Ministerial Briefing Volume II - First 100 days

1: Implementing Platform Commitments
2: Issues for Early Action
3: Health Portfolio Priorities
4: First 100 Days

1: Implementing Platform Commitments

Health Related Platform Commitments

Health Portfolio
November 2019

Purpose

The following slides outline in detail the Government’s health related platform commitments.

The Health Portfolio is ready to support you in advancing these platform commitments in collaboration with other federal Ministers and in many cases, the provinces and territories and key stakeholders.

Liberal Party Platform

Your platform contains a number of initiatives and commitments for improving the health of Canadians:

Building a Strong Middle Class by Building Stronger, Healthier Families
- Strengthen Public Health Care
- National Pharmacare
- Pediatric Cancer Research
Protecting Our Environment and Moving Our Economy Forward
- Fighting and Preparing for Climate Change: Disaster Response^{Footnote 1}
- Protecting Canada’s Natural Legacy: Reduce Plastics and Protect People from Harmful Chemicals^{Footnote 2}
Building a Stronger Canada by Keeping Canadians Safe
- Drug Use and Addiction
- Post-Traumatic Stress injuries for First Responders^{Footnote 3}
Building a Stronger Canada by Promoting Equality and Diversity
- An End to Gender-Based Violence^{Footnote 4}
- Sexual and Reproductive Health
- Ending the Discriminatory Blood Donation Ban
- Better Health Care for Women
- LGBTQ2 Mental Health Support Lines
- Ban on Conversion Therapy^{Footnote 5}
Building a Stronger Canada by Helping Canadians get Better Service
- More Accurate Labelling of Seafood Products^{Footnote 6}
Building a Better Future with Indigenous peoples by
- Closing the Gap with Better Services: High-Quality Health Care/Indigenous Health Legislation^{Footnote 7}
- Continuing on the Path of Reconciliation and Self-determination^{Footnote 8}

Building a Strong Middle Class – by Building Stronger, Healthier Families

Public Health Care

Strengthen the public health care system and make sure all Canadians get the high quality care they deserve.

Through collaboration and negotiations with provinces and territories the platform commits to:

ensure that Canadians have the access they need to a family doctor or primary health care team;
set clear national standards for access to mental health services so Canadians can get fast access to the support they need, when they need it;
continue to improve access to homecare and palliative care; and
implement national pharmacare, guided by the recommendations of the Advisory Council on the Implementation of National Pharmacare.

The platform commits $6 billion of additional funding over the next four years “as a down payment” ($750M in 2020-21, rising to $1.75B for each of the next 3 years). Funding will be tied to outcomes. (Costing is not broken out against individual objectives.)

National Pharmacare

Moving forward on implementing national universal pharmacare so that all Canadians have the drug coverage they need at an affordable price.

Establish the Canada Drug Agency to make drug purchasing more effective and efficient;
Implement a national formulary with provinces, territories and other stakeholders in order to lower drug prices; and
Implement a rare disease drug strategy to help Canadian families save money on high-cost drugs.

As part of negotiations with provinces and territories on renewed health care priorities, seek a mandate to design and implement national pharmacare, guided by the recommendations of the Advisory Council on the Implementation of National Pharmacare.

Pediatric Cancer Research

To improve federal health research that can help lead to better outcomes and healthier lives for young patients, investing an additional $30 million next year in pediatric cancer research.

Work closely with families, experts, and researchers over the next year to develop a long-term plan to ensure pediatric cancer research has the funding it needs to be sustainable and to help families when they need help most.

$30M in funding in 2020/21

Protecting Our Environment and Moving Our Economy Forward – by Fighting and Preparing for Climate Change

Disaster Response^{Footnote 9}

Building on the $2 billion already invested in helping communities prepare for and prevent weather related disasters like floods and fires, the platform commits to an additional $1 billion investment over the next decade in the Disaster Mitigation and Adaptation Fund, so communities have a proactive, permanent and sustainable way to address the emerging threats of climate change.

Protecting Our Environment and Moving Our Economy Forward – by Protecting Canada's Natural Legacy

Reduce plastics and protect people from harmful chemicals^{Footnote 10}

Reduce plastic pollution by taking steps to ban harmful single-use plastics. This builds on an existing ban on products with plastic microbeads, which threaten the health of our lakes, oceans, and wildlife.

Move forward with new standards and targets for businesses that manufacture plastic products or sell items with plastic packaging, to make sure that businesses take full responsibility for collecting and recycling their plastic waste.

Further strengthen Canada’s Environmental Protection Act, to better protect people from toxins and other pollution.

Building a Stronger Canada – by Keeping Canadians Safe

Drug Use and Addiction

To make it easier for people to get the help they need, with better access to treatment, the platform outlines new investments that help provinces and territories:

expand community-based services;
build more in-patient rehab beds; and
scale up the most effective programs – such as extending hours for InSite and other safe consumption sites.

Drug Treatment Court will also be the default option for first-time non-violent offenders charged with simple possession, to help drug users get quick access to treatment (led by the Minister of Justice).

