Good afternoon, everyone.
Madam Chair and members of the committee, it's a pleasure to be back here to discuss the main estimates for the health portfolio. With me today are Glenda, Krista, Dr. Greg, and James. I believe this is the last appearance for James before this committee. He will be retiring on Friday.
Some hon. members: Hear, hear!
Hon. Leona Aglukkaq: I'm sure he's quite happy about that, so give him a good time today and don't be too hard on him.
Over the past year, the committee has discussed and considered many of this country's most important health issues. During my last appearance before the committee, in November, I highlighted our government's efforts to reduce the deficit, and our emphasis on protecting the front-line health care services within the health portfolio. I am pleased to report that we have honoured and continue to follow through on these commitments.
Madam Chair, we remain committed to sound financial management. Building on budget 2012 commitments, we are increasing effectiveness and efficiencies across the portfolio. We're reducing redundancies and aligning efforts, where possible. As well, we are focusing on core mandates to help us meet emerging demands and adapt to new realities.
The main estimates for the health portfolio represent a net decrease of $104.9 million over last year. This decrease is mainly due to the savings identified as part of our economic action plan 2012, and sunsetting programs. However, for a more complete picture of the future direction of the health portfolio, we also need to consider the government's investments in health, as outlined within the economic action plan 2013.
As highlighted in economic action plan 2013, our government invests over $2.4 billion annually for first nations and Inuit health, including primary health care for on-reserve communities, as well as non-insured health benefits. On top of this investment, economic action plan 2013 provides $52 million over the next two years to improve access to quality health services for first nations and Inuit. This funding will help expand electronic health services, including telehealth within the remote and isolated first nation communities, and it will expand the number of accredited health care facilities on reserves, as well as mental wellness teams.
The funding is on top of the $90 million in main estimates that will also be dedicated to the continued implementation of both the residential school settlement agreement and the first nations water and wastewater action plan. Once these funds are added in the future supplementary estimates, the health portfolio planned spending for 2013-14 will increase over the 2013 main estimates level.
Our government has once again confirmed that health remains a key federal priority. As confirmed in economic action plan 2013, this government will not balance the books on the backs of the provinces and the territories. We are on a sustainable, long-term track for health transfers to the provinces and the territories that will see funding reach a record high of $30.3 billion this year, and it will continue to grow. This will help ensure health care services are there for Canadian families, when needed.
Federal action on health doesn't stop at annual transfers. The federal government remains the largest single investor in Canadian health innovation, primarily through the grants made by the Canadian Institutes of Health Research. We are supporting ongoing health innovation with advanced research through an additional ongoing investment of $15 million per year for Canada's strategy for patient-oriented research. Again, this will help ensure patients are placed at the centre of care.
The federal role in health extends far beyond health care services. This week I delivered a keynote address about how our government is supporting Canadian families. I announced several important new initiatives that demonstrate how we are strengthening the safety of consumer products, food, and drugs.
Today, I would like to echo those remarks in the context of the estimates and our priorities moving forward.
Health Canada is always on the lookout for emerging threats to health. For example, it's clear that some products containing small powerful magnets pose a danger to children. These magnets are found in some novelty sets and some children's toys. If more than one magnet is swallowed in a short period of time, the results can be very serious or even fatal. Under the Canada Consumer Product Safety Act, Health Canada is taking actions to identify these dangerous products and contacting companies to have the products removed from the marketplace.
Our government wants to make sure that playpens remain safe, which is why Health Canada is proposing to strengthen regulations for playpens, including adding new requirements for playpen accessories, which will result in the application of even higher standards for their construction and safety features.
I also noted this week that the safety of our medication is also of vital importance to Canadians and their families, which is why we're improving safety standards. We're ensuring that hospitals have strong systems in place for reporting adverse drug reactions. We're working with industry to improve drug-naming practices to reduce the number of products that are confused because their names look or sound alike. This will help Canadians to better understand what they're taking and prevent dangerous mix-ups of drugs, particularly among our seniors.
With regard to natural health products, we have listened to the industry and consumers, and we have streamlined our approaches while maintaining safety as our top priority. This means that Canadians will benefit from access to over 60,000 authorized products.
Canadians need to know that the products they buy, use, and eat are subject to strict safety standards. They need to know that their government can detect and correct problems quickly, and they need to know that the information and labelling that they see are helpful and accurate. This is particularly true with food safety. For people with food allergies, for example, proper labelling is essential. Now when people shop for groceries, they will find more straightforward ingredient labels. These labels declare allergens and gluten sources that may not have been disclosed in the past. It's about helping Canadian families to get the information they need to make healthy, safe choices.
