Bill C-5 (Historical)

Public Health Agency of Canada Act

An Act respecting the establishment of the Public Health Agency of Canada and amending certain Acts

This enactment establishes the Public Health Agency of Canada to assist the Minister of Health in exercising or performing the Minister’s powers, duties and functions in relation to public health. It also provides that the Governor in Council may make regulations respecting the collection and management of public health information and the protection of confidential information, including personal information. It also makes related and consequential amendments to certain Acts.

Public Health Agency of Canada Act

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

moved that the bill be read the third time and passed.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I am pleased to speak in the House today at third reading of Bill C-5, an act respecting the establishment of the Public Health Agency of Canada.

We had an opportunity at the Standing Committee on Health to discuss the key elements of the bill. I am pleased to report that there were no amendments to the bill made by the committee.

The committee agreed to report back to the House on this bill for third reading. I was pleased to see the strong support of my colleagues for the legislation. Additionally, I am happy to report that the Canadian Public Health Association has written in support of the legislation.

I think that most of us agree that the bill will provide the stability and authorities that the agency and the Chief Public Health Officer need to help protect and promote the health of all Canadians.

It is important that the bill be passed for a number of reasons. The legislation is not only to provide stability for the agency, but it is also needed so that we can properly address and respond to public health threats and emergencies.

In the event that we are faced with a public health emergency, such as an influenza pandemic, the agency and the Chief Public Health Officer must have the authorities and tools to be able to effectively respond.

First, the Public Health Agency of Canada must have specific regulatory authorities for the collection, management and protection of public health information to ensure that the agency can receive the information it needs. As the SARS outbreak clearly showed, it is important for the government to have the ability and the means to assess accurate information.

I would like to mention that the current Minister of Health was indeed the minister responsible for issues around SARS when it broke out in Canada, when he was minister of health in Ontario. This is in large part the reason why the government is so enthusiastic about creating a legislative framework to ensure that we can fight pandemics in an effective and meaningful manner. We are certainly fortunate in Canada to have the Minister of Health who is also someone who has had firsthand experience in dealing with these types of issues.

This is of particular importance because of the growing threat of an influenza pandemic or other public health emergencies. The Public Health Agency of Canada must have clear legal authority to collect, use, disclose and protect information received from third parties. The bill provides that authority.

This is important as it will first, give the provinces and territories the necessary assurances that they can share public health information with the agency in accordance with their own privacy legislation. Second, the Chief Public Health Officer must have the parliamentary recognition as Canada's lead public health official. He must have the expertise and legislative authority to communicate with Canadians and report on public health issues.

Bill C-5 establishes the position of a Chief Public Health Officer and gives him the legislative authority to speak out on issues of public health. Finally, as the public health agency was established only through an order in council in the past, passing the bill will provide a statutory foundation to the agency.

This will provide the stability that the Public Health Agency of Canada needs to continue to promote and protect the health of Canadians through leadership, partnership, innovation and action.

It will also provide the foundational basis for the Public Health Agency of Canada to meet the challenges ahead and address many of the other public health issues that were raised during second reading.

I understand that there may be a concern by some members that the legislation encroaches upon provincial jurisdiction. Let me be clear. Bill C-5 does not expand existing federal activities related to public health. Further, the bill does not supercede any existing provincial legislation nor does it impinge on the activities of provincial public health agencies and organizations. Rather, it simply creates a statutory foundation for the agency and establishes the position and dual role of the Chief Public Health Officer.

By providing a statutory footing for the agency, the bill responds to provincial and territorial demands for a federal focal point with appropriate authority and capacity to work with them in preparing for and addressing public health emergencies. In fact, the federal government has a well established leadership role in public health, working in collaboration with provinces, territories and other levels of government.

We intend to continue along this approach. The preamble of Bill C-5 clearly states the federal government's desire to promote cooperation with the provincial and territorial governments, and coordinate federal policies and programs. For example, the agency is working with provincial and territorial authorities through the pan-Canadian public health network. The public health network is a forum for multilateral intergovernmental collaboration on public health issues and respects jurisdictional responsibilities in public health. The network represents a new way of federal, provincial and territorial collaboration on public health matters.

By facilitating intergovernmental collaboration through the public health network, the agency is also able to develop scientific knowledge and expertise in order to provide the best public health advice to Canadians. This legislation continues the strong tradition of cooperation and collaboration which has been part of Canada's approach to public health for decades.

