On the agenda this afternoon: Various medical associations, including the Canadian Association of Nuclear Medicine and the Canadian Association of Radiologists.
Okay, first off, I have to warn you all up front that I’m going to miss the last bit of today’s hearing, because I’ve got a Very Important Date with CityTV to talk about the TotT(LRM). Which means I’ll probably have to bail on the last witness – and I apologize in advance for that – but I’m sure we’ll learn plenty about the importance of isotopes from the first set of witnesses. Who are idling around the table as we speak — at least, I *assume* those are the witnesses — trying not to look like they’ve just wandered into the eye of a political maelstrom. Do maelstroms have eyes? Anyway, you know what I mean. The members are starting to turn up as well, including Russ Hiebert, who I’ve not seen since last time I covered the Ethics committee. For some reason, he has a properly printed nameplate, but Cheryl Gallant, who is a permanent member, still has to make do with a handwritten one. Weird.
And – action!
Leon Benoit welcomes the committee with a twist on his now familiar announcement that they’ll be holding a housekeeping-y meeting after the witnesses finish up; this time, it will be to discuss possible travel expenses for the possible field trip to Chalk River, which ITQ devoutly hopes will be open to the press.
Anyway, with that, he hands the floor over to Jean-Luc Urbaine with the Canadian Association for Nuclear Medicine, who promptly begins to deliver what seems to be a starkly realistic opening statement. He gives a recap of the story so far, at least as far as the isotope supply — high-level working groups, those unfortunate Maple reactors — before getting to the most recent shutdown at Chalk River, which he describes as “catastrophic” – which is “neither a funny or sexy story”. Ouch.
Urbaine goes on to explain why the alternative diagnosis methods are simply not sufficient, and – you know, this is getting *really* technical, but the gist seems to be that using 20th century technology in the 21st century is really, really, really not adequate, and that Canada is in danger of falling into third – or even fourth – world practices. This is the first time in his career that — but what sounds like it was going to be a fairly devastating description of the current crisis is cut short, literally: the microphone keeps going off due to some sort of power glitch, so the chair suspends for a few minutes to give the committee techies a chance to fix it.
Lots of scampering back and forth by Commons staffers — but eventually, we reconvene. Urbaine jokes that he can assure Canadians that his group has “nothing to do with the interruption”, and – oh, apparently, someone flicked the switch to “in camera”, which kills the mics.
Anyway, back to the presentation, and how Urbaine has never seen this many advanced cases of cancer; it’s also increasingly difficult to attract young doctors, which is why he recommends that the government repeal the decision to cancel the Maple reactors, as well as work with the provinces and territories to subsidize the cost imposed by suppliers, and ensure that the relevant ministers – Natural Resources and Health – work with the medical profession to ensure access to the tools needed. Well, that will make for some interesting questions.
Over to the Canadian Association of Radiologists, and Edward Lyons, who begins by noting that the organization has served on the ad hoc expert panel as well. He points out that radiologists are an essential part of the diagnosis process, and says that the effect of a shortage on an “already stressed system” is substantial, although it differs across the country, since provinces and territories manage their own supplies of isotopes.
He’d like to see a coordinated national strategy that would ensure the needs of patients “from coast to coast to coast’ will be the top priority; the Bloc Quebecois MPs don’t seem to be displaying a reflexive repulsion to the very notion, but maybe they’re used to this sort of potential jurisdictional interference idea cropping up.
The current situation requires “immediate action,” he says – and the CAR can help, through assisting in a “comprehensive study” on how worldwide shortages will affect Canada, like how many patients could be affected, and what sort of increase would it put on the workload.
The CAR suggests that one solution would be an expansion of his association’s “evidence-based guidelines” for treatment, which sounds rather ominous, for some reason. I think it’s how he keeps stressing the words “evidence based”.
Anyway, they could help the government to expand said guidelines across the country. Also, coordination and long-term planning, and how many units would be needed to meet the demand. As far as the current shortage, he sees it as a national issue that will require cooperation between all levels of government, as well as the medical profession and industry.
Okay, I didn’t catch his name, but the witness from the Quebec-based nuclear medicine group is definitely the least holds barred of the lot as far as Raitt’s comments, although he notes that the government – not clear if it’s the federal or provincial government he’s talking about – for setting up treatment centres, and helping doctors keep in touch with their patients. That said, he notes that those same patients have “totally lost faith” in the authorities; we are in a “medical catastrophe”; medical clinics are going to start closing down this week, and the Quebec sector totally supports their colleagues across the country.
One more witness, this one by teleconference – from a Hamilton clinic. Dr. Karen Gelenchen notes that she appeared before the committee during the December 2007 Chalk River crisis, so she won’t repeat what she said then; she agrees with previous witnesses that this crisis was not only predictable, but inevitable. (I actually mistyped that as “ineffable”.) She discusses some of the steps that have been taken in Hamilton, and notes that the planning undertaken “has worked” — the suppliers have found backup sources, although in reduced quantities. They’re reducing the number of treatments they perform, but to outside observers “it might not look like there is a crisis”.
