44th Parliament222Presented to the House of CommonsMarch 22, 2024441-02265441-02265 (Health)ElizabethMaySaanich—Gulf IslandsGreen PartyBCMarch 22, 2024February 8, 2023PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWhereas:
  • Statistics Canada cites that approximately 4.8 million Canadians do not have a regular doctor;
  • Despite the number of physicians in Canada growing, the number of Canadians without a regular doctor remains stable;
  • 92 per cent of physicians work in urban centres, while just 8 per cent work in rural areas; and
  • In Victoria and Sidney, B.C., average wait time for a walk-in clinic are 92 and 180 minutes respectively.
We, the undersigned citizens and residents of Canada, call upon the House of Commons in Parliament assembled to:
  • Work with all the provinces and territories in Canada to come to a holistic and fair solution to Canada's family doctor shortage.
Family doctorsHealth services accessibility
44th Parliament222Presented to the House of CommonsFebruary 14, 2024441-02159441-02159 (Health)ElizabethMaySaanich—Gulf IslandsGreen PartyBCFebruary 14, 2024October 12, 2023PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWhereas:
  • Statistics Canada cites that approximately 4.8 million Canadians do not have a regular doctor;
  • Despite the number of physicians in Canada growing, the number of Canadians without a regular doctor remains stable;
  • 92 per cent of physicians work in urban centres, while just 8 per cent work in rural areas; and
  • In Victoria and Sidney, B.C., average wait time for a walk-in clinic are 92 and 180 minutes respectively.
We, the undersigned citizens and residents of Canada, call upon the House of Commons in Parliament assembled to:
  • Work with all the provinces and territories in Canada to come to a holistic and fair solution to Canada's family doctor shortage.
Family doctorsHealth services accessibility
44th Parliament223Government response tabledJune 9, 2023441-01348441-01348 (Health)ArifViraniParkdale—High ParkLiberalONApril 26, 2023June 9, 2023March 30, 2023Petition to the Government of CanadaWHEREAS:
  • Tuberculosis (TB), despite being a preventable and curable disease, continues to cause suffering and death in Canada, with deep inequities in its burden across the country, most notably among newcomer and Indigenous communities;
  • Indigenous populations in Canada continue to face a disproportionate burden of TB, despite the Government of Canada's commitments to domestic TB elimination, including its specific commitment to ending TB across Inuit Nunangat by 2030;
  • Globally, the COVID-19 pandemic has severely disrupted TB services, and similar disruptions jeopardise the already-stagnant efforts to end TB here in Canada. However, the lack of updated national TB data hinders our understanding of the impact COVID-19 has had on TB programs in the country;
  • There is an urgent need for the Government to scale up genuine efforts to end TB in Canada;
  • The lack of a National Tuberculosis Elimination Strategy is a major barrier to TB elimination in the country;
  • The failure to address tuberculosis in Canada is a failure to protect the health of all Canadians equally; and
  • Aligning with the newest edition of the Canadian Thoracic Society TB Standards, outlining best practices in TB prevention and care in Canada,
We, the undersigned, citizens and residents of Canada, call upon the Government of Canada to:1. Establish a national working group or committee to oversee the planning and creation of the National TB Elimination Strategy (hereafter the Strategy), that works closely with TB physicians, researchers and advocates, as well as Indigenous community representatives, to set evidencebased priorities for the Strategy;2. Launch the Strategy, including specific commitments required to achieve TB elimination in Canada, such as:a. Improving TB screening and care among high-priority groups,b. Addressing the social determinants of health and barriers to TB care,c. Improving access to essential medicines for TB,d. Implementing timely TB surveillance infrastructure,e. Adopting accountability, monitoring and evaluation measures for TB programming; and3. Commit the funding required to fulfil the recommendations of the Strategy and achieve its milestones and targets in a timely manner.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Adam van KoeverdenOur government recognizes the impact of tuberculosis (TB) on individuals and families. We are working with provincial, territorial, and Indigenous partners to take steps to reduce rates of tuberculosis in Canada, especially among priority populations. We want to improve access to prevention, treatment, and care for populations most at risk for the disease. Our approach is focused on removing barriers such as stigma through awareness and education and providing culturally appropriate services and treatment.Canada continues to contribute to TB prevention and control efforts in several ways including working with provincial, territorial, and Indigenous partners to take steps in reducing rates of tuberculosis in Canada, especially among vulnerable populations. For example, the government collaborates with partners to conduct surveillance, develop TB prevention, and control standards, and provide outbreak support. In addition, the National Microbiology Laboratory provides reference and diagnostic services, and supports public health partners with testing.The Government of Canada is committed to continuing to work collaboratively with provincial and territorial governments, Indigenous leaders, and other stakeholders, including partners in the health and non-health sectors, to better prevent, detect and control TB in order to accelerate our efforts to eliminate TB in Canada. We are committed to working with other nations to end the worldwide Tuberculosis epidemic, as set out by the United Nations.
