HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Monday, February 14, 2000

• 1534

[English]

The Chair (Mr. Lynn Myers (Waterloo—Wellington, Lib.)): Ladies and gentlemen, we have a vote, orders of the day. We have about 20 minutes to get to the House, so we'll go now and then we'll come back afterwards. We'll try to get this bill done this afternoon, so let's go back to the House now.

Mr. Mac Harb (Ottawa Centre, Lib.): May I make a suggestion, Mr. Chair?

The Chair: Yes.

Mr. Mac Harb: There's no objection to the substance of what we are trying to do. Can we dispatch it through, or are there witnesses we have to hear?

The Chair: No, we don't have to hear the witnesses, but we don't have a quorum to do that. I wish we did.

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): Somebody wanted to ask some questions.

The Chair: Now, who might that be?

• 1535

Mr. Réal Ménard: But we will agree to adopt them in order to finish today.

The Chair: Yes, we're going to finish it. So we're going to try to get the people here after the vote.

Mr. Réal Ménard: Yes.

The Chair: All right?

Mr. Réal Ménard: We can adopt with one vote the last ten clauses. I think it's only for transition...

The Chair: All right. We'll come back after the vote. Thank you.

• 1536

• 1643

The Chair: We're going to call this meeting to order. We don't quite have quorum. There's one more person who will be joining us.

We do have clause 20 that is standing. There had been discussion on that. You will recall that we did clauses 21 and 22 and we'll be going on to clause 23.

(On clause 20—Establishment)

The Chair: In light of the fact that we want to move and move expeditiously, and knowing we are still one shy of a quorum, I'll ask Mr. Rivard to lead off on the issue of the conflict of interest and give us a kind of background that we maybe should have with respect to that issue. And I'm going to ask Monsieur Charbonneau to give his view and perspective.

I think we all understand what's at stake here. I think we understand that there are some questions with respect to that. So maybe after we hear from Mr. Rivard and Monsieur Charbonneau we'll be a little clearer. I hope we don't need to have a lot of debate after that. I think we can simply either proceed or vote if we need to.

Mr. Rivard.

Mr. Glenn Rivard (General Counsel, Department of Justice Canada): Thank you very much.

Since the last meeting of the committee I've had an opportunity to review the conflict of interest and post-employment code for public office holders and I've spoken to Howard Wilson, who is the ethics counsellor. I just want to give you a quick overview of it.

Essentially, the conflict of interest code contains three parts. Part one has a list of ten ethical principles, which apply to everyone covered by the code. The code also contains a number of compliance measures, including reporting requirements and divestiture and asset management requirements, which apply to some of the people covered by the code. It also vests authority in the ethics counsellor to oversee compliance with the code.

• 1645

In terms of the CIHR, what this means is that the president, who will be a full-time Governor in Council appointee, will be subject to the entire code. Part-time members of the governing council will be subject to part I of the code, which is the list of the ten ethical principles I mentioned. The staff of the CIHR will also be subject to this part I. The code itself would not apply to Governor in Council appointees to committees or institute advisory boards, unless they are also council members or employees of the CIHR.

When I was speaking with Mr. Wilson, the ethics counsellor, he explained that it is his normal practice to meet with the head of new agencies. In this case he would meet with the president of the CIHR and would develop, with the head of the agency, a conflict of interest code that meets the specific needs of that agency. His experience has been that the conflict of interest issues will differ depending on the mandate, structure, functioning, etc. of the particular body.

Therefore they develop a code, which is based on the ten principles but is tailored to the needs of the particular agency. In this way, additional requirements or additional needs around conflict of interest for the CIHR, above and beyond what is covered by the code, would be addressed, and it would be handled in that fashion.

That's basically a summary of how it operates.

The Chair: Thank you very much.

Bring it a little further into perspective please, Mr. Charbonneau.

[Translation]

Mr. Yvon Charbonneau (Anjou—Rivière des Prairies, Lib.): The concern expressed by our colleague at the beginning of this debate was mentioned by a certain number of witnesses who appeared before us. It is therefore an issue in the minds of some people interested in the establishment of the research institutes. We will need to answer this concern. Mr. Rivard explained to us the ground rules that apply generally in all similar institutions in the government, the basic ethical principles and the implementation measures. He also told us what would be done to adapt to the needs of the institutes once they are created. The general principles will be transposed and adapted to the particular situation of the institutes.

