Evidence of meeting #3 for Health in the 40th Parliament, 3rd session. (The original version is on Parliament’s site, as are the minutes.) The winning word was process.
A recording is available from Parliament.
Conservative
NDP
Chief Public Health Officer, Public Health Agency of Canada
No, Madam.
Madam, that is not true. Others have reviewed this. We have--
NDP
Judy Wasylycia-Leis NDP Winnipeg North, MB
Would you table the others, then? Would you table the others?
Conservative
Conservative
Patrick Brown Conservative Barrie, ON
Thank you, Madam Chair.
I just want to follow up with some more questions on the Canada Health Infoway. I've got a few questions.
In terms of the X-rays you mentioned that are digitalized, was that only in Alberta or P.E.I., or do we actually have digitalized X-rays in Ontario?
Second, we talked about digitalizing prescriptions for pharmaceutical products or drugs. Is that taking place in Ontario as of yet? And if not, when can we expect that to take place?
How much do we invest into Ontario for the Canada Health Infoway?
Lastly, given the concerns we've had in the past few years with how the Ontario government has managed the Health Infoway funds, what monitoring tools do we have to make sure that in the future, federal dollars are used as efficiently as possible?
Deputy Minister, Department of Health
Thank you.
Let me say at the outset that I don't think I have with me all the specific information you want, but we will endeavour to get it and to provide it.
I can give you a little bit more information. To give you an example of things that have been done, drug information systems are in place in the following provinces: Alberta, British Columbia, Saskatchewan, and Prince Edward Island. A system is not yet in place in Ontario. That I can tell you.
I know that digitization of X-ray film is under way, as I said, across the country, but I wouldn't say that it's absolutely completed across the country. Again, we will come back to you with specifics on Ontario.
I'm sorry; what was the last part of your question?
Conservative
Deputy Minister, Department of Health
We have provided money to Infoway; Infoway then provides money to the provinces. The cost-sharing ratio, I believe, is 75% to Infoway and 25% to the provinces. It is not done, as I mentioned earlier, on an across-the-board basis. Infoway isn't just providing money to everybody; Infoway insists--and this is part of the strength of Infoway--that they have to have a partner actually ready in the provincial electronic health records system with a plan that demonstrably can put the system into place before Infoway will flow the money. It is a very strict gated-funding approach.
Conservative
Patrick Brown Conservative Barrie, ON
Do we have any ballpark figures on how much that's resulted in Ontario projects?
Deputy Minister, Department of Health
I don't have that information. That information is available; I don't happen to have it here, but I would be happy to provide it to you as soon as we can.
Conservative
Patrick Brown Conservative Barrie, ON
The most important question is the last one. What monitoring mechanisms do we have, given the challenges that we have seen in Ontario?
Associate Deputy Minister, Department of Health
We've had a number of monitoring mechanisms. The most significant is the one that the deputy raised in terms of making sure only projects that actually meet the criteria get funded. It's not a per-capita approach that gives every province its share; it's actually project-specific, and they have to meet the criteria. Only when the system is in place, working, and actually being used does the remaining funding flow. A significant portion of the funding is held back. We use the term “gated”.
In addition, following the Auditor General's reports and some of the concerns that have been raised by provincial auditors, in the most recent funding that we are flowing to Canada Health Infoway, we have put in some additional conditions. For example, there are things such as maximum daily rates for consultants by jurisdiction, and those kinds of things. There are a number of accountability measures in place now with Canada Health Infoway that they, in a sense, pass on to their individual projects. For example, there is the architecture of the national standards; we want to be able to have information that is consistent and comparable across the country.
Conservative
Patrick Brown Conservative Barrie, ON
If we wanted to find out which projects have been approved in each province, do we have a list of projects that have met those criteria you speak of?
Deputy Minister, Department of Health
Yes. Infoway would have that, and we could provide it.
The other thing I should say is that this is a multi-year program. If you look at the way both the previous Liberal government and the present government have provided funding, you see that it has been provided in tranches. To date, there has been $2.1 billion provided, but not in one big chunk. It comes in chunks of $400 million or $500 million. As well, there is a funding agreement between Infoway and Health Canada; Infoway has to demonstrate that it is actually making progress.
There will be more money needed to implement the electronic health record; there is no question about that, given some of the estimates that we've seen put together. I think it's fair to say that every time, we want to see results. We have seen results to date, and we need to keep seeing results from Infoway and from the provinces in order to keep flowing that money.
In terms of what's happened over the past year with the series of audits, the audits are intended to be helpful in addressing any deficiencies in management practices. As I said, I thought the Infoway audit federally was basically a good-news audit. Some small things were addressed; there were a number of other things in the provincial audits, and that will help to move forward to make sure that this is all being done on a prudential basis.
Conservative
The Chair Conservative Joy Smith
Thank you, Mr. Rosenberg.
We have time now to go to yet another round, so we're going to do that. I am going to suspend at a quarter to 11 because we will need to vote on the estimates.
We'll go now to the second round. It's a seven-minute round.
We will begin with Dr. Duncan.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you, Madam Chair.
I really am struggling with this, with regard to CHVI. We put four applicants through an expensive process, doing due diligence at the end of the process and not at the beginning. I find it highly unusual.
I am going to pick up on what my colleague Ms. Wasylycia-Leis said, which is that Dr. Gerson has been used in the past. I am wondering if he was involved in this process.
Chief Public Health Officer, Public Health Agency of Canada
I am not aware; certainly we used a range of international expertise.
Again, this is a critique of a study. This is not another study. This is not another assessment. We and the Gates Foundation are satisfied that we have enough information to make the decision.
In terms of the applicants themselves, none of them met the bar. There were deficiencies in all of them. I obviously can't go into details for matters of confidentiality, but the point is that we had a transparent process. We used outside expertise, we used expertise in the government, and we used the Gates Foundation and others.
That's the nature of scientific application. I have had proposals that I've worked on extensively that were very costly and they were not funded. That's the nature of the business.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
I think we both understand scientific process and how proposals get funded. The question I have--and if it can't be answered today, I would like to know--is if Dr. Gerson was part of this process.
One of the reasons this facility was called for was to have a facility accessible to researchers. The Canadian Association of HIV Research has spoken loudly that the need is still there. Why have you cancelled this facility?
Chief Public Health Officer, Public Health Agency of Canada
It is our view that there is capacity out there. It's not specifically in this particular facility, but there is capacity. As you note, in the study itself, researchers have tended to use certain preferred suppliers or vaccine-manufacturing facilities. There are others available, so part of it will be matching the researchers to the facilities that are available so they can get it done.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Well, I think it's really key to know whether Dr. Gerson was part of this review process. And I appreciate that it is one study, but I think that really needs to be looked at.
Can you confirm that there was a scientific expert review, a steering committee, and a department decision?