Health Committee on Dec. 7th, 2009

[Dr. Jean Rouleau]

Yes, sir.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you for clearing that up. I have another question.

Mr. Brenders, you were cut off as well, and I think with your organization, you represent a whole group. There has been some concern that if you have industry on a council like this, it can be detrimental. But we've heard from other witnesses last time that places like Australia, U.K., and Ireland all have private sector representation. I know the research and development investment went up astronomically in Ireland.

I was wondering what you say to people who say these boards are prisoner to the private sector once they have a private sector person on the board.

[Peter Brenders]

I think what you see is a strengthened diversity of opinions that come to the board and make the board and its work more strategic, more relevant. It speaks to helping to bring what our directions are in terms of currency of research and where it's going and what's going to be relevant at the end of the day.

I think what we see across Canada—whether they're provincial health research foundations or as you outlined in terms of international research foundations—is having the perspective that is current and knowing what is going on in the breadth. We have to remember that in the world of research that's going on, the Global Forum for Health Research estimates that next year there will be $433 billion spent on health research. Compare that to CIHR's budget on that one.

There's a lot of research and strategy going on. CIHR benefits from the breadth of its governing council in understanding what's going on in that global context. And the opportunity in front of it, to have people willing to sit on that board, to take that breadth of expertise forward, bodes well for Canada. I think we need more of that.

[Colin Carrie, Conservative, Oshawa, ON]

All right.

From what you've seen, does one person on a board of that size make that much of a decision on it? How much influence does one person on a board have?

[Peter Brenders]

I think Dr. Rouleau said it well. You have, certainly, great perspectives. People have an opportunity to think and hear different perspectives, much as you would see around a committee like this. You have different perspectives, and it's great for a discussion. But at the end of the day, you still have the strength of every committee member and the direction they are heading in and how those affect the decision-making process.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Brenders.

Now we're going to go into the five-minute Q and A. The Liberals will start.

I understand, Dr. Bennett, that you're going to give your time to Ms. Wasylycia-Leis?

[Carolyn Bennett, Liberal, St. Paul's, ON]

Yes, please.

[The Chair, Conservative, Joy Smith]

Okay.

Ms. Wasylycia-Leis.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Thank you very much, Carolyn.

Perhaps I'll begin by asking Dr. Downie about the reaction there has been from the academic, scientific, and research community in response to this appointment. Also, perhaps you could talk a bit about some of the people supporting efforts to annul this nomination and about the number of people who have signed a petition.

And then I'd like to ask Dr. Trudo Lemmens to talk about some of the ways in which other countries have actually handled this issue so as not to leave the impression that this is a normal pattern around the world.

[Prof. Jocelyn Downie]

Yes, certainly.

We've had over 3,700 signatures on an online petition that has been up for less than two weeks. The breadth of people who have signed it is remarkable. Many members of the lay public are signing it and routinely framing their concern as one of conflict of interest. So they get the problem.

There are also a whole lot of doctors, physicians, professors, and researchers who are signing. These people don't tend to be petition signers, so I was surprised to find that there are approximately 1,000 people out of those who gave their titles who fall under the category of doctor or professor. And I think that's very significant. They're also identifying themselves as active CIHR researchers. Many active CIHR researchers have signed a petition that is opposed to this appointment.

We also have a number of very distinguished individuals who have signed it, including for example James Till, whom you may know as a co-discoverer of stem cells. He demonstrated that stem cells exist.

Another interesting group is people who support commercialization and who explicitly state that they support commercialization of research. They partner with industry in their research. They say that, and then they say, “But pharma does not belong at the governance table.” They're the ones saying, “Look, put them on advisory committees. That's all well and good and important information to get.”

I sat down with a researcher who I associate with commercialization. He's one of the people I know most who do commercialization. I asked him about this when it first came out, and he looked at me and said, “Absolutely not.” That's purely on the basis of conflict of interest.

That takes me to the issue of the one in seventeen point. It's really important to recognize that conflict of interest is not only about actual conflict but also about perceived conflict. One in seventeen... Just look at the petition comments. Many comments have been made. One in seventeen poisons the well with respect to perceived conflicts of interest on the CIHR governing council. And it's a real threat to the reputation of the institution.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Thank you.

Trudo Lemmens, perhaps you could talk about other countries' approaches to this issue as well as your view of the role of the governing council, given some of the comments that have been made.

[Prof. Trudo Lemmens]

Yes. I already emphasized that there are many countries, actually, with very successful commercialization mandates that do not have, in similar research-funding agencies, members of the pharmaceutical industry directly on the governing body. So there's no inherent requirement to have someone for successful commercialization.

It's basically a judgment call about the extent to which the significant financial interests that come with being a vice-president of a large pharmaceutical company will create conflict with respect to the specific mandates of the Canadian Institutes of Health Research. And it's important to emphasize here that the Canadian Institutes of Health Research report to the Minister of Health, unlike, for example, Genome Canada and some of the other federal funding agencies that report to the Ministry of Health. So if you think about the mandate of the CIHR, it is clearly to improve the health of Canadians and Canadian health care. And it is there that the significant conflict of interest exists.

It is true that many people have conflicts of interest. But it is actually inappropriate to qualify the conflict of interest that Dr. Prigent has as a conflict just like those of other people. None of the people on the governing council of the CIHR actually have in their professional lives, in their professional obligations toward their universities or towards research, obligations that can actually contradict what the CIHR is about. And that is actually the conflict of interest that Dr. Prigent has, as has been highlighted by the fact that the pharmaceutical industry actually has a primary mandate and a primary obligation towards its shareholders.

