:
Thank you very much.
Merci, monsieur le président. Mr. Chair and colleagues, it is my pleasure to join you once again in the standing committee.
I will introduce a few of our officials who are here today. First is Dr. David Butler-Jones, who is of course the Chief Public Health Officer of Canada and head of the Public Health Agency of Canada. Next is Susan Cartwright, who is the associate deputy minister of Health Canada, and next is Frank Fedyk, the acting assistant deputy minister of the health policy branch in Health Canada. Then comes Chantale Cousineau-Mahoney, who is the chief financial officer of Health Canada; and Luc Ladouceur is the chief financial officer of the Public Health Agency of Canada.
With your consent, of course, Chair, I will ask them to address any of the more technical detailed questions that come up today when I am unable to answer.
But before we take those questions, I want to make a few points, including this one. These supplementary estimates are substantially about one fact: when it comes to our government, the new government of Canada, we are keeping our health promises to Canadians. Since Canadians elected the government, we have followed through on our campaign commitments.
Our main priority is one I will of course elaborate on further, but we have been working with the provinces and territories to introduce patient wait time guarantees. l'm proud to remind members that on Monday, I announced this country's first ever pilot project on wait time guarantees.
We've also shown our commitment through our announcement in July of nearly $1 billion that has been set aside in a special settlement fund for Canadians who contracted hepatitis C through the blood system before 1986 and after 1990. This is a promise our party made during the election campaign and of course has kept.
In fact, we've demonstrated our commitment to the health of Canadians through several recent announcements as well.
For example, two days ago we announced a series of measures to help the thousands of individual Canadians with autism spectrum disorder, or ASD, and of course their families. These measures include beginning to explore the creation of a research chair to focus on effective treatments and interventions; a consultation process to develop an autism surveillance program; a stakeholder symposium; a new web page on Health Canada's website; and the designation of my department's health policy branch as the policy lead on ASD.
Only a few weeks ago I announced that work will begin on the development of a new heart health strategy to fight heart disease in Canada. It is backed by an initial investment of $3.2 million this fiscal year and it increases to $5.2 million annually for future years.
We're taking concrete action on protecting human health and the environment. Canada has completed its systematic review of 23,000 chemical substances used in general commerce prior to 1994, and we are the first country in the world to do so.
In fact, the World Health Organization, among many others, has called our scientific and innovative approach “precedent setting internationally”. The completion of the process will form the basis for our chemicals management plan moving forward.
Mr. Chair, we're following up on our commitments through the budget as well. We are doing it through policy choices. We are doing it through program decisions. That's the real story of these estimates. We are backing up our commitments, with real money, right now.
Let me take a few minutes to comment on some specifics that prove that point, right across the health portfolio.
[Translation]
I will insert a few paragraphs in French in my presentation.
[English]
Let me start with my first priority, which is moving ahead on patient wait time guarantees.
In a nation as wealthy and as modern as Canada, I believe it's simply unacceptable to have a health system that permits unconscionably long delays, in some cases, and offers patients no recourse to alternative treatment options.
We see the development of patient wait time guarantees as a necessary evolution of our health care system. In fact, as I announced on Monday, Canada's new government is the first in the country's history to introduce a guarantee pilot project, based on patients receiving the care they need when they need it.
I announced that I am working in partnership with first nations to develop patient wait time guarantees for prenatal care on reserves. We'll begin by working with first nations communities to develop and test a set of guarantees, through pilot projects in up to ten first nations communities, that will ensure women on reserve will have access to early prenatal care in the first trimester and throughout the pregnancy.
We are also seeing progress on wait time guarantees across the country, as provincial governments take action within their own jurisdictions, most notably, of course, in the province of Quebec. Through discussions with my provincial and territorial colleagues, we're looking to expand that progress.
[Translation]
All Canadians will know what they can expect from the health system and will have recourse if their expectations are not met.
[English]
And our actions are helping governments deliver on those guarantees. A good example of this is our work on human resource issues in health.
We know that in order to better serve Canadians and get them the health care they need, when they need it, our system definitely needs more health professionals. Already we're investing $20 million annually to facilitate interprofessional education, to contribute to recruiting and retaining professionals, and to help forecast supply and demand for our health workers.
