Newly appointed minister of health of Canada, The Honourable Ginette Petitpas Taylor, shares the core tenets of her mandate, the Federal government’s priorities for investment into the Canadian healthcare ecosystem, as well as the strategic significance of the life sciences industry for the country.
Healthcare was a core issue on the Liberal Party’s winning platform in 2015, specifically in the areas of home care and mental health. Coming up to two years into your term, what specific milestones and achievements would you like to highlight?
Strengthening Healthcare
By working with the provinces and territories, we have made significant progress in strengthening healthcare for all Canadians. I am especially proud of the historic investments our Government has made – CAD 11 billion (USD 8.6 billion) over ten years – to improve access to home care and mental health services. These are issues that touch the lives of all Canadians, and we are committed to working with our provincial and territorial partners to make tangible progress in these areas.
Federal, provincial and territorial governments recently reached agreement on a Common Statement of Principles on Shared Health Priorities, which outlines key priorities for federal investments in home and community care, and in mental health and addiction services. With this Common Statement in place, our Government is now working with individual jurisdictions to develop and finalize bilateral agreements that will set out details of how each jurisdiction will use federal funding in future years, and to establish a focused set of common indicators to allow Canadians to track our progress on improving home care and mental health services.
Indigenous Health
Our Government recognizes the significant disparities in Indigenous health outcomes compared to the Canadian population. We have, along with our provincial and territorial counterparts, committed to working with First Nations, Inuit and Métis to improve access to health services and health outcomes of Indigenous Peoples and to discuss progress.
Consistent with our commitment to close the socio-economic gap and strengthen Indigenous health, we committed an investment of CAD 646.5 million over five years through Budget 2017, including CAD 204.2 million (USD 159.4 million) for First Nations and Inuit mental wellness alone. This is in addition to our annual investment of more than CAD 2.7 billion (USD 2.11 billion) towards Indigenous health. Health Canada is working with First Nations and Inuit partners in all regions of Canada to allocate these additional investments to support a full suite of health services, including:
- maternal and child health,
- mental wellness,
- home and palliative care, and
- primary care.
In addition to Budget 2017, Health Canada is providing more than CAD 3 million (USD 2.3 million) this year to help address the mental wellness needs of Indigenous communities. Recognizing that providing culturally appropriate care is essential to the success of our efforts, the First Nations Mental Wellness Continuum Framework and the National Inuit Suicide Prevention Strategy guides the Department in this work. We have increased the number of Mental Health Crisis Intervention Teams and Mental Wellness Teams nation-wide and launched a culturally safe 24-hour crisis support line. We are also working in close partnership with indigenous leaders to ensure the maximize collaboration and information sharing to close gaps, promote best practices provide the right service when it is needed.
Finally, we are working hard to fill service gaps by implementing Jordan’s Principle [This is a child-first principle meant to prevent First Nations children from being denied essential public services or experiencing delays in receiving them – Ed.] At the end of August, almost 14,000 services, supports and products had been approved by Health Canada in the past year.
What was the significance of your appointment as the new Minister of Health – and what would be the federal government’s health priorities for the rest of your term?
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The August 28th appointment reinforces our government’s commitment to a renewed relationship with Indigenous Peoples. I have been asked to use all levers at my disposal, work with provincial, territorial and community leaders to tackle the opioids crisis.
My priority in this area is to strengthen harm-reduction efforts, and build on existing collaboration to enable care providers to get the services they need when they are needed. This means looking beyond health care, and working with all levels of government to address social determinants that affect this situation. As a social worker, it is also incredibly important for me to address the stigma often associated with substance use. We must show empathy, and ensure people are not ashamed to ask for the care they need. This is the first barrier to addressing this issue, and it prevents us from gathering the important data we need to better understand how this crisis is evolving across the country.