Health services accessibilityTuberculosis Elimination StrategyTuberculosis in humans
44th Parliament223Government response tabledApril 19, 2023e-4177e-4177 (Health)RyanHooeyBonitaZarrilloPort Moody—CoquitlamNDPBCNovember 2, 2022, at 11:25 a.m. (EDT)March 2, 2023, at 11:25 a.m. (EDT)March 6, 2023April 19, 2023March 2, 2023Petition to the <Addressee type="3" affiliationId="" mp-riding-display="1">Government of Canada</Addressee>Whereas:Diabetes and sight loss are closely connected;Canada has one of the highest rates of diabetic retinopathy (25.1% of people living with diabetes), which is the fourth leading cause of sight loss in Canada, and the leading cause of sight loss in working-age adults; An estimated 750,000 Canadians live with the condition;People living with diabetes and sight loss often rely on insulin pumps for their diabetes treatment, like their sighted peers;Individuals living with diabetes and sight loss live independent lives but are unable to safely and independently use insulin pumps due to the lack of accessibility features and visual cues on the device;Health Canada does not assess accessibility as part of the approval process for medical devices, which jeopardizes device efficacy and patient safety, and creates further barriers for people who are blind or partially sighted; andInsulin pump manufacturers have issued public warnings (called contraindications) advising people with sight loss to avoid using insulin pumps, citing safety concerns.We, the undersigned, citizens and residents of Canada, call upon the Government of Canada to: 1. Ensure the Health Canada approval process for new medical devices (e.g., insulin pumps) includes an accessibility assessment; and 2. Work with insulin pump manufacturers to address the safety concerns with existing insulin pumps, expressed on the contraindications and ensure that future contraindications are not considered for insulin pumps.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Adam van KoeverdenThe Food and Drugs Act (the Act)and its Medical Devices Regulations (the Regulations) set out the scope of Health Canada’s authority for the approval process for new medical devices, including insulin pumps. Health Canada’s Health Products and Food Branch (HPFB) is responsible for pre-market review of insulin pumps in compliance with the Act and Regulations.Health Canada is committed to facilitating access to Insulin pumps to all Canadians, including populations such as individuals who are blind, deafblind, and partially sighted. HPFB is responsible for the approval process of insulin pumps and operates within the scope and mandate of its regulatory authority.Under sub-section 11(1) of the Regulations “A medical device […] shall not, when used for the medical conditions, purposes or uses for which it is manufactured, sold or represented, adversely affect the health or safety of a patient, user or other person, except to the extent that a possible adverse effect of the device constitutes an acceptable risk when weighed against the benefits to the patient and the risk is compatible with a high level of protection and safety”.  In order to assess an application against this requirement, Health Canada’s pre-market reviews of devices include the assessment of device safety in relation to the medical conditions, purposes or uses for which it is manufactured, sold or represented.  This includes consideration of the intended target population for a given device. As such, Health Canada’s review evaluates evidence from usability testing to ensure the device can be used safely by the target population. In this usability testing, patients are asked to try to complete important device tasks, and the manufacturer confirms these tasks can be done safely without introducing errors.Health Canada cannot compel manufacturers to develop or seek to market a device specific to a user group. It is the manufacturer’s responsibility to determine the intended target population for their devices. In the case that the manufacturer makes a claim that the device is accessible to certain patient populations, Health Canada would assess the data available to support that claim, including usability testing. However, if the manufacturer does not make a claim that the device is accessible to certain patient populations, Health Canada does not have the authority to require the manufacturer to produce evidence, revise their intended use or labelling, or redesign their device to make it accessible to special populations. Section 10 of the Regulations requires that a “medical device shall be designed and manufactured to be safe”, and if certain risks cannot be eliminated, to “provide, with