Health Committee on March 10th, 2011

[Glenda Yeates]

It varies from place to place. What we hear often is that sometimes lack of community programs, for example, will end up being manifested in the hospitals. We hear, in Ontario particularly, that there have been concerns about what are called ALC patients, alternate level of care patients. They are patients who no longer require hospital care, but their case managers are having some challenges transitioning them to appropriate home care or long-term care, and they are taking up valuable resources in hospitals.

There are a variety of challenges. It varies, again, in parts of the country and from rural to urban. Often it is that the system is very much a continuum. There are issues sometimes at the front end of what can be done in primary care. Then there is acute care and then community care. It often is a continuum.

[Patrick Brown, Conservative, Barrie, ON]

Dr. Beaudet, it looks like you have the answer.

[Dr. Alain Beaudet]

I just found the figure on Alzheimer's. Last year we spent over $22 million specifically on Alzheimer's disease or related dementia. In addition to that, as you know, we've launched a $25-million international initiative on Alzheimer's disease with a number of partners, including the U.K., France, Germany, China, and the U.S.

[Dr. David Butler-Jones]

In relation to the question on the system, as Glenda was saying, the dialogue has changed and the issues have changed for institutions. There is a growing consensus that if we look at it as a system, we need to shift upstream. We need to have people healthier in the first place. We also have to manage better the resources we have, and we need to be able to care for people afterward.

That's why we see ministers across the country signing on to the Declaration on Prevention and Promotion and focusing on childhood obesity for the future. At the same time, we need to engage the professions and others on how we best use it, because clearly, primary care has diminished in Canada. That's left a void which creates a backup in the system as everything gets specialized.

There are a number of things, really. Across the system there is a lot of conversation and discussion about where we need to go in the future, but clearly, a big part of that will be moving upstream.

[The Acting Chair, Conservative, Tim Uppal]

Thank you very much.

Monsieur Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you, Mr. Chair.

Dr. Butler-Jones, in the supplementary estimates (C), we read that the Public Health Agency is going to make a transfer to Human Resources and Skills Development Canada for developing a national standard for psychological health and safety in the workplace. This seems to be a complete intrusion into the constitutional jurisdiction of Quebec and the provinces.

Can you tell me why we need to establish a Canada-wide standard for psychological health and safety in the workplace? Also, are you able to tell me who is going to participate in developing this standard?

[Dr. David Butler-Jones]

First, it is a small step for the agency. It will be done together with the Department of Health. It is a way for us to ensure more effective cooperation. The other agencies work well with the provinces, but this is different from the activities of the provinces.

[Glenda Yeates]

Mr. Chair, I can expand a bit on this issue.

This funding is to support an initiative by the Mental Health Commission of Canada.

One of the remits of the Mental Health Commission is to do a mental health strategy for the country. It is working away on that. One of the priorities that came through its consultations was from employers and others who said, “We are not doing a very good job as employers at managing mental health in the workplace. We could use some help and some tools here”.

The funding that is being transferred is in support of this Mental Health Commission initiative to develop a national standard of psychological health and safety in the workplace. This would be a guide to help employers and others deal with what we all acknowledge is a challenge in the workplace. Employers are probably better at dealing with situations when people have cancer or heart disease, than when there are mental health challenges. There's a real opportunity to furnish a tool and a guide that will be useful.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you.

It has been agreed that the increasing use of antibiotics creates resistant pathogens in various species.

My question is for Dr. Beaudet and perhaps also for Dr. Butler-Jones.

I have been asking myself the following question. Have studies been done to see, for example, what happens in animals that have developed resistance, that is to say where pathogens have become resistant to antibiotics? When taken by human beings, are the people affected directly or do the pathogens that affect people become more resistant because the person ate meat from animals that have developed this resistance?

Have studies been done on this issue?

[Dr. David Butler-Jones]

Perhaps I will answer in English, because there are a lot of details.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Yes, go ahead, I can understand you.

[Dr. David Butler-Jones]

Yes, and it's multiple. When you put it all together, the relationship between pathogens in animals and humans is very complex. Some don't pass over; a number do. That's partly what we're concerned about.

