Health Committee on May 30th, 2006

[The Chair, Conservative, Rob Merrifield]

Okay.

[Rick Dykstra, Conservative, St. Catharines, ON]

Thank you, Mr. Chair.

Through you, to Ms. Beckett, one of the things that's being pointed out is what you talked about, that from your perspective, priority has not been placed on this. Has the CIHR actually developed a central registry of research relevant to this?

[Barbara Beckett]

We have a database, through which we have records of the research that has been funded in the past and that is currently being funded. I have to say there's not a huge amount of capacity in Canada. We currently have five research projects funded. In the past there have been some more, but in the current fiscal year, there's approximately $800,000 going into FASD research.

Sorry, what was the rest of your question?

[Rick Dykstra, Conservative, St. Catharines, ON]

Is there a central registry of research?

[Barbara Beckett]

The central registry would be our database, really.

[Rick Dykstra, Conservative, St. Catharines, ON]

Does that database feed the practical application of education?

[Barbara Beckett]

There is not a lot of research going on at CIHR relating to surveillance or evidence about incidents and prevalence. We do have a couple of programs that have been funded in the past, and that are currently funded, dealing with community-based research in aboriginal communities and women's health issues.

I don't have a lot of details about exactly what has been found.

[Rick Dykstra, Conservative, St. Catharines, ON]

Okay, thank you.

[Dr. David Butler-Jones]

If I may, in the last few years there's been about $2.9 million in research and five current projects. They've tended to focus on issues of causation, data, better understanding of how common the issue is, better treatment strategies, and the most cost-effective and appropriate treatment services, etc. So it's building our capacity.

In terms of your question of how that translates, that research, not just in Canada but internationally, then feeds into the development of guidelines and the dissemination of information to assist practitioners in how they actually address these.

[Rick Dykstra, Conservative, St. Catharines, ON]

How many GPs do we have in Canada?

[Dr. David Butler-Jones]

That's a good question.

[Rick Dykstra, Conservative, St. Catharines, ON]

Take a wild guess.

[Dr. David Butler-Jones]

A wild guess would be 20,000. But I really don't know.

[Rick Dykstra, Conservative, St. Catharines, ON]

Based on all the research we've done, based on all the money that's been spent over the last number of years, and based on the fact that all of the research since 1996 has never been consistent in terms of how it was completed--but at least, at the end of the day, there's research available--how long would it take for us to develop a general practitioners kit with respect to this issue? How much time would it take to put a kit together?

I know that some folks on the other side of the House aren't happy about five-point plans or five-point priorities, but there are five of them here, in this framework for action. These could help build the strategy and develop for 20,000 practitioners the four- or five-page kit that Mr. Szabo talks about. I think that would actually identify for so many GPs in the country, in a very practical way, how....

When women go in to see their general practitioners, when they're thinking about getting pregnant and asking about the issues related to it, why could we not, in a very practical and meaningful way, based on all of the research that's available, create a kit for each one of those general practitioners in this country?

[Dr. David Butler-Jones]

Along that line, as a special supplement to the Canadian Medical Association Journal, which goes to all doctors related to both provincial and national...there was in fact a supplement on fetal alcohol syndrome with diagnostic guidelines. And other information has already gone out.

[Rick Dykstra, Conservative, St. Catharines, ON]

I'm talking about creating one kit for the GP that he or she could actually speak about and hand to the woman who is his or her patient.

[Dr. David Butler-Jones]

In terms of both pre-conception counselling and advice and prenatal care, there are materials given to women. I won't speak for the fact that every doctor actually uses them, but in a number of resources the issues of fetal alcohol are included.

The suggestion you're making, and it's a good one, looks at whether there's something else that would be useful as a resource. That's part of the follow-up in terms of the ongoing stages of working with the professionals, not just doctors but also nurses working in the community, etc. That includes information for pharmacists, chiropractors--the whole range of professionals out there who are involved in giving advice. What would be most useful next would be to have this process of discussion: what would they find most useful, and what would patients find most useful, to actually have?

[Rick Dykstra, Conservative, St. Catharines, ON]

If we could recommend or if we could provide that guidance, would the five of you be receptive to working towards that type of strategy?

[Dr. David Butler-Jones]

Absolutely. And that's part of the thinking.

One of the challenges, having done this thing for a long time, is that just having pamphlets to give out is not necessarily effective. It's really about an understanding of what it is that women, or their partners, need and what physicians and other health care workers need that would be most useful, and identifying that and the other strategies that would complement that. Having been a family doctor at one time in my life, I know that just having pamphlets on the wall or having something to hand out doesn't necessarily translate into behaviour change.

So it's a key, important element, and I appreciate your raising it.

[The Chair, Conservative, Rob Merrifield]

Thank you, Mr. Dykstra. Maybe you can get on in another round.

Ms. Priddy.

[Penny Priddy, NDP, Surrey North, BC]

Thank you.

I don't need you to answer my first question verbally. If we could receive your answer at some other time in writing, I'd be happier. These activities were all identified as short-, medium-, and long-term, and I'm not sure what that means. It probably means something different for each area, but I don't know whether short-term means next week, next month, or next year. Many of the issues that I'm concerned about are identified as medium-term issues. I'd appreciate it if at some stage we could have in writing what the timelines for those initiatives are, rather than taking up my question time to have somebody respond to that.

My second point is that this is really--and I agree with the first speaker--a women's health issue. The infant is the victim of it, but it's a women's health issue. We have groups of special needs adoptive parents who are very active in this area around the country. The May 5 Canadian Medical Association Journal, which included the uniform diagnosis standards, was to look next at the screening tool--at least I think the committee was.

As for those women at risk, I would want to add--because I haven't heard them mentioned--the people who have any responsibility, and that's often not a lot, for urban aboriginal health, not aboriginal health on reserve.

In my province, British Columbia, one of the largest groups of FASD babies are those from the U.K. That's why under theme one you're talking about international partnerships. In the U.K. they still tell moms it's okay to drink; you can drink only a certain amount, which is actually quite outrageous. You can't smoke, but you can drink a certain amount. So I'm very interested in getting into international partnerships, because we're seeing a larger number of U.K. babies in the province of British Columbia who are FASD or along that line.

My second point--if you have time to respond to it--is that we focus a lot on children, infants, toddlers, etc., but when those people are teens and young adults, we're seeing them in conflict with the law, we're seeing them in the prison system. I have an interest in what work is going on to work with those people so that they don't end up in the prison system or in conflict with the law because they didn't have the attention they needed when they were younger.

[Dr. David Butler-Jones]

Certainly.

I'll start with the last. Clearly, corrections and justice and others are keenly engaged in these issues and recognize the challenge. They are looking at alternative processes for dealing with those who come into contact with the law. More broadly, though, in terms of prevention and engagement, there are community-based programs, specifically those focused on children, such as Canada's prenatal nutrition program, the action program for children, and Aboriginal Head Start. I'll address those issues as well.

In terms of your first question, short is one to two years, medium is three to five, and long is five-plus years.

[Penny Priddy, NDP, Surrey North, BC]

So the international partnerships focusing on, for instance, the fact that we're seeing increasing numbers of babies from Commonwealth countries, when we should not be, would not come into effect for five to seven years?

[Dr. David Butler-Jones]

No, there is actually action now on that. We're actually engaged internationally with WHO to develop an alcohol strategy internationally, one challenge of which, obviously, is fetal alcohol. We constantly share information. We are always looking at what they're doing, and they're looking at what we're doing in terms of how we move forward.

[The Chair, Conservative, Rob Merrifield]

Thank you.

Mr. Batters, you have five minutes.