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View Rona Ambrose Profile
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.
David Eaves
View David Eaves Profile
David Eaves
2014-04-03 8:57
If I were looking at this committee and I was trying to think about how we were going to assess the value of Canada's open data policies, I'd be looking at three things.
The first thing I'd be looking at is whether we are thinking strategically about the policy in economic areas that we want to be driving into and what the data is that we're releasing that might support those places.
The second is whether we are thinking hard about how government itself is using the open data that it releases, so it does what we call “dogfooding”, which is that it uses its own information rather than sharing with others and expecting them to use it, but using something completely different itself.
The third is whether we are actually sharing information about government itself. Where is the budget? Where are the things that make government transparent so that citizens themselves can better understand and make government more legible, so they can become more engaged in the political process and contribute in interesting ways in the policy debates?
Thank you.
Mark Gayler
View Mark Gayler Profile
Mark Gayler
2014-04-03 9:06
Hello, and thank you to the committee for inviting me to participate this morning. It's bright and early in Vancouver.
My name is Mark Gayler. I work for Microsoft Canada. I've been working with Microsoft for more than 10 years. I'm a technology strategist for Microsoft Canada. I work primarily with municipalities. As part of that role, I'm a subject matter expert on open data and open source technologies.
I'd like to comment on a few things. First of all, I very much appreciate the comments by my colleagues David and Ms. Miller just previously.
One of the things I have experience with is working with different governments around the world, and so I've been engaged with open data projects in Canada, but also in the U.S.A.., Colombia, Japan, central and eastern Europe, and the U.K. I'd like to make some comparisons, even though I totally and fully agree with David's comment earlier on that it's dangerous to make comparisons in terms of a league table. But I think there are some insights we can gain from what other countries are doing compared with how open data has evolved in Canada today.
I'd like to start there, and then I'd like to pick up on a couple of other points that my colleagues have raised already.
What is interesting about the way open data is evolving around the world is that it's evolving in different ways based on the way that government agencies have chosen to engage it.
For example, in the U.K. and the U.S., we see a very top-down approach whereby the U.K. and U.S. governments at the very top levels of government have sponsored open data initiatives. They are driving adoption of open data throughout government departments and agencies, and we see this top-down approach as it flows downwards through the government infrastructure.
I would say that in Canada what we have seen is more of a bottom-up approach to open data. In early days it was adopted primarily by the cities, and then the provinces caught up. I think Vancouver started in April 2009, and we have seen other cities adopt open data initiatives. Then the provinces have come in, and I think the federal government has come in after some of these cities and smaller agencies had already adopted open data initiatives.
That explains why we see different countries and different initiatives at different stages of evolution, to a certain degree.
In the U.K. and U.S., I would say that open data initiatives across government are fairly mature and fairly consistent in the way open data is thought of. I would say that in Canada we see open data being adopted in different ways at different levels of government jurisdiction.
The second point I'd like to make around this is that as we look around the world, it's important to understand that open data itself is not an end point. Open data is a transition to something else. It's an enabler for other things to happen. It's an enabler for such things as economic stimulus, as we have discussed, and I'm sure we'll discuss more on that during the session. It's an enabler particularly for citizen engagement, getting citizens actively involved and participating in the business of government.
I think it also represents a cultural change internally for government and government agencies. When I've been around the world talking to national and provincial and state governments about their open data initiatives and the way we can use open data to engage citizens, particularly those parts of citizenry we may not already be engaged with, a big comment that I get at the end of my engagement with that particular government is: this is great, but now that we have this capability to share data and to collaborate, we want to do it internally as much as we want to do it externally. I think that point was made very well by my colleagues previously.
The opportunity for the Canadian government here is to provide guidance, to provide a framework to take the open data initiatives that already exist, to create opportunities to share more open data, to engage citizens and third parties and encourage them to share this data and use this data, and to enable the sharing of the data in such a way that it can easily be consumed by any of the actors in the ecosystem, be it a data scientist, a researcher, a citizen, an application developer, or a student.
