Ottawa, ON
August 18, 2014
Check Against Delivery
Introduction
Good morning ladies and gentlemen. Many thanks to Dr. (Louis Hugo) Francescutti and Dr. (Chris) Simpson for inviting me to speak to you today.
I particularly want to recognize Dr. Francescutti, not just for his leadership of the CMA this past year, but for his innumerable achievements as an emergency physician, teacher, and advocate for health and safety in Canada.
Hugo, you and I have a fantastic relationship and not just because we are both Albertans.
I remember the first time we spoke was for over an hour. You talked to me about being in the emergency room and how many patients you saw, that you knew many of them should never have ended up in the hospital… because their injuries were preventable.
With statistics telling us that the direct and indirect costs of intentional and unintentional injuries in Canada was estimated at almost $20 billion in 2009, not to mention the thousands of Canadians it affected, I knew you were onto something!
We both agreed that there needed to be a paradigm shift in terms of our collective thinking around injury prevention, whether it was wearing a helmet when riding a bike or not looking at your cell phone when driving - we agreed it was time for cultural change.
On that very first call you bent my ear about injury prevention and that led to my introduction to Parachute, an important organization whose sole mandate is to prevent injury in Canada. And the rest is history… sort of.
Last year's Speech from the Throne outlined our Government's forward agenda.
In our Governments' vision going forward, we committed to collaborate with injury prevention organizations like Parachute to reduce the injury rate in this country.
Though you may not realize it, you are a large part of why injury prevention has become a part of our Government's policy and for that I applaud you!
I also want to congratulate Dr. Simpson, and though we may not cheer for the same hockey team, I am certain that over the next year we will be able to accomplish great things together.
We had the opportunity to speak last week and I think we too are on the same page. Dr. Simpson, the work you have done on Wait Times in this country has not gone unnoticed and I believe has made a difference for patients across Canada.
When I was with all of you last year, I pledged to you an open mind and an open door.
And today I stand before you after traveling across the country and meeting with hundreds, quite literally hundreds, of people and health groups.
I stand before you proud of Canada's healthcare system, our global reputation and the incredible front line people, like you.
I even had the chance to learn first-hand about challenges of delivering healthcare in a busy urban hospital. I was fortunate to have been invited to be a resident at St. Joseph's Health Centre in Toronto for a day.
Experiencing life "in the scrubs," I saw first-hand the great work our doctors, nurses and healthcare practitioners are doing on a day-to-day basis.
It was a great opportunity to speak with not only front-line workers, but also patients and their families in a busy hospital setting. They even gave me a pager!
And though this past year has been an incredible experience, I also recognize the great challenges we have before us.
Some challenges we have conquered together, others remain ahead.
I'd like to talk about some of the challenges and achievements today, but first let me say that in getting to know healthcare professionals like yourselves, the thing that impresses me most is your disciplined, practical and scientific approach to your work.
You are trained - and perhaps congenitally predisposed - to diagnose problems and develop solutions.
And you apply this discipline with equal vigour to both patient treatment and to addressing administrative problems within our vast and complex public healthcare system.
I know medicine is both an art and a science, where humanity and empathy are as important to successful treatment as knowledge and expertise.
But at the end of the day, for policymakers like me, it's the medical science and data-based evidence that must guide our decisions on health sector regulation and allocation of resources.
So I am very grateful for the input we get from organizations like the CMA: It is invariably grounded in facts and reason, the necessary basis for sound public policy.
Working together, we have made real progress in the last year on improving public health and safety.
Nowhere is this truer than last December, when I introduced "Vanessa's Law", a bill that is named after my colleagues' daughter.
Terrence Young tragically lost Vanessa after she died from a heart attack while on a prescription drug that was later deemed unsafe and removed from the market.
Canadians deserve to have confidence that the medicines they are using are safe.
We as a government need the power to recall a drug and take it off the store shelves when it is not safe.
And through Vanessa's Law, we'll be able to do just that, and not wait for a company to act.
For the very first time, adverse drug reactions have to be reported by healthcare institutions.
We will be able to impose penalties that include up to $5 million per day or even jail time for unsafe products.
