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EVIDENCE

[Recorded by Electronic Apparatus]

Thursday, November 23, 1995

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[English]

The Chairman: I call the meeting to order to resume consideration of Bill C-95, an Act to establish the Department of Health and to amend and repeal certain Acts. I shall call clause 2.

For purposes of our illumination we have as witnesses today officials from Health Canada. Perhaps the easiest thing is for you to introduce yourselves, beginning with Mr. Juneau, assistant deputy minister.

Mr. André Juneau (Assistant Deputy Minister, Policy and Consultation Branch, Health Canada): Good afternoon, Mr. Chairman, and thank you very much. As you said, I'm André Juneau. I'm the assistant deputy minister for policy and consultation in the proposed health department.

With me are Mark Wheeler, who is the assistant director in the health determinance division in my branch, and Mario Simard, who is a senior counsel in the legal services of the department.

We also have with us Pat Russell, who many of you know and who is with our parliamentary relations office.

The Chairman: I understand you will be making a brief statement and then we'll open for questions from our members. With that we can proceed.

Mr. Juneau: Thank you very much.

[Translation]

If I may, Mr. Chairman, I propose to begin with a few words about the federal role in health, about the health department and about Bill C-95. Then I will ask Mario Simard to take you through the bill clause by clause, after which we would be pleased to try to answer your questions.

[English]

The first thought that comes to Canadians' minds about health is health care delivery. Our personal experience with health is often confined to our encounters with doctors, nurses, hospitals. Since section 92 of the Constitution Act of 1867 says that provinces have jurisdiction over hospitals, the regulation of health professionals, matters of local concern, it's not surprising we often think of health as a provincial issue. This is, of course, appropriate.

It's useful to note that a number of elements of section 91 of the Constitution Act give the federal Parliament considerable jurisdiction over health-related matters. For instance, out of 64,000 departmental employees only 25 administer the Canada Health Act.

Mr. Chairman, I don't want to cover the ground you and your colleagues covered during second reading of this bill, other than to note federal authority is found in Parliament's criminal law powers, its trade and commerce powers, the spending powers, the peace, order and good government clause, and in other heads of power enumerated in section 91.

[Translation]

The department is made up of three program branches and two corporate branches. Forty percent of our employees, out of a total of 6400, work in the Health Protection Branch, which is home to our regulatory and disease monitoring functions. Administering the Food and Drugs Act is perhaps the most visible function, although whenever there is a risk of the plague - a small epidemic recently broke out in India - or a risk of Ebola, which broke out in Africa some time ago, or some other emergent disease, LCDC gains ready prominence.

Our other large branch is the Medical Services Branch, which delivers health services on Indian reserves and on the Yukon Territory. We used to deliver health services in the NWT as well, but this function was devolved to the territorial government some years ago. In fact, the long-term aim of this branch is to devolve the administration of services completely to the Yukon government and to Indian health authorities.

[English]

Turning to our smaller branches, health promotion and programs is home for our population health strategies, for the national health research and development program and for a great deal of collaborative work with the provinces.

My own branch, policy and consultation, covers overall policy, strategic planning, communications, plus the women's health bureau, administration of the Canada Health Act and international affairs. Finally, there's the corporate services branch, which handles functions such as personnel, finance and so on.

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This is obviously a very cursory overview, but I think all of you are familiar with the department through your review earlier this year of our plans. Many of us have had the privilege of appearing in front of the committee for one reason or another. Let me say at this point, Mr. Chairman, if there are briefings the members would want on one or another aspect of the department's work, we would be pleased to arrange those briefings.

Let me turn briefly to Bill C-95. During the second reading debate, Dr. Hill suggested C-95 did not amount to much more than a name change. In a sense, while I don't want to play down the importance of establishing the department I belong to, at one level Dr. Hill was absolutely right.

The bill serves two purposes. It formalizes the government reorganization, which saw two welfare branches of the former Department of National Health and Welfare transferred to the new Department of Human Resources Development; the amateur sport, but not the fitness element of the former fitness and amateur sport branch transferred to the Department of Canadian Heritage; and the product safety operations of the former Department of Consumer and Corporate Affairs transferred to Health.

The other thing the bill does is freshen up some of the language used to describe departmental functions. It's striking that most of the content in the current act dates from 1944, and it was similar to the original content of 1919. So it's remarkable to see how enduring our core functions have been over a time that has seen such remarkable changes.

[Translation]

But there is one purpose that C-95 does not serve, and that is to alter the federal role in health. The operative clause is found in section 4(1) of the bill which defines the department's mandate in terms of matters over which the Parliament of Canada has no jurisdiction: no more, no less.

