Health Committee on Nov. 20th, 2014

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

Sure, but here is just one more thing about marijuana.

It's really important that everyone, as health committee members, remember that marijuana is not an approved drug in this country. It has never gone through any rigorous approvals or scientific clinical trials to show that it is safe to take as a medicine. Let's all remember that. Think about it as health committee members. It's very difficult, because that message is out there, and kids have a sense that somehow it's safe because it's “a medicine”, whereas it has never gone through any approval processes at Health Canada, is not an approved drug, and is not an approved medicine.

Going back to your question about Vanessa's Law, I again commend the committee and all members of Parliament who worked so hard in a multi-party, non-partisan way to make these important improvements.

The legislation, as you know, updates the Food and Drug Act for the first time in 50 years, something which is incredibly important. The sound amendments that were made by the committee..... Again, I want to thank each and every one of you for having been a part of this achievement. You laid it out quite well. Nowhere is confidence and transparency more important than in the decisions made that affect the health and safety of Canadians.

Vanessa's Law will ensure that additional details on Health Canada's drug approval process are made public, concerning both those that receive approval and those that do not, which was, I know, an important point brought to light when the legislation was first tabled. I was happy the committee was able to amend it.

We now have a world-leading regulatory transparency and openness framework and action plan, and I will continue, as I said, to work with Health Canada to further our transparency in the way we approve drugs. I'm very pleased to report that, as of November 5, Health Canada has posted a list of all of its inspections of drug manufacturing plants over the past three years, something that I know Canadians were looking for. I applaud them for their level of transparency.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

Mr. Kellway, go ahead, sir, for five minutes.

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

Thank you, Mr. Chair.

Thank you, Minister, for coming today and spending some time with us and answering questions. I have two questions for you today. Let me set them both out and leave you to determine how to judge your response times.

The first has to do with the Mental Health Commission of Canada and mental health as an issue that we need to deal with. Of course, Minister, our job in the opposition is always to be critical, but when asked whether I can say something good about the government I always happily refer to the Mental Health Commission of Canada. It's accomplished a great deal in a very short period of time. It's put in place a national strategy, as you know, and has moved beyond that to do a lot more in terms of policy and best practices and training, and so on.

But the issue, Minister, as you know, is not going away. One in five Canadians is living with mental illness and it's costing our economy $50 billion a year, and it's anticipated that those costs are going to rise significantly as we move forward. It's time and the Mental Health Commission of Canada has asked to put in place a renewed mandate to turn their strategy into an action plan and extend the funding to support a new mandate for the Mental Health Commission of Canada. So my first question is this. Will your government do that, extend the mandate of the commission, and of course provide funding to support that mandate?

The second question has to do with food labelling. We know that chronic diseases are the leading cause of death and disability in Canada and are among the most costly but also preventable diseases. We know that part of that equation is an unhealthy diet and that they are in fact a public health risk to Canadians with 60% of adults suffering from obesity and nearly a third of kids. We know that Canadian diets do not meet national recommendations. We also know that your department has put forward some recommendations or proposals with respect to food labelling, but those proposals seem to have some glaring omissions to us.

First is that they continue to give, on the front of food packaging, priority to the marketing claims of the producer as opposed to nutritional information. Second, the labelling doesn't deal with added sugars, and we know that research is showing that excess sugar from added sugars can triple the risk of dying from heart disease. Lastly, we ought to have on those labels standardized serving sizes that actually reflect consumption, so that we don't have to reach for calculators to figure out what it is we're actually taking in.

Have your proposed changes to food labelling gone through, been approved, or are they outstanding? Depending on your answer to that, will you make some further changes to those proposals or why didn't you include these three issues in your proposals?

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

Sure. Maybe I can get more specifics from you offline, but standardized serving sizes is one of the things that we're looking at and we went out to consult with Canadians at large and then also to consult with health groups. In the industry we've done focus groups. The consultation is just wrapping up. But by all means, if you have some ideas you want to share with us we're happy to take them. But standardized serving size was something we heard loud and clear about from people. I use the example of one of my staffers who said when she buys two different brands of perogies, one serving size is six and one serving size is two. Trying to figure out the calorie content—and who eats two perogies, nobody does—it's very confusing. When you're buying bread it's by one slice. Normally people eat two.

