Health Committee on May 7th, 2007

[Dr. David Butler-Jones]

The recommendations are based on the studies in terms of the age group 9 to 13.

[Susan Kadis, Liberal, Thornhill, ON]

To 26.

[Dr. David Butler-Jones]

Yes, it's available for up to that age. But in terms of the focus of a prevention program, you want to get to kids before they're actually being exposed to the virus.

[Susan Kadis, Liberal, Thornhill, ON]

But it wasn't tested on this age range, the prepubescent girls. I only want to confirm that.

[Dr. David Butler-Jones]

Well, certainly we're working from the national advisory committee, which we use to assess the evidence to provide advice as to the appropriateness on what it should be. As for what was involved in all of their assessment of that, I don't have all that information. But they are the ones we look to.

[Susan Kadis, Liberal, Thornhill, ON]

On the issue of the bulk buying, are you interested in taking up on that proposal being put forward by provincial health?

[Dr. David Butler-Jones]

There are a number of things the provinces are putting forward and we will certainly look at all of them, not only that issue of bulk buying.

[Susan Kadis, Liberal, Thornhill, ON]

The other issue I've noticed is a discrepancy in the money between the estimates and the budget in terms of the cancer strategy. It's $50 million in the estimates and $52 million in the budget document. I'm wondering where the $2 million is. I noticed that discrepancy.

[Morris Rosenberg]

I believe it's $50 million that's flowing to the Canadian Strategy for Cancer Control, $1 million to Health Canada, and $1 million to the Public Health Agency.

[Susan Kadis, Liberal, Thornhill, ON]

What role will the federal government play? Perhaps I could very briefly get a response to that. Because it's being given off to another body, will we play a passive or active role in a cancer strategy?

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

Certainly an active role. We're on the body itself. We're the funder of the body. But we recognize that there are many other centres of expertise, other than Health Canada or the Public Health Agency of Canada. So we're all going to be in it together.

[The Chair, Conservative, Rob Merrifield]

Okay. We'll move on now to Ms. Lynne Yelich. The floor is yours for five minutes.

[Lynne Yelich, Conservative, Blackstrap, SK]

Thank you, Minister.

I want to ask a little bit about the national mental health strategy, because I think it's something that's really important. It's probably one of the most silent killers, and it certainly, I think, overlaps with some of the other issues and strategies you're addressing.

My question is, has there ever been any national strategy on mental health? Where was it before this announcement or this particular...I guess I don't have anything in front of me to say it's a strategy. Where was it before? Where was it funded? How was it addressed? How do you define it when it comes to mental health?

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

Thank you.

You know, the report by the Senate Standing Committee on Social Affairs, Science and Technology really was amongst the driving forces here, although I think society was moving in this direction as well. The committee called their final report, last May, “Out of the Shadows at Last”. I thought that was a very appropriate title, really, because mental health and mental health strategy has been in shadows--in the workplace and in terms of being in the forefront of public policy in health areas in the past.

That has changed, and is changing. What we're seeing now, through the establishment of a Canadian mental health commission and making that another arm's-length organization.... Again, we're using this approach not just in the cancer care area or the cardiovascular area but also in mental health. It will allow practitioners in the area and allow people who have had exposure to mental health issues to be part of our approach to this issue.

That's revolutionary in this country. It's kind of old hat in some other countries, but it's revolutionary that we've taken this approach of really levelling out the playing field, saying that we're all on the same level, we all have something to add, we all have something that may be appropriate to establishing the solutions. So that's what's new about this.

What also is new is an understanding that within our own area of competency, the federal government can play a leadership role--working with provinces and territories, of course--in terms of understanding what the best practices are, what the surveillance is around the country on a particular health issue, such as mental health, and how we can learn from one another on the best way to proceed.

So I think all of that is new. To have it in mental health illustrates that mental health now is a mainstream concern. It's not something that is an add-on or an afterthought; it's something that can be at the core of some of our most profound health issues.

[Lynne Yelich, Conservative, Blackstrap, SK]

I know in Saskatchewan, in my own riding, it has been an issue, especially for parents and families who are dealing with something like schizophrenia. They don't know where to go. So I just wanted to know more about that.

Also, when people talk about aboriginals being under-represented in professions--for example, as doctors or nurses--is that not something...? Or where do the provinces step up to the plate here?

In our province there are a lot of seats open for particularly aboriginal or disabled. So they are doing that, but what they don't do is open more seats to accommodate a lot of people.

Is it not a little more the responsibility of the provinces to make sure of this? You are, I understand, funding some of this to make sure that aboriginals do choose these professions.

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

One thing we're doing is in the area of scholarships and bursaries. I was pleased, in my own riding of Parry Sound—Muskoka, to present five bursaries to Métis students, four of whom had chosen nursing and one of whom had chosen to be a family physician.

So that's just one example. The same goes for first nation and Inuit; we are there in terms of scholarships and bursaries.

I had an interesting exchange with a first nations leader that shows how complex this issue is. I told him that if we could get more of the kids in his community into nursing school, it would help eliminate some of the pressure on nurses in the community. They could practise in the community. And those are good jobs--good jobs for any nursing student, first nation or otherwise.

