HEAL Committee Meeting

STANDING COMMITTEE ON HEALTH

COMITÉ PERMANENT DE LA SANTÉ

EVIDENCE

[Recorded by Electronic Apparatus]

Tuesday, November 30, 1999

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[English]

The Chair (Mr. Lynn Myers (Waterloo—Wellington, Lib.)): Ladies and gentlemen, we'll call this Standing Committee on Health to order. As you know, in accordance with our mandate under Standing Order 108(2), we're dealing today with the Canadian Institutes of Health Research. You're probably also aware that this was referred to committee as of yesterday.

We're very pleased to get on with this and to get into our hearings with respect to the CIHR. We'll move as quickly as we can given our timelines, while noting that this is a very important bill not only for researchers across Canada but for Canadians as a whole.

Having said that, we have a number of witnesses today. I understand that each of them, in order, will have opening statements. In the interests of time, I think what we'll do is to go through each of the opening statements first, and then we'll open it up for questions after each witness has presented his case.

From the Council for Health Research in Canada, we have with us the chairperson, David Hill. Mr. Hill, I wonder if you would be prepared to make an opening comment or two, and then we'll move on to the other people.

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Mr. David Hill (Chair, Council for Health Research in Canada): Thank you very much, Mr. Chair.

[Translation]

Good morning, ladies and gentlemen. My name is David Hill.

[English]

I am the volunteer chair of the Council for Health Research in Canada. I'm very pleased to have the opportunity to appear before you this morning to comment on Bill C-13, the proposed legislation establishing the Canadian Institutes of Health Research, and I thank you for that opportunity.

The Council for Health Research in Canada was formed in 1993. It is composed of most of the country's privately funded health research institutes and several of the major voluntary health organizations that are involved in public fundraising for health research.

The mission of our council is the ongoing promotion of health research. Obviously the federal government has a major role to play in the development and sustenance of health research. Accordingly, our council works at building a bridge for sustained policy dialogue with the government on this topic.

We have been excited in recent months to see the federal government's initiatives in health research, ranging from the Canada Foundation for Innovation, to increases in granting council budgets, to the most recent announcement of the development of 2,000 chairs, the 21st century chairs for research excellence, announced in the last Speech from the Throne. We commend these government initiatives that have paved the road to where we are today. The Canadian Institutes of Health Research are now another step forward in order to complete the picture of a new thrust in health research in this country.

I would be remiss if I did not mention the debt that I believe we all owe to Dr. Henry Friesen of the Medical Research Council. In 1997, Dr. Friesen suggested the concept of CIHR. In response to Dr. Friesen's suggestion, the Minister of Health formed a national task force to consider the matter. Our council was a participant in that task force. The task force recommended that the concept of CIHR be developed, and in the February 1999 federal budget the government announced it was proceeding to establish CIHR. Since then, an interim governing council has been hard at work finalizing the details, including participating in the drafting of the legislation that your committee is now charged with reviewing.

Our council had three members on the interim governing council. From Dr. Friesen's suggestion until today, our council has been intimately involved with a development of CIHR and this legislation. We consider the CIHR initiative to be a response to our council's raison d'être.

The CIHR will be a quantum leap forward for health research in this country. It will help to encourage scientists starting into their careers to seriously consider health research, it will help to retain health researchers who face so many challenges in their professions, and I dare say it will assist in enticing back to Canada research scientists who were educated and trained here but who have left this country for professional reasons.

This encouragement of health research and the additional development of researchers in Canada will result in research whose outcome will assist in the diagnosis and treatment of disease. It must also not be overlooked that the development of research infrastructure, the employment activities of research operations, and the commercialization spin-off from research will be economic engines for Canada in an area of knowledge-based development that will bring economic growth and prosperity.

Research needs stable funding and predictability. The results of research may not be immediate, and the new thrust of government, particularly the CIHR development will, we believe, give greater opportunity to develop proper, stable funding for health research in the country. That will in turn produce better research results.

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As with most endeavours, CIHR will be driven by the people involved: those on the governing council and on the advisory boards of the various institutes. We believe the success of CIHR will rapidly come down to the quality of people selected. The employment of this country's most brilliant and respected minds in the CIHR infrastructure will not only ensure success, it will send a powerful message throughout the research community that the government is serious in pushing the development of health research in Canada.

Our council believes that what is needed in selecting people to make CIHR successful is a balance of skills. We would strongly recommend that there be in that balance a significant number of actual, bench-applied scientists who are working on the front lines of health research. We are, however, quite confident that the government, having moved so decisively in this direction, will recruit the brightest and best people to make CIHR work. We will do what we can to assist in this recruiting.

Mr. Chair, the Council for Health Research in Canada has absolutely no recommendations for change in the draft legislation that you are reviewing. It is enabling legislation, and much of the details of the operation of CIHR will be worked out within the general legislative framework. We may well have comments for the governing council as it deals with those operational details, but we are not advocating to you any legislative change.

The CIHR concept has moved rapidly through the proposal, study, and development stages to arrive at this legislation. We would urge you and your colleagues to support the legislation and to expedite as much as possible its enactment. It is of utmost importance to our council that the legislation be in place as rapidly as possible so that we can begin taking advantage of this initiative. Research is a rapidly moving endeavour, and Canada must quickly equip itself to maintain its world position in health research for the benefit of the health of Canadians and for the benefit of the economic development of the country. CIHR is the way to do that.

Again, thank you for this opportunity to speak to you this morning. I will be pleased to answer any questions at the appropriate time.

The Chair: Thank you very much, Mr. Hill. We appreciate your time.

I would like now to move on to the Canadian Consortium for Research. The chairperson, Dr. John Service, is here.

Dr. John C. Service (Chair, Canadian Consortium for Research): Mr. Chair, I thank you and the committee for this opportunity to talk to you today.

I'll first say a word about the Canadian Consortium for Research, of which I'm the chair. It's about 25 years old and has about 25 organizations. It's an organization of organizations that represent the humanities, the social sciences, the medical biological sciences, and the natural sciences. Member organizations have members who are university students, faculty, government scientists, and people who work in the private sector. Examples would be physicists, chemists, or psychologists.

I've had the privilege, as well, of being a member of the minister's task force that developed the initial framework for the CIHR. Through this whole process, I think we've seen a remarkable development that will in fact be extremely important for research and medical research in Canada.

The Canadian Consortium for Research thinks the CIHR will in fact significantly revitalize health research in Canada for a number of reasons. It will provide more opportunity for researchers and graduate students in Canada. It will encourage more collaboration between researchers, settings, and countries. It will develop highly effective networks that will be both productive and flexible to the new research needs. It will support more integrated and thematic approaches to research. It will operationalize a broad and inclusive mandate, as demonstrated, for example, just in the change of the name from medical to health research. We think this inclusiveness is one of the bedrocks and most exciting pieces of the CIHR.

This is a piece of legislation that is broadly written, and it is permissive, as my previous colleague said. It sets out the necessary directions and framework for the CIHR, its continued operation, and its continued development.

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In my opinion, this has been a remarkable example of consensus-building within a community, this being the health research community. In my day job, I'm the executive director of the Canadian Psychological Association, so from a professional point of view, it's been really fascinating to me to watch this thing develop. But it has been remarkable, and I think it has done an extremely good job, and it continues to do an extremely good job, of satisfying the disparate needs of the members of this community. I think you can tell that operationally by the equal amount of excitement and perhaps joy at the CIHR's development as well as fear and worry about how it's going to develop in the future. I think that's shared equally amongst the community, so I think it has been a very good consensus-building operation.

There are no doubt issues that remain to be decided. For example, current research strengths demonstrated by MRC and the health-related SSHRC and NSERC research programs have been and must continue to be protective in the transition period. We can't not do what we do well. We have to continue to do that.

The CIHR needs to remain flexible to some extent. It has to have an element of flexibility in it so that it can direct research energies towards strategic issues that may arise in the future that we're not aware of. One of them might be, for example, from the past, AIDS. We need that kind of research flexibility in order to move quickly on specific issues.

We're going to have to ensure that this inclusiveness remains throughout the life of the CIHR. I'm confident that it will, because the bill and the way the institutes themselves are constructed with advisory committees will, I think, effectively address that.

There are a bunch of other issues I could address, but I'll look forward to doing that in the discussion.

Certainly I thank you for this opportunity to meet with you this morning. We are very excited about this bill and very excited about the next stages, which will bring about further development and implementation.

Thank you, Mr. Chairman.

The Chair: Thank you very much, Dr. Service. We appreciate your comments as well.

Let's move on to the Canadian Health Services Research Foundation. We have the executive director with us today, Mr. Jonathan Lomas.

Mr. Jonathan Lomas (Executive Director, Canadian Health Services Research Foundation): Thank you very much, Mr. Chair, for the opportunity to present to you on the exciting new initiative of the Canadian Institutes of Health Research.

In addition to being executive director of the Canadian Health Services Research Foundation, I'm also a member of CIHR's interim governing council.

It has been a privilege to be associated with such an innovative concept, something that's being watched with a mixture of envy and interest by the international health research community. One international colleague commented to me last week, “It must be an exciting time to be a health researcher in Canada.” It certainly is.

In the next few minutes, I want to do three things. I'll give you a brief description of the Canadian Health Services Research Foundation, what we do and why we do it. Secondly, I'll comment on the immense potential of CIHR from the perspective of our applied research community. And thirdly, I want to make a plea for resources in CIHR to maximize the use and application of its work for the health of Canadians and of our health systems.

The Canadian Health Services Research Foundation is a not-for-profit corporation with an independent board of trustees. It's at the applied end of the research spectrum, working to bring research and researchers to the “coal-face” of the health system.

In the year of the knowledge economy, we can be thought of as knowledge brokers finding ways to bring the research and decision-making processes closer together. We ensure that promising discoveries under ideal conditions of a university environment prove their worth in the everyday circumstances of health systems. Our mission, in other words, is to facilitate evidence-based decision-making in the health sector.

We consult with and identify the research needs of decision-makers who work in the health system. We require as a condition of our funding that researchers and decision-makers work collaboratively together on projects investigating the themes. We improve the way research is communicated, not only by researchers themselves but by others such as the media. And we help health care organizations to locate and apply research to their decisions. We also have a special remit from the last federal budget to increase the capacity of nursing to do research.

On the potential of CIHR, if one looks at the reorganization of health systems in the 1990s, it has been profound and painful both for patients and providers. Medicare's design had its roots in the circumstances of the 1950s, when health care was more like a cottage enterprise. Running today's systems under that design was like prairie grain farming with a garden hose and the Farmer's Almanac. Health care was, and to a large extent still is, poorly equipped to absorb and accommodate accelerating technology, increasing expectations, and modern management.

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Much of the recent upheaval in paying for those in health care is because we're attempting this transition from a cottage enterprise to a managed and accountable system in one fell, almost panic-stricken, swoop instead of changing gradually.

The recent hepatitis C controversy illustrates the problem. First, the system waited until long after research had made a screening test available before adopting it for the blood supply. Second, managers had no follow-up systems to signal quickly that a problem had been created. For health systems, research is both the source of new possibilities and the early warning canary in the mines for problems.

In the case of hepatitis C, the system had available neither the link to the solution from external research nor the internal research capacity to identify the problem early. Part of the difficulty in the last decade or more has been the treatment of the research community as a retail store, the false belief that the research tap can be turned on and off as needed—that research teams, databases, and equipment can be dismantled and reconstituted at will. When health systems need a couple of kilos of treatment innovations, or a cost-effective service alternative, they drop in to the research store with a few dollars in hand and become surprised when it's not available on demand.

