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SOCI - Standing Committee

Social Affairs, Science and Technology


Proceedings of the Standing Senate Committee on
Social Affairs, Science and Technology

Issue 3 - Evidence - Meeting of February 7, 2008

OTTAWA, Thursday, February 7, 2008

The Standing Senate Committee on Social Affairs, Science and Technology met today at 10:45 a.m. to examine the impact of the multiple factors and conditions that contribute to the health of Canada's population — known collectively as the social determinants of health.

Senator Art Eggleton (Chair) in the chair.


The Chair: Welcome to the Standing Senate Committee on Social Affairs, Science and Technology. Today we are examining child poverty in an urban environment.


Our committee has two subcommittees: one on population health and the other on major challenges facing our cities. Given that poverty, housing and homelessness are common to both subcommittees, we have decided to meet as a full committee. At the end of our public meeting, we need to go in camera for five minutes to discuss the schedule for this February and March for both the main committee and the two subcommittees.

In doing this work on poverty, housing and homelessness, we are building upon previous work done at the Senate. Regarding poverty, for example, there is the 1971 report headed by Senator Croll and the 1997 report by Senator Cohen titled Sounding the Alarm: Poverty in Canada. Our study is complementary to the work being done by the Standing Senate Committee on Agriculture and Forestry chaired by Senator Fairbairn, who is here. At the request of Senator Segal, they are dealing with the issue of rural poverty. We are trying to pull all of that together in dealing with these issues.

Today, we have four panellists, each of whom will speak for five minutes. Emily Noble is President of the Canadian Teachers' Federation, which was founded in 1920 in Calgary and currently represents 220,000 public school teachers across Canada. Nicki Sims-Jones is Policy Consultant to the Canadian Nurses Association. This association, founded in 1908, is now a federation of eleven provincial and territorial registered nurses associations and colleges. It represents approximately 250,000 registered nurses across Canada.

Michael Goldberg is Chair of the First Call BC Child and Youth Advocacy Coalition. That coalition is made up of individuals and organizations whose purpose is to create a greater understanding of advocacy for legislation, policy and practice to ensure that all children and youth have the opportunities and resources required to achieve full potential.

Marie-Paule Duquette is the Executive Director of the Montreal Diet Dispensary. This organization is the oldest, going back to 1879. It is there to promote community health with emphasis on low income mothers whose babies are potentially at risk.

Emily Noble, President, Canadian Teachers' Federation: Thank you for the opportunity to be here. The Canadian Teachers' Federation is a voluntary organization and national voice. We have member organizations in all of the provinces and territories.

The Canadian Teachers' Federation has a long-standing interest in reducing child poverty. In 1989, CTF released a report which examined the impact of poverty on children, with particular reference to how poor children fare in elementary and secondary schools. Our policy on children and poverty states that all children, regardless of family income or circumstances, have the right to the full benefits of publicly-funded education.

CTF is an active member of various coalitions and networks enhancing the well-being of Canadian children and youth, including the National Alliance of Children and Youth and Campaign 2000. Among CTF's priorities is to support teachers and teachers' organizations as strong advocates for social justice with a particular focus on issues related to child poverty.

According to Campaign 2000's recent report card on child and family poverty, despite a growing economy, a soaring dollar and low unemployment, Statistics Canada data shows that the after-tax child poverty rate is 11.7 per cent. This is exactly where it was when all the federal parties decided that action was urgently needed. Other findings from the report paint a bleak national picture, particularly for vulnerable groups such as Aboriginal children, children of new immigrants and children with disabilities.

Some of the highlights in our report include the fact that more parents are working but they are still poor, and that children and families who face systemic discrimination run a greater risk of growing up in poverty. The First Nations population is young and growing, and child poverty rates are a formidable barrier. Twenty-eight per cent of Aboriginal children living in First Nations communities are living in poverty. That number is 40 per cent, off-reserve.

I will speak to poverty in schools. Given the prevalence of child poverty in Canada, its effects are played out in schools and classrooms. Laurel Rothman, Co-Coordinator of Campaign 2000, speaks to the impact of poverty going beyond material deprivation and how it contributes to social exclusion.

Grade 4 and 5 students in North Bay related that they feel ashamed that their dads could not find a job, and often say they have forgotten their lunches. Rothman also emphasizes that, as daily mentors in children's lives, teachers experience the impacts of poverty upon children firsthand. This is the area we support in the Campaign 2000. We maintain that schools are essential and influential partners in improving life chances for low-income students.

The Canadian Teachers' Federation report in 1989 found that many low-income children experience reduced motivation to learn, delayed cognitive development, lower achievement, less participation in extracurricular activities, lower career aspirations, often interrupted school attendance, a lower college and university attendance, increased rates of illiteracy and high school dropout. Therefore, there is a strong correlation between social-economic status and children's academic performance. This is well established both in school and outside.

Some of the strategies stressed are: We need remedies to address the negative relationship between poverty and schooling outcomes. In other words, the problem is two pronged. The remedies must include school-based policies. Teachers take their responsibilities seriously, but we need support from governments. Whether it be at a municipal, provincial or the federal level, it is important that we all work together.

Strategies and policy recommendations that could have a positive impact on inadequate educational opportunities linked to families' social economic status include an increased minimum wage, a restoration of broad eligibility for Employment Insurance, a major investment in social housing and improved accessibility and affordability of post- secondary education and training.

We are also strong advocates for a universal child care system, providing high-quality daycare for children and investments in other early childhood education initiatives. Additionally, we advocate for support for school boards and relevant community agencies in their coordination in terms of health, recreation and social services.

We are pleased about the growing momentum to tackle poverty. However, now is the opportunity to act. Opinion polls show most Canadians believe concrete government action can drastically reduce poverty. The Canadian Teachers' Federation joins the call for political commitment to a national poverty reduction strategy for Canada. Parents should be able to provide an adequate living standard for their children. Working together, governments can ensure that this happens. All of us can ensure that a child grows up to fulfil his or her potential.

The Chair: Thank you very much.

Nicki Sims-Jones, Policy Consultant, Canadian Nurses Association: Good morning. I will try and keep my submission to five minutes as well.

We are pleased to have the opportunity to address this committee on the important issue of child poverty. The Canadian Nurses Association is the national, professional voice of registered nurses. We support them in their practice and advocate for healthy, public policy and an equal, not-for-profit health system.

Nurses work with children and families in many settings and in all communities across the country. They work in primary care and community health centres and in public health, visiting new babies and families with children in the homes, in schools, in hospitals and in universities, conducting research on effective ways to care for children and families. We also work in community- and institutional-based mental health services.

Nurses work in inner cities and, in communities, most often work with the poorest of children and families. They work in street health programs, increasingly with women and children, as well as in First Nations communities. As such, nurses witness the impact that poverty has on children's growth and development every day. They work diligently to mitigate the effects and advocate for public policy to change the fate of these young Canadians.

As my colleagues have pointed out, too many children in Canada are poor. The poverty rate has not changed since 1989. Some children are more likely to be poorer than others. These include families new to Canada, those with disabled children, those from visible minority groups and those who are Aboriginal. We have evidence in Canada that poor children are at greater risk of health and developmental problems than children who are not poor. The details are in the paper that has been prepared. I will provide an overview.

We have evidence that the risk of problem pregnancies and poor birth outcomes increase with socio-economic disadvantage. Being poor means that infants are born early or pre-term, and have low birth weights. These infants are at greater risk of having a disability, and for negative outcomes such as cerebral palsy, visual impairment, learning disabilities and respiratory problems.

Poor infants are more likely to die from all causes than children who are not poor. If the death rate were the same for all children as it was for children from wealthy households, Canada would have lost 258 fewer children than in 1996. Bear in mind, this is a country with a low infant mortality rate. In relation to Aboriginal children, it is important to note that health and other social outcomes are among the worst in Canada.

Obesity among children has become a serious public health problem in Canada. We have been accumulating evidence that poor children are more likely to be obese than non-poor children, and suffer consequent health and social effects.

Mental health problems have been described as the new morbidity for Canadian children and youths. It has been demonstrated that mental health is affected by poverty in relation to both psychiatric disorders and emotional or behavioural problems.

Children are particularly vulnerable to environmental exposure, and poor children are even more vulnerable. For example, low-income neighbourhoods are often located in close proximity to sources of environmental contaminants such as landfills, urban industry and roadways. Moreover, poor nutrition of children from low-income families worsens their risks from exposure to contaminants like lead and pesticides. If you have an anaemic child who is exposed to lead, the lead is more readily absorbed across the gut. Children living in persistent poverty are particularly vulnerable, and a longitudinal study that looked at children who moved in and out of poverty over time, children in persistent poverty had less favourable mental health outcomes. They were more likely to have emotional and anxiety problems, aggressive behavioural problems and hyperactivity. They are also less likely to live in safe neighbourhoods and less likely to enjoy access to cultural and recreational activities that most Canadians take for granted.

It should be encouraging to governments to know that there are concrete actions that can lead to reduce disparities faced by children. These actions will be a combination of universal and targeted programs and will involve many sectors. Universal programs mean that such children are not labelled or stigmatized. It means that a broad population of children can potentially benefit, and that the programs can focus on community features and issues.

