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Minister wants tobacco plain-packaging bill passed by summer

By Jolson Lim      

In an exclusive interview, Health Minister Ginette Petitpas Taylor weighs in on the results of an external review calling for several health agencies to be overhauled, as well as drug prices, seniors' care, and other hot topics.

Health Minister Ginette Petitpas Taylor says she agrees with a recent external review that pan-Canadian health organizations are in need of change. The Hill Times photograph by Andew Meade
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Health Minister Ginette Petitpas Taylor says she wants to see a heavily-lobbied bill that proposes to standardize plain packaging for cigarettes finally passed before summer after nearly two years of study by legislators.

Bill S-5, introduced by the government Senate representative in November 2016 and now back in the House after committee study, having already passed the Senate, would regulate vaping and standardize the packaging of cigarettes. Tobacco companies lobbying the government say it would only serve to boost organized crime, but anti-smoking advocates say the bill makes sense for health reasons.

“I’m hoping we’ll see that piece of legislation get through the House by the end of June 2018 because we certainly recognize that those types of measures are absolutely key to preventing…people from smoking,” said Ms. Petitpas Taylor (Moncton-Riverview-Dieppe, N.B.) in a wide-ranging phone interview last week that also covered topics including drug prices and a potential seniors strategy or ministry.

The health minister, in her eighth month in the role as a rookie cabinet minister, said the move of the behemoth First Nations and Inuit Health Branch from her department, Health Canada, to the new Indigenous Services Canada is going well, considering “a lot” of concerns raised when the new department was announced last August, amid her shuffle into the job. The branch accounted for $3.1-billion of Health Canada’s $4-billion-plus budget last year.

In reaction to an external report she commissioned that concluded last month that pan-Canadian health agencies weren’t doing enough work to better engage Indigenous groups in the spirit of reconciliation, Ms. Petitpas Taylor said Health Canada and other government stakeholders will “have to move forward in ensuring that more work needs to be done.”

The review suggested phasing out three of the eight pan-Canadian health organizations, noting gaps and overlaps in how these federally funded groups work. The minister acknowledges change is needed, though she’s not sure on the details yet.

The minister also talked about her government’s recent move to lower the drug-price ceiling. Despite criticism from brand-name drug companies, it appears she is sticking to her guns, as outlined in draft regulations presented last year. The idea is to save an expected $13-billion over 10 years by changing the list of countries Canada uses to compare drug price ceilings.

And Ms. Petitpas Taylor called attention to the advisory panel struck in February to study a national pharmacare strategy, to report back before the 2019 election.

This interview has been edited for length and style.

The Canadian Medical Association believes that the federal government should facilitate the creation of a national seniors’ strategy in order to improve co-ordination in health care for a burgeoning elderly population. Do you agree that there should be a plan? 

“I really have to say that I’m proud of the work of the government…so far in the area of seniors. I really feel like we’ve taken a whole-of-government approach with all departments that are involved. We formed government in 2015; significant investments have been made in the area of seniors. I know that when I did a lot of door-to-door during campaigns during 2015, I certainly met with a lot of seniors and they brought several matters to our attention, one being specifically our low-income seniors within this country. And I was very pleased to see that we were able to raise their guaranteed income supplements by 10 per cent, which in [a] monetary amount [is] $1,000 more a month for a single low-income senior [to] get more, all within their budget. So we saw that made a significant change in their monthly budgets.

“The other thing that’s there that I’m really proud to see, as well, is the investments we’re making in our National Housing Strategy. That, of course, does help our seniors, but we certainly know that our low-income seniors…we certainly have to make sure their basic needs are met, and that housing is absolutely a basic need. So I’m pleased to see that significant investments are being made in that area.

“I always say that all government departments need to make sure we [have] that lens to ensure that we address the needs of seniors. I don’t believe that it just belongs to one department, I think collectively all departments need to really have that lens when putting together public policy.”

The NDP is calling for a Seniors’ Department and some have discussed a minister for seniors. What do you think of those ideas?

