HEAL Committee Meeting

37th PARLIAMENT, 2nd SESSION

Standing Committee on Health

EVIDENCE

CONTENTS

Tuesday, November 5, 2002

¹

1545

The Clerk of the Committee

Mr. Stan Dromisky (Thunder Bay—Atikokan, Lib.)

The Clerk

Mrs. Brenda Chamberlain (Guelph—Wellington, Lib.)

The Clerk

Ms. Judy Sgro (York West, Lib.)

The Clerk

Ms. Carol Skelton (Saskatoon—Rosetown—Biggar, Canadian Alliance)

The Clerk

Ms. Hedy Fry (Vancouver-Centre, Lib.)

The Clerk

¹

1550

Mrs. Brenda Chamberlain

The Clerk

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ)

¹

1555

The Clerk

The Chair (Ms. Bonnie Brown (Oakville, Lib.))

Mr. Rob Merrifield (Yellowhead, Canadian Alliance)

The Chair

Ms. Hedy Fry

The Chair

Mr. Réal Ménard

º

1600

The Chair

Mr. Stan Dromisky

The Chair

Mr. Stan Dromisky

The Chair

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP)

The Chair

Ms. Judy Wasylycia-Leis

The Chair

Ms. Judy Wasylycia-Leis

The Chair

Ms. Carol Skelton

The Chair

Ms. Carol Skelton

º

1605

The Chair

Mr. Paul Szabo (Mississauga South, Lib.)

The Chair

Mr. James Lunney (Nanaimo—Alberni, Canadian Alliance)

The Chair

Ms. Yolande Thibeault (Saint-Lambert, Lib.)

º

1610

The Chair

Mr. Stan Dromisky

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

º

1615

Mr. Rob Merrifield

The Chair

Mr. Rob Merrifield

The Chair

Mr. Réal Ménard

The Chair

Mr. James Lunney

The Chair

Mr. Réal Ménard

º

1620

The Chair

Ms. Judy Wasylycia-Leis

The Chair

Ms. Carolyn Bennett (St. Paul's, Lib.)

The Chair

Ms. Hedy Fry

The Chair

Mrs. Brenda Chamberlain

º

1625

The Chair

Mrs. Brenda Chamberlain

The Chair

Ms. Hélène Scherrer (Louis-Hébert, Lib.)

The Chair

Ms. Judy Sgro

The Chair

Mr. Stan Dromisky

º

1630

The Chair

Mr. Rob Merrifield

The Chair

Mr. James Lunney

The Chair

Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.)

The Chair

The Chair

º

1635

The Chair

The Chair

The Chair

The Chair

The Chair

The Chair

The Chair

The Chair

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CANADA

Standing Committee on Health

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NUMBER 001

l

2nd SESSION

l

37th PARLIAMENT

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EVIDENCE

Tuesday, November 5, 2002

[Recorded by Electronic Apparatus]

¹  (1545)  

[Translation]

    The Clerk of the Committee: Honourable members of the committee, I see a quorum. We can therefore proceed with the election of the chair.

[English]

    Are there any nominations for the position of chair?

    Mr. Dromisky.

    Mr. Stan Dromisky (Thunder Bay—Atikokan, Lib.): Stan Dromisky's my name, and I nominate Bonnie Brown for chair.

    The Clerk: Are there any other nominations?

[Translation]

    Are there any other nominations?

[English]

    Mrs. Brenda Chamberlain (Guelph—Wellington, Lib.): I want to know what she's promising us. I know what Stan is going to give us. I want to know what Bonnie is going to give us.

    An hon. member: Coffee, food and--

    Mrs. Brenda Chamberlain: I'd go for that.

[Translation]

    The Clerk: So, there are no further nominations.

[English]

    The nominations are now closed.

    All those in favour of Ms. Brown taking the chair, please signify.

    (Motion agreed to)

    The Clerk: The yeas have it.

    Now we will proceed to the election of the vice-chairs.

    An hon. member: Which vice-chair are we...?

    The Clerk: Perhaps we can start with the government vice-chair, if that's okay.

    Ms. Judy Sgro (York West, Lib.): I nominate Stan Dromisky for vice-chair.

    An hon. member: Is the chair not running things?

    The Clerk: No, not yet; only after the vice-chairs have been elected. That is the new procedure.

    Some hon. members: Oh, oh!

    The Clerk: Are there any other nominations for the government side? No?

[Translation]

    There are no nominations.

[English]

    Okay, the nominations are closed.

    So Mr. Dromisky is the vice-chair for the government side.

    Now we can proceed to the election of the vice-chair on the opposition side.

    Ms. Carol Skelton (Saskatoon—Rosetown—Biggar, Canadian Alliance): I would like to nominate Rob Merrifield, please.

