Health Committee on Nov. 20th, 2014

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

MP Davies, I think there's been some misinformation. The media, I think, didn't do Canadians a service on this. This is not a travel ban. This is a pause in new applications of visas. Just to put it into context, we get very few visa applications from even the three combined countries—

[Libby Davies, NDP, Vancouver East, BC]

But it's anybody coming with visas, is that correct?

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

Existing visas, and there are about 1,900 of them that are active today from people who have visas from those countries. Many of them are multiple-entry visas. People will continue to be able to travel back and forth from those West African countries, and Canadians can travel in an unlimited way. But we have told Canadians not to travel there unless they need to, unless they're humanitarian workers or it's essential business travel.

We've done the same thing in reverse. In a very practical way we said we'd look at it case by case. If it's essential travel for economic purposes, we're honouring the visas that exist, both single entry and multiple entry, and the Minister of Immigration has the discretion to look at these on a case-by-case basis. It's a cautious, prudent, and practical approach. We're taking the same approach with Canadians.

[The Chair, Conservative, Ben Lobb]

Thank you, Ms. Davies.

Thank you for the explanation, Ms. Ambrose.

Ms. Adams, you have seven minutes, please.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Thanks, Mr. Chair.

Thank you, Madam Minister, for joining us here at the committee today. It's our great pleasure to have you.

I'd like to follow up and ask some additional questions regarding Ebola. I want to thank you for your comments and for focusing on the significant contributions that Canada has made to date.

This is, in our lifetime, one of the most significant health crises that the world is facing. Perhaps you could provide some additional detail on the leadership role that Canada has played in fighting the Ebola outbreak in West Africa.

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

Sure, I always appreciate the opportunity to speak about Canada's response to the Ebola outbreak in West Africa. It also allows me to correct some of the misinformation that exists and combat the stigma that we're seeing in some places, especially for returning health care workers.

It's clear that we're in the midst, as you said, of the largest outbreak ever in the four-decade history of this disease, but for all the headlines and the horrifying statistics, there is a great deal of misinformation about Ebola, and that persists. Because the virus has never actually been present in Canada, the facts about what Ebola actually is and how it spreads might not be top of mind for many Canadians. That's why earlier this month we announced that throughout November we're broadcasting a public awareness campaign to communicate the facts on Ebola and combat stigma. This includes the basics on what the virus is, how it spreads, and what people should do to be prepared.

What was of significant concern to me after speaking to the heads of our aid agencies was that many aid workers were returning home to Canada and not being treated like the heros they really are. The head of Doctors Without Borders was particularly concerned about how people in neighbourhoods were reacting to returning doctors, how hospitals were reacting, and even other health care workers were reacting to people who were returning.

The truth is that these people are putting their lives on the line at great personal risk, and the aid agencies are managing their health care workers with very rigorous rest periods and self-isolation. They're taking all the precautions necessary. The Canadian public needs to have the facts on the virus should there be a case of Ebola ever occurring here in Canada, but we also need to make sure that the public is well educated, and as a country we need to be prepared.

In terms of our preparedness, I feel quite reassured about the level of preparedness in the provinces and territories. I speak regularly with my provincial counterparts, and Dr. Taylor speaks almost twice a week with his counterparts. Our provincial colleagues feel very confident about their preparedness or their readiness. The Public Health Agency has now provided updated guidance to provincial and territorial health authorities.

Of course, they are responsible for training their health care workers, but we've really seen them step up to the plate and offer the necessary training to nurses and doctors. What I've said to the heads of the nurses union and nurses association is that if any of their members still feel vulnerable to step up and speak to the people in their organization, make sure that the training is offered and that it's hands-on training, not just a video, and that they feel completely confident putting that equipment on and taking it off. It seems to me from the feedback I've received that this is happening. People are speaking up should they feel they need more training and the provinces are working hard to make sure that training is available.

As I mentioned earlier, the Public Health Agency stands ready with all our expertise. Our five rapid response teams are ready to support the provinces should they have to receive a patient with Ebola. Our teams are ready to deploy at a moment's notice. We've been provided with the aircraft necessary to make sure we're able to get to any point in Canada should we need to do that.

