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Results: 1 - 28 of 28
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 Dave MacKenzie Profile
CPC (ON)
View Dave MacKenzie Profile
2014-05-15 10:30
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Okay. I thank you.
The another area that we see frequently, certainly in my home province of Ontario, is that money in health care has not necessarily gone to health care. The federal government does not have controls over the province in the administration of delivery of its health care system. When we look at what we could do with innovation and research with money, how do we better work together with our provinces on the delivery, which is their responsibility? How do we better work with them to try and provide some direction or guidance?
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George Da Pont
View George Da Pont Profile
George Da Pont
2014-05-15 10:31
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In my experience, not all provinces want direction and guidance, but the main mechanism is as the minister noted—the regular meetings that she has with all of the provincial health ministers. They identify areas of common concern, areas where they can work together. Prescription drug abuse is one, or looking at bulk buying of drugs. There is a variety of things that are carved out in that process, where the federal government and the provinces work together, looking at, as the minister said, having the innovation panel looking at this more broadly and seeing what ideas there are for best practices and things that we could adopt, either best practices that are already under way in some part of this country or from abroad.
I think that will be a catalyst, hopefully, to look at some of these issues on a broader basis.
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Michael Ferguson
View Michael Ferguson Profile
Michael Ferguson
2012-10-25 11:37
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Thank you, Mr. Chair.
Mr. Chair, I am pleased to present my report, which was tabled in the House of Commons last Tuesday.
I am accompanied by Assistant Auditors General Jerome Berthelette and Wendy Loschiuk, as well as by Glenn Wheeler, the principal responsible for the audit of transfer payments to the aerospace sector.
The report contains the results of that audit. In the first chapter, we looked at how Public Works and Government Services Canada, Health Canada, and Human Resources and Skills Development Canada plan their use of professional service contractors. We found that the departments plan their needs for employees and contractors separately. This hampers their ability to assess whether they have the best mix of employees and contractors to meet their objectives.
Departments need to consider the full range of options that will enable them to most effectively deliver programs and services to Canadians.
I'll move now to our report about grant and contribution program reforms. In May 2008 the government announced an action plan to reform the administration of grant and contribution programs and to streamline the administrative and reporting burden on recipients. Our audit looked at whether the government has adequately implemented this action plan. We found that the government has in fact focused its actions where they're most important. Treasury Board Secretariat has provided leadership and guidance to federal organizations to make the necessary changes, and these organizations have acted on most of their obligations. The government has made good progress in implementing the 2008 action plan. Now it needs to determine if the actions taken have made a difference for recipients.
Let's turn now to our audit about what government is doing to help protect Canadian infrastructure against cyber threats. Critical infrastructure includes the power grid, banking and telephone systems, and the government's own information systems. The government has a leadership role to play in ensuring that information about threats is shared, and it has to improve the way it does this. This is important because officials are concerned that cyber threats are evolving faster than the government can keep pace.
In 2001 the government committed to building partnerships with the owners and operators of critical infrastructure systems to share information and provide technical support. We found that 11 years later, those arrangements are not fully operational. Similarly, the Canadian Cyber Incident Response Centre has only been operating eight hours a day, five days a week. It's not the 24/7 information hub it was designed to be in 2005. Furthermore, it's not being kept abreast of cyber security incidents in a timely manner.
Since 2010, the government has made some progress in protecting its own systems and building partnerships to secure Canada's infrastructure. The government must now ensure that the sector networks are in place and working with the Cyber Incident Response Centre.
We are also reporting on how National Defence and Veterans Affairs Canada manage selected programs, benefits, and services to support eligible ill and injured Canadian Forces members and veterans in the transition to civilian life.
There are many support programs, benefits, and services in place to help ill and injured members of the military make the transition to civilian life. However, we found that understanding and accessing these supports is often complex, lengthy, and challenging. The lack of clear information about programs and services, the complexity of eligibility criteria, and the dependence on paper-based systems are some of the difficulties for both clients and departmental staff.
We also found inconsistencies in how individual cases are managed and problem-sharing information between the two departments. As a result, forces members and veterans did not always receive services and benefits in a timely manner or at all.
National Defence and Veterans Affairs recognize they need to work together on solutions. I'm pleased they've accepted our recommendations, including to streamline their processes to make programs more accessible for ill and injured forces members and veterans.
