Evidence of meeting #21 for Health in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was plan.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

David Butler-Jones  Chief Public Health Officer, Public Health Agency of Canada
Morris Rosenberg  Deputy Minister, Department of Health
Anne-Marie Robinson  Assistant Deputy Minister, Department of Health

3:35 p.m.

Liberal

The Vice-Chair Liberal Joyce Murray

Good afternoon, everyone.

I would like to welcome Minister Aglukkaq to our meeting on the main estimates today.

Welcome, Minister. Thank you for being here.

We're here today pursuant to Standing Order 81(4) to discuss the main estimates for 2009-10. With the minister, we have some witnesses from the Department of Health: Morris Rosenberg, deputy minister; and Alfred Tsang, chief financial officer. From the Public Health Agency of Canada, we have Dr. David Butler-Jones, the Chief Public Health Officer, and we are expecting the chief financial officer, James Libbey.

Minister, we're very interested in your remarks. You have the floor.

3:35 p.m.

Nunavut Nunavut

Conservative

Leona Aglukkaq ConservativeMinister of Health

Thank you.

Good afternoon, Madam Chair and members of the committee. It's again my pleasure to be here with you.

l'm here today to address the health portfolio's main estimates for this fiscal year, which represent an increase of approximately $236 million.

I also want to talk about how our spending and legislative priorities support a stronger focus on the federal role in the health and well-being of Canadians. In particular, this year's main estimates include investments supporting stronger product safety, further recruitment of new health researchers, and better health outcomes for first nations and Inuit.

But before I go any further, I want to address our response to the H1N1 flu virus.

For the better part of a month, public health officials in Canada and throughout the world have been monitoring the development of this virus and responding according to the level of risk. Thankfully, the impact on Canada has been relatively mild so far, but let me be clear: we cannot afford to let our guard down. H1N1 is a new strain of influenza. As a result, we can't be sure of the next turn it will take, so we will stay vigilant and be ready to respond as necessary.

Canadians can take comfort in the fact that we have a well-informed, well-supported, and well-developed pandemic preparedness plan. We will continue working with the provinces, the territories, and international partners, as well as learning from the data we have collected and the research we conduct at the National Microbiology Laboratory.

As precautions, we issued a travel warning advising against non-essential travel to Mexico, stationed more quarantine officers at Canadian airports that receive direct flights from Mexico, and distributed health alert notices to travellers--over 1.5 million a week.

I also want to highlight the achievements of researchers at the National Microbiology Lab who made an important discovery last week by sequencing the genome of Mexican and Canadian samples of this virus, essentially decoding its genetic makeup. This discovery has provided important information for researchers around the world. With this knowledge, we were able to eliminate genetic mutation as a possible reason for why the virus has apparently hit Mexico harder than Canada. Identifying the nature and composition of this virus will also help with vaccine development.

Health Canada experts are working with a vaccine manufacturer on the initial steps toward developing a vaccine. However, it is internationally acknowledged that producing a safe and effective vaccine could take up to six months. It is imperative that we balance the need for speed with quality and safety. In the meantime, should the situation dictate, we have safe and effective anti-viral stockpiles at the ready.

Madam Chair, let me say that so long as this situation persists, we will remain vigilant. As we have from day one, we will keep Canadians well-informed and well-advised as important details emerge. We are constantly considering the effectiveness of everything we do so we can make adjustments and continue to provide the leadership Canadians need and deserve. Providing leadership in protecting the health of Canadians against infectious disease is a key federal health responsibility. It is one we are committed to fulfilling.

As you know, our government has pledged to improve our ability to meet another key federal health responsibility. l'm referring to our commitment to modernize our safety system for consumer, food, and health products. Some of the essential changes we seek are represented in Bill C-6, the Canada Consumer Product Safety Act. This is important legislation that will bring our consumer product safety regime in line with the realities of today's global economy.

Of course, amendments to the Food and Drugs Act remain part of our food and consumer safety action plan, but for now, I want to thank the members on this committee for your careful review of Bill C-6.

I also want to thank you for your thoughtful input on Bill C-11, the Human Pathogens and Toxins Act. That legislation has been improved, thanks to the work of this committee. The bill will increase biosafety and security at Canadian labs that work with human pathogens and toxins. Please allow me to thank all members for their efforts in putting forward important changes to this bill at committee.