[English]

Now, Mr. Chairman, with your permission, I would like to ask Mr. Simard to take members through the clauses of the bill.

[Translation]

Mr. Mario Simard (Senior counsel, Legal Services, Health Canada): I will go over each section of the bill and briefly explain each one. If I go too fast or too slowly, please tell me, and I will adjust my pace.

[English]

I think you have a clause-by-clause in the binder that was provided to you. Clause 1 essentially determines what the name of the department will be. It will be the Department of Health as opposed to what used to be the Department of National Health and Welfare. There's not much more to say about that.

Clauses 2 and 3 simply establish the department and provide for the appointment of a minister and a deputy minister. It's strictly routine.

Then we get to subclause 4(1), which is really at the heart of the bill. I will leave you a few seconds to read it. It defines in broad terms the mandate of the department.

As you can see, the mandate of the department is defined as relating to the ``promotion and preservation of the health of the people of Canada'' for matters that are not assigned to some other department or agency, all of that within the federal jurisdiction.

Then follows a list in subclause 4(2). It's not an exhaustive list, but a series of examples of what that mandate encompasses.

Then you have essentially a definition of health, which says:

As you can see, this is a holistic definition of health because it refers not only to the physical and mental well-being of the people but also to their social well-being, because all those factors are connected. This is, by the way, the definition of the World Health Organization.

Again, this is always for matters that are not by law assigned to other departments. For example, on social matters, certain specific issues, such as the Labour Code, are assigned to the Department of Human Resources and Development.

[Translation]

The purpose of paragraph 4(2)b) is the protection of the people of Canada against risks to health and the spreading of diseases. This is a new provision. It does not substantially alter the role of the department, but it clarifies its functions.

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The bill more or less represents a security net whose purpose is to anticipate situations that might threaten the public and are not covered by other bills, such as the Food and Drugs Act.

For instance, if someone wanted to import a dangerous virus into Canada, such as the Ebola virus, it would not fall under the Food and Drugs Act because the virus cannot be eaten nor is it a drug. In that case, the general bill would be used to control the situation and, if necessary, to adopt regulations, as has already been done.

In the past, we always simply referred to the general mandate of promoting and preserving health. However, in the case of situations like the one I've just described, situations which may call for drastic action, it is important to clearly define the responsibility of the department in terms of health protection.

Moving on to paragraph 4(2)(c):

The wording has been slightly changed, but it does not affect the substance of the provision. It basically calls for a national organization which would monitor the evolution and spread of diseases.

For instance, there might one day be an outbreak of meningitis. It's possible that there would be only one case reported in one province, but that several cases were reported in other provinces. So our role would basically be to monitor diseases.

Paragraph 4(2)(d) reflects the fact that with government reorganization, the Dangerous Consumer Products Division has been transferred to the Health Department. This is new, but the reorganization is already complete.

Paragraph 4(2)(e) is not new. The wording was changed slightly to modernize this provision, but it does not affect the substance. It basically deals with the protection of public health on railways, ships, aircraft and other methods of transportation.

Paragraph 4(2)(f), which relates to the health of public servants, is not new either. The department has a certain mandate in terms of the health of federal public servants.

As well, paragraph 4(2)(g) is a provision which has been in the Act since 1919. It basically speaks to the government's responsibility in the area of applying recommendations made by the International Joint Commission on the Great Lakes.

Paragraph 4(2)(h) is also not a new provision. It was in existence already. It basically deals with the collection, analysis and interpretation of statistics relating to public health.

Let's move on to paragraph 4(2)(i). I would like to draw your attention to this provision which has been in existence since 1919. One of the roles of the department is to cooperate with provinces in the area of health.

[English]

This is the list of the functions and duties that fall under the responsibilities of the Minister of Health.

Clause 5 contains a new provision. Clause 5 essentially provides for the enforcement of the Department of Health Act or its regulations by inspectors. For example, there are regulations with regard to the importation of human pathogens, which have been adopted under the Department of Health Act.

Currently there is no provision to give any power to our inspectors in this area. For example, with the importation of human pathogens, we have to rely on the Customs Act for enforcement purposes. Those provisions are not adapted to our needs. For example, it doesn't provide for the taking of samples and so forth.

Clause 5 says that when we have inspectors enforcing regulations adopted under the Department of Health Act, they will have the same powers as they have when they enforce the Food and Drugs Act.

Clauses 6 to 10 would allow the department to charge fees for services it renders that are of a commercial value for the recipient. I should mention at the outset that those clauses are exactly the same as those that were adopted recently for other bills, such as the Department of Industry Act and the Department of Canadian Heritage Act.