Unfortunately, the order needs prepayment, and the production and delivery process, as with all R and D, takes years. Just as an airline needs to look a few years down the road to order its planes, health systems have to anticipate the future and invest in tomorrow's research needs and capacity today.

Thankfully, the proposed investment in CIHR signals a change in how governments view the health research enterprise. It promises treatment less like just-in-time inventory and more like a national park, worth nurturing and preserving all the time so it's there when we need it and want to use it.

CIHR's proposed structure also recognizes the importance of what you might call biodiversity, the need for interaction between the ideas of basic scientists labouring at their laboratory benches, clinical investigators trying new treatments with patients, health services researchers experimenting with new ways of organizing the system, and social scientists exploring the health of populations. Right now these are independently funded and separately conducted areas of health research. Their integration under CIHR will create a whole that is greater than the sum of its parts. The potential for Canada to be a world leader in this broadened vision of health research is absolutely immense.

Now, what we do need to do is make sure we maximize the use of CIHR research—what I would call funding the research process, not just researchers. CIHR can link research to health systems more effectively than past efforts have, by giving those working in the health system continuous access to an ongoing flow of new and proven ideas. No more gut-wrenching restructuring, just a slow, steady accommodation to the established rivers and prevailing winds of research.

If the federal government plants this seed with the CIHR, the researchers, clinicians, managers, and policy-makers in the system will gladly tend its growth and harvest the benefits for improved health services. They will, however, need more than funding for researchers in CIHR to do this. That's because research, however solid, rarely speaks for itself. It was more than five years before Sir Richard Doll's studies showing the link between lung cancer and smoking generated any government action. It was more than 10 years before the finding that clot busters saved lives after heart attacks was implemented as routine in emergency rooms. Even now, nearly 30 years after their demonstrated effectiveness for first-contact health care, nurse practitioners are still not in widespread use in Canada's health systems.

In short, research needs help to move speedily from theory to practice. In addition to funding researchers, CIHR will need to fund the transfer of research into practice. How can CIHR do that? Well, it can do it by actively involving those working in health systems early in the process to ensure that the research is relevant to their needs.

It can do that by linking decision-makers to the research while it is being done, to keep them aware of progress, to alert them to its potential future use in health systems, and to educate them generally about the value of research and how to use it in their work. It can do it by translating the results of research into everyday language, into formats that those outside the research community can understand.

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Unless CIHR funds these companion activities, we will fall far short of harvesting the full potential of the research conducted within and indeed outside CIHR.

Unfortunately, traditional granting councils have not seen these as part of the funding and research process. Rather, they have not been allowed to see these as part of the funding process. There's been a tendency to confuse resources spent on assessing priorities, communicating findings, bringing researchers and decision-makers together, with administrative expense. We have therefore inadvertently squeezed out the support for these activities under the name of administrative efficiency.

We must not do that with CIHR. Provincial governments, hospital executives, regional health authorities, community agencies, other research funders, and the public will all need to be partners if CIHR is to realize its full potential.

Developing, maintaining, and nurturing these partnerships is also part of the research process, and that too takes resources. The health research process is there for more than the investigations undertaken by researchers themselves. It is priority assessment. It is linkage and exchange between partners. It's effective and persuasive communication of research findings and of the value of research and ensuring a quality health service.

The drug industry has long understood this. In a 1997 interview on Marketplace, Judy Erola of the then Pharmaceutical Manufacturers' Association of Canada outlined how almost 50% of the R and D costs of a drug involved educating those who might use it or fund it about the research results. This contrasts markedly with the analysis of federal research funding done under the Federal/Provincial/Territorial Advisory Committee on Health Services in 1995. They found that not 50%, but less than one-third of 1% of federal health research funding was dedicated to communicating and disseminating the findings to those who might use them. There was clearly an imbalance in the relative efforts to get for-profit research and publicly funded research results deployed in health systems.

Confusing the cost of doing these crucial research relevance and communication exercises with administrative cost, demonizing them as bureaucracy or missed opportunities to fund university researchers, will doom CIHR to fall far short of its potential to improve the health of Canadians. Nothing would be more tragic than to fund the researchers but fail to fund the mechanisms that will maximize the impact of their work on the health of Canadians. It would be like a pharmaceutical company that fired its marketing and communications people and loaded the task onto their laboratory researchers.

In the marketplace of ideas, CIHR must pull its weight by not only funding the researchers but also funding the tasks that bring research results to the attention of all those who can use them.

Thank you.

The Chair: Thank you very much, Mr. Lomas. We appreciate your opening comments.

We have the executive director from the

[Translation]

Fonds de la recherche en santé du Québec, Dr. Pierre Boyle. Dr. Boyle, please.

Dr. Pierre Boyle (Executive Director, Fonds de la recherche en santé du Québec): Thank you, Mr. Chairman.

The Fonds de la recherche en santé du Québec is involved in the planning, development, promotion and funding of health research in Quebec. This year, we will be investing nearly $70 million, the largest investment by a provincial health research agency. My remarks to you today were formulated in co-operation with three other organizations, namely the Fonds pour la formation de chercheurs et l'aide à la recherche, the FCAR, which supports research on university campuses, whereas the FRSQ supports research in hospital research centres where most of the biomedical research is done in Quebec. The FCAR supports university research; part of its funds are allocated to health research. The Conseil québécois de la recherche sociale, which allocates about 25 per cent of its budget to supporting social research directly related to health, was also involved, as was the Conseil d'évaluation des technologies de la santé, which advises government on the effectiveness of health technologies in a broad sense and is a principal player in the dissemination of knowledge to clinical practice, to political decision-makers and to administrative decision-makers.

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Our remarks will focus specifically on Bill C-13. Needless to say the idea of creating Canadian Institutes of Health Research is welcomed universally as a breath of fresh air in a context characterized in recent years by deep depression as the result of a chronic underfunding of health research in Canada. Since the idea of these institutes is warmly welcomed throughout, our remarks will not focus on the what, but rather the how.

First off, we fully agree with the mission proposed for the CIHRs. We think this project, as submitted and through its transformative nature, should build on the work of the Medical Research Council of Canada and on past work of scientific excellence, while preparing health research to better meet the challenges of tomorrow and enabling research and researchers to better meet new challenges.

We are very pleased to see that the approach taken by the legislator will give all health researchers in Canada a chance to find a niche in one or other of the institutes that will be created by the CIHRs. We understand as well that the CHIRs will build intensely on co-operation among organizations and individuals in carrying out their mission. We consider that very important.

There is one issue from among the missions set for the institutes that warrants priority and immediate attention in our view and that is the question of our ability to train, attract and keep the best brains and expertise needed to carry out quality and relevant health research in the coming years.

It will be important to create dynamic environments that will enable deserving researchers to enjoy career opportunities that, at the moment, are not even available more often than not to even the most brilliant.

Our second remark concerns funding. We are obviously pleased that public officials recognize the importance of significantly and quickly improving the financial support given to health research. We are convinced that this support will help reduce the gap between Canada and the G7 countries in this regard.

On the other hand, given that this is a community investment and not a government expenditure, everything must be done to maximize the benefits of this investment for the community. We are all somewhat concerned that the administrative costs of setting up the institutes may be given exaggerated importance. We must not forget that the main objective is to increase, in the short term, the number of funded researchers and the level of funding and, then, to create the conditions that will foster more consistent development of health research.

We think the legislator should establish a ceiling, in the bill or in regulations, for administrative spending. A figure of five per cent would seem reasonable on the basis of the experience of national and provincial agencies in this regard.

Our third comment concerns the integrative approach, which is totally innovative and refreshing. The CIHRs will integrate disciplines, fields and regions into a network of expertise, which we think will be most promising for the future. This approach is part of a trend already in place of interdisciplinary and inter-university networking and linking of expertise in various fields of health research.

An approach of this sort has many benefits. It enriches and cross-fertilizes scientific work, which is very important, it provides single window access to the best brains in the country in a given area and creates an international scientific showcase for Canadian scientists.

This integration of the five major research fields—biomedical research, clinical research, research on health services and systems, research on populations and research on the effects of the environment on health, the last added latterly—will contribute to future successes.

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We consider the emergence of a critical mass of researchers in targeted areas capable of covering a broad range of issues and of interworking clinical and applied research and social research and research on populations exciting for the future. Quebec agencies have already begun to use this approach in the centres they support. Such an integrative approach will also help build links between the CIHRs and the decision-makers, that is, those affected by the focus, management and delivery of health programs and services in Canada.

The creation of such a functional link between the CIHRs and the future users of the products of research is vital, although a successful formula for achieving this end has yet to be fully developed. We must be innovative in our approach.

Within the five fields identified, there are major challenges. Basic or biomedical research is essential to many health research activities and is a vital field in a sense. It should get major support in the coming years and the conditions it needs to grow.

Clinical research is in a real state of crisis in North America and especially in Canada. There is a lack of competitiveness in Canada on the international scale in this field that is worrisome. The working conditions of health care professionals and clinician researchers, who devote much of their time to clinical research, are one of the problem areas requiring attention in the coming years if we are to increase Canada's involvement in innovative clinical research, vital to the delivery of laboratory discoveries to the bedsides of patients and on to the community as a whole.

Needs in the field of research into health care services and systems, despite significant advances in recent years, continue to far outstrip our ability to meet them. This sector requires an investment in development of both brains and our abilities. The links to be established between the users and the producers of knowledge must be forged with care.

It will be important, in our opinion, to avoid duplication such as with existing agencies like the Canadian Health Services Research Foundation.

The field of research into the health of populations and the social and cultural aspects of health has long been considered an emerging field. At the moment, it must be said that Canada has cutting edge expertise acknowledged worldwide in this field. The field has acquired undeniable scientific credibility community wide. Agencies such as the Social Sciences and Humanities Research Council, the Conseil québécois de la recherche sociale and others have played a key role in developing research in social sciences and humanities, and we hope that in co-operation with the institutes they will continue to attract and train international calibre researchers in this field. We must continue to support this area of research and even increase our support to it.

Finally, on the questions of management and accountability, we cannot overemphasize the importance of the selection of the members of the governing council of the CIHRs and the people managing the various divisions of the institutes. They will bring style, dynamism and credibility to each of the institutes, and they must be selected for their excellence, credibility and scientific influence and as uncontestable leaders, visionaries and mobilizers.

There is also the issue of accountability. We are perhaps a bit concerned in this regard. The lawmakers must understand that there must be certain limits to the need to provide an accounting of the effects of research. Nearly all western countries are currently looking at ways to measure the effects of research. I must tell you that this is a question with significant limits at the moment. There can be no expectation of quantifying everything in the very short term. This is a highly complex issue, and research is a slow process, with results arising from considerable effort over protracted periods.

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In closing, I would simply mention the longstanding tradition of complementarity among the Medical Research Council of Canada, the FRSQ and other provincially funded organizations. Interaction involving a multitude of institutes may make this relationship more complex.

In our case, we have already started adapting our programs to the Canadian perspective and we hope that provincial agencies, including the FRSQ, may be considered as key partners with the Canadian Institutes of Health Research. We hope to be able to draw on advances in the past to enrich future partnerships.

We hope the institutes will develop win-win partnerships with agencies across Canada already involved in supporting health research for Canadians. I will tell you that nearly one third of the market for biomedical research, if I may describe it thus, and for health research in broad terms lies in Quebec. Despite the fact that Quebec accounts for only 24 per cent of Canada's population, its researchers compete for more than 33 per cent of the MRC's funding at the moment.

