HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Wednesday, December 1, 1999

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[English]

The Chair (Mr. Lynn Myers (Waterloo—Wellington, Lib.)): Ladies and gentlemen, I'll call this meeting of the health committee to order.

We have a couple of housekeeping matters to deal with. We have a number of witnesses today, and we want to move to them as soon as possible.

But first you will recall that David Hill was here the other day and had the ankle rule, and we asked that it be distributed. It's only in English; however, it's in French on the website. So with your permission, I'll distribute it at this time.

The other item is that the clerk has sent out, with respect to the CIHR, the notice indicating that we'll be dealing with Bill C-13 on clause-by-clause on December 9. So that has been circulated, and if we can proceed accordingly....

The other note you would have received from the clerk is with respect to a recent copy of Bill C-13. It states that it is a reprint. It's noted on the front cover. I want to highlight that and bring it to your attention. If you don't have that in front of you, it will be sent to your office.

The final housekeeping item we want to deal with is a motion from Mr. Martin, and we should deal with that now. It was actually a 48-hour notice of motion. I think each of you has a copy of it. It reads:

That, the Standing Committee on Health, immediately following its deliberations on C-13, conduct a study, consult broadly and report back to the House on the Premier of Alberta's recent proposals with regards to all aspects of the delivery of Health care, and that the committee hearings be televised.

I think that's fairly accurate in both official languages. I'm hoping that's the case. If it's not, we'll have clarification on that now.

Mr. Martin.

Mr. Keith Martin (Esquimalt—Juan de Fuca, Ref.): There is an inconsistency in the French translation. To make it consistent with the English translation, what I'm going to do is replace the word immédiatement with the word après. So in the French translation, it will read procède après aux délibérations du projet de loi.

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): Thank you, Keith, for your French.

The Chair: Thank you, Mr. Ménard, for your English.

Mr. Réal Ménard: It's a wonderful country.

The Chair: Stay in it.

Mr. Réal Ménard: Control yourself, everybody.

The Chair: It's all on the record, Réal.

Okay, so we know what the motion is. What I plan to do is have Mr. Martin speak to it briefly, and then we'll have not a long but a quick and hopefully thorough debate on whether we should proceed, because we don't want to keep the witnesses too long. So if you'd lead off now, I think that would be appropriate.

Mr. Maurice Vellacott (Wanuskewin, Ref.): First I have a question with respect to the translation. Is that appropriate now?

The Chair: Why don't we clarify that first?

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Mr. Maurice Vellacott: With this après, then, does that mean “immediately following” or just “following”? The English says “immediately following”, so I'm not sure if that comes out.

Dr. Patry, to add just après there instead of immédiatement, does that mean that immediately after deliberations on Bill C-13 we'll proceed to that?

[Translation]

Mr. Ted McWhinney (Vancouver Quadra, Lib.): It says: À procèder immédiatement aux délibérations.

Mr. Bernard Patry (Pierrefonds—Dollard, Lib.): It says: À procèder immédiatement après aux délibérations du projet de loi C-13, qu'il mène une étude. Does that mean while the House is sitting, please?

[English]

The Chair: Okay, Mr. Martin, which is it?

Mr. Keith Martin: It's immédiatement après aux délibérations.

The Chair: Okay, is everyone clear on what we're doing here?

[Translation]

Mr. Ted McWhinney: That's correct.

[English]

The Chair: Mr. Martin, do you want to tell us your rationale for this 48-hour notice of motion?

Mr. Keith Martin: Thank you, Monsieur le président.

Briefly, the motion deals with a very important issue taking place in health care today, dealing with the issue Premier Klein put forth. This motion, if the committee chose to look at it, would be a win-win situation for the government and for the opposition parties. It would enable the Minister of Health to task the committee to do something extremely important. It would be an important adjunct to his deliberations. It would enable the committee also to look at the role of private services within the health care system and give guidance not only to the government and the minister but to the opposition, so that collectively we can build a stronger health care system in the future.

As I said before, that is one of the most pressing issues in health care and it is on the cutting edge. I think this committee could be of enormous use to all interested in health care if we were to take up this particular issue after the deliberations on Bill C-13.

The Chair: Thank you for that rationale. We appreciate that very much.

The parliamentary secretary to the Minister of Health, Mr. Charbonneau.

[Translation]

Mr. Yvon Charbonneau (Anjou—Rivière-des-Prairies, Lib.): First of all, Mr. Chairman, could you tell us what items to put on the agenda after the 13th? We passed an agenda including the items which we agreed upon.

[English]

The Chair: To Mr. Charbonneau and to all members of the committee, we are actually meeting as a steering committee on December 13, a Monday, at 3:30 p.m. You will recall that we're still looking at Mr. Martin's motion with respect to supplementary estimates and the minister coming to that prior to December 6.

Mr. Elley has a request in with respect to genetically modified foods, as well as aboriginal health. Ms. Wasylycia-Leis has the same with respect to genetically modified foods and—

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): It's with respect to food safety, generally.

The Chair: —food safety in general. Thank you.

Mr. Ménard has one with respect to the blood supply.

So we will be dealing with a number of topics on December 13.

We can either proceed today on the vote on this matter or we can defer it to December 13 for further deliberation. But that's where we're at, at this point.

[Translation]

Mr. Yvon Charbonneau: I believe, Mr. Chairman, that you already have several items to deal with during the last week before the holidays. The item raised by our colleague Martin is very wide. If the Committee wanted to start a debate on this issue, it would certainly be a long debate. I do not believe it would be appropriate to start dealing with such an issue two or three days before the end of this session. So I can already tell you that the government side will vote against the motion.

[English]

The Chair: Thank you very much for your comments.

Monsieur Ménard, and then Monsieur Patry.

[Translation]

Mr. Réal Ménard: I have two comments to make, Mr. Chairman.

First of all, I too would like this to be included in the issues raised by the Committee so far. I'm not opposed to the motion, because I believe it might be interesting, but why limit the debate to Alberta? Would it not be worthwhile for the Committee to study the impact that the cuts in transfer payments have had on all the provinces which are generally carrying out their responsibilities under the National Health Act, and not only on Alberta?

Secondly, I would like to know what happened with the documents that we requested two weeks ago. We still have not received them. Are you going to ensure that we get them?

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I believe that there is certainly something that the Committee could deal with but, as far as the Bloc Québécois is concerned, we're not ready to stop there. I was wondering if the Reform Party would accept extending the scope of its proposal.

[English]

The Chair: Thank you very much, Monsieur Ménard.

The clerk advises me that she has those documents in her office, and they will be distributed this week. So they are coming. So that answers your question on that.

[Translation]

Mr. Patry, please.

Mr. Bernard Patry: Thank you very much, Mr. Chairman.

[English]

First of all, we cannot accept this, Keith, for a couple of reasons. The first reason is that we didn't receive the recent proposal of Premier Klein; we just read it in a paper, and that's not sufficient. We need to know exactly what you're talking about. And what you want to do is just reopen the Canada Health Act. It's going to take a couple of years just to study this. It includes what Mr. Ménard was just talking about, the impact of the cuts in the transfer cuts, things like this. It's much too broad. We cannot accept this because it just reopens....

And the five principles of the Canada Health Act you want to change to make it private—you say medicines and things like this. But for the moment I don't think we're ready to do this at all, and I will vote against it.

The Chair: Thank you very much for your comments.

Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: Thank you, Mr. Chairperson.

I will support the motion, although you can imagine I'm coming from an entirely different position than my honourable colleague from the Reform. I would certainly agree with him that it is a worthwhile endeavour for the committee given the urgency of the situation, given Ralph Klein's intentions to proceed as quickly as possible towards the privatization of health care or at least the siphoning off of public funds into private for-profit hospitals in his province, and we all know the kinds of ramifications and repercussions that has for the rest of Canada.

I certainly disagree with my honourable colleague, Mr. Patry, from the Liberal party when he suggests we don't have the information and therefore we can't do anything. His minister has had this information for a good six weeks; however, he has been very cautious and timid in the response of the government towards Ralph Klein's proposal. I think that begs for action from this committee.

So I certainly would support it, and, by the way, I would suggest that given the Auditor General's report yesterday, with his very scathing commentary on the state of affairs in Health Canada around just not having basic knowledge about where money is going—

The Chair: Ms. Wasylycia-Leis—

Ms. Judy Wasylycia-Leis: —and what objections are being met—

The Chair: —we're now going on another path. Let's speak to the motion here.

Ms. Judy Wasylycia-Leis: All right. I was referencing the Auditor General's report because I think it drives home the point here about the urgency and the need for this committee to grapple with this issue.

My only reservation is that I think we are faced with a number of crises in the health portfolio, not the least of which is also referenced by the Auditor General in yesterday's report on food safety. So my concern is that as a committee we deal with and tackle all of these very critical issues. I'm certainly prepared to start with the most fundamental of all that, which is the future of medicare for this country.

The Chair: Thank you for your comments. We will be tackling those issues on the 13th, as I outlined.

I don't want to put words in Monsieur Patry's mouth, but of course he was correct in the sense that the legislation has not been given yet, and we're still waiting to see that. I'm sure that's exactly what he meant when he said what he did.

Mr. Elley.

Ms. Judy Wasylycia-Leis: We'll wait until it's too late then.

Mr. Reed Elley (Nanaimo—Cowichan, Ref.): The only statement I would make on this is that I've been sitting on this committee for two years and for two years I've been asking that the government majority on the committee allow us to take a look at what I believe is the more important job we have to do here as a committee, and that is to investigate the state of health care in this country. For two years the answer has been no. So I ask, when are we going to do this? When are we going to be allowed to do the job we're here to do?

The Chair: Thank you. That's a very good question, and of course we as a committee will deal with that at the appropriate time—

Mr. Reed Elley: Which means never.

The Chair: —which means on the 13th.

Mr. Martin, you're going to close off debate on this and then I'm going to call the question.

Mr. Keith Martin: Thank you. All I can say is that as Mr. Elley, my colleague, said, regardless of what side of the argument you sit on in terms of the role of private health care and the state of affairs of health care in this country today, it is exceedingly important to have this debate. It doesn't occur and hasn't occurred adequately. This committee could be an enormously important tool for the public, for the minister, for the ministry, and for the parties in the House, to be able to explore this issue in a definitive way. I disagree with my colleague, Dr. Patry, that we can't do it. Of course we can do it, and it is a matter of will.

In my view, we would rather try to deal with something substantive that can save people's lives than to pretend we're doing something that has importance to Canadians when in fact it is of minor importance in the issue of health care. So I would implore each and every one of you to vote for this so that we can develop constructive solutions for saving the publicly funded health care system in our country today, because it's declining and people are suffering and in fact even dying as we wait.

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The Chair: Thank you very much for those comments. I think we all understand the motion. I think we understand the arguments as they've been presented. Now I'm going to call the question. All those in favour of Mr. Martin's motion?

Mr. Keith Martin: Could we have a recorded vote?

(Motion negatived: nays 7; yeas 5)

The Chair: The motion is defeated.

We'll now move on to our witnesses. We have a number of witnesses present here today. What we'll do is hear from each and every one of you. Then afterwards, we'll have committee members give questions based on your opening statements and your presentations today.

We have an additional witness, and that person is Dr. Jeff Reading from the Assembly of First Nations, a university professor. With your permission, I'm going to add him to the list, if that's agreeable to everyone. Is it agreed?

Some hon. members: Yes.

The Chair: Thank you. So now we'll ask Dr. Gary Glavin, who is the associate vice-president of research from the University of Manitoba, to lead off. Dr. Glavin.

Dr. Gary Glavin (Associate Vice-President of Research, University of Manitoba): Thank you, Mr. Chairman and honourable members of the Standing Committee on Health.