Clearly, we all have a shared interest to protect and promote the health of all Canadians. Through this legislation we will be demonstrating to Canadians that we have listened to their calls to establish a permanent focal point to better address public health issues and that we are taking the necessary steps to strengthen the public health system as a whole.

It is important that we have such legislation in order to provide a statutory foundation for the Public Health Agency of Canada and support our collective efforts to strengthen public health in Canada.

I would also like to add that the government has brought forward this legislation in its first 100 days which I think demonstrates the commitment that the government has to public health. I realize that some members opposite may suggest that they had brought forward the legislation, but it is important to point out that at that time it had not even made it to second reading.

Having said that, I am pleased to say that all the federalist parties seem to support the government in bringing forward this legislation and it is important to demonstrate that through action. In budget 2006 we saw $1 billion set aside to deal with pandemic preparedness. That shows not only are we bringing forth legislation, we are going to back up the legislation with the necessary resources and the necessary political, public and governmental commitments to ensure that Canada is as prepared as possible to ensure the protection of health and that the health of Canadians is maintained in case of a pandemic emergency.

With that, I am very pleased that the bill has approached third reading and will come to a vote shortly. I look forward to the support of all the federalist parties to ensure the protection of all Canadians.

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, I thank the member for his opening speech on this bill which I am sure will have the support of all parties. Health care continues to be the number one priority of Canadians. I think that the initiatives with regard to establishing wait time benchmarks in the last Parliament and a commitment to wait time guarantees will also be important building blocks in our health care system.

The member mentioned whether or not this was a predecessor bill. When the House begins each and every day, we begin with a prayer. The prayer is that we make good laws and wise decisions. Quite frankly, I do not care where it came from. What I do care about is that we do the right job on behalf of all Canadians.

I had the opportunity to be in committee when it had Dr. David Butler-Jones before it. There is this challenge, I would say, that we have with regard to the agency, with regard to its funding, and more importantly, with regard to its priorities. I think it would be very interesting and helpful to the House if the member could relay some of the concerns that the committee had around the priority areas to make absolutely sure that we are not just creating another agency that is going to begin creating an empire.

It has an important mandate, but it also has some options. I think those priorities are important for Canadians to know about as well as the concerns that the committee had expressed. The member may want to share those thoughts with us.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, it is very important to understand that we all need to ensure that the agency focus on its core competencies, which is of course pandemic preparedness and infectious disease.

There are other things that overlap, but I know the member was particularly concerned in the last Parliament with fetal alcohol syndrome. The health committee will have further information when it reports to Parliament on this issue. I ask the member to be patient and he will see that report presently.

With regard to the preamble in the member's comments on benchmarks in health, I must take a moment to remind the House that in too many cases the benchmarks were not set by the previous government and the health care guarantee was actually a promise made by the Conservative Party in the last election. Interestingly, about a month after it was announced, it was largely copied by a couple of the other parties.

The guarantee stems from the Supreme Court decision that came in June, which is a decision that access to wait time is not access to health care. Unfortunately, that has been quite an indictment on the previous government, where wait times doubled and there was a shortage of family physicians and other health care professionals. However, that is just to clear the record.

I am very pleased that among the federalist parties there is an understanding that with Bill C-5 a pandemic does not respect borders. We must be prepared and we must work together across party lines and political parties to ensure that we are prepared as much as possible to ensure the protection of public health and Canadians.

[Joy Smith, Conservative, Kildonan—St. Paul, MB]

Mr. Speaker, I am very pleased to ask the member a question regarding the Public Health Agency of Canada because, as the member knows, it is located in Winnipeg.

It is a very important agency, especially with the issue of the future and possible pandemics and, as the member so eloquently relayed to us, the present health minister was actually in charge when the SARS epidemic hit Ontario.

Could the member outline some of the very important things that the Public Health Agency, under Dr. Butler, will offer to all Canadians in terms of safety, health care in a possible pandemic at some point in time, and how that might relate to West Nile virus, for example?

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, I would like to thank the member for highlighting the point that the current Minister of Health essentially led Canada's response to the SARS crisis. The lessons learned during that time were the genesis of the Public Health Agency.

