Health committee  I believe that—

Health committee  Okay, so can I wait for a moment and just compose my thoughts? I want to give a thoughtful answer.

Health committee  I agree more can be done, and I think maybe we need to do it in a staged approach. My concern is that amendments could delay getting some of these key authorities in place sooner, so that's my only concern. I think there's always room to improve. There will always be ongoing improvement that's going to be needed, and there'll be more changes needed to the Food and Drugs Act.

Health committee  I'm not sure the risks are lower. Our position is the understanding that the inclusion of natural health products in the more complex bills cause them not to move forward and be enacted. Bringing that into this bill might actually slow down the great work that's already been started.

Health committee  I have just a comment on one of your questions. The Food and Drugs Act hasn't been amended in, I think, about 50 years. If you are asking, are we lagging behind? We are lagging behind a little in the authorities for Health Canada. My understanding is that there were more complex bills proposed, Bill C-51, Bill C-52.

Health committee  Mr. Chair, members of the committee, and staff, thank you for giving me the opportunity to be here on behalf of ISMP Canada. I would like to state our strong support for Bill C-17,, the protecting Canadians from unsafe drugs act, also known as Vanessa's law. ISMP Canada is an independent, not-for-profit organization established in 2000 to analyze incidents of preventable harm from medications, to identify system improvements, and to work collaboratively to advance medication safety.

Health committee  I thought of a quick addition. In answer, yes, there is a serious problem, and we use a fair number of drugs in this country. We do have a privileged health care system, but we also have access to a lot of drugs. I think one of the interesting areas that isn't yet accessible is usage, really being aware of how many drugs are used and to what extent.

Health committee  That's a good question. Overall, there isn't great awareness amongst the public of the fact that they can report adverse reactions to drugs they are taking. I do believe that is one of Health Canada's post-marketing surveillance strategies: to increase education to the public, to let them know that they themselves can report adverse effects that they experience with a drug.

Health committee  I want to respond that health care is a little behind in utilizing technology, but there are efforts under way to implement computerized order entry systems, recognizing that there are problems with handwritten notes. There are also initiatives under way with manufacturers to look at voluntary bar coding standards, so that bar coding technology can be utilized in health care where appropriate.

Health committee  Well, Health Canada has the MedEffect program, and it is the adverse reaction reporting program. There is a regulatory definition for an adverse reaction. There is also acceptance by the adverse reaction program for adverse event reports that might extend past the regulatory definition.

Health committee  In terms of the report and recommendations, I think our organization would like to see, where there are databases that do contain reports about preventable harm from medications, that there is a method for analysis that considers the practice concerns, the clinical significance, the systems issues, and the potential preventative measures, because there are two different ways of analyzing the information that comes to us around adverse drug events.

Health committee  Yes. I would just like to add that you're correct, the definition is extremely important. Different definitions are used in studies and reporting programs. The message would be that whatever reporting program it is, there needs to be a clear definition of what it is that's expected to be reported, who's expected to report, and how it's going to be analyzed.

Health committee  Yes, and thank you for your question. I think Health Canada's approach to collaborating with partners and coordinating efforts of different groups interested in safety and pharmaco-vigilance is the way to go, and I think it's to be commended. As was mentioned before, there are various pockets of information in different databases, and their outputs can be coordinated.

Health committee  Thank you. Carmen, do you have the handouts?

Health committee  Thank you, Madam Chair. On behalf of the Institute for Safe Medication Practices Canada, I would like to thank you for inviting us to be part of your study on post-market surveillance. ISMP Canada is an independent national not-for-profit organization established for the analysis of medication error or incident reports.