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Ministerial briefing volume II: Health Portfolio priorities

Table of contents

A. Commitments and priorities overview

Mandate letters

December 16, 2021

Dear Minister Duclos,

Thank you for agreeing to serve Canadians as Minister of Health.

From the beginning of this pandemic, Canadians have faced a once-in-a-century challenge. And through it all, from coast to coast to coast, people have met the moment. When it mattered most, Canadians adapted, helped one another, and stayed true to our values of compassion, courage and determination. That is what has defined our path through this pandemic so far. And that is what will pave our way forward.

During a difficult time, Canadians made a democratic choice. They entrusted us to finish the fight against COVID-19 and support the recovery of a strong middle class. At the same time, they also gave us clear direction: to take bold, concrete action to build a healthier, more resilient future. That is what Canadians have asked us to do and it is exactly what our Government is ready to deliver. We will work to build that brighter future through continued collaboration, engagement, and the use of science and evidence-based decision-making. With an unwavering focus on delivering results, we will work constructively with Parliamentarians and maintain our strong partnerships with provincial, territorial and municipal governments and Indigenous partners. This decade has had an incredibly difficult start, but this is the moment to rebuild a more resilient, inclusive and stronger country for everyone.

The science is clear. Canadians have been clear. We must not only continue taking real climate action, we must also move faster and go further. As Canadians are increasingly experiencing across the country, climate change is an existential threat. Building a cleaner, greener future will require a sustained and collaborative effort from all of us. As Minister, I expect you to seek opportunities within your portfolio to support our whole-of-government effort to reduce emissions, create clean jobs and address the climate-related challenges communities are already facing.

This year, Canadians were horrified by the discovery of unmarked graves and burial sites near former residential schools. These discoveries underscore that we must move faster on the path of reconciliation with First Nations, Inuit and Métis Peoples. We know that reconciliation cannot come without truth and our Government will continue to invest in that truth. As Ministers, each of us has a duty to further this work, both collectively and as individuals. Consequently, I am directing every Minister to implement the United Nations Declaration on the Rights of Indigenous Peoples and to work in partnership with Indigenous Peoples to advance their rights.

We must continue to address the profound systemic inequities and disparities that remain present in the core fabric of our society, including our core institutions. To this effect, it is essential that Canadians in every region of the country see themselves reflected in our Government's priorities and our work. As Minister, I expect you to include and collaborate with various communities, and actively seek out and incorporate in your work, the diverse views of Canadians. This includes women, Indigenous Peoples, Black and racialized Canadians, newcomers, faith-based communities, persons with disabilities, LGBTQ2 Canadians, and, in both official languages.

Across our work, we remain committed to ensuring that public policies are informed and developed through an intersectional lens, including applying frameworks such as Gender-based Analysis Plus (GBA Plus) and the quality of life indicators in decision-making.

Canadians continue to rely on journalists and journalism for accurate and timely news. I expect you to maintain professional and respectful relationships with journalists to ensure that Canadians are well informed and have the information they need to keep themselves and their families safe.

Throughout the course of the pandemic, Canadians and their governments have adapted to new realities. Governments must draw on lessons learned from the pandemic to further adapt and develop more agile and effective ways to serve Canadians. To this end, I expect all Ministers to evaluate ways we can update our practices to ensure our Government continues to meet the challenges of today and tomorrow.

The success of this Parliament will require Parliamentarians, both in the House of Commons and the Senate, to work together across all parties to get big things done for Canadians. I expect you to maintain constructive relationships with your opposition critics and coordinate any legislation with the Leader of the Government in the House of Commons. As Minister, you are accountable to Parliament both individually, for your style of leadership and the performance of your responsibilities, and collectively, in support of our Ministry and decisions taken by Cabinet. "Open and Accountable Government" sets out these core principles and the standards of conduct expected of you and your office. I expect you to familiarize yourself with this document, which outlines my expectations for each member of the Ministry.

Our platform lays out an ambitious agenda. While finishing the fight against the pandemic must remain our central focus, we must continue building a strong middle class and work toward a better future where everyone has a real and fair chance at success and no one is left behind.

As Minister of Health, your immediate priority is to help finish the fight against COVID-19, working in close cooperation with provinces and territories. As we emerge from this pandemic, I expect you to work in partnership with provinces and territories to strengthen our universal public health care system and public health supports, backed by an early increase of investments in primary and virtual care and mental health services so all Canadians can get the care they need no matter where they live. Collaboration with provinces and territories will be key to ensuring the primary care system is positioned for the future, including accessible health system data, as well as working to improve the quality and availability of long-term care.

To realize these objectives, I ask that you achieve results for Canadians by delivering the following commitments.

Continue to provide leadership to finish the fight against COVID-19, including by:

With the support of the Deputy Prime Minister and Minister of Finance, lead our renewed commitment to work in partnership with and increase funding to provinces and territories to strengthen our universal public health system, ensure health care workers are supported and recruited across the country and advance an integrated, comprehensive and patient-centric strategy, harnessing the full potential of data and digital systems, including by:

Work with the Minister of Mental Health and Addictions and Associate Minister of Health and with the support of the Deputy Prime Minister and Minister of Finance to establish a permanent, ongoing Canada Mental Health Transfer, to help expand the delivery of high-quality, accessible and free mental health services, including for prevention and treatment.

With the support of the Minister of Seniors, negotiate agreements with provinces and territories to support efforts to improve the quality and availability of long-term care homes and beds. This includes working with provinces and territories to improve infection prevention and control measures, identify shared principles, and develop national standards and a Safe Long-Term Care Act to ensure seniors get the care they deserve. In support of this work, you will work with the Minister of Employment, Workforce Development and Disability Inclusion and provinces and territories to train up to 50,000 new personal support workers and raise wages.

With the support of the Minister for Women and Gender Equality and Youth, work to ensure that all Canadians have access to the sexual and reproductive health services they need, no matter where they live, by reinforcing compliance under the Canada Health Act, developing a sexual and reproductive health rights information portal, supporting the establishment of mechanisms to help families cover the costs of in vitro fertilization, and supporting youth-led grassroots organizations that respond to the unique sexual and reproductive health needs of young people.