We also have set aside $3 million for the provinces and territories to support them in their preparedness on the community side.

As committee members will appreciate, I want to thank my officials from the Public Health Agency. They've worked very collaboratively with the provinces and territories and with front-line health care workers. At every point that there have been any concerns, they have been invited in to be heard. We've done our very best to respond to everyone, whether it's the provincial-level officials or nursing associations. Even though nurses may not be our jurisdiction we wouldn't even think about not having them at the table. We've worked very hard to make sure everyone is included at every step in the guidelines we've been providing. We've communicated directly with not only the provinces and territories but with many front-line organizations as well so that we can support them directly.

We'll continue to take all steps necessary, and we continue to respond to requests.

Canada's response has been very significant and very effective, and it has been based on requests. As requests come in from the World Health Organization, such as for protective equipment, we'll continue to respond.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Thank you.

Let me move on to food safety, Minister. We had some wonderful news this morning as we opened up The Globe and Mail. Canada has tied for first place in food safety, along with Ireland.

It's of paramount concern to ensure that the food we're placing on the table before our families is safe. I can tell you that it's something I'm concerned about as a mom and that my girlfriends are concerned about as they prepare meals for their families.

Could you update us on Canada's food safety system and what the next steps might be?

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

I'd be happy to, and I'd like to take this opportunity to congratulate Bruce on the number one position—no pressure on the head of the CFIA, but it's obviously great news. A lot of work has been done at the Canadian Food Inspection Agency over the last few years to continue striving to be the best.

It's obviously wonderful to be recognized. It doesn't mean that we won't stop working very hard, because this is an issue that matters to all of us, as you said. In the last budget, we reinforced our commitment to food safety by investing another $400 million to strengthen our food safety regime. We hope this will give our inspectors and those who work in this area the tools they need to continue to ensure that our food safety system remains the best in the world.

In addition to that, of course, our government has now invested more than half a billion dollars in various safety initiatives since 2008. These also include enhancing food inspection programs and hiring more inspectors. The significant funding being delivered through our economic action plan over five years is further strengthening our food safety system, and it will include resources to hire 200 additional food safety inspectors and staff.

We're also establishing the food safety information network, which is a network among federal, provincial, and territorial food safety partners and laboratories. What it does is it helps better protect Canadians from food safety risks by improving our ability to anticipate, detect, and respond to food safety hazards.

The funding will also—

[The Chair, Conservative, Ben Lobb]

Ms. Ambrose? Minister, we're way over time. I'm sorry to cut you off. It's just to be fair to everybody.

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

I'm sorry; I didn't look at you.

[The Chair, Conservative, Ben Lobb]

Ms. Fry, go ahead.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you very much, Mr. Chair.

I want to thank the minister for the presentation. I've always felt that health is too important for us to play political, partisan games with, so I will start by congratulating the minister on what I consider to be now—in the past, the minister knows how I felt about certain of the Ebola initiatives—a very excellent response, including the vaccine.

The only question I have to ask with regard to that is this—and I'm going to ask the questions, and maybe you can answer afterwards, so that we can get a fulsome answer. Who did you consult with concerning the pause in visas? I know that the World Health Organization and many other public health officials felt that it created a bit of an anxiety in the public when you did that pause because they felt people would believe that travellers could in fact be a risk.

That's the first question I want to ask. Other than that, good work on Ebola, I say to Dr. Taylor and to you.

I also want to bring up the issue of marijuana. As you well know, I felt that the marijuana report.... We had a report that suggested that the study was very flawed, because you cannot look at risks without looking at benefits, and there was very little done to look at benefits.

We felt that much of the contradictory evidence that came from many of our expert witnesses was not reflected in the report. We also felt that there were a couple of pieces, including looking at some studies and some research that would eventually talk about risks and benefits and at long-term and short-term effects of marijuana both on youth and on others, that were very important things to do. That was not accepted as a recommendation. So we feel that the report leaves a lot to be desired.

