Health Committee on Nov. 23rd, 2006

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

As I said, the consultation is now with the communities in saying that we should develop something that will work, because 59% of the population is involved in tobacco consumption—

[Tina Keeper, Liberal, Churchill, MB]

That's why there's a great need for the program.

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

—and it's not good for society and not good for first nations—

[Tina Keeper, Liberal, Churchill, MB]

Well, that just points to the need for the program.

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

—so the consultation is taking place.

[Tina Keeper, Liberal, Churchill, MB]

Well, that's a good point--the need for the program. Thank you.

[The Chair, Conservative, Rob Merrifield]

Ms. Keeper, your time is gone.

Mr. Batters, you have five minutes.

[Dave Batters, Conservative, Palliser, SK]

Thank you very much, Mr. Chair.

I'd like to thank you, Mr. Clement, and all your officials for being here and for appearing before our committee today.

I want to commend you, Minister, on your heart health plan, your recently announced plan for autism, and the monumental announcement you made regarding prenatal care on reserve. Certainly you have shown leadership. I think it's fair to say that you inherited a lot of the problems in your department, and they can't be solved overnight, but you're tackling them.

I want to talk to you about juvenile diabetes. It's a topic that's very close to my heart. A good constituent of mine, 11-year-old Chloe Rudichuk, from Regina, appeared before this committee, along with Mitchell Burke, a constituent of Mr. Fletcher's. They were among 45 children with juvenile diabetes. I know you attended that luncheon, sir. You heard the case they made on behalf of the Juvenile Diabetes Research Foundation. I know you listened to them intently.

What the Juvenile Diabetes Research Foundation is suggesting is that they're looking for $25 million a year from the federal government for five years. That will then be matched by the JDRF. In essence, it will be a partnership.

Canada has been a research leader in diabetes and certainly in the search for a cure for type 1 diabetes. The vast majority of research money, Minister, is directed towards type 2 diabetes. There are certainly more people with type 2 diabetes, but would you agree that there's a need for more money to be invested towards juvenile diabetes research, and will you and your officials take a good look at the JDRF partnership proposal?

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

Thank you very much for the question.

I did enjoy meeting directly, as you did, with moms and dads. We tend to create organizations and so on, but really we were talking to moms and dads and kids, and I found it just terrific that they made their trek to Ottawa to talk to us.

In terms of some of the facts and figures for the committee record, in 2005-06 about $6.6 million was committed from the Canadian Institutes of Health Research for type 1 diabetes research, and, you're quite right, for type 2 it was $11.4 million--so it was $6.6 million versus $11.4 million, type 1 versus type 2--but there was also $12.8 million for general research on diabetes and its complications, so that could have been involved generally with diabetes, of course. There's also something called the Canada Foundation for Innovation, which has spent about $27 million over the last few years supporting diabetes research infrastructure across Canada.

That's the state of it right now on the research end. Obviously we heard the case.

You and I are in this room, while over there another committee meeting is going on in another room; they're talking about the economic situation as a prelude to a budget next year, and we'll all be waiting for the budget, I'm sure.

[Dave Batters, Conservative, Palliser, SK]

Thank you, Minister. I know that topic is also near and dear to your heart.

I would be doing my province an injustice if I didn't bring up the doctor shortages that exist in my home province of Saskatchewan, and it is certainly a wait times issue. Under the provincial NDP government in Saskatchewan--and many people would be surprised to learn this--we have the highest health care wait times in Canada. So I want to know from you, Minister, how we're going to tackle that, not just in my home province but throughout the nation.

Clearly we have to train and retain more Canadian health care practitioners, but what is this government doing to help foreign-trained doctors, nurses, and other health professionals to become licensed and to integrate into the Canadian health workforce? What are you doing to attract and then retain foreign-trained doctors, nurses—

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

Sure. It is absolutely a critical issue, as I mentioned earlier.

Parts of the announcements I made earlier in the week were designed specifically to assist in those issues--to assist prospective physicians to obtain the information, get connected to the right people, and then be certified if they meet our standards.