His reply was, “Great idea, Minister, except that right now in my community, the kids drop out of school, or they finish high school without the necessary science courses in order to be accepted into nursing school.”

So you know, I want to fix the health care system, but we also have to fix the education system. These are interconnected issues. We could put $1 billion more in first nation and Inuit health care, but if we don't fix some of the education issues, ultimately our health care outcomes will be better and then will degrade again.

This is why we have to tackle some of these issues simultaneously, and that's the approach I'm taking with respect to the tripartite agreements I'm pursuing with first nations and with provincial governments. Each one of us, each leg of the stool, has something to add to make the process better or to make the results better.

[Lynne Yelich, Conservative, Blackstrap, SK]

Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Now we'll move on to Madame Gagnon.

[Christiane Gagnon, Bloc, Québec, QC]

Minister, I believe Ms. Bennett raised this issue earlier, but I'd like to go back to it. You know that, in the Senate, they're discussing a bill on drug exports to the United States. We would be lifting the prohibition from buying drugs in large quantities in Canada. If this legislation were passed and the medications cross the border to meet the demand of Americans—I don't have any figures, but the U.S. market is enormous—that could have serious repercussions for supply and the reserve in Canada and Quebec. That could affect the industry's balance in maintaining the inventory of available medications. You also have to think about expiry dates, production and so on.

That doesn't seem to trouble you. I met with people from your department who said that that scenario wasn't likely, that the exchange rate had fluctuated and that there was now new insurance to reimburse the cost of medications for part of the U.S. population. Apart from all that, if it becomes too attractive for them—medications are much less expensive in Canada—what is your plan to prohibit this practice? Why don't you prohibit it automatically?

Various countries are conducting transactions to buy medications. Why go headlong in this direction and allow citizens and businesses to make wholesale purchases in Canada. What is your action plan? What act could allow you to prohibit this practice overnight, in view of the fact that this is what is happening? It is happening; we mustn't put our heads in the sand. This is a promising market for the Americans, who need drugs. Shouldn't the industry produce more drugs?

Answer that question, minister.

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

Thank you for your question.

We of course continue to monitor the situation. This year, the problem in the country has declined by 60%, for various reasons, including the value of the Canadian dollar, the policies of the Bush administration and so on. We're monitoring the situation in the U.S. Congress. If there is a problem regarding the exporting of medications, our challenge, our responsibility will be to react and to protect drugs for Canadians.

[Christiane Gagnon, Bloc, Québec, QC]

Would the prohibition be established under an act? What mechanism would you put in place to protect the market?

First of all, we have to respond to the market. That doesn't appear to be that easy. We could simply produce more, but it seems that a rate has to be respected for an industry that has a limited production capacity. These are products with a limited shelf life.

What would be the instrument for you? You say yes, but what would you do if that happened tomorrow? We can't be concerned for tomorrow, but the industry people are concerned. I've spoken to some of them and to pharmacists, who told me that some products were no longer available because people came and bought them in Canada. There have been articles on the subject in La Presse. I think we have to look further ahead and be a little more proactive. You say it's not really a problem right now because there is a veto and everything is controlled through certain prohibitions by the United States.

If the bill were passed, I think we'd have to have in mind what control mechanism we could have.

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

I'm going to respond briefly, Mr. Chairman.

If there is a problem, we will of course have to react, but there clearly isn't one right now. If a problem arose, a bill could be tabled, if necessary, but it could be a measure other than a bill. The deputy minister told me that, to address this problem, the Minister of Health could use protocols and powers that are ready to be used.

Ironically, this results from the Cold War with the communists, but it could eventually be with the United States. Whatever the case may be, I can tell you that, if a problem were to arise, I could use measures now. If necessary, we would table a bill.

[The Chair, Conservative, Rob Merrifield]

Okay, thank you.

Mr. Fletcher, you have five minutes.

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

Thank you, Mr. Chair.

Minister, we had a real problem when we took office in regard to the fact that hepatitis C victims outside the 1986-to-1990 window had not been compensated. This government has found the moneys, $1 billion, to compensate these victims. I wonder if you could provide us with an update on how the compensation is going. I know there were a lot of challenges with the court system. I wonder if you could share with us the progress on that front.

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

Sure.

This was, as you recall, a topic of conversation in this very place a year ago, and of course, this committee quite rightly was concerned about making sure that promise was fulfilled. Since that time, of course, we were able to announce the package of the final settlement with those individuals who were infected before 1986 and after 1990.

The next stage of the process, after the final settlement, was to have that settlement reviewed by supreme courts in provinces, I suppose, and we are nearly there. I'm led to believe that three out of four courts have approved the deal. There is one court to go that is dealing with what I would consider to be a relatively minor issue, and I really can't comment any further on that. But we are down to the very short strokes on it.

You have certainly my commitment that once we are through the legal approach that has to be done—I can't shorten that; that's up to the courts—that we have done the necessary work in terms of the administration--