Thank you very much, Mr. Chair. Through you to the committee, thank you for your kind invitation to be here.
I'm here today to support your examination, which is so critical to our parliamentary democracy, of the estimates for the departments and agencies in the health portfolio.
I'd like to commence by introducing the officials with me today. I may call upon these people from time to time to add additional information as needed: from Health Canada, my Deputy Minister Morris Rosenberg, my Associate Deputy Minister Hélène Gosselin, and my Chief Financial Officer Chantale Cousineau-Mahoney. From the Public Health Agency of Canada side, I would introduce the Chief Public Health Officer, Dr. David Butler-Jones, and the Director General of Finance and Administration, Luc Ladouceur.
Mr. Chair, as you know, the health portfolio comprises one department, Health Canada, and a number of other bodies, including the Public Health Agency of Canada, the Canadian Institutes of Health Research, the Pest Management Regulatory Agency, the Hazardous Materials Information Review Commission, and the Patented Medicine Prices Review Board.
You, sir, are considering estimates that capture more than $4.3 billion during this fiscal year, and that does not take into account the new commitments we made in our budget last month. Those commitments will appear in our supplementary estimates later on this year.
The money in these estimates goes to responsibilities such as drug and medical device safety, the safety of consumer products, and information and guidance on many other health matters. It supports research, through the Canadian Institutes of Health Research, to improve the health of Canadians and to build a stronger, sustainable health system. It supports innovation in our health system and activities that enable us to implement legislated requirements in such fields as regulating pest control products and handling potentially hazardous materials.
These activities have an everyday impact on the lives of all Canadians.
Although the health portfolio is very broad, I'll briefly address three areas that are particularly important commitments for the Prime Minister and myself.
The first is our government's commitment to seek the cooperation of the provinces and territories in establishing a guarantee on waiting times for medically necessary services.
I expect that every one of us has heard specific concerns about wait times from people waiting for treatment or from people who have family members waiting for treatment. I've heard concerns from physicians in my own riding. Their patients will often encounter delays when referred to specialists located only in larger cities outside of Parry Sound—Muskoka, such as Sudbury, Toronto, or Barry. This is mimicked in many other areas in rural Canada, where they have to look to Edmonton, Toronto, Quebec City, Regina, Winnipeg, Vancouver, or Montreal for services.
I can tell you that I've already been in contact with most of my provincial and territorial colleagues on ways to get real results on wait times reductions. At a financial level, our government is making a substantial contribution through the $5.5 billion over 10 years that has been set aside for this issue specifically, as part of the $41 billion amount in the 10-year plan to strengthen health care.
That money will help the provinces and territories introduce and expand the innovations that will generate the results that Canadians want. They will enable more provinces to follow the lead of Ontario, for instance, with its Cardiac Care Network, or Alberta with its hip and knee pilot project, or Saskatchewan with its Surgical Care Network, and many other initiatives besides, and to do so in a manner that reflects their opportunities and specific situations.
Mr. Chair, the 2006 budget outlined that there will be a 6% increase in the Canada health transfer through to 2013-14. These estimates include specific funding for the national wait times initiative to cover specific activities within the health portfolio to get us to our goal. That money will be used to support wait times research and education related to wait times. It will fund demonstration projects on innovative wait times management approaches. It will enable the communication of best practices from Canada and other countries in wait times management and measurement.
Permit me to give you an example. These estimates include $10.4 million this year and $75 million over five years for the internationally educated health care professionals initiative. This initiative is supporting the provinces and individual professionals as we all work to get more of these wonderful women and men accredited to practise their professions in this country and help us to reduce the wait times and indeed improve timely access.
Mr. Chairman, the second point that I want to address is the work we're doing to prepare for an influenza pandemic that could occur at any time. I want you to know that Canada's preparations are progressing well, but that much remains to be done.
