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

4:20 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Thank you.

FASD is one file I've been involved in for the last five years in the provinces and territories. We have a number of initiatives. There were some reports that there were some cuts to FASD. I want to reassure this committee that there were never any cuts to FASD. We give out grants and contributions, and 90% of that was spent. We will continue to address the FASD projects in communities where it's needed and where there is study. Our government is committed to making investments in the areas of prevention, counselling, and screening. We'll continue to work in that area.

4:25 p.m.

Conservative

Tim Uppal Conservative Edmonton—Sherwood Park, AB

Thank you.

Minister, respiratory diseases, including lung cancer, are the third leading cause of death and hospitalization in Canada. Lung diseases also account for over $12 billion annually in direct and indirect health care costs. What is the government doing to improve the lung health of Canadians?

4:25 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Our government recently announced that we were investing $10 million over three years to provide Canadians with ways to prevent and detect respiratory illnesses. That was the major element of the national lung health framework.

Recently I made the announcement that we would invest $10 million in the Lung Association of Canada, here in Ottawa. We know that lung diseases can be completely preventable. We know that we can invest in prevention through public health and so on. But this year we recently announced a $10 million investment to address some of those issues.

4:25 p.m.

Conservative

Tim Uppal Conservative Edmonton—Sherwood Park, AB

Thank you.

Given the interest and involvement of this committee, as well as the interest of the media and the public, on the issue of trans fats, could you please inform us as to what Health Canada is doing to monitor the levels of trans fats in Canadian foods?

4:25 p.m.

Deputy Minister, Department of Health

Morris Rosenberg

As you know, the government asked companies a couple of years ago to voluntarily limit the amount of trans fats they put in their foods. Our sense now is that 80% of the foods tested are under the 5% limit that was imposed. We had given notice at that time, two years ago, that industry would have two years to reduce trans fats to the lowest levels possible, as recommended by the trans fat task force. We are now examining just how far this has gone.

The trends are good. Most companies are complying. There are a few outliers. The question that remains, in finalizing this analysis, is the extent to which one continues with the voluntary approach to encourage people to go along, maybe accompanied by some publicity, as we've already done, for companies that are non-compliant. Or is now the time to switch to a more regulatory approach, recognizing that for companies that have complied with the voluntary limit on trans fats, the regulations would really not impose any hardship? All they would do is reflect where those companies are. But regulations might in fact be an important inducement for those who are not in compliance to bring themselves there.

So this is an issue we are currently studying, and we hope, within the next few months, to be out with a proposal we would be consulting on publicly.

4:25 p.m.

Conservative

Tim Uppal Conservative Edmonton—Sherwood Park, AB

Thank you.

For my last question, I want to follow up on Ms. Wasylycia-Leis's question regarding the strategic review.

Can you tell us about those documents? I know you'll table them later anyway, but could you just take a few minutes--I think there are still a few minutes left--to go over those numbers?

4:25 p.m.

Deputy Minister, Department of Health

Morris Rosenberg

Thank you, Madam Chair.

I apologize if there was any misunderstanding. I have some notes here in English. We can have them ready in French very quickly, but not today. I will take you through what we have. Dr. Butler-Jones and I are prepared to table our notes.

Health Canada's strategic review helped identify areas where we can better focus the federal government's core role in health; where we can improve how we work with partners inside and outside the federal government; and where we can improve the efficiency and effectiveness of how we do business within the department.

Health Canada exercises the federal role in three main areas: consumer and environmental safety, working with provinces and national health systems, and first nations and Inuit health. On the latter role, as the result of the Province of Alberta's decision to eliminate health care premiums for its residents, $11 million of payments that Health Canada previously made to Alberta to cover the cost of health premiums for first nations living in that province are no longer required. These savings contributed toward the 2009 budget's reinvestment of $440 million over two years to ensure the department's ability to continue to deliver and improve health services for first nations and Inuit clients.

As a department with a very broad mandate, engaging in partnerships with third parties, other federal departments, and other levels of government, this is critical to our ability to deliver on our objective to help Canadians maintain and improve their health. To that end, we are exploring a few small changes.

First, current laboratory facilities for environmental health science at Health Canada are housed in an aging building. We are looking at opportunities to co-locate these laboratories with compatible laboratory facilities at academic institutions so we can avoid repair costs for our current facilities estimated at around $700,000.

