Section 1: Overview

Minister's Message

The Departmental Performance Report (DPR) is a cornerstone of government accountability to Parliament and to Canadians. It is a public record of accomplishments and lessons learned. As Minister of Health, I am particularly pleased to share this DPR because it covers our first full year as a Government. It outlines progress that we made to fulfill our commitments to Canadians in the Speech from the Throne, the 2006-2007 Report on Plans and Priorities, the 2006 and 2007 budgets and throughout the year. It also demonstrates sound governance and improved accountability in the delivery of our mandate.

In the 2006 Speech from the Throne, our Government specifically committed to negotiate Patient Wait Times Guarantees with the provinces as one of just five key priorities. I worked closely with my counterparts in the provincial and territorial governments and with people across Canada's health system to make these guarantees a reality.

Our government began support of four pilot projects that are building knowledge and identifying best practicesrelated to Patient Wait Times Guarantees and the reduction and better management of wait times. By April 2007, each provincial and territorial government agreed to establish a Patient Wait Times Guarantee by 2010, in at least one of the following priority clinical areas: cancer radiation, cataract surgery, hip and knee replacement, cardiac care, diagnostic imaging and primary health care. Our additional Budget 2007 funding will help to accelerate the kinds of wait times results that Canadians want and deserve.

As Minister, I have underlined the priority that I attach to ensuring that this country is well prepared to deal with the threat of avian flu and potential emergence of pandemic influenza. I know how important it is for plans to be in place, for the necessary supplies to be ready and for international collaboration and information sharing to be established. Over the past year, I have overseen actions that mean Canada is much better able to deal effectively with these threats that could arise at any time.

Cancer remains a serious threat to Canadians and it is one that we addressed early in our mandate. This year alone, some 160,000 Canadians will be diagnosed with cancer; it will take the lives of over 70,000. Our Government heard the call of more than 700 cancer survivors and experts to pool expertise and knowledge in order to reduce the toll of cancer in our country. We answered that call in Budget 2006 with $260 million over five years for the Canadian Strategy for Cancer Control. My Department led the federal government work to create the Canadian Partnership Against Cancer, which the Prime Minister announced in November 2006. The Partnership is already guiding the flow of our Budget money in a better-coordinated approach to achieve an estimated reduction of 1.2 million cases of cancer over the next 30 years, and to prevent 423,000 cancer deaths.

Many of this Department's actions have been part of government-wide commitments over the past year. An excellent example of a shared commitment to results is the Health Canada role in our Government's Chemicals Management Plan, which the Prime Minister announced in December 2006. Under the Plan, this Department is already beginning to assess those chemicals that entered Canadian use between 1984 and 1986 for their potential threats to human health. Just as we did for more recently introduced chemicals, Health Canada scientists are building an evidence base for sound scientific decisions on the future use of these chemicals. While this DPR provides details on our many steps forward to help improve the health of Canadians, I want to end this message by mentioning our launch of a revised version of Canada's Food Guide to Healthy Eating in February 2007. The health of Canadians is influenced by an extremely diverse range of factors. When we as individuals make choices such as a healthy diet and regular exercise, we make choices with clear and proven benefits. In a time with so many conflicting health claims and so many questions about health, it is important to be able to turn to reputable, sound sources - and Health Canada continues to consolidate its reputation as that kind of source for Canadians.

Canada's Food Guide and our many other information resources are tools that help Canadians make informed choices. They demonstrate that not only does our Government work with partners in other governmentsand across the health system to make that system work well, we want individuals to have the power and tools to make their own choices for better health for themselves and their families.

While we are proud of the results that we have generated in our first full year as a Government, we know there is much more work to accomplish in the years ahead.

The Honourable Tony Clement
Minister of Health Government of Canada

Management Respresentation Statement

I submit for tabling in Parliament, the 2006-2007 Departmental Performance Report for Health Canada.

This document has been prepared based on the reporting principles contained in the Guide for the Preparation of Part III of the 2006-2007 Estimates: Reports on Plans and Priorities and Departmental Performance Reports:

• It adheres to the specific reporting requirements outlined in the Treasury Board Secretariat guidance;
• It is based on the Department's Strategic Outcomes and Program Activity Architecture that were approved by the Treasury Board;
• It presents consistent, comprehensive, balanced and reliable information;
• It provides a basis of accountability for the results achieved with the resources and authorities entrusted to it; and
• It reports finances based on approved numbers from the Estimates and the Public Accounts of Canada.

