:
I call this meeting to order.
Welcome, everyone, to meeting number 45 of the House of Commons Standing Committee on Health. The committee is meeting today to study the emergency situation facing Canadians in light of the COVID-19 pandemic.
Before I welcome the witnesses, however, I would like to draw the committee's attention to the supplementary budget request for this study. I believe all committee members should have a copy from the clerk. This request supplements our previously adopted budget for this study. It requests an additional amount of $4,125. This covers additional costs for witness headsets, video conferencing, shipping and such. If there's any discussion, we can bring it up later. I'm hoping, however, that it is the will of the committee to approve this budget at this time.
Do we have unanimous consent to do so?
Some hon. members: Agreed.
The Chair: Seeing no dissent, thank you, all. The supplementary budget is therefore approved. Thank you.
I would now like to welcome the witnesses.
[Translation]
We welcome, as an individual, Professor Alain Lamarre from the Institut national de la recherche scientifique (INRS).
[English]
Also as an individual, we have Professor Ambarish Chandra from the University of Toronto. We have Dr. Michael Silverman, chair and chief of infectious diseases at Western University. From the Lu'ma Medical Centre, we have Dr. Michael Dumont, medical director and family physician.
We'll start with statements. I will advise the witnesses that I shall hold up a yellow card when their time is in the vicinity of being over, and I'll hold up a red card when it's actually over.
If you see the red card, please try to wrap up. You don't have to quit instantly, but do try to wrap up. Thank you.
[Translation]
We'll begin with Mr. Lamarre.
Professor Lamarre, you have the floor for five minutes.
:
Thank you very much, Mr. Chair.
First, I would like to thank the committee for inviting me to participate in this meeting.
I would like to take a few minutes to talk about the importance of significantly increasing research funding in Canada, particularly for basic research. I believe that this is a key issue in maintaining and enhancing Canada's place on the world stage of health innovation.
I am a full professor at the Centre Armand‑Frappier Santé Biotechnologie of the Institut national de la recherche scientifique in Laval. I have been studying the immune response to viral infections and vaccines for over 20 years. As a result, I have been able to see a relative decrease in research funding in Canada during that period.
Basic research is an indispensable component of the development of new technologies for the prevention and treatment of disease. For example, the messenger RNA technology, which is the basis for the new COVID‑19 vaccines, grew out of developments in the design of new approaches to cancer treatment. This means that the development of innovative approaches cannot always be accelerated by targeted, problem‑specific investments, but often comes from broad investments in basic research, the potential benefits of which were often unsuspected at the outset.
The business model of the pharmaceutical industry has changed dramatically in recent decades. Large pharmaceutical companies are increasingly turning to the public and academic sectors to develop new technologies, rather than relying solely on their own research and development resources. For this reason, a rich and diverse public research ecosystem is increasingly important in the development and commercialization of innovative new treatments for patients.
The majority of biomedical research funding in Canada comes from the Canadian Institutes of Health Research (CIHR). According to a recent analysis by the Canadian Association for Neuroscience using CIHR data, the success rate of funding applications to CIHR open competitions has steadily declined since 2005, from a 31% success rate to less than 15% in 2018. Such a low success rate means that excellent applications are not funded and will need to be resubmitted, placing a significant additional workload on researchers and potentially even leading to the closure of successful labs, especially for researchers just starting their careers. In addition to the low success rate of CIHR projects in open competitions, applications that are funded typically see the budget reduced by more than 25%, further demonstrating the glaring lack of funding.
According to data from the Organisation for Economic Co‑operation and Development (OECD), Canada is the only G7 country where gross domestic expenditures on research and development have been declining since 2001. It is now the second lowest in the G7 on this measure, ahead of only Italy. As an example, the per capita amount of research investment is more than three times higher in the United States than in Canada. This clearly demonstrates the considerable effort that Canada should make to become a world leader in this area.
As a contribution to the reflection on these strategic issues, I would like to propose two measures that the Government of Canada could consider in order to maximize the benefits of its investments in biomedical research. These actions are consistent with recent recommendations from the Canadian Association for Neuroscience and with the final report of the Advisory Panel on Healthcare Innovation, entitled “Unleashing Innovation: Excellent Healthcare for Canada.”
First, federal investments in basic research in Canada should be increased by 25% now, and by 10% per year for the next 10 years, in order to catch up with other G7 countries. Second, federal investments in leading‑edge research infrastructure through the Canada Foundation for Innovation (CFI) must be continued and increased. We know that new advances in basic research require state‑of‑the‑art infrastructure. Such infrastructure entails significant operating and maintenance costs for researchers and universities. It will therefore be essential in the coming years to continue and increase CFI investments, not only in infrastructure, but also in its long‑term operating and maintenance costs.
In conclusion, the COVID‑19 pandemic has highlighted the importance of having a rich and diverse basic research ecosystem to better protect against future health crises.
Canada should make significant additional efforts to re‑establish itself, as a world leader in research and development and should invest heavily in research funding over the next decade.
Thank you. I am available to answer your questions.
:
Good afternoon, and thank you for inviting me today.
I'm an associate professor of economics at the University of Toronto. My past and current research focus is on airlines and the U.S.-Canada border. I have published articles in this area, and I have written a number of related opinion pieces in the media. I have previously provided testimony to Senate committees on the subject of airlines and cross-border travel. My statement today is on Canada's policies towards the border and international travel since the start of the pandemic.
