Health Committee on Nov. 21st, 2011

[Hedy Fry, Liberal, Vancouver Centre, BC]

All right.

To Dr. Butler-Jones, there is more than rumour that in fact the HIV/AIDS federal initiative will be disbanded on March 31, 2012. True or false?

[Dr. David Butler-Jones]

False.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Good. I'm glad to hear that. Thank you.

[Dr. David Butler-Jones]

There are rumours and there are rumours, and I can't keep up with the rumours, but the reality for this government is that HIV/AIDS support and addressing it in the context of the many factors, from the social determinants on, is absolutely key.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Good. Thank you.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Fry.

We'll now go to Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Madam Chair.

One of the things the minister said when she was here...her speech on page 2 mentions an increase of $64 million for the chemical management plan. I know it is a comprehensive strategy to protect Canadians and the environment from the harmful chemicals we see in the environment. The budget provided renewed funding for the plan.

I wonder if you could take us back and tell us a little bit about the importance of the plan and how it is safeguarding the health of Canadians from harmful chemicals.

[Glenda Yeates]

Thank you very much for the question.

Madam Chair, I am pleased to be able to speak with the committee about the chemicals management plan. It has been a real success story for the department. We have been working in a very collaborative way with the Department of the Environment to assess these chemicals both from a human health and an environmental impact point of view.

In the first phase of the chemicals management plan, which we began in 2006, we have met our targets. We have looked at all of the priority chemicals and have addressed, to this point, more than 1,100 priority chemicals; we have categorized them and done the follow-up where necessary in terms of protecting both human health and the environment.

That plan has been renewed as we go forward, so we are now on target for addressing the remaining 3,200 priority chemicals by 2020. That was part of the initial plan. As we go through that, we are very pleased with the progress we have been making. We think we are getting even better as we define the processes, which are getting more refined, and we are on track to meet the targets.

[Colin Carrie, Conservative, Oshawa, ON]

Excellent. Thank you.

Looking through the paperwork here, I see that some of the appropriations being sought by Health Canada are for the non-insured health benefits program and for nursing services for first nations communities.

I was wondering if you could please outline what this money is going to be spent on.

[Glenda Yeates]

Again, Madam Chair, I'm pleased to be able to deal with such an important program.

Obviously, first nations programming is about two-thirds of the expenditure of the Department of Health. It is about 65% or 66% of our budget, and when we run a large program like the non-insured health benefits, which is for dental and pharmacy and medical transportation, we typically have to refine our estimates. So often when we are here with the committee speaking about what's in the main budget, it doesn't reflect the full amount. And when we come for supplementary estimates, then we get the full picture, so we actually see that we do have the amounts we need to continue offering the programs that support first nations, particularly the non-insured health benefits, the areas that fall under provincial jurisdiction—the hospital and physician insurance, which, as the minister mentioned, are provided to first nations people by the provinces and territories—and the supplementary benefits such as dental care and medical transportation. A number of first nations communities are in very remote areas and they need fly-in transportation, for example, for specialist appointments or for emergency care certainly. These are the remaining funds for that program to support the needs we have for that program.

As well, there is money, as was mentioned, for the primary care services. So, again, these are estimates that we refine as we go forward, and we have additional funding in these supplementary estimates to support the primary care services we offer to the remote first nations communities on the ground.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much.

I wonder if we could do a follow-up with Dr. Butler-Jones, because you are here with us today. I wonder if you could outline what the Government of Canada is doing to improve public health in the north.

[Dr. David Butler-Jones]

There are a number of things. As you know, there are particular challenges in the north, most notably in Nunavut, in terms of everything from infectious disease to social determinants to the increasing burden of chronic disease. There is actually a range of things that will all have an impact, all of which are key—the government's initiatives around housing and around Nutrition North, as well as providing the expertise we provide based in the territories to support public health programming. As well, there have been a number of issues such as the burden of methicillin-resistant Staph aureus in communities, so epidemiologists—and the same on tuberculosis—work with the territories around the most appropriate ways to respond.

It's a tremendous challenge. Quite honestly, I'm very pleased that the government and the Prime Minister are so focused and interested in the north. There is a lot more we can do, and we'll continue to work with the territories. Ultimately, it is their jurisdiction, but we have some capacities and abilities that can facilitate their work.

[Colin Carrie, Conservative, Oshawa, ON]

How am I doing for time?

[The Chair, Conservative, Joy Smith]

You have a couple of minutes.

[Colin Carrie, Conservative, Oshawa, ON]

Awesome. Thank you very much.

I noticed that in the minister's speech she talked about $26 million for the clean air regulatory agenda. I was wondering if you could explain to the committee what this program is all about and how these further investments will be used.

[Glenda Yeates]

Thank you. This is another part of our supplementary estimates that I'm very pleased to speak about with the committee.

This is a renewal of the clean air agenda for Health Canada. It is a five-year program. This is a government-wide crosscutting initiative, but the Health Canada role involves, in particular, looking at heat and air pollution. We are looking at, for example, the expansion of our heat alert and response system. We've been piloting, with four areas across the country, the ability to work with health facilities and health providers to help them understand what might be the thresholds whereby we might alert health providers to different kinds of heat effects they might see in the population. Those four pilots have been in Winnipeg, in the Assiniboine region of Manitoba, in Windsor, and in Fredericton.

