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Minister's Message

The Departmental Performance Report for 2009-2010 summarizes Health Canada's accomplishments and its ongoing work on key health priorities for this period. The Department continues to implement strategies that focus attention on, and resources to, areas with the greatest potential benefits for Canadians. Health Canada is turning to new ideas, information, and approaches to guide its choices to achieve better immediate and long-term health outcomes.

For several years now, First Nations and Inuit health has been a key priority for our Department. While we can point with some pride to the improvements in the health outcomes of Aboriginal people in Canada, obvious gaps remain. Our Government recognized this, and provided needed financial support for First Nations and Inuit health services through Budget 2009. We also provided critical funding, through Canada's Economic Action Plan, to improve health facilities and nurses' residences in many First Nations and Inuit communities. We recognize the importance of longer-term change and, as a result, we continued working with First Nations and provincial government partners to achieve better integration of First Nations health services with provincial health systems.

Through collaboration with provincial and territorial governments and other partners, we are working towards our short-term goals while pursuing longer-term goals that will make Canada's health system more responsive to the needs of Canadians. For example, we worked to minimize the impact of supply shortages of medical isotopes and expedited the review of alternative isotope sources, continued investments to provide Canada's communities with the skilled health professionals they need, and we increased funding to the provinces and territories as they explored improvements in patient wait times. Canadians have seen changes, and they are also seeing results, some of which are making individual differences now and others that are setting the stage for more fundamental improvements in the years ahead.

Our Government's Food and Consumer Safety Action Plan, along with our environmental health activities, offer additional examples of our commitment to bring about changes that have immediate impacts and that lead to long-term benefits for Canadians. Health Canada is addressing the health needs of Canadians: whether by applying the Air Quality Health Index to Canadians in more communities; testing chemicals for health impacts; improving how health and consumer product safety concerns are reported and communicated; or implementing important tobacco regulations. At the same time, our work on new consumer product safety legislation and on modernizing important health and safety-related laws, demonstrates our Government's commitment to leading the change that will improve the health and safety of Canadians.

It is important to remember that this progress took place during the same year that Canadians witnessed the sudden emergence of H1N1 influenza. Health Canada worked with the Public Health Agency of Canada and other partners to implement the Canadian Pandemic Influenza Plan. We also worked closely with officials in other countries to pave the way for the accelerated testing and approval of new vaccines and the continuous improvement of response strategies and information that helped limit the impact of H1N1 on Canadians. While Health Canada had to adjust its plans, priorities, and resources to deal effectively with H1N1, we were still able to deliver on key commitments. We will continue to meet new challenges that arise and work to improve the health and wellbeing of Canadians-now and in the future.

Section I - Departmental Overview

Raison d'être

Responsibilities

Health Canada has many roles and responsibilities that help Canadians maintain and improve their health. First, as a regulator, Health Canada is responsible for the regulatory regimes governing the safety of products including food, pharmaceuticals, medical devices, natural health products, consumer products, chemicals, radiation emitting devices, cosmetics and pesticides. It also regulates tobacco products and controlled substances, public health on aircraft, ships and other passenger conveyances, and helps manage the health risks posed by environmental factors such as air, water, radiation and contaminants.

The Department is also a service provider. Improving the health of Aboriginal people is a shared responsibility among the federal, provincial, and territorial governments, and Aboriginal partners. Health Canada supports: basic primary care services in remote and isolated First Nations communities; home and community care in First Nations and Inuit communities; community-based health programs for First Nations and Inuit, focussing on children and youth, mental health and addictions, and chronic disease and injury prevention; and public health programs for First Nations, including communicable disease control. The Department also provides a limited range of medically-necessary health-related goods and services to eligible First Nations and Inuit that are not otherwise provided through other public programs or private insurance plans.

Health Canada is a catalyst for innovation, a funder, and an information provider in Canada 's health system. It works closely with provincial and territorial governments to develop national approaches on health system issues and promotes the pan-Canadian adoption of best practices. It administers the Canada Health Act, which embodies national principles to ensure a universal and equitable publicly-funded health care system. It provides policy support for the federal government's Canada Health Transfer to provinces and territories, and provides funding through grants and contributions to various organizations to help meet Health Canada's objectives. The Department draws on leading-edge science and policy research to generate and share knowledge and information to support decision-making by Canadians, development and implementation of regulations and standards, and health innovation.

Comprising over 30% of Health Canada's staff, regional operations represent the face of the Department to the people of Canada and support all of Health Canada's strategic outcomes. In 2009-2010 Health Canada 's regions continued to be a key strategic business partner by delivering services in the areas of First Nations and Inuit health - including H1N1 vaccinations on-reserve; occupational health and safety; inspection and surveillance; health products and food; and, prevention and treatment of illicit drug use and abuse.

Strategic Outcome(s) and Program Activity Architecture (PAA)

In order to pursue its mandate most effectively and allocate resources appropriately, Health Canada has identified four strategic outcomes, each of which is supported by a framework of program activities and sub-activities.

