Debates of Feb. 24th, 2000

Canadian Institutes Of Health Research Act

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Mr. Speaker, I am delighted to participate in this debate on Bill C-13.

At the very outset I cannot help but indicate to you, Mr. Speaker, a certain amount of cynicism about the process. Time and time again we were told by the members of the Liberal government that this bill was urgently needed. We were under considerable pressure at committee to get it through the whole process.

Interestingly, there were many occasions when Liberal members failed to show up for their responsibilities at the committee. In fact, there was a meeting where we could not proceed because no Liberal member chose to show up. We had that real push to get this through, yet the government could not even ensure that the process was followed with integrity.

I also have to indicate my cynicism around this bill. While we are debating a bill that parliament has a say on, the Minister of Health is out trotting across the country announcing money under the auspices of the Canadian institutes on health research.

We have had press release after press release. On January 11, 28 and February 4 the Minister of Health announced grants for research saying that they were under the MRC, soon to be renamed the Canadians institutes on health research. It was very cleaver.

We have seen parliament bypassed on many occasions and this is just another example of how little weight this place has when it comes to thorough review of legislation. That disregard for parliament and the democratic will was evident throughout the entire process on Bill C-13.

Earlier today we heard Reform members and other members who participated at the committee talk about how seriously we took the process at committee in terms of amendments and discussions with no credence or support from the Liberal members on that committee for that kind of participation. I think it is absolutely important to put that on the record.

When the bill was introduced, we in the New Democratic Party said—and I think other caucuses have said the same—that we support the concept behind the Canadian institutes of health research and we endorsed the principle of the bill at second reading.

However, we also identified a number of concerns that we felt had to be addressed at committee stage. We therefore participated actively in that process by listening to witnesses, seeking clarification and proposing amendments. In that regard, it is important on the part of everyone in the House to thank the dozens of individuals and organizations who either appeared before the committee or wrote to us with very thoughtful presentations and indepth analysis of the bill.

What struck me, and I am sure struck others who were at committee, was a recurring theme, an opinion repeated time and time again, to the point where we had to take it seriously. The theme was yes, but. It is a good idea on paper but how will it work? How can we be sure that the noble principles of the bill will be translated into action? That really is the essence of our concerns with the bill before us today and with the process that we are involved in today.

We all know what the bill attempts to do. We know it ends the Medical Research Council and establishes the Canadian institutes of health research. It appears to support a considerably expanded range and volume of health and health research in Canada. It deals with addressing a full range of health research priorities in the country today, from biomedical services to applied clinical research, to health systems and services research, and finally to research on the broader social and economic determinants of health that lie outside the system.

Who can disagree with that? Obviously that is something many of us have been saying for a long time. It is much needed in Canada today. On the basis of that stated objective, it is a bill worth supporting.

However, what we are left with is trying to answer the question: In terms of the details of the bill, are we sure? Have we been guaranteed that these noble principles will be put into practice? Is the bill prescriptive, clear and detailed about how this transformative approach to health research in the country will happen? Or, are we left with vague statements and unclear requirements that leave in doubt the application of the principles? That is exactly the situation we are dealing with.

I would point members to a very useful presentation we received at committee from a well-known health researcher and policy analyst in the country today, Bob Evans. He wrote a letter to the committee, dated November 19, saying:

My impression, watching mostly but not entirely from the sidelines has been of a continuing struggle between those genuinely committed to this broad view of the CIHR mandate, and those who would prefer to see an “MRC on steroids”—a vastly expanded program of basic biomedical and clinical research, with at best a nod in the direction of research on either the provision (and financing) of health services, or the more fundamental determinants of health embedded in human social economic and economic environments.

That point has to be addressed by the House today because we were unsuccessful in committee in terms of trying to convince the government to put more weight on the whole issue of research based on economic, social, cultural and environmental determinants of health and well-being.

Over and over again presenters mentioned how imbalanced the legislation was when it came to this very issue. A great deal of weight, a lot of words and a lot of emphasis on biomedical research and applied clinical research but only passing references to economic, social and environmental determinants of health.

We heard from many groups involved in women's health. We certainly heard from people involved in environmental health. I want to briefly quote from a document presented by the Canadian Labour Congress, which really captured the essence of this difficulty. It states:

—the fact is that there is no central focus given to the environmental determinants of health, no priority given to research on the prevention of ill-health and no mention at all of the importance of research into the causation of ill-health.

That reflects a very important gap in the legislation and one which has to be addressed.

We have a number of concerns. I have said that we support the principle, but we obviously have a number of concerns with the bill. Let me go through those concerns, because it will help to reveal how much disregard the government had for the process.

