Bill C-293

Pandemic Prevention and Preparedness Act

An Act respecting pandemic prevention and preparedness

This enactment enacts the Pandemic Prevention and Preparedness Act to require the Minister of Health to establish, in consultation with other ministers, a pandemic prevention and preparedness plan, which is to include information provided by those ministers.
It also amends the Department of Health Act to provide that the Minister of Health must appoint a national pandemic prevention and preparedness coordinator from among the officials of the Public Health Agency of Canada to coordinate the activities under the Pandemic Prevention and Preparedness Act .

[Patrick Taillon]

No, this is not an investigation. Bill C‑293 is forward-looking. Unfortunately, I'm afraid it's a diversion to avoid making an assessment that would be desirable. Ultimately, it's up to each administration to do its own assessment.

I think the agency could, on its own initiative, learn from experiences it has had in recent years. I'm afraid that by trying to anticipate a future crisis, we're sparing ourselves the critical examination that should be done to answer questions that are nonetheless quite simple. For example, why was the federal government so slow to manage borders? Why was it so slow to remove border obstacles? Why was it so difficult for it to manage vaccine supplies? These are matters for which the federal government is directly responsible. These are the questions we need to prioritize.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Thank you, Mr. Chair. I appreciate the opportunity.

Again, thank you to the witnesses staying a little extra longer with us.

As I'm sure you're well aware, the BMJ has published a number of articles on Canada's response to the virus.

One of the quotes I will read to you states, “A national inquiry in 2023 is critical. Consistent with reports both before and after this pandemic, we call for a culture of data sharing that enables diverse use by a broader range of users.”

I'll start with you, Dr. Taillon.

Do you feel that this is a national inquiry that Bill C-293 would provide?

[Shuv Majumdar, Conservative, Calgary Heritage, AB]

Thank you very much.

At the onset of the pandemic, the Trudeau government discovered it had dismantled a critical and successful early warning system. When the world began border closures to protect citizens, the “do as I say, not as I do” health minister Hajdu held to an ideology decrying conspiracy theories, accusing critics of being racist and parroting the People's Republic of China talking points and outsourcing critical national interest decisions to a World Health Organization bent on destroying its own credibility.

Bill C-293 is not a pandemic inquiry. It barely begins to assess pandemic prevention and it begs that we pay better attention to what decisions were made in that time.

Dr. Barrett, in the past you've stated that you're a fan of keeping masks on faces and have defended mandates on social media.

Let's see how that played out. The Alberta Medical Association survey cites 77% of parents who have reported that the mental health of their children aged 15 and over is worse than before the COVID-19 pandemic. According to the Canadian Institute for Health Information, during the first year of the pandemic, almost 25% of hospitalizations for children and youth were mental health-related.

Let me ask you a question. These mandates destroyed the mental health of Albertans and Canadians, and destroyed small businesses and destroyed the livelihoods of thousands of people who are now afflicted by an opioid crisis. Do you still stand by your comments today?

[Luc Thériault, Bloc, Montcalm, QC]

I'd like to talk about animal protection.

A brief sent to us by the Chicken Farmers of Canada criticizes Bill C‑293, which aims to prevent and prepare for pandemics. In it they say that its content is not limited to pandemic preparedness, but includes a negative and biased perspective on poultry farming.

The producers' concerns about Bill C‑293 focus on the type of language used to describe factory farming. The focus is on agriculture in the context of antimicrobial resistance, rather than using the “One Health” approach, and the overlapping jurisdiction of provincial governments in agricultural production.

Further on, they tell us about their strategy on the responsible use of antimicrobials approved by Health Canada's Veterinary Drugs Directorate.

What do you think of this critique of the bill?

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

To World Animal Protection, in your submission to the committee, you wrote that World Animal Protection supports Bill C-293 because it takes a “one-health” approach to pandemic prevention, requiring government to address the underlying causes of pandemics.

What is the “one-health” approach, and how does it relate to both animal protection and pandemic prevention?

[Patrick Taillon]

Yes.

