We've been advised that they need this room for the budget. We looked around for other rooms, Dr. Bennett, and there just isn't anything available that day. I also understand that, traditionally on budget day, this is common practice because of the unavailability of rooms. But thank you for that question.
Does anybody else have a question?
Are you all in agreement, then, that the February meeting will be cancelled in lieu of budget day?
Going on, the last item of business I want to bring before you is that there will be a very short pause—and I should tell this to the witnesses too—before the minister comes to the table at 12:15. That will allow the minister to assume his place at the witness table and it will give the witnesses a chance to remove themselves, if they don't mind. The witnesses are welcome to stay, it's just that the minister and his people will be here. That's just to let you know. I'll give you the cue when that happens.
Pursuant to Standing Order 108(2) and the motion adopted by the committee on Tuesday, January 20, 2008, I would like to welcome the witnesses who are with us today on the subject of the supply of radioisotopes.
We have with us Grant Malkoske, who is the vice-president of strategic technologies, and David McInnes, who is the vice-president of international relations, both of whom are from MDS Nordion; and Douglas Abrams, who is the president of the Canadian Society of Nuclear Medicine.
I would like to remind witnesses that you have ten minutes per organization to make your presentations, and after the presentations we will proceed to questions.
I welcome you today. We're quite anxiously looking forward to hearing what you have to say.
Let us begin with the witnesses from MDS Nordion.
Good morning, Madam Chair and members.
My name is Grant Malkoske. I am vice-president of strategic technologies at MDS Nordion. Accompanying me is David McInnes, vice-president of international relations.
MDS Nordion is an Ottawa-based life sciences company with more than 700 employees at locations in Laval, Vancouver, and Belgium.
We welcome the opportunity to appear before you today to provide our perspective on the 2007 medical isotope supply shortage caused by the NRU reactor shutdown. This event had a significant impact on medical isotope production and our ability to supply medical isotopes to the nuclear medicine community and, in turn, that community’s ability to supply to hospitals, physicians, and patients.
As you may be aware, we appeared before the Standing Committee on Natural Resources last week. As we stated there, there is a sequence of steps in the medical isotope supply chain that ends with hospitals. The steps involve a reactor, a processor, a radiopharmaceutical manufacturer, and a hospital and/or radiopharmacy that administer the product to the patients.
The AECL NRU reactor is our primary source of medical isotopes. MDS Nordion is the processor of these medical isotopes at our facility in Ottawa. It is important to note that MDS Nordion is not the direct supplier of radiopharmaceuticals to hospitals. We distribute medical isotopes, which are active pharmaceutical ingredients, to our customers--radiopharmaceutical companies, all of which are based outside Canada. Our customers, in turn, manufacture radiopharmaceuticals and distribute them to hospitals and radiopharmacies in Canada and worldwide.
Two American companies are our primary customers and supply all of Canada’s radiopharmaceutical products. Canadian-produced medical isotopes are responsible for supplying a total of more than 50% of the world’s medical isotopes, some 60,000 procedures a day, 5,000 in Canada alone.
One important aspect in this supply picture is the global production capacity. The NRU reactor is the most reliable reactor in the world for medical isotope production. Its supply reliability exceeds 97%. There are only three other sources to call upon for backup supply: South Africa, Belgium, and the Netherlands.
If one of these reactors goes off-line, NRU can quickly ramp up to meet 100% of the additional demand. However, the reverse is not true, as we saw last November and December. If NRU is off-line for more than seven days, no other foreign reactor or combination of foreign reactors today can fully fill the supply gap left by NRU. Even with the world’s other reactors ramping up to capacity, there was still approximately a 35% total global shortage in medical isotopes. That gap would have persisted had the NRU reactor remained off-line.
On the evening of November 21 we were informed that NRU would not be restarting after its scheduled shutdown. We immediately initiated our contingency protocol for such emergencies. With only two days of inventory remaining, we began notifying affected customers, radiopharmaceutical manufacturers. We remained in close contact with them over the course of the outage period.
On the morning of November 22, in a meeting with AECL, we were informed of the potential extent of the NRU outage. We advised AECL this outage would cause a shortage of global supply of approximately 30%.
