Health Committee on Dec. 2nd, 2009

[Carolyn Bennett, Liberal, St. Paul's, ON]

Minister, because the information kept changing, the cost of communicating with Canadians has continued to rise, in particular on behalf of the provinces. As we've crisscrossed the country, what we've heard in many local public health areas is that having a full-page ad from the federal government right next to a full-page ad from the province, with different information in it in terms of priority groups or whatever, has not been helpful and has in fact really confused the population such that the province has to spend even more to clarify this duelling information coming from two levels of government.

Will the federal government reimburse the provinces for what they've had to do to continue to communicate with their citizens because of the absolutely appalling lack of consistent information from the public health community and the public health network?

[The Chair, Conservative, Joy Smith]

Minister.

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you.

I said earlier that communicating with Canadians has been probably the most challenging part of managing this pandemic. It was very important to ensure that the information getting to Canadians was the most current and accurate and based on science. Since April I've had over fifty press conferences with Canada to keep Canadians informed as we learned about H1N1, and we will continue to communicate to Canadians what we've been dealing with. That will continue on through Christmas and into the new year, because we're not over the pandemic situation. Provinces and territories have also stepped up to the plate in communicating with their populations the importance of getting the vaccine.

As information or misinformation goes out into the general population, of course it's going to cost us more money to respond to make sure that Canada and Canadians get the right information about the safety of the vaccine, the importance of washing your hands, what to do when you're sick, and the importance of the vaccine. The challenge is to manage the number of organizations and individuals out there that may not necessarily have the right information. So keeping up with that has been the biggest challenge of managing a pandemic. We will continue to go out there to inform Canadians of the facts based on science, as we deal with this peak and possibly third wave of the pandemic.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Minister, on a number of occasions we've asked you and your department if it would be possible to have the very important information, as you've discussed, around getting the vaccine, washing hands, but most importantly, what the normal symptoms of the flu are and what is not a normal symptom of the flu, in terms of shortness of breath and the need to get medical attention.

In our country, some of the most vulnerable people do not speak English or French. This is a huge expense to local public health organizations, to not only do the translation into the other language but do the re-translation back into English to make sure that it was accurate information getting to these groups. Are you planning and will you plan to provide that kind of information on your website so that local public health can download this information and not have to use their scarce dollars for the translation and re-translation?

[The Chair, Conservative, Joy Smith]

Minister.

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you, Madam Chair.

Most jurisdictions that delivered health care before the pandemic were already doing this. It is important to communicate with the population you provide services to. It's not just during a pandemic that information on important health issues is communicated to Canadians.

I have a list here on a number of the provinces. There are 19 languages in Ontario. In Manitoba, there are about 15. Nunavut has four official languages. This is an ongoing issue, and I have every confidence in the translators in those jurisdictions to translate the medical information we produce into the appropriate languages. That is their profession.

I can say that Inuktitut translators do a fantastic job of translating medical terms for the population they provide services to; this is part of providing services to individuals within their own province. In Nunavut, for example, we have four official languages--English, French, Inuktitut, Inuinnaqtun--and information is made available by the territorial health department. The Northwest Territories has nine official languages, and so on. So it will vary by jurisdiction.

It's not just about doing this in a pandemic. You need to continue, through public health, to communicate important public health messages, and that is a common practice throughout the country.

Thank you, Madam Chair.

[The Chair, Conservative, Joy Smith]

Thank you, Minister.

We'll now go to Monsieur Malo.

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

Thank you very much, Madam Chair.

Madam Minister, government officials, thank you for being here with us this afternoon.

In your presentation, Madam Minister, you referred to the isotope crisis, a crisis—we need to remember—that was caused by the closure of a reactor under the responsibility of an organization directly under the federal government's responsibility. This closure was the result of a lack of concrete action and vision by the previous Liberal government, as by yours. In fact, you were unable to ensure a supply of radioactive isotopes not only for Quebec and Canada, but also for the entire world.

In your presentation, Madam Minister, you also referred to the extraordinary work that doctors and all medical staff in the area of nuclear medicine have done. They have faced the challenge and ensured that for patients, who are the primary stakeholders, the damage is limited. This has, however, created extraordinary pressure on the Quebec and provincial health care systems, and so this has led to additional costs.

Last August, you will recall that the Standing Committee on Health held an extraordinary meeting to talk about this issue. Ontario and Quebec had then assessed the additional costs related to the isotope crisis. Minister Bolduc from Quebec talked at that time about costs of approximately an additional $10 million. What you told me then did not satisfy me, because you told me that we would have to wait for a request to be made.

At that time, I had asked you to be more proactive, to anticipate the additional costs that would need to be compensated. In that regard I asked Dr. McEwan this question once again; he is your special advisor, the special advisor you had appointed to resolve the crisis. He told me that the government was assessing the additional costs to the provinces to resolve the crisis. He even told me that this issue had been addressed during the last federal-provincial-territorial meeting and that it would be on the agenda for other similar meetings.

Unfortunately, Dr. McEwan was not able to tell me—since he told me that this was not part of his duties—if, Madam Minister, you had made the commitment with your provincial counterparts to do everything in your power to ensure that the provinces would be compensated in light of the crisis caused by the closure of the Chalk River reactor.

