Q-14062 — June 6, 2013 — Ms. Duncan (Etobicoke North) — With regard to the Minister of Health’s signed response to Order Paper Question Q-1254: (a) how does the Minister and her government define “transparency”; (b) what does the Minister mean by ”this Government has been as transparent as possible with parliamentarians and the public on this issue”; (c ) how does taking 225 days to answer Q-1254 meet the Minister’s definition of transparency, (i) how does taking 225 days meet the statement that Ministers are accountable to Parliament, and that they “must answer all questions pertaining to your (sic) areas of responsibility”, as cited in “Accountable Government: A Guide for Ministers and Ministers of State”, (ii) what criteria were used to ensure transparency; (d) how does
answering only sub-questions (a), (q) and (z) of Q-1254 meet (i) the Minister’s definition of transparency used in (a), (ii) the guidelines in “Accountable Government”, (iii) what criteria were used to ensure transparency; (e) how does partially answering sub-questions (b), (c), and (n) meet (i) the Minister’s definition of transparency used in (a), (ii) the guidelines in “Accountable Government”, (iii) what criteria were used to ensure transparency; (f) how does refusing to answer sub-questions (d) to (h), (j), (l) to (m), (r) to (s), (u) to (y), and (aa) meet (i) the Minister’s definition of transparency used in (a), (ii) the guidelines in “Accountable Government”, (iii) what criteria were used to ensure transparency; (g) why does the government not track by hours, cost, number of drafts, and persons who work on speeches, when it tracks projected costs to answer opposition MPs’ Order Paper questions; (h) who does the government consider to be “key partners” regarding chronic cerebrospinal venous insufficiency (CCSVI) procedure; (i) what are the main CCSVI stakeholders across the country, (i) which, if any, does the government consider a “key partner”, (ii) with which, if any, does the “government communicate on a regular basis”; (j) why does the Canadian Multiple Sclerosis (MS) Monitoring System, which “was ready to receive data as of September 2012”, not contain any submitted data, (i) what are the barriers to having submitted data, (ii) what, if anything, can be done to make the system operational and functional, including, but not limited to, increased political will, human resources, financial resources, or improved cooperation with stakeholders; (k) if new Statistics Canada data was published in September 2012 showing that the number of people living with multiple sclerosis in Canada is 93,500, (i) why did John Wright, President and CEO of the Canadian Institute for Health Information use the numbers 55,000 to 75,000 at the October 4th, 2012 hearings on Bill S-204; (l) regarding the September 6, 2011, consensus workshop to determine the best procedures to standardize imaging of veins in the neck and brain, (i) who were the invited experts, (ii) how many imaging procedures for CCSVI had each expert undertaken, (iii) by whom were each of the experts trained, (iv) how many of the experts were funded by the Canadian Institutes for Health Research (CIHR); (m) what was the funding by each of CIHR, the MS Society of Canada, and the provinces of British Columbia, Manitoba, and Quebec for the $6 million CCSVI clinical trial; (n) which of (a), (b), or (c) is the government’s position regarding follow-up care (a) “MS patients who have received a venous procedure abroad should be reassured that they will be continued to be cared for by their physicians and/or regular MS specialists as any other patients?” (ATIP), (b) follow-up care as an issue that is primarily the responsibility of provincial and territorial governments (ATIP) or (c) “the federal government has provided regular MS research updates to provincial and territorial jurisdictions, which have the responsibility to ensure that Canadians receive appropriate health treatments and follow-up care” (answer to Order Paper question Q-1254); (o) what recourse and resources do Canadians who have been treated for CCSVI have should they be denied follow-up care, as Roxanne Garland was; (p) has the government been informed of a preliminary study for CCSVI undertaken in British Columbia, and if so, what were the preliminary results; and (q) has the
$6 million CCSVI clinical trial begun and if not, why not, and if so, (i) on what date did patient accrual begin in each of the provinces, (ii) how many patients have been recruited for the trial by province, (iii) how many CCSVI procedures have been undertaken by province?
Q-11552 — January 29, 2013 — Ms. Duncan (Etobicoke North) — With respect to the Process Working Group (formerly the Consultative Steering Committee or CSC) for the government’s greenhouse gas regulation development for the oil and gas sector: (a) is the PWG still in operation and, if not, when did it cease to operate; (b) what is/was the membership of the PWG, including name and affiliation of each member; (c) what specific framework elements of a regulatory approach are/were being considered; (d) what principles under which the performance standards will be developed are/were being considered; (e) what scope and stringency of the performance standards are/were being considered; (f) what compliance mechanisms are/were being considered; (g) what architectural approaches in the development of sub-sector performance standards are/were being considered; (h) is/was carbon pricing being considered and, if so, what are/were the specific considerations; (i) how many meetings have taken place to date and for each meeting, (i) what was the date, (ii) who was in attendance, (iii) where did the meeting occur, (iv) what was the agenda; (j) when will oil and gas sector greenhouse gas regulations be ready to publish in Canada Gazette 1, and why were they delayed from the end of 2012; and (k) when (month and year) are oil and gas regulations scheduled to come into force?
Q-11522 — January 28, 2013 — Ms. Duncan (Etobicoke North) — With respect to the government’s answering of order paper questions: (a) how many times last year did the government estimate the cost of answering an Order Paper question, and as a result of the cost, did not provide an answer to the Order Paper question; (b) for each instance identified in (a), (i) what was the question, (ii) who did the analysis, (iii) how much time did it take to do the analysis, (iv) how was the estimate calculated; (c) for each instance identified in (a), (i) were consultants hired, (ii) if so, what was their hourly rate; (d) for each instance identified in (a), if consultants were not hired, was providing answers to order paper questions part of the regular job duties of the individual(s) involved in preparing the answer; (e) how many times last year did government Members ask for an estimate of the cost to answer an opposition Member’s Order Paper question; and (f) for each instance identified in (e), (i) what was the question, (ii) who did the analysis, (iii) how much time did it take to do the analysis, (iv) how was the estimate calculated?
Q-11532 — January 28, 2013 — Ms. Duncan (Etobicoke North) — With respect to the government’s answering of access to information requests: (a) how many times last year did the government fail to answer an access to information request within (i) 45 days, (ii) 90 days, (iii) 135 days, (iv) 180 days, (v) 225 days, (vi) 270-plus days; and (b) for each question which took over 180 days to answer as identified in (a)(iv), (a)(v) and (a)(vi), (i) what was the question, (ii) how much time did it take to provide an answer?
Q-11232 — December 11, 2012 — Ms. Duncan (Etobicoke North) — With respect to the government’s position on chronic cerebrospinal venous insufficiency (CCSVI): (a) does the government track clinical trials on CCSVI currently being undertaken by other countries and, if yes, what are all clinical trials, identified by phase, currently being undertaken worldwide, (i) which countries are undertaking Phase lll trials; (b) does the government question whether CCSVI exists and, if yes, (i) why does the government not question whether treating CCSVI actually improves quality of life for Canadians with multiple sclerosis (MS); (c) how many cases of “major complications associated with venous angioplasty” have occurred in Canada and, if it is not possible to give this number, why, (i) what are identified complications to CCSVI and, for each complication, how many cases versus the number of procedures undertaken have occurred; (d) what are all procedures that have been performed on veins in Canada, including, procedures for Budd-Chiari syndrome and May-Thurner syndrome; (e) what is the government’s position on ballooning veins and why does it consider that ballooning veins even once could be unsafe on fragile veins, even though participants involved in the proposed clinical trial will experience two procedures-one real, one simulated-in a one-year period; (f) is the government consulting with Canadians with MS, if so, (i) provide a list of all CCSVI groups the Minister of Health has met with along with the dates of the meetings, (ii) provide a list of all MS groups the Minister of Health has met with along with the dates of the meetings, (iii) provide the number of Canadians with MS the Minister of Health has met and the dates of all meetings, and if the government is not consulting, (iv) why not; (g) how does inviting the investigators of the seven MS-funded CCSVI studies to participate in the consensus workshop on ultrasound imaging meet CIHR’s conflict of interest guidelines; (h) what were the results of the consensus workshop on ultrasound imaging, and specifically, (i) what exact imaging procedure will be used in the clinical trials, (ii) will the investigators use Dr Zamboni’s procedure and, if so, will they be trained by Dr Zamboni, (iii) will the investigators use multi-modal imaging and, if so, what techniques, (iv) what training will investigators undergo, by whom, what is the number of procedures they will have to perform, and how will “sufficiently practiced” be ensured; (i) approximately how many Canadians with MS have died since November 2009, and by what EDSS score will Canadians with MS have worsened, on average by, since the same time period, and specifically, (i) how many are diagnosed each month, (ii) how many die each month; (j) when will patient accrual actually begin for clinical trials which were to begin on November 1st; and (k) what, if any, research or investment has been undertaken to consider whether to investigate the handling of the CCSVI file, particularly in relation to the “fast-tracking” of a new procedure in Canada, and the down-loading of services to provinces, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when?
Q-10922 — December 4, 2012 — Ms. Duncan (Etobicoke North) — With regard to drug safety in Canada and the protection of Canadians’ health: (a) for each of the recommendations in the Auditor General’s 2011 fall report, Chapter 4, Regulating Pharmaceutical Drugs—Health Canada, what are the actions taken to date, and specifically, which of these actions (i) has yet to begin, (ii) is in progress, (iii) is completed; (b) for drugs produced in off-shore factories, how does Health Canada monitor safety, (i) how many inspections has it undertaken since 2006, and (ii) for each identified inspection, what was the reason for investigating, and what were the results; (c) what are all the positive and negative impacts of the “user-fee” model, by which drug companies pay to submit a drug for approval, and what, if any, research or investment has been undertaken to consider alternative models, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (d) will Health Canada make registering clinical trials for drugs mandatory, and if so, when; (e) what, if any, research or investment has been undertaken to examine whether the pharmaceutical industry suppresses negative clinical trial results, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (f) what, if any, research or investment has been given to having Health Canada provide information regarding clinical trials, including, but not limited to, information confirming safety and efficacy, the number of people in the trials, and the number of people who drop out due to bad side effects, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (g) what, if any, research or investment has been undertaken to identify new drugs for consumers, as in the United Kingdom, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (h) what, if any, research or investment has been undertaken to adopt plain language labelling, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (i) will Health Canada be undertaking plain language labelling and, if so, when; (j) what specific post-market monitoring of drugs does Health Canada undertake itself, (i) how many drugs have been approved since 2006, (ii) how many of these were later given safety warnings, (iii) how many of these were later removed from market, (iv) for each drug given a warning or a removal, did it follow a warning or removal by the European Medicines Agency (EMA) or the US Food and Drug Administration (FDA), (v) did Health Canada ever issue a warning or removal before the EMA/FDA; (k) what specific post-market monitoring of drugs that have had a 180-day priority review does Health Canada undertake itself, (i) how many drugs have been approved since 2006, (ii) how many were later given safety warnings, (iii) how many of these were later removed from market, (iv) for each drug given a warning or a removal, did it follow a warning or removal by the EMA or the FDA, (v) did Health Canada ever issue a warning or removal before the EMA/FDA; (l) when will Health Canada offer a list of drugs that received fast-track approval, and why fast-tracking took place, (ii) what other variables might Health Canada consider making available to increase transparency regarding priority-review drugs; (m) what, if any, research or investment has been undertaken to develop an independent drug-monitoring agency with the power to remove unsafe drugs from the market, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (n) what, if any, research or investment has been undertaken to provide plainly worded risk warnings, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) and if results and recommendations are available, will Health Canada be acting upon them and when; (o) will Health Canada be undertaking plainly-worded risk warnings, and if so, when; (p) how many Canadians die each year of prescription drugs in Canada, (i) what is the most recent data Health Canada has regarding these deaths, (ii) what specific action has Health Canada taken to reduce these numbers, (iii) what data does Health Canada or the Canadian Institutes for Health Research have regarding how these data are expected or predicted to change in the future; (q) what action has been taken to address each of the 59 recommendations of the coroner’s jury in the inquiry into Ms. Vanessa Young’s death, what action has been taken to address each of the 16 recommendations of the coroner’s jury in the inquiry into Ms. Sara Carlin’s death, and for each recommendation, (i) identify if the recommendation is being acted upon, is in progress, or is completed, (ii) if it is not being acted upon, identify why; (r) what, if any, research or investment has been undertaken to making “related to a drug prescribed” a category of death, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (s) what, if any, research or investment has been undertaken to determine what percentage of adverse reactions are never reported, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (t) what, if any, research or investment has been undertaken to make reporting adverse effects of drugs mandatory for doctors, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) and if results and recommendations are available, will Health Canada be acting upon them and when; (u) what, if any, research, or investment has been undertaken to make reporting adverse effects of drugs mandatory for pharmacists, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (v) what, if any, research or investment has been undertaken to make reporting adverse effects of drugs mandatory for all healthcare professionals, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (w) what, if any, research or investment has been undertaken to make public adverse effects reports from companies, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (x) what, if any, research or investment has been undertaken to make Health Canada’s on-line, adverse-reactions-to-drugs database more navigable and user-friendly, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when; (y) when will Health Canada offer a full list of every warning given for a specific drug; (z) what, if any, research or investment has been undertaken to make Health Canada’s website more user-friendly and transparent, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) and if results and recommendations are available, will Health Canada be acting upon them and when; and (aa) what, if any, research or investment has been undertaken to give Health Canada the authority to unilaterally revise a label or remove a drug from market, (i) what are the dates, results and recommendations of any research, (ii) the dollar amount of any investment, (iii) if results and recommendations are available, will Health Canada be acting upon them and when?
Q-566 — May 15, 2012 — Ms. Duncan (Etobicoke North) —With respect to greenhouse gas (GHG) emissions in the oil sands: (a) what studies, if any, have been undertaken to estimate GHG emissions intensity for the oil sands, and, for each identified study, (i) who are its authors, (ii) what are its dates, (iii) what are its findings, (iv) what are its recommendations; (b) what briefing notes, memos, or any other documentation, if any, have been provided to the Prime Minister, Minister of Natural Resources, Minister of the Environment, their respective Parliamentary Secretaries, their respective Deputy Ministers, and their respective staff members, regarding GHG emissions intensity for the oil sands, and, for each, what were the findings and recommendations; (c) does the government have any information or evidence indicating that a shift towards the use of steam in oil sands extraction is accelerating GHG emissions, and, if so, what is this information or evidence; (d) how does the emissions intensity of mining compare to in situ production; (e) what are the details of the government’s projections or of projections it possesses for (i) how GHG emissions will increase over the next decade, the next two decades, and the next three decades, (ii) how GHG emissions from the oil sands will compare to emissions from every other Canadian economic sector over the next decade, the next two decades, and the next three decades, (iii) how GHG emissions from the oil sands will compare to all Canadian economic sectors combined over the next decade, the next two decades, and the next three decades, (iv) how increasing GHG emissions will impact climate change over the next decade, the next two decades, and the next three decades; and (f) what are the findings and any recommendations of the discussion paper, “Estimating GHG Emissions Intensity for the Oil Sands Sector over Time”” document DM/146926?
Q-562 — May 10, 2012 — Ms. Duncan (Etobicoke North) — With respect to clinical trials for chronic cerebrospinal venous insufficiency (CCSVI): (a) what was the deadline for receiving applications for clinical trials for CCSVI and has the application process closed; (b) how many applications were received, and, for each application received, (i) from what institution and country was it received, (ii) are the researchers who submitted the application practiced in the diagnosis and treatment of CCSVI; (c) why was it decided that an international review panel was needed to assess applications for clinical trials; (d) what was the specific process for and who was involved in choosing the members of the international review panel; (e) who had the ultimate decision-making authority on the appointments to the international review panel; (f) has the international review panel been chosen, and, if so, (i) who is on the panel, (ii) why was each member chosen, (iii) for each member, is he or she practiced in the diagnosis and treatment of CCSVI; (g) how will all potential conflicts of interest of members of the international review panel be (i) recorded, (ii) confirmed, (iii) publicly declared; (h) has the review process of applications begun, (i) is it in progress, (ii) by what date is the review expected to be finished; (i) what specific criteria have been established to review applications; (j) by what date is an announcement expected to be made regarding the chosen research team or teams; (k) what, if any, monies have been set aside for clinical trials, (i) how was the required amount of money decided, (ii) will the monies allow for an adequate number of patients to be included to demonstrate clinical efficacy at the 0.05 level of significance; (l) what timeline is being allowed for ethics approval; (m) by what date is patient accrual expected to take place; (n) by what date are clinical trials expected to commence; and (o) what is a detailed timeline of what can be expected over the next year in terms of significant dates for clinical trials, as well as any dates for meetings regarding CCSVI?
Q-4192 — January 30, 2012 — Ms. Duncan (Etobicoke North) — With respect to the risk of corrosion and spills and other safety concerns arising from the transport of bitumen in pipelines, and to government action to address these risks: (a) how does diluted bitumen compare with West Texas Intermediate (WTI) in terms of (i) abrasive material content, (ii) acid concentration, (iii) sulphur content, (iv) viscosity; (b) to what extent is diluted bitumen more likely than WTI to cause corrosion or erosion in the pipelines through which they respectively flow; (c) what is the composition of diluted bitumen in Canada; (d) what are all of the volatile chemicals, persistent organic pollutants or carcinogenic substances present in diluted bitumen in Canada; (e) in the process of diluting bitumen in Canada, what are the (i) natural gas condensates used, (ii) other petroleum products used; (f) what is the process by which diluted bitumen corrodes pipelines, with specific reference to (i) abrasion, (ii) friction, (iii) high pressure, (iv) settling of sediment, (v) velocity, (vi) sulphur-reducing bacteria, (vii) other significant factors; (g) for all proposed or existing National Energy Board (NEB)-regulated pipelines, what is (i) the amount of hard sediment passing through the pipeline annually, (ii) the average pressure, (iii) the average temperature; (h) what, if any, (i) research, (ii) action, (iii) investment has the government undertaken to determine whether diluted bitumen can flow safely through pipelines; (i) what, if any, (i) research, (ii) action, (iii) investment has the government undertaken to determine whether or not conventional crude should be distinguished from diluted bitumen when setting minimum standards for pipelines; (j) what, if any, (i) research, (ii) action, (iii) investment has the government undertaken to design safety and spill responses and spill liability management capabilities that are appropriate specifically to diluted bitumen; (k) how does a diluted bitumen spill compare with a conventional light sweet oil spill in terms of (i) the impacts of the natural gas liquid condensate used to dilute the bitumen, (ii) diluted bitumen’s ability to form an ignitable and explosive mixture; (l) in the case of a diluted bitumen spill, at what temperatures would ignition of the spill occur, and what heat sources might cause ignition; (m) what, if any, are the (i) names, (ii) dates, (iii) conclusions, (iv) recommendations of research undertaken by the government concerning the environmental and economic risks of a diluted bitumen spill; (n) what, if any, are the (i) names, (ii) dates, (iii) conclusions, (iv) recommendations of risk analyses (including such factors as potential avalanches, flooding, remote location, rockslides, and snowpack) undertaken by the government concerning the danger of a diluted bitumen spill; (o) what, if any, are the (i) names, (ii) dates, (iii) conclusions, (iv) recommendations of analyses undertaken by the government concerning the possible economic, environmental, and social impacts of a diluted bitumen spill on First Nation and non-First Nation ways of life; (p) what are the challenges associated with clean-up specifically of a diluted bitumen spill, in rivers, wetland and marine environments (including when surface water is frozen), particularly as raw bitumen is heavier than water; (q) what appropriate clean-up operations might, in case of a diluted bitumen spill, be required in terms of equipment, personnel, and supplies, compared to a spill of light sweet crude oil; (r) what are the likely economic and environmental costs of a diluted bitumen spill compared to a spill of light sweet crude oil; (s) how might a diluted bitumen spill impact human health, including, but not limited to, (i) potential impacts both in the short-term and the long-term of exposure to toxins, including benzene, hydrogen sulphide, polycyclic aromatic hydrocarbons, and n-hexane, (ii) potential impacts of exposure to toxins (such as arsenic, nickel, mercury and other heavy metals that do not biodegrade) that can bio-accumulate in the food chain; (t) what health and safety precautions does the government require emergency personnel to take when responding specifically to diluted bitumen spills; (u) what are all pipeline spills that have occurred from 1990 to 2010 in NEB-regulated pipelines, including (i) location, (ii) cause, (iii) affected area, (iv) environmental costs, (v) significant challenges to clean-up, (vi) impacts on human health, (vii) equipment, personnel and supplies required, (viii) economic costs; (v) what, if any, (i) research, (ii) action, (iii) investment has the government taken to evaluate the need for new Canadian pipeline safety regulations and standards that reflect the unique characteristics of diluted bitumen, and to restrict further diluted bitumen pipeline development until adequate safety regulations are in place; (w) what, if any, (i) research, (ii) action, (iii) investment has the government undertaken concerning changes to the design, operation and decommissioning of pipelines that may be necessary due to impacts of climate change, including but not limited to melting permafrost, changing moisture regimes, more severe storm events, increased incidence of forest fires, and slope instabilities; (x) what, if any, (i) research, (ii) action, (iii) investment has the government undertaken regarding the adoption of pipeline regulations and standards that require new pipeline routes to avoid landslide-prone routes, and that provide an adequate risk assessment for risks to pipelines arising from landslides and snow avalanches; (y) what, if any, (i) research, (ii) action, (iii) investment has the government undertaken to evaluate the risk of pipeline spills caused by multiple incidents happening at the same time, including worst-case scenarios; (z) what specific action and investment will the government take to ensure (i) that bitumen pipeline operators will fix safety problems identified at their facilities, (ii) that bitumen pipeline operators keep their emergency procedures up-to-date; (aa) what specific actions will the government take to ensure that pipeline companies which transport bitumen employ emergency-procedures manuals that adequately (i) identify the hazards posed by the operation of the pipelines, (ii) assess the risks posed by those hazards, (iii) map nearby residences and evacuation routes, (iv) describe and locate emergency response equipment, (v) identify any environmentally sensitive areas potentially affected by an incident, (vi) explain governmental roles in an emergency response; and (bb) in what ways, if any, must the emergency-procedures manuals referred to in sub-question (aa) differ from those concerning pipelines that do not carry bitumen?
Q-4202 — January 30, 2012 — Ms. Duncan (Etobicoke North) — With respect to Canada’s international commitments on climate change and the government’s withdrawal from the Kyoto Protocol: (a) for each of the international commitments that the government has made concerning climate change, (i) what is that commitment, (ii) what are the government’s obligations under it, (iii) does the government plan to fulfill each obligation or not; (b) what specific actions or negotiating positions were taken in support of the government’s statements that it (i) “went to Durban in a spirit of good will,” (ii) “went [to the Durban climate change conference] committed to being constructive,” (statement by Minister Kent, Foyer of the House of Commons, December 12, 2011); (c) in detail, how does the government plan to achieve the goal of reaching a new international agreement on climate change with particular reference to (i) how the government plans to achieve legally binding commitments for all major emitters, (ii) how the government plans to find solutions to meet the agreed-upon-objective of staying below 2°C of warming; (d) what information does the Minister of the Environment possess that supports his statement that “increasingly, support is growing for Canada’s position – from the EU, to the United States, Australia, New Zealand, least developed countries and the group of 43 small island states” (statement by Minister Kent, Foyer of the House of Commons, December 12, 2011); (e) does the Minister of the Environment possess information that Canada’s withdrawal from the Kyoto Protocol is a positive step for Canada’s economy, in contradiction of the National Roundtable on the Environment and the Economy’s projected costs of $21-43 billion annually by 2050 (depending on whether a low climate change–slow growth scenario or a high climate change–rapid growth scenario), and what is that information; (f) what, in detail, are the “radical and irresponsible choices” (statement by Minister Kent, Foyer of the House of Commons, December 12, 2011) that Canada was facing under the Kyoto protocol; and (g) what are the penalties to which Canada would have been subject to under the Kyoto protocol for not meeting agreed emission reductions, and what analysis does the government possess in support of the statements that these penalties would have entailed “the loss of thousands of jobs” and “the transfer of $14 BILLION from Canadian taxpayers to other countries – the equivalent of $1600 from every Canadian family — with no impact on emissions or the environment” (statement by Minister Kent, Foyer of the House of Commons, December 12, 2011)?