I believe that that answer is generally satisfactory to us. However, to pin things down or take them a little further, and to avoid having to amend the bill in various areas, we could include a recommendation in our report asking explicitly that the Governing Councils of the institutes draft and implement a code of ethics that would be adapted to the institutes and similar to the general code of ethics that exists in similar institutions in the government.

If the committee agreed, such a recommendation would reflect the fact that we have given a great deal of attention to this matter and that we have noted that such instruments already exist. We can put our own stamp on it by saying that this issue was raised and that we recommend explicitly that the institutes put such a code in place. The witnesses who raised this concern will be able to see that the committee has assumed its responsibilities by bringing the issue to the attention of the Governing Councils of the future institutes.

• 1650

The Chairman: Thank you very much.

[English]

Thank you very much. You're certainly giving clarity to what is another option, another process.

I'm wondering if there's agreement to proceed in that fashion. Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): I understand, based on the parliamentary secretary's comments, that the concerns we raised last week about the possibility of conflict of interest, at least when it comes to members of advisory committees, will be addressed and can be addressed through a recommendation from this committee to the report stage of the bill.

I haven't yet heard this afternoon any suggestion that this isn't a legitimate concern, that in fact the normal conflict of interest provisions through Order in Council appointments wouldn't apply to everyone in this bill, and certainly not to members of standing advisory committees.

I just want clarification of that. If that's the case, and the recommendation of the parliamentary secretary is that we just take a recommendation forward to have this addressed in the future and not have something entrenched in the legislation, we leave a pretty big hole. That would be a fairly significant grey area and it would leave the possibility of serious problems down the road.

The Chair: In fairness, Ms. Wasylycia-Leis, we know that's a political decision. We know this is a serious issue. It's a question of how we address it. We had Mr. Szabo arguing his position in the last meeting, saying he wants it written in. He may do that again today; we'll see. We have Mr. Charbonneau indicating there's another route. Really what we need to do as a committee is decide, and we'll do that momentarily.

Mr. Szabo.

Mr. Paul Szabo (Mississauga South, Lib.): I'd like to have clarification as to what the proposal from the parliamentary secretary is with regard to a recommendation. If there is going to be a vote on this, maybe the clerk can advise the committee members whether, if that is proceeded with, that would preclude a report stage motion coming forward on the issue of conflict of interest.

The Chair: Ms. Enman, can you help us out on that?

The Clerk of the Committee: We would have to see the amendment first to see what it covers. If the issue of conflict of interest is covered in the amendment moved in committee, then you're correct, moving it at report stage would be ruled out of order.

The Chair: I don't think we're talking about amendments, though; we're talking simply of a report.

The Clerk: A separate report?

The Chair: A recommendation.

Our best advice is that it could be moved at report stage.

Mr. Paul Szabo: My inclination, Mr. Chairman, would be that since we've just received the background advice from the witnesses and heard what we could do on a current basis with regard to posing a recommendation, that still leaves the door open for a report stage amendment if subsequent discussions would find that would be appropriate and we could pursue that. As long as that door is open, I'd be happy to support the general thrust of what the parliamentary secretary said.

The Chair: Great. Thank you very much. We can then...

Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: If I can have an amendment on the table right now that I have proposed—

The Chair: It's yours. We're going to go to that in a minute. I want to clear this off first.

Ms. Judy Wasylycia-Leis: Right. But that amendment is pertinent to this discussion. In fact, the discussion we're in flowed from that amendment being put on the table.

I'm quite prepared to pull this amendment off the table if I have a clear understanding that there's another way to deal with it or that there's a problem with the way in which this amendment is now worded in terms of dealing with the problem we've been talking about. Is there another avenue altogether that we should pursue? I'm just looking for some advice. I can pull this off the table right now, but I sure would like to know how we're going to address conflict of interest in a substantive way.

The Chair: You know you have the option at report stage. You know you can do that; you're aware of that, right?

Ms. Judy Wasylycia-Leis: Yes.

• 1655

The Chair: I think what you need to do is, in your mind, either decide if you're going to pull amendment NDP-9 or if you want to have a vote. We'll be happy to have the vote, but I do want to proceed. What do you hope to do?

Ms. Judy Wasylycia-Leis: I guess I was hoping to do it today, because we put off the discussion to get some expert advice on what difficulties there are with this amendment in terms of getting at this matter.