The bill mentions commercialization and in fact includes as one of its objectives facilitating the commercialization of health research. There is no need for legislation dealing with public health research to emphasize commercialization. There are other places where we deal with the question of the commercial advantage of business in the country, but surely our job in parliament is not to give any credence to the needs of private interests over the wishes of the public. We tried to amend the bill to get rid of those words about commercialization. We failed. The Liberals said no to that amendment.

On conflict of interest, there is no provision in this bill to ensure that people who are appointed to the board have no pecuniary or proprietary interests in the pharmaceutical industry or the medical devices industry. We proposed a clear conflict of interest amendment to ensure that kind of situation would not occur. What did the government do? It said no to that amendment.

We also tried to ensure that there was an independent process around ethics. We called on the government to put in place an independent ethics advisory board to ensure that we could guarantee the protection of human beings in all clinical trials of research projects undertaken. What did the government say? It said no.

We made proposals on some basic, fundamental issues.

We said that there should be in this day and age, given what the Liberals themselves have said, gender parity on the board. We thought that would be a normal assumption and that the government would gladly adhere to that principle of equality between women and men on appointments to the board. The government said no. Liberal members on the committee said no.

We did not win on that one, so we suggested mainstreaming in terms of a provision for the institutes of health research. What did the government do? It said no.

We then proposed a women's health research institute. The government said no.

We then proposed that the government address some of the other concerns by looking at ensuring that there was an institute on aboriginal health. We proposed an institute on occupational and environmental health. The government said no.

The devil is in the detail and that is why we have concerns with this bill and why we want the government to take seriously the need for amendment to ensure that this bill is a shining beacon when it comes to transparency and accountability.

Mr. Speaker, could I have the unanimous consent of the House to continue for two minutes?

[The Acting Speaker (Mr. McClelland)]

The hon. member for Winnipeg Centre has asked for the unanimous consent of the House to continue for two minutes. Is there unanimous consent?

[Some hon. members]

Agreed.

[Judy Wasylycia-Leis, NDP, Winnipeg North Centre, MB]

Thank you, Mr. Speaker. I appreciate the flexibility you have provided me on this very important bill.

We really want to support this bill because the principle is such an important one, but it is very difficult to give our blessing to a bill when the government refuses to address very fundamental questions which would ensure that the principles are translated into action the way they have been outlined and portrayed.

Why would the government not agree to some basic changes to the bill to ensure transparency and accountability? Why is there no provision on conflict of interest in terms of appointments to the governing council? That was supported by numerous organizations, including the Canadian Healthcare Association, the Canadian Nurses Association, the Canadian Medical Association, the Canadian Labour Congress, the Women's Health Research Institute, and the list goes on and on.

There was absolutely clear support for ensuring that this bill upheld some very fundamental principles around which there would be no questions of conflict between private greed and public need.

We are left with big questions around the future because there is not that kind of specificity in the bill. We would implore members opposite to consider amendments that would actually improve the bill and give people guarantees and the comfort that in fact we will transform the research agenda and improve and enhance Canada's public health care system.

[The Acting Speaker (Mr. McClelland)]

I will now give the floor to the hon. member for Compton—Stanstead, then we will hear a government member.

[Réal Ménard, Bloc, Hochelaga—Maisonneuve, QC]

Mr. Speaker, on a point of order. I apologize to the Progressive Conservative members. This has nothing to do with their speeches. I understood that we had agreed that, because of the number of motions we have on the Order Paper, you would recognize the Bloc Quebecois members, and then the Progressive Conservative members and finally the New Democratic Party member spoke.

Would you please explain the rationale for the order in which you intend to recognize speakers or what you expect that order to be, so that we may know where we stand?

[The Acting Speaker (Mr. McClelland)]

We discussed what the order would be. There is no formal order. I had said that there would be the opportunity for the government to respond. However, as is the tradition, every time there is a set of motions a member from each of the recognized political parties has the opportunity to speak. The hon. member for Compton—Stanstead will be the first speaker representing his party. Then we will recognize a member on the other side and then we will recognize the hon. member for Bloc.

I understand that the Bloc has many motions and from now until the end of the day we will keep that in mind.

[David Price, Progressive Conservative, Compton—Stanstead, QC]

Mr. Speaker, on behalf of my hon. colleague from New Brunswick Southwest, I rise to speak to the amendments he has put forward at report stage of Bill C-13, an act to establish the Canadian institutes of health research and to repeal the Medical Research Council Act.

I hope my hon. colleagues on all sides of the House will listen carefully to the motions that are being put forward and will give them every consideration when it is time to vote.

