Health Committee on May 15th, 2008

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

I can certainly say a few words on that subject.

First of all, most of the time, the funding intended to improve aboriginal access to hospitals and health care is the responsibility of the provinces and territories. It is not direct funding.

The same is true of wait time guarantees. When we announced those guarantees to all the provinces and territories, each one promised to implement them. Those guarantees will benefit both the first nations and the general public.

As regards aboriginal people living on reserves, we have announced pilot projects offering guarantees, in particular a maternity program. That program is mainly intended for aboriginal people living on reserves.

All the programs will help to improve the situation. This is not a program or a system, but a strategy that embraces all our investments.

[Christiane Gagnon, Bloc, Québec, QC]

With all due respect, minister, allow me to doubt the human resource and funding efforts made to give a real hand to one of the clienteles that is a federal responsibility.

On a number of occasions, I have asked that the Standing Committee on Health conduct a survey on aboriginal health. We will definitely be hearing from witnesses. I'm sure we will hear another story regarding aboriginal people's demands to improve their health and the support that could be given to them in that area. Then the committee can hear from you again and provide you with a completely different report, a much more pessimistic and less optimistic report than yours.

You also announced a grant of $59 million to the Canadian Institutes of Health Research. I met a number of health researchers, and some told us that research demand had increased. However, as a result of a shortage of available funding, they had the impression that a number of research projects had been rejected in spite of the fact that they met the criteria.

How is it that a number of types of research projects are rejected and that the funding is lacking? Research laboratories often have to cut back their activities, even stop research, in some cases, for lack of money.

You say you're increasing the budget of the Canadian Institutes of Health Research. That means it's possible the money is being distributed less effectively.

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

Today the government supports more than 11,000 health researchers in Canada. Our country of course has a lot of world renowned researchers.

There's a lot of competition for these grants, there's no question about it. But we think that by adding to our totals and creating....

There are a number of measures. There's a new Canada global excellence research chair fund, which I think will be helpful in a lot of these. We're putting more money into Genome Canada. I know we're funding stem cell research directly as well. There's a lot of very exciting world-class things that our researchers are involved in. The Government of Canada has certainly proven that we can be part of the solution.

We now have a new science and technology policy, which we call the Science and Technology Strategy. That strategy is important in ensuring the economy's future success.

It's not just for health care; it's for the economy as well. We will continue to support our researchers in health care as well as in many other areas.

[Christiane Gagnon, Bloc, Québec, QC]

Some researchers have told us that the funding application success rate fell from 30% in 2004 to 21% in 2007. That means a drop of 8.9 percentage points, a net reduction. These figures clearly illustrate the situation of many researchers.

Researchers are asking that the success rate of applications be restored to 25% because it has really dropped. They're not asking that it be restored to 30%, but at least to 25%. They're asking that there be a reinvestment because research in certain fields deserves to be pursued and researchers currently cannot continue.

I visited a number of small research centres, and you often see that small teams are conducting research on a shoestring.

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

Yes, we've planned a change in leadership for that agency.

CIHR has a new leader. You probably know him as a result of his leadership in Quebec over the last few years.

I have every hope that, with this new leadership, we'll be able to work together to meet that challenge. Of course, there are challenges.

When one looks at the situation from a worldwide perspective, Canada is doing very well. We're considered a world leader in medical research. It's something we want to continue. Medical research has been identified as one of the top--

[Christiane Gagnon, Bloc, Québec, QC]

We must—

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

--priorities in the science and technology strategy, so we will continue to make efforts for sure.

[Christiane Gagnon, Bloc, Québec, QC]

Some researchers are leaving Canada to go elsewhere because they can't continue their research. We have another vision of things.

Minister, you say you want to invest $111 million in the prevention and treatment of substance abuse associated with illicit drugs. I wouldn't want to quote you out of context, but you say you have a firm strategy.

We were quite concerned recently because you withdrew from the market a book that was designed to help fight drug dependence and address prevention. In Quebec, there was an outcry of protest from a number of sectors, the police and various observers in the field, such as university professors.

[The Vice-Chair, Liberal, Lui Temelkovski]

Madame Gagnon, could you just ask your question?

[Christiane Gagnon, Bloc, Québec, QC]

It's been said that you want to exercise your veto on a matter of principle or out of a closed attitude toward this matter, which is important. That's a step backwards in view of the situation.

