HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Thursday, May 27, 1999

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[English]

The Chair (Mr. Joseph Volpe (Eglinton—Lawrence, Lib.)): Thank you, colleagues, ladies and gentlemen. Welcome to the ongoing sessions of the Standing Committee on Health.

This meeting is being held pursuant to Standing Order 81(4) and the orders of the House of February 26, 1999, and March 25, 1999, regarding main estimates 1999-2000 under Health Canada and the Report on Plans and Priorities for Health Canada.

We have with us today the Honourable Allan Rock, the Minister of Health. He is accompanied by Mr. David Dodge, Deputy Minister, and I believe by most of the senior staff from the department, for the purposes of discussing the estimates we have before us, and on which we plan to report.

I want to advise colleagues that the minister himself has another appointment at around noon, so if you have some questions, we're going to direct them to him before then. Then I will excuse him, and I think the departmental officials are here with us until 1 p.m.

Mr. Minister, thank you very much for joining the committee in its deliberations on the estimates. You are always welcome here even if your schedule sometimes doesn't coincide with our plans.

We are pleased to be joined—and I mean that sincerely—by Mr. David Dodge, who has appeared before this committee on a couple of other occasions and been more than forthright. I hope he will continue in that tradition.

Mr. Minister, normally we have about five minutes for our witnesses and then questions and answers as we go through. I think you probably would be better served by having a ten-minute introductory period. We'll probably be elastic on that time if it's so required. Subsequent to that, colleagues will go into five-minute question and answer periods on a per-party basis.

I know you're familiar with the usual rules, but I thought I'd repeat them for our colleagues as we go through.

My understanding is that you're going to speak and that Mr. David Dodge may wish to speak later or simply answer questions.

Mr. Minister, you're first on the mike.

Hon. Allan Rock (Minister of Health, Lib.): Thank you.

I know members will have questions, so I will be brief in an opening statement to express my thanks.

[Translation]

First of all, I would like to sincerely thank the members of the committee for the exceptional work they have done over the past few months. Mr. Chairman and colleagues, I particularly appreciated the reports and the recommendations on two difficult and complicated subjects, namely the regulation of natural health products and organ and tissue donation.

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As far as natural health products are concerned, you know that I accepted all 53 recommendations that you made and I have already announced the establishment of the Natural Health Products Office. I appointed an interim manager and an advisory board of independent experts to help.

You have done some very good work. I would like to congratulate and thank you.

[English]

Obviously, the focus for me during the past several months has been the preparation of the budget—the health budget, so-called.

The extraordinary events of February set the stage for what I believe is a change of significance for our health care system. The Prime Minister was able to reach agreement with all premiers with respect to the use of additional moneys provided in the budget. All premiers agreed additional money would be devoted to health and health care.

In addition, the social union framework agreement that was signed called for, among other things, measurement and monitoring of the performance of the health care system.

Of course, as we know, $11.5 billion of additional money has been devoted over the coming five years, in the transfers, to reinforcing the health care system, not only addressing immediate problems but also working toward putting in place structural changes for the longer term to allow us to maintain the health care system, of which we're so proud, with an aging population and increased pressures on costs.

Quite apart from the increased transfers to the provinces, Mr. Chairman, the thing that I believe is most significant for Health Canada is the $1.4 billion that has been allotted over the coming three years for the following initiatives at the federal level:

(1) information systems to permit us to manage and measure, as the social union framework agreement contemplates;

(2) research, and the creation of the Canadian Institutes for Health Research, a virtual doubling of the amount of money we spend on health research, a different way of conducting health research with all the voices at the table deciding on priorities and the allocation of funds;

(3) efforts to prevent disease and illness and promote good health, such as through the prenatal nutrition program, where an additional $75 million will be spent over the next three years to broaden the program so that it affects all of those mothers at risk by reason of social or economic circumstance;

(4) strengthening of the food safety branch at Health Canada through an additional $65 million;

(5) devotion of money to research on toxic substances, a total of $82 million over the coming four years;

(6) the money for first nations health, $190 million over three years to help us establish home and community care services in first nations communities to address a need that now is unmet; and

(7) money to support innovations, some $50 million over the coming three years to help us pilot projects and demonstrate different ways of delivering services.

There are a couple of innovations at Health Canada itself that I'd like to mention en passant.

The first is in relation to rural and remote health. I created the position of executive director of rural and remote health at Health Canada about a year ago. Money from the innovation fund in the budget will be used to help us explore how Health Canada can assist provinces in meeting the demands of delivering services in rural and remote areas, developing a national strategy.

Now, delivering services is obviously a provincial responsibility, but we believe the Government of Canada can play a helpful and useful role.

The second is in the creation of the executive director of nursing policy at Health Canada. We recently announced the name of the person who has been hired to fill that position. Again, nursing services is a provincial responsibility, but the Government of Canada relies upon nurses to help it meet its commitment of delivering services in first nations communities. We believe the nursing perspective should be brought to bear whenever health policy is being developed.

Lastly, there's the health protection branch, which preoccupies all members of this committee, I know, regardless of political stripe. We're all concerned that we restore and strengthen the confidence of Canadians in the health protection branch.

For the deputy and for me over these past several months, that's been a subject of major significance.

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Under the leadership of the deputy and the management of the department, steps have been taken to move along the right direction. The process of transition, of creating a health protection branch for the 21st century, is fully underway, with methodical public consultation and reaching out to get the best possible advice.

We created an independent Science Advisory Board, chaired by Dr. Roberta Bondar and populated by people of unimpeachable integrity and expertise. Their task is nothing less than to do a scientific audit of Health Canada, to look at the scientists we have, and to tell me, frankly and openly, whether we have the science capacity to fulfil our mandate.

Whatever they tell me, I'll make public. I already have, in part. Whatever they've told me to date, I've made public, and we will act on their advice.

We're reinvesting in the health protection branch, with $125 million over the next five years to strengthen our capacity to regulate in the supply of blood, and $65 million, as I've mentioned, in relation to food safety.

These changes are obviously only the beginning, Mr. Chairman. We need to design and to manage and to fund a health protection branch for the 21st century, one that's accessible to the public and one that is transparent.

The deputy recently told a Senate committee of our intention to open an office of consumer affairs and public involvement at the health protection branch so that the public feels it has a window into the workings of the branch and an opportunity to become involved when issues affect more than just science but also public policy.

This is an exciting time to be Minister of Health. It's a privilege I enjoy greatly. It's also a privilege to work with Mr. Dodge as deputy and the team we have here today to assist in responding to any questions the committee may have.

I look forward to the opportunity to exchange views with colleagues on these important subjects before us.

The Chair: Thank you, Mr. Minister, and thank you for the kind words regarding the committee's work on herbal medicines and alternative therapies.

I know the committee received your response to that report with great enthusiasm, because it reinforced the value the government places in the work of committee and it underscores the value that committee members bring to the parliamentary process.

I know I speak for all committee members in suggesting that perhaps you might want to use the same type of response mechanism to its latest report on organ donations and transplantations.

Mr. Minister, I'm going to go directly to the opposition members for the first series of questions.

Mr. Grewal.

Mr. Gurmant Grewal (Surrey Central, Ref.): Thank you, Mr. Chairman.

I would like to take this opportunity to welcome the minister and his deputy to the committee. I appreciate very much their taking the time to answer some questions on the estimates.

I have many questions, Mr. Chairman, so I will be brief, and I will expect short answers from the minister.

Canadians are sorrowful about the innocent victims of the federal government's control of tainted blood. We know Justice Krever recommended that all victims be compensated. I listened to the infomercial by the minister right now, but where in the estimates—on what page, in what chart—is the money to compensate all victims of government-controlled tainted blood? On what page can I find that money?

Mr. Allan Rock: Mr. Chairman, as Mr. Grewal undoubtedly knows, the response by the Government of Canada to the hepatitis C tragedy has been very substantial. We have contributed $800 million toward a fund that totals $1.1 billion, which has been offered to those persons infected by the blood system between 1986 and 1990.

I understand that discussions are now close to completion between the parties on exactly how that fund should be organized and paid out, what the criteria should be, and how the settlement should be structured.

In addition, we have committed $300 million to ensure that those persons infected through the blood system prior to 1986 and after 1990 have lifelong access to needed medical goods and services, including free drugs and nursing care. We are close to agreement with seven of the ten provinces in relation to that arrangement.

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We've contributed $125 million toward strengthening the regulation of the blood supply to minimize the prospect of any such thing happening ever again.

We've committed $50 million to new hepatitis C research and disease prevention, and $50 million has been offered to provinces for look-back and trace-back programs so that those who may have been contaminated will know, and will take appropriate steps.

That's a total of $1.3 billion from the Government of Canada in response to this tragedy. And that's only the federal part.

Mr. Gurmant Grewal: Excuse me, Mr. Chairman—

Mr. Allan Rock: I hope that's of assistance to Mr. Grewal in understanding the federal response to this tragedy.

