Good morning, everyone.
Madam Chair and members of the committee, it's a pleasure again for me to be here to discuss the supplementary estimates (C), as well as the main estimates for the health portfolio.
Before I do that, I would like to introduce the officials who are here with me this morning, many of whom you already know. With me is Glenda Yeates, the deputy minister, Department of Health; Dr. David Butler-Jones, chief public health officer for the Public Health Agency; and Paul Glover from Health Canada, health products and food branch.
Before I begin, let me say a few words about the important debate that took place last night in the House, and I believe most of you were there. Being able to explain the different roles and responsibilities with respect to the drug supply was important for me to get across and emphasize. We are responsible for access to drugs, using the highest standards of safety and efficacy. We provide guidance and insight to the purchasers—namely, the provinces and the territories—but our government is extremely respectful of their jurisdictions.
Provinces and territories are responsible for the delivery of health care. They know the needs of the Canadians who live there. They know what drugs are consumed and in what quantities. They know what to order when entering into a contract with the pharmaceutical industry. They also know whether their supplier is a single source for drugs they order, and it is up to them to ensure that there's a plan B. They're also responsible for the terms of these contracts.
As I stated, I wrote to industry last summer and requested that they take the issue seriously. They have responded and are setting up websites that will inform provincial and territorial health care professionals of impending drug shortages. In fact, just yesterday, I heard from Sandoz officials, who responded to my letter in a very positive manner. They have agreed to post information about drug shortages online and give a 90-day notice of any other drug shortage that will arise in the future. This is very encouraging, and I hope they will live up to their commitment.
This is far from being a Canadian issue. We work with our global communities to alleviate any stresses on our system, as we witnessed during the isotope shortage. We will continue to provide our jurisdictions with the support and guidance they need, as always.
I'm pleased to be invited here this morning, not only to discuss the supplementary (C) and main estimates, but also to update members on progress made in the health care portfolio. As the needs of Canadians change, so do the demands on our health care system. In many of the discussions I have had with my provincial and territorial minister colleagues, there are two issues that are always acknowledged.
First, there is a keen interest to provide information to Canadians regarding healthy living and healthy lifestyles. Maintaining a healthy weight and healthy diet, as well as doing regular exercise, will ensure that the number of health-related issues in this country, including chronic diseases, will go down. This will have a significant impact on the provinces and the territories in the delivery of health care to their jurisdictions, as the number of doctors' visits would decrease, as would the number of hospitalizations.
Second, the provinces and territories are keenly aware of the fact that they will need to be more innovative. They realize that they need to adapt the system in their jurisdictions to the needs of their citizens, and that the emergency room is not always the band-aid solution.
One of the ways we have made much progress, and we are very proud of it, is the creation of a new model of health governance for first nations in British Columbia. Most recently, we also hosted an important meeting between the crown and first nations that included important discussions about health care. In the months and years ahead, the sustainability of our health care system will be a recurring subject of our discussions.
I suggest, Madam Chair, that sustainability will come from innovation and cooperation. Providing Canadians with the information they need to make healthy decisions for their loved ones is key to optimum population health.
Madam Chair, since I was named Minister of Health, I have continued to work with my provincial and territorial colleagues towards a more sustainable health care system that achieves better results. Our government is committed to strengthening the health care system, and we have delivered on our commitments under the 2004 health accord: we have made progress in reducing wait times, increasing the number of doctors and nurses, and introducing electronic health records.
Since 2006, the federal health care transfers have been growing at a rate of 6% annually. In 2011-12 we provided $27 billion to the provinces and territories through Canada health transfers. By 2013-14, that will be more than $30 billion. It will reach $40 billion by the end of the decade, and our government has been clear that we will not cut health transfers.
Last November, I met with the health ministers in Halifax, where we discussed health care priorities and challenges and our common focus on health care renewal. In December, the Minister of Finance announced long-term federal funding for health care beyond 2014. With the growing funding guaranteed, governments can focus on health care renewal.
I have already met with several health ministers to talk about ways in which we can work together to ensure a more sustainable health system. I believe there is a great deal of will to work towards this common goal.