And we'll be able to compel drug companies to revise labels to clearly reflect health risk information, including updates for health warnings for children; and ask companies to do further testing on a product, including when issues are identified with certain at-risk populations such as children.
It is my hope that "Vanessa's Law" will soon obtain Royal Assent, as I am confident it will make a difference in protecting Canadians.
I want to thank the CMA for your input on Vanessa's Law.
Your input was also vital to Health Canada when we launched the "Regulatory Transparency and Openness Framework and Action Plan."
Under the leadership of Prime Minister Stephen Harper, we have pushed to make Government and Departments more transparent.
We believe Canadians have a right to know how their tax dollars are being spent, and to have access to information, especially when it comes to their health.
Canadians deserve to have confidence in the consumer products, drug products and medical devices they rely on.
Now, with the click of a mouse, a concerned parent, patient or health practitioner can go on Health Canada's website to get more information.
When we launched the Framework, we posted the first Summary of a safety review for the acne treatment, Diane-35. And we didn't stop there.
Diane-35 had affected the lives of many young women. We also worked with the Canadian Pharmacists Association, the Canadian Dermatology Association, and the Institute for Safe Medication Practices to develop a checklist to guide healthcare professionals through the decision to prescribe Diane-35.
The checklist reinforces existing warnings and precautions and works to ensure that Canadians and their healthcare communities know the risks.
And with your help and support, we're also tackling the growing problem of prescription drug abuse.
This is a major public health and safety issue for many Canadian communities and families.
The statistics speak for themselves.
Let me give you a few examples.
The 2012 Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) indicates close to 1 million youth, aged 15 to 24 years, reported having used prescription drugs in the past 12 months.
The same survey shows approximately 410,000 Canadians reported abusing prescription drugs like opioid pain relievers, (such as Demerol and OxyContin); stimulants, (such as Ritalin and Adderall); and tranquillizers and sedatives, (such as Valium, Ativan and Xanax).
Recently, an Ontario report showed the annual rate of opioid-related deaths jumped by 242 per cent between 1991 and 2010.
And we know Canada is now the second-largest per capita consumer of prescription opioids (exceeded only by the United States), according to the International Narcotics Control Board (2013). Globally, North America consumes approximately 80% of the world's opioids.
Quite frankly, these numbers are frightening, unacceptable and the reason why our Government is taking action.
In January, I co-hosted a Symposium where officials from different levels of government, as well as physicians, pharmacists, First Nations representatives, law enforcement, addictions specialists and the CMA discussed how we could collectively tackle this issue.
Since that time, we have made several investments and taken concrete action, including $45 million in this year's budget to expand the National Anti-Drug Strategy to include prescription drug abuse.
Recently, we also issued a call for proposals looking for new ways to improve prescribing practices for opioids and other drugs that pose a high risk of abuse or addiction.
I also announced that I was looking into how we could regulate tamper-resistance properties to help prevent things like Oxy from being crushed and snorted or injected.
Today, I am pleased to announce that we have implemented label changes to enhance the safe and appropriate use of controlled release opioids, like Oxy.
The changes include standardized wording that more clearly outlines the risks and safety concerns associated with these medicines. The new label has been modified to remove "moderate" pain and clarify these drugs should only be used to manage severe pain.
This is just another step our Government is taking to try and combat prescription drug abuse.
Too many people are abusing prescription drugs. Too many people are suffering and dying as a result.
We must develop practical solutions that will prevent abuse while keeping medications available for patients who really need them.
Innovation
Last year at this gathering I spoke about two of my personal priorities: family violence and innovation.
First, on family violence.
I want to reiterate what I said last year and as someone who has long been active in advocating for the prevention of family violence, I see it as fundamentally a public health problem.
I want to remind you of the statistics I shared last year:
- $7.4 billion - That is the estimated yearly cost of spousal violence alone;
- $6 billion - This includes healthcare costs, for medical treatment and psychological services; and
- 329 - That is the number that the Calgary police alone investigated for child abuse in 2012.
Unfortunately today, I stand before you and these stats remain similar and much work remains.