In the afternoon of November 22 we attended a regularly scheduled meeting arranged by AECL with Natural Resources Canada and ourselves. At that meeting we reiterated the estimated impact of this outage on global supply.
On November 23 we contacted our other suppliers in South Africa, Belgium, and the Netherlands in an attempt to source backup supply. Virtually every day we remained in contact with these suppliers.
It is important to note that at this point it was not clear when the NRU reactor would resume isotope production. The information provided by AECL was in constant flux with regard to resolution options and restart schedules. By late November, AECL advised us that it was working toward an early December restart. Based on that information, we then issued a press release.
Starting on December 5, government officials from several departments sought regular briefings from us to update them. That led to later discussions by department officials with Natural Resources Canada and Health Canada to involve us in the development of a communication protocol, should any such supply event occur again.
In addition to repeatedly requesting additional medical isotopes from our backup suppliers, we took a number of steps to facilitate extra supply. We obtained U.S. Food and Drug Administration approval to combine any available backup supply in any proportion. We contacted the Belgian nuclear regulator to validate the shortage crisis and enable special dispensation for increasing processing limits at the Belgian processing facility. We shipped licensed containers to all our suppliers to facilitate immediate shipments should any material become available.
In addition to seeking the backup supply I mentioned earlier, on December 3 we also initiated a meeting with all the world's suppliers to make an unprecedented request that they share their regular supplies. They refused.
Despite persistent attempts to source backup supply, we were only able to get a marginal amount of isotopes from abroad, about 20% of what we needed. All backup supply received by MDS Nordion prior to the time Bill was passed on December 12 came from South Africa. We were not able to get any backup supply from Europe.
Although the medical isotope shortage turned out to be about 35%, the shortage varied from country to country. In Canada's case, it was about 65% because the NRU reactor is a primary source in our supply chain. As we have learned from the nuclear medicine community, the shortage was more acute in certain regions of the country. The reason for the geographic variation depended upon where each hospital obtained its finished radiopharmaceuticals. Our customer, U.S.-based Bristol-Myers Squibb Medical Imaging, was and still is the largest supplier of finished radiopharmaceuticals to Canada.
We prevailed upon Bristol-Myers Squibb to ensure that Canada received its fair share of available finished radiopharmaceuticals. They informed us that in fact Canada did receive its fair share of the limited supply of medical isotopes then available over the course of the NRU outage period.
In summary, Madam Chair, we believe we acted swiftly and worked diligently to address the medical isotope supply shortage caused by this outage. However, the reality is that there is no source of backup supply that can fulfill the worldwide gap that NRU creates as a result of an extended shutdown. Clearly, it is imperative that government, industry, and the nuclear medicine community collectively find a long-term solution for the reliable supply of isotopes from Canada.
We're available for your questions.
Thank you, Madam Chair and committee members, for allowing me the opportunity to appear before you today.
I am a pharmacist specializing in nuclear medicine and radiopharmaceuticals and I am the director of the Edmonton Radiopharmaceutical Centre at the Cross Cancer Institute. I'm currently president of the CSNM and I am also a member of the ad hoc committee that was brought together to advise on the isotope shortage.
I would like to provide some very brief background on nuclear medicine and radiopharmacy. I won't go into as much detail as Mr. Malkoske did, so you won't be bored twice in a row.
Nuclear medicine uses many different isotopes for the diagnosis and treatment of a wide variety of diseases. The majority of the diagnostic tests are for heart disease and cancer, although many other disease states are impacted by a shortage. The majority of therapeutic applications are for thyroid-related diseases, but a growing number of therapies are in development and showing much promise.
However, although the number varies with different sources, about 80% to 85% of diagnostic procedures in nuclear medicine use technetium-99m radiopharmaceuticals. This is a short-lived isotope that is conveniently derived from a much longer-lived isotope called molybdenum-99. The isotope shortage reflected the decreased supply of molybdenum-99 when the NRU reactor shutdown was extended beyond the original planned date.
As technetium-99m has only a half-life of six hours and most radiopharmaceuticals have only a 12-hour shelf life, these products are prepared on a daily basis and cannot be stockpiled. This shortcoming is offset by the use of a generator system in which the longer-lived molybdenum-99, which has a 66-hour half-life, or about three days, can be used as the supply for the technetium-99m. These generator systems can be used for up to two weeks.