As the jurisdictions responsible for the delivery of health care, it is up to the provinces and the territories to decide on the direction and the pace of change for their own health systems. I am interested in working with them to see how federal tools and levers can support them in their reforms to improve health care, and I continue to dialogue with my counterparts on a regular basis.
Innovation comes from rethinking what we do. We need to analyze every aspect of health care to see whether it is delivering what it should and whether it is being done efficiently. We invest over $1 billion annually in innovation through the Canadian Institutes of Health Research, Canada Health Infoway, the Canadian Agency for Drugs and Technologies in Health, and other programs that support research, health human resources, and the assessment of technology.
The Canadian Institutes of Health Research is leading research in many areas. For example, the CIHR is funding research into the way we deliver primary care through family physicians, nurse practitioners, pharmacists, and other front-line services. We can see the day when medicine is personalized or tailored to the needs of the individual based on their genetic profile. It is the next step in the evolution of the way we treat disease.
Right now, we treat disease based on what we know about the disease. In personalized medicine, we will treat the disease based on what we know about the disease and what we know about the person. Treatments that are tailored to the patient will be more cost effective and, more importantly, will mean better health outcomes.
To get us closer to making that a reality, we are working in partnership with Genome Canada, the Canadian Institutes of Health Research, and the Cancer Stem Cell Consortium to invest $67.5 million in research for the development of personalized medicine.
While we are creating new models of health care delivery, we are also working to prevent as many health-related problems as possible. We already know that unhealthy weights can lead to many health problems, and we know there is a growing problem of overweight and obesity, especially among our children. To reverse that trend, we will need the help of individuals, industry, and organizations that can help create the conditions that lead to healthier eating and more active lives.
In September 2010, I was proud to join my provincial and territorial colleagues in endorsing the “Declaration on Prevention and Promotion” and “Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights”.
In September of last year, I added my signature to the UN declaration on the prevention and control of chronic diseases. The role of active living and healthy eating in preventing chronic diseases, such as diabetes and heart disease, is highlighted in the declaration.
A few months ago, my provincial and territorial colleagues and I endorsed the recommendations and key areas of action that can be taken by government to support healthy weights and reduce childhood obesity. But governments alone cannot address the growing obesity epidemic. We all have a role to play in promoting healthy weights and helping our children get the healthiest possible start in life.
I recently co-hosted a summit on healthy weights with my colleague from Nova Scotia. This summit brought together a variety of sectors: industry, the voluntary sector, and governments. In my view, this was a historic event. We challenged everyone to think outside the box and to build partnerships for collective action. We are also developing partnerships with a variety of organizations, and those bonds will serve us well in combatting obesity in order to reduce the incidence of chronic disease in this country.
Regarding HIV/AIDS, and in order to speed up the pace of research, we are funding five major research projects that will drive the development of a vaccine. These projects represent an investment of $17 million. They are the kind of research that will bring us closer to finding a vaccine and that will foster the next generation of HIV researchers. As well, Madam Chair, to help administer and guide future research, we are providing funding for the creation of the Canadian HIV Vaccine Initiative Research and Development Alliance coordinating office. It will be funded for the next five years by the Government of Canada and the Bill and Melinda Gates Foundation. It is an additional investment of $3.2 million and is an important part of the Canadian HIV vaccine initiative.
Our government has been very proactive and serious about ensuring the health and safety of Canadians. As you know, there have been important changes with the passing of legislation such as the Canada Consumer Product Safety Act, which has given us new tools to improve the safety of products in the marketplace. It is an important piece of legislation that has helped us to protect Canadians from dangerous products. In fact, in late December, our inspectors found children's jewellery that had high levels of cadmium and lead being sold across Canada. Backed by the new authority in our act, we were able to work with the companies involved to accelerate the removal of these products from shelves.
Another area we have been working on is that of traditional Chinese medicine. While many Canadians look to modern medicine for treatment, many others use traditional Chinese medicine to maintain or improve their health. We want to make sure that those products are both safe and effective, and we want to get input from those who are most knowledgeable about them. Late last year, my parliamentary secretary, Colin Carrie, and I hosted round table discussions with practitioners and representatives from industry in Toronto and Vancouver. The face-to-face discussions were very useful from both points of view. We appreciated their input and they appreciated being heard. This has inspired us to create a TCM advisory committee to provide advice on emerging issues related to traditional Chinese medicine.
