Evidence of meeting #3 for Health in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was million.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

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

3:30 p.m.

Conservative

The Chair Conservative Joy Smith

Good afternoon, ladies and gentlemen. Thank you for being so prompt today. It's very much appreciated.

We have business that we need to do today. For the first hour, I would like to welcome the Minister of Health, the Honourable Leona Aglukkaq.

It's so nice to have you here, Minister, to present and to answer questions. The committee is quite looking forward to listening to you today. Welcome.

Following the hour of the minister's presentation and the questions, we will then have the departmental officials stay and you'll be able to ask all the questions you want at that time.

Committee, please be aware that at 5:15 we're going to sit in camera to discuss some future business. There was a request to do this so that we could be organized for the next meeting.

Having said that, I would like to ask our minister to make a 10-minute presentation. Then we will open up for questions. Thank you.

3:30 p.m.

Nunavut Nunavut

Conservative

Leona Aglukkaq ConservativeMinister of Health

Thank you very much. Members of the committee, bonjour, uplaakut, good afternoon.

l'm here today with Morris Rosenberg, Deputy Minister of Health Canada, and Chief Financial Officer Alfred Tsang; and from the Public Health Agency of Canada, Chief Public Health Officer Dr. David Butler-Jones and Chief Financial Officer James Libbey.

Please let me begin by congratulating you, Madam Chair, on your re-election as chair. Being elected chair means being honoured by your colleagues, and I was very honoured to meet with some of you this afternoon as well. In my opinion, among this group of dedicated members, that's indeed a high honour to be selected by your peers.

While l've been meeting one on one with opposition health critics, today marks my first time at this table. Let me say what a pleasure it is to be together with you around this table instead of being seated across and divided by an aisle. It is in times like today that Canadians need cooperation among their elected representatives, rather than division, more than ever.

Let me tell you, as health minister, it is my intention to be open, to listen, and to build effective relationships with stakeholders and colleagues, as well as with my critics. While I may be new in this role at the federal level, I come to this table as an experienced health minister from my time in the government of Nunavut.

As minister responsible for the north, I bring to this table and this House a very unique perspective. I believe that national strategies need to be truly national in scope. Our vision needs to extend north of 60 if we want it to be truly national.

In my time as Nunavut's health minister, I was proud to work toward establishing community-based health programs, advancing a territorial public health strategy, developing a long-term health human resources strategy, and expanding culturally relevant training programs for traditional midwifery, social workers, and nursing, just to list a few.

Having worked on these issues, I know that working for a healthier population means a combined effort among governments at all levels, with first nations and Inuit and with the medical and research communities. Of course, l'm proud to be here before you today, just weeks after our government made important investments in Budget 2009.

As health minister, l'm enthused about new investments in health care across Canada. For example, an additional $1.4 billion is being invested in the Canada health transfer, for a total of $24 billion. This meets our commitment to increasing the transfer by 6% annually until 2013-14. In addition, $440 million was announced to improve health care delivery and infrastructure for first nations and Inuit. And $500 million was announced to make greater progress toward a future where health care for all will become safer, more effective, and affordable, thanks to greater use of electronic health and medical records.

In both these cases, I know that investment serves only part of what's needed and that partnerships with stakeholders are ultimately what will drive us to the health care success we wish to achieve. But of course as a former and current health minister, I know full well that health means more than health care. For too long the focus has been on treating illness and constantly increasing health care spending. Rather than focusing so much on treating the sick, we need to focus more on keeping people well.

Without question, treatment can, must, and will always be there for people who are sick, but imagine our country if people worked more to keep well. That means people maintaining their personal health by living healthier lifestyles and health professionals being better educated on how to help people do that.

While we can't make choices for Canadians, it is our role as government to inform the choices and encourage conditions that lead to healthy choices. That's why our government has renewed Canada's Food Guide to Healthy Eating. That's why we publish the physical activity guide for Canadians, fund the child fitness tax credit, and work with partners to eliminate barriers to healthy choices. And it's why we remain dedicated to restricting tobacco marketing and other inducements aimed at youth, to continue driving down smoking rates even lower than where they sit today.

As health minister and as a parent, I sincerely commit to working with you and other governments, first nations and Inuit, and all stakeholders so that the next generation of Canadians grows to be healthier than their parents and not less.

For Canadians who want to live healthier, let it be clear that our government is here to help; and for Canadians who have concerns about the safety of products on store shelves, in their medicine cabinets, or in their kitchen, our government is here to protect.

We remain committed to an approach where we make legislative changes based on active prevention, targeted oversight, and rapid response. For example, on January 29, I tabled Bill C-6, the proposed Canada Consumer Product Safety Act. With this legislation, we are proposing a change to an existing law that is outdated and out of step with modern times.

