Health Committee on May 15th, 2014

[Terence Young, Conservative, Oakville, ON]

Thank you, Chair.

Welcome, Minister.

Fourteen years ago my daughter, Vanessa Young, died tragically from a heart arrhythmia due to the prescription drug Prepulsid, which was deemed not safe and later removed from the market. In fact it was removed from the U.S. market three days after she died.

Vanessa's death and the deaths of many others could have been prevented with stronger safety warnings on labels and clear communication with doctors. Moreover, during our study on prescription drug abuse, a number of witnesses ranging from doctors to researchers testified that there needs to be stronger label warnings and restrictions put in place on prescription drugs that clearly identify addictive properties and potential adverse drug reactions.

Minister, several important steps have been taken to strengthen patient safety in Canada. Can you inform the committee on what is being done to strengthen drug and patient safety in Canada to better protect all Canadians from the potentially dangerous consequences of adverse drug reactions?

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

Sure. A great deal of the work is being done because of your leadership, Mr. Young, so thank you very much for your question.

As you know, we not only committed to introducing new patient safety legislation in our Speech from the Throne, we also did that recently with the introduction of Vanessa's law late last year. I just want to thank you for the great work you've done in leading the awareness around drug safety issues. You have obviously been a very powerful advocate on this.

But stories like your daughter's really do remind us all about the serious consequences that pharmaceutical drugs can have and the role that the regulator has to ensure—that's Health Canada's role and the role of government—that we have strongest possible safety systems in place to ensure that we're preventing other families and patients from going through an experience like your family's in suffering such a terrible loss.

Of course, Health Canada is responsible for reviewing all drugs for sale in Canada to ensure that they are safe and effective, but the powers included in Vanessa's law will ensure that we are able to take that to a new level. We must continue to remain vigilant, even after the law passes. Health care institutions, of course, are not currently required to report adverse drug reactions, as you noted for example, and there exists no authority to order label changes or packaging if we feel that additional information or studies are required around a particular safety issue we might find. And of course, as you know, Vanessa's law will address that.

Science and medicine have evolved considerably in the last 50 years, as we know, since the Food and Drugs Act was last updated. I believe Canada does lag behind our international regulatory counterparts, which have improved patient safety through their enhanced regulatory oversight of products on the market. But Vanessa's law will bring us in line with where we should be, and in fact it will take us even further. We are going to be introducing, through Vanessa's law, tough new fines for those who don't comply in addition with any of the measures that we're putting in place. The law allows for quite significant penalties, as you know, including jail time. Just to put it into perspective, a previous fine would be about $5,000 a day. As you can imagine, that's about the same as somebody could be fined for littering under some municipal bylaws. When Vanessa's law comes into force, we'll change that to $5 million a day. I think that sends a strong message to pharmaceutical companies about the need to work with us on safety.

Vanessa's law also speaks to the importance that we place on ensuring that Canadian patient safety remains paramount. As a government and as a regulator, I hope that all parties will support this bill. I was very pleased to see when you spoke in the House that you did receive the support of all parties. I know there has been an interest from members, including yourself, for potential amendments, and we're open to those, as I said. I look forward to seeing those amendments and working with members to strengthen the bill even further.

[Terence Young, Conservative, Oakville, ON]

Thank you.

Our committee recently undertook a study on the troubling rise in prescription drug abuse. We heard expert witness testimony from doctors, pharmacists, regulatory bodies, law enforcement officials, first nations leaders, and parents on the scope and severity of prescription drug abuse, as well as some suggested solutions to the problem.

One of the problems we kept hearing about was a lack of awareness among Canadians about the risks associated with prescription drugs that can be addictive. We also heard from experts that proper storage and disposal of prescription drugs was paramount to protecting against the un-prescribed consumption of these drugs. We heard in fact that teenagers in some communities actually go and grab a bunch of pills out of their parents' medicine cabinet and throw them in a bowl, and this is called a “pill party”, which is extremely dangerous.

Minister, the problem of prescription drug abuse is a problem that impacts many Canadians and their families. Can you inform this committee on the work being done to address the problem of prescription drug abuse in Canada?

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

Sure. Thank you very much.

Thank you to the committee for the work you did on this as well. This is a major public health issue and we have been raising more awareness of it, reaching out to the medical community. We recognize that prescription drug abuse is a growing problem in Canada. I am very concerned about it.

We are actively working with the provinces and territories as well to address this issue. We have worked with them. As you know, some of them have drug monitoring programs, others don't, but I know they are endeavouring to put that in place.