Morris Rosenberg
Deputy Minister

Summary Information

About Health Canada

Health Canada develops, implements and enforces regulations, legislation, policies, programs, services and initiatives and works with other federal partners, the provinces and territories to maintain and improve the overall health of Canadians. As administrator of the Canada Health Act, we ensure that the principles of Canada's universal health care are respected, allowing Canadians to be confident in the services they receive from the public health care system. The Minister of Health is also responsible for the direct administration of another 18 statutes including the Food and Drugs Act, the Pest Control Products Act and the Controlled Drugs and Substances Act¹.

We provide policy leadership and portfolio coordination among our partners in the Government of Canada's Health Portfolio, each of which produces its own Report on Plans and Priorities, namely:

• Public Health Agency of Canada;
• Canadian Institutes of Health Research;
• Hazardous Materials Information Review Commission;
• Patented Medicine Prices Review Board;
• Assisted Human Reproduction Agency of Canada.

Our Vision

Health Canada is committed to improve the lives of all people in Canada and to make Canada's population among the healthiest in the world as measured by longevity, lifestyle and effective use of the public health care system.

Our Mission

Health Canada is the federal department that helps the people of Canada maintain and improve their health.

Our Objectives

By working with others in a manner that fosters the trust of Canadians, Health Canada strives to:

• prevent and reduce risks to individual health and the overall environment and enhance the sustainability, innovation and integration of the health system;
• promote healthier lifestyles through sustained health protection and regulations;
• ensure high quality health services that are efficient and accessible;
  integrate renewal of the health care system with longer term plans in the areas of prevention, health promotion and protection;
• reduce health inequalities in Canadian society; and
• provide health information to help Canadians make informed decisions.

Our Roles

Health Canada employees play key roles in promoting, protecting and improving the health of Canadians - roles that assist other stakeholders working towards the same goals.

Health Canada operates in all regions of Canada as indicated on the accompanying map.

Health Canada at Work Across the Country

Innovators

As a science-based department, Health Canada employees are innovators, providing leading-edge science, sound policy research, and effective program and service development. Keeping abreast of global developments on diseases enabled Health Canada to play a leading role in Canada's response to the SARS, BSE and West Nile virus outbreaks.

Knowledge Brokers

Through research, risk assessments and surveillance, Health Canada provides knowledge to Canadians and others working in the health care field to enable them to make sound choices to protect health. The Department also monitors and researches health threats from environmental factors such as toxic substances, air and water pollution, climate change and other threats. This work fosters sound decision making and policy development at all levels to help reduce health risks.

Enablers

In all program areas, Health Canada brings stakeholders together, as well as provides information, research and education. The work of Health Canada enables Canadians to be up-to-date and informed about issues that can impact their health.

Trustees / Stewards

Health Canada, through administration of the Canada Health Act, aims to ensure that all eligible residents of Canada have reasonable access to medically necessary insured services. The Department's broad regulatory responsibilities to protect Canadians and promote health and safety range from prescription drugs and vaccines to toxic substances, from cardiac pacemakers to natural health products and food, from consumer goods to pesticides.

Proponents of Transparency

All work at Health Canada, from assessment of products under the Canadian Environmental Protection Act to regulation and approval of thousands of products is conducted transparently. Health Canada has committed to be accountable in delivering results to Canadians. The public had an opportunity to be involved in consultations on major regulatory initiatives such as the Pest Control Products Act and will continue to be consulted in other areas as part of the Department's consultations framework.

¹ For more information on legislative acts, please visit the Department of Justice website

Overall Departmental Performance

Financial Resources (millions of dollars):

Human Resources (FTEs) :

* The increase from Planned Spending to Authorities is due mainly to new program initiatives and sustainability funding which is received through Supplementary Estimates.

** The difference between Authorities and Actual Spending is mainly the result of lapses in the TB Special Purpose and Frozen Allotments.

