Debates of Nov. 23rd, 2004

Supply

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, with respect to the earlier point the hon. member raised with respect to the registry of drugs, I will take her suggestion under advisement. I think it is an excellent suggestion. We will consider it. We do need an independent institution looking at some of these serious issues.

With respect to adverse drug reactions, I recognize that manufacturers and suppliers have an obligation and are mandated to report once they know of adverse drug reactions post-approval of the drugs. However, reporting by medical practitioners and consumers is of course voluntary. As I said a couple of times earlier, I am in favour of mandatory adverse drug reaction reporting.

I do recognize that there is the issue of online reporting and the lack of equipment or the appropriate mechanisms by at least 50% of the medical practitioners to report. I think that is an issue Health Canada needs to look at. I will also be taking a look at that issue because I believe we need stronger and better reporting of adverse drug reactions.

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Chair, another thing that the Standing Committee on Health concluded was needed is this: specific resources dedicated to the Health Products and Food Branch of Health Canada for vigorous enforcement of direct to consumer advertising of prescription drugs.

We heard much testimony in our cross-country hearings that direct to consumer advertising definitely increases the use of prescription drugs, as citizens are inclined to identify conditions from these ads and ask their doctor for those particular drugs. We found out from studies done in the United States, which has direct to consumer advertising, that physicians, in order to keep their patients happy, are inclined to prescribe one of the new advertised drugs, which is probably more expensive than the generic drug they might have otherwise prescribed, thus driving up the cost of drugs in the country.

I wonder if Health Canada has begun to plan to enforce regulations that control direct to consumer advertising.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, I understand that Health Canada vigorously and rigorously enforces compliance on these issues. However, I think the hon. member is aware that we live next to a great big country that in fact allows direct to consumer marketing. When we watch television that is beamed into our homes from across the border, we are then obviously influenced by that advertising.

Direct to consumer advertising is not allowed within Canada. It is in fact highly regulated. We are looking at that and we are trying to address the issue but it may be difficult if not impossible to address in the short run.

[Bonnie Brown, Liberal, Oakville, ON]

Mr. Chair, certainly I would beg to differ with the minister on this point of strong enforcement on this. It is voluntary. It is weak.

One of the committee members had a suggestion about the phone number people might use to complain. This is based upon complaints, and I would ask Canadians who are watching, how many of them know that direct to consumer advertising for pharmaceuticals is illegal? How many Canadians know that if they complain something might be done about it? How many Canadians know the phone number? There was a joke at our committee about this phone number, that because it was so well hidden it was a state secret. Nobody knew whom to phone, so how can Health Canada enforce something that people do not even know how to complain about? It is a very passive approach.

While the American advertising does come over the border into our living rooms, I think this is a perfect example where we do not want to lower ourselves to a lower standard that is happening somewhere else. Instead, we want to set the standard and have these rules, which we to have, and enforce them vigorously.

On these three things, I do not expect the minister to manage to do all of this in a couple of months. I do not want it to appear that I have foolish expectations; however, we are now in the process of preparing the next budget and the Department of Health has had the committee's report for several months now.

The report is based upon the premise that it is our responsibility to keep Canadians safe. I put that as a high priority item, so my question is, does the minister have his officials costing out our recommendations and is the minister planning on including those additional resources in his budget requests for the next fiscal year?

We understand that it will require more people even to answer the phone for the complaints on direct to consumer advertising and more money to advertise the telephone number. There is a variety of ways and we are going to need more people hired at Health Canada to do this work. My question is about how much it is going to cost. Do we know yet? Is anybody working on it? Are you planning to ask for that money?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, obviously the member knows, having been here much longer than I have been, in the House and in the government, that it is very difficult to talk about budgetary issues as we go into the budget cycle for the coming fiscal year, but the department is looking at all of these issues.

I do know that the legislation is antiquated. I know that it is difficult to enforce. I know that we are looking at the renewal legislation. As part of that, this may be amended. I know it is being worked on.

I take the member's advice. I accept it very carefully and I will obviously be speaking to the department. We have the deputy minister sitting here with me and he will take note of that.

[The Deputy Chair]

May I remind the member to ask her questions through the Chair, please.

[Bonnie Brown, Liberal, Oakville, ON]

I am sorry, Mr. Chair.

Mr. Chair, I would like to ask the minister about patent protection. Most people know that the 20 year patent protection given to companies for new pharmaceuticals was given in exchange for a commitment from drug companies that they would indeed invest 10% of their profits in research and development.

A report just last week showed that this is the second if not the third year that the companies as a group have failed to meet their commitment. The group of companies has been averaging about 8% of their profits into R and D.

I want to ask the minister what if any sanctions he is planning for companies which consistently fail to live up to their bargain with the Government of Canada.

[An hon. member]

Good question.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, obviously the hon. member is raising an interesting issue. I must admit that in my short time here I have not looked at the issue of the extension of the patent at all. I have focused on the evergreening issue and I have focused on the data protection issue. Those are issues I am working on.

I will in fact look at the issue the hon. member is raising. I have heard about it, but I have not been able to pay much attention to it, I must confess. I will look into it.

[Diane Ablonczy, Conservative, Calgary Nose Hill, AB]

Mr. Chair, I will be splitting my time with the member for New Brunswick Southwest.