Alberta was relatively unscathed by this crisis, as the three major centres in Edmonton, Red Deer, and Calgary all get their technetium-99m generators from Covidien, which sources most of its isotopes from Holland. However, as noted previously, the impact was very patchy and many small clinics within Alberta were using generators from BMS, which relies on the NRU reactor supply.
My involvement was to facilitate supply to as many smaller centres as possible, which we did through discussions with Health Canada. Our major efforts were to extend the lifetime of generators after their normal expiry date, facilitate transport of used generators to smaller centres, and look into the use of alternate isotopes.
I think I'll end there. I won't go into too much detail because I suspect I'll get questions asking me for more detail.
Thank you very much, Madam Chair.
I want to thank both MDS Nordion and the president of the nuclear medicine society for coming today, because this is a very important issue. In the words of the society, it in fact had all the makings of a national medical crisis across this country.
Now, I heard from MDS Nordion that they were aware of the problem on November 22 and that they met with Natural Resources Canada on this issue on November 22. You physicians who were going to need this were not aware until November 27, five days later. Then Dr. O'Brien said in his communiqué that he did not actually talk to anybody at all from Health Canada until probably December 5. So there was a lag time of 13 days before there was any way of talking with anybody in Health Canada to say: What is it we need to do? How can we work on this together?
How did you know on November 22 that this was coming down? Had the nuclear medicine society been consulted? This was obviously going to impact on the nuclear medical society and the patients who see nuclear medicine physicians. Had you been aware on November 22, do you believe there were steps you could have taken, as physicians across the country, to deal with this issue in a way in which you could have triaged patients based on need and so on? Do you think you could have dealt with it over a period of maybe about a month? On the steps that were eventually taken--it was crisis management more than anything else, the shutting down of the reactor and the reopening of the reactor--do you believe your patients could have been served for about a month if you had been consulted early? Do you believe the steps that were eventually taken by the government could have been, in fact, mitigated because you would have been able to deal with it?
Those are the questions I really want to ask you. Were there alternative routes that could have been taken to deal with this thing before it became a crisis and before shutting down and starting up had occurred?
What we implemented required a short amount of time for us to work with Health Canada to put in place policies that would allow us to transport generators that had been used in one facility. Then if they were small enough we could ship them out to other facilities. This worked very well for a number of outlying facilities, especially farther north and farther south from us.
The other thing was to use generators somewhat beyond their normal expiry date, implementing the appropriate safeguards for testing to make sure things had not gone awry after the expiry date.
Those were the two things we needed to do. Health Canada responded fairly well with us by giving us process, and we made a process to allow us to do that. We needed the time to do that, but once that was in place, we were set. There wasn't much else we could do.
The other thing we did look at, which might have helped with advance notice, was that some areas that did have cyclotrons could use fluorine 18 fluoride as a bone imaging agent, and this would help offset one of the technetium radiopharmaceuticals for bone scanning. We did not have an approved radiopharmaceutical for that in Edmonton, and in cooperation with Dr. Gulenchyn in Hamilton, we put forward a very hasty clinical trial application to use fluoride, but we never did use that. As things unfolded, we didn't need to.
Thank you for the question.
I think the important thing to reflect upon is the world-wide production capability. The fact is that if NRU goes down from a precipitous event, such as took place, there is insufficient capacity around the world to respond and replace the NRU. Frankly, there is no amount of planning in advance that would compensate for that type of an event.
In the normal supply period when the reactors are operating without such a precipitous event, there are scheduled reactor outages around the world. Those by the Europeans are planned well in advance. In fact, through normal production, there is no conflict with regard to the availability of isotopes and the supply of medical isotopes.
Furthermore, we do have backup supply agreements in place with some of our suppliers to make sure isotopes are available through normal outages, which would not be so eventful as one with the NRU. We have plans in place to receive material from the Europeans and South Africans.
So in this type of an event, we do not think that planning is an issue.
Please let me try to clarify that.
When the NRU event took place, we immediately started—on November 23, as I reported a moment ago—to contact our suppliers in Europe and South Africa. What we were looking for was an incremental amount of material, whatever they would have available, frankly, to fill the NRU gaps. They did increase some of their production capability. The best information we have is that they increased it by about 10% or 15%.