On Tuesday, I announced that through the internationally educated health professional initiative, Canada's new government is launching four new programs, totalling $18 million, to help increase the number of health professionals working in Canada. This initiative helps reduce barriers and build bridges, and it helps internationally educated health professionals secure their proper place in Canada's workforce. We believe this will lead to significant increases of up to an additional 1,000 physicians, 800 nurses, and 500 other health professionals.
There are certain other health needs that those professionals can help address. One is the potential of pandemic influenza.
When I appeared before you in June, I made my determination clear. Canada will be ready to deal with the potential of a pandemic influenza outbreak. I pointed out that Budget 2006 provides $1 billion over five years to further Canada's pandemic influenza preparedness. The supplementary estimates start putting that money in place, beginning with a total of $52.9 million across the government, including more than $24.1 million in the health portfolio. That money funds an improved capacity to detect a potential pandemic influenza outbreak. It funds our capacity to respond in case of an actual outbreak.
So for Health Canada, the Public Health Agency of Canada, and the Canadian Institutes of Health Research, the supplementary estimates are about expanding our emergency preparedness, research, antiviral stockpiling, and rapid vaccine development technology. They are about supporting the Canadian pandemic influenza plan for the health sector.
In fact, as part of that plan, my provincial and territorial colleagues and I have already agreed to work together to increase the joint national antiviral stockpile, from 16 million to 55 million doses.
[Translation]
This supplementary budget contains another element that proves our commitment to facing the eventuality of a flu pandemic: it is our investment in people.
[English]
As the provincial minister who oversaw the Ontario response to SARS in 2003, I saw firsthand how important a strong, skilled, and professional public health workforce is for the health and security of our citizens.
Our government is determined to continue working with all jurisdictions in this country to help ensure they have access to the public health professionals they need.
These supplementary estimates show that we mean what we say on the issue. They provide $4.2 million in new funding for the Public Health Agency of Canada and the Canadian Institutes of Health Research to increase the number of students in master's, doctoral, and post-doctoral programs relevant to public health; to increase the capacity of academic programs to provide training in public health; and to provide new tools for workforce development.
The money will boost the number of community medicine residents moving into practice and will support improved curricula and training resources for our public health professionals.
In short, Chair, we promised action, and the supplementary estimates demonstrate that we are putting real money behind our commitments to public health.
We met last in June. I also pointed out our Budget 2006 commitment to the Canadian strategy for cancer control. Together with the provinces and territories, we are moving forward on strategic priorities to address cancer in Canada.
Let me talk a bit about first nations and Inuit health. I mentioned some of the major new health initiatives of our government.
[Translation]
This supplementary budget also demonstrates our firm desire to shoulder our responsibilities with regard to the health of Aboriginals, notably by providing them with significant funds.
[English]
The estimates show that we're increasing funding for the non-insured health benefits program by $30 million to ensure it continues to meet the needs of eligible first nations and Inuit peoples. We're carrying forward another $8.1 million for that program so it can keep up with the need for eyeglasses, dental services, prescription drugs, and other items, as well as many services such as medical transportation.
As I mentioned earlier, this week I announced this country's first ever wait times guarantee pilot project for prenatal care on reserves.
Let me, finally, just make a few additional comments to end my opening remarks. I've only touched on some of the many actions covered by these supplementary estimates, and there are many more. For example, through supplementary estimates (A), the government increased the budget of the Canadian Institutes of Health Research by $31 million, bringing its annual budget to $737 million. That new money is now here in these supplementary estimates.
Over 10,000 CIHR-funded researchers and over 250 institutions across Canada are addressing priority areas such as wait times, cardiovascular disease, diabetes, fetal alcohol spectrum disorder, obesity, mental health, and cancer.
I hope to have the opportunity to describe our other initiatives during the rest of this hearing, but let me end with this point, Mr. Chair.
[Translation]
Promises made, results due. That is the objective of this supplementary expense budget.
[English]
Promises made, promises kept. That's the story of these supplementary estimates.
Thank you.
:
Thank you very much to the minister and his officials for taking the time to come before the health committee today.
I know in the past, from sitting on the health committee, that all members of this committee have worked very closely together to address the issue of health. I think it's of tremendous importance to Canadians all across the country. Being the critic for health for the Liberal Party, I know that both myself and my colleagues here today have received numerous e-mails and numerous letters and phone calls from concerned Canadians across the country.
