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  3. HESA#113: On Women's Health

HESA#113: On Women's Health

Jenny Kwan Vancouver East, BC
NDP

Thank you very much, Mr. Chair.

Thank you to all of the witnesses for sharing your expertise with this committee.

I'm particularly interested in what work you think can be done and what the government should do, particularly in looking at the issues through the lens of under-represented communities, for example, in the racialized community, the LGBTQ2+ community and, I would even venture as far as to say, for seniors, who are often put on the back burner, especially as they age. What are some of the health concerns, both on the research side, as well as on the side of actually providing real supports?

That is to all of the presenters, please.

 

Dr. Pamela Valentine
President and CEO, MS Canada

I'll jump in. I don't know if anybody else will make the same comment.

We have a real problem with information and data in this country. I sit as the CEO for MS Canada, and I cannot answer what the diversity of our population living with MS in this country looks like. I can give gender—it's fantastic to know that there are three times as many women as there are men—but after that, it's really difficult to answer those questions.

To get data in this country that crosses provincial borders is exceptionally difficult. That will not be a surprise to you. That definitely costs us more time, money and energy to get the solutions that we have today, as Ruth Ann has suggested, into the hands of the people who are going to put that information to work.

It's a very real barrier for us.

Health Committee on May 2nd, 2024
Evidence of meeting #113 for Health in the 44th Parliament, 1st Session

1:20 p.m.

 

The Chair Sean Casey
Liberal

Thank you, Dr. Valentine.

Next we have Ms. Kwan, please, for six minutes.

 

Jenny Kwan Vancouver East, BC
NDP

Thank you very much, Mr. Chair.

Thank you to all of the witnesses for sharing your expertise with this committee.

I'm particularly interested in what work you think can be done and what the government should do, particularly in looking at the issues through the lens of under-represented communities, for example, in the racialized community, the LGBTQ2+ community and, I would even venture as far as to say, for seniors, who are often put on the back burner, especially as they age. What are some of the health concerns, both on the research side, as well as on the side of actually providing real supports?

That is to all of the presenters, please.

 

Dr. Pamela Valentine
President and CEO, MS Canada

I'll jump in. I don't know if anybody else will make the same comment.

We have a real problem with information and data in this country. I sit as the CEO for MS Canada, and I cannot answer what the diversity of our population living with MS in this country looks like. I can give gender—it's fantastic to know that there are three times as many women as there are men—but after that, it's really difficult to answer those questions.

To get data in this country that crosses provincial borders is exceptionally difficult. That will not be a surprise to you. That definitely costs us more time, money and energy to get the solutions that we have today, as Ruth Ann has suggested, into the hands of the people who are going to put that information to work.

It's a very real barrier for us.

 

Dr. Deborah Money
Professor and Head, Department of Obstetrics and Gynaecology,
University of British Columbia, As an Individual

I'd like to pick up on that theme.

What we know is that with many diseases, particularly as they affect women, they're definitely overrepresented in racialized communities and in rural and remote communities. However, we have a terrible problem with getting accurate data, really, on any health condition in this country that covers the whole country and that tells us where people live, what their cultural or racial background is, what their first language is and so on.

The lack of ability to link data within health authorities across the province and across provinces and territories is an enormous barrier to moving the dial in this area.

 

Jenny Kwan Vancouver East, BC
NDP

Thank you for that.

What do you suggest to address this issue? Should there be dedicated funding targeted toward this data collection and research in this area?

What would you say needs to be done? What is the number one priority that the government should undertake to address this?

Dr. Money.

 

Dr. Deborah Money
Professor and Head, Department of Obstetrics and Gynaecology,
University of British Columbia, As an Individual

Funding is always helpful, but to be perfectly honest, the barrier is legislation. We are not permitted to share data without enormously complicated agreements. Every single time we try to look at another thing—be it COVID, syphilis, congenital syphilis or whatever—we have to go through new individual-level agreements to get permission to share what is actually de-identified data, but has some information on it around, say, rurality.

That's our biggest barrier.

 

Jenny Kwan Vancouver East, BC
NDP

To that end, the federal government should take a national approach and coordinate this effort between provinces and territories through legislation or whatever is needed so that it doesn't become a barrier to addressing women's health.

I'm seeing nodding heads. We will make sure that....

 

Dr. Deborah Money
Professor and Head, Department of Obstetrics and Gynaecology,
University of British Columbia, As an Individual

Absolutely.

 


Jenny Kwan Vancouver East, BC
NDP

That's your recommendation for a priority item that the government should undertake.

 

Dr. Deborah Money
Professor and Head, Department of Obstetrics and Gynaecology, University of British Columbia, As an Individual

It's a big priority for me. That's for sure.

 

Jenny Kwan Vancouver East, BC
NDP

Dr. Valentine, do you have anything to add?

 

Dr. Pamela Valentine
President and CEO, MS Canada

I was just going to ask Dr. Marrie if she wanted to comment, as a researcher who very regularly tries to get data across provinces.

 

Dr. Ruth Ann Marrie
Professor, Department of Medicine, Max Rady College of Medicine,
University of Manitoba, As an Individual

Thank you for that.

Yes, I agree with the regulatory barriers issue. We know why they're there. It's important to protect the privacy of health information.

Unlike countries in Scandinavia, where you can have all the national data all at once through a single process, we have multiple processes, as Dr. Money said. Even within provinces, I had one study that needed 13 regulatory approvals to do one study in one province. This adds to costs, it reduces the productivity that we have for the amount of research dollars invested and it limits our ability to do things that are relevant on a national scale.

In addition, we have a fundamental data harmonization problem. We collect information differently in different regions about these key socio-demographic and diversity characteristics.