What I want to ask, though, is very simply this. There are ads out there now, and I know that the minister is asking for more than $5 million to present the ads. Given what we heard in the testimony, that the evidence was not really out there suggesting that the long-term effects of marijuana use are so absolutely awful—we know the short-term effects—who did the minister consult when she put those ads out? Would she tell us who they were, list them, and table the list to the committee at some point in time?

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

Sure, no problem.

[Hedy Fry, Liberal, Vancouver Centre, BC]

That's the second question.

The third question is about PHAC. Again, while I congratulate you on how well you have responded to Ebola—although we thought there was a bit of foot-dragging at the beginning, now I think the response is good—I wanted to know if you could tell us who you consulted when you created the changes in the chief public health officer's position within Health Canada.

Not that this has anything against Dr. Taylor or Ms. Outhwaite, but I do think that the concept of the chief public health officer having a deputy minister position was one that was studied really well as a result of some of the things that we found after SARS and after H1N1. This all came together with a lot of public health officials coming up with this particular way that Health Canada had existed, and now this change, I think, brings down the chief public health officer's ability to respond quickly to get the resources he needs. Currently that may work if he and Ms. Outhwaite get along really well, but when changes occur.... It shouldn't be personal; it should be objective.

I want to know who the minister consulted with. I have heard from many public health officers across the country that they think this is a bad decision, so I wanted to know who the minister consulted with. Could she table the list of people she consulted, because I do think it's a major problem?

Finally, actually, no, that's it. Those are the questions.

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

Do I have time to answer?

[The Chair, Conservative, Ben Lobb]

Yes.

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

Okay.

Sure, I'm happy to answer.

Thank you for your compliment on the Ebola response. The Public Health Agency has worked very hard. We have tried, as a government, to.... I shouldn't say try, we've supported them in every possible way with any requests that they've had to make sure that they're able to respond appropriately, and we'll continue to do that.

On marijuana, who did we consult? I held a number of round tables that I'm happy to share with you. Actually, I think we put out a press release after the expert round table we had with researchers and physicians who have studied this issue for many years, addiction specialists. When I asked them, overwhelmingly their message to me was that the evidence is absolutely irrefutable. Of course, the same message has been made publicly by the head of the Canadian Medical Association, that the evidence is irrefutable about the harm of marijuana to youth and the developing brain.

I asked the researchers point-blank, “What can we as a government do? If you had your wish, what would you ask me to do to help you?” They said that we needed a national marijuana smoking cessation campaign, a national one. Kids don't know how harmful marijuana is to their health. Parents think it's the same as what they smoked 30 years ago. They have no clue about how this could harm their kids. We've seen psychosis; we've seen mental health issues.

I said, “Okay, we're going to try to do that”, and we did. We put together an awareness campaign, focused on the impact on the developing brain of youth. Health Canada did a lot of work with researchers to make sure that anything that was said in those campaigns was backed by research, and we can table that and give it to you should you want to see it. We can provide you a briefing. There's no question about the harmful effects of marijuana on the developing brain. The science is irrefutable.

To your point about people wanting to know what the benefits are, if there are any legitimate researchers who would like to do a clinical trial, I haven't met them yet. They haven't come forward to me and said, “We have the funds and the backing of a company or someone who wants to do clinical trials.” There's no evidence right now, and you know that from the recent report of the Canadian Family Physician and from the guidelines that are being given to doctors to prescribe marijuana across this country. We don't have the evidence that it's actually—

[Hedy Fry, Liberal, Vancouver Centre, BC]

Minister, I sat through the committee hearings. The recommendations from many of our experts was that we do research on the benefits and risks of marijuana, the short- and long-term effects of marijuana on the developing brain. There's only one study that said irrefutably that there were very long-term effects.

The idea of saying that the CMA, etc.—and I think that's unfair to them—have decided that you should do this ad, when they refused to do the ad with the Ministry of Health—

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

I did not say that. What I said is—

[Hedy Fry, Liberal, Vancouver Centre, BC]

It's not true.

