Mr. Speaker, I am pleased to rise to make a few comments on what I believe to be a very important bill for Canada. Bill C-13 seeks to establish the Canadian institutes of health research.
By way of background so that hon. members will have an idea of some of the dynamics involved with the bill, the Canadian institutes of health research will create a series of institutes developed to link the research and health needs of Canadians. It is a very important concept. It means that we will make every effort to translate health research into health care for Canadians. This will improve the functionality, efficiency and effectiveness of health care. A very important principle is being espoused in the bill.
The institutes created under the Canadian institutes of health research will not be buildings. They will not be institutes that have bricks and mortar. In fact it is a virtual institute that will support the linking of researchers who may be located in universities, hospitals and other research centres to their colleagues in other institutions in other parts of the country and across all disciplines. In today's society linking people, not physically but technologically and through our communications vehicles, is extremely important to expand upon the synergy available to us so that people can share ideas and work for the common good of all Canadians.
A network of some 10 to 15 institutes will be established. It will bring together the top research minds to bear on the most critical health challenges and priorities of Canadians. There is no question at all that this is an important step for us to take.
One of the witnesses who appeared before the health committee described the institute as follows. This was echoed by many witnesses, but I thought this was well put. The witness said that this was a public body that would control millions of dollars, in fact about $500 million of research money, and would probably be “the most decisive institution in Canada with respect to the health of Canadians”. Many other witnesses also said that.
That should not be taken very lightly. This is a very important bill. Notwithstanding the fact that all parties in the House agree with the bill, they may have some concerns about some aspects of the administration of the bill. In fact, no witnesses came before the health committee to argue against the creation of the Canadian institutes of health research.
It is very significant. This will be the replacement vehicle for the Medical Research Council, which heretofore has been responsible for the granting of research moneys. We have to do this right, though. That brings me to basically the theme I want to talk about in my comments: who said other things at committee other than this is a great idea.
I thought it was very interesting that many of the witnesses represented the who's who of health care and health care research. They all came before the committee and they were talking about how important it was for their area of interest to be one of these new institutes.
We have to think about it for a while, but then we come to the conclusion that there are not enough institutes to provide for all people, all agencies and all groups in health research to have an institute. In other words there will be winners and there will be losers. That is an important aspect of the bill. As a result of the creation of these Canadian institutes of health research there will be losers. The losers will be fighting viciously to make sure everything they can possibly do is done to get their health research area on the agenda of the Canadian institutes of health research.
The very fact that there will be losers means that somebody's interest is not being addressed. It could very well be the interest of Canadians. It could be the interest of the broad majority of Canadians that may not be fully represented. It is a possibility. I do not anticipate that would be the case, but the fact is we will not be able to do everything through this new concept.
A number of other witnesses came before the committee that wanted to talk about the administration of the act which deals with the Canadian institutes of health research. When we consider how so many had come before the committee and praised the creation of this new body, there were some who had some other observations and concerns. Members should ask themselves why anyone would have concerns. What is the motivation?
There are some reasons. It could very well be that what happened under the Medical Research Council was a situation that they were not happy with. They did not want us to take one institution and roll it over into a new institution and be faced with the same kinds of frustrations or problems. In fact some of those concerns were expressed. We have to be honest. As legislators we have to ask questions about why they are raising these issues.
The president and chief executive director of the Canadian Healthcare Association, Mrs. Sharon Sholsberg-Gray, said in her testimony:
To further strengthen this transparency and accountability, we recommended that Bill C-13 include the provision for a parliamentary review every five years. Given what is at stake in terms of innovation, global competitiveness, the health of Canadians, the effectiveness of our health care system, and the enormous amounts of money that will be involved—we hope they'll be even larger amounts those predicted now—a regular parliamentary review seems necessary and appropriate.
It is a signal that something needs to be addressed. Many of these agencies obviously have longstanding linkages with the health care system, with Health Canada, with the Medical Research Council and others. They were obviously very cautious not to be critical, but in a very diplomatic way they were trying to raise issues which might suggest to legislators that we have to be careful about how we are doing this and to make sure that we get it right.
There was also an intervention by Dr. Mary Ellen Jeans of the Canadian Nurses Association who said:
We believe the criteria for the selection for the proposed institutes, for their evaluation and monitoring, should be articulated in the legislation. We'd encourage the addition of a parliamentary review process to ensure true accountability to Canadians. We recommend that it take place very five years.
The theme comes up again. In Dr. Jeans' response to some questions she referred to historical inequities and lack of balance in health research. It is a question that has been posed to legislators to assess what happened and what is happening in the Medical Research Council, and what it is we want to ensure does not translate into the Canadian institutes of health research. She said:
I mean, I would anticipate, five years from now, a significant increase in research that addresses caregiving, quality of life, relief of pain and other symptoms, coping with aging and chronic illnesses, and so on.
This is the vision of this group of caregivers, the Canadian Nurses Association. She went on to say that we should see that vision being reflected in the mandate and the actions of the Canadian institute of health research.
That is why they recommended a parliamentary review, so that they would have a place to go and tell legislators that they did not get it quite right and ask what changes could be made to make it right. That is why review and evaluation are critical. It was another reference to a concern about what has been going on historically and what should go on in the new institutes of health research.
I want to look at this issue from the standpoint of whether or not there was sufficient opportunity for parliament to have a review. Today the health critic of the Canadian Alliance rose to speak in favour of a five year review. I was absolutely shocked because just last night when I rose to put that motion in the House and ask for a vote on it, the whip of the Canadian Alliance looked me straight in the eye and said no. Unanimous consent was not granted by the Canadian Alliance, yet its health critic rose today and argued quite the opposite.