In working with international partners and stakeholders over the next few years, we'll be looking to update and improve the efficiency of the process for how we review and approve low-risk veterinary drugs for companion animals and how we undertake supportive corporate activities in the health products and food branch. Further steps are needed before we're ready to implement changes in 2011-12. Once implemented, approximately $2.8 million in program costs and related supporting activities could be saved.

Since the funding of educational institutions is a provincial responsibility, rather than acting as the sole funder of the National School of Dental Therapy, Health Canada will be limiting its support to providing $600,000 in financial assistance directly to aboriginal students pursuing careers in dental studies. To ensure that the national school will be able to continue operations, we will work with the school's administration to help find alternative sources of funding. Net savings are approximately $1.4 million.

Some discretionary project funding related to Health Canada's international affairs will be reduced, and we will further centralize the coordination of international activities and policy advice within the department. In total, our spending on international affairs will be reduced by approximately $2.6 million by 2011-12.

We also looked at realigning resources where objectives have already been achieved, and we sought efficiencies by proposing new ways of organizing functions within Health Canada. A departmental emphasis on continuous improvement has identified several areas where we're able to produce savings without compromising the quality of services being provided.

Over the past four years of providing training and advice to other federal departments, we're managing the cleanup of contaminated sites. We've gained considerable experience and have found ways to operate at a much lower cost. As a result, a one-time savings of approximately $2.6 million has been identified that we will not need to spend.

4:30 p.m.

Liberal

The Vice-Chair Liberal Joyce Murray

Thank you very much, Mr. Rosenberg.

We'll now go to the second round of questions.

The first one is for Dr. Duncan, for five minutes.

4:30 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

Thank you, Madam Chair, and thank you to the minister and to the officials for coming.

I'm going to pick up on my honourable colleague's questions. I guess my concern is, as my colleague mentioned, that we are in response mode right now. We're at phase 5 pandemic alert. This virus is spreading rapidly. It is mild. No one can predict what the future will hold, but there is the possibility that the virus will mutate. I think we have to take every opportunity, as the minister said, to be vigilant.

I'm concerned that there is a drop in funding for preparedness from $38 million down to $26 million. I have an understanding that $400 million gives you some sense that there's help, and in reality we've learned it's $80 million per year. If we don't use it, we lose it. I'm wondering if the funding will be adjusted right now because we are in that response mode.

I'm going to ask a number of questions. You mentioned the antiviral strategy, which wasn't mentioned in 2006, 2007, 2008, or 2009. I guess my first question has to be what the national antiviral strategy is. We talk about 55 million doses. Have we stockpiled for 17% of the population or for 25%? The next question is, how much of that stockpile reaches its shelf life this year? When will that be replenished? The last question I'll ask is around our health care providers, who we are going to depend on to cope if the virus mutates. I'm hoping the minister can assure us that they will be protected and that antivirals will be made available to them.

Thank you.

4:35 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Thank you for your question.

Again, just to talk about the pandemic plan, this plan was tabled back in 2006 when we developed the plan with the provinces and jurisdictions. It outlines very clearly the roles and responsibilities of provinces and jurisdictions, the federal role, and what we would provide in terms of support with provinces and jurisdictions, whether it be funding and separation of roles and responsibilities and so on.

Right now, the health and safety of Canadians is our top priority as we respond to the H1N1 situation. We are working very closely with the provinces and jurisdictions. We keep going back to this $1 billion investment, the $80 million, the $400 million, but I want to reassure this committee again that the health and safety of Canadians is our top priority. Should we require additional funding in the case of H1N1, should it develop again in the fall, we will do that. I think Canadians would expect us to do that, and right now the plan we have is to implement how we respond to it in partnership with the provinces and jurisdictions.

That's part of the plan.

4:35 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

Minister, with due respect, I know the plan and I know how hard you're working.

We have this window of opportunity, and I would like to know why we're not going to take this now to look at other potential technologies—but with your assurances, I think I'll move on. I'd really like to know what the antiviral strategy is, and how much of that stockpile becomes due this year and how we're replenishing it.

4:35 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

I want to thank you for your question.

I'm going to leave now. I'll have the officials respond to how we're preparing for the antivirals.

Thank you very much for your time.

4:35 p.m.

Liberal

The Vice-Chair Liberal Joyce Murray

Thank you, Madam Minister, for being here and for staying longer than we expected.

So it's over to your officials to answer the questions for the rest of the meeting.

4:35 p.m.

