Debates of Nov. 26th, 2020

Health—Main Estimates, 2020-21

[The Deputy Chair, NDP, Carol Hughes]

I would remind the member that she must address her remarks to the Chair, even in committee of the whole.

Resuming debate. The hon. member for Joliette.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, I would first like to acknowledge the minister. Committee of the whole meetings in the evening are a different sort of exercise. They must be very demanding for the people responsible for the file, since they last for several hours. I would like to acknowledge her and thank her for making herself available for this.

I want to begin by quoting Sophie-Hélene Lebeuf, a Radio-Canada journalist. She wrote:

Dr. Moncef Slaoui, the head of the operation, said that the United States will be able to produce enough doses of the COVID-19 vaccine to vaccinate every American who wants be vaccinated by May or June 2021.

I would like to ask the minister whether the situation is the same in Canada.

[Patty Hajdu, Liberal, Minister of Health]

Madam Chair, I thank the member for his kind words. These are long nights for all of us, and I appreciate that we are together, even if we are so virtually.

As I said, I am confident in the vaccine portfolio we have acquired for Canadians, including doses of Pfizer, Moderna and AstraZeneca, which are three vaccines being reviewed right now by Health Canada. They are under regulatory review.

We work with Americans and the European Union, sharing data so we can quickly assess these vaccines together and ensure, to the best of our ability, that we have no data gaps. As soon as those vaccines are proven to be safe here in Canada by our regulators, we will be able to deploy them in Canada.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, I am sorry. There are some slight delays with interpretation and that sort of thing for those of us participating virtually. I want to recognize and thank all of the interpreters.

I thank the minister for her answer. Let us hope that all Canadians get vaccinated as quickly as possible.

To the minister's knowledge, has the government estimated the cost of a one-month delay in vaccination, for example? Suppose the public is vaccinated a month later than originally planned. Has the government calculated the economic impact of such a decision?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Madam Chair, the member opposite's observation that we cannot separate the health of Canadians from the health of the economy of Canada is a wise one. All too often we hear people trying to make that balance between doing what is right for the economy and doing what is right for health. His comments reflect what is increasingly becoming visible around the world, which is that we need a healthy community and population to have a healthy economy.

Having said that, we know we are well positioned to receive the vaccine, and the vaccine will be a very important tool to bring COVID-19 to its knees, so to speak. There are so many things we still do not understand about immunity with COVID-19, including whether vaccines will need to be delivered on an annual basis and how—

[The Deputy Chair, NDP, Carol Hughes]

The hon. member for Joliette.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, I thank the minister for her answer.

I would have liked to know whether the government has estimated the cost of a one-month delay. The minister said that there were still too many unknowns to carry out an accurate assessment, but I think that this piece of information, as imperfect as it may be, would be important to consider when assessing the options available.

Furthermore, as she said, we still do not know how long immunity will last with a potential vaccine.

Can the minister tell me whether the government is looking into manufacturing vaccines in Quebec and in Toronto, instead of simply buying them from the United States or somewhere else in the world? It could be the three vaccines we are talking about or any others that may be developed later in the year. By manufacturing them in Canada, we would be less bound by the timelines of multinational corporations that do not have labs here.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Madam Chair, as the member opposite heard, the Prime Minister has made a commitment and we have invested in biomanufacturing here in Canada, including the Quebec company Medicago, of which I am sure we are all very proud of. This is a commitment for the long term, and it is a commitment to rebuild Canada's capacity to have a strong and robust biomanufacturing sector.

Having said that, Canadians cannot wait. We need to ensure that we can procure vaccines as they become available. That is why we have such a diverse portfolio. It is why we have committed to purchasing more doses per capita than any other country in the world. Canadians need to have access to that vaccine, and we are going to make sure they do.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, as far as I know, the investments that were announced were not directly aimed at increasing our vaccine production capacity. They might help increase capacity, but they were not intended to produce more Canadian-made vaccines. Perhaps I misunderstood what was said about that.

At the start of the pandemic eight months ago, the government decided to negotiate contracts to purchase vaccines from various pharmaceutical companies. There were many risks to be managed, and it certainly had to assess the possibility of immediately investing in Canada's vaccine production capacity. At that time, the government did not go with that option, and it chose to sign contracts instead.

