[Recorded by Electronic Apparatus]
Tuesday, November 21, 1995
.0910 
[English]
The Chairman: Good morning. Now that we have a quorum, let's get under way to make the best use of our time.
These are the supplementary estimates. We're going to have some witnesses from the Department of Health in a moment.
First, let me say to the committee that we're going to need some time at the end. So we're going to take maybe twenty or thirty minutes and see how this thing is going in terms of the witnesses at about 10:30 a.m.
Then we'll take a few minutes on our own to make a couple of decisions related to our other assignment, the study on prevention.
All right, let me welcome our friends from the department.
Mr. Lafleur, you're in charge this morning.
Mr. Robert Lafleur (Senior Assistant Deputy Minister, Corporate Services Branch, Department of Health): I'll lead off, Mr. Chairman.
The Chairman: Maybe you can just introduce your team, then make a brief opening statement, and leave some time for us to ask you some questions.
Mr. Szabo (Mississauga South): Mr. Chairman, did you notice that Orvel is still at the end of the table of witnesses?
The Chairman: We have no doubt who's in charge over there.
Some voices: Oh, oh!
Mr. Lafleur: Mr. Chairman, I think Orvel Marquardt is well known to the committee. In fact the director general of finance for the department last year came with only one person to attend the hearing of the committee. I understand from him that the committee would have wished to have had the opportunity to question some program officials from the department.
Given that this morning the committee is dealing with the supplementary estimates of $43.6 million, and more specifically with the transfer of the pest management regulatory activities to Health Canada from Agriculture Canada, Environment Canada and Natural Resources, as well as approval of the aboriginal head start initiative, and the inclusion of an operating budget carry-over and a number of other related issues, we have with us a number of officials from the department whom the committee might wish to call on.
I'd like to introduce four of them who might be more immediately on call to the committee: Claire Franklin, executive director of the pest management regulatory agency, newly created at Health Canada; Esther Kwavnick, associate director, childhood and youth division, health, promotion and programs branch; Weldon Newton, director general, management and program services, health protection branch; and Myra Conway, director of programs and operations coordinator for medical services branch.
Mr. Chairman, I know the committee wishes to reserve as much time as possible for questioning of witnesses, so that will be the extent of my introductory remarks.
The Chairman: I notice the format for the supplementary estimates is a bit different this year. To put it differently, you've given us a lot less detail. Is there a rationale for that?
If you compare this with the supplementary estimates we dealt with last November...compared with those, you'll notice there's not as much detail this year. Is there some particular reason for that?
Mr. Orvel Marquardt (Director General, Financial Administration Directorate, Department of Health): I don't think there's any change in the format, Mr. Chairman. All that is disclosed in the supplementary estimates is the vote items that are affected, a brief explanation of the requirements, and then a listing of the object of expenditures.
That really hasn't changed in display. We may have had a few more items in the supplementary estimates last year and therefore the explanation of requirements may have been a little more lengthy.
The Chairman: Last year you had a breakdown by budgetary items, which you don't appear to have this year. It's just a matter of information. We wondered if you had a reason for doing that, that's all.
Mr. Lafleur: I don't think I have an answer to that either, Mr. Chairman, except that I know at the Treasury Board there are ongoing revisions to the estimates process. I'm not sure that has affected the way in which these supplementary estimates are presented.
The Chairman: Well, maybe you don't have an answer now, but could you get an answer? More to the point, could you undertake to supply us with that kind of breakdown? It's difficult for the committee to track if we can't have something to compare to.
.0915
We have the breakdown by budget or item last year. Can we get that same kind of thing with respect to the supplementary estimates for this year? Is that a problem?
Mr. Lafleur: I'll certainly raise it with the Treasury Board officials, Mr. Chairman.
The Chairman: How are we doing, folks? Do you have some burning questions you want to put?
Oh, I'm sorry, Mr. Szabo is ahead of me as usual. Go ahead.
Mr. Szabo: Just to start it off, since we've transferred the pesticide regulatory agency to Health Canada, possibly you could have someone explain the reason for the transfer of the department and what we have done so far. What assessment have we made? What plans do we have to address the state of the union, as it were?
Ms Claire Franklin (Executive Director, Financial Services, Pesticides Management Regulatory Agency): The decision to have consolidation of the activities involved with registration of pest management products was the result of an advisory committee.
The document was tabled in 1990, and approaches were taken to implement.... In 1994 there was a decision that it should actually be consolidated within one department, and Health Canada was chosen as the department.
The resources that were involved with the decision-making on registration of pesticides from the involved departments - Agriculture, Natural Resources Canada, Environment Canada and Health - were then consolidated. The agency came into effect on April 1 of this year.
Mr. Szabo: Do we have a fence, now that we've created...? I don't know how long the timeframe is, but we are now in.... What are your objectives at this point? What's your purpose now?
Ms Franklin: The purpose of consolidation was to expedite the way in which decision-making was taken. As you may well be aware, there are in essence three components involved in deciding on the suitability of registration of a pest-controlled product: the safety information, in terms of both human health and environmental safety; the efficacy of the product; and the value of the product.
The fragmented approach, having several different departments involved in that, did not necessarily lead to a very easy consolidation and an appropriate risk/value decision being taken. The consolidation has put the responsibility for ensuring that type of balanced approach under one minister.
So far what we've seen in the agency is obviously very new, but in my view we've already seen an improvement in our capacity to take the balanced decision that needs to be taken. Obviously we are hoping ultimately to expedite the timeframe within which decisions are taken without jeopardizing the health and safety of the environment or of people.
Mr. Szabo: How many employees did Health Canada have in the last fiscal year? How many are we budgeting for this current year? Whatever the number, what are the prospects that this could be reduced without impairing the delivery of service for Health Canada?
Mr. Marquardt: We have about 6,200 FTEs or people within the department this year. That's a little less than last year in terms of the total that was partially reduced because of the first program review, but it has been offset by the transfer of the new resources for PMRA from the three departments Dr. Franklin mentioned and the new tobacco demand reduction strategy as well.
So there are approximately 6,200 FTEs; it hasn't changed very much.
Mr. Szabo: The last part was on outlook, possibilities. I'll tell you why. Just yesterday constituents said, Health Canada employees, 8,000 people, and all they do is write cheques to the provinces to deliver health care. Do we need all these people? That's the constituent, wherever they get.... That's a perception and it's probably more from reading editorials than it is from knowing the facts, but there is a perception.
.0920
Mr. Lafleur: Mr. Chairman, the health department is composed of a number of programs and there are significant program elements that involve service directly to the public. The native health programs, for example, involve service to native communities on reserves. There are services provided in the health protection branch that deal with elements of the health community, including pharmaceutical companies and so on.
So there are many more people than just the people who hand out cheques. Even the people who are involved ultimately in providing for the transfer of moneys do so with a lot of consultation and work within various groups in the health communities representing various health issues. It is not just a process of handing out cheques.
The department has downsized significantly in terms of its overall resources as a result of various program reductions through budgets and through program review. We're now undergoing the second of the program reviews of the government and there will be further reductions to the department.
The Chairman: Bernard.
[Translation]
Mr. Patry (Pierrefonds - Dollard): The 1995-96 Supplementary Estimates show a carry forward of the order of $25.4 million in the department's operating budget. I would like to know whether it is actually reprofiling, i.e. a carry forward of funds that would have been spent otherwise in the 1994-95 fiscal period, and also which programs and activities of Health Canada are affected by this carry forward.
Mr. Lafleur: These funds represent expenditures that should have been made in the last fiscal year but were not for a variety of reasons. We are now authorized by the government to carry forward up to 5% of our total operating budget into the following year in order to ensure that departments make an efficient use of public funds.
Before this new policy, managers had a tendency to spend the money they had left in their budgets in a hurry to avoid being allocated a lesser amount the following year. These expenditures were not always wise. By authorizing the carry forward of a certain percentage, this situation can be avoided. I'll ask Mr. Marquardt to give you a breakdown of those expenditures and to explain how we intend to use this carry-forward money.
