Health Committee on Dec. 6th, 2018

[The Chair, Liberal, Bill Casey]

Thank you, and the same to you.

We'll suspend for a moment while we change the panel.

[The Chair, Liberal, Bill Casey]

We'll reconvene. We'll start our new round with Mr. McKinnon, whom we cut short in the last round.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

I'm segueing off of one of Mr. Davies' questions—actually, all of his questions.

It's widely known that certain health issues can disproportionately affect Canadians who are in the LGBTQ2 community. As you may know, I've introduced a motion to study LGBTQ2 health in this committee, and we are poised to commence our study in the new year. I'd like to know what the government is doing to support the physical and mental health needs of the LGBTQ2 community.

[Simon Kennedy]

I think this a question, Mr. Chair, that a number of us could probably speak to. I can quickly start for Health Canada.

I will assure the member that when our ministry is supporting the government in the design and delivery of health programs, we do try systematically to look at how the programming may or may not disproportionately impact various groups, including groups that might be vulnerable for a variety of reasons. I'll just give one example, and we can certainly talk about a whole variety of areas.

In the renewal of Canada's tobacco control strategy, for example, we are aware that there are some groups on whom the burden of tobacco-related disease and smoking falls disproportionately. The LGBTQ community would be one clear example of that. In the design of our new tobacco cessation programming and measures to deal with tobacco control, that's a particular sensitivity that we try to bring to its development.

Colleagues from the research side and the public health side and so on probably have other things they could add. I'd just say that we could talk about each area of programming, but we try to look systematically at these sorts of issues. I'm sure we could do better, but that is one way we try to be responsive.

I don't know if colleagues wish to jump in.

[Dr. Siddika Mithani, President, Public Health Agency of Canada]

There are a number of ways the Public Health Agency of Canada supports the LGBTQ2 community. The first is the report on Canada's health inequalities, which provides data on diverse populations. That data allows us to focus on the issues around the LGBTQ2 community and be able to look at programs and policies that would be able to support them.

From an HIV/AIDS perspective, there was World AIDS Day last week, as you know, and the government announced a $7-million investment to support a group called the Advance Pan-Canadian Community Health Alliance, which will undertake to increase access for gay, bisexual, two-spirit and transgender populations to the equitable and effective health services that they need through the HIV/AIDS program.

We also have a number of anti-stigma programs, and the minister also announced an anti-stigma campaign that will also support the LGBTQ2 communities.

We also have family violence programs and gender-based violence programs that include communities involving LGBTQ, and they provide support around prevention and health promotion.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Thank you.

Does anyone else have a comment?

[Michel Perron, Executive Vice-President, Canadian Institutes of Health Research]

Yes. With respect to research from the Canadian Institutes of Health Research, one of the elements that I think might be of interest to the member is the commitment that we made to sex-based and gender-based policy analysis as regards research, not only in terms of how sex and gender play out in terms of the research question, but also in the nature of the research that's undertaken.

We are very much dedicated to exploring how gender and sex influence the health of women, men and gender-diverse people and to making sure that the research actually reflects those needs through the participation of women and under-represented groups in the research, and also to check unconscious biases among researchers in the formulation of the research questions and their application. We are paying broad attention to the matter, not only in how the research is conducted but also in the nature of the research itself.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Thank you.

I have a very quick question. My other questions are all about the opioid crisis, which has been very thoroughly canvassed with the minister.

I would like to talk about the Good Samaritan Drug Overdose Act, which was my private member's bill that has been law now for about a year and a half. I wonder if you can tell me—and I hope you can tell me—that there have been positive impacts and maybe what they are.

[Simon Kennedy]

Mr. Chair, on this issue I would say that Health Canada sees the Good Samaritan Drug Overdose Act as an important part of the government's strategy on dealing with the opioid crisis, in particular around the issue of stigma reduction.

We have heard anecdotally that there has been some progress with that legislation, but there's probably more that we can do to help support its adoption and awareness across the country.

I don't have good empirical data I can share off the top of my head, for which I apologize. I would be happy to see if I can get some firm statistics, but what I can report is that my own staff in their dealing with people at the front lines have indicated that there's probably more we can do to raise awareness and boost awareness at the street level in various places across the country. That's something we're looking at very carefully, to see whether we can put an additional profile on the Good Samaritan Drug Overdose Act as part of our go-forward public education and anti-stigma work.