In my opinion, Canada has made some correct decisions but also some mistakes in its approach to the border. I am sympathetic toward those who had to make quick decisions in stressful times, often with little available data or evidence, so these remarks are not meant to be overly critical. However, it is important to recognize the correct decisions, as well as identify the mistakes, to prevent them from happening again.
Economists do not generally favour severe restrictions on international travel. My own research shows the huge social and economic benefits of travel, yet last year I wrote to support the decision to stop non-essential travel between the U.S. and Canada. I still believe that decision was correct.
I also believe that Canada's government correctly identified major essential sectors that were exempted from any travel restrictions. These were defined by Public Safety Canada and include categories such as food, water, health, manufacturing and others.
I believe mistakes were made and continue to be made in the mandatory testing and quarantine procedures for travellers entering Canada. Many travellers were exempted from quarantine or testing, including those who provide essential services, those who maintain the flow of essential goods or people, and those who commute for work or school. We correctly exempted these travellers from testing and quarantine, yet we continue to impose these requirements on a small minority of travellers for little purpose.
To be clear, it was necessary to exempt truck drivers, other transportation staff, commuting workers and students, and anyone working in an essential industry. We have incredibly highly integrated supply chains with the United States. Our food networks, manufacturing supply chains and deliveries of everything from medicines to construction supplies require regular cross-border travel. Trucks won't cross if drivers need to quarantine for two weeks. Everyday commuters cannot realistically quarantine, and health staff should not be deterred from crossing the border.
By my calculations, around 14,000 trucks enter Canada every day from the United States, which is about five million per year. I also estimate around two million car trips by commuters per year. When I add together the truckers, commuters, essential workers and other exempt travellers, I estimate that over 80% of current cross-border travellers are not required to test or quarantine.
Canadians have been led to believe that testing and quarantine at the border protects us from infectious disease and emerging variants, but in fact these policies are weak. Consider, for example, returning snowbirds who cross the border by taxi, as they're permitted to do. Even if fully vaccinated, the snowbirds still need to test three times and quarantine for 14 days, meanwhile the taxi driver, who may well be unvaccinated, is not required to test or quarantine.
Given this, there can be little doubt that viruses and their variants that are present in, say, the United States, have made and will continue to make their way here no matter what. Why, then, do we require the remaining 20% of travellers to test and quarantine and to do so even when they have evidence of vaccination? Continuing to test and quarantine fully vaccinated travellers is extremely expensive for the government, time-consuming for CBSA and onerous for travellers, for no clear benefit.
Canada's government is currently ignoring clear recommendations from its own expert panel to let vaccinated travellers enter freely, and also to resume normal cross-border flows. This is baffling. Past governments have always supported the free flow of people and goods, and opposed moves to “thicken” the border. Canada acted quickly in the wake of 9/11 to prevent the border from being closed, and successfully carved out Canadian exemptions to American regulations such as passport requirements and the buy America provisions. Canada's policy has always been that a relatively open border is in the clear interests of Canadian citizens and businesses.
It would be a massive miscalculation for Canada to continue restricting most forms of travel, given the low case numbers in both countries, especially as U.S. lawmakers express their own bafflement and frustration at the continuing situation. At stake are not just the charter rights of citizens but also the survival of the tourism industry, which employs, directly or indirectly, 10% of Canadians.
At some point, Canadians can expect to see a commission of inquiry to examine Canada's response to the pandemic. While there are many aspects that will be evaluated, the government's handling of the air and land borders must receive special attention. I have no doubt that an inquiry would reveal both correct and incorrect decisions. We must record and acknowledge these in order to improve our future decisions.
Thank you.
:
Thank you for the invitation to speak to you today.
I would like to address the issue of health care worker COVID vaccination.
Vaccination of health care workers has been an incredibly effective intervention in the control of COVID-19. A study by the Cleveland veterans affairs department found that health care workers who had been vaccinated had a 19-fold lower risk of acquiring COVID than those who were unvaccinated. Furthermore, the institution suffered from four COVID outbreaks, all of which were associated with transmission from unvaccinated health care workers. There were no outbreaks from vaccinated workers.
A recent outbreak involved a single unvaccinated health care worker who transmitted COVID to 20 other health care workers and 26 residents, and led to three patient deaths. This occurred despite the facility having extensive patient vaccination.
In Canada, there is a wide variation in health care worker vaccination rates between institutions, with many having staff vaccination rates well below the general population. As having your personal health care worker vaccinated can help protect you from exposure, these variable rates in vaccination raise an important issue of equity in health care delivery and patient safety.
Many patients do not respond to the vaccine because of serious underlying conditions, such as cancer, dialysis, organ transplantation or other immunocompromising conditions. They are vulnerable, and thus dependent on the health care workers and those around them to shield them from exposure to COVID.
Unlike going into a private business, patients who need to go to hospital cannot simply choose to stay home. Therefore, we have a moral obligation to assure these people that we will do everything we can to prevent them from becoming catastrophically ill and dying while in our care.
This then raises the issue of whether vaccination should be mandatory for health care workers who provide direct patient care.
