Question Period Note: Access to Pediatric Care and Medicines

Access to children’s health services across the continuum of care remains an issue in Canada, including lengthy backlogs for essential services such as surgical, diagnostic, mental health, and children’s rehabilitation.

The Government of Canada recognizes that our children’s healthcare system has been under significant strain and is committed to improving the health and wellbeing of Canada’s children.
Through the Government’s plan, “Working Together to Improve Health Care for Canadians,” we continue to work closely with provinces and territories on our shared health priorities, including:
o Access to family health services,
o Supported health workers and reduced backlogs,
o Access to mental health and substance use services, and
o Modernizing health systems.
• Our Government is investing nearly $200 billion over 10 years for health care, including $46.2 billion in new funding to improve health care services for Canadians across the country. This funding included an immediate unconditional $2 billion Canada Health Transfer (CHT) top-up to address immediate pressures on the health care systems especially in pediatric hospitals, emergency rooms and long wait times for surgeries.
The Government of Canada will continue to work collaboratively with stakeholders to make sure that parents and caregivers have the drugs that are necessary to take care of their children.
IF PRESSED ON WHAT THE HEALTH PORTFOLIO IS DOING FOR THE UPCOMING FLU SEASON
The Public Health Agency of Canada (PHAC) continues to closely monitor respiratory infections in Canada.
Based on trends observed during the summer of 2023, there may be elevated levels of pediatric hospitalizations due to influenza; however, they will likely not be at the extraordinary levels observed in the 2022-2023 season.
Since the 2022 surge in respiratory illnesses, Health Canada has taken steps to develop, with the help of the Canadian Institute for Health Information, a mechanism to monitor pediatric bed and ventilator utilization in Canada. This will allow to better anticipate and react to respiratory virus surges.
In addition, the Government of Canada used all available levers to help alleviate the pediatric acetaminophen and ibuprofen products shortage. These medicines are now widely available across Canada.
Health Canada continues to monitor the situation closely, work with stakeholders, and explore policy options to further support access to drugs and other health products in Canada.
IF PRESSED ON PEDIATRIC DRUG SHORTAGE
The supply of pediatric analgesics (children’s acetaminophen and ibuprofen products) has stabilized and products are readily available at community and hospital pharmacies.
Health Canada continues to work closely with key stakeholders, including industry and health care system partners, to actively monitor the supply of children’s analgesics in Canada.
Between November 2022 and August 2023 domestic suppliers released over 15 million units of children’s acetaminophen and ibuprofen products into the Canadian market, with production continuing at elevated levels.
Over 4.4 million units of foreign-authorized supply of both ibuprofen and acetaminophen have been imported as of August 25, 2023.

Health System Capacity
The children’s healthcare system is drastically undersized to deal with the increased demand placed on children’s health services. Access to children’s health services across the continuum of care remains an issue in Canada, including lengthy backlogs for essential services such as surgical, diagnostic, mental health, and children’s rehabilitation. Children now wait longer than adults for many essential and time sensitive healthcare interventions.
Children and youth have unique health needs that must be considered and measured, requiring system-wide solutions, investments and planning across all levels of government to ensure the best possible outcomes for children’s physical and psychological health and development.
2022/23 Surge in Respiratory Illnesses
In 2022, there was higher than usual activity and healthcare demand due to many factors, including the interaction of COVID-19, seasonal flu and RSV, as well as increased susceptibility to illness due to limited exposure to other respiratory illnesses during COVID-19. Higher than usual RSV activity in children was observed in early November, with 1,045 cases detected between October 22-29, 2022.
During the surge, Canada saw an increased use of emergency care due to the uptake of respiratory illnesses in children. Families and children were also being affected by the pediatric analgesics shortage. The 2022 fall surge forced hospitals to pause other services, including surgeries, further exacerbating wait times. For example, across four pediatric hospitals in Ontario, 11,789 children have yet to receive necessary surgeries and about half of these children have been waiting beyond the clinically recommended wait times.
Monitoring of pediatric health capacity
Since the 2022 fall surge, the Government of Canada has been working collaboratively with children’s health leaders and the Canadian Institute for Health Information to address significant data gaps in pediatric health capacity monitoring. Partners are developing a mechanism to monitor pediatric bed and ventilator utilization in Canada to better anticipate and react to respiratory virus surges.
Supply of Pediatric Medication
Since the surge, the supply of pediatric analgesics products has stabilized and products are readily available at community and hospital pharmacies. However, pediatric hospital capacity for inpatient admissions continues to be strained due to factors such as shortages in health human resources (HHR), increased mental health admissions, and gaps in access to family health services.
Federal Investments in Healthcare
Budget 2023 outlines the federal government’s plan to provide close to $200 billion over ten years in health transfers to provinces and territories, including $46.2 billion in new funding through new Canada Health Transfer measures, tailored bilateral agreements to meet the needs of each province and territory, funding for personal support workers, and an increase to the Territorial Health Investment Fund.
Canada Health Transfer Top-Up: The federal government will provide $2 billion in 2023-24 to address urgent pressures in emergency rooms, operating rooms, and pediatric hospitals, building on $6.5 billion in top-ups provided throughout the pandemic.
Tailored Bilateral Agreements: The federal government will provide $25 billion over ten years through a new set of bilateral agreements to address individual provincial and territorial health system needs, such as expanding access to family health services, supporting health workers and reducing backlogs, increasing mental health and substance use support, and modernizing health systems.
Expectations on the Upcoming 2023/24 Flu Season
This season, there is an expectation that there may be elevated respiratory virus activity and healthcare demand due to many factors, including the interaction of COVID, seasonal flu and RSV, as well as increased susceptibility due to limited exposure to other respiratory illnesses during COVID-19. Based on trends observed during the summer of 2023, there may be elevated levels of pediatric hospitalizations due to influenza; however, they will likely not be at the extraordinary levels observed in the 2022-2023 season.
The Public Health Agency of Canada (PHAC) continues to closely monitor respiratory infections:
• As of early October, although most indicators of COVID-19 activity in Canada remain low to moderate, there have been recent increases in activity.
• At the national level, influenza activity continues to be low and within expected levels typical of this time of year; however, it is expected to increase in the coming weeks.
• RSV activity is low and within expected levels; however, activity is increasing which is expected for this time of year.
In anticipation of the 2023 flu season, Health Canada is monitoring current respiratory virus trends in the southern hemisphere to anticipate potential demand over Canada’s winter. Domestic manufacturers continue increased production of pediatric analgesics and are building up inventory ahead of the 2023-24 cold and flu season.
HESA Study on Children’s Health
The Standing Committee on Health (HESA) passed a motion on February 9, 2022 to undertake a study on children’s health and the impact of the pandemic on children’s health outcomes. The study was completed in the spring of 2023 and HESA is expected to issue a study report with recommendations in fall 2023.

Children and youth are among the highest users of Emergency Departments (ED) for mental health and substance use services. From 2020 to 2021, admissions for mental health conditions increased by 24.9% while overall hospital admissions increased by 4.8%.
As of July 2023 two-thirds of patients at Ontario’s children’s hospitals have surpassed recommended wait times for surgery. The situation is similar across the country. In Nova Scotia, 2,500 pediatric patients are waiting for surgery, with 40% waiting beyond the recommended window.