If Bill C‑293 is all about planning and thinking, I'd say those are already powers amply available to the federal bureaucracy. So there's no need to legislate. All this is already possible and permitted. Otherwise, we're talking about giving the government coercive powers to force things through, particularly with regard to harmonization with the provinces and attempts to standardize. If that's the case, I think we're putting our energies in the wrong places.

When I heard Dr. Ross, with respect, talk about a registry for the training of health care personnel, I thought to myself that we were then touching on the field of education, which is a provincial jurisdiction. It's normal that at the federal level, we don't have this information, because it doesn't fall under federal jurisdiction. Professional corporations, which determine who can become a doctor or nurse, fall under provincial jurisdiction, as does hospital management.

The challenge in the next crisis—it may be opioids, it may be an environmental crisis, it may be something else—would be for everyone to get their responsibilities right. The federal government has had its shortcomings, such as border management during the pandemic, which wasn't always perfect. There was also the management of vaccine supplies, which wasn't always perfect either.

So we mustn't let Bill C‑293 become an excuse to avoid doing the imperative assessment of how Ottawa has discharged its responsibilities. It's as if we were in primary school, with good students and mediocre students, and the worst student in the class wanted to teach the other students how to study.

That's not how things works. Everyone needs to do their homework on their own; the federal government has lessons to learn from the last crisis in its own areas of jurisdiction if it wants to better exercise its powers without trying to take control, coordinate everything, and harmonize what doesn't fall under its responsibilities.

[Luc Thériault, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

I thank the witnesses for their patience and apologize for the digression. It's not that the subject isn't serious and important, but I'd like to reassure you and tell you that, when the Standing Committee on Health receives witnesses, it usually conducts at least one round of questions before moving on to another subject, when the subject is important. We're going to do that now, but I wanted to apologize anyway. This is not the way the committee usually operates. I thought the motion would have been tabled after at least a first round of questions.

So, I return to Mr. Taillon.

I'd like to go back a bit, because over time, we may have lost a bit of the essence of your testimony.

First, you said that Bill C‑293 was unnecessary insofar as you wondered whether legislation was really needed to put forward an action plan. On the other hand, are we to believe that the authorities currently involved are not already developing a plan and addressing the shortcomings of the pandemic?

Did I understand you correctly in this respect?

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Thank you very much, Mr. Chair.

This is an incredibly important topic to talk about. As a committee, we're tasked with legislation. The legislation we are tasked with tonight on a tight timeline is Bill C-293.

Dr. Ross said it's important to hear from people on the front line. Dr. Barrett is famous for saying, “health without knowledge doesn't happen.”

With respect for our witnesses, I move to adjourn debate.

[The Vice-Chair, Conservative, Stephen Ellis]

Very good. Thank you for clarifying that, Mr. Fisher.

I will echo those comments; I'm sorry to the witnesses. Obviously this is committee business that is not related to Bill C-293. I am unsure as to how long this may take. I would ask my honourable colleagues to consider thinking about releasing the witnesses. This may take some time.

I'm at the will of the committee, but I would suggest to my honourable colleagues that, if it is your desire to release the witnesses and apologize to them, I'd be absolutely happy to do that. I'll leave it to the will of the committee.

[Dr. Kathleen Ross, President, Canadian Medical Association]

Thank you, Mr. Chair.

My name is Dr. Kathleen Ross. I'm joining you from the traditional territories of the indigenous people of Treaty No. 7 and the Métis Nation of Alberta Region 3. We acknowledge and respect the many first nations, Métis and Inuit who have lived in and cared for these lands for generations.

I am a family doctor working in British Columbia. As president of the Canadian Medical Association, I represent the voices of the country's physicians and medical learners, those they care for and those who don't have access to care.

As the committee studies Bill C-293, an act respecting pandemic prevention and preparedness, it's important to hear from those who have been on the front lines since long before COVID-19. Already caring for patients in a broken system, health care workers were submerged under deeper backlogs and even greater system impacts with each subsequent wave. Canada's response to COVID-19 must inform our plans for future pandemic preparedness and prevention strategies. Appropriate planning to support our health workforce at the outset remains critical to keeping Canada safe.