Several concerns about a mandatory vaccination policy have been raised. Firstly, due to personal privacy concerns, health care workers do not have to even report their health care information to their institution.
Although it is true that the principle of privacy of health care information needs to be maintained, there are well-established exceptions where the public has a right to know in order to be protected. An individual’s struggles with alcoholism should remain a private matter. However, if that individual is a commercial pilot, the airline safety regulator has a well-established right to demand this information.
In our own experience, many of us would not be comfortable having someone who was unvaccinated come into our home. However, when a patient is ill in hospital, they at present have no right to even ask whether the health care worker entering their room is vaccinated.
The vast majority of patients would not consent to being directly cared for by a non-vaccinated person. However, this practice is still commonplace and is only maintained because of a lack of transparency, which enables the system to deny this information to the patient.
Patients have a right to expect that when they are being cared for in a medical facility, scientific principles will be used to determine the approach to care. We would not accept a health care worker making a unilateral decision, based on the belief that hand washing is not necessary, to continue to provide care between patients without washing their hands. Certain scientific principles that have overwhelming consensus and important patient safety issues must be maintained in order to provide a science-informed basis in care.
I am not recommending that any individuals who feel strongly opposed to vaccination must undergo it against their will. However, I do say that providing frontline health care services is a privilege and not a right.
If health care workers choose not to be vaccinated, despite the well-documented risks to both themselves and their patients, then hospitals should be able to decide not to allow their patients to be put at risk. These workers may be redeployed to non-frontline activities, if possible, or if not, then terminated. Special arrangements for health care workers with a vaccine allergy will have to be made, but a true vaccine allergy is an extremely rare phenomenon.
Our hospitals already mandate that health care workers provide proof of vaccination against other common transmissible agents, including measles and hepatitis B. Several countries have instituted mandatory health worker COVID vaccination policies.
The United States Equal Employment Opportunity Commission has ruled that all companies can mandate employees to be vaccinated in order to protect their customers. Many large U.S. hospitals have, therefore, undertaken a mandatory staff vaccination policy.
In Canada, however, despite the fact that most health care leaders would like to institute such a policy, they have been hamstrung by concerns regarding the legal framework, including the Charter of Rights and Freedoms, and a lack of federal or provincial direction.
Federal guidance and a national strategy on this issue are urgently needed. I therefore request that a committee be set up that would include representatives of health care institutions, health care providers, ethicists, patient advocacy groups and legal experts. This would enable rapid development of guidelines regarding implementing mandatory COVID vaccination policies for frontline health care workers.
Thank you.
My name is Michael Dumont. I am Anishinabe Marten Clan. My family is from the Shawanaga First Nation, and I also carry mixed European ancestry. I am calling from the unceded territory of the Musqueam, Squamish and Tsleil-Waututh peoples, where I am honoured to make my home. I am a family physician and represent the Lu'ma Medical Centre, where I serve as medical director.
I would like to thank the committee for the opportunity to speak today about urban indigenous primary care in the COVID-19 pandemic.
Indigenous peoples in Canada experience unacceptable disparities in health outcomes, and there continues to be a large unmet need for culturally safe medical care to address this gap. With this goal in mind and guided by TRC call to action 22, in 2016 we established Lu'ma Medical Centre, an indigenous-operated not-for-profit society. Our centre delivers safe, culturally integrated primary care to 1,900 indigenous people in urban Vancouver through a team-based, two-eyes-seeing model, blending western and traditional indigenous approaches to health and healing.
We have been fortunate to build excellent partnerships with the First Nations Health Authority, Vancouver Coastal Health and our provincial health ministry in developing our community-guided service plan, which funds our multidisciplinary team. The support from our local MP, , and our provincial MLA and health minister, Adrian Dix, has been invaluable.
However—
Indigenous peoples in Canada experience unacceptable disparities in health outcomes, and there continues to be a large, unmet need for culturally safe medical care to address this gap. With this goal in mind and guided by TRC call to action number 22, we established Lu'ma Medical Centre in 2016, an indigenous-operated not-for-profit society. Our centre delivers safe, culturally integrated primary care to 1,900 indigenous people in urban Vancouver through a team-based, two-eyed-seeing model, blending western and traditional indigenous approaches to health and healing.
We have been fortunate to build excellent partnerships with the First Nations Health Authority, Vancouver Coastal Health and our provincial Ministry of Health, in developing our community-guided service plan that funds our interdisciplinary team. The support from our local MP, Don Davies, and our provincial MLA and provincial health minister, Adrian Dix, has been invaluable.
However, we stand in a difficult position. We are facing unprecedented demand for our primary care services, fuelled by the overlapping health emergencies of the COVID-19 pandemic, opiate overdose epidemic and indigenous-specific racism in health care. We have run out of physical space in our building to meet the needs of our growing patient panel and seek financial support to make the necessary capital improvements to an adjacent unit in our building to expand our services.
With this planned expansion, we plan to build two additional medical exam rooms, a physiotherapy gym, a sacred space for group healing and ceremony, a traditional medicines room, a culturally integrated pharmacy and three counselling rooms. These improvements will allow us to fully expand to the full realization of our service plan, attaching 2,800 first nations away from home and urban indigenous people to culturally safe primary care.
