Health Committee on June 6th, 2006

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

Thank you, Mr. Minister. Speaking as someone who's been involved in the file, I am 100% confident that you will fulfill our commitments. I think we're very fortunate that you're in charge of that file.

Another item that came up last year, Mr. Minister, was the Canadian strategy for cancer control. We had a motion that was brought forward by the Conservatives and adopted. My understanding is that the strategy was on the table for about five or six years, and the previous government refused to implement or fund this strategy. But you were able to get full funding for this strategy in your first opportunity to get it in the budget, which is actually quite remarkable.

I wonder if you could comment a little bit more on cancer and on what your goals are to deal with cancer and other deadly or chronic diseases.

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

Thank you. I think we were assisted in achieving that goal by the campaign platform commitment in which I know you had a very important part to play.

I can tell members of the committee that I do think there can be a pan-Canadian role, a federal role if you will, that does not, as I say, trample on the flower patch of the provinces. We all have our areas of competency and jurisdiction. We all know that provinces have the primary role and responsibility when it comes to delivering at least non-native health services. It's not my place to disagree with that.

What I can say is that we can advance some of our goals by greater coordination and collaboration. That's exactly what the Canadian strategy on cancer control is all about. There are things, as the provinces will tell you, that can benefit from a national collaboration, a pan-Canadian collaboration if you will, whether it's screening and prevention or research activities. A number of cancer advocacy groups are nationwide in their representation and scope. It does make a certain amount of sense to deal with them from a national perspective.

All of those things, I believe, can be accomplished and can mean that the federal role is one that is complementary to the provinces and territories rather than being at cross purposes with them.

Of course, we're doing it with the funding that was agreed to, that is in the budget, the $260 million. My hope and expectation is that we can, in a collaborative way, come to an understanding that involves a number of the advocacy groups and agencies, and the provinces and territories, so that we can do as much good as possible.

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

I have one last quick question, Mr. Minister. There was a significant investment in pandemic preparedness. You are considered to be one of the world experts because of your firsthand knowledge when you were Ontario health minister. I wonder if you could just flesh out a bit more what you've done for pandemic preparedness and why such a significant investment has been made.

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

Certainly the investment in budget 2006 will be very helpful as we move forward with some of our pandemic preparedness. With the creation a couple of years ago of the Public Health Agency of Canada...and Dr. David Butler-Jones' appointment to that position. We hope to have that sanctified by Parliament very soon. A lot of work has been done since the Public Health Agency of Canada was created, including a very important document, the first national pandemic planning document. Its first iteration was released in 2004. We expect to continue to improve that document and to continue to improve our surveillance, our containment strategies, our healing strategies, and our recovery strategies.

On the healing aspect, as you know, we came to a federal-provincial-territorial agreement to up the stockpile of antivirals to 55 million doses. The commitment of Canada, working with the provinces and territories, is that for anyone who is sick--based on our projections on a pandemic, which are all futuristic--we expect an antiviral to be available to that person.

I'm very proud of Canada's preparation for vaccine development; we are very far ahead. As you know, you cannot produce the vaccine until the exact mutation and strain of pandemic influenza is isolated, and we don't know that until it's amongst us. But there's a lot of preparatory work we can do, and we are doing that work. That work is funded. It is done in collaboration with the provinces.

Information-sharing with the provinces has come a long way. Information-sharing with international agencies has come a long way. One of the things I found to be quite frustrating with SARS was that the information-sharing wasn't there. The second thing was health human resources. In British Columbia, when nurses and doctors from B.C. wanted to help out in Ontario during SARS, there were so many impediments to that happening from a professional point of view that it just didn't happen. Now we're starting to have a protocol where we can eliminate those barriers and deploy HHR.

I'm getting the signal from the boss that my answer is a bit too long-winded. I'll wrap it up.

You can see that a lot has to be done but also is being done.

[The Chair, Conservative, Rob Merrifield]

Actually, the answers are very good, it's just that we want to honour the time allotted for individuals.

Thank you, Mr. Fletcher.

Ms. Chamberlain, you have five minutes.

[Brenda Chamberlain, Liberal, Guelph, ON]

Thank you, Mr. Merrifield.

I have a whole lot of questions, Minister, but unfortunately there's not enough time.

I want to talk a little about mental health. I'm from Guelph, and we have the Homewood Health Centre there. It's a fantastic centre, but there aren't enough beds for everyone. We have a lot of adult health care mental problems, but we also have a tremendous amount of kids who are having huge problems, including suicide. The beds just are not available for them. In a place like Homewood, for instance, they have an age stipulation, so they look at more adult clientele. But I do have people come to me from time to time with particularly youth.

I'm wondering if you can tell me what you're going to do as a government for these adults but also for the youth that seem to have no place at all. Could you give me some information on that, on whether there's going to be more money for mental health, and on how we're going to approach that as a government?

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

Thank you very much for the question.

Indeed, I want to commend you for Homewood. It's a place I visited as Ontario Minister of Health and Long-Term Care. It really is a beacon of hope in a sometimes rocky sea of despair, which is what we find in mental health issues frequently.

I believe passionately that mental health has to have its day, and it has to be the focus of a Canada-wide debate. It has to be something we take seriously as a society. I think those barriers are being broken down. Would we like it to be quicker and more complete? The answer is obviously yes. There are still some stigma issues, some coordination issues, and indeed some funding issues, as you referenced, in the way of that.

We have a number of strategies that are already in place. We do have a national youth suicide prevention strategy, which has $65 million over five years. It's focusing on aboriginal youth, which is where we can directly focus some of our programming. That's something I'd like to signal to you.