“I think it’s really important to ensure we can’t look at seniors’ issues just in a silo. I think every department really has a role to play…When I look at the budget investments that we made with respect to the $11-billion in mental health and home care, we only recognized that home-care money is predominantly going to go to seniors to make [it so] they can stay in their homes longer.

“So I see every department and every ministry really has to ensure we have that lens when putting together policies that affect the day-to-day lives of seniors. Seniors, at the end of the day, deserve our utmost respect. And we need to make sure they are certainly a priority when developing different policies.”

How do you respond to critics who say your move to lower the drug-price ceiling would reduce the availability of new medicines for Canadian patients, stifle innovation in Canada, and lead to fewer clinical trials and job losses in the pharmaceutical industry?

“I think as a government we certainly recognize Canadians, at the end of the day, pay too much for prescription drugs. And we’re really committed to taking whatever action is needed to bring down those prices. We have taken significant steps in order to deal with this, and we certainly have a lot of work that still needs to be done. I believe Canadians are proud of these steps that the government is taking because we certainly want to do all that we can to ensure that Canadians have access to the drugs they need. Also, at the end of the day, we certainly recognize that the investments to be made in that area—that we can save money in the health-care system as a whole.”

So the move to lower the drug-price ceiling, would you say, is the best available solution? 

“Well, it’s certainly a step in the right direction. That’s why in Budget 2017 we made significant investments to help with respect to drug prices.

“The federal government joined the pan-Canadian Pharmaceutical Alliance back last year. As a result of being able to join the provinces and territories to bulk-purchase the drugs together, we’ve already saved over a billion dollars. So that’s direct savings we can see. That is certainly a step in the right direction.

“They’re aware of our recent announcement of our advisory council on a national pharmacare program. But before we can look at a pharmacare program, we certainly have to look at what were already the drug prices. These steps we’ve taken over the past few years is certainly a step in the right direction and I’m looking forward to seeing the recommendations that will be brought forward by the advisory council. It will be chaired by Dr. [Eric] Hoskins and other members who are experts in the field of pharmacare….”

There was an external review of pan-Canadian Health Organizations that found they had not seriously undertaken the work of Indigenous reconciliation. What is your reaction to that finding, and does it suggest more work to be done on the matter?

“…I was very pleased we were able to commission the report that was prepared by P.G. Forest and Danielle Martin. And yes, one of the comments that they made is that with pan-Canadian organizations, that there was limited work in that area. As our government and our prime minister has made it very, very clear, there is absolutely no relationship that is more important to us than that [of the one with] our Indigenous communities. And we’re committed to having a renewed relationship with Indigenous people to make progress in all areas.

“One thing that I’ve indicated very clearly: no decision has been made with respect to what steps we’re going to take moving forward with the PanCan organizations, however, the status quo is not an option. Specifically, I’ve made the comment when we look at Indigenous relationship we certainly have to move forward in ensuring that more work needs to be done in order to foster those relationships and to make sure Indigenous people are actively involved and represented within these groups.”

The report, first and foremost, recommends a fundamental overhaul of PCHOs, including the idea of merging some current ones together. What is your reaction to that?

“We’ve asked Danielle and P.G. to do a review because we’ve certainly expected to really have an open mind and come up with some bold ideas with respect to the PanCan [groups], I have to say that [the groups have] done tremendous work over the years and some of them have accomplished their mandate. They’ve done tremendous work over the past 30 years. No specific decision has been made going forward as to what direction we’re going to take, but I’m certainly reflecting on the options that have been presented by P.G. and Danielle.

Government Senate Representative Peter Harder introduced Bill S-5 in November 2016, to regulate vaping and the packaging of cigarettes. It’s now back in the House after committee study, having passed the Senate earlier. The Hill Times file photograph

“It doesn’t necessarily mean one of those recommendations alone will be the recommendation of choice. We can certainly take some of the recommendations from one group and some from the others as well. But we certainly want to make sure we can use those resources efficiently to meet the needs of the 21st-century health-care system and challenges that we’re facing because we certainly recognize that…things have changed and we certainly have to be very efficient with the resources that we have.”