Q-4212 — January 30, 2012 — Ms. Duncan (Etobicoke North) — With respect to increasing evidence for the threat of climate change and Canada’s response to it, including emission reductions and adaptation strategies: (a) do the government’s policies address the growing scientific consensus that the threat of climate change is now incontrovertible; (b) do the government’s policies acknowledge that continuing on a business-as-usual pathway could lead to (i) a potential temperature rise of 4°C by the end of the century, (ii) dangerous impacts for Canada and the world; (c) do the government’s policies acknowledge that the small number of climate change deniers who continue to contest either that climate change is real or that humans are causing it (i) are generally not climate scientists, (ii) employ arguments that have been discredited by the international scientific community; (d) do the government’s policies acknowledge that (i) while our scientific understanding of the climate system is not complete, the evidence is sufficiently strong to show that climate change poses a real threat, (ii) further delays in addressing this threat will entail greater risks and costs; (e) do the government’s policies acknowledge that if the scenario in (b)(i) becomes a reality, serious consequences, such as coastal flooding, extreme weather events, and forest fires, will intensify over the coming decades with significant costs for the economy and the environment, both in Canada and globally; (f) what research, if any, has the government undertaken or planned to undertake to assess the impact of climate change on the Canadian economy and the costs of adaptation to climate change, and what are (i) the names of these studies, (ii) the dates they were carried out, (iii) their conclusions, including projected costs and whether and under what circumstances said costs can be kept to manageable levels, (iv) their recommendations; (g) what are specific examples of how the government is taking advantage of “shorter-term opportunities to address climate change” (notes for remarks by the Honourable Peter Kent, P.C., M.P., Announcement on Domestic Climate Change Adaptation, Toronto, Ontario, November 8, 2011); (h) what sectors are to be included in the government’s sector-by-sector approach to climate change, and what are the dates for the inclusion of each sector; (i) what concrete examples demonstrate the government’s climate change plan has “a strong, corresponding international component” (notes, November 8, 2011); (j) what, if any, (i) research, (ii) action, (iii) investment has the government carried out to “reduce the soot, methane, ozone and other gases” (notes, November 8, 2011) which are short-lived drivers of the climate system; (k) what research, if any, has the government undertaken to compare the costs of early mitigation of climate change with the costs of late adaptation to climate change, and what are (i) the names of these studies, (ii) the dates they were carried out, (iii) their conclusions, including projected costs and whether (and under what circumstances) said costs can be kept to manageable levels, (iv) their recommendations; (l) what, if any, (i) research, (ii) action, (iii) investment has the government carried out to develop a pan-Canadian plan for energy efficiency with targets for the years 2020, 2030, 2040, and 2050; (m) what, if any, (i) action, (ii) investment has the government undertaken to implement low-impact renewable energy solutions in Canada for the years listed in (l); (n) what, if any, (i) research, (ii) action, (iii) investment has the government undertaken to develop a strategy for sustainable transportation in Canada with targets for the years listed in (l); (o) what actions, if any, has the government carried out to develop a fund for climate-neutral pilot projects that will allow municipalities to reduce greenhouse gas (GHG) emissions as much as possible, and to use carbon offsets to neutralize unavoidable emissions; (p) what, if any, (i) research, (ii) action, (iii) investment has the government undertaken to develop a plan to rationalize and phase out fossil fuel subsidies, with targets for 2015, 2020 and 2025, in order to achieve the goal of a ‘medium term’ phase-out; (q) what, if any, (i) research, (ii) action, (iii) investment has the government undertaken to develop a plan to increase research and development into and deployment of low-carbon technology in Canada; (r) what, if any (i) research (ii) consultations has the government undertaken to determine if, given various possible scenarios, an investment of $148.8 million over the next five years will be sufficient to help Canada adapt adequately to climate change by the target dates 2030, 2040, and 2050; and (s) what specific provisions has the government made to allow Environment Canada’s Adaptation and Impacts Research Section to undertake research to help Canada adapt to climate change?
Q-4222 — January 30, 2012 — Ms. Duncan (Etobicoke North) — With respect to nutrition in child and adolescent populations in Canada: (a) does government policy include recognition and acceptance of the principle that Canada’s children and adolescents are entitled to nutritious food (i) regardless of where they live, (ii) regardless of their family income, (iii) particularly when economic forces undermine efforts by parents and caregivers to ensure healthy eating; (b) given that the 1992 World Declaration on Nutrition, to which Canada was a signatory, states that access to nutritionally adequate and safe food is a right of each individual, what specific actions have the Canadian Institutes of Health Research (CIHR) and Health Canada undertaken for children and adolescents in order to fulfill this commitment; (c) what percentage of children and adolescents in Canada is food insecure, (i) do disparities exist, including, but not limited to, disability status, ethnicity, gender, geography, socio-economic status, (ii) if so, specify; (d) what percentage of children and adolescents lives below the poverty line, (i) do disparities exist, including, but not limited to, disability status, ethnicity, gender, geography, socio-economic status, (ii) if so, specify; (e) what percentage of children and adolescents has, as a result of living below the poverty line, (i) poor nutritional status, (ii) poor health outcomes due to their poor nutritional status; (f) what percentage of members of each of the following groups is food insecure, (i) child and adolescent newcomers, (ii) children and adolescents who live in poverty, (iii) children and adolescents who live in priority neighbourhoods, (iv) Aboriginal children and adolescents; (g) what percentage of children and adolescents (i) involuntarily misses meals, (ii) lacks healthy variety in its diet; (h) does the government have information, and, if so, what is that information, concerning (i) how (g)(i) and (g)(ii) impact the caloric and nutrient intake of young children, (ii) how (h)(i) affects growth and development and school readiness; (i) what percentage of child and adolescent newcomers, children and adolescents who live in poverty, children and adolescents who live in priority neighbourhoods, and Aboriginal children and adolescents (i) involuntarily misses meals, (ii) lacks healthy variety in its diet; (j) what percentage of children and adolescents has fewer than the recommended daily servings of (i) vegetables and fruit, (ii) milk products, (iii) grain products; (k) what percentage of child and adolescent newcomers, children and adolescents who live in poverty, children and adolescents who live in priority neighbourhoods, and Aboriginal children and adolescents has fewer than the recommended daily servings of (i) vegetables and fruit, (ii) milk products, (iii) grain products; (l) what percentage of children and adolescents from all income brackets is vulnerable to inadequate nutrition, (i) for what specific reasons; (m) what percentage of elementary students and secondary school students does not eat a nutritious breakfast before school, (i) do disparities exist, including, but not limited to, disability status, ethnicity, gender, geography, socio-economic status, (ii) if so, specify; (n) what percentage of children and adolescents is vulnerable to poor academic, health, and socio-emotional outcomes as a result of inadequate nutrition; (o) what percentage of overweight and obese children and adolescents does not eat a nutritious breakfast; (p) how are children’s learning capabilities (including, but not limited to, creativity testing, voluntary endurance, and working memory) affected by how recently a child has eaten; (q) how does malnutrition in early life limit long-term intellectual development; (r) what impact, if any, does an inadequate childhood diet have on the risk of adult chronic disease; (s) how is the behaviour of children and adolescents (including, but not limited to, ability to concentrate, anxiety, depression, fatigue, and irritability) affected by whether or not they have eaten breakfast; (t) what research, if any, has the CIHR or Health Canada undertaken to assess whether schools play a role in shaping the dietary behaviours of children, and, if such research has been undertaken, (i) what are the studies, (ii) what are the studies’ dates, (iii) what are the studies’ conclusions, (iv) what are the studies’ recommendations; (u) what research, if any, has the CIHR or Health Canada undertaken to assess possible links between student nutrition and academic performance, classroom behaviour, and antisocial behaviour, and, if such research has been undertaken, (i) what are the studies, (ii) what are the studies’ dates, (iii) what are the studies’ conclusions, (iv) what are the studies’ recommendations; (v) what research, if any, has the CIHR or Health Canada undertaken to assess whether nutrition programs delivered at school sites are effective in providing children with (i) more nutritious diets, (ii) better cognitive abilities, (iii) better cooperation among children, (iv) improved discipline, (v) improved interpersonal behaviours, (vi) improved emotional and physical health, (vii) reduced risk of chronic disease, and, if such research has been undertaken, (viii) what are the studies, (ix) what are the studies’ dates, (x) what are the studies’ conclusions, (xi) what are the studies’ recommendations; (w) what research, if any, has the CIHR or Health Canada undertaken to assess whether nutrition programs delivered at school sites improve (i) nutritional adequacy, (ii) nutritional education, (iii) positive socialization, (iv) school attendance, (v) community mobilization, partnerships and social support, and, if such research has been undertaken, (vi) what are all the studies, (vii) what are the studies’ dates, (viii) what are the studies’ conclusions, (ix) what are the studies’ recommendations; (x) what percentage of children and adolescents is enrolled in a school district with (i) a nutrition program, (ii) nutritional guidelines for school meals; (y) what percentage of child and adolescent newcomers, children and adolescents who live in poverty, children and adolescents who live in priority neighbourhoods, and Aboriginal children and adolescents, is enrolled in a school district with (i) a nutrition program, (ii) nutritional guidelines for school meals; (z) what information does the government possess that explains why school sites are an effective venue to deliver student nutrition and what is this information; (aa) are there specific reasons why Canada does not have a pan-Canadian nutritional initiative delivered at school sites, and, if so, (i) what are these reasons, (ii) does the government have any analysis of the obstacles that would have to be overcome to develop a pan-Canadian nutrition program and what are those obstacles; (bb) what research, if any, has been undertaken by the CIHR or the government into a pan-Canadian nutrition initiative to be delivered at school sites, including (i) the cost per student per day, (ii) the annual return on investment of a pan-Canadian nutrition initiative delivered at school sites, (iii) the annual payback on a pan-Canadian nutrition initiative if the graduation rate increased by five percent, (iv) the annual return on investment of a pan-Canadian nutrition initiative if obesity, cardiopulmonary, and diabetes rates were reduced by five percent as a result of the initiative; (cc) what research, if any, has been undertaken by the CIHR or the government into fully funding on-reserve aboriginal student meals, including (i) the cost per student per day, (ii) the annual return on investment of a student nutrition initiative, (iii) the annual payback on a student nutrition initiative if the graduation rate increased by five percent, (iv) the annual payback on a student nutrition initiative if obesity, cardiopulmonary, and diabetes rates were reduced by five percent as a result of the initiative; (dd) has the government taken any action or made any investment, and, if so, what is the nature of said action or investment, to (i) initiate discussions with the provincial and territorial ministers responsible for agriculture, education and health to develop a comprehensive pan-Canadian school nutrition initiative, (ii) fully fund on-reserve aboriginal student meals; and (ee) what research, if any, has been undertaken by Agriculture and Agri-Food Canada, and what economic impacts on the Canadian economy have been identified in said research, into (i) a possible economic stimulus resulting from the implementation of a pan-Canadian nutrition initiative delivered at school sites, including, but not limited to, the impacts on ancillary industries, such as, distribution, refrigeration, and service, (ii) the development of local markets for farmers?
Q-2642 — November 30, 2011 — Ms. Duncan (Etobicoke North) — With respect to the planning for and the execution of the joint meeting of the Canadian Institutes for Health Research (CIHR) and the Multiple Sclerosis Society of Canada (MSSC), on August 26, 2010: (a) what were the most recent statistics CIHR had regarding MS as of August 26, 2010, and had CIHR received, internally or externally, any request to update the figures beforehand; (b) what criteria were used to identify which international experts in chronic cerebrospinal venous insufficiency (CCSVI) should be invited to the August 26, 2010, meeting, and, (i) was Dr. Mark Haacke a candidate for invitation and, if so, why was he not invited, (ii) was Dr. Marion Simka a candidate for invitation and, if so, why was he not invited, (iii) was Dr. Paolo Zamboni a candidate for invitation, and, if so, why was he not invited, (iv) which invitees had expertise or experience administering CCSVI treatment, (v) why did the criteria not exclude from participation individuals who had publicly criticized the validity of CCSVI, (vi) what was the rationale for “[keeping] the international participation in focus” (Answer to Access to Information Request ATI 2010-006); (c) what CIHR experts were consulted regarding CCSVI/MS prior to the August 26, 2010, meeting, and, if any CIHR experts were consulted, what recommendations did they make, including any recommendations concerning large multi-centre clinical trials; (d) what briefings did the Minister of Health provide to members of the Conservative caucus regarding CCSVI or MS prior to the August 26, 2010, meeting, (i) what were the dates of any briefings, (ii) what information was provided; (e) did provincial governments express “mounting pressure” (ATI 2010-006) from the public regarding the need for clinical trials and treatment for CCSVI, and, if so, which provinces expressed any such pressure; (f) did any of the provinces and territories communicate an interest in partnering with the federal government on a “potential initiative” (ATI 2010-006), and, if so, what were the details of the “potential initiative” (ATI 2010-006); (g) by what date and by whom was CIHR made aware of the history of the theory of abnormal vasculature in MS dating back more than 100 years; (h) what was CIHR’s rationale for focussing its literature review on CCSVI and for excluding from consideration literature on the theory of abnormal vasculature in MS and why did CIHR decide to have students work on this literature review; (i) what criteria did the CIHR use to determine which of the 19 studies identified through PubMed (July 2010) it would include in its review of existing literature and research; (j) on what date did the President of CIHR first state that he would be pleased to provide for a randomized control trial on CCSVI treatment for review at the next grant competition, and (i) did the President ever speak to the “F/P/T” (ATI 2010-006) regarding the need for randomized clinical trials; (k) what lobbyists and/or pharmaceutical companies asked for a meeting with the Minister of Health’s office prior to August 26, 2010, to discuss a new oral MS drug and CCSVI treatment, and (i) what lobbyists and/or companies were “well respected” (ATI 2010-006) and had “a solid reputation with the MSSC” (ATI 2010-006); (l) why did CIHR change its position in March 2011 regarding an MS registry, and how was this change possible, given CIHR’s previous statements to Dr. Carolyn Bennett and Dr. Kirsty Duncan that the creation of such a registry “was outside” their “mandate” (ATI 2010-006); (m) did CIHR have money available for funding clinical trials related to CCSVI, (i) was CIHR “overcommitted” (ATI 2010-006), (ii) if so, by how much, (iii) could CIHR have found “some money” (ATI 2010-006), (iv) when could money have been available; (n) prior to the August 26, 2010, meeting, how many provinces and territories “expressed some level of support for a clinical trial” (ATI 2010-006); (o) concerning the e-mail exchange of August 24, 2011, contained in the response to ATI 2010-006, did the Minister of Health “have authority or [did] she need to go through cabinet” (ATI 2010-006); (p) were abnormal veins discussed in any of the August 26, 2010, presentations, and, if so, (i) which presenters covered this issue, (ii) what historical papers were referenced; (q) was iron accumulation in MS brains discussed in any of the August 26, 2010, presentations, and, if so, (i) which presenters covered the issue, (ii) what historical papers were referenced; (r) did any of the presentations explore a possible relationship between abnormal brain veins and tissue damage in MS, and, if so, (i) which presenters covered the issue, (ii) what historical papers were referenced; (s) what criteria were used or what process was followed to prepare the Summary Report of the August 26, 2010, meeting and, specifically, why was no reference made in the Summary Report to historical papers discussing abnormal vasculature and iron accumulation; and (t) does the Summary Report of the August 26, 2010, meeting disclose potential conflicts of interests of the attendees, and, if not, why was this information not included?
Q-2242 — November 15, 2011 — Ms. Duncan (Etobicoke North) — With respect to development of the oil sands, and its impacts on Aboriginal communities: (a) what are all the studies, along with their dates and results, undertaken by the government concerning the (i) possible impacts of the oil sands industry on land, water, and wildlife, (ii) potential impacts on Aboriginal livelihoods, inherent and treaty rights, and constitutional rights; (b) which government accommodation and consultation policies regarding the oil sands have been designed in partnership with Aboriginal peoples to ensure that free, prior and informed consent is obtained, and how does the government ensure that consultation policies are (i) designed in partnership with Aboriginal peoples, (ii) consistent with the United Nations Declaration on the Rights of Indigenous Peoples; (c) what are all consultations, including the dates of the consultations and those present, undertaken by the government with Aboriginal peoples, where there was consideration given to oil sands-related activities that might impact Section 35 rights, and what were the results or conclusions of these consultations; (d) does the government ensure that consultation with Aboriginal peoples occurs early in the decision-making process as related to the development of the oil sands and, if so, how does it do this; (e) what are all consultations with Aboriginal peoples which occurred early in the decision-making process as related to the development of the oil sands, and for each such consultation, how does it meet the government’s criteria for “early consultation”; (f) what are all legal challenges that have been undertaken or are being undertaken by First Nations communities against the government as related to the oil sands, and what is the stated reason for each challenge; (g) what are the studies, along with their dates and results, undertaken by the government concerning the possible impacts of legal challenges by First Nations communities on the oil sands industry; (h) which, if any, First Nations communities have asked for a full public inquiry into the impact of oil sands development and what are (i) the reasons provided for each such request, (ii) the projected cost of such an inquiry, (iii) the steps taken by the government to address each identified concern as outlined in (h)(i); (i) does the federal government plan to ensure that development in the oil sands region is consistent with the constitutionally-protected rights of Aboriginal peoples and the internationally-accepted doctrine of free, prior, and informed consent, and (i) other than actions referenced in the responses to parts (a) through (h), what federal decisions have been taken and what federal policies or programs have been developed taking into account Aboriginal peoples’ constitutionally-protected rights; and (j) what, if any, studies has the government funded to ensure that Aboriginal communities impacted or potentially impacted by the oil sands have the resources to direct their own baseline health studies and environmental monitoring programs?
Q-2232 — November 15, 2011 — Ms. Duncan (Etobicoke North) — With respect to Lyme disease-carrying ticks and Lyme disease in Canada: (a) what percentage of Lyme disease cases are thought to be reported, (i) what percentage of people who receive treatment for Lyme disease develop post-treatment Lyme disease syndrome, (ii) what percentage of people with untreated Lyme disease infections experience intermittent bouts of arthritis, (iii) what percentage of untreated Lyme disease patients are at risk of developing chronic neurological complaints months to years after infection; (b) based on all epidemiological data collected since Lyme disease became a nationally-reportable disease, what is the most recent data available about Lyme disease cases, broken down (i) by province, (ii) by month, (iii) by symptom, (iv) incidence by age and sex; (c) how does the government define a “Lyme-endemic area”, (i) in what specific areas of Canada are ticks endemic and highly endemic, (ii) what areas of Canada have the highest numbers of human infections; (d) what is Lyme disease’s (i) ranking among vector-borne diseases in Canada, (ii) ranking among nationally notifiable diseases; (e) is it possible to have more than one tick-borne infection, and, if so, (i) are possible co-infections being investigated and tracked, (ii) does one’s chance of having multiple tick-borne infections depend on geographic location, and, if so, what areas are particularly at risk, (iii) what is the rate of co-infection by province; (f) broken down by province, over the last 20 years, how has a warming climate impacted Lyme disease, in particular, (i) how has warming impacted tick distribution by province, (ii) how has warming impacted the distribution of Lyme disease by province; (g) what does the government project will be the effect of climate change on (i) the geographical range of ticks in 2020 and 2050, (ii) the distribution of ticks across Canada, (iii) human Lyme disease infections, (iv) the distribution of Lyme disease infections in Canada; (h) how has municipal development changed in tick-endemic areas throughout Canada over the last 20 years, (i) how have these changes brought humans in contact with ticks, (ii) how has development impacted the distribution of the disease, (iii) what are the government’s projections concerning how development will change over the next 40 years, (iv) what are the government’s projections concerning how development will impact the spread of Lyme disease over the next 40 years; (i) what are Health Canada’s recommended treatment guidelines for Lyme disease, and what was the process used to develop them; (j) what tests does Health Canada recommend for diagnosing cases of Lyme disease, (i) what is the percentage accuracy of the recommended tests at each stage of disease, namely, when a patient has an erythema migrans rash, when a patient is in the early disseminated stage (days to weeks post-tick bite), and when a person is in the late disseminated stage (months to years post-tick bite), (ii) what tests for diagnosing Lyme disease are available and recommended in Canada during each of the above-mentioned stages of the disease, (iii) can patients be treated based solely on their symptoms or must they have had positive test results; (k) is the government aware of any organization that recommends physicians who are familiar with diagnosing and treating Lyme disease, and, if so, where can this information be accessed; (l) what percentage of patients with Lyme disease respond well to antibiotics, (i) what percentage of patients with Lyme disease experience fatigue, muscle aches, sleep disturbance, or difficulty thinking even after completing a recommended course of antibiotic treatment, (ii) what research has been undertaken regarding the benefits and risks of a longer course of antibiotics, (iii) what are Health Canada’s recommendations concerning a longer course of antibiotics, (iv) what follow-up has Health Canada undertaken to ensure that patients have access to a longer course of antibiotic treatment if required; (m) what, if any, recommendations does Health Canada make concerning those who suffer post-treatment Lyme disease syndrome; (n) what, if any, resources does Health Canada provide to clinicians regarding diagnosis, treatment, and testing; (o) what, if any, resources does Health Canada provide to clinicians for continuing medical education on the topic of Lyme disease; (p) what, if any, case definition and report forms does Health Canada make available concerning Lyme disease, and when were each of these forms last updated by Health Canada; (q) what specific actions are Health Canada and the Canadian Institutes of Health Research undertaking regarding prevention of Lyme disease, including, but not limited to, (i) programs of research, (ii) programs of service, (iii) education programs for the public and healthcare providers; (r) what resources have been provided to each initiative identified in response to (q); (s) what, if anything, is Health Canada doing with national surveillance data regarding Lyme disease, in particular, (i) what is it doing to maintain such data, (ii) what is it doing to analyze such data, (iii) what resources has it allocated to such activities; (t) in what, if any, epidemiologic investigations is the government currently involved, in any capacity, including that of funding, (i) what resources is the government providing for any such study; (u) what, if any, diagnostic and reference laboratory services does the government provide in relation to Lyme disease, (i) what financial resources are provided for any such services; (v) what, if any, steps is Health Canada and the Canadian Institute for Health Research taking to develop and test strategies for the control and prevention of Lyme disease in humans; and (w) what, if any, information does Health Canada provide to pregnant mothers about Lyme disease?