I would like to ask the minister about what may be the number one concern of Canadians, certainly a very high concern of Canadians, with respect to the health care system and that is the shortage of doctors and nurses.

The minister will know that about 3,800 physicians are expected to retire in the next two years. In fact in his own province of British Columbia, 200,000 British Columbians cannot find a family doctor.

Also, Canadian accreditation of internationally trained doctors is often very difficult for these individuals to obtain. With respect to nurses, over one-quarter will retire by 2006 and over half in the next 10 years. Also, only half of nurses work full time and about half work only part time.

Since Canada needs to increase the number of medical school placements and find more efficient ways to work internationally trained doctors into the system, why was this goal not explicitly targeted by federal funding that was recently offered to the provinces?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, I believe that implicit in the wait times reduction fund is an element which will go toward training of health human resources across the country. Beginning with 2010-11 there is $250 million ongoing for training of health human resources.

There was also money in the budget last year, if I remember correctly, with respect to the international medical graduates and streamlining of those medical graduates into the mainstream of medical practice here.

I think those two issues are being dealt with. There is work being done across government, not just on medical practitioners and health professionals but all kinds of professionals, so that when people come to this country bringing talents and skills, we utilize their skills. Otherwise it is a loss to them and it is a loss to Canada. Medical graduates, whether they be nurses or doctors, are no different and there is work being done across government on this issue.

As part of the health accord the--

[Steven Fletcher, Conservative, Charleswood—St. James, MB]

A point of order, Mr. Chair. I am concerned about the time the minister is taking to answer.

[The Deputy Chair]

The point of order has been heard. I had just indicated to the minister that he had a few seconds left. We are checking the time. The Minister of Health.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, I just wanted to say the fact is that the first ministers specifically addressed this issue. The federal government has said that we are willing to coordinate--

[The Deputy Chair]

The hon. member for Calgary--Nose Hill.

[Diane Ablonczy, Conservative, Calgary Nose Hill, AB]

Mr. Chair, in spite of what the minister says, there is still a great lag between the number of doctors going into training, the number of doctors that are going to be retiring and the number that will be needed in our society.

Why does the federal government not get busy and perhaps build a couple more medical schools? We simply do not have enough places, equipment and trainers to do the job right now.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, I think that we all fell victim over the last several years, I believe some 10 to 15 years ago, to some experts who said we have an over supply of doctors, nurses and the like. Schools right across the country reduced the number of spaces for health care professionals.

There is a time lag. Money has been provided. There is a time lag with respect to these issues. I agree with the hon. member that if there is a need, we should all work together. We are prepared to work together with the governments across the country.

[Diane Ablonczy, Conservative, Calgary Nose Hill, AB]

Mr. Chair, the Canadian Nurses Association has asked that the government lead the development of a pan-Canadian framework within which provincial and territorial governments can develop and coordinate their plans for recruiting and retaining human capital in the health sector.

Why has the government not introduced this kind of a pan-Canadian initiative?

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, that is exactly what we talked about at the last health ministers conference. We said very clearly that the federal government is interested in coordinating and assisting jurisdictions across the country to train more quickly medical health professionals and bring on stream medical professionals from foreign countries who are now Canadians. We have in fact $85 million in the budget with respect to the IMGs, international medical graduates, and coordinating that strategy across the country.

[Diane Ablonczy, Conservative, Calgary Nose Hill, AB]

Mr. Chair, the Canadian Nurses Association also cites research showing that coordinated school health programs and services can influence risk and proactive factors in physical activity, nutrition, tobacco use, alcohol and drug use, and mental and sexual health.

Why does the government not provide financial resources specifically to stimulate such work? The CNA estimates that this would cost about $75,000 per school board.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Chair, we were very optimistic when all first ministers agreed in the September meeting to work together on school health and the formation of a school health consortium. The Minister of Health was able to organize hat at the meeting.

We are very keen to move forward and do our part in this in terms of sharing best practices and defining what school health would mean, just as the member has said, in terms of all of the common risks, from vending machines to physical education in the schools but also some of the--

[The Deputy Chair]

The hon. member for Calgary—Nose Hill.

[Diane Ablonczy, Conservative, Calgary Nose Hill, AB]

Mr. Chair, the question was about underwriting some of the cost of these programs, not just discussing them. I would like to move on to a question on accountability.

I believe the federal government has a positive duty to ensure accountability and results based benefit from the new spending that it has offered. Why did the minister not attend definitively to this important issue when he met with the provinces? It is very important that there be a firm accountability regime in place and at this point it is still under discussion.

[Ujjal Dosanjh, Liberal, Vancouver South, BC]

Mr. Chair, the agreement that we made in September has an unprecedented degree of accountability imbedded in it.

There is a clause that says that the funding arrangements in the agreement require compliance with the reporting provisions by all participating jurisdictions, bar none. We talked about this at the health minsters conference. We have agreed to develop comparable indicators. We are working on the establishment of benchmarks across the country. We also agreed on the aboriginal issues that we will be working on creating a blueprint with the aboriginal health ministers and co-chairs of the aboriginal health ministers--

[The Deputy Chair]

I remind the hon. member for Calgary—Nose Hill that she indicated she would be sharing her time with her colleague from New Brunswick Southwest.