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Minister's Message

Minister of Health - Leona Aglukkaq

I am pleased to present Parliament with Health Canada's 2011-2012 Report on Plans and Priorities. This Report outlines the Department's proposed priorities for the next three years.

Health Canada will continue to help Canadians maintain and improve their health through policies, programs and activities that keep Canadians healthy, keep them safe, and sustain health programs and systems. The operational priorities will support Health Canada's commitment to help make this country's population among the healthiest in the world.

Health Canada plays key roles in Canada's health system by working with provincial and territorial governments as a catalyst for innovation, and administering the Canada Health Act. Over the next three years, we will work to keep Canadians healthy by focusing our efforts where the need is the greatest. To address the incidence of health problems in First Nations and Inuit communities, we are working to implement renewed health programs, such as improved primary care services with increased access to physicians, nurses, and other health care providers. In addition, we will concentrate on higher-risk groups in Canadian society, such as children and youth who, for the first time in history, are at risk of having a lower life expectancy than their parents. We will work with the Public Health Agency of Canada and other partners to address child and youth obesity. And, in collaboration with federal, provincial and territorial partners, we will support strategies that promote better health and prevent chronic disease, such as reducing sodium and tobacco consumption.

We will also strive to keep Canadians safe by continuing to strengthen and update our legislative and regulatory tools. We will support the implementation of the new Canada Consumer Product Safety Act and continue to take measures to improve food and drug safety. We will also address environmental risks to the health of Canadians through continued efforts on air quality and climate change adaptation initiatives. Finally, we will modernize user fees related to human drugs and medical devices regulatory programs to strengthen the delivery of our health protection programs and initiatives.

We will sustain health programs and systems by continuing to work with our provincial and territorial partners and with other health care partners to address health system sustainability, including measures to attract and retain health human resources. We will implement a tripartite agreement on First Nations health governance with British Columbia First Nations and the Government of British Columbia. We will also explore similar opportunities to integrate federal First Nations health programs with provincial programs in other provinces. And, because we count on the contributions of a myriad of partners to ensure that we have a health system that is responsive to the needs of Canadians, we will nurture strategic partnerships with federally-funded, third-party organizations, such as Canada Health Infoway.

I am confident that carrying out the plans described in this Report will help make our country healthier, and I look forward to working with Canadians across the country to achieve this goal.

The Honourable Leona Aglukkaq, P.C., M.P.
Minister of Health



Section I - Departmental Overview

Raison d'être

Health Canada helps Canadians maintain and improve their health. The Department is committed to making this country's population among the healthiest in the world as measured by longevity, lifestyle and effective use of the public health care system.

Responsibilities

Health Canada is responsible for the following three areas:

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, cosmetics, chemicals, radiation emitting devices, and pesticides. It also regulates tobacco products and other controlled substances, and helps manage the health risks posed by environmental contaminants.

The Department is also a service provider. Health Canada supports basic primary health care services in the following areas: 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. Health Canada's Non-Insured Health Benefits (NIHB) Program 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 also the supplier of employer-provided health benefits to the federal civil service such as occupational health services.

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 to 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 in support of health decision-making by Canadians, the development and implementation of regulations and standards, and health innovation.

Addressing Climate Change and Clean AirMaintaining Water Quality and AvailabityShrinking the Enviromental Footprint - Beginning With GovernmentContribution to the Federal Sustainable Development Strategy (FSDS)

Health Canada contributes to the Federal Sustainable Development Strategy (FSDS) under three themes. These themes are: 1) Addressing Climate Change and Air Quality; 2) Maintaining Water Availability and Quality; and 3) Greening Government Operations.

The FSDS represents a major step forward for the Government of Canada by including environmental sustainability and strategic environmental assessment (SEA) as an integral part of its decision-making processes.

Contributions are further explained in Section II. For additional details on Health Canada's sustainable development strategy, please see www.health.gc.ca/sustainabledevelopment.

