Health Committee on April 11th, 2016

[Jane Philpott, Liberal, Markham—Stouffville, ON]

This is something that I'm really interested in. As a health care provider myself I know, if I may say politely, the chaos that exists across the country in electronic health records. I think we've made progress in terms of health care providers, hospitals, and others using more and more electronic records, although we had lagged for some time. Canada's starting to improve our track records in terms of the availability, but the huge challenge is integration of systems.

We've seen for instance that Quebec has recently taken some steps to ensure that there will be much more uniformity across different platforms, and I think we need to do much more of that in Canada.

One of the areas that we did invest in through the recent budget is the Canada Health Infoway, so we were able to add some funding there.

I would like to make this a part of our health accord discussions because you know as a provider as well as I do that it's really unacceptable that a family doctor in one part of a city should not be able to communicate with a family doctor in another part of the city in accessing laboratory results and all sorts of other things, and a patient should not have to repeat their whole story, repeat blood tests, because there's a huge amount of waste in the system. You will have my full support in making sure we do better on digital technology.

[The Chair, Liberal, Bill Casey]

Thank you.

Ms. Harder, welcome to the committee.

She is our newest permanent member of the committee, and we look forward to her contributions.

[Rachael Thomas, Conservative, Lethbridge, AB]

Thank you very much.

Thank you for being here. I've looked at your record and the background that you're coming with and you have a lot of experience.

I'm just curious. When it comes to physician-assisted dying, should you return to the field, I'm wondering if you would be comfortable with assisting someone in dying.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

First of all I'm going to say this is probably the last set of questions I can take. I'm not trying to avoid this question. I'll answer you in a second. I just want to let you know that you're probably the last person I can take questions from and then I'm going to have to go, but I will be available in the future.

I believe that patients need to have access to a range of options at the end of life and I would support the fact that they need to have access to that range of options.

[Rachael Thomas, Conservative, Lethbridge, AB]

Is PAD something that you would be comfortable with administering?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

On matters of the choices that I would make as a physician—and I'm here as the Minister of Health and not as a physician—I would make sure that my patients had access to the range of options at the end of life. That's a necessity for us and in fact it is required of us.

The other thing that I would point out to you is that the legislation that is going to be introduced in the very near future addresses the fact that the Supreme Court of Canada has made it very clear that we need to make sure that Canadians have access to assistance in dying at the end of life and it is our responsibility as parliamentarians to make sure that we put the laws in place. There is no question about whether or not medical assistance in dying needs to be available to all Canadians. That has already been made clear by the court.

[Rachael Thomas, Conservative, Lethbridge, AB]

I find it interesting that in your personal life as a doctor you would make sure that your patients had access to whatever form of care they chose at the end of life, yet as a minister you haven't put an emphasis on palliative care. I don't see it anywhere in the budget, so I find that precarious.

Moving on, I'm just wondering as well if you placed emphasis on the Charter of Rights and Freedoms and whether or not you believe it should be upheld no matter what.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

I fully believe in the Charter of Rights and Freedoms.

[Rachael Thomas, Conservative, Lethbridge, AB]

When we move forward with regard to putting legislation in place for PAD would you say that the conscience rights of doctors and institutions will be protected in the legislation that we expect to come forward soon?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

I have heard from all kinds of colleagues, physicians as well as others, who are very concerned about the matter of conscience rights of health providers. Whether it's the special joint committee, the external panel, the provincial and territorial report, none of those reports had any argument with the fact that we should uphold the conscience rights of health care providers. I think that will give you a clue as to what the legislation will show.

[Rachael Thomas, Conservative, Lethbridge, AB]

Thank you.

The report that did come out required referral from doctors, which could arguably be against their conscience protection or their conscience rights. I'm going to leave it at that for now, and I'm going to share my time with my colleague over here.

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you.

I'm glad you can at least stick around for a little of the time, Minister. I find it a little disturbing that you have to leave a standing committee to address the media. Anyway, I will ask my questions and hopefully I can get some answers here.