I think I'll leave it for some experts to go into a little bit more detail on that.

Frank, are you prepared to talk a little bit about some of the details?

[Frank Fedyk]

Sure.

The minister announced money for the Medical Council of Canada to develop a standard national knowledge exam and performance assessment for international medical graduates. An international educational professional centre was established in Ontario with funding of almost $16 million. An orientation program for internationally educated nurses, pharmacists, and other health professionals was developed to help them adapt their practices to the Canadian health care system; $599,000 goes to the pharmacy faculty in Toronto for that project.

As well, Manitoba received $1.4 million for an assessment in registration requirements and appointment opportunities for internationally educated health professionals in Manitoba. There is funding for all jurisdictions. We haven't concluded one with Saskatchewan; there's money set aside for that province as well.

Those are some of the items.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Madame Demers, you have five minutes.

[Nicole Demers, Bloc, Laval, QC]

Thank you, Mr. Chairman.

Good afternoon Minister, ladies and gentlemen; thank you for being here.

Minister, I would like to begin by thanking you for having extended Insite’s license until December 2007.

Minister, you are investing an additional $18 million in a training program for medical doctors. However, we all know that access to good health care is not only a question of professionals being available but also of sufficient and adequate equipment. Given that you have recently given a license to Mentor Corporation and Inamed Corporation for silicone gel breast implants, we can expect that a large number of women will need magnetic resonance imaging at least every other year. Even Inamed Corporation has said so in its documentation.

Have you planned to transfer funds to the provinces so they can purchase the necessary equipment to respond to these needs?

Mentor and Inamed in the U.S. have agreed to pay for a large part of the costs of operations should women require to have the silicone breast implants removed in case of rupture. Has Canada had the wisdom to require the same conditions from Mentor and Inamed?

I have another question, Mr. Chairman. Last week, Ms. Sharma told us that our request for documentation would cost $53 million for 65,000 sheets. I checked with 20 agencies who do technical and scientific translation and none asked for more than $6 million. Can you explain how things work at Health Canada for translation to cost so much?

Thank you very much.

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

I will speak first and my colleagues can complete the reply.

With regard to funding and financing, it is of course up to the provinces and territories to fund health, hospitals and doctors. I am convinced that a process exists in each province to ensure health services to women who need them.

As for the costs of translating documents to satisfy committee requests, I have heard about the issue and it worries me greatly. If there are other ways to provide the information, I will be happy to do so because I want to satisfy the committee. I don’t want to have—

an argument with you over the cost of the materials. I would like to have as much material as possible before you, but we also have an obligation to the taxpayers. If there's some compromise, then I'd be more than willing to see whether we can accommodate that.

Susan, do you want to add anything?

[Susan Cartwright]

No, I'll just reinforce that.

We are looking into other solutions to provide the information at a justifiable cost to respond to the committee’s needs. We will inform the committee regarding those solutions.

[Nicole Demers, Bloc, Laval, QC]

Dr. Butler-Jones, I am pleased to see you among us again. I would like to know what you think of women having to pay costs that are over and above those covered by the health system. It seems to me that your role is to protect the health of all Canadians.

What do you think of having authorized breast implants that are insured if they rupture? It is written in the company’s documentation. The responsibility for those costs falls on the health sector.

[Dr. David Butler-Jones]

There are many aspects of the system to consider with regard to the choice of professionals to bring about improvements in health and image. The documentation says that, in this context, it is not so much a question of health but rather of choice. Moreover, there are also other types of cosmetic surgery that impact the body.

It is a clinical question that a woman must discuss with her doctor. There are many such situations.

In my opinion, there are good and bad choices to be made and it is not up to me to dictate this issue.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Just for the committee, I believe it was a bit of a shock to all of the committee when we learned at the last meeting of the $55.9 million cost to get information to the committee. I believe no one on the committee would have discerned that it would have taken anything near that kind of funding for the request that was made for information. I believe there's a motion to re-examine and try to discern why it would take that kind of cost. That is just to let the minister know we'll be revisiting that matter, I'm sure.

