Public Accounts Committee on April 22nd, 2010

[Terence Young, Conservative, Oakville, ON]

Thank you, Mr. Chair.

Madam Fraser, adverse drug reactions are the fourth leading cause of death in our society today. I'm talking about adverse drug reactions that occur in hospital with the drug given as prescribed, rather than in error, which is what the drug companies like to talk about when doctors make errors that are overdoses. A common reason that happens is that a patient is given a drug that is contraindicated for use with another drug they're already on, and someone doesn't know that it's contraindicated or they don't know that they're on that. For example, Lipitor, the world's largest selling drug, the top selling drug in Canada, is now contraindicated with Plavix, which is I think number five. They can be life-threatening if taken together.

Those of us who work in prescription drug safety were hoping that eHealth records would help prevent those deaths and injuries, but you're reporting here that there's a risk that the electronic health records systems will not be compatible across the country, so when a patient goes into hospital in another province, in an emergency, even if their record was available in one format, it would not be able to be understood in another format. As well, barriers to computerizing doctors' records may exist as well, so even if they were in hospital in an emergency situation and they got their medical record from their doctor, it wouldn't have all the information. That's a very serious problem, and it's a great risk to Canadian patients.

What should we do to help coordinate and make sure these systems can talk to one another, and that we get the best out of the system?

[Sheila Fraser]

The member is certainly correct that one of the major benefits foreseen from having these electronic health records is the prevention of these adverse drug reactions. Medical professionals will be able to know what the person is taking and will be able, hopefully, to have all the information needed as well to, for example, prevent duplication of very expensive testing.

There is agreement among the provinces on this blueprint that Infoway has put in place. The responsibility, of course, to meet that is up to each provincial authority. There are some provinces, Prince Edward Island being a good example, that actually do have electronic health records, but those may not be completely compatible with the blueprint that has been developed. So one of the questions is how that gap will be closed and how these records will be compatible so that there is a pan-Canadian solution to this.

[Terence Young, Conservative, Oakville, ON]

So we have a question, but we don't have the answer?

[Sheila Fraser]

We have a question. I think a lot of it is going to come down to funding of these projects across the country. Should the committee decide to look at this in more detail, that would certainly be one of the questions to ask Infoway.

[The Chair, Liberal, Shawn Murphy]

Mr. Shipley, you have three minutes.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Thank you.

I have just a quick one, and it is on chapter 3.

One of the things you don't talk about--or I'm missing it--is the ineffective oversight we have on projects. In 3.79, you give the example of West Block. There's partial funding allocated for a total project, yet that building is going to be closed down, whereas a project could actually start; we could bring in the required people, complete it, and get it done.

Second, before paragraph 3.58, you say “Project management practices are generally sound”, and yet I think for those of us who have actually been out in the real world, these sorts of ineffective, inefficient practices we have for doing the work are almost intolerable. Scaffolding goes up around a building, it sits there for two years, and nobody goes in it. I don't know how that project management can be seen as sound.

We have a building behind the Justice building. I don't know how many hundreds of thousands we spent to paint it--extraordinary means--and now, three years later, it's back to almost the condition it was in. I don't see that as good, sound project management.

You don't tend to make comments about this, and yet I think it is something all of us see every day. We see it as very frustrating, and I'm wondering if there's a course of action you could talk to us about for that.

[Sheila Fraser]

Mr. Chair, as we note in the report, we looked at the project management for certain buildings on Parliament Hill: the West Block and the Library of Parliament.

We didn't look at all the project management activities of Public Works. Should there be a hearing, those would be the kinds of issues you might want to discuss with them.

One of the big issues, though--and we have raised this on other occasions--is the way funding is given to projects. If it goes year by year, there are stops and starts. Certain members will know we have had very interesting and long discussions with other committees about accrual appropriations, multi-year appropriations, to ensure that when a project starts, be it the construction of a building or an IT project, all the costs are known to parliamentarians at the beginning, that they are approved, and then the project proceeds.

The way it is now, they essentially get the money perhaps for the scaffolding, but then they don't get the money to actually do the repairs. I don't know if that is applicable in that case, but they can get funds to dig a hole and then they don't get the funds to build the building.

We believe there is a real need to look at these large projects that extend over many years and resolve how the appropriations are dealt with in that case. I know there have been recommendations from other committees that this be done, and that might be an issue. I would encourage the committee to look at that with government again. I think that is also one of the reasons for many of these delays they're incurring.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Thank you.

[The Chair, Liberal, Shawn Murphy]

Thank you very much, Mr. Shipley.

Before we adjourn, do you have any concluding comments, Ms. Fraser?

[Sheila Fraser]

Thank you, Mr. Chair, for your interest in the report. It is very important to us that parliamentarians engage with us in the discussion on these audits. We do very much appreciate your interest and look forward to future hearings with the committee.

Thank you.

[The Chair, Liberal, Shawn Murphy]

On behalf of all members of Parliament, I want to thank you for your excellent work.

Before I adjourn, I want to announce that on Tuesday of next week we did originally have the Auditor General scheduled to appear before us to talk about her agency's estimates and her departmental performance reports in addition to her departmental report on plans and priorities. Because of an issue, she's not able to do that at that time. She's asked that it be rescheduled for two weeks later. The steering committee agreed to that.

It is too late now to schedule another performance report, and we do not have any ongoing reports that we're writing up. Therefore, the chair will not be calling the meeting on Tuesday of next week. Our next meeting is a week from today.

The meeting is adjourned.