I am passionate about working towards improving access to mental health and addiction services, as well as home and community care for Canadians. I plan to complete bilateral agreements with each province and territory outlining the specific action plans and performance indicators to improve access to these services. These bilateral agreements should result in measurable improvements, with clear, public reporting on the outcomes achieved.
The Prime Minister has also made it clear that extra billing practices are not acceptable and I will work diligently with provinces and territories to promote and defend the Canada Health Act, making it clear that extra-billing and user fees are illegal under Canada’s public medicare system. It is essential policies are developed in collaboration with provinces and territories to improve verification and compliance with the Canada Health Act.
I look forward to being able to promote public health in a variety of ways, including: increasing vaccination rates; completing the introduction of plain packaging requirements for tobacco products; and implementing a pan-Canadian concussion strategy and raise awareness for parents, coaches, and athletes on concussion treatment.
I am also looking forward to working closely with the Minister of Agriculture and Agri-Food to align the Healthy Eating Strategy regulatory initiatives with the Food Policy for Canada. Initiatives such as: introducing new restrictions on the commercial marketing of unhealthy food and beverages to children; bringing in tougher regulations to eliminate trans fats and to reduce salt in processed foods; and improving food labels to give more information on added sugars in processed foods, are already underway.
Subject to Parliamentary approval, the proposed Cannabis Act will come into force no later than July 2018. We know that the current approach to cannabis does not work and has allowed organized crime to profit, while failing to keep cannabis out of the hands of our kids. The Government has been actively working on this proposal for nearly two years, collaborating with provinces and territories, municipalities, law enforcement, and other stakeholders, to deliver on our commitment to Canadians to legalize, strictly regulate and restrict access to cannabis. I am excited to further advance this legislation and to work with the Ministers of Justice and Public Safety and Emergency Preparedness, as well as the Leader of the Government in the House of Commons, and the Representative of the Government in the Senate, to help ensure timely passage of Bills C-45 and C-46, leading to the legalization and strict regulation of cannabis.
Negotiations on the Canada Health Transfers to replace the old Canada Health Accord, which expired in 2014, were concluded early this year. What impact do you expect this to have on national health outcomes?
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Our Government has consistently emphasized how important it is that Canadians see tangible results from federal investments, and I believe that healthcare is no exception.
That is why the new federal investment of CAD 11 billion (USD 8.6 billion) over 10 years has been targeted to areas that governments collectively agree are priorities for Canadians: mental health and home care services. Provinces and territories have agreed to work with the Canadian Institute of Health Information to develop common indicators that will be used to report on progress to Canadians. In addition, Budget 2017 also committed CAD 544 million (USD 425 million) over five years to federal and pan-Canadian health organizations to support health innovation and pharmaceutical initiatives.
Taken together, I am proud that these targeted investments will address specific gaps in our healthcare system, such as increasing the availability of home and palliative care, helping youth access needed mental health services, expanding the use of electronic health records, and lowering the cost of prescription drugs. They are also in addition to the funding provided through the Canada Health Transfer (CHT), which will provide CAD 37.1 billion (USD 29 billion) to the provinces and territories in 2017-18. This funding will continue to increase each year, in line with the growth rate of the economy, with a minimum increase of at least 3 percent per year. Over the next five years, CHT funding to provinces and territories is expected to total approximately CAD 200 billion (USD 156.2 billion).
While Canada has a well-established universal healthcare system and world-class medical infrastructure, the country continues to deal with issues like the opioid crisis, Indigenous populations’ access to healthcare and a rapidly aging population. Given that healthcare – except for a few groups – falls under the constitutional jurisdiction of the provinces and territories, how is the Federal government leading and supporting the search for solutions?
All Canadian governments recognize the important role that health system innovation can play in transforming health systems, making them more sustainable, and enabling them to provide a higher quality of care. Although Canada has 13 distinct provincial and territorial health systems, the federal government plays an important role as a convener, funder and catalyst for change. Through our new investments in home care and mental health, we will be working with provinces and territories to improve access to these vital services. We also support a suite of pan-Canadian health organizations that perform key health system functions and support innovation in a number of areas. And through the Canadian Institutes of Health Research, we are also the primary funder of health research across a broad range of health disciplines.