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

Strategic Outcome(s) and Program Activity Architecture

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PAA Crosswalk

Health Canada has updated its Program Activity Architecture (PAA) and the supporting performance measurement framework, effective April 1, 2011. The new PAA improves the alignment of departmental programs along the Department's three business lines: health system innovation, consumer protection and environmental health and First Nations and Inuit health. Together, with strengthened performance measurement indicators and streamlined financial coding structure, we will improve the Department's ability to measure and monitor results achieved for Canadians. Accordingly, all strategic outcomes and program activities are now focused more clearly on core departmental responsibilities.

  • The revised Strategic Outcome 1 has a new set of three program activities. The first focuses on Health Canada's leadership and funding roles and its contributions to health policy. The second encompasses occupational health services that are provided to employees of the Government of Canada. The third highlights federal contributions to the health aspects of official language minority communities.
  • The Department has integrated the former Strategic Outcomes 2 and 3* into a new Strategic Outcome 2, which brings together the full range of departmental responsibilities for protecting the health and safety of Canadians. This strategic outcome incorporates the Department's role to inform Canadians of health risks and regulate products such as pharmaceuticals, consumer products and pesticides, as well as departmental responsibilities in areas such as tobacco control. It also incorporates the role that Health Canada increasingly plays in relation to the links between health and the environment.
  • Strategic Outcome 3 (formerly 4) has been reframed, and a new approach to measuring performance is being applied in order to clearly demonstrate the results of the health services delivery and support activities of the Department. Program activities under this outcome include efforts to strengthen First Nations and Inuit health programming by increasing First Nations and Inuit control of health program delivery, as well as integration of First Nations and Inuit programming with existing provincial health systems and programming to leverage efficiencies and avoid duplication. This health systems approach includes Supplementary Health Benefits as well as two newly structured program activities: Primary Health Care and Health Infrastructure Support.

*"Access to safe and effective health products and food and information for healthy choices", and "Reduced health and environmental risks from products and substances, and healthy, sustainable living and work arrangements."

Health Canada's 2010-2011 Program Activities ($millions)
  Canadian Health System Specialized Health Services Official Language Minority Community Development Health Products Food Safety and Nutrition Environ-mental Risks to Health Consumer Products Safety Substance Use and Abuse
Canadian Health System 287.8   39.3          
Canadian Assisted Human Reproduction 1.5              
International Health Affairs 13.5              
Health Products       263.2        
Food and Nutrition       5.3 57.8      
Sustainable Environmental Health   4.0       49.3    
Consumer Products             28.5  
Workplace Health   27.9            
Substance Use and Abuse               139.1
Pesticide Regulation                
First Nations and Inuit Health                
Internal Services       0.6        
Sub-total 302.8 31.9 39.3 269.1 57.8 49.3 28.5 139.1
Deduct: Respendable Revenue**   8.3   100.8   1.2 0.5  
2011-2012 Total Planned Spending 302.8 23.6 39.3 168.3 57.8 48.1 28.0 139.1

Health Canada's 2010-2011 Program Activities ($millions)
  Radiation Protection Pesticide Safety First Nations and Inuit Primary Health Care Supplementary Health Benefits for First Nations and Inuit Health Infrastructure Support for First Nations and Inuit Internal Services Totals
Canadian Health System             327.1
Canadian Assisted Human Reproduction             1.5
International Health Affairs           6.7 20.2
Health Products           1.4 264.6
Food and Nutrition             63.1
Sustainable Environmental Health 2.7           56.0
Consumer Products 2.0           30.5
Workplace Health 2.9           30.8
Substance Use and Abuse             139.1
Pesticide Regulation   41.1         41.1
First Nations and Inuit Health     945.5 983.9 256.8   2,186.2
Internal Services 0.2         314.0 314.8
Sub-total 7.8 41.1 945.5 983.9 256.8 322.1 3,474.9
Deduct: Respendable Revenue** 6.0 7.0 5.5       129.2
2011-2012 Total Planned Spending 1.8 34.1 940.0 983.9 256.8 322.1 3,345.7

** Respendable revenue refers to revenue received through offering of products or services that can be "re-spent" or "used" to help offset the Department's voted operating funding requirements.