The Chair: I think we've heard all the advice we need. We've heard Mr. Rivard report. There's nothing wrong with your amendment. It's a question of whether we are in favour or are opposed. We're going to call the question in a minute, unless you withdraw it.

Mr. Charbonneau.

[Translation]

Mr. Yvon Charbonneau: I would like to answer our colleague by telling him what I understood from what Mr. Rivard said. There is a code and the president will be subject to the entire code. Only part I of the code will apply to employees, part-time members or otherwise. People from outside who are brought onto the advisory committees will not be covered by the code. However, the ethics counsellor will meet with the president so that they can develop a code that will apply to those people.

[English]

So I think it would cover the people you envisaged it covering through your amendment. They are coming maybe from the industry. They are outside people. They are invited to be members of the consultative or advisory boards. They would be covered through the elaboration and the implementation of a tailor-made code of ethics derived from the basic lines.

The Chair: Thank you very much.

[Translation]

Mr. Ménard.

Mr. Réal Ménard: Mr. Chairman, I am trying to understand the difference between the NDP amendment and what Mr. Charbonneau is proposing. You would like the report that will be tabled in the House by the chairman to give clear direction to the Governing Council to develop a specific code of ethics for the institutes. That is the gist of your amendment.

Mr. Yvon Charbonneau: And it will cover the people from the pharmaceutical industry and all the others.

Mr. Réal Ménard: Are we sure that this will be binding on the Governing Council? If it is in the report that the chairman will table, the Governing Council will be bound by it. It will have no other choice than to draft a code. Is that the case?

Mr. Yvon Charbonneau: Mr. Chairman, if...

[English]

The Chair: No, I think we have to be careful here. It's not going to bind anyone. What it's going to do is give a very strong signal, however, that this committee thoughtfully and methodically went through the process, thought hard and long about this issue, and thinks it's very important. It's important enough, as I understand it, to now report to the House in order to make sure they are aware of this committee's wish in this regard.

But as to binding, I don't think we're binding anyone. I think we need to make that clear.

Mr. Yvon Charbonneau: Maybe it won't be legally binding, but morally speaking,

[Translation]

if the president of the institute were to come here in a year without having done anything as far as ethics code is concerned, I think that he would really hear it from us.

[English]

The Chair: The point is well taken. We are using moral suasion on them in a very strong way, if that's what you're saying it is.

Mr. Szabo.

Mr. Paul Szabo: Is there suggested language for this recommendation?

The Chair: Not that I'm aware of, not for this recommendation.

Mr. Yvon Charbonneau: Yes.

The Chair: Oh, very good. That's excellent. Do you want to read it out, please?

Mr. Yvon Charbonneau: I would recommend that the committee recommend that the governing council develop and implement a particular set of conflict of interest guidelines for the agency, including the Canadian Institutes of Health Research.

The Chair: Okay, very good. Are we all in agreement on that?

[Translation]

Mr. Réal Ménard: Yes.

[English]

The Chair: Anyone?

Mr. Paul Szabo: Is the amendment being withdrawn?

Ms. Judy Wasylycia-Leis: Yes. We probably should be able to...

[Editor's Note: Inaudible]

...if you want to have a fair discussion on this recommendation.

The Chair: No, I think we're just going to agree with it or we're not going to agree with it. Are you agreeing and therefore withdrawing your amendment?

Mr. Yvon Charbonneau: That's including the Institutes of Health Research.

The Chair: Yes, we understand.

Judy.

Ms. Judy Wasylycia-Leis: In terms of good faith and considering very seriously the recommendation that this committee may bring forward from committee, I would certainly be happy to pull this amendment. I look forward to some more dialogue between now and third reading of the bill to see if this issue is covered. If there's agreement, I'll pull it off the table.

• 1700

The Chair: Great. Thank you very much. And that you and Mr. Charbonneau can have in abundance.

Let's move to your other three, Ms. Wasylycia-Leis. I don't see a lot of discussion here, because I think we've all been lobbied by people trying to get certain institutes up and running. It seems to me that you're talking about, on the one hand, the Centres of Excellence for Women's Health. On the other, you're talking about an environmental health research institute, and in the third instance, an aboriginal health research institute. I see them as straightforward. You may want to put a little bit of context to them, but not a lot.

