Health Committee on May 7th, 2007

[Morris Rosenberg]

The rate the departments were required to use for 2007-08 main estimates was adjusted down to 18.5%. That will explain the reduction.

[Penny Priddy, NDP, Surrey North, BC]

So that would account for all of the numbers there in terms of not being staff reductions, but only the way the contributions are calculated.

[Morris Rosenberg]

With respect to the benefits, I believe so.

[Penny Priddy, NDP, Surrey North, BC]

That's yes? Okay, thank you.

Infoway, we know, is a very important piece of the whole pie of how health care works efficiently. A lot of physicians are telling me they aren't getting much help in how to use it. So while it's an important piece, I'm wondering how we're going to help physicians learn to use it and learn to use it efficiently.

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

To clarify, Infoway is leverage-funded, with 70% from the federal government and 30% from the provincial. It's designed to ensure that whatever software, whatever hardware, whatever system or network a province uses to move forward on electronic health records, it is interoperable. That is to say you don't have health authority A not able to speak to health authority B, or province C not being able to speak to province D.

[Penny Priddy, NDP, Surrey North, BC]

So there is consistency? I'm hearing there isn't.

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

Yes. In our part of it there is consistency. There may be some problems with whatever the province is doing.

[The Chair, Conservative, Rob Merrifield]

Thank you very much. Your time has gone.

But just for the committee, if the primary health care transition fund report could be sent to the committee instead of to Ms. Priddy's office, we'd appreciate that. And then we'll distribute it.

We'll now move to Mr. Fletcher. You have 10 minutes.

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

Thank you, Mr. Chair.

Thank you, Mr. Minister for coming, and thank you, officials.

Minister, the issue of chemicals seems to have come up a few times, so I'd like to ask about chemical management. Chemicals aren't just in cosmetics, they're all around us. They're in our environment, in our food, our clothes, and even in our bodies. I wonder if you could share with us what is being done to protect the health of Canadians and our environment from harmful chemicals.

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

Thank you for the question.

As I indicated, late last year the Prime Minister announced a first-ever chemicals management plan, which was designed to deal.... We have a very strict regime right now on the addition of new chemicals in the environment, but there is a series of 20,000 legacy chemicals that had not gone through the same strict process. Canada was the first country to get through that list of 20,000 chemicals to decide which ones merit further investigation and which ones are safe for the environment. Of those 20,000, 4,300 of them were found to still be of concern, or we needed more information. Those are the ones that are subject to the reverse onus provision with industry, saying we need proof. They need to show us the scientific evidence that those chemicals can be found in our workplace or found in our kitchen or found in our backyard without having a negative impact on our health and safety.

We've already published a list of certain chemicals that have gone through the process. There will be another list of chemicals published soon, and we're just aggressively going through all these chemicals clump by clump, section by section, to identify which ones should be removed from the manufacturing process or removed from our living space. That will continue until we're done.

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

Thank you.

Minister, you have experience with SARS, and in my home city of Winnipeg we have the national microbiology laboratory. When that was first being contemplated, SARS was not contemplated specifically. Now we hear from the WHO that there is fear of a pandemic. I wonder if you could share with us what is being done to ensure that Canada has sufficient laboratory capacity and expertise to identify and respond to any new influenza viruses or any other public health threat.

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

Thank you. I'm quite proud of our national pandemic planning. It has a number of different facets, including our ability to respond in a surge way to any nasty virus that comes along. It also involves working with the provinces and territories on antiviral strategies.

But perhaps Dr. Butler-Jones can talk a little bit about the role of the national microbiological laboratory.

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

Thank you, Minister.

And thank you for the question.

Certainly there are a number of elements, not just laboratory. But specific to laboratory, maintaining the federal reference laboratory, it's the only level four in the country. In addition to being a reference laboratory for provincial laboratories and others on these items, we also support the development of standards. So within the public health network, there is a committee specifically dealing with laboratories across the country and the kinds of standards, approaches, linkages, information technology needs, etc., that will allow us to better manage these issues.

As well, Canada is fortunate with the kind of expertise we have. We're seen as one of the leaders internationally, and we share that expertise internationally, as well as training people from other countries in our laboratory to improve their own methods.

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

Thank you.

And by the way, Dr. Butler-Jones, we're very proud of the team that you have in Winnipeg, with Dr. Frank Plummer, Allen Ronald, and many others.

Minister, what is probably most paramount for Canadians is that they want the health care they need when they need it. I wonder if you could share with us what the government is doing to improve the certainty of timely care in Canada.

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

Thank you for the question.