Planning Summary


Financial Resources ($ millions)
2011-12 2012-13 2013-14
3,345.7 3,272.8 3,233.5

The financial resources table above provides a summary of the total planned spending for Health Canada for the next three fiscal years. The decrease in planned spending is primarily associated with the sunsetting of some programs.

Human Resources (Full-time Equivalent - FTEs)
2011-12 2012-13 2013-14
9,988 9,823 9,766

The human resources table above provides a summary of the total planned human resources for Health Canada for the next three fiscal years.


Strategic Outcome 1: A Health System Responsive to the Needs of Canadians
Performance Indicators Targets
  • # of new or modified health system policies, proposals or practices to advance health system priorities by:
    • target audience
    • subject matter
    • type of material
Increased # of policies, practices and proposals put forward in order to address health system priorities
  • Examples of collaborative working arrangement that address health system priorities

Better and increased collaboration among Health Canada and health system stakeholders

Program Activity Forecast Spending
2010-11
Planned Spending Alignment to Government of Canada Outcomes
2011-12 2012-13 2013-14
Canadian Health System 328.1 302.8 270.7 270.8 Healthy Canadians
Specialized Health Services 0.0 23.6 23.4 23.4
Official Language Minority Community Development 0.0 39.3 40.0 23.8
Canadian Assisted Human Reproduction 1.4 0.0 0.0 0.0  
International Health Affairs 21.4 0.0 0.0 0.0  
Workplace Health 22.1 0.0 0.0 0.0  
Total Planned Spending 365.7 334.1 318.0  

The decrease from forecast to planned spending is primarily associated with changes made to the Program Activity Architecture.

 


Strategic Outcome 2: Canadians are informed of and protected from health risks associated with food, products, substances and environments, and are informed of the benefits of healthy eating
Performance Indicators Targets
  • % of target audience aware of the health risks associated with food, products, substances and environments, and of the benefits of healthy eating.

Based on overall performance indicator details for program activities:
2.1 Health Products
2.2 Food Safety and Nutrition
2.3 Environmental Risks to Health
2.4 Consumer Products Safety
2.5 Substance Use and Abuse
2.7 Pesticide Safety

  • % and # of timely regulatory actions by:
    • program activity
    • pre- or post-market
    • type of regulatory action
    • result of regulatory action

Based on overall performance indicator details for program activities:
2.1 Health Products
2.2 Food Safety and Nutrition
2.3 Environmental Risks to Health
2.4 Consumer Products Safety
2.7 Pesticide Safety

  • Level of exposure or prevalence by:
    • environmental contaminants
    • radiation/radon
    • tobacco
    • controlled substances

Based on overall performance indicator details for program activities:
2.3.4 Health Impacts of Chemicals
2.5 Substance Use and Abuse
2.6 Radiation Protection

Program Activity Forecast Spending
2010-11
Planned Spending Alignment to Government of Canada Outcomes
2011-12 2012-13 2013-14
Health Products 165.8 168.3 155.8 156.0 Healthy Canadians
Food Safety and Nutrition 77.3 57.8 54.8 54.7
Environ-mental Risks to Health 149.1 48.1 47.8 47.8
Consumer Products Safety 32.8 28.0 29.0 29.1
Substance Use and Abuse 142.6 139.1 132.6 109.8
Radiation Protection 0.0 1.8 1.8 1.8
Pesticide Safety 49.1 34.1 34.3 34.3
Total Planned Spending 477.2 456.1 433.5  

The decrease from forecast to planned spending is primarily associated with the sunsetting of some programs.

