Proceedings of the Standing Senate Committee on
Social Affairs, Science and Technology
Issue 8 - Evidence
OTTAWA, Wednesday, November 1, 2006
The Standing Senate Committee on Social Affairs, Science and Technology, to which was referred Bill C-5, respecting the establishment of the Public Health Agency of Canada and amending certain acts, met this day at 4:15 p.m. to give consideration to the bill.
Senator Art Eggleton (Chairman) in the chair.
[English]
The Chairman: The committee will now go into clause-by-clause consideration of Bill C-5, respecting the establishment of the Public Health Agency of Canada and amending certain acts.
We have three officials here with us today, if there are any questions with respect to any of the clauses as we go through them. They are Jane Allain, who is General Counsel to the Public Health Agency of Canada; Jim Harlick, who is Assistant Deputy Minister Strategic Policy, Communications, Corporate Services Branch of the Public Health Agency of Canada; and the Chief Public Health Officer himself, Dr. David Butler-Jones, who has been here previously.
I will now proceed into clause-by-clause consideration. Shall the title stand postponed, honourable senators?
Hon. Senators: Agreed.
The Chairman: Shall the preamble stand postponed?
Hon. Senators: Agreed.
The Chairman: Shall clause 1 stand postponed?
Senator Watt: I am not in agreement, so I do not want to be included. I am making my stand here.
The Chairman: Shall clause 2 carry?
Hon. Senators: Agreed.
The Chairman: Shall clauses 3 to 5 carry? That is, establishment of the public health agency.
Hon. Senators: Agreed.
The Chairman: Shall clauses 6 to 12 carry?
Hon. Senators: Agreed.
The Chairman: Shall clauses 13 to 15 carry?
Hon. Senators: Agreed.
Senator Callbeck: Under that clause, where it talks about advisory committees and so on, I think this is the right time.
The Chairman: Is that section 14(1)?
Senator Callbeck: I think my question comes under this clause. I just wanted to ask Dr. Butler-Jones a question regarding the letter that he sent to the chair of the committee.
Dr. Butler-Jones, on page 3 of that letter, the third paragraph, second sentence, you say that at the working level, Aboriginal health experts will be integrated into the existing FPT public health network structures. Is that something you will commit to and promise today?
Dr. David Butler-Jones, Chief Public Health Officer, Public Health Agency of Canada: Absolutely. We have already started to do that. We made reference to that at a previous meeting, that one of the committees already has done that. Kim Barker, who has presented here, is a member of one of the committees. We have committed to the First Nations that we will do that. It is our intent to do so, and the provinces and territories in the network have agreed to it.
We have been in consultation over some time now with First Nations, the national Aboriginal organizations, on how to best accomplish that most effectively, and I think there was some reference to it in the sense that they have come to us, we have sent something back, and we are actually sitting down and contemplating how to make that best happen. Therefore it is a definite; it is not a maybe.
Senator Callbeck: Are you committing to everything that is in this letter?
Dr. Butler-Jones: Absolutely.
Senator Watt: Why do you reject explicitly mentioning that in the bill itself? That would provide a guarantee, and no questions will be asked after that.
Dr. Butler-Jones: At this point in the process of the bill, given the time that this issue has been out there, and the level of consultations and discussions that have gone on, as I think I described, my concern is that if we get into an event, if we get into a situation, that further exacerbates the potential for problems in terms of the sharing of information, et cetera, and the authority or existence of the agency. I believe that we can address at least those items that relate to questions about the public health network, et cetera, and that is our intent, and continues to be our intent. Once this agency is established, then actually we have the legislative authority to start talking about what would a public health act for Canada look like, and how does that get engaged, et cetera.
That, at least, is my view. It is obviously up to the committee how they wish to proceed, but my concern at this point is with additional delays. We are already two years into the establishment of the agency. Fortunately, we have not had a big event such as SARS again, given the indications from provinces and others about whether we may or may not be able to share information if we do not have the authorities in place to receive that information and use it for public health concerns. I do not want to have that debate during an event. I would like to have this issue resolved in advance.
Senator Watt: Your main concern is a delay; otherwise you would have accepted those amendments?
Dr. Butler-Jones: There are processes for that, and so many of the suggestions made at the Senate committee were new to us. We had not heard them before. Obviously, there would need to be legal machinery and other considerations made as to their implications. However, if we can get at, for example, such conceptions as the chief public health officers reporting to me, I would point out that the agency does not actually provide services in the North or on reserve. Is that the best place for them? What I would want to do from this point is to have a discussion with people such as First Nations or the Nunavut people, etcetera, as to what it is they hope to accomplish, given the existence of a medical officer in their area, as to what added value there could be, and how best to accomplish it. It may be that solution, or it may be that another solution would be more effective, given the shortage of medical officers. Having two or three more medical officers in Ottawa versus working in the field may or may not be in the interests of public health or of those communities.