The Indigenous health portfolio has largely been moved to Indigenous Services Canada, resulting in the giant First Nations and Inuit Health Branch being relocated to that department from Health Canada. How’s the move going? 

“I’d have to say that the move has gone really well. Of course, if you remember very well when the Department of Indigenous Services was created last August, there was a lot of, perhaps, concern, but people didn’t know how that was going to go. But I have to say that the move has gone quite seamless, actually, if you think of the big shifts there. Myself and [Indigenous Services] Minister [Jane] Philpott continue to work closely together in order to make sure we meet the needs and to certainly make sure the transfers are done in an orderly way possible. I would say the split in the department has gone well.

“But I also have to indicate to respect [the] work we still continue to do at the Department of Health. We still have an Indigenous lens we have to keep at all times, and for all departments in our government. Just because we have a Department of Indigenous Services, it doesn’t mean that it’s only Minister Philpott’s responsibility. I think when we look at a renewed relationship with Indigenous people as a government as a whole, we have to make sure we always had that lens. But it’s certainly very beneficial having the new Indigenous Department moving forward. But we certainly have to continue to work collaboratively to make sure to address their needs.”

There were some new measures in the 2018 budget, including tackling the opioid crisis. What’s the value-added of such measures?

“We certainly recognize as a country that we’re in a national public health crisis when it comes to the opioid situation in the country and we have to do all that we can as a government to effectively turn the tide on this national public health crisis. I’ve made it very clear it’s very important for all levels of government, whether it be the federal, provincial, and municipal government, civil society—we have to have all hands on deck in order to turn the tide on this crisis. In Budget 2018, new investments have been made. I believe it’s $231-million to address the crisis.

“One hundred fifty million dollars of that new money is going to be going to emergency treatment funding for provinces and territories. You’ll see the federal government is usually not in the position to fund treatment to provinces and territories, but with the situation, the magnitude of the crisis that we’re facing, we want to use all the levers at our disposal. We thought it was really important to support provinces with what they’re facing on the ground. So the $150-million investment will be provided to provinces and territories, and that will be matched funding. It will be matched dollar-for-dollar to help them with what’s going on on the ground.

“Additionally, we also want to make sure we have a public education and awareness campaign specifically to address stigma when it comes to treatment. We want to do all that we can to reduce barriers for those seeking treatment because so often we hear from many individuals that they feel judged and that, oftentimes, they don’t get the help that they need. So it’s really important for the government to make sure we put together an anti-stigma campaign. We certainly have to continue to work with all levels of government and bring forward evidence-based solutions because we certainly want to save lives and stop this epidemic.”

There were also some anti-tobacco measures in the budget, significant because it has been a while since it’s been a topic for government action. How come they’re in there?

“We certainly recognize that tobacco use is the leading preventable cause of disease and premature [death] in Canada. A lot of work has been done in this area over the years, and we see that our tobacco rates are really on the decline, which is a step in the right direction. But, again, we have to keep the pedal on the metal and we have to continue the work that needs to be done in order to get that number even lower. Our Tobacco Strategy ended in March of this year, so we were pleased to see in Budget 2018, we received another $80-million to help support, prevent, and help Canadians reduce contraband tobacco.

“There’s a bill in the House right now that will move forward, which is about [introducing] plain packaging and creating a new framework for vaping products, so we continue to move aggressively in that area as well. I’m hoping we’ll see that piece of legislation get through the House by the end of June 2018 because we certainly recognize that those types of measures are absolutely key to preventing…people from smoking.”

There were some anti-tobacco groups that expressed concerns government funding has dried up. What do you say to them?

“The issue of preventing tobacco is absolutely a priority of our government. Calls for proposals will be open later on this year with respect to being able to apply for funding. And we hope those folks will apply, and—if they meet the criteria, and then from there—hope they will receive the funding to continue the good work that needs to be done in this year.”

jlim@hilltimes.com

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