[English]
Mr. Marquardt: First of all, the origin of the carry-forward of the resources comes from primarily three or four areas. The tobacco demand reduction strategy happens to be what they call a special purpose account, which means the money that was lapsed in that particular program, which is $3 million, has to be rolled over to be used only for tobacco. It cannot be used elsewhere within the department. There was about $4 million in the Indian and northern health services envelope, again a special purpose account; it must roll over to be used for that purpose only. There was about a $3 million lapse in Green Plan money across the department in various areas. Then there were several other small items in all the branches across the department.
There's also an item in there that is fairly large. About $11 million of that $25 million is for the statutory items or legislative items that have to be paid under collective agreements: severance pay, maternity leave, vacation credits when someone retires or is surplus. That amounts to about $11 million in total.
So that's the origin of it. We will be using it in 1995-96, subject of course to the approval of these supplementary estimates. It will be in areas such as the blood inquiry. We have some residual costs we have to support for the Krever inquiry. We have a commitment of about $1 million to participate in the funding of the Canada census in 1996.
.0925
We have an account within the department called the prosecution fund whereby we pay for the prosecution costs for drug-related offences run by Justice. They hire the lawyers and we have to pay the bill. Prior to this year we had been receiving supplementary estimates, and if you go back to your ``sups'' last year you'd see about a $10 million item in there to cover off those costs, because they were never funded within Health Canada to the amount we have to pay out. We have been told this year by the board that we have to find that money internally, so some of these resources will be directed towards that particular shortfall.
As I mentioned, we have severance payments we have to make. There are two components to a severance payment: one we can collect back from the board, and that's the amount I talked about in terms of the $11 million we received. But there's a component that we have to pay under the WFA, and we estimate that will amount to $3 million or $4 million in the coming year.
We have some shortfalls in cost recovery that we are going to be offsetting. The important note here is that when revenues have been booked for cost recovery, it means that our appropriation, which you approve in Parliament, is reduced by the amount of the projected cost recovery of revenue. If we do not generate it, we have to find that shortage internally within the department. That's another few million dollars we have to cover.
Those are the plans for the roll-over as we know them today. Obviously it depends on circumstances, but certainly we have unfunded pressures greater than the amount of the carry-forward that we have.
[Translation]
Mr. Patry: As chairman of the sub-committee on aids, I would like to know whether there is a carry forward for the National AIDS Strategy and, if so, what is the amount involved.
[English]
I also want to know if Health Canada is still involved...because with food mail it was half a million dollars last year. That was the amount paid by Health Canada in the food mail process.
Mr. Marquardt: First of all, the age strategy remains untouched at about $40.7 million. The estimated expenditures indicate that they will spend the total amount of the strategy, and that exists as well for the coming year.
Mr. Patry: And the food mail?
Mr. Marquardt: There was half a million dollars and that's still in there for this year. We think this may be the last year we'll have to subsidize Canada Post for that particular amount.
Mr. Patry: This is the last one, Mr. Chair.
You talked about cost recovery. What steps has Health Canada taken to address these concerns?
Mr. Lafleur: I'll ask Mr. Newton to come to the table to get into some details for you on cost recovery.
Let me just say that the department, as you know, is cost-recovering or planning to cost-recover in a number of areas, a number of which come under the health protection branch. The cost-recovery process is a long one to put into existence because it involves a lot of consultation with industry. We have had extensive discussions with various elements of industry, particularly in the field of drugs and medical devices.
We of course have been cost-recovering for a number of years in some areas in the medical services branch and in other areas such as dosimetry services, which is in the health protection branch. The new areas for cost recovery are drugs and medical devices, and the pest management area that Claire Franklin referred to earlier in her testimony.
Mr. Newton will give you a bit more detail on that.
Mr. Weldon Newton (Director General, Management and Program Services, Health Protection Branch, Department of Health): When the health protection branch notified the health industries of its intent to cost-recover for services where the industry was a beneficiary, understandably there was considerable concern and resistance.
In dialogue with the industry it became quite evident that the health protection branch would have to articulate and publish a strategic framework or policy within which we would pursue our cost-recovery activities.
.0930
In December 1994, at the very outset of our cost-recovery activities, we issued what we call an IL, an information letter, number 812, which can be provided to the committee, Mr. Chairman. It's basically a policy framework for cost recovery in the foods, the drugs and the medical device sectors, or any sectors, in fact, within the health protection branch. That policy was to ensure that we remained, as an organization, client-focused and service-oriented and that we adhered to the principle of due process.
We have now gone through substantial consultations in both the drugs and the medical device sectors. In fact, this past week we were able to obtain unanimous agreement with the medical device industry on pre-market evaluations of medical devices.
There were compromises made on both sides. We had published our fees, we had stakeholder meetings, and in the end both sides compromised, with the result that the fees were reduced by a third and other formulas were approved or agreed to that would be determined by low-volume activities within the industry.
The bottom line is - and I bring a quote from the minutes of a meeting that took place in Toronto on October 17, 1995, which was attended by the health protection branch, other federal departments, industry stakeholders, and individual manufacturers. It says:
- Members representing the pharmaceutical side said that a positive change had occurred within
the Health Protection Branch....
- - because we had to undergo a cultural change, but -
- ...there was still room for improvement....
So with the feedback we're receiving through minutes of meetings and through consultations that are taking place today in Aylmer with the pharmaceutical industry, I think there's been a meeting of the minds and we're much more in tune with each other's concerns. There's a fundamental understanding that perhaps didn't exist a year ago.
Mr. Patry: Thank you.
The Chairman: Ovid.
Mr. Jackson (Bruce - Grey): Thanks, Mr. Chairman. I want to follow up on the cost recovery in regard to the pesticide review committee.
Pesticides are a very big concern for farmers. They are concerned that their American neighbours get permission to use certain pesticides for their crops. Sometimes it's right in the immediate vicinity, because Canada has a very long border with the United States and it actually blows across with the wind. They see their neighbours using it. The stuff actually comes across. We buy the products.
What are we doing with regard to harmonizing with the United States in order to speed up that particular process?
I have a number of questions, but I'll stay with the pesticide regulatory question, and then I have one on aboriginal head start.
It seems to me there was an agreement - it's hazy in my mind - that you worked out with the farmers, and they were quite concerned that they had to pay the user fees.
You may not have enough time to do that, but I'm particularly interested in how you worked out what their share of that thing is.
Have we worked out this harmonization, which is a main concern for them? They like to get their crops going, and, as you know, we gross ourselves up by understanding our crops and being able to use technology in order to make sure...whether it's a potato beetle or whatever bugs get into other plants. For me, coming from a rural riding, it's a big concern for the farmers and I'd like to get some more information on that.
The other question is, I'd like to know how you're doing with your aboriginal head start program in terms of implementing that particular policy. Again, if you don't have enough time, you could probably send us copies, an executive summary of both, so that we don't spend a lot of time on that.
Ms Franklin: On the harmonization and the cost to farmers, I certainly can keep you updated, but I can give you a quick summary.
I think the harmonization issue is one of the key issues for us to enter into the capacity to be able to get products onto the market sooner, and perhaps the even more telling aspect of that is to get the manufacturers to come and make applications in Canada at the same time as they do in the U.S. The lag phase is frequently because they don't come into Canada until a year or two after they've actually been into the U.S.
.0935
Part of the reason for that is the difference in data requirements in the package that industry has to submit. We're working very closely with our U.S. counterparts to ensure that we don't have different data requirements.
The area you alluded to, that in fact the political boundary doesn't have very much to do with the geographic characteristic of the area, so that to have different requirements simply because it's Canada versus the U.S. doesn't make a great deal of sense...we've actually taken enormous strides to have what we're calling ``eco-zones''. If the data are generated in one country they will be accepted in another. That really has been a very significant step forward.