I thank you for your invitation, Mr. Chairman.

The Chairman: Thank you very much, Dr. Boyle.

[English]

Thank you very much.

We'll now move on to the Association of Universities and Colleges of Canada, and representing them is the president and chief executive officer, Monsieur Robert Giroux. Monsieur.

[Translation]

Mr. Robert J. Giroux (President, Association of Universities and Colleges of Canada): Thank you very much, Mr. Chairman and good morning to the members of the Standing Committee on Health. I want to thank you for having invited me to speak to you today on behalf of the Association of Universities and Colleges of Canada. It was with pleasure that I accepted your invitation, especially as the subject you are currently discussing is very dear to the hearts of our member institutions.

I would point out that the Association of Universities and Colleges of Canada represents 90 members, that is all Canadian universities and the colleges that grant university diplomas. The vast majority of these institutions is keenly interested in health research. We have 16 that have faculties of medicine, and a number have humanities and social sciences faculties and science faculties. A number have faculties of veterinary medicine, and others have nursing faculties. They are therefore all very interested in health research in Canada.

After a year of anticipation, Bill C-13, An Act to establish the Canadian Institutes of Health Research, was introduced in the House of Commons. I would first remind you if I may that the AUCC and its member institutions are very favourable to the idea of creating Canadian Institutes of Health Research. This very innovative bill marks a turning point for health research in Canada. If it passes, it will undoubtedly become a model for the rest of the world.

The Canadian Institutes of Health Research are proof of the federal government's commitment to making health research one of the ways to improve the health and well-being of Canadians, while participating in the training of some of the best and brightest of the next generation of health researchers. The institutes will have everything they need to give a considerable boost to the research work of Canadian universities.

Bill C-13 contains the elements essential to the successful establishment and subsequent operation of the institutes. It defines their objectives and mission. It also sets out the functions and areas of responsibility. It provides the organizational structure of the institutes along with the responsibilities of the President and the governing council. Finally, it describes the process for a smooth transition from the Medical Research Council to the institutes.

Drawing on legislation that created other research granting councils, Bill C-13 is empowering without being too prescriptive. That, in our opinion, is one of its greatest assets. The bill sets out the institutes' operating structure, but it leaves enough manoeuvring room for the governing council to formulate the details of the programming in the future.

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More important still, the bill gives the institutes the flexibility they will need to respond to changes in the health environment by enabling them to adjust their financing to new health problems and new opportunities for research.

The bill is wide-ranging. Under the umbrella of health research institutes, researchers in all sectors and every discipline, including the social sciences and the humanities, will join together in studying the multiple facets of health.

Although the bill does not establish specific institutes, our understanding is that they will support biomedical research, clinical research and research into health care systems and services along with all the other possible dimensions of health care.

This integrated approach to research constitutes the factor that makes the institutes so different from other health research funding programs.

Bill C-13 ensures that the institutes will be at arm's length from the government. The governing council, chaired by the President, will be free to establish strategic directions, have responsibility for approving the budget and have full powers of internal management without having to consult the minister in advance.

We believe that the governing council needs this latitude to run its business efficiently, and we are grateful to Parliament for incorporating this independence in Bill C-13.

Providing financial assistance to research through peer- adjudicated competitions, without partisan or political considerations, is one of the most important features of the Canadian research funding system. It is an approach that has served Canada well and is seen as a model to follow by many other countries. It is also one of the reasons for the international excellence that we have achieved despite levels of financial support that are much lower than in other industrialized countries.

Detaching the institutes from the government in no way means they will not be accountable. They will provide an accounting through their governing council, which will be responsible for administering the institutes and seeing that objectives set are met to the benefit and in the interest of the people of Canada.

The members of the governing council will be appointed by the Governor in Council. Their backgrounds will be varied, and they will be required to meet the highest standards of scientific excellence. The members of the governing council may be appointed for no more than two consecutive terms, and no more than one third of the members will be replaced each year.

This provision in the bill will help ensure cohesion in the governing council and continuity in its activities.

[English]

We would like, Mr. Chairman and members of the committee, to make a few observations about three powers that Bill C-13 confers on the CIHR, namely, the power to engage in research, paragraph 4(e); the power to commercialize intellectual property, paragraph 26(1)(f); and the power to create a separate private corporation, paragraph 26(1)(c).

As we stated earlier, this legislation is enabling legislation, and we support it. It seeks to create a framework that is sufficiently large and flexible to enable the CIHR to adapt to changes in the research environment.

Nevertheless, these three powers in particular warrant a few comments. The current Medical Research Council legislation already gives it a mandate to perform research. In its 30-year history it has never used this power. We hope, and are confident, that the CIHR governing council will exercise the same discretion as the Medical Research Council has shown in using this power. The combination of a research support and a research performance mandate can give rise to situations of conflicts of interest, whether real or perceived. Such situations must be avoided.

Paragraph 26(1)(f) of the proposed legislation empowers the CIHR to:

license, assign, sell or otherwise make available any patent, copyright, industrial design, trade-mark, trade secret or other like property right held, controlled or administered by the CIHR.

In addition, paragraph 26(1)(c) empowers the CIHR to create separate private corporations or acquire and dispose of shares in any such corporations.

The CIHR's primary and overriding function will be to support research excellence wherever it is found in this country. As such, we expect that its policy on intellectual property will follow that of MRC and other granting councils in that it will not claim property rights to inventions resulting from research arising from its research grants. Moreover, it is also our expectation that the CIHR will encourage researchers to protect and commercialize their inventions in partnership with their university or institute.

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We trust that the CIHR will be guided by a recent report of the Prime Minister's Advisory Council on Science and Technology in matters related to the commercialization of research results. The Advisory Council on Science and Technology commissioned an expert panel last spring to examine the commercialization of university research in Canada. The panel concluded that commercialization is the joint responsibility of the researcher and his or her institution. It recommended, among other things, that the government invest an additional $50 million in universities to help strengthen their capacity to commercialize research results. Notably, the expert panel did not suggest that the federal granting agencies should become directly involved in the commercialization of the research they support.

The granting councils have played a key catalytic role through programs that support university-industry or university-government partnerships, and we would urge the CIHR to build on this tradition. We would also urge the CIHR governing council to exercise the greatest discretion in accepting such research mandates directly, so as to avoid duplicating the research efforts of universities or other research organizations.

Finally, we also expect that the CIHR governing council will exercise its power to create subsidiary entities only after extensive public consultation and scrutiny.

In conclusion, Mr. Chairman, AUCC strongly supports Bill C-13 and recommends its adoption by Parliament. The creation of the Canadian Institutes of Health Research Act is of fundamental importance to thousands of researchers and research institutions in Canada. It represents a turning point in Canadian health research history and provides an opportunity for health researchers from across the country in a variety of disciplines to come together to collaborate on common research projects.

The CIHR has the potential to make an enormous difference in the health of Canadians. Let's not let this opportunity go to waste.

Thank you.

[Translation]

The Chairman: Thank you very much, Mr. Giroux.

[English]

Thank you for those opening comments.

Let's move now to the Coalition for Biomedical and Health Research, which is represented by Dr. Barry McLennan, the chair of that organization.

Dr. Barry D. McLennan (Chair, Coalition for Biomedical and Health Research): Thank you, Mr. Chairman. A copy of my presentation has been distributed to your committee members.

I'd like to say just a quick word about CBHR. The Coalition for Biomedical and Health Research represents over 40,000 biomedical, clinical, and health researchers in Canada. The membership of our organization includes the 16 medical schools, the Canadian Society for Clinical Investigation, the veterinary colleges, the Canadian Institute of Academic Medicine, and the Royal College of Physicians and Surgeons of Canada.

Our coalition was launched in 1992 with two simple objectives: one, to increase public awareness of science; and two, to encourage increased funding for biomedical, clinical, and health research activities in Canada with a view to getting a greater understanding of the progress and value of these activities, to improve the quality of life for all Canadians, and to enhance our economy.

We've been intimately involved with this activity not only for the last year but also going back two or three years, because we've been pushing for this kind of organization. So we're terribly pleased it's at the stage it's at now. Indeed, Mr. Chairman, I would suggest that we're a little too close to it to really understand and appreciate the significance of this act. I think the history books will show that the creation of CIHR will be as big a blip on the radar screen as was the introduction of universal access to medical care 30 years ago.

I'm so excited about this. I think it's just the most amazing thing that's happening in our health research community. So we're very anxious that this committee approve the legislation as drafted, and do so as soon as possible. Let me get that off my chest right now.

As some of my other colleagues have said, CIHR is a landmark in the history of health innovation in Canada. The creation of CIHR is a key element in the federal government's strategy to ensure that Canada is at the leading edge of the knowledge-based economy as we move into the next millennium.

• 1200

The CIHR and the 21st century chairs program, which was announced a few weeks ago by our Prime Minister, will turn the Canadian environment into one of brain gain, not brain drain. This morning I noticed in the Globe and Mail that the brain drain is still with us. This is an article from Atlantic Canada. I've spoken to this committee about this before, but let me just say it clearly once more: we lose five health researchers from Canada to the United States for every one who comes back. And I would quickly say that the bean counters don't always understand this, because they say if you lose one, you hire one; it's a zero-sum game. It's not a zero-sum game, because you're losing someone at the peak of their career; they're very productive, they're very, very knowledgeable, and they have active research programs. The person you hire is knew, unknown.

So it's not a zero-sum game, and that cost to Canadians is over $560 million a year. We must fix it. CIHR will go a long way toward addressing that problem.

Some of you may have seen the Global TV show a week ago Monday that interviewed a number of Canadians who had gone to the States to establish and pursue their careers there. Every one of those Canadians in their hearts would have liked to stay in Canada, but in order to pursue their careers and take advantage of opportunities, they could not afford not to leave—they had to leave. It's a very sad situation.

As others have said, Mr. Chairman, CIHR is enthusiastically supported by a wide coalition of partners in Canadian health research. This has been an amazing exercise and it has happened very quickly. The legislation, as others have commented, has been drafted to be enabling and flexible. That was deliberate. The process of developing CIHR from the vision to reality began just over a year ago with the national task force, and today continues through the work of the interim governing council.

Mr. Chairman and committee members, as chair of the Coalition for Biomedical and Health Research, I've had the pleasure of being both a member of the task force and the interim governing council. I can attest to the intense debate and the hard work of this group of dedicated and concerned Canadians. I can also attest to the unquestionable resolve of the IGC to get it right so that CIHR can meet its objectives.

Our role as members of the IGC, as Jonathan Lomas has pointed out, has been to advise the Minister of Health on the design and structure of CIHR. We are working in close consultation with the broad health research community and have engaged hundreds of individuals and organizations in the process of transforming the health research sector in Canada.

The objective of CIHR—let me be clear—is very simple, and it's outlined in the legislation. It is to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products, and a strengthened Canadian health care system. Very simply, ladies and gentlemen, we want to move the results of research from the laboratory to the bedside and out into the community to help improve the quality of health care for all Canadians.

CIHR will create thematic virtual institutes, 10 to 15, that will link researchers from coast to coast, from St. John's to Vancouver, to find cures and expedite new discoveries. It will create networks in which cooperation and imagination can flourish.

The legislation makes it clear that CIHR will improve the coordination, funding, and organization of health research. Others have commented on this in detail, so I won't elaborate further. But it will broaden the scope of health research based on the increasing recognition of the importance of understanding the underlying determinants of health and disease. The CIHR strategy, with the four crosscutting themes, offers an inclusive approach that will address not only the biomedical and clinical aspects of preventing and treating disease, but also the efficacy of health systems and the social, economic, and environmental factors associated with health and disease.