The bottom line is that it has to be profitable. And this has, in the past, led to regulatory transgressions and ethical transgressions. So it's basically a question of balance. Will the CIHR be able to provide some balance and promote independent research with a focus on improving the health of Canadians? I think that's really the issue. And so the conflict of interest that Dr. Prigent has is not of the same nature, actually, as that which anybody else on the governing council could have.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Lemmens.

Ms. Davidson.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you very much, Madam Chair, and thanks very much to our presenters for being here with us this afternoon.

We all around this table know that health research and science and technology are priority areas for both government and the private sector. It's not an area that one has a greater interest in than others. It's something we're all very concerned about and are all trying to improve. We've had countless reports over the years that have shown how well collaboration between the public and private sectors has worked and how important that is, that as a matter of fact, it's probably critical to success in research.

I have a couple of questions, Dr. Rouleau. What are CIHR's current priority areas? How will this appointment help those priority areas? While you're talking about that, as a member of governing council, can you elaborate a little bit more on what kinds of decisions the GC makes and how you perceive that it's not a conflict? How will this fit in with furthering CIHR's goals and priority areas?

[Dr. Jean Rouleau]

One of the big priorities we have right now is patient-oriented research. As I've mentioned before, we're doing pretty well in discovery, and it's pretty exciting when you listen to what's happening in the basic sciences, and that needs to continue. Where we've had problems is in bringing that to the patient, to the bedside. To be able to do that kind of study you need to have the kinds of resources that you have with industry, generally, to bring these things forward. So we work very closely with industry in that type of project. Sometimes we prove our hypothesis. Because these are investigator-initiated studies, they try to identify the projects and how to go through them, so that part of it--we'll call it the valley, or big need--needs to be worked out.

Another one is optimal practice, which, in this patient-oriented research initiative, is really how to bring what we know from the bedside into practice, into clinical medicine, and to be sure that we're getting the right drug to the right patient at the right time. There again, we need to work with different levels of government, but also we believe that industry, in well-organized and well-balisés...I don't know...well-delimited projects, can be very useful. Right now we're working very hard on patient-oriented research and trying to fill the holes we have, both in the translation of knowledge bench to bedside, and then the other one, from bedside to practice.

The kinds of decisions we make at governing council are large decisions like whether we should go to patient-oriented research, or whether we're meeting our mandate to help and improve health care of Canadians. Those are the kinds of things that we need to be making the decisions on at a high level.

There is the scientific council, which does make decisions about which exact projects and what the limits would be of each project, so the kinds of decisions that we're making wouldn't generally be affected in a negative way by having somebody like Bernard, but Bernard could help us understand how best to partner with industry to meet our goals, which are to improve the health of Canadians.

It's all done at a high level. We don't meso-manage or micromanage. The scientific committee is really the one making the decisions that concern many people in the community--not just the people in this room, but many people in the community.

[The Chair, Conservative, Joy Smith]

Thank you so much, Dr. Rouleau.

I'm going to thank all of you kindly for joining our committee. We're now going into another piece of business, and I would ask if you would leave the room for our next part.

I'll give you a minute to leave. Thank you for being here.

We're going to go into a motion now. Where's Mr. Brown?

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Could I say, Madam Chair, that it's not in camera, so people don't have to leave the room.

[The Chair, Conservative, Joy Smith]

You don't need to leave. You're very welcome to stay.

Ms. Wasylycia-Leis.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Thank you, Madam Chair.

You will recall that in the motion that led to these hearings, I had also included a report back to the House. So I would like to make two motions to present to the committee.

The first one is available in English and French. If you want to circulate it, I'll read it as it's being presented:

That the Standing Committee on Health Report to the House that:

Pursuant to Standing Order 110 and 111, your Committee has considered the Order in Council appointment of Bernard Michel Prigent to the Governing Council of the Canadian Institutes of Health Research referred to the Committee on October 21, 2009.

Your Committee has examined the qualifications and competence of the appointee and finds that due to the fact that Bernard Michel Prigent's competencies and abilities are compromised by his employment responsibilities, his ability to perform Governing Council duties with respect to the public interest objectives of the Canadian Institutes of Health Research set out in the Canadian Institutes of Health Research Act is seriously impeded. This Committee calls on the Prime Minister to withdraw Bernard Michel Prigent's appointment to the Governing Council of the Canadian Institutes of Health Research.

I so move.

[The Chair, Conservative, Joy Smith]

We're open for discussion. Is there any discussion on this motion?

Ms. Murray.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

I want to check with the writer of the motion whether a friendly amendment would be considered that removes the reasons and just leaves the conclusion:

This Committee has examined the qualifications and competence of the appointee and calls on the Prime Minister to withdraw Bernard Michel Prigent's appointment to the Governing Council of the Canadian Institutes of Health Research.

[The Chair, Conservative, Joy Smith]

All right.

Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Madam Chair, I think we've heard how this is written right here:

Your Committee has examined the qualifications and competence of the appointee and finds that due to the fact that Bernard Michel Prigent's competencies and abilities are compromised by his employment responsibilities, his ability to perform Governing Council duties with respect to the public interest...

I think we heard the exact opposite, so I'd like to state that I will definitely be voting against any motion of this sort. We heard today quite clearly that the decisions they are making are very high-level, that the council does not micromanage. They're looking for somebody from the private sector who has experience in helping them fulfill their mandate to improve the health of Canadians and move forward at high-level direction.

[The Chair, Conservative, Joy Smith]

Ms. Murray.

[Joyce Murray, Liberal, Vancouver Quadra, BC]

Following up on Dr. Carrie's comments, I think we heard two versions here. We heard there were very strong concerns by the head person responsible for ethics for every one of the organizations the CIHR collectively represents. So I think we did hear clearly that there were concerns by large numbers of people respected in the medical and the research communities that having someone who has a primary responsibility to shareholders of a particular company is a concern and that there are other ways of bringing that expertise to bear on the decisions the CIHR is required to take.