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The reality is that the exact wording of these clauses is the result of discussions between officials of the Department of Industry and representatives of the parliamentary Standing Joint Committee on Scrutiny of Regulations.

So I repeat that those fees are meant for people who get the commercial advantage; for example, a company that would get a licence to market a drug. I don't want to get into the details here, but ceilings are provided. So there are limits to what can be charged. Also, as you can see, one feature of those provisions is that when adopting those fees, the department is not subject to the full regulatory process.

On the other hand, checks and balances have been introduced in the provisions, namely that the bill provides that there must be a consultation, there must be a publication of the fees, Parliament through the standing joint committee can intervene at any time, and also that this is subject to Treasury Board controls.

That brings me to clause 11. Clause 11 is essentially the clause providing that regulations may be adopted under the act. The only difference is that in the current legislation the maximum fine for an individual is $200 or a maximum penalty of three months of imprisonment. This dates back to 1944.

We are proposing here to simply align the bill with the summary conviction provisions of the Criminal Code, which means the maximum penalty for an individual would be $2,000 plus six months imprisonment and for a company the imprisonment can be replaced by a $25,000 fine. I should mention that we made a quick calculation and the $200 in 1944 would represent $1,935 in today's money. So we haven't changed things substantially in that sense.

Clause 12, especially in these difficult times, is a very important clause. Essentially, what it says - and this is something that has been there since 1919 - is that nothing in the act authorizes the minister to exercise any jurisdiction or control over any provincial authority.

Then we get to transitional provisions. Clauses 13 to 34 essentially provide for the transfer of personnel from the former department to the new one, transfer of appropriations, and transfer of legislative powers. This is strictly technical. It is the same for the consequential amendments.

Finally, I should simply mention that the Department of Consumer and Corporate Affairs is repealed because it has become an empty shell. All its powers have been transferred to other departments.

Thank you very much.

The Chairman: Thank you very much. I appreciate your taking us through this.

I welcome Dr. Hill. The good doctor missed the assistant deputy minister acknowledging his wisdom earlier, or perhaps you heard it and that's why you raced over. I'm not sure. But the assistant deputy minister was acknowledging the fact that it was fundamentally a name change, as you had pointed out on Tuesday.

We'll begin questions with Mrs. Picard for ten minutes.

[Translation]

Ms Picard (Drummond): My question is for Mr. Simard. Paragraphs 4(2)(a) and 4(2)(b) describe general functions of the department within the framework of Canadian health policy.

However, we might wonder what kind of means the Minister would use to implement the function described in paragraph 49(2)(c):

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How can the Health Department monitor the development of a disease without accessing relevant data? Indeed, section 12 of Bill B-95 reads as follows:

But we know that the institutions which fall under the Act respecting health services and social services are precisely the ones which fall under provincial legislation.

Mr. Juneau: If I understand the Member's question, this provision is based on cooperative arrangements which date back several years, mainly between the Disease Control Laboratory and its provincial equivalents. There is an epidemiological network throughout the country in which there are all kinds of data exchange mechanisms and if you're interested, we can provide you with more details.

Ms Picard: Thank you.

[English]

The Chairman: Thank you.

Dr. Hill.

Mr. Hill (Macleod): I would like to direct attention to paragraph 4(2)(c), as well. One of the concerns I've had in terms of the monitoring of diseases is new arrivals coming into Canada with diseases that I consider to be highly infectious. This is not a new subclause here at all. Is there anything that I can foresee in the future as far as restricting individuals with infectious disease coming into Canada is concerned?

Mr. Juneau: Mr. Simard may wish to comment on that, but the authority to do it is found in the Immigration Act in paragraphs 19(1)(a) and 19(1)(b). I think if there were to be developments in that respect, they would be in the domain of the Minister of Citizenship and Immigration. I would add, though, that we work very closely with them on the technical aspects of the management of that section.

To the extent that you are talking not of people who seek to settle in Canada permanently or for significant periods but about people who may be visitors, for instance, or others who ought to be quarantined, there is the Quarantine Act, which is an act under the jurisdiction of the Minister of Health.

Mr. Hill: I would like to go to the area of fees. I don't see any dispute settlement mechanism in this series of clauses. If there is a dispute, how might that be handled?

Mr. Juneau: I'll ask Mr. Simard to answer that.

Mr. Simard: Do you mean a dispute in the process of adopting the fee schedules or in the process of charging them?

Mr. Hill: Let's just say there are no fees at present on the health food market and the government decides it is going to go to cost recovery for new health food products coming. Is there any mechanism to dispute either the ability of the department to come along with fees or the amount of the fees?

