Health Committee on April 18th, 2013

[The Chair, Conservative, Joy Smith]

Yes.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

This week, in the House, the minister answered questions on incorrect chemotherapy doses.

Could you please give us additional information on the next steps, from a more technical perspective?

Madam Chair, just so you know, I will share my time with my colleague Matthew Kellway.

[Glenda Yeates]

Thank you very much for the question.

I understand the question to be about the chemotherapy situation currently in Ontario. Is that correct?

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Yes.

[Glenda Yeates]

It's obviously a very important issue. I think we have all been working very closely together with the Province of Ontario, with provincial officials, and with the Ontario College of Pharmacists to address the situation.

We understand there's a situation in which compounds that were—or in some cases still are—mixed in the hospital pharmacy for chemotherapy have, in the case of these particular hospitals, moved outside the hospital through a contract to an outside company. We are working very closely with Ontario to understand what is happening and to assure ourselves, and obviously Ontario, that we are providing whatever assistance we can to them to make sure there is proper oversight of this situation.

It is a changing and evolving one, as we are learning. That's why we are working closely with our partners in Ontario. We will obviously want to work across the country as well.

[The Chair, Conservative, Joy Smith]

Thank you.

Mr. Kellway.

[Matthew Kellway, NDP, Beaches—East York, ON]

Thank you.

Ms. Yeates, we left off with you saying there'd be no change in the department's policy with respect to the blood scheme. But something has changed in the context, which is a $6 million private sector investment in this blood-for-profit scheme, which is, frankly, both predatory and exploitive. These shops are being set up cheek by jowl with homeless shelters and methadone clinics.

Can you tell me what the department is going to do about it, or if that's unclear at this point in time, at least what options you're assessing?

[Glenda Yeates]

Thank you again for the opportunity to continue the dialogue on this very important question.

As I said, there's no change. Blood used for transfusion by both the Canadian Blood Services and Héma-Québec is collected only from volunteer donors. Plasma is also collected from donors and used in the manufacturing of pharmaceutical products, blood products that are very necessary, and there is an increasing demand for those products.

Historically, in Canada, 70% of those products have, in fact, been sourced from compensated plasma donors. Many of them come from the U.S., because Canada is, in fact, not self-sufficient. But also in Canada...there is one long-standing instance in Manitoba. There's a Canadian company that has, in fact, manufactured a plasma product for compensation.

[Matthew Kellway, NDP, Beaches—East York, ON]

You don't see a change here, in that you're not proposing to deal with the issue?

[Glenda Yeates]

If I might continue, Madam Chair, I should be clear here about the role. Health Canada is very concerned about the strict screening and the safety, because we are the regulator. We are very concerned about the safety of these products. That is our role, to make sure nothing in any process or any part of the process will affect the safety of the products.

Provincial and territorial governments have the authority to deal with the question of compensation, whether it is for blood, cells, tissues, or organs. We know that some jurisdictions, notably Quebec, have made a provision that they are not compensating for any of these. Other provinces—and I mentioned that this is a long-standing practice in at least one jurisdiction in Canada. This is, therefore, something we are in dialogue, again, with our provincial and territorial colleagues about, as the payment question is one in their jurisdiction.

The Canadian Blood Services and Héma-Québec are also involved. Obviously, patients who rely on these products.... We held an initial consultation with groups that are very reliant on some of these specialist products. But as I say, currently 70% of them are sourced from plasma from paid donors, so this group of people also has a voice and an interest in this topic.

We are working with our provincial and territorial colleagues. We have the safety mandate; they have the payment question.

[The Chair, Conservative, Joy Smith]

I'm sorry, Mr. Kellway, you've already had a little extra time. Thank you so much.

Thank you, Ms. Yeates, for your answer.

Mr. Gill, I understand you and I are sharing a question. So you begin and just leave off when you finish, if there is time. How's that?

[Parm Gill, Conservative, Brampton—Springdale, ON]

I have two quick questions, Madam Chair, and then I'll pass the time on to you.

A few months ago, the committee heard about the importance of genomic research and the possibilities it presents for the future of health care. Does budget 2013 have any proposed funding to support this emerging technology?

[Glenda Yeates]

I'll start with the answer, Madam Chair, and it may be that my colleague from CIHR will continue.

There is an announcement in budget 2013—I'm just looking for my notes on this—of a renewal of funding for Genome Canada. That is an organization outside the Health portfolio but obviously one of interest to us, with our science interest and our health interest.

The budget did in fact announce the renewal of funding for a Canadian research capacity in genomics.

[Parm Gill, Conservative, Brampton—Springdale, ON]

Thank you.

My second question is regarding medical isotopes, which are very helpful in the detection and treatment of some cancers. Unfortunately, in recent years the global community has experienced shortages.

