Evidence of meeting #13 for Natural Resources in the 39th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was aecl.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Gordon Edwards  President, Canadian Coalition for Nuclear Responsibility
Karen Gulenchyn  Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
Brian McGee  Senior Vice-President and Chief Nuclear Officer, Atomic Energy of Canada Limited
Thomas Perry  Department of Medicine and Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia

12:35 p.m.

Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton

Dr. Karen Gulenchyn

Actually, there was a broader variety of people involved. There was a representative of the cardiology community, a representative of the oncology community, and the head of the Edmonton Radiopharmaceutical Centre, who provided really excellent technical advice as to how these products were distributed and what changes could be made to their distribution to improve the situation. Those were the people from the medical community who were involved. Then there were representatives as well from Health Canada.

12:35 p.m.

Conservative

Mike Allen Conservative Tobique—Mactaquac, NB

So there's a very broad cross-section of people who are very experienced in these types of procedures and very experienced in isotopes.

12:35 p.m.

Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton

Dr. Karen Gulenchyn

And they are also experienced in the use of those procedures.

12:35 p.m.

Conservative

Mike Allen Conservative Tobique—Mactaquac, NB

Okay.

My second question is about replacements. There's been a lot of discussion, and the Minister of Health talked in his testimony, about alternatives and the ability to go offshore for certain of these alternatives. It was very clear in that testimony that the French, the Dutch, and the Belgians could probably supply--on the fringes, I guess--maybe 15%, but that even then that supply couldn't come until possibly even as late as the end of December.

Did you read that information, seeing as this was a pending health crisis? What would have been the result if Chalk River had not started and all those things had been in play?

12:35 p.m.

Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton

Dr. Karen Gulenchyn

Certainly that exact information was provided to us as part of the ad hoc working group, in terms of the fact that they could ramp up, but we would be looking at about a 10% to 15% increase and it would not fill the entire capacity, and also it would not be available to Canadians until the end of December. So all of that information was provided to us.

We then, again, looked at the impact that would have on health care, and as we said, we were looking at about 10% of the examinations that we currently do where an immediate answer is required. Without that immediate answer, there may be jeopardy in terms of the person's health or delivery of care, an increased risk in terms of the delivery of care, and another 40% of individuals for whom there would have been a significant impact with an increase in suffering as a result of not being able to access care.

It's always very hard. I have two credentials. I am a general internist and I'm also a nuclear medicine specialist. Up until five years ago, when I left Ottawa, I looked after patients directly. It's always very difficult to connect a diagnostic test or the absence of a diagnostic test with what the eventual outcome is in terms of the patient, because what you're dealing with is narrowing the diagnostic probabilities and trying to improve the outcome for the patient.

The question that we've been asked by the press and by a lot of other people is this. Would people have died? It's a very difficult question to answer. Would people's care have been impacted? Absolutely. Yes. Would the health system have been made less sustainable? I believe yes, it would have been, because it would have had backlogs that we were trying to deal with. Could people have died? Yes, they could have under certain circumstances.

12:35 p.m.

Department of Medicine and Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia

Dr. Thomas Perry

A comment from British Columbia, Mr. Chair?

12:35 p.m.

Conservative

The Chair Conservative Leon Benoit

Sure. Go ahead, Dr. Perry, please.

12:35 p.m.

Department of Medicine and Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia

Dr. Thomas Perry

I'm sorry, I didn't catch the name of the member of Parliament who made the comment earlier.

Listening to Dr. Gulenchyn, I'd love to work with her. We would respect each other a lot in practice.

I wouldn't want to leave the impression that British Columbians are not concerned about the rest of the country. After all, I did my rotating internship in Nova Scotia, but I've also worked, at least briefly, in some of the smallest and most remote places in Canada, including some of the most remote sites in British Columbia, and one learns in that that there are various ways to get around a problem.

Also, in a hospital like the one I worked at, at the University of British Columbia, where there isn't much in the way of radiologic services on weekends or nights, one learns alternate ways. I think Dr. Gulenchyn has made that clear, that a relatively small fraction of nuclear medicine studies would be urgent under any circumstances and that nuclear medicines or radioisotopes are seldom used, if ever, for urgent therapy.

From the public perspective, the kind of thing that would reassure Canadians like me, as a hopefully literate, intelligent citizen, would be for your committee to help get the facts out. I was thinking to myself about how one would really know whether Parliament ought to have sat in the middle of the night, or whether that was a very dangerous precedent that threatened the essence of a good working democracy, which is more the way I saw it.

I'm not saying the reactor ought not to have been reopened within a timely way--

12:40 p.m.

Conservative

Mike Allen Conservative Tobique—Mactaquac, NB

I have a point of order, Mr. Chair.

Thank you, Doctor. I will say I appreciate your point of view.