The next report also concerns National Defence—specifically, how the department is managing its real property at 21 main bases across Canada. The Canadian Forces rely on real property such as buildings, airfields and training facilities to carry out missions. These assets are valued at $22 billion. I am concerned that the department is not yet adequately maintaining and renewing its assets.
We found several weaknesses in the department’s management practices. For example, the approval process for construction projects is cumbersome and slow. It takes an average of 6 years to approve projects over $5 million.
We also found that National Defence is behind in its spending targets for maintenance and repair, and recapitalization. As such, weaknesses in National Defence’s management of real property could jeopardize the Canadian Forces’ ability to carry out its missions. National Defence recognizes it needs to improve and change its approach to managing real property.
We also looked at two programs that provide repayable assistance to support industrial research and development in Canada’s aerospace sector. Since 2007, Industry Canada has authorized almost $1.2 billion in assistance to 23 Canadian aerospace companies through the Strategic Aerospace and Defence Initiative and the Bombardier CSeries Program. Industry Canada has done a good job of managing most of the administrative aspects of the two transfer payment programs. However, we found that the department has been slow to measure progress against program objectives and report results publicly. Repayable support to the aerospace sector represents a significant investment on behalf of Canadians. Industry Canada has a responsibility to ensure that funding contributes to meeting the government’s objectives in this area.
Finally, in our audit focusing on long-term fiscal sustainability, we found that Finance Canada analyzes and considers the long-term fiscal impact of the policy measures it recommends. However, at the time of the audit, the government had yet to make public its reports on long-term fiscal sustainability. Analysis that provides a long-term budgetary perspective would help parliamentarians and Canadians better understand the fiscal challenges facing the federal government.
The department has accepted our recommendations. Following the tabling of my report in Parliament, the department issued its first long-term analysis for the federal government. We also recommended that the department publish, from time to time, an analysis for all governments combined—federal, provincial, and territorial—to give a total Canadian perspective.
Mr. Chair, that concludes my opening statement.
We will be happy to answer any questions you may have.
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Neil Maxwell
View Neil Maxwell Profile
Neil Maxwell
2012-03-29 8:53
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Thank you, Mr. Chair.
Thank you for this opportunity to present the results of our audit on regulating pharmaceutical drugs at Health Canada.
With me today, as you noted, is Louise Dubé, the principal responsible for audits in the health sector.
There are about 13,000 prescription and non-prescription drugs on the Canadian market. Pharmaceutical drugs play an important role in Canada's health care system and economy. Health Canada regulates the safety, efficacy, and quality of all pharmaceutical drugs in Canada before and after the products enter the Canadian marketplace.
The department does this through a combination of scientific review, monitoring, compliance, and enforcement activities. It aims to ensure that the public has timely access to safe and effective pharmaceutical drugs, and that those who need to know of safety concerns are informed.
For our 2011 fall report, we examined whether Health Canada fulfilled its key responsibilities for pharmaceutical drugs. These responsibilities involved timeliness, consistency, transparency, conflict of interest, and risk-based post-market activities.
We found that the department had not adequately fulfilled most of these key responsibilities related to clinical trials, submission reviews, and post-market activities.
In particular, we found that Health Canada had problems with the timelines and transparency of its activities.
Health Canada is not meeting its service standards for the timely review of most of the drug submissions it receives, thus delaying Canadians' access to the health benefits of new drugs. It is also delaying access to more affordable treatments.
Health Canada has established processes to identify potential safety issues for marketed drugs, but it is slow to act. It can take the department more than two years to complete an assessment of potential safety issues and to provide Canadians with new safety information.
In 2004, the House of Commons Standing Committee on Health recommended that this department create a public database to provide information on clinical trials in progress, abandoned and completed. Health Canada committed to enhancing public access to information about clinical trials. In the fall 2011 audit, we found that, despite this commitment, Health Canada had not taken action. This lack of information increases the risk that Canadians may be unaware of new treatment options or may unknowingly participated in an unauthorized trial.
The department is also not disclosing information on drugs that it rejects, drugs that the manufacturer withdraws from the review process, or drugs with conditions.
Health care providers have the discretion to prescribe a drug for conditions that the drug has not been authorized to treat. Therefore, it is important that health care providers be informed when the department rejects a marketed drug for a new use, so they understand the department's concerns.