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

We've announced a new national drug strategy. It's important that there be prevention and treatment strategies, and we've announced investments. I don't think the old strategies are suited to future situations. That's our decision, but it's supported by the public.

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you very much.

Madame Gagnon, thank you.

We'll have Mr. Fletcher, since Madame Wasylycia-Leis will be absent for a few minutes.

Don't get excited, Minister--she is coming back.

Mr. Fletcher.

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

Thank you, Mr. Chair.

I'd like to thank the minister and his officials for coming to the committee today.

I think I'll follow up on some of the themes that the Bloc brought up.

Minister, our government has announced the Mental Health Commission and a national anti-drug strategy, and they seem to have some crossover at some level. As you know, we committed $110 million over five years to the Mental Health Commission to study the most effective ways to address mental health and homelessness. The commission was set up to research projects on housing and other types of supports in major centres like Vancouver, Winnipeg, Toronto, Montreal, and Moncton.

My first question is what does the government hope will be achieved by the Mental Health Commission as they undertake their research in areas of homelessness, mental health, and addiction? I'd also like to ask how it fits in with the national drug strategy. Our government announced $64.3 million over two years, and that strategy is designed to reduce and prevent the use of illicit drugs, particularly among youth and aboriginal peoples, treating those drug dependencies and combatting the illicit production and distribution of drugs.

As you are aware, Minister, there have been many questions from both the media and members of Parliament about what the government is doing on the illicit drugs in Canada, particularly in Vancouver's downtown east side. What is being done to address illicit drug use across Canada in these vulnerable communities, and how does it tie in with the Mental Health Commission. Or is there a tie-in? There may not be.

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

Actually, there is.

Certainly in a lot of distressed communities, where there's a high percentage of addicts, it's not just an addiction issue; it's a social supports issue generally. We feel that there has to be a national body of research on this—that was the money accorded to the Mental Health Commission—to pursue the pilot projects that you mentioned. It will create a national body of knowledge on how we can, through effective housing programs and social support programs, also have an impact on reducing addictions in some of these urban centres. Obviously it's not the whole solution for all of Canada, but I think it's a good start in dealing with these areas.

And of course one of the areas we're dealing with is the downtown east side of Vancouver. It's no secret that it's a distressed community, with over 5,000 injection drug addicts in a few square blocks. But at the same time, there are lots of people who do some wonderful work there. So we're going to be supporting them through treatment programs. We're going to be supporting them through these quick-response teams that we have funded, based on the announcement yesterday. And of course we're working in partnership with Vancouver Coastal Health Authority, with the mayor's office in Vancouver, and with the provincial government.

So there is a tie-in. You're dealing with not just an addiction issue or a homelessness issue, but also with a whole lot of social distress. That's why you have to look at it from a comprehensive point of view.

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

Certainly I've heard many positive comments about how this government's looking at the whole perspective of the challenges in Vancouver's east side and across Canada. So I think we're definitely on the right track there.

To change gears a little bit, Minister....

It's unfortunate that the opposition members are heckling. I wish they would respect our ability to ask questions to the minister.

Many provincial governments have undertaken sustainability reviews and other publicly funded health care plans in the past year. The governments of British Columbia, Alberta, Ontario, Quebec, New Brunswick, and Nova Scotia have all concluded their reviews. With British Columbia announcing new legislation, the B.C. legislation seeks to enshrine the five principles of the Canada Health Act and add another principle: sustainability.

I wonder, Minister, if you could give us a perspective on the Government of Canada's plans for the Canada Health Act and how we are supporting the provinces to ensure that Canada Health Act goals are being achieved.

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

Our party and our government support the pillars of the Canada Health Act, the principles that are enshrined in the Canada Health Act. Of course provinces are finding the need to innovate in their health care systems, and we support that. Quebec has done some quite far-reaching things in its system, and you mentioned the other provinces, including British Columbia, New Brunswick, Nova Scotia, and so on.

We do support those initiatives. One proviso, obviously, is that they have to be consistent with the Canada Health Act, but my view is that it is perfectly possible and appropriate to do a whole lot of innovation. You can do so within the Canada Health Act. There's a lot of innovation that can occur to increase accessibility, decrease wait times, improve management, improve accountability, improve sustainability, all of which can be done within the CHA, and we're very supportive of that. When provinces come to me, as they do frequently, and say they're thinking about doing this or trying that, I try to be as supportive as possible, as long as the principles of the Canada Health Act are not violated.