It is my belief that these motions will by no means take away from the bill, but in fact will add to its credibility. We could probably even say clarity at this point.

The government must demonstrate a commitment and respect for the principle of accountability through public access to research material and reports pertaining to public health issues.

The Minister of Health has given us a bill that is specific in its explanation of the organization of the CIHR. The CIHR will consist of a president and governing council. Together they will be responsible for the overall direction of the institutes.

The bill states that the members of this governing council will reflect the highest standards of scientific excellence. The bill further states that the appointments will be made by the governor in council; by definition, the cabinet and ultimately the Prime Minister. Here we go again. This is a very cozy arrangement and the very reason we should be concerned. In other words, cabinet and the Prime Minister will decide who will hold these positions.

The president and the governing council of the CIHR will hold these positions at the pleasure of the government and they will be up for review every five years. The motions before us speak clearly to the re-examination of the formula we currently use for appointments to positions such as these.

I believe the motions before us today offer a distinct opportunity to move beyond partisan politics. We must put in place a process that is both transparent and principled, a process that will be dependent on the credentials of the highest order.

As I read the bill it became increasingly evident that I was on familiar ground. The bill projects Jean Charest's plan for Canada's next century, the platform for health care that I ran and won on in the 1997 election. I cannot fault the minister for coveting the plan of the Progressive Conservative Party because our plan is visionary.

As Mr. Charest said, we should continue to adopt new medical treatments, new pilot and experimental programs that would provide Canadians with state of the art, cutting edge services and treatments, and new technologies to improve the access to care in rural and remote areas of the country. He said there would be programs to test new integrated delivery systems aimed at providing health care based on the the highest quality of health practices. He spoke of the development and maintenance of a Health Canada worldwide website on the Internet to provide a state of the art health care information system, including advice on the prevention and treatment of illness to help hospitals and researchers link their knowledge bases in the country. Is that not the task of the new agency?

In 1997 the Progressive Conservative Party said that it would create a national institute for health with membership drawn from the health care field. It would have a board that would be co-chaired by the federal minister, along with the provincial and territorial ministers. The Progressive Conservative platform in 1997 laid out the right process to save our health care system. It was one of vision and challenge.

The Liberal policy is a disaster for our research institutions and probably the major cause of the brain drain, particularly on top of very high taxes. Are members aware that people with cancer are being sent to the United States for very high-priced treatment?

Today, they are forced to go after those brains for the new technology and superior equipment that we should have here.

Members of the Progressive Conservative Party support Bill C-13 in principle since we had already written most of it. However, the government now, more than ever, is under scrutiny by the Canadian people for its accountability, responsibility and lack of transparency and it might do well to give consideration to the motions before us today, which pertain to these very issues.

[Paul Szabo, Liberal, Mississauga South, ON]

Mr. Speaker, I am pleased to rise to speak to the report stage motions in Group No. 1 to amend Bill C-13. As a member of the health committee I had the opportunity to listen to the excellent witnesses who appeared before the committee.

Fourteen institutes of health research will be established. It turned out to be a bit of a love-in early in the testimony of the witnesses. Many groups and organizations appeared before the committee to lobby with regard to issues concerning cancer, women's issues, aboriginal issues and so on. It became very clear that there are far more demands for health research dollars in specific areas than there will be research institutes. That means that it will be a very difficult process for the governing council of the new Canadian institutes of health research to determine how to properly structure those research institutes.

The previous NDP speaker, who did an excellent job in representing her views on the committee, suggested that the government was opposed to setting up specific institutes for women, for aboriginals and so on.

According to the bill that is the responsibility of the governing council. It is not a matter of the government being opposed to any particular research institutes or promoting any particular research institutes. Those are the responsibilities of the governing council.

The NDP member also raised a twofold issue with regard to conflict of interest. All order in council appointees will automatically be subject to the public service conflict of interest rules. However, the member was quite right to point out that there was an extension in this regard to the extent that there would be appointees by the governing council which could include the executive committee and the various advisory and standing committees of the institutes of health research and of the governing council. They will not specifically be subject to any conflict of interest guidelines.

It would therefore seem appropriate to ensure, as with every agency exercising authority in terms of government funding, that appropriate conflict of interest guidelines be established. There is a generic clause in the bill that requires them to put into place all good management practices. It is included implicitly although not as explicitly as the member requested.

Once we were beyond the lobbying for who wants to have health research institutes, the issue for a number of witnesses changed to that of accountability and transparency. As the previous speaker mentioned, it is a very important issue with respect to all legislation with which the House deals.

