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View Rona Ambrose Profile
CPC (AB)
Thank you very much, Mr. Chair, and thank you to the committee. I want to thank all of you for the work you do on the health committee. I know many of you are passionate about the issues of health, and I thank you for your commitment to that.
I'm joined by Simon Kennedy, Health Canada's new deputy minister; Krista Outhwaite, our newly appointed president of the Public Health Agency of Canada; and Dr. Gregory Taylor, whom you've met before, Canada's chief public health officer. I know he'll be here for the second half. You might want to ask him about his trip to Guinea and Sierra Leone to visit our troops and others who are working on the front dealing with Ebola. I'm sure he'll have some great things to share with you.
Michel Perron is here on behalf of the Canadian Institutes of Health Research. He's also new. Last time I know you met Dr. Alain Beaudet.
We also have Dr. Bruce Archibald, who's the president of the Canadian Food Inspection Agency. I think you've met Bruce as well.
Mr. Chair, I'd like to start by sharing an update on some of the key issues that we've been working on recently. I'll begin by talking about Canada's health care system, the pressures it's facing, and the opportunities for improvement through innovation. I will then highlight some recent activities on priority issues such as family violence and the safety of drugs in food.
According to the Canadian Institute for Health Information, Canada spent around $215 billion on health care just in 2014. Provinces and territories, which are responsible for the delivery of health care to Canadians, are working very hard to ensure their systems continue to meet the needs of Canadians, but with an aging population, chronic disease, and economic uncertainty, the job of financing and delivering quality care is not getting easier.
Our government continues to be a strong partner for the provinces and territories when it comes to record transfer dollars. Since 2006, federal health transfers have increased by almost 70% and are on track to increase from $34 billion this year to more than $40 billion annually by the end of the decade—an all-time high.
This ongoing federal investment in healthcare is providing provinces and territories with the financial predictability and flexibility they need to respond to the priorities and pressures within their jurisdictions.
In addition of course, federal support for health research through the CIHR as well as targeted investments in areas such as mental health, cancer prevention, and patient safety are helping to improve the accessibility and quality of health care for Canadians.
But to build on the record transfers and the targeted investments I just mentioned, we're also taking a number of other measures to improve the health of Canadians and reduce pressure on the health care system. To date we've leveraged over $27 million in private sector investments to advance healthy living partnerships. I'm very pleased with the momentum we've seen across Canada.
Last year we launched the play exchange, in collaboration with Canadian Tire, LIFT Philanthropy Partners, and the CBC, to find the best ideas that would encourage Canadians to live healthier and active lives. We announced the winning idea in January: the Canadian Cancer Society of Quebec and their idea called “trottibus”, which is a walking school bus. This is an innovative program that gives elementary schoolchildren a safe and fun way to get to school while being active. Trottibus is going to receive $1 million in funding from the federal government to launch their great idea across the country.
Other social innovation projects are encouraging all children to get active early in life so that we can make some real headway in terms of preventing chronic diseases, obesity, and other health issues. We're also supporting health care innovation through investments from the Canadian Institutes of Health Research. In fact our government now is the single-largest contributor to health research in Canada, investing roughly $1 billion every year.
Since its launch in 2011, the strategy for patient-oriented research has been working to bring improvements from the latest research straight to the bedsides of patients. I was pleased to see that budget 2015 provided additional funds so that we can build on this success, including an important partnership with the Canadian Foundation for Healthcare Improvement.
Canadians benefit from a health system that provides access to high-quality care and supports good health outcomes, but we can't afford to be complacent in the face of an aging society, changing technology, and new economic and fiscal realities. That is why we have been committed to supporting innovation that improves the quality and affordability of health care.
As you know, the advisory panel on health care innovation that I launched last June has spent the last 10 months exploring the top areas of innovation in Canada and abroad with the goal of identifying how the federal government can support those ideas that hold the greatest promise. The panel has now met with more than 500 individuals including patients, families, business leaders, economists, and researchers. As we speak, the panel is busy analyzing what they've heard, and I look forward to receiving their final report in June.
I'd also like to talk about another issue. It's one that does not receive the attention that it deserves as a pressing public health concern, and that's family violence. Family violence has undeniable impacts on the health of the women, children, and even men, who are victimized. There are also very significant impacts on our health care and justice systems.