Mr. Chairman, most importantly, CIHR will work in partnership with other stakeholders in the community—the voluntary sector, the private sector, and government—in building a stronger health platform in this country. A guiding principle in the work of the IGC has been that everyone involved in health research, regardless of their home or academic discipline, whether they be based in universities, teaching hospitals, or research institutes, will be a winner with CIHR. Not only will there be increased funding available, but researchers will have opportunities to network with colleagues to identify opportunities for collaboration and to transfer new knowledge generated to others—and as others have said this morning, I predict that CIHR will become a model for other countries to emulate.

• 1205

So by investing in CIHR, the federal government is investing in the creation of new knowledge that will expedite the discovery of new treatments and prevention strategies and result in better health care for Canadians. And most importantly, as I said earlier, through CIHR, Canada's best and brightest researchers will have opportunity at home, and international researchers may be attracted to Canada—in other words, brain gain, not brain drain. CIHR activity will support economic development in Canada and help create and keep highly skilled jobs here in Canada.

The next phase in the process, as far as the interim governing council is concerned, is the naming of the CIHR institutes. I should point out that there has now been placed on the CIHR website a document on institute design. That will be an important piece of information to look at and to evaluate as you decide on the naming of institutes. The IGC is now consulting with Canadians on the slate of institutes to be included in the process. In other words, we're inviting the community to name these 10 to 15 institutes. We've had lots of MFIs—“my favourite institute”. That's not good enough. We want the big picture. Give us the 10 or 15 names that will accomplish the objectives of CIHR.

In conclusion, CBHR and the over 40,000 researchers and clinicians we represent have worked tirelessly over the past few years to build and enhance the health research environment in Canada. We strongly believe that the establishment of CIHR will permit Canada to begin a collaborative, coordinated journey to its rightful place as a world leader in health research. Mr. Chairman, I urge you and your committee to do everything in your power to ensure that Bill C-13 is passed as quickly as possible so that CIHR can begin its exciting work for the benefit of all Canadians.

Thank you very much.

The Chair: Thank you very much for those comments, Dr. McLennan. We appreciate that.

Finally, we will hear from the Institut des recherches cliniques de Montréal, the director of the laboratory of immunology, Dr. Rafik-Pierre Sékaly.

Dr. Sékaly, please.

Dr. Rafik-Pierre Sékaly (Director, Laboratory of Immunology, Institut des recherches cliniques de Montréal): Thank you very much, Mr. Chairman.

[Translation]

Ladies and gentlemen, members of the Standing Committee on Health, I represent today the IRCM, the Institut de recherches cliniques de Montréal, an institute that, as its name indicates, has been working for over 30 years to bring the discoveries of the research laboratory to the bedside of the patient. In this sense, I am as well somewhat of an active representative of the research community and I hope that other researchers will make a contribution to this committee.

I would first like to thank the Government of Canada, its Minister of Health and Parliament for having taken such a significant step to develop what is now called the knowledge economy by creating, with Bill C-13, the Canadian Institutes of Health Research.

For a number of years now, the Canadian research community has been encouraging the various governments to intervene to stop the brain drain to greener pastures and the lessening of the competitiveness of Canadian researchers and accordingly Canadian society internationally. The step taken today will have nothing but beneficial effects and has already received the support of the entire community of researchers.

In the virtual cycle of economic growth, research occupies a significant place at the heart of progress of all types. We are delighted to note that the federal government has recognized this fact and that medical and health research and its expansion have now become a priority.

The growth of medical and health research can only benefit Canadian society. In the matter that concerns us specifically today, Bill C-13 will have short, medium and long term effects on the health of Canadians and on their economic prosperity.

When we first read Bill C-13 we have to congratulate ourselves on it in its entirety, because its aim is to create a new mobilizing and integrating entity, namely the CIHRs, which will be the driving force behind this renewed effort in research.

However, all ambiguities that could reduce the effectiveness of this initiative must be cleared up from the outset. My remarks here should be taken as suggestions simply to improve something that is already well developed and advanced.

• 1210

Accordingly, I consider it important to make it as clear as possible that the primary focus of this bill is an investment in medical and health research. While the ultimate goal of this research is to improve the health of Canadians, it must be made clear, in order to avoid any ambiguity, that the bill must provide for ongoing and increased investment in medical and health research.

It is essential that the emphasis, from the preamble on, be on the pursuit of excellence. Certainly, multidisciplinary research is necessary, but it must not be conducted at the cost of excellence and even less at the cost of scientific curiosity. We must avoid falling into the trap of focusing our research on short-term imperatives, because often our research may move in a new direction different from the one planned at the outset and lead to new avenues. It is often said in research that an answer to one question simply raises new questions.

It is also essential in my opinion that the terms «scientific curiosity» and «investigator-initiated research» be mentioned specifically and be promoted in the text of the bill. Sub-clause 4(c) in the bill creates ambiguity because it talks of forging an integrated health research agenda. Certainly the ultimate goal is to improve the health of Canadians, but, for the reasons set out above, the approach must not be predetermined and, more importantly, the program must not be cast in stone. Accordingly, a secure place must be set aside for basic research, which leads to discovery and to intellectual property, increased productivity and the creation of new jobs.

Biomedical research is mentioned frequently. In my opinion, it would be wiser to use the expression «basic and biomedical research» as often as possible. It is basic research that led to the growth of molecular biology and to the discoveries essential to an understanding of so many diseases: cancer, AIDS and genetic disorders. This field, the source of so much progress, must continue to be secure.

In Canada, we do not have a strong tradition of supporting international research, not because we do not want to do so, but because we have not always had the resources. A number of us receive American or international funding. The reverse is not always true. In this context, Canada must, with the globalization of markets, assume an important position internationally. The CIHRs are obviously the vehicle of choice, since the American interlocutor, the NIH, is an international leader, providing research funding to the entire international community and involving itself in the development of a worldwide research agenda. Are we going to have the resources necessary to deliver the goods? What means will we have to join with other countries in the development of an international research agenda?

It seems to me that one of the mandates of the CIHRs and their heads is to recommend a budget to federal officials and defend it. This budget must not be cast in stone, in our opinion. It must provide a minimum to ensure that the agency does not face the same crises experienced by the MRC in recent years. On the other hand, there must be manoeuvring room to permit annual budget increases.

A clear mechanism must be established therefore. Who defends the budgets of the institutes? Is it the President of the CIHRs or the heads of the individual institutes. In the case of the NIHs, both the director of the NIHs and the institute directors must justify their future budgets and spending as well during the course of the fiscal year. So it is not just a matter of approving a budget, but participation in its preparation and its defence with the appropriate authorities as well.

To ensure that the CIHRs' agenda best serves the community of researchers and the people of Canada, a majority of the members of the governing council must be experienced researchers, who themselves receive funding and continue to be active in the research community. This is point No. 6.4. In the United States, the director of the NIHs is a Nobel laureate, an active researcher with his own laboratory. In France, the director of INSERM is also an active researcher. This situation often permits closer ties among researchers and their managers. The process of appointing members to the governing council should, in my opinion, be clarified.

Points 20 and 21 mention fact that one of the mandates of the governing council would be to recommend the closure of a research institute. Even if this statement of principle is supported by a five-year review of the performance of each institute, it would be preferable to avoid such a measure. The closing of an institute could be destabilizing, demoralizing the researchers at the institute and potentially casting a pall over the entire program. Closing an institute would also be a waste of human and financial resources. It is therefore vital, in my opinion, to make a wise choice at the outset to avoid such action. It would be better to start the program with few institutes that form a real and not artificial grouping and to add to them over time rather than give into everybody's demands, which could bring an abrupt end. In this regard, I have nothing but praise for the vast process of consultation that is to lead to the selection of these institutes.

• 1215

In closing, I must say it is important to recall the historical role of the Medical Research Council, which has served the community of researchers so well since its inception. I must underscore the essential role of the researchers, who have fought for many years for recognition by the various levels of government. Finally, the government and its Minister of Health are to be congratulated for formulating this bill.

This bill enshrining the creation of the CIHRs is fundamental to Canada's future. It must therefore be fine tuned as necessary so we may be guaranteed a positive start, which will enable us to meet the ambitious objectives of this new program in the near future. Thank you.

[English]

The Chair: Merci beaucoup, Dr. Sékaly, and thank you to all of you for those excellent opening comments.

We'll have questions in a moment, but before we do, I just want to let everyone know here today, especially members of the committee, that last Thursday we had an on-site tour of three facilities. We went to the Ottawa Heart Institute, the Loeb Health Research Institute, and the Ottawa Hospital. It was very beneficial for us as a committee to have a hands-on view of what's taking place in these research facilities.

Certainly I want to thank Pierre Cadieux, who's in the audience today, the executive director for the Council for Health Research in Canada, along with Rachel Grondin, for assisting us in that matter. It was very useful. We certainly appreciate all of that.

The other thing I want to note is that there are sandwiches here for members of the committee and everyone else. This is a working lunch, so really feel free at any time.

But let's get to the questions now. Mr. Elley, would you lead off, please?

Mr. Reed Elley (Nanaimo—Cowichan, Ref.): Thank you very much, Mr. Chairman.

I want to begin by thanking each one of you for coming today and presenting before us. Thank you for your comments about the legislation and the creation of the CIHR. It isn't often that we have an impending love-in for legislation that comes before us, but it's quite possible that this may be the case with this legislation.

The Chair: May we quote you on that?

Voices: Oh, oh!

Mr. Reed Elley: Oh, of course you can. We've already said that from the Reform Party's perspective, we're very grateful to the government for coming up with something like this, and we want to be prepared to compliment the government when they do something right. We often are the other way around.

Voices: Oh, oh!

Mr. Reed Elley: However—

A voice: However!

Voices: Oh, oh!

Mr. Reed Elley: The proverbial however.

A couple of you have waved some small red flags, which actually we have waved already in some speeches in the House. One of them was waved by Dr. Boyle, and I'd like to address a question to him, and then the other was kind of waved by Mr. Lomas, and I'll ask a question to him.

We have seen of course in other organizations that do good work that administrative costs do become something of great concern, and you have waved a little red flag on that one, Dr. Boyle. Do you think there would be any wisdom to maybe amending the legislation to say administrative costs should not exceed 5% of the budget each year?

Dr. Pierre Boyle: Certainly the community of researchers expects a major part of the new investments towards creation of CIHR to go to direct support to research. There's no magic number, but if we look at the present administrative costs of both national and provincial health research funding agencies, they vary from a little over 3% to something a little over 5%. To most of us who are involved in running these kinds of agencies, 5% seems a reasonable figure.

Whether the ceiling is in the legislation, in the regulation, or in some form of administrative measure, I think it would be reassuring for the scientific community to acknowledge that there is that safeguard, and that given the innovative character of the institutes, we are not in something where the spectre of administrative costs looms over the potential impact of CIHR.

• 1220

Mr. Reed Elley: Thank you. I know the MRC has had a pretty good track record in this regard. However, it's interesting to get your reaction to that.

The second question is to you, Mr. Lomas. You raised a very interesting question about the need to transfer research into practice. Someone else mentioned it; I think it was Dr. McLennan. And of course, from the ordinary Canadian's perspective, this is what we hope will happen, and we're not just going to be spending all kinds of dollars on research that's not going to ultimately benefit Canadians. Although of course in the research process, one has problems along the way sometimes in reaching the goal, and money is spent that can never be recovered.