The platform commits $700M over the next four years, starting in 2020-21 ($100M each in years 1 and 4, with $250M each in years 2 and 3). Costing is not broken out by individual commitments.

First Responders – Post-Traumatic Stress Injuries^{Footnote 11}

Advancing Canada’s first-ever National Action Plan on post-traumatic stress injuries, which will help support Canada’s first responders and public safety workers.

Building a Stronger Canada – by Promoting Equality and Diversity

Better Health Care for Women

As part of a broader goal to deliver better health care for women, create a National Institute for Women’s Health Research. The Institute would bring together experts in women’s health from across the country to tackle persistent gaps in research and care – taking an intersectional approach that includes race, ability, indigeneity and more. Work with the Canadian Institutes of Health Research to integrate sex and gender- based analyses, as well as diversity analyses, to ensure research considers diversity factors to improve women’s health care.

Sexual and Reproductive Health

Protect a woman’s right to make decisions about her body and make family planning and sexual and reproductive health care more accessible and affordable, by working with provinces and territories to make sure that sexual and reproductive health medications are covered under national pharmacare.

An End to Gender-Based Violence^{Footnote 12}

Build upon the previous Gender-Based Violence Strategy and invest $30 Million to develop a National Action Plan to protect more people and end gender-based violence.

An End to the Blood Ban

End the blood donation ban – one that is discriminatory to gay, bisexual and other men who have sex with men – by moving forward in partnership with Canadian Blood Services and Héma-Québec to support the implementation of a behaviour-based model that eliminates the ban permanently.

LGBTQ2 Support Lines

Make sure that LGBTQ2 people get the mental health support they need. Invest an additional $2 million annually to ensure the LGBTQ2 community is well served by hotlines and other support services, including support lines that provide sexual education.

Ban on Conversion Therapy^{Footnote 13}

Work with PTs to end conversion therapy, a scientifically discredited practice that targets vulnerable LGBTQ2 Canadians in an attempt to change their sexual orientation or gender identity. This includes making amendments to the Criminal Code that will prohibit this practice, especially against minors.

Building a Stronger Canada – by Helping Canadians Get Better Service

More Accurate Labelling^{Footnote 14}

Create a “boat-to-plate” seafood traceability program, developed in partnership with industry and environmental leaders, to help combat foreign fish product fraud and mislabeling and help Canadian fishers better market their products.

Building a Better Future With Indigenous Peoples – by Closing the Gap With Better Services

High-Quality Health care^{Footnote 15}

Indigenous Peoples have the right to high-quality care that reflects distinctions- based needs, and that makes things like mental health, healing, assisted living and long-term care, and preventative care a priority, available when and where it is needed.

To move forward with making high-quality health care a reality for all Indigenous Peoples, distinctions-based Indigenous Health legislation will be co-developed – backed with the investments needed to deliver this care – and continued work with Indigenous communities to ensure Indigenous control over the development and delivery of services.

Building a Better Future With Indigenous Peoples – by Continuing on the Path of Reconciliation and Self-determination

Continuing on the Path of Reconciliation^{Footnote 16}

Through continued work in a number of areas, including:

Work to implement the Truth and Reconciliation Commission’s Calls to Action, and the National Inquiry into Missing and Murdered Indigenous Women and Girls’ Calls for Justice, in partnership with First Nations, Inuit, and Métis peoples.
Support for Indigenous-led processes for rebuilding and reconstituting Indigenous nations, advancing self-determination and, for First Nations, the transition away from the Indian Act.
Progress on Indigenous priorities, meeting regularly through the Assembly of First Nations – Canada Memorandum of Understanding on Joint Priorities, the Inuit-Crown Partnership Committee, and the Métis Accord.
Continuing to advance meaningful inclusion of First Nations, Inuit, and Métis partners in federal and inter-governmental decision-making processes that have an impact on Indigenous rights and interests.

Moving Forward

The Health Portfolio has been reviewing these platform commitments and is ready to provide introductory briefings and engage you on potential approaches to implementing these commitments.

2: Issues for Early Action

A number of key issues will require the Minister's immediate decision or attention – either because of an upcoming deadline or key date, or because they may be expected to provide their views.

Officials are prepared to brief you on these issues, especially those requiring immediate attention, in the early days of your mandate, taking into consideration any particular time sensitivities.

Medical Assistance in Dying

In 2015, the Supreme Court of Canada (SCC) found that Criminal Code prohibitions against physician-assisted dying were unconstitutional. In response, Parliament passed amendments to the Criminal Code in June 2016 allowing for a medically assisted death for individuals who met specific eligibility criteria. From the outset, the criterion that a person's natural death must be reasonably foreseeable (RFND) has been controversial, as some argue that this provision does not respect the SCC decision.

In June 2017, federal and provincial Medical Assistance in Dying (MAID) legislation was challenged in a Quebec court by two individuals with disabilities and degenerative diseases (Truchon/Gladu) on the basis that RFND (and a similar provincial criterion) were in violation of the Charter.

The RFND provision is one of a number of controversial provisions in federal MAID legislation that could lead to a succession of debates, court challenges and amendments to the Criminal Code in the coming years.