I would like to know why the government did not decide to immediately increase production capacity eight months ago, so that now, eight or ten months later, we could produce the vaccines ourselves without depending on contracts with foreign pharmaceutical companies.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Madam Chair, as the member opposite knows and has heard, the Prime Minister has made the commitment. We have been investing in the capacity of Canada to grow its biomanufacturing sector.

Having said that, we cannot wait for that sector to be ready. We must be able to deliver vaccines when they are available. That is why we have purchase agreements with seven vaccine providers, three of which have already applied for regulatory approval. This is good news for Canadians because we know that as vaccines become ready, available and safe, Canadians will have access to them.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, my question was obviously not about recent announcements. It was about the choice that was made eight months ago, at the beginning of the pandemic, to not immediately make investments to build a production capacity that would have allowed vaccines to be produced right now, or at least in early winter.

Today, the Premier of Quebec, François Legault, announced that he would be having a conversation with the Prime Minister of Canada this evening. He said he wanted to find out two things, namely the date when the first vaccines would arrive and the quantity of vaccines that would come in each week.

Can the minister confirm that this conversation took place and that the Prime Minister answered both questions from the Premier of Quebec, François Legault?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Madam Chair, I can confirm that, to the best of my knowledge, the premiers meeting went ahead. However, I cannot confirm what was discussed, as I was not there participating. I am here.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, I was thinking that she might have heard something about it through text or email. I was just trying my luck to see whether we might get that information.

We know that there will be six million doses in Canada between January and March, which means we will be able to vaccinate three million people, if all goes well in the approval and distribution process, of course.

Has the government already decided how it will distribute the doses among the provinces? If so, will they be distributed based on the population, based on the population aged 70 and over, or based on the population aged 70 and over living in residences like long-term care centres?

I think this information has already been given, but I am asking the question to make sure.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Madam Chair, the finalization of the sharing agreement has not been completed. The provinces and territories are working right now on a formula to equitably share vaccine doses as they arrive. We have had great success in this area, though, with previous negotiations, including for personal protective equipment and testing devices. I have every confidence we will work out an agreement that meets everybody's needs.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, in her speech at the beginning of this committee of the whole, the minister reiterated her plans to impose Canada-wide standards for long-term care facilities. I personally have not heard anyone in my riding say that things are not going well because there are no Canada-wide standards. I would like to know whether the minister speaks frequently with her counterpart, the Quebec minister of health, Christian Dubé, and whether she has spoken to him about this. Does she know what he thinks?

From what I have heard, the problem in long-term care centres is not down to a lack of Canada-wide standards. Rather, it is down to lack of staff, in other words, a lack of funding. Is the minister considering increasing the health transfers? The provinces are calling on Ottawa to increase its share of health care spending from 22% to 35%.

Furthermore, since staff must be paid every year for the system to work properly, this should be a recurring transfer, not a one-time transfer.

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Madam Chair, all Canadians think elderly people living in long-term care homes and other congregate settings need to have the utmost care and the utmost protection. The tragedy of deaths in long-term care homes is something Canadians will never forget. In fact, 85% of the deaths in the first wave occurred in long-term care homes and we are seeing the same pattern with the deaths occurring now. Clearly more has to be done in all provinces and territories by all jurisdictions.

The member opposite is right: There are staffing issues. In Quebec, 328 Red Cross staff are still in long-term care homes assisting the province to provide quality care to seniors so we do not see those kinds of horror stories again this time around. However, we have supported, through the safe restart agreement, $740 million to provinces and territories to strengthen infection and prevention control.

I look forward to those conversations, quite frankly, and I am certain they will include the ways the federal government can support the provinces and territories to deliver better care for long-term care residents, no matter which province they live in.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, I would like to know how much time I have left.

[The Deputy Chair, NDP, Carol Hughes]

You have one minute and 44 seconds.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, I thank the minister for her answers.

On Monday, we will be getting the eagerly awaited economic update. We have not had a single budget since the last election, but a number of bills have been passed. We asked the previous finance minister for an update, but all we got was an economic snapshot.

Can the minister tell us if the provinces' request to boost federal health transfers from 22% to 35% might be an item in the next budget?

[Patty Hajdu, Liberal, Thunder Bay—Superior North, ON]

Madam Chair, I am just as excited as the member to hear the fall economic update from our new finance minister, and I look forward to hearing it with him.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Chair, I would like to wrap things up by thanking the minister and telling her that I am excited about her answer.

