REPORT OF THE COMMITTEE
|THURSDAY, April 6, 2000|
The Standing Senate Committee on Social Affairs, Science and Technology has the honour to present its
Your Committee, to which was referred Bill C-13, An Act to establish the Canadian Institutes of Health Research, to repeal the Medical Research Council Act and to make consequential amendments to other Acts, in obedience to the Order of Reference of Tuesday, April 4, 2000, has examined the said Bill and now reports the same without amendment.
Attached as an appendix to this Report are the observations of your Committee on Bill C-13.
Bill C-13, An Act to establish the Canadian Institutes of Health Research, to repeal the Medical Research Council Act and to make consequential amendments to other Acts
Observations of the Standing Senate Committee on Social Affairs, Science and Technology
During the hearings of the Standing Senate Committee on Social Affairs, Science and Technology on Bill C-13, An Act to establish the Canadian Institutes of Health Research, to repeal the Medical Research Council Act and to make consequential amendments to other Acts, no witnesses spoke against the legislation. The Committee was told that the Canadian Institutes of Health Research (the CIHR) would eliminate longstanding barriers of discipline and geography through innovative "virtual" linkages and networks. We also heard that these virtual institutes would be multi-disciplinary in nature and would foster the integration of the four sectors of health research basic biomedical research, applied clinical research, research on health care systems and services and, population health research. The Committee strongly supports this innovative approach.
Although witnesses were very supportive of the development of the CIHR, some suggestions were made with respect to the selection of the research institutes. While Bill C-13 provides for the creation of a number of institutes, it does not specify how many of them will be created, nor does it identify any fields of research. These decisions will be the responsibility of the Governing Council of the CIHR. A number of witnesses stressed that particular attention should be given to Aboriginal Canadians and Canadians living in remote and rural areas.
We were told that, while Aboriginal Canadians have made impressive improvements in terms of health status, they remain at higher risk for illness, and earlier death than the Canadian population as a whole. They suffer from more chronic diseases such as diabetes and heart disease than the general population, and there is evidence that these conditions are increasing among Aboriginal groups. Similarly, Canadians in rural and remote localities usually have a lower health status than Canadians in urban areas. Further, they do not have access to the broad range of health services available in cities. The Committee was told that Canada has a special vantage point in dealing with rural and Aboriginal issues given our unique geography and multicultural make-up.
The Committee agrees with the assessment that Canada could become a world leader in these fields of research. Consequently, the Committee suggests that, in establishing the research institutes, the Governing Council of the Canadian Institutes of Health Research pay special attention to the specific health problems of Aboriginal Canadians and of Canadians living in rural and remote areas.
The Committee was also told that mental illness and mental health should be given special consideration under the CIHR. We heard that while 16% of total health care costs are mental-health related, less than 5% of research costs are applied to this area. Even though one in five Canadians will have a diagnosable mental illness that requires treatment, the stigma attached to mental illness has the effect of marginalizing a significant segment of our population. The Committee supports raising the profile and status of mental health issues within the medical and research community and, accordingly, suggests that the Governing Council of the Canadian Institutes of Health Research pay special attention to mental illness and mental health when establishing the institutes.
Furthermore, the Committee was told that, throughout their lives, women face life conditions and health issues specific to their biology and social circumstances and that, similarly, men face differential biological and social circumstances. Accordingly, witnesses stressed that gender-based analysis should be an integral part of health research. The Committee shares these views and, therefore, we suggest that gender analysis be incorporated in each of the institutes in order to reflect the health issues that have an impact on either women or men.
The Committee heard that the Centres for Excellence have stood as a centrepiece of the governments commitment to womens health research and are important milestones in the evolution of health research in this country. Moreover, the Committee is of the view that the role of the Centres for Excellence and that of the CIHR are not mutually exclusive and we encourage all research bodies to co-ordinate their efforts.
Witnesses stressed that health research requires transparent and credible ethical procedures, predominantly for the protection of human subjects of research. They welcomed Clause 4(g), which fosters the application of ethical principles to health research. The Committee believes that ethics cross-cuts all sectors of health research and advocates the consideration of ethical issues in all CIRH research initiatives.
Finally, some witnesses discussed the organizational structure of the CIHR. More specifically, they raised concerns about Clause 9 of the bill, which states that the President of the CIHR would also be the Chairperson of the Governing Council. In order to ensure transparency and accountability of the CIHR, they contended that these two positions should be filled by different people. The Committee shares these concerns and therefore we urge the federal government to amend the act at the end of the Presidents first five year term so that the position of President of the CIHR and the Chairperson of the Governing Council cannot be occupied simultaneously by the same person.