On September 11, 2019, the Quebec Superior Court ruled in favour of the plaintiffs and found both the federal and provincial criteria invalid. The effect of the judgement was suspended for six months (i.e., until March 11, 2020). The decision only applies in Quebec. However, if federal legislation is not changed by March 11th, 2020, eligibility for a medically-assisted death would differ in Quebec and the rest of Canada.

The Quebec government did not appeal the decision, and is examining the ruling to determine what, if any, additional legislative changes are required. It may request an extension to the suspension period. Canada also did not appeal the decision. Health Canada is expected to play a significant role in advising Justice Canada on this and any other future legislative amendments.

Vaping

Since late 2018, Health Canada has been tracking increasing reports and statistical evidence of a rapid rise in youth vaping. A survey conducted by external researchers found that vaping among Canadians aged 16 to 19 increased from 8% in 2017 to 15% in 2018: a 74% increase. This rate has continued to grow in 2018-2019. Youth vaping is an urgent public health concern; primarily because of the potential that vaping could lead to nicotine addiction and/or future tobacco use in current non-smoking youth. Health Canada has taken a series of actions to address the rise in youth vaping and the risks that vaping poses to their health.

Although they are separate public health issues, concern over youth vaping has been amplified by the emergence of severe lung illnesses related to vaping in the United States (U.S.) and Canada. As of November 5, 2019 the United States Centers for Disease Control and Prevention (US CDC) reported 2051 confirmed and probable cases of severe pulmonary illnesses related to vaping from 49 states, the District of Columbia, and one U.S. territory. Thirty-nine deaths have been confirmed in 24 states.

In Canada, as of November 12, 2019, seven cases and zero deaths (two confirmed cases and five probable cases) have been reported by provincial or territorial health authorities to the Health Portfolio.

Chemical exposure is believed to be the cause. The product(s) and/or toxic agent(s) involved have not yet been identified in all cases, but the latest national and regional findings in the U.S. suggest products containing tetrahydrocannabinol (THC) play a role in the outbreak. According to the US CDC, as of October 15, 78% of patients report using THC-containing products, 31% report exclusive use of THC-containing products, 58% report using nicotine-containing products, and 10% report exclusive use of nicotine-containing products. On October 4, 2019, the U.S. Food and Drug Administration advised consumers to stop using all THC-containing vaping products and any vaping products obtained from the illegal market.

On October 11, 2019, the Council of Chief Medical Officers of Health, led by the Chief Public Health Officer of Canada, issued a statement on vaping in Canada. Recommendations included that Canadians refrain from using e-cigarettes or vaping products–particularly any products that have been purchased illegally–including any products that contain THC, and that Canadians see a health care provider immediately if they have recently used vaping products and have symptoms of pulmonary illness.

Officials are monitoring the situation and can provide an early briefing on potential further actions to address these challenges.

Drug shortages and proposed bulk importation of drugs by the US

Drug shortages are a widespread, global problem with complex causes that are hard to predict and take time to resolve. When shortages occur, they can have serious impacts on the ability of Canadians to access medicine they need. Almost half (44%) of all marketed drugs in Canada have experienced at least one shortage since 2017, and over 1,500 drugs (14%) are in shortage today. Shortages have impacted all major drug classes and the number of unresolved shortages in Canada has been steadily increasing year to year. While Canadians look to the federal government for leadership in resolving and mitigating the impact of drug shortages, a multi- stakeholder effort is required, involving manufacturers and distributors, provinces and territories, health professionals, and patient groups. Recent proposals in the U.S. to import Canadian drugs in bulk could exacerbate drug shortages in Canada and harm Canadians.

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New Cannabis products

On October 17, 2019, the Regulations Amending the Cannabis Regulations came into force. The amended regulations govern the production and sale of edible cannabis, extracts and topicals. It is expected that new products within these three classes will begin to appear gradually in provincial/territorial-authorized physical and online stores no earlier than December 16, 2019.

Health Canada has spent the past several months preparing for the implementation of the amended regulations, including providing guidance to the industry, delivering public education messaging on the unique health risks posed by these new classes of products, and building internal capacity (e.g., training inspectors).

With the coming into force of the amended regulations, the department will closely monitor the regulated industry, focusing compliance verification and enforcement on any products found to be appealing to young persons, or that are non-compliant with regulatory requirements designed to reduce the risk of harm to the health of the user.

Canada Health Act

At any given time, there will be an array of Canada Health Act (CHA) compliance issues, often involving patient charges for medically necessary physician and hospital services. These charges contravene the extra-billing and user charges provisions of the CHA. Provinces and Territories report each December on extra-billing and user charges, and these reports form the basis for mandatory dollar-for-dollar deductions to the Canada Health Transfer (CHT) funds owed to the province or territory in question. If a province or territory fails to report such charges, or there is evidence they have not reported fully, Health Canada may estimate amounts of extra-billing and user charges levied, and authorize a CHT deduction accordingly.