In 1997 I believe an unprecedented education effort took place on the part of health researchers in Canada, an education effort directed towards people such as yourselves, members of Parliament. That education effort was designed to make you, members of all parties, understand that health research in Canada should be seen not as an expenditure but as an investment. I believe that since 1997 the message has been accepted and received, and received favourably, by members of Parliament across all parties.

This unprecedented effort in 1997 resulted in the government of the day restoring the budgets of the major research granting councils to pre-program review levels, a major and significant step for all research, but particularly for health research in Canada. That was a very important step.

As soon as that was done, the Minister of Health, Mr. Rock, took the people who were responsible for this effort, notably Dr. Henry Friesen, the president of the Medical Research Council of Canada, aside and simply said, coming back to federal members of Parliament year after year, hat in hand, saying you need more money for research is not going to be sufficient. Mr. Rock essentially said, show us something different. Dr. Friesen, who I'm very proud to say is from Manitoba, is an incredibly forward-thinking creative man, and this resulted in what we see essentially being heard and debated these last few days: the CIHR, the Canadian Institutes of Health Research.

I think the CIHR concept fulfils at least a couple of missions that were present in 1997. Number one is that investment in health research is in fact that—an investment, not an expenditure. Number two, I believe it reinforces the message that began to be delivered in 1997 and has been delivered consistently since then, that the fundamental principle underlying health research is that good health research translates directly and tangibly into good health care. There is a direct link. Under CIHR, the topic of consideration today, a number of very positive things will happen to health research and by extension health care to Canadians.

But first is that true translational research will take place. You've heard that phrase quite a bit over the last little while. All that simply means is when a scientist, a health researcher, discovers something in his or her lab bench, it used to be the case that it might be ten years or more before that discovery could translate into health care. Nowadays, the true translation from the bench to the bedside of the patient, the time taken in order to do that, to translate a fundamental discovery into health care, is infinitely shorter. CIHR will provide the mechanism whereby laboratory results translate directly into health care, and it will shorten the time required to do so. That's very important for the health of Canadians.

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Secondly, under CIHR, health researchers and health care providers in Canada will be able to more rapidly and in a more coordinated fashion respond to emerging health crises.

We saw what happened during the tainted blood crisis. We don't know where the next crisis is going to come from. It might be an infectious disease outbreak of some kind or another that a travelling passenger brought to Canada. It might be an investigation of why, in a particular region of Canada, there is a sudden increase in a particular kind of cancer or a particular kind of neurologic disease, or some sort of rapid outbreak of some disease.

Under CIHR, the ability of researchers and caregivers to coordinate and respond to that crisis will be infinitely faster and infinitely more coordinated. There's a great deal of incredible talent in health research and health care in Canada. CIHR will coordinate and be able to focus that talent on an emerging health crisis.

Under CIHR the definition of health research is much more widened, as you well know, and that's a very positive aspect of CIHR. It's not just basic biomedical research, people in a laboratory doing molecular biology, because the definition of health research under CIHR expands to include social sciences as they relate to health, health systems and services research. Are we doing the optimal health care delivery to various regions of Canada? These are all very important and included under CIHR.

The issue of partnering under CIHR will expand—partners with other volunteer agencies that are related to health in Canada. The Canadian Cancer Society, the Parkinson Foundation, the Heart and Stroke Foundation—all very important volunteer agencies—will be very important and included under CIHR, as well as the small and continuing partnering effort with industry to get medications to market in a coordinated and rapid fashion.

But perhaps one of the best benefits that I see of CIHR—and it's not very scientific, and it's odd for me to sit here and talk about this in a somewhat non-scientific way, but I can only give you the experience I've had at my university and less so at a couple of other centres. That benefit, that incredibly positive benefit of CIHR, is on the young people; that is, on two groups I define as young people. First is the young scientists and the young investigators who are relatively early in their careers, perhaps in the first three or four years of their careers, and going back a step to the trainees, the young people who we are now training to take our places. I don't think there's a greater calling than to train our replacements, the next generation of health researchers and health caregivers in Canada.

Prior to 1997, the mood was not good. Quite frankly, it was not good at all. You would go to the faculty of medicine and the morale was very low. People were very pessimistic about the future.

Since that time, with the restoration of budgets to pre-program review levels, and now with the Canada Foundation for Innovation, with the 21st century chairs for research excellence, with the millennium scholarships, with the Canadian Foundation for Health Services Research, and now with CIHR, the mood has turned around 180 degrees. The young people we're training to take our places in the future are optimistic. A career in health research and health care is now a valued career. It's seen as a positive future, and that's not a very quantifiable.... I can't put a number on that. I can't say it went from 2 to 58, or something like that.

What I can tell you is that at our centre, and when I visit other centres around Canada and talk to the health researchers, particularly the trainees and the young faculty members and the young scientists, the mood of optimism is as high as I've ever seen it in 24 years of doing this kind of work. And that benefit cannot be underestimated, because the better we treat our young investigators and trainees, the better is the future of health research and health care in this country.

Thank you very much.

The Chair: Thank you, Dr. Glavin. I appreciate those comments.

I will now move again to the University of Manitoba. Dr. Black, please.

Dr. Charlyn Black (Co-Director and Senior Researcher, Manitoba Centre for Health Policy and Evaluation, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba): Thank you.

I'd like to take an opportunity to introduce myself and the organization I'm representing at the University of Manitoba, the Manitoba Centre for Health Policy and Evaluation. This is an organization that produces research evidence about important health policy issues, I think issues that are important both at the provincial and the federal levels.

For instance, why are some people healthy and others not? Are less healthy people in that health condition because the health care system is failing them, or are they less healthy in spite of receiving adequate and good medical care? What mechanisms for paying providers of publicly funded services lead to the best health outcomes for Canadians? This is a question that was on your agenda not a few moments ago. What potential solutions exist to address seasonal pressures on hospitals?

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I just want to also mention that when I was a Winnipeg physician, I was very interested in developing some research skills to study this kind of issue. I had to look south of the border to be able to acquire the research skills, so I travelled to Baltimore to learn to do policy-relevant research.

With that background, I'd just like to offer comments. I'll try not to duplicate some of the comments Dr. Glavin has offered. I'd just like to express my strong approval of this legislation and encourage members of the standing committee to be very supportive of this.

First of all, I think, as Dr. Glavin has mentioned, it will provide important training capabilities so that instead of going south, young Canadians can stay at home and receive their training in Canada, in a Canadian context, to identify research questions that are important from a Canadian perspective and are relevant to Canadians.

This new funding will also help us recruit. I have a student who has travelled to Florida who is thinking of coming back to Canada to join us in what will be, I think, a more stable environment for supporting young researchers. So we're very pleased at being able to create an environment in which policy researchers can come back and contribute to our understanding of what works in Canadian health care. This will allow us to create very supportive environments.

I think while I'm speaking to a kind of research that has been tenuously supported in Canada—health services research, research that supports health policy and decision-making—it's fair to say that this legislation will support and augment a whole range of research, and will support a very multidimensional approach that will allow us to really bring in a new perspective as well as disseminate research and make it more useful.

I've had the privilege of working in an environment where as a junior researcher, my research career was supported by long-term stable funding. It's been very unusual in Canada. This was true in Manitoba. The Manitoba Centre for Health Policy Research and Evaluation has been supported by a long-term contract.

So I think the level of contribution to the literature, the level of productivity, has been very high in that kind of environment.

Most importantly, the legislation's focus on supporting research to create new knowledge and its translation into—and I quote here from the legislation—“improved health for Canadians, more effective health services and products and a strengthened Canadian health care system” is very important. As someone who's really interested in seeing us make the best decisions to improve the health of Canadians, I think this is critical in the legislation, and I really support that.

It's my understanding that there has been some tension between the direction for economic development and the extent to which it would play a strong role in this legislation. I'm very supportive of its current emphasis, which focuses on improving health, because as we're well aware, there can be tensions between that and an economic development agenda, where specific products that are delivered into the health care market can increase costs without necessarily improving health of Canadians.

So it's very important in operationalizing this legislation that the committee be aware of this and be very vigilant to make sure the legislation is really aimed at improving health.

While my understanding is that the Prime Minister will make appointments, I think it's very important that these appointments be made so that the public interest of Canadians is served and that there be an accountability process such that as the CIHR moves into action, there is a clear review and focus on the extent to which the research really does contribute to improving the health of Canadians.

I think the issues of accountability and reporting to Parliament are critical ones that should be considered.

Thanks very much.

The Chair: Thank you very much, Dr. Black. We appreciate your opening comments.

We'll now move to the Canadian Association of University Teachers, and we have Dr. Turk with us.

Dr. Turk.

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Dr. James L. Turk (Executive Director, Canadian Association of University Teachers): Thank you very much, Mr. Chair.

I also would like to introduce myself and my organization. The Canadian Association of University Teachers, of which I'm the executive director, represents about 30,000 faculty in 56 universities in every province in Canada. We have a serious interest in granting councils, generally, and in the proposed new Canadian Institutes of Health Research. We've had substantial discussions of the proposals and have been involved in the process all along. We come to this committee strongly encouraging you to support this bill. We think it's a very positive step forward.

We're particularly pleased with the statement of the objective in clause 4, which very clearly indicates the purpose of the new body will be the creation of new knowledge and its translation into improved health for Canadians, more effective health services, and a strengthened Canadian health care system. We're also quite pleased that in several clauses of the bill, both in subparagraph 4(d)(ii) and in the discussion on health research institutes in clause 20, there's a broad definition of “health”, and reference is made to societal and cultural dimensions of health and environmental influences on health. We think that broad vision of health is critical for achieving the objectives that I think we all share.

Having said that we strongly support the bill, we do have two concerns with two segments of it and would like to recommend that the committee consider making recommendations for changes in two places.

The first concern has to do with commercialization and compromising the priority of the public interest in improved health and the health care system by commercial interests. Particularly, we draw your attention to paragraph 4(i), which lists the objectives and how these objectives are going to be achieved. It mentions encouraging innovation. Remember, “innovation”, contrary to English language usage, does not mean creating new ideas. “Innovation” has come to have a very specific jargonistic meaning, that is, taking ideas to market—not creating the ideas, but taking ideas to market.

Some of the members of this committee will be aware of the expert panel on the commercialization of university research, which has recently reported and will be coming forward with recommendations. Dr. Brzutowski is bringing recommendations on his consultation to cabinet on this matter. So there's this unusual notion of innovation.

Paragraph 4(i) says:

encouraging innovation, facilitating the commercialization of health research in Canada and promoting economic development through health research in Canada.

We would remind the committee of a paragraph in the preamble of the Canadian Institutes of Health Research Interim Governing Council subcommittee on partnerships and commercialization, which looked at this issue. It said the following:

While private sector organizations are recognized as vibrant drivers of the Canadian economy and contributors to economic development, it is clearly recognized by all that their primary responsibilities are rightly to their shareholders. Public health objectives and the objectives of the private sector do not always coincide. For this reason, the Interim Governing Council (IGC) of the CIHR has affirmed that public health objectives have primacy in CIHR's policies and programs over economic development objectives.

Now, I think this concern about the incompatibility of these two sets of objectives is a very real one. It's not a theoretical concern. We've seen ample examples of this recently. You may recall about two weeks ago the case of Dr. Anne Holbrook, a pharmacist and a physician at St. Joseph's Hospital in Hamilton and McMaster University, who evaluates drugs for the Ontario government. She was evaluating a medication call Losec, which is one of the five largest-selling prescription medicines in the world. In her evaluation, she found that this drug, which costs $3 a pill, had no effective benefit over two very much cheaper alternatives. She said this in a report that she issued, and she became the target of intimidating letters and legal charges by the drug company that manufacturers it.

