CHAPTER III: CONCLUSIONS AND RECOMMENDATIONS
During the hearings, members of the House of Commons Standing Committee on Health heard from many people who are actively working toward the positive physical, mental and emotional development of children. They listened as caring individuals talked about the multiple ways that they try individually and through professional, community and governmental organisations to secure a better future for Canadian children. They noted the diverse approaches aimed at ensuring healthy developmental outcomes for young children being implemented across the country.
But, they were also reminded that Canada has a poor overall record in relation to its efforts for children. International comparisons with other industrialised countries showed that Canada fell behind the others, ranking only better than the United States in terms of child poverty rates. Members were told that the problem was not too few programs but too little co-ordination and collaboration; not necessarily too little money but too minimal an understanding of the impact of proposed policies on the children and their families and communities.
A. GOVERNMENT CO-ORDINATION AND COLLABORATION FOR CHILDREN
The Committee believes that co-operation among all levels of governments is essential to successful outcomes for Canadian children. Each level of government - municipal, provincial/territorial, and federal - has a particular role. These roles are reinforced and supported through various established mechanisms that currently exist for ensuring co-ordination and collaboration. In the view of the Committee, these mechanisms can and should be utilised to work toward initiatives relevant to the well-being of our children and their families. Its members assert that any federal initiative should be exercised through cooperation and partnership with other levels of government.While fully cognisant of the jurisdictional division of responsibilities in health, social assistance, education, employment and other areas that affect the lives of children, as a federal Committee, the attention of members has focused on measures to ensure that children become a national priority. This has led them to examine the role of the federal government in co-ordinated and collaborative strategies on behalf of Canadian children. They heard examples of the multiple and apparently uncoordinated activities related to children that occurred among multiple federal departments. For them, the absence of a federal mechanism to integrate existing financial and human resources is problematic.
The Committee members are aware of the movement by several provinces to establish specific ministries focused on the needs of children and their families. They know that the federal and provincial governments have already established parallel ministries that currently address the needs of other populations such as women. The members believe that the movement by provinces toward designating a specific minister to be responsible for children is a step in the right direction. In pursuing a similar path at the federal level, Committee members recognise that the task could be assigned to an existing minister and could operate within existing human and financial resources.
Because the Minister of Health is currently responsible for the promotion and preservation of the health of the people of Canada, the Committee members feel that this minister could appropriately be designated the role of overseeing this fundamental issue of the well-being of Canadian children. However, if the designated minister is to be effective, there is a need for greater co-ordination and collaboration within the federal government between its own departments and well as between the federal and provincial governments. Any unnecessary overlap or duplication of efforts should be avoided. In addition, parliamentarians need to know on an annual basis about the plan of action and the progress made in implementing it.
1. Federal Involvement for Children
The Committee recommends that:
- the federal government clearly designate the Minister of Health to be responsible for and co-ordinate strategies for the well-being of Canadian children;
- this federal minister be assigned specific responsibility to plan, co-ordinate and implement a comprehensive plan of action for Canadian children;
- the plan of action be based on population health principles; establish clear goals and set specific time frames for implementing measures for the positive development of children;
- the minister table an annual progress report to Parliament.
2. Interdepartmental Co-ordination for Children
The Committee recommends that:- the Minister of Health, in conjunction with other relevant federal ministers such as Finance, Justice and Human Resources Development, establish an interdepartmental mechanism to develop and implement the comprehensive plan of action for Canadian children;
- this interdepartmental mechanism ensure that the specified goals are accomplished within the specific time frames and involve ongoing participation by assistant deputy ministers from relevant departments;
- this interdepartmental mechanism utilise human and financial resources currently existing within departments to develop a secretariat for children with co-ordinators in each department.
3. Federal, Provincial and Territorial Consultation, Collaboration and Co-ordination for Children
The Committee recommends that:- the Minister of Health, through the Canadian Conference of Ministers of Health, continue work on national goals for child health and support the setting of objectives at the provincial and territorial level that can be integrated within the comprehensive plan of action for Canadian children;
- the Minister of Health, through the Council of Ministers of Education, liaise with the relevant provincial and territorial ministers, to promote the application of effective interventions through the school system, including education related to sexual and reproductive health, early childhood development and parenting preparation that can be incorporated into the comprehensive plan of action;
- the Minister of Health, work through the federal, provincial and territorial ministers responsible for Justice, to assist in the development of a national strategy on justice issues that can be integrated within the comprehensive plan of action;
- the Minister of Health, working with the federal ministers of Finance and of Human Resources Development and their provincial and territorial counterparts, consider ways to redesign federal transfers under the Canada Health and Social Transfer in order to facilitate the development of clear principles and standards for funding specific programs for children.