We have fundraised $60,000 through local and provincial partners but need an additional $160,000 to complete this capital project. It is exceedingly difficult for indigenous health organizations such as ours to access capital funding to develop needed projects like this off reserve, where the majority of indigenous people—status, non-status and Métis—live.
We call for a partnership between Indigenous Services Canada and the Department of Health to develop a funding stream for capital grants to support the development of indigenous-specific health centres off reserve. This mechanism could provide enormous benefits for status first nations and other indigenous people living in urban centres away from their home communities and help the federal government meet its commitment to closing the health gap between indigenous and non-indigenous people in this country.
I'd like to highlight how we have responded to local care needs during the COVID-19 pandemic. We are currently the sole indigenous-specific COVID-19 vaccination site in the city of Vancouver, providing cultural support services through the full vaccination experience. Of the 10 mass vaccination clinics completed or scheduled, seven have had bookings handled under the provincial booking system. At these clinics, only 1% to 29% of attendees were indigenous, as non-indigenous people were still able to book appointments and displaced our community members, who sought the familiar safe environment of our centre for their vaccinations. In the subsequent three pilot clinics where the bookings have been coordinated directly by our organization, 99% of vaccines have gone directly to indigenous community members.
We see this as a major success in overcoming vaccine hesitancy and improving immunity in our urban indigenous population, which faces higher rates of COVID-19 infection, hospitalization and death compared to non-indigenous Canadians.
We advocate for Health Canada and Indigenous Services Canada to build more direct partnerships with urban indigenous organizations such as ours, which have earned the trust of our local communities, for the safe and effective delivery of COVID-19 vaccines to indigenous people off reserve. We believe this approach will lead to higher vaccination rates and improved health outcomes compared with the current reliance on provincial or territorial partners for all off-reserve vaccinations for indigenous peoples.
Thank you very much for your time and opportunity to share the story of the Lu'ma Medical Centre in this forum.
Hay'qa o'siem. Chi miigwetch. All my relations.
:
You talked about the research and life sciences ecosystem.
On July 1, the reform of the Patented Medicine Prices Review Board, or PMPRB, will come into effect. Mr. Clark of the PMPRB told us that in five years, the board has never done a study to assess the impact of life sciences reform in Quebec and Canada.
Several witnesses, including representatives from Research Canada, told us that weakening the biopharmaceutical sector, which is a key link in the health sciences innovation chain, can be expected to have a negative impact on the entire chain in Quebec, including research institutes, teaching hospitals, contract research organizations and clinical trial centres.
Does that worry you, Mr. Lamarre?
The issue of school openings and closures has been highly debated. However, there is strong consensus that because of both the short-term and long-term developmental and mental health risks of missing in-person learning and the low likelihood of severe physical harm to children from COVID, the safest place for children is in school.
However, these considerations must be balanced against the health risks to teachers of in-person learning as well as the potential health risk to parents and the overall trajectory of community transmission. These are all medical questions. They involve triaging between various medical priorities and, therefore, are best decided by the medical officer of health.
I would differentiate these issues from political concerns such as business closures. In the setting of closing the economy, economic bailouts and mitigating strategies that involve the public purse can be employed, so the politicians have an important role in decision-making. In contrast, school closures are purely a matter of triaging health care priorities. No amount of economic bailout can compensate a child for changes in their long-term development.
Politicians are subject to community advocacy pressures, which should not impact decision-making on the best approach to maximize public health. Promises are commonly made that schools should be the last thing to close and the first to reopen. However, in practice, this doesn't happen due to strong political pressures by various advocacy groups. Data from the United States shows that with the same level of community transmission, states run by Democratic governors were much more likely to have closed their schools than states run by Republican ones.
Decisions about school closure should be apolitical and made by the public health system, with the same separation of decision-making as occurs with the justice ministry. This would assure that public health priorities remain paramount.
:
I call this meeting back to order.
Welcome to the second part of meeting 45 of the House of Commons Standing Committee on Health.
The committee is meeting today at this point to study supplementary estimates (A), 2021-22: votes 1a and 5a under the Canadian Food Inspection Agency; vote 5a under the Canadian Institutes of Health Research; votes 1a, 5a and 10a under the Department of Health; and votes 1a, 5a and 10a under the Public Health Agency of Canada.
I would like to welcome the witnesses.
Appearing today is the Honourable Patty Hajdu, Minister of Health.
Appearing with the minister we have, with the Canada Border Services Agency, Denis Vinette, vice-president, travellers branch. From the Canadian Food Inspection Agency, we have Dr. Siddika Mithani, president. From the Canadian Institutes of Health Research, we have Dr. Michael Strong, president. From the Department of Health, we have Mr. Stephen Lucas, deputy minister. With the Department of Public Safety and Emergency Preparedness, we have Monik Beauregard, associate deputy minister. From the national advisory committee on immunization, we have Mr. Matthew Tunis, executive secretary; and with the Public Health Agency of Canada, we have Dr. Theresa Tam, chief public health officer; Mr. Iain Stewart, president; and Brigadier-General Krista Brodie, vice-president, logistics and operations.
With that, I would invite the minister to present a statement for 10 minutes, please.
:
Thank you very much, Mr. Chair.
Thank you for the opportunity to appear before all of you today to speak to the supplementary estimates (A) for the health portfolio.
