Evidence of meeting #31 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was disease.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Marc Ouellette  Scientific Director, Institute of Infection and Immunity
Steven Sternthal  Acting Director General, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Infectious Diseases Prevention and Control Branch, Public Health Agency of Canada
Robbin Lindsay  Research Scientist, National Microbiology Laboratory, Public Health Agency of Canada
Justin Vaive  Procedural Clerk

9:40 a.m.

Acting Director General, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Infectious Diseases Prevention and Control Branch, Public Health Agency of Canada

Steven Sternthal

Canada's guidelines are the same as those in the U.S. They are the guidelines established by the Infectious Diseases Society of America in 2008 or 2009. The Canadian guidelines were adopted by the Canadian association of clinicians.

9:40 a.m.

NDP

Dany Morin NDP Chicoutimi—Le Fjord, QC

In your view, are the guidelines restrictive?

9:40 a.m.

Acting Director General, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Infectious Diseases Prevention and Control Branch, Public Health Agency of Canada

Steven Sternthal

This year, the guidelines were based on the information available on Lyme disease.

9:40 a.m.

NDP

Libby Davies NDP Vancouver East, BC

If there are a couple of minutes left, perhaps Ms. May could continue.

9:40 a.m.

Conservative

The Chair Conservative Ben Lobb

Okay.

9:40 a.m.

NDP

Libby Davies NDP Vancouver East, BC

In fact, she might even want to pick up that last point about whether or not the guidelines are restrictive vis-à-vis the United States.

9:40 a.m.

Green

Elizabeth May Green Saanich—Gulf Islands, BC

I'm sorry that I was out for a moment. I was conferring about some of the amendments.

The issue, of course, between guidelines, national standard of care, and best practices is that all of these terms have significant linkage around jurisdictional questions. For patients in the Lyme disease community, the term best practices has been used in ways that have made them feel they've been denied treatment. National standard of care is a term that a lot of the Lyme disease community prefers.

In terms of guidelines from the federal agency versus national standard of care versus best practices, what's the best way forward, in your view, to make sure that we actually advance the diagnosis and treatment of patients without being hung up on the jurisdictional semantics?

I mean, it's important to respect the jurisdictions. It's also important to make sure that the patients receive the best possible care and the best diagnosis.

9:45 a.m.

Acting Director General, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Infectious Diseases Prevention and Control Branch, Public Health Agency of Canada

Steven Sternthal

Thank you for the question.

I think the standards of care are set by professional associations in the country, which very much are creatures of provincial jurisdictions. We recognize that this is just the way in which the system currently functions. However, on many diseases, on many health issues, the federal government has weighed in on the available evidence to support practice and has encouraged the adoption and sharing of practices across the country as they've been developed locally in the country. They are based on the latest scientific evidence as well, through CIHR and other research funding agencies.

From our perspective, the work that we would do—I appreciate that the label is really important and carries meaning—would really be to look at the evidence and to provide advice to clinicians with the best information and tools that could help them. We often use the terminology of guidance, guidelines, and best practices to get across essentially the evidence information base that we'd like clinicians to have at the tips of their fingers and their tongues to be able to use as part of their work.

9:45 a.m.

Conservative

The Chair Conservative Ben Lobb

Thank you very much.

That concludes our question and answer portion of the meeting.

I'll suspend the meeting for just a moment to allow our legislative clerk and our other member of the analyst team to come up. When everybody is set and ready to go, we will go through the bill clause by clause.

Thank you to our guests for taking the time to participate today.

So we'll suspend for a moment, grab a coffee, and everybody can get set.

9:50 a.m.

Conservative

The Chair Conservative Ben Lobb

We're back at it here. We have our legislative clerk here as well, to help out. If anybody has any questions relevant to the bill, or amendments, we'll certainly be available to provide input and feedback. We'll take our time to make sure that we do this correctly and in order.

I guess everybody has a copy of the bill and the amendments that were brought forward. Fortunately, our clerk is always prepared. He has the amendments, so we'll circulate those if you didn't bring them.

For your information, in the beginning there is the preamble and then there's the short title. We'll postpone those until the end, and we'll get right into clause 2.

(On clause 2—Definitions)

9:50 a.m.

Conservative

Eve Adams Conservative Mississauga—Brampton South, ON

Mr. Chair, I'd like to propose an amendment to clause 2, dealing with definitions:

“federal framework” means a framework

to address the challenges of the recognition and timely diagnosis and treatment of Lyme Disease.

9:50 a.m.

Conservative

The Chair Conservative Ben Lobb

Okay.

9:50 a.m.

Conservative

Eve Adams Conservative Mississauga—Brampton South, ON

The rationale for that, obviously, is that a federal framework is more appropriate, given that the mechanisms and platforms for collaboration already exist to address Lyme disease. This is consistent with the approach used for the federal framework for suicide prevention.

Further, the term “strategy” could be interpreted by provinces and territories as too prescriptive, given that treatment of Lyme disease is a provincial and territorial responsibility.

9:50 a.m.

Conservative

The Chair Conservative Ben Lobb

I think what might work out best, and I appreciate that amendment.... I think you have another one before that?

9:50 a.m.

Conservative

Eve Adams Conservative Mississauga—Brampton South, ON

On clause 1. You called clause 2, sir.

9:50 a.m.

Conservative

The Chair Conservative Ben Lobb

Okay.

Clause 1 is the short title.

9:50 a.m.

Conservative

Eve Adams Conservative Mississauga—Brampton South, ON

Yes.

9:50 a.m.

NDP

Libby Davies NDP Vancouver East, BC

Could we operate from the list of amendments? You know, we have G-1, G-2 and so on. Is Ms. Adams speaking to G-1 or is it a new amendment that we don't have? That's what I think is confusing.

9:50 a.m.

Conservative

The Chair Conservative Ben Lobb

To your point, that's good.

9:50 a.m.

NDP

Libby Davies NDP Vancouver East, BC

Ms. Adams, through the Chair, are you speaking to your G-1 amendment, or are you speaking about a new amendment? Your G-1 is adding, after line 4, changing it to “agency”.

9:50 a.m.

Conservative

The Chair Conservative Ben Lobb

I think that's what...

9:50 a.m.

NDP

Libby Davies NDP Vancouver East, BC

You're not going beyond what G-1 is, right?

9:50 a.m.

Conservative

Eve Adams Conservative Mississauga—Brampton South, ON

No. I`ll revert now to G-1.

Sorry, I was at the immigration committee yesterday; we worked off the other documentation, so I'll revert now to health committees.

9:50 a.m.

NDP

Libby Davies NDP Vancouver East, BC

I do have one question about G-1. Anyway, if that's where we are. I wanted to clarify that.

9:50 a.m.

Conservative

The Chair Conservative Ben Lobb

Okay. But before Ms. Adams presents that one, if everybody looks at the bottom of that G-1 amendment, paragraph (c) repositioning....