Work with the Minister of Public Safety, President of the Queen's Privy Council for Canada and Minister of Emergency Preparedness, Minister of Fisheries, Oceans and the Canadian Coast Guard and Minister of Transport, among other colleagues, to ensure the Government of Canada continues to be prepared to proactively mitigate, and respond to, emerging incidents and hazards.

In moving forward with a uniquely Canadian approach modeled on the Defense Advanced Research Projects Agency (DARPA), work with the Minister of Innovation, Science and Industry to develop a plan to modernize the federal research funding ecosystem to maximize the impact of investments in both research excellence and downstream innovation, with a particular focus on the relationships among the federal research granting agencies and the Canada Foundation for Innovation.

With the support of the Chief Science Advisor, continue to ensure science and evidence are integrated into our pandemic response.

With the support of the Minister of Foreign Affairs, work with the Minister of International Development to continue to reinforce international efforts to ensure that people around the world have access to health interventions to fight COVID-19, including vaccines, therapeutics and strengthened health systems.

Work with partners to take increased and expedited action to monitor, prevent and mitigate the serious and growing threat of antimicrobial resistance and preserve the effectiveness of the antimicrobials Canadians rely upon every day.

Continue engaging with willing provinces and territories towards national universal pharmacare, while proceeding with a national strategy on high-cost drugs for rare diseases and advancing the establishment of the Canada Drug Agency.

To protect Canadians from harmful chemicals, strengthen the Canadian Environmental Protection Act, introduce mandatory labelling of chemicals in consumer products, introduce legislation to end testing on animals, increase testing of products for compliance with Canadian standards, and implement an action plan to protect Canadians, including firefighters, from exposure to toxic flame retardants found in household products.

Work with the Leader of the Government in the House of Commons in their work to develop a plan to both make Parliament a more inclusive place for families and to respond with greater agility in the event of a future national health crisis.

To ensure Canadians are protected from risks associated with the use of pesticides and to better protect human health, wildlife and the environment, modernize and strengthen the Pest Control Products Act to ensure it supports transparency, use of independent scientific evidence and input to the decision-making process.

Recognizing that a healthy population is key to reducing vulnerability to health events, promote healthy eating by advancing the Healthy Eating Strategy. This includes finalizing the front-of-package labelling to promote healthy food choices and supporting restrictions on the commercial marketing of food and beverages to children.

In support of the Indigenous Early Learning and Child Care system, continue to invest in Aboriginal Head Start in Urban and Northern Communities Program.

In this, the UN Decade of Healthy Ageing (2021-2030), promote seniors' physical and mental health to enable them to live longer at home, including by supporting the Minister of Seniors in their work to establish an expert panel to provide recommendations for establishing an Aging at Home Benefit.

In collaboration with provinces, territories, families and stakeholders, accelerate the development of the National Autism Strategy.

As Minister, you are also responsible for actively engaging with your Cabinet and Caucus colleagues. As we deliver on our platform commitments, it will be important that members of the Ministry continue to collaborate and work constructively to support rigorous and productive Cabinet decision-making. I expect you to support your colleagues in delivering their commitments, leveraging the expertise of your department and your own lived experiences.

To best achieve results for Canadians, Ministers must be rigorous and coordinated in our approach to implementation. I would therefore ask that you return to me with a proposed approach for the delivery of your mandate commitments, including priorities for early implementation. Furthermore, to ensure we are accountable for our work, I will be asking you to publicly report to me, and all Canadians, on your progress toward these commitments on a regular basis.

As we have been reminded throughout the pandemic, adapting to change is not only something government should do, it is something government must do. As you work to fulfil our commitments, I expect you to actively consider new ideas and issues as they emerge, whether through public engagement, your work with Parliamentarians or advice from the public service. I also expect you to work with your Deputy Minister to assess priorities on a continual basis as we build a better future for all Canadians. In addition to achieving results, you are responsible for overseeing the work of your department and ensuring the effective operation of your portfolio.

As you staff your office and implement outreach and recruitment strategies for federally appointed leadership positions and boards, I ask that you uphold the principles of equity, diversity and inclusion. This helps ensure that federal workplaces are dynamic and reflective of the Canadians we serve. You will also ensure your Minister's office and portfolio are reflective of our commitment to healthy and safe workplaces.

Canadians expect us to work hard, speak truthfully and be committed to advancing their interests and aspirations. When we make mistakes – as we all will – Canadians expect us to acknowledge them, and most importantly, to learn from them.

I know I can count on you to fulfill the important responsibilities entrusted in you, and to turn to me, and the Deputy Prime Minister, early and often to support you in your role as Minister.

Sincerely,

Rt. Hon. Justin Trudeau, P.C., M.P.
Prime Minister of Canada

December 16, 2021

Dear Minister Bennett:

Thank you for agreeing to serve Canadians as Minister of Mental Health and Addictions and Associate Minister of Health.

From the beginning of this pandemic, Canadians have faced a once-in-a-century challenge. And through it all, from coast to coast to coast, people have met the moment. When it mattered most, Canadians adapted, helped one another, and stayed true to our values of compassion, courage and determination. That is what has defined our path through this pandemic so far. And that is what will pave our way forward.

During a difficult time, Canadians made a democratic choice. They entrusted us to finish the fight against COVID-19 and support the recovery of a strong middle class. At the same time, they also gave us clear direction: to take bold, concrete action to build a healthier, more resilient future. That is what Canadians have asked us to do and it is exactly what our Government is ready to deliver. We will work to build that brighter future through continued collaboration, engagement, and the use of science and evidence-based decision-making. With an unwavering focus on delivering results, we will work constructively with Parliamentarians and maintain our strong partnerships with provincial, territorial and municipal governments and Indigenous partners. This decade has had an incredibly difficult start, but this is the moment to rebuild a more resilient, inclusive and stronger country for everyone.

The science is clear. Canadians have been clear. We must not only continue taking real climate action, we must also move faster and go further. As Canadians are increasingly experiencing across the country, climate change is an existential threat. Building a cleaner, greener future will require a sustained and collaborative effort from all of us. As Minister, I expect you to seek opportunities within your portfolio to support our whole-of-government effort to reduce emissions, create clean jobs and address the climate-related challenges communities are already facing.