I'm also pleased to note that just recently in our budget we committed to extending our national anti-drug strategy to include the fight on prescription drug abuse, which I think is an important one. This includes educational measures; prevention and treatment services, particularly in aboriginal communities; and also improved surveillance. This will build on actions we've already taken to tighten licensing rules for pharmaceutical companies that will help to prevent drugs like oxycontin from being illegally distributed. This includes implementing strict controls in the public drug plan that's administered by Health Canada, including maximum monthly and daily drug limits, monitoring the usage of certain drugs to address potential misuse, and real-time warning messages to pharmacists at the point of sale.

One of the other things that was important that we did was to reach out to the medical community—

[The Vice-Chair, NDP, Libby Davies]

Minister, could you just wrap up your response? You're just a few seconds away from the end of the time.

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

Sure.

I think one of the most important things we did was reach out to the prescribers themselves. For the first time we put everyone in a room to talk about what we can do together, what the health community and what the medical community can do. We held a symposium, and there is a lot of work being done collaboratively to tackle this issue.

[The Vice-Chair, NDP, Libby Davies]

Thank you very much.

I know I keep interrupting, but I'm trying to keep to the time just so as many members as possible can get to ask a question.

Next we go to Mr. Gravelle. Now we're on a five-minute round.

[Claude Gravelle, NDP, Nickel Belt, ON]

Thank you, Madam Chair.

Thank you, Minister, for being here.

We've covered a lot of ground and a lot of different subjects here so far this morning. I'd like to talk about something that we haven't mentioned yet, and that is dementia.

I have a personal interest in dementia. As you are probably aware, there are 747,000 Canadians who have dementia right now, and that number is expected to grow to 1.4 million by 2030. Presently it's costing Canada's health care system $33 billion per year, and that is expected to rise to $293 billion per year.

Madam Minister, can you tell me, do you support a national strategy for dementia?

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

I'm interested in a national strategy, but I have approached the provinces, and there is no consensus for the creation of one. What we will do with the provinces is continue to work with them in any way that we can, but we do have our own federal plan, if you want to call it that, to work on dementia. There is a great deal of work that's being done in Canada.

As you know, we have joined forces, even internationally with our G-8 counterparts, to commit to finding a cure for dementia by 2025. We've now invested close to $1 billion in dementia research and Alzheimer's research, so there is a lot of work being done at the federal level.

As you know, we've expanded our patient-oriented research to create the Canadian Consortium on Neurodegeneration in Aging to tackle the growing onset of dementia and related illnesses. So there are a number of actions that the federal government is taking.

[Claude Gravelle, NDP, Nickel Belt, ON]

Thank you.

How many provinces have you met with?

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

I meet with all of the provinces together at our federal-provincial-territorial meetings. On this particular issue I worked with my co-chair from Alberta and asked him to approach the rest of the provinces.

As I said, some provinces have their own. For instance, Quebec has a very good seniors plan that includes dementia, and they're not interested in working on a national strategy. But that does not stop us from working with the provinces and supporting them, particularly with the research they need, so that they can put in place practical programming at the local level.

[Claude Gravelle, NDP, Nickel Belt, ON]

You keep mentioning research. Research is good, and I agree totally with research. We want more research. But what about early diagnosis and prevention? I think that's also important. What about training for the dementia workforce? What about support for caregivers? Those are all important things. Can you tell me why we can't get that done?

You said that you've met with some of the provinces, so which provinces are not in agreement with a national strategy?

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

Provinces are doing good work in their own area of jurisdiction, and we want to support them in any way we can. For instance, we are supporting 44 research projects on Alzheimer's disease and related dementia in universities and hospitals.

You asked, where is the training? Much of that does result in the support for the appropriate training and the appropriate practice on the ground. That is one of the ways we can support the good work of the provinces.

[Claude Gravelle, NDP, Nickel Belt, ON]

You mentioned research again, and I totally agree with you that research is good. Research is good. But what about the caregivers? Why can't we help the caregivers? Why can't we help the doctors, especially the older doctors? They're not necessarily trained in detecting dementia and working with dementia patients.

Why can't we do more? Research is fine, but we have to do more.

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

I know you're passionate about this issue, but I think we have to recognize that the research that we do actually informs what is the best way, the best practices that are then used by physicians. That's what they look to. They look to finding out from research what is the best practice for them to use to identify Alzheimer's, for instance, or to identify the onset of dementia. That's what they look to us for and that is what we do to support the practical information that they need.

