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Minister's Message

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

Health Canada's mandate is to help Canadians maintain and improve their health. As such, our focus is targeted at First Nations and Inuit health, consumer and environmental safety, and working with provincial and territorial partners to support health system innovation. Investments under Canada's Economic Action Plan will play a key role in our progress towards that end.

Health Canada is committed to helping make this country's population among the healthiest in the world. But this will only be reached when all Canadians share more equally in positive health outcomes. To that end, we will continue to work with provincial and First Nations partners towards integrating these health systems. Through better integration, communities will be more empowered, systems will be strengthened, and health outcomes will be improved. New and renovated health infrastructure, support for primary care services, and strengthening of our Non-Insured Health Benefits program, represent investments in stronger, healthier First Nations and Inuit communities.

We have made great strides in recent years in health protection, including modernizing Canada's regulatory system for food, drugs and consumer products. But more can be done. As we move ahead, Health Canada will continue to implement the recommendations of the independent investigator on listeriosis. We will also undertake work to make natural health products more available, while balancing the regulatory burden and accessibility to products. Building on the significant progress made in the areas of health promotion and disease prevention, we will continue efforts to curb youth smoking rates by further regulating marketing and flavouring in tobacco products. We will also minimize the risks to Canadians from environmental hazards through continued implementation of the Chemicals Management Plan.

Our Government has identified priorities with respect to health system innovation. Health practitioners are the cornerstone of an accessible and equitable health system. While Canada's health system remains the envy of many countries, some Canadians still experience difficulty gaining access to physicians, nurses and other health care providers. As a result, the Department will continue to collaborate with provincial and territorial partners on measures to better meet Canada's needs in health human resources.

Our Government will continue to enhance its readiness to deal with health emergencies such as the H1N1 flu pandemic and the National Research Universal reactor shutdown. Both situations have had important implications for the health of Canadians. They have also presented Health Canada with opportunities to learn, improve policies and programs, and better prepare for the future. With respect to H1N1, Health Canada will work with the Public Health Agency of Canada to assess our response to the H1N1 outbreak to further strengthen Canada's broader emergency preparedness. Health Canada will continue to work with First Nations communities to help them prepare and deal with future outbreaks in their communities. As well, Health Canada will continue to support the ongoing efforts of the medical community and the provinces and territories to minimize the impact of disruptions in the supply of medical isotopes. Health Canada will review other sources and alternatives to isotopes to ensure they are safe and effective for Canadians.

I am confident the plans and priorities described in this Report will help make Canada healthier, and I look forward to working with Canadians across the country in moving forward with this plan.

Section I - Overview

Summary Information

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 regime 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. The federal government has provided basic health services to First Nations since 1904. Today, Health Canada provides basic primary care services in approximately 200 remote First Nations communities, home and community care in 600 First Nations communities, support for health promotion programs in Inuit communities across four regions and a limited range of medically-necessary health-related goods and services not insured by private or other public health insurance plans to eligible First Nations and Inuit. The Department also funds or delivers community-based health programs and public health activities to First Nations and Inuit. These activities promote health, prevent chronic disease and address issues such as substance abuse and the spread of infectious diseases.

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.  Lastly, 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.

Strategic Outcomes and Program Activity Architecture

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

The financial resources table provides a summary of the total planned spending for Health Canada for the next three fiscal years:

Financial Resources ($ millions)

2010-11	2011-12	2012-13
3,448.5	3,099.2	3,123.7

The decrease in planned spending from fiscal year 2010-11 to 2011-12 is due to a number of factors: the end of the Canada's Economic Action Plan funding, discussed later in this report; the sunsetting of funding for certain programs; and, implementation of decisions identified in 2009 Strategic Review decisions.

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

Human Resources (FTEs)

2010-11	2011-12	2012-13
9,745	9,380	9,354

 

Strategic Outcome 1: Accessible and Sustainable Health System Responsive to the Health Needs of Canadians

Performance Indicator	Targets
Percentage of Canadians reporting timely access	Increased number of Canadians reporting timely access (baseline is 80% of Canadians reporting timely access taken from the Health Services Access Study, published in 2006)
Percentage of Canadians satisfied with quality of primary, acute, chronic and continuing health care service	Increased number of Canadians satisfied with overall quality of health services (baseline is 85% of Canadians taken from Canadian Community Health Survey published in 2006)
Increased sustainability of the health system through the development of new initiatives (long-term funding commitments, primary health care reform, use of science and technology)	Increased number of initiatives that improve sustainability in the health system

Program Activity	Forecast Spending ($ millions) 2009-10	Planned Spending ($ millions)			Alignment to Government of Canada Outcomes
		2010-11	2012-12	2012-13
Canadian Health System	293.1	297.3	291.2	291.8	Healthy Canadians
Canadian Assisted Human Reproduction	1.4	1.3	1.3	1.3
International Health Affairs	21.8	21.3	20.2	20.4
Total for SO 1	316.3	319.9	312.7	313.5