With regard to the government model for the Canadian institutes of health research, the Public Policy Forum published a document called “Proposed Governance Structure for the Canadian Institutes of Health Research” on January 4, 1999. It articulated excellent points for consideration, which were taken into account by the advisory committee to the government, with regard to structuring the legislation and designing the governance model for the CIHR.

It laid out six principles of a good governance model and No. 3 was accountability and transparency. It stated:

Those within the CIHR, those who make decisions about funding the CIHR, and the Canadian public in general, must be able to hold accountable those in whom the responsibility for health research has been entrusted. The lines of accountability must be clear and clean. Making that accountability clear is the transparency that is deemed fundamental to the CIHR.

There are many references in this document with regard to accountability and good governance, transparency, et cetera. It is an issue to which we are very sensitive.

A number of interveners before the committee decided to raise specifically some of these issues. Dr. Susan Pisterman was one such intervener. The Canadian Nurses Association, the Canadian Medical Association and the Canadian Health Association all raised the same theme with regard to transparency and accountability.

I have a couple of interesting quotes. To put it in context, the first one is from Dr. James Turk, executive director of the Canadian Association of University Teachers. His final issue was commercialization and he said:

—there is a potential conflict of interest of members of the governing council, which is not addressed in this bill. Quite frankly, no one who represents major private commercial interests should be able to be appointed to the governing council.

This matter is covered by the conflict of interest guidelines to which order in council appointees by the governing council will be subject. I believe that concern has been appropriately addressed. However, as I said earlier, any other appointees by the governing council who are not covered by the public service conflict of interest guidelines should be adequately covered by good management practices. He went on to say:

This is a public body that will control millions of dollars of research money and will be probably the most decisive institution in Canada with respect to the health of Canadians.

There is no question about that. The Canadian institutes of health research will be responsible for peer review and consideration of about $500 million worth of grants. In view of its size and importance there is no question that accountability and transparency issues will be carefully taken into account by parliament to ensure that they are in place. I am very confident about that.

Other concerns were raised. The Canadian Health Association and its spokesperson, Mrs. Sharon Sholzberg-Gray, also raised issue about the fact that the CIHR president and the chairperson of the governing council would be the same person and that there should be a review in that regard. She also recommended that to further strengthen transparency and accountability Bill C-13 should include provisions for a parliamentary review.

There was consistency with regard to those who came to talk, not just about the importance of having an authoritative body to manage such an important area as health research in Canada but to ensure that if there were ever any problems with regard to the Medical Research Council, or any others, the mechanisms are in place so that the public and parliament are comfortable with the provisions of the bill.

I want to conclude my comments. I support the bill. I support those who came before the committee to compliment and to congratulate the government with regard to the structure of the governance model being proposed. I am very sure the concerns raised by a number of the witnesses with regard to issues such as accountability and transparency have been adequately dealt with in the bill and will be taken care of as we move forward to establishing probably one of the most important health institutions in Canada.

[The Acting Speaker (Mr. McClelland)]

It is my duty, pursuant to Standing Order 38, to inform the House that the questions to be raised tonight at the time of adjournment are as follows: the hon. member for Churchill River, The Environment; the hon. member for Halifax West, Visible Minorities.

[Hélène Alarie, Bloc, Louis-Hébert, QC]

Mr. Speaker, I am pleased to rise in the House to speak to Bill C-13 at report stage. We are dealing with the first group of amendments.

This bill is aimed at officially creating Canadian institutes of health research to organize, co-ordinate and fund health research at the federal level. These institutes will replace the Medical Research Council and will receive additional funding totalling $65 million for the 1999 fiscal year and about $500 million until 2002.

What will the institutes of health research do? They will promote new ways of conducting research on biomedical themes and also on issues more directly related to social sciences, which is something totally new.

Moreover, these institutes will be virtual, since they will allow researchers in universities, hospitals and other research centres in Canada, as well as university students, to communicate with each other and to share information electronically.

The institutes will have various themes on which they will be able to focus their research, including ageing, arthritis, musculoskeletal development, cancer, molecular biology—a new area of research—the health of children and their mothers and the relationship between the two, clinical assessments, technology assessments, heart disease, and many more. They should also look at new genetic and reproductive technologies. These themes will be studied from a social perspective.

The mandate of these institutes also includes other interesting and innovative elements. Ethical issues are to be taken into consideration.

I am always surprised when this issue is raised, because the feeling is that, in the scientific community, ethics are at the forefront. It seems however that, with the new developments in science, this issue will become more pressing.

Emphasis will also be placed on the need for integrated health research with the co-operation of several groups: various organizations, women's groups and governments currently involved in research. This will be an important element in the future. The approach is clearly multidisciplinary.