We reported very similar findings in our June 2011 report on the regulation of medical devices about a lack of timeliness to review submissions related to those devices. We found that Health Canada was not making use of assessment work done in other jurisdictions, as part of its own assessments of the safety and efficacy of medical devices that could lead to program efficiencies. Health Canada has recently launched an initiative to make greater use of this information for medical devices and pharmaceuticals.
We are pleased that Health Canada has agreed with our recommendations from both reports and that it has developed action plans to address them.
The regulation of pharmaceutical drugs is important to Canadians. With an aging population, the role of pharmaceuticals is expected to grow as researchers come up with new therapies to replace earlier treatments or provide new options where no treatment existed before. The committee may wish to obtain the assurance and commitment from Health Canada to implement our recommendations in a timely manner.
Mr. Chair, that concludes my opening statement. We would be pleased to answer your committee's questions.
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Glenda Yeates
View Glenda Yeates Profile
Glenda Yeates
2012-03-29 8:57
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Thank you very much, Mr. Chair, and good morning to you and members of the committee.
Thank you for the opportunity to appear before the committee to discuss chapter 4 of the Auditor General's report dealing with the regulation of pharmaceutical drugs in Canada. I am joined here today, as was noted, by Paul Glover, assistant deputy minister of the health products and food branch, and Dr. Marc Berthiaume, director of the marketed health products directorate.
Canada has one of the safest and most rigorous drug safety systems in the world. At Health Canada, we take our regulatory role in support of the drug safety system very seriously and carry it out in a scientifically rigorous and independent manner. We know, however, that there is always room for improvement.
In this spirit, I would like to thank the Auditor General for his work. As the Auditor General noted, we need to improve the timeliness of our reviews; we can better document and accelerate the process of identifying potential safety issues; and we can increase the amount of information available to Canadians about our processes.
We do, Mr. Chair, as was noted, have a detailed action plan, which has been tabled with the committee. I can assure the committee of our commitment to carry out these actions as part of our ongoing process to improve how we protect the health and safety of Canadians.
I am pleased to report that as of April 1, 2011, we have significantly more resources available to fulfill our mandate as a result of our new cost-recovery program.
As was supported by the Auditor General in a previous audit, we have now increased fees that are charged to industry in support of drug applications, thereby returning us to a more historically balanced funding model. As a result, Canada is now much more in line with comparable international regulatory agencies such as the United States Food and Drug Administration and Europe's European Medicines Agency.
These fees are expected to generate, and in fact, are already generating significant new revenues. These incremental resources have already enabled us to hire 160 new staff, strengthen our capacity to improve our processes, and upgrade things like our computer systems.
Now I would like to briefly describe some of the specific actions that either have been taken or are under way to improve the safety, transparency, and timeliness of our systems.
At Health Canada, there is no higher priority than safety. The department reviews all drugs for safety, efficacy, and quality. Canadians can be confident that the drugs approved by Health Canada have undergone a rigorous assessment against these criteria.
The Auditor General recommended that Health Canada strengthen its risk-based approach to monitoring clinical trial sites and adverse drug reaction reports during clinical trials. This past September, we introduced a risk-based approach for monitoring and assessing clinical trial adverse drug reaction reports, and we have already completed and begun to implement an updated risk-based selection process for inspection of clinical trial sites.
Moving on to transparency, Mr. Chair, we recognize that the work we do is of great interest to Canadians, and that we have a duty to make information about the safety and effectiveness of drugs available to them. As I said, we take this duty very seriously.
The department is improving transparency with respect to marketed health products with the launch of phase II of the summary basis of decision project in June. These reports will provide information in a much clearer manner so that it can be understood by Canadians.
We are improving public access to information about clinical trials by publishing summary reports about clinical trial inspections. The first of these reports was published a few days ago.
We are also making important health information more easily accessible to doctors and patients. We are working with stakeholders to make labels more understandable to Canadians, and we are posting all authorized drug labels on Health Canada's online drug product database.
We will continue to take steps through policy guidance, and if necessary, regulatory proposals to improve transparency.
We are doing a number of things to improve timeliness in our core regulatory activities.
We believe that we are making significant progress in addressing the Auditor General's concerns about the pace of assessment of potential safety issues.