But I want to thank the CMA and other groups like Canadian Nurses Association, Canadian Centre on Substance Abuse, College of Family Physicians, Canadian Paediatric Society, Mental Health Commission of Canada, Society of Obstetricians, Gynaecologists of Canada, Canadian Psychological Association, Canadian Psychiatric Association, and several others for attending a roundtable in March at the Sheldon Kennedy Child Advocacy Centre.
After being at the Centre we had a groundbreaking and emotional meeting where we all committed to tackle this issue head on. I hope to share more with you in the coming months on this file.
Now, on innovation.
Medicine has always attracted innovators. The strides we've made over the last century in preventing and curing disease are truly amazing.
Governments, to put it politely, are typically rather less innovative.
But good governments are those that listen to experts and innovators and act on their advice.
And the CMA and its members are a tremendous source of innovative ideas and practices.
Your involvement in the "Choosing Wisely" initiative is a great example.
It's obviously good medicine to engage patients in conversations about unnecessary tests.
With all the new technologies available, it's understandable for patients in health-threatening situations to seek any and all diagnostic tools.
But most will choose rationally if they are fully informed about which tools are necessary and appropriate, and which are unnecessarily costly and potentially harmful.
From an administrative perspective, this is innovation at its finest; for it reduces wasteful spending and effort, and redirects resources into positive health outcomes.
The provinces and territories are all on board with healthcare innovation, particularly through the Council of the Federation's Healthcare Innovation Working Group.
I'd like to applaud the provinces and territories for their work; they recognize innovation is critical in improving the quality and cost-effectiveness of care.
Federally, we're all over this too.
Through the Canadian Institutes of Health Research (CIHR), we're building a vast and valuable knowledge base.
We also are investing in research that translates into better bedside care for patients, through our strategy on patient-oriented research, or SPOR.
I spoke about SPOR briefly last year and this year I am proud to say we have partnered with more provinces and increased funding for this research initiative in our latest budget.
But with an aging population and the growing burden of chronic disease, we also know we need to accelerate the pace of progress on innovation.
That's why, in June, I appointed an Advisory Panel on Healthcare Innovation.
I've asked the panel to identify the most promising areas of innovation both here in Canada and internationally, and to give me advice on how the federal government can better support innovation.
The panel is headed by Dr. David Naylor, whom many of you will know. You may also recognize Dr. Cy Frank, a leading Canadian researcher.
The other six members come from a range of backgrounds and provide considerable bench strength on this issue.
Over the next 10 months, they will engage with the provinces and territories, stakeholders and Canadians, looking for areas of innovation and advising on how the federal government can help accelerate progress.
The Panel is expected to formally meet with stakeholders this fall and they will engage with the provinces and territories on an ongoing basis.
I know many of you in this room have ideas on how we can do things differently and better to improve the cost-effectiveness and quality of healthcare.
The panel will be eager to hear the views and ideas of the CMA and those of physicians from across the country.
The panel will be eager to hear the views and ideas of the CMA and those of physicians from across the country.
Please stay tuned for more information on how the panel will consult with stakeholders.
Prevention & Healthy Aging
Innovation on disease prevention and healthy aging strategies is absolutely critical to the sustainability of our healthcare system.
I have just returned from my annual camping trek in the Rockies with Laureen Harper and some other friends.
We hiked over 70 kilometers in the back country and like last year, I am going to encourage all of you if you get some time, to take a health break and go for a hike here in the Gatineau Hills.
Though I am biased -- it doesn't compare to the great Rockies.
I am a firm believer we have to practice what we preach.
This includes being active, eating healthy and not smoking!
I believe prevention is fundamental in healthy living.
Treatment of chronic disease consumes 67% of all direct healthcare costs. In fact, two out of five Canadians over the age of 12 have at least one chronic disease, including cancer, diabetes or heart disease.
Today, one in four adults in Canada is obese, and a third of all children are already overweight or obese.
That's why our government is investing tens of millions every year in projects aimed at reducing the risk factors that underlie most chronic diseases.
This includes everything from working with the Canadian Partnership Against Cancer to launching the Play Exchange with the goal of nudging Canadians off the couch and into play!