the device, information relative to the risks that remain”. For example, if an inability or reduced ability to visually confirm information provided by an insulin pump presents an unacceptable risk to the patient, it is the manufacturer’s responsibility to take steps to eliminate or mitigate this risk, in compliance with section 10 of the Regulations. If a manufacturer has determined that it is not possible to eliminate the risk if a person with sight loss uses that insulin pump (i.e., the device design is inherently unsafe for use by people with sight loss), one of the manufacturer’s responsibilities is to provide information with the device relative to the risk (i.e., label the limitations of the device). This is the reason why a manufacturer might include a warning in the device labelling advising that users must have adequate vision to allow safe use of the device.Health Canada’s responsibility in the pre-market review of insulin devices is to ensure that the manufacturer has provided sufficient analysis of the risks associated with their device and has complied with section 10 for any such risks. This includes ensuring that a manufacturer has eliminated risks where possible and that a manufacturer provides adequate information about the risks that cannot be eliminated, including statements of warning or contraindications, in the device labelling. Although Health Canada may request additional warnings or contraindications be added to a device’s label based on the evidence provided or known risks associated with the technology, Health Canada generally does not request a manufacturer remove particular warnings or contraindications that the manufacturer has identified are necessary or relevant for the safe use of their device.After medical devices are licensed for sale, the Department monitors them for safety, effectiveness, and quality. This includes monitoring devices through recalls, as well as incident reports from consumers, manufacturers, health care providers and other sources. The Department follows up and takes appropriate action, as required. This can range from requesting a label change, controlling distribution, recalling the device, or even suspending a medical device licence. While the Department does not regulate the practice of medicine, if warranted, Health Canada may communicate about the risk of devices on the market.Health Canada has engaged in outreach with associations representing those with sight loss. In 2020 and 2021, the Department met with the Canadian National Institute for the Blind (CNIB) to discuss issues related to insulin pumps and persons with sight loss. In March 2022, the Department also engaged with key manufacturers of insulin pumps to share the concerns related to accessibility of these devices for people living with diabetes and sight loss.Health Canada welcomes the submission of medical device applications for devices that are accessible to underserved patient populations and that have eliminated, as far as possible, risks associated with the use of the device. When an application is received, Health Canada will undertake the review in a timely manner in accordance with its service standards. Health Canada offers medical device priority reviews for a device that provides a significant benefit-risk improvement over existing licensed devices or responds to an unmet urgent health need. The first application for an insulin pump designed to be used safely and effectively by persons with sight loss would, therefore, meet Health Canada’s criteria for priority review since it addresses an accessibility need, which may lead to a shorter time to market for these devices.Finally, through the special access program for medical devices, health care professionals can access custom-made and unlicensed devices for patients under their care when conventional therapies have failed, are unavailable or are unsuitable to treat a patient.
Health services accessibilityInsulin medicationMedical and assistive devices
44th Parliament223Government response tabledJanuary 30, 2023441-00867441-00867 (Health)ElizabethMaySaanich—Gulf IslandsGreen PartyBCNovember 23, 2022January 30, 2023November 15, 2022PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWhereas:
  • Statistics Canada cites that approximately 4.8 million Canadians do not have a regular doctor;
  • Despite the number of physicians in Canada growing, the number of Canadians without a regular doctor remains stable;
  • 92 per cent of physicians work in urban centres, while just 8 per cent work in rural areas; and
  • In Victoria and Sidney, B.C., average wait time for a walk-in clinic are 92 and 180 minutes respectively.
