Question Period Note: ACCESS TO SEXUAL AND REPRODUCTIVE HEALTH CARE INFORMATION AND SERVICES

• Currently, women, youth, LGBTQ2 people, racialized Canadians, and Indigenous populations face the highest sexual and reproductive health risks and the greatest barriers to accessing support, information, and services. Too often, they do not receive the same quality of care, particularly if they are from marginalized communities.

• All Canadians should have access to a full suite of sexual and reproductive health resources and services, no matter where they live.
• We will fund community-based organizations to produce inclusive training materials for sexual and reproductive health care providers, work with providers to develop and implement best practices, carry out public awareness activities, and provide travel and logistical support to access abortion care.
• Budget 2021 committed $45M to advancing sexual and reproductive health. To date, nine contribution agreements have been signed, for a dollar value of $15.5 million. Of the nine projects, two address access to abortion, five address 2SLGBTQI communities, and two address youth. Two of the nine projects include components focusing on Indigenous peoples. In addition, per capita funding of $9.7M will be provided to the Province of Québec to support community-based organizations located in Québec.

IF PRESSED ON DATA…
• We are also investing $7.6 million over five years for Statistics Canada to collect data that will fill existing information gaps and help us target appropriate sexual and reproductive health supports for Canadians.

IF PRESSED ON ABORTION SERVICES…
• Our Government believes that Canadians should have access to the full range of reproductive health services, including abortion services.
• Individuals should not face charges when seeking these insured services regardless of where the services are provided.
• The Canada Health Act is clear: where there is evidence of patient charges, a mandatory deduction to federal health transfer payments to the province or territory must be taken.
• Our Government will uphold the Canada Health Act to help ensure that patients do not face barriers when accessing medically necessary health care.
• The Government of Canada has invested $3.6M to date to support two projects aimed at improving access to abortion for those who face the greatest barriers to care.

IF PRESSED ON WHETHER THE GOVERNMENT WILL PROVIDE FUNDING TO ORGANIZATIONS OFFERING ALTERNATIVES TO ABORTION (I.E. CONTINUING THE PREGNANCY) …
• One element of this initiative will provide funding to support travel and logistical costs for individuals who would not otherwise be able to access abortions. Other elements of the funds will support initiatives to help improve access and improve professional skills and competencies in a broad range of sexual and reproductive health issues.
• This fund will not support initiatives that discourage or are opposed to freedom of choice or attempt to override the individual’s right to make decisions about their own body.

The Government of Canada has made strong commitments to gender equality, using a feminist lens, and realizing and protecting sexual and reproductive health rights.

Key barriers and challenges related to inequitable and variable access to sexual and reproductive health services remain. Women, members of LGBTQ2 communities, youth, racialized Canadians and Indigenous peoples face the highest sexual and reproductive health risks and the greatest barriers to accessing support, information, and services.

An initial targeted call for proposals inviting select organizations to submit applications for funding was launched on July 29th, 2021 and closed October 4, 2021. Nine contribution agreements have been signed. A subsequent solicitation will follow to address any remaining gaps and ensure the priorities of the initiative are adequately addressed.

Canada’s current national-level data on sexual and reproductive health is limited to a narrow range of indicators. There is insufficient data available to support understanding and evidence-based decision-making to address a full range of key indicators of sexual and reproductive health, including prevalence of sexually transmitted infections, contraception use, pregnancy intention, and sexual knowledge and behaviours.

Patient charges for abortion services

Patient charges for abortion services received in private clinics are considered extra-billing and user charges under the Canada Health Act and raise concerns under the accessibility and comprehensiveness criteria of the Act. In New Brunswick, Regulation 84-20 of the NB Medical Services Payment Act limits coverage of surgical abortion services to approved hospitals (three NB hospitals currently offer the service – two in Moncton and one in Bathurst). This means that individuals who receive these services at the private clinic in Fredericton are required to pay out-of-pocket. The most recent deduction to New Brunswick was taken in March 2022, in the amount of $64,850, for the province’s refusal to cover surgical abortion services provided outside the hospital setting, which results in patient charges for these medically necessary services. Similarly, Ontario’s March 2022 federal health transfer was reduced by $6,560, with respect to patient charges for abortion services provided at certain independent health facilities. These deductions will be outlined in the 2021-2022 Canada Health Act Annual Report, which will be published in February 2023.

Evidence indicates that some private abortion clinics in Ontario (ON) charge to access insured surgical abortion services. While the Ontario Health Insurance Plan provides coverage for physicians' fees related to abortion services in all private clinics, the province only covers facility fees in the four private abortion clinics licensed as Independent Health Facilities (IHF). Health Canada has advised ON that patient charges being levied in non-IHF clinics are user charges under the CHA, and based on patient charges reported by ON to Health Canada, a deduction of $13,905 was levied against the province’s CHT payment in March 2021.

• Investment of $45M over three years to help make sexual and reproductive health care information and services more accessible to Canadians.
• Investment of $7.6M over five years for Statistics Canada to collect data that will fill existing information gaps and help us target appropriate sexual and reproductive health supports for Canadians.