Mr. Gurmant Grewal: Mr. Chairman, my question is that to compensate all victims of hepatitis C, the government grabbed $30 billion the day before yesterday from the public service pension employees. Did the minister put $1 billion, $2 billion, $3 billion into the estimates to cover all victims of hepatitis C? Is the money there to cover all victims of hepatitis C?

Mr. Allan Rock: I think I've detailed the steps we have taken, Mr. Chairman. Those are indeed the measures we have put in place in response to this tragedy.

Mr. Gurmant Grewal: I didn't get the answer, Mr. Chairman. Let me move on to my other question in the limited time we have.

Under the watchful eye of the minister, since 1993 the waiting lists have grown for various treatments. The waiting lists have grown to now probably close to 200,000 in Canada, human beings waiting for treatment from various facilities.

Is there any money anywhere in the estimates that will help to reduce those waiting lists? Can the minister show me some money in these estimates?

Mr. Allan Rock: Mr. Grewal will know that the delivery of health services is a provincial responsibility. If there are waiting lists, then I think we should bear in mind that any influence I would have over waiting lists for medical services in the provinces is indirect at best.

The provincial ministers of health are obviously concerned about waiting lists. They're concerned about access to services, and they're taking a variety of measures to overcome those challenges.

I work with the provincial ministers. I meet with them regularly. I speak with them occasionally on the telephone as a group, and I speak with some of them individually on this as well as other problems.

Obviously, as I said in the opening, the steps we took in the most recent budget are intended to provide assistance from the federal level. We've increased very significantly the transfers to the provinces, and the provinces have agreed that all of that additional money will be used for health and health services. As I mentioned, that's to deal first with immediate pressures and problems, including waiting lists, and then also to look to the longer-term solutions, to structural changes that may overcome some of these problems.

But that, of course, is not all. Every dollar—every dollar—of the money for health announced in the budget will help, directly or indirectly, in dealing with the very real problems my colleague has talked about. All of us know somebody who has been touched, either themselves or members of their family, by the challenges facing our health care system, whether it's waiting for an operation or having difficulty getting access to a specialist or waiting for test results. The anguish that's involved is very real.

I want to assure the member that I feel that very directly and very personally, but I also believe the steps we've announced are going to help. It's not only the additional transfers; look at the initiatives on research. I mentioned that the Canadian Institutes for Health Research will change the way we conduct health research in this country. Let me tell you how that relates to waiting lists.

At the table for the first time, in deciding on priorities for research in this country through the institutes, will be not only the biomedical researchers, those people in white lab coats who look through microscopes at molecules, but also the people who do clinical research, who determine the efficacy of treatments or protocols in the field, and those who do research on health service delivery. In this way we can better understand how services can be organized and managed in order to avoid such problems as waiting lists. As well, there will be those who do research on population health and health determinants so that we can prevent and avoid some of these difficulties that cause the waiting lists in the system.

Now, that's quite apart from the money we'll devote to innovations, including rural and remote health, and to providing access to services in parts of Canada that are underserved at the moment. That's quite apart from the money we have invested to avoid problems through prenatal nutrition.

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Without going on at great length, my answer to the man is this: I don't run the provincial health systems, but I work with those who do. I give them money and I also conduct direct initiatives that can help relieve their burden.

So although he cannot expect me to provide action at the provincial level to deal with their waiting lists, he can expect the Government of Canada to provide help, and that's exactly what we've done.

The Chair: Thank you, Mr. Minister.

Mr. Grewal, you may wish to come back on another round.

Mr. Bigras.

[Translation]

Mr. Bernard Bigras (Rosemont, BQ): I too would like to thank the Minister of Health and welcome him to the committee. The committee is often a forum where we can obtain more specific answers to questions raised in the House of Commons, for instance.

My intervention will deal more specifically with the government's statements made by your parliamentary secretary on May 25. These were probably the most specific statements that we were able to obtain from your government with respect to the use of marijuana. Your parliamentary secretary stated:

The government is committed to enabling scientific research into the potential benefits and hazards of marijuana. We want to compile the needed evidence to meet our legislative challenges—

My question is as follows. Do you intend to conduct phase 1, 2 or 3 clinical trials knowing that the phase 3 trials could be broadened to include between 600 and 900 patients? Do you, yes or no, intend to conduct phase 3 clinical trials?

I have another question. When talking about supply, your parliamentary secretary stated:

Health Canada has already taken the initiative of exploring possibly securing legal, licit, quality sources of marijuana for medicinal use for the vital research we want to conduct.

I'm not asking you to talk about your specific plan today. I understand that you will be unveiling the plan in June. We know that marijuana can be imported, it can be produced in an institutional setting or through small businesses or private firms that are given production licences. Have you, at this point, decided whether or not the marijuana will be imported, produced institutionally or produced privately? These are my first two questions. I would then like to talk about the special access program.

[English]

The Chair: Mr. Minister, even though we have dedicated this to estimates, I know you will find in your response a way to link the material. If not, we are accustomed to having wide-ranging questions in this committee.

I hope your answers will be short so that we can fit you into that five-minute timeframe.

[Translation]

Mr. Allan Rock: I am pleased to have the opportunity to answer these questions. I have often clarified the government's position in the House of Commons. I answered questions that were raised by Mr. Bigras and his colleagues. Two days ago, we adopted the proposed motion which was amended by my parliamentary secretary, Ms. Caplan, and we intend to adopt a three-part strategy.

First of all, in a few weeks time, I'm going to be announcing the details of our research initiative. Before the session is over, I will explain the parameters and the framework of this research. The officials are currently working out the details.

Secondly, we will look into the possibility of building a supply of marijuana here, in Canada, for medicinal purposes. All of the details have not yet been worked out, but we are working on it. Within a few weeks or a few months, I hope that I will be able to announce the details and to state whether or not we will have a supply of marijuana in Canada for this purpose.

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Thirdly, we have already published the details of the forms that must be filled out by those individuals seeking permission to use marijuana under section 56 of the Controlled Drugs and Substances Act.

I am currently studying the applications made by Mr. Wakeford and other individuals who have asked for permission to use marijuana.

This is our three-part strategy. Unfortunately, I don't have all the details, but we are in the process of working on them.

Mr. Bernard Bigras: More specifically—

The Chairman: Mr. Bigras, you can go back to this issue during the next round.

Mr. Patry.

Mr. Bernard Patry (Pierrefonds—Dollard, Lib.): Mr. Minister, thank you for your visit. I was very pleased that you provided a response to the report on natural health products. I am hoping that we will soon be receiving your response to the report on organ and tissue donation because I worked on this issue.

I am particularly interested in the health of children. In 1993, we established the Canada Prenatal Nutrition Program. We also invested

[English]

a lot in the Community Action Program for Children, or CAPC. It's working very well, particularly in Quebec. We've also invested in Prestation fiscale canadienne pour enfants, regarding poverty and children. We're talking now about the children's agenda.

In the preamble to your remarks, you talked about toxic substances. I'm really concerned about toxic substances regarding the health of children.

If we compare the weight of a child with that of an average adult, a child between one and six months is drinking seven times more liquid than an adult. A child between one and five is eating five times more than an average adult. A regular child at rest is breathing twice more often than an adult.

This is quite important, because my question is the following. Because a child is much more susceptible to toxic substances in the air and the water and also in the food, what is the department doing with regard to toxic substances that could interfere with the development of a child?

Secondly, I was parliamentary secretary for two years with Indian Affairs. With regard to the Aboriginal Head Start Initiative, which is working very well, do you have any benchmarks or anything with regard to the money being spent over there?

As you know, 50% of our first nations population consists of people under age 25. What do you think about this program? To me, it's working well, but do you think we should spend more money there in the future?

[Translation]

Mr. Allan Rock: You raised the issue of toxic substances. I would like to say that we dedicated $82 million, in the last two budgets, to research on toxic substances.

This afternoon, with my colleague, the Minister of the Environment, I will be announcing some grants for Canadian researchers so that they will be able to conduct an in-depth study on the impact of toxic substances on youth, for instance. I share your concern with respect to the impact of these substances on young people. As a father and as the Minister of Health, I'm concerned by all of that. I am also responsible for the Pest Management Regulatory Agency.

Yesterday, I was very interested in reading the Report of the Commissioner of the Environment and Sustainable Development, who criticized the way that we fulfil our responsibilities in regulating the substances. We will learn from this report and we will modify our approach to ensure that we assess substances based on their impact on humans, and more particularly, on young people.

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Your second question concerned Aboriginal people. It is true that we began this Head Start Program outside the First Nations' territories.

[English]

We developed some experience with Head Start for aboriginal children in the broader communities. It worked well, and we spent about $25 million a year in that regard.

It worked so well that in October of last year we announced, along with Secretary of State Ethel Blondin-Andrew, the creation of the Aboriginal Head Start Initiative in first nations territory, for about the same amount—namely, about $25 million a year.

