Health Committee on May 15th, 2008

[The Vice-Chair, Liberal, Lui Temelkovski]

You had five minutes.

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

You've got a grudge against me, Mr. Chairman.

[The Vice-Chair, Liberal, Lui Temelkovski]

Madam Davidson, please.

No, it's Mr. Tilson.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Mr. Tilson's going first.

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

I'm going to ask a quick question, and then it will be Ms. Davidson.

I'm going to ask a question on the investment in seniors. The 2006 census showed that the population of seniors over 65 passed the four million mark. One out of every seven Canadians is a senior citizen.

Your riding, of course, is cottage country. More and more people are moving to areas such as yours and living in those areas, retiring in those areas. The question is whether, of course, they have the facilities to serve seniors, whether they have facilities that are designed for seniors. There's no question that the Government of Canada is committed to ensuring that policies, programs, and services meet the needs of seniors.

My question to you, Minister, is what the role of the Public Health Agency of Canada is in regard to the healthy aging of seniors.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Sure, and I'm sure Dr. Butler-Jones would be pleased to add some things.

Let me say at the outset that of course many of our policies are going to have a very positive impact on seniors' health and seniors' welfare. When I look at the national cancer strategy, for instance, when I look at our cardiovascular strategy, when I see what we're doing for seniors' mental health as part of our mental health strategy, all of these things have an impact. Drug safety, food safety, product safety, all these can all have a very positive impact on seniors' health and safety as well.

Perhaps Dr. Butler-Jones can add a few comments.

[Dr. David Butler-Jones]

Certainly, Minister.

Simply as a couple of illustrative points, we worked and funded WHO for a broad multinational look at age-friendly communities, age-friendly cities, as well as age-friendly rural areas, and what the components are that actually support healthy aging. They're not only for seniors but for all ages--everything from falls prevention to the kinds of characteristics of community that are supportive, as well as working with other departments of government and across different sectors around elder abuse, around falls prevention, around emergency preparedness. In other words, how do communities respond and ensure that we avoid the tragedy of Paris, where in a heatwave many seniors died alone in their apartments.

Those are some illustrative things that fall into a broader framework of what it is about communities that make them more conducive to the health and wellbeing of people of all ages, and in particular, in this case, of older persons.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

I want to add a quick question on the end here, and this is perhaps for Dr. Butler-Jones as well. I think it comes under the Public Health Agency of Canada.

For a lot of years you've had a number of programs and initiatives targeted to pregnant women or women who may become pregnant, women in that child-bearing age, encouraging consumption of healthy diets and regular physical activity, those types of things, discouraging smoking and consumption of alcohol. I think last year you launched the first national advertising campaign to promote this healthy lifestyle, and it's my understanding that the second wave of this campaign is currently under way during this month.

Could you tell me what the federal government is doing to help young single women lower their chance of having an unhealthy pregnancy?

[Dr. David Butler-Jones]

May I respond to this question, Minister?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Go ahead.

[Dr. David Butler-Jones]

I think the issue is that for support of healthy pregnancies and wellbeing, we have to think well before the pregnancy even occurs. That's why it really requires partnerships that cross over different levels of government, different sectors, voluntary agencies, etc.

One of the things we do is to kind of gather up best evidence and to have, for example, the healthy pregnancy campaign and information for women of whatever age in terms of what factors they can do and then how we, as communities, can support or create environments that are more supportive of healthy pregnancies. It covers everything from the things that we do as individuals, but also getting good medical care through the pregnancy, having systems in place, etc.

The honourable member mentioned the importance of how these pieces come together, and we play one piece of it. Most of the action happens locally, obviously, but we try to contribute in a way by pulling the pieces together and illustrating the kinds of things that we can do to actually improve the potential good outcomes and consistently, hopefully, good outcomes of pregnancy.

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you.

Madam Wasylycia-Leis.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Thank you very much.

I'm very concerned to hear today that you, Mr. Minister, have dismissed the idea of any kind of role for the federal government in providing home care or community care. That's been a longstanding belief among Canadians; it's the next stage of medicare, and you've dismissed it as something that's strictly local. Frankly, without being disparaging to provincial governments, I find your whole approach today is very provincial, very local, and not national.

You suggest that by raising these questions I should be back in Manitoba running for provincial politics. I suggest to you, Mr. Minister, that what we desperately need is a national vision around health care, and nowhere have you described your vision, have you put down on paper or said to this committee or the House how you intend to sustain health care.

At your convenience you use the argument of provincial jurisdiction, so when it comes to home care you're not going to tamper with provincial governments. But when it's convenient to you to put on this front of being tough on drugs and consumer products, you're going to tell all the hospitals and all the provinces they must collect information on adverse reactions.