Do you think the proposed CIHR has the capacity to do what you are suggesting, or do other things need to be done in terms of this?

Mr. Jonathan Lomas: Thank you very much for the opportunity to talk about my favourite hobby horse.

Indeed the CIHR has some of the tools. It will need to be resourced adequately.

I'll just take one moment to catch on the tail end of the question you levelled towards my colleague Pierre Boyle. The concern about setting limits such as 5% on administrative costs has been a history of confusion about what is administrative cost and what isn't administrative cost. So for instance, within the current research council budgets, it is not at all clear that they are even allowed to spend funding on some of these kinds of transfer activities, because of the previous structures that were designed twenty or thirty years ago.

Now they are faced with a challenge to realize it does take time for research to get into practice. It doesn't automatically happen. Therefore additional tools are required. There's been a tendency to confuse that with administrative expense. That isn't. That's very clearly a message we're trying to give. That is not administrative expense. That is adjunct program activity to ensure the research that's being done will indeed have an impact in practice.

However, to return to the core question you asked, I have to say there is no way one single organization can undertake this task on its own. It is quite clearly exactly in the spirit of partnership that CIHR has. Provincial health care systems are really where the rubber hits the road in Canada. Those provincial health care systems need to be significant partners with CIHR, as part of the entire health research endeavour, if we're going to see the benefits yielded for the patients and for the managers who are running the system out there as well.

We also need significant partnerships with some of those who are the main purveyors of knowledge in our Canadian health system: the media, people who at the present time tend to orient towards the identifiable victim, the sexy research findings. But those findings, like those I quoted earlier around nurse practitioners and effective delivery of first-contact care, get little attention from the media at the present time. So we also—and the Canadian Health Services Research Foundation has been doing this—need to work significantly with the media to get them to be a better-informed purveyor of the news from health research in general and be a little less selective in what they are reporting on.

Then finally, there need to be some significant investments among those who are running the health system at large. That we can have a billion-dollar regional health authority, which we do have in Canada, that has no research and development line in its budget is to me a sad comment on the 1990s as we move into the 21st century. The organizations that can use the research have to engage in a two-way street. They need to develop the capacity to acquire the information to do some research themselves on their own activities, and to be able to be informed consumers of the health research that comes from CIHR.

So partnerships with other knowledge-producers and with those who can do communication, partnerships and education with those who purvey the research knowledge out to those who can use it, and commitment of resources to this activity by those who are actually in the decision-making environments are all needed for us to have effective transfer of research into practice.

The Chair: Thank you very much.

[Translation]

Have you any questions, Mr. Ménard?

• 1225

Mr. Réal Ménard (Hochelaga—Maisonneuve, BQ): Mr. Chairman, I always have questions. You know that I love life. As we have heard interesting testimony, I have a rush of four or five questions.

First, I would ask you to explain your understanding of the autonomy of the institutes' operations. The bill gives many powers to the governing council. How do you see its autonomy and the division of labour between the governing council and the various institutes that will be created and that are not defined as institutes but rather divisions in the bill?

Second, how do you understand resources are to be allocated? I think Dr. Sékaly talked about this. It is important to come back to it.

Third, I would remind you that Quebec has a very specific issue and that is the development of a scientific policy. I must point out that Quebec has invested $406 million of its budget in research over two years. This is significant, because the figure for Canada as a whole is $500 million. I would ask Dr. Boyle to describe the forces in Quebec and tell us how he fits into this dynamic.

Here is my last question. If new infrastructures are to be created, from the point targeted areas are established and researchers are networked, how will a balance be struck and how will the creation of new structures be arbitrated? Do you understand that under their mandate the institutes could create new infrastructures? I would like your view on this.

If there is enough time, I would also ask Dr. Sékaly of the Institut des recherches cliniques de Montréal to give me his view on the need for an AIDS-specific institute. Would he like to see in incorporated in something broader?

The Chairman: Thank you very much.

Dr. Boyle, please.

Dr. Pierre Boyle: I will speak of the forces in Quebec and of the way Quebec sees its involvement in the field of research.

It is true, Quebec is working to develop a policy on science and innovation that will address a number of concerns we all share, including intellectual property, technological transfer and so on.

The situation in Quebec has been different over the past 30 years. Funding bodies such as the FRSQ have invested primarily in research infrastructures and in developing brains and a lot less in directly funding research projects, which has enabled us to establish some twenty ultra modern research centres in university hospitals.

More recently, Quebec has developed targeted research networks, somewhat in the style of the CIHRs, networks that serve to develop not only co-operation, but shared infrastructure and technological platforms to conduct the research that may be useful to all researchers regardless of their university, their field of practice—be it aids, mental health, rehabilitation or aging, to name but a few. These project-oriented networks are based on the priorities of Quebec's health and welfare policy. They serve, to all intents and purposes, to create linkages between researchers so they may be part of the research effort as a group, when this is appropriate, with the given that there must be more competition between researchers in Quebec and those in Boston, Stanford or Düsseldorf rather than between those at Laval, the University of Sherbrooke, McGill or the University of Montreal. Such competition is healthy, but it is counterproductive in certain instances.

Our experience with project-oriented research networks, despite start-up problems, has been extremely positive to date, and we are pleased to see a similar approach proposed for the Canadian Institutes of Health Research.

• 1230

One thing moves us to review the way research is supported. We think the innovative nature of the CIHR bill, which will allow for the grouping of people from social, cultural, epidemiological and basic research fields in a real, if virtual, network, is extremely promising. In recent months in Quebec this possibility has given cause for thought to funding bodies. For example, we realized our targeted rehabilitation network included very few people from the social sciences and from engineering. The people working in engineering faculties do research on applications of great importance in patient rehabilitation. These researchers have been rather isolated up to now. The type of linkage proposed by the CIHR bill is certainly a step in the right direction, and the idea has already begun to change the way research is conducted.

On the question of the autonomy of the institutes and researchers, when it comes to targeted research and free basic research, the very creation of the institutes on a project-oriented basis sets a certain target. It would, however, be desirable for each institute to have maximum spending go to free basic research, because research is built first on the expertise of the researchers and this expertise is acquired, as you know, over a very long time.

We do not change suits because fashion changes. Researchers do not change their expertise because the research program is different. I hope this research agenda will remain fairly broad and we will not be tempted to draw up a shopping list for researchers at an institute. If this were to happen, it would be catastrophic. Research grows like a flower: it must be nourished from below. Pulling it from above will not make it grow. This image applies to each of the institutes as well.

[English]

The Chair: Mr. McLennan, did you have something to add, and then perhaps Dr. Sékaly.

Dr. Barry McLennan: I'd like to respond to some of the questions posed by Réal Ménard. The question as to autonomy I think has been answered at least in part by Dr. Boyle, but I want to remind the committee to remember the overriding objectives of CIHR. It is not business as usual, but rather to establish research activity that is integrative and innovative.

Yes, the institutes are virtual, but the researchers are real. The institute directors will be located wherever their home base is, and a good many of them, I could anticipate, would be in the province of Quebec. As you've explained, your research activity there in the health sector has been very admirable.

But there are some overriding objectives for CIHR, and it will be the responsibility, I submit, of the governing council to ensure the institutes do that. In other words, the institutes will be asked to ensure that they respect the four cost-cutting themes and bring together the biomedical, clinical, health services, and so on.

Let me give you a simple example. I used to do cancer research as a biomedical scientist, as a matter of fact, and there's an important role there for biomedical people in cancer. There's also an important role for clinicians.

Let me put this to you: If we could persuade young people in this country not to start smoking, we could decrease the morbidity and mortality of cancer overnight. What's that? That's a behavioural science product. That's why we want to bring all these researchers together to address this problem—not only that one, but others. So this is the integrative feature that must be respected and delivered in this.

On the allocation of dollars, if I may, the fundamental principle in CIHR will be that you will reward research excellence. In other words, the individual researchers, through their applications to a peer review process, will receive funding. That same researcher will identify one or more institutes with which he or she would like to be associated. So funding to the institutes will flow in two ways. Most of it, I submit, will go through the individual investigator-initiated work. Secondly, as institutes develop and begin to roll out their programs, they may request dollars for specific initiatives, specific programs. So funding will flow in two ways.

I think you asked a question about peer review. I made the comment that the peer review process is crosscutting. Institutes will not have their own peer review panels; rather, it's at the GC level. And I think that's essential, it's fundamentally important, so that there's an overriding peer review process that cuts across all research activity.

• 1235

If I may, Mr. Chairman, can I answer a question about the costs that was posed by Mr. Reed Elley?

When we started discussions on this, we said let's keep it lean and mean, let's keep most of the money going to research. The 5% figure is not a bad target, but as Jonathan Lomas explained, this is not business as usual. We want to bring the research community together. We want to make sure, as we implement evidence-based medicine across this country, that we get the research results from the bench to the bedside to the community. It's no good having a research result if it sits on a shelf.

So the knowledge dissemination of research and the integration of research results will cost something. I submit that this is part of the research process and should not be counted as an administrative cost.

So the 5% target is fine, but keep in mind that we're talking about a new way of doing business. At the end of the day, I think it'll result in less cost to Canadians than we're presently doing, marching off on our own various roadways.

There's a final thing, if I may. The crosscutting processes are important to remember. Peer review is one of them, knowledge transfer is another one. And I'm sure you haven't had a chance to look—but maybe you have—at all the working documents. This is not in the legislation, it's in the working documents. But I can assure you we've spent a lot of hours trying to figure out how this should be done. There are four crosscutting research themes. There are also several crosscutting processes: peer review, knowledge dissemination, partnerships, and—a terribly important one—business development. So those are also the activities of the governing council.

Thank you.

The Chair: Thank you for those comments.

Dr. Sékaly, did you have anything to add?

[Translation]

Dr. Rafik-Pierre Sékaly: To respond to the question on the research institute on AIDS, my own context was a bit ambiguous in a sense, and I mentioned it briefly in my initial presentation.

I think what is important is to start with institutes based on a set of givens and not a hodgepodge of a not of things. It should be mentioned that the community researching AIDS has always operated in a multidisciplinary fashion. The aim of the CIHRs is to have institutions functioning on a multidisciplinary project. The AIDS research community has done so for 15 years. It has done it very well. It functions on various levels, both in providing knowledge and carrying out of research. It is integrated research, and so on.

On the other hand, we must not have a multiplicity of institutes with each interest group having its own institute. This is where things become a bit muddled.

I personally can see very, very easily a research institute for AIDS and related diseases being created, since, as they say in English,

[English]

you're going to get the biggest bang for your buck,

[Translation]

because something that already exists works well. If this were ever mixed with something larger, we run the risking of losing this integrity.

The Chairman: Thank you very much.

[English]

Mr. Jackson, you have a question.

Mr. Ovid L. Jackson (Bruce—Grey, Lib.): Thank you very much, Mr. Chairman.

It's interesting to listen to the group. I think it's a significant step you're making. I want to congratulate all of you for your contribution to your country and your community.

It's something that probably all government departments should follow, but what you have is quite a challenge. I could imagine, for instance, the Auditor General going over your stuff and coming up with what he may think is a boondoggle. Since people don't understand science, and given the fact that you understand what you have to do as researchers, it's important we don't come to some of these conclusions quickly or easily.

I remember going to an egghead breakfast the other day, and one of the scientists, who was using viruses to attack cancer, said that he had this student who did this experiment backwards. He told him not to do it, but he insisted on doing it and then he got a certain result that brought on all kinds of bells and whistles and the scientist told him to do it again. He found out in fact that it was something important in the particular field of research he was getting.