Ms. Judy Wasylycia-Leis: Thank you, Mr. Chairperson. I would like to spend a little bit of time on these amendments, and I appreciate your interest in moving this bill along. However, I think we have a significant number of clauses left to deal with, and I hope we'll give them the in-depth consideration this bill warrants. I think it's a bit unfair to put this kind of pressure on us to expedite everything as quickly as possible in half an hour when in fact we all came last Thursday to do this, but government members chose not to attend that meeting and we lost that opportunity. I think we need to have the time necessary to do a complete review of this bill, so I would like to move each amendment separately and see if there is some discussion and hopefully some support for the amendments.

The first reads:

That Bill C-13, in clause 20, be amended by striking out the word “and” at end of line 21 on page 10, by adding the word “and” at the end of line 23, and by adding after line 23 the following:

(d) without limiting the number and function of any other institute, establish a Women's Health Institute which in turn shall fund and provide policy and program direction to the Women's Health Centres of Excellence Program.

If I could just speak about that briefly, Mr. Chairperson, I think it's important to put this in context. This isn't just simply an attempt to influence the final makeup of the institutes that will be selected once the governing council is appointed and the whole structure in place.

In the case of women's health, I'd like to make several points. Members should be aware that this government has supported, with significant dollars, the establishment of centres of excellence in terms of women's health. That point was made fairly clearly at committee, and the organizations that testified before us wanted all of us to know that there is a time limit in terms of their centres of excellence. They have been funded for a couple more years, at which point there are no guarantees that these centres of excellence for women's health will continue. In fact, they have been told their efforts will be folded into the CIHR and addressed accordingly. That means they go into the mix with all of the 170 other proposals, as I understand it, and will be judged accordingly.

That's fair enough on one hand, but I think members have to realize that if we do not have some way to continue the work begun by these centres of excellence, a great opportunity will have been lost at the very time when these centres are beginning to make a significant difference and have a real impact on the way in which health research is pursued in this country, and on the kinds of policies and programs that are being recommended for dealing with very serious health concerns among women. There is no budget in place for these centres beyond March 31, 2002. You can imagine the concern and anxiety that is being felt by women across this country, and certainly by the centres of excellence for women's health, and for women's health generally.

Committee members will know that a concerted effort was made for our committee and the government to understand the importance of integrating women's concerns throughout the entire process, and it was on the basis of those presentations that I made a recommendation for gender parity on the governing council that was defeated. It was on the basis of those witnesses and presentations that I suggested an attempt at mainstreaming women's health issues throughout all the institutes—

The Chair: Ms. Wasylycia-Leis, we're now covering old ground.

Ms. Judy Wasylycia-Leis: —and that was defeated, Mr. Chairman.

The Chair: Make your point, and then we're going to vote.

Ms. Judy Wasylycia-Leis: You can imagine we're left with very few opportunities to ensure that the concerns of women are addressed in this bill. So the last opportunity, really, to try to make the case to this committee and to try to amend the bill so that there is a security for the centres of excellence and for women's health research in this country is, in fact, by amending the bill to include a women's health research institute as part of the 15 or so institutes that will be determined once this bill is through.

• 1705

I think it's important for members to realize that there is a huge number of proposals coming forward to the interim governing council—at last count, as I heard today, 170. We've been told that the hope is to get that down to maybe 15 institutes, so there needs to be some real thought about the makeup of those institutes, about whether or not this new transformative approach to health research will actually become a reality, and about how we can really be true to the words of this bill, the rhetoric of the bill, around pursuing economic, social, environmental, and cultural determinants of ill health.

I think it's important for us to have that discussion. I would have liked the opportunity to have a few minutes just to hear what the plans are once this bill is passed. I can keep proposing these kinds of amendments, but it sure would be nice if we had some sense of what the process will be when we vote on third reading and the bill is proclaimed. How will it be decided? Who will make the decision? What factors will be considered?

Some of us met today with the folks involved in heart disease in regard to their real concern about an institute that deals with chronic diseases, particularly heart disease. I think we need to give some advice through this process back to the minister and to the governing council about what that should look like.

I can tell you that some very good proposals have been presented to us. I think, for example, of the women's health researchers that appeared before our committee. They made an excellent suggestion to divide the 15 institutes into different categories, one being diseases and body systems institutes. That would cover off body parts and diseases as we've come to know them in this committee—

The Chair: Ms. Wasylycia-Leis, I'm going to interrupt at this point. I think that we genuinely—all of us—have listened very closely to the testimony that has been given. We've repeatedly heard Dr. Friesen and others talk about what process is going to be used to try to meet the objectives of where we're heading here. I see really no purpose in rehashing all of this again.