The spirit of Bill C-293 is to improve the way we prepare for the next pandemic. We welcome the proposed steps towards collaboration across jurisdictions and are pleased to see an emphasis on building primary care capacity. The language that speaks to improving working conditions for essential workers while increasing the ability of health care workers to perform their duties in a scenario of increased demands is promising. However, the stark truth is that we must focus on alleviating the significant impact the pandemic continues to have on the health workforce today. Creating a safe, robust and healthy workforce can't wait.

The heroic efforts of our health workers continue, and we are at record-high levels of burnout and exhaustion. My colleagues are demoralized and looking to exit the profession. We hope the impact on the health and wellness of health professionals will be a big part of any review and an even bigger piece of planning.

Rebuilding the trust of our health workers and Canadians is critical to pandemic preparedness. Mr. Chair, the announcement of increased health funding earlier this year was welcomed. That spending must be targeted and invested in areas that truly bolster health care systems. Canadian physicians must be able to work where the needs are greatest.

As an example, in April 2021, COVID-19 cases were surging in central Canada and many communities were pushed beyond their resources. A cadre of health care workers, including physicians from Newfoundland and Labrador, assembled quickly to help struggling communities 3,000 kilometres away. That deployment necessitated a swift and temporary lifting of the usual provincial licensing restrictions, allowing physicians to get an Ontario licence within one week.

Look at the potential of that model: A single licensing system implemented across the country can alleviate the pressure on medical workforces, serve patients in rural and remote communities, provide virtual care across provincial and territorial borders, and provide more timely access. This is critical in preparing for future pandemics. Pan-Canadian licensure can be implemented across the country, which provincial and territorial health ministers committed to last week in P.E.I. This is the time to deliver on our promise to increase access to family doctors and primary care. Scaling up collaborative, interprofessional care is central to increasing access and limiting the spread of future disease.

Physicians are overwhelmed by unnecessary administration, a lack of interoperability, third-party and federal forms, and managing large volumes of data that are often incomplete. Admin burden amounts to 18.5 million hours per year. Those hours could be transferred to better patient care and physicians' own wellness—hours we cannot afford to lose in the surge of a pandemic.

We must plan for what our health workforce may face. Gaps in the availability of timely health data are critical. We need to be able to harness data in order to contribute to the development of an integrated pan-Canadian health human resources plan. Data is necessary to understand the breadth of the myriad of health care challenges we face and to chart a sustainable course for the future. Without a transparent and accountable blueprint, we are unlikely to reach consensus on our destination.

Mr. Chair, I thank you for the committee's time today.

I'll welcome any questions the members of the committee might have.

[Melissa Matlow, Campaign Director, World Animal Protection]

Thank you, Mr. Chair, and committee members for the invitation to testify on Bill C-293.

I'm the campaign director at World Animal Protection. We're an international animal welfare charity with offices in 12 countries.

We conduct a lot of research on the intersectionality of animal health and welfare, environmental sustainability and human health. That research then informs our policy recommendations that we bring. Those intersections really are what “one health" is all about.

We have general consultative status with the United Nations. We have a formal working relationship with the World Organization for Animal Health and we're members of the National Farm Animal Care Council.

Joining with me today is Michèle Hamers, our wildlife campaign manager, who has an M.Sc. in animal biology and is co-author of the first published article on Canada's wildlife trade, specifically on the potential for disease risk and the lack of data and monitoring for it.

You may be wondering why an animal welfare group wants to testify on this bill. Seventy-five per cent of new and emerging infectious diseases originate in animals, principally from wildlife. It is our mistreatment of animals and exploitation of nature that is driving the frequency and severity of diseases, and it's not just us who are saying that. It is repeatedly cited in various UN reports like the report by the United Nations Environment Programme on pandemics, or the report by IPBES on pandemics, with regard to Mpox, Ebola, SARS, MERS, West Nile virus, Nipah, Zika, COVID-19.