But it's very important that we understand that this is a cultural change that will lead to other positive benefits; this is not just about sharing data itself. And so it's important that the government provide a framework to encourage parties to collaborate around the sharing and reuse of open data—private-public partnerships, for example—and particularly engage those parts of the citizenry with whom perhaps we are not already engaged and get them actively involved in the business of government.
Let me give you a very simple example. Two weeks ago we ran a teen hackathon in the city of Surrey. The City of Surrey is sharing its open data; they have an open data portal. They invited teens, young people from the ages of 13 to 19, to participate in this hackathon. For half a day we worked with them with technology and showed them how to produce applications. What was interesting is that at the end of it we asked for feedback and ideas, and it was amazing to see these teenagers come up with ideas about how to use transit data to better navigate through the city, how to use weather data to better understand when weather might affect particular tourist spots or landmarks.
You could look at that initially and just say that these are interesting ideas but ask whether they would ever come to any kind of fruition. But what was really interesting about the whole thing was that the city was stimulating students and young people to think about engaging the city in ways that had not previously been possible. These were young people who were thinking about actively working with the city—visitors to the city, citizens of the city. Getting them excited and engaged in looking at ways to improve city services both for visitors and for folks who already live in the city is quite transformational. This is a very simple example of transformational cultural change that can be brought about by sharing open data.
Another example I will give you, from a cultural aspect, comes from when I was engaged with the Government of Colombia. I was invited down there to provide some guidance to them about the way they would share data with their citizens. When I went down there I said I was surprised that the Government of Colombia was thinking about sharing open data, because they're not known, to an external person, for their openness or the way they might engage a citizen in a transparent way; that it might be considered to be a threat to the government.
They said that this was their entire reason for doing it. Whereas other governments say they're doing this for economic stimulus or doing it for better engagement with certain parts of society, in Colombia they are doing it deliberately to show that they're being open and transparent. This is part of their cultural change with their citizens.
The last point I would like to make is that I think the opportunity is huge for Canada to be a leader in this area. Even though we look around the world and see open data initiatives evolving in different ways, we have a long way to go with open data, to speak to David's point earlier on. There is much more that can be done and there is much more transformational benefit that can arise out of open data.
But I think the government can help. It can stimulate this by providing, for frameworks for working particularly in public-private partnerships, guidance in the sharing and openness of data, and also by providing ideas and guidance about the sustainability of open data and how it can be part of the ongoing business of government and citizen engagement, rather than just being seen as an end in itself.
Thank you very much.
Michael Ferguson
View Michael Ferguson Profile
Michael Ferguson
2013-11-27 15:33
Thank you.
Mr. Chair, I am pleased to present my Fall 2013 Report, which was tabled in the House of Commons yesterday. I am accompanied by assistant auditors general Wendy Loschiuk and Maurice Laplante, and principals Gordon Stock and John Affleck.
This report touches on a range of long-standing issues the government has been struggling to address, with potentially significant impacts for Canadians.
Rail safety is one such issue. Fourteen years ago, Transport Canada recognized the need to shift from an inspection-based oversight approach to one that integrates the oversight of safety management systems. This shift is ongoing. Much work remains to be done, and the transition is taking too long.
Transport Canada completed only 26% of its planned audits of federal railways over a three-year period. Most of these audits were narrowly focused and provided assurance on only a few aspects of railway safety management systems. The department has yet to establish an audit approach that provides a minimum level of assurance that federal railways have implemented adequate and effective safety management systems for complying on a day-to-day basis with Canada's framework for rail safety.
Our audit of Canada's food recall system showed that the Canadian Food Inspection Agency does a good job of managing most aspects of recalls. However, the weaknesses we saw in both follow-ups with industry and in large emergency recalls leave significant gaps in the system. While illnesses were contained in the recalls we examined, I'm not confident the system will always yield similar results. The weaknesses we found in decision-making and follow-up stand in the way of the continuous improvement of a system intended to deal with food safety incidents in Canada.