• 1240

I guess it was our good friend Mr. Elliott who said that he'd give you a pat on the back, but I want to caution you that the difference between a pat on the back and a kick on the bum is only six inches.

Voices: Oh, oh!

Mr. Ovid Jackson: I was interested in Mr. Lomas' comments with regard to the media. It may have more sex appeal to talk about the 120-year-old guy who still makes love, so you go to him and ask him how it is that he has lived to be 120 years old and is still in good shape and all that. He says “Well, you know, I drink wine, never water.” You say “That made you live this long?” He says “Oh, yes, because I have a body of iron and water rusts iron.”

So I'm sure that as a researcher you'd want to get some of his genes, put them in your gene pool, and make sure everybody lives to be 120 years old.

I have two questions, I guess.

The Chair: We've been waiting for them.

Mr. Ovid Jackson: First, an organization like yours has to grow, and the only way it's going to grow is with new talent and money. Notwithstanding the fact that you're going to use your research money and maybe give it back to the scientists and the universities, I think some of that money should come back into that pool. I think that pool should grow under your direction and under the scrutiny...I don't want us telling you how to spend your money and all of that. I think that's important. You've decided among yourselves that's something you can do.

But unless it grows—not just expecting the money from the government—I don't think it would do very well, because it will depend on who's in the government, on what they want to do, and on whether or not they have a good budget or a bad budget. As an organization having science—and there's value to it—I think part of that component is that you should get some of that money out of it to make you grow in the direction you think you want to grow—and I don't know how we could accomplish that.

The other part of this was about the dissemination of information. The example I gave of the old guy that lived to be 120 years old would have a lot of sex appeal for the media, but trying to say that if you smoke cigarettes it'll kill you, that there's a direct relationship between smoking cigarettes and lung cancer...how do you get that one out?

Those are my questions to you.

The Chair: Well, who wants to lead off here?

Mr. Greg Thompson (New Brunswick Southwest, PC): Could I ask the first question to Mr. Jackson?

How much is that wine per bottle, sir, and where did...?

Voices: Oh, oh!

The Chair: Dr. McLennan, did you want to respond to that?

Dr. Barry McLennan: I'll try, Mr. Chairman.

The question of getting a better bang for the buck, which I think is what you were saying, is real. We all know, having come through a very difficult period of the erosion of the research base in this country.... And let me commend the government for turning that corner a year ago and putting on the table a new program, CFI, which is an infrastructure program, and now CIHR, for research. These are tremendous programs and they signal the commitment and the resolve of the government to make it right in terms of the health research in the community.

Having said that, there's never enough, right? I think it behooves the governing council to think of ways in which they can partner with other sectors, with the private sector, the health charities, and so on, with respect to leveraging these dollars. That's the debate that's already gone on in our discussions. Indeed, partnership is already happening in the programs of the MRC. This is not a new idea. We see it in the partnership between the federal government and the provinces. If they both contribute to some funding, you make the program work. We see it within the university sector. That's a very real question.

Mr. Ovid Jackson: If I may, just briefly, you've discovered a technique, for instance, so that if a person breaks their ankle, you don't have to go through X-rays and all that. Do you get something back every time a doctor uses it? Could you get $5 or something like that to put in the institute? That's one question. The other question is how you get that information so that everybody doesn't use a gazillion amount of X-rays to figure out something that you've—

Dr. Barry McLennan: I've had this debate with health economists. Of course we tell them that if they invest in health research and get a better treatment or a better regimen for doing something, they will reduce health care costs. They say they can never find the costs, they can never identify that money, but of course it's there. The burden of illness in this country is costing every one of us over $5,000 a year. Healthier people work. They generate wealth. They do good things in the community. Sick people do not. So reducing the burden of illness is a cost-saving measure. I don't care if the bean-counters can't find the money; it just makes sense that if people are healthier, they work. Unhealthy people can't.

The Chair: Thank you very much.

Monsieur Giroux, would you add to this discussion?

Then, Mr. Lomas, would you as well?

• 1245

Mr. Robert Giroux: Thank you, Mr. Chairman.

I would just like to add that we of course see the very strong benefits of the CIHR. Its first and most important objective is to improve the health of Canadians. That's the important objective, because when you look at the very high costs of health care in this country, improvements through research will contribute greatly to reducing this overall cost and, therefore, the pressure on both our federal and provincial governments.

The second major benefit, of course—and I think Mr. Jackson talked to it—is maybe the benefits of commercialization. We believe it is important to commercialize the research results. We believe they should commercialized to the benefit of Canadians.

But really, what is more important than what could be some small returns...because our experiences in the universities as a result of commercialization in terms of returns to the institutions is not that major. The returns are much more important in encouraging Canadian industry to establish itself in Canada, to use the results of the research, to develop it, to commercialize it, and to market it overseas. It creates jobs. It strengthens the community itself. We see this as a very important product.

Of course it's one of the areas that the federal government quite justifiably wants to increase in terms of the impact as a result of its investments in research, but it has to be done through the dynamics that exist in institutions among the researchers, the institutions, and the capacity of those institutions to commercialize those results.

I would like to emphasize those two definitely big products of the CIHR initiative.

The Chair: Thank you very much.

Mr. Lomas.

Mr. Jonathan Lomas: These obviously are related issues. You've raised them as related issues: the dissemination and the need for leveraging of additional funding.

There are two points. First, I'd be very concerned about the fact that there are already enough barriers to getting the research from the production by the scientists into practice, and I wouldn't want to put any further financial barriers in the way of that process. So if we're looking at only funding some of those dissemination and transfer activities when there is partnership or leverage available with others, or if we're going to be charging for such as the Ottawa ankle rules—I see that we have the wallet card right here—we're going to be charging and giving access only to those individuals who can afford to buy these in bulk or whatever. I think we need to be a little cautious about not adding additional barriers to the dissemination exercise.

Mr. Ovid Jackson: I wasn't going in that direction. One of the things I think we lack in Canada.... When you look at an ivy league university like this, what did they do? Well, they started out quite small. Then they got a lot of bright people. Part of what they do is that they have quite a recruiting system: they go around the world and choose the best and give them scholarships—and people who want to go there go there anyway.

I don't want to impede the scientists at all, but sometimes scientists put their heads in the clouds and forget the reality. The reality is that governments don't always have money. Part of what you have to do is to get some money. With the kind of thing that you have, you can generate dollars. You should be thinking. You know that if you put more money into it you're going to get more results. Notwithstanding the fact that a scientist may take a long time to get a breakthrough, which we can't understand...the gentleman's going to call it a boondoggle, but you know it's important.

I don't want to take that away from the scientists or anything like that, but as an organization I think you have to grow. Part of it is that you have to figure out how you're going to do that.

Mr. Jonathan Lomas: That was my second point, which is really to say, building on the idea that we have to grow, let us be cautious in how we grow, because if we are only going to go where the money is, most of the money available for additional funding for research in this country is currently in the private sector. Yes, it is indeed wonderful to get some partnerships with the private sector, and I'm certainly not opposed to appropriate commercialization, but I also would warn you and caution you that as soon as you involve the private sector in the research process in any significant degree, you encounter some difficulties.

The difficulty you encounter is that they have a research agenda that is very different from the public research agenda. There are two recent examples of this.

One of my ex-colleagues from McMaster—I was in fact a health services researcher myself until I became part of the bloated bureaucracy of health research by coming to Ottawa—has recently undergone an extremely unpleasant experience. She participated in a piece of research that was trying to warn that there are drugs in a particular class that are just as cost-effective, that do not cost as much money as the current drug of choice. The drug company owning the drug of choice took her to court and tried to prevent her from releasing that research and that information.

• 1250

We all know about the Nancy Olivieri case at the Toronto Hospital for Sick Children. There are a series of examples in which, once you involve the private sector as a funder with you on board in something like CIHR, you encounter some very significant proprietary issues that are not very compatible with the collective public funding approach we are taking within CIHR and elsewhere.

So I have complete support for your idea. Yes, we need more money. In my own organization we managed to leverage a $9-million-a-year budget into a $15 million a year budget but largely in hands-off, arm's-length collaborations and very much in collaboration with other public agencies that can use the work we do.

Mr. Ovid Jackson: That's a challenge for your board, to avoid becoming captive to the devil.

Mr. Jonathan Lomas: Exactly.

The Chair: Mr. Jackson, you've made your point. I think Mr. Hill has been wanting to get in here. Perhaps you can put a little water into Mr. Jackson's wine.

Mr. David Hill: I'm not sure I'd like to do that. Wine sounds really good, Mr. Chair.

A word of caution: partnering with the private sector is great, and I think researchers are aware of that, but there is also the ability to save government funding of health care that is not related to commercializing some invention. That was one of the issues Mr. Jackson raised. He was talking about the Ottawa ankle rules developed at the Loeb Health Research Institute. It saves the value of X-rays not done, and this saves government health care dollars but doesn't produce a regular income for the inventor. The amount saved is equivalent to the entire annual budget of the Loeb Health Research Institute, and the saving is only related to the number of ankle X-rays not done in eastern Ontario.

So there can be a big payoff in research that doesn't necessarily have to partner with a commercial venture to sell a product. There are both types of savings, and we shouldn't forget that.

The next one up is the Ottawa knee rules, which are just coming in. I don't know the figures on that, but there can be a considerable amount of savings for government in delivering health care through health research.

The Chair: Mr. Hill, can you make those available to the committee?

Mr. David Hill: Absolutely.

The Chair: Mr. Thompson has been very, very patient here. Mr. Thompson.

Mr. Greg Thompson: Thank you, Mr. Chairman.

I want to thank my NDP colleague for allowing me to go ahead of her. I have to leave here after my questioning. I'll listen to the responses.

The committee generally gets nervous when we have more expert witnesses than we do committee members, and that's the case today. I would say that it's not because we're not interested; it's because this crazy schedule around this place doesn't allow us all to be here to hear very valuable testimony such as yours.

I think generally, Mr. Chairman, without speaking out of turn, there's great support for this bill from all political parties in the House of Commons. Obviously the purpose today is to sort of pick your brains and pick out some flaws or what we might consider deficiencies in the bill.

Your two colleagues, speaking to our expert witnesses to my immediate left, brought up a couple of points I want clarification on, Mr. Chairman. Mr. Sékaly mentioned in passing the arm's-length relationship between the institutes and the government, maybe just questioning how this process might work. Mr. Service may want to comment on that, because I think you were involved more at the planning stages than Mr. Sékaly was. I think that's a legitimate question. I had quite a few comments on that very point in our last committee meeting.

My concern, of course, is that the president of the CIHR is chosen by the Prime Minister of Canada. Each governing council member is again appointed by the Prime Minister of Canada. The governing council in turn appoints the advisory boards. I think the whole process deserves at least some explanation, because I think it creates a problem.

• 1255

On page 2 of his brief, Mr. Lomas said that running today's systems under the old design “was like prairie grain farming with a garden hose and the Farmer's Almanac”. There's a little bit of humour here, Jonathan, but I would suggest that the process of appointment is like the Prime Minister of Canada standing out in that wheat field with an election campaign book in one hand and a sledgehammer in the other. Witnessing what has happened in Health Canada and other organizations where the strong arm of the government sometimes comes into play, I really question the independence in terms of the structure and the setting up of that structure.