We then also took a second step. We asked them if they would be prepared to look at the redistribution of the product they had in their normal production capacity, in their normal or routine capability. This is where they declined. So they had a baseload, if you will, and they were not prepared to share the baseload.
Of the incremental 10% or 15% available from the world-wide production chain—still causing a shortfall of 35% globally—we at Nordion were only able to obtain about 20%. So of the increase of 10% to 15%, we got about 20% and distributed it as equitably as we could to our customers, the manufacturers.
So I think there's a bit of difference between routine capability and incremental ramp-up capability to deal with shortages.
I guess I'm having a little trouble believing that you couldn't predict that there would be a problem on November 27, and that you would then wait for the calls and letters to be coming in--in a panic--at the first clinical problem, instead of actually predicting it.
Therefore I am having trouble with what Mr. Malkoske said, which is that planning is not the issue, only communication is. That means there isn't a plan B. If the only possible solution is starting up a shaky forty-year-old reactor in an earthquake zone--if that's plan B--we aren't doing very well in terms of planning. I guess I want to know where we are going on plan B in terms of what you would do again. I haven't heard that we've learned anything so far.
Secondly, you said the problem was mainly communication. I guess I would like MDS Nordion to have a chance to answer the CMAJ allegations that a lot of the problem seems to be a lack of communication between you and AECL, in that you don't seem to be at the meetings and being able to say what each other is doing. Then there's the allegation from the Netherlands in that article that said we never get any information from the Canadians, and that you wouldn't cooperate with Europe's two large-scale isotope suppliers. Nordion is represented at our meetings, but either AECL doesn't tell Nordion or they don't allow Nordion to tell us.... The breakdown in communication, let alone the nonsense between the natural resources minister and the health minister, who don't seem to have a telephone....
Could you help me with what plan B is? Then I would like MDS Nordion to tell me what R and D you are doing so that in the future you could use fluoride, you could use partical accelerator kinds of isotopes that do not require the high-grade enriched uranium at all, in terms of how we move forward out of this pickle of your monopoly for 50% of the world supply with no plan B.
As I mentioned, we supply to a radiopharmaceutical manufacturer. They are one of the two suppliers who supply back to Canada. Bristol-Myers Squibb and Covidien are the suppliers of radiopharmaceutical products to Canada. We supply Bristol-Myers Squibb with the medical isotopes that go into their finished products. Covidien obtains their material from the Netherlands. So there is a dual supply stream.
On the first part, about a plan B, I agree with you that this is a tenuous situation. I think what we need is a national isotope supply strategy for Canada. At 50 years old, the NRU reactor is the most reliable reactor in the world. It has a 97% supply reliability. It stands as the pre-eminent reactor in all of the world to do that. So an investment into the NRU infrastructure to keep it operating, to keep it licensed beyond 2011, we believe is absolutely essential.
The MAPLE reactors are solely dedicated isotope production reactors. One alone could provide the capacity that we require. The second one is a complete backup system. Bring the MAPLE reactors on line as quickly as possible.
So we think there is a plan B. But the difficulty we all face today in the world is the eventuality of a precipitous event like NRU. It would be something like if Saudi Arabia were shut down from supplying gas or oil to the world, what would you do immediately? There would be a shortage. That's the kind of situation we were facing with NRU.
So it's not a matter of planning for such a precipitous event. How do you do that? The global capacity was only able to fill 15% of the NRU gap. If NRU had continued on, it would still be a 15% gap. So planning three months or six months in advance would not have alleviated that situation. It is interesting to note that during this period of outage we contacted the Belgians, we contacted the people in the Netherlands, and we contacted the South Africans on November 23 to try to get any incremental amount of backup supply that we possibly could. We were very diligent; we consistently went through that.
Interestingly, during this outage there was one European reactor that was down completely during that outage period because of a pre-planned maintenance cycle. It did not come on line until somewhere around December 18. Interestingly enough, a reactor in France shut down during that period, before Bill was passed. What kind of planning would prevent that from happening?
There is a global capacity issue that needs to be dealt with. That is the fundamental issue in all of this.