Our Operating Environment and Context

Health is a fundamental priority of the Government and Health Canada is the focal point for much of the federalhealth agenda. During 2006-2007, as in previous years, Health Canada worked closely with our Health Portfolio partners. We also collaborated with other federal departments on issues of shared responsibility such as environmental health, agriculture and improvements to regulatory approaches.

Health Canada continued to consult with a wide spectrum of partners: provincial and territorial governments, First Nations and Inuit organizations and communities, professional associations, consumer groups, universitiesand research institutes, international organizations and volunteers.

The Department used a mix of policy development and program delivery activities to carry out its responsibilities. Health Canada's grants and contributions programs funded partners in the health sector and at the community level to pursue shared goals, such as health system modernization and improved health outcomes for First Nations and Inuit. To support greater control over their health services, Health Canada also continued to transfer funding and responsibilities to First Nations and Inuit for the provision of many programs and services.

Health Canada's operating context in 2006-2007 evolved largely as projected in the Report on Plans and Priorities (RPP). The Government established key health commitments such as Patient Wait Times Guarantees; action to ensure Canada's preparedness for pandemic influenza and implementation of the Canadian Strategy for Cancer Control. We recognized the resource pressures affecting many of our activities and the need to modernize some of our core work such as regulation of health products and food.

Summarizing Health Canada's Performance - Our Medium Term Corporate Priorities and Key Areas of Focus

Health Canada continued to address four medium-term corporate priorities established in 2004 and further articulated and revised in the 2006-2007 RPP. These are based on the Department's vision, mission, and mandate, as well as on government directions and commitments, including First Ministers' Agreements. The priorities
integrated activities across all strategic outcomes.

Working with others to strengthen the efficiency and effectiveness of the publicly-funded health care system

(Including the key area of focus for 2006-2007: Develop the building blocks for establishing a Patient Wait Times Guarantee)

In its 2006 Speech from the Throne, the Government established its commitment to negotiate Patient Wait Times Guarantees as one of five key priorities. This led to discussions on research, and knowledge exchanges on wait times initiatives with governments of the provinces and territories. For example, our department began support of four pilot projects to help advance knowledge and best practices related to Patient Wait Times Guarantees and the reduction and better management of wait times. Pilot projects addressed diabetes and prenatalcare for First Nations communities. An additional pilot project focussed on wait times for children in need of surgery.

By April 2007, the government of each province and territory had committed to establishing a Patient Wait Times Guarantee by 2010, in one or more of: cancer radiation, cataract surgery, hip and knee replacement, cardiac care, diagnostic imaging and primary health care. Those governments also agreed to launch at least one pilot project to test guarantees and how they can best be implemented. The Quebec National Assembly passed legislation that establishes a framework in Quebec to guarantee access to hip and knee replacement and to cataract surgery.

That work will be accelerated with the Budget 2007 commitment of $1billion from 2006-2007 expenditures to fund a Patient Wait Times Guarantee Trust. The Trust will make payments over three years to support actions by the provinces and territories. Other funds were committed in that budget for 2007-2008 and for subsequent investments in electronic health information systems and to support provincial and territorial Patient Wait Times Guarantee pilot projects.

Projects under the Primary Health Care Transition Fund came to an end as scheduled during the year and we worked with partners to make the results of those projects widely known. To help solve health human resource challenges we focused on improvements to health care workplaces to encourage professionals to stay in those settings. The Department also supported provinces and territories as they created opportunities for internationally educated health professionals to earn Canadian credentials. In November 2006 the Government signed a Memorandum of Understanding with the Province of British Columbia and the British Columbia First Nations Leadership Council. This MOU committed the parties to building a tripartite relationship for improving the health of BC First Nations, and led to the signing of the Tripartite First Nations Health Plan for British Columbia in June 2007.

Reducing the risks to the health of the people of Canada

(Including the key area of focus for 2006-2007: Advance efforts to prepare for a global pandemic outbreak)

Risks to health take many forms and Health Canada has many ongoing regulatory responsibilities that seek to reduce those risks. The Department's direct activities in fields such as the safety of health products, food, consumer products and pest management products, as well as support for the work of other levels of government
in such areas as drinking water safety all contribute to the health of Canadians.