The Government of Canada committed new funding in Budget 2017 for several pan-Canadian health organizations to advance federal and national objectives for healthcare, including the Canadian Foundation for Healthcare Improvement (CFHI) and Canada Health Infoway. For example, the CFHI is working with the Government of New Brunswick to adopt a proven approach to reducing the inappropriate use of antipsychotic medication for nursing home residents with dementia. Early results show that a reduction of inappropriate use improves the social engagement of residents and their ability to manage their own care. CFHI is now expanding this approach to other jurisdictions.
Canada Health Infoway is working with the provinces and territories to expand e-prescribing and tele-home care, and to support the continued adoption and use of electronic medical records. Ideally, we want patients to be able to interact with their healthcare system as easily as they do in other sectors, like banking or retail. The Government is investing CAD 300 million (USD 234.2 million) over the next five years in Canada Health Infoway to support digital health across Canada’s health systems.
Indigenous populations’ access to healthcare
Our Government is committed to a renewed relationship with Indigenous Peoples, based on the recognition of rights, respect, co-operation, and partnership. We have worked to implement this vision along two interrelated tracks: closing the socioeconomic gap between Indigenous Peoples and non-Indigenous Canadians, and making foundational changes to our laws, policies and operational practices based on the recognition of rights to advance self-determination and self-government.
In support of this commitment, we have made historical investments and important progress, but existing colonial structures have not helped us work coherently on both tracks.
More than 20 years ago, the Royal Commission on Aboriginal Peoples acknowledged that a new relationship with Indigenous Peoples would require new structures. It recommended that we dramatically improve the delivery of services while accelerating a move to self-government and self-determination of Indigenous Peoples. One mechanism to achieve this was the dissolution of Indigenous and Northern Affairs Canada (INAC) and the creation of two new ministries to facilitate this work.
We agree with the Royal Commission that rights recognition must be imperative. That is why, for our part, we have dissolved INAC. In its place, we are establishing two new departments: a Department of Crown-Indigenous Relations and Northern Affairs, and a Department of Indigenous Services. These changes are modelled on the recommendations of the Royal Commission and will be finalized in cooperation with Indigenous Peoples. The new Minister of Indigenous Services will continue the important work of improving the quality of services delivered to First Nations, Inuit and Métis people. This will include ensuring a consistent, high quality, and distinctions-based approach to the delivery of those services. A rigorous results and delivery approach will be adopted, focused on improving outcomes for Indigenous Peoples.
Opioid crisis
Our Government is deeply concerned by the opioid crisis and its devastating impacts. Opioid-related overdoses have claimed the lives of thousands of Canadians, affecting families and communities across the country.
In response, our government has provided significant funding to address this national public health crisis. In Budget 2017, we invested CAD 100 million (USD 78 million) over five years, and CAD 22.7 million (USD 17.7 million) ongoing, to support national measures to respond to the opioid crisis, as well as CAD 20 million (USD 15.6 million) in funding to the hardest-hit provinces. Although provinces and territories are largely responsible for the delivery of healthcare services and treatment, the federal government also has a role to play in removing barriers at the federal level for potential treatment options, supporting research and sharing best practices, and supporting the delivery of health services to First Nations and Inuit communities and federal inmates.
Our government is exploring ways to promote new and innovative ideas to help overcome this crisis. We are supporting research to enhance our understanding of the crisis, to inform best practices, and to provide new tools and treatment options for individuals affected by problematic opioid use. For example, we recently announced an investment of CAD 7.5 million (USD 5.9 million) to support a new national research program to improve interventions by front-line workers.