We want to provide for better oversight of consumer products in Canada, including toys and cribs. We want to be able to act sooner and order recalls when necessary to protect Canadians from potentially harmful products that could cause injuries.

We want to encourage compliance, with higher fines and penalties for violators. For example, the bill proposes increasing the maximum fine from $1 million to $5 million. To make it work, we are committed to doubling the number of consumer products inspectors.

In proposing these improvements, we are listening to the views of stakeholders to ensure our approach is clear, balanced, effective, and fair.

In addition to taking action for safer products, our government is also committed to ensuring the safety of our food supply. That's why, alongside the Canadian Food Inspection Agency, the health portfolio stands ready to support the independent investigator into last summer's listeriosis outbreak. We are eager to receive her report, to increase our knowledge and put it into action as needed for the benefit of Canadians.

Making good on our commitment to translate knowledge into action is also exemplified by the progress we're making through the chemical management plan. So far, our researchers have examined 70 chemical substances that were in use long before the dawn of our modern regulations. Industries have the challenge to show that the chemicals they use do not pose health concerns and are being managed appropriately.

As a result of our reviews, several new actions have been proposed to better protect the health of our families and our environment. I want to take the time right now to thank my predecessor, the Honourable Tony Clement, for the leadership he brought to this plan. This of course included moving forward to ban the sale, importation, and advertising of polycarbonate baby bottles containing bisphenol A. Through this regulatory decision, our government put families first. It represented a world first, and it clearly showed how the chemical management plan has made Canada a world leader in the safe management of chemical substances. Through our action, we're protecting the health of Canadians.

This is the same goal we're seeking from the drug safety and effectiveness network, funded by $32 million, as I announced in January. Thanks to this network, Canadian researchers will be supported in working together to examine safety and effectiveness of drugs being used by Canadians. The network's coordinating office will be housed at the Canadian Institutes of Health Research. Through CIHR, the health portfolio is making strong contributions to the government-wide commitment to science.

Science helps inform policy and establishes priorities for our future, and to make sure we train the next generations of health researchers, I'm happy to note that Budget 2009 provides an additional $35 million for the CIHR, for the Canada graduate scholarships program. This comes in addition to new support from these estimates for leading-edge research into hepatitis C and childhood obesity, which I know is a subject on which many members of this committee have worked hard in the recent past.

Indeed, these estimates reflect our government's seeking to achieve, through the actions of the health portfolio, safer products for Canadians, stronger research for more effective policy, and stronger support for improved health care and healthier choices, all for a healthier population today and an even healthier generation tomorrow in communities across Canada, including first nations and Inuit.

As health minister, and along with you, I commit to strive toward this goal.

Thank you all for the time to speak, and now I look forward to your questions.

3:40 p.m.

Conservative

The Chair Conservative Joy Smith

I want to thank you so much, Minister, for your presentation.

We're now going to be going into our line of questioning. I just want to remind you that we'll have the Liberal side for 15 minutes, the Bloc for 10 minutes, the NDP for 10 minutes, and the Conservatives for 10 minutes, and then we'll recycle following that. I'm just talking about the first round.

The second round, as you know, is five minutes.

Dr. Bennett, you have 15 minutes, and I understand you're sharing your time.

3:40 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Thank you very much.

Thank you very much, Minister. Your amazing reputation as someone who truly understands the difference between health and health care precedes you. My line of questioning will be about the problem you've inherited in a government that has chosen health as part of this strategic review and that now has a reputation for having put many community organizations and programs at huge risk. Given that all of the grants and contributions are now sitting somewhere where the Prime Minister's Office can look at them, we are particularly concerned that the ideology and other interests are not exactly.... Or perhaps “strategic review” is just code for the Prime Minister's Office getting to pick and choose. All of this means that community organizations and programs have never been more insecure.

In fact there is a reputation in your department, Minister, for things being promised year after year, going through the proper channels, going all the way up through the department, and then being killed on the desk of the previous minister. This has created huge insecurity, and it means there are tons of programs out there right now for which people do not know whether or not they will be getting money on March 31. So I would like to go through a little checklist, and maybe you would be able to say yes or no to whether these people would be able to expect their money. It seems to me everything in your estimates that has the word “grant” or “contribution” has big brackets, with millions of dollars now missing because of the strategic review, as it is there on page 138, grants, “(4,873,071)”, with a big bracket.

