May 27, 1938

LIB

Olof Hanson

Liberal

Mr. HANSON:

Will the minister give the number of cases in each province?

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

The division for the ensuing year, 1938-39, as between the provinces will be on the basis of population combined with the number of treatments for syphilis during the year 1936, which is the last available year. These are the treatments in the various provinces in 1936:

Prince Edward Island 809

Nova Scotia 7,904

New Brunswick 16,024

Quebec 112,161

Ontario 92,656

Manitoba 12,800

Saskatchewan 10,414

Alberta 26,070

British Columbia 16,907

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Of course, division on the basis of population works along the same lines. The total of treatments for 1936 in the whole of Canada was 296,408.

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LIB

Donald Alexander McNiven

Liberal

Mr. McNIVEN:

Is that for all types of venereal disease?

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

legislation to control infection of others, both directly and indirectly; financial contributions by the central government to the local public health authorities. Sweden claims that on the whole the results were favourable of the legislation dealing with compulsory notification and so on. Canada I am afraid will not find it so satisfactory. All the provinces shortly after 1919 placed on their statute books legislation of varying degrees of severity in order to prevent the spread of venereal disease. I am informed that, although there have been prosecutions and even convictions in certain provinces, the law has to a large extent become a dead letter. The law with respect to compulsory notification has not been carried out to anything like the full extent. The law with respect to compulsory treatment is largely confined now to those who come before the criminal courts or who are in penal institutions. Outside of that these Draconian laws passed in 1919 are to a considerable extent a dead letter. However, Sweden I believe found very much the same results from their campaign as have been found in Canada. I do not wish to take time to give all the details with respect to Sweden and comparisons of their experience with that of Canada; suffice it to say that apparently the results were about the same. Perhaps Sweden is more proud of it than is Canada, particularly since, as has often been repeated, the Canadian government gave up the work in 1931.

I have here a statement showing the number of admissions for syphilis reported at clinics in the five year period between 1932 and 1936. The figures are as follows for all Canada:

1932 9,730

1933 9,408

1934 7,178

1935 6,241

1936 5,832

There was a considerable drop in the number of new admissions for syphilis during that period.

The same results were perhaps not attained with respect to gonorrhoea, where there has not been the same decrease in new admissions to hospitals. During the course of the discussion much was made of the influence of syphilis on the state of the mind, and the number of persons suffering from venereal diseases who afterwards became the inmates of mental institutions. Whilst I am not at all prepared to contradict any of the figures which have been given, perhaps it would be interesting to note the figures I have received from the bureau of statistics for the year 1936. These figures are given for all Canada.

The total number of first admissions to mental hospitals from 1932 to 1935 inclusive was 6,932. Of these there were 392 cases of general paralysis from syphilis, and 17 attributable to cerebral syphilis, making a total of 409. That is a percentage of 5-9 of all admissions. During the same period 7-4 per cent of the patients in mental hospitals died from general paralysis, and 0-7 per cent from cerebral syphilis. These appear to be the figures given by the bureau of statistics. I am told that the discharges from recoveries in mental cases from mental hospitals using modern methods reach as high as fifty per cent.

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LIB

James Joseph McCann

Liberal

Mr. McCANN:

Is the minister including all cases which have arisen as a result of syphilis?

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

Yes, all cases. The fifty per cent covers all cases, including those resulting from syphilis.

Some time ago when the house was discussing statements the hon. member for Winnipeg North Centre read from a book entitled Social Work and Legislation in Sweden, and detailed a lengthy list of services which had been carried on in that country. His suggestion was that we should do something similar in Canada, and he was very critical of the government and of the department because the work had not been done. Again this afternoon he referred to Sweden.

During the course of the earlier debate to which I have referred I did not have the time to discuss conditions in Sweden or what Sweden has been doing along social lines, as compared with Canada. But in order to show that Canada is doing a great deal in the way of health legislation it might be well to put certain figures on Hansard. When we speak about work in Canada towards the advancement of health we do not necessarily refer only to the federal government. It carries on only a very small portion of the work. A great many people believe there is some overlapping, and that we should do none of it.

In the following table I shall set out the figures for Sweden and Canada in connection with certain social work, where the suggestion had been made that Sweden is far ahead of us.

Sweden: Accident insurance, 2,400,000 kronor or $600,000 or 9 cents per capita.

