Government Operations Committee on June 20th, 2011

[The Chair, NDP, Pat Martin]

Minister, if I could, I'll interrupt you at that point.

That concludes your time, Mr. Armstrong.

For the NDP, Nycole Turmel.

[Nycole Turmel, NDP, Hull—Aylmer, QC]

Thank you.

I would like to come back to the point raised by the deputy minister. It has to do with the lack of information about the side effects of medication on children. The minister said firmly that the situation was going to be looked at.

Could you tell me what concrete action the department is planning to take to improve the situation and to ensure that children are not affected by the side effects of prescription drugs due to lack of information?

[Glenda Yeates]

Mr. Chair, thank you very much for the question.

Again, this is a very important topic for us. I think we are working very hard, as all drug regulators are, to make sure we have the best and the utmost up-to-date scientific information.

As the member noted, in some cases for children, because they obviously have different metabolisms--they're in a different stage of life--there can be a need for specific information. That's why at Health Canada we have established a pediatric expert group to give us information. We've been working with the industry and with other regulators internationally to try to understand what is the best approach and what are the tools we can use to make sure we protect children as best we can.

Those are a number of the things that we are doing to tackle this issue.

[Nycole Turmel, NDP, Hull—Aylmer, QC]

Denis.

[Denis Blanchette, NDP, Louis-Hébert, QC]

Good morning, Madam Minister. I am very pleased to meet you and to have the opportunity to ask you a question.

As you know, one of the health sectors where prices are increasing exponentially at a rapid pace is that of medication. Some provincial governments have been thinking out loud and have been talking about buying drugs.

At your end, are you planning to adopt a national drug procurement strategy?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you for your question.

The issue of drug costs and whatnot has been in the works for some time now. As I'm sure you're well aware, each jurisdiction determines which drug will be publicly funded within their formularies. Health Canada approves the drugs and the jurisdictions determine whether or not they will cover them within their public system. Recently, jurisdictions have been collaborating--the Atlantic region and Ontario--on how to better coordinate bulk purchase of products. That work continues with each jurisdiction.

From the meetings we had in September, I can say that it is quite encouraging in terms of what the jurisdictions are doing to partner. It's quite innovative, in my view, to have provinces and territories collectively recognizing that there's a benefit to this, and they are continuing those discussions. As Health Canada, we also purchase drug programs for our direct responsibility, which is first nations health care delivery, so we are a partner to that discussion with jurisdictions as well.

Thank you.

[Denis Blanchette, NDP, Louis-Hébert, QC]

The Patented Medicine Prices Review Board looked at the possibility of increasing the number of countries against which we can compare the prices of Canadian drugs in order to be able to offer Canadians—all while paying a fair price—drugs at a lower price, just by expanding the range of comparable countries from seven to 13.

Does the minister intend to take this approach and, therefore, allow Canadians to save more than $2 billion on drug prices?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you.

What you've just outlined is currently not something that we're having a discussion on.

Perhaps, Glenda, you can...?

[Glenda Yeates]

Certainly.

Thank you again for the important question.

The Patented Medicine Prices Review Board works to try to establish a pricing regime and a regulatory overview for Canada. They do have a series of countries that they look at as comparators for determining whether the prices for patented medicines are fair in the Canadian context. There is a group of countries, as the member noted, and they currently are used from time to time.

There are proposals put forward about possible changes to that group, and those proposals do come forward from time to time, but it's not something that is currently being implemented. Currently, the PMPRB is working very hard and diligently with the regulatory framework and with the group of comparator countries that is currently in force.

[The Chair, NDP, Pat Martin]

That's the end of your time, Denis.

We'll go to Bernard Trottier.

[Bernard Trottier, Conservative, Etobicoke—Lakeshore, ON]

Thank you, Minister, as well as the staff in the Ministry of Health, for coming in this morning.

I want to ask you about an important issue for most Canadians, certainly in Ontario, where my riding is, but also across the country, I'm sure. It's the preoccupation with wait times for critical medical services.

Could you describe the progress that's really been made in various areas of health delivery? What is the federal government doing to improve the wait-time situation?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you for your question.

This is an area that jurisdictions have been working on for some time. I was the territorial health minister when we started dealing with how we can address some of the issues around wait times.

I can say that the latest data from the Canadian Institute for Health Information and the provinces and the territories shows that we have had some decrease in wait times across the country. Our government, as I stated before, will continue to provide to the provinces and the territories as they adopt innovative approaches to delivering on and addressing wait times. At the same time, we will continue to provide the provinces and territories with the 6% escalator, which they will use to allocate to areas of need.

We continue to work with the provinces and territories on a health accord. As I stated before, the health accord has three more years left. A lot of work has gone into addressing wait times, as an example, as a priority area. But in order to see the true reflection of what we were able to achieve within the 10 years, we need to let the course run itself. Within the wait-time reports across the country, we are seeing significant reductions, and we'll continue to work on that.

In addition, our government has made significant investments in prevention, such as the prevention of hip injury, as an example, and in a number of other areas, which will mitigate some of the pressures we see within the hospitals around wait times.

[Bernard Trottier, Conservative, Etobicoke—Lakeshore, ON]

Could you give some examples of specific procedures for which the wait times have been reduced? In what types of procedures are we experiencing some success, and what's driving the success?