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Or there was the case mentioned today in the media. In the Auditor General's report, he commented on the Canadian Food Inspection Agency backing away from the key inspection of a plant implicated in one of the country's largest food poisoning epidemics in history after the company owners complained to the Minister of Agriculture.

Or there was the case a few years ago, which is still alive, of Dr. Gordon Guyatt, a senior physician at McMaster University Medical Centre and head of their residency training program in internal medicine. Dr. Guyatt was troubled that the drug companies were coming in and providing free seminars and advice to residents. He argued that really residents should be learning about drugs and medication through scientific sources and not be a captive audience for private purveyors of the medications, and so ended the practice. One of the drug companies threatened him and threatened to withdraw all funding for any research scientists at McMaster University because of this action.

I could go on with examples. The point is, as the subcommittee indicated, there are conflicting interests here. It's essential for the integrity of the CIHR and the perceived integrity of the CIHR to have a clear separation.

When one talks about economic benefits or economic development, it really gets into fairly muddy waters. If a drug company develops a new medication that costs $20 a pill, and it sells widely but has relatively little benefit over and above a medication that's available at 20¢ a pill, but because of marketing it's bought, it's a big economic benefit for Canada in one sense of that term. That is, the drug company makes big profits and employs people, so it seems to be an economic benefit. But since the major purchasers of this medication are the people of Canada, provincial health care systems, hospitals, and so on, it's a dubious economic benefit.

So it's very important, as you consider this legislation, to go even further than the bill does in separating the two. In that sense we'd encourage you to delete paragraph 4(i) from the clause on objectives.

The other concern we have is with appointments. Clause 7 talks about the appointments to the governing council. Our lawyers tell me the wording of subclause 7(3) is pretty soft in the following sense. It says:

The members appointed under subsection (2) shall be appointed to hold office during pleasure.

That would imply their tenure is not as arm's-length as it might be.

There's other wording we'd encourage you to get legal advice about. For example, in human rights legislation, it frequently says that appointments shall hold office “during good behaviour”, which as I understand it from a non-legal point of view means there has to be some demonstrable misconduct before you can remove somebody, whereas “during pleasure” allows someone to be removed more easily.

Similarly, in subclause 7(4), it says:

The Governor in Council shall appoint as members of the Governing Council women and men who are able to contribute to the achievement of the objective of the CIHR in the overall interests of Canadians. The Governor in Council shall consider appointing women and men who reflect the highest standards of scientific excellence and women and men who reflect a range of relevant backgrounds and disciplines.

Surely appointing men and women who reflect the highest standards of scientific excellence should not be considered but should be done. So we'd encourage you to change that wording or recommend a change in that wording to “The Governor in Council shall appoint women and men who”.

We'd recommend a similar change in subclause 20(4) with regard to the appointments to the health research institutes.

Finally—and this relates to the issue I was talking about earlier, about commercialization—there is a potential conflict of interest of members of the governing council, which is not addressed in this bill. Quite frankly, no one who represents major private commercial interests should be able to be appointed to the governing council. This is a public body that will control millions of dollars of research money and will be probably the most decisive institution in Canada with respect to the health of Canadians. It's absolutely critical that its decisions not be tainted or be perceived to be tainted by those with commercial interests.

So there should be some specification in this legislation dealing with the issue of conflict of interest, and assurance that those who have conflicting interests cannot be appointed to the governing council.

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Thank you, Mr. Chair.

The Chair: Thank you very much, Dr. Turk, for those comments. We appreciate all you said.

We'll move on now to Dr. Richard Gordon from the Canadian Association for Responsible Research Funding, again from the University of Manitoba.

Dr. Gordon, please.

Dr. Richard Gordon (Vice-President, Canadian Association for Responsible Research Funding; Professor of Radiology and Adjunct Professor of Electrical and Computer Engineering, University of Manitoba): Thank you.

My name is Richard Gordon. I'm vice-president of the Canadian Association for Responsible Research Funding, which is known as CARRF. I'm a full tenured professor of radiology and also an adjunct professor of electrical and computer engineering at the University of Manitoba.

It is important for you to know with whom you are dealing, so I'm going to give you a little bit of my background. My undergraduate degree is in mathematics and my PhD is in chemical physics.

I have two careers. In the field of embryology and evolution, I have just published this two-volume tome, which you may pass around if people want to look at it. The title is The Hierarchical Genome and Differentiation Waves. It shows how much of the mystery of the growth of embryos can be explained in terms of physics combined with genetics. It also explains how evolution has produced ever-more-complex organisms, leading eventually to human beings. It explains how an embryo forms many kinds of cells from one egg cell, and how this is likely to open up a new pharmaceutical industry.

My second career is in medical imaging. In this I have concentrated for the past 23 years on the detection of breast cancer. I'm now working with a company with which I have designed a breast scanner that should detect small breast tumours before they spread. It will then zap them with X-ray beams. If it works as planned, it will cure this disease. I hope you will put a rider on the CIHR bill to give me the $3 million we need to build and test this prototype.

CARRF is a gadfly organization of about forty professors spread across Canada, including five from Quebec. The president is Geoff Hunter, a chemist at York University. Alex Berezin, a physicist at McMaster, is our executive secretary. Dan Osmond, a physiologist at the University of Toronto, is also a vice-president.

About ten people in other countries, in the National Cancer Institute of Canada, and in the Canadian Federation of Biological Societies listen in to our e-mail discussions and sometimes contribute their opinions. We have published many articles and even a forthcoming book. I brought a list of our publications, if anyone wants to look at it. We have been featured on CBC Radio's Quirks and Quarks twice.

Some of us have been haranguing MRC and NSERC since 1983. In 1995 we incorporated in preparation for a case of one our members against NSERC in the Federal Court of Canada. We lost that one, but not our hope of someday reforming the grant system.

Our opponents will portray us as losers. I have had fourteen federal grants myself, and the cumulative value of all my grants exceeds $1 million, which is not bad for someone who is primarily a theoretician. Many CARRF members are presently federally funded.

What do CARRF members want? Simply put, we want all university professors who are paid part of their salaries to do scientific research and want to pursue it to be able to actually do some. The present federal granting system gives all of the money to a fraction of the scientists, and the rest get nothing—literally nothing.

A survey done by Joe Pear and me in Manitoba last January showed NSERC funded 50% of their targeted academic scientists and MRC funded only 21%. Bryan Poulin, who you'll hear from next, and I have documented how innovative organizations give all of their scientists some time and money to play around with crazy ideas. A few succeed, and we have revolutions in industry, in health, and in our daily lives.

No one can predict in advance which scientists will have the ideas that work. That includes scientists. MRC can't make these predictions, nor can CIHR.

MRC and CIHR are stuck in a rut, wanting to peer-review every idea to death, no matter how fresh and untested. They need your help to get out of this rut. Without federal legislation via an amendment to the CIHR bill, Bill C-13, nothing will change. But if Parliament were to legislate that a fraction of the CIHR budget be shared equally amongst all health scientists, we predict a very substantial increase in Canadian innovation.

Thank you.

The Chair: Thank you very much for those comments. We're certainly interested in your point of view, and you've expressed it, so we're grateful for that.

• 1620

We'll move on to Lakehead University. Dr. Bryan Poulin is an associate professor there.

Dr. Bryan J. Poulin (Associate Professor in Strategic Management, Faculty of Business Administration, Lakehead University): Thank you very much.

Honourable members of the Standing Committee on Health, it's a pleasure to address you.

I don't come here presenting myself as knowing much about medical research, but over the last fifteen years I have looked at the innovation process. I did a masters degree in that and followed through with a doctoral degree on effective organizations and how to improve their morale, which was another point brought up by Dr. Glavin.

We believe morale is a very important issue in any kind of research. One of the reasons why I got together with Dr. Richard Gordon is that I told him there were instances of the best organizational practices in which the support was radically different from what he was telling me occurred at MRC and the new organization that was going to replace it.

I told him about 3M, which was primarily a commercial organization giving some free rein to scientists, inventors, and engineers at the idea stage. We used 3M as a baseline case because 3M is primarily a commercial organization, although I accept the point that we're not really looking at commercialization as a priority.

My definition of innovation is somewhat different from what I've heard from Dr. James Turk, but it has some parallels. In my view, the innovation process starts with an idea, tests out that idea through the feasibility stage, and eventually leads to commercialization. We're not suggesting that anything like the majority of the effort would go to commercialization. Most should be in the idea stage and in the testing stage. That's the mandate of university research, medical research, and research of any kind. To my mind, it's publicly funded. However, it seems to me that the response of the ineffective organizations is to try to simplify things beyond the complex nature that exists.

Such simplification is actually dangerous. The world is complex, research of any type is complex, and the phenomena we deal with are complex. Even the three-stage model that we've looked at is a simplification, but it's not a gross simplification in which you treat all the stages equally and peer-review everything to death before things get started. What we're saying here is that, at the idea stage, there is no way you can tell a priori whether an idea is going to reach the commercialization stage, nor is there any way that there are peer reviews in any sense of the term.

Somebody having a new idea usually is considered, frankly, crazy. The person who invented or looked at electric phenomena in human species was accused of trying to play with frogs to make them dance. The thing is that when we do curiosity-driven research, it is very difficult...in fact, it is impossible to see where it's going to lead. Oftentimes in innovation, a real innovation comes from somebody who's aware enough to see something different and whose mistake can lead to the proper solution. Therefore, it's easy to critique something because of supposed errors. It's those very errors and the initiative in following the curiosity that often lead to a breakthrough solution.

This is what we're proposing. We're proposing that we follow the innovation process and set in place something that actually mirrors that process. Chaos ought to reign in the idea stage. Then, over time, as it reaches the feasibility and commercial stage, we rein in the chaos. We don't rein in the chaos before it even gets started. That's what I see as so fundamentally flawed with the MRC's approach to peer-reviewing everything, especially the scientists who are going to have the breakthroughs, who are not going to be part of the old boys' network, who are not going to be part of excellence defined in terms of having received grants. Excellence ought to be the impact of one's career, not a particular stage of it, and especially not the beginning stage.

• 1625

Let's go back to morale. When we do things in a way that reflects reality, people get excited and empowered. The morale is low now, but I believe it's higher because we expect changes in the new CIHR. If those changes are not made in a meaningful way, that morale will collapse to the floor again.

Richard and I are suggesting that what we need to do is mandate a little bit of seed money to the scientists to whom we already pay $60,000 and $70,000 to sit in their chairs with no equipment. We need to give them a little bit of the resources needed to get started. We can then have the ideas come forward, and the best ones can be vetted in a little bit more formal way through the feasibility stage. Then, in the commercialization stage, which is a very small part of the effort, we can get into very rigorous peer review. In fact, it will be not only peer review; it most likely will be industrial review.

Thank you very much.

The Chair: Thank you for those comments, Dr. Poulin.

As I said at the outset, we're going to add Dr. Reading at this time. I think that would be appropriate, and I just wanted to note that Dr. Jeff Reading is an assistant professor at the Faculty of Medicine at the University of Manitoba. As I understand it, he is also a health research adviser with the Assembly of First Nations here in Ottawa.

Is that correct, Doctor?

Dr. Jeff Reading (Assistant Professor, Faculty of Medicine, University of Manitoba): That's right.

The Chair: Well, we're certainly glad to have you here to testify today. Proceed.

Dr. Jeff Reading: Thank you very much for adding me to the agenda and for giving me this opportunity this afternoon.

I do represent the Assembly of First Nations as their health research adviser. We have been supportive of the CIHR initiative, and that has not just been anecdotal. We have been successful in two of our applications to put forward our proposals to inform the CIHR of where we are interested in placing ourselves, and those are under consideration. With my colleagues at the University of Manitoba and at the Assembly of First Nations, we have agreed and have put forward a consensus in those documents.