We're working actively through what used to be the CUSTA and now NAFTA committee to ensure that we have harmonization, that we don't have differences that are really not going to make much difference on the basis of safety or efficacy. I think there's a tremendous amount of activity.
We now do joint reviews with the U.S. That also will expedite the availability of products at the same time in both countries.
So I think we have taken some very positive steps that have been ongoing in that area and that will make, in my estimation, significant differences as far as farmers are concerned.
The second question relates to fee for service or fees to farmers or tax or whatever has been bandied about. This really comes in essence from the necessity we have in the agency to generate fees. At this point in time, as you are well aware, approximately 50% of our budget is tied in with Green Plan funds, which will sunset in 1997. That will be a significant loss of dollars to the program.
The other aspect is that with the consolidation and the reform that is taking place, there will be a necessity to have increased resources. The way in which we will be recouping that is through cost recovery. We are actively analysing what it costs us to do the work we do, looking for whatever efficiencies we can put into the system. Joint reviews and sharing with other countries is part of that. Developing the options as to where we could generate costs and anticipate going out for consultation on that with stakeholders in the new year is a very active area for us and a very critical one.
We will attempt, obviously, to have the burden shared in a reasonable fashion and certainly make every attempt that this will not affect the competitiveness for farmers, which is a very real problem and something we have to be very aware of while we're entering into this.
Mr. Lafleur: Mr. Chairman, maybe I could deal with the question of the head start program. As committee members may know, this red book commitment was announced by cabinet in June 1994 after it had approved the concept for the program.
In June 1995, after extensive consultations with the communities that would benefit from this particular program, the moneys were approved by Treasury Board. Between June and November of this year we have been working more specifically with the individuals representing the native communities on the exact operation of the program and of course hiring staff.
We're now basically ready to go. A guide has been published for access to the funds in the program. Of the staff that have been hired, 70% are native, and we expect the start-up of the program in January 1996. After that, basically it is the submission of projects and consideration for approval of those projects by the department.
The Chairman: Sharon.
Mrs. Hayes (Port Moody - Coquitlam): Thank you, Mr. Chair.
Just reviewing what is here, you have the breakdown of operating expenditures, operating capital transfer. There were a couple of questions relating to the operating expenditures. Perhaps you could clarify them. Some major ones of note would be personnel at $9.5 million; transportation communications at $6 million; professional and special services at $17 million; and utilities and material supplies at $2 million. Could you perhaps clarify the difference between personnel and professional and special services, particularly as they're both major items on this?
.0940
Mr. Lafleur: Mr. Marquardt will do that.
Mr. Marquardt: Personnel costs are basically the salary costs of the employees. They are $9.5 million primarily due to the transferring in of the 240 FTEs for PMRA from the other three departments - that means you would therefore see a corresponding decrease in the other three departments' sups - and about 30 FTEs for the aboriginal head start program.
Let me just deal with professional and special services. That refers to the contracted and special services we use to deliver our programs. It's a bit of an anomaly in that when we looked at the carry-over of the $25 million, we weren't too sure where that money would be spent at the time when these sups were being put together. Indeed, we have some plans, but they're not firm plans at this point, so we stuck most of that roll-over money into professional and special services. No doubt as that money is used throughout the year, it will be allocated to all the other objects of expenditure. It could be for salaries if we hire more people, or it could be for supplies or transportation and communication costs, and so on.
With the transportation and communication costs, again we've primarily put a large amount - I guess it is almost $6 million - in there from our carry-forward just to allocate it somewhere. We know we will indeed have transportation and communication costs. Primarily, those would be communication costs for computer hook-ups, telephones, faxes and so on. Again, that most likely will be reallocated to the actual expenditure plans once we have those formulated in the department.
Mrs. Hayes: You have no specific plans for that. It's just a...? Do you have any budgeted items for that procedure?
Mr. Marquardt: No. For instance, I believe there are the prosecution fund amounts that we do pay. I would assume those will be paid out under professional and special services because they are contracted lawyer fees from the Department of Justice. That's probably where that amount would be charged, so that's one of the reasons a large amount would be in there, if indeed we use that roll-over for that purpose.
Mr. Lafleur: Perhaps I could add that in terms of exactly how we're going to use moneys that rolled over from previous years, for example, we're not always in a position to give exact details to Treasury Board when they are preparing the estimates. We're asked to put it somewhere, so we put it in a place from where we can explain it, and we move it out into the areas where we will have to make the expenditures during the year. Technically, within the public service, that's known as parking money. We temporarily put it there to be used for appropriate purposes when the time comes.
Mrs. Hayes: Okay, but you're convinced you're going to need it somewhere.
Mr. Lafleur: Yes, our pressures are way beyond what we've been able to roll over from the previous fiscal year.
Mrs. Hayes: Perhaps you could tell us a little bit about the $2.5 million in utilities, materials and supplies. Is that again simply...?
Mr. Marquardt: Again, a major part of that came from the roll-over. I can tell you the breakdown of that for the other programs that are coming. In the aboriginal head start program, there is about $134,000; in pest management, there is $429,000.
Mrs. Hayes: Before I finish I would just ask this. I would be interested in seeing the IL with the health protection branch that you offered to the committee.
Mr. Lafleur: Yes, we'll provide that.
Mrs. Hayes: Thank you very much.
The Chairman: Mr. Culbert.
Mr. Culbert (Carleton - Charlotte): Thank you very much, Mr. Chairman.
Good morning, gentlemen.
First of all, in regard to the aboriginal head start program, it certainly falls in place with a study that was done by this committee earlier in the year on the wellness of our first nations, our aboriginal peoples, as you are probably well aware.
This is just a quick question. Maybe you can explain to me the difference between the two criteria - the grants and the contributions - that you have broken down. First of all, though, why is it broken down in that way?
.0945
Mr. Lafleur: Perhaps we could ask Ms Kwavnick to come to the table to respond to your questions on that.
Ms Esther Kwavnick (Associate Director, Childhood and Youth Division, Population Health Directorate, Health Promotion and Programs Branch, Department of Health): Thank you.
The grants allow us to move with community assessments and are there so that groups can in fact get some assistance with the development of proposals. The contributions, on the other hand, represent the vehicles by which the aboriginal head start projects will be funded once they are up and running. So if you take a look at assessing applications in terms of ongoing commitments, it will be via contributions, and the grants allow us to move more quickly in terms of assisting groups with doing community needs assessments and the development of proposals.
Mr. Lafleur: I'd like to add to that.
Mechanically, in terms of how grants and contributions operate, grants allow the department to have more oversight on the details of the proposal. Therefore, as we are setting up the program at the front end, it makes more sense to use grants.
Mr. Culbert: Basically they are intended to get the local institutions and local communities involved in the start-up.
Mr. Lafleur: Yes.
Mr. Culbert: Just to follow up on a different subject, what progress has been made on the integration of Canada's food inspection system to date?
Mr. Lafleur: As you might know, this process of looking at ways and means of integrating our attentions to food on the federal level has been under way for some time. There have been a number of interdepartmental discussions, discussions with provinces, discussions with various other interest groups. The latest step in that process is a proposal that is basically a concept document on various organizational arrangements that might be entertained. Some, going right up to the creation of an agency, are more substantial than others in terms of change. We are now looking at the implications of that, and at some point it will be tabled with cabinet for consideration. But we have done a lot of the groundwork in detailed analysis of the import of these various organizational solutions.
Mr. Culbert: Do I have a bit more time, Mr. Chair?
The Chairman: Yes, go ahead.
Mr. Culbert: Just to follow up on what my colleague mentioned earlier, one of the things we are faced with time and time again in this committee is the fact that health care, according to our Constitution, is like education in that it is somewhat of a provincial responsibility. Of course, the questions always come forward about what the responsibilities and the areas are in which Health Canada should play a role on behalf of all of Canada and all Canadians and what areas ultimately should be transferred to the provinces. When you went through the process of review for the estimates throughout the various departments within the branch, in your opinion did you come across areas that should be transferred to the provinces? If so, what were those areas?