We are constantly evaluating the performance of these projects. We're very happy with the effects they've had. I have some of the details here of the number of children whose lives we've touched through the Community Action Program for Children, through the Canada Prenatal Nutrition Program and through Head Start.

They are really quite terrific. They are very effective. Our evaluations have been very positive, and I think they have a long-term future.

I work, as you know, with Minister Pettigrew on the national children's agenda,

[Translation]

in partnership with my counterparts. Over the next few years, I would like to invest more money in child-related initiatives.

[English]

I'd like to see us build on what we've learned about CAPC and the prenatal programs and Head Start. They work, and they don't cause any constitutional friction. In fact, there are more CAPC and prenatal projects in Quebec than in any other province. We have a written protocol with the ministers provincially. Nobody's talking Constitution or quarrelling about jurisdiction; we're just focusing on the needs of children.

I think we ought to build on these successes, and do more of it. I'd like to see that happen as part of the national children's agenda.

The Chair: Thank you, Mr. Minister.

Madam Wasylycia-Leis.

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): Thank you, Mr. Chairperson.

Given the shortness of time, I'd like to focus in on the whole area of the health protection branch, as you can imagine, and raise some of the issues that have come to light recently.

The first question has to do with blood and the stories and reports of the tainted blood from prisons in the United States. Notwithstanding the whole issue of a perceived conflict of interest vis-à-vis the finance minister, what I'd like to know from the Minister of Health is what his department is doing in terms of investigating exactly what happened in those years, how it would happen, and what regulatory provisions were breached to make that happen.

The second question has to do with the whole area of regulation of food, particularly with the emergence of genetically altered foods on the market and our concerns, as we've said before, with the reduction of the in-house, independent research capacity in the department.

Of course, with that is the concern about partnerships with business, being influenced by business over research.

So my question on that one is, of the $65 million set aside for food safety, how much of that money will go towards restoring in-house, independent research capacity within the health protection branch?

The final question pertains to the issue just talked about with respect to the environment commissioner's report on toxins in food. When we've raised this in the past, we were assured that the Canadian Food Inspection Agency was on top of these issues and working hand in hand with HPB in ensuring food safety.

This morning, when the question of toxins in foods was raised at the CFIA meeting, the representatives of that agency said they had nothing to do with toxins in food; it was not their responsibility.

It seems on every front there's no one in charge when it comes to food safety. Who is in charge when it comes to toxins in foods, and what measures are being taken to present a coordinated, meaningful strategy on food safety for Canadians?

The Chair: Okay, Mr. Minister, you have only a couple of minutes left. I did say these would be far-ranging questions. Go ahead.

Mr. Allan Rock: My colleague has raised very important issues.

First of all, I'm one of those responsible, so I'm not going to say it's anybody else's responsibility. I share in the responsibility of making sure that Canadians have safe food and that they know what they're eating. That's part of my responsibility.

I'm pleased to be here today and to accept that, and to respond to your questions as directly as I can. They're good questions. They're important questions.

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Now, on the subject of the health protection branch generally, you've been very interested in that, and you've often raised good questions about the branch and its workings. As I said at the opening, I think it's very important that we restore the confidence of Canadians in that branch. They have to know that we have good science, we have independent inquiry, we have reasonable regulation, and we have responsible regulation for the safety of Canadians.

Under the direction and leadership of the deputy minister, I really believe we're on the right track. I know there have been controversies in the past. It's been troubling to me as well as to everybody else. This branch has had real challenges in the past 10 or 15 years, but I really believe we're on the right track.

Do you know that by 2001 the budget for the health protection branch will be up 70%—70%—compared with its budget in 1997? Now, part of that is by virtue of the initiatives I mentioned in relation to blood regulation, the $125 million over five years. Part of it is in relation to the $65 million in food. Overall, though, we're seeing a reinvestment in the health protection branch, because I recognize, the deputy does, and the government does, that we have to have a health protection branch in which Canadians have confidence. That means having good-quality scientists who can conduct independent inquiry.

We're in the process of a transition. The officials are undertaking a methodical and very public and sometimes painful re-evaluation of how the health protection branch does its business. We've had cross-country consultations in public. We've invited people to criticize and offer constructive suggestions. We're in the process of putting together a health protection branch that will be able to meet the challenges of the 21st century. We're hiring new people. We're hiring good people.

Look at the recent hirings at the health protection branch. We have hired a fellow to become director general of our foods division and to help us invest this $65 million in a way that's going to make a real difference. This guy has a PhD in food engineering from the University of Paris and a master's in science, in chemical engineering, from the University of California. This man was the director of research at the University of Guelph, and is a very distinguished scientist. His name is Marc Le Maguer.

In the foods directorate he is going to lead the effort to look at some of these challenging questions—for instance, genetically modified food; what the standards for safety should be for the future; and how we can get Canadians to once again believe and to know that the health protection branch is a collection of good scientists acting in ways that are consistent with the public interest. So these are important questions.

Now, let me come to the specifics. On the question of blood, we are not conducting any inquiries about the past. It's really not our role. Mr. Justice Krever spent all those years producing a report of four volumes, or maybe three—at any rate, it was a long report—on what happened, and on who did what, where. I know the RCMP has been investigating as well.

So I can't tell you that we're actually doing any investigations on past activities. Our focus has been on the future and getting that right.

On your subject about toxins in food, I share that responsibility. I work hand in glove with my colleague, the Minister of Agriculture and Agri-Food, whose department is the home for the Canadian Food Inspection Agency. We establish the standards of safety and the CFIA goes out and enforces it. That's the way we're supposed to work together.

I think we're working well together now. There have been some difficulties in the past, but I think they've been pretty well worked out, and I think we have a good working relationship with the inspection agency.

Look, I'm not here to tell you that the health protection branch is everything it's going to be, but I can tell you that, under the direction of the deputy minister, we are taking an honest, open look at the way we do business. We know we have to adapt it to the new challenges in the future. We're committed to doing that. We have more money, and we have the attention of the government in that regard.

We're putting together a team to supplement the really strong people who are already there, and we're determined to strengthen the confidence of Canadians in the branch.

The Chair: Thank you, Mr. Minister.

Mr. Jackson.

Mr. Ovid L. Jackson (Bruce—Grey, Lib.): Thank you very much, Mr. Chair.

Welcome, Mr. Minister, and Mr. Dodge. It's good to see you guys here today.

When we looked at natural health products, Health Canada accepted all the recommendations. In the recommendations, they were to establish an office for natural products.

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Where is that office located on your organizational chart? Is it going to be under Dr. Losos, the deputy, or is going to be through the director general's office? How are you going to control it? As well, what funds have you committed to that department?

Mr. Allan Rock: Mr. Chairman, I wonder if I might take the liberty of asking the deputy to respond to those structural questions.

As well, I overlooked one of the questions my colleague asked. She wanted to know what percentage of the money was going to scientists at the food directorate. That's been a preoccupation of mine.

Perhaps I can ask the deputy to include that in his response when he deals with Mr. Jackson's questions about the management function.

The Chair: Maybe that's one of the reasons he's invited as well.

Mr. Dodge.

Mr. David A. Dodge (Deputy Minister, Department of Health): Thanks, Mr. Chairman.

The office of natural health products will be located in Dr. Losos' branch, and will report to Dr. Losos, just as the other directorates report to him. So it's a full standing office right there in the branch.

It will provide a window in respect of all natural health products, but in the field the branch will rely on other parts of the branch for inspection and so on. So it will be an office with a full calibre of scientists and other professionals to deal with the problem.

Initially, the budget for this particular group will be in the order of $7 million a year. As well, we will be doing additional research, which we are now trying to organize in cooperation with a couple of universities across the country.

Finally, Mr. Chairman, on the question of research on the food side, a large fraction of the $65 million will directly or indirectly be going to research, but not all necessarily inside the department. One of our real jobs is to try to build partnerships with researchers in universities across the country. We cannot do everything inside and be of gold-standard quality in so doing.

So we will be building up our internal capacity but at the same time be building partnerships with researchers at universities across the country and indeed internationally.

The Chair: Mr. Jackson.

Mr. Ovid Jackson: I have one quick follow-up.

When we did the study, the participants, people who came here and spoke to us, were concerned about “food versus drug”. Has that part been handled as well?

Mr. David Dodge: This is with respect to natural health products?

Mr. Ovid Jackson: Yes.

Mr. David Dodge: There are basically three parts to this. There are natural health products that come in dosage form and make claims, just like ordinary chemical pharmaceuticals. There are those that come in dosage form and do not make claims, which is the big bulk. Then there are those that come in food form.

Obviously, all of the expertise with respect to foods cannot be re-duplicated inside the office of natural health products. While there will be some additional expertise, we will be relying on the buildup of expertise on the food side to try to help with some of those issues.

The Chair: Thank you, Mr. Dodge, and Mr. Jackson.

Let's go over to Mr. Vellacott.

Mr. Maurice Vellacott (Wanuskewin, Ref.): Right.