 


Strategic Outcome 3: First Nations and Inuit communities and individuals receive health services and benefits that are responsive to their needs so as to improve their health status
Performance Indicators Targets
  • Non-Insured Health Benefits (NIHB) Program utilization rate (percentage of eligible clients who accessed at least one NIHB benefit)
Maintain access levels according to medical necessity
  • % of the on-reserve population who rate their own health status as excellent or very good
Maintain existing levels
  • # of First Nations and Inuit engaged in the control, design, development and delivery of health programs and services based on their own identified needs
5 % increase over 5 years
Program Activity Forecast Spending
2010-11
Planned Spending Alignment to Government of Canada Outcomes
2011-12 2012-13 2013-14
First Nations and Inuit Primary Health Care 0.0 940.0 891.9 890.4 Healthy Canadians
Supplementary Health Benefits for First Nations and Inuit 0.0 983.9 1,007.0 1,030.5
Health Infrastructure Support for First Nations and Inuit 0.0 256.8 272.4 252.6
First Nations and Inuit Health Programming and Services 2,402.4 0.0 0.0 0.0  
Total Planned Spending 2,180.7 2,171.3 2,173.5  

The decrease from forecast to planned spending is primarily associated with the sunsetting of some programs.

 

Internal Services
Internal Service Forecast Spending
2010-11
Planned Spending
2011-12 2012-13 2013-14
Internal Services 358.3 322.1 311.3 308.5
Total Planned Spending   322.1 311.3 308.5

 

Contribution of Priorities to Strategic Outcome(s)


Operational Priorities Type Links to Strategic Outcome(s) Description
I - Promote Health System Innovation Ongoing 1, 2 and 3

Why is this a priority?

The health care system in Canada is vital to addressing the health needs of Canadians wherever they live and whatever their financial circumstances. Given the importance of the health system to Canadians, Health Canada places a priority on working with partners to improve the effectiveness and efficiency of the health system. Health Canada continues to provide leadership as the health system continues to face sustainability and other challenges due to such issues as the availability of health human resources, shifting consumer demands and demographic changes. Addressing these challenges requires leadership to ensure the availability of better health information to make decisions and engage effective inter-jurisdictional and inter-organizational cooperation.

Plans for meeting the priority

  • Continue to work with provinces, territories, First Nations and Inuit communities, and other health care partners on health system sustainability, including measures to better manage health technologies in the health system and use of electronic health records and information
  • Work with partners to improve access to physicians, nurses and health care providers
  • Support health promotion and chronic disease prevention strategies (e.g., sodium reduction, tobacco, childhood obesity, trans fats), in collaboration with provincial and territorial partners
II - Modernize Health Protection Legislation and Programs Ongoing 2

Why is this a priority?

Health Canada is responsible for the regulatory regime for products in the everyday lives of Canadians, including food, pharmaceuticals, medical devices, natural health products, cosmetics, chemicals, radiation emitting devices, cosmetics and pesticides. As well, Health Canada helps manage the risks posed by environmental factors and the health implications of air quality and water quality, radiation and environmental contaminants. Rapid technological change and the advent of new products that blur the line between traditional definitions of various products and incorporate innovative components, such as nanotechnology and biotechnology, challenge the Department's ability to carry out its health and safety mandate. To this end, the Department needs to continue with the modernization of its regulatory programs to better respond to this reality. We will, therefore, support the implementation of the new Canada Consumer Product Safety Act (CCPSA) and continue to take measures to improve food and drug safety. Also, the Department funds many of its regulatory activities through a mix of public funds and user fees which continue to be reviewed and updated to ensure that they are appropriately aligned with the costs of providing services.

Plans for meeting the priority

  • Continue to advance initiatives to enhance the protection of the health and safety of Canadians through the Canada Consumer Product Safety Act
  • Continue to address environmental risks to the health of Canadians
  • Improve the capacity to do quality and timely reviews of human drugs and medical devices, including implementing modernized user fees
III - Strengthen First Nations and Inuit Health Programming Ongoing 3

Why is this a priority?

  • While health outcomes for most Canadians are improving, First Nations and Inuit continue to experience serious health challenges. Health Canada plays an important role in supporting the delivery of, and access to, health programs and services for First Nations and Inuit. The Department achieves this by working with partners on key health challenges and innovative approaches to strengthen access and to better integrate health services, and to encourage greater control of health care delivery by First Nations and Inuit. Current departmental strategies received additional funding in recent federal budgets and are expected to improve the health services available to First Nations and Inuit.