Moreover, the institutes will not be dedicated, which will allow them to be more flexible and to alter their priorities to adapt quickly to the changing nature of society and the fast-paced developments in the research field. This is in response to the OECD, which has been urging Canada since 1993 to increase its investment in R and D.

It is expected that the health research institutes governing council might start its activities as early as April 2000, in keeping with the wishes of the government and the scientists who are insisting on this timeline.

The Bloc Quebecois, whose support for increased R and D funding is unwavering, salutes the efforts of the scientists who were involved in the drafting of the bill to ensure they would have access to innovative tools to improve the dissemination of health information and facilitate the development of cutting edge technologies in this area.

However—and this is significant—in its present form, Bill C-13 might encroach on provincial jurisdiction over health. The Bloc Quebecois cannot support the bill as it is currently worded. The problem is not the creation of the institutes per se. R and D falls under residual powers and, as such, is theoretically subject to federal jurisdiction. The problem comes from the possibility of direct encroachment on provincial jurisdiction in the area of public health care, without any prior earnest consultation with the provinces.

This is why the Bloc Quebecois is proposing a series of amendments mainly designed to highlight the importance of respecting and sharing jurisdictions, and to reaffirm the primacy of provincial jurisdiction in the area of health.

In addition, the Bloc Quebecois supports increased investment in health research, and it is vital Quebec receive its fair share of federal research and development funds, especially since, historically, Quebec has received only 14% of federal spending on research and development on infrastructures.

It is particularly noteworthy, however, that we receive about 30% of funding for researchers awarded on the basis of an evaluation by their peers, because this funding is awarded on the basis of merit. This means, therefore, that our researchers are productive in Quebec and excel in such fields as mental health, cancer research, genome research and biotechnology.

Although the multidisciplinary vision of Bill C-13 is commendable, it is unacceptable that the provinces were not given a major role. Respect for Quebec's jurisdisction should be at the heart of any intervention in the field of health. This is why we must oppose the bill, if our amendments are defeated.

The government is doing a good thing by investing more money in research now, but there is no need to lose sight of the need to reinstate the transfer payments to the provinces. In fiscal year 1999-2000, the shortfall in social transfers to Quebec is estimated to be nearly $1.7 billion. Of this amount, Quebec is denied nearly $850 million annually in the area of health.

We supported the principle of Bill C-13, we support the flexible and multidisciplinary structure, the increased funding to research and development, which could make researchers feel more secure and slow down the brain drain. However, our basic conditions are that the government re-establish transfer payments and respect provincial jurisdictions.

Given the events we have witnessed of late, Bill C-20, which denies Quebecers' basic rights, and the number of gag orders we face with the clarity bill and the concerns we have about the democratic process with regard to this bill, I move:

That the House do now adjourn.

[The Acting Speaker (Mr. McClelland)]

Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

[Some hon. members]

No.

[The Acting Speaker (Mr. McClelland)]

All those in favour of the motion will please say yea.

[Some hon. members]

Yea.

[The Acting Speaker (Mr. McClelland)]

All those opposed will please say nay.

[Some hon. members]

Nay.

[The Acting Speaker (Mr. McClelland)]

In my opinion the nays have it.

And more than five members having risen:

[The Acting Speaker (Mr. McClelland)]

Call in the members.

(The House divided on the motion, which was negatived on the following division:)

Division No. 751

[The Speaker]

I declare the motion lost.

[Keith Martin, Reform, Esquimalt—Juan de Fuca, BC]

Madam Speaker, it is a pleasure today to speak to the amendments to Bill C-13, the CIHR.

I want to publicly congratulate Dr. Friesen on the great work he has done in pushing this through. I also want to make some comments about my friend from the NDP, the health critic, who also brought up some excellent points that were ignored in committee and to which answers were not forthcoming.

Quite frankly, when I sat on the committee last year as the health critic, we as a party were firmly in support of the essence of the bill, the organization of it and the public-private partnership notion. It had a great deal of foresight. Dr. Friesen and his colleagues deserve a great deal of credit for that. It is a good idea and something that we in the Reform Party support.

However, a number of very constructive solutions that our party put forward at committee stage were repeatedly shot down. Why? Because once again the committee demonstrated very clearly that it was not demonstrating the autonomy that it ought to have if it was going to have credibility as an institution.

Committee members made amendments that would have strengthened the bill and allayed the concerns of the research community. These amendments were universally defeated by the government without, I might add, a great deal of forethought. The amendments put forward—some by the NDP, some by the Reform Party and some no doubt by other opposition parties—would have strengthened the bill and made it better. However, those amendments were defeated because they came from the opposition, and I think that is a sham.