I would like to ask the minister this with respect to the cost of the proposed hepatitis C compensation settlement, particularly as it relates to children who have been taken out of Canada. I don't know if anything is reflected in the estimates.

This situation was brought to the attention of the member for North Vancouver by one of his constituents. This North Vancouver man's son contracted hepatitis C at the Lions Gate Hospital in 1989, so he's therefore covered by the compensation agreement. However, that son, who's now 17, was taken to the U.S.A. by his mother, who has custody of him. At present he's receiving treatment under his mother's health care plan, but has been told that when he leaves home to establish himself independently, he'll likely be unable to purchase medical insurance.

My understanding, from looking at that compensation agreement, is that it allows for compensation for medical costs for a person like him but only up to the maximum in Canada rather than the actual costs in the U.S.A.

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Has the department carried out an estimate of the additional costs that would be incurred if eligible Canadians living outside of Canada were 100% compensated for their medical costs? For what must surely be a very tiny or small percentage of individuals, why not provide full compensation for medical costs in the country of residence, particularly in cases like this one, where an infected person was taken out of the country as a child?

Mr. Allan Rock: I must say, I hadn't heard of this, but let me find out about it. I will ask the people who were involved in the discussions to see if I can get an answer for you as to whether such a person would be covered, and if so, to what extent.

Mr. Maurice Vellacott: It's nothing that's come to your attention as yet, situations like this?

Mr. Allan Rock: No, sir. I haven't heard of that before.

Mr. Maurice Vellacott: If you could follow that up and get a response to me, I would very much appreciate it.

Mr. Allan Rock: Yes. Let me find out for you, and I'll give you a written response very soon.

The Chair: We'd be pleased to receive it through the committee, through the clerk, so that all members can share in that response.

Mr. Vellacott, do you have a supplementary?

Mr. Maurice Vellacott: That's my question.

The Chair: Okay.

Ms. Minna.

Ms. Maria Minna (Beaches—East York, Lib.): Thank you.

Welcome to the committee, Mr. Minister. It's good to see you.

I want to get back to two things. One has to do with the Canadian Food Inspection Agency and the other has to do with the children's agenda.

There have been articles in newspapers with respect to the Canadian Food Inspection Agency's problems—the number of food poisonings, say, and the response of the inspection agency in a number of instances where it actually stood back and the provincial arm had to come in. The articles were constantly around the conflicting guidelines the CFIA has—the economic side as well as the protection role.

This has caused a great deal of my constituents to call me and write letters. They've sent some to your office. Your office has been kind enough to give us some answers.

I wonder whether you could help me understand how that works, and, if there is a conflict that causes a problem, then, as the minister responsible for health, obviously that really is the overriding issue here, not should be the overriding issue.

Is there anything being done with respect to that or is there discussion going on to try to maybe review the mandate of the CFIA at this point in time?

Mr. Allan Rock: The starting point should be that Canadians have just about the safest food supply in the world, but to keep it that way, we obviously have to make sure we have rigorous regulation and careful surveillance.

One of the reasons the establishment of food safety standards was put in Health Canada was to keep it away from either Industry Canada or Agriculture Canada so that it's done on the basis of science and safety, and issues of business or industrial development don't enter into it.

So we establish the standards for food safety. The actual Canadian Food Inspection Agency is in Agriculture and Agri-Food Canada. That's why I work closely with Lyle Vanclief.

It's fair to say that in the first few months of operation of the CFIA, which we only created in the last mandate, there were some growing pains, questions of, “Where does our job leave off and theirs begin?”, or “How does their jurisdiction intersect with ours?” There were some challenges to overcome.

There is now a memorandum of understanding or agreement between the agency and Health Canada clarifying that, and I think we're working very effectively together now.

I think some of the stories you've referred to spoke about the period before those issues were resolved, but it's something we always have to be conscious of. We have to make sure that health and safety predominate.

I think that is the case now. I'm confident it is. I think the development of the relationship between the Department of Health and the inspection agency has been successful, and I think we have a good working relationship on the ground now.

Ms. Maria Minna: Okay. Thanks.

The other area I want to get into is children, which is, as you know, a favourite area of mine. I'm very happy to see that there's finally a discussion paper on the children's agenda. It's finally out, and we can begin to have a public dialogue. As you know, some of us have been working on that for some time, and we have some ideas of our own on how we might go.

• 1150

What I wanted to ask you was that given the fact that obviously Health Canada has already been involved with children, through CAPC and prenatal nutrition and Head Start, and that early childhood development is, in part, nutrition but also stimulation, and environment, and quality care, and a whole lot of things...

I know you said earlier to another question that there would be some collaborative discussion, but I was wondering what kind of consultations are being set up, if there are cross-departmental consultations, both federally and provincially. So many different departments seem to have a little piece of our children at the federal level as well as at the provincial level.

I'm just wondering how the consultations are going to be pulled together and what role Health Canada will play in that to try to ensure some cohesion.

Mr. Allan Rock: Well, you're an active member of the caucus committee on children, with John Godfrey and Senator Pearson, and you and I have talked about these things in the past. I know of your particular interest.

One of the points you've made in the past is that there are so many people doing things about children, in the name of children, from so many places, that it's become very fragmented. The feds do CAPC and prenatal, but the provinces may have a healthy babies initiative that sometimes conflicts, and then the municipality may have a public health officer who's doing something that's inconsistent. So a lot of money is being spent, but it isn't necessarily being spent in the most effective way.

The very reason for convening a meeting of provincial and federal ministers on the national children's agenda is to try to overcome that. The discussion paper we've recently published asks questions—for instance, do we have the right objectives, and if we do, are we going about achieving them in the right way, or are there ways we can change the way we deliver services or provide help in the community so that it's more coordinated, better harmonized, and therefore more effective?

As to how the consultations will be conducted, it's really free-form. Between now and September or October, Health Canada will be doing some consultations. There will be regional round tables with provinces and the federal government and non-governmental organizations all there. There may be a national consultation where we'll bring people to a specific city to talk about these things. Pierre Pettigrew and I are very open about how the consultations should be conducted.

By the way, provinces are free to conduct their own.

So there will be a lot of talking going on over the next few months with the consultation document as the focal point.

Coming back to your fundamental point, one of the real purposes we have is to make sure that the money that's being spent...

Look, the country's full of good intentions. Everybody wants to do something about children living in poverty and children having an equal chance, but the fundamental purpose is to make sure that we don't defeat ourselves by working at cross-purposes. Trying to get everybody on the same page is something I guess we're trying to do.

The deputy reminds me that the federal-provincial deputy ministers of health and social services are meeting on June 17 to try to begin to achieve the objectives set out in that discussion paper.

So this is going on at various levels.

The Chair: Thank you, Mr. Minister.

I will go back to Monsieur Bigras.

I think we'll have just enough time for you to answer a question by Madam Redman and then I'm going to let you go, after which we'll direct our attention to Mr. Dodge.

An hon. member: I didn't get a chance to ask a question.

The Chair: No, no, you'll have an opportunity. Don't worry.

Mr. Gurmant Grewal: Can we have two rounds, Mr. Chair?

The Chair: You can have a thousand rounds, Mr. Grewal, but we're here until 1 p.m., and—

Mr. Gurmant Grewal: The issue, Mr. Chair, is that if someone can have time twice, but another doesn't get time even once—

The Chair: No, I understand, but the rotation is by party. Madam Picard is giving her time to Monsieur Bigras. I mean, I can't help that. Everybody gets the same chance.

Monsieur Bigras.

Ms. Judy Wasylycia-Leis: On a point of order, Mr. Chairperson, I'm wondering if we could ask the minister if he could extend his time by 15 minutes to give us all a chance to ask two sets of questions.

The Chair: Well, I can ask him publicly for you, but I've already made the arrangement to have him out of here by noon, and I'm going to honour my arrangement. If he thinks he can make the change, that'll be his business.

So I've said it publicly, but I'm honouring my agreement with him to have him out of here by noon—give or take a couple of minutes, I hope.

Do you want to get one more question in?

Mr. Allan Rock: I can stay till 12.15 p.m., if that'll help. I am making an announcement with Minister Stewart, and I should be out of here no later than about 12.15 p.m. If that'll help, I'll be happy to do that.

The Chair: I'll tell you what will help; we'll give Dr. Martin an opportunity to ask a question.

• 1155

So we'll go to Monsieur Bigras—if we don't have any more points of clarification or order—and then we'll go to Madam Redman. Immediately afterwards, we'll give Monsieur Martin a question. That way, everybody will have had an opportunity to ask the minister something, and we'll direct our attention to Mr. Dodge afterwards.

Ms. Judy Wasylycia-Leis: What about the order?

The Chair: Madam Wasylycia-Leis, yes, we could go on a rotational basis, that's right, but we'll never get back to Mr. Martin, which will defeat the purpose of asking for the extension. But that's your prerogative as a member, and that's fine.

Let's go on directly to the questions. The minister has indicated a willingness to stay a little longer. I'm going to try to get him to answer the questions, if we can get to the questions.

