Evidence of meeting #58 for Health in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was drugs.
A recording is available from Parliament.
12:05 p.m.
Conservative
The Chair Conservative Joy Smith
Thank you, Dr. Beaudet.
Thanks for the question, Mr. Brown.
We'll now go to Mr. Kellway.
12:05 p.m.
NDP
Matthew Kellway NDP Beaches—East York, ON
Thank you very much Madam Chair and, through you, thank you to our guests. It's a very interesting discussion today.
In the summer of 2011, I had the opportunity to go to MDA in the Toronto area to see the Canadarm, but also to look at how that technology has been transferred into new surgical devices. I guess one calls these robotic surgical devices. It was quite fascinating.
One of the things that occurred to me, looking at this, was whether or not the kinds of skills required for the human resources in our health care system are changing as a result of some of the innovations and new devices that are occurring.
Dr. Beaudet, I was wondering if you are seeing new technologies changing the human resource requirements in health care. Is there a general direction in which these things are going? Is there a process where this is going back into medical schools, etc., so they know that these new technologies are coming up and skills are changing?
12:10 p.m.
President, Canadian Institutes of Health Research
In fact you are touching upon a very important topic of how we adapt to these new technologies and the human factor in the adaptation.
The type of research we are funding is all about discovering these new technologies and, I believe, not enough about how we cope with those new technologies. We're now getting into more research that is more social research. Also, how do we change practice? How do we get the current health practitioners to change their practice, to change their ways, to accept and adopt these technologies?
This is what we call implementation research, which is not far from behavioural psychology, to tell you the truth. We believe it is important to fund more of that type of research so that we get a better handle on implementing these new technologies, but also sometimes to change very mundane practices, such as the way you disinfect a central line. You know that all the literature says that the way you are doing it is not the right way, but to change the practice into the right way of doing it is difficult because you are dealing with people.
Through our patient-oriented research strategy, again working with the provinces, we are putting a lot of emphasis on supporting implementation research and translational research that will tell us how to better bring these innovations into practice and change practice.
It's absolutely critical, because we are talking about human behaviour, and that is not something that is as easy to change as one might want.
12:10 p.m.
NDP
Matthew Kellway NDP Beaches—East York, ON
In this case at MDA, you have a doctor sitting behind a glass panel with a joystick doing surgery as opposed to something else. I found that to be quite fascinating.
Do our other witnesses have any comments on the issue of technology and changing practice?
12:10 p.m.
Director General, Therapeutic Products Directorate, Health Products and Food Branch, Department of Health
I would add that it underscores the need for our evaluators to stay up to speed as well on developments. One of the things we try to do is ensure they have access to experts in the various fields. We just won't be able to, nor should we, hire every leading-edge expert for doing the reviews. We want them out there treating patients.
We have a series of advisory committees and on those committees we have experts from the various areas, so that we can get access to the expertise when we need it for review.
12:10 p.m.
President and Chief Executive Officer, Canadian Agency for Drugs and Technologies in Health
It's certainly something we look at when we're doing an assessment of a new technology or an existing technology, just to ensure that those human factors he talked about are actually going to make that technology useful to the system. You have hit on a significant issue, which is scopes of practice and who can use these newer technologies and advances.
Some provinces have started to institute changes to their scopes of practice to allow other professions to do things now that used to be only in the domain of a physician, for example.
12:10 p.m.
NDP
Matthew Kellway NDP Beaches—East York, ON
Thank you.
Very quickly, Dr. Beaudet, you can paint a very exciting picture not just about the potential for this research to lower health care costs, but also about the kind of economic multipliers that come out of this.
The question is whether we are maximizing our ability to do that and, if not, how we take full advantage of the development of new technologies.
12:10 p.m.
President, Canadian Institutes of Health Research
I think my colleague, Brian, could also tackle this one. We're obviously trying to maximize it. Do we maximize it now? No. The current statistics tell us that between 25% and 30% of medical acts or lab tests being done in the current health system are, in fact, useless or even harmful. To maximize this we need to stop doing a certain number of things. Bringing in new technologies is great—
12:10 p.m.
Conservative
12:10 p.m.
Conservative
Mark Strahl Conservative Chilliwack—Fraser Canyon, BC
I thank the witnesses for their presentations.
We've mentioned mental health, and it seems to be something that touches on every study we've done so far. Whether it's chronic or other diseases, there always seems to be that mental health component. I think it's a good thing we're discussing it as an integral part of what we do here.
I was at the Mental Health Commission's fifth anniversary national mental health awards this week. There were a number of exciting social program innovations that were celebrated there.
Are there technological innovations taking place with a focus on mental health? If there are examples of that, could you share those with the committee?
12:15 p.m.
President, Canadian Institutes of Health Research
Absolutely there are. For one thing, we are starting to better understand, through genetics actually, certain genetic predispositions in mental health. Through epigenetics, we're starting to understand how the environment, external events, will act on your genome and modify chemically your DNA. By environment I don't mean only the physical environment or the toxins you may be exposed to; I'm talking about the psychological environment, such as maternal love, for instance. These modifications will modify the expression of your genes. That's absolutely critical for mental health. We're starting to find out what is in your genetic makeup, what is partly genetic but also partly acquired through the environmental experiences, which is absolutely critical as well, and things that are due to development versus things that are chemical imbalances. Obviously, modifying chemical imbalances is easier than reverting to what has been, often due to genetic causes, a major problem in development and the establishment of the synaptic connections in the brain. We're starting to better understand that. Are we ready to cure all these disorders? No, but we are making enormous progress.