    The Clerk: Are there any other nominations?

    Ms. Fry.

[Translation]

    Ms. Hedy Fry (Vancouver-Centre, Lib.): I nominate Réal Ménard. 

    The Clerk: Are there any other nominations for the position of opposition vice-chair?

¹  (1550)  

[English]

     Non? Donc, nominations are closed.

    Now, since more than one candidate has been nominated, pursuant to Standing Order 106 I'm authorized to preside over the election of the vice-chair by secret ballot.

    Before proceeding, I'll very briefly explain how this process will be conducted.

    My colleague and I will stand on each side of the table and we will ask you to come forward. We will distribute ballots. You will come on either side, write the name of your choice of candidate, and deposit your ballot in the box here. Afterwards I will count the votes and declare the successful candidate. If there's no majority, then we'll have to proceed to a second ballot.

    Is that clear?

    Mrs. Brenda Chamberlain: Are they going to do speeches so we know what they're--

    Some hon. members: No, no!

[Translation]

    The Clerk: I am pleased to announce that the opposition vice-chair will be Mr. Réal Ménard.

    Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): I accept with pleasure. Thank you very much.

¹  (1555)  

[English]

    The Clerk: I would now invite the chair to come and preside.

    The Chair (Ms. Bonnie Brown (Oakville, Lib.)): Thank you very much, ladies and gentlemen. I don't think you want to spend too much time here today, so I would suggest we just take a few minutes. I think the bill is before us, now numbered C-13. Some of us have been at this topic for more than two years now, so I think I can assume most of us are anxious to proceed with alacrity on this bill.

    I have had some requests from both sides of the table to hear a few more witnesses. I would suggest we take maybe half an hour with the officials to have a quick resume of where they're at in the Department of Health and then move on to a few witnesses, bearing in mind that the next date, when we come back, is Tuesday, November 19. That doesn't leave us a lot of time to do this bill.

    Am I right in assuming there are a number of people who would like to hear some witnesses, provided it doesn't go on and on? Mr. Merrifield.

    Mr. Rob Merrifield (Yellowhead, Canadian Alliance): I'm not sure exactly what your questions are relating to. I think we need to examine this in as thorough a way as we need to, to put forward a piece of legislation that is as important as this that we've worked two years on. We should not rush it to the point where we are not feeling comfortable, and we need to have enough information to be able to make the appropriate decisions.

    What we've had so far is the bulk of witnesses on the draft piece of legislation. We've had a considerable amount of change in the whole technology side of it. I think we need, for sure, to get updates on where technology has gone, where adult stem cells have gone as far as surrogacy is concerned, and on some of the developments there. There are many different facets of that piece of legislation that are considerably different from the piece of work we had worked so hard on--in the draft legislation, compared with the actual bill we're dealing with now.

    We did, this spring, have a chance to really rush some witnesses through. Some could not make it. I'm not prepared to sit and to rush this through again. I think we need to take a little more time and hear the witnesses, so that we're as comfortable as we need to be on this legislation, because it is very important.

    To put timelines on it and say it has to be driven through by Christmas or whatever, I think.... We may strive for that, but let's not get our priorities wrong by saying the time is more important than the piece of legislation.

    The Chair: Dr. Fry.

    Ms. Hedy Fry: Thank you very much, Madam Chair.

    I wanted to suggest that I support the idea we should have some more witnesses. I don't think we should go into an extensive list of witnesses, because obviously we've done this. You've been doing it for two years.

    I just wanted to comment that I think there is a group who have been--not missing, but that we haven't really heard from, given the human side of this problem. I was thinking we need to hear from some people. I don't want to prescribe whom we hear from, but I just wanted to throw in that there are the people who are in need of this technology--the infertile couples--that we may want to hear from on the human dimension of this issue.

    The Chair: Thank you.

    Mr. Ménard.

[Translation]

    Mr. Réal Ménard: I agree with Ms. Fry. I do not think that there is any need to hear from dozens of witnesses. We have a great deal of information. I would be prepared to spend one or two additional weeks on the matter.

    Obviously, the Government of Quebec is against the bill. So we will be voting against it. We will not filibuster. The Government of Quebec has sent the Minister of Health a letter indicating why it has concerns about setting up the regulatory agency. The issue of prohibited practices does not pose any problem. Basically we are dealing with two ways of thinking that pertain to a power relationship. We will not be obstructing the committee. If the committee wants to pass this bill quickly we will not object, so that things can get done. We have heard the opinions and they are not irreconcilable, but we will be voting against the bill because the Government of Quebec demonstrated that it had a problem with the regulatory agency. It seems to me that the committee has a lot of other work to do. I do not want to minimize the significance of the bill, because I know that it is important, however it seems to me that we have talked about the cost of drugs and other legislative measures that are coming. We have been working on this now for two years and it's starting to seem like a lot of months.