To answer the first question, I think that as the length of time the reactor was down progressed, we would have stabilized on the amount of technetium and molybdenum that we were able to get. I think we would have maximized what we could get from the worldwide supply, so we would have reached an equilibrium at that point. At that point there probably would have been about 30....
BMS has about 80% of the Canadian market and Covidien has about 20% of the Canadian market. Covidien was able to ramp up a little, and that would have brought it up to maybe 35%. Let's say they could double it, to 40%; we probably would have had a 50% to 60% shortage of radioisotopes and we would have needed to make sure that our supply was as appropriate as possible.
At the same time, we probably would have been able to look at other isotopes for some of the tests. Thallium 201 probably would have been able to take a little more of the technetium heart scans, and the use of fluoride from cyclotrons may have been able to ameliorate some of the bone scans. The problem with the fluoride would have been that there are very few cyclotrons in Canada and that it has a very short half-life of two hours. It would have been a stopgap measure. Only the larger centres in Canada could do that.
We would probably have been able to rationalize better and better what we were doing. The number of Canadians missing their tests probably would have been around 50% to 60%. That's just looking at the numbers as I see them now.
The communiqué was generated out of relief that something had happened. We felt that the government must have had the appropriate information to make that decision. We're not in a position to evaluate how the decision was made or why the decision was made, but once it was made, it was certainly a relief to all the nuclear medicine physicians in Canada.
Good afternoon, Madam Chair, ladies and gentlemen of the committee.
I'm here this afternoon with my deputy minister and my assistant deputy minister on this file.
It is my pleasure to address the health impact the Chalk River nuclear shutdown with you.
As members of the Standing Committee on Health, you are keenly aware of the importance of correct diagnosis, especially in cases of critical illnesses such as cancer and cardiovascular disease. Radioisotopes are used in the diagnosis and treatment of cancer and cardiovascular disease.
As members know, the Chalk River reactor is an essential source of medical isotopes in Canada and indeed world-wide. The extended shutdown of the NRU reactor significantly reduced the supply in Canada and throughout the world.
As soon as I became aware of the situation, on December 5, my officials and I started acting immediately to stem what was quickly evolving into an urgent health crisis. We communicated with 773 health care facilities across Canada, including 245 nuclear medicine facilities, to determine initially the severity of the shortage. We found that shortages were felt in smaller rural and remote areas, particularly in Atlantic Canada, and that shortages were imminent elsewhere.
We inquired into gaining supply from the four other medical isotope suppliers in France, Belgium, the Netherlands, and South Africa. In doing so, we found that French and South African reactors were going through routine maintenance at exactly the same moment. All in all, we found that overseas suppliers could increase their output by only 10%, or at maximum, 15%. Furthermore, overseas suppliers indicated that the earliest they could provide us with the additional supply would be December 29. Based on the information we were receiving, this would have been too little, too late, as the shortage situation would have, I'm absolutely convinced, escalated to unmanageable levels long before that.
During this time we also established a group of experts from the fields of oncology, cardiology, and nuclear medicine, as well as representatives of the Canadian Medical Association and the Canadian Society of Nuclear Medicine. Based on the information from this group, it was clear we were in the midst of a growing health crisis, and one that needed action. One of the members of our expert group, Dr. Karen Gulenchyn, told the natural resources committee of Parliament last week that “...we believe that unmanageable shortages would have occurred within a week”. This group estimated that approximately 10% of affected patients were indeed facing life-and-death decisions.
The group of experts also gave information that another 30% to 40% were facing the risk of under-equipped physicians making inappropriate diagnostic and treatment decisions. This message was reiterated in a letter dated December 10, 2007, to Linda Keen, and copied to me, in which Dr. Brian Day, who of course is president of the Canadian Medical Association, stated that the CMA “...joins the Canadian Society of Nuclear Medicine....to express our deep concern and profound disappointment with the disruption of supply of medical isotopes due to the extended shutdown of the reactor at Chalk River”.
He goes on:
||The devastating impact that this has had on patient care across Canada, and indeed around the world, has been compounded by what we perceive as a true lack of understanding of what the extended shutdown means to patients who need access to vital diagnostic procedures. For physicians it means we are increasingly being forced to make difficult clinical decisions without appropriate critical diagnostic tools.
