Health Committee on Nov. 20th, 2014

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

We put money towards research.

[Libby Davies, NDP, Vancouver East, BC]

You could initiate that yourself.

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

We did initiate a number of years ago through Health Canada and when I asked what happened, they said that basically the clinical trials fell apart because the research that was happening wasn't valid.

[Libby Davies, NDP, Vancouver East, BC]

Do you think it's important to do research and clinical trials?

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

Pardon me?

[Libby Davies, NDP, Vancouver East, BC]

Do you think it's important to do clinical research?

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

Absolutely; without clinical trials, without research, we have no evidence that these things work. So this mom comes to Health Canada and says, “Can you give me special access to this drug?”, but the researchers look at all the evidence and say, “There's no evidence that this works”.

We're the government. We don't do clinical trials. You know how it works. There needs to be evidence and research and clinical trials. There needs to be clear scientific evidence that this is not harmful, and that it's useful and effective.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

Again, I'd like to thank the minister for taking a full hour today to review the supplemental estimates.

I'd also like to thank all the committee members.

For anybody watching at home today, just to see an hour of good, friendly debates and questions...in a very respectful manner.

We'll suspend for a couple of minutes to allow the minister to leave. If any other officials need to to come up to the table, we'll allow them the time to bring up their binders.

Thank you.

[The Chair, Conservative, Ben Lobb]

We're back in session.

We finished off our last round of questioning with the NDP, so Conservative members will be next.

I believe next up on our list is Mr. Lunney.

Go ahead, sir. You have five minutes.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

Thank you very much.

Thanks to our officials. To the new faces who've just joined us at the table, welcome. We appreciate your being here today.

One of the issues that's top of mind for everybody in health care right now—and I didn't get a chance to address this to the minister—is of course the subject of innovation. Actually, everybody seems to have an opinion on where we're going with innovation. We have an advisory panel to which the minister has appointed some very capable Canadians. About eight distinguished Canadians are joining Dr. Naylor on the panel.

But Dr. Chris Simpson from the CMA spoke here in Ottawa just a couple of days ago on a national strategy for seniors. The minister mentioned in her remarks the challenges facing us with chronic diseases and managing those. Dr. Simpson's remarks had to do with the contribution of chronic illnesses to occupying hospital beds, creating gridlock in the hospitals, and tying up whole facilities because there's no place to move people. The Hill Times has about 20 pages of opinions on how to get through some health care innovation.

By way of background, I'll just say that in my own province, I think we're at about 45% of the provincial budget. Most of them are at 45% or 46% right now of their entire provincial budget. But going back to 2000, when I first ran for office, in my province, when you added education and social services, you were at 85% of the entire provincial budget on those three alone.

So we know that health care, as we've been practising it, is not sustainable. Dr. Simpson's take is that we have to dehospitalize health care. We're hoping that the panel, as they hear lots of opinions from across the country, will come up with some useful suggestions. The minister mentioned briefly in her opening remarks that Dr. Naylor's committee has hit the ground running, that they're doing consultations.

The minister is not here now to answer this question, so Mr. Glover, Mr. Da Pont, or whoever wants to address this, can you please give us a review of where Dr. Naylor's committee is at, how this is playing out, and how those consultations are taking place?

[George Da Pont]

Thank you very much.

As the minister indicated, the panel is now out in full force in its consultation process. There are several different avenues under way. As the minister mentioned, there is an open, online consultation available to any Canadian who wants to offer ideas to the panel.

The panel has been meeting various health care stakeholders and associations on an individual basis. They also have been and are planning to meet at various regional levels with a broad section of stakeholders. For example, I believe just a couple of weeks ago they had their first such meeting in Halifax, well attended by 25 to 30 key health care stakeholders in that province, including a good representation by provincial officials. They're intending to have similar sessions over the next month or so in various other parts of the country. I think they have sessions set up for Toronto, Vancouver, Winnipeg, and a couple of other cities.

Dr. Naylor and his panel have been doing work with provincial governments seeking input from them as well. They will be doing the same with territorial governments. Finally, they are looking at and working to see if there are any international examples or models of innovation that could possibly be considered or applied here in Canada.

One of the things that I certainly am aware of and the panel is seeing is that there's a great deal of innovation going on across the country in almost every single jurisdiction. There are many effective pilots that have been done or are under way. I think one of the biggest challenges is that it seems so difficult to take those effective pilots and scale them up on a broad basis. I think those are some of the issues that are coming out in the discussions that they're having.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

Thank you for that.

I know time is short, so I quickly want to review an issue that I've raised before with officials for a number of years, and that's the proton pump inhibitor issue. I want to ask if it is under PHAC, the Public Health Agency of Canada, or under CIHR, that the CNISP program is managed.