There are several time-sensitive CHA issues that will require your engagement:

Patient Charges

Health Canada must finalize amounts to be deducted and reimbursed by January-February 2020 to meet the Department of Finance's March 2020 deadline for CHT deductions and reimbursements. The Minister will be informed of planned deductions and reimbursements as there are often implications from an inter-governmental perspective.

An estimate may be required for New Brunswick if it does not report on patient charges at the private abortion clinic in Fredericton. The previous federal Minister of Health signaled that these charges contravene the CHA's prohibitions on extra-billing and user charges.

Implemented in 2018, the Reimbursement Policy allows for a refund of a mandatory CHT deduction to a province/territory, if the jurisdiction carries out a Reimbursement Action Plan that successfully eliminates patient charges within two years after the deduction occurred. Health Canada officials are currently working with British Columbia and Newfoundland and Labrador on their Action Plans, which could, if patient charges are eliminated, lead to partial or full reimbursement of previously-deducted CHT funds in March 2020. The Newfoundland and Labrador situation is relatively straightforward. British Columbia's situation is complicated by an injunction, which is impeding some elements of that province's Action Plan.

Portability

On December 31, 2019, Ontario will terminate coverage for its residents when they require emergency medical care while outside the country. While most provinces provide coverage at levels that do not fully meet the requirements of the portability criterion of the CHA, Ontario is the first province to directly contravene the Act by eliminating coverage altogether.

Opioid overdose crisis

Canada is experiencing an unprecedented and unrelenting rate of opioid overdose deaths. From January 2016 to March 2019, 12,813 Canadians died from opioid-related overdoses. The crisis is widely regarded as one of the most significant public health crises in a generation. The scale of the crisis is so severe that it has had the effect of halting the increase in life expectancy in Canada for the first time in more than 40 years.

Given the immediacy of the situation, officials are prepared to provide an early briefing on the whole of government response to the crisis, including advice on the implementation strategy for platform commitments.

Antimicrobial resistance (AMR)

Antibiotics that we rely on to treat common infections are becoming increasingly ineffective, making life-saving procedures such as organ transplants, cancer chemotherapy and surgeries more risky and complicated. Antimicrobial resistance is a global public health concern that threatens human and animal health, and has a direct impact on the viability of our healthcare system and agri-food industry. In 2018, the estimated number of AMR-related deaths in Canada was 5,400. By 2050, the cumulative number of AMR-related deaths in Canada is predicted to rise to 390,000. In addition, a new report on the health and socioeconomic impacts of AMR by the Council of Canadian Academies was released on November 12, 2019, which brought public attention to the crisis we are facing. As part of Canada's efforts to preserve the effectiveness of antimicrobial drugs, particularly antibiotics, the Pan-Canadian Action Plan on AMR is expected to be finalized by 2020, which would set out plans for governments to respond to this threat. Within this context, there is an opportunity for federal leadership commensurate with the growing economic and health threat that AMR presents to all Canadians.

Health security

The Minister of Health has a leadership role in the detection of, preparedness for, and response to health security threats, including influenza pandemic preparedness and response. Canada's pandemic preparedness strategy depends on access to domestically produced vaccine, to protect against the threat of embargoes, border closures, and transportation and shipment delays in the event of an influenza pandemic.

The Government of Canada's existing contract for pandemic influenza vaccine will expire in March 2021. [REDACTED]

Regulatory modernization and innovation

Maintaining and improving the health of Canadians is a priority for the Health Portfolio. The Portfolio must also evolve and adapt in a rapidly changing environment characterized by increased complexity and risks. These flow from the growing complexity of health and biosciences and agri-food sectors and services, the sheer number of products now available on the market and how they can be obtained (e.g., in stores and online), the pace at which new technologies become available, a globally integrated market, and the expectations of Canadians for increased openness and transparency in regulatory decision-making. It is important that our legislative and regulatory frameworks adapt to include added ways to support the adoption of promising new therapies in the health care system so that they are accessible to Canadians, protect Canadians against environmental health risks, improve international alignment, increase digitalization of government processes as well as other practices to promote innovation and remove undue regulatory burden on industry.

The Portfolio has supported regulatory modernization and innovation over the past 10 years, most recently having developed a regulatory roadmap for the health and biosciences sector, and participated in the development of the roadmap for the agri-food and aquaculture sector.

To build on regulatory efforts of the past decade, the Portfolio is proposing to advance a number of regulatory amendments in the next few years by implementing these roadmaps. Advancing these amendments would support agile and flexible regulatory frameworks, improve international alignment, and reduce burden for regulated parties, while protecting the health and safety of Canadians and their environment.

The Portfolio has also identified other opportunities to improve the regulatory framework by developing proposals that would remove outdated, archaic and redundant legislative requirements that prevent innovation and efficiency. You will be briefed in more detail on various regulatory modernization and innovation proposals.

Canadian Institutes of Health Research (CIHR) Strategic Plan

Canadian Institutes of Health Research is in the process of extensive engagement with the health research community as it develops a new strategic plan to guide its operations and investments from 2020 to 2025. With this plan, CIHR also seeks to lay the foundation for a shared vision for how Canada's health research ecosystem could look in the next 30 years. The Minister will be invited to provide opening remarks at the CIHR Health Research Summit in Ottawa on December 13, 2019, where CIHR will share its high-level proposed priorities with approximately 100 health research stakeholders for discussion and validation.

