:
I'd like to call the meeting to order.
First, I want to thank the minister for being with us. We have a full two hours today, and we certainly appreciate the minister taking the time, along with a good number of his departmental staff, to be here with the committee to talk about the estimates we have before us.
We want to get started and not leave too much time.
With the minister, we have Morris Rosenberg, the deputy minister; and then we have Frank Fedyk, the acting assistant deputy minister of the public health branch. Thank you for being here.
Of course, Dr. David Butler-Jones has been here many times. It's good to have you with us.
Marcel Nouvet is the acting chief financial officer from the chief financial officer branch. And then we have Luc Ladouceur. It's good to have you as well.
We thank you for coming and taking this time, and we look forward to your presentation, as well as a brisk round of questioning on the spending of this department.
With that, we invite the minister to start with his presentation, and then we'll move on to questioning.
I'll lay it out right now that when the minister is here, we have a different timing for the questioning. It's 15 minutes for the official opposition, 10 minutes for the Bloc, 10 minutes for the NDP, and then 10 minutes for the government; and then it's five minutes alternating.
Minister, the floor is yours.
[Translation]
I am pleased to appear before your Committee once again - this time to discuss Main Estimates for the Health Portfolio. I expect that all of you have some questions for me today and I would like to start by making a few points that will provide some context for the discussion.
[English]
Many of my remarks will refer to budget 2007 items that may not appear in the main estimates but will be included later in supplementary estimates. I want to discuss our overall vision for a healthier Canada, of which budget 2007 is a major part.
First, at Health Canada we're pursuing a new way of doing things. Across our agenda, we're getting results by working with a wide range of partners. This includes provincial and territorial health ministers, of course, but also health care experts, providers, and practitioners. It includes patient advocates, patients, and industry as well.
All of our efforts aim squarely at serving the needs of patients and improving the health of Canadians.
The best known example is our work with partners to modernize and transform the health care system.
[Translation]
Mr. Chairman, a year ago, the question for some was whether we could work toward the patient wait times guarantees that our government promised. A year later, the investments made through Budget 2007 are enabling all provinces and territories to show how these can be delivered.
[English]
I'm proud that every province and territory has agreed to develop at least one patient wait time guarantee by 2010.
Mr. Chairman, another important related commitment in budget 2007 is the $400 million invested in the Canada Health Infoway. The additional funding for this public, not-for-profit organization will support early movement toward patient wait time guarantees, through maximizing the benefits of information technology.
All of this is in addition to our government's launching four wait time guarantee pilots, three involving diabetic care and prenatal screening for first nations on reserve, and one linking Canada's 16 pediatric surgical centres.
All of these steps forward are grounded in our commitment to collaborate with our partners. For example, we're working closely with first nations and Inuit partners to find new and results-focused ways of improving health outcomes. Of significance are the joint initiatives under way with the Assembly of First Nations and the Inuit Tapiriit Kanatami, along with a tripartite initiative with the B.C. government and the B.C. First Nations Leadership Council. I believe each of these are revolutionary, quite frankly, but each of these sets the stage for improved health outcomes.
As minister, I'm collaborating with many partners to take on numerous other health challenges facing Canada as well. Canada's new government is creating a new Canadian mental health commission, which will consist of experts, patients, and policy-makers. This commission will work to reduce the impact of mental health on our families, and in our workplaces and communities in Canada, by focusing on mental health prevention, recovery, and education. This is the first time in Canadian history that there will be a high level, strongly led, national arm's-length body.
Our government also took the leadership last fall to announce a new non-profit organization called the Canadian Partnership Against Cancer. By drawing on expertise from across Canada and internationally, this new agency will serve as a clearing house for state of the art information about preventing, diagnosing, and treating cancer. With $260 million from budget 2006, this agency will implement a strategy for cancer control with such goals as reducing the number of new cases of cancer amongst Canadians, as well as enhancing the quality of life of those living with cancer, and finally, improving the likelihood of survival for Canadians with cancer.
Of course, we know that science will contribute to our progress in fighting cancer, and science is also central to the chemicals management plan our government launched last December. Through an investment of $300 million over four years, Canada will become a world leader in testing and regulating the chemicals used in thousands of industrial and consumer products.