B. ISSUES FOR CHILDREN AND their FAMILIES
1. Making Time for Children and Work
The Committee members were aware of the 1994 report of the federally-created Advisory Group on Working Time and the Distribution of Work arguing that a redistribution of working time could lower unemployment, mitigate inequalities and achieve a better balance between work and family life. The study pointed out that families face three major and often competing pressures: the need to care for children, especially pre-schoolers; the need to care for ageing parents; and the need to maintain family incomes by having two people in paid work. Trying to balance jobs with family and personal life resulted in people squeezing out voluntary and civic activity, night school courses, leisure and relaxation with or without family and friends.The members heard similar arguments from witnesses over the course of the study. Job sharing, flex-time and compressed work weeks along with unpaid leaves of absence from work after the birth or adoption of a child were recommended as measures to facilitate family interactions. Such initiatives could also assist people choosing to reintegrate into the workforce after time out for care of their children.
The Committee recommends that:
- the Minister of Health and the Minister of Human Resources Development co-ordinate efforts to initiate immediate and vigorous public discussions on this issue;
- these ministers work closely with federal and provincial ministers of Labour to ensure that the issue receives priority and supports new arrangements in the public and private sectors under their jurisdictions;
- the new arrangements be oriented to family responsibility considerations and provide a full assessment of job sharing, flex-time, compressed work weeks and unpaid leaves of absence.
2. Caring for Children
Witnesses told the Committee members that the quality of parental care and the influence of a parent or parents are major determinants of health, crucial to the development of coping skills and a normal psyche, during a child's first years of life. To support parents in shaping healthy children, suggestions ranged from breastfeeding and secure and consistent child-adult bonding to nutrition and stimulating environments. The promotion of positive approaches to parenting was seen as crucial.Many witnesses asserted that parental decisions about the daily care of the children are of vital importance. Most supported a range of options but particularly ones that gave parents real choices. Some reported that, in families with pre-school children where both parents worked, the majority indicated that, if they could, they would chose to have one parent provide direct parental care in the home. Others asserted that, when two parents work and there are pre-school children, after child care costs, taxes and the cost of employment, the net take home pay is greatly reduced. Child care expense deductions are only available to the lower income earning spouse.
The Committee members believe that the federal government could work with the other levels of government to promote a greater range of options for those seeking care for their children. These options should include direct parental care in the home along with other choices.
The Committee recommends that:
- the Minister of Health co-ordinate publication and nation-wide distribution of a guidebook outlining factors affecting the probabilities of positive outcomes for children, including a focus on the role of breastfeeding, emotional bonding, pre and post natal nutrition, physical and mental stimulation and parental attitudes;
- the Minister of Health with the Minister of Finance examine ways of providing equivalent tax benefits to families who choose at-home parental care and those with caregivers for their children;
- the Minister of Health, in conjunction with federal and provincial counterparts, continue discussions aimed at implementing a child care policy that is national in scope, oriented to early childhood development, and beneficial to children during their various developmental stages.
3. Promoting Strong Families for Children
The Committee received evidence from the recent Statistics Canada report on children that reinforces the view that strong caring families have a greater probability of producing strong resourceful children. These children are less likely to become reliant on social programs, health care and correctional services. As part of its focus on preventive approaches aimed at children, the Committee sees a role for the federal government in promoting policies and programs that support parents and strengthen families. Included in its commitment to children and their families, the federal government should ensure that its tax laws discriminate in their favour, with assurances that children in families who stay together are no worse off than those in families who live apart.The Committee recommends that:
- the Minister of Health, in collaboration with the Minister of Justice, consider ways of educating the Canadian public about the positive effects on the healthy development of children associated with strong and committed families, including measures like counselling, mandatory or otherwise, prior to any legal consideration of separation or divorce;
- the Minister of Health, in collaboration with the Minister of Finance, re-examine tax laws and policies to ensure that they treat all families with children in a fair and equitable way.
4. Intervening with Children in Families at Risk
Committee members are aware that, while poverty is an exacerbating factor, poor people can raise healthy children and rich people can raise unhealthy children. However, they also know that where there is a child in poverty, there is parental deprivation, both emotional as well as physical, that has an adverse effect on their children.Living with only one parent means that a child is about four times more likely than those with two parents to live in poverty, a factor with a direct relationship to the quality of their health. The Statistics Canada study showed that, of the children up to 11 years of age who live in poverty, 43% live with only one parent. Children in this type of family comprise about 16% of this age group. (See table 4) However, other parental factors such as illiteracy, unemployment, substance abuse, violence, and teenage pregnancy are also strongly linked to negative outcomes for children.
The members feel that efforts to identify and intervene with high-risk families must be initiated at the prenatal stage and continued during children's developmental stages. The task must extend beyond the health area and involve co-operation and co-ordination across all sectors. In particular, it must involve a thorough assessment of the financial commitment that the federal government is prepared to make to Canadian children.
The Committee recommends that:
- the Minister of Human Resources Development and other relevant ministers, working with the provinces and territories, promote job creation and education and training;
- the Ministers of Health and Human Resources Development work with their provincial counterparts to support and promote early intervention for children in families at risk including prenatal nutrition, home visiting, peer support, respite services and parenting education;
- the Minister of Finance, with other relevant ministers, provide a thorough assessment of the positive and negative considerations relevant to the creation of a stable, designated investment fund specifically for children in families at risk.