Health Committee on Nov. 25th, 2013

[The Chair, Conservative, Ben Lobb]

Thank you, Ms. Fry. We're just over time.

[Hedy Fry, Liberal, Vancouver Centre, BC]

We're finished, okay. Sorry about that.

[The Chair, Conservative, Ben Lobb]

Thank you.

Next is Mr. Hawn for seven minutes.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Thank you very much, Mr. Chair.

Thank you, Minister Ambrose and all your officials, for being here. Apparently I do mean “all your officials”. That's quite a crowd.

Everybody here has been touched by mental health in one way or another, whether it's depression or Alzheimer's. I lost an aunt to Alzheimer's, and I know other people who have been touched by it. With one in five Canadians suffering some form of mental health.... Obviously, it has serious effects on all of our lives, whether it's us personally or people we know and love. There has been some good work going on by our government to support mental health research, and funding through your portfolio, and these dollars have gone a long way toward developing resources needed to tackle those issues.

Can you talk about some of those mental health research programs that we've undertaken and some we might be planning in the future?

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

Sure, I would be happy to do that.

You're right in saying mental health affects everyone. I think the more we know about it, the more we recognize that it is part of every aspect of health care. It really is, and it's an area where research grows, and the more research we have, I think the better interventions we see, which is great.

Obviously we've made significant investments in mental health, both on the research side and the promotion side. We created, of course, the Mental Health Commission of Canada, which has developed a national strategy for ensuring best practices across the country.

I would say that Alzheimer's is one of the foremost challenges to mental health today, and it's been a key investment target for our government through the Canadian Institutes of Health Research. We've invested more than $146 million now in research specific to Alzheimer's disease and related dementias, including nearly $27 million in one year alone, in 2011-12.

We have also created the Canadian Consortium on Neurodegeneration in Aging, which was launched in March of this year. This particular initiative brings together all of the relevant Canadian expertise and acts basically as a research hub for all aspects of neurodegenerative processes affecting cognition, including Alzheimer's.

We are also active at the international level. CIHR is very active in supporting research through what's called the international collaborative research strategy for Alzheimer's disease. This particular strategy's goal is to prevent or delay the onset of Alzheimer's through early intervention and diagnosis. It's also focused on improving the quality of life for those who are afflicted and for their caregivers, which is interesting. As you well know, caregivers are deeply affected when their loved ones develop dementia and Alzheimer's. It also improves access to quality care and enables our health system to deal more efficiently with the rising number of affected individuals.

It seems to me, from what I've seen, that it's working. To date, we've been able to leverage an initial $13.4 million to over almost double that—actually more than double that—through international partnerships, so it helps us to partner with other countries and other organizations.

Through our federal responsibilities, which is in aboriginal communities, of course, we have also invested significantly. We've committed over $260 million annually now to target mental health issues in aboriginal communities, and our budget last year announced an additional $4 million specifically for mental health services for first nations.

So all of this, I think, plays a big part in dealing with mental health issues. These investments obviously ensure not only that our health researchers have the resources they need, but that then, of course, corresponds with innovative strategies and also on-the-ground support for those who are practitioners and physicians.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Thank you.

PTSD is not just an affliction of the military but of any first responder and other people throughout society. Can you talk a little bit about the coordination between Health Canada and DND, particularly on dealing with mental health issues that DND is concerned about, and PTSD writ larger?

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

I'll let Krista say a few words more specifically, but just recently I was really thrilled—if that's the word—to see that the Canadian Institutes of Health Research is funding research projects dealing with those who have experienced IED explosions and other explosive-type environments, to study how that affects our soldiers returning from battle, and that's very promising. The more research we have, the better information to actually deal with those who are suffering from PTSD.

Would you like to say a few more words on the work that we do at DND, Krista?

[Krista Outhwaite]

Yes, thank you. I'd be delighted to.

As you know, the Public Health Agency of Canada is busy these days working on the implementation of bill C-300, An Act respecting a Federal Framework for Suicide Prevention. This is where our relationships with colleagues such as National Defence come into play very significantly. They're working with us and developing this suicide prevention framework at the federal level, the federal framework, and being very helpful in that respect.

They are also partnering with us to look at what tools and innovative developments can be brought to bear to meet the needs of mental health promotion generally, but also specifically for military families and DND personnel. It's a very important area of work, and we are delighted that they are coming to the table in the way they are to work with us on this.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Are you paying special attention to the military, obviously, but also to first responders, through public safety and so on, and obviously fire, police, and so on? Are they kind of wrapped up in the same bit of cooperation?

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

In terms of pandemic response, or in terms of PTSD?

[Laurie Hawn, Conservative, Edmonton Centre, AB]

No, in terms of the first responders, who do respond just as—I mean, military are first responders in many ways and they suffer the same kinds of traumatic incidents.

[Krista Outhwaite]

Yes.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Your “yes” is actually to public safety and so on?