The estimates for Health Canada and the Public Health Agency of Canada that you have before you include $18.6 million for pandemic preparation. The supplementary estimates will include $100 million to be allocated to departments and agencies, and the potential for an additional $70 million, which will be set aside as a contingency to be accessed on an as-needed basis. As announced through the 2006 budget, these funds are the first-year allocation of our five-year $1 billion commitment to further improve our readiness to deal with a potential pandemic.
Mr. Chair, our commitments are clear. We are funding additional antiviral medicines for the national stockpile. This is not an issue exclusive to the health portfolio, either. Indeed, it goes far beyond the health portfolio. I have spoken with my cabinet colleagues on this very point, to emphasize that the whole of government must be engaged in preparation.
Of course, the need to be ready to deal with a pandemic is not only a federal government issue. As you may know, I met with my provincial and territorial colleagues on May 13 in Toronto to discuss our preparations and to identify our common actions. We're working to formalize our roles and responsibilities. We're putting the agreements in place so that we will all share health human resources and supplies across jurisdictions. We're supporting these efforts with an effective pan-Canadian public health information system.
Our job does not stop there, but allow me simply to say that we are on the right track: we have the capacity to produce vaccines and anti-viral drugs. We have one of the best action plans for dealing with the influenza pandemic in the world.
In late April, I went to Geneva to attend the annual general meeting of the World Health Organization, and met with other G8 Health ministers. I observed that there is now broad cooperation among countries and that Canada is making a significant contribution.
For example, we are a leader in tracking disease outbreaks around the world. We have moved effectively on planning and communicating with our citizens so that they can be prepared. We're working with other countries so that they can draw on our best practices.
The new money in budget 2006 means that there are still things coming down the pipeline. More improvements will be made in our readiness as a country and in our capacity to respond to outbreaks both at home and indeed abroad.
The final point I wish to make, Mr. Chair, is about our actions on cancer control. We all know that cancer is a major health issue for Canadians. An estimated 153,100 new cases of cancer and 70,400 deaths from cancer will occur in Canada in 2006. Each of those cases will have impacts, not just on the person who has been diagnosed with cancer but on their loved ones, their friends, their workplaces, their communities.
Beginning about 1999, the cancer community in Canada—led by the National Cancer Institute of Canada, the Canadian Association of Provincial Cancer Agencies, and Health Canada—came together to develop a pan-Canadian and strategic response to rising cancer numbers and the unnecessary suffering and death from this disease. The final product of seven years of work is called the Canadian strategy for cancer control.
In simple terms, this strategy consists of a series of expert-led round tables that will support the creation of new cancer knowledge already available to us. The Canadian Cancer Society estimates that the application of current knowledge more evenly across Canada will, over the next 30 years, save 1.2 million Canadians from getting cancer and save 423,000 of them from dying of this disease.
In the supplementary estimates, we will include the budget 2006 decision to invest $260 million over the next five years for the Canadian strategy for cancer control. This funding will support the pan-Canadian round tables developed by the CSCC, including but not limited to prevention, screening, clinical practice guidelines, surveillance, and research.
Our government recognizes that this type of investment in Canada—that includes the patient voice, and enhanced coordination among the federal government, cancer organizations, and the provinces and territories—is critical to developing a modern, flexible, and fast-learning health care system. It is essential in reducing patient wait times.
Mr. Chair, these are just three examples of the work taking place in the health portfolio. I have focused on these today, but there are many services that we deliver directly to Canadians all across the country. For instance, as you know, the single biggest component of Health Canada spending is on the federal responsibility for first nations and Inuit health, with approximately $2 billion for program activity.
Like you, Mr. Chair, my riding of Parry Sound—Muskoka has many first nations communities, seven in total in my case. Five Health Canada-funded nurses, employed by six local bands, travel between those communities to provide front line health services. The same is true in the seventh community that has taken on direct responsibility for these services through an agreement with my department. As in many other communities across this country, those nurses do more than just provide immediate health services; they help to link the communities to the broader health care system, such as physicians and hospitals.
