Industry Committee on March 24th, 2015

[Judy Sgro, Liberal, York West, ON]

It needs to be handled somewhere along with this package.

[Janet Cooper]

Yes.

[Judy Sgro, Liberal, York West, ON]

Okay, thank you.

[The Chair, Conservative, David Sweet]

Thank you very much.

Now we'll go on to Ms. Gallant.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Thank you, Mr. Chairman.

My first question goes to Ms. Romanko. Does financial abuse that is reported to you include the sale of vehicles to people suffering from the effects of dementia? For example, if we have an elderly person who is sold a car and that person can't drive or doesn't have a licence, can people report that to you as financial abuse?

[Catherine Romanko]

They can. That case that was recently in the media actually did come through our office in a very preliminary way early on. The circumstances could be reported as abuse, but when it's a commercial operator, the chances are the report would go to the police rather than the Public Guardian and Trustee to see whether the transaction was legitimate, and whatever. It's unlikely that we would be involved from the perspective of pursuing the vendor of the vehicle, the commercial operator, but rather protecting the adult.

What we might do in those circumstances is examine the affairs of the adult to determine whether there are supports in place and ways to protect the adult. Does the Public Guardian and Trustee need to become involved on an ongoing basis as a committee, for example, to manage the affairs of the adult?

There are certain types of situations that simply can't be avoided. People who have legal representatives but are incapable may still enter into transactions without the vendor knowing that the person is incapable, and presumably, they've entered into a situation that may not be in their best interests. There are provisions under British Columbian law that would perhaps negate that transaction to protect the vulnerable adult, but there are some things that are really difficult to protect. Our office would be involved only from the perspective of protecting the adult, not necessarily undoing the transaction or pursuing a vendor.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Okay. If there were a financial institution involved or a lending practice, has it been your experience that any financial institutions reported abuse when it involved a loan as opposed to a withdrawal of deposit?

[Catherine Romanko]

The loans haven't been particularly our experience, unless it is a situation where you have a vulnerable adult come into the bank with a new person in their life and unusual withdrawals are being taken and loans to this new person. That sort of thing is reported to us. With respect to loans that are made by the bank to vulnerable adults, that is not something I'm referring to.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Okay, thank you.

Ms. Cooper, are you or your membership in the Canadian Pharmacists Association aware whether or not they've ever suffered a data breach?

[Janet Cooper]

I'm not aware of that information being disclosed. I think there have been some extremely isolated incidents—you know, a member of the pharmacy staff might have looked up a patient record—but there are really good processes in place to identify that. In provinces like British Columbia, there is a province-wide information system of all the medications that every pharmacy can get. The same as breaches within a hospital, or any provider, some of that is being detected. How much it's reported, I don't know.

But in terms of prescription information being breached, I can't recall that having happened in spite of having electronic records of prescription data for about three and a half decades.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Do pharmacies conduct audits of who is accessing...? Can an employee, for the sake of whatever, snoop on a client's profile to see what medication they are on?

[Janet Cooper]

In the provinces that have a province-wide drug information system, it's a government system, so they are auditing that. They can identify the people who are accessing when they shouldn't be. That's not unique to pharmacy, either.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Would you be able to explain how prescribing information can be used for research that would benefit patients? You used that phrase earlier in responding to a question, but would you follow through on that concept and explain to the people here how patients in general would benefit from that type of prescribing-pattern research?

[Janet Cooper]

It's all part of post-marketing surveillance to look at a lot of safety information. Before drugs come on the market, they're tested in a fairly narrow, often homogeneous group. When they come out on the market and you're using them in pediatrics or the elderly or people with kidney dysfunction, they probably haven't been tested in some of those populations, so it's really important to get that information.

Most drug plans, in particular the government drug plans, have formularies and they have restricted access. They want to know that these drugs that are restricted because of either cost or safety concerns are being used appropriately and for the right patients. Without collecting that information, you wouldn't be able to research any of that.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

I don't see how you're able to connect the dots with respect to prescribing patterns when you don't actually have the knowledge of how that patient is reacting to what's prescribed.

[Janet Cooper]

In terms of the clinical outcomes for that particular individual?

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

What you just described requires knowing how the patient is being affected by the medication. Based on what is on a prescription order, that's not indicated.

[Janet Cooper]

You start to get more of that with better integration of adverse drug reaction reporting and clinical outcomes. British Columbia has a pretty impressive integrated.... They can look at cardiac outcomes based on utilization of cardiac medicines, that type of thing. These are all very highly educated researchers. Most of them who are doing a lot of this research are on faculties of medicine or pharmacy.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

So you're not comparing actual outcomes per patient; you're comparing statistics to statistics.

[Janet Cooper]

That's right. When you look at clinical research, it's the number who have been treated and what their outcomes are compared to a control group that's not on medications or on a different medication, that type of thing.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Thank you.

[The Chair, Conservative, David Sweet]

Thank you, Ms. Gallant.

Now on to Ms. Borg.

You have eight minutes.

[Charmaine Borg, NDP, Terrebonne—Blainville, QC]

Thank you, Mr. Chair.

I thank the witnesses very much for being here today.

My first question is for Mr. Levin.

I had the opportunity of hearing your testimony at the Standing Committee on Access to Information, Privacy and Ethics. You said that businesses had to be motivated to protect people's personal information.

In my opinion, Bill S-4 is an improvement, but it does not go far enough to encourage companies like Google and Facebook to properly protect individuals' personal information. You mentioned briefly that you were in favour of compliance agreements, but you added that they should confer more powers.

Could you provide some further explanations on that?

[Prof. Avner Levin]

If I understand the question correctly—and thank you for the question—it was asking what we need beyond the compliance agreements that are currently in the bill.

I think what we need is the power, at the end, for the commissioner to make an order and instruct those companies to comply with whatever it is that the commissioner has found. You have a process of discussion and you have findings and you have a compliance agreement, but what we have right now is that at the end of the day the commissioner can then go to court and request an order.

We have seen an excellent example with the research that was done by the commissioner with respect to Facebook a few years ago—very thorough research by the assistant privacy commissioner, currently the privacy commissioner of British Columbia, into Facebook—with lots of media attention, lots of findings, lots of recommendations. Then Facebook says that's wonderful and moves on and keeps doing business as usual. They disregard Canada and they disregard the regulator, because the regulator doesn't have the power to order them to comply with any of those, and the only option is maybe to take them to court.

In order for big businesses to take the Canadian environment seriously, the commissioner has to be able to tell them at the end of the day that they have to comply with a certain finding or a certain request. What is baffling to me is that this is very common in data protection regimes. You see that they treat Europe differently as a result, because the commissioners there have the ability to regulate and make orders. You can see how they treat even provincial commissioners differently, because they have within their provinces the ability. The only outlier is the Privacy Commissioner of Canada.

I don't understand what the compelling reasons are to make an exception in this case, so that the Privacy Commissioner of Canada cannot be given the powers of making orders that all the others have.

[Charmaine Borg, NDP, Terrebonne—Blainville, QC]

Thank you very much.

I would also like to raise the issue of consent, which is I think of concern to all of us. The fact that there are 10-page forms that people cannot read is indeed very worrisome. Bill S-4 at least sets the stage for limiting the circumstances in which consent could be considered valid. This is in clause 5 of the bill. Several witnesses made different comments on that clause.

Mr. Levin, Mr. Brown and Ms. Romanko, since you spoke of the most vulnerable populations, I would like to ask you whether in your opinion this clause is appropriate as it stands, or whether it should be amended. If so, what would you propose?