I don't know if the member is aware, but the other thing is we have been printing up wallet cards and doing a lot of activity to increase awareness and to make sure that frankly the young people in the community and people out in the cities and towns across the country are aware that this legislation exists and aware that this option is now there.

There's a lot of activity going on, but I think our assessment is that we could do more and there's more that needs to be done.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Great. Thank you.

[The Chair, Liberal, Bill Casey]

Ms. Gladu is next.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thank you, Chair. My first question will be for the deputy minister.

It is regarding cannabis regulations. I don't know if you heard the question I asked the Prime Minister yesterday in the House about a Montreal couple who had been convicted of having 997 cannabis plants and more than $15,000, and they're under investigation for trafficking of illegal drugs. They have been granted a licence to grow medical marijuana, 600 plants, by Health Canada. It's one of the enforcement things that doesn't appear to be happening.

I've also had complaints about marijuana production facilities in Lindsay, Ontario, and Leamington, Ontario, and my own riding of Enniskillen Township in Langley, B.C., where there are off-site odour impacts that are not in compliance with the regulation and in some cases, with the Lindsay example, no security fencing or anything that is required by the regulation.

When people have called Health Canada, they've been told “Don't call us; call the police.” The police have said, “We're able to enforce impaired drug driving and trafficking, but we don't enforce Health Canada's regulations. You have to call Health Canada.”

Can you tell me who in Health Canada is responsible for enforcement, and are you aware of these situations of the regulations not being followed?

[Simon Kennedy]

Mr. Chair, just to clarify that—maybe not for the benefit of the member, because I know that there's obviously a good familiarity, but maybe for the benefit of the committee—we administer a number of regimes. Sometimes in the press and sometimes publicly the activities under each regime get a bit confused, so I just want to explain very briefly.

When it comes to the production of cannabis for medical purposes by a licensed producer or for the legal market by a licensed producer, there are a whole series of very stringent regulations that have to be followed to maintain their licence so that they have the right to sell to patients or to sell into the recreational market.

It is absolutely the case that there have been instances of community concerns around odour and those sorts of things, and I want to assure the member and the committee that we are quite aggressive in following up on that. There are very clear regulations around odour control and filtration systems, etc. There have been cases in the past in which the judgment has been that maybe companies had to do more to ensure compliance, and we're quite aggressive, actually, at following up.

We have extensive authority to actually go onto the facility, inspect property and review records—all those sorts of things—and I think there's a reasonable case to be made that we do that very aggressively. In fact, our level of inspection of those facilities is considerably higher than in a number of of our other regulatory regimes.

Then there is the case of individuals who have a medical condition and have permission from their doctor. They've gone to see their physician—

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

That's okay. That's not the situation. I'll just make sure that I forward the exact locations—

[Simon Kennedy]

Actually, if there is an issue, it would be useful to get the material.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Yes, absolutely. I'm going to move along to another issue.

This is just an urban legend. I had heard that there was a cut to the number of food inspectors at the Canadian Food Inspection Agency. I'm concerned about that in light of the issues about E. coli in romaine lettuce, which have gone on for a long time. Also, concerns have been brought to my attention that the inspection of pigs in Canada has gone down.

Can you tell me if that's true or not? If it is, what are we doing about it?

[Paul Glover, President, Canadian Food Inspection Agency]

Thank you, Mr. Chair, for the member's question.

At the urging of this committee and others, CFIA now makes public the number of inspectors that we have in the agency. That report is available to committee members. The number of inspection staff overall is stable and often increasing year over year. That's at an aggregate level. That's everything from the people in the labs who are doing the tests that the inspectors.... It's overall. There is no shortage of work and those numbers are not decreasing. We happily, at the urging of this committee, make those public.

With respect to hog inspection, we are looking at how we can modernize the way we inspect those facilities. Science is changing, the line speeds are increasing, and we are looking to make sure that we can work with industry to do that in the most efficient way possible and to look at the interventions that are most relevant to the safety of that product. That's work that's ongoing.

