Evidence of meeting #36 for Health in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was supplies.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Morris Rosenberg  Deputy Minister, Department of Health
Paul Gully  Senior Medical Advisor, Department of Health
Audrey O'Brien  Clerk of the House of Commons, House of Commons
Kathryn Butler Malette  Director General, Human Resources, Corporate Planning and Communications, House of Commons
Kevin Vickers  Sergeant-at-Arms, House of Commons

4:15 p.m.

Conservative

Cathy McLeod Conservative Kamloops—Thompson—Cariboo, BC

Thank you, Madam Chair.

This has been a very interesting report for me. Back in the early eighties I was one of those nurses working in one of these remote or isolated communities, and I can recall thinking I was ordering a dose of something and I actually ordered a case of saline solution. They are probably still using that saline solution to this day.

I reflect on this whole incident, and as a nurse, to overestimate...first of all, to look at the pain it caused my community and how it escalated into something from a mis-estimation as a nurse working in a community. In actual fact, at that time I was one of the first band-employed nurses, and it would not otherwise have escalated because I was directly responsible to the community I worked for; it would have stayed at that level.

So what has happened more recently is really unfortunate. I think what we need to do is to recognize it for what it is, and I think the report is very clear on that. I think it's time for us to move on. Perhaps sometimes out of difficult circumstances we can learn lessons, as you've articulated, and we can just move on. Clearly it is time to do that.

We've talked a lot about Manitoba, and certainly that's an area we are concerned about in terms of how things are going. But I would also be very curious to hear from Dr. Gully about what's happening across the country—and again, it's only been a month.

4:20 p.m.

Senior Medical Advisor, Department of Health

Dr. Paul Gully

Thank you.

What I have learned in the few weeks I've been here is that there are large differences in the arrangements between Health Canada, first nations communities, and the provinces. It is not simply that there are some communities where it has been transferred, because communities can actually be responsible but the provision of nursing services can still be the responsibility of Health Canada. That's a particular agreement.

The situations in which planning occurs vary tremendously. The requirements in terms of remote and isolated communities vary tremendously.

What I've seen is a common theme of communication, but this communication is also different. For example, there is a tripartite table in Manitoba that meets weekly; there's also one in B.C. that meets weekly--at the provincial level--and those issues are raised there, in terms of issues that might occur.

We will continue to have to deal with this large number of arrangements when we move on to an immunization program, because the provision of vaccine is totally integrated with the provinces. Therefore, when the vaccine arrives at the provinces it would get distributed to health centres, and then it would be available to Health Canada for distribution to communities. That planning is going on right now, taking into account the time schedule that has been announced--early November--but also then recognizing how the vaccine may receive authorization. So we have to be nimble, we have to prepare, but we have to take account of things that may change. That is occurring.

We have antivirals pre-positioned, we have vaccine plans, and even where we don't have nursing stations, there are health centres that give immunization in southern communities, so we have to work with that as well. On the other hand, in many places in southern communities, communities actually access health care and immunization through the province. This real work is going on.

Finally, and probably most importantly, there's our collaboration between Health Canada and the surveillance systems in the provinces and how we get information from our nursing stations, how we share that with the provinces, so we know precisely what's going on and if there is an issue we have to then concentrate more resources on.

4:20 p.m.

Conservative

The Chair Conservative Joy Smith

Thank you, Dr. Gully, for those very insightful comments.

Monsieur Malo.

4:20 p.m.

Bloc

Luc Malo Bloc Verchères—Les Patriotes, QC

Thank you again, Madam Chair.

I do not know if you are aware of this, Deputy Minister, but last Monday we heard from health professionals who informed us that they did not yet have all of the information they needed in order to deal with patients' concerns. If they do have the information, it is not always in a format that is easily or quickly accessible.

Moreover, we are hearing at times contradictory messages on various channels. Some of the information casts doubt on the findings of the Public Health Agency of Canada or of the public health agencies in Quebec and the provinces.

Could you, first of all, give me your opinion on this matter and tell me whether or not, in your opinion, there is a problem?

4:25 p.m.

