Health Committee on Nov. 16th, 2010

[Colin Carrie, Conservative, Oshawa, ON]

I appreciate that very much.

Thank you.

[The Chair, Conservative, Joy Smith]

We have about three minutes left. I will cut it off at three minutes, because we have to suspend.

Ms. Leslie, you have three minutes.

[Megan Leslie, NDP, Halifax, NS]

Thank you, Madam Chair.

Ms. Baylis, in your opening statement you wrote the following:

Through various acts of omission and commission, the Agency either failed to effectively promote these principles or appeared to actively undermine these principles.

I think that's a pretty strong statement. Is there anything else you'd like to say about that, beyond what you said in your opening?

[Dr. Françoise Baylis]

Not at this time, no.

[Megan Leslie, NDP, Halifax, NS]

Okay. Thanks.

Ms. Slater, you mentioned in your opening statement that substantive input by board members into regulations was blocked. Can you expand on that?

[Barbara Slater]

Yes. There was an instance when Health Canada presented its plan for regulations on embryo transfer, and the board expressed serious concerns about their plan. And at this time there was board consensus favouring a more restrictive policy that was more in step with current science and evidence. Board members suggested a strategic response to this, including providing advice to the minister, which the legislation clearly allows for in the board's mandate in section 30.

There was reluctance on the part of the president and the chair to take that step. Instead of doing that with the regulation, the board's energy was directed to develop a policy as to when the board could give advice to the minister. For reasons that are not clear, it took nearly 10 months to draft a relatively simple and straightforward policy on when the board could or should give advice to the minister--without any decision ever being made on whether advice should be given to the minister in that instance. Given the board's mandate, which includes providing advice to the minister, there should have been at least a draft policy in place from the very beginning.

So that was a really good example. And we had board consensus on this. It wasn't just a few people; the whole board agreed.

[Megan Leslie, NDP, Halifax, NS]

Thank you.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Leslie.

I thank the guests for coming in.

We'll suspend for a few minutes and bring the other panel forward.

Thank you.

[The Chair, Conservative, Joy Smith]

Welcome back. We're going to our second panel now.

We're very pleased to have with us John Hamm, who is the chair of Assisted Human Reproduction Canada.

Welcome, Dr. Hamm.

We also have with us Elinor Wilson, president of Assisted Human Reproduction Canada.

Welcome to the panel.

With them, we have Suzanne Scorsone, board member, and Theresa Kennedy, another board member.

We're going into five-minute presentations with each of you. I have to tell the committee that because of the equal time we will be going until 2 o'clock.

We will begin with Dr. Hamm.

[Dr. John Hamm, Chair, Assisted Human Reproduction Canada]

Thank you, Madam Chair.

The focus of today's meeting is an administrative review of the agency. We welcome this.

As the chair has indicated, we are joined today by two current board members, Dr. Suzanne Scorsone and Ms. Theresa Kennedy. Also with us is the agency's president and board member, Dr. Elinor Wilson.

I would like to begin by thanking Dr. Françoise Baylis, Ms. Barbara Slater, and Ms. Irene Ryll for their contributions. They brought a healthy range of perspectives to board dialogue and their input was helpful to me as chair. I would like to reassure this committee that, despite their departures, the board continues to be committed to its job, does offer a wide breadth of expertise, and will deliver on the mandate it has been given by Parliament.

There's no doubt that the board's work has been challenged by the fact that we are awaiting the opinion of the Supreme Court of Canada. Nonetheless, we have moved forward with a sense of purpose and commitment. The board has a vital role in the agency's ongoing evolution by approving its goals, operational policies, and annual budget.

The board takes seriously its responsibility for fiscal management. Given concerns expressed by a former board member about inconsistencies in particular budget information, and also concerns about an agency initiative, at the request of the president the board approved having the agency's financial statements audited for the fiscal year ending March 31, 2010, as well as the initiative in question. I'm pleased to report that the preliminary document prepared by PricewaterhouseCoopers does not raise any issues that cause concern for the board, and when the Comptroller General releases the report to PricewaterhouseCoopers, they will be releasing it publicly.