Q-1522 — September 22, 2011 — Ms. Duncan (Etobicoke North) — With respect to the development of unconventional gas resources, including shale, tight and coal bed methane, and its possible impacts on the environment: (a) what, if any, research has the government undertaken regarding the development of unconventional gas resources, (i) what was the scope of this research in the areas of, but not limited to, air quality, aquatic and terrestrial ecosystem impacts, economic impacts, occupational risks, public safety concerns, and seismic risks, (ii) what, if any, resources did the government provide for this research, (iii) what, if any, process was established to ensure the independence of the researchers, their research, and their findings, (iv) what, if any, case studies were considered as a part of this research, (v) what, if any, scenarios regarding the development of unconventional gas resources were developed as frameworks for the research, (vi) what economic, environmental and social impacts were identified by this research, (vii) what, if any, priority research areas were identified for further study as a result of this research, (viii) what, if any, departments were involved in this research, (ix) what, if any, action was undertaken to ensure inter-departmental cooperation throughout the research process, (x) what, if any, gaps or weaknesses in the regulatory framework did the research identify; (b) what, if any, research has the government undertaken regarding balancing shale gas’ potential contribution to energy security with environmental risks; (c) what are the sources of greenhouse gas emissions associated with unconventional gas; (d) has the government developed a process to determine the overall carbon footprint of shale gas throughout the life cycle of natural gas use, if not, why not, and, if so, (i) what federal departments are involved in this process, (ii) how does the government ensure inter-departmental collaboration on this process, (iii) what is the process, (iv) what, if any, data has been acquired and analysed through this process, (v) what is the government’s estimate of shale gas’ potential footprint in Canada; (e) what are the government’s calculations concerning how the overall carbon footprint of shale gas compares with conventional oil and gas for various end-uses; (f) what, if any, analysis has the government conducted concerning carbon capture and storage opportunities in the development of unconventional gas resources, namely analysis of (i) its feasibility, (ii) its cost-effectiveness, (iii) its reliability, (iv) liabilities that might arise from such strategies; (g) what, if any, research has the government undertaken regarding how effective well construction practices are at containing fluids and gases before, during, and after hydraulic fracturing, what are the dates of any such studies, and what were the results of this research; (h) what, if any, research has the government undertaken regarding well-bore drilling and sealing techniques and their reliability in containing hydraulic fracturing fluids and produced water from shale gas extraction, what are the dates of any such studies, and what were the results of this research; (i) what, if any, cases of gas bubbling (i.e. methane contaminating surface water) related to hydraulic fracturing have been reported, and what, if any, process is in place to ensure reporting; (j) what, if any, cases of drinking water contamination related to shale gas activity have been reported, and what, if any, process is in place to ensure reporting; (k) what are the potential impacts of the injection and fracturing process on (i) water availability, (ii) water quality, (iii) water quantity; (l) what, if any, studies has the government undertaken, for each of the issues listed in (k); (m) what are the potential impacts of pre-existing human-made or natural pathways and features on contaminant transport, (i) how is the concept of “acceptable risk” defined and determined, (ii) which wells, if any, have undergone a risk analysis, (iii) which wells, if any, have been found to exceed “acceptable risk”, (iv) what are the potential impacts on drinking water, (v) what factors may affect the likelihood of contamination of drinking water resources, (vi) what are the possible human health impacts of possible drinking water contamination, (vii) how effective are mitigation approaches in reducing impacts to drinking water resources; (n) what is the specific composition of hydraulic fracturing fluids, (i) what chemicals are non-biodegradable, (ii) how long does each persist in the ground, (iii) how are non-biodegradable chemicals tracked in groundwater, (iv) does the government currently undertake any such tracking, (v) what, if any, results are available concerning this tracking; (o) what steps is the government taking to ensure that the volume of water required for shale gas fracturing does not challenge resources in regions already experiencing water stress; (p) what is the composition and variability of flowback and produced water, and what does the government project will be the possible impacts of releases of flowback and produced water on drinking water resources; (q) what steps, if any, is the government taking to ensure that best practices are adopted by industry in areas including, but not limited to, well development and construction, especially casing, cementing, and pressure management; (r) have micro-seismic surveys been conducted to assure that hydraulic fracturing is limited to gas-producing formations; (s) what steps, if any, is the government taking to ensure (i) inspections at safety-critical stages of well construction and hydraulic fracturing, (ii) that operators take prompt action to repair defective cementing jobs; (t) what analysis, if any, has the government conducted concerning whether it should require that baseline water quality and quantity monitoring occur prior to the hydraulic fracturing process; (u) what analysis, if any, has the government conducted concerning encouraging or requiring producers of unconventional gas to use non-toxic drilling fluids; (v) what analysis, if any, has the government conducted concerning the implementation of proximal restrictions for both horizontal and vertical drilling with the aim of avoiding the potential for contamination of valuable water sources; (w) what analysis, if any, has the government conducted concerning strategies that would ensure that companies declare the type, concentration, and volume of all chemicals added to the hydraulic fracturing fluid; (x) what is the government’s assessment regarding whether the necessary resources exist to detect identified chemicals in water supplies should an incident lead to potential contamination of water resources; (y) what analysis, if any, has the government conducted concerning important landscapes, habitats, and migration corridors to inform planning, prevention, mitigation and reclamation of surface impacts; (z) what analysis, if any, has the government conducted concerning the need to limit drilling and support infrastructure in unique or sensitive areas; and (aa) what, if any, studies has the government undertaken regarding (i) the prospects for shale gas in Canada, (ii) Canadian shale gas estimates, (iii) Canadian exploration and production of shale gas, (iv) shale gas markets and prices, (v) the security of the supply of shale gas, (vi) government support for shale gas production, (vii) renewable energy sources in comparison with shale gas, (viii) the risks of rapid depletion of shale gas, (ix) regulatory challenges surrounding shale gas?
Q-1422 — September 19, 2011 — Ms. Duncan (Etobicoke North) — With respect to the venous system, and more particularly, chronic cerebrospinal venous insufficiency (CCSVI): (a) what, if any, steps is the government taking to address research questions regarding the venous system, including (i) what does the normal venous system look like, and, specifically, what does it look like in infants, children, and adults, (ii) can the veins, in particular the jugulars and the azygous, look normal, and the flow be abnormal, (iii) what is the normal range of flow through veins, in particular the jugulars and the azygous, (iv) how should normal range of flow through veins, in particular the jugulars and azygous, be defined, (v) what is the normal range of blood gases in veins, in particular the jugulars and the azygous, (vi) what causes venous pathology and when does it occur, (vii) theoretically, what is the complete range of possible vascular problems in the head, neck, chest, and spine, which ones might impact health, and specifically which ones might be linked to multiple sclerosis (MS), (viii) how does the complete range of possible vascular problems compare with those actually seen in patients, (ix) how should abnormal flow through veins, in particular the jugulars and the azygous, be defined, (x) how might abnormal blood gases in veins affect health in the short-term and long-term, (xi) what, if any, reflux is normal in veins, and, if some reflux is normal, what is the ‘tipping point’ to abnormal, (xii) can a catalogue of venous pathology (in the head, neck, chest and spine), abnormal flow, and potential health impacts be established, (xiii) what protects against abnormal venous pathology and abnormal flow, (xiv) who should receive venous protective measures, and when should protective measures be put in place; (b) what, if any, steps is the government taking to address research questions regarding the venous system and MS, including, (i) can fluid mechanics predict where physiologic changes in the brain might occur, (ii) how does the neurologist’s understanding of flow through the brain compare with that of physicists, (iii) does decreased metabolism lead to hypoxia which may lead to endothelial damage and inflammation, (iv) what occurs first, inflammatory changes in the brain or iron deposition, (v) what role does reduced perfusion have in MS, (vi) does stenosis extra-cranially cause less perfusion in the brain, (vii) does stenosis extra-cranially cause morphological changes in the brain, (viii) do cerebral veins actually disappear over time, or is it merely a lack of flow that makes them look like they disappear in magnetic resonance imaging (MRI) studies; (ix) what, if any changes beyond lesions, occur in the spinal cord of MS patients, as a result of reduced vertebral flow, (x) do vertebral veins show a similar disappearance over time, (xi) what percentage of MS patients show evidence of venous pathology, as compared to ‘normals’, (xii) what other venous abnormalities might MS patients have (e.g., bladder, intestine, kidney), might these abnormalities play a role in their disease, and, if so, how should they be imaged and treated, (xiii) what percentage of MS patients show venous abnormalities below the chest (e.g., May Thurner syndrome), and does this have an impact on their disease, (xiv) how does the vascular system of someone with benign MS compare to that of someone with relapsing-remitting, primary progressive or secondary progressive MS; (c) what, if any, steps is the government taking to address research questions regarding CCSVI and MS, including, (i) what is the prevalence of CCSVI in relapsing-remitting, primary progressive or secondary progressive MS, (ii) does CCSVI worsen over time with the progression of disease, (iii) does CCSVI play a role in MS, and, if so, how, (iv) is CCSVI specific to MS, (v) what are the potential health impacts of CCSVI in the short-term, medium-term and long-term, both with and without treatment; (d) what, if any, steps is the government taking to address research questions regarding CCSVI diagnosis, including (i) how do the results of MRI compare with those of ultrasound for diagnosis of CCSVI, (ii) what is the best way to image the venous system and the best way to image venous pathology, (iii) what are the limitations of current diagnostic tools to image the venous system, (iv) should intravascular ultrasound be used, and what are the benefits and the risks, (v) what is the learning curve for the various diagnostic procedures, and what should practitioners undertake to become sufficiently accomplished, (vi) can a standardized protocol be established for diagnosing CCSVI in MS patients, and when should MS patients be tested for CCSVI, (vii) can a standardized system for describing lesions (e.g., type, location) be established, (viii) what should be the decision-making process regarding whether to treat or not to treat (e.g., anatomy, flow, etc.), (ix) should arterial, venous and CSF flow be monitored, how often, and for what purpose, (x) should lesions and iron load be monitored, how often, and for what purpose; (e) what, if any, steps is the government taking to address research questions regarding CCSVI treatment, including (i) what timescale is useful for treatment of CCSVI, (ii) what are the benefits and risks associated with treatment of CCSVI, (iii) what are best practices for treating each identified vascular problem, (iv) how should a successful CCSVI treatment be defined (e.g., valvular correction, reduction in stenosis, increased flow, improved blood gases), (v) can malformed jugulars and azygous be treated to achieve normal flow, (vi) can malformed jugulars and azygous be treated to achieve a normal range of blood gases, (vii) can jugulars and azygous be sufficiently treated to make up for poor vertebral flow, and, if not, what procedures can be developed to improve vertebral flow, (viii) should stents be used, and, if so, under what circumstances, (ix) what are the immediate complications of CCSVI treatment, and in what percentage of treatments does each occur for each identified abnormality, (x) what is the best follow-up anti-coagulant therapy, what are the potential risks, and what is the prevalence of complications, (xi) what are the best follow-up therapies, including, brain plasticity exercises, nutrition, physiotherapy, speech therapy, etc., and which therapies have the best associated outcomes, (xii) what are late complications, what follow-up is necessary to determine late complications, and in what percentage of treatments does each occur for each identified abnormality, (xiii) what treatments are available should a stent be occluded, either through hyperplasia or thrombosis, (xiv) what is the success rate of each identified treatment for an occluded stent; (f) what, if any, steps is the government taking to address research questions regarding determining the best CCSVI treatment, including, (i) is CCSVI treatment with the addition of pharmacological agents more efficacious than just the CCSVI procedure, (ii) what pharmacological agents could be used to treat venous inflammation, iron storage, and hydrocephaly, and could these agents be added to CCSVI treatment, (iii) what safe apparatuses could be developed to keep treated veins open, (iv) are vein grafts possible, and if so, on whom, and when should they be used, (v) is CCSVI treatment more efficacious with mesenchymal-derived or adipose-derived stem-cell infusion than just the CCSVI procedure alone, (vi) what methods might be added to reduce permeability of the blood-brain barrier, including pharmacological agents and stem cells, (vii) what are the effects of chelators on iron uptake and release from the brain, and might iron chelators be used as therapeutic agents; (g) what, if any, steps is the government taking to address research questions regarding possible impacts of CCSVI treatment on MS patients, including (i) what impact does CCSVI treatment have on patients immediately, (ii) what impact does CCSVI treatment have on patients at 24 hours, 3 months, 6 months, 1 year, and 2 years, (iii) what does the magnetic resonance venography (MRV) of a treated patient look like at 24 hours, 3 months, 6 months, 1 year, and 2 years, (iv) what percentage of MS patients show functional improvement at 3 months, 6 months, 1 year, and 2 years, (v) what are the most appropriate scales to measure any health impacts following CCSVI treatment as reported by MS patients, (vi) do new scales have to be created to measure reported changes following treatment, (vii) which patients show the greatest improvement, and does early intervention allow for a better outcome, (viii) what are the treatment outcomes associated with each of the identified venous problems, (ix) what percentage of MS patients show a reduction in MS attacks and brain lesions following the CCSVI procedure, (x) what percentage of MS patients with little or mild blockage show improvement following the CCSVI procedure, (xi) for those MS patients whose conditions do not improve or become worse, why does this occur; (h) what, if any, steps is the government taking to address research questions regarding CCSVI re-stenosis and diagnosis, including, (i) what is rate of stenosis for each identified vascular abnormality, (ii) what changes should patients be told to look for to in order to recognize whether they are possibly re-stenosing, (iii) what diagnostic methods should be used after treatment for CCSVI, (iv) what diagnostic methods should be used to look for re-stenosis, and at what timescales; (i) what, if any, steps is the government taking to address research questions regarding secondary procedures for CCSVI, including, (i) are secondary procedures safe, and if so, how many, (ii) what should be the follow-up protocol for secondary procedures, (iii) should there be a methodology established regarding whether to do a secondary procedure or not; and (j) what, if any, steps is the government taking to address research questions regarding prevention in the next generation, including, (i) do vascular issues develop in utero, during childhood, or later, and what would be the best methods to discover circulation problems at the earliest time possible to avoid health impacts at a later date, (ii) might vascular birthmarks and tumours be an indication of potential vascular problems, (iii) might skin discolouration, skin abnormalities, and even proliferation of moles be an indication of an autoimmune or neural condition, (iv) might giving vitamin D to pregnant mothers reduce the risk of children being born with, or developing, vascular problems and other conditions and, if so, what dosage is appropriate, (v) do antioxidants, vitamin D and omega 3 reduce vein inflammation, (vi) will giving children and adolescents vitamin D reduce the risk of developing vein inflammation and venous hypertension and, if so, what dosage is appropriate, and what quantity should be recommended for a child with a family history of CCSVI, vascular problems or MS, etc., (vii) what would be the optimum time to undertake CCSVI treatment to avoid health impacts at a later date?
Q-1412 — September 19, 2011 — Ms. Duncan (Etobicoke North) — With respect to climate change and international and national security: (a) what does the government project are the potential impacts on currently stable regions of the world of such climate change-related phenomena as, but not limited to, (i) rises in sea level, (ii) increases in extreme weather events, (iii) increases in the spread of infectious disease, (iv) increases in environmental refugees; (b) what does the government project will be (i) the consequences of the impacts identified in (a)(ii), (a)(iii), and (a)(iv) on domestic military missions, (ii) the consequences of (a)(i), (a)(ii), (a)(iii), (a)(iv) and (b)(i) in terms of the military’s capacity to respond and the availability of troops for missions not related to conflicts induced by climate change-related phenomena; (c) what does the government project will be the potential impacts on already-weakened states of such climate change-related phenomena as, but not limited to, (i) sea level rise, (ii) extreme weather events, (iii) the spread of infectious diseases; (d) what does the government project will be the extent of the effects climate impacts could have on already-weakened states, including, but not limited to, (i) expanded ungoverned spaces, (ii) further weakened and failed states, (iii) increased conflicts, (iv) increased migrations; (e) what does the government project will be the impact of the effects identified in (d) on Canada’s national security; (f) which nations does the government project will be most affected by climate change, (i) what is the government’s assessment of each such country’s capacity to adapt or cope, (ii) what, if any, action is Canada taking to strengthen the capacity of weak governments to better cope with societal needs projected to arise as a result of climate change-related impacts, (iii) what is the government’s assessment of possible security risks if Canada does contribute to international efforts related to (f)(i) and (f)(ii); (g) has DND or the Canadian military conducted any studies of how climate change can have a multiplier effect on instability in unstable regions of the world and, if so, what were these studies and their results; (h) what are the studies, along with their dates and results, undertaken by the government concerning the possible national security risks of climate change, and what specific observations were included in these studies concerning the impacts the research might have for government efforts pertaining to, but not limited to, (i) the encouragement of regional cooperation, (ii) the improvement of international confidence, (iii) the improvement of public relations; (i) what, if any, departments have participated in an inter-departmental process to develop a policy to reduce national security risks resulting from climate change and (i) if departments have participated in such a process, have all agencies involved with climate science, treaty negotiations, economic policy, and national security been involved in the process, and what were the results, (ii) if departments have not participated in such a process, why not; (j) what, if any, strategies has the government developed, including the dates of each completed strategy, concerning the integration of the national security consequences of climate change into national security and national defence strategies, and if the government has developed such strategies, (i) do the strategies examine the capabilities of the Canadian military to respond to the consequences of climate change, (ii) do the strategies include guidance to military planners to assess climate change risks on future missions, (iii) do the strategies provide guidance for updating defence plans based on new assessments; (k) for each strategy identified in (j), what are (i) the details of any testing of the strategy that has been conducted, (ii) the details of the implementation of the strategy, including, but not limited to, working with allies and partners to incorporate climate mitigation strategies, capacity building, and relevant research and development; (l) what are the government’s plans as concerns its engagement in global partnerships intended to help less developed nations build the capacity and resiliency to better manage climate impacts; and (m) what, if any, conferences has DND undertaken with respect to climate change and national security, if no such conferences have been undertaken, why not, and, if any such conferences have been undertaken, (i) who participated, (ii) what topics were covered, (iii) what findings were made, (iv) what recommendations were made, (v) what follow-up has occurred?
Q-1402 — September 19, 2011 — Ms. Duncan (Etobicoke North) — With respect to development of the oil sands, its impacts on the environment and surrounding communities, and the economic effects of these impacts: (a) what, if any, steps has the government taken to establish air emission limits or air quality standards to achieve the World Health Organization’s Air Quality Guidelines to protect air quality and human health; (b) what, if any, steps has the government’s sector-by-sector approach taken to regulate carbon emissions in the oil sands to ensure the oil sands industry makes appropriate reductions in its greenhouse gas (GHG) emissions to contribute to Canada’s GHG emission reduction goal of 17% below the 2005 level; (c) what, if any, studies has the government undertaken to examine the effect of the oil sands expansion on (i) GHG emissions, (ii) Canada’s ability to meet its GHG emission reduction goals, (iii) Canada’s contribution to the goal of staying below a 2°C increase in global average surface temperature, relative to the pre-industrial level, as articulated at the G8 meeting in L’Aquila, Italy and at the United Nations Framework Convention on Climate Change negotiations through the Copenhagen Accord in December 2009 and the Cancun Agreements in December 2010, (iv) the full suite of sustainability criteria, including environmental, economic and social sustainability, and (v) what were the results of any studies identified in (c)(i), (c)(ii), (c)(iii), and (c)(iv); (d) what, if any, studies has the government undertaken to examine (i) the scope of oil sands expansion if the oil sands sector is not required to deliver its proportional share of GHG reductions, (ii) the impacts such a decision would have on other sectors’ allowable GHG emissions, (iii) whether other sectors of the Canadian economy would have to do more than their proportional share to reduce emissions, (iv) what were the results of any studies identified in (d)(i), (d)(ii), and (d)(iii); (e) what, if any, studies has the government undertaken to assess safety, risks and effectiveness of carbon capture and storage (CCS) and what were the results of any identified study; (f) what, if any, studies, has the government undertaken to assess safety, risks and effectiveness of enhanced oil recovery and what were the results of any identified study; (g) what, if any, studies has the government undertaken to examine the possible impact of CCS technology on GHG emissions in the oil sands, (i) what are the government’s projections for the level of reductions that is feasible with CCS, (ii) what are the government’s projections for how CCS technology would impact oil sands emissions by 2020 and by 2050, (iii) does the government project that an oil sands industry equipped with CCS technology would be able to meet the specific reductions targets established by the government for 2020 and 2050; (h) how does the government plan to address emissions that cannot be reduced by CCS, such as (i) emissions from smaller in situ projects, (ii) mine fleet emissions, (iii) tailings fugitives; (i) what, if any, steps has the government taken to set an economy-wide price on carbon, rather than a sector-by-sector regulatory approach, as a means to reducing GHG emissions from the oil sands; (j) what, if any, steps has the government taken to adopt regulations to require all new oil sands facilities that began operations in 2010 or later to implement full-scale CCS by 2015, and will projects for which CCS is not an option still be approved by the government, whenever such approval is required for the project to proceed; (k) what, if any, steps has the government taken to quantify and eliminate air and water pollution discharge from tailings ponds by 2020 through Section 36(3) of the Fisheries Act (i) by identifying substances associated with tailings ponds as toxic under the Canadian Environmental Protection Act (CEPA), and (ii) what would be the projected impacts on the environment, human health, industry, and migratory birds of such legislative measures; (l) what, if any steps has the government taken to implement its phase ll monitoring plan (i) when will data collection of begin, (ii) when will data be available for inclusion in decision-making processes, (iii) will monitoring programs be reformed in advance of any new oil sands expansion; (m) what steps is the government taking to ensure sufficient capacity exists to (i) implement the Northwest Territories Water Strategy, (ii) help reform water monitoring in the Mackenzie River Basin; (n) what, if any, steps has the government taken to develop a federal emergency response plan to strengthen the Mackenzie River Basin Transboundary Waters Master Agreement in case of a failure of a tailings lake dyke; (o) are Mackenzie River Basin residents in particular and Canadians in general financially protected from a major industrial accident such as the failure of a tailings dyke and, (i) if so, why are both groups protected, (ii) if not, why, and does the government plan to implement measures to ensure these groups are protected; (p) what, if any, studies has the government undertaken to identify critical habitats for woodland caribou in north-eastern Alberta, and what were the conclusions of each study, including the results of consultations with First Nations on conservation of woodland caribou; (q) what, if any, studies has the government undertaken to determine the level of oil sands development that is consistent with caribou conservation in Alberta; and (r) does the government plan (i) to conduct a comprehensive health study of the impacts of oil sands development on surrounding communities, (ii) to identify and implement measures to reduce any health impacts discovered in such a study?