In terms of emergency preparedness, we continue to be prepared to respond to a range of public health issues. More recently we have been monitoring events in China related to the H7N9 virus. While the risk to Canadians remains low at this time, we continue to share information with the public, communicate with our public health experts in China, and work in close collaboration with our many partners.
l'm also proud to report that we're expanding our food-borne illness surveillance program, known as C-EnterNet, with a third surveillance site. This is one way we're able to track food-borne illnesses and their sources, and to help prevent diseases from occurring. Through close collaboration between the Public Health Agency, Health Canada, and all our food safety and surveillance partners, we are committed to providing Canadians with the best possible food safety protection.
We've also demonstrated our commitment to protecting families when and where they need it. In partnership with the Heart and Stroke Foundation, we're going where Canadians are, to help ensure safe environments that are both active and healthy. For example, earlier this year announced a four-year initiative to support the installation of automated external defibrillators in hockey arenas across Canada. It's one way we're reaching Canadians in their communities. This is technology that we know works, is easy to use, and can help save lives.
We need to be there for Canadians when they want advice or guidance, and that's why our government is also tapping into the power and reach of social media. HealthyCanadians.gc.ca allows even the busiest parent to stay informed. The latest alert on unsafe products, information on food, and tips on nutrition or quitting smoking are all on the HealthyCanadians site, as a one-stop shop.
Madam Chair, families, and all Canadians, want their government to be that kind of a partner in their health—not to lecture them, not to interfere in their daily lives, but to be there when they need it, to make sound policy decisions based on solid research, and to provide practical and clear advice as the world around them changes.
Today l've outlined some of the ways we're partnering with families across the country. As we look to the year ahead, l'd like to thank all members for their hard work and their shared commitment to Canadians.
I would be happy to take your questions this afternoon.
Thank you, Madam Chair.
:
Thank you very much, Madam Chair.
I want to thank you, Minister, for being here again with your officials at the health committee. We always enjoy having you here and we do appreciate your forthright answers to our questions.
You're well aware of one of the things that I'm very interested in. As a chiropractor in Oshawa, before I got involved in politics, I had a practice full of people who were very wellness-oriented, preventive-care oriented, very much into personal responsibility for their health. Some of the things that I used in my practice were vitamins, minerals, herbs, and things along these lines.
Back in 2004, under the previous government, the Liberal government brought in these new regulations. Over the last several years I've heard from a lot of Canadian businesses and consumers who have expressed their discontent with regard to the bureaucratic backlog created when these regulations came into force.
I was wondering if you could provide an update for our committee on any progress we have made on this issue, because I think at one time there was a backlog of over 10,000 products. Would you be able to give us some insight?
:
The good thing about this one, for us in Health, is that there is long-term stable funding for transfers to provinces and territories, first of all. The second is in our primary responsibility, which is first nations' health. We have the budget for long-term predictable funding in this area. We have resources to provide more innovative services to first nations within that—accreditation is an example. Those, I think, are the highlights for us—a long-term stable area.
Other areas relate to better integration of our own services within the Public Health Agency and Health Canada, and in how we can better collaborate and work with similar resources internally, cutting down some of the red tape to provide better services. We've been able to make some improvements in that—in reducing red tape in processing applications, as an example.
So there are a number of great investments in health care.
At the same time, I think it has been very well received by the provinces and territories that they have long-term, stable, predictable funding that allows each jurisdiction to provide their own investments in areas of their priorities.
The other area is research. We have research funding. CIHR is providing funding to more than 10,000 research projects in our communities. That will also be very helpful in addressing some of the challenges we have in health care, particularly around tuberculosis. As an example, the pathways to health equity program is to basically bridge the health gaps between aboriginal people and the rest of Canadians. That program focuses on areas such as obesity, diabetes, oral health, suicide, and mental health, as well as tuberculosis.
This is the first time research investments are being made in partnership with aboriginal people. One key element that has changed is that we're not approving research projects in which aboriginal people are being studied from afar. It requires a partnership of health care researchers partnering with aboriginal people on the ground, so that we can bridge between traditional knowledge and modern medicine in how we address some of those challenges.
That area is very exciting, and it's new. I look forward to making some announcements around some of the proposals that are coming forward.
Thank you.