Does budget 2013 have any proposed funds to ensure a secure supply of these medical isotopes?

[Glenda Yeates]

I think there has been really heightened awareness of the importance of these substances in our health system as a result of recent years. Budget 2013 does provide $141 million over two years to secure a supply of medical isotopes, and maintain safe and reliable operations at Atomic Energy of Canada Limited's Chalk River Laboratories. That, as you know, has been one of the....

As there's a shift and a change happening here, the budget does provide funding for that lab at Chalk River.

[Parm Gill, Conservative, Brampton—Springdale, ON]

Thank you.

You can take over, Madam Chair.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Gill.

The clerk is going to keep me on time, so I'll be within my time as well. Thank you for the opportunity.

Ms. Yeates and officials, according to the 2013-14 report on plans and priorities, Health Canada will be investing in e-health tools for first nation and for Inuit communities. Can you tell me how these investments will result in cost savings in terms of medical travel? Medical travel seems to be a huge issue. It comes up here at committee every time we have people who are in rural areas.

Second, will these investments in e-health tools be used on such innovations as Rosie the robot, as used in Nain, Labrador? That has been a very successful initiative. We feel we know Rosie personally.

Can you please answer those two things?

[Glenda Yeates]

Thank you, Madam Chair, for the questions.

In terms of cost savings, we have made significant investments in e-health, and we have seen that it can reduce travel in two ways. First, and perhaps most importantly, for patients, if we can connect them to health providers through telehealth, it may avoid a trip that may have been an overnight and certainly very disruptive for patients, but also very costly. We've looked at that in Manitoba, where we've made significant investments and we've done a bit of a study. There was also an external study done in northern Ontario, and there were significant savings.

There's a second way in which there are savings. Nurses, our staff in the communities, also need to keep their skills up. They want professional development and training. We can provide much more of that professional education and training to our staff through telehealth as well. So there are also savings in that important respect for our nurses.

With regard to Rosie the robot, I will say that the plans for this time are in fact to concentrate on things that perhaps are not quite as well known to the committee as Rosie, things that are in fact a bit less flashy, perhaps I can say. These are things like connectivity. We're looking to connect the next number of 35 new communities and provide them with clinical telehealth services. We're looking to increase the bandwidth in over 120 communities. We're looking to increase the use of mobile health technologies.

So there is this very interesting pilot with the robot, but that is at this point not planned for replication. It is a costly thing, and we have communities saying they need some of these very basic connected pieces.

[The Chair, Conservative, Joy Smith]

Thank you very much.

I've finished my questions and we have a little bit of time.

Dr. Fry, I was going to suspend at 5:15, but for your benefit, you could ask one question that's near and dear to your heart, and then we'll suspend.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you very much, Madam Chair.

There is something that I want to ask you about. The Patented Medicine Prices Review Board is having a cut of about 7.5%.

It would seem to me to be logical that they should get an increase, because they certainly need more resources to deal with the fact that the Auditor General has repeatedly said that the whole issue of adverse drug reporting is not timely and that more resources need to be added to it. I just want some sort of explanation as to why there's a cut in such an important area.

Thank you.

[Glenda Yeates]

Thank you again for question.

Madam Chair, I certainly would agree that the Patented Medicine Prices Review Board is a very critical and important institution. I would characterize the reduction in two ways.

One is that there are some administrative savings that they have found and that I think they feel they can manage with no impact, certainly, on their services.

They also were able to reduce funding they had set aside for hearings. Hearings are quite costly in their case, and again, there can be a number of years in which they hold a number of hearings. Their budget is increased to consolidate that. They've found that in recent years they simply weren't spending this money because they didn't need it. The hearings weren't required. They have indicated to us that they feel there will be no impact on their ability to fulfill their functions, because at current levels they were not needing those funds.

Thank you.

[The Chair, Conservative, Joy Smith]

Thank you, Dr. Fry.

Now I'm going to thank our guests for coming and giving us their very insightful and knowledgeable comments.

Mr. Roberge, we would have brought a cake had we known that you were going to retire. We're very happy for you and wish you well. We have retirement envy all across the way here.

We'll suspend for one minute, and only one minute, because we have to go into votes and some people are catching planes.

Thank you.

[The Chair, Conservative, Joy Smith]

I would like to have the committee resume, please. Could you please take your seats?

I'm just trying to be considerate of the people who have to catch airplanes shortly after this meeting. Their schedule is very tight to get back to their ridings, so I want to be mindful about that.

We have to do the votes. I must have unanimous consent so that I can call all the votes together. Do I have unanimous consent to do that rather than going through them one by one?

[Some hon. members]

Agreed.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Yes, Madam Chair.