Evidence of meeting #48 for Health in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was pandemic.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Alfred Tsang  Chief Financial Officer, Department of Health
Morris Rosenberg  Deputy Minister, Department of Health
David Butler-Jones  Chief Public Health Officer, Public Health Agency of Canada

3:30 p.m.

Conservative

The Chair Conservative Joy Smith

Good afternoon, ladies and gentlemen.

It is very good to see everybody back here at committee. I would ask that everyone take their seats so we can start.

I want to especially welcome the Honourable Leona Aglukkaq.

Minister, thank you for coming today. We so look forward to your presentation.

Of course, we also welcome Morris Rosenberg from the Department of Health.

Welcome back again. It's like old times, isn't it.

As well, we welcome Alfred Tsang, chief financial officer.

From the Public Health Agency is no stranger to our committee, Dr. David Butler-Jones, chief public health officer.

Welcome, Dr. Butler-Jones.

We also welcome James Libbey, chief financial officer.

As you know, the timing is a bit different for questions and answers when a minister is here. What will happen is the minister will give a presentation of 15 minutes or so, and following that, we'll proceed.

Minister Aglukkaq, we welcome you.

3:30 p.m.

Nunavut Nunavut

Conservative

Leona Aglukkaq ConservativeMinister of Health

Thank you.

Good afternoon everyone. It's my pleasure to be here with you once again.

With me today from Health Canada are Morris Rosenberg, Deputy Minister, and Alfred Tsang, chief financial officer. As well, from the Public Health Agency of Canada, we have Dr. David Butler-Jones, chief public health officer, and Jim Libbey, the chief financial officer.

This has been an extraordinary year for the health portfolio. Since I appeared before you on the main estimates in May, we have been moving forward with many important improvements to our tobacco laws, Bill C-32, and our consumer protection legislation, Bill C-6, while dealing with an emerging influenza pandemic.

Since May, we have also developed and made investments in improving protections against food-borne illnesses in response to all 57 recommendations made by independent investigator Sheila Weatherill.

Collaborations with the provinces and territories, as well as first nations communities, have been of primary importance. International discussions and information-sharing have proved to be fruitful and, in the case of the H1N1 pandemic, have helped in our success.

We are now in the middle of the largest vaccination campaign in this country's history. It is one that could only have been undertaken with the unprecedented level of cooperation we have seen between all levels of government. We have kept close contact with the World Health Organization and other international partners. Here at home, we have maintained an open line of communication with provincial and territorial governments with respect to the H1N1 virus.

From a national perspective, the vaccination program is progressing very well. From our largest urban centres to small, isolated communities, the vaccine is getting to those who want it and need it. This is the sixth week of the campaign, and more than 20 million doses have been made available to Canadians so far. We are well on our way to having enough vaccine for everyone who wants it by Christmas. I would again like to express my appreciation to the provinces, territories, and all the front line workers who are vaccinating thousands of Canadians every day.

We were able to approve a safe and effective vaccine thanks to the unprecedented level of collaboration among international regulators. This collaboration started a few years ago, and Canada has been an active participant. In fact, the key Canadian contribution occurred in the spring, when public health scientists helped identify the strain of the new virus.

Our work with the H1N1 pandemic has provided us with an opportunity to learn. A better understanding of this flu has allowed us to acquire the wisdom and knowledge to respond to the illness if a third wave comes. It will also provide us with experience and guidance for the future, if needed.

Our work on this is ongoing. That is why the Canadian Institutes of Health Research announced support for five new research projects designed to help further understand and address the H1N1 flu virus. We are already a global leader in H1N1 flu virus research. The new research being funded will help ensure that our knowledge, approach, and planning remains amongst the best in the world.

Canadian scientists will try to understand, among other things, why the virus causes some patients to develop serious respiratory illnesses. Another team will study the impact of the virus on pregnant women and try to determine why some develop complications. Another group will study the impact this pandemic is having on health care resources.