I think you must be upset that the healthy eating program is gone. The aboriginal wellness program is gone. The centres of excellence for women's health seem to be on some lifeline, having maybe extracted one year. The centres of excellence for children's well-being we still don't know about. The Health Council of Canada still does not have any funding after March 31. HIV/AIDS groups across this country don't know if they're getting their money or not. You got a terrible report on the national pharmaceutical strategy.

What are you going to do to make the people who actually do the work in the communities feel secure that you as the new minister understand the importance of these things like women's health, children's health, and particularly research? It is astounding that in the name of increasing efficiency and effectiveness, granting councils can end up with less money when their only job is to get money out the door. I would like you to tell us how you're going to make the community organizations feel more comfortable about what their life after March 31, 2009, or March 31, 2010, will be like.

3:45 p.m.

Conservative

The Chair Conservative Joy Smith

Madam Aglukkaq.

3:45 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Thank you, Dr. Bennett, for your questions. I sense your frustrations and I look forward to working with you to address some of your concerns and some of your questions.

We're not here to really discuss Budget 2009 or get into the specifics of the strategic review. But what I will say is that under Health Canada--the Public Health Agency--the Canadian Institutes of Health Research have undertaken the review to better align programs, to do science research and support Canadian health. I'm a strong believer that we need to do some reviews in the delivery of how we manage programs. As an example, the legislation I introduced in the House is 40 years old, and that went through a review. It was necessary to introduce legislation that is keeping up with time. It's just good business periodically to do reviews of our programs on a regular basis as we try to serve Canadians. Basically, as a result of these reviews, the government is refocusing its programs to better deliver on its core federal role in health, realigning existing resources and programs to improve management of risks to human health and so on. I would be very happy to return to this committee in the spring to discuss this in more detail with the honourable member. As it is right now, we're focusing on the implementation of some of these changes that we're proposing, but I can also say that for some of these programs in HIV/AIDS, the Health Council, there is ongoing funding to support those important initiatives, as outlined by my colleagues. I'll leave it at that.

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

I look forward to that, and I think if you look at the transcript, you can maybe table or send to us the yes or no answers on the centres of excellence for children's well-being. The Health Council of Canada actually has a new program, probably the most important recommendation of the Romanow commission, exactly how the HIV/AIDS funding would be broken down.

I guess one of the other things that bugs me is that we aren't going to be asked as a committee to look at the statutory review of the Assisted Human Reproduction Act and yet we've never received the regulations for this, other than for chapter 8. I want to know what on earth the agency can be doing when it doesn't even have any regulations and it's now time for us to review the act. It looks like you've transferred $75,000 to CIHR out of the budget of the agency, and I would like to know how this agency can even be acting or doing anything if we still don't have the regulations.

3:50 p.m.

Conservative

The Chair Conservative Joy Smith

Madam Minister.

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

I'm going to defer to Morris to answer that.

3:50 p.m.

Morris Rosenberg Deputy Minister, Department of Health

Thank you, Madam Chair. On the latter part of Madam Bennett's question, on the transfer from the agency to CIHR, the purpose of the transfer of $75,000 to CIHR from Assisted Human Reproduction Canada is to support specific research in the areas of assisted human reproduction and reproductive technologies. The goal of the program is to facilitate the dissemination and uptake of research results through appropriate knowledge translation strategies and activities, based on the best evidence resulting from the completion of grant research. The specific research will be focused on the area of assisted human reproduction and reproduction technologies. I can give you more detail on that if you want to have it. This would include things like artificial insemination, ovarian stimulation, gamete intrafallopian transfer, zygote intrafallopian transfer.

3:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

I guess the issue is, this is an agency that is supposed to be regulating, and having couples who are having difficulty forming families feel more comfortable that this is an area that now is regulated, we decided we needed a law for it. We don't have a law and we don't have the regulations, and now we're being asked to review the law. I hope the minister will get us the regulations before we have to review the law.

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Thank you.

3:50 p.m.

Conservative

The Chair Conservative Joy Smith

Madam Minister, did you want to comment on that, or do you want Ms. Murray to ask her question?

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

I can comment that the government has brought an appeal before the Supreme Court of Canada to address any questions regarding the constitutionality of the act, and out of respect for the authority of the Supreme Court of Canada, Health Canada will not pre-publish the regulations, from what I understand, until the question before the court has been resolved.

3:50 p.m.

Conservative

The Chair Conservative Joy Smith

Mr. Rosenberg, did you want to make a comment on that as well?

3:50 p.m.

Deputy Minister, Department of Health

Morris Rosenberg

I can elaborate on that a little bit, just by way of context. As the committee may be aware, the Government of Quebec brought a constitutional challenge, by way of a reference to the Court of Appeal of Quebec, some time ago.