º  (1600)  

[English]

    The Chair: Yes. Mr. Dromisky.

    Mr. Stan Dromisky: I realize that most members of this committee are probably sitting on some other committee. I know that's going to create a problem for us, or it's going to create a problem in relation to the recommendation I'll make.

    I know we're slated for two sessions per week. From November 20 to the time we dissolve for Christmas holidays, we have three weeks. I would strongly recommend that we really seriously consider the spare days--in other words, the days when members of this committee aren't sitting on other committees--and try to squeeze in some extra meetings, which means possibly all day Monday and Wednesday afternoons and whenever possible on Tuesday and Thursday mornings.

    My understanding is this committee is going to be meeting on Tuesdays and Thursday afternoons. Is that correct?

    The Chair: Yes, that's correct.

    Mr. Stan Dromisky: I don't know whether that'll help or whether it will just complicate and frustrate the members, because members here have been sitting for nearly two years dealing with this. I don't know if they feel as I do. I don't think there's an urgency, but I do think we should get on with the task and try to get as much covered as possible in the short period of time.

    The Chair: Ms. Wasylycia-Leis.

    Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): Thank you, Madam Chair. You may not appreciate the suggestion I'm about to make, but I'm going to make it anyway.

    The Chair: I always appreciate your suggestions.

    Ms. Judy Wasylycia-Leis: Much as I would like to see this legislation go through and see the process expedited, I think that, as the health committee of the Parliament of Canada, we are under some obligation and have a responsibility to receive an overview on the Romanow commission report, which is scheduled to be tabled by November 30. We should be taking the two weeks before we rise in December to review the report of Roy Romanow and to give some thought to the directions he might be proposing. I think it clearly demands our attention. We all feel a sort of regret that the whole world has been studying health care except the health committee of Parliament. We do need to spend a little bit of time, as soon as the report is out, just to get our heads around it, to be able to be knowledgeable in order to give some help and advice down the road.

    Having said that, in terms of the actual Bill C-13, I believe we need to hear from some witnesses. We should make decisions based on a number of criteria, and this is where research could perhaps give us some help and advice. We do need to look at hearing from witnesses if there are areas of new scientific breakthroughs or new medical information that has transpired since we last reviewed this bill.

    I think we need to look at and get advice from researchers on any areas pertaining to the area of reproductive technologies that have not been addressed by the committee. If there are gaps in witnesses—and Hedy Fry has mentioned one, perhaps...I'm not so sure we didn't hear from some witnesses pertaining to infertility, but if there are gaps in the survey of the work we've done, then we should do that. I would therefore suggest that we reconsider how much time we spend on witnesses at the next meeting following a report by research.

    The Chair: Do you mean our research staff?

    Ms. Judy Wasylycia-Leis: Yes, our own staff who have followed this legislative process.

    The Chair: Ms. Skelton.

    Ms. Carol Skelton: I agree with Ms. Wasylycia-Leis. I would also like to suggest that we hear from the minister on Bill C-13. I would like to have her come before us now, too, and I agree that we should hear—

    An hon. member: She's never been here on it.

    The Chair: That's all?

    Ms. Carol Skelton: I agree with her about the Romanow commission.

º  (1605)  

    The Chair: Mr. Szabo.

    Mr. Paul Szabo (Mississauga South, Lib.): Thank you, Madam Chair.

    I've been following the bill closely, and I'm aware that a number of changes will be proposed to the bill. The committee might want to apprise itself of what changes the government is contemplating at an early period, rather than only when the amendments are proposed. That will give the members an opportunity maybe to not be too concerned about certain areas that are already going to have some changes. That might be helpful.

    One of the areas is with regard to definitions, and I think it's extremely important. We had a major package presented to the health committee from...I believe the doctor's name was Dianne Irving. The committee has received that testimony in both official languages. It's very extensive, and I think it's very apropos with regard to the proposed changes that are going to be made.

    The other one was commercialization. I think the committee had agreed to see Dr. Timothy Caulfield in the last round, but for reasons I'm not sure of, we didn't get around to hearing him. He authored the book on the commercialization of biotechnology, and that was a pretty important issue with regard to the Canadian Institutes of Health Research. Also, at the Canadian diabetes convention, there was concern expressed that commercialization and the patent ability issue would restrict the availability of new technologies for cures and therapies, etc., so it seems to be of interest to the community.

    Finally, on the fertility clinics question, there is an article in today's newspapers about a study that's going to be conducted to find out how many embryos might be available in the 24 fertility clinics across Canada. It appears that no one really knows, and depending on what that number is, it may have some significant impact on the approach that the committee takes on the bill with regard to the whole question of the utilization of embryos.

