Health Committee on March 10th, 2011

[Colin Carrie, Conservative, Oshawa, ON]

Thank you.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

First of all, I want to welcome all the presenters here today and thank them for their fine presentations.

I noticed in your presentation, Glenda Yeates, that we see a decrease as a result of $706,000 transferred to Indian and Northern Affairs. They are looking after their own self-government for the Yukon first nations. Is this their first attempt at this, or has this been going on for a few years?

[Glenda Yeates]

Mr. Chair, I'm happy to answer the member's question about what I think is a very important development in the country. As the members of the committee would know, as we, through Health Canada, deliver health services to first nations and Inuit people, we typically deliver on reserve. Often even those are transferred, because I think we recognize that first nations delivery is often the best route to effective programming in those circumstances. In those areas of the country where there are actual self-government agreements that are signed--and those are led by our colleagues at Indian and Northern Affairs—and come to fruition, then the funding actually leaves Health Canada and is transferred from INAC as part of that self-government arrangement. In these cases, in a sense, we go beyond just the transfer to an individual community. We actually transfer the responsibility and the dollars as part of the self-government agreement. It's new in this instance, but it would have occurred in other parts of the country.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

In other areas. They must be setting up a health committee to take care of this funding and follow it through with their residents.

[Glenda Yeates]

Yes. The situations may vary from one self-governing arrangement to another, but yes, on the governance, typically there is a health committee and a health structure to run the programs under the first nations self-government arrangement.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

As a teacher, and as all of us know here, we certainly see an always increasing presence of autism, so I was happy to see the $200,000 set aside to choose a chair. When will the research chair for the treatment and care of autism be established?

[Glenda Yeates]

Given that this was money we transferred to CIHR, perhaps....

[Dr. Alain Beaudet]

We're actually talking of a $1-million chair—

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

A million dollars?

[Dr. Alain Beaudet]

—over five years. We're currently in discussion with potential partners to double this amount to $2 million. When we talk about the $200,000, we're talking about the tranche for this year.

The idea is to focus this chair on innovative approaches to the treatment and care of patients with autism. In other words, we want to focus this chair on applied research. We already have enormous strength in this country in looking at the causes of the disease and trying to understand the biological mechanisms underlying autism. We believe that we have to invest in capacity to bring the research results into the clinic and develop innovative treatments. This is where the chair is going.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

It will be a great discovery because more and more we're wondering why it occurs in one family and what are the root causes. It will be a great study and a valuable amount of money. No money could really replace those facts on what we can do and what we can learn about autism.

That's fine, Mr. Chair.

[The Acting Chair, Conservative, Tim Uppal]

What we'll do now is go into our second round. We'll probably have a shortened round because we do have some committee business to do in camera. I think what would be best is if we allowed each party one question, and then at the end if we still have some time, maybe we'll go back to the Conservatives, who are going to get bumped in this round.

We will start with Dr. Dhalla.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Thank you to everyone for coming here today.

Since we only have one question, I wanted to raise an issue that is important to many of my constituents in Brampton—Springdale. As you may or may not know, in Brampton, we've built one of the largest and newest hospitals in the country. We have seen a tremendous number of challenges at that hospital, in terms of the wait times and in terms of the services that have been received. The hospital has done a great job in trying to work with the community to rectify these.

Most recently, there was a woman who had the wrong leg amputated. It is a serious, serious issue. Even though the delivery is supposed to be provincial, we wrote to the Minister of Health requesting that she visit the hospital to see it first hand and to get an insight on how severe the challenges are. We were quite astonished to receive her response that she did not have time. I would ask the deputy minister, who I know is very passionate about health care and about delivery, to ensure the message is passed on that there are some serious challenges out there.

My colleague, Dr. Duncan, spoke about the 2014 health care agreement. You stated that there is no formal discussion going on at this point, only through the Senate. I find that very alarming. We are three years away and I can tell you that every Canadian across the country is very concerned and worried.

The question I have actually is on another important public health issue in regard to organic chicken. We had a variety of stakeholders before us at our last meeting. They sounded a bit of an alarm in terms of what's going on in the industry. I wanted to ask Dr. Butler-Jones about organic chicken, which people assume is very safe. They were saying there are not the same monitoring mechanisms for people who sell organic chicken that there are for chicken sold off the market. They were saying that only 97% of the producers are actually in compliance with the protocols that have been established by the Public Health Agency. What happens to the other 3%? What's going on with the producers of organic chicken?