Senator Callbeck: I have one brief question in terms of passing this bill: If this bill is not passed, what information would you not be able to receive?
Dr. Butler-Jones: During the SARS outbreak, for example, we were not able to receive information about potential SARS patients. We had laboratory information that suggested there were people who may have been infected with SARS, for whom we had positive tests, and we were not able to actually discern who those people were because the province would not share that information. The legal advice was that the province was not allowed to share it because we had no authority to receive that information.
We had other incidents where provinces are not reporting on diseases in the normal fashion again because of that kind of uncertainty, namely, our ability to receive it and to guarantee the protections that the regulations and the legislation would guarantee in terms of the protection of privacy. That is their decision. Our legal advice on this point, and from consultation with legal advisors in the provinces, is that this bill and the regulations that will follow will facilitate that situation.
Senator Pépin: I am going back again to your letter. You say that you are committed to ensuring that your reports reflect the best understanding of related issues and that, in order to do so, Aboriginal health expertise and perspective must be effectively engaged. Can we rely on you in that respect?
Dr. Butler-Jones: Quite honestly, for me to do a report with any credibility, it must engage the expertise and the perspectives necessary to actually bring an appropriate public health perspective to the situation and to the areas, otherwise I am not doing my job in respect of those reports. During our conversations with a number of groups, not just Aboriginal, it has clearly emerged that that has to be my commitment if I am to be successful with those reports. Those reports will have resonance. If I put out material in the reports just because I feel like it, how effective is that likely to be?
The Chairman: I will call again; shall clauses 13 to 15 carry?
Hon. Senators: Agreed.
The Chairman: Carried. Shall clauses 16 to 20 carry?
Hon. Senators: Agreed.
The Chairman: Carried. Shall clauses 21 and 22 carry?
Hon. Senators: Agreed.
The Chairman: Shall clause 23 carry?
Hon. Senators: Agreed.
The Chairman: Shall clause 24 carry?
Hon. Senators: Agreed.
The Chairman: Carried.
Now we go back to clause 1, which is the title. Shall clause 1 carry?
Hon. Senators: Agreed.
The Chairman: Shall the preamble carry?
Hon. Senators: Agreed.
The Chairman: Shall the title carry?
Hon. Senators: Agreed.
The Chairman: Carried.
Honourable senators, observations come in at this point in time before the final motion. I want to say, concerning the observations document that honourable senators have before them, that Senator Fairbairn and others have asked that there be a further strengthening of that sort of thing.
First, under ``E,'' with the heading ``First Nations and Inuit Public Health Act,'' as I had indicated in discussion earlier, concerning the whole question of public health issues and the possibility of untimately having a public health act, I would suggest that we strengthen that observation so that the committee now says that it intends to be seized of this matter. In other words, we intend to follow up on the broader concerns that have been raised by these different communities that have come before us. That is a commitment we could put in there. It is a commitment that I, too, make personally that we would continue to follow those concerns that the witnesses raised when they were before us.
Furthermore, under ``Review of the Agency,'' the final paragraph, instead of saying that the committee intends, I suggest we say that the committee is committed — in other words, to strengthen that language — committed to a full review, and to also recall the agency to this table to review their operations of the Public Health Agency of Canada after six months in order to determine the extent to which it has implemented these observations with respect to the commitment to First Nations and the Inuit. Those are the amendments that I would propose should find their way into the observation document in order to strengthen the commitments therein.
Are there any other comments on the observations?
Senator Pépin: There was one. The committee wants to see the obligation — and I spoke about it on the French translation, and we say the following:
[Translation]
The committee asks that there be an obligation for representation of First Nations and Inuits on the advisory and other committees established by the Minister.
[English]
In French, I changed a word.
The Chairman: I take it that is in order. It is the same thing? Very well —
Is there anything else on the observations, colleagues?
With those amendments, in order to strengthen them, is it agreed that we insert those observations?
Hon. Senators: Agreed.
The Chairman: Carried. Is it agreed that this bill be adopted with the observations; that is with the amendment?
Hon. Senators: Agreed.
Senator Watt: One disagrees.
The Chairman: Okay. One is in disagreement.
Is it agreed that I report this bill with the observations at the next sitting of the Senate?
Hon. Senators: Agreed.
The Chairman: Carried. That deals with it.
Thank you very much, honourable senators. The bill will then be reported to the Senate, without amendment to the bill itself but with observations in amended form.
The committee adjourned.