When you want to, you do it; when it's convenient to you to do it, you will, but not when it comes to building on medicare, which would be advancing--as many experts in the field have always said--from hospitals and doctors, to drug coverage, to home care, and to community care. Frankly, I'm absolutely appalled at the lack of vision coming from you and your suggestion that there is no room on the part of the federal government to engage in these areas.

Have you totally dismissed the idea of national home care? Have you totally dismissed the idea of a national pharmacare strategy?

You talk about a national cancer strategy, which is great. Everybody appreciates that. But it stops short of research and prevention issues. You draw the line conveniently between research and development of drugs and prevention, and ignore people who are dying of cancer.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Sorry, but that's ridiculous.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

I don't mean to exaggerate. I'm sorry, I will take that back.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Thank you.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

To suggest that palliative care has no place in the federal regime, because you have cut back, and there is no longer a palliative care office....

You say there's no place for a national home care program to help those who are in need of supports when they're trying to deal with cancer, heart disease, or any other issues.

Can you complete the picture and try to approach this from a holistic point of view and from a national perspective with some visioning?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Sure. I appreciate that.

Certainly I wish to ensure that the record is accurate on this, because of course the federal government is involved in home care and in community care. It's called transfer payments. They have increased this year alone by 6%, $1.2 billion extra to the provinces.

I don't think you and your party wish to run on creating a whole new level of bureaucracy to deal with home care, rather than transferring the home care funds to the provinces so they can deliver better home care. You can run on that, go right ahead, but I'm not here saying we're going to have a whole new level of bureaucracy for home care and community care.

You talk about national vision. In my role as health minister we are focusing on the things the federal government should be focused on and we let the provinces do what is right in provincial areas of jurisdiction. If the NDP wants to run in our country on something different from that, I welcome you to do that.

But our vision on health care is that the federal government, for 40 years, didn't overhaul product safety and for 40 years didn't overhaul drug safety and food safety because it was too busy meddling in the affairs of the provinces. I'm letting the provinces do what they have to do, and I'm going to do what we have to do for Canada.

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you very much, Mr. Minister.

Mr. Thibault, for a couple of questions.

[Robert Thibault, Liberal, West Nova, NS]

Actually, because we're so short of time, I'm going to put two questions to you and a comment. If you have time to deal with them now, please do, but if not, could you get back to the committee on them?

First, I want to thank you for staying beyond the regular hours at our committee. Unfortunately, the votes cut us short.

I want to come back to the question of surge capacity. You're a former minister of health in Ontario during the SARS time. You said then that you personally felt we had to build in more surge capacity. All the hospital administrators across the country are telling us this is a huge problem in the case of a pandemic, especially when you get yourselves in a situation where your front-line workers are at risk and are the first affected. So we need that surge capacity.

I recognize it's provincial administration, but I believe there's a federal role, and the following is a suggestion I would like you to consider. In federal-provincial relations in all departments across the board, I think if we look at what we do in social housing, if we look at the role that CMHC could play—a role that it has played in the past, and I think it could play again—in helping to build nursing home facilities, and those types of things, we could at least optimize front-line hospitals and not have that broken capacity, which I think would help in emergency medicine and with surge capacity in having that potential.

I'd like to bring up another point that I have discussed with you in the House in the past. The bills that you're bringing forward now—and I know we'll be discussing them fully—give authority where there was not authority before. There's always a danger that it becomes a responsibility that must be used at all times.

Right now, your department advises Canadians of the health risks of certain foods and of certain behaviours, and that's fine and necessary, but sometimes it crosses the line. We had one example this week with lobster tomali, on which you gave Canadians an advisory that there was a risk. It's an advisory from the Department of Health, which has a great reputation and which Canadians trust. But when you read the third paragraph of the advisory, it says that if you eat the tomali of more than two lobsters a day, there may be some risk of parasitic shellfish poisoning—if that happens to be in that population of lobsters. It's a very, very remote risk, but you may be putting a billion-dollar industry at risk in coastal Atlantic Canada.

So my question to you is, what process do you follow? Do you talk to the Department of Fisheries and Oceans, and all of those people, and the provinces, before putting out advisories?

If you have time, there's one more question you could answer, on the Assisted Human Reproduction Act. The act has been in place for a number of years now. A couple of years ago we had the first set of regulations on signing, or consent. Where are all the others? Where are the seven other sets of regulations? Why haven't they been coming forward? When can we expect them?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

This fall.

[Robert Thibault, Liberal, West Nova, NS]

The seven this fall?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

There are some more coming this fall.

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you.

I think, Minister, if you could respond to the other two questions by sending your response to the clerk, that would be very much appreciated.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Yes, I think that's probably the wisest way. Thank you.