The disadvantage of universal programs include limited benefits to individual children, particularly those most at risk whose families are least likely to take advantage of these programs. They also have limited overall effects and tend to have a fairly high cost.

The advantages of targeted programs are that they are potentially effective at dealing with specific behavioural or social problems. The disadvantages of these programs are that they may lead to the labelling of participating children and tend to target small, high-risk populations rather than large, low-risk populations.

Nurses can play a role in programs that are effective for children and families at a cost the system can bear. Research studies within the paper provided are cited. One looks at a home visiting program where children were followed for 15 years. They found that the children of the mothers who were visited during pregnancy were 68 per cent less likely to be convicted of a criminal offense. There is an inter-generational benefit to these types of programs.

The other one I will mention is a study that comes out of Hamilton's McMaster University, with Gina Browne. She took two groups of young women with children who were on social assistance. One group was left to their own devices to find services; the other group received intervention that linked them up with recreational and child care opportunities and offered home visits by public health nurses. Not surprisingly, the ones who had interventions did better in terms of their health and social outcomes. They were also less expensive to the system. They were also less likely to be on social assistance or to use the facilities at the emergency department. In other words, solutions are possible.

Michael Goldberg, Chair, First Call BC Child and Youth Advocacy Coalition: My opening comments highlight some key arguments that are detailed in my paper. It is not possible to summarize all of them, but there are some charts in the written submission that describe poverty over time. There are also a couple of pages that discuss the various ways to measure poverty — something that I presented with Senator Fairbairn at the rural poverty report. All of that is available for your reading.

What I do want to discuss here today is the fragmented system of benefits that currently exist, and how the problem of stacking makes it difficult for low-income families to improve their lives. In some degree, this is similar to what John Stapleton and John Richards spoke about at your December session, although I am looking primarily at working low- income families, not just those transitioning off welfare.

Stacking effects occur when benefits have overlapping income thresholds and reduction rates. They can be exacerbated if there is a lack of integration between labour market policies, taxation and statutory reductions, income transfer and income-tested social benefits. In my written submission, I provide tables showing what happens with increases in market income for a two-parent family and a lone-parent mother and two children; there are six scenarios given in there. In the tables, we see that the two-parent family with two children in B.C., with one adult working full time, full year, would need to earn $16 an hour in order to reach the after-tax poverty line. When we talk about minimum wages at $10, we need to realize that that is not a family wage; that is a wage for a single person.

The table also shows that this family would only retain 21 per cent of the increased income between a lower paying job and a higher paying job — going from $11 to $16 an hour — after deductions for Canada Child Tax Benefits, the entire loss of the provincial rental supplement and relatively modest increases in taxes and statutory contributions.

We often hear that we tax people into being poor. That is not true. The tax part is actually a small part of what happens; it is the benefit side that is a disaster.

The situation is similar when both parents were working full time, full year, at wages well above the minimum in B.C. In that particular case, the family incurs costs for child care, even after receiving virtually the entire provincial subsidy. Again, the disposable income in this family example only increases by 26 per cent — that is, two parents working full time, full year — because of reductions in benefits and extraordinary high costs to obtain the additional income. Income taxes and, again, statutory contributions only increase moderately for that family.

Another important feature discussed in more detail in the written submission is having clear principles and guidelines, or a rationale for setting policy. Federal, provincial and territorial governments should state what measures or criteria would be used in setting policy.

The written submission identifies a number of specific areas for policy change, such as changes in the minimum wage, employment standards, Employment Insurance coverage, improvement in Child Tax Benefits, improvements to welfare rates and the development and enhancement of a system of child care and affordable housing. Others have talked about that and there is some detail in the submission. I would be pleased to elaborate on all of these during the discussion.

While many of the specific solutions fall under provincial jurisdiction, the federal government can play a leadership role and can use its spending powers, I argue, to encourage provincial action. For example, setting a federal minimum wage under the labour code that could be set at a before-tax poverty line and then indexed to inflation would send an important message to all of the provinces.

The federal government could also use its spending powers under the Canada Social Transfer to provide additional funds to those provinces and territories that agree to set welfare rates, for example, at the after-tax poverty line; or agree to implement a more publicly-funded child care program, similar to that in Quebec.

One thing I did not include in my report is the issue of language training and support for immigrants and refugees, which is another important area in terms of poverty reduction.

The federal government can directly raise the Child Tax Benefit so that the combined value of the Child Tax Benefit and the National Child Benefit would be equal to, say, the difference between the before-tax cycle for a one-person household and a two-person household. Again, we are setting some criteria to establish these benefits.

Most important, the federal government could commit to a poverty reduction strategy with firm targets and timelines and proposed actions to achieve that strategy. The federal government can take the lead on re-examining the tax and benefit system to ensure that the people with low incomes are not paying effective marginal tax rates that are significantly greater than the wealthiest people in Canada.

Better coordination, both between government departments at the federal level and between federal and provincial governments in the design of each individual benefit, may help reduce the worst effects of stacking; but it may take a complete overhaul of our tax and benefit system to get rid of the problem.

While my written submission is about the numbers, it is important to remember we are talking about the lives of real people. I vividly remember a mother whom I spoke with while interviewing people with low incomes, asking them to describe what it meant to be poor. This mother said that she and her children felt like Klingons. I was a bit puzzled and confused, wondering how poverty was linked to Klingons from Star Trek. She said it was not about the Klingons from Star Trek. Rather, she and her children had to ``cling on'' to someone else if they wanted to go somewhere or do something beyond bare survival. In my interviews, most people with low incomes talked about being left out, about being embarrassed at having to use the food banks or ask for permission to get some help; and of constantly being excluded from being part of their community.

Canada has shown what it can do when it makes firm commitments with targets and timelines. It is to be hoped that the time has come when the rhetoric contained in the 1989 House of Commons unanimous resolution to eliminate childhood poverty will lead to the work that will be required to make that pledge a reality.


Marie-Paule Duquette, Executive Director, Montreal Diet Dispensary: Thank you, Mr. Chairman. It is an honour for me to present the vision of the Montreal Diet Dispensary on child poverty in an urban environment.

I can tell you that poverty has declined in Montreal since 1996, but the fact remains that 36 per cent of households living on social assistance in Quebec are in Montreal, and there has also been an increase in the number of Montrealers living on social assistance for more than 10 years.

Despite child benefits we, at the dispensary, have seen that the financial situation of individuals on social assistance as well as that of low-income earners has remained much below the low-income thresholds. The gap is much more significant among families without children, which I call ``future families'' than among families with several children.

And the income of people on social assistance does not meet the needs determined by the dispensary for a minimum standard of comfort. These levels are far from being what we would recommend, and are well below the low-income level. Incomes below the levels set by the dispensary endanger the health of family members, and these families are far from receiving these income levels.

We also know that most immigrants in Quebec live in Montreal, and that 42 per cent of these families live below the low-income cut-off. Fifty per cent of these immigrants are between 20 and 34, that is in their child-bearing years. Forty-four per cent of the babies born in Montreal have mothers who were born in another country.

These people are facing serious financial problems, because often they are refugee claimants or people without status and sometimes their income is 30 per cent below Statistics Canada low-income cut-off. These people are living in extreme poverty. This affects women the most and close to 6 single-parent families out of 10 live below the LICO.

The number of women living below the LICO is on the rise in Montreal. We know that poor people have difficulty getting adequate food. At the dispensary, we have established what we call the ``nutritional grocery cart'' and we show in a study that it is hard for poor families to get this cart.

At the moment, disadvantaged families spend approximately 21 per cent of their income on food, when they should be spending about 32 per cent in order to get proper nutrition.

The biggest problem here is really the cost of housing. The underprivileged families spend approximately 46 per cent of their income on housing. And children are the greatest victims of this poverty. Unborn children are particularly affected by this, because pregnant women will have much smaller babies born much earlier, and everyone knows about the problems caused by low-birth weight.

The poverty of these families we see at the dispensary leads to another problem: a great deal of emotional stress. We see cases of isolation, lack of affection, and very unstable relationships as well as what I would call the disappearance of fathers, which is something that happens very often at the moment.

All of these factors can have a major impact on the health of family members, particularly the children, and can be harmful to the bond between parents and children.

At the dispensary, we are fighting poverty by trying to prevent the problem of low-birth weight babies. We are trying to encourage mothers to breastfeed their babies and we support them in this. The dispensary sees 2,000 families each year, and this is over one-third of the disadvantaged families on the Island of Montreal.

We provide new mothers with nutritional counselling by a dietician using the Higgins method. This method was developed by the MDD and involves the use of a food supplement. The MDD has been a pioneer for birth weight programs in the United States, but also for the OLO programs in Quebec (eggs-milk-oranges) and also for the Canadian Prenatal Nutrition Program throughout Canada.

The dispensary also promotes breastfeeding and supports mothers who are breastfeeding. There are also information, participatory and social groups for these women to help them feel less isolated and to develop their parenting skills.

The dispensary's figures for low-birth weight babies are the same as those in well-off communities in Montreal. Studies have also shown that the risk of a woman having a low-birth weight baby dropped between 50 and 78 per cent if she used the dispensary's services.