This year, Canadians were horrified by the discovery of unmarked graves and burial sites near former residential schools. These discoveries underscore that we must move faster on the path of reconciliation with First Nations, Inuit and Métis Peoples. We know that reconciliation cannot come without truth and our Government will continue to invest in that truth. As Ministers, each of us has a duty to further this work, both collectively and as individuals. Consequently, I am directing every Minister to implement the United Nations Declaration on the Rights of Indigenous Peoples and to work in partnership with Indigenous Peoples to advance their rights.

We must continue to address the profound systemic inequities and disparities that remain present in the core fabric of our society, including our core institutions. To this effect, it is essential that Canadians in every region of the country see themselves reflected in our Government's priorities and our work. As Minister, I expect you to include and collaborate with various communities, and actively seek out and incorporate in your work, the diverse views of Canadians. This includes women, Indigenous Peoples, Black and racialized Canadians, newcomers, faith-based communities, persons with disabilities, LGBTQ2 Canadians, and, in both official languages.

Across our work, we remain committed to ensuring that public policies are informed and developed through an intersectional lens, including applying frameworks such as Gender-based Analysis Plus (GBA Plus) and the quality of life indicators in decision-making.

Canadians continue to rely on journalists and journalism for accurate and timely news. I expect you to maintain professional and respectful relationships with journalists to ensure that Canadians are well informed and have the information they need to keep themselves and their families safe.

Throughout the course of the pandemic, Canadians and their governments have adapted to new realities. Governments must draw on lessons learned from the pandemic to further adapt and develop more agile and effective ways to serve Canadians. To this end, I expect all Ministers to evaluate ways we can update our practices to ensure our Government continues to meet the challenges of today and tomorrow.

The success of this Parliament will require Parliamentarians, both in the House of Commons and the Senate, to work together across all parties to get big things done for Canadians. I expect you to maintain constructive relationships with your Opposition Critics and coordinate any legislation with the Leader of the Government in the House of Commons. As Minister, you are accountable to Parliament both individually, for your style of leadership and the performance of your responsibilities, and collectively, in support of our Ministry and decisions taken by Cabinet. "Open and Accountable Government" sets out these core principles and the standards of conduct expected of you and your office. I expect you to familiarize yourself with this document, which outlines my expectations for each member of the Ministry.

Our platform lays out an ambitious agenda. While finishing the fight against the pandemic must remain our central focus, we must continue building a strong middle class and work toward a better future where everyone has a real and fair chance at success and no one is left behind.

As Minister of Mental Health and Addictions and Associate Minister of Health, you will work with the Minister of Health to build a healthier future, with a particular focus on ensuring that health inequities are understood and addressed, including for Indigenous Peoples, Black Canadians and vulnerable Canadians. You will work to ensure that mental health care is treated as a full and equal part of our universal health care system, working in close collaboration with provinces and territories, and lead a whole-of-society approach to address problematic substance use in Canada.

To realize these objectives, I ask that you achieve results for Canadians by delivering the following commitments.

Work with the Minister of Health, and with the support of the Deputy Prime Minister and Minister of Finance, to establish a permanent, ongoing Canada Mental Health Transfer to help expand the delivery of high-quality, accessible and free mental health services, including for prevention and treatment.

In order to support the mental health of Canadians, develop and implement a comprehensive, evidence-based plan, leveraging existing and new investments, including to:

Support the Minister of Indigenous Services to co-develop and invest in a distinctions-based Mental Health and Wellness Strategy to meet the needs of First Nations, Inuit and the Métis Nation, including culturally appropriate wraparound services for addiction and trauma, suicide and life promotion and the building of treatment centres.

Oversee the implementation of our investments in mental health interventions and supports for people disproportionately impacted by COVID-19, including health care workers, front-line workers, seniors, Indigenous people, and Black and racialized Canadians.

Work with the Minister of Families, Children and Social Development and Minister for Women and Gender Equality and Youth to ensure mental health supports are accessible to children and youth as they recover from the impact of the pandemic.

Advance a comprehensive strategy to address problematic substance use in Canada, supporting efforts to improve public education to reduce stigma, and supporting provinces and territories and working with Indigenous communities to provide access to a full range of evidence-based treatment and harm reduction, as well as to create standards for substance use treatment programs.

Require tobacco manufacturers to pay for the cost of federal public health investments in tobacco control.

Support the Minister of Public Safety to continue advancing Canada's first-ever National Action Plan on Post-Traumatic Stress Injuries, including additional investment to support the health and well-being of first responders.

Support the Minister of Veterans Affairs to ensure Canadian Armed Forces members and Veterans have access to adequate mental health resources, services and training programs tailored to their specific needs.

With the support of the Minister of Rural Economic Development, explore pathways to increase the accessibility of mental health services in rural areas.

As Minister, you are also responsible for actively engaging with your Cabinet and Caucus colleagues. As we deliver on our platform commitments, it will be important that members of the Ministry continue to collaborate and work constructively to support rigorous and productive Cabinet decision-making. I expect you to support your colleagues in delivering their commitments, leveraging the expertise of your department and your own lived experiences.

To best achieve results for Canadians, Ministers must be rigorous and coordinated in our approach to implementation. I would therefore ask that you return to me with a proposed approach for the delivery of your mandate commitments, including priorities for early implementation. Furthermore, to ensure we are accountable for our work, I will be asking you to publicly report to me, and all Canadians, on your progress toward these commitments on a regular basis.

As we have been reminded throughout the pandemic, adapting to change is not only something government should do, it is something government must do. As you work to fulfil our commitments, I expect you to actively consider new ideas and issues as they emerge, whether through public engagement, your work with Parliamentarians or advice from the public service. I also expect you to work with your Deputy Minister to assess priorities on a continual basis as we build a better future for all Canadians. In addition to achieving results, you are responsible for overseeing the work of your department and ensuring the effective operation of your portfolio.

As you staff your office and implement outreach and recruitment strategies for federally appointed leadership positions and boards, I ask that you uphold the principles of equity, diversity and inclusion. This helps ensure that federal workplaces are dynamic and reflective of the Canadians we serve. You will also ensure your Minister's office and portfolio are reflective of our commitment to healthy and safe workplaces.

Canadians expect us to work hard, speak truthfully and be committed to advancing their interests and aspirations. When we make mistakes – as we all will – Canadians expect us to acknowledge them, and most importantly, to learn from them.

