Evidence of meeting #55 for Health in the 40th Parliament, 3rd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was chair.
A recording is available from Parliament.
NDP
Megan Leslie NDP Halifax, NS
I have a point of order. Just so it is one-hundred per cent clear, I understand the 10 minutes for opening statements, but in terms of Standing Order 81(5) and Standing Order 108(2), is this all at once? Are we not having a break?
NDP
Conservative
The Acting Chair Conservative Tim Uppal
We are doing seven for the first round, and then five for the second round.
Conservative
Glenda Yeates Deputy Minister, Department of Health
Thank you very much, Mr. Chair.
I was going to start with a process question. As you mentioned, in addition to being here as a portfolio on supplementary estimates (C), we also understood that the committee wanted to speak about a very specific matter in terms of food and antibiotics. We have some of our technical experts here to deal with those questions. My question was as to which you wanted to deal with first, but I assume we'll start off with supplementary estimates (C).
Conservative
The Acting Chair Conservative Tim Uppal
We're going to do it all together. That's probably the best way.
The members may decide where they want to take their questioning. It's up to them.
NDP
Megan Leslie NDP Halifax, NS
In terms of testimony, we would encourage the witnesses to combine everything into their one 10-minute period, correct?
Conservative
Deputy Minister, Department of Health
Yes, Mr. Chair. I don't think we were planning to make opening statements on the other.
Conservative
The Acting Chair Conservative Tim Uppal
You don't need 20 minutes of opening statements for both, do you?
Conservative
The Acting Chair Conservative Tim Uppal
If you could fit it all into 10 minutes, that would be appreciated. Thank you.
Deputy Minister, Department of Health
I will be very brief, Mr. Chair.
Mr. Chair, members of the committee, it is a pleasure to be here to discuss supplementary estimates (C) for the budget year that's soon coming to a close.
This year was an eventful one in terms of health legislation, health research and health promotion. The minister will discuss these subjects more closely when she appears before the committee later this month.
As you know, the department I represent delivers a number of critical programs and services to Canadians, and does so based on its mission of helping Canadians to maintain and improve their health.
I'm now going to turn my attention directly to supplementary estimates (C).
For Health Canada, these estimates represent a net decrease of $818,000 in the 2010-11 supplementary estimates (C), which reduces our total budget from $3.756 billion to $3.755 billion for the current fiscal year.
I'm not going to go through every one of the major items contributing to this decrease, but they include a transfer of $706,000 to Indian Affairs and Northern Development.
These funds are destined to support self-governing Yukon first nations as they assume direct responsibility for the delivery of certain health programs and services. Funding will support them to administer health promotion programming related to diabetes, youth suicide prevention, the anti-drug strategy, and maternal and child health. These are services that previously had been funded and provided directly by Health Canada, and they'll now be provided by the self-governing first nations. This is in keeping with our general policy of transferring relevant departmental funding following the finalization of self-governing agreements.
The other significant transfer for us is the transfer of $200,000 to the Canadian Institutes of Health Research. This was proposed to be transferred to CIHR to help establish a research chair for autism.
Both of those transfers are fulfilling commitments made in recent years to making long-term improvements to health care.
With respect to autism, the transferred funds will be used to establish a research chair to focus research on this condition.
With reference to the Yukon first nations programs, this too is a part of a long-term commitment to give first nations greater control over the delivery of their own health services. This is based on the sound principle that first nations have the best understanding of the needs of their communities.
Mr. Chair, members of the committee, I hope this gives everyone a better snapshot of Health Canada's supplementary estimates (C).
Thank you for this opportunity. We will be pleased to answer any questions you might have.
Conservative
The Acting Chair Conservative Tim Uppal
Thank you.
We'll now hear from the Public Health Agency of Canada.
Dr. David Butler-Jones Chief Public Health Officer, Public Health Agency of Canada
I would like to thank the committee for this opportunity to provide an update on supplementary estimates (C) as they pertain to the Public Health Agency of Canada.
With me today is James Libbey, chief financial officer, and Dr. Rainer Engelhardt, who is here as it related to the second topic, antimicrobial resistance.
As the current fiscal year comes to a close, the agency actually has no additional funding to request under these estimates.