Again, if there are ways to do that more efficiently and with fewer inspectors, we will not reduce the number of inspectors. There are other food safety issues to which they would be reassigned.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

I have one last question, then. This one is on drug shortages. I'm really concerned.

We had an EpiPen injector shortage in August and we have another one now. It's the fourth one in a year. There are four approved suppliers to Canada. There don't appear to be shortages in other countries. Also, we had a shortage of Wellbutrin, which is an antidepressant drug.

I don't understand why we have all these shortages and what we can do about it, but I am concerned to make sure that it's not price that's driving it.

I don't know which one of you can best answer that.

[Simon Kennedy]

Just to assure the committee, Health Canada takes drug shortages very seriously. This is a phenomenon that does not just affect Canada; I can certainly assure the committee of that.

Part of it has to do with the structure of the global pharmaceutical industry. There are cases in which there might only be a small handful of active pharmaceutical ingredient suppliers for a particular class of drug, and so you may have a phenomenon whereby a given API that's needed to manufacture a drug is in global shortage. Shortages are an issue. Actually, when we talk to our colleagues in other countries around the world, we find they're grappling with some of the same issues. I want to assure members of that.

The second thing I would say, with regard to EpiPen specifically, is that there have been approvals given to a number of manufacturers to market their products in Canada.

As to the decision of when they enter the market and so on—they obviously they have to set up supply chains to get the products onto shelves—we anticipate having some of the products we approved coming into the market over the next year, which will give Canadians other options.

In the case of EpiPen specifically, particularly given the concern around it, we authorized the import from the United States of an equivalent product. We've had bulk shipments of that product coming into the Canadian market to make sure that while the Canadian product is in shortage, people have an option.

We have a committee that works very closely together as a kind of federal-provincial-territorial committee, and when there's a serious drug shortage, we are, frankly, on the phone with our colleagues at the provincial-territorial level constantly to get a sense of where the supply is in Canada and how we can work together to make sure that patients are attended to.

The other thing I would say is that we are also on the phone with our colleagues internationally. In the case of EpiPen, I can assure members that we're talking to colleagues in other major industrial countries with similar regulatory systems to see whether they have supply and whether we can get the supply into Canada. When there's a major drug shortage, we hear about it instantaneously from provinces and we're all over it.

Obviously, though, sometimes there are limits to the ability to get our hands on product, and I appreciate that it's a real concern for Canadians.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thank you.

[The Chair, Liberal, Bill Casey]

Mr. Davies is next.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Chair, I'm going to pick up a question I asked the minister to which, unfortunately, I didn't hear an answer. It's about the vaping advertising. Last spring the Tobacco and Vaping Products Act received royal assent. It clearly bans lifestyle advertising for vaping products; there's no question. That's what the law says, but we know that Imperial Tobacco Canada is openly flouting the rules. I've actually seen the lifestyle ads for this Vype ePen 3. I'm wondering whether you have. They've been running on television, on social media, and elsewhere. I know that complaints have been sent to the ministry, yet so far we've seen no action taken.

Here's a clear question: Is Health Canada investigating these lifestyle ads by tobacco companies on vaping, and if so, can we expect to see charges?

[Simon Kennedy]

I can assure the committee that we're well aware of some of these instances that have been reported in the press, and we are absolutely following up. I'm not in a position to get into specific cases and what may or may not be done, but certainly we have an enforcement team, we have rules in place, and wherever there are violations, we are pursuing them actively.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay.

I want to move to CFIA. In the past six months, a study came out with some very disturbing and alarming data on mislabelling of seafood and fish products. I'm going by memory, but it was something like up to 50%, in some cases, of these products in restaurants or retail outlets not being labelled properly and containing products that were not on the label.

Has any action been taken by CFIA to address that specific concern?

[Paul Glover]

Thank you very much, Mr. Chair, for the member's question.

We're very much aware of that study. We are deeply concerned not just about seafood, but frankly about the issue of food fraud more generally, and in particular, economically motivated food fraud. It's not just fish; you'll often hear the same thing about honey, which can be just adulterated sugar.

Does the consumer know the difference? With the seafood issue, most often it's in retail establishments, and they're not able to tell—it's not packaged.

We continue to work very aggressively, both domestically and internationally, with our sampling programs to test and look for food fraud broadly and generally. That would include fish.