First of all, I wish to thank the committee members for their exceptional work over the last several months as Canada responds to COVID-19 and the pandemic. Your diligent oversight is key to ensuring we continue to work effectively together to protect Canadians during the pandemic and beyond.
COVID-19 continues to dominate our work in the health portfolio. It's, therefore, the driving force behind the spending plans I'll outline for you today.
Today, I'm joined by Dr. Stephen Lucas, deputy minister, Health Canada; Iain Stewart, president, Public Health Agency of Canada; Dr. Theresa Tam, chief public health officer; Brigadier-General Krista Brodie, vice-president, vaccine rollout task force, logistics and operations; Dr. Siddika Mithani, president, Canadian Food Inspection Agency; and Dr. Michael Strong, president, Canadian Institutes of Health Research.
I'll begin with an update on our ongoing response to COVID-19.
It's pleasing for everybody to see that disease activity continues to decline across Canada. We're seeing fewer new cases, and the number of people who are severely ill is also decreasing as overall infection rates come down. At the same time, the vaccine supply continues to increase, making it possible for more and more Canadians to get their first and second doses. As of earlier this month, there was enough Moderna vaccine delivered to the territories to fully vaccinate 85% of the adults who live and work there.
In total, 29 million doses of vaccine have been delivered across Canada. I believe that's probably outdated a bit as of today. As a result, more than 70% of eligible adults in Canada have already received at least one shot.
These trends are encouraging and of course increased vaccination, combined with strict public health measures, are working. The national case count is now at its lowest level in weeks, and we are hopeful the summer ahead will be a safer and healthier one for all of us.
Nevertheless, we are at a critical junction in the pandemic. As immunity builds across the population, we have to continue to work to keep those infection rates low, so that everybody has a chance to get fully vaccinated. This is particularly important with the more transmissible variants of concern circulating in most provinces and territories.
That's why, for the time being, we're asking all Canadians, whether they're vaccinated or not, to continue to follow their local public health guidance. Some extra caution now will set the stage for a safe reopening in the months to come and a resumption of our lives with, hopefully, a resumption of our capacity to have more normal activities in the fall.
In the health portfolio, we're focused on keeping Canadians healthy and safe as we navigate this precarious moment in the pandemic. The supplementary estimates I'm presenting today support this commitment.
Given the shifting nature of the pandemic, we've realigned some of our resourcing plans to better support our evolving work. In total, I'm seeking an additional $5.5 billion on behalf of the health portfolio, which includes Health Canada, the Public Health Agency of Canada, the Canadian Institutes of Health Research and the Canadian Food Inspection Agency.
Let me begin with Health Canada. Through these supplementary estimates, Health Canada will receive a net increase of just over $1 billion. This amount, which includes both new funding and funds reprofiled from last year, will go primarily towards Canada's COVID-19 response. This includes investments to strengthen the long-term care sector, improve virtual care and digital health tools, and safely restart the economy.
These estimates also include funding to support Health Canada's ongoing work in other areas, including $53.5 million for Canada's chemicals management plan, $27 million to extend the territorial health investment fund and $14.25 million to support the Mental Health Commission of Canada. There is also just over $15 million for employee benefit plans.
The Public Health Agency of Canada continues to focus on mounting a robust response to the COVID-19 pandemic. Through these supplementary estimates, the agency is proposing an increase of just under $4.4 billion. This includes new and reprofiled funds. Most of these requested funds will support the ongoing response to COVID-19, including research and vaccine developments, border and travel measures and isolation sites, and medical countermeasures. It will include testing, contact tracing and data management as part of the safe restart agreement.
Some funding will also go towards indigenous early learning and child care through the aboriginal head start program, as well as Canada's chemicals management plan.
Next, I'll turn to the Canadian Institutes of Health Research, which is seeking an increase of approximately $111 million in the supplementary estimates. This investment, resulting from a reprofile of the medical countermeasures phase three funding from 2020-21, helps address persistent and emerging gaps in the research on COVID-19 and priority areas such as variants and long COVID.
Finally, I will speak to the Canadian Food Inspection Agency, or CFIA. As you know, the COVID-19 pandemic has put a great deal of pressure on Canada's food production and supply chain. With this in mind, CFIA is proposing a net increase of just over $35 million to help safeguard the integrity of Canada's food safety system. This includes an increase of $28.7 million to increase food inspection capacity and maintain a daily shift inspection presence in federally registered meat processing establishments. It also includes $6.4 million to support employee benefit plan adjustments.
Mr. Chair, as I said, this is a key moment in the pandemic. The government's top priority remains protecting Canadians' health and safety. With continued care, caution and vigilance, we will set the stage for a safe reopening and a return to all of the activities we have missed over the past year.
The supplementary estimates (A) that I presented today will support the important work that must take place before, during and after that transition.
My colleagues and I are happy to take your questions.
Thank you, Mr. Chair.
I think it's important to clarify what we're doing today. First of all, we are here to discuss the supplementary estimates and there is historically an incredibly wide berth not only to ask about anything that's in the estimates but even about what's not in the estimates. Second, we are also here and these witnesses are here pursuant to the motion of this committee, which is to deal with matters that deal with the government's handling of COVID.