 

Strategic Outcome 2: Access to Safe and Effective Health Products and Food and Information for Healthy Choices

Performance Indicator	Targets
Incidence/rate of illness/risk related to health products and food	Baseline information will be established in next two years
Increased rate of adherence to/compliance by industry with the Food and Drugs Act and its regulations, standards and guidelines	Human drugs: 98% compliance Veterinary drugs: 95% compliance Biologics: 100% for both blood and semen compliance
Increased public confidence in available information related to health products, food and nutrition	Year-over-year improvement of Canadians being confident in the safety of the Canadian food supply

Program Activity	Forecast Spending ($ millions) 2009-10	Planned Spending ($ millions)			Alignment to Government of Canada Outcomes
		2010-11	2012-12	2012-13
Health Products	168.8	144.7	145.9	145.4	Healthy Canadians
Food and Nutrition	66.1	69.7	66.0	63.1
Total for SO 2	234.9	214.4	211.9	208.5

The decrease from forecast to planned spending is a result of the implementation of process efficiencies.

Strategic Outcome 3: Reduced health and environmental risks from products and substances, and healthy, sustainable living and working environments

Performance Indicator	Targets
Number of incidents of deaths, exposures, illness, injury and adverse reactions	Baseline information to be established in the next two years for defined populations
Proportion of regulatory actions addressed within service standards/targets	An average of 90%.
Percentage of inspected or verified registrants/firms/users compliant/non-compliant	Baseline information to be established in the next two years for defined populations

Program Activity	Forecast Spending ($ millions) 2009-10	Planned Spending ($ millions)			Alignment to Government of Canada Outcomes
		2010-11	2012-12	2012-13
Sustainable Environmental Health	150.7	152.2	61.1	59.7	Healthy Canadians
Consumer Products	25.6	33.9	36.9	38.1
Workplace Health	21.6	20.2	20.1	20.1
Substance Use and Abuse	134.2	133.6	134.8	130.3
Pesticide Regulation	50.0	47.3	35.0	34.6
Total for SO 3	382.1	386.9	287.9	282.8

The decrease in planned spending from fiscal year 2010-11 to 2011-12 is primarily due to some program funding supporting sustainable environmental health scheduled to come to a close and by leveraging capacity in the area of workplace health.

Strategic Outcome 4: Better health outcomes and reduction of health inequalities between First Nations and Inuit and other Canadians

Performance Indicator	Targets
Life expectancy (at birth by gender, on and off reserve), comparison of First Nations and Inuit with other Canadians	Interim targets for 2010/2011: Food security pilot projects implemented in two First Nations and Inuit communities 90% of First Nations communities with a tested pandemic preparedness and response plan 200 sites have access to telehealth services Accreditation of three Native Alcohol and Drug Abuse Treatment Centres Certification of 100 additional addictions workers 200 First Nations and Inuit youth suicide prevention projects implemented 80 maternal child health projects implemented in 200 communities 600 First Nations communities with diabetes prevention services
Birth weight (comparison of First Nations and Inuit with other Canadians)
Infant mortality rates (comparison of First Nations with other Canadians)
Rates of conditions by type--e.g., diabetes, suicide

Program Activity	Forecast Spending ($ millions) 2009-10	Planned Spending ($ millions)			Alignment to Government of Canada Outcomes
		2010-11	2012-12	2012-13
First Nations and Inuit Health Programming and Services	2,356.8	2,199.7	1,977.6	2,017.7	Healthy Canadians
Total for SO 4	2,356.8	2,199.7	1,977.6	2,017.7

The decrease from forecast to planned spending is primarily associated with the funding of some programs coming to a close and by identifying alternative sources of funding for some initiatives outside of the Department's responsibilities.

Program Activity	Forecast Spending ($ millions) 2009-10	Planned Spending ($ millions)			Alignment to Government of Canada Outcomes
		2010-11	2012-12	2012-13
Internal Services	358.4	327.6	309.1	301.2	Healthy Canadians
Total	358.4	327.6	309.1	301.2

The decrease from forecast to planned spending is primarily associated with efficiency dividends realized through consolidation of certain shared services, including the streamlining of internal processes, and a more administratively efficient management of contribution agreements.

Contribution of Priorities to Strategic Outcome(s)

For 2010-2013, Health Canada has identified three operational and three management priorities.  The operational priorities outline the planned actions to be taken to improve the delivery of the Department's programs and achieve better results for Canadians.  Departmental management priorities generally focus on improving internal management practices and controls to strengthen overall performance.