In addition, 95 per cent of the new mothers we see breastfeed and 77 per cent are still breastfeeding after six months. This is very helpful in developing the bonds between new mothers and their babies. The results for families born in Quebec with less than 11 years of schooling are as outstanding. This is quite an achievement, because this is a very high-risk group.

As a result of all the support we provide for new mothers, they regain confidence in their abilities and feel better equipped to take charge of their lives. This is reflected in the fact that many women after giving birth, come back afterwards to help out at the dispensary, to give back something of what they received. Often, we encourage them to go back to school or to help them complete their education so that they can join the labour force some day.

The dispensary recommends a number of steps to break the vicious circle of poverty where it begins — with the birth of a child. Every effort must be made to ensure that every newborn child has the chance to begin life in good health and there must be government assistance to children that is as effective for families in the making as for large families.

The dispensary also recommends that government assistance to children be made available to all newborn children, regardless of parental status, and that government measures be implemented to correct the impact of housing costs on parental abilities to provide children with proper nutrition.


The Chair: Thank you for your presentations. I will open with a couple of general questions.

As you know, in 1989 the House of Commons unanimously supported a motion to end child poverty by the year 2000, yet here we are in 2008 and still in virtually the same position as we were in back then. Why is that so? Second, how do we get back on track towards doing what they wanted to do then, or at least to reduce child poverty significantly and then ultimately eliminate it — a multi-stage process. We have heard from you today and from others in the past about some of the things that need to be done, such as increasing the Child Tax Benefit, increasing the minimum wage, recognizing that child poverty is really family poverty in that children are in a poor circumstance because their parents are, child care and affordable housing. How do we get to the next stage in moving towards what they wanted to do in 1989? How would you see a plan evolving? How would you see these different elements fitting in? What are the various priorities? I am giving you a wide area of latitude in terms of your comments.

Ms. Noble: Thank you for the question. There was a willingness in 1989 and, from a philosophical point of view, we needed to do something. However, we did not put the next steps in place to take action on it. Now, we have an opportunity to put some of those steps in place and make it a priority across party lines. Whether you are with the Tax Federation or with the Canadian Teachers' Federation, we all have to work together on this initiative because we are paying considerably in other ways. Mr. Dan Offord, who did some fantastic work, talked about putting the money up front. Let us be realistic and give kids a beginning so that we do not have to pay more at the end of the day. That is basically what I would say in terms of the Canadian Teachers' Association. Let us come together and say that eradicating child poverty will be the priority across party lines and across all organizations. Let us commit to a specific task and plan of action, as Mr. Goldberg talked about.

Ms. Sims-Jones: I feel uncomfortable giving the perspective of the Canadian Nurses Association because I have not had a chance to run this past our board. Speaking as someone who has spent much of my career with families of poor children, one thing that changed hugely in the mid-1990s was the issue of housing. I remember managing a program in 1996 under which we dealt with families in desperate circumstances. I might write a letter to keep them out of a shelter or to get them into a shelter, but that changed from 1996 to 2001. The availability of subsidized housing decreased. CMHC and the federal government got out of that role, but I would urge us to look at all three levels of government now to determine how we can ensure that housing is available for families who are in need of subsidized housing.

In England, they have done a very good job of ensuring that families have access to housing. One of the major stresses we see with our families occurs at the end of the month when there is not enough money to pay the rent and buy food. Those families end up at food banks. Otherwise, they will end up in a shelter, provided sufficient space can be found to accommodate them.

Mr. Goldberg: In 1989, we were at the low end of the child poverty levels, and economically we were in a better place. Then, of course, the recession and the slowing economy that started in 1990-91 drove the poverty numbers up. Poverty numbers will go up and down depending on what is happening in the economy. That is inevitable. We see that historically and in almost every country. At the same time, we exacerbated the situation through the 1990s under the Liberal government predominantly, and then later on under the Conservative government. By 1996, when we peaked on poverty, we had also reduced the capacity of the provinces to do much. You see welfare rates that have fallen dramatically right across the provinces. The provinces had lowered their welfare rates by not raising them. They did not meet inflation, so people were trying to live at even deeper poverty levels, and that exacerbated ongoing problems at the provincial level.

We see minimum wages not tied to anything. B.C. raised their minimum wage to $8 an hour in 2001 and say they do not need to increase it eight years later, as though no prices have gone up and there has been no change. We see that right across the country when we look at minimum wages. Wages at the bottom never keep up with the cost of living in all of the provinces. We are always lagging behind. When that happens, we see increasing numbers of poor children in working families simply because the labour market at the lower end is not keeping up the pace with the others.

We see reductions in labour standards. One thing we all take for granted, and I used to work for a social planning council, is that we all get paid sick leave. However, if you are at the margins of the labour market, in low paid work, you get sick days off but you do not get paid. Families are incredibly vulnerable to these issues of illness and illness issues around their children.

Child care in every province, even to some extent in Quebec — although the Quebec model is far superior to anything we have anywhere else — is difficult. Parents have so many problems getting child care that if there is a breakdown in the child care arrangements, often one of the parents will lose their work because they cannot find care for their children. We expect parents to be the wage earners and go into the labour market, yet we do not provide the tools to ensure that that can happen and make sure that their children are well cared for.

These things were all talked about at some point or another federally, and once the deficit was dealt with in the mid- 1990s we had the full capacity to deal with them but, instead, the government chose to have tax cuts. We eroded our capacity to do the things that needed to be done. However, we can get back there. Some of it will require tax increases if we want to do it fully, but if we want to commit to this thing, and we want to have champions to go out there, we must recognize that it cannot be done cheaply. That is what we tried to do before, and that is why we have not exceeded. Either we commit to doing it and are willing to spend the money, and we find how to get it, or we do not commit to it. However, if we just engage in rhetoric and say that we ought to eliminate child poverty because it is a bad thing, and no one will say it is a good thing, we will not succeed. It will not work.

The Chair: You mentioned goals and timetables as a means of trying to reach that goal.

Mr. Goldberg: One thing we learned from Britain and a number of other countries — and we have actually started to see this in Quebec and now in Newfoundland, and Ontario is now talking about it; my province is in the dark woods at this stage. The Western provinces are having their own particular approach to things these days — is that when you set targets and timelines, you then must come up with action plans because you are now accountable to a larger body public. The goal of 1989 was a really outstanding goal. It was not a realistic goal. Eliminating child poverty, even in a decade, would be really difficult to eliminate it entirely, but there is no reason why we cannot reduce it. In England, they reduced it by 25 per cent in five years, and I hear there is a five in 25 thing taking place in Ontario, and they committed to reducing it by 50 per cent in 10 years. They are very close on their five-year target, although they did not quite meet it, but the next target will be more difficult, and they recognize that. It is a hard nut to crack.

In the U.K., they have committed to it publicly, and the champion was the Minister of Finance and the Prime Minister, who are nice champions to have on a particular policy profile. They have committed themselves to trying to achieve that, and they are held accountable for it. Having goals and targets and having champions is critical. People will say, ``How are you going to do it? Show us.'' That will get the work done.

The Chair: You mentioned successes in Quebec.


Ms. Duquette: In order to eradicate poverty, we must act on several levels. Housing of course is a huge problem, and as Mr. Goldberg said, we should make monetary investments so that people are not below low-income thresholds.

At the moment, we have some families at less than 30 per cent below the LICO. There is no doubt that we cannot eliminate poverty without acting at several levels.

It is also important to target very high-risk families, because they tend to perpetuate the culture of poverty. I think we have to work very hard on this aspect of the problem.

There are programs that were set up. In Quebec, added to the anti-poverty policy, we have the seven-dollar-a-day child care system, which helps out families a great deal. However, as long as families still live in poverty, with incomes 40 per cent below the LICO, we cannot expect that they will be able to achieve miracles with so little.

Poverty leads to other problems. If we want results, we are going to need the political will to invest a lot of money and ensure that there is a better distribution of wealth.

In Montreal at this time, 10 per cent of families have incomes below $10,000, while another 10 per cent have incomes over $180,000. There must be a better distribution of wealth if we are going to eliminate poverty.


Senator Munson: My question is to the Canadian Nurses Association. It is mentioned here that injuries are the leading cause of death of children and youth in Canada. In urban centres, of youth under 15, the lowest income group are 1.3 times more likely to die as a result of an injury. Can you expand on why these children are more at risk of dying from injuries and what can be done to prevent them?

Ms. Sims-Jones: That is a good point. One of the main things would be the environment in which they are living. If you are in an environment which is not intrinsically safe, then you are more likely to suffer from an injury. For some reason, there is not a gate on the stair. It may be more cluttered. There may be more people around. When you go into these homes sometimes, because of the complete absence of resources, it is difficult for the parents to provide the type of safe environment that they would like to provide for their child. I think the first one would be environmental.

The second one may be time and pressure on the parents with competing demands because they are trying to care for their children, they are trying to earn an income, and they are trying to engage with others in their community. They may not be able to offer their children the same level of supervision as they might be able to have in a more affluent, less stressed household.