We do have some concerns about the CIHR, because it's sort of moving forward. We don't have any real aboriginal representation on the interim governing council, and that's in part due to capacity within the aboriginal community, although we would like to see that being considered in the final make-up of the final governing council.

As you know, Canada has quite an enviable reputation around the world. For five years, it has been cited by the United Nations as the country that enjoys the best standard of living. Unfortunately, that is not really translated to some 600 reserves and aboriginal communities in the country, where we have problems with diabetes, suicide, and HIV/AIDS. In practically every health indicator that we can measure, we show a gross disparity among aboriginal people, so clearly this is an identifiable population for which we can make a bit of effort.

Aboriginal health in Canada has informed...and has a very distinguished past. We've informed other circumpolar countries around the world. In fact, we will be sending a large delegation to the Norway meeting planned for June. We also informed New Zealand, Australia, South Africa, and some other countries concerning the strides we've made in indigenous health here in Canada. That was in large part supported by SSHRC and NHRDP.

One of the concerns we have is that this tradition of distinguished research in aboriginal and indigenous health needs to be protected. We need to look at succession planning in terms of aboriginal health, and we need to bring along the next cadre of researchers. One of the concerns we have is that it's not on the radar screens of the universities. Aboriginal health as a discipline is not really involved.

I myself am Canadian-born. I'm a Mohawk Indian from Tyendinaga. I was trained at the University of Alberta and the University of Toronto, and my area was in cardiovascular medicine.

When I wanted to get into aboriginal health research, I found there was no other place, with the exception of the University of Manitoba. The mentors I have there have helped me a lot, but I think when we want to start to address the legitimate health concerns of first nations, we have to start to look at creating a network of research institutes across the country that have as their role an aboriginal health agenda.

• 1630

I see that as a win-win situation in terms of how aboriginal communities can benefit from such a scenario, but also in terms of how CIHR can benefit from having an aboriginal entity within its institution. An example would be a researcher who's engaged in immunology or molecular biology and who has a legitimate interest in trying to extend their work to the legitimate health concerns of aboriginal peoples—say, for example, diabetes in aboriginal children, which is emerging right now. We know very little about the mechanisms of the pathophysiology of that problem, so that researcher would be able to go to a colleague within the institute who is connected through the network of aboriginal centres across the country and would be able to have their work resonating within the community. They would be able to enter the community in a respectful way through the linkages within the existing network. Flowing the other way, the network itself would gather the expertise from all the other researchers within the CIHR.

I think research has moved beyond the investigator-driven, single-person form. It is really multidisciplinary, and aboriginal health is really just an example of how there's a win-win situation in multidisciplinary research in terms of how the sum is greater than the whole.

Complex research questions require multidisciplinary research teams that respect each other. So far, I feel we've played the game and have tried very hard to have our interest respected within the institute. I hope we can be acknowledged perhaps in the legislation. That's not so important, but it's really important that we be acknowledged on the governing council and within the practical development of the CIHR.

Thank you very much.

The Chair: Thank you very much, Dr. Reading. Certainly we've made notes of what you said with respect to the governing council and other matters. We'll take them under advisement and proceed accordingly.

We're now going to go to questions. These questions will no doubt be targeted to some of you, or perhaps even all of you, and we'll lead off with Mr. Martin.

Mr. Keith Martin: Thank you very much, Mr. Chairman, and thank you very much, all of you, for coming here today.

If any of you have any suggestions, such as what Dr. Turk presented in terms of amendments to the bill, I'm sure my colleagues and I would really appreciate receiving them. They would help to guide us in our deliberations.

Also, I would say thanks to Dr. Reading, who also lives in the best part of Canada—and you can guess where that is.

Ms. Judy Wasylycia-Leis: Manitoba, right?

Mr. Keith Martin: He probably travels more than we do, believe it or not.

I have a couple of questions, and one of the questions I have is about the effect on basic research. I like what Dr. Poulin mentioned, meaning his analogy to the chaos theory of research. How can we ensure that basic research that doesn't have any necessarily short- or even long-term quantifiable benefits to society is not going to have the legs cut out from underneath it within the parameters of the CIHR?

Secondly, how does the U.S. National Institutes of Health model compare to the CIHR model that we have today? As Dr. Black mentioned, how do we ensure that the Dr. Holbrooks of this world can engage in research on Losec, and that companies, manufacturers, and others cannot present undue and unfair pressure that will impede or compromise the independence of the researcher in their ability to engage in the initiatives being pursued?

Lastly, how do we ensure that accountability is put into the process so that we have the most competent independent people doing the peer review on the research that will be taking place within our country?

Thank you.

The Chair: Those are all very good questions. Who's going to lead off?

Dr. Gary Glavin: I'll take a stab at answering a couple of those questions.

The mechanism for ensuring that research that doesn't have an immediate application to a particular disease, which is a curiosity-driven proposal—what would happen if I did something to this cell, or to this tissue, or whatever?—is easily allowed for under the CIHR funding system. There are many different kinds of funding proposals, but there are two that bear on your question.

• 1635

The first are what are called insight proposals. An investigator has a hypothesis, an idea, about something that in the beginning the investigator himself or herself couldn't necessarily say if I did this experiment and it worked out, I would have an answer to a fundamental problem in heart disease, or diabetes, or whatever. An insight proposal is just that: I wonder what would happen if I fiddled with this gene or did this with this cell, or what have you. So it allows for those kinds of proposals.

Challenge proposals, on the other hand, address the issue of an idea that may seem to be out in left field. It may go against convention wisdom. It may be that everybody else is saying A equals B, but a researcher thinks A equals C. Challenge proposals allow for those kinds of research to continue and to flourish under CIHR.

Your second question dealt with the comparison to the NIH model. NIH, National Institutes of Health, in the United States, are indeed bricks and mortar. They are physical buildings that deal with the National Heart, Lung and Blood Institute, the National Institute of Allergy and Infectious Diseases, and so on. They are bricks and mortar, actual buildings, actual intramural research programs.

CIHR are virtual institutes, which means Jeff and I might have a common interest, he in B.C. and I in Winnipeg, and if our research happens to have a commonality, although we might meet only twice a year at a formal scientific meeting, it means we are automatically linked through that common institute. Say it would be an institute in aboriginal health and wellness, or something like that. He and I would always be in touch through that institute without having to build a bricks-and-mortar building. So the concept of a virtual institute simply capitalizes on technology today.

In fact, I've done that. I have conceived the experiments, carried out the experiments, analyzed the data, and written the report with a colleague in Hong Kong, and we never met face to face. This is envisioned as expanding under the CIHR.

I'm sorry, I'm old. I can't remember your third and fourth questions.

The Chair: Neither can Mr. Martin.

Mr. Keith Martin: The truth hurts.

The other one was on how to protect the Dr. Holbrooks of this world, to ensure they will not be under undue influence.

Dr. Gary Glavin: I can't speak for Toronto, but at the University of Manitoba we have a system whereby if any scientist in any discipline, not just health, wishes to engage in a contractual relationship with a private company, for example, a drug company, in order for them to do so, that contractual arrangement has to be cleared and vetted, first, by my office, and secondly, by the university legal counsel.

The tests are as follow. One is, is there any restriction whatsoever on the free ability to publish the results, whatever they may be, of that research for which you entered into the contractual relationship? That's the condition of our accepting contracts. So the individuals would always be free to publish their results, either orally or in writing, whether those results were favourable or not to the particular agenda of the company.

The Chair: On that point, Dr. Black will be first, and then Dr. Turk.

Dr. Charlyn Black: I want to mention that in fact it was Dr. Turk who mentioned Dr. Holbrook, but I think it's an excellent example. It's perhaps an example less of the type of conflict that Dr. Glavin has explained and a particular one that the Canadian health care system faces.

This was a physician who was asked to undertake a role that serves the public interest, to try to provide evidence to the health care system about which drug should be used routinely to provide the most adequate level of benefit at the lowest cost. She came up with some findings that were in direct conflict with the corporate agenda of AstraZeneca, and so in her role as working for the public system, she was attacked personally. I think that's a really critical issue.

Mr. Keith Martin: What I'm driving at, whether you're speaking about Dr. Holbrook or Dr. Olivieri, is that they have findings that are contrary to the industrial component of the public-private partnership.

Dr. Charlyn Black: Right.

Mr. Keith Martin: How do we ensure the independence and the protection of that researcher?

Dr. Charlyn Black: I'm very much in support of the recommendations that were made by Dr. Turk, at least to the extent that there is private representation on the governing board. It should not be private representation that can reap direct benefits from promoting the adoption of specific health care technologies. To the extent that private interests are represented on the governing board, it would be beneficial if they were private interests that benefit from an understanding that it's general economic development, not the adoption of a particular drug or a particular technology, that will benefit the health of Canadians.

• 1640

The Chair: Dr. Turk, let's hear from you on this point.

Dr. James Turk: I want to start with Mr. Martin's first question, which I think is a fundamental one for this committee. That is, how do we protect basic research in this country? This is a very serious problem that goes beyond the CIHR but I think is central to the CIHR.

It is a concern that comes to us from many of our members. You may have seen a week ago that one of the most esteemed scientists in Canada, John Polanyi, a Nobel laureate, spoke out quite strongly, saying that the commercialization of science is ruining Canada's universities and driving the best young scientists out of the country. I quote him:

“At a certain point...we don't have universities any more, but outlying branches of industry”.... “Then, all the things industry turns to universities for—breadth of knowledge, far time horizons and independent voice—are lost.”

He pointed out that researchers at Canadian universities rely twice as much on direct industry support as their American counterparts, four times as much as their French counterparts, and six times as much as their Japanese counterparts. In other words, increasing amounts of federal and provincial government research money, public research money, is contingent on having a private sector partner. So if I'm interested in an idea and I want to develop it, I can't get public money unless I can find a private sector partner who wants to co-fund it.

That has a very stultifying effect on the ability to do basic research, because as other witnesses have said, oftentimes the kind of research that pays off economically, as well as socially and culturally, isn't seen to do that at the outset.

Dr. Polanyi went on in his comments to say:

...this level of funding in Canada has allowed industry to “steer” research into the short-term market goals it needs to survive in a fiercely competitive global marketplace. The result is a “patchwork quilt of ad hoc” research projects.

So in answer to your question, I think it's absolutely central for the CIHR to discontinue as many of its partnership programs and to give research where it's directly publicly funded, accountable publicly, and doesn't require getting a private sector partner to approve of what you're doing as a condition of getting public money.

One of the things that's unfortunate in this country is that the private sector does less and less research of its own, much less than in the United States, so it's turning and trying to leverage public dollars to supplement its meagre private dollars. There are a lot of reasons for this historically. It's a longstanding problem. Unless this committee and the government recognize the very serious situation that Dr. Polanyi pointed out and many of us have been commenting on, we are going to have an increasingly serious problem. The only way you can ensure real basic research is to have it publicly funded and judged on grounds other than its commercial applicability, because oftentimes, and most of the time, those short-sighted interests aren't the best guidelines as to what research should be done.

The Chair: Thank you very much. I'm going to move on now to Monsieur Ménard.

[Translation]

A question, perhaps?

Mr. Réal Ménard: Yes, Mr. Chairman. I have four brief questions. I want to make sure that the witnesses understand clearly my position. This follows on Keith Martin's statements.

My first question is for Mr. Turk. You asked for an amendment to the Bill so that the governing council, which is for the time being an interim council but which will become permanent and will be made up of 20 people, does not include any representative of the patented drug industry, for example. I know that it's not the same situation for the generic drug industry. Do I understand clearly that the amendment you would like would be such that the governing council would include no representative of the pharmaceutical industry or of the private sector, or of any person that would be linked in any way to the marketing of drugs?