[Dr. David Butler-Jones]

Can I generalize the question a bit? It is an issue as it relates to some of our assumptions that getting something at the farm gate or whatever somehow has to be healthier because it's more natural. At the same time, it doesn't have the same level of oversight. It's not so much the oversight of testing and inspection, but the processes in place to minimize the risk of infections and transmission.

If you look at the food supply system generally, in order to get disease, several things actually have to happen. There must be a pathogen in place, a bacteria, a virus or whatever. Food must have come in contact with a human, because it's not cooked right, it's not stored right, or there's cross-contamination, etc.

The reality is that animals carry a number of diseases, some of which can potentially infect humans. All the measures in the health system in commercial operations are there to minimize that risk, and then, at the end of the day as a consumer, we have to make sure we cook the meat appropriately. There are numbers involved. As Paul was saying, there's very close collaboration among ourselves, CFIA, and Health Canada to make sure that all the parts of the system are in fact working in the same direction, and then with provincial authorities, because again, in many of these areas, the provinces actually have authority.

My first concern is people should not make assumptions that because something is called “natural” or “organic” that somehow it is more healthy. It's like the debate about special bottled water, which often has more pathogens and more stuff in it than our tap water. These generalizations are not helpful for health.

I think it's absolutely essential in getting the best advice, in getting that kind of information, to not make assumptions and actually to understand the sources of the food and the risks, and the things we can do to mitigate that risk. That would be the Public Health approach, not just in terms of organic chickens, but more broadly, whether it's cheese or other things as well.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Very quickly to the deputy minister, going back to my first point in regard to the dilemmas in health care, what do you think needs to be looked at for the 2014 health agreement to ensure that Canadians have greater accessibility to doctors, to reduced waiting times, and also to reduced waiting times to see specialists or get access to certain medical treatments?

[The Acting Chair, Conservative, Tim Uppal]

You have 10 seconds.

[Glenda Yeates]

Well, we're sitting here in 2011, and I guess one thing we realize when we look back over the accords is that 10 years is a long time. The priorities evolve. The health system has different concerns and priorities now than it did then.

My sense is that by the time we get to 2014, the health system will be dealing with the priorities of that day. I wouldn't want to speculate on them today. If you look historically at the 2000 accord, the 2003 accord, and the 2004 accord, it is interesting to see how some of the issues that were major issues at that time are not as pressing now. Others are starting to be emerging issues, and you mentioned patient safety or quality. You see a number of provincial jurisdictions, for example, focusing on quality, on those sorts of things. It evolves.

[The Acting Chair, Conservative, Tim Uppal]

Thank you.

We'll go to Mr. Brown.

[Patrick Brown, Conservative, Barrie, ON]

I have a few questions for Dr. Beaudet on CIHR. I know that Kirsty started off with some questions.

I was interested, when it was mentioned earlier, in the $200,000 transfer to have a research chair for autism. What other research chairs in the neurological subset does CIHR currently fund?

[Dr. Alain Beaudet]

As you know, CIHR funds a large number of research chairs in many areas through the Canada research chairs program, CRC, and the Canada excellence research chairs program. There are a large number of funded chairs in Canada currently.

CIHR funds very few specific research chairs because of these existing programs. We fund certain chairs in very specific areas in which we believe more capacity for research is needed and in which there are no Canada research chairs currently.

In the area of autism, there are two Canada research chairs in the field of the genetics of autism. That's the reason the research chair we will be funding will be more focused on applied research and treatment.

[Patrick Brown, Conservative, Barrie, ON]

Are there any other research chairs in neurological disorders?

[Dr. Alain Beaudet]

Yes, there are actually quite a few Canada research chairs for a variety of neurological disorders. We could certainly send you the list if you want it. It's a large number.

[Patrick Brown, Conservative, Barrie, ON]

Okay.

What investments are there currently through CIHR in Alzheimer's and dementia?

[Dr. Alain Beaudet]

I can't give you that exactly. I'll ask my colleague, Jim Roberge, to tell you exactly what the figure is for Alzheimer's and dementia.

[Patrick Brown, Conservative, Barrie, ON]

While you're looking that up, I look at everything through the scope of the hospital in my hometown of Barrie, Ontario, where the CEO gives us briefings once in a while. She has said that her greatest challenge in administering health care in our hometown is the fact that the hospital is at 98% capacity. With existing labour agreements, just to keep the status quo, she has a 3% increase in costs year over year, yet her funding model with the province gives her a 1.5% increase for her hospital.

Through the Department of Health, are you hearing similar concerns across the country about challenges with capacity and challenges with the funding models for hospitals?