The Court of Appeal of Quebec issued its decision in 2008 and found that parts of the Assisted Human Reproduction Act were unconstitutional. We have challenged that. We have appealed the ruling of the Court of Appeal of Quebec. We think it's important, given that there is uncertainty in this area, to get guidance from the Supreme Court of Canada.

We will be continuing to work up our regulatory projects in the meantime. We are moving forward quickly. We have filed our factum. A number of provinces have intervened. They will be filing theirs. I believe the hearing will take place over the next few months.

Typically, Supreme Court decisions take about--no guarantees--six months. We want to be in a position very quickly to move after that.

3:50 p.m.

Conservative

The Chair Conservative Joy Smith

Ms. Murray.

3:50 p.m.

Liberal

Joyce Murray Liberal Vancouver Quadra, BC

Thank you.

Minister, I'm going to ask just a couple of questions in order to understand your government's and your department's approach to research. There are some seemingly contradictory statements.

On the one hand, we hear that you want to work well with the research communities. On the other hand, there are some pretty major reductions to the granting councils. Also, we see in the strategic review that $6.3 million was refocused in regard to research towards advancements in science, so I'm not sure how you refocus by cutting $6 million.

But it's the Genome Canada funding that I'm most interested in. I see in the supplementary estimates that you're asking for an additional $4 million for the genomics research and development initiative. Meanwhile, Genome Canada, which was expecting $120 million, was very disappointed to see no additional funding. They believe that only research that's well under way can continue and that nothing new can start. “It's like we fell between the chairs,” said the president.

Could you tell me if this $4 million is making up for the $120 million that is being cut from future funding for Genome Canada? Or what is that budget for?

3:50 p.m.

Conservative

The Chair Conservative Joy Smith

Madam Minister.

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Thank you, Madam Chair.

Our government is making strategic investments in the health and safety of Canadians. This includes health research. For example, in that area, Genome Canada has stated they are pleased with the federal government's 2009 budget. It's an industry lead.

On the specific question on the $4 million, I will ask my deputy to explain that allocation in more detail. Thank you.

3:55 p.m.

Conservative

The Chair Conservative Joy Smith

Mr. Rosenberg.

3:55 p.m.

Deputy Minister, Department of Health

Morris Rosenberg

Thank you.

Just to be clear, the federal genomics initiative is I think what the question refers to, and that is not Genome Canada, which has a responsibility that is under the Industry portfolio.

The federal genomics initiative is a horizontal research initiative that includes Health Canada and the public health agencies, as well as several other departments, including the NRC, Fisheries and Oceans, Natural Resources, and Environment Canada. The initiative supports research and development performed in federal government labs, and that should be distinguished from Genome Canada, which supports large-scale initiatives performed in universities and in industry.

That being said, we do, at Health Canada, collaborate with Genome Canada scientists. The new projects--to understand the molecular basis of nutrition, radiation impact, environmental toxicology, markers for carcinogens, and hepatitis C treatment--will be undertaken under this genomics research and development initiative. That is what the $4 million is about.

3:55 p.m.

Liberal

Joyce Murray Liberal Vancouver Quadra, BC

So we may expect to see Genome Canada having its funding continue. Certainly, I know a lot of researchers out at UBC who feel that's an important investment. Otherwise, we'll see very talented people moving to the United States.

I wanted to raise a second issue, and that's harm reduction. Again, there is a nod to science and research and scientists. As we know, by far the majority of peer-reviewed research supports harm reduction. Insite in Vancouver saves lives, but I didn't see anything in the supplementary estimates to fund, to support, or to in any way continue with that harm reduction program.

Minister, do you have the same view as your predecessor, which was that Insite and harm reduction are an abomination, or is this something you support? Might we see you taking a different approach?

3:55 p.m.

Conservative

The Chair Conservative Joy Smith

Madam Minister.

3:55 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Thank you, Madam Chair.

A notice of appeal was filed, as the member knows, with the B.C. Court of Appeals on June 30, 2008. This appeal is set to be heard early this year. As the matter is before the courts, my comments on it are limited. We have to respect the court process.

I want to be clear that we agree that injection drug users are in need of assistance. Our government has invested $100 million over five years to improve access to treatment for drug addiction. Of this, $10 million was set aside for Vancouver's downtown eastside. The funding has created 20 new transitional recovering beds to help individuals with drug addictions. I understand that facility was opened last week.

The focus of our national anti-drug strategy is on prevention and treatment of those with drug dependencies. We care about preventing people, especially our young people, from becoming addicted to drugs in the first place. That's the approach we're proud of taking to Canadians.

Thank you.