Last week when Dr. Friesen and others were here, I pointed out—and I think I'm correct in this—that the model this is based on is the U.S. National Institutes of Health. I suggested that in fact appointments to those institutes don't happen as they will for the CIHR. In other words, if that's the model we're using, we're not really conforming as strictly to the U.S. model as perhaps I was led to believe last Thursday.

In the U.S. system the director is appointed by the President of the United States on the recommendation of the Secretary of Health and Human Services. There is a significant difference there. With regard to membership on the advisory boards in the U.S., names are submitted by members of Congress, universities, private companies, and I guess under the U.S. system you could nominate yourself. The names are put into a computerized database. When a council member is needed, the qualifications required are put into that database, and all qualified candidates are contacted. In other words, they have a very sophisticated process.

In the act, as I read it, I really can't take much comfort in that process. I think Dr. Sékaly raises a very important issue in terms of the arm's-length relationship between the new agency and the government.

I think that's enough said. Maybe we could have an open discussion on that, Mr. Chairman.

There is another point I want to make just for the record, Mr. Chairman, if I have time, and perhaps Mr. Giroux could comment on it. I'm not sure how much leeway the chairman is going to give me, but he has been pretty generous up to now.

On page 5 of your brief, Mr. Giroux, you say:

Notably, the expert panel did not suggest that the federal granting agencies should become directly involved in the commercialization of the research they support.

I'm trying to abbreviate this, Mr. Giroux, and I know that's pretty difficult. You refer specifically to paragraph 26(1)(f). and you say:

The current MRC legislation already gives it a mandate to perform research. In its 30-year history it has never used this power. We hope and are confident that the CIHR Governing Council will exercise the same discretion as the MRC Council has shown in using this power. The combination of a research support and a research performance mandate can...

I won't read it all. I think you're making a very legitimate point here, and I'm just wondering whether you think we should consider putting forth an amendment to this bill to change the very points you bring out.

Mr. Chairman, I think there may be a mistake in Mr. Giroux's brief. I'm not positive about this, but I just want to see if I'm right.

• 1300

There's a mistake in your brief in terms of the clauses. You're pointing out a clause; I think you've incorrectly pointed to paragraph (f) twice when it should have been another paragraph.

Mr. Robert Giroux: It should be paragraph (c).

Mr. Greg Thompson: Yes, good.

Anyway, Mr. Giroux, maybe if we have time you can comment on that, and Mr. Sékaly or Dr. Service, and we'll go from there. Thank you.

The Chair: Mr. Giroux, why don't you comment first and then we'll get to the broader issue of the appointment process.

Mr. Robert Giroux: I would not recommend that you make an amendment to the legislation, Mr. Chairman. I think the legislation is enabling, and as such, we support enabling legislation because we're building something that will last for the next 10 to 15 years. Therefore it's important that we allow as much room to manoeuvre and flexibility as possible.

I would also point out that whoever sits on the governing council will be watched very carefully by the Association of Universities and Colleges of Canada as well as others, because our institutions are going to be very much influenced and involved in the activities of the CIHR.

What I wanted to point out, though, as observations, was we have established some practices here that our research community are used to in their operations. We are just making the observations that we would expect that those powers will be used with the utmost discretion and only with justification if the need arises, but not leading to duplication of activities, and respecting what has been in our view a very well functioning research community. We want to build on its strength and not start to play around with it, whatever that may mean.

That's basically where I was coming from, Mr. Thompson, on that particular one.

You're quite right; on page 4 we talk about paragraph 26(1)(f), and then next we should say paragraph 26(1)(c).

The Chair: We'll make sure we correct that accordingly.

Dr. Service and then Dr. Sékaly.

Dr. John Service: I couldn't agree with you more that autonomy of the CIHR is absolutely essential. We believe autonomy is essential throughout the whole operation. An example would be that we have to have strong peer review; it has to be a peer review system that is independent, that decides on the scientific merit. I'm sure Barry and Jonathan, who have been even more intimately involved in the more recent discussions about the CIHR development, would be able to answer this more clearly. But we would expect that recommendations for the GC would come from the community, that these would be vetted and that suggestions would then be forwarded to government. I hope that would certainly be continuing. It would be a model that would be used similar to, I suppose, the granting councils as well, and I think that has served us quite well.

As well, it's going to be incumbent in the development of the GC, the governing council, to have a balance that relates to linguistic and regional, but as well it will have to balance in terms of other interests—social science, biomedical science, consumers. There's going to be a very intricate mix, and all of that is going to have to be clearly kept in mind as the recommendations are vetted through the system.

Mr. Greg Thompson: Excuse me for the interruption, Mr. Chairman. Is there anything, Dr. Service, that we could put into the legislation that would spell this out more clearly, because if I look at the exact wording of appointments and the whole process...? Is that something you people have considered, and if so, what might we consider?

Dr. John Service: I'll answer that very quickly. The CCR has not considered that in detail and has looked at the governing and administrative structures in relationships to government and seen it to be similar to previous experience. If past experience is a good predictor of future behaviour, then we would think we'd have confidence in it.

I might ask Jonathan or Barry, who have been more intimately involved, to answer that more specifically.

The Chair: Dr. McLennan.

Dr. Barry McLennan: Thank you.

I'll just point out, although I'm not a lawyer, that the process that is in place for the appointments is similar to what's been used for the three existing granting councils. I think the research community has certainly been very happy with that process. The MRC, NSERC, and SSHRC councils have functioned very well and fulfilled their mandated to the best of their ability.

In the case of CIHR, I believe the process has been opened up even further. Indeed, to reassure you, Mr. Thompson, the working papers on the website are clearly saying there will be invitations.

• 1305

As a matter of fact, I think in the next few days there will be a call going out not only to the community for the naming of the institutes, but also followed by a call for names to be suggested for the president and chief executive officer, and then following that, the names of the other 19 wise people who will make up the permanent governing council. So I think we're reassured on the council that the process is fine.

Yes, the legislation clearly says, and I think correctly, that the ultimate authority is the Governor in Council. But that parallels the other processes that the community is used to, and I think we can take confidence—at least I take confidence in the fact that if the community is consulted and they come up with a list of names, I think they'll be respected.

The Chair: Well, that's reassuring, because I think it has been a troubling point, certainly for Mr. Thompson, so it's good to hear that clarification.

Mr. Greg Thompson: It's only a troublesome point when you're in opposition.

The Chair: Well, we certainly commiserate with you, but not too much.

Mr. Lomas.

Mr. Jonathan Lomas: Very briefly, yes, this is a much more open process than previously. There is planned, mid-December, an open nomination process for governing council members. There will be an actual advertisement, an invitation for application for the position of president of the CIHR. The process for selection will not be an isolated internal government exercise, but will involve a committee of individuals from outside government as well. So I would say—

Mr. Greg Thompson: It's reassuring to hear that, Mr. Chairman, because that's obviously not spelled out in the deal.

The Chair: I know you now are duly reassured, so we're very happy at the committee level.

Mr. Greg Thompson: Mr. Chairman, we also have to look at things in the sense that someday we may form government again.

The Chair: That too is duly noted.

Ms. Wasylycia-Leis. I can't believe you've been this patient, but you certainly have and it's now your turn.

Ms. Judy Wasylycia-Leis (Winnipeg North Centre, NDP): It's very unusual, right?

The Chair: Yes, it is.

Ms. Judy Wasylycia-Leis: Thank you very much, Mr. Chairperson. I think I'm paying penance for coming in late; it's the price you pay.

I have three questions; some of them have been touched on. In this round and the one before, some of the members before us, the witnesses before us, expressed some caution around going too far down this path of emphasis on partnerships between the public and the private sector. I think it was Mr. Hill who talked about the absolute necessity for autonomy in the whole area of research.

In hearing those remarks, I'm a bit surprised that there aren't more concerns about some of the wording in the bill. In my estimation, and I think we're going to hear some of this as we go along, there's some concern about quite a considerable emphasis on commercialization and putting it almost on an equal level with the public good, as opposed to something that flows from research that's in the best interest of the public good.

I think Jonathan was referencing the Anne Holbrook case and he also mentioned the Nancy Olivieri case, both of which, I think, remind us that when our universities become so dependent on private funding and pharmaceutical company support, we can end up with this kind of sacrificing of the public good for private sector interest that is not in the public good.

In fact we hear from academics and researchers time and time again about how they feel with this pressure from the enormous funding from the private sector at the university level. They feel more and more as if they're involved in a situation of either incest or prostitution, and I think it's a very legitimate concern.

A few of you have touched on this, but in the context of the scale, it seems to me, shouldn't we be a little bit more careful about our wording around commercialization? I would reference specifically not the clause Mr. Giroux did, but paragraph 4(i), with its very specific reference to commercialization, and tie that in to the working paper for the ICG's document when it clearly says the CIHR should ensure that its research priorities are set at arm's length from commercial concerns. I don't see how that requirement is fulfilled in the bill, so I'm throwing that out for a comment.

The Chair: Let's have Dr. McLennan lead off on this, please.

Dr. Barry McLennan: Thank you. I was going to make a comment about the commercialization piece, because I want to disagree just slightly with my colleague Jonathan Lomas.

You must not take too narrow an interpretation of the word “commercialization”—let me just comment. In the job that pays my salary, associate dean of research, college of medicine, University of Saskatchewan, I am continually dealing with the approval of protocols for research contracts and clinical trials. Yes, the cases such as the one that's been mentioned, the Nancy Olivieri case, make the headlines, but they're a small number out of the hundreds of situations that work out well.

• 1310

I also am concerned that the document from the expert panel on commercialization is causing some concern in the university community, because it suggests the only projects we should support are commercializable ones, and that's nonsense. If you take a hundred research projects in the health sector, maybe one or two will lead to something licensable or commercializable.

And why shouldn't we, as Canadians and as a country, benefit from that? I have individual researchers who come to me and want to file a patent for some work they're doing. It has nothing to do with the private sector. It's their own innovation and their own discovery, and we need to reward that. We need to expedite that process. We're fools to send that off and let some other country exploit that. We should generate that wealth for Canada, which by the way, back to Mr. Jackson's question, would provide a source of revenue to help pay for the research to begin with.

So please don't take too narrow a version or interpretation of the word “commercialization”. It's a broad-spectrum word.

Concerning the private sector, with respect, the Nancy Olivieri case would never have happened if the usual rules had been applied in the approval process. As an administrator within a university, I know researchers get very angry, because they have to have three signatures on every research proposal: one from the department head, one from the dean's office, and one from the university president of research. Those checks are there for a reason. They're to ensure that the work they're undertaking is defensible from the university community's point of view and that they're not entering into a contract they would regret, as happened with Nancy Olivieri.

I'm simply making the point that we can do business in the health research sector with the private sector, but we have to understand clearly what their objective is and they have to understand what ours is. If you can't agree on the rules of engagement, then you don't engage.

The Chair: Thank you.

Dr. Boyle and then Mr. Giroux.

Dr. Pierre Boyle: When we think of partnerships with industry, we usually think of commercial-type partnerships. There are other forms of partnerships in which we could engage.

Let me point out one serious problem we have. Industry is certainly right now part of the problem and hopefully part of the solution. There are areas of research, and I will identify three—pharmaco-economics, pharmaco-epidemiology, and the new science of pharmaco-kinetics—that are of prime importance for industry. Our universities have a lot of difficulty right now in developing critical-mass capacity in those areas, because as soon as a hot new researcher comes along, industry zaps that person with a salary that is at least twice what the university community can support, and in doing that, it compromises our capacity to develop critical mass and expertise in areas where both industry and the community can benefit. It seems to me that's an area in which partnership in addressing a problem is certainly something we could entertain without necessarily having a strictly or directly financial component to it.

