This bill is from the 39th Parliament, 1st session, which ended in October 2007.
Tony Clement Conservative
This bill has received Royal Assent and is now law.
This is from the published bill. The Library of Parliament has also written a full legislative summary of the bill.
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.
All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.
Bill numbers are reused for different bills each new session. Perhaps you were looking for one of these other C-5s:
Public Health Agency of Canada ActGovernment Orders
Mario Silva Liberal Davenport, ON
Mr. Speaker, the member briefly talked about the Quarantine Act. I do not think she raised any concerns. The act that was introduced in the last session of Parliament was somewhat a reform to an earlier act that had not been changed in almost 100 years. It is quite shocking that it had taken so long for the Quarantine Act to be changed, given the new evolving situations happening internationally.
Does the member have anything else to add to that? Does she think anything could be changed in the Quarantine Act, or is she satisfied with the present act?
Penny Priddy NDP Surrey North, BC
Mr. Speaker, I will be interested in the discussion at committee.
My current concern about the Quarantine Act is who declares a quarantine. In the provinces, the provincial medical officer of health can declare a quarantine based on scientific and medical information. There seems to be cognitive dissonance when we get to the federal level. It is not within the power of the public health officer to declare a quarantine. Why the difference?
Dave Batters Conservative Palliser, SK
Mr. Speaker, it is with great pleasure that I rise today to address this important bill, Bill C-5, an act respecting the establishment of the Public Health Agency of Canada.
Before I begin, I welcome the member for Surrey North to this place and thank her for her intervention this morning. I found her comments to be very informative. It is clear that she was a nurse before she came to this place.
She said that the health of Canadians is of utmost importance to members of Parliament. She commented on the SARS crisis in 2003 and how people were afraid for lives, especially people in Ontario and the GTA. She talked about the need for leadership, and I could not agree more.
The member for Surrey North may agree with me when I say the Minister of Health provided the leadership to the people of Ontario at that most difficult time. He has received a lot of praise for the work he did during that crisis. Canadians can take a lot of comfort in the fact that the Minister of Health will oversee the Public Health Agency of Canada and the Chief Public Health Officer. He will be at the helm, God forbid, should another crisis such as the SARS outbreak take place.
This important legislation is key to the implementation of the government's vision of a renewed and strengthened public health system for Canada. As we all know, preventing and managing chronic and infectious diseases, as well as promoting good health, is key to a healthier population and to reducing pressure on the acute health care system.
The legislation underlines the government's commitment to promote and protect the health of Canadians. It would not only bring greater visibility and prominence to public health issues, but it would also support policy coherence across the health sector.
The bill also responds to the recommendations made by Dr. David Naylor and Senator Michael Kirby in the wake of the SARS outbreak. In their report both Dr. Naylor and Senator Kirby recommended that the Government of Canada establish a new public health agency. Further, provinces and territories and public health stakeholders have called for a federal focal point to address pubic health matters with the appropriate authority and capacity to work with other jurisdictions in preparing for and responding to public health threats and emergencies.
The legislation responds to those recommendations by establishing a statutory footing for the Public Health Agency of Canada. It would establish the agency as a separate organization within the health portfolio. In this regard, the agency would support the Minister of Health in exercising his duties, powers and functions in public health. In doing so, the minister recognizes the importance of continuing to foster collaborative relationships with federal, provincial, territorial and municipal governments as well as with international organizations and public health experts. The preamble of Bill C-5 further reinforces the agency's desire to work in cooperation with the provinces and territories.
A key aspect of the Naylor and Kirby report was their recommendation to appoint a Chief Public Health Officer for Canada. Specifically, Dr. Naylor recommended that a Chief Public Health Officer head the new agency in addition to serving as an independent credible voice on public health nationally. The legislation responds to that recommendation by formally establishing the position of the Chief Public Health Officer. Specifically, the legislation confirms the position, duties and powers of the Chief Public Health Officer and recognizes his unique dual role as both the deputy head of the agency and Canada's lead public health professional.
As the deputy head of the agency, the Chief Public Health Officer will be accountable to the Minister of Health for the day to day operations of the agency. In this role the Chief Public Health Officer will support the Minister of Health in fulfilling his public health mandate. He will be expected to advise the minister on public health matters and to inform policy development in these areas, along with the deputy minister of Health Canada and other deputy heads within the portfolio.