Part of the reason for inspections by CFIA is to make sure that no sick animal gets into the food system. They make sure they're fundamentally healthy so we don't have situations where there are abscesses in the meat, or infection directly in the meat that could be transferred.

On the other hand, there are infections that come from fecal material, like E. coli, that get on the carcasses, on the meat, and potentially cross-contaminate, or something like listeria, which is in the environment and gets in through the food-processing system. There are various testing methods to minimize that impact.

In general, if you're eating a healthy animal, as opposed to road kill or something you picked up in the forest, it's not going to be through the meat. The animal is healthy. If you cook it well or cook it properly, you're going to kill off any bacteria or viruses on the surface. Generally, healthy meat won't have bacteria or viruses in the meat itself. That's one of our key assurances, as long as we don't cross-contaminate.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Is resistance passed from animals to human beings?

[Dr. David Butler-Jones]

No, if you kill the bacteria, there's no way that you're transferring the resistance. The resistance is in the bacteria itself and isn't transferable.

[The Acting Chair, Conservative, Tim Uppal]

Thank you.

[Dr. Alain Beaudet]

Resistance is transferred among humans largely through the overuse of antibiotics. Transmission mechanisms are certainly of a concern to us. The overall development of resistance to antibiotics is a research area that we consider to be crucial and that will certainly have a huge impact on future treatment.

On the one hand, there is the whole aspect of caution in using antibiotics and in preventing people from misusing them. On the other hand, there is the need to invest in research to better understand how resistance mechanisms develop and how we can fight against them. With this in mind, I am pleased to have the opportunity to inform you that we have just signed a research agreement with the United Kingdom that focuses on antibiotic resistance. We are investing $10 million for the next five years and so is the United Kingdom.

[The Acting Chair, Conservative, Tim Uppal]

Ms. Leslie.

[Megan Leslie, NDP, Halifax, NS]

Mr. Beaudet, I have a narrow question to which I would like a written response, because I don't expect you to know this off the top of your head.

Assisted Human Reproduction Canada and CIHR issued a call for proposals for research under the catalyst grant program on psychosocial issues associated with assisted human reproduction. Some $500,000 was transferred from Assisted Human Reproduction Canada to CIHR.

Could you give me a breakdown of the total funds that were available for grants, the total funds used, and what has happened to the remaining money?

[Dr. Alain Beaudet]

Indeed, I don't have it off the top of my head, but I would be glad to provide you with the information.

[Megan Leslie, NDP, Halifax, NS]

Thank you.

I have a question that I think will go to Mr. Glover. At this committee on December 2, the Minister of Health said that she and her department were aware of the loophole in former Bill C-32 concerning cigarillos, and said that she'd be looking into solving this problem. I'm wondering what has happened on that.

[Glenda Yeates]

Maybe we could clarify that Mr. Glover is now working in another area of the department, health products. He is here for the antibiotics questions.

There is ongoing monitoring with regard to the Tobacco Act. We continue to do compliance and enforcement work. We are working with companies. We are working to settle outstanding questions in the existing act, and we are following up with a number of manufacturers.

[Megan Leslie, NDP, Halifax, NS]

Are there legislative changes coming?

[Glenda Yeates]

We are working on two things, one of which is compliance with, and enforcement of, the present act, which has allowed us to capture most of the products targeted at youth. Also, we are continuing to investigate whether there are products targeted at youth that the existing act does not capture.

[Megan Leslie, NDP, Halifax, NS]

In 2009, officials from Health, who shall remain nameless, said that it would take about 12 months to organize a ban on smokeless tobacco. It's been about 20 months since then. Can you give us an update on smokeless tobacco?

[Glenda Yeates]

I think the committee may have been given some of the data on the follow-up to that hearing, perhaps in February. We have done additional research to understand the prevalence of smokeless tobacco and some of the other products. We find it is very low, not something being used by youth. Even so, we are continuing to monitor this situation based on the data we have. As I said, I think we submitted some of that background information to the committee last month, but we would be happy to follow up.