[Krista Outhwaite]

Yes, they would be part of that larger family. Yes.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Back to the Canadian Mental Health Commission for a minute. That was an initiative that has gotten off the ground very well. Is that meeting expectations? You talked about the international area a bit. Are they hooked in pretty closely with similar international organizations for research and sharing of information?

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

I specifically mentioned the dementia issue.

[Krista Outhwaite]

You're referring to the government support and implementation of the Mental Health Commission and how it's functioning.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Yes. How are they working with international partners with similar mandates in terms of sharing information and research?

[Krista Outhwaite]

The Government of Canada, in addition to the Mental Health Commission of Canada, has really been reaching out significantly to partners around the world to work on this important issue. I should also say the Mental Health Commission of Canada has seen many countries come to them to understand and learn from the work of the Mental Health Commission here in Canada.

The development of the first strategic plan for mental health has been received very positively, and in fact I would be remiss if I did not mention that Canada has been active in bringing this forward at the World Health Assembly—the topic of mental health. We've sponsored meetings and discussions, and the work of the Mental Health Commission, as well as all the partners, whether they're governmental or private sector, have factored into those discussions. And other countries are very keen to see what we're doing.

[The Chair, Conservative, Ben Lobb]

Thank you, Mrs. Outhwaite.

Thank you, Mr. Hawn.

We're into our second round now with five-minute questions.

Mr. Marston, please.

[Wayne Marston, NDP, Hamilton East—Stoney Creek, ON]

Thank you, Mr. Chair.

Welcome, Minister. We're pleased to have you here with us today.

A recent report from the Public Health Agency of Canada referred to more than 200,000 Canadians acquiring antibiotic-resistant infections while seeking treatment, and close to 8,000 Canadians die of these infections annually. I have tried to put these things into frame from personal experience. Recently, you may have recalled in the House, I spoke of my wife having surgery. She was scheduled for four days and she wound up with 13 days because she picked up an infection. Fortunately, antibiotics dealt with it.

This brings me to a point I'd like to make. My background is in the labour movement, and a lot of the work I did had to do with hospital unions and their representatives. A lot of Canadian hospitals are unionized, and in that environment they have a health and safety committee. If they're going through their daily work and they find a problem with procedures, they don't have to risk a confrontation with a manager. They can go through their union, which raises it as a health and safety concern. What I'm concerned about today is there are often times that work is contracted out to cleaning services, where you have a $10-an-hour employee, a part-timer, who is reluctant to raise issues because where he's contracted, he's easily disposed of by his manager—not necessarily the hospital. It opens the door to failure within the cleaning system when we're looking at those people who have acquired the resistant pathogens out there.

Canada's chief public health officer believes that 70% of infections could be prevented, and of course where the national role comes in is with a monitoring system of some sort. There have been complaints. I understand that doctors have pointed out that the federal government has offloaded the collection of this data to the provinces. Again, as you can see, that balances off with my earlier comments. How does the government explain that there's a 1,000% increase in these infections in Canada when places like the United Kingdom have cut their infection rate by half, with the leadership of that particular government? Is the minister prepared to address the concerns these doctors have in making sure that up-to-date information is provided to them?

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

Well, I would just start by saying yes. And the Public Health Agency of Canada is actively engaged with provincial partners, monitoring the spread of infection. Any reports of disease surveillance are verified with outside medical experts, and they're regularly shared with key stakeholders. But they do have a rigorous process they go through before they post that information. I'm happy to let Krista expand on that.

But what I will say to you is that in this situation, on the labour side, anyone who is a patient and has been a patient, including myself, expects that people follow health and safety procedures, regardless of being unionized or non-unionized, obviously. But Krista can elaborate a little more on that because I know she has an issue she'd like to raise.

[Krista Outhwaite]

Mr. Chair, the topic of antimicrobial resistance is an extremely important one. It's emerging in terms of discussions at the World Health Organization. The U.K. is providing some interesting insight into this particular area. In fact, all countries now are really putting a focus on antimicrobial resistance, for all of the reasons the member has brought to the table.

In this country, the Public Health Agency of Canada has a bit of a unique surveillance program in which we actually look for resistant microbiological agents—bacteria and things like that—in hospitals and health care settings. We do that with the cooperation of a number of hospitals across this country. We work very actively to get the results of that surveillance out to the public health community, which needs it and uses it as quickly as we can. It takes a little while, as the minister was mentioning, to make sure that the data are accurate, valid, and appropriate and that we protect any concerns with respect to individual patient information. We absolutely want to do that.

But once we've done that process, we give that data over, as I say, to the public health community. We are also working very actively to make sure that we also introduce the outcomes of those surveillance programs on our website as quickly as we can, which is I think the issue the member was pointing to.

[Wayne Marston, NDP, Hamilton East—Stoney Creek, ON]

How is my time, Chair?

[The Chair, Conservative, Ben Lobb]

It was perfectly timed. That was five minutes. Thank you.