June 13, 1975 (30th Parliament, 1st Session)

Mr. Bruce Halliday (Oxford):

Madam Speaker, before launching into the words I wish to say this afternoon I should like to compliment my colleague, the hon. member for Athabasca (Mr. Yewchuk), for bringing this motion before the House. I think the motion is so well worded that it bears restating. It reads as follows:
That this House regrets the government's failure to give adequate priority to matters which directly affect the health of Canadians, and in particular for its relative downgrading of the health research budget, and its failure to assume proper responsibility in the area of food and drug safety.
The hon. member who introduced this motion discussed it in great detail. I was really worried about the minister as I sat here and noted his concern about the points being made by the hon. member for Athabasca. I saw in him certain signs which worried me; I was apprehensive about the signs of reactive depression I saw in him. Then when he arrived late for the sitting this afternoon I became even more disturbed. But all of us must have some build-up or be paid a compliment once in awhile and I wish to compliment the minister in all sincerity. Three days ago I had the pleasure of listening to him in Montreal when he very admirably represented our country before representatives of 87 other countries of the world. He was a member of a panel discussing the subject entitled "International Understanding-What can one man do". I say quite sincerely that he acquitted himself in very fine fashion.
For the information of the House, I might say that some 20 years ago the minister was a Rotary International Fellow and indeed a fine ambassador for Canada. I think he was talking in this broad field three days ago in Montreal when he discussed international understanding. I believe we have in him a budding new secretary of state for external affairs of this country.
There are three parts to this motion. The last part deals with some specifics in respect of the food and drug safety problem. I wish to allude to four of these which have entered our discussion. They are listed in a small book entitled "Compendium of Pharmaceuticals and Specialties". The first drug referred to is called Afagon "C", known as a type of tonic to build up people. Among the ingredients are amino acids, arsenic, strychnine and ascorbic acid. The precautions to be taken are the following:
Keep out of the reach of children. Contains strychnine. Do not exceed recommended dosage. Indiscriminate use may be dangerous, especially in the case of elderly persons.
The second drug is one of a similar type, called Hemosomaton. In this case, also, precautions are indicated. It contains iron, arsenic and glycerophosphates. The warning is as follows:
Contains strychnine. Do not exceed stated dosage. Indiscriminate use
June 13, 1975