Operational Priorities

Operational Priorities	Type	Links to Strategic Outcome(s)	Description
I. Modernized safety framework	Ongoing	2 and 3	Why is this a priority? Health Canada is responsible for the regulatory regime governing the safety of a broad range of products affecting the everyday lives of Canadians, including food, pharmaceuticals, medical devices, natural health products, consumer products, chemicals, radiation emitting devices, cosmetics, and pesticides.  It also helps manage the risks posed by environmental factors such as air, water, radiation and environmental contaminants. The regulatory environment in which Health Canada carries out its health and safety mandate is changing rapidly and, while the Department's track record on food and product safety has been good, Health Canada's regulatory programs need to be modernized in step with this changing environment.   To this end, the Department has made great strides under the Food and Consumer Safety Action Plan, including progress on legislative framework modernization.  However, as recent events have shown, such as the Listeria outbreak, further efforts are needed to modernize the framework to enhance the Department's capacity to protect the health of Canadians. Plans for meeting the priority Continue to move forward with legislative proposals to enhance the protection of the health and safety of Canadians, including the Canada Consumer Product Safety Act, and proposed amendments to the Food and Drugs Act Increase consistency in the departmental regulatory approach across product areas Provide effective management of regulatory issues and emergency preparedness management In collaboration with partners, respond to recommendations and lessons learned from the listeriosis incident Continue implementation of the Chemicals Management Plan
II. Strengthen First Nations and Inuit health programming	Ongoing	4	Why is this a priority? While health outcomes for all Canadians are improving, First Nations and Inuit still experience serious health challenges. Health Canada continues to play an important role in supporting the delivery of, and access to, health programs and services for First Nations and Inuit.  It does so by working with partners on key health challenges and on innovative approaches to strengthen access to, and encourage greater control of, health services by First Nations and Inuit.  Current departmental strategies, supported by additional funding in recent Budgets, are expected to further reduce the gap between health outcomes of First Nations and Inuit and those of other Canadians. Plans for meeting the priority Strengthen the First Nations health system Continue to explore potential to integrate and harmonize federal and provincial First Nations health programs and services through tripartite discussions With funding from the Canada's Economic Action Plan, continue to strengthen the provision of primary care services to First Nations communities and non-insured health benefits coverage to First Nations and Inuit, and support new and renovated health infrastructure in First Nations communities Support health promotion and disease prevention in First Nations and Inuit communities
III. Health system innovation	Ongoing	1	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. The health care system also plays a significant role in the economy, accounting for over 10% of Gross Domestic Product in 2008. Given this importance, Health Canada places a priority on promoting innovation to improve the effectiveness and efficiency of this system. Plans for meeting the priority Continue to work with provincial and territorial governments as well as with other health care partners on health system sustainability, including measures to improve access to physicians, nurses and other health care providers for Canadians Continue to work with Canada Health Infoway to accelerate the implementation of a pan-Canadian Electronic Health Record in collaboration with provincial and territorial governments. Collaborate with partners to address the medical imaging needs of Canadians

Management Priorities

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

IV. Create a more collaborative, accountable and results-driven corporate culture

Plans for meeting the priority Update business models in areas of policy, science, regulation and regional program delivery, to create a more collaborative, responsible and results-driven corporate culture Continue to implement the Department's Talent Management Strategy and transformational initiatives to maximize investments in people at all levels and in all areas of expertise (e.g., the scientific and technology communities)

V. Enhance Corporate processes for increased accountability and effectiveness

Plans for meeting the priority Increase the integration of planning, monitoring and reporting to improve information, with an emphasis on performance measurement, enabling decision-making affecting the Department's current and future operations Enhance the Financial Management Control Framework to ensure the effective allocation and monitoring of financial resources to achieve departmental objectives and priorities Increase the effectiveness of grants and contributions program management to provide for a more risk-based approach for decision-making to ensure a stronger focus on higher risk areas

VI.  Increase transparency and innovative engagement with Canadians

Plans for meeting the priority Develop effective, up-to-date departmental tools and processes to engage Canadians Establish systematic, comprehensive departmental approaches to communicate and collaborate with stakeholders as well as engage citizens in the development, and review of departmental policies and programs Further implement means to ensure public access to timely, relevant health and safety information

Risk Analysis

As Health Canada strives to achieve its strategic objectives and priorities, it will face challenges and opportunities, both of which will have an impact on its ability to deliver programs.  The Department operates in an ever evolving environment characterized by an increasing pace of socio-economic change, globalization and growing expectations on the part of the public for accountability and information.  There are also a number of external and internal risk factors the Department must be prepared to address if it is to effectively deliver on its mandate.