Plans for meeting the priority

  • Implement renewed First Nations and Inuit community health programs including those addressing diabetes, youth suicide, and maternal and child health
  • Strengthen the provision of primary health care services to First Nations communities including ensuring nurses have the clinical expertise and support to provide needed primary health care
  • Continue negotiations to finalize a tripartite Framework Agreement in BC and build on similar opportunities to integrate and harmonize federal First Nations and Inuit programs and services with programs in other provinces and territories
  • Support effective delivery of Non-Insured Health Benefits to eligible First Nations and Inuit
  • Continue to harmonize the management of contribution agreements with Indian and Northern Affairs Canada and other partners

Management Priorities

The following three management priorities support Health Canada's ongoing efforts to achieve management excellence and promote a corporate culture that is focussed on sound management practices and strong public service values. These management priorities are ongoing in nature and support all strategic outcomes.

Management Priorities Description
IV - Align resources to priorities in a way that is flexible and forward-looking

Plans for meeting the priority

  • Develop a transformation plan and approach to align investments and resource allocation with strategic priorities, and implement a common departmental approach to managing projects
  • Continue to focus on ongoing improvements in the delivery of internal services
V - Improve service delivery

Plans for meeting the priority

  • Identify best practices and improve service delivery through enhanced performance measurement and monitoring
  • Continue to improve on horizontal service delivery models in regions
VI - Increase transparency and innovative communications and engagement with Canadians

Plans for meeting the priority

  • Develop innovative communication tools and approaches to engage Canadians including renewing the departmental Internet site to better inform, educate and engage Canadians to take an active role in maintaining and improving their health
  • Strengthen the consistency of consultation processes through the use of common tools and best practices

Risk Analysis

At Health Canada, risk management is a fundamental underpinning of good management and decision-making. Moreover, risk management is a truly integrated process designed to address risk in any area or level within the Department, whether at strategic, program or project levels, in order to provide reasonable assurance regarding the achievement of corporate objectives and desired outcomes. Some of the sources and drivers of Health Canada's risks are internal in nature, while others are externally driven.

A key risk faced by Health Canada is the failure to anticipate, effectively respond to, or manage an incident resulting in harm to the health of Canadians. The source of the incident could be a natural hazard, an external development or the result of an action or decision from an external organization. This risk is of great importance to the Department because of its high impact, the difficulty of predicting and a low tolerance of health and safety risks. Being able to mitigate or respond effectively to this risk requires ongoing review and improvements to response plans and strategies. The Department will use lessons learned from past domestic and international events, such as the 2008 listeriosis outbreak and the response to the H1N1 influenza virus to ensure that effective plans are ready to execute in the event of an incident. Work will also continue, through modernization of consumer, food and drug safety regulations, to enhance the Department's capacity to respond to emerging issues quickly and effectively.

In delivering various aspects of its mandate, Health Canada works with a range of external parties, such as health portfolio organizations, provincial, territorial and municipal governments, industry and national and international organizations. Misalignment, or unclear roles and responsibilities with external parties, can hamper Health Canada's ability to deliver its programs and to improve health outcomes for Canadians. To address this, Health Canada applies lessons learned following major health incidents to improve areas of weakness and potential gaps between partners. The Department will continue to identify and foster strategic partnerships to ensure that we collaborate with the right partners, on the right activities, at the right time. Health Canada will also integrate communications and consultation plans on issues of shared jurisdiction to prevent confusion and strengthen the Government of Canada's response to these issues.

The regulatory programs aimed at informing and protecting Canadians from health risks associated with consumer products, drugs, food and pesticides face an increasingly complex environment driven by the globalization of health products and rapid technological change. There has been an increase in the number of new health, food and consumer products made using modern technologies. These products need to be properly assessed, regulated and used in a manner that will safeguard or promote the long-term health of Canadians. Furthermore, to respond to the increasingly global supply chains and availability of such products, Health Canada will continue to cooperate with international regulators and health organizations to improve the Department's understanding of the impact of new products.