Also making headlines in recent months has been the debate on MS and CCSVI. I want members of this committee to know that the government shares the desire of MS patients to find a cure for this disease and to better understand the procedure proposed by Dr. Zamboni. That is why we are funding research on MS. To date, the government, through CIHR, has invested $55 million in MS research. In partnerships with the MS Society of Canada, the Canadian Institute for Health Information, and the networks of MS clinics, we are building a Canadian MS monitoring system that will become a valuable source of information for patients, doctors, and researchers on MS.
CIHR is also currently selecting a research team to conduct a clinical trial on the proposed procedure. This research initiative is being conducted in collaboration with the provinces, the territories, and key stakeholders, such as the Multiple Sclerosis Society of Canada, to determine whether this new procedure is safe and effective. These important questions have not been answered unequivocally by the international research community. Our clinical trials will provide the answers we seek.
It is also our role to move forward on this important health issue without putting the lives of Canadians at risk.
In conclusion, Madam Chair, health care is a priority for most Canadians. I know that each member of this committee shares the desire to provide Canadians with the best tools we can for leading healthy lives and to access the best health care that can be made available to them.
I'd like to thank the members for your hard work. If you have any questions, I would be pleased to answer them this morning.
Thank you, Madam Chair.
Thank you, Madam Chairperson.
Thank you, Madam Minister, and all the officials who have come here today. We appreciate your making the time, because obviously we have many important issues to discuss, some of which you've raised in your comments today.
Thank you also for being at the emergency debate we had in the House last night.
I think there is a fundamental question about why the voluntary agreement on drug shortages is not working. I hope we'll have further discussion on that, because clearly the approach the government is taking has not solved the problem, and we have quite a crisis before us.
I want to focus today on two questions to do with health care funding and the regulation of processed foods. If I may, I'd like to put the two question to you.
On the first one, Madam Minister, the premiers have made it very clear that they expect much more from the federal government than a non-negotiable funding package. In fact, the premiers have repeatedly called for a collaborative health care funding process that would uphold the commitments of the 2003-04 accords. Despite your comments today that those commitments have been met, there is still a long way to go even to uphold the 2004 commitments and to ensure accountability.
It's very interesting that the response of the government has been this unilateral decision. We know that you sent a letter to the premiers, but there hasn't been any significant process. There haven't been any meetings jointly, other than the one that took place last year. I think there's a real question about where your leadership is on this issue, because that's what Canadians expect. Why is the federal government, and why are you, as minister, walking away from this collaborative and joint process with the provinces and territories?
My second question has to do with processed foods. Not only have you walked away from talking to the provinces and territories about health care funding, you've also not acted to reduce salt, sugar, and trans fats in our food, despite repeated calls from health care organizations and practitioners.
You might know that the British Medical Journal singled out Canada as blocking an international agreement to reduce salt, sugar, and trans fats in processed foods. It was recently revealed that you personally ended a plan to reduce trans fats in processed foods.
Why are you continually siding with industry rather than looking out for Canadians who are trying to make healthier food choices?
Thank you very much, Madam Chair.
I want to thank the minister for coming to answer questions today, and to discuss the supplementary estimates.
I want to go straight to something that my colleague, Libby Davies, from the NDP talked about. I see that one of the major points made by the minister is that maintaining a healthy weight and a healthy diet, as well as doing regular exercise, will ensure the numbers of health-related issues in this country, including chronic diseases, go down.
The minister then went on to discuss the importance to the health care system of decreasing chronic disease and managing chronic disease well. The minister also spoke about signing a health promotion and disease prevention initiative and focusing on that.
I know, as the minister said, that there are more than 10 ways to skin a cat. But the only really important way to skin the cat is the one in which evidence has proven is the most effective way to skin the cat. We know that the most effective way to get healthy weights in this country and to bring down chronic diseases, such as diabetes caused by obesity, chronic heart disease, is to look at three very important issues: salt, trans fats, and sugar.
The minister absolutely has in her power the ability to mandate those amounts. Her own department has told her so. Advisory committees have told her so. All of the health care providers she's met with have told her so.