Q-372 — June 15, 2011 — Ms. Duncan (Etobicoke North) — With respect to the statements by the Honourable Jim Prentice, Minister of the Environment, entitled “Canada’s Green Budget 2009” and “Minister Prentice Highlights the Environment in 2010 Budget”: (a) how many applications were submitted under the 2009 $1 billion investment in clean energy research, development and demonstration projects, and, for each project identified, (i) who was the applicant and in what sector does the applicant work, (ii) what was the amount of funding requested, (iii) what were the projected outcomes, (iv) what was the projected return on investment; (b) what, in detail, are all of the clean energy research development and demonstration projects awarded funds through the 2009 $1 billion investment, and, for each project identified, (i) who was the recipient of the funds and in what sector does the recipient work, (ii) what was the amount of funding requested, (iii) what was the amount of funding awarded, (iv) what were the projected outcomes, (v) what was the projected return on investment, (vi) has the project been started, is it in progress, or has it been completed, (vii) what, if any, findings, publications, contracts, etc., have resulted from the project, (viii) in what geographic area was the project located; (c) what monies of the 2009 $1 billion investment for clean energy research development and demonstration projects have been spent, (i) what monies remain available, (ii) what, if any, advertising did or does the government undertake to promote the program, (iii) what, if any, costs are associated with any advertising of the program; (d) how many project applications were submitted under the 2009 $1 billion Green Infrastructure Fund, and, for each project identified, (i) who was the applicant and in what sector does the applicant work, (ii) what was the amount of funding requested, (iii) what were the projected outcomes, (iv) what was the projected return on investment; (e) how many projects were awarded funding through the $1 billion Green Infrastructure Fund, and, for each project identified, (i) who was the recipient of the funds and in what sector does the recipient work, (ii) what was the amount of funding awarded, (iii) what were the projected outcomes in terms of reductions in emissions, waste, or other environmental payoffs, (iv) what was the projected return on investment, (v) has the project been started, is it in progress, or has it been completed, (vi) what, if any, findings, publications, contracts, or other significant results have been produced as a result of the project; (f) how many retrofits were undertaken under the 2009 $300 million eco-ENERGY Retrofit program, (i) what was the average cost of a retrofit, (ii) what was the average income of the family or individual undertaking a retrofit, (iii) what was the average household savings on energy, (iv) what was the average household savings in terms of money spent on energy annually, (v) what is the estimated savings to the environment each year, in terms of greenhouse gas emissions (GHGs); (g) what specific projects were undertaken to maintain federal laboratories for $250 million in 2009, (i) why did the government identify these projects as investments in the environment, (ii) what laboratories benefitted, and what was the investment per lab, (iii) what specific laboratories need maintenance or further maintenance; (h) what specific projects, by station, were undertaken or are being undertaken under the $85 million for key Arctic research stations, why did the government identify these projects as investments in the environment, and, for each project identified, (i) what was the investment, (ii) what is the life expectancy of the investment, (iii) is further work needed, (iv) what projects does the government know still require funding; (i) what progress has been made to date on the $2 million investment in a feasibility study for a world-class Arctic research station, (i) what was the mandate of the feasibility study, (ii) what was its start date, key milestones, and end date, (iii) what, if any, results are available; (j) what are all federal contaminated sites across Canada, and, for each contaminated site identified, (i) where specifically is the site located, (ii) has the site had an environmental assessment (iii) if so, what are the main contaminants at the site, what is the projected cost of remediation, (iv) if not, what is the projected cost of an environmental assessment and the time required for that assessment; (k) is there a priority list for addressing contaminated sites listed in (j), and if so, (i) in what order do the sites appear on that list, (ii) what methodology is used to establish priority, (iii) who undertakes any priority assessments, what are their expertise, and how are experts chosen; (l) how much of the $80.5 million set aside for assessment of federal contaminated sites has been spent to date and what, if any, monies are remaining, (i) how many assessments have been started, are in progress, or have been completed to date, (ii) what are the findings for any completed assessment in terms of the environmental contamination, any threats to human health, and the projected cost of remediation, (iii) how many jobs have been created to date; (m) how much of the $165 million set aside for remediation of federal contaminated sites has been spent to date and what, if any, monies are remaining, (i) what remediation projects are started, are in progress, or have been completed to date, (ii) what are the findings for any completed remediation in terms of reducing environmental contamination and any threats to human health, (iii) what is the cost or projected cost of all remediation projects identified in (m)(i), (iv) how many jobs have been created to date; (n) what specific national parks projects have been undertaken with the $75 million earmarked in 2009, and, for each project identified, (i) what is the park’s name, (ii) what is its location, (iii) what is the total investment, (iv) what is a description of the project; (o) what, if any, progress has the government made on its 2009 $10 million investment in annual reporting of key environmental indicators such as clean air, clean water and GHG emissions, (i) what system was in place for reporting each, (ii) what, if any, system is now in place, (iii) when will the government make use of improvements in data resulting from this investment in its reports; (p) what, if any, progress has the government made on its 2010 $18.4 million investment to enhance the tracking of environmental data through the Canadian Environmental Sustainability Indicators program, (i) what specific projects does the government plan to undertake with the money and, for each project identified, (ii) how much money will be spent, (iii) how will monies spent improve environmental reporting, (iv) when will the government use improvements in its reports; (q) what, if any, action has been taken on the 2010 $100 million Next Generation Renewable Power Initiative; (r) what, if any, consultation regarding environmental assessments has taken place with Aboriginal peoples in 2010, (i) identify all projects that affect Aboriginal communities, (ii) on which of the identified projects in (r)(i) have Aboriginal peoples been consulted to date; (s) how much of the $2.8 million earmarked for consultations with Aboriginal communities has been spent and how much is still available; (t) what are all contaminated Great Lake sites and where specifically is each site located, (i) what is a ranking of these contaminated sites, (ii) what is the method used to determine levels of contamination, (iii) what is the scale used to compare levels of contamination, (iv) what is the government’s definition of “most degraded”, (v) what are all “most degraded” sites, (vi) for each site identified in (t)(v), what is a description of the contamination and what is the cost of the remediation; and (u) what specifically is the $16 million ear-marked for to clean up the “most-degraded” Great Lakes sites, what monies have been spent to date, on what specific projects, and what is the projected return on investment in terms of the environment?
Q-122 — June 6, 2011 — Ms. Duncan (Etobicoke North) — With respect to chronic cerebrospinal venous insufficiency (CCSVI), the liberation treatment, and multiple sclerosis (MS): (a) what consensus documents have been published regarding the diagnosis and treatment of CCSVI, (i) by whom, (ii) on what dates, (iii) what were the recommendations, (iv) were they reviewed by the August 26, 2010, meeting of the CIHR in collaboration with the Multiple Sclerosis Society of Canada (MSSC); (b) why were Canadian members of the International Union of Phlebology (IUP), who were part of the consensus process regarding the diagnosis and treatment of CCSVI, not consulted during the August 26 meeting of the Canadian Institutes of Health Research (CIHR); (c) what are the details of any plan the government has or is developing to collect evidence regarding the diagnosis and treatment of CCSVI, for example, through clinical trials or the creation of a registry; (d) what percentage of surgical procedures in Canada have been double-blind tested over the last 40 years and, for this percentage, (i) what is the risk of complication, (ii) what is considered an acceptable risk of complication, (iii) how do physicians judge acceptable risk and convey this risk to their patients, (iv) what actions do physicians take to reduce risk if the patient chooses to undertake the procedure; (e) when a medical treatment appears to be potentially effective, is its approval ever fast-tracked by the relevant Canadian authorities and, if so, (i) what are any examples of this in Canada over the last five years, (ii) has this ever happened with respect to MS, (iii) if so, who advocated for a fast-tracking and when, (iv) what process was followed to allow the treatment, (v) who made the decision to proceed, (vi) why was fast-tracking deemed necessary, (vii) what were the known risks at the time of the request, (viii) what, if any, negative impacts resulted; (f) what are the reasons for the length of time it has taken the relevant Canadian authorities to implement clinical trials or to develop a registry; (g) why did no member of the August 26 group declare any conflicts of interest, either real or perceived; (h) how many liberation procedures did the August 26 group estimate have been undertaken, (i) which countries were undertaking the procedure, (ii) to which countries were Canadians travelling, (iii) were the practitioners considered to be sufficiently trained, (iv) were the procedures in these countries found to be safe; (i) which people, labs and operating theatres had undertaken the diagnosis or treatment of CCSVI in Canada prior to the August 26 meeting; (j) why did the August 26 meeting not include Canadian experts in the imaging or treatment of CCSVI and for what reasons was Dr. Sandy McDonald not included as a participant; (k) why did the August 26 meeting not include international experts in diagnosis and treatment of CCSVI, data presented at international scientific conferences or site visits to labs and operating theatres, which were or had been undertaking diagnosis or treatment; (l) what is a comprehensive explanation of why the inclusion of CCSVI and liberation experts might have biased the sample of the August 26 group and whether such selection is an established practice at all CIHR meetings; (m) what are all the names of the group members who had spoken out against diagnosis or treatment of CCSVI or the liberation procedure prior to the August 26 meeting, what were the details of their positions, and what are their publically-available comments on the matter; (n) who were all the members of the August 26 group and, for each member, what were his or her stated or declared conflicts of interest or perceived conflicts of interest; (o) what was the August 26 group’s assessment of and comments concerning all reviewed published papers, including both positive and negative observations; (p) did the August 26 group find it unusual that two of the reviewed papers had been accepted for publication in only six weeks, (i) did the group review whether this is a common practice in medicine, (ii) did the group consider how and why this might happen, (iii) did the group explore the expertise of those writing the papers, their experience, how their results compared with those of Dr.Zamboni and, if so, (iv) what were the group’s findings for questions posed in (iii); (q) which neurologists, present at the August 26 meeting, had followed MS patients who were diagnosed with CCSVI and who had been treated for the condition, (i) how had neurologists followed them (e.g., appointment, EDSS score/another scale, MRI, neurological exam, etc.), (ii) what, if any, evidence did they present of patients’ progress following the liberation procedure; (r) did the August 26 group find the reversal in the MSSC’s position, who was part of the greater group, unusual, (i) did the group investigate or consider the reasons for this change in position and, if so, (ii) what observations did it make or conclusions did it come to regarding the reversal; (s) did the August 26 group estimate how its decision might impact Canadian MS patients, including (i) impacts on their mental health and how this might impact their disease, (ii) the number of Canadian MS patients who might feel forced to seek help outside Canada, (iii) how air travel, a compromised vascular system, recent surgery, and lack of follow-up in Canada might impact their disease and, if so, (iv) what are the results of those estimations; (t) what consensus documents are forthcoming, (i) by whom, (ii) when will they be published; (u) what is the work plan for the new expert working group which met for the first time on November 23, 2010, (i) who are the panellists, what are their qualifications and what is their expertise in diagnosis and treatment of CCSVI, (ii) how were the panellists chosen and by whom, (iii) what is the group’s mandate and how was it derived, (iv) what is the schedule of meetings, (v) what is the timeline for the group’s work, (vi) what evidence will be reviewed to reach any decision about possible clinical trials, registry, diagnosis, treatment, follow-up care, etc.; (v) what was the agenda for the November 23 meeting of the expert working group, (i) what abstracts, documents, and presentations were reviewed, (ii) which Canadian and international experts, with experience in diagnosis and treatment of CCSVI, were consulted, (iii) what Canadian and international unpublished data were explored, (iv) what Canadian and international labs or operating theatres were reviewed and visited; (w) for what reasons is the new group going to analyze interim and final results from seven studies funded by the Canadian and US MS Societies and why are these studies considered more worthwhile cases for analysis than other studies already completed; (x) when will the November 23 expert panel declare and post any conflicts of interest, following the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) guide, on the CIHR website to eliminate the possibility of real or perceived conflicts; and (y) further to assurances made by the President of CIHR, Dr. Alain Beaudet, to the Subcommittee on Neurological Diseases on December 7, 2010, that MS patients who have had the liberation procedure would have follow-up, what are the details of how that follow-up will occur, specifically, (i) how will “a message be sent”, by whom, to whom, by when and what will the message be, (ii) specifically, will all patients who travel or travelled outside Canada be assured that their doctors will see them, that appointments will not be cancelled, that tests will not be cancelled, that they will have access to recommended prescriptions, that they will not lose their long-term care and that they will not be berated for making the decision to have liberation, (iii) how will this be enforced, (iv) what action should MS patients take if they are denied care, (v) to whom should they report a denial of care, (vi) what are the consequences for a physician or health practitioner or organization who delivers care but fails to provide follow-up care, (vii) will follow-up include ultrasound or MRI to image the veins of MS patients and, if so, how often will these imaging procedures occur and who will pay for them?
Q-112 — June 6, 2011 — Ms. Duncan (Etobicoke North) — With respect to depleted uranium (DU), military service, and Veterans Affairs Canada (VAC) benefits and programs: (a) what are all potential sources of DU to which Canadian Forces (CF) members and veterans might have been exposed between 1990 and the present; (b) what are any operations between 1990 and the present that might have brought CF members and veterans into direct or close contact with DU, including, but not limited to, operations in which Canadian personnel seconded to other military forces were involved; (c) did any CF member or veteran serve between 1999 and 2003 in areas assessed by the United Nations Environment Programme (UNEP) to be DU areas; (d) what, if any, DU munitions, vehicles made with DU, or ships carrying DU munitions, were used by CF between 1990 and the present; (e) what are all possible exposure routes for each source of DU identified in (a), (b), and (d); (f) what, if any, field measurements were taken around any DU source identified in (a), (b), and (d) and, if such measurements were taken, what was the level of contamination of the environment for each site, for each time sampled; (g) what, if any, studies were undertaken by the Department of National Defence (DND), or any other federal government department or crown corporation, from 1990 to the present, regarding DU environmental contamination linked to the military and what were the chief findings of each such report, including (i) whether it identified a need or made a recommendation to work with caution in DU contaminated areas, (ii) whether it identified a need or made a recommendation to do policy work regarding DU contaminated areas; (h) what follow-up took place concerning the chief recommendations of each report identified in (g), as well as concerning the issues identified in each of (g)(i) and (g)(ii); (i) what, if any, clean-up operations were undertaken in impact zones between 1990 and the present, and, if such operations were undertaken, why was each clean-up operation deemed necessary, and what national or international recommendations were followed in each clean-up; (j) which, if any, experts were consulted to determine any possible DU contamination between 1990 and the present, and, if experts were consulted, who were they, and in what field or fields did each expert work; (k) what, if any, specific training, equipment and guidance was given to CF members and veterans who were required to work in areas of DU contamination or to conduct any DU field assessments and clean-ups; (l) what, if any, specific radiation field measurement and health and safety equipment was provided to CF members and veterans, including equipment used to determine the presence of DU, and what specific training was provided concerning the use of any such equipment; (m) what, if any, training, equipment and guidance was given to CF members and veterans concerning the handling of both intact and damaged weapons previously used to fire DU munitions; (n) from 1990 to the present (i) what was the CF’s policy regarding transportation, use, exposure, risk mitigation, and testing of DU from 1990 to the present, (ii) how did or does the policy comply with all relevant guidelines and regulations for the protection of the environment and personnel, including, but not limited to, those established in the Canada Labour Code, by the Canadian Nuclear Safety Commission, and through the Workplace Hazardous Materials Information System, (iii) were the guidelines and regulations identified in (ii) followed during CF operations abroad, (iv) how was the policy elaborated in (n)(i), enforced during CF activities both in Canada and abroad; (o) is there a protocol accepted by the government for urine testing for DU and what are its details, including, but not limited to, (i) who should be screened, (ii) following what exposures should screening occur, (iii) which laboratories were or are used for the screening, (iv) what criteria have been used to select the laboratory that conducts the screening and how can quality assurance in screening processes and results be ensured, (v) the maximum acceptable delay between DU exposure to initial screening, (vi) the screening method and how that method was chosen, (vii) the screening schedule, (viii) any follow-up mechanisms, (ix) how screening is documented, (x) when this protocol was accepted; (p) what, if any, screening procedure exists for potential DU exposure for CF members and veterans, including, but not limited to, (i) an exposure questionnaire, (ii) a 24-hour urine collection test, (iii) a detailed physical exam, (iv) clinical tests of organ systems function; (q) what, if any, DU follow-up program or similar program intended to screen and monitor health problems associated with DU exposure is available to CF members and veterans; (r) what, if any, CF members or veterans have been identified and tracked following potential exposure to DU through situations related to (a), (b) and (d), and what was involved in the tracking procedures, specifying whether the tracking included (i) urinary uranium determinations, (ii) clinical laboratory values, (iii) psychiatric and neuro-cognitive assessments, (iv) other forms of tracking; (s) what, if any, summary statistics are now available for cases identified in (r); (t) what, if any, CF members or veterans have been identified and tracked following exposure to (i) vehicles hit with friendly fire, (ii) burning vehicles, (iii) fires involving DU munitions, (iv) the inspection or salvaging of damaged vehicles; (u) what, if any, information is given to CF members or veterans who might have been exposed to harmful DU conditions, and, specifically, how is this information relayed; (v) can CF members or veterans who might have been exposed to harmful DU conditions ask to be screened for DU exposure, if not, why not, and, if so, (i) what procedure do they follow, (ii) who does the testing, (iii) what is the cost of the testing; (w) what are the potential health effects from (i) external exposure to DU, for both low and high dosages, in both the short term and the long term, and (ii) internal exposure to DU, for both low and high dosages, in both the short term and the long term; (x) what, if any, CF members or veterans have applied for compensation associated with DU exposure during military service, specifying (i) the number of requests, (ii) whether compensation was awarded, (iii) whether compensation is pending, (iv) whether compensation is in appeal, (v) how many appeals have been made; (y) have any of DND’s medical or surgical members ever identified a possible link between a CF member’s service or a veteran’s service, exposure to DU, and particular health effects, and, if so, (i) how many times has such a possible link been made by DND’s medical or surgical members, (ii) what follow-up occurred as a result of any identified possible linkages; and (z) does the government have plans to convene a working group to review the latest research on hazardous materials exposure, including, but not limited to, exposure to DU, and possible health effects and, if so, (i) what is the planned scope of the review, (ii) who is to convene the working group, (iii) how are experts to be chosen, (iv) how are conflicts of interest to be avoided and declared, (vi) what is the timeline for the review and the review’s milestones?
Q-102 — June 6, 2011 — Ms. Duncan (Etobicoke North) — With respect to the full process currently being undertaken by the Canadian Institutes of Health Research (CIHR) regarding chronic cerebrospinal venous insufficiency (CCSVI), including the August 26, 2010, meeting of the Scientific Expert Working Group (SEWG) and the CIHR’s “knowledge synthesis review”: (a) what is the accepted operating definition of “conflict of interest” for the CIHR, (i) why was no disclosure statement made by all participants who attended the August 26, 2010, joint meeting of the CIHR and the Multiple Sclerosis Society of Canada (MSSC), (ii) are there plans to provide an opportunity to declare possible conflicts of interest subsequent to the meeting; (b) what are the details of all information produced and circulated by the CIHR in January 2011 regarding follow-up care for multiple sclerosis (MS) patients and to which organizations was the information sent; (c) will the disclosure statement to be signed by members of the SEWG at its next meeting in June 2011 include specific reference to any (i) consultancy, (ii) grant support, (iii) membership on advisory councils, (iv) speaker’s bureau, (v) other sources of funding a member might have; (d) how does the CIHR plan to ensure that all members of the SEWG have the same understanding of private or personal interests that could influence decision-making; (e) will all disclosure statements in (c) be made publicly available and, if so, when, and, if not, why not; (f) which, if any, of the SEWG’s members have been trained in Dr. Zamboni’s methods and by whom were these members trained; (g) which, if any, of the SEWG’s members have watched diagnosis and treatment of CCSVI and, for each member identified (i) where did this observation take place, (ii) under what guidance, (iii) how many images and treatments were studied by the member; (h) which, if any, of the SEWG’s members have undertaken diagnosis and treatment of CCSVI and, for each member identified, (i) where were these actions performed, (ii) under what guidance, (iii) how many images and treatments were performed by the member; (i) does the CIHR recognize the emerging scientific discipline of neurovascular disease; (j) does the SEWG include any members of the International Society for NeuroVascular Disease (ISNVD) and, if so, who are these members, and, if not, why not; (k) which, if any, members of the SEWG have attended any of the ISNVD’s conferences, specifying for each such member the conferences that he or she attended; (l) does the inclusion of investigators of the seven MS Society-funded studies in the SEWG comply with the CIHR’s operating definition of “conflict of interest” and, if so, what are the reasons that explain this compliance; (m) regarding the “knowledge synthesis review”, (i) what is the protocol for the review, (ii) how is research deemed to be, or not to be, pertinent, (iii) who specifically is undertaking the review, how were they chosen, and what expertise do they have to undertake the review, (iv) why has the CIHR decided to have them undertake the review, (v) what are the CIHR’s reasons for not having the SEWG undertake the review, (vi) what is the cost of the review, (vii) what is a comprehensive list of abstracts to be reviewed, (viii) what additional material, people, or other sources will be consulted, (ix) will the review include scientific evidence presented at all the major scientific conferences on CCSVI to date, namely, Hamilton (February 2010), New York (July 2010), Washington (October 2010), Katowice (March 2011), Bologna (March 2011), Chicago (April 2011), and San Diego (May 2011), (x) will the review include contacting the leading experts in the field, asking for their unpublished data, visiting their laboratories and operating theatres, (xi) if the answer to (m)(x) is in the affirmative, what, if any, protocol has been established for each contact, and what, if any, weighting will be applied to this evidence; (n) how does the CIHR plan to weigh or asses the seven MS Society-funded studies and the “knowledge synthesis review” in its establishment of any future policy, particularly in its deliberations on whether to undertake clinical trials for CCSVI in Canada; (o) which , if any, members of the SEWG have attended any CCSVI conferences, specifying for each such member (i) what conferences he or she attended, (ii) in what capacity, (iii) who paid for the trip or attendance at the conference, (iv) what written evidence did he or she report to either the CIHR or SEWG, (v) if no written evidence was reported, why not; (p) which members of the CIHR have attended any CCSVI conferences, specifying for each such member (i) what conferences he or she attended, (ii) in what capacity, (iii) who paid for the trip or attendance at the conference, (iv) what written evidence he/she reported to either the CIHR or SEWG, (v) if no written evidence was reported, why not; (q) why has the CIHR decided not to further investigate CCSVI through clinical trials; (r) why has the CIHR decided not to follow recommendations made by the Ontario Association of Neurologists, the Canadian Society of Radiologists, the Canadian Society of Vascular Surgery, the American Society of Interventional Radiology, and the International Union of Phlebology regarding CCSVI; (s) what does the CIHR consider an “appropriate pace”, a term used in its May 18, 2011, e-mail to Dr. Kirsty Duncan, Member of Parliament for Etobicoke North, for the introduction to Canada of any potential new medical treatment for any medical condition, and how much evidence does the CIHR consider is required before a treatment should undergo clinical trials in Canada in terms of (i) the number of procedures undertaken, (ii) the number of countries undertaking the procedure, (iii) scientific evidence presented in academic peer-reviewed journals, (iv) scientific evidence presented at academic conferences, (v) scientific evidence presented at academic conferences for conditions that are progressive diseases, especially progressive diseases for which there are limited or no options for treatment; (t) what is the CIHR’s accepted protocol, including all necessary steps, for bringing a new treatment to clinical trials in Canada, (i) when was the protocol established, (ii) what treatments have undergone clinical trials as a result of the protocol, (iii) which treatments have been rejected to date; (u) is the creation of a SEWG a standard step in the CIHR’s protocol for bringing a new treatment to clinical trials in Canada, and, (i) if so, since the creation of the protocol, what are all new treatments and their associated SEWGs, (ii) if not, why was this step deemed necessary for approval of clinical trials for CCSVI; (v) what are the last five medical treatments for any medical condition accepted by the CIHR for use in Canada and, for each treatment, what are the details of all evidence required by the CIHR in its decision to have the treatment undergo clinical trials, including, but not limited to, the number of procedures undertaken, the countries undertaking the procedure, and scientific evidence presented in both peer-reviewed journals and academic conferences; and (w) with regard to the MS registry announced March 23, 2011, (i) who specifically is collecting the information, (ii) what precise information is being collected, (iii) what consent will be necessary from patients for any data collection, (iv) when will information begin to be collected, (v) what specific information is being collected regarding the treatment of CCSVI, (vi) what information is being gathered or tracking is being done of individuals who have chosen to have the liberation procedure outside Canada?