We, the undersigned citizens and residents of Canada, call upon the House of Commons in Parliament assembled to:
  • Work with all the provinces and territories in Canada to come to a holistic and fair solution to Canada's family doctor shortage.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Adam van KoeverdenPrimary care is the backbone of high-performing health care, serving as Canadians’ first point of contact with the system and playing a critical role in the delivery of health services. We understand that Canadians still struggle to secure timely access to a regular primary care provider or team. Over 14% of Canadians aged 12 years and older lack a regular primary health care provider, and people living in rural and remote communities can have an even harder time accessing high-quality primary care in a timely manner. The COVID-19 pandemic only exacerbated these challenges; health care workers bore the brunt of the extreme pressures of the health system, leading to significant vacancies, shortages, stress and burnout.Improving primary care access and working toward a future in which all Canadians and residents have timely access to a primary care provider or team is a key priority for the Government. Our Government continues to partner with the provinces and territories on this critical issue, building on a foundation of Federal-Provincial-Territorial (FPT) collaboration initiated during the pandemic. In March 2020, the FPT Virtual Care and Digital Health Table was struck, to facilitate collaboration on ways to maintain access to the health system through virtual care. Supported by the strong collaboration of this FPT Table, the Government began flowing $240.5M to help Canadian health systems support access to health care services, including primary care, through virtual approaches and digital tools. Of this, $150M was set aside to flow directly to provinces and territories through bilateral agreements to address the challenges of delivering health care during the COVID-19 pandemic and beyond. As well, by virtue of the strong collaboration of that same FPT Table, Health Canada is also supporting a two-year project.Like other countries, Canada is facing significant challenges in recruiting and retaining health workers in the wake of the COVID-19 pandemic. High patient loads, absenteeism due to illness, and fear for personal safety have led to unprecedented levels of burnout, absences, and turnover. This builds on longstanding issues that limit Canada’s ability to recruit, retain and appropriately plan for the health workers we need. These are real issues that require thoughtful discussions. Canadians expect the federal, provincial and territorial governments to work together to make meaningful change and support the health workforce in this country.Furthermore, from the beginning of the pandemic, the federal government has committed to investing $72 billion to support health systems and protect Canadians. To address the health care workers shortage and access to care, some of these investments include the following:
  • $6.5 billion in top-ups to the Canada Health Transfer, Canada’s largest federal transfer to provinces and territories, including $2 billion announced in March 2022 to continue to address immediate pressures, such as backlogs in surgeries and procedures (which supplements Budget 2021’s investment of $4 billion for the same purpose);
  • $26.2 million through Budget 2022 to increase the forgivable amount of student loans for doctors and nurses who practice in rural and remote communities ($30,000 in loan forgiveness for nurses and up to $60,000 for doctors, with proposals to expand the list of eligible professionals under the program);
  • $38.5 million over two years to support the training of up to 4,000 personal support worker interns to address acute labour shortages in long-term and home care; and,
  • $115 million over five years through Budget 2022, with $30 million ongoing, to expand the Foreign Credential Recognition Program to help up to 11,000 internationally trained health care professionals per year get their credentials recognized, and support projects, including standardized national exams, easier access to information, faster timeliness, and less red tape, to reduce barriers to foreign credential recognition for health care professionals.
The federal government recognizes that it has a key leadership role to play in supporting solutions for the challenges facing health systems across the country and remains committed to continuing to work with provincial and territorial governments to protect and strengthen the publicly funded health care system. Our Government is working with provincial and territorial governments to share best practices and identify opportunities to scale and spread promising practices across the country. We have also been engaging with health system partners and stakeholders over recent months to further understand health workforce gaps and needs, and work collaboratively to identify concrete solutions to address challenges and deliver results for Canadians, their families and our health care workers.The Government of Canada recently established a Coalition for Action for Health Workers, which will inform immediate and long-term solutions to address health workforce challenges, so that Canadians can access the quality care they need and deserve. Skilled and supported health workers are key to ensuring quality health care, which is why the Coalition’s initial priorities will include providing advice on the following:
  • workers’ retention so health workers continue to stay in their jobs;
  • increasing the supply of health professionals in the country;
  • improving health workforce data; and,
  • opportunities to put in place new models of care to address key barriers.
In addition to investments and the Coalition, the Government has also taken other concrete steps to address key concerns voiced by health care providers, including:
  • appointing a Chief Nursing Officer to provide strategic advice on health workforce planning, long-term care, and models of care;
  • amendments to the Criminal Code (under the former Bill C-3), in order to ensure health care workers are safe and free from threats, violence and harassment; and,
  • investing $140 million over two years, via Budget 2022, for the Wellness Together Canada (WTC) portal, which offers free, confidential mental health and substance use tools and services for frontline health care workers (these online services can also be accessed through PocketWell, the WTC companion app).
Through these various activities, our Government continues to work with provinces and territories to help Canadians have timely access to a regular primary care provider or team, as best suits their respective challenges and contexts. Going forward, we are committed to continuing that record of collaboration to building on progress already made in order to advance Canadians’ priority of better access to primary care.
Family doctorsHealth services accessibility
44th Parliament223Government response tabledSeptember 20, 2022441-00571441-00571 (Health)ElizabethMaySaanich—Gulf IslandsGreen PartyBCJune 14, 2022September 20, 2022May 10, 2022PETITION TO THE HOUSE OF COMMONS IN PARLIAMENT ASSEMBLEDWhereas:
  • Statistics Canada cites that approximately 4.8 million Canadians do not have a regular doctor;
  • Despite the number of physicians in Canada growing, the number of Canadians without a regular doctor remains stable;
  • 92 per cent of physicians work in urban centres, while just 8 per cent work in rural areas; and
  • In Victoria and Sidney, B.C., average wait time for a walk-in clinic are 92 and 180 minutes respectively.