Unfortunately, this takes place far too often in committees. Committees are supposed to be an avenue where members from across political parties can negotiate, discuss and debate issues related to bills in a manner that is largely beyond partisanship. The health committee chose not to pursue that course on a bill which could be enormously supportive of the research community and of the health and welfare of Canadians.

The organization is fairly good. We support Dr. Friesen's contention and promise that a maximum of 5% of the moneys allocated toward research will go toward administration, making this a lean, mean organization, one where 95% of the money is spent on the hard edge of research, which we support. In order for this to happen, I put forward an amendment on behalf of the Reform Party but it was not accepted.

Another important issue is to ensure that basic research, a fundamental aspect of research in Canada, would be secured and that 20% of the money that was available would be proportioned directly to basic research.

One of the problems of involving a public-private partnership is that basic research, which does not have any short term to intermediate term benefit and no observable, concrete benefit in terms of profit-making for the private sector, would not be adequately funded in Canada. Dr. Polanyi, our Nobel prize laureate in chemistry, and other researchers, sent letters to all committee members saying that this was very important. We put forth an amendment to ensure that at least 20% of the money allocated to the CIHR would go toward basic research but that was defeated.

There are no assurances in the bill that basic research will be financially supported, basic research that may not have the support of the private sector. This is a flaw in the bill which I hope the government will rectify as soon as possible.

We also found that there was not enough support for conflict of interest provisions, which the NDP health critic talked about very eloquently. These provisions could affect the decision making and allocation of funds through the CIHR. This needs to be addressed and I would ask the government to do that.

I have further issues that need to be addressed in the bill for the sake of research in the country.

First, at least 20% of the money that is available should go toward basic research. I challenge the new CIHR to investigate naturopathic substances. As a physician, one of the problems we have in the practice of medicine is trying to incorporate naturopathic substances. We know some of it has a placebo effect, is not useful and is not backed by any science. Others have a demonstrative therapeutic effect on people but we do not know if it is a placebo effect or if it is based on good science. The medical community would love to know which naturopathic substances have a therapeutic effect and which ones do not.

Pharmaceutical companies are not prepared to engage in the roughly $500 million required to determine if a substance has an effect. Therefore, it would be up to organizations like the CIHR to engage in a public-private partnership to see which of these naturopathic substances have an effect and which do not. This would be fascinating.

It is frustrating to see substances such as EDTA being used by people in Canada and the United States with allegedly profound impacts on cardiovascular disease when there is not enough evidence to show whether it truly works or whether it has a placebo effect. If it does not work, then we should know about it. If it does work it could have a profound impact on lessening the need for surgical and non-surgical interventions in treating cardiovascular disease. Statements have been made by patients indicating that this has had a profound impact on their health and well-being. I have no factual evidence to back this up and no scientific proof that substances such as EDTA work.

St. John's wort can work very well for people with depression. This is the impression we have and it has worked on patients. However, we would like some scientific basis as to why these things work. It would certainly help medical practitioners in Canada.

I would also like to bring up the issue of research and how moneys are allocated. Too often moneys are allocated on the basis of special interest groups. The interest group that screams the loudest gets the most money.

My colleague from Vancouver North Shore has done a yeoman's job in bringing the issue of prostate cancer to the forefront. For many years prostate cancer did not get the funding it warranted based on the number of people it affected. Similarly, breast cancer did not get the funding it required based on the number of women it affected.

We should base the research, and the moneys that are proportioned to it, on the morbidity, mortality and economic effects a disease has on society. It should not be based on the group that screams the loudest.

The House might be interested to know that unipolar disorder or major depression will have a profound effect on our country in the future. In fact, it will be the second leading cause of disability in the next 20 years. Just imagine major depression being the second leading cause of morbidity in our country.

Another issue our policy makers are ignoring is the impact that psychiatric disorders, particularly dementia, will have on our health care system in the future. There is not enough leadership on this issue. I plead with the Minister of Health to meet with his ministers to look at what can be done today to address the future problem of dementia. As we get older the issue of psychiatric and dementia problems in the geriatric population will have a profound impact on our health care dollar. If we do not put in place today the tools to deal with it, we will be caught in a very difficult situation in the future.

I will now put a plug in for my private member's motion that passed in the House in May 1997 for the national headstart program. I know it was supported by members across party lines, but we need a spark to ignite it. It will save the taxpayers billions of dollars. It will save thousands and thousands of children in the country. It will deal with issues such as fetal alcohol syndrome and fetal alcohol effects. It will reduce teen pregnancy by 40%. It will keep kids in school longer. It is something that will benefit children.