Q-9512 — February 7, 2011 — Ms. Duncan (Etobicoke North) — With respect to chronic cerebrospinal venous insufficiency (CCSVI), the liberation treatment, and multiple sclerosis (MS): (a) what consensus documents have been published regarding the diagnosis and treatment of CCSVI, (i) by whom, (ii) on what dates, (iii) what were the recommendations, (iv) were they reviewed by the August 26, 2010, meeting of the Canadian Institutes of Health Research (CIHR) in collaboration with the Multiple Sclerosis Society of Canada (MSSC); (b) why were Canadian members of the International Union of Phlebology (IUP), who were part of the Consensus process regarding the diagnosis and treatment of CCSVI, not consulted during the August 26 meeting of the Canadian Institutes of Health Research (CIHR); (c) what are the details of any plan the government has or is developing to collect evidence regarding the diagnosis and treatment of CCSVI, for example, through clinical trials or the creation of a registry; (d) what percentage of surgical procedures in Canada have been double-blind tested over the last 40 years and, for this percentage, (i) what is the risk of complication, (ii) what is considered an acceptable risk of complication, (iii) how do physicians judge acceptable risk and convey this risk to their patients, (iv) what actions do physicians take to reduce risk if the patient chooses to undertake the procedure; (e) when a medical treatment appears to be potentially effective, is its approval ever fast-tracked by the relevant Canadian authorities and, if so, (i) what are any examples of this in Canada over the last five years, (ii) has this ever happened with respect to MS, (iii) if so, who advocated for a fast-tracking and when, (iv) what process was followed to allow the treatment, (v) who made the decision to proceed, (vi) why was fast-tracking deemed necessary, (vii) what were the known risks at the time of the request, (viii) what, if any, negative impacts resulted; (f) what are the reasons for the length of time it has taken the relevant Canadian authorities to implement clinical trials or to develop a registry; (g) why did no member of the August 26 group declare any conflicts of interest, either real or perceived; (h) how many liberation procedures did the August 26 group estimate have been undertaken, (i) which countries were undertaking the procedure, (ii) to which countries were Canadians travelling, (iii) were the practitioners considered to be sufficiently trained, (iv) were the procedures in these countries found to be safe; (i) which people, labs and operating theatres had undertaken the diagnosis or treatment of CCSVI in Canada prior to the August 26 meeting; (j) why did the August 26 meeting not include Canadian experts in the imaging or treatment of CCSVI and for what reasons was Dr. Sandy McDonald not included as a participant; (k) why did the August 26 meeting not include international experts in diagnosis and treatment of CCSVI, data presented at international scientific conferences or site visits to labs and operating theatres, which were or had been undertaking diagnosis or treatment; (l) what is a comprehensive explanation of why the inclusion of CCSVI and liberation experts might have biased the sample of the August 26 group and whether such selection is an established practice at all CIHR meetings; (m) what are all the names of the group members who had spoken out against diagnosis or treatment of CCSVI or the liberation procedure prior to the August 26 meeting, what were the details of their positions, and what are their publically-available comments on the matter; (n) who were all the members of the August 26 group and, for each member, what were his or her stated or declared conflicts of interest or perceived conflicts of interest; (o) what was the August 26 group’s assessment of and comments concerning all reviewed published papers, including both positive and negative observations; (p) did the August 26 group find it unusual that two of the reviewed papers had been accepted for publication in only six weeks, (i) did the group review whether this is a common practice in medicine, (ii) did the group consider how and why this might happen, (iii) did the group explore the expertise of those writing the papers, their experience, how their results compared with those of Dr.Zamboni and, if so, (iv) what were the group’s findings for questions posed in (iii); (q) which neurologists, present at the August 26 meeting, had followed MS patients who were diagnosed with CCSVI and who had been treated for the condition, (i) how had neurologists followed them (e.g., appointment, EDSS score/another scale, MRI, neurological exam, etc.), (ii) what, if any, evidence did they present of patients’ progress following the liberation procedure; (r) did the August 26 group find the reversal in the MSSC’s position, who was part of the greater group, unusual, (i) did the group investigate or consider the reasons for this change in position and, if so, (ii) what observations did it make or conclusions did it come to regarding the reversal; (s) did the August 26 group estimate how its decision might impact Canadian MS patients, including (i) impacts on their mental health and how this might impact their disease, (ii) the number of Canadian MS patients who might feel forced to seek help outside Canada, (iii) how air travel, a compromised vascular system, recent surgery, and lack of follow-up in Canada might impact their disease and, if so, (iv) what are the results of those estimations; (t) what consensus documents are forthcoming, (i) by whom, (ii) when will they be published; (u) what is the work plan for the new expert working group which met for the first time on November 23, 2010, (i) who are the panellists, what are their qualifications and what is their expertise in diagnosis and treatment of CCSVI, (ii) how were the panellists chosen and by whom, (iii) what is the group’s mandate and how was it derived, (iv) what is the schedule of meetings, (v) what is the timeline for the group’s work, (vi) what evidence will be reviewed to reach any decision about possible clinical trials, registry, diagnosis, treatment, follow-up care, etc.; (v) what was the agenda for the November 23 meeting of the expert working group, (i) what abstracts, documents, and presentations were reviewed, (ii) which Canadian and international experts, with experience in diagnosis and treatment of CCSVI, were consulted, (iii) what Canadian and international unpublished data were explored, (iv) what Canadian and international labs or operating theatres were reviewed and visited; (w) for what reasons is the new group going to analyze interim and final results from seven studies funded by the Canadian and US MS Societies and why are these studies considered more worthwhile cases for analysis than other studies already completed; (x) when will the November 23 expert panel declare and post any conflicts of interest, following the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) guide, on the CIHR website to eliminate the possibility of real or perceived conflicts; (y) further to assurances made by the President of CIHR, Dr. Alain Beaudet, to the Subcommittee on Neurological Diseases on December 7, 2010, that MS patients who have had the liberation procedure would have follow-up, what are the details of how that follow-up will occur, specifically, (i) how will “a message be sent”, by whom, to whom, by when and what will the message be, (ii) specifically, will all patients who travel or travelled outside Canada be assured that their doctors will see them, that appointments will not be cancelled, that tests will not be cancelled, that they will have access to recommended prescriptions, that they will not lose their long-term care and that they will not be berated for making the decision to have liberation, (iii) how will this be enforced, (iv) what action should MS patients take if they are denied care, (v) to whom should they report a denial of care, (vi) what are the consequences for a physician or health practitioner or organization who delivers care but fails to provide follow-up care, (vii) will follow-up include ultrasound or MRI to image the veins of MS patients and, if so, how often will these imaging procedures occur and who will pay for them?
Q-9222 — February 3, 2011 — Ms. Duncan (Etobicoke North) — With respect to Canadian Forces (CF) members, reservists, and veterans and Alzheimer’s disease and related dementias (ADRD), multiple sclerosis (MS), Parkinson’s disease (PD), and acquired brain injury (ABI): (a) what, if any, research examines a possible relationship between military service and (i) ADRD, (ii) MS, (iii) PD, (iv) ABI and, if so, (v) what is the summary of research findings related to each of (i), (ii), (iii), (iv) and any of their recommendations and, if not, (vi) why not; (b) what, if any, research examines a possible relationship between operational stress injuries (OSIs), particularly post-traumatic stress disorder (PTSD), and ADRD and, if so, what are the findings; c) what, if any, research examines a possible relationship between OSIs, particularly PTSD, and initiation of MS or exacerbation of MS and, if so, what are the findings; (d) what, if any, research examines a possible relationship between military environmental exposures and (i) ADRD, (ii) PD; (e) what, if any, research examines a possible relationship between ABI and PTSD and between ABI and ADRD; (f) what are the Department of National Defence’s (DND) policies with respect to a CF member’s or reservist’s diagnosis for each of the four identified conditions, specifically what a diagnosis means in terms of (i) current employment, (ii) opportunity for advancement, (iii) honourable discharge, (iv) presumptive illness, (v) pension, (vi) benefits; (g) what happens when someone in the CF or the reserves is diagnosed with each of the four conditions; (h) what are Veterans Affairs Canada’s (VAC) policies with respect to a veteran’s diagnosis for each of the four identified conditions, specifically what a diagnosis means in terms of (i) any employment, (ii) opportunity for advancement, (iii) presumptive illness, (iv) pension, (v) benefits; (i) what are the benefits for which a CF member and reservist with (i) ADRD, (ii) MS, (iii) PD, (iv) ABI is eligible; (j) how are benefits in (i) calculated and for what services and therapies, including but not limited to, aids and maintenance of the aids, disease modifying therapies, medical equipment, medical exams, occupational therapy, physical therapy, etc., are members and reservists eligible; (k) how do benefits for ADRD, MS, and PD differ from those available to members of the CF and reservists who suffer from a physical injury or an OSI; (l) what are the benefits for which a veteran with (i) ADRD, (ii) MS, (iii) PD, (iv) ABI is eligible; (m) how are benefits in (l) calculated and for what services and therapies, including but not limited to, aids and maintenance of aids, disease modifying therapies, medical equipment, medical exams, occupational therapy, physical therapy, etc., are veterans eligible; (n) what, if any, studies of international efforts have been undertaken by DND and VAC regarding military service and each of ADRD, MS, PD, and ABI and, (i) if so, specify what studies, the chief findings, and any recommendations and, (ii) if not, why not; (o) how many members currently serving in the CF and reserves have received a diagnosis of ADRD, MS, PD, or ABI and how many veterans suffer from each of the identified conditions; (p) of the cases identified in (o), (i) how many have been awarded a service-related disability, (ii) what specific criteria were required to award a service-related disability, (iii) how was “benefit of the doubt” ensured and what was the framework followed to ensure reliability and validity, (iv) how many were denied a service-related disability, (v) how many people are appealing a decision; (q) how many CF members and reservists with (i) ADRD, (ii) MS, (iii) PD, (iv) ABI were required to leave the military during the last 5 years, 10 years and 20 years; (r) of those CF members and reservists in (q), what was the average time from diagnosis to honourable discharge, what opportunities might have existed for members and reservists to keep working but in an altered capacity, were opportunities explored, why or why not, and what was the average impact on pension and benefits; (s) what, if any, tracking was undertaken of the member’s or reservist’s (i) disease progression, (ii) work status, (iii) family life, (iv) mental health, etc., (v) what recommendations, if any, have been made or could be made to improve the quality of life of former military personnel; (t) how are each of ADRD, MS, PD, and ABI tracked among (i) CF members, (ii) reservists, (iii) veterans; and (u) what long-term care is available, if necessary, for modern-day veterans suffering from each of the four identified conditions?
Q-8652 — January 31, 2011 — Ms. Duncan (Etobicoke North) — With respect to cuts in government funding to newcomer settlement organizations: (a) how does this policy reflect Canada’s commitment to cultural diversity; (b) what, if any, needs assessments of newcomers to Canada have been undertaken over the last five years, if none were undertaken, why not, and of those undertaken, (i) when were they undertaken, (ii) by whom, (iii) what were the results, (iv) what were the chief recommendations; (c) what was the detailed process undertaken to examine funding of newcomer settlement programs, which led to the government’s cuts; (d) over the past five years, how much money did the government promise to invest in newcomer settlement services, by province and territory, and what amount was actually invested in newcomer settlement services, by province and territory; (e) how was the decision to cut $53 million from newcomer settlement organizations made, (i) what were all the procedural steps in the decision-making process, (ii) what stakeholders were consulted, (iii) which departments were involved in the decision-making process, (iv) what formulas were used, (v) how was it determined that 85 percent of the cuts were necessary in Ontario; (f) what percentage of the Ontario cuts to newcomer settlement organizations were made in the Greater Toronto Area (GTA); (g) how many newcomers arrived in Canada in each of the last five years, (i) how many newcomers arrived in each of the provinces and territories, (ii) how many people settled in each of the provinces, (iii) how many people settled in each of Canada’s ten largest cities; (h) what information does the government have regarding the movement of newcomers from one province to another or from one city to another in the newcomers’ first three years after arrival in Canada; (i) from which countries did the newcomers arrive in each of the last five years and, for each country identified, (i) what are the official languages spoken, (ii) is English or French one of the country’s official languages; (j) what services are needed by newcomers to Canada and what services are provided by settlement organizations in Canada, by province and territory; (k) what, if any, research has been undertaken in Canada regarding gaps in services, by province and territory, and (i) when was the gap analysis undertaken and by whom, (ii) what were the results and recommendations, by province and territory, (iii) if no such analysis has been conducted, why not; (l) for each province and territory, (i) how many settlement organizations exist, (ii) what services do they provide, (iii) what populations do they serve, (iv) how many settlement organizations applied for federal funding, and (v) how many organizations that applied had their federal funding increased, decreased, or cut; (m) for each GTA constituency, (i) what percentage of constituency inhabitants are newcomers, (ii) what percentage of constituency inhabitants are not yet citizens, (iii) what percentage of constituency inhabitants are first generation Canadian born, (iv) how do percentages in (i) to (iii) rank nationally amongst the 308 ridings, (v) did any consituency’s settlement organizations receive an increase or a decrease in funding and, if so, in what amount; (n) for each group given in (m) (i) to (iii), what major challenges do they face, including, but not limited to, family reunification, and language and job barriers; (o) how were organizations informed of any funding decision, (i) what reasons were given for a denial, (ii) were complete contact details given so that an organization could ask for further feedback, (iii) if so, what were those details, (iv) if not, why not; (p) what programs in the GTA (i) had their funding decreased, (ii) had funding cut entirely, (iii) will have to close down; (q) for each identified program in (p) (i) to (iii), (i) what are the specific reasons for denial, (ii) is the program an essential or unique program; (r) which schools in the GTA provided newcomer services, including, but not limited to, “We Welcome the World Centres”, and which schools had their funding increased or decreased and by how much; (s) for each school identified in (r), what percentage of students are (i) newcomers, (ii) newcomers who do not speak English or French as their first language; (t) what, if any, research was undertaken to determine the impact of any decreases or cuts to funding for schools in (r) and what were the projected impacts on (i) student learning, (ii) student test scores, (iii) school performance in relation to other Ontario schools, (iv) socio-economic status of families, (v) tertiary education; (u) what, if any, plans have been developed to absorb the thousands of newcomer families who will be impacted by a loss of newcomer settlement services, by (i) province and territory, (ii) specifically, Canada’s ten largest cities; (v) is there an appeals process to funding-related decisions and (i) if yes, what is it, (ii) if not, why not; (w) what, if any, impact analysis was undertaken to determine the socio-economic impacts of cuts to newcomer settlement services on (i) clients, (ii) their families, and (iii) the economy of the GTA, and Canada, (iv) what were the results and recommendations of any analysis; and (x) by province and territory, as of January 1, 2011, (i) how many organizations had been informed of a funding decision, (ii) how many organizations were under review, (iii) how many were still waiting to hear about funding?
Q-8642 — January 31, 2011 — Ms. Duncan (Etobicoke North) — With respect to mental health and suicide in the Canadian Forces (CF), including regular forces, reservists and veterans, as well as among Royal Canadian Mounted Police (RCMP) veterans: (a) what does history and research show from the First World War (WWI) and the Second World War (WWII), regarding the percentage of Canadian veterans who suffered some degree of Post Traumatic Stress Disorder (PTSD) and how it might have impacted their ability to (i) hold down jobs, (ii) maintain relationships, (iii) overcome substance abuse, (iv) maintain their will to live; (b) how are suicides tracked for CF regular forces, reservists and veterans, including RCMP veterans, (i) has the tracking method changed over time (from 2000 onwards) for any of these groups, including name changes (e.g., suicide versus sudden death) and, if so, how, why and when, (ii) how are suicides tracked among veterans who may not be known to Veterans Affairs Canada (VAC) and who may be under other types of care (e.g., in hospitals) or in homeless shelters, prisons, etc.; (c) what are the identified gaps in tracking for each of the identified groups and, for each gap, what action items (i) are planned (including predicted start and completion dates, and necessary funding), (ii) are being implemented (including predicted completion date and necessary funding), (iii) have been completed to address the problem; (d) how are suicides investigated for each identified group today and, for each group, for the years 1990 to the present (or years available), (i) what percentage of victims were known to either the Department of National Defense (DND) or VAC prior to the suicide, or to the medical, social-aid or prison system, (ii) what percentage had attempted suicide before, (iii) what percentage suffered from an identified Operational Stress Injury (OSI), including PTSD, anxiety, depression or substance abuse, (iv) what percentage suffered from acquired brain injury (ABI), (v) what, if any, relation was found between the number of traumatic events and suicide, (vi) what percentage were under mental health care counselling, (vii) what percentage were under addictions counselling, (viii) what percentage had been discharged for misconduct, (ix) what percentage had called the crisis help line in the month before the suicide, (x) what percentage had seen their physician in the month before the suicide, (xi) in what percentage of deaths might it have been possible to intervene, (xii) what percentage had experience with any of the suicide education and awareness programs, and screening and assessment, (xiii) what percentage had had follow-up care for suicide attempts, (xiv) what percentage had had restriction of access to lethal means; (e) do DND and VAC try to determine the trigger for a suicide and, if so, (i) what are the broad triggers (e.g., financial problems, relationship breakdowns, substance abuse, tensions with other members of the unit, traumatic event, etc.), (ii) is trigger information included in suicide prevention programs, (iii) is it possible to identify how military service might have generally impacted the mental and physical health of the victim and, if so, is it possible to reduce these impacts; (f) what are the suicide statistics for each identified group, namely CF regular forces and reservists, and veterans, including RCMP veterans, for the last 10 years, 20 years and, if possible, back to 1972, (i) broken down by gender and by five-year age group, (ii) for each group, how does the data compare with that of the general Canadian population; (g) for five-year periods, for the years 1972 to present (or years available), for every CF suicide identified, how many members of the CF were hospitalized, on average, for attempting to take their own life; (h) for five-year periods, for the years 1972 to present (or years available), for every veteran suicide identified, how many veterans were hospitalized, on average, for attempting to take their own life; (i) for five-year periods, for the years 1972 to present (or years available), what is the number of CF regular forces, reservists and veterans who died in auto accidents, and how much more likely is it that members who serve in Afghanistan will die in an auto accident or motorcycle crash than civilians; (j) how do DND and VAC report accidental drug-related overdoses, and for five-year periods, for the years 1972 to present (or years available), what is the number of CF members, reservists or veterans who died of accidental drug-related overdoses; (k) what, if any, mental health surveys have been undertaken by DND, particularly regarding suicide, (i) for what years, (ii) how many members were surveyed, (iii) what were the survey questions, (iv) what percentage of Air Force, Army, and Navy members had attempted suicide; (l) what, if any, mental health surveys have been undertaken by VAC regarding suicide, (i) for what years, (ii) how many veterans were surveyed, (iii) what were the survey questions, (iv) what percentage of former Air Force, Army, Navy and RCMP members had attempted suicide; (m) what, if any, surveys of health-related behaviours have been undertaken by DND, (i) how many CF members and reservists were surveyed and for what years, (ii) what were the survey questions, (iii) what percentage of Air Force, Army and Navy personnel showed dangerous levels of alcohol and drug abuse, such as abuse of pain killers; (n) what, if any, surveys of health-related behaviours have been undertaken by VAC, (i) how many CF and RCMP veterans were surveyed and for what years, (ii) what were the survey questions, (iii) what percentage of former Air Force, Army, Navy and RCMP personnel showed dangerous levels of alcohol abuse and the illicit use of drugs such as pain killers; (o) what percentage of CF members and reservists today have suicidal thoughts before seeking treatment and what percent have attempted to kill themselves; (p) what percentage of veterans today have suicidal thoughts before seeking treatment, and what percent have attempted to kill themselves; (q) how do DND and VAC explain any changes in the suicide statistics among any of the above groups in (f), (i) what specific practical steps have been undertaken by both DND and VAC to reduce the number of suicides for each identified group, (ii) how is success of these steps measured, (iii) what, if any, change have the identified steps made in the number of suicides; (r) how has operational tempo and number of tours impacted OSIs, particularly PTSD, as well as addictions, anxiety, and depression, and suicides for the groups identified, (i) what does research show the impacts of increased operational tempo and number of tours are, (ii) what recommendations are suggested by research to reduce these impacts, (iii) what, if any, steps has DND and VAC taken to implement these recommendations; (s) what, if any, health surveys have been undertaken regarding military service and physical demands on mental health (e.g., chronic pain, ABI, and sleep deprivation); (t) since the establishment of the 24-hour, seven-day-per-week suicide hotline, how many CF members, reservists, and veterans have been counselled, and how many suicides are estimated to have been prevented through the hotline; (u) how does DND reconcile its suicide statistics with those of Mr. Sartori, which are based on access to information requests, and what, if any, discussions have taken place with him regarding (i) the publication or presentation of his work, (ii) the implications of his work, (iii) what specific actions might be undertaken to reduce suicides; (v) what do CF members and reservists who seek mental health services risk (e.g., loss of duties, loss of security clearances and weapons, etc.), and how might these losses impact their career aspirations; (w) what specific efforts are being undertaken to reduce the stigma associated with a CF member or reservist seeking mental health help, (i) what, if any, efforts are being taken to review performance among officers, senior non-commissioned officers, etc., regarding mental health attitudes, (ii) what, if any, efforts are being taken to review military programs addressing mental health and suicide for quality and efficacy, (iii) are attitudes and delivery of mental health training and suicide prevention part of performance training and review and, if so, how important are they in the review, (iv) how often are people and programs reviewed; (x) what, if any, review has been undertaken of suicide prevention methods (e.g., mandatory mental health review every two years, confidential internet-based screening available any time) in the military of other countries for possible implementation in Canada; (y) what, if any, effort has been undertaken to interview CF members and reservists who have attempted suicide and their family members, (i) how many members and their families were surveyed, for what years, (ii) what were the survey questions, (iii) what were the results and recommendations; (z) what, if any, review has been undertaken of the DND’s and VAC’s efforts to prevent suicides among CF members, reservists and veterans, (i) how many were surveyed and what were the major findings, (ii) was trust measured and, if so, how, (iii) did members and veterans trust DND or VAC to help them, (iv) did members and veterans think suicide prevention training programs were successful and, if not, why not, (v) what percentage of servicemen and veterans came in for mental health help and, if they did not come, why did they not; (aa) what, if any, review has been undertaken of veteran transition programs for mental health training and suicide prevention training, and will successful programs be implemented across the country; (bb) what, if any, thought has been given to skills-based suicide prevention training for families; and (cc) what, if any, thought has been given to DND and VAC partnering with Canadian Institutes of Health Research (CIHR) to undertake a comprehensive study of military and veteran mental health and suicide, (i) what would a comprehensive study cost to identify risk and protective factors for suicide among members, reservists and veterans, and provide evidence-based practical interventions to reduce suicide rates, (ii) what factors could be included (e.g., childhood adversity and abuse, family history, personal and economic stresses, military service, overall mental health)?
Q-5962 — November 25, 2010 — Ms. Duncan (Etobicoke North) — With respect to tobacco use in Canada: (a) for each year between 2000 and 2009, (i) on average, how many Canadian children started smoking every day, (ii) what percentage of 15-year-olds became regular smokers, (iii) how many adults smoked, (iv) how many working days were lost as a result of smoking-related illnesses, (v) what percentage of smokers who continued to smoke died before they reached age 65, (vi) how many deaths were caused by smoking, and how did tobacco-related deaths rank in terms of premature and preventable deaths, (vii) how many life years were lost to tobacco use, (viii) what percentage of Canadians gave up smoking, (ix) how much money did the government raise in cigarette taxes; (b) for the periods from 2000 to 2005 and 2006 to 2009, what were the financial and human health costs of smoking in Canada, including, but not limited to, (i) morbidity and mortality of smokers, (ii) morbidity and mortality costs of those exposed to second-hand smoke, (iii) drug costs, (iv) hospital costs, (v) institutional costs, (vi) physician costs, (vii) workers’ absenteeism, (viii) future earnings lost by reason of death, (ix) fires; (c) is Health Canada required by law to refresh tobacco warnings and, if so, how often; (d) why has Canada not refreshed or enlarged the health warning messages that appear on its cigarette packages since 2000; (e) have any stakeholders (i) asked the government to revise the Tobacco Products Information Regulations (TPIR) to refresh the current cigarette health warnings, (ii) asked the government not to revise these regulations and, if so, who were they and on what date were these representations made; (f) with respect to the renewal of the TPIR, and since September 1, 2009, has any elected representative or official associated with the Prime Minister’s Office, the Privy Council Office, Justice Canada, the Department of Foreign Affairs and International Trade, Industry Canada or Health Canada met with any industry associations, manufacturers or importers of tobacco products or their representatives and, if so, with whom and on which dates; (g) has the government reviewed the consistency of mandating health warning messages that occupy 70 percent or more of the principal display space of tobacco product packaging with international trade, intellectual property, investment or other commercial agreements to which Canada is a party and, if so, what decisions were made in this regard; (h) has Health Canada established a research work plan, policy or regulatory development work plan for the fiscal years 2010-2011 or 2011-2012 and, if so, what are the objectives of such a plan or plans; (i) has the government commissioned any studies to review whether revising the TPIR to increase the size of health warning labels would affect in any way the proportion of cigarettes sold in Canada on which excise taxes have not been paid and, if so, (i) by whom were these studies conducted, (ii) when were they completed, (iii) what were the conclusions of each report; (j) is the position of the government that it continue to examine the renewal of warning messages on tobacco packaging, but that it is not ready to move forward at this time and, if so, what detailed measures are being taken to examine the renewal of warning messages; (k) since January 1, 2003, what is the total cost of Health Canada’s (i) staff time, (ii) commissioned research directed towards the revision of the TPIR; (l) did Health Canada research the use of an image of Barb Tarbox, who spent the last months of her life warning Canadians about the consequences of smoking, as part of a health warning message for cigarettes and, if so, what were the results of that research; (m) did Health Canada plan to add a toll-free, quit smoking number to cigarette warning labels and, if so, why have those plans not been put in place; (n) at the Health ministers meeting in September 2010, which provinces, if any, were supportive of (i) updating warning labels, (ii) establishing a national quit line; (o) has the government established reasons why it cannot revise the TPIR while concurrently pursuing a strategy to reduce contraband tobacco sales and, if so, what are those reasons; and (p) what consideration, if any, has Health Canada given to developing a bill to stop the illegal sale of tobacco products over the internet, by mail order and by the telephone, including the illegal sale to youth?
