HESA Committee Report

Dissenting Report by the Liberal Party of Canada Health Critic

Hon. Dr. Hedy Fry, P.C., M.P.

The Liberal Party of Canada (LPC) presents this dissenting report. We agree with the text of the report per se, but think the Committee recommendations do not adequately reflect witness testimony. We are also concerned that Part II of the main report contains no recommendations.

The Committee broadened the scope of the study, calling in expert witnesses, to discuss innovations in health care delivery and the barriers and costs of implementing new technological innovations.

Witnesses made several recommendations, contained in the main report, that were not reflected in the Committee’s recommendations. These pertained to federal leadership in the areas of technological innovation and innovation in health care delivery, and where collaboration and cooperation among levels of governments and other groups was necessary.

The LPC thinks the federal government has a leadership role to play in the development of policies, programs, and strategies that impact the health of all Canadians. This role, due to constitutional requirements, requires negotiations with provincial and territorial governments, regulatory authorities and health professional organizations. We do not accept that all health care delivery is only a provincial jurisdiction. The Canada Health Act and Medicare confirms this. The 2004 Health Accord, signed by all Premiers and the Prime Minister endorses a cooperative model. Innovation in health care delivery is impossible without jurisdictional flexibility. One notes that federal government is the fifth largest deliverer of health care, and fourth largest purchaser of prescription drugs, to First Nations and Inuit communities, Corrections, and the Canadian Forces.

Witnesses outlined significant challenges associated with interoperability of Electronic Health Record (EHR) systems. Many jurisdictions had developed their own programs, but are unable to communicate with other EHR systems across Canada, creating a fragmented system. It was pointed out that hospitals needed to link with regional and province-wide EHRs, in line with Canada Health Infoway Inc.’s standards for interoperability.

REC 1. Canada Health Infoway Inc. promotes the interoperability, automation, and integration of different health care sectors into one Electronic Health Record System across Canada.

Witnesses were concerned over the lack of broadband networks, to access remote health care services in remote and rural First Nations and Inuit communities. Evidence shows Canadians in these areas face poor health outcomes and increased costs due to medical travel for care.

REC 2. Health Canada prioritize the expansion of broadband networks to remote and northern First Nations communities.

Witnesses stated that case-by-case determination regarding whether a new application of nanotechnology is a drug or medical device led to confusing regulations. They expressed concern that nanotechnology research is not a priority in Canada.

REC 3. Health Canada establish a regulatory framework for pharmaceuticals and medical devices that is responsive to developments in technology.

REC 4. CIHR establish a new institute of health research devoted to nanotechnology.

Witness stated many health care organizations lacked the fiscal capacity to implement newly-developed technologies.

REC 5. The Government of Canada provide incentives to health care organizations to adopt clinically and cost-effective technologies.

Witnesses noted, while Canada is a world leader in genetic research and 80% of rare diseases have a genetic basis, Canada lags behind other nations in developing rare disease treatments and genetic screening tests for newborns.

REC 6. Health Canada implement a national strategy for screening newborns for rare diseases, identifying best practices, diseases that may be detected, and updating this list as necessary.

REC 7. Health Canada, working with provinces/territories and health professional authorities, establish national standards for treatment of rare diseases.

Concerns were raised regarding Canadians’ access to new and innovative technologies for prevention and management of chronic diseases, because of costs, literacy, or complexity.

REC 8. The Government of Canada create a program to share best practices among industry, researchers and clinicians with respect to technological innovations in chronic disease prevention and management and to consider ways to improve accessibility to all Canadians.

REC 9. The Government of Canada implement tax incentives for employers who implement e-health solutions for their employees.

REC 10. The Public Health Agency of Canada, develop a framework to evaluate public health apps and other self-management tools, and a means of identifying and validating their scientific accuracy.

Witnesses were concerned about the cost and availability of safe and effective prescription drugs and suggested the establishment of a National Pharmaceutical Strategy to realize cost savings and to evaluate different drug pricing policies, to ensure Canadians can afford the medically necessary medications they need.

REC 11. The Government of Canada, the provincial and territorial governments establish a pan-Canadian Pharmaceutical Strategy, as in the 2004 Accord.

We heard that basic research is at the core of, and stimulates other research and innovations in health care.

REC 12. The Government of Canada increase funding for basic research.

REC 13. CIHR, NSERC and SSHRCC work with provinces/territories and provincial academia to develop guidelines for the development of intellectual property policies.

Witnesses stressed evaluation and measuring of outcomes and agreed the Health Council of Canada should undertake that role.

REC 14. Federal government reinstate the Health Council of Canada and broaden its mandate to include the promotion of innovation in health care delivery and maintain the Innovation Portal beyond 2014 for use by health care providers, and policy makers of all jurisdictions in Canada.

REC 15. CIHI share data with health care organizations, provincial and territorial governments, for evaluation of innovative health care delivery, including primary care reform.

REC 16. The Pan-Canadian Public Health Network’s Communicable and Infectious Disease Steering Committee evaluate British Columbia’s “seek and treat” Highly Active Anti-Retroviral Therapy (HAART) program’s success and develop these as pan-Canadian guidelines.

REC 17. PHAC review and promote successful harm reduction programs, (Vancouver’s InSite) and work with provinces/territories, municipalities, communities and other authorities to establish Safe Consumption Sites.

REC 18. The Government of Canada resume collaboration with provincial and territorial governments, to develop a pan-Canadian Health Human Resources Strategy, as in the 2004 Accord.