Our party is prepared to work with members from across party lines to put this into action. I implore the relevant ministers to call their provincial counterparts in justice, health and human resources and work together to put a national headstart program in place that will benefit all Canadians.

[Jocelyne Girard-Bujold, Bloc, Jonquière, QC]

Madam Speaker, I am pleased to be able to speak today in the debate on report stage of Bill C-13, the short title of which is the Canadian Institutes of Health Research Act. I would like to congratulate my colleague from Hochelaga—Maisonneuve for the excellence and relevance of his speech this morning.

My pleasure at being able to speak on the institutes of health research stems from my very longstanding interest in this matter. As far back as 1997, I wrote the federal Minister of Health submitting a medical research project in the area of genetics that had been prepared by a leading group of researchers in the region I represent.

At that time I asked him to examine the merit of the proposal in order to award it some funding. At that time, unfortunately, the Minister of Health informed me that there was no money.

Last June, I again wrote the Minister of Health, inviting him to take advantage of being in my region to meet a team of researchers interested in the possibility of a virtual research institute which might meet their needs.

My party and I have long been calling for a fair share of R and D investments for Quebec, and if these were to benefit my region, all the better.

I would like to conclude this overview by mentioning that last week I sent a letter to the Minister of Health in which I pointed out my disagreement with federal government cuts since 1993 in the health sector and with the longstanding unfairness in the disbursement of federal research and development funding in Quebec.

I then observed that of course we would respond favourably to an opportunity to receive our fair share of these new investments and to provincial jurisdiction over health being respected.

At this time, I also wish to thank the member for Hochelaga—Maisonneuve for giving me a prime spot in committee during clause-by-clause consideration of Bill C-13.

I used the opportunity to invite two researchers from my region to appear as witnesses. Dr. Marcel Mélançon, director of Quebec's genetic and ethical research group at the Université du Québec à Chicoutimi, and Michel Perron, director of the ECOBES research group at the Cegep de Jonquière, which is studying the living conditions and needs of populations, pointed out that expertise in the Saguenay-Lac-Saint-Jean region in the field of genetic determinants in the health of the population is very promising.

They also reminded committee members that it was important to consolidate scientific expertise in the regions and to promote the integration of researchers and interdisciplinarity. Mr. Perron said that it was essential to support the training of research graduates from the regions and that incentives were necessary to keep them in contact with regional health problems.

Mr. Mélançon testified that project evaluation should be done by peers, i.e. other scientists, and that it was essential that a single committee of experts not be given sole authority.

CIHRs should ensure that science is conducted with conscience and that it serves the public's best interests. The contribution of normative social sciences such as ethics and law should not be neglected. This is why he was saying that CIHRs should have ethics committees or even that an institute dealing exclusively with ethical issues in research would be totally justified.

It would be good if people outside the scientific community, sometimes called lay persons, could have their say, without interfering with strictly technical decisions, so that the wishes and concerns of the people can be heard and so that scientists are not isolated in their ivory tower.

My party, the Bloc Quebecois, and I have long supported the idea of reinvesting in research. The Bloc Quebecois supported the principle of the bill at second reading.

Even though we agree with the principle of the bill, it does not mean that we are willing to accept it as is. The Bloc Quebecois has proposed amendments which, if adopted, would make the bill acceptable. I truly believe in the importance of this bill and I think it is possible to amend it to make it better.

My colleague, the member for Hochelaga—Maisonneuve, has brought forward essential amendments, which would recognize the provinces' jurisdiction in the area of health and which would subject CIHRs to a consultation process with the provinces. It is crucial that the bill be more explicit with regard to the importance of treating the regions fairly in allocating the research institutes that will be created.

I will briefly summarize the amendments brought forward by the Bloc Quebecois. Specifically, the first group of motions is comprised of 11 amendments, which clearly specify that the bill is about health research, not about a potential expansion of mandates beyond that research.

The idea is to ensure that decisions about the choices and principles underlying health networks and services to the public come under the exclusive authority of the provinces, as provided by the Constitution, which the Liberals claim to protect when in fact they are violating it through increasingly more unacceptable infringements on provincial jurisdictions.

We are simply asking that the bill allow the establishment of the institutes while respecting the division of powers.

This is why we insist on these amendments, which seek to clearly indicate that Bill C-13 is about health research. Again, it is not the establishment of institutes that poses a problem to the Bloc Quebecois, but the possibility of infringement on a provincial jurisdiction, namely health services to the public, without meaningful consultations with the provinces.

It is essential that the federal government make it clear that it has no intention of using this bill to create parallel structures and that it supports the initiatives undertaken by the provinces.