So, do you have an answer to give me in this respect today?

[The Chair, Conservative, Joy Smith]

Madam Minister.

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you, Madam Chair.

We recognize the challenge that has arisen as a result of the shutdown of Chalk River, which is an ongoing situation. We continue to work with the provinces and territories as well as the medical community in that area. I believe Dr. McEwan appeared before HESA to give the committee an update in regard to what the medical community on nuclear medicine was actually doing to mitigate the impact of the shortage of Tc-99.

From the original shutdown, there had been lessons learned that prepared us across the country to come up with a contingency plan to mitigate it, to identify alternatives to Tc-99 in the research community, and to invest in research where we can look at alternatives. That is ongoing. The work did not just start when this situation occurred. It started years before, when there was a shutdown, and there were lessons learned from that. We'll continue to work with Dr. Sandy McEwan along with other jurisdictions on that subject.

As far as the dollars involved go, some provinces have put forth a request in regard to that. Some provinces are doing better than others. Provinces that have put in triage alternatives for dealing with cancer patients have managed much better than jurisdictions that have not diversified their supply. We continue to work with the provinces and territories to encourage them to look at alternatives to mitigate the impact of the shutdown and the shortage of the supply.

In terms of the dollar value of the additional costs incurred, I have not received the actual breakdown of what jurisdictions have actually incurred while trying to mitigate the impact of the shutdown, and what it would cost if it happened again. What they have done to mitigate it is a big question for every jurisdiction to answer. Dr. McEwan has been working with each jurisdiction to assist it to put those plans in place.

Having said that, I will say again that we continue to increase the transfers to the provinces and the territories. This year we have transferred $24 billion to the provinces. Each province, respecting that it is responsible for the delivery of its health care, allocates and invests those moneys where it sees fit. That could be related to looking at different types of Tc-99 or alternative purchases. It's up to each province to invest its resources where it sees they are most needed. That applies to Quebec as well.

Thank you.

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

Madam Minister, as you did last August, you are avoiding answering my question. Of course, there are transfers, and they can be increased, but that is another issue altogether. I am asking whether you intend to compensate the provinces for the additional costs they incurred as a result of the isotope shortage. This is the question to which I want an answer. Are you committing to compensating the provinces?

[The Chair, Conservative, Joy Smith]

Madam Minister.

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you, Madam Chair.

Madam Chair, what I've said to the provinces is that I will sit down with each province and have a discussion in regard to what that means. We've received some preliminary figures from provinces, but in terms of the concrete dollar value and a list of the additional resources each province or territory incurred as a result of this, I have not received that from the provinces and territories. I have committed to working with the provinces and territories to look at alternatives. We've invested $6 million in research to look at an alternative supply to Tc-99, which will benefit provinces and territories in managing the Tc-99 shortage across the country. This is an investment we have put forward.

In terms of the day-to-day delivery, we have received estimates but not concrete dollars from, I'd say, one jurisdiction.

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

Absolutely. We agree on that. However, I was expecting a commitment to the general idea; it is a commitment on your part that I was hoping for.

I would also like to talk to you about the additional $9 million approximately that you will invest in order to certify natural health products. With regard to the objectives that the government established in this area, it's clear that it is a failure, Madam Minister. All natural health products were to be certified by the end of this year. However, we have learned that the deadline will be extended until March.

Could you prove to us that the additional funding will ensure that the commitment you made can be met with all manufacturers and clients who want to ensure the safety of the products they are taking?

[The Chair, Conservative, Joy Smith]

Your time is running out, Monsieur Malo, so please wrap it up.

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

Thank you very much, Madam Chair.

[The Chair, Conservative, Joy Smith]

Thank you.

Madam Minister.

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you.

I can say that about 76% of product licence applications have been completed. We still are working towards the deadline we had set forward, which is, I believe, next March, in 2010.

Health Canada's priority is, again, to protect and promote the health and safety of Canadians. The natural health regulations were developed with extensive consultations with stakeholders and the Canadian public. But the update I have in terms of where we are at with this is that of the 17,000 applications that have been assessed...resulting in 22,000 products, with a full range of health claims, becoming accessible to Canadians.

So we have completed 76%, and we will continue to target to meet the backlog for March 31, 2010.

[The Chair, Conservative, Joy Smith]

Thank you, Madam Minister.

Ms. Wasylycia-Leis.

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

Thank you, Madam Chairperson.

Thanks to all of you.

Let me start with the H1N1 pandemic, since that's top of mind.

How much are you paying GSK for every dose of H1N1 vaccine—just the straight figure per dosage?

[The Chair, Conservative, Joy Smith]

Dr. Butler-Jones.

[Dr. David Butler-Jones, Chief Public Health Officer, Public Health Agency of Canada]

We have a contract with GSK for 50.4 million doses, and $403 million is the total cost for that.

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

The federal government is paying 60% of that?

[Dr. David Butler-Jones]

That's correct.

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

Roughly how much profit is GSK making based on the cost to produce the vaccine and what they're making above that?