Health Committee on Sept. 30th, 2009

[Dr. Paul Gully]

That works at a variety of different levels. It works at the level of the Assembly of First Nations and that recognition that prompt, regular communication between the AFN and the Government of Canada is important. In addition, though, it also sends a message to the government departments that they will continue to have a close relationship at the regional level and at the community level.

For example, I do know that in certain regions, as part of the tripartite process, there are actually regular—and I know in Manitoba they're weekly—meetings between the tripartite members at the present time so that information is transmitted and then questions can be asked.

In addition to that, there have been a number of calls with national aboriginal organizations to ensure they are updated and then to receive their concerns—for example, about immunization.

Finally, as I mentioned earlier, there is the virtual summit, which is being organized between Health Canada and the Assembly of First Nations. That hopefully will enable many communities and many individuals to pose questions in a virtual way over a period of time and get answers to their concerns. That's using more up-to-date technology. The protocol is important, because it does send a message to the Government of Canada, but also then to the first nations communities and organizations, that we do mean to carry this through.

We will continue to do that and continue to have meetings at various levels, as we did last week with the grand chief in Manitoba.

[Colin Carrie, Conservative, Oshawa, ON]

All right.

As parliamentarians, we all have our different constituents. Can we be confident in saying that 90% of first nations communities do have these plans, and they have been tested? We can bring that answer back to our constituents?

[Dr. Paul Gully]

Exactly. That's exactly what we're sharing.

In fact, it would be interesting to pose that question to all communities across the country of varying sizes about preparedness. We have that information and that's what we have given to you. We have confidence in that information.

[Colin Carrie, Conservative, Oshawa, ON]

I know we have that in my own community of Oshawa. We have the ads in the paper, and as I said, the radio is coming through quite clear.

I wonder if you could address this discrepancy. This is with regard to sufficient supplies in first nations communities. I've heard that there's some concern that maybe there aren't the supplies there.

How do we have that communication feedback so that we can confidently tell our constituents that, yes, we are looking after first nations; that they are indeed receiving the supplies that they require; that all the reports saying that they're not there are false reports? How do we know?

[Dr. Paul Gully]

I can confirm. I've seen the figures and I have the information in terms of the supplies that have been purchased by Health Canada and distributed by the regions to the communities. That includes the N95 mask, which may be useful at times. It includes the gown, the gloves, and so on. They were purchased for the use of health care workers to enable them to carry out their work, to protect them, but also to ensure that they remain well so that they can carry on doing their work.

I think the difference occurs when there's an assessment of what supplies are there. I know there's a concern about access to Tylenol, for example, or anti-fever drugs. The nursing stations certainly have that. They certainly have that available so that if a person is sick, they can go; it could be prescribed, if necessary.

We would rather in this situation that sick individuals did seek care from the nursing station, which is available in those communities, so that if those individuals are ill and are becoming severely ill, then the most quick and appropriate treatment in terms of certainly antivirals, but then also, if necessary, medial evacuation, can occur as soon as possible.

[Colin Carrie, Conservative, Oshawa, ON]

So then--

[The Chair, Conservative, Joy Smith]

Sorry, we have to go now to Ms. Murray.

Thank you.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Thank you, Madam Chair.

I would like to ask a bit about resources. I'd like to go back to the comment that resources aren't an issue and we'll do what needs to be done--which was good to hear. So $400 million was set aside as a contingency fund in budget plan 2006. How much money is in that contingency fund? Who has the authorization to spend it? How is it being allocated?

That is my first set of questions. Then I have another concern, which I would like to get to next, that comes from the chief medical officer in British Columbia.

[Dr. David Butler-Jones]

Sure. I'll try to be quick.

Basically, there was the original $1 billion, of which $600 million was allocated over a number of years. Then there's the $80 million per year that would expire--as we've talked about previously at the committee--if it wasn't spent, wasn't needed. Then there's this year's, which has been allocated amongst the departments, focusing on the surge and the challenges we had in the spring.

We've been encouraged, as we need it, to come forward if additional resources are required. Again, that would require the approval of cabinet, Treasury Board, etc.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

So it was down to the $80 million, but that's now been used with the spring surge.

Dr. Butler-Jones, you're the one who has the pen in allocating that?

[Dr. David Butler-Jones]

Well, it's our department, as well as Health Canada, as well as CFIA and others. In terms of that contingency, it was basically those three departments. But other costs related to this--to actually address, anticipate, and respond to--are more than that. That's an ongoing discussion.

But particularly the Public Health Agency's role, I'm responsible for that.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

My understanding is that the federal government has signed a 40:60 cost-sharing agreement with the provinces on the vaccines--

[Dr. David Butler-Jones]

Correct.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

--but that there have been requests for cost-sharing with municipalities and provinces on all the other costs. I don't know what they are, but I guess they would be things like supplies, plan preparation, training, extra human resources, and so on. But that's been turned down, or there hasn't been a response to that. I know it's a frustration in the province of British Columbia.

I'm trying to square that with the comment that there's no problem with adequacy of resources.

[Dr. David Butler-Jones]

There are federal, provincial, and municipal roles to deal with this. In a pandemic, as in any outbreak, we all have parts to play. At this point we don't know what the long-term costs and impacts will be. Our ministers have said previously that, at least from the health standpoint, those would be addressed as needed. We have a draft MOU with the provinces and territories that also makes reference to, once we get through this, looking at what's involved in terms of our capacity to actually address it. Immunization is normally a provincial responsibility. In order to ensure equity and access, the federal government will be paying 60¢ on the dollar, and we have done the same with anti-virals as well for the stockpiles.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

I'm not sure I understood correctly. I'm hearing from the province that there's a request for funding help, cost-sharing with all of this important stuff around getting plans, supplies, training, getting all that readiness, and it's been turned down. So might there be municipal or provincial programs or communications that are not happening because they don't have the money?

[Dr. David Butler-Jones]

These preparations, plans, and responses are a normal part. Every influenza season, hospitals experience surge. Every influenza season, there are additional costs. We have an MOU. Part of that is a commitment from all parties to sit down and look at what that means should there be extraordinary costs on the health side.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

So I can go back to B.C. and say, if after the fact it can be shown that there were extraordinary costs related to this pandemic, they'll be retroactively covered?

[Dr. David Butler-Jones]

No. We don't know at the end of the day whether the costs dealing with the pandemic.... It could be, if we do this right, not much more than an annual flu year. So what we've all committed to is to continue to work together, to collaborate, to make sure that what needs to get done is done, and if there are extraordinary costs, then we'll sit down together and see what we do with that. And they are a party to that same MOU.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

So you're not concerned that things that should be done in terms of preparedness won't get done?

[The Chair, Conservative, Joy Smith]

I'm sorry, Ms. Murray we have to move on.

[Dr. David Butler-Jones]

Absolutely not. All jurisdictions have committed to do the work, and we'll worry about those other things later.

[The Chair, Conservative, Joy Smith]

Thank you.

Ms. McLeod, you're next.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

I have three quick questions.

My first question is for Ms. Chatigny. In terms of the strategy around communication, I'm just wondering if you've done any focus groups and polling in terms of trying to create a certain outcome. Are you actually seeing where you're at right now and seeing if you are managing to create that outcome with your communication strategy?

[The Chair, Conservative, Joy Smith]

Ms. Chatigny, maybe you could go into the other question as well, as you're answering.