Evidence of meeting #61 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was million.
A recording is available from Parliament.
3:30 p.m.
Conservative
The Chair Conservative Ben Lobb
Good afternoon, ladies and gentlemen. Welcome to our meeting.
We're here today to study the main estimates. This afternoon we have the minister here as well as many of her officials.
Minister, thank you for taking the time out of your schedule to appear today and have your officials all be here as well. You have prepared a statement. We'll allow you to present it and then follow it with our standard round of questions.
Thank you.
3:30 p.m.
Edmonton—Spruce Grove Alberta
Conservative
Rona Ambrose ConservativeMinister of Health
Thank you very much, Mr. Chair, and thank you to the committee. I want to thank all of you for the work you do on the health committee. I know many of you are passionate about the issues of health, and I thank you for your commitment to that.
I'm joined by Simon Kennedy, Health Canada's new deputy minister; Krista Outhwaite, our newly appointed president of the Public Health Agency of Canada; and Dr. Gregory Taylor, whom you've met before, Canada's chief public health officer. I know he'll be here for the second half. You might want to ask him about his trip to Guinea and Sierra Leone to visit our troops and others who are working on the front dealing with Ebola. I'm sure he'll have some great things to share with you.
Michel Perron is here on behalf of the Canadian Institutes of Health Research. He's also new. Last time I know you met Dr. Alain Beaudet.
We also have Dr. Bruce Archibald, who's the president of the Canadian Food Inspection Agency. I think you've met Bruce as well.
Mr. Chair, I'd like to start by sharing an update on some of the key issues that we've been working on recently. I'll begin by talking about Canada's health care system, the pressures it's facing, and the opportunities for improvement through innovation. I will then highlight some recent activities on priority issues such as family violence and the safety of drugs in food.
According to the Canadian Institute for Health Information, Canada spent around $215 billion on health care just in 2014. Provinces and territories, which are responsible for the delivery of health care to Canadians, are working very hard to ensure their systems continue to meet the needs of Canadians, but with an aging population, chronic disease, and economic uncertainty, the job of financing and delivering quality care is not getting easier.
Our government continues to be a strong partner for the provinces and territories when it comes to record transfer dollars. Since 2006, federal health transfers have increased by almost 70% and are on track to increase from $34 billion this year to more than $40 billion annually by the end of the decade—an all-time high.
This ongoing federal investment in healthcare is providing provinces and territories with the financial predictability and flexibility they need to respond to the priorities and pressures within their jurisdictions.
In addition of course, federal support for health research through the CIHR as well as targeted investments in areas such as mental health, cancer prevention, and patient safety are helping to improve the accessibility and quality of health care for Canadians.
But to build on the record transfers and the targeted investments I just mentioned, we're also taking a number of other measures to improve the health of Canadians and reduce pressure on the health care system. To date we've leveraged over $27 million in private sector investments to advance healthy living partnerships. I'm very pleased with the momentum we've seen across Canada.
Last year we launched the play exchange, in collaboration with Canadian Tire, LIFT Philanthropy Partners, and the CBC, to find the best ideas that would encourage Canadians to live healthier and active lives. We announced the winning idea in January: the Canadian Cancer Society of Quebec and their idea called “trottibus”, which is a walking school bus. This is an innovative program that gives elementary schoolchildren a safe and fun way to get to school while being active. Trottibus is going to receive $1 million in funding from the federal government to launch their great idea across the country.
Other social innovation projects are encouraging all children to get active early in life so that we can make some real headway in terms of preventing chronic diseases, obesity, and other health issues. We're also supporting health care innovation through investments from the Canadian Institutes of Health Research. In fact our government now is the single-largest contributor to health research in Canada, investing roughly $1 billion every year.
Since its launch in 2011, the strategy for patient-oriented research has been working to bring improvements from the latest research straight to the bedsides of patients. I was pleased to see that budget 2015 provided additional funds so that we can build on this success, including an important partnership with the Canadian Foundation for Healthcare Improvement.
Canadians benefit from a health system that provides access to high-quality care and supports good health outcomes, but we can't afford to be complacent in the face of an aging society, changing technology, and new economic and fiscal realities. That is why we have been committed to supporting innovation that improves the quality and affordability of health care.
As you know, the advisory panel on health care innovation that I launched last June has spent the last 10 months exploring the top areas of innovation in Canada and abroad with the goal of identifying how the federal government can support those ideas that hold the greatest promise. The panel has now met with more than 500 individuals including patients, families, business leaders, economists, and researchers. As we speak, the panel is busy analyzing what they've heard, and I look forward to receiving their final report in June.
I'd also like to talk about another issue. It's one that does not receive the attention that it deserves as a pressing public health concern, and that's family violence. Family violence has undeniable impacts on the health of the women, children, and even men, who are victimized. There are also very significant impacts on our health care and justice systems.