Also, the other thing I want to know about is the areas from which Health Canada gets its revenues. Obviously we know where they get it from - the government side or the taxation side - but if you could, just outline briefly for me the other areas from which there is revenue coming in for Health Canada.
Mr. Lafleur: In terms of the review of the department's operations, we went through a long process of looking at the future requirements of the department and how it would fit overall in the federal structure. That strategic process started four or five years ago. It lead ultimately to a more detailed analysis as part of the program review process that we are now involved with. As I mentioned earlier, we are now involved in phase two or the second element of program review.
.0950
In all of that, the department is involved in areas that have clearly been federal areas of attention since time immemorial, I guess, in terms of provision of health services to native communities. We've been involved in that from the early years.
In terms of health protection activities - the activities of the specialized laboratories that are there to track diseases that tend to attack populations - again there has been a long-time federal involvement, as there is in most countries.
Other programs have been voted by Parliament to be implemented by the federal government in areas of population health, directed at areas that visibly needed attention such as specific areas of research, areas of national health concern that go across provincial boundaries, AIDS, breast cancer research, and so on.
When we did the review we didn't find specific areas the federal government was in that properly belonged to the provinces, but there is a constant dialogue with the provinces on areas where the federal government and the provinces can work together to create greater efficiencies in the use of resources in the health field.
We found areas where we decided to pull out because the federal government really no longer has the available resources for some of the activities that are less important to the core role of the department. They were put there in times of greater resources in the 1970s and early 1980s, and now we're forced to restrict our expenditures.
With program review phase one, when you set aside resources such as the resources for specific legislative commitments under health protection, for example, and look at what resources the department has that are somewhat discretionary in the sense that they can be moved by government decision from one area to another, there's about $700 million there per year at this time.
Program review phase one took $200 million out of that health envelope, so it's quite a significant shock to the system in terms of available resources. We've had to tighten up in a number of areas and make some choices.
Certain interdepartmental integrative activities are going on. We're doing a lab rationalization study, for example, to see the extent to which we can combine lab capacity at the federal government level, to reduce our need for space. We're also looking at working with the provinces in the area of the use of laboratory space. There are a lot of activities like that going on that permit us to deal with some of the pressure caused by the reduction of $200 million.
The Chairman: Mr. Hill.
Mr. Hill (Macleod): You've talked about funds being reduced in the department. Paul mentioned that we have 6,200 employees and asked about the future. I think he was trying to ask if we are looking at reductions in the Department of Health in the future. Are we likely to see some of the 45,000 employees to be reduced in the federal government come out of the Department of Health?
Mr. Lafleur: No doubt there will be reductions. There have been fairly significant reductions in the past five years in all administrative areas not related directly to the delivery of programs. According to the last analysis we did, the department had one of the lowest proportions of administrative staff to program staff.
.0955
We also have the sunsetting of programs on the horizon. A large number of the department's resources are tied in with programs that are called sunsetting programs that have a beginning and an end. We have to plan for the elimination of those programs.
Mr. Hill: So you're saying there will be reductions.
Mr. Lafleur: I'm saying some of those programs are scheduled to be eliminated. Unless something is done to revitalize them and find new funds to support them, some are scheduled to cease in 1997 and others in 1998.
Mr. Hill: You'll appreciate that I try to keep my questions really short, and I'd like the responses to be relatively short so I can cover what I need to, please.
The Minister of Health has said there is some research going on in semi-private clinics in Ontario and Quebec. At present those clinics are being focused upon in other provinces. I'd like to know where the department stands in that research. How many semi-private clinics are there in Ontario, for instance, that will be penalized by the minister in the same way she's penalizing them in other provinces?
Mr. Lafleur: I'm not able to answer that immediately, but I will provide the member with the information.
Mr. Hill: By the way, if you need any help, I have some research I would be happy to share with the department on that issue.
On the issue of expenditures on selected programs, Mr. Lafleur, you mentioned AIDS particularly. In the AIDS strategy we have over $40 million being spent. In breast cancer research, $4.1 million is being spent in the current fiscal year. In cardiovascular disease research, $3.8 million is being spent. Some commentators say those figures don't match with the actual import of these various diseases to the Canadian population. I wonder how prioritizing of funds is handled by the department.
Mr. Lafleur: First, of course, the government allocates funds specifically for programs, and therefore the funds that are allocated to the AIDS program are specific and used for that. Where there is some element of discretion, we go through a process of analysis of where those funds should be spent every year. All the information available is put on the table and some very difficult choices are made. There is certainly not enough money available to the department to address all the issues it would wish to address that are important to Canadians. Unfortunately, we are faced with fiscal restraint.
Mr. Hill: You can see what I'm getting at, though. Cardiovascular disease is a major mortality factor in our country. I don't have the exact figures, but huge numbers of individuals are dying of cardiovascular disease, and we're spending $3 million on basic research on cardiovascular disease. Three times that amount is being spent on AIDS.
Where does the decision come from in prioritizing funds? These are huge issues. I'm quite interested in who makes the decision as to the proportion of funds that will be spent. Is it because AIDS is an infectious disease and it's looked upon as specifically being more likely that a cure will be found for it? Is it because there's huge public pressure brought on a specific disease? Where are these factors weighed in the department?
Mr. Lafleur: A large number of factors are weighed, and ultimately the decision is made by cabinet and the funds are approved by Parliament. The ministers of health share their views with colleagues on where the funds should be expended, and decisions are always made that involve less funds than what would ultimately be needed to fully address the issues.
We realize there are various areas where pressures are immense, but those are the considerations, as well as considerations related to what else is being done in society with respect to these areas of health concern, such as the amount of research going on elsewhere, the amount of research going on in universities and university hospitals and in special research groups.
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Mr. Hill: Do we consider what's going on in other countries? Do we try to -
Mr. Lafleur: Oh yes, we do. To the extent that we can, we involve ourselves in structures that will allow us to discuss these things with other countries and obtain information from other countries.
Mr. Hill: Finally, on the issue of cost recovery, you didn't talk about health food products. From Bill C-7 and a significant outpouring of comments from health food providers and wholesalers and what not, there's a fair amount of concern that cost recovery is going to become an immense issue in that sector of alternate health providers. Could you give me some indication of the department's view of health food and of the alternative practitioners and cost recovery?
Mr. Lafleur: I'm not sure I can respond to that question. Maybe Mr. Newton can.
Mr. Newton: With regret, I don't think I'll be able to either, but I can tell the members that based on our assessment there are limited opportunities for cost recovery in the food program and in the health food provider sector.
The only area currently on our agenda in our elective dialogue with the industry is veterinary drug approvals. We're looking at vet drugs for cost recovery for 1996. That's the only area we're looking at right now.
We are recovering on drug identification numbers. For veterinary drug identification numbers, we're going to vet drug approvals, but to the best of my knowledge we're not looking at health food providers.
Mr. Hill: Did I understand you to say there are limited opportunities in this field for cost recovery?
Mr. Newton: Yes, because Treasury Board policy defines the areas where you can and cannot recover costs for government services.
The Chairman: Andy, go ahead. Then I have a couple of questions myself.
Mr. Scott (Fredericton - York - Sunbury): Thank you very much, Mr. Chairman.
I want to follow up a little bit on what Grant was talking about relative to research, but more generally I would speak to the comment made with regard to the fact that in times of less resources, tough decisions have to be made for some programs that are less important, which was the reference here.
I am curious as to what extent Health Canada sees itself as the service provider or research instrument or whatever of last resort or first resort. In other words, do we look at where we want to go, take that road, and have other people fill in gaps, or do we look at where everyone is going and realize that certain roads haven't been ploughed and go that way?
Mr. Lafleur: First, we don't have very large resources in research. NHRDP is our biggest area, of course, and in the total health portfolio there is also research done by the MRC, the Medical Research Council. As for amounts, $25 million is for NHRDP and $250 million is for MRC. In the field of research that doesn't represent a huge amount of money, even though the amounts are very large.
