Health Committee on April 17th, 2008

[Wajid Khan, Conservative, Mississauga—Streetsville, ON]

Dr. Bennett's intent is welcome, and I guess she has the right to put the motion. No problem there. But as the parliamentary secretary stated, the witnesses are here and we ought to listen to them rather than going into a debate on this issue.

[The Chair, Conservative, Joy Smith]

Mr. Khan, Dr. Bennett is within her right to put the question forward. I will say as chair of this committee that we have important witnesses here that we should be listening to. To my way of thinking, going into a debate between committee members right now is not a respectful thing to do.

I will put the question forward.

[An hon. member]

[Inaudible--Editor]

[The Chair, Conservative, Joy Smith]

I have just clarified with the clerk and we cannot table the motion, Mr. Tilson. We can vote on the question right now.

All in favour?

(Motion agreed to)

[The Chair, Conservative, Joy Smith]

I have to express my apologies to the witnesses. You know what it is like in the political world. We are very interested in what you have to say to the committee today, and we would certainly like to continue.

Mr. Fletcher.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Thank you, Madam Chair.

I think the fact that the report is going to come down in three weeks should have alleviated the concerns of the member from St. Paul's.

Mr. Dhaliwal, who is visiting, may not appreciate that residency spots and medical graduates fall within provincial jurisdiction. What doesn't fall within provincial jurisdiction is people from abroad trying to get into the country. Our immigration bill is designed to ensure that people with skills in the medical area—doctors, nurses, and others—will be able to get into the country and not have to deal with the 800,000-person waiting list that we inherited as a government.

I wonder if you could explain the IMG program and what the government is doing to encourage people with the proper qualifications to come to Canada. A lot of the provinces have received a tremendous amount of money through transfer payments to help create residency spots. I know that's the case in Manitoba, and I believe it's happening in other places. As a matter of fact, Manitoba just announced $5 million today.

I have another question dealing with the Health Council of Canada.

How much money does the federal government allocate to the Health Council of Canada? Is it enough?

I wonder if you could also expand a little bit more on what Health Council reports and other reports the health committee could expect shortly that we would find helpful.

Thank you, Madam Chair.

[Dr. Karen Dodds]

Thank you.

The internationally educated health professionals initiative has been established to accelerate and expand the assessment and integration of internationally educated health professionals into the health care system. The federal government has committed $75 million over five years to this initiative. We work with the provinces, whose responsibility it is to integrate them into the health human resource population within the province. They also have the $18 million per year on the health human resource strategy itself that they can use for that impact.

In terms of the Health Council, they can draw up to $10 million per year. I believe in the last year they drew under $7 million, so it's clear that their funding is adequate for what they want to do. They can continue to increase their draw to a maximum of $10 million per year.

Health Canada does not have a mandate to collect information from the provinces. It was the Health Council of Canada that was given the mandate, with the health accord, to do the reporting at the provincial and territorial levels. As I said, their next report is expected out in about three weeks' time.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Do I have any time left?

[The Chair, Conservative, Joy Smith]

You do, Mr. Fletcher. You have two minutes.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

The Canadian strategy for cancer control is something the Conservative Party championed when we were in opposition and the government at the time refused to implement. Now that it's fully funded and moving forward, I wonder if the witnesses can comment on the strategy and the progress there. Of course, cancer is a huge issue. There probably isn't a single Canadian alive who hasn't been touched by cancer in some way.

I'd also like to give an opportunity to the witnesses. They have witnessed an exchange, a debate. I think there were some facts that were not correct or that were missing. I'd like to give the witnesses an opportunity to address any errors or omissions found in the presentation of the other parties.

[Jane Billings]

With respect to what the federal government is doing with cancer, certainly preventing and managing cancer is complex. It requires the collaborative efforts of the entire cancer community across the country.

The Government of Canada has a long history of working with a broad range of partners in cancer control. Some specific examples of federal efforts to fight cancer include $300 million over three years for provinces and territories to support the launch of a national human papillomavirus vaccine program to protect women against cancer of the cervix, and the $124.8 million investment in cancer research by the Canadian Institutes of Health Research in 2006 and 2007, with a total of almost $650 million invested in CIHR cancer research since 2000.

In addition, Budget 2006 committed $260 million over five years to the implementation of a disease-specific strategy known as the Canadian strategy for cancer control, which will be implemented by the Canadian Partnership Against Cancer.

Further, our healthy living and chronic disease initiative supports an integrated approach to chronic diseases by addressing common risk factors for cancer, such as unhealthy eating, unhealthy weight, and physical inactivity.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Billings.

Could we now go to Monsieur Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you, Madam Chair.

I could go back to the plans and strategies that we consider, and the Government of Quebec considers, to be interferences in matters under the jurisdiction of Quebec and the provinces, but I would rather directly address an aspect of health care that the federal government is specifically responsible for. I am referring to the entire question of Aboriginal health care.