Deputy Minister, Department of Health

Morris Rosenberg

Madam Chair, I cannot answer this question fully because part of it pertains to the mandate of the Public Health Agency. I know that you have regular briefing sessions with its officials, and it would be more appropriate to direct the public health questions to Dr. Butler-Jones or other officials from this agency.

What I can tell you is that in a federation where responsibilities regarding health and public health are shared between the provinces and the territories, our objective is to provide better coordination in a pandemic situation.

We are trying to improve our coordination by holding various meetings. For example, there are weekly meetings between the chief medical officers of health and the Chief Public Health Officer of the Public Health Agency of Canada. In addition, there are regular teleconferences between the health deputy ministers in all of the jurisdictions in the country. One of the main goals is to coordinate activities as well as possible.

4:25 p.m.

Bloc

Luc Malo Bloc Verchères—Les Patriotes, QC

Did you discuss communication with the public and health professionals, in particular, during your meeting in Mexico?

4:25 p.m.

Deputy Minister, Department of Health

Morris Rosenberg

We can use North America, as an example, but you could use any country as an example. Through the World Health Organization, you could take a country like Canada. The objective is the same. In a pandemic situation, coordination, the exchange of information and scientific opinions represent one of the big challenges. I am not a doctor, but one of the things that I have learned since joining Health Canada as a lawyer, is that this is not an exact science like mathematics. Opinions and decisions are different.

Discussions are required in order to reconcile opinions and we need to establish mechanisms at every level of our government, within the federation, within North America and within the World Health Organization in order to provide the world's citizens with information that is as clear as possible.

We are not perfect, but we are trying to do this better.

4:25 p.m.

Conservative

The Chair Conservative Joy Smith

Thank you, Deputy Minister Rosenberg, and thank you, Dr. Gully, for coming today and giving us your very insightful comments. We appreciate your time very much.

I am now going to suspend the meeting for two minutes to allow the Clerk of the House of Commons to come in and take her seat.

4:30 p.m.

Conservative

The Chair Conservative Joy Smith

Good afternoon, Ms. O'Brien and Ms. Malette, and also Mr. Vickers. We're very pleased to have you come today to present to our committee.

Committee members, we are going to conclude at twenty after five so that we have 10 minutes. We have three items of business and we will do that at that time.

I would ask that you give a 10-minute presentation, and I understand the handouts have been distributed to the committee members. At the end of the time, we will have a Q and A time, seven minutes for questions and answers from all sides of the House. Again, welcome. This is a rare opportunity to have you here, so, Ms. O'Brien, could you please start your presentation.

4:30 p.m.

Audrey O'Brien Clerk of the House of Commons, House of Commons

Thank you very much, Madam Chair. Bonjour, tout le monde. Good afternoon. I'm very happy to be here to speak to you today about the House of Commons H1N1 preparedness approach and our response to the issue of the pandemic.

I'm joined today by Kathryn Butler Malette, who is the director general of Human Resources and as such is responsible for occupational health and safety as well as corporate planning and communication services, and the Sergeant-at-Arms, Kevin Vickers, who is responsible for business continuity in a larger umbrella.

To begin with, I would like to provide you with some background to our approach. I will then explain the purpose and the scope of our pandemic plan. I will also give you an overview of the governance structure of the plan and explain how the information will be forwarded, and the corresponding responsibilities. I will conclude by providing you with information on the resources available to members.

As of April 2009--and I'm speaking basically to the PowerPoint slides that have been distributed to you--the draft pandemic plan of the House of Commons administration as it was then was activated at an accelerated rate as a result of the increased pandemic alert levels. We developed the plan with expert advice from Vanguard Emergency Management Consultants, who specialize in business continuity and emergency and pandemic planning and management.

In April 2009 the House administration also created what we call the influenza monitoring committee. It's a senior-level House administration committee that is chaired by Kathryn, and her alternate is Kevin, with experts from across the House administration, and it continues to meet regularly and is closely monitoring the pandemic situation. In the spring it took a number of mitigating actions, including installing additional hand-sanitizing stations across the precinct, increasing cleaning measures in high-traffic areas, issuing regular communication updates to the House of Commons community, and holding information sessions for front-line employees.

