Health Committee on June 17th, 2024

[Mark Holland, Liberal, Ajax, ON]

A number of recommendations will soon be implemented, even the recommendations concerning packaging, for example. It's vital to protect people from substance abuse. There are many other things to do, and in the coming—

[Luc Thériault, Bloc, Montcalm, QC]

Are you for or against the use of a QR code on cannabis product labels? Would you consider implementing one?

[Mark Holland, Liberal, Ajax, ON]

I'll get back to you on that later.

[Luc Thériault, Bloc, Montcalm, QC]

We'll be expecting your written answer on this topic.

I hope that we can talk again about your vision for working with the provinces and Quebec. I don't get the impression at all that you're on the same wavelength as the Quebec authorities, particularly when it comes to implementing pharmacare.

I'll tell you right now what my next question will be. I hope that your answers will be more specific than your previous responses.

[Mark Holland, Liberal, Ajax, ON]

In Quebec, there are two major agreements. We're having good discussions with Minister Dubé and the Legault government. We're also discussing dental care. In Quebec, over 60% of professionals are currently enrolled in the programs. They have also been participating in the program for many years. This is good news for the health of Quebeckers.

We're having good conversations about pharmacare. I'm sure that we can come to an agreement in that area too.

[The Chair, Liberal, Sean Casey]

Thank you, minister.

Colleagues, we're going to be voting momentarily, so I'm going to suspend the meeting pursuant to an agreement among the whips. Once a meeting is suspended because of the bells, the meeting is to resume 10 minutes after the vote is completed. If it is the will of the committee to resume before that, let me know. I'm going to be here. We can do it by unanimous consent and authorize it after the fact.

Mr. Julian, do you have something you need to say?

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Yes. I think you could get unanimous consent to reconvene after all members of the committee have voted.

[The Chair, Liberal, Sean Casey]

If somebody has technical difficulties and ends up having to run over to the House, we're going to have to wait for them, so I would like people during the suspension to come to me to say, “I'm good to go.” When I've heard from everyone, we'll go. If not, we'll respect the agreement.

Minister, I know you have a hard stop at five o'clock. There's still a chance that we can get Mr. Julian's time in before that. If we can't, we'll absolutely respect the deadline that you have. Thank you.

The meeting is suspended.

[The Chair, Liberal, Sean Casey]

I call the meeting back to order.

During the suspension, I had an opportunity to consult with every member of the committee. They have confirmed to me that they have all voted and wish to start the meeting right away, in view of the timelines faced by the minister.

We are back in session by unanimous consent of the committee.

Next up is Mr. Julian for six minutes.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Thank you, Mr. Chair.

I gather that about 49.1% of Quebeckers don't have dental insurance. I would like to know how many Quebeckers have signed up for this new dental care program proposed by the NDP. I think that we need to see the level of interest in this program on the part of Quebeckers.

[Mark Holland, Liberal, Ajax, ON]

In Quebec, over 700,000 seniors aged 65 and over have signed up for the program. The number is probably higher now, since these aren't the most recent figures.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

You said that 700,000 Quebeckers have signed up. Is that right?

[Mark Holland, Liberal, Ajax, ON]

Yes.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Wonderful! It's good to see that the NDP's proposed dental care program is generating so much interest.

I note that it was three years ago yesterday that Jack Harris for the NDP brought forward the dental care motion that failed. The Liberals and the Conservatives voted against it. However, in this minority Parliament, we're now seeing real interest in dental care.

I'd like to ask you this, Minister: Over two million seniors have already signed up for the dental care program the NDP pushed so hard for. The next stage is June 27, I believe, when kids under 18 and people with disabilities will be able to join the program. There is absolutely no doubt there is an intense need for dental care. The reality is that it saves money in the acute care system, because people no longer need to go to emergency wards when they have a dental emergency. That is very important.

What measures will the government take to ensure there is as much uptake among people with disabilities and kids under 18 as there has been among seniors, who were given information and told they could apply for the program? What is the government going to do to ensure that same level of participation for these other groups at the end of the month?

[Mark Holland, Liberal, Ajax, ON]

It's an important question. We've seen incredible uptake among seniors. We estimated that about three million folks are eligible. In just a couple of months, over two million signed up. That has been exceptional. We've been able to connect with the people who need that care.