I know I can count on you to fulfill the important responsibilities entrusted in you, and to turn to me, and the Deputy Prime Minister, early and often to support you in your role as Minister.

Sincerely,

Rt. Hon. Justin Trudeau, P.C., M.P.
Prime Minister of Canada

Summary of the 2021 speech from the throne

On November 23, 2021, Her Excellency the Right Honourable Mary Simon, Governor General of Canada, delivered the Speech from the Throne to open the first session of the 44th Parliament.

The speech focused on several themes, including:

Under the first theme, the Speech from the Throne placed a strong emphasis on the COVID-19 pandemic, noting that "priority number one remains getting the pandemic under control," with a focus on vaccination. Of note, efforts to implement mandatory vaccinations for federal and federally regulated workers, and for those travelling within Canada by plane, train or ship were highlighted, as were steps to secure the next generation of COVID-19 vaccines, boosters, and doses for kids from 5 to 11.

On healthcare issues more broadly, the Speech from the Throne stated that "to build a healthy future, we must also strengthen our healthcare system and public health supports for all Canadians, especially seniors, veterans, persons with disabilities, vulnerable members of our communities, and those who have faced discrimination by the very system that is meant to heal." In this respect, it was noted that further work was needed on issues such as: accessibility; care in rural communities; delayed procedures; mental health and addiction treatment; long-term care; and, improving data collection across health systems to inform future decisions and get the best possible results.

Beyond the Health Portfolio, reconciliation with Indigenous Peoples was a cross-cutting theme. On this, this Government of Canada committed to invest in a distinctions-based mental health and wellness strategy, guided by Indigenous Peoples, survivors, and their families.

Other commitments in the Speech from the Throne of note to the Health Portfolio include:

Budget 2023 Health Portfolio summary note

Overview

The Government of Canada presented Budget 2023 in the House of Commons on March 28th, 2023. In Budget 2023, "A Made-In-Canada Plan: Strong Middle Class, Affordable Economy, Healthy Future", the Government of Canada is focusing on making life more affordable, stronger public health and dental care, and growing a green economy, while taking steps to lower the national net debt-to-GDP ratio.

Implications for the Health Portfolio

Budget 2023 announced a number of measures directly relevant to the Health Portfolio.

1. Health System Priorities (HC-SPB)

Budget 2023 reiterated the Prime Minister's February 7th commitments on health system priorities, with $195.8 billion over 10 years, including $46.2 billion in new funding:

2. Dental care (HC-SPB)
3. PHAC Renewal (PHAC)
4. Sexual and Reproductive Health Fund (HC-SPB)
5. A Renewed Canadian Drugs and Substances Strategy (HC-CSCB)
6. Implementing 988- The Suicide Prevention Line (PHAC)
7. Tobacco cost recovery (HC-CSCB)
8. Food and Mouth Vaccine Bank for Canada (FMD) (CFIA)
9. Sunsetters

Several programs that are sunsetting this fiscal year were extended, including:

10. Other

Budget 2023 also highlighted $1.6 billion over five years, starting in 2023-24, to implement Canada's first National Adaptation Strategy, which was announced in fall 2022. Funding is being provided to multiple departments, including Health Canada.

Budget 2023 also highlighted federal investments made since 2016 to support research and science across Canada, including supports to the CIHR. It reiterates its commitment to modernizing Canada's research ecosystem including through the consideration of the advice provided by the independent Advisory Panel on the Federal Research Support System, with more detail to follow in the coming months on further efforts to modernize the system.

Legislative Measures

In addition to funding, Budget 2023 also noted several legislative amendments of interest to the Health Portfolio:

[REDACT]

Measures from Other Government Departments of Relevance to the Health Portfolio

Health Workforce
Indigenous Health
Tax Filing
Other
Governance

Budget 2023 included several measures focused on promoting good governance, including measures geared towards strengthening official languages, as well as measures to fight systemic racism, discrimination and hate. These measures include:

Budget 2023 also included several measures geared towards controlling government spending. These include:

Supply and confidence agreement – health commitments

The Prime Minister announced an agreement on March 22nd, 2022 that was reached by the Liberal Party of Canada and the New Democratic Party called, "Delivering for Canadians Now, A Supply and Confidence Agreement". The agreement wants to build a strengthening economy that supports their families with green jobs and climate action, more housing and child-care affordability, and stronger healthcare. The following four bullets below are health commitments that the parties agreed to prioritize for a better healthcare system.

Health Systems

Dental Care

Safe Long-Term Care

Pharmacare

B. Issues for early attention

Officials are prepared to brief you on these issues, with key milestones in Summer and Fall 2023.

Working together to improve health care for Canadians – agreements with provinces and territories

In February 2023, the Government of Canada announced an investment of nearly $200 billion over 10 years, including $46.2 billion in new funding, to improve health care services for Canadians. This funding includes an immediate, unconditional $2 billion Canada Health Transfer (CHT) top-up to address immediate pressures on the health care system. These investments will help build a health care system that includes:

This funding includes providing $25 billion over 10 years to provinces and territories to support shared health priorities through tailored bilateral agreements. Agreements in principle have been announced with provinces and territories except Quebec, and action plans are being negotiated now that outline how funds will be spent and how progress will be measured.

In addition, the February announcement included $2 billion over 10 years to address unique challenges Indigenous Peoples face when it comes to fair and equitable access to quality and culturally safe health care services.

Health workforce

Canada's health workforce is currently facing challenges in the supply of health workers, low retention and workplace conditions that put additional pressure on workers. High patient workloads, fewer workers and fear for personal safety have led to unprecedented levels of burnout, absences and turnover. Action is required in four key areas to support the workforce:

The Government of Canada has taken numerous steps to help address health workforce needs, including:

The Government is also advancing specific actions on foreign credential recognition and labour mobility with PTs as part of commitments made through the Working Together to Improve Health of Canadians funding. The Government will table response to Standing Committee on Health (HESA) report on "Addressing Canada's Health Workforce Crisis".

