Environment Committee on May 3rd, 2007

[Dr. Supriya Sharma]

There are a number of different hospital associations, so there is an umbrella organization that represents all hospitals. Again, it's not a group that we would normally consult with, simply because they're primarily administrative. Each province has its own hospital associations, and they're very different in terms of how they interact with the individual health authorities, etc. So we actually go on a province-by-province basis and we see who their responsible associations are and how they function, and then we try to bring the best people to the table.

If there is a public health aspect of it, we would then either go to the ministries of health or we would go through the community, actually the public health officers. Again, it really is on a case-by-case basis, but we have to match who we bring to the table to the issue that we're there to discuss. It's a very varied stakeholder group, usually on a case-by-case basis.

[The Chair, Conservative, Bob Mills]

Mr. Regan.

[Geoff Regan, Liberal, Halifax West, NS]

Thank you, Mr. Chairman.

I think your point is well taken about the concern that obviously doctors have to make the decision. But I think what Mr. Cullen was looking for is that you're going to have one list of the products that contain phthalate, so why not also have a list of products that don't contain phthalate? You aren't making the decision for the doctors about which one they will use in the end. The point is that they at least would have a list available to them of what alternatives are there, and then it helps them make their judgment, it strikes me.

I think this seems like a reasonable suggestion.

[Dr. Supriya Sharma]

I think that's why I was seeking clarification, because what I was understanding is that there would be an individual product and then an alternative suggested for that product.

In terms of the numbers, simply to go over it, when we're talking about all classes of medical devices, we're talking about approximately 650,000 devices. When we're talking about the products we're dealing with in the classes of 2s, 3s and 4s, it's in the tens of thousands as well.

When we're talking about a list, then, if we actually talk simply about a list of medical devices that are containing DEHP, we're already talking around a list of about 10,000 products. If the request is that we're making a list of about 10,000 products and then making a comparable list of 30,000 to 40,000 products, we start getting into a question of how useful those lists would be and the ability of an individual to really go through all that and make an assessment.

The last point about the list of products that wouldn't contain DEHP is that this would also include lists of medical devices that would never include DEHP because there would be no reason for them to. So I wonder--and again this is obviously for the committee to debate--whether or not it would be more confusing or helpful.

I think that's the perspective we're coming from.

[The Chair, Conservative, Bob Mills]

I apologize, Mr. Bigras. I believe I cut you off earlier. You had one more point, I believe, and then we'll go to Mr. Cullen.

[Bernard Bigras, Bloc, Rosemont—La Petite-Patrie, QC]

I had a supplementary question. In your opinion, if this paragraph 6(d) were passed, would it mean that the Minister of Health could deal directly with hospital associations without the need to go through public health authorities? What I read is clear:

6. The Minister of Health shall:

(d) take steps to facilitate the drafting by health professionals associations and hospital associations of clinical practice guidelines respecting the use of medical devices [...]

Do I understand that if we pass this paragraph, we give the minister the power to visit hospital associations directly in order to draw up guidelines? Am I mistaken?

[Dr. Supriya Sharma]

I think that's correct. It actually speaks directly to those two groups. It doesn't speak at all to the ministries of health.

It doesn't prohibit us from doing that. Our normal practice is to go through those groups. I agree that the way it's worded, it doesn't specify that this needs to happen.

[Bernard Bigras, Bloc, Rosemont—La Petite-Patrie, QC]

So, Mr. Chair, would it be possible to split the vote in order to vote first on paragraph 6(d), among others, and then on the rest? I would not like to throw the baby out with the bath water because of one point in the amendment with which I have a problem.

[The Chair, Conservative, Bob Mills]

You could also look at a subamendment to that. Actually, we haven't had anything moved at this point.

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

I feel as if I have assurances from government that we can make some of these changes, so I'll not move my amendment. Then I'll allow government to do what it needs to do.

[The Chair, Conservative, Bob Mills]

Next is NDP-3.3 on page 13.3.

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

I'll withdraw NDP-3.3.

[The Chair, Conservative, Bob Mills]

Okay.

Then we'll go to NDP-3.4.

Mr. Cullen.

[Nathan Cullen, NDP, Skeena—Bulkley Valley, BC]

I think this is the contentious point of Mr. Bigras. I'll withdraw this and we'll deal with it in G-9.

[The Chair, Conservative, Bob Mills]

Okay, so NDP-3.4 is withdrawn. We'll now go to G-9.1, which we've already discussed. It may have subamendments once we get it moved.

Mr. Warawa.

[Mark Warawa, Conservative, Langley, BC]

I will move it, but we can't accept friendly amendments. Is that correct?

[The Chair, Conservative, Bob Mills]

We can have subamendments.

[Mark Warawa, Conservative, Langley, BC]

Under paragraph 6(c), Mr. Cullen had suggested--

[The Chair, Conservative, Bob Mills]

Excuse me, Mr. Warawa, you can move it any way you want.

[Mark Warawa, Conservative, Langley, BC]

Okay, so I will move it with the change under paragraph 6(c), so it will read:

within 24 months after the coming into force of this Act, the government requires the labelling of

I think that's what Mr. Cullen was hoping for. Is that correct?

[The Chair, Conservative, Bob Mills]

It's the Minister of Health.

[Mark Warawa, Conservative, Langley, BC]

That's correct. Instead of the government, it would be the Minister of Health.

[The Chair, Conservative, Bob Mills]

The clerk has suggested you could simply take out “take steps to” and say:

coming into force of this Act, require the labelling of medical devices that

You have “The Minister of Health” at the top, so you don't have to repeat that.

Okay? So that's how it's being moved, so that's not a subamendment.

[Mark Warawa, Conservative, Langley, BC]

Okay.

And through you, Chair, to Mr. Bigras, did he suggest an amendment to deal with the hospitals?

[Bernard Bigras, Bloc, Rosemont—La Petite-Patrie, QC]

It will be moved by myself or Mr. Lussier, because I have to leave in a few minutes. The intent is to take 6(d) out of amendment G-9.1.