Basically, the choices are made as a result of consultation with the communities and other people involved in research. They are ultimately committees of peers who make decisions on which areas should be pursued. Obviously, we will be attentive to those areas the department considers important enough for its involvement, as well as in terms of program resources. For example, we'll tend to support research in the field of breast cancer.
Generally, in the field of health research the federal government tries to leverage research by investing moneys and obtaining support from a variety of partners in carrying out research. Of course, we have a perspective that we describe as ``national in scope'', so using our health intelligence, we want to go into those areas where attention is needed, areas that perhaps are not getting sufficient attention from other sources.
Generally, research is also discussed when opportunities arise with provinces through federal-provincial conferences, with deputy ministers, for example.
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There are a variety of ways in which that is put together, but there is core research in those areas in which the department is most interested.
Mr. Scott: Speaking of the MRC, I'd like to talk a little bit about the centres of excellence. I see there's an additional $1 million in the supplementary estimates through MRC for them. I'm new to the committee. Could you give me a little background on that, please?
Mr. Marquardt: Members of the MRC are to appear before you, I believe in the next -
The Chairman: That was the case.
Mr. Marquardt: That ``was'' the case?
The Chairman: They're preoccupied elsewhere.
Mr. Marquardt: Oh. We can relay that question to them and have them get back to you.
Mr. Scott: Okay.
Finally, there was a reference to a $700-million figure that was reduced through program review by $200 million. Could you clarify what that was about, please?
Mr. Lafleur: In our overall resources for the department, some resources are really ``no choice'' resources. We have to spend the money because we have commitments. For example, we have legislative commitments. We also have a portion where the government can more easily make choices as to where the moneys may be spent. These two portions are described roughly as funds that cannot be used in a discretionary way and funds that can be.
The $700 million refers to what would be described as discretionary funds in the sense that you can make some changes in the way those funds are used. They're obviously large segments where funds are spent for long-term programs and where, in reality, you can't move them out very easily. It is certainly different from a commitment based on legislation, where the requirement is brought to you and the legislation then requires you to act on it and spend the money.
The $700 million is really the discretionary fund, if you like, and that's where this $200 million reduction was effected.
Mr. Scott: Thank you.
The Chairman: First, just for the record, let me come back to something Dr. Grant Hill was saying. His line of questioning put you heavily into the policy determination area. I allowed the questioning because you were doing so well at answering, but I fully expected you to say it's not your area. It was really my job, as chair, to disallow the question because that's the kind of question we should be putting to the politicians, not to the bean-counters, not to the people who implement what others decide. I'm sure Grant was aware of that but was being Grant and was seeing how far he could go without being jumped on by the chair.
Let me come back to something Sharon was raising with you. This whole business, the whole reason we're here, is about accountability. I find it strange - and so help me, there must be a good reason for this - to hear you say, we park so much money here until we know what we're going to do with it. Doesn't that fly in the face of what the whole estimates procedure is all about?
You come in and say you want to spend x dollars on this and y on this and so on. This morning you appear to be saying that in this x and y you have some z, and you don't know what you're going to do with it. But you're asking us to approve it anyway and as soon as you figure what to do with it you'll unpark it and use it. That's the way it came across.
Surely that's not the case, is it?
Mr. Lafleur: No, Mr. Chairman. I didn't mean to suggest that this money was used without very serious consideration. The estimates are established at certain times during the year because there is lead time for Treasury Board to put the documents together and so on.
When the time comes to provide the information, there are some areas where the details are not available, so it's hard to put it into a specific line item. Therefore we put it in areas where we think most of it will be spent, but sometimes we later have to adjust that when we get more detailed information.
Maybe Orvel can add something to that.
Mr. Marquardt: I will address the timing. Although the fiscal year ends at the end of March, the books, if you like, remain open until about the end of June to ensure that all receivables and all accounts are included. That means we don't know what our year-end lapse really is until about the end of June. We're putting these supplementaries together in August. So the timing is very short for including an item in these supplementaries and being very specific about where we're going to use that money.
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As Mr. Lafleur and I have pointed out, the funding pressures that the department faces will exceed the roll-over money that we have in these supplementary estimates.
The Chairman: Harold, I cut you off earlier. Do you have any further questions?
Mr. Culbert: There was just one, Mr. Chair. I think I asked the question, but due to time limitations I'm not certain that I got any kind of response.
My question was related to the revenue component and where Health Canada receives the revenue and where there may be opportunities to receive revenue in fees for service as carried out by other departments. I think one area was touched on briefly, but maybe you could just outline that. We know the quite obvious one through taxation and through approvals of Parliament.
Mr. Lafleur: Basically our budget is $1.5 billion and out of that $90 million is obtained through various cost-recovery activities for this year. Of course, that will increase in future years as we continue with our cost-recovery activities.
Mr. Culbert: Can you just briefly give me a breakdown of some of the areas where that type of cost recovery comes from and who pays it?
Mr. Marquardt: Yes, I can. One was mentioned this morning, the dosimetry services. That's about $2.9 million for the current year.
Medical devices, part V, is starting off at about $200,000 this year and will increase to $2 million by next year.
Product safety is projecting a minimal amount starting in 1996-97.
The cosmetics industry is at about $300,000 per year.
We've talked about the drug submission evaluations. That's forecast at about $4 million this year, to grow to about $13 million or $14 million next year. Drug product licences are roughly about $7 million. Drug establishment licences are at about $7 million beginning in the next fiscal year. Then we have a lot of smaller items: drug product master file, drug import/export certificates.
In the medical services branch we also have a few: civil aviation medicine and quarantine services. Those are relatively small. The CAM - the civil aviation - is projected at about $500,000 for next year. The quarantine services for ridding ships of rats is at about $250,000 for next year. A large component in MSB is the $16 million in recoveries made through the hospitals. This recovery has been taking place for many years now. The money has been going into the consolidated revenue fund, but we will be retaining that money starting in the new year.
Mr. Culbert: Finally, would it be safe to say the individuals or the corporations who receive the benefit of those particular items you notated would be the ones who would pay those fees?
Mr. Marquardt: Exactly. That is the intent of cost recovery. Those who benefit strictly or mostly from that particular service should pay for that service.
Mr. Culbert: Thank you.
The Chairman: Sharon.
Mrs. Hayes: Thank you, Mr. Chairman. Following up on that, one of the officials mentioned there was a health board policy on who can and cannot do a cost-recovery program and where it can and cannot be done. Is that policy available to the committee, and if so, could we have a copy of it?
Mr. Newton: Sure. I'll provide IL 812, the original health protection policy framework augmenting the government framework, so they are both identified and so the linkages are clear. I'll also give you IL 815, the industry responses to our consultation. This was also published; there were 10,000 copies. So I'll provide both those documents.
Mrs. Hayes: Would it be possible to get a list of some of what you were just describing, details of the cost-recovery and who is involved in that?
Mr. Marquardt: At least for the current year as we know it, yes.
Mrs. Hayes: Yes. That would be interesting.
I would like just to comment and maybe to follow up on my original questioning. Maybe you could comment again on this.
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My impression of a supplementary estimate is money that is needed that wasn't expected to be needed. If anything, these supplementary estimates should be more detailed than the original estimates because they are, in a sense, unexpected demands upon the department. I would reflect what we discussed earlier. It seems strange that here they are unexpected and yet undefined. That doesn't quite seem to follow.
Mr. Lafleur: Perhaps I would not use the word ``unexpected''. At the time the estimates are put together, what may be required to convey to Parliament adequate information about the program is not yet available. Therefore you do it later in the year through this process, which luckily we have and we call supplementary estimates.
Something like the integration of the pest management regulatory capacity of other departments into this department would not have been ready for the main estimates because of the lead-up time to the main estimates. So we use this one. It's not that it was unexpected. It's just that we didn't have the details to put together. In that sense, they are like the main estimates except they happen a little later in the process. Essentially you are providing the same kind of information.