    Related to that is the overall question of the operations of clinics. The question was posed—at least to the health officials, I think, although there wasn't an answer—and I think that now becomes even more important in terms of understanding more clearly the role of the fertility clinics and how they specifically interact with the research community. It appears that the fertility clinics, which will have to be licensed, have to undergo a fair bit of overhaul, as it were, to comply with the proposed CIHR regulations, and I assume the regulations ought to come forward similarly in this legislation.

    The non-commercialization or non-commodification aspects would restrict the fertility clinics from receiving any consideration for transferring embryos to the research community. I'm not sure exactly how that happens, and we didn't get the answer to whether or not there is a direct or indirect compensation or cost recovery with regard to embryos that are given to fertility clinics.

    So those are a couple of the items that come to mind, as does the Privacy Commissioner because of the aspects and concerns that the committee expressed with regard to the disclosure of information.

    I know the committee heard a hundred witnesses or so on the draft bill, but only about ten witnesses on the actual bill. There may be some gaps there simply because of the time element, as well as the differences between the draft bill and the ultimate bill.

    The Chair: Mr. Lunney.

    Mr. James Lunney (Nanaimo—Alberni, Canadian Alliance): Thank you, Madam Chair.

    One of the areas that I know the committee was concerned about is the commercialization of the technologies. We're concerned about the import and export—at least, I certainly have a concern about the import and export—of gametes, of stem cells, and of embryos. I've just seen some information come by about biotech companies that are already advertising importing and exporting cell lines. It's an area we should be concerned about, but I don't think we've heard witnesses on it.

    I don't know how we can regulate what goes on outside our borders if we're importing and exporting. I think it's a real can of worms, I think we need to look at this very carefully, and I think there probably are some witnesses we should hear from in this area.

    The Chair: Madame Thibeault.

[Translation]

    Ms. Yolande Thibeault (Saint-Lambert, Lib.): Thank you, Madam Chair.

    We have been working on this for two years. In my opinion, this is not exactly rushing the bill through. We heard from more than 100 witnesses, as we all know. I know that some people arrived a little bit later, but the people who sat on this committee have given a great deal of thought to the matter. It was even quite difficult at times. I cannot see us starting over with other witnesses. I do not see how this can serve any purpose whatsoever. However, Ms. Fry's proposal is valid in that it is true that we have not heard from enough people who use these techniques that we want to regulate. So we could spend one day on that, but no more.

º  (1610)  

[English]

    The Chair: Thank you.

    Mr. Dromisky.

    Mr. Stan Dromisky: I do think my concern can be addressed through the mail—in other words, we don't have to bring a witness before the committee—and it pertains to surrogacy. I've raised the concern on three different occasions in the past regarding payment for services, and we have never really clarified where that area begins. Does it begin in the doctor's office when two sisters come in and ask for medical tests to be conducted and OHIP covers the cost of that service? Is that doctor in a sense really jeopardizing his position as a professional person in light of what we have already in the bill? I would like a legal opinion from the Ontario Medical Association, as well as...well, I think we could go to the Canadian Medical Association—they have their own lawyers—and ask them for an interpretation pertaining to that section of our bill. We've never had that.

    The Chair: We're now starting to get suggestions on topics.

    Mr. Rob Merrifield: Yes, that's what I wanted to address.

    The Chair: Do you mean more topics?

    Mr. Rob Merrifield: No. I could have gone through an entire list of topics, but I didn't think that's what we were doing here.

    The Chair: That's not what we're doing. I'm trying to get an idea of the timing that we want.

    Mr. Rob Merrifield: That's exactly right, and in light of what we're hearing, that's why committee members perhaps should start to get to the clerk, within this next week, the names of witnesses they feel they need to hear from, so that we can get started on that route. Once we hear some of them, we'll have a better sense of how many more we feel we need in order to get all the information that we need.

    Let's get started on that and do as much as we can, perhaps until the Romanow commission. If we then decide we want to spend a couple of weeks, a week, or even a couple of days, discussing that issue, I would be open to it. I think it's appropriate that we do that as a committee and then carry on from there. I don't think we can sit here and say we have to block off this much time and have to stuff it all in there regardless of what happens. I think that's tying our hands.

    The Chair: Having heard all this, do I have your permission to put forward a proposal as to how we get around this?

    Some hon. members: Agreed.

    The Chair: I've heard three or four basic subject areas put forward. The first one is the infertility community, and from my private conversations with you, I know Dr. Fry is speaking on behalf of four or five others. It isn't just her opinion.