Q-5872 — November 23, 2010 — Ms. Duncan (Etobicoke North) — With respect to nuclear testing and operations: (a) what are each above-ground nuclear weapons trials in which Canadian military personnel participated between 1946 and 1963, and for each trial, (i) what was the number of Canadian personnel, (ii) what was their branch of the forces or to which branch were they related, in the case of civilian employees of the Government of Canada attached to elements of the air, army or naval forces of Canada for the purpose of scientific or technical support to the forces, (iii) what were their assigned tasks, (iv) did a radiation detection team go in before the test to establish the ‘background’ radiation levels and, if so, what were the measured levels, (v) what was the size of the test, (vi) what were measured levels of nuclear fall-out, (vii) what precautions were taken to protect personnel, (viii) what was the distance from the test, specifying, if any, varying distances for different groups, (ix) what was the length of exposure, (x) what were possible exposure routes, (xi) what was the average number of showers taken by those exposed, and any other decontamination methods employed, (xii) what were the measurements of contamination taken of personnel, and specifically any samples taken, (xiii) were any personnel measured for radiation levels after each shower or other decontamination methods employed, (xiv) were any health effects reported at the time of the test, including, but not limited to, nausea, diarrhoea, hair loss, radiation burns, vomiting, or radiation poisoning, (xv) was there any follow-up with personnel, including, but not limited to, dose reconstruction and samples, (xvi) is there any long-term tracking of health effects and trans-generational effects through a registry; (b) regarding Canadian military personnel and civilian employees of the Government of Canada attached to elements of the air, army or naval forces of Canada for the purpose of scientific or technical support to the forces involved in the two Chalk River Reactor clean-ups in 1952 and 1958, (i) what was their number, (ii) what was their branch of the forces, (iii) what were their assigned tasks, (iv) what were the measured levels of nuclear contamination in the Chalk River Reactors in both 1952 and 1958, (v) what precautions were taken to protect personnel, (vi) what were the measured levels of nuclear contamination of those exposed, and any samples taken, (vii) what was the length of exposure, (viii) what were possible exposure routes, (ix) what was the average number of showers taken by those exposed, and any other decontamination methods employed, (x) were personnel measured for radiation levels after each shower or other decontamination methods employed, (xi) were any health effects reported at the time of the clean-up, including, but not limited to, nausea, diarrhoea, hair loss, radiation burns, vomiting, or radiation poisoning, (xii) was there any follow-up with personnel, including, but not limited to, dose reconstruction and samples, (xiii) is there any long-term tracking of health effects and trans-generational effects through a registry; (c) what was “Task Force Warrior”, (i) how many people were employed, (ii) how many blasts were they exposed to, (iii) were there witnesses and, if so, how far were they stationed from the blasts, and how were they protected, (iv) how many of “Task Force Warrior” members have died, (v) what was their cause of death; (d) in ascending order of magnitude, what were the exposure levels for all identified incidents in (a), (b) and (c); (e) in ascending order of magnitude, what was the length of exposure for all identified incidents in (a), (b) and (c); (f) combining the information in (d) and (e) and other dose reconstruction methods, what was the severity of the event in ascending order for all tests; (g) what, if any, poor pregnancy outcomes, birth defects, developmental problems, cancers, cataracts and cardiovascular problems were tracked among Canadian Forces personnel and Government of Canada employees who supported the forces, following nuclear testing and the Chalk River clean-up for the years (i) 1946 to 1963, (ii) up to 2010; (h) was compensation for damages paid to households, businesses, farms, etc. in the area surrounding Chalk River in the years following 1952 and 1958 and, if so, in what amounts; (i) was a disease registry developed to track the health of Canadian Forces and Government of Canada personnel and their families who were exposed through nuclear testing or the clean-up of Chalk River, and, if not, why not and, if so, (i) when was the registry developed, (ii) who operated the registry, (iii) what information was tracked and for who, (iv) what follow-up has continued to 2010; (j) what critical integrative analyses, such as longitudinal evaluation of cancer amongst the two populations have been undertaken in Canada, and what information has been made available to the public; (k) what, if any, efforts has the government made to understand the trans-generational effects of exposure to radiation through nuclear testing and the clean-up of Chalk River; (l) what are all environmental, occupational, and veterans studies undertaken in Canada regarding exposure to radiation through nuclear testing or clean-up of Chalk River, and their findings; (m) what process was developed to identify an appropriate form of recognition beyond pension for both nuclear testing and the clean-up of Chalk River, (i) who was engaged in the process both within and across government agencies, (ii) what are all relevant stakeholders who were engaged, (iii) for each identified group in (i) and (ii) what were their recommendations, (iv) how was each recommendation considered, (v) was the recommendation accepted or rejected; (n) what consideration was given to providing awards for “presumptive” radiation health issues, including cancers, and other health conditions, and why was the recommendation not ultimately pursued; (o) how was the ex-gratia payment of $24,000 calculated as a suitable award, (i) what are all relevant stakeholders who were engaged, (ii) for each identified group, what were their comments on the calculated figure; (p) of the 700 former Canadian military personnel who participated in up to 29 United States and United Kingdom nuclear weapons trials between 1946 and 1963, identified in Dr. Clearwater’s report, (i) how many applied for the Atomic Veterans Recognition Program (AVRP), (ii) how many had one or more health conditions that might have been caused by their exposure, (iii) how many had children who might have had health conditions linked to a parent’s exposure, (iv) how many would have benefitted through a presumptive awards program; (q) did additional people come forward who were not included in Dr. Clearwater’s report, and if so, (i) how many applied for the AVRP Program, (ii) what processes did they have to follow in order to be recognized, (iii) how many of these were awarded an ex-gratia payment and how many were denied, and for each denial, what was the explanation given, (iv) how many sought an appeal, (v) how many were awarded an ex-gratia payment after one or more appeals; (r) of the 200 former Canadian military personnel who participated in the clean-up and decontamination activities in Chalk River, (i) how many applied for the AVRP Program, (ii) what processes did they have to follow in order to be recognized, (iii) how many of these were awarded an ex-gratia payment and how many were denied, and for each denial, what was the explanation given, (iv) how many sought an appeal, (v) how many were awarded an ex-gratia payment after one or more appeals; and (s) of the 900 identified people in Dr. Clearwater’s report, by province and territory, (i) how many of the Canadian Forces members or National Defence Civilian Employees were deceased on the date the application was completed, (ii) what was the cause of death for each of the deceased, (iii) how many estate executors, primary beneficiaries, or primary caregivers of these employees submitted an application on behalf of the deceased, (iv) what were the specific guidelines used to determine whether or not to award the ex-gratia payment, (v) how many ex-gratia payments were granted to one of the following, namely, the deceased forces veteran or National Defence Civilian Employee’s estate, their primary beneficiary, or their primary caregiver, (vi) how many ex-gratia payments were denied, and for each denial, what was the explanation, (vii) how many appeals were sought, (viii) of these, how many were awarded?
Q-5862 — November 23, 2010 — Ms. Duncan (Etobicoke North) — With respect to long-term care (LTC) medical facilities for veterans: (a) by province and territory, what is the history and the rationale for the closure of LTC medical facilities for veterans including, for each facility closed, (i) the name of the facility, (ii) the number of beds closed, (iii) the date of each closure, (iv) what became of the facility; (b) what are the requirements for access to LTC facilities for (i) Second World War veterans, (ii) modern day veterans; (c) what are the health challenges and, if possible, statistics for each identified challenge for (i) Second World War veterans, (ii) modern day veterans; (d) what percentage of Second World War veterans in LTC facilities have dementia or mental health challenges; (e) regarding Korean War veterans, (i) what percentage of them are expected to develop dementia or mental health challenges, (ii) what additional impacts might Post Traumatic Stress Disorder (PTSD) or traumatic brain injury play in serving these patients, (iii) by province and territory, what planning has been undertaken to meet this increasing demand, (iv) what, if any, thought has been given to developing specialized centres or beds to meet the increasing needs of this veteran population; (f) by province and territory, what are all LTC facilities (including hospitals, care, community care, and contract facilities) available to Second World War veterans and, for each facility, (i) how many beds are available, and how many were available at the facility’s maximum use, (ii) what is the wait time, (iii) what are the standards of care, how are they measured and how often, (iv) what are all specialized programs available to meet the medical needs of the aging veteran population, (v) what are all specialized programs available to veterans to improve their quality of life, (vi) what is the average distance of the facility from a veteran’s home or family, (vii) how many veterans are currently residing in the facility, (viii) what is the average stay of a veteran, (ix) what is the average cost per bed in the facility, (x) what is the average cost to the veteran, (xi) what is the average cost to the veteran’s family; (g) by province and territory, for each LTC facility identified in (f) and modern veterans, (i) how many beds are available, and how many were available at the facility’s maximum use, (ii) what is the wait time, (iii) what are the standards of care, how are they measured and how often, (iv) what are all specialized programs available to meet the medical needs of the aging veteran population, (v) what are all specialized programs available to veterans to improve their quality of life, (vi) what is the average distance of the facility from a veteran’s home or family, (vii) how many veterans are currently residing in the facility, and how this is expected to change over the next five to ten year period, (viii) what is the average stay of a veteran, (ix) what is the average cost per bed in the facility, (x) what is the average cost to the veteran, (xi) what is the average cost to the veteran’s family; (h) what are examples of (i) unique facilities, (ii) unique specialized programs to meet medical needs, (iii) unique programs to improve quality of life that might be replicated in other provinces and territories for Second World War veterans; (i) by province and territory, what are the requirements for Second World War veterans (i) to qualify to receive home care and health care benefits while they wait at home for an available bed, (ii) to be placed in a long-term care bed in a community facility; (j) by province and territory, how many veterans are currently on a wait list for LTC facilities (i) for Second World War veterans, (ii) modern day veterans; (k) how does Veterans Affairs Canada (VAC) determine what it will contribute to the cost of a Second World War veteran’s long-term care and a modern day veteran’s care, and what is the (i) average monthly pay-out for each group, (ii) short-fall that must be provided by veterans, families or caregivers, by province and territory; (l) by province and territory, what are the comprehensive statistics from 2005 to 2010 regarding the demand by the Second World War veteran population and the modern day veteran population for beds, and what is the projection for demand over the next five years for each identified population; (m) by province and territory, for each LTC facility that do not appear to be using its full capacity, (i) what is the name of the facility, (ii) how many priority access beds are not being used, (iii) is there is a wait list, (iv) do forecasts show a need for beds in the future, (v) what plans, if any, are being made for the facility, (vi) how will VAC work with the facility and the province or territory to ensure a smooth transition; (n) what, if any, consideration has been given to expand the definition of eligible veterans for LTC facilities to include modern day veterans, and what eligibility criteria might be put in place; and (o) what challenges do modern day veterans have in accessing specialized LTC facilities, including, but not limited to, (i) competing with the general public for beds in LTC homes or hospitals, (ii) long wait lists, (iii) long distances from a veteran’s home and family, (iv) lack of expertise to address veterans needs such as amputee rehabilitation, PTSD treatment, and severe body and head trauma?
Q-5662 — November 12, 2010 — Ms. Duncan (Etobicoke North) — With regard to chemical spraying programs conducted at CFB Gagetown from 1956 to 1984 and the government’s management of their environmental and human health effects through to the present: (a) what is a detailed overview of the programs, in particular, for each chemical used in the spraying programs from 1956 to 1984, (i) what is its name, (ii) what were its years of use, (iii) what is its half-life, (iv) was it biodegradable or water-soluble, (v) does it bioaccumulate, (vi) in what area was it sprayed, (vii) how much of the chemical was used, including the number of barrels, (viii) how were the barrels which contained the chemical disposed of and how was this disposal monitored, (ix) how much did it cost to purchase the chemical, (x) how many people were living, recreating or working within five kilometres of CFB Gagetown in the years the chemical was sprayed, (xi) what concentrations or levels of the chemical are currently found in the area’s soil and vegetation, (xii) based on a backward extrapolation from information about current chemical concentrations or levels, what concentrations or levels does the government estimate were present in the area’s soil and vegetation in the years immediately following its use in the spraying programs; (b) were any sensitive areas cordoned off at any time since 1956 as a result of the spraying programs and, if so, what areas; (c) was compensation for damages paid to farms in the area surrounding CFB Gagetown from 1956 to 1984 and, if so, in what amounts; (d) what was the total cost of the spraying programs for each year from 1956 to 1984; (e) what is the ranking of the years 1956 through 1984 in terms of the amount of chemicals sprayed each year; (f) in what years and in what specific locations were each of the Agents Orange, Purple and White sprayed; (g) what are the details of every environmental and health and safety warning provided to Canadian Forces (CF) members, their families and the civilian population of the surrounding areas, in each year from 1956 to 1984, both before and during spraying; (h) for each year from 1956 to 1984, what are the details of any attempts made, additional to those in (g), to reduce human exposure to the chemicals used in the spraying programs; (i) what specific measures, including the communication of recommendations, were implemented to protect pregnant mothers, women who wanted to become pregnant, newborns and children, and what, if any, follow-up was undertaken with these groups after spraying; (j) for each year from 1956 to 1984, what are the details of any biological, environmental, and human health monitoring that took place in the area of spraying and surrounding areas, in particular the monitoring of (i) humans, (ii) animals, identifying each species, (iii) potable water wells, (iv) recreational areas, (v) recreational sub-watersheds, (vi) areas where CF members and civilians worked and recreated, (vii) areas where children played; (k) which of the monitoring programs in (j) took into consideration meteorological conditions at the time of spraying; (l) for each chemical identified in (a), what were the possible exposure routes for people living in and around CFB Gagetown; (m) following spraying and in subsequent years, what was the estimated load of Agents Orange, Purple and White found in (i) pregnant women, (ii) newborns, (iii) children, (iv) CF members, (v) the civilian population; (n) what poor pregnancy outcomes, birth defects, developmental problems, cancers and immune problems were tracked at CFB Gagetown and in CF families following time spent at CFB Gagetown; (o) for each chemical presently found at CFB Gagetown that does not occur naturally in the environment, (i) what is its name, (ii) what is its concentration, (iii) how does this concentration compare to the chemical’s Maximum Acceptable Concentration; (p) what is the precautionary principle and how has the government applied it to the safety of the environment and the health and welfare of members of the CF and the civilian population at CFB Gagetown; (q) for each chemical identified in (o), (i) what environmental monitoring currently takes place, including the monitoring of soil, water and vegetation, (ii) what areas are considered to be contaminated by the chemical and a risk to human health, (iii) what areas were recommended to be cordoned off, (iv) what clean-up has been undertaken or has been deemed necessary, (v) what areas will remain cordoned off for the foreseeable future; (r) for each chemical identified in (o), what medical monitoring currently takes place of CF members, their families, and the civilians in the areas surrounding CFB Gagetown; (s) was a disease registry developed to track the health of CF personnel, their families and civilians in the areas surrounding CFB Gagetown who were exposed to chemicals used during the spraying programs from 1956 to 1984 and, if not, why not, and, if so, (i) when was the registry developed, (ii) who operated the registry, (iii) what information was tracked, (iv) what follow-up has continued to 2010; (t) what critical integrative analyses, such as longitudinal evaluation of cancer data, have been undertaken in Canada and what information has been made available to the public; (u) what efforts has the government made to understand the trans-generational effects of exposure to the various chemicals used during the spraying programs; (v) does Canada have an equivalent to the United States’ Agent Orange Act of 1991, in particular, is Canada required to conduct updates of the science every two years to review newly available literature regarding Agents Orange, Purple and White and to draw conclusions from the overall evidence; (w) what environmental, occupational and veterans studies have been undertaken in Canada regarding exposure to Agents Orange, Purple and White during the last four years, and what were the findings; (x) what years does the government recognize as possible exposure periods to (i) Agent Orange, (ii) Agent Purple, (iii) Agent White, (iv) other identified chemicals of major public health concern; (y) which of the diseases recognized by the Institute of Medicine as connected to exposure to Agent Orange are not recognized by Veterans Affairs Canada in connection with the provision of any form of compensation; (z) what are the details of Canada’s compensation measures for individuals exposed to Agent Orange, in particular, (i) does Canada offer a cost-free Agent Orange registry health exam, (ii) what is the eligibility criteria for veterans’ health care benefits, (iii) what kind of treatment is offered at war-related illness and injury study centers, (iv) what compensation is provided to veterans’ children with spina bifida or other birth defects; and (aa) for Agent Orange claims, (i) how many have been submitted up to the day of the extension, (ii) how many have been paid out to date, (iii) how many have been denied and what was the reason for each denial, (iv) what is the average time required to process a claim, (v) how many claims are currently being appealed, (vi) what is the average time required to process an appeal?
Q-3972 — September 30, 2010 — Ms. Duncan (Etobicoke North) — With respect to initiatives and programs run by the Department of National Defence (DND) and Veterans Affairs Canada (VAC) in relation to veterans’ health and welfare: (a) what are the issues affecting (i) Canada’s traditional war veteran population, (ii) Canadian Forces (CF) veterans; (b) for each group of veterans in (a), how many cases were there per identified issue, per year, over the last five years; (c) for each group of veterans in (a), what changes have occurred in the issues over the last five years; (d) for CF veterans, what key issues are anticipated following the withdrawal from Afghanistan in 2011, and for each anticipated issue, what are the (i) challenges, (ii) changes necessary to VAC, (iii) actions taken to date; (e) what recommendations, if any, have been made to improve the quality of life for veterans identified in (a) and what steps, if any, have been taken to address these recommendations; (f) what specific measures are being taken to ensure that VAC (i) responds quickly to emerging research, such as the possible link between combat and amyotrophic lateral sclerosis, and combat and dementia, (ii) implements research recommendations in a timely manner; (g) what are the categories of injuries sustained by the Canadian troops in Afghanistan; (h) what specific rehabilitation is provided for each injury category, by region; (i) what reviews of rehabilitation procedures have been undertaken, by date and region; (j) for each injury category identified in (g), what percentage of veterans are able to return to civilian work; (k) what specific measures are undertaken by region to help veterans normalize to civilian life; (l) what specific measures are used to ensure veterans returning from Afghanistan are informed of veterans’ benefits; (m) what is the process for acquiring the help of a case manager; (n) what are the specific steps a veteran needs to take following a release or a medical release in order to gain access to (i) financial benefits programs, (ii) health benefit programs, (iii) rehabilitation programs, (iv) other programs; (o) what are the rules regarding the privacy of veterans’ medical files, specifically (i) who has clearance to review medical files, (ii) what checks and balances exist to prevent a veteran’s file from being shared, (iii) what, if any, reviews have ever been undertaken to ensure privacy; (p) how is “benefit of the doubt” defined by VAC and the Veterans Review and Appeal Board (VRAB); (q) what specific criteria are used to assess “benefit of the doubt”; (r) what monitoring is undertaken to ensure that the “benefit of the doubt” concept is interpreted correctly by VAC and VRAB; (s) how do legal advantages compare for workers’ compensation board (WCB) cases and veterans’ cases; (t) what are the specific steps a survivor or dependent needs to take following the death of a CF member; (u) in the event of the death of a CF member, is a case worker assigned; (v) what is the average time from the death to receipt of payment of (i) death benefits, (ii) supplementary death benefit, (iii) pensions, (iv) any support for a dependent’s education; (w) what was the government’s response to the 2009 report, “Serve with Honour, Depart with Dignity”, and for each of the seven issues of concern, does the government accept or reject the concern, and what, if any, action has been taken to date for each of the concerns; (x) how many CF members are expected to become veterans following deployment to Afghanistan by quarter for each of the years 2011 and 2012; (y) what, if any, increases in case managers are required for the same time period and, if increases are required, when will case managers be hired and trained; (z) what, if any, specific decompression measures will be undertaken for veterans in Canada and who will oversee them; (aa) what, if any, follow-up is undertaken with veterans, and at what time intervals; (bb) what analyses are planned and over what timeline, to ensure that (i) CF and VAC programs are working well together, and what measures will be used to assess the interrelationship, (ii) veterans know what programs they are eligible for, (iii) veterans are applying to these programs and what measures will be used to monitor progress, (iv) veterans are in good health, including economic, financial, and mental health, and how will each be monitored and reported, (v) veterans are not suffering from such difficulties as alcohol or drug abuse, and Post Traumatic Stress Disorder (PTSD), family loss, financial or home loss, and legal problems without the benefit of care, services, and support, (vi) veterans who enter either the criminal system or become homeless are tracked and given the support they require, particularly if they have suffered either PTSD or a traumatic brain injury; (cc) what percentage of the Estimates is needed for both DND and VAC, by year and for the next five years, to ensure returning CF members have the necessary programming and field staff; (dd) what, if any, actuarial analysis has been undertaken regarding the present values of benefits through the New Veterans Charter (NVC), compared to the actuarial present values of benefits under the Pension Act and for what groups of veterans does the NVC produce lower actuarial present values; and (ee) what are the advantages and disadvantages of the lump-sum payment?
Q-3742 — September 16, 2010 — Ms. Duncan (Etobicoke North) — With respect to veterans, Canadian Forces (CF) members and their mental health needs: (a) what are the 31 recommendations regarding post-traumatic stress disorder (PTSD) made in 2002 by the Ombudsman for the Department of National Defence and the Canadian Forces, Mr. André Marin, listing for each recommendation (i) whether it is unfulfilled, partly fulfilled, or completed, (ii) any action taken to date; (b) what are the nine highlighted recommendations in the second follow-up report, made in 2008 by the Interim Ombudsman for the Department of National Defence and the Canadian Forces, Ms. Mary McFadyen, listing for each recommendation, (i) whether it is unfulfilled, partly fulfilled, or completed, (ii) any action taken to date; (c) how many psychiatrists, clinical psychologists, mental health nurses, social workers, chaplains and other counselling personnel currently serve in the Canadian Forces (CF), listing for each group (i) the ratio of practitioners to clients, (ii) the numbers of practitioners by region, including Afghanistan, and any other location where CF are based or deployed; (d) what is the average wait time for PTSD treatment by region, and what is the projected delay for treatment by region once the CF leave Afghanistan in 2011; (e) what follow-up is done for veterans with PTSD; (f) what research will be undertaken to determine (i) whether the risk of dementia can be reduced by effectively treating PTSD, (ii) what role traumatic brain injury might play in PTSD; (g) what data are currently being collected regarding current and former CF members affected by mental illness; (h) how many CF personnel have been treated for Operational Stress Injuries (OSI), anxiety, depression, or PTSD annually since 2001; (i) how many CF personnel have required in-patient treatment for severe PTSD annually since 2001 and what is the average distance to travel for in-patient care by region; (j) of the CF personnel currently serving in Afghanistan, how many are expected to develop OSIs, anxiety, depression or PTSD, and how many per year are expected to require in-patient treatment for severe PTSD; (k) what programs exist for families of military members affected by mental illness by province or territory; (l) what financial, human resource, and program planning is being put in place to address the mental health needs of returning CF personnel, including, but not limited to, in-patient mental health capability, building stronger relationships with mental health institutions, developing less onerous entry criteria to treatment programs, and developing or finding treatment programs which can also address addictions; and (m) what specific actions are being taken to address the mental health needs of soldiers and veterans once the CF leave Afghanistan in 2011?