Mr. Marquardt: If I could just add to that as well, no item can be included in supplementary estimates unless it has received Treasury Board approval. I know it doesn't help you here in this committee, but all items included in the supplementaries are approved prior to coming here.
Mrs. Hayes: But it is our duty to make sure they make sense. Thank you.
The Chairman: Mr. Newton, you wanted to say something.
Mr. Newton: I realize I don't have standing as a member, but I'd like to go back to Mr. Hill's question about health foods. What I said about food is correct. You add the word ``health'' and any food that makes a medical claim triggers a potential question of whether it's in a grey area between a drug and a food.
I'd like to suggest you undertake to look more specifically at that area for cost recovery and examine what our intentions are.
The Chairman: I just have one other intervener. Paul.
Mr. Szabo: The Treasury Board introduced changes to the departmental rules of the game by allowing carry-forwards. This was the second year. What was our experience in the first year? I wonder if you would remind me.
Mr. Marquardt: Last year our roll-over was about $19 million.
Mr. Szabo: You're carrying over $25 million.
Mr. Marquardt: Right. The estimates were about the same amount in terms of total money that it applies to. It doesn't apply to the total of $1.6 billion we have. It applies to the operating budgets only: the salaries, the supplies, the services and so on.
Mr. Szabo: Okay. Expenses are not generally lumpy; they're pretty well in a straight line. So the reasonable expectation is that every year - so you don't have to scramble to dump money at the end of March - there is always going to be a carry-forward. Why don't we have an offset just like we do for year-end accruals? We always reduce by the things that accrue so we have equal offsetting.
Mr. Marquardt: At the moment there is the capability to set up accruals at year-end. So we do now operate under a modified cash accrual system. It is not all-inclusive at this point, so some of the items will necessarily lapse in and have to be rolled over.
Often we deliver our programs through professional services and also contracts. We have contracts with individuals and companies to do certain things and they may perhaps not get it all done by year-end. We do monitor those as closely as we can. But even if we take out the non-insured and so on, we're looking at close to a billion dollars of the budget. I guess the board, in their wisdom, when they established a 5% roll-over, felt it was a good figure to try to achieve in terms of maximizing resources and minimizing the roll-overs.
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Mr. Szabo: One last quick question -
Mr. Lafleur: I should also bring to your attention that this year is somewhat exceptional because we do have $11.9 million related to downsizing. Those are moneys we spend that normally are supposed to come from the board. We spend them and then the board gives them back to us the following year. Therefore, it is not lapses per se. That's unusual, tied in with program review and reductions within the department.
Mr. Szabo: That's fine, Mr. Chairman.
The Chairman: Robert and Orvel and the rest of your team, we thank you very much for coming. Are there any brilliant closing statements you want to make at this point?
Mr. Lafleur: Thank you for your time.
The Chairman: That kind of limits your options, doesn't it?
The committee will take a few seconds for the transition. We do have three items we have to deal with. It should take only a few minutes.
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The Chairman: Okay, we'll reconvene.
We have three items to deal with: the head-by-head consideration of the supplementary estimates, a motion that Andy needs for his subcommittee, and the question of what witnesses we ought to call for our prevention study.
On the last point you'll remember that we had scheduled to finalize, if possible, or at least look at, a further draft of our work plan at our next meeting, which is next Tuesday, November 28. In the meantime, the committee has given enough of a general direction of where we are going to the staff to be able to determine what kind of witnesses we ought to be calling at the outset. The staff has some suggestions as to which witnesses we should call for the December 5 meeting, which will be two weeks from today.
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Once again, next week we will look at our work plan. The following week we would actually hear some witnesses. Given the timeframes and the need for these people to make themselves available, we need some direction from you today as to whether or not you're comfortable with the kind of witnesses who are going to be proposed.
So these are the three issues. We'll deal with them in that order.
The estimates, if we don't do anything, are deemed reported by the three days before the last supply day, which is December 10 or 11, or something like that. I'd rather we were overt about it. We've had an opportunity to talk to the departments. If it's your wish, we can report the estimates or deal with them and decide what we're going to report. You have a sheet that relates to this that was just handed out to you.
Sharon?
Mrs. Hayes: Following our discussion this morning, could I make a motion that we accept the supplementary estimates but reduced by the amount of the carry-over?
The Chairman: Okay. There's a way to do that. It'll be done by a motion, but specific to an item.
You should look at the sheet handed out to you a moment ago, at the very bottom of that first side under 1a. The appropriate motion there, Sharon, would be when I call vote 1a in a moment, you could put the motion at the bottom of the page there that vote 1a in the amount of $37 million, etc., be reduced by such and such. It would be reduced by the $25,399 million. Are you with me? Do you see where I'm getting the two figures?
Mrs. Hayes: Okay.
Mr. Szabo: I'd just like to suggest a little caution with regard to the carry-forward.
If we were to eliminate it from the estimates, it effectively says that they don't get the benefit of the carry-forward or they don't have that latitude. What we have to remember is that they should be coming in $25 million under budget at least, because we would like to see an equal and offsetting.... You can only have 12 months' worth of expenses in any one year. If you have a carry-forward from one, then you must have a carry-forward. So it shouldn't be there, technically, but I think we have to memo it.
However, the principle here is whether or not we want to force them to change or artificially change their spending pattern just to fit into a tighter or time-sensitive envelope that would allow them to infer the cost as needed, rather than them saying, we have extra money or we have to spend this, otherwise we're going to lose it and they won't allow us to carry it forward.
The theory of the carry-forward is to make sure they don't go blowing money on poorly thought out expenditures.
I understand your point and I think it's right, but I think we have to be careful not to maybe frustrate the preferred approach, and that is to make sure they don't dump money at fiscal year-end. That carry-forward, actually, is useful. We just have to remember that when their figures come in and the next time we look at them, theoretically, we should have a $25-million surplus or below budget situation. It is noted with the memo thing.
Mr. Scott: Along the same lines, we have to remember that the purpose of the exercise is to cause people not to just spend the money because they want to make sure they don't lose it.
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There is a cumulative limit, I believe. It's such that if you carry over into fiscal 1995-96 there's a limit as to how much you can carry over. So if you carry over from last year and then you have the same circumstance that would allow you to carry over again, you have the effect of making sure that this doesn't get carried away. I think that's an important consideration to bring to this.
I wouldn't want to send a signal to departments that the idea of carrying forward is bogus by virtue of the fact that if you do it you will lose it. I think that's the wrong signal because it defeats the purpose of the exercise.
Mrs. Hayes: Perhaps it isn't so much saying that we're negating the carry-over and that policy should not be there, not spent. Then you lose the kind of thing that worked against departments and worked against the proper use of the funds granted. Even in the discussion today, I'm not convinced that isn't the mindset anyway. We have a carry-over. We have to allot it somewhere because we are convinced that we need that much more money. We can't have the mindset that we must cut back, that we put a limit on our spending. It's there. We're going to allot it no matter what is the mindset on the other side.
There is still a limit, but I guess the mindset shouldn't be putting everything to the limit and seeing if things work out. I think the mindset needs to be that we are going to cut back. We are going to make sure that things aren't spent if they're not needed to be spent. If that's done up front, then it's far more powerful than after the fact, saying we have some extra change in our jeans.
The Chairman: Madam Fry.
Ms Fry (Vancouver Centre): I wanted to echo what was said by Andy and Paul, and I wanted to add something else.
Anybody...including the member's office budget.... As you well know, if you haven't spent all of your money you can carry over 5% and no more. I think what happens is that, especially where there are programs that tend to have started and ended at certain particular points in time, the fact is that if you don't actually send in the actual bills for your money by the end of the fiscal year, it's gone. This is why you have some overlapping programs.