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Planning Summary

Health Canada's financial resources directly impacted the ability of the Department to achieve its strategic outcomes and deliver on its program activities. The following sections will highlight Health Canada's performance and demonstrate linkages between resources and results.

At the outset of the 2009-10 fiscal year, Health Canada's planned spending was $3,587 million. Through Main Estimates and Supplementary Estimates, the department was allocated total authorities of $3,813.3 million. Actual spending for Health Canada was $3,748.9 million.

The human resources table above provides a summary of the total planned human resources and actual human resources for Health Canada for fiscal year 2009-10.

Performance Summary Table

Performance Data is from either:
(*) Healthy Canadians: A federal report on comparable health indicators, 2008 or
(**) Statistics Canada. Cansim Table 105-0501 - Health indicator profile, annual estimates, by age group and sex, Canada, provinces, territories, health regions (2007 boundaries) and peer groups, occasional, CANSIM (database).

*Note: Health Canada continues to work with its federal (e.g. Statistics Canada, Indian and Northern Affairs Canada) provincial and territorial partners as well as with First Nations and Inuit to improve the quality and accessibility of performance indicator data. Many indicators (e.g. life expectancy, mortality) only show changes over the very long-term.

*Note: Commencing in the 2009-2010 Estimates cycle, the resources for Program Activity Internal Services is displayed separately from other program activities; they are no longer distributed among remaining program activities, as was the case in previous Main Estimates. This has affected the comparability of spending and FTE information by Program Activity between fiscal years.

Contribution of Priorities to Strategic Outcome(s)

Health Canada applied the performance status rating as defined by Treasury Board of Canada Secretariat in their Guide to the Preparation of Part III of the 2010-11 Estimates.

• Exceeded - More than 100 per cent of the expected level of performance (as evidenced by the indicator and target or planned activities and outputs) for the expected result or priority identified in the corresponding RPP was achieved during the fiscal year.
• Met All - 100 per cent of the expected level of performance was achieved during the fiscal year.
• Mostly Met - 80 to 99 per cent of the expected level of performance was achieved during the fiscal year.
• Somewhat Met - 60 to 79 per cent of the expected level of performance was achieved during the fiscal year.
• Not Met - Less than 60 per cent of the expected level of performance was achieved during the fiscal year.

Risk Analysis

Over the last fiscal year, a number of risks were faced by the Department and needed to be managed in order to achieve the Department's mandate and strategic objectives. Also, there were three major external incidents that influenced the year's events for Health Canada. The first was the pace of progress on the Food and Consumer Safety Action Plan. In particular, the legislative process surrounding Bill C-6, the proposed Canada Consumer Product Safety Act, did not receive Royal Assent. Without the Royal Assent necessary for the Department to proceed on key changes, it was not possible to deliver all the expected results for the year.

The second event was the emergence of H1N1 influenza in April 2009. Health Canada management shifted much of its focus, and substantial resources, to the work necessary to understand and address H1N1 in Canada and to work with partners on international aspects of the H1N1 response. Health Canada reallocated resources from lower-priority commitments to ensure that a new vaccine would be available for all Canadians and emergency interventions could be improved. Joint measures were conducted in partnership with the Public Health Agency of Canada to ensure a coordinated response to national health risks and protect the well-being of Canadians.

The Department took similar action to support the Government in addressing the impact on access to medical isotopes after the shutdown of the Chalk River nuclear reactor. Alternative sources of isotopes around the world were identified and used by provincial and territories health establishments to secure isotope supplies, while the Department also identified the value of planning for similar medical situations in ways that take into account the complex interplay of medical, social and business interests.

Beyond that, other elements of the risk analysis set out in the RPP were managed during the year. Health Canada applied the lessons learned from the 2008 listeriosis outbreak. This led to actions such as a revision of roles between organizations and evaluation of options to increase laboratory capacity and access. In collaboration with the Canadian Food Inspection Agency (CFIA) and the Public Health Agency of Canada (PHAC), public health officials and provincial and territorial Ministries of Health, Health Canada revised its policy on Listeria monocytogenes in ready-to-eat foods that would have impacts on the Canadian Food Inspection Agency, provincial/territorial governments and food industry as they identify steps to reduce the risk of Listeria contamination in these foods. Health Canada briefed the medical community, public health officials, the food industry and the public on matters related to listeriosis, and participated in public awareness campaigns about safe food practices.

Health Canada recognized the risks associated with the growing expectation and need for information from the public in a context where the information is globalized and made available 24 hours a day, and where science and technology rapidly evolve. For example, the Department supported the development and dissemination of health knowledge and information through the funding for the Canadian Institute for Health Information; by ensuring a consistent approach to communicating risks and benefits of regulated products; and by dedicated resources to better explain health risks to Canadians.

