Health Committee on Nov. 23rd, 2006

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Good question. I'm sure someone has an answer. I'm sure we're not eliminating all of our policy research programs.

No. Okay. That's the good news.

Someone can perhaps give you a bit more detail.

[Frank Fedyk]

The health policy research program was one very small program within the department. Overall we have over $800 million invested in policy research, through both the Canadian Institutes for Health Research and other programs within the department. We consolidated the research in there and we have adequate funds available for supporting those.

[Bonnie Brown, Liberal, Oakville, ON]

I find that surprising, Mr. Minister, because one would think that with a title like “Health Canada's Health Policy Research Program”, it would be the overarching program that coordinated the smaller programs you were referring to, but I take your word for it.

I'm also thinking that it's too bad you didn't use the funds between February and now, to the tune of $12 million, that were health policy grants. I guess those would be outside bodies doing policy and research for you. When you combine them, you've cancelled just under $20 million in research that could have sometimes provided you with the good information on which to make these judgments.

I'm also concerned about something that was in The Globe and Mail a couple of weeks ago. It says, “Private clinic's lax rules blamed for death”. This was the situation of the woman who died after six hours of surgery in a private clinic in Montreal.

I know the supervision of health care is provincial, but considering the growth of particularly these cosmetic private clinics and the coroner's statement that “...right now, surgical clinics like the Clinique de chirurgie esthétique Notre-Dame escape the legal guidelines and almost all the control mechanisms that are the fate of public establishments"--and I predict there will be a growing number of these clinics, what with the approval of the breast implants--I'm wondering if there is anything you can do, even from the point of view of a bully pulpit or at a federal-provincial conference, to try to make sure these places where women's health is at risk are supervised and are inspected and have to live up to the same rules.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

I can tell you, as I understand it from the media reports as well, that Quebec Health Minister Philippe Couillard is intending to take the report under advisement and respond in due course. So I do believe it is a topic of conversation in the Quebec health community. I think your words are wise to him, and I hope you take the opportunity, if you wish, to share them with him.

[Bonnie Brown, Liberal, Oakville, ON]

I'm wondering if you would commit now to making sure that somebody at Health Canada also gets a copy of that report, because I don't think it will be limited to some clinic in Montreal, particularly considering that since the approval of those breast implants, my local municipality is now the recipient of full-page ads, with no mention of complications, with no mention of any wait time to get implants removed. I would guess this ad probably cost about $10,000. We're seeing it weekly now from a plastic surgeon, enticing women to come for cosmetic purposes and submit their bodies to this.

You and I have had a private conversation about this, but I think this death in Montreal makes it more urgent, because I think you're going to find these clinics are growing and growing and are being advertised to the public as something desirable.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

As a brief response, as you know, the decision was made to approve with conditions, and there are a number of conditions, one of which is that the manufacturer has to, in good faith, educate the woman about the impacts of breast implant surgery.

Here's one example of one company with all the information about pre-op and post-op care, what complications there could be, and so on. I think it is important that manufacturers have a requirement--which, I will say before this committee, I will to the best of my ability strictly enforce--to educate women, to ensure that they have all the facts before they make a decision about their body. That's certainly my commitment to this committee. We know that's an important part of this, and I'll certainly take your comments under advisement.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Mr. Epp, you have five minutes.

[Ken Epp, Conservative, Edmonton—Sherwood Park, AB]

Thank you very much.

There's no doubt about it that in people's minds, rightly or wrongly, one of the biggest issues is wait times, and I was wondering whether you and/or your officials could inform the committee as to what you have done specifically to address this issue.

For example, because the delivery of health care is in the provincial jurisdiction, I would think that you may have had some meetings already at the federal-provincial levels with the health ministers, or maybe there are more meetings planned so that we can start cooperating with all of the provinces to achieve some actual, perceivable, measurable, reduced wait times.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Wait times and wait time guarantees have been topics of conversation between me and my provincial and territorial counterparts during two meetings. A third health ministers' meeting is being planned for two weeks from now, and wait time guarantees and wait times will be a topic of conversation.

In the provinces, we are seeing different rates of warming up to this topic. I believe Quebec and Manitoba have gone the farthest. With my announcement on Monday, we have shown leadership in our sphere of competency. I am quite convinced that more can and will be done as we move forward.

There are local factors. New Brunswick just had a provincial election, so the new health minister has just taken his seat and is getting to know his portfolio. In Alberta they are in the midst of a leadership election, so my ability to have a meaningful dialogue with Alberta kind of phased out over the summer. People did not want to bind any new premier or leaders. But I expect that to ramp up again once the leadership is over in Alberta.

Premier Campbell in British Columbia wants to see robust reform and improvement in the British Columbia health care system. But they were just finishing a consultation process, and it was difficult for them to be a partner with us until they had finished it.

As you move across the country, we have 14 health ministers including the federal one. Consequently, there are some local conditions that either benefit this project or retard it. But I've said this publicly and I'll say it again: I believe that wait time guarantees are inevitable. Once the provinces decided that they would establish clinical benchmarks, you couldn't say to a patient, “The benchmark for your procedure is four weeks, but we're not going to do anything to make sure you get it.” I don't think that position is tenable over the long term, especially with 85% of Canadians wanting accountability of the health care system to the patient through wait time guarantees. Any resistance we face won't continue for any length of time.