I'm going to close with a comment. One of the comments you did make in your testimony was that you would defer to people who are the experts in nuclear medicine, and I believe we have one of those people here. Dr. Gulenchyn provided that testimony. You are completely ignoring the small-market impacts of what happened in some of the smaller centres, and I believe that is very important to the health care of Canadians.

Thank you, Mr. Chair.

12:40 p.m.

Conservative

The Chair Conservative Leon Benoit

Mr. Allen, your time is up.

Go ahead, Dr. Perry.

12:40 p.m.

Department of Medicine and Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia

Dr. Thomas Perry

Far from it, sir. I think one would like to know the truth about that.

It would be very reassuring to me to learn, for example, that there were small-market impacts that were seriously threatening patients. If that were true, I could better understand why Parliament might have acted in the middle of the night. Being a strong advocate of freedom of information and someone who worked very strongly in my own parliamentary career here to get freedom of information in British Columbia, I think one answer to that would be to see the cabinet briefing documents prepared by the Privy Council Office. If your committee could see those...I can't see a reason, as a Canadian citizen, that those ought not to be made public. There is no matter of national security at stake.

If one saw that the briefing notes explained to the Prime Minister's Office and to the leaders of the opposition parties that there was truly a crisis, this would be reassuring to people like me, just as Canadian citizens. That's the only reason I'm really here today. I'm a Canadian citizen, and I have enough respect for Parliament and parliaments, in general, to take the time out of my day to contribute the little insight I have.

I don't think I disagree very much with Dr. Gulenchyn, from what I've heard.

12:40 p.m.

Conservative

The Chair Conservative Leon Benoit

Thank you, Dr. Perry.

Parliament actually didn't meet in the middle of the night, just for clarification. We meet in the evenings now and again. In fact, towards the end of a session, it's quite common, and we were finished before midnight, so it really wasn't all that unusual. The type of hearing we had was a bit unusual.

To Mr. Alghabra, for five minutes.

12:40 p.m.

Liberal

Omar Alghabra Liberal Mississauga—Erindale, ON

Thank you, Mr. Chair.

By the way, that was also around the same time Ms. Keen was fired, just so everybody knows.

Dr. Perry, I don't want you to feel that you're being ignored--because your testimony is very compelling--and I don't think we have many questions for you, but I just wanted to thank you for being here today.

12:40 p.m.

Department of Medicine and Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia

Dr. Thomas Perry

There wasn't that much to say. Thank you for the opportunity.

12:40 p.m.

Liberal

Omar Alghabra Liberal Mississauga—Erindale, ON

You had a lot to say and it was very compelling.

My question is to Mr. McGee.

Mr. McGee, you mentioned the revenue is roughly about $30 million for the isotopes. What percentage is that, again roughly, of the revenue stream for Chalk River?

12:40 p.m.

Senior Vice-President and Chief Nuclear Officer, Atomic Energy of Canada Limited

Brian McGee

In terms of the total operations of the site--so think of revenue in that respect--it's over a $300 million operation.

12:40 p.m.

Liberal

Omar Alghabra Liberal Mississauga—Erindale, ON

So it's close to 10%.

12:40 p.m.

Senior Vice-President and Chief Nuclear Officer, Atomic Energy of Canada Limited

Brian McGee

It would be less than 10%. We can provide the committee with detailed information. We're pleased to do that, but it's over $300 million to operate the site.

12:40 p.m.

Liberal

Omar Alghabra Liberal Mississauga—Erindale, ON

Thank you.

My next question is to Dr. Gulenchyn. Are there any unique characteristics about the isotopes produced by Chalk River, or can any of the other international suppliers provide you with adequate material that would perform the same tests?

12:40 p.m.

Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton

Dr. Karen Gulenchyn

Medical radiopharmaceuticals are in fact drugs that are assessed by Health Canada. So any supplier would have to submit a file that would identify both the safety and efficacy of the product that they were putting on to the market. Once approved by Health Canada, physicians in the country have the assurance of Health Canada that the product is both safe and efficacious and can be used.

12:40 p.m.

Liberal

Omar Alghabra Liberal Mississauga—Erindale, ON

Were other products approved by Health Canada?

12:40 p.m.

Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton

Dr. Karen Gulenchyn

There were alternative generators that have been approved by Health Canada. The difficulty was that the company was not able to supply the entire market.

12:45 p.m.

Liberal

Omar Alghabra Liberal Mississauga—Erindale, ON

Which company was not able to supply the entire market?

12:45 p.m.

Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton

Dr. Karen Gulenchyn

I believe there are two major generator manufacturers. One of them is Bristol-Myers Squibb and the other one is Covidien. My understanding was that there were insufficient numbers of generators coming into the country in order to supply the market. That certainly was what we were experiencing.

12:45 p.m.

Liberal

Omar Alghabra Liberal Mississauga—Erindale, ON

Where did you get that understanding from? Who supplied you with that information? Who told you that they couldn't supply the entire market?