Q-3732 — September 16, 2010 — Ms. Duncan (Etobicoke North) — With respect to services offered to veterans in Canada: (a) how many full-time and part-time positions have been cut from Veterans Affairs Canada (VAC) between 2006 and 2010; (b) what is the number of uniformed professionals, public servants and contractors by region; (c) what is the overall cost of contract workers; (d) over the next five years, what plans does VAC have to cut back or expand (i) its operational budget, (ii) full-time, part-time or contract positions, (iii) programs or services offered; (e) since 2005, broken down by year, how many (i) Second World War veterans have passed away, (ii) Canadian Forces (CF) members became veterans, and how many of these veterans have families, (iii) new recruits have become CF members and how many of these new CF members have families; (f) how are the numbers in (e) expected to change over the next five years; (g) how many Veterans Affairs’ case managers and client service agents currently exist and specifically, (i) where are they located, (ii) what is the average number of clients they serve, (iii) what are the projected numbers of case managers and client service agents needed over the next five years, (iv) what specific preparations are being undertaken to meet these needs; (h) how many times has the “Veterans Charter” been altered, listing for each change (i) the date, (ii) the nature of the change, and (iii) the reason for the change; (i) how many veterans are living from (i) the Second World War, (ii) the Korean War, (iii) Afghanistan, (iv) Canada’s peace-keeping missions; (j) for each group listed in (i) how many veterans are (i) disabled, (ii) severely disabled, (iii) receiving the monthly disability payment, (iv) received the lump sum pay-out of up to $276,089; (k) for those who received the lump sum pay-out, how many veterans received (i) the maximum pay-out, (ii) the average pay-out; (l) how many veterans received a lump sum pay-out between (i) $0 and $25,999.99, (ii) $26,000 and $50,999.99, (iii) $51,000 and $75,999.99, (iv) $76,000 and $100,999.99, (v) $101,000 and $125,999.99, (vi) $126,000 and $150,999.99, (vii) $151,000 and $175,999.99, (viii) $176,000 and $200,999.99, (ix) $201,000 and $225,999.99, (x) $226,000 and $250,999.99, (xi) $251,000 and $275,000.00; (m) how is financial need measured; (n) how many veterans are currently receiving social assistance, and how do these statistics compare with those under the previous monthly disability program; (o) how often was the monthly payment increased and why; (p) how many veterans have lost their homes in the last five years; (q) what was the average payment for spouses and children prior to 2006, and how do these statistics compare with the new lump sum, specifically (i) how often is the lump sum increased, (ii) is there a portion of the latter payment for spouses and children; (r) what was the average disability pay-out under the system prior to 2006 particularly over a Second World War and Korean War Veteran’s lifetime (in today’s Canadian dollars), and how do these statistics compare with each category identified in (l) and the maximum lump sum pay-out of $276,089; (s) what specific actions are being taken to address the 31 per cent of veterans not satisfied with the lump sum payment as identified in the VAC survey released in June 2010; (t) how many veterans are currently appealing decisions regarding their disability pensions, and what is the average time taken to a final decision; (u) how many veterans have appealed a decision regarding their disability pension (i) once, (ii) twice, (iii) thrice, (iv) four times, (v) five times; (v) how many veterans’ complaints were reviewed by the Veterans Ombudsman during his tenure, up to and including September 20, 2010, broken down by complaints against (i) Veterans Affairs Canada services, (ii) Veterans Bill of Rights, (iii) the Veterans Review and Appeal Board, (iv) the Bureau of Pension Advocates; (w) in detail, what are all emerging and systemic issues related to programs and services provided or administered by Veterans Affairs Canada brought forward by the Ombudsman during his tenure up to and including September 20, 2010, including, but not limited to, physical and mental health issues, the replacement of pensions with lump-sum payments and disability stipends, and pension claw backs; (x) what are the details of all outreach activities to veterans or organizations that serve veterans across Canada during the national “Leave Nobody Behind” campaign launched by the Veterans Ombudsman, including the issues brought forward by veterans or organizations; and (y) what specific measures were used to evaluate the Veterans Ombudsman’s performance in the areas of (i) accountability, (ii) ethics (iii) training, (iv) governance and stakeholder engagement?
Q-3622 — September 16, 2010 — Ms. Duncan (Etobicoke North) — With respect to chronic cerebrospinal venous insufficiency (CCSVI): (a) do the Canadian Institutes of Health Research (CIHR) or Health Canada recognize the Consensus Document of the International Union of Phlebology (IUP) on the diagnosis and treatment of venous malformations, in which CCSVI is recognized as venous truncular lesions obstructing the main outflow routes from the central nervous system; (b) does CIHR or Health Canada recognize the recommendations by the IUP expert panel for therapeutic interventions, including angioplasty, stenting, or open surgical repair of the lesions, in proven CCSVI cases; (c) did anyone from CIHR or Health Canada attend the July 26, 2010 CCSVI Professional Symposium and, if not, (i) was there a review of the findings of the Symposium, (ii) was the review included in the process for the August 26, 2010 meeting between CIHR and the Multiple Sclerosis Society of Canada (MSSC); (d) what were the terms of reference for the August 26, 2010 meeting between CIHR and the MSSC; (e) in detail, what were the steps taken in the review of the current state of CCSVI science for the August 26 meeting and, specifically, (i) were international experts outside of the United States consulted, (ii) what process was undertaken to ensure fair and unbiased reviewers, (iii) what check of reviewers’ backgrounds was undertaken regarding links to specific organizations, review panels and grants obtained, (iv) which, if any, of the reviewers had previously spoken for or against the CCSVI theory or liberation procedure, (v) were reviewers who had experience or expertise with CCSVI selected and, if not, why not, (vi) which, if any, of the reviewers declared a conflict of interest, (vii) what, if any, action was taken to address any identified conflict of interest; (f) did the Health Minister review the biographies of the committee members for the August 26 meeting (i) if not, why, (ii) if so, were any problems identified and any action taken; (g) what published papers were reviewed by panel members, broken down by (i) those that confirm venous malformations in Multiple Sclerosis (MS) patients, (ii) those that deny venous malformations in MS patients, (iii) those that neither confirm nor deny venous malformations in MS patients; (h) were international practitioners, such as those in Bulgaria, Italy, Kuwait and the United States, consulted to learn (i) how many liberation procedures they had undertaken, (ii) what, if any, improvements their patients experienced, particularly in relation to fatigue, “brain fog”, motor skills, and Expanded Disability Status Score; (i) what were the details of the agenda for the August 26, 2010 meeting; (j) what will be the process for establishing the CCSVI working group, announced August 31, 2010, and (i) will it be an open or closed process, (ii) will it include CCSVI and liberation procedure experts from Canada, such as Dr. Sandy MacDonald, and around the world, (iii) who will Chair the group, (iv) how often will it meet, (v) how often will it report and to whom; (k) what are CIHR and Health Canada’s responses to the Society of Interventional Radiology’s September 2010 position statement, particularly its statement that it “strongly supports the urgent performance of high-quality clinical research to determine the safety and efficacy of interventional MS therapies, and is actively working to promote and expedite the completion of the needed studies”; (l) prior to the CIHR’s announcement on August 31, 2010 that pan-Canadian clinical trials on the liberation procedure would not go forward at this time, how many provinces or territories requested that the federal government undertake national clinical trials; (m) since the beginning of 2010, how many Canadians have travelled abroad for the liberation procedure and what, if any, tracking has CIHR or Health Canada undertaken regarding each patient’s procedure, progress and related expenses; (n) will Health Canada be undertaking a review of the liberation procedure at each location it is performed worldwide, including an examination of (i) the cost, (ii) the number of procedures performed, (iii) the data collected, (iv) the safety and efficacy of the procedure, (v) the follow-up, (vi) the ranking of the sites for Canadians wishing to pursue this treatment; (o) what consideration has CIHR or Health Canada given to how the August 31 recommendation not to proceed with national clinical trials will impact the number of Canadians travelling outside of Canada for the liberation procedure and what, if any, studies have been undertaken to address the possible impacts; (p) will CIHR or Health Canada undertake any studies relating to any challenges MS patients face on returning to Canada after receiving the liberation procedure abroad, including medical complications, the refusal of treatment by neurologists or practitioners and the refusal of care by long-term health facilities; (q) will the government grant the $10 million the MSSC has requested for research and, if so, when; (r) how much of the $16 million the government allocated to CIHR will be available for (i) MS research, (ii) CCSVI research; (s) will CIHR funds be made available to assist in the creation of a registry that collates data regarding the progress of MS patients who undergo the liberation procedure and, if so, (i) who will be involved in its development, (ii) what is the timeline for development and roll-out; and (t) what research is CIHR or Health Canada undertaking or funding regarding (i) an atlas of anatomical venous variations in the neck and chest, (ii) treatment for venous inflammation, iron storage and hydrocephaly, (iii) possible linkages among CCSVI, MS and other unidentified factors, (iv) treatment and follow-up protocols, (v) design of safe apparatuses and procedures to keep liberated veins open?
Q-2772 — May 26, 2010 — Ms. Duncan (Etobicoke North) — With respect to chronic cerebrospinal venous insufficiency (CCSVI), does the government plan to have: (a) Health Canada establish that no Canadian ought to be deprived of the imaging necessary for diagnosis, or deprived of the angioplasty indicated by a diagnosis of venous insufficiency in the drainage of the brain, only by reason that that person would also have been diagnosed with Multiple Sclerosis (MS); (b) the Minister of Health convene her provincial and territorial counterparts to a meeting for the purpose of ensuring that no impediment will be placed in the way of diagnosis of venous insufficiency or of treatment by angioplasty on the mere ground that the patient has been diagnosed with MS; (c) Canadian Institutes of Health Research (CIHR) funds made available to assist in the creation of a registry by which it would be possible to collate data regarding the progress of MS patients who undergo venous angioplasty; (d) the funds released, as per the MS Society’s research proposal, to allow for that research, with the help of the data collated in the registry referred to above, keeping in mind that such research should not be an impediment to patients obtaining diagnosis or the angioplasty to correct diagnosed venous insufficiency, but should proceed in parallel to any such treatment; (e) Health Canada or the CIHR investigate technology to study the vascular system in utero and, if so, (i) whether vascular or venous problems develop during this time period, (ii) what and where vascular or venous problems potentially occur, (iii) how identified problems might be treated; (f) Health Canada or the CIHR study whether pregnant women should be given vitamin D to understand the risk of children being born with, or developing, vascular problems and other conditions and, if so, determine what dosage is appropriate; (g) Health Canada or the CIHR study whether children and adolescents should be given vitamin D to reduce the risk of developing vein inflammation and venous hypertension and, if so, (i) what dosage is appropriate, (ii) what quantity is recommended for a child with a family history of CCSVI, vascular problems or MS, etc.; (h) Health Canada or the CIHR investigate whether vascular issues develop during childhood and, if so, identify methods to discover circulation problems at the earliest time possible; (i) Health Canada or CIHR study whether antioxidants, vitamin D and omega 3 reduce vein inflammation; (j) Health Canada or the CIHR determine the normal range of flow through veins, in particular the jugulars, and whether or not occluded jugulars can be treated to achieve normal flow; (k) Health Canada or the CIHR study how CCSVI potentially affects flow through the veins and possible permeability of the blood-brain barrier, and methods to reduce permeability, including mesenchymal stem cells and pharmacological agents; (l) Health Canada or the CIHR study the effects of chelators on iron uptake and release from the brain, and the potential use of iron chelators as therapeutic agents for the treatment of MS and perhaps other neurodegenerative disorders; (m) Health Canada or the CIHR investigate how the vascular system of someone with benign MS compares to that of someone with relapsing-remitting, primary progressive or secondary progressive MS; (n) Health Canada or the CIHR study whether a relationship exists between CCSVI and other neurological diseases, as well as between CCSVI and autoimmune disease; (o) funds made available to CIHR across the Institutes to bring together a conference of leading researchers in fields including CCSVI and the liberation procedure, vascular surgeons and neurologists; (p) research funds made available to design safe apparatuses to keep liberated veins open; and (q) a National Research Chair awarded in the diagnosis and treatment of venous abnormalities?
Q-233 — May 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to chronic cerebrospinal venous insufficiency (CCSVI), the “liberation” procedure, and multiple sclerosis (MS): (a) does Health Canada recognize the International Union of Phebology (IUP), and is Canada a member; (b) does Health Canada recognize the IUP’s Consensus Document on the diagnosis and treatment of venous malformations; (c) will Health Canada be respecting the IUP’s standards regarding diagnosis and treatment of venous malformations; (d) will the government work with the provinces and territories to establish imaging and treatment guidelines for CCSVI and, if so, over what timeline and, if not, why not, (i) what are the benefits and risks associated with imaging and treatment techniques, (ii) what are the costs for each of the identified methods; (e) will the government, in collaboration with the provinces and territories, commit to imaging MS patients for venous malformations, and treating those patients who require interventions and, if not, why not and, if so, (i) over what timeline, (ii) what barriers would have to be overcome; (f) is CCSVI recognized as an official diagnosis and, if so, by what professional medical organizations and how is it defined; (g) what is the cause of narrow veins in the neck or thorax and what methods could possibly be undertaken to reduce their occurrence either in utero, in childhood, or in adulthood; (h) with what medical conditions is CCSVI associated; (i) what are the potential health impacts of CCSVI in the short-term, medium-term and long-term, both with and without treatment; (j) what percentage of MS patients show one or more blocked veins; (k) what veins, other than the jugular veins, are commonly blocked, damaged, or twisted in the human body, (i) what imaging procedures are used to identify the problems, (ii) what interventions are required to address the problems and why, (iii) what are the possible health impacts if left untreated, (iv) are interventions time sensitive, (v) what are the costs of imaging procedures and treatment; (l) what specific methods are used to investigate CCSVI, what costs are associated with each method, and what are the benefits and risks associated with these techniques; (m) where in Canada are these imaging methods available and, for each location, what procedures are offered and how much do they cost; (n) where in the world are private clinics emerging, what are their efficacy and safety records, and what are the imaging and treatment costs; (o) what percentage of MS patients show a reduction in MS attacks and brain lesions following the liberation procedure; (p) what percentage of MS patients with little or mild blockage show improvement following the liberation procedure; (q) what discussions is the government having regarding CCSVI, its imaging, and the possible link with MS; (r) what studies are government scientists conducting to assess the reliability and validity of imaging techniques, the possible association between CCSVI and MS, and to follow-up on patients who have undergone the liberation procedure; (s) how much money has the government allocated to research related to CCSVI, the liberation procedure and MS; (t) what is the estimated number of MS patients in Canada, and what is (i) the percentage who can no longer work, (ii) the percentage who depend on family caregivers, (iii) the percentage who require around-the-clock care from professional caregivers; (u) what is the estimated national annual economic impact of MS on families and healthcare plans; (v) what is the estimated national annual cost of disease-modifying therapies, including Copaxone and Interfon, for families and healthcare plans; (w) what are the projected imaging costs for CCSVI and treatment costs for MS patients who show a vascular abnormality; (x) what are the projected imaging costs for CCSVI and treatment costs for all MS patients; (y) what recommendations regarding CCSVI and imaging are being provided by the government to MS patients, particularly regarding (i) reputable imaging and treatment clinics, (ii) the pros and cons regarding venoplasty and stents, (iii) the need for continuing treatment regimes following any liberation procedure; (z) what steps is the government taking to educate MS patients about blogger patients and sham imaging and treatment centres; and (aa) what is the estimated number of Canadians who have gone overseas for imaging and treatment, and what tracking is being undertaken of their condition following such trips?
Q-2342 — May 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to nutrition in Canada: (a) does the government recognize good nutrition as a basic human right; (b) how is food insecurity defined by the government, and what factors are responsible for it in Canada; (c) what action, if any, has the government taken to address each of the factors as identified in the answer to (b); (d) what action, if any, has the government taken to promote nutrition in Canada and which specific populations have been targeted; (f) does Canada have a comprehensive initiative that aims to reduce undernutrition and hunger at the national scale and, if so, (i) what is it, and if not, (ii) why not; (g) what successes has the current government had in building on effective programs to reduce food insecurity, undernutrition and hunger, and what barriers has it had to overcome; (h) has the government facilitated communications between the provinces and territories concerning the best methods of improving infant, child and adolescent nutrition in Canada and, if so, (i) on what dates and what were the recommendations and, if not, (ii) why not; (i) what are the names of all food security, nutrition, hunger prevention, etc. stakeholders with whom the government meets; (j) what percentage of Canadian families seeks assistance from food banks, and how has this changed over the last 20 years; (k) what percentage of Canadian infants, children and adolescents require assistance from food banks to meet their nutritional needs, and are all their needs met; (l) what action, if any, has the government taken to address in particular the nutrition of pregnant women and children through two years of age; (m) what percentage of Canadian children and adolescents experience food insecurity or hunger, and how does this translate into numbers, how have these data changed over the last 20 years, and for what reasons; (n) has the government considered a national breakfast, lunch or snack program to help ensure that children and adolescents meet their nutritional needs; (o) how does the government define the categories overweight and obese, and what percentage of Canadian infants, children, and adolescents are overweight and obese; (p) how does socio-economic level impact overweight and obesity in Canadian infants, children, and adolescents; (q) what are the medical and psychological complications of child and adolescent overweight and obesity; (r) how has childhood overweight and obesity increased in Canada over the last 20 years, and what action, if any, has the current government taken to address the situation; (s) how has type 2 diabetes increased in Canadian children and adolescents over the last 20 years; (t) how many treatment centres for childhood and adolescent obesity exist in Canada, and has the government increased or decreased funding to these, and by what percentage; (u) what action, if any, has the government taken to expand the number of child obesity treatment centres; (v) what action, if any has the government taken to facilitate communications between the provinces and territories concerning successful overweight and obesity prevention and treatment programs, and replication of what is working well; (w) what action, if any, has the government taken to support research and evaluation of childhood overweight and obesity prevention, including behavioural, dietary, environmental, pharmacological, and physical activity approaches, and treatment initiatives; (x) what analysis, if any, has the government undertaken of nutrition programs in other jurisdictions, such as the United Kingdom and the United States; and (y) what consideration, if any, has been given to the Pennsylvania program that has led to more than 80 supermarkets being set up in unserved areas in the last five years?
Q-65 — March 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to the climate summit in Copenhagen and climate change: (a) what criteria needed to be met in order to be part of the Canadian delegation; (b) what were the name and position of each member of the Canadian delegation, what expertise and skills did each bring to the table, and for what time period were each in Copenhagen; (c) what was the total budget for the delegation, from flights to accommodation and living expenses; (d) what, if any, offsets were purchased for the delegation; (e) what was the description, in detail, of the Canadian climate change plan, and when will it be revealed to Canadians; (f) who were all the stakeholders consulted in the development of the plan, and how does each goal/target reflect or does not reflect each stakeholder’s views; (g) did the government include the voice of Canadians who are on the “front line of climate change”, and were those who will be impacted by climate change meaningfully involved, and, if so, how; (h) what accountability measures, if any, were in place to ensure that the Canadian delegation would be responsible to those Canadians who will be particularly impacted (e.g., those living in low-lying areas and Aboriginal peoples); (i) what has been the stakeholder response to the plan, particularly from business, NGOs, scientists, and all stakeholders, and if available, what is the actual response of stakeholders’ consulted; (j) what were the specific goals of the Canadian delegation, and how do they compare (in advance and afterward) with those of the G-20 or OECD in terms of baseline, absolute reductions, and target date; (k) did the Canadian delegation support the notion that climate change is not just an environmental issue, but rather a human rights issue and a justice issue and, if so, what is the description, in detail, of Canada’s position; (l) did the Canadian delegation listen to the world’s “frontline voice”, such as Bangladesh’s and the Maldives’, and act upon scientific and humanitarian evidence; (m) what were the projected costs of mitigating acid precipitation and reducing chemicals that destroyed stratospheric ozone, the costs of inaction, and what were the actual costs required; (n) what are the projected costs of adapting to and mitigating climate change in Canada today, and what are the costs of inaction for each year, five years, and decade delayed; (o) will the government commit new research dollars to support global climate research and services; (p) in detail, what percentage of 2009′s stimulus was “green”, and how was it a “triple win” for the economy, jobs, and the atmosphere, and going forward, what specific targets in Canada’s climate change plan will be a “triple win”; and (q) what are the costs the government is willing to pay to mitigate climate change, and how do these costs compare with the projected economic, environmental and social costs of climate change?
Q-66 — March 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to armed conflicts where Canada is both directly and indirectly involved: (a) what are the sites and in detail, Canada’s involvement; (b) how are civilians, and particularly, children, minorities, and women impacted for each identified site; (c) which identified areas have refugees and refugee camps, with the numbers of civilians, and particularly, children and minorities affected, and what are the living conditions in refugee camps if applicable; (d) what is the process for determining whether Canada becomes either directly or indirectly involved or not in a conflict, and how does Canada become involved; (e) how does the process ensure that good verifiable information is obtained from the field, particularly in areas where there is poor communication; (f) how does Canada obtain information from civilians who might be afraid to speak out, as well as NGOs, who need to have their work protected; (g) what is the process for ensuring that good information is acted upon, and what is the demonstration, if applicable, of where Canada has acted upon such evidence with regard to identified sites; (h) does Canada invest in development and reintegration in areas to ensure alternative lifestyles for civilians and, if so, in which areas specifically; and (i) what are the other sites, by countries, where Canada is aware of an armed conflict but is not involved?
Q-672 — March 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to humanitarian issues and crisis and Canada’s involvement: (a) how does Canada increase awareness around the world that abuse of children, minorities, women, etc. will be punished; (b) how often is humanitarian evidence examined in Canada, and by whom; (c) what accountability measures are in place to demonstrate Canada’s commitments with respect to human rights internationally; (d) what processes are in place to give Canadian family members information, and to give information on how to help; (e) what processes are in place or can be put in place to allow Canadians to sponsor family members more quickly if required; (f) what, if any, audit process follows Canada’s direct or indirect involvement during a humanitarian crisis; (g) what, if any, process follows the resolution of a humanitarian crisis, and how Canada performed with respect to it; (h) what opportunity, if any, is there for Canadians to have their input in such an audit process; and (i) with respect to Canada’s involvement during last year’s crisis in Sri Lanka, (i) what, if any, audit will follow Canada’s involvement, (ii) what, if any, evidence is Canada receiving that might suggest violations against children, minorities, and women, (iii) what steps, if
applicable, is Canada taking to address such evidence?