As the lead adviser to the minister on public health matters, the Chief Public Health Officer will help to ensure that public health issues are well represented in the health policy making process. At the same time, provisions within the proposed legislation will ensure greater policy coherence across the health portfolio by reinforcing the responsibilities of the deputy minister of Health Canada for supporting the minister in coordinating efforts across the portfolio.
Further, as a deputy head within the federal system, the Chief Public Health Officer also has the standing to engage other federal departments on key public health issues. As one example of this kind of work, over the past several months Dr. Butler-Jones has been working closely with the deputy minister of Public Safety and Emergency Preparedness Canada and the president of the Canadian Food Inspection Agency to strengthen Canada's pandemic and avian influenza preparedness.
As the deputy head, the Chief Public Health Officer is also able to mobilize the agency's considerable public health resources to respond quickly to emerging threats to the health of Canadians. This departmental model gives the Chief Public Health Officer considerable responsibilities while ensuring continued ministerial accountability for federal activities in public health.
In addition to his role as deputy head, the legislation also recognizes the Chief Public Health Officer's role as Canada's lead public health professional, with demonstrated experience in the field. As part of this role and in response to the strong expectations of public health stakeholders and Canadians, the Chief Public Health Officer will also serve as a credible and impartial voice on public health issues.
To ensure his or her credibility with stakeholders and the public, the legislation would give the Chief Public Health Officer the authority to communicate directly with stakeholders and to provide Canadians with information on public health matters. I think that addresses one of the concerns the member for Surrey North, that the Chief Public Health Officer has the authority to communicate directly with Canadians. He or she would be able to prepare and publish reports on public health issues.
In keeping with the government's focus on strengthening accountability, the Chief Public Health Officer will also be required to submit to the Minister of Health, for tabling in Parliament, an annual report on the state of public health in Canada. This requirement will not only provide greater transparency to Canadians, but it will also support the government's direction for an increased role for deputies in strengthening government accountability.
As the House knows, Dr. Butler-Jones has been serving in the Chief Public Health Officer role since September 2004. He brings to this position a considerable background in public health practice and years of demonstrated leadership in the field, in government settings at all levels, as well as within the non-profit sector. The proposed legislation gives parliamentary sanction to office of the Chief Public Health Officer, confirms the appointment of Dr. Butler-Jones for the remainder of his specified term and gives him the legislative authority to speak out on issues of public health. The Chief Public Health Officer must be an impartial, credible voice on public health matters.
Stakeholders have made it clear that they expect the Chief Public Health Officer to be an independent voice, able to drive real change by speaking out on public health matters and issuing reports. Making the Chief Public Health Officer Canada's lead public health professional and ensuring that future chief public health officers have qualifications in the field of public health will help confirm this credibility with stakeholders and Canadians.
The credibility of the Chief Public Health Officer is also reinforced by the fact that he can communicate directly with the public and stakeholders and can report on public health problems and solutions. The Chief Public Health Officer's expertise, status and power to communicate make him a visible symbol of the federal government's commitment to protect and promote the health of Canadians.
The dual role of the Chief Public Health Officer is unique among deputy heads of departments at the federal level. We acknowledge that there will be a healthy tension between these two roles.
On the one hand, the Chief Public Health Officer will be an integral part of the health portfolio with direct responsibility for the operations of the agency, for providing advice on public health to the minister and for carrying out the policy direction of the government.
On the other hand, the Chief Public Health Officer will be an impartial spokesperson on public health with an interest in maintaining the scientific and ethical credibility of the office. For example, the Chief Public Health Officer can work with his provincial colleagues in the pan-Canadian public health network to receive information and advice. With the authorities granted to him in legislation, the Chief Public Health Officer can then communicate and provide Canadians with the best public health advice.
We see this dual role being inherent in the nature of the office, but one that is manageable and demonstrates this government's commitment to accountability.
It is also not without precedent, as Dr. Naylor has noted in his report that the chief medical officers in both Manitoba and British Columbia have the authority to communicate and act independently when they deem it to be in the best interests of the health of their citizens, while remaining accountable to the governments they work within.
