Evidence of meeting #8 for Government Operations and Estimates in the 43rd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was testing.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Pat Whalen  Chairman and Chief Executive Officer, LuminUltra Technologies Ltd.
Clerk of the Committee  Mr. Paul Cardegna
Paul Lem  Chief Executive Officer, Spartan Bioscience Inc.
Kevin Smith  President and Chief Executive Officer, University Health Network

12:35 p.m.

Conservative

The Chair Conservative Tom Lukiwski

Thank you very much.

We'll now go to Mr. Green for six minutes, please.

12:35 p.m.

NDP

Matthew Green NDP Hamilton Centre, ON

I'd like to begin by acknowledging the fantastic Dr. Kevin Smith, who, although he is in Toronto currently, we still claim in Hamilton for his 25 years of service at St. Joseph's hospital. Of course, Dr. Smith, you led the way there through some very significant strategic partnerships. We now know that in your new role, you're also creating health networks in the Toronto area.

My first and most obvious question, coming from Hamilton Centre, is what types of collaborations are you seeing with, for instance, McMaster University, or Hamilton Health Sciences, or the other world-class health research bodies across the country?

12:35 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

It's nice to see you again, Mr. Green, and thank you for your service. It's nice to see a leader from Hamilton back in the Government of Canada. I would say that is a great question and great collaboration.

At the clinical level, Hamilton Health Sciences and St. Joseph's Health System are both very actively involved at the provincial table and the federal table. As we know, with health being a provincial delivery responsibility, it has been more focused there. In looking at the coordination of care, Hamilton has been leading the way in creating an integrated care system, from primary care right through to hospice and palliative care. I think much of what this disease will show us and has shown us is the lack of concentration on the latter parts for frail citizens and under-housed citizens, an area that Hamilton has thrived in championing.

I think the other piece of this is collaboration and research. Just as an example, the laboratories at University Health Network and the Hamilton regional laboratory medicine program, which operates through both of the hospitals under Hamilton's supervision, are already collaborating. They are coming up with very creative ideas, such as the idea that perhaps through our laboratory system we should be coming up with our own swabs, our own medium, and a number of other technologies and testing analyses that would allow us not to be dependent on the international marketplace where, frankly, Canada is a small player and we don't always get to the trough first. Those who buy the most product often are those who get the quickest response. Unfortunately, the response has not been as rapid as we'd like in a number of key diagnostic areas.

12:35 p.m.

NDP

Matthew Green NDP Hamilton Centre, ON

Why do you think that is?

12:35 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

I think literally everyone around the world is looking for the same products at the same time. That's number one.

Number two, I think, is stockpile management. We probably could do a better job of ensuring that we're swapping out stockpiles. As we went to the stockpile, I think many people, not only in Canada or Ontario, found stale-dated activities, stale-dated masks and other things.

That said, in inventory management, we might be wiser to think about how we renew and swap out products within stockpiles. The same would be true for things as complicated as ventilators. For example, those that we bought after SARS, 17 years ago, are not the state-of-the-art material of today.

I think there is a whole opportunity for us to re-evaluate how inventory management occurs and certainly how supply chains occur.

12:35 p.m.

NDP

Matthew Green NDP Hamilton Centre, ON

I couldn't agree more. If you happened to tune in to previous sessions of this committee, you'll know that I've been talking ad nauseam about the national emergency strategic stockpile supply, and I'll continue to do that.

As it relates to the grey area, I'll call it, between the hypercompetitive world of research within post-secondary and the private sector, you've referenced Thornhill Medical as a technology corporation that is affiliated with the UHN. It has received some support from the government, or at least letters of intent.

In this phase—this crisis, this emergency—how is the data that's being produced publicly by publicly funded institutions like our universities and hospitals being shared in an open source way across all private sectors as well as public research bodies? My concern is that the proprietary nature of publicly funded research might slow down the process of getting things to the marketplace. Can you share your thoughts on that?

12:35 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

Sure. I would say that at the moment the focus of research has really been rapid results and rapid sharing of information.

As you know, science is a self-organizing enterprise. People get grants, publish results and share them openly. There's always this debate about whether we should publish our work or not publish it so that it can be patented and result in economic prosperity for the inventor as well as the nation.

At this point in time, I see no investigators who are not fully and completely divulging information rapidly and with massive uptake, as you can see in the Twittersphere, which I've [Inaudible--Editor], literally within hours of results, we're seeing people share that information. The challenge—

12:40 p.m.

NDP

Matthew Green NDP Hamilton Centre, ON

I'm sorry to interrupt, Dr. Smith. Are there any policy directives or anything when you're dealing with the hundreds of millions of dollars going out in funding for clinical trials, start-ups and innovation? Do you know of anything that is actually within the policies or the contracts of the federal government that require it, in this time of emergency, to be shared broadly? Or is there still the opportunity for proprietary use of the technology?