However, as my colleagues in the health portfolio are proceeding this morning, before I respond to committee questions I would like to provide the context in which this activity is taking place.
Mr. Chair, generally speaking, Canadians are healthier today than they have ever been.
Life expectancy in Canada has increased by more than two years in the last decade alone, and by more than 30 years since the early 20th century. Most Canadians today consider themselves to be in very good or excellent health.
Advances in treatment and medical science, while crucial, are not the only reason, and may be only a small reason, for the improvements we've seen. Canada has a remarkably strong history of action and partnership in health promotion and disease prevention, from the early colonial period to the 1986 Ottawa Charter for Health Promotion to the Declaration on Prevention and Promotion by Canada's Ministers of Health and Health Promotion/Healthy Living in 2010.
Since the formation of the agency six years ago, Canada has solidified its place as a global leader in public health.
Each year, at the agency, we are able to build on the sound policy, surveillance and science we generate, and on successful programs that directly help Canadians.
The main reason we need to keep building on this success is that improvements in health aren't shared equally among all Canadians. In many cases, health inequalities between Canadians are growing. Not all health trends are improving, and not all Canadians are benefiting to the same degree. Some groups in Canada experience lower life expectancy, as well as higher rates of infant mortality, injury, disease, and addiction.
The Public Health Agency plays a key role in the effort to narrow these gaps through partnership, advocacy, enabling, and mitigating when needed, but while government efforts are central, public health is, at its heart, local. Health promotion and disease prevention need to reach Canadians at home, in their communities, and at work. We need the partnership that all levels of government, health professionals, the corporate world, and community organizations can provide.
This is the idea behind so much of what we do at the agency, and each year our resources are devoted accordingly. This week, for example, Canada's ministers of health launched Our Health Our Future: A National Dialogue on Healthy Weights.
The dialogue is a key step in identifying actions to curb childhood obesity, a significant health concern in this country, and to promote healthy weights.
It's about engagement and discussion because, as in many public health issues, everyone plays a role. Everyone can commit to action on curbing childhood obesity. As Canada deals with an increasingly less active and more obese and overweight population, tied closely to escalating levels of chronic disease, I expect this will be a continued priority moving into the next fiscal year.
Of the $684.6 million allocated to the agency, over $182 million was dedicated to health promotion. These funds are helping to support activities like the dialogue I just mentioned, updating the physical activity guidelines, and building on our accomplishments through successful community-based programs, including those for vulnerable populations. This year $116 million was devoted to the disease prevention agenda.
These funds continue to enhance Canada's ability to prevent and manage diseases and injuries, and they are helping us continue to gather and analyze data on the traits, trends, and patterns of injuries in Canada. They are helping, for example, to increase awareness of risks such as lung disease and to increase capacity and knowledge on prevention and control of a broad range of chronic diseases, including diabetes, heart disease, cancer, and neurological diseases.
Under these supplementary estimates, the agency will be transferring approximately $1.9 million to other government departments for public health activities that help us reach these goals. For example, $1 million will be transferred to the Canadian Institutes of Health Research to support the need for enhanced research in population health interventions and the reduction of health inequalities, particularly in the realm of obesity and mental health.
An additional $800,000 will be transferred to CIHR for research on HIV and AIDS co-infections and other co-morbidities, which will help us understand how a spectrum of chronic diseases interact.
We are focusing our efforts where they are needed most.
We continue working to increase public health capacity and enhancing our national and international collaborations. We continue to strengthen surveillance and increase capability in assessing the health of the population.
We remain the government-wide lead on efforts to study and address determinants of health. We continue to work closely with all our partners to ensure that the government's responses to national outbreaks, including food-borne diseases and pandemics, are watertight, efficient, and well coordinated.
Before I close, I would like to highlight one additional area that you've requested in which the agency collaborates closely.
The Government of Canada as a whole has committed significant resources to tracking antibiotic use and resistance. The agency leads national surveillance systems that track antibiotic resistance and antibiotic use in health care, in community settings, and in the food supply.
The agency will also be working with Health Canada, CFIA, and Agriculture on the development of a coordinated approach to AMR, antimicrobial resistance, in Canada. This will include working closely with the health portfolio, provincial and territorial partners, as well as many other stakeholders to help control the spread of AMR in Canada.