More recent, in 2004 the province of Ontario made amendments to its legislation to grant the chief medical officer of health more independence.
In light of the many potential threats facing Canadians from a possible influenza pandemic, to combatting chronic diseases such as cancer, to dealing with the persistent challenges of obesity and other health risk factors, public health is an important priority of this government. As such, the government considers that the dual role attributed to the Chief Public Health Officer by the proposed legislation will ensure the attainment of the two policy objectives mentioned above.
The Chief Public Health Officer will be firmly situated within the health portfolio where he or she can advise the government and play a meaningful role in a coordinated government-wide response to ongoing and emerging public health threats and issues. At the same time, it is very clear that Canadians want and expect the nation's lead public health official to have both the necessary qualifications and the mandate to speak out on matters affecting their health.
Canadians can be assured that the government understands the importance of having a Chief Public Health Officer whose overriding interests must be the health of Canadians. I believe the legislation strikes the correct and necessary balance between the dual roles of a chief public health officer, ensuring that the office has the ear of the government and the independence to first and foremost be a servant of the public interests.
I would like to take a moment to thank Dr. Butler-Jones for the great work that he has done. He has an extensive background in public health. Most recently, he served as the medical health officer for the Sun Country Health Region in my home province of Saskatchewan, only approximately 100 kilometres from my home town of Estevan, Saskatchewan. Sun Country is located in Weyburn, Saskatchewan. The public health care of Canadians is in good hands with Dr. Butler-Jones.
Keith Martin Liberal Esquimalt—Juan de Fuca, BC
Mr. Speaker, I listened intently to the member's speech on a very important issue for all Canadians. As somebody who has spent quite a few years practising in the emergency department, I am obviously fully supportive of more resources going to the acute side of medicine because there is a definite need right now. Emergency rooms across the country are being choked and emergency health care professionals are overworked in the commission of their duties in our time of greatest need.
However let us project forward and look at what is happening in the country. It is very disturbing to know that our youngest generation could now for the first time have a shorter lifespan than our generation and older generations. We need to address the fact that public health issues, and usually small interventions do have dramatic effects, will be required in order to prevent problems and continue with the extension of lifespans and the quality of life. Water, food, the quality of food and water, and lifestyle issues have to be addressed.
I would submit the following to the hon. member and he can consider telling it to the Minister of Health. It is the small preventative issues that could work well. For example, the head start program, which would have been part of our early learning program, would have ensured that children had their basic needs met for the first six to eight years of life. This is probably the easiest and simplest way of actually having a profound positive impact upon the lives of children and adults. It ensures that children are aware of proper nutrition, activity and that parents and caregivers are able to spend quality time with children and interact with them over a prolonged period of time.
Those kinds of simple interventions have a very positive impact upon children's lives. Will the hon. member present to his Minister of Finance a proposal for supporting a national head start program, a national mental health care strategy and a national medical manpower strategy with the support of the provinces? Will he also look at adopting the findings of the Walkerton inquiry which were very good toward developing national standards for water quality? All of those things could have a profound positive impact upon the health of Canadians.
Dave Batters Conservative Palliser, SK
Mr. Speaker, I know the member opposite is a physician and certainly has very useful insight to add to this place and to this very important debate.
It is nice to see the support that the bill has, at least from two opposition parties, but I think the Bloc Québécois would support the spirit of it.
The member talked about lifespans and the fact that we face some very serious challenges right now in Canada in terms of public health. If some of these epidemics are not brought under control, things that are very widely accepted and well-known but the impact may not be well understood, such as heart disease, diabetes, childhood obesity, the need for lifestyle improvements and primary prevention measures, we could have lifespans on the decline in Canada and that truly would be a shame.
The member asked if I would take this to the Minister of Health. Absolutely. I am very proud to be serving on the health committee in this 39th Parliament. I look forward to working with other members of the committee who will look at this and other bills and see if improvements can be made. I will go to the Minister of Health and talk about everything we can do in terms of primary prevention in order to improve the health care of Canadians, to address things like water quality, as the member mentioned, and lifestyle modifications, a mental health strategy for the country and basic policies to address heart disease and diabetes.
