Health committee  Madam Chair, thank you for the question. I will be brief. I believe that I indicated in my submission, my initial presentation, that we are now looking at medium- to long-term solutions. I believe we do provide an environment that is attractive for medical radiation technologist trainees.

Health committee  I think that's a very important question. I know it is a matter that was discussed at the last federal-provincial-territorial ministers meeting, I know it is on the agenda for future federal-provincial-territorial meetings, and as I indicated in my submission, we are waiting for data from the provinces to understand those real cost impacts.

Health committee  We need to recognize that the system is coping with this situation. It is doing no more than coping. I believe that the CIHR competition has addressed some of the requests of the CMA. In particular, I believe that the opportunities in at least two of the grants providing for alternative tests are significant and will supply us with data to facilitate the way in which these tests can be brought into clinical practice.

Health committee  Thank you, Madam Chair. Both Dr. O'Brien and Dr. Urbain identified the issue of cost. This is clearly multifactorial. Cost increases had been announced before the NRU shutdown. We are waiting to hear from our provincial colleagues on what the provincial differences in costs are, and we will report back as and when we get those data.

Health committee  Madam Chair and honourable members, thank you for the opportunity of appearing before the committee again. I am grateful for this chance to give you an update of where I perceive we stand in dealing with this issue. I will remind you that I also appeared before the Standing Committee on Natural Resources on October 19.

Natural Resources committee  Mr. Chairman, those data aren't in yet.

Natural Resources committee  My game plan is, I guess, a three-step plan. The first step is to increase my conversation with AMSMNQ and with the OANM, because those are the two areas where these regional imbalances are occurring. The second step is to work with the provinces and territories to try to get a handle on what their understanding of the disparities is.

Natural Resources committee  I'm hoping to get as much of it done as I can. The minister will be meeting with the provincial and territorial ministers of health in September, and I think it would be very helpful if I could have at least a somewhat clearer understanding in advance of that meeting.

Natural Resources committee  That actually is a very complex question. I think there's no doubt that we have learned from this supply shortage that the business model we have used in nuclear medicine is perhaps imperfect. I think that if we try to look at the tests that can be utilized as alternatives, there are some PET tests.

Natural Resources committee  Mr. Chairman, I will remind the member of the committee that I am not a member of the government, I'm an adviser to the minister. My requirement is to provide advice on dealing with the crisis, and I believe I am doing that to the best of my ability. When I look across the country, certainly in Alberta we are coping very well indeed.

Natural Resources committee  We have to look at the best options we can for our patients. We are looking, through CIHR, at alternative radio-pharmaceuticals. We have approved fluoride for bone scanning. In my own hospital, we have now moved 50% of our bone scans to fluoride so we can free up technetium for other tests.

Natural Resources committee  There is a weekly bulletin put out on supply levels for the following week. That is now proving to be remarkably accurate and to help hospitals plan. The use of alternative tests frees up technetium for those patients in whom the alternative tests are not appropriate. For example, regarding fluoride bone scanning, I would not do fluoride bone scanning routinely in children.

Natural Resources committee  Thank you, Mr. Chairman. I agree with you that the length of the shutdown and the length of the supply issue are of concern. We have improved the utilization of the available supply in a number of short-term ways, and we have been able to keep patient volumes up better than we had originally envisaged.

Natural Resources committee  Mr. Chairman, if I can respond to that, I find it offensive that he would regard my comments as jovial. They are not jovial. I recognize the importance of this to my patients. I practise and I see patients every day. I am actually in the middle of a clinic. I have come out of that clinic to come to talk to this panel, so I find his comments unfortunate.

Natural Resources committee  Mr. Chairman, I was not aware the AECL board had made that recommendation that early. I think there is clearly hope that the NRU will come up in the first quarter of this year. The proposals I am aware of that have gone to the NRCan expert panel look creative. Many of them provide made-in-Canada solutions, and I'm looking forward with a great deal of enthusiasm to the report of that panel.