We need to know why it is that members of the Canadian Alliance can play political games with the health care system of Canada in parliament. Why can they not be consistent? Why can they not stand and be consistent in terms of what they believe in? If they believe in accountability and transparency, they should not have said no last night to the review by parliament. Canadians should know that when it suits their purpose they play politics with important issues related to Canadians. I think that is shameful.
Report stage Motion No. 56, which I had put on the order paper and which was in order, was not moved during report stage. The finance committee was meeting at the same time. I sat in my place at the finance committee and was unable to be here to properly move that motion. I came to the House during report stage debate, still having ample opportunity to put the motion on the table. All parties at that point agreed to provide consent to allow me to move that motion, but members of the Bloc Quebecois said no.
They said no for one simple reason, because my motion said that the review would be conducted by parliament. As we know, parliament as defined includes the House of Commons and the Senate. They withheld their unanimous consent to move this important motion related to accountability and transparency because they wanted me to amend the motion to exclude the Senate. They wanted me to say that the review would be done only by the House of Commons and not by the Senate, so I would have had to eliminate the word parliament to effectively exclude the Senate.
Here again are politics coming into play. I will not question the motivation of members of the Bloc Quebecois on why they wanted certain amendments. I am a backbench member of parliament. I came before the House to put a motion to amend the legislation so that the administration of the act dealt with the concern of witnesses and we would have a five year review of the administration of the act. The health minister, after consultation over several weeks, finally agreed and we worked out a way to bring in the resolution in a manner that would be constructive and useful for parliament to add to accountability and transparency.
Ultimately the bottom line result was that the Canadian Alliance, known then as the Reform Party, and the Bloc Quebecois said no. They both said no to transparency and accountability in parliament. They then said no to Canadians with regard to supporting the health care system and supporting research. It was all due to politics, and Canadians should know that.
During the review of report stage motions, and the critic for the New Democratic Party articulated this, a number of resolutions or suggestions were made on how to improve the bill. I thought there were some very interesting questions.
Under the bill the government will make order in council appointments to the Canadian institutes of health research, a governing body. Because they are order in council appointees, they are subject to the conflict of interest guidelines for the public service.
However, clause 10 of Bill C-13 says that the governing council may establish by bylaw an executive committee and other committees of the governing council. It goes on in paragraph 2 to say that the bylaw establishing a committee other than an executive committee may provide for the committee's membership to include persons who are not members of the governing council. In other words, in such an important body which will be responsible for about $500 million worth of health research expenditure, there will be people who are appointed by the governing council who in fact will not be covered by public service conflict of interest guidelines.
It was an important and valid discussion. Generally in the terms of reference guiding the objectives and the operations of the governing council, certainly something like establishing conflict of interest guidelines for people who are not order in council appointees is an important element. I am sure they will do it. The request was to put it in specifically and I did not disagree. It is on the record.
I am sure the governing council will understand because of the importance and the sensitivity of the institutes of health research, that these kinds of measures are needed. Conflict of interest guidelines are needed to ensure that inappropriate actions are not taking place with regard to commercialization or special interest groups infiltrating committees by virtue of their lobbying of members.
I understand that these people will be of the highest integrity. They will be the best in Canada, guiding the shaping of research in Canada. They will be beyond reproach.
We are talking about an enormous virtual institution that will be influenced daily. If hon. members do not believe that those people will have any influence on the decisions, why is it that so many of them came before the health committee to lobby for one of the institutes to be for their special interest? They came before the health committee for one reason, because they believe they have the opportunity to influence.
We should never risk exposing ourselves to undue influence particularly when it comes to matters of importance. It is not debatable. We have to make sure that all the tools are in place. When I conclude my speech I will outline how I feel that parliament will still have the levers, notwithstanding that we do not have a five year review.
The bill lays out for parliament and Canadians what the governing council will do. The call was that health research objectives, priorities, et cetera should not be tied up with the legislators. They should be independent and at arm's length to make sure that our health care givers, those who are involved in the science of research and development in our health care system, are the ones who will measure the priorities and the importance to Canadians and develop a vision that will not be driven by political interests. That is why it will operate at arm's length.
These are the buzzwords of some of the governing council's objectives: to exercise leadership; to create a robust health research environment; to forge an integrated health research agenda; to encourage disciplinary integration in our health research; to promote and assist in undertaking research that meets the highest international scientific standards; to address emerging health opportunities; to foster the discussion of ethical issues; to promote the dissemination of knowledge; to encourage innovation; to build the capacity of the Canadian health research community; to pursue opportunities providing support for the participation of Canadian science and international collaboration; and to ensure transparency and accountability generally.
The governing council will have the opportunity to run its own show. But as I said, we need to make sure that the vision of the governing council of the Canadian institutes of health research is compatible and consistent with the needs of Canadians and with the objectives and the visions of all the stakeholders in health care in Canada.
We already have mechanisms in place. In January 1999 the Public Policy Forum published a proposed governing structure for the Canadian institutes of health research in anticipation of the importance of this to Canadians. This might be the most important institution driving the health care agenda in Canada. We need to think about the governance model.
The Minister of Health is going to be the primary lead on this matter in terms of accountability to parliament. The Canadian institutes of health research are going to be responsible to the Parliament of Canada. The minister has the opportunity to make or to cancel the order in council appointments. The auditor general is going to do an annual review. His report will include tests of economy, efficiency and effectiveness.
The report also recommended a five year review and appearance before committees. We do have the annual review of the estimates. I believe committees will have the opportunity to have the chair of the governing council come before them to talk about the success the Canadian institutes of health research have had in meeting the health care objectives of Canada and of all Canadians.