Chief Public Health Officer, Public Health Agency of Canada

Dr. David Butler-Jones

Thank you.

The plan continues to evolve and it keeps being adapted, etc. We are obviously looking at all options, not just in Canada but internationally. We're working with the WHO, with the Americans and Mexicans and others in terms of effective responses--what the alternatives are, the appropriateness of distancing measures, what other things might actually be effective.

Unfortunately with the antivirals, every antiviral known eventually will have resistance. That's why we, a long time ago, started to diversify with the addition of Relenza, to which none of the influenza viruses we've seen has yet developed resistance. So we've been focusing on adding to—and not replacing Tamiflu completely, but a lot of that being Relenza. Right now there are no other licensed products available, but there is research on a number of other options going forward.

There is a number that are expiring. Some are expiring this year, some next year. We're working with the provinces and territories to replace those.

4:35 p.m.

Liberal

The Vice-Chair Liberal Joyce Murray

Dr. Butler-Jones, if you could wrap up your comments....

4:35 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

What percentage of the stockpile—

4:35 p.m.

Liberal

The Vice-Chair Liberal Joyce Murray

We're onto the next questioner. Sorry, Dr. Duncan.

The next questioner is Mrs. Davidson.

4:35 p.m.

Conservative

Patricia Davidson Conservative Sarnia—Lambton, ON

Thank you, Madam Chair.

Thank you very much to the officials for being here again. It's always good to see you.

When I'm looking through the main estimates book, I see strategic outcome number four says: “Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians.”

I have three questions I want to ask. I'll ask the questions and then just leave it open for response.

I want to know how the aboriginal health transition fund is improving health outcomes for aboriginal Canadians.

I would like to know what investments are being made by Health Canada to improve the quality of health services for first nations and Inuit.

Thirdly, we all know we're in uncertain economic times, and that you as well as everyone else in the government is under pressure to do more with less. I know that in the past Health Canada has funded a range of programs to address improved health outcomes for first nations and Inuit. Because of the economic times, will the government continue to make those commitments, such as the prescription drugs and other important programs? Are they going to make those still available for first nations and Inuit? Or are there going to be cutbacks in those areas?

4:40 p.m.

Liberal

The Vice-Chair Liberal Joyce Murray

There's a new witness at the table.

Could you introduce yourself, please?

4:40 p.m.

Anne-Marie Robinson Assistant Deputy Minister, Department of Health

Yes. My name is Anne-Marie Robinson. I'm the assistant deputy minister of the First Nations and Inuit Health Branch.

4:40 p.m.

Deputy Minister, Department of Health

Morris Rosenberg

Thank you, Madam Chair.

I was going to turn to Ms. Robinson in a moment. I was going to start trying to answer a couple of these questions.

In terms of some of the new investments the government has made, the 2009 budget invested $305 million over two years to strengthen nursing services and the non-insured health benefits program. I guess that answers, in part, your third question, around prescription drugs, since the government will continue, through the NIHB program to provide prescription drugs for first nations.

There was also, in the 2009 budget—and I think the minister may have alluded to this—$135 million for the construction and renovation of health services infrastructure in first nations communities, including health clinics and nursing residences.

On the question of the aboriginal health transition fund, I was going to ask Ms. Robinson to elaborate for you.

4:40 p.m.

Assistant Deputy Minister, Department of Health

Anne-Marie Robinson

Thank you.

The aboriginal health transition fund is a five-year fund where we invest $200 million over five years. There are approximately 300 projects that we do in partnership with provinces and aboriginal organizations. These are things to either adapt or integrate aboriginal health care with provincial jurisdictions.

One example would be in northern Saskatchewan. The local health authority is working with a local first nations tribal council to look at a plan to integrate their laboratory services and to integrate their diabetes testing services.

So these are projects that are on the ground. They support our tripartite mandate and they look to build efficiencies, both locally and provincially, so that we can better align our services with provinces.

4:40 p.m.

Conservative

Patricia Davidson Conservative Sarnia—Lambton, ON

Do I still have some time?

4:40 p.m.

Liberal

The Vice-Chair Liberal Joyce Murray

You have just over a minute and a half.

4:40 p.m.

Conservative

Patricia Davidson Conservative Sarnia—Lambton, ON

Okay, great.

Could you elaborate a little bit more on the health clinics and nursing end of that? When I look at the estimates, are the FTEs remaining fairly constant or are they increasing or decreasing?