Health Committee on May 7th, 2007

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

I hope so too because, otherwise, the problem would be even more serious.

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

We'll have to correct this problem, if that is the case, of course.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you.

I don't know whether you know that the Official Languages Committee has made a major tour of Canada to meet with the various minority communities. Among the important topics that were addressed with the minority Francophone communities, there was, of course, improved access to health services in their language. This issue seemed to be a major priority for them.

You also know that, in each of the provinces, the French-language health networks, through a federal-provincial-territorial partnership, were of course able to work and develop a project framework called “Préparer le terrain”.

Can you tell us whether, in the anticipated budgets, there is a long-term extension, for example, of this program to support the implementation of action plans?

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

Mr. Nouvet can answer your question.

[Marcel Nouvet]

In the past four years, Health Canada has spent a lot of money as part of these initiatives. An evaluation currently underway will be published in the fall of this year. That evaluation will enable us to make appropriate recommendations regarding the need to continue funding these investments.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

What exactly are you evaluating?

[Marcel Nouvet]

We're evaluating the extent to which the pilot projects, which have been undertaken, again with the approval of the provinces and territories, have in fact produced results, improved access for Francophones living in a minority setting, and so on. We want to know whether they have delivered the goods.

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

I have nothing to add.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Mr. Chairman, is my time up?

[The Chair, Conservative, Rob Merrifield]

Do you have a very short question?

Okay, ask a very short one.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Absolutely.

Minister, earlier you said that you were preparing your response to the report on obesity. In your response, are you going to take it for granted that, in some provinces, measures, plans and initiatives have already been developed, are in place and allow for a certain respect for jurisdictions?

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

Absolutely. It's important to respect the jurisdictions of the provinces and territories. In Quebec, for example, there is now an action plan to combat obesity in children. We have to ensure that the federal government

doesn't reinvent the wheel.

I think it's possible to have a federal plan that respects the jurisdictions of the provinces, while providing national leadership in the context of this situation.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Now we'll move on to Mr. Patrick Brown.

[Patrick Brown, Conservative, Barrie, ON]

Thank you, Mr. Chairman.

I wanted to touch upon wait times, Minister. I really think there are some quiet success stories that we're seeing across the country. In anticipation of your visit, I asked my local hospital for some stats, because sometimes it's better to look at how a federal government policy is working through the lens of your local hospital.

I asked our local hospital what the 6% increase in federal transfers to the provinces means for the Royal Victoria Hospital in Barrie. They told me they were able to do 606 additional cancer, cataract, and joint replacement surgeries and that there were 1,080 additional MRI hours. They've been able to expand the MRI service from part-time to having the machines working 24 hours a day. That has allowed the wait times for an MRI at RVH to go from 54 weeks to 7 weeks in the last 16 months. I understand there are lots of success stories happening across the country because of the 6% increase in health care funding to the provinces.

I wanted to get you to touch upon what the positive synergies are in the health care system that are allowing the provinces to see this reduction in wait times and how you are shepherding it. If I look back to when the wait times increased, between 1993 and 2005 there were negative synergies, whether because of the cutbacks to the Canadian health transfers at that time by the Minister of Finance for the previous government, or because of the Premier of Ontario between 1990 and 1995, when he limited medical enrolment and capped doctors. We saw Ontario really struggle with filling those voids in hospitals and communities where they struggled to find doctors. Those were the negative synergies.

What positive synergies are you leading the charge on that have allowed this incredible turnaround to where we're actually seeing reductions in wait times, rather than the increases that were the mainstay of the previous government?

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

Thank you for the question.

Let me say a couple of things.

First of all, from an evidence-based point of view--because I think your anecdotes are absolutely correct, but you should be assured that they're also borne out by the evidence--it's not just something great that's happening at RVH, and great that's happening in Barrie, but it's also happening nationally.

The Canadian Institute for Health Information, which of course is an independent body in terms of its research, came out with a report very recently, in the last few months, that indicated generally across the country wait times in the priority areas have been reduced by approximately 7%, I believe, and in non-priority areas have also been reduced by a lesser amount, but nonetheless by 2%. For those who were concerned that focusing in on the priority areas would mean wait time reductions there, while in other areas there would be wait time increases, there is at least evidence that it needn't be the case or that it is not the case. I think that's a good piece of evidence.

The federal government sponsored what we called a success conference. It was a conference into which we brought all the experts from across the country to talk about wait time reductions and to share their stories. We found that we had hundreds of people at the conference, and it was a revelation to many people.

What's going on in British Columbia and Manitoba? British Columbia was doing a lot of interesting work in primary care. Manitoba was doing some interesting work in cancer care. Ontario was doing some interesting work in cataract surgery. Nova Scotia was doing some interesting work in supplying nursing care in innovative ways. All of this stuff was going on in our country, and we didn't have a forum through which we could at least understand what was going on. Now we do.