Monsieur Bigras.

[Translation]

Mr. Bernard Bigras: I would like to go back to the special access program. Earlier, Mr. Minister, you said that you were pleased with the recent publication of guidelines for the special access program under section 56. These guidelines were released the very day that the Wakeford decision was rendered. The program already existed, but you repeated that there was in fact a special access program and you indicated, publicly, what the guidelines for this program were.

According to our information, there are apparently 20 applications for ministerial exception to use marijuana that are sitting on your desk and waiting for your approval.

Given the decision rendered by Justice LaForme, which I felt was based on compassion, given that he has now granted Mr. Wakeford a constitutional exemption and not a ministerial exception, and given that paragraph 14 of the LaForme decision indicated that section 5.1.1.C of your interim document is unfair—and I quote: "unfair question"—when will you process the applications that are currently sitting on your desk and do you intend to grant a ministerial exemption to these 20 applicants?

Basically, it's terrible that sick people are compelled to turn to the courts in order to obtain an exemption that they can get from the political and ministerial authority.

Mr. Allan Rock: I intend to begin making decisions with respect to all of these applications within a few weeks. As you have pointed out, we have established guidelines. This is the first time that this has been done. I am the first Minister of Health to establish such guidelines. It's also the first time that we have ever announced a research program on the use of marijuana for medical purposes.

[Editor's Note: Inaudible]

Mr. Bernard Bigras: ...of the Bloc.

Mr. Allan Rock: No. It's progress.

In his decision, Justice LaForme pointed out that we had acted responsibly by creating that framework under section 56. Yes, he also deemed that one of our questions had been unfair. It is clear that we have now set up a process for those people who would like to have an exemption in order to use marijuana for medical purposes.

I hope that within a few weeks, I will be able to begin making decisions regarding ministerial exemptions. Once again, we're making progress.

Mr. Bernard Bigras: Basically, the problem is, and you'll admit it, the whole issue of supply.

Mr. Allan Rock: That's not a problem for Justice LaForme.

Mr. Bernard Bigras: That wasn't a problem for Justice LaForme. He said that Mr. Wakeford could grow it at home and consume it.

• 1200

Mr. Allan Rock: The exemption is that Mr. Wakeford is now free not only to use marijuana but also to cultivate it for medical purposes.

Mr. Bernard Bigras: Exactly. Let me go back to the whole issue of supply. Do you intend to take into account the expertise that Canadian and Quebec companies have acquired in growing hemp and take advantage of this expertise to find a supply of marijuana, or are you planning to import marijuana, possibly from Mississippi or Holland?

Mr. Allan Rock: Why from Mississippi?

Mr. Bernard Bigras: Because Mississippi has a number of major universities with a great deal of expertise in this area. Can you tell us whether—

Mr. Allan Rock: Have you visited Mississippi, Mr. Bigras?

Mr. Bernard Bigras: No. Could you tell us whether any of your officials have recently travelled to Mississippi to see the expertise in marijuana cultivation that the University of Mississippi has acquired?

Mr. Allan Rock: I have asked my officials to prepare for the three components that I described: first of all, research parameters, and secondly, the possibility of having a Canadian supply of marijuana for research and medical purposes. At present, we are studying this entire issue. I know nothing about any trip to Mississippi. The deputy minister may have travelled to the University of Mississippi to look into these matters, but he hasn't talked to me about it.

The third option is the section 56 process, which we have already discussed. One of the possibilities would be to set up a Canadian supply of marijuana for these purposes. Someone could conceivably need marijuana for medical purposes, but might not have the tools to grow it himself or herself. That's a possibility, but we don't have all the answers today, Mr. Bigras. We must find answers in a responsible fashion, and we are doing that.

We have announced a direction and a policy. Now the details have to be hammered out. Naturally, you have asked me what the details were. We are in the process of implementing all these changes.

[English]

The Chair: Mr. Minister, this is a really engaging conversation, and we appreciate the fact that you're responding in such a friendly manner to Mr. Bigras. We know—and I can't resist saying this on behalf of all committee members—that your enthusiasm for this subject stems from the studies that this committee, under my predecessor, Mr. Simmons, conducted just prior to the last election. It's a topic that's galvanized the interest of the committee on an ongoing basis. I know that you and your departmental officials were responding to the studied approach by this committee.

I say this—and I know Mr. Bigras will agree with me—because victories have many, many fathers, and defeats are usually orphans. This is one of those cases where we would all like to claim paternity. So thank you for your initiative in this regard.

Madam Redman.

Mrs. Karen Redman (Kitchener Centre, Lib.): Thank you, Mr. Chairperson.

Your comment earlier, Minister, about making a joint announcement with Christine Stewart—I'm assuming it's Christine, anyway—is actually a great segue into my question.

Under the grants we're providing, speaking to the risks to health and promotion of public health, my question is, are we allocating for, or in any way being sensitive to, environmental issues? Something I have a personal sympathy for, and have a great deal of interest in my community about, is looking at health in that broader scope.

I'm just wondering if we're directing both the research dollars and education dollars we're putting into this to partnering with non-governmental agencies, or directing research to those areas.

• 1205

Mr. Allan Rock: Let me answer in two ways. First, we are systematically going through the Health Protection Branch to determine where the most urgent needs are for more money, more resources, more scientists, more attention and more effort. Blood was the first, second was food, and the next is environment. The focus of my next specific request from cabinet colleagues for more reinvestment in Health Canada will be in the environmental area, because again, as in food, we establish standards for environmental safety in many respects, although others are responsible for enforcing and making sure they're respected.

We're finding that given the increased complexity of the environmental issues, the new knowledge about the effective substances, and the need to re-evaluate substances that had in the past been taken as safe, more money and more attention are required.

As part of the first response, I have to tell you that we put aside $82 million over the last two budgets for research in toxic substances and their effects, both long term and short term, on the human body, human health, and so on. One of the things Christine Stewart and I will be announcing this afternoon is a series of grants to people to conduct specific research projects using that money. It's really the first significant expenditure of that money.

The second response I would give you is that the Canadian institutes for health research will result in a very fundamental difference in the way we conduct health research in Canada. It will no longer be medical research. Right now we have the Medical Research Council—that means people in white coats looking at molecules through microscopes. It's very important and is where you discover cures and treatments, but it's laboratory-based medical science. We will now have Canadian institutes of health research—health being a much broader term than medical. The four points in the spectrum will be there. Yes, there will be biomedical research, but also clinical—what happens in the field. There will be health services delivery—research into how we can better deliver health services in modern communities. Determinants of health is the fourth point. How do you prevent illness? How do you promote good health? That's the point, in particular, where environmental issues will come to the fore.

On the interim governing council of the institutes and the eventual governing council, we have not only all those four represented, but also industry, the charities, the voluntary sector, the public, universities, and the provinces. So we're taking a very wide and comprehensive approach to health research, not just medical research. I think it's essential that environmental issues be part of that, and I assure you they will be.

Mrs. Karen Redman: That's very reassuring. Just very quickly, I'm pleased to hear about the clinical trials of marijuana, because in my constituency I think we have the highest incidence of MS per capita in Canada, if not North America. I was with a group of them last week, and they're really looking forward to when you make your announcement.

The Chair: Mr. Minister, you talked about the three priorities you have, and I think there's a fourth one. It's an ongoing one that has captured a lot of attention by this committee in the past and in this current mandate. It's the issue of prevention and promotion, specifically as they relate to tobacco, tobacco products, and the proactive approach government is taking—particularly your department—in addressing this health issue, in particular among youth. I have a couple of questions.

First, in your estimates you have a substantial amount of money put aside for public education—a substantial amount of money, on an annual basis over five years, directed specifically at curbing youth consumption of tobacco products. I'd like to get an understanding of how effectively that money has been utilized in the marketplace.

Secondly, has it been producing the kinds of results we would have expected? I say we collectively—all legislators regardless of political stripe—especially as it relates to an education program directed specifically at youth.

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I recognize the difficulties legislators have in this regard. A Supreme Court decision came before the public about four years ago and essentially thwarted the initial directions legislators had, to engage in one of their primary objectives, i.e., prevention, with respect to addressing tobacco consumption.

Mr. Allan Rock: We reacted to that by tabling the Tobacco Sales to Young Persons Act. Minister Dingwall tabled that in early 1997 and it was passed before the election in 1997. So we took the advice of the Supreme Court, which said we had gone too far with the first statute. We've now enacted the Tobacco Sales to Young Persons Act, which we believe is consistent with the Supreme Court's judgment. Now it's in court, and we'll find out, but we think we have it right. So that part's been looked after.

Putting words on a piece of paper in a book in the parliamentary library is one thing, but making them come to life in the communities is quite another. That's what you're really asking about, if I may respectfully suggest it. How are we moving from policy to practice in getting kids not to smoke? What I usually say to Madam Wasylycia-Leis when she asks me this question in the House is “Well, we've set aside $100 million over five years”. I just say that, the Speaker stands up, I have to sit down and it's over anyway.