Supplementary Estimates

There are several time-sensitive items that will require Ministerial consideration by December 2019, if funding and authorities are to be accessed this fiscal year. These will require Treasury Board approval to access the resources and implement related programs and initiatives.

Litigation

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3: Health Portfolio Priorities

Health Portfolio officials are prepared to provide you with more information on a number of program and policy priorities tied to your mandate.

Food safety

Canada has one of the strongest food safety systems in the world. However, ongoing efforts are needed to ensure food safety. In recent years, a number of important food safety incidents (e.g., Salmonella in frozen raw breaded chicken, E. coli from contaminated romaine lettuce) have highlighted the need for the federal government to continue to work with all levels of government, the food industry and consumers to ensure the food supply remains safe along the entire food production and processing continuum and beyond (including restaurants, food services and homes).

At the same time, innovative technologies used to develop new foods, products and ingredients, along with a globalization of the food supply present new challenges to ensure food safety in a highly globalized and complex food supply.

To protect Canadians from unsafe foods, the Health Portfolio is focusing efforts in three key areas: protecting Canadians from critical food safety issues; enhancing preparedness for emerging risks and issues; and informing Canadians on how to reduce food safety risks.

Healthy eating

Poor diets that are high in nutrients of concern (sodium, sugars, or saturated fat) are strongly linked to obesity, type-2 diabetes, cardiovascular disease and some cancers. Canadians' intake of these nutrients remains high. Health Canada has been working to improve the food environment in Canada to make it easier for Canadians to make the healthier choice. Through its Healthy Eating Strategy, the department's efforts have been focused on improving healthy eating information, improving the nutritional quality of foods, and protecting children. Over the past few years, the department has advanced various initiatives (e.g., revising Canada's Food Guide, banning trans fats, and improving the Nutrition Facts table and list of ingredients) to achieve these goals.

Review of the Pesticide Post-Market Review Program

Health Canada's Pest Management Regulatory Agency (PMRA) is facing challenges keeping pace with legislated re-evaluations to ensure that pesticides on the market meet modern safety standards. These challenges have resulted in significant stakeholder concern regarding timeliness of decisions, and could lead to potentially unacceptable risks to health and the environment for products that are not reviewed on schedule.

To begin to address these challenges, PMRA has undertaken extensive stakeholder consultations, which could lead to a new process model. In addition, PMRA has prioritized work on legacy^{Footnote 17} and other critical risk^{Footnote 18} pesticides and is exploring other legislative options, such as exempting those that pose the lowest risk.

Environment and health

Canada is warming at about twice the global average, with Canada's North warming even more quickly. The effects of widespread warming are evident in many parts of Canada (e.g., flooding, wildfire, and the spread of ticks and mosquitoes) and are projected to intensify in the future. As such, climate change poses an acute risk of harm to human health and wellness. The Health Portfolio helps Canadians and health authorities understand the impacts of climate change on health, and informs adaptation strategies to minimize the health effects.

The Health Portfolio is also responding to increasing interest in the impact of the natural and built environment on the health of Canadians by providing health advice on chemicals, air quality, and water quality. This expertise supports programs like the Chemicals Management Plan, as well as specific activities such as the development of air quality standards, drinking water quality guidelines, and support for healthy built environments. The Portfolio also contributes expertise on the human health aspect for impact assessments of major resource projects and efforts to address federal contaminated sites.

Indigenous health

Indigenous peoples in Canada continue to experience a lower quality of life and poor health outcomes when compared with other Canadians. Improving health outcomes is a key and ongoing priority for Indigenous peoples.

The provision of health services to Indigenous peoples is an area of shared responsibility between the federal and provincial/territorial governments and Indigenous partners. While Indigenous Services Canada is the key federal department delivering health programming and services for First Nations people on reserve and Inuit, the Health Portfolio continues to play an active role in supporting Indigenous health priorities across its mandate areas to support efforts to close the gaps in health outcomes between Indigenous peoples and other Canadians.