Ms. Davidson, you have five minutes.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you, Mr. Chair, and I'd like to thank you, Mr. Minister, as well as the other members who are here, for attending our meeting today. I certainly appreciate your being here to answer our questions.

Mr. Minister, I know you're well aware of the health care situation in the province of Ontario. Since that's where I'm from, that's the one I'm most aware of as well. We all know wait times are a huge problem. We're all facing long waits. We're all facing doctor shortages--most of us are, in any case--and shortages of family doctors in particular. We know that the people affected by hepatitis C had a long wait, and I think it's very commendable that a decision has been made on that. The human resources shortages definitely had to be addressed, and I'm certainly glad to see you've done that.

We've had people who have been concerned about all the other things we've talked about here today too--the autism, the heart strategy, the cancer strategy, and so on. I know that people in general are impatient, and it is understandable that they're impatient; they've been waiting a lot of years for something to be done. I think it's commendable that there is some hope that we are moving forward; I think people understand it, and they can see some movement on it, so although they are impatient, I know they're thankful that there is progress in sight. I just wanted to reiterate that.

In many cases, we're at a crisis stage in our health care system. It's not something that can be fixed overnight; it's going to be a long, slow process, and I think everybody needs to realize that.

There is one thing I wanted to ask you about. In my riding I have several children suffering from autism, and I have one family in particular that has taken very much of a lead role on autism in the provincial association in trying to move things forward with an autism strategy.

The challenges these families face are tremendous; they're horrendous, in many cases, and I know you're well aware of that. I know you have looked into this issue, and we've discussed it previously in different forums. I was very pleased to see some announcements were being made about autism. Could you please outline the announcement you've made?

I know that solutions or treatments for autism are a shared jurisdiction--there are provincial or territorial areas and there are areas where perhaps the federal government could help. Could you give us an outline of what you've done, and what you see as the federal role for autism?

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

Thank you very much, Mrs. Davidson.

Two days ago I was happy to announce, on behalf of the Government of Canada, a package of initiatives on autism spectrum disorder relating primarily to knowledge and research.

Let me just outline.... There are five particular points. I think I would characterize them as focusing our research better by establishing a research chair. We do a lot of research at the federal level on autism--the causes of autism, possible treatments, those kinds of things. Some questions have not been answered yet. Why do certain parts of Canada seem to have a greater prevalence of autism than others? It seems some basic questions haven't been answered. I believe establishing a federally funded research chair will help our country get to some of the answers, which will then help us as a society deal with the issues that are raised.

The second important thing is that I believe there is a federal role, through the Public Health Agency, on greater surveillance programs. Perhaps it is both sides of the same coin, but until we can identify.... We don't even know how many kids or how many people in Canada have autism or one of the ASD disorders. Surveillance is going to be important, because when you actually know what you're dealing with from coast to coast, you can tailor your programming and focus your research.

I believe those are helpful measures. They certainly were taken that way by some of the stakeholders. From my perspective, I'd rather do something focused like this. Some would say--I think I said on the day--it is modest. I didn't announce the end of autism as we know it, but I did say there is a role we can play and that we should be constructive and actually get something done.

I believe strongly in that. I'm hoping this will make a difference for lots of moms and dads and kids.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Ms. Brown, you have five minutes.

[Bonnie Brown, Liberal, Oakville, ON]

Thank you very much.

Thank you, Minister, for coming.

Where is the deputy today?

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

I can talk to you about it later. There's a personal thing he has to deal with.

[Bonnie Brown, Liberal, Oakville, ON]

Thank you.

I'm impressed with your comments around the autism file and the need for surveillance and research and then policy and response based upon the research. That's why I'm surprised to see in your savings list the elimination of Health Canada's policy research program. Without that program, how are you going to do the surveillance and the research that will lead to good policy development?