The third thing is the notion of the communities not being, perhaps, as safe as others, so that when the child goes outside, and because they are close to high traffic areas, there may be more of an opportunity for a traffic accident. The community itself is not as safe in many of the low-income communities.

In terms of what we can do about it, we can support parents to prevent injuries in the same way we support them to parent their children, and that means making sure that they have the resources they need to parent their children, and several people have spoken to that, so that they can offer the child a safer environment.

Senator Munson: What sort of resources are we talking about?

Ms. Sims-Jones: It is a reiteration of what has already been said: adequate income, adequate housing, all relating to less stress, which means they can then provide the supervision that they want for their children. They can move to a safer neighbourhood.

Senator Munson: Quebec, Prince Edward Island and Alberta are the only provinces with child poverty rates in single digits. What are they doing right, and what can we learn from these provinces?


Ms. Duquette: I focused more on poverty in Montreal. There is no doubt that it has dropped since 1996, but it is still very prevalent. Quebec has established some integrated prenatal services throughout the province, and they are very good. We are trying to target high-risk individuals and to get involved over a long period of time, over five years, with these future families. It would be good if these families could at least have an adequate income. If that were the case, these families could do better. We realize that families do not have $2 a day for food, whereas a grocery cart of food costs at least $5 to $6 a day per person.

When people have to depend on food banks, this can of course lead to other problems. Food banks often have food that is not necessarily healthy, and this can lead to obesity and all the other problems.

It is true that we have made progress in Quebec, but a great deal remains to be done.


Mr. Goldberg: It is too bad the senator from Prince Edward Island had to step out. One of the reasons Prince Edward Island has a lower poverty rate is a measurement issue. Using the LICO and the after-tax LICO, the cost of living in PEI is less than it is elsewhere. The threshold is lower and people are more able to get there. Nevertheless, in Prince Edward Island many people are on income assistance and are also living in poverty. While the numbers are lower in the after-tax system, there is also deep poverty in Prince Edward Island.

Quebec just got below 10 per cent this year. They have committed to doing something because of the act. Inasmuch as there is resistance with the new government — that is, compared to the government that passed the act — the act is there. It forces politicians to take into consideration something they said they would do. Pressure can be built in there.

In Alberta, it is the economy. Alberta's economy is unbelievable. As an economist, it is unbelievable. I am sure the senator from Alberta will agree. However, it is ironic that, after tax, 7 per cent of the children are poor in an economy where there should be no poverty. You cannot get an economy that is much better than that of Alberta. If you cannot eliminate it in a place like Alberta, then it must be done with political will.

We know there are other places that do not have an economy like Alberta, for example the Nordic countries. However, they are doing well. They have driven their poverty rates down to 2 per cent. There is no reason that Alberta could not do that, if it chose to do so. The labour market cannot drive it any lower. It is as good as it will get. Government must play a role to drive poverty figures down. We know that from every other country which has had successes in this area.

Senator Munson: I was struck by what you said about the minimum wage. Do we need uniformity in the minimum wage across the country or should it be left up to each province? Most people sit in their offices and expect that 2 per cent to be added in on April 1. However, 2 per cent is 2 per cent. People come to expect it, even senators. People who live on a minimum wage, however, do not expect very much because they see it that is coming down the pipe in five years and that we will build it to $8.50 and get up to $11.00 soon. It is always coming soon.

Mr. Goldberg: As the former director of research at the Social Planning Research Council of B.C., I wrote a report with economists from UBC on the effects of minimum wage. We wanted to examine whether there were employment effects. This is something that the Fraser Institute and others have written about, namely, if you raise the minimum wage, you will kill jobs. Looking at Canada in a 20-year time frame when the minimum wages went up, that did not happen. There are ``disemployment'' effects, but they are very small. The total wage bill, which is what you are looking at, is better for people if you raise the minimum wage.

The big problem we have had is that minimum wages have tended to jump by big amounts. It is important that businesses can plan for this sort of thing. We recommended $8 in 1999. That was the poverty line then and that is where we said it should go. If it was just pegged to the inflation rate, it would be almost $11.

How do you raise the minimum by $30 without having a ``disemployment'' effect? You cannot. You must do it in stages. It will be painful because we did not do the work in an ongoing way. We need to do with that what we did with other benefits. We increased benefits for seniors by inflation. We now do it with children, with the child benefits, to ensure that people at the bottom do not fall behind. That is critical and must be pegged to cost of living increases.

The Chair: Does anyone else want to comment on that question?


Ms. Duquette: I think the minimum wage must be increased to make it more attractive and encouraging for welfare recipients to go back into the labour market.


Senator Keon: This is a tremendously complex problem but it certainly is a problem that should be solvable; I agree with you.

I want to draw all of you into an approach, perhaps. There is an old saying that it takes a village to raise a child. I think we ramp that up now to say that it really takes a community to raise a child.

I think many of our initiatives are coming in at 30,000 feet. They are not really being implemented by people who know the population, who know the problems, and who know how to get things done. I am not suggesting that we do not need the involvement of every level of government, because we do. Furthermore, I am not suggesting that we abandon anything that is there because we should try to use it.

However, the schools are absolutely essential in dealing with underprivileged children. The schools must be subsidized to feed these children as well as educate and maybe to even clothe them. Someone must clothe them. The schools are essential but they must be linked into community services if we are ever to overcome this situation.

It is my feeling also that minimum wage is not a very effective way of dealing with poverty because too many poor people are not working at all. They do not know how to get a job in the first place, and they do not know how to hold it if they get one. There may be one wage earner there with four or five kids in the family. We must ramp that up to minimum family income. We must face it, and then it must be pegged either to the cost of living allowance or to inflation.

Imagine how absurd it is that an executive making a million-plus a year has an automatic COLA adjustment every year and most of them are not satisfied with that; they want a little more. They get that automatically. The poor devil working for minimum wage, doing whatever he or she does, is not getting any COLA adjustment.

I have thrown to you the question of community implementation and organization and the question of minimum family income. I would like all of you to address those two principles.

Ms. Noble: I will jump in first. I strongly support the idea that schools are essential, but it is the whole sense of community that is essential. That is why, from my perspective, there is such an opportunity now. There is the whole concept of talking about poverty. People want to eradicate it. As Mr. Goldberg says, we may not be able to eradicate the whole thing but we can certainly reduce it. In schools, we used to talk about things like that before. It is a key factor now. The Elementary Teachers Federation of Ontario has received major funding from the government to study what poverty looks like in the classroom and how we can make a difference in terms of communities across Ontario. There are some really good things that can come out of that initiative.

In terms of implementation, I am not that familiar in terms of money and statistics, and so on. However, I agree with Mr. Goldberg's points that there must be a commitment with all levels of government and that it starts with the community. That is the key, as well as timelines and an action plan. Surely in this day and age we can all participate in that, and educators can be a key force in moving that agenda forward.

Senator Keon: What about minimum family income as opposed to minimum wage?

Ms. Noble: If it is to be of benefit, then let us move it forward. If the government has the will to say that this is what it wants to see happen, and it will be of benefit to families and children in poverty, then let us do it.

I have a real caution with regard to our language. Often as a teacher I get caught in the same milieu. You will see it in our brief. Sometimes we blame the people in poverty for their circumstances. Whatever decision we make, we cannot do that because that exacerbates the issue.

Ms. Sims-Jones: I will start off by speaking to the issue of community services.

Before the children get to school, they need to have services through pregnancy, as Ms. Duquette spoke so eloquently about, as well as infancy and early childhood. A system of community services needs to be set up to identify those children who are most at risk, who are in families living in the most difficult life circumstances, to ensure that they have the supports they need before they get to school. If you identify a child who is not hearing well at four years of age, you have a speech problem that you will not be able to correct. Nurses would urge early and targeted services to reach the children who most need them. That would be my main point.

With regard to your other question, schools are certainly important because we do not want to lose those children once they get to school.

With regard to the notion of a minimum family income, I need to find out more about that. The nice thing about increasing the minimum wage is that when people go out to work, they are paid for the work they are doing. If we went to minimum family income, which certainly you could do through tax exemptions to ensure that everyone had a minimum amount, you would also want to ensure that you had a working wage for when they went out to work.


Ms. Duquette: For example, the poorest age group in Montreal is the zero to five group, which makes up 38 per cent. As Ms. Jones was saying, we have to work to fight poverty. We will have to work on the quality of life of babies before birth, and during the early years. These are the ages when families are the poorest. Once children reach school age, families are not as poor. I think it would be ideal to have a guaranteed minimum income for all families. Then women would be able to get proper nutrition, adequate housing and a safer environment. Housing in Montreal is deteriorating. Something must be done about this. We need to take action so that children are ready for school when they reach five.

That is what we are working on in Quebec with the integrated programs. We must target the high-risk groups. This means we need the help of specialists to work with high-risk individuals to change behaviours. That is not an easy thing to do.


Mr. Goldberg: On the schools issue, remember the time before now when there was a declining enrolment in schools and we created community schools. I am familiar with some in Ontario and Alberta. Social services, child care and other services used this marvellous public facility that we paid for rather than shutting it down or bulldozing it, to ensure that the full needs of the community were met. Unfortunately, population ebbs and flows, and more kids came into the neighbourhoods. They took away the community programs because the space was needed for classrooms. While that is their primary mandate, they should have expanded the school and left the community component in there.