But I can go on a little longer today and say that half of that is set aside for enforcing the Tobacco Act. In other words, when the Tobacco Act uses the federal criminal law power to say you can't sell cigarettes to people under 18, that's all very well, but how do you make sure that happens? Well, we've taken the $50 million over five years—$10 million a year—and entered into agreements, for example, with provinces. Some of them have taken the responsibility for hiring the enforcement officers themselves; others use federal people. But we actually have efforts going to corner stores and using young people, or in other respects, gathering information to find out whether store operators are selling to young people. If they are, then they're prosecuted.

You saw recently in the newspapers we're looking at the possibility of using the Contraventions Act so we can give a ticket instead of having a long and expensive court proceeding. So whether it's through enforcing the age restrictions on the sale or in other respects, we're devoting half of that money to enforcing the Tobacco Act, so it really has an effect on the ground.

The other half of the money—$10 million a year over five years—we're devoting toward efforts to get people not to smoke, particularly if they're young, or to cut down or quit if they're already smoking. That involves a wide variety of steps, such as TV ads, public education through people using school rooms, or underwriting the cost of community programs to get information out there to kids.

Now, you asked a very fair question, Mr. Chairman. What do we know about the success we're having? Is it working?

The Chair: Is it?

Mr. Allan Rock: Well, you look at the rates of youth smoking and you wonder and worry. It's very tough. You know, I'm the father of a 14-year-old girl and two boys who are about to turn 12. They're at the highest risk group for the attractiveness of smoking. I started smoking myself when I was 13 years of age and smoked heavily for many years. I know the nature of the addiction and I know its attractiveness if peer pressure is there.

Environics just did some work for us—you may have seen it published in newspapers recently—on what attracts kids to cigarettes. Peer pressure and the fact that it's deemed to be cool are among the leading factors. So I can't tell you we have the formula to prevent youth smoking. I can't tell you we have the formula to make a real dent in the rates of smoking overnight, but I can tell you we're always at work trying to figure out how to improve our efforts.

Last January, for example, we had an international meeting here in Ottawa, which I attended. We brought in people from around the world who face this same problem, to try to figure out what they're doing and what we can learn from them that might help. People came from Massachusetts, California, and Florida—states that have devoted big money in aggressive campaigns against youth smoking. Some have been more successful than us, so we're using some of their techniques and looking at others.

We have a caucus committee that's looking at this whole issue of Bill S-13, whether we should be spending more money, and how it should be done in collaboration with the health groups. That committee's going to report in due course, and maybe we'll learn something from them.

The Chair: I hope as soon as you get hold of some of the data that gives us an indication of the effectiveness of some of these programs, you'll make it available to this committee. I'm a non-smoker, by the way, and never succumbed to the temptation when I was 12 or 13, even though my dad was a chain-smoker. But like everybody else on this committee, I guess I'm just as interested, like all committee members, in seeing if the money we devote to these projects actually bears fruit. You would find no happier MP if the answer were yes.

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Mr. Allan Rock: Let me just conclude by saying that Ian Potter's among those in attendance, and he will be able to give you more particular details as to how the money is being spent and what the results have been.

The Chair: We'll get him on this next round. I know that you have to leave and we promised we'd have you out of here. Thank you very much. Mr. Dodge and his staff are still staying here, so we'll continue through the questions until the questions are exhausted.

Mr. Allan Rock: Thank you very much, Mr. Chair, and thank you, colleagues.

[Editor's Note: Inaudible]

Mr. Gurmant Grewal: —

The Chair: No, I didn't say that, but thank you very much.

We'll take about a 30-second pause and let the minister leave, and then we'll go back.

Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: Thank you very much, Mr. Chairperson. We've just heard a lot of fine rhetoric from the minister and concern about many issues that have been in the public eye over the last while with respect to the safety of drugs, foods, and blood and medical devices, but we've had no specific actions announced today.

The deputy minister confirmed my worst fears: that this government is indeed bent upon an approach of off-loading onto universities in terms of research, and partnering with business for risk management or reducing liability. So I would like to know from the deputy minister, and I would have liked to have heard it from the minister, specifically what action plan is in place to deal with the safety of our drugs, foods, medical devices, blood, and so on.

We hear a lot about standards. The problem is there is a very limited investigative capacity, as we know clearly from the recent report by Brian Emmett. There's no enforcement, basically. There is no independent research capacity. So I'd still like to come back to why this government, in the face of all these difficult issues, isn't putting some resources back into the in-house, independent research capacity of the Health Protection Branch to ensure that whenever serious issues emerge we've got the ability to track the problems, and why we aren't going down the path of a more proactive approach, as opposed to this passive risk-management agenda that is clearly being pursued.

The Chair: Mr. Dodge.

Mr. David Dodge: Mr. Chairman, first off, in order to conduct the most effective research, what we really have to do is ensure not only that we have researchers within the department, but that those researchers work in an atmosphere and work in a context that is likely to be most effective. That context requires us to open up the department; to have researchers publish, be subject to peer review, and be subject to the best scientific standards; and to work with researchers who are out there in our universities, and indeed, out there around the world.

So to talk about offloading is absolutely the wrong word. This truly is building a partnership so that we can provide services better to Canadians in the years to come. This will cost more money. Indeed, we are going to be devoting additional resources to that research, starting, as we indicated, with the Bureau of Biologics now moving this year into foods. And as the minister indicated, our next major step will be in the area of environmental health.

The Chair: Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: Will any of that new $65 million go into restoring capacity in the food research laboratory?

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Mr. David Dodge: We have a problem looking ahead, not looking backwards. There are a lot of new problems as we look ahead in respect to foods, and what we and Dr. Le Mageur will be doing is building a capacity to try to deal with the problems that are confronting us down the road.

Ms. Judy Wasylycia-Leis: Have you responded at all to Brian Emmett's report indicating that when it comes to toxins in foods, this is an area in which he's identified a disturbing lack of vigilance, inspection, and cooperation between departments? Contrary to the minister's statement that Canada has the safest food supply in the world, he points to the fact that there is evidence showing a marked increase in pesticide residues in Canadian fruit and vegetables, and really no capacity for this government to identify the dangers of those toxins and to take necessary steps. Is there a plan of action in place to start to deal with this area of toxins in Canadian foods?

Mr. David Dodge: Mr. Chairman, our strategy here is to be absolutely gold quality in the work we do, and to ensure that we have access to gold-quality work across all areas both from other Canadian sources and internationally. In fact, in some of the key areas here... Canada is an absolute leader in the world in the area of prions. Perhaps Dr. Losos would like to come to the table and talk further about that.

With respect to the field operations, which I think was the other part of your question, our job under law is twofold: first to provide the rules; and secondly, to provide the audit and follow-up to ensure that those rules in fact are being enforced. That is, as you know from the new legislation, a bit of a change. We are doing that. And obviously as we start off not everything is perfect, but it will get better over time.

Perhaps Dr. Losos could say a couple of words about this.

The Chair: It would be a couple, unless we go to another round.

Dr. Joe Losos (Assistant Deputy Minister, Health Protection Branch, Department of Health): Mr. Chair, if I could comment on the deputy's comments on prions, certainly with the blood investment, the new money on blood, we've strengthened our capacity very proactively. This looks like it's a looming world problem, and it's very similar in many ways to the early days of the HIV epidemic. It's an unknown pathogen. We don't really know how it's spread. It seems it may be spread through blood, potentially at least, but there are other methods of spread.

So we are being very proactive in setting up and mobilizing a number of academic centres, including the Tanz Institute in Toronto, to help us with diagnostics, and a number of other laboratories in and around the country. We are setting up a new capacity in the Winnipeg facility to look at the genetics and the chemistry of these strange organisms that cause infections.

Frankly, we're leading the world as far as surveillance is concerned. A week from now we'll be having an international meeting in Winnipeg to upgrade the design of national surveillance systems in Creutzfeldt-Jakob and other prion diseases. So we are right on top of this particular health problem.

The Chair: Thank you, Mr. Losos.

I think I have Madam Picard next.

[Translation]

Ms. Pauline Picard (Drummond, BQ): I have three questions to ask, if you don't mind, and I'll try to be brief.

The first has to do with the regulation of tobacco products. I don't know whether my colleagues have experienced the same thing, but ever since you tabled the consultation documents, practically all the merchants in my area who sell tobacco products have sent me a letter or tried to meet with me to discuss the regulation of tobacco products. I think that retailers are very concerned because the consultation document says that they may have to change the physical layout of the place where tobacco products are sold, and the displays.

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If you intend to issue regulations that would oblige merchants to change the way they display tobacco products and make physical changes to their premises, does the budget for these regulations include amounts to compensate merchants for their expenses in this area?

My second question is about reproductive technologies. According to the newspapers, you are getting ready to table a bill on new reproductive technologies. Apparently you are using the British example as a model. Could you tell us more about this study that you are currently conducting?