We are working with the United States and some European countries to streamline our drug-submission system and share information about inspections and adverse reactions. Moving forward, we plan to expand our cooperation with other countries.
With regard to evaluating drug submissions, I am pleased to report that we are making progress. The backlog for new drug submissions was eliminated in December 2011. We do still have a challenge in meeting our performance targets for generic drug reviews and we have devoted significant new resources to tackle this area.
In summary, the Auditor General's report has been helpful in guiding some of the changes that we need to make to continue to perform our regulatory responsibilities to protect the health and safety of Canadians. We have one of the most rigorous drug safety systems in the world, and Health Canada is consistently and constantly looking for ways to strengthen it, which is why we're taking the findings of the Auditor General very seriously.
Thank you.
My colleagues and I would be pleased to take your questions.
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View Gerry Byrne Profile
Lib. (NL)
Thank you, Mr. Chair.
Health Canada has a minimum of eight years of understanding exactly what the appetite of Parliament is in terms of this issue. It has had much longer than eight years to understand the appetite of the pharmaceutical industry to want to limit disclosure and transparency. It has had much more than eight years of understanding the Canadian public's appetite to want to expand transparency.
I would like to have this included in our report, as to whether or not Health Canada's meeting what the broad objectives were originally within the Health Canada study of increased transparency.
Would you be able to explain to us or provide and maybe table to this committee not just that you have an action plan and are committed to it, but spell out to us exactly what is in the action plan? When will disclosure occur, not only for clinical trials but for marketed drugs? What information will be disclosed? How often will that information be disclosed? Can you tell us, how is it disclosed, and quite frankly, whether or not it is done in a routine and regular basis, and how inclusive it is—whether or not all drugs are being summarized or being posted or published on a regular basis, and not just whether or not intermittent inspections are being published?
Would you commit to being able to table to the committee that comprehensive form of information, providing us with exact, full details—full disclosure—of how Health Canada is going to approach this in the future?
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Glenda Yeates
View Glenda Yeates Profile
Glenda Yeates
2012-03-29 9:34
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Yes, thank you very much. We share the desire of the committee for greater transparency. In fact, as we've gone forward with our strategic thinking in terms of how we tackle this with the new resources that I've mentioned.... We have to focus first on timeliness, because we know that we had some issues. We need to focus on some of the regularization of some of the processes and making sure that we strengthen that. Transparency is very much part of our agenda. We would be pleased to give a sense to the committee of what our plan is, what we post, the progress we've made, and the progress we foresee making in the next years.
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View Joyce Bateman Profile
CPC (MB)
Thank you very much, Mr. Chair.
I want to speak to Madam Yeates and I'm going to be focusing on transparency. First I want to clarify a few things with Mr. Maxwell.
When a department heartily agrees with all of the recommendations, this is what makes Canada wonderful. This is what makes our bureaucracy a model for the world. We listen and we work in partnership to make things better for all Canadians. I compliment the work of the Auditor General, always.
Was this your first review, Mr. Maxwell, of the responsibilities for pharmaceutical drugs in regard to transparency and consistency?
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Neil Maxwell
View Neil Maxwell Profile
Neil Maxwell
2012-03-29 9:53
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We have audited almost everything in the federal government. This particular area, the regulation of pharmaceutical drugs, was something we hadn't looked at for about a decade. In my opening statement, I mentioned that we had done a similar audit of the medical devices regulation with quite similar findings. Yes, it's the first in some time.
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View Hedy Fry Profile
Lib. (BC)
View Hedy Fry Profile
2012-03-13 9:15
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Thank you very much, Madam Chair.
I want to thank the minister for coming to answer questions today, and to discuss the supplementary estimates.
I want to go straight to something that my colleague, Libby Davies, from the NDP talked about. I see that one of the major points made by the minister is that maintaining a healthy weight and a healthy diet, as well as doing regular exercise, will ensure the numbers of health-related issues in this country, including chronic diseases, go down.
The minister then went on to discuss the importance to the health care system of decreasing chronic disease and managing chronic disease well. The minister also spoke about signing a health promotion and disease prevention initiative and focusing on that.
I know, as the minister said, that there are more than 10 ways to skin a cat. But the only really important way to skin the cat is the one in which evidence has proven is the most effective way to skin the cat. We know that the most effective way to get healthy weights in this country and to bring down chronic diseases, such as diabetes caused by obesity, chronic heart disease, is to look at three very important issues: salt, trans fats, and sugar.