We are working closely with our employees, both those represented by unions and the non-unionized, to ensure they are aware of the evolving situation so they can take responsibility for their personal health. The pandemic plan was presented and approved by the Board of Internal Economy on September 28, 2009.

The House of Commons Administration pandemic response plan is designed to, to the extent possible, continue the two business lines of the administration, namely administration as employer and administration as supporting the House of Commons and its members in carrying out their constitutional functions.

The plan is also designed to help the House of Commons, as an institution, and the members of Parliament to manage the impacts of the pandemic on their operations and functions. What is most important is that the House of Commons be able to carry out its activities as part of the state's legislative power. This is a priority for us. This imperative may therefore override the provisions of the plan. We may have to give priority to various services and resources that directly support such activities so that the House of Commons can continue providing the services it deems necessary.

The overall approach of the House of Commons administration pandemic plan is to address appropriate mitigation and preparedness for a worldwide infectious disease outbreak and to define incident response and business continuity objectives that align with a public health emergency. The steps outlined in the plan are modelled on industry best practices and guidance and information that has been offered by the World Health Organization and by federal, provincial, and municipal public health authorities.

To ensure an integrated approach, the pandemic plan supports the House administration's overall business continuity management program and crisis communications plan. The House of Commons administration has extensive business continuity plans in place for potential events that could disrupt the primary business functions of the House of Commons administration, but we're here today really to focus on what we are doing with regard to the pandemic.

I would also like to stress that obviously the pandemic plan is intended to be a living document. It will continue to be revised as additional information and guidance are issued by public health authorities, and we will also be testing the plan through various tabletop exercises to continue to improve upon it.

This is the organization chart, which presents an overview of the governance structure for the pandemic plan for the House administration in the event that an outbreak of influenza results in a high level of employee absenteeism within the parliamentary precinct that affects the level of service normally provided to members. Any decision that would need to be taken on resources that are provided to members and the impact on House administration service levels generally would be brought forward by me to the Board of Internal Economy.

As you know, I'm the senior permanent officer of the House and therefore the head of its administration, and as such I'm responsible for the management of the House in accordance with the policies, decisions, and directions of the Board of Internal Economy. Therefore, I'm responsible for activating the plan, ensuring that it is effectively carried out and that the administration supports the House of Commons and its members in carrying out their constitutional functions, including their roles as employers and as administrators of their members' office budget. It's certain that the influenza monitoring committee itself, which I mentioned earlier, is responsible for implementing the plan here on the Hill and ensuring that the pandemic risk mitigations and response actions are implemented on a timely basis as risk levels change.

As I mentioned, Kathy is the chair of the committee and Kevin is her backup. One of the things I wanted to make clear as well is that I'm working very closely with the whips of the various caucuses, because you all have operations back in your constituencies; you have staff back at the constituencies. So it becomes important that you become partners with us in terms of managing those employees. Obviously, again, because there have been regional outbreaks and these things tend to be sort of localized, you'll need to be paying close attention to what's happening in your region or city and to the advice given by the local public health authorities there.

At the same time, you'll be in contact with your whip and the whips will be in contact with each other. For example, let's take a kind of extreme geographic example: if there were a severe outbreak in British Columbia, what one would likely see is the whips getting together to suggest, first of all, that travel to and from British Columbia be limited, if not done away with altogether, and they would take the kinds of decisions among themselves with regard to the pairing of members for votes and so forth. Those are the kinds of decisions that need to be taken at the political level.

Our discussion at the Board of Internal Economy—without revealing the secrets of the star chamber—was in that vein. Each caucus has its own way of operating. The whips have their own ways of operating with their members. This is a very important partnership for us. If it turns out that there is at any point some kind of difficulty with a member serving his or her constituents because of a very high level of absenteeism in a particular region that's been particularly hard hit, for example, then the whip would likely be bringing that to my attention and I in turn would likely be bringing the whole case, the whole issue, before the board for some kind of mitigation. Again these are hypotheticals.

The important thing is to keep the lines of communication open so that we are aware, each of us in our various roles, what exactly is happening. So the kind of information that is going out from us and from the IMC—the committee that is monitoring these things—that goes out to all employees, will also be shared with all members because we're all part of the Parliament Hill community, and that, obviously, of course, would apply as well to constituency offices in the national capital region.