More generally, we have the work of senators Kirby and Keon, who released their report back on May 9, looking at national approaches, pan-Canadian approaches, to these issues. Again, not trying to take over the competency of the provincial governments, are there ways that we could collaborate and do some things together? Obviously the government is seized with that report as a society, and I'm hoping to respond once we have thoroughly reviewed it.

[Brenda Chamberlain, Liberal, Guelph, ON]

But, Minister, the problem really is that there aren't beds for these kids particularly--adults too, but for the kids. That's the strategy that I'm asking about--namely, how are you going to increase these beds? How are we actually going to get on the ground and get some help?

I have talked to parents, as I'm sure you have in both capacities--in Ontario, and now as a federal minister—who really don't know where they're going to go for help. There is so little of it around sometimes.

I know what you're saying, that we need a pan-Canadian approach and so on, but what actually are you going to do to increase beds?

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

I think it's fair to mention, though, that an extra $41 billion, as part of the federal tax base, is going to provinces and territories as a result of the 10-year accord that was signed in 2004. Much of that is destined to fill some gaps.

Much of it--as I said, $5.5 billion--is specifically dedicated to reduce wait times to increase access. I would expect provinces to do the right thing when it comes to mental health issues and make sure that mental health gets its fair share of the pie.

[Brenda Chamberlain, Liberal, Guelph, ON]

The Conservatives, with due respect, had talked about a Canadian mental health commission. Will you move on that?

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

Again, that's one of the report recommendations of senators Kirby and Keon, and I want to recognize that. I do recognize that--

[Brenda Chamberlain, Liberal, Guelph, ON]

Is that a yes? I don't want to be difficult, but is that a yes? Will you move on that? It was said in November that you would, as you went into an election. Will you move on it?

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

Listen, with the greatest of respect, these are all issues that could have been dealt with by the previous government but weren't. So--

[Brenda Chamberlain, Liberal, Guelph, ON]

And that's fine; that's a good answer, and we've been listening to it for six months. But this is something you promised in November, and I'm asking, will you move on it? It's an easy question: will you move on it?

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

I don't think this is a place to grandstand. These are significant issues.

[Brenda Chamberlain, Liberal, Guelph, ON]

With due respect, Minister, this is not grandstanding.

[The Chair, Conservative, Rob Merrifield]

Excuse me, but your time has gone. I actually stretched it out a little bit beyond gone. You might have a chance to get in on another round.

Mr. Dykstra--or Mr. Batters, okay.

[Dave Batters, Conservative, Palliser, SK]

Thank you very much, Mr. Chair.

Mr. Minister, officials, we do appreciate very much your time today in appearing before this committee.

Minister, access to new, innovative medicines and medical devices is one of the key elements that underlies a strong health care system. For years Health Canada has been the subject of intense criticism for the length of time required for drug and device product reviews. The chief complaint is that there's a huge backlog in terms of the number of drugs and devices put forward for approval and the amount of time it takes to get those approvals.

I'm wondering what the government is doing to ensure that access to medicines improves. Does Health Canada currently have a more timely regulatory process for drug approvals, and has the level of Canadian research in pharmaceuticals increased in the last few years?

I know this is of significant concern to the pharmaceutical industry, but it's also of significant concern to physicians, and to patients who are looking to get, in a timely fashion, treatments that are going to help them live happier, healthier lives.

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

I appreciate the question.

This is another area of frustration that patients have with the system, perhaps. I do have some statistics that indicate some hope for the future and indeed for the present. In terms of new pharmaceutical submissions, the statistic is that the submissions reached a 90% target performance level. That is to say, I guess 90% are approved within....

[Morris Rosenberg]

Within six months.

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

So 90% of them were dealt with, I guess--approved or not--within a six-month period. That was achieved in September of 2005. That's compared with 2003, when just 16% were dealt with in that time.

On the medical device side, that has improved dramatically as well, going from 73% to 90% meeting the target in the first quarter of 2006. When you look at biological drugs, there's a 67% reduction in the backlog compared with March 2004.

Are we where we want to be perfectly? No. I think there are still some improvements. But I would say that overall there have been some dramatic increases in performance.

Sorry, Mr. Chair, but Morris is letting me know that I've misread the statistic....

So what does the 90% target mean, then, Morris, when we say we've reached 90%?

[Morris Rosenberg]

I think what we're trying to do is approve 90% of our drugs within a standard time comparable to other jurisdictions. We're somewhat ahead of schedule, six months ahead of schedule, in having done that for new drug submissions.

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

So I guess there are benchmarks, international and national benchmarks, and we're 90% of the way there.

[Dave Batters, Conservative, Palliser, SK]

Thank you for your clarification, Minister. I did think that the 90% within six months sounded a little bit optimistic, because that's not what I've been hearing from some people who have concerns about that.

Just as a follow-up to that, has the level of Canadian research in pharmaceuticals increased in the last few years? Are we on the upswing? Perhaps you could comment on that. I recognize that you may not have those figures readily at your disposal, but in your experience in this portfolio, are we increasing research in pharmaceuticals?

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

Industry Canada might have a little bit more of a handle on that, but based on my knowledge of the industry a little bit, I can say that we're always fighting for mandates from pharmaceutical companies that usually operate in many different countries. We sometimes hold our own, but I think there's more work to be done.

The general statistic on research and development as a percentage of sales in Canada is 8.5% investments, as a percentage of sales, for Rx and D members, and for all patentees it's 8.3%. That's pretty competitive. I think there are probably a few countries that might be a bit higher than that, but that sort of keeps us in the ballpark in terms of new patents and the research that goes along with that.