Health data

As part of the February 7th Working Together plan, the Government of Canada announced close to $200B over 10 years for provinces and territories to improve health care services for Canadians, including modernizing the health care system with standardized health data and digital tools. As part of the agreements, PTs are committing to adopt common standards and policies, including the Interoperability Roadmap, and to better collect, share, use, and report on health data to drive transparency on results. These data commitments were informed by significant FPT government collaboration, guided by the advice of an Expert Advisory Group on the development of a Pan-Canadian Health Data Strategy (PCHDS), intended to modernize how health data is managed in Canada. To support this work, the funding announcement included $505M over 5 years to the Canadian Institute for Health Information, Canada Health Infoway, and federal data partners to work with provinces and territories to advance digital health tools and the Interoperability Roadmap.

Dental care

A third of Canadians currently do not have dental insurance, and in 2018, more than one in five Canadians reported avoiding dental care because of the cost. Delaying preventative care can have wide-reaching impacts, including costlier treatments and worsening health outcomes.

Budget 2023 provided $13 billion over five years, starting in 2023-24, and $4.4 billion ongoing to implement the Canadian Dental Care Plan. The plan will provide dental coverage for uninsured Canadians with annual family income of less than $90,000, with no co-pays for those with family incomes under $70,000.

The interim Canada Dental Benefit, launched on December 1, 2022, was the first step toward fulfilling the government's Budget 2022 dental care commitment. The Canada Dental Benefit provides direct payments to eligible applicants of up to $650 per child under 12 years of age and up to $1300 over two years. The second Canada Dental Benefit application period opened on July 1, 2023 to help pay for out-of-pocket expenses incurred for dental care services received between July 1, 2023 to June 30, 2024. Health Canada will continue to work towards delivering the program for the long-term to all Canadians.

Pharmacare Act

Through Budget 2022, the Government of Canada reaffirmed its commitment to work towards a pharmacare program. This included tabling a Canada Pharmacare bill and working to pass it by end of 2023. Health Canada's objective is to improve prescription drug accessibility, affordability and appropriate use over time and highlight that these would be applied to all Canadians (i.e. principle of universality).

The Canadian Drug Agency Transition Office (CDATO) was formally established in 2021 to work with PTs and stakeholders, conduct analysis and develop options to advance a CDA. Since its establishment, the CDATO has held over 300 meetings/roundtables with stakeholders to inform the development of the CDA and its functions, which will include pharmaceuticals data and appropriate use. Additionally, the Canadian Drug Agency is tasked develop a national formulary.

In addition, the Government of Canada launched the National Strategy for Drugs Rare Diseases in March 2023, with an investment of up to $1.5 billion over three years. As part of this overall investment, the Government of Canada will make available up to $1.4 billion over three years to provinces and territories through bilateral agreements. This funding will help provinces and territories improve access to new and emerging drugs for Canadians with rare diseases, as well as support enhanced access to existing drugs, early diagnosis and screening for rare diseases.

Medical assistance in dying

Current work on MAID is focussed on preparing for the eligibility of those with mental illness as a sole underlying condition on March 17, 2024. HC established the independent MAID Practice Standards Task Group comprised of individuals with clinical, regulatory, and legal expertise to develop a practice standard. The practice standard and advice to the profession were released in March 2023 and disseminated to practitioners. HC is funding the Canadian Association of MAID Assessors and Providers (CAMAP) to develop a national, accredited MAID curriculum. This curriculum is set to be launched in Fall 2023.

As noted by the Expert Panel on MAID and Mental Illness, Indigenous engagement is required to better understand the unique perspectives around end-of-life held by Indigenous Peoples, which need to be considered in the context of supporting culturally safe MAID policies at all levels of government. To this end, a distinctions-based "plus" engagement process is underway in collaboration with Indigenous Peoples including through Indigenous-led and Health Canada-led engagement activities, which will culminate in a "What We Heard Report" in 2025.

On June 7, 2023, the Québec National Assembly passed Bill 11, An Act to amend the Act respecting end-of-life care and other legislative provisions. The former Bill 11 contained a permanent exclusion of mental disorders, other than neurocognitive disorders, as an eligible condition for MAID in QC. It also included a provincial regime to permit advance requests for MAID, with implementation delayed for two years.

Safe Long Term Care Act

In July 2023, the Government of Canada launched online consultations for the Safe Long-Term Care (LTC) Act. The 60-day online consultation invited people, including LTC residents and their families, to share their perspectives and expertise on how to improve the quality and safety of LTC, foster the implementation of the LTC standards, address human resources challenges, and strengthen accountability in the LTC sector. Feedback will help inform the drafting of the legislation.

The development of the Safe LTC Act, a joint mandate item with the Minister of Seniors, complements the new independent national long-term care standards released by standards development organizations in December 2023 and January 2024. It also complements the Government's ongoing work with provinces and territories to help support improvements in home and community care, including palliative care, and in LTC. This includes creating an expert panel, National Seniors Council, to provide recommendations to support Canadians who wish to age at home as well as targeted funding (e.g., Health Care Excellence Canada) to help support quality, safe, and respectful care for seniors and persons with disabilities in LTC homes across Canada.

COVID-19

The COVID-19 pandemic, and the response to it, have had a profound impact on Canadians. Since the start of the pandemic, there have been over 4.6 million reported cases of COVID-19 in Canada and over 53,000 deaths. Since the April 2022 Omicron waves, large waves of infection have not occurred and there are high-levels of vaccine and infection-induced immunity. Approximately 32 million Canadians, or 83.2% of the total population, have received at least one dose of vaccine.

The Health Portfolio continues to monitor COVID-19 activity using a comprehensive integrated surveillance approach. This includes genomic surveillance, wastewater monitoring, and hospitalization surveillance. The Health Portfolio is also actively reviewing immunization guidance, working to better understand Post-COVID Condition, and taking steps to identify and apply lessons learned over the course of the pandemic response.

Opioids crisis response

Canada is experiencing an unrelenting rate of overdose deaths and harms. From 2016 - 2022, 36,442 Canadians died from opioid-related overdoses. In 2022 alone, 7,328 people died as a result of an overdose —a rate of approximately 20 deaths per day. This is one of the most significant public health crises in a generation—from 2007 to 2022, opioid-related deaths increased by nearly 250% in Canada. Since the onset of the COVID-19 pandemic, deaths have remained elevated above levels seen prior to the pandemic. Officials will brief you on continued engagement and collaboration with PTs, Indigenous communities, people with lived and living experience, health professionals, researchers and other key stakeholders to take a comprehensive approach to addressing the overdose crisis. A full continuum of evidence-based actions as well as innovative strategies are necessary to save lives and help reverse this national public health crisis.