We lost an opportunity back in the early 1980s and now we have another chance to do that again. I would strongly urge that, at the community level, the school board level, the municipal level and the provincial level — the federal government does not have a role here, unfortunately, but perhaps you could encourage people to do certain things in terms of education — that schools not be closed. In B.C. we are closing schools left, right and centre and we are literally giving up the facilities we could use to create a sense of community, as they are within walking distance for young children. They would be great places in which to put community-based child care. We did that. Many of us who were community school coordinators were able to do those things in the late 1970s and early 1980s. There is an opportunity to do that again.

I want to talk about family wage. Minimum wage is a tool in a toolbox. I agree that it is a blunt instrument; it is the hammer. You need the screwdriver, the saw, the chisel and all kinds of other tools in order to address child poverty. Minimum wage, on its own, will maybe assist those who work who are single but will not address all the issues of the family.

We are currently involved in a project where we are looking at what we call a living wage. It is often referred to as a family wage: What would it take to make a family wage, and what are the public components that need to be there? In B.C. we are doing that. We are looking at a family that is working 60 hours a week — two partners who work 30 hours each — to reach the standard. We are using the MBM process, the market basket measure described in the brief, done by the federal government, and taking off the taxes but adding in child benefits, taking off costs for health and child care as is in our province. That family with two people, working 60 hours a week to meet a living wage above poverty, would require over $17 an hour at that number of hours per week.

That is our dilemma. We have not done a very good job of linking economic policy — labour market policy, on the one hand, including employment standards, minimum wage and a number of labour market policies — with our fiscal policy, which is the taxation, although we are doing better there, and the statutory requirements for CPP and EI. We have done a horrific job on the benefits side. Child benefits drop 23 per cent after you hit $20,000 for a family of two. On income-geared programs for subsidized housing, 30 per cent is taken off the top for every dollar you get, and fifty cents on every dollar once you pass the threshold in child care. If you make an extra $10, you lose $5 because you get $5 knocked off your child care. If you are in subsidized housing, you get another 30 cents knocked off. Then you have taxes, CPP and everything else. There are families with marginal tax rates of 126 per cent. That is nuts. That is because we have done such a bad job. I cannot tell you how bad a job we have done of linking the range of programs so that they do not interfere with one another in a way that is really negative. It primarily hurts low-income families.

The rest of us have done well. If you are in the middle class, earning $60,000 to $100,000 as a family, you are doing fine. However, in the $30,000 to $40,000 range, we beat up on you. That is not fair.


Senator Pépin: Thank you for your presentation. When we hear what you have told us, we wonder what can be done, and we know that something must be done quickly. Ms. Duquette, you mentioned the figure of 42 per cent for immigrant families. You talked about fathers who disappear, and I am wondering what you mean by that?

Ms. Duquette: Often, the father leaves when his girlfriend becomes pregnant. He leaves her alone to deal with the responsibility of children. That is not unusual. We see it often at our office. These women are extremely poor. I am thinking of a young woman who had two premature children and who was expecting twins. When she had the twins, the father left. She was left alone with her children. We are going to have to work to teach fathers to assume responsibility for their children and help them play their role. We see fathers who simply disappear all too often.

Some of them are even proud to say that they have four or five children, all the same age. We are going to have to do something about this.

Senator Pépin: Do you see this as a new phenomenon? Is it on the rise?

Ms. Duquette: It is increasing, but it is not new. It existed before, but this has become more frequent. It is quite simply easier to leave now. Just yesterday we had a call from a mother who was feeling desperate: she had her baby on February 3, her husband left her and she is already raising two children.

Senator Pépin: You talked about the success you have when you work with a woman throughout her pregnancy, right up to birth. Thanks to your help, even very poor mothers have babies with an adequate birth weight. Have you been able to track these children over a long period of time afterwards, to find out how they manage at school?

Ms. Duquette: We have not done any studies that go that far. The Dispensary is a not-for-profit group which receives some of its funding from the United Way. We help out 2,000 mothers a year, and we have approximately 200 mothers on a waiting list for our services. We have no staff to do longitudinal research at this time. But we do have information about individual cases. I am thinking of a number of mothers who have now completed university, and these were women who started off with a handicap, who had been damaged by life since childhood, and who are now university graduates. One of them called us recently to say that she had bought a house.

These are isolated cases: We cannot say that we have had that type of impact on every mother. However, if we do some work with them, I do think we can turn things around for them. Of course, this is a long-term effort. We work with mothers during their pregnancies, during the breastfeeding period and throughout the first two years of the baby's life. That gives children a good start. Of course, children can run into problems once they become teenagers.

Senator Pépin: There is also the fact that they do not have access to child care services. We went to Cuba, and I can tell you that these people are not wealthy, but we learned a great deal. Of course, there are services for pregnant women, but there are also services for children. They go to child care centres and have services provided up to elementary school. Services are available throughout this entire time, and all this preventive work means that these children do better in life. We are going to have to find a way of doing that as well.

At the moment, the Quebec Department of Health and Social Services is providing vulnerable families integrated support services during pregnancy and early childhood. There is also a support program for young parents, including home visits. Is the dispensary part of this network and this program?

Ms. Duquette: No, we are not officially part of the program, because we are a not-for-profit organization, that is non-government. The program of integrated prenatal and early childhood services is definitely designed to provide support to all pregnant women, even the most vulnerable, and to continue support during the first five years of the child's life. These measures are in place at the moment and seek to provide women the support they need. However, I think there is a shortage of personnel to meet all these needs. It does require a lot of resources to work with a family for five years.

Senator Pépin: You get some funding from government, but I believe you also said that the United Way provides some support. That must mean that the amounts you are getting are not adequate.

Ms. Duquette: No; we get some funding from the United Way, and we get some from the Canadian Prenatal Nutrition Program and also from the Department of Health and Social Services in order to make ends meet. We help 2,000 mothers a year, and we give each of them one litre of milk a day, one egg and some flaxseed. And we have been doing that for years. It costs us $20,000 a year for the milk, and we know how the price of milk has been increasing. It went up by five cents again in February. For the last three years, the price of milk has been increasing, and it is a very nutritional food. The dispensary offers it to mothers but it costs us $20,000 per month.

The cost of the dispensary's services is very low. It costs us about $500 to $600 for each mother for the follow-up services we provide, including nutritional and professional support. This is little compated to the amount of money the province saves in health care costs.

Senator Pépin: I have a question for Ms. Sims-Jones. In your brief, you talk about the Nurse Home Visitation Program. You say that this is one way of reducing disparities in health care. A similar study was done in Memphis involving Afro-American families, and the results show that the program had many positive results for mothers and their children.

My question is whether the program has been tested and proven its worth, and what improvements there have been in the last 20 years in the various communities. Should the program be changed or improved to make it work even better?


Ms. Sims-Jones: If I understand your question, you were asking about the nurse home visiting programs and what types of things they improve across the country?

Senator Pépin: I was also asking what should be done to improve.

Ms. Sims-Jones: Similar to Ms. Duquette, I can talk about the home visiting program. I was involved in putting it together within the province of Ontario. I would like also to reinforce some of the other issues. With home visiting, we are trying to support people where they are, and clearly we would like to be in a better place. We would like them to have adequate housing and sufficient income to be able to feed their children a nutritious diet, but with many families that is not so. With the home visiting program we have been trying to identify the families that are living in the most difficult life circumstances and provide an intensive home-visiting program.

There have been studies around the world, starting with a study in the United States with David Olds, where they were looking at high risks for American women. Most of them were teen mums and they followed them for two years quite intensively. They have now followed them for 15 years and had a number of positive health and social outcomes among these families.

They have a similar program in Ontario. It involves both nurses and lay home visitors. The lay home visitors work closely with the nurses, and we try to support the families to identify their goals for their families, and then work with them toward achieving those goals. It is very much a goal-driven program. The research supports a goal-driven program approach.


Senator Pépin: In 1998, the cost of the Nurse Home Visitation Program in the United States was between $2,800 and $3,200. If we were to try to introduce the same program here, how much do you think it would cost for each low- income family? Here we have the figure of $3,200 a year for each family.


Ms. Sims-Jones: That is an excellent question, and I can get you that answer. I do not have it with me. There are home programs within Canada, and I can work out what they cost per family.

Senator Pépin: Do you think it would be a good program to implement everywhere?

Ms. Sims-Jones: Yes. They tend to work very well. The study by Gina Browne found that if you reach out to women who are on social assistance and offer them programs, they do much better than if you leave them to cope on their own.

Senator Cochrane: Some observers say that childhood poverty can lead to adult poverty. Do you see a strong link between childhood and adult poverty?

Mr. Goldberg: There is a strong link. It is the notion of disadvantage; that is, if you start of being disadvantage, the possibility of your becoming disadvantaged later on increases. It does not mean that you will necessarily be poor, but the risks are much higher. We find that many adults who are poor experienced the scourge of child poverty when they were growing up.