I join all of you in hoping for the quick passage of Bill C-6 and Bill C-11 through the Senate, towards gaining royal assent. The sooner this happens, the sooner the health of Canadians will be better protected.

Of course, research is essential in finding new ways of protecting and improving Canadians' health. It is for this reason that our government is providing further support to the Canadian Institutes of Health Research. This government is committed to supporting innovation and research.

Budget 2009, or Canada's economic action plan, contains some $5.1 billion in science investments. With respect to health research since 2006, CIHR has benefited from $117.2 million in permanent budget increases and a further $154.6 million in time-limited, targeted funding, supporting priorities such as pandemic preparedness. Furthermore, I'm proud to say that this year's main estimates include greater investments in scholarship programs designed to recruit and develop the health research stars of tomorrow.

And Budget 2009 commits even more.

In the past, CIHR-funded research has led to improvements in cancer treatment, cardiac care, and patient safety. As a result, l'm confident that the investments we're making today to attract new talent will lead to significant health improvements in the future.

This year's main estimates also include new investments for better first nations and Inuit health--today.

As I said in my opening remarks, we're dedicated to sharpening our focus on federal responsibilities. Among the most important objectives within my portfolio is ensuring the availability of health care services for first nations and Inuit.

Today, health disparities between aboriginal communities and the rest of Canada are apparent, and it's our goal to reduce them. As a result, these main estimates invest more than $200 million for core first nations and Inuit health programs, services, and infrastructure to better meet front-line demands.

Indeed, these investments represent a clear focus on federal responsibility, one of my portfolio's primary objectives since 2006. And future decisions will continue to be made along these lines.

Accordingly, this same approach was taken during the health portfolio's strategic review process. In February, I know, members of this committee had questions regarding this, and my officials and I are committed to discussing details with you today. Across the portfolio, Health Canada, the Public Health Agency, and CIHR carefully reviewed their programs to ensure their efficiency and effectiveness. The goal was to reallocate funding to better meet Canadians' needs.

In doing so, officials were asked to propose ways for making programs and services more effective and efficient, to focus on providing programs that are consistent with federal roles and responsibilities, and to align federal activities with the needs and priorities of Canadians. The portfolio will realize the following savings: $44.6 million in 2009-10, $61.7 million in 2010-11, and $108.4 million in 2011-12.

Additionally in February, some committee members feared there would be cuts to important aboriginal and women's health programs. l'm happy to say that these fears were unfounded. In fact, the reinvestments we were able to make will improve our ability to protect the health and safety of Canadians.

For example, Budget 2009 included $35 million over three years to CIHR through the Canada graduate scholarships program to support future research stars, $440 million for first nations and Inuit health care and infrastructure, and $500 million to accelerate the use of electronic health records in Canada, which will lead to higher-quality, more effective health care. These are important investments that are in line with the priorities of Canadians.

In conclusion, I want to take a moment to salute my officials and all employees who have worked so hard in responding to the challenge of the H1N1 flu virus. I also want to thank our partners, both internationally and within Canada, for their ongoing collaboration.

Let me also thank the committee for your work, past, present, and future, and I look forward to the observations that will come from your study on health human resources as well as from the new subcommittee that will study the impact of neurological disease.

As we take further actions to sharpen the focus on the federal role in health, I look forward to your ideas. Thank you, also, for accepting my invitation to visit Nunavut later this month. In my February appearance before this committee, I said that our vision needs to extend north of 60 if we want to be truly national.

This will represent the first time in history that the health committee has visited my home territory, so I thank you for accepting my invitation to broaden our perspective to account for the full vastness of the country we all love so much.

Thank you. I look forward to your questions.

3:40 p.m.

Liberal

The Vice-Chair Liberal Joyce Murray

Thank you very much for those comments.

We'll go to a round of questions now. I'd like to remind committee members that when the minister appears, there's different timing, so there will be 15 minutes for the Liberal questions, and 10 minutes for the Bloc, NDP, and Conservative questions in the first round, and then it will go to five minutes for each of the question opportunities, in the usual order of our committee.

Dr. Bennett.

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Thanks very much.

Thank you very much, Minister.