Our goal is to learn as much as we can while this virus is having its greatest impact. That kind of learning experience will guide our response to future pandemics. This pandemic is unique because we continue to learn about it the longer it is around. Obviously, we want to keep ahead of it as it continues to circulate through the country and the globe.

Earlier this year, when the illness had spread in some isolated first nations communities, we addressed the vulnerability of the hundreds of remote and isolated communities throughout the country. Ever since that first wave, Health Canada and the Public Health Agency have been helping first nations prepare for the second wave. Being from a remote community, I know so well the challenges these regions face with health issues.

A federal-provincial-territorial working group was created at the outset of the pandemic to address issues specific to isolated and remote communities. I also appointed Dr. Paul Gully, who provided the much needed support and link between the first nations communities and our offices.

By October 23 more than 95% of first nations communities had pandemic plans in place. First nations had been sent supplies needed to deal with a pandemic, and antiviral medications had already been shipped to strategic locations for easy distribution. A plan was also in place to reallocate nursing staff to facilitate vaccine rollout.

As testimony to our efforts, I have provided you with the video of my visit to the Cowessess First Nation in Saskatchewan. This community was thoroughly prepared for the second wave of the virus. During my visit I met community leaders who embraced the challenge of getting their friends, family, and neighbours prepared.

The success of the preparations in Cowessess and hundreds of other communities just like it is due to the collaboration between the federal government and first nations. Many small communities were hit by the virus during the first wave, and the lessons learned during the first outbreak enhanced our preparations for the second wave.

Within three days of the approval of the vaccine, teams of health care workers flew to remote communities to vaccinate everyone who wanted to be vaccinated. The response was very high. Clearly, our message regarding the importance and safety of the vaccine had been effectively communicated.

I also signed a communications protocol with the Minister of Indian and Northern Affairs, Chuck Strahl, and the National Chief of the Assembly of First Nations, Shawn Atleo. That protocol was and continues to be a commitment to share information with first nations in a timely way.

Our first initiative under that protocol was to host a virtual summit to share important information about H1N1.

Preparations for the second wave in first nations were guided by annex B of the Canadian pandemic influenza plan, which had been adjusted to incorporate lessons learned during the first wave.

While flu activity has levelled off in some parts of the country, we continue to roll out our vaccine, inform Canadians, and remain vigilant in the event of a third wave of the H1N1 virus. We'll also continue the process of broadening our pandemic planning and make specific plans on how we will deal with future health concerns. This has been the first real test of our Canadian pandemic influenza plan, and, as I mentioned earlier, our biggest vaccination program.

While the H1N1 virus has dominated the health agenda since April, the other business of the health portfolio has kept moving forward.

With your cooperation we have passed Bill C-32, the Cracking Down on Tobacco Marketing Aimed at Youth Act. This legislation will protect children from tobacco marketing practices designed to entice young people to smoke. As well, by the banning of flavours and additives and by instituting minimum package sizes, the appeal of these products to children and youth is greatly reduced.

Bill C-6, the Canada Consumer Product Safety Act, is now before the Standing Senate Committee on Social Affairs, Science and Technology. In fact, senators are engaged in clause-by-clause consideration of this bill right now, as I speak to you. The proposed legislation would better protect Canadian families from dangerous consumer products. It would allow for much needed product recalls and mandatory reporting. In short, it will give the government the necessary tools to act in a timely and consistent manner to protect Canadians against unsafe consumer products. This is so important, particularly at this time of year when many parents are shopping for Christmas gifts. Parents need to know that the gifts they put under their Christmas trees are safe for their children.

I applaud this committee for recognizing the importance of this long overdue bill and for its timely yet diligent scrutiny of Bill C-6. I urge the Senate to follow suit and pass the legislation without delay. I hope they will be inspired by my encouragements today.

Another major issue for the health portfolio has been the global shortage of medical isotopes since the shutdown of the reactor at Chalk River. The impact of the shortage has been managed here in Canada because the lessons learned during the shutdown at Chalk River were used to develop contingency plans. These plans are now helping medical staff cope with the shortage.

