in the same way and report on them in the same way.
We have, and have had for some time, good data on the occurrences of specific mental illnesses. We have started to supplement those data where we can, and Statistics Canada, of course, is a great help to us through the national surveys it does. When we want to know more about the factors that are affecting resilience or some of the more complex measures of positive mental health, that's where the work that we have started to do with the Mental Health Commission of Canada and with our other partners is really important to us. At the end of the day, what our experts tell us is that the ability of children, as they develop through early childhood, to develop those coping skills and the ability of parents to develop parenting skills are the precursors to the resilience to deal with life's adversities down the road and to develop positive mental health.
That is why we are focused now on work that will establish what indicators Canada needs to measure over the long term to be able to say that we are going in the right direction in developing our population so that we have positive mental health.
View Cathy McLeod Profile
Mr. Phillips, the patient-specific research that is now happening, or SPOR, is a big shift. Are you doing things now that haven't been done in the past to really try to analyze this issue and move the bar on it? Is that a fair comment?
Anthony G. Phillips
View Anthony G. Phillips Profile
Anthony G. Phillips
2015-05-12 16:04
SPOR, the strategy for patient-oriented research, is emphasizing the need for more translational research.
We invest about half a billion dollars a year in generating a better understanding of all the determinants of health, but obviously people are looking for the translation of that knowledge, where appropriate, into better diagnosis and better treatment. That's the overarching theme about SPOR. The way in which it is being transacted is through a partnership with many different groups in Canada, especially the provinces, which of course have responsibility for delivering the health care services to Canadians.
We have just finalized eight support units in different geographic regions of Canada that will provide an infrastructure for ensuring, for example, a better clinical trial structure or a better analysis of the effectiveness or ineffectiveness of interventions. The difference that you might be looking for here is a strong commitment by CIHR to more translational research. That's what SPOR represents.
View Hedy Fry Profile
Lib. (BC)
Sorry, I was just going to say that I recognize that epidemiology is different and it involves comparing, but that's all we do. We compare and contrast all the time in Canada. We say, “Look, we're number one in the world.” So they're using the same thing that they can't criticize now.
The point is there were three questions that were subjectively asked of the children themselves. They were asked, “Are you happy?” and Canada ranked 24 out of 29.
I'm glad to hear that you're focused on school-based intervention, because I agree with you that this is really the most important place we can focus on.
You said that better integration of efforts is needed. I would really like to know what the barriers are to that integration of effort. Certainly as a federation, the provinces, territories, and the federal government should be able to work really closely in integrating that kind of information and not allowing this old thing of falling through the cracks to occur. What is the biggest barrier you see to this integration of effort?
Kimberly Elmslie
View Kimberly Elmslie Profile
Kimberly Elmslie
2015-05-12 16:13
I think often the barrier is not having a clear agenda on how we want to move forward together. We now have a mental health strategy for Canada, and that's a really important foundation to get us all rowing in the same direction.
View David Wilks Profile
I thank the witnesses.
Each one of you in your speeches to us today didn't use the one word I wanted to hear, and that was “stigma”. As a person who is in long-term recovery, I would like to hear from each one of you what your agencies are doing to remove stigma from either addiction recovery or mental health recovery.
I'll start with you, Dr. Phillips.
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