We learned that we needed an individual who was beyond politics, someone who could see the big picture and who had the scientific knowledge necessary to deal with something like SARS. That is where the Chief Public Health Officer comes in. The Chief Public Health Officer can coordinate and deal in a non-political, scientific and evidence based manner with the issues around infectious diseases, pandemics and things like the West Nile virus.

The member also pointed out that we have a world-class level four lab in Winnipeg that can test for pandemic viruses, flus and other infectious diseases. The member may also know that it was a previous Conservative government and the then health minister Jake Epp that brought that lab to Winnipeg. As a fellow Winnipegger, I am very proud to have that facility in my province.

I am pleased to have the support of Manitoba colleagues in bringing forward Bill C-5 as it will affect Winnipeg in many ways. More important, it will help protect the health of Canadians in ways that have been outlined in debates at health committee, in this House, and in other venues.

I look forward to seeing this bill pass so we can get on with other matters as well.

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

Mr. Speaker, I want to commend the member opposite on the great work he has done along with me and other health committee members.

In his opening remarks he mentioned investments that have been made by the new Conservative government for the Public Health Agency and public health initiatives. Perhaps the member could expand on exactly what those initiatives are.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, the gist is that $1 billion over five years has been set aside for pandemic preparedness. This is a significant investment. It is an important investment. I would like to refer the member to the budget for further details as I am getting the signal from the Speaker that I have run out of time.

We thank members from all federal parties for their support in allowing this bill to pass.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

Mr. Speaker, I have a quick question with regard to the Public Health Agency.

In the summer of 2003 the Okanagan mountain park suffered damage as a result of forest fires. There was a real need for leadership from the provincial side that was somewhat challenged at the time. I appreciate the member saying that the federal level needs to show leadership. I know the provinces will be on side for that because they need stability, certainty and leadership during a national health crisis.

SARS occurred about four years ago and we identified that as a pandemic. It was shouting at us from a national perspective. Why has it taken so long for the Public Health Agency legislation to come forward?

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, it is a bit of a mystery why legislation was not brought forward until the very last days of the previous government. It should have been brought forward long before that.

The current government has brought it forward to deal with things such as a natural disaster. Heaven forbid that Canada should ever have to deal with something like hurricane Katrina or a pandemic situation. The Chief Public Health Officer will have laid the foundation along with provincial, territorial and municipal governments and first nation communities to ensure that we have an effective and quick response plan in place to reduce any harmful effects and protect the health of Canadians.

[The Acting Speaker, Royal Galipeau]

It is my duty, pursuant to Standing Order 38, to inform the House that the question to be raised tonight at the time of adjournment is as follows: the hon. member for Thunder Bay—Rainy River, Softwood Lumber.

Resuming debate, the hon. member for Brampton—Springdale.

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

Mr. Speaker, it is with great pleasure that I stand here today to provide support for the third reading of Bill C-5, a bill to create the Public Health Agency of Canada.

In the previous Parliament this bill was introduced by the previous Liberal government as Bill C-75. However, due to the dissolution of the 38th Parliament, it died on the order paper.

Bill C-75, which was introduced by the Liberals in the last Parliament, was the initial step toward strengthening the ability of the federal government to protect the health and well-being of Canadians. I am glad to see that the new Conservative government has recognized this great piece of public policy initiative that was brought forward by the previous Liberal government and is now trying to ensure that we provide the necessary legislative framework for the Public Health Agency of Canada.

In September 2004 the Public Health Agency of Canada was established by an order in council, once again by the previous Liberal government. The agency's mandate was to strengthen Canada's public health and emergency response capacity, and to develop national strategies for the management of infectious and chronic diseases.

The Public Health Agency will assume the responsibility for the Canadian strategy for cancer control, an issue that is important to many Canadians across the country. Also as part of its key initiatives, the agency will develop an integrated pan-Canadian public health plan which will address issues of chronic diseases, including important diseases such as cancer and heart disease.

The need to improve and strengthen our coordination in the area of public health has been highlighted by the inadequate response to a national tragedy in 2003, the outbreak of severe acute respiratory syndrome, also known as SARS. After the SARS outbreak, the federal Liberal government appointed a National Advisory Committee on SARS and Public Health.