Collaboration will always be our watchword. I believe these estimates reflect that priority. I appreciate your time and I am happy to answer any questions.
Conservative
The Acting Chair Conservative Tim Uppal
Thank you, Doctor.
We will now go to the Canadian Institutes of Health Research, for up to 10 minutes.
Dr. Alain Beaudet President, Canadian Institutes of Health Research
I would like to thank the committee for this opportunity to discuss the transfers to the Canadian Institutes of Health Research under supplementary estimates (C).
As you have seen, CIHR's grants vote will increase by $10.67 million with approval of the 2010-11 supplementary estimates (C). This increase will bring CIHR's reference levels for the 2010-11 fiscal year to $1.026 billion.
I would like to highlight the potential impact of a few of these transfers on health outcomes and commercialization of health discoveries.
The largest transfer is $9.36 million for the Centres of Excellence for Commercialization and Research. This investment is being used to fund two centres of excellence: the Centre for Commercialization of Regenerative Medicine located in Toronto, and the Centre for Imaging Technology Commercialization located in London.
Regenerative medicine and medical imaging are two areas at the forefront of discovery in health research. They are also two areas in which Canada is world-renowned for its scientific expertise. These two new centres therefore represent exciting opportunities for future breakthrough discoveries with impact on the health of Canadians and the strength of our life sciences industry.
CIHR's transfers, as you just heard, also include a transfer of $1 million from the Public Health Agency of Canada for population health intervention research. With this investment, CIHR and PHAC have succeeded in attracting other partners, including the Canadian Institute for Health Information, the Heart and Stroke Foundation of Canada, the New Brunswick Health Research Foundation, and the Ontario Ministry of Health and Long-Term Care. Together with these partners, CIHR will fund seven major research projects in the area of mental health promotion and the prevention and reduction of obesity, two major priority areas for the health of Canadians.
For CIHR this is but one of many of these very Canadian examples where government investment serves as a catalyst for the engagement of other partners so as to increase the coherence of research funding and maximize its potential for impact.
A third transfer of $800,000 from the Public Health Agency will go to major projects on HIV and AIDS co-infections and other co-morbidities, as you have heard. This research will provide the evidence needed for future programs and policies to prevent or control HIV and AIDS co-infections and other co-morbidities.
Finally, CIHR is transferring out the amount of $700,000 to the International Development Research Centre for an international research initiative on adaptation to climate change. This investment will support multinational research teams to advance a fuller understanding of climate and related stressors on vulnerable populations, resources, and ecosystem health in Canada and in low income and middle income countries.
The purposes of having this knowledge are: to shape policies and practices that help people and vulnerable segments to adapt to climate change; to train highly qualified staff; and, finally, to establish networks that will enhance the ability of governments, of the private sector and of civil society to adapt to climate change and to reduce its effects.
I would like to thank you for your support of CIHR's endeavours and for health research in general.
I'm pleased to take any questions that you may have.
Conservative
The Acting Chair Conservative Tim Uppal
Thank you very much for everybody's opening comments.
We will go into our first round of questioning, and it will be a seven-minute round.
We will begin with Dr. Duncan.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you to everyone for coming.
I'm going to look for short answers because we do have limited time. Are there discussions taking place regarding 2014, yes or no?
Deputy Minister, Department of Health
Mr. Chair, the Senate has just begun its review of the accord. There are ongoing discussions with stakeholders in the public domain. We are at this point awaiting the outcome of the parliamentary review to begin other discussions. There are a lot of discussions taking place, but the formal discussions at this point are through the Senate review.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you. I'm going to ask that you table this with the committee, please.
At what level are discussions taking place, when did they start, and how many meetings have taken place?
I'm also going to ask about wait times, and I'm going to ask that this information be tabled, please. What money has been invested since 2004? Where are there unacceptable wait times? Why are there unacceptable wait times? I hope we can get that information and also regarding emergency wait times by province and territory, .
In the fall the Canadian Pharmacists Association released a survey. It showed that 81% of pharmacists said they had trouble locating one medication during their last shift, and 93% in the past week. What, if any, action has been taken to address drug shortages?