 

Jenny Kwan Vancouver East, BC
NDP

Thank you very much that. I really appreciate it. I hope we'll make sure that we can advance that as a recommendation from this committee.

One of the issues that women often tell me is forgotten or is even hard to diagnose is endometriosis in women, and particularly young women. They're in such pain. Do you have any advice or action that needs to be taken to address that?

Dr. Money.

 

Dr. Deborah Money
Professor and Head, Department of Obstetrics and Gynaecology, University of British Columbia, As an Individual

We do have research in this space looking at biomarkers—so markers in the blood—to pick up endometriosis in its early stages. It can be diagnosed surgically, and that requires a specialized centre and individuals with expertise. Again, focused research in areas like this are making a difference, and I think if we can get to the point of non-invasive markers that make it simpler in-community to make these diagnoses, it will help these young women.

 

The Chair Sean Casey
Liberal

Thank you, Ms. Kwan.

Colleagues, we have resources and sufficient time for one more round of questions from each party if the witnesses are prepared to stay for another 15 or 20 minutes. Does that suit you? Great. Thank you.

Ms. Roberts, please go ahead for five minutes.

 

--------

 

1:40 p.m.

 

 

The Chair Sean Casey
Liberal

Thank you, Dr. Money.

Thank you, Ms. Larouche.

The last word goes to Ms. Kwan, please, for two and a half minutes.

 

Jenny Kwan Vancouver East, BC
NDP

Thank you very much, Mr. Chair.

I just want to follow up quickly on my last question.

It's good to hear that there is perhaps more research and potentially emerging research coming forward. In the meantime, what should women do? Often it's just sort of overlooked, and it's hard for women to tell their physician to look into the issue, so what can they do? What can they do practically at this point?

 

Dr. Deborah Money
Professor and Head, Department of Obstetrics and Gynaecology,
University of British Columbia, As an Individual

I think there are two sides to it. One is that women need to be empowered with the understanding of what this condition is and how it can manifest, and then they can self-advocate.

The side I sit on is as an educator for women's health for obstetricians and gynecologists, primary care providers and so on. We have spoken about this a great deal. We need to increase the general understanding by practitioners of how this manifests and ensure that these women are taken seriously when they present with symptoms that may be a little bit non-specific but can sometimes be very devastating.

We need to increase the number of practitioners in OB/GYN who can do the current surgical diagnostic procedures that are needed until we get research into non-invasive options.

 

Jenny Kwan Vancouver East, BC
NDP

I note in the MS Canada presentation the need for research and the call for a $15-million investment in research. Of the different recommendations that you want to make to the Canadian government, would this be your number one request by way of research investment?

 

Dr. Pamela Valentine
President and CEO, MS Canada

What we do know is that less than 6% from the major MS research organizations around the globe—both governmental and not-for-profit organizations like mine—is spent on prevention. I think this is an unprecedented opportunity to prevent a debilitating neurological disease, which largely affects women, in the next generation, and probably in 10 years.

I think about where we've gone in the last 15 years; we have gone from three to 20 disease-modifying therapies that have produced the kinds of health outcomes that have reduced mortality by 30% and offset disability by 10-plus years. To be able to make those investments today is going to change the face of MS 10 years from now. There isn't another neurological disease, I don't think, in which you could make that claim with the evidence that's available to us today.

We're certainly asking the federal government to come in on that as a partner with a lot of concerned citizens who are going to give us money to partner on that. That's one of the specific requests that we've been making.

 

The Chair Sean Casey
Liberal

Thank you, Ms. Kwan.

Thank you, Dr. Valentine, for allowing us to finish on such an optimistic note.

This concludes the time that we have, and it also concludes the testimony that we intend to receive on this particular study. Next week, we'll be giving drafting instructions to the analysts.

Thank you for sticking with us and putting in the extra time. It will be of significant value to us. We appreciate your patience and professionalism.

Is it the will of the committee to adjourn the meeting?

 

Some hon. members

Agreed.

 

The Chair Sean Casey
Liberal

I see consensus. The meeting is adjourned.

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FINA#147: Bill C-69 on Concerns Around Expanding Immigration Detention into Federal Prisons

Jenny Kwan Vancouver East, BC
NDP

Thank you very much, Mr. Chair. I will speak to it very briefly.

As I was indicating, on March 13, over 80 civil societies, settlement agencies and religious organizations wrote a strongly worded letter to the Prime Minister with their concerns around expanding immigration detention into federal prisons.

Earlier today, the provisions around setting up this format were passed, but with that being said, this amendment is an attempt by the NDP to at least try to put some parameters within that framework, to have “high risk” clearly defined in legislation rather than leaving it up to regulation and having it be defined behind closed doors.

To that end, Mr. Chair, that's what the amendment seeks to do. The definition of “high risk” is really meant to provide some limitations around what would be deemed as high risk in this instance.

Mr. Chair, I just want to highlight a couple of elements within that. I won't, of course, read the entire amendment into the record here.

Really, we attempted to put some parameters there as to the nature and level of danger to the public the person poses related to, for example, any conviction to do with sexual offences or an offence involving violence or weapons and for the same conviction outside of Canada. As well, there are provisions with regard to pending charges for these offences. Also, we wanted to put parameters around engagement with terrorism or gang activities and such.

Mr. Chair, I think these are some of the provisions for declaring what is deemed to be “high risk” in that context.

The other thing worth noting here is that we're also adding to this with an amendment around mental health; when considering these matters, the mental health aspect of the individual should also be taken into consideration. That's written within the amendment here.

Of course, there are some accountability measures related to it, which means that when someone is to be detained, there has to be some level of accountability with respect to written notice advising the individual as such and then, of course, allowing the individual to undertake representation if they seek to do so.

That's a quick summary of where it is at in terms of trying to put these parameters in place.

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