It is widely acknowledged that a wildlife market played a significant role in the COVID-19 pandemic, whether it was originating the origins of the virus or amplifying it. These markets typically hold a variety of different animal species that wouldn't normally encounter each other in the wild. They are kept in cramped, stressful and often unsanitary conditions. These are called hotbeds for emerging diseases. When animals are stressed they become more vulnerable to infections and they become more infectious. That is why this is very much an animal welfare problem at the core.

We strongly support this bill because it takes a “one-health" approach and puts emphasis on prevention, it identifies the top pandemic drivers and requires government to address those drivers and mitigate those risks.

So often prevention is viewed as increasing surveillance and monitoring, but surveillance cannot detect asymptomatic animals that carry disease, nor does it prevent pathogen mutation and emergence. Scientists have warned that we are entering a pandemic era. If we truly want to reverse course, we must include pre-outbreak measures to prevent spillover at the human-animal-environment interface.

To quote from the IPBES report, “Without preventative strategies, pandemics will emerge more often, spread more rapidly, kill more people and affect the global economy with more devastating impact than ever before.”

Tackling the root causes of spillover is a fraction of the cost of responding to a pandemic. One study found that halting deforestation and regulating the wildlife trade could cost as little as 2% of the economic cost of responding to the COVID-19 pandemic.

It is also critically important that this bill mentions well-known pandemic drivers. These are already identified in the scientific literature by credible authorities and global agreements that Canada has committed to.

These drivers include the illegal and under-regulated legal wildlife trade, which is growing in volume, live animal markets, intensive farming methods, and land use changes. These have been identified, again, in the UNEP report and the IPBES report, which I believe are available to you.

The current draft of the World Health Organization's international pandemic instrument also mentions the need to address disease drivers including, but not limited to, climate change, land use change, the wildlife trade, desertification and antimicrobial resistance. Bill C-293 would help Canada fulfill its obligations to this new global agreement.

The World Health Organization refers to the rise in antimicrobial resistance as the silent pandemic and one of the biggest public health concerns of the 21st century. This relates back to animal welfare because three-quarters of all antimicrobials used in Canada and around the world are given to farm animals. For decades, these preventative antibiotics have been given in the absence of clinical disease to stop stressed animals from getting sick and to facilitate intensive farming methods.

Thank you for your time.

[Patrick Taillon, Professor and Associate Director of the Centre for Constitutional and Administrative Law Studies, Faculty of Law, Université Laval, As an Individual]

Thank you, Mr. Chair.

I would first like to thank the members of the committee for this invitation to testify about Bill C‑293.

Right from the outset, I'd like to share three criticisms of the bill.

First, it's an unnecessary bill in many ways; second, it distracts us from the real issue; and third, it contravenes the principle of federalism and provincial jurisdiction in the health field.

First of all, it is unnecessary, to some extent, because it aims to set up a preventive bureaucracy. Cabinet members, along with senior federal government officials, already have all the latitude they need to assess, forecast and anticipate the next crisis. It's already their role to do so. They don't need legislation to do it. It's already part of their job description.

Next, it's a bill that distracts us from the real issue, which is the need to take stock of federal action during the last pandemic. It seeks to anticipate the next crisis on all fronts, including those outside federal jurisdiction, rather than focusing on the important issues. Why was the federal government so slow to shoulder its responsibilities during the COVID-19 crisis? Why was it so slow to manage border controls, which are its responsibility? Why was border quarantine so slow to be established? Why did cities like Montreal have to try to make up for the federal government's shortcomings? Why were the maritime provinces forced to create borders within Canada to compensate for federal inaction? Why was the slowness in establishing rules and procedures to manage the crisis accompanied by a delay in withdrawing the measures at the end of the crisis? Why was the federal government always two or three steps behind?