This might be an interesting amendment but do not forget that the patented drug industry—and I do not believe that its representatives will appear before us—invests close to $500 million in research in Canada. Would it not be dangerous, in a perspective of partnership, to deprive ourselves of people who are in any case major partners in research? I would like you to explain clearly your position on this.

• 1645

I'm going to ask you four questions one after the other and then I will let you answer them.

Ms. Black, you stated that historically, in Canada, for reasons that you did not explain but that you alluded to, very little research has been done in the health services field.

This morning, I explained this bill to my caucus. You know that all the political parties have a caucus meeting on Wednesday mornings. The first thing that my colleagues asked me was if such a bill would not be some kind of interference in a provincial jurisdiction. I do not believe so and that is the position I explained to my caucus.

Do you believe that direct funding of research in the field of health services would be compatible with provincial jurisdictions?

Here is my third question. I do not remember if it was Dr. Poulin or Dr. Gordon who seemed to ask for an equal distribution of resources for each of the institutes. Do you mean that, if ten, twelve or thirteen institutes are created by the governing council, each of them should get the same amount of resources and the same budget? It is probably not what you wanted to say but this is what could be understood from your statement. I would like you to explain your position.

This is my last question. If we asked each and everyone of you in which fields you would wish research institutes to be created, how would you answer?

[English]

The Chair: Thank you very much.

We'll start with you, Dr. Turk.

Dr. James Turk: I want to make one thing quite clear. So much of the talk about commercialization makes it appear that those who are critical of commercialization are critical of industrial research. That's not the case at all. The question and the issue for us is, where does that research take place?

Dr. Polanyi, in the same interview I was quoting from earlier, commented that there's a significant difference between the United States and Canada. In the United States there's a widespread view that the place to do industrial research, whether it be pharmaceutical or otherwise, is in the industry itself. They do it best. They are closest to the market. That kind of research shouldn't be loaded onto academic researchers and basic researchers.

One of the problems in this country is that the private sector doesn't do enough of its own research. Publicly funded research gets compromised as a result.

So in answer to your question, yes, the pharmaceutical industry should do research. It should do its own research and fund its own research. If it's trying to develop a medication that's going to create a bigger profit for it, it should fund that itself. Publicly funded research should deal with more basic curiosity-driven research or visionary research, and that's what's being compromised.

I'm sorry for giving concrete examples, but it's very easy for this to sound rhetorical.

I want to give another concrete example, and those of you who—

Mr. Réal Ménard: I want concrete examples.

Dr. James Turk: Okay.

You may have seen this two weeks ago in the Citizen. There was a front-page story about the Nortel chair of emerging technologies at the University of Toronto, Jimmy Xu, who is leaving the University of Toronto to go to Brown University. He's a very distinguished scientist who does commercially related research. I mean, he is the Nortel professor.

When asked why he was leaving, he said, well, I'm not leaving because of taxes and I'm not leaving because I'm making more money. I am leaving because the ability to get research money in this country is so dependent on having private sector partners that steer the research, it compromises my ability to do the research I want to do.

He goes on to say—and I'm quoting—the following:

“Canada has been led through a process of what almost looks like industrialization of R & D (research and development),”... Government funding agencies “have been encouraging and to some extent forcing industry-guided research.”

...too often research grants from the government or other funding sources depended on finding an industry sponsor, which could push Canada farther behind in cutting-edge research areas....

• 1650

The article continues:

“R & D is supposed to lead the industrial development. If you used a metaphor, the horse is R & D, the cart is industry”.... “The horse should be in front of the cart. Right now in many cases, you see the opposite.”

So he's leaving the country because he can't get the research funding from the public sector that frees him from being directed and guided and having his research steered by private corporate interests. That's the concern.

The Chair: Thank you.

Dr. Black, please.

Dr. Charlyn Black: I believe the question directed at me was whether there was any danger of having a federal funding organization move more into the areas that are clearly in provincial jurisdictions or where questions are of importance to provincial jurisdictions.

[Translation]

Mr. Réal Ménard: Health services.

[English]

Dr. Charlyn Black: Right, health services.

I think we have many examples across Canada of differences in the way health care is provided, and yet many of the problems are the same. In fact, we previously had a very strong national presence in the NHRDP, which supported, I know, a lot of research across the provinces, and from which it was possible for different provinces to learn about innovations in different provinces and to understand whether or not some of them had been successful.

Some of the provinces have certainly moved and developed their own research capabilities in the area of health services, and very strongly. Quebec is a prime example of that. At the same time, there is perhaps not enough sharing of the evidence of what works across provinces. I would hope that a funding process at the federal level would provide an opportunity for us to do a number of things: to focus on and be able to understand some of the differences in the approaches to introducing health services; to be able to study the effectiveness of different approaches; to understand the outcomes; and to be able to learn from them.

I think what we're trying to do is provide a way to put evidence on the table in order to learn from the differences and to provide evidence that will help us make correct decisions at the federal level. That way individual provinces can decide which decisions they want to take as well.

The Chair: Thank you very much.

Dr. Poulin.

Dr. Bryan Poulin: I think I had two questions directed to me, but I'll go back to Dr. Turk's answer and start with that position, how to protect basic research in Canada. I'll also go back to what Dr. Black mentioned about sharing.

We can get into vicious competition or we can get into cooperation. I'll go back to the questions from both Mr. Martin and Mr. Ménard that mainly had to do with what we give to researchers in the way of funding.

To protect basic research in Canada is actually not so very complex, since scientists self-select to go into science. The motivation of scientists is not really an issue. Scientists will volunteer to take money out of their pocket if need be to pursue their research interests. They are highly motivated. They are also very highly qualified. They all have medical degrees or doctorate of philosophy degrees. They are also extremely well vetted by the system. To get a tenured professorship at a university, you must show some potential and some demonstrated performance.

I want to be polite. I don't want to be blunt or rude. But I think this needs to be said: It is arrogant to dream about such things as research grants in terms of insight proposals or challenge proposals. I mean, this is craziness. People, when they pursue their curiosity with visionary ideas, look only chaotic to the outside. After time goes on and these ideas are developed, the apparent chaos disappears and the vision becomes clear.

• 1655

I agree with this article. People don't leave Canada because of money. They do so because they don't get resources. If you have a list of 20 items and people are resourced, money goes to the bottom. But when people are not resourced in some way, then, by its exception, the resource issue becomes a dominant one. It's only there because it hasn't been addressed.

What we're doing now in Canada is leaving out 80% of these highly motivated, highly qualified professionals. We're paying them to sit in their chairs and either take money out of their own pockets or wait for research grants that don't come in. They're spending sometimes up to six months of their year submitting applications that never succeed. We then have the MRC saying that they fund 58% of applications, which is true. But after being turned down for so many years, many people are out of this system altogether, and they would rather take money out of their pockets, thank you very much, than spend another six months applying for a research grant they will never get. Why not get on with a little bit of research? That's really what's happening. If they are really bright and they find these kinds of structural impediments, they hive off and go to the States. And who would blame them?

Back to Mr. Ménard's suggestion, we're asking for an additional clause where the government would direct the MRC or the CIHR, who won't listen.... They have not listened for 10 years, I'm sorry, from my experience.

I spent some time in New Zealand, and we watched the first nations get empowered. First you gave them some resources, and low and behold they became empowered. It doesn't happen without resources.

We need to mandate that some small percentage goes to the idea stage with not a single application at all. We've had enough vetting already. It's done through the universities. Give to the universities 20% to 40% of your budget, which is less than the extra you're going to give in the long term. I think you're going to increase it something like 40%, 50%, or 60%. Give a good part of that to the idea stage. Don't have researchers spend all their time filling out applications. Let them get on with their research. They'll work 60 hours a week. You'll have 100% of them, or at least 98%, gainfully employed instead of 20%.

The reason people don't share is because they compete with each other. If you're going to compete and you have only a one in five chance, who would share an idea? That would be crazy.

The system we have is structurally flawed. We're suggesting an even spread of some money. Of course, over time the universities will find a way of making it not quite so even and will reward the people who have more of the good ideas. But in the first cut of it, keep it kind of simple, make it shared, let it run for five years, get some feedback, and learn something from it in the spirit of innovation. I think you'll have much more innovation, and it will have the difference we've been asked for.

I think we could all agree, except that we want to get into a rut, as Dr. Gordon says, and we're too damn stubborn actually to admit that somebody else has a better idea.

If you wanted to look at evidence, go look at organizations that succeed. They give money in the idea stage with no questions asked. As it becomes more feasible, they ask very serious questions. During the time it's ready for commercialization, they ask the most serious questions. Thank you.

The Chair: Thank you.

Dr. Glavin, the final point, quickly.

Dr. Gary Glavin: Thank you. I just wanted to address very briefly the issue of commercialization, which seems to be a thread in this particular question. I would point out at the beginning that my answer is neither arrogant nor crazy. It's factual.

The process seems to work in a different manner. Let me give you a concrete example. A fellow at our university was working in the fundamental biology of cancer. He had no interest in commercialization. He's a fundamental cancer biologist. He isolated a mechanism whereby cancer cells don't die. They essentially immortalize themselves. This was a fundamental biological process, which he published. It was only at that point that the pharmaceutical industry contacted him and said, “We read your paper. We're obviously interested in making anti-cancer medications. We'd like to talk to you about the process you've observed.”

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So he sat down with them, and he ended up obtaining some research money from a pharmaceutical firm, but there were no strings attached to that money. They were interested in accelerating the process whereby he uncovered fundamental processes in cancer cells. They consumed the information, as did anybody who read his papers, and adapted it to the work of their own company to make new cancer medications.

I think it's significant that 60% of the research cited in patent applications from drug companies—they must give references for the scientific statements they make—is university-based research, which is largely funded by the Medical Research Council of Canada. It's fundamental research. It's not commercialized research. But it's a very important partnership.

So in many of these cases the company comes after the scientist after reading what has been published, and only then do they enter into some kind of an arrangement. Sometimes they do; sometimes they don't. So it's not a selling of your soul, as it were.

The Chair: I'm going to provide a little latitude here only because I know you want to get in, Dr. Gordon. We have a number of other questions, and Dr. Patry has been very patient. Please answer very quickly.

Dr. Richard Gordon: I'd just like to very quickly address Mr. Martin's question and to clarify something for Mr. Ménard.

Mr. Martin, with regard to the comparison between CIHR and NIH, NIH has two distinct portions: one is called the extramural program, which is similar to the granting program of MRC.

The other is the intramural program, which employs about 3,000 scientists, who, as Dr. Glavin pointed out, work in a set of laboratories that are located mostly in Bethesda, Maryland. These people never have to apply for grants. They all have some funding. They have some mechanisms for when somebody has something more ambitious. They have a military type of hierarchy in terms of organization. They have produced a number of Nobel Prize winners. They produce an amount of medical literature that is out of proportion. They are all civil servants of the U.S. government. It's a lifetime job. They also have full tenure. In this atmosphere a lot of very good work gets done. This is not part of the CIHR model.

So I just want to clarify that NIH has these two very distinct modes. NIH is schizophrenic. They in no sense ever apply this internal mode, which they regard as a great privilege, to the extramural program where they give grants. There's a very strange mentality there.

For Mr. Ménard, I think a document entitled “How to Organize Science Funding” was circulated. There is a French translation, and I think item 7 would clarify our intention with regard to the distribution of funds. Basically, we would like to see each health scientist directly receive in the order of $10,000 to $20,000 per year with no questions asked. They would have to meet a qualifications test, which could be worked out. There would be no peer review of this. If you think of it, $10,000 to $20,000 per year is a small fraction of their salary, which they get anyway, and part of their mandate is to do research.