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

—that the president of the Canadian Medical Association is on the record saying, “especially in youth, the evidence is irrefutable—marijuana is dangerous.”

What I'm telling you is that I think the experts told me loud and clear what we needed to do, so we have a public awareness campaign to support parents who are struggling with trying to help their kids get off marijuana.

[The Chair, Conservative, Ben Lobb]

Thank you, Minister.

Next up for seven minutes is Mr. Wilks. Go ahead, sir.

[David Wilks, Conservative, Kootenay—Columbia, BC]

Thank you very much, Mr. Chair.

Thank you, Minister, for being here today.

I'll go down that same road with you, Minister, with regard to Health Canada and their running of a series of TV ads warning children and parents about the serious health risks involving both prescription drug abuse and smoking marijuana.

As MP Fry has indicated, the committee recently concluded our study on the serious health risks and harms of smoking marijuana, in which we recommended that a public awareness campaign be undertaken. During that study we heard from doctors and researchers on the serious and harmful effects associated with marijuana use, especially on teens.

Could I add that in my previous career I did three years of drug work, predominantly on marijuana? I can rest assured that not only with regard to teens, but well beyond that, there are some significant problems and we need to deal with them. So I'm very happy to see that we ran this series of TV ads.

Could you update the committee on how this campaign has been received?

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

It's interesting, because someone approached me the other day and said, “I didn't know that marijuana is so much stronger today than it was when I was a kid”. In fact, there are experts who think that we've underestimated, and that it's actually much stronger, but we used very credible researchers, very credible experts, to ensure that what is in these ads is completely defensible. I'd be happy to share any of that information from Health Canada.

I commend Health Canada for doing this. I don't think we've had an anti-marijuana smoking-cessation campaign for a.... Well, I don't even know if we've ever had one in Canada. What we know, I think it's from UNICEF, is that our kids are smoking more pot per capita than anywhere in the world. We know that the experts are saying very clearly that it's harmful to the development of their brains. That's not only in terms of mental health issues, but serious mental health issues such as psychosis and the onset of schizophrenia.

I could give you reams of documents from very credible experts who say the same thing. The former head of the CMA said it's dangerous. The current head of the CMA said, “Any effort to highlight the dangers, harm and potential side effects of consuming marijuana is welcome”. Addiction specialists are struggling, people who are dealing with these kids in their offices are struggling, and rehab specialists are struggling.

Kids are using more and more of this. People are putting it in the form of candy now, and giving it to kids in grade school. I mean, this stuff is more addictive. This is not the pot of the 1960s, and it's really difficult for parents because they're up against the idea that it's normal, that it's like smoking cigarettes, and that it's not as harmful as alcohol. Well, alcohol is harmful; smoking cigarettes is harmful. We have smoking-cessation campaigns for tobacco. We don't want people to drink a lot. We have all kinds of ad campaigns about alcohol abuse, yet somehow we're not supposed to have an ad campaign about kids smoking pot. It's nuts.

I can't believe the reaction of people from a partisan point of view. This is based on science. Parents are struggling with their kids, who are clearly being impacted mentally and physically, and it would be irresponsible for us not to do a public awareness campaign. So I think in the face of accusations where the Liberals are normalizing marijuana so that somehow this is a partisan campaign, this is absolutely ludicrous. It's based on science, it's necessary, and we'll continue with it.

[David Wilks, Conservative, Kootenay—Columbia, BC]

Thank you very much.

Prior to the marijuana study, we did a study on Vanessa's Law, on which I must congratulate my colleague Terence Young for his admirable work and years of getting it to where it got to. We heard testimony from several witnesses who are experts in the field of drug safety on the need to ensure that Health Canada shares information in an open and transparent manner.

As a former police officer, I know that there are a number of inherent risks present in many drugs, including those that are freely available over the counter. That is why I was very pleased to be part of the committee's deliberations on Vanessa's Law and of amending the legislation to include a greater degree of transparency.

Can you update the committee on what is being done to ensure that drug safety information is being made available to those who need it?