The research for alternatives and the methods of dealing with the shortage had been well under way long before Chalk River went down. We have been able to cope with the shortage through cooperation with the provinces and the territories. The impact of the shortage has been mitigated by the hard work and dedication of the nuclear medicine community. With alternative solutions, however, patients ultimately receive the diagnostic scans they need.

In 2009 we also took actions to strengthen Canada's food safety system. In partnership with the Minister of Agrigulture, Gerry Ritz, I announced that the government will invest $75 million in Canada's food safety system in response to the recommendations made by independent investigator Sheila Weatherill. Those new investments will improve our ability to prevent, detect, and respond to future outbreaks of foodborne illness. The investments will mean expanded listeria testing, more inspectors, and better surveillance and communication. In the months ahead we must remain vigilant and adapt quickly.

Thank you for providing me with this opportunity to address you today. My experience as federal Minister of Health has been extremely rewarding. I have been given the opportunity to travel and meet with Canadians from across the country. I work with intelligent, determined, and thoughtful individuals who have the same care for the well-being of Canadians that I do. It is truly a privilege to be here on their behalf.

Thank you.

3:45 p.m.

Conservative

The Chair Conservative Joy Smith

I thank you very much, Minister.

We're now going to go into our first round of questioning. As the committee knows, when a minister is with us we start off with the Liberals for 15 minutes; then the Bloc for 10 minutes; the NDP for 10 minutes; and the Conservatives for 10 minutes subsequently.

We will begin with Dr. Bennett.

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Thanks very much.

Thank you, Minister.

Over the last couple of sets of estimates, a number of members have been interested in this first section--how health dollars are being transferred to ministers without portfolio or ministers of state who do not preside over a ministry of state. Can you explain what that first section is and why health money keeps being spent on ministers of state without portfolio?

3:45 p.m.

Conservative

The Chair Conservative Joy Smith

Who would like to take that question?

3:45 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Can you clarify what section you are making reference to?

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

It's on page 171 of the estimates, the first section, under the title of “Health”.

3:45 p.m.

Conservative

The Chair Conservative Joy Smith

Mr. Tsang.

3:45 p.m.

Alfred Tsang Chief Financial Officer, Department of Health

I do not have page 171 in front of me, but we're not making any proposals in this supplementary estimate (B) to those items.

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

It says “Adjustments to Appropriations”, $4 million.

3:45 p.m.

Chief Financial Officer, Department of Health

Alfred Tsang

The details of the $4-million adjustment are provided on page 173. It consists of a number of adjustments. I will certainly be happy to walk through them. Some of the major ones include our H1N1 flu virus outbreak for $18 million. You can see the list on page 173.

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Maybe we will put that aside.

Seeing as the latest economic update was not tabled in the House, could somebody tell me whether the asterisk over the $500 million for Infoway has been removed? It was tabled through the back door, through the journals branch; it was not tabled in the House.

3:45 p.m.

Conservative

The Chair Conservative Joy Smith

Who would like to answer?

Mr. Rosenberg.

3:45 p.m.

Morris Rosenberg Deputy Minister, Department of Health

Thank you, Madam Chair.

In terms of the last report, there was work to be done with Infoway on further due diligence. Since that time the Auditor General has released her report on Infoway. I know that the Auditor General and Mr. Alvarez were before this committee the other day.

We continue to work with Infoway on some of the observations the Auditor General made in that report. The next step, as I understand it, is that Infoway will be tabling an action plan with the public accounts committee in December. We look forward to seeing that action plan and to working with them on that.

3:45 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

I think the testimony on Monday was pretty conclusive, that the sooner they can get the money, the sooner we save money for the health care system in this country and save lives. I'm not sure what the negotiation needs to be when it's a transfer to an independent body that actually just gives out money itself.