Q-682 — March 3, 2010 — Ms. Duncan (Etobicoke North) — With respect to the Canadian HIV Vaccine Initiative (CHVI) and the Level 5 Laboratory (L5L): (a) what are the details of the initial request for proposals for the CHVI; (b) what amount were the government and the Gates Foundation planning to invest in the CHVI and what were the scheduled dates for investment; (c) how many bids for the CHVI were submitted and by which organizations; (d) what are the details of the CHVI process for determining suitable award winners; (e) what were the selection criteria for awarding the CHVI bid and who was responsible for identifying the criteria; (f) how many people made up the independent evaluation committee for the CHVI bids, how were they selected, and from which disciplines and geographic areas were they drawn; (g) were representatives from the pharmaceutical industry invited to be part of the independent evaluation committee for the CHVI bids and, if so, on what date did each representative serve and, if not, why not; (h) what were the results for each of the selection criterion for each of the organizations bidding on the CHVI and how were the bids ranked; (i) did the independent evaluation committee for the CHVI bids reach a recommendation, and, if so, on what date, and to whom was the information conveyed in the government; (j) was there a steering committee for the CHVI bids and, if so, who were the members, who was the chair and what was its mandate; (k) were there changes to the steering committee for the CHVI bids and, if so, on what dates and for what reasons; (l) was any organization bidding on the CHVI informed, formally or otherwise, that it had been chosen to host the facility and, if so, how and on what date; (m) did the federal government put up a notice on its Web site to announce that the CHVI project had been cancelled or would not proceed and, if so, on what date; (n) was the notice in (m) removed from the Web site and, if so, on what date and for what reason; (o) have each of the organizations bidding on the CHVI seen the results of the peer-review process and, if so, on what date and, if not, why not; (p) what constructive criticism was given to each of the organizations bidding on the CHVI; (q) what specific problems were identified that prevented each of the organizations bidding on the CHVI from being selected; (r) why were bidding organizations not encouraged to redevelop their CHVI bid; (s) why and by whom was the CHVI cancelled; (t) on what dates was the CHVI project cancelled, were the submitting organizations formally informed and was the Canadian public informed; (u) what do “changing needs” and “reallocation of resources” mean in relation to the cancellation of the CHVI project; (v) what post-mortem audit does the government plan to undertake to investigate how Canadian investigators and research centres failed to meet the selection criteria for the CHVI bid; (w) how will the planned CHVI investment monies be spent; (x) what are the details of both the CHVI’s and the L5L’s history from January 2009; (y) what are the organizations involved in the L5L, and what, if any, overlap (e.g., goals, funds, personnel, etc.) exists between the International Centre for Infectious Diseases, which was bidding for the CHVI, and the L5L; (z) what, if any, involvement does the government have in the L5L; and (aa) what, if any, review process is in place for the L5L?
September 24, 2009 — Ms. Duncan (Etobicoke North) — With regard to the current pandemic of new influenza A (H1N1) virus in Aboriginal (First Nations, Inuit, Metis) communities in Canada: (a) what were the containment measures taken to slow the spread of the virus within households, between households, and among communities; (b) what were the control measures taken in more remote areas to flatten the epidemiological peak; (c) what was the average length of time from symptoms to treatment for those Aboriginal peoples who required a stay in intensive care unit (ICU); (d) what percentage of hospitalizations, ICU cases, and deaths were among Aboriginal peoples, and how do these compare with the Canadian population at large; (e) what was the average length of time on a ventilator and the mean length of stay in an ICU for Aboriginal peoples; (f) what specific measures are being planned to reduce the time to treatment, hospitalizations, ICU, and deaths; (g) when will the results of the preliminary investigation in First Nations communities be available, specifically, (i) how many Aboriginal communities in Canada have a revised H1N1 pandemic influenza plan, (ii) how many have tested their plan, (iii) how many have necessary supplies in place; (h) what specific actions have been undertaken to address the fact that only two of 30 communities in northern Manitoba had a pandemic plan, and none had been tested; (i) where did the Minister of Health obtain the 90 percent figure she used in her August 28 response letter to Drs Bennett and Duncan; (j) what funding have Aboriginal communities requested, and what additional funds have been made available to Aboriginal communities for pandemic planning and response in 2009; (k) is there any encouragement to identify vulnerable people, such as pregnant women and those with underlying medical conditions, to take additional precautions, specifically, (i) how many communities lack necessary clean water for infection control measures, (ii) what funding and progress has been made to address this situation; (l) what measures are being put into place to decrease transmission in households where there is overcrowding; (m) are all Aboriginal people on the priority list for vaccine, or just communities in remote and isolated settings; (n) are anti-virals pre-positioned in all Aboriginal communities, should they be required urgently, and are there provisions for communities without registered nurses; and (o) what measures exist to ensure that remote and isolated communities will have the necessary human resources to ensure appropriate and timely treatment, particularly in communities where weather may impact help?
September 24, 2009 — Ms. Duncan (Etobicoke North) — With respect to the current pandemic of new influenza A (H1N1): (a) who is at the top of the pandemic organizational chart for the country; (b) what gaps still exist in the government’s overarching plan, recognizing that it is an ever-evolving plan, and by what date will identified gaps be addressed; (c) what money remains from the $400 million contained in the budget of 2006 as ‘to be set aside as a contingency to be accessed on an as-needed basis’; (d) what funds have been spent since the start of the pandemic in Canada to address response, specifically, (i) what government departments have tested their pandemic plan, (ii) what departments operationalized their plans or part of their plans in the spring, and updated their plans since the lessons learned from the spring; (e) should there be an election, what is the pandemic preparedness plan for Elections Canada, both to protect the health and well-being of its employees and Canadians; (f) what are the outstanding issues among medical personnel in terms of preparedness, and how are these issues being addressed; (g) what was the process for monitoring swine herds prior to April 24, 2009, and how has it increased since that date; (h) what is the purpose behind the absence of a Canadian notifiable swine influenza surveillance system; (i) what is known of the clinical spectrum of the disease at this time, and what are the possible long-term impacts on lungs, and other organs, and potential long-term costs to the healthcare system; (j) by what date are provincial and territorial vaccine distribution plans to be in place, what oversight exists to ensure they are in place, and will they be made public; (k) what contingency plans are being put in place should Canadian distributors run out of stock of N95 masks; (l) will there be a compensation package should there be challenges with the vaccine; (m) what recommendations are being made to those with chronic conditions, such as cardiovascular disease, diabetes, and immunocompromised patients, and how is this information being relayed to these groups to see their doctor now; (n) what are the details of the “alternative strategies” being developed by provinces and territories; (o) what are the details of adding a “small amount of amantadine” to the National Emergency Stockpile System, and is its use in combination thought to be effective when the virus is resistant to amantadines; (p) are there any other alternative therapies being explored to address antiviral resistance and, if so, what funds are being allocated to the effort; (q) will 500 ventilators meet the potential intensive care unit (ICU) burden considering Canada’s ICU cases were around 20% of its hospitalized, compared to 15% in heavily impacted communities in the southern hemisphere; and (r) what do recent modelling studies show?
October 1, 2009 — Ms. Duncan (Etobicoke North) — With respect to the current pandemic of new influenza A (H1N1): (a) what is the key leadership shown by the organizational reporting chart, from the two lead ministries, the Public Health Agency of Canada and Public Safety Canada, through to the deputy ministers; (b) what is the decision-making process to determine which of the two ministries leads on issues; (c) what, if any, funding requests have been made by government departments for pandemic planning since the beginning of the pandemic in Canada; (d) what, if any, additional funding is required to ensure all government departments have tested their H1N1 plans and rolled them out to their employees; (e) what, if any, specific agreements have been signed with the provinces and territories, and which, if any, agreements still need to be signed; (f) what are the government’s identified critical services, what is the decision-making process to reduce services if required, and who has responsibility for these decisions; (g) how will the government acquire and distribute medical countermeasures if required; (h) what guidance is being provided to foreign missions, including consulates, embassies, high commissions and trade offices, and what is the decision-making process to reduce services, or repatriate staff; (i) what guidance is being provided to the Canadian Forces, including the army, the air force and the navy, and what recommendations are being made for military personnel; (j) with regard to recommendations being made to the Canadian Forces and military personnel concerning vaccinations, what processes are in place to (i) re-evaluate policies as required, (ii) ensure legal compliance and respect ethical considerations, (iii) ensure protection of our troops in Afghanistan; (k) on what date was the pandemic vaccine ordered, and what, if any, effect did having only one supplier, or the decision to use adjuvant, had on the delivery date for the H1N1 vaccine; (l) what, if any, actions is the government taking to investigate claims of unpublished Canadian data regarding vaccination, and what updates are available in Canada and internationally; (m) what, if any, recommendations will the government make in terms of timing of seasonal and H1N1 vaccines, why was priority setting or sequencing different from that of the World Health Organization, and what considerations have been given to possible impacts of varying provincial and territorial vaccination plans on short-term and long-term trust in public health officials and vaccination rates; (n) what, if any, oversight exists to ensure Canadian communities have H1N1 pandemic plans in place, and what specific recommendations are being made for those who live in poverty or in crowded housing conditions, including prisons and shelters; (o) what, if any, gaps exist in medical surge capacity; (p) what, if any, monitoring is being undertaken for influenza-like illness in daycares, schools, colleges, and universities, and, if so, what patterns are occurring; (q) what percentage of people who died of H1N1 during the last four months had secondary bacterial infection, and what, if any, underlying health conditions did they have, and how might possible secondary bacterial infections be reduced in at-risk populations; (r) what, if any, ethical guidelines are in place to allow for consistent decision-making regarding ventilators; (s) what research, if any, has been undertaken to determine what percentage of healthcare workers might be concerned to work during a possible second wave, and what mitigating efforts have been taken to address this possible challenge; (t) what, if any, recommendations exist regarding “duty to care” and institutional supports to healthcare workers during a pandemic; (u) what efforts are being taken to boost vaccination rates among pregnant women, and how is this information being conveyed to medical practitioners and expectant mothers; (v) what, if any, consideration has been given to the construction of field hospitals in remote and isolated areas; (w) with historical hindsight, and knowledge of increased vulnerability to H1N1 of Aboriginal communities due to underlying health conditions and socio-economic problems, what, if any, containment measures were taken to slow the spread of the H1N1 virus in the spring; (x) what preventive and treatment measures are being implemented to reduce the percentage of Aboriginal people who will be hospitalized, who will stay in intensive care units, and who will die, compared to the whole of the Canadian population; and (y) what, if any, consideration has been given to share a portion of Canada’s antiviral medication, vaccine allotments, and flu management kits with developing countries?
October 7, 2009 — Ms. Duncan (Etobicoke North) — With respect to the current pandemic of new influenza A (H1N1): (a) what specific healthcare professional stakeholder groups have been consulted since the beginning of the H1N1 pandemic, what was the consultation process, and what concerns were raised; (b) what concerns from the consultation process have been addressed, what concerns are remaining, and by what date will they be addressed; (c) what, if any, additional funding was requested to address identified challenges; (d) do identified stakeholder groups report there are sufficient human resources and supplies to meet the need during a second wave of H1N1 and, if not, what are the identified gaps; (e) what, if any, additional education and training was requested by stakeholder groups; (f) what procedures are in place to ensure applicability, consistency and clarity of protocols to healthcare professional organizations, and do stakeholders report that they are receiving clear, concise, timely messaging; (g) what, if any, differences exist in how healthcare professionals will be protected among provinces and territories; (h) what specific agreements have been made in respect to assuring sufficient human resources during a second wave; (i) what, if any, differences exist between the national guidelines and those of the provinces and territories, with respect to antivirals, N-95 masks, vaccines, and other personal protective measures, and how should healthcare professionals address any discrepancies; (j) what are the known and suspected benefits and risks of the H1N1 vaccine; (k) what non-clinical and clinical trials have been or are being undertaken regarding the H1N1 vaccine, on what dates were they completed, and what are the outcomes of these trials; (l) what possible side effects, including rare events, might be expected with the H1N1 vaccine; (m) what are the possible legal risks associated with an H1N1 vaccination programme, and what efforts have been taken to reduce these risks; (n) what, if any, plans exist for rapid distribution and administration of vaccines for the first mass vaccination effort; (o) what special efforts are being made to reach out to young adults, minorities, and other at-risk groups to get vaccinated, and what languages and media outlets are being used; (p) for how long will vaccination campaigns continue past the fall in case of a possible third wave; (q) how do hospitals across the nation vary in their ability to bear the burden of H1N1 cases; (r) what percentage of hospitals are operating at their limit today; (s) what percentage of hospitals will be able to accommodate the predicted surge capacity if 15%, 35% and 50% of the population is impacted by H1N1; (t) what percentage of hospitals will be expected to meet intensive care unit (ICU) and ventilator surge capacity if the above percentages of people are affected; (u) do any hospitals or provinces and territories had difficulty meeting surge capacity in the spring and summer; (v) what, if any, surge capacity challenges existed in the spring and summer in terms of hospitalizations, ICU stays, and ventilator use, and what measures have since been taken to address these challenges; (w) what, if any, funding has been given to address surge capacity challenges; (x) what specific efforts are being taken to help reduce the burden on hospitals by distributing high profile messages about when to seek medical care for pandemic H1N1 infections; and (y) what is being undertaken to reduce the risk of resistance (i) in patients with severely compromised or suppressed immune systems who have prolonged illness, have received oseltamivir treatment, but still have evidence of persistent viral replication, (ii) in people who receive oseltamivir for post-exposure prophylaxis, and who then develop illness despite taking oseltamivir?
June 4, 2009 — Ms. Duncan (Etobicoke North) — With regard to funding for pandemic response in the 2006-2007, 2007-2008 and 2008-2009 fiscal years: (a) what is the detailed breakdown of the (i) total funding allocated, (ii) total funding spent; (b) what are the official criteria required to access the pandemic response funding; and (c) what funding amounts have been distributed, on what date and towards what project?
— June 4, 2009 — Ms. Duncan (Etobicoke North) — With regard to the current outbreak of new influenza A (H1N1) virus, including its potential global spread, and including the probability that it will become widely established: (a) seeing as swine is an important reservoir for the new virus, what specific measures are being undertaken by animal and human health experts in Canada to monitor swine; (b) what, if any, funding has been made available for a coordinated surveillance effort; (c) how does the new H1N1 compare with the 1918 H1N1 virus and H5N1, particularly regarding the adaptation markers and virulence, and are the current human cases of H1N1 similar (in pattern) to the possible cases of influenza between the spring and fall of 1918 and, if so, what lessons can be learnt; (d) what planning is being undertaken for a worse-case scenario, especially if a more virulent virus emerges during the course of a pandemic; (e) what specific measures are being taken to reduce the spread of H1N1 in local communities (and particularly in low resource areas) and institutions, and in the future, at what point should affected provinces consider activating aggressive containment or mitigation efforts for affected communities; (f) what new surveillance is taking place in the southern hemisphere, particularly in respect to the Americas’ flyways, humans, and pig populations; (g) has the source of H5N1 infection in the Fraser Valley of British Columbia been established and, if so, what is the source, and is it endemic; (h) what steps are being taken to address the source of H5N1 infections in the Fraser Valley, particularly with the approach of the Vancouver Olympic Games; (i) what specific preventive and treatment recommendations, if any, will be provided to young adults and pregnant women; (j) what are the predicted impacts on the Canadian economy and society should a pandemic occur if illnesses and deaths are concentrated in a young, economically productive age group, and what specific measures can be implemented to reduce these effects; (k) what underlying medical conditions may make individuals more at risk of complications or more likely to experience severe or lethal infections, and how will this information be related to at-risk groups; (l) how might our current disease burden influence the impacts of a possible H1N1 pandemic, and how might these impacts be reduced; (m) what is the known full clinical spectrum of the disease caused by H1N1, does it impact multiple organs and, if so, which ones, what specific supportive therapies might be given, and will there be resources to provide these; (n) what specific steps have been taken to engage the private and voluntary sector in Canada, what percentage of organizations are prepared for the economic and social impacts of a possible pandemic, and what measures are being taken to better prepare these sectors; (o) what percentage of Canadian companies activated their pandemic response plans because of the H1N1 epidemic, and what are the learnings from these companies; (p) since the emergence of the H1N1 epidemic, what steps have been taken to evaluate the effectiveness of communications among all stakeholders, including the levels of public awareness, degree of concern, and complacency; (q) what, if any, steps could have been taken to contain the spread of H1N1 infection in Canada, and going forward, what is the decision framework to move from a policy of containment to mitigation; (r) what will be the decision process for deciding whether to produce and stock seasonal or new influenza A (H1N1) vaccines for Canada; (s) what specific measures will be taken to avoid complacency about the H1N1 virus and keep the public engaged; (t) what steps are being taken to monitor antiviral resistance in Canada, (i) what alternative therapies, including, new antiviral agents for flexibility in developing prophylaxis treatment, benefits of combination therapies and novel therapies, including, monoclonal antibodies, are being explored to deal with this possibility, (ii) what resources are being provided for these efforts, (iii) how will it be decided who has been exposed and requires treatment, (iv) how will antivirals be distributed in the event of a pandemic; (u) what specific funding is being provided for clinical vaccine studies for commercial-scale production of both antigen and adjuvant for a novel H1N1 influenza vaccine; (v) how quickly will influenza A (H1N1) vaccines be available, (i) what regulatory processes would need to be modified, (ii) what delays might occur in production, (iii) how could these be overcome; (w) will vaccines being developed now be effective if the virus causes a mild pandemic in the warmer months and changes into something more severe in the fall; (x) who specifically is likely to receive priority for vaccination with a future pandemic vaccine, and how can decision makers engage citizens regarding ethical choices in order that the public understand the decisions that will have to be made during a pandemic; (y) what advice is being given to medical personnel and community members regarding masks, (i) what is the Canadian stockpile of N-95 and surgical masks, (ii) could Canadian companies supply enough of the required masks for a serious outbreak, (iii) what is the Canadian supply of respirators and does it meet the needs of the government’s estimate; and (z) what is the possibility of a wider clinical spectrum of H1N1, and a longer medical legacy (i.e. long-term sequelae)?
— June 11, 2009 — Ms. Duncan (Etobicoke North) — With respect to genocide: (a) does the government define the term according to the 1951 Convention on the Prevention and Punishment of the Crime of Genocide; (b) how does the government qualify and quantify “acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group” (e.g. is there a critical threshold that must be surpassed in terms of numbers of people killed, extent of physical destruction), and how does the government distinguish among domestic conflict, genocide and war; (c) what are the government’s legal and ethical responsibilities to intervene and protect as a signatory to the 1951 Convention; (d) what is the decision-making process that the government takes in determining whether killing is genocide or not, whether Canada takes action or not, and what possible action might look like; (e) how does the government ensure that it does not use the wording of the convention, namely the lack of numbers of dead or displaced to constitute genocide, to avoid enforcing it; (f) does the government have any measures in place to ensure that national sovereignty is not used as an excuse to prevent Canada from enforcing United Nations regulations; (g) what is the decision-making process that ensures that Canada has multiple viewpoints before making a decision on a possible genocide, and does not just take the viewpoint of a main party while ignoring the opposing side and third-parties; (h) has the government examined past genocides, and identified early warnings, where Canada might have taken action earlier, what the savings would have been in terms of human life, society, and the economy, and how such lessons might be applied to current conflicts, such as Pakistan and Sudan; (i) what factors has the government identified as potentially leading to genocide, and has it developed an early-warning system or response centre / institution; (j) what specific tactics has the government established to stop genocide; (k) does the government have a special representative for genocide prevention, as well as access to people who are experts in genocide early warning and, if so, to what departments do they belong, and do they have sufficient funding to properly do their jobs; and (l) what legislation is in place to allow Canada to take action, and to hold aggressors to account?
— June 11, 2009 — Ms. Duncan (Etobicoke North) — With respect to Sri Lanka, what is the government doing: (a) to accelerate the processing of visas and refugee claims for those living in refugee camps, and specifically, how many applications have been made, and how many processed; (b) to help Canadian citizens of Tamil heritage locate their family members; (c) to increase humanitarian assistance and medical aid to those living in refugee camps, and specifically, how much aid is being sent, in what form, how is it being tracked, and how is delivery ensured for those in need; (d) to assure full access to the camps by the international community and journalists; (e) to ensure a comprehensive effort at national reconciliation with full recognition of the rights of all communities and respect for the rule of law; and (f) to determine whether there is classification, dehumanization, or extermination of the Tamil people?
Q-92 — January 26, 2009 — Ms. Duncan (Etobicoke North) — With respect to mitigating the impacts of the next pandemic influenza: (a) have provincial pandemic plans been tested during the last twelve months and, if so, which ones were tested, and what revisions were made based on lessons learned; and (b) what legislative and logistical steps has the government taken regarding social distancing measures?
Q-102 — January 26, 2009 — Ms. Duncan (Etobicoke North) — With regards to the risk of a pandemic influenza: (a) what steps has the government taken to protect the health of Canadians during the initial delay in the availability of a specific influenza vaccine for the pandemic strain; (b) what human health and economic costs have been identified for Canada for the delay period, and what steps has the government taken to reduce these costs; (c) what is the government stockpile of Tamiflu, and has the government achieved the stockpile target for antivirals and, if not, when will it be reached; and (d) what specific steps has the government taken to address the limited shelf life of Tamiflu, and the development of resistance to the drug?
Q-112 — January 26, 2009 — Ms. Duncan (Etobicoke North) — With regards to the stockpiling of Tamiflu for an influenza pandemic: (a) how does Canada rank among other G7 countries in terms of the number of antiviral treatments the government has stockpiled or intends to stockpile; (b) how do the steps of the government compare to the actions of other G7 countries in terms of using Tamiflu for prophylaxis and treatment; (c) what is the ethical framework for identifying priority groups during a pandemic, and what priority groups have been identified by the government for prophylaxis and treatment; and (d) what priority age groups in order of ranking for prophylaxis and treatment during an influenza pandemic have been identified?
Q-402 — January 29, 2009 — Ms. Duncan (Etobicoke North) — With respect to caffeinated energy drinks: (a) what does the term energy drink mean, and what Canadian regulatory agencies recognize the term; (b) what are the brands sold in Canada, what is the caffeine, guarana, and taurine content and concentration, if applicable, for each, and what regulations the brands passed; (c) what is the content and warning labels for each of the brands, and how do they compare with international standards, such as the European Union and the United States; (d) what are the pre-mixed caffeine-alcohol drinks, the caffeine and alcohol content and concentration, and the regulations passed; (e) what is the scientific evidence for the positive benefit claims; (f) what pre-existing health conditions might make adolescents more susceptible or more at risk to caffeinated energy drinks; (g) what are the acute and long-term effects resulting from chronic and excessive consumption of energy drinks; (h) what are the acute and chronic long-term effects of consumption of caffeine in combination with other substances, such as alcohol, B vitamins, herbal derivatives, nicotinamide, pyridoxine, riboflavin, and taurine; (i) what is the safe daily amount of caffeine, and caffeine and taurine, for adolescents, aged 12-18 years; (j) were there any deaths that have been, in part, linked to consumption of energy drinks in Australia, Canada, the European Union, and the United States and, is so, in each case, what was the drink, the content and the concentration of caffeine and the number of drinks consumed; (k) what are the top-selling brands as well as pre-mixed caffeine-alcohol drinks, and what is the total retail market value for each in Canada; (l) what studies have been undertaken regarding adolescent use, adverse effects, and mixing with alcohol; (m) what are the impacts of caffeine-alcohol interactions, and what might this mean for abuse, drunk-driving, or injury; (n) has caffeine overdose been increasing among caffeine abstainers as well as habitual users in Canada; (o) what, if any, cases of caffeine abuse from caffeinated energy drinks have been reported to Canadian poison centres, and how do these data compare to the European Union and the United States; (p) what measures have been taken to warn the public regarding the adverse health effects, including caffeine intoxification, caffeine dependence and withdrawal; (q) what measures have been taken to warn children and adolescents, who do not use caffeine regularly, regarding possible adverse health effects; (r) what restrictions have been placed on aggressive marketing to youth and inexperienced users, and what mechanisms are in place to ensure compliance; and (s) what measures have been taken to inform medical practitioners regarding the potential health consequences of consumption of energy drinks?