The minister absolutely has in her power the ability to mandate those amounts. Her own department has told her so. Advisory committees have told her so. All of the health care providers she's met with have told her so.
I'd like to know why the minister doesn't follow evidence-based decision-making in her department. It would seem to me that all of this is just a lot of talk, which we have been hearing since 2006, and nothing has been done to deal with this most significant issue.
I would like to know why the minister has in her power the ability to do this and has done absolutely nothing about it.
There is a second thing I want to ask the minister. She talks about money being spent on HIV/AIDS for a vaccine. This is good. This is very good. But is the minister aware of the fact that in British Columbia there is a proven, again evidence-based, drug that will not only treat the patient who has HIV, but by the second dose will bring down the viral load so completely that HIV will be prevented from then on. If I could not think of a better way to look at something in place of a vaccine while we're waiting for a vaccine, that's the way to do it.
I would hope that the minister would work with provinces to talk about a way of ensuring that this is part of a major HIV/AIDS strategy. It's called the HAART program. British Columbia is spending $18 million a year to treat every single person who is HIV-positive. This is a smart, evidence-based way of doing things.
So that's the second thing I want to ask the minister about.
There is a third thing I want to ask the minister. She talks very much about the crown and first nations model of health governance. Since the money for the aboriginal healing fund was transferred from the aboriginal communities into Health Canada, can the minister give me an update on how that aboriginal healing fund has progressed within Health Canada? How much of that has gone to actual aboriginal communities to work on healing, to make a difference?
In fact, INAC originally told us it was so effective they hoped this fund would continue within aboriginal communities. Health Canada should give evidence to me about the outcomes that are better than the aboriginal healing fund outcomes.
Finally, on personal health, the minister talked about a genetic profile and that you cannot pick different things to solve a problem. Well, does the minister believe that genetic profiles are the only things that cause disease? What about poverty and unemployment? What about the environment? What about smoking? What about obesity? What about alcohol? Those are things that also create disease, not merely your genetic profile.
If the minister has that kind of money to spend, I would like to know why the minister isn't dealing with bringing down chronic diseases.
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View Dany Morin Profile
NDP (QC)
Thank you very much.
The residential school system represents a shameful part of Canada's history, and we've since been forced to apologize for it. While the government's apology was certainly historic, its actions since then have done little to improve the lives of first nations in Canada. As with many things done by this government, words, sadly, were louder than actions.
As a result of continued government inaction, the suicide rate in aboriginal communities is reaching epidemic proportions in some regions of Canada. Survivors are angry and outspoken. They expect Canada, they expect Ottawa, to work with them to find long-lasting solutions for themselves and their children.
Enough is enough. When will this government stop wasting everyone's time and finally implement the recommendation of the Truth and Reconciliation Commission on the extension and enhancement of health support services?
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Glenda Yeates
View Glenda Yeates Profile
Glenda Yeates
2012-03-13 9:50
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Thank you.
The member raises a very important question. We are all very much focused on providing the kinds of supports for communities and individuals that we know are needed.
There are two things I would mention in response to the member's question about what we're doing at Health Canada as part of this process.
Budget 2010 expanded five years of coverage, essentially, for a series of prevention programs in a number of areas, including mental wellness, early childhood development, and youth suicide prevention, for example. We have a number of programs across the country. Some are in very targeted communities. For example, on youth suicide, we're working with 160 communities very specifically on this issue to try to provide prevention and support to communities. It varies community by community.
Our regions work with individual first nations and the people in those communities, and in some cases the AFN and others, to try to tailor the supports needed.
The member also raised the issue of the truth and reconciliation process. We are working very closely with that process to provide the supports we know are needed. As individuals come forward as a part of that process, they themselves need support. We've been working very closely to provide those supports. When the reconciliation commission is in a centre having discussions or hearings, we are very much there providing both health professional support and traditional support. The court has indicated that we must provide these. We are working very hard and have had some very good comments on the support we're providing under some very challenging circumstances, obviously.
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View Dany Morin Profile
NDP (QC)
Will the Minister of Health implement the three recommendations—I could read them—of the Truth and Reconciliation Commission?