Family violence can lead to chronic pain and disease, substance abuse, depression, anxiety, self-harm, and many other serious and lifelong afflictions for its victims. That's why this past winter I was pleased to announce a federal investment of $100 million over 10 years to help address family violence and support the health of victims of violence. This investment will support health professionals and community organizations in improving the physical and mental health of victims of violence, and help stop intergenerational cycles of violence.
In addition to our efforts to address family violence and support innovation to improve the sustainability of the health care system, we have made significant progress on a number of key drug safety issues. Canadians want and deserve to depend on and trust the care they receive. To that end, I'd like to thank the committee for its thoughtful study of our government's signature patient safety legislation, Vanessa's Law. Building on the consultations that we held with Canadians prior to its introduction, this committee's careful review of Vanessa's Law, including the helpful amendments that were brought forward by MP Young, served to strengthen the bill and will improve the transparency that Canadians expect.
Vanessa's Law, as you know, introduces the most significant improvements to drug safety in Canada in more than 50 years. It allows me, as minister, to recall unsafe drugs and to impose tough new penalties, including jail time and fines up to $5 million per day, instead of what is the current $5,000 a day. It also compels drug companies to do further testing and revise labels in plain language to clearly reflect health risk information, including updates for health warnings for children. It will also enhance surveillance by requiring mandatory adverse drug reaction reporting by health care institutions, and requires new transparency for Health Canada's regulatory decisions about drug approvals.
To ensure the new transparency powers are providing the kind of information that Canadian families and researchers are looking for, we've also just launched further consultations asking about the types of information that are most useful to improve drug safety. Beyond the improvements in Vanessa's Law, we're making great progress and increasing transparency through Health Canada's regulatory transparency and openness framework. In addition to posting summaries of drug safety reviews that patients and medical professionals can use to make informed decisions, we are now also publishing more detailed inspection information on companies and facilities that make drugs. This includes inspection dates, licence status, types of risks observed, and measures that are taken by Health Canada. Patients can also check Health Canada's clinical trials database to determine if a trial they are interested in has met regulatory requirements.
Another priority of mine is tackling the issue of drug abuse and addiction in Canada. There's no question that addiction to dangerous drugs has a devastating and widespread impact on Canadian families and communities. In line with recommendations from this committee, I am pleased that the marketing campaign launched last fall by Health Canada is helping parents talk with their teenagers about the dangers of smoking marijuana and prescription drug abuse. The campaign addresses both of those things, because too many of our young people are abusing drugs that are meant to heal them.
Our government also recognizes that those struggling with drug addictions need help to recover a drug-free life. From a federal perspective, of course, we provide assistance for prevention and treatment projects under our national anti-drug strategy. We've now committed over $44 million to expand the strategy to include prescription drug abuse and are continuing to work with the provinces to improve drug treatment.
I've now met and will continue to meet with physicians, pharmacists, first nations, law enforcement, addictions specialists, medical experts, and of course parents to discuss how we can collectively tackle prescription drug abuse.
Finally, our government continues to make very real investments to strengthen our food safety system. As only the latest example, I recently announced a five-year investment of more than $30 million in the CFIA's new food safety information network. Through this modern network, food safety experts will be better connected, and laboratories will be able to share urgently needed surveillance information and food safety data, using a secure web platform. This will put us in an even better position to protect Canadians from food safety risk by improving our ability to actually anticipate, detect, and then effectively deal with food safety issues. This investment will continue to build on the record levels of funding we've already provided, as well as the improved powers such as tougher penalties, enhanced controls on E. coli, new meat labelling requirements, and improved inspection oversight.
In conclusion, those are just some of the priorities that will be supported through the funding our government has allocated to the Health portfolio. This year's main estimates, notably, include investments for first nations health, for our ongoing contribution to the international response to the Ebola outbreak in West Africa, and the key research and food safety investments that I have already mentioned.
I'll leave it at that. If committee members have any questions, my officials and I would be very pleased to answer them. Thank you.
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View Hedy Fry Profile
Lib. (BC)
View Hedy Fry Profile
2012-04-03 10:11
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Thank you very much for your presentation, Mr. Glover, Ms. Mullin, and Ms. Sabourin.
In countries that have dealt successfully with this drug shortage, such as New Zealand and the United States, they do a couple of important things: they identify the drugs that are going to be short, they anticipate, and they manage.