I'm probably going to give my staff more work to do here, but if we can have those slide decks that were presented at that conference circulated through you, Chair, to this committee, I think you'd be very impressed with the kind of work that is going on. Of course the provinces and territories deserve kudos for that, but that is partially funded through federal dollars as well. By putting this in the shop window, I believe that the Government of Canada is pushing forward for innovation and reform in this area.

It's on our website, apparently, and so that saved them a few hours of work there.

[Patrick Brown, Conservative, Barrie, ON]

Minister, I know you're in continuous dialogue with the provinces. I think one of the finest things you've ever done was in your previous position as Minister of Health in Ontario. You opened a medical school in northern Ontario. As there are such shortages in northern Ontario, that's really been an example and has ingrained into doctors who have spent time there to actually practise in northern communities.

Have you ever had any conversations with the provinces on that topic of getting doctors into underserviced areas? It would be great if the provinces across the country followed the lead that you took when you were health minister in opening the one in Thunder Bay.

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

Of course that remains a topic of conversation. One of the things that are helping us is technology. Technology is our friend in this area, because those health professionals who find themselves in rural and remote northern regions of our country do have access through federal government investments in Infoway and other things like Telehealth, or telemedicine services. There's been a huge investment in digitization of radiology images and so on, which helps our physicians, our nurses, and other medical professionals be able to gain consultation outside of their catchment area. These things are occurring.

From our perspective, we are working with the Society of Rural Physicians of Canada. We have funded them to look at specific strategies for rural and remote areas when it comes to retention and recruitment of rural physicians. Obviously, as you are an MP from Ontario, you are familiar with the Ontario context, but this is something that affects all of us. For first nations and Inuit communities, the needs are great as well. We believe that within our area of competency and jurisdiction, we are being of assistance.

[Patrick Brown, Conservative, Barrie, ON]

Terrific.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Now we'll move on to Ms. Susan Kadis.

[Susan Kadis, Liberal, Thornhill, ON]

Welcome, Minister, and our guests.

My question is regarding the HPV vaccine to fight cervical cancer. Only two provinces, I understand, have signed the agreement: P.E.I. and Nova Scotia. Other provinces appear to be reluctant. They're concerned that the funding is temporary. Four childhood vaccines that are going to be sunsetted, as well as many other areas that are being sunsetted within this estimates document, are of great concern, which I think needs to be addressed as does the general direction of the government.

Are you willing to take up the idea that health officials provincially have put forward, I believe, to stockpile the vaccines so they can access them? There's a lot of uncertainty regarding the commitment on the part of federal government to this very important area. Again, you have a cancer strategy, which has been referred to, and you are lapsing the areas of the other four childhood vaccines. What is really going on with the HPV vaccine to prevent cervical cancer?

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

I will defer to Dr. Butler-Jones in a second, but let me say initially that I believe it is an appropriate role for the federal government in this area to fund emerging vaccines and emerging therapies using vaccines. That means we are funding the HPV vaccine for a total of three years right now. It means that now more mainstream vaccines, we believe, are the role and responsibility of provincial and territorial governments.

As I said at the outset, general funding for PT governments increased by $1.2 billion this year alone as part of the 2004 health accord. We believe that provinces and territories are best equipped to make their decisions on what their priorities are within their health budgets. In terms of leading-edge vaccines, for instance, such as the one against cervical cancer, we can at least be a mover to get these into our society, whereas before there was some reluctance by PTs to do so.

Perhaps, Dr. Butler-Jones might want to add something.

[Dr. David Butler-Jones]

Thank you, Minister.

Very briefly, monsieur le président, the vaccines clearly are one of the most cost-effective measures in terms of health that we can take, because it's doing something for the future as opposed to only for today. Often in the past, even though we had very strong recommendations around the utility and the cost savings, it could take up to a decade or more for provinces consistently to implement it.

The experience with the first fund showed that within two years virtually every jurisdiction--province and territory--had all four vaccines in place, whereas it often would take five to ten years or more for that implementation. Again, it has shown that it has been a useful thing in terms of encouraging and supporting provinces in that implementation phase, while respecting that longer term that is within provincial jurisdiction.

[Susan Kadis, Liberal, Thornhill, ON]

If I may follow up on the issue of the idea being put forward to bulk-buy, so that people will take up on this important initiative, are you considering acting on that?

Also, Mr. Chair, on the issue of the prepubescent young girls, I understand they were not in the clinical study.

Could you respond to those two issues?

[Dr. David Butler-Jones]

I'm sorry, the...?

[Susan Kadis, Liberal, Thornhill, ON]

The prepubescent girls were not in the clinical study, I understand.