Canada: Accident insurance (workmen's compensation), $13,380,000 or $1.20 per capita. Sweden: Sickness insurance, 13,000,000 kronor or $3,250,000 or 50 cents per capita.

Canada: Sickness insurance-Nil.

Sweden: Pension insurance, 55,900,000 kronor or $13,975,000 or $2.15 per capita.

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Canada: Soldiers pensions, $47,786,123.51-42 cents per capita.

Old age pensions, $21,520,302.66-$1.95 per capita.

Total-$09,306,426.17 or $2.37 per capita. (Widows' pensions and superannuation of civil servants not included.)

Sweden: Assistance to blind, 1,700,000 kronor or $425,000 or 6 cents per capita.

Canada: Pensions to blind-Nil-Act not passed until 1936.

Sweden: Poor relief and child welfare, 3,700,000 kronor or $925,000 or 14 cents per capita. Canada: Charitable and benevolent institutions - (These include homes for adults and children, orphanages, children's aid societies, juvenile immigration societies, institutes for the deaf, dumb and blind and day nurseries), $9,120,593 or 82 cents per capita.

Sweden: Workers' protection, labour exchanges, social board, etc., 2,600,000 kronor or $650,000 or 10 cents per capita.

Canada: Workers' protection, labour exchanges, etc.-No figures available.

Sweden: Unemployment (including unemployment insurance), 54,200,000 kronor or $13,550,000 or $2.08 per capita.

Canada: No insurance-unemployment relief

cost dominion government alone, 850,201,000 or $4.56 per capita.

Sweden: Public health and care of the sick, 38,300,000 kronor or $9,575,000 or $1.40 per capita.

Canada: Public health, $7,000,000-66 cents per capita.

Hospitalization of sick, $46,500,000-$4.15 per capita.

Hospitalization of mental cases, $10,938,882- $1 per capita.

Total of health and hospitalization, $64,438,882 or $5.81 per capita.

Sweden: Reformatories (care of vagrants and inebriates, 1,900,000 kronor or $475,000 or 7 cents per capita.

Canada: Penal institutions (dominion, provincial and municipal), $4,921,641 or 44 cents per capita.

Sweden: Other social purposes, 4,100,000 kronor or $1,025,000 or 16 cents per capita.

Canada: Expenditures of voluntary organizations, $1,818,279.02.

Dominion grants to voluntary organizations,

Total-(calendar year 1937), $1,920,479.02 or 17 cents per capita.

Sweden: Cost of living bonuses, petty expenses, etc., 2,200,000 kronor or $550,000 or 8 cents per capita.

Canada: Cost of living bonuses, etc.-Nil.

Total expenditure Sweden-180,000,000 kronor or $45,000,000.

Total expenditure Canada-$213,289,021.19.

Summary: The above figures do not represent the total expenditures for health and social services in Sweden and Canada. The total figures for Sweden in the year 1932-33 are given as 350,000,000 kronor or $87,500,000 -a per capita expenditure of $11.85. The figures shown above for Canada, namely, $213,-289.021.19-a per capita expenditure of $15.37

-do not cover exactly the same services as those indicated for Sweden, but serve only for the purpose of rough comparison.

So that taking Canada by and large, it would seem that we do a great deal for health. I would be the last to say that we should not enlarge our services, and the last to say that I would not like to have a great many millions of dollars to spend on health services in Canada. There are other diseases which must be considered and which must receive the attention of the federal parliament and the legislatures. The total number of deaths in Canada in 1936 amounted to 106,617, and the general death rate was 9-7 per 1,000 of population. The following table will set out the diseases, the number of deaths and the rate per 100,000 of population:

Deaths Rate per 100.000 of population

Heart disease .. 16,361 148-5Cancer 11,652 105-8Pneumonia .. 7,266 65-8Tuberculosis .. 6,745 61-2Kidneys .. 6,734 61 [DOT] 1Influenza 3,096 28-0Syphilis .. death rate 5-3

There are other diseases, apart from this particular group, which need the attention of all health authorities of Canada. A beginning has been made in the distribution of these arsenicals to the provinces, and it is my hope that it will be possible to carry on the campaign with greater vigour in another year.

Topic:   DEPARTMENT OF PENSIONS AND NATIONAL HEALTH
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LIB

James Joseph McCann

Liberal

Mr. McCANN:

Has this matter been taken up with the several provincial health departments?