People want consistent, realistic, relevant serving sizes to what they actually eat, so we've been looking at that and I hope we can make progress on it. Sugars is a big one. We heard that loud and clear from moms—I say moms, because moms apparently do almost all the shopping as we found out through a lot of questions—and they said loud and clear they want to know about added sugar and how much sugar is in the food. So that was one of the things we had on our proposed label change.

In terms of front-of-package labelling, I might ask Bruce to speak a bit to that. But if a company or a manufacturer does make a health claim they do have to come through Health Canada. They have to show evidence of that health claim if that's what you mean. If it's just marketing, different kinds of marketing.... Do you want to be more specific, maybe?

[The Chair, Conservative, Ben Lobb]

Sorry, we're quite a bit over time. Maybe the NDP should have one more round before we conclude today, so maybe Mr. Archibald can pick up there if you like, but it's up to you.

Next we have Mr. Young for five minutes, sir.

[Terence Young, Conservative, Oakville, ON]

Thank you.

I was tempted to ask a question about when you buy hot dogs and there are 10 in the package, and when you buy buns, there are only eight, so you always have two hot dogs—maybe that's not a federal responsibility, I don't know.

[Voices]

Oh, oh!

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

I hope not.

[Terence Young, Conservative, Oakville, ON]

Minister, I'd like to expand on my colleague's previous question on transparency and delve a little more deeply into the mechanics behind Vanessa's Law. Like you, I was extremely pleased to see it receive royal assent three weeks ago.

A number of measures contained in this bill are effective immediately upon the Governor General signing the bill into law, while others will take some time to come into effect. I get a lot of questions about that. We know there's a need for more consultation. Health Canada has done a superb job on consultation on this bill over the years, which I much appreciate.

Can you please update the committee on what measures in Vanessa's Law are law right now, immediately, and which ones will require some ongoing consultations and come into force over time.

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

Sure, I'd be happy to.

First of all, thank you for the many years of your work on this. I think it provided all of us with the knowledge, but also the inspiration, to work together across parties to get this done.

With royal assent, I can tell you that the new authorities for me and any future ministers as Minister of Health, would be the ability to compel information, recall unsafe therapeutic products, impose tougher fines and penalties, incorporate by reference, disclose confidential business information, direct package label changes, and seek an injunction.

In terms of regulations that are not in force and that we will be developing and are already developing to ensure they come into force soon are the ability to require tests and studies, order a reassessment, and attach terms and conditions to market authorizations. I would say they still need further work in the regulatory process. They're important, but I think the ones that matter the most, as you know, are the ability to recall products quickly, compel information, direct label changes, and tougher fines.

For the things that really impact consumers and those who are using the product, we have the power today, thanks to all the work you and the committee did, both here in the House and the committee in the Senate. I would say it also saves us a great deal of time. I know I spent some time speaking about this in the Senate, but the fact that we now have the power to do this means we don't have to negotiate with pharmaceutical companies. Our officials spent literally hundreds of hours negotiating with companies to change their labels, to pull unsafe products off the shelves. Of course, the longer they can keep them on the shelves, the better for them, and the more profits. It was very frustrating.

The fact that this law has passed will not only allow us to act more quickly in the public interest, but also frees our officials to do the work they should be focused on instead of negotiating with companies.

[Terence Young, Conservative, Oakville, ON]

Thank you, Minister.

Dr. Beaudet, I'd like to refer to the Ottawa statement, which was put together by some Canadian scientists in Ottawa, I think it was four years ago. It's a very high standard for clinical-trial transparency, and it makes reference to.... I'll just read a section from it, because I respect it so much.

Protocol information and results from all trials related to health or healthcare—regardless of topic, design, outcomes, or market status of interventions examined—should be registered and publicly available....

I'm familiar with CIHR's standard for trials on transparency that CIHR funds right now. I want to refer to any changes that might happen with regard to how you enforce transparency in CIHR-funded trials, and how you intend to enforce those changes, please.