12:40 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

I believe, to my knowledge, that I can't think of a single federally funded or supported clinical trial that doesn't encourage rapid sharing. That is different for research funded by the private sector. The majority of clinical trials are, frankly, funded by the private sector.

On the open source side, where government is funding the research, I think it is rapid dissemination. Where it's truly contract research, the company is hiring our investigators to enrol subjects and then gather the information. We are governed by statutes that require us to report information, particularly erroneous, challenging, or negative outcomes, but that remains within the proprietary relationship of the company and the investigator.

12:40 p.m.

Conservative

The Chair Conservative Tom Lukiwski

Thank you very much.

We'll now go to five-minute rounds, starting with Mr. McCauley, please.

12:40 p.m.

Conservative

Kelly McCauley Conservative Edmonton West, AB

Dr. Smith, thanks very much. This is very informative.

I was very encouraged by your earlier comment that you've never seen so much co-operation between the levels and also the speed at which everyone is acting. Is this sustainable? One of the things we've seen in this committee is the slow, slow pace of purchasing with the amount of regulation and with hurdles thrown in front of every organization.

I'm glad that we're getting past that. Is this a new dawn that we're waking up to and seeing how much time we're wasting? Or is this a short-term thing, and as soon as we're past this crisis, we'll perhaps go back to the old ways?

12:40 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

I'm an optimist by nature. I hope I've conveyed that in my comments today.

12:40 p.m.

Conservative

Kelly McCauley Conservative Edmonton West, AB

Very much so.

12:40 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

I'd love to hope the latter is true, but I do fear the former might be true, and here's why. I think that when we take outcomes that are sometimes less than desirable—when events occur that have made, for example, a purchasing process less than fair, or questionable in terms of ethics—we put new processes in place to correct those. Those have now mutated and culminated to sometimes make the process more important than the outcome.

12:40 p.m.

Conservative

Kelly McCauley Conservative Edmonton West, AB

At a time like this....

May 1st, 2020 / 12:40 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

Yes, sadly. At a time like this, I think everyone has parked that and said, “We know there are some things we need like swabs, ventilators, reagents and personal protective equipment. Go and get them, and we will figure out the best process and follow it solidly."

I recognize why the previous model existed and that it was often risk mitigated, but I would certainly encourage us, as this completes, to go back and ask, does the complexity of our process warrant the outcome we're trying to achieve or waste a tremendous amount of time and taxpayer dollars for the illusion of fairness? At times, frankly, this is frustrating to the purchaser, the provider community and to the end user. I'm not suggesting for a minute that we should walk away from it.

12:40 p.m.

Conservative

Kelly McCauley Conservative Edmonton West, AB

Yes, it's not really fair in the end.

There is the opportunity, months or years from now, to perhaps build a new template based on what we're doing now.

12:40 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

Especially if we're thinking about trying to encourage Canadian production of materials that are essential during times like these.

12:40 p.m.

Conservative

Kelly McCauley Conservative Edmonton West, AB

Great. Thanks very much.

You talked about the need for a healthy stockpile for the NESS. Mr. Green talked about the strategic stockpile and, obviously, we've seen that it hasn't served us well federally. Some of the provinces have done very well. Alberta has been exemplary on this. Should it all be shifted to the provinces, do you think? What should the federal role be?

As a follow-up question, I've been getting a bit of feedback that we were focusing on the viral issues and not the PPE as such. All of the pandemic plans I've read are more focused on vaccines and that. Where best should we go forward so that we don't run into this again?

12:40 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

First of all, when one looks back, there was no error of commission. There may have been some errors of omission. People, with the best of intentions, I think, in retrospect, would ask, “Was there good enough communication between those various levels of government and the private sector around stockpiling?" I don't think anyone intentionally said, “Let's make this not work better.”

12:45 p.m.

Conservative

Kelly McCauley Conservative Edmonton West, AB

No, I don't think anyone ever does.

12:45 p.m.

President and Chief Executive Officer, University Health Network

Dr. Kevin Smith

No, I agree.

I think if health is to continue to be mostly operated provincially, then I think there has to be a collaboration between the federal government and the provinces, but I suspect that the stockpile is advantaged by being weighted to the provinces. While I recognize that the Government of Canada does also have responsibility for indigenous persons and persons within the military, one would need to ensure that that could be appropriately managed, be it federally or provincially. While it is the responsibility of the Government of Canada, it's often still delivered by the provinces.

I think it's one of those ones where you could do a dive, and people more knowledgeable than I on both procurement and pandemic stockpiling should come back. I would encourage us to look around the world at who did this best during this outbreak and what we may do differently to mirror that in future.

12:45 p.m.

Conservative

The Chair Conservative Tom Lukiwski

You only have about 15 seconds, Mr. McCauley.

12:45 p.m.

Conservative

Kelly McCauley Conservative Edmonton West, AB

Okay, I'll just say thanks for your time then.

12:45 p.m.

Conservative

The Chair Conservative Tom Lukiwski

We'll now go for five minutes to Monsieur Drouin.