Mr. Simard: That would normally present itself when services are rendered to a corporation or a person, or when a licence is issued. The normal way to settle those matters is through the civil courts, as with any other claim.

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

I'll go to the government side and Dr. Patry.

[Translation]

Mr. Patry (Pierrefonds - Dollard): Bill C-95 contains provisions relating to cost. There are even three series of provisions on cost recovery. However, Bill C-95 says nothing about the categories of users or beneficiaries who will have to pay these fees.

Of course, pharmaceutical companies and food processing plants will have to pay fees, but what of beneficiaries such as the Inuit or status Indians who receive services from the department? Will they have to pay?

Mr. Simard: The fees imposed by the government, in that situation, only apply when a commercial benefit is derived from the service rendered.

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For instance, if a pharmaceutical company asks for permission to sell a drug, it will have to pay licence fees because the licence has commercial value. These fees are also imposed on a manufacturer whose product is inspected and then sold.

However, there will be no fees for the delivery of health care, at least not in the way you meant.

[English]

The Chairman: Do we have anyone else from the government side?

Mr. Szabo.

Mr. Szabo (Mississauga South): Subclause 11(2) deals with punishment for the contravention of a regulation. When we dealt with Bill C-7 on controlled drugs and substances, this issue did come up. I understood at the time that it was necessary to specifically indicate the penalty in the bill rather than simply defaulting to the Criminal Code. If you could, please explain why this is okay here.

I have a second question, but let's deal with this first.

Mr. Simard: I don't exactly know what happened in the context of Bill C-7, but essentially the maximum penalty is defined in the Criminal Code. The Criminal Code says the maximum penalty is going to be $2,000 for an individual. All we do is adopt it by reference here, so the penalty is known to the public. I think the problem in Bill C-7 may have occurred because you were looking at different penalties than the ones you find already in the Criminal Code.

Mr. Szabo: If I recall your discussion, the current clause says $200, and you explained that in today's dollars that was equivalent to something else.

Ms Fry (Vancouver Centre): It's $1,900.

Mr. Szabo: This says $200.

Ms Fry: In today's dollars, it would be equivalent to $1,900.

Mr. Szabo: Is that true?

Mr. Simard: Yes.

Mr. Szabo: Okay, so there is no problem. It's an automatic default if it's not specified.

Mr. Simard: Yes, that's exactly it. It's by default if it's not specified. As a matter of fact, right now there are two regulations where there are fines under this bill: the importation of human pathogens and potable water on common carriers. In those two cases there is already a $200 fine set up. That would have to be changed; otherwise it will still apply even after the bill is adopted.

Mr. Szabo: My second question has to do with clause 12, with regard to the jurisdiction of the Government of Canada as it relates to the activities of a province. I'm not familiar with it, so you'll have to educate me on the authority of a province to institute regulations for itself requiring that it do certain things in the area of health. If it's a unilateral assumption of responsibility, does that preclude the federal government from still having jurisdiction, even though the province has taken it on itself?

Mr. Juneau: If I understand your question, it's a question of constitutional law. As I understand the field of health, this is not a field where in general one level of government can legislate if the other one has not done so. By and large, the responsibilities of the two levels are fairly clear. The provinces are essentially, with some exceptions, responsible for the delivery of health care. The exceptions were mentioned in my introductory remarks. It would be inconceivable to me, but if a province had not legislated in that area and had not regulated, it would not allow us to intervene because they haven't legislated.

Mr. Szabo: I wasn't sure whether or not a province could assume certain responsibilities that weren't specifically under the federal jurisdiction, and -

Mr. Juneau: Well, it does -

Mr. Szabo: - subsequently the feds could step in and say that for national interests, it was going to do this in all provinces, therefore taking the responsibility away from the province.

Mr. Juneau: As a rule we couldn't do that simply by asserting that.

The other thing you may want to keep in mind - and it does happen from time to time in this field, as in other fields - is that the courts take a position. The Supreme Court found recently that the federal government did have the power to regulate tobacco as a product. But as I said, it's not an area in which one government can intervene if the other level of government isn't being active.

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There are a number of cases, a number of areas, in which the federal government does perform a function serving all provinces because it seems to make sense. For instance, once you've figured out what the proper approach to screening for breast cancer is, this is not something that would vary a lot; by agreement, all governments might choose to adopt certain standards. But this is not a case in which the federal government would be saying that because it is of interest to everybody, it will move in. There has to be a basis for the federal government to intervene in the criminal law, in trade and commerce, or based on the spending powers, even though the use of the spending power can't be the last word on something.