[Leona Aglukkaq, Conservative, Nunavut, NU]

I can say that across jurisdictions we adopted wait-time targets. I'll use hip replacement surgery as an example. Different jurisdictions are further ahead than others. The Health Council just came out with their review of how we're doing in some of these areas. We don't do enough to share some of our success stories, and certainly that's an effort that I think we can do better at.

On the issue of wait times in jurisdictions that have had success, they are concentrating on putting the systems and processes in place, whether that be having better record systems, such as electronic health, or more staff, more human resources, to provide support. But part of it is also the ongoing, predictable funding that has come from our government, which provinces and territories are able to invest in areas of need to address some of their wait-time priorities.

[Bernard Trottier, Conservative, Etobicoke—Lakeshore, ON]

Thank you.

I have a final question.

A theme across all ministries when it comes to budgets is our aging population. Could you describe some measures or some programs the Ministry of Health is putting in place to improve health delivery for Canadians?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you.

As you know, globally we're dealing with an aging population. But where I come from, in Nunavut, it's the complete opposite. In Nunavut, we have more young people today, as opposed to other jurisdictions. So there will be some differences in provincial areas of work.

Our government is supporting areas to deal with our aging population, around injury prevention, as an example, and seniors in aging friendly communities. We've also encouraged communities to design programs for active and health living for aging. We have the Canadian prevention program for seniors--the name escapes me at the moment. But we're putting programs in place to address the healthy aging of our population.

Our government continues to also make significant investments in the area of research to support Alzheimer's care--the brain funding we announced--and dementia programs.

There are a number of significant investments we've made that way. As well, through the Canadian Institutes of Health Research, through the leadership of Dr. Beaudet, Canada is leading in coordinating Alzheimer's research internationally, as an example. The results, again, will help us identify programs we can make investments in.

Thank you.

[The Chair, NDP, Pat Martin]

We're way over time with that.

Alexandre Boulerice has a question.

[Alexandre Boulerice, NDP, Rosemont—La Petite-Patrie, QC]

Poll after poll has shown that Canadians are telling us that health is their priority and that the quality of the public health care system in the country is very important to them. A number of Canadians even see this as being part of their identities.

Over the past four or five years in Montreal, we have seen a real shift towards the privatization of health care systems through an increase in private clinics and private hospitals at times. Those institutions are charging more and more fees for some medical procedures or for patients to have tests done or see a doctor.

We hold so strongly to the principles under the Canada Health Act, including universal health care and access to health care.

Could you tell me what the department is going to do to uphold those principles, which are at the very heart of our public health system, and to prevent credit cards from replacing health cards in order to have access to care?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you for the question.

As I stated before, the Government of Canada is committed to the Canada Health Act, which requires the provinces and the territories to provide coverage for medically necessary hospital services. Jurisdictions often will experiment in terms of innovative ways to deliver health care under the publicly funded umbrella, but still consistent with the Canada Health Act. When we have concerns such as those you just raised, we investigate the incidents or reports in partnership with the jurisdictions. Some will raise questions around that, so we do follow up with jurisdictions when we hear of concerns. But our findings are that they have been consistent with the Canada Health Act.

Thank you.

[The Chair, NDP, Pat Martin]

Because there's a moment left in that time, I have one question I'd like to put to you, Minister, and perhaps to Mr. David Butler-Jones as well.

Today the committee of the parties to the Rotterdam Convention are meeting in Geneva to determine what are those hazardous chemicals that require informed prior consent to be traded internationally. Canada has consistently said that asbestos should not be on that list. But we just recently got a memo from Health Canada advising the government that, yes, Health Canada believes chrysotile asbestos should be on the list of the Rotterdam Convention, the United Nations list of chemicals requiring informed prior consent.

Could you advise us on whether, since you've been minister, Minister Aglukkaq, your department has been asked for an opinion? I would put a similar question to David Butler-Jones.

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you for that.

I'll start off. The Rotterdam Convention takes place this week. I'm not going to pre-empt the discussions that will take place around this subject there. What I can say is that the position.... The scientific review that has been done clearly has confirmed that chrysotile can be used safely under controlled conditions. Over the last 30 years this has been the position. If applied under controlled management and conditions, it is safe. So I will just pass that on.

Do you want to elaborate, Dr. Butler-Jones?

[Dr. David Butler-Jones, Chief Public Health Officer, Public Health Agency of Canada]

As part of one of my former lives I was actually the physician for asbestos miners and mill workers.

[The Chair, NDP, Pat Martin]

I'm aware of that.

[Dr. David Butler-Jones]

If we had treated asbestos with respect in the beginning--and if not for smoking, which dramatically compounds the risk of disease as a result of asbestos--and it was used in controlled conditions, we wouldn't be having the kinds of concerns we have. But I remember, before I was the physician there, stories of people taking asbestos fibre and making it into snowballs to throw at each other and the industry of the day claiming there was no risk in any way. So finding the appropriate balance is key. I look forward to the results of the discussions.

[The Chair, NDP, Pat Martin]

The only question I have, though, is this. The list doesn't ban asbestos. All it requires is that if you're selling asbestos, it has to have a warning label on it so that people can take health and safety protocols. Is it the position of Health Canada that people should be warned that asbestos is a class A carcinogen?