I do, however, know that you have an amendment on the floor. I would like to now call the question on that amendment.

Ms. Judy Wasylycia-Leis: May I just finish that one interjection I was making about the kind of framework that's been suggested by—

The Chair: No, we're aware of that, Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: I don't know if this actually got on the record, just the four categories: diseases and body systems institutes; life stages institutes; population health institutes; and finally, integrated comprehensive institutes. I think those are four categories that will help to encapsulate many of the specific concerns we've heard. I think it would be worthwhile to have a discussion on that and ensure that this kind of formulation is put into the mix and is looked at seriously.

The Chair: I know that those who will be doing this precise process will look at all of our testimony and all that we have said, and they will make sure that all of those factors are weighed in and considered appropriately. I know that'll happen.

We'll call the question now, with a recorded vote.

(Motion negatived: nays 6; yeas 2)

The Chair: The motion is defeated, as appended.

We'll go on to environmental health research. I will assume the same arguments: you want this included as well. We'll call the question on that as well.

Ms. Judy Wasylycia-Leis: There are slightly different arguments, Mr. Chairperson. Could I present the motion?

The Chair: Go ahead, Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: Thank you.

I would like to move that Bill C-13 in clause 20 be amended by striking out the word “and” at the end of line 21 on page 10, by adding the word “and” at the end of line 23, and by adding after line 23 the following:

(d) without limiting the number and function of any other institute, create an Occupational and Environmental Health Research Institute.

This is a different matter than the one we've just addressed in terms of women's health. Folks will recall we were told quite clearly that there is very little organized, coordinated effort in this country to ensure that occupational and environmental concerns are integrated into our whole research model.

• 1710

I think this is an area that does beg some discussion by the committee. We had a bit of a chance at committee to go over this area, but not a lot of time to really question how the issues of environmental health and occupational health and safety are integrated into what is supposed to be a new and innovative model for health research in this country.

Members will recall, in fact, that we heard that countries smaller than Canada... In fact, if I'm looking at the brief, I see that countries such as Sweden and Finland, with much smaller populations than Canada, have occupational health research institutes while Canada has none. We really are dealing with a complete vacuum and crying out for this government, through this new mechanism, the CIHR, to address those concerns.

Given all the concerns we've heard recently, like the report from the environmental commissioner around linkage between solvents and chemicals in the environment and the links to cancer, the new revolutions around carcinogenic substances in the environment, the concerns we have around this bill for disease prevention and not just looking at chronic diseases as traditionally defined but broadening our whole window and looking at the links between an environment and health and well-being, we have to give some serious consideration to the proposal.

It was advanced very strongly by the Canadian Labour Congress. I would assume that everyone around this table has had significant contact from that organization. We've had letters—

The Chair: Not as much as you, I'm sure.

Ms. Judy Wasylycia-Leis: I think they've done a good job of trying to call on all of us. I just hope we've all heard the message that this is a very important issue and needs to be considered seriously.

I hope committee members will take this amendment very seriously and will actually agree to the amendment and send a recommendation that this is something we believe in strongly. If we are talking about new, transformative approaches to research, then surely this is where it begins.

The Chair: Thank you very much. Monsieur Charbonneau, who has an extensive wealth of information in this area as chair of environmental and sustainable environment, will, I'm sure, bring this into perspective.

Monsieur Charbonneau.

Mr. Yvon Charbonneau: Mr. Chair, I would like to address, with your authorization, the three amendments: the previous one, and you may say it's too late, but it's the same idea, which is to create an institute; this one; and the following one.

Basically this is the same argument, as far as I am concerned. It's not an argument that comes from the binder, I would like to assure my colleagues. It's just considering the whole process. We are going to adopt this bill and then the appropriate people will gather and select a certain number of institutes to be set up in the coming months. There is a broad consultative process currently taking place. Many people will be involved in this selection process of a definite number of or at least the first group of institutes to be set up.

I would like to put on the record that I am very sensitive to the three areas mentioned by our colleague, whether it is with the women or with these occupational and environmental health research areas. I would see it on an even broader basis; this formulation could go further. Aboriginal health in the next one is the same. We have heard the same witnesses and we know there are important realities behind this.