We, the undersigned citizens and residents of Canada, call upon the House of Commons in Parliament assembled to:
  • Work with all the provinces and territories in Canada to come to a holistic and fair solution to Canada's family doctor shortage.
Response by the Minister of HealthSigned by (Minister or Parliamentary Secretary): Adam van KoeverdenPrimary care is the backbone of high-performing health care, serving as Canadians’ first point of contact with the system and playing a critical role in the delivery of health services. We understand that Canadians still struggle to secure timely access to regular primary care provider or team. Approximately 14% of Canadians aged 12 years and older lack a regular primary health care provider, and people living in rural communities can have an even harder time accessing high-quality primary care in a timely manner. The COVID-19 pandemic only exacerbated these challenges; health care workers bore the brunt of the extreme pressures of the health system, leading to significant vacancies, shortages, stress and burnout.Improving primary care access and working toward a future in which all Canadians and residents have timely access to a primary care provider or team is a key priority for the government. Our government continues to partner with the provinces and territories on this critical issue, building on a foundation of FPT collaboration initiated during the pandemic. In March 2020, the Federal-Provincial-Territorial (FPT) Virtual Care and Digital Health Table was struck, to facilitate collaboration on ways to maintain access to the health system through virtual care. Supported by the strong collaboration of this FPT Table, the government began flowing $240.5M to help Canadian health systems support access to health care services, including primary care, through virtual approaches and digital tools. Of this, $150M is flowing directly to provinces and territories through bilateral agreements to address the challenges of delivering health care during the COVID-19 pandemic and beyond. As well, by virtue of the strong collaboration of that same FPT Table, Health Canada is also supporting a two-year project, led by the Centre for Digital Health Evaluation, to evaluate the benefits of virtual care and support capacity building within provinces and territories.Like other countries, Canada is facing significant challenges in recruiting and retaining health workers in the wake of the COVID-19 pandemic.  High patient loads, absenteeism due to illness, and fear for personal safety have led to unprecedented levels of burnout, absences, and turnover. This builds on longstanding issues which limit Canada’s ability to recruit, retain and appropriately plan for the health workers we need. These are real issues that require thoughtful discussions. Canadians expect the federal, provincial and territorial governments to work together to make meaningful change and support the health workforce in this country.Our government is working with provincial and territorial to share best practices and identify opportunities to scale and spread promising practices across the country. We have also been engaging with health system partners and stakeholders over recent months to further understand the health workforce gaps and needs, and work collaboratively to identify concrete solutions to address the challenges and to deliver results for Canadians, their families and our health care workers.The Government has taken action to address key concerns voiced by health care providers, including:
  • Amendments to the Criminal Code (under the former Bill C-3), in order to ensure health care workers are safe and free from threats, violence and harassment.
  • Budget 2022 provided $26.2 million in funding to increase the forgivable amount of student loans for doctors and nurses who practise in rural and remote communities. This will mean up to $30,000 in loan forgiveness for nurses and up to $60,000 in loan forgiveness for doctors working in underserved rural or remote communities. It also proposes expanding the list of eligible professionals under the program in order to help bring more health care workers to the communities who need them most.
  • Budget 2022 provided an additional $140 million over two years to the Wellness Together Canada (WTC) portal, which offers free, confidential mental health and substance use tools and services for frontline health care workers. These online services can also be accessed through PocketWell, WTC companion app.
  • Additionally, Budget 2022 provided $115 million over five years, with $30 million ongoing, to expand the Foreign Credential Recognition Program and help up to 11,000 internationally trained health care professionals per year get their credentials recognized and find work in their field. It will also support projects — including standardized national exams, easier access to information, faster timelines, and less red tape — that will reduce barriers to foreign credential recognition for health care professionals.
  • This is in addition to a $2 billion top-up to the Canada Health Transfer, provided to provinces and territories, to reduce backlogs caused by COVID-19. This is helping to support the health and well-being of Canadians and those on the frontlines of our health care system. This investment supplements the Budget 2021 investment of $4 billion through the Canada Health Transfer to help provinces and territories address immediate health care system pressures.
Through these various activities, our government continues to work with provinces and territories to help Canadians have timely access to a regular primary care provider or team, as best suits their respective challenges and contexts. Going forward, we are committed to continuing that record of collaboration to building on progress already made in order to advance Canadians’ priority of better access to primary care.
Family doctorsHealth services accessibility