I can ask Dr. Alain Beaudet to perhaps speak specifically to some of these issues.

[Dr. Alain Beaudet, President, Canadian Institutes of Health Research]

Well, I can only concur, Minister. You're talking about the issue of prevention and early recognition.

We're funding a lot of things. For instance, what are the right biomarkers? What are the standards in terms of the early deterioration that you can see through, for instance, brain imagery? In terms of caregivers, what are best standards of care? A big part of the CCNA will actually be looking at funding standards of care, models of care.

[The Vice-Chair, NDP, Libby Davies]

Thank you, Dr. Beaudet. We've reached the five minutes. I know it goes fast.

We'll now go to Dr. Lunney.

[James Lunney, Conservative, Nanaimo—Alberni, BC]

I think Wlady was up next.

[The Vice-Chair, NDP, Libby Davies]

Sorry: go ahead, Mr. Lizon.

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

Thank you very much, Madam Chair.

Thank you, Minister, for being here with us today.

Minister, I often hear that Canada has one of the safest and healthiest food systems in the world. This is very encouraging to hear, as one of the most important things for Canadian families is the safety of the food that is put on the dinner table. Indeed, Minister, I've heard and I've been very pleased to see that the number of food safety inspectors continues to rise as a result of the investments in the Canadian Food Inspection Agency that our government has been making.

Could you please inform this committee on our government's latest investments in food safety?

[Rona Ambrose, Conservative, Edmonton—Spruce Grove, AB]

Thank you very much for that, MP Lizon.

Let me begin by saying that you're right, Canada has one of the safest and healthiest food systems in the world. In our recent budget we further reinforced this by delivering almost $400 million to strengthen Canada's food system. This is in addition to the more than half a billion dollars we've already invested in various food safety initiatives since 2008.

It includes enhancing food inspection programs and also hiring more on-the-ground food inspectors. Indeed, since 2006 there has been a net increase of over 750 inspectors, and of course the recent budget commits to hiring even more inspectors.

But other measures, I think, are important to highlight. We've brought into force tougher penalties for those companies that violate our food safety system. I think that's important. We have enhanced controls on E. coli; new meat labelling requirements as well that speak to safety; and more than 750 new inspectors, as you know. Of course, Canadians have concerns about food that is imported, so we're making sure we have the right measures in place to crack down on unsafe food imports. Canadians need to know that is being done, and it is.

The feedback from this work has been tremendously positive. In fact, I would say that we've come a long way in making sure that we have the right people in place to do this work. But we will continue to strengthen the food safety system.

We also have recently launched our safe food for Canadians action plan. This is working very well and it's delivering the peace of mind I think that Canadian families expect and deserve. In fact, the Food and Consumer Products of Canada has said that these changes are going to further enhance Canada's reputation as a global food product safety leader.

In that spirit, we brought together all the players that we think contribute to food safety under one roof. As you know, we have made a policy change as it relates to the Canadian Food Inspection Agency. I think this is simply good policy. We've brought the Canadian Food Inspection Agency into the Health portfolio. That means that Canadians can be assured not only that we have one of the safest food systems in the world but we will also be focused on encouraging Canadians to eat healthy food. They can rest assured that the safety of food will always come first, will always trump trade or any industry issues.

We're also working, as you know, to expand our food-borne illness surveillance program, known as FoodNet. It's very important in that we can communicate with public health officers and others around the country to ensure that risks are identified quickly so that we can deal with them quickly. This is a system made up of surveillance sites. It helps track our food-borne illnesses at their sources. Scientists then use this data collected to communicate important information to governments, industry, and Canadians. That in turn helps us to prevent any disease from occurring.

Essentially this program tracks food poisoning and traces illnesses back to their source, which is important because we're trying to work on the preventive side of things, not just to be reactive, be it food, water, animals, or any combination of these. With that information in hand, I think the agency can then determine which sources are actually making Canadians ill at the source.

Expanding FoodNet Canada will improve food safety surveillance and assist our partners across all levels of government and industry when it comes to taking the right preventative measures to help keep our food system safe. There's a great deal of work being done, and we'll be doing more.

Thank you.

[The Vice-Chair, NDP, Libby Davies]

You have just 15 seconds left.

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

I will give up those 15 seconds.

Thank you.

[The Vice-Chair, NDP, Libby Davies]

Thank you very much.

We're now back to Dr. Morin.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Thank you very much.

Minister, regarding food safety, can you tell us what is being done to monitor the truth of claims on food packaging? I know you talked about this issue earlier.