Finance Committee on Oct. 16th, 2018

[Dr. Victor Ling]

Thank you.

The Terry Fox Research Institute gets its money only from the Terry Fox Foundation. We are a charity. We are not for profit. Of course, when we distribute the money to top scientists such as Dr. Wouters and his team, and others, they have also applied to federal agencies like CIHR and Genome Canada, etc. Those are the infrastructures that support and enhance what we give them in a very powerful way.

If I may, I'll ask Dr. Wouters to present from the perspective of his institution.

[Dr. Bradly Wouters, Princess Margaret Cancer Centre, University Health Network, Toronto, Terry Fox Research Institute]

Thanks for the question.

At the Princess Margaret Centre, funding for research comes from a large number of different places. It comes through the tri-councils, the federal government—primarily to individuals and individual research projects. It comes, to some extent, from provincial governments, although that contribution is relatively small. It comes from industry and industry partners, commercialization activities and so on. It also comes, in large part, from philanthropy. The Princess Margaret Cancer Foundation contributes about half of the entire research budget at Princess Margaret, and its contributions are around the people, the infrastructure, the platforms, and the technologies that enable both the clinical research and basic research to happen there.

What we're talking about creating here is a network of comprehensive cancer centres—and there are other similar comprehensive cancer centres—for which the mission and goals are around delivering excellent care, but at the same time training the next generation of cancer researchers and clinicians as well as doing the research that is going to change what we have to offer patients in the future. That last part is funded, in large part, by that philanthropic effort.

You know, the opportunity we have now is to translate what we've learned into more personalized forms of therapy, the long-term goal being better therapy for patients, but to be able to do that, we really need to do it at scale. The Princess Margaret has put enormous resources into that through its own ability to raise funds. That's how all of the pilot project was funded. It was all through philanthropic donations. It leverages the enormous contributions that are already made in the forms of supporting health care and cancer care and delivery.

The money to date in the pilot project has been through the Terry Fox Foundation, through the BC Cancer Foundation and through the Princess Margaret Cancer Foundation—all philanthropic gifts.

[Matt Jeneroux]

I couldn't help but notice that very low administration costs run through the research institute. That's quite impressive.

I'm curious as to how what you're speaking of now differs from or enhances the current node process that the institute does. Every year I do a fundraiser with the Kids with Cancer Society in our local community—I'm from Alberta. What they strongly focus on is the after-diagnosis piece of cancer, and even what happens after they've been given a clean bill of health, if you will. They focus a lot on what happens after the cure. I'm curious about the research institute's focus post-success or the ringing-of-the-bell ceremony that happens, with kids or with adults.

[Dr. Victor Ling]

The way we treat cancer patients is 360 degrees. It's not just after they have cancer; it's also before they have cancer. Even after they have cancer, you want to have early detection to see if it's going to recur or not.

One other thing about precision medicine is that in the past we treated everybody the same way. If you were a woman with breast cancer, you were given chemotherapy as a standard of care. We know that only two out of 10 women really need it. With precision medicine, we can identify who those two are and save the other eight women from having chemotherapy. This is happening in real time now.

We need to collect our own data so that we can treat our own patients in Canada with the kind of treatment we give in Canada. This idea of precision medicine is really going to not only save lives but also save the quality of life when people don't have to get unnecessary treatments. This is the power of precision medicine.

[Matt Jeneroux]

Do you mean the chemotherapy...?

[Dr. Victor Ling]

Yes.

[The Chair, Liberal, Wayne Easter]

Thank you.

Ms. Rudd, we'll go to five minutes.

[Kim Rudd]

Thank you. Matt went down the road I wanted to go down as well.

First of all, I have to let you know, there's a member of Parliament from Oakville North-Burlington, Pam Damoff.... You're shaking your head. You know she's a great supporter of your application and the work that you're doing.

We're asked to spend money on a whole variety of things. What would be the outcome of not funding it, in layman's terms?

[Dr. Bradly Wouters]

Canada has made enormous investments in health. It led the world in the idea of delivery and access and quality, not only from a social and equitable point of view, but also from an investment point of view—investment that is made in Canada and Canada's future.

The ability to leverage that investment and to learn from our patients as a means of improving the opportunities we have to treat patients in the future....

One of the things you see in a cancer centre is that no one is satisfied with what we have to offer many of our patients today. Many patients are treated extremely well, and there has been enormous progress, but there is still a very big unmet need.

Part of the mandate of these comprehensive cancer centres is to change that. We recognize that we need to do that in a collaborative way, where we have an opportunity to generate data, share data and learn at scale across Canada. This will not only accelerate that process, it will coordinate the efforts of doing so, reduce inefficiencies and create access to that network for all Canadians.