[Ken Epp, Conservative, Edmonton—Sherwood Park, AB]

Recently we met with the Capital Health Authority in the Edmonton area. They have some interesting projects going, particularly in the areas of their specialty. They have some good procedures. They're doing heart procedures on infants, and there's a lot of good work going on with diabetes. They mentioned to us that there were now a number of patients being transported from British Columbia to Edmonton to undergo procedures. That seems to be a good process, because you'll end up with specialties in an area where they can efficiently do these procedures. This type of thing should be funded, but the funding factor gets you into a bit of a hassle when you have interprovincial transportation of patients.

I was wondering whether you have any plans to address that issue when you meet with the ministers.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

It certainly is a topic of conversation. I want to assure you of that. The Capital Health Authority is a very innovative body, and Sheila Weatherill and I have had numerous discussions. They're ready to go to the next level, but we have this little thing called democracy, and we've got to wait for the leadership race to be over in Alberta. With the new premier, I'm sure it will be a topic of conversation. So I would urge a little patience. I think we'll see some interesting stuff coming out of B.C. and Alberta in the months ahead.

[The Chair, Conservative, Rob Merrifield]

Thank you.

Ms. Dhalla.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Thank you, Minister, for all your answers. Despite what my colleague Mr. Fletcher says about taking the high road, I think everyone around this table, regardless of political stripe, is concerned about the issues and the challenges we face in the health care system.

As a provider, I've seen this first hand. You mentioned that 85% of Canadians want a wait time guarantee. You described very eloquently what provinces are doing. Canadians are also looking to the federal government, whoever is in power, to ensure that they deliver results. People are getting sick and tired of having to wait. The progress made last year was a significant step forward. You mentioned a number of different initiatives you were carrying out. The last Liberal government invested $5.5 billion for a guarantee of wait times reduction. I would hope that your government would follow through in the next budget.

The other topic I want to touch on, before I give it over to my colleague Hedy Fry, is the national immunization strategy. Funding is up for renewal at the end of March 2007. They are quite scared. They have to sit on the fence, as they have not heard back from you. You have already made significant progress on the national immunization strategy, and I hope you continue to move forward.

There is another initiative that you need to move forward on—the national pharmaceutical strategy. The report was released in June 2006. They made a series of recommendations, including catastrophic drug coverage, an important issue to many Atlantic Canadians. We have to have the leadership. We need to have an action plan. We want you to invest the time, the resources, and the effort to make sure that your government delivers on those fronts.

I will now turn it over to Hedy Fry.

[Hedy Fry, Liberal, Vancouver Centre, BC]

I'd like to throw my bit in so that you can answer everything together. We talked about pandemics. I know Dr. Butler-Jones has his finger in that pie, but we're talking about a pandemic that has one of the highest mortality rates in the history of the world, HIV/AIDS.

At the international AIDS conference you promised to reveal a plan of action soon. Well, everyone is waiting to see the plan. We still haven't heard. This was a very controversial issue, because the Prime Minister did not go. But you promised there'd be a plan, so we would like to hear what it is.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Shall I answer that question first?

[Hedy Fry, Liberal, Vancouver Centre, BC]

It's up to you.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Well, you don't give a politician a chance to pick what answer he's going to make.

[The Chair, Conservative, Rob Merrifield]

You're only going to have two and a half minutes to do it.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Let me address the HIV/AIDS issue. You are probably aware that we are doubling the funding to $84 million a year for persons suffering with HIV/AIDS in this country.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thanks for renewing that.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

That's very important, and we're having a great consultation with some of the agencies to see how we can make the money go further. We want to target it to places where it can do the most good. I want to assure you that's important.

There are other announcements forthcoming. I will not be making them at committee today, but they are forthcoming.

As for delivering the results that Ms. Dhalla mentioned, you're absolutely right. One of the frustrations of the job is the 2004 health accord signed by Mr. Martin with the provinces. It's difficult for the federal government to insist on results, because there are no strings attached to the money. I think a great opportunity was missed in this country with the little part missing in that accord.

I'm absolutely committed to working with the provinces and territories. My provincial and territorial counterparts know that people want results, and I will continue to work with them in a spirit of collaboration and cooperation.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Can you address the catastrophic drug coverage?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

I knew I forgot one. That is part of the national pharmaceutical strategy discussion. The paper has a number of elements in it, including catastrophic drugs. It also talks about ways to contain costs better. Are there ways we can collaborate better to ensure that there's access to drugs at an affordable cost to the system? I don't believe you could talk about one without the other. Doing one helps pay for the other. That's the kind of discussion we're going to have at the health ministers' meeting in two weeks' time.

[The Chair, Conservative, Rob Merrifield]

Mr. Fletcher.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Thank you, Mr. Chair.

I am intrigued by the Liberal member's comments. I remember when the wait time guarantee was announced during the election in December of last year. My campaign office was on Portage Avenue in Winnipeg. The Liberals, during the election, criticized the wait time guarantee that the Prime Minister announced. It was about a month before the Liberals essentially endorsed the Prime Minister's response.

Minister, during this presentation you've taken the high road, and you've demonstrated your non-partisanship. You mentioned provincial governments, Conservative governments, Liberal governments, and NDP governments. I wonder if you can give us some insight on how you are able to bridge these partisan divides and these jurisdictional issues that seem to have plagued the debate in health care for so many years. I wonder if you could discuss your role as provincial Minister of Health in Ontario, and your role now, and compare for us how having experienced both roles has enabled you to accomplish so much in such little time.