Guy André Bloc Berthier—Maskinongé, QC
Mr. Speaker, I have a question for the hon. member.
In Quebec we have the Institut national de santé publique du Québec. This institute specializes in research on various health problems. We have an entire organized health network: CLSCs, hospitals and so forth. Many services are organized to provide the public with appropriate health care.
I read an article recently that said the universities were getting deeper in debt. However, researchers just want to research.
My question for the hon. member is on the fiscal imbalance. During the election campaign the Conservative government said it absolutely wanted to respect provincial jurisdictions, especially those in Quebec with a view to independence. In Canada, a bigger budget is allocated to research. Could some research mandates be given to the Institut national de santé publique du Québec and some to the universities? That way Quebec's jurisdictions would be more respected. Furthermore, that is what the Conservative government promised to do during the last election campaign.
Dave Batters Conservative Palliser, SK
Mr. Speaker, Quebec has a number of high quality universities, as there are throughout the country, and federal dollars do flow down through the provinces to these universities for such research. This type of activity is something the government would encourage.
As the member knows, some very important work happens within the private sector in terms of research and development in the field of health care. However the member is absolutely right when he says that more work could be done in the universities in Quebec and throughout Canada.
It certainly is not the intention of the government, in introducing this legislation, to infringe in any way upon the provincial control or the provincial responsibility for health care. Clearly, that responsibility is well defined in our Constitution. What we are trying to do with the bill is to follow up on the recommendations of Dr. Naylor and Senator Kirby to provide some federal role which these individuals believe would benefit the health care of Canadians.
Dennis Bevington NDP Western Arctic, NT
Mr. Speaker, coming from the north, as I do, and being familiar with the conditions of health care in the northern regions, it is an overriding concern that crosses the country. In many cases, people in small communities and on reserves face very difficult health conditions and very limited resources to deal with them.
Having said that, I am interested in the Public Health Agency as a federal responsibility and how it will work. In our perusal of the legislation, it seems to indicate that the chief health officer would not have jurisdiction over aboriginal reserves or perhaps even over self-government arrangements that are constitutionally given through the federal government.
How does the member see the bill improving the life of aboriginal people on and off reserves? The chief health officer represents a very significant service that one would receive if one were under provincial jurisdiction. How does the member see that fitting with the federal responsibilities on reserves?
Dave Batters Conservative Palliser, SK
Mr. Speaker, I know the hon. member is a new member and I want to welcome him to the House.
I sat here this morning and listened to the member from the Bloc Québécois talk about the significant number of individuals working within the Public Health Agency of Canada who are devoted to the health care of our first nations peoples. That is a very positive step. Perhaps the member could look into those figures. I believe it was in a neighbourhood of 1,500 to 1,700 employees dedicated to first nation health and certainly a lot of work will be done both on and off reserves.
The member is concerned that the Chief Public Health Officer would not have standing or authority on reserves. In fact, the Chief Public Health Officer, under this bill, would be a deputy answering to the Minister of Health. I will give the member perhaps a couple of different scenarios.
Ultimately, the Minister of Health will have responsibility for what happens in terms of health care on reserves, such as in the case of an emergency, quarantines or containing a pandemic. The Minister of Health would do that, I would guess, in cooperation with the Minister of Indian Affairs and Northern Development. The Chief Public Health Officer, as a deputy, would work with other deputies within the Department of Indian Affairs and Northern Development to address the health care concerns of our first nations people.
Olivia Chow NDP Trinity—Spadina, ON
Mr. Speaker, the act to establish a Public Health Agency of Canada is a good first step. Health promotion, disease and injury prevention, and public health emergency preparedness response is a federal responsibility and a Public Health Agency is long overdue.
This agency would collect data, issue reports and coordinate various efforts. One of the goals of the Chief Public Health Officer is to identify and reduce public health risk factors.
We know that when children are overweight, they are likely to develop more health problems and illnesses. We know that when children grow up not knowing drownproofing, they could be in trouble if they are near water. We know that there is a public health risk when the environment is polluted. We know that there are ways to prevent and reduce the risks of cancer.