Minister, while reviewing your hospitality expenses, I note that your office charged the taxpayers of Canada $3.94 for a trip to the cafeteria on Friday, December 4. You would have signed off on these expenses, of course, and I'm sure that the processing of this minor expense cost more than the $3.94 you claimed. The MP per diem that week when we were in there was $95 a day. Did you make a hospitality claim, as well, while also collecting this claim? Can you please let us know what the purchase was of such a minor amount that needed to be charged to taxpayers here in Canada? Do you believe this is a wise use of taxpayer money?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Thank you for the question.

I will have to look into the specifics of that. I can't recall off the top of my head what I spent money on, on December 4, but I will be happy to get that information for you.

[Len Webber, Conservative, Calgary Confederation, AB]

Good. Thank you. I appreciate it.

I also have a question on pharmacare, Minister. As you know, this committee is studying the issue of pharmacare here in Canada, and I think it is fair to say that everyone around this table would love to see medicines more accessible and affordable. But the reality is that someone has to pick up this tab, and ultimately it's the taxpayer. I also noted, Minister, that your mandate letter says that you need to work with the provinces and territories to improve access to necessary prescription medicines. With regard to the issue of pharmacare, we can't ignore the elephant in the room: the enormous cost that is associated with expanding drug coverage here in Canada.

Without funding set aside in your main estimates, Minister, for a massive new drug coverage plan, it appears to me that the intention here is to download these costs to our provinces and territories. Would there be any increased drug coverages expensed to our provinces, and would any of these increased drug coverages be an additional expense for the federal government? If so, how much do you think we can afford, as taxpayers, from the federal level?

I'll let you answer this question.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Thank you.

Clearly, the federal government would have to have a long and thoughtful conversation with the provinces and territories on the direction of drug costs. Certainly I'm not in the business of off-loading expenses to provinces and territories that are not appropriate. Having said that, as I said, we've already undertaken some important measures. I can tell you the provinces were delighted when we decided to join the pan-Canadian pharmaceutical alliance, which will effectively decrease costs for all jurisdictions across the country that participate in that alliance.

Obviously we're not in the position of implementing pharmacare at this time. Mr. Davies already pointed out his support for pharmacare. I think the other thing I would emphasize to you is that one of the reasons I'm interested in making sure drugs are affordable and accessible to Canadians is that there is considerable evidence, particularly with certain medications, that we would save money in the long run if we were to make sure that Canadians had access to drugs. I'm happy to give you, and I know Dr. Eyolfson would similarly be happy to give you examples of patients who could not access insulin or blood pressure medications and who ended up having end-stage heart and kidney failure, which in the end cost the health care system thousands of dollars. If we had been able to make sure that those people had access to the medications they needed when they needed them, it would have saved huge money down the road.

There is no question that, while it sounds as if it might be expensive and that's one of the reasons why we're not in the position where we're about to implement pharmacare, there are public drug plans across this country for people who can't afford their medication. That's a good thing. But we still need to make sure all Canadians can access the medicine they need, and that's what we're working toward.

[Len Webber, Conservative, Calgary Confederation, AB]

Does this include experimental drugs as well?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

You raise an interesting point, because with advances in technology, drugs are getting more expensive. That's a matter we can't be in denial about and we need to make sure there are mechanisms in place to keep those costs under control.

[The Chair, Liberal, Bill Casey]

Thank you.

Are you departing now?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

I believe I am apparently departing. It's been a pleasure to be with you. I do hugely appreciate the work you're doing, and we really look forward to hearing the results of all of your projects.

[The Chair, Liberal, Bill Casey]

We look forward to having you back.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

I'd be happy to come back.

[The Chair, Liberal, Bill Casey]

Thank you.

We'll just take a little break, and then, Ms. Sidhu, you're up for questions.

[The Chair, Liberal, Bill Casey]

Welcome to our committee again.

Are you intending to make a presentation on the main estimates or would you like to launch into questions? What's your preference?

[Simon Kennedy]

I think, Mr. Chair, we're just ready for questions, no statements.

[The Chair, Liberal, Bill Casey]

Just ready for questions, all right.

Ms. Sidhu, you have five minutes. We're in five-minute rounds now.