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

First of all, I thank you for this question and for your comments.

You should know that some of these new regulations will be incorporated in the TCPS, which is the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans. We're again tightening some of the screws in the policy, which as you know is really the guideline used universally in Canada for ethics regulating trials. Obviously, what we can regulate are the trials we fund.

[Terence Young, Conservative, Oakville, ON]

The trials that are registered but not completed....

[The Chair, Conservative, Ben Lobb]

Okay, Doctor, we are over time, so to be fair to everybody, maybe we can pick that up in the second hour of our meeting.

For the last questions of the day, we'll go to the NDP and Ms. Davies.

[Libby Davies, NDP, Vancouver East, BC]

Thank you very much.

I know we just have a few minutes left with the minister, so just to follow up on a couple of things.... We didn't actually get a response and maybe Mr. Da Pont could respond about the question on the Mental Health Commission of Canada. We know that they're seeking a new 10-year mandate. They have put in a funding request. We'd like to know if the minister specifically is supporting that new mandate and the funding request. Obviously, it goes through the finance department but it's very important to know if the minister is supporting that. Then I have a quick second question.

So if you could just answer briefly, please....

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

If the question is about me, then I'd be happy to answer it and George can follow up if he wants.

The Canadian Mental Health Commission's mandate is over in 2017, so I do know that they are starting to talk about a new mandate. I haven't had a chance to meet with them directly. I do know that there is that request but there is still time obviously for—

[Libby Davies, NDP, Vancouver East, BC]

The material that we got that was sent around says that they're seeking a new mandate of 10 years, 2015 to 2025. I think it is coming up earlier and that's why they put in the prebudget consultation this year because they know it is coming up.

[George Da Pont, Deputy Minister, Department of Health]

Actually both points are correct. The current mandate does run longer and you're correct that they have come in with a proposal for an earlier renewal of their mandate, a proposal both for funding and the mandate. We're working with them on that. Their mandate doesn't end in 2015. It does run later. They just would like an earlier renewal.

[Libby Davies, NDP, Vancouver East, BC]

So we can assume that this mandate is going to continue. They're not going to get chopped off in 2017.

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

I would just say that obviously they've done incredible work and we'll consider this. But I would just say that they're still working hard. Their mandate ends in 2017 and we'll obviously take a look at what they.... But regardless, I think it's clear from not only the investment in the Canadian Mental Health Commission but billions of other investments that this government has made that—

[Libby Davies, NDP, Vancouver East, BC]

Okay, thank you.

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

—mental health is a huge priority for us.

[Libby Davies, NDP, Vancouver East, BC]

If I could move on to my last question, just to come back to the medical marijuana, you might have seen a story yesterday on CBC. It was called “My QP”. It was a very compelling story about a young mother who has a very young son who suffers from a rare condition that results in multiple seizures. The only thing that's proved effective is to take medical marijuana but not in a smoked form. The question arose from this mother as to why the rules from Health Canada are so rigid and inflexible that it doesn't allow her to use an ointment or a tincture, which is a much better product for her son.

I know that you're totally opposed to medical marijuana and it's only there because it's being compelled by the courts. But it seems to me that there is evidence and there are compelling situations where different kinds of products are needed. I want to ask if Health Canada and you as minister are prepared to consider these kinds of situations so that Ms. McKnight can actually get the help she needs. What she's doing now is basically illegal. She said that publicly. Of course, she doesn't want to do that, but what is she left to do to help her young son? So I wonder if you would respond to that.

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

Sure, I would be happy to. I have a lot of sympathy for what she is dealing with, obviously. But we do consider these things. We consider them through the special access program. The special access program is there for drugs that have not been approved or are experimental or are not available in Canada. That decision is made by experts and researchers and scientists within Health Canada. My understanding is that when these requests have been made, the researchers, the scientists have said there is no evidence. I don't know what to say to you. What we need is research. We need clinical trials to show that these kinds of alternatives are actually—

[Libby Davies, NDP, Vancouver East, BC]

But the government hasn't wanted to do any research.