After collecting data, after consulting everyone, and after reports, annual reports and various reports, a Canada Public Health Agency must have the mandate to act. After knowing what the health risks are, the new Public Health Agency must also have spending power. Let me give an example. Children need good health and we know that it comes from food, for example. Right now there is a CAPC program that delivers some kind of food program to kids across Canada, but it is very much underfunded, not well understood and not well appreciated. Canada is one of the very few countries that does not have a national food policy.
Some 72,000 children in Toronto have nutritious snacks, hot breakfasts or lunches in community centres, schools and church programs. The federal government used to be a small partner with the Department of Health, but throughout the years the percentage of contribution has declined. There is absolutely no reason why a child in Montreal or Vancouver or Halifax should also not enjoy such a program.
We see that preliminary research, primarily from the United States, has found associations between households classified as food insecure and the health of young children in those homes. These associations included poor health child status; lack of iron; more frequent hospitalizations, which by the way costs taxpayers money; stomach aches; headaches; lower physical functions, including problems--now this is for children--with walking, running, doing chores; low energy levels, and we are talking about low energy levels in young kids; impaired social interaction skills; and emotional status.
A study of 21,000 U.S. children found that if there was food insecurity among kindergarten children, even if the kids were not from poor families, it hurt their academic performance in reading and math for boys and girls and there was a decline in social skills among boys when followed to grade 3. Those of us who are worried about bullying and safety, all of those issues, we must first think about the public health risk when kids do not have the right food to eat.
The study also looked at older children from 6 to 12 years of age and noticed that there was anxiety, aggression, psychological dysfunction, and difficulty getting along with other children. The parents had poor physical health, feelings of anxiety, loss of control, family dysfunction and psychological impairment, regardless of income status. A feeling of shame or embarrassment about not being able to feed oneself or one's children can also promote social exclusion, a feeling of isolation from neighbours and the community at large.
The British House of Commons, through the public health agency's promotion, is debating a children's food bill, as we speak, which would legislate a number of changes to optimize a child's diet, nutrition and health. It has widespread support and the endorsement of 150 national organizations in England.
A Canadian child's food bill, coming from the recommendation of the Public Health Agency, could support and implement visions proclaimed by many federal charters and conventions that we have declared in the past.
I notice that the former Minister of Health has joined us. We talked about a national plan that would see all children in grade 3 learning drownproofing. The same principle of public health applies. After all, Canada is surrounded by water. We have tragic drownings of Canadian children and young people. That can be prevented if they knew how to swim or, as a bare minimum, knew drownproofing.
After all the studies, reports and gathering of data, a national government has the responsibility to establish a general plan with standards and provide funding, so local community organizations and municipalities or provinces could cooperate and deliver programs. No, we should not be delivering programs, but certainly community agencies from the grassroots up should be provided the kind of support, so they can take the data from the Public Health Agency and do something with the annual reports.
Approximately 68,000 people in Canada will die this year from cancer. It is estimated that one in three will be diagnosed with the disease during their lifetime. We know that some cancers are caused by pollution and environment depredation. Sarnia, Ontario residents, for example, have higher rates of cancer. That is because of the local activities of petrochemical companies. My colleague from Windsor tells me that local residents have a high rate of thyroid disease and cancer, which occurs because of environmental depredation.
Environmental health activists point to the fact that about 500 new chemicals are being used in commercial processes each year, on which no or minimal information is available to consumers. As our ecosystem becomes more permeated with chemicals from agriculture, industrial and residential uses, so do our human systems, especially that of our children. I hope the Public Health Agency would disclose information on products and the contents in food to consumers, so that we can regulate food safety.
At the turn of the century, a public health agency noticed that polluted water leads to bad health. As a result, purification systems were set up. It was also a public health agency which noted that kids grow up with bad teeth if they do not lead very productive lives. As a result, in my city of Toronto, there are dental clinics for kids and seniors who cannot afford to have their teeth fixed privately.
It is very important that as we set up this Public Health Agency, with a Chief Medical Officer, that the agency be given the responsibility to act.
Lastly, I want to echo what my colleague said earlier, that the SARS crisis illustrated that we must have a clear protocol and a place where all the data can be stored. Information available in Vancouver should also be available in Toronto or Montreal. We must expand the mandate of the agency, so it would cover airports and rail lines because we live in a global environment and the transportation corridors are extremely important. It is very important that the Public Health Agency have a mandate over airports and rail lines.