    Mr. Merrifield has raised advances in technology, and Madame Wasylycia-Leis has talked about hearing from our own research staff on new breakthroughs in research as well. I also think Mr. Merrifield would like to hear from some of the researchers out in the field as part of his area.

    Mr. Rob Merrifield: Believe me, it's not an exhaustive list that I put forward.

    The Chair: No, I'm not trying to get witnesses. I'm trying to get subject areas in order to have an idea of how many sessions we need to have to cover what you need to know.

    Mr. Rob Merrifield: The regulatory body is another area that we haven't talked about. The list is a long way from being exhaustive. That's why I'm saying I have a whole list back in my office. I didn't think we were going to get to that degree when I came to this meeting here, so I just wouldn't want our hands to be tied by what we decide now. We have some subject matters that I think we should move ahead on, but—

    The Chair: This is about when we need information from the outside, not when we have opinions that differ from the bill. We deal with our opinions that differ from the bill through the process of amendments, and then we debate those fully.

    Mr. Rob Merrifield: That's what I'm talking about. We need more information.

    The Chair: You want more information on the regulatory body as it's described in the bill?

º  (1615)  

    Mr. Rob Merrifield: More information as to the difference between what we went through when we talked about our draft regulations, because it was completely different from what came out in the actual piece of legislation--

    The Chair: You mean our report as compared--

    Mr. Rob Merrifield: Bill C-13 is completely different from the report this committee did a year ago, and we have to examine that.

    The Chair: I think we're all aware of that.

    Mr. Rob Merrifield: Yes, but we didn't have a chance to exhaust that at all this spring and talk about what is the best way, and we need to sit and talk about that.

    The Chair: Okay. Well, there are obviously several problems. One is Quebec's objection and the letter that was sent. Someone else wants to see the minister. So I'm wondering if we could begin with the minister, followed by the officials, who would give us what they understand about advances in technology since last May or so, plus their understanding of Quebec's objection. So that would be the minister, followed by the officials, on those two particular things, and that followed by our own researchers, who would maybe work with the officials to clarify advances in technology that we have not discussed here that have turned up, say, over the summer.

    So the first meeting, it seems to me, could be the minister, the officials, and then our own researchers. But I'm hearing so many topics you want to hear about that I'm wondering if, seeing as we have next week off, you could get your suggestions for witnesses to the clerk before the end of this week. He could spend next week, or maybe even the tail end of this week, trying to get those people. And I wonder if you would agree to come back on November 18 for an all-day session on Monday. I had thought we might use a day and a half for witnesses--

    An hon. member: No.

    The Chair: --but I don't think we're going to get it done in a day and a half. You're saying no to the Monday? Okay, how about starting at 9 a.m. on the Tuesday? We would give it the full day on Tuesday, and if there are some we haven't heard from, we would get them for Wednesday afternoon and possibly Thursday morning, so that in the first week all these questions we have on these various topics could be answered. Then we would come back on Tuesday, November 26, which is the second week, with the goal--we're not stuck to it, but with the goal--being that we get to clause-by-clause by Tuesday, November 26, having used the previous week to hear as much as we can get in the way of witnesses.

[Translation]

    Mr. Réal Ménard: Do you know why it's not possible on the 18th? Because there is an important forum on mental health and one representative from each political party will be in attendance. I will be there on the 18th. I do not know who will be representing the government side, but I do believe that there will be a forum on mental health from 9 to 2 o'clock, and we will be dealing with the issue of drugs in the afternoon. For those of you who sit on the Special Committee on the Non-Medical Use of Drugs, this will be the deadline for tabling the report. This is why the 18th is not possible. Perhaps you will be attending the mental health forum.

[English]

    The Chair: Thank you for pointing that out. I didn't have anything down for November 18, but we certainly couldn't do without our vice-chair. So we won't meet on November 18; we'll meet on November 19. Is it agreeable that we come early on Tuesday, November 19, and start with the minister and whosoever the clerk is able to get, after you give suggestions as to names?

    Some hon. members: Agreed.

    The Chair: Can I also have agreement that if one member hands in 25 different people's names, we don't need to hear from 25 people on the same subject?

    Mr. James Lunney: We might.

    The Chair: Well, you'd have to have the agreement of the committee. I'm trying to read the committee.

    Madam Wasylycia-Leis, what I didn't get from you.... I did get this idea about the Romanow report, but you know the standing order requires that legislation take priority. At the end of this, I was going to get to the idea that we might want to establish a subcommittee on Romanow, which could work in the evening or something like that, to develop a response. But I don't think we can take our regular meetings when we have legislation in front of us. That would be my reading of the Standing Orders.

    Yes, Mr. Ménard.

