Health Committee on April 18th, 2013

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you very much.

Welcome, everybody.

For my first question, I note there are consultations taking place with first responders, including firefighters, on the update of Canada's pandemic influenza plan.

Can you update us on how those are going?

[Krista Outhwaite]

Thank you for the question. I'd be delighted to update you on this.

As you know, Canada has a pandemic preparedness plan for pandemics and influenza. Building on our experience from the H1N1 pandemic, we of course wanted to revise and update that plan in terms of lessons learned.

Among many stakeholders who have an interest in the pandemic plan, we also have first responders, including firefighters. We are commencing an eight-to-ten-week consultation process with all of our stakeholders. We're going to extend invitations to health professional associations and other organizations. We will also provide two complementary processes for emergency service workers including firefighters, as well as aboriginal populations, and we're also going to run a number of webinars. So there will be lots of opportunity for people to give input, particularly these emergency responders.

We know they take great interest in the pandemic plan. They were affected by it. They were a critical part of the last pandemic, and we're eager to hear from them.

We expect to conclude our consultations by the end of June this year. Then we'll move on with that input to revise the plan in concert with provinces and territories.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you very much.

The next one will be more on the budget. In Canada we're experiencing the aging of the baby boomer generation. Of course, as a result, there will be pressure on the labour market of health care professionals.

My question is whether budget 2013 has any proposals for palliative and end-of-life care.

[Glenda Yeates]

Thank you very much for the question.

I think there is real and growing interest in the country on the issue of palliative care and end-of-life care. We recognize it as an area where many families, many communities and facilities, all face a sense of the challenge in doing this as best we can for Canadians.

Budget 2013 did make an announcement of funding for some research into how best to do end-of-life care, with $3 million over three years to the Pallium Foundation of Canada. This organization has a national scope, providing professional development and modules for family care providers—family physicians, for example, or nurse practitioners—and developing interdisciplinary palliative care training modules and education. They have already educated over 500 health professionals through a number of learning projects.

There are funds in this budget over the next three years for them to have continued support to increase this development. We see it as a key area, and one where we think the federal government can play a role, not in delivering the service but in helping to support the improvement by providing these resources.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Regarding current service providers, we can look at an example from Ontario. I know from my own experience, on the board of directors of a seniors residence, that a lot of services have been downloaded by the province, unfortunately to the regions. Therefore, there's a challenge there as well, so maybe in the new health accord, or in the budget....

There are no provisions in the budget, I suppose, for direct financial help to the providers of long-term care.

[Glenda Yeates]

As the minister mentioned, the Canada health transfer to the provinces is obviously the significant financial support for the delivery of health services. There is provision through Health Canada to try to support some of the areas where doing something once in the country makes some sense.

So we do some work on health human resources planning and—

[The Chair, Conservative, Joy Smith]

I'm sorry, Ms. Yeates. I hate to interrupt you, but would you be so kind as to watch the chair so that I can tell you when your time is up? And your time is up, I'm sorry.

We'll now go to Mr. Kellway.

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

Thank you, Madam Chair.

To the officials, thank you for staying with us.

Congratulations to you, Mr. Roberge, on your happy news there.

I'd like to say how unfortunate it is that the minister only saw fit to spend an hour with the committee.

I would also say it's unfortunate, Madam Chair, that you let Mr. Lobb waste his time and our time trying to prove he's the smartest guy in the room, instead of making constructive use of the minister's time.

[The Chair, Conservative, Joy Smith]

Do you have a question, Mr. Kellway?

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

I do, Madam Chair, and I'm using my time as I see fit. If you're going to start counselling members, you should have counselled Mr. Lobb on a losing gambit there.

[The Chair, Conservative, Joy Smith]

Would you like to ask a question, Mr. Kellway?

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

Yes, I would, Madam Chair.

I'd like to pick up where Mr. Lizon left off, with the issue of long-term care, and particularly home care and palliative care. I note that we've all been aware for years and years, of course, of the demographic bubble and the aging population. It's no surprise to anybody that there are health care implications flowing from that. But all I see in budget 2013 to help with the issue of personal home care services is a GST/HST tax exemption.

I know you guys aren't the.... You're the policy people, and you're not there, but perhaps you could please explain what your understanding is of why we've adopted a policy that doesn't put more effort and funding into what are obvious needs and desires for Canadians in their health care system, the palliative care and long-term home care.

[Glenda Yeates]

Thank you very much for the question.

I'll try to keep my eye firmly on the chair, as I was instructed to. I apologize for sometimes missing the chair's signals.

I think there's a strong desire...and in fact we've seen in the data that there are actually strong increases in home care that the provinces and territories, as the direct deliverers of care, are providing across the country. But I think as the minister outlined, the fact that the federal government puts its increases in funding to the provinces and territories through the Canada health transfer allows them essentially to determine where their greatest areas of need are.