4: First 100 Days

Placemat

Reports	Departmental Reports
	TOPICS	DURATION OF PREPARATION	COMMENTS
Early Calls and Meetings	Portfolio Heads	To be completed by mid-November	Meet within first one to two weeks
	Provincial and Territorial Health Ministers	To be completed by mid-November	Meet within first one to two weeks
	Key Stakeholders	To be completed within the first month in office	Meet within first month
Events	100 Years of Health / Health Portfolio event	To be completed by November 29, 2019	November 29, 2019
	World AIDS Day	To be completed by December 1, 2019	December 1, 2019
	CIHR Health Research Summit	To be completed by December 13, 2019	December 13, 2019
	Scientific Advisory Committee on Health Products for Women	To be completed by late 2019/early 2020	Late 2019/early 2020
	FPT Health Ministers' Meeting	To be completed by early 2020	Early 2020
	Fifth Annual Patient Safety Summit	To be completed by February 27-28, 2019	February 27-28, 2020
	Ministerial Advisory Board on Dementia Meeting	To be completed by February 2020	February 2020
	Table and publish Departmental Results Reports	To be approved/tabled by mid-December	By mid-December 2019 for each portfolio organization
	Parliamentary Reports
	Tabling of annual Fees Reports	To be approved/tabled by December 13, 2019	By December 13, 2019 for each portfolio organization
	Tabling of Annual Report on the Access To Information Act	To be approved/tabled by mid-December 2019	Report to be tabled within first 15 sitting days for each portfolio organization
	Tabling of Annual Report on the Privacy Act	To be approved/tabled by mid-December 2019	Report to be tabled within first 15 sitting days for each portfolio organization
	Tabling of the PMPRB Annual Report	To be approved/tabled by mid-December 2019	Report to be tabled fall 2019
	Tabling of PMRA Annual Report (Pest Control Products Act)	To be approved/tabled by December 2019	Report to be tabled December 2019
	Tabling of Report on the Federal Framework on Post-Traumatic Stress Disorder	To be approved/tabled by December 21, 2019	Report to be tabled December 21, 2019
	Tabling of Annual Chief Public Health Officer's Report on the State of Public Health in Canada	To be approved/tabled by winter 2019-20	Report to be tabled winter 2019-20
	Tabling of Canada Health Act Annual Report	To be approved/tabled by February 21, 2020	Report to be tabled February 21, 2020
Appointments / Vacancies	Appoint CEO of the Canadian Centre on Substance Use and Addiction (GiC)	To be initiated by mid-December	Initiate process by December 2019, to be concluded by July 27, 2020
	Appoint five members to the CIHR Governing Council (GiC)	To be initiated by mid-December	Initiate process by December 2019, to be concluded by November 28, 2020
	Appoint three to five members to the Pest Management Advisory Council (Ministerial appointment)	Decision to be made by early January	Decision to be made on whether to appoint new members – at Minister's discretion

Meetings

There are a number of early calls and meetings in the first 100 days that the Minister may wish to take part in, such as meetings with Health Portfolio heads and calls with provincial and territorial health Ministers. A package will be provided to the Minister that outlines the considerations for these meetings.

In addition to these introductory calls and meetings, the Minister may wish to meet with key Portfolio stakeholders. Officials will be ready to provide advice regarding possible meetings.

Reports to be tabled in Parliament

The Minister of Health is responsible for tabling reports and other documents in Parliament on a variety of subjects under his or her purview. Most often, this involves tabling annual reports related to key activities under the responsibility of the Health Portfolio and related organizations to inform Parliament and Canadians about areas of government activity or spending.

In most cases, the requirement for an annual report is based in statute, and they can be provided to Parliament through a “back-door tabling.” In other cases, the requirement is set out in a funding agreement or Treasury Board policy and must go through a “front-door tabling.”

Deadlines for tabling each report are established in either the legislation, funding agreement, or Treasury Board policy. When the tabling deadline falls on a date when Parliament is adjourned or dissolved (i.e., not sitting), the reports must be tabled in the first 15 sitting days after Parliament resumes (with the exception of the Patented Medicine Prices Review Board Annual Report, which must be tabled within 30 sitting days).

The following table provides an overview of the reports that must be tabled in Parliament in the first 100 days of the Minister’s mandate. Packages will be provided to the Minister early on to seek approval of the following reports, and officials are ready to brief the Minister on the tabling process.

