Health Committee on Nov. 25th, 2010

[The Chair, Conservative, Joy Smith]

Welcome to the health committee. It's a pleasure to see everybody again this morning, and a special pleasure to have our guests here.

Pursuant to Standing Order 81(5), we have supplementary estimates (B) 2010-11: votes 1b, 5b, 10b, 20b, 25b, and 40b under Health, referred to the committee on Thursday, November 4, 2010.

We have our witnesses with us. From the Department of Health, we have Glenda Yeates, deputy minister, and Germain Tremblay, chief financial officer. Welcome.

From the Public Health Agency of Canada, we have Dr. David Butler-Jones, chief public health officer, and James Libbey, chief financial officer.

We are expecting, from the Canadian Institutes of Health Research, Alain Beaudet, president, and James Roberge, chief financial officer.

We will begin now, because we need to get our meeting on the way. I'm sure Mr. Beaudet will be joining us in a timely manner.

We'll begin with the Public Health Agency of Canada. Dr. David Butler-Jones.

[Dr. David Butler-Jones, Chief Public Health Officer, Public Health Agency of Canada]

Thank you, Madam Chair.

If I cough a little, it's not because I'm infectious. It's just my asthma. But I'm well drugged, so we'll see how the questions go.

[The Chair, Conservative, Joy Smith]

That's not very hopeful. We find out you're drugged and you've got allergies and you're not quite with it.

[Dr. David Butler-Jones]

But the drugs are all legal, just prednisone and things like that.

[The Chair, Conservative, Joy Smith]

Continue. We have faith in you.

[Dr. David Butler-Jones]

Thank you.

With me today is Jim Libbey, chief financial officer for the Public Health Agency. I appreciate the opportunity to speak to the supplementary estimates (B) for 2010-11 as they pertain to the agency.

Our commitment to chronic disease prevention and control is among our highest priorities for the coming year and this year.

Chronic diseases, such as cancer, heart disease and diabetes, remain the greatest cause of death and disability in Canada.

It is remarkable that much of this is preventable. It demonstrates an ever-increasing need for Canadians to focus on their own health. And it underscores the necessity of collaboration between governments at all levels, their partners, communities, and individuals to help prevent these diseases and to increase awareness and understanding.

In September the Minister of Health announced a landmark declaration on prevention and promotion, including Canada's first intergovernmental framework for curbing childhood obesity.

The declaration is a visionary public statement of our intent. Governments across this country are working together on these crucial issues. We are providing the foundation for much of our future work.

This fiscal year $685.6 million has been allocated to the agency. As I noted in June, we are devoting over $115 million this year to efforts surrounding chronic disease.

That includes efforts to increase capacity and knowledge in prevention and control of diseases, such as HIV and AIDS.

It also helps us gather and analyze data on the rates, trends, and patterns of injuries and disease in Canada. As an update since June, the agency will also be transferring funds worth approximately $4.3 million this fiscal year, much of which will complement those initiatives. For example, $600,000 dollars will be transferred to the Canadian Institutes for Health Research to support intervention research and knowledge translation to address chronic disease prevention.

There is one other major item I would like to mention before I close.

Breast cancer, as members know, is the most common cancer among Canadian women.

Hundreds of Canadians are newly diagnosed with breast cancer each week. It is imperative that the government continue to support cancer prevention, control, and research, and to do its part to reduce the burden of cancer in Canada.

For these reasons, I am pleased to report that, through a permanent transfer of $3 million to the Canadian Institutes for Health Research, the agency is helping to fund targeted breast cancer research.

I am confident this funding will go a long way towards improved survival rates, and improved prevention and quality of life for those suffering from breast cancer.

This represents our single biggest transfer for these estimates. I have only touched the surface of the agency's priorities this year. The H1N1 pandemic, for example, which lasted into this year, solidified our place, we believe, as global leaders in responding to infectious disease outbreaks.

2010 saw the agency continue to build on the lessons learned from H1N1, focusing efforts on continued collaboration with all partners. These efforts will strengthen our preparedness for future pandemics and outbreaks.

Madam Chair, these supplementary estimates show that the Public Health Agency's vision remains constant and relevant to healthy Canadians and communities in a healthier world. All of Canada, we believe, will benefit from our efforts.