I am looking forward to good news about health funding in Monday's economic update. I think the pandemic serves as a reminder that Ottawa has a role to play in health care, and that is to ensure adequate funding for the sector.

[Ken Hardie, Liberal, Fleetwood—Port Kells, BC]

Madam Chair, I know the first line that my scriptwriter has put here echoes everybody's sentiment: I am pleased to be here today. We are having an important discussion tonight, and my portion of it will reflect something that is critically important. It is the process that goes on all the time outside of a pandemic, but is never more important than during a pandemic. We are here to discuss the regulatory modernization and the achievements relating to facilitating access to much-needed health products for Canadians.

Health Canada has played in the past, and will continue to play, a key role in protecting the health and safety of Canadians, and 2020 has been a really challenging year in that regard.

Our government's top priority has been to respond to the COVID-19 pandemic. To achieve this, we have focused on implementing innovative and agile regulatory measures to help prioritize and expedite the regulatory review of drugs and medical devices, including critical COVID-19 health products. We have had to do this without compromising Canada's high standards for safety, efficacy and quality.

There are obviously some pushes every now and again for politicians to set the agenda as to when such-and-such is going to happen or when so-and-so is going to be available. However, politicians should not be making those decisions. We should leave them to the experts and the people whose task it is to keep us all safe.

Our efforts to modernize regulatory pathways did not begin as a response to the global pandemic. We have been at this for a while. In fact, for several years, Health Canada has mobilized on many fronts to improve access to the products that Canadians need for taking care of their health and the health of their families.

Since 2017, Health Canada has been working on the regulatory review of the drugs and devices initiative to improve access to needed health products for Canadians. This has included strengthening the way the department collaborates with other regulators on the scientific review of drugs and medical devices. It has allowed Canadians faster access to many therapies, and so far this has been done in the areas of cancer, blindness, pediatrics, depression, opioid addiction, which is a major issue in British Columbia, and HIV home testing. Many more products are now coming to Canada as a result of these actions.

Health Canada has improved its scientific capacity to review more affordable generic medicines and has also created accelerated pathways to provide earlier access to promising new drugs for patients. This is what we are seeing demonstrated today. For example, Health Canada has approved three novel cell-based gene therapy products, including one for the treatment of pediatric cancer patients. There is also a new IV formulation for five difficult-to-treat bacterial infections and another treatment for vision loss due to inherited retinal conditions. In other words, there are Canadians who gain faster access to therapies that directly help, thanks to these regulatory efforts.

Additionally, Health Canada launched an ambitious regulatory innovation agenda, and as part of these reviews, stakeholders made it clear that regulatory agility was key to economic growth and innovation. The pandemic has reinforced the need, of course, for the regulatory agility and flexibility that we need for getting health product oversight and a principled focus of the agenda's initiatives.

Health Canada has also launched additional temporary emergency measures to help companies bring urgently needed health products and medical supplies for COVID-19 into our market. The measures include solutions intended to broaden access to clinical trials, expedite the regulatory review of health products and support enhanced management of product shortages. They have provided an opportunity to pilot many of the improvements planned as part of the agenda.

As a result of these measures, Health Canada has approved 4,000 hand sanitizers, 495 medical devices, two drug treatments and 46 testing devices, and it has done all of this since March. The department has also received three vaccine submissions, with more expected in the near future. This has made a tremendous impact on Canada's leading response to COVID-19.

Canadians and health care workers can count on Health Canada to ensure that their communities have access to the products they need to stay safe from the risks of COVID-19. Moving forward, Health Canada will build on the administrative and regulatory agility that has been put in place in response to COVID-19 to further support industry in providing timely access to much-needed health products.

Medical devices are playing a critical role in the public health response to COVID-19. Many Canadians also rely on these products to maintain and improve their health and well-being. Health Canada is continuing important work for the medical devices action plan.

Health Canada has already accomplished a great deal under this plan. For example, in December 2019, Health Canada became the first regulator worldwide to bring into force regulations that required hospitals to report all serious adverse drug reactions and medical device incidents. This will be particularly useful in the pandemic, because we will be able to identify any safety issues Health Canada will need to take action on.

Finally, Health Canada established a new scientific advisory committee on health products for women. The committee was created to provide Health Canada with timely patient-centred scientific and clinical advice on current and emerging issues regarding women's health and the regulation of medical devices and drugs.