In closing, Mr. Chairman, allow me to emphasize the importance I attach to this process. These estimates cover a broad range of interventions that have a direct impact on the health and lives of Canadians. The fact that ministers, departments and parliamentary communities can work together on these kinds of issues in the context of an accountability exercise constitutes the cornerstone of our democracy.
I also want to make it clear that as the new federal Minister of Health, inheriting this portfolio, I do value your counsel as to what the federal government can do to make Canada's health system more effective and responsive to the needs of Canadians.
Mr. Chair, I thank you for the opportunity to provide my comments. I'd be pleased to take any questions from the members of this committee.
Thank you. I'll defer to my experts to go over the sometimes complex issues of the funding.
Let me just say for the record to the honourable member that this is a key interest of mine as health minister. It's an area where Health Canada does directly interact with citizens in Canada, with patients. Certainly, based on my consultations to date with many native chiefs and leaders in the first nations and Inuit communities, there is more work to be done. Indeed, I think there is a general consensus that the health outcomes in native communities, and amongst natives wherever they live in our country, are of concern. When you have, generally speaking, five to six times the suicide rates and two to three times the type 2 diabetes in those communities as compared with Canada as a whole, that signifies that what has existed in the past has not been successful on the health outcomes front.
I have engaged with first nations communities to ask them for their assistance, their advice, their guidance on how best to obtain better health outcomes for first nations, for aboriginal communities throughout the country. I really see that as one of the first orders of responsibility of my department. Of course, I will be working with Jim Prentice, the Indian Affairs minister, and many other players.
Before I get to the cold hard numbers, I can tell you that are some successes. I don't want this to be completely a story of failure. A number of individual programs are working quite well in various first nations communities. I'm reminded of a telehealth service in Ontario that connects about a dozen first nation communities with doctors, nurses, and hospitals. That has reduced wait times and given front line advice to sick aboriginal Canadians who need that advice quicker. A project in Nova Scotia that has focused on primary care and the access to primary care has reduced the wait time for primary care by, I think, 40%.
So there are some successes out there. What we have to do, obviously, is build on those successes and apply them sensitively to local traditions and surroundings, but I think there is something there that we can build on.
With that, just on the numbers, maybe I can turn it over to Madam Gosselin.
Thank you, Mr. Minister, and the staff who are here with you, for spending this much time answering questions. It's important for all of us. I realize it's a fair chunk out of your day, so we appreciate that.
I'd like to continue on with the question asked by my colleague just previous, with regard to people with hepatitis C outside the window. It's not as if we have not done this before. We know what negotiations look like, because we did that for people who were inside the window. It's not a brand new process for the lawyers to know how to do this.
I understand in some ways your saying the lawyers are working on it, but when you are someone with hepatitis C who has, I don't know, a week or a month to live, and you're losing your home, and you've lost your job....
If you were to look over your left shoulder, Mr. Minister, you would see, in the whole front row, people who have come--because they knew you would be here--from across this province, spending what is for them very precious energy that they may not get back, to hear from you an answer on when they will be able to have compensation.
I know you said it's a top priority, and I don't doubt the sincerity of that, but you said it during the election, and that was five months ago. On May 2 I think you said to me, in the House, the words “with alacrity”. I assume that means--the last time I checked--as quickly as possible, or speedily. I don't know if it's alacrity that we're seeing here.
The other thing is that we have people here who truly, as I say, are not taking their medicine. They cannot afford it. They are losing their homes, and they're losing family members and friends. They need to know, if you're saying you can't tell us a date, that there will be a commitment. I would ask you today if you could provide a date for an agreement to an interim payment, for people to at least be able to afford to feed their children, to be able to have their medication, to be able to at least have a certain amount in their lives, based on an interim payment.
This is my question to you today: are you able to give those people, sitting in the front row, watching you with hope--and they came here with hope--a date for when they would receive an interim payment?