Family violence can lead to chronic pain and disease, substance abuse, depression, anxiety, self-harm, and many other serious and lifelong afflictions for its victims. That's why this past winter I was pleased to announce a federal investment of $100 million over 10 years to help address family violence and support the health of victims of violence. This investment will support health professionals and community organizations in improving the physical and mental health of victims of violence, and help stop intergenerational cycles of violence.
In addition to our efforts to address family violence and support innovation to improve the sustainability of the health care system, we have made significant progress on a number of key drug safety issues. Canadians want and deserve to depend on and trust the care they receive. To that end, I'd like to thank the committee for its thoughtful study of our government's signature patient safety legislation, Vanessa's Law. Building on the consultations that we held with Canadians prior to its introduction, this committee's careful review of Vanessa's Law, including the helpful amendments that were brought forward by MP Young, served to strengthen the bill and will improve the transparency that Canadians expect.
Vanessa's Law, as you know, introduces the most significant improvements to drug safety in Canada in more than 50 years. It allows me, as minister, to recall unsafe drugs and to impose tough new penalties, including jail time and fines up to $5 million per day, instead of what is the current $5,000 a day. It also compels drug companies to do further testing and revise labels in plain language to clearly reflect health risk information, including updates for health warnings for children. It will also enhance surveillance by requiring mandatory adverse drug reaction reporting by health care institutions, and requires new transparency for Health Canada's regulatory decisions about drug approvals.
To ensure the new transparency powers are providing the kind of information that Canadian families and researchers are looking for, we've also just launched further consultations asking about the types of information that are most useful to improve drug safety. Beyond the improvements in Vanessa's Law, we're making great progress and increasing transparency through Health Canada's regulatory transparency and openness framework. In addition to posting summaries of drug safety reviews that patients and medical professionals can use to make informed decisions, we are now also publishing more detailed inspection information on companies and facilities that make drugs. This includes inspection dates, licence status, types of risks observed, and measures that are taken by Health Canada. Patients can also check Health Canada's clinical trials database to determine if a trial they are interested in has met regulatory requirements.
Another priority of mine is tackling the issue of drug abuse and addiction in Canada. There's no question that addiction to dangerous drugs has a devastating and widespread impact on Canadian families and communities. In line with recommendations from this committee, I am pleased that the marketing campaign launched last fall by Health Canada is helping parents talk with their teenagers about the dangers of smoking marijuana and prescription drug abuse. The campaign addresses both of those things, because too many of our young people are abusing drugs that are meant to heal them.
Our government also recognizes that those struggling with drug addictions need help to recover a drug-free life. From a federal perspective, of course, we provide assistance for prevention and treatment projects under our national anti-drug strategy. We've now committed over $44 million to expand the strategy to include prescription drug abuse and are continuing to work with the provinces to improve drug treatment.
I've now met and will continue to meet with physicians, pharmacists, first nations, law enforcement, addictions specialists, medical experts, and of course parents to discuss how we can collectively tackle prescription drug abuse.
Finally, our government continues to make very real investments to strengthen our food safety system. As only the latest example, I recently announced a five-year investment of more than $30 million in the CFIA's new food safety information network. Through this modern network, food safety experts will be better connected, and laboratories will be able to share urgently needed surveillance information and food safety data, using a secure web platform. This will put us in an even better position to protect Canadians from food safety risk by improving our ability to actually anticipate, detect, and then effectively deal with food safety issues. This investment will continue to build on the record levels of funding we've already provided, as well as the improved powers such as tougher penalties, enhanced controls on E. coli, new meat labelling requirements, and improved inspection oversight.
In conclusion, those are just some of the priorities that will be supported through the funding our government has allocated to the Health portfolio. This year's main estimates, notably, include investments for first nations health, for our ongoing contribution to the international response to the Ebola outbreak in West Africa, and the key research and food safety investments that I have already mentioned.
I'll leave it at that. If committee members have any questions, my officials and I would be very pleased to answer them. Thank you.
3:40 p.m.
Conservative
The Chair Conservative Ben Lobb
Thank you very much, Minister.
Mr. Rankin, go ahead. You have seven minutes.
3:40 p.m.
NDP
Murray Rankin NDP Victoria, BC
Thank you, Minister Ambrose, and your officials, for being with us today. It's a pleasure to see you.
My first question concerns Parliament's motion, unanimously passed in December, to provide full support for the victims of thalidomide. As you may know, since that motion was passed, the 97 who were identified as survivors have now, sadly, been limited to 94. There have been three deaths. The government—I think you, Minister—on March 6, promised $125,000 as a lump sum this year, and then $168 million for their lifetime care.
I wonder if you could explain to the committee how the department came up with that particular number of $168 million.
3:40 p.m.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
First of all, let me say it's important that we remember this tragic event that happened in the 1960s, reflect upon the good work of this committee around Vanessa's Law, and remember why it's so important that we have strong drug safety laws in this country.