Responding to these regulatory challenges requires strong internal capacity to undertake science-based analysis and research. A significant component of our science-based work is conducted in laboratories located across the country. Requirements for laboratory facilities and the physical/technological infrastructure to support scientific activities can impact Health Canada's ability to deliver on its science related commitments. A number of the Department's laboratories exceed their normal life expectancy and require major retrofit and updated equipment. To respond to this risk, the Department is developing a five year departmental-level strategic investment planning process and has put in place of number of short, medium and long-term initiatives in place to ensure the continuity of services and update infrastructure.

There is also a need to attract and retain the human resources required to conduct regulatory activities. The Department is facing an increased need to hire experienced professionals due to an ageing workforce and increasing rate of scientific staff eligible for retirement. To address this, Health Canada will continue to implement the Talent Management Strategy as well as other human resources initiatives that ensure investments in people at all levels and in all areas of expertise, including the scientific and technology and health care practitioner communities.

Health Canada continues to face financial constraints from rising program costs associated with delivering health care services to First Nations and Inuit, due mainly to factors such as a population that is growing almost twice as fast as the overall Canadian population, impact of changes to program or service eligibility, rising drug prices and use of new technologies. Furthermore, the Aboriginal population has a higher than average rate of injuries and disease than the Canadian population and the remoteness of many First Nations and Inuit communities places increasing demands for health care services and increases the cost of service delivery. The challenge to access nurses and community medicine specialists continues to put pressure on Health Canada's ability to provide health care service to First Nations, particularly in remote northern communities. In response, Health Canada continues to work to integrate and harmonize federal, provincial and territorial health programs through tripartite agreements with the aim of addressing availability and access to quality health services. The Department will also continue to explore options and strategies to address recruitment and retention of health professionals in remote northern communities such as the continued implementation of the Aboriginal Health Human Resources Initiative.

The Canadian public relies on Health Canada to provide timely and authoritative evidence-based information that will assist them in making informed decisions. With the increasing globalization of health products, rapidly evolving science and technology and a 24-hour news cycle, many Canadians learn of health events in the media and seek immediate information. A key source of information for Canadians is the Internet, where incomplete or incorrect health and safety information can pose a risk to Canadians. Moreover, the outlets for information are growing in number and evolving quickly with the advent of YouTube, Facebook and Twitter. Health Canada recognizes the demand for health information and is working to establish comprehensive and innovative approaches to communicate with, engage and collaborate with stakeholders and citizens to improve public access to timely, relevant health and safety information.

Finally, to ensure the Department has the capacity and competency to effectively manage both internal and external challenges, work will continue to improve and strengthen the enabling functions such as human resource management, values and ethics, information management and technology, asset management, planning and performance measurement, and risk management. Efforts will continue to improve the performance measurement information available for decision making and for making investment decisions that will enhance the Department's ability to meet its strategic priorities.

Expenditure Profile

For the 2011-12 fiscal year, Health Canada plans to spend $3,345.7 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 2006-07 to 2013-14.

Spending Trend

Expenditure Profile - Spending Trend Graph

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For the 2006-07 to 2010-11 periods, the total spending includes all Parliamentary appropriation sources: Main Estimates, Supplementary Estimates, and Treasury Board Votes 10, 15, and 23. For the 2011-12 to 2013-14 periods, the total spending corresponds to planned spending. Supplementary funding and carry forward adjustments are not reflected.

In 2007-08, actual spending was $1 billion more than originally planned due to the settlement of compensation payments to individuals infected with the Hepatitis C virus through the Canadian blood supply before 1986 and after 1990. The decrease in planned spending is primarily associated with the sunsetting of some programs.

Estimates by Vote

For information on our organizational votes and/or expenditures, please see the 2011-12 Main Estimates publication. An electronic version of the Main Estimates is available at
http://www.tbs-sct.gc.ca/est-pre/20112012/me-bpd/toc-tdm-eng.asp.