I'd like to know why the minister doesn't follow evidence-based decision-making in her department. It would seem to me that all of this is just a lot of talk, which we have been hearing since 2006, and nothing has been done to deal with this most significant issue.
I would like to know why the minister has in her power the ability to do this and has done absolutely nothing about it.
There is a second thing I want to ask the minister. She talks about money being spent on HIV/AIDS for a vaccine. This is good. This is very good. But is the minister aware of the fact that in British Columbia there is a proven, again evidence-based, drug that will not only treat the patient who has HIV, but by the second dose will bring down the viral load so completely that HIV will be prevented from then on. If I could not think of a better way to look at something in place of a vaccine while we're waiting for a vaccine, that's the way to do it.
I would hope that the minister would work with provinces to talk about a way of ensuring that this is part of a major HIV/AIDS strategy. It's called the HAART program. British Columbia is spending $18 million a year to treat every single person who is HIV-positive. This is a smart, evidence-based way of doing things.
So that's the second thing I want to ask the minister about.
There is a third thing I want to ask the minister. She talks very much about the crown and first nations model of health governance. Since the money for the aboriginal healing fund was transferred from the aboriginal communities into Health Canada, can the minister give me an update on how that aboriginal healing fund has progressed within Health Canada? How much of that has gone to actual aboriginal communities to work on healing, to make a difference?
In fact, INAC originally told us it was so effective they hoped this fund would continue within aboriginal communities. Health Canada should give evidence to me about the outcomes that are better than the aboriginal healing fund outcomes.
Finally, on personal health, the minister talked about a genetic profile and that you cannot pick different things to solve a problem. Well, does the minister believe that genetic profiles are the only things that cause disease? What about poverty and unemployment? What about the environment? What about smoking? What about obesity? What about alcohol? Those are things that also create disease, not merely your genetic profile.
If the minister has that kind of money to spend, I would like to know why the minister isn't dealing with bringing down chronic diseases.
Thank you, Madam Chair.
I thank the for being here this morning to discuss supplementary estimates (C).
I would also like to thank her for having participated in the emergency debate suggested by my colleague Libby Davies, the debate which took place yesterday, on the drug shortage. However, the debate turned out to be rather sterile, since the government seems to want to avoid any responsibility in the matter. And yet, the stated that she wanted to work to accelerate the approval process for new suppliers, so as to help the provinces to make better decisions.
She claims to be proactive with regard to legislation, and yet the medication shortage is a recurring problem. In Quebec alone, according to data from the Institut national de l'excellence en santé et en services sociaux [institute for excellence in health and social services], in 2010, there were 116 shortages. So, we have a problem: there is no long-term plan. If there were one, it should include more regulation, which several provinces and health experts are clamouring for. Over the past few days, they have spoken to the media, both the anglophone and francophone media, from one end of the country to the other.
It is important to point out that in her opening statement, Madam Minister states that “providing Canadians with the information they need to make healthy decisions for their loved ones is key to optimum population health”. And yet, the blame is constantly being put on the provinces and on companies, whereas the federal government has the responsibility to protect health and ensure the safety of treatments, and find tools to “strengthen the health care system”. Once again, that is taken from the minister's opening statement.
Currently, the federal government does not oblige pharmaceutical companies to report their stock decreases. It is clear that the voluntary system whereby they provide information on stocks is not at all producing the hoped-for results, since we are once again facing a shortage.
We know very well that fires or technical problems can occur in any kind of industry. All companies do not release that information regarding their stocks. They choose what information they release. Consequently, several provinces and health experts are unable to obtain information on time. The proof of that is that it took several months before people in Quebec knew about the production slowdown at the Sandoz plant.
Madam Minister, it seems to me that the time has come to take preventive action, rather than doing crisis management to handle events that occur on a regular basis, even if they are spontaneous. It seems to me that there ought to be permanent coordination between the provinces, the federal government, health experts and the suppliers of pharmaceutical products, in order to guarantee continuity in the production and supply chain.
What concrete measures do you intend to take to prevent further shortages? Is it not time to show leadership—that is being called for by everyone, everywhere—and bring in a mandatory information disclosure system, as well as adequate regulation of drugs?