As for the other, I'd like to emphasize the point just made by Dr. McLennan. Canadian scientists fare very well in terms of their ability to publish, and all the international indicators will support that. Canada is really at the top of the list of countries where scientists are most often quoted, with the greatest impact factors, and so on.

When we look at Canada's ability to innovate, commercialize, and transfer that knowledge into applicable domains, including commercialization, we fare very badly, and there's no reason this should continue. There's no reason Americans should commercialize discoveries made by Canadian scientists supported by Canadian funds. This cannot go on.

So we have to build strategies and we have to transmit a signal to the research community that this is legitimate, but

[Translation]

there have to be guidelines.

[English]

It can't be a free-wheeling operation. But certainly in and of itself it can contribute to improving not only health but also wellness and collective wealth for all Canadians.

• 1315

The Chair: Thank you for your observations.

Monsieur Giroux.

Mr. Robert Giroux: Thank you very much, Mr. Chairman.

Very briefly, I would like to point out that what is so crucial and important here is government contribution towards and government funding of basic or intellectually driven research. That's at the source of all we're talking about, and has to be sustained and maintained and increased.

I saw statistics the other day that the one-year budgetary increase to the national Institute of Health in the United States, which means government funding towards health research, is the size of the current research effort of all of our three governing councils. Now, the United States is very successful in commercialization, but it has not forgotten that the other side of the equation is basic, strong government funding to basic research.

In our view, the main purposes behind the government doing that would be to improve the health of Canadians, and secondly—I agree—to the extent that this can be commercialized, to encourage it to be commercialized, in Canada, marketed from Canada, so that it provides the strongest economic benefits that then contribute to more funding for research.

So it's a very positive circle.

The Chair: Thank you very much.

Monsieur Charbonneau, last question.

[Translation]

Mr. Yvon Charbonneau (Anjou—Rivière-des-Prairies, Lib.): Thank you for your opinion and for preparing it so carefully. Given the time and the content of your remarks, it is not appropriate for me to question you in detail. I would like to discuss two concerns.

In your brief, Mr. Giroux, you mention three concerns. I would like to return to the first of them. I know you discussed a bit with my colleague, Mr. Thompson, but I would like to understand your concern better. It is on page 4 of your brief.

In a passage in English in your brief, you say:

[English]

“namely the power to engage in research (4(e))”.

You go on to say:

The current MRC legislation already gives it a mandate to perform research. In its 30-year history it has never used this power.

[Translation]

I would ask you to be more specific. What problem are you pointing out? They have the powers, they have never used them, and you want things to remain that way?

[English]

The combination of a research support and a research performance mandate can give rise to situations of conflict of interest....

[Translation]

I would like you to explain this point.

I would also like to put a question to Mr. Sékaly on the same point. If I have understood, you are suggesting that the members of the governing councils should be themselves experienced and active researchers with contracts.

From my perspective, Mr. Giroux and Mr. Sékaly, you are talking about realities that are pretty close to one another. One wants the council not to do research, but simply fund it, and the other wants the governing council to comprise people actively doing research. Conflict of interest, conflict of interest... I would like to understand what each of you is saying exactly.

I have a question for Mr. Boyle as well. I would like you to repeat more slowly the figures you quoted on the percentage of research budgets in Quebec compared to the population size. Obviously, I would have liked to put this question in the presence of my Bloc Québecois colleague.

[English]

The Chair: Thank you, Mr. Charbonneau.

Dr. Boyle, if you want to make your point, we'll then go to Monsieur Giroux.

[Translation]

Dr. Pierre Boyle: I said that Quebec has 24 per cent of Canada's population and that Quebec researchers, in competition, receive 32 or 33 per cent of the funds granted by the Canadian Medical Research Council. In the case of the Social Sciences and Humanities Research Council, the figure is 28 or 29 per cent. So the share of Quebec researchers far exceeds the Quebec's demographic weight.

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I think these proportions must be considered when the make-up of the governing council is considered. A population-based formula would seem rather unfair given the current research effort in the various communities.

Mr. Yvon Charbonneau: Mr. Chairman, we heard at least a dozen speeches in the House yesterday and last week telling us that research budgets in Quebec were at the 12 or 14 per cent level, while the population represented 24 per cent. Today we heard figures from eminently well-informed sources, who are not in politics, that will have to be re-examined at some appropriate time a little later on.

[English]

The Chair: Mr. Charbonneau, in your role as parliamentary secretary to the Minister of Health, I'm sure you'll make those points in the House at the appropriate time. You certainly made them here, and we appreciate that.

Monsieur Giroux and Dr. Sékaly, can you sort out the issue Mr. Charbonneau had?

[Translation]

Mr. Robert Giroux: I would also like to add, Mr. Charbonneau, that Quebec's share from the Canadian Foundation for Innovation is also very high because of initiatives taken by Quebec researchers. This is an add on. I do not have the figures, but we can get them for your.

Mr. Yvon Charbonneau: Do you have an order of magnitude?

Mr. Robert Giroux: I think it is on the order of 28 or 29 per cent.

There is another thing. It is not necessarily a concern, but we nevertheless wanted to point out to you that you have today a network whose players do not necessarily work very well together and could be harmonized. Co-ordination and co-operation could be improved. You have universities, hospitals attached to universities, research institutes, research labs and all sorts of sectors.

We would like the governing council to make sure, before telling us what sort of research to do, that the research is not already done. All these infrastructures in place are the result of a lot of investment by former governments. We must make the most of this.

You are right in saying that we have one small fear. If the Medical Research Council has not, in the past 30 years, felt the need to do so, well, care must be taken before a decision is made to do one's own research oneself. We must make sure the research has not already been done.

The Canadian Institutes of Health Research represent a new approach, a new way of doing things. They may identify sectors—research policy or others—that cannot be established at the moment because the current system lacks the means to do so and decide to spend a little money on this research. This would be legitimate, but, in my opinion, these powers to be given the governing council should not go further.

Dr. Rafik-Pierre Sékaly: What counts is having people on the governing council who are familiar with the research system, who have done and are continuing to do research, not people who are funded by the governing council, but people actively doing research.

The last thing we should have is a governing council with a majority of officials and administrators. It is important to have people with a finger on the pulse of the community of researchers. That was what I was trying to say.

Mr. Yvon Charbonneau: Mr. Sékaly, will you be submitting your notes in writing?

Dr. Rafik-Pierre Sékaly: Yes, I will give copies to...

Mr. Yvon Charbonneau: Fine. You made a series of suggestions, but I had no written document.

Dr. Rafik-Pierre Sékaly: I was asked to bring two copies of it, I should have brought four.

Mr. Yvon Charbonneau: Perhaps I missed some suggestions.

[English]

The Chair: We'll get those and have them distributed to everyone.

[Translation]

Mr. Yvon Charbonneau: You expressed a concern about the potential closing of certain institutes. You would not like them to close. You mentioned a clause, but you went quite quickly. You saw the possibility...

Dr. Rafik-Pierre Sékaly: Points 20 and 21 provide that the governing council could close institutes. I think this would definitely not be desirable. People must give serious thought from the outset. I think that the process of consultation Dr. McLennan mentioned is very, very important. We will have institutes that are sought by a vast majority of researchers, and there will be no need to close institutes. As I have said, if institutes are ever closed, it would be discouraging for researchers and for the program. So, from the outset...

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Mr. Yvon Charbonneau: According to sector development and changes in science, do you foresee the possibility of remodulating the institutes? If there are 15 of them, could we, six or seven years later on, say there are two that are less relevant and use this fact to move into other areas that seem less important now, rather than simply adding on? If we simply add on, there will not be 12 or 15, but rather 22 or 25. Everyone has a good reason for adding on.

Dr. Rafik-Pierre Sékaly: The point of my remarks was to have you understand the need to start properly, with a limited number of institutes, and not with some 15 of them and the fact that these institutes must be fully justified and have the full support of the community of researchers. When the time comes to add more, well, so be it. Closing an institute in my opinion would create a negative dynamic, which is not what we want in the context of the program.

Mr. Yvon Charbonneau: In any case, we are along way away from the prospect of closing institutes; we are creating them, Mr. Chairman. Let us not panic unnecessarily.

[English]

The Chair: Okay, very good. Thank you very much.

I had a couple of clarification questions, Mr. Hill. In terms of the ankle rules that you had a minute ago, the Loeb Health Research Institute promoted those in other countries, did they not? Am I correct in thinking that?

Mr. David Hill: Yes, it is known internationally as the Ottawa ankle rules, and if you present in Paris, France, with an ankle injury, they will use the Ottawa ankle rules to determine whether you need an X-ray.

The Chair: How was that promotion done? That's really my question.

Mr. David Hill: It was really through the network of researchers. It's an amazing network internationally. There was no really formal system of doing it, but it has gone worldwide. The Ottawa knee rules are the next ones going out.

The Chair: Do you anticipate the CIHR doing this differently, or would the same format and process take place?

Mr. David Hill: That I'm not sure of. That's a very interesting question, and I don't know the answer to it yet. I think it needs a little more discussion.

The Chair: We'd like to know maybe at some point.

Mr. Lomas.

Mr. Jonathan Lomas: I just want to clarify that indeed there was a lot of money invested in the dissemination of the Ottawa ankle rules. The Institute for Clinical Evaluative Sciences in Toronto, an investment of the provincial government, which is very interested in ensuring that this kind of health services research finds its way into the system, invested well in excess of $100,000 in helping not only with the tail-end funding of the research, but with the actual dissemination exercise and the production of some materials.

So it does in fact illustrate the important point that funding of just the research and the researchers is very often not enough to get a widespread kind of impact from something like the Ottawa ankle rules.

The Chair: Okay, thank you very much. I'd like another quick clarification.

A number of witnesses have talked about the national task force leading up to the formation of the CIHR. Very quickly, can somebody tell me why that was done, by whom, and what the mandate was? I just want to be really clear on that process.

Dr. McLennan.

Dr. Barry McLennan: Yes, in 1990 the initial group that came together at the request of the Minister of Health was called the CIHR task force. That group worked up until February 1999. When the government then introduced the budget in February 1999, they created the interim governing council, which replaced the task force. I might also add that it was also made quite a bit larger.

If I may, while we're talking about the composition of the governing council, remember that the spirit of CIHR is to benefit all regions of Canada. We're talking about going from coast to coast.

In subclause 7(4), which you were talking about, I think the first sentence should be read just as thoroughly as the second sentence, where it says:

The Governor in Council shall appoint as members of the Governing Council women and men who are able to contribute to the achievement of the objective of the CIHR.

Then the second point talks about:

women and men who reflect the highest standards of scientific excellence and men and women who reflect a range of relevant backgrounds and disciplines.

Now, that's very carefully phrased.

Certainly the active researchers in the community would probably say they want all 19 to be researchers. I don't think that's going to happen. Nor did the Governor in Council suggest that, for obvious reasons. Nonetheless, as several people have said today, I would hope there's a fair proportion of men and women on that council who either are active researchers or clearly understand what CIHR is all about.

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The Chair: Thank you very much.

I'm sorry we took so long today, but it seems to me, based on the questions and what you had to say, it was important that we do so. I hope we haven't inconvenienced you too much. Let me simply, on behalf of the committee, thank each and every one of you for the very informative discussion we've had. We look forward to expediting this process as soon as we can. Thanks very much.

This meeting stands adjourned.