You also have some programs where there is still an ongoing review of a program that hasn't been evaluated yet and hasn't been given the green light. So that piece of money is there to pick up that kind of flak, because programs are constantly being reviewed. Programs don't come in at a particular set point in time and end at a particular set point in time. So it's considerable overlap and there's considerable review, and sometimes it's the review that's taking a little longer than necessary and the end of the fiscal year comes. Then, if you give up that money, you are in effect saying ``sorry'' to people whose programs you said you would look at.
So we're not talking about a large amount. It's not the full overlap, and you now know that of course departments don't get to go back to the Treasury Board to ask for any more money during the year such as they used to in the past. What they get is what they've got, and they can't have any excess going back to the Treasury Board and say, please, sir, can I have more? They need to be really sure.
I'll give you an example. When during the AIDS strategy all that money was not spent in one year, that amount of money...it wasn't because it wasn't actually spent in terms of the cheque being given, but it was spent in terms of the fact that there were still some projects that were under review and hadn't come in yet. Therefore, if they had given up that money at the end of the year and weren't able to have it carry over, they would have had to drop those particular programs that they had been reviewing for awhile and hadn't finished reviewing.
So there is that kind of overlap going on, which means that to have that little amount of leeway is very important to allow.
I understand what you're saying. I think in fact what Treasury Board did is, first, by limiting the fact that you couldn't come back for more money and by only allowing a small amount of carry-over, you couldn't really deal...especially when you were dealing in ministries that had programs. You couldn't really have these hard and fast, tight time lines that you needed.
The Chairman: Being a very lenient chairman I've already allowed an extensive discussion with no motion at all. I was still in the process of outlining what we're going to do. We haven't done it yet.
So if Sharon wants to move to reduce, she should do it when I call vote 1a. If necessary, we can have a discussion at that time.
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The first decision is contained in the first paragraph of that handout. The committee has to decide whether or not it wants to adopt the votes and report to the House. That's the first question.
Is it the committee's wish to report to the House on this matter?
Mr. Jackson: I move we do that.
Some hon. members: Agreed.
NATIONAL HEALTH AND WELFARE
- Health Program
Mrs. Hayes: I move we reduce vote 1a in the amount of $37,497,066 by the amount of the operating budget carried forward, which in this budgetary estimate is $25,399,000.
Motion negatived
Vote 1a agreed to
- Health Program
Vote 10a - The grants listed $5,169,000
- Medical Research Council
Vote 25a - The grants listed $1,050,000
Votes 5a to 25a inclusive agreed to
The Chairman: Shall I report the supplementary estimates to the House?
Some hon. members: Agreed.
The Chairman: Paul.
Mr. Szabo: As we evolve in this process, I would like to draw to the attention of the committee the Medical Research Council of Canada grants in the sum of $0.25 billion. It's an area I am particularly interested in. If it's the will of the committee, at some point could we possibly have someone who is responsible for that area present to the committee what we do and what kind of value we're getting out of it? It's an awful lot of money.
The Chairman: Actually, we had invited them to come today but they have a meeting in Toronto. All their principal personnel are involved in this other event in Toronto, so maybe what we ought to do is ensure we get them in for the main estimates, since we've now dealt with the supplementary estimates.
Mr. Szabo: When are you going to have the estimates?
The Chairman: That's in February. Soon after we get back we're going to have the main estimates, so we should make a note to have the MRC people come in. As I said, we wanted to have them this time but it wasn't arrangeable.
The second item I want to deal with, Andy, is the motion you have. Has it been circulated? Could you just explain what this is all about, please?
Mr. Scott: Basically, the organization committee meeting of the subcommittee on Bill C-95 is this afternoon. I understand it is necessary to get authorization from the main committee for expenditures by that subcommittee since we don't have a budget of our own. Consequently, this motion is simply to ask the main committee to give us the authority for payment of reasonable travel and living expenses for witnesses appearing before the subcommittee in accordance with the guidelines that have already been established by the committee.
The Chairman: Nancy, would you like to speak to this?
The Clerk of the Committee: I could. Under the current system, all subcommittees do not have an operating budget when they're created by the main committee. Either the main committee sets aside a specific amount for the work of the subcommittee or passes a motion such as this. In this case we don't actually know what the total costs will be. We'll probably have a better idea after the organization meeting. In any event, in order for the subcommittee to actually start to call witnesses there has to be a motion authorizing them to spend money to do so. So that's what this is all about.
The Chairman: That's with the understanding that the subcommittee will come back later to indicate what kind of money it's going to need.
The Clerk: Yes. If in fact the money is going to be substantial and there are going to be a number of witnesses, the main committee will probably have to submit a supplementary budget request.
The Chairman: So this is an interim thing to get them through the first meeting.
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The Clerk: Yes.
The Chairman: Grant.
Mr. Hill: I think this is premature. We're having our organizational meeting this afternoon. I still can't believe we will be calling witnesses to change the name of the department. That's what this bill did. So I would prefer to wait until our next meeting, after we have had this organizational meeting. I hope to squash the need for any witnesses. This is mind-boggling. Do you think we're premature?
Mr. Scott: It's my understanding that there have been interventions received by staff from interested parties who would like to appear. There are a lot of references to the mandate of the Department of Health or other things that would be of interest, so consequently I think we could at least recognize at this point the possibility.
The Chairman: Andy, just let me stop you right there.
We've mandated this committee to do a job. We're therefore not going to discuss or guess before the fact what they might decide on whether or not to call witnesses. This motion would facilitate their doing so. To put it in much cruder terms, all we're doing is providing the gallows; we're not deciding if anybody is going to be hanged. That's the committee's decision. The fact that we vote for this motion doesn't mean the committee has to call witnesses. It just gives them the facility to do so if the committee decides to do so.
Andy, then Paul.
Mr. Scott: If it makes Grant more comfortable, I see this as a limiting feature in accordance with guidelines adopted by the main committee. To stay with the chair's analogy with regard to the gallows, I think we're being asked to hang people quite humanely. It's not my intention to see this as an opportunity to do something we wouldn't choose to do. It simply says that if we do choose to do it, we will be operating within the guidelines of the committee.
Mr. Szabo: Mr. Chairman, if it's appropriate, I think I would like to see some limitation here. This seems to be a blanket authorization and I don't think it would be prudent to pass it at the present time.
The Chairman: Well, the limitation is in the last phrase, ``in accordance with the guidelines adopted by the Main Committee''.
Mr. Szabo: Yes, but every committee is different. We could say we want a thousand witnesses and we're going to pay for all their staff coming from Vancouver.
The Chairman: Paul, excuse me. We're not talking about every committee. ``Main Committee'' here means this committee, the health committee.
Mr. Szabo: I know, but the guidelines we use for the authorization.... We're seconding that authorization. I think there should be only so much that we're prepared to spend on the subcommittee of this particular bill. Without a dollar figure or a limiting figure it's kind of a blank cheque, is it not?
Mr. Scott: Is it not the case - and the point was made - that we would come back to the main committee after we've organized a committee? Really all we're doing is establishing the possibility that if we do exercise the option, we're operating under guidelines. We can therefore call upon staff to make the necessary arrangements to begin to work after this afternoon if we decide to do that. So I don't see it as a blank cheque because we have to come back to committee. It's operating inside of the guidelines. Besides, I know the membership of the committee and I have all the confidence in the world of the process.
Mr. Szabo: Is it possible if we add the words ``intends to authorize''?
Mr. Culbert: May I?
The Chairman: Sure.
Mr. Culbert: Mr. Chair, I have all the confidence in the members of that committee and the make-up of that committee. I'm sure that if it's not necessary to call witnesses and to expend any dollars, that will be the case. I would expect that would be respected by the committee, so I have all the confidence in the world. If it is necessary at this point in time, I'm certainly prepared to support that motion.
The Chairman: But Andy is right in repeating what the chair said earlier: that this motion is accepted with the clear understanding that it is an interim motion, and that the committee would in reasonable time tell the main committee what its financial requirements are, and you have to go through the approval process to get that budget approved.
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So I see this as being an interim thing to facilitate the work of the subcommittee.