My third question relates to tainted blood. I'd like to know what stage you have reached in the negotiations with Quebec for the compensation of all victims. We know that a part of the $300 million amount is due to Quebec since it already provides the drugs.

The Chairman: Thank you, Ms. Picard.

[English]

Mr. Dodge, I know you were looking for some of your other staff to address that first question.

Mr. David Dodge: Thank you, Mr. Chairman.

The Chair: Mr. Dodge, if there are other members you want at the table, please don't be shy. We've invited everybody because we wanted to speak to everybody.

[Translation]

Mr. David Dodge: I'll ask Marie Fortier to answer you concerning the new reproductive technologies and tainted blood and Ian Potter to answer your question about the regulation of tobacco products.

The Chairman: And negotiations with Quebec?

Mr. David Dodge: Yes.

Ms. Marie Fortier (Assistant Deputy Minister, Home Care Development, Department of Health): Mr. Chairman, as far as the genetic and reproductive technologies are concerned, the model the Minister recently referred to and that he intends to present to the Cabinet Committee shortly contains two parts. The prohibitions adopted by the House of Commons in 1996 will probably be substantially the same; the main difference between the 1996 bill and the one the Minister intends to present is the creation of an agency that will play a role relating to those technologies that are authorized but that require regulation.

The British model is the model of a fairly autonomous agency. The decisions relating to the link between the agency and the government have not yet been taken. Of course there will be a link but it remains to be determined. In the final analysis, it is the Prime Minister's prerogative to choose what type of relationship there will be between the agency and the government. It is clear that this will be an agency with a federal mandate. A great deal of consultation must take place with the provinces concerning their role in the management of this system once it has been set up.

As far as tainted blood is concerned, negotiations with the complainants are advancing very quickly. As you know, the federal government is negotiating jointly with all the provinces in this matter. It is an example of very close collaboration. We expect that the proposed regulation will be tabled before the courts by mid-June. At that time, all the interested parties will have an opportunity to make their representations to the courts and the final decision to approve the agreement will be made by the courts in three places, in Ontario, Quebec and British Columbia.

The Chairman: Thank you, Ms. Fortier.

[English]

Mr. Potter.

Mr. Ian Potter (Assistant Deputy Minister, Health Promotion and Programs Branch, Department of Health): With respect to the question on regulation of tobacco products, we are at present looking at promulgating regulations in three areas. One area is with respect to the reporting by tobacco companies, which has actually been proposed, and we're into a formal consultation with the companies and other organizations about that. The second areas is with respect to labelling of tobacco products, and the third is with respect to promotion and what kind of promotional activities can be undertaken.

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I believe the question that you raised is with respect to the nature of the promotion and the effect it might have on the vendors of tobacco products. At this time we are only at the preliminary stage of discussions. We are having active discussions with the companies, with the representatives of the store owners that sell tobacco products, with health groups, with the general public. We have put forward some discussion papers about how we could approach the question of promotion, but we haven't made a formal proposal yet. As you know, when we make a formal proposal there's a period of consultation, and at that time we will have to determine the impact of the specific proposal we come to.

At this stage, therefore, we believe it's too early to get into the what-ifs, because we haven't come to an agreement on a particular proposed set of promotional regulations.

The Chair: Mr. Potter, perhaps I could follow that up for a second.

As Madam Picard has indicated, many members of Parliament, especially those who are on the health committee, are receiving letters from virtually all of the variety store owners and every small retailer in their ridings regarding the proposals to which you've just alluded. Many of those people are telling us that with respect to promotion, the regulations that are being contemplated will have a direct negative impact on their revenue. They ask why Mr. Villeneuve—you know, Canada's athlete of the year of a year ago, the famous formula one racer—doesn't have the same kind of negative repercussions they do. Is that an unfair question?

Mr. Ian Potter: Mr. Chairman, I don't know that I could answer that question.

I can tell you, though, that there has been a letter circulated to corner stores and other retail outlets for tobacco products by tobacco companies. We felt, and we have expressed this to them, that the contents of that document were not fully accurate, did not fully portray the position of the Government of Canada at this moment, and our minister has sent a letter to them and to tobacco merchants as well—I believe he has sent a copy to all members of Parliament—outlining our view as to what the situation is.

Obviously it's not the intention of the government to introduce regulations that will result in economic harm to small retailers, but we do have an obligation to the health of Canadians to take steps within the law that would restrict the selling and promotion of tobacco products. We are trying to develop regulations that are consistent with the will expressed in the law passed by Parliament, but we also recognize the situation of current retailers.

As I said, we're in the process of discussing those at the moment, and when the minister takes the decision to put forward a specific proposal on those regulations, we will have further discussion on their impact.

The Chair: Thank you, Mr. Potter.

For those members who have not yet received a copy of the letter from the minister that you mentioned, I wonder if you would make that letter available through the clerk so we can distribute it among the committee members.

[Translation]

Mr. Drouin.

Mr. Claude Drouin (Beauce, Lib.): Could we have the details on the proposal being made by the department? Will it result in costs for retailers who are in a difficult situation? We know that the large retail stores are open seven days a week until late in the evening. If they're forced to make changes to their set-up, it will be a significant burden to them. Is that part of your proposal? I'd like you to elaborate a bit on this because I have not seen the letter from the Minister. Thank you.

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The Chairman: Thank you.

[English]

Monsieur Dodge, did you want Mr. Potter to answer that?

Mr. Ian Potter: At the moment, Mr. Chairman, it's very difficult to determine what impact there would be and what would be an appropriate role for government. These relationships are commercial relationships, generally between the retailer and the tobacco companies. It's very difficult, not within our power, to determine what action the tobacco companies will take with respect to the funds they are now providing to retailers to promote their products. In some ways this is the equation... It's a commercial transaction in which we are not really able to determine the action of both parties. I think, at the moment, it is speculative as to what the impact would be. When we have a clearer idea of the kind of regulation we're proposing we will look into the expected impact.

[Translation]

Mr. Claude Drouin: If I understand correctly, you are saying that the tobacco companies have agreements with each retailer to pay for the costs involved. You are sure of that. I gather that the measures that you are considering have not yet been established. We are told that what is exposed to customer view will have to be out of view but nothing has been set down. Is that what you are telling us?

[English]

Mr. Ian Potter: I can only repeat that it's not within our power to determine what actions the tobacco companies will take. In some ways it may be that they indicate they are prepared to take certain actions to encourage the government to follow a different line. We're apprised of the situation. We are going to try to honestly understand the situation. We are in dialogue with those concerned. It's our hope that we will provide recommendations to the minister that provide a full understanding of the impact, that at the same time respect the law and the intent of the law so that the regulations can have the desired effect and can put the interests of the health of Canadians as a premier concern, as per the will of Parliament under that law.

The Chair: Thank you.

Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: Thank you, Mr. Chairperson.

I have three questions. One, back to reproductive technologies for a moment, I would ask Marie. The news reports today suggest that in the deliberations around the bill to come before Parliament on reproductive technologies, the bill will actually not prohibit the sale of sperm. I think that comes as a complete shock to many of us, given the news reports around money-making efforts in the area of reproductive technologies. Is that clearly the case? Is it on the table, that the new legislation may in fact not prohibit the buying and selling of sperm? Does that also include, then, human eggs? And where does that take us in terms of human organs?

The Chair: Is that all of your questions?

Ms. Judy Wasylycia-Leis: That's one question, Mr. Chairman.

The Chair: Do you want to get the other ones in?

Ms. Judy Wasylycia-Leis: Or I could hear the answer on this and get to the others if time permits.

The Chair: Okay. Nothing has been presented before us, so go ahead.

Ms. Marie Fortier: All I can say is that the legislation is not drafted yet, obviously. The next step for the minister is to take his proposal to cabinet for drafting instructions, following which it will be drafted. It will then be tabled.

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I can't tell you what cabinet will decide until cabinet decides. The prohibitions we're considering are the prohibitions that were in the 1996 act, but things change, and the minister has to look at the evolving reality since then. As well, as he said himself, he has to look at the reactions to the earlier bill and how that played out when it was debated, because it was in 1997, as you know.

It is not that everything is up to being reconsidered from A to Z, but I really can't answer you with absolute certainty on any aspect of the bill until cabinet has decided.

Ms. Judy Wasylycia-Leis: I'd love to pursue this, but I know you're going to cut me off soon. However, I'd like to ask David a question about the minister's earlier statement about you announcing at the Senate committee hearings on May 13 that a process had been put in place, a committee struck, involving consultation and community participation on HPB transitions.

My concern is as follows. I know that a number of groups were asked to participate in a meeting through the Department of Health on April 19 at which there were 14 different groups represented. I understand Dr. Losos was present, Ian Shugart, Joel Weiner, and Mary Hegan. At that time the proposal was put before these groups around a citizen-focused HPB, and assurances were given to those groups. They raised concerns. They said they would be invited back for consultations. They haven't been, yet you have proceeded, at any rate, with an announcement—or the minister has—for that process. I think there are real concerns about how genuine the government is with respect to citizen participation and how that truly fits with the recommendations of the consultation report talking about a more transparent and open decision-making process.