[Translation]

    Mr. Réal Ménard: Madam Chair, I am not sure that we need to discuss this now, but as for the Romanow Commission, we'll have to see about that, because there will be a lot of commissions dealing with the issue. There will be the Kirby report, the Romanow Commission and seven out of ten provinces have commissions of inquiry. Would we be making the best use of the committee time if we were to review the commissions of inquiry?

    As regards health, all citizens are concerned about the cost of drugs. It seems to me that we could determine how to look at the cost of drugs. There are quite a lot of concerns. I do not have a final opinion: if someone can show me that it is imperative that the committee deal with the Romanow report... but are we going to hear from witnesses who testified before the Romanow Commission? I'm not sure that we need to discuss this now. We have not got a great deal of time and we have to use it wisely.

º  (1620)  

[English]

    The Chair: Okay. Did you want to respond?

    Ms. Judy Wasylycia-Leis: I wouldn't mind a brief word on this.

    I hear what you're saying, Madam Chair, about legislation taking precedence. However, it seems to me there have been various attempts over a decade to get legislation. While the need to complete this process is no less than it was when we were dealing with the last round, it seems to me that when you have something as significant as a commission on the future of health care reporting, there's some urgency to the health committee of Parliament having a look at it, getting familiar with it, and being prepared to offer advice to the government in terms of response, especially given the fact that the first ministers will be meeting in January on this very topic. I would think we would want to give some overview and advice and recommendations leading up to that event.

    I would think if we've waited ten years for legislation, we can wait two months. I'm not suggesting we delay the legislation, that we put off this important process; I think we should take a two-week break, the weeks of December 2 to 6 and December 9 to 13. The committee days that are available in those two weeks should be devoted to Romanow so that we could offer some insight into this most fundamental, critical issue of the day.

    The Chair: Madam Wasylycia-Leis has put a pretty clear proposal on the table, that we take the two last weeks we're here, from December 2 forward, using all the regular meetings, for an examination of the Romanow recommendations. Could I have a show of hands to see how many people would support that idea? This would be moving off the bill.

    Did you want to talk or are you voting?

    Ms. Carolyn Bennett (St. Paul's, Lib.): I'd like to comment in terms of what the objective would be. I would hope we could have two objectives for that little study. One would be some strong recommendations pre-budget to Minister Manley, and the other would be a strong message to the first ministers when they meet; that is, two letters--not a real study, but two letters--one on what we would like to see in the budget, as an almost pre-budget thing, and also a letter to the first ministers. Then I would support it.

    The Chair: Dr. Fry.

    Ms. Hedy Fry: Madam Chair, I hear what Judy is saying, and I agree with her in principle. But I think the government would not have had the opportunity to look at the Romanow report, to respond to it. For all we know, the government may say, yes, we're going to adopt the whole thing. Let's hear what the government has to say, and then we can come up with a response that says we think the government is on the wrong path, we think it's on the right path, etc.

    I think we should finish the legislation, get this done. There is going to be enough time for us to deal with what's going to happen with Romanow and how we're going to deal with that. I just don't think at this point in time it's the best use of the committee's time.

    The Chair: Okay, here we go.

    Madam Chamberlain.

    Mrs. Brenda Chamberlain: Thank you, Madam Chair.

    I happen to agree with Judy. I think this is a very important issue, the health care of this country. I have people in Guelph who have no family physicians. This is very far-reaching, and if we could give any guidance to the premiers, I would be in support of that.

    I don't know what kind of tight timeline you're operating on from the point of this legislation. It seems as though it has been a long time. It seemed at one point as though they were even prepared to shelve it. To me, the health care of the nation is extremely important, just all these things, such as people waiting for specialists. For months on end they can't see a specialist. At some point, the federal government has to step in and give a push. It seems to me the Prime Minister has indicated he feels strongly that there will be more money allocated to this, so I think this is a perfect thing for the health committee to be involved in at this time.

º  (1625)  

    The Chair: You were saying you don't know what kind of tight timeline I'm on with this.

    Mrs. Brenda Chamberlain: No, I don't.

    The Chair: I'm not on any timeline; I am here at your service. I think I could fairly suggest that the minister would like to get this bill done, as all ministers would like to get their legislation through. I'm just not sure, according to the Standing Orders, if we're free to go off and use a few weeks on another topic when the House has referred a bill to us. It's my understanding that we're not.

    Madam Scherrer.