The chemicals management plan is an example of one of the most effective ways to improve the health of Canadians: preventing us from getting sick in the first place. This is the most effective way to reduce wait times, and this approach will become increasingly important as our population ages. I place particular emphasis on efforts involving prevention and protection.
Let me give you a prime example: obesity. It is one that we know will translate into higher rates of diabetes and cardiovascular disease if we do not act. In fact, we are developing a response to your recent report on childhood obesity right now.
In the meantime, we are building from consultations with experts to inform Canadians on making healthier choices. Our new partnership with ParticipACTION and a children's fitness tax credit will encourage more Canadians to lead more active and healthier lifestyles.
Meanwhile, the 2007 version of Canada's Food Guide and also the food guide for first nations, Inuit, and Métis offer Canadians guidance, helping all of us to make more informed, healthier eating choices.
Certainly direct disease prevention is also part of our agenda. This is what's behind our drive to develop a national heart health strategy, and of course this inspired budget 2007's $300 million investment, enabling provinces and territories to launch the HPV vaccine program, protecting women and girls from cervical cancer.
In addition, budget 2007 invests $64 million over two years in a national anti-drug strategy. This will provide a focused approach to supporting innovative approaches in treatment, developing system improvements, and reducing the supply of and demand for illicit drugs.
Of course the ultimate goal is ensuring that our communities are safer and healthier. Protecting the health and safety of Canadians is at the heart of the blueprint for renewal of health products and food regulation. This year, we will continue this effort to modernize our regulatory framework, ensuring we have the tools to protect Canadians in a world of rapidly evolving science and increasingly complex products.
But we also remain focused on the readiness for the influenza pandemic, which many health experts anticipate. The federal-provincial-territorial collaboration that has updated the world-renowned pandemic preparedness plan for Canada is helping considerably as we work to create a North-America-wide plan under the security and prosperity partnership.
Mr. Chairman, before I conclude my remarks, I want to touch briefly on our government's initiatives relating to health research and sharing knowledge. Our new initiatives take many forms, including the commitment of up to $111 million for the Canadian HIV vaccine initiative, in partnership with the Bill & Melinda Gates Foundation; budget 2007's $37 million annually in increased funding for the Canadian Institutes of Health Research; and the $30 million allocated to the Rick Hansen Foundation.
These are investments that translate research into practical benefits. This is a concept by which we focus on applying better what we already know, and this is of vital importance to sustaining our health care system. It's a concept that ultimately could save millions of dollars, but also improve productivity and of course improve the quality of life for thousands of Canadians.
Our research efforts also strive to ensure we're getting results in modernizing Canada's health care system. This is what budget 2007's $22 million per year for the Canadian Institute for Health Information is all about. It will help us track emerging issues and mark pan-Canadian progress on wait times.
And a final item I should note is our government's sponsorship of a national autism spectrum disorder research symposium, coming later this year. We expect that it will further the development of knowledge and communication between health care professionals, stakeholders, and of course Canadian families.
Mr. Chairman, the health portfolio estimates cover an extremely wide variety of responsibilities and actions.
[Translation]
Our government is working with many partners to use new models to get results. We are working together to put the patient at the centre of the system's modernization and necessary evolution. We are taking action to inform people's choices for a healthier population.
[English]
So your committee's efforts are a valuable contribution to those strategies and choices, Mr. Chairman.
I look forward to taking your questions today and of course to working with all of the members of the committee in the future.
Thank you very much.
As you know, there's been a lot of hubbub in the media lately about assisted human reproduction and your new board and things like that. I'll not go into the details of that, because I actually think the media is off base. There's nothing to manage yet, as you know, because there are no regulations implementing the act, except one small section.
But it seems to me--and I think we talked about this with you the last time you came--it's taking a tremendously long time to get these regulations going. It seems to me we should be hiring extra people to do this work, because there's confusion out there amongst the providers, the patients, and the people who say they belong to the industry--that is, agents and lawyers, etc.--with the lack of regulations.