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

It will be taken up at the dominion council of health which meets in June.

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Item agreed to. Food and drugs, $155,995.


CCF

Charles Grant MacNeil

Co-operative Commonwealth Federation (C.C.F.)

Mr. MacNEIL:

I have in my hand a copy of the regulations that were issued under the Food and Drugs Act, as authorized by order in council of August 16, 1934. Page 29, section 8, subsections 3 and 4, have to do with the purity of flour and bleached flour. These regulations refer to the processing of flour in the milling industry. Just recently I secured a copy of the new regulations in English and French which have been placed in circulation, and I notice that these two paragraphs have been deleted. The order in council which authorized that deletion was circulated in the French language but not in the English.

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

Do I understand my hon. friend to say that the order in council was circulated in French and not in English?

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CCF

Charles Grant MacNeil

Co-operative Commonwealth Federation (C.C.F.)

Mr. MacNEIL:

It was only with the French copy that I received a copy of the order in council, also in French.

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

I understood nay hon. friend to say it was circulated only in the one language.

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CCF

Charles Grant MacNeil

Co-operative Commonwealth Federation (C.C.F.)

Mr. MacNEIL:

I had to make a special request to the department to secure a copy of the order in council because it was not included with the copy of the regulations circulated in the English language.

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

When was that?

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CCF

Charles Grant MacNeil

Co-operative Commonwealth Federation (C.C.F.)

Mr. MacNEIL:

Just within the last month.

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

The order in council was passed only on March 24, so I suppose it had not been printed.

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CCF

Charles Grant MacNeil

Co-operative Commonwealth Federation (C.C.F.)

Mr. MacNEIL:

I should like to direct attention to this order in council which reads:

His Excellency the Governor General in Council, on the recommendation of the Minister of Pensions and National Health, is pleased to amend the regulations under the Food and Drugs Act, established by order in council of the 16th August, 1934, P.C. 123/1852, and they are hereby amended as follows:

Subsections 3 and 4 of section VIII-grain products are hereby deleted and subsections 5 to 15 of the above section are renumbered 3 to 13.

The subsections deleted by this amendment were as follows:

3. Flour shall be the fine, clean sound produce made by bolting wheat meal, and shall contain _ not more than thirteen and five-tenths (13-5) per cent of moisture, not less than one and twentydive hundredths (il-25) per cent of organic nitrogen, nor more than two (2) parts per million of nitrite reacting nitrogen, not more than one (I) per cent of ash, and not more than fifty hundredths (0-50) per cent of fibre.

4. Bleached flour shall be flour which has undergone processing for the purposes of making it lighter in colour. The residual nitrite reacting nitrogen shall not exceed five (5) parts per million. The presence of more than two (2) parts per million of nitrite reacting nitrogen in flour shall be held to be proof of its having been bleached by oxides of nitrogen.

Note.-Nitrite reacting nitrogen shall be calculated as sodium nitrite (NaN02) which for the purposes of this definition shall be identical with nitrogen.

These subsections dealing with the purity of flour or bleached flour have been deleted from the regulations. I am concerned with the reason for the deletion of these subsections. I want to know whether it means that the consumers are to be deprived of the protection formerly extended to them with respect to the purity of flour or bleached flour. What is the explanation for the deletion of these important subsections in the regulations?

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LIB

Charles Gavan Power (Minister of Pensions and National Health)

Liberal

Mr. POWER:

This is a somewhat technical question and has involved considerable controversy in the past. Some time in 1935, I think it was, the department instructed certain of the millers that they were no longer to use potassium bromate in flour. Representations were made, and there seems to have been some confusion as to just what was the final decision. There appears to be nothing on the files of the department to the effect that permission was granted to the millers generally to use potassium bromate. I do not just know how it came about, but in any case the first I heard of it was that a decision of the department apparently had been given that potassium bromate was not to be used. This was brought to my attention by the manager of the Maple Leaf Milling Company who called attention to the fact that other companies were using this improver. He wanted to know why his company could not do likewise, which was a reasonable request. Upon inquiry I found that the departmental officials were of the opinion that it should be prohibited. The other millers asked for a hearing before any definite decision was reached.