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Glenda Yeates
View Glenda Yeates Profile
Glenda Yeates
2012-03-13 9:53
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I do not have those recommendations with me, Madam Chair, but we work very closely with the commission. We are going to study the recommendations and do everything we can to help and support people who need those services.
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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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View Libby Davies Profile
NDP (BC)
View Libby Davies Profile
2011-11-21 15:53
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Madam Minister, are you not concerned that in asking the drug companies themselves about these shortages you're getting a very one-sided view? It seems to many people, including academics and health care professionals, that somehow there is a shortage of generics, which happen to be the cheapest drugs.
I really don't understand your answer in terms of a lack of responsibility to follow through on this question and determine for the public interest why these shortages actually occur.
And could you also answer my other question, which is why hasn't the federal government done anything in terms of its commitment in 2004 for a universal drug coverage plan? We've made no progress on this. This is an issue that has gone into the decades. What is your government intending to do about a universal program?
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View Leona Aglukkaq Profile
CPC (NU)
View Leona Aglukkaq Profile
2011-11-21 15:58
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Before I respond, let me say that I'm also looking forward to the review that's being conducted by the Senate committee on the 10-year accord. There was a requirement under the 2004 accord that there would be an evaluation as to what had been achieved over the last 10 years, so we're looking forward to that. That will also be very helpful to the provinces and territories.
As I stated before, our government is committed to a universal and publicly funded health care system and the Canada Health Act, but the upcoming discussions with the provinces and territories will be about accountability and results for Canadians. I have already been in contact with some of my provincial and territorial counterparts for preliminary discussions as to what their priorities are in the future on a go-forward basis. As well, the meeting later this week is an opportunity to engage them in improving accountability as we move forward beyond 2014.
As we've done in the past with Quebec, our government will continue its dialogue with Quebec for the renewal of an agreement and accord. We're very mindful, again, in working with jurisdictions like B.C., that it is a provincial jurisdiction.
So we'll be following that example. I'm looking forward to my conversation with the provincial and territorial health ministers this week.
Thank you.
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View Mark Strahl Profile
CPC (BC)
Sticking with the tripartite agreement, you mentioned accountability for tax dollars. Does the framework have an accountability mechanism built into it? How are we ensuring that there is accountability for the federal dollars and federal investments in first nations health?
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View Leona Aglukkaq Profile
CPC (NU)
View Leona Aglukkaq Profile
2011-11-21 16:13
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Thank you for that question.
That agreement does include accountability measures, not only financially, in the area of annual audit functions, but also in terms of accountability measures on what population health indicators we're dealing with and targeted investments related to the challenges in population health. The accountability goes beyond just the dollars, but rather how we improve better health outcomes based on the health of first nations in that jurisdiction.
Through the signing of the agreement, we're promoting a better model of health services to integrate that. It integrates with provinces collectively for before hospital care and hospital care, because the provinces deliver provincial hospital care. So it's a better integration of that.
When we signed the agreement in October, we agreed to provide resources. As I said, the first nations health authority will organize a governance structure with principles that are legally binding. There are a number of provisions, again, for accountability of the board—they will need to meet, health outcomes, financial pieces. So the accountability measure is quite broad. But again, it’s the first of its kind in health, not just this agreement but with any agreement in Canada. This is the most focused in all aspects of delivering health, not just the financial piece of it.
Thank you.
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View Djaouida Sellah Profile
NDP (QC)
Thank you, Madam Chair.
I did not finish my question for the minister. We understand that she's very busy. So, my question is for the officials.
In the 2004 health accord, there were some indicators—about 60 of them, I think—on which the governments, including the Government of Quebec, had agreed. The objective was to make it possible to gauge the progress made. However, since this government has been in power, no data has been provided that would make it possible to take stock of the progress made by our health care system and to determine which areas are in need of improvement. The only available barometer is whether or not people have access to a family doctor and how much time they spend in the waiting room before finally being seen.
What does the government plan to do, especially as part of the 2014 accord, the next agreement on health care? How can you know what tools we need if you don't even know what has and has not worked in the past?
Unless I'm mistaken, the provinces were supposed to be accountable to taxpayers for the duration of the accord, but they didn't follow through. I want to know what the government has done or will do when it comes to this principle, this kind of accountability.
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Glenda Yeates
View Glenda Yeates Profile
Glenda Yeates
2011-11-21 16:41
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Thank you, Madam Chair.