Having a federal approach to doing it this way, not only to deliver care but also to learn and change the future for care, is an extreme need. It is built around an amazing opportunity, because of the investments we've already made.

[Kim Rudd]

Thank you.

Would this include all types of cancer? As MPs we hear presentations by various cancer organizations. As you know, some of them have joined together recently, but ovarian cancer is one example of something that hasn't had enough attention, I believe, over the past good number of years.

So would all cancer—I hate to use the word “types”—be included?

[Dr. Bradly Wouters]

Yes, they would. The large comprehensive cancer centres are the centres that see all those cancers, even when they're relatively rare. I can say that at Princess Margaret, there are 20,000 new patients per year who come there, so even rare cancers are seen by specialists, and there are opportunities to address them in groups.

For the rarest kinds of cancers—and when you start to talk about the individual differences in cancer, at the genetic level, this is why we need to do it at scale. Even in a place as big as Toronto or B.C. or Montreal, these institutes by themselves are not big enough to address those unique aspects of individual cancers. That drives the need to do this in a collaborative and shared way.

[Kim Rudd]

Thank you.

[The Chair, Liberal, Wayne Easter]

Mr. Kelly will now speak, and then Mr. Julian.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

I do want to return to a point made by Mr. Lewis-Manning on the regulation of your industry.

We've heard and we know that bottlenecks in the distribution channels for Canadian products, and in particular, energy products, are robbing the federal government of tax revenue that could easily and comfortably fund every budgetary ask we've had at this table today.

This is a very important point, that we do something—anything that we can—to shrink the Alberta discount.

In your opening remarks you referred to regulation that is out of date and cumbersome. Do you have some specifics that you want to address, under those headings of unnecessary, out of date or cumbersome regulation, that harm your industry and our ability to get all commodities to market?

[Robert Lewis-Manning]

I'm going to turn it over to Bonnie, who has some good examples.

[Bonnie Gee, Vice-President, Chamber of Shipping]

We have just gone through a modernization review of the Pilotage Act, and we're also going through one with the ports, with the Canada Marine Act.

There are concerns about the inability of government departments to work together. For example, vessels that come into Canadian ports are subject to the Customs Act, the Canada Shipping Act, the Immigration and Refugee Protection Act, the Plant Protection Act and the Marine Transportation Security Act. Our members have to submit pre-arrival notifications to each individual department. Each individual department reviews the pre-clearance advice and makes its own decision on whether or not a vessel is acceptable to come in.

We feel there needs to be a whole-of-government approach, as we mentioned in our opening statement. There is a lack of coordination and sharing of information between the government departments, which hinders our ability to be competitive in the marine commercial sector.

[Robert Lewis-Manning]

Thank you.

[The Chair, Liberal, Wayne Easter]

How would that compare with the case in United States? I noted the whole-of-government point in your brief, but if your same shipping companies are entering the port in Seattle, do they have to go through as many agencies?

[Bonnie Gee]

No. They've had a single-window approach in place for some time, where the coast guard receives the pre-arrival advice and sends it out to the various departments that need that information.

[The Chair, Liberal, Wayne Easter]

Maybe our analysts can check that single-window approach in the U.S. and we'll have a look at it.

Sorry, Pat. Go ahead. You have time for one more.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

I'll maybe just leave it at that with the Shipping Chamber.

Mr. Kershaw, are there dangers around the efficacy of some of the demographic analysis you've talked about? The reason I ask is that Ms. Rudd mentioned Boom, Bust & Echo and I can't help but think that book contained all kinds of terrible advice to people historically. The author drew conclusions that did not bear out over time, especially about the real estate industry. I'll let you comment on that or on whether you think demographic analysis should influence policy.

[Dr. Paul Kershaw]

In contrast to asking the federal government to make projections, what we're asking for is to report what's happening in the current year and to interpret that in light of what happened in the previous decades. There's a great deal of certainty about that data, and it can provide a great deal of wisdom to inform our current decisions and some estimates going forward. What we're looking at does not fall into some of those risks that you rightly identify about Boom, Bust & Echo, although I wasn't citing that in my particular piece today.

We have a nice new deck of infographics that can help bring this to life. We're actually bringing that to Ottawa next week. We'll be in Ottawa on the 24th. Come for lunch. We'll even have wine. We know that can get MPs out. I can send that as part of our follow-up to this meeting.

[Pat Kelly, Conservative, Calgary Rocky Ridge, AB]

Thank you.

[The Chair, Liberal, Wayne Easter]

Thank you.

Mr. Julian, you have the last series of questions.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

I have two fairly straightforward questions.

I'll go first to you, Ms. Jackson. Thank you for headquartering your organization in Burnaby.