may be dangerous, especially in the case of elderly persons. Oral iron preparations may aggravate existing peptic ulcer, regional enteritis and ulcerative colitis.
One of the implications in respect of the safety of the drugs listed in this compendium which are available is that they are dangerous particularly in the hands of children. I hope the minister and the officials of his department will look into this matter in some detail.
Two other drugs bear mentioning at this time, because I think the people of Canada are being subjected to drug advertisements that not only delude them and encourage them to spend money but that encourage them to buy drugs which are potentially dangerous.
I refer first to a commonly used facial cream known as Noxzema facial cream. Some years ago one of the leading dermatologists in southwestern Ontario told me there is not one single company that makes more business for him than the Noxzema company. He was referring, of course, to the dangers of contact dermatitis which arises from the use of this particular compound.
The second drug is even more popular. It is known as Vicks. Perhaps you remember having had it used on you when you were children. The father of pediatrics in Canada, the man who built the first children's hospital in Toronto, and the second one also, used to teach us students who put Vicks on children's backs, that one might as well put a postage stamp on their backs. Yet we are allowing and encouraging citizens to spend millions of dollars a year on drugs of this type.
This is some of the information that the department should be studying. But there are more important areas than this, and I am referring to some areas that are of broad concern across the country, matters which cannot be handled by a province and cannot be handled by Canadian citizens as individuals. I speak here of three different areas that I want to discuss this afternoon briefly. The first one is in regard to medical manpower; the second one is in regard to the quality and provision of health care; and the third one is in regard to personal responsibility in the provision of health care.
For a number of years we have been hearing that the federal government is spending funds on trying to determine the status of medical manpower across the country. We are still awaiting a meaningful report on this, and we are worried about the rumours that are spreading that this report will be most inadequate. For instance, in deciding the present ratio of family physicians, as opposed to specialists, to the population, apparently the group studying this matter are going about it in a very simplistic manner. They are identifying the number of specialists across the country, which is very easy to do, and subtracting the number from the gross total number of physicians. They arrive at a figure which they say represents the number of general practitioners or family physicians in Canada. This is a meaningless figure and could not be further from the truth.
I took the opportunity in committee not too many weeks ago of bringing this matter to the attention of the Minister. I told him that, for example, in British Columbia there is an error of some 40 per cent in the figure which they
Food and Drug Safety
present. At that time I did not have the figures with me and I was not able to give specifics, but since that time I have acquired them and I find that it is even worse than I intimated to the minister at that time.
If one looks at the federal manpower inventory for 1973 which was published in 1974, and if one considers the province of British Columbia, one finds that they list a total of 1,946 general practitioners, which gives you a ratio of one GP to 1,217 people in the province. From information obtained from British Columbia we learn that at the University of British Columbia the Health Manpower Research Unit under the direction of Dr. Anderson took a much more realistic view in approaching this whole problem.
It is obvious that physicians who are not specialists are not all GPs. Many of them are doing administrative medicine, many are interns, and you cannot count them as part of the medical work force of the country.
If you take a realistic approach and try to establish how many are practising, functioning GPs, you do this as they did in British Columbia, by referring to the provincial medical scheme figures. They chose the figure of $20,000 gross earnings as the figure they would use as being the average earnings of a person practising family medicine. They said that a person earning less than that was obviously not doing much general practice. They got the figure of 1,270, which represents the number of true general practitioners or family physicians in B.C. So the margin of error there is not 40 per cent but closer to 53 per cent.
I think we must ask ourselves whether or not the government is looking ahead. We heard the hon. member for Northumberland-Miramichi (Mr. Dionne) this morning give us a long list of the accomplishments of governments in the past. I assume he included past Conservative governments in his list. We must start to look ahead. We cannot be satisfied with the situation as it has been in the past. We must also look ahead in trying to predict the manpower situation for the provision of health care in the future.
We must decide first of all how we want health care provided in this country, whether totally by specialists, or basically by family physicians augmented by specialists where necessary. The government has failed to give any leadership on that in terms of trying to delineate what the people of Canada want. It appears to me, and to many people who are looking ahead, that what the country needs is health care provided by general practioners and, where necessary, we need specialists. We must try to determine how many of each brand of physicians we will try to train. Apparently the present government is not interested in doing this.
The manpower study being undertaken should look to the future, not backwards. I hope that when figures come out in the future we will see something with a prospective approach to it rather than a purely retrospective approach. As my colleague says, we should not adopt a purely urban oriented approach. That is a good point.
I want to talk now on the second matter, that is, the quality of health care. The hon. member for Nanaimo-Cowichan-The Islands (Mr. Douglas) stressed the need for practising preventive medicine, prophylactic medicine. I

June 13, 1975
Food and Drug Safety
think there is some truth in this, but we are spending in this country more money per person than most other countries in the world, and more money in relation to our gross national product, and yet the hon. member for Nanaimo-Cowichan-The Islands thinks we should be spending more money still. What we need to do is to take a look at the money we are spending now and try to decide whether it should not be spent more effectively. In other words, what we need to do is try to get quality out of our health care, and not provide more and more to people and encourage less responsibility on the part of the citizens of this country.
As the hon. member for Athabasca has said, we need to spend more money on research. Relatively speaking, we have been spending scads of dollars on epidemiological research, clinical research, and basic science research. But what we have been neglecting are two other areas of research, namely, educational research and operational research in the areas of health care delivery. I think those latter two areas are the ones on which we should be spending more funds.
I heard a very distressing comment recently on this matter of quality control of health care. It may be a rumour and perhaps the minister will confirm or deny it, that an American named Dr. Lawrence Weed, who is famous for developing a program of problem orientated medical records, is being offered a job by our government which will cost us to the tune of $5 million, to develop a quality care research program here in Canada. I have heard this both confirmed and denied. It alarms me to think that we have to go to the U.S.A. to find adequate medical personnel to assess the quality needs of the people of this country. I know many physicians and researchers in this country who would be more than delighted to have a small share of that $5 million to study the problems of quality care in medical research in Canada.
I think the Ontario Medical Association not many years ago on their own initiative launched a program to assess quality health care. They bogged down completely because of lack of funds. Now we have the rumour that the federal government is offering $5 million to an American to tell us what quality health care is. I think it is a shame.