The National Advisory Committee on SARS and Public Health was given the mandate to provide a third party assessment of current public health efforts and lessons learned for any future infectious disease control. One of the many issues that the committee examined was how a federal public health agency could contribute to the renewal of public health, as well as how this new agency would be structured. The committee was chaired by Dr. David Naylor and hence the Naylor report was issued.

Given the objectives that the national advisory committee had, one of the main objectives was to ensure that there would be a chief public health officer who would serve as a national voice and a spokesperson for public health, especially during any outbreaks or other federal health emergencies.

The chief public health officer it was recommended would advocate for effective disease prevention and health promotion programs and activities, would provide science based health policy analysis and would advise the Minister of Health. Also when required the chief public health officer would advise and make recommendations to the provincial and territorial health ministers, would provide leadership in areas of health initiatives and would ensure that we increased the quality of public health practice in this country.

In November 2003 the report from the Standing Senate Committee on Social Affairs, Science and Technology echoed the opinions that were issued in the Naylor report and agreed with the creation of a public health agency. The committee also recommended that the agency would enhance the federal government's ability to support local work in disease control and prevention.

In April 2004 our former minister of health, Anne McLellan, created a working group on public health that would work with the recommendations in the Naylor report and the standing committee report as well. A number of different witnesses appeared before the working group. They also recommended the creation of an agency that would concentrate and focus federal resources, that would enhance collaboration between the different levels of government and providers of public health services, that would allow for a faster and more flexible response to emergency situations and also would ensure that we improved and focused our communication efforts.

The committee stressed the need to take immediate steps for the creation of a public health agency. It felt, along with the many other stakeholders, that the agency should be responsible for emergency preparedness, immunization and chronic disease prevention.

The previous Liberal government was committed to public health in Canada. An investment of over $354 million was made to over 1,600 health research projects. The former Liberal government was also very committed to ensuring that Canadians received the highest quality of health care services in this country. Hence, an investment of $42 billion over 10 years was made to ensure that wait times were reduced in this country and also to ensure that Canadians received the highest quality of public health care service.

Budget 2005 by the former Liberal government invested another $805 million over five years in the area of health, including chronic disease prevention, pandemic influenza preparedness, drug safety and environmental health. A federal wait times advisor was appointed. In addition, the Canadian public health care protection initiative was further strengthened.

We believe it is very important that an agency be created and that the new Conservative government also make significant financial investments to ensure the effectiveness of this agency. Public health efforts on health promotion and disease prevention are extremely critical. As a chiropractor, I think it is really important that we start practising a model of wellness and prevention in our country.

Many of the chronic diseases that face Canadians, including cardiovascular disease, cancer, heart disease and diabetes are the leading causes of death and disability in Canada. The Liberal Party and many individuals in our caucus remain committed to ensuring that we protect the health and safety of Canadians. Health care is one of the most important issues to many Canadians across this country.

While I support Bill C-5, there is one element that is missing from the bill and the Conservative Party's agenda. The Conservative Party cancelled the ministry of state for public health that existed with the previous Liberal government. Health care is one of the most important concerns to Canadians. As a result, the Minister of Health has a number of obligations and responsibilities. One would want to see a public health minister in place in government to ensure that the health of Canadians was promoted and protected.

I strongly believe that the Conservative government should reconsider and reappoint a minister of state for public health to ensure that the leadership and innovation that is needed in the area of public health in this country is provided. Hence, I would request the reinstatement of the ministry of state for public health as a government department. The minister of state for public health could work with the Minister of Health, the Public Health Agency and the Chief Public Health Officer to provide the leadership and innovation that is needed in this area.

Some members who spoke before me are from Winnipeg, Manitoba which is where the headquarters for the Public Health Agency are located. As a former Winnipegger, I definitely hope that the Public Health Agency continues to have its headquarters in Winnipeg to ensure that it continues to provide the leadership in the area of public health across the country.

In conclusion, on behalf of my constituents of Brampton—Springdale and many members on this side of the House, we support Bill C-5 and the creation of the Public Health Agency. I would also hope that in the months to come the new Conservative government would once again reinstate the very important position of minister of state for public health. Public health is an issue that affects many Canadians across this country. I would hope that we could provide an environment of wellness and prevention to ensure that Canadians live their lives to the fullest.

[Steven Fletcher, Conservative, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I found it interesting that the member would talk about the minister of public health when the position is not included in the bill. Ministerial positions are not generally included in legislation, particularly ministers of states.