I look forward to working with the Public Health Officer and hope that some of the areas that we already know about could be prevented and that the bad health of Canadians can be acted upon. If not, setting up the agency will really be just a paper exercise. We will have many reports and a lot of coordination, but no real action.
Brian Masse NDP Windsor West, ON
Mr. Speaker, I want to ask my colleague a question regarding Bill C-5.
One of the things she mentioned in her speech was the environmental contaminants issue. In this chamber in 2002, I presented a motion on environmental contaminants and human health. It looked to create an investigative body that would go to hot spots where we know that cancer rates, for example, or other contaminant issues that are linked to environmental pollution are problematic for those communities. It would look at ways to take remedial action and investigations as well as introduce some best practices to lower the actual percentages of either the cancer rates or other types of illnesses.
In my area, we have respiratory diseases. We have a significant pollution problem from the United States and from our own industries that cause health problems. We actually have some benefits that could be introduced through remedial action.
It is important to add a prevention element to this as well because some of the issues that we deal with, related to disease as well as contaminants, could be done in the forefront by preventing those things in the first place. My question to the member is, how should that envisioned role be part of public health in terms of lowering our costs and, most important, improving the lives of our citizens on a daily basis in order to extend their lives?
Olivia Chow NDP Trinity—Spadina, ON
Mr. Speaker, one of the goals that is identified in Bill C-5 is very clear and it is in writing. It says that the Chief Public Health Officer will “identify and reduce public health risk factors”.
There have been many reports that connect environmental depredation with a higher risk of cancer, whether it is asbestos, pollutants, airborne pollutants or substances that are in the food or water. Those really have health risks.
It is critically important that we label our food. Many European countries do that, but Canada does not. We do not know what is in some of our health care products or beauty products that we use. I know there are other products that kids are exposed to that have chemical ingredients that are a cancer risk.
I certainly hope that this Public Health Officer would have the power to say to the government that we know this is a risk and that is why we must take action.
Public Health Agency of Canada ActGovernment Orders
Winnipeg South Manitoba
Conservative
Rod Bruinooge ConservativeParliamentary Secretary to the Minister of Indian Affairs and Northern Development and Federal Interlocutor for Métis and Non-Status Indians
Mr. Speaker, some of the member's points are well taken. I can speak specifically for the aboriginal community in relation to food and diet. There are clear specific issues throughout the north and throughout Canada concerning diabetes.
However, I will not insinuate perhaps the direction she might be thinking in terms of how to mitigate the circumstances of diet. I would offer that there is a certain degree of government overaction in some areas. I know there needs to be education. I will use smoking as an example. Clearly we know that second hand smoke is something that is very detrimental to people in the immediate vicinity of smokers. That was the biggest reason why there has been such an initiative across Canada to bring about the regulation of smoking. However, in terms of diet, I think education is the right approach.
I would ask the member, what would be her intention in terms of her party and herself in helping to mitigate this issue?
Olivia Chow NDP Trinity—Spadina, ON
Mr. Speaker, I have seen food programs in schools in very depressed neighbourhoods where there is a lot of food insecurity and low academic performance. With a small investment at the local level and from the businesses in the neighbourhood through fundraising efforts, but also from the government, a CAPC program was initiated, which again is a federal program, and I have seen the academic performance of children rise dramatically.
Do not take my word for it. Take the word of principals, teachers and parents. As the parents come together to cook and provide a decent hot breakfast for their kids, they learn life skills. As the kids learn to eat proper food, rather than all the junk food they see on television, and which is more expensive by the way, they are able to have much higher productivity in life.
As a result, the families do a lot better. I know that in some of the aboriginal communities there is a lot of depression and a teenage suicide problem. I cannot help but wonder whether a program that is run by the elders working together and financially supported by the government would have dramatic results.
I certainly have seen it in some communities. I know that it is not a top down solution. It should be done by the people themselves. We only have to present a general guideline and leave it alone, and allow the communities to come up with the program because every community is different. It should come from the grassroots up and should be organized by the people themselves. I have seen dramatic improvements in the health of children and the health of the entire community, including their families.
