Evidence of meeting #34 for Health in the 41st Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was know.
A recording is available from Parliament.
Conservative
The Chair Conservative Joy Smith
We'll begin again.
Thank you so much to the Health Canada representatives and the representatives from the Public Health Agency of Canada.
The presentation was already made by the minister, so what I'm going to do is just go straight into the questions. I think that's fair enough, and it will give us more time.
Does the committee agree to just going straight into the questions rather than to any more presentations?
NDP
Dany Morin NDP Chicoutimi—Le Fjord, QC
Thank you very much.
The residential school system represents a shameful part of Canada's history, and we've since been forced to apologize for it. While the government's apology was certainly historic, its actions since then have done little to improve the lives of first nations in Canada. As with many things done by this government, words, sadly, were louder than actions.
As a result of continued government inaction, the suicide rate in aboriginal communities is reaching epidemic proportions in some regions of Canada. Survivors are angry and outspoken. They expect Canada, they expect Ottawa, to work with them to find long-lasting solutions for themselves and their children.
Enough is enough. When will this government stop wasting everyone's time and finally implement the recommendation of the Truth and Reconciliation Commission on the extension and enhancement of health support services?
Glenda Yeates Deputy Minister, Department of Health
Thank you.
The member raises a very important question. We are all very much focused on providing the kinds of supports for communities and individuals that we know are needed.
There are two things I would mention in response to the member's question about what we're doing at Health Canada as part of this process.
Budget 2010 expanded five years of coverage, essentially, for a series of prevention programs in a number of areas, including mental wellness, early childhood development, and youth suicide prevention, for example. We have a number of programs across the country. Some are in very targeted communities. For example, on youth suicide, we're working with 160 communities very specifically on this issue to try to provide prevention and support to communities. It varies community by community.
Our regions work with individual first nations and the people in those communities, and in some cases the AFN and others, to try to tailor the supports needed.
The member also raised the issue of the truth and reconciliation process. We are working very closely with that process to provide the supports we know are needed. As individuals come forward as a part of that process, they themselves need support. We've been working very closely to provide those supports. When the reconciliation commission is in a centre having discussions or hearings, we are very much there providing both health professional support and traditional support. The court has indicated that we must provide these. We are working very hard and have had some very good comments on the support we're providing under some very challenging circumstances, obviously.
NDP
Dany Morin NDP Chicoutimi—Le Fjord, QC
Will the Minister of Health implement the three recommendations—I could read them—of the Truth and Reconciliation Commission?
Deputy Minister, Department of Health
I do not have those recommendations with me, Madam Chair, but we work very closely with the commission. We are going to study the recommendations and do everything we can to help and support people who need those services.
NDP
Dany Morin NDP Chicoutimi—Le Fjord, QC
I will continue on the topic of aboriginal populations.
The 2012-2013 main estimates indicate that there will be a decrease in the contributions for First Nations and Inuit primary health care over 2011-2012. I find this rather surprising. There is a decrease from $684.5 million last year to $665.3 million this year. Does this $20 million decrease reflect a drop in your commitment to the priority given to first nations in Canada? We saw this with Attawapiskat—there is no shortage of needs in these communities. Why are you saying that these aboriginal populations do not deserve those $20 million this year? Would it be in order to pay for the fighter jets?
Deputy Minister, Department of Health
It is very important for you to know that we are focused on primary health care for aboriginal communities. It is one of the most important aspects of our mandate in remote communities situated far from locations where provincial services are dispensed, for instance. There are communities that are very close to cities, whose members can access provincial services. Several of our communities are located very far away from urban centres and we must ourselves provide primary health care in those communities. We work with the aboriginal communities.
I can assure the committee that there is no budget decrease in that area.
I'll just mention that we have in some cases supplementary estimates. In fact, before the committee today are both the main estimates for the following year and also supplementary estimates (C), which are the last set of estimates for this year.