The Chair: Thank you very much for those clarifications.

Mr. Patry, if you would, please.

[Translation]

Mr. Bernard Patry: Thank you very much, Mr. Chairman.

[English]

Thank you.

I have two questions, one for Dr. Poulin and one for Dr. Gordon.

First of all, thank you for providing us with an executive summary in both official languages. It's very appreciated, from both my point of view and that of Mr. Ménard.

I want to come back to what you just mentioned about item 7, which says:

We recommend baseline grants of $10,000-$12,000/yr for the estimated 10,000 health researchers in Canada, subject to a simple qualifications test, with no peer review.

I understand that the bill in front of us will be a copy of the MRC bill, which right now goes with peer review. In your remarks you mentioned twice—that's why I came back to this—that we need to fund curiosity. Making mistakes can bring us to a breakthrough solution.

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Who will be responsible for the simple qualification if there's no peer review? For me, that's important, you see, and I don't know who will be responsible for that.

My other question is this. Can you name me a country in the world—because you mentioned there are some places—that grants and gives money without peer review? Are you going to give money to somebody who's going to come up with an idea? I mean, are you going to say, you're a researcher, so just for curiosity, we're going to give you $25,000? I have problems with this. That's my first question for you.

But I'm glad that today we have some people here who don't fully agree with the bill in some ways—that's why you're here—and I just want to know a little more about this.

The Chair: Thank you very much.

Dr. Poulin.

Dr. Bryan Poulin: It's interesting that human life is paradoxical. What seems to be a paradox is that you give this money or the resources and then you find that wonderful things happen afterwards. It seems like a paradox. That's why many people use the business model, which is this accountability. I know hospitals that talk about accountability: there are seven accountants, and by the time the accountability experts are through, you have 70 accountants and no doctors.

Mr. Bernard Patry: Yes, I agree.

Dr. Bryan Poulin: What happens here is why we used a strictly commercial enterprise as an example of the best of enterprise, as a baseline case. We used 3M, which is, frankly, a commercial organization.

We found—and I've known for some time—that they give 15% of their resources, with no questions asked, to technicians, engineers, right up to scientists—no questions asked—and then they give grants. For anybody that has an idea, they have a soft grant. They'll give them a grant with just a simple application.

When they get into the feasibility study stage, the questions get much more serious, and there's much more scrutiny and much more accountability. When they get into the commercialization stage—because they are, after all, a commercial organization—they put the person through the mill.

That's just 3M. Then we looked at whether there were any other organizations, and of course there are. There are the Bell laboratories, which have singularly also been responsible for Nobel prizes, not the least of which is the invention of the integrated circuit, which led to microcomputers for all of what's going to be nanosurgery in the future, where we can get in and attack a cell. We were only able to do that with the aid of these computers and this sophisticated technology, which has been referred to. This happened in the Bell laboratories, where there isn't any vetting, any so-called accountability.

Who actually makes scientists accountable? When you have an innovative environment, the people who hold the others accountable are the bright scientists. To stay in a very creative system and you not being creative is like being part of the Montreal Canadiens and not being able to play hockey. How long would you stay on the team? You wouldn't even get to skate. That's what we're saying.

It seems contradictory, and that's why it's so hard for—I'm sorry to say it—non-visionary people to see it. The people who want an accountable system, who are accountants by heart, can never see the future as it's going to be—it's somebody who is able to get and seek out a creative environment like what could happen in Canada. Then these people would stay in Canada because the environment is creative.

Just one more thing. We're not against the extra funding you're considering giving to the medical research community.

A voice: No?

Dr. Bryan Poulin: Not at all. It's welcome, and on that we agree. On the scientists that are already making discoveries and are funded through the MRC and have made major advances, we're not against that. That's wonderful.

But what we're saying is—and Richard Gordon has actually coined it—is it's the tip of the iceberg of innovation and ideas that never saw the light of day. We have maybe 20% or 30% of the potential we could have if we engaged all our scientists. We say that not only is engaging a scientist a good idea, but the morale, the trust, and the creative environment that occur go well beyond that, because people know that they have a career in science, that they're going to get some base level funding, and that they're going to be able to pursue their curiosity, at least to some extent, even if they don't get a grant for 10 years. There's going to be some level at which they can carry out their life's work.

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The Chair: Thank you, Dr. Poulin.

Dr. Bryan Poulin: And that's what we're saying.

The Chair: Mr. Patry, do you want Dr. Gordon and Dr. Reading to answer?

Mr. Bernard Patry: No, I just want to get another one to Dr. Turk, please.

Dr. Turk, in your response to Monsieur Ménard regarding the pharmaceutical company, it seems—I don't know if I understand it very well—that you would like to have no funding going from the brand-name pharmaceutical companies to the universities. It's my understanding from what you just said that they should not be part of the universities, that the universities should be funded just by public funds.

Coming back to our bill in front of us, it seems that you are really worried about the conflict of interest or mainly the perception of conflict of interest, and that you would prefer, as you mentioned, to see a clear separation between the economics and the research itself.

I have two very short questions. In my understanding of the bill, it doesn't seem that all the health institutes that are going to be formed...some of them will have no economic base. If it's going for certain to health research or something like that, it's not to be commercialized after. For me, it's irrelevant for these clauses. But on the other part, I'd like to know because it's the continuation of MRC. Are you aware of anything, any conflict of interest, that occurred in the past few years regarding the economics of what MRC was involved in?

Next is not a question, just a comment. I look at Quebec and BioChem Pharma. BioChem Pharma started with a grant at McGill University. It has ended up as one of the most successful companies in the country with 3TC. I think it's good for my area, for the province, for the country, and for the world.

I just wanted to get a little bit of clarification on this to see if we could improve the bill. I just want to get your advice.

The Chair: Thank you very much.

Dr. Turk

Dr. James Turk: Thank you, Mr. Chair.

In answer to your first question, Mr. Patry, I was not saying that there should be no industrial funding of university research. What I was saying is that if university-based researchers want to apply for money from drug companies or engineering companies or whatever, they should be free to do that. I believe Dr. Glavin has mentioned that most universities have policies as to the conditions under which you can do that: you can't sign an agreement that keeps your research secret—there are a variety of protections. There's nothing wrong with that.

What I was speaking against is public money through granting councils having as a condition of getting the money that you have a private sector partner, because it means, then, that private sector interests essentially can veto a grant. That's just to be clear on that. I appreciate your question, because I would like the record to be straight on that.

Mr. Bernard Patry: Okay. That's for the record.

Dr. James Turk: Secondly, you were pointing out that a number of the health institutes clearly will not have an economic basis. In fact, I believe it was Monsieur Ménard who asked a question about examples of research institutes that we might support. I think our organization feels that the list provided in subclause 20(4) is a reasonably comprehensive list of areas. I think we'd agree with the support of that list.

But in areas that have an economic basis, here again, when we say that publicly funded research should be given out, it doesn't mean that some of that will not generate commercial activity. I don't know the details of the BioChem Pharma example, but there's a lot of research done by a lot of people who...I was citing the example of John Polanyi and Jimmy Xu for two reasons. These are people who do research that has enormous commercial importance.

But what they're saying is that in order to be able to do that research, they don't want to be dictated to or have their research steered by the private sector. They want the money...and that kind of research is often...in fact, I would say that kind of research is almost always what produces the most economic benefit, as opposed to that research which is narrowly conceived, like “we want you to go and find a solution to this problem”. That's not how most creative things are done. I don't know if that answers your questions.

Mr. Bernard Patry: It answered them very well. Thank you.

The Chair: Dr. Glavin.

Dr. Gary Glavin: I have two very quick points about commercialization. I don't disagree with what Dr. Turk is saying, but I'd like to give just two quick comments on that.

The first is in the Olivieri case, which is arguably a high-profile case where obviously something went wrong between a researcher and a contractual relationship with a pharmaceutical company. Please remember that in the end, the University of Toronto called in a former president of our university, Dr. Arnold Naimark, to investigate and make a report, which is now public. And one thing that's very clear is that it's obviously a terrible situation. But Dr. Olivieri did not go through the process I described, whereby you have your contract vetted by the university. She signed it on her own and did give away those rights. That's number one.

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Number two, it's a very small percentage of the MRC, and what will be the CIHR, budget—2.4%—that is available for partnership with the pharmaceutical industry, with industry. It's a very small percentage. But keep in mind also the beneficiary of that. If you are a university researcher, a health researcher, and you have what's called a UI, a university-industry funding, under that particular program, first of all it's investigator initiated; it's not company initiated. Second, it's peer-reviewed. And third, the individual is free to do with the results whatever he or she wishes.

But the other beneficiaries of that, of course, are the students of the person who's getting that particular grant. The pharmaceutical industry in Canada is short some 5,000 or 6,000 PhD and masters-level health researchers, so the student who works with an individual who has one of those relationships with a company automatically gets an in with the company. They'll have that much more opportunity; they'll be a known quantity to the company.

Mr. Bernard Patry: Thank you.

The Chair: Dr. Turk, on the point.

Dr. James Turk: I have just a brief point in response to Dr. Glavin. Unfortunately, the picture is not quite as rosy as he points out.

There are a number of concerns. When a researcher gets industrial money tied to public money, it steers the research. It also steers the research of the graduate student, so the graduate student learns a message that you do research to serve somebody else rather than to pursue your own science, and so on. So there are concerns we have.

Secondly, in the case of Dr. Olivieri and a number of other cases that have come to our attention where researchers have signed agreements, our concern has been that the university has not defended them against this intrusion into the rights to publish, and so on.

So the situation is a more difficult one than I think was suggested.

The Chair: Dr. Turk, just before I get to Dr. Reading, I just want something clear in my own mind. You used the term “veto”, that there would be a veto used against researchers.

Dr. James Turk: Yes.

The Chair: Do you have first-hand knowledge of that?

Dr. James Turk: What I'm saying is if a granting council says to me that they will approve my application provided I can get a private sector partner.... In other words, if you look at the Canadian Foundation for Innovation, which puts up 40¢ on the dollar, you have to get the 60¢ from somebody else.

So if you can't find a private commercial enterprise or other private enterprise interested in doing that, they effectively have veto power, because even though the public granting body says yes, we think this is good research and we're prepared to fund it, the funding can be denied if you can't find a private sector partner.

It was in that sense that I was using the term “veto”.

The Chair: That clarifies it. Thank you.

Dr. Reading, and then Ms. Wasylycia-Leis.

Dr. Jeff Reading: I just want to talk a little bit about the pent-up demand for research. I finished my doctorate in 1994, so a lot of the people I finished working with not only left Canada, but also left the research area.

Many PhDs will go into clinical medicine to make a life, make a career, or they'll go to education. So in terms of the people who stayed in research, my sense is that they stayed in because they have a passion and they have a need, an inquiring mind. That's what has kept people in.

An example of that, and the pent-up demand for research, is what we've experienced at the University of Manitoba. The Assembly of Manitoba Chiefs came up with $500,000 to create an institute for research at the university. We were able to be successful within that competition for the innovations grant to get dollars to put capital into the institute, and that's being featured now on an innovations type of cross-Canada presentation tomorrow.

That's just an example of the pent-up demand for research, and I think what's going to happen is.... The competition is very stiff. It's like a starving community. It's been starving for so long, and now this resource is going to come out there, and it's going to start to feed that hunger. Maybe in a few years we'll start to get to the stage where we start to get back to an equilibrium.

So that's the sense I have.