Annual Reports to Be Tabled in Parliament in the First 100 Days
Report	Report Description	Tabling Requirement	Statutory Authority	Tabling Timeline
*1. Annual Departmental Results Report* (HC, PHAC, CFIA, CIHR, PMPRB)**	Annual report by individual departments and agencies that provides an account of results achieved against planned performance expectations (as set out in respective Departmental Plans) for the most recently completed fiscal year	Tabled in the House of Commons by the President of the Treasury Board	Required as per Treasury Board Policy – the Departmental Results Report is part of the Estimates process and a report to Parliament must be tabled	Mid-December 2019 (Ministerial signature is required by November 29 to meet this deadline)
*2. Annual Fees Report* (HC, PHAC, CFIA, CIHR, PMPRB)**	Annual report that sets out detailed information on fees in individual departments or agencies to improve government transparency and oversight of service standards and fees charged	Tabled in the House of Commons by December 13, 2019	Service Fees Act (S.C. 2017, c. 20, s. 451(s. 20(1)))	December 13, 2019 (Ministerial signature is required by November 29 to meet this deadline - TBC)
3. Annual report: access to information (HC, PHAC, CFIA, CIHR, PMPRB)	Annual report that provides information on the administration of the Access to Information Act within the institution during each fiscal year	Tabled in each House of Parliament on any of the first 15 days on which that House is sitting after September 1 of the year in which the report is prepared	Access to Information Act (R.S., 1985, c. A- 1, s. 72(2))	Within the first 15 sitting days after September 1
4. Annual report: privacy (HC, PHAC, CFIA, CIHR, PMPRB)	Annual report that provides information on the administration of the Privacy Act within the institution during each fiscal year	Tabled in each House of Parliament on any of the first 15 days on which that House is sitting after September 1 of the year in which the report is prepared	Privacy Act (R.S., 1985, c. P- 21, s. 72(2))	Within the first 15 sitting days after September 1
5. Annual report: activities of the Board (PMPRB)	Annual report that provides information on the activities of the Board for the most recently completed fiscal year, including information regarding its regulatory mandate and its reporting mandate	Tabled in each House on any of the first 30 days on which that House is sitting after the Minister receives the report	Patent Act (R.S., 1985, c. P- 4; s. 100(4) added by 1993, c. 2, s. 7)	Fall 2019 (may not fall within the first 100 days)
6. Annual report: administration and enforcement of the Pest Control Products Act	Annual report that highlights PMRA's accomplishments over the last fiscal year, including new products registered, re-evaluation activities, an overview of PMRA's role in international pesticide regulatory developments, and key engagement with stakeholders	Tabled in each House as soon as possible after the end of each fiscal year	Pest Control Products Act (2002, c. 28, s. 80(1))	December 2019 (may not fall within the first 100 days)
7. Report on the Federal Framework on Post- Traumatic Stress Disorder	Report that sets out the Federal Framework on Post-Traumatic Stress Disorder (PTSD), which is intended to address the challenges of recognizing the symptoms, and providing timely diagnosis and treatment of PTSD	Tabled in the House of Commons within 18 months of the date that the legislation came into force (June 21, 2018)	Bill C-211, Federal Framework on Post-Traumatic Stress Disorder Act	December 21, 2019
8. Annual Chief Public Health Officer's Report on the State of Public Health in Canada	Annual report on the state of public health in Canada that provides a snapshot of the health of Canadians, as well as detailed information on a yearly theme, as determined by the Chief Public Health Officer	Tabled in each House within the first 15 days on which that House is sitting after the Minister of Health has received it The CPHO is required to submit the report to the Minister of Health within six months after the end of each fiscal year	Public Health Agency of Canada Act	Winter 2019/20
*9. Canada Health Act Annual Report* (HC)**	Annual report on the extent to which provincial and territorial health care insurance plans have satisfied the criteria and the conditions for payment under the Canada Health Act, which is Canada's federal health care insurance legislation and defines the national principles that govern the Canadian health care insurance system	Tabled in each House on any of the first 15 days on which that House is sitting, after the report is completed Report must be completed as soon as possible after the end of each fiscal year, and no later than December 31 of the next fiscal year	Canada Health Act (R.S., 1985, c. C-6, s. 23)	February 21, 2020 (may not fall within the first 100 days)

Appointments - Decisions on Governor in Council and Ministerial Appointments

The following document outlines the current Governor in Council or Ministerial vacancies where the appointments require Ministerial consideration. Officials are prepared to brief you on the following appointments and the appointment process, especially those requiring immediate attention, in the early days of your mandate.

Governor in Council (GIC) Appointments Required

Chief Executive Officer (CEO), Canadian Centre on Substance Use and Addiction (CCSA)

The Canadian Centre on Substance Use and Addiction (CCSA) is a pan-Canadian Health Organization (PCHO) that promotes awareness and reduce the harms of substance use. The CCSA is the only PCHO created by federal legislation, under the Canadian Centre on Substance Abuse Act, and meets at least twice annually. The current CEO's term will expire on July 27, 2020 and the CEO is eligible to apply for a second term once a selection process begins.

Finalizing a selection process and identifying a candidate for the position will be lengthy. A selection process would need to be launched as soon as possible upon your appointment in order to identify a successful candidate well before the July 27, 2020, term expiry. Because it is a leadership position, the Privy Council Office (PCO) would lead the selection process with the Department's assistance.

If the position remains vacant once the current CEO's term expires, as per the CCSA Act (s.18), the Board may authorize any member of the Board or any officer or employee of the CCSA to act as CEO. This authorization would not be valid for more than 180 days unless approved by the Governor in Council.

Governing Council Members, Canadian Institutes of Health Research (CIHR)

The CIHR Governing Council provides oversight on the strategic directions, goals and policies of the organization, and directs its operational activities by evaluating performance, appointing scientific directors, approving budgets and by-laws, and establishing/maintaining/terminating CIHR's institutes. The terms of five (of the 15) members of the CIHR Governing Council will expire on November 28, 2020; all five are eligible for reappointment. An early decision will be sought to either reappoint current members or launch a selection process.

Should a new selection process be required, it would need to begin immediately in order to allow sufficient time for completion (a selection process could take up to one year to finalize).

CIHR's Governing Council did not reach full membership until June 2019 due, in part, to the length of the Governor in Council appointment process. Given the important business being conducted by the Governing Council currently and over the coming year, including the development and implementation of CIHR's new strategic plan, a timely decision will be required to mitigate risks associated with delaying a new selection process/reappointment.