It's PHAC, okay.

[The Chair, Conservative, Ben Lobb]

Mr. Lunney.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

I'll just pose my question quickly.

[The Chair, Conservative, Ben Lobb]

Okay, very quickly.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

We know that there is a 40% to 275% increased risk when patients are on those medications. The CNISP program has been reviewing this for a number of years. They haven't been collecting data on the medications the patients are on at admission. That's an issue I've raised with the department before.

Do you feel, Dr. Beaudet, or the two of you as clinicians, that in fact collecting data would help clarify the role of proton pump inhibitors in contributing to C. difficile cases?

[The Chair, Conservative, Ben Lobb]

Thank you very much.

I'm sorry, we are over time, and I'm trying to be fair to all members.

Mr. Morin, go ahead.

[Marc-André Morin, NDP, Laurentides—Labelle, QC]

Thank you, Mr. Chair.

My question is for the deputy minister.

The government receives $700 million in supplementary revenue because of the increased tobacco tax, but it does not use that money to reduce smoking. Instead, the government has cut funds set aside for reducing smoking.

The government has also put forward weak regulations against flavoured tobacco. It isn't following the lead of other countries, like Australia, that impose regulations on uniform packaging.

When will the government get serious about reducing the biggest predictable cause of death in Canada?

[George Da Pont]

Thank you for your question.

The government launched a very good campaign to reduce the number of smokers here, in Canada.

When you look at the results, today we have among the lowest smoking rates in this country that we've ever had, both among youth and among adults. They're among the lowest in the world, and that is an indication of the many years of work and campaigning—education and other campaigns—not just by Health Canada but by many other organizations.

At the same time we've taken a leadership role in dealing with issues of flavoured tobacco, which appeals to children and has a significant risk of renormalizing smoking. As you're aware, a few years ago Canada was the first country in the world to put these sorts of measures in place, and the minister has recently announced an intent to augment those measures even further to deal with the innovation of tobacco products by some of the major companies.

I think we are seeing very good results. We are continuing to invest in this program. I am really encouraged by the results we are getting, which are among the best in the world.

[Marc-André Morin, NDP, Laurentides—Labelle, QC]

Of course, there has been a drop in tobacco use, but the costs for smoking-related health care resulting from smoking are still quite substantial. When you see people smoking outside hospitals with their IV drips, you have to wonder how many of them are unaffected by this government action and find themselves in this situation.

Shouldn't extra effort be made?

[George Da Pont]

I will repeat the same answer and say that we have made a lot of progress in this area.

Right now smoking rates among Canadians are down to 16%. Smoking rates among young people are down to 7%. Both are record lows, and I think they show the effectiveness of the work that has been done and continues to be done not just by Health Canada but by many medical organizations, provincial governments, and many others.

We are continuing to see a steady reduction. As I mentioned, we are putting more effort into an area where we think there is risk, and that is flavoured tobacco. It appeals to children, and in our view, it has a very high risk of renormalizing smoking.

The measures the government put in place a few years ago and the enhanced measures the minister announced a few weeks ago are good demonstrations of continued effort. From the work we are doing, we are getting very good results.

[The Chair, Conservative, Ben Lobb]

Thank you, Mr. Morin.

Thank you. Welcome to the committee.

Mr. Lizon.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you very much, Mr. Chair.

Welcome to all the witnesses. Thank you for coming.

The first question I have is related to supervised consumption sites. How would Bill C-2, the respect for communities act, change the process for exemptions related to supervised consumption sites?

[George Da Pont]

Thank you very much for the question.

The proposed legislation that is before you for consideration would essentially create two separate exemption regimes: one for licit substances, which are defined as substances obtained in a manner authorized by the Controlled Drugs and Substances Act or its regulations, and a second for illicit substances, generally street drugs.

The new regimes will strengthen the safety and security provisions for licit substances—the authorized uses—as they would obviously be for medical and scientific research and other things that are in the public interest. For activities involving licit substances, the categories under which applications would be considered would be medical, law enforcement, or prescribed purpose.

As I'm sure you and members are aware, there was a Supreme Court decision around some of these issues that set some broad principles and categories of things that would be taken into account in assessing applications, and those are set out and expanded upon in the proposed legislation.

The other significant piece is that the proposed legislation would authorize the minister to publicly post a notice of application for an exemption for a supervised consumption site and invite comments from the public on that application for a period of time. The purpose of that is to ensure that the broader community has an opportunity to express its views on an application as obviously it would be affected by the outcome.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you.

Actually, I would like to go back to the question of marijuana and the clinical studies that were conducted.

Are you familiar with any study anywhere in the world that would prove or suggest that either marijuana or a substance derived from marijuana can be used to treat certain medical conditions?