Now, for those under 18 and for persons with disabilities eligible for the tax credit, that's June 27, as you mentioned. We're looking at how to communicate to see a similar strong uptake. The point is well taken that we need to be aggressive in making sure folks know about it, because it is an essential matter of prevention, not just social justice. When people are getting dental care, they're not winding up in emergency rooms. They're not costing the health system more money.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

I was knocking on doors this weekend in Newfoundland and Labrador, and also in Montreal. People were talking about the program. There's been a magnificent uptake. The more publicity and information sent out the better.

I'd like to move on to pharmacare now. It passed through the House of Commons. It has not passed through the Senate yet, which is disturbing and concerning, because there are so many people who have diabetes, in particular. My constituent Amber pays $1,000 a month for diabetes medication. This pharmacare program for people with diabetes will make a huge difference.

I'm interested in knowing how many provinces are ready to talk about pharmacare, now that it's through the House, while we await Senate approval? To what extent are provinces interested in stepping up?

[Mark Holland, Liberal, Ajax, ON]

The interest has been very strong.

In your home province of British Columbia, Adrian Dix would be ready to sign now if we had royal assent, I think. We've had the opportunity to talk about what that range of action might look like.

Your point around the need for medication is important. It's not just a preventative health measure. You're absolutely right about that. There are all kinds of people who, if they don't have access to diabetes medication, could be in a situation where they lose a limb or have a cardiac event, a stroke or a kidney failure. It's also critically important because what we're looking at is cost. In the last estimate in 2018, diabetes cost our health system about $27 billion. By 2028, that figure is expected to be $37 billion.

Not actioning in a preventative way isn't just unfair in terms of bad patient outcomes. It's also dumb in terms of money.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

I want to come to the task force on preventive health care and its recommendations that breast cancer screening not take place until after the age of 50. We know that for racialized and indigenous women, the prevalence of breast cancer is much higher in their 40s.

Have you lost confidence in the task force on preventive health care? How can we get to the point that the task force makes recommendations that pass the nod test with Canadians and ensure that we're saving lives? They admit that it will save one in a thousand, which is saving hundreds of women's lives every year. How could they make a recommendation when it doesn't match the evidence?

[Mark Holland, Liberal, Ajax, ON]

I've stated publicly that I was disappointed in the recommendations, and I've heard shared disappointment very clearly from stakeholder groups and experts.

I think it's extremely important that we have that process be examined by an expert panel, so we're accelerating the review to be done by an expert panel to do that right away. We're stepping up, with Theresa Tam leading an effort to convene experts to make sure that we hear from everybody provincially and territorially in terms of health experts and that they're well heard in this space, so that we can have the review period of those recommendations appropriately challenged. In the first order, we'll make sure that we get those recommendations right, and, in the second order, we'll accelerate that review so that we can scientifically arrive at a point of answering the question you've asked.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Thank you, Mr. Julian.

Next we have Mrs. Goodridge, please, for five minutes.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Mr. Chair.

The Canadian Medical Association said that the tax increase “jeopardizes the stability of our struggling health care system. The risk of already over-stretched physicians leaving the profession or reducing their hours in response to heightened taxation is real”.

Do you disagree with the Canadian Medical Association?

[Mark Holland, Liberal, Ajax, ON]

I do. There are a couple of really important tax benefits that are retained.

One is that, if you incorporate, you still have the opportunity to shield and, unlike with an RRSP, there's no limit to that, so you can shield and incorporate your gains and allow them to compound.

Second, when you remove money, you continue to enjoy a capital gains exemption, and it will move from 50% to one-third.

Again, the important point here is that a nurse who is—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you.

To quote from the Canadian Medical Association again:

Given the current economic climate, the tax changes, coupled with a housing crisis and rising student debt, will also impact young physicians and medical learners who find themselves in a much tougher financial position than they would have been in 10 to 15 years ago. This will create another disincentive to becoming a community-based doctor at a time when there is a grave shortage.

We need community-based doctors, Minister.

What analysis did Health Canada do on these proposed tax changes before moving forward with this reckless implementation?

[Mark Holland, Liberal, Ajax, ON]

We absolutely need community doctors. That's why we're investing in doing exactly that with provinces and territories. If you're a young doctor starting out, you're not sitting on large—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Okay, what specific analysis—