Work across federal government departments and agencies to address overdose crisis includes supporting evidence-based treatment and harm reduction services; awareness, prevention and stigma reduction activities; research and surveillance initiatives; and strengthening law enforcement capacity to address illegal drug production and trafficking. Since 2016, federally authorized supervised consumption sites increased from 1 site to 39, and reversed over 40, 000 overdoses; over 300 Substance Use and Addictions Program prevention, harm reduction, and treatment projects have been funded to build the evidence around innovative practices and barriers have been removed to accessing drugs used to treat opioid use disorder or by safer supply programs, including through regulatory changes.

The Government's approach to opioids crisis and substance use more broadly is guided by the Canadians Drugs and Substances Strategy (CDSS). This strategy advances a compassionate, comprehensive, collaborative, and evidence-based approach to drug policy. The Government committed to support a renewed CDSS to save lives and protect health and safety of Canadians. Work is underway to announce the renewal of the CDSS based on full continuum of evidence-based options to promote the health and safety of all Canadians by preventing and minimizing substance use harms for individuals, families and their communities.

Vaping

Vaping products, "vapes" or "e-cigarettes", comprise a wide range of products that heat a substance to produce an aerosol that is inhaled. While smoking rates among Canadian youth are at all all-time low, vaping rates among youth remain too high, despite having levelled off over the past two years. The Government of Canada has implemented a comprehensive suite of measures to address youth vaping, including enhanced public education, increased compliance and enforcement of existing rules and regulations to put in place more controls. Health Canada is also working to further strengthen regulations to prevent youth and people who do not smoke from being addicted to nicotine and provide health information on tobacco use and vaping.

Mental health

The Government recognizes that Canadians need timely access to quality mental health and substance use services regardless of where they live. The intersections between mental illness, substance use, homelessness, and public safety and crime are complex. Improving access to integrated, patient-centered mental health and substance use services is central to the Government of Canada's approach. Health Canada is providing funding to PTs via bilateral agreements that started in 2017 ($5 billion over 10 years through Common Statement of Principles). PT action plans include diverse initiatives that intersect with mental health and substance use (MHSU), including those that support integrated youth services, early intervention and prevention, and access along the continuum of care. Budget 2023 announced $25 billion in new funding for PTs from 2023-2033 through a new set of tailored bilateral agreements. This funding, as part of the Working Together to Improve Health Care for Canadians plan, will support four priority areas, including increasing mental health and substance use supports. The government will continue to work collaboratively with PTs to support a multi-disciplinary system of care that will integrate mental health and substance use health across shared priorities. The focus is to support improved access to mental health and substance use services as part of a patient centered approach to health care. Health Canada is also working with partners to develop standards for mental health and substance use health services in key areas such as integrated youth services.

9-8-8 Implementation

In July 2023, the Government of Canada announced an investment of $156 million over three years to the Centre for Addiction and Mental Health (CAMH) to support the implementation of the 9-8-8: Suicide Crisis Helpline, a national three-digit number of suicide prevention and emotional distress. By November 30, 2023, the 9-8-8: Suicide Crisis Helpline will be available in English and French, 24 hours a day and seven days a week, to everyone in Canada. The 9-8-8 service will offer trauma-informed and culturally appropriate crisis services, and will be delivered by trained crisis responders using best practices, procedures and protocols. Implementation and delivery of the 9-8-8 service will continue to be informed by ongoing engagement with provinces and territories, CAMH, and organizations representing populations most affected by suicide.

Cannabis legislative review

The Cannabis Act requires the Minister of Health to cause a review of the Act three years following the coming into force, and to table a report in both Houses of Parliament within 18 months.

To fulfill these requirements, an independent Expert Panel was launched in September 2022 to undertake the legislative review. The Panel will provide you with independent, expert advice on progress made towards achieving the Act's objectives, and will help identify priority areas for improving the functioning of the legislation. The Terms of Reference for the Cannabis Act legislative review require the Expert Panel to publish a "What We Heard Report" summarizing their consultations, as well as to develop an interim report based on their fact finding and engagement in their first phase of work. The "What We Heard Report" is expected this fall with final report to be tabled in Parliament by March 2024.

Legislative review of the Tobacco and Vaping Products Act

As per s.60.1(1) of the Tobacco and Vaping Products Act, the Minister is required to undertake a legislative review of the Act every two years.

The first review was tabled in Parliament in December 2022 and focused on the vaping-related provisions of the Act. To complement this, the second review will focus primarily on the tobacco-related provisions of the Act and its administration and operation. It will be evidence-based and involve the systematic collection of data and information to support analysis. The review will be informed by public consultations that seek the input and perspectives of Canadians and a broad range of stakeholders, through an open and transparent process.

Climate change and health

Climate change has multiple, cascading impacts on our physical and mental health. Health Canada is the federal government lead on the health impacts of climate change and led the development of the 2022 scientific assessment "Health of Canadians in a Changing Climate: Advancing our Knowledge for Action". The issue of climate change and health was also the focus of the Chief Public Health Officer of Canada's 2022 annual report, "Mobilizing Public Health Action on Climate Change in Canada".

Health Canada is currently engaging provincial and territorial counterparts to implement the Health and Wellbeing pillar of the National Adaptation Strategy, which lays out framework to reduce the risk of climate-related disasters, improve health outcomes, protect nature and biodiversity, build and maintain resilient infrastructure, and support a strong economy and workers.

Climate-related events are increasing in Canada and this year across the country, several provinces and territories are experiencing a severe wildfire season and record-breaking temperatures. Health Canada and PHAC are working to respond to the health impacts of these events.

Other Health Portfolio work related to climate change includes:

Antimicrobial resistance

Antimicrobials, and in particular, antibiotics, that we rely on to treat common infections are becoming increasingly ineffective, leading to fewer treatment options, increased healthcare costs, and a looming threat of undoing a century of medical progress and a return to the pre-antibiotic era. Inadequate infection prevention and control in health care settings and inappropriate use of existing antimicrobials (e.g., antibiotics and antifungals), coupled with a lack of diagnostics, effective vaccines and therapeutics, have led AMR to becoming one of the World Health Organization's top ten global public health threats.