Motion agreed to
The Chairman: The other item I'd like to deal with is the question of what witnesses to call for our meeting on December 5, which is two weeks from today.
Could I ask Nancy Miller-Chenier and Odette Madore to tell us if they have narrowed it down to two or three people.
Ms Nancy Miller-Chenier (Committee Researcher): On next Tuesday you will have the proposed work plan for the study and in that work plan Odette and I have suggested three phases for the study.
The first phase proceeds from where the department has left us, still trying to identify generally what the determinants of health for children are.
With that in mind, until the retreat, when we'll get more focused on specifics, we were going to suggest that we should hear from groups who can continue to educate us and continue to provide us with the broad picture. So we were going to suggest to you that we have public hearings with some people who have what we'd call an intersectoral approach, which would be the Canadian Institute of Child Health. You've received their fact book, and I think it would be useful to hear from Denis Savard about how they arrived at that book, and perhaps also from some of the people who are working with him.
The Canadian Institute for Advanced Research again managed to bridge the medical-social-economic aspects of this area quite nicely, so we were hoping to ask Fraser Mustard or some appropriate substitute to come as a witness.
Other groups with a broad approach that might be slightly more traditional in the health service or medical sector are people like the Canadian Paediatric Society, the Canadian Public Health Association, and the Canadian Mental Health Association. People with a social perspective who we thought we might approach are groups like the Child Welfare League of Canada, the Vanier Institute for the Family, and the Canadian Teachers' Federation, who are very interested in early childhood and the school community kind of approach.
Finally, those with an economic perspective might include somebody representing Campaign 2000. Also, someone has suggested to me that the Conference Board of Canada, which acts as a pull-together group for a lot of initiatives in the private sector, might have some initiatives in this area, so I was going to explore that a bit further with them.
Those are just some suggestions that would keep us more than preoccupied in the few weeks that we have left before the Christmas break.
Mrs. Hayes: Just for clarification, are these all groups that are represented, and would this be simply the beginning of our witness pool? So we would go on to other individuals, groups, or whatever after our retreat.
Ms Miller-Chenier: The way we had envisioned it, phase one would be identification of the problems. The committee has heard in only a very scanty fashion from the department about what approaches they're taking, and maybe at a later date we would like to hear from them in more detail about the 29 programs that Odette and I listed - and we'll include that in the work plan - that we heard about only in passing. So we're hoping to hear from groups that could both enlighten us about how they work with Health Canada on their initiatives, because that's important, and maybe tell us about areas Health Canada has missed. In other words, it's to get us going at this stage.
The second stage, which would include the retreat, where we would hear from experts with more particular experience and perhaps some additional people at public hearings, would help the committee probably to define whether or not they want to get into some particular area. From Health Canada we heard about particulars such as accidents and injuries; we heard about other particulars in relation to prenatal nutrition.
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At some point the committee may want to decide whether to have a really solid focus on one or two areas. In the third phase, the committee members themselves have suggested we look at solutions and areas where things are really working. We would definitely want to hear from key individuals from academic institutions and people working in the field in very specific areas. The third phase, which is where we will probably have more individual-focused presentations, would follow the retreat and further decisions by the committee.
I guess we're saying that at this point we're still looking for good educational information on what is being done currently in relation to preventive strategies for children.
Mrs. Hayes: I guess I'm a little concerned that from what you're saying - correct me if I'm wrong - this would define the total pool of problems, and from that we would narrow it down to specific areas of interest or particular things we felt needed to be addressed.
If a problem isn't identified by all these groups.... For instance, I was talking to the tobacco group yesterday. I'm not sure whether that would come out in one of these areas, but maybe it wouldn't. It is concerned about prenatal and postnatal exposure to tobacco and that kind of thing. I don't really see that popping out here. It may not be a major issue, but it's an example in point. There's also a group, the National Foundation for Family Research and Education, out of Alberta that specifically focuses on the effects of family and family structure. I really don't see that here.
I don't want us to narrow ourselves into something we may not be able to come back to.
Ms Miller-Chenier: Again, the will of the committee is what decides this. I will say that some of the groups we are suggesting act as coalitions for many of the groups with more particular concerns. In other words, many of them serve as clearing-houses and list many provincial and local organizations as their members. While I don't have the exact list of their memberships in front of me, I would be surprised if they don't include in their membership many of the particular groups we would probably hear from later, if we were to go out to the communities and find out exactly what's working at the local level.
I guess what we're looking for at this stage is whether we can book some witnesses to get us going before the Christmas break. What's the wish of people around the table?
There will be lots of opportunity to name additional witnesses. As you know, we sent an e-mail to everyone's office asking for suggestions. Several people have responded, but we're still waiting. There are a few people we haven't heard from.
The Chairman: Keep in mind what this exercise was about this morning.
We have three Tuesday mornings remaining before the Christmas recess. Next week we're going to look at the draft work plan. We thought yesterday we'd have it ready for today, but there are the matters of some rewriting and the translation, so it will be circulated to you prior to next Tuesday's meeting.
We will spend our time next Tuesday hopefully finalizing the work plan and addressing the kind of things Sharon has raised. How do we identify some of the causes?
Nobody is suggesting that has to be done before Christmas or in the first or second meeting. I would think a fair amount of that identification will be done as late as the seminar we're going to have in February. There's no gun to our heads. It isn't a now or never type of thing.
All we're saying this morning - perhaps a bit clumsily - is give us some general direction as to what kind of witnesses you'd like to see in those two remaining evenings. We have a meeting next week on the plan and we have two remaining meetings on the 5th and the 12th. In those two meetings we will call two or three witnesses each day.
Nancy rhymed off a list here, just to give you an idea of what kind of person we can call. In the process, if you see a person or organization you think would be counter-productive or we shouldn't call, we want you to tell us. That's the general kind of thing.
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We have to give them some discretion, because we may find the first three on the list can't come that week anyway. So you have to give them a bit of discretion, a bit of direction, at the same time.
I have three interveners. We should have been out of here now, because there's another committee coming, so can you make it really fast or save it until next week?
Paul, Harold and Hedy.
Ms Fry: Take me off the list.
The Chairman: Okay. Paul.
Mr. Szabo: First of all, with regrets, I'm going to be out of the country from December 5, so I'm not going to be at any of this stuff, but I will have a replacement here.
Second, with regard to the time, I think it would be really a shame, Mr. Chairman, if we followed the old process of bringing in three or four witnesses at a meeting and having absolutely no time.
The first few witnesses and groups such as the child institute, the CIAR, need a whole meeting for each one of them really.
There's so much. We have the book. The child health institute is an Ottawa-based organization. They're here, very flexible, and we could certainly spend a whole meeting with them.
I also have advised the staff that I will be providing the staff with a one-hour VCR program with five or six other doctors on this very subject. If the staff so recommends, you may want to have that as well.
I would think that between now and that thing and considering that we may also be dealing with C-95 issues or might have to come back, the only witness we probably would be calling would be the child health institute, and let the rest be planned for the new season.
The Chairman: You're saying have them for two meetings?
Mr. Szabo: No, just the one meeting, a full meeting.
The Chairman: We have two meetings, though.
Mr. Szabo: I understand that. The next one, the child health thing, is going to be in the plan. But then you also have the possibility of either the....
The Chairman: We have to go.
Mr. Szabo: Okay.
The Chairman: Harold, do you have anything?
Mr. Culbert: Just very quickly, Mr. Chair, and thank you. This is just a reminder. In my view when we were speaking originally about the study, it's the wellness of Canadian youth. It goes over into social areas and it goes over into the justice system. We may want to look at HRD and at the justice system at the onset.
The only other point I wanted to make was that someone like Fraser Mustard and that group should come to the forum we're going to have in February or thereafter rather than before.
Ms Fry: I just wanted to mention the name of a group we haven't talked about that is absolutely essential, and that is CASH, the Canadian Association for School Health. They have a very holistic approach to how you assist children to be -
The Chairman: All right. Thanks, folks, for your indulgence. The meeting is adjourned.