Ms. Duquette: A pregnant woman who has no support during her pregnancy and has a low birth weight baby has a child that is in danger of doing exactly what his or her mother did. If we provide infants with a solid foundation from birth and during early childhood, there is a chance that the situation will improve. We see that a great deal. It may take one or two generations. But there is progress and we can see it.

The dispensary has existed for 128 years, I am the fifth director and I have seen many families in the past. I can tell you that some of these families have really made a great deal of progress. There is a chance for them to turn things around, but children must be given a good start. There has to be a strong bond and a solid foundation. The solid foundation is built during pregnancy and during the first years of life. During pregnancy, we do not have much time to take action, because mothers come to us at 20, 25 or even 28 weeks. So there is very little time to change the mother's behaviour. If she is not eating right, we have to change that behaviour in a few weeks, and that is a very short time. Sometimes we have to change a behaviour like smoking, drugs, et cetera. So we have to take action quickly and effectively. We need people skilled in this type of work with a talent for working with these individuals to get them to change their behaviour. This takes someone who is a good listener, and not everyone has that skill. So we really have ensure good training for people who do this work.


Senator Cochrane: On that topic, your work is focused mainly on ensuring the health of newborns. Would you elaborate on that?


Ms. Duquette: Yes, we are trying to turn things around for the 2,000 pregnant women we work with each year. Once they come to us, we help them throughout their pregnancy and provide individual consultation. Each woman is seen individually by a dietician who assesses their nutrition, identifies their risks and takes action as required in order to turn things around for the mother. For example, if the pregnant woman is in danger of giving birth to a low birth weight baby, we hope that during the weeks we have available, we will be able to ensure that this woman has a baby with the proper birth weight. We often see a difference among these mothers. I am thinking of a young girl who weighed 2 pounds at birth. We worked with this girl. When she came to the dispensary, she could not concentrate, she was very nervous, was 5 foot 10 inches tall and weighed about 120 pounds and smoked 20 cigarettes a day. She also was using drugs and had very poor self-esteem. She said she was good for nothing, that she had not completed grade 3. She had already had 2 low birth weight babies. We helped her understand that she could now start afresh, and with support, as a mother, she could turn her life around. She gave birth to a baby boy who weighed 7 pounds. She came back to see us with her baby to tell us that she now knew what the verb ``to love'' meant. Her other two children were taken away from her and put into care. The two earlier pregnancies were failures for her. They reminded her that she could not succeed, that she was good for nothing. She did not have any other pregnancies right away, because she had this baby to love and to focus on. We ensure that babies have a good weight at birth, and we provide support for many women with breastfeeding, without forcing them to do anything. We encourage mothers to breastfeed, to decide to breastfeed once they have their baby. We have them take part in two breastfeeding activities so that they are ready to breastfeed their babies when the time comes. We also provide support once they choose to breastfeed their babies. We provide all the support they need to succeed.

Generally speaking, 77 per cent of nursing mothers continue to breastfeed up to six months. We conducted a study on young people born in Quebec, with an education level of less than ten years to determine nursing rates. Of this group, 33 per cent consumed drugs or cigarettes, 20 per cent were under 20 years of age, and 40 per cent of the group continue to breastfeed after six months. They live in extreme poverty, but these are small steps and we have to focus specifically on families to help them change their behaviour.


Senator Cochrane: Is there any data on schools that have brought in breakfast programs for children? My background is teaching, and my experience is that all the children, not only the poor ones, wanted to partake in the breakfast program, which was wonderful. I found this to be a very effective way of helping children to learn. When they had had a good breakfast, it was much easier for them to learn.

Ms. Noble: I do not have specific data with me. I was fortunate to be at a couple of schools where the parent community or a church provided a breakfast program that was open to everyone, which is a key point. We do not want to label anyone, because then there is blame, and we need to get away from that.

A breakfast or lunch program should be for everyone. One of the service clubs provided fruit and granola bars for the school kids. The teachers reported that the children were not falling asleep by ten o'clock in the morning. They were more attentive and would participate more in physical activities, and physical fitness leads to a healthy mind.

In the Algoma district in Northern Ontario, where I am from, the dairy farmers allowed school boards to access milk at an incredibly reduced rate.

You spoke about Cuba. In the 1980s, Canada did a wonderful thing. We exported some wonderful Holstein bulls down to Raul Castro's farm in Cuba. There were things happening around the Oshawa area. I know this firsthand, as a result of visiting some of the schools. One of the reasons they did so was, first, to improve their milk production and the quality of milk. Canadian Holstein bulls provided that.

Quite frankly, that is the result of what Canada did 25 years ago: a milk program within schools that is providing nutrition for all the kids.

Senator Trenholme Counsell: Thank you and welcome. We in this committee are also conducting a study on early childhood development and quality child care as a result of our OECD malperformance rating. I am always interested that, whenever there is a panel on poverty, this subject comes up.

I have noted that, Ms. Noble, you mentioned the need for a universal child care system and, Mr. Goldberg, for high- quality publicly-funded child care. I thank you for mentioning those.

I have two questions, the first for Ms. Noble. I have just returned from New Zealand. I was fortunate to go there. In New Zealand, child care services fall under the Ministry of Education. They are very high quality with a curriculum and with child care workers being paid the same as elementary schoolteachers. There is a requirement that by, I think it is 2011, all workers will have at least a three-year program. It is being phased in.

I wanted to ask you how you see your reference to a universal child care system fitting in with education in this country.

I will ask my second question, which is to Ms. Duquette.


Welcome, Ms. Duquette. I have tremendous admiration for your institution.


— Montréal Diet Dispensary, because a little over 50 years ago, I was a student there when I studied at the Royal Victoria Hospital. I think Ms. Higgins —


— who was there then in the early days of the institution, isn't that so?

Ms. Duquette: Not quite. The institution was founded in 1879 by Ms. Emily De Witt, a volunteer. She was a woman of great vision, because as of 1920, she understood that poverty was a very significant problem, as well as housing and malnutrition caused by poverty. She therefore retained the services of a dietician to manage the Dispensary in 1920, the very first school of dieticians located at McGill University. Afterwards, Ms. Ann Garvock and Ms. Higgins came. I am the fifth director in 128 years.

Senator Trenholme Counsell: I have great admiration for the Quebec day care program and I would like to ask you a question on this subject.

Firstly, for families who are not able to pay $7 a day, does this program provide any other specific arrangements?

In addition, I would like to know your opinion on the Quebec day care program. I feel that it is an example for the rest of the country, and I would like to know your opinion.

Ms. Duquette: The day care system works very well in Quebec. It is great program.

With respect to families living under the poverty line, early childhood centres provide free spaces. The problem is that space is limited, and one has to reserve well in advance to be able to get it. One practically has to sign up during pregnancy to guarantee a space. The government is working to create more spaces.

Overall, it is a program that works well. We truly support it. It provides respite for families in need.

Senator Trenholme Counsell: Perhaps I did not understand you properly, but can you clarify what the situation is for families who are unable to pay the $7 per day?

Ms. Duquette: If they do not have $7 to pay per day, certain early childhood centres provide free childcare services. However, they are not enough spaces to meet the demand. I do not know what template is used to assign free spaces.

Senator Trenholme Counsell: Is the decision made by the centre or the government?

Ms. Duquette: I believe it is the decision of early childhood centres. They try to find a space for everyone. Families in great need are often moving, and that may create problems; but most of them have a rather easy access to spaces.

Senator Trenholme Counsell: It is free for these families, more or less.

Ms. Duquette: I do not know the amount paid based on the family's revenue. It is more or less free for some people, but not for everyone.


Ms. Noble: In terms of the education piece, certainly we advocate the idea of a seamless system. Picking up on what Mr. Goldberg was talking about, there was the Yours, Mine and Ours document that came out 20 years ago and talked about the school being a centre in the community, so let us use all the extra space.

My mother was a public health nurse, and I can remember her coming to the school, going out and visiting, as you say, mothers. Mothers would bring their babies to the school. This is in a rural area.

There is an opportunity for us to look at it, particularly from my perspective as a teacher, so that it is a seamless kind of thing.

I draw an example from my own area. One of the reserves, Batchewana, takes education very seriously. They have a nursery school and a daycare. The bus picks children up on the reserve and takes them there. The kids go from the nursery to the junior school, the bus picks them up to bring them to the school and then takes them back. The kindergarten is only half a day, so you pick them up there and take them back to the junior school. It is very much of a seamless approach.

I think some of the Nordic countries use that kind of approach for children. It is certainly worthy enough that we should look at it.

Senator Cook: Thank you for bringing the complexity of what we are studying to my attention again this morning.

We know where we want to go, but we are not sure how to get there. I know that in your areas of expertise and within your mandate, you have strategies and programs that are indeed making a difference. For me, that is a small piece of the bigger picture.

I have two questions, but first I want to quickly run by you a framework that was initiated in my province in 2006. It was called ``Reducing Poverty: An Action Plan for Newfoundland and Labrador.'' It is on the Internet, if you would like to read it. It set out goals and objectives. It is an action plan; it is run by a ministerial committee, across government departments. It encompasses Aboriginal affairs, education, finance, community services, and the Minister of Innovation, Trade and Rural Development. It has a reporting mechanism to the House of Assembly in my province, and has a budget of $2.4 million attached to it as a 10-year plan. Therefore if you want to think about a framework such as this, and I know I live in a small province, could we use these kinds of models to get where we are going?