I share with Canadians the need for the agency to regulate AHR service in accordance with the principles and provisions of the act, and I assure you that the board is working closely with the agency to ensure that such expectations and goals are met.

Despite being an easy target for those who believe the legislation goes too far, or does not go far enough, and for those who are disappointed with the delay of the implementation of the regulations, the agency is demonstrating tangible results. Recently, the board commissioned an independent performance evaluation of the agency. Despite acting in an environment of uncertainty, the report reveals that the agency has made good progress on five of the seven strategic directions--specifically, personal health information management; education; best practices; research, especially with the formation of the science advisory panel; and international collaborations.

In the areas of compliance and outreach, the report found that the agency could be more effective in letting stakeholders know about its activities and successes. Nevertheless, I assure you that the agency continues to make progress in this area, as seen, for example, through the ongoing publication of materials and its new and improved website, which was launched in September.

The agency must walk a fine line between an individual's right to privacy in a most sensitive field and informing the public on matters that are currently dependent on publication of the regulations, an area that is outside the control of the agency.

Another area of importance to the board is transparency. In the spring, the board started discussions on further improving this. As a result, the board is providing more information and highlights of board meetings to date through the new website.

Privilege has its price. The price for being a board member is to disassociate from personal agendas and special interests. The privilege is this: the ability to provide advice to the minister on matters that impact the health and safety of Canadians using these technologies, to oversee an area that has important ethical issues for all Canadians, and to have direct input into regulation.

By accepting to sit on the board, members must agree to administer the law as expressed by the will of Parliament and to refrain from activities that may be perceived as undermining the act. The board and its members take seriously our jobs as Governor in Council appointees upholding the principles of confidentiality and consensus that guide our deliberations.

It is a privilege for me and my fellow board members to contribute to an important health and safety issue that is so important to many Canadians.

Thank you.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Hamm.

We'll now go to Elinor Wilson.

[Dr. Elinor Wilson, President, Assisted Human Reproduction Canada]

Thank you, Madam Chair.

I appreciate this opportunity to return to the committee as it undertakes the administrative review of Assisted Human Reproduction Canada.

I would like to preface my remarks by saying that the establishment of the agency and its board has not been questioned in the Supreme Court reference. While we wait for the opinion and the subsequent release of further regulations, the agency continues with its mandate of promoting, monitoring, and enforcing compliance with those provisions of the act that are in force and it has been taking proactive measures to promote and protect the health and safety of Canadians consistent with the principles and framework of its governing legislation.

Our compliance activities are well under way. In addition to an active monitoring program, the agency has a formal process in place to assess allegations of violations of the act or regulations. A thorough assessment of each allegation is conducted and privacy issues in this sensitive field are thoroughly considered before deciding on the appropriate course of action.

Beyond its regulatory responsibilities, the agency fulfills a broad mandate under the act in relation to assisted human reproduction. Its mandate, as stated, is monitoring and evaluating developments in Canada and internationally, consulting persons and organizations in Canada and internationally, providing information to the public and professions, including on risk factors associated with infertility, and providing advice to the minister.

Here are just a few of the agency's accomplishments.

A first international forum on cross-border reproductive care: the purpose was to increase knowledge of quality and safety issues and to build agreement among participating organizations and countries on the principles that underpin safe, quality care.

A scientific round table on the issue of multiple births: the purpose of the meeting was to develop a framework to address multiple births in Canada associated with infertility treatments and to support the implementation of the framework across the country.

A symposium on oncofertility: this symposium was designed to facilitate knowledge transfer among reproductive scientists, oncology staff, fertility preservation specialists, and patient advocates, and to encourage research collaboration in the field of fertility preservation for cancer patients.

Ongoing engagement with national patient organizations: this was to help reach Canadians who are affected by assisted human reproductive technologies so as to understand their needs when we develop information products.