The issues that were before the House originated over concerns raised at the Winnipeg laboratory, which was dealing with viruses, and there is a clear connection between that and potential interference or involvement in compromising Canada's COVID research, etc., so there are nexuses between this line of questioning and the purpose of which we heard today.
What I am concerned about is that Ms. O'Connell has interrupted, I think, four times now with the very same point of order, and you have ruled on it repeatedly. I think there is a certain point where a member who is being repetitive and vexatious and is raising the same point of order repeatedly, given your ruling.... It interrupts the flow of questioning. I think it's a privilege of every member here to have their six minutes to do with what they will. There is no question that these questions are relevant, so I would ask that all members not interrupt each other, particularly when their points of order have been ruled upon and they have not prevailed on that point of order.
While I appreciate Mr. Davies' intervention, my ability as a member to raise points of order, as any member does, is a privilege point that we all have.
Mr. Chair, to that, the member mentioned that she was referring to a section of the supplementary estimates, and then did not cite it. I appreciate Mr. Davies' comments, but Ms. Rempel Garner opened that door and then did not provide the facts or the receipts to back up her comments.
My final point on this argument is the fact that Ms. Rempel Garner suggested that she has questions about the microbiology lab that would be relevant to the supplementary estimates and spending, which I would agree is in bounds. However, her entire questioning to Mr. Stewart has been in relation to a motion in the House—a procedure—and whether he will comply, and she hasn't asked a single question on the lab. She has simply asked questions about a procedural motion that came from another Conservative, and that has nothing to do—
Thank you, Mr. Stewart.
On that, had you ignored the advice of the national security intelligence community or the experts on that part of the redaction and released unredacted documents in open-source format, are there any provisions to prevent, say, China, Russia, Iran or any other foreign national governments from also accessing that national security information, once it is publicly released?
The point I am making here, Mr. Chair, and my question to you, Mr. Stewart, is whether there would be any safety protections once those documents are released. The Conservatives continue to make the argument that Canadians have to see this information. They fail to point out, however, that the law Mr. Stewart is referring to in terms of national security protections is in place because it's not just Canadians' eyes seeing this information. Once it's in an open-source or unsecured format, it's actually bad actors around the world who would love to see Canada's national security and intelligence information.
Mr. Stewart, had you ignored the law and the advice of national security experts, would there be any protections against other bad actors, or governments around the world, gaining access to Canada's national security and intelligence information?
Do you have any powers that would have prevented that broader access once it was in open-source format?
:
Thank you, Mr. Chair, and thank you, honourable member.
You're very right. When it comes to security, there's open source, there are soft sources and then there's specific intelligence. Materials related to things around a level 4 lab are of interest to many parties.
In my experience over the past several weeks, where we have provided materials, those have immediately been made public by the Commons committee reviewing the matter. The cumulative effect of making these materials available does, in and of itself, begin to create security concerns for the intelligence community.
The materials we have not released to date due to our concerns about security—and national security, of course—are classified, so the impact you're talking about is even more profound.
If I may, we were asked to provide the materials unredacted to a committee where none of the members had security clearances. They had no ability to handle classified documents nor even to have secure communications. It was done over the World Wide Web.
I have a question for Minister Hajdu.
Yesterday, we learned that a prominent Quebec researcher, microbiologist Gary Kobinger, who developed vaccines against Zika and Ebola and who is currently working on a COVID‑19 vaccine, will be leaving Quebec to head the Galveston National Laboratory at the University of Texas. His main reason was that funding didn't pose an issue there and that the projects were plentiful. Remember that Ottawa denied him the funding needed to complete his research and clinical trials for his COVID‑19 vaccine.
Although you significantly increased research funding during the pandemic year, you didn't maintain the same level of investment. A number of researchers won't be able to obtain proper funding for their research. How can we resolve this issue? During question period, you told my colleague, Mario Simard, that you were already making substantial investments, that you were in touch with scientists and researchers and that the production capacity in the country needed improvement.
When asked in the past hour, Mr. Lamarre said that basic research should be increased by 25% and then increased by 10% per year for the next 10 years to ensure that Canada catches up with the other G7 countries. Canada is currently in second last place, ahead of Italy.
Do you feel that you're doing enough right now? What will it take to really increase research funding and stop the brain drain?
I want to reiterate the importance of long‑term investments. A strong signal must be sent to the research community, who is waiting for this signal.
In 2017, Quebec adopted the Quebec life sciences strategy for 2017‑27. This constitutes an important sector of the Quebec economy. Several billions of dollars are invested in research and development. This sector includes over 660 companies and 32,000 high‑quality jobs in Quebec.
On July 1, the PMPRB reform is scheduled to come into effect, even though Douglas Clark told us five years ago that the PMPRB had never studied the impact of the life sciences reform in Quebec and in Canada. Yet we know that research takes place at the centre of an ecosystem with strong components and that weakening the biopharmaceutical sector undermines the entire chain.
The Bloc Québécois is proposing a solution that has consensus. It involves changing the countries' reference basket and delaying the contentious issues in order to set up a discussion table. No one wants a third passive delay, since this would prolong the uncertainty.
Do you agree to implement these recommendations, Madam Minister?
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That's such an important point from the member. Through the chair, I'd just like to thank the member for her very hard work in her riding with long-term care homes and their residents. She's absolutely right that this has been a national tragedy all across the country, and in some provinces far worse than in others. We know that in Ontario and Quebec, for example, those scathing military reports of the conditions in long-term care homes in those provinces horrified all Canadians.