Some provinces are still working on their drug coverage. Other provinces have younger populations; others have older populations. But we do see in the country that most, I think, if not all of the provinces are making increasing investments in home care and long-term care.

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

Where there are levers, though, for the federal government—and I look to, for example, EI compassionate care benefits and stuff like that—those could have been used at least to support what we all know is a legion of volunteer helpers, loved ones and friends, who help seniors who need home care services in this country. Why not pick up on something like that, for example?

[Glenda Yeates]

As I said, I know that is an HRSDC program, so they do have that program. But again, the health department's role here is largely to support some of the infrastructure needs, hence our support for some of the information or for Canada Health Infoway and the funding that allows provinces and territories to focus on the areas where they feel the needs are greater.

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

As a last question, on this issue of blood for profit, can I very briefly read from the very first sentence of Justice Krever's report? He says it's his “account...of a public health disaster that was unprecedented in Canada and, if we have learned from it, one that will never occur again”.

That disaster involved 20,000 lives lost and $5 billion in compensation. Yet I got news this morning regarding the construction of a third blood-for-profit shop being built in Ontario. I'm very concerned that this government is not doing something to stop the undermining of our current volunteer blood services system in this country.

[Glenda Yeates]

I appreciate the question. This is something that I think is of critical importance to Canadians. Canada has one of the safest—if not the safest, according to some sources—blood systems in the world. There has been no change in the government's policy on blood donations. Blood used for transfusion is collected only from volunteer donors in Canada.

The manufacturing of plasma products is not a new practice. In some cases, that is the situation that is currently being discussed in Canada.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Yeates.

We'll now go to Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Madam Chair.

I want to thank Ms. Yeates for clearing up the misinformation that's out there on blood products.

I want to take this opportunity as well to congratulate Mr. Roberge. I know about all the work you've done over the years, and your retirement is certainly well earned. Thank you very much for all the work you've done for Canadians.

I wanted to ask a question about SPOR, because at the end of the day, it's about the Canadian patient. I realize that Health Canada is taking a significant leadership role. In committee this week, we heard from somebody from Oshawa, Dr. Carolyn McGregor, who mentioned the work being done through the strategy for patient-oriented research, SPOR, and the benefit it provides to the Canadian health care system. I was wondering if you could discuss SPOR in budget 2013 and any proposed funding that is going to be allocated to SPOR, because we're hearing some great feedback on that.

[James Roberge, Chief Financial Officer and Executive Vice-President, Resource Planning and Management Portfolio, Canadian Institutes of Health Research]

Thank you very much for the question.

Yes, indeed, there is incremental funding again for SPOR. This is the third consecutive year. There's a total of $45 million cumulatively; $15 million from this budget. SPOR is a very overarching strategy with the view of trying to bring the fruits of research directly to benefit patients. A lot of the effort is dealing with bridging the gap between research findings and the impediments of putting them into use. That involves research into how to apply certain interventions effectively. It also involves research into whether certain treatments are effective or not, or cost effective. Research can contribute to that and directly benefit patients as a result.

[Colin Carrie, Conservative, Oshawa, ON]

We've heard over and over from witnesses in front of committee that it's also about best practices. Would you be able to give some examples to the committee about some of the research that is being done with SPOR right now and some of the projects that are already on the go or have been announced?

[James Roberge]

Thank you for the question.

One area we've been focusing on, in which research is starting to show quite dramatic results, is the efficacy of certain tests. Tests are widely used in this system. There's evidence that they're overused and that they're frequently not effective and are very costly. So understanding which tests are required and under what circumstances is extremely important. Personalized medicine, which is really about tailoring the application of medical interventions to the individual's particular circumstances—their genetics as an example—again is a way of making sure that the interventions are targeted, effective, and not wasteful.

[Colin Carrie, Conservative, Oshawa, ON]

Are we finding any instances where we're doing research on multidisciplinary types of clinics? How is that working? We have heard from the more remote rural communities and first nation communities that sometimes there's difficulty with human health resources and getting people to go to these areas to serve the public. Do we have some examples of multidisciplinary research projects?

[James Roberge]

Science is converging in many ways. The disciplines are working together more and more. As an example, we see it through the work we do with the Natural Sciences and Engineering Research Council in bringing engineers and medical researchers together to develop more effective medical devices. As an example, these could be prostheses for people who have had limbs amputated.

It's that kind of convergence, where the disciplines work together, that really can benefit in ways that siloed researchers cannot. Much of our work on SPOR, for example, is about putting networks of people together, and they're often people who have not worked closely together previously because they were from different disciplines.

[Colin Carrie, Conservative, Oshawa, ON]

Is there an uptake from the provinces in regard to the information that the federal government is finding out through these different projects? How do the provinces and territories partner with the federal government on these? Is there a partnership there? Or do they just take a look, see what we've done, and decide what they'd like to utilize or not utilize?