Now given that you, as a federal government, are responsible for regulation and approval, you have a huge role to play in identifying and managing and fast-forwarding areas where you think there's going to be a shortage and in other areas involving manufacturing the drugs, etc. There is a role.
We heard from many people who presented here that the Food and Drug Administration has been very successful in using their mandate to predict, identify, and manage shortages. First and foremost, patients need medication when they need medication. Many patients who don't get that medication could die or could be severely impaired for the rest of their lives.
When we start talking about whose jurisdiction is what, it becomes moot. It isn't really about who you pick up the phone and call; it is about whether the patient gets the drug and gets to be well. At the end of the day, I think the responsibility rests with the people who regulate the drugs and who are able to work with others—as I would like to say, a leader—to try to find a way around this problem. It's about human beings. It's about Canadians. It's about protecting them and caring for them.
We're trying to find a resolution here. It's not a case of fault or blame. Could we put that aside for a minute?
In November 2011 the Food and Drug Administration told Sandoz that they did not comply with manufacturing standards. Was your department aware of that in November 2011? Were you aware then of what that impact could be on real people? I hope you didn't know. If you had, I would have thought you would have felt it was a moral obligation to warn people that this was going to happen, so that doctors, anesthetists, pharmacists, hospitals, etc. could start stockpiling.
Were you aware of the November 2011 FDA ruling? If you were, did you tell people? Did you warn them? If you didn't, why not? That's my first question.
Second, I continue to hear the federal government saying that they are just regulators and approvers, but you're the fifth-largest deliverer of health care in this country, so you're not just regulators and approval parties. You actually deliver services to the armed forces, the Inuit, the first nations, etc., so you need to know how these people you deliver services to are going to be able to get their medications and be able to get help.
Can you give me an answer about your knowledge of Sandoz and about thinking a federal leadership role is required, first in delivering care to the people you need to and second in terms of coming together and working with the provinces to make sure Canadians get drugs?
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Paul Glover
View Paul Glover Profile
Paul Glover
2012-04-03 10:15
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First and foremost, we agree that patients need to come first. We absolutely understand and respect that, and that's why we're doing our part in this time of crisis. We are not hiding behind our role, our jurisdiction, and we have taken extraordinary measures to expedite review processes to approve drugs through the special access program. However, as the member pointed out, all parties need to step up and do their part if we're going to be able to deal with these shortages. We continue to believe that we play a unique role, as do other parts of the health system, and we must all step up equally to respond to this challenge.
With respect to the November warning letter that was issued by the FDA, there are a couple of elements that are important for the committee to clearly understand. The FDA issued its warning letter. That was made publicly available. We saw it on the FDA's website in December. That was a warning letter. There was a deficiency, and it asked Sandoz to respond to that deficiency. It did not close the plant. It was not specific to Sandoz Boucherville; there are two sites in the U.S. It was a warning letter that did reference Sandoz but also included other sites in the United States.
It's also important to note that Health Canada had been in and inspected the Sandoz plant. As with the FDA, we had observations with respect to our inspection and had written to the company asking them to follow up with us as well. At no point were we aware that there would be a shortage, the crisis that we are facing today.
We followed up with Sandoz through the months of November, December, and January to understand how they would be responding to both our observations as a regulator in Canada and in regard to what they would be doing in response to the FDA. We were not fully aware of the full extent to which Sandoz would be dealing with this until they publicly wrote to all of their clients.
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View Dany Morin Profile
NDP (QC)
View Dany Morin Profile
2012-03-29 10:25
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Thank you, Madam Chair.
First off, I want to offer a special thanks to my colleague Anne Minh-Thu Quach for being the first member of Parliament to raise the drug shortage issue involving Sandoz in the House of Commons. I am proud to belong to a party that sees drug shortages as important and one that shows leadership.
Ms. Quach then addressed a question to the Parliamentary Secretary to the Minister of Health, Mr. Carrie. He replied that he would see to it that the appropriate information was provided to the right people at the right time and that, as a result, doctors, pharmacists and patients would be informed of what was happening with enough advance notice to adjust treatments if need be. That was his reply. If I go by that, I am inclined to think that the government is showing leadership, although everything you have said suggests that the federal Conservative government has failed to show any leadership in this matter.
Furthermore, Ms. Lamarre, I was quite struck by something you said: between 2006 and 2010, shortages had quadrupled. You even said the most recent shortage was widespread. That is disturbing, indeed.