But is it enough to create an institute on every particular matter? We have to make sure the group of institutes that is be set up will take charge of these realities. Is it necessary for each particular topic or area to set up a particular institute? If we are not satisfied with the global or comprehensive or strategic planning that will be presented to us later, then we could come back as parliamentarians and tell the president or chair of the institute that this area is not being covered appropriately, or just not being covered. Then we could push them to either set up a particular institute or open the door for research projects covering these areas.

• 1715

So I am not ready today to vote for a particular institute on these particular issues. We have other proposals that deserve greater interest. Why should we not adopt a particular institute for aging people, for example? I could find perhaps two or three more areas that deserve greater interest.

In conclusion, today I think we must take into account the whole process of consultation, and then in one year or a few months ahead we could come back and tell them, well, we think this is not well covered, and then push them to cover the area better.

The Chair: Thank you very much.

Mr. Szabo.

Mr. Paul Szabo: Mr. Chairman, I think we should have a motion that Ms. Wasylycia-Leis be appointed to the governing council. I think we'd have all the bases covered.

I would just point out that in paragraph 4(e) there is a specific reference to environmental influences on health that refers to the objectives of the governing council. It's repeated in subclause 20(4) with respect to the advisory councils. On that basis, certainly environmental influences on health are covered on a blanket basis.

I think the member's points are well taken, but I would tend to agree with the parliamentary secretary that it may be a little difficult to start naming the specific centres when in fact that's one of the duties of the governing council.

The Chair: Thank you very much.

I'll call the question.

(Amendment negatived)

The Chair: Amendment 0.8, Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: I'd like to move that Bill C-13, at clause 20, be amended by striking out the word “and” at the end of line 21 on page 10, by adding the word “and” at the end of line 23, and by adding after line 23 the following:

(d) without limiting the number and function of any other institute, create an Aboriginal Health Research Institute.

Just to explain—

The Chair: Ms. Wasylycia-Leis, I think we know the arguments. I think we've heard both. I think it's similar to what Mr. Charbonneau just referred to.

Ms. Judy Wasylycia-Leis: Well, it's not. It is a different amendment, and I'd like to address the concerns of Mr. Charbonneau in the process.

Again, I think it is a unique area. We are talking about the original peoples of this country. We are talking about the most serious health situations anywhere in the world. We're talking about third world conditions, and we're talking about the possibility, through this new model, of actually addressing those concerns. I think it's incumbent upon us to give this very special and unique attention because of the unique and special circumstances we're dealing with.

As Mr. Charbonneau mentioned, we heard presenters raise issues of concern around aboriginal health. There should be enough for us now to say let us make a recommendation to government to help direct the work of the governing council and ensure that this area is covered as a very important policy research area. It deserves to be considered as an institute on a stand-alone basis.

The Chair: I'm going to cut here—

• 1720

Ms. Judy Wasylycia-Leis: I want to make one other comment with regard to Mr. Charbonneau's comments—

The Chair: No, Ms. Wasylycia-Leis, I'm going to cut here. We genuinely have heard all these arguments about their being very unique and very different.

Ms. Judy Wasylycia-Leis: I want a point of order, then.

The Chair: All right, a point of order.

Ms. Judy Wasylycia-Leis: On a point of order, Mr. Charbonneau asked why not all the other areas. I would agree with him that aging is certainly an area. In fact, if you look at the model I presented earlier, there are proposals for 11 institutes—

The Chair: It's not a point of order, it's an argument.

Ms. Judy Wasylycia-Leis: —that would cover off disease and chronic situations, life situations.

The Chair: We understand, Ms. Wasylycia-Leis, we genuinely understand, but we're calling the question.

Mr. Szabo.

Mr. Paul Szabo: Mr. Chairman, I think it really is unfortunate that neither clause 4 nor 20 makes any reference whatsoever to aboriginal health issues. It is by far one of the most tragic areas of health. I think as a health committee we would be remiss if we did not at least make a recommendation, as we have with regard to conflict of interest, where hopefully, within the cultural and whatever, we at least acknowledge that aboriginal health issues are of significant concern to Canadians and that we look forward to that being addressed by the governing council when they do their work.

The Chair: Mr. Charbonneau, there's a recommendation. Do you have any problem with that?