At page 79 of tab 5 of the report, I read what the governments promised:

Develop Aboriginal health reporting framework. ... What we know/don’t know ... Unclear if funds have been released. ... Aboriginal health reporting framework will be completed by 2007, with reporting to begin in 2010-2011. ... Status is unclear. ... Aboriginal health blueprint released in November 2005 with an additional $1.3 billion for health initiatives. ... Status is unclear. ... Targets to reduce infant mortality, youth suicide, childhood obesity and diabetes by 20% in 5 years and by 50% in 10 years. ... Status is unclear. Many jurisdictions have programs to address health disparities faced by Aboriginal peoples, but these programs are not coordinated through a national strategy.

When I read all that, I get the impression that they are trying to solve problems that are connected with things under the jurisdiction of Quebec and the provinces rather than clearly and directly tackling the question of what the government should be doing, which is looking after the populations for which it is responsible when it comes to health care, that is, Aboriginal people.

Can you explain why we don't know anything and why nothing of what was promised is clear?

[The Chair, Conservative, Joy Smith]

Who would like to take that question?

Mr. Potter.

[Ian Potter]

Madam Chair, I can respond to that question, and thank you very much for it.

I am not certain of the member's concern with respect to the lack of reporting. We have been reporting, on an annual basis, our activities, and we could provide further information to the chair for your perusal.

With respect to the commitments for aboriginal health, it is not an exclusively federal-provincial area. It's an area of mixed responsibility, and therefore much of the work we have done is in clear partnership with provinces, territories, and aboriginal people.

The government has increased its expenditures on the first nations and Inuit health branch from 2004-05, the year of the accord--when it was $1.677 million--$100 million, to the budget tabled estimates for this fiscal year 2008-09, of $2.37 million. That is a 54% increase in the budget, an average increase of 9%.

In the accord there was a provision that the federal government commit $700 million over the next five years for a number of initiatives: an aboriginal health transition fund; an aboriginal health human resources initiative, which I spoke of earlier; and programs with respect to suicide prevention, diabetes, maternal child health, and early childhood development.

Those programs, I'm pleased to say, are operating well. As I said, they require partnerships and collaboration with the aboriginal organizations and provinces. The aboriginal health transition fund has agreements with all provinces on partnerships for improving and adapting the programs of the federal and provincial governments to better serve aboriginal populations.

And we were pleased to be able to sign an agreement with the Government of British Columbia for a new tripartite plan, which will bring a new type of benefit to the health services for aboriginal people, collaborating with and making more efficient and effective the programs that are run by the three different groups at the moment.

Thank you.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Potter.

Your time is up Monsieur Malo.

Mr. Tilson.

[David Tilson, Conservative, Dufferin—Caledon, ON]

Most of you have assisted two administrations--the Liberal administration and now the Conservative administration. I wonder if you can tell us about the areas with respect to the accord and the progress thereof that you're proud of.

[The Chair, Conservative, Joy Smith]

Who would like to respond to Mr. Tilson?

[Arlene King, Director General, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada]

Thank you very much, Mr. Tilson, for your question.

I think there are two key areas where there has been significant progress made. One is in the area of preparedness for infectious disease emergencies, specifically a pandemic preparedness. There was a million dollars invested in 2006, and considerable progress has been made not only with the development of our Canadian pandemic plan, but also as components of that progress on a pandemic vaccine strategy, which will enable all Canadians to have access to a pandemic vaccine as quickly as possible in the event of a pandemic.

In May 2006 there was a federal-provincial--territorial health ministerial agreement to achieve a stockpile for early treatment with anti-viral drugs in the event of a pandemic--a 55-million-dose target--and we have achieved 53 million doses within that stockpile. We are only two million doses short because we have not yet determined what pediatric formulation of drug would be optimal for that stockpile.

Additionally, I think the area of health human resource capacity has also been addressed through pandemic funding, particularly in public health. I want to talk about the fact that we do have 23 federal health workers supporting surveillance and outbreak investigation in provinces and territories right now, and through the pandemic funding that was allocated in 2006, we will be achieving approximately 53 full-time equivalents in provinces and territories to support public health capacity development, which I think is really very important.

I also would like to talk a bit more about our international contributions as well as pandemic planning. We all know that pandemics are in fact by definition a global event. We've contributed $106 million to international pandemic preparedness, and we certainly have been recognized by the WHO as a global leader in pandemic planning. I think it's something we all need to be very proud of.

On another note, I'd like to talk about immunization because we know that immunization is among the most cost-effective and effective strategies for improving health in the population.

[The Chair, Conservative, Joy Smith]

Dr. King, I just have to tell you that we are about to adjourn, so perhaps you want to say a couple of words about that, and then we will have to stop.

[Arlene King]

Two key investments in immunization were made. One was in Budget 2004, and that covered four vaccines. I'm pleased to say that all jurisdictions have implemented programs for all four programs, and we look forward to data coming as a result of the impact of those four programs. It's a critical initiative.

The other is the HPV immunization fund, which has been really important and was lauded by the Society of Obstetricians and Gynaecologists of Canada as being an important initiative. To date so far, we have four provinces that have implemented programs and five other provinces and territories that have announced their intent to implement programs this year. So I think this is very important for women's health.

Thank you.

[The Chair, Conservative, Joy Smith]

I want to say a special thank you to the witnesses. As Mr. Khan said, we learn so many new things every day being on this committee, and you've really added a lot to that bank of knowledge. I want to especially thank you.

The meeting is adjourned.