In this report, we also looked at how the Canada Revenue Agency followed up on a list of possible Canadian residents with accounts in a European bank. The Canada Revenue Agency's initial work on offshore banking information shows promise. However, with more lists to look at and changes in legislation that will give the agency access to more information, I believe that it needs to formalize its approach to deal with the increase in its workload.
In another audit, we looked at border controls to prevent illegal entry into Canada. It is very important for the safety of Canadians that controls at the border work as they are supposed to. I am very concerned that our audit found too many examples of controls not working.
Though the Canada Border Services Agency has made significant progress in some of its efforts to detect high risk travellers, it often does not get the information it needs to identify these travellers before they arrive in Canada. Furthermore, even when the agency has the information, we found that controls do not always work. We also found that the RCMP does not know the extent to which it is successful in intercepting people who enter the country illegally between ports of entry.
Though it is not the first time we have raised these issues, border controls are still not working as they should. With better analysis of existing information and better monitoring, many of these issues can be fixed.
Our audit of disaster assistance to agricultural producers is an example of a program with a disconnect between the program's objectives and its outcomes.
Providing quick assistance to agricultural producers is a key goal of the AgriRecovery program. While Agriculture and Agri-Food Canada has delivered assistance to producers for large disasters within their targeted timeline, those producers impacted by disasters with a smaller total payout often wait more than a year for financial help.
Agriculture and Agri-Food Canada needs to streamline its processes for smaller initiatives, and it must track whether it is meeting its timelines.
Let's now move on to our audit of online government services. We found that, since 2005, the government has not significantly expanded the services it offers online to its citizens. As Canadians rely more on the Internet in their day-to-day lives, they expect the government to provide them with online information and services that address their needs.
The government has estimated that savings can be realized by providing better online services for Canadians, but there needs to be a concerted client-focussed strategy. Departments need to work together to make this happen.
Our audit of Aboriginal Affairs and Northern Development Canada's role in supporting emergency management on first nations reserves showed that the department is in a cycle of reacting to emergencies. It has not been able to focus on what can be done to prevent and mitigate these events.
Some reserves continue to be adversely affected in significant ways by repeated emergencies, such as floods. These difficulties are compounded by the fact that the respective roles and responsibilities of the federal government and other stakeholders are unclear. Aboriginal Affairs and Northern Development Canada must work with other stakeholders, including first nations, to reduce the human and financial costs of emergencies over the long term.
We also followed up on our audit of internal controls over financial reporting. Eight years after the government made it a priority to have in place effective internal controls over financial reporting, I am concerned that several large departments are still years away from knowing whether these controls are in place and working effectively. With annual spending of nearly $300 billion across government, effective internal controls are a necessary part of safeguarding public assets. It is imperative that departments get this work done without further delay.
This report also looked at the national shipbuilding procurement strategy, specifically whether it has been designed and managed to help sustain Canadian shipbuilding capacity and capability over the coming decades. It's still early, but so far the strategy has resulted in the transparent and efficient selection of two yards to build ships for the navy and the coast guard.
Although only a few contracts have signed to date, and it will be a few years before any ships are delivered, the national shipbuilding procurement strategy shows promise. As with anything new, there are risks involved, and these will need to be closely monitored on an ongoing basis.
A look over the audits that we are reporting on today shows that, in many cases, the results need to be improved. Even when the government recognizes a problem, it takes too long to develop and implement solutions. The resulting delays can have significant impacts on Canadians, both directly and indirectly.
Departments need to focus on critical success factors that are proven to work. These include setting clear priorities, applying lessons learned, and monitoring deliverables against timelines and objectives.
Mr. Chair, that concludes my opening statement.
We are happy to answer any questions the members may have. Thank you.
Peter Gillespie
View Peter Gillespie Profile
Peter Gillespie
2013-02-07 9:04
Thank you and good morning.