In conclusion, the Bloc Quebecois is prepared to co-operate with the federal government to amend this bill, so that it will truly serve health research while also respecting federal and provincial jurisdictions, for the benefit of the public's health, and so that the region of Jonquière, which I have the honour of representing, can benefit from it. In our region, we have top researchers who, in spite of limited funding over the years, have made their mark at the local, provincial and national level.

Therefore I call on the government to pay very close attention to the Bloc's amendments. If it does, we will be pleased to support its bill. But if the government does not do that, we will unfortunately have no choice but to oppose the bill.

[Francine Lalonde, Bloc, Mercier, QC]

Mr. Speaker, it is extremely important that the Bloc Quebecois be here to speak to this bill.

While this may also be true of other provinces, we all know that, in Quebec, research, and health research in particular, has been extremely hard hit by the cuts made by the central government. We have just gone through a period when transfers were cut by some 40%. Universities have seen their budgets reduced. We has been hard to provide training to new researchers.

Yet, Quebec has continued to contribute more than Canada, allowing Canada to build up its resources, which, as we now know, have become surpluses the importance of which we will find out on Monday.

As a result, while graphs on the growth of health research in the United States showed an increase, those on health research in Canada for the same period showed a decline. It was urgent for the Canadian government to invest in health.

We have nothing against the Canadian government investing in health, on the contrary. But how does it go about it? It decides to change the structure. Instead of putting money back into the centre for biomedical research which had been funding and supporting, all over the country, groups that may also find other funding sources and thrive, as was often the case in Quebec—Quebec and its research groups are often cited as examples—the federal government has seen fit and necessary to centralize biomedical research through this legislation.

Some may argue that these are virtual centres. True, but the intention is clear. That is why one the Bloc's amendments seeks to change a paragraph in the preamble of the bill.

On page 2 of the bill it states, and I quote:

Whereas Parliament believes that health research institutes should be created to coordinate, focus—

I did not invent the word “focus”.

—and integrate health research based on

When they talk about co-ordination, one might wonder, because this usually involves independent entities. They use the word “focus” in reference to research, but focussing is not always necessary; sometimes complementarity is required, and teams working in different directions may, at some point in time, through healthy competition, achieve results faster. This bill however seeks to focus and integrate health research.

I know that distinguished people have worked on that issue, but we are here to fulfil our responsibilities as politicians and, in politics, one cannot rely on politicians and deputy ministers fits of generosity. We read the enactments. If we did not read them and report what we found in them, we would not be doing our job.

Too many extraordinary efforts have been made in the field of biomedical research in Quebec, and too much creativity and genius has been put into not only discovery but also preparation and organisation processes to let the federal government step in with its maple leaf and centralise and integrate health research when money is being invested.

It is totally unacceptable. There is no doubt that those who drafted this bill knew that it was totally unacceptable to Quebec, but they also knew that the research industry has become exhausted because of lack of funding and that it needs money. We do understand that. But it is our responsibility to say that we will not agree to anything just because we need money. Otherwise, we would be saying that the government was right in doing what it has done since 1994, which was to empoverish the provinces, and particularly Quebec, when we all know how the health budget was treated the last time. It would be saying that the government had been right, because it would allow it to take control over the centralization and integration of health.

This clearly shows the importance of the Bloc Quebecois' presence here.

Under such conditions, Quebec's opposition is not surprising. I am sure that nobody is happy about it, because we all know very well that we need the money, but we cannot easily give up what could be called community ownership. It would be utterly unacceptable.

Although its authors' intentions are praiseworthy, this bill is dangerous and unacceptable as it stands, and the Bloc will say that it is dangerous and unacceptable. Would it be so difficult for members opposite to accept to take away the words “to centralise and integrate the research”? I would be very surprised if they accepted to take that passage out.

What is happening with Bill C-20 can be seen in a general way in the attitudes. I know that the members opposite are laughing, but I urge them to try to understand that the people of Quebec, its representatives, the National Assembly and all those who defend our common heritage cannot understand that, for this country that they claim to care for, they do not accept to make amendments that are only legitimate, normal, necessary and minimum.

We will therefore strongly oppose this bill.

Business Of The House

[The Acting Speaker (Mr. McClelland)]

I inform the House that under the provisions of Standing Order 30, I am designating Thursday, March 2, 2000 as the day fixed for the consideration of private member's Motion No. 211, standing in the order of precedence in the name of the hon. member for Churchill.

This other period set out for the consideration of Private Members' Business will be held from 6.30 p.m. to 7.30 p.m. and the House will then move on to the adjournment proceedings pursuant to Standing Order 38.

It being 5.31 p.m., the House will now proceed to the consideration of Private Members' Business, as listed on today's order paper.