Ministerial Appointments Required

Member, Pest Management Advisory Council (PMAC)

PMAC is a multi-stakeholder advisory body that fosters dialogue among stakeholders with Health Canada's PMRA, providing advice directly to the Minister of Health on issues related to the federal pest management regulatory system. Membership includes pesticide manufacturers and users; groups with environmental and health interests; academia, and individuals with appropriate expertise. Two of the members appointed by the Minister this past spring were not able to accept their appointments. At the last PMAC meeting (May 30, 2019), the council recommended its membership be expanded to provide broader representation from sectors affected by the pest management regulatory system. A decision on filling the two current vacancies, as well as whether to propose the appointment of new candidates, will require early attention in order to ensure that the appointments are made in advance of the winter/spring council meeting.

Events for possible Ministerial attendance

The Minister of Health has a role in participating in many events, such as those at the international level, as well as opportunities to engage with provinces and territories, stakeholders, and within the Health Portfolio. The key events that are scheduled to take place in the first 100 days have been included here for Ministerial consideration.

The following table provides information on these events, and possible opportunities for a Ministerial role. More information will be provided to you regarding your possible participation.

Domestic Events
Date	Event	Description	Possible Ministerial Role
November 29	100 Years of Health – Dialogue Santé	Dialogue Santé is a Health Canada dialogue series open to employees and broadcast on the web to Health Canada and PHAC staff across the country. As 2019 marks the 100th anniversary of Health Canada, the event will feature a panel discussion that touches on key pivotal moments that have affected the Health Portfolio, and an on-site exhibit with interesting information and artifacts. Speakers include Dr. Susan Lamb, Hannah Chair in History of Medicine, University of Ottawa; Dr. Zayna Khayat, future strategist with Saint Elizabeth Health Care; Dr. Theresa Tam, Chief Public Health Officer of Canada; and André Picard, Globe and Mail as moderator.	Opportunity to provide opening remarks. Opportunity to attend and engage with Health Portfolio staff.
December 1	World Aids Day	World AIDS Day, held annually on December 1, aims to unite people worldwide in the fight against human immunodeficiency virus (HIV), show support for people living with HIV and commemorate people who have died. Each year, the Minister of Health engages in activities in the week leading up to and including World AIDS Day.	Opportunity to demonstrate federal leadership and commitment to the domestic response to HIV and AIDS. Opportunity to participate in the flag-raising ceremony on Parliament Hill, reception with MPs, and attend a proposed roundtable meeting with people living with HIV.
December 13	CIHR Health Research Summit	At the Summit, CIHR will share its high-level proposed priorities with approximately 100 health research stakeholders, for discussion and validation. Following the Summit, CIHR will develop and validate a draft strategic plan that will guide its operations and investments from 2020 to 2023, with an aim to publish in June 2020 in commemoration of CIHR’s 20th anniversary.	Provide the opening remarks at the Summit. Meet with key health stakeholders (including health researchers, funders, charities, Indigenous representatives, the general public and policy- makers) to discuss opportunities for cooperation.
Late 2019 /Early 2020	Scientific Advisory Committee on Health Products for Women (SAC-HPW)	The SAC-HPW provides Health Canada with timely, patient-centered, scientific, technical, medical and clinical advice on current and emerging issues regarding women’s health and the regulation of medical devices and drugs. It was established as part of the “Action Plan on Medical Devices,” announced by the Minister in December 2018 in response to criticism of the regulation of medical devices in Canada, particularly those used primarily or exclusively by women. Members are experts on women’s health issues, including health care professionals, patients, an Indigenous member and women’s health researchers.	Opportunity to meet SAC- HPW members. Meet with key health stakeholders (including health practitioners, researchers and patients) to discuss opportunities for cooperation.
Early 2020	Federal- Provincial/ Territorial (FPT) Health Ministers’ Meeting (HMM)	The HMM is an annual meeting to advance key health issues of shared interest. The Ontario Health Minister is the co-chair of the meeting this year.	Initial multilateral engagement with PT Health Ministers and work to develop an agenda. Foster PT relationships in areas of shared interest.
February 2020	Ministerial Advisory Board on Dementia Meeting	The Ministerial Advisory Board on Dementia provides evidence- informed advice to the Minister on current and emerging issues, challenges and opportunities that help improve the lives of persons living with dementia. The Board is legislated to meet twice a year. Topics to be discussed include advice related to the implementation of the National Dementia Strategy, including on indicators to support annual reporting, new evidence and initiatives, and emerging issues.	Opportunity to meet the Board and discuss topics for ongoing engagement.

International Events
Date	Event	Description	Possible Ministerial Role
February 27-28, 2020	The fifth (annual) Global Ministerial Summit on Patient Safety	The World Health Organization (WHO) estimates that patient harm is the 14th leading cause of global burden of disease, comparable to tuberculosis and malaria. The Canadian Institute for Health Information’s Hospital Harm Measure estimates that 5.3% of Canadian hospitalizations resulted in at least one case of potentially preventable harm in 2018-19. The summit of Health Ministers from WHO countries will take place in Montreux, Switzerland on February 27-28, 2020. In May 2019, a World Health Assembly declaration committed governments, including Canada, to new action on patient safety.	Minister may be invited to make remarks and to participate in a panel discussion.

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