I'm hoping we can all agree that a faulty diagnostic or treatment decision today is the first step to a more complicated or critical situation tomorrow.
In short, in order to serve the needs of patients in a way Canadians rightfully expect, gaining a minimal supply of medical isotopes from overseas was no substitute for a running reactor at Chalk River, which produces more than half of the world's supply. As a result, we had a responsibility to seek information from the Canadian Nuclear Safety Commission about ways to resolve the growing health crisis.
First we wanted to see if there could be an expeditious hearing to consider the merits of AECL's safety case, without in any way directing the commission to reach a particular conclusion. Alas, such a decision was not reached.
Second, our government issued a policy directive stipulating that the commission's decisions take into account the health of Canadians who depend on nuclear substances to meet medical needs, but that had no effect.
So our government had to take decisive action on December 11 by proposing to Parliament. Of course this bill passed with all-party support, and by December 19 isotope production was returned to pre-shutdown levels, and deliveries resumed over the holidays.
Dr. Andrew Ross, a nuclear medicine specialist at Queen Elizabeth II Health Sciences Centre in Halifax, called our action “a great Christmas present”. Indeed, he was not alone. The Canadian Medical Association and the Canadian Society of Nuclear Medicine thanked all parliamentarians of “all political stripes” for the fast legislative action.
Now that the situation has passed, my officials are continuing to work with the expert advisory group to establish contingency plans in the event of any future supply disruption.
This includes assessing the possibility for alternative sources, along with substitute diagnostic techniques that could be used if needed, and examining opportunities for enhancing international collaboration to coordinate supply.
This work is also aiming to ensure timely notification of issues that may affect supply.
As a result, we have developed a notification protocol between AECL, Natural Resources Canada and Health Canada. It provides clarity about who needs to be contacted and when. As well, it states that information will be shared immediately when it concerns Chalk River's operations and therefore the supply of medical isotopes.
In the future, if my department receives information about a potential shortage, we will be able to draw on the best practices employed in December and the lessons learned from that experience to immediately establish contact with provinces, territories, the health care communities, and relevant experts to assess the potential impact and launch strategies to respond.
In closing, Madam Chair, I want to underline the fact that our government acted out of necessity for the health of Canadians. Going without isotopes provided by Chalk River meant health care providers were under-equipped to meet the urgent needs of patients. As the shutdown went on longer, the potential for a health crisis grew stronger. Accordingly, our government acted decisively to stop it before it was too late. We did so with all-party support in Parliament.
Together, all parliamentarians put aside partisanship to act as needed when lives were threatened.
Our government did what was needed for the health of Canadians—and I thank everyone here today for your votes in December which helped achieve this result.
Perhaps you can seek clarification from your staff, but I believe both of those shipments to Nordion were prior to the end of December.
I don't want to spend too much time on the decision in Parliament. We all supported it. We got to a position where we had a lack of isotopes and we had to get isotopes generated in our system. I understand it's operating normally and a Natural Resources Canada committee is looking at those questions.
I do object, however, to the way your government handled Ms. Keen. A regulator has to follow the law and regulate. If cabinet or Parliament have to take decisions beyond that of the capability of the regulator, then that's a job for cabinet or Parliament, and Parliament exercises responsibility in that regard.
I'd like to discuss a couple of areas with you. First, on communication--and this is coming from the presentation or in response to a question by Mr. Malkoske this morning--you didn't just deal with communications within Canada in your presentation, but international communications. Very few reactors are capable of producing these isotopes. We are the biggest producer.
If you look at this situation, we had an extended stage shutdown. At the same time, just subsequent to our shutdown, there were two other shutdowns by reactors internationally. It seems a simple solution to have an international protocol among all producers that no shutdown be very close to another, because one of those can always be extended for one reason or another.
Are those discussions happening internationally? Are we going to be in the position next year, in two years, or in ten years when exactly the same situation can repeat itself?
I know Mr. Rosenberg is an able man. I had the pleasure of serving as parliamentary secretary to the Minister of Health for 18 months, at the time Mr. Rosenberg came into his present duties.