Just as a note, the Halifax Initiative, the organization I am with, is a coalition of Canadian NGOs, labour, and faith-based groups, and we focus on international economic issues.
Personally, I am not a tax attorney. I have spent the last 30 years of my life working with anti-poverty organizations in Asia and Africa, and thus my comments today will focus largely on the role of tax havens in facilitating tax losses from developing countries. Tom has certainly already spoken about that.
I will also comment on the part that Canada can play to promote transparency in international finance.
As my colleague Tom said, tax havens are essentially secrecy jurisdictions, and these jurisdictions enable people or entities to escape the laws, rules, and regulations of other countries.
I know that some of you met James Henry when my organization brought him to Ottawa last November. Mr. Henry conducted a major piece of research into how much individual wealth has been channelled through offshore tax havens. That study estimated that $21 trillion to $32 trillion of the financial wealth of individuals from 139 low- to middle-income countries has been channelled tax-free through more than 80 offshore tax havens. This represents tax losses to these countries of almost $200 billion a year.
Colleagues at the University of Massachusetts have found that $700 billion fled 33 sub-Saharan African countries between 1970 and 2008. This means that sub-Saharan Africa is a net creditor to the rest of the world, its foreign assets far exceeding its foreign debts of about $175 billion. A significant proportion of these assets is in the hands of individuals.
In 2007 African high-net-worth individuals had offshore assets of $1 trillion. As my colleagues have said, tax havens also provide opportunities for multinational companies to reduce or eliminate their tax obligations. By establishing subsidiaries in tax havens, they can transfer profits from high-tax to low-tax jurisdictions. A recent study by Christian Aid calculated that between 2005 and 2007, transfer mispricing shifted $8.5 billion out of the world's 49 poorest countries, resulting in tax losses of $2.6 billion over that three-year period.
An African colleague of mine was speaking at a conference this week in South Africa, and he asked, “How is it possible that a company with 3,000 employees in Malawi and three employees in the Cayman Islands can attribute 70% of its profits to the Cayman Islands?”
The deputy finance minister of Zambia said a month ago that most international mining companies operating in Zambia report that they're unprofitable and thus pay no corporate income tax. He reckons that his country loses $2 billion a year due to profit-shifting. He said, “That money could build a lot of hospitals and schools.”
This reality has deadly outcomes for poor countries. It reduces the capacity of poor countries to finance essential public services. It contributes to higher child mortality rates—there's research on that—and it undermines development assistance from countries like Canada.
So we have four propositions, some of which Tom has already alluded to.
First, we believe that a multilateral framework for the automatic exchange of tax information needs to be established, requiring all governments to collect data from financial institutions on income paid to non-residents, corporations, and trusts.
Second, we need to put an end to the secrecy provisions that provide anonymity to individuals and companies. The beneficial ownership, control, and accounts of companies, trusts, and foundations should be on the public record.
Thirdly, we believe—Tom mentioned this—that transnational companies should be required to report all of their financial transactions: sales, purchases, labour costs, financing costs, taxes, and value of assets on a country-by-country basis. This would reduce the ability of corporations to shift profits to low-tax jurisdictions and costs to high-tax jurisdictions. We have made submissions on this issue to the International Accounting Standards Board.
Lastly, we support the call of many developing countries to transform the UN tax committee into an intergovernmental commission, a proposal that Canada has to date opposed. International tax policy has been dominated by the OECD, an association of 34 wealthy countries. Developing countries want an international forum where their needs and interests on tax matters are represented.
We believe that Canada should be a leader in the G-8, the G-20, the OECD, in promoting transparency in finance and in promoting tax compliance. Prime Minister Cameron has said that corporate tax avoidance will be a priority agenda item during Britain's G-8 presidency this year, and we hope that Canada will support and engage in that initiative.
Our proposals are ambitious, but the stakes are high. If these massive outflows from developing countries can be curtailed, it could lead to major improvements in the lives of millions of poor people.
Thank you.
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