Mr. Yvon Charbonneau: No, I would agree with a recommendation indicating that, for us, it would be important to be considered by the governing body.

The Chair: Very good.

So we understand. We have an amendment. We have a recommendation. The parliamentary secretary says that's something he would be prepared to include by virtue and by process of a recommendation procedure.

I'm now calling the question.

(Amendment negatived)

The Chair: Shall clause 20 carry—

Ms. Judy Wasylycia-Leis: Can I ask what the recommendation will be, then?

The Chair: It will be similar to the other one on conflict of interest, that the powers that be will be given direction that aboriginal health be—

Mr. Yvon Charbonneau: Considered.

The Chair: Yes, considered.

Ms. Judy Wasylycia-Leis: I'd like to make another recommendation, then, Mr. Chairperson, that in our report to the House at report stage we make a recommendation for the government to consider a makeup or configuration that involves a number of categories.

The first category, called “diseases and body systems institutes”, would include: (1) heart health; (2) cancer; (3) immunology and infectious diseases; (4) bone and joint health; and (5) brain and mental health. The second category, “life stages institutes”, would involve child and youth health and aging. The third category would be “population health institutes”, which would include aboriginal health, environmental and occupational health, and disability/injury prevention. A final category would be called “integrated comprehensive institutes”, with a specific requirement for a women's health institute.

I think that's a way to address the concerns we've talked about today. That's not to exclude anybody but to have reasonable categories and to go forward with the recommendations.

The Chair: It's on the floor.

Monsieur Charbonneau.

[Translation]

Mr. Yvon Charbonneau: Mr. Chairman, I indicated that I agreed with the suggestion made by our colleague, Mr. Szabo, for a recommendation that would focus on Aboriginal people in particular, but I am not prepared to support a recommendation that would be a sort of complete blueprint of what the Governing Council should do.

I would like to congratulate our colleague Judy for coming up with the ideal configuration for all the institutes. That is an outstanding piece of work, and it will appear in the minutes of today's meeting. She will be able to put forward her suggestions again at the next stage in the debate. I am not prepared to make a recommendation dealing with the entire structure, but I am prepared to support a recommendation regarding the Aboriginals.

The Chairman: Mr. Ménard.

Mr. Réal Ménard: Mr. Chairman, I too am uncomfortable at the idea of passing a provision that would ask the Governing Council to establish certain institutes. That would leave little latitude for setting up other institutes that the Governing Council may choose to set up. Moreover, I would not want us to forget that we are talking about a call for tenders process in which the scientific community must be involved.

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Second, I think that if there is an institute about which we should be insistent, it is certainly the one regarding Aboriginals. There are two reasons for that.

I don't know whether you were a member of the Standing Committee on Health at the time, but the committee has already studied Aboriginal health. It produced a report in which we recommended something quite similar to what Judy is suggesting. Without trying to direct the Governing Council and the scientific community, which should be free to act, in light of the Aboriginal situation, we should be very insistent and clear about our desire that an institute be established for them.

As far as the rest goes, I have to agree with Mr. Charbonneau. We should not include too much, because if we do, the scientific community will not feel involved in the process. However, we should make an exception for the Aboriginal community.

[English]

The Chair: Thank you very much.

Ms. Wasylycia-Leis, I don't see a lot of support, so I think we're going to drop it. It's on the record. I think what you said is important. It's there for all to see.

(Clause 20 agreed to on division)

(On clause 23—President)

Ms. Judy Wasylycia-Leis: I had a question on clause 23.

The Chair: Go ahead.

Ms. Judy Wasylycia-Leis: In fact, I had posed the question earlier, and I was told to wait until we got to the appropriate clause.

It is a question the Canadian Healthcare Association asked us, and I don't believe we had an answer: why are this president and the chairperson of the governing council one and the same? The CHA pointed out that this flies in the face of other governance models that stress transparency and accountability. So I think it is a pretty fundamental issue, and I'm wondering if we could have an explanation on that one.

The Chair: Are you going to respond to that, Mr. Rivard?

Mr. Hoye.

Mr. David Hoye (Director of Policy and Government Relations, CIHR Transition Secretariat, Canadian Institutes of Health Research): Mr. Chair, a great deal of thought was given to the issue of chair/president and to whether there should be one position or two. It's something we did quite a bit of research on and it was discussed at length within the department and in the interim governing council. In the end, the recommendation of the interim governing council was that there be one position there.

