Health Committee on Nov. 20th, 2012

[The Chair, Conservative, Joy Smith]

It's not a point of order, I'm sorry.

We'll now go to Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Madam Chair.

Actually, I think Mr. Strahl would like to start.

[The Chair, Conservative, Joy Smith]

Okay, do you want to share your time?

[Colin Carrie, Conservative, Oshawa, ON]

Yes, thank you. We're going to split it.

[The Chair, Conservative, Joy Smith]

Okay.

Mr. Strahl, go ahead.

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

Thank you, Madam Minister, for coming.

I'll do my best to ask questions and allow you to answer.

You held a press conference yesterday regarding OxyContin. You mentioned it in your remarks. I have some questions for you regarding that. First of all, could you give us a brief summary of what was announced yesterday?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you for that question.

This is a very complex issue that requires us to balance access to drugs for therapeutic purposes while protecting the individuals and the communities against the harm caused by prescription drug diversions or abuse. Addressing the area of prescription drug abuse involves many stakeholders in the health care systems, from the federal, provincial, territorial governments, to physicians, to prescription drug manufacturers and distributors, and health care providers as well as law enforcement officials.

With respect to the generic OxyContin, under the Food and Drugs Act, there is no basis for the health minister to withhold approval of a drug where the drug is otherwise considered safe and effective for its recommended use. The law does not permit approval to be withheld on the basis of potential misuse or abuse. Our government is doing everything in its jurisdiction to address the issue, so Health Canada will now impose tougher new conditions on the licences of dealers who manufacture and distribute products that contain the controlled release formulation of oxycodone.

Part of the reason for the abuse of OxyContin is that it was sometimes prescribed for conditions it was never intended to deal with. There's overprescribing and giving it out in amounts far greater than what was needed.

Yesterday, and in my letter to my provincial and territorial counterparts, which I mentioned in my comments, I called upon the provincial and territorial governments and medical practitioners to look at what they can do within their areas of jurisdiction to tackle the serious problem of prescription drug abuse. I am open to considering a greater federal role, as I stated yesterday, in overseeing the use of potentially addictive drugs, including restrictions on prescribing or dispensing practices.

There is a high risk that creating more bureaucratic hoops for physicians and pharmacists to jump through will have a negative impact on patient care. My strong preference is that we work together to address this issue within the existing laws and authorities. I want to remind all of us that the most important factor in every decision is the patient.

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

Thank you, Madam Minister.

I did meet with a constituent, James O'Reilly, recently who lost his son after a long battle with drug addiction that started with OxyContin, so I think these measures and working with the provinces and territories will certainly help address the problems with addiction to that.

I want to share some time with Dr. Carrie. I know he has some important questions to ask as well.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Minister, and thank you, Mr. Strahl.

Minister, you know I've been very involved with the natural health product community. First of all, I want to congratulate you and officials at Health Canada for consulting and working with the industry in a way that has been very much welcome, with improvements in cutting red tape and things like that. I was wondering if you could give the committee an update on what has been the result of these consultations you've had with the natural health product community.

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you for that question. We've come a long way since we started this review. Our government's aim is to protect the health and safety of Canadians while respecting that there is consumer choice. We have heard many stories from stakeholders, consumers, and parliamentarians that there is a need for increased access to products while maintaining consumer safety. They also want to reduce unnecessary administrative burdens for companies trying to bring safe products to the market.

As a result, we have introduced a new way of regulating natural health products that focuses on reducing, as you mentioned, red tape and increasing consumer access to safe and effective products. In fact, the officials who were doing the consultations and round tables in British Columbia yesterday received a standing ovation from stakeholders, so I think that is a testament to the great work being done.

The approaches that we are taking include a new product review system, where systems will review in as short as 10 days products that are at lower risk. It used to take up to 180 days to review most products, but now only 1% to 3% will require this amount of review time. We've also introduced new tools for bringing products to market. These changes will provide a stable, predictable, regulatory environment for the efficient processing of applications. I think there has been great progress since we started dealing with this issue.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much.

[The Chair, Conservative, Joy Smith]

You have just under a minute.

[Colin Carrie, Conservative, Oshawa, ON]

The minister mentioned something in her speech and I wanted to ask her a follow-up on that.

You mentioned actions taken by the government to restrain cost and address fraud in NIHB. This is a very important issue. Could you expand on the measures you've taken in that regard?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Yes, thank you for that question. As I stated in my opening remarks, under the federal program that we're responsible for, the non-insured health benefit program, we've put in a number of measures that have produced great work and results. In fact, the Auditor General commented that this is a model of putting in systems with checks and balances and commended Health Canada for its efforts in monitoring this particular program.

Through the work that we have introduced through the non-insured health benefit program, as I stated, we're able to track spikes in prescriptions, such as OxyContin, across the country. We're able to investigate which physicians are actually prescribing. We have also been able to detect fraud in the program and those particular incidents have resulted in RCMP involvement and charges being laid and going through the court systems.

We take that matter very seriously. This program was designed to provide services to the most vulnerable in this program. It concerns me that there is abuse in the system, and we will take corrective actions.

In Nova Scotia a pharmacist has now been incarcerated for the fraud that was committed. In Ontario we continue to investigate, and in Manitoba as well as Saskatchewan. We are doing our part to monitor this program very closely.

[The Chair, Conservative, Joy Smith]

Thank you very much, Minister.

We'll now go to Dr. Fry.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you very much, Madam Chair.

I want to thank the minister for coming. I would like to echo Ms. Davies' concern that we only have her for an hour.

However, I'd like to ask a couple of very specific questions with regard to spending itself. There are specific programs that are no longer funded and organizations that are no longer funded under the budget cuts. Can you tell me exactly what is not being funded any more? What programs are not being funded?

[Leona Aglukkaq, Conservative, Nunavut, NU]

I will ask the deputy to go through the details, line by line.

[Glenda Yeates, Deputy Minister, Department of Health]

Madam Chair, the minister mentioned in her opening comments that the entire portfolio, all of the operations of the portfolio in all the areas we've funded, was looked at.

I can break down the reductions that are outlined in four categories. The first, I would say, is administrative efficiencies and rationalizations of structures. We very much looked internally at how we do business, looked at Gs and Cs, the very process of government which over time builds up. We found a good proportion of our savings there. We looked at how we might share things with our portfolio partner, the Public Health Agency. Again, there was another internal set of changes there.

We did look at grants and contributions. We reviewed those as well.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Specifically what I'd like to know--

[Glenda Yeates]

I would say by category, the first category is that we asked some of our partners, our pan-Canadian organizations, to take some administrative reductions. For example, very good work is done by CIHI, by the Canadian Partnership Against Cancer, by the Mental Health Commission. We asked them to take a reduction of 5% over the course of three years. They are working very hard to do that.

We looked at the first nations and Inuit health branch. As the minister said, we wanted very much to protect front line delivery, so we looked at non-service delivery areas. Both regionally and nationally, we had grants for areas such as research or building capacity. The minister has mentioned in the past the National Aboriginal Health Organization. Those were some of the organizations where we reduced funding.

[Hedy Fry, Liberal, Vancouver Centre, BC]

I could use up all my time on these answers, so I'd like to clarify specifically.

[The Chair, Conservative, Joy Smith]

I think she has another question, Ms. Yeates.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Are the maternal and child health programs within the Inuit health care budget being cut?

[Glenda Yeates]

No, all of the front line delivery services are being protected, so no community services for maternal and child health are being reduced.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you.

Are there any suicide prevention programs being cut?