As in the past, Health Canada will continue to face key challenges from events that may adversely affect the health of Canadians.  The source of an incident could be an external development or event, such as the emergence of a new influenza virus or food borne illness, or result from the action of an external organization, such as that resulting from the supply disruption of medical isotopes.   The Department maintains ongoing activities to ensure that it will be prepared to effectively respond to, and minimize the impact on the health of Canadians from incidents relating to food, drug or product safety.  Such activities include modernizing its legislative and regulatory framework, and increasing the consistency in the departmental approach across product lines.

Health Canada faces financial constraints from rising program costs associated with the delivery of health care to First Nations and Inuit.  The growing Aboriginal population with a higher than average rate of injuries and disease burden, and the remoteness of many First Nations and Inuit communities places increasing demands on health care services.  This challenge is amplified by the national shortage of nurses and community medical specialists which 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.

In delivering various aspects of its mandate, Health Canada works with a range of external parties, such as health portfolio organizations, other government departments, other levels of government, industry and national and international organizations.  This diversity of inter-relations complicates the understanding of roles and responsibilities, and requires more complex delivery approaches, shared action and horizontal delivery strategies.  To improve alignment with external parties, Health Canada continues to review protocols and communications with external partners through lessons learned following major health incidents.

There is an expectation on the part of the public that Health Canada will provide timely and authoritative evidence-based information to assist Canadians in making informed decisions.  With increasing globalization, 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.   Health Canada is working to establish comprehensive approaches to communicate with, engage and collaborate with stakeholders and citizens to improve public access to timely, relevant health and safety information.

The regulatory programs at Health Canada also face an increasingly complex environment driven by global supply chains and changing demographics that are driving demand for an increased diversity of products.  Also, 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.  The Talent Management Strategy and other transformational initiatives will continue to ensure investments in people at all levels and in all areas of expertise, including the scientific and technology and health care practitioner communities.

Expenditure Profile

For the 2010-11 fiscal year, Health Canada plans to spend $3,448.5 million to meet the expected results of its program activities and contribute to the achievement of its strategic outcomes.

The figure below illustrates Health Canada's spending trend from 2006-07 to 2012-13.

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For the 2006-07 to 2009-10 periods, the total spending includes all Parliamentary appropriation sources: Main Estimates, Supplementary Estimates, and Treasury Board Votes 10, 15, and 23. For the 2010-11 to 2012-13 periods, the total spending corresponds to planned spending. Supplementary funding and carry forward adjustments are not reflected. The decrease in planned spending is associated primarily with the funding of certain programs coming to a close and with the implementation of 2009 Strategic Review decisions.

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.

In 2010-11, the increase in Total Spending + CEAP is due to the inclusion of $500M for additional funding to Canada Health Infoway Inc. Following the Auditor General of Canada's Report of November 3, 2009, Canada Health Infoway is implementing its recommendations to ensure proper accountabilities are in place. The Government will continue to work with Canada Health Infoway to assess progress before taking next steps.

Canada's Economic Action Plan

Health Canada was allocated $963.2 million ($211.9 M - 2009-2010; $751.3 M - 2010-2011) under Canada's Economic Action Plan (CEAP), as announced as part of Budget 2009. This funding has been designated to support six initiatives that reflect CEAP guiding principles and meet important departmental priorities.  They are:

1. $0.3 million in 2009-2010 for a one-year extension of the Canadian Environmental Sustainability Indicators
2. $500 million for additional funding to Canada Health Infoway Inc., would be governed by the terms and conditions of a new agreement between Infoway and Health Canada
3. $6.8 million in 2010-2011 for a one year extension for the Accelerated remediation of sites initiative under the Federal Contaminated Sites Action Plan
4. $304.9 million ($135 M - 2009-2010;  $169.9 M - 2010-2011) to strengthened Non-Insured Health Benefits program and enhanced support for primary care services for First Nations and Inuit
5. $135 million ($67.4 M - 2009-2010; $67.4 M - 2010-2011) for infrastructure investments through the Health Facilities and Capital Program (HFCP) for First Nations and Inuit
6. $16.3 million ($9.2M - 2009-2010; $7.1 M - 2010-2011) for investments in the maintenance and modernization of Health Canada's laboratories

More information about these initiatives is available in Section II of this report or visit the Canada's Economic Action Plan web site.

Voted and Statutory Items

The table below provides information on the Health Canada resources approved by Parliament.  The table also shows changes in resources derived from supplementary estimates and other authorities.

Vote # or Statutory Item (S)	Truncated Vote or Statutory Wording	2009-10 Main Estimates ($ millions)	2010-11 Main Estimates ($ millions)
1	Operating expenditures	1,788.4	1,876.1
5	Capital expenditures	40.8	37.7
10	Grants and contributions	1,422.7	1,382.7
(S)	Minister of Health - Salary and motor car allowance	0.1	0.1
(S)	Contributions to employee benefit plans	116.7	122.8
	Total	3,368.7	3,419.4

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