Thank you for the question.
The value of indicators and information is critical.
Those things are very important if we want to have an idea of the progress made since the 2004 accord.
Tremendous importance has been placed on data. Both the Canadian Institute for Health Information and the Health Council of Canada put out information from time to time about progress that's been made on the accord, and about progress in the health system generally.
It was mentioned by the honourable member that we have made considerable progress in some focused areas, for example, wait times. I think the data is much better than it was. It was a big focus area under the accord. It's very difficult and it has been very difficult to get comparable data. But the last report from CIHI commented on the fact that we are now getting much more comparable data, and we can actually see the progress that's been made.
Health human resources was mentioned by the honourable member. Again, CIHI most recently put out—and regularly puts out—the progress we're making on numbers of physicians, for example, and the nursing workforce. We've expanded the number of health professions that we are tracking to other critical professions, such as physiotherapists, occupational therapists, and pharmacists, for example. So we are continuing to expand the role of information that we have.
We have data on some areas of the accord, for example, home care. We have some information about how much home care is available across the country, but it's not an area where, at the moment, we have comparable indicators.
Individual jurisdictions, as was mentioned, report to their citizens. I would say that, relative to the past, we have much better data, but it continues to be an area where we would like to do better. As the minister mentioned, it's one of the reasons accountability is a discussion for this week's meeting, but it will be a discussion on an ongoing basis.
As I talk to my colleagues across the country, there's certainly an understanding that we need to have more data and better data. I would like to say I think we're making significant progress, but we would certainly want to continue that progress and have increasingly better data to manage and to measure, and be transparent to Canadians about the system.
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View Mike Wallace Profile
CPC (ON)
View Mike Wallace Profile
2011-06-20 11:53
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As members of Parliament, we would never see.... Where would somebody find that? There's nowhere it's listed that these are the programs and this is what was funded.
This is at a fairly high level, so it's grouped together. There's no way for us to be able to figure that out, as members of Parliament, so that when you come here, I can question you about program A, B, or C. How is it doing? How is it evaluated? Does that exist anywhere for me to see?
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Glenda Yeates
View Glenda Yeates Profile
Glenda Yeates
2011-06-20 11:54
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We report to parliamentarians in a number of ways with our program activity architecture. We try to give parliamentarians a good sense that here are all of our programs and this is what we do. We do reports on plans and priorities. I think those would be some of the places. It doesn't reflect the budgeting mechanisms or the scrutiny mechanisms a government might put in place, but it gives parliamentarians, I think....
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View Mike Wallace Profile
CPC (ON)
View Mike Wallace Profile
2011-06-20 11:54
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Asking you back to discuss your plans and priorities document would be a good time for us to do that. Would that be correct?
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Glenda Yeates
View Glenda Yeates Profile
Glenda Yeates
2011-06-20 11:54
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I think that's certainly a possibility, but the committee may have other possibilities as well, Mr. Chair.
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View Pat Martin Profile
NDP (MB)
View Pat Martin Profile
2011-06-20 11:59
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If I might just say, some of the answers given today serve as a graphic illustration to the committee that we've got to find better ways to follow the money. Your answers are honest and they're forthright and fulsome, but really what you're saying is there's no way of telling. Looking at these books, comparing this set of mains to this set of mains, the public would never know really what's going on. As the oversight committee for estimates, it's really difficult.
Mike has made it his life's work to follow the money and try to compare. But to compare apples to apples, we should be able to review those books and be able to say at the end of the day, this department went up or that department went down. It's a very frustrating process. But it's no fault of your own. I appreciate your answers and we appreciate your being here today.
Peter, did you have a point you wanted to make?
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View Peter Julian Profile
NDP (BC)
Yes, thank you, Mr. Chair.
Just to follow up on that, it would be very helpful to have the supplementaries on those departmental supplementary funds for 2010-11. A cut is a cut, and if the amount is coming back, and we're talking about the same programs that we have in the estimates for 2011-12, it would be helpful for the committee to be able to compare apples to apples, as the chair said.
I also wanted to say to you, Mr. Chair, that you bring a lot of poise and dignity to this position.
Some hon. members: Oh, oh!
Mr. Peter Julian: I think a lot of other chairs on Parliament Hill could be well served—
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