Because the primary care services are very important, we sometimes adjust them from year to year, and we would typically review those. Those would come later in the supplementary estimates. Just as last year I think the committee raised the question, not all of the moneys for our primary care nor some of our initiatives were in our main estimates, those are things for which we review the precise need levels and then we make adjustments.
We can assure the committee that there is no reduction planned for primary care service levels. This really reflects the budgetary process rather than a diminution of service.
Conservative
Mark Strahl Conservative Chilliwack—Fraser Canyon, BC
Thank you very much to all of the officials for being here today.
My question is about the medicinal marijuana directorate, the system that Health Canada has responsibility for. In my riding, which includes the city of Chilliwack, it's a very big issue. Medical marijuana is being grown in residential settings. The local government is very concerned that they aren't allowed to really know where things are and about the threat to public safety when a medical marijuana grow op is found.
We're now finding that organized crime is becoming a problem. They're latching onto those folks who have a licence. There are concerns about neighbours being misidentified as having a grow op.
I was encouraged when I heard about the minister's initiative to make it easier for patients to go straight to a doctor and get prescribed medicinal marijuana, but I was also encouraged to hear that we were looking to move medicinal marijuana grow operations out of residential settings altogether.
I'm hoping you can provide the committee with an update on that program and perhaps give us some timelines—I know the consultation period has ended—so that communities like Chilliwack and others can know what the future holds for that program.
Conservative
Deputy Minister, Department of Health
This is also a very important program within Health Canada, so I'm very pleased to bring the committee up to date on the progress. As the member mentioned, we hear a number of concerns as well. I would say they fall into two categories. In one case, individuals are often concerned about whether we're able to approve their requests in a timely way. I'm happy to report to the committee at this time that the number of users has been growing significantly, so we have staffed up. We are in fact meeting our timelines—less than ten weeks—for approvals. We are now in a position, I'm happy to report to the committee, of doing those in a timely way.
That's one set of concerns we often hear, but the other is the one the member raised, which is whether we have the right model, essentially. As was mentioned, we have been hearing concerns about the program perhaps being open to abuse or exploitation. We've heard concerns about the municipalities and police or fire officials. That's the reason why, in a sense, we've put forward for public consultation a proposed set of changes that would look to perhaps treating medical marijuana more in the way we treat other medications, for example. So we've put that proposal out for consultation.
We've had a number of very excellent comments back. We've been doing focus groups as well, so in addition to the public consultation, we wanted to make sure that we heard specifically, for example, from physicians, from municipalities. We've been talking to the provinces and territories, so we're trying to make sure we get that input as well.
Those two processes of consultation have just wrapped up, as was mentioned, and we're now in the process of working through what we heard in response to the proposal we put out. I think it's fair to say that once the government has considered that, it will then make its decision about how we move forward. I think we're also thoughtful that if we do make a change here, as has been proposed in our consultation document, it won't be an immediate one. It will take some time to transition from one system to another.
So in terms of timing, we're pulling together the analysis now. Once the government makes a decision, part of that will obviously deal with the appropriate way to transition from one system to another.
Conservative
Mark Strahl Conservative Chilliwack—Fraser Canyon, BC
A lot of members here have met with firefighters. I know the fire chiefs will be here again tomorrow. Dr. Butler-Jones, they've raised concern about the priority for vaccinations like an H1N1 situation; they weren't considered a priority in the first round of immunizations.
I'm wondering what goes into that decision-making process, that ranking, and if any thought has been given to first responders like firefighters, getting them moved into that top rung.
Dr. David Butler-Jones Chief Public Health Officer, Public Health Agency of Canada
Thanks very much for the question, because it's one of those eternal questions. The principles that underlie the recommendations in terms of priority are those who are most likely to be seriously ill or die, so protecting life, and then protecting essential functions. Clearly police, fire, first responders, central services, etc., obviously come into the category of essential services, trying to minimize disruption in the face of an outbreak, etc.
With H1, clearly firefighters and others who were at risk of severe disease were in the first tier, but we found that with people of that age, it was not a threat to civil society. If it had been, if they were either at greater risk or there was an issue of access, then clearly they would have moved up the queue.