In a context of declining fiscal flexibility for the Government of Canada, the Department acknowledged that financial integrity of key programs could be at risk, considering for example challenges from increasing costs of its regulatory activities, outdated user fee regimes, and the ongoing need to support First Nations and Inuit health services. To ensure the sustainability of key programs: Health Canada reallocated funds to align with priorities; conducted monthly financial reviews to manage resources effectively; moved to secure increased cost-recovery revenues through new user fees proposals; and obtained additional funding for First Nations and Inuit health programs and benefits.

Health Canada addressed risks associated with managing horizontal initiatives such as the Chemicals Management Plan, Clean Air Agenda, and Food and Consumer Safety Action Plan. In an effort to increase engagement with external partners, Health Canada built on and clarified existing roles, responsibilities and accountabilities in order to enhance collaboration and achieve outcomes. Lessons in optimizing horizontal external relationships will be important as the Department moves forward in its ongoing effort to support collaboration among federal, provincial and Aboriginal partners. These collaborative efforts support the improvement of health services for First Nations through enhanced integration and alignment of federal and provincial health systems as well as increased First Nations and Inuit capacity to design, deliver and manage their own health programs.

The Department also addressed risks associated with its internal management. Committed to develop policy based on cutting-edge science, the Department addressed associated risks through initiatives such as creation of a Science and Policy Integration Unit, a new Science and Policy Round Table and the Health Canada Science Forum. Health Canada also implemented initiatives to attract and retain key talent in the face of a competitive labour market and human resource challenges such as an aging work force, a high rate of staff eligible for retirement, the need to staff positions in remote locations and the need to respect official language commitments. The Department also continued to implement a reorganization that has addressed regional decision-making and accountability challenges.

Expenditure Profile

For the 2009-10 fiscal year, Health Canada spent $3,748.9 million to meet the expected results of its program activities and contribute to its strategic outcomes.

The figure below illustrates Health Canada's spending trend from 2007-2008 to 2009-2010.

Spending Trend

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For the 2007-2008 to 2009-2010 periods, the total spending includes all Parliamentary appropriation sources: Main Estimates, Supplementary Estimates, Treasury Board collective bargaining, operating budget carry forward, and other special adjustments.

In 2007-08, actual spending was particularly high due to the $1 billion compensation payments to individuals infected with the Hepatitis C virus through the Canadian blood supply before 1986 and after 1990.

The table below offers a comparison of the Main Estimates, planned spending, total authorities and actual spending for the most recently completed fiscal year, as well as the historical actual spending figures for the previous year.

Note: Commencing in the 2009-10 Estimates cycle, the resources for Program Activity: Internal Service is displayed separately from other program activities; they are no longer distributed among the remaining program activities, as was the case in previous Main Estimates. This has affected the comparability of spending and FTE information by Program Activity between fiscal years.

The $218.3 million increase from Main Estimates to Planned Spending is due to anticipated funding from the Government's Economic Action Plan to stabilize the Non-Insured Health Benefits program and primary care services and a direct investment for construction and renovation of infrastructure for First Nations and Inuit health services, as well as anticipated additional funding relating to the Official Languages Health Contribution Program.

The $226.3 million increase from Planned Spending to Total Authorities is due to new program initiatives received through Supplementary Estimates, including funding for addressing the first and second wave of the H1N1 flu virus outbreak, for providing mental health and emotional support services and the administration and research required to support the federal government's obligations under the Indian Residential Schools Settlement Agreement, and for addressing the submission review backlog in the Natural Health Products Program.

The $64.4 million difference between Total Authorities and Actual Spending was mainly the result of lapses in TB special purpose allotments for H1N1, the Indian Residential Schools Settlement Agreement, and Health Council, as well as in the TB frozen allotment for the National Anti-Drug Strategy (Mandatory Minimum Penalties).

Canada's Economic Action Plan (CEAP)

Health Canada was allocated $211.9 M in 2009-2010, for initiatives under Canada's Economic Action Plan (CEAP). They are:

• $0.3 M for a one-year extension for Canadian Environmental Sustainability Indicators;
• $134.5 M to strengthen the Non-Insured Health Benefits program and enhance support for primary care services for First Nations and Inuit;
• $67.4 M for infrastructure investments through the Health Facilities and Capital Program for First Nations and Inuit;
• $9.0 M for investments in the maintenance and modernization of Health Canada laboratories;
• $0.7 M for maintenance or upgrading of existing Arctic research facilities (facilities transferred from INAC to HC in 2009-2010).

In addition, $500 M announced in the 2009 Budget and confirmed in Budget 2010, will be provided to Canada Health Infoway, which will be governed by the terms and conditions of a new agreement.

Departamental Spending Trend
($ millions)

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Voted and Statutory Items

The table below illustrates the way in which Parliament approved Health Canada's resources in 2008-09 and 2009-10 and shows, for 2009-10, changes in resource levels from planning to Main Estimates to final authorities, as well as the actual spending at year-end.

(S) Denotes statutory items which do not require an appropriation act

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