Within your scope, as I said, you are making a division, but the discrepancies are still with us. We cannot get beyond that barrier. First and foremost, for me, is the dignity of the individual, the people we are talking about collectively here, and the other thing is, if I could encapsulate, food and security. I have two questions.

The idea of a national pharmacare plan has been around for a long time. What are the barriers this morning that prevent government from initiating that pharmacare? I think of the social services piece of money that people get that is far below the poverty line, no matter where you live in this country. What is the barrier to allowing that family to earn a modest income that would take them to the living wage in whatever province they live in? Why can we not make those steps? To me, that would help us get to where we are going.

Mr. Goldberg: I will start that one off. First, congratulations in being from Newfoundland and Labrador. Your premier has made some very bold statements. To be really blunt, he has produced and provided some of the more progressive commentary on this issue in this country. Those of us who live in British Columbia, where we are going in the opposite direction, I wish we could get Danny Williams to speak to our premier and have him move along and nudge him up a little on what needs to happen.

The key thing is that you have a plan. A plan is goals, it is objectives, it is an action strategy, it is getting people together who can actually implement the action strategy, and monitoring it. That is what a plan is. He has talked about a plan. I am curious to see the very specific goals and targets. I think those are still being worked out. The proof will be in the details. He ran for election, saying he will raise the minimum wage to $10 an hour by 2010. Given the cost of living in Newfoundland compared to B.C., we would be really happy to get our premier to go to a comparable level.

You are right: It is a lot about food and security. There is a report referenced in the document I gave you that looks at the complex policy arenas that you need to have in order to address food and security for single people, or families with children, or seniors, who have the lowest amount of food and security, interestingly enough. That was because, when the Croll commission report was mentioned, the thing that was the big poverty issue in 1971 was of that among seniors. The government of the day said ``That is not good enough'' and so we did things about that. Governments can make a difference, and we have shown that with the introduction and enhancement of the programs for seniors: CPP, Old Age Security, and particularly the GIS, which really helped at the bottom end for the vast majority of seniors to get out of poverty.

I have never understood why we never had a national pharmacare plan. I spent some years in England. When we were there, if you and your kids needed dental service, you went to the dentist and the dentist billed the health service. If you needed medication, they billed the health service. It was infinitely, economically more efficient than what we do now. Unfortunately, they had a prime minister who decided to go backwards, so they have lost a lot of those things.

I am trained as an economist. My background is in economics. The question that an economist asks, more than anything else, when you have a set of values and things you are looking at, is what is the most efficient way to do something so thata you make the best use of your dollars? Clearly, the amount we spend on pharmaceuticals is high because we do it inefficiently. If we had a national plan, as they have in New Zealand, the buying power is astronomical. You can get into better referenced-based pricing and you can get into things to ensure that you get the biggest bang for the available dollars.

The Quebec child care system is an example. Why would we waste money getting parents to pay $7 a day? Those of us who run businesses know that you need to receipt all that money, and make sure that you get it. For those who do not have the money, you need someone who adjudicates the subsidy that they might receive. From an economist's point of view, that is all wasted activity. You do not get anything for that. You do not get any more child care. People get jobs, so it is not totally wasted, but it does not give you what you want.

Therefore I have never understood this hesitancy to move to much higher-efficient models, most of which are universal, and most of what we have are universal in nature, and people treat them well. They do not misuse them because they are paying for them, and they just do that through a tax system, which is actually a more efficient system than everyone paying a little money and having to receipt all that money. I do not understand why we do not have such a plan. It makes no economic sense not to have one.

Senator Cook: Will you comment on someone receiving social assistance to bring them to the living wage?

Mr. Goldberg: Earlier in my presentation, I said that we may have to remake the tax and benefits system. I think John Stapleton and John Richards talked about that fact that, in many provinces, the people who are on income assistance, if they earn income they lose 50 per cent of their welfare benefit for each dollar they get on income. In my province, they lose 100 per cent, so if you make a bit of money, you lose it all off your benefits. Almost everyone says that you need to have something that is much more progressive in terms of the speed at which people would lose benefits, or you are replacing earned income from benefit income.

We have not figured that out yet. The worst thing we have done, and again I think John Stapleton mentioned this in his presentation, is that when you have a family on income assistance which is now trying to earn income, a single mom, perhaps, trying to get into the labour market, working part-time, getting to keep half her income, but in the meantime also losing and having to pay other benefits, like CPP and EI, and then if she is in subsidized housing, having some more taken off to the point, literally, where we allow these people to keep just 20 cents on the dollar.

If you have an earned income exemption of some kind, you have to ensure that it melds nicely with all the other programs you have. Nobody ever should lose more than 50 per cent of their benefits when they are stacked.

Senator Cook: We have done some marvellous things within the EI program, or whatever the current buzzword is for it. Why can governments not put in a similar type of program?

Mr. Goldberg: I do not think there are earnings exemptions under EI. I know you can earn a little bit, but mostly if the replacements are high enough, then you would not receive benefits.

Senator Cook: I am talking about the fact that we seem to be able to do one program very well but we cannot seem to get beyond to the one that is most needed. It is not only economic, if I may be so bold as to say, it is about the dignity of that family. One parent or the other can go to work and feel good at the end of the day. It might only be $20, but at least we could eliminate the fact that if you are on social assistance, you are not losing the worth you are earning by doing a few hours of work. I think that is wrong. Someone else might like to comment on that.

Ms. Noble: I would like to make a comment, picking up on the dignity of the child, too, at school. I can think of situations where they do not have the money if there is a field trip, or as the other senator talked about, the ones who go for the breakfast program when it is not for everyone. I think you are right on there when you talk about dignity and self-esteem. It is really important.

The Chair: We will move on to Senator Fairbairn from Alberta.

Senator Fairbairn: Much of what I have been listening to is partly very encouraging. In some cases, not necessarily discouraging but challenging.

Certainly, more than one of our guests has talked about education and learning and the role that that plays in the larger picture of how the country is to face its own responsibilities and opportunities.

You may know that for many years I have been involved with the subject of literacy. In the document relating to child poverty in schools, you can read in two or three places that the issues that have been before us and bothered us for many years are still there to a degree. When it comes to health issues, or almost any issues, if you do not have that foundation, you are in difficulty. We had a bit of kerfuffle a year ago about the issue with the federal government, but things have straightened out to a degree so that every part of Canada can have an opportunity to help people who are not able but who want to read and write, whether they are seniors or regular workers or children.

In your studies, how much does this raise itself as a truly difficult stopping point for some people who need the kind of assistance and help that they should get and yet have that problem? I know, my friend at the end of the table, we talk about this in our rural poverty study as well. This issue just keeps coming up.

Do you have up-to-date thoughts on that? I will not beat away on it, but could you give us a sense, when we are talking about issues such as urban child poverty, of how much of this issue is still a major part of the difficulty faced by families in trying to make their way and also to give their children a fair chance?

Ms. Sims-Jones: You raise a good point, because it is very difficult to work if you cannot read, and one of the groups we were working with closely were newcomers to Canada who could not read in their own language. It is difficult to learn to read English if you cannot read in your own language. At that point, they were setting up programs to teach young moms to read in their native language, and to then be able to teach them how to read in English. In order to be able to work and give long-term contribution to this country, they will need to be able to read in order to support that in their own children.

We had a focus on literacy within this home-visiting program that was targeted to meet the needs of families living in difficult circumstances. Those are the perspectives that I would have on literacy.


Ms. Duquette: When we are talking about urban poverty, as in Montreal, where 42 per cent of immigrant families are living below the poverty line, I can tell you that among the families we see at the dispensary who come from 90 different countries, the women often do not speak English or French that well. Most of the time, their children become the interpreters for the family, and language becomes a huge obstacle for these families when they try to find a job.

It takes immigrants 14 years to become part of Canadian society, and it can take 20 years before they reach an income level equivalent to that of people born in Canada. It is a long process.


Mr. Goldberg: The large metropolitan areas have the issue of immigrants, particularly refugees, and the need to enhance ESL training or first language training. For some of the immigrants and refugees, this is absolutely critical. The other critical arena I would argue is among the urban Aboriginal population. That is the second group that also has high levels of functional illiteracy. They may have managed to get through Grades 6, 7, 8, 9 and 10 in school, but their functional literacy is sometimes problematic. However, we need to find ways that do not treat this as a literacy issue, because most Aboriginal people would be offended if it were done in that way. They are culturally sensitive to some things that have happened with them and their parents and grandparents, in terms of residential schools and other kinds of exposures that have made life extremely difficult for the Aboriginal urban population. Along with the immigrant population, I think those are the two arenas we need to serve.

Senator Fairbairn: You mentioned my province of Alberta earlier and the situation that is very well-known, and it is encouraging and everything else about how we get along there; however, there is a very different part that some people do not understand or even know about. As we are using every bit of the new technology, we have managed to turn our oil sands into something else altogether. That has caused a great enthusiasm for people in every part of Canada to come to Calgary, for instance. They come there and think that they are heading up to Fort McMurray, and it will be terrific and they will get the jobs and the return on that and have a good house and a good future and all of this. It is often viewed as being an industry that has a great deal of manual labour in it.