Health Canada is a participant in the government-wide effort led by the Public Health Agency of Canada (PHAC) and the Canadian Food Inspection Agency to ensure that Canada is well prepared to deal with the threat of avian flu and potential emergence of pandemic influenza. For example, we improved our regulatory system in order to respond quickly to submissions for new vaccines that may be needed and to track their results once they are in use. Provincial and territorial health care systems are responsible for meeting the needs of most Canadians in a pandemic influenza, with PHAC responsible for some cases such as quarantines involving passengers and crews of aircraft, ships and trains. Health Canada, in collaboration with PHAC, is working with First Nations, and provinces and territories to develop integrated and coordinated pandemic response plans for First Nations at the community level. We also worked closely with health officials in other countries to improve information sharing and collaborative action on avian flu and pandemic influenza.

Health Canada's contributions formed a central element of the Government's launch of the Chemicals Management Plan in December 2006. That Plan will regulate chemicals that are harmful to human health or the environment and is part of the Government's comprehensive Environmental Agenda. It will expand the rigorous assessment of chemicals for health risks to include those introduced between 1984 and 1986. This will complement the work we completed in 2006-2007 involving our categorization of the 23,000 substances already placed on the Domestic Substances List for health implications.

While not specifically identified in our RPP, in October 2006, we released the Blueprint for Renewal: Transforming Canada's Approach to Regulating Health Products and Food for consultation. The Blueprint articulates our vision and plan over the coming years to modernize a regulatory system for health products and food that has essentially been in place since 1953. The Blueprint targets creation of a progressive licensing framework that will evaluate and monitor the safety, quality and effectiveness of health products, such as pharmaceuticals, throughout the years they are in use in Canada. This would replace the current focus on a company's initial request to gain approval for Canadian use of a product. The Blueprint is meant to ensure that Canadian legislation, regulations and practices keep pace with advancing science and technology, existing and emerging public health challenges, consumer expectations in terms of safety, the need for transparency, faster drug approvals and international developments.

That process of modernization will be similar in many respects to the effort we completed during 2006-2007 to implement the Pest Control Products Act. The new Act significantly increases transparency, enables greater public participation, expedites the registration of lower risk products and includes a new process to better protect human health and the environment. Communication and stakeholder engagement ensured that Canadians, especially businesses and major users of pest control products, were properly informed about the Act, and enabled us to gain feedback on opportunities to improve our services.

Contributing to the improvement of the health of Canadians

(Including the key area of focus for 2006-2007: Implement the Canadian Strategy for Cancer Control)

Health Canada has many roles that contribute to the improvement of the health of Canadians. For example, our launch of the revised Canada's Food Guide to Healthy Eating in February 2007 and the number of requests for printed copies as well as visits to the online version showed the demand for this kind of resource to promote eating choices that meet nutrient needs, promote health and minimize the risk of nutrition-related chronic disease. The culturally-specific Food Guide for First Nations, Inuit and Métis was also produced, tailored to reflect their traditions and food choices.

In Budget 2006, the Government allocated $260 million over five years to the Canadian Strategy for Cancer Control. While we continued cancer-related work, such as sun safety information for children to reduce the risk of skin cancer, our core role was to be the federal government's liaison with the Canadian Partnership Against Cancer announced by the Prime Minister in November 2006. The Partnership will collect, classify and distribute information on preventing, diagnosing and treating cancer, so that all health care providers have access to the best cancer care practices across Canada. It has the responsibility to implement a Strategy that experts have predicted could pre-empt 1.2 million cases of cancer and prevent 423,000 cancer deaths over the next 30 years.

We played a central role in developing options which led to the creation of the Mental Health Commission of Canada that was announced in Budget 2007. The Commission will undertake knowledge exchange, anti-stigma efforts and development of a National Strategy on Mental Health and Mental Illness. Health Canada's support included research into how gender could be integrated into federal mental health policy.

By far our largest category of expenditures as a department are our programs and services for addressing the health needs of First Nations and Inuit. These include primary health care services, home and community care, public health, and community programs aimed at children and youth, mental health and addictions, chronic and communicable diseases and environmental health, as well as the Non-Insured Health Benefits program that funds supplementary health benefits for all eligible First Nations and Inuit.