We have also made a commitment to work closely with our parliamentary partners. In addition, we have regular meetings with the Senate, the Library of Parliament and the Office of the Conflict of Interest and Ethics Commissioner to discuss issues such as communications, labour relations and the planning of the continuity of operations.

The activities mentioned in the pandemic plan are based on three distinct risk levels: low to moderate, high and severe. The appropriate risk level is determined on the basis of several factors, such as the seriousness of the cases, the spread of the flu, Health Canada's recommendations regarding closures, restrictions on public gatherings, travel and, of course, absenteeism.

Slide 9 gives an overview of the decisions and communications between the clerk, the Speaker and the Board of Internal Economy.

The slide show is an overview of decision-making authorities, communication flows, and responsibilities. Based on the pandemic risk level, decisions would be brought forward to the appropriate body.

The Board of Internal Economy is, of course, responsible for administrative decisions at the policy level, and these would include decisions on mitigation measures to cope with high absenteeism that might, perhaps, for example, affect levels of service in certain administrative functions. One thinks perhaps of IT, information technology, where a lot of our workers are quite young. So it's not only that they, themselves, might be affected, but because a lot of them have young children, we might be in a situation where they're at home taking care of sick kids.

Along with the Board of Internal Economy, I'll be working closely with the whips, as I mentioned, to monitor impacts on your office and research staff and the mitigation measures that may be required if a member's ability to respond to constituents is affected. Whips are responsible for monitoring the impact on their members and for bringing forward to me problems on a case-by-case basis.

In keeping with standard practice, members will continue to be guided in the management of staff by the Members' Allowances and Services manual in such matters as the administration of leave and the terms and conditions of work.

Up-to-date and accurate information about the pandemic will be provided by the House administration to members and their staff and to the employees of the House administration, as I just said.

As the pandemic could have varying impacts across Canada, it's important to note—and I repeat this, because I think it is a very important feature—that members need to be guided by their local health units in their local constituencies for their constituency office pandemic planning. That is in addition to the guidelines provided by WHO and the Public Health Agency of Canada. Likewise, on Parliament Hill, we are guided by these matters.

I guess the last matter I should mention, because there have been questions about it, concerns what we have every year, usually around this time, or maybe a little bit later, which is the vaccination for the seasonal flu. It's important to understand that the vaccination program for seasonal flu is not within our control. That is something that is recommended and managed by the Public Health Agency. Public health authorities have told us that at this time they are not going to go ahead with vaccination programs, and we're going to be issuing, tomorrow, a communiqué to staff and members to advise them formally of that. There are no plans for the traditional seasonal vaccination day, if you will, nor are there any plans for vaccination for H1N1.

The recommendation coming so far from the Public Health Agency is that vaccinations for H1N1 are available to people over 60 years of age, and that's in the community at health clinics or at family doctors' offices. That, as I say, is not really within our control. That's something that's controlled by the health agencies. I wanted to make that clear, because of course people have come to count on that every fall.

Lastly, I just want to mention that there is a tool kit for members that provides Qs and As about leave and dealing with employees and so forth, and that's available on the Internet site.

The House Administration has prepared this information kit. In addition to these tools, resources and general information on pandemic awareness, it includes questions and answers designed to help members in their role as an employer. The kit is available on Intraparl.

I hope this very brief overview has been useful. We would be happy to take your questions.

4:45 p.m.

Conservative

The Chair Conservative Joy Smith

Thank you, Ms. O'Brien.

I let you go over time because this is very important.

4:45 p.m.

Clerk of the House of Commons, House of Commons

Audrey O'Brien

I'm sorry, I tried to go as fast as I could.

4:45 p.m.

Conservative

The Chair Conservative Joy Smith

No, no, that is fine. It's some very insightful information, which is needed.

We're now going to go into our first round of questions and answers, and that's seven minutes per question and answer.

We'll start with Dr. Bennett.

4:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Thanks very much.