Addressing AMR requires a One Health approach that acknowledges the interconnections between the health of humans, animals, and the environment and thereby encompasses collaborative efforts across various sectors to improve health for all. In June 2023, federal, provincial and territorial governments released a Pan-Canadian Action Plan on AMR. The Action Plan articulates AMR commitments over the next five years (2023-2027).

Internationally, Canada also actively contributes to cutting edge research to achieve better public health outcomes and to harmonize regulatory requirements. At the G7 Summit in May, 2023, G7 decided to accelerate research and development to respond to future pandemics, health emergencies, and antimicrobial resistance as a "silent pandemic", and commit to exploring and implementing pull and push incentives to accelerate research and development on antimicrobials. The Government of Canada also announced an investment of $6.3 million to Combatting Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) in support of global and domestic antimicrobial innovation.

[REDACT]

C. Relationship management: early calls and meetings

Early meetings and events for possible ministerial attendance

Date Event Description
Provincial and Territorial Counterparts
July & August 2023 Introductory calls with PT Health Ministers and PT Ministers responsible for Mental Health and Substance Use Bilateral discussions with provincial and territorial Health Ministers and Ministers responsible for Mental Health and Substance Use
Late August (TBC) FPT Ministers responsible for Mental Health and Substance Use Virtual meeting anticipated at the end of August
October 11-12, 2023 Joint FPT Health Ministers' and Ministers Responsible for Mental Health and Substance Use Multilateral meeting with PT counterparts in Prince Edward Island
Stakeholders
August 17, 2023 2023 Canadian Medical Association Health Summit Opportunity for the Minister to take part in the opening session of the 2023 Canadian Medical Association Health Summit
International
August 18-19, 2023 G20 Health Ministers' Meeting G20 Health Ministers' Meeting to be held in India. Early decision required on participation
September 21, 2023 United Nations High Level Meetings on Universal Health Coverage, Pandemic Preparedness, Prevention and Response, and Tuberculosis The 2023 high-level meetings are an opportunity to advance key domestic and international health priorities including universal health coverage, pandemic preparedness and tuberculosis
October 5-6, 2023 Global Mental Health Summit Global Mental Health Summit to be held in Argentina
November 2023 World Health Summit World Health Summit to be held in Berlin, Germany

D. Key timelines

Issues for attention: placemat

Item Topics Month Comments
Early calls and meetings Portfolio heads

July

Introductory meeting / briefing

 Meet within first couple days
Chief Public Health Officer of Canada

July

Introductory meeting / briefing

 Meet within first couple days
Provincial and Territorial Health Ministers

July-August

Introductory meeting / briefing

 Meet within first week
Key Stakeholders

July-August

Introductory meeting / briefing

 Meet within first month
Government study and response Government Response to HESA Report # 10 – Health Workforce

July-August-September

Event for consideration

 September 18, 2023
Government Response to FEWO Report #6 - Mental health of young women and girls

July-August-September

Event for consideration

 September 18, 2023
HESA Study on Children's Health

July-August-September

Report for Approval or Tabling

 Fall 2023 - Publication anticipated
Reports Table and publish Departmental Results Reports July-October Fall 2023
Table and publish Departmental Sustainable Development Strategy Annual Progress Report July-October Fall 2023
Tabling of annual Fees Report July-September Fall 2023
Tabling of Annual Report on the Access To Information Act July-October Fall 2023
Tabling of Annual Report on the Privacy Act July-October Fall 2023
Tabling of CFIA Corporate Business Plan July-October Fall 2023
Tabling of CIHR Annual Report July-October Fall 2023
Tabling of Annual Chief Public Health Officer's Report on the State of Public Health in Canada July-October Fall 2023
Tabling of Canadian Centre on Substance Use and Addiction Annual Report July-October Fall 2023
Tabling of Public Accounts for Canada for 2022-2023 July-October Fall 2023

Reports to be tabled in Parliament

The Minister of Health must table reports and other documents in Parliament on a variety of subjects under his or her purview. Most often, this involves tabling annual reports related to key activities under the responsibility of the Health Portfolio and related organizations to inform Parliament and Canadians about areas of government activity or spending.

The requirement to table a report is typically found in statute. In these cases, the report can be provided to Parliament through a "back-door tabling" (i.e. the Parliamentary Affairs Unit provides the report to Parliament via the Clerks of the House of Commons and Senate). In other cases, the requirement is set out in a funding agreement or Treasury Board policy and must go through a "front-door tabling" (i.e. the Minister must table the report in the House of Commons during Routine Proceedings).

The following table provides an overview of the reports that could be tabled in Parliament this fall. Packages will be provided to the Minister early on to seek approval of the following reports, and officials are ready to brief the Minister on the tabling process.