Indeed, as I referenced earlier, the real cornerstone of our approach to this is the patient wait time guarantees. If we were having this conversation a year ago, there would have been the Province of Quebec that declared that they were moving forward. We didn't have any of our national pilot projects in first nations communities or the pediatric pilot project out yet. Now, today, we have the first nations pilot projects, we have the pediatric project on children's surgery, and we have every province and territory committed to patient wait time guarantees.

I would expect that over the next few months, as early as the next few months, you'll start to see provinces declaring their guarantees, saying that 100% of the cases in cataract surgery, access to cancer care or cardiac care, can be delivered within a certain period of time as close to home as possible, or if not, that there is a plan in place to give that patient a choice and recourse within the publicly funded system.

That's the approach. It really puts the patient at the centre of the care. The federal government has taken a leadership role with our funding to allow that to occur. And the provinces and territories are now our partners to ensure that we move to this new level.

And I must say, this is a revolutionary decision. This is something that will change the face of our health care system and reorient it towards a patient-centred approach for years to come. And it's certainly gratifying to see it started.

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

I'm running out of time, Minister, but we're all very concerned here about the issue of mental health, particularly among young aboriginal people. I wonder if you could share with us what we are doing to address the high rates of suicide among that demographic.

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

Thank you.

Obviously the much-elevated suicide rates among young aboriginal people is of great concern to Canadian society as a whole. I was gratified to see in the budget that the national mental health commission initiative is funded and is starting to be up and running. But in the meantime, we do have a national aboriginal youth suicide prevention strategy, which is funded to the tune of $65 million by the federal government.

We're collaborating with aboriginal communities. We're working with our provincial and territorial counterparts. We want to get the experts who can advance some evidence-based suicide prevention strategies. That's there to support the mental health of our young people on-reserve within those communities, perhaps, and to devise some community-based suicide prevention programs.

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

Thank you.

Minister, we also have a crisis in regard to diabetes in this country. I wonder if you could share with us the status of the diabetes community-based programming.

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

Yes. Certainly from our perspective, there is a role we can play in terms of coordinating diabetes prevention and control in this country.

We have a strategy, which the Public Health Agency has the lead on, to fund community-based programs in this area. Preventing diabetes among high-risk groups has to be a priority. Supporting approaches for the early detection of type 2 diabetes, again, is a priority that we are funding, and of course the management of type 1 and type 2, if it comes to that. I just approved 41 community-based projects with respect to diabetes in these areas across the country. They will help on the ground with diabetes management and also diabetes prevention.

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

Minister, I wonder if you could share with us a little bit more about the Canadian Partnership Against Cancer. Cancer is projected to be the number one killer, over cardiovascular disease, of Canadians. I wonder if you could share with us what we are doing on cancer and also cardiovascular disease.

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

I probably only have time for one, Mr. Chair. I'll take cancer and maybe come back to cardiovascular.

Certainly I think Canadians can be proud that their national government is working with the provinces and territories on a pan-Canadian, national strategy with the Canadian Partnership Against Cancer. The thing that I think is revolutionary about this approach is that it's a bottom-up approach. It's not Ottawa saying, here's the plan, sign on to the plan; it's saying to the oncologists, to the practitioners, to cancer survivors, and to other public health experts, work with us on a level playing field on the plan against cancer.

So we're looking at better surveillance, better prevention, and better dissemination of best practices across the country, and of course, at coordinating the research and treatment options and those kinds of things. So you're going to see, over time, as we build up to this, that truly everyone is actually on the same page and is working together.

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

Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

We'll now move on to our five-minute time. We have five minutes on the opposition side and five minutes on the government side.

We'll start with Carolyn Bennett. I believe you're a little short of time, so you'll start first.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Thank you.

Minister, on all these things that you say are so important, I'm a bit worried that you have less money for almost everything we care about. Page 35 talks about the free market evaluation of regulatory process. In view of the fact that the Dorgan bill may come through Congress today and that there may be this big sucking noise as our drugs go to the States, which then could mean huge numbers of counterfeits coming into Canada, could you explain why you would need less money for surveillance? And are you planning audits and the kinds of things you would need to make sure Canadians know they're getting real drugs instead of counterfeit drugs?

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

Sure. Perhaps Mr. Fedyk might have a bit more to say about this.

On the particular public policy issue, certainly I can assure you that we're watching events unfold very closely in Congress in the United States. And of course, there has been some speculation on a presidential veto of the bill you mentioned. Clearly, we will let the Congress of the United States do what it wishes to do and let the executive branch do what it wishes to do, and if there is any evidence of a threat to supply for Canada, we will act. There's no question about it. That has to be our primary focus.

I don't know if you wanted to mention anything in terms of the resources, Frank.