Much more has to be done. That's why the made that commitment and stepped up to provide support to the provinces and territories now and into the future to strengthen protections for long-term care. For example, the fall economic statement provides $500 million from the safe long-term care fund through the supplementary estimates (A) to strengthen infection and prevention control measures and to spend that money on ways that they can secure a stable workforce so that people are not left alone in undeniably terrible conditions for very long.
I will also say that this builds on the $740 million that was already provided through the safe restart agreement. Budget 2021 also has a lot of money, $3 billion, dedicated to working with the provinces and territories on measures that will strengthen protection for people in long-term care homes.
Of course, we're working towards those national standards and on how we can ensure that we not only have national standards but also enforce them so that no matter where you live in a province or territory, if you are a resident in a long-term care home, an elderly person, a person with a disability or any other person, you have the security that you can live there in dignity and safety.
Thank you for your question.
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Certainly, it's looking a lot better for the people in Brampton and across the country. The vaccines are making a big difference, and so are the public health measures that the provinces and territories have imposed, some of them albeit later than we would have liked, but nonetheless. They're strong, and the cases are coming down with those combination of factors.
In fact, over 35.3 million vaccines have been delivered to the provinces and territories to date. As you know, the and announced today that we'll be getting 11 million more Moderna doses earlier than we thought, which means that more early second doses will be administered across the country. This gives us a much better outlook in terms of moving into the late summer and fall, and what we might expect in the fall of 2021.
One thing that's really hurt my heart, and maybe yours as well, is the challenge that many children have had, particularly in provinces where schools have been closed for so long. In fact, in Ontario, it's the jurisdiction where schools have been closed the longest across the country.
Many researchers are now saying there will be long-lasting effects on students from being out of school and not being able to study. It is my hope, and I'm sure yours as well, that in the fall we will see students return to classrooms and get the education they need and deserve in a way that helps foster their social development and keeps families able to do the many things they do as a result of our education system.
My questions today will be for Minister Hajdu.
Last week, the testimony from the folks who were here on behalf of Dan's Legacy in Vancouver was really compelling and actually hit quite close to home for me. It's something that I think all members and all Canadians would agree is relevant to Canadians from coast to coast to coast. We know that the opioid crisis is one of the most significant public health crises in Canada. My heart and our hearts, I know, go out to those who have lost a loved one or who are struggling with addiction right now.
I have some context. My riding covers a large portion of rural Cape Breton, as well as small rural communities in mainland Nova Scotia. It's the geographic area of the province that makes up what the Nova Scotia Health Authority refers to as the “eastern zone”. To put this in perspective, in Nova Scotia there are 1,638 individuals in active opioid recovery, and the majority of those—about 830—are in our zone, my zone, the eastern zone.
I want to thank David Sawler, pastor for the Lighthouse Church and youth director of Undercurrent Youth Centres, for all his work on the ground and for providing those stats to me.
Colleagues, unlike previous governments, I'm proud that our government is treating the opioid crisis as a public health issue, not a criminal one. As you know, both the Province of British Columbia and the City of Vancouver are working with Health Canada to explore how those with substance use disorders can better access treatment. Quite frankly, it's an approach to this crisis that I've been following very closely as to how it could be applied to the communities I represent.
I have two questions for the minister.
What are we hearing from organizations on the ground? Do you think this is the right approach? Why or why not?
The second question is equally important. On this type of collaboration between all levels of government, do you think this is something that we can expand beyond the current work Health Canada is doing with the City of Vancouver?
Thank you.
First of all, my heart breaks for families who are struggling with substance use and problematic substance use, including opioid use. I have to say that the stigma of dealing with substance use and problematic substance use is partly what keeps people away from effective treatment and harm reduction services.
I'll just tell you that on a personal note this is a multi-generational challenge in my family. It is partly why I'm so passionate about this. I've personally seen too many lives that have been destroyed and damaged as the result of problematic substance use. I think that if we look in our souls, we can all say that we know someone we love who struggles with problematic substance use, or maybe we have ourselves.
That's why I think these honest, open conversations are so important, because the more we can talk about it, the more they can talk about it and the more people can feel safe in reaching out. That's the point, I think, behind the conversation around safe supply, harm reduction and decriminalization. It really isn't about encouraging drug use, which some Conservative opponents might say and have said, in fact, in the harmful policy under the Harper legacy for a decade. Rather, it's about meeting people where they're at and offering supports and services in a compassionate way that reduces their risk of dying.
I used to have a colleague who said that no one can get treatment if they're dead. We have to save lives so that people have an opportunity to get better, and that's exactly the focus of this Liberal government. We will work with communities on tools that they feel are appropriate, including safe supply, including harm reduction, including safe consumption sites and including making sure that community groups on the ground that are doing that hard work with families every day have what they need to keep doing that work.
Finally, let me just say that if you have not heard of the group Moms Stop the Harm, please go and visit that website. Listen to some of those moms. They will tell you heartbreaking stories of their young people who have died of opioid overdose, and they are begging governments to be non-partisan in this approach and to work together to get the job done to save lives.
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Thank you very much to the member for that question as well.