We are working with health professionals, people with lived and living experience, provinces, territories and municipalities to address this crisis and the underlying causes of problematic substance use. We recognize that there is still more work to be done. No one person, organization or any one level of government will solve the opioids crisis alone. That is why, as part of my mandate letter as the Minister of Health, I have been asked to work closely with all levels of government, as well as substance use experts, service providers, first responders, law enforcement, and people with lived and living experience to ensure Canada’s response to the opioid crisis is robust, well-coordinated and effective.
Antimicrobial resistance
Another key concern for Canada is the serious global health threat of antimicrobial resistance (AMR). Existing antibiotics are becoming less effective at treating infections and the development of new drugs is not keeping pace. Unless action is taken, even common infections could become life-threatening. Estimates indicate that by 2050, annual worldwide human deaths attributable to AMR could reach 10 million.
While many of the levers for a sustained pan-Canadian response to AMR lie outside federal jurisdiction, the Government of Canada is leading a concerted and coordinated effort with all levels of government and across sectors, including public health, healthcare, animal health, agriculture, industry and academia to tackle AMR. Earlier this fall, the Government of Canada endorsed the Global Action Plan on Antimicrobial Resistance and released Tackling Antimicrobial Resistance and Antimicrobial Use: A Pan-Canadian Framework for Action.
The Pan-Canadian Framework was developed jointly with provinces, territories and key partners in the human and animal health sectors. It is grounded in a One Health approach, which recognizes the interconnectedness of humans, animals and the environment. It identifies opportunities for collective action and desired outcomes under four pillars: surveillance, stewardship, infection prevention and control, and research and innovation. We are now turning our attention to developing the Pan-Canadian Action Plan that will define specific commitments, measurable outcomes, and timeframes to put the Framework into use.
With Canada’s economy having historically been quite dependent on natural resources, what do you see as the strategic significance of the healthcare and life sciences industry to Canada’s economic development?
The Canadian life sciences sector is engaged in creating the medical innovations that will improve healthcare delivery and patient care in Canada and abroad. It accounts for more than 90,000 jobs in about 850 pharmaceutical and medical device firms, and represents CAD 7.8 billion (USD 6.1 billion) in GDP and CAD 13.2 billion (USD 10.3 billion) in merchandise exports. This is comparable in scale to other R&D-intensive sectors in Canada’s economy, such as the aerospace and automotive sectors. Overall, Canada’s life sciences manufacturing sector is Canada’s third-largest R&D spender, fifth-largest manufacturing exporter, and sixth-largest employer of R&D professionals.
Our Government’s Innovation and Skills Plan positions Canada as a nation of innovators, and includes important measures to foster inclusive growth and create opportunities in the health and biosciences sector. This sector is one of six highly innovative industries to be highlighted. There are many opportunities to leverage the health and biosciences sector to create jobs, grow the middle class, and support an inclusive, innovative economy. The Innovation and Skills Plan will provide the means by which we can work together to advance sector opportunities in areas like skills and talent, adoption and commercialization of health innovations, and access to capital and firm growth.
From the invention of insulin to radiation therapy and numerous vaccines, Canada has a long and distinguished tradition in medical R&D and innovation, as well as basic science. How will your government continue to build on this legacy?
We are proud of Canada’s legacy of medical R&D and innovation. Canadian discoveries were created on a foundation of basic science in the public sector. Our Government is committed to supporting our scientific communities to ask the critical questions, identify our R&D gaps, explore solutions, and innovate.
Our investment in health research is allowing Canadian researchers to continue to make remarkable contributions, from developing the first effective Ebola vaccine and ZMapp® treatment, to creating new scientific knowledge about health threats like the Zika virus and antibiotic-resistant infections, to playing a leading role in the field of cancer immunotherapy, and helping to lead the hunt for an HIV vaccine. Investment in health research makes sense for Canada because we are a country with world-class R&D in:
- stem-cell and regenerative medicine, where Canada is third in quality and global influence,
- clinical trials, where Canada is sixth globally for quality, expertise and complex studies,
- oncology, where Canada is fifth globally in the number of research publications,
- biopharmaceuticals, where Canada has the third biggest pipeline of products globally, and
- metabolic disorders, where Canada is eighth globally in the number of research publications.