Our government has very deep sympathy for what happened. While this happened in the sixties, I offered our government's and all Canadians' public regret and apologies to those who were affected by thalidomide. We know we can never undo the pain and suffering that people have experienced.
I had an opportunity to meet a few times with Mercedes Benegbi, who is the head of the Thalidomide Victims Association of Canada. As you know, we did announce $180 million to be distributed among the survivors. I'm pleased to say that we've been able to get out the $125,000 tax-free lump sum immediately to survivors. The reason we worked very quickly is that it will take us some time to get the yearly pension set up with the other $168 million we have. Also, we have an extraordinary medical assistance fund. We're in the middle of working out the details of that.
3:40 p.m.
NDP
Murray Rankin NDP Victoria, BC
Are you able to identify when that might be done? Will it be done this year?
3:40 p.m.
NDP
Murray Rankin NDP Victoria, BC
You indicated in the budget very specific numbers for radiation protection, $20.2 million, and $40 million for pesticides, but we couldn't see any specific reference to that $168 million in the estimates.
3:40 p.m.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
The money is there and it's budgeted. It's in the fiscal framework. Yes, we do expect to work out the details of the annual payments in the near future. We're working very hard on it.
3:40 p.m.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
We knew it would take some time to create. It doesn't happen overnight to create all the parameters. We also have the need to identify an appropriate third party that will help us with the distribution of the funds.
3:40 p.m.
NDP
Murray Rankin NDP Victoria, BC
You appreciate how difficult it is for the survivors to plan their lives and pay for renovations to their houses and for transportation and the like, in order to address this crisis going forward. You're not able to tell us when. Will they know before the election?
3:40 p.m.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
Absolutely. We hope we'll be able to tell them in the very near future. We're working expeditiously, but it's why we wanted to get out the $125,000 sum immediately, so they had something they could rely on.
3:45 p.m.
NDP
Murray Rankin NDP Victoria, BC
I have very little time. I really appreciate that.
On the issue of drug safety inspections, we had an order paper question that revealed that since April 1, 307 inspections on drug safety were carried out, but only one company received a “proposal to suspend” their licence—one of 307. By contrast, the U.S. Food and Drug Administration, through 110 inspections of Canadian-owned facilities in the last 10 years, found objectionable activity.
The Toronto Star reported that 4,000 clinical trials are conducted per year in Canada. But only 1.5% of them are being inspected annually.
How many inspections result in actions being taken in respect of drug safety, on an annual basis?
3:45 p.m.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
I can't give you the exact number, but I am happy to say that with our transparency framework at Health Canada around drug safety and drug trials, Canada now has the most transparent system in the world. Canadians will actually be able to go on a website to see what plant was inspected, what problem there may or may not have been, and if there was a problem, what corrective action was ordered.
3:45 p.m.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
Simon just gave this to me because you were asking for numbers.
In 2013-14, we did 428 inspections.
3:45 p.m.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
Overall, 96% of the establishments that had an inspection were assigned a compliant rating. There were 19 that were found to be non-compliant. We do keep track of all of those numbers.
Importantly, I think, is that people wanted to know what was happening, so now that is transparent under our new framework.
3:45 p.m.
NDP
Murray Rankin NDP Victoria, BC
I appreciate that.
As you speak of transparency, that takes me to Vanessa's Law, to which you made reference earlier.
Toronto doctor, Nav Persaud, made an information request to Health Canada to get clinical trials on a pregnancy drug, an anti-nausea drug called Diclectin. He tried that three and a half years ago. He finally got 359 pages, 212 of which were completely redacted or censored.
In March, after Vanessa's Law came in, he resubmitted the request for all of the 359 pages, and so far has been given nothing. I got that as recently as two days ago in a letter. The clinical trial data was something that was to be made available, as I understood it, under Vanessa's Law. His experience has been entirely frustrating.
3:45 p.m.
Conservative
Rona Ambrose Conservative Edmonton—Spruce Grove, AB
I sympathize with his experience.
Under Vanessa's Law, the intention is to make clinical trial information available, but still to some extent—and for legal reasons obviously—protect confidential business information. Our intention under Vanessa's Law—and it's my belief—is that we should be sharing as much as we possibly can.
On that specific one, I think that's still under way, but I know Simon is working on that.
3:45 p.m.
Simon Kennedy Deputy Minister, Department of Health
Thanks, Minister.
On this particular case, the original submission was made under the access to information rules. The ministry is obliged to apply the access law, which does require a number of exemptions for business information and so on.
With new authorities under Vanessa's Law, there is this other avenue we can use to make information available where there is a health or safety threat. We've spoken to the researcher in question, and we sent him a fairly detailed letter to explain the process to make an application under Vanessa's Law. That conversation is going on and our hope would be to be able to move through that avenue to deal with the issue.