We're now at the next stage. We think we can take the lessons learned from those pilots, which were quite successful, and roll out those tools across the country to help health professionals, whether in emergency rooms or elsewhere, to understand what might be the signs and what might be the responses the health system should have in a heat wave, for example, that might have the kinds of health effects that we've seen in other parts of the world.

We're actually very pleased that we can focus on that. We also have some research money as part of this that helps us to continue to focus on the science behind clean air issues, air pollution, and other things to make sure that our scientists continue to be on top of the latest scientific thinking across the world so that we understand the health impacts.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Yeates.

Now we'll go into our five-minute rounds. We'll begin with Mr. Morin.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you, Madam Chair.

First of all, I would have liked to put most of my questions to the health minister. Unfortunately, I cannot do that. I do hope that you will be able to provide me with the right answers.

There are two things that really worry me. I'm talking about what has happened at the Department of Health in the past year and the decisions made by the Minister of Health.

First, let's go back to what happened a few weeks ago, or even a few months ago, regarding the Canadian government and the regulation of energy drinks. We know that Health Canada recommends that young people under the age of 18 stay away from energy drinks for a number of reasons. Studies have shown that they adversely affect the health and development of these young people. The drinks can even lead to addiction. Yet, the Minister of Health did not see fit to regulate the sector. She preferred to let young people choose, and leave it up to their parents to educate themselves when deciding whether to buy drinks that stimulate the nervous system.

As an expert, do you still feel that young people under the age of 18 should not consume those products? How can you explain the minister's decision to leave the responsibility for that matter to free enterprise and to trust in people's individual choice? These days, I see that as a problem. In fact, regardless of what type of question we ask the Minister of Health or the government, we are always told that the Department of Health simply lets people choose. The authorities seem convinced that people will make the right decision and that the government need not get involved any further.

[The Chair, Conservative, Joy Smith]

Who would like to answer that question?

Ms. Yeates, go ahead, please.

[Glenda Yeates]

Thank you, Madam Chair.

This is a very important topic for Canadians and the committee. We are very concerned about the effectiveness of regulations. We are especially concerned about health.

I would just like to reassure the committee that it is not the case that we are proposing not to regulate energy drinks. We have a variety of regulatory regimes and mechanisms in the department.

Previously energy drinks fell under the natural health products category. What was announced by the government in October was that we would be proposing that energy drinks move over and be classified as foods. Foods are also regulated, so there are maximum caffeine levels that will apply in these drinks. There will be labelling requirements. There will be a number of regulatory measures. So we are very much intending to regulate energy drinks as foods.

I would point out that we believe this is how they're consumed--as food--and in fact when we look, as we do, across the world at our international partners, this is how our international colleagues are also dealing with energy drinks.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

I don't mean to interrupt you, but your own expert panel studied the issue and wanted those products to be designated as

stimulant drug-containing drinks

and not as food.

Yet, the Minister of Health used her right of veto to go against the advice of her own expert panel. I think it's absurd that the minister thinks she is more of an expert in this area than they are.

What do you think about that?

[Glenda Yeates]

It's an important question. We did have a panel look at this question. They provided us with very helpful advice on a number of matters, and it was one of the things we took into consideration as we moved forward, about what kind of labelling, for example, labelling indicating “not recommended for children”, “not recommended for pregnant or breast-feeding women” or “...for individuals who are sensitive to caffeine”. As well, I think we indicate that energy drinks should not be mixed with alcohol. These are all very important things. It was one of the sources of our information.

But also, as we always do in regulatory matters, we had extensive consultations with our international colleagues as well, and we looked to see how these were being handled across the world. What we have concluded is that we think these can be effectively regulated as foods. We think they are consumed as foods. We think that, in a sense, is how Canadians think of it.

Foods have certain labelling requirements, for example, that currently don't apply.

[The Chair, Conservative, Joy Smith]

Okay, thank you. Our time is up now. Thank you very much, Ms. Yeates.

We're now going to go into the voting portion of the supplementary estimates.

I want to thank our witnesses so much for coming today, and for your very insightful and useful comments. I'm going to ask that you leave the room.

I'm not going to suspend the committee. I'm just going to go straight into the votes.

HEALTH

Department

Vote 1b--Operating expenditures..........$279,992,776

Vote 5b--Capital expenditures..........$3,600,000

Vote 10b--The grants listed in the Estimates and contributions..........$38,252,373

Canadian Institutes of Health Research

Vote 20b--Operating expenditures..........$909,250

Vote 25b--The grants listed in the Estimates..........$24,040,000

Public Health Agency of Canada

Vote 40b--Operating expenditures..........$27,276,580

Vote 45b--Capital expenditures..........$1,597,412

Vote 50b--The grants listed in the Estimates and contributions..........$1,000,000

(Votes 1b, 5b, 10b, 20b, 25b, 40b, 45b, and 50b agreed to)

Shall I report the supplementary estimates (B) to the House?

[Some hon. members]

Agreed.

[The Chair, Conservative, Joy Smith]

I will do that tomorrow morning at 10 o'clock.

Dr. Carrie, please go ahead.