With respect to this administrative review, I wish to assure this committee that the agency, as part of the federal health portfolio, follows Government of Canada directives and guidelines in its initiatives, be they related to finance, accountability, official languages, privacy, access to information, and human resources.

As Dr. Hamm noted, the performance evaluation conducted shows good progress on multiple fronts of our mandate. The agency has been able to accomplish this while waiting for the regulations to be brought into force, keeping its level of staffing and expenditures lower than its authorized levels, but commensurate with the extent of its mandate that is enabled. In fact, the agency has been frugal in its expenditures, spending less than 50% of its annual allocation of $10.5 million on the initiatives that are mandated under the act.

The agency realizes it has a considerable amount of work ahead of it, particularly once the regulations are in place, and it is actively looking to fill needed positions. However, recruitment is somewhat challenged by the outstanding court opinion and lack of regulations as well as by the completion of the move to the headquarters in Vancouver. Until those regulations are in place, it is often more efficient and cost-effective to hire contractors on a temporary basis to help the organization meet its strategic and operational objectives.

Madam Chair, we take great pride in the fact that the agency has been constructing the foundations of a dynamic, highly professional, and accountable organization that is committed to promoting and protecting the health and safety of Canadians who use or are born of assisted human reproduction. None of this work would have been possible without the commitment and direction of the board of directors under the leadership of Dr. John Hamm.

Thank you.

[The Chair, Conservative, Joy Smith]

Thank you very much.

I understand just the two of you are going to be presenting today, or do the other two have something they want to say as well?

[Dr. Elinor Wilson]

For formal presentations, we had listed the two of us. We would be quite open to the other two board members making opening remarks, if you would allow it.

[The Chair, Conservative, Joy Smith]

Do either of you want to?

You're fine, Ms. Kennedy?

[Theresa Kennedy, Board Member, Assisted Human Reproduction Canada]

I have nothing substantive right now, so let's go to questions.

[The Chair, Conservative, Joy Smith]

Thank you very much.

We'll now go into our first round of questions and answers, seven minutes for Q and A.

We'll begin with Mr. Dosanjh.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Thank you very much.

Good to see you, Dr. Hamm, and others, of course.

I have a couple of questions. First, I want to make a request of the board and of the president to actually produce documents....

Let me restart the question. I would formally request that you produce documents relating to all financial details of the organization, including but not limited to audits, full financial data, travel receipts, grants, contributions, contracts, disbursements from 2006 to the present day, and any e-mails and correspondence with respect to all these issues.

I'm just going to leave that there. This is a request. It's a broad request. Obviously, issues were raised, and we're concerned and want to look into it.

[The Chair, Conservative, Joy Smith]

Mr. Dosanjh, is that for the committee?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

It is for the committee, yes: produce for the committee.

[The Chair, Conservative, Joy Smith]

Dr. Hamm....

Excuse me; I'm just eating a delicious sandwich, brought by my daughters, and trying to act very professionally here.

Dr. Hamm, could you submit those documents to my clerk? She will distribute them to committee members. I would really appreciate that. Thank you.

[Dr. John Hamm]

Thank you, Madam Chair.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Thank you.

I have a question for Ms. Wilson.

Ms. Ryll raised an issue with respect to your using some words at a meeting with respect to particular potential users of the technologies that you deal with. It was at a board meeting, I'm told.

I'd like you to cast your mind back to June of 2009 and tell me if you remember what particular expression you used that might have been offensive.

[Dr. Elinor Wilson]

Thank you, Madam Chair, for the question.

I am sorry, I do not recall that particular discussion. What I can tell you is that we work very closely with all of the patient organizations in the Canadian context. We have IAC, which you mentioned earlier, the Infertility Network, Fertile Future; we have a committee of all the patient organizations, and we work very closely and have good relations with them.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

No, I understand that, ma'am, but you don't recall using any word that may have been deemed to be offensive by others?