Health Committee on May 4th, 2023

[Dr. Stephen Nicolaidis]

Once again, like Dr. Lennox mentioned, I'm not really familiar with the machinations at that level of the government, but I think the need for a registry is so common sense at this point. Mr. Thériault, from Quebec, brought this forward. I don't see why any physician or organization would be against the idea. As I said, I think the expense has to be picked up by the breast implant companies, so there will be some cost but it won't be something insurmountable at the level of government in terms of cost for anybody.

[Jenna Sudds, Liberal, Kanata—Carleton, ON]

Actually, before we go to Dr. Lennox, can I also expand upon that, just to ask you to comment on the complexities of private clinics versus hospitals, and what that dynamic adds to this issue?

[Dr. Stephen Nicolaidis]

Certainly. It's just one more reason to have a mandatory registry. At the end of the day, in hospitals things tend to get better documented, and that's certainly an issue with plastic surgery. You'll have breast implants being used for both private aesthetic surgery and breast reconstructions. Either way, the registry has to involve all these people, because they're all patients, at the end of the day, who need care.

[Jenna Sudds, Liberal, Kanata—Carleton, ON]

That's excellent. Thank you very much.

Dr. Lennox, would you like to comment as well?

[Dr. Peter Lennox]

Sure. To answer your second question first, I agree. I don't think it would be a barrier if there was a mandatory or opt-out registry in place. You wouldn't have any choice. You would have to do the appropriate upload of data.

That's one of the things that are really important: making that process simple with a good database. Uploading the data into it is an easy thing to do.

On your first question about the relationship between provincial and federal mandates, I'm aware of the division in the delivery of care, but I wasn't aware that if.... It seems that if Health Canada is mandated to ensure the safety of devices...if they put in place a mandatory registry, I can't imagine that provinces would balk at that or interfere in any way.

[Jenna Sudds, Liberal, Kanata—Carleton, ON]

Thank you, both.

To me, as I think through this process and many aspects of the work we do here, it's the dynamic of how we interact with a province and how we can ensure that, despite various responsibilities and roles, we are able to bring them onside to work well for the betterment of Canadians.

I'll leave it at that. I think my time is up.

Thank you very much.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Sudds.

That concludes the rounds of questions, except that I have one, just by way of clarification for you, Dr. Lennox.

Mr. Aboultaif asked you about the characteristics of a quality registry. You submitted a brief to the committee that has eight criteria in it. I think you referenced criteria in your answer, without enumerating them.

Is that what you were referring to, or is there something else?

[Dr. Peter Lennox]

I think I also submitted a PDF of a PowerPoint presentation I gave. That has a couple of different summaries collated from different papers, with lots of crossover.

I'll go through some of them very quickly: clear objectives, stable and long-term funding, being independent financially and technically, a simple interface and data upload, an opt-out model, concise data requirements and clean data that can be utilized and reported easily.

That's a perfect registry right there, if you can achieve that. There are well-documented guidelines for a good medical device registry.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Lennox, and thank you, Dr. Nicolaidis.

I can only imagine how busy you are, with the very specialized expertise that you have. We certainly appreciate the time you spent with us today. The discussion we've had here will undoubtedly be of great value as we go forward on this study.

With that, colleagues, we're going to suspend while we move over to the in camera portion of our meeting.

Thanks again to our witnesses.

The meeting is suspended.

[Proceedings continue in camera]