[Translation]

    Ms. Hélène Scherrer (Louis-Hébert, Lib.): I've heard some very interesting suggestions. I too feel that we have no choice but to examine the conclusions of the Romanow Commission; we're going to have to deal with that. But my problem pertains more specifically to the bill. We know that we have been reviewing the bill for two years now and it is a very complicated bill. Every time that we are away from it for one month, two months or three months, we realize that we have to refresh our memory because new things have happened. Since this is a very complex bill, I think that we are going to have to get a handle on it so that we can review it and concentrate. As for witnesses, we could hear from them for another year, because this is a very complicated subject. And when you talk about research, we could hear from witnesses for yet another year and learn new things. I think that the objective, prior to adopting a bill, is not to know the subject from A to Z, but to get a good idea about what it entails so that you can vote on the bill. Every time we put things off for one, two or three weeks, we realize that we have to get back into the bill and start from the beginning.

    Since we are already studying the issue, I would suggest, if we have a few witnesses that we want to hear from again, that we not start at the beginning, because every time we hear from one position, we usually have to hear from the opposing side so that we can form an opinion. I will not be starting over. If the committee deems that we really do not have enough information in order to make a decision, I will only get information that I feel is pertinent. We should try to get through this without any interruption. Otherwise, we will not make it, because we have to start right back at the beginning every time. So I will be doing the study all at once.

    My only problem is that we changed the schedule from last year. For example, you were suggesting that we meet in the morning. Since I am also a member of the Environment Committee which is also dealing with a bill, I have a scheduling problem. There may be other people who have scheduling problems. So I think that we should set a schedule quite quickly so that everything is fresh in our memory and we can hear witnesses and get through the bill very quickly. Every time there is an interruption, we start over and over.

[English]

    The Chair: Madam Sgro.

    Ms. Judy Sgro: Thank you, Madam Chair. As much as I would very much love to spend a couple of weeks on the Romanow commission report and the Kirby report, there are people waiting for this legislation. Things that we don't support are going on in this country, and as long as we don't have any firm legislation on the table, that kind of activity that most of us are not supportive of is going to continue.

    Let's try to set the goal that you've set out. Let's try to get this finished by the Christmas break, if possible. In January, at our first meeting, maybe we can then have the people from the Romanow commission at that time. But I think we have an objective. In January, there may be changes to committees again. We have an obligation to the Canadian public to move this forward now.

    The Chair: Dr. Dromisky.

    Mr. Stan Dromisky: Yes, I think we have to be very realistic about the whole process and the timing. I agree that this committee must look at the Romanow report. There's no doubt about that. We can't avoid it. It's our responsibility. That's what I feel. However, it's a question of timing.

    We can go ahead and take two weeks in December, and by the third week we can pass on some information, some kind of directive, or some kind of guideline or recommendation to the government regarding what we feel should be supported, more or less, in the February budget. But I think we have to be realistic.

    By the third week of December, vast sections of the budget changes and proposals and everything else that will be presented to the House at the beginning of February are more than likely at the printers already. I don't think for one moment that whatever we pass on in the third week of December is going to have any kind of impact on the decisions that people have been working on already for the last year or two years or three years. I therefore think we should get along with our business here, get this off the roll as quickly as possible, and then go ahead and deal with the Romanow report so that we can have some kind of input and maybe a future impact on the following budget. We won't in February 2003, but—

º  (1630)  

    The Chair: I think I have the picture of what you are saying.

    Mr. Merrifield, you seem to feel it doesn't matter how soon we get this bill done. If it took until next June but you felt it was thorough, you'd be happy, right?

    Mr. Rob Merrifield: I think we should have thoroughness as an objective over timing. We've waited a decade, and when you really compare the two, the bill is very important. We have to get it right, and I think we should take the time to do that . I'm not trying to delay the bill, because I think it's long overdue. Nonetheless, this bill really impacts a fraction of our population compared to what the Romanow Commission on the Future of Health Care does.

    In a sense, I would agree with Stan that it's all about timing. With the Prime Minister committing to meeting with the first ministers to have a first ministers conference in early February, prior to the budget, on what is going to come out of the Romanow commission, we'll never speak on the issue if we don't speak now. I absolutely think it's very important to sit down for two weeks to give some sort of guidance, or we just button up and let it go because that's as far as we will be able to impact it. That's all we can do.

    The Chair: Dr. Lunney.

    Mr. James Lunney: I also would like to suggest that I agree with Judy that the Romanow report is important. It's coming down, and I think it would be worthwhile to consider that little bit of time in December as a very appropriate time to hear witnesses, if only for one week—two sessions—for at least some of that time in order to address that. I think it is appropriate to do so, Madam Chair, but I think you had a good idea to have the minister, the officials, and our researchers brief us as to where they see the bill in question.

    There has been some discussion about the types of witnesses we'd like to hear. I think we should perhaps see what ideas come forward on the witnesses and what names all members feel they'd like to submit for witnesses before we commit to a timeframe for that process. It's too important to rush through, and I think we're going to have some lengthy discussions on some issues related to the bill.