I want to speak about an issue that perhaps resonates with people from all across the country in all provinces and territories, and that is the issue of the wait times guarantee. We saw during the last election that the Conservatives promised the implementation of a wait times guarantee, perhaps continuing on the work that the former Liberal government had done, both with the signing of the health care accord and the investment of $42 billion, in particular the $5.5 billion for the reduction of wait times.
There were five areas that were decided upon, both by the former federal minister and the ministers of health from all the provinces and territories. Those were in the areas, as you know, Minister Clement, of cancer, cardiac care, cataracts, CT and MRIs diagnostic testing, and hip and joint replacement. I think it was quite disturbing to many people around this committee, and also to Canadians and parliamentarians, when they took a look at the stories that have appeared in The Globe and Mail over this past week. Just today, we have a story that I think says it all, where perhaps some individuals feel that Ottawa has dropped the ball on waiting times.
I would like to know, despite the promise that was made during your election platform, what you have in your supplementary estimates that says that as a new government you are investing in the wait times initiative.
I know that last week you announced the initiative or pilot project for prenatal care. Putting that specific project aside, which you have also mentioned in your speech here today, what other types of initiatives have you undertaken since coming into government, of working with the provinces, of working with the territories, to ensure that wait times are reduced? Despite the fact that a pilot project dealing with aboriginal women is of extreme importance, it did not address any of the five priorities.
When we take a look at the article, it talks about the fact that people affected with prostate cancer have to wait longer than the four weeks and that women in the country who have been affected by breast cancer have to wait longer than the targets that were set by the health care accord from the Liberal government.
So what types of initiatives have you taken, Minister, to ensure that this issue is addressed?
Secondly, what types of financial and monetary resources are you providing to the provinces and territories to address this important issue?
:
Thank you for the question. It's a very comprehensive one. Let me answer it in a couple of different ways.
First, of course, when it comes to patient wait time guarantees, there are a number of cornerstones that have to be part of any promise.
We made a promise that said we would work with the provinces and territories toward the establishment of patient wait time guarantees in this country. That's a promise that we are keeping and that we intend to keep. Of course, some provinces are moving more quickly than others.
The Province of Quebec comes to mind, with its five guarantee areas, including cancer, cardiac, hip and knee replacement, and cataracts.
The previous minister in Manitoba indicated, at the legislative committee in Manitoba, that the wait time guarantees operate, in essence, in his words, in cardiac and cancer.
Ontario's government has announced that in eight out of nine targeted areas, the wait times have been reduced.
So things are happening out there.
What I wanted to demonstrate on Monday was that although we are of course willing to work with provinces, we're not waiting for the provinces. In areas of federal responsibility, where the federal government can be active, we are willing to show leadership. That's what Monday was all about. But there are other cornerstones, which include research.
In order to have guarantees rolled out in this country, we have to continue the research. You mentioned the benchmarks. The benchmarks are not picked out of thin air. They are based on clinicians and their decisions and approaches to these medical procedures. I did of course mention in my remarks how the CIHR continues to have increases in its funding. The Canadian Institute for Health Information continues to be supported by virtue of Budget 2006, and there are funds specified within their envelopes directed to research when it comes to wait time guarantees. That's one.
The second one is that you need IT, and through our government's continued support for Canada Health Infoway, I believe we are helping the provinces have the IT infrastructure that is going to be necessary in order to roll out the guarantees.
The third one I believe I did allude to in my remarks, which is health human resources. You can't establish a guarantee and then not have the medical professionals who are required in order to get that done.
Those are three areas. The fourth area, of course, is federal-provincial cooperation, which obviously is something we continue to work with, with our colleagues at the provincial and territorial levels.
So I would say, on balance, in answer to your question, we are moving ahead and we're showing leadership where it is required to be shown, but this is a multi-year, complex process. That is something that I and the Prime Minister indicated very early on, that this is not something where you walk into the chamber just down the hall and put a bill down. You have to work to achieve some consensus, and I believe we're doing that.
:
Thank you, Mr. Minister and officials, for being here.