Mr. David Dodge: Let me respond to that in three ways.

First, the only decision that has been taken is that we will establish this office. Prior to doing that and establishing the modalities for it, although we have set aside money to do it, we are going back for another round of consultation over the course of the summer on this. I cannot tell you today exactly what the modalities will be, because we are going back for some further consultation. Indeed, that office will undoubtedly evolve over time as we see what is effective and what is not effective.

Clearly, for the Health Protection Branch or any of our operations at Health Canada to really have the trust of the public, we must function in an open and transparent way. That is the minister's commitment, that is my commitment, that is the department's commitment. The real trick is to find out how to do that in an effective way. That is number one.

Number two—and this is a very real problem for us, as I know you appreciate—with respect to all of that material that comes in that is commercially confidential, how can we release enough of that information that citizens can have confidence that the products are fine and that we have done our job in an appropriate manner, but at the same time do not release so much that companies simply say “Well, we're not going to put stuff on the market in Canada because all of our commercial secrets will be revealed”?

This is an extraordinarily difficult balance. It's a balance parliamentarians are going to have to help us with as we go forward, because it is in part legal as well as simply practical. So as we come forward to you at some point with renewed legislation, we are going to have to really try to get that balance right. There is no absolutely right answer. This is a very difficult issue. I know I, the minister, and my colleagues really will welcome input on this very, very, difficult issue.

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The Chair: Thank you, Mr. Dodge. I know we've moved away from estimates, but I thank you for your willingness to answer all these questions.

I'm going to close with Madam Picard.

[Translation]

Ms. Pauline Picard: I'd like to come back to the clarification that Mr. Drouin wished to obtain about the regulation of tobacco products. It's important to understand the point here. All corner stores and retailers now receive from $1,000 to $5,000 for customer display cases on their counters. Retailers, particularly small ones, claim that if they are no longer allowed to display these products on their counters, it will mean a significant revenue drop for them because they are small retailers. Moreover, if they're asked to modify their counters for the display of cigarettes, it will mean additional costs. In other words, they will have decreased revenue along with extra costs.

We would like people from the working group to have a look at this question. Would it not be possible for us to take steps to support retailers who will be undergoing costs? That is what I think. I wanted to clarify the point being made by Mr. Drouin.

[English]

The Chair: Do you want to give it another shot, Mr. Dodge?

[Translation]

Mr. David Dodge: It's difficult because the regulations are not yet complete, but it is quite true that the results of our efforts will be measured by the reduction in the sale of tobacco products. Corner stores and other retailers will see a drop in their sales. That will be a good result from the point of view of health. That is what we hope to achieve. The effect on retailers may be more or less difficult. Of course we would like to come up with a less difficult impact on retailers but there will nonetheless be a change and I hope there will be a decrease in sales.

[English]

The Chair: Thank you, Mr. Dodge.

Before I let you go, in case I forget to do so, let me thank you and your staff for coming. I know we will have an opportunity to call them back again, because next week we're going to begin reconsideration of Bill C-247, and maybe some of your staff would want to be available to us. I know we've already made some initial contact with your staff in terms of having them here before us, so we can be appropriately briefed and can address the appropriate questions. I know we have this ongoing relationship where your staff is always available to us when we need them, and I thank you for that on behalf of the entire committee.

I didn't want Mr. Losos to go away before receiving a question from the chair. I wonder if I can have him back for a moment. It's really a very brief question and then we can proceed to consideration of the estimates.

Mr. Losos, thanks a lot. This is a bit of a specific question, but I thought you might be the one who could address it. I'll be very brief. You are familiar, I think, with the drug Herceptin. It's a new drug. Oncologists have referred to it as a breakthrough in the treatment of metastatic breast cancer. I'm a little hesitant to ask about it, because it's a very specific question.

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Dr. Joe Losos: I'm not that familiar with it, Mr. Chairman, but since you asked the question, I'd be very happy to get back to you on it.

The Chair: Thank you.

Breast cancer advocates report to us that the material on Herceptin to support its approval in Health Canada was filed with Health Canada in September 1998. They were given assurances that the drug would be fast-tracked, with a decision in 180 days. As of today, there is still no decision on Herceptin, and therefore it is not available to women in Canada. Can you give us an idea of where Herceptin is in the approval process?

Dr. Joe Losos: Marta Caris has the pharmaceutical assessment group. I will find out from her today and through you as chair I'll get you the information.

The Chair: The next two supplementary questions might be a little redundant. I'll ask them anyway, just so you'll be aware of them. Perhaps when you can give us a response through the clerk I can distribute it to all members. This might be helpful.

How does the fast-tracking of cancer drugs compare with the fast-tracking of drugs for patients with AIDS or HIV?

Dr. Joe Losos: Mr. Chairman, the fast-tracking of drugs goes through quite a systematic process: the burden of the disease, the science behind the drug itself, and whether or not it will in fact have a high potential of helping people. When these criteria are selected, drugs are fast-tracked. They're not selected vis-à-vis one disease against another. They're selected for their impact on the disease specific to that drug. We don't compare or weigh one disease against another.

The Chair: The next question would interest all MPs. First of all, does the advocacy effort influence the speed of the drug approval process in Canada? And if so, to what extent?

Dr. Joe Losos: Mr. Chairman, the advocacy movement is important in Canada for people to let their opinions be known. I will assure you that we go through our process based on health and safety. If a drug has a high potential for impacting health, we'll give it higher attention. We get advocacy from both sides, from industry and from the public sector, all the time. We focus in on health and safety, and that's the way it has to be.

The Chair: Mr. Losos, thank you for your forthright answers.

Again, Mr. Dodge, to you and all of your staff, thank you very much for coming and helping the committee through its deliberations of the estimates and in the consideration of questions that are related, even if marginally so, to the estimates. They are very important from a policy perspective. Thank you, once again.

While you're on your way out, the committee has a brief moment or two of business. I hope you won't mind if we continue.

I have a question, colleagues, about whether or not we are going to report the estimates. I'm assuming that what we'd want to do is give a report on the estimates or at least the consideration that the committee has considered the estimates.

Mr. Ovid Jackson: Are you looking for a motion for that? I so move, Mr. Chairman.

The Chair: It is seconded by Ms. Minna.

We'll all go through the process. I have a series of motions that have to be asked, and I'm hoping we'll have concurrence.

I now call vote 1. Shall vote 1 less the amount of $249,813,000 voted in interim supply carry?

HEALTH DEPARTMENT

Health Department

Vote 1—Operating expenditures ...... $999,252,000

(Vote 1 agreed to)

The Chair: I now call vote 5.

Health Department

Vote 5—Grants and contributions ...... $822,677,000

(Vote 5 agreed to)

The Chair: I now call vote 10.

Hazardous Materials Information Review Commission

Vote 10—Program expenditures ...... $1,009,000

(Vote 10 agreed to)

The Chair: I now call vote 15.

Medical Research Council

Vote 15—Operating expenditures ...... $10,650,000

(Vote 15 agreed to)

The Chair: I will call vote 20.

Medical Research Council

Vote 20—Grants ...... $263,475,000

(Vote 20 agreed to)

The Chair: I call vote 25.

Patented Medicine Prices Review Board

Vote 25—Program expenditures ...... $2,750,000

(Vote 25 agreed to)

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The Chair: Shall I report the estimates to the House?

Some hon. members: Agreed.

The Chair: Okay, thank you.

Be it so ordered that the chair reports the preceding votes, as reported, to the House.

Colleagues, I thank you very much for your patience through all of this and for your support through the entire process.

I'm not sure, Madam Clerk... On Tuesday, what is the status of the...

The Clerk of the Committee : There is no meeting on Tuesday. The next one is Thursday.

The Chair: Okay. And those people who wanted to add other members onto the consideration for Bill C-247, have you been getting those?

The Clerk: I spoke with Judy Wasylycia-Leis, so we're fine.

The Chair: Okay. So we will meet then on Thursday on Bill C-247.

Ms. Maria Minna: Mr. Chair, I won't be here on Thursday.

The Chair: I'm going to try to do it without you, Madam Minna. We have that agenda to meet.

Ms. Maria Minna: I'm just letting you know that there will be some members missing.

The Chair: I understand that, Madam Minna, but we're going to try to get that done, if we can.

Ms. Judy Wasylycia-Leis: So it will be on Thursday, then the following Tuesday.

The Chair: That's right.

[Translation]

Ms. Picard.

Ms. Pauline Picard: Will we not have a meeting on Tuesday?

The Chairman: No, because the witnesses were not available.

Ms. Pauline Picard: I see.

The Chairman: So we had to make adjustments for next Thursday and Tuesday.

Ms. Pauline Picard: I see. Thank you.

The Chairman: Thank you, Madam.

[English]

The meeting is adjourned to the call of the chair.