I became aware of the situation when you had news articles appearing by the Canadian press on December 1 and you had a CBC story from Halifax on December 4. I'm not privy now to the clippings that are collected by your department on a daily basis. Your department won't share that with opposition critics, but we find them. Your department was aware at that time. There's no way such a situation can come....
I can't conceive that on November 22 the chairman of AECL would find out about an extended shutdown.... Mr. Burns, ironically, is in charge of nuclear energy--it reminds me a bit of The Simpsons. And he's not a Liberal hack; he's a Conservative appointee as chairman of that corporation. He says that the Minister of Natural Resources was advised at that same time.
Now, I've been a minister before. I know that advice to the minister isn't necessarily on the minister's desk at the same time, but I can assure you it's in the minister's office on that day, or in the deputy minister's office. I can't conceive that you could have an extended shutdown at Natural Resources on November 22 and that the Minister of Natural Resources would only find out on December 3, and that the Minister of Health would only find out on December 5, or that nobody in the Department of Health.... I'm sure Nordion put out a press release on November 21, I believe.
A voice: The thirtieth.
Hon. Robert Thibault: On November 30 they put out a press release advising their customers. It's inconceivable to me that this information wouldn't have come to the Department of Health.
Thank you, Madam Chairperson.
Thank you, Minister, and your staff, for being here.
I know that you felt we were in a life-threatening situation; you said so during the debate on December 11. But nothing that you did, Mr. Minister, leading up to that moment suggests that you reacted in any way that resembled reacting to a life-and-death situation. Even if you didn't know until December 5.... And I have no proof to suggest otherwise, except that it just seems incredible, unbelievable, that you wouldn't have known about this life-threatening situation before December 5, especially given our testimony from MDS Nordion, where irrefutable evidence was clearly put on record to suggest that they let your government know on November 22.
So even if you didn't know until December 5, it seems to me that you didn't react with any haste. You didn't let the health community know publicly. You didn't let parliamentarians know. You didn't take any immediate steps to actually deal with this on a very urgent basis. Even when your deputy minister was asked if he knew if it was December 5 when he had heard, he said, “I heard on December 5, and I believe the department learned on December 5.” So clearly, he's left the door open to the fact that somebody in the department would have known. There would have been some communication somewhere if it had been as life-threatening as you talk about.
We also know today from the testimony by MDS Nordion that on November 23 they were out making calls all around the world looking for other suppliers. For the health department not to know that strikes me as absolutely bizarre. If we accept the fact that you didn't know on December 5, that means there was a clear breakdown of communication in your government. That's what we had hoped you would address today, that you would acknowledge this problem and say how you're going to fix it. There is nothing that you have said either in the protocol or in your remarks today that suggests how you will make sure in your government that when someone in one department, like Natural Resources, hears something of a life-threatening nature, there's a mechanism for getting that information to the highest levels of government.
Mr. Minister, you may shake your head at all of this, but I also have been a minister in a government, and I know that if I had faced a similar situation, my head would have rolled, because we operate, as you should, on the basis of ministerial responsibility. You're ultimately responsible for decisions that are made or not made, and you failed in your duties--not personally, but somewhere in your system you failed--and there wasn't a proper line of communication. That's what we haven't heard you address.
So I would like to hear what your plan is in government for ensuring that when such life-threatening information is conveyed to government, it gets from that official to that department to that minister, to the next department that is involved, and to you as Minister of Health responsible for this life-threatening situation.
I heard you out, now you hear me out.
How dare you second-guess my department, which has made it absolutely clear that they did not know. If you have one scintilla of evidence that they knew something, you provide it. Otherwise, I suggest you keep your accusations to yourself.
My department acted forthrightly and quickly, in lightning speed. I put it to you that they did so because they believe in the health and safety of Canadians. I'd resign the second I felt that I let Canadians down, but I can tell you I've had e-mails and letters from people around the country who said that we acted quickly. They had a friend, a relative, or a neighbour who was in dire need of radioisotopes, and we did the right thing to help the health and safety of Canadians. Those are the people I listen to, and if they told me to resign, I'd resign. But I'm not going to resign because you think you could do a better job.
I've been through this as the Minister of Health for five years, and I can tell you that every time there's a situation like this the opposition demands the resignation of the health minister. I think it's disgusting, and you should be ashamed of yourself.