Thank you for your time. I will be happy to answer questions later.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Butler-Jones. You did very well this morning, considering all the challenges we started off with initially.

We'll now go to the Department of Health to Glenda Yeates, deputy minister, please.

[Glenda Yeates, Deputy Minister, Department of Health]

Thank you very much. Good morning, Madam Chair and members of the committee. It is a pleasure to be here today to discuss the supplementary estimates (B) and how these funds will be used to help Canadians improve their health.

The funds we will be discussing today will be used for a variety of important programs, many of which have been in place for years and have been proven effective.

Health Canada is seeking a net funding increase of $48.1 million in the following areas: aboriginal health programs, Nutrition North program, tobacco litigation, and medical isotopes.

Most of the increases are strategic investments for us that were announced in budget 2010. Much of this additional funding will allow Health Canada to continue to provide support to Canada's aboriginal people by delivering valuable programs, some of which are provided in partnership with the Department of Indian Affairs and Northern Development.

With respect to the first nations health programs, $32.8 million is being sought for the Indian residential schools resolution health support program. As committee members may be aware, this program provides emotional and cultural health support services as well as professional counselling to former students and their families throughout all phases of the Indian residential schools settlement agreement. Some services are provided directly through local aboriginal organizations, and others are provided by psychologists and social workers who have experience working with aboriginal people.

This investment ensures that Health Canada can fulfill its commitment to provide culturally appropriate mental health and emotional support services to residential school survivors and their families.

Another notable item is $5.5 million for additional health programs in the areas of maternal child health, mental health and addictions, and community capacity for two Innu communities in Labrador.

Additional funds are also required to help in the transition from the outdated Food Mail program to the new Nutrition North Canada program.

Nutrition North Canada will support improvements to ensure that northerners benefit from improved and increased access to nutritious food throughout the year. Nutrition North will also support improvements such as education initiatives intended to increase awareness of healthy eating while developing skills for selecting and preparing healthy products from stores along with traditional or country foods. Health Canada is allocating $1.5 million this fiscal year and $2.9 million for 2011-12 for nutrition and education initiatives.

Among our additional investments in these supplementary estimates is the provision of $10.3 million to support the defence of the Government of Canada in ongoing tobacco litigation.Three million dollars over two years is also being sought to support non-reactor-based production of medical isotopes, to look to optimize the use of the existing supply, and to support the development of new medical imaging technologies that do not use isotopes.

In closing, the resources requested through the supplementary estimates (B) will be used to help Canadians maintain and improve their health in these very specific areas.

Thank you for your time, and I look forward to answering any questions the committee may have.

[The Chair, Conservative, Joy Smith]

Thank you.

Welcome, Dr. Beaudet. We are so pleased to have you here.

Could we have your presentation, please?

[Dr. Alain Beaudet, President, Canadian Institutes of Health Research]

Thank you, Madam Chair.

Members of the committee, as president of the Canadian Institutes of Health Research it's a privilege for me to offer you a report card on the supplementary estimates (B) and use this opportunity to discuss how CIHR has employed its budgetary allocation to ensure fulfilling our mandate to improve through research the health of Canadians and the health care system.

As you know, an additional, recurrent amount of $16 million has been allocated to the CIHR budget for 2010-2011 so that we can continue our cutting edge research dedicated to improving the health of Canadians.

Four million of these dollars have been targeted to CIHR's open operating grant program. As its title implies, this program is an open call for research proposals, with no restrictions on areas of research or maximum level of requested funds. All proposals are subjected to the highest international standards of peer review to ensure excellence.

This increase in funding brings total plan spending in this program to more than $400 million.

Though CIHR currently supports more than 4,000 multiyear research projects under the program, the demand continues to increase and we are able to fund only a small portion of the proposals that have cleared the bar that our criteria of excellence have set very high and that have been recommended for funding by our committees of experts.

Six million dollars has been allocated to advance the strategy on patient-oriented research. This strategy is a nation-wide coalition aimed at improving health outcomes and service delivery by enhancing the clinical application and economic impact of health innovations and by providing health care professionals and policy-makers with information on how to deliver high-quality care and services in a cost-effective manner.

In collaboration with the provinces, we aim to improve the clinical research environment and infrastructure, set up mechanisms to better train and mentor health professionals engaged in clinical research, and strengthen organizational, regulatory, and financial support for clinical studies.