The Honourable Kirsty Duncan, Minister of Science, recently commissioned a Fundamental Science Review to ensure that our funding ecosystem is strategic, effective and meeting the needs of our researchers. In addition to this review, we are also taking steps to facilitate collaboration among academic institutions, research institutes, private industry and government.
We are also creating six industry-led Economic Strategy Tables with prominent private sector leaders. These Tables will develop growth strategies in key industries, including one in health and biosciences. Each Economic Strategy Table will provide a formal avenue to convene and work collaboratively with industry to identify sector-specific challenges and “bottlenecks” to innovation, and lay out specific strategies to help innovators achieve their targets. There are opportunities for industry to step up and partner with our small-and-medium size biotech and medical technology firms, scientific community, hospitals and other academic institutions. This will help move research discoveries from bench to bedside and increase the uptake of health innovations for the benefit of all Canadians.
These efforts ensure that Canada’s strong legacy of research excellence continues and translates to innovative marketable products that are embraced by Canada’s healthcare systems. In turn, this can drive economic growth and improve patient care.
Globally as in Canada, healthcare stakeholders increasingly grapple with challenges like reconciling patient access to innovation with fiscal sustainability and increasing global competition for life sciences industry investment. On the 150th anniversary of the Confederation, what leadership role do you think Canada can – and should – play on the global healthcare and life sciences landscape?
Good health is a universal objective, and nations can benefit from strong partnerships and collaboration on shared health priorities. Global health challenges require collaborative, whole-of-society approaches to prevent crises, respond to health-related emergencies and recover effectively.
Canada has globally recognized research and commercialization strengths in areas like stem-cell and regenerative medicine, clinical trials, oncology, biopharmaceuticals and metabolic disorders to name but a few. And we have a long history of leadership and collaboration on the world stage. Canadian collaboration between industry and academia is generating new breakthrough ideas, therapies and technologies that are bringing new solutions to the market and benefiting Canadians and people all over the world.
The Government has an important role to play in supporting and advancing science, research and innovation — pillars of strong economies. The Innovation and Skills Plan provides an opportunity for industry and government to work collaboratively to leverage Canada’s strengths and recent investments, including in artificial intelligence, to fully benefit from the convergence of disruptive platform technologies in the health and biosciences sector. We are working with all innovation actors to set the stage for economic growth and better patient outcomes.
In addition, I am working with provinces, territories and a spectrum of partners to encourage the adoption of digital health technology to improve access, increase efficiency, and improve outcomes for patients. This includes improving access to and affordability of necessary prescription medications, ensuring appropriate prescribing guidelines and tracking, and improving health information. Budget 2017 committed CAD 544 million (USD 424.6 million) over 5 years to supporting this work.
We will also continue working with international partners to strengthen global health, and explore how we can best address complex global health challenges. One area that requires concerted global effort is antimicrobial resistance (AMR).
With our G7 colleagues, Canada supported commitments to combat AMR in 2015 and in 2016, and again at this year’s G20 summit. At the World Health Assembly in May 2017, former Health Minister Philpott joined the Alliance of Champions, a group of health ministers committed to promoting the issue of AMR to their colleagues in other portfolios. In November 2016, we announced CAD 9 million (USD 7 million) in funding for the World Health Organization AMR Secretariat to support the implementation of the multi-sectoral Global Action Plan. More recently, Canada provided support for the World Organization for Animal Health (OIE) to engage in the United Nations Interagency Coordination Group on AMR.
In addition to these and several other existing commitments, Canada has this past month (October 2017) assumed a new leadership role on this issue as the Chair of the Global Health Security Agenda’s AMR Action Package.