One would think there should be some impetus to get this done more quickly than is planned, but I notice that on page 27 it's $3.1 million this year, $1.5 million next year, $1.5 million the year after, and scarier to me is the fact that there are 25 full-time equivalents assigned to this task this year, which is reduced to nine next year and nine the year after, even though your long-range plan doesn't show the job being finished for a few years yet.
How do you explain shrinking the staff who are charged with this responsibility, while there's confusion out there, and shrinking the money they have to work with, and then making an announcement about who the board members are? That's like somebody who's starting a company in five years saying they've named their board. For what?
:
Thank you for the question.
Indeed, as I referenced earlier, the real cornerstone of our approach to this is the patient wait time guarantees. If we were having this conversation a year ago, there would have been the Province of Quebec that declared that they were moving forward. We didn't have any of our national pilot projects in first nations communities or the pediatric pilot project out yet. Now, today, we have the first nations pilot projects, we have the pediatric project on children's surgery, and we have every province and territory committed to patient wait time guarantees.
I would expect that over the next few months, as early as the next few months, you'll start to see provinces declaring their guarantees, saying that 100% of the cases in cataract surgery, access to cancer care or cardiac care, can be delivered within a certain period of time as close to home as possible, or if not, that there is a plan in place to give that patient a choice and recourse within the publicly funded system.
That's the approach. It really puts the patient at the centre of the care. The federal government has taken a leadership role with our funding to allow that to occur. And the provinces and territories are now our partners to ensure that we move to this new level.
And I must say, this is a revolutionary decision. This is something that will change the face of our health care system and reorient it towards a patient-centred approach for years to come. And it's certainly gratifying to see it started.
:
Thank you for the question.
Let me say a couple of things.
First of all, from an evidence-based point of view--because I think your anecdotes are absolutely correct, but you should be assured that they're also borne out by the evidence--it's not just something great that's happening at RVH, and great that's happening in Barrie, but it's also happening nationally.
The Canadian Institute for Health Information, which of course is an independent body in terms of its research, came out with a report very recently, in the last few months, that indicated generally across the country wait times in the priority areas have been reduced by approximately 7%, I believe, and in non-priority areas have also been reduced by a lesser amount, but nonetheless by 2%. For those who were concerned that focusing in on the priority areas would mean wait time reductions there, while in other areas there would be wait time increases, there is at least evidence that it needn't be the case or that it is not the case. I think that's a good piece of evidence.
The federal government sponsored what we called a success conference. It was a conference into which we brought all the experts from across the country to talk about wait time reductions and to share their stories. We found that we had hundreds of people at the conference, and it was a revelation to many people.
What's going on in British Columbia and Manitoba? British Columbia was doing a lot of interesting work in primary care. Manitoba was doing some interesting work in cancer care. Ontario was doing some interesting work in cataract surgery. Nova Scotia was doing some interesting work in supplying nursing care in innovative ways. All of this stuff was going on in our country, and we didn't have a forum through which we could at least understand what was going on. Now we do.
I'm probably going to give my staff more work to do here, but if we can have those slide decks that were presented at that conference circulated through you, Chair, to this committee, I think you'd be very impressed with the kind of work that is going on. Of course the provinces and territories deserve kudos for that, but that is partially funded through federal dollars as well. By putting this in the shop window, I believe that the Government of Canada is pushing forward for innovation and reform in this area.
It's on our website, apparently, and so that saved them a few hours of work there.
You know, the report by the Senate Standing Committee on Social Affairs, Science and Technology really was amongst the driving forces here, although I think society was moving in this direction as well. The committee called their final report, last May, “Out of the Shadows at Last”. I thought that was a very appropriate title, really, because mental health and mental health strategy has been in shadows--in the workplace and in terms of being in the forefront of public policy in health areas in the past.
That has changed, and is changing. What we're seeing now, through the establishment of a Canadian mental health commission and making that another arm's-length organization.... Again, we're using this approach not just in the cancer care area or the cardiovascular area but also in mental health. It will allow practitioners in the area and allow people who have had exposure to mental health issues to be part of our approach to this issue.
That's revolutionary in this country. It's kind of old hat in some other countries, but it's revolutionary that we've taken this approach of really levelling out the playing field, saying that we're all on the same level, we all have something to add, we all have something that may be appropriate to establishing the solutions. So that's what's new about this.