:
The work we're doing in British Columbia is historic and very innovative. The first nation communities and first nation leaders in that region, in partnership with Health Canada and the provincial government, have established a first nations health tripartite agreement. The first rollout of it will happen this summer, when the first nations authority will take responsibility for delivering health care, by first nations people for first nations people, in partnership with the provincial government.
The opportunity there is to break down the silos of delivering health care, with better partnerships and with collaboration with similar existing provincial programs. The provinces have partnered in this. This is the first of its kind in Canada—in a provincial setting, anyway—in which Health Canada direct delivery will be out. It will be a first nations health authority delivering programs.
Another exciting piece about this is that they'll have a great opportunity to better incorporate aboriginal knowledge into the delivery of their programs and to have a better design of community-based health care services incorporating traditional knowledge of aboriginal people in the medical practice, as an example.
It's the first of its kind, and we're quite excited about it. The first nation leadership in British Columbia has been fantastic, and it has been a great joy working with them. They're thinking outside the box, planning and prioritizing their areas based on their needs in their communities.
This summer and in the fall, the first nations health authority will be delivering that. This is really exciting.
I think we'll be able to share some of these types of models in other jurisdictions that may be interested in looking at how to break down some of the silos in a provincial, federal, and first nation health delivery system. This is one that has been in the works for over five years, and I commend the leadership of the first nations people in British Columbia.
I'm very pleased, Madam Chair, to respond to this question.
As the committee has reflected in the past, or discussed in the past, the courts have been clear that what we need to maintain in the country is reasonable access to marijuana for medical purposes, but there have been challenges with the way the system has been structured.
The go-forward plan is to treat marijuana as much as possible like other narcotics that are used for medical purposes. We want to create the conditions for a new industry that would be responsible for its production and distribution, where the quality is controlled.
Therefore, under that system, Health Canada would no longer receive applications from program participants, but rather, a new supply and distribution system based on licensed producers, who would be audited and inspected by Health Canada, would be established. The production of marijuana in homes and in communities would be phased out, so as I said, it would treat this medication, which is very helpful when used for medical purposes for some individuals, as was noted, more like other substances—controlled through licensed producers, and as prescribed by medical practitioners, shipped to patients directly.
:
Thank you very much for the question, Madam Chair. I'm happy to answer it.
Because we're comparing all-year funding with supplementary estimates (A), (B), and (C) in the previous year to the main estimates in this year, the funding looks very significant, as was noted, but I can certainly flag for the members the reasons for that.
The first is that the innovation fund that we spoke of—the infrastructure on telehealth and on accreditation, which was noted—has been renewed and has been announced in the budget, so you as a committee will see that come forward in the supplementary estimates. That was an infrastructure program so it is not reflected in the main estimates, but it will come before your committee.
Another significant area was that we provided upfront money to the First Nations Health Authority. Obviously, there's a huge undertaking to do this very important transfer that we're doing in British Columbia, so there was one-time money provided to the First Nations Health Authority for readiness. What we will see in 2013-14 will be the transfer of the whole of the money. That's just one of the things that come out of the fund.
There was a coding change, I was told, and there is some reduction in non-service delivery organizations, which I think we spoke about last time before the committee. So there was the elimination of funding to NAHO, for example. We had some funds that were for front-line delivery, which we've protected, but some of those non-service delivery reductions occurred here as well.
:
Thank you, Madam Chair, for the questions.
In terms of cost savings, we have made significant investments in e-health, and we have seen that it can reduce travel in two ways. First, and perhaps most importantly, for patients, if we can connect them to health providers through telehealth, it may avoid a trip that may have been an overnight and certainly very disruptive for patients, but also very costly. We've looked at that in Manitoba, where we've made significant investments and we've done a bit of a study. There was also an external study done in northern Ontario, and there were significant savings.
There's a second way in which there are savings. Nurses, our staff in the communities, also need to keep their skills up. They want professional development and training. We can provide much more of that professional education and training to our staff through telehealth as well. So there are also savings in that important respect for our nurses.
With regard to Rosie the robot, I will say that the plans for this time are in fact to concentrate on things that perhaps are not quite as well known to the committee as Rosie, things that are in fact a bit less flashy, perhaps I can say. These are things like connectivity. We're looking to connect the next number of 35 new communities and provide them with clinical telehealth services. We're looking to increase the bandwidth in over 120 communities. We're looking to increase the use of mobile health technologies.
So there is this very interesting pilot with the robot, but that is at this point not planned for replication. It is a costly thing, and we have communities saying they need some of these very basic connected pieces.