I would also ask about survivor benefits. I don't know if survivor benefits have been spoken of. I have not heard them spoken of in this particular negotiation. Many of these people here have husbands, wives, children that they are responsible for. If an agreement is not reached with survivor benefits included, then not only will they have lost what they have, but their families also will be left in destitute positions.
So I would ask if you could answer those questions: Will survivor benefits be included, and can you provide today a date for when people would be receiving an interim payment, if you cannot announce today a date for when an agreement will be reached?
As I said, I think people have done this before, the lawyers have experience, and I would think it's like inventing it again. It seems to me they could move faster, and I would be expecting, if I were minister, that they would.
If you could answer those questions, I'd appreciate it.
Thank you very much. I appreciate your concerns. I know we're all trying to do the right thing around this table. I don't think any of us want to exploit this and the victims themselves for cheap political advantage. I think we're all here for the right reasons, and I will take your comments and your questions in that context.
A voice: [Inaudible--Editor]
Hon. Tony Clement: That's why I said it.
What can I say? This is a very frustrating time for the individuals in question. For them it's not a question of waiting five months, it's a question of waiting years and years for a government that would listen to them and that would take their plight seriously. When we try to measure the timeframe of frustration for the people....
Many of these people I dealt with as the Ontario Minister of Health and Long-Term Care. They were as frustrated then...or in some ways more so. We all have constituents who are impacted by this; I do too. I cannot imagine the stress and the health issues they have to go through. I'm not pretending to be in their stead, but certainly as a human being I can empathize with them. I want to do what I can do on some form of restitution. That's what we're committed to as a government. We were committed to it in opposition, along with members of your party. I took that very seriously upon being sworn in as Minister of Health.
I don't think it's wise for me, in the middle of negotiations, to be too specific about what I think the appropriate deal should be. That would be bargaining in bad faith, quite frankly. So I choose to be more general than I usually am in answering questions on the issues you raised. We have a very serious process that the government side takes seriously and the plaintiff side takes seriously, and, just as they are, I am wedded to that process.
My friends behind me have legal representation, as a class. That legal representation is responsible to them. If they have questions about the negotiating stance of the legal representation, I can't answer on behalf of that legal representation, but they can get answers.
I think it would be wise for me to stop there. Believe me, this is frustrating for me, although not half as frustrating as what they have to go through, and I know that. I want to do the right thing, just as you do.
Thank you, Mr. Chairman.
Thank you for being with us today, Minister. My question will be much more political than financial in nature.
However, it is a question that has a very significant effect on the finances of the provinces in the area of health. The provinces have to deal with problems arising from policies that have been adopted. In only the past five years, Health Canada's Special Access Program, which is intended to provide access to special instruments and drugs, has provided surgeons who so request on behalf of their patients with silicone gel breast implants.
However, as many as 67% of the requests submitted to that program concern silicone gel implants. But those implants were prohibited in 1992, and Health Canada has not approved them to return to the market. The problem is that the same program also has a mandate to provide certain drugs to people who need them.
As a result, six persons with HIV/AIDS who had requested drugs in April were denied access to those drugs, which could have saved their lives. And yet this program is supposed to enable Canadians to obtain drugs where they are not on the market, where they have not yet been approved or where other therapies have not worked.
Minister, I don't understand how priority can be given to the fitting of breast implants for women who have small breasts or a few ripples caused by implants filled with saline solution. When I think of people whose lives could end because they're denied access to drugs that could save their lives, I don't see how we can give priority to the replacement or fitting of silicone gel implants. Can you explain that to me?
I'd also like you to tell us whether you intend to repeal this program, at least as regards silicone gel breast implants. The person responsible for the program told us that he was unable to intervene when the physician decided that a given solution was best for a patient. That's what he recently said on television on a CBC program. He said that his role was not to intervene and that he relied on the physician's competence in determining the best solution for his patient. If he relied on the physician's competence in the case of silicone gel implants, why didn't he do the same thing for people suffering from AIDS who need drugs in order to live?