What also is new is an understanding that within our own area of competency, the federal government can play a leadership role--working with provinces and territories, of course--in terms of understanding what the best practices are, what the surveillance is around the country on a particular health issue, such as mental health, and how we can learn from one another on the best way to proceed.
So I think all of that is new. To have it in mental health illustrates that mental health now is a mainstream concern. It's not something that is an add-on or an afterthought; it's something that can be at the core of some of our most profound health issues.
:
One thing we're doing is in the area of scholarships and bursaries. I was pleased, in my own riding of Parry Sound—Muskoka, to present five bursaries to Métis students, four of whom had chosen nursing and one of whom had chosen to be a family physician.
So that's just one example. The same goes for first nation and Inuit; we are there in terms of scholarships and bursaries.
I had an interesting exchange with a first nations leader that shows how complex this issue is. I told him that if we could get more of the kids in his community into nursing school, it would help eliminate some of the pressure on nurses in the community. They could practise in the community. And those are good jobs--good jobs for any nursing student, first nation or otherwise.
His reply was, “Great idea, Minister, except that right now in my community, the kids drop out of school, or they finish high school without the necessary science courses in order to be accepted into nursing school.”
So you know, I want to fix the health care system, but we also have to fix the education system. These are interconnected issues. We could put $1 billion more in first nation and Inuit health care, but if we don't fix some of the education issues, ultimately our health care outcomes will be better and then will degrade again.
This is why we have to tackle some of these issues simultaneously, and that's the approach I'm taking with respect to the tripartite agreements I'm pursuing with first nations and with provincial governments. Each one of us, each leg of the stool, has something to add to make the process better or to make the results better.
This was, as you recall, a topic of conversation in this very place a year ago, and of course, this committee quite rightly was concerned about making sure that promise was fulfilled. Since that time, of course, we were able to announce the package of the final settlement with those individuals who were infected before 1986 and after 1990.
The next stage of the process, after the final settlement, was to have that settlement reviewed by supreme courts in provinces, I suppose, and we are nearly there. I'm led to believe that three out of four courts have approved the deal. There is one court to go that is dealing with what I would consider to be a relatively minor issue, and I really can't comment any further on that. But we are down to the very short strokes on it.
You have certainly my commitment that once we are through the legal approach that has to be done—I can't shorten that; that's up to the courts—that we have done the necessary work in terms of the administration--
A voice: [Inaudible--Editor]
Hon. Tony Clement: There is no decision anywhere. I'm sorry, I thought we had three out of four. They've all heard it, so they're all going to decide together.
But I am advised that there is one court where they are tweaking a couple of issues. Once that occurs, we have done a lot of the preparatory work in terms of the administration of the fund, so that we will be in a position to respond rapidly once the settlement has been approved.
:
That's reassuring. That's great, actually.
I just want to bring to the attention of the committee that we have nine votes to vote on at the end.
I would like to actually call the questioning part of the meeting over, thank the minister and the department for being here, and proceed with these very quickly so we can get them completed. If that's all right, we'll proceed in that way.
Thank you very much, Minister, and thanks to your department.
We'll now move very quickly to the votes.
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Vote 1--Operating expenditures..........$1,690,951,000
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Vote 5--Grants and contributions..........$1,225,859,000
Assisted Human Reproduction Agency of Canada
Vote 10--Program expenditures..........$12,834,000
Canadian Institutes of Health Research
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Vote 15--Operating expenditures..........$42,439,000
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Vote 20--Grants..........$822,476,000
Hazardous Materials Information Review Commission
Vote 25--Program expenditures..........$3,024,000
Patented Medicine Prices Review Board
Vote 30--Program expenditures..........$10,584,000
Public Health Agency of Canada
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Vote 35--Operating expenditures..........$438,390,000
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Vote 40--Grants and contributions..........$189,271,000
(Votes 1, 5, 10, 15, 20, 25, 30, 35 and 40 agreed to)
The Chair: Shall the Chair report the votes 1, 5, 10, 20, 25, 30, 35 and 40 under Health to the House?
Some hon. members: Agreed.
The Chair: This meeting is adjourned.