We invited the millers to come to Ottawa to discuss the matter. At that conference the Maple Leaf Milling Company stated that they had no objection to this improver being added to the flour, provided they were allowed to use it as well as were the other millers. The matter was discussed with the officials of the Department of Agriculture and the Department of Trade and Commerce, which latter department has a real interest in the sale of Canadian wheat. After considerable study I came to the conclusion that the use of infinitesimal quantities of potassium bromate was not deleterious to human health. This improver is being used to an unlimited extent by the bakers because we have no control over its use by them. However, we had automatically excluded its use by the millers who had been using other improvers of a non-deleterious nature for a number of years. It was pointed out to us, to the point of conviction in so far as I was concerned, that [DOT]there was no reason why it should not be used except for the fact that its use was forbidden by the regulation. I thought, I suppose because I am not overly fond of regulations, just because they are regulations, that it would be just as well to do away with it.

Then it was pointed out that in competition with other countries, particularly in our export trade to hot countries, we were at a

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disadvantage. In the United States there are no restrictions whatever on the use of improvers of that kind. United States flour competes with ours and gets the advantage of us in countries like Cuba, West Africa and other countries. Great Britain, after studying the matter, decided not to prevent the use of improvers. France, having studied it, came to the conclusion -that improvers should not be used. Mr. Geddes, expert in grain chemistry, in the research laboratory of the board of grain commissioners, gave his opinion that no harm would be done to Canadian wheat and that the sale of Canadian wheat would not be injured by any decision which we might arrive at with respect to the matter. Mr. Aitken, assistant expert in grain chemistry, in the grain research laboratory of the board, gave his opinion that not only was potassium bromate not deleterious to humans but that it might certainly improve the flour to allow bromate to be added. In the face of these decisions I came to the conclusion that there was no harm in allowing it to be used.

The next question asked was, Would it be necessary to amend our regulations? Had we done so, we should have had to add to the regulation read by my hon. friend a moment ago-the regulation that reads:

Flour shall contain not more than thirteen and five-tenths (13'5) per cent of moisture, not less than one and twenty-five hundredths (1-25) per cent of organic nitrogen, nor more than two (2) parts per million of nitrite reacting nitrogen, not more than one (1) per cent of ash, and not more than fifty hundredths (0-50) per cent of fibre.

It would have been necessary to add:

And not more than such a percentage of bromate, and not more than certain other ingredients which from time immemorial have been mixed with flour.

So it would have made a definition which would have included practically everything. We therefore thought it advisable to repeal the regulation altogether, but in order to protect the public we have sections of the act which give ample power to the department to prosecute and punish anyone who sells food which might be deleterious to humans. Section 4 of the act, which deals with adulteration, and certain other sections give us ample power. There is no danger whatsoever that we have forfeited any of our powers under the act.

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CCF

Charles Grant MacNeil

Co-operative Commonwealth Federation (C.C.F.)

Mr. MacNEIL:

Unless that section of the act is given effect to in regulations, it would appear that the situation now is that the milling industry may introduce an adulterant in a staple that appears on every family table, while some doubt exists as to whether it is deleterious for human consumption. I do

not wish to arouse any false alarms, but it is a well established principle that we should not permit adulterants of any sort in flour. I am well aware that potassium bromate as a salt is used in flour in very small quantities to stabilize or accelerate the action of the yeast, and that if used in excessive quantities it would probably result in the fermentation getting beyond control. But I am reliably informed by medical men, and I must take their advice because I am not a medical man myself, that the case with regard to the use of potassium bromate is not proven one way or the other. There is considerable evidence to show that the use of this salt in flour, or introduced as an improver in compounds used by bakers, is injurious to the workers in the industry because it gives rise to certain skin disorders. There is also evidence to show that when the flour is consumed, particularly by people who may be susceptible to certain skin diseases, it does tend to aggravate skin disorders or induce more serious consequences. I contend that the same result in proper action of the yeast would be secured by a more careful blending of the grains. I think it is extremely unwise that a well established monopoly such as we have in the baking and milling industry should influence departmental policy in this regard and should secure the right to introduce a questionable-I think that is the least one can say of it-improver or adulterant when there is the slightest degree of risk to those who consume the bread, and when there is definite risk to the workers in the industry who are exposed to the action of the salt. I would earnestly urge the minister to reconsider his position in the matter and to re-enact regulations which will establish definite standards of purity in connection with the use of a product that is of such importance in all households.

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May 27, 1938