It is one of the silver linings of COVID-19. There aren't many, although maybe we'll find more over the next decades. Right now, a silver lining of the pandemic is that virtual care was able to arise so quickly. Provinces and territories quickly sprung into action to create, for example, billing codes to be able to properly compensate health care practitioners for providing care online or in virtual ways.
I also come from a semi-rural community. The work we have been doing with provinces and territories to strengthen access to virtual care is really critical. We've provided $240 million in funding, including $72 million through supplementary estimates (A). This is about building up the capacity to deliver virtual health care services in a way that protects people's privacy and data and ensures that people get that quality care.
This is not going to replace in-person care, but it certainly can augment in-person care, in particular for people who have a hard time getting access to in-person care.
Thank you, MP Kelloway, through the chair.
First, I want to respond to what the minister said. When all Quebeckers are asked the question, no one wants conditional transfers from Ottawa. We want unconditional transfers, especially for health care. The National Assembly, unanimously, and all the provinces voted for an unconditional increase in health transfers to 35% of provincial spending. The word “unconditional” is important.
Madam Minister, you boast on Health Canada's website that the two interim orders have eased the rules around COVID‑19 vaccines to ensure that Canada remains an attractive location for clinical trials, thereby improving Canadians' access to potential COVID‑19 treatment options.
Yet with the regulatory reform of the PMPRB, you'll do the opposite. You're tightening the rules without listening to the stakeholders. The uncertainty and complexity of these rules have and will have an impact on the number of new drug launches in Canada and on clinical trial activities.
Are you aware of this blatant contradiction?
To the member of Parliament, through the chair, thanks for the opportunity to highlight the team Canada approach that we decided on earlier. I think I started to speak about that in response to another member's question. We really felt at the beginning of this pandemic that although we have jurisdictional roles and responsibilities, Canadians needed us to, as a federal government, step up to help. Health human resources has been one of those aspects where provinces and territories have called on us to do so.
Early on in the pandemic, we created a rapid response program that could move vital resources like nurses, doctors and other critical public health workers, epidemiologists, to provinces and territories when they needed the extra help. For example, earlier this year, we helped coordinate the deployment of doctors and nurses from Newfoundland and Labrador, who volunteered in Ontario, to help on the third wave.
I'll turn to Dr. Tam to speak a few more words about other resources we provided to provinces and territories.
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Thank you very much for the question.
I had an opportunity to meet with the volunteers at the Kids Help Phone just this week. What an enormous piece of work they're doing for Canadians. They're responding to calls from people, often young people but actually people of every age, across the country. We knew early on that we needed to support that work.
Wellness Together also grew out of a sense that the pandemic was going to create such change in Canadians' lives that it would exacerbate mental health conditions and put people in distress at all hours of the day or night. We wanted to make sure that no matter what a Canadian's circumstance, no matter what a person's circumstance in this country, they would have access to that service.
We'll be extending these services for another year. We know that, first, we're not out of this yet, and second, as people return to their lives, many things have changed. People have suffered tremendously. There's been enormous sacrifice, some that we know and some that we don't know. People's routines have been disrupted. Their relationships have been disrupted. Their work settings have been disrupted. We know that Canadians will continue to need support for some time to come.
This is our contribution to ensuring that Canadians have that help when they need it, through emergency helplines but also through the Wellness Together portal that helps connect people to the help they need, when they need it and in the language they need it.
My question is for Minister Hajdu, because I liked part of her answer. She said that she consulted with all the people that I wanted to bring to the table.
However, does she see the difference between consulting with people and bringing them to the table so that together they can find the best possible strategy and speak about the different areas of expertise?
I'm thinking in particular of the COVID‑19 vaccine task force. Remember that the transparency and ethics of certain people around the table were criticized. I consider it important to ensure collaboration, particularly with respect to the PMPRB.
Research Canada has four recommendations regarding caution. First, the entire health research and innovation ecosystem should be maintained.
Second, the government should reconsider not only the PMPRB reforms' impact on drug costs, but also on drug value and patients' access to innovative medicines and clinical trials.
Third, the federal government should consider the reforms' impact on employment for the next generation of highly skilled researchers and on its investments in this area.
As a result, the fourth recommendation is that the federal government defer implementation of the PMPRB reforms until it has concluded a more comprehensive process in support of the full health research and innovation ecosystem, bringing all key stakeholders who will be impacted by these reforms to the table.
What does the minister have to say to Research Canada: an alliance for health discovery?
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We're very fortunate in Canada to actually have very effective vaccines. However, vaccines are not 100% effective even with two doses.
To illustrate this, if a vaccine is 80% effective, you might still get a fifth of the population, even after vaccination, who may be susceptible to infection. What we do know, in general, is that these infections are going to be milder, so the prevention of serious outcomes is also very key.
You've brought up a very important point, which is that you can still get infected. Even though you have a mild illness, you could pass it on to someone else who might not have been well vaccinated. The bottom line still stays the same, whether it's the variants we have now, or the fact you may still see cases after vaccination. The bottom line is to get two doses of a vaccine, or to complete a full course of vaccines. That will still work.
Sports teams have to have protocols. At this time, these types of games are performed under the auspices of public health departments that have safety plans in place so that, should people become positive, they don't spread that virus to a lot of other people.