The bill's ambition to coordinate everything is very unhealthy. It's a distraction. It deprives the federal government and its administration of a critical examination of its own action. Above all, the bill clashes with federalism and the provinces' common law jurisdiction in health matters. It is the manifestation of a centralizing intention, of the idea that everything would be better managed if it were coordinated from above. This standardizing ambition is clearly evident. It is evident, for example, in paragraph 4(2)(c), which states that care must be taken, with the provincial governments, to “align approaches and address any jurisdictional challenges [...].”

“Align” means everyone doing the same things, which is a euphemism for saying that we're really trying to standardize everything. To “standardize” is to deprive ourselves of the contribution of grass-roots initiatives, and of the freedom and autonomy that have made it possible for certain provinces within the federation to do well, and for others to imitate them. If we centralize and standardize everything, that means that, in the next crisis, the mistakes we make at the top will be made uniformly across Canada. This is the opposite of the spirit of autonomy and freedom that federalism implies.

The same section also mentions “the collection and sharing of data.” Once again, this is a euphemism for a form of accountability in which the provinces are required to provide information in areas where they are nonetheless fully autonomous.

In closing, let me say that we shouldn't be naive. If the prevention and coordination work proposed in the bill is not really about decision-making, in that case we don't really need a bill, since the administration already has all the freedom to do the necessary reflection and coordination work. If, on the other hand, we're really looking to delegate new powers to the administration in order to coordinate and harmonize some things with the provinces, that means we're really looking to distort Canadian federalism, i.e., a federalism in which the bulk of responsibility for health care lies with the provinces.

Thank you.

[The Vice-Chair, Conservative, Stephen Ellis]

Good evening, everyone. I call the meeting to order.

Welcome to meeting number 82 of the House of Commons Standing Committee on Health. Today's meeting is taking place in a hybrid format, pursuant to the Standing Orders.

I would like to make a few comments for the benefit of witnesses and members.

Please wait until I recognize you by name before speaking. For those participating by video conference, click on the microphone icon to activate your mike, and please mute yourself when you're not speaking.

With regard to interpretation, for those on Zoom you have the choice at the bottom of your screen of the floor, English or French. Those in the room can use the earpiece and select the desired channel.

I will remind you that all comments should be addressed through the chair—that would be me. Additionally, screenshots or taking photos of your screen are not permitted.

In accordance with our routine motion, I am informing the committee that all remote participants have completed the required connection tests in advance of the meeting.

Pursuant to the order of reference of Wednesday, February 8, 2023, the committee is resuming its study of Bill C-293, an act respecting pandemic prevention and preparedness.

I would like to welcome our panel of witnesses. Appearing as individuals and by video conference, we have Dr. Lisa Barrett, physician-researcher; and Patrick Taillon, professor and associate director of the Centre for Constitutional and Administrative Law Studies, faculty of law, Université Laval. Representing the Canadian Medical Association, we have Dr. Kathleen Ross, president, by video conference; and representing World Animal Protection, we have Melissa Matlow, campaign director; and Michèle Hamers, wildlife campaign manager.

Thank you for taking the time to appear today. You will each have up to five minutes for your opening statement. The order we will use will be Dr. Barrett, Mr. Taillon, Dr. Ross....

I'm unsure, so could you clarify, Ms. Matlow, whether you will do the entire five minutes? Very well.

I will remind you when you have one minute left. We're going to keep to a schedule here this evening.

That being said, thank you all for being here, and let's get the show on the road.

We'll start with Dr. Barrett.

Thank you.

Health

[The Speaker, Anthony Rota]

It being 3:26 p.m., pursuant to order made earlier today, the House will now proceed to the taking of the deferred recorded division on the motion to concur in the 14th report of the Standing Committee on Health concerning an extension to consider Bill C-293.

Call in the members.

[Sean Casey, Liberal, Charlottetown, PE]

Mr. Speaker, I have the honour to present, in both official languages, the 14th report of the Standing Committee on Health, in relation to Bill C-293, an act respecting pandemic prevention and preparedness.

The committee has studied the bill and, pursuant to Standing Order 97.1(1), humbly requests a 30-day extension to consider it.