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.
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
More global information was coming to us through the Health Canada ad hoc committee, in terms of what they were able to supply.
On the ground, had our central radiopharmacy been able to access more generators, then they certainly would have done so and would have been able to supply us with more product. We were short product for the entire time of this shortage.
Liberal
Omar Alghabra Liberal Mississauga—Erindale, ON
Did you read the report that was done by the Canadian Medical Association Journal entitled, “Canada's Nuclear Fallout”, which talks about the availability of alternate supplies, and that the other manufacturers felt they were not really consulted and that they could actually provide supply that would be enough to cover the shortage?
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
This is the piece that was published by the CMAJ just this week? Is that correct?
February 5th, 2008 / 12:45 p.m.
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
I was provided with it this morning by the CMA and I have reviewed it. I think what is important to understand is that given adequate notice, given the time to ramp up supply and bring the material into the country, then yes, they could have presumably done so. But in the situation we were in, in December, they could not have possibly met the needs of the country.
Liberal
Omar Alghabra Liberal Mississauga—Erindale, ON
I agree. So you bring up the issue of adequate notice and you also--
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
I actually bring up the issue of planning.
Liberal
Omar Alghabra Liberal Mississauga—Erindale, ON
Planning. That's an even better word. You also talked about the fact that there was no formal channel of information with Health Canada and that in fact you took the initiative to contact Health Canada.
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
We contacted Health Canada on a separate issue, and that was implementing the supply of sodium fluoride for bone scanning.
Liberal
Omar Alghabra Liberal Mississauga—Erindale, ON
All right.
You talked about inadequate planning. Who, in your opinion, should have been responsible for planning?
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
I think the community has learned a lot from this event. I believe it is the responsibility...I guess maybe of all of us. We need to be able to assure ourselves that there is security of supply. That is why we are anxious to move forward with Health Canada and the other parties concerned to look at this event, look at what we need to learn from it, and ensure that it doesn't happen again. I don't think right now that we can point our finger at one person and say that person should have been responsible for security of supply—
Liberal
Omar Alghabra Liberal Mississauga—Erindale, ON
I'm not even talking about a person. I'm not asking for a name.
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
—or a company.
Liberal
Omar Alghabra Liberal Mississauga—Erindale, ON
I'm asking for an entity. Who should have been responsible or should be? And do we have a plan right now?
Let's bring it back to what we were trying to accomplish, which is to avoid having this issue surface again. Who should have been planning, and do we have a plan right now?
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
I believe we have a plan to work towards a plan at the moment. I think it would be disingenuous for me to say we have everything covered and are all ready to go, and that tomorrow, if Chalk River shut down, we wouldn't be back to where we started from. We would be there again.
It may be that some of the European manufacturers have ramped up a bit and could fill a little more of the hole, and it wouldn't be 15% but it might be 30% or 35%.
Do we have a plan to ensure that the generator manufacturers have an uninterrupted supply of molybdenum, which is what they require to ensure that we then have an uninterrupted supply of generators? No, we do not. We will be working towards that plan.
Conservative
The Chair Conservative Leon Benoit
Thank you, Ms. Gulenchyn.
Thank you, Mr. Alghabra.
We'll go now to the government side, to Mr. Anderson, for five minutes.
Conservative
David Anderson Conservative Cypress Hills—Grasslands, SK
Thank you, Mr. Chair.
I should ask Mr. Alghabra if he can confirm that he actually wrote those questions himself. I see he was using his BlackBerry, and we're hoping he wasn't getting them from somewhere else.
Liberal
Omar Alghabra Liberal Mississauga—Erindale, ON
They're off the top of my head, which is something you're not used to, David.
Conservative
David Anderson Conservative Cypress Hills—Grasslands, SK
Ms. Gulenchyn, I'd like to come back to the fact that health impacts were already taking place by the time Parliament acted, in spite of what Mr. Perry wants us to believe.
I should also point out that Mr. Perry hasn't been entirely clear on whom he represents. He was an NDP cabinet minister in British Columbia for three years, I think, in the 1990s. I would suspect he's here for more than just his respect for Parliament, as he said.
We have a story in the Hamilton Spectator from December 13. It said:
The four city hospitals that perform imaging procedures—McMaster, Henderson, Hamilton General and St. Joseph's Healthcare—see about 60 patients a day.
When the shortage hit, that had dropped to 12 patients already.
You've talked a bit about the other 48 cases. Some of them would not have involved essential treatments, but it is clear that there was an impact. It was already taking place. People can't say it wasn't. We were getting anecdotal evidence of nuclear health care people being sent home because they didn't have access to the materials.
Can you comment on that a bit further?
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
Yes, those were my numbers, and that was me in the paper. I underestimated the number of procedures we were doing across those four hospitals. It was actually 90 procedures that we were doing a week.
In that first week, we did drop down to that number of 12. Fortunately, due to the tremendous efforts of my staff and also of our central radiopharmacy, we were able to bump that up and do a bit better in the second and third weeks of the crisis. We ended up doing about 40% to 50% of our workload, which was about what the rest of the centres who had access to product were doing.
I believe that by triaging we did all the tests we absolutely had to do. I think we got them all done in Hamilton. But I know that other centres literally shut their doors, and there were tests that didn't get done. There were patients who required lung scans for the diagnosis of pulmonary embolism where there was not access to CT services, and those studies didn't get done. I have not heard that those patients suffered any harm as a result of that.
Again, taking a step back to the diagnostic process, which begins with a patient complaint followed by a history and a physical and a good physician assessing what the risks and probabilities are, people make decisions in the absence of diagnostic tests. They don't just stand there and say, “I'm not going to do anything.” They treat people with the best ability they have.
To the best of my knowledge, I am not aware of any patient who actually died or suffered a serious event as a result of this crisis, because I think we were managing reasonably well up until the time Parliament acted and the reactor was turned back on.
Can I say for certain that didn't happen to anyone across North America? No, I can't say for certain that it didn't happen.
Conservative
David Anderson Conservative Cypress Hills—Grasslands, SK
We did have someone approach us after one of the meetings and make the point that his wife was one of the people affected by that and he felt it had made a huge difference in her health. So there are people who believe that.
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
I'm sorry to hear that.
Conservative
David Anderson Conservative Cypress Hills—Grasslands, SK
Did you see any projections at all of what the consequences would have been had that reactor not come back online until the second pump was installed, which was just this past weekend?
Medical Chief, Department of Nuclear Medicine, Hamilton Health Sciences and St. Joseph's Healthcare Hamilton
I didn't see any formal projections of what would happen. We were making estimates as to what would happen based upon the number of generators that were coming in from alternate sources. What we did know is that one of the major suppliers would not be supplying us with anything. That happens to be the one that actually supplies my radiopharmacy with their generators.
We anticipated that unless they could source them from an alternate supply, we would have been completely out of business right across Hamilton by the first week in January. That was why we worked so hard in order to use the cyclotron, which for us was an alternate source of radiopharmaceuticals, to get into place some options for our patients.