Five million dollars are dedicated to international research collaboration on Alzheimer's disease and other age-related dementias. As members know from recent debates in the House, like many other nations, Canada's aging population is facing an upcoming tide in the numbers of persons who will be afflicted by Alzheimer's disease and dementia.

The good news is that Canada is already investing in this field and has built an excellent track record and a reputation for high-impact, collaborative health research.

These new funds have allowed us to build on our leadership in the area of Alzheimer's disease and related dementias by establishing an international network for cooperation that will allow us to increase our research capacity and to expand our horizons in the area. Already, cooperative projects have begun with France, the United Kingdom, Germany and the United States.

Working closely with the Alzheimer Society of Canada, we have launched funding opportunities focused on the early diagnosis and early treatment of the disease. The long-term objective is to delay by five years the onset of symptoms.

Finally, of the $16 million, $1 million has been allocated to operating requirements to address the significant increase in applications for open operating grants and to address the new patient-oriented research and Alzheimer's strategies.

The supplementary estimates (B) also include CIHR's access to $10 billion in funding over two years from the isotope supply initiative to support research to develop and demonstrate new technologies, to optimize the use of medical isotopes and alternative medical imaging technologies, and to establish a clinical trial network to test new isotopic and non-isotopic tools.

It also includes funding for the Canada Excellence Research Chairs, a program that supports the development of a world-class workforce, which is crucial to the innovation process. It positions Canada as a magnet for the world's top researchers and graduate students and promotes the development and application of leading-edge knowledge. Six Canada Excellence Research Chairs were awarded in health and related life sciences and technologies. Total funding for CIHR for the eight years amounts to $60 million.

The supplementary estimates (B) also reflect CIHR's funding for the Banting post-doctoral fellowships program to offer new, prestigious fellowships at an internationally competitive level of funding to attract and retain top-tier post-doctoral talent from Canada and abroad.

Total funding for CIHR is $1.5 million in 2010-11 and $3.4 million in 2011-12 and ongoing.

I will certainly be pleased to answer any questions.

Merci beaucoup, madame la présidente.

[The Chair, Conservative, Joy Smith]

Thank you very much, Dr. Beaudet. Thank you to all of the witnesses.

We'll now go into the first round of seven minutes for questions and answers.

We will begin with Mr. Dosanjh.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Thank you very much, all of you, for being here.

My questions are essentially three brief questions, and they may be directed, I believe, to Ms. Yeates.

First, in terms of the mass media expenditure for tobacco control, we have figures going back many years, even back to 2006-07, in terms of Health Canada spending money in that area. We have no figures for 2007-08, 2008-09, or 2009-10, and none projected in 2010-11. Can you tell us why?

[Glenda Yeates]

I don't have those figures here. I will see if we have them in terms of the background.

I have here figures for the tobacco control strategy, generally. You mentioned the years 2007-08, 2008-09, and 2009-10.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

I'm actually talking about the advertising, the mass media campaigns.

[Glenda Yeates]

It is the case, according to the figures I have here for 2007-08, 2008-09, and 2009-10, that we had evaluation dollars in those years of about $100,000 per year.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

But you had no mass-media dollars for those years. Is that true?

[Glenda Yeates]

That is correct.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

And none are projected for 2010-11.

[Glenda Yeates]

That's correct.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Thank you.

The other question I have is from a document called Canada's Implementation of the Framework Convention on Tobacco Control . It's a civil society shadow report.

On page 3 it states that most of the provincial governments have indicated the amount of money they spent from 2005-06 to 2009-10 inclusive. The federal government also spent money, and it indicates what it spent in 2005-06, 2006-07, 2007-08. But no figures are available for 2008-09 and 2009-10. Can you tell us why?

[Glenda Yeates]

As you've mentioned, and as the figures I just showed mentioned, we do not have advertising mass-media dollars available. We do have dollars in other areas of the tobacco strategy. So we have dollars, for example, in public education and other areas.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

So would it be fair to say that you have essentially given up on tobacco control--mass media?

[Glenda Yeates]

We would not view it that way.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

How would you view it, Madam?

[Glenda Yeates]

We are committed to reducing smoking, and we have a number of items that we are currently portraying and doing. For example, we have $15.8 million annually to support tobacco use reduction initiatives across Canada. We continue to collaborate with the provinces and territories--