Health Committee on Jan. 31st, 2012

[The Chair, Conservative, Joy Smith]

Ms. Quach.

[Anne Minh-Thu Quach, NDP, Beauharnois—Salaberry, QC]

It seems to me that this could come into the area of best practices. I think that Patrick Brown said himself that the federal government could pay a role in establishing best practices. I don't see how this would conflict with the federal role.

Since the procedural clerk has confirmed that all the amendments are in keeping with the spirit of the bill and do not contravene it in any way, I am very hopeful. I hope that we will be able to make amendments to the bill in order to improve it.

[The Chair, Conservative, Joy Smith]

Mr. Brown.

[Patrick Brown, Conservative, Barrie, ON]

Thank you.

Paragraph 2(c) of the bill says just that. It says that through the Canadian breast cancer screening initiative, we'd share information regarding dense breast tissue during screening and any follow-up procedures. It actually says the words, “any follow-up procedures”. I think the vehicle can be used federally, but I don't think we can tell the provinces how to do follow-up procedures. That's not our role. However, the Canadian breast cancer screening initiative has provincial and territorial representatives and non-governmental representatives, and I think this is the vehicle the federal government can contribute to, and we are currently contributing. I think this bill would simply prod that focus on dense breast tissue.

[The Chair, Conservative, Joy Smith]

Ms. Davies.

[Libby Davies, NDP, Vancouver East, BC]

I just wanted to respond to Mr. Brown's last comment, because I did read paragraph 2(c), and I read it just slightly differently.

When you read paragraph 2(c), it says “sharing through the Canadian Breast Cancer Screening Initiative”, etc., etc., “during screening and any follow-up procedures”. I interpret that to mean follow-up procedures that may already exist. We've heard that they're not great, but I'm sure there are some. I read it slightly differently, and that's why in my amendment I put in the key words, the need for follow-up; it's the issue of trying to have a more systematic follow-up, based on the need to do that. There's a slight difference, and that's why I actually put it in as an amendment.

I think my amendment is based on what we need to look at, whereas I read your paragraph 2(c) as what's sort of here and now, what the status quo is. So it's just a slight difference, if you could relate to that.

[The Chair, Conservative, Joy Smith]

Dr. Fry.

[Hedy Fry, Liberal, Vancouver Centre, BC]

I just think that this enters into the scope of practice. It's not something that a government should be telling physicians—how to practise medicine. That's something that has to come through clinical guidelines that are set by researchers and others who do that kind of work. I think it's an intrusive thing to do.

[The Chair, Conservative, Joy Smith]

Thank you.

(Amendment negatived: nays 7; yeas 4)

We'll now go to the last amendment. Dr. Fry, go ahead.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you. This is the friendly amendment I referred to. I don't know how Patrick will feel about it.

On line 20, I just wanted to add a paragraph (d) that says “adopting within the Canadian Breast Cancer Screening Initiative a clearing house for best practices in terms of screening and detecting cancer in persons with dense breast tissue.”

[The Chair, Conservative, Joy Smith]

Thank you.

Could you read that again, Dr. Fry?

[Hedy Fry, Liberal, Vancouver Centre, BC]

Line 20, which would be a paragraph (d) that we'd add there, would be "adopting within the Canadian Breast Cancer Screening Initiative a clearing house for best practices in terms of screening and detecting cancer in persons with dense breast tissue."

[The Chair, Conservative, Joy Smith]

Thank you.

Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Would it be okay if we...?

[The Chair, Conservative, Joy Smith]

Mr. Brown, did you have a comment?

[Colin Carrie, Conservative, Oshawa, ON]

Would the committee be so kind as to give us a couple of minutes?

[The Chair, Conservative, Joy Smith]

Yes.

Can I just make a comment before we go into any further discussion?

It has been brought to my attention that there are some concerns with regard to a possible need for a royal recommendation for this amendment. That came from our expert here. I just want to raise those flags.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Do you see the word "adopting"? It's been changed to "adopting"?

[The Chair, Conservative, Joy Smith]

Do you want to speak to it? Go ahead.

[Mike MacPherson]

It's not so much that, as it is the term "clearing house". It's not sufficiently defined. I don't know what that would entail. Is that a new section?

[Hedy Fry, Liberal, Vancouver Centre, BC]

I just wanted to suggest that "clearing house" is very common terminology. It's been used within medical practice and within any other practices across this country for many years. It's just a place where you collect things, information, best practices, or whatever. People can then go into it and get information out of it—i.e., provinces or anyone who wants to see what other people are doing well.

[The Chair, Conservative, Joy Smith]

Okay.

[Hedy Fry, Liberal, Vancouver Centre, BC]

So "clearing house" is a really defined term that's been used many times in the past.

[The Chair, Conservative, Joy Smith]

He's not prepared to rule it inadmissible, but it's just a red flag that when it goes back to the House, there could be points of order. It could be subject to a royal recommendation on several fronts. That's just a red flag.

Now, do we have more discussion on this?

Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Madam Chair, if you could just give us a couple of minutes, we would like to confirm the point that was brought up. When you are suggesting the formation of a clearing house, it may involve expense, which means a royal recommendation. We on our side—and I think everybody—don't want to do anything to slow down the bill.

If you would give us two minutes to suspend, we'll check on that.