I want to pick up on what my colleague Libby Davies pointed out. In 2008, the industry minister, Tony Clement, was made aware through a report by the Competition Bureau. In 2011, the Canadian Anesthesiologists' Society also contacted the Minister of Health, Ms. Aglukkaq, who has been on the job for four years. Unfortunately, raising the matter with cabinet or even Ms. Aglukkaq's office does not do any good. I agree with you, the government is failing to show leadership on this issue, and I find that appalling.
What's more, as Dr. Haggie mentioned, the current government prefers to point the finger at the provinces. Ms. Leitch, a Conservative member, repeated that position today. She blamed health professionals for not monitoring the situation, and the provinces, saying it was their problem.
What it boils down to, in my opinion—and I would like Dr. Haggie to comment on this—is a lack of leadership by the federal government and a passing of the buck to the provinces. It is already common knowledge that there is a doctor shortage in the provinces, at least in Quebec, and given the scarce drug supply, some treatments and surgeries are being delayed. Provincial wait times to see a doctor and receive treatment for a variety of conditions will increase. So that will be the provinces' problem, not the Government of Canada's. I am appalled by this lack of leadership. I want to hear your thoughts, Dr. Haggie, on what I just said.
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John Haggie
View John Haggie Profile
John Haggie
2012-03-29 10:28
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Looking at it from a patient's perspective, they don't have a grasp of the niceties of jurisdictional disputes. They really don't understand how it is that the drugs they get actually get to them. To be perfectly honest, before these last few weeks, I was pretty well completely ignorant as well. I'm not sure I'm any wiser now, because what this whole exercise has highlighted to me is that there isn't a seamless approach to health care. There isn't a seamless approach to the issue of pharmaceuticals.
You could almost argue that pharmaceuticals now are the defining modality of medical management. When I trained, we were on the end of fixing things surgically. Diseases I treated with a knife, as a resident, are now treated medically, for the benefit of the vast majority of patients. Drugs are no longer just one of those things that are there as an optional extra.
I turn it back from the patient's point of view and say that the constitutional debate, the funding debate, the financing debate between health boards, provinces, and the national group has not informed them. It has not made them feel comfortable. It has not made them feel as though things are moving in the right direction. Finger pointing and blame....
You need to learn from case studies, and where you stand on that depends on where you sit, quite frankly.
As Rick Hillier, another Newfoundlander, said, no good crisis should go to waste. The one good thing that could come out of this is that we can do it a hell of a lot better next time and we won't end up in this pickle in the future. If that requires that the feds and the provinces and the territories sit down together and actually talk to each other, is that such a bad thing?
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View Libby Davies Profile
NDP (BC)
View Libby Davies Profile
2011-11-21 15:47
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Thank you very much, Chairperson.
To the minister, thank you for coming today and for your presentation. You've presented some information, but I have to say from hearing you and reading through your brief, I think there are several major issues facing our health care system that are not being addressed by the federal government. I'd like to focus on that by asking you some questions.
You've spoken a little about one of the issues, which is the shortage of drugs. I noted in the House today that you said you're very happy there's now a plan; you asked these drug companies to come up with something. I would point out that this was all done behind closed doors.
We wanted to study this at the health committee. There's been no discussion here. There's been no public disclosure. I think it's very obvious that a pledge to post information is just that: it's just providing information. It doesn't actually resolve the problem of the drug shortages themselves. As I'm sure you're aware, a number of medical journals, academics, and health professionals seriously question why these shortages exist. It's very interesting that the shortages seem to be mostly among the older generic drugs—some of which have been around for 50 years—forcing people to pay more.
I'm very perplexed that your government's response, your response, to this is basically to say, well, post the information. That's not resolving the question, Minister. We'd like to know what you intend to do to ensure that these shortages, which put people in jeopardy, don't continue to exist. I think this is very much related to the whole question of affordable drugs and accessibility.
As you know, in the 2004 health accord, a commitment was made for a universal prescription drug coverage plan. We can go as far back as 1964 to 1997 to 2002—the Romanow commission, the 2004 accord—and when we look at the reality of what's going on, we can see again that the federal government has taken no action in addressing this critical issue.
So these two things are related. I find it very problematic that we've seen nothing from you or the government to address what is now the biggest cost in our health care system, and that's the cost of prescription drugs, and now we've got shortages as well.
I'd like you to respond to that and say why nothing has been done and what is intended to be done, to address these two issues.
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