More important, however, is the rapid regulatory response, which has been key to supporting access to health products during the pandemic. Health Canada has introduced several innovative measures to maximize regulatory agility while maintaining protections for health and safety. The amount of work that has occurred on the regulatory side over the past few months is incredible. It is truly a historic response. For instance, the Minister of Health has signed five interim orders with respect to health products related to COVID-19.

An interim order is one of the fastest mechanisms available to the federal government to help make health products available to address larger scale public health emergencies. These include expedited pathways for clinical trials and access to drugs and medical devices. These new pathways have been successful in bringing COVID therapies faster to Canada.

Due to the high impact of illness from COVID-19, Health Canada and other highly regarded international regulators are prioritizing and expediting the review of all submissions for COVID-19 treatments. Health Canada is working with all our international partners to share information, to discuss the scientific evidence we are gathering and to ensure Canada's approach is aligned globally.

While we are working hard to give Canadians access to COVID-19 drugs, personal protective equipment and medical devices as fast as possible, we will not compromise Canada's safety, efficacy and quality standards. The agile response needed for the pandemic is rooted in the innovation and vision for a modern regulatory review of drugs and devices. We are proud of our accomplishments to date, our regulatory leadership and the ability to respond to an unprecedented health crisis.

I now have some questions for the minister.

It is clear that successive and robust border measures, including quarantine and travel restrictions, have had an impact on reducing travel-related COVID-19 infections in Canada. I would like to add that, from the British Columbia perspective, an analysis of where our initial infections came from surprised many people because they thought airliners coming over from Asia brought the virus with them.

In fact, the vast majority of initial infections in British Columbia came from eastern Canada, and they got into eastern Canada as a result of people coming back from spring break. A lot of those people said to close the border, but I would not like to try to keep any of my buddies out of the country if they were coming back from their spring break. We actually had an obligation to let them back.

Despite the fact that essential workers are allowed to enter the country, the social and economic impact of travel restrictions has put a strain on Canadians and our economy. Considering certain U.S. states have lower rates of infection than others, from a border perspective, and to reduce the impact of border restrictions on Canadians, what would it take for Canada to allow selective re-entry from certain U.S. states?

[Patty Hajdu, Liberal, Minister of Health]

Madam Chair, I thank the member for explaining so deftly the ins and outs of regulatory processes in Canada, including the changes we have made to accelerate access to medications and medical devices, particularly during the pandemic. It is a testimony to Canadian integrity that our regulators are seen worldwide as leaders in this field.

In response to borders, the member is right. Since the pandemic, we have taken successively stronger measures at the borders, first, going from screening from affected countries, and then later to actually restricting entry for non-essential travellers and foreign nationals.

Obviously Canadians always have the right to come home, as the member has pointed out. Even for Canadians returning home, we have additional measures, including mandatory quarantines for 14 days. We even have quarantine facilities for people who are coming into Canada who are either ill or unable to quarantine safely, to ensure that we can catch any importations of illness.

A lot has happened on the border. As the member points out, some Canadians are frustrated, on the other side, about the border measures and how it either restricts travel or it restricts reunification with friends and extended family.

There is a lot of work happening right now to better understand how to manage the border to prevent importation, but also to do so in a way that allows for increased mobility. It is very exciting to have ongoing border pilot projects doing that work of gathering research right now, including one in partnership with the Province of Alberta. These testing—

[The Deputy Chair, NDP, Carol Hughes]

The hon. member for Fleetwood—Port Kells.

[Ken Hardie, Liberal, Fleetwood—Port Kells, BC]

Madam Chair, yes, we noted with interest the rapid test pilot in Alberta and despite what we have heard quite often about how rapid testing could really be a game-changer in controlling the spread of the virus, the rapid testing in Alberta has not necessarily produced that result.

Studies have indicated that the quick identification of positive cases through testing does allow for the isolation of those who are sick and timely contact tracing to limit the spread of COVID-19. Recently we have seen an increase in the global use of these rapid point-of-care tests to enable diagnosis and screening. Furthermore, these kinds of tests can also help reduce the strain on the public health system. That said, they do have their limitations and, in fact, dangers. We have seen the United States withdraw from rapid testing because in many cases they are not used properly and the results they get are highly inaccurate in some cases.

That said though, what steps is the government taking to ensure ready access to these tests?