In terms of provincial jurisdiction, I just want to take the opportunity to talk about that. There are some 600 first nations across the country that have a historic and legal relationship with the Government of Canada. And it wouldn't be appropriate, we just wouldn't be successful, going to provincial jurisdictions to get research dollars to create a health research infrastructure. So we see this as a very important and key opportunity for us to develop what we want to do.

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And finally, in terms of sectors, I think there are new ways of knowing—ways of knowing that we haven't looked at before. Research can be a sword or a shield, and many communities—and people I work with—see researchers as stigmatizing the communities in ways that don't really meet the sort of legitimate aspirations for self-governance, because the communities are seen to be put into a chaotic state and they can't manage their affairs. Essentially, it reinforces unequal-power relationships. That's the rhetoric in native communities about research. And here is a historic opportunity at the CIHR to change that relationship, to say to communities, we understand you have different ways of knowing, and we're willing to cooperate and collaborate in ways that will lead to health outcomes for native people across the country. We're very hopeful that we'll have this opportunity to create this new kind of relationship.

The Chair: Thank you very much.

Ms. Wasylycia-Leis.

Ms. Judy Wasylycia-Leis: Finally. Does this mean that no one else is here? Sorry, Bernard.

Mr. Bernard Patry: I'm going to leave. You have an hour.

Ms. Judy Wasylycia-Leis: I can take the rest of the hour.

I have three areas of questioning, if you'll permit me, Mr. Chairperson—

The Chair: Absolutely.

Ms. Judy Wasylycia-Leis: —to try to get them all in, in the time available.

I first would like to thank the presenters for coming today. I'm sorry we haven't very many here at this hour of the day. And I'd just like to acknowledge the significant contingent from Manitoba, which I think reflects the huge contribution that health researchers in that province make to the national agenda.

I'd like to start by asking first a couple of questions around the issue of commercialization and the governing council, because in fact I've been trying to pursue that over the course of these hearings and not getting very far. It's refreshing to be able to get some constructive proposals on the table.

I think what I'm hearing is that the significance of the cases of Nancy Olivieri and Anne Holbrook is not so much in terms of the individual institutional failings, but more a reflection of a deep-rooted, systemic problem, which is that universities are becoming more and more dependent upon private sector funding, and what that does to the integrity of research and the integrity of the researcher. I think that's coupled with the fact that we have tremendous cutbacks at the federal government level, offloading of science-based research, and a move away from a regulatory framework that really does preserve independence and science-based endeavours.

So it's in that context that everybody's looking to this bill as a beacon of light in this otherwise gloomy political climate. In that context, I think what many are saying is that we have to be absolutely clear that this bill does not advance that agenda of private sector domination of the research agenda.

I should just point out that when we've raised these questions with Dr. Friesen, who has been behind this bill and the interim governing council, there's clearly no appetite for amendments. And I certainly don't see any appetite for amendments from the government, based on Allan Rock's speech to the House.

The Chair: Ms. Wasylycia-Leis, be careful here.

Ms. Judy Wasylycia-Leis: All right, sorry. Am I going too far?

The Chair: We are not going to prejudge this process.

Ms. Judy Wasylycia-Leis: All right, sorry.

The Chair: We are going through it in good faith, and I expect the same from you.

Ms. Judy Wasylycia-Leis: I was going to say, based on the minister's speech to the House, where he portrayed—

The Chair: Okay, you've made your point. Move on.

Ms. Judy Wasylycia-Leis: —this as a revolutionary change in the agenda.

So given that, my question to Jim, and anyone else who would like to answer it, is how do we make inroads in terms of some amendments? On paragraph 4(i), I hear the recommendation is to delete that whole section. I'm wondering, if we can't get a deletion, can we amend it any way, phrase it something like “utilization of research in both public and private sectors for the sake of the public good”—a sort of fallback position?

On the governing council, I'm wondering if Jim could just be a little more specific about how we can spell out, through an amendment, that there is absolutely no appointment made where there's a conflict with private commercial interest. I'm wondering how to do that and what you'd recommend.

I'll just go onto my second and third areas before the chair cuts me off.

My second area has to do with acknowledging what Charlyn and others have said about this legislation holding the promise of a new way of doing research and the potential for a multisectoral, multidisciplined approach. I guess my questions are: how does this proposal, this legislation, get integrated with your centre, Charlyn, and all 100 or so more centres across this country doing research? How do we ensure that some of this money gets down to the community level, where there are some innovative approaches around addressing cultural, economic, and environmental determinants of ill health?

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Finally on that point, how do we translate results from research like that into good public policy? I think Dr. Glavin mentioned hepatitis C as an example. That's also an example of where you can have all the research in the world, but you don't have the political will to act and make the necessary changes.

My third area of questioning is to Richard and Bryan over the question of whether or not this is truly a revolutionary shift in the research agenda and is going to mean a big difference in the field.

I think what you're saying is, let's be careful not to oversell this bill, because in fact it may just mean we in effect support the established interests in society, and those who are excluded from the system stay excluded. Someone else said to me not too long ago that this bill will make the rich richer and the poor poorer. So given the fact that we're only talking about a budget increase of $250 million by the year 2002—not much money, given all the demands—what's the best percentage, what's the best way we can ensure there is some support for curiosity-driven research?

The Chair: Well, as always, Ms. Wasylycia-Leis has excellent questions, and that's been demonstrated here again today.

Ms. Judy Wasylycia-Leis: And long-winded.

The Chair: We'll take them one at a time.

Dr. Turk, you begin.

Dr. James Turk: First—and this has to do with your preface, rather than your first question to me—in my view and in our organization's view, there is not enough industrial funding of research in this country. I tried to answer Monsieur Patry's question in the same way. We're not calling for less industrial funding of research. In fact most industry in Canada funds far less research than their counterparts in the United States.

What we're speaking to is a different issue, and that is that basic research, which historically has been funded in part in the private sector as well as in the public sector, in the face of growing globalization and competition, is being increasingly less supported in the private sector.

I remember a speech recently by Stefan Dupré where he said support for basic research doesn't get a lot of interest in the corporate boardrooms he deals with, so it really harms the research capability of this country, to the extent that the only remaining consistent source of public funding for basic research increasingly turns to the private sector and brings them into it.

The integrity of basic research is dependent—and this is the point I've been trying to make—on public funding not contaminating its funding by requiring private partners who can have the effect of vetoing it. Private funders should be funding research they want done, whether on their own premises or making it available to university or other researchers, but it should not be part of the public, and that separation needs to be made clear.

That's why we're concerned about the PMAC partnership with the MRC, quite frankly. There's no reason the pharmaceutical companies don't do more research. The bulk of their research is clinical research, as opposed to more fundamental research, and we'd encourage them to do more. There are a variety of ways to deal with the ethical and other practical problems of researchers at universities who receive that money. We're not speaking against that. But we don't want that mixed in with the very vital money the granting councils give, and it's not enough money, so let's make sure it's used for basic research.

Having said that, how do we deal with the very concrete problems you raised?

With regard to our recommendation that paragraph 4(i) be deleted, I'm afraid we really don't see how creation of new knowledge and its translation into improved health for Canadians, more effective health services, and a strengthened health care system are promoted by facilitating the commercialization of health research and promoting economic development through health research in Canada. Amendments to bills in first reading are always difficult when you go to second reading, so whether you amend it by watering it down slightly or removing it, there's probably the same difficulty. We feel it needs to be removed.

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With regard to the issue of appointments to the governing council, because our appearance here was on relatively short notice, this is an issue that I've asked our legal staff to look at in order that we can make some concrete recommendations as to how subclause 7(4), “Appointment criteria”, might be amended to deal with that.

I don't have an answer for you now, but you might also have the legal staff of this committee look at this question. I think there are straightforward ways in which conflict of interest provisions have been mentioned in other pieces of legislation, and they may be applicable here.

The Chair: Dr. Turk, if you get that interpretation, you might want to forward it by letter to our clerk. I think that would be appropriate.

Dr. James Turk: Thank you, Mr. Chair. Again, I apologize, but because of the short time from when we were asked to appear to now, when we have appeared—

The Chair: That's why I'm giving you the offer, because I think we recognize that.

Dr. James Turk: We would in fact like to send a letter to the clerk specifying our recommendations, and we will be doing that shortly.

The Chair: Excellent. Thank you very much.

On the second question, Dr. Black, please.

Dr. Charlyn Black: I believe the questions addressed were how this research gets integrated first with existing centres like ours and, secondly, into the community, and then how it gets translated into the policy, into play.

In terms of how it gets integrated, we are currently dependent on peer-review funding for about a third of our research funding, in addition to a contract that we have with Manitoba Health. We expect that, over time, we will be able to be competitive within a new CIHR framework. We also expect that we will be collaborating with many different and new collaborators across the country, other centres and other groups. We currently collaborate with, for instance, Dr. Reading's group on aboriginal health. There are many new opportunities to do that.

In terms of the integration, I see many opportunities for integration on many different levels with CIHR. I am very optimistic that this is likely to improve the integration, at least with existing researchers.

In regard to the community, there are a number of innovative grant proposal programs that have been at least specified for the first round. I believe Dr. Glavin can really speak about some of those and explain some of them, certainly with regard to communities. Certainly, there are some very innovative requests for proposal that are currently out. It's anticipated that the communities will be responsive to them in submitting letters of intent, and they clearly involve communities. This is real innovation from an MRC perspective, so I think there is a good sense that there will be the possibility to integrate into the communities.

How does it get translated? Again, the CIHR group has been very inclusive in including the SSHRC, or the Canadian Health Services Research Foundation, which do have greater experience in translating evidence that is coming from research and putting it into play in the policy process. I think the inclusiveness of the process speaks well for, hopefully, the potential for this to be translated into policy. This is an explicit expectation of CIHR. Presumably the research will be commented on in the report to Parliament, and there will be a prominence given to the research that's produced that hopefully will bring it into play in a policy context.

The Chair: Dr. Reading, did you have something on that point?

Dr. Jeff Reading: Yes, I just want to echo the concern about the research and policy interface and talk about an example. We recently completed a survey of some 10,000 first nations people on 200 reserves across the country. The data was undertaken in a partnership with the Medical Services Branch in terms of helping to define a new relationship between first nations and the Government of Canada. The data that came out of there was really very similar to the Manitoba centre's in terms of creating information. It's like policy development in real time.

The evidence created from the research was actually implemented, and the Minister of Health was therefore informed in terms of ongoing developments in the Aboriginal Diabetes Initiative, the home care initiative, and the prenatal nutrition initiative. These are evidence of how research can really...the word “empower” was used there, and research actually can do that. We've shown that it can work that way.

I think what's missing is the willingness to involve first nations people in a collegial environment of the research agenda and in helping them to be involved in the research from the initial creation, in the initial involvement in saying which kinds of research need to be done, when, by whom, and how.

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Finally, it's not appropriate or desirable for aboriginal people to create parallel structures of research institutes that have already clearly shown they're world leaders in terms of what they do, but we do need to have entry points into those institutes. Similarly, those institutes need to have entry points into the communities where the people obviously have ill health. We need to have this collegial environment in which we can have mutual respect. That way, I think we'll have improved relationships and improved health outcomes.

In some ways, aboriginal health represents an opportunity to showcase what can actually be done within this kind of CIHR environment. Like many initiatives, other communities will learn from the experience that we have already engaged in ourselves.

The Chair: Dr. Reading, while you're talking about that, I want to ask a question, because I want to have it clear in my own mind what your view is on this. In terms of all the institutes as proposed under the CIHR, do you think aboriginal health will be part of those, or could there be a separate aboriginal institute? Again, I'm asking you for a personal opinion.