The main reason for proposing that these two functions be concentrated in one person has to do with accountability, on the one hand, and, on the other hand, with what I'll call integrity, if I may use that word in the sense of integration. We have a very large and diverse coalition that brought CIHR to the attention of the government and of Parliament, and as we've been discussing here today, it spans a very great range. It was felt, as we looked at this executive position, that what was needed was one place in the organization where all of the lines of communication and the interests of the many parties who support and would be partners of and would be involved in CIHR would have a point of integrity and of integration—one person, therefore, who is accountable for that to the governing council, to the minister, and through the minister to Parliament, to the House of Commons standing committee, and the Senate;

If I may, Mr. Chairman, there is more, but I'll stop there and say that those were the primary reasons the decision was made to integrate those two into one position.

I'll add just one thing, which is present practice. At the present time, all the granting councils have a single position, including the MRC.

The Chair: Thank you very much. This also came up in testimony. I think it was asked maybe three or four times. I think it was responded to three or four times, and we hear it yet again today. So I'm hopeful we can move on.

Mr. Ménard.

[Translation]

Mr. Réal Ménard: I think this clause is very dangerous, Mr. Chairman. There are many public and semi-public organizations, such as the Régie des installations olympiques (Olympics Installations Board), which have both a president and a chairperson of the board. Let me tell you why I think that the proposal is dangerous.

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The chairperson of the Governing Council must deal with budgetary considerations and the mandate of the council. The internal person, on the other hand, looks after personnel management and routine operations, and has quite a different mandate. I think we are taking a very great risk if we insist that there be only one person accountable, and by refusing to believe in the balance that should exist between the head of an organization and the chair of the Governing Council. I will therefore be voting against this clause.

[English]

(Clause 23 agreed to: yeas, 6; nays, 2)

(Clauses 24 and 25 agreed to)

(On clause 26—Ancillary powers)

The Chair: All those in agreement on clause 26—

[Translation]

Mr. Réal Ménard: It is 5:30 p.m., Mr. Chairman, and I have to leave now. Can we come back to this tomorrow?

[English]

The Chair: We had actually scheduled the meeting to 6 o'clock. I would like to get through, with your concurrence... There is a government amendment in clause 26. I'd like to get through clause 26, and I don't see a lot of problem right up to clause 30. There are amendments later, however, so perhaps we can agree to take maybe two or three minutes and get through up to and including clause 30.

We're wasting time. Let's do it.

[Translation]

Mr. Yvon Charbonneau: There is a government amendment to clause 26 which would eliminate subclauses (2) and (3). The reason for the amendment is that the drafters realized that these provisions were not required because sections 43 and 44...

[English]

Mr. Paul Szabo: Is there a handout on that?

The Chair: Yes, it's G-3.

Mr. Yvon Charbonneau: Now I would like to delete lines 14 to 24 on page 13.

The Chair: That's straightforward, Mr. Charbonneau. If we proceed with that, it makes redundant our Reform-15.

Mr. Yvon Charbonneau: Yes, it will be made useless.

The reason we want to delete lines 14 to 24 is that these provisions are not required, because sections 43 and 44 of the Financial Administration Act already provide a scheme to manage government borrowing.

Section 43 states that money can be borrowed or security issued by the government only with the authority of Parliament. Section 44 provides that where borrowing is authorized by an Act of Parliament, the Minister of Finance may raise money by a means of treasury bills, loans or securities.

So there is no reason to control the—

The Chair: I think we got the gist of it. I think we understand.

Mr. Yvon Charbonneau: I have three or four more lines—

The Chair: No, that's okay.

Can we agree to that?

(Amendment agreed to)

(Clause 26 as amended agreed to)

(Clauses 27 to 30 inclusive agreed to)

The Chair: All right, we will come back tomorrow and we'll do the rest then. Is that agreed?

Ms. Judy Wasylycia-Leis: At what time?

The Chair: We will meet at 4 o'clock, after the vote, all right? And can we agree to take no more than an hour and a half, from 4 o'clock to 5:30?

Ms. Judy Wasylycia-Leis: Yes. I have some amendments.

The Chair: Okay. So we'll be done by 5:30 tomorrow. Is that agreed?

Some hon. members: Agreed

The Chair: Thank you.

This meeting is adjourned.