Mr. Szabo: Finally, this reference is with regard to the laws of any province. How are the territories covered?

Mr. Simard: The Interpretation Act provides that when a statute mentions a province, it includes the territories.

Mr. Szabo: Merci.

The Chairman: Thank you, Mr. Szabo.

Dr. Fry, do you have any questions?

Ms Fry: No.

The Chairman: We'll go back to Madame Picard, then. No?

Dr. Hill?

There are no more questions, so I thank you very much for your time, everyone. I'd like to excuse the officials and reconvene.

Mr. Szabo: I guess I have a final question before you leave.

Is there any aspect of this act, in the context of the bill, that you feel would be worthy of debate or question for Canadians in general? Is there anything in here that you feel would be contentious?

Mr. Juneau: Mr. Chairman, Mr. Szabo, no, I don't think there is anything in here that ought to be contentious. I guess I defer to the case made by the parliamentary secretary during second reading. The purpose of the bill was explained by her, and by a number of members, in some detail. I hope that has served to inform those Canadians who are interested in this.

As I said, I don't think there's anything controversial here. Having said that - and you weren't here, Mr. Hill - in some ways, Dr. Hill was right in saying this is largely a name change. At the same time, I have to say that as a public servant, as an official in what is temporarily the Department of Health, I'm quite proud of it. I think my colleagues in the department are proud to be in a department that devotes itself with more focus to health matters within the limits of our jurisdiction. I guess I would leave it to the judgment of the members of the House about whether or not that's worthy of being known more broadly, but I'm proud of it myself.

Mr. Szabo: As a potential indication, has Health Canada been approached by any groups, organizations or individuals challenging any aspect of this proposed bill?

Mr. Juneau: We haven't been approached in any formal way. I have talked to some of the groups that were considering intervening or testifying.

As you may know, a question has been asked whether or not it is consistent to have a broad definition of ``health'' in this bill in order to guide the work of a department that obviously does not have all the instruments to address that broader definition of ``health''. I, myself, don't consider that controversial, but it has been raised with us.

Our answer is along two lines. Firstly, it's not because we have a relatively defined focus that we ought not to have in our own minds a broad definition. It allows us to figure out where we fit. Secondly, we have very extensive collaborative arrangements with the other departments that are relevant to this broader definition. So on the whole, whereas that comment has been made to us, I don't consider it to be very controversial.

The Chairman: Madame Picard would like one more question.

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[Translation]

Ms Picard: Paragraphs 4(2)(a), 4(2)(b) and 4(2)(c) are new provisions. In your opinion, do these provisions have a broader scope?

Mr. Juneau: These provisions simply clarify the department's current responsibilities. They do not have a broader scope and do not affect the status quo.

[English]

The Chairman: Thank you very much for your time. I appreciate it.

I would ask members to just stick around for a couple of minutes so we can attend to the business that was left unfinished on Tuesday.

Before we proceed, I've been given a note to the effect that Mr. Juneau, the assistant deputy minister, quoted in his opening statement a figure of $64,000 - was it dollars? - and that in fact it should have been $6,400.

An hon. member: I think he was referring to employees.

The Chairman: Okay, then let me start over.

For the record, Mr. Juneau quoted a figure of 64,000 employees, but it should have been 6,400 employees.

Members, as you recall, on Tuesday we had proposed a tentative work plan that would have us hearing witnesses, beyond those from the Department of Health, beginning on Tuesday, November, 28, at 3:30 p.m. At that time we had received a request to appear from two groups, the Canadian Nurses Association and the Association pharmaceutique canadienne. We asked them for one-page notes identifying their particular interests in order to make sure they were consistent with what was contained in the bill. I understand we have received a response from each of those groups. One of them has sent a note. The other said we would get it tomorrow.

Also at that time, Madame Picard had received inquiries and was going to check them out in order to get confirmations. Madame Picard, do you have anything to report on that front?

[Translation]

Ms Picard: I cannot confirm that now. It might be at the beginning of next week.

[English]

The Chairman: Is it safe to assume the people who would be interested in appearing would be ready to appear next week?

[Translation]

Ms Picard: That's possible; otherwise, we will simply cancel the meeting.

[English]

The Chairman: Okay. That being said, would you leave it to staff and I to contact the groups to make arrangements for them? I understand we're talking about possibly one or two witnesses. We could begin the process of scheduling for Tuesday at 3:30 p.m., and we could probably have all the witnesses heard Tuesday. That's if everyone is in agreement.

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Some hon. members: Agreed.

The Chairman: Thank you very much.

The meeting is adjourned.

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