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

Minister, there was some question from the opposition members about public health funding. Could you share with us how the Canadian Partnership Against Cancer and the cardiovascular strategy are reflected in the estimates?

Also, could you expand on the action the government has taken on transfats and sodium? That seems to be the topic of conversation among many people in the cardiovascular community. Given it is hypertension week, it seems like an appropriate time to ask you the question.

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

Sure.

In terms of the Canadian Partnership Against Cancer, obviously there has been funding for that. There is also funding for research, for instance---about $124 million--going to cancer research this year.

The strategy involves--and you were involved with this, of course, in your days in opposition, so I want to publicly commend you for all of the spade work you did for the Canadian strategy for cancer control. As you know, it's broadly based. It's multi-faceted. We have the provinces at the table. We have the cancer societies at the table and oncologists and cancer survivors. So I really think it is the wave of the future in terms of how we want to proceed. Indeed, it is animating our discussions on other disease-specific national initiatives, such as the cardiovascular strategy that you mentioned; it is probably a couple of years behind the cancer strategy, but is rapidly catching up. The diabetes strategy has been retooled and revamped, for instance.

You mentioned some of the work we've done on the transfat issue, which was a very hot issue around this place a few years ago, as you know, and led to the creation of the transfat task force. When we were in government we approved of their recommendations, and we've been busy working with them to reduce the incidence of transfat in a number of different foods. In fact, it seems to be working. There's a lot less transfat around now. I think it has been reduced by over 50% already, and we look forward to seeing them meet their goals in the next couple of years.

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

How much time do I have left, Mr. Chair?

[The Vice-Chair, Liberal, Lui Temelkovski]

A minute and a half.

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

On the chemicals management plan, Minister, when we recently banned bisphenol A for baby bottles and things of that nature, I think that announcement touched a lot of people. I have a brother in California, and he actually heard about that announcement on the mainstream news in California, and he says he never hears about Canada in the news down there.

I wonder if you could tell us where you think the chemicals management plan is, where it's going, the costs associated with it, both upfront as well as the costs of not doing it.

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

Thank you for that.

You're quite right that the bisphenol A announcement was carried world-wide. If mimicry is the most sincere form of flattery in politics, I noted that Senator Hillary Clinton introduced a Senate bill, basically mimicking what we're doing here in Canada. So it must be right, if she's doing that.

Looking at it, though, that was only one piece of a broader strategy, which again is world-leading, the chemicals management plan. We reviewed over 25,000 chemicals, legacy chemicals, as they're called. We identified 200 high-priority chemicals we wanted to get some research on immediately. The next stage is another batch, you should know. I guess maybe I'm releasing this a couple of days early, but there's another batch that will be gazetted in the next couple of days. There's another series of about 16 chemicals, I believe, upon which we have the research back and we'll be making some decisions on those as well, so you'll be seeing that.

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you very much, Minister. Thank you, Mr. Fletcher.

Now we move on to Susan Kadis.

[Susan Kadis, Liberal, Thornhill, ON]

Thank you, Mr. Chair.

Welcome, Minister.

It certainly is the federal responsibility to work with the provinces to ensure there is surge capacity in the event of a pandemic, yet I'm not seeing anything in the estimates that would help hospitals cope with the demand for beds and care in the event of one, or to build the pressure rooms they would require.

Could you please explain how your plan you referred to before for pandemic preparedness addresses the matter of surge capacity in Canadian hospitals? As I'm sure you're aware, in Ontario Dr. McGeer, of Mount Sinai, and others in Calgary, etc., have raised serious concerns about the lack of surge capacity.

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

I'll take a stab at that, and I'll leave the rest to Dr. Butler-Jones.

Certainly we are doing things within our federal mandate. One of those, as I mentioned, is the anti-viral stockpile, which is now up to the level that has been recommended by scientists. There is the work we've done on vaccine initiatives for a pandemic, and of course the structuring of our response on a national emergency plan, which we constantly work with the provinces on. We are responsible for our own jurisdiction. The provinces get increased transfers every year from the federal government, which they put to good use in their hospitals and with their doctors and nurses and so forth. That's how we help contribute to fund hospital capital and the surge capacity.

Dr. Butler-Jones might want to add to that.