Dr. Jeff Reading: I think there are two functions there. There is a role for a separate aboriginal institute because the directors of these institutes, when they get created, are going to have a say in how to allocate funds toward long-term, difficult, complex questions and how to understand them. An aboriginal researcher needs to be at the level of a director sitting around with the other directors of institutes in order to be able to understand that.

In the States, that has resulted in centres or offices that were cross-cutting, but within the Canadian Institutes of Health Research I think it would be desirable and appropriate to have an aboriginal health institute. But these are living things. If such an institute wasn't needed in 30 or 50 years, it wouldn't be needed and that would be great.

At the moment, given the health status and given that it's a major problem, the existing structures haven't actually had that much of an impact. Health status is getting worse in aboriginal communities, and we need to get a good understanding as to why. We're very good at describing what's happening, but we're very poor at describing why it's happening. That's why I think that at this time in history it's important to have an aboriginal or first nations institute that can work while cross-cutting with the other institutes, in order to start to unmask the kind of information and expertise that's created within those other institutes. Otherwise, we'll be cap in hand, going to the other institutes to ask them to look at their kinds of research questions from our perspective. But if we're involved as equal partners at the table when research initiatives are being discussed, that will actually lead to better value.

When you look at peer review, that was discussed here, and it ties into ethics. We've been involved with the Social Sciences and Humanities Research Council on the tri-council ethics document. It's very important that the peer review be vetted through community values around peer review. For example, if a community gets characterized as having a fetal alcohol syndrome or other negative circumstances, it's not a very helpful thing for that community to be characterized that way. Vetting the proposal through an aboriginal peer review committee under the auspices of a first nations or an aboriginal health research institute would be a useful and I think value-added component to the CIHR itself.

The Chair: I'm sorry, but I just want one further clarification. Your comments raised another point, and that was that at Health Canada recently—within the last year or two—there was budget money set aside for an Aboriginal Health Institute. I wonder how you see that interfacing with what's being talked about today at the CIHR.

Dr. Jeff Reading: The Aboriginal Health Institute is in the process of implementation right now, and I see it as a higher level of policy integration and information dissemination shop. They may initiate research, and there would be a clear and strong linkage between the Aboriginal Health Institute and the Aboriginal Health Research Institute that is part of the CIHR.

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For example, the seat on the governing council that could be targeted to an aboriginal person would probably, in the future, be designated from the Aboriginal Health Institute, which would have more of a political accountability. But in research it is very important to be at arm's length from the political process, to be unbiased researchers working in the milieu of the research community, and not to be accountable to the political process. I see them as strongly coupled but also autonomous within each other. The expectations for that Aboriginal Health Institute are quite high for the $5 million that's been allocated to it. They're separate animals, but they need to be linked together.

The Chair: Thanks for that clarification. That was important.

Dr. Gordon, you've been very patient. Thank you.

Dr. Richard Gordon: I came here to champion the researchers who get no funding, but I'm going to let myself be drawn into this commercialization debate—

The Chair: Please do.

Dr. Richard Gordon: —with perhaps an almost opposite point of view.

Let me tell you the tale of tele-radiology in Canada. Tele-radiology started back in the 1960s. Canada was putting up satellites where we were transmitting radiographic images by satellites, by any means of communication we had. I was working in this field in the period 1978 to 1981 or so. If you look back at it, what Canada did is it produced 50% of the world's literature on tele-radiology. We have not got one single commercial outfit in this country selling those, even though there are many in the world, and it was a total failure of transfer from university to industry of a field that we should have excelled in. We were leaders in the field and we completely flunked out.

I don't know why that happened. I saw the dynamics in my own lab. I had calls from the Department of Communications and I got absurd responses. They'd say, if we give you $1 million, can you have something to produce in six months? I'm a university professor, not a manufacturer who knows how to run a factory. We had the government on one side, me on the other side, nothing in the middle in terms of industry, and a total failure of the process. I was part of the failure and so was everyone else who was working on it. We gave the ideas away to the world. Now we buy tele-radiology systems from outside.

Something is wrong here. I don't have the experience; I don't know how to fix it. I don't think CIHR has a proposal here on how to fix that. I don't think it's even been thought about. And all this stuff about being defensive about commercial involvement is the opposite of what I'm saying. I'm saying that somehow we have to get proper commercial involvement so that we succeed in commercialization in this country.

The Chair: That point has been raised. It certainly is one we've had other discussion on and certainly a good one that you reinforced. I think it's most appropriate that we hear it again today from you.

Dr. Richard Gordon: But we need the expertise to do it. Bryan brought it up in the sense that when we give grants that are grants involving matching grants, the people who judge them should not be peer reviewers. They should be people who are what you might call industrial reviewers who themselves have personally succeeded in commercialization and therefore have the wisdom and understanding as to what's going to work—that would be an example—not the standard peer review committee. A bunch of scientists cannot judge how to do something commercial successfully. And that's all we're going to get out of CIHR.

The Chair: Thank you very much.

Dr. Glavin.

Dr. Gary Glavin: This is in relation to Ms. Wasylycia-Leis's comment about commercialization. I want to give you a concrete example of how this actually works at a university. I'll give you the example of myself.

I had two particular areas of expertise. First, I had developed a new drug and patented it, protected it, and, secondly, I developed a method whereby I could evaluate this drug from everything right down to a single cell. A Spanish pharmaceutical company was interested in this work.

The process goes something like this. We entered into a contractual arrangement and there were x amount of dollars—and that was all vetted by the university, the whole bit. In that contract there were x amount of dollars, and this, the contractual part of it, is absolutely driven by the company. They say, for this money you will do A, B, and C with this drug. They say, here's one we made that's similar to yours; you'll test it out in this, this, and this, and you'll do it in just this way. That's the part that is controlled by the company.

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However, when you enter into a contractual arrangement, and in this case with the pharmaceutical company, but it could be any other outfit, there's something the university charges on those contracts called overhead to reflect the indirect costs. It can be anywhere from 30% to 100%. In this case it was 100%. So the money came to me to do the contractual part, A, B, and C, exactly as they said, and the other 100%, the exact same amount, went to the university. That was in the days before I was in this job. A small percentage is taken by what is now my office. The large percentage went back to the originating faculty and it's split between the dean of that faculty and the investigator. So the investigator then ends up with a substantial portion of that overhead back to his or her lab for completely unencumbered curiosity-driven research.

So there are two components to it. There is the component that is driven by the company, absolutely. It's spelled out what you will do. The only thing that isn't spelled out is that you're absolutely free to publish those results. But the overhead money, a good portion of it, filters back to that individual researcher for unencumbered curiosity-driven research. So there is a benefit to contractual research—not a reliance, but a benefit.

The Chair: Thank you very much.

Dr. Poulin, please.

Dr. Bryan Poulin: I have a final point in answer to the minister's question, will the rich get richer. I'm not a medical researcher. I teach strategy and leadership in a social science field in business and government policy. Therefore, I don't have any real vested interest in it. If I show some enthusiasm for it, it's because I think it's a systemic problem that goes across fields. But I think what we have failed to do in some sense is to get an appreciation for the richness of the examples we mentioned but didn't describe.

We have two commercial organizations. The leading commercial organization—commercial manufacturing—in the world is the 3M Corporation. The leading private research lab in the world is Bell Labs.

It was public goods, by the way, the invention of the microcircuit, that gave us a switching device that turned into an integrated circuit that turned into the computer age. That was public property. It was so much in the public interest it became public property. Bell Labs never received one commercial cent, not one dollar, from what I'd call that innovation.

Then we have the NIH intramural program, which has had Nobel prize winners. Both of them did.

What we see here is that in each case in these leading organizations, which you will not find through survey research because they are rich examples, they're the best of the examples, and in the best of the examples the researchers have complete freedom of resources at the idea stage.... See, we're polite here. I've acknowledged the points they've made. I've acknowledged that they've been good points. Every one of the points here has been a good point. I'm somewhat frustrated.

The points we've raised, which are the best examples of research in private and medical research, the NIH intramural program—which has its faults too, but it's generally sound, in our view. Those examples are going to be ignored by this legislation. Even if it was just a small amount in principle, when we're talking about principles and ethics, allocated without forms and programs at the idea stage, just a small amount to researchers to get them going, if we could just do that, I think you'd be astounded by the motivational aspects, and not just motivational, but the productivity gains that would happen in this venture.

We're not asking maybe that you do go for 40% of your budget, which we'd like, but choose some number as a statement of recognition for the best examples of innovation, the best examples of discovery, in the world. Let's not go to the medium and the mediocre. Let's go for the best in that science.

The Chair: Thank you very much for those comments. I think we're rapidly running out of time. We're certainly running out of members.

Dr. Bryan Poulin: Who are we talking to? We're talking to ourselves.

The Chair: No, it's all part of being on the record, and it's a very important process.

Dr. Black, I—

Ms. Judy Wasylycia-Leis: You'll be in the annals of history.

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The Chair: Ms. Wasylycia-Leis, can you hang on? I have a question.

Dr. Black, in earlier testimony you referred to the funding for the NHRDP. As I understand it, that's the National Health Research and Development Program. How do you see that carrying on under CIHR, or do you?

Dr. Charlyn Black: I don't know. Actually, I'm chairing an NHRDP panel that will be meeting in January, so I'm still involved with it. I think there's great uncertainty about that program. There is a recognition that Health Canada may still require targeted research and a targeted research program. I think that issue is very much up in the air. I'm not aware of any decisions that have been made.

The Chair: It's my understanding that it's a very good program.

Dr. Charlyn Black: I would say it certainly has been. I certainly benefited from that program. It provided funding for me to do my PhD out of the country at Johns Hopkins University, so I was a direct beneficiary of that program. It supported a number of career scientists. It really supported the development of a capacity in Canada to do health services research and health economics research. It helped fund a lot of Quebec researchers. We always saw a lot of French proposals at NHRDP.

I think it really placed Canada in a very good position. There has been a state of being in limbo, and we've developed a capacity such that we can move into different types of programs. Yet the sort of solidarity and long-term support of NHRDP have fallen out. So we're very hopeful that CIHR will provide a peer-reviewed, competitive process that's more broadly supportive for this kind of research. At the same time there is the issue of whether Health Canada will need the capacity to direct and ask specific questions and to ask the researchers to take on those questions and respond to them. So I think that's an important issue to be considered.

The Chair: That's very helpful. Thank you.

Dr. Reading, do you have anything to add?

Dr. Jeff Reading: We're very interested in contributing to advanced knowledge and maintaining Canada's competitive position as an innovator in indigenous research. The NHRDP allocated something like 25% to 40% of its budget toward aboriginal-specific research. It supported the careers of a cadre of researchers. The director of my Department of Community Health Sciences, Dr. Kue Young, was a direct beneficiary, and he is seen as being probably one of the top five researchers in indigenous research internationally. That was supported directly by the NHRDP program.

In terms of our own succession planning, we have concerns about how we're going to ensure that aboriginal health research maintains its competitive position in terms of the leadership role Canada can take in providing solutions to other indigenous communities around the world. Diabetes, in which Kue Young was a big player throughout his research career, is now a major issue in New Zealand, Australia, and the circumpolar countries of the north. That didn't happen by accident. That's why we are concerned about how we're going to maintain that momentum and bring along the next cadre of aboriginal researchers.

Because of the strong links to the Medical Research Council and the focus on biomedical research, the CIHR is equally important. But let's not forget that the pendulum has to swing across the four dimensions of the CIHR, and aboriginal people also have to be included. It's not a question of not having capacity. It's a question of succession planning.

The Chair: Thank you for that clarification.

Thanks to all of you. We really appreciate the fact that you'd take the time to be here. What you've said is very important. It's all part of the public record. Of course, we'll take the time to review and carefully analyse everything that was said here today.

This meeting is adjourned.