Ooh, turns out she has an outstanding bone to pick with the media from how her comments were reported last time — apparently, she was asked whether patients would die if the reactor wasn’t restarted, and we reported that her eventual answer was no; that, apparently, was not what she said at all. It’s hard to directly link a specific death to an isotope shortage, but that doesn’t mean it doesn’t happen.
And – questions! First up, Carolyn Bennett, who thanks the witnesses for being here, and asks for more of an explanation of what the “ad hoc expert committee” actually does. In response, Gelenchen – who apologizes for not jumping in immediately, she’s still getting used to the whole appear-by-camera thing – and tells the committee that when you have five reactors over forty years of age, it’s hard to avoid problems, which is why she’s disappointed that no progress has been made. Bennett wonders whether she is confirming that the committee hasn’t met since the end of the Maple reactors, and Urbaine tries to answer, but gets rebuked by the chair, who tells him rather officiously that if he wants to hand his question off to someone else, he should go through the chair. Why? Not sure — but I don’t think that’s standard practice at any *other* committee I’ve seen.
Anyway, Urbaine and Bennett discuss isotope alternatives, but Bennett notes that none of the plans dealt with the possibility of an extended shutdown.
Bennett raises the rather alarming prospect of a global bidding war for the dwindling supply of isotopes, which Urbaine agrees could happen; with that, the chair informs Bennett that her time is up.
Over to the Bloc Quebecois’ Paule Brunelle, who is also very worried about the situation, and is probably not likely to be reassured by the Quebec witness — still haven’t gotten a peek at his nameplate — who confirms that there is “no solution” to the shortage caused by the shutdown of the NRU.
According to Urbaine, there is no evidence of any significant cooperation on the international level — nor has there ever been, really — which seems to diminish the possibility that the Dutch will be able to save the day by ramping up production, as repeatedly averred by Raitt in the House. The French reactor, he points out, only produces 3% of the world’s supply, so a 50% increase wouldn’t actually do much. Brunelle tries to ask another question, but is waved into silence by Benoit, who hands the floor over to Nathan Cullen.
Oh, another ouch: Cullen asks if people would have died in 2007, had the reactor not been restarted, and Urbaine doesn’t hesitate in saying they would. He – Cullen, that is – then asks whether the situation is better now; no, Urbaine tells him – it’s worse. That’s — pretty much the opposite of what the government would prefer to have us believe.
Cullen then reads the “roll the dice” line from the tapes – oh, you know which tapes – and asks him what he thinks; after noting that he wants to verify the source, Urbaine doesn’t seem to think much of it at all.
Cullen tries to get Gelenchen to give a good, human-interesty soundbite by asking her to describe the conversations she has with patients needing treatment, and facing a delay, but she just won’t do it; Urbaine, however, is willing to come right out and say that in his opinion, Canada does not have a sufficient supply.
Over to Team Government, and Brad Trost, who tries to get the witnesses to blame the last government – heck, the last twenty years of governments; no skin off *his* nose – for the crisis – by asking whether they should have expanded the technological capacity starting back in the 1990s, but while Urbaine agrees that it started in the 90s, he’s not going to oblige.
I’m sorry, did Trost just use the phrase “roll the dice” in his question on the decision to cancel the Maples? Really? *Really*?
Trost goes back to Gelenchen to try to get her to confirm the minister’s most upbeat talking point — if the Dutch reactor goes online, will that greatly improve the situation? Unfortunately, the witness won’t play along; she notes that she can’t really answer the question, but that wouldn’t be the adjective that she would use. Ouch the third.
According to Glenerchen, there is, as far as she knows, no exact number on the quantity of isotopes currently available in Canada.
McGuinty gives a particularly downbeat recap of what *he* has heard so far before moving onto an even more alarming subtopic — given the dependency on isotopes for treatment of pediatric cancers, does this shortage mean that *children* will die? Yes, it does, Urbaine tells him – children are “a nightmare” for them.
Is it my imagination, or is this going really, really badly for the government, as far as reassuring anyone that Things Are Better This Time? Also, I’m not sure whether he has another engagement, or just came to the same conclusion as ITQ and decided to get out before it gets worse, but the parliamentary secretary – David Anderson – has departed.
And with that, ITQ will, most regretfully, do the same — I wish I could stick around for the last round, but duty calls — and I figured that, when it comes to liveblogging committee, better some than none. I’ll make it up to y’all on Thursday. Promise. (If any readers out there feel like picking up where I’ve left off, feel free to continue the liveblogging in the comment thread.)