I am also extremely excited and honoured to be named a FIFA Ambassador. Not only do I love soccer, but I believe all of us in this room have a responsibility as role models to encourage the younger generation to be more active and fit!
Healthy eating is obviously key to healthy living too, which is why we're also leading a number of healthy-eating initiatives.
We know parents are struggling to make informed decisions for their families.
So this year I began consulting with Canadians to hear what we could do to improve food labels.
Just a few weeks ago, I was pleased to propose new changes to the food label. Changes that make Canada a world leader in food labelling and changes that will better help parents!
The proposed changes are to the format of the Nutrition Facts table, the list of ingredients, the list of nutrients that must appear in the table, and to the Daily Values.
We also propose providing guidelines to industry to make the serving sizes displayed in the Nutrition Facts table more consistent among similar products.
And SUGAR - not so sweet sugar.
For the first time, parents and consumers will have a clear picture of how much sugar is added to food. Sugars will also be grouped together and the labels are easier to read.
And we have added a percent daily value for sugar to make sure that consumers are able to identify foods that contain a lot of sugar.
I realize these are aggressive steps and at home my kids have told me that I've killed the Cookie Monster. But joking aside, we heard from parents across the country that they are concerned and wanted more information, so we acted!
Meanwhile, since we last met, the Canadian Food Inspection Agency moved into the Health Portfolio, where we created the Healthy and Safe Food for Canadians Framework, whichis promoting healthier food choices, improving food safety, and protecting Canadians from unsafe products entering the marketplace.
Not only do we want Canadians to be able to make healthier food choices, we want parents to be confident the food in their pantry and on their table is safe.
I'd like to conclude - by noting all of us in this room, including the media, share one thing in common:
We are all ageing!
And with that, I'd like to commend the CMA for engaging Canadians across the country through townhalls and making the topic of end-of-life care a priority.
It's difficult for most people to talk about--but for health professionals, it goes with the territory.
Approximately 6% of Canadians over the age of 65 are living with Alzheimer's or dementia, and that number is expected to double by 2031.
The economic cost is pegged at $8.3 billion a year, but the cost to family members, caregivers and communities is immeasurable.
As Canada's population ages, we need to better understand how to deal with neurological diseases.
I'm very proud of the CIHR and their research into dementia--and of the significant investments our government has made in their work--more than $182 million since 2006.
And just this past spring, Prime Minister Stephen Harper joined Brain Canada and announced new public-private partnerships with the Chagnon Family, who supports innovative research projects to help prevent the onslaught of Alzheimer disease on the Canadian population.
At the G8 Summit on Dementia in London last year, I committed Canada to co-hosting with France a Global Dementia Legacy Event in Ottawa next month. , and I hope to see many of you there.
Our Government understands the difficult challenges faced by Canadian families when they are caring for aging loved ones.
That is why we are taking a leadership role when it comes to things like dementia and why we continue to work alongside the provinces and territories on ways to ensure that Canadians receive the highest level of care.
For instance, since 2006 we have invested more than $43 million to support palliative care research. We have also committed $6 million to support initiatives to broaden the range of care settings and training for providers of palliative care.
But none of the work we do in Government would be possible without groups like the Alzheimer's Society, the Canadian Hospice Palliative Care Association, the Pallium Foundation of Canada and countless others.
Not to mention the doctors, nurses, home care providers and frontline workers, who work every day supporting Canadians as we age.
I look forward to continuing discussions on seniors care with the CMA and working together to ensure, that as we get older, we have the best possible care.
Conclusion
Ladies and gentlemen, Canadians expect their national government to play a major role in sustaining our high-quality healthcare system.
And today I want to reinforce that our Government is at the table and we want to make sure Canadians have the highest level of care.
That's why, along with all the national initiatives we are working directly with the provinces and territories on innovation, health human resources, prescription drug abuse and mental health initiatives.
Healthcare remains a top priority for all Canadians; it is perhaps no accident that a neurosurgeon recently became premier of Canada's second largest province.
So it is here with you: We all want the same thing - the best healthcare system in the world to provide the highest quality healthcare for Canadians.
Let's continue the great relationship we have built over the past year. My door remains open to you and like last year, I look forward meeting with many of you today!
Merci!
