Health Committee on March 24th, 2011

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Thank you very much.

I'm trying to save time. I'm asking very brief questions.

Now, I see that there is no money in the budget anywhere that is dedicated to the commencement of a national pharmacare plan or a national pharmaceutical strategy. You know, Minister, that in the 2004 accord there is a specific provision, which is titled “national pharmaceutical strategy”. It talks about cost options for catastrophic coverage, a common national drug formulary, access to break-through drugs, and many other things. Have there been any discussions since you took over as Minister of Health on that portion of the accord with any of the governments in Canada?

[Leona Aglukkaq, Conservative, Nunavut, NU]

I think the member knows well that pharmaceuticals are a shared responsibility with the provinces and territories. We continue to work with the provinces and territories, and there has been some discussion with provincial health ministers around just this very subject, looking at ways we can move forward on that. But we're not at the position where there is consensus on what that would look like. The provinces continue to work within their own priorities, and we've stated before that the federal government would be a part of that. The discussions continue today.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Have you ever discussed with the ministers of health the establishment of a common national drug formulary, as was envisioned in the accord, and when was that?

[Leona Aglukkaq, Conservative, Nunavut, NU]

I can say as a former territorial health minister that it has been discussed around FPTs. The issue, both sides—

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

No, I'm asking you—

[Leona Aglukkaq, Conservative, Nunavut, NU]

Let me finish.

As you know, pharmaceuticals is a shared responsibility with the provinces and territories. The challenge has always been getting consensus on a national strategy. We're looking at different options, such as bulk purchasing, as an example. So those conversations continue with the provinces and the territories.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

And those conversations were based on the national pharmaceutical strategy, with the intention of providing the kind of coverage it talks about, or were they just isolated discussions?

[Leona Aglukkaq, Conservative, Nunavut, NU]

The conversations have been around what that would look like, around what you just described, but again—

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

At what meeting of the ministers did that discussion take place?

[The Chair, Conservative, Joy Smith]

Mr. Dosanjh, can we just let the minister finish, please?

[Leona Aglukkaq, Conservative, Nunavut, NU]

It's been going on since I've been health minister, since 2006, 2005.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

What meeting of the ministers—

[Leona Aglukkaq, Conservative, Nunavut, NU]

September.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

—did specifically discuss the national pharmaceutical strategy?

[Leona Aglukkaq, Conservative, Nunavut, NU]

I have conversations with territorial and provincial ministers on this and a number of issues all the time. What I can say again is that provinces and territories continue to discuss what that would look like, and I use the example of bulk purchasing. The challenge has always been, as provinces and territories deliver health care, to have consensus on what that national strategy would look like. As you know, the federal responsibility is to approve drugs for markets, and it's up to the jurisdictions to approve within their own formularies what they will publicly cover.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Ma'am, I do know the process.

[Leona Aglukkaq, Conservative, Nunavut, NU]

That has always been a challenge in that process, and they're continuing to work through some of those.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Thank you.

The question I have is that I see no money in this budget--or the earlier budget, for that matter--dedicated towards assisting the provinces to expand home care. There was supposed to be a report at the end of 2006 provided by the ministerial task force to the Government of Canada, and then there were to be further steps taken. Would you confirm for me if there have been any discussions about expansion of home care and if there is any money in this budget for that?

[Leona Aglukkaq, Conservative, Nunavut, NU]

Thank you, Madam Chair.

In terms of home care, as you know, we're working with the provinces and the territories in that area. They deliver health care. They have responsibility for primary health care, including home care, and for decisions on how they would like to design that.

We also recognize that there are cost-effective means of delivering some of those home care initiatives. Some jurisdictions have moved forward quicker than other jurisdictions just around that. Our government continues to provide, as per the health accord, the increases to their budgets.

Each jurisdiction then allocates to areas of their own priorities. That continues to be rolled out in each jurisdiction, addressing their priorities within the allocated funding from the federal government.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

I'm not interesting in wasting your time or mine, ma'am. I'm asking you a question that you haven't answered. You've given me a long-winded answer. But thank you.

Let me go on, since I didn't get the answer to that question, and move over to the next area of questions.

Has there been any dialogue amongst ministers with respect to what will happen to the 2004 accord in 2014?

[Leona Aglukkaq, Conservative, Nunavut, NU]

First, the review has started with the Senate committee. I'm looking forward to the recommendations coming out of that review from the Senate committee on the 2014 health accord. They have a long list of people who will be presenting on that. That information will be critical in terms of the conversations we will have nationally.

As well, this committee will be making a decision later today on whether they want to conduct their own review or not.

It's important; it's a requirement within the health accord to do a mandatory review of the accord. So the review that's been initiated is key--

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Ma'am, you're not answering the question.

[Leona Aglukkaq, Conservative, Nunavut, NU]

It is key--

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

No. Please don't waste my 15 minutes.

[Leona Aglukkaq, Conservative, Nunavut, NU]

--to moving forward with the provinces and the territories.