We also had antivirals, which were very effective, so we found early treatment was particularly effective during the pandemic. Even if somebody—a firefighter, doctor, or whoever—became ill, getting immediate treatment shortened the duration and reduced the severity as well. As it turned out, we were able to manage that without changing the priorities, ensuring that those who were at greatest risk of getting severely ill and dying had first access. In Canada, we essentially wiped out the pandemic before Christmas, which no other country can say.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Thank you very much, Madam Chair.
I wanted to go back to a question I asked earlier. I wondered if you could give me some information about what the outcomes are in terms of the Aboriginal Healing Foundation, since it has been transferred to Health Canada and moved away from the aboriginal communities.
As you know, it was proven to have been a very successful program within aboriginal communities, and when the evaluation was done by the Department of Indian and Northern Affairs, they decided it should have stayed there. I want to know if that move has made health outcomes better for aboriginal people. How many programs do they have access to? Is the whole fund being used? That's my first question.
My second question is for Dr. Butler-Jones, and it has to do with the HAART program. As you know, in British Columbia, with regard to the treatment as prevention...that was the new drug that has been.... In fact, it's a Canadian celebration, in that Canadians have been the ones who have brought this drug forward, and the World Health Organization thinks it is the best step to take in preventing HIV infection and in dealing with the problem of its transformation, etc. You know what I'm talking about, so perhaps you can answer me.
Deputy Minister, Department of Health
Thank you very much for the question.
As I mentioned earlier, I think the issue of support for first nations clients in terms of mental health services and healing is very important.
I should clarify that the Aboriginal Healing Foundation funding was not transferred to Health Canada. It was always intended to be a time-limited program. It reached the end of its time limitation and was not renewed. That is certainly the case.
As that programming wound down, we tried to reach out to the communities that had projects that had been supported by the Aboriginal Healing Foundation to try to connect them to the services I mentioned we have within Health Canada. The funding wasn't transferred, but we do have support programs for mental illness and suicide prevention.
We also have programming under the Indian residential schools resolution health support program. We have specific money tied to that process. We've tried to make sure we are linking individuals in communities with that process as well. That's the activity we've been doing.
Chief Public Health Officer, Public Health Agency of Canada
Thank you for the question.
Basically, treatment as prevention is actually an old concept, which is secondary prevention. It's early identification and treatment to minimize the impact of any disease, whether it's through screening, and then early treatment, or, in this case, with HIV/AIDS, the recognition....
It's come clearer in the last while, with Julio's and others' work in Vancouver, that this is an effective way of doing it, but it's one of a series of measures. It's not a substitute for not getting infected in the first place. Clearly, identifying, and people being able to come forward to get diagnosed, to get appropriate treatment, is one part of that. Even in some parts of the world, circumcision is a primary prevention. The development of a vaccine ultimately will be the ultimate in dealing with it.
It really requires a focus on primary prevention—in other words, not getting infected in the first place—early diagnosis and treatment for those who are infected, and appropriate care for what's becoming a chronic disease.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
I realize that this is the spectrum of how public health would look at an issue, but to my knowledge, this new drug actually brings the viral load down to zero for as long as that drug is being taken, so that the patient is not able to pass on HIV. That's a significant new development. It's almost as if you've given the person.... Well, “almost”; you know what I mean.
This is not simply secondary prevention. This is actually a new drug that is dropping the viral load to zero.
Chief Public Health Officer, Public Health Agency of Canada
It does not cure the disease. It is secondary prevention.
Chief Public Health Officer, Public Health Agency of Canada
It's a very important thing, but it's not a substitute. In clinical trials, well-controlled clinical trials with close follow-up, we know that it does work. In a population level where people sometimes take their drugs but don't consistently take their drugs, it's not a substitute for not being infected in the first place.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
No one is suggesting that. I'm saying that while you're waiting for your vaccine, it is a way to actually bring transmission down to zero.