It is an area where we have to invest in basic research, because until we understand how the brain works, we won't be able to truly develop treatments that are cures. We'll be able to play with symptoms, but we won't be able to cure things. It's the last frontier. It's a complex organ, but it is amazing to see the speed at which we've made progress in that area. There's really hope for patients with mental health issues.
You have to realize that a few years back we wouldn't even have recognized a mental health issue. It's something you wouldn't talk about because of the stigma. Now, in many areas, mental health is recognized for what it is. It's not worse to have a mental health problem than to have diabetes, and often there are similarities. You can have a dysfunctional enzyme. You can have a hormone that's not secreted properly. You can have a neurotransmitter that has either overproduced or has not produced enough. We're starting to get a handle on this. It's complicated.
12:15 p.m.
President and Chief Executive Officer, Canadian Agency for Drugs and Technologies in Health
I would echo a lot of those comments as well. One of our priorities is in mental health. We do a fair bit of work and review not just of drugs but of newer types of therapy, such as psychological therapies and other social therapies that are helping to both prevent and treat mental health illnesses.
It was wonderful that the Mental Health Commission came out with Canada's first national mental health strategy last year. We're starting to learn from that as well. We've also done some work with the Canadian Psychiatric Association to ensure that the research work we do or the recommendations we put out are matched with some of the thoughts they have moving forward .
12:15 p.m.
Conservative
The Chair Conservative Joy Smith
Thank you, Mr. Strahl.
That was fascinating. I just want to make one comment, if I may.
Our committee had the RCMP for the first time. They had never been to the health committee before. Do you remember? You were on, Ms. Davies, at the time, I think.
It was absolutely amazing to hear about the mental health issues they had based on environment. They didn't start out that way.
That was a very fascinating question and a very fascinating answer. Thank you.
Welcome to our committee, Mr. Nantel, and I hope you enjoyed our nice hot lunch today.
October 18th, 2012 / 12:20 p.m.
NDP
12:20 p.m.
Voices
Oh, oh!
12:20 p.m.
Conservative
12:20 p.m.
NDP
Pierre Nantel NDP Longueuil—Pierre-Boucher, QC
I guess the health committee has no May Wests or steaks.
Thank you, Madam Chair.
I would like to thank the witnesses for their presentations this morning.
I am replacing Ms. Sellah. I am not a specialist, but I was fascinated by your passion and all these technological advances in the health field.
Dr. Beaudet, what I particularly appreciated—and this is probably quite related to your mandate—were the explanations concerning your work. It is very concrete and you speak often about the patient.
In fact, the main question that people who aren't familiar with the subject may ask when they hear this conversation is that if we are truly talking about the patient, the goal is that every Canadian's troubles be relieved. You did a good job of summarizing the fact that it would be very productive to resolve back problems and depression in general.
I would like to ask you, Ms. Sabourin, how long have you been working in your directorate?
12:20 p.m.
Director General, Therapeutic Products Directorate, Health Products and Food Branch, Department of Health
I've been working in my department since 1980.
12:20 p.m.
NDP
Pierre Nantel NDP Longueuil—Pierre-Boucher, QC
That's amazing experience.
I very much appreciate your great commitment.
How do you intend to deal with the budget cuts that are being imposed on you? Surely, you will have to cut back on some activities. How are you going to do that?
12:20 p.m.
Director General, Therapeutic Products Directorate, Health Products and Food Branch, Department of Health
My group is responsible for the evaluation of drugs and medical devices. Recently, we changed the cost recovery regime, which is the regime that really allows the manufacturers to provide money for our services in reviewing and evaluating new products. That was very helpful in allowing us to get new resources. We're now able to meet our targets and our timelines for all of our product lines, with the exception of generic drugs, on which we're working very hard to continue to make progress.
In terms of the budget reductions, we were able, to a large extent, to protect our scientific resources. We feel they're essential and provide a real high-priority service for Canadians, and so we're fortunate to be able to protect those.
We did not escape untouched, and we do have some areas where we've made some changes. One example would be the consolidation of three groups, all of which were responsible basically for setting up meetings with external stakeholders. We were able to consolidate them into one area. That's an example of an initiative we've been able to undertake to save a few dollars. Similarly, across our branch, we looked at resources around internal communications. We've done some streamlining in that area. Also on the policy side, we've been able to identify a way of doing business that's slightly different and allows us to make some savings in that area.
I think we need to always stay relevant to the needs of Canadians and the needs of the health system, and as the world changes around us, we need to change as well. As a Canadian, I expect that from my government, and I expect that from my group as well.
12:20 p.m.
NDP
Pierre Nantel NDP Longueuil—Pierre-Boucher, QC
Ms. Sabourin, you mention that the world is changing and that we need to change with it. I'm sure you are right. There have been technological advances that we could not have imagined in the past. We all have a BlackBerry. I hope everyone is listening to you, even if we are working at the same time.
There is certainly a savings in time, particularly when it comes to transport. An average citizen will surely find that this is strange because health needs are increasing. Of course, we all want to be more efficient, but I am convinced—and I think you are very brave to appear here today—that you are in a very challenging situation. You are being asked to do more with less. That is quite something. I am aware that there are savings to be made and that there always will be, for example, with respect to office supplies, compared with 10 years ago. We can also stop buying cartridges.