In the previous government, the minister of public health really did not speak to issues of public health at committee or in the public. It was often the health minister. It is important to understand that the legislation makes it clear that the health minister will be responsible for determining the scope of the mandate of the Public Health Agency as it goes to things outside the pandemic preparedness.

The member mentioned the Canadian strategy for cancer control which, intrinsic in the strategy, is an arm's length body. That is what was in the debate on the June 7 motion last year and the understanding that exists now.

My concern is that the creation of a public health ministry would blur the lines of communication. It is very clear that in a pandemic the Chief Public Health Officer has a specific role, as does the health minister. Having a minister of public health, as was the case in the previous government, blurs the lines of communication. This was mentioned many times in the health committee and I believe I also mentioned that concern. We want an effective government and an effective cabinet, and creating more positions that may or may not be necessary is probably not in the interests of Canadians.

Members of the Bloc gave us some feedback that somehow pandemic preparedness interferes with provincial jurisdiction. I wonder if the member would agree that pandemics do not respect borders and that it is important that we have a national strategy and that we be part of an international strategy.

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

Mr. Speaker, I first want to comment on his comments in regard to the minister of state for public health, which I had mentioned in my speech. I did not, in my speech, mention that the position should be included within the bill.

However, after looking at the mandate and at the different branches within the Public Health Agency, including the infectious disease and emergency preparedness branch, the health promotion and chronic disease prevention branch, the public health practice and regional operations branch, and the strategic policy communications and corporate services branch, I believe it is extremely important to the public health strategy of this country to have a minister of state of public health who would work alongside the Minister of Health to ensure we have a pan-Canadian strategy to address issues of importance to Canadians, like cancer prevention, heart disease and other chronic diseases.

In regard to the member's question about the Bloc perhaps thinking that the Public Health Agency would impinge on provincial jurisdictions, I think what Canadians across the country are really looking for right now in the area of health care is leadership. Health care, sickness and disease know no boundaries and people want, I think, federal, provincial and municipal elected officials to put aside their territorial jurisdictions and ensure we do what is best for the Canadian public.

When it comes to the area of health care, Canadians from coast to coast to coast want to see all individuals work together to address the issues that are important to them, such as reducing wait times, ensuring we have wait time guarantees, ensuring Canadians have access to doctors, ensuring that when we bring in the best and brightest physicians from all over the world that those physicians have the opportunity in Canada to have their qualifications licensed and accredited so they can contribute successfully to the health work force.

Canada should be providing and taking an international role when it comes to addressing issues of pandemic preparedness, such as the avian flu and the West Nile virus. When it comes to the issue of emergency preparedness, we as a country and Ontario as a province have already been through the unfortunate tragedy of SARS in 2003. As a result of that, we have learned a tremendous amount and can provide the leadership that is required internationally to address other emerging issues, like the avian flu and the West Nile virus.

In that light, I would hope all parties will support the legislative framework of Bill C-5 for the Public Health Agency.

[Jean-Yves Roy, Bloc, Haute-Gaspésie—La Mitis—Matane—Matapédia, QC]

Mr. Speaker, what I just heard strikes me as a bit simplistic, both what the parliamentary secretary had to say as well as the hon. member who just spoke.

I will just give the example of the World Health Organization. It does not give orders to anyone, not to any country in the world. Does it give orders to the United States or to the Canadian or Quebec health agencies? No, it does not give any orders.

They say they want to establish a Canadian health agency because the provinces are incapable of getting along or incapable of doing their job or because sicknesses know no boundaries. It is very simplistic to say these kinds of things.

We should also not forget that the health agency will have a $665-million budget. Of this amount, about $165 million will be spent over two years on other federal public health initiatives. What are these other initiatives? Will these initiatives not just duplicate services that are already provided in other provinces?

Quebec has a fine health care system. The problem it has, as in the other provinces, is the chronic under-funding from which it has suffered since 1993, the reduction in federal funding, which fell from 50¢ to 14¢ on the dollar. This is what we need to realize.

The provincial health care systems, including the one in Quebec, are very effective now and have developed over the years. However, they have been under-funded, probably on purpose by the previous government. It did this so that some day, since the provinces and health systems were starved out, it could barge in claiming that the systems were not very effective. It is obviously impossible to be effective when there is no money.

I would like the hon. member to reply to these questions.