On the response to the pandemic, we are still, I think, asking about the $400 million that's been set aside for pandemic response. There doesn't seem to be a real explanation of how the money for response is being spent, compared to that for purchasing vaccine.

Again I ask this, on behalf of the provinces. I understand that the unilateral decision that the provinces would pay for 40% of the cost of the vaccine but 100% of the delivery of the vaccine into Canadians' arms is still of huge contention for the provinces and territories. Local public health services are scrambling. In 2007 the decision to cut the $100 million that was there for provinces to build up local public health has been very evident to Canadians in terms of how this rollout happened this fall.

I guess I would like to know if there is any money to help the provinces with the rollout of the pandemic response. Also, I think the provinces are wondering where the money is to help with the extensive costs over time and the difficulty because of the isotope crisis that was caused by the federal government.

3:50 p.m.

Conservative

The Chair Conservative Joy Smith

Who would like to take that?

Minister.

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Thank you.

In my view, the rollout of the pandemic plan has gone very well in Canada. Canada has been seen as a world leader in responding to this pandemic. I said in my opening comments that the success of how we rolled out the pandemic plan in this country comes from years of planning. At the same time, with the cooperation of the provinces and territories, we've done very well in addressing the rollout of the vaccines in provinces and territories.

We continue to work with them. We are in weekly contact with the provinces and territories, and I can say that the contingency and investments that were made in Canada--the billions of dollars that were invested--were rolled out. The communications, antivirals, enhanced emergency response, and surveillance of the outbreaks were also investments that were made. I can say that there were no cuts to that funding that the member makes reference to.

We will continue to work with the provinces and territories in the rollout and evaluate how we've done once we get through this pandemic.

Thank you, Madam Chair.

3:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

I think the question actually was whether the provinces can expect any assistance in money from the federal government on the actual response to the pandemic. I don't think the minister answered that.

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

I can answer that question now.

The response is that we have assisted provinces financially in response to this pandemic. We've covered 60% of the vaccine, we've invested $1 billion to position Canada to respond to a pandemic, and we will continue to work in partnership with the provinces.

In addition to that, this year our government has transferred $24 billion under the Canada Health Act. This new year, under the health transfers, that will increase by another 6%. Canada's health ministers in provinces can invest—

3:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Minister--

3:50 p.m.

Conservative

The Chair Conservative Joy Smith

Dr. Bennett, let her finish.

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

They can invest that money as they see fit in the delivery of health care, as they are responsible for the delivery of health care.

3:50 p.m.

Liberal

Carolyn Bennett Liberal St. Paul's, ON

Minister, I think you know as well as I do that the 6% escalator is from the 2004 accord. It has nothing to do with the pandemic response, and it really isn't fair to bring that to this discussion right now.

On page 176 of the estimates, it says that the funding to government advertising programs is $4.55 million. This morning in La Presse, it says that Quebec alone has spent $7 million.

Do you think it's appropriate that the federal government has only spent $4.5 million in public education when even the Province of Quebec has already spent $7 million?

At the same time, your economic action plan is--at the latest count--$56 million.

3:50 p.m.

Conservative

The Chair Conservative Joy Smith

Minister.

3:50 p.m.

Conservative

Leona Aglukkaq Conservative Nunavut, NU

Thank you.

Part of managing a pandemic is ensuring that there is accurate information getting to Canadians. It's one of the most challenging parts of managing a pandemic, to manage the misinformation that is out there and to ensure that Canadians have the right information to make important decisions on what to do to prevent the spread of H1N1. We will continue to communicate with Canadians through print, radio, and television ads, with toll-free numbers and so on.

On the issue in terms of how much we've invested, it is more than the $4 million you make reference to. Each province and territory has been communicating with its population through its health care system as well. This is a joint initiative. Part of the investments we made in the $1 billion was also funding to put communications strategies in place across the country, as well as the surveillance system. To date, we've invested over $30 million in communicating on behalf of the provinces and the territories in response to this pandemic.

Thank you.