    The Chair: Thank you.

    Dr. Castonguay.

[Translation]

    Mr. Jeannot Castonguay (Madawaska—Restigouche, Lib.): Madam Chair, I get the distinct impression that we simply want to postpone this bill indefinitely. We had almost finished with it in June. However, we know what happened and now we are postponing it again. We will always have important issues that appear on the radar screen. We have to be realistic. Whether it be the Romanow report or the cost of drugs, at one point we'll have to study the matter. I think that these are all important issues for Canadians, but the bill before us is also important. If we postpone studying this bill in order to undertake another study, we will never be successful. We all have to sit down at the table and deal with the bill. Let us not rehear all of the witnesses who have already appeared. I think we have to determine whether or not we are missing any testimony, and if that is the case, go and get it. Once we have spent one or two days on the matter, I think that we will have a good grasp of this issue.

    We know that there will always be some disagreements on various clauses in the bill; that is reality. Some positions have already been taken; some will be negotiable whereas others will not be. I think that we should shoulder our responsibilities and bring this bill home.

[English]

    The Chair: I think my ambitions were too great when I came into this meeting thinking we could get a little plan formalized and agreed upon, so let me see if something else will fly.

    Could we at least agree to take the first week back, starting Tuesday, November 19, to hear as many witnesses as we can based on your suggestions to the clerk? Then, at the final meeting of that week, which would probably be Thursday afternoon—so I guess flying home early is out—we'll take a vote on whether to hear more witnesses, proceed to clause-by-clause the following week, or divert and do the Romanow report. And the other suggestion, the fourth, is the subcommittee.

    An hon. member: D'accord.

    The Chair: So we're agreed as to what's to happen that week. I will ask you to submit your witnesses. I would ask you not to have four witnesses who are going to say the same thing. I ask you to be discreet about that. We don't need to hear the same message 10 times in a row. We've already heard most of these messages. I would prefer it be people we have not heard from, or perhaps someone we've heard from who has made another breakthrough in science that we haven't hard about.

    So try to be discreet in your lists. It is not a contest to see how many witnesses you can hand in. Is that agreeable?

    Some hon. members: Agreed.

    The Chair: Seeing agreement, I'm going to take advantage of this wonderful moment. There are some routine motions that I will read and look for a mover, and hopefully we will pass them.

    The first is that the committee retain the services of one more researcher from the Library of Parliament as needed to assist the committee in its work at the discretion of the chair.

    You'll recall we had a lawyer and another scientist at the crucial moment in the pesticides bill, and I think it would be the same kind of thing.

    Dr. Fry has moved that.

    (Motion agreed to)

º  (1635)  

    The Chair: The second one is on witness expenses: that if requested, reasonable travel, accommodation, and living expenses be reimbursed to witnesses, not exceeding two representatives per organization, and that in exceptional circumstances payment for more representatives be at the discretion of the chair.

    Moved by Madam Sgro.

    (Motion agreed to)

    The Chair: A reduced quorum: that the chair be authorized to hold meetings to receive and publish evidence when a quorum is not present, provided at least three members are present, including one member of the opposition, and that the chair be authorized to call a meeting to order no sooner than 15 minutes after the time indicated on the notice of meeting as long as three members are present.

    Moved by Dr. Dromisky.

    (Motion agreed to)

    The Chair: Next is that the clerk of the committee, in consultation with the chair, be authorized to make necessary arrangements to provide for working meals for the committee.

    And that will be necessary that first week, because we're going to work hard. Moved by Dr. Lunney.

    (Motion agreed to)

    The Chair: Orders in council: that the clerk of the committee circulate order in council appointments referred to the Standing Committee on Health.

    Moved by Dr. Bennett.

    (Motion agreed to)

    The Chair: Document distribution: that the clerk of the committee be authorized to distribute to the members of the committee documents only when they exist in both official languages.

    It is moved by Madam Wasylycia-Leis that we have them in both official languages.

    (Motion agreed to)

    The Chair: Transcripts of in camera meetings: that one copy of the transcript of all in camera meetings--which we won't be having many of, I can tell you--be kept in the committee clerk's office for consultation by members of the committee.

    It means we don't get them, but the committee clerk has them and you each have the right to go and see them.

    Moved by Madam Skelton.

    (Motion agreed to)

    The Chair: The next one is that 48 hours' notice be given before any new item of business be considered by the committee. Notice given on a Friday shall be deemed to have been given on the following Monday.

    Moved by Mr. Ménard.

    (Motion agreed to)

    The Chair: Thank you very much, ladies and gentlemen, and thank you for the confidence you have placed in me. I look forward to seeing you on Tuesday, November 19, probably all day.

    Thank you very much. This meeting is adjourned.