With increased funding to reflect growing First Nations and Inuit populations, the Department expanded programming in some areas. For maternal and child health, we implemented home visiting in 40 communities and launched a Healthy Pregnancy campaign to provide women with information to make healthy lifestyle choices before and during pregnancy. We provided funding to expand Aboriginal Head Start On-Reserve, to provide outreach in small communities, and improved early childhood development facilities.

Our Department obtained funding to provide mental health, emotional, and cultural supports to all eligible former students of Indian Residential Schools under the new IRS Settlement Agreement. Recognizing the much greater incidence of diabetes among Aboriginal people, First Nations diabetes-related services were the focus of two of four federal Patient Wait Times Guarantee pilot projects. We also enhanced diabetes prevention activities, diagnostic and complications screening, as well as care and treatment services. Community drinking water quality monitoring activities were also expanded.

Strengthening accountability to Parliament and the public

Health Canada has continued to implement a series of activities to respond to new and/or enhanced government-wide initiatives such as the Federal Accountability Act, the Public Service Modernization Act (PSMA) and the Management Accountability Framework (MAF). As well, to ensure greater accountability and transparency to Parliament and the public, the Department has developed an action plan and specifically committed to strengthening resource management and performance measurement / reporting in relation to its regulatory programs.

The Department has continued to move forward with the sustainable development (SD) initiative in all programs and activities. Health Canada's Sustainable Development Strategy III (SDS III 2004-2007): Becoming the Change We Wish to See is comprised of three themes: helping to create healthy social and physical environments; integrating sustainable development into departmental decision making and management processes; and minimizing the environmental and health effects of the Department's physical operations and activities.

Health Canada has successfully achieved various objectives and targets under each of the themes, including, for example, the drafting of an SD Policy Lens, which will undergo a pilot test in 2007, with the aim of improving SD considerations embedded in policies, plans and programs. We have also carried out the planning to create SDS IV, which will build on the lessons learned to date and set new directions for close alignment with government-wide SD efforts.

The 2006 Treasury Board Secretariat assessment of our Management Accountability Framework noted improvements in several areas, including IT management, citizen-focused services, effective procurement and extra-organizationalcontributions. It also noted the progress the Department has made in clarifying responsibilities and improving resource allocation to ensure accountability and a greater focus on priorities and results.

Our Chief Financial Officer Branch is leading a department-wide effort for improving management accountability and stewardship of resources. As part of the Financial Management Renewal Initiative led by the Office of the Comptroller General, Health Canada accelerated the development and implementation of its Financial Management and Control Framework, which, among other things, includes initiatives for enhancing budget management and assessing /ensuring readiness for audited departmental financial statements for 2008-2009.

We continued with the implementation of the Departmental Operational Planning (DOP) aimed at establishing clear linkages between priorities, planned activities, expected results, and proposed resource allocation. Enhancements to the DOP process have assisted management at all levels in focussing on priorities, identifying funding pressures, and facilitating reallocation of resources from lower to higher priorities.

As part of Treasury Board Management of Resource and Results Structure, the Department has established plans and commenced work to review and enhance baseline information for performance measurement for all areas, particularly regulatory programs. As well, the Department continues to focus on developing guidelines and tools to improve the quality and results-focus of evaluations, including the piloting of the "value for money" tool developed by Treasury Board Secretariat. The Department has also enhanced its effort for reviewing the performance measurement and evaluation strategies outlined in Treasury Board submissions and Memoranda to Cabinet.

The Department continued to integrate more rigorous management practices into its operations, including enhancement of the management of contracts, grants and contributions by ensuring that solid governance structures and administrative processes are in place. As well, the Department implemented Phase 1 of an automated Contract Requisition and Reporting System that affords more effective controls over contract administration.

Our strategic Outcomes and Program Activities

Strategic Outcome - Strengthened Knowledge Base to Address Health and Health Care Priorities

Access to Safe and Effective Health Products and Food and Information for Healthy Choices

Reduced Health and Environmental Risks from Products and Substances, and Safer Living and Working Environments - A

Reduced Health and Environmental Risks from Products and Substances, and Safer Living and Working Environments - B

Better Health Outcomes and Reduction of Health Inequalities between First Nations and Inuit and Other Canadians