I think, as you know, we began asking questions about the parliamentary plan at the first public meeting with Dr. Butler-Jones in May. I guess to find out that there's a tool kit on the Internet today is a bit surprising in that none of us knows it's there. I guess we're a little bit concerned that the plan is only as good as what each of us knows our role will be in the plan.

Each of us is an employer, in a certain way. We're responsible for our staff, and I guess I just want to know if there will be information sessions. When will there be training? And how will you, as the clerk, determine which of our offices are ready and which are not in terms of which of us has shown up at the training sessions. It would be the same as anybody in charge who would have to determine whether the departments are ready and whether the others are. We were very concerned when we heard from Treasury Board and PCO that they couldn't actually tell us which departments were ready. Do you feel that you will be able to have a handle on which members' offices are ready or not ready, in terms of that?

I guess the other question would be whether you have determined what the critical activities or critical committees that need to meet would be. Is there technology available that would allow staff, members, and particularly support staff, such as the library, to be able to work from home?

4:45 p.m.

Clerk of the House of Commons, House of Commons

Audrey O'Brien

That's quite a series of questions.

First of all, let me say that with regard to the tool kit, people don't know about the tool kit because it went up on the Internet today. There will be a communiqué going out today that says this tool kit is available.

As I mentioned earlier, the plan is something that has evolved. You will recall that in May and June of last year, quite a series of communiqués went out to members' offices that informed them of what level had been declared by WHO and that kept people informed as we ourselves were informed.

One thing I want to make very clear--I suspect I'm going to be disappointing you in this--is that while, as the clerk, I am responsible for the implementation of the plan here on Parliament Hill for the House of Commons, and I'm responsible for ensuring that each one of my direct reports is prepared and their employees are prepared for an eventual pandemic, I have no authority over members of Parliament or their offices.

Members of Parliament are completely, from my point of view, independent creatures. They operate both as independent employers and as members of a caucus.

So when I was talking about the kind of partnership we have with the whips, that is to make information available to the whips and to sensitize them to the kinds of questions they may get from their members.

4:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

But in terms of training, I don't think the whip is in any position to train members or their staff about reasonable practices, or to make sure there's hand sanitizer in the offices, or to have what the “min specs” would be from the precinct.

4:50 p.m.

Clerk of the House of Commons, House of Commons

Audrey O'Brien

With regard to the advice we're giving about sanitizing and washing hands and whatnot, those go out to every individual.

4:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

But will there be sanitizer, those machines, in every MP's office?

4:50 p.m.

Clerk of the House of Commons, House of Commons

Audrey O'Brien

Right now there are sanitizers throughout the precinct. There are no plans at the moment--

4:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

People are eating at their desks, and visitors are coming and going, shaking hands. Could you not put one in all the MPs' offices?

4:50 p.m.

Clerk of the House of Commons, House of Commons

Audrey O'Brien

I suppose we could put one in MPs' offices. The thing of it is that I don't want to get myself into a position where I'm basically...and I don't mean any disrespect by--

4:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

You provide us with water....

4:50 p.m.

Clerk of the House of Commons, House of Commons

Audrey O'Brien

We do provide you with water.

Kathy reminds me that some members have purchased hand sanitizer, and there are hand sanitizer stands in the high-traffic areas.

I would have thought that how the office itself is...you know, whether an MP thinks that they want hand sanitizer or not. Some people don't want the hand sanitizer stuff. They find that it dries out hands, and it's no use, and people should just use soap.

We don't want to impose hand sanitizers on people, so we had not considered that. We can happily consider that if that is something people want, but there's really an arm's length here.

And with regard to--

4:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

But in terms of training, the whips can't do training on pandemic preparedness. There has to be training, for us as employers as well as members of Parliament, to know the risks, and to know what role we will have to play in a pandemic coming up. Where will the training be? Will the tabletops include MPs, if you're going to test your plan?

4:50 p.m.

Clerk of the House of Commons, House of Commons

Audrey O'Brien

We have provided training sessions for managers in terms of their answering questions from their staff. We would be happy to provide similar kinds of sessions for members, if they are interested in having a question-and-answer session. This is one of the reasons why we prepared the tool kit. It's a way of answering questions that employees might have.

Frankly speaking, though, I guess I'm not quite sure what kind of training you would--