I certainly can't speak for all Canadians. I wouldn't suggest that I could. I can speak for many of the residents in the constituency in which I live, which is Surrey North, and I can speak based on information that I get as the health critic for the NDP on correspondence that comes from Canadians who are concerned about our health care system.
Many people voted for the Conservative Party because they put faith in the promise that you made about wait times. I am hearing from people that they are concerned that they have misplaced their faith. I'm not going to take up time. Ms. Dhalla has covered wait times very well, but I needed to reinforce that I am hearing the same kinds of things that Ms. Dhalla has gone over.
I'd like to ask you three questions. I will do them quickly so you will have an opportunity to respond.
I realize, since you and I have both done this before, that hepatitis C has to go before the courts, but I don't know that it is not possible to put out an interim amount—because people are indeed dying, and they have, and we can name some who have died since the announcement was made—in order to at least help people get to that stage where they will have some money to be able to eat properly and nourish themselves, because they are suffering from this disease.
I'd like to ask about the elimination of the Inuit tobacco control strategy, which has some irony for me, because you announced a pilot project for prenatal aboriginal women, which is around wait times, and yet they will go back to a community where their tobacco cessation program has been eliminated. They will go back into homes and into communities where people are smoking at considerably higher rates than we might see outside the reserves or outside their homes. On eliminating the tobacco strategy, it's about 10%, or more than 10% actually, of the annual tobacco control budget. How is that community being serviced now? Was the previous strategy not working? Usually if a strategy isn't working, you alter it as you go along. You don't wait until the end of a project and then say now it's done. Is somebody creating a new strategy for that?
The second question I'd like to ask, if I could, is around the patent drugs and the additional dollars being asked for in supplementary estimates, which are normally unforeseen expenditures. Why is it unforeseen that so many people are going to come and want to talk at public hearings about patent drugs? Although I'm very optimistic that if you're having public hearings on patent drugs, it will indeed lead to the lower cost of drugs for people, I'm sure the intention of your public hearings is to lower the drug costs for people who are suffering from that.
My last comment would be about the Assisted Human Reproductive Agency. We have an agency on which we are spending money that does not have a board of directors. The regulations we have not yet seen. I don't know who has developed the infrastructure, who signs this off. If all this can be done without a board, why are we spinning it off at all? It seems that we have this agency on which we are spending a lot of money that doesn't really exist. I'm a little puzzled, and I would like to know how that money is actually being spent and when there will actually be an agency up and running, given the money that's going into it.
:
Thank you, Mr. Chair, and I'd like to thank you, Mr. Minister, as well as the other members who are here, for attending our meeting today. I certainly appreciate your being here to answer our questions.
Mr. Minister, I know you're well aware of the health care situation in the province of Ontario. Since that's where I'm from, that's the one I'm most aware of as well. We all know wait times are a huge problem. We're all facing long waits. We're all facing doctor shortages--most of us are, in any case--and shortages of family doctors in particular. We know that the people affected by hepatitis C had a long wait, and I think it's very commendable that a decision has been made on that. The human resources shortages definitely had to be addressed, and I'm certainly glad to see you've done that.
We've had people who have been concerned about all the other things we've talked about here today too--the autism, the heart strategy, the cancer strategy, and so on. I know that people in general are impatient, and it is understandable that they're impatient; they've been waiting a lot of years for something to be done. I think it's commendable that there is some hope that we are moving forward; I think people understand it, and they can see some movement on it, so although they are impatient, I know they're thankful that there is progress in sight. I just wanted to reiterate that.
In many cases, we're at a crisis stage in our health care system. It's not something that can be fixed overnight; it's going to be a long, slow process, and I think everybody needs to realize that.
There is one thing I wanted to ask you about. In my riding I have several children suffering from autism, and I have one family in particular that has taken very much of a lead role on autism in the provincial association in trying to move things forward with an autism strategy.
The challenges these families face are tremendous; they're horrendous, in many cases, and I know you're well aware of that. I know you have looked into this issue, and we've discussed it previously in different forums. I was very pleased to see some announcements were being made about autism. Could you please outline the announcement you've made?
I know that solutions or treatments for autism are a shared jurisdiction--there are provincial or territorial areas and there are areas where perhaps the federal government could help. Could you give us an outline of what you've done, and what you see as the federal role for autism?