This has changed profoundly in recent years, and this industry is as high tech as you are going to get. Very often, right now today, in places such as the city of Calgary, you are finding people on the streets of all ages, young and old, who have come with great enthusiasm, thinking this will be the way ahead, and they find out that they do not have the opportunity to advance themselves in that industry because they cannot read sufficiently in order to use the technological machinery that is now available.

This issue surely is involved with many other things across Canada and not simply in the province of Alberta. It is very troublesome, and so when we are talking about the need at every level of government to connect, if possible, the abilities to offer literacy help; that that is the only way you are going to get into that level of work and be able to have a decent life for yourself and your family.

I find it very troubling, and yet it is an issue that many people — and you know this — want to walk away from or do not believe in. Even mentioning Alberta, you have to believe it because you can see how people are coming with great hope and finding out that, without the ability to read and understand the new technology, they are in a great deal of difficulty.

The Chair: Could we get a brief comment on that?

Mr. Goldberg: If you can build in the literacy programs — one of the lovely things about the community schools of 30 years ago was the premise of the community school, which was lifelong learning. We had adult education, kids and adults learning together, grandparents who could barely read learning with grandchildren. All of those things become possibilities in an environment that talks about education in a building called a school, and in that case is open from 7:00 in the morning until 11:00 at night. There are all kinds of things to do in that environment that give people opportunities beyond the more rigid, formal literacy programs which some people find difficult to get to, or resist, or a whole bunch of other reasons. Yes, literacy will be crucial in a knowledge-based economy; there is no doubt about it.

Ms. Noble: We have to understand that literacy is not just about reading words; it is about reading numbers and all of those things that are technology, and that is key. Was there not an Air Canada employee who put less gas into the plan because of confusion over one-quarter and one-eighth? That is an example that could have been dysfunctional, or a safety issue. It is that kind of thing. It is literacy in a very holistic view.

Senator Brown: Mr. Goldberg, I agree with two of your suggestions. The first is the matter of the minimum wage. It is terrible that the situation gets to a crisis level and then we throw money at it, and then it goes to another crisis. I agree on your assessment that it should be based on inflation, or slightly above inflation, in order to catch up.

Second, regarding the reduction of benefits received, we have been through that argument over welfare payments and such before. I do not see why we want to give someone help and then take most of it back, whether it is through reduced benefits or snatching it back in taxes. It is really stupid.

One thing that scares me is when people start talking about universality. I think it is a major problem in this country. We had a gentleman from Quebec who had to go all the way to the Supreme Court in order to have the right to obtain health care. The Supreme Court made a decision that resounded right across this country.

In Alberta, we had a woman whose plea was stronger than the gentlemen from Quebec. Her exact words were ``Why can't I use my life savings to save my life?'' That is what you get from the idea of universality, when you put in place regulations that bar someone who can afford it to go outside the system. They are penalized, and the system is penalized as well.

I have a situation in my family where someone waited two and half years to get relief from chronic pain. We finally gave up and took her to another province where she could get treatment at considerable cost, but it was already too late. She has permanent nerve damage in her back because she could not get the needed operation in less than three years in Alberta, where we are having discussions about all the money we have in the province.

The situation is that we do not have enough people working in our health care system. It is probably also a symptom of the universality program that allowed Americans to buy our doctors and nurses for decades. Now, we will have to find a way to get them back, or train more of them. I think the problems are a direct result of universality.

Why should people who make $100,000 to $400,000 per year not be able to go where they want? They do go, in fact. I can go to other provinces and countries to get health care but I cannot pay for it in my own province and shorten the line, thereby permitting other people to actually get care.

Mr. Goldberg: You have raised three points to which I will respond. One, in 2001, I was in Alberta holding a national social welfare policy conference at the University of Calgary. The then Minister of Social Services was asked how they set their welfare rates. He said they were planning to use the market basket measure when it came out. We were happy with that answer, but they did not do it. It would have significantly raised the welfare rates and helped people to get by. The current rate is below what they really need, but they would be able to get by. For many, there was a disappointment about a promise made and not kept.

Second, everyone agrees that taxing people or reducing benefits is ineffective in reducing poverty. If you look at the tables I provided, the tax portion of what people lose at $40,000 is small. Taxes are not the real issue. It is the loss of benefits that are huge: Fifty per cent to 70 per cent of the benefit is reduced for each additional dollar earned. Only about 3 per cent of that reduction is attributable to tax and maybe 6 per cent to 7 per cent is attributable to other deductions such as CPP or EI.

We have misled ourselves that we need to cut taxes to benefit lower income people. We do not. We need to change the benefits system so that we do not nail them to the proverbial cross.

Senator Brown: I agree with you on the first two things.

Mr. Goldberg: Three, I want to talk about universality for a moment. You raise the conundrum between planning to have sufficient doctors and nurses, and the ability to pay and deliver the programs. Whether you are poor or rich, the cost of that surgery will be the same whether it comes out of your pocket or you pay for it through your taxes. The big difference is that the taxpayer who has a lot of money is helping pay some of the costs for the person who has little money.

We have many universal systems such as roads, fire departments, police forces and schools — though not post- secondary education. I would argue that if you said that the wealthy person should pay the fireman who comes to his house to put out a fire, a user-pay system like that would destroy our fire service.

The question is: What is the most economically efficient? If you say there is a pool of money, how many services can we get if they are well planned? The fact that we now have a shortage of doctors and nurses was a result of lousy planning. It was bad planning because we were planning in 10-year cycles instead of 70- or 80-year life cycles.

In B.C., for example, bad planning is the closing schools. Twenty-five years from now, these places will be short of schools. I will bet on that, but you cannot get a government to think 25 years ahead. Therefore, the current medical situation is not a problem with universality. If someone has the money go to the U.S. and have their procedure done, then go ahead. However, you must be sure that the person who does not have the money has access.

Senator Brown: There is the problem, though, of having that money leave the province unnecessarily. Why should I take a member of my family to British Columbia and pay tens of thousands of dollars for health care that I could receive in Alberta, thereby reducing the costs in Alberta and increasing the ability to hire more doctors? That does not make sense for people who are either extraordinarily wealthy or even if they are just above the welfare level and can afford to pay for that procedure that they need. We are restricting their abilities.

You cannot answer the question of the lady who asked ``Why can I not use my life savings to save my life?''

Mr. Goldberg: She could have, but probably not in Alberta, because there were no doctors or nurses available. I do not know the answer.

The Chair: The health care system is not the subject today. Let me pose one more question to close off this point.

In terms of the measurement of poverty, we most frequently use the low income cut-off measurement, or LICO, but Statistics Canada will tell us that that is not intended as a measurement of poverty.

Should we spend the time and effort, either in the short run or the long run, to establish a new measurement for poverty? If we are going toward goals and timetables, we should have something to measure it against. What might such a system look like? Would it be the market basket system or something else?

Mr. Goldberg: That is part of my brief, but I did not address that point today. However, it is one that I used at the rural poverty meeting. In the first two pages, I give some definitions and measures. There is a table on page 2 showing how similar the poverty measures are, looking at before and after tax. The Fraser Institute is the only one there that varies significantly, but they use physical survival needs rather than something based on community needs.

All of us who have been in the field and arguing on these issues for many years say that we do not need another poverty measure. We have good tools already, before tax, after tax and others you can use for international comparison. They are close. Choose one of those. You could go with a consumption measure if you wanted to use a particular measure for welfare rates. I would go with the market basket measure. If you are looking at employment policy, it would be a before-tax measure. Perhaps, you want a mixed income consumption measure like the a before-tax LICO. The point is, you could spend hours discussing whether it is 2,000 above or below the line; a 4 per cent margin of error. Who cares? The answer is: Please, whatever you do, do not ask to go there. Say X, Y and Z are our goals; we will use all three indicators and see how we are doing against all of them. It is solved; it is done.

The Chair: Anyone else?


Ms. Duquette: I am quite in agreement that new measures should not be introduced. In any case, according to Statistics Canada's figures on the LICO, 54.7 per cent of income should go to housing, food and clothing. I recently calculated that for a family of five in 2008 who is receiving welfare and all that, they have had to spend 86 per cent of their income to meet these three basic needs.

Clearly, if we try to find a different LICO, we will be merely working with figures, and this will not help us achieve our objective, which is to get children out of poverty. I do not think we will achieve our objective in this way.


Ms. Noble: I agree with my colleagues: Do not go there. We have enough measures. I see the faces of kids. I want them to learn. I think we have an opportunity now to make a difference for this generation of kids so they will not end up in poverty in 20 or 30 years. That is what it is all about.

Ms. Sims-Jones: I would certainly support Ms. Noble: We do know there are measures that can make a difference. We have learned them within Canada and internationally. It is time to implement them.

The Chair: We have unanimous advice from the panel. Thank you for being with us. You have certainly provided some very valuable information, thoughts and a lot of experience.

Honourable senators, we will now move to an in camera session.

The committee continued in camera.

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