Annual reports to be tabled in Parliament in fall 2023
Report Report description Tabling requirement Statutory authority Tabling timeline
Government Response to HESA Report #10 - Health Workforce Response to Committee report 120 days after the Committee tables its Report House Standing Orders September 18, 2023
Government Response to FEWO Report #6 - Mental health of young women and girls Response to Committee report 120 days after the Committee tables its Report House Standing Orders September 18, 2023
Annual Departmental Results Report (HC, PHAC, CFIA, CIHR, PMPRB) Annual report by individual departments and agencies that provides an account of results achieved against planned performance expectations (as set out in respective Departmental Plans) for the most recently completed fiscal year Tabled in the House of Commons by the President of the Treasury Board Required as per Treasury Board Policy – the Departmental Results Report is part of the Estimates process and a report to Parliament must be tabled Fall 2023
Annual Fees Report (HC, PHAC, CFIA, CIHR, PMPRB) Annual report that sets out detailed information on fees in individual departments or agencies to improve government transparency and oversight of service standards and fees charged Tabled in each House of Parliament in Fall 2023 Service Fees Act (S.C. 2017, c. 20, s. 451(s. 20(1))) Fall 2023
Annual report: access to information (HC, PHAC, CFIA, CIHR, PMPRB) Annual report that provides information on the administration of the Access to Information Act within the institution during each fiscal year Tabled in each House of Parliament on any of the first 15 days on which that House is sitting after September 1 of the year in which the report is prepared Access to Information Act (R.S., 1985, c. A-1, s. 72(2)) Fall 2023
Annual report: privacy (HC, PHAC, CFIA, CIHR, PMPRB) Annual report that provides information on the administration of the Privacy Act within the institution during each fiscal year Tabled in each House of Parliament on any of the first 15 days on which that House is sitting after September 1 of the year in which the report is prepared Privacy Act (R.S., 1985, c. P-21, s. 72(2)) Fall 2023
CFIA Corporate Business Plan (CFIA) At least once every five years, the Agency must submit a corporate business plan to the Minister for approval The Minister must table a copy of the plan in each House of Parliament on any of the first fifteen days on which that House is sitting after the Minister approves the plan Canadian Food Inspection Agency Act (S.C. 1997, c. 6, s. 22(1)) Fall 2023
Departmental Sustainable Development Strategy Annual Progress Report (HC, PHAC, CFIA) The Report is to outline progress toward the commitments outlined in the 2020-21 Departmental Sustainable Development Plan, and the Department's contributions to the Federal Sustainable Development Strategy (FSDS), led by Environment and Climate Change Canada The Minister shall cause the strategy to be tabled in each House of Parliament on any of the first 15 days on which that House is sitting after the Minister receives it Federal Sustainable Development Act [ 2019, c. 2, s.12(2)] Fall 2023
CIHR Annual Report (CIHR) The Governing Council shall, within four months after the end of each fiscal year, submit to the Minister a report on the operations and activities of the CIHR in that fiscal year and its strategic directions and goals, and shall include the CIHR's financial statements The Minister shall cause a copy of the report to be laid before each House of Parliament on any of the first 15 days on which that House is sitting after the Minister receives it Canadian Institutes of Health Research Act [2000, c. 6, s. 32(2)] Fall 2023
Annual Chief Public Health Officer's Report on the State of Public Health in Canada (PHAC) Annual report on the state of public health in Canada that provides a snapshot of the health of Canadians, as well as detailed information on a yearly theme, as determined by the Chief Public Health Officer Tabled in in each House of Parliament within the first 15 days on which that House is sitting after the Minister of Health has received it The CPHO is required to submit the report to the Minister of Health within six months after the end of each fiscal year Public Health Agency of Canada Act Fall 2023
Canadian Centre on Substance Use and Addiction Annual Report (CCSA) The Chief Executive Officer shall, within three months after the end of each financial year of the Centre, submit to the Board a report of the activities of the Centre for that year, including the financial statements of the Centre and the auditor's report thereon, and the Board shall make the report available to the public at the principal office of the Centre Within one month after a report is submitted to the Board, the Centre shall provide copies thereof to the Minister of Health who shall cause a copy of each such report to be laid before each House of Parliament on any of the first fifteen days on which that House is sitting after the day on which the Minister receives the copies Canadian Centre on Substance Abuse Act [1996, c. 8, s. 32] Fall 2023
Public Accounts for Canada for 2022-23 Includes the audited consolidated financial statements of the Government of Canada and information from departments, agencies, Crown corporations and other reporting entities Tabled before the House of Commons by the President of the Treasury Board on or before the thirty-first day of December next following the end of that year Section 64 of the Financial Administration Act Fall 2023
2023-24 Departmental Plan (HC, PHAC, CFIA, CIHR, PMPRB) The Departmental Plan (DP) presents the Department/Agency spending plan and describes its priorities, planned results and associated resource requirements for the next fiscal year DPs are tabled in Parliament by the President of the Treasury Board on behalf of the ministers who preside over the appropriation-dependent departments and agencies on or before March 31 each year Schedules I, I.1 and II of the Financial Administration Act Winter 2024
Canada Health Act Annual Report (HC) Annual report on the extent to which provincial and territorial health care insurance plans have satisfied the criteria and the conditions for payment under the Canada Health Act, which is Canada's federal health care insurance legislation and defines the national principles that govern the Canadian health care insurance system Tabled in in each House of Parliament on any of the first 15 days on which that House is sitting, after the report is completed. Report must be completed as soon as possible after the end of each fiscal year, and no later than December 31 of the next fiscal year Canada Health Act (R.S., 1985, c. C-6, s. 23) February 2024
Annual report: activities of the Board (PMPRB) Annual report that provides information on the activities of the Board for the most recently completed fiscal year, including information regarding its regulatory mandate and its reporting mandate Tabled in in each House of Parliament on any of the first 30 days on which that House is sitting after the Minister receives the report Patent Act (R.S., 1985, c. P-4; s. 100(4) added by 1993, c. 2, s. 7) Winter 2024

Governor in council appointments

Decisions on governor in council appointments

The following document outlines the current Governor in Council vacancies where the appointments require Ministerial consideration in the next fiscal year. Officials are prepared to brief you on the following appointments and the appointment process, especially those requiring immediate attention.

Governor In Council (GIC) appointments required

1. Vice-Chairperson, and 2 Members, Patented Medicine Prices Review Board (PMPRB)

The Board consists of not more than five members appointed by Governor in Council to hold office for a period of five years. The Vice-Chairperson exercises all the powers and functions of the Chairperson should the Chairperson be absent, or if the office of the Chairperson is vacant.

The Vice-Chair position is currently vacant, along with two member positions.

2. President, Vice-Chairperson, and 6 members, Governing Council, Canadian Institutes of Health Research (CIHR)

The CIHR is governed by a Governing Council of up to 18 members.

The President is an ex-officio and non-voting member. The President of the Governing Council's appointment expires September 30, 2023.

The Vice-Chairperson's appointment expires on November 29, 2023, and the incumbent is no longer eligible for reappointment. There are six other member positions for which the incumbent is no longer eligible for reappointment or the position is vacant.

3. Director, Canadian Centre on Substance Use and Addiction (CCSA)

The CCSA is governed by a voluntary Board of Directors.

There is currently one vacant director position.

4. Member, National Seniors Council (NSC)

The National Seniors Council (NSC) was established in 2007 by an Order in Council to advise the Government, through the Minister of Seniors and the Minister of Health, on matters related to the well-being and quality of life of seniors including opportunities arising from a rapidly growing and increasingly diverse aging population.

The NSC currently has two vacancies.

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