Thanks again to your officials for the hard work you've done in this recent outbreak and for your inclusiveness in allowing us to be briefed appropriately and to hopefully to be part of building the confidence of Canadians in what you are doing.

I believe your intentions are well founded, but in looking at the estimates, I'm worried that you don't necessarily have the money to do it. I would like, therefore, to understand, just beginning with the line item on emergency preparedness and response, why it would be more than $10 million less than last year. There was $38.97 million last year, and there's just $26.8 million this year.

Also, as you know, there's pandemic preparedness and then there's pandemic response. We are now into response, so we want to know what happened to the $400 million that was booked in the 2006-07 budget, which was $600 million for departments and agencies over the next five years, and $400 million that could be set aside as a contingency fund, accessed only as necessary. My understanding is that this is down now to $80 million.

We want to know if you have been able to access that contingency fund. How big is it? Why are the estimates for emergency preparedness and response so much lower than they were even last year?

3:45 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Thank you.

To start off, in Budget 2006 we had invested $1 billion to develop the pandemic preparedness plan for Canada in partnership with the provinces and territories. The plan that was developed included planning for the stockpiling of antivirals and so on. As we establish a contingency plan, how we access the funding goes through the Public Health Agency of Canada. The original investment of $1 billion was to develop the plan in partnership, to stockpile, to build the vaccine capacity, and so on. We continue to work with our provincial and territorial counterparts as we respond to this H1N1.

This is the first time--

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

The $400 million was for a contingency--

3:45 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

I'll get to that.

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

--in the event of needing a response.

3:45 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Yes. I'll get to your question.

In terms of developing a plan, this is the first time that we're actually dealing with an issue like a pandemic--the H1N1. As we are implementing the pandemic plan, we are working very closely with the provinces and jurisdictions in monitoring how we deal with it. If there is a requirement to access additional funds to deal with the H1N1 pandemic issue, we will go forward with that.

I will now ask my officials to elaborate in terms of how we established the contingency fund to respond to this.

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Before the officials answer, I would like to say you used the subjunctive, Minister: you said “should” we need. We are in response mode now. Have you accessed the contingency fund, particularly in view of the fact that in this year's estimates you have reduced the support for public health infrastructure across this country? It was $325 million and it's now done to $137 million. What are the provinces and territories, your partners, saying about the fact that there's less money for them now?

3:45 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

The provinces and territories, as part of the pandemic plan, have already established stockpiles in their jurisdictions, as an example. They also deliver health care on a front-line basis to the delivery of health care--

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Minister, this isn't about stockpiles. It's about having public health nurses.

3:45 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

We do have the funding for that--

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

It's about building infrastructure.

3:45 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Do you want me to answer your question or...?

3:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

I don't want to hear about stockpiles anymore, because they have to be refreshed.

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

That is part of the plan. Part of the plan to deal with the pandemic included stockpiling. If the provinces and territories need it to respond to the H1N1, it's there. We made the investment. It's there.

3:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

So what is being reduced in your estimates for this year from $325 million to $137 million of what you're sending? You even have reductions in the grants to agencies to support health promotion. Is handwashing in health promotion or is it in response to pandemic? How can you be reducing the money to health promotion in this year's estimates?

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

In terms of the pandemic plan process, I'll get Dr. Butler-Jones to elaborate.

Thank you.

3:50 p.m.

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

There are a number of things.

Firstly, with regard to the contingency fund that you were referring to, $80 million per year was the way it was laid out. We, as needed, can draw on the $80 million as it relates to this year as part of the contingency. It was not $400 million that sat there; it was $80 million a year over the five years of the contingency. Obviously if there are requirements beyond that, then we will deal with that through the usual processes.

In terms of the reductions, part of it, as the minister's saying, really does relate to stockpiling. In other words, when we bought antivirals and when we purchased other materials and how we built up the national emergency stockpiles--

3:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

So just to be clear, every year that you don't have a pandemic, you lose the $80 million? Is it only $80 million for a pandemic response?

3:50 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

The way that the--

3:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

What about the $1 billion that was booked?